Nagelberg Jodi, Burks Heather, Mucowski Sara, Shoupe Donna
Keck School of Medicine, Los Angeles, CA 90033 USA.
University of Southern California, Los Angeles, CA 90033 USA.
Contracept Reprod Med. 2016 Aug 24;1:14. doi: 10.1186/s40834-016-0025-2. eCollection 2016.
Age-adjusted rates of obesity are reported to be 35.8 % among US adult women and 49 % in some race/ethnicity, underserved populations. (1). Underserved populations often have less access to weight-loss intervention options and are at high risk for obesity related problems including anovulation, infertility, pregnancy-related complications and adverse long-term health outcomes. (2). The purpose of this study was to evaluate a home exercise plan using a pedometer on weight loss, ovulation induction and pregnancy rates in our overweight and obese underserved clinic population.
Twenty one overweight (BMI ≥ 25-29.9) and obese I-II (BMI ≥ 30-39.9) 18-42 years old were recruited. Participants received an exercise/nutrition questionnaire at the initiation and completion and called weekly for 4 weeks. Ten participants were randomly assigned to the home exercise program (PedGp). PedGp received a pedometer, daily step-count goal, and were called to increase goal by 50 % weekly. All participants then underwent clomiphene stair-step ovulation induction. All study participants were referred to the University Wellness Clinic for diet and exercise counseling.
There were high percentages of women with co-morbidities in both groups including fatty liver, low vitamin D, hyperlipidemia, hypothyroidism, prediabetes and diabetes.1. Those completing the 4-week home program increased baseline steps by 21.2 % weekly. Only 3/10 women reached at least one weekly goal of 50 % increase. Although the goal was rarely met, participants who completed study had increased number of daily steps.2. Greater number in PedGp lost weight or stayed the same (5/10 vs. 2/11).3. Greater number in PedGp spontaneously ovulated (4/10 vs. 1/11) or became pregnant (4/10 vs. 3/11). (not statistically significant due to small sample size).
There are high percentages of comorbidities in this population. Although the goal was rarely met, participants who completed study had increased number of daily steps. A greater number in PedGp lost weight or stayed the same. A greater number in PedGp spontaneously ovulated or became pregnant (not statistically significant due to small sample size). Importantly, 40 % of women who lost weight became pregnant. This is highly encouraging and suggests that the development of pedometer interventions may prove a cost effective option.
据报道，美国成年女性中年龄调整后的肥胖率为35.8%，在一些种族/族裔、医疗服务不足的人群中这一比例为49%。（1）医疗服务不足的人群往往较少有机会获得减肥干预措施，并且面临肥胖相关问题的高风险，包括无排卵、不孕、妊娠相关并发症以及不良的长期健康后果。（2）本研究的目的是评估一项使用计步器的家庭锻炼计划对我们超重和肥胖的医疗服务不足的门诊人群的体重减轻、排卵诱导和妊娠率的影响。
招募了21名年龄在18 - 42岁的超重（BMI≥25 - 29.9）和肥胖I - II级（BMI≥30 - 39.9）的女性。参与者在开始和结束时接受了一份运动/营养问卷，并在4周内每周进行电话随访。10名参与者被随机分配到家庭锻炼计划组（PedGp）。PedGp组的参与者收到一个计步器、每日步数目标，并且每周被电话通知将目标提高50%。所有参与者随后接受克罗米芬阶梯式排卵诱导。所有研究参与者都被转介到大学健康诊所接受饮食和运动咨询。
两组中患有合并症的女性比例都很高，包括脂肪肝、低维生素D、高脂血症、甲状腺功能减退、糖尿病前期和糖尿病。1. 完成4周家庭计划的参与者每周将基线步数增加了21.2%。只有3/10的女性达到了至少一个每周增加50%的目标。尽管目标很少实现，但完成研究 的参与者每日步数增加了。2. PedGp组中体重减轻或维持不变的人数更多（5/10 vs. 2/11）。3. PedGp组中自发排卵（4/10 vs. 1/11）或怀孕（4/10 vs. 3/11）的人数更多。（由于样本量小，无统计学意义）。
该人群中合并症的比例很高。尽管目标很少实现，但完成研究的参与者每日步数增加了。PedGp组中体重减轻或维持不变的人数更多。PedGp组中自发排卵或怀孕的人数更多（由于样本量小，无统计学意义）。重要的是，40%体重减轻的女性怀孕了。这非常鼓舞人心，表明计步器干预措施的开发可能是一种具有成本效益的选择。
