Unick Jessica L, Lang Wei, Williams Samantha E, Bond Dale S, Egan Caitlin M, Espeland Mark A, Wing Rena R, Tate Deborah F
Brown University and the Miriam Hospital's Weight Control and Diabetes Research Center, 196 Richmond Street, Providence, RI, 02903, USA.
Wake Forest School of Medicine, Winston-Salem, NC, USA.
Int J Behav Nutr Phys Act. 2017 Dec 4;14(1):165. doi: 10.1186/s12966-017-0620-x.
Reductions in physical activity (PA) are common throughout young adulthood and low PA is associated with weight gain. The SNAP Trial previously reported that two self-regulation approaches to weight gain prevention reduced weight gain over a 2-year period in 18-35 year olds. Presented here are secondary analyses examining changes in PA and the relationship between PA and weight change over 2 years.
599 young adults (age: 27.4 ± 4.4 yrs.; BMI: 25.4 ± 2.6 kg/m) were randomly assigned to 1 of 3 treatment arms: Small Changes (reduce calorie intake by 100 kcals/day & add 2000 steps/day), Large Changes (lose 2.3-4.5 kg initially & increase PA to ≥250 min/wk), or Self-guided (control condition). Small and Large Changes received 10, face-to-face group sessions (months 1-4), and two 4-week refresher courses each subsequent year. Body weight and PA were objectively-measured at baseline, 4 months, 1 and 2 years. Daily steps and bout-related moderate-to-vigorous intensity PA (MVPA: ≥3 METs, ≥10-min bouts) was calculated.
Changes in bout-related MVPA and daily steps did not differ among treatment groups over the 2-year period (p's > 0.16). Collapsed across groups, participants gaining >1 lb. (n = 187; 39.6%) had smaller changes in bout-related MVPA at 4 months, 1 and 2 years relative to those maintaining or losing weight (≤1 lb. weight gain; n = 282, 60.4%, p's < 0.05). Averaged across time points, this difference equated to 47.8 min/week. Those gaining and not gaining >1 lb. did not differ on daily steps (p's > 0.10). Among participants engaging in ≥250 min/wk. of MVPA at 2 years (n = 181), 30% gained >1 lb. from baseline to 2 years, which was not different from those engaging in 150-250 min/wk. (n = 87; 36%; p = 0.40), but this percentage was significantly lower when compared to those engaging in <150 min/wk. (n = 176; 49%; p < 0.001).
On average, PA differences were not observed between young adults assigned to small or large changes self-regulation interventions to prevent weight gain. Regardless of group assignment, higher levels of MVPA were associated with better weight gain prevention over 2 years. Our data suggest that achieving >150 min/week of MVPA is needed for weight gain prevention and that increasing MVPA, rather than steps, should be targeted.
www.clinicaltrials.gov (NCT01183689). Registered Aug 13, 2010.
在整个青年期,身体活动(PA)减少的情况很常见,而低水平的PA与体重增加有关。SNAP试验此前报告称,两种预防体重增加的自我调节方法在18至35岁的人群中,在两年时间内减少了体重增加。本文展示的是对PA变化以及PA与两年内体重变化之间关系的二次分析。
599名年轻人(年龄:27.4±4.4岁;体重指数:25.4±2.6千克/平方米)被随机分配到3个治疗组中的1组:小改变组(每天减少100千卡热量摄入并增加2000步/天)、大改变组(最初减重2.3 - 4.5千克并将PA增加到≥250分钟/周)或自我指导组(对照条件)。小改变组和大改变组在第1至4个月接受10次面对面小组课程,并在随后每年接受两次为期4周的复习课程。在基线、4个月、1年和2年时客观测量体重和PA。计算每日步数以及与运动回合相关的中度至剧烈强度PA(MVPA:≥3梅脱,≥10分钟回合)。
在两年期间,各治疗组之间与运动回合相关的MVPA和每日步数变化没有差异(p值>0.16)。综合各小组来看,体重增加超过1磅(n = 187;39.6%)的参与者在4个月、1年和2年时与运动回合相关的MVPA变化,相对于体重维持或减轻(体重增加≤1磅;n = 282,60.4%)的参与者更小(p值<0.05)。在各时间点进行平均,这种差异相当于每周47.8分钟。体重增加和未增加超过1磅的参与者在每日步数上没有差异(p值>0.10)。在两年时进行≥250分钟/周MVPA的参与者(n = 181)中;从基线到两年,30%的人体重增加超过1磅,这与进行150 - 250分钟/周MVPA的参与者(n = 87;36%;p = 0.40)没有差异,但与进行<150分钟/周MVPA的参与者(n = 176;49%;p<0.001)相比,这个百分比显著更低。
平均而言,在被分配到小改变或大改变自我调节干预以预防体重增加的年轻人之间,未观察到PA差异。无论分组如何,更高水平的MVPA与两年内更好的体重增加预防相关。我们的数据表明,为预防体重增加需要达到每周>150分钟的MVPA,并且应该以增加MVPA而非步数为目标。