肥胖和不孕女性在 6 个月的孕前生活方式干预中成功生活方式改变的决定因素。
Determinants of successful lifestyle change during a 6-month preconception lifestyle intervention in women with obesity and infertility.
机构信息
Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
出版信息
Eur J Nutr. 2019 Sep;58(6):2463-2475. doi: 10.1007/s00394-018-1798-7. Epub 2018 Aug 3.
PURPOSE
To identify demographic, (bio)physical, behavioral, and psychological determinants of successful lifestyle change and program completion by performing a secondary analysis of the intervention arm of a randomized-controlled trial, investigating a preconception lifestyle intervention.
METHODS
The 6-month lifestyle intervention consisted of dietary counseling, physical activity, and behavioral modification, and was aimed at 5-10% weight loss. We operationalized successful lifestyle change as successful weight loss (≥ 5% weight/BMI ≤ 29 kg/m), weight loss in kilograms, a reduction in energy intake, and an increase in physical activity during the intervention program. We performed logistic and mixed-effect regression analyses to identify baseline factors that were associated with successful change or program completion.
RESULTS
Women with higher external eating behavior scores had higher odds of successful weight loss (OR 1.10, 95% CI 1.05-1.16). Women with the previous dietetic support lost 0.94 kg less during the intervention period (95% CI 0.01-1.87 kg). Women with higher self-efficacy reduced energy intake more than women with lower self-efficacy (p < 0.01). Women with an older partner had an increased energy intake (6 kcal/year older, 95% CI 3-13). A high stage of change towards physical activity was associated with a higher number of daily steps (p = 0.03). A high stage of change towards weight loss was associated with completion of the intervention (p = 0.04).
CONCLUSIONS
Determinants of lifestyle change and program completion were: higher external eating behavior, not having received previous dietetic support, high stage of change. This knowledge can be used to identify women likely to benefit from lifestyle interventions and develop new interventions for women requiring alternative support.
TRIAL REGISTRATION
The LIFEstyle study was registered at the Dutch trial registry (NTR 1530; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1530 ).
目的
通过对一项随机对照试验干预组进行二次分析，研究一项孕前生活方式干预措施，确定成功生活方式改变和项目完成的人口统计学、（生物）物理、行为和心理决定因素。
方法
为期 6 个月的生活方式干预包括饮食咨询、体育锻炼和行为改变，旨在实现 5-10%的体重减轻。我们将成功的生活方式改变定义为成功的体重减轻（≥5%体重/BMI≤29kg/m2）、体重减轻量、能量摄入减少和干预期间体力活动增加。我们进行了逻辑和混合效应回归分析，以确定与成功改变或项目完成相关的基线因素。
结果
外部进食行为评分较高的女性成功减肥的几率更高（OR 1.10，95%CI 1.05-1.16）。有过饮食支持的女性在干预期间体重减轻了 0.94kg（95%CI 0.01-1.87kg）。自我效能感较高的女性比自我效能感较低的女性能量摄入减少更多（p<0.01）。伴侣年龄较大的女性能量摄入增加（每增加 6 岁，95%CI 3-13）。朝着体力活动改变的高阶段与每天的步数增加有关（p=0.03）。朝着减肥改变的高阶段与完成干预有关（p=0.04）。
结论
生活方式改变和项目完成的决定因素包括：较高的外部进食行为、未接受过以前的饮食支持、改变阶段较高。这些知识可以用来识别可能受益于生活方式干预的女性，并为需要替代支持的女性开发新的干预措施。
试验注册
LIFE 研究在荷兰试验注册处注册（NTR 1530；http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1530）。
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