Gibbs Bethany Barone, Tudorascu Dana, Bryce Cindy L, Comer Diane, Fischer Gary S, Hess Rachel, Huber Kimberly A, McTigue Kathleen M, Simkin-Silverman Laurey R, Conroy Molly B
University of Pittsburgh, 32 Oak Hill Court, Pittsburgh, PA, USA.
University of Utah, Salt Lake City, UT, USA.
J Gen Intern Med. 2020 Nov;35(11):3227-3233. doi: 10.1007/s11606-020-06056-x. Epub 2020 Aug 17.
Though long-term weight loss maintenance is the treatment goal for obesity, weight regain is typical and few studies have evaluated lifestyle habits associated with weight regain.
To identify dietary and physical activity habits associated with 6- and 24-month weight regain among participants in a weight loss maintenance clinical trial.
Secondary analysis of randomized clinical trial data.
Adult primary care patients with recent, intentional weight loss of at least 5%.
Lifestyle habits included consumption of low-fat foods, fish, desserts, sugary beverages, fruits, and vegetables and eating at restaurants from the Connor Diet Habit Survey; moderate-vigorous physical activity by self-report; steps recorded by a pedometer; and sedentary behavior by self-report. The outcome variable was weight change at 6 and 24 months. Linear regression models estimated adjusted associations between changes in weight and changes in dietary and physical activity habits.
Overall, participants (mean (SD): 53.4 (12.2) years old; 26% male; 88% white) maintained weight loss at 6 months (n = 178, mean (SD): - 0.02 (5.70)% change) but began to regain weight by 24 months (n = 157, mean (SD): 4.22 (9.15)% increase). When considered all together, more eating at restaurants, reduced fish consumption, and less physical activity were most consistently associated with weight regain in fully adjusted models at both 6 and 24 months of follow-up. In addition, more sedentary behavior was associated with weight regain at 6 months while reduced consumption of low-fat foods, and more desserts and sugary beverages were associated with weight regain at 24 months.
Consuming less fish, fewer steps per day, and more frequent restaurant eating were most consistently associated with weight regain in primary care patients. Primary care providers may consider addressing specific lifestyle behaviors when counseling patients after successful weight loss.
ClinicalTrials.gov Identifier: NCT01946191.
尽管长期维持体重减轻是肥胖症的治疗目标，但体重反弹很常见，而且很少有研究评估与体重反弹相关的生活习惯。
确定在一项体重维持临床试验中，与6个月和24个月体重反弹相关的饮食和身体活动习惯。
对随机临床试验数据进行二次分析。
近期有意减重至少5%的成年初级保健患者。
生活习惯包括从康纳饮食习惯调查中获取的低脂食物、鱼类、甜点、含糖饮料、水果和蔬菜的摄入量以及外出就餐情况；自我报告的中等至剧烈身体活动；计步器记录的步数；以及自我报告的久坐行为。结局变量是6个月和24个月时的体重变化。线性回归模型估计体重变化与饮食和身体活动习惯变化之间的校正关联。
总体而言，参与者（平均（标准差）：53.4（12.2）岁；26%为男性；88%为白人）在6个月时维持了体重减轻（n = 178，平均（标准差）：-0.02（5.70）%变化），但到24个月时开始体重反弹（n = 157，平均（标准差）：4.22（9.15）%增加）。综合考虑，在随访的6个月和24个月时，完全校正模型中，更多地外出就餐、鱼类摄入量减少以及身体活动减少与体重反弹最一致相关。此外，久坐行为增加与6个月时的体重反弹相关，而低脂食物摄入量减少、更多的甜点和含糖饮料摄入与24个月时的体重反弹相关。
鱼类摄入量减少、每日步数减少以及更频繁地外出就餐与初级保健患者的体重反弹最一致相关。初级保健提供者在为成功减重的患者提供咨询时，可考虑关注特定的生活方式行为。
ClinicalTrials.gov标识符：NCT01946191。
