Berendsen Brenda A J, Hendriks Marike R C, Rutten Geert M, Kremers Stef P J, Savelberg Hans H C M, Schaper Nicolaas C
Nutrition and Movement Sciences, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, the Netherlands.
Maastricht University Campus Venlo, Venlo, the Netherlands.
Prev Med Rep. 2020 Sep 11;20:101204. doi: 10.1016/j.pmedr.2020.101204. eCollection 2020 Dec.
Combined lifestyle interventions (CLIs) that target both physical activity (PA) and diet have been shown to improve PA and health of adults who are overweight; however, optimal amount of guidance remains unclear. This study evaluated the effects of adding PA group sessions to a standard CLI in primary care in the Netherlands. 411 participants (BMI 34.5 ± 4.4 kg/m) in thirty locations were randomised into a one year CLI or CLI+. CLI comprised individual meetings with lifestyle coach (LSC) and physiotherapist, and group meetings with dietician. PA group sessions were added in CLI+. Primary outcome was minutes of moderate to vigorous PA per week. Secondary outcomes of PA, diet and cardiovascular risk factors (i.e. waist circumference, HbA1c and blood pressure) were evaluated after 12 and 24 months with multilevel analyses. Data were collected from 2010 to 2015. Significant between-group effects were only found for waist circumference, which was significantly lower at twelve months in the CLI+ group (p = 0.011), no other between-group differences were found. Several within-group changes were significant. After participating in the intervention, walking time increased with 83 ± 35 min/week and 100 ± 38 min/week, and BMI decreased with 0.7 ± 0.3 kg/m and 1.5 ± 0.3 kg/m in CLI and CLI+ respectively (p < 0.001). Diet, HbA1c and systolic blood pressure changed favourably in both groups. Adding PA group sessions did not elicit added, sustained benefits. A programme with individual meetings with LSC and physiotherapist, and group meetings with dietician can be sufficient to facilitate a healthy lifestyle and reduce cardiovascular risk factors in a population with overweight.
针对身体活动（PA）和饮食的综合生活方式干预（CLIs）已被证明可改善超重成年人的身体活动水平和健康状况；然而，最佳指导量仍不明确。本研究评估了在荷兰初级保健中，在标准CLIs基础上增加PA小组课程的效果。30个地点的411名参与者（BMI 34.5±4.4kg/m²）被随机分为为期一年的CLIs组或CLIs+组。CLIs包括与生活方式教练（LSC）和物理治疗师的单独会面，以及与营养师的小组会面。CLIs+组增加了PA小组课程。主要结局是每周中等至剧烈身体活动的分钟数。在12个月和24个月后，通过多水平分析评估身体活动、饮食和心血管危险因素（即腰围、糖化血红蛋白和血压）的次要结局。数据收集时间为2010年至2015年。仅在腰围方面发现了显著的组间效应，CLIs+组在12个月时腰围显著更低（p = 0.011），未发现其他组间差异。几个组内变化具有显著性。参与干预后，CLIs组和CLIs+组的步行时间分别增加了83±35分钟/周和100±38分钟/周，BMI分别降低了0.7±0.3kg/m²和1.5±0.3kg/m²（p < 0.001）。两组的饮食、糖化血红蛋白和收缩压均有有利变化。增加PA小组课程并未带来额外的持续益处。一个包括与LSC和物理治疗师单独会面以及与营养师小组会面的项目，可能足以促进超重人群的健康生活方式并降低心血管危险因素。
