Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia; School of Medicine & Public Health, College of Health, Medicine & Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia; School of Health Sciences, College of Health, Medicine & Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
Appetite. 2021 Oct 1;165:105273. doi: 10.1016/j.appet.2021.105273. Epub 2021 May 1.
Reduced energy intake is a major driver of weight loss and evidence suggests that physical activity, dietary, and sleep behaviours interact to influence energy intake. Energy restriction can be challenging to sustain. Therefore to improve intervention efficacy, evaluation of how changes in physical activity, diet, and sleep behaviours mediate reduced energy intake in adults with overweight/obesity who participated in a six-month multiple-behaviour-change weight loss intervention was undertaken. This was a secondary analysis of a 3-arm randomised controlled trial. Adults with body mass index (BMI) 25-40 kg/m were randomised to either: a physical activity and diet intervention; physical activity, diet, and sleep intervention; or wait-list control. Physical activity, dietary intake, and sleep was measured at baseline and six-months using validated measures. The two intervention groups were pooled and compared to the control. Structural equation modelling was used to estimate the mediated effects (AB Coefficient) of the intervention on total energy intake. One hundred and sixteen adults (70% female, 44.5y, BMI 31.7 kg/m) were enrolled and 70% (n = 81) completed the six-month assessment. The significant intervention effect on energy intake at six-months (-1011 kJ/day, 95% CI -1922, -101) was partially mediated by reduced fat intake (AB = -761.12, 95% CI -1564.25, -53.74) and reduced consumption of energy-dense, nutrient-poor foods (AB = -576.19, 95% CI -1189.23, -97.26). In this study, reducing fat intake and consumption of energy-dense, nutrient-poor foods was an effective strategy for reducing daily energy intake in adults with overweight/obesity at six-months. These strategies should be explicitly targeted in future weight loss interventions.
能量摄入减少是体重减轻的主要驱动因素，有证据表明，身体活动、饮食和睡眠行为相互作用，影响能量摄入。能量限制可能难以维持。因此，为了提高干预效果，评估身体活动、饮食和睡眠行为的变化如何介导超重/肥胖成年人在参加为期六个月的多行为减肥干预后减少能量摄入，对参加了一项为期六个月的多行为减肥干预的超重/肥胖成年人进行了研究。这是一项 3 臂随机对照试验的二次分析。身体质量指数（BMI）为 25-40 kg/m 的成年人被随机分配到以下三组之一：身体活动和饮食干预组；身体活动、饮食和睡眠干预组；或候补对照组。使用经过验证的措施在基线和六个月时测量身体活动、饮食摄入和睡眠。将两组干预组合并并与对照组进行比较。结构方程模型用于估计干预对总能量摄入的中介效应（AB 系数）。共有 116 名成年人（70%为女性，44.5 岁，BMI 为 31.7 kg/m）入组，70%（n=81）完成了六个月的评估。干预组在六个月时能量摄入的显著影响（-1011 kJ/d，95%CI-1922，-101）部分由减少脂肪摄入（AB=-761.12，95%CI-1564.25，-53.74）和减少能量密集、营养贫乏食物的消耗（AB=-576.19，95%CI-1189.23，-97.26）介导。在这项研究中，减少脂肪摄入和能量密集、营养贫乏食物的消耗是超重/肥胖成年人在六个月内减少每日能量摄入的有效策略。这些策略应在未来的减肥干预中明确针对。
