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Weight, physical activity and dietary behavior change in young mothers: short term results of the HeLP-her cluster randomized controlled trial.

Lombard CB, Deeks AA, Ball K, Jolley D, Teede HJ - Nutr J (2009)

Bottom Line: Mean measured weight decreased significantly in the intervention group (-0.78 kg 95% CI; -1.22 to -0.34, p < 0.001).The intervention reported increased physical activity although the difference between groups did not reach significance.ACTRN12608000110381.

View Article: PubMed Central - HTML - PubMed

Affiliation: Monash University, Australia. catherine.lombard@med.monash.edu.au

ABSTRACT

Background: Preventing weight gain rather than treating established obesity is an important economic and public health response to the rapidly increasing rates of obesity worldwide. Treatment of established obesity is complex and costly requiring multiple resources. Preventing weight gain potentially requires fewer resources to reach broad population groups, yet there is little evidence for successful interventions to prevent weight gain in the community. Women with children are an important target group because of high rates of weight gain and the potential to influence the health behaviors in family members.

Methods: The aim of this cluster randomized controlled trial was to evaluate the short term effect of a community-based self-management intervention to prevent weight gain. Two hundred and fifty mothers of young children (mean age 40 years +/- 4.5, BMI 27.9 kg/m2 +/- 5.6) were recruited from the community in Melbourne, Australia. The intervention group (n = 127) attended four interactive group sessions over 4 months, held in 12 local primary schools in 2006, and was compared to a group (n = 123) receiving a single, non-interactive, health education session. Data collection included self-reported weight (both groups), measured weight (intervention only), self-efficacy, dietary intake and physical activity.

Results: Mean measured weight decreased significantly in the intervention group (-0.78 kg 95% CI; -1.22 to -0.34, p < 0.001). Comparing groups using self-reported weight, both the intervention and comparison groups decreased weight, -0.75 kg (95% CI; -1.57 to 0.07, p = 0.07) and -0.72 kg (95% CI; -1.59 to 0.14 p = 0.10) respectively with no significant difference between groups (-0.03 kg, 95% CI; -1.32 to 1.26, p = 0.95). More women lost or maintained weight in the intervention group. The intervention group tended to have the greatest effect in those who were overweight at baseline and in those who weighed themselves regularly. Intervention women who rarely self-weighed gained weight (+0.07 kg) and regular self-weighers lost weight (-1.66 kg) a difference of -1.73 kg (95% CI; -3.35 to -0.11 p = 0.04). The intervention reported increased physical activity although the difference between groups did not reach significance. Both groups reported replacing high fat foods with low fat alternatives and self-efficacy deteriorated in the comparison group only.

Conclusion: Both a single health education session and interactive behavioral intervention will result in a similar weight loss in the short term, although more participants in the interactive intervention lost or maintained weight. There were small non-significant changes to physical activity and changes to fat intake specifically replacing high fat foods with low fat alternatives such as fruit and vegetables. Self-monitoring appears to enhance weight loss when part of an intervention.

Trial registration: ACTRN12608000110381.

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Related in: MedlinePlus

Mean weight change according to BMI category. Control group BMI < 25 n = 24, BMI 25–29.9, n = 38, BMI ≥ 30 n = 20. Intervention group BMI < 25 n = 37, BMI 25–29.9 n = 28, BMI ≥ 30 n = 21.
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Figure 2: Mean weight change according to BMI category. Control group BMI < 25 n = 24, BMI 25–29.9, n = 38, BMI ≥ 30 n = 20. Intervention group BMI < 25 n = 37, BMI 25–29.9 n = 28, BMI ≥ 30 n = 21.

Mentions: Using self-reported weight, both control and intervention groups reported a similar but non-significant mean weight loss at 16 weeks, -0.72 kg (95% CI:-1.59 to 0.14 p = 0.10) and -0.75 kg (95% CI:-1.57 to 0.07, p = 0.07) respectively. However, based on the measured weight, the intervention group participants significantly reduced weight by -0.78 kg (95% CI: -1.22 to -0.34, p < 0.001) (see additional file 1). There were differences between groups in the distribution of weight loss after stratification by BMI category, although this did not reach significance (figure 2). We then further stratified women into those who lost weight (≥ 1 kg), maintained weight within 1 kilogram of baseline (+/- 0.9 kg) to account for day to day variation in weight, or gained weight (≥ 1 kg). More women in the intervention group lost or maintained weight compared to the comparison group, particularly if they were overweight at baseline (figure 3). Again, the difference between groups did not reach significance. The obese category reported some large increases or decreases in weight over this short period (figure 3).


Weight, physical activity and dietary behavior change in young mothers: short term results of the HeLP-her cluster randomized controlled trial.

Lombard CB, Deeks AA, Ball K, Jolley D, Teede HJ - Nutr J (2009)

Mean weight change according to BMI category. Control group BMI < 25 n = 24, BMI 25–29.9, n = 38, BMI ≥ 30 n = 20. Intervention group BMI < 25 n = 37, BMI 25–29.9 n = 28, BMI ≥ 30 n = 21.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2683875&req=5

Figure 2: Mean weight change according to BMI category. Control group BMI < 25 n = 24, BMI 25–29.9, n = 38, BMI ≥ 30 n = 20. Intervention group BMI < 25 n = 37, BMI 25–29.9 n = 28, BMI ≥ 30 n = 21.
Mentions: Using self-reported weight, both control and intervention groups reported a similar but non-significant mean weight loss at 16 weeks, -0.72 kg (95% CI:-1.59 to 0.14 p = 0.10) and -0.75 kg (95% CI:-1.57 to 0.07, p = 0.07) respectively. However, based on the measured weight, the intervention group participants significantly reduced weight by -0.78 kg (95% CI: -1.22 to -0.34, p < 0.001) (see additional file 1). There were differences between groups in the distribution of weight loss after stratification by BMI category, although this did not reach significance (figure 2). We then further stratified women into those who lost weight (≥ 1 kg), maintained weight within 1 kilogram of baseline (+/- 0.9 kg) to account for day to day variation in weight, or gained weight (≥ 1 kg). More women in the intervention group lost or maintained weight compared to the comparison group, particularly if they were overweight at baseline (figure 3). Again, the difference between groups did not reach significance. The obese category reported some large increases or decreases in weight over this short period (figure 3).

Bottom Line: Mean measured weight decreased significantly in the intervention group (-0.78 kg 95% CI; -1.22 to -0.34, p < 0.001).The intervention reported increased physical activity although the difference between groups did not reach significance.ACTRN12608000110381.

View Article: PubMed Central - HTML - PubMed

Affiliation: Monash University, Australia. catherine.lombard@med.monash.edu.au

ABSTRACT

Background: Preventing weight gain rather than treating established obesity is an important economic and public health response to the rapidly increasing rates of obesity worldwide. Treatment of established obesity is complex and costly requiring multiple resources. Preventing weight gain potentially requires fewer resources to reach broad population groups, yet there is little evidence for successful interventions to prevent weight gain in the community. Women with children are an important target group because of high rates of weight gain and the potential to influence the health behaviors in family members.

Methods: The aim of this cluster randomized controlled trial was to evaluate the short term effect of a community-based self-management intervention to prevent weight gain. Two hundred and fifty mothers of young children (mean age 40 years +/- 4.5, BMI 27.9 kg/m2 +/- 5.6) were recruited from the community in Melbourne, Australia. The intervention group (n = 127) attended four interactive group sessions over 4 months, held in 12 local primary schools in 2006, and was compared to a group (n = 123) receiving a single, non-interactive, health education session. Data collection included self-reported weight (both groups), measured weight (intervention only), self-efficacy, dietary intake and physical activity.

Results: Mean measured weight decreased significantly in the intervention group (-0.78 kg 95% CI; -1.22 to -0.34, p < 0.001). Comparing groups using self-reported weight, both the intervention and comparison groups decreased weight, -0.75 kg (95% CI; -1.57 to 0.07, p = 0.07) and -0.72 kg (95% CI; -1.59 to 0.14 p = 0.10) respectively with no significant difference between groups (-0.03 kg, 95% CI; -1.32 to 1.26, p = 0.95). More women lost or maintained weight in the intervention group. The intervention group tended to have the greatest effect in those who were overweight at baseline and in those who weighed themselves regularly. Intervention women who rarely self-weighed gained weight (+0.07 kg) and regular self-weighers lost weight (-1.66 kg) a difference of -1.73 kg (95% CI; -3.35 to -0.11 p = 0.04). The intervention reported increased physical activity although the difference between groups did not reach significance. Both groups reported replacing high fat foods with low fat alternatives and self-efficacy deteriorated in the comparison group only.

Conclusion: Both a single health education session and interactive behavioral intervention will result in a similar weight loss in the short term, although more participants in the interactive intervention lost or maintained weight. There were small non-significant changes to physical activity and changes to fat intake specifically replacing high fat foods with low fat alternatives such as fruit and vegetables. Self-monitoring appears to enhance weight loss when part of an intervention.

Trial registration: ACTRN12608000110381.

Show MeSH
Related in: MedlinePlus