Rate of weight gain predicts change in physical activity levels: A longitudinal analysis of the EPIC-Norfolk cohort

Medical Research Council Epidemiology Unit, Institute of Metabolic Science, Cambridge, UK.
International journal of obesity (2005) (Impact Factor: 5). 04/2012; 37(3). DOI: 10.1038/ijo.2012.58
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Objective:To investigate the relationship of body weight and its changes over time with physical activity (PA).Design:Population-based prospective cohort study (Norfolk cohort of the European Prospective Investigation into Cancer and Nutrition, EPIC-Norfolk, United Kingdom).Subjects:A total of 25 639 men and women aged 39-79 years at baseline. PA was self-reported. Weight and height were measured by standard clinical procedures at baseline and self-reported at 18-month and 10-year follow-ups (calibrated against clinical measures). Main outcome measure was PA at the 10-year follow-up.Results:Body weight and PA were inversely associated in cross-sectional analyses. In longitudinal analyses, an increase in weight was associated with higher risk of being inactive 10 years later, after adjusting for baseline activity, 18-month activity, sex, baseline age, prevalent diseases, socioeconomic status, education, smoking, total daily energy intake and alcohol intake. Compared with stable weight, a gain in weight of >2 kg per year in the short-, medium- and long-term was consistently and significantly associated with greater likelihood of physical inactivity after 10 years, with the most pronounced effect for long-term weight gain, OR=1.89 (95% CI: 1.30-2.70) in fully adjusted analysis. Weight gain of 0.5-2 kg per year over long-term was substantially associated with physical inactivity after full adjustment, OR=1.26 (95% CI: 1.11-1.41).Conclusion:Weight gain (during short-, medium- and long-term) is a significant determinant of future physical inactivity independent of baseline weight and activity. Compared with maintaining weight, moderate (0.5-2 kg per year) and large weight gain (>2 kg per year) significantly predict future inactivity; a potentially vicious cycle including further weight gain, obesity and complications associated with a sedentary lifestyle. On the basis of current predictions of obesity trends, we estimate that the prevalence of inactivity in England would exceed 60% in the year 2020.International Journal of Obesity advance online publication, 24 April 2012; doi:10.1038/ijo.2012.58.

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    • "Similarly, men have been underrepresented in physical activity research, where interventions designed to increase physical activity have also largely targeted women (George et al., 2012; Kassavou, Turner, & French, 2013) and, consequently, may not appeal to men (Kassavou et al., 2013; Wong, Gilson, van Uffelen, & Brown, 2012). Increased weight has been reported to be a significant determinant of future physical inactivity (Golubic et al., 2013), and physical activity is recognized as being important for the prevention of obesity and other negative health outcomes (Biswas et al., 2015; Byberg et al., 2009). Physical activity also has a recognized role in lifestyle management programs aimed at promoting weight loss or preventing weight regain (National Institute for Health and Care Excellence, 2013a, 2013b). "
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    ABSTRACT: Men are underrepresented in obesity services, suggesting current weight loss service provision is suboptimal. This systematic review evaluated evidence-based strategies for treating obesity in men. Eight bibliographic databases and four clinical trials' registers were searched to identify randomized controlled trials (RCTs) of weight loss interventions in men only, with mean/median body mass index of ≥30 kg/m(2) (or ≥28 kg/m(2) with cardiac risk factors), with a minimum mean/median duration of ≥52 weeks. Interventions included diet, physical activity, behavior change techniques, orlistat, or combinations of these; compared against each other, placebo, or a no intervention control group; in any setting. Twenty-one reports from 14 RCTs were identified. Reducing diets produced more favorable weight loss than physical activity alone (mean weight change after 1 year from a reducing diet compared with an exercise program -3.2 kg, 95% confidence interval -4.8 to -1.6 kg, reported p < .01). The most effective interventions combined reducing diets, exercise, and behavior change techniques (mean difference in weight at 1 year compared with no intervention was -4.9 kg, 95% confidence interval -5.9 to -4.0, reported p < .0001). Group interventions produced favorable weight loss results. The average reported participant retention rate was 78.2%, ranging from 44% to 100% retention, indicating that, once engaged, men remained committed to a weight loss intervention. Weight loss for men is best achieved and maintained with the combination of a reducing diet, increased physical activity, and behavior change techniques. Strategies to increase engagement of men with weight loss services to improve the reach of interventions are needed. © The Author(s) 2015.
    American journal of men's health 06/2015; DOI:10.1177/1557988315587550 · 1.15 Impact Factor
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    • "However, it is difficult to directly attribute the observed differences to age alone, given the different methods used to assess PA. The inverse relationship of BMI with PAEE and MVPA is in line with our previous findings from the EPIC-Norfolk cohort which showed a significant cross-sectional relationship between body weight and inactivity, and demonstrated that weight gain over time is associated with future physical inactivity [61]. Although BMI is an indicator of overall body composition, it does not distinguish between fat and fat-free mass, but PA in this age-group has been found to play a major role in the preservation of fat-free mass [62-64]. "
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    ABSTRACT: Background Detailed assessment of physical activity (PA) in older adults is required to comprehensively describe habitual PA-levels in this growing population segment. Current evidence of population PA-levels is predominantly based on self-report. Methods We examined PA and sedentary behaviour in a nationally representative sample of British people aged 60–64, using individually-calibrated combined heart-rate and movement sensing and a validated questionnaire (EPAQ2), and the socio-demographic and behavioural factors that may explain between-individual variation in PA. Results Between 2006–2010, 2224 participants completed EPAQ2 capturing the past year’s activity in four domains (leisure, work, transportation and domestic life) and 1787 participants provided 2–5 days of combined-sensing data. According to objective estimates, median(IQR) physical activity energy expenditure (PAEE) was 33.5 (25.3-42.2) and 35.5 (26.6- 47.3) kJ/kg/day for women and men, respectively. Median (IQR) time spent in moderate-to-vigorous PA (MVPA; >3MET), light-intensity PA (1.5-3 MET) and sedentary (<1.5 MET) was 26.0 (12.3-48.1) min/day, 5.4 (4.2-6.7) h/day and 18.0 (16.6-19.4) h/day, respectively, in women; and 41.0 (18.8-73.0) min/day, 5.2 (4.0-6.5) h/day and 17.9 (16.3-19.4) h/day in men. PAEE and time spent in MVPA were lower and sedentary time was greater in obese individuals, those with poor health, and those with lower educational attainment (women only). Questionnaire-derived PAEE and MVPA tended to have similar patterns of variation across socio-demographic strata. In the whole sample, domestic PA had the greatest relative contribution to total questionnaire-derived PAEE (58%), whereas occupational PA was the main driver among employed participants (54%). Only 2.2% of participants achieved an average of >30 min MVPA per day combined with >60 min strength-training per week. Conclusions The use of both self-report and objective monitoring to assess PA in early old age provides important information on the domains of PA, PAEE and time spent at different intensity levels. Our findings suggest PA levels are generally low and observed patterns of variation indicate specific subgroups who might benefit from targeted interventions to increase PA.
    International Journal of Behavioral Nutrition and Physical Activity 05/2014; 11(1):58. DOI:10.1186/1479-5868-11-58 · 4.11 Impact Factor
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    ABSTRACT: The current review aimed to examine the evidence on prospective associations between sedentary behavior (i.e., sitting time) and weight gain. Prospective studies published between January 2010 and August 2012 were identified from searches in the Medline databases. In total 13 studies (seven in adolescents and six in adults) examining the prospective association between sedentary behavior and any measure of weight gain met inclusion criteria. In adolescents, mixed evidence was observed for a positive association between sedentary behavior at baseline and weight gain at follow-up. In adults, there was insufficient evidence that sedentary time at baseline was a strong predictor of weight gain at follow-up. The majority of the included studies used self- or parent-reported sedentary time which can be affected by social desirability and recall bias. Marked heterogeneity in study populations, exposure and outcome measures precluded a quantitative meta-analysis. Failure to appropriately adjust the results for baseline measures of the outcome particularly in the studies in children and adolescents may partly explain the observations. Therefore, firm conclusions whether prolonged sitting time predict weight gain in young people and adults is currently not possible. High-quality studies using repeated objective measures of sedentary behavior is warranted to establish a causal association.
    03/2012; 2(1). DOI:10.1007/s13679-012-0039-2
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