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ABSTRACT: Maintenance of weight loss remains a challenge for most individuals. Thus, practical and effective weight-loss maintenance (WTLM) strategies are needed. A two-group 12-month WTLM intervention trial was conducted from June 2007 to February 2010 to determine the feasibility and effectiveness of a WTLM intervention for older adults using daily self-monitoring of body weight, step count, fruit/vegetable (F/V) intake, and water consumption. Forty weight-reduced individuals (mean weight lost=6.7±0.6 kg; body mass index [calculated as kg/m²] 29.2±1.1), age 63±1 years, who had previously participated in a 12-week randomized controlled weight-loss intervention trial, were instructed to record daily body weight, step count, and F/V intake (WEV [defined as weight, exercise, and F/V]). Experimental group (WEV+) participants were also instructed to consume 16 fl oz of water before each main meal (ie, three times daily), and to record daily water intake. Outcome measures included weight change, diet/physical activity behaviors, theoretical constructs related to health behaviors, and other clinical measures. Statistical analyses included growth curve analyses and repeated measures analysis of variance. Over 12 months, there was a linear decrease in weight (β=-0.32, P<0.001) and a quadratic trend (β=0.02, P<0.01) over time, but no group difference (β=-0.23, P=0.08). Analysis of the 365 days of self-reported body weight for each participant determined that weight loss was greater over the study period in the WEV+ group than in the WEV group, corresponding to weight changes of -0.67 kg and 1.00 kg, respectively, and an 87% greater weight loss (β=-0.01, P<0.01). Overall compliance to daily tracking was 76%±5%. Daily self-monitoring of weight, physical activity, and F/V consumption is a feasible and effective approach for maintaining weight loss for 12 months, and daily self-monitoring of increased water consumption may provide additional WTLM benefits.
Journal of the Academy of Nutrition and Dietetics. 05/2012; 112(5):685-692.e2.
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ABSTRACT: The number of US adults classified as overweight or obese has dramatically increased in the past 25 years, resulting in a significant body of research addressing weight loss and weight loss maintenance. However, little is known about the potential of weight loss maintenance interventions to be translated into actual practice settings. Thus, the purpose of this article is to determine the translation potential of published weight loss maintenance intervention studies by determining the extent to which they report information across the reach, efficacy/effectiveness, adoption, implementation, and maintenance (RE-AIM) framework. A secondary purpose is to provide recommendations for research based on these findings. To identify relevant research articles, a literature search was conducted using four databases; 19 weight loss maintenance intervention studies were identified for inclusion. Each article was evaluated using the RE-AIM Coding Sheet for Publications to determine the extent to which dimensions related to internal and external validity were reported. Approximately half of the articles provided information addressing three RE-AIM dimensions, yet only a quarter provided information addressing adoption and maintenance. Significant gaps were identified in understanding external validity, and metrics that could facilitate the translation of these interventions from research to practice are presented. Based upon this review, it is unknown how effective weight loss maintenance interventions could be in real-world situations, such as clinical or community practice settings. Future studies should be planned to address how weight loss maintenance intervention programs will be adopted and maintained, with special attention to costs for participants and for program implementation.
Journal of the American Dietetic Association 10/2010; 110(10):1511-22, 1522.e1-3. · 3.59 Impact Factor
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ABSTRACT: Sports that emphasize low body weight for optimal performance, such as ballet, are associated with an increased prevalence of the female athlete triad (FT). Previous research in this area that involves dancers has been limited; the majority of studies have been performed on adolescents training in classical ballet, and not professional adult dancers. The purpose of this study is to compare the physical and behavioral characteristics of female elite ballet dancers to sedentary, recreationally active non-dancing controls, with regard to characteristics of the FT and energetic efficiency. Women aged 18 to 35 years were recruited as participants. The dancers (N = 15) and non-dancing controls (N = 15) were pair-matched via age (dancers: 24.3 ± 1.3 years; controls: 23.7 ± 0.9 years), body mass index (dancers: 18.9 ± 0.2; controls: 19.4 ± 0.2 kg/m 2 ), and fat-free mass (dancers: 44.3 ± 0.8; controls: 44.1 ± 0.9 kg). Assessments included habitual dietary intake using 4-day food records, self-reported physical activity, psychometric measures of eating behaviors, health and menstrual history, body composition and bone density (dual energy x-ray absorptiometry), and resting metabolic rate (RMR) assessed by indirect calorimetry. Characteristics of the FT, specifically menstrual irregularities (6 of 15 dancers reported irregular or no menses; 1 of 15 controls reported irregular menses) and low energy availability, were more prevalent in dancers than in pair-matched controls. Despite having a similar fat-free mass (FFM), dancers had a significantly lower absolute RMR (dancers: 1367 ± 27; controls: 1454 ± 34 kcal/d; p ≤ 0.05) and significantly lower RMR relative to FFM (dancers: 30.9 ± 0.6; controls: 33.1 ± 0.8 kcal/kg fat-free mass/d; p ≤ 0.05). Energy intake between dancers (1577 ± 89 kcal/d) and pair-matched controls (2075 ± 163 kcal/d) also differed significantly (p ≤ 0.01). Six of the 15 dancers met the criteria for the FT (including low bone mineral density, menstrual irregularities, and eating pathology accompanied by low energy availability) and, therefore, represent a population of individuals afflicted with this disorder. These findings provide insight as to the metabolic impact of chronic energy restriction, and suggest that alterations in RMR (i.e., energetic efficiency) may be an indicator of low energy availability. Future larger-scale studies are warranted to address this possibility. Interventions aimed at increasing energy availability in elite female ballet dancers may be needed to promote optimal health status.
Journal of dance medicine & science: official publication of the International Association for Dance Medicine & Science 01/2010; 14(4):146-54.
