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A Prospective Study of Holiday Weight Gain

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It is commonly asserted that the average American gains 5 lb (2.3 kg) or more over the holiday period between Thanksgiving and New Year's Day, yet few data support this statement. To estimate actual holiday-related weight variation, we measured body weight in a convenience sample of 195 adults. The subjects were weighed four times at intervals of six to eight weeks, so that weight change was determined for three periods: preholiday (from late September or early October to mid-November), holiday (from mid-November to early or mid-January), and postholiday (from early or mid-January to late February or early March). A final measurement of body weight was obtained in 165 subjects the following September or October. Data on other vital signs and self-reported health measures were obtained from the patients in order to mask the main outcome of interest. The mean (+/-SD) weight increased significantly during the holiday period (gain, 0.37+/-1.52 kg; P<0.001), but not during the preholiday period (gain, 0.18+/-1.49 kg; P=0.09) or the postholiday period (loss, 0.07+/-1.14 kg; P=0.36). As compared with their weight in late September or early October, the study subjects had an average net weight gain of 0.48+/-2.22 kg in late February or March (P=0.003). Between February or March and the next September or early October, there was no significant additional change in weight (gain, 0.21 kg+/-2.3 kg; P=0.13) for the 165 participants who returned for follow-up. The average holiday weight gain is less than commonly asserted. Since this gain is not reversed during the spring or summer months, the net 0.48-kg weight gain in the fall and winter probably contributes to the increase in body weight that frequently occurs during adulthood.
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A PROSPECTIVE STUDY OF HOLIDAY WEIGHT GAIN
Volume 342 Number 12
·
861
Special Article
A PROSPECTIVE STUDY OF HOLIDAY WEIGHT GAIN
J
ACK
A. Y
ANOVSKI
, M.D., P
H
.D., S
USAN
Z. Y
ANOVSKI
, M.D., K
ARA
N. S
OVIK
, B.S., T
UC
T. N
GUYEN
, M.S.,
P
ATRICK
M. O’N
EIL
, P
H
.D.,
AND
N
ANCY
G. S
EBRING
, M.E
D
., R.D.
A
BSTRACT
Background
It is commonly asserted that the av-
erage American gains 5 lb (2.3 kg) or more over the
holiday period between Thanksgiving and New Year’s
Day, yet few data support this statement.
Methods
To estimate actual holiday-related weight
variation, we measured body weight in a conven-
ience sample of 195 adults. The subjects were weighed
four times at intervals of six to eight weeks, so that
weight change was determined for three periods:
preholiday (from late September or early October to
mid-November), holiday (from mid-November to ear-
ly or mid-January), and postholiday (from early or
mid-January to late February or early March). A final
measurement of body weight was obtained in 165
subjects the following September or October. Data
on other vital signs and self-reported health meas-
ures were obtained from the patients in order to mask
the main outcome of interest.
Results
The mean (±SD) weight increased signif-
icantly during the holiday period (gain, 0.37±1.52 kg;
P<0.001), but not during the preholiday period (gain,
0.18±1.49 kg; P=0.09) or the postholiday period (loss,
0.07±1.14 kg; P=0.36). As compared with their weight
in late September or early October, the study sub-
jects had an average net weight gain of 0.48±2.22 kg
in late February or March (P=0.003). Between Feb-
ruary or March and the next September or early Oc-
tober, there was no significant additional change in
weight (gain, 0.21 kg±2.3 kg; P=0.13) for the 165 par-
ticipants who returned for follow-up.
Conclusions
The average holiday weight gain is
less than commonly asserted. Since this gain is not
reversed during the spring or summer months, the
net 0.48-kg weight gain in the fall and winter proba-
bly contributes to the increase in body weight that
frequently occurs during adulthood. (N Engl J Med
2000;342:861-7.)
©2000, Massachusetts Medical Society.
From the Unit on Growth and Obesity, the Developmental Endocrinolo-
gy Branch, National Institute of Child Health and Human Development
(J.A.Y., K .N.S., T.T.N.); the Division of Digestive Diseases and Nutrition
(S.Z.Y.) and the Division of Nutrition Research Coordination (K.N.S.), Na-
tional Institute of Diabetes and Digestive and Kidney Diseases; and the Nu-
trition Department, Warren G. Magnuson Clinical Center (N.G.S.) — all
at the National Institutes of Health, Bethesda, Md.; and the Medical Uni-
versity of South Carolina, Charleston (P.M.O.). Address reprint requests to
Dr. Jack A . Yanovski at the National Institutes of Health, Bldg. 10, R m.
10N262, 10 Center Dr., MSC 1862, Bethesda, MD 20892-1862.
VERWEIGHT and obesity affect approx-
imately one half of the U.S. adult popu-
lation,
1,2
and the proportion of those with
obesity, defined as a body-mass index (the
weight in kilograms divided by the square of the
height in meters) of 30 or more, has increased by 50
percent during the past decade.
3
Because obesity, once
established, is difficult to reverse, the development
of effective strategies for prevention is imperative.
O
Understanding times when people are more likely
to gain weight throughout the life cycle is important
for the development of such strategies. Several peri-
ods, including adolescence,
4,5
pregnancy,
6,7
and mid-
life
8
in women and the period after marriage in men,
9
appear to be times of particular susceptibility to weight
gain. Behavioral or environmental changes, such as
quitting smoking
10,11
or emigrating to a more highly
urbanized culture,
12,13
can also be associated with
weight gain.
For most adults, there is a slight increase in weight
over time, with the average weight gain in young
adults ranging from 0.2 to 0.8 kg per year.
14-19
The
first National Health and Nutrition Examination Sur-
vey follow-up study found that among adults 25 to
44 years old, the body weight measured at 10-year in-
tervals increased by an average of 3.4 percent in men
and 5.2 percent in women.
16,18
It is not known whether the weight gain observed
in long-term studies of U.S. adults results from small,
steady increases in weight throughout the year or from
increases during discrete periods of increased energy
intake, decreased energy expenditure, or both, such as
holiday periods or particular seasons. Few studies have
measured individual changes in body weight at inter-
vals of less than one year. Two studies reported self-
measured body weight in narrowly selected popula-
tions in Europe.
20,21
Each found seasonal variations
in body weight of less than 0.6 kg. In contrast, studies
relying on self-reports have found that healthy peo-
ple believe their weight increases, on average, by more
than 5 lb (2.3 kg) in the fall and winter.
22,23
In the United States, the winter holiday season
is generally considered to begin with Thanksgiving
and end after New Year’s Day. Winter holiday–related
weight gain has been the subject of many reports in
the lay press. For example, on December 25, 1995,
the Cable News Network reported that “the aver-
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862
·
March 23, 2000
The New England Journal of Medicine
age American [will] gain seven to 10 pounds [3.2 to
4.5 kg] before the New Year.”
24
A report from the
Texas Medical Association stated that “most studies
show the average American gains 8 pounds [3.6 kg]
during the period from Thanksgiving to New Year’s
Day.
25
All the reports we retrieved
24-31
suggested that
at least 5 lb were gained from Thanksgiving to New
Year’s Day, but none offered a credible source for
that suggestion. A literature review failed to identify
any clinical research findings supporting the claim of
a 5-lb or greater average weight gain over the winter
season.
20,21,32-35
In order to determine the effect of both the season
and the holiday period on changes in body weight in
U.S. adults, we measured weight in a convenience sam-
ple of adults from September to March and calculat-
ed individual changes in body weight before, during,
and after the winter holiday season. We hypothesized
that any observed weight change would be similar
during each measurement period.
METHODS
Subjects
A total of 200 subjects were recruited for a study of “seasonal
changes in vital signs” by means of advertisements placed through-
out the National Institutes of Health campus in Bethesda, Mary-
land. Subjects were compensated for participation. Recruitment was
stratified to ensure the equitable participation of both sexes, sev-
eral racial and ethnic groups, and a range of ages and occupations
(Table 1). Entry criteria included an age of at least 18 years, good
general health, and willingness to attend all study visits. Subjects
were excluded if they had serious medical conditions, were taking
medications known to affect body weight, or were pregnant. Sub-
jects were enrolled without regard to weight, dietary habits, or
dieting history. The study was approved by the institutional re-
view board of the National Institute of Child Health and Human
Development, and all subjects provided written informed consent
before enrollment.
Protocol
The subjects were seen on four occasions at intervals of six to
eight weeks: during late September or early October, during mid-
November (before Thanksgiving), in early or mid-January (after
New Year’s Day), and in late February or early March. Height was
measured to the nearest 1 mm at the first visit with a stadiometer
(Holtain, Crymmyck, United Kingdom) that was calibrated against
a standard height before each use. At each visit, weight was meas-
ured to the nearest 0.01 kg with an electronic scale (Life Meas-
urement Instruments, Concord, Calif.) that was calibrated against
a standard weight before each measurement. The subjects were
weighed wearing undergarments and hospital gowns without shoes.
Each subject was weighed at the same time of day as at the initial
visit (e.g., in the morning after breakfast or in the afternoon after
lunch).
We masked the main outcome of interest (changes in body
weight) by carrying out additional measurements at study visits.
Temperature was measured electronically (Sherwood Medical, St.
Louis) once at each visit, and both pulse and blood pressure were
measured with an automated sphygmomanometer (Critikon, Tam-
pa, Fla.) before and after the subjects completed a series of ques-
tionnaires. These questionnaires included a health screening form
and forms evaluating factors such as stress, dietary and activity pat-
terns, and depression, including winter seasonal affective disor-
der.
22,23
The subjects were asked to describe changes in their habits
during the previous six weeks at the first visit, and changes since the
last visit at all other visits. At the visit in late February or early March,
the subjects were asked about their understanding of the main pur-
pose of the research project and were asked how much weight
they believed they had gained over the winter holiday period.
The subjects were subsequently invited to return for two addi-
tional visits, in June and in late September or early October, for
observation of changes in body weight over a one-year period.
Statistical Analysis
The data were analyzed on a Macintosh PowerPC with Stat-
View software (version 4.5, Abacus Concepts, Berkeley, Calif.). The
weights from the first four measurements were used to compute
weight change for three periods: preholiday (from late September
or early October to mid-November), holiday (from mid-November
to early or mid-January), and postholiday (from early or mid-
January to late February or early March). Because there were in-
dividual differences in the intervals between measurements, the
data were also analyzed as weight change adjusted for a six-week
interval by dividing the weight change by the number of days be-
tween measurements and multiplying by 42. The results were un-
changed when this method of analysis was used, and therefore
the unadjusted weight changes are presented. The weight change
between measurements was also calculated for the subgroup of
subjects measured in June and September or October.
Analysis of variance for repeated measures was used to examine
both body weight and change in body weight, with race or ethnic
group and sex tested as independent factors. Post hoc paired t-tests,
with significance adjusted by the Bonferroni correction for mul-
tiple comparisons, were used to detect differences in weight and in
*Plus–minus values are means ±SD. The body-
mass index is the weight in kilograms divided by the
square of the height in meters. The Hollingshead
scale of social classes ranges from I (the status of un-
skilled workers) to V (that of professionals). Because
of rounding, not all percentages total 100.
T
ABLE
1.
D
EMOGRAPHIC
C
HARACTERISTICS
OF
THE
195 S
UBJECTS
.*
V
ARIABLE
V
ALUE
Age (yr)
Mean
Range
39±12
19–82
Sex (%)
Male
Female
49
51
Race or ethnic group (%)
Black
Asian
White
Hispanic
17
10
67
6
Initial weight (kg)
Mean
Range
74.4±16.3
43.4–139.2
Initial body-mass index
Mean
Range
<25 (%)
»25 but <30 (%)
»30 (%)
25.9±4.8
17.8–46.8
52
28
21
Hollingshead scale of socio-
economic status
Median
Range
IV
II–V
No. of holiday par ties attended
Mean
Range
4.4±2.8
0–10
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A PROSPECTIVE STUDY OF HOLIDAY WEIGHT GAIN
Volume 342 Number 12
·
863
weight change for each interval. Paired t-tests were also used to
determine differences between actual holiday weight change and the
change estimated by the subjects. Contingency-table analysis was
used to determine differences in weight change among subjects
who were not overweight (body-mass index, <25), subjects who
were overweight (body-mass index, »25 but <30), and subjects
who were obese (body-mass index, »30). Linear regression was
used to determine the relation between weight change and con-
tinuous variables such as age and initial body-mass index. Data are
presented as means ±SD unless otherwise stated.
RESULTS
Demographic data on the 200 recruited subjects
are presented in Table 1. Fifty-one percent of the sub-
jects were women. The sample was racially diverse,
and ages ranged from 19 to 82 years. The initial mean
body-mass index (25.9±4.8) and median body-mass
index (24.8) were similar to the median body-mass in-
dex reported for the U.S. adult population (25.5),
1
as was the prevalence of overweight (27 percent of
the subjects had a body-mass index of »25 but <30)
and obesity (21 percent had a body-mass index of
»30).
2
Eighty-eight percent of the subjects worked
at the National Institutes of Health, a government fa-
cility that employs more than 19,000 people in occu-
pations ranging from maintenance and food service
to biomedical research. The subjects were recruited
from a variety of occupations. Their socioeconomic
status, as assessed by the Hollingshead scale, ranged
from social classes II through V, with a class of I in-
dicating the status of unskilled workers and a class of
V that of professionals.
36
Of the 200 recruited subjects, complete data on
weight from the first four visits were available for 195
(98 percent). Analysis of variance for repeated meas-
ures revealed that weight changed significantly during
the study (P=0.01). The mean weight increased
significantly (Fig. 1) during the holiday period (gain,
0.37±1.52 kg; range, ¡6.96 to +4.07 [negative
numbers indicate weight loss]; P<0.001), but not
during the preholiday period (gain, 0.18±1.49 kg;
range, ¡4.33 to +8.07; P=0.09) or the postholiday
period (loss, 0.07±1.14 kg; range, ¡6.18 to +2.47;
P=0.36). The weight change during the holiday pe-
riod was not significantly different from the weight
change during the preholiday period (P=0.23), but
it was greater than that in the postholiday period
(P=0.002). As compared with their weight in Sep-
tember or early October, the study subjects had an av-
erage net weight gain of 0.48±2.22 kg at the Febru-
ary or March measurement (range, ¡9.33 to +8.02
kg; P=0.003). However, most subjects had no large
changes in weight: at more than 50 percent of all
measurements after the initial one, the weight differed
from that in the previous measurement by no more
than 1 kg (Fig. 2).
Twenty-nine subjects (15 percent) reported that
they attempted to lose weight during the holiday peri-
od, but their holiday weight change (+0.13±1.73 kg)
did not differ significantly from that of the subjects
who reported no such attempts (+0.42±1.49 kg, P=
0.35). There were no independent effects of sex, race
or ethnic group, or socioeconomic status on weight
change during any interval, and there was no corre-
lation between weight change and age (r
2
<0.001).
Forty-five percent of the subjects were weighed dur-
ing the first week of January, and 86 percent were
weighed before January 14. There was no signif-
icant relation between the week in January during
which weight was measured and the amount of weight
Figure 1.
Mean (±SE) Weight Change in 195 Subjects.
The preholiday period is the interval from late September or early October to mid-November (before
Thanksgiving). The holiday period is the interval from mid-November to early or mid-January (after
New Year’s Day). The postholiday period is the interval from early or mid-January to late February or
early March. Total is the interval from the first measurement in late September or early October to the
last measurement in late February or early March. P<0.001 for the weight increase over the holiday
period; P=0.002 for the change in weight between the holiday and the postholiday periods; P=0.003
for the weight increase over the total measurement period.
0.8
Preholiday
–0.2
0.0
0.2
0.4
0.6
Holiday Postholiday Total
Weight Change (kg)
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·
March 23, 2000
The New England Journal of Medicine
change (first week, +0.55±1.4 kg; second week,
+0.23±1.49 kg; third week, +0.56±1.67 kg; fourth
week, +0.30±1.77 kg) or the proportion of subjects
reporting that they had attempted to lose weight dur-
ing the holiday period (P=0.74 by chi-square test).
The amount of weight change during the holiday
period was not significantly correlated with body-mass
index (r
2
<0.006). However, when the subjects were
categorized as not overweight, overweight, or obese
according to their body-mass index, there was a trend
toward a greater likelihood of gaining at least 2.3 kg
with increasing degree of overweight (P=0.06) (Fig.
3). Because a weight gain of 2.3 kg corresponds to a
3 percent weight change for a person with the aver-
age body weight in this study (74.4 kg), we also de-
termined whether a holiday weight gain of at least
3 percent was more common among overweight or
obese subjects. When a major weight gain was defined
in this manner, the probability of a weight gain of at
least 3 percent did not differ significantly (P=0.76)
among subjects who were not overweight (probabil-
ity, 7.9 percent), overweight (11.1 percent), or obese
(7.5 percent).
Using self-reported data, we examined several other
possible predictive factors for holiday weight gain:
changes in the level of perceived stress, hunger, or ac-
tivity; changes in smoking habits; the presence of win-
ter seasonal affective disorder; and the number of
parties or receptions attended. The only factors relat-
ed to holiday weight change were reported changes
in activity (P=0.01) and in hunger (P<0.001) (Fig.
4). Those who reported being much more active or
much less hungry since their last visit had the greatest
weight loss; conversely, those reporting being much
less active or much more hungry since their last visit
gained the most over the holiday interval.
The subjects were asked at their February or March
clinic visit how much weight they believed they had
gained over the holiday period. The perceived weight
gain (1.57±1.47 kg) was significantly greater than the
measured weight gain by an average of 1.12±1.79 kg
(P<0.001 by paired t-test); there was no effect of sex,
Figure 2.
Distribution of Weight Changes.
In more than 50 percent of all measurements of weight after the initial one, the change from the pre-
vious measurement was no more than 1 kg.
0
60
Lost
»2.3 kg
Gained
»2.3 kg
20
40
Lost
>1 but
<2.3 kg
Gain or
loss of
«1 kg
Gained
>1 but
<2.3 kg
Percentage of Measurements
Preholiday
Holiday
Postholiday
Figure 3.
Percentage of Subjects with Major Holiday Weight
Gain (»2.3 kg) among 101 Nonoverweight, 54 Overweight, and
40 Obese Subjects.
Nonoverweight subjects were defined as those with a body-mass
index of <25, overweight subjects as those with a body-mass
index of »25 but <30, and obese subjects as those with a
body-mass index of »30. The 95 percent upper confidence limit
is shown. There was a trend toward a greater likelihood of major
holiday weight gain as the degree of overweight increased
(P=0.06).
0
30
Nonoverweight Overweight Obese
10
20
Subjects with Major
Holiday Weight Gain (%)
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A PROSPECTIVE STUDY OF HOLIDAY WEIGHT GAIN
Volume 342 Number 12
·
865
race or ethnic group, or body-mass index on the de-
gree of overestimation.
In order to assess the adequacy of the masking pro-
cedures, the subjects were also asked at the February
or March visit to describe what they believed to be
the primary purpose of the study. Only 21.4 percent
identified seasonal weight change as the main out-
come of interest. The remainder named a variety of
primary outcomes, including seasonal changes in psy-
chological factors or vital signs such as temperature,
pulse, or blood pressure (64.8 percent), or were un-
sure (13.8 percent). The holiday weight change of
those who identified weight as the primary outcome
(+0.24±1.52 kg) was not significantly different from
that of subjects who named other primary outcome
measures (+0.41±2.33 kg, P=0.53).
A subgroup of 165 subjects (85 percent) agreed
to return for two additional visits in June and in late
September or early October. The subjects who com-
pleted these additional visits did not differ significant-
ly from those who declined to return with regard to
initial body weight, body-mass index, age, sex, race or
ethnic group, or socioeconomic status. Their average
holiday weight change (+0.32±1.52 kg, P=0.003)
and their net weight change from September or Oc-
tober to February or March (+0.40±2.28 kg) were
Figure 4.
Mean (±SE) Self-Reported Changes in Physical Activity (Panel A) and Hunger (Panel B) in
Relation to Weight Change during the Holiday Interval.
The relation was significant for both activity (P=0.01) and hunger (P<0.001). The values in parentheses
are the numbers of subjects in the subgroups.
1.5
Somewhat
less
hungry
(34)
–1.5
–1.0
–0.5
0.0
0.5
1.0
Much
less
hungry
(9)
B
No
change
in hunger
(105)
Somewhat
more
hungry
(45)
Much
more
hungry
(2)
Holiday Weight Change (kg)
1.5
Somewhat
less
active
(74)
–1.5
–1.0
–0.5
0.0
0.5
1.0
Much
less
active
(28)
A
No
change
in activity
(48)
Somewhat
more
active
(39)
Much
more
active
(6)
Holiday Weight Change (kg)
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866
·
March 23, 2000
The New England Journal of Medicine
also not significantly different from the weight changes
of those who did not choose to return. For these 165
subjects, there were no significant changes in body
weight between February or March and June (+0.03
±1.91 kg, P=0.86), or between June and the next
September or October (+0.19±1.75 kg, P=0.16).
Between February or March and September or Oc-
tober, their net change in weight was a gain of 0.21
±2.3 kg (P=0.13), leading to a net weight gain of
0.62±3.03 kg during the one-year observation pe-
riod (P=0.01).
DISCUSSION
In contrast to the common perception that weight
increases during the winter holiday season, the meas-
ured weight of the vast majority of subjects in this
study changed little between Thanksgiving and New
Year’s Day. The subjects believed they had gained four
times as much weight as their actual holiday weight
gain of 0.37 kg. Fewer than 10 percent of subjects
gained 2.3 kg or more, and more than half of all meas-
urements of weight after the initial one were within
1 kg of the previous measurement. Thus, despite the
fact that 85 percent of the study subjects made no ef-
fort to control their weight, large weight gains over
the winter holiday season were not the norm. Unfor-
tunately, we also found that the 0.18-kg average weight
gain during the fall preholiday period and the 0.37-kg
increase during the holiday season were largely main-
tained during the postholiday winter period from Jan-
uary to February or March, resulting in a net average
weight gain of 0.48 kg. In subjects who completed
one year of observation, the weight increased by an
average of 0.32 kg during the holiday period and
0.62 kg over the entire year, suggesting that the pe-
riod contributing most to yearly weight change is the
six-week holiday period.
A potential limitation of our study is that we used
a convenience sample, primarily National Institutes
of Health employees, rather than a population-based
sample. The subjects resided in a large, urban area, and
persons from the lowest socioeconomic levels were
underrepresented. It is also possible that National In-
stitutes of Health employees may be more health-
conscious than the general population. Although the
range of the study group in terms of age, race or eth-
nic group, socioeconomic status, and body-mass in-
dex was broad, and although both the mean body
weight and the prevalence of overweight and obesity
were remarkably similar to those in the U.S. adult pop-
ulation, these findings may not be generalizable to
all U.S. population groups.
The rate of retention of the cohort was excellent,
with 98 percent of the subjects completing the pri-
mary study and 85 percent of these returning for
weight measurements in June and September or Oc-
tober. Accurate measurements of body weight were
obtained with the use of standardized protocols for
weighing, which required each subject to wear sim-
ilar clothing each time he or she was weighed and to
be weighed at the same time of day. Our attempts to
mask the primary purpose of the study by collecting
additional data appeared to be effective, since only
21.4 percent of the subjects concluded that investi-
gating change in body weight was the primary pur-
pose of the study. Masking may have decreased the
likelihood that the subjects would attempt to change
their body weight (for example, by dieting or skip-
ping meals) before their study visits. We believe that
our results are likely to reflect actual holiday weight
change more accurately than studies that rely on
clinical samples or self-reports.
We also found that those who had a major holiday
weight gain, defined as a gain of at least 2.3 kg, were
more likely to be overweight or obese than those who
did not have such a major gain. Such weight gain may
be clinically important, particularly for those who are
already at risk for obesity-related conditions. A Swed-
ish study of obese subjects in a weight-maintenance
program and of hospital employees found that self-
recorded Christmastime weight gain (over a three-
week period) averaged 0.6 kg or less in each group.
However, the variability in weight change was signif-
icantly greater in obese subjects who had previous-
ly lost weight than in controls (maximal increases in
weight, 6.1 and 2.2 kg, respectively).
21
Others have de-
scribed a lowering of the efficacy of weight-reduction
or weight-maintenance programs during the winter
season.
35,37-39
Taken together, these results suggest that the win-
ter holiday season may present special risks for those
who are already overweight or obese and that such
persons may benefit from seasonal efforts to prevent
weight gain.
35,39,40
The relation we found between
reported physical activity and weight change points
to the need for further studies to determine whether
increasing physical activity can prevent holiday-relat-
ed weight gain in persons at risk.
Weight gain during adulthood has serious conse-
quences for health and is a risk factor for the develop-
ment of type 2 diabetes,
41
cardiovascular disease,
42
and
other conditions.
43,44
The 0.48-kg weight gain of the
subjects in this study between September or Octo-
ber and February or March might not appear to be
clinically important and could easily go unnoticed by
both the subjects and health care providers. Our data
suggest that this weight gain is not reversed during
the spring and summer months. Therefore, the cu-
mulative effects of yearly weight gain during the fall
and winter are likely to contribute to the substantial
increase in body weight that frequently occurs during
adulthood.
Supported by a grant (Z01 HD-00641) from the National Institute of
Child Health and Human Development and the Office of Research on Mi-
nority Health (to Dr. Jack A. Yanovski).
The New England Journal of Medicine
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A PROSPECTIVE STUDY OF HOLIDAY WEIGHT GAIN
Volume 342 Number 12
·
867
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... In this system, body fatness between the two points is not physiologically regulated and exhibits a "zone of indifference." This is consistent with the observation that people in the USA often gain weight during the holiday period averaging about 0.3 to 0.5 kg, but this weight is subsequently not lost [76]. Moreover, many people gradually increase body weight year upon year [77] without any countervailing response to reduce it. ...
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LEARNING OUTCOME: To test whether a liquid meal replacement plan can prevent weight gain during the holidays. It is a commonly held belief that Americans gain weight over the holidays (Thanksgiving to New Years), even though reliable data on holiday weight changes does not appear in recent literature. Retention of even small amounts of weight following every holiday season could contribute significantly to overall weight gain. The objective of this study was to apply a maintenance strategy which involved exchanging two regular meals with a commercial liquid meal replacement for each holiday eating event, such as parties and dinners, from Dec 15 to Jan 15. Male and female subjects (Ss) selected from a university population included staff, faculty, and students 25-60 years old Ss were randomized into treatment (N=27) and control (N=31) groups and matched by weight using a BMI of >27 for overweight. All Ss were given a baseline questionnaire designed to determine weight loss history including questions about their usual holiday weight gain. Ss reported to the clinic for a fasted morning weigh-in at the start and finish of the 4 week period. Control Ss tracked their holiday meals while treatment Ss tracked meal replacements, body weight, holiday-related eating events, and the perceived effectiveness of seven weight maintenance statements. Treatment Ss consumed an average of 16.3±7.8 meal replacement beverages during the study period. Treatment Ss lost 0.06+2.81bs while control Ss gamed 1.36±2.6 lbs (p<0.05). Ss reported an average usual holiday weight gain of 4.85 ±2.3 lbs, which did not significantly differ between groups (p<0.05). A comparison between the current year's gain and the usual holiday gain (actual gain-reported usual gain) showed a significant treatment effect with a difference of -5.03 ± 2.8 and -2.81 ±3.0 lbs in the treatment and control groups, respectively (p<0.05). The control group change reflected a placebo effect of study participation, but the differences remained significant. The treatment group had a significantly greater rate of success (59%) compared to control (18%) (p< 0.05) where “success” was defined as weight maintenance or loss. Overall, the holiday meal replacement plan was successful and may serve as a model for simplifying strategies designed to prevent weight gain during the holidays and/or special events which predictively occur.
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Because migration is such a widespread phenomenon, studies of the effects of accompanying life change on the health and well-being of the migrant have special significance in areas like California that support large migrant communities. Previous studies have shown that increased weight and elevated blood pressure may be linked to changes in diet, exercise habits, and the altered sociocultural milieu of the migrant. Among Samoans, a Pacific Island population of Polynesian descent, these changes appear to be particularly prominent in segments of the population that have moved to the environment of Hawaii, which epidemiologic studies have characterized as 'intermediate-modern'. Preliminary findings from a survey of weight, height, blood pressure, fasting glucose levels, and mortality records among Samoans living in California indicate that individuals living under more highly urbanized conditions exhibit even more pronounced changes. Adult weight among Samoans in California (San Francisco) greatly exceeds that of their counterparts in Hawaii and Samoa. Elevated blood pressure are also seen, though the extent to which this is associated with excessive weight gain is unclear. The number of individuals with high ([greater-or-equal, slanted]160 mg/dl) fasting plasma glucose levels would be consistent with a population in which the prevalence of diabetes is many times higher than in the U.S. population. Although mortality patterns are difficult to determine for this population, available records suggest an excess mortality from cardiovascular disease of all types among adult Samoans under age 50. Future investigations will attempt to link biobehavioral changes in the migrants' lifestyle to these observed patterns of risk.