Effects of an Abbreviated Weight Loss Program on Physical Activity and Sedentary Time Christine Pellegrini, PhD Kevin Moran, MPH Bonnie Spring, PhD April 1, 2016
Intensive Weight Loss Program Increases Activity Diabetes Prevention Program Research Group,. N Engl J Med 2002;346:393-403 1
Can an Abbreviated Program Work Cut sessions in half (16 to 8) Vs Cut sessions in half PLUS use technology to: Replace in-person contacts Reduce self-monitoring burden Provide real-time feedback Provide supportive accountability Just as Well? 2
Purpose To determine if abbreviated weight loss interventions (Standard & Tech) increase daily moderate-to-vigorous physical activity (MVPA) and decrease sedentary time more than a self-guided control group PI: Bonnie Spring, PhD Funded by the NIDDK, 1RC1DK087126-01 3
DIETARY & EXERCISE 1200-2000 kcal/day; fat grams 25% of total intake Progress to 175 min/week of MVPA Self-monitor in paper diary Group weight loss competitions at 3- and 6-months INTERVENTION & CONTACT Weekly group meetings during weeks 1-8 Regular coaching calls during months 1-6 Mailed quarterly newsletter Group Lifestyle Balance DVDs (DPP 12 mock group sessions) TECHNOLOGY Smartphone with ENGAGED applications Wireless accelerometer (Shimmer) Self-monitor on ENGAGED application Social networking on ENGAGED application Standard Technology- Supported Self-Guided
Methods All participants wore an Actigraph 7164 for 7-10 days at baseline, 3-, and 6-months. Analyses restricted to participants with at least 4 valid days with 10 hours of wear time. Non-wear time defined as 90 minutes with zero activity counts, allowing for up to 2 minutes of <100 counts Sedentary time defined as counts <100. Calculated % of day spent in sedentary behavior MVPA defined as counts 2020, in at least 10 minute bouts. 5
Participant Characteristics Characteristic All Participants (n=96) Standard (n=32) Technology (n=32) Self- Guided (n=32) Age, mean (SD) (y) 39.3 (11.7) 37.3 (13.3) 40.4 (10.7) 40.1 (11.1) Female, No. (%) 84.4 81.3 87.5 84.4 Ethnicity, No. (%) Hispanic or Latino 19.8 31.3 12.5 15.6 Race, No. (%) White Black or African American 57.3 31.3 62.5 18.8 56.3 40.6 53.1 34.4 College Graduate or above (%) 68.8 65.6 68.8 71.9 Weight (kg) 94.8 (12.4) 96.0 (14.6) 94.7 (11.6) 93.5 (11.0) BMI (kg/m 2 ) 34.6 (3.0) 34.8 (3.0) 34.8 (2.8) 34.3 (3.2) 6
Retention: 3 Months 92% 6 Months 90% Self-Guided lowest retention (p=0.04) 7
No Differences in MVPA Intensive Contact Ended 8
Tech Less Sedentary at 3 Months 9
So, What Happened? Highly active group at baseline Participants averaging ~154 min/week Goal of 175 min/week may not have been sufficient enough to further increase activity 8 weeks may not be long enough to enhance activity outcomes Technology 10
Why was the technology MOST helpful? Warnick, J. Losing weight with a little help from my friends. SBM 2015 11
Why was the technology LEAST helpful? Warnick, J. Losing weight with a little help from my friends. SBM 2015 12
Percent Weight Loss Weight Loss Outcomes 0-1 -2-3 -4-5 -6-7 -8-9 Baseline 3 Months 6 Months Standard Technology Self-Guided 13
Conclusions An abbreviated weight loss program, with or without technology, did not change physical activity or sedentary behavior. Weight loss interventions may need to adapt program goals and topics based on baseline activity levels. Technology has many benefits, but does not always result in greater behavior change. 14
Thank You! Questions? Christine Pellegrini Kevin Moran Bonnie Spring C-Pellegrini@northwestern.edu Kevin.Moran@northwestern.edu BSpring@northwestern.edu