|Das, Sai Krupa|
Submitted to: American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/9/2013
Publication Date: 2/20/2013
Citation: Salinardi, T.C., Batra, P., Roberts, S.B., Urban, L.E., Robinson, L.M., Pittas, A.G., Lichtenstein, A.H., Deckersbach, T., Saltzman, E., Das, S. 2013. A lifestyle intervention reduces body weight and improves cardiometabolic risk factors in worksites. American Journal of Clinical Nutrition. DOI: 10.3945/ajcn.112.046995. Interpretive Summary: Worksites are potentially effective locations for obesity control because they provide opportunities for group intervention and social support. This paper describes the effectiveness of weight loss interventions in these settings. The effects of a multicomponent lifestyle intervention on weight loss and prevention of regain was examined in four worksites. The mean weight loss was substantial in intervention participants, whereas control subjects gained weight. 89% of participant’s completed the weight loss phase. The study also resulted in significant improvement in common markers for cardiovascular disease and diabetes risk over the 6 month period. In addition, the worksites requested to continue the program, and 48% of participants reenrolled in a structured weight maintenance program from 6 to 12 months, that documented no significant weight regain. Mean changes in body weight and markers for cardiovascular disease and diabetes risk were substantial in this study, suggesting that worksites have the potential to become effective dissemination points for weight management programs that reduce disease burden and health care costs associated with excess body weight. Additional research is needed to study the sustainability of worksite programs beyond 12 months and to identify predictors of success that will allow the targeting of worksites that can benefit most from on-site programs.
Technical Abstract: Worksites are potentially effective locations for obesity control because they provide opportunities for group intervention and social support. Studies are needed to identify effective interventions in these settings. We examined the effects of a multicomponent lifestyle intervention on weight loss and prevention of regain in 4 worksites (2 intervention and 2 control sites). Overweight and obese employees (n = 133) enrolled in this pilot worksite-randomized controlled trial with a 0-6-mo weight-loss phase and a 6-12-mo structured weight-maintenance phase. The intervention combined recommendations to consume a reduced-energy, low-glycemic load, high-fiber diet with behavioral change education. Outcome measurements included changes in body weight and cardiometabolic risk factors. Results: The mean +/- SEM weight loss was substantial in intervention participants, whereas control subjects gained weight (-8.0 +/- 0.7 compared with +0.9 +/- 0.5 kg, respectively; P < 0.001), and 89% of participants completed the weight-loss phase. Intervention effects were not significant at the 0.05 level but would have been at the 0.10 level (P = 0.08) in a mixed model in which the worksite nested within group was a random factor. There were also significant improvements in cardiometabolic risk factors in intervention compared with control subjects regarding fasting total cholesterol, glucose, systolic blood pressure, and diastolic blood pressure (P is less than or equal to 0.02 for each). No significant weight regain was observed in participants who enrolled in the structured weight-maintenance program (0.5 +/- 0.7 kg; P = 0.65), and overweight and obese employees in intervention worksites who were not enrolled in the weight-loss program lost weight compared with subjects in control worksites (-1.3 +/- 0.5 compared with +0.7 +/- 0.2 kg, respectively; P = 0.02). Worksites can be effective for achieving clinically important reductions in body weight and improved cardiometabolic risk factors. This trial was registered at clinicaltrials.gov as NCT01470222.