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Weight loss success in metabolic syndrome by telephone interventions: results from the SHINE Study.

Abstract：

BACKGROUND:The Diabetes Prevention Program (DPP) intensive lifestyle intervention resulted in significant weight loss, reducing the development of diabetes, but needs to be adapted to primary care provider (PCP) practices. OBJECTIVES:To compare a DPP-translation using individual (IC) vs. conference (CC) calls delivered by PCP staff for the outcome of percent weight loss over 2 years. DESIGN:Randomized clinical trial. SETTING:Five PCP sites. PARTICIPANTS:Obese patients with metabolic syndrome, without diabetes (IC, n = 129; CC, n = 128). INTERVENTION:Telephone delivery of the DPP Lifestyle Balance intervention [16-session core curriculum in year 1, 12-session continued telephone contact in year 2 plus telephone coaching sessions (dietitians). MAIN MEASURES:Weight (kg), body mass index (BMI), and waist circumference. KEY RESULTS: BASELINE DATA:age = 52 years, BMI = 39 kg/m(2), 75 % female, 85 % non-Hispanic White, 13 % non-Hispanic Black, and 48 % annual incomes <$40,000/year. In the intention-to-treat analyses at year 2, mean percent weight loss was -5.6 % (CC, p < 0.001) and -1.8 % (IC, p = 0.046) and was greater for CC than for IC (p = 0.016). At year 2, mean weight loss was 6.2 kg (CC) and 2.2 kg (IC) (p < 0.001). There was similar weight loss at year 1, but between year 1 and year 2 CC participants continued to lose while IC participants regained. At year 2, 52 % and 43 % (CC) and 29 % and 22 % (IC) of participants lost at least 5 % and 7 % of initial weight. BMI also decreased more for CC than IC (-2.1 kg/m(2) vs. -0.8 kg/m(2) p < 0.001). Waist circumference decreased by 3.1 cm (CC) and 2.4 cm (IC) at year 2. Completers (≥9 of 16 sessions; mean 13.3 sessions) lost significantly more weight than non-completers (mean 4.3 sessions). CONCLUSIONS:PCP staff delivery of the DPP lifestyle intervention by telephone can be effective in achieving weight loss in obese people with metabolic syndrome. Greater weight loss may be attained with a group telephone intervention.

journal_name

J Gen Intern Med

journal_title

Journal of general internal medicine

authors

Weinstock RS,Trief PM,Cibula D,Morin PC,Delahanty LM

doi

10.1007/s11606-013-2529-7

subject

Has Abstract

pub_date

2013-12-01 00:00:00

pages

1620-8

issue

eissn

0884-8734

issn

1525-1497

journal_volume

pub_type

杂志文章,多中心研究,随机对照试验

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Weight loss success in metabolic syndrome by telephone interventions: results from the SHINE Study.