Erschienen in:
01.12.2013 | Original Research
Weight Loss Success in Metabolic Syndrome by Telephone Interventions: Results from the SHINE Study
verfasst von:
Ruth S. Weinstock, MD, PhD, Paula M. Trief, PhD, Donald Cibula, PhD, Philip C. Morin, MS, Linda M. Delahanty, MS, RD
Erschienen in:
Journal of General Internal Medicine
|
Ausgabe 12/2013
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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.
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/m2, 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/m2 vs. −0.8 kg/m2
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.