Self-monitoring of spontaneous physical activity and sedentary behavior to prevent weight regain in older adults

Abstract

Objective This study determined whether adding a self-regulatory intervention (SRI) focused on self-monitoring of spontaneous physical activity and sedentary behavior to a standard weight loss intervention improved maintenance of lost weight. Design and Methods Older (65–79 yrs), obese (BMI=30–40 kg/m2) adults (n=48) were randomized to a five-month weight loss intervention involving a hypocaloric diet (DIET) and aerobic exercise (EX) with or without the SRI to promote spontaneous physical activity and decrease sedentary behavior (SRI+DIET+EX compared to DIET+EX). Following the weight loss phase, both groups transitioned to self-selected diet and exercise behavior during a 5-month follow-up. Throughout the 10-months, the SRI+DIET+EX group utilized real-time accelerometer feedback for self-monitoring. Results There was an overall group by time effect of the SRI (P < 0.01); DIET+EX lost less weight and regained more weight than SRI+DIET+EX. The average weight regain during follow-up was 1.3 kg less in the SRI+DIET+EX group. Individuals in this group maintained ~10% lower weight than baseline compared to those in the DIET+EX group whom maintained ~5% lower weight than baseline. Conclusions Addition of a self-regulatory intervention, designed to increase spontaneous physical activity and decrease sedentary behavior, to a standard weight loss intervention enhances successful maintenance of lost weight.

The Impact of Interventions that Integrate Accelerometers on Physical Activity and Weight Loss: A Systematic Review

“…Twelve studies reported on outcomes related to physical activity [29–40] and 11 on outcomes related to weight [27–29,31–37,39]. Four trials were conducted with older adults; five with overweight, obese, or sedentary adults; three with participants with a chronic medical illness (e.g., chronic obstructive pulmonary disease, metabolic disease, diabetes); and two with healthy volunteers.…”

“…Two small trials judged to be at high risk of bias compared accelerometer interventions with active comparators [29,31]. While both trials demonstrated a positive trend of weight loss (MD −3.60 to −2.10), only one study [31] was statistically significant.…”

Spontaneous Physical Activity Defends Against Obesity

“…Blood levels of the activity related neuropeptide orexin (discussed below) are higher among people with higher amounts of physical activity [23]. Few intervention studies have addressed the clinical significance of elevated SPA to human obesity or addressed whether an increase in SPA mitigates weight gain in the predicted manner by increasing total energy expenditure in adults [24, 25]. Despite the limitations that were acknowledged in those studies [24, 25], the difficulty of designing SPA interventions may be related to the inherent difficulty of intervening to increase SPA levels based on its operational definition as low intensity physical activity that distinguishes this “non-exercise physical activity” from formal exercise.…”

Autonomous physical activity based program versus aerobic exercise based interventions to improve health and cardiovascular status in sedentary overweight adults: A review

“…Nicklas et al, (2014), determined whether adding a self-regulatory intervention focused on self-monitoring of spontaneous physical activity and sedentary behavior to a standard weight loss. To do this, the sample was divided into two groups, one that made diet plus aerobic exercise and the other that was dieting, aerobic exercise and was instructed to improve spontaneous physical activity and decrease sedentary behaviour.…”