Small Changes in Nutrition and Physical Activity Promote Weight Loss and Maintenance: 3-Month Evidence from the ASPIRE Randomized Trial

Lutes, Lesley D.; Winett, Richard A.; Barger, Steven D.; Wojcik, Janet R.; Herbert, William G.; Nickols‐Richardson, Sharon M.; Anderson, Eileen S.

doi:10.1007/s12160-008-9033-z

Cited by 94 publications

(71 citation statements)

References 17 publications

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“…The threshold model [51] postulates, though, that the stimulus can be brief if it is at a proper threshold of intensity. Research with the Graded Exercise Protocol [55] showed that after a graded warm-up to a 4-min work segment at~75 % VO 2max with twice-aweek training produced about the same increase in CRF as much as longer duration training at the same intensity. Very similar outcomes including favorable changes in glucose metabolism and blood pressure (BP) with a single, harder 3-4 min workpiece have PRACTICE AND PUBLIC HEALTH POLICIES been found by a prominent Norwegian research group [56] and Gibala's group in Canada [52].…”

Section: Very Brief Aerobic Training To Improve Treatmentmentioning

confidence: 99%

“…Recent exercise science studies have shown that higher intensity interval training protocols safely produce, even for people with prominent risk factors, improved health-related outcomes versus typical low to moderate intensity protocols with the same energy expenditure [49][50][51][52][53][54][55][56]. However, those interval protocols have multiple repeats, raising the question of translatability [49,50,[52][53][54].…”

Section: Very Brief Aerobic Training To Improve Treatmentmentioning

confidence: 99%

“…The multiple health behavior ASPIRE intervention was developed for overweight and obese weight status middle-aged, inactive adults with central obesity (WC, mean=105 cm) [55]. Nutrition and physical activity counseling plus initial supervised RT and AT, emphasizing mastery experiences and self-regulation, were all fitted into two 1-h sessions per week.…”

Section: Feasibility and Evidence: Sct-based Interventionsmentioning

confidence: 99%

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Developing a new treatment paradigm for disease prevention and healthy aging

Winett

Davy

Marinik

et al. 2013

Behav. Med. Pract. Policy Res.

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An increasingly prevalent pattern of risk factors has emerged in middle-aged and older adults that includes the presence of type 2 diabetes or prediabetes, overweight or obese weight status with central obesity and very high body fat, low cardiorespiratory fitness (CRF), low strength, and a low lean-body-mass-to-body-fat ratio. Traditionally, these problems have been approached with a low-fat and low-calorie diet and with lower to moderate intensity activity such as walking. While the treatment has some clear benefits, this approach may no longer be optimal because it does not reflect more recent findings from nutrition and exercise sciences. Specifically, these fields have gained a greater understanding of the metabolic and functional importance of focusing on reducing body fat and central obesity while maintaining or even increasing lean body mass, a quality weight loss, and how to efficiently and effectively increase CRF and strength. Evidence is presented for shifting the treatment paradigm for disease prevention and healthy aging to include the DASH nutrition pattern but with additional protein, higher intensity, brief aerobic training, effortbased, brief resistance training, and structured physical activity. Recent interventions based on social cognitive theory for initiating and then maintaining health behavior changes show the feasibility and efficacy of the approach we are advocating especially within a multiple health behavior change format and the potential for translating the new treatment paradigm into practice. KEYWORDSDiabetes, Quality weight loss, Treatment paradigm, Multiple health behaviors IMPORTANCE OF THE PROBLEM, USUAL TREATMENT, CHANGING THE TREATMENT PARADIGM A pressing public health problem is the high prevalence of engagement in multiple, poor health behaviors, creating patterns of high risk for morbidity and mortality and contributing to considerable individual and societal financial burden [1,2]. One pattern that is becoming increasingly prevalent is the combination of prediabetes, overweight or obese weight status, central obesity (increased visceral adipose tissue), and low cardiorespiratory fitness (CRF) with gradual loss of lean body mass and strength [3], which further increases the risks for type 2 diabetes (T2D), cardiovascular diseases, and some cancers, disabilities, and premature death [4]. The prevalence of T2D, based on fasting glucose or hemoglobin A1c levels in adults, aged 45-64 years old, is~14 %, and the prevalence of prediabetes for adults >20 years old is~35 % [5]. For adults over 65 years old, the prevalence of T2D is 27 % and the prevalence of prediabetes is~50 % [5]. Overweight, not just obesity weight status, is often comorbid for central obesity (waist circumference (WC) ≥102 cm for men and ≥88 cm for women) [3], which is associated with increased risk of T2D, especially for women [6]. Overweight individuals with large WC's, though at high risk, are often not identified for interventions [6,7]. The normal agerelated loss of lean body mass beginning in m...

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Section: Very Brief Aerobic Training To Improve Treatmentmentioning

confidence: 99%

Section: Very Brief Aerobic Training To Improve Treatmentmentioning

confidence: 99%

Section: Feasibility and Evidence: Sct-based Interventionsmentioning

confidence: 99%

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Developing a new treatment paradigm for disease prevention and healthy aging

Winett

Davy

Marinik

et al. 2013

Behav. Med. Pract. Policy Res.

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“…Although the 12% increase in consumption in this study is fairly modest, even small changes in behaviors like diet and exercise have been shown to have meaningful health benefits (72). We also note that the intervention itself was very modest-just one exposure to guidelines a month before the choice task.…”

Section: Case Study: Evolution Of Nutrition Guidelinesmentioning

confidence: 63%

Communicating science-based recommendations with memorable and actionable guidelines

Ratner

Riis

2014

Proc. Natl. Acad. Sci. U.S.A.

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For many domains of basic and applied science, a key set of scientific facts is well established and there is a need for public action in light of those facts. However, individual citizens do not consistently follow science-based recommendations, even when they accept the veracity of the advice. To address this challenge, science communicators need to develop a guideline that individuals can commit to memory easily and act on straightforwardly at moments of decision. We draw on research from psychology to discuss several characteristics that will enhance a guideline's memorability and actionability and illustrate using a case study from the US Department of Agriculture's communications based on nutrition science. We conclude by discussing the importance of careful research to test whether any given guideline is memorable and actionable by the intended target audience.cognitive psychology | consumer behavior | social psychology I n many domains of basic and applied science, a key set of scientific facts is well-established, and there is a need for public action in light of those facts. And yet, individual citizens do not consistently follow science-based recommendations, even when they accept the veracity of the advice. The complexity of daily life and the limited capacity of the human mind prevent important science-based recommendations from getting the intended behavior change. To address this challenge, we argue that a specific type of communication tool is needed to promote a scientific field's most important recommendations. In this review paper, we refer to this tool as the memorable and actionable guideline.Because of the cognitive limitations of memory and attention that we review in this article, science-based recommendations must be focused on influencing the moments when key consumer decisions are likely to be made. People do what they do in their daily lives, and communications should be structured so that they can influence particular key moments, whether it is food choices at mealtime, energy use at home in the evening, intervening when you see a friend about to do something dangerous, etc. Recommendations must be memorable at those key moments and must be usable/actionable at those key moments.The challenge of getting people to take action is one that has interested psychologists and communications experts for decades. Research on attitude change demonstrates that persuasive communications need to convince people that the scientific facts are credible and that the science-based recommendations are sound. However, even once the audience is convinced that the facts and recommendations are legitimate, behavior change will not necessarily follow. For example, even though most Americans think it is important to be ready for emergencies, only a minority have taken the necessary actions to be prepared for a disaster (1). Science communicators need to activate people's behaviors to incorporate the science-based recommendations into their lives. Given this major challenge, considerable research in fields ra...

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“…The first objective was to develop the Aspiring to Lifelong Health (ASPIRE) Coaching Fidelity Checklist (ACFC) to measure and report fidelity in the delivery of a weight management intervention. ASPIRE is an evidence-based treatment weight management program using a small changes approach that has been shown to be effective in several previous studies across 3, 6, 9, and 12 months [16][17][18]. The measure for the present study was developed and tested based on the largest and most recent study completed to date with 12-month outcomes.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of the ASPIRE-VA coaching fidelity checklist (ACFC): a tool to help ensure delivery of high-quality weight management interventions

Damschroder

Goodrich

Kim

et al. 2015

Behav. Med. Pract. Policy Res.

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Practical and valid instruments are needed to assess fidelity of coaching for weight loss. The purpose of this study was to develop and validate the ASPIRE Coaching Fidelity Checklist (ACFC). Classical test theory guided ACFC development. Principal component analyses were used to determine item groupings. Psychometric properties, internal consistency, and inter-rater reliability were evaluated for each subscale. Criterion validity was tested by predicting weight loss as a function of coaching fidelity. The final 19-item ACFC consists of two domains (session process and session structure) and five subscales (sets goals and monitor progress, assess and personalize self-regulatory content, manages the session, creates a supportive and empathetic climate, and stays on track). Four of five subscales showed high internal consistency (Cronbach alphas>0.70) for group-based coaching; only two of five subscales had high internal reliability for phone-based coaching. All five sub-scales were positively and significantly associated with weight loss for group-but not for phone-based coaching. The ACFC is a reliable and valid instrument that can be used to assess fidelity and guide skill-building for weight management interventionists.

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Small Changes in Nutrition and Physical Activity Promote Weight Loss and Maintenance: 3-Month Evidence from the ASPIRE Randomized Trial

Abstract: More modest behavioral changes are capable of promoting weight loss, decreasing adiposity markers and sustaining these changes over 3 months. Longer-term studies comparing this approach with traditional behavioral weight loss treatments are warranted.

Cited by 94 publications

References 17 publications

Developing a new treatment paradigm for disease prevention and healthy aging

Developing a new treatment paradigm for disease prevention and healthy aging

Communicating science-based recommendations with memorable and actionable guidelines

Development and validation of the ASPIRE-VA coaching fidelity checklist (ACFC): a tool to help ensure delivery of high-quality weight management interventions

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