The clinical trial of Women On the Move through Activity and Nutrition (WOMAN) study

Kuller, Lewis H.; Kriska, Andrea M.; Kinzel, Laura S.; Simkin‐Silverman, Laurey R.; Sutton-Tyrrell, Kim; Johnson, B. Delia; Conroy, Molly B.

doi:10.1016/j.cct.2006.10.009

Cited by 32 publications

(63 citation statements)

References 76 publications

(46 reference statements)

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“…There were 12 designated topics for the sessions (Online Appendix Table A), led by the study physician (MBC), who was also a provider at the practice, or one of two PhD-level interventionists (KLS, KCS) not affiliated with the practice. The content focused on physical activity, diet, and stress relief adapted from a lifestyle intervention for premenopausal and postmenopausal women 13,16,17 as well as portions of the Diabetes Prevention Program (DPP). 18 Participants were given PA and dietary goals similar to those given in the DPP, with target calorie and fat gram goals based on starting weight and a PA goal of at least 150 min of moderate PA per week.…”

Section: Interventionsmentioning

confidence: 99%

“…Waist Circumference, measured using a non-stretch tape measure marked in centimeters. Blood pressure, measured averaging three readings collected using a written protocol 13 by trained staff using manual blood pressure cuffs (Welch Allyn).…”

Section: Secondary Outcomesmentioning

confidence: 99%

“…13 Physical Activity was measured using the one-month version of the Modifiable Activity Questionnaire (MAQ), administered by a trained, certified staff member. We focused on leisure activity estimates, because our intervention was designed to target leisure PA. 13 PA levels were calculated as the product of the duration and frequency of each activity (in hours per week), weighted by an estimate of the metabolic equivalent (MET) of that activity and summed for all activities performed. PA data were expressed as metabolic equivalent hours per week (MET-hour/week).…”

Section: Primary Outcomesmentioning

confidence: 99%

“…13,14 We conducted a randomized, controlled trial of a PA and weight loss intervention for overweight and obese, inactive women, delivered in coordination with primary care. We hypothesized that an interventionist-led (IL), primary carebased PA and weight loss intervention would increase PA levels and decrease weight to a greater degree than a selfguided (SG) program in the short-term (3 month) and longterm (12 months).…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of a Physical Activity and Weight Loss Intervention for Middle-Aged Women: Healthy Bodies, Healthy Hearts Randomized Trial

et al. 2014

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BACKGROUND: Physical inactivity is a significant risk factor for cardiovascular disease and remains highly prevalent in middle-aged women. OBJECTIVE: We hypothesized that an interventionist-led (IL), primary-care-based physical activity (PA) and weight loss intervention would increase PA levels and decrease weight to a greater degree than a self-guided (SG) program. DESIGN: We conducted a randomized trial. PARTICIPANTS: Ninety-nine inactive women aged 45-65 years and with BMI ≥ 25 kg/m 2 were recruited from three primary care clinics. INTERVENTIONS:The interventionist-led (IL) group (n=49) had 12 weekly sessions of 30 min discussions with 30 min of moderate-intensity PA. The self-guided (SG) group (n=50) received a manual for independent use. MAIN MEASURES: Assessments were conducted at 0, 3, and 12 months; PA and weight were primary outcomes. Weight was measured with a standardized protocol. Leisure PA levels were assessed using the Modifiable Activity Questionnaire. Differences in changes by group were analyzed with a t-test or Wilcoxon rank-sum test. Mixed models were used to analyze differences in changes of outcomes by group, using an intention-to-treat principle. KEY RESULTS: Data from 98 women were available for analysis. At baseline, mean (SD) age was 53.9 (5.4) years and 37 % were black. Mean weight was 92.3 (17.7) kg and mean BMI was 34.7 (5.9) kg/m 2 . Median PA level was 2.8 metabolic equivalent hours per week (MET-hour/week) (IQR 0.0, 12.0). At 3 months, IL women had a significantly greater increase in PA levels (7.5 vs. 1.9 MET-hour/week; p=0.02) than SG women; there was no significant difference in weight change. At 12 months, the difference between groups was no longer significant (4.7 vs. 0.7 MET-hour/week; p = 0.38). Mixed model analysis showed a significant (p=0.048) difference in PA change between groups at 3 months only. CONCLUSIONS:The IL intervention was successful in increasing the physical activity levels of obese, inactive middle-aged women in the short-term. No significant changes in weight were observed.

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Section: Interventionsmentioning

confidence: 99%

Section: Secondary Outcomesmentioning

confidence: 99%

Section: Primary Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effectiveness of a Physical Activity and Weight Loss Intervention for Middle-Aged Women: Healthy Bodies, Healthy Hearts Randomized Trial

et al. 2014

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“…Since the initial evaluation of the MAQ (3) , the past-year component of the MAQ has been widely used in epidemiological studies (5)(6)(7)(8) , including the Woman On the Move through Activity and Nutrition (WOMAN) study, a clinical trial of early postmenopausal women (5,(9)(10)(11) . However, physical activity questionnaires that utilize a longer time frame may be limited by inaccurate participant recall (12) and poor temporal relationship between one's past-year physical activity and current physical activity status (13) .…”

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confidence: 99%

Reliability and convergent validity of the past-week Modifiable Activity Questionnaire

Gabriel

McClain

Schmid

et al. 2010

Public Health Nutr.

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Objective: To examine the reliability and convergent validity of physical activity (PA) and inactivity estimates obtained with the past-week Modifiable Activity Questionnaire (PWMAQ). Design: The PWMAQ, an interviewer-administered questionnaire, was administered twice, one week apart, during visits 3 and 4 of six total visits. Intra-class correlation coefficients (ICC) between administrations of the PWMAQ were used to assess the reliability of summary estimates. Spearman rank-order correlation coefficients (r) were used to examine the associations of PWMAQ summary estimates with temporally matched and averaged accelerometer data in all participants and then stratified by whether the data were reflective of usual PA. Setting: Data were obtained from the Evaluation of Physical Activity Measures in Middle-Aged Women (PAW) study. Subjects: Sixty-six women, mean age 52?6 (SD 5?4) years. Results: The reliability of the PWMAQ physical inactivity estimate suggested substantial agreement over one week (ICC 5 0?77, 95 % CI 0?57, 0?82; P , 0?0001). With the exception of light-intensity PA, the PWMAQ leisure PA estimate was significantly associated with averaged accelerometer data (r 5 0?33-0?76; P , 0?05). For both temporally matched and averaged accelerometer data, correlation coefficients were higher between the PWMAQ estimate and moderatewalk-to vigorous-intensity PA in those who indicated that reported activity was reflective of usual PA; however, the association with moderate-lifestyle-intensity PA was higher in those reporting that data were not reflective. Conclusions: The PWMAQ is a reliable and valid measure of leisure PA levels in middle-aged women and supports subsequent studies evaluating this questionnaire in other population subgroups. Keywords Psychometrics Self-report Physical activity WomenFor decades, researchers have been interested in detecting and quantifying physical activity-related energy expenditure in order to examine the relationship between physical activity and health-related outcomes. If researchers are interested in measuring movement, rather than physical activity behaviour, then objective activity monitors (i.e. accelerometers) are optimal. However, objective measures may not be appropriate for all research applications due to the lack of contextual information (i.e. activity type) that they provide. Thus, subjective measures are still needed to estimate participants' physical activity levels in settings where objective methods may not provide meaningful information to appropriately address study objectives.Self-report measures of physical activity have their own set of limitations, however, that can undermine the precision of the derived estimate (e.g. recall bias, language and educational barriers). Further, the overall quality of many commonly used physical activity questionnaires, including the reproducibility and validity of computed summary estimates (i.e. MET?h/week), is often not well understood in middle-aged women. Furthermore, most questionnaires used in epidemiological s...

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Reduced or modified dietary fat for preventing cardiovascular disease

Hooper

Summerbell

Thompson

et al. 2011

Cochrane Database of Systematic Reviews

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Background Reduction and modification of dietary fats have differing effects on cardiovascular risk factors (such as serum cholesterol), but their effects on important health outcomes are less clear. Objectives To assess the effect of reduction and/or modification of dietary fats on mortality, cardiovascular mortality, cardiovascular morbidity and individual outcomes including myocardial infarction, stroke and cancer diagnoses in randomised clinical trials of at least 6 months duration. Search methods For this review update, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE, were searched through to June 2010. References of Included studies and reviews were also checked. Selection criteria Trials fulfilled the following criteria: 1) randomised with appropriate control group, 2) intention to reduce or modify fat or cholesterol intake (excluding exclusively omega-3 fat interventions), 3) not multi factorial, 4) adult humans with or without cardiovascular disease, 5) intervention at least six months, 6) mortality or cardiovascular morbidity data available. Data collection and analysis Participant numbers experiencing health outcomes in each arm were extracted independently in duplicate and random effects meta-analyses, meta-regression, sub-grouping, sensitivity analyses and funnel plots were performed. Main results This updated review suggested that reducing saturated fat by reducing and/or modifying dietary fat reduced the risk of cardiovascular events by 14% (RR 0.86, 95% CI 0.77 to 0.96, 24 comparisons, 65,508 participants of whom 7% had a cardiovascular event, I2 50%). Subgrouping suggested that this reduction in cardiovascular events was seen in studies of fat modification (not reduction - which related directly to the degree of effect on serum total and LDL cholesterol and triglycerides), of at least two years duration and in studies of men (not of women). There were no clear effects of dietary fat changes on total mortality (RR 0.98, 95% CI 0.93 to 1.04, 71,790 participants) or cardiovascular mortality (RR 0.94, 95% CI 0.85 to 1.04, 65,978 participants). This did not alter with sub-grouping or sensitivity analysis. Few studies compared reduced with modified fat diets, so direct comparison was not possible. Authors’ conclusions The findings are suggestive of a small but potentially important reduction in cardiovascular risk on modification of dietary fat, but not reduction of total fat, in longer trials. Lifestyle advice to all those at risk of cardiovascular disease and to lower risk population groups, should continue to include permanent reduction of dietary saturated fat and partial replacement by unsaturates. The ideal type of unsaturated fat is unclear.

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The clinical trial of Women On the Move through Activity and Nutrition (WOMAN) study

Cited by 32 publications

References 76 publications

Effectiveness of a Physical Activity and Weight Loss Intervention for Middle-Aged Women: Healthy Bodies, Healthy Hearts Randomized Trial

Effectiveness of a Physical Activity and Weight Loss Intervention for Middle-Aged Women: Healthy Bodies, Healthy Hearts Randomized Trial

Reliability and convergent validity of the past-week Modifiable Activity Questionnaire

Reduced or modified dietary fat for preventing cardiovascular disease

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