Preventing Weight Gain One-Year Results of a Randomized Lifestyle Intervention: one-year results of a randomized lifestyle intervention

Background: Lifestyle interventions targeting prevention of weight gain may have better long-term success than when aimed at weight loss. Limited evidence exists about such an approach in the primary care setting. Design: An RCT was conducted. Setting/Participants were 457 overweight or obese patients (BMI=25-40 kg/m(2), mean age 56 participants: years, 52% women) with either hypertension or dyslipidemia, or both, from 11 general practice locations in the Netherlands. Intervention: In the intervention group, four individual visits to a nurse practitioner (NP) and one feedback session by telephone were scheduled for lifestyle counseling with guidance of the NP using a standardized computerized software program. The control group received usual care from their general practitioner (GP). Main outcome measures: Changes in body weight, waist circumference, blood pressure, and blood lipids after 1 year (dropout Results: There were more weight losers and stabilizers in the NP group than in the general practitioner usual care (GP-UC) group (77% vs 65%; p Conclusions: Standardized computer-guided counseling by NPs may be an effective strategy to support weight-gain prevention and weight loss in primary care, in the current trial, particularly among men

Skin autofluorescence as proxy of tissue AGE accumulation is dissociated from SCORE cardiovascular risk score, and remains so after 3 years

Background: Skin autofluorescence (SAF), as a proxy of AGE accumulation, is predictive of cardiovascular (CVD) complications in i.a. type 2 diabetes mellitus and renal failure, independently of most conventional CVD risk factors. The present exploratory substudy of the Groningen Overweight and Lifestyle (GOAL)-project addresses whether SAF is related to Systematic COronary Risk Evaluation (SCORE) risk estimation (% 10-year CVD-mortality risk) in overweight/obese persons in primary care, without diabetes/renal disease, and if after 3-year treatment of risk factors (change in, Delta) SAF is related to Delta SCORE. Methods: In a sample of 65 participants from the GOAL study, with a body mass index (BMI) >25-40 kg/m(2), hypertension and/or dyslipidemia, but without diabetes/renal disease, SAF and CVD risk factors were measured at baseline, and after 3 years of lifestyle and pharmaceutical treatment. Results: At baseline, the mean SCORE risk estimation was 3.1 +/- 2.6%, mean SAF 2.04 +/- 0.5AU. In multivariate analysis SAF was strongly related to age, but not to other risk factors/SCORE. After 3 years Delta SAF was 0.34 +/- 0.45 AU (p Conclusions: Baseline and 3-year-Delta SAF are not related to (Delta) SCORE, or its components, except age, in the studied population. Delta SAF was negatively related to Delta weight. As 3-year SAF was higher in persons with CVD, these results support a larger study on SAF to assess its contribution to conventional risk factors/SCORE in predicting CVD in overweight persons with low-intermediate cardiovascular risk

Randomized trial of a lifestyle program in obese infertile women

BACKGROUND: Small lifestyle-intervention studies suggest that modest weight loss increases the chance of conception and may improve perinatal outcomes, but large randomized, controlled trials are lacking. METHODS: We randomly assigned infertile women with a body-mass index (the weight in kilograms divided by the square of the height in meters) of 29 or higher to a 6-month lifestyle intervention preceding treatment for infertility or to prompt treatment for infertility. The primary outcome was the vaginal birth of a healthy singleton at term within 24 months after randomization. RESULTS: We assigned women who did not conceive naturally to one of two treatment strategies: 290 women were assigned to a 6-month lifestyle-intervention program preceding 18 months of infertility treatment (intervention group) and 287 were assigned to prompt infertility treatment for 24 months (control group). A total of 3 women withdrew consent, so 289 women in the intervention group and 285 women in the control group were included in the analysis. The discontinuation rate in the intervention group was 21.8%. In intention-to-treat analyses, the mean weight loss was 4.4 kg in the intervention group and 1.1 kg in the control group (