NHLBI Study Tests Novel Ways To Help Americans Keep Weight Off
The National Heart, Lung, and Blood Institute (NHLBI) today announced
the launch of a major study that could help solve one of the hardest
aspects of weight loss–keeping off lost pounds. The study,
called the “Weight Loss Maintenance Trial,” will be
done in two phases at four clinical sites.
The study will include 1,600 men and women in its first phase, and
800 in its second. Phase I is a 5-month weight loss program; phase
II will try to help those who lose 9 or more pounds in phase I keep
the weight off for 2 ½ years.
The study has begun seeking participants, who must be overweight
or obese, age 25 or older, and taking medication to control high
blood pressure and/or high blood cholesterol. About 60 percent will
be women and 40 percent will be African American.
“Maintaining weight loss is a critical element in the struggle
against overweight and obesity, which have reached epidemic proportions
in the United States,” said NHLBI Director Dr. Claude Lenfant.
“Two of every three adults are overweight or obese. This study
could yield answers that can help many Americans lead healthier
lives.”
“Americans have shown that they can lose weight in the short-term,”
said Dr. Laura Svetkey, Director of the Duke Hypertension Center
and of Clinical Research at the Sarah Stedman Nutrition and Metabolism
Center at Duke University in Durham, NC, and lead investigator in
the study. “Yet, only a small proportion of them achieve long-term
weight control. To successfully fight the obesity epidemic, clinicians
and other health care providers must have options that are effective
and feasible for a broad range of people.
“The best weight-loss strategy will not only lead to long-term
weight control, but also achieve it by establishing a healthy dietary
pattern and physical activity routine that lasts a lifetime,”
she added.
Overweight/obesity is the second leading cause of preventable death
in the United States. Overweight and obesity increase the risk of
heart disease and other conditions, including high blood pressure,
high blood cholesterol, diabetes, stroke, and some cancers.
About 65 percent of American adults–about 129 million persons–are
overweight or obese, and the prevalence is increasing. In 1988-94,
almost 60 percent of American adults were overweight or obese, while
in 1999-2000, nearly 65 percent were overweight or obese.
The four centers involved in the Weight Loss Maintenance study are:
Duke University; Pennington Biomedical Research Center at Louisiana
State University in Baton Rouge; Kaiser Permanente Center for Health
Research (KPCHR) in Portland, OR; and The Johns Hopkins Medical
Institutions in Baltimore, MD. KPCHR also serves as the study’s
coordinating center.
In the study’s first phase, participants will receive counseling
to help them make lifestyle changes to reduce their weight. These
lifestyle changes will include reducing calories and increasing
physical activity. Participants will be encouraged to follow the
DASH eating plan, which has been shown to reduce blood pressure
and cholesterol. DASH is high in fiber and low in saturated fat,
cholesterol, and total fat, and emphasizes fruits, vegetables, and
lowfat dairy foods. Phase I participants will keep food and fitness
diaries to monitor their diet and physical activity. Those who lose
9 or more pounds after 5 months will be eligible to enroll in phase
II.
In phase II, participants will be randomly assigned to one of three
weight-maintenance strategies: self-directed/usual care (SD/UC);
personal contact (PC); and interactive technology (IT). The SD/UC
group will meet once with a health counselor for advice on how to
maintain their weight loss and to discuss their own weight loss
plans. They also will receive educational materials about diet and
physical activity.
Those in the PC group will receive personal guidance and counseling
on how to maintain their weight loss through monthly telephone calls
and occasional visits with a health counselor.
Participants in the IT group will use an Internet-based, individually
tailored, interactive computer program to help them keep their weight
off. They can use the program as often as they wish and can log
on anywhere they have Internet access: at home, work, a school,
or a public library. They also will receive weekly e-mails with
tailored messages on their progress that include links to the Web
site. Further, they will receive reminders by an interactive voice
phone system to log onto the study’s Web site and respond
to e-mail.
“The study will compare these two methods with the self-directed/usual
care group,” said Svetkey. “The study involves a large,
diverse group of overweight and obese people, and will determine
the impact of these maintenance strategies on their weight and heart
disease risk factors. It also will see if the strategies have other
effects, such as on participants’ quality of life.”
“The Surgeon General, the Secretary of Health and Human Services,
the medical community–everyone recommends that Americans maintain
a healthy weight,” said Dr. Eva Obarzanek, NHLBI nutritionist
and project officer for the Weight Loss Maintenance study. “But
very few people become ‘successful long-term losers.’
This study will test two behavioral methods to help people keep
lost weight off for the rest of their lives, especially people who
are at a high risk of developing heart disease and other serious
conditions.”
Those interested in finding out about enrolling in the study can
call the site near them: for Duke University, (919) 419-5904; for
Pennington, (225) 763-2596; for Kaiser Permanente, (503) 499-5766;
for Johns Hopkins, (410) 281-1881.
To arrange an interview with an NHLBI scientist, contact the Institute's
Communications Office at (301) 496-4236. Study investigators also
are available for interviews: For Svetkey, contact Jeffrey Molter
at the Duke University Medical Center Press Office at (919) 660-4148;
for Dr. Lawrence Appel, Professor of Medicine at Johns Hopkins,
contact Karen Blum in the Office of Communications and Public Affairs
at (410) 955-1534 or email her at kblum@jhmi.edu; for Dr. Patricia
J. Elmer, Senior Investigator at Kaiser Permanente, contact Terry
Fitzpatrick at the Communications Office at (503) 335-6602 or email
him at terry.fitzpatrick@kpchr.org; and for Dr. Phillip J. Brantley,
Chief of Primary Care Research and Director of the Division of Educational
Programs at Pennington, contact Alan Pesch in the Communications
Office at (225) 763-2500.
NHLBI press releases and other materials, including an “Aim
For A Healthy Weight” Web page, are available online at www.nhlbi.nih.gov
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