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      The Primary Results of the Treating Adult Smokers at Risk for Weight Gain with Interactive Technology (TARGIT) Study

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          Abstract

          Objective

          To evaluate whether a behavioral weight management program combined with a smoking cessation program delivered via interactive technology could prevent post-cessation weight gain.

          Methods

          330 young adult smokers age 18 to 35 were randomized to a smoking cessation program alone (Comparison group) that included behavioral counseling and nicotine replacement or to a behavioral weight management program adapted from the Look AHEAD trial plus the same smoking cessation program (Intervention group).

          Results

          TARGIT randomized 164 to the Comparison and 166 to the Intervention group respectively. On average the participants gained +0.91 kg after 24 months in the trial (Comparison group +1.45 kg and Intervention group +0.32, p = 0.157). The only variable systematically affecting weight change over time was smoking abstinence, where those that were abstinent on average gained 0.14 kg more per month compared to those who continued to smoke (p < 0.001). In exploratory analyses, the Intervention participants who were abstinent at 6 months had numerically smaller weight gains compared to abstinent Comparison participants, but these differences were not statistically significant.

          Conclusions

          Providing an intensive weight gain prevention program combined with a smoking cessation program via interactive technology was not associated with greater long-term weight gain prevention.

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          Most cited references27

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          Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001.

          Obesity and diabetes are increasing in the United States. To estimate the prevalence of obesity and diabetes among US adults in 2001. Random-digit telephone survey of 195 005 adults aged 18 years or older residing in all states participating in the Behavioral Risk Factor Surveillance System in 2001. Body mass index, based on self-reported weight and height and self-reported diabetes. In 2001 the prevalence of obesity (BMI > or =30) was 20.9% vs 19.8% in 2000, an increase of 5.6%. The prevalence of diabetes increased to 7.9% vs 7.3% in 2000, an increase of 8.2%. The prevalence of BMI of 40 or higher in 2001 was 2.3%. Overweight and obesity were significantly associated with diabetes, high blood pressure, high cholesterol, asthma, arthritis, and poor health status. Compared with adults with normal weight, adults with a BMI of 40 or higher had an odds ratio (OR) of 7.37 (95% confidence interval [CI], 6.39-8.50) for diagnosed diabetes, 6.38 (95% CI, 5.67-7.17) for high blood pressure, 1.88 (95% CI,1.67-2.13) for high cholesterol levels, 2.72 (95% CI, 2.38-3.12) for asthma, 4.41 (95% CI, 3.91-4.97) for arthritis, and 4.19 (95% CI, 3.68-4.76) for fair or poor health. Increases in obesity and diabetes among US adults continue in both sexes, all ages, all races, all educational levels, and all smoking levels. Obesity is strongly associated with several major health risk factors.
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            Global physical activity questionnaire (GPAQ): nine country reliability and validity study.

            Instruments to assess physical activity are needed for (inter)national surveillance systems and comparison. Male and female adults were recruited from diverse sociocultural, educational and economic backgrounds in 9 countries (total n = 2657). GPAQ and the International Physical Activity Questionnaire (IPAQ) were administered on at least 2 occasions. Eight countries assessed criterion validity using an objective measure (pedometer or accelerometer) over 7 days. Reliability coefficients were of moderate to substantial strength (Kappa 0.67 to 0.73; Spearman's rho 0.67 to 0.81). Results on concurrent validity between IPAQ and GPAQ also showed a moderate to strong positive relationship (range 0.45 to 0.65). Results on criterion validity were in the poor-fair (range 0.06 to 0.35). There were some observed differences between sex, education, BMI and urban/rural and between countries. Overall GPAQ provides reproducible data and showed a moderate-strong positive correlation with IPAQ, a previously validated and accepted measure of physical activity. Validation of GPAQ produced poor results although the magnitude was similar to the range reported in other studies. Overall, these results indicate that GPAQ is a suitable and acceptable instrument for monitoring physical activity in population health surveillance systems, although further replication of this work in other countries is warranted.
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              The Look AHEAD study: a description of the lifestyle intervention and the evidence supporting it.

              The Look AHEAD (Action for Health in Diabetes) study is a multicenter, randomized controlled trial designed to determine whether intentional weight loss reduces cardiovascular morbidity and mortality in overweight individuals with type 2 diabetes. The study began in 2001 and is scheduled to conclude in 2012. A total of 5145 participants have been randomly assigned to a lifestyle intervention or to an enhanced usual care condition (i.e., diabetes support and education). This article describes the lifestyle intervention and the empirical evidence to support it. The two principal intervention goals are to induce a mean loss >or = 7% of initial weight and to increase participants' moderately intense physical activity to > or =175 min/wk. For the first 6 months, participants attend one individual and three group sessions per month and are encouraged to replace two meals and one snack a day with liquid shakes and meal bars. From months 7 to 12, they attend one individual and two group meetings per month and continue to replace one meal per day (which is recommended for the study's duration). Starting at month 7, more intensive behavioral interventions and weight loss medication are available from a toolbox, designed to help participants with limited weight loss. In Years 2 to 4, treatment is provided mainly on an individual basis and includes at least one on-site visit per month and a second contact by telephone, mail, or e-mail. After Year 4, participants are offered monthly individual visits. The intervention is delivered by a multidisciplinary team that includes medical staff who monitor participants at risk of hypoglycemic episodes.
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                Author and article information

                Journal
                101264860
                32902
                Obesity (Silver Spring)
                Obesity (Silver Spring)
                Obesity (Silver Spring, Md.)
                1930-7381
                1930-739X
                27 July 2017
                October 2017
                01 October 2018
                : 25
                : 10
                : 1691-1698
                Affiliations
                [1 ]Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
                [2 ]Department of Counseling, Educational Psychology and Research, University of Memphis, Memphis, TN
                Author notes
                Corresponding Author: Karen C. Johnson, MD, MPH, Professor and Endowed Professor of Women’s Health, University of Tennessee Health Science Center, Department of Preventive Medicine, 66 N. Pauline, suite 633, Memphis, TN 38163, kjohnson@ 123456uthsc.edu
                Article
                NIHMS895817
                10.1002/oby.21968
                5679058
                28948720
                735b09e8-1551-425f-9fd2-c2ae334f9744

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                Categories
                Article

                Medicine
                weight gain,smoking cessation,interactive technology
                Medicine
                weight gain, smoking cessation, interactive technology

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