Objectively Assessed Physical Activity and Weight Loss Maintenance among Individuals Enrolled in a Lifestyle Intervention

Abstract

Objective: To examine the relationship between objectively assessed moderate-to-vigorous intensity physical activity (MVPA) and 4-year weight loss (WL) and WL maintenance among individuals with diabetes enrolled in the Look AHEAD trial.

Methods: MVPA was measured in a subgroup of lifestyle intervention participants with accelerometry data at baseline and at 1 and 4 years (n = 553; age: 59.7 ± 6.8 y; BMI: 35.5 ± 5.9 kg/m² ). Minutes per week of bout-related MVPA were calculated (≥ 3 metabolic equivalents, ≥ 10-min bouts), and adherence to the national physical activity (PA) recommendation for WL maintenance (≥ 250 min/wk) was assessed.

Results: Independent of 1-year WL, 4-year MVPA (β = -0.003, SE = 0.002, P = 0.006), but not 1-year MVPA (β = 0.0001, SE = 0.001, P = 0.50), was significantly associated with 4-year WL. Compared with "nonmaintainers" (≥ 10% WL at year 1, but < 10% at year 4; n = 132), WL maintainers (≥ 10% WL at years 1 and 4; n = 103) had higher MVPA at year 1 (253.4 ± 251.8 vs. 163.9 ± 158.2 min/wk, P = 0.002) and year 4 (155.3 ± 180.6 vs. 111.4 ± 154.5 min/wk, P = 0.046). Although 38.8% and 22.3% of WL maintainers engaged in ≥ 250 min/wk at years 1 and 4, respectively, many engaged in < 150 min/wk (year 1: 41%, year 4: 61%).

Conclusions: Higher weekly MVPA is associated with greater long-term WL and weight maintenance; however, many individuals are able to maintain ≥ 10% WL while engaging in little MVPA.

Trial registration: ClinicalTrials.gov NCT00017953.

Figure 1

a: Percent weight change at 1 year, stratified by 1-year MVPA levels (Aim 1) b: Percent weight change at 4 years, stratified by 4-year MVPA levels (Aim 2) Physical activity categories based upon minutes/week of bout-related MVPA at Year 1 (a) and Year 4 (b). Overall p-value represents a group effect for categorized MVPA. Values with different superscripts indicate that groups are significantly different from one another. a. Percent weight change at 1 year, stratified by 1-year MVPA levels (Aim 1), b. Percent weight change at 4 years, stratified by 4-year MVPA levels (Aim 2)

Figure 2

a: Aim 3: Percentage of participants maintaining or not maintaining weight loss from years 1-4, stratified by MVPA levels at year 1 b: Aim 3: Percentage of participants maintaining or not maintaining weight loss from years 1-4, stratified by MVPA levels at year 4 Maintain: ≥10% weight loss at Year 1 and Year 4; Non-maintain: ≥10% weight loss at Year 1 and <10% weight loss at Year 4. Overall p-value represents whether the distribution of participants falling into the various PA categories differs between weight loss Maintainers and Non-maintainers. * indicates that the percentage of Maintain participants falling within a particular MVPA category is significantly different from the percentage of Non-maintain participants falling into that category. a. Aim 3: Percentage of participants maintaining or not maintaining weight loss from years 1-4, stratified by MVPA levels at year 1, b. Aim 3: Percentage of participants maintaining or not maintaining weight loss from years 1-4, stratified by MVPA levels at year 4