Objectively-assessed physical activity and weight change in young adults: a randomized controlled trial

Abstract

Background: Reductions in physical activity (PA) are common throughout young adulthood and low PA is associated with weight gain. The SNAP Trial previously reported that two self-regulation approaches to weight gain prevention reduced weight gain over a 2-year period in 18-35 year olds. Presented here are secondary analyses examining changes in PA and the relationship between PA and weight change over 2 years.

Methods: 599 young adults (age: 27.4 ± 4.4 yrs.; BMI: 25.4 ± 2.6 kg/m²) were randomly assigned to 1 of 3 treatment arms: Small Changes (reduce calorie intake by 100 kcals/day & add 2000 steps/day), Large Changes (lose 2.3-4.5 kg initially & increase PA to ≥250 min/wk), or Self-guided (control condition). Small and Large Changes received 10, face-to-face group sessions (months 1-4), and two 4-week refresher courses each subsequent year. Body weight and PA were objectively-measured at baseline, 4 months, 1 and 2 years. Daily steps and bout-related moderate-to-vigorous intensity PA (MVPA: ≥3 METs, ≥10-min bouts) was calculated.

Results: Changes in bout-related MVPA and daily steps did not differ among treatment groups over the 2-year period (p's > 0.16). Collapsed across groups, participants gaining >1 lb. (n = 187; 39.6%) had smaller changes in bout-related MVPA at 4 months, 1 and 2 years relative to those maintaining or losing weight (≤1 lb. weight gain; n = 282, 60.4%, p's < 0.05). Averaged across time points, this difference equated to 47.8 min/week. Those gaining and not gaining >1 lb. did not differ on daily steps (p's > 0.10). Among participants engaging in ≥250 min/wk. of MVPA at 2 years (n = 181), 30% gained >1 lb. from baseline to 2 years, which was not different from those engaging in 150-250 min/wk. (n = 87; 36%; p = 0.40), but this percentage was significantly lower when compared to those engaging in <150 min/wk. (n = 176; 49%; p < 0.001).

Conclusions: On average, PA differences were not observed between young adults assigned to small or large changes self-regulation interventions to prevent weight gain. Regardless of group assignment, higher levels of MVPA were associated with better weight gain prevention over 2 years. Our data suggest that achieving >150 min/week of MVPA is needed for weight gain prevention and that increasing MVPA, rather than steps, should be targeted.

Trial registration: www.clinicaltrials.gov (NCT01183689). Registered Aug 13, 2010.

Keywords: Body weight; Exercise; Physical activity; Weight gain; Young adulthood.

Fig. 1

a Title: Categorization of participants based upon achievement of ≥250 min/week at 4 months and 2 years. a Legend: ‘Non-adopt’: <250 min/week at 4 months and 2 years; ‘Late adopt’: <250 min/week at 4 months, but ≥250 min/week at 2 years; ‘Maintain’: ≥250 min/week at 4 months and 2 years; ‘Non-maintain’: ≥250 min/week at 4 months but <250 min/week at 2 years. Model adjusts for clinic, gender, race, dietary intake, baseline weight, and baseline PA. b Title: Categorization of participants based upon achievement of ≥2000 steps/day above baseline at 4 months and 2 years. b Legend: Non- adopt: <2000 step increase above baseline at 4 months and 2 years; Late Adopt: <2000 step increase above baseline at 4 months but > = 2000 step increase at 2 years; Maintain: > = 2000 step increase above baseline steps at 4 months and 2 years; Non-maintain: > = 2000 step increase above baseline at 4 months and <2000 step increase above baseline at 2 years. Model adjusts for clinic, gender, race, dietary intake, baseline weight, and baseline steps

Fig. 2

Flow of participants through the study