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Biomedical subjects

Rena R Wing

Publications and source records attributed to Rena R Wing.

At least 19 recordsLinked to original sources
PubMed2006

Effect of limiting snack food variety across days on hedonics and consumption.

Decreased variety within a meal reduces intake, which is hypothesized to be due to sensory-specific satiety. This study examined whether reduced variety across days also influences food hedonics and intake. Twenty-one, non-obese, college-aged, dietarily unrestrained males were randomized to one of two conditions: a Same Snack condition in which they were given the same sweet snack food (crumb cake) to eat in four laboratory sessions and to take home and eat between sessions, or a Variety condition in which they were given different snack foods (both sweet and salty) to eat in four sessions and to take home and eat between sessions. Dependent measures were caloric intake from crumb cake and hedonic ratings of snack foods in sessions 1 and 4. Mixed repeated measures analysis of variance found no effect of snack food variety on consumption. However, the Same Snack condition had a lower hedonic rating of the crumb cake on Day 4 than the Variety condition and the change from day 1 to 4 in hedonics of the crumb cake was greater than that of the salty snack foods in the Same Snack condition. These findings indicate that limiting variety across several days reduces hedonics of the limited food.

Adult↗
PubMed2006

Are the eating and exercise habits of successful weight losers changing?

OBJECTIVE: The purpose of this study was to examine whether the diet and exercise behaviors of successful weight losers entering the National Weight Control Registry (NWCR) have changed between 1995 and 2003. RESEARCH METHOD AND PROCEDURES: Participants (N = 2708) were members of the NWCR who enrolled in intermittent years since 1995. Participants had lost an average of 33.1 kg and maintained a 13.6-kg loss for 5.8 years before enrollment. Evaluations of diet and physical activity were conducted at entry into the NWCR and prospectively over 1 year. RESULTS: From 1995 to 2003, the daily percentage of calories from fat increased from 23.8% to 29.4%, saturated fat intake increased from 12.3 to 154.0 g/d, and calories from carbohydrate decreased from 56.0% to 49.3% (p < 0.0001). The proportion consuming <90 grams of carbohydrate (considered a low-carbohydrate diet) increased from 5.9% to 17.1% (p = 0.0001). Physical activity was elevated in 1995 (mean = 3316 kcal/wk) but comparable in all other years (mean = 2620 kcal/wk). Stepwise regression collapsing across cohorts indicated that weight regain over 1 year was related to higher levels of caloric intake, fast food consumption, and fat intake and lower levels of physical activity (p < 0.03). DISCUSSION: The macronutrient composition of the diet of NWCR members has shifted over the past decade. Still, only a minority consumes a low-carbohydrate diet. Despite changes in the diet over time, the variables associated with long-term maintenance of weight loss were the same: continued consumption of a low-calorie diet with moderate fat intake, limited fast food, and high levels of physical activity.

Adult↗
PubMed2006

Physical activity in individuals at risk for diabetes: Diabetes Prevention Program.

PURPOSE AND METHODS: Leisure physical activity was assessed using questionnaires with different time frames in the Diabetes Prevention Program (DPP) cohort of 3234 overweight individuals aged > 25 yr with impaired glucose tolerance (IGT) from 27 centers across the United States. The three questionnaires were the Modifiable Activity Questionnaire (MAQ; past year), the Low-Level Physical Activity Recall (LOPAR; past 7 d), and the Third National Health and Nutrition Examination Survey (NHANES III; past month). This provided the opportunity to examine the relationship between the three activity measures and to compare activity levels of the DPP sample with that of a national sample with IGT. RESULTS: Leisure activity determined by the three questionnaires significantly correlated with each other, although the correlations between MAQ and NHANES III were stronger (men: rho = 0.52; women: rho = 0.49; P < 0.01) than between LOPAR and either measure (men: rho = 0.20 for MAQ, 0.24 for NHANES; women: rho = 0.10 for MAQ, 0.13 for NHANES). In the DPP, measures of obesity and glucose tolerance were significantly correlated with activity levels determined by MAQ and NHANES, but not LOPAR. Activity levels in DPP participants determined by the NHANES III questionnaire were generally higher than those reported by individuals meeting DPP eligibility criteria who were part of the NHANES cohort for similar age, body mass index, and race or ethnicity. CONCLUSION: If the DPP participants were more active than a national sample of individuals with IGT, this would have implications for translation when using the DPP lifestyle intervention in less active or less motivated populations. Finally, the weak relationship between activity levels obtained with MAQ and LOPAR may result from the fact that they encompass different time frames and different components of leisure activity.

Adult↗
PubMed2006

Effect of weight loss with lifestyle intervention on risk of diabetes.

OBJECTIVE: Diabetes Prevention Program (DPP) participants randomized to the intensive lifestyle intervention (ILS) had significantly reduced risk of diabetes compared with placebo participants. We explored the contribution of changes in weight, diet, and physical activity on the risk of developing diabetes among ILS participants. RESEARCH DESIGN AND METHODS: For this study, we analyzed one arm of a randomized trial using Cox proportional hazards regression over 3.2 years of follow-up. RESULTS: A total of 1,079 participants were aged 25-84 years (mean 50.6 years, BMI 33.9 kg/m(2)). Weight loss was the dominant predictor of reduced diabetes incidence (hazard ratio per 5-kg weight loss 0.42 [95% CI 0.35-0.51]; P < 0.0001). For every kilogram of weight loss, there was a 16% reduction in risk, adjusted for changes in diet and activity. Lower percent of calories from fat and increased physical activity predicted weight loss. Increased physical activity was important to help sustain weight loss. Among 495 participants not meeting the weight loss goal at year 1, those who achieved the physical activity goal had 44% lower diabetes incidence. CONCLUSIONS: Interventions to reduce diabetes risk should primarily target weight reduction.

Adult↗
PubMed2005

Effect of limiting snack food variety on long-term sensory-specific satiety and monotony during obesity treatment.

Limiting meal variety decreases hedonic ratings of eaten foods more so than non-eaten foods, demonstrating sensory-specific satiety. Exposure to a food over time decreases the food's hedonic ratings, indicating monotony. The effect of limiting food group variety over time on long-term sensory-specific satiety and monotony is unknown. Thirty overweight adults were randomized to one of two 8-week behavioral weight loss interventions. One condition limited snack food intake to one chosen snack food (reduced variety), while the other limited snack food intake to <1 serving/day (control), with no variety limit. In the reduced variety condition, hedonic ratings of the chosen snack food showed a decrease (p < .05) over time and decreased more (p < .05) than hedonic ratings of other snack foods. Weight loss (-7.4 +/- 5.8 lb) occurred in both conditions. Limiting food group variety over 8 weeks produced long-term sensory-specific satiety and monotony. Future research should examine if limiting food group variety over an extended time affects intake and could be used as a technique in weight loss interventions.

Adult↗
PubMed2005

Predictors of weight control advice in primary care practices: patient health and psychosocial characteristics.

BACKGROUND: Past research has surveyed primary care physicians (PCP) about their attitudes and practices towards obese patients, yet less is known about the patients receiving advice. METHODS: The Primary Care Weight Control Project (PCWC) enrolled 18 PCPs in a randomized clinical trial and asked 255 of their patients who were either overweight or obese at baseline about past weight control advice. RESULTS: At baseline, 66.4% of patients reported that their physician previously told them they were overweight. Body mass index (BMI) was a strong predictor of being identified as obese. While 65.1% received information on the health benefits of weight loss, only 36.6% of patients were ever given specific weight control advice, and 28.2% were advised to increase their physical activity. A history of type 2 diabetes, high cholesterol, or hypertension was associated with physician-delivered weight control advice. Stages of change and number of prior visits with the PCP were also associated with physician advice. CONCLUSIONS: Patients were more likely to receive education about weight loss than specific behavioral advice on how to lose weight. Physicians were more likely to provide weight control advice to their patients who had obesity-related comorbidities than to patients who were overweight or obese and without risk factors.

Adult↗
PubMed2005

Amount of food group variety consumed in the diet and long-term weight loss maintenance.

OBJECTIVE: Decreases in variety of foods consumed within high-fat-dense food groups and increases in variety of foods consumed within low-fat-dense food groups are associated with lower energy intake and greater weight loss during obesity treatment and may assist with weight loss maintenance. This study examined food group variety in 2237 weight loss maintainers in the National Weight Control Registry, who had lost 32.2 +/- 18.0 kg (70.9 +/- 39.5 lbs) and maintained a weight loss of at least 13.6 kg (30 lbs) for 6.1 +/- 7.7 years. RESEARCH METHODS AND PROCEDURES: At entry into the registry, registry members completed a food frequency questionnaire from which amount of variety consumed from different food groups was assessed. To provide a context for interpreting the level of variety occurring in the diet of registry participants, food group variety was compared between registry participants and 96 individuals who had recently participated in a behavioral weight loss program and had lost at least 7% of initial body weight. RESULTS: Registry members reported consuming a diet with very low variety in all food groups, especially in those food groups higher in fat density. Registry participants consumed significantly (p < 0.001) less variety within all food groups, except fruit and combination foods, than recent weight losers after 6 months of weight loss treatment. DISCUSSION: These results suggest that successful weight loss maintainers consume a diet with limited variety in all food groups. Restricting variety within all food groups may help with consuming a low-energy diet and maintaining long-term weight loss.

Adult↗
PubMed2005

Long-term weight loss maintenance.

There is a general perception that almost no one succeeds in long-term maintenance of weight loss. However, research has shown that approximately 20% of overweight individuals are successful at long-term weight loss when defined as losing at least 10% of initial body weight and maintaining the loss for at least 1 y. The National Weight Control Registry provides information about the strategies used by successful weight loss maintainers to achieve and maintain long-term weight loss. National Weight Control Registry members have lost an average of 33 kg and maintained the loss for more than 5 y. To maintain their weight loss, members report engaging in high levels of physical activity ( approximately 1 h/d), eating a low-calorie, low-fat diet, eating breakfast regularly, self-monitoring weight, and maintaining a consistent eating pattern across weekdays and weekends. Moreover, weight loss maintenance may get easier over time; after individuals have successfully maintained their weight loss for 2-5 y, the chance of longer-term success greatly increases. Continued adherence to diet and exercise strategies, low levels of depression and disinhibition, and medical triggers for weight loss are also associated with long-term success. National Weight Control Registry members provide evidence that long-term weight loss maintenance is possible and help identify the specific approaches associated with long-term success.

Body Mass Index↗
PubMed2004

Medical triggers are associated with better short- and long-term weight loss outcomes.

BACKGROUND: Medical events are often reported as triggers for weight loss, but it is unknown whether medical triggers result in better short- and long-term weight control. METHODS: The relationship between medical triggers and weight loss was examined in the National Weight Control Registry (NWCR), a database of individuals who have lost > or =30 lbs and kept it off for > or =1 year. Recall of weight loss triggers may become difficult over time, thus participants were limited to those reporting weight loss <5 years ago. Three groups were examined: (1) participants with medical triggers (N = 207), (2) participants with nonmedical triggers (N = 539), and (3) participants with no trigger (N = 171). RESULTS: Participants with medical triggers were older than those with nonmedical triggers or no trigger (50.5 +/- 11.7, 44.9 +/- 11.8, 46.7 +/- 13.3 years; P = 0.0001), had a higher initial BMI at entry into the NWCR (26.1 +/- 5.0, 25.0 +/- 4.3, 24.8 +/- 4.4 kg/m2; P = 0.004), and were more likely to be male (37.1%, 18%, 17.2%; P = 0.0001). Participants with medical triggers reported greater initial weight loss than those with nonmedical triggers or no trigger (36.5 +/- 25.0, 31.8 +/- 16.6, 31.8 +/- 17.1 kg; P = 0.01). Participants with medical triggers also gained less weight over 2 years of follow-up than those with nonmedical triggers or no trigger (P = 0.003). CONCLUSIONS: Medical triggers may produce a teachable moment for weight control, resulting in better initial weight loss and long-term maintenance.

Adult↗
PubMed2004

Achieving weight and activity goals among diabetes prevention program lifestyle participants.

OBJECTIVE: The Diabetes Prevention Program (DPP) showed that intensive lifestyle intervention reduced the risk of diabetes by 58%. This paper examines demographic, psychosocial, and behavioral factors related to achieving weight loss and physical activity goals in the DPP lifestyle participants. RESEARCH METHODS AND PROCEDURES: Lifestyle participants (n = 1079; mean age = 50.6, BMI = 33.9, 68% female, and 46% from minority groups) had goals of 7% weight loss and 150 min/wk of physical activity. Goal achievement was assessed at the end of the 16-session core curriculum (approximately week 24) and the final intervention visit (mean = 3.2 years) as a function of demographic, psychosocial, and behavioral variables. RESULTS: Forty-nine percent met the weight loss goal and 74% met the activity goal initially, while 37% and 67%, respectively, met these goals long-term. Men and those with lower initial BMI were more likely to meet activity but not weight loss goals. Hispanic, Asian, and Native Americans were more likely to meet the long-term activity goals, and whites were more likely to meet the initial weight loss goal. In multivariate analyses, meeting the long-term weight loss goal and both activity goals increased with age, while psychosocial and depression measures were unrelated to goal achievement. Dietary self-monitoring was positively related to meeting both weight loss and activity goals, and meeting the activity goal was positively related to meeting the weight loss goal. Participants who met initial goals were 1.5 to 3.0 times more likely to meet these goals long-term. DISCUSSION: Success at meeting the weight loss and activity goals increased with age. Initial success predicted long-term success. Self-monitoring and meeting activity goals were related to achieving and sustaining weight loss.

Adult↗
PubMed2004

Is dietary fat intake related to liking or household availability of high- and low-fat foods?

OBJECTIVE: Despite the increasing availability of low- and reduced-fat foods, Americans continue to consume more fat than recommended, which may be a contributing factor to the obesity epidemic. This investigation examined relationships between liking and household availability of high- and low-fat foods and their association with dietary fat intake. RESEARCH METHODS AND PROCEDURES: A food frequency questionnaire assessed percent calories from fat consumed over the past year in 85 men and 80 women. Participants reported their degree of liking 22 "high-fat foods" (>45% calories from fat) and 22 "low-fat foods" (<18% calories from fat), and the number and percentage (number of high- or low-fat foods/total number of foods x 100) of these high- and low-fat foods in their homes. RESULTS: Hierarchical regression analyses examined the ability of liking and household availability of low- and high-fat foods to predict percent dietary fat intake. After controlling for age, sex, and BMI, liking ratings for high- and low-fat foods and the interaction of liking for low-fat foods by the percentage of low-fat foods in the household were significant predictors of percent dietary fat consumed. Greater liking of high-fat foods and lower liking of low-fat foods, both alone and combined with a lower percentage of low-fat foods in the home, were predictive of higher dietary fat intake. DISCUSSION: Interventions designed to reduce dietary fat intake should target both decreasing liking for high-fat foods and increasing liking for low-fat foods, along with increasing the proportion of low-fat foods in the household.

Adult↗
PubMed2003

Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial.

CONTEXT: Weight loss programs on the Internet appear promising for short-term weight loss but have not been studied for weight loss in individuals at risk of type 2 diabetes; thus, the longer-term efficacy is unknown. OBJECTIVE: To compare the effects of an Internet weight loss program alone vs with the addition of behavioral counseling via e-mail provided for 1 year to individuals at risk of type 2 diabetes. DESIGN, SETTING, AND PARTICIPANTS: A single-center randomized controlled trial conducted from September 2001 to September 2002 in Providence, RI, of 92 overweight adults whose mean (SD) age was 48.5 (9.4) years and body mass index, 33.1 (3.8). INTERVENTIONS: Participants were randomized to a basic Internet (n = 46) or to an Internet plus behavioral e-counseling program (n = 46). Both groups received 1 face-to-face counseling session and the same core Internet programs and were instructed to submit weekly weights. Participants in e-counseling submitted calorie and exercise information and received weekly e-mail behavioral counseling and feedback from a counselor. MAIN OUTCOME MEASURES: Measured weight and waist circumference at 0 and 12 months. RESULTS: Intent-to-treat analyses showed the behavioral e-counseling group lost more mean (SD) weight at 12 months than the basic Internet group (-4.4 [6.2] vs -2.0 [5.7] kg; P =.04), and had greater decreases in percentage of initial body weight (4.8% vs 2.2%; P =.03), body mass index (-1.6 [2.2] vs -0.8 [2.1]; P =.03), and waist circumference (-7.2 [7.5] vs -4.4 [5.7] cm; P =.05). CONCLUSION: Adding e-mail counseling to a basic Internet weight loss intervention program significantly improved weight loss in adults at risk of diabetes.

Adult↗
PubMed2003

Behavioral techniques for treating the obese patient.

With more than 50% of American adults overweight or obese, primary care physicians should play an active role in helping overweight patients lose weight. Modest weight losses of as little as 7% to 10% can produce significant health benefits, such as preventing the development of diabetes. To help individuals achieve this weight loss, behavior change strategies should be emphasized with all overweight patients. Changes in diet and exercise can produce long-term weight loss with tremendous positive impact. Primary care physicians are well positioned to support these behavior changes in their overweight patients.

Behavior Therapy↗
PubMed2003

Prescribed "breaks" as a means to disrupt weight control efforts.

OBJECTIVE: Research on long-term maintenance of weight loss is hampered by the fact that relapse typically does not occur until after 6 months. We sought to determine whether relapses could be induced earlier by intentionally interrupting the momentum of weight loss during a treatment program and thus provide a model for weight maintenance research. RESEARCH METHODS AND PROCEDURES: Subjects (N = 142) were recruited at two centers and randomly assigned to a control group, a long break group (LB), or a short break group (SB). The control group received a standard behavioral weight loss program with 14 weekly sessions; the LB and SB groups received the same. However, the LB group took a 6-week break after lesson 7, and the SB group took a 2-week break after lessons 3, 6, and 9. Participants were instructed to stop all weight loss efforts during breaks. RESULTS: Participants seemed to take breaks as prescribed, with interruptions in self-monitoring, dietary adherence, and self-weighing (but not in exercise). However, participants quickly resumed these behaviors after the break. Breaks produced a slowing of weight loss or slight regain, but weight losses during the breaks were not significantly different from the control group. Importantly, overall weight losses (0 to 5 months or 0 to 11 months) did not differ between conditions. DISCUSSION: This study was not successful in developing a method to experimentally produce weight loss relapses. However, the finding that prescribed breaks do not have adverse effects may have clinical application.

Adult↗
PubMed2003

Physical activity and weight loss: does prescribing higher physical activity goals improve outcome?

BACKGROUND: Recommending increased physical activity facilitates long-term weight loss, but the optimal level of physical activity to recommend is unknown. OBJECTIVE: The objective of the study was to evaluate the efficacy for long-term weight loss of recommendations for much higher physical activity than those normally used in behavioral treatments. DESIGN: Overweight men and women (n = 202) were randomly assigned to either a standard behavior therapy (SBT) for obesity, incorporating an energy expenditure (EE) goal of 1000 kcal/wk, or to a high physical activity (HPA) treatment, in which the goal was an EE of 2500 kcal/wk. To help HPA treatment group participants achieve this high exercise goal, their treatment included encouragement to recruit 1-3 exercise partners into the study, personal counseling from an exercise coach, and small monetary incentives. RESULTS: The HPA treatment group reported achieving higher mean (+/- SD) physical activity levels than did the SBT group at 6 mo (EE of 2399 +/- 1571 kcal/wk compared with 1837 +/- 1431 kcal/wk), 12 mo (EE of 2249 +/- 1751 kcal/wk compared with 1565 +/- 1309 kcal/wk), and 18 mo (EE of 2317 +/- 1854 kcal/wk compared with 1629 +/- 1483 kcal/wk) (all P < 0.01). Mean (+/- SEM) cumulative weight losses at 6, 12, and 18 mo in the HPA treatment group were 9.0 +/- 7.1, 8.5 +/- 7.9, and 6.7 +/- 8.1 kg, respectively. In the SBT group, the corresponding weight losses were 8.1 +/- 7.4, 6.1 +/- 8.8, and 4.1 +/- 7.3 kg, respectively. Between-group differences in weight loss were significant at 12 and 18 mo. CONCLUSION: These results suggest that recommendations of higher levels of physical activity (EE of 2500 kcal/wk) promote long-term weight loss better than do conventional recommendations.

Adult↗