BACKGROUND: Lifestyle interventions targeting prevention of weight gain may have better long-term success than when aimed at weight loss. Limited evidence exists about such an approach in the primary care setting. DESIGN: An RTC was conducted. SETTING/PARTICIPANTS: Participants were 457 overweight or obese patients (BMI=25-40 kg/m(2), mean age 56 years, 52% women) with either hypertension or dyslipidemia, or both, from 11 general practice locations in The Netherlands. INTERVENTION: In the intervention group, four individual visits to a nurse practitioner (NP) and one feedback session by telephone were scheduled for lifestyle counseling with guidance of the NP using a standardized computerized software program. The control group received usual care from their general practitioner (GP). MAIN OUTCOME MEASURES: Changes in body weight, waist circumference, blood pressure, and blood lipids after 1 year (dropout <10%). Data were collected in 2006 and 2007. Statistical analyses were conducted in 2007 and 2008. RESULTS: There were more weight losers and stabilizers in the NP group than in the general practitioner usual care (GP-UC) group (77% vs 65%; p<0.05). In men, mean weight losses were 2.3% for the NP group and 0.1% for the GP-UC group (p<0.05). Significant reductions occurred also in waist circumference but not in blood pressure, blood lipids, and fasting glucose. In women, mean weight losses were in both groups 1.6%. In the NP group, obese people lost more weight (-3.0%) than the non-obese (-1.3%; p<0.05). CONCLUSIONS: Standardized computer-guided counseling by NPs may be an effective strategy to support weight-gain prevention and weight loss in primary care, in the current trial, particularly among men. TRIAL REGISTRATION: The study was registered with the Netherlands Trial Register (NTR), www.trialregister.nl, study no. TC 1365.
RCT Entities:
BACKGROUND: Lifestyle interventions targeting prevention of weight gain may have better long-term success than when aimed at weight loss. Limited evidence exists about such an approach in the primary care setting. DESIGN: An RTC was conducted. SETTING/PARTICIPANTS: Participants were 457 overweight or obesepatients (BMI=25-40 kg/m(2), mean age 56 years, 52% women) with either hypertension or dyslipidemia, or both, from 11 general practice locations in The Netherlands. INTERVENTION: In the intervention group, four individual visits to a nurse practitioner (NP) and one feedback session by telephone were scheduled for lifestyle counseling with guidance of the NP using a standardized computerized software program. The control group received usual care from their general practitioner (GP). MAIN OUTCOME MEASURES: Changes in body weight, waist circumference, blood pressure, and blood lipids after 1 year (dropout <10%). Data were collected in 2006 and 2007. Statistical analyses were conducted in 2007 and 2008. RESULTS: There were more weight losers and stabilizers in the NP group than in the general practitioner usual care (GP-UC) group (77% vs 65%; p<0.05). In men, mean weight losses were 2.3% for the NP group and 0.1% for the GP-UC group (p<0.05). Significant reductions occurred also in waist circumference but not in blood pressure, blood lipids, and fasting glucose. In women, mean weight losses were in both groups 1.6%. In the NP group, obesepeople lost more weight (-3.0%) than the non-obese (-1.3%; p<0.05). CONCLUSIONS: Standardized computer-guided counseling by NPs may be an effective strategy to support weight-gain prevention and weight loss in primary care, in the current trial, particularly among men. TRIAL REGISTRATION: The study was registered with the Netherlands Trial Register (NTR), www.trialregister.nl, study no. TC 1365.
Authors: Michael D Jensen; Donna H Ryan; Caroline M Apovian; Jamy D Ard; Anthony G Comuzzie; Karen A Donato; Frank B Hu; Van S Hubbard; John M Jakicic; Robert F Kushner; Catherine M Loria; Barbara E Millen; Cathy A Nonas; F Xavier Pi-Sunyer; June Stevens; Victor J Stevens; Thomas A Wadden; Bruce M Wolfe; Susan Z Yanovski; Harmon S Jordan; Karima A Kendall; Linda J Lux; Roycelynn Mentor-Marcel; Laura C Morgan; Michael G Trisolini; Janusz Wnek; Jeffrey L Anderson; Jonathan L Halperin; Nancy M Albert; Biykem Bozkurt; Ralph G Brindis; Lesley H Curtis; David DeMets; Judith S Hochman; Richard J Kovacs; E Magnus Ohman; Susan J Pressler; Frank W Sellke; Win-Kuang Shen; Sidney C Smith; Gordon F Tomaselli Journal: Circulation Date: 2013-11-12 Impact factor: 29.690
Authors: Barbara S Taylor; Yuanyuan Liang; L Sergio Garduño; Elizabeth A Walter; Margit B Gerardi; Gregory M Anstead; Delia Bullock; Barbara J Turner Journal: J Acquir Immune Defic Syndr Date: 2014-02-01 Impact factor: 3.731
Authors: David M Levine; Stella Savarimuthu; Allison Squires; Joseph Nicholson; Melanie Jay Journal: J Gen Intern Med Date: 2014-08-19 Impact factor: 5.128
Authors: Benjamin J Keeney; Deborah Fulton-Kehoe; Thomas M Wickizer; Judith A Turner; Kwun Chuen Gary Chan; Gary M Franklin Journal: J Occup Environ Med Date: 2013-03 Impact factor: 2.162
Authors: Meike A Q Mutsaerts; Henk Groen; Nancy C W ter Bogt; Johanna H T Bolster; Jolande A Land; Wanda J E Bemelmans; Walter K H Kuchenbecker; Peter G A Hompes; Nick S Macklon; Ronald P Stolk; Fulco van der Veen; Jacques W M Maas; Nicole F Klijn; Eugenie M Kaaijk; Gerrit J E Oosterhuis; Peter X J M Bouckaert; Jaap M Schierbeek; Yvonne M van Kasteren; Annemiek W Nap; Frank J Broekmans; Egbert A Brinkhuis; Carolien A M Koks; Jan M Burggraaff; Adrienne S Blankhart; Denise A M Perquin; Marie H Gerards; Robert J A B Mulder; Ed T C M Gondrie; Ben W J Mol; Annemieke Hoek Journal: BMC Womens Health Date: 2010-06-25 Impact factor: 2.809