- 期刊
Sustainability of Lifestyle Changes Following an Intensive Lifestyle Intervention in Insulin Resistant Adults: Followup at 2-Years
有胰島素阻抗性的成人接受密集的生活型態介入後對其後續生活型態的改變：追蹤2年
摘要
此研究目的為評估有胰島素阻抗且體重過重的人，在4個月的生活型態介入，降低體重及改善心血管疾病危險因子之後，是否能長期維持那些生活型態改變。79名胰島素阻抗的成年人，隨機分配為控制組、或者是4個月的適度或是密集生活型態介入組。之後合併2組介入組。追蹤所有參與者在第8、12及24個月的情形。測量他們的體位、血壓、禁食血糖、血脂、胰島素及有氧體適能，並評估飲食攝取。面訪參與者以找出那些對維持健康的生活習慣之自覺促進或是阻礙的因子。在第8、12及24個月，分別有72名(91.1%)、69名(87.3%)及62名(78.5%)參與者仍在這個研究中。在4個月時，適度介入組及控制組之間的調整體重差異為-3.4kg(95%CI:-5.4,-1.3)，p=0.002，密集介入組與控制組為-4.7kg(95%CI:-6.9,-2.4)，p=0.0001。在2年時，三組間或是介入組與控制組相比，體重均沒有顯著差異。在2年時，64%的參與者報告顯示較頻繁的追蹤可以幫助他們去維持健康的生活習慣。甚至4個月的密集介入及後繼每4個月的一次諮詢及每年的監測對於維持生活型態改變以致於降低體重是不夠的。三分之二的參與者認為不定期的頻繁監測對於維持他們最初的生活型態改變是必要的。
並列摘要
The objective of this study was to determine whether overweight insulin resistant individuals who lost weight and improved cardiovascular risk factors during a 4-month lifestyle intervention could sustain these lifestyle changes in the long-term. Seventy-nine insulin resistant adults were randomised to a control group or either a modest or intensive lifestyle intervention group for 4-months. Thereafter the two intervention groups were combined and all participants were followed-up at 8, 12 and 24 months. Anthropometry, blood pressure, fasting glucose, lipids, insulin and aerobic fitness were measured and dietary intake was assessed. An interview was conducted to determine factors which participants perceived facilitated or hindered maintenance of healthy lifestyle habits. Seventy-two (91.1%), sixty-nine (87.3%) and sixty-two (78.5%) participants were retained at 8, 12 and 24-month respectively. At 4-months the adjusted difference in weight between the modest and control groups was -3.4 kg (95% CI -5.4, -1.3) p=0.002 and intensive and control groups was -4.7 kg (-6.9, -2.4) p=0.0001 respectively. At 2-years there were no significant differences for weight when the initial 3 groups were compared or when the combined intervention group was compared with the control group. At 2-years, 64% of participants reported that more frequent follow-up would have helped them to maintain healthy lifestyle habits. Even intensive counselling for 4-months with 4-monthly and then yearly monitoring were not enough for maintaining lifestyle changes sufficient to sustain weight loss. More frequent monitoring for an indefinite period was perceived by two-thirds of participants as necessary for them to maintain their initial lifestyle changes.