Schlicht, W. (Wolfgang)
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- Sociocognitive factors associated with lifestyle intervention attrition after successful weight loss among participants with prediabetes-The PREVIEW study(Wiley, 2020) Martinez, J.A. (José Alfredo); Muirhead, R. (Roslyn); Schlicht, W. (Wolfgang); Raben, A. (Anne); Handjieva-Darlenska, T. (Teodora); Jalo, E. (Elli); Huttunen-Lenz, M. (Maija); Drummen, M. (Mathijs); Poppitt, S.D. (Sally D.); Meinert-Larsen, T. (Thomas); MacDonald, I. (Ian)Introduction: Major risk factors for type 2 diabetes are lifestyle choices such as lack of physical activity (PA) and poor diet. Many individuals either do not take part or struggle to complete interventions supporting lifestyle changes. Demographic and theory-based sociocognitive factors associated with PREVIEW intervention attrition after successful weight loss were examined. Methods: Participants (1,856) who started the weight maintenance phase after completion of low-energy diet were retrospectively divided into three clusters depending on the point they left the trial. Discriminant analysis examined which demographic and theory-based sociocognitive variables were associated with cluster membership. Results: Most of the participants were women and well-educated. Two discriminant functions were calculated (χ2 (24) = 247.0, p ≥ .05, d = 0.78). The demographic variables, such as age and ethnicity, and the social cognitive variable outcome expectancies on the other side were associated with cluster membership. Older age, Caucasian ethnicity, and fewer expected disadvantages of PA were associated with high success. Discussion: The discriminant model gave insight into some factors associated with early attrition. For practitioners planning interventions it underlines the necessity to take extra attention to younger participants and to those being afraid that being physically active causes unpleasant ramifications.
- Compositional analysis of the associations between 24-h movement behaviours and cardio-metabolic risk factors in overweight and obese adults with pre-diabetes from the PREVIEW study: cross-sectional baseline analysis(2020) Martinez, J.A. (José Alfredo); Bogdanov, G. (Georgi); Muirhead, R. (Roslyn); Swindell, N. (Nils); Brodie, S. (Shannon); Rees, P. (Paul); Schlicht, W. (Wolfgang); Brand-Miller, J. (Jennie); Westerterp-Plantenga, M. (Margriet); Tikkanen, H. (Heikki); Larsen, T.M. (Thomas M.); Raben, A. (Anne); Vestentoft, P.S. (Pia Siig); Handjieva-Darlenska, T. (Teodora); Silvestre, M.P. (Marta P.); Jalo, E. (Elli); Navas-Carretero, S. (Santiago); Gant, N. (Nicholas); Adam, T.C. (Tanja C.); Drummen, M. (Mathijs); Fogelholm, M. (Mikael); Poppitt, S.D. (Sally D.); Boyadjieva, N. (Nadka); Stratton, G. (Gareth); MacDonald, I. (Ian)Background: Physical activity, sedentary time and sleep have been shown to be associated with cardio-metabolic health. However, these associations are typically studied in isolation or without accounting for the effect of all movement behaviours and the constrained nature of data that comprise a finite whole such as a 24 h day. The aim of this study was to examine the associations between the composition of daily movement behaviours (including sleep, sedentary time (ST), light intensity physical activity (LIPA) and moderate-to-vigorous activity (MVPA)) and cardio-metabolic health, in a cross-sectional analysis of adults with pre-diabetes. Further, we quantified the predicted differences following reallocation of time between behaviours. Methods: Accelerometers were used to quantify daily movement behaviours in 1462 adults from eight countries with a body mass index (BMI) ≥25 kg·m− 2 , impaired fasting glucose (IFG; 5.6–6.9 mmol·l − 1 ) and/or impaired glucose tolerance (IGT; 7.8–11.0 mmol•l − 1 2 h following oral glucose tolerance test, OGTT). Compositional isotemporal substitution was used to estimate the association of reallocating time between behaviours. Results: Replacing MVPA with any other behaviour around the mean composition was associated with a poorer cardio-metabolic risk profile. Conversely, when MVPA was increased, the relationships with cardiometabolic risk markers was favourable but with smaller predicted changes than when MVPA was replaced. Further, substituting ST with LIPA predicted improvements in cardio-metabolic risk markers, most notably insulin and HOMA-IR. Conclusions: This is the first study to use compositional analysis of the 24 h movement composition in adults with overweight/obesity and pre-diabetes. These findings build on previous literature that suggest replacing ST with LIPA may produce metabolic benefits that contribute to the prevention and management of type 2 diabetes. Furthermore, the asymmetry in the predicted change in risk markers following the reallocation of time to/from MVPA highlights the importance of maintaining existing levels of MVPA. Trial registration: ClinicalTrials.gov (NCT01777893).
- Demographic and social-cognitive factors associated with weight loss in overweight, pre-diabetic participants of the PREVIEW study(Springer, 2018) Martinez, J.A. (José Alfredo); Schlicht, W. (Wolfgang); Brand-Miller, J. (Jennie); Sluik, D. (Diewertje); Raben, A. (Anne); Handjieva-Darlenska, T. (Teodora); Huttunen-Lenz, M. (Maija); Drummen, M. (Mathijs); Fogelholm, M. (Mikael); Poppitt, S.D. (Sally D.); Hansen, S. (Sylvia); Meinert-Larsen, T. (Thomas); MacDonald, I. (Ian)Purpose Weight loss has been demonstrated to be a successful strategy in diabetes prevention. Although weight loss is greatly influenced by dietary behaviors, social-cognitive factors play an important role in behavioral determination. This study aimed to identify demographic and social-cognitive factors (intention, self-efficacy, outcome expectancies, social support, and motivation with regard to dietary behavior and goal adjustment) associated with weight loss in overweight and obese participants from the PREVIEW study who had pre-diabetes. Method Prospective correlational data from 1973 adult participants were analyzed. The participants completed psychological questionnaires that assessed social-cognitive variables with regard to dietary behavior. Stepwise multiple regression analyses were performed to identify baseline demographic and social-cognitive factors associated with weight loss. Results Overall, being male, having a higher baseline BMI, having a higher income, perceiving fewer disadvantages of a healthy diet (outcome expectancies), experiencing less discouragement for healthy eating by family and friends (social support), and lower education were independently linked to greater weight loss. When evaluating females and males separately, education was no longer associated with weight loss. Conclusion The results indicate that a supportive environment in which family members and friends avoid discouraging healthy eating, with the application of a strategy that uses specific behavior change techniques to emphasize the benefits of outcomes, i.e., the benefits of a healthy diet, may support weight loss efforts. Weight loss programs should therefore always address the social environment of persons who try to lose body weight because family members and friends can be important supporters in reaching a weight loss goal.
- PREVIEW study-influence of a behavior modification intervention (PREMIT) in over 2300 people with pre-diabetes: intention, self-efficacy and outcome expectancies during the early phase of a lifestyle intervention(Taylor and Francis Group, 2018) Martinez, J.A. (José Alfredo); Handjiev, S. (Svetoslav); Sando-Pedersen, F. (Finn); Schlicht, W. (Wolfgang); Brand-Miller, J. (Jennie); Pietiläinen, K.H. (Kirsi H.); Raben, A. (Anne); Berendsen, A.A.M. (Agnes A. M.); Silvestre, M.P. (Marta P.); Navas-Carretero, S. (Santiago); Taylor, M. (Moira); Adam, T.C. (Tanja C.); Huttunen-Lenz, M. (Maija); Drummen, M. (Mathijs); Fogelholm, M. (Mikael); Poppitt, S.D. (Sally D.); Hansen, S. (Sylvia); Meinert-Larsen, T. (Thomas); MacDonald, I. (Ian); Christensen, P. (Pia)Purpose: Onset of type 2 diabetes (T2D) is often gradual and preceded by impaired glucose homeostasis. Lifestyle interventions including weight loss and physical activity may reduce the risk of developing T2D, but adherence to a lifestyle change is challenging. As part of an international T2D prevention trial (PREVIEW), a behavior change intervention supported participants in achieving a healthier diet and physically active lifestyle. Here, our aim was to explore the influence of this behavioral program (PREMIT) on social-cognitive variables during an 8-week weight loss phase. Methods: PREVIEW consisted of an initial weight loss, Phase I, followed by a weightmaintenance, Phase II, for those achieving the 8-week weight loss target of ≥ 8% from initial bodyweight. Overweight and obese (BMI ≥25 kg/m2) individuals aged 25 to 70 years with confirmed pre-diabetes were enrolled. Uni- and multivariate statistical methods were deployed to explore differences in intentions, self-efficacy, and outcome expectancies between those who achieved the target weight loss (“achievers”) and those who did not (“non-achievers”). Results: At the beginning of Phase I, no significant differences in intentions, self-efficacy and outcome expectancies between “achievers” (1,857) and “non-achievers” (163) were found. “Non-achievers” tended to be younger, live with child/ren, and attended the PREMIT sessions less frequently. At the end of Phase I, “achievers” reported higher intentions (healthy eating χ2 (1)=2.57; P <0.008, exercising χ2 (1)=0.66; P <0.008), self-efficacy (F(2; 1970)=10.27, P <0.005), and were more positive about the expected outcomes (F(4; 1968)=11.22, P <0.005). Conclusion: Although statistically significant, effect sizes observed between the two groups were small. Behavior change, however, is multi-determined. Over a period of time, even small differences may make a cumulative effect. Being successful in behavior change requires that the “new” behavior is implemented time after time until it becomes a habit. Therefore, having even slightly higher self-efficacy, positive outcome expectancies and intentions may over time result in considerably improved chances to achieve long-term lifestyle changes.