title: Steps ahead: a randomized trial to reduce unhealthy weight gain in the Lower Mississippi Delta.
abstract: OBJECTIVE
  The Lower Mississippi Delta (LMD) region of the United States is characterized by high levels of obesity and physical inactivity. The objective was to test the effectiveness of adapting the 2010 Dietary Guidelines for Americans (DG), with and without a physical activity (PA) component, for attenuating weight gain.
  
  
  METHODS
  Overall, 121 white and African-American adults (35-64 years; body mass index 25-34.9 kg/m(2)) were randomized to a DG only group (n = 61) or a DG + PA group (n = 60). Both groups received a 12-week dietary education and behavior change intervention. The DG + PA group also received PA education and a pedometer. Changes in weight (kg), %weight, and waist circumference (WC; cm) were determined. Analyses considered all completers (n = 99) and those who engaged with ≥80% of the intervention (n = 83). General linear models compared mean changes between groups after adjustment for baseline values, race, and sex.
  
  
  RESULTS
  Weight, %weight, and WC significantly decreased from baseline to follow-up in both groups (p < 0.05; unadjusted values). Adjusted analysis showed a main effect of group for weight (p = 0.041) and %weight (p = 0.047) in the completers analysis, and WC (p = 0.046) in the ≥80% attendance analysis, with the DG + PA group improving weight-related outcomes more.
  
  
  CONCLUSIONS
  Low-burden behavioral interventions could be effective strategies in attenuating unhealthy weight gain in the LMD.
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA; Diabetes Research Centre, University of Leicester, Leicester, UK.
authors.forename: Deirdre M
authors.initials: DM
authors.lastname: Harrington
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Champagne
authors.forename: Stephanie T
authors.initials: ST
authors.lastname: Broyles
authors.forename: William D
authors.initials: WD
authors.lastname: Johnson
authors.forename: Catrine
authors.initials: C
authors.lastname: Tudor-Locke
authors.forename: Peter T
authors.initials: PT
authors.lastname: Katzmarzyk
mesh_terms: D000328:Adult; D001741:Black or African American; D001521:Behavior Therapy; D015992:Body Mass Index; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008019:Life Style; D008145:Louisiana; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000517:prevention & control; D055105:Waist Circumference; D015430:Weight Gain