title: Compliance to step count and vegetable serve recommendations mediates weight gain prevention in mid-age, premenopausal women. Findings of the 40-Something RCT.
abstract: The 40-Something RCT aimed to determine if a 12-month health professional-led intervention could modify diet and physical activity behaviour for obesity prevention, in 44-50 year old, non-obese (BMI = 18.5-29.9 kg/m(2)) premenopausal women. Women were monitored for an additional 12 months to determine if effects could be maintained. This paper aimed to explore dietary and physical activity behavioural mediators hypothesised to be causally associated with weight change. Fifty-four women were randomised to a Motivational Interviewing Intervention (MI) (n = 28; five health professional consultations) or a Self-Directed Intervention (n = 26; written advice). Compliance to 10 study recommendations was measured at three months by a four-day weighed food and physical activity record including pedometer-measured step counts, self-reported exercise minutes and sitting time. The 10 compliance scores were independently assessed in mediation models for 12- and 24-month weight change. The MI effect on step count was an increase of 0.99 points on the 10-point compliance scale (p ≤ 0.01). This MI effect on step count significantly mediated the 12 and 24 month effect on weight (12 months AB = -0.74, 95%CI = -1.95, -0.14; 24 months AB = -1.06, 95% CI = -2.56, -0.36), accounting for 37.23% and 53.79% of the effect, respectively. The MI effect on vegetable serves was an increase of 1.50 points on the compliance scale (p = 0.02). The MI effect on vegetable compliance significantly mediated the effect on weight at 24 months (AB = -0.54, 95% CI = -1.50, -0.04), accounting for 24.92% of the effect. The remaining eight dietary and physical activity compliance scores did not significantly mediate weight loss. Encouraging women to take 10,000 steps and eat five vegetable serves per day may be a promising strategy to achieve long-term weight control at mid-life.
authors: Nutrition and Dietetics, School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia; Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia. Electronic address: Jenna.Hollis@uon.edu.au.
authors: Jenna L
authors: JL
authors: Hollis
authors: Nutrition and Dietetics, School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia; Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia; Nutrition and Dietetics, School of Allied Health Sciences, Griffith University, Southport, QLD 4215, Australia.
authors: Lauren T
authors: LT
authors: Williams
authors: Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia; School of Education, Faculty of Education and Arts, The University of Newcastle, Callaghan, NSW 2308, Australia.
authors: Myles D
authors: MD
authors: Young
authors: Nutrition and Dietetics, School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia.
authors: Katherine T
authors: KT
authors: Pollard
authors: Nutrition and Dietetics, School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia; Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia.
authors: Clare E
authors: CE
authors: Collins
authors: Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia; School of Education, Faculty of Education and Arts, The University of Newcastle, Callaghan, NSW 2308, Australia.
authors: Philip J
authors: PJ
authors: Morgan
mesh_terms: D056044:Actigraphy; D000328:Adult; D015992:Body Mass Index; D003376:Counseling; D004032:Diet; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D008875:Middle Aged; D062405:Motivational Interviewing; D009765:Obesity / Q000517:prevention & control*; D010349:Patient Compliance; D017697:Premenopause; D014675:Vegetables; D016138:Walking; D015430:Weight Gain; D015431:Weight Loss
keywords: Mediator; Motivational interviewing; Nutrition; Obesity prevention; Pedometer