Behavioral Mediators of Weight Loss in the SHED-IT Community Randomized Controlled Trial for Overweight and Obese Men
Little is known about which behavioral strategies are most important to target in weight loss interventions for men.
The aim of the current study was to identify behavioral mediators of weight loss in the male-only Self-Help, Exercise, and Diet using Information Technology (SHED-IT) community weight loss study.
A randomized controlled trial with 159 overweight/obese men [mean (SD) age = 47.5 (11.0) years; body mass index = 32.7 (3.5) kg/m2] assessed at baseline, 3 months (post-test) and 6 months (follow-up).
In an intention-to-treat, multiple-mediator model, the significant intervention effect on weight at 6 months (−3.70 kg; p < 0.001) was mediated by increases in physical activity (steps/day) and decreases in takeaway meals (kJ/day) and portion size at 3 months. The largest mediation effect was for physical activity (−0.6 kg; 95 % confidence interval −1.4, −0.1). Overall, the targeted mediators accounted for 47.0 % of the intervention’s effect on weight.
Step counts, takeaway food consumption, and portion sizes may be key areas to target in future weight loss programs for men (ACTRN12610000699066).
- 2.National Health and Medical Research Council. Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. Melbourne: National Health and Medical Research Council;2013.Google Scholar
- 9.Lubans DR, Morgan PJ, Collins CE, Okely AD, Burrows T, Callister R. Mediators of weight loss in the 'Healthy Dads, Healthy Kids' pilot study for overweight fathers. Int J Behav Nutr Phys Act. 2012; 9.Google Scholar
- 12.Morgan PJ, Collins CE, Plotnikoff RC, et al. The SHED-IT community trial study protocol: a randomised controlled trial of weight loss programs for overweight and obese men. BMC Public Health. 2010; 10.Google Scholar
- 14.Blomfield RL, Collins CE, Hutchesson MJ, Young MD, Callister R, Morgan PJ. Impact of self-help weight loss resources with or without online support on the dietary intake of overweight and obese men: The SHED-IT randomised controlled trial. Obes Res Clin Pract. in press.Google Scholar
- 16.Gray CM, Hunt K, Mutrie N, et al. Football Fans in Training: the development and optimization of an intervention delivered through professional sports clubs to help men lose weight, become more active and adopt healthier eating habits. BMC Public Health. 2013; 13.Google Scholar
- 19.Collins CE, Watson JF, Guest M, et al. Reproducability and comparative validity of a food frequency questionnaire for adults. Clin Nutr. 2013; 33: 906-914.Google Scholar
- 20.Giles GG, Ireland PD. Dietary Questionnaire for Epidemiological Studies (Version 2). The Cancer Council Victoria: Melbourne; 1996.Google Scholar
- 24.Hollis JL, Williams LT, Young MD, Pollard KT, Collins CE, Morgan PJ. Compliance to step count and vegetable serve recommendations mediates weight gain prevention in mid-age, premenopausal women: findings of the 40-something RCT. Appetite. 2014; 83: 33-41.Google Scholar
- 25.Avenell A, Brown TJ, McGee MA, et al. What interventions should we add to weight reducing diets in adults with obesity? A systematic review of randomized controlled trials of adding drug therapy, exercise, behavior therapy or combinations of these interventions. J Hum Nutr Diet. 2004; 17: 293-316.CrossRefPubMedGoogle Scholar
- 26.Morgan PJ, Scott HA, Young MD, Plotnikoff RC, Collins CE, Callister R. Associations between program outcomes and adherence to Social Cognitive Theory tasks: Process evaluation of the SHED-IT community weight loss trial for men. Int J Behav Nutr Phys Act. 2014; 11: 89.CrossRefPubMedCentralPubMedGoogle Scholar
- 29.Lubans DR, Morgan PJ, Collins CE, Warren JM, Callister R. Exploring the mechanisms of weight loss in the SHED-IT intervention for overweight men: a mediation analysis. Int J Behav Nutr Phys Act. 2009; 6.Google Scholar