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| NHLBI Study Tests Novel Ways to Help Americans Keep Weight Off |
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The National Heart, Lung, and Blood Institute (NHLBI) today
announced the launch of a major study that could help solve
one of the hardest aspects of weight loss-keeping off lost
pounds. The study, called the "Weight Loss Maintenance
Trial," will be done in two phases at four clinical sites.
The study will include 1,600 men and women in its first
phase, and 800 in its second. Phase I is a 5-month weight
loss program; phase II will try to help those who lose 9 or
more pounds in phase I keep the weight off for 2½ years.
The study has begun seeking participants, who must be
overweight or obese, age 25 or older, and taking medication
to control high blood pressure and/or high blood
cholesterol. About 60 percent will be women and 40 percent
will be African American.
"Maintaining weight loss is a critical element in the
struggle against overweight and obesity, which have reached
epidemic proportions in the United States," said NHLBI
Director Dr. Claude Lenfant. "Two of every three adults are
overweight or obese. This study could yield answers that
can help many Americans lead healthier lives."
"Americans have shown that they can lose weight in the
short-term," said Dr. Laura Svetkey, Director of the Duke
Hypertension Center and of Clinical Research at the Sarah
Stedman Nutrition and Metabolism Center at Duke University
in Durham, NC, and lead investigator in the study. "Yet,
only a small proportion of them achieve long-term weight
control. To successfully fight the obesity epidemic,
clinicians and other health care providers must have
options that are effective and feasible for a broad range
of people.
"The best weight-loss strategy will not only lead to long-
term weight control, but also achieve it by establishing a
healthy dietary pattern and physical activity routine that
lasts a lifetime," she added.
Overweight/obesity is the second leading cause of
preventable death in the United States. Overweight and
obesity increase the risk of heart disease and other
conditions, including high blood pressure, high blood
cholesterol, diabetes, stroke, and some cancers.
About 65 percent of American adults-about 129 million
persons-are overweight or obese, and the prevalence is
increasing. In 1988-94, almost 60 percent of American
adults were overweight or obese, while in 1999-2000, nearly
65 percent were overweight or obese.
The four centers involved in the Weight Loss Maintenance
study are: Duke University; Pennington Biomedical Research
Center at Louisiana State University in Baton Rouge; Kaiser
Permanente Center for Health Research (KPCHR) in Portland,
OR; and The Johns Hopkins Medical Institutions in
Baltimore, MD. KPCHR also serves as the study's
coordinating center.
In the study's first phase, participants will receive
counseling to help them make lifestyle changes to reduce
their weight. These lifestyle changes will include reducing
calories and increasing physical activity. Participants
will be encouraged to follow the DASH eating plan, which
has been shown to reduce blood pressure and cholesterol.
DASH is high in fiber and low in saturated fat,
cholesterol, and total fat, and emphasizes fruits,
vegetables, and lowfat dairy foods. Phase I participants
will keep food and fitness diaries to monitor their diet
and physical activity. Those who lose 9 or more pounds
after 5 months will be eligible to enroll in phase II.
In phase II, participants will be randomly assigned to one
of three weight-maintenance strategies: self-directed/usual
care (SD/UC); personal contact (PC); and interactive
technology (IT). The SD/UC group will meet once with a
health counselor for advice on how to maintain their weight
loss and to discuss their own weight loss plans. They also
will receive educational materials about diet and physical
activity.
Those in the PC group will receive personal guidance and
counseling on how to maintain their weight loss through
monthly telephone calls and occasional visits with a health
counselor.
Participants in the IT group will use an Internet-based,
individually tailored, interactive computer program to help
them keep their weight off. They can use the program as
often as they wish and can log on anywhere they have
Internet access: at home, work, a school, or a public
library. They also will receive weekly e-mails with
tailored messages on their progress that include links to
the Web site. Further, they will receive reminders by an
interactive voice phone system to log onto the study's Web
site and respond to e-mail.
"The study will compare these two methods with the self-
directed/usual care group," said Svetkey. "The study
involves a large, diverse group of overweight and obese
people, and will determine the impact of these maintenance
strategies on their weight and heart disease risk factors.
It also will see if the strategies have other effects, such
as on participants' quality of life."
"The Surgeon General, the Secretary of Health and Human
Services, the medical community-everyone recommends that
Americans maintain a healthy weight," said Dr. Eva
Obarzanek, NHLBI nutritionist and project officer for the
Weight Loss Maintenance study. "But very few people become
'successful long-term losers.' This study will test two
behavioral methods to help people keep lost weight off for
the rest of their lives, especially people who are at a
high risk of developing heart disease and other serious
conditions."
Those interested in finding out about enrolling in the
study can call the site near them: for Duke University,
(919) 419-5904; for Pennington, (225) 763-2596; for Kaiser
Permanente, (503) 499-5766; for Johns Hopkins, (410) 281-
1881.
To arrange an interview with an NHLBI scientist, contact
the Institute's Communications Office at (301) 496-4236.
Study investigators also are available for interviews: For
Svetkey, contact Jeffrey Molter at the Duke University
Medical Center Press Office at (919) 660-4148; for Dr.
Lawrence Appel, Professor of Medicine at Johns Hopkins,
contact Karen Blum in the Office of Communications and
Public Affairs at (410) 955-1534 or email her at
kblum@jhmi.edu; for Dr. Patricia J. Elmer, Senior
Investigator at Kaiser Permanente, contact Terry
Fitzpatrick at the Communications Office at (503) 335-6602
or email him at terry.fitzpatrick@kpchr.org; and for Dr.
Phillip J. Brantley, Chief of Primary Care Research and
Director of the Division of Educational Programs at
Pennington, contact Alan Pesch in the Communications Office
at (225) 763-2500.
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