Empowered With Movement to Prevent Obesity and Weight Regain (EMPOWER)

Wake Forest University (WFU)

Status: Completed

Conditions: Weight Loss; Obesity; Sedentary Lifestyle

Treatments: Behavioral: Sitless; Behavioral: Weight loss; Behavioral: Exercise

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT02923674

R01AG051624-02S2 (U.S. NIH Grant/Contract)

R01AG051624-02S1 (U.S. NIH Grant/Contract)

IRB00035300

R01AG051624 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

This study will help determine the appropriate type, amount and intensity of physical activity most beneficial for preventing weight regain after weight loss in older adults.

Full description

The investigators will use a 3-group design in 180 older (65-85 years), obese (BMI=30-45 kg/m2), sedentary men and women, all of whom will undergo a 9-month Weight Loss (WL) intervention (6-mo intensive phase and 3-mo reduced contact phase), followed by a 9-month self-managed follow-up phase with minimal contact, to test our overall hypothesis that intervening on Sedentary Behavior (SitLess) will enhance long-term Weight Loss in this age group. The diet element of the intervention is identical across groups, but groups differ by activity intervention: 1) structured, moderate-intensity, aerobic exercise (EX) (WL+EX); 2) intervening on SB throughout the day (WL+SitLess); or 3) (WL+EX+SitLess).

Enrollment: 183 patients

Sex: All

Ages: 65 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 65-85 years
• BMI=30-45 kg/m2
• Weight stable-no loss or gain (±5%) in past 6 mo
• Sedentary
• No contraindication for safe and optimal participation in exercise training
• Approved for participation by Medical Director
• Willing to provide informed consent
• Agree to all study procedures and assessments
• Able to provide own transportation to study visits and intervention

Exclusion criteria

• Dependent on cane or walker

• Reported unintentional or intentional weight loss or gain of >5% in past 6 mo Participation in regular resistance training and/or > 20 mins/day of aerobic exercise in past 6 months

• Cognitive impairment (MoCA score <22)

• Low bone density (T-score < -2.3 on hip or spine scan)

• Severe arthritis, or other musculoskeletal disorder

• Joint replacement or other orthopedic surgery in past 6 mos

• Joint replacement or other orthopedic surgery planned in next 2 years

  • Uncontrolled resting hypertension (>160/90 mmHg);
  • Current or recent past (within 1 year) severe symptomatic heart disease, uncontrolled angina, stroke, chronic respiratory disease other than asthma or COPD, any disease requiring oxygen use, neurological or hematological disease; cancer requiring treatment in past year, except non-melanoma skin cancers
  • Serious conduction disorder, new Q waves or ST-segment depression (>3 mm), or uncontrolled arrhythmia
  • Room air SpO2 (oxygen saturation) at rest or with exercise qualifying for supplementary oxygen (SpO2≤88%)
  • Abnormal kidney or liver function (2x upper limit of normal);
  • eGFR <45 mL/min/1.73m2
  • Anemia (Hb<13 g/dL in men/ <12 g/dL in women);
  • Uncontrolled diabetes (fasting glucose >140 mg/dl);
  • Deficient levels of vitamin D (25 hydroxyvitamin D level < 20 ng/mL) in those not taking a vitamin D supplement;
  • Smoker (No nicotine in past yr)
  • No heavy alcohol use (>14 drinks/week)
  • Unstable severe depression

• Regular use of: growth hormones, oral steroids, weight loss medications or prescription osteoporosis meds

• Current participation in other research study

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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183 participants in 3 patient groups

Weight loss + sitless

Other group

Description:

All participants will undergo a dietary WL intervention designed to elicit behavioral changes leading to decreased caloric intake sufficient to yield a \~10% loss of initial body mass. Participants will be encouraged and taught to reduce sedentary behavior (SB) during waking hours. The SitLess treatment targets increases in postural shifts and light, spontaneous physical activity (SPA) (MET level \<3).

Treatment:

Behavioral: Sitless

Behavioral: Weight loss

Weight loss + exercise

Other group

Description:

All participants will undergo a dietary WL intervention designed to elicit behavioral changes leading to decreased caloric intake sufficient to yield a \~10% loss of initial body mass. Participants will be asked to perform structured aerobic exercise (mostly treadmill walking) of moderate-intensity for 4-5 days/week, progressing to a duration of 200 min/week.

Treatment:

Behavioral: Exercise

Behavioral: Weight loss

Weight loss + exercise + sitless

Other group

Description:

All participants will undergo a dietary WL intervention designed to elicit behavioral changes leading to decreased caloric intake sufficient to yield a \~10% loss of initial body mass. Participants will be encouraged and taught to reduce sedentary behavior (SB) during waking hours. The SitLess treatment targets increases in postural shifts and light, spontaneous physical activity (SPA) (MET level \<3). Participants will be asked to perform structured aerobic exercise (mostly treadmill walking) of moderate-intensity for 4-5 days/week, progressing to a duration of 200 min/week.

Treatment:

Behavioral: Sitless

Behavioral: Exercise

Behavioral: Weight loss