Do lifestyle interventions for preventing weight gain in young adults work?

Here in the Woodland I’ve been quietly checking out the young adult elves amongst us. Trying to figure out if the research that shows that younger generations are gaining weight faster than their parents is indeed true.

It’s a crazy time isn’t it, the action packed years between 18 and 35? You head out into the big wide woodland with your whole life in front of you.  You feel invincible, ‘Live fast, (hopefully don’t) die young’ and all that. Perhaps going off to college, starting a new job, getting married and eventually having babies.

It seems that there is a real issue with age-related weight gain during young adulthood. The cause of this appears to be lifestyle based, with work, study and social commitments taking precedent. You exercise less than at school, eat out more and often live a more sedentary lifestyle. The cardiovascular and metabolic disease risk factors associated with weight gain are well documented so preventing weight gain in the first place is desirable. In order to understand more clearly how to intervene effectively in this population more research is needed.

To that end a systematic review from Australia has been published recently. The aim was to examine randomised controlled trials (RCTs) of lifestyle behaviour change interventions for preventing weight gain among healthy adults and to identify the specific characteristics of effective interventions. The study investigated interventions such as supervised exercise sessions, education and information on physical activity and dietary and behavioural skills for weight management, such as self-regulation, goal setting or the provision of feedback. The primary outcome measured was the mean body weight change. After a search of relevant databases they found eight relevant RCT studies that were suitable for inclusion involving 388 healthy subjects aged 18-35 years. A meta-analysis of the RCTs was carried out and this is what they found:

  • Young adults receiving interventions lost a mean 0.87kg (95% CI -1.56, -0.18), compared with controls that gained 0.86kg (95% CI 0.14, 1.57)
  • Further analysis revealed that participants receiving evidence based interventions for 4 months or longer achieved a greater significant weight loss (-1.62 [95% CI -3.21, -0.04], P=0.045)
  • Characteristics of the evidence based interventions included teaching or requiring participants to perform self-monitoring of weight related behaviours, tailoring advice or feedback to the person, providing as a minimum an initial consultation followed up by group meetings, phone or email support, aiming to increase physical activity and reduce dietary energy density

But:

  • Overall the small number of studies, short duration and large heterogeneity of trials mean that the effectiveness of lifestyle interventions for young adults remains unclear
  • Studies published in languages other than English were excluded
  • The review also excluded obesity treatment interventions, which may have components of lifestyle behaviour change that are relevant for weight gain prevention

The authors concluded:

Future trials conducted over longer periods with larger samples are urgently required to develop effective programmes that will protect against weight gains in future generations

Efficacy of future trials may be increased by providing regular follow-up support, addressing nutrition, physical activity and behavioural skills for weight management, and by tailoring interventions to not only the young adult population generally, but to the individual level so that recommendations or advice are personally relevant

The ‘live fast, die young’ attitude has stiff competition from the ‘live slow (eat well, move more), die as old as possible’ theory. I know I much prefer the latter! Young adults need to understand and adopt health-promoting behaviours so that they can reduce the risk of becoming overweight for themselves and for their own children. More research is needed in this field to develop effective intervention programmes that can prevent this worrying trend.

Link

Hebden, L., Chey, T. and Allman-Farinelli, M. (2012), Lifestyle intervention for preventing weight gain in young adults: a systematic review and meta-analysis of RCTs. Obesity Reviews, 13: 692–710. doi: 10.1111/j.1467-789X.2012.00990.x [PubMed]