Differential response of African American and Caucasian women to extended-care programs for obesity management.

OBJECTIVE: The current study examined ethnic differences in patterns of weight loss and regain in response to an initial behavioral weight loss intervention followed by an extended-care maintenance program. METHODS: We analyzed data from 224 women (African American n = 43, Caucasian n = 181) from rural communities who participated in an initial 6-month lifestyle intervention for obesity and were then randomized to a face-to-face, telephone, or educational/control extended-care condition. RESULTS: African American participants lost less weight during the initial phase of treatment than Caucasian participants (mean +/- SE = -6.8 +/-.80 vs -10.7 +/- .38 kg, respectively, P = .003). Investigating weight change during month 6 to month 18, we found a significant interaction between ethnicity and the provision of an extended-care program. Caucasian participants randomized to either of two extended-care programs regained less weight than those assigned to the control condition (1.2 +/- .58 and 4.2 +/- .79 kg, respectively, P=.003), but the provision of extended care did not influence weight regain among African American participants (1.9 +/- 1.12 and 1.34 +/- 2.04 kg, respectively, P = .815). CONCLUSION: Collectively, these findings suggest that although African American participants lost less weight during the initial phase of treatment, they exhibited better long-term weight-loss maintenance than Caucasian participants. Further, while the provision of extended care successfully enhanced weight maintenance among Caucasian participants, African American participants maintained their initial weight losses regardless of extended care.

A multicomponent intervention reduces body weight and cardiovascular risk at a GEICO corporate site.

PURPOSE: To determine whether a multicomponent nutrition intervention program at a corporate site reduces body weight and improves other cardiovascular risk factors in overweight individuals. DESIGN: Prospective clinical intervention study. SUBJECTS/SETTING: Employees of the Government Employees Insurance Company (GEICO) (N = 113), aged 21 to 65 years, with a body mass index > or =25 kg/m(2) and/or previous diagnosis of type 2 diabetes. INTERVENTION: A 22-week intervention including a low-fat, vegan diet. MEASURES: Changes in body weight, anthropometric measures, blood pressure, lipid profile, and dietary intake. ANALYSIS: Multivariate analyses of variance were calculated for clinical and nutrient measures, followed by univariate analyses of variance, to determine the significance of differences between groups in changes over time. RESULTS: Intervention-group participants experienced greater weight changes compared with control-group participants (mean, -5.1 [SE, .6] kg vs. + .1 [SE, .6] kg, p < .0001), as well as greater changes in waist circumference (mean, -4.7 [SE, .6] cm vs. + .8 [SE, .6] cm, p < .0001) and waistratiohip ratio (mean, -.006 [SE, .003] vs. + .014 [SE, .005], p = .0007). Weight loss of 5% of body weight was more frequently observed in the intervention group (48.5%) compared with the control group (11.1%) (chi(2)[1, N = 113] = 16.99, p < .0001). CONCLUSIONS: Among individuals volunteering for a 22-week worksite research study, an intervention using a low-fat, vegan diet effectively reduced body weight and waist circumference.

A worksite vegan nutrition program is well-accepted and improves health-related quality of life and work productivity.

BACKGROUND/AIMS: Vegetarian and vegan diets are effective in preventing and treating several chronic diseases. However, their acceptability outside a clinical trial setting has not been extensively studied. The aim of this study was to determine the acceptability of a worksite vegan nutrition program and its effects on health-related quality of life and work productivity. METHODS: Employees of a major insurance corporation with a body mass index > or =25 kg/m(2) and/or a previous diagnosis of type 2 diabetes received either weekly group instruction on a low-fat vegan diet (n = 68) or received no diet instruction (n = 45) for 22 weeks. RESULTS: The vegan group reported improvements in general health (p = 0.002), physical functioning (p = 0.001), mental health (p = 0.03), vitality (p = 0.004), and overall diet satisfaction (p < 0.001) compared with the control group. The vegan group also reported a decrease in food costs (p = 0.003), and increased difficulty finding foods when eating out (p = 0.04) compared with the control group. The vegan group reported a 40-46% decrease in health-related productivity impairments at work (p = 0.03) and in regular daily activities (p = 0.004). CONCLUSIONS: A worksite vegan nutrition program is well-accepted and can be implemented by employers to improve the health, quality of life, and work productivity of employees.

A worksite programme significantly alters nutrient intakes.

OBJECTIVE: To examine whether a worksite nutrition programme using a low-fat vegan diet could significantly improve nutritional intake. DESIGN: At two corporate sites of the Government Employees Insurance Company, employees who were either overweight (BMI > or = 25 kg/m2) and/or had type 2 diabetes participated in a 22-week worksite-based dietary intervention study. SETTING: At the intervention site, participants were asked to follow a low-fat vegan diet and participate in weekly group meetings that included instruction and group support (intervention group). At the control site, participants received no instruction (control group). At weeks 0 and 22, participants completed 3 d dietary records to assess energy and nutrient intake. SUBJECTS: A total of 109 participants (sixty-five intervention and forty-four control). RESULTS: In the intervention group, reported intake of total fat, trans fat, saturated fat and cholesterol decreased significantly (P < or = 0.001), as did energy and protein (P = 0.01), and vitamin B12 (P = 0.002), compared with the control group. Intake (exclusive of any use of nutritional supplements) of carbohydrate, fibre, vitamin C, magnesium and potassium increased significantly (P < or = 0.0001), as did that for beta-carotene (P = 0.0004), total vitamin A activity (P = 0.004), vitamin K (P = 0.01) and sodium (P = 0.04) in the intervention group, compared with the control group. CONCLUSIONS: The present study suggests that a worksite vegan nutrition programme increases intakes of protective nutrients, such as fibre, folate and vitamin C, and decreases intakes of total fat, saturated fat and cholesterol.