Diabetes prevention and control in the workplace: a pilot project for county employees. Pragmatic randomised trial of a 12-week exercise and nutrition program for Aboriginal and Torres Strait Islander women: clinical results immediate post and 3 months follow-up Effect of individual counseling on physical activity fitness and health: a randomized controlled trial in a workplace setting. Effects of workplace-based dietary and/or physical activity interventions for weight management targeting healthcare professionals: a systematic review of randomised controlled trials Diet, physical exercise and cognitive behavioral training as a combined workplace based intervention to reduce body weight and increase physical capacity in health care workers - a randomized controlled trial Efficacy of a workplace-based weight loss program for overweight male shift workers: the Workplace POWER (Preventing Obesity Without Eating like a Rabbit) randomized controlled trial. Effectiveness of workplace interventions in rehabilitating musculoskeletal disorders and preventing its consequences among workers with physical and sedentary employment: systematic review protocol para tu Salud: Reduction of Weight and Waistlines by Integrating Exercise Breaks into Workplace Organizational Routine Reducing office workers’ sitting time: rationale and study design for the Stand Up Victoria cluster randomized trial Health benefits of a pedometer-based physical activity intervention in sedentary workers. Cardiorespiratory Fitness in Childhood and Adolescence Affects Future Cardiovascular Risk Factors: A Systematic Review of Longitudinal Studies Evaluation of a modified cognitive–behavioural programme for weight management The impact of a bodyweight and physical activity intervention (BeWEL) initiated through a national colorectal cancer screening programme: randomised controlled trial Physical activity and body composition outcomes of the GreatFun2Run intervention at 20 month follow-up A single-blind, pilot randomised trial of a weight management intervention for adults with intellectual disabilities and obesity: study protocol Intrapersonal, social and physical environmental determinants of moderate-to-vigorous physical activity in working-age women: a systematic review protocol School-Based Health Center Intervention Improves Body Mass Index in Overweight and Obese Adolescents ALIFE@Work: a randomised controlled trial of a distance counselling lifestyle programme for weight control among an overweight working population [ISRCTN04265725] Living Well With Diabetes: 24-Month Outcomes From a Randomized Trial of Telephone-Delivered Weight Loss and Physical Activity Intervention to Improve Glycemic Control Exercise more or sit less? A randomized trial assessing the feasibility of two advice-based interventions in obese inactive adults. An intervention to reduce sitting and increase light-intensity physical activity at work: Design and rationale of the 'Stand & Move at Work' group randomized trial. The effects of a graduated aerobic exercise programme on cardiovascular disease risk factors in the NHS workplace: a randomised controlled trial Effects of Nordic walking on cardiovascular risk factors in overweight individuals with type 2 diabetes, impaired or normal glucose tolerance.
OBJECTIVES To improve nutrition and physical activity of county employees and promote weight loss . DESIGN R and om assignment to begin the program when first offered or after 3 months ( " wait control " group ) . SETTING Worksite . PARTICIPANTS Onondaga County employees ( n = 45 ) at risk for diabetes ( n = 35 ) or with diabetes ( n = 10 ) . Mean ( ±SD ) age = 51.2 ( ± 8.0 ) years and body mass index ( BMI ) = 37.3 ± ( 6.8 kg/m ) . INTERVENTION Twelve weekly healthy lifestyle sessions based on the Diabetes Prevention Program curriculum , followed by monthly sessions for up to 12 months . OUTCOMES Medical : Weight , BMI , waist circumference , blood pressure , fasting glucose , lipid , and hemoglobin A1c levels . Psychosocial/behavioral : Health-related quality of life Short Form-12 , Impact of Weight on Quality of Life Scale ) , physical activity ( International Physical Activity Question naire ) , eating behavior ( 3-Factor Eating Question naire , National Cancer Institute Fat Screener ) , job satisfaction . RESULTS The intervention group lost significant weight compared to the wait control group over the first 3 months ( mean [ 95 % CI ] , -2.23 kg [ -3.5 to 0.97 ] ) vs [ + 0.73 kg ( + 0.17 to + 1.28 ) ] , with a decrease in BMI ( P < .001 ) and waist circumference ( P = .004 ) , an increase in physical activity ( International Physical Activity Question naire , P = .011 ) and lower dietary fat intake ( P = .018 ) . Over 12 months , 22.5 % ( 9/40 ) lost more than 5 % body weight and 12.5 % ( 5/40 ) lost more than 7 % body weight . After the first 3 months , there was gradual partial weight regain but reduction in waist circumference was maintained . The intervention group demonstrated significant improvement in Impact of Weight on Quality of Life Scale ( P < .001 ) , 3-Factor Eating ( cognitive restraint P < .001 , uncontrolled eating P = .003 , and emotional eating P = .001 ) , International Physical Activity Question naire ( P = .011 ) , and Short Form-12 Physical Component Summary ( P = .048 ) . No improvements were observed in blood pressure , lipid , hemoglobin A1c , or glucose levels . Job satisfaction was inversely related to BMI at baseline ( P = .001 ) with a trend for improvement with the modest weight loss . CONCLUSIONS A worksite intervention program can help government employees adopt healthier lifestyles and achieve modest weight loss Background Aboriginal and Torres Strait Isl and er women experience higher rates of heart disease and type 2 diabetes than non-Indigenous Australian women . Increasing physical activity , improving diets and losing weight have been shown to reduce cardio metabolic risk . The primary aim was to evaluate the effectiveness of a 12-week structured exercise and nutrition program in a cohort of urban Indigenous Australian women on waist circumference , weight and biomedical markers of metabolic functioning from baseline ( T1 ) to program completion ( T2 ) . The secondary aim assessed whether these outcomes were maintained at 3-month follow-up . Methods One hundred Aboriginal and /or Torres Strait Isl and er women aged 18–64 years living in the Adelaide metropolitan area were recruited . The program included two 60-minute group cardiovascular and resistance training classes per week , and four nutrition education workshops . Participants were r and omly assigned to an ‘ active ’ group or ‘ waitlisted ’ control group .  Body weight , height , waist and hip circumference , blood pressure , fasting glucose , fasting insulin , glycated haemoglobin ( HbA1C ) , lipid profile and C-reactive protein ( CRP ) were assessed at baseline ( T1 ) , immediately after the program ( T2 ) and three months post program ( T3 ) . Results The active group showed modest reductions in weight and body mass index ( BMI ) . Compared to the waitlisted group , the active group had a statistically significantly change in weight and BMI from baseline assessment s ; at T2 , -1.65 kg and -0.66 kg/m2 and at T3 , -2.50 kg and -1.03 kg/m2 , respectively . Systolic and diastolic blood pressure also had a statistically significant difference from baseline in the active group compared to the waitlisted group at T2 , -1.24 mmHg and -2.46 mmHg and at T3 , -4.09 mmHg and -2.17 mmHg , respectively . The findings were independent of the baseline measure of the outcome variable , age , households with children and employment status . Changes in waist circumference and other clinical measures were not significant at T2 or T3 . The primary outcome measure , waist circumference , proved problematic to assess reliably . Missing data and participants lost to follow-up were significant . Conclusions This 12-week exercise program demonstrated modest reductions in weight , BMI and blood pressure at T2 , which improved further at 3-month follow-up ( T3 ) . Positive intervention effects were observed despite low attendance at exercise classes . Structured exercise programs implemented in community setting s require attention to underst and ing the barriers to participation for this high risk group . Trial registration Australian New Zeal and Clinical Trials Registry BACKGROUND Physical inactivity and obesity are major public health problems . Our objective was to investigate the effectiveness of an individual counseling intervention at the workplace on physical activity fitness and health . Counseling content derived from the Patient-centered Assessment and Counseling for Exercise and Nutrition ( PACE ) program . METHODS A total of 299 employees of three municipal services in the Dutch town of Enschede were r and omly allocated into intervention ( n = 131 ) and control group ( n = 168 ) . Over a 9-month period , intervention group subjects were offered seven counseling sessions . Counseling was based on the individual 's stage of behavioral change using PACE physical activity and nutrition protocol s. Subjects in both the intervention and control group received written information about several lifestyle factors . Primary outcome measures were physical activity ( total energy expenditure , during sports activities , during physical activity leisure time other than sports , and meeting the moderate-intensity public health recommendations ) ; cardiorespiratory fitness ; and prevalence of musculoskeletal symptoms . Secondary outcome measures were body composition ( body mass index [ BMI ] , and percentage of body fat measured via skinfold thicknesses ) ; blood pressure ; and blood cholesterol . RESULTS There were significant positive effects on total energy expenditure , physical activity during sports , cardiorespiratory fitness , percentage of body fat , and blood cholesterol . No effects were found for the proportion of subjects meeting the public health recommendation of moderate-intensity physical activity , physical activity during leisure time other than sports , prevalence of musculoskeletal symptoms , body mass index , and blood pressure . CONCLUSIONS Individual face-to-face counseling at the workplace based on PACE protocol s positively influenced physical activity levels and some components of physical fitness . The implementation of workplace counseling programs for individuals should therefore be promoted Background The prevalence of overweight and obesity is high amongst healthcare professionals and there is growing interest in delivering weight loss interventions in the workplace . We conducted a systematic review to ( i ) examine the effectiveness of workplace-based diet and /or physical activity interventions aim ed at healthcare professionals and to ( ii ) identify and describe key components of effective interventions . Seven electronic data bases were systematic ally search ed . Results Thirteen r and omised controlled trials met the inclusion criteria , of which seven had data available for meta- analysis . Where meta- analysis was possible , studies were grouped according to length of follow-up ( < 12 months and ≥12 months ) and behavioural target ( diet only , physical activity only or diet and physical activity ) , with outcome data pooled using a weighted r and om effects model . Nine studies reported statistically significant ( between-group ) differences . Four studies reported being informed by a behaviour change theory . Meta- analysis of all trials reporting weight data demonstrated healthcare professionals allocated to dietary and physical activity interventions lost significantly more body weight ( −3.95 Kg , [ 95 % CI −4.96 to- 2.95 Kg ] ) than controls up to 12 months follow up . Conclusions Workplace diet and /or physical activity interventions targeting healthcare professionals are limited in number and are heterogeneous . To improve the evidence base , we recommend additional evaluations of theory-based interventions and adequate reporting of intervention content Background Health care workers comprise a high-risk workgroup with respect to deterioration and early retirement . There is high prevalence of obesity and many of the workers are overweight . Together , these factors play a significant role in the health-related problems within this sector . The present study evaluates the effects of the first 3-months of a cluster r and omized controlled lifestyle intervention among health care workers . The intervention addresses body weight , general health variables , physical capacity and musculoskeletal pain . Methods 98 female , overweight health care workers were cluster-r and omized to an intervention group or a reference group . The intervention consisted of an individually dietary plan with an energy deficit of 1200 kcal/day ( 15 min/hour ) , strengthening exercises ( 15 min/hour ) and cognitive behavioral training ( 30 min/hour ) during working hours 1 hour/week . Leisure time aerobic fitness was planned for 2 hour/week . The reference group was offered monthly oral presentations . Body weight , BMI , body fat percentage ( bioimpedance ) , waist circumference , blood pressure , musculoskeletal pain , maximal oxygen uptake ( maximal bicycle test ) , and isometric maximal muscle strength of 3 body regions were measured before and after the intervention period . Results In an intention-to-treat analysis from pre to post tests , the intervention group significantly reduced body weight with 3.6 kg ( p < 0.001 ) , BMI from 30.5 to 29.2 ( p < 0.001 ) , body fat percentage from 40.9 to 39.3 ( p < 0.001 ) , waist circumference from 99.7 to 95.5 cm ( p < 0.001 ) and blood pressure from 134/85 to 127/80 mmHg ( p < 0.001 ) , with significant difference between the intervention and control group ( p < 0.001 ) on all measures . No effect of intervention was found in musculoskeletal pain , maximal oxygen uptake and muscle strength , but on aerobic fitness . Conclusion The significantly reduced body weight , body fat , waist circumference and blood pressure as well as increased aerobic fitness in the intervention group show the great potential of workplace health promotion among this high-risk workgroup . Long-term effects of the intervention remain to be investigated . Trial registration Clinical Trials.gov : OBJECTIVE To evaluate the feasibility and efficacy of a workplace-based weight loss program ( Workplace POWER-WP ) for male shift workers . METHOD A prospect i ve , two-armed r and omized controlled trial of 110 overweight/obese ( BMI 25 - 40 ) ( mean [ SD ] age = 44.4 [ 8.6 ] years ; BMI = 30.5 [ 3.6 ] ) male employees at Tomago Aluminium aged 18 - 65 . In October ( 2009 ) men were r and omized to either ( i ) WP program ( n=65 ) or ( ii ) a 14-week wait-list control group ( n=45 ) . The 3-month program involved one information session , program booklets , group-based financial incentives and an online component . Men were assessed at baseline and at 14-week follow-up for weight ( primary outcome ) , waist circumference , BMI , blood pressure , resting heart rate , self-reported physical activity and dietary variables , and physical activity and dietary cognitions . RESULTS Intention-to-treat analysis using linear mixed models revealed significant between group differences for weight loss after 14 weeks ( P < .001 , Cohen 's d = 0.34 ) . Significant intervention effects were also found for waist circumference ( P < .001 , d = 0.63 ) , BMI ( P < .001 , d = 0.41 ) , systolic blood pressure ( P = .02 , d = 0.48 ) , resting heart rate ( P < .001 , d = 0.81 ) , physical activity ( P = .03 , d = 0.77 ) , sweetened beverages ( P < .02 , d = 0.5 - 0.6 ) and physical activity-related cognitions ( P < .02 , d=0.6 ) . CONCLUSION The WP program was feasible and efficacious and result ed in significant weight loss and improved health-related outcomes and behaviours in overweight male shift workers Background Musculoskeletal disorders ( MSDs ) are the leading cause of work disability and sickness absence worldwide . The prevalence of MSDs increases with age , consequently challenging sustainable employability among the growing ageing workforce . Knowledge of feasible and efficient workplace-based interventions to rehabilitate MSD or prevent its consequences is therefore warranted . This systematic review will evaluate the effectiveness of workplace-based interventions on MSDs and its consequences among adult workers with physical and sedentary work tasks , respectively . Methods We will search the following bibliographic data bases : PubMed ( including the data base ‘ MEDLINE ’ ) and Web of Science Core Collection ( including the data bases ‘ Science Citation Index Exp and ed ’ , ‘ Social Sciences Citation Index ’ and ‘ Arts & Humanities Citation Index ’ ) . Manual search es will also be performed . We will include r and omised controlled trials ( RCTs ) and non- RCTs reported in English in which ( 1 ) participants are adult workers with MSD , ( 2 ) interventions are aim ing at rehabilitating pain symptoms of MSD or preventing the consequences of MSD and ( 3 ) interventions are initiated and /or carried out at the workplace . The review will adhere to the ‘ Preferred Reporting Items for Systematic review s and Meta-Analyses ’ ( PRISMA ) guidelines for reporting systematic review s and the Institute for Work and Health ( IWH ) guidelines for workplace-based interventions . For the primary evaluation of the review , the quality assessment and evidence synthesis will conform to the IWH guidelines . Secondary evaluation will include a meta- analysis ( unless the included studies do not allow this due to heterogeneity ) and employ the risk of bias domains recommended by Cochrane along with the Grading of Recommendations , Assessment , Development and Evaluations ( GRADE ) approach on the studies with pain intensity as an outcome . Discussion This systematic review will provide knowledge on effective workplace-based interventions among physical and sedentary workers with MSD . RCTs are considered the most powerful experimental design in clinical trials , but solely including these may be too restrictive to underst and effective workplace-based interventions where r and omised and carefully controlled trials ( RCTs ) are not always possible . In order to maximize practical relevance , the selection process will , therefore , include both RCTs and non- RCTs and the quality assessment and evidence synthesis will conform to IWH guidelines focusing on developing practical guidelines for stakeholders . The result of this work will form the basis for industry-specific evidence -based recommendations on effective workplace-based interventions for rehabilitation of MSDs and its consequences that will later be operationalised into concrete and user-friendly practical tools for workplaces . Systematic review registration International Prospect i ve Register of Systematic Review s ( PROSPERO ) number CRD42018116752 Introduction Proactive worksite strategies that change the physical or sociocultural environment(s ) to incorporate obligatory physical activity may be necessary to engage sedentary people . This study describes implementation and evaluation of an intervention , Pausa para tu Salud ( Pause for Your Health ) , that integrated a brief period of group exercise into the workday . Methods An uncontrolled pretest – post-test study design tested the effects of integrating daily 10-minute exercise breaks during paid work time during January 2003 through January 2004 . A total of 335 Mexican Ministry of Health office workers provided baseline data as a part of routine annual clinical screening examinations . Results Baseline mean body mass index and waist circumferences were 27.8 kg/m2 and 87.6 cm for women and 26.6 kg/m2 and 89.7 cm for men . Complete data were available for 271 ( 80.9 % ) employees at 1-year follow-up . Two-tailed , paired t-test comparisons were used . Body mass index decreased by 0.32 kg/m2 ( P = .05 ) , and waist circumference by 1.6 cm ( P = .0009 ) overall . The body mass index decrease , however , was significant only for men ( −0.43 kg/m2 , P = .03 ) . Multivariate analyses revealed a significant decrease in diastolic blood pressure among women ( z = −2.04 , P = .042 ) . Conclusion The intervention was associated with significant improvements in both measures of body composition . Substantive health and organizational benefits may result from integrating brief periods of physical activity into the workday if these findings are replicated in r and omized controlled trials in other worksites Background Excessive time spent in sedentary behaviours ( sitting or lying with low energy expenditure ) is associated with an increased risk for type 2 diabetes , cardiovascular disease and some cancers . Desk-based office workers typically accumulate high amounts of daily sitting time , often in prolonged unbroken bouts . The St and Up Victoria study aims to determine whether a 3-month multi-component intervention in the office setting reduces workplace sitting , particularly prolonged , unbroken sitting time , and results in improvements in cardio-metabolic biomarkers and work-related outcomes , compared to usual practice . Methods / Design A two-arm cluster-r and omized controlled trial ( RCT ) , with worksites as the unit of r and omization , will be conducted in 16 worksites located in Victoria , Australia . Work units from one organisation ( Department of Human Services , Australian Government ) will be allocated to either the multi-component intervention ( organisational , environmental [ height-adjustable workstations ] , and individual behavioural strategies ) or to a usual practice control group . The recruitment target is 160 participants ( office-based workers aged 18–65 years and working at least 0.6 full time equivalent ) per arm . At each assessment ( 0- [ baseline ] , 3- [ post intervention ] , and 12-months [ follow-up ] ) , objective measurement via the activPAL3 activity monitor will be used to assess workplace : sitting time ( primary outcome ) ; prolonged sitting time ( sitting time accrued in bouts of ≥30 minutes ) ; st and ing time ; sit-to-st and transitions ; and , moving time . Additional outcomes assessed will include : non-workplace activity ; cardio-metabolic biomarkers and health indicators ( including fasting glucose , lipids and insulin ; anthropometric measures ; blood pressure ; and , musculoskeletal symptoms ) ; and , work-related outcomes ( presenteeism , absenteeism , productivity , work performance ) . Incremental cost-effectiveness and identification of both workplace and individual-level mediators and moderators of change will also be evaluated . Discussion St and Up Victoria will be the first cluster- RCT to evaluate the effectiveness of a multi-component intervention aim ed at reducing prolonged workplace sitting in office workers . Strengths include the objective measurement of activity and assessment of the intervention on markers of cardio-metabolic health . Health- and work-related benefits , as well as the cost-effectiveness of the intervention , will help to inform future occupational practice .Trial registration BACKGROUND Inactivity is a leading contributor to chronic health problems . Here , we examined the effects of a pedometer-based physical activity intervention ( Prince Edward Isl and -First Step Program , PEI-FSP ) on activity and specific health indices in 106 sedentary workers . METHODS Participants were recruited from five workplaces where most jobs were moderately-highly sedentary . Using subjects as their own control , physical activity ( pedometer-determined steps per day ) was compared before and after a 12-week intervention . Changes in body mass index ( BMI ) , waist girth , resting heart rate , and blood pressure were evaluated . RESULTS The PEI-FSP was completed by 59 % of participants . Steps per day increased from 7,029 + /- 3,100 ( SD ) at baseline to a plateau of 10,480 + /- 3,224 steps/day by 3.96 + /- 3.28 weeks of the intervention . The amount that participants were able to increase their steps per day was not related to their baseline BMI . On average , participants experienced significant decreases in BMI , waist girth , and resting heart rate . Reductions in waist girth and heart rate were significantly related to the increase in steps per day . In contrast , reductions in BMI were predicted by the initial steps per day . CONCLUSIONS The PEI-FSP increased physical activity in a sedentary population . Importantly , those with a higher BMI at baseline achieved relatively similar increases in their physical activity as participants with a lower BMI Background Although cardiorespiratory fitness ( CRF ) in childhood and adolescence may be linked to future cardiovascular health , there is currently limited evidence for a longitudinal association . Objectives To provide a systematic review on the prospect i ve association between CRF in childhood and adolescence and cardiovascular disease ( CVD ) risk factors at least 2 years later . Methods Using a systematic search of Medline , Embase , and SPORTD iscus , relevant articles were identified by the following criteria : generally healthy children and adolescents between 3 and 18 years of age with CRF assessed at baseline , and a follow-up period of ≥ 2 years . The outcome measures were CVD risk factors . We appraised quality of the included articles with STROBE and QUIPS checklists . Results After screening 7524 titles and abstract s , we included 38 articles , assessing 44,169 children and adolescents followed up for a median of 6 years . Eleven articles were of high quality . There was considerable heterogeneity in methodology , measurement of CRF , and outcomes , which hampered meta- analysis . In approximately half of the included articles higher CRF in childhood and adolescence was associated with lower body mass index ( BMI ) , waist circumference , body fatness and lower prevalence of metabolic syndrome in later life . No associations between CRF in childhood and adolescence and future waist-to-hip ratio , blood pressure , lipid profile , and glucose homeostasis were observed . Conclusion Although about half of the included articles reported inverse associations between CRF in childhood and adolescence and future BMI , body fatness , and metabolic syndrome , evidence for other CVD risk factors was unconvincing . Many articles did not account for important confounding factors such as adiposity . Recommendations for future research include st and ardizing the measurement of CRF , i.e. by reporting VO2max , using st and ardized outcome assessment s , and performing individual patient data meta-analyses OBJECTIVE : To evaluate a modified cognitive – behavioural treatment ( M-CBT ) for weight management which addresses both the psychosocial costs and the physiological health risks of obesity , without a focus on weight loss . DESIGN : R and omized controlled trial comparing M-CBT with st and ard cognitive – behavioural therapy (S-CBT).SUBJECTS : Sixty-three overweight women with body mass index ( BMI ) ≥28 kg/m2 , mean age=47.5 and mean BMI = 35.4 .  MEASURES : Weight , waist and hip circumference , blood lipids , blood glucose , blood pressure , psychological well-being , depression , self esteem , stress , binge eating , eating style , body image , nutrient intake , aerobic fitness , activity levels , patient satisfaction with treatment . RESULTS : Both M-CBT and S-CBT achieved improvements in a broad range of physical , psychological and behavioural variables . Weight loss in the S-CBT group was greater than in the M-CBT group immediately after treatment , but both groups lost weight . Participants in the M-CBT group continued to lose weight up to the 1 y follow-up . M-CBT was evaluated positively by participants . CONCLUSIONS : Both M-CBT and S-CBT programmes were successful at inducing modest weight loss , as well as improving emotional well-being , reducing distress , increasing activity and fitness , improving dietary quality and reducing cardio-vascular disease risk factors . The improvements were maintained or continued at 1 y follow-up . These results suggest that treatment based on the new weight-control paradigm which emphasizes sustained lifestyle change without emphasis on dieting , can produce modest benefits to health and well-being Objective To evaluate the impact of a diet and physical activity intervention ( BeWEL ) on weight change in people with a body mass index > 25 weight (kg)/height (m)2 at increased risk of colorectal cancer and other obesity related comorbidities . Design Multicentre , parallel group , r and omised controlled trial . Setting Four Scottish National Health Service health boards . Participants 329 overweight or obese adults ( aged 50 to 74 years ) who had undergone colonoscopy after a positive faecal occult blood test result , as part of the national bowel screening programme , and had a diagnosis of adenoma confirmed by histopathology . 163 were r and omised to intervention and 166 to control . Intervention Participants were r and omised to a control group ( weight loss booklet only ) or 12 month intervention group ( three face to face visits with a lifestyle counsellor plus monthly 15 minute telephone calls ) . A goal of 7 % reduction in body weight was set and participants received a personalised energy prescription ( 2508 kJ ( 600 kcal ) below that required for weight maintenance ) and bodyweight scales . Motivational interviewing techniques explored self assessed confidence , ambivalence , and personal values concerning weight . Behavioural strategies included goal setting , identifying intentions of implementation , self monitoring of body weight , and counsellor feedback about reported diet , physical activity , and weight change . Main outcome measures The primary outcome was weight change over 12 months . Secondary outcomes included changes in waist circumference , blood pressure , fasting cardiovascular biomarkers , and glucose metabolism variables , physical activity , diet , and alcohol consumption . Results At 12 months , data on the primary outcome were available for 148 ( 91 % ) participants in the intervention group and 157 ( 95 % ) in the control group . Mean weight loss was 3.50 kg ( SD 4.91 ) ( 95 % confidence interval 2.70 to 4.30 ) in the intervention group compared with 0.78 kg ( SD 3.77 ) ( 0.19 to 1.38 ) in the control group . The group difference was 2.69 kg ( 95 % confidence interval 1.70 to 3.67 ) . Differences between groups were significant for waist circumference , body mass index , blood pressure , blood glucose level , diet , and physical activity . No reported adverse events were considered to be related to trial participation . Conclusions Significant weight loss can be achieved by a diet and physical activity intervention initiated within a national colorectal cancer screening programme , offering considerable potential for risk reduction of disease in older adults . Trial registration Current Controlled Trials IS RCT N53033856 Background Physical inactivity is recognised as a public health concern within children and interventions to increase physical activity are needed . GreatFun2Run was a school-based healthy lifestyles intervention that showed positive changes in physical activity levels and body composition immediately post-intervention . The purpose of this paper was to examine whether these changes in physical activity and body composition were maintained 18 - 20 months after the intervention ended . Method Participants ( n = 589 , aged 7 - 11 yrs ) from 4 intervention and 4 control schools took part in the 10-month intervention , of which 421 ( 71 % ) were present for follow-up . The intervention comprised a CD-rom learning and teaching re source for teachers ; an interactive website for pupils , teachers and parents ; two highlight physical activity events ( 1 mile school runs/walks ) ; a local media campaign ; and a summer activity wall planner and record . R and omisation was not possible because of local media content . Outcome measures were objective ly measured physical activity ( pedometers and accelerometers ) and body composition variables ( body mass index , waist circumference , estimated percent body fat , and sum of skinfolds ) . Teacher interviews and participant focus groups were conducted . Multi-level modelling was employed for the data analysis . Results Both control and intervention participants had increased their physical activity at follow-up but there was no group by time interaction ( control : 2726 steps per day increase ; intervention 3404 steps per day increase , p > .05 ) . There were significant increases in estimated percent body fat , sum of skinfolds , waist circumference and body mass index ( BMI ) with increasing age . In the control group , there was evidence for a plateauing in the rate of change in all body composition variables with increasing age , except BMI . In contrast , significant interaction terms suggest that the rate of change in waist circumference , BMI and BMI SDS continued to increase with age in the intervention group . Teacher interviews suggested that because of time pressures , competing re sources , curriculum dem and s and staff changes the majority of teachers had not continued to use the re sources . Conclusions While the intervention initially produced positive changes in physical activity levels and body composition , these changes were not sustained once the intervention ended . Facilitating long-term health behaviour change in children remains a challenge Background The prevalence of obesity in adults with intellectual disabilities has consistently been reported to be higher than the general population . Despite the negative impact of obesity on health , there is little evidence of the effectiveness of weight management interventions for adults with intellectual disabilities and obesity . Preliminary results from a single-str and ed feasibility study of a multi-component weight management intervention specifically design ed for adults with intellectual disabilities and obesity ( TAKE 5 ) and that satisfied clinical recommendations reported that it was acceptable to adults with intellectual disabilities and their carers . This study aims to determine the feasibility of a full-scale clinical trial of TAKE 5 . Methods This study will follow a pilot r and omised trial design . Sixty-six obese participants ( body mass index ( BMI ) ≥30 kg/m2 ) will be r and omly allocated to the TAKE 5 multi-component weight management intervention or a health education ‘ active ’ control intervention ( Waist Winners Too ( WWToo ) ) . Both interventions will be delivered over a 12-month period . Participants ’ anthropometric measures ( body weight , BMI , waist circumference , percentage body fat ) ; indicators of activity ( levels of physical activity and sedentary behaviour ) and well-being will be measured at three time points : baseline , 6 and 12 months . The research er collecting outcome measures will be blind to study group allocation . Conclusions The data from this study will generate pilot data on the acceptability of r and omisation , attrition rates and the estimates of patient-centred outcomes of TAKE 5 , which will help inform future research and the development of a full-scale r and omised clinical trial . Trial registration IS RCT N52903778 Background The majority of North American adult females do not meet current physical activity recommendations ( 150 min of moderate-to-vigorous intensity physical activity ( MVPA ) per week accrued in ≥10 min bouts ) ultimately placing themselves at increased risk of morbidity and mortality . Working-age females face particular challenges in meeting physical activity recommendations as they have multiple dem and s , including occupational , family and social dem and s. To develop effective interventions to increase MVPA among working-age females , it is necessary to identify and underst and the strongest modifiable determinants influencing these behaviours . Therefore , the objective of this systematic review is to examine the available evidence to identify intrapersonal , social and environmental determinants of MVPA among working-age females . Methods / Design Six electronic data bases will be search ed to identify all prospect i ve cohort studies that report on intrapersonal , social and /or environmental determinants of  MVPA  in working-age females . Grey literature sources including theses , published conference abstract s and websites from relevant organizations will also be included . Articles that report on intrapersonal ( e.g. health status , self-efficacy , socio-economic status ( SES ) , stress , depression ) , social environmental ( e.g. crime , safety , area SES , social support , climate and capital , policies ) , and environmental ( e.g. weather , workplace , home , neighbourhood , recreation environment , active transportation ) determinants of MVPA  in a working-age ( mean age 18–65 years ) female population will be included . Risk of bias will be assessed within and across all included studies using the Tool to Assess Risk of Bias in Cohort Studies and the Grade s of Recommendation , Assessment , Development and Evaluation approach . Harvest plots will be used to synthesize results across all determinants , and meta-analyses will be conducted where possible among studies with sufficient homogeneity . Discussion This review will provide a comprehensive examination of evidence in this field and will serve to highlight gaps for future research on the determinants of MVPA in working-age females and ultimately inform intervention design . Systematic review registration PROSPERO : CRD42014009750 Adolescents Committed to Improvement of Nutrition and Physical Activity ( ACTION ) was undertaken to determine feasibility of a school-based health center ( SBHC ) weight management program . Two urban New Mexico SBHCs were r and omized to deliver ACTION or st and ard care . ACTION consisted of eight visits using motivational interviewing to improve eating and physical activity behavior . An educational nutrition and physical activity DVD for students and a clinician toolkit were created for use as menu of options . St and ard care consisted of one visit with the SBHC provider who prescribed recommendations for healthy weight .  Sixty nondiabetic overweight/obese adolescents were enrolled . Measures included BMI percentile , waist circumference , insulin resistance by homeostasis model assessment ( HOMA-IR ) , blood pressure , triglycerides , and HDL-C levels . Pre- to postchanges for participants were compared between groups . Fifty-one students ( mean age 15 years , 62 % female , 75 % Hispanic ) completed pre- and post measures .  ACTION  students ( n = 28 ) had improvements in BMI percentile ( P = 0.04 ) and waist circumference ( P = 0.04 ) as compared with students receiving st and  ard care ( n = 23 ) . No differences were found between the two groups in blood pressure , HOMA-IR , triglycerides , and HDL-C. The ACTION SBHC weight management program was feasible and demonstrated improved outcomes in BMI percentile and waist circumference Background The prevalence of overweight is increasing and its consequences will cause a major public health burden in the near future . Cost-effective interventions for weight control among the general population are therefore needed . The ALIFE@Work study is investigating a novel lifestyle intervention , aim ed at the working population , with individual counselling through either phone or e-mail . This article describes the design of the study and the participant flow up to and including r and omisation . Methods / Design ALIFE@Work is a controlled trial , with r and omisation to three arms : a control group , a phone based intervention group and an internet based intervention group . The intervention takes six months and is based on a cognitive behavioural approach , addressing physical activity and diet . It consists of 10 lessons with feedback from a personal counsellor , either by phone or e-mail , between each lesson . Lessons contain educational content combined with behaviour change strategies . Assignments in each lesson teach the participant to apply these strategies to every day life . The study population consists of employees from seven Dutch companies . The most important inclusion criteria are having a body mass index ( BMI ) ≥ 25 kg/m2 and being an employed adult . Primary outcomes of the study are body weight and BMI , diet and physical activity . Other outcomes are : perceived health ; empowerment ; stage of change and self-efficacy concerning weight control , physical activity and eating habits ; work performance/productivity ; waist circumference , sum of skin folds , blood pressure , total blood cholesterol level and aerobic fitness . A cost-utility- and a cost-effectiveness analysis will be performed as well . Physiological outcomes are measured at baseline and after six and 24 months . Other outcomes are measured by question naire at baseline and after six , 12 , 18 and 24 months . Statistical analyses for short term ( six month ) results are performed with multiple linear regression . Analyses for long term ( two year ) results are performed with multiple longitudinal regression . Analyses for cost-effectiveness and cost-utility are done at one and two years , using bootstrapping techniques . Discussion ALIFE@Work will make a substantial contribution to the development of cost-effective weight control- and lifestyle interventions that are applicable to and attractive for the large population at risk OBJECTIVE To evaluate the effectiveness of a telephone-delivered behavioral weight loss and physical activity intervention targeting Australian primary care patients with type 2 diabetes . RESEARCH DESIGN AND METHODS Pragmatic r and omized controlled trial of  telephone counseling ( n = 151 ) versus usual care ( n = 151 ) . Reported here are 18-month ( end-of-intervention ) and 24-month ( maintenance ) primary outcomes of weight , moderate-to-vigorous-intensity physical activity ( MVPA ; via accelerometer ) , and HbA1c level . Secondary outcomes include dietary energy intake and diet quality , waist circumference , lipid levels , and blood pressure . Data were analyzed via adjusted linear mixed models with multiple imputation of missing data . RESULTS Relative to usual-care participants , telephone counseling participants achieved modest , but significant , improvements in weight loss ( relative rate [ RR ] −1.42 % of baseline body weight [ 95 % CI −2.54 to −0.30 % of baseline body weight ] ) , MVPA ( RR 1.42 [ 95 % CI 1.06–1.90 ] ) , diet quality ( 2.72 [ 95 % CI 0.55–4.89 ] ) , and waist circumference ( −1.84 cm [ 95 % CI −3.16 to −0.51 cm ] ) , but not in HbA1c level ( RR 0.99 [ 95 % CI 0.96–1.02 ] ) , or other cardio-metabolic markers . None of the outcomes showed a significant change/deterioration over the maintenance period . However , only the intervention effect for MVPA remained statistically significant at 24 months . CONCLUSIONS The modest improvements in weight loss and behavior change , but the lack of changes in cardio-metabolic markers , may limit the utility , scalability , and sustainability of such an approach OBJECTIVES The risk of metabolic and cardiovascular disease may be reduced by a healthy pattern of daily physical activity . We investigated the feasibility and preliminary effectiveness of advice-based interventions aim ing at either increasing  moderate-to-vigorous intensity physical activity ( MVPA ) or reducing sedentary time ( ST ) in obese volunteers . DESIGN R and omized non-blinded two-armed trial . METHOD Inactive , obese adults were r and omly assigned to reduce sedentary behavior ( SitLess ) ( n=30 ) or increase MVPA ( ExMore ) ( n=29 ) for 4 weeks . Participants wore ActivPAL ( AP ) and ActiGraph ( AG ) devices for 7 consecutive days at baseline and during the final week of the intervention period . Cardiometabolic risk factors ( waist circumference , BMI , percent body fat , blood pressure , VO2max and blood markers ) were measured at baseline and at follow-up . Trial was set in Midtjyll and Denmark from 2012 to 2014 . RESULTS The interventions were completed by 77 % ( SitLess ) and 69 % ( ExMore ) of the participants . The SitLess group reduced sedentary time by 53min/day ( 95 % CI 10 ; 96 ; P<0.05 ) while ExMore increased MVPA by 16min/day ( 95 % CI 5 ; 27 ; P<0.05 ) . SitLess and ExMore both improved VO2max by 8 % and 11 % , respectively ( P<0.05 ) . None of the other measured cardiometabolic risk factors changed over the 4 weeks of intervention . CONCLUSIONS This trial showed that completion of 4-week , advice-based interventions led to reduced ST or increased MVPA  in obese adults . Furthermore , both interventions led to small significant increases in VO2max . Studies of longer duration are needed to determine if these behavioral changes can be maintained , and to quantify possible longterm effects of reduced ST or increased MVPA on cardiometabolic risk factors BACKGROUND American workers spend 70 - 80 % of their time at work being sedentary . Traditional approaches to increase moderate-vigorous physical activity ( MVPA ) may be perceived to be harmful to productivity . Approaches that target reductions in sedentary behavior and /or increases in st and ing or light-intensity physical activity [ LPA ] may not interfere with productivity and may be more feasible to achieve through small changes accumulated throughout the workday METHODS / DESIGN : This group r and omized trial ( i.e. , cluster r and omized trial ) will test the relative efficacy of two sedentary behavior focused interventions in 24 worksites across two states ( N=720 workers ) . The MOVE+ intervention is a multilevel individual , social , environmental , and organizational intervention targeting increases in light-intensity physical activity in the workplace . The ST AND + intervention is the MOVE+ intervention with the addition of the installation and use of sit-st and workstations to reduce sedentary behavior and enhance light-intensity physical activity opportunities . Our primary outcome will be objective ly-measured changes in sedentary behavior and light-intensity physical activity over 12months , with additional process measures at 3months and longer-term sustainability outcomes at 24months . Our secondary outcomes will be a clustered cardiometabolic risk score ( comprised of fasting glucose , insulin , triglycerides , HDL-cholesterol , and blood pressure ) , workplace productivity , and job satisfaction DISCUSSION : This study will determine the efficacy of a multi-level workplace intervention ( including the use of a sit-st and workstation ) to reduce sedentary behavior and increase LPA and concomitant impact on cardiometabolic health , workplace productivity , and satisfaction . TRIAL REGISTRATION Clinical Trials.gov Identifier : NCT02566317 ( date of registration : 10/1/2015 ) Background Sufficient levels of physical activity provide cardio-protective benefit . However within developed society sedentary work and inflexible working hours promotes physical inactivity . Consequently to ensure a healthy workforce there is a requirement for exercise strategies adaptable to occupational time constraint . This study examined the effect of a 12 week aerobic exercise training intervention programme implemented during working hours on the cardiovascular profile of a sedentary hospital workforce . Methods Twenty healthy , sedentary full-time staff members of the North West London Hospital Trust cytology unit were r and omly assigned to an exercise ( n = 12 ; mean ± SD age 41 ± 8 years , body mass 69 ± 12 kg ) or control ( n = 8 ; mean ± SD age 42 ± 8 years , body mass 69 ± 12 kg ) group . The exercise group was prescribed a progressive aerobic exercise-training programme to be performed 4 times a week for 8 weeks ( initial intensity 65 % peak oxygen consumption ( VO2 peak ) ) and to be conducted without further advice for another 4 weeks . The control was instructed to maintain their current physical activity level . Oxygen economy at 2 minutes ( 2minVO2 ) , 4 minutes ( 4minVO2 ) , VO2 peak , systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP ) , BMI , C-reactive protein ( CRP ) , fasting glucose ( GLU ) and total cholesterol ( TC ) were determined in both groups pre-intervention and at 4 week intervals . Both groups completed a weekly Leisure Time Question naire to quantify additional exercise load . Results The exercise group demonstrated an increase from baseline for VO2 peak at week 4 ( 5.8 ± 6.3 % ) and 8 ( 5.0 ± 8.7 % ) ( P < 0.05 ) . 2minVO2 was reduced from baseline at week 4 ( -10.2 ± 10.3 % ) , 8 ( -16.8 ± 10.6 % ) and 12 ( -15.1 ± 8.7 % ) , and 4minVO2 at week 8 ( -10.7 ± 7.9 % ) and 12 ( -6.8 ± 9.2 ) ( P < 0.05 ) . There was also a reduction from baseline in CRP at week 4 ( -0.4 ± 0.6 mg·L-1 ) and 8 ( -0.9 ± 0.8 mg·L-1 ) ( P < 0.05 ) . The control group showed no such improvements . Conclusion This is the first objective ly monitored RCT to show that moderate exercise can be successfully incorporated into working hours , to significantly improve physical capacity and cardiovascular health BACKGROUND Physical activity remains a valuable prevention for metabolic disease . The effects of Nordic walking on cardiovascular risk factors were determined in overweight individuals with normal or disturbed glucose regulation . METHODS We included 213 individuals , aged 60 ± 5.3 years and with body mass index ( BMI ) of 30.2 ± 3.8 kg/m(2 ) ; of these , 128 had normal glucose tolerance ( NGT ) , 35 had impaired glucose tolerance ( IGT ) and 50 had type 2 diabetes mellitus ( T2DM ) . Participants were r and omized to unaltered physical activity or to 5 h per week of Nordic walking with poles , for a 4-month period . Dietary habits were unaltered . BMI , waist circumference , blood pressure , glucose tolerance , clinical chemistry , maximal oxygen uptake ( peak VO(2 ) ) and self-reported physical activity ( question naire ) were assessed at the time of inclusion and after 4 months . The participants in the exercise-intervention group kept a walking diary . RESULTS In the NGT exercise group , self-reported physical activity increased markedly , and body weight ( -2.0 ± 3.8 kg ) , BMI ( -0.8 ± 1.4 kg/m(2 ) ) and waist circumference ( -4.9 ± 4.4 cm ) ( mean ± SD ) decreased . Exercise power output ( 12.9 ± 9.9 W ) and peak VO(2 ) ( 2.7 ± 2.8 mL/kg/min ) increased in the IGT exercise group . More cardiovascular risk factors were improved after exercise intervention in people with NGT compared with those with IGT or T2DM . Exercise capacity improved significantly in all three groups of participants who reported at least 80 % compliance with the scheduled exercise . CONCLUSIONS Nordic walking  improved anthropometric measurements and exercise capacity . However , unsupervised Nordic walking may not provide a sufficient increase in exercise intensity to achieve ultimate health-promoting benefits on the cardiovascular parameters assessed in this study , particularly for those with disturbed glucose regulation
Reduction in blood pressure , lipids and blood glucose was not statistically significant .
Conclusions Workplace interventions  significantly reduced body weight , BMI and waist circumference .
Non-significant results for biochemical markers could be due to them being secondary outcomes in most studies .
Background Adults in urban areas spend almost 77 % of their waking time being inactive at workplaces , which leaves little time for physical activity .
The aim of this systematic review and meta- analysis was to synthesize evidence for the effect of workplace physical activity interventions on the cardio-metabolic health markers ( body weight , waist circumference , body mass index ( BMI ) , blood pressure , lipids and blood glucose ) among working adults .