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BMC Public Health
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

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

Authors: Jeanette R Christensen, Anne Faber, Dorte Ekner, Kristian Overgaard, Andreas Holtermann, Karen Søgaard

Published in: BMC Public Health | Issue 1/2011

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Abstract

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 randomized 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-randomized 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

ClinicalTrials.gov: NCT01015716
Appendix
Available only for authorised users
Literature
1.
Koh-Banerjee P, Wang Y, Hu FB, Spiegelman D, Willett WC, Rimm EB: Changes in body weight and body fat distribution as risk factors for clinical diabetes in US men. Am J Epidemiol. 2004, 159: 1150-1159. 10.1093/aje/kwh167.CrossRefPubMed
2.
van Dam RM, Willett WC, Manson JE, Hu FB: The relationship between overweight in adolescence and premature death in women. Ann Intern Med. 2006, 145: 91-97.CrossRefPubMed
3.
Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, et al: Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet. 2005, 366: 1640-1649. 10.1016/S0140-6736(05)67663-5.CrossRefPubMed
4.
Han TS, Schouten JS, Lean ME, Seidell JC: The prevalence of low back pain and associations with body fatness, fat distribution and height. Int J Obes Relat Metab Disord. 1997, 21: 600-607. 10.1038/sj.ijo.0800448.CrossRefPubMed
5.
Tunceli K, Li K, Williams LK: Long-term effects of obesity on employment and work limitations among U.S. Adults, 1986 to 1999. Obesity (Silver Spring). 2006, 14: 1637-1646. 10.1038/oby.2006.188.CrossRef
6.
Houston DK, Cai J, Stevens J: Overweight and obesity in young and middle age and early retirement: the ARIC study. Obesity (Silver Spring). 2009, 17: 143-149. 10.1038/oby.2008.464.CrossRef
7.
Konnopka A, Bodemann M, Konig HH: Health burden and costs of obesity and overweight in Germany. Eur J Health Econ. 2010
8.
Kautiainen S, Koivisto AM, Koivusilta L, Lintonen T, Virtanen SM, Rimpela A: Sociodemographic factors and a secular trend of adolescent overweight in Finland. Int J Pediatr Obes. 2009, 4: 360-370. 10.3109/17477160902811173.CrossRefPubMed
9.
Marques-Vidal P, Bovet P, Paccaud F, Chiolero A: Changes of overweight and obesity in the adult Swiss population according to educational level, from 1992 to 2007. BMC Public Health. 2010, 10: 87-10.1186/1471-2458-10-87.CrossRefPubMedPubMedCentral
10.
Torgen M, Nygard CH, Kilbom A: Physical work load, physical capacity and strain among elderly female aides in home-care service. Eur J Appl Physiol Occup Physiol. 1995, 71: 444-452. 10.1007/BF00635879.CrossRefPubMed
11.
Pohjonen T: Age-related physical fitness and the predictive values of fitness tests for work ability in home care work. J Occup Environ Med. 2001, 43: 723-730. 10.1097/00043764-200108000-00011.CrossRefPubMed
12.
Kivimaki M, Makinen A, Elovainio M, Vahtera J, Virtanen M, Firth-Cozens J: Sickness absence and the organization of nursing care among hospital nurses. Scand J Work Environ Health. 2004, 30: 468-476.CrossRefPubMed
13.
Caruso CC, Waters TR: A review of work schedule issues and musculoskeletal disorders with an emphasis on the healthcare sector. Ind Health. 2008, 46: 523-534. 10.2486/indhealth.46.523.CrossRefPubMed
14.
Torgen M, Punnett L, Alfredsson L, Kilbom A: Physical capacity in relation to present and past physical load at work: a study of 484 men and women aged 41 to 58 years. Am J Ind Med. 1999, 36: 388-400. 10.1002/(SICI)1097-0274(199909)36:3<388::AID-AJIM6>3.0.CO;2-3.CrossRefPubMed
15.
Nygard CH, Luopajarvi T, Suurnakki T, Ilmarinen J: Muscle strength and muscle endurance of middle-aged women and men associated to type, duration and intensity of muscular load at work. Int Arch Occup Environ Health. 1988, 60: 291-297. 10.1007/BF00378476.CrossRefPubMed
16.
Andersen LL, Christensen KB, Holtermann A, Poulsen OM, Sjogaard G, Pedersen MT, et al: Effect of physical exercise interventions on musculoskeletal pain in all body regions among office workers: a one-year randomized controlled trial. Man Ther. 2010, 15: 100-104. 10.1016/j.math.2009.08.004.CrossRefPubMed
17.
Atlantis E, Lange K, Wittert GA: Chronic disease trends due to excess body weight in Australia. Obes Rev. 2009, 10: 543-553. 10.1111/j.1467-789X.2009.00590.x.CrossRefPubMed
18.
Proper KI, Hildebrandt VH, van der Beek AJ, Twisk JW, van MW: Effect of individual counseling on physical activity fitness and health: a randomized controlled trial in a workplace setting. Am J Prev Med. 2003, 24: 218-226. 10.1016/S0749-3797(02)00645-1.CrossRefPubMed
19.
Wu T, Gao X, Chen M, van Dam RM: Long-term effectiveness of diet-plus-exercise interventions vs. diet-only interventions for weight loss: a meta-analysis. Obes Rev. 2009, 10: 313-323. 10.1111/j.1467-789X.2008.00547.x.CrossRefPubMed
20.
Shaw K, Gennat H, O'Rourke P, Del MC: Exercise for overweight or obesity. Cochrane Database Syst Rev. 2006, CD003817-
21.
Dalle GR, Calugi S, Centis E, El GM, Marchesini G: Cognitive-behavioral strategies to increase the adherence to exercise in the management of obesity. J Obes. 2011, 2011: 348293-
22.
Atlantis E, Chow CM, Kirby A, Fiatarone Singh MA: Worksite intervention effects on physical health: a randomized controlled trial. Health Promot Int. 2006, 21: 191-200. 10.1093/heapro/dal012.CrossRefPubMed
23.
Shaw K, O'Rourke P, Del MC, Kenardy J: Psychological interventions for overweight or obesity. Cochrane Database Syst Rev. 2005, CD003818-
24.
Holtermann A, Jorgensen MB, Gram B, Christensen JR, Faber A, Overgaard K, et al: Worksite interventions for preventing physical deterioration among employees in job-groups with high physical work demands: background, design and conceptual model of FINALE. BMC Public Health. 2010, 10: 120-10.1186/1471-2458-10-120.CrossRefPubMedPubMedCentral
25.
Gallagher D, Heymsfield SB, Heo M, Jebb SA, Murgatroyd PR, Sakamoto Y: Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index. Am J Clin Nutr. 2000, 72: 694-701.PubMed
26.
Hvid T: Overvægtens psykologi. 2004, Copenhagen, Modtryk
27.
The Danish Council on Smoking and Health: At tale om forandring. 2000, Copenhagen
28.
Nordic Council of Ministers: Nordic Nutrition Recommendation 2004 Integrating nutrition and physical activity. 2004, Copenhagen, Norden, 4
29.
Franz MJ, VanWormer JJ, Crain AL, Boucher JL, Histon T, Caplan W, et al: Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc. 2007, 107: 1755-1767. 10.1016/j.jada.2007.07.017.CrossRefPubMed
30.
Linton SJ, Andersson T: Can chronic disability be prevented? A randomized trial of a cognitive-behavior intervention and two forms of information for patients with spinal pain. Spine (Phila Pa 1976). 2000, 25: 2825-2831. 10.1097/00007632-200011010-00017.CrossRef
31.
Appleyard M: The Copenhagen City Heart Study, Østerbroundersøgelsen. A book of tables with data from the first examination (1976-78) and a five year follow-up (1981-83). Scand J Soc Med. 1989, 1-160. Supplementum 41
32.
Andersen LB: A maximal cycle exercise protocol to predict maximal oxygen uptake. Scand J Med Sci Sports. 1995, 5: 143-146.CrossRefPubMed
33.
Essendrop M, Maul I, Laubli T, Riihimaki H, Schibye B: Measures of low back function: a review of reproducibility studies. Clin Biomech (Bristol, Avon). 2002, 17: 235-249. 10.1016/S0268-0033(02)00022-0.CrossRef
34.
Schibye B, Hansen AF, Sogaard K, Christensen H: Aerobic power and muscle strength among young and elderly workers with and without physically demanding work tasks. Appl Ergon. 2001, 32: 425-431. 10.1016/S0003-6870(01)00034-5.CrossRefPubMed
35.
Fairfax AH, Balnave R, Adams RD: Variability of grip strength during isometric contraction. Ergonomics. 1995, 38: 1819-1830. 10.1080/00140139508925229.CrossRefPubMed
36.
Backman E, Johansson V, Hager B, Sjoblom P, Henriksson KG: Isometric muscle strength and muscular endurance in normal persons aged between 17 and 70 years. Scand J Rehabil Med. 1995, 27: 109-117.PubMed
37.
Yates JW, Kamon E, Rodgers SH, Champney PC: Static lifting strength and maximal isometric voluntary contractions of back, arm and shoulder muscles. Ergonomics. 1980, 23: 37-47. 10.1080/00140138008924716.CrossRefPubMed
38.
Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G, et al: Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987, 18: 233-237. 10.1016/0003-6870(87)90010-X.CrossRefPubMed
39.
Videman T, Nurminen T, Tola S, Kuorinka I, Vanharanta H, Troup JD: Low-back pain in nurses and some loading factors of work. Spine (Phila Pa 1976). 1984, 9: 400-404. 10.1097/00007632-198405000-00013.CrossRef
40.
Lüders K, Andersen B, Berggren F: Det Batter. 1996, Institute of Sport Sciense & Clinical Biomechanics, University of Suthern Denmark
41.
Rigsby A, Gropper DM, Gropper SS: Success of women in a worksite weight loss program: Does being part of a group help?. Eat Behav. 2009, 10: 128-130. 10.1016/j.eatbeh.2009.01.002.CrossRefPubMed
42.
Abrams DB, Follick MJ: Behavioral weight-loss intervention at the worksite: feasibility and maintenance. J Consult Clin Psychol. 1983, 51: 226-233.CrossRefPubMed
43.
Wier LT, Ayers GW, Jackson AS, Rossum AC, Poston WS, Foreyt JP: Determining the amount of physical activity needed for long-term weight control. Int J Obes Relat Metab Disord. 2001, 25: 613-621. 10.1038/sj.ijo.0801586.CrossRefPubMed
44.
Crouch M, Sallis JF, Farquhar JW, Haskell WL, Ellsworth NM, King AB, et al: Personal and mediated health counseling for sustained dietary reduction of hypercholesterolemia. Prev Med. 1986, 15: 282-291. 10.1016/0091-7435(86)90047-2.CrossRefPubMed
45.
Briley ME, Montgomery DH, Blewett J: Worksite nutrition education can lower total cholesterol levels and promote weight loss among police department employees. J Am Diet Assoc. 1992, 92: 1382-1384.PubMed
46.
Stevens VJ, Obarzanek E, Cook NR, Lee IM, Appel LJ, Smith WD, et al: Long-term weight loss and changes in blood pressure: results of the Trials of Hypertension Prevention, phase II. Ann Intern Med. 2001, 134: 1-11.CrossRefPubMed
47.
Holtermann A, Mortensen OS, Burr H, Sogaard K, Gyntelberg F, Suadicani P: Physical demands at work, physical fitness, and 30-year ischaemic heart disease and all-cause mortality in the Copenhagen Male Study. Scand J Work Environ Health. 2010, 36: 357-365.CrossRefPubMed
48.
Malone M, Alger-Mayer SA, Anderson DA: The lifestyle challenge program: a multidisciplinary approach to weight management. Ann Pharmacother. 2005, 39: 2015-2020. 10.1345/aph.1G287.CrossRefPubMed
49.
Benedict MA, Arterburn D: Worksite-based weight loss programs: a systematic review of recent literature. Am J Health Promot. 2008, 22: 408-416. 10.4278/ajhp.22.6.408.CrossRefPubMed
50.
Brownell KD, Cohen RY, Stunkard AJ, Felix MR, Cooley NB: Weight loss competitions at the work site: impact on weight, morale and cost-effectiveness. Am J Public Health. 1984, 74: 1283-1285. 10.2105/AJPH.74.11.1283.CrossRefPubMedPubMedCentral
51.
Peregrin T: Weighing in on corporate wellness programs and their impact on obesity. J Am Diet Assoc. 2005, 105: 1192-1194. 10.1016/j.jada.2005.06.012.CrossRefPubMed
52.
Diabetes Prevention Program Research Group: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002, 346 (6): 393-403.CrossRefPubMedCentral
Metadata
Title
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
Authors
Jeanette R Christensen
Anne Faber
Dorte Ekner
Kristian Overgaard
Andreas Holtermann
Karen Søgaard
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-671

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