Abstract
BackgroundWeight gain during young adulthood is common and is associated with increased cardiovascular risk. Preventing this weight gain from occurring may be critical to improving long-term health. Few studies have focused on weight gain prevention, and these studies have had limited success. SNAP (Study of Novel Approaches to Weight Gain Prevention) is an NIH-funded randomized clinical trial examining the efficacy of two novel self-regulation approaches to weight gain prevention in young adults compared to a minimal treatment control. The interventions focus on either small, consistent changes in eating and exercise behaviors, or larger, periodic changes to buffer against expected weight gains.Methods/DesignSNAP targets recruitment of six hundred young adults (18–35 years) with a body mass index between 21.0-30.0 kg/m2, who will be randomly assigned with equal probability to: (1) minimal intervention control; (2) self-regulation with Small Changes; or (3) self-regulation with Large Changes. Both interventions receive 8 weekly face-to-face group sessions, followed by 2 monthly sessions, with two 4-week refresher courses in each of subsequent years. Participants are instructed to report weight via web at least monthly thereafter, and receive monthly email feedback. Participants in Small Changes are taught to make small daily changes (~100 calorie changes) in how much or what they eat and to accumulate 2000 additional steps per day. Participants in Large Changes are taught to create a weight loss buffer of 5–10 pounds once per year to protect against anticipated weight gains. Both groups are encouraged to self-weigh daily and taught a self-regulation color zone system that specifies action depending on weight gain prevention success. Individualized treatment contact is offered to participants who report weight gains. Participants are assessed at baseline, 4 months, and then annually. The primary outcome is weight gain over an average of 3 years of follow-up; secondary outcomes include diet and physical activity behaviors, psychosocial measures, and cardiovascular disease risk factors.DiscussionSNAP is unique in its focus on weight gain prevention in young adulthood. The trial will provide important information about whether either or both of these novel interventions are effective in preventing weight gain.Trial registrationClinicalTrials.gov, NCT01183689
Highlights
Weight gain during young adulthood is common and is associated with increased cardiovascular risk
SNAP is unique in its focus on weight gain prevention in young adulthood
Young adults, ages 20–35, experience the greatest rate of weight gain, averaging 1 to 2 pounds per year [1,2]. This weight gain is associated with a worsening in cardiovascular risk factors and an increase in the prevalence of metabolic syndrome [3,4]
Summary
Only a few large-scale randomized clinical trials have targeted weight gain prevention, and their success has been limited. SNAP will provide evidence as to whether this approach works for young adults, a developmental period with its own unique challenges including establishing autonomy, adjusting to school-work transitions, and navigating interpersonal relationships and child rearing Both interventions are designed with dissemination in mind with limited face-to-face interaction and utilization of internet, email, and smart phone communication to engage participants in the treatment process. If either or both of the large changes and small changes approaches are successful in preventing weight gain, an important step will be to translate the interventions beyond the research setting and into community or commercial use.
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