Life Events, Physical Activity, and Weight Loss Maintenance: Decomposing Mediating and Moderating Effects of Health Behavior

in Journal of Physical Activity and Health

Click name to view affiliation

Kara L. Gavin
Search for other papers by Kara L. Gavin in
Current site
Google Scholar
PubMed Close
,
Julian Wolfson
Search for other papers by Julian Wolfson in
Current site
Google Scholar
PubMed Close
,
Mark Pereira
Search for other papers by Mark Pereira in
Current site
Google Scholar
PubMed Close
,
Nancy Sherwood
Search for other papers by Nancy Sherwood in
Current site
Google Scholar
PubMed Close
, and
Jennifer A. Linde
Search for other papers by Jennifer A. Linde in
Current site
Google Scholar
PubMed Close
DOI:
https://doi.org/10.1123/jpah.2018-0135
Keywords:
methods; obesity; interventions
In Print:
Volume 16: Issue 4
Page Range:
267–273
Restricted access

Background: This analysis helps clarify the individual and joint effects of moderate to vigorous physical activity (MVPA) in concert with significant life events (eg, divorce, marriage, job change or loss, pregnancy, etc) on weight following a behavioral weight loss intervention. Methods: Data from the Tracking Study weight loss trial were utilized to perform a 4-way decomposition of moderation and mediation of life events (≥ 1 vs 0) and MVPA (low <2500 kcal vs high ≥ 2500 kcal) on 24-month weight. Results: The total effect of life events and MVPA on weight was estimated to be 1.63 kg (95% confidence interval = 0.30 to 2.96; P = .02). The controlled direct effect of life events on 24-month weight suggested that experiencing at least one life event controlling for MVPA was associated with an increase of 2.31 kg (95% confidence interval = 0.29 to 4.33) at 24 months. Other interaction and mediation estimates were not statistically significant. Conclusions: This analysis offers new potential for examining health behaviors that may act as both mediators and effect modifiers of health. Although more work is needed to understand the interaction of life events and MVPA on weight loss maintenance, findings help rule out mediation. Life events and MVPA should be considered for their unique effects on weight loss maintenance in the future.

Gavin is with the Behavioral and Psychosocial Research Training Program in Cancer Prevention and Control, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL. Wolfson, Pereira, Sherwood, and Linde are with the University of Minnesota, Minneapolis, MN.

Gavin (kara.gavin@northwestern.edu) is corresponding author.
  • Collapse
  • Expand

Journal of Physical Activity and Health

Cover Journal of Physical Activity and Health
  • 1.

    MacLean PS, Wing RR, Davidson T, et al. NIH working group report: innovative research to improve maintenance of weight loss. Obesity. 2015;23(1):7–15. doi:10.1002/oby.20967

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Klem ML, Wing RR, McGuire MT, Seagle HM, Hill JO. A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am J Clin Nutr. 1997;66(2):239–246. PubMed ID: 9250100 doi:10.1093/ajcn/66.2.239

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Catenacci VA, Grunwald GK, Ingebrigtsen JP, et al. Physical activity patterns using accelerometry in the National Weight Control Registry. Obesity. 2011;19(6):1163–1170. doi:10.1038/oby.2010.264

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Kim J-H, McKenzie LA. The impacts of physical exercise on stress coping and well-being in University Students in the context of leisure. Health. 2014;6:2570 –2580. doi:10.4236/health.2014.619296

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Norris R, Carroll D, Cochrane R. The effects of physical activity and exercise training on psychological stress and well-being in an adolescent population. J Psychosom Res. 1992;36(1):55–65. PubMed ID: 1538350 doi:10.1016/0022-3999(92)90114-H

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Harris AH, Cronkite R, Moos R. Physical activity, exercise coping, and depression in a 10-year cohort study of depressed patients. J Affect Disord. 2006;93(1–3):79–85. PubMed ID: 16545873 doi:10.1016/j.jad.2006.02.013

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Epiphaniou E, Ogden J. Evaluating the role of life events and sustaining conditions in weight loss maintenance. J Obes. 2010;2010:859413. PubMed ID: 20798851 doi:10.1155/2010/859413

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Oman RF, King AC. The effect of life events and exercise program format on the adoption and maintenance of exercise behavior. Health Psychol. 2000;19(6):605–612. PubMed ID: 11129364 doi:10.1037/0278-6133.19.6.605

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Kwasnicka D, Dombrowski SU, White M, Sniehotta F. Theoretical explanations for maintenance of behaviour change: a systematic review of behaviour theories. Health Psychol Rev. 2016;10(3):277–296. PubMed ID: 26854092 doi:10.1080/17437199.2016.1151372

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Linde JA, Jeffery RW, Crow SJ, et al. The tracking study: description of a randomized controlled trial of variations on weight tracking frequency in a behavioral weight loss program. Contemp Clin Trials. 2015;40:199–211. PubMed ID: 25533727 doi:10.1016/j.cct.2014.12.007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Unick JL, Beavers D, Jakicic JM, et al. Effectiveness of lifestyle interventions for individuals with severe obesity and type 2 diabetes: results from the Look AHEAD trial. Diabetes Care. 2011;34(10):2152–2157. PubMed ID: 21836103 doi:10.2337/dc11-0874

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Sarason IG, Johnson JH, Siegel JM. Assessing the impact of life changes: development of the Life Experiences Survey. J Consult Clin Psychol. 1978;46(5):932–946. PubMed ID: 701572 doi:10.1037/0022-006X.46.5.932

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Ogden J, Stavrinaki M, Stubbs J. Understanding the role of life events in weight loss and weight gain. Psychol Health Med. 2009;14(2):239–249. PubMed ID: 19235083 doi:10.1080/13548500802512302

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Paffenbarger RS Jr, Wing AL, Hyde RT. Physical activity as an index of heart attack risk in college alumni. Am J Epidemiol. 1978;108(3):161–175. PubMed ID: 707484 doi:10.1093/oxfordjournals.aje.a112608

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Ainsworth BE, Leon AS, Richardson MT, Jacobs DR, Paffenbarger RS Jr. Accuracy of the College Alumnus Physical Activity Questionnaire. J Clin Epidemiol. 1993;46(12):1403–1411. PubMed ID: 8263567 doi:10.1016/0895-4356(93)90140-V

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Donnelly JE, Blair SN, Jakicic JM, et al. American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2009;41(2):459–471. PubMed ID: 19127177 doi:10.1249/MSS.0b013e3181949333

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Jeffery RW, Wing RR, Sherwood NE, Tate DF. Physical activity and weight loss: does prescribing higher physical activity goals improve outcome? Am J Clinl Nutr. 2003;78(4):684–689. doi:10.1093/ajcn/78.4.684

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Catenacci VA, Ogden LG, Stuht J, et al. Physical activity patterns in the National Weight Control Registry. Obesity. 2008;16(1):153–161. doi:10.1038/oby.2007.6

  • 19.

    National Cancer Insitute [Internet] Applied Research CCaPS, National Cancer Institute. Diet History Questionnaire II and Canadian Diet History Questionnaire II (C-DHQII). National Institutes of Health: Washington. c2010. http://appliedresearch.cancer.gov/dhq2/. Accessed December 23, 2012.

    • Search Google Scholar
    • Export Citation
  • 20.

    Millen AE, Midthune D, Thompson FE, Kipnis V, Subar AF. The National Cancer Institute diet history questionnaire: validation of pyramid food servings. Am J Epidemiol. 2006;163(3):279–288. PubMed ID: 16339051 doi:10.1093/aje/kwj031

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    VanderWeele TJ. A unification of mediation and interaction: a 4-way decomposition. Epidemiology. 2014;25(5):749–761. PubMed ID: 25000145 doi:10.1097/EDE.0000000000000121

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Turk MW, Sereika SM, Yang K, Ewing LJ, Hravnak M, Burke LE. Psychosocial correlates of weight maintenance among black & white adults. Am J Health Behav. 2012;36(3):395–407. PubMed ID: 22370440 doi:10.5993/AJHB.36.3.10

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Allender S, Hutchinson L, Foster C. Life-change events and participation in physical activity: a systematic review. Health Promot Int. 2008;23(2):160–172. PubMed ID: 18364364 doi:10.1093/heapro/dan012

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Au N, Hauck K, Hollingsworth B. Employment, work hours and weight gain among middle-aged women. Int J Obes. 2013;37(5):718–724. doi:10.1038/ijo.2012.92

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Wing RR, Hill JO. Successful weight loss maintenance. Annu Rev Nutr. 2001;21(1):323–341. doi:10.1146/annurev.nutr.21.1.323

  • 26.

    VanderWeele TJ, Vansteelandt S. Conceptual issues concerning mediation, interventions and composition. Stat Interface. 2009;2:457–468. doi:10.4310/SII.2009.v2.n4.a7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Pearl J. The causal mediation formula—a guide to the assessment of pathways and mechanisms. Prev Sci. 2012;13(4):426–436. PubMed ID: 22419385 doi:10.1007/s11121-011-0270-1

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Warner ET, Wolin KY, Duncan DT, Heil DP, Askew S, Bennett GG. Differential accuracy of physical activity self-report by weight status. Am J Health Behav. 2012;36(2):168–178. PubMed ID: 22370255 doi:10.5993/AJHB.36.2.3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    Lantz PM, House JS, Mero RP, Williams DR. Stress, life events, and socioeconomic disparities in health: results from the Americans’ changing lives study. J Health Soc Behav. 2005;46(3):274–288. PubMed ID: 16259149 doi:10.1177/002214650504600305

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 2692 759 14
Full Text Views 50 20 10
PDF Downloads 23 4 1