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Background: To examine the relationship between early physical activity (PA) adoption (2, 3, and 4 mo) and longer-term PA adherence (1 y) among individuals who were inactive at baseline and received a lifestyle intervention. Methods: Participants (n = 637) received weekly behavioral weight loss sessions, calorie reduction, and PA goals (50–175 min/wk progression). PA was assessed via self-reported measures at baseline, months 2 to 4, and 1 year. Results: PA at months 2 to 4 was significantly correlated with PA at 1 year (rs = .29–.35, P < .01). At all early time points, those failing to meet the prescribed PA goal (early nonadopters) engaged in significantly less PA at 1 year than those meeting the early PA goal (initial adopters). For example, using 2-month criteria, initial adopters engaged in 108.3 minutes per week more at 1 year compared with early nonadopters (P < .01) and had 2.8 times the odds (95% confidence interval, 1.9–4.2) of meeting the 1-year PA goal (≥175 min/wk, P < .01). Conclusions: Failure to achieve PA goals at 2, 3, or 4 months results in less overall PA at 1 year. Thus, PA observed as early as month 2 may be a useful indicator for identifying at-risk individuals who may benefit from more intensive PA intervention strategies.

Unick and Wing are with the Miriam Hospital Weight Control and Diabetes Research Center, Warren Alpert Medical School, Brown University, Providence, RI, USA. Walkup and Miller are with the Wake Forest School of Medicine, Winston-Salem, NC, USA. Apolzan is with the Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA. Brubaker is with Wake Forest University, Winston-Salem, NC, USA. Coday is with the University of Tennessee Health Science Center, Memphis, TN, USA. Hill is with the Department of Nutrition Sciences, The University of Alabama, Birmingham, AL, USA. Jakicic is with the Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA, USA. Middelbeek is with the Joslin Diabetes Center, Boston, MA, USA. West is with the University of South Carolina, Columbia, SC, USA.

Unick (junick@lifespan.org) is corresponding author.

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  • 1.

    Kesaniemi YK, Danforth E Jr, Jensen MD, Kopelman PG, Lefebvre P, Reeder BA. Dose-response issues concerning physical activity and health: an evidence-based symposium. Med Sci Sports Exerc. 2001;33(suppl 6):1S358.

    • Search Google Scholar
    • Export Citation
  • 2.

    Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: the evidence. CMAJ. 2006;174(6):801809. PubMed ID: 16534088 doi:10.1503/cmaj.051351

  • 3.

    Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116(9):10811093. PubMed ID: 17671237 doi:10.1161/CIRCULATIONAHA.107.185649

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

    Penedo FJ, Dahn JR. Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Curr Opin Psychiatry. 2005;18(2):189193. PubMed ID: 16639173 doi:10.1097/00001504-200503000-00013

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

    Rebar AL, Stanton R, Geard D, Short C, Duncan MJ, Vandelanotte C. A meta-meta-analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations. Health Psychol Rev. 2015;9(3):366378. PubMed ID: 25739893 doi:10.1080/17437199.2015.1022901

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

    Centers for Disease Control and Prevention (CDC). Physical activity: data and statistics. https://www.cdc.gov/physicalactivity/downloads/trends-in-the-prevalence-of-physical-activity-508.pdf

    • Search Google Scholar
    • Export Citation
  • 7.

    Muller-Riemenschneider F, Reinhold T, Nocon M, Willich SN. Long-term effectiveness of interventions promoting physical activity: a systematic review. Prev Med. 2008;47(4):354368.

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

    Wing RR, Hamman RF, Bray GA, et al. Achieving weight and activity goals among diabetes prevention program lifestyle participants. Obes Res. 2004;12(9):14261434. PubMed ID: 15483207

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

    Jakicic JM, Tate DF, Lang W, et al. Effect of a stepped-care intervention approach on weight loss in adults: a randomized clinical trial. JAMA. 2012;307(24):26172626. PubMed ID: 22735431 doi:10.1001/jama.2012.6866

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

    Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014;129(25):S102S138. doi:10.1161/01.cir.0000437739.71477.ee

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

    Wadden TA, West DS, Neiberg RH, et al. One-year weight losses in the Look AHEAD study: factors associated with success. Obesity. 2009;17(4):713722. doi:10.1038/oby.2008.637

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

    Unick JL, Hogan PE, Neiberg RH, et al. Evaluation of early weight loss thresholds for identifying nonresponders to an intensive lifestyle intervention. Obesity. 2014;22(7):16081616. doi:10.1002/oby.20777

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

    Unick JL, Neiberg RH, Hogan PE, et al. Weight change in the first 2 months of a lifestyle intervention predicts weight changes 8 years later. Obesity. 2015;23(7):13531356. doi:10.1002/oby.21112

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

    Unick JL, Leahey T, Kent K, Wing RR. Examination of whether early weight loss predicts 1-year weight loss among those enrolled in an Internet-based weight loss program. Int J Obes. 2015;39(10):15581560. doi:10.1038/ijo.2015.89

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

    Unick JL, Dorfman L, Leahey TM, Wing RR. A preliminary investigation into whether early intervention can improve weight loss among those initially non-responsive to an internet-based behavioral program. J Behav Med. 2016;39(2):254261. PubMed ID: 26518207 doi:10.1007/s10865-015-9691-9

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

    Unick JL, Pellegrini CA, Demos KE, Dorfman L. Initial weight loss response as an indicator for providing early rescue efforts to improve long-term treatment outcomes. Curr Diab Rep. 2017;17(9):69. PubMed ID: 28726155 doi:10.1007/s11892-017-0904-1

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

    Nackers LM, Ross KM, Perri MG. The association between rate of initial weight loss and long-term success in obesity treatment: does slow and steady win the race? Int J Behav Med. 2010;17(3):161167. PubMed ID: 20443094 doi:10.1007/s12529-010-9092-y

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

    Haaga DA. Introduction to the special section on stepped care models in psychotherapy. J Consult Clin Psychol. 2000;68(4):547548. PubMed ID: 10965628 doi:10.1037/0022-006X.68.4.547

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Unick JL, Gaussoin SA, Hill JO, et al. Four-year physical activity levels among intervention participants with type 2 diabetes. Med Sci Sports Exerc. 2016;48(12):24372445. PubMed ID: 27471785 doi:10.1249/MSS.0000000000001054

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Pi-Sunyer X, Blackburn G, Brancati FL, et al. Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial. Diabetes Care. 2007;30(6):13741383.

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

    Jakicic JM, Gregg E, Knowler W, et al. Activity patterns of obese adults with type 2 diabetes in the look AHEAD study. Med Sci Sports Exerc. 2010;42(11):19952005. PubMed ID: 20386337 doi:10.1249/MSS.0b013e3181e054f0

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

    U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans. 2nd ed. Washington, DC: U.S. Department of Health and Human Services; 2018.

    • Search Google Scholar
    • Export Citation
  • 23.

    Jakicic JM, Marcus BH, Lang W, Janney C. Effect of exercise on 24-month weight loss maintenance in overweight women. Arch Intern Med. 2008;168(14):15501559. PubMed ID: 18663167 doi:10.1001/archinte.168.14.1550

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

    Jakicic JM, Winters C, Lang W, Wing RR. Effects of intermittent exercise and use of home exercise equipment on adherence, weight loss, and fitness in overweight women: a randomized trial. JAMA. 1999;282(16):15541560. PubMed ID: 10546695 doi:10.1001/jama.282.16.1554

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

    Pate RR, Pratt M, Blair SN, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273(5):402407. PubMed ID: 7823386 doi:10.1001/jama.1995.03520290054029

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Jeffery RW, Wing RR, Sherwood NE, Tate DF. Physical activity and weight loss: does prescribing higher physical activity goals improve outcome? Am J Clin Nutr. 2003;78(4):684689. PubMed ID: 14522725 doi:10.1093/ajcn/78.4.684

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

    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):161175. PubMed ID: 707484 doi:10.1093/oxfordjournals.aje.a112608

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

    Strath SJ, Bassett DR Jr, Swartz AM. Comparison of the college alumnus questionnaire physical activity index with objective monitoring. Ann Epidemiol. 2004;14(6):409415. PubMed ID: 15246329 doi:10.1016/j.annepidem.2003.07.001

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

    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):14031411. PubMed ID: 8263567 doi:10.1016/0895-4356(93)90140-V

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Tate DF, Jeffery RW, Sherwood NE, Wing RR. Long-term weight losses associated with prescription of higher physical activity goals. Are higher levels of physical activity protective against weight regain? Am J Clin Nutr. 2007;85(4):954959. PubMed ID: 17413092 doi:10.1093/ajcn/85.4.954

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Paffenbarger Physical Activity Questionnaire. A collection of physical activity questionnaires for health-related research. Med Sci Sports Exerc. 1997;29(Suppl 6):8388.

    • Search Google Scholar
    • Export Citation
  • 32.

    American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription. 8th ed. Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins; 2010.

    • Search Google Scholar
    • Export Citation
  • 33.

    Liu Q, Li C, Wanga V, Shepherd BE. Covariate-adjusted Spearman’s rank correlation with probability-scale residuals. Biometrics. 2018;74(2):595605. PubMed ID: 29131931 doi:10.1111/biom.12812

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Unick JL, Lang W, Tate DF, Bond DS, Espeland MA, Wing RR. Objective estimates of physical activity and sedentary time among young adults. J Obes. 2017;2017:9257564. PubMed ID: 28116151 doi:10.1155/2017/9257564

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Bond DS, Jakicic JM, Unick JL, et al. Pre- to postoperative physical activity changes in bariatric surgery patients: self report vs. objective measures. Obesity. 2010;18(12):23952397. doi:10.1038/oby.2010.88

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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