Abstract：
BACKGROUND: Intensive lifestyle interventions including modest reductions in daily caloric intake (i.e., continuous calorie energy reduction (CER)), are recommended by U.S. national professional health organizations (e.g. American Heart Association). However, they are less effective in Black communities. A burgeoning literature has reported the promise of intermittent fasting (IF) as an alternative strategy for weight loss. However, IF studies have been conducted with predominately White participants and provided participants resources not readily available in real-world situations.
OBJECTIVE: Weight loss and weight-related outcomes of a scalable (able to be widely disseminated and implemented) IF intervention developed with and for Black adults were compared to a CER intervention for the purpose of determining IF\'s feasibility (initial effectiveness, adherence, acceptance) in a Black community.
METHODS: A cluster randomized controlled pilot study was conducted.
METHODS: A total of 42 Black adults with a BMI≥25 were recruited from five Black churches (3 IF churches, 2 CER churches) in Western New York State from September 2021 until May 2022. Participants were free of medical conditions that might have contraindicated participation in a weight reduction program and other factors that might affect weight loss.
METHODS: Community health workers delivered the 6-month, 16-session faith-based IF and CER interventions.
METHODS: The primary outcome was feasibility, consisting of initial effectiveness on body weight (percent body weight lost from baseline to 6-month follow-up), adherence, and acceptability.
METHODS: Descriptive statistics and linear mixed models accounting for within-church clustering were used. A baseline covariate corresponding to the outcome variable was included in the model. Intent-to-treat analysis was used.
RESULTS: There was statistically significant weight loss within both arms [IF: -3.5 (-6, -0.9)]; [CER: -2.9 (-5.1, -0.8) kg], from baseline to 6-month follow-up. Compared to CER, IF led to significantly lower daily energy intake [414.2 (55.2, 773.2) kcal] and fat intake [16.1 (2.4, 29.8) g]. IF may result in lower fruit and vegetable intake [-103.2 (-200.9, -5.5) g] and fiber intake -5.4 (-8.7, -2) compared to CER. Participants in the IF arm completed 3.8 (1.4) more self-monitoring booklets compared to those in the CER arm (p=0.02). Participants reported high levels of satisfaction with the program.
CONCLUSIONS: An IF intervention developed with and for Black adults can be feasibly implemented in Black churches. Larger studies need to be conducted to ascertain the extent IF can serve as a viable weight loss alternative to CER interventions in Black communities.
OBJECTIVE: Weight loss and weight-related outcomes of a scalable (able to be widely disseminated and implemented) IF intervention developed with and for Black adults were compared to a CER intervention for the purpose of determining IF\'s feasibility (initial effectiveness, adherence, acceptance) in a Black community.
METHODS: A cluster randomized controlled pilot study was conducted.
METHODS: A total of 42 Black adults with a BMI≥25 were recruited from five Black churches (3 IF churches, 2 CER churches) in Western New York State from September 2021 until May 2022. Participants were free of medical conditions that might have contraindicated participation in a weight reduction program and other factors that might affect weight loss.
METHODS: Community health workers delivered the 6-month, 16-session faith-based IF and CER interventions.
METHODS: The primary outcome was feasibility, consisting of initial effectiveness on body weight (percent body weight lost from baseline to 6-month follow-up), adherence, and acceptability.
METHODS: Descriptive statistics and linear mixed models accounting for within-church clustering were used. A baseline covariate corresponding to the outcome variable was included in the model. Intent-to-treat analysis was used.
RESULTS: There was statistically significant weight loss within both arms [IF: -3.5 (-6, -0.9)]; [CER: -2.9 (-5.1, -0.8) kg], from baseline to 6-month follow-up. Compared to CER, IF led to significantly lower daily energy intake [414.2 (55.2, 773.2) kcal] and fat intake [16.1 (2.4, 29.8) g]. IF may result in lower fruit and vegetable intake [-103.2 (-200.9, -5.5) g] and fiber intake -5.4 (-8.7, -2) compared to CER. Participants in the IF arm completed 3.8 (1.4) more self-monitoring booklets compared to those in the CER arm (p=0.02). Participants reported high levels of satisfaction with the program.
CONCLUSIONS: An IF intervention developed with and for Black adults can be feasibly implemented in Black churches. Larger studies need to be conducted to ascertain the extent IF can serve as a viable weight loss alternative to CER interventions in Black communities.
摘要：
背景：强化生活方式干预，包括适度减少每日热量摄入（即连续卡路里能量减少（CER）），由美国国家专业健康组织（例如美国心脏协会）推荐。然而,他们在黑人社区的效率较低。新兴的文献报道了间歇性禁食（IF）作为减肥的替代策略的前景。然而,IF研究主要是针对白人参与者进行的，并为参与者提供了在现实世界中不容易获得的资源。
目的：为了确定IF的可行性（初始有效性，坚持,接受)在黑人社区。
方法：进行整群随机对照试验研究。
方法：从五个黑人教堂中招募了42名BMI≥25的黑人成年人（3个IF教堂，2个CER教堂），从2021年9月至2022年5月在纽约州西部。参与者没有可能禁忌参加减肥计划的医疗条件和其他可能影响减肥的因素。
方法：社区卫生工作者交付了6个月，第十六届会议基于信仰的综合框架和CER干预措施。
方法：主要结果是可行性，包括对体重的初始有效性（从基线到6个月随访的体重减轻百分比），坚持,和可接受性。
方法：使用了说明教堂内聚类的描述性统计和线性混合模型。对应于结果变量的基线协变量包括在模型中。使用意向治疗分析。
结果：两组均有统计学意义的体重减轻[IF：-3.5（-6，-0.9）]；[CER：-2.9（-5.1，-0.8）kg]，从基线到6个月的随访。与CER相比，IF导致每日能量摄入量[414.2(55.2,773.2)kcal]和脂肪摄入量[16.1(2.4,29.8)g]显著降低。与CER相比，IF可能导致水果和蔬菜摄入量[-103.2（-200.9，-5.5）g]和纤维摄入量-5.4（-8.7，-2）。与CER组（p=0.02）相比，IF组的参与者完成了3.8（1.4）多的自我监测手册。参与者报告对该计划的满意度很高。
结论：针对黑人成年人开发的IF干预措施可以在黑人教堂中可行地实施。需要进行更大的研究，以确定在黑人社区中IF可以作为CER干预措施的可行减肥替代方案的程度。
目的：为了确定IF的可行性（初始有效性，坚持,接受)在黑人社区。
方法：进行整群随机对照试验研究。
方法：从五个黑人教堂中招募了42名BMI≥25的黑人成年人（3个IF教堂，2个CER教堂），从2021年9月至2022年5月在纽约州西部。参与者没有可能禁忌参加减肥计划的医疗条件和其他可能影响减肥的因素。
方法：社区卫生工作者交付了6个月，第十六届会议基于信仰的综合框架和CER干预措施。
方法：主要结果是可行性，包括对体重的初始有效性（从基线到6个月随访的体重减轻百分比），坚持,和可接受性。
方法：使用了说明教堂内聚类的描述性统计和线性混合模型。对应于结果变量的基线协变量包括在模型中。使用意向治疗分析。
结果：两组均有统计学意义的体重减轻[IF：-3.5（-6，-0.9）]；[CER：-2.9（-5.1，-0.8）kg]，从基线到6个月的随访。与CER相比，IF导致每日能量摄入量[414.2(55.2,773.2)kcal]和脂肪摄入量[16.1(2.4,29.8)g]显著降低。与CER相比，IF可能导致水果和蔬菜摄入量[-103.2（-200.9，-5.5）g]和纤维摄入量-5.4（-8.7，-2）。与CER组（p=0.02）相比，IF组的参与者完成了3.8（1.4）多的自我监测手册。参与者报告对该计划的满意度很高。
结论：针对黑人成年人开发的IF干预措施可以在黑人教堂中可行地实施。需要进行更大的研究，以确定在黑人社区中IF可以作为CER干预措施的可行减肥替代方案的程度。
