THE RIGHT BALANCE
Changing behavior is notoriously difficult, and stumbling blocks often include lack of time and encouragement. But Mark Crisci discovered a lunch-hour program to lose weight and get active ...
Mark Crisci was going to the gym and trying to lower his cholesterol levels, but it wasn’t until he joined a healthy-lifestyle group at work that he found weight-loss success and continued support to keep his cholesterol, blood pressure and blood sugar levels in a healthy range.
Mr. Crisci, 51, of Weirton, W.Va., works as a product line manager at Bayer MaterialScience LLC in Robinson, and he has nothing but positive comments about the workplace program in which he participated five years ago, which he credits with helping him learn new habits for lasting weight control and good health.
“I increased my activity levels with more elliptical training, and I joined a spinning class. I go three times a week for an hour at the gym now,” he said. “I lost 7 percent of my weight.”
Changing behavior is notoriously difficult, and stumbling blocks often include lack of time and encouragement. For working people, a lunch hour seems like a good time to try a wellness program, but though many have tried, most of these programs have reported uneven success.
In Pittsburgh, that is changing. By modifying a well-tested program that has been successful in helping people at risk of developing diabetes, University of Pittsburgh researchers report lasting success in the Group Lifestyle Balance program. University of Pittsburgh researchers teamed up with Bayer, tested it and found that the program did indeed help participants reduce their risk of diabetes and heart disease.
“In the group, I think we all made progress,” Mr. Crisci said. The lunch-hour program, which ran from 2010 to mid-2012, gave participants a chance to learn and encourage each other, he said. “You’re accountable. ... You want to do well.” And they could keep their results private if they wanted to.
It’s based on the landmark national Diabetes Prevention Program, an evidence-based initiative with successful outcomes lasting 10 to 15 years so far. Since its results were first reported in 2002, adaptations of the lifestyle intervention have been used in community settings including doctor’s offices, outpatient diabetes education clinics, senior and community centers, the YMCA and churches. Some small and limited adaptations in workplaces had shown success, leading to the Bayer experiment.
“There’s a lot of interest, but a lot of confusion about what to offer,” said Kaye Kramer, director of the Diabetes Prevention Support Center at the University of Pittsburgh’s Graduate School of Public Health and lead author of
the Bayer study. It was published recently in the Journal of Occupational and Environmental Medicine.
“Education alone is not enough,” pointed out Andrea Kriska, epidemiology professor at the school and principal investigator of the study. Both Pitt researchers hold doctorates in epidemiology.
“You still need behavioral support. It’s a long-range problem to change behavior,” Ms. Kramer said. “There is no bad food, everything in moderation …. You have to be realistic about lifestyle change. You’re going to slip.”
Ms. Kriska agreed: “There’s no judgment. If it takes you a long time, it’s OK.”
At Bayer’s Robinson location, 89 employees at risk for diabetes or heart disease were enrolled in the program in 2010 and were followed for 18 months. The program combined education, support and helpful tools, and in the end they lost weight, trimmed their waistlines and were more physically active.
The program consisted of 22 sessions over a year, with two groups each led by a lifestyle coach, trained by the Pitt Diabetes Prevention Support Center. A nurse practitioner employed by Bayer also attended the workshop and observed the sessions. Twelve weekly core sessions transition to monthly sessions. An alternative option using a DVD, with the 12-core sessions material, was offered to people who traveled or didn't want to be in a group or to those who missed a group session. Weekly phone calls or emails with the coach supported those participants.
At each in-person meeting, participants were weighed and everyone received session handouts, a fat and calorie counter, selfmonitoring logs, a pedometer and exercise bands.
To allow anyone who wanted to participate to do so, the researchers randomly assigned people to either start the program right away or delay their participation for six months. Those who were delayed were the control group to compare progress. The goal was to achieve and maintain a 7 percent weight loss and to safely reach a level of moderate physical activity for 150 minutes per week.
Mr. Crisci chose the faceto-face program and was part of the delayed group. He said he attended most of the sessions and especially enjoyed the group discussions.
“We learned if you can talk yourself out of it — going to class, going for a walk — you can talk yourself into it. And you can talk yourself out of picking up that candy bar.”
Watching calories became important when they learned that it takes a reduction of 3,500 calories per week to lose one pound, he said. After learning to read food labels, he decided to substitute bottled salad dressing with balsamic vinegar and a little bit of olive oil.
Another idea from the class: Research a restaurant’s menu before going out to eat.
“Some restaurants are off my list now,” he said, citing one place that has a 1,400-calorie chicken sandwich.
“There was a camaraderie; you could find someone to go with you for a walk [on the Bayer campus trails]. Our sessions ran through the holidays. We talked about being in charge of what we ate, how to make our menus and recipes as light as possible.” One tip: nonfat cream cheese for the family’s favorite cheesecake.
By the end of the first year, the intervention participants lost an average of 5 percent of their body weight, reduced their waists by about 2 inches and reduced the levels of fat and sugar in their blood. They also doubled their physical activity.
At 12 months, the groups were combined and there were again weight loss and improvements in physical activity, blood sugar control, blood pressure, waistlines and body mass index.
Phil Franklin, Bayer’s U.S. corporate medical director, said the company was very pleased with the lifestyle intervention.
“What makes this program very unique is this was a very vigorous program done with a national university and the National Institutes of Health,” Dr. Franklin said. “It’s one of the few out there that is in the workplace. And it had a very long follow-up, at 18 months.”
Among 1,300 people at Bayer’s Robinson site, Dr. Franklin said, many fell under the study criteria in which they were at risk of developing diabetes.
“I think it’s translatable to other companies, both large and small,” he said. “If they can take the time. We’d like to see that happen.”
Information: www.diabetesprevention.pitt.edu.