- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT07605169
Long-term Health and Economic Effects of an Individualized Lifestyle Intervention (LI-PAD-Extended) (LI-PAD-EXTENDE)
Long-term Follow-up of Individualized Lifestyle Intervention Focused on Physical Activity and Diet: Effects on Weight Loss, Dietary Habits, Cardiovascular Health, Motivation, Health-related Quality of Life, and Health Economics (LI-PAD-Extended)
The goal of this clinical trial is to learn if an individualized lifestyle intervention works to improve weight, diet, physical activity, cardiovascular health, health-related quality of life, and cost-effectiveness in overweight and obese adults aged 45-65 years.
The main questions it aims to answer are:
Does the intervention lead to sustained weight loss after 18 months?
Does the intervention improve cardiovascular risk factors, metabolic markers, and health-related quality of life compared to general written advice?
Is the intervention cost-effective?
Researchers will compare the individualized lifestyle intervention to a control group that receives general written advice on physical activity and diet to see if the intervention provides greater long-term health and economic benefits.
Participants will:
Attend counseling sessions with a health promoter Take part in supervised aerobic and resistance training with a physiotherapist Use swimming facilities and participate in the Lifestyle School Access a digital health coach and the online Lifestyle Tool Complete measurements of body weight, diet, physical activity, and cardiovascular health markers (waist-to-hip ratio, blood pressure, blood lipids, fasting glucose, HbA1c, CRP, and liver enzymes) Complete assessments of resting energy expenditure, aerobic fitness, muscle strength, motivation, and health-related quality of life Provide blood samples at baseline, 6 months, and 18 months for dietary biomarker analysis Contribute data for health economic evaluation to assess cost-effectiveness
Přehled studie
Postavení
Podmínky
Intervence / Léčba
Detailní popis
Background Overweight and obese adults, especially those with type 2 diabetes, have increased risk of cardiovascular disease (CVD). Lifestyle interventions with physical activity (PA) and diet improve CVD risk factors, but long-term behavior change is challenging. Individualized approaches are recommended, yet rarely implemented for both PA and diet in clinical practice.
Objectives
The study evaluates whether an individualized precision health intervention:
Produces greater weight loss at 6 months (short-term) and 18 months (long-term)
Improves cardiovascular risk factors, metabolic markers, diet, PA behaviors, fitness, and psychosocial outcomes
Is feasible and cost-effective compared to standard lifestyle advice
Study Design
Randomized controlled trial with two arms:
Intervention group: Individualized precision health program
Control group: Standard lifestyle advice
Total participants: 120 (60 per group), aged 45-65 years, BMI 28-34
Exclusion: known coronary artery disease, inability to participate in lifestyle interventions, or language barriers
Intervention (LI-PAD Precision Health):
Step 1: Individual Adaptation
Adjust recommendations for medical conditions, comorbidities, medications, psychosocial factors, preferences, readiness to change, and barriers/facilitators
Step 2: Individualized Advice
PA prescription based on accelerometry, VO₂max, and muscle strength
Dietary guidance based on food intake diaries and measured resting energy expenditure (REE)
Step 3: Support for Goal Achievement
Education and skill training
Behavioral support: health promoters, group sessions, face-to-face and online coaching, apps for diet and PA, nudging
Control Group:
Standard lifestyle advice: healthy diet, ≥300 min/week moderate-intensity aerobic PA, 2 sessions/week strength training
Outcome Measures:
Primary Outcome:
Change in body weight from baseline to 6 months and 18 months
Secondary Outcomes:
BMI, waist and hip circumference
Blood pressure
Blood markers: cardiometabolic (lipids, HbA1c, cholesterol, HDL, LDL; ASAT, ALAT, ALP, GGT, hs-CRP) and dietary intake biomarkers
Cardiorespiratory fitness and muscle strength
Behavioral measures: PA (accelerometry, SGPALS), diet (MiniMeal-Q, REE)
Psychosocial outcomes: health-related quality of life (EQ5D-3L, RAND-36), motivation, self-efficacy
Cost-effectiveness analysis based on BMI and secondary outcomes
Additional Outcomes (Intervention Group):
Feasibility: attendance, compliance, participant evaluation
Barriers and facilitators to behavioral change
GPS tracking of PA and dietary behavior
Assessments:
Baseline, 6-month, and 18-month follow-ups
Anthropometry, REE, blood pressure, blood markers, fitness tests, accelerometry, questionnaires, and dietary logs
Statistical Analysis:
Multilevel mixed models for repeated measures
Linear and logistic regression for continuous and categorical variables
Structural equation modeling and partial least squares regression to explore relationships between intervention components and outcomes
Collaborators:
Sahlgrenska University Hospital/Östra: health promoters, physiotherapists, biomedical analysts
University of Gothenburg: Food and Nutrition, Sport Science, metabolomics, health economics
National and international collaborators with expertise in PA, diet, and cardiovascular health
Summary:
LI-PAD-Extended is an 18-month follow-up evaluating individualized precision health interventions. The study combines objective PA and dietary assessments with behavioral support and cost-effectiveness evaluation. This long-term follow-up allows assessment of sustained effects of precision lifestyle interventions on weight, cardiovascular risk, fitness, psychosocial outcomes, and economic efficiency.
Typ studie
Zápis (Odhadovaný)
Fáze
- Nelze použít
Kontakty a umístění
Studijní kontakt
- Jméno: Mats Börjesson, Professor
- Telefonní číslo: +46 0705298360
- E-mail: mats.borjesson@gu.se
Studijní záloha kontaktů
- Jméno: Carina U Persson, Associate Professor
- Telefonní číslo: +46 706 14 25 60
- E-mail: carina.persson@vgregion.se
Studijní místa
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Västra Götaland County
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Gothenburg, Västra Götaland County, Švédsko, 416 85
- Nábor
- Centre for Lifestyle Intervention
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Kontakt:
- Carina U Persson, study coordinator, research leader, Associate Professor
- Telefonní číslo: +46 706 14 25 60
- E-mail: carina.persson@vgregion.se
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Popis
Inclusion Criteria:
- Adults aged 45-65 years at baseline of the original LI-PAD study
- Body mass index (BMI) ≥28 and ≤34
- Completed the original LI-PAD study
- Able and willing to attend follow-up assessments and provide necessary data
- Able and willing to provide informed consent
Exclusion Criteria:
- Known coronary artery disease (clinical symptoms or earlier event)
- Inability to understand the language used in the study
- Inability to complete follow-up assessments at 18 months
- Severe illness or medical condition that, in the investigator's opinion, precludes participation in follow-up assessments
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Prevence
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Žádné (otevřený štítek)
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
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Žádný zásah: Standartní péče
Kontrolní skupině se dostane (bude nabídnuta) obvyklá péče definovaná jako písemná doporučení týkající se životního stylu na základě obecných doporučení pro dietu (Nordic Nutrition Recommendations, 2012.
Integrace výživy a fyzické aktivity.
Kodaň: Severská rada ministrů, 2014) a PA (Světová zdravotnická organizace).
Pokyny Světové zdravotnické organizace pro fyzickou aktivitu a sedavé chování, 2020), včetně zdravé a pestré stravy, zaměřené na 300 minut týdně středně intenzivní aerobní PA a silový trénink dvakrát týdně.
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Experimentální: Individualized Lifestyle Program
The intervention group will receive (offered) an optimal prescription of physical activity and diet based on medical (comorbidities, risk profile, medications, symptoms) and psycho-social (preferences for physical activities and diet, barriers-facilitators, social support, readiness to change, accelerometry and predicted VO2-max data (Ekblom Bak ergometer test), resting energy expenditure and knowledge and skills (lifestyle education school for achieving knowledge and skills in handling change in diet and physical activity in daily life) and support (health promotors, behavioral change app, food diary app, face-to-face, phone/online coaching, physical activity (aerobic training, strength training) in group and nudging.
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Precizní zdraví
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Body Weight Change
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in body weight measured using calibrated scales and standardized protocols.
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Baseline, 6 months, 18 months
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Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Change in Body Mass Index (BMI)
Časové okno: Baseline, 6 months, 18 months.
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Change from baseline in body mass index (BMI) measured using standard protocols.
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Baseline, 6 months, 18 months.
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Change in Systolic Blood Pressure
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in systolic blood pressure measured using standardized sphygmomanometer protocols.
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Baseline, 6 months, 18 months
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Change in Waist Circumference
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in waist circumference (cm) measured using standard protocols.
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Baseline, 6 months, 18 months
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Change in Hip Circumference
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in hip circumference measured using standard protocols.
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Baseline, 6 months, 18 months
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Change in Total Cholesterol
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in total cholesterol.
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Baseline, 6 months, 18 months
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Change in HDL Cholesterol
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in high-density lipoprotein (HDL) cholesterol.
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Baseline, 6 months, 18 months
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Change in LDL Cholesterol
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in low-density lipoprotein (LDL) cholesterol.
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Baseline, 6 months, 18 months
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Change in Triglycerides
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in triglycerides
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Baseline, 6 months, 18 months
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Change in HbA1c
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in glycated hemoglobin (HbA1c)
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Baseline, 6 months, 18 months
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Change in Aspartate Aminotransferase (ASAT)
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in aspartate aminotransferase (ASAT)
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Baseline, 6 months, 18 months
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Change in Alanine Aminotransferase (ALAT)
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in alanine aminotransferase (ALAT).
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Baseline, 6 months, 18 months
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Change in High-Sensitivity C-Reactive Protein (hs-CRP)
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in high-sensitivity C-reactive protein (hs-CRP).
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Baseline, 6 months, 18 months
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Change in Dietary Biomarkers (Metabolomics)
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in dietary biomarkers assessed using metabolomics.
Biomarkers reflect intake of selected food groups (e.g., whole grains, dairy products, legumes, and sugars) and are quantified using validated analytical methods and expressed as relative concentrations or standardized scores.
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Baseline, 6 months, 18 months
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Change in Cardiorespiratory Fitness (VO₂max)
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in cardiorespiratory fitness (VO₂max) (mL/kg/min) assessed using the Ekblom-Bak cycle test.
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Baseline, 6 months, 18 months
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Change in Muscle Strength (Handgrip Strength)
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in muscle strength (kg) assessed by handgrip strength using a Jamar hand dynamometer.
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Baseline, 6 months, 18 months
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Change in Mean Daily Physical Activity Counts as Assessed by Accelerometry
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in physical activity assessed using accelerometry, summarized as mean daily activity counts at 6 and 18 months.
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Baseline, 6 months, 18 months
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Change in Self-Reported Physical Activity (Saltin-Grimby Physical Activity Level Scale, SGPALS)
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in physical activity assessed using the Saltin-Grimby Physical Activity Level Scale (SGPALS).
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Baseline, 6 months, 18 months
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Change in Resting Energy Expenditure (REE)
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in resting energy expenditure (REE) (kcal/day).
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Baseline, 6 months, 18 months
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Change in Dietary Intake (MiniMeal-Q questionnaire)
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in dietary intake assessed using the MiniMeal-Q questionnaire.
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Baseline, 6 months, 18 months
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Change in Health-Related Quality of Life (EQ-5D-3L)
Časové okno: Baseline, 6 months, 18 months
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Change from baseline in health-related quality of life assessed using the EQ-5D-3L index.
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Baseline, 6 months, 18 months
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Motivation for Lifestyle Change
Časové okno: 18 months
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Motivation assessed at 18 months using a standardized questionnaire.
The assessment reflects the preceding 12 months (i.e., the period between the 6-month and 18-month follow-up).
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18 months
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Perceived Self-Efficacy
Časové okno: 18 months
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Self-efficacy assessed at 18 months using a standardized questionnaire.
The assessment reflects the preceding 12 months (i.e., the period between the 6-month and 18-month follow-up).
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18 months
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Cost-Effectiveness (Incremental Cost-Effectiveness Ratio, ICER)
Časové okno: 18 months
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Incremental cost-effectiveness ratio (ICER) comparing individualized lifestyle intervention to standard advice, expressed as cost per quality-adjusted life year (QALY) gained.
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18 months
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Motivation for Maintaining Lifestyle Change
Časové okno: 18 months
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Motivation for maintaining lifestyle change, assessed at 18 months using a single-item question rated on a scale from 0 (not at all important) to 10 (extremely important).
Higher scores indicate greater motivation.
The assessment reflects the preceding 12 months (i.e., the period between the 6-month and 18-month follow-up).
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18 months
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Perceived Autonomous Motivation for Weight Management
Časové okno: 18 months
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Autonomous motivation for weight management, assessed at 18 months using a study-specific multi-item questionnaire.
Items reflecting intrinsic motivation are rated on a 5-point Likert scale (1 = not at all true to 5 = completely true) and aggregated into a mean score.
Higher scores indicate greater autonomous motivation.
The assessment reflects the preceding 12 months (i.e., the period between the 6-month and 18-month follow-up).
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18 months
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Perceived Controlled Motivation for Weight Management
Časové okno: 18 months
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Controlled motivation for weight management, assessed at 18 months using a study-specific multi-item questionnaire.
Items reflecting external and introjected regulation are rated on a 5-point Likert scale (1 = not at all true to 5 = completely true) and aggregated into a mean score.
Higher scores indicate greater controlled motivation.
The assessment reflects the preceding 12 months (i.e., the period between the 6-month and 18-month follow-up).
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18 months
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Perceived Importance of Individualization in Lifestyle Intervention
Časové okno: 18 months
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Participant-reported perceived importance of individualized components of the lifestyle intervention for maintaining weight stability or weight loss, assessed at 18 months using a study-specific single-item question rated on a 5-point Likert scale (1 = not at all to 5 = completely).
Higher scores indicate greater perceived importance.
The assessment reflects the preceding 12 months (i.e., the period between the 6-month and 18-month follow-up).
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18 months
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Perceived Appropriateness of Study Duration
Časové okno: 18 months
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Participant-reported perception of study duration in relation to achieving sustainable lifestyle change, assessed at 18 months using a single-item categorical question with response options: "too short," "somewhat short," "appropriate," "somewhat long," and "too long."
The assessment reflects the preceding 12 months (i.e., the period between the 6-month and 18-month follow-up).
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18 months
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Perceived Importance of Lifestyle Intervention Components
Časové okno: 18 months
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Participant-reported perceived importance of different components of the lifestyle intervention (e.g., counseling sessions, mobile application, gym access, supervised exercise, and educational sessions) for maintaining weight stability or weight loss.
Each component is rated on a 5-point Likert scale (1 = not at all to 5 = completely).
Items are aggregated into a mean score based on available responses.
Higher scores indicate greater perceived importance of the intervention components.
Participants who did not engage in a specific component are excluded from that item in the score calculation.
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18 months
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Perceived Psychological Capabilities for Lifestyle Change
Časové okno: 18 months
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Psychological capabilities for lifestyle change, assessed at 18 months using a study-specific multi-item questionnaire.
Items related to self-efficacy, stress management, behavioral awareness, and ability to initiate and maintain behavior change are rated on a 5-point Likert scale (1 = not at all to 5 = completely) and aggregated into a mean score.
Higher scores indicate greater perceived capability for lifestyle change.
The assessment reflects the preceding 12 months (i.e., the period between the 6-month and 18-month follow-up).
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18 months
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Importance of Behavioral Strategies for Weight Management
Časové okno: 18 months
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Participant-reported importance of behavioral strategies for weight management, assessed at 18 months using a study-specific multi-item questionnaire.
Items related to dietary awareness, meal planning, portion control, weight monitoring, and self-monitoring behaviors are rated on a 5-point Likert scale (1 = not at all important to 5 = very important) and aggregated into a mean score.
Higher scores indicate greater perceived importance of behavioral strategies.
The assessment reflects the preceding 12 months (i.e., the period between the 6-month and 18-month follow-up).
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18 months
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Perceived Positive Social Support for Weight Management
Časové okno: 18 months
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Perceived positive social support for weight management, assessed at 18 months using a study-specific multi-item questionnaire.
Items related to emotional and practical support from close contacts and external support services are rated on a 5-point Likert scale (1 = not at all to 5 = completely) and aggregated into a mean score.
Higher scores indicate greater perceived positive social support.
The assessment reflects the preceding 12 months (i.e., the period between the 6-month and 18-month follow-up).
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18 months
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Perceived Negative Social Influence on Weight Management
Časové okno: 18 months
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Perceived negative social influence on weight management, assessed at 18 months using a study-specific multi-item questionnaire.
Items related to negative comments and social norms are rated on a 5-point Likert scale (1 = not at all to 5 = completely) and aggregated into a mean score.
Higher scores indicate greater negative social influence.
The assessment reflects the preceding 12 months (i.e., the period between the 6-month and 18-month follow-up).
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18 months
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Perceived Environmental Support for Healthy Lifestyle
Časové okno: 18 months
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Perceived environmental support for maintaining a healthy lifestyle, assessed at 18 months using a study-specific multi-item questionnaire.
Items related to home environment, workplace environment, and commuting environment in relation to physical activity and healthy eating are rated on a 5-point Likert scale (1 = not at all to 5 = completely) and aggregated into a mean score.
Higher scores indicate greater perceived environmental support for healthy lifestyle behaviors.
The assessment reflects the preceding 12 months (i.e., the period between the 6-month and 18-month follow-up).
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18 months
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Perceived Financial Support for Healthy Lifestyle
Časové okno: 18 months
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Perceived financial support for maintaining a healthy lifestyle, assessed at 18 months using a study-specific multi-item questionnaire.
Items related to financial ability to engage in physical activity and maintain a healthy diet are rated on a 5-point Likert scale (1 = not at all to 5 = completely) and aggregated into a mean score.
Higher scores indicate greater perceived financial support for healthy lifestyle behaviors.
The assessment reflects the preceding 12 months (i.e., the period between the 6-month and 18-month follow-up).
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18 months
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Spolupracovníci a vyšetřovatelé
Sponzor
Vyšetřovatelé
- Vrchní vyšetřovatel: Mats Börjesson, Professor, University of Gothenburg, Sahlgrenska University Hospital
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
- Onemocnění endokrinního systému
- Poruchy výživy
- Metabolické choroby
- Nadměrná výživa
- Tělesná hmotnost
- Změny tělesné hmotnosti
- Poruchy metabolismu glukózy
- Diabetes Mellitus
- Patologické stavy, příznaky a symptomy
- Chování
- Nutriční a metabolické nemoci
- Příznaky a symptomy
- Nadváha
- Obezita
- Ztráta váhy
- Prediabetický stav
- Motorická aktivita
- Strava, jídlo a výživa
- Fyziologické jevy
- Nutriční fyziologické jevy
- Strava
Další identifikační čísla studie
- LI-PAD EXTENDED
- 285373 (Jiný identifikátor: Researchweb, Vastra Gotalandsregionen)
Plán pro data jednotlivých účastníků (IPD)
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Popis plánu IPD
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