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Behavior, Psychology and Sociology

Halo effect of a Mediterranean-lifestyle weight-loss intervention on untreated family members’ weight and physical activity: a prospective study

International Journal of Obesity volume 45, pages 1240–1248 (2021)Cite this article

Subjects

Abstract

Objectives

Obesity is subject to strong family clustering. The relatives of participants in weight-loss interventions may also modify their lifestyle and lose weight. The aim of this study was to examine the presence and magnitude of a halo effect in untreated family members of participants enrolled in a randomized, multi-component, lifestyle intervention.

Methods

A total of 148 untreated adult family members of participants in an intensive weight-loss lifestyle intervention (the PREDIMED-Plus study) were included. Changes at 1 and 2 years in body weight, physical activity, and adherence to a traditional Mediterranean diet (MedDiet) were measured. Generalized linear mixed models were used to assess whether the change differed between family members of the intervention group compared to the control.

Results

Untreated family members from the intervention group displayed a greater weight loss than those from the control after 1 and 2 years: adjusted 2-year weight change difference between groups was −3.98 (SE 1.10) kg (p < 0.001). There was a halo effect with regard to adherence to the MedDiet at one year which was sustained at two years: 2-year adjusted difference in MedDiet score change +3.25 (SE 0.46) (p < 0.001). In contrast, no halo effect was observed with regard to physical activity, as the untreated family members did not substantially modify their physical activity levels in either group, and the adjusted difference at two years between the 2 groups was −272 (SE 624) METs.min/week (p = 0.665).

Conclusions

In the first prospective study to assess the influence on untreated family members of a diet and physical activity weight-loss intervention, we found evidence of a halo effect in relatives on weight loss and improvement in adherence to a MedDiet, but not on physical activity. The expansion of MedDiet changes from individuals involved in a weight-loss intervention to their family members can be a facilitator for obesity prevention.

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Fig. 1: Flow chart of the halo study.
Fig. 2: Halo effect results in weight, physical activity and MedDiet adherence.
Fig. 3: Halo effect correlation.

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Acknowledgements

CIBEROBN is a ISCIII initiative.

Funding

OC was funded with JR17/00022. This work was supported by the Strategic Plan of Research and Innovation in Health (PERIS) 2016-2020, Department of the Generalitat de Catalunya, and Instituto de Salud Carlos III (ISCIII). CL is supported by the Beatriu de Pinós postdoctoral program of the Government of Catalonia’s Secretariat for Universities and Research of the Ministry of Economy and Knowledge [2017-BP-00021].

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Author notes

  1. These authors contributed equally: A. Goday, O. Castaner

Authors and Affiliations

  1. Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain

    M. D. Zomeño, C. Lassale, A. Perez-Vega, S. Perez-Fernández, R. Llimona, J. Muñoz, M. Fitó, I. Subirana, H. Schröder & O. Castaner

  2. Programa de Doctorado en Alimentación y Nutrición, Facultad de Farmacia, Universidad de Barcelona, Barcelona, Spain

    M. D. Zomeño

  3. Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain

    C. Lassale, N. Babió, J. Salas, X. Pintó, E. Sacanella, M. Fitó, A. Goday & O. Castaner

  4. Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 43202, Reus, Spain

    J. Basora

  5. Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain

    N. Babió, I. Paz-Graniel & J. Salas

  6. Institut d’Investigació Sanitària Pere i Virgili (IISPV), 43204, Reus, Spain

    N. Babió & J. Salas

  7. Hospital Universitari Sant Joan de Reus, HUSJR, Reus, Spain

    J. Salas

  8. Lipid Unit, Department of Internal Medicine, Bellvitge Biomedical Research Institute (IDIBELL)-Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, 08908, Barcelona, Spain

    X. Pintó

  9. Department of Internal Medicine, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, 08026, Barcelona, Spain

    E. Sacanella

  10. Consorcio CIBER, de Epidemiología y Salud Publica (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain

    I. Subirana & H. Schröder

  11. Endocrinology Service. Institut Hopsital del Mar d’Investigacions mèdiques, Barcelona, Spain

    A. Goday & O. Castaner

Authors
  1. M. D. Zomeño
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  2. C. Lassale
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  3. A. Perez-Vega
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  13. M. Fitó
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Correspondence to O. Castaner.

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Supplementary information

41366_2021_763_MOESM1_ESM.xlsx

SUPPLEMENTAL TABLE 1: Halo effect on weight loss by tertiles of weight change of the PREDIMEDplus participants from the intervention group 1 year from baseline.

41366_2021_763_MOESM2_ESM.xlsx

SUPPLEMENTAL TABLE 2: Halo effect on weight loss by tertiles of weight change of the PREDIMEDplus participants from the intervention group 2 years from baseline.

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Zomeño, M.D., Lassale, C., Perez-Vega, A. et al. Halo effect of a Mediterranean-lifestyle weight-loss intervention on untreated family members’ weight and physical activity: a prospective study. Int J Obes 45, 1240–1248 (2021). https://doi.org/10.1038/s41366-021-00763-z

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