A gender-sensitised weight-loss and healthy living program for men with overweight and obesity in Australian Football League settings (Aussie-FIT): A pilot randomised controlled trial

Abstract

Background

Recent evidence shows that sport settings can act as a powerful draw to engage men in weight loss. The primary objective of this pilot study was to test the feasibility of delivering and to evaluate preliminary efficacy of Aussie-FIT, a weight-loss program for men with overweight/obesity delivered in Australian Football League (AFL) settings, in preparation for a future definitive trial.

Methods and findings

This 6-month pilot trial took place in Perth, Australia. Participants were overweight/obese (Body Mass Index [BMI] ≥ 28 kg/m ²), middle-aged (35–65 years old) men. Participants were recruited in May 2018, and the intervention took place between June and December 2018. The intervention involved 12 weekly 90-min face-to-face sessions, incorporating physical activity, nutrition, and behaviour change information and practical activities delivered by coaches at 2 clubs. Data were collected at baseline and immediately postintervention. For trial feasibility purposes, 6-month follow-ups were completed. Outcomes were differences in weight loss (primary outcome) and recruitment and retention rates, self-reported measures (for example, psychological well-being), device-measured physical activity, waist size, and blood pressure at 3 months. Within 3 days of advertising at each club, 426 men registered interest; 306 (72%) were eligible. Men were selected on a first-come first-served basis ( n = 130; M age = 45.8, SD = 8; M BMI = 34.48 kg/m ², SD = 4.87) and randomised by a blinded researcher. Trial retention was 86% and 63% at 3- and 6-month follow-ups (respectively). No adverse events were reported. At 3 months, mean difference in weight between groups, adjusted for baseline weight and group, was 3.3 kg (95% CI 1.9, 4.8) in favour of the intervention group ( p < 0.001). The intervention group’s moderate-to-vigorous physical activity (MVPA) was higher than the control group by 8.54 min/day (95% CI 1.37, 15.71, p = 0.02). MVPA among men attracted to Aussie-FIT was high at baseline (intervention arm 35.61 min/day, control arm 38.38 min/day), which may have limited the scope for improvement.

Conclusions

Aussie-FIT was feasible to deliver; participants increased physical activity, decreased weight, and reported improvements in other outcomes. Issues with retention were a limitation of this trial. In a future, fully powered randomised controlled trial (RCT), retention could be improved by conducting assessments outside of holiday seasons.

Trial registration

Australian New Zealand Clinical Trials Registry: ACTRN12617000515392.

Abstract

Eleanor Quested and colleagues report the findings from a pilot, football-based randomised controlled trial aimed at men with overweight/obesity.

Author summary

Why was this study done?

• The prevalence of overweight and obesity is higher in men than in women in Australia (71% versus 56%).

• Provision of weight-loss programs suitable for men is limited, and men are less likely than women to take part in weight-loss programs.

• Use of sport settings, such as Australian Football League (AFL) club facilities, can be used as a powerful way to encourage men to participate in weight-loss programs.

What did the researchers do and find?

• 130 men took part in the Aussie-FIT program. This men-only weight-loss program included 12 weekly 90-min sessions that included weight-loss education and coach-led physical activity. The AFL themed program was delivered in 2 Australian football club settings.

• After all of the men’s initial weight and health measures were taken, half of the group received the program, and the other half waited for 3 months to receive it. At 3 months, the measurements were repeated so that we could compare differences in weight (and other indicators of health) between men who had already completed the program and the men who were waiting to receive the program.

• We found that the men who had participated in the program lost on average 3.33 kg more than the men who had not. Men who had completed Aussie-FIT did, on average, 8.54 min more moderate-to vigorous physical activity per day than their counterparts who had not yet received the program.

What do these findings mean?

• Aussie-FIT is feasible to deliver in Australian football settings. This study provides some initial evidence that Aussie-FIT may be appealing and effective as a weight-loss program for men with overweight and obesity in Australia.

• This study was relatively small (130 men took part). In order to make definitive policy recommendations regarding program scale out, a follow-up study involving more participants and more football clubs is needed. Also, studies with longer follow-up are needed.

• A limitation of this study was that the program did not attract men from culturally or linguistically diverse backgrounds or indigenous Australians; future studies should explore how the program can be made more appealing and acceptable to men from more diverse backgrounds.