Obesity has been constantly increasing across the globe at an alarming rate. In Latest Zealand (NZ), around 31% of adults are obese, and 35% are chubby, with the prevalence of chubby men significantly greater than women. Notably, Māori and Pasifika men are more obese than non-Māori and non-Pasifika men. Due to this fact, there’s a necessity for effective and sustainable technique of intervention to deal with issues related to being chubby and obese amongst NZ men.

Study: Rugby Fans in Training Latest Zealand (RUFIT NZ): a randomized controlled trial to evaluate the effectiveness of a healthy lifestyle program for chubby men delivered through skilled rugby clubs. Image Credit: Peopleimages.com – Yuri A / Shutterstock.com

Background

Men are mostly underrepresented in the vast majority of weight reduction programs. Based on the reports of fourteen randomized controlled trials (RCTs) linked to men-only weight reduction and maintenance programs, a combined intervention of exercise, dietary, and behavior change techniques was found to be simplest.

Motivated by the positive results of a previously developed Football Fans in Training (FFIT) program in Scotland, an identical program was designed in NZ. This latest program was developed to support obese or chubby NZ men through skilled rugby clubs.

A pilot RCT of Rugby Fans in Training-NZ (RUFIT-NZ) was conducted using 96 participants. Notably, this study documented a weight reduction of around 2.5 kg among the many participants after 12 weeks of intervention.

Along with the load loss, these participants exhibited a decrease in resting heart rate, waist circumference, and diastolic blood pressure. An overall improvement in fitness level was also observed.

Importantly, all participants who accomplished this system strongly really useful this program to their friends, thereby indicating the potential for broader acceptance of RUFIT-NZ. Thus, a large-scale RCT was required to evaluate its sustained effect.

A recent International Journal of Behavioral Nutrition and Physical Activity study determines the efficacy and cost-effectiveness of RUFIT-NZ on lifestyle change, fitness, weight reduction, blood pressure, and health-related quality of life (HRQoL).

In regards to the study

A two-arm, multi-center, and parallel RCT was conducted in NZ between January 21, 2019, and October 22 22, 2020. RUFIT-NZ was delivered to participants by skilled rugby franchises in a 12-session program.

This study cohort included chubby men between 30 and 65 years of age. These study participants were initially screened through the Physical Activity Readiness Questionnaire (PAR-Q). Any participants who were already related to other healthy lifestyle programs were excluded. 

Weight changes, the first consequence, were recorded after 52 weeks of intervention. As well as, secondary outcomes resembling changes in waist circumference, cardiorespiratory and musculoskeletal fitness, blood pressure, lifestyle behaviors, and HRQoL were evaluated at 12 and 52 weeks.

A complete of 308 participants were recruited and randomly divided into two arms, each comprising 154 men. Notably, the study cohort constituted 150 Māori participants.

A wait-list control approach was adopted for the control group, through which participants randomly assigned to this group were asked to proceed with their routine lifestyle for 52 weeks. Following this, they were offered RUFIT-NZ intervention at the top of the 12-month follow-up period.

Each RUFIT-NZ intervention session included workshop-based education where the participants learned in regards to the importance of nutrition, sleep, physical activity, and sedentary behavior for about one hour. The next session included one hour of exercise training for the treatment group. Although this was a group-based session, each participant’s exercise was tailored to their individual needs.

Study findings

RUFIT-NZ interventions had overall sustained changes in weight, physical fitness, waist circumference, self-reported physical activity, alcohol consumption, and HRQoL within the treated group. Nevertheless, no significant change was observed in blood pressure or sleep post-RUFIT-NZ intervention.

Taken together, 200 participants accomplished the RUFIT-NZ intervention before the implementation of coronavirus disease 2019 (COVID-19) restrictions. The intervention group reported higher consumption of fruit and veggies at 12 weeks.

At 52 weeks, this group revealed a weight reduction of around 2.77 kg. As well as, waist circumference reduction, high physical activity levels, and HRQoL were reduced at 12 and 52 weeks.

The effectiveness of this intervention was also analyzed based on cost per quality-adjusted life 12 months (QALY). Incremental cost-effective ratios of $259 per kg lost or $40,269 per QALY were obtained. A marginal gain in QALY was attributed to the short testing period. 

Conclusions

One in all the critical limitations of the current trial was related to the lockdowns and restrictions implemented in the course of the COVID-19 pandemic. As a consequence of these restrictions, the RUFIT-NZ intervention couldn’t be delivered to some participants. Nevertheless, based on the recommendation of the trial steering committee, data were analyzed for participants from the primary two waves.

One other limitation of this study was the absence of blinded consequence assessments. 

Despite these limitations, the general positive primary and secondary outcomes emphasized the efficacy of this intervention in stopping the possible opposed events of morbidity and mortality as a result of obesity.

Journal reference:

• Maddison, R., Hargreaves, E. A., Jiang, Y., et al. (2023) Rugby Fans in Training Latest Zealand (RUFIT NZ): a randomized controlled trial to evaluate the effectiveness of a healthy lifestyle program for chubby men delivered through skilled rugby clubs. International Journal of Behavioral Nutrition and Physical Activity 20 (37). doi:10.1186/s12966-022-01395-w, https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-022-01395-w