We measured physical activity (mins /day of at least moderate intensity, mins /day of sedentary time, steps per day and total accelerometer counts) using Actigraph GT3XE accelerometers. We measured resting systolic and diastolic blood pressure (taking the lowest of three measurements in the right arm, following at least 3 minutes seated); fasting plasma glucose; fasting LDL, HDL and total cholesterol; triglycerides; glycosylated haemoglobin (HbA1c); liver function tests (our clinical liaison specified alanine transaminase (ALT), which is used as a marker of inflammation [33 (link)] as the main variable of interest); BMI; waist circumference (mean of three consecutive measurements); dietary intake (using the DINE questionnaire) [34 (link)]; and the EQ-5D health-related quality of life measure [35 (link)]. Based on clinical risk markers we calculated QRISK2 ten-year cardiovascular risk score [15 (link)] and the presence of metabolic syndrome (a composite cardiovascular risk classification based on having a combination of high waist circumference, fasting plasma glucose, blood pressure and /or lipid abnormalities. We used the WHO definition of metabolic syndrome to assess this [36 (link)]).
All outcomes were measured on entry into the study and 12 months later. Four months after baseline we assessed weight, physical activity and questionnaire-based measures to identify the immediate (short-term) impact of the intervention on weight and lifestyle behaviours.
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