scholarly journals OnTrack: development and feasibility of a smartphone app designed to predict and prevent dietary lapses

2018 ◽  
Vol 9 (2) ◽  
pp. 236-245 ◽  
Author(s):  
Evan M Forman ◽  
Stephanie P Goldstein ◽  
Fengqing Zhang ◽  
Brittney C Evans ◽  
Stephanie M Manasse ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Control ◽  
Smartphone Application ◽  
Management Plan ◽  
Just In Time ◽  
Time Data ◽  
Adaptive Intervention ◽  
Weight Loss Programs ◽  
Female Body Mass ◽  
Study Participants

Abstract Given that the overarching goal of weight loss programs is to remain adherent to a dietary prescription, specific moments of nonadherence known as “dietary lapses” can threaten weight control via the excess energy intake they represent and by provoking future lapses. Just-in-time adaptive interventions could be particularly useful in preventing dietary lapses because they use real-time data to generate interventions that are tailored and delivered at a moment computed to be of high risk for a lapse. To this end, we developed a smartphone application (app) called OnTrack that utilizes machine learning to predict dietary lapses and deliver a targeted intervention designed to prevent the lapse from occurring. This study evaluated the feasibility, acceptability, and preliminary effectiveness of OnTrack among weight loss program participants. An open trial was conducted to investigate subjective satisfaction, objective usage, algorithm performance, and changes in lapse frequency and weight loss among individuals (N = 43; 86% female; body mass index = 35.6 kg/m2) attempting to follow a structured online weight management plan for 8 weeks. Participants were adherent with app prompts to submit data, engaged with interventions, and reported high levels of satisfaction. Over the course of the study, participants averaged a 3.13% weight loss and experienced a reduction in unplanned lapses. OnTrack, the first Just-in-time adaptive intervention for dietary lapses was shown to be feasible and acceptable, and OnTrack users experienced weight loss and lapse reduction over the study period. These data provide the basis for further development and evaluation.

Responses to Two Weight-loss Programs Based on Approximating the Diet to the Ideal: Differences Associated with Increased Cereal or Vegetable Consumption

2006 ◽  
Vol 76 (6) ◽  
pp. 367-376 ◽  
Author(s):  
Ortega ◽  
Rodríguez-Rodríguez ◽  
Aparicio ◽  
Marín-Arias ◽  
López-Sobaler
Keyword(s):  
Weight Loss ◽  
Weight Control ◽  
Dietary Intervention ◽  
Vegetable Consumption ◽  
Healthy Eating Index ◽  
Anthropometric Data ◽  
Control Programs ◽  
Weight Loss Programs ◽  
Spanish Women ◽  
The Ideal

The fight against excess weight and obesity is a health priority. The aim of this study was to analyze the anthropometric changes induced by two weight control programs based on approximating the diet to the theoretical ideal (increasing the consumption of foods with the largest differences between the recommended and observed intakes: cereals and vegetables – for which a minimum of 6 and 3 servings/day are recommended, respectively). The study subjects were 57 Spanish women with a body-mass index (BMI) of 24–35 kg/m², all of whom were randomly assigned to one of two slightly hypocaloric diets for a six-week period: diet V, in which the consumption of greens and vegetables was increased, or diet C, in which the consumption of cereals was increased. Dietetic and anthropometric data were collected at the start of the study and again at two and six weeks. The dietary intervention approximated the subjects’ energy provision from proteins, fats, and carbohydrates to those recommended. The Healthy Eating Index (HEI) improved with both diets. Reductions in body weight, BMI, and the amount of body fat (kg) were also achieved with both diets. Weight loss was 1.56 ± 0.93 kg and 1.02 ± 0.55 kg at two weeks with diet C and V respectively, and 2.8 ± 1.4 kg and 2.0 ± 1.3 kg at six weeks (p < 0.05). Approximating the diet to the theoretical ideal by increasing the consumption of vegetables or cereals may therefore be of use in weight control. In terms of weight loss and the improvement of the diet quality (energy profile and HEI), diet C was significantly more effective than diet V.

Abstract 17239: Grandparents as Agents of Change for Addressing Childhood Obesity: Preliminary Data From a Caregiver Weight Loss Intervention

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
MinKyoung Song ◽  
Karen S Lyons ◽  
Sydnee Stoyles ◽  
Lissi Hansen ◽  
Christopher S Lee
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Childhood Obesity ◽  
Sedentary Time ◽  
Rank Order ◽  
Vigorous Physical Activity ◽  
Ripple Effect ◽  
Time Data ◽  
Grandparent Caregivers ◽  
Weight Loss Programs

Introduction: Much interventional research seeks to reduce childhood obesity by capitalizing on parents’ influence as caregivers. However, few studies have investigated whether grandparent-caregivers might have a similar influence on children’s weight-related health. This dearth of evidence is surprising since there has been a rapid increase in grandparent caregiving in the U.S. Purpose: Examine for a ripple effect on weight-related outcomes in children whose grandparent-caregivers have been enrolled in a weight loss program. Methods: We recruited 9 grandparent-grandchild (aged 6 to 12 years) dyads where both members had overweight or obesity. We collected data on weight/height, physical activity/sedentary time, and dietary behaviors at baseline and at 8 weeks. Physical activity and sedentary time data were collected using accelerometers over two, seven-day cycles (after baseline and 8-weeks’ visits). Dietary data were collected using the Block Food Screener. Spearman’s rank-order correlation was used to quantify associations in changes between the dyad members. Results: Mean age was 64.3 ± 5.2 years and 9.0 ± 1.7 years for grandparents and grandchildren, respectively; 88.9% of grandparents and 66.7% of grandchildren were female. At 8 weeks: (1) there was a positive association between changes in grandparents’ BMI and changes in their grandchildren’s BMI (r=0.40; p<0.01); (2) changes in grandparents’ levels of moderate-to-vigorous physical activity (MVPA)/sedentary time was positively associated with changes in grandchildren’s levels of MVPA/sedentary time (r=0.52, p<0.01; r=0.55, p<0.01, respectively). Conclusions: We demonstrated moderate associations between changes in children’s BMI/MVPA/sedentary time and changes in their grandparents’ BMI/MVPA/sedentary time. Our findings show that enrolling adult caregivers in weight loss programs could represent an effective delivery vehicle for improving childhood obesity. Additionally, our findings can help demonstrate to grandparent-caregivers that they can act as agents for improving health outcomes in their grandchildren by improving their own weight-related health, offering encouragement for grandparent-caregivers to enroll in weight-loss programs.

Weight Management and Weight Loss Strategies of Professional Jockeys

2002 ◽  
Vol 12 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Jan M. Moore ◽  
Anna F. Timperio ◽  
David A. Crawford ◽  
Cate M. Burns ◽  
David Cameron-Smith
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Weight Management ◽  
Weight Control ◽  
Response Rate ◽  
Management Strategies ◽  
Management Plan ◽  
Rapid Weight Loss ◽  
Additional Weight ◽  
The Impact

Jockeys are required to maintain very low body weight and precise weight control during competition. This study examined the weight loss and weight management strategies of professional horseracing jockeys in the state of Victoria, Australia. An anonymous, self-completed questionnaire was administered (55% response rate, n=116). Almost half (43%) reported that maintaining riding weight was difficult or very difficult, with 75% routinely skipping meals. In preparation for racing, 60% reported that they typically required additional weight loss, with 81% restricting food intake in the 24 hours prior to racing. Additionally, sauna-induced sweating (29%) and diuretics (22%) were frequently employed to further aid in weight loss prior to racing. These rapid weight loss methods did not differ between the 51% of jockeys who followed a weight management plan compared to those who did not. The impact of these extreme weight loss practices on riding performance and health remains unknown.

Randomized controlled trial of OnTrack, a just-in-time adaptive intervention designed to enhance weight loss

2019 ◽  
Vol 9 (6) ◽  
pp. 989-1001 ◽  
Author(s):  
Evan M Forman ◽  
Stephanie P Goldstein ◽  
Rebecca J Crochiere ◽  
Meghan L Butryn ◽  
Adrienne S Juarascio ◽  
...  
Keyword(s):  
Machine Learning ◽  
Weight Loss ◽  
Randomized Controlled Trial ◽  
Randomized Trial ◽  
Controlled Trial ◽  
Weight Loss Program ◽  
Just In Time ◽  
Adaptive Intervention ◽  
Randomized Controlled

This randomized trial demonstrated qualified support for the ability of a machine learning-powered, smartphone-based just-in-time, adaptive intervention to enhance weight loss over and above a commercial weight loss program.

A Processes of Change Model for Weight Control for Participants in Community-Based Weight Loss Programs

1994 ◽  
Vol 29 (2) ◽  
pp. 161-177 ◽  
Author(s):  
Susan R. Rossi ◽  
Joseph S. Rossi ◽  
Linda M. Rossi-Delprete ◽  
James O. Prochaska ◽  
Stephen W. Banspach ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Control ◽  
Processes Of Change ◽  
Change Model ◽  
Community Based ◽  
Weight Loss Programs

scholarly journals Optimizing a Just-in-Time Adaptive Intervention to Improve Dietary Adherence in Behavioral Obesity Treatment: Protocol for a Microrandomized Trial

10.2196/33568 ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. e33568
Author(s):  
Stephanie P Goldstein ◽  
Fengqing Zhang ◽  
Predrag Klasnja ◽  
Adam Hoover ◽  
Rena R Wing ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Weight Loss ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Treatment Protocol ◽  
Time Of Day ◽  
Obesity Treatment ◽  
Just In Time ◽  
Adaptive Intervention ◽  
Contextual Moderators

Background Behavioral obesity treatment (BOT) is a gold standard approach to weight loss and reduces the risk of cardiovascular disease. However, frequent lapses from the recommended diet stymie weight loss and prevent individuals from actualizing the health benefits of BOT. There is a need for innovative treatment solutions to improve adherence to the prescribed diet in BOT. Objective The aim of this study is to optimize a smartphone-based just-in-time adaptive intervention (JITAI) that uses daily surveys to assess triggers for dietary lapses and deliver interventions when the risk of lapse is high. A microrandomized trial design will evaluate the efficacy of any interventions (ie, theory-driven or a generic alert to risk) on the proximal outcome of lapses during BOT, compare the effects of theory-driven interventions with generic risk alerts on the proximal outcome of lapse, and examine contextual moderators of interventions. Methods Adults with overweight or obesity and cardiovascular disease risk (n=159) will participate in a 6-month web-based BOT while using the JITAI to prevent dietary lapses. Each time the JITAI detects elevated lapse risk, the participant will be randomized to no intervention, a generic risk alert, or 1 of 4 theory-driven interventions (ie, enhanced education, building self-efficacy, fostering motivation, and improving self-regulation). The primary outcome will be the occurrence of lapse in the 2.5 hours following randomization. Contextual moderators of intervention efficacy will also be explored (eg, location and time of day). The data will inform an optimized JITAI that selects the theory-driven approach most likely to prevent lapses in a given moment. Results The recruitment for the microrandomized trial began on April 19, 2021, and is ongoing. Conclusions This study will optimize a JITAI for dietary lapses so that it empirically tailors the provision of evidence-based intervention to the individual and context. The finalized JITAI will be evaluated for efficacy in a future randomized controlled trial of distal health outcomes (eg, weight loss). Trial Registration ClinicalTrials.gov NCT04784585; http://clinicaltrials.gov/ct2/show/NCT04784585 International Registered Report Identifier (IRRID) DERR1-10.2196/33568

Examination of the relationship between lapses and weight loss in a smartphone-based just-in time adaptive intervention

2020 ◽  
Author(s):  
Stephanie P Goldstein ◽  
Leslie A Brick ◽  
J Graham Thomas ◽  
Evan M Forman
Keyword(s):  
Weight Loss ◽  
Random Effect ◽  
Secondary Analysis ◽  
Future Research ◽  
Just In Time ◽  
Behavioral Weight Loss ◽  
Moderation Effect ◽  
Adaptive Intervention ◽  
Behavioral Weight Loss Intervention ◽  
Post Hoc

Abstract We developed a smartphone-based just-in-time adaptive intervention (JITAI), called OnTrack, that provides personalized intervention to prevent dietary lapses (i.e., nonadherence from the behavioral weight loss intervention diet). OnTrack utilizes ecological momentary assessment (EMA; repeated electronic surveys) for self-reporting lapse triggers, predicts lapses using machine learning, and provides brief intervention to prevent lapse. We have established preliminary feasibility, acceptability, and efficacy of OnTrack, but no study has examined our hypothesized mechanism of action: reduced lapse frequency will be associated with greater weight loss while using OnTrack. This secondary analysis investigated the association between lapse frequency and the weekly percentage of weight loss. Post hoc analyses evaluated the moderating effect of OnTrack engagement on this association. Participants (N = 121) with overweight/obesity (MBMI = 34.51; 84.3% female; 69.4% White) used OnTrack with a digital weight loss program for 10 weeks. Engagement with OnTrack (i.e., EMA completed and interventions accessed) was recorded automatically, participants self-reported dietary lapses via EMA, and weighed weekly using Bluetooth scales. Linear mixed models with a random effect of subject and fixed effect of time revealed a nonsignificant association between weekly lapses and the percentage of weight loss. Post hoc analyses revealed a statistically significant moderation effect of OnTrack engagement such that fewer EMA and interventions completed conferred the expected associations between lapses and weight loss. Lapses were not associated with weight loss in this study and one explanation may be the influence of engagement levels on this relationship. Future research should investigate the role of engagement in evaluating JITAIs.

scholarly journals Optimizing a Just-in-Time Adaptive Intervention to Improve Dietary Adherence in Behavioral Obesity Treatment: Protocol for a Microrandomized Trial (Preprint)

2021 ◽  
Author(s):  
Stephanie P Goldstein ◽  
Fengqing Zhang ◽  
Predrag Klasnja ◽  
Adam Hoover ◽  
Rena R Wing ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Weight Loss ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Treatment Protocol ◽  
Time Of Day ◽  
Obesity Treatment ◽  
Just In Time ◽  
Adaptive Intervention ◽  
Contextual Moderators

BACKGROUND Behavioral obesity treatment (BOT) is a gold standard approach to weight loss and reduces the risk of cardiovascular disease. However, frequent lapses from the recommended diet stymie weight loss and prevent individuals from actualizing the health benefits of BOT. There is a need for innovative treatment solutions to improve adherence to the prescribed diet in BOT. OBJECTIVE The aim of this study is to optimize a smartphone-based just-in-time adaptive intervention (JITAI) that uses daily surveys to assess triggers for dietary lapses and deliver interventions when the risk of lapse is high. A microrandomized trial design will evaluate the efficacy of any interventions (ie, theory-driven or a generic alert to risk) on the proximal outcome of lapses during BOT, compare the effects of theory-driven interventions with generic risk alerts on the proximal outcome of lapse, and examine contextual moderators of interventions. METHODS Adults with overweight or obesity and cardiovascular disease risk (n=159) will participate in a 6-month web-based BOT while using the JITAI to prevent dietary lapses. Each time the JITAI detects elevated lapse risk, the participant will be randomized to no intervention, a generic risk alert, or 1 of 4 theory-driven interventions (ie, enhanced education, building self-efficacy, fostering motivation, and improving self-regulation). The primary outcome will be the occurrence of lapse in the 2.5 hours following randomization. Contextual moderators of intervention efficacy will also be explored (eg, location and time of day). The data will inform an optimized JITAI that selects the theory-driven approach most likely to prevent lapses in a given moment. RESULTS The recruitment for the microrandomized trial began on April 19, 2021, and is ongoing. CONCLUSIONS This study will optimize a JITAI for dietary lapses so that it empirically tailors the provision of evidence-based intervention to the individual and context. The finalized JITAI will be evaluated for efficacy in a future randomized controlled trial of distal health outcomes (eg, weight loss). CLINICALTRIAL ClinicalTrials.gov NCT04784585; http://clinicaltrials.gov/ct2/show/NCT04784585 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/33568

How to Maintain a Healthy Body Weight

2006 ◽  
Vol 76 (4) ◽  
pp. 208-215 ◽  
Author(s):  
Astrup
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Body Weight ◽  
Glycemic Index ◽  
Dairy Products ◽  
Weight Control ◽  
Healthy Body Weight ◽  
Healthy Body

The epidemic of both obesity and type 2 diabetes is due to environmental factors, but the individuals developing the conditions possess a strong genetic predisposition. Observational surveys and intervention studies have shown that excess body fatness is the major environmental cause of type 2 diabetes, and that even a minor weight loss can prevent its development in high-risk subjects. Maintenance of a healthy body weight in susceptible individuals requires 45–60 minutes physical activity daily, a fat-reduced diet with plenty of fruit, vegetables, whole grain, and lean meat and dairy products, and moderate consumption of calorie containing beverages. The use of table values to predict the glycemic index of meals is of little – if any – value, and the role of a low-glycemic index diet for body weight control is controversial. The replacement of starchy carbohydrates with protein from lean meat and lean dairy products enhances satiety, and facilitate weight control. It is possible that dairy calcium also promotes weight loss, although the mechanism of action remains unclear. A weight loss of 5–10% can be induced in almost all obese patients providing treatment is offered by a professional team consisting of a physician and dieticians or nurses trained to focus on weight loss and maintenance. Whereas increasing daily physical activity and regular exercise does not significantly effect the rate of weight loss in the induction phase, it plays an important role in the weight maintenance phase due to an impact on daily energy expenditure and also to a direct enhancement of insulin sensitivity.

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