Comparison of traditional versus mobile app self-monitoring of physical activity and dietary intake among overweight adults participating in an mHealth weight loss program

Abstract Background: Obesity is a major health concern in western countries. In Norway, patients with obesity can attend weight-loss programmes, which focus on changes in dietary and physical activity habits. Use of self-monitoring is advocated when changing dietary and physical activity habits for adults with obesity. This study aimed to explore the experiences of patients with obesity who used activity monitors while attending a weight-loss program.Methods: Patients with body mass index (BMI) > 35 kg/m2 with weight related comorbidities or a BMI > 40 kg/m2 referred to an intermittent weight-loss programme were recruited into this study. They were introduced to one of three different activity monitors, Fitbit ZipTM, Mio FuseTM, or Mio SliceTM. Semi-structured interviews were performed with patients six months into the weight-loss programme. Thematic analysis was applied when analysing the data.Results: Of the 29 informants (aged 21 to 66 years) interviewed, 59% were female. Their experience with activity monitors was related to their adherence to the weight-loss programme. Two main themes emerged from the informants stories: 1. “Activity monitors visualize proof of effort or failure to change health habits”. 2. “Activity monitors act as a positive or negative enforcer when incorporating change”.Conclusions: Using activity monitors either strengthens or undermines patients’ attempts to change health habits when attending a weight-loss program. Our findings suggest a need for more individualized weight-loss programmes for patients with obesity.Trial Registration: The study was registered in ClinicalTrials.gov on July 7 2016, with the registration number NCT02826122 and URL: https://clinicaltrials.gov/ct2/show/NCT02826122?term=NCT02826122&draw=2&rank=1.

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Enrolling Caregivers in Obesity Interventions to Improve Obesity-Related Outcomes in Children

Western Journal of Nursing Research ◽

10.1177/01939459211037057 ◽

2021 ◽

pp. 019394592110370

Author(s):

Hannah Bessette ◽

MinKyoung Song ◽

Karen S. Lyons ◽

Sydnee Stoyles ◽

Christopher S. Lee ◽

...

Keyword(s):

Physical Activity ◽

Body Mass Index ◽

Weight Loss ◽

Linear Regression ◽

Body Mass ◽

Sedentary Time ◽

Vigorous Physical Activity ◽

Weight Loss Program ◽

Weight Loss Programs ◽

Obesity Interventions

In this study, we assessed the influences of change in moderate-to-vigorous physical activity (MVPA)/sedentary time (ST) of caregivers participating in a commercial weight-loss program on their children’s change in MVPA/ST. Data from 29 caregivers and their children were collected over 8 weeks. We used multivariable linear regression to assess associations of changes in caregiver’s percent of time spent in MVPA/ST and changes in their child’s percent of time spent in MVPA/ST. For caregivers that decreased body mass index (BMI) over 8 weeks, changes in caregivers’ MVPA was strongly associated with the change in children’s MVPA (β = 2.61 [95% CI: 0.45, 4.77]) compared to caregivers who maintained/increased BMI (β = 0.24 [–2.16, 2.64]). Changes in caregivers’ ST was strongly associated with changes in children’s ST (β = 2.42 [1.02, 3.81]) compared to caregivers who maintained/increased BMI (β = 0.35 [–0.45, 1.14]). Findings reinforce encouraging caregivers to enroll in weight-loss programs for the benefit of their children as well as for themselves.

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Effects of Increased Physical Activity and/or Weight Loss Diet on Serum Myokine and Adipokine Levels in Overweight Adults with Impaired Glucose Metabolism

Journal of Diabetes and its Complications ◽

10.1016/j.jdiacomp.2021.107892 ◽

2021 ◽

pp. 107892

Author(s):

Özlem Tok ◽

Savaş Volkan Kişioğlu ◽

Halil Önder Ersöz ◽

Bahittin Kahveci ◽

Zeynep Göktaş

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Glucose Metabolism ◽

Impaired Glucose Metabolism ◽

Weight Loss Diet ◽

Overweight Adults

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Efficacy of a Multi-Component m-Health Diet, Physical Activity, and Sleep Intervention on Dietary Intake in Adults with Overweight and Obesity: A Randomised Controlled Trial

Nutrients ◽

10.3390/nu13072468 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2468

Author(s):

Sasha Fenton ◽

Tracy L. Burrows ◽

Clare E. Collins ◽

Anna T. Rayward ◽

Beatrice Murawski ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Randomised Controlled Trial ◽

Dietary Intake ◽

Controlled Trial ◽

Intervention Group ◽

Weight Loss Intervention ◽

Traditional Group ◽

Traditional Diet ◽

Randomised Controlled

This three-arm randomised controlled trial evaluated whether (1) a multi-component weight loss intervention targeting diet, physical activity (PA), and sleep was effective at improving dietary intake over six months and 12 months, compared with a control, and (2) the enhanced diet, PA, and sleep intervention was more effective at improving dietary intake than the traditional diet and PA intervention. A total of 116 adults (70% female, 44.5 years, BMI 31.7 kg/m2) were randomised to either traditional diet and PA intervention; enhanced diet, PA, and sleep intervention; or wait-list control. To examine between-group differences, intervention groups were pooled and compared with the control. Then, the two intervention groups were compared. At six months, the pooled intervention group consumed 1011 fewer kilojoules/day (95% CI −1922, −101), less sodium (−313.2 mg/day; 95% CI −591.3, −35.0), and higher %EI from fruit (+2.1%EI; 95% CI 0.1, 4.1) than the controls. There were no differences in intake between the enhanced and traditional groups at six months. At 12 months, the pooled intervention and control groups reported no significant differences. However, compared to the traditional group, the enhanced reported higher %EI from nutrient-dense foods (+7.4%EI; 95% CI 1.3, 13.5) and protein (+2.4%EI; 95% CI 0.1, 4.6), and reduced %EI from fried/takeaway foods (−3.6%EI; 95% CI −6.5, −0.7), baked sweet products (−2.0%EI; 95% CI −3.6, −0.4), and packaged snacks (−1.1%EI; 95% CI −2.2, −0.3). This weight loss intervention reduced total energy and sodium intakes as well as increased fruit intake in adults at six months. The enhanced intervention group reported improved dietary intake relative to the traditional group at 12 months.

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Abstract P073: Insufficient and Poor Sleep are Associated with Barriers to Healthy Eating and Lower Physical Activity: Baseline Characteristics of the EMPOWER Study

Circulation ◽

10.1161/circ.131.suppl_1.p073 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Christopher E Kline ◽

Patrick J Strollo ◽

Eileen R Chasens ◽

Bonny Rockette-Wagner ◽

Andrea Kriska ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Sleep Quality ◽

Lifestyle Intervention ◽

Body Fat ◽

Healthy Eating ◽

Perceived Barriers ◽

Poor Sleep ◽

Body Habitus ◽

Overweight Adults

Background: Sleep is emerging as an important factor that impacts dietary habits, physical activity, and metabolism. However, minimal attention is typically given to sleep in traditional lifestyle interventions. The purpose of these analyses was to examine baseline associations between sleep and physical activity and perceived barriers to healthy eating, which are two common lifestyle intervention targets, in a sample of apparently healthy adults enrolled in a behavioral weight loss intervention study. Methods: 150 overweight adults (51.1±10.2 y; 91% female; 79% Caucasian) participated in a 12-month lifestyle intervention that featured adaptive ecological momentary assessment. Sleep, physical activity, barriers to healthy eating and body habitus/composition were assessed prior to the intervention. Objective sleep was estimated with 7 days of wrist-worn actigraphy (Philips Actiwatch 2); sleep onset latency (SOL; the amount of time it takes to fall asleep after going to bed), sleep efficiency (SE; the percentage of time in bed that is spent asleep), and total sleep time (TST; total time spent asleep) served as the primary actigraphic sleep variables. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Physical activity was assessed with 7 days of waist-worn accelerometry (ActiGraph GT3x). Perceived barriers to healthy eating were assessed with the Barriers to Healthy Eating questionnaire. Body mass index (BMI) served as the measure of body habitus, and body fat was assessed with bioelectrical impedance. Results: Mean BMI and body fat for the sample were 34.0±4.6 kg/m2 and 43.7±5.5%, respectively. Mean TST was 6.6±0.8 h/night; approximately 23% of the sample averaged less than 6 hours of sleep. Mean SOL and SE for the sample were 15.3±16.2 min and 85.7±6.1%, respectively. Based on the PSQI, 52.0% of the sample had poor sleep quality. Following adjustment for age, sex, and race, longer SOL was associated with fewer steps/day (β=-.19, p=.02) and less time spent in moderate to vigorous physical activity (MVPA; β=-.16, p=.03), and lower SE was related to less MVPA (β=.15, p=.04). Shorter TST was associated with greater barriers to healthy eating (β=-.16, p=.05). Longer SOL was associated with higher BMI (β=.16, p=.05) and body fat % (β=.15, p=.03), and lower SE was related to higher body fat % (β=-.13, p=.06). Conclusions: Short sleep duration and sleep disturbance were highly prevalent in this sample of overweight adults. Significant associations were observed between sleep and measures of body habitus/composition and eating and physical activity habits. Efforts to improve sleep during a behavioral intervention for weight loss may reduce barriers to healthy eating and improve physical activity habits as well as weight loss outcomes.

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Using the Habit App for Weight Loss Problem Solving: Development and Feasibility Study (Preprint)

10.2196/preprints.9801 ◽

2018 ◽

Author(s):

Sherry Pagoto ◽

Bengisu Tulu ◽

Emmanuel Agu ◽

Molly E Waring ◽

Jessica L Oleski ◽

...

Keyword(s):

Weight Loss ◽

Problem Solving ◽

Mobile Apps ◽

Mobile App ◽

Behavioral Weight Loss ◽

Problem Solving Therapy ◽

Pilot Studies ◽

Self Monitoring ◽

Problem Solving Skills ◽

Automated Delivery

BACKGROUND Reviews of weight loss mobile apps have revealed they include very few evidence-based features, relying mostly on self-monitoring. Unfortunately, adherence to self-monitoring is often low, especially among patients with motivational challenges. One behavioral strategy that is leveraged in virtually every visit of behavioral weight loss interventions and is specifically used to deal with adherence and motivational issues is problem solving. Problem solving has been successfully implemented in depression mobile apps, but not yet in weight loss apps. OBJECTIVE This study describes the development and feasibility testing of the Habit app, which was designed to automate problem-solving therapy for weight loss. METHODS Two iterative single-arm pilot studies were conducted to evaluate the feasibility and acceptability of the Habit app. In each pilot study, adults who were overweight or obese were enrolled in an 8-week intervention that included the Habit app plus support via a private Facebook group. Feasibility outcomes included retention, app usage, usability, and acceptability. Changes in problem-solving skills and weight over 8 weeks are described, as well as app usage and weight change at 16 weeks. RESULTS Results from both pilots show acceptable use of the Habit app over 8 weeks with on average two to three uses per week, the recommended rate of use. Acceptability ratings were mixed such that 54% (13/24) and 73% (11/15) of participants found the diet solutions helpful and 71% (17/24) and 80% (12/15) found setting reminders for habits helpful in pilots 1 and 2, respectively. In both pilots, participants lost significant weight (P=.005 and P=.03, respectively). In neither pilot was an effect on problem-solving skills observed (P=.62 and P=.27, respectively). CONCLUSIONS Problem-solving therapy for weight loss is feasible to implement in a mobile app environment; however, automated delivery may not impact problem-solving skills as has been observed previously via human delivery. CLINICALTRIAL ClinicalTrials.gov NCT02192905; https://clinicaltrials.gov/ct2/show/NCT02192905 (Archived by WebCite at http://www.webcitation.org/6zPQmvOF2)

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