scholarly journals Assessing the Contribution of Self-Monitoring Through a Commercial Weight Loss App: Mediation and Predictive Modeling Study (Preprint)

2020 ◽  
Author(s):  
Gregory Farage ◽  
Courtney Simmons ◽  
Mehmet Kocak ◽  
Robert C Klesges ◽  
G Wayne Talcott ◽  
...  
Keyword(s):  
Weight Loss ◽  
Linear Regression ◽  
Controlled Trial ◽  
Caloric Intake ◽  
Secondary Analysis ◽  
Principal Component ◽  
Exercise Frequency ◽  
Self Monitoring ◽  
Substantial Impact ◽  
Predict Weight Loss

BACKGROUND Electronic self-monitoring technology has the potential to provide unique insights into important behaviors for inducing weight loss. OBJECTIVE The aim of this study is to investigate the effects of electronic self-monitoring behavior (using the commercial <i>Lose It!</i> app) and weight loss interventions (with differing amounts of counselor feedback and support) on 4- and 12-month weight loss. METHODS In this secondary analysis of the Fit Blue study, we compared the results of two interventions of a randomized controlled trial. Counselor-initiated participants received consistent support from the interventionists, and self-paced participants received assistance upon request. The participants (N=191), who were active duty military personnel, were encouraged to self-monitor their diet and exercise with the Lose It! app or website. We examined the associations between intervention assignment and self-monitoring behaviors. We conducted a mediation analysis of the intervention assignment for weight loss through multiple mediators—app use (calculated from the first principal component [PC] of electronically collected variables), number of weigh-ins, and 4-month weight change. We used linear regression to predict weight loss at 4 and 12 months, and the accuracy was measured using cross-validation. RESULTS On average, the counselor-initiated–treatment participants used the app more frequently than the self-paced–treatment participants. The first PC represented app use frequencies, the second represented calories recorded, and the third represented reported exercise frequency and exercise caloric expenditure. We found that 4-month weight loss was partially mediated through app use (ie, the first PC; 60.3%) and the number of weigh-ins (55.8%). However, the 12-month weight loss was almost fully mediated by 4-month weight loss (94.8%). Linear regression using app data from the first 8 weeks, the number of self–weigh-ins at 8 weeks, and baseline data explained approximately 30% of the variance in 4-month weight loss. App use frequency (first PC; <i>P</i>=.001), self-monitored caloric intake (second PC; <i>P</i>=.001), and the frequency of self-weighing at 8 weeks (<i>P</i>=.008) were important predictors of 4-month weight loss. Predictions for 12-month weight with the same variables produced an <i>R</i><sup>2</sup> value of 5%; only the number of self–weigh-ins was a significant predictor of 12-month weight loss. The <i>R</i><sup>2</sup> value using 4-month weight loss as a predictor was 31%. Self-reported exercise did not contribute to either model (4 months: <i>P</i>=.77; 12 months: <i>P</i>=.15). CONCLUSIONS We found that app use and daily reported caloric intake had a substantial impact on weight loss prediction at 4 months. Our analysis did not find evidence of an association between participant self-monitoring exercise information and weight loss. As 12-month weight loss was completely mediated by 4-month weight loss, intervention targets should focus on promoting early and frequent dietary intake self-monitoring and self-weighing to promote early weight loss, which leads to long-term success. CLINICALTRIAL ClinicalTrials.gov NCT02063178; https://clinicaltrials.gov/ct2/show/NCT02063178

scholarly journals Assessing the Contribution of Self-Monitoring Through a Commercial Weight Loss App: Mediation and Predictive Modeling Study

10.2196/18741 ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. e18741
Author(s):  
Gregory Farage ◽  
Courtney Simmons ◽  
Mehmet Kocak ◽  
Robert C Klesges ◽  
G Wayne Talcott ◽  
...  
Keyword(s):  
Weight Loss ◽  
Linear Regression ◽  
Controlled Trial ◽  
Caloric Intake ◽  
Secondary Analysis ◽  
Principal Component ◽  
Exercise Frequency ◽  
Self Monitoring ◽  
Substantial Impact ◽  
Predict Weight Loss

Background Electronic self-monitoring technology has the potential to provide unique insights into important behaviors for inducing weight loss. Objective The aim of this study is to investigate the effects of electronic self-monitoring behavior (using the commercial Lose It! app) and weight loss interventions (with differing amounts of counselor feedback and support) on 4- and 12-month weight loss. Methods In this secondary analysis of the Fit Blue study, we compared the results of two interventions of a randomized controlled trial. Counselor-initiated participants received consistent support from the interventionists, and self-paced participants received assistance upon request. The participants (N=191), who were active duty military personnel, were encouraged to self-monitor their diet and exercise with the Lose It! app or website. We examined the associations between intervention assignment and self-monitoring behaviors. We conducted a mediation analysis of the intervention assignment for weight loss through multiple mediators—app use (calculated from the first principal component [PC] of electronically collected variables), number of weigh-ins, and 4-month weight change. We used linear regression to predict weight loss at 4 and 12 months, and the accuracy was measured using cross-validation. Results On average, the counselor-initiated–treatment participants used the app more frequently than the self-paced–treatment participants. The first PC represented app use frequencies, the second represented calories recorded, and the third represented reported exercise frequency and exercise caloric expenditure. We found that 4-month weight loss was partially mediated through app use (ie, the first PC; 60.3%) and the number of weigh-ins (55.8%). However, the 12-month weight loss was almost fully mediated by 4-month weight loss (94.8%). Linear regression using app data from the first 8 weeks, the number of self–weigh-ins at 8 weeks, and baseline data explained approximately 30% of the variance in 4-month weight loss. App use frequency (first PC; P=.001), self-monitored caloric intake (second PC; P=.001), and the frequency of self-weighing at 8 weeks (P=.008) were important predictors of 4-month weight loss. Predictions for 12-month weight with the same variables produced an R2 value of 5%; only the number of self–weigh-ins was a significant predictor of 12-month weight loss. The R2 value using 4-month weight loss as a predictor was 31%. Self-reported exercise did not contribute to either model (4 months: P=.77; 12 months: P=.15). Conclusions We found that app use and daily reported caloric intake had a substantial impact on weight loss prediction at 4 months. Our analysis did not find evidence of an association between participant self-monitoring exercise information and weight loss. As 12-month weight loss was completely mediated by 4-month weight loss, intervention targets should focus on promoting early and frequent dietary intake self-monitoring and self-weighing to promote early weight loss, which leads to long-term success. Trial Registration ClinicalTrials.gov NCT02063178; https://clinicaltrials.gov/ct2/show/NCT02063178

High and Low Responders in a Comprehensive Lifestyle Program for Weight Loss - Secondary Analysis of a Randomized Controlled Trial

2017 ◽  
Vol 24 (4) ◽  
pp. 232-239 ◽  
Author(s):  
Dieter Melchart ◽  
Erich Wühr ◽  
Wolfgang Weidenhammer
Keyword(s):  
Weight Loss ◽  
Randomized Controlled Trial ◽  
Weight Reduction ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Overweight And Obesity ◽  
High Response ◽  
Self Monitoring ◽  
Randomized Controlled ◽  
Lifestyle Program

Background/Objectives: Unhealthy lifestyle is often related to overweight and obesity and thus to chronic diseases. Web-based programs might be an option for a comprehensive approach to improving long-term weight management. Data from a randomized controlled trial (RCT) evaluating the impact of a lifestyle program on weight reduction were used for a secondary analysis. The objectives were (a) to identify potential predictors for marked weight loss, (b) to explore associations of weight reduction with changes in health-related variables, and (c) to evaluate whether self-monitoring of the daily lifestyle is associated with weight loss. Methods: 67 subjects with a body mass index of 28-35 who underwent the 1-year ‘Individual Health Management' (IHM) program were included in the analysis (mean age 49.8 years, 79% female). Two subgroups (high response: ≥7.5% weight reduction vs. low response: <7.5%) were compared in terms of sociodemographic data, baseline values, and pre-post changes of various risk and protective factors. A logistic regression was performed to identify potential predictors of weight loss. Results: 70% of the subjects fulfilled the criterion of high response. There were no statistically significant differences between the two subgroups with respect to sociodemographic and baseline data. Regression analysis failed to identify any predictors for the amount of weight reduction. Subjects with high response showed a more distinct improvement in life satisfaction and neurovegetative stability. The findings indicated an association between the level of self-monitoring and weight loss. Conclusions: More research is needed to establish optimal strategies for maximizing the longer-term maintenance of weight loss and prevention effects. For weight reduction, support strategies like feedback learning through self-monitoring, reporting systems, and self-performance measurement with questionnaires might ameliorate high-intensity lifestyle modification programs.

scholarly journals Examination of Nutrition Literacy and Quality of Self-monitoring in Behavioral Weight Loss

2018 ◽  
Vol 52 (9) ◽  
pp. 809-816 ◽  
Author(s):  
Diane L Rosenbaum ◽  
Margaret H Clark ◽  
Alexandra D Convertino ◽  
Christine C Call ◽  
Evan M Forman ◽  
...  
Keyword(s):  
Weight Loss ◽  
Caloric Intake ◽  
Secondary Analysis ◽  
Behavioral Weight Loss ◽  
Food Record ◽  
Obese Adults ◽  
Baseline Measure ◽  
Self Monitoring ◽  
Session Attendance

Abstract Background Few have examined nutrition literacy (i.e., capacity to process and make informed nutritional decisions) in behavioral weight loss. Nutrition literacy (NL) may impact necessary skills for weight loss, contributing to outcome disparities. Purpose The study sets out to identify correlates of NL; evaluate whether NL predicted weight loss, food record completion and quality, and session attendance; and investigate whether the relations of race and education to weight loss were mediated by NL and self-monitoring. Methods This is a secondary analysis of 6-month behavioral weight loss program in which overweight/obese adults (N = 320) completed a baseline measure of NL (i.e., Newest Vital Sign). Participants self-monitored caloric intake via food records. Results NL was lower for black participants (p < .001) and participants with less education (p = .002). Better NL predicted better 6-month weight loss (b = −.63, p = .04) and food record quality (r = .37, p < .001), but not food record completion or attendance (ps > 0.05). Black participants had lower NL, which was associated with poorer food record quality, which adversely affected weight loss. There was no indirect effect of education on weight loss through NL and food record quality. Conclusions Overall, results suggest that lower NL is problematic for weight loss. For black participants, NL may indirectly impact weight loss through quality of self-monitoring. This might be one explanation for poorer behavioral weight loss outcomes among black participants. Additional research should investigate whether addressing these skills through enhanced treatment improves outcomes. Clinical trial information NCT02363010.

scholarly journals Relationship Between Weekly Patterns of Caloric Intake and Reported Weight Loss Outcomes: Retrospective Cohort Study (Preprint)

2017 ◽  
Author(s):  
Christine Hill ◽  
Brian W Weir ◽  
Laura W Fuentes ◽  
Alicia Garcia-Alvarez ◽  
Danya P Anouti ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Linear Regression ◽  
Mobile Phone ◽  
Body Mass ◽  
Caloric Intake ◽  
Body Mass Index Category ◽  
Obese Adults ◽  
Weight Loss Outcomes ◽  
The Relationship

BACKGROUND Although millions of overweight and obese adults use mobile phone apps for weight loss, little is known about the predictors of success. OBJECTIVE The objective of this study was to understand the relationship between weight loss outcomes and weekly patterns of caloric intake among overweight and obese adults using a mobile phone app for weight loss. METHODS We examined the relationship between weekly patterns of caloric intake and weight loss outcomes among adults who began using a weight loss app in January 2016 and continued consistent use for at least 5 months (N=7007). Unadjusted and adjusted linear regression analyses were used to evaluate the predictors of percentage of bodyweight lost for women and men separately, including age, body mass index category, weight loss plan, and difference in daily calories consumed on weekend days (Saturday and Sunday) versus Monday. RESULTS In adjusted linear regression, percentage of bodyweight lost was significantly associated with age (for women), body mass index (for men), weight loss plan, and differences in daily caloric intake on Mondays versus weekend days. Compared with women consuming at least 500 calories more on weekend days than on Mondays, those who consumed 50 to 250 calories more on weekend days or those with balanced consumption (±50 calories) lost 1.64% more and 1.82% more bodyweight, respectively. Women consuming 250 to 500 calories or more than 500 calories more on Mondays than on weekend days lost 1.35% more and 3.58% more bodyweight, respectively. Compared with men consuming at least 500 calories more on weekend days than on Mondays, those consuming 250 to 500 calories or more than 500 calories more on Mondays than on weekend days lost 2.27% and 3.42% less bodyweight, respectively. CONCLUSIONS Consistent caloric intake on weekend days and Mondays or consuming slightly fewer calories per day on Mondays versus weekend days was associated with more successful weight loss. CLINICALTRIAL ClinicalTrials.gov NCT03136692; https://clinicaltrials.gov/ct2/show/NCT03136692 (Archived by WebCite at http://www.webcitation.org/6y9JvHya4)

Association of Caloric Intake, Protein Intake, and Enteral Feeding Initiation with Weight Gain in Infants Born 32 to 34 Weeks' Gestation

2019 ◽  
Vol 37 (12) ◽  
pp. 1228-1233
Author(s):  
Meryem Khadija Talbo ◽  
Marie-Eve Besner ◽  
Hugues Plourde ◽  
Martine Claveau ◽  
Marc Beltempo
Keyword(s):  
Intensive Care Unit ◽  
Weight Loss ◽  
Linear Regression ◽  
Protein Intake ◽  
Retrospective Cohort ◽  
Neonatal Intensive Care ◽  
Caloric Intake ◽  
Patient Characteristics ◽  
Initiation Time ◽  
Included Patient

Abstract Objective This study aimed to determine the association of caloric intake, protein intake, and enteral feed initiation time in the first 3 days of life with weight loss percentage (%WL) at 7 days among infants born 32 to 34 weeks' gestational age (GA). Study Design This is a retrospective cohort study of 252 infants admitted to a neonatal intensive care unit. Patient data included patient characteristics, daily weight, intake, and method of nutrition in the first 3 days. Multivariate linear regression was used to explore associations between outcome (%WL at day 7 of life) and exposures (caloric intake, protein intake, and enteral feed initiation time) and adjusted for covariates (GA, birth weight, and sex). Results Median 7 days %WL was 2.3% (interquartile range: −5.2, 1.2). Average caloric intake and average protein intake in the first 3 days were 57 kcal/kg/d and 2.3 g/kg/d. In the adjusted linear regression, caloric intake and protein intake (coefficient = 0.03, 95% confidence interval [CI]: −0.06, 0.09 and coefficient = 0.11, 95% CI: −0.36, 2.30) were not associated with %WL at 7 days. Enteral feeds ≤12 hours were associated with less %WL at 7 days of life (Coef = −0.15, 95% CI: −2.67, −0.17). Conclusion Enteral feeds ≤12 hours after delivery is associated with lower %WL at 7 days among preterm infants 32 to 34 weeks' GA.

scholarly journals A Pilot Randomized Controlled Trial of a Telenutrition Weight Loss Intervention in Middle-Aged and Older Men with Multiple Risk Factors for Cardiovascular Disease

Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 229 ◽  
Author(s):  
Melissa Ventura Marra ◽  
Christa Lilly ◽  
Kelly Nelson ◽  
Dominick Woofter ◽  
James Malone
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Controlled Trial ◽  
A Priori ◽  
Intervention Group ◽  
Caloric Intake ◽  
Overweight And Obesity ◽  
Retention Rates ◽  
Weight Loss Intervention ◽  
Dietary Counseling

Overweight and obesity threaten the health, functionality and quality of life of 77.2% men in West Virginia. The purpose of this study was to evaluate the feasibility and effectiveness of a 12-week primary care referred telenutrition weight loss intervention. Fifty-nine 40–70-year-old men with obesity were randomized to either the intervention group (n = 29) or an enhanced usual care (EUC) (n = 30) group. Participants from both groups were prescribed a moderate energy restricted diet (500–750 kcal/day below energy requirements) and provided diet-related educational materials; but, only those in the intervention group received weekly support from a registered dietitian nutritionist via telephone and videoconferencing. Both groups significantly reduced body weight, waist circumference, percent body fat and caloric intake and improved diet quality from baseline (p < 0.0001). Groups did not differ after controlling for time (all p > 0.30) and none of the group by time interactions were statistically significant. At week 12, a greater proportion of participants from the intervention group than the EUC group lost at least 5% of their baseline weight, (70.4% vs. 41.4%, p = 0.035). Retention rates and participant-reported adherence and satisfaction rates were ≥80% in the telenutrition group, thereby meeting the a priori criterion for feasibility of a larger trial. Primary care referred telenutrition interventions have the potential to improve access to dietary counseling for obesity treatment in health disparate populations. A larger longer-term trial is warranted.

scholarly journals Process Evaluation of the Type 2 Diabetes Mellitus PULSE Program Randomized Controlled Trial: Recruitment, Engagement, and Overall Satisfaction

2017 ◽  
Vol 11 (4) ◽  
pp. 1055-1068 ◽  
Author(s):  
Elroy J. Aguiar ◽  
Philip J. Morgan ◽  
Clare E. Collins ◽  
Ronald C. Plotnikoff ◽  
Myles D. Young ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Type 2 Diabetes Mellitus ◽  
High Risk ◽  
Process Evaluation ◽  
Controlled Trial ◽  
Screening Process ◽  
Self Monitoring

Background: Men are underrepresented in weight loss and type 2 diabetes mellitus (T2DM) prevention studies. Purpose: To determine the effectiveness of recruitment, and acceptability of the T2DM Prevention Using LifeStyle Education (PULSE) Program—a gender-targeted, self-administered intervention for men. Methods: Men (18–65 years, high risk for T2DM) were randomized to intervention ( n = 53) or wait-list control groups ( n = 48). The 6-month PULSE Program intervention focused on weight loss, diet, and exercise for T2DM prevention. A process evaluation questionnaire was administered at 6 months to examine recruitment and selection processes, and acceptability of the intervention’s delivery and content. Associations between self-monitoring and selected outcomes were assessed using Spearman’s rank correlation. Results: A pragmatic recruitment and online screening process was effective in identifying men at high risk of T2DM (prediabetes prevalence 70%). Men reported the trial was appealing because it targeted weight loss, T2DM prevention, and getting fit, and because it was perceived as “doable” and tailored for men. The intervention was considered acceptable, with men reporting high overall satisfaction (83%) and engagement with the various components. Adherence to self-monitoring was poor, with only 13% meeting requisite criteria. However, significant associations were observed between weekly self-monitoring of weight and change in weight ( rs = −.47, p = .004) and waist circumference ( rs = −.38, p = .026). Men reported they would have preferred more intervention contact, for example, by phone or email. Conclusions: Gender-targeted, self-administered lifestyle interventions are feasible, appealing, and satisfying for men. Future studies should explore the effects of additional non-face-to-face contact on motivation, accountability, self-monitoring adherence, and program efficacy.

scholarly journals Eating self-efficacy changes in individuals with type 2 diabetes following a structured lifestyle intervention based on the transcultural Diabetes Nutrition Algorithm (tDNA): A secondary analysis of a randomized controlled trial

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242487
Author(s):  
Harvinder Kaur Gilcharan Singh ◽  
Winnie Siew Swee Chee ◽  
Osama Hamdy ◽  
Jeffrey Ian Mechanick ◽  
Verna Kar Mun Lee ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Weight Loss ◽  
Motivational Interviewing ◽  
Lifestyle Intervention ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Registration Number

Objective Eating self-efficacy behavior is an important predictor of successful lifestyle intervention. This secondary analysis evaluated the changes in eating self-efficacy behavior in patients with type 2 diabetes (T2D) and overweight/obesity following structured lifestyle intervention based on the Malaysian customized transcultural Diabetes Nutrition Algorithm (tDNA). Methods Patients with T2D and overweight/obesity (n = 230) were randomized either into the tDNA group which included a structured low-calorie meal plan using normal foods, incorporation of diabetes-specific meal replacements, and an exercise prescription or usual T2D care (UC) for 6 months. Patients in the tDNA group also received either counseling with motivational interviewing (tDNA-MI) or conventional counseling (tDNA-CC). The UC group received standard dietary and exercise advice using conventional counseling. Eating self-efficacy was assessed using a locally validated Weight Efficacy Lifestyle (WEL) questionnaire. All patients were followed up for additional 6 months’ post-intervention. Results There was a significant change in WEL scores with intervention over one-year [Group X Time effect: F = 51.4, df = (3.4, 318.7), p<0.001]. Compared to baseline, WEL scores improved in both the tDNA groups with significantly higher improvement in the tDNA-MI group compared to the tDNA-CC and UC groups at 6 months (tDNA-MI: 25.4±2.1 vs. tDNA-CC: 12.9±2.8 vs. UC: -6.9±1.9, p<0.001). At 12 months’ follow-up, both the tDNA groups maintained improvement in the WEL scores, with significantly higher scores in the tDNA-MI group than tDNA-CC group, and the UC group had decreased WEL scores (tDNA-MI: 28.9±3.1 vs. tDNA-CC: 11.6±3.6 vs. UC: -13.2±2.1, p<0.001). Patients in the tDNA-MI group with greater weight loss and hemoglobin A1C reduction also had a higher eating self-efficacy, with a similar trend observed in comparative groups. Conclusion Eating self-efficacy improved in patients with T2D and overweight/obesity who maintained their weight loss and glycemic control following a structured lifestyle intervention based on the Malaysian customized tDNA and the improvement was further enhanced with motivational interviewing. Clinical trial This randomized clinical trial was registered under National Medical Research Registry, Ministry of Health Malaysia with registration number: NMRR-14-1042-19455 and also under ClinicalTrials.gov with registration number: NCT03881540.

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