Engagement in New Dietary Habits—Obese Women’s Experiences from Participating in a 2-Year Diet Intervention

How Do Emotions during Goal Pursuit in Weight Change over Time? Retrospective Computational Text Analysis of Goal Setting and Striving Conversations with a Coach during a Mobile Weight Loss Program

During behavioral weight management, individuals reflect on their progress and barriers through goal pursuit (goal setting and goal striving). Emotions during goal pursuit are largely unknown, and previous investigations of emotions in weight management have primarily relied on self-report. In this retrospective study, we used a well-validated computational text analysis approach to explore how emotion words changed over time during goal setting and striving conversations with a coach in a mobile weight loss program. Linear mixed models examined changes in emotion words each month from baseline to program end and compared emotion words between individuals who set an overall concrete goal for the program (concrete goal setters) and those who set an overall abstract goal (abstract goal setters). Contrary to findings using self-report, positive emotion words were stable and negative emotion words significantly increased over time. There was a marginal trend towards greater negative emotion word use being associated with greater weight loss. Concrete goal setters used more positive words than abstract goal setters, with no differences in negative emotion words and weight loss. Implications include the possibility that individuals may need increasing support over time for negative emotions expressed during goal setting and striving, and concrete goals could boost positive emotion. Future research should investigate these possibilities.

Behaviour change during dietary Type 2 diabetes remission: a longitudinal qualitative evaluation of an intervention using a very low energy diet

AIM

To understand the process of behaviour change through the experiences of people with Type 2 diabetes engaged in an 8-month diabetes remission intervention including a 2-month weight loss phase with the use of a very low energy diet (VLED), and a 6-month, structured weight maintenance phase.

METHODS

Data were collected in three semi-structured interviews at baseline, week 8 (end of the weight loss phase), and month 8 (end of the weight maintenance phase). Longitudinal inductive thematic analysis was used to analyse participants' narratives and identify change over time.

RESULTS

Eleven of 18 participants completed all three interviews. The following themes of change were identified in their narratives: (1) 'Building behavioural autonomy' as a process of growing confidence to engage in health behaviours that are independent of those of other people; (2) 'Behavioural contagion' describing how one's new health behaviours tend to affect those of other people; (3) 'From rigid to flexible restraint', reflecting the changes in attitudes and behaviours required for a successful adaptation from weight loss to weight maintenance; and (4) 'Shift in identity', representing changes in the participants' perceptions of themselves.

CONCLUSIONS

This longitudinal qualitative study provided new insights into how behaviour change is experienced by people with Type 2 diabetes engaged on a weight management intervention using VLED, contributing to theoretical and practical understanding of weight management behaviours. The themes identify potential areas in which individuals can be supported in achieving dietary diabetes remission and long-term maintenance of weight loss.

Association of Food Access, Recreational Opportunities, and Natural Amenities with Engagement in the Veterans MOVE! Weight Management Program

OBJECTIVE

The aim of this study was to examine the association of county-level food access, recreational opportunities, and natural amenities with participant engagement in a weight management program.

METHODS

In this cohort study, participants in the Veterans Health Administration MOVE! weight management program between October 1, 2007, and September 30, 2013, were observed for 12 months after enrollment. Engagement was measured as the number of program visits per year at 12 months. Cross-sectional analysis and spatial regression were used to examine county characteristics associated with greater participant engagement at 12 months.

RESULTS

A total of 321,624 participants in 2,708 counties were included. Greater engagement was associated with older age, female sex, white race, being married, and being retired. After accounting for similarities between nearby communities, engagement at 12 months was 3.1 visits higher for each additional farmers' market per 1,000 population (P = 0.01). Engagement was highest for participants living in counties with the most natural amenities (P < 0.001). Recreational opportunities had only a small effect on engagement in the program (β = 0.02 visits at 12 months; P = 0.002).

CONCLUSIONS

Consideration of a participant's county characteristics in addition to other known demographics and program factors may help to explain variation in engagement in weight management programs.

Influence of Paleolithic diet on anthropometric markers in chronic diseases: systematic review and meta-analysis

BACKGROUND

The Paleolithic diet has been studied in the scope of prevention and control of chronic noncommunicable diseases (CNCD). The objective of this study was to analyze the influence of the Paleolithic diet on the prevention and control of CNCD in humans, specifically on anthropometric markers, through a systematic review with meta-analysis.

METHODS

What is the effect of the Paleolithic diet on anthropometric parameters (weight, body mass index and waist circumference) compared to other control diets based on recommendations in adults? We included only randomized studies with humans that used the Paleolithic Diet in the prevention and control of CNCD published in Portuguese, English or Spanish. The search period was until March 2019, in the LILACS, PubMed, Scielo, Science Direct, Medline, Web of Science and Scopus databases. The abstracts were evaluated by two researchers. We found 1224 articles, of which 24 were selected and 11 were included in the meta-analysis. The effect of dietary use on body weight, body mass index and waist circumference was evaluated.

RESULTS

The summary of the effect showed a loss of - 3.52 kg in the mean weight (CI 95%: - 5.26; - 1.79; p < 0,001; I² = 24%) of people who adopted the Paleolithic diet compared to diets based on recommendations. The analysis showed a positive association of adopting the Paleolithic diet in relation to weight loss. The effect was significant on weight, body mass index and waist circumference.

CONCLUSION

The Paleolithic diet may assist in controlling weight and waist circumference and in the management of chronic diseases. However, more randomized clinical studies with larger populations and duration are necessary to prove health benefits.

TRIAL REGISTRATION

CRD42015027849 .

Dairy-Related Dietary Patterns, Dietary Calcium, Body Weight and Composition: A Study of Obesity in Polish Mothers and Daughters, the MODAF Project

The role of the family environment in regards to dairy products and dietary calcium in the context of obesity is not fully understood. The aim of the study was to investigate the association among dairy-related dietary patterns (DDPs), dietary calcium, body weight and composition in mothers and daughters. Data were collected through a cross-sectional survey within the MODAF Project. A total sample of 712 pairs of mothers (<60 years) and daughters (12-21 years) was studied. This study included 691 pairs. A semi-quantitative food frequency questionnaire (ADOS-Ca) was used to collect dietary data. Waist circumference (WC), body fat, waist-to-height ratio (WHtR) and body mass index (BMI) were determined. Previously derived DDPs were used-three in mothers and three in daughters. In mothers, two of the DDPs were characterized by higher consumption of various dairy products with suboptimal calcium content (means: 703 or 796 mg/day) which decreased the chance of: z-WC > 1 standard deviation (SD), WC > 80 cm, body fat > 32%, WHtR > 0.5, BMI = 25-29.9 kg/m² or BMI ≥ 30 kg/m² by 44-67% when compared to low-dairy low-calcium DDP (288 mg/day). In mothers per 100 mg/day of dietary calcium, the chance of z-WC > 1SD, WC > 80 cm, z-WHtR > 1SD, WHtR > 0.5 cm, BMI = 25 to 29.9 kg/m² or BMI ≥ 30 kg/m² decreased by 5-9%. In correspondence analysis, a clear association was found between mothers' and daughters' low-dairy low-calcium DDPs and upper categories of z-WC (>1 SDs). This study reinforces evidence of the similarity between mothers and daughters in dairy-related dietary patterns and provides a new insight on the adverse relation between low-dairy low-calcium dietary patterns and obesity. It was found that diets containing various dairy products with suboptimal dietary calcium content may be recommended in obesity prevention.

Weight Gain Prevention among Midlife Women: A Randomized Controlled Trial to Address Needs Related to the Physical and Social Environment

Women tend to gain weight at midlife (40–60 years) increasing risk of obesity-related chronic diseases. Within specific eating occasions, needs related to the physical and social environment may result in less healthy eating behavior, which can lead to weight gain over time. The purpose of this study was to determine if a dietitian-delivered nutrition counseling intervention tailored to eating occasion needs could improve diet and prevent weight gain among midlife women over two years. A randomized controlled trial was conducted with healthy midlife women (n = 354) in one U.S. metropolitan area. The intervention group (n = 185) received ten hours of individual nutrition counseling from dietitians over six months, while women in a control group (n = 169) received no counseling. Measured height, weight and waist circumference, and dietary intakes were collected at baseline and every six months over two years. Mixed linear models were used to test for intervention effect on change in outcome variables over time. Dietary intakes of fruit, reduced/low-fat dairy foods and refined grains were significantly improved over time in the intervention compared to control group. However, the intervention had no effect on weight over time (p = 0.48). Nutrition counseling tailored to address eating occasion needs improved self-reported diet but did not significantly affect weight change.

Patient perceptions of weight loss: Implications for patients, providers, and trainees

OBJECTIVES

The prevalence of overweight and obese individuals in the United States is growing, and primary health care represents a setting in which providers may address weight with their patients. However, many providers and medical trainees feel ill-prepared to address the full scope of complexities associated with weight loss. This study sought to investigate patients' perceptions of the barriers and facilitators they encountered in their weight loss journeys. The results of the mixed-methods study will be used to inform a better understanding among providers and medical students of how to address weight loss with their patients. This study was approved by the institutional review board of Medical College of Wisconsin.

METHODS

Participants were selected from patient panels at a Family Medicine Residency Program. Participants who enrolled in the study completed a survey that collected attitudes and behaviors about weight loss and demographics. The patients also participated in a 60- to 90-min guided interview. Interviews were transcribed verbatim and analyzed using open-coding techniques and principles of grounded theory.

RESULTS

To date, five participants completed the study. All were female with a mean age of 52 years. Two primary themes emerged from a grounded theory model. The first theme centered on individual's knowledge, attitudes, and behaviors to lost weight. The second theme emphasized that societal relationships serve as both a barrier and a facilitator to weight loss.

CONCLUSION

The overarching conclusion of this study is that individuals often have the knowledge to make positive health behaviors changes, but multiple factors may prohibit this from occurring. When a supportive environment exists, healthy behavior changes are more attainable. Physicians, mid-level providers, and medical trainees and even medical systems can provide appropriate support to join the patient on their weight loss journey.