Evaluation of meal replacements and a home food environment intervention for long-term weight loss: a randomized controlled trial.

Tytuł:: Evaluation of meal replacements and a home food environment intervention for long-term weight loss: a randomized controlled trial.
Autorzy:: Lowe MR; Department of Psychology, Drexel University, Philadelphia, PA.
Butryn ML; Department of Psychology, Drexel University, Philadelphia, PA.
Zhang F; Department of Psychology, Drexel University, Philadelphia, PA.
Źródło:: The American journal of clinical nutrition [Am J Clin Nutr] 2018 Jan 01; Vol. 107 (1), pp. 12-19.
Typ publikacji:: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural
Język:: English
Imprint Name(s):: Publication: 2023- : [New York, NY] : Elsevier
Original Publication: Bethesda, MD : American Society of Clinical Nutrition
MeSH Terms:: Meals*
Weight Loss*
Obesity/*therapy
Overweight/*therapy
Adolescent ; Adult ; Aged ; Body Mass Index ; Diet ; Exercise ; Female ; Follow-Up Studies ; Health Behavior ; Humans ; Life Style ; Male ; Middle Aged ; Surveys and Questionnaires ; Treatment Outcome ; Young Adult
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Grant Information:: R01 DK080909 United States DK NIDDK NIH HHS
Contributed Indexing:: Keywords: behavior therapy; diet; home food environment; meal replacements; nutritional intervention; nutritional treatment; obesity; treatment; weight loss
Molecular Sequence:: ClinicalTrials.gov NCT01065974
Entry Date(s):: Date Created: 20180131 Date Completed: 20190520 Latest Revision: 20240318
Update Code:: 20240318
PubMed Central ID:: PMC5972600
DOI:: 10.1093/ajcn/nqx005
PMID:: 29381791
: Czasopismo naukowe

Background: Lifestyle change treatments for weight loss produce medically meaningful weight reductions, but lost weight is usually regained. Meal replacements (MRs) represent one avenue for improving long-term weight loss. Another, nutrition-focused approach involves having participants make specific changes in the energy density, composition, and structure of the foods in their personal food environments.
Objective: Three conditions were compared: behavior therapy (BT), BT plus MRs (BT+MR), and a nutrition-focused treatment aimed at modifying the home food environment (HFE).
Design: Overweight and obese individuals (n = 262) were randomly assigned to 1 of the 3 conditions. Treatment occurred in weekly groups for 6 mo and in biweekly groups for 6 mo. Assessments were conducted at baseline and at 6, 12, 18, 24, and 36 mo. Multilevel models were used to estimate weight-change trajectories for each participant and to examine the treatment group effect on long-term weight loss.
Results: A multilevel analysis indicated that all 3 groups showed significant weight loss over 12 mo that was gradually regained to the 36-mo follow-up. Mean ± SD percentages of baseline weight loss at 12 mo for BT, BT+MR, and HFE were 9.41% ± 7.92%, 10.37% ± 7.77%, and 10.97% ± 7.79%, respectively. Comparable percentages at 36 mo were 4.21% ± 8.64%, 3.06% ± 6.93%, and 4.49% ± 7.83%. Those in the HFE condition lost more weight than those receiving BT through the 36-mo assessment (P < 0.01), as reflected in 2 treatment × time interactions. Further analyses showed that HFE produced the largest increases in cognitive restraint and that this increase largely mediated the HFE group's improved weight loss.
Conclusion: The nutrition-focused intervention studied here produced modestly greater long-term weight loss than BT, an effect that was largely explainable by an unexpected boost in cognitive restraint in this condition. This study was registered at clinicaltrials.gov as NCT01065974.
(© 2018 American Society for Nutrition. All rights reserved.)

Comment in: Am J Clin Nutr. 2018 Jul 1;108(1):201-203. (PMID: 29982309)

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