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A smartphone based attentive eating intervention for energy intake and weight loss: results from a randomised controlled trial.

ABSTRACT: BACKGROUND:Laboratory studies suggest that eating more 'attentively' (e.g. attending to food being eaten and recalling eating episodes) can reduce food intake among participants with both healthy weight and overweight. The aim of this trial was to assess whether a smartphone application that encourages a more attentive eating style reduces energy intake and promotes weight loss. METHODS:In an open-label, single centre, parallel groups, individually randomised controlled trial, 107 adults with overweight/obesity in Merseyside, UK used an attentive eating smartphone application along with standard dietary advice (intervention group) or standard dietary advice only (control group) for 8?weeks. The primary outcomes were change in body weight at 8?weeks and energy intake at 4 and 8?weeks. Additional outcomes included self-reported eating behaviours measured at 8?weeks. Differences between groups were assessed with linear regression (adjusted) using multiple imputation for missing data. Study protocol registered prospectively at ( https://doi.org/10.17605/osf.io/btzhw ). RESULTS:There was no significant difference between the intervention and control group in weight lost at 8?weeks, or change in self-reported 24?h or objective taste-test energy intake at 4 or 8?weeks. Mean weight loss in the intervention group (n?=?53) was 1.2?kg and 1.1?kg in the control group (n?=?54), adjusted difference of -?0.10 (-?1.6 to 1.3) kg. Self-reported eating behaviours at 8?weeks also did not differ across groups. The intervention was largely used as intended and a per protocol analysis confined to participants in the intervention group that used the attentive eating smartphone application regularly and as intended also showed no effect on energy intake or weight loss. CONCLUSIONS:A smartphone based attentive eating intervention and standard dietary advice did not result in reduced energy intake or greater weight loss at 4 or 8?week follow-up than standard dietary advice alone. TRIAL REGISTRATION:ClinicalTrials.gov, NCT03602001 . Registered retrospectively on 26th July 2018. Prospectively registered on the Open Science Framework on 11th August 2017.

SUBMITTER: Whitelock V

PROVIDER: S-EPMC6528285 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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A smartphone based attentive eating intervention for energy intake and weight loss: results from a randomised controlled trial.

Whitelock Victoria V Kersbergen Inge I Higgs Suzanne S Aveyard Paul P Halford Jason C G JCG Robinson Eric E

BMC public health 20190521 1

<h4>Background</h4>Laboratory studies suggest that eating more 'attentively' (e.g. attending to food being eaten and recalling eating episodes) can reduce food intake among participants with both healthy weight and overweight. The aim of this trial was to assess whether a smartphone application that encourages a more attentive eating style reduces energy intake and promotes weight loss.<h4>Methods</h4>In an open-label, single centre, parallel groups, individually randomised controlled trial, 107 ...[more]

PMID: 31113400

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Project description:BackgroundShort-term laboratory studies suggest that eating attentively can reduce food intake. However, in a recent randomized controlled trial we found no evidence that using an attentive eating smartphone app outside of the laboratory had an effect on energy intake or weight loss over 8 weeks.ObjectiveThis research examined trial participants' experiences of using an attentive eating smartphone app and whether app usage was associated with energy intake and weight loss outcomes over 8 weeks.MethodsWe conducted thematic analysis of semistructured interviews (N=38) among participants in the attentive eating smartphone app group of the trial who completed the 8-week assessment. Linear regression models examined the associations between energy intake and weight loss outcomes at 8 weeks and app usage.ResultsParticipants reported several barriers and facilitators to using the smartphone app, including repetition of app content, social setting, motivation, and habitual use of the app. Participants believed that using the app had some beneficial effects on their eating behavior and diet. Exploratory analyses indicated that more frequent recording of eating episodes in the app was associated with lower body weight (B=-0.02, P=.004) and greater self-reported energy intake (B=5.98, P=.01) at 8 weeks, but not body fat percentage or taste-test energy intake. Total audio clip plays, gallery views, and percentage of food entries recorded using an image were not significantly associated with energy intake or weight.ConclusionsFrequent recording of eating episodes in a smartphone app was associated with greater weight loss. There are barriers and facilitators to frequent use of an attentive eating smartphone app that may be useful to address when designing dietary behavior change smartphone apps.Trial registrationClinicalTrials.gov NCT03602001; https://clinicaltrials.gov/ct2/show/NCT03602001; Open Science Framework DOI 10.17605/osf.io/btzhw; https://osf.io/btzhw/.

Project description:IntroductionAdolescent eating patterns are characterised by high consumption of unhealthy foods, which has resulted in an increasing prevalence of overweight and chronic diseases. It is crucial to promote healthy eating habits, and nutritional interventions based on the transtheoretical model have been found to be especially effective. Mobile health strategies also seem promising for adolescents. This study aims to outline a smartphone intervention via WhatsApp for adolescents to promote healthy eating consumption, better nutritional knowledge, self-efficacy in the adoption of healthy practices and progress through the stages of change.Methods and analysisThere will be three distinct groups in this randomised study: a general intervention group (GG), in which the participants will receive the same healthy eating messages, based on the Brazilian food guide; a tailored intervention group (TG), in which the participants will receive healthy eating messages based on their stage of change; and a control group (CG), in which participants will receive messages on a different theme. Possession of a smartphone, use of WhatsApp and being a senior student (16-19 years) from a public school of the Federal District of Brazil will be the study's inclusion criteria. Rural schools will be excluded. The sample size estimated is 390 individuals: 38 in the GG, 314 in the TG and 38 in the CG. The intervention will last 6 weeks, with a daily message sent to the students. We will investigate nutritional knowledge, self-efficacy in the adoption of healthy eating practices, food consumption and stages of change using preintervention and postintervention questionnaires. Memorisation of the messages will be also assessed.Ethics and disseminationThe study was approved by the University of Brasília, School of Health Sciences and Research Ethics Committee. At the end of the study, the participating schools will receive a printed report with the main results of the intervention.Trial registration numberRBR-5b9jk7.

Dataset Information

A smartphone based attentive eating intervention for energy intake and weight loss: results from a randomised controlled trial.

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A smartphone based attentive eating intervention for energy intake and weight loss: results from a randomised controlled trial.

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