Northern California Institute for Research and Education, San Francisco, CA, USA.
J Acad Nutr Diet. 2013 Jul;113(7):928-35. doi: 10.1016/j.jand.2013.04.001. Epub 2013 May 23.
Diet plays a critical role in the pathogenesis of major chronic diseases common in populations of US veterans. The role of nutrition-focused wellness coaching in improving dietary behavior and/or reducing weight in overweight and obese US veterans is not known. At the San Francisco Veterans Affairs Medical Center, US veterans aged 25 to 80 years were randomized to receive nutrition coaching on eating behaviors at baseline only (control group, n=22) or an additional eight times over the course of 6 months (intervention group, n=28) in 2010-2011. Multiple coaching contacts decreased intake of energy, fat, and carbohydrate by 31% (P≤0.001) as evaluated by the 2005 Block food frequency questionnaire, which is composed of 111 food items. A weight loss of 5% from baseline (92.8 to 88.2 kg; P<0.01) was observed in the intervention group with mean body mass index decreasing from 30.4 to 28.9 (P<0.05). The control group showed a decrease in fat intake by 20% (P=0.01), but no statistically significant changes in intake of other nutrients or body weight (88.7 to 87.4 kg). Those in the intervention group reported diets at follow-up that were lower in cholesterol, saturated fat, sodium, sugar (P≤0.01), calcium (P< 0.05), and vitamin D (P<0.01), although when adjusted for energy (ie, nutrient density) calcium intake increased and vitamin D remained unchanged. Veterans' readiness to change eating behavior for weight loss improved with nutrition coaching. This study demonstrates that intermittent nutrition coaching can be an effective strategy to promote reductions in energy intake, body weight, and body mass index in overweight US veterans. Further research is needed to determine whether nutrition coaching improves other clinical outcomes and sustains weight loss.
饮食在常见于美国退伍军人人群中的主要慢性疾病的发病机制中起着关键作用。营养为重点的健康教练在改善饮食行为和/或减轻超重和肥胖的美国退伍军人的体重方面的作用尚不清楚。在旧金山退伍军人事务医疗中心，2010-2011 年，年龄在 25 至 80 岁之间的美国退伍军人被随机分为仅在基线时接受饮食行为营养指导（对照组，n=22）或在 6 个月内接受额外 8 次干预（干预组，n=28）。通过由 111 种食物组成的 2005 年布洛克食物频率问卷评估，多次教练接触使能量、脂肪和碳水化合物的摄入量减少了 31%（P≤0.001）。干预组体重从基线下降了 5%（92.8 至 88.2kg；P<0.01），平均体重指数从 30.4 降至 28.9（P<0.05）。对照组的脂肪摄入量减少了 20%（P=0.01），但其他营养素或体重没有统计学意义上的变化（88.7 至 87.4kg）。干预组在随访时报告的饮食中胆固醇、饱和脂肪、钠、糖（P≤0.01）、钙（P<0.05）和维生素 D（P<0.01）的含量较低，尽管在调整能量（即营养素密度）后，钙的摄入量增加，维生素 D 保持不变。退伍军人对为减肥而改变饮食行为的准备情况随着营养指导而改善。这项研究表明，间歇性营养指导可以成为一种有效的策略，以促进超重的美国退伍军人减少能量摄入、体重和体重指数。需要进一步的研究来确定营养指导是否能改善其他临床结果并维持体重减轻。
