Svensson Madeleine, Hult Mari, van der Mark Marianne, Grotta Alessandra, Jonasson Josefine, von Hausswolff-Juhlin Yvonne, Rössner Stephan, Trolle Lagerros Ylva
Halmstad University, Deparment of Health and Social Sciences, Halmstad, Sweden.
J Med Internet Res. 2014 Nov 3;16(11):e234. doi: 10.2196/jmir.3131.
BACKGROUND: Eating behaviors are essential components in weight loss programs, but limited research has explored eating behaviors in Web-based weight loss programs. OBJECTIVES: The aim was to evaluate an interactive Web-based weight loss program on eating behaviors using the 18-item Three-Factor Eating Questionnaire Revised (TFEQ-R18) which measures uncontrolled eating, emotional eating, and cognitive restrained eating. Our Web-based weight loss program is comprised of information about healthy lifestyle choices, weekly chats with experts, social networking features, databases for recipe searches, and features allowing members to self-report and track their weight, physical activity, and dietary intake on the website. METHODS: On registering for the weight loss program, 23,333 members agreed to take part in the research study. The participants were then asked to complete the TFEQ-R18 questionnaire at baseline and after 3 and 6 months of participation. All data collection was conducted online, with no face-to-face contact. To study changes in TFEQ-R18 eating behaviors we restricted our study to those members who completed all 3 TFEQ-R18 questionnaires. These participants were defined as "completers" and the remaining as "noncompleters." The relationships between sex, change in eating behaviors, and total weight loss were studied using repeated measures ANOVA and Pearson correlation coefficient. RESULTS: In total, 22,800 individuals participated (females: 19,065/22,800, 83.62%; mean age 39.6, SD 11.4 years; BMI 29.0 kg/m(2); males: 3735/22,800, 16.38%; mean age 43.2, SD 11.7 years; BMI 30.8 kg/m(2)). Noncompleters (n=22,180) were younger and reported a lower score of uncontrolled eating and a higher score of cognitive restrained eating. Over time, completers (n=620) decreased their uncontrolled eating score (from 56.3 to 32.0; P<.001) and increased their cognitive restrained eating (from 50.6 to 62.9; P<.001). Males decreased their emotional eating (from 57.2 to 35.9; P<.001), but no significant change was found among females. The baseline cognitive restrained eating score was significantly and positively associated with weight loss for completers in both men (P=.02) and women (P=.002). CONCLUSIONS: To our knowledge, this is the largest TFEQ sample that has been documented. This Web-based weight loss intervention suggests that eating behaviors (cognitive restrained eating, uncontrolled eating, and emotional eating) measured by TFEQ-R18 were significantly changed during 6 months of participation. Our findings indicate differences in eating behaviors with respect to sex, but should be interpreted with caution because attrition was high.
背景:饮食行为是减肥计划的重要组成部分,但针对基于网络的减肥计划中的饮食行为的研究有限。 目的:旨在使用18项三因素饮食问卷修订版(TFEQ-R18)评估基于网络的交互式减肥计划对饮食行为的影响,该问卷用于测量无节制饮食、情绪化饮食和认知性克制饮食。我们基于网络的减肥计划包括有关健康生活方式选择的信息、与专家的每周聊天、社交网络功能、食谱搜索数据库,以及允许会员在网站上自我报告和跟踪其体重、身体活动和饮食摄入量的功能。 方法:在注册减肥计划时,23333名会员同意参与该研究。参与者随后被要求在基线时以及参与3个月和6个月后完成TFEQ-R18问卷。所有数据收集均在线进行,无面对面接触。为了研究TFEQ-R18饮食行为的变化,我们将研究限制在那些完成了所有3份TFEQ-R18问卷的会员中。这些参与者被定义为“完成者”,其余的为“未完成者”。使用重复测量方差分析和Pearson相关系数研究性别、饮食行为变化和总体体重减轻之间的关系。 结果:共有22800人参与(女性:19065/22800,83.62%;平均年龄39.6岁,标准差11.4岁;BMI 29.0kg/m²;男性:3735/22800,16.38%;平均年龄43.2岁,标准差11.7岁;BMI 30.8kg/m²)。未完成者(n=22180)更年轻,报告的无节制饮食得分较低,认知性克制饮食得分较高。随着时间推移,完成者(n=620)降低了他们的无节制饮食得分(从56.3降至32.0;P<0.001),并提高了他们的认知性克制饮食得分(从50.6升至62.9;P<0.001)。男性减少了他们的情绪化饮食(从57.2降至35.9;P<0.001),但女性中未发现显著变化。基线时的认知性克制饮食得分与完成者的体重减轻在男性(P=0.02)和女性(P=0.002)中均显著正相关。 结论:据我们所知,这是有记录以来最大的TFEQ样本。这项基于网络的减肥干预表明,在参与的6个月期间,TFEQ-R18测量的饮食行为(认知性克制饮食、无节制饮食和情绪化饮食)发生了显著变化。我们的研究结果表明了饮食行为在性别方面的差异,但由于损耗率较高,应谨慎解读。
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