Department of Family Medicine, David Geffen School of Medicine at UCLA, University of California, 10880 Wilshire Blvd, Ste 1800, Los Angeles, CA, 90024, USA.
Charles R. Drew/UCLA Medical Education Program, Los Angeles, USA.
BMC Public Health. 2019 Jul 24;19(1):990. doi: 10.1186/s12889-019-7294-z.
Primary care-based behavior change obesity treatment has long featured the Calorie restriction (CC), portion control approach. By contrast, the MyPlate-based obesity treatment approach encourages eating more high-satiety/high-satiation foods and requires no calorie-counting. This report describes study methods of a comparative effectiveness trial of CC versus MyPlate. It also describes baseline findings involving demographic characteristics and their associations with primary outcome measures and covariates, including satiety/satiation, dietary quality and acculturation.
A comparative effectiveness trial was designed to compare the CC approach (n = 130) versus a MyPlate-based approach (n = 131) to treating patient overweight. Intervenors were trained community health workers. The 11 intervention sessions included two in-home health education sessions, two group education sessions, and seven telephone coaching sessions. Questionnaire and anthropometric assessments occurred at baseline, 6- and 12 months; food frequency questionnaires were administered at baseline and 12 months. Participants were overweight adult primary care patients of a federally qualified health center in Long Beach, California. Two measures of satiety/satiation and one measure of post-meal hunger comprised the primary outcome measures. Secondary outcomes included weight, waist circumference, blood pressure, dietary quality, sugary beverage intake, water intake, fruit and vegetable fiber intake, mental health and health-related quality of life. Covariates included age, gender, nativity status (U.S.-born, not U.S.-born), race/ethnicity, education, and acculturation.
Baseline characteristics were compared using chi square tests. Associations between covariates and outcome measures were evaluated using multiple regression and logistic regression.
Two thousand eighty-six adult patients were screened, yielding 261 enrollees who were 86% Latino, 8% African American, 4% White and 2% Other. Women predominated (95%). Mean age was 42 years. Most (82%) were foreign-born; 74% chose the Spanish language option. Mean BMI was 33.3 kg/m; mean weight was 82 kg; mean waist circumference was 102 cm. Mean blood pressure was 122/77 mm. Study arms on key baseline measures did not differ except on dietary quality and sugary beverage intake. Nativity status was significantly associated with dietary quality.
The two treatment arms were well-balanced demographically at baseline. Nativity status is inversely related to dietary quality.
NCT02514889 , posted on 8/4/2015.
以初级保健为基础的行为改变肥胖治疗长期以来一直以热量限制（CC）和控制部分饮食为特色。相比之下，基于 MyPlate 的肥胖治疗方法鼓励食用更高饱腹感/更高满足感的食物，并且不需要计算卡路里。本报告介绍了 CC 与 MyPlate 比较有效性试验的研究方法。它还描述了涉及人口统计学特征及其与主要结局测量和协变量的关联的基线发现，包括饱腹感/满足感、饮食质量和文化适应。
设计了一项比较有效性试验，以比较 CC 方法（n=130）与基于 MyPlate 的方法（n=131）治疗超重患者。干预者是经过培训的社区卫生工作者。11 次干预会议包括两次家庭健康教育会议、两次小组教育会议和七次电话咨询会议。问卷调查和人体测量评估在基线、6 个月和 12 个月进行；食物频率问卷在基线和 12 个月进行。参与者是加利福尼亚州长滩市一家联邦合格健康中心的超重成年初级保健患者。饱腹感/满足感的两个测量指标和一个餐后饥饿感测量指标构成了主要结局测量指标。次要结局包括体重、腰围、血压、饮食质量、含糖饮料摄入量、水摄入量、水果和蔬菜纤维摄入量、心理健康和健康相关生活质量。协变量包括年龄、性别、出生国（美国出生、非美国出生）、种族/民族、教育程度和文化适应。
使用卡方检验比较基线特征。使用多元回归和逻辑回归评估协变量与结局测量之间的关联。
对 2086 名成年患者进行了筛查，有 261 名患者入组，其中 86%为拉丁裔，8%为非裔美国人，4%为白人，2%为其他种族。女性占主导地位（95%）。平均年龄为 42 岁。大多数（82%）是外国出生的；74%选择西班牙语选项。平均 BMI 为 33.3kg/m；平均体重为 82kg；平均腰围为 102cm。平均血压为 122/77mmHg。关键基线测量指标的研究臂除了饮食质量和含糖饮料摄入量外，没有差异。出生国与饮食质量显著相关。
在基线时，两个治疗臂在人口统计学上平衡。出生国与饮食质量呈负相关。
NCT02514889，于 2015 年 8 月 4 日注册。
