疾病控制与预防中心认可的数字糖尿病预防项目中体重减轻的驱动因素。
Drivers of weight loss in a CDC-recognized digital diabetes prevention program.
作者信息
Painter Stefanie L, Lu Wei, Schneider Jennifer, James Roberta, Shah Bimal
机构信息
Livongo Health, Mountain View, California, USA
Livongo Health, Mountain View, California, USA.
出版信息
BMJ Open Diabetes Res Care. 2020 Jul;8(1). doi: 10.1136/bmjdrc-2019-001132.
INTRODUCTION
To investigate the impact of the digital Livongo Diabetes Prevention Program (DPP) on weight at 12 months, understand participants' self-monitoring behaviors associated with greater weight loss, and evaluate the impact of coaching interactions on more frequent self-monitoring behaviors.
RESEARCH DESIGN AND METHODS
A retrospective analysis was performed using data from 2037 participants enrolled in the Livongo DPP who completed lesson 1 and recorded a starting weight during 2016-2017. Self-monitoring behaviors, including weigh-ins, food logging, activity, and coach-participant interactions, were analyzed at 6 and 12 months. Subgroup analysis was conducted based on those who were highly engaged versus those minimally engaged. Multiple regression analysis was performed using demographic, self-monitoring, and lesson attendance data to determine predictors of weight loss at 12 months and coaching impact on self-monitoring.
RESULTS
Participants had a mean age of 50 years (SD ±12), with a starting weight of 94 kg (SD ±21), were college-educated (78%), and were female (74%). Overall, participants lost on average 5.1% of their starting weight. Highly engaged participants lost 6.6% of starting body weight, with 25% losing ≥10% at 12 months. Logistic regression analysis showed each submitted food log was associated with 0.23 kg (p<0.05) weight loss, each lesson completed was associated with 0.14 kg (p<0.05) weight loss, and a week of 150 active minutes was associated with 0.1 kg (p<0.01) weight loss. One additional coach-participant message each week was associated with 1.4 more food logs per week, 1.6% increase in weeks with four or more weigh-ins, and a 2.7% increase in weeks with 150 min of activity.
CONCLUSIONS
Food logging had the largest impact on weight loss, followed by lesson engagement and physical activity. Future studies should examine further opportunities to deliver nutrition-based content to increase and sustain weight loss for DPP.
引言
研究数字Livongo糖尿病预防计划（DPP）在12个月时对体重的影响，了解参与者与更大程度体重减轻相关的自我监测行为，并评估指导互动对更频繁自我监测行为的影响。
研究设计与方法
使用来自2037名参加Livongo DPP的参与者的数据进行回顾性分析，这些参与者在2016 - 2017年期间完成了第1课并记录了起始体重。在6个月和12个月时分析自我监测行为，包括称重、食物记录、活动以及教练与参与者的互动。根据参与度高与参与度低的人群进行亚组分析。使用人口统计学、自我监测和课程出勤数据进行多元回归分析，以确定12个月时体重减轻的预测因素以及指导对自我监测的影响。
结果
参与者的平均年龄为50岁（标准差±12），起始体重为94千克（标准差±21），接受过大学教育（78%），女性占74%。总体而言，参与者平均减轻了起始体重的5.1%。参与度高的参与者减轻了起始体重的6.6%，其中25%在12个月时体重减轻≥10%。逻辑回归分析表明，每次提交的食物记录与0.23千克（p<0.05）的体重减轻相关，每完成一节课与0.14千克（p<0.05）的体重减轻相关，每周150分钟的活跃时间与0.1千克（p<0.01）的体重减轻相关。每周多一条教练与参与者的信息与每周多1.4次食物记录、称重4次及以上的周数增加1.6%以及有150分钟活动的周数增加2.7%相关。
结论
食物记录对体重减轻的影响最大，其次是课程参与度和体育活动。未来的研究应探讨进一步提供基于营养的内容的机会，以增加和维持糖尿病预防计划中的体重减轻。
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