O'Reilly Holly, Panizza Chloe E, Lim Unhee, Yonemori Kim M, Wilkens Lynne R, Shvetsov Yurii B, Harvie Michelle N, Shepherd John, Zhu Fengqing Maggie, Le Marchand Loïc, Boushey Carol J, Cassel Kevin D
The Technological University Dublin and The University of Dublin, Trinity College, 191 North Circular Road, D07 EWV4, Dublin, Ireland.
University of Hawai'i Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI, 96813, USA.
Pilot Feasibility Stud. 2021 Feb 11;7(1):48. doi: 10.1186/s40814-021-00786-3.
BACKGROUND: We examined the utility of self-rated adherence to dietary and physical activity (PA) prescriptions as a method to monitor intervention compliance and facilitate goal setting during the Healthy Diet and Lifestyle Study (HDLS). In addition, we assessed participants' feedback of HDLS. HDLS is a randomized pilot intervention that compared the effect of intermittent energy restriction combined with a Mediterranean diet (IER + MED) to a Dietary Approaches to Stop Hypertension (DASH) diet, with matching PA regimens, for reducing visceral adipose tissue area (VAT). METHODS: Analyses included the 59 (98%) participants who completed at least 1 week of HDLS. Dietary and PA adherence scores were collected 8 times across 12 weeks, using a 0-10 scale (0 = not at all, 4 = somewhat, and 10 = following the plan very well). Adherence scores for each participant were averaged and assigned to high and low adherence categories using the group median (7.3 for diet, 7.1 for PA). Mean changes in VAT and weight from baseline to 12 weeks are reported by adherence level, overall and by randomization arm. Participants' feedback at completion and 6 months post-intervention were examined. RESULTS: Mean ± SE, dietary adherence was 6.0 ± 0.2 and 8.2 ± 0.1, for the low and high adherence groups, respectively. For PA adherence, mean scores were 5.9 ± 0.2 and 8.5 ± 0.2, respectively. Compared to participants with low dietary adherence, those with high adherence lost significantly more VAT (22.9 ± 3.7 cm vs. 11.7 ± 3.9 cm [95% CI, - 22.1 to - 0.3]) and weight at week 12 (5.4 ± 0.8 kg vs. 3.5 ± 0.6 kg [95% CI, - 3.8 to - 0.0]). For PA, compared to participants with low adherence, those with high adherence lost significantly more VAT (22.3 ± 3.7 cm vs. 11.6 ± 3.6 cm [95% CI, - 20.7 to - 0.8]). Participants' qualitative feedback of HDLS was positive and the most common response, on how to improve the study, was to provide cooking classes. CONCLUSIONS: Results support the use of self-rated adherence as an effective method to monitor dietary and PA compliance and facilitate participant goal setting. Study strategies were found to be effective with promoting compliance to intervention prescriptions. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03639350 . Registered 21st August 2018-retrospectively registered.
背景：我们研究了自我报告的饮食和体育活动（PA）处方依从性作为一种监测干预依从性并在健康饮食与生活方式研究（HDLS）中促进目标设定的方法的效用。此外，我们评估了参与者对HDLS的反馈。HDLS是一项随机试点干预研究，比较了间歇性能量限制联合地中海饮食（IER + MED）与终止高血压饮食方法（DASH）饮食，并匹配PA方案，对减少内脏脂肪组织面积（VAT）的效果。 方法：分析纳入了完成至少1周HDLS的59名（98%）参与者。在12周内分8次收集饮食和PA依从性评分，采用0至10分制（0 = 完全不，4 = 有点，10 = 严格遵循计划）。计算每位参与者的依从性评分平均值，并使用组中位数（饮食为7.3，PA为7.1）将其分为高依从性和低依从性类别。报告从基线到12周时按依从性水平、总体以及随机分组情况的VAT和体重的平均变化。检查参与者在干预结束时和干预后6个月的反馈。 结果：低依从性组和高依从性组的饮食依从性平均±标准误分别为6.0±0.2和8.2±0.1。对于PA依从性，平均评分分别为5.9±0.2和8.5±0.2。与饮食依从性低的参与者相比，依从性高的参与者在第12周时VAT减少显著更多（22.9±3.7 cm对11.7±3.9 cm [95%可信区间，-22.1至-0.3]），体重减轻也更多（5.4±0.8 kg对3.5±0.6 kg [95%可信区间，-3.8至-0.0]）。对于PA，与依从性低的参与者相比，依从性高的参与者VAT减少显著更多（22.3±3.7 cm对11.6±3.6 cm [95%可信区间，-20.7至-0.8]）。参与者对HDLS的定性反馈是积极的，关于如何改进研究，最常见回答是提供烹饪课程。 结论：结果支持将自我报告的依从性作为监测饮食和PA依从性以及促进参与者目标设定的有效方法。研究策略在促进对干预处方的依从性方面被发现是有效的。 试验注册：ClinicalTrials.gov标识符：NCT03639350。2018年8月21日注册——追溯注册。
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