Goldstein Stephanie P, Evans E Whitney, Espel-Huynh Hallie M, Goldstein Carly M, Karchere-Sun Renee, Thomas J Graham
Department of Psychiatry and Human Behavior Warren Alpert Medical School of Brown University The Miriam Hospital/Weight Control and Diabetes Research Center Providence Rhode Island USA.
Obes Sci Pract. 2022 Jan 25;8(4):442-454. doi: 10.1002/osp4.587. eCollection 2022 Aug.
Lapses from the dietary prescription in lifestyle modification interventions for overweight/obesity are common and impact weight loss outcomes. While it is expected that lapses influence weight via increased consumption, there are no studies that have evaluated how dietary lapses affect dietary intake during treatment. This study examined the association between daily lapses and daily energy and macronutrient intake during a lifestyle modification intervention.
This study used an intensive longitudinal design to observe participants throughout a 6-month lifestyle modification intervention. Participants ( = 32) were adults with overweight/obesity (body mass index 25-50 kg/m) and a diagnosed cardiovascular disease risk factor (e.g., hypertension) with a desire to lose weight. Participants underwent a gold-standard individual in-person lifestyle modification protocol consisting of 3 months of weekly sessions with 3 months of monthly sessions. Each participant's dietary prescription included a calorie target range that was based on their starting weight. Participants completed ecological momentary assessment (EMA; repeated daily smartphone surveys) every other week to self-report on dietary lapses and telephone-based 24-h dietary recalls every 6 weeks.
On days with EMA and recalled intake ( = 210 days), linear mixed models demonstrated significant associations between daily lapse and higher total daily caloric intake ( = 139.20, < 0.05), more daily grams of added sugar ( = 16.24, < 0.001), and likelihood of exceeding the daily calorie goal ( = 0.89, < 0.05). The associations between daily lapse and intake of all other daily macronutrients were non-significant.
This study contributes to literature suggesting that dietary lapses pose a threat to weight loss success. Results indicate that reducing lapse frequency could reduce overall caloric intake and added sugar consumption.
在超重/肥胖的生活方式改变干预措施中，偏离饮食处方的情况很常见，并且会影响减肥效果。虽然预计饮食偏离会通过增加摄入量来影响体重，但尚无研究评估饮食偏离在治疗期间如何影响饮食摄入。本研究探讨了在生活方式改变干预期间每日饮食偏离与每日能量及宏量营养素摄入之间的关联。
本研究采用密集纵向设计，在为期6个月的生活方式改变干预期间观察参与者。参与者（n = 32）为超重/肥胖的成年人（体重指数25 - 50 kg/m²），并患有已确诊的心血管疾病风险因素（如高血压）且有减肥意愿。参与者接受了一项金标准的个人面对面生活方式改变方案，包括为期3个月的每周一次课程以及为期3个月的每月一次课程。每位参与者的饮食处方包括基于其起始体重的卡路里目标范围。参与者每隔一周完成一次生态瞬时评估（EMA；每日重复的智能手机调查）以自我报告饮食偏离情况，并每6周完成一次基于电话的24小时饮食回顾。
在有EMA和回顾摄入量的日子里（n = 210天），线性混合模型显示每日饮食偏离与每日总热量摄入增加（β = 139.20，P < 0.05）、每日添加糖克数增加（β = 16.24，P < 0.001）以及超过每日卡路里目标的可能性（β = 0.89，P < 0.05）之间存在显著关联。每日饮食偏离与所有其他每日宏量营养素摄入之间的关联不显著。
本研究为文献提供了依据，表明饮食偏离对减肥成功构成威胁。结果表明，降低饮食偏离频率可减少总体热量摄入和添加糖的消费。
