Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA.
Br J Nutr. 2023 Dec 14;130(11):2013-2021. doi: 10.1017/S0007114523001137. Epub 2023 Jun 7.
In the few weight loss studies assessing diet quality, improvements have been minimal and recommended calculation methods have not been used. This secondary analysis of a parallel group randomised trial (regsitered: https://clinicaltrials.gov/ct2/show/NCT03367936) assessed whether self-monitoring with feedback (SM + FB) . self-monitoring alone (SM) improved diet quality. Adults with overweight/obesity (randomised: SM 251, SM + FB 251; analysed SM 170, SM + FB 186) self-monitored diet, physical activity and weight. Real-time, personalised feedback, delivered via a study-specific app up to three times daily, was based on reported energy, fat and added sugar intake. Healthy Eating Index 2015 (HEI-2015) scores were calculated from 24-hour recalls. Higher scores represent better diet quality. Data were collected August 2018 to March 2021 and analysed spring 2022. The sample was mostly female (78·9 %) and white (85·4 %). At baseline, HEI-2015 total scores and bootstrapped 95 % CI were similar by treatment group (SM + FB: 63·11 (60·41, 65·24); SM: 61·02 (58·72, 62·81)) with similar minimal improvement observed at 6 months (SM + FB: 65·42 (63·30, 67·20); SM: 63·19 (61·22, 64·97)) and 12 months (SM + FB: 63·94 (61·40, 66·29); SM: 63·56 (60·81, 65·42)). Among those who lost ≥ 5 % of baseline weight, HEI-2015 scores improved (baseline: 62·00 (58·94, 64·12); 6 months: 68·02 (65·41, 71·23); 12 months: 65·93 (63·40, 68·61)). There was no effect of the intervention on diet quality change. Clinically meaningful weight loss was related to diet quality improvement. Feedback may need to incorporate more targeted nutritional content.
在少数评估饮食质量的减肥研究中，改善效果甚微，且未使用推荐的计算方法。本平行组随机试验的二次分析（注册于：https://clinicaltrials.gov/ct2/show/NCT03367936）评估了自我监测加反馈（SM+FB）与单纯自我监测（SM）是否能改善饮食质量。超重/肥胖成年人（随机分配：SM 251 人，SM+FB 251 人；分析时 SM 组 170 人，SM+FB 组 186 人）进行饮食、身体活动和体重的自我监测。通过专门的研究应用程序实时提供个性化反馈，每日最多提供三次，该反馈基于报告的能量、脂肪和添加糖摄入量。使用 24 小时回顾法计算健康饮食指数 2015 （HEI-2015）得分。得分越高表示饮食质量越好。数据于 2018 年 8 月至 2021 年 3 月收集，并于 2022 年春季进行分析。该样本主要为女性（78.9%）和白人（85.4%）。在基线时，根据治疗组，HEI-2015 总分和 bootstrap 95%CI 相似（SM+FB：63.11（60.41，65.24）；SM：61.02（58.72，62.81）），6 个月时观察到相似的最小改善（SM+FB：65.42（63.30，67.20）；SM：63.19（61.22，64.97）），12 个月时也观察到相似的最小改善（SM+FB：63.94（61.40，66.29）；SM：63.56（60.81，65.42））。在基线体重减轻≥5%的人群中，HEI-2015 得分有所提高（基线：62.00（58.94，64.12）；6 个月：68.02（65.41，71.23）；12 个月：65.93（63.40，68.61））。干预对饮食质量变化没有影响。有临床意义的体重减轻与饮食质量改善有关。反馈可能需要纳入更有针对性的营养内容。
