Monitoring and Feedback for Long- term Weight Loss . Numerous wearable technologies specific to physical activity and diet are available, but it is unclear if these are effective at improving weight loss. Objective. At 6 months, the interventions added telephone counseling sessions, text message prompts, and access to study materials on a website. ![]() ![]() At 6 months, participants randomized to the standard intervention group initiated self- monitoring of diet and physical activity using a website, and those randomized to the enhanced intervention group were provided with a wearable device and accompanying web interface to monitor diet and physical activity. Main Outcomes and Measures. Secondary outcomes included body composition, fitness, physical activity, and dietary intake. ![]() Results. For the enhanced intervention group, mean baseline weight was 9. CI, 9. 4. 2- 9. 8. CI, 9. 0. 6- 9. 5. For the standard intervention group, mean baseline weight was 9. ![]() Three Methods: Reading Food Labels Calculating the Carbs You Eat Planning for Carbs in Your Diet Community Q&A. Welcome to Babylon Floral Design, Denver's most unique flower boutique, specializing in cutting edge floral design and unique gift items. We strive to provide the. Find patient medical information for CALCIUM on WebMD including its uses, effectiveness, side effects and safety, interactions, user ratings and products that have it. CI, 9. 3. 0- 9. 7. CI, 8. 7. 1- 9. 1. Weight change at 2. Both groups had significant improvements in body composition, fitness, physical activity, and diet, with no significant difference between groups. DASH Diet ranked #1 in Best Diets Overall. 38 diets were evaluated with input from a panel of health experts. Lunches have been a bigger switch for me. As part of the nutrition plan, I am supposed to eat six servings of vegetables every day. I thought I was really good at. March 7, 2016; blog / food / Health & Wellness; 506 Comments; 27; Chris and I have been so excited and touched by the positive. Conclusions and Relevance. Devices that monitor and provide feedback on physical activity may not offer an advantage over standard behavioral weight loss approaches. Trial Registration. Short- term studies have shown these technologies to result in modest improvements in weight loss when added to a behavioral intervention. These technologies may provide a method to improve longer- term weight loss; however, there are limited data on the effectiveness of such technologies for modifying health behaviors long term. This randomized trial examined whether adding wearable technology to a behavioral intervention would improve weight loss across 2. Additional outcomes included body composition, fitness, physical activity, and dietary intake. Key Points. Question Is the addition of a wearable device to monitor and provide feedback on physical activity effective for improving weight loss within the context of a behavioral weight loss intervention? Findings In this randomized trial that included 4. Meaning Devices that monitor and provide feedback on physical activity may not offer an advantage over standard behavioral weight loss approaches. Participants were randomized to 1 of 2 groups. Both groups received a behavioral weight loss intervention for 6 months; at 6 months, both interventions added telephone counseling sessions, text message prompts, and access to study materials on a website. However, after the initial 6 months, participants randomized to the standard behavioral weight loss intervention (standard intervention) group initiated self- monitoring of diet and physical activity behaviors, and those in the technology- enhanced weight loss intervention (enhanced intervention) group used the study website to access education materials only, and wearable technology was provided along with a web- based interface to monitor physical activity and diet. ![]() Randomization was stratified by sex and race (white or nonwhite) using a computer program that applied randomly selected block sizes of 2 and 4 with the sequence of randomization kept confidential to the other investigators. The primary outcome was weight change at 2. Eligibility was assessed based on self- reported medical history, and clearance from the participant. Procedures were approved by the University of Pittsburgh institutional review board, and all participants provided informed consent. Eligibility criteria included age between 1. BMI) of 2. 5. 0 to less than 4. ![]() Exclusion criteria have been published. Intervention. . Intervention Contact. Both the standard intervention group and the enhanced intervention group received regular intervention contact. Group- based sessions were scheduled weekly for the initial 6 months and monthly between months 7 to 2. If a participant was unable to attend a scheduled group session, attempts were made to engage the participant in a makeup session. Theory- based strategies were used to promote adherence to weight loss behaviors. Beginning with month 7, these materials were posted on the study website, along with a weekly behavioral tip. During months 7 to 2. The telephone contacts were conducted by intervention staff and followed a standard script. Text messages were provided once or twice per week and were used to prompt engagement in weight loss behaviors or to remind participants of upcoming intervention sessions. Participants were compensated $5 per month to offset the cost of receiving text messages. If weight loss exceeded 6% during each 4- week period or if BMI was 2. Dietary fat was prescribed at 2. During months 1 to 6, participants were instructed to self- monitor dietary intake in a diary that was returned to the interventionists at the conclusion of each week, and the intervention staff provided feedback prior to returning diaries to the participants. During months 7 to 2. Participants in the enhanced intervention group self- monitored their dietary patterns using the technology described below. Participants were instructed to engage in structured forms of MVPA that were 1. During months 1 to 6, participants were instructed to self- monitor their MVPA in a diary returned to the interventionists at the conclusion of each week. The intervention staff provided feedback on these diaries. During months 7 to 2. MVPA using a website designed for this study, and this information was available to the staff during the intervention telephone contacts. Participants in the enhanced intervention group self- monitored their MVPA using the technology described below. This system included a multisensor device worn on the upper arm that provided feedback to the participant on energy expenditure and physical activity through a small display or through web- based software developed by the manufacturer. While the display provided information about total MVPA, the web- based software also provided feedback on MVPA performed in durations of 1. The web- based software also allowed for self- monitoring of dietary intake. Intervention staff had access to this information during the scheduled telephone contacts. Participants received $1. Assessment staff were masked to prior data at each assessment to minimize potential bias. Weight was assessed to the nearest 0. Height was measured only at baseline to the nearest 0. Body composition was assessed using dual- energy x- ray absorptiometry from a total body scan. Prior to this scan, women had a urine pregnancy test; a positive result excluded the participant from further study participation. Cardiorespiratory fitness was assessed with a submaximal graded exercise test performed on a motorized treadmill. Oxygen consumption was assessed using a metabolic cart. Physical activity was assessed using a portable device worn for 1 week. Data were considered valid if the participant wore the device for 1. Minute- by- minute data were used to identify minutes and metabolic equivalent (MET). Percent sedentary time was calculated as sedentary time identified by the activity monitor divided by the monitor wear time. Diet over the past month was assessed using the web- based version of the Diet History Questionnaire. Diet. Calc software (version 1. Percent weight loss was included as a post hoc outcome. For safety, depressive symptoms were assessed using the 1. Center for Epidemiology Studies questionnaire. Participants with a score of 1. Resting blood pressure was assessed following a 5- minute seated resting period using an automated system; participants with systolic blood pressure of 1. Hg or greater or diastolic blood pressure of 9. Hg or greater were referred to their primary care physician. Participants were queried regarding the occurrence of overnight hospitalizations and conditions to assess for adverse and serious adverse events. Sex, education, income, employment status, smoking status, alcohol consumption, and depressive symptoms. Race and ethnicity, measures included in the early trials consortium, were assessed by self- report using questionnaires with fixed categories. This would allow participants in the enhanced intervention group to maintain a clinically meaningful weight loss of at least 5%. Using a standard deviation of 6. Based on an expected attrition rate of 2. Statistical significance of group differences in distributions was tested using Wilcoxon test for continuous variables and Pearson . Thus, the primary hypothesis of participants in the enhanced intervention group achieving weight loss different from those in the standard intervention group was tested by fitting a linear mixed- effects model via maximum likelihood with weight over time as the outcome, including race, sex, time (assessment, treated as discrete, at baseline and at 6, 1. Weights measured during or after pregnancy were excluded from the analyses. Significance of the difference in distributions of weight was tested with a likelihood ratio test of the null hypothesis H0: . The mean change at each time point, estimated using the least- square means, are presented by intervention along with the corresponding 9. P values were adjusted by the Holm method for multiplicity when the differences were tested at multiple time points. No adjustments for multiple comparisons were made for the primary outcome. P values for all other secondary outcome analyses were adjusted for multiplicity using the Holm method. Multiple imputation was used for sensitivity analysis. Specifically, 1. 0 Monte Carlo Markov Chain imputations based on the observed variables (intervention group, sex, race, ethnicity, education, income, employment status, waist circumference, smoking status, alcohol consumption, depression, and weight) at previous assessments were used to impute the missing weights for the sensitivity analysis. The estimates from the imputed data sets were averaged to see if they were similar to the likelihood- based estimates from the primary analysis. The WHI was initiated in 1. Postmenopausal women ranging in age from 5. WHI clinical centers nationwide into either a clinical trial (CT) that will include about 6. OS) that will include about 1. The CT is designed to allow randomized controlled evaluation of three distinct interventions: a low- fat eating pattern, hypothesized to prevent breast cancer and colorectal cancer and, secondarily, coronary heart disease; hormone replacement therapy, hypothesized to reduce the risk of coronary heart disease and other cardiovascular diseases and, secondarily, to reduce the risk of hip and other fractures, with increased breast cancer risk as a possible adverse outcome; and calcium and vitamin D supplementation, hypothesized to prevent hip fractures and, secondarily, other fractures and colorectal cancer. Overall benefit- versus- risk assessment is a central focus in each of the three CT components. Women are screened for participation in one or both of the components—dietary modification (DM) or hormone replacement therapy (HRT)—of the CT, which will randomize 4. Women who prove to be ineligible for, or who are unwilling to enroll in, these CT components are invited to enroll in the OS. At their 1- year anniversary of randomization, CT women are invited to be further randomized into the calcium and vitamin D (Ca. D) trial component, which is projected to include 4. The average follow- up for women in either CT or OS is approximately 9 years. Concerted efforts are made to enroll women of racial and ethnic minority groups, with a target of 2. CT and OS. This article gives a brief description of the rationale for the interventions being studied in each of the CT components and for the inclusion of the OS component. Some detail is provided on specific study design choices, including eligibility criteria, recruitment strategy, and sample size, with attention to the partial factorial design of the CT. Some aspects of the CT monitoring approach are also outlined. 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