A Potential Tool for Clinicians; Evaluating a Computer-Led Dietary Assessment Method in Overweight and Obese Women during Weight Loss

Widaman, Adrianne; Keim, Nancy L.; Burnett, D. D.; Miller, Beverly; Witbracht, Megan; Widaman, Keith F.; Laugero, Kevin D.

doi:10.3390/nu9030218

Cited by 14 publications

(6 citation statements)

References 31 publications

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“…By the end of the intervention, engaged users reported an average intake of 1470 (SD 535) calories per day , representing the recommended daily intake of 1200-1600 calories per day for achieving weight loss [30]. Although overweight and obese women often underreport their energy intake [31], the ASA24 can be a useful tool for determining the dietary intake of this population; Widamen and colleagues [32] found only a 5% difference between energy reported and actual energy consumed. Despite the associations between obesity and the issue of underestimating, this study considered the process of self-monitoring to be more important than the accuracy of reported dietary intake [33].…”

Section: Discussionmentioning

confidence: 99%

The Twazon Arabic Weight Loss App: App-Based Intervention for Saudi Women With Obesity

Alnasser¹,

Kyle²,

Aloumi³

et al. 2019

JMIR Mhealth Uhealth

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Background By 2022, it is estimated that the rate of female obesity (78%) in Saudi Arabia will almost double that of males (41%). Despite being mainly attributed to poor diet, sedentary lifestyle, and a lack of health awareness, behavioral modification interventions are relatively new to the population; bariatric surgery continues to be the treatment of choice for comorbidities. However, neither pre nor postoperative diet and exercise are promoted. Evidence-informed mobile health (mHealth) weight loss apps and interventions may be an effective tool for delivering a culturally relevant intervention. Objective This study aimed to determine the feasibility of a weight loss intervention that tests the effectiveness of Twazon, an originally designed Arabic weight-loss app that promotes lifestyle modification specific to Arab populations. Methods A pre-post single‐arm pilot study was carried out among a sample of 240 overweight volunteer Saudi women residing in Riyadh, Saudi Arabia who used the Twazon app over a 4-month period. Anthropometric, diet, and physical activity measures were assessed 3 times: baseline, 2-months and 4-months; frequency of app use and system usability were evaluated during the 2 latter data collection periods. Repeated measures analysis of variance was used to identify changes over time. Results A total of 40 participants completed the 4-month intervention with an attrition rate of 83%. An evaluation of the frequency of app use fostered 2 groups: engaged users (65%) and unengaged users (35%). At 4 months, the engaged users experienced more successful outcomes; body weight was lowered on average by 1.3 (SD 0.6) kg ( P =.18), waist circumference (WC) was reduced by 4.9 (SD 1.1) cm ( P <.001), and daily energy consumption was decreased by >600 calories ( P =.002). Unengaged users experienced minor changes in body weight, WC, and reduced energy intake. Conclusions The findings have demonstrated that engagement with the Twazon app renders positive changes in body weight, WC, and energy intake. mHealth weight loss apps and interventions have the potential to be effective in promoting weight loss and healthy lifestyle modification in Saudi Arabia and similar populations.

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Section: Discussionmentioning

confidence: 99%

The Twazon Arabic Weight Loss App: App-Based Intervention for Saudi Women With Obesity

Alnasser¹,

Kyle²,

Aloumi³

et al. 2019

JMIR Mhealth Uhealth

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“…After enrolment, women completed three 24 h dietary recalls (two on weekdays and one on a weekend day) for 1 week before the dietary intervention using the Automated Self-Administered 24-Hour Dietary Recall (ASA24), which has been previously validated in pregnant women [18] and women of childbearing age [19] against measures of true intakes and interviewer-administered 24 h recall. Images assisted with portion size estimation, and food codes from the Australian Food Supplement and Nutrient Database (AUSNUT) 2011-2013 are automatically assigned.…”

Section: Dietary Assessmentmentioning

confidence: 99%

Reduction in Maternal Energy Intake during Lactation Decreased Maternal Body Weight and Concentrations of Leptin, Insulin and Adiponectin in Human Milk without Affecting Milk Production, Milk Macronutrient Composition or Infant Growth

et al. 2021

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Maternal diet has the potential to affect human milk (HM) composition, but very few studies have directly assessed the effect of maternal diets on HM composition. The primary aim of this study was to assess the effect of improving dietary quality in lactating women over 2 weeks on the concentrations of macronutrients and metabolic hormones in HM. The secondary aims were to assess the impact of the dietary intervention on 24 h milk production, maternal body composition and infant growth. Fifteen women completed a 1-week baseline period followed by a 2-week dietary intervention phase targeted towards reducing fat and sugar intake. Maternal anthropometric and body composition and infant growth measurements were performed weekly. Total 24 h milk production was measured before and after the dietary intervention, and HM samples were collected daily. Maternal intakes of energy (−33%), carbohydrate (−22%), sugar (−29%), fat (−54%) and saturated fat (−63%) were significantly reduced during the dietary intervention. HM insulin, leptin and adiponectin concentrations were 10–25% lower at the end of the dietary intervention, but HM concentrations of macronutrients were unaffected. Maternal body weight (−1.8%) and fat mass (−6.3%) were significantly reduced at the end of the dietary intervention, but there were no effects on 24 h milk production or infant growth. These results suggest that reducing maternal energy, carbohydrate, fat and sugar intake over a 2-week period is associated with significant reductions in HM insulin, leptin and adiponectin concentrations. These changes may be secondary to decreases in maternal weight and fat mass. The limited studies to date that have investigated the association between metabolic hormone concentrations in HM and infant growth raise the possibility that the changes in HM composition observed in the current study could impact infant growth and adiposity, but further studies are required to confirm this hypothesis.

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“…For example, Kirkpatrick et al [33] found that more intrusions (items not consumed) were present with the use of a web-based self-administered 24HR method than in an interviewer-administered 24HR method. Widaman et al [35] found no statistically significant differences between estimated and observed intake of grain foods using web-based self-administered 24HR methods, although all other food groups were overestimated. These findings illustrate how controlled feeding studies can provide insights into the mechanisms of dietary intake measurement errors that would otherwise remain unknown.…”

Section: Introductionmentioning

confidence: 94%

“…Controlled feeding studies allow for the examination of measurement errors at the level of foods and beverages. Studies with measures of known food and beverage intake enable the understanding of factors contributing to misreporting, such as omission of particular types of foods, intrusions, inaccurate portion size estimation, and incorrect food descriptions [31][32][33][34][35].…”

Section: Introductionmentioning

confidence: 99%

Accuracy and Cost-effectiveness of Technology-Assisted Dietary Assessment Comparing the Automated Self-administered Dietary Assessment Tool, Intake24, and an Image-Assisted Mobile Food Record 24-Hour Recall Relative to Observed Intake: Protocol for a Randomized Crossover Feeding Study

Whitton¹,

Healy²,

Collins³

et al. 2021

JMIR Res Protoc

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Background The assessment of dietary intake underpins population nutrition surveillance and nutritional epidemiology and is essential to inform effective public health policies and programs. Technological advances in dietary assessment that use images and automated methods have the potential to improve accuracy, respondent burden, and cost; however, they need to be evaluated to inform large-scale use. Objective The aim of this study is to compare the accuracy, acceptability, and cost-effectiveness of 3 technology-assisted 24-hour dietary recall (24HR) methods relative to observed intake across 3 meals. Methods Using a controlled feeding study design, 24HR data collected using 3 methods will be obtained for comparison with observed intake. A total of 150 healthy adults, aged 18 to 70 years, will be recruited and will complete web-based demographic and psychosocial questionnaires and cognitive tests. Participants will attend a university study center on 3 separate days to consume breakfast, lunch, and dinner, with unobtrusive documentation of the foods and beverages consumed and their amounts. Following each feeding day, participants will complete a 24HR process using 1 of 3 methods: the Automated Self-Administered Dietary Assessment Tool, Intake24, or the Image-Assisted mobile Food Record 24-Hour Recall. The sequence of the 3 methods will be randomized, with each participant exposed to each method approximately 1 week apart. Acceptability and the preferred 24HR method will be assessed using a questionnaire. Estimates of energy, nutrient, and food group intake and portion sizes from each 24HR method will be compared with the observed intake for each day. Linear mixed models will be used, with 24HR method and method order as fixed effects, to assess differences in the 24HR methods. Reporting bias will be assessed by examining the ratios of reported 24HR intake to observed intake. Food and beverage omission and intrusion rates will be calculated, and differences by 24HR method will be assessed using chi-square tests. Psychosocial, demographic, and cognitive factors associated with energy misestimation will be evaluated using chi-square tests and multivariable logistic regression. The financial costs, time costs, and cost-effectiveness of each 24HR method will be assessed and compared using repeated measures analysis of variance tests. Results Participant recruitment commenced in March 2021 and is planned to be completed by the end of 2021. Conclusions This protocol outlines the methodology of a study that will evaluate the accuracy, acceptability, and cost-effectiveness of 3 technology-enabled dietary assessment methods. This will inform the selection of dietary assessment methods in future studies on nutrition surveillance and epidemiology. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12621000209897; https://tinyurl.com/2p9fpf2s International Registered Report Identifier (IRRID) DERR1-10.2196/32891

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A Potential Tool for Clinicians; Evaluating a Computer-Led Dietary Assessment Method in Overweight and Obese Women during Weight Loss

Cited by 14 publications

References 31 publications

The Twazon Arabic Weight Loss App: App-Based Intervention for Saudi Women With Obesity

The Twazon Arabic Weight Loss App: App-Based Intervention for Saudi Women With Obesity

Reduction in Maternal Energy Intake during Lactation Decreased Maternal Body Weight and Concentrations of Leptin, Insulin and Adiponectin in Human Milk without Affecting Milk Production, Milk Macronutrient Composition or Infant Growth

Accuracy and Cost-effectiveness of Technology-Assisted Dietary Assessment Comparing the Automated Self-administered Dietary Assessment Tool, Intake24, and an Image-Assisted Mobile Food Record 24-Hour Recall Relative to Observed Intake: Protocol for a Randomized Crossover Feeding Study

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