Examination of Nutrition Literacy and Quality of Self-monitoring in Behavioral Weight Loss

Abstract

Background Few have examined nutrition literacy (i.e., capacity to process and make informed nutritional decisions) in behavioral weight loss. Nutrition literacy (NL) may impact necessary skills for weight loss, contributing to outcome disparities. Purpose The study set out to: identify correlates of NL; evaluate whether NL predicted weight loss, food record completion and quality, and session attendance; and investigate whether the relations of race and education to weight loss were mediated by NL and self-monitoring. Methods This is a secondary analysis of 6-months of a behavioral weight loss program in which overweight/obese adults (N = 320) completed a baseline measure of NL (i.e., Newest Vital Sign). Participants self-monitored caloric intake via food records. Results NL was lower for black participants (p <.001) and participants with less education (p = .002). Better NL predicted better 6-month weight loss (b = −.63, p = .04) and food record quality (r = .37, p <.001), but not food record completion or attendance (ps > 0.05). Black participants had lower NL, which was associated with poorer food record quality, which adversely affected weight loss. There was no indirect effect of education on weight loss through NL and food record quality. Conclusions Overall, results suggest lower NL is problematic for weight loss. For black participants, NL may indirectly impact weight loss through quality of self-monitoring. This might be one explanation for poorer behavioral weight loss outcomes among black participants. Additional research should investigate whether addressing these skills through enhanced treatment improves outcomes. NCT02363010.

Combined Amylin/GLP-1 pharmacotherapy to promote and sustain long-lasting weight loss

“…Among them, liraglutide has proven to be one of the most commonly prescribed pharmacotherapy for treating obesity, due in large part to the pronounced weight loss and relatively modest profile of adverse events 21,22,53 . While all of these approved therapies, including liraglutide, are successful at producing initial weight loss, each is limited in the magnitude, and for some, the duration of efficacy 21,40,54,55 . Indeed, a well-documented phenomenon undoubtedly contributing to the resistance of these drugs in producing a greater duration and magnitude of weight loss is the host of counter-regulatory metabolic and neuroendocrine changes that occur with weight loss 54 .…”

“…While all of these approved therapies, including liraglutide, are successful at producing initial weight loss, each is limited in the magnitude, and for some, the duration of efficacy 21,40,54,55 . Indeed, a well-documented phenomenon undoubtedly contributing to the resistance of these drugs in producing a greater duration and magnitude of weight loss is the host of counter-regulatory metabolic and neuroendocrine changes that occur with weight loss 54 . Regardless of the precise mechanisms contributing to this phenomenon, a growing appreciation is that the central nervous system (CNS) is sensing multiple changes in redundant hormonal systems that drive hyperphagia to restore a previous body weight set point 54 .…”

“…Indeed, a well-documented phenomenon undoubtedly contributing to the resistance of these drugs in producing a greater duration and magnitude of weight loss is the host of counter-regulatory metabolic and neuroendocrine changes that occur with weight loss 54 . Regardless of the precise mechanisms contributing to this phenomenon, a growing appreciation is that the central nervous system (CNS) is sensing multiple changes in redundant hormonal systems that drive hyperphagia to restore a previous body weight set point 54 . Thus, a theoretical advantage of utilizing combinatorial pharmacotherapy is to provide a pharmaceutical means to counteract even more of these counter-regulatory neuroendocrine changes being sensed by the brain.…”

“…Experiments were designed to determine whether chronic combinatorial administration of an amylin receptor agonist with a GLP-1R agonist is superior in producing a greater magnitude of sustained weight loss and food intake suppression compared to monotherapy in a diet induced obese rat model. These studies were also designed to determine whether the typical plateau of weight loss that occurs with any pharmacotherapy intervention 22,23,40,41,46,52,54,75 , even combinatorial therapies 33,50,51 could be overcome through a unique stepwise approach of introducing the combinatorial therapy in attempt to overcome the tachyphylaxis of sustained pharmacotherapy administration from the beginning of treatment. To this end, obese rats ( n = 10–12 per group; matched for mean body weight at the start of treatment at 770 g ± 10 g) received daily IP injections of vehicle (1 mL/kg), sCT (3 μg/kg), liraglutide (50 μg/kg), a combination of sCT and liraglutide (3 μg/kg + 50 μg/kg) or a stepwise administration of the amylin and GLP-1R analogs, where rats received sCT treatment for the first week, liraglutide treatment for the second week, followed by a combination treatment of sCT and liraglutide for the remaining testing period.…”

Privacy Concerns of Overweight Adults to use Wearable Devices for Sustained Health Monitoring

“…Sustained monitoring involves an increased knowledge about diet and activity levels for effective decision-making related to weight control. Findings from previous studies have suggested that sustained self-monitoring is a vital element of treating overweight adults (Rosenbaum, Clark, Convertino, Call, Forman, & Butryn, 2018;Perenc et al, 2015;Asch, Muller, & Volpp, 2012).…”