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RCT·nutrition, dietetics, clinical nutrition, clinical trial, epidemiology·PMC10632722

Effect of an mHealth weight loss intervention on Healthy Eating Index diet quality: the SMARTER randomised controlled trial

The British journal of nutrition · 9 authors, 5 centres

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TL;DR

Over 12 months, the intervention did not lead to a significant improvement in overall diet quality as measured by the Healthy Eating Index.

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This secondary analysis of the SMARTER trial evaluated the effect of an mHealth weight loss intervention with personalised dietary feedback on diet quality. Limitations include the secondary analysis nature and missing dietary data in a portion of the cohort.

STUDY TYPE

RCT

SPECIALTY

nutrition

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100% · A

ORIGINAL PAPER

PMC10632722

Effect of an mHealth weight loss intervention on Healthy Eating Index diet quality: the SMARTER randomised controlled trial

The British journal of nutrition

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ABSTRACT

Abstract 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) v . self-monitoring alone (SM) improved diet quality. Adults with overweight/obesity (randomised: SM n 251, SM + FB n 251; analysed SM n 170, SM + FB n 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. Keywords: Diet quality, Mobile health, Weight loss, Behaviour change

CITATION EXPORT

Jessica Cheng, Tina Costacou, Susan M Sereika et al.. Effect of an mHealth weight loss intervention on Healthy Eating Index diet quality: the SMARTER randomised controlled trial. The British journal of nutrition. (2023). https://doi.org/10.1017/S0007114523001137

AUTHORS

9 · 5 CENTRES

Jessica Cheng, Tina Costacou, Susan M Sereika, Molly B Conroy, Bambang Parmanto, Bonny Rockette-Wagner, Andrea M Kriska, Mary Lou Klem, Lora E Burke

1Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
2Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
3Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
4Department of Health Information Management, School of Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
5Health Sciences Library System, University of Pittsburgh, Pittsburgh, PA, USA