A randomised trial of an internet weight control resource: The UK Weight Control Trial [ISRCTN58621669]

BACKGROUND: Obesity treatment is notoriously unsuccessful and one of the barriers to successful weight loss reported by patients is a lack of social support. The Internet offers a novel and fast approach to the delivery of health information, enabling 24-hour access to help and advice. However, much of the health information available on the Internet is unregulated or not written by qualified health professionals to provide unbiased information. The proposed study aims to compare a web-based weight loss package with traditional dietary treatment of obesity in participants. The project aims to deliver high quality information to the patient and to evaluate the effectiveness of this information, both in terms of weight loss outcomes and cost-effectiveness. METHODS: This study is a randomised controlled trial of a weight loss package against usual care provided within General Practice (GP) surgeries in Leeds, UK. Participants will be recruited via posters placed in participating practices. A target recruitment figure of 220 will enable 180 people to be recruited (allowing for 22% dropout). Participants agreeing to take part in the study will be randomly allocated using minimisation to either the intervention group, receiving access to the Internet site, or the usual care group. The primary outcome of the study will be the ability of the package to promote change in BMI over 6 and 12 months compared with traditional treatment. Secondary outcomes will be the ability of the Internet package to promote change in reported lifestyle behaviours. Data will be collected on participant preferences, adherence to treatment, health care use and time off work. Difference in cost between groups in provision of the intervention and the cost of the primary outcome will also be estimated. CONCLUSION: A positive result from this study would enhance the repertoire of treatment approaches available for the management of obesity. A negative result would be used to inform the research agenda and contribute to redefining future strategies for tackling obesity

Study protocol: a cluster randomised controlled trial of a school based fruit and vegetable intervention – Project Tomato

Background The School Fruit and Vegetable Scheme (SFVS) is an important public health intervention. The aim of this scheme is to provide a free piece of fruit and/or vegetable every day for children in Reception to Year 2. When children are no longer eligible for the scheme (from Year 3) their overall fruit and vegetable consumption decreases back to baseline levels. This proposed study aims to design a flexible multi-component intervention for schools to support the maintenance of fruit and vegetable consumption for Year 3 children who are no longer eligible for the scheme. Method This study is a cluster randomised controlled trial of Year 2 classes from 54 primary schools across England. The schools will be randomly allocated into two groups to receive either an active intervention called Project Tomato, to support maintenance of fruit intake in Year 3 children, or a less active intervention (control group), consisting of a 5 A DAY booklet. Children's diets will be analysed using the Child And Diet Evaluation Tool (CADET), and height and weight measurements collected, at baseline (Year 2) and 18 month follow-up (Year 4). The primary outcome will be the ability of the intervention (Project Tomato) to maintain consumption of fruit and vegetable portions compared to the control group. Discussion A positive result will identify how fruit and vegetable consumption can be maintained in young children, and will be useful for policies supporting the SFVS. A negative result would be used to inform the research agenda and contribute to redefining future strategies for increasing children's fruit and vegetable consumption

Study protocol: can a school gardening intervention improve children's diets?

BACKGROUND: The current academic literature suggests there is a potential for using gardening as a tool to improve children's fruit and vegetable intake. This study is two parallel randomised controlled trials (RCT) devised to evaluate the school gardening programme of the Royal Horticultural Society (RHS) Campaign for School Gardening, to determine if it has an effect on children's fruit and vegetable intake. METHOD/DESIGN: Trial One will consist of 26 schools; these schools will be randomised into two groups, one to receive the intensive intervention as "Partner Schools" and the other to receive the less intensive intervention as "Associate Schools". Trial Two will consist of 32 schools; these schools will be randomised into either the less intensive intervention "Associate Schools" or a comparison group with delayed intervention. Baseline data collection will be collected using a 24-hour food diary (CADET) to collect data on dietary intake and a questionnaire exploring children's knowledge and attitudes towards fruit and vegetables. A process measures questionnaire will be used to assess each school's gardening activities. DISCUSSION: The results from these trials will provide information on the impact of the RHS Campaign for School Gardening on children's fruit and vegetable intake. The evaluation will provide valuable information for designing future research in primary school children's diets and school based interventions. TRIAL REGISTRATION: ISRCTN11396528

The Internet for weight control in an obese sample: results of a randomised controlled trial

Rising levels of obesity coupled with the limited success of currently available weight control methods highlight the need for investigation of novel approaches to obesity treatment. This study aims to determine the effectiveness and cost-effectiveness of an Internet-based resource for obesity management

Process evaluation of a cluster randomised controlled trial of a school-based fruit and vegetable intervention: Project Tomato.

The present analysis evaluates the overall appreciation and implementation of an intervention, Project Tomato, designed to maintain fruit and vegetable intake in children aged 8-9 years

The use of supermarket till receipts to determine the fat and energy intake in a UK population

OBJECTIVES: To validate the use of supermarket receipts as an index of fat and energy intake in a population that buys most of its food from supermarkets. DESIGN: Cross-sectional, prospective dietary survey - feasibility study. SETTING: Households situated within a 20-mile radius of a large (Tesco) supermarket in Leeds. SUBJECTS: Two hundred and fourteen households who spend >or=60% of their food purse in (Tesco and other) supermarkets. RESULTS: Mean daily household purchase of fat, energy and percentage energy from fat contained in food from supermarkets were 185 g, 19.2 MJ and 35.9%. Mean daily household intakes of fat and energy were 190 g and 20.7 MJ, and 35% of energy was derived from fat. Mean household size was 2.4 persons. The association between the amount of fat and energy purchased from supermarkets and the amount of fat and energy consumed by households was strong. 0.90 MJ (95% confidence interval (CI): 0.8-1.0) of energy were consumed for every 1 MJ purchased from supermarkets and 0.76 g (95% CI: 0.64-0.87) of fat were consumed for every 1 g of fat purchased. CONCLUSIONS: The results show a strong association between estimates of the intakes of fat and energy and percentage energy from fat using 4-day food diaries and 28 days of receipts, in populations who buy most of their food from supermarkets. They also show that the fat content of total food purchases from supermarkets is 35.9% energy from fat compared with 33% energy from fat recommended by the Department of Health. This preliminary research indicates the feasibility of and potential for utilising large quantities of readily available data generated from supermarket checkouts in dietary surveys

Can a dietary quality score derived from a short-form FFQ assess dietary quality in UK adult population surveys?

Objective: To devise a measure of diet quality from a short-form FFQ (SFFFQ) for population surveys. To validate the SFFFQ against an extensive FFQ and a 24 h diet recall. Design: Population-based cross-sectional survey. Setting: East Leeds and Bolton in Northern England. Subjects: Adults (n 1999) were randomly selected from lists of those registered with a general practitioner in the study areas, contacted by mail and asked to complete the SFFFQ. Responders were sent a longer FFQ to complete and asked if they would take part in a telephone-based 24 h diet recall. Results: Results from 826 people completing the SFFFQ, 705 completing the FFQ and forty-seven completing the diet recall were included in the analyses. The dietary quality score (DQS), based on fruit, vegetable, oily fish, non-milk extrinsic sugar and fat intakes, showed significant agreement between the SFFFQ and the FFQ (κ=0·38, P<0·001). The DQS for the SFFFQ and the diet recall did not show significant agreement (κ=0·04, P=0·312). A number of single items on the SFFFQ predicted a ‘healthy’ DQS when calculated from the FFQ. The odds of having a healthy diet were increased by 27 % (95 % CI 9, 49 %, P<0·001) for an increase in fruit of 1 portion/d and decreased by 67 % (95 % CI 47, 79 %, P<0·001) for an increase in crisps of 1 portion/d. Conclusions: The SFFFQ has been shown to be an effective method of assessing diet quality. It provides an important method for determining variations in diet quality within and across different populations

A cluster-randomised controlled trial of a school-based fruit and vegetable intervention: Project Tomato.

Objective The present study aimed to determine whether a multi-component school-based intervention can maintain children's fruit and vegetable intake post eligibility for free school fruit and vegetables. Design A random sample of fifty-four English primary schools was randomised to receive the 10-month intervention Project Tomato, a multi-component theory-based intervention, or the control. Each group consisted of twenty-seven schools. Setting Children's intake of fruit and vegetables is below recommendations. The English School Fruit and Vegetable Scheme has a short-term impact on intake while children are eligible for the scheme. Subjects Dietary measurements were collected from 658 Year 2 pupils aged 7–8 years at baseline and at follow-up 20 months later. Results Following an intention to treat analysis, the intervention as delivered compared with the control had no impact on the intake of fruit and vegetables (2 g/d, 95 % CI −23, 26 g/d) or on the number of portions of fruit (0·0 portions, 95 % CI −0·3, 0·3) or vegetables (0·0 portions, 95 % CI −0·2, 0·3) consumed daily by children. Intake of fruit and vegetables at school and home dropped by ∼100 g/d and 50 g/d, respectively, between baseline and follow-up in both the intervention and control groups. Conclusions Implementation of the intervention was low, with associated lack of impact on fruit and vegetable consumption in children. Alternatives to the delivery of an intervention by teachers and parents are needed to improve the dietary intake of primary-school children