Understanding the Relationship between Food Variety, Food Intake, and Energy Balance

Purpose of Review: In accordance with US dietary guidance, incorporating variety into the diet can align with energy balance, though greater food variety in some categories may make energy balance more challenging. Thus, experimental and epidemiologic evidence is summarized on the relationship between food variety, food and energy intake, and energy balance. Recent Findings: Lab-based, experimental research consistently demonstrates that greater variety within foods or sensory characteristics of food increases food and energy intake within an eating occasion. Epidemiologic evidence is less consistent, potentially driven by differing methodologies, particularly in defining and measuring food variety. Moreover, the effect of variety on energy balance appears to be moderated by food energy density. Summary Integrating insights from experimental and epidemiologic research are essential for strengthening food variety guidance including developing evidence-based definitions of food variety, understanding moderators of the relationship, and developing practical guidance interpretable to consumers

Are Changes in Consumption of “Healthy” Foods Related to Changes in Consumption of “Unhealthy” Foods During Pediatric Obesity Treatment?

Increasing fruits and vegetables (FVs), a dietary recommendation for pediatric weight management, is theorized to reduce energy intake by reducing intake of more energy-dense foods, such as snack foods (SFs). This study examined the relationship between changes in FV, SF, and energy intake in children enrolled in a 6-month, family-based behavioral pediatric weight management trial. Secondary data analyses examined dietary intake in 80 overweight (≥85th to <95th percentile for body mass index [BMI]) and obese (≥95th percentile for BMI) children (7.2 ± 1.7 years) with complete dietary records at 0 and 6 months. Participants were randomized to one of three treatment conditions: (1) increased growth monitoring with feedback; (2) decrease SFs and sugar sweetened beverages; or (3) increase FVs and low-fat dairy. With treatment condition controlled in all analyses, FV intake significantly increased, while SF and energy intake decreased, but not significantly, from 0 to 6 months. Change in FV intake was not significantly associated with change in SF consumption. Additionally, change in FV intake was not significantly related to change in energy intake. However, reduction in SF intake was significantly related to reduction in energy intake. Changing only FVs, as compared to changing other dietary behaviors, during a pediatric obesity intervention may not assist with reducing energy intake

Using Explainable Artificial Intelligence to Discover Interactions in an Ecological Model for Obesity

Ecological theories suggest that environmental, social, and individual factors interact to cause obesity. Yet, many analytic techniques, such as multilevel modeling, require manual specification of interacting factors, making them inept in their ability to search for interactions. This paper shows evidence that an explainable artificial intelligence approach, commonly employed in genomics research, can address this problem. The method entails using random intersection trees to decode interactions learned by random forest models. Here, this approach is used to extract interactions between features of a multi-level environment from random forest models of waist-to-height ratios using 11,112 participants from the Adolescent Brain Cognitive Development study. This study shows that methods used to discover interactions between genes can also discover interacting features of the environment that impact obesity. This new approach to modeling ecosystems may help shine a spotlight on combinations of environmental features that are important to obesity, as well as other health outcomes

A Self-Regulation Program for Maintenance of Weight Loss

BACKGROUND Since many successful dieters regain the weight they lose, programs that teach maintenance skills are needed. We developed a maintenance program based on self-regulation theory and tested the efficacy of delivering the program face to face or over the Internet. METHODS We randomly assigned 314 participants who had lost a mean of 19.3 kg of body weight in the previous 2 years to one of three groups: a control group, which received quarterly newsletters (105 participants), a group that received face-to-face intervention (105), and a group that received Internet-based intervention (104). The content of the programs in the two intervention groups was the same, emphasizing daily self-weighing and self-regulation, as was the frequency of contact with the groups. The primary outcome was weight gain over a period of 18 months. RESULTS The mean (±SD) weight gain was 2.5±6.7 kg in the face-to-face group, 4.7±8.6 kg in the Internet group, and 4.9±6.5 kg in the control group, with a significant difference between the face-to-face group and the control group (2.4 kg; 95% confidence interval [CI], 0.002 to 10.8; P=0.05). The proportion of participants who regained 2.3 kg or more over the 18-month period was significantly higher in the control group (72.4%) than in the face-to-face group (45.7%; absolute difference, 27%; 95% CI, 14 to 39; P<0.001) or the Internet group (54.8%; absolute difference, 18%; 95% CI, 5 to 30; P=0.008). Daily self-weighing increased in both intervention groups and was associated with a decreased risk of regaining 2.3 kg or more (P<0.001). CONCLUSIONS As compared with receiving quarterly newsletters, a self-regulation program based on daily weighing improved maintenance of weight loss, particularly when delivered face to face

Home grocery delivery improves the household food environments of behavioral weight loss participants: Results of an 8-week pilot study

<p>Abstract</p> <p>Background</p> <p>Household food availability is consistently linked to dietary intake; yet behavioral weight control treatment includes only minimal instruction on how to change the home environment to support dietary goals. This pilot study examined whether it is feasible to change the household food environments of behavioral weight loss participants through the use of a commercially available grocery home delivery service.</p> <p>Methods</p> <p>Overweight participants (N = 28; BMI = 31.7 ± 3.6 kg/m²; 89.3% women, 47.9 ± 9.5 years) were randomly assigned to 8-weeks of standard behavioral weight loss (SBT) or to SBT plus home food delivery (SBT+Home). SBT+Home participants were instructed to do their household grocery shopping via an online service affiliated with a regional supermarket chain and were reimbursed for delivery charges.</p> <p>Results</p> <p>Compared to SBT, SBT+Home produced significantly greater reductions in the total number of foods in the home (p = .01) and number of foods that were high in fat (p = .002). While the groups did not differ in 8-week weight losses, within SBT+Home there was a trend for the number of home deliveries to be associated with weight loss (p = .08). Participants reported that the home delivery service was easy to use and that it helped decrease impulse purchases and lead to healthier choices; however, few planned to continue using the service after the study.</p> <p>Conclusion</p> <p>Encouraging weight loss participants to use a commercially available online grocery ordering and home delivery service reduces the overall number of food items in the home and decreases access to high-fat food choices. More research is needed to determine whether this is a viable strategy to strengthen stimulus control and improve weight loss outcomes.</p

A Review of Different Behavior Modification Strategies Designed to Reduce Sedentary Screen Behaviors in Children

Previous research suggests that reducing sedentary screen behaviors may be a strategy for preventing and treating obesity in children. This systematic review describes strategies used in interventions designed to either solely target sedentary screen behaviors or multiple health behaviors, including sedentary screen behaviors. Eighteen studies were included in this paper; eight targeting sedentary screen behaviors only, and ten targeting multiple health behaviors. All studies used behavior modification strategies for reducing sedentary screen behaviors in children (aged 1–12 years). Nine studies only used behavior modification strategies, and nine studies supplemented behavior modification strategies with an electronic device to enhance sedentary screen behaviors reductions. Many interventions (50%) significantly reduced sedentary screen behaviors; however the magnitude of the significant reductions varied greatly (−0.44 to −3.1 h/day) and may have been influenced by the primary focus of the intervention, number of behavior modification strategies used, and other tools used to limit sedentary screen behaviors

The Relationship between Physical Activity Variety and Objectively Measured Moderate-to-Vigorous Physical Activity Levels in Weight Loss Maintainers and Normal-Weight Individuals

Given the importance of physical activity (PA) for weight control, identifying strategies to achieve higher PA levels is imperative. We hypothesized that performing a greater variety of self-reported moderate-to-vigorous activities (MVPAs) would relate to higher objectively measured MVPA minutes in two groups who were successfully maintaining their body weight: weight loss maintainers (WLM/n = 226) and normal-weight individuals (NW/n = 169). The Paffenbarger Questionnaire and RT3 accelerometer were used to determine variety/number of different MVPAs performed and MVPA minutes, respectively. The variety/number of different activities performed by WLM and NW was similar (1.8 ± 1.2 versus 1.7 ± 1.2, P = 0.52). Regression analyses showed that greater variety (P < 0.01) and WLM status (P < 0.05) were each positively related to greater MVPA minutes/day and meeting the ≥250 MVPA minutes/week guideline for long-term weight maintenance. The association between greater variety and higher MVPA was similar in NW and WLM. Future studies should test whether variety can facilitate engagement in higher MVPA levels for more effective weight control