Validation of Anthropometric Measures Self-Reported in a Randomized Controlled Trial of a Web-Based Platform for Weight Loss

Racial disparities in lifestyle habits and dietary patterns in university students during the COVID-19 pandemic

Objectives

To evaluate lifestyle habits and dietary patterns among university students during the COVID-19 pandemic and their association with skin color.

Methods

This cross-sectional study was conducted with 1315 undergraduate students from a public higher education institution. Sociodemographic characteristics, lifestyle habits, and food consumption were collected. Factor analysis was used to identify dietary patterns and multivariate logistic regression was conducted to estimate the associations between race/skin color and outcomes.

Results

Black individuals were less likely to show behaviors associated with the use of cigarettes or tobacco products (OR = 0.61; 95% CI 0.42-0.89). However, black individuals with higher income (greater than, or equal to one minimum wage per person) were less likely to show behaviors associated with illicit drug use (OR = 0.54; 95% CI 0.31-0.96), use of cigarettes or tobacco products (OR = 0.46; 95% CI 0.24-0.87) and alcohol consumption (OR = 0.64; CI 95% 0.42-0.98). In addition, individuals of race/skin color black with lower income (less than one minimum wage per person) showed decreased consumption of vegetables (OR = 0.68; CI 95% 0.48-0.96).

Conclusions

Black college students with higher income were less likely to show undesirable behaviors related to the use of psychoactive substances. In contrast, individuals with lower income had lower consumption of foods from the vegetable group, which can be considered an unfavorable health-related behavior.

Anthropometric assessment in ambulatory nutrition amid the COVID-19 pandemic: Possibilities for the remote and in-person care

Background and aims

The COVID-19 pandemic has caused many changes in the nutritional care process as a result of the social distancing measures imposed, especially in the assessment of nutritional status, in which obtaining anthropometric measures is necessary.

Methods

Critical review of the international anthropometry literature, in the light of the recent scientific evidence of COVID-19.

Results

This paper presents recommendations for anthropometric assessment of the nutritional status of people in ambulatory settings for both remote and in-person assessment. The most appropriate measures to the current pandemic scenario are also discussed, in order to contribute to the monitoring of nutritional status and to minimize health impacts.results

Conclusion

When sanitary conditions cannot be guaranteed during in-person encounters or when the person cannot attend the office of the professional, the remote anthropometric assessment can be a useful strategy to nutritional surveillance.conclusions

Personalized Web-Based Weight Loss Behavior Change Program With and Without Dietitian Online Coaching for Adults With Overweight and Obesity: Randomized Controlled Trial

Background

The effect of computer- or human-delivered personalized feedback on the effectivess of web-based behavior change platforms for weight loss is unclear.

Objective

We aimed to compare the effectiveness of a web-based behavior change intervention personalized through either computerized or human-delivered feedback with a nonpersonalized intervention in promoting weight loss in community-based adults with overweight or obesity.

Methods

This pragmatic, 3-group, parallel-arm, randomized trial recruited students and staff in a Brazilian public university who were aged 18 to 60 years, had a BMI of ≥25 kg/m², and were not pregnant. Participants were allocated to one of 3 groups: platform only (24-week behavior change program delivered using a web platform with personalized computer-delivered feedback), platform plus coaching (same 24-week web-based behavior change program plus 12 weeks of personalized feedback delivered online by a dietitian), or waiting list (nonpersonalized dietary and physical activity recommendations delivered through an e-booklet and videos). Self-reported weight at 24 weeks was the primary outcome. Changes in dietary and physical activity habits within 24 weeks were secondary outcomes.

Results

Among the 1298 participants, 375 (28.89%) were lost to follow-up. In the intention-to-treat analysis, the platform-only and platform plus coaching groups had greater mean weight loss than the waiting-list group at 24 weeks (–1.08 kg, 95% CI –1.41 to –0.75 vs –1.57 kg, 95% CI –1.92 to –1.22 vs –0.66 kg, 95% CI –0.98 to –0.34, respectively). The platform-only and platform plus coaching groups, compared with the waiting list group, had a greater increase in the consumption of vegetables (3%, 95% CI 1% to 6% vs 5%, 95% CI 2% to 8% vs –3%, 95% CI –5% to 0%) and fruits (9%, 95% CI 6% to 12% vs 6%, 95% CI 2% to 9% vs 2%, 95% CI 0% to 6%) and a larger reduction in ultraprocessed food intake (–18%, 95% CI –23% to –13% vs –25%, 95% CI –30% to –20% vs –12%, 95% CI –16% to –8%). Changes in physical activity did not differ across the groups. Engagement was higher in the platform plus coaching group than in the platform-only group (7.6 vs 5.2 completed sessions; P=.007). Longer usage of the platform was associated with clinically meaningful (≥5%) weight loss (odds ratio 1.02, 95% CI 1.01 to 1.04).

Conclusions

The web-based behavior change programs with computer- and human-delivered personalized feedback led to greater, albeit small-magnitude, weight loss within 24 weeks. Improvement in multiple dietary habits, but not physical activity, were also greater in the personalized programs compared with the nonpersonalized one. The human-delivered personalized feedback by the online dietitian coach increased user engagement with the program and was associated with a significantly higher chance of clinically meaningful weight loss.

Trial Registration

ClinicalTrials.gov NCT03435445; https://clinicaltrials.gov/ct2/show/NCT03435445

International Registered Report Identifier (IRRID)

RR2-10.2196/10.1186/s12889-018-5882-y