Ana M Palacios, Alexandra M Lee, Chelsie Parker, Cullun Q Watts, Stephanie L Dickinson, Beate Henschel, Grace Anderson, Jing X Kersey, David B Allison, Gary D Foster, Michelle I Cardel
{"title":"数字体重管理程序对饮食质量的有效性：一项随机对照试验。","authors":"Ana M Palacios, Alexandra M Lee, Chelsie Parker, Cullun Q Watts, Stephanie L Dickinson, Beate Henschel, Grace Anderson, Jing X Kersey, David B Allison, Gary D Foster, Michelle I Cardel","doi":"10.1016/j.ajcnut.2025.06.024","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The effect of behavioral commercial weight programs (CP) on weight loss is clear, yet their effects on diet quality are less studied.</p><p><strong>Objectives: </strong>This study aims to evaluate the relative effectiveness of a digital CP on diet quality compared with standard nutritional guidance (SNG) over 6 mo.</p><p><strong>Methods: </strong>This randomized controlled trial (clinicaltrials.gov/NCT05648344) included 376 United States adults with a body mass index of 27-45 kg/m<sup>2</sup> and a self-reported desire to lose weight. Participants were randomly assigned to a 6-mo digital, behavioral CP (WeightWatchers) (n = 187) or to SNG (n = 189). SNG participants received a monthly email with information from the United States Department of Agriculture MyPlate.gov. The primary outcome was the between-group, 6-mo difference in diet quality (Healthy-Eating Index, HEI-2020) calculated from 3 24-h dietary recalls gathered with the Automated Self-Administered 24-h Dietary Assessment Tool. Secondary outcomes included percent weight loss and weight-loss milestones of 3%, 5%, and 10%. Intention-to-treat, 6-mo differences between CP and SNG were compared with analysis of covariance or logistic regressions with multiple imputation adjusted for sex, age, race, ethnicity, education, and baseline values.</p><p><strong>Results: </strong>Participant's mean age was 47.7 y (standard deviation = 12); 65.7% self-identified as non-Hispanic White, 20.7% as male, and 17.8% experienced food insecurity. Improvements in mean HEI were significantly greater with CP, 5.3 (standard error = 1.5), than SNG, 1.1 (1.4); between-group mean difference 4.2 (1.2); 95% confidence interval (CI): 1.8, 6.6. CP participants lost significantly more % body weight, -5.4% (0.9), than SNG participants, -1.5% (0.8); mean difference -3.9% (0.7); 95% CI: -5.4, -2.5. Odds ratios for achieving 3%, 5%, and 10% weight loss for CP compared with SNG participants were 2.7 (95% CI: 1.7, 4.2), 3.3 (95% CI: 2.1, 5.4), and 7.1 (95% CI: 3.2, 15.8), respectively.</p><p><strong>Conclusions: </strong>A CP was significantly more effective than SNG for improving diet quality and weight loss among a diverse sample of adults living with overweight or obesity in the United States.</p><p><strong>Trial registration number: </strong>https://clinicaltrials.gov/study/NCT05648344.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of a digital weight management program on diet quality: a randomized controlled trial.\",\"authors\":\"Ana M Palacios, Alexandra M Lee, Chelsie Parker, Cullun Q Watts, Stephanie L Dickinson, Beate Henschel, Grace Anderson, Jing X Kersey, David B Allison, Gary D Foster, Michelle I Cardel\",\"doi\":\"10.1016/j.ajcnut.2025.06.024\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The effect of behavioral commercial weight programs (CP) on weight loss is clear, yet their effects on diet quality are less studied.</p><p><strong>Objectives: </strong>This study aims to evaluate the relative effectiveness of a digital CP on diet quality compared with standard nutritional guidance (SNG) over 6 mo.</p><p><strong>Methods: </strong>This randomized controlled trial (clinicaltrials.gov/NCT05648344) included 376 United States adults with a body mass index of 27-45 kg/m<sup>2</sup> and a self-reported desire to lose weight. Participants were randomly assigned to a 6-mo digital, behavioral CP (WeightWatchers) (n = 187) or to SNG (n = 189). SNG participants received a monthly email with information from the United States Department of Agriculture MyPlate.gov. The primary outcome was the between-group, 6-mo difference in diet quality (Healthy-Eating Index, HEI-2020) calculated from 3 24-h dietary recalls gathered with the Automated Self-Administered 24-h Dietary Assessment Tool. Secondary outcomes included percent weight loss and weight-loss milestones of 3%, 5%, and 10%. Intention-to-treat, 6-mo differences between CP and SNG were compared with analysis of covariance or logistic regressions with multiple imputation adjusted for sex, age, race, ethnicity, education, and baseline values.</p><p><strong>Results: </strong>Participant's mean age was 47.7 y (standard deviation = 12); 65.7% self-identified as non-Hispanic White, 20.7% as male, and 17.8% experienced food insecurity. Improvements in mean HEI were significantly greater with CP, 5.3 (standard error = 1.5), than SNG, 1.1 (1.4); between-group mean difference 4.2 (1.2); 95% confidence interval (CI): 1.8, 6.6. CP participants lost significantly more % body weight, -5.4% (0.9), than SNG participants, -1.5% (0.8); mean difference -3.9% (0.7); 95% CI: -5.4, -2.5. 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Effectiveness of a digital weight management program on diet quality: a randomized controlled trial.
Background: The effect of behavioral commercial weight programs (CP) on weight loss is clear, yet their effects on diet quality are less studied.
Objectives: This study aims to evaluate the relative effectiveness of a digital CP on diet quality compared with standard nutritional guidance (SNG) over 6 mo.
Methods: This randomized controlled trial (clinicaltrials.gov/NCT05648344) included 376 United States adults with a body mass index of 27-45 kg/m2 and a self-reported desire to lose weight. Participants were randomly assigned to a 6-mo digital, behavioral CP (WeightWatchers) (n = 187) or to SNG (n = 189). SNG participants received a monthly email with information from the United States Department of Agriculture MyPlate.gov. The primary outcome was the between-group, 6-mo difference in diet quality (Healthy-Eating Index, HEI-2020) calculated from 3 24-h dietary recalls gathered with the Automated Self-Administered 24-h Dietary Assessment Tool. Secondary outcomes included percent weight loss and weight-loss milestones of 3%, 5%, and 10%. Intention-to-treat, 6-mo differences between CP and SNG were compared with analysis of covariance or logistic regressions with multiple imputation adjusted for sex, age, race, ethnicity, education, and baseline values.
Results: Participant's mean age was 47.7 y (standard deviation = 12); 65.7% self-identified as non-Hispanic White, 20.7% as male, and 17.8% experienced food insecurity. Improvements in mean HEI were significantly greater with CP, 5.3 (standard error = 1.5), than SNG, 1.1 (1.4); between-group mean difference 4.2 (1.2); 95% confidence interval (CI): 1.8, 6.6. CP participants lost significantly more % body weight, -5.4% (0.9), than SNG participants, -1.5% (0.8); mean difference -3.9% (0.7); 95% CI: -5.4, -2.5. Odds ratios for achieving 3%, 5%, and 10% weight loss for CP compared with SNG participants were 2.7 (95% CI: 1.7, 4.2), 3.3 (95% CI: 2.1, 5.4), and 7.1 (95% CI: 3.2, 15.8), respectively.
Conclusions: A CP was significantly more effective than SNG for improving diet quality and weight loss among a diverse sample of adults living with overweight or obesity in the United States.
期刊介绍：
American Journal of Clinical Nutrition is recognized as the most highly rated peer-reviewed, primary research journal in nutrition and dietetics.It focuses on publishing the latest research on various topics in nutrition, including but not limited to obesity, vitamins and minerals, nutrition and disease, and energy metabolism.
Purpose:
The purpose of AJCN is to:
Publish original research studies relevant to human and clinical nutrition.
Consider well-controlled clinical studies describing scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention or health benefits.
Encourage public health and epidemiologic studies relevant to human nutrition.
Promote innovative investigations of nutritional questions employing epigenetic, genomic, proteomic, and metabolomic approaches.
Include solicited editorials, book reviews, solicited or unsolicited review articles, invited controversy position papers, and letters to the Editor related to prior AJCN articles.
Peer Review Process:
All submitted material with scientific content undergoes peer review by the Editors or their designees before acceptance for publication.
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