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Dietary Intervention and Lifestyle Modification in the Management of Obesity: Progresses and Challenges

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Policies and Education for Health Promotion".

Deadline for manuscript submissions: closed (1 November 2021) | Viewed by 18489

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Dr. Riccardo Dalle Grave

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Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Italy
Interests: eating disorders; obesity; nutrition; cognitive behavior therapy; lifestyle modification; digital treatment; weight loss drugs
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Dear Colleagues,

Lifestyle modification, combining diet, physical activity, and behavior therapy, is the foundation of weight loss management. However, treatment of obesity based on lifestyle modification is afflicted by two main problems. The first is that many people with obesity cannot receive this evidence-based treatment due to the lack of therapists trained in this approach. The second is that although the lifestyle modification treatment of obesity provides good and healthy weight loss in the short term, it is plagued by unsatisfactory long-term weight maintenance.

To address the first problem, the use of digital technology may offer a practical and reliable means to deliver lifestyle modification a very large number of people that do not have the possibility to participate in face-to-face treatment—a problem that has been enhanced by the recent COVID-19 pandemic.

To address the second problem, the use of diets differing in nutrient contents along with specific procedures to address the cognitive processes implicated in dietary intake, weight regain, and/or new weight loss drugs have, in conjunction with weight loss lifestyle modification treatment, the potential to improve the long-term outcome of obesity management.

The purpose of this Special Issue is to provide an update on the latest evidence regarding weight loss lifestyle modification and dietary interventions. Particularly, papers (reviews and clinical or experimental studies) dealing with the use of digital technology, specific dietary interventions, and innovative cognitive and behavior procedures toward improving dietary intake and the outcome of obesity treatment will be included.

Dr. Riccardo Dalle Grave
Guest Editor

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Keywords

Obesity
Lifestyle modification
Weight loss
Weight maintenance
Treatment
Digital treatment
Cognitive behavioral therapy

Published Papers (4 papers)

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Research

19 pages, 4375 KiB

Open AccessArticle

Analysis of Eating Habits and Body Composition of Young Adult Poles

by Anna K. Mazurek-Kusiak, Agata Kobyłka, Natalia Korcz and Małgorzata Sosnowska

Nutrients 2021, 13(11), 4083; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13114083 - 15 Nov 2021

Cited by 5 | Viewed by 4247

Abstract

Background: Obesity and overweight affect a large proportion of the world’s population. Increasingly, this problem can be observed among young adults. The aim of the study was to identify the motivations and barriers to healthy eating habits among young Poles, the relationship between physical activity and healthy eating and the impact of healthy eating on the body composition of the young. Methods: The method used in the research was a diagnostic survey using direct personal interviews. The research was conducted in the years 2016–2019 on a group of 399 young Poles aged 18–26. Their body composition was analyzed by determining resistance and reactance using the biological impedance method, with a TANITA SC-330ST Body Composition Analyzer. Results and conclusion: The main reasons for healthy eating among young Poles are the intent to follow a doctor’s recommendations, to lose weight and to live a healthy lifestyle and to follow a trend. On the other hand, the largest barriers to proper nutrition are: lack of time to prepare healthy meals and of financial resources, inability to prepare meals and limited knowledge of the principles of healthy eating. The eating behavior varied significantly in relation to the physical activity of the respondents. Active people’s eating habits were the best, and those of sedentary people the worst. Healthy eaters also had normal body composition indicators (adipose tissue level, BMI, body type). Young adults should be educated on the principles of healthy eating and have access to healthy food in canteens and vending machines, both at work and at university. Full article

(This article belongs to the Special Issue Dietary Intervention and Lifestyle Modification in the Management of Obesity: Progresses and Challenges)

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16 pages, 554 KiB

Open AccessArticle

Application of Clinical Decision Support System to Assist Breast Cancer Patients with Lifestyle Modifications during the COVID-19 Pandemic: A Randomised Controlled Trial

by Panos Papandreou, Aristea Gioxari, Frantzeska Nimee and Maria Skouroliakou

Nutrients 2021, 13(6), 2115; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13062115 - 20 Jun 2021

Cited by 17 | Viewed by 4438

Abstract

Clinical decision support systems (CDSS) are data aggregation tools based on computer technology that assist clinicians to promote healthy weight management and prevention of cardiovascular diseases. We carried out a randomised controlled 3-month trial to implement lifestyle modifications in breast cancer (BC) patients by means of CDSS during the COVID-19 pandemic. In total, 55 BC women at stages I-IIIA were enrolled. They were randomly assigned either to Control group, receiving general lifestyle advice (n = 28) or the CDSS group (n = 27), to whom the CDSS provided personalised dietary plans based on the Mediterranean diet (MD) together with physical activity guidelines. Food data, anthropometry, blood markers and quality of life were evaluated. At 3 months, higher adherence to MD was recorded in the CDSS group, accompanied by lower body weight (kg) and body fat mass percentage compared to control (p < 0.001). In the CDSS arm, global health/quality of life was significantly improved at the trial endpoint (p < 0.05). Fasting blood glucose and lipid levels (i.e., cholesterol, LDL, triacylglycerols) of the CDSS arm remained unchanged (p > 0.05) but were elevated in the control arm at 3 months (p < 0.05). In conclusion, CDSS could be a promising tool to assist BC patients with lifestyle modifications during the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Dietary Intervention and Lifestyle Modification in the Management of Obesity: Progresses and Challenges)

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14 pages, 2268 KiB

Open AccessArticle

The Impact of COVID-19 Lockdown on Patients with Obesity after Intensive Cognitive Behavioral Therapy—A Case-Control Study

by Simona Calugi, Beatrice Andreoli, Laura Dametti, Anna Dalle Grave, Nicole Morandini and Riccardo Dalle Grave

Nutrients 2021, 13(6), 2021; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13062021 - 11 Jun 2021

Cited by 2 | Viewed by 3591

Abstract

Background: The COVID-19 lockdown may have negatively impacted the treatment of obesity. This study aimed to assess the effect of COVID-19 lockdown in patients with obesity treated with intensive residential cognitive behavioral therapy (CBT-OB). Methods: This retrospective case-control study analyzed 129 patients with severe obesity who experienced COVID-19 lockdown in the 6 months after discharge from intensive residential CBT-OB, comparing their outcomes on weight loss, binge-eating episodes, and general health status with those in a sample of patients matched by gender, age, and body mass index given the same treatment before the COVID-19 outbreak as control. Patients were assessed at baseline and by phone interview 6-month follow-up. Results: Both groups had lost more than 9% of their baseline bodyweight and reported a significant decrease in binge-eating episodes and similar general health status at 6-month follow-up. However, control patients achieved a significantly greater weight loss than those who experienced lockdown, although half of lockdown patients reported persisting with CBT-OB procedures after their discharge. Conclusion: Patients with obesity treated with CBT-OB and exposed to COVID-19 lockdown, despite achieving lower weight loss than non-exposed patients, had a healthy weight loss at 6-month follow-up and comparable reduction in binge-eating behaviors. Full article

(This article belongs to the Special Issue Dietary Intervention and Lifestyle Modification in the Management of Obesity: Progresses and Challenges)

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15 pages, 290 KiB

Open AccessArticle

Self-Reported Nutritional Factors Are Associated with Weight Loss at 18 Months in a Self-Managed Commercial Program with Food Categorization System: Observational Study

by Ellen S. Mitchell, Qiuchen Yang, Annabell S. Ho, Heather Behr, Christine N. May, Laura DeLuca and Andreas Michaelides

Nutrients 2021, 13(5), 1733; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13051733 - 20 May 2021

Cited by 8 | Viewed by 4881

Abstract

Little is known about nutritional factors during weight loss on digital commercial weight loss programs. We examined how nutritional factors relate to weight loss for individuals after 4 and 18 months on a mobile commercial program with a food categorization system based on energy density (Noom). This is a two-part (retrospective and cross-sectional) cohort study. Two time points were used for analysis: 4 months and 18 months. For 4-month analyses, current Noom users who met inclusion criteria (n = 9880) were split into 5% or more body weight loss and stable weight loss (0 ± 1%) groups. Individuals who fell into one of these groups were analyzed at 4 months (n = 3261). For 18-month analyses, individuals from 4-month analyses who were still on Noom 18 months later were invited to take a one-time survey (n = 803). At 18 months 148 participants were analyzed. Noom has a system categorizing foods as low-, medium-, and high-energy-dense. Measures were self-reported proportions of low-, medium-, and high-energy-dense foods, and self-reported nutritional factors (fruit and vegetable intake, dietary quality, nutrition knowledge, and food choice). Nutritional factors were derived from validated survey measures, and food choice from a novel validated computerized task in which participants chose a food they would want to eat right now. ANOVAs compared participants with 5% or more body weight loss and participants with stable weight (0 ± 1%) at 4 months on energy density proportions. Analyses at 18 months compared nutritional factors across participants with >10% (high weight loss), 5–10% (moderate weight loss), and less than 5% body weight loss (low weight loss), and then assessed associations between nutritional factors and weight loss. Individuals with greater weight loss reported consuming higher proportions of low-energy-dense foods and lower proportions of high-energy-dense foods than individuals with less weight loss at 4 months and 18 months (all ps < 0.02). Individuals with greater weight loss had higher fruit and vegetable intake (p = 0.03), dietary quality (p = 0.02), nutrition knowledge (p < 0.001), and healthier food choice (p = 0.003) at 18 months. Only nutrition knowledge and food choice were associated with weight loss at 18 months (B = −19.44, 95% CI: −33.19 to −5.69, p = 0.006; B = −5.49, 95% CI: −8.87 to −2.11, p = 0.002, respectively). Our results highlight the potential influence of nutrition knowledge and food choice in weight loss on a self-managed commercial program. We also found for the first time that in-the-moment inclination towards food even when just depicted is associated with long-term weight loss. Full article

(This article belongs to the Special Issue Dietary Intervention and Lifestyle Modification in the Management of Obesity: Progresses and Challenges)

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