Dissertation
Beyond calorie tracking: evaluating a remotely delivered lifestyle modification intervention using an ad libitum plant-based diet versus a balanced calorie deficit diet
Doctor of Philosophy (Ph.D.), Drexel University
06 Jul 2023
DOI:
https://doi.org/10.17918/00001780
Abstract
Background: Most traditional behavioral weight loss (BT) programs rely on calorie prescriptions and meticulous calorie tracking. By contrast, plant-based diets have demonstrated clinically significant weight loss with ad libitum prescriptions and without calorie tracking. Objective: This pilot randomized controlled trial was the first to compare a remotely delivered BT with a balanced calorie deficit diet (BCDD-BT, the current gold-standard) to BT with an ad libitum whole food plant-based diet (WFPBD-BT) in which participants were instructed to eat until satiation and not track dietary intake. Methods: Adults (N = 55, BMI 27-50 kg/m2) participated in a remotely delivered intervention consisting of 12 weeks of moderate-intensity intervention (web-modules, regular brief coaching calls), followed by low-intensity intervention (monthly calls). Assessments occurred at 6-weeks, 12-weeks (following the moderate-intensity phase), and post-treatment (24-weeks). Results: Weight loss was significant in both conditions (6.0%, SE = .59). Results from multilevel models indicated that WFPBD-BT produced overall greater weight loss than BCDD-BT. Differences were most pronounced when intervention intensity was higher (6-week 5% weight loss attainment: OR = 5.7, p = .02) and attenuated over time (12-week OR = 2.5, p = .14; post-treatment OR = 1.6, p = .44). WFPBD-BT also reduced appetite levels and improved dietary patterns compared to BCDD-BT. Inconsistent with hypotheses, no differences in quality of life or future dietary adherence intentions were observed. Moderation analyses revealed that greater social support facilitated greater weight loss within WFPBD-BT but not BCDD-BT. Mediation analyses indicated that the effects of WFPBD-BT on weight outcomes were partially explained by reduced levels of appetite. Across conditions, coach experience was associated with attrition and weight outcomes. Conclusions: Results suggest that both remotely delivered BCDD-BT and WFPBD-BT are effective, and that WFPBD has potential advantages for weight outcomes, appetite, and healthful patterns of dietary change during more intensive intervention periods.
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Details
- Title
- Beyond calorie tracking
- Creators
- Christina Chwyl
- Contributors
- Evan M. Forman (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- 79 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology); College of Arts and Sciences; Drexel University
- Other Identifier
- 991021212413604721