Weight Reduction Through a Digital Nutrition and Food Purchasing Platform Among Users With Obesity: Longitudinal Study
Weight Reduction Through a Digital Nutrition and Food Purchasing Platform Among Users With Obesity: Longitudinal Study
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DOI：
10.2196/19634
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发表时间：
2020-09-02
影响因子：
7.4
通讯作者：
Shurney, Dexter
中科院分区：
文献类型：
--
作者：
Hu, Emily A.;Nguyen, Viet;Shurney, Dexter
背景：监测或提供饮食建议的数字营养应用程序已被发现对肥胖者的行为改变和减肥有效。然而，关于个性化营养建议的整合以及通过在线膳食计划和杂货配送、膳食包和杂货激励来改变食品购买环境如何影响肥胖个体的减肥的证据较少。目的：本观察性纵向研究的目的是检查肥胖个体的体重减轻和体重减轻的预测因素，这些肥胖个体是数字营养平台的用户，该平台集成了基于行为理论的营养建议和食品购买环境变化的工具。方法：我们纳入了2013年1月至2020年4月期间使用Zipongo， Inc .， DBA Foodsmart数字Foodsmart平台的8977名肥胖成年人。我们回顾性分析了用户特征及其与减肥的关系。参与者报告了年龄、性别、身高、至少两项体重和日常饮食摄入量。健康饮食评分是一个衡量整体饮食质量的评分，是根据对食物频率调查问卷的回答计算出来的。我们使用配对t检验来比较基线和最终体重以及基线和最终健康饮食评分的差异。我们使用单变量和多变量logistic回归模型，根据性别、年龄、基线BMI、健康饮食评分、健康饮食评分变化和入组时间估算体重减轻5%的比值比和95% CI。我们进行了分层分析，以检查按入组时间、性别、年龄、基线BMI和健康饮食评分变化的平均体重变化百分比。结果：在入组的中位（IQR）为9.9（0.03-54.7）个月期间，59%的参与者体重减轻。在使用Foodsmart平台至少24个月的参与者中，33.3%的人体重减轻了5%。在完全调整后的logistic回归模型中，我们发现基线BMI (OR 1.02, 95% CI 1.02-1.03
Background: Digital nutrition apps that monitor or provide recommendations on diet have been found to be effective in behavior change and weight reduction among individuals with obesity. However, there is less evidence on how integration of personalized nutrition recommendations and changing the food purchasing environment through online meal planning and grocery delivery, meal kits, and grocery incentives impacts weight loss among individuals with obesity.Objective: The objective of this observational longitudinal study was to examine weight loss and predictors of weight loss among individuals with obesity who are users of a digital nutrition platform that integrates tools to provide nutrition recommendations and changes in the food purchasing environment grounded in behavioral theory.Methods: We included 8977 adults with obesity who used the digital Foodsmart platform, created by Zipongo, Inc, DBA Foodsmart between January 2013 and April 2020. We retrospectively analyzed user characteristics and their associations with weight loss. Participants reported age, gender, height, at least 2 measures of weight, and usual dietary intake. Healthy Diet Score, a score to measure overall diet quality, was calculated based on responses to a food frequency questionnaire. We used paired t tests to compare differences in baseline and final weights and baseline and final Healthy Diet Scores. We used univariate and multivariate logistic regression models to estimate odds ratios and 95% CI of achieving 5% weight loss by gender, age, baseline BMI, Healthy Diet Score, change in Healthy Diet Score, and duration of enrollment. We conducted stratified analyses to examine mean percent weight change by enrollment duration and gender, age, baseline BMI, and change in Healthy Diet Score.Results: Over a median (IQR) of 9.9 (0.03-54.7) months of enrollment, 59% of participants lost weight. Of the participants who used the Foodsmart platform for at least 24 months, 33.3% achieved 5% weight loss. In the fully adjusted logistic regression model, we found that baseline BMI (OR 1.02, 95% CI 1.02-1.03; P