Multiple Behavior Change in Diet and Activity

描述（由申请人提供）：高饱和脂肪饮食，低水果和蔬菜（F/V）摄入量和久坐不动的生活方式是大多数美国成年人的特征，增加了心血管疾病和癌症的风险。改善饮食和活动可以降低风险，但同时促进更健康饮食和更积极生活方式的最佳处方仍然未知。通过比较4组随机进行增加健康与减少不健康饮食和活动的所有组合，这项研究测试了关于如何优化同时健康行为改变的相互竞争的假设。熟悉性假说预测，最熟悉的节食处方（减少脂肪，增加体力活动）将最大限度地改善健康行为。基于行为经济学理论的最优替代假说预测，增加F/V摄入量同时减少久坐行为将通过最大化健康饮食和活动对不健康饮食和活动的行为替代来超越替代品。基于自我控制理论的低抑制需求假说预测，在增加体力活动的同时增加F/V将是最成功的，因为这种处方对自我控制资源的需求最少。生活方式不活跃且饮食不理想的社区居住成年人（n=200）将在以下期间通过PDA自我监测饮食、身体活动和情绪：2周基线期、3周处方期（付款取决于同时改变饮食和活动以达到目标标准）和4个月维持期。有针对性的和间接的饮食和活动变化将通过自我报告，加速计和杂货收据来衡量。假管道尿检将鼓励遵守。实验室测试将测量行为选择，渴望和注意力分配到限制的食物和活动在一个允许的情况下，以阐明介导健康的生活方式改变的行为和心理过程。研究结果将有助于填补临床知识的一个重要空白，即如何优化成人饮食和活动的健康同时变化。

DESCRIPTION (provided by applicant): High saturated fat diet, low fruit and vegetable (F/V) intake, and sedentary lifestyle characterize a majority of adult Americans, heightening risk for cardiovascular disease and cancers. Improved diet and activity can reduce risk, but the best prescription to promote healthier diet and more active lifestyle simultaneously remains unknown. By comparing 4 groups randomized to perform all combinations of increasing healthy versus decreasing unhealthy eating and activity, this research tests competing hypotheses about how to optimize simultaneous health behavior change. The Familiarity Hypothesis predicts that the most familiar dieting prescription (decrease fat, increase physical activity) will maximize healthy behavior change. The Optimal Substitution Hypothesis, based on Behavioral Economic Theory, predicts that increasing F/V intake while decreasing sedentary behavior will surpass alternatives by maximizing behavioral substitution of healthful for unhealthful eating and activity. The Low Inhibitory Demand Hypothesis, based on Self-Control Theory, predicts that increasing F/V's while increasing physical activity will be most successful because this prescription places fewest demands on self-control resources. Community-dwelling adults (n=200) with inactive lifestyle and suboptimal diet will self-monitor diet, physical activity, and mood via PDAs during: a 2- week baseline, a 3-week prescription period (when payment is contingent upon changing eating and activity simultaneously to targeted standards), and a 4-month maintenance period. Targeted and collateral diet and activity changes will be measured by self-report, accelerometer, and grocery receipts. Bogus pipeline urinary testing will encourage adherence. Laboratory testing will measure behavioral choices, craving, and attentional allocation to restricted foods and activities in a permissive context in order to shed light on behavioral and psychological processes that mediate healthy lifestyle change. Findings will help to fill an important gap in clinical knowledge about how to optimize healthy simultaneous change in diet and activity among adults.