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Title:Dietitian-led programming and creation of a mobile application, MealPlot, to induce sustainable and significant weight losses in obese adults
Author(s):Shaffer, Annabelle
Advisor(s):Nakamura, Manabu T
Contributor(s):Pan, Yuan-Xiang; Hsu-Lumetta, Jennie
Department / Program:Nutritional Sciences
Discipline:Nutritional Sciences
Degree Granting Institution:University of Illinois at Urbana-Champaign
Degree:M.S.
Genre:Thesis
Subject(s):weight loss
mobile application
obesity
nutrition
Abstract:Introduction: National and international rates of overweight and obesity have dramatically risen in recent decades due to changes in the global food landscape. Overweight and obesity are linked to many health problems: cardiovascular disease, hypertension, diabetes, elevated cancer risk, and others. Despite best efforts, a sustainable weight management solution does not exist. Existing programs are high cost, have low success rates, and low sustainability. The Individualized Dietary Improvement Program (iDip) and MealPlot mobile application are two projects aiming to develop a weight management program that leads to sustainable weight losses of greater than 5% initial body weight, contributes to healthful dietary changes, and is lower in cost than previous, similarly successful programs. Methods: iDip was a two-year before and after study design without a control group. It occurred in-person at the University of Illinois Urbana-Champaign from March 2019-2021. Thirty participants from the surrounding community were enrolled and completed 19 in-person dietitian-led education sessions, three individual advising meetings, dietary monitoring via 24- hour dietary records and food frequency questionnaire, body composition and measurements, and daily self-weighing. Dietary records were collected bi-monthly throughout year 1; food frequency questionnaires at baseline, 12 months, 24 months; and body composition, waist and hip circumference at baseline, 6 months, 15 months, and 24 months. Participants received individualized feedback via weekly weight monitoring charts and the novel, protein-fiber food displays. Outcomes were analyzed using mean, Students t-test, and regression analysis. MealPlot was developed in coordination with the University of Illinois Urbana- Champaign Applied Research Institute from January 2020-Present. Strategies from iDip 2, namely protein-fiber food displays, weight charts, health assessment, and communication with advisors, are heavily utilized in the application. MealPlot was developed on a HIPAA-secure server pulling data from the USDA Nutrition Database and the participant’s Wi-Fi scale. Results: At 12 months, 22 participants (73.3% retention, 13 females) remained enrolled. Mean baseline age and body mass index was 49.3 (11.5, SD) years and 37.4 (5.1) kg/m2, respectively. Mean weight loss was -6.5 (8.4)% and mean body mass index change was -2.33 kg/m2. Weight loss primarily occurred in the first six months, and early weight losses were predictive of long-term weight losses. On both the food frequency questionnaires and dietary records, participants significantly increased protein (p<1e-6) and fiber (p<0.001) densities and significantly reduced caloric intake (p<0.01) and intake of non-nutrient dense foods (p<1e-4). iDip 2 had insignificant improvements in weight loss versus iDip 1 and was significantly lower in cost than similarly successful programming. The three core features of MealPlot were developed and internally tested: Meal Planner, One Day Record, and Weight Chart. MealPlot will be incorporated in the EMPOWER programming. Conclusions: iDip lead to clinically significant weight losses in many participants. However, weight losses were highly variable among participants. Dietary improvements were significant but inconsistent among dietary records. Follow-up studies and larger cohorts are needed to identify the sustainability of weight losses and dietary changes. MealPlot’s core features are fully developed and await incorporation into the EMPOWER program. Based on participant feedback, MealPlot will be updated with additional features.
Issue Date:2021-04-26
Type:Thesis
URI:http://hdl.handle.net/2142/110803
Rights Information:2021 ANNABELLE SHAFFER
Date Available in IDEALS:2021-09-17
Date Deposited:2021-05


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