A feasibility study to test a novel approach to dietary weight loss with a focus on assisting informed decision making in food selection

• Published in: PloS one 2022-05, Vol.17 (5), p.e0267876
• Main Authors: Lee, Mindy H, Applegate, Catherine C, Shaffer, Annabelle L, Emamaddin, Abrar, Erdman, Jr, John W, Nakamura, Manabu T
• Format: Article
• Language: English
• Subjects: Biology and Life Sciences; Body Mass Index; Body weight loss; Calories; Chronic illnesses; Computer and Information Sciences; Decision Making; Density; Diet; Diet, Reducing; Dietary Fiber; Educational aspects; Energy; Energy Intake; Feasibility Studies; Feedback; Female; Food habits; Food Preferences; Food selection; Gastrointestinal surgery; Health aspects; Humans; Intervention; Maintenance; Medicine and Health Sciences; Methods; Nutrition research; Obesity; Overweight; Physical Sciences; Proteins; Recipes; Surgical outcomes; Surveys; Sustainability; Weight control; Weight Loss; Weight loss maintenance
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0267876

Obesity is a significant contributor to the development of chronic diseases, some of which can be prevented or reversed by weight loss. However, dietary weight loss programs have shortcomings in the success rate, magnitude, or sustainability of weight loss. The Individualized Diet Improvement Program's (iDip) objective was to test the feasibility of a novel approach that helps individuals self-select a sustainable diet for weight loss and maintenance instead of providing weight loss products or rigid diet instructions to follow. The iDip study consisted of 22 dietary improvement sessions over 12 months with six months of follow-up. Daily weights were collected, and a chart summarizing progress was provided weekly. Six 24-hour dietary records were collected, and dietary feedback was provided in the form of a protein-fiber plot, in which protein/energy and fiber/energy of foods were plotted two-dimensionally together with a target box specific to weight loss or maintenance. An exit survey was conducted at 12 months. Twelve (nine female, 46.3±3.1 years (mean±SE)) of the initial 14 participants (BMI>28 kg/m2) completed all sessions. Mean percent weight loss (n = 12) at six and 12 months was -4.9%±1.1 (p = 0.001) and -5.4%±1.7 (p = 0.007), respectively. Weight loss varied among individuals at 12 months; top and bottom halves (n = 6 each) achieved -9.7%±1.7 (p = 0.0008) and -1.0%±1.4 weight loss, respectively. The 24-hour records showed a significant increase in protein density from baseline to final (4.1g/100kcal±0.3 vs. 5.7g/100kcal±0.5; p = 0.008). Although mean fiber density showed no significant change from the first month (1.3g/100kcal±0.1), the top half had significantly higher fiber/energy intake than the bottom half group. The survey suggested that all participants valued the program and its self-guided diet approach. In conclusion, half of the participants successfully lost >5% and maintained the lost weight for 12 months without strict diet instructions, showing the feasibility of the informed decision-making approach.