Think AHEAD (A Healthy Eating And Drinking) Study
A 6-Month Study on Diet and Weight Loss in Overweight Adolescents
Advice to increase water consumption as part of a weight-reducing diet - typically to 8 cups (64 fl oz, ~2 L) per day ("8x8" water recommendation) - is almost ubiquitously recommended by healthcare professionals. Many believe that water promotes weight loss through numerous physiological mechanisms. However, only limited observational data and virtually no experimental data exist regarding the effects of water consumption on body weight. In this study, we propose a randomized controlled pilot study in which two groups of overweight adolescents will receive a standard weight loss regimen, either with (experimental intervention) or without (control intervention) additional advice and support to increase water consumption. We will utilize individual sessions, an innovative text messaging protocol, and motivational telephone calls to promote adherence to the interventions. The purpose of this pilot study is to evaluate feasibility and obtain preliminary efficacy data, to inform design of a future, definitive study.
It is hypothesized that increasing water consumption will improve the efficacy of a standard weight-reducing diet and will lead to decreased consumption of energy-containing beverages, decreased total energy intake, improved diet quality, improved immune status, and improved cardiovascular and diabetes risk factors. This simple behavioral intervention will be feasible and will significantly increase water consumption among participants in the experimental vs. control group.
調査の概要
詳細な説明
This is a 6-month randomized controlled trial. After the initial baseline screening and assessments, 60 overweight adolescents will be randomly assigned (30 subjects per group) to a standard weight-reducing diet with the advice to consume 8 cups of water per day (experimental group) or the same standard weight-reducing diet without additional advice (control group). The interventions will consist of nutrition education and behavioral counseling by a registered dietitian, during individual sessions and telephone calls. Mobile text messaging will be used to reinforce information presented at the individual sessions and thereby foster adherence to dietary advice. Diet prescriptions will differ only in regard to the specificity of recommendations regarding water consumption and physical activity recommendations will not differ between groups. The frequency and content of text messages will be consistent between the experimental and control groups, with the exception that the experimental group will receive an additional phrase with each message to encourage the "8 x8" water recommendation.
A registered dietitian will communicate with each participant one time per month, either during an individual session or by telephone. Individual sessions will include nutrition classes, taste testing, hands-on activities, and opportunities for questions and answers. Text messages will be sent on a daily basis.
Study outcomes will be assessed at baseline and at regular intervals throughout the 6 months of the study.
ANALYSIS PLAN:
The blinding of the randomization will be broken on or after July 28, 2014 and the data will be analyzed according to the following plan. All analyses will follow the intention-to-treat principle, attributing each subject to his or her assigned diet regardless of compliance. Baseline characteristics will be compared between the diet groups using the Fisher exact test for categorical variables and t-test for continuous variables. The 6-month change from baseline in the primary and secondary outcomes will be compared between groups using a general linear model, adjusting for baseline covariates that are potentially correlated with the outcome. These include demographics, socioeconomic status, anthropometrics, physical activity, and beverage consumption. We will further test covariates for potential interaction, i.e., differential effect on outcome in the two trial arms. The null hypothesis is that the 6-month change from baseline will not differ between diet groups.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Massachusetts
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Boston、Massachusetts、アメリカ、02115
- Children's Hospital Boston
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- BMI ≥ 85th percentile for sex and age according to CDC growth charts
- Access to a working telephone and cell phone
- At least one parent willing and able to participate in the intervention with the subject
- Residing in predominately one household (no more than one weekend every two weeks in a secondary household)
- Medical clearance from a primary care provider or treating physician to rule out any major medical illness, disability, or disorder (e.g., liver disease, renal failure, cancer)
Exclusion Criteria:
- Intake of more than 4 cups (250 mL per cup) of water per day
- BMI ≥ 40 kg/m2
- Currently smoking (> 1 cigarette in the past week)
- Major surgery within the previous 6 months
- Does not have a primary care provider
- Physician diagnosis of a major medical illness (e.g. diabetes)
- Previous diagnosis of an eating disorder
- Physical, mental, or cognitive handicaps that prevent participation
- Chronic use of medications that may affect study outcomes (e.g. stimulants or diuretics)
- Another member of the family (first degree relative) or household participating in the study
- A friend, classmate or coworker participating in the study with whom they have contact with one or more times per week
- Girls who are pregnant, planning to become pregnant in the next 6 months, lactating, or within 6 months postpartum
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：独身
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的：Diet + Water
Participants will be counseled to follow a standard weight-reducing diet including consumption of 1) ample vegetables, fruits, and legumes; 2) whole rather than refined grains; and 3) high-quality proteins at most meals and snacks.
Moreover, we will recommend limiting intake of added fats and sugars and avoiding juices and sugar-sweetened beverages (per standard practice).
Participants will also be counseled to increase their water intake to 8 cups per day, consistent with the popular "8 × 8" recommendation (eight 8-oz glasses of water).
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Participants will receive personalized dietary counseling to promote behavior change
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アクティブコンパレータ：Diet
Participants will be counseled on the same standard weight-reducing diet, as described above, with no specific advice regarding water consumption.
Furthermore, no specific dietary recommendations will be provided on altering fluid/beverage intake, other than to decrease calorie-containing beverages as noted above.
When participants ask for a recommendation regarding water intake, they will be advised that drinking plain water is the best way to satisfy thirst and instructed to drink when thirsty.
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Participants will receive personalized dietary counseling to promote behavior change
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
時間枠 |
|---|---|
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Body mass index
時間枠：6 month change
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6 month change
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二次結果の測定
結果測定 |
時間枠 |
|---|---|
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Body fat percentage
時間枠：6 month change
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6 month change
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Body circumferences
時間枠：6 month change
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6 month change
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Urine specific gravity
時間枠：Change throughout 6 months
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Change throughout 6 months
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Hunger, satiety, and palatability ratings
時間枠：6 month change
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6 month change
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Diet quality
時間枠：6 month change
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6 month change
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Satisfaction rating
時間枠：6 months
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6 months
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Immune status
時間枠：6 month change
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6 month change
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Cardiovascular risk factors
時間枠：6 month change
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6 month change
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Diabetes risk factors
時間枠：6 month change
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6 month change
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協力者と研究者
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- X09-11-0587
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