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Randomized Controlled Trial
. 2013 Jan;56(1):3-7.
doi: 10.1016/j.ypmed.2012.10.012. Epub 2012 Oct 22.

Fruit and vegetable intake and eating behaviors mediate the effect of a randomized text-message based weight loss program

Gregory J Norman  1 , Julia K Kolodziejczyk, Marc A Adams, Kevin Patrick, Simon J Marshall
Affiliations
Randomized Controlled Trial

Fruit and vegetable intake and eating behaviors mediate the effect of a randomized text-message based weight loss program

Gregory J Norman et al. Prev Med. 2013 Jan.

Abstract

Introduction: We hypothesized that fruit/vegetable intake and eating behaviors mediate the relationship between experimental condition and weight loss in a randomized trial evaluating a text-message based weight loss program.

Methods: Overweight/obese individuals from San Diego, CA (N = 52 with complete data) were randomly assigned in 2007 into one of two groups for four months: 1) the intervention group that received 2-5 weight management text-messages p/day; 2) the usual-care comparison group. Three 24-hour recalls assessed fruit/vegetable intake change and the eating behavior inventory (EBI) measured change in eating behaviors. Regression path models tested intervention mediation.

Results: Direct effects of the intervention were found for change in body weight (b = -3.84, R(2) = 0.074), fruit/vegetable intake (b = 2.00, R(2) = 0.083), and EBI scores (b = 7.15, R(2) = 0.229) (ps < 0.05). The treatment group to weight change path was not statistically significant (b = -0.673, R(2) = 0.208) when fruit/vegetable intake change and EBI score change were specified as intervention mediators in the model. The total indirect effect was 3.17 lb indicating that the indirect paths explained 82.6% of the total effect on weight change.

Discussion: Fruit/vegetable intake and eating behaviors mediated the intervention's effect on weight change. The findings suggest that sending text-messages that promote healthy eating strategies resulted in moderate short-term weight loss.

Trial registration: ClinicalTrials.gov NCT00415870.

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Figures

Figure 1
Figure 1
Path model of the adjusted direct effects of experimental group on weight loss, change in fruit & vegetable intake, and change in eating behaviors. The standard error for each unstandardized coefficient is presented in parentheses. Solid lines are statistically significant at p < .05.
Figure 2
Figure 2
Mediation path model depicting how change in fruit & vegetable intake and change in eating behaviors mediate the relationship between experimental group and weight loss. The standard error for each unstandardized coefficient is presented in parentheses. Solid lines are statistically significant at p < .05.
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