Loaded morning and evening diets result in similar weight loss, with no differences in energy metabolism

Most adults seeking to lose weight overestimate the health of their diet

In a small study, most adults seeking to lose weight overestimated the health of their diet, according to preliminary research presented at the 2022 American Heart Association Scientific Sessions. The meeting, held in person in Chicago and virtually November 5-7, 2022, is A leading global exchange of the latest scientific developments, research, and evidence-based clinical practice updates in the cardiovascular sciences.

“We found that while people generally know that fruits and vegetables are healthy, there may be a disconnect between what researchers and health care professionals consider a healthy, balanced diet compared to what the public believes to be a healthy, balanced diet.” Study author Jessica Cheng, PhD, a postdoctoral research fellow in epidemiology at the Harvard T.H. Chan School of Public Health and General Internal Medicine at Massachusetts General Hospital, both in Boston.

This research was conducted while Dr. Cheng was a Pre-Doctoral/PhD Fellow. Candidate in the Department of Epidemiology at the University of Pittsburgh School of Public Health.

Nearly half of adults in the United States try to lose weight each year, according to the Centers for Disease Control and Prevention, with the majority trying to eat more fruits, vegetables, and salads. Healthy eating is essential for heart, overall health, and longevity. Dietary guidelines from the American Heart Association issued in 2021 advise adults to eat a variety of fruits and vegetables; Choose whole grains instead of refined grains; Choose healthy protein sources. Replace fat-free and low-fat dairy products with full-fat versions; choose lean cuts of meat (for a meat eater); the use of liquid vegetable oils instead of tropical oils and animal fats; Choose processed foods with minimal processing; Limit foods and drinks with added sugar; choose foods with little or no salt; Limit or avoid alcohol.

Researchers evaluated the diets of 116 adults between the ages of 35 and 58 in the greater Pittsburgh, Pennsylvania area, who were trying to lose weight. Study participants met with a dietitian to discuss their nutrition, then tracked everything they ate and drank daily for a year on the Fitbit app. They also weighed themselves daily and wore a Fitbit device to track their physical activity.

The researchers calculated a Healthy Eating Index (HEI) score at the beginning and end of the study based on the types of foods the participants reported eating. Participants were asked to complete a 24-h food retrieval for 2 days at each time point. The HEI Index is a measure of how well a dietary pattern complies with the US government’s Dietary Guidelines for Americans. A score from 0 to 100 is possible, with a higher score indicating a healthy diet. The result depends on the frequency of eating different food components such as fruits, vegetables, whole and refined grains, meat, seafood, sodium, fats, and sugars.

Participants recorded the quality of their diet at the beginning and end to determine their perceived outcome. Their scores were also on a 0-100 scale based on the HEI components. The self-assessment of their diet initially was a “look back” as they scored their diet at the start and end at the end of the study. The difference in the start and end scores was their perceived diet change. A difference of 6 points or less between the researcher’s score in HEI and the participant’s perceived score was considered a ‘good fit’.

At the end of the study, about 1 in 4 participants had good agreement between their perceived diet score and the score assessed by the researcher. The scores of 3 out of 4 participants were weakly in agreement, and most reported a perceived score higher than the HEI score set by the researchers. The mean perceived score was 67.6, and the mean HEI score was 56.4.

When judging the change in diet score over 12 months, only 1 in 10 participants had good agreement between the self-assessed change compared to the change in the researchers’ HEI score. At the end of the study, the participants improved the quality of their diet by about one point based on the score evaluated by the researcher. However, the participants’ self-esteem was a significant improvement of 18 points.

“People trying to lose weight, health professionals helping people with weight loss, or nutrition goals should be aware that there is likely more room for diet improvement than expected,” Cheng said. She suggests providing specific information about areas of their diet that could be improved and how to make healthy and sustainable dietary changes.

“Future studies should examine the effects of helping people close the gap between their perceptions and objective measures of diet quality,” she said.

“Overestimates of the perceived health of eating can lead to weight gain, frustration with not achieving personal weight loss goals or reduced likelihood of adopting healthy eating habits,” said Deepika Ladu, PhD, assistant professor at the College of Applied Health. Science at the University of Illinois, Chicago, and chair of the American Heart Association’s Council on Changing Lifestyle Behaviors to Improve Health Factors. “While misunderstandings of nutritional intake is common among dieters, these findings provide additional support for behavioral counseling interventions that include more frequent contacts with health care professionals, such as dietitians or health coaches, to address gaps in perception and support long-term realistic eating behaviors. health”.

Among the study’s limitations is that participants were predominantly female (79%) and the majority reported white (84%), so the results may not apply in the same ways to other populations. Additionally, the researchers only assessed diet quality perceptions at the end of the study. Assessments during the study may have helped answer questions, such as whether perception was more realistic during the study period or whether a person’s perception of their diet helped or hindered them from making dietary changes.

Co-authors are Tina Costaco, Ph.D.; Susan M. Srika, Ph.D.; Bonnie Rocket Wagner, Ph.D.; Andrea M. Criska, Ph.D.; Mary Lou Klem, Ph.D., MLIS; Margaret B. Conroy, MD, MPH; Bambang Parmanto, Ph.D.; and Laura E. Burke, Ph.D., MPH authors’ disclosures are listed in the abstract.

The study was funded by the National Heart, Lung, and Blood Institute, a division of the National Institutes of Health.

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