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Implementing Strategies for Eating Behaviour Modification Based on Portion Control

Active, not recruiting
Conditions
Lifestyle, Healthy
Behavior Change
Weight Management
Registration Number
NCT06519539
Lead Sponsor
Clinica Universidad de Navarra, Universidad de Navarra
Brief Summary

This is a pre-post intervention study designed to evaluate the feasibility of a self-applied weight management intervention based on portion control. A total of 40 healthy volunteers with overweight/obesity will take part in a 6-month intervention featuring 4 components: a portion control toolset; a manual including instructions for the use of the tools, dietary and activity recommendations, and behavioural strategies; a mobile app to motivate intervention engagement; and biweekly telephone support. The primary outcome will be Intervention adherence, assessed as the change in dietary energy density, meal nutrient composition and utilization of intervention components from start to end of trial. Other measurements (at baseline, 3 and 6 months from baseline) will include body composition, fasting biochemical parameters, inhibitory control, eating behaviour, portions size norms and acceptance of the intervention.

Detailed Description

According to recent meta-analyses, portion control tools represent an acceptable and potentially effective strategy to aid in weight loss. However, how well these tools work depends on their consistent use and a good integration with other lifestyle modification strategies around body weight control and overall health. The present pilot study was designed to evaluate the feasibility of a self-applied weight management intervention based on portion control and to identify factors influencing adherence. The sample will consist of 40 healthy volunteers with overweight/obesity who will engage in a pre-post intervetion study lasting six-months. The intervetion will include four components: (1) a portion control toolkit (serving spoon and oil dispenser); (2) a phsyical manual with instructions for using the tools, dietary and physical activity recommendations, and strategies to build habits and improve mental wellbeing; (3) a mobile app to motivate intervention engagement; and (4) biweekly short telephone support. Adherence to the intervention will be the primary outcome, assessed on a fortnightly basis as the change from baseline in dietary energy density and change in meal nutrient composition plus frequency of using the intervention components. Other measurements that will be taken at baseline, 3 and 6 months from baseline, will be: body composition, fasting biochemical parameters, inhibitory control (only baseline and 6 months), eating behaviour, portion size norms and intervention acceptance. After 3 months of taking part in the intervention, a subset of the sample will participate in a nominal group session aimed at identifying barriers to intervention adherence and strategies to overcome them. The study results will inform the design of a full-scale controlled trial featuring the most successful components.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Body mass index equal or above 27.5 kg/m2 (26.0 kg/m2 for those of Asian descent)
  • Eating home-made meals at least 5 days a week
  • Physically and mentally fit as assessed by the study researcher
  • On-going pharmacological and hormonal treatment is accepted when this does not affect the study parameters (e.g. glucose response, appetite), and when the participant has been in a stable dose for at least 3 months
  • Agreeing to undergo all the study procedures
  • Being able to attend in person on 3 clinical investigation days during working hours
  • Being able to understand and agree to sign the informed consent form
Exclusion Criteria
  • Being a regular smoker (that is, smoke more than 4 cigarettes a month)
  • Being pregnant, breastfeeding or planning a pregnancy
  • Exceed the alcohol consumption limit marked for the corresponding sex (more than 14 units in women and 20 units in men)
  • Having followed a meal plan for weight loss and/or muscle mass gain in the 3 months prior to the start of the study intervention
  • Having used a portion measuring instrument (e.g. scale, calibrated plate, etc.) consistently (at least in one main meal for at least 5 days a week) during the 3 months prior to the start of the study intervention
  • Experiencing a weight change greater than 5% in the last 3 months
  • History of relevant functional or structural anomalies of the digestive system, such as malformations, angiodysplasias, active peptic ulcers, chronic inflammatory or malabsorption diseases, or history of intestinal or bariatric surgery
  • Suffer from some type of cancer, currently undergoing treatment for cancer, or when a period of at least 5 years has not elapsed since its eradication
  • On-going chronic metabolic disease or obesity-related disease, or any systemic intestinal, liver or kidney disease such as type 1 or type 2 diabetes, severe dyslipidemia, uncontrolled thyroid function disorder, cirrhosis, inflammatory bowel disease, untreated anemia, etc. . (will not be excluded due to "fatty liver")
  • Avoiding, being allergic, or being intolerant to the study foods or their ingredients (lactose free and regular chocolate milkshake)
  • History of anaphylactic reaction to any food
  • Taking any nutritional supplementation as a prescription medication that may affect the results of the study
  • Taking over-the-counter nutritional supplementation (that is, without a medical prescription) that may affect the results of the study, unless the person is willing to stop it during the 6 months of the study duration and only when a minimum washout period of 14 days can be guaranteed prior to the basal measurements being taken
  • A high incidence of attitudes and behaviors associated with eating disorders, expressed as a score greater than 20 on the 26-item Eating Attitudes Test scale (EAT - 26)
  • Co-inhabiting with a study participant
  • For former PORTIONS-3 study participants, when less than 3 months have passed since the last intervention visit (accepted if 3 or more months have elapsed).

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Change from baseline in 24 h total dietary energy intakeClinical investigation day 1 (week 0); Phone call (week 2, week 4, week 6, week 8, week 10); Clinical investigation day 2 (week 12); Phone call (week 14, week 16, week 18, week 20, week 22); Clinical investigation day 3 (week 24)

24 h total dietary energy intake (in kcal) will be obtained from the 24 h dietary record

Change from baseline in 24 h total dietary volume intakeClinical investigation day 1 (week 0); Phone call (week 2, week 4, week 6, week 8, week 10); Clinical investigation day 2 (week 12); Phone call (week 14, week 16, week 18, week 20, week 22); Clinical investigation day 3 (week 24)

24 h total dietary volume intake (in g) will be obtained from the 24 h dietary record

Change from baseline in daily dietary energy densityClinical investigation day 1 (week 0); Phone call (week 2, week 4, week 6, week 8, week 10); Clinical investigation day 2 (week 12); Phone call (week 14, week 16, week 18, week 20, week 22); Clinical investigation day 3 (week 24)

24 h total dietary energy intake (kcal) and 24 h total dietary volumen intake (g) will be combined to report daily dietary energy density (in kcal/g). Daily dietary energy density is defined as the ratio of 24 h total dietary energy intake (in kcal) to the 24 h total dietary volume intake (in g)

Intervention adherenceClinical investigation day 1 (week 0); Phone call (week 2, week 4, week 6, week 8, week 10); Clinical investigation day 2 (week 12); Phone call (week 14, week 16, week 18, week 20, week 22); Clinical investigation day 3 (week 24)

Daily dietary energy density, meal nutrient composition and use of intervention components (spoon, oil dispenser, guide, app) will be combined to report intervention adherence (as a qualitative measure)

Secondary Outcome Measures
NameTimeMethod
Change from baseline in meal dietary energy densityClinical investigation day 1 (week 0); Phone call (week 2, week 4, week 6, week 8, week 10); Clinical investigation day 2 (week 12); Phone call (week 14, week 16, week 18, week 20, week 22); Clinical investigation day 3 (week 24)

Meal (breakfast, lunch and dinner) dietary energy density (kcal/g) will be calculated as the ratio of meal total dietary energy intake (in kcal) to the 24 h total dietary volume intake (in g), obtained from the 24 h dietary record

Change from baseline in meal nutrient composition: GramsClinical investigation day 1 (week 0); Phone call (week 2, week 4, week 6, week 8, week 10); Clinical investigation day 2 (week 12); Phone call (week 14, week 16, week 18, week 20, week 22); Clinical investigation day 3 (week 24)

Meal (breakfast, lunch and dinner) nutrient content (in g) will be defined as the meal's content of carbohydrate (g), protein (g), vegetables (g), fibre (g), and sodium (mg) obtained from the 24 h dietary record

Change from baseline in meal nutrient composition: % energyClinical investigation day 1 (week 0); Phone call (week 2, week 4, week 6, week 8, week 10); Clinical investigation day 2 (week 12); Phone call (week 14, week 16, week 18, week 20, week 22); Clinical investigation day 3 (week 24)

Percent of daily energy from meals will be defined as the % energy provided by carbohydrate, protein and vegetables at each meal (breakfast, lunch and dinner), obtained from the 24 h dietary record

Use of serving spoon (24 h frequency)Phone call (week 2, week 4, week 6, week 8, week 10); Clinical investigation day 2 (week 12); Phone call (week 14, week 16, week 18, week 20, week 22); Clinical investigation day 3 (week 24)

Number of times the intervention spoon has been used in a period of 24 h

Use of oil dispenser (24 h frequency)Phone call (week 2, week 4, week 6, week 8, week 10); Clinical investigation day 2 (week 12); Phone call (week 14, week 16, week 18, week 20, week 22); Clinical investigation day 3 (week 24)

Number of times the intervention oil dispenser has been used in a period of 24 h

Use of intervention guide (24 h frequency)Phone call (week 2, week 4, week 6, week 8, week 10); Clinical investigation day 2 (week 12); Phone call (week 14, week 16, week 18, week 20, week 22); Clinical investigation day 3 (week 24)

Number of times the intervention guide has been consulted in a period of 24 h

Use of oil dispenser (15 day frequency)Phone call (week 2, week 4, week 6, week 8, week 10); Clinical investigation day 2 (week 12); Phone call (week 14, week 16, week 18, week 20, week 22); Clinical investigation day 3 (week 24)

Number of times the intervention oil dispenser has been used in a period of 15 days

Use of intervention app (24 h frequency)Phone call (week 14, week 16, week 18, week 20, week 22); Clinical investigation day 3 (week 24)

Number of times the intervention app has been used in a period of 24 h

Use of serving spoon (15 day frequency)Phone call (week 2, week 4, week 6, week 8, week 10); Clinical investigation day 2 (week 12); Phone call (week 14, week 16, week 18, week 20, week 22); Clinical investigation day 3 (week 24)

Number of times the intervention spoon has been used in a period of 15 days

Anthropometric profile: Change from baseline in body fat compositionClinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)

Body fat composition will be quantified as fat mass (in kg, %) from a body composition analyser

Use of intervention guide (15 day frequency)Phone call (week 2, week 4, week 6, week 8, week 10); Clinical investigation day 2 (week 12); Phone call (week 14, week 16, week 18, week 20, week 22); Clinical investigation day 3 (week 24)

Number of times the intervention guide has been consulted in a period of 15 days

Use of intervention app (15 day frequency)Phone call (week 14, week 16, week 18, week 20, week 22); Clinical investigation day 3 (week 24)

Number of times the intervention app has been used in a period of 15 days

Anthropometric profile: Change from baseline in Body Mass IndexClinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)

Weight and height will be combined to report BMI in kg/m\^2

Anthropometric profile: Change from baseline in Body WeightClinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)

Weight will be measured in kg; Weight and height will be combined to report BMI in kg/m\^2

Anthropometric profile: Body HeightClinical investigation day 1 (week 0)

Height will be measured in m using a stadiometer; Weight and height will be combined to report BMI in kg/m\^2

Anthropometric profile: Change from baseline in Waist circumferenceClinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)

Waist circumference will be measured in cm using a measuring tape. Waist circumference and hip circumference will be combined to report Waist-to-hip ratio.

Anthropometric profile: Hip circumferenceClinical investigation day 1 (week 0)

Hip circumference will be measured in cm using a measuring tape. Waist circumference and hip circumference will be combined to report Waist-to-hip ratio.

Anthropometric profile: Change from baseline in Waist-to-hip ratioClinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)

Waist circumference and hip circumference will be combined to report Waist-to-hip ratio. Waist to hip ratio is defined as the ratio of the waist circumference (cm) to the hip circumference (cm)

Biochemical profile: Change from baseline in fasting blood glucoseClinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)

Fasting blood glucose levels (mg/dL)

Biochemical profile: Change from baseline in fasting blood insulinClinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)

Fasting blood insuliln levels (mIU/L)

Biochemical profile: Change from baseline in fasting blood triglyceridesClinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)

Fasting blood triglycerides levels (mg/dL)

Biochemical profile: Change from baseline in fasting blood ghrelinClinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)

Fasting blood total ghrelin levels (pg/mL)

Biochemical profile: Change from baseline in fasting blood cholesterolClinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)

Fasting blood total cholesterol levels (mg/dL)

Biochemical profile: Change from baseline in fasting blood leptinClinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)

Fasting blood leptin levels (ng/mL)

Meal eating behaviour: Change from baseline in Eating rateClinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)

Average amount of milkshake consumed per unit of time (g/min), based on validated methodology (Yeomans, 2000)

Meal eating behaviour: Change from baseline in bite sizeClinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)

Average amount of milkshake consumed at each sip (g), based on validated methodology (Yeomans, 2000)

Meal eating behaviour: Change from baseline in meal durationClinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)

Average time used to drink a milkshake (min), based on validated methodology (Yeomans, 2000)

Meal eating behaviour: Change from baseline in deceleration rateClinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)

Average change in eating rate (g/sec-squared), based on validated methodology (Yeomans, 2000)

Inhibitory control pattern: Change from baseline in N200 wave latencyClinical investigation day 1 (week 0), clinical investigation day 3 (week 24)

N200 wave latency (milisec), based on the Go/No Go paradigm (Ochner et al., 2009)

Inhibitory control pattern: Change from baseline in N200 wave lengthClinical investigation day 1 (week 0), clinical investigation day 3 (week 24)

N200 wave length (microV), based on the Go/No Go paradigm (Ochner et al., 2009)

Inhibitory control pattern: Change from baseline in P300 wave latencyClinical investigation day 1 (week 0), clinical investigation day 3 (week 24)

P300 wave latency (milisec), based on the Go/No Go paradigm (Ochner et al., 2009)

Inhibitory control pattern: Change from baseline in P300 wave lengthClinical investigation day 1 (week 0), clinical investigation day 3 (week 24)

P300 wave length (microV), based on the Go/No Go paradigm (Ochner et al., 2009)

Learning task: Change from baseline in learned meal portion sizeClinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)

% error in chosen portion sizes for starch, protein and vegetables of a virtual meal vs recommended portion sizes (based on Brunstrom \& Rogers, 2009)

Learning task: Change from baseline in learned meal nutrient contentClinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)

% error in chosen nutrient content of a virtual meal vs recommended nutrient content (based on Brunstrom \& Rogers, 2009)

Trial Locations

Locations (1)

University of Navarra, Dept. of Food Science and Physiology, Center for Nutrition Research

🇪🇸

Pamplona, Navarra, Spain

University of Navarra, Dept. of Food Science and Physiology, Center for Nutrition Research
🇪🇸Pamplona, Navarra, Spain

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