Single-Arm Trial of a Flexible Multicomponent Commercial Digital Weight Management Program

Background Hunger and food cravings predict poor outcomes in lifestyle interventions for weight management. For this reason, flexible weight management programs, as opposed to restrictive weight management programs, are needed. WW (formerly Weight Watchers)—a widely available, commercial weight management and wellness program—includes an approach that allows participants to obtain a personalized zero-point food (ZPF) list, which includes foods that do not need to be weighed, measured, or tracked. With over 300 potential options, ZPFs can include fruits, vegetables, legumes, whole grains, nonfat dairy, and lean sources of protein. Participants are assigned an individualized daily and weekly point target and can use ZPFs to help budget their points throughout the day, which can nudge participants toward a healthier overall dietary pattern. Objective In a 6-month, single-arm trial, we examined the efficacy of WW when delivered via multimodal digital tools, including a mobile app for assisting with point tracking, weekly virtual workshops, weekly 5-minute wellness check-ins, and a Facebook group in which participants could socialize and support each other. Methods The outcomes included weight change from baseline, as measured by the Bluetooth scales provided to each participant; hunger (visual analogue scale); food cravings (Food Craving Inventory); the intake of fruits and vegetables (The Five Factor Screener); physical activity (Global Physical Activity Questionnaire); and overall well-being (WHO-5 Well-Being Index). Results Of the 153 participants, 70% were female, and 66% were White. Participants’ mean age was 41.09 (SD 13.78) years, and they had a mean BMI of 31.8 (SD 5.0) kg/m2. Retention was high, as 91.5% provided 6-month follow-up data. Participants lost an average of 5.1% of body weight from baseline to 6 months (mean −4.4, SD 4.87 kg; P&lt;.01), with 51% losing clinically significant weight (≥5%). Hunger significantly declined over 6 months (mean percent change −14.74%, SD 64.28%; P&lt;.01), as did food cravings (mean percent change −16.99%, SD 19.98%). The intake of fruits (mean percent change 65.95%, SD 188.78%; P&lt;.01), vegetables (mean percent change 68.29%, SD 172.61%; P&lt;.05), and salad (mean percent change 127.43%, SD 250.82%; P&lt;.001) significantly increased. Engagement in moderate physical activity increased by an average of 32 (SD 133) minutes per day (P&lt;.01), and sedentary time decreased by 90 (SD 24.5) minutes per day (P&lt;.001). Finally, well-being significantly increased (mean change 17.77%, SD 46.21%; P&lt;.01). Conclusions This program, which used a less restrictive method of food tracking and provided personalized ZPFs, resulted in significant weight loss and an increase in fruits, vegetables, and exercise, while also reducing hunger and food cravings. Future research should compare the effectiveness of these approaches to traditional programs that require the self-monitoring of all foods and beverages. Trial Registration ClinicalTrials.gov NCT04302389; https://clinicaltrials.gov/ct2/show/NCT04302389 Conflicts of Interest None declared. </jats:sec

Stability of multi-micronutrient-fortified juice drink

Background: To reduce the prevalence of micronutrient malnutrition problems in the country, particularly iron deficiency anemia (IDA) among children, 7-12 year-old, the Food and Nutrition Research Institute of the Department of Science and Technology (FNRI-DOST), in partnership with the Industry, developed an orange-flavored non-carbonated fortified juice drink and determined its commercial potential. The orange juice was fortified with vitamins A and C, iron, and zinc based on the Philippine Recommended Nutrient Intakes (RNIs) and lysine based on the US Recommended Dietary Allowance (RDA) per 200 ml. serving size for 7-12 year-old children. Prior to the conduct of the fortification trials, the potency of the fortificants was determined to establish their correct levels. Laboratory scale trials were conducted to determine the technical viability of the fortified juice. The juice from laboratory trials was sent to the Industry partner\u27s laboratory in Shanghai, China for further evaluation and selection of the best formulation. Large scale production trials were conducted to make the necessary adjustments in the formulation and to determine the economic viability of the process. Retention after processing and hornogeneity of the nutrients were also determined in the large scale production trials. Objective: To determine the stability of vitamins A and C, iron, zinc and lysine in the multi-micronutrient- fortified juice drink during 12 month-storage. Methods: Samples from 4 production trials were stored in the FNRI storage room for 12 months under simulated market conditions (280-34°C). The temperature and the relative humidity of the room were monitored during the period. Two independent samples were randomly collected per production trial to determine the stability of the fortified orange juice in terms of physical, chemical and microbiological properties and sensory attributes. Physical properties which include Total Soluble Solids (TSS), Titratable Acidity (TA), pH and color analysis were determined monthly using Refractometer, Titration, pH meter and Colorimeter, respectively. Chemical properties such as Vitamin A analysis were determined using High Performance Liquid Chromatography (HPLC); Vitamin C by Titration Method; iron and zinc, using Atomic Absorption Spectrophotometry (AAS); and lysine using Gas Liquid Chromatography (GC). Microbiological analysis was done at the start of and after the 12 month-storage period. Microbiological load was determined following the Food and Drug Administration-Bacteriological Analysis Manual (FDA-BAM). Sensory attributes were determined by Triangle, Descriptive, and Hedonic Rating tests. SPSS program was used for data processing. All data were statistically analyzed at 5% level of significance. Results: The vitamins A and C contents were retained and within the recommended levels per 200mL, respectively, after 12 months of storage. Iron, zinc, and lysine contents also remained stable during storage. The fortified orange juice remained acceptable in appearance, color, odor, taste, texture, and general acceptability after 10 months of storage. Conclusion: The fortified orange juice in 200 mL laminated aluminum foil pack is microbiologically safe, and has a shelf-life of 10 months under simulated market conditions. The results of the study can be used as basis for the commercial scale production by the Industry partner. This multi-micronutrient-fortified orange Juice drink called Nutrijuice is a testimony to the effective alliances among the public-private sectors that is grounded on research and development