University of Navarra, Dept. of Food Science and Physiology, Center for Nutrition Research
Pamplona, Navarre, 31008, Spain
NCT Number: NCT06519539
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.
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Notify Me18 year–65 year
All sexes
Observational
Pamplona, Navarre, 31008, Spain
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.
Healthy volunteers accepted: Yes
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
Exclusion criteria
The intervention includes 4 components, including: a portion control tool set previously developed and tested in our laboratory; a supporting guide (physical book) with dietary, activity and behavioural recommendations; a mobile application aligned with the guide; and biweekly telephone calls from the psychologist and/or dietitian.
Time frame: Clinical 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
Time frame: Clinical 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
Time frame: Clinical 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)
Time frame: Clinical 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)
Time frame: Clinical 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
Time frame: Clinical 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
Time frame: Clinical 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
Time frame: 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
Time frame: 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
Time frame: 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
Time frame: 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
Time frame: 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
Time frame: 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
Time frame: 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
Time frame: 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
Time frame: Clinical 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
Time frame: Clinical 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
Time frame: Clinical 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
Time frame: Clinical 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.
Time frame: Clinical 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.
Time frame: Clinical 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)
Time frame: Clinical 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
Time frame: Clinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)
Fasting blood glucose levels (mg/dL)
Time frame: Clinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)
Fasting blood insuliln levels (mIU/L)
Time frame: Clinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)
Fasting blood triglycerides levels (mg/dL)
Time frame: Clinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)
Fasting blood total cholesterol levels (mg/dL)
Time frame: Clinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)
Fasting blood total ghrelin levels (pg/mL)
Time frame: Clinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)
Fasting blood leptin levels (ng/mL)
Time frame: Clinical 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)
Time frame: Clinical 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)
Time frame: Clinical 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)
Time frame: Clinical 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)
Time frame: Clinical 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)
Time frame: Clinical 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)
Time frame: Clinical 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)
Time frame: Clinical 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)
Time frame: Clinical 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)
Time frame: Clinical 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)
Time frame: Pre-screening
Socio-demographic characteristics of the sample collected via self-reported questionnaire (age, sex, education, marital status, household composition, employment, physical activity level, smoking, alcohol intake)
Time frame: Pre-screening
Score in the Eating Attitudes Test-26, ranging from 0-78 points, validated by Garner et al., 1982. Scores above 20 suggest risk for presence of potential eating disorders.
Time frame: Clinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)
Profile defined by the combined Restraint (0-21 points), Disihnibition (0-16 points) and Susceptibilty to hunger (0-14 points) sub-scales scores of the Three Factor Eating Questionnaire (TFEQ), validated by Stunkard & Messick, 1985. Restraint values above 11, disinhibition values above 8 and susceptibility to hunger values above 4 are considered worse outcomes (i.e. risk for development of obesity and other eating disorders)
Time frame: Clinical investigation day 3 (week 24)
Previous usage of portion control tools (end of study interview)
Time frame: Pre-screening
Frequency of consuming home made meals via self-reported questionnaire
Time frame: Pre-screening
Frequency of consuming take away meals via self-reported questionnaire
Time frame: Pre-screening
Responsible person for cooking at home, via self-reported questionnaire
Time frame: Clinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)
Liking for the foods to be used in the intervention, via self-reported questionnaire (100 mm visual analogue scale)
Time frame: Clinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)
Familiarity with the foods to be used in the intervention, via self-reported questionnaire (100 mm visual analogue scale)
Time frame: Clinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)
Scores for hunger, fullness, thirst, prospective intake, nausea measured on a 100 mm visual analogue scale before consumption of a milkshake (validated questionnaire based on Hill & Blundell, 1982)
Time frame: Pre-screening (week 0), clinical investigation day 3 (week 24)
Self-reported questionnaire assessing caloric beverage intake, awareness of beverage portion sizes and acceptance of portioning tools for liquids currently on the market (pre-piloted on-line BPS survey, Vargas-Alvarez et al., 2021)
Time frame: Clinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)
Validated questionnaire (Carter & Jansen, 2012) used to identify eating patterns associated with the risk for obesity. It consists of 25 items answered on a 5-Pt intensity scale. The information collected can be used qualitatively, to identify problematic behaviors, or quantitatively by adding the direct scores. Scores greater than 50 suggest a moderate to high frequency of behaviors associated with obesity.
Time frame: Pre-screening (week 0)
Self-reported questionnaire based on previous studies (Almiron-Roig et al., 2023) asking about special dietary needs, pregnancy, lactation, menopause, history of eating disorders, history of mental illness, incompatible medical conditions (e.g. cancer, diabetes, memory loss), regular medication including nutritional and other supplements
Time frame: Clinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), clinical investigation day 3 (week 24)
Fat mass distribution (trunk, arms, legs), fat-free mass (kg, %), fat-free mass distribution, basal metabolic rate (kcal/day)
Time frame: Pre-screening
Score in the NEO-Five Factor Inventory (NEO-FFI) 60 item validated questionnaire (Costa & McCrae, 1989). The score for each central domain of normal personality defined by the Five-Factor Model of personality (neuroticism, extraversion, conscientiousness, agreeableness, and openness to experience) is calculated. A higher score on a scale assessing a certain personality domain indicates a stronger expression of traits associated with this particular domain
Time frame: Pre-screening
Score in the Perceived Stress Scale-14 (PSS-14) validated questionnaire (Cohen et al., 1983). Scores ranging from 0 to 13 suggest low stress, scores ranging from 14 to 24 suggest moderate stress, and scores above 27 suggest high perceived stress
Time frame: Pre-screening
Score in the Trait Meta-Mood Scale-24 (TMMS-24) validated questionnaire (Salovey et al., 1995). The score for three different dimensions of emotional intelligence are calculated. To obtain a score for each factor, items 1 to 8 are added for the emotional attention factor, items 9 to 16 for the emotional clarity factor, and items 17 to 24 for the emotional repair factor.
Time frame: Pre-screening
Score in the Profile of Mood States (POMS) validated questionnaire (McNair et al., 1971). The score for six different dimensions of mood (tension, anger, fatigue, depression, confusion, and vigour) is calculated. A higher score on a scale assessing a certain mood dimension indicates a stronger expression of associated feelings. The resulting scores will range from -24 to 177, with lower scores indicative of people with more stable mood profiles
Time frame: Clinical investigation day 1 (week 0)
Self-constructed scale evaluated with the sum of scores (1-10) for 5 items (based on Nau & Borkovec, 1972). The 5 items include rating the intervention's logic, satisfaction, recommendability, expected usefulness, and the respondent's readiness to follow it. A higher score reflects a more positive expectation towards the upcoming intervention.
Time frame: Clinical investigation day 2 (week 12), Clinical investigation day 3 (week 24)
Self-constructed scale evaluated with the sum of scores (1-10) for 5 items (based on Nau & Borkovec, 1972). The 5 items include rating the intervention's logic, satisfaction, recommendability, usefulness, and the respondent's readiness/intention to continue with it. A higher score reflects a more positive opinion towards the experienced intervention.
Time frame: Clinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), Clinical investigation day 3 (week 24)
Previously piloted questionnaire (Almiron-Roig et al., 2016) including 5-Pt Likert scores for portion tool attractiveness, fits within lifestyle, embarrassment, ease of use, perceived effectiveness and resistant to use. An average score of 1 or 2 indicates low acceptance, 3 neutral, and 4 or 5 high acceptance.
Time frame: Clinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), Clinical investigation day 3 (week 24)
Single scale instrument measuring the level of intention to use each component from 0-100 on a 100 mm visual analogue scale (previously piloted questionnaire, Almiron-Roig et al., 2016).
Time frame: Clinical investigation day 2 (week 12), Clinical investigation day 3 (week 24)
System Usability Scale (SUS) (based on Brooke, 1996). Includes ten 5-Pt Likert questions of which 5 items are scored positively (pleasant, easy to use, good functionality, quick to learn, safe), and 5 items are scored reversedly (complex, requires support, inconsistent, complicated to use, requires learning). A higher overall score indicates higher perceived usability.
Time frame: Clinical investigation day 2 (week 12)
Self-constructed questionnaire including 20 items answered with a 5-Pt Likert scale. The first 10 items assess content of the guide (credibility, coherence, usefulness, applicability) and the second 10 items assess format (organisation, word choice and communication style). A score <60 indicates poor assessment (the tool cannot be used in clinical practice as it stands); a score between 60-79 indicates the tool needs revision before implementation; a score of 80 or above indicates the tool is well rated by potential users and may be useful in clinical practice.
Time frame: 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)
Types of meals in which the serving spoons were most frequently used
Time frame: 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)
Types of meals in which the oil dispenser was most frequently used
Time frame: 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)
Guide sections most frequently checked
Time frame: 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)
App functions most frequently used
Time frame: Clinical investigation day 1 (week 0), Clinical investigation day 2 (week 12), Clinical investigation day 3 (week 24)
Self-constructed interview to verify participants' compliance with arrival time, physical activity and dietary requirements and any change in medication occurred prior to each clinical investigation day
Time frame: Clinical investigation day 3 (week 24)
Self-constructed interview to assess participant's overall experience with the intervention at study end (items include previous tools/methods employed, satisfaction with intervention, consistency of use, barriers experienced and intention to continue using the components)
Clinica Universidad de Navarra, Universidad de Navarra
Other
Implementing Strategies for Eating Behaviour Modification Based on Portion Control: Methodological Development and Pilot Study
Acronym: PORTIONS-4
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