Vtrim Research
Obesity is an epidemic that currently rivals smoking in related deaths and health care costs. There is an urgent need to determine ways to help people control their weight before developing obesity-related chronic diseases.
Weight loss research at the University of Vermont is helping to shed light on this health crisis by investigating innovative ways to help people manage their weight.
The Vtrim Weight Management Research Program (today it is known as iReach) was founded by Jean Harvey-Berino, PhD, RD. She has been conducting weight loss and maintenance research at the University of Vermont since 1992.
Dr. Harvey-Berino's is continuing to research internet weight loss strategies.
Click on the titles below for selected abstracts of her most recently published work.
- Minimal in-person support as an adjunct to internet obesity treatment.
- Weight loss on the web: A pilot study comparing a structured behavioral intervention to a commercial program.
- Personal digital assistants are comparable to traditional diaries for dietary self-monitoring during a weight loss program.
- The use of a personal digital assistant for dietary self-monitoring does not improve the validity of self-reports of energy intake.
- Consumers may not use or understand calorie labeling in restaurants.
- Participation in a behavioral weight-loss program worsens the prevalence and severity of underreporting among obese and overweight women.
- The impact of calcium and dairy product consumption on weight loss.
- Effect of internet support on the long-term maintenance of weight loss.
- Obesity prevention in preschool native-american children: a pilot study using home visiting.
- Weight reduction in the cardiac rehabilitation setting.
- The feasibility of using Internet support for the maintenance of weight loss.
- Impact of interviewer's body mass index on underreporting energy intake in overweight and obese women.
1: Ann Behav Med. 2007 Feb;33(1):49-56.
Minimal in-person support as an adjunct to internet obesity treatment.
Micco N, Gold B, Buzzell P, Leonard H, Pintauro S, Harvey-Berino J.
Nutrition and Food Sciences Department, University of Vermont, Burlington, VT 05405, USA.
BACKGROUND: Internet-based weight-loss programs appear promising in the short-term but, to date, have not been able to produce the level of weight loss seen in traditional in-person treatment; thus, novel approaches are necessary. Using a combination of interactive technology and in-person support has been beneficial in other areas of medicine. PURPOSE: The aim of this study is to compare 12-month weight-loss outcomes of an Internet-only behavioral weight-loss treatment with the same program supplemented with monthly in-person meetings. METHODS: One hundred and twenty-three participants were randomized to an Internet-only (n = 62) or an Internet + in-person treatment (I+IPS; n = 61). All participants then participated in a 12-month behavioral weight-loss program conducted over the Internet. The groups met online weekly for the first 6 months and biweekly for the second half of the intervention. The I+IPS group had access to the same Web site as the Internet-only group but, once a month, attended an in-person meeting in place of an online chat. Assessments included body weight, program adherence, and social support measures. RESULTS: An intent-to-treat analysis (n = 123) revealed there were no significant Group x Time differences (p = .15) in weight loss at either 6 (-6.8 +/- 7.8 vs. -5.1 +/- 4.8, p = .15) or 12 months (-5.1 +/- 7.1 kg vs. -3.5 +/- 5.1 kg, p = .17, for Internet-only and I+IPS, respectively). Differences between groups for those completing all measures (n = 77) also revealed no significant differences at 6 months (-9.2 +/- 7.0 kg vs. -6.9 +/- 4.2 kg, p = .08) or 12 months (-8.0 +/- 7.5 kg vs. -5.6 +/- 5.5 kg, p = .10 for the Internet-only and I+IPS conditions, respectively). CONCLUSIONS: Supplementation of an Internet weight-loss treatment with monthly in-person meetings did not result in greater weight losses over 12 months. Dynamic, socially supportive, and interactive elements of the Web site may have obviated the need for further interpersonal behavioral counseling.
2: Obesity (Silver Spring). 2007 Jan;15(1):155-64.
Weight loss on the web: A pilot study comparing a structured behavioral intervention to a commercial program.
Gold BC, Burke S, Pintauro S, Buzzell P, Harvey-Berino J.
Department of Nutrition and Food Sciences, University of Vermont, 250 Carrigan Wing, 109 Carrigan Drive, Burlington, VT 05405, USA.
OBJECTIVE: Internet weight loss programs have become widely available as alternatives to standard treatment, but few data are available on their efficacy. This study aimed to investigate the effectiveness of a structured behavioral weight loss website (Vtrim) vs. a commercial weight loss website (eDiets.com). RESEARCH METHODS AND PROCEDURES: A randomized, controlled trial was conducted from February 2003 to March 2005, in 124 overweight and obese subjects ages 18 years and older with a BMI of 25 to 39.9 kg/m2 (mean age, 47 +/- 9 years; BMI, 32 +/- 3 kg/m2; 20% men). Analyses were performed for the 88 subjects who had complete follow-up data. Participants were randomly assigned to 12-month Vtrim (n = 62) or eDiets.com (n = 62) intervention. Vtrim participants had access to a therapist-led structured behavioral weight loss program delivered on-line. eDiets.com subjects had access to a self-help commercial on-line weight loss program. Body weight, social support, and use of website components were measured at 0, 6, and 12 months. RESULTS: Repeated-measures analyses showed that the Vtrim group lost significantly more weight than the eDiets.com group at 6 months (8.3 +/- 7.9 kg vs. 4.1 +/- 6.2 kg; p = 0.004) and maintained a greater loss at 12 months (7.8 +/- 7.5 kg vs. 3.4 +/- 5.8 kg; p = 0.002). More participants in the Vtrim group maintained a 5% weight loss goal (65% vs. 37.5%; p = 0.01) at 12 months. DISCUSSION: An on-line, therapist-led structured behavioral weight loss website produced greater weight loss than a self-help commercial website. Because commercial sites have great potential public health impact, future research should investigate the feasibility of incorporating a more structured behavioral program into a commercial application.
3: J Behav Med. 2007 Apr;30(2):165-75. Epub 2007 Jan 10.
Personal digital assistants are comparable to traditional diaries for dietary self-monitoring during a weight loss program.
Yon BA, Johnson RK, Harvey-Berino J, Gold BC, Howard AB.
Department of Nutrition and Food Sciences, University of Vermont, Burlington, VT, Canada.
Dietary self-monitoring is considered the core of behavioral weight control programs. As software for personal digital assistants (PDA) has become more available, this study investigated whether the use of a PDA would improve dietary self-monitoring frequency and subsequent weight loss over the use of traditional paper diaries. One-hundred-seventy-six adults (BMI 25-39.9) participated in a 6-month behavioral weight control program. Treatment subjects (n = 61) were provided with a PalmZire 21 with Calorie King's Diet Diary software installed. Their self-monitoring habits and weight loss were compared with the results from a previous program (n = 115) which followed the same protocol using paper diaries for self-monitoring. No significant differences in weight loss or dietary self-monitoring were found. More frequent self-monitoring correlated with weight loss in both groups (p<.001). People seeking to lose weight should be encouraged to self-monitor and be matched with a mode of self-monitoring that is fitting to their lifestyle and skills.
4: J Am Diet Assoc. 2006 Aug;106(8):1256-9.
The use of a personal digital assistant for dietary self-monitoring does not improve the validity of self-reports of energy intake.
Yon BA, Johnson RK, Harvey-Berino J, Gold BC.
University of Vermont, Burlington, VT 05405, USA.
Underreporting of energy intake is a pervasive problem and resistant to improvement, especially among people with overweight and obesity. The goal of this study was to investigate whether the use of a personal digital assistant (PDA) for dietary self-monitoring would reduce underreporting prevalence and improve the validity of self-reported energy intake. Adults with overweight and obesity (n=61, 92% women, mean age 48.2 years, mean body mass index 32.3) were provided with a PalmZire 21 (Palm, Inc, Sunnyvale, CA) loaded with Calorie King's Diet Diary software (version 3.2.2, 2002, Family Health Network, Costa Mesa, CA). Subjects participated in a 24-week in-person behavioral weight control program and were asked to self-monitor their diet and exercise habits using the PDA. Basal metabolic rate and physical activity level were estimated at baseline. Energy intake from 7-day electronic food records were collected within the first month of the weight-control program. As subjects were actively losing weight, Bandini's adjustments were used to correct self-reported energy intake for weight loss. In this group, where 41% of the subjects were categorized as low-energy reporters, the use of a PDA did not improve validity of energy reporting when compared to what is reported in the literature.
5: J Am Diet Assoc. 2006 Jun;106(6):917-20.
Consumers may not use or understand calorie labeling in restaurants.
Krukowski RA, Harvey-Berino J, Kolodinsky J, Narsana RT, Desisto TP.
Department of Psychology, University of Vermont, 2 Colchester Avenue, John Dewey Hall, Burlington, VT 05405, USA. .(JavaScript must be enabled to view this email address)
This study was an investigation of the possible utility of calorie labeling legislation in restaurants in community (n=649) and college student (n=316) samples. Only 48% to 66% of participants presently looked at food labels, and 64% to 73% were able to report accurate knowledge of daily caloric needs. Furthermore, 44% to 57% reported that they were not likely to use food label information in restaurants if it were available. Therefore, public education campaigns focused on calorie requirements may need to precede restaurant labeling, and perhaps other possibilities in labeling formats should be considered (eg, defining foods as "low," "moderate," and "high" calorie).
6: J Am Diet Assoc. 2005 Dec;105(12):1948-51.
Participation in a behavioral weight-loss program worsens the prevalence and severity of underreporting among obese and overweight women.
Johnson RK, Friedman AB, Harvey-Berino J, Gold BC, McKenzie D.
College of Agriculture and Life Sciences, University of Vermont, Burlington 05403, USA. .(JavaScript must be enabled to view this email address)
Underreporting of energy intake is a serious and pervasive problem, especially among women with overweight and obesity. The aim of this study was to determine if the prevalence and severity of underreporting changed after participating in a behavioral weight-loss program. Women with overweight and obesity (N=156, mean age 39.4 years, mean body mass index 31.9) completed a 6-month behavioral weight-loss program. Basal metabolic rate, physical activity level, and energy intake from 7-day food records were collected at baseline and 6 months. The major finding was that underreporting significantly increased in prevalence (39.7% vs 60.3%; P<.001), as did severity of misreporting (-105+/-583 vs -415+/-504 kcal/day; P<.001) following the behavioral weight-loss program. Thus, after completing a behavioral weight-loss program, the prevalence of underreporting and severity of misreporting became significantly worse among women with overweight and obesity.
7: Obes Res. 2005 Oct;13(10):1720-6.
The impact of calcium and dairy product consumption on weight loss.
Harvey-Berino J, Gold BC, Lauber R, Starinski A.
Department of Nutrition and Food Sciences, University of Vermont, Burlington, VT 05405-0148, USA. .(JavaScript must be enabled to view this email address)
OBJECTIVE: Recent evidence suggests that diets high in calcium and dairy products are associated with lower body weight, particularly lower body fat levels. The purpose of this study was to compare weight and body fat loss on a calorie-restricted, low-dairy (CR) vs. high-dairy (CR+D) diet. RESEARCH METHODS AND PROCEDURES: Fifty-four subjects (BMI 30 +/- 2.5 kg/m2, 45 +/- 6.6 years, 4 men) were randomly assigned to calorie-restricted (-500 kcal/d) low-dairy calcium (n = 29; approximately 1 serving dairy/d, 500 mg/d calcium) or high-dairy calcium (n = 25; 3 to 4 servings dairy/d, 1200 to 1400 mg/d calcium) diets for 12 months. Main outcome measures included change in weight (kilograms) and body fat (percentage). RESULTS: There were no significant differences between groups at baseline. At 12 months, weight and body fat loss were not significantly different. Subjects in the CR vs. CR+D conditions lost 9.6 +/- 6.5 vs. 10.8 +/- 5.9 kg (p = 0.56) and 9.0 +/- 3.8 vs. 10.1 +/- 3.6 kg body fat (p = 0.37). DISCUSSION: These findings suggest that a high-dairy calcium diet does not substantially improve weight loss beyond what can be achieved in a behavioral intervention.
8: Obes Res. 2004 Feb;12(2):320-9.
Effect of internet support on the long-term maintenance of weight loss.
Harvey-Berino J, Pintauro S, Buzzell P, Gold EC.
Department of Nutrition and Food Sciences, The University of Vermont, Burlington, Vermont 05405-0148, USA. .(JavaScript must be enabled to view this email address)
OBJECTIVE: To investigate the efficacy of an Internet weight maintenance program. RESEARCH METHODS AND PROCEDURES: Two hundred fifty-five healthy overweight and obese adults (mean +/- SD BMI, 31.8 +/- 4.1 kg/m(2)) men (18%; mean +/- SD age, 45.8 +/- 8.9 yrs) participated in a 6-month behavioral weight control program conducted over interactive television. Treatment was followed by a 12-month weight maintenance program with three conditions: frequent in-person support (F-IPS), minimal in-person support (M-IPS) and internet support (IS). Main outcome measures included body weight, program adherence, and social influence components. RESULTS: There were no significant differences among the groups in weight loss (mean +/- SD) from baseline to 18 months (7.6 +/- 7.3 kg vs. 5.5 +/- 8.9 kg vs. 5.1 +/- 6.5 kg, p = 0.23 for the IS, M-IPS, and F-IPS, respectively). DISCUSSION: Participants assigned to an internet-based weight maintenance program sustained comparable weight loss over 18 months compared with individuals who continued to meet face-to-face. Therefore, the internet appears to be a viable medium for promoting long-term weight maintenance.
9: Obes Res. 2003 May;11(5):606-11.
Obesity prevention in preschool native-american children: a pilot study using home visiting.
Harvey-Berino J, Rourke J.
Department of Nutrition and Food, Sciences University of Vermont, Burlington, Vermont 05405-0148, USA. .(JavaScript must be enabled to view this email address)
OBJECTIVE: To determine whether maternal participation in an obesity prevention plus parenting support (OPPS) intervention would reduce the prevalence of obesity in high-risk Native-American children when compared with a parenting support (PS)-only intervention. RESEARCH METHODS AND PROCEDURES: Forty-three mother/child pairs were recruited to participate. Mothers were 26.5 +/- 5 years old with a mean BMI of 29.9 +/- 3 kg/m(2). Children (23 males) were 22 +/- 8 months old with mean weight-for-height z (WHZ) scores of 0.73 +/- 1.4. Mothers were randomly assigned to a 16-week OPPS intervention or PS alone. The intervention was delivered one-on-one in homes by an indigenous peer educator. Baseline and week 16 assessments included weight and height (WHZ score and weight-for-height percentile for children), dietary intake (3-day food records), physical activity (measured by accelerometers), parental feeding style (Child Feeding Questionnaire), and maternal outcome expectations, self-efficacy, and intention to change diet and exercise behaviors. RESULTS: Changes in WHZ scores showed a trend toward significance, with WHZ scores decreasing in the PS condition and increasing among the OPPS group (-0.27 +/- 1.1 vs. 0.31 +/- 1.1, p = 0.06). Children in the OPPS condition also significantly decreased energy intake (-316 +/- 835 kcal/d vs. 197 +/- 608 kcal/d, p < 0.05). Scores on the restriction subscale of the Child Feeding Questionnaire decreased significantly in the OPPS condition (-0.22+/- 0.42 vs. 0.08+/- 0.63, p < 0.05), indicating that mothers in the OPPS group were engaging in less restrictive child feeding practices over time. DISCUSSION: A home-visiting program focused on changing lifestyle behaviors and improving parenting skills showed promise for obesity prevention in high-risk Native-American children.
10: J Cardiopulm Rehabil. 2002 May-Jun;22(3):154-60.
Weight reduction in the cardiac rehabilitation setting.
Savage PD, Lee M, Harvey-Berino J, Brochu M, Ades PA.
University of Vermont College of Medicine, USA.
BACKGROUND: Most patients with coronary heart disease are overweight. However, only minimal weight loss occurs with participation in a standard cardiac rehabilitation (CR) program. METHODS: The study investigated 82 patients with coronary heart disease who entered an outpatient CR program and completed 36 sessions of exercise over a 12-week period. The effects of a structured, nurse-coordinated, weight loss intervention during phase 2 CR were compared with those observed in a CR control group receiving usual care. RESULTS: The intervention group lost an average of 4.3 +/- 2.8 kg (P <.0001), as compared with a weight loss of 1.7 +/- 2.6 kg (P <.001) in the control group (P <.005 between groups). The effect of the weight loss intervention on total cholesterol (172 +/- 34 to 166 +/- 29 mg/dL) differed from the response in a control group receiving usual care (180 +/- 30 to 187 +/- 28 mg/dL) (P <.05 between groups). The weight loss group experienced a significantly greater improvement (P <.05) than the control group in the physical function score on the Medical Outcomes Study SF-36 questionnaire. A significant correlation was found between the number of weight loss sessions an individual attended and the amount of weight loss experienced (R = 0.39; P <.05). CONCLUSIONS: The current study demonstrated that a behavioral weight loss intervention is effective in reducing body weight in a CR setting. Participants in the intervention group experienced significantly greater improvements in body weight, body mass index, and total cholesterol than a control group. Additionally, participants in the weight loss program reported greater improvements in their physical function score than the control patients.
11: Behav Modif. 2002 Jan;26(1):103-16.
The feasibility of using Internet support for the maintenance of weight loss.
Harvey-Berino J, Pintauro SJ, Gold EC.
University of Vermont, Behavioral Weight Control Research Program, Department of Nutrition and Food Sciences, Terrill Hall, Burlington, VT 05405-0148, USA. .(JavaScript must be enabled to view this email address)
This pilot study examined the acceptability and feasibility of conducting a weight loss maintenance intervention over the Internet. Obese adults participated in a 15-week behavioral weight control intervention and were then randomly assigned to one of the following three maintenance conditions: (a) in-person, therapist-led (TL); (b) Internet, therapist-led (I); and (c) control (C). Both maintenance interventions met biweekly for 22 weeks using the same program content. Results showed that TL participants were more likely to attend their meetings and feel more satisfied with their group assignment. However, there were no differences between the TL and I groups in overall attrition or number of peer support contacts made. There was also no significant difference in weight loss between the groups. Thus, the Internet may hold promise as a method for maintaining contact with patients to facilitate long-term behavior change.
12: Obes Res. 2002 Jun;10(6):471-7.
Impact of interviewer's body mass index on underreporting energy intake in overweight and obese women.
McKenzie DC, Johnson RK, Harvey-Berino J, Gold BC.
Department of Nutrition and Food Sciences, The University of Vermont, Burlington 05405, USA.
OBJECTIVE: To determine if overweight and obese women provide more accurate reports of their energy intake by 1) in-person recall with an obese interviewer, 2) in-person recall with a lean interviewer, or 3) telephone recall with an unknown interviewer. RESEARCH METHODS AND PROCEDURES: Eighty-eight overweight and obese women participated in this study. Subjects completed one telephone-administered multiple-pass 24-hour recall (MP24R) with an unknown interviewer and were then randomly assigned to an in-person MP24R with either a lean or obese interviewer to gather reported energy intake (rEI). Basal metabolic rate (BMR) was measured using a Deltrac monitor, and physical activity (EEPA) was estimated using a Caltrac accelerometer. Therefore, estimated energy expenditure was determined by: estTEE = (BMR + EEPA) x 1.10. RESULTS: No significant differences were found between the two in-person interview modes for subject age, weight, body mass index, percentage of body fat, total energy expenditure, rEI, and misreporting of energy intake. In-person recall data were combined for comparison with the telephone recalls. No significant difference was found between the in-person and telephone recalls for rEI and misreporting. Mean reported energy intake was significantly lower than estimated total energy expenditure for the telephone recalls and combined (lean and obese modes) in-person recalls. CONCLUSIONS: This study found that interviewer body mass index had no impact on self-reported energy intake during an in-person MP24R, and that telephone recall data were comparable with in-person recalls. Underreporting was a widespread problem ( approximately 26%) for all modes in this sample.
©2009 Vtrim® The University of Vermont, Burlington, VT
