The Relationship Between Food Tracking And Attendance in a Weight Management Intervention in African American Women
Kitzman-Ulrich, Heather PhD
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Background: Approximately eighty percent of African American are overweight or obese. Interventions show less weight loss and shorter periods of maintenance overtime compared to Caucasians. Current interventions with AA women show less weight loss overall, and lower maintenance over time compared to other populations. Literature has shown that food tracking is one of the most effective ways to aid in weight loss. However, this behavior is difficult to adopt and sustain. A recent study found that there was a 3% adherence to “actively” documenting their food intake. Barriers that have been identified are: the process is tedious, makes one feel guilty at times, and not being able to correctly identify what to enter when making home cooked meals. These barriers are suspected to influence program attendance among participants. The Better Me Within (BMW) program is a faith-enhanced Diabetes Prevention Program (DPP) for women in African American churches. This study examines food tracking patterns over time compared to attendance during a 16 week behavioral intervention. Methods: African American women from 11 churches in Dallas/Fort Worth attended weekly classes over 16 weeks in the BMW program. Participants were asked to track dietary intake each week through paper food logs or online food tracking programs. Health coaches at each church collected food logs, weight and attendance during class and reported this information to research staff. Attendance rates and frequency of food tracking were calculated from research logs. Descriptive statistics, and independent t-tests were conducted to examine the relationship between attendance and frequency of food tracking. Results: A total of 221 AA women were randomized to intervention or control (mean age=48.8+11.2; mean BMI=36.7+8.4; 52% technical or high school). The mean attendance was significantly higher among the group who submitted more than four or more food logs (u = 14.14, SD = 1.77) than the group who submitted less than four food logs (u = 8.8, SD = 4.9), p Conclusions: Participants who engaged in higher levels of food tracking attended nearly twice as many sessions as women who completed less tracking. Both behaviors, self-monitoring through food tracking, and program attendance, have been associated with better health outcomes such as reduced weight and associated chronic disease risk factors. Future studies should evaluate what factors influence these behaviors such as self-efficacy, motivation, or barriers.