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Self-monitoring has traditionally been done using a paper record, which can be tedious and burdensome. A personal digital assistant (PDA) with dietary software can provide an alternative to a paper record. The study aimed to describe the differences in dietary changes at 6 months between participants randomly assigned to use a paper record or PDA for self-monitoring in a clinical trial of weight-loss treatment. Self-monitoring adherence and changes in weight and diet were assessed between 2006 and 2009. The sample (n=192) was 84% female and 78% white, with a mean age of 49 years and body mass index (calculated as kg/m(2)) of 34.1. At baseline, the groups did not differ in energy intake, percent calories from fat, and number of servings of the examined food groups. At 6 months, both groups had significant reductions in weight, energy intake, and percent calories from total fat and saturated fatty acids (P<0.001); no between-group differences were found. Compared to the paper record group, the PDA group significantly increased consumption of fruit (P=0.02) and vegetables (P=0.04) and decreased consumption of refined grains (P=0.02). Interactions among self-monitoring and the two groups were found in relation to changes in percent calories from total fat (P=0.02), monounsaturated fatty acids (P=0.002), and trans-fatty acids (P=0.04). Frequent self-monitoring was significantly associated with total sugar (P=0.02) and added sugar (P=0.01) intake in both groups. Our findings suggest that use of a PDA for self-monitoring might improve self-awareness of behavior and dietary changes., (Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.)

Objective: Diets of lower energy density are associated with higher diet quality, lower body weights, and better health outcomes. This study examined associations among dietary energy density, energy-adjusted diet costs, and socioeconomic indicators of study participants., Design: In this cross-sectional study, energy and nutrient intakes for 164 men and women aged 25 to 65 years were obtained using a food frequency instrument between June 2005 and September 2006. Dietary energy density (kcal/g) was calculated with and without beverages. Energy-adjusted diet costs ($/2,000 kcal) were calculated using food prices in Seattle, WA. Tertile splits of energy density and energy cost were analyzed using tests for linear trend. Linear regression models tested the association between education, income, and dietary variables, adjusting for age and sex., Results: Diets of lower energy density were associated with higher absolute nutrient intakes. Diets of lower energy density were also associated with higher energy-adjusted diet costs. Conversely, highest energy density diets were associated with lower intakes of micronutrients and fiber and lower costs. Education and household income showed a negative association with dietary energy density in regression models. Education and household incomes showed a positive association with the energy-adjusted cost of the diet. Education was a stronger predictor of both energy density and energy cost than was household income., Conclusions: Higher-quality diets were not only more costly per kilocalorie but were also consumed by persons of higher educational level. The influence of diet quality on health, observed in some epidemiologic studies, might be modulated by unobserved indexes of socioeconomic status.

Objective: While various weight-management approaches produce weight loss, they may differ in dietary quality. We monitored changes in nutrient intakes in overweight and obese subjects on three different weight-management programs., Design: Randomized clinical trial (pilot study) with two 12-week phases: phase 1, weekly counseling; phase 2, monitoring only., Subjects/setting: One hundred eighty nonsmoking, sedentary overweight and obese adults began this outpatient study; 134 (body mass index [calculated as kg/m(2)]=30.9+/-2.4; age=42.3+/-1.2 years) were used in analyses., Intervention: Twenty-four weeks of exercise only (control group), hypocaloric diet plus exercise, or hypocaloric diet with fiber-rich whole-grain cereals plus exercise., Main Outcome Measures: At weeks 0, 12, and 24, diet quality was assessed by 3-day food records and body weight was measured., Statistical Analyses Performed: Three-way analysis of variance with repeated measures., Results: The hypocaloric diet with fiber-rich whole-grain cereals plus exercise decreased energy intake more than exercise only (P=0.032). By week 12, the hypocaloric diet with fiber-rich whole-grain cereals plus exercise and the hypocaloric diet plus exercise decreased total fat more than exercise only, which was sustained in the hypocaloric diet with fiber-rich whole-grain cereals plus exercise at 24 weeks (P<0.001). At weeks 12 and 24, the hypocaloric diet with fiber-rich whole-grain cereals plus exercise reduced saturated fat intake more than exercise only. The hypocaloric diet with fiber-rich whole-grain cereals plus exercise increased total fiber, insoluble fiber (both P<0.001), magnesium (P=0.004), and vitamin B-6 (P=0.002) intakes more than the hypocaloric diet plus exercise and exercise only. Calcium and vitamin E intakes were inadequate in all groups. Weight loss was similar in the hypocaloric diet with fiber-rich whole-grain cereals plus exercise and the hypocaloric diet plus exercise., Conclusions: Weight-reduction strategies may be associated with reduced intake of micronutrients, such as calcium and vitamin E. However, a hypocaloric diet with fiber-rich whole-grain cereal is effective for improving or maintaining other aspects of dietary quality during weight loss.

A review of the literature and research on food restriction indicates that inhibiting food intake has consequences that may not have been anticipated by those attempting such restriction. Starvation and self-imposed dieting appear to result in eating binges once food is available and in psychological manifestations such as preoccupation with food and eating, increased emotional responsiveness and dysphoria, and distractibility. Caution is thus advisable in counseling clients to restrict their eating and diet to lose weight, as the negative sequelae may outweigh the benefits of restraining one's eating. Instead, healthful, balanced eating without specific food restrictions should be recommended as a long-term strategy to avoid the perils of restrictive dieting.

Rationales for government regulation in the weight loss industry are developed on the basis of the concepts of market failure and potential harm to consumers. Evidence shows that consumers face problems in judging the quality of the industry's products and services, and they lack adequate protection against possible harm. The pros and cons of a variety of public and private strategies are examined for correcting these deficiencies. Recommendations are suggested for strengthening existing government regulations and expanding research.

Twenty-four obese but otherwise normal men and women were followed for: Two weeks on their usual food intake; eight weeks on a high-protein, low-carbohydrate diet; and then again for two weeks on their usual diet. During this time, several metabolic parameters were measured bimonthly. The high-protein, low-carbohydrate dieting resulted in substantial weight loss, probably due to a combination of salt and water loss, as well as caloric restriction. Plasma triglycerides fell as well. Significant increases occurred in LDL-cholesterol, uric acid, and free fatty acid levels. HDL-cholesterol levels failed to rise despite significant weight loss, indicating that the previously reported relationship between HDL-cholesterol and weight may be dependent, in part, on the composition of the diet.

One hundred twenty-five subjects in a behaviorally oriented, weight loss program that used several dietary patterns were retrospectively grouped according to the percentage of time they followed one of four dietary regimens: (a) Group 1--partial fasting, 400 kcal; (b) group 2--600 kcal; (c) group 3--1,200 to 1,500 kcal; and (d) group 4--failure to diet. The groups were described and compared regarding program completion, i.e., success and cost of weight loss. Groups 1 and 2 did significantly better than the other two in nearly all respects. Group 1 did better than Group 2 on program completion; the reverse was true when success of those completing 75 and 100 per cent of the program was compared. Groups 1 and 2 did not differ significantly on success variables.