Effectiveness of interventions with a dietary component on weight loss maintenance: A systematic review.

Abstract

Review Question/Objective: The primary objective of this review is to determine the effectiveness of structured weight loss maintenance interventions that include a specific dietary modification component(s) on maintenance of lost weight in overweight and obese adults. The second objective is to assess the impact of these interventions on dietary intake at the pre-maintenance and post-maintenance phases of the weight loss maintenance intervention.The third objective is to assess the adherence to prescribed dietary interventions within weight loss maintenance interventions.The final objective is to report attrition within weight loss maintenance interventions that include a dietary component. Criteria for Inclusion: Types of Participants: This review will consider studies that include adults aged greater than or equal to 18 years, who on entry to the weight loss phase or prior to weight maintenance were classified as being overweight or obese. For the purpose of this review, overweight will be defined as body mass index (BMI) of 25 to 29.9 kg/m 2 and obesity will be defined as BMI of equal to or greater than 30 kg/m. 3, 6, 7 Studies will be considered if the participants have existing co morbidities, such hypertension, dyslipidemia or polycystic ovarian syndrome, that are associated with overweight and obesity, however, studies will be excluded if participants have an eating disorder, learning disabilities, mental disease or history of major medical problems such as major heart disease or diabetes requiring insulin treatment. Types of Interventions: Interventions will be considered only if they have an active weight loss maintenance or weight maintenance phase. A weight loss maintenance or weight maintenance phase for this review will be classified as an intervention program in which participants are required to make dietary, physical activity or behavioural modifications in an attempt to keep their weight stable and/or prevent regain of lost weight. For example, daily 500 kcal reduction in dietary energy intake, adoption of dietary modifications including the Dietary Approaches to Stop Hypertension (DASH) principles and 225 minutes or more per week of moderate-intensity physical activity as such in the WLM intervention. Outcome Measures: To assess the primary objective the following outcomes will be determined: Overweight/obesity related outcomes % weight change, body mass index (BMI) change, waist measurements change and % body fat change.