Examining Normative Values in Wearable Device Bite Count Data from a One‐Week Free‐Living Intervention

Abstract

Overweight and obesity remain prevalent worldwide, with millions of adults seeking to lose weight and improve health. Wearable technology can provide self‐monitoring and feedback, which have been shown to be beneficial in weight loss and maintenance. The Bite Counter® can be worn like a watch and has been validated in previous studies to be an effective tool in counting the number of bites taken by the user. Data analysis of this novel device requires the application of normative value parameters, previously established by creators of the device. However, these parameters have not been independently tested in real‐world situations. Data were analyzed from a pilot study in which 19 overweight and obese college‐aged adults consented (19.7 ± 1.6 years; 15 female & 4 male; BMI 29.0 ± 3.4 kg/m2), and 17 subjects completed, a one‐week intervention testing the efficacy of the Bite Counter® in establishing a personal bite count goal and reducing daily bite count. Days in which subjects used the Bite Counter® in their own free‐living environment, with no supervision, were analyzed. Eating occasions with fewer than 4 bites, and those that lasted 3600 seconds (automatic shut off time of device), were removed; additionally, raw data were transformed to z scores, and scores greater than 3.29 were removed to exclude outliers and reduce within‐subject variability. Raw and revised data were compared using paired t tests. The 19 enrolled subjects averaged 4.84 ± 2.43 days of device use, with two subjects not using it at all; device usage increased to 5.41 ± 1.84 days when excluding the two non‐users. Significant differences were found between average daily eating time in minutes (28.65 ± 12.84 vs. 21.36 ± 12.40, p=.007), average daily bite count (65.65 ± 31.03 vs. 61.48 ± 30.88, p=.004), and eating rate as measured by bites per minute (2.44 ± .92 vs. 3.15 ± .84, p=.038). However, average meal duration in minutes did not differ (8.06 ± 5.46 vs. 7.50 ± 4.58, p=.542). These results demonstrate that the application of normative value parameters lead to significant differences in most Bite Counter® outcomes, and may help future researchers more effectively interpret data from bite‐counting wearable technology.Support or Funding InformationFunding: The University of Rhode Island Council for Research Grant, July 2015.