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Funded by the National Heart, Lung and Blood Institute at the NationalInstitutes of Health, the study is one of the few studies to recruit a largepercentage of African Americans as study participants (44 percent). AfricanAmericans have a higher risk of conditions that are aggravated by beingoverweight, including diabetes and heart disease. In this study, the majorityof African American participants lost at least nine pounds of weight, which ishigher than in previous studies.
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"The more food records people kept, the more weight they lost," said leadauthor Jack Hollis Ph.D., a researcher at Kaiser Permanente's Center forHealth Research in Portland, Ore. "Those who kept daily food records losttwice as much weight as those who kept no records. It seems that the simpleact of writing down what you eat encourages people to consume fewer calories."
In addition to keeping food diaries and turning them in at weekly supportgroup meetings, participants were asked to follow a heart-healthy DASH (aDietary Approaches to Stop Hypertension) diet rich in fruits and vegetablesand low-fat or non-fat dairy, attend weekly group sessions and exercise atmoderate intensity levels for at least 30 minutes a day. After six months, theaverage weight loss among the nearly 1,700 participants was approximately 13pounds. More than two-thirds of the participants (69 percent) lost at leastnine pounds, enough to reduce their health risks and qualify for the secondphase of the study, which lasted 30 months and tested strategies formaintaining the weight loss.
"More than two-thirds of Americans are overweight or obese. If we all lostjust nine pounds, like the majority of people in this study did, our nationwould see vast decreases in hypertension, high cholesterol, diabetes, heartdisease and stroke," said study co-author Victor Stevens, Ph.D., a KaiserPermanente researcher. For example, in an earlier study Stevens found thatlosing as little as five pounds can reduce the risk of developing high bloodpressure by 20 percent.
The Kaiser Permanente Care Management Institute's Weight ManagementInitiative (http://www.kpcmi.org/weight-management/index.html) has recommendedfood journaling as a strategy for losing weight since 2002. The WeightManagement Initiative unites clinicians, researchers, insurers, andpolicymakers to identify practical, effective, non-surgical approaches for theprevention and treatment of overweight and obesity.
"Keeping a food diary doesn't have to be a formal thing. Just the act ofscribbling down what you eat on a Post-it note, sending yourself e-mailstallying each meal, or sending yourself a text message will suffice. It's theprocess of reflecting on what you eat that helps us become aware of ourhabits, and hopefully change our behavior," says Keith Bachman, MD, a WeightManagement Initiative member. "Every day I hear patients say they can't loseweight. This study shows that most people can lose weight if they have theright tools and support. And food journaling in conjunction with a weightmanagement program or class is the ideal combination of tools and support."
The study, coordinated by the Kaiser Permanente Center for Health Researchin Portland, also was conducted at Duke University Medical Center, PenningtonBiomedical Research Center, and Johns Hopkins University. In addition toHollis and Stevens, the Kaiser Permanente research team included William M.Vollmer, Ph.D.; Cristina M. Gullion, Ph.D.; Kristine Funk, M.S.; and DanielLaferriere, MR. Other study co-authors included Phillip J. Brantley, P
