Nutrition Science and Everyday Application - beta v 0.1

428 ALICE CALLAHAN, PHD, HEATHER LEONARD, MED, RDN, AND TAMBERLY POWELL, MS, RDN
recommendations, it is easy to see that these two areas of behavior are of primary interest
in improving the health and weight of our nation.
Evidence-Based Behavioral Recommendations
Behavioral weight loss interventions have been described as approaches “used to help
individuals develop a set of skills to achieve a healthier weight. It is more than helping people
to decide what to change; it is helping them identify how to change.” 15 Cornerstones for
these interventions typically include self-monitoring through daily recording of food intake
and exercise, nutrition education and dietary changes, physical activity goals, and behavior
modification. 16 Research shows that these types of interventions can result in weight loss
and a lower risk for type 2 diabetes, and similar maintenance strategies lead to less weight
regained later. 17
Behavioral interventions have been shown to help individuals achieve and maintain weight
loss of at least 5 percent from baseline weight. The Food and Drug Administration (FDA)
considers a 5 percent weight loss to be clinically significant, as this level of weight
loss has been shown to improve cardiometabolic risk factors such as blood lipid levels
and insulin sensitivity. 17,18 The behavioral intervention team often includes primary care
clinicians, dietitians, psychologists, behavioral therapists, exercise physiologists, and lifestyle
coaches. 17 These programs may include a variety of delivery methods, often through group
classes of 10-20 participants both in-person and online, and may use print-based or
technology-based materials and resources. The interventions usually span one to two years
with more frequent contact in the initial months (weekly to bi-monthly) followed by less
frequent contact (monthly) in the latter months, or maintenance phase. 17 A variety of
behavioral topics are covered over the course of the program and range from nutrition
education and goal-setting to problem-solving and assertiveness. Relapse prevention is
included as participants move into the maintenance phase. 16