Cafeteria-Based Study of Weight Gain Prevention
Condition: Cardiovascular Diseases; Heart Diseases; Obesity
MeSH terms: Cardiovascular Diseases; Heart Diseases
Study type: Interventional

Summary: 
      To investigate two cafeteria-based methods of weight gain prevention in overweight men and
      women.
    

Detailed description: 
      BACKGROUND:

      Obesity is a risk factor for a number of adverse medical and psychosocial outcomes. Solving
      the obesity problem will require a much greater emphasis on prevention. Treatment research
      indicates that interventions focusing directly on the food environment (structured meals and
      control of food stimuli) have considerable promise for weight control. Prevention research
      has found little support for trying to modify characteristics (e.g., knowledge, beliefs,
      skills) of individuals, perhaps because this approach does little to modify the food
      environment. The research will be implemented in a workplace cafeteria where employees eat
      year-round and where the nutritional composition of the food can be modified.

      The study was initiated in response to a Request for Applications issued in October, 2001 on
      "Environmental Approaches to the Prevention of Obesity". The Request for Applications was
      jointly issued by the National Institute of Diabetes and Digestive and Kidney Diseases, the
      National Institute of Environmental Health Sciences, the National Center for Minority Health
      and Health Disparities, the Office of Behavioral and Social Sciences Research, and the
      National Heart, Lung, and Blood Institute.

      DESIGN NARRATIVE:

      The influence of two promising interventions on food intake, weight change, and related
      outcomes will be investigated. The first intervention consists of a training program aimed at
      reducing the energy density of participants' diets inside and outside of the cafeteria. The
      second intervention consists of financial incentives to encourage the consumption of
      cafeteria foods lower in energy density. Participants will be 195 Caucasian and
      African-American men and women between the ages of 21 and 65. They will have a BMI of 23-35
      and will have characteristics associated with an increased risk of weight gain. Selection and
      intake of lunch foods will be measured with digital photography and cashiers' computerized
      records of food purchases. Cafeteria patrons will be randomly assigned to 1) a
      measurement-only condition; 2) an intervention designed to teach participants how to reduce
      the energy density of their diets; or 3) the reduced energy density intervention plus
      financial incentives for choosing cafeteria foods low in energy density. The potential
      moderating influence of individual differences characteristics on outcome will also be
      evaluated. Outcome measures will be administered repeatedly during the intervention and at 9-
      and 18-month follow-ups. The assessments will include measures of anthropomorphic and blood
      lipid variables, nutritional intake (both in and out of the cafeteria), physical activity,
      overeating, eating self-efficacy, and weight-related quality of life.
    

Intervention name(s): diet; financial incentives
Intervention type(s): Behavioral; Behavioral
Allocation: Randomized
Primary purpose: Prevention