Fruit and vegetable intake and eating behaviors mediate the effect of a randomized text-message based weight loss program

IntroductionWe hypothesized that fruit/vegetable intake and eating behaviors mediate the relationship between experimental condition and weight loss in a randomized trial evaluating a text-message based weight loss program.MethodsOverweight/obese individuals from San Diego, CA (N = 52 with complete data) were randomly assigned in 2007 into one of two groups for four months: 1) the intervention group that received 2-5 weight management text-messages p/day; 2) the usual-care comparison group. Three 24-hour recalls assessed fruit/vegetable intake change and the eating behavior inventory (EBI) measured change in eating behaviors. Regression path models tested intervention mediation.ResultsDirect effects of the intervention were found for change in body weight (b = − 3.84, R2 = 0.074), fruit/vegetable intake (b = 2.00, R2 = 0.083), and EBI scores (b = 7.15, R2 = 0.229) (ps < 0.05). The treatment group to weight change path was not statistically significant (b = − 0.673, R2 = 0.208) when fruit/vegetable intake change and EBI score change were specified as intervention mediators in the model. The total indirect effect was 3.17 lb indicating that the indirect paths explained 82.6% of the total effect on weight change.DiscussionFruit/vegetable intake and eating behaviors mediated the intervention's effect on weight change. The findings suggest that sending text-messages that promote healthy eating strategies resulted in moderate short-term weight loss.

► Tested mediation of a text-message based intervention for weight loss. ► Hypothesized fruit/vegetable intake and eating behaviors were intervention mediators. ► Mediation explained 82.6% of the total effect of the intervention on weight loss. ► Text-messages that promote healthy eating resulted in short-term weight loss.