Background – One of the most effective intervention methods to assist with lifestyle modifications for weight management involves individual counselling with face to face contact, however, this method is time intensive and costly for patients. Recently, internet based interventions and education programs have been developed. The internet can access a large number of consumers in a more cost effective manner than other information delivery channels. Objectives – To determine whether an online, personalised weight reduction program including dietary advice plus exercise is more effective in reducing weight than an exercise only program over 12 weeks.
Design – Participants were randomized to either an exercise only group (EX) or a diet plus exercise group (ED). Body Mass Index (BMI) and 24 hour dietary records were collected at baseline and week 12. Participants attended a baseline and final intervention visit where anthropometric measurements were performed. Subjects wore a pedometer, recorded daily steps and set weekly goals to increase daily steps through the internet program. The ED group also received healthy eating advice, set dietary goals via the internet and received personalised email assistance.
Outcomes – Seventy three participants commenced and 53 completed (EX n = 26; ED n = 27; BMI (mean (SD)), 29.7 (2.5) kg/m2; age 46.3 (10.8); 21% male). The percent weight changes were: EX, 2.1 (0.6) %; ED, 0.9 (0.6) % (P = 0.15), and change in total energy intake was EX, +110 (666.6) kJ ED, -1812.6 (803.4) kJ, P = 0.07 between groups, with no difference in daily step change (ED 3525 (896.7), EX 3148 (848.2) steps, P = 0.76).
Conclusions – An internet-based program with goal setting resulted in a mean weight loss of 1-2%. The combined exercise and dietary modifications did not result in a greater weight loss when compared to exercise alone. Dietary education did not enhance weight loss over 12 weeks and there was an indication of a greater weight loss in the exercise only group, even though the ED group reported a similar increase in physical activity and a greater fall in energy intake. It may be that those randomised to the exercise group made additional lifestyle changes that we were unable to detect.