Health at Every Size Program Intervention Versus Traditional Weight Loss Intervention: Impact on Diet and Physical Activity

Backround. A shift from a weight-focus to a health focus -Health At Every Size (HAES)-has been suggested. Yet, little research has compared the impact of this approach to a traditional weight loss program on diet, while physical activity, anthropometric and health indicators have been mixed. Objective. This study evaluated diet, physical activity, anthropometric measurements, blood pressure, blood sugar and cholesterol in participants in these two interventions. It was hypothesized that the HAES group would consume a more nutrient dense diet, more whole foods, higher fiber and lower sodium, while the traditional group would consume lower calories, fat and fiber and that physical activity would increase in both. Study design. A convenience sample controlled trial. Participants. 46 adults (n=29 in HAES and n=17 traditional) in the community, registered to one of the four medical facilities, without diabetes or an eating disorder. Attrition rate was (n=4) 14% in HAES and (n=10) 59% in traditional group. Intervention. Parallel interventions on Manitoulin Island were run from April to July 2015. The HAES group focused on mindful eating and movement and body and food acceptance. The traditional group focused on calorie and fat reduction and increasing physical activity to achieve weight loss and diabetes prevention. Statistical analysis. T-tests were used to compare baseline data. Regression analysis was used to compare follow-up demographic and health indicator data, mixed model regression was used for follow-up diet data and changes within groups were assessed using paired t-tests. Group, age and caloric intake were controlled for as applicable. Results. Both groups lost weight and the traditional group significantly lowered waist circumference (all p=0.01). Systolic blood pressure and hemoglobin A1c decreased in the HAES group (p=0.01). Healthy Eating Index score increased (7.41±2.31; p=0.01) and sodium intake decreased (-1298.26±612.20; p=0.05) in the HAES group. The traditional group ate more calories (p=0.05) and less fiber (p=0.01) than the HAES group. The traditional group consumed significantly less vitamin C from pre- to post-intervention (-46.63±17.77, p=0.05). Conclusions. Both groups lost weight but the traditional approach resulted in a more favorable change in body composition, while the HAES approach facilitated health indicator and dietary improvements