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Q: Compliance Factors for Diets ( Answered 5 out of 5 stars,   3 Comments )
Subject: Compliance Factors for Diets
Category: Health > Fitness and Nutrition
Asked by: broker-ga
List Price: $60.00
Posted: 27 Jul 2005 17:35 PDT
Expires: 26 Aug 2005 17:35 PDT
Question ID: 548743
I need to find any research that analyzes what factors in diets --
whether south beach, atkins, zone, whatever -- results in the highest
compliance...that is, those sticking with the diet.

For example, I've come across some research that says that having a
buddy do that diet with you increases compliance, and thus success of
the diet.
Subject: Re: Compliance Factors for Diets
Answered By: bobbie7-ga on 27 Jul 2005 21:38 PDT
Rated:5 out of 5 stars
Hello Broker,

Here is a study that states that prepared meal programs improve dietary compliance.

?Examination of the study's results reveals strong support for the
idea that prepared meal programs improve dietary compliance through
facilitation of planning and implementation. The results were
self-evident in that patients in the prepared meal plan group showed a
significantly greater reduction in hassles related to planning and
preparation of meals. These results may be explained by the fact that
self-selecting and preparing a meal is time consuming and involves
several complex and difficult tasks including calculation of the
nutrient content of the foods, determination of the correct balance of
foods that provide the appropriate combination of nutrients,
determination of appropriate portion sizes, and determination of food
preparation. Prepared meals on the other hand, require none of these
tasks. Further improvements in monitoring  compliance by lessening
burdens associated with diet plan implementation.?

January Lee (2001) ?Diet Programs and Compliance: Do Prepared Meal
Programs Increase Adherence??,
Nutrition Bytes: Vol. 7: No. 1, Article 3.

Download here:


Another study states that exercise enhances dietary compliance. 


?The effect of aerobic exercise on dietary compliance was assessed in
13 obese women (44 +/- 3% fat) during a 12-wk weight-reduction program
(EX group). Seventeen obese women (45 +/- 5% fat) not engaged in
aerobic exercise (NX group) served as control subjects. The reducing
diets were designed to promote a weight loss of 1 kg/wk, with energy
intakes individually prescribed (mean +/- SD: 4.9 +/- 0.6 MJ/d) to
approximate 75% of each subject's measured basal metabolic rate. The
EX group completed of three 45-min sessions/wk of supervised aerobic
exercise at 65% of maximal oxygen consumption (VO2max). Daily energy
intakes were calculated by summing changes in body stores, measured by
total body water isotope dilution, and total daily energy expenditure,
measured by doubly labeled water (DLW). Dietary compliance was
assessed by comparing calculated intakes with prescribed intakes. Both
the EX and NX groups reported consuming close to their prescribed
daily intakes, with differences of -0.08 +/- 0.28 (EX group) and +0.03
+/- 0.57 (NX group) MJ/d, respectively. However, expenditure/balance
data determined by the DLW method indicated that the EX subjects
exhibited better dietary compliance than the NX subjects, with intakes
exceeding those prescribed by only 0.7 +/- 1.5 compared with 2.3 +/-
1.6 MJ/d for the NX subjects (P = 0.01).?

?Therefore, an additional benefit of aerobic exercise during energy
restriction is enhanced dietary compliance, which has important
implications for the treatment of moderate obesity.?

Exercise enhances dietary compliance during moderate energy
restriction in obese women.?
Department of Medicine, University of Chicago, IL 60637, USA 
American Journal of Clinical Nutrition, Vol 62, 345-349


An informative article by Steven Masley, MD ?Enhancing Dietary
Compliance: How Can We Do A Better Job??


?Growing evidence shows that providing detailed menu plans and meeting
with patients in group settings also improves dietary compliance.?

Dietary compliance is improved by intense initial nutrition counseling.
?Some programs have used a residential component which was effective
but added significant expense to the program. Other investigators
simplified their recommendations by teaching patients to count the
grams of fat they were eating. Group cooking and shopping classes are
less expensive than are residential training programs and are also

Monthly monitoring of food intake can be a powerful tool in improving compliance. 

?Patients who use one-, four-, or seven-day food records are forced to
analyze their food intake and to assess their fat intake. Monthly
records not only reinforce dietary compliance, but also help patients
to become experts on the fat content of commonly eaten foods.
Simplified for patient convenience, the record can be modified to
count only servings of high-fat foods, whole grains, vegetables, and

Social Support Systems and Motivational Techniques

?Family involvement can "make or break" dietary compliance, especially
if a partner does the shopping or cooking. Inviting spouses and
companions to nutrition classes improves dietary compliance. In
addition, food preparation is easier when only one meal is made, and
the stigma of changing diets is lessened when the family changes
eating habits together. In a managed care environment, inviting family
has the added value of improving the health outcome for two or more
people for the price of treating one.?

?Providing food directly to patients improves dietary compliance.?

The Permanent Journal

Here is a list of 9 factors that enhance dietary compliance.


Dietary compliance is likely a function of psychological issues

?Dietary compliance is likely a function of psychological issues
(e.g., frequency of dietary counseling, coping with emotional eating,
group support) rather than macronutrient composition, per se . Being
conscious of one?s behaviors, using social support, confronting
problems directly, and using personally developed strategies may
enhance long-term success . Ogden  notes that successful weight loss
and maintenance may be predicted by an individuals? belief system
(e.g., that obesity is perceived as a problem that can be modified and
if modifications bring changes in the short-term that are valued by
the individual concerned).?

Summary and Recommendations 

?Caloric balance (calories in vs. calories out), rather than
macronutrient composition is the major determinant of weight loss.
However, what is not clear is the effect of macronutrient content on
long-term weight maintenance and adherence. Furthermore, it is not
known whether maintenance of weight loss and dietary adherence is
related to psychological issues (and brain neurochemistry),
physiological parameters (e.g., hormones involved in body weight
regulation such as insulin and leptin), physical activity, energy
density, or some other factor(s).?

United States Department of Agriculture
Popular Diets: A Scientific Review 1/2
Obesity Research 9(2001):

Popular Diets: A Scientific Review

Download full text here::


It has also been claimed that dietary compliance is likely to be
better with diets having a low carbohydrate content.

?This concept is based on the observation that carbohydrate reduces
hyperketonaemia, which is alleged to reduce hunger. The
hyperketonaemia of starvation is particularly sensitive to
carbohydrate intake. Diets containing more carbohydrate have been
reported to be associated with greater hunger (DAVIES et al., 1984),
and therefore more likely to be associated with a poor dietary
compliance. However, hard data to support the concept that ketone
bodies have an important effect on hunger is difficult to find.?

United Nations University


Search terms: 

Dietary compliance weight loss + research
Compliance factors diets  + study

I hope the information provided is helpful!

Best regards,

Request for Answer Clarification by broker-ga on 27 Jul 2005 22:22 PDT
This is all great.

Do you have any more data you can get on compliance via the buddy
system, with peer support?  Specifically looking for protocols and
methods used to design buddy system, what rules of engagement were
used, how the programs were structured, etc.

Clarification of Answer by bobbie7-ga on 27 Jul 2005 23:40 PDT
Hello again Broker,

Here is some information regarding the Buddy System used in dieting.

The Get Lean America? Exercise and Nutrition Program

?Motivation drives you toward your goal. People start out their
get-in-shape programs full of enthusiasm and motivation, but lose
steam along the way. That?s because part of staying motivated is
rooted in Reason One, starting with the right information. If you have
the right information you will see results, which will help motivate
you to continue your program. Positive feedback reinforces positive
behavior. Getting a ?buddy? or partner to go through this program with
you is helpful and will provide a support system for you.?


Why The Buddy System Works


Evidence-Based Trends for Achieving Weight Loss and Increased Physical
Activity: Applications for Diabetes Prevention and Treatment

?The weight and activity outcomes achieved in these diabetes
prevention studies appear to be largely a function of goal-setting,
tailored treatment, and the intensity of follow-up related to diet,
activity, and weight-loss goals. In the DPP, if participants had
difficulty achieving the weight-loss and physical-activity goals, a
toolbox approach was used to help tailor strategies to each
participant?s individual situation. Lifestyle coaches discussed
barriers to achieving or maintaining the physical activity and
weight-loss goals with each participant and then selected from a
variety of approaches to help them improve or maintain their
physical-activity or weight-loss performance. Toolbox options included
telephone reminders, contracting, a buddy system, meal replacements,
structured menus, subsidizing gym membership, and others.?


People and pets can succeed together in fighting obesity epidemic

?Results of the first-ever, 12-month combined people and pet weight
management study were presented today at the North American
Association for the Study of Obesity's (NAASO's) Annual Scientific
Meeting?the largest conference in North America focusing on obesity
research and treatment. The People and Pets Exercising Together
(P-PET) study by Northwestern Memorial Hospital and Hill's Pet
Nutrition, the maker of Science DietŪ and Prescription DietŪ brand pet
foods, demonstrates people and their pets are both more successful in
staying with a weight loss program when they exercise together.?


The Buddy System for Losing Weight Works

"If you're looking for motivation and social support to lose weight,
you probably don't have to look any further than the pet in your own
home," said Dr. Robert Kushner of Northwestern Medical School in
Chicago, who led the study.

?The dog owners did slightly better than the dieters who walked and
dieted alone. Overall, people lost an average of 11 pounds, or 5
percent of their body weight, in the first four months and kept it off
for the next eight. The most anyone lost was 51 pounds. But the diet
was less onerous and more fun for the dog-walkers. ?

To obtain a more in depth response about Buddy Systems I would suggest
that you post a new question. Please specify that your requirements
are protocols, methods, rules and how the programs were structured.

Best regards,
broker-ga rated this answer:5 out of 5 stars and gave an additional tip of: $20.00
Great job with this...added some extra for your clarifications/expansions.

Subject: Re: Compliance Factors for Diets
From: bobbie7-ga on 28 Jul 2005 10:03 PDT
Thank you very much for the five stars and nice tip!
Subject: Re: Compliance Factors for Diets
From: broker-ga on 28 Jul 2005 11:09 PDT
BTW, I did post a separate question to drill down into more detail on
the buddy system, so feel free to take a crack at that if you like.
Subject: Re: Compliance Factors for Diets
From: bobbie7-ga on 28 Jul 2005 11:29 PDT
Thanks for letting me know. I'll see what I can find.

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