Internal Cues Versus External Cues for Eating and Activity

University of Delaware

Status: Completed

Conditions: Dietary Habits; Eating Behavior; Diet Habit; Body Image

Treatments: Other: Internal Cues; Other: External Cues

Study type: Interventional

Funder types: Other

Identifiers

NCT04025099

1408101

Details and patient eligibility

About

The majority of female undergraduate students experience disordered eating and/or weight gain, increasing the risk for two serious public health problems, eating disorders and obesity. Traditional nutrition education about weight control delivered during college has not been effective and may even exacerbate these problems. Thus, the investigators propose that instead of focusing on external information as taught by nutrition education (e.g. 'calories in, calories out', quantification and cognitive processing of nutrition information), at-risk females be trained to become more attuned to their internal hunger and fullness signaling to set them on a trajectory for decreased chronic disease risk as they age.

Full description

The proposed study, Internal versus External Cues for Eating and Activity, will collect data on within-person changes in psychological (e.g. attunement with bodily signals, eating and activity behaviors) and physiological (e.g., body mass index, heart rate, saliva) markers of risk for both eating disorders and obesity in female University of Delaware students. Outcomes will be assessed at baseline, mid-treatment, end-of-treatment, and one-year follow-up. This three-armed randomized, controlled trial will assess the effects of a novel internal cues intervention (treatment group; intuitive eating and body positive yoga) compared to an active control group consisting of traditional healthy weight sessions, following standardized government recommendations for eating and activity, and a no-treatment control group completing assessments only. The Internal Cues group will attend one intuitive eating session and take three body-positive yoga sessions weekly for ten weeks. The External Cues group will attend one healthy weight class and three cardiovascular-based exercise sessions each week for ten weeks. The Assessment Only no-treatment control group will only attend assessments. The curriculum for the intuitive eating classes (previously piloted and revised accordingly) and healthy weight classes (modeled off of classes offered at universities and government-available recommendations and educational documents) will be taught by two Registered Dietitians who are Certified Intuitive Eating Counselors. The yoga classes will be taught by a Registered Yoga Instructor trained in Body Positive Yoga and in a curriculum specifically designed for UD students (funded by Dean Matt). During the Internal Cues group's intuitive eating classes, participants will, as a group, eat dinner that is prepared by ServSafe certified undergraduate dietetics students in the test kitchen in the STAR Tower. This dinner will allow the participants to experientially learn the intuitive eating principles taught in class. The External Cues group will receive an identical dinner during the class period but they will learn how to properly portion their meals to meet their caloric needs, in line with traditional education about weight control. Finally, students randomized to the External Cues group will receive a UD fitness pass and will be able to choose from select cardio-based fitness classes in order to meet public health recommendations for physical activity.

Additionally, the interventionists for both the Internal Cues and External Cues sessions will be video recorded to allow content to be tested in a lab study following the intervention. The research team worked with IT at STAR campus to position equipment so that the video only captures the interventionists (session leaders). Participants will not be recorded. If any participant audio is captured, content containing participants' voices will be deleted from the file. The purpose of recording is to modify the curriculum for future interventions and programs.

Enrollment: 32 patients

Sex: Female

Ages: 18 to 26 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Female
• Between the ages of 18 and 26
• Freshman, Sophomore, or Junior University of Delaware student
• Willing and able to commit to the 10-week study at the specified times and a follow up visit 1-year after the completion of the study
• Have concerns about body shape, weight, and/or eating
• Are not currently being treated for an eating disorder

Exclusion criteria

• They do not meet the inclusion criteria.
• They have a severe medical food allergy.
• They are pregnant - this program is not geared towards someone who is pregnant.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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32 participants in 3 patient groups

Internal Cues

Experimental group

Description:

Over 10 weeks, participants will be asked to participate in the following: 1. Classes (held in STAR Tower 419/420 IPE Space and Conference Room 413) * One \~60-minute Intuitive Eating class per week (total = 10 classes); * Two \~60-minute yoga classes per week (total = 20 classes); * Repeat one of the \~60-minute yoga classes each week on the participants' own, in a space participants feel comfortable, using a video recording (total = 10 classes). 2. Assessments (held in STAR tower) * Three \~60-minute assessments\* which will include: 1. Height \& weight measurements (taken privately) 2. A questionnaire that asks about participants' relationship with their body and eating and activity behaviors 3. Collection of participants' heart rate overnight (on their own) 4. Collection of participants' saliva three times in one day (on their own)

Treatment:

Other: Internal Cues

External Cues

Active Comparator group

Description:

Over the next 10 weeks, participants will be asked to participate in the following: 1. Classes (held in STAR Tower 419/420 IPE Space) * One \~60-minute Healthy Eating class per week (total = 10 classes); * Participants will be provided with a UD group fitness membership. Using this membership, participants will be asked to attend at least 2 cardio fitness classes per week and do an additional 30 minutes of heart-raising activity on participants' own (total = 3 exercise sessions/week). 2. Assessments (held in STAR tower) * Three \~60-minute assessments\* which will include: 1. Height \& weight measurements (taken privately) 2. A questionnaire that asks about participants' relationship with their body and eating and activity behaviors 3. Collection of participants' heart rate overnight (on their own) 4. Collection of participants' saliva three times in one day (on their own)

Treatment:

Other: External Cues

Assessment Only

No Intervention group

Description:

Over the next 10 weeks, participants will be asked to participate in the following: a. Assessments (held in STAR tower) •Three \~60-minute assessments\* which will include: 1. Height \& weight measurements (taken privately) 2. A questionnaire that asks about participants' relationship with their body and eating and activity behaviors 3. Collection of participants' heart rate overnight (on their own) 4. Collection of participants' saliva three times in one day (on their own)