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When lifestyle interventions target households, change may be possible

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We know one person can adopt a more healthful lifestyle -- but can an entire household? It’s possible, with some success, according to a recent study published online in the journal Obesity.

Most weight-loss intervention studies focus on individuals, but researchers in this study worked with 90 households to see if an intervention designed to create more beneficial habits would have any effect. Half of the households took part in the intervention for a year, while the other half did not, and served as a control.

In the intervention homes, locking devices were placed on televisions to limit viewing time. Scales were provided so adults could weigh themselves daily, and food purchases were noted.

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Goals were set for households and individuals to influence them to change their behavior. Households, for example, were encouraged to cut TV viewing time in half, encourage family members to do 30 minutes of physical activity a day, and limit the availability of sweetened drinks to 12 ounces or less per person. Individuals were encouraged to limit high-calorie snack foods such as chips or cake, eat at least five servings of fruit and vegetables per day, and eat smaller portions.

Households also took part in six group sessions, received monthly newsletters, and had a series of home-based activities that supported the behavior-change messages.

The result: the intervention households ate sweets and snack foods far less often. When broken down by age, teens in the intervention group upped their intake of fruits and vegetables, and adults consumed far fewer snacks, sweets and sugar-sweetened beverages compared with the control group. The intervention households also spent less money on eating out compared with the controls. Television watching also decreased considerably in the intervention households, and adults in that group also walked and took part more in moderate to vigorous physical activity than the controls.

Having the scales seemed to make a difference as well. In the intervention group 71% of adults weighed themselves weekly or more frequently, compared with 36% in the control group.

Body mass index did not change significantly in the intervention group. While the authors wrote that they were disappointed that weight did not change, they offered some reasons why it may not have gone down: the study was designed to prevent weight gain, so the behavior changes suggested were modest; and the year-long intervention may have been too short to see any significant weight changes. Also, targeting a number of behaviors can prove challenging.

The authors wrote, “Stronger home food environment intervention components and longer intervention durations are needed to prevent excess weight gain among families in the community.”

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