title: American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Electronic feedback in a diet- and physical activity-based lifestyle intervention for weight loss: a randomized controlled trial Using Internet technology to deliver a behavioral weight loss program. Using Internet and Mobile Phone Technology to Deliver an Automated Physical Activity Program: Randomized Controlled Trial A smartphone-supported weight loss program: design of the ENGAGED randomized controlled trial A randomized trial comparing human e-mail counseling, computer-automated tailored counseling, and no counseling in an Internet weight loss program. Physical activity, sedentary behavior and total wellness changes among sedentary adults: a 4-week randomized controlled trial Feasibility and Effectiveness of Online Physical Activity Advice Based on a Personal Activity Monitor: Randomized Controlled Trial The effectiveness of physical activity monitoring and distance counseling in an occupational setting – Results from a randomized controlled trial (CoAct) "Go4Life" exercise counseling, accelerometer feedback, and activity levels in older people. Computerized self-monitoring and technology-assisted feedback for weight loss with and without an enhanced behavioral component. The comparison of a technology-based system and an in-person behavioral weight loss intervention. The efficacy of a technology-based system in a short-term behavioral weight loss intervention. Validation of the Fitbit One activity monitor device during treadmill walking. Tweets, Apps, and Pods: Results of the 6-Month Mobile Pounds Off Digitally (Mobile POD) Randomized Weight-Loss Intervention Among Adults
abstract: Overweight and obesity affects more than 66 % of the adult population and is associated with a variety of chronic diseases . Weight reduction reduces health risks associated with chronic diseases and is therefore encouraged by major health agencies . Guidelines of the National Heart , Lung , and Blood Institute ( NHLBI ) encourage a 10 % reduction in weight , although considerable literature indicates reduction in health risk with 3 % to 5 % reduction in weight . Physical activity ( PA ) is recommended as a component of weight management for prevention of weight gain , for weight loss , and for prevention of weight regain after weight loss . In 2001 , the American College of Sports Medicine ( ACSM ) published a Position St and that recommended a minimum of 150 min wk(-1 ) of moderate-intensity PA for overweight and obese adults to improve health ; however , 200 - 300 min wk(-1 ) was recommended for long-term weight loss . More recent evidence has supported this recommendation and has indicated more PA may be necessary to prevent weight regain after weight loss . To this end , we have reexamined the evidence from 1999 to determine whether there is a level at which PA is effective for prevention of weight gain , for weight loss , and prevention of weight regain . Evidence supports moderate-intensity PA between 150 and 250 min wk(-1 ) to be effective to prevent weight gain .  Moderate-intensity PA between 150 and 250 min wk(-1 ) will provide only modest weight loss . Greater amounts of PA ( > 250 min wk(-1 ) ) have been associated with clinical ly significant weight loss .  Moderate-intensity PA between 150 and 250 min wk(-1 ) will improve weight loss in studies that use moderate diet restriction but not severe diet restriction . Cross-sectional and prospect i ve studies indicate that after weight loss , weight maintenance is improved with PA > 250 min wk(-1 ) . However , no evidence from well- design ed r and omized controlled trials exists to judge the effectiveness of PA for prevention of weight regain after weight loss .  Resistance training does not enhance weight loss but may increase fat-free mass and increase loss of fat mass and is associated with reductions in health risk . Existing evidence indicates that endurance PA or resistance training without weight loss improves health risk . There is inadequate evidence to determine whether PA prevents or attenuates detrimental changes in chronic disease risk during weight gain Background The SenseWear ™ Armb and ( SWA ) ( BodyMedia , Inc. Pittsburgh , PA ) is a physical activity and lifestyle monitor that objective ly and accurately measures free-living energy balance and sleep and includes software for self-monitoring of daily energy expenditure and energy intake . The real-time feedback of the SWA can improve individual self-monitoring and , therefore , enhance weight loss outcomes . Methods We recruited 197 sedentary overweight or obese adults ( age , 46.8 ± 10.8 y ; body mass index ( BMI ) , 33.3 ± 5.2 kg/m2 ; 81 % women , 32 % African-American ) from the greater Columbia , South Carolina area . Participants were r and omized into 1 of 4 groups , a self-directed weight loss program via an evidence -based weight loss manual ( St and ard Care , n = 50 ) , a group-based behavioral weight loss program ( GWL , n = 49 ) , the armb and alone ( SWA-alone , n = 49 ) , or the GWL plus the armb and ( GWL+SWA , n = 49 ) , during the 9-month intervention . The primary outcome was change in body weight and waist circumference . A mixed-model repeated- measures analysis compared change in the intervention groups to the st and ard care group on weight and waist circumference status after adjusting for age , sex , race , education , energy expenditure , and recruitment wave . Results Body weight was available for 62 % of participants at 9 months ( 52 % st and ard care , 70 % intervention ) . There was significant weight loss in all 3 intervention groups ( GWL , 1.86 kg , P = 0.05 ; SWA-alone , 3.55 kg , P = 0.0002 ; GWL+SWA , 6.59 kg , P < 0.0001 ) but not in the St and ard Care group ( 0.89 kg , P = 0.39 ) at month 9 . Only the GWL+SWA group achieved significant weight loss at month 9 compared to the St and ard Care group ( P = 0.04 ) . Significant waist circumference reductions were achieved in all 4 groups at month 9 ( St and ard Care , 3.49 cm , P = 0.0004 ; GWL , 2.42 cm , P = 0.008 ; SWA-alone , 3.59 cm , P < 0.0001 ; GWL+SWA , 6.77 cm , P < 0.0001 ) , but no intervention group had significantly reduced waist circumference compared to the St and ard Care group . Conclusions Continuous self-monitoring from wearable technology with real-time feedback may be particularly useful to enhance lifestyle changes that promote weight loss in sedentary overweight or obese adults . This strategy , combined with a group-based behavioral intervention , may yield optimal weight loss . Trial Registration Clinical Trials.gov : CONTEXT Rapid increases in access to the Internet have made it a viable mode for public health intervention . No controlled studies have evaluated this re source for weight loss . OBJECTIVE To determine whether a structured Internet behavioral weight loss program produces greater initial weight loss and changes in waist circumference than a weight loss education Web site . DESIGN R and omized , controlled trial conducted from April to December 1999 . SETTING AND PARTICIPANTS Ninety-one healthy , overweight adult hospital employees aged 18 to 60 years with a body mass index of 25 to 36 kg/m(2 ) . Analyses were performed for the 65 who had complete follow-up data . INTERVENTIONS Participants were r and omly assigned to a 6-month weight loss program of either Internet education ( education ; n = 32 with complete data ) or Internet behavior therapy ( behavior therapy ; n = 33 with complete data ) . All participants were given 1 face-to-face group weight loss session and access to a Web site with organized links to Internet weight loss re sources . Participants in the behavior therapy group received additional behavioral procedures , including a sequence of 24 weekly behavioral lessons via e-mail , weekly online su bmi ssion of self-monitoring diaries with individualized therapist feedback via e-mail , and an online bulletin board . MAIN OUTCOME MEASURES Body weight and waist circumference , measured at 0 , 3 , and 6 months , compared the 2 intervention groups . RESULTS Repeated- measures analyses showed that the behavior therapy group lost more weight than the education group ( P = .005 ) . The behavior therapy group lost a mean ( SD ) of 4.0 ( 2.8 ) kg by 3 months and 4.1 ( 4.5 ) kg by 6 months . Weight loss in the education group was 1.7 ( 2.7 ) kg at 3 months and 1.6 ( 3.3 ) kg by 6 months . More participants in the behavior therapy than education group achieved the 5 % weight loss goal ( 45 % vs 22 % ; P = .05 ) by 6 months . Changes in waist circumference were also greater in the behavior therapy group than in the education group at both 3 months ( P = .001 ) and 6 months ( P = .005 ) . CONCLUSIONS Participants who were given a structured behavioral treatment program with weekly contact and individualized feedback had better weight loss compared with those given links to educational Web sites . Thus , the Internet and e-mail appear to be viable methods for delivery of structured behavioral weight loss programs Background The Internet has potential as a medium for health behavior change programs , but no controlled studies have yet evaluated the impact of a fully automated physical activity intervention over several months with real-time objective feedback from a monitor . Objective The aim was to evaluate the impact of a physical activity program based on the Internet and mobile phone technology provided to individuals for 9 weeks . Methods A single-center , r and omized , stratified controlled trial was conducted from September to December 2005 in Bedfordshire , United Kingdom , with 77 healthy adults whose mean age was 40.4 years ( SD = 7.6 ) and mean body mass index was 26.3 ( SD = 3.4 ) . Participants were r and omized to a test group that had access to an Internet and mobile phone – based physical activity program  ( n = 47 ) or to a control group ( n = 30 ) that  received no support . The test group received tailored solutions for perceived barriers , a schedule to plan weekly exercise sessions with mobile phone and email reminders , a message board to share their experiences with others , and feedback on their level of physical activity . Both groups were issued a wrist-worn accelerometer to monitor their level of physical activity ;  only the test group received real-time feedback via the Internet . The main outcome measures were accelerometer data and self-report of physical activity . Results At the end of the study period , the test group reported a significantly greater increase over baseline than did the control group for perceived control ( P < .001 ) and intention/expectation to exercise ( P < .001 ) . Intent-to-treat analyses of both the accelerometer data ( P = .02 ) and leisure time self-report data ( P = .03 ) found a higher level of moderate physical activity in the test group . The average increase ( over the control group ) in accelerometer-measured moderate physical activity was 2 h 18 min per week . The test group also lost more percent body fat than the control group ( test group : −2.18 , SD = 0.59 ; control group : −0.17 , SD = 0.81 ; P = .04 ) . Conclusions A fully automated Internet and mobile phone – based motivation and action support system can significantly increase and maintain the level of physical activity in healthy adults Background Obesity remains a major public health challenge , dem and ing cost-effective and scalable weight management programs . Delivering key treatment components via mobile technology offers a potential way to reduce expensive in-person contact , thereby lowering the cost and burden of intensive weight loss programs . The ENGAGED study is a theory-guided , r and omized controlled trial design ed to examine the feasibility and efficacy of an abbreviated smartphone-supported weight loss program . Methods / design Ninety-six obese adults ( BMI 30–39.9 kg/m2 ) will be r and omized to one of three treatment conditions : ( 1 ) st and ard behavioral weight loss ( STND ) , ( 2 ) technology-supported behavioral weight loss ( TECH ) ; or ( 3 ) self-guided behavioral weight loss ( SELF ) . All groups will aim to achieve a 7 % weight loss goal by reducing calorie and fat intake and progressively increasing moderate intensity physical activity to 175 minutes/week . STND and TECH will attend 8 group sessions and receive regular coaching calls during the first 6 months of the intervention ; SELF will receive the Group Lifestyle Balance Program DVD ’s and will not receive coaching calls . During months 1–6 , TECH will use a specially design ed smartphone application to monitor dietary intake , body weight , and objective ly measured physical activity ( obtained from a Blue-tooth enabled accelerometer ) . STND and SELF will self-monitor on paper diaries . Linear mixed modeling will be used to examine group differences on weight loss at months 3 , 6 , and 12 . Self-monitoring adherence and diet and activity goal attainment will be tested as mediators . Discussion ENGAGED is an innovative weight loss intervention that integrates theory with emerging mobile technologies . We hypothesize that TECH , as compared to STND and SELF , will result in greater weight loss by virtue of improved behavioral adherence and goal achievement . Trial registration BACKGROUND Several studies have shown that e-mail counseling improves weight loss achieved in self-directed Internet programs . Computer-tailored feedback offers a population -based alternative to human e-mail counseling . METHODS One hundred ninety-two adults , aged 49.2 + /- 9.8 years , having a body mass index ( calculated as weight in kilograms divided by height in meters squared ) of 32.7 + /- 3.5 , were r and omized to 1 of 3 Internet treatment groups : No counseling , computer-automated feedback , or human e-mail counseling .  All participants received 1 weight loss group session , coupons for meal replacements , and access to an interactive Web site . The human e-mail counseling and computer-automated feedback groups also had access to an electronic diary and message board . The human e-mail counseling group received weekly e-mail feedback from a counselor , and the computer-automated feedback group received automated , tailored messages . RESULTS Retention was 82 % at 3 months and 80 % at 6 months for all 3 groups . At 3 months , completers in both the computer-automated feedback ( -5.3 + /- 4.2 kg ) and human e-mail counseling ( -6.1 + /- 3.9 kg ) groups had significantly greater weight losses compared with the no counseling group ( -2.8 + /- 3.5 kg ) and these groups did not differ from each other . At 6 months , weight losses were significantly greater in the human e-mail counseling group ( -7.3 + /- 6.2 kg ) than in the computer-automated feedback ( -4.9 + /- 5.9 kg ) or no counseling ( -2.6 + /- 5.7 kg ) groups . Intent-to-treat analyses using single or multiple imputation techniques showed the same pattern of significance . CONCLUSIONS Providing automated computer-tailored feedback in an Internet weight loss program was as effective as human e-mail counseling at 3 months . Further research is needed to improve the efficacy of automated computer-tailored feedback as a population -based weight loss approach Background The construct of total wellness includes a holistic approach to the body , mind and spirit components of life . While the health benefits of reducing sedentary behavior and increasing physical activity are well documented , little is known about the influence on total wellness of an internet-based physical activity monitor design ed to help people to achieve higher physical activity levels . Purpose The purpose of this four-week , personal activity monitor-based intervention program was to reduce sedentary behavior and increase physical activity levels in daily living for sedentary adults and to determine if these changes would also be associated with improvement in total wellness . Methods Twenty-two men and 11 women ( 27 years ± 4.0 ) were r and omly assigned to either an intervention ( n = 18 ) or control group ( n = 15 ) . The intervention group interacted with an online personal activity monitor ( Gruve Solution ™ ) design ed to reduce sedentary time  and increase physical activity during activities of daily living . The control group did not interact with the monitor , as they were asked to follow their normal daily physical activities and sedentary behavior routines . The Wellness Evaluation of Lifestyle ( WEL ) inventory was used to assess total wellness . Sedentary time , light , walking , moderate and vigorous intensity physical activities were assessed for both intervention and control groups at baseline and at week-4 by the 7-day Sedentary and Light Intensity Physical Activity Log ( 7-day SLIPA Log ) and the International Physical Activity Question naire ( IPAQ ) . Results Significant increases in pre-post total wellness scores ( from 64 % ± 5.7 to 75 % ± 8.5 ) ( t ( 17 ) = -6.5 , p < 0.001 ) were observed in the intervention group by the end of week four . Intervention participants decreased their sedentary time ( 21 % , 2.3 hours/day ) and increased their light ( 36.7 % , 2.5 hours/day ) , walking ( 65 % , 1057 MET-min/week ) , moderate ( 67 % , 455 MET-min/week ) and vigorous intensity ( 60 % , 442 MET-min/week ) physical activity ( all p < 0.001 ) . No significant differences for total wellness were observed between the groups at baseline and no pre-post significant differences were observed for any outcome variable in the control group . Conclusion Total wellness is improved when sedentary , but sufficiently physically active adults , reduce sedentary time and increase physical activity levels ( i.e. light , waking , moderate and vigorous ) Background Inactive people are often not aware of the fact that they are insufficiently active . Providing insight into their actual physical activity ( PA ) levels may raise awareness and could , in combination with tailored PA advice , stimulate a physically active lifestyle . Objective This study evaluated the feasibility and effectiveness of a 3-month intervention in which Dutch office workers were provided with a personal activity monitor ( PAM ) coupled to simple and concise Web-based tailored PA advice ( PAM COACH ) . Method Participants were r and omly assigned to the 3-month PAM intervention ( n = 51 ) or received a single written information brochure with brief general PA recommendations ( n = 51 ) . Study outcome measures were changes in PA ( recall of minutes per week spent on PA , as measured by the Activity Question naire for Adolescents and Adults ) , determinants of PA , aerobic fitness , and body composition . Follow-up measurements were performed immediately after the 3-month intervention and at 8-months , 5 months after the end of the 3-month intervention period . Results A total of 102 workers , 23 to 39 years old , completed the baseline measurement at the worksite . 48 completed the 3-month follow up and 38 the 8-month follow-up in the intervention group , 50 completed the 3-month follow up and 42 the 8-month follow up in the control group . 35 out of 48 ( 73 % ) participants in the PAM intervention group reported wearing the PAM regularly , and the PAM COACH was used almost once a week ; 24 out of 46 ( 52 % ) PAM users set a personal goal , and 33 ( 72 % ) entered their favorite activities on the website . Main reasons for not using these items were lack of interest or not being able to find the item on the website . The majority of PAM users ( 34 out of 46 , 74 % ) read the advice , of whom 14 ( 39 % ) found it unappealing . After the 3-month intervention , no significant intervention effect was observed ( adjusted difference in min/week ) for sedentary behavior ( β = 10 , 95 % CI = −435 to 455 ) , light-intensity PA ( β = −129 , 95 % CI = −337 to 79 ) , moderate-intensity PA ( β = −13 , 95 % CI = −89 to 63 ) , vigorous-intensity PA ( β= −6 , 95 % CI = −75 to 62 ) , and moderate- to vigorous-intensity PA ( β = −23 , 95 % CI = −121 to 76 ) . No significant intervention effect was observed in the PA outcomes at the 8-month follow-up . For the determinants of PA , aerobic fitness , and body composition , no statistically significant intervention effect was observed in the total study population immediately after the 3-month intervention or the 8-month follow-up . Conclusions The intervention appeared to be easily applicable to real-life setting s. The intervention was ineffective in improving PA behavior or its determinants in healthy office workers . More attention should have been given to the quality and appropriateness of the tailored advice . Trial Registration International St and ard R and omized Controlled Trial Number ( IS RCT N ) : 93896459 ; http://www.controlled-trials.com/IS RCT N93896459/ ( Archived by WebCite at http://www.webcitation.org/5iR3mf7ex Background Lack of physical activity ( PA ) is a known risk factor for many health conditions . The workplace is a setting often used to promote activity and health . We investigated the effectiveness of an intervention on  PA and productivity-related outcomes in an occupational setting . Methods We conducted a r and omized controlled trial of 12 months duration with two 1:1 allocated parallel groups of insurance company employees . Eligibility criteria included permanent employment and absence of any condition that risked the participant ’s health during PA . Subjects in the intervention group monitored their daily PA with an accelerometer , set goals , had access to an online service to help them track their activity levels , and received counseling via telephone or web messages for 12 months . The control group received the results of a fitness test and an information leaflet on PA at the beginning of the study . The intervention ’s aim was to increase PA , improve work productivity , and decrease sickness absence . Primary outcomes were PA ( measured as MET minutes per week ) , work productivity ( quantity and quality of work ; QQ index ) , and sickness absence ( SA ) days at 12 months . Participants were assigned to groups using block r and omization with a computer-generated scheme . The study was not blinded . Results There were 544 r and omized participants , of which 521 were included in the analysis ( 64 % female , mean age 43 years ) . At 12 months , there was no significant difference in physical activity levels between the intervention group ( n = 264 ) and the control group ( n = 257 ) . The adjusted mean difference was −206 MET min/week [ 95 % Bayesian credible interval −540 to 128 ; negative values favor control group ] . There was also no significant difference in the QQ index ( −0.5 [ −4.4 to 3.3 ] ) or SA days ( 0.0 [ −1.2 to 0.9 ] ) . Of secondary outcomes , body weight ( 0.5 kg [ 0.0 to 1.0 ] ) and percentage of body fat ( 0.6 % [ 0.2 % to 1.1 % ] ) were slightly higher in the intervention group . An exploratory subgroup analysis revealed no subgroups in which the intervention affected physical activity . No adverse events were reported . Conclusions The intervention was not found effective , and this study does not provide support for the effectiveness of the workplace PA intervention used here . Trial registration Clinical Trials.gov identifier : Older people are more sedentary than other age groups . We sought to determine if providing an accelerometer with feedback about activity and counseling older subjects using Go4Life educational material would increase activity levels . Participants were recruited from independent living areas within assisted living facilities and the general public in the Rochester , MN area . 49 persons aged 65 - 95 ( 79.5±7.0 years ) who were ambulatory but sedentary and overweight participated in this r and omized controlled crossover trial for one year . After a baseline period of 2 weeks , group 1 received an accelerometer and counseling using Go4Life educational material ( www.Go4Life.nia.nih.gov ) for 24 weeks and accelerometer alone for the next 24 weeks . Group 2 had no intervention for the first 24 weeks and then received an accelerometer and Go4Life based counseling for 24 weeks . There were no significant baseline differences between the two groups . The intervention was not associated with a significant change in activity , body weight , % body fat , or blood parameters ( p>0.05 ) . Older ( 80 - 93 ) subjects were less active than younger ( 65 - 79 ) subjects ( p=0.003 ) . Over the course of the 48 week study , an increase in activity level was associated with a decline in % body fat ( p=0.008 ) . Increasing activity levels benefits older patients . However , providing an accelerometer and a Go4Life based exercise counseling program did not result in a 15 % improvement in activity levels in this elderly population . Alternate approaches to exercise counseling may be needed in elderly people of this age range OBJECTIVE The purpose of this study was to develop and evaluate a 12-week weight management intervention involving computerized self-monitoring and technology-assisted feedback with and without an enhanced behavioral component . METHODS 120 overweight ( 30.5±2.6kg/m(2 ) ) adults ( 45.0±10.3 years ) were r and omized to one of three groups : computerized self-monitoring with Basic feedback ( n=45 ) , Enhanced behavioral feedback ( n=45 ) , or wait-list control ( n=30 ) . Intervention participants used a computer software program to record dietary and physical activity information . Weekly e-mail feedback was based on computer-generated reports , and participants attended monthly measurement visits . RESULTS The Basic and Enhanced groups experienced significant weight reduction ( -2.7±3.3 kg and -2.5±3.1 kg ) in comparison to the Control group ( 0.3±2.2 ; p<0.05 ) . Waist circumference and systolic blood pressure also decreased in intervention groups compared to Control ( p<0.01 ) . CONCLUSIONS A program using computerized self-monitoring , technology-assisted feedback , and monthly measurement visits produced significant weight loss after 12 weeks . However , the addition of an enhanced behavioral component did not improve the effectiveness of the program . PRACTICE IMPLICATION S This study suggests that healthcare professionals can effectively deliver a weight management intervention using technology-assisted strategies in a format that may complement and reduce face-to-face sessions The purpose of this study was to compare a technology-based system , an in-person behavioral weight loss intervention , and a combination of both over a 6-month period in overweight adults . Fifty-one subjects ( age : 44.2 ± 8.7 years , BMI : 33.7 ± 3.6 kg/m(2 ) ) participated in a 6-month behavioral weight loss program and were r and omized to one of three groups : st and ard behavioral weight loss ( SBWL ) , SBWL plus technology-based system ( SBWL+TECH ) , or technology-based system only ( TECH ) . All groups reduced caloric intake and progressively increased moderate intensity physical activity . SBWL and SBWL+TECH attended weekly meetings . SBWL+TECH also received a TECH that included an energy monitoring armb and and website to monitor energy intake and expenditure . TECH used the technology system and received monthly telephone calls . Body weight and physical activity were assessed at 0 and 6 months . Retention at 6 months was significantly different ( P = 0.005 ) between groups ( SBWL : 53 % , SBWL+TECH : 100 % , and TECH : 77 % ) . Intent-to-treat ( ITT ) analysis revealed significant weight losses at 6 months in SBWL+TECH ( -8.8 ± 5.0 kg , -8.7 ± 4.7 % ) , SBWL ( -3.7 ± 5.7 kg , -4.1 ± 6.3 % ) , and TECH ( -5.8 ± 6.6 kg , -6.3 ± 7.1 % ) ( P < 0.001 ) . Self-report physical activity increased significantly in SBWL ( 473.9 ± 800.7 kcal/week ) , SBWL+TECH ( 713.9 ± 1,278.8 kcal/week ) , and TECH ( 1,066.2 ± 1,371 kcal/week ) ( P < 0.001 ) , with no differences between groups ( P = 0.25 ) . The TECH used in conjunction with monthly telephone calls , produced similar , if not greater weight losses and changes in physical activity than the st and ard in-person behavioral program at 6 months . The use of this technology may provide an effective short-term clinical alternative to st and ard in-person behavioral weight loss interventions , with the longer term effects warranting investigation OBJECTIVE The objective was to examine the efficacy of adding a technology-based program to an in-person , behavioral weight loss intervention . RESEARCH METHODS AND PROCEDURES Fifty-seven subjects ( BMI = 33.1+/-2.8 kg/m2 ; age=41.3+/-8.7 years ) participated in a 12-week intervention with r and om assignment to St and ard In-Person Behavioral Weight Control Program ( SBWP ) or Intermittent or Continuous Technology-Based Program ( INT-TECH , CON-TECH ) . SBWP subjects received seven individualized weight loss sessions encouraging dietary and exercise modifications . INT-TECH and CON-TECH subjects received all SBWP components ; additionally , these groups used a SenseWear Pro Armb and ( BodyMedia , Inc. ) to monitor energy expenditure and an Internet-based program to monitor eating behaviors . These features were used by INT-TECH subjects during weeks 1 , 5 , and 9 and CON-TECH subjects weekly throughout the intervention . RESULTS Intent-to-treat analysis revealed weight loss of 4.1+/-2.8 kg , 3.4+/-3.4 kg , and 6.2+/-4.0 kg , for SBWP , INT-TECH , and CON-TECH groups , respectively ( CON-TECH > INT-TECH , p < or=0.05 ) . DISCUSSION These results indicate that the technology-based program needs to be used continuously throughout the intervention period to significantly impact weight loss . Future studies should examine the long-term and independent effect of this technology on weight loss , and for whom this intervention format is most effective OBJECTIVES In order to quantify the effects of physical activity such as walking on chronic disease , accurate measurement of physical activity is needed . The objective of this study was to determine the validity and reliability of a new activity monitor , the Fitbit One , in a population of healthy adults . DESIGN Cross-sectional study . METHODS Thirty healthy adults ambulated at 5 different speeds ( 0.90 , 1.12 , 1.33 , 1.54 , 1.78 m/s ) on a treadmill  while  wearing three Fitbit One activity monitors  ( two on the hips and one in the pocket ) . The order of each speed condition was r and omized . Fitbit One step count output was compared to observer counts and distance output was compared to the calibrated treadmill output . Two-way repeated measures ANOVA , concordance correlation coefficients , and Bl and and Altman plots were used to assess validity and intra-class correlation coefficients ( ICC ) were used to assess reliability . RESULTS No significant differences were noted between Fitbit One step count outputs and observer counts , and concordance was substantial ( 0.97 - 1.00 ) . Inter-device reliability of the step count was high for all walking speeds ( ICC ≥ 0.95 ) . Percent relative error was less than 1.3 % . The distance output of the Fitbit One activity monitors  was significantly different from the criterion values for each monitor at all speeds ( P<0.001 ) and exhibited poor concordance ( 0.0 - 0.05 ) . Inter-device reliability was excellent for all treadmill speeds ( ICC ≥ 0.90 ) . Percent relative error was high ( up to 39.6 % ) . CONCLUSIONS The Fitbit One activity monitors are valid and reliable devices for measuring step counts in healthy young adults . The distance output of the monitors is inaccurate and should be noted with caution Background Previous interventions have shown promising results using theory-based podcasts to deliver a behavioral weight-loss intervention . Objective The objective of our study was to examine whether a combination of podcasting , mobile support communication , and mobile diet monitoring can assist people in weight loss  . Methods In this 6-month , minimal contact intervention , overweight ( n = 96 , body mass index 32.6 kg/m2 ) adults were recruited through television advertisements and email listservs and r and omly assigned to Podcast-only or Podcast+Mobile groups . Both groups received 2 podcasts per week for 3 months and 2 minipodcasts per week for months 3–6 . In addition to the podcasts , the Podcast+Mobile group was also instructed to use a diet and physical activity monitoring application ( app ) on their mobile device and to interact with study counselors and other participants on Twitter . Results Weight loss did not differ by group at 6 months : mean –2.7 % ( SD 5.6 % ) Podcast+Mobile , n = 47 ; mean –2.7 % ( SD 5.1 % ) Podcast , n = 49 ; P = .98 . Days/week of reported diet monitoring did not differ between Podcast+Mobile ( mean 2.3 , SD 1.9 days/week ) and Podcast groups ( mean 1.9 , SD 1.7 days/week ; P = .28 ) but method of monitoring did differ . Podcast+Mobile participants were 3.5 times more likely than the Podcast group to use an app to monitor diet ( P = .01 ) , whereas the majority of Podcast participants reported using the Web ( 14/41 , 34 % ) or paper ( 12/41 , 29 % ) . There were more downloads per episode in the Podcast+Mobile group ( 1.4/person ) than in the Podcast group ( 1.1/person ; P < .001 ) . The number of podcasts  participants reported downloading over the 6-month period was significantly moderately correlated with weight loss in both the Podcast+Mobile ( r = –.46 , P = .001 ) and the Podcast ( r = –.53 , P < .001 ) groups . Podcast+Mobile participants felt more user control at 3 months ( P = .02 ) , but not at 6 months , and there was a trend ( P = .06 ) toward greater elaboration among Podcast+Mobile participants . There were significant differences in reported source of social support between groups . More Podcast participants relied on friends ( 11/40 , 28 % vs 4/40 , 10 % ; P = .045 ) whereas Podcast+Mobile participants relied on online sources ( 10/40 , 25 % vs 0/40 ; P = .001 ) . Conclusions Results confirm and extend previous findings showing a minimally intensive weight-loss intervention can be delivered via podcast , but prompting and mobile communication via Twitter and monitoring app without feedback did not enhance weight loss . Trial Registration Clinical trials.gov NCT01139255 ; http:// clinical trials.gov/ct2/show/NCT01139255 ( Archived by WebCite at http://www.webcitation.org/625OjhiDy
target: Conclusion These studies provide preliminary evidence suggesting that EAMS can increase physical activity and decrease weight significantly , but their efficacy compared to other interventions has not yet been demonstrated .
background: Background Obesity is a growing global health concern that may lead to cardiovascular disease , type II diabetes , and cancer .
  Several systematic review s have shown that technology is successful in combating obesity through increased physical activity , but there is no known review on interventions that use an electronic activity monitor system ( EAMS ) .
  EAMSs are defined as a wearable device that objective ly measures lifestyle physical activity and can provide feedback , beyond the display of basic activity count information , via the monitor display or through a partnering application to elicit continual self-monitoring of activity behavior .
  These devices improve upon st and ard pedometers because they have the ability to provide visual feedback on activity progression , verbal encouragement , and social comparison .
  This systematic review aim ed to synthesize the efficacy and feasibility results of EAMSs within published physical activity interventions .