Study finds that American Heart Association Scientific Sessions 2022 , Summary 385
In a small study, most adults looking to lose weight overestimated the healthiness of their diet, according to preliminary research to be presented at the American Heart Association’s 2022 Scientific Sessions. The meeting, held in person and virtually in Chicago from November 5-7, 2022, is a premier global exchange of the latest scientific advances, research and updates to evidence-based clinical practice in cardiovascular science.
"We found that while people generally know that fruits and vegetables are healthy, there may be a disconnect between what researchers and health professionals consider a healthy, balanced diet compared to what the public thinks is a healthy, balanced diet," said study author Jessica Cheng, Ph.D., a postdoctoral researcher in epidemiology at the Harvard TH Chan School of Public Health and in general internal medicine at Massachusetts General Hospital, both in Boston. This research was conducted while Dr. Cheng was a predoctoral fellow/Ph.D. candidate in the department of epidemiology at the University of Pittsburgh School of Public Health.
Nearly half of adults in the U.S. try to lose weight each year, according to the Centers for Disease Control and Prevention, and most try to eat more fruits, vegetables and salads. A healthy diet is essential for your heart, overall health, and longevity. The American Heart Association’s dietary guideline issued in 2021 advises adults to eat a variety of fruits and vegetables; opt for whole grains instead of refined grains; choose healthy protein sources; replace fat-free and low-fat dairy products with full-fat versions; choose lean cuts of meat (for meat eaters); use liquid vegetable oils instead of tropical oils and animal fats; choose minimally processed foods instead of ultra-processed ones; minimize foods and drinks with added sugar; choose foods with little or no added salt; and limit or avoid alcohol.
Researchers evaluated the diets of 116 adults ages 35 to 58 in the Pittsburgh, PA, metropolitan area who were trying to lose weight. Study participants met in person with a dietician to discuss their nutrition and then recorded everything they ate and drank every day for a year on the Fitbit app. They also weighed themselves daily and wore a Fitbit device to track their physical activity.
The researchers calculated a Healthy Eating Index (HEI) score at the beginning and end of the study based on the types of foods participants reported eating. Participants were asked to complete a 24-hour food withdrawal for two days at each time point. The HEI is a measure to assess how closely a dietary pattern aligns with the US government’s Dietary Guidelines for Americans. A score of 0 to 100 is possible; a higher score indicates a healthier diet. The score is based on the frequency of consumption of various dietary components, such as fruits, vegetables, whole and refined grains, meats and seafood, sodium, fats and sugars.
Participants self-assessed the quality of their initial and final diet to determine their perceived scores. Their scores were also on a scale of 0 to 100 based on the components of the HEI. The self-assessment of their initial diet was a “look back,” as they rated both their initial and final diets at the end of the study. The difference in their initial and final score was their perceived diet change. A difference of 6 points or less between the researchers’ HEI score and the participant’s perceived score was considered “good agreement.”
At the end of the study, about 1 in 4 participants’ scores had good agreement between their perceived diet score and the researcher-assessed score. The remaining scores of 3 out of 4 participants had poor agreement , with the majority reporting a perceived score that was higher than the HEI score assigned by the researchers. The mean perceived score was 67.6 and the mean HEI score was 56.4.
When judging the change in diet score over 12 months, only 1 in 10 participants had good agreement between their self-assessed change compared to the researchers’ HEI score change. At the end of the study, participants improved their diet quality by about one point based on the researcher-assessed score. However, participants’ self-esteem was a perceived improvement of 18 points.
“People trying to lose weight or health professionals helping people with weight loss or nutrition-related goals should be aware that there is likely more room for improvement in the diet than expected,” Cheng said. She suggests providing concrete information about what areas of your diet can be improved and how to make healthy, sustainable nutritional changes.
“Future studies should examine the effects of helping people close the gap between their perceptions and objective measurements of diet quality,” he said.
“Overestimating the perceived healthiness of your food intake could lead to weight gain, frustrations over not meeting personal weight loss goals, or a lower likelihood of adopting healthier eating habits,” said Deepika Laddu, Ph.D. .D., assistant professor in the College of Applied Health Sciences at the University of Illinois, Chicago, and chair of the American Heart Association’s Council on Lifestyle Behavior Change to Improve Health Factors. “While misperception of dietary intake is common among dieters, these findings provide additional support for behavioral counseling interventions that include more frequent contacts with health professionals, such as dieticians or health coaches, to address gaps in perception and support realistic and lasting interventions. healthy eating behaviors.
Limitations of the study include that participants were mostly female (79%) and the majority reported white race (84%), so the findings may not apply in the same way to other populations. Additionally, the researchers assessed perceptions of diet quality only at the end of the study. Assessments throughout the study may have helped answer questions, such as whether perception became more realistic over the course of the study or whether a person’s perception of their diet helps or hinders making dietary changes.
Co-authors are Tina Costacou, Ph.D.; Susan M. Sereika, Ph.D.; Bonny Rockette-Wagner, Ph.D.; Andrea M. Kriska, Ph.D.; Mary Lou Klem, Ph.D., M.L.I.S.; Margaret B. Conroy, MD, MPH; Bambang Parmanto, PhD; and Lora E. Burke, Ph.D., MPH Author disclosures are listed in the abstract.
The study was funded by the National Heart, Lung, and Blood Institute, a division of the National Institutes of Health.
Statements and conclusions from studies presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect the policy or position of the Association. The Association does not represent or guarantee its accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, but are selected by independent review panels and considered based on the potential to add to the diversity of scientific topics and viewpoints discussed at the meeting. . The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.
