Nutrition-Focused Wellness Coaching Promotes a Reduction in Body Weight in Overweight US Veterans


      Diet plays a critical role in the pathogenesis of major chronic diseases common in populations of US veterans. The role of nutrition-focused wellness coaching in improving dietary behavior and/or reducing weight in overweight and obese US veterans is not known. At the San Francisco Veterans Affairs Medical Center, US veterans aged 25 to 80 years were randomized to receive nutrition coaching on eating behaviors at baseline only (control group, n=22) or an additional eight times over the course of 6 months (intervention group, n=28) in 2010-2011. Multiple coaching contacts decreased intake of energy, fat, and carbohydrate by 31% (P≤0.001) as evaluated by the 2005 Block food frequency questionnaire, which is composed of 111 food items. A weight loss of 5% from baseline (92.8 to 88.2 kg; P<0.01) was observed in the intervention group with mean body mass index decreasing from 30.4 to 28.9 (P<0.05). The control group showed a decrease in fat intake by 20% (P=0.01), but no statistically significant changes in intake of other nutrients or body weight (88.7 to 87.4 kg). Those in the intervention group reported diets at follow-up that were lower in cholesterol, saturated fat, sodium, sugar (P≤0.01), calcium (P< 0.05), and vitamin D (P<0.01), although when adjusted for energy (ie, nutrient density) calcium intake increased and vitamin D remained unchanged. Veterans' readiness to change eating behavior for weight loss improved with nutrition coaching. This study demonstrates that intermittent nutrition coaching can be an effective strategy to promote reductions in energy intake, body weight, and body mass index in overweight US veterans. Further research is needed to determine whether nutrition coaching improves other clinical outcomes and sustains weight loss.


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      M. Shahnazari is an assistant research scientist, Northern California Institute for Research and Education, San Francisco, CA


      C. Ceresa is clinical nutrition section chief, Nutrition and Food Service, San Francisco VA Medical Center, San Francisco, CA


      S. Foley is an assistant professor, Clinical Nutrition, Rush University, Chicago, IL.


      A. Fong is a registered dietitian, University of California, San Francisco Medical Center, San Francisco.


      E. Zidaru is a registered dietitian, Community Health Resource Center, San Francisco, CA.


      S. Moody is an associate professor of medicine, Department of Medicine, Division of Geriatrics, University of California, San Francisco.