Feasibility and Preliminary Efficacy of an Online Cardiovascular Disease Prevention Randomised Controlled Trial Targeting Addictive and Compulsive Overeating Among Australian Young Adults

TL;DR

A pilot study tested an online program to reduce cardiovascular disease risks in young adults with addictive eating behaviors, finding it feasible and showing some dietary improvements.

Contribution

This study demonstrates the feasibility of a telehealth intervention targeting addictive eating to improve cardiovascular risk factors in young adults.

Findings

The TRACE program successfully recruited and engaged young adults with addictive eating behaviors.

The intervention group showed significant improvements in dietary intake compared to the control group.

Website engagement was high in the intervention group but low in the control group.

Abstract

Cardiovascular disease (CVD) is a major cause of mortality and morbidity. The number of young adults with at least one CVD risk factor has increased over the past two decades. Evidence suggests that addictive eating behaviours cluster with other CVD risk behaviours, including poor diet, lack of physical activity and poor sleep quality. The primary aim of this pilot study is to determine the feasibility (adherence to the programme), acceptability and engagement of an innovative intervention comprising of five telehealth sessions ranging from 20 to 45 min with an Accredited Practising Dietitian over 8 weeks aimed at improving CVD risk factors in young Australian adults aged 18–35 years with addictive eating behaviours.

A total of 53 young adults with ≥ 3 symptoms of addictive eating assessed via the Yale Food Addiction Scale 2.0 and a body mass index > 18.5 kg/m2 were recruited. Adherence to the programme was assessed through the number of participants completing the telehealth sessions. Acceptability (including overall satisfaction, appropriateness and effectiveness of recruitment materials) was assessed via semi‐structured phone interviews with participants upon study completion. Engagement with the programme website was assessed with Wix Analytics and comprised of website access and webpage dwell time. Changes in dietary intake, food addiction symptoms, physical activity, sleep quality, mental health (depression, anxiety and stress), and CVD blood biomarkers were also assessed and compared between groups and over time.

Nine of the 27 participants randomised to the intervention group did not adhere to the programme by completing all five telehealth sessions. Twenty‐one (56.8%) participants completed the semi‐structured phone interview, with all reporting an overall ‘positive’ experience with the programme. Based on the total number of participants provided with website access in the intervention (n = 21) and control (n = 16) groups, the percentage who logged in to the website at least once was 95.2% and 18.8% respectively. The intervention group was superior compared to the control group for improvements in percent from fat (−4.87%/day [95% CI: −8.04, −1.70], p = 0.005), saturated fat (−1.77%/day [95% CI: −3.33, −0.20], p = 0.03) and non‐core foods (−9.20%/day [95% CI: −17.53, −0.87], p = 0.03) from baseline to 8 weeks. While other outcomes (i.e., changes in food addiction symptoms, physical activity, sleep, mental health, stress and CVD biomarkers – triglycerides) improved significantly over time, there were no between‐group differences.

A CVD intervention targeting addictive eating behaviours successfully recruited young adults, a recognised population group difficult to reach. The telehealth programme was found to be feasible and demonstrated improvements in dietary outcomes.

Addictive eating behaviours often cluster with other CVD risk behaviours, including poor diet, lack of physical activity and poor sleep quality.The online ‘TRACE programme – young adults’, which aimed to improve CVD risk factors in young adults, was found to be feasible.A larger, more appropriately powered RCT is now needed to examine the efficacy of the TRACE programme at improving CVD risk factors in young adults.

Addictive eating behaviours often cluster with other CVD risk behaviours, including poor diet, lack of physical activity and poor sleep quality.

The online ‘TRACE programme – young adults’, which aimed to improve CVD risk factors in young adults, was found to be feasible.

A larger, more appropriately powered RCT is now needed to examine the efficacy of the TRACE programme at improving CVD risk factors in young adults.

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