Tonya Turner, RD, LD MUSC Weight Management Center

Sodexo Clinical Nutrition Update 2012

12-week pilot study assessing the Bite Counter as a tool for weight lossMUSC Weight Management Center

Patrick O’Neil, PhDTonya Turner, RD

Laura Nance, RD, CDERobert Malcolm, MDSuzanne Kuker, MASusan Pechon, RN

The Bite Study has been funded through South Carolina Clinical and Translational Research Center (SCTR)

Bite Counter

The Bite Counter is worn on the wrist and functions like a watch

Automatically counts the number of bites taken at meals and snacks

Invented by two college professors from Clemson UniversityDr. Eric Muth and Dr. Adam Hoover

Manufactured in South Carolina

Study objectivesTo examine whether increases and decreases in

bite count are related to increases and decreases in caloric intake

To determine whether providing bite count feedback and bite count reduction goals will lead to reductions in numbers of bites and calorie intake

To learn how users rate the Bite Counter’s acceptability and tolerability

To see if any changes in weight and body fat are related to use of the Bite Counter

Study overview12-week pilot study2-week screening period with 1 or more visits

before the study beganParticipant visits occurred every 2 weeks for a

total of 7 visits Participants were be required to keep a 3-day

food diary during the screening period, 2 3-day food diaries during the first month, and 1 per month there after.

There were 9 visits over the course of 14 weeks

Study design20 participants were assigned to 1 of 2

conditionsFeedbackNo-Feedback

Subject CharacterizationsGenerally Healthy Males and FemalesAges 18 to 70Body Mass Indexes (BMIs)from 27 to 35

Study DesignScreening visit

Measured height, weight, and blood pressureBody composition using a bioelectrical

impedance machineMedical history Questionnaires Instruction by WMC RD on how to keep a 3 day

food diary

Study DesignBaseline Visit

Turned in screening 3 day food diaryBegan wearing a Bite Counter for 2 weeks

without feedbackAssigned another 3 day food diary Completed questionnaires

Study DesignRandomization visit

Participants were assigned to either 1 of 2 groups Feedback Non-feedback

Assigned a 3 day food diary Completed questionnaires

Study DesignStudy Visits (Weeks 4, 6, 8, and 10)

Measured weightsCompleted 2 additional 3 day food dairiesUploaded Bite Counter data Completed questionnaires

Final Visit (week 12)Measured weight, height, and blood pressureEnding body compositionUploaded Bite Counter data Completed questionnaires

Study DesignRetention

Frequent reminder calls and emailsBi-weekly follow up visitsCompensation

$50.00 for completion of all study visits $100.00 for successful return of bite counter and

charger

Dietary AimsTo provide subjects with an estimated

reduction goal for bites or calories to equal approximately 500 calories

Estimated by 3-day food diaries and 2 week run-in of wearing bite counter

Study demographics20 participants

randomized 18 females, 2 malesMean age: 46.2Mean BMI: 31.4

19 completed 17 females, 2 males10 No-Feedback9 Feedback1 Lost to follow-up

Baseline Data Calories BitesMean Caloric Intake (All

Subjects)1816 calories

Mean Calorie Goal (No-Feedback)1400 calories

Mean Bites (Randomization)184

Estimated Calories per Bite9.9 calories per bite

Mean Bite Goal (Feedback)121

Week 12 ResultsMean BMI

30.8 Changed by 0.6 BMI

points

Mean Weight Change (lbs.)No feedback- 4.29Feedback – 4.55

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10

No Feedback Feedback

Pounds Lost

Week 12 ResultsMean Caloric Intake

All Subjects - 1582 calories/day

234 Calories

No-Feedback – 1488 calories/day

(Mean Goal 1400)

Feedback – 1687 calories/day

Mean Bites All subjects – 123

bites/day Estimated Calories

per Bite 12.9 calories per bite

Feedback – 104 bites/day (Mean Goal 121)

No-Feedback – 137 bites/day

Our Observations…

1 Serving = 17 Grapes = 17 Bites = 57 Calories

1 Serving = 1 Slice Pizza = 10 Bites = 272 Calories

Which do you prefer, completing and using the eating diaries or wearing and using the Bite Counter?

44%

55%

Week 12

Bite Counter Food Diaries

70%

30%

Baseline

Bite Counter Food Diaries

Usability and TolerabilityIn the past week how much did you like this approach to dieting?

1 2 3 4 5 6 7 Extremely

Liked Extremely Disliked

Baseline: 4.2Week 12: 3.9

Usability and TolerabilityIn the past week how easy did you find it

to follow this diet?

1 2 3 4 5 6 7 Extremely

Liked Extremely Disliked

Week 12: 4.2Baseline: 3.9

Our ObservationsLimited success with use of bite counter as a

tracking methodComments from subjects

To hard to remember to turn on and offNot attractiveNot accurateNot waterproofMalfunctioned

Bite Technologies

http://www.icountbites.com/index.html