Background

Lifestyle interventions with behavioral modification approaches are essential to reversing the obesity epidemic. Multiple dietary and exercise plans have been shown to be effective for managing weight in adolescents with obesity and its common comorbidities. This study examined the feasibility, acceptability, and compliance of a 3-month, clinic-initiated lifestyle intervention that combined the Dietary Approaches to Stop Hypertension (DASH) and High Intensity Interval Training (HIIT), aka DASH-IT, implemented with and without telehealth.

Methods

After a face-to-face counseling session for diet and exercise education, information manuals were emailed to participants based on randomization to 3 groups: Intervention (DASH-IT; weekly telehealth counseling), Reduced (DASH-IT; no telehealth), and Standard Care (Stoplight diet/moderate intensity exercise; no telehealth). HIIT exercise videos created for this study were available via YouTube. Three, 24-hour dietary recalls, anthropometrics, vitals, and fitness tests (400 meter walk; sit and reach) were collected at baseline and follow up. An electronically administered, post treatment questionnaire evaluated acceptability and compliance.

Results

Participants were randomized (8 Intervention, 6 Reduced, 6 Standard Care). On a scale of 0-10 (5=good; 8=great), average rating was 6.5 for DASH and 5.6 for HIIT. Participants liked twice as many components of the program than they disliked, >60% plan to continue DASH-IT post study and >58% would recommend it to a friend. Of the Intervention participants, 57% liked weekly goal setting, believed telehealth held them accountable, and made them more successful. Also, 57% found food tracking helpful, but 28% felt burdened. Half attended follow-up visits, where changes to weight, BMI, and blood pressure were measured.

Conclusions

This 3-month, clinic-initiated pilot study of the DASH-IT intervention with and without telehealth follow-up supports this approach as feasible and acceptable for adolescents with obesity.