Physical Activity And Dietary Changes Following A Telephone-based Lifestyle Intervention Among Rural Ohio Residents

PURPOSE: Obesity-related health disparities in rural populations warrant the need for weight loss programs. The Home-based Exercise in Rural Ohio (HERO) study aimed to utilize evidence-based intervention strategies in a rural sample. This analysis examines the effect of the 15-week telephone-based weight loss intervention on physical activity and dietary changes among rural Ohio residents. METHODS: A total of 40 rural Ohio residents with BMI ≥ 25 kg/m2 were randomized via a 2:1 ratio to a 15-week telephone-based weight loss (n = 27) or active control (n = 13) group. The weight loss group received weekly telephone sessions from health coaches to increase physical activity and modestly restrict calorie intake. The control group received educational brochures describing physical activity and dietary guidelines. At baseline and 15-weeks, physical activity was objectively measured using the ActivPAL accelerometer (7-days) coupled with self-reported Leisure-Time Exercise Questionnaire. Dietary intake was self-reported using a 7-day food checklist. Mixed linear models were used to examine the change over time by group. RESULTS: Among the intervention group, significant increases in objectively measured physical activity were observed: steps/day (∆ = 952.59, p = 0.02), total physical activity (min/day, ∆ = 14.13, p = 0.008), and MET-h/day (∆ = 0.44, p = 0.02). Similarly, increases in self-reported walking, moderate, and vigorous activity were observed (min/week; ∆ = 73.67, p = 0.001; ∆ = 41.88, p < 0.001; and ∆ = 55.19, p < 0.001, respectively). No significant changes in objectively measured or self-reported physical activity were observed in the control group. The between-group changes in physical activity were not significant. In terms of dietary intake, the intervention group showed significant improvements in dairy and snack intake (∆ = 0.25, p = 0.04; ∆ = -0.34, p = 0.004, respectively), while the control group increased fruit and vegetable intake (∆ = 0.99, p = 0.004). The between-group changes were significant on snack intake (∆ = -0.59, p = 0.004), favoring the intervention. CONCLUSION: The promising improvements in physical activity and dietary intake from this pilot study provides valuable data to inform future large-scale randomized controlled trials to promote healthy lifestyle change in rural populations.