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This study is a randomized controlled intervention trial in adults aged 50+ years with overweight or obesity, which will compare three groups with different diet prescriptions: 1) pre-meal water consumption (500 ml, before each main meal) with a hypocaloric diet; 2) 1500 ml water consumed throughout the day with a hypocaloric diet; 3) hypocaloric diet with no instructions regarding water consumption. Smart water bottles will objectively assess water intake timing and volume. Urine osmolality, urine volume, and serum osmolality will be used as objective indicators of compliance with the water intake prescription. We will investigate changes in perceived hunger and fullness and appetite-regulating hormones as potential mechanisms by which premeal water could improve appetite regulation. We will also investigate the impact of water consumption and hydration on executive function capabilities, which may influence intervention adherence. Although increasing water intake could be an effective weight management strategy, no evidence-based recommendations exist for the timing of water intake needed for this benefit.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pre-meal water + Hypocaloric diet | Experimental | premeal water ( 500 ml) before each main meal, three times per day + hypocaloric diet |
|
| Daily water + Hypocaloric diet | Experimental | total daily water prescription (1500 ml/d) + hypocaloric diet |
|
| Hypocaloric Diet alone | Active Comparator | hypocaloric diet with not instructions regarding water intake |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Water intake and weight control in older adults - Premeal Water + hypocaloric diet | Behavioral | Individuals will be randomly assigned to one of three groups. All individuals will receive counseling in a structured hypocaloric meal plan (1200-1500 kcal) that is consistent with a healthy dietary pattern as described by the Dietary Guidelines for Americans. This group will receive specific instructions for daily water intake timing and volume. |
| Measure | Description | Time Frame |
|---|---|---|
| Body weight change | Body weight change in weight loss and weight loss maintenance phases | weeks 0 to 12 in the weight loss phase, month 0 to 12 post weight loss phase |
| Measure | Description | Time Frame |
|---|---|---|
| Change in appetite sensations | Changes in hunger and fullness, assessed using 100mm Visual Analog Scales (VAS), in weight loss and weight loss maintenance phases. These changes may mediate adherence to the hypocaloric diet and weight loss outcomes. | weeks 0 to 12 in the weight loss phase, month 0 to 12 post weight loss phase |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in appetite hormones | Changes in appetite hormones, specifically blood concentrations of ghrelin, PYY 3-36, leptin, and CCK in response to a standardized test meal with an energy content of 25% estimated energy requirements. | weeks 0 to 12 in the weight loss phase, month 0 to 12 post weight loss phase |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Brenda Davy, PhD RDN | Contact | 540-231-6784 | bdavy@vt.edu | |
| Elaina Marinik, PhD | Contact | 540-231-0923 | emarinik@vt.edu |
| Name | Affiliation | Role |
|---|---|---|
| Brenda Davy, PhD RDN | Virginia Polytechnic Institute and State University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Virginia Tech | Recruiting | Blacksburg | Virginia | 24061 | United States |
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|
| Water intake and weight control in older adults - Total Daily Water + hypocaloric diet | Behavioral | Individuals will be randomly assigned to one of three groups. All individuals will receive counseling in a structured hypocaloric meal plan (1200-1500 kcal) that is consistent with a healthy dietary pattern as described by the Dietary Guidelines for Americans. This group will receive specific instructions for total daily water intake. |
|
| Water Intake and weight control in older adults - hypocaloric diet alone | Behavioral | Individuals will be randomly assigned to one of three groups. All individuals will receive counseling in a structured hypocaloric meal plan (1200-1500 kcal) that is consistent with a healthy dietary pattern as described by the Dietary Guidelines for Americans. This group will receive instructions in the hypocaloric diet, without specific fluid intake recommendations. |
|
| Change in hydration status |
Changes in hydration status, assessed using urine and serum osmolality, urine specific gravity, and serum sodium, in weight loss and weight loss maintenance phases. These changes may mediate intervention adherence. |
| weeks 0 to 12 in the weight loss phase, month 0 to 12 post weight loss phase |
| Change in executive function (EF) | Changes in EF (attention, inhibition) assessed using ePRIME computerized tasks, in weight loss and weight loss maintenance phases. These changes may mediate intervention adherence. | weeks 0 to 12 in the weight loss phase, month 0 to 12 post weight loss phase |
| ID | Term |
|---|---|
| D050177 | Overweight |
| D009765 | Obesity |
| ID | Term |
|---|---|
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D004326 | Drinking |
| ID | Term |
|---|---|
| D004435 | Eating |
| D009747 | Nutritional Physiological Phenomena |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
| D004068 | Digestive System Physiological Phenomena |
| D055688 | Digestive System and Oral Physiological Phenomena |
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