All had to use personal digital assistants to track their progress and communicate via email or phone with coaches. The participants could earn $175 for meeting goals.
The researchers found that average daily fruit and vegetable intake grew from 1.2 to 5.5 servings over three weeks, while sedentary leisure -- typically TV time -- fell from 219 to 89 minutes. Saturated fat, as a percentage of overall calories, fell from 12 percent to 9.4 percent.
However, even though most participants at a 20-week follow-up said they tried to continue their lifestyles, they had trouble. Their daily consumption of fruits and vegetables fell to an average of 2.9 per day, while their minutes of sedentary leisure grew to 126 minutes a day and their percentage of saturated fat calories rose to 9.9 percent.
Overall, targeting fruit and vegetable consumption and couch-potato lifestyles proved more effective than attempting to reduce saturated fats and increase physical activity, the researchers found. But that might have been because those goals were easier to achieve, one expert said.
So, did the coaching or the money make the difference? "We really don't know," Spring said. "What's important to realize is that if you talk to most physicians, they do not believe you can get people to make behavior changes like this."
As for cost, in the future it may be possible to create virtual coaches and use smartphone apps to replace the live coaches, which would considerably lower the cost, she said.
William Riley, a program director in the division of cardiovascular sciences at the U.S. National Heart, Lung, and Blood Institute, who wrote a commentary accompanying the study, said the cost may be low long-term if the strategies improve people's health.
"If just one
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