2 Jul 2015

Losing Weight and Getting Healthy - the SWIFT Study

From Our Changing World, 9:46 pm on 2 July 2015

By Alison Ballance

“This diet, if my wife had come up with it, I probably would have told her it is a stupid idea. But I read about it in the paper and it sounded like what I wanted to do.”
Geoff Keeling, South Canterbury dairy farmer

Geoff Keeling is on a diet and exercise programme – and in just a few weeks he’s already seeing the benefits. The Canterbury dairy farmer seems like an unlikely candidate for a diet, but this is no ordinary weight-loss programme. He’s taking part in the University of Otago’s SWIFT study, a 2-year project that hopes to identify popular and effective diet, exercise and support strategies that people can easily incorporate into their daily lives.

Diets such as the Mediterranean and Paleo include lots of fresh fruit and vegetables.

Diets such as the Mediterranean and Paleo include lots of fresh fruit and vegetables. Photo: Keith Weller, USDA ARS

Geoff says his motivation for getting involved came from looking around and seeing other middle-aged, overweight and unfit men. He says his farming lifestyle is probably less energetic than most people would expect – he spends much of his time in meetings or in the office, and often drives a tractor around the farm. The SWIFT study has enlisted 250 participants, more than 30% of whom are male, which is a high proportion for this kind of study.

SWIFT stands for Support strategies for Whole-food diets, Intermittent fasting and Training, and PhD student and medical doctor Melyssa Roy is adamant that weight-loss is just a small part of the study. The focus of the study, she says, is to support people who want to make healthy life-style changes, by looking to see whether “these alternatives that are popular in popular culture are feasible alternatives from a public health point of view.”

Michelle Jospe, another PhD student working on the project, says “you can lose weight following many different diets, but it’s a matter of finding one that works for you. And then we’re interested in seeing how places like a GP practise can help a patient follow the diet and exercise plans that they want to follow.”

The 250 study participants can choose between three diet options and two exercise options, and then they are randomly assigned to one of five support strategies. The three diets are popular diets that haven’t all been well-researched: the well-known Mediterranean diet of whole foods, fresh fruit and vegetables, and low meat; the palaeo diet, which is similar except there is no limit to the amount of meat that can be eaten, and no processed food; and the intermittent fasting or 5:2 diet, in which people eat normally for five days, and then eat no more than 500 calories for women or 600 calories for men on the remaining two days.

The choice of exercise programme was either moderate intensity exercise, which is the current standard recommendation of 30 minutes a day, or high intensity exercise, which is a very sharp intense exercise bout for 5-10 minutes two to three times a week. This has grown in popularity recently as it doesn’t involve much time.

Geoff has chosen to follow the 5:2 diet, as it fits in well with his busy, energetic family without impacting their diet. He chose to follow a moderate intensity exercise programme, as again it works in well with his family – his children swim a lot, so he can either swim with them or take a walk, and he is also trying to make himself walk rather than use the quad bike around the farm.

The third key component of the study is the support strategy that people are randomly assigned to. The control group is current GP care, in which people are briefed at the beginning and then left to their own devices; a more traditional support strategy that involves coming in occasionally for weighing and a chat about successes or failures; daily weighing and reporting-in, with feedback in the form of a monthly email; use of the popular mobile app My Fitness Pal, which you use to log your eating and exercise; and hunger training – during the first four weeks of the programme  people gain awareness of when and why they want to eat, by monitoring blood glucose levels to determine if they actually need to eat.

Geoff was assigned to the hunger training support group, and credits this with losing 7 kilograms in weight during the first 5 weeks of the study.

“I was effectively training myself to only eat when absolutely required, which meant that there are no snacks between mealtimes, my meals are generally smaller, and with two kids that loved monitoring what my blood glucose was, watching what I eat and sniping at me [it had] huge effects, straight-away.”

The intensive hunger training system really opened Geoff’s eyes.

“It illustrated that we eat a lot of food needlessly. I got to the stage after a couple of days I knew my blood glucose wouldn’t be in the right level so even though I felt like I wanted to eat I just didn’t even bother.”

The SWIFT study runs for two years, and results won’t be available until after June 2017.