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Table 1 Daily challenges, ranking, description and rationale

From: Adherence to daily dietary and activity goals set within a Māori and Pacific weight loss competition

Daily Challenge

Points value

Description

Rationale

Sugar-free Drink Day

10

A day without drinking sugar-sweetened soft drinks or fruit juices or cordials. This included not adding sugar to tea or coffee.

One of the major sources of added sugars are non-alcoholic beverages, such as sugar-added carbonated drinks and fruit juices [22]. According to the 2008/09 New Zealand Adult Nutrition Survey, 35.5% of Māori adults and 39% of NZ Pacific adults have sugary drinks three or more times each week [56]. The Ministry of Health Nutrition Guidelines recommend limiting consumption of sugar-added drinks to less than once a week [22]

3+ Vege Day

10

A day when at least 3 servings of vegetables were consumed.

Replacing high density foods with vegetables can help prevent excess weight gain since they are low in energy [57] In addition, this decreases the risk of non-communicable diseases such as stroke and some types of cancer [58, 59]. For this reason, it is recommended that New Zealanders consume at least three servings of vegetables per day [22].

Exercise Day

10

A day when at least half an hour continuous walking or more strenuous exercise was completed.

A low amount of physical exercise has been proposed as a main contributor to obesity [60]. It has been suggested that increasing physical activity may reduce obesity [61, 62].

¼¼½ Dinner Day

8

A day when the main meal is made up of ½ vegetables, ¼ protein and ¼ carbohydrates.

Healthy eating patterns involve eating a range of foods from four food groups: fruits and vegetables, grain foods, diary and legumes, chicken, nuts or red meat [22]. It is recommended that half of the meal consists of non-starchy vegetables because these are lower in total energy and contain a lot of vitamins and minerals. One quarter of the meal should consist of carbohydrates such as potato or kumara (sweet potato) and the last quarter should be protein-rich products [63].

Fast & Fried-free Day

8

A day without fast or fried food.

Fast food products are usually high in calories [64]. Reducing the intake of saturated fat or replacing it by unsaturated fats is linked to a reduced risk of CVD [65]. Reduction in the intake of fast and fried foods, which are often deep-fried and high in saturated fats, is recommended [66, 67].

Sweet Treat-free Day

8

A day without eating sugar-sweetened biscuits, cakes, lollies, chocolate or puddings.

The intake of added sugars is linked to excess weight gain. The WHO recommends lowering the intake to less than 10% of the total energy intake [22, 68].

Stand Up Day

6

A day when long periods of sitting down are broken up by standing for at least a minute and this is done at least 3 times (once in the morning, once in the afternoon and once in the evening).

Over the last few decades, the time spent sitting has increased among NZ adults [69]. There are several reasons for this, including increased use of technology, and the built environment and transport being increasingly structured around sitting [70]. Taking regular breaks to stand and move around has been recommended to counter this [71].

Water First Day

6

A day of drinking a glass of water no more than 5 min before eating each of your 3 main meals (breakfast, lunch & dinner).

This behaviour was intended to prompt mindfulness. Kabat-Zinn defines mindfulness as: ‘awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to the unfolding of experience moment by moment’ [72]. It is proposed that mindfulness can be employed to increase awareness of what you are eating and slow down your eating. Mindfulness is associated with lower calorie intake and healthier food choices [73].

Build Me Up Day

6

A day when at least 10 continuous minutes was spent focused on learning about or practising a new behaviour that will reduce stress, improve sleep quality or improve knowledge of nutrition. Visiting the WEHI website, reading the Tip of the Day and posting on the team page can count towards this.

This challenge was included to encourage participants to visit the website where they could find extra information on losing weight via the Tip of the Day, which was a main source of educational information, motivational messages and suggestions for dealing with barriers to change.