INTRODUCTION: The study aimed to investigate the effectiveness of combining nutrition education, physical activity, mindful eating, and behavior modification, along with the Nutrition Care Process (NCP), in managing body weight and body fat composition. The increasing prevalence of obesity and overweight worldwide necessitates the need for effective treatment methods to be imparted to health professionals involved in weight management. The study highlights that a combination of these strategies is more successful in achieving and maintaining a healthy weight compared to calorie restriction and physical activity alone.

METHODS: The study used a quantitative, observational, and longitudinal design, and a representative sample of 300 Cypriot adults between the ages of 18 and 51 participated in a 38±2.5-week study. Participants were assessed for obesity and overweight using measurements such as weight, height, Body Mass Index, Waist Circumference, Neck Circumference, and Body Fat Composition, which were compared to standard values. Obesity and overweight were defined based on BMI. Participants' food intake history and physical activity habits were also assessed. The participants were then divided into a control group (diet only) and an intervention group (including nutrition and physical activity behavior changes program and the use of NCP). The intervention group received individualized nutrition education, diet plans, everyday physical activities, and behavioral change factors including mindful eating, which were assessed and evaluated every two weeks. The Mindful Eating Questionnaire (MEQ) and the International Physical Activity Questionnaire (IPAQ) were used for baseline assessment, and validated Worksheets for lifestyle changes were applied to the intervention group.

RESULTS: The results of the study showed that both male and female participants in the intervention group lost more weight than those in the control group. Specifically, males in the control group lost around 3-3.7 kg in 19 weeks, while males in the intervention group lost 9 and 10 kg in the 18-24 and 25-51 age groups respectively. Similarly, females in the control group lost around 3 kg in 19 weeks, while females in the intervention group lost 8.6 and 9.6 kg in the 18-24 and 25-51 age groups respectively. Additionally, the results of the worksheets for nutritional habits showed an improvement in eating habits for the intervention group, with a mean score of -35.01 at the beginning of the study, 43.02 at week 19, and 62.15 at week 38. The participants in the intervention group also reported that their busy schedule was the main factor that prevented them from engaging in physical activity, but despite this, they were able to improve their physical activity scores through lifestyle changes.

CONCLUSIONS: The conclusion of the study emphasizes that physical inactivity and poor diet are major contributors to the leading causes of death in developed countries including Cyprus. The current research work confirms that traditional methods of calorie restriction dieting are not effective in achieving and maintaining weight loss, and that instead, a combination of nutrition education, physical activity, and behavioral changes are more successful. Furthermore, it identifies that by using the Nutrition Care Process (NCP) in combination with a healthy lifestyle plan including nutrition education, physical activity, mindful eating, and behavioral modification, it was possible to effectively manage body weight and body fat composition. High mindful eating scoring appears to relate to normal BMI. Therefore, the study suggests that incorporating appropriate behavioral lifestyle changes using nutrition education with the NCP is an essential component of achieving and maintaining a healthy body weight.