Michelle Jospe

• Doctor of Philosophy
• Research consultant at Georgetown University

Objective: To determine the effectiveness of various monitoring strategies on weight loss, body composition, blood markers, exercise, and psychosocial indices in adults with overweight and obesity following a 12-month weight loss program. Methods: Two hundred fifty adults with BMI ≥ 27 were randomized to brief, monthly, individual consults, dail...

Background: Intermittent fasting (IF) and Paleolithic (Paleo) diets produce weight loss in controlled trials, but minimal evidence exists regarding long-term efficacy under free-living conditions without intense dietetic support. Objectives: This exploratory, observational analysis examined adherence, dietary intake, weight loss, and metabolic o...

Background Hunger training teaches people to eat according to their appetite using pre-prandial glucose measurement. Previous hunger training interventions used fingerprick blood glucose, however continuous glucose monitoring (CGM) offers a painless and convenient form of glucose monitoring. The aim of this randomised feasibility trial was to compa...

Background Amidst the escalating prevalence of glucose-related chronic diseases, the advancements, potential uses, and growing accessibility of continuous glucose monitors (CGM) have piqued the interest of healthcare providers, consumers, and health behaviour researchers. Yet, there is a paucity of literature characterising the use of CGM in behavi...

Background Recent advancements in personal biosensing technology support the shift from standardized to personalized health interventions, whereby biological data are used to motivate health behavior change. However, the implementation of interventions using biological feedback as a behavior change technique has not been comprehensively explored. O...

Background Continuous glucose monitoring (CGM) holds potential as a precision public health intervention, offering personalised insights into how diet and physical activity affect glucose levels. Nevertheless, the efficacy of using CGM in populations with and without diabetes to support behaviour change and behaviour-driven outcomes remains unclear...

BACKGROUND The Data-Driven Fasting (DDF) app implements glucose-guided eating (GGE), an innovative dietary intervention that encourages individuals to eat when their glucose level falls below a personalised threshold to improve metabolic health. Clinical trials using GGE, facilitated by paper logging of glucose and hunger symptoms, have shown promi...

The 2020–2025 Dietary Guidelines for Americans recommend limiting intakes of saturated fat and added sugars (SF/AS) to <10% total energy. Data-driven approaches to identify sources of SF/AS are needed to meet these goals. We propose using a population-based approach to identify the leading food and beverage sources of SF/AS consumed by US adults. F...

The 2020-2025 Dietary Guidelines for Americans recommends limiting intakes of saturated fat and added sugars (SF/AS) to 88% of the representative sample of U.S. adults. The top sources of SF were cheese, pizza, ice cream, and eggs. The leading sources of AS were soft drinks, tea, fruit drinks, and cakes and pies. This analysis reflects a parsimonio...

Background High glycemic variability (GV) is a biomarker of cancer risk, even in the absence of diabetes. The emerging concept of chrononutrition suggests that modifying meal timing can favorably impact metabolic risk factors linked to diet-related chronic disease, including breast cancer. Here, we examined the potential of eating when glucose leve...

2024 SBM Annual Meeting Abstracts Supplement. Ann Behav Med. 2024:58(Suppl 1);S56.

Background: Glucose-guided eating (GGE) improves metabolic markers of chronic disease risk, including insulin resistance, in adults without diabetes. GGE is a timed eating paradigm that relies on experiencing feelings of hunger and having a preprandial glucose level below a personalized threshold computed from 2 consecutive morning fasting glucose...

Background: Recent advances in personal biosensing technologies have supported a shift from standard interventions to personalized interventions that incorporate feedback about biological markers of health (biological feedback). Nonetheless, the use of biological feedback to motivate health behavior change in behavioral interventions has not been c...

BACKGROUND Glucose-guided eating (GGE) improves metabolic markers of chronic disease risk, including insulin resistance, in adults without diabetes. GGE is a timed eating paradigm that relies on experiencing feelings of hunger and having a preprandial glucose level below a personalized threshold computed from 2 consecutive morning fasting glucose l...

BACKGROUND Recent advances in personal biosensing technology support the shift from standardized to personalized health interventions, whereby biological data is used to motivate health behavior change. However, the implementation of interventions using biological feedback as a behavior change technique has not been comprehensively explored. OBJEC...

Postmenopausal breast cancer is the most common obesity-related cancer death among women in the U.S. Insulin resistance, which worsens in the setting of obesity, is associated with higher breast cancer incidence and mortality. Maladaptive eating patterns driving insulin resistance represent a key modifiable risk factor for breast cancer. Emerging e...

Weight losses >10% favorably modulate biomarkers of breast cancer risk but are not typically achieved by comprehensive weight loss programs, including the Diabetes Prevention Program (DPP). Combining the DPP with hunger training (HT), an evidence-based self-regulation strategy that uses self-monitored glucose levels to guide meal timing, has potent...

BACKGROUND Many health conditions can be prevented, managed, or improved through behavioral interventions. Biological feedback, as a component of health behavior change interventions, is of particular interest given recent advances in wearable biosensing technology, digital health apps, and personalized health and wellness. Yet, there is a paucity...

Background: Many health conditions can be prevented, managed, or improved through behavioral interventions. As a component of health behavior change interventions, biological feedback is of particular interest given recent advances in wearable biosensing technology, digital health apps, and personalized health and wellness. Nevertheless, there is...

Context Although dietary advice has long been a cornerstone of a healthy lifestyle, how sleep quality and quantity may interact with dietary intake or eating behaviors remains unclear. Objective To consider a bidirectional relationship between sleep and diet in children aged 6–12 years via a systematic review following PRISMA guidelines. Data Sou...

INTRODUCTIONPractice nurses in general practice are ideally placed to deliver weight management treatments. Teaching people to eat according to their appetite, based on measurements of blood glucose (‘hunger training’), is known to lead to weight loss and improved eating behaviour. To effectively translate this research to primary care requires und...

Objectives Hunger training (HT) is an intervention designed to teach people to eat according to their hunger by connecting physical symptoms of appetite with glucose levels. HT is most effective for weight loss, and improving eating behaviours when adherence is high. However, adherence is a challenge that should be explored prior to wider dissemina...

Aim: Adherence to dietary change is crucial for long-term benefit and a key element of adherence is the satisfaction of a given diet. We aimed to develop a brief questionnaire, suitable for use in clinical practice that can assess satisfaction with a diet, and to conduct preliminary evaluation of its reliability and validity. Methods: The questi...

An infographic developed with the Otago Southland Diabetes Research Trust to help promote World Diabetes Day in New Zealand.

Objectives While tracking progress is one of the strongest predictors of success in healthy eating and physical activity interventions, it is uncertain whether it matters which behavior (diet, activity or weight) is being tracked. The aim of this study was to determine the effectiveness of four different monitoring strategies on weight loss, body c...

Background “Hunger training” aims to teach people to eat according to their appetite rather than in response to their environment or emotions. As many overweight adults have a blunted sense of hunger and satiety, blood glucose measurement provides an objective indicator of hunger and a guide for when one should eat. While hunger training has been s...

Purpose: Although high-intensity interval training (HIIT) and moderate-intensity continuous exercise have comparable health outcomes in the laboratory setting, effectiveness studies in real-world environments are lacking. The aim of this study was to determine the effectiveness of an unsupervised HIIT programme in overweight/obese adults over 12 m...

Objectives Although monitoring is considered a key component of effective behaviour change, the development of apps has allowed consumers to constantly evaluate their own diet, with little examination of what this might mean for eating behavior. The aim of this study was to investigate whether self‐monitoring of diet using the app MyFitnessPal or d...

Monitoring blood glucose prior to eating can teach individuals to eat only when truly hungry, but how adherence to ‘hunger training’ influences weight loss and eating behaviour is uncertain. This exploratory, secondary analysis from a larger randomized controlled trial examined five indices of adherence to ‘hunger training’, chosen a priori, to exa...

Background: Physical activity plays a critical role in health, including for effective weight maintenance, but adherence to guidelines is often poor. Similarly, although debate continues over whether a "best" diet exists for weight control, meta-analyses suggest little difference in outcomes between diets differing markedly in macronutrient compos...

"Hunger training", which aims to teach people to eat only when blood glucose is below a set target, appears promising as a weight loss strategy. As the ability of participants to adhere to the rigorous protocol has been insufficiently described, we sought to determine the feasibility of hunger training, in terms of retention in the study, adherence...

Background: Despite the hundreds of diet apps available for use on smartphones (mobile phones), no studies have examined their use as tools for dietary assessment and tracking in sports nutrition. Objective: The aim is to examine the prevalence and perceptions of using smartphone diet apps for dietary assessment and tracking among sports dietitian...