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Multidisciplinary Approach to Obesity Management: A Case Report
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Applying user-centered design to develop a culturally sensitive, low-calorie meal plan for enhancing dietary
Maya Balakrishnan1,2, Paola Martinez3, Brett Deng3
1Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA. maya.balakrishnan@bcm.edu.
BMC Nutrition
|May 7, 2026
Summary
Culturally tailored meal plans can help manage metabolic dysfunction-associated steatotic liver disease (MASLD). This study developed a practical, calorie-restricted plan for Mexican and Central American patients, improving dietary self-efficacy.
Area of Science:
- Nutrition Science
- Public Health
- Behavioral Science
Background:
- Dietary management is crucial for metabolic dysfunction-associated steatotic liver disease (MASLD).
- Patients face barriers including knowledge gaps, cost, time, and cultural relevance of dietary changes.
- Tailoring interventions is key to overcoming these challenges.
Purpose of the Study:
- To develop a culturally tailored, calorie-restricted dietary intervention for Mexican and Central American patients with MASLD.
- To create a seven-day structured meal plan aligned with MASLD and weight loss guidelines.
- To apply user-centered design and the Theory of Planned Behavior.
Main Methods:
- A three-phase, mixed-methods approach was used with 25 MASLD patients of Mexican/Central American descent.
- Phase 1: Semi-structured interviews to understand meal patterns and preferences.
- Phase 2 & 3: Development of calorie-level meal plan prototypes (1200-1800 kcal) and usability testing via ecological momentary assessments and daily interviews.
Main Results:
- Patients favored home-cooked meals, with challenges in lunch/dinner preparation.
- Recipe modifications focused on increasing fiber and reducing fat/refined carbohydrates.
- Usability testing indicated the meal plans were culturally aligned, practical, and improved portion awareness and dietary self-efficacy.
Conclusions:
- A patient-centered process for culturally tailoring dietary interventions was established.
- The developed calorie-restricted meal plan demonstrated preliminary feasibility and acceptability.
- Further evaluation of large-scale implementation and impact on dietary change and weight loss is ongoing.
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