A Comment on Griffin et al “My Quest, an Intervention Using Text Messaging to Improve Dietary and Physical Activity Behaviors and Promote Weight Loss in Low-Income Women”

We read with great interest the article “My Quest, an Intervention Using Text Messaging to Improve Dietary and Physical Activity Behaviors and Promote Weight Loss in Low-Income Women,” by Griffin et al, and we found their results to be important in the field of clinical prevention. The authors evaluated changes in dietary and physical activity behaviors and weight after implementing a 12-week text messaging initiative. They concluded that a text messaging initiative particularly targeting women residing in rural communities with high rates of poverty and obesity can promote weight loss and improve dietary and physical activity.

With reference to the findings reported in the article, we would like to make the following contribution to the discussion. In a recent analysis performed on 650 healthy premenopausal women, we evaluated the effects of physical activity on a healthy lifestyle. Physical activity was self-assessed using a questionnaire. We found that women in the higher quartile of adherence to the Mediterranean diet had greater levels of physical activity compared with women in the lower quartile. Women with greater adherence to the Mediterranean diet and a greater level of physical activity had a lower prevalence of preclinical atherosclerosis, evaluated using the ankle brachial index. This group of women had a lower body mass index compared with women in the lower quartile of the Mediterranean diet. Dietary behaviors showed a greater intake of fruit, vegetables, and dark chocolate food categories that are rich in antioxidants (P < .01). It is possible that the amount of antioxidants included in foods associated with high levels of physical activity positively affected the lower development of atherosclerosis.^,  We suppose that a healthy lifestyle, which includes physical activity, may prevent preclinical atherosclerosis. We agree with Griffin et al that social support components such as group text messaging and self-monitoring using a smartphone might improve physical activity and diet with a beneficial impact on cardiovascular prevention.