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Sample records for adult weight management

  1. Weight Management in Older Adults

    PubMed Central

    Gill, Lydia E.; Bartels, Stephen J.; Batsis, John A.

    2017-01-01

    As the number of older adults increases rapidly, the national epidemic of obesity is also affecting our aging population. This is particularly concerning given the numerous health risks and increased costs associated with this condition. Weight management is extremely important for older adults given the risks associated with abdominal adiposity, which is a typical fat redistribution during aging, and the prevalence of comorbid conditions in this age group. However, approaches to weight loss must be considered critically given the dangers of sarcopenia (a condition that occurs when muscle mass and quality is lost), the increase risk of hip fracture with weight loss, and the association between reduced mortality and increased BMI in older adults. This overview highlights the challenges and implications of measuring adiposity in older adults, the dangers and benefits of weight loss in this population, and provides an overview of the new Medicare Obesity Benefit. In addition we provide a summary of outcomes from successful weight loss interventions for older adults and discuss implications for advancing clinical practice. PMID:26627496

  2. Marital status and body weight, weight perception, and weight management among U.S. adults.

    PubMed

    Klos, Lori A; Sobal, Jeffery

    2013-12-01

    Married individuals often have higher body weights than unmarried individuals, but it is unclear how marital roles affect body weight-related perceptions, desires, and behaviors. This study analyzed cross-sectional data for 4,089 adult men and 3,989 adult women using multinomial logistic regression to examine associations between marital status, perceived body weight, desired body weight, and weight management approach. Controlling for demographics and current weight, married or cohabiting women and divorced or separated women more often perceived themselves as overweight and desired to weigh less than women who had never married. Marital status was unrelated to men's weight perception and desired weight change. Marital status was also generally unrelated to weight management approach, except that divorced or separated women were more likely to have intentionally lost weight within the past year compared to never married women. Additionally, never married men were more likely to be attempting to prevent weight gain than married or cohabiting men and widowed men. Overall, married and formerly married women more often perceived themselves as overweight and desired a lower weight. Men's marital status was generally unassociated with weight-related perceptions, desires, and behaviors. Women's but not men's marital roles appear to influence their perceived and desired weight, suggesting that weight management interventions should be sensitive to both marital status and gender differences.

  3. Weight Management

    MedlinePlus

    ... Together Understanding Adult Overweight & Obesity About Food Portions Bariatric Surgery for Severe Obesity More Weight Management Topics Healthy ... Sleep Apnea Weight Management Topics About Food Portions Bariatric Surgery for Severe Obesity Being Healthy is a Big ...

  4. Low weight and overweightness in older adults: risk and clinical management.

    PubMed

    Jahangir, Eiman; De Schutter, Alban; Lavie, Carl J

    2014-01-01

    The prevalence of individuals who are overweight or obese is growing exponentially in the United States and worldwide. This growth is concerning, as both overweightness and obesity lead to impaired physical function, decreased quality of life, and increased risk of chronic diseases. Additionally, overweightness and obesity are related to increased mortality among young and middle-aged adults. This weight-related risk of mortality is more ambiguous among older adults. In fact, obesity may be protective in this population, a relationship described as the "obesity paradox". In this review we discuss the effects of overweightness and obesity among the elderly on cardiovascular disease and all-cause mortality, along with the risks of low weight. We conclude by discussing the goal of weight management among older adults, focusing particularly on benefits of preserving lean body mass and muscular strength while stabilizing body fat. Ideally, overweight or mildly obese elderly individuals should devise a plan with their physicians to maintain their weight, while increasing lean body mass through a plan of healthy diet, behavioral therapy, and physical activity.

  5. Young adults' strategies for managing social support during weight-loss attempts.

    PubMed

    Faw, Meara H

    2014-02-01

    Obesity and being overweight often result in serious health problems. Despite growing awareness of the dangers associated with being overweight, many individuals struggle to lose weight. Investigators have identified social support as a key element in weight-loss attempts. Unfortunately, little has been done to investigate how people solicit social support from members of their pre-existing social network without a structured intervention. To address this limitation, I conducted in-depth interviews with 25 participants. Through grounded theory analysis of these interviews, I developed a typology of support management strategies used by overweight young adults when attempting to lose weight. I outline these strategies, their perceived success, and implications for future research in this article.

  6. Weight Management

    MedlinePlus

    ... Weight share What It Takes to Lose Weight: Calorie Basics When you’re trying to lose weight... ... wcdapps.hhs.gov/Badges/Handlers/Badge.ashx?js=0&widgetname=betobaccofreew200short</NOFRAMES& ...

  7. Results from an Online Computer-Tailored Weight Management Intervention for Overweight Adults: Randomized Controlled Trial

    PubMed Central

    van Empelen, Pepijn; Boon, Brigitte; Borsboom, Gerard; Visscher, Tommy; Oenema, Anke

    2012-01-01

    Background Prevention of weight gain has been suggested as an important strategy in the prevention of obesity and people who are overweight are a specifically important group to target. Currently there is a lack of weight gain prevention interventions that can reach large numbers of people. Therefore, we developed an Internet-delivered, computer-tailored weight management intervention for overweight adults. The focus of the intervention was on making small (100 kcal per day), but sustained changes in dietary intake (DI) or physical activity (PA) behaviors in order to maintain current weight or achieve modest weight loss. Self-regulation theory was used as the basis of the intervention. Objective This study aims to evaluate the efficacy of the computer-tailored intervention in weight-related anthropometric measures (Body Mass Index, skin folds and waist circumference) and energy balance-related behaviors (physical activity; intake of fat, snacks and sweetened drinks) in a randomized controlled trial. Methods The tailored intervention (TI) was compared to a generic information website (GI). Participants were 539 overweight adults (mean age 47.8 years, mean Body Mass Index (BMI) 28.04, 30.9% male, 10.7% low educated) who where recruited among the general population and among employees from large companies by means of advertisements and flyers. Anthropometric measurements were measured by trained research assistants at baseline and 6-months post-intervention. DI and PA behaviors were assessed at baseline, 1-month and 6-month post-intervention, using self-reported questionnaires. Results Repeated measurement analyses showed that BMI remained stable over time and that there were no statistically significant differences between the study groups (BMI: TI=28.09, GI=27.61, P=.09). Similar results were found for waist circumference and skin fold thickness. Amount of physical activity increased and intake of fat, snacks and sweetened drinks decreased during the course of the

  8. Level of interest in a weight management program among adult U.S. military dependents

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There is little information on the extent to which different challenged populations with high rates of overweight and obesity have interest in participating in weight management programs. The purpose of this study was to identify potential rates of enrollment in a weight management program among adu...

  9. Nurses’ self-efficacy and practices relating to weight management of adult patients: a path analysis

    PubMed Central

    2013-01-01

    Background Health professionals play a key role in the prevention and treatment of excess weight and obesity, but many have expressed a lack of confidence in their ability to manage obese patients with their delivery of weight-management care remaining limited. The specific mechanism underlying inadequate practices in professional weight management remains unclear. The primary purpose of this study was to examine a self-efficacy theory-based model in understanding Registered Nurses’ (RNs) professional performance relating to weight management. Methods A self-report questionnaire was developed based upon the hypothesized model and administered to a convenience sample of 588 RNs. Data were collected regarding socio-demographic variables, psychosocial variables (attitudes towards obese people, professional role identity, teamwork beliefs, perceived skills, perceived barriers and self-efficacy) and professional weight management practices. Structural equation modeling was conducted to identify correlations between the above variables and to test the goodness of fit of the proposed model. Results The survey response rate was 71.4% (n = 420). The respondents reported a moderate level of weight management practices. Self-efficacy directly and positively predicted the weight management practices of the RNs (β = 0.36, p < 0.01), and fully or partially mediated the relationships between perceived skills, perceived barriers, professional role identity and teamwork beliefs and weight management practices. The final model constructed in this study demonstrated a good fit to the data [χ2 (14) =13.90, p = 0.46; GFI = 0.99; AGFI = 0.98; NNFI = 1.00; CFI = 1.00; RMSEA = 0.00; AIC = 57.90], accounting for 38.4% and 43.2% of the variance in weight management practices and self-efficacy, respectively. Conclusions Self-efficacy theory appears to be useful in understanding the weight management practices of RNs. Interventions targeting the

  10. Fit and Strong! Plus: Design of a Comparative Effectiveness Evaluation of a Weight Management Program for Older Adults with Osteoarthritis

    PubMed Central

    Smith-Ray, Renae L.; Fitzgibbon, Marian L.; Tussing-Humphreys, Lisa; Schiffer, Linda; Shah, Amy; Huber, Gail M.; Braunschweig, Carol; Campbell, Richard T.; Hughes, Susan L.

    2014-01-01

    Osteoarthritis (OA) is the most common chronic condition and principal cause of disability among older adults. The current obesity epidemic has contributed to this high prevalence rate. Fortunately both OA symptoms and obesity can be ameliorated through lifestyle modifications. Physical activity (PA) combined with weight management improves physical function among obese persons with knee OA but evidence-based interventions that combine PA and weight management are limited for this population. This paper describes a comparative effectiveness trial testing an evidence-based PA program for adults with lower extremity (LE) OA, Fit and Strong!, against an enhanced version that also addresses weight management based on the evidence-based Obesity Reduction Black Intervention Trial (ORBIT). Adult participants (n=400) with LE OA, age 60+, overweight/obese, and not meeting PA requirements of >=150 minutes per week, are randomized to one of the two programs. Both 8-week interventions meet 3 times per week and include 60 minutes of strength, flexibility, and aerobic exercise instruction followed by 30 minutes of education/group discussion. The Fit and Strong! education sessions focus on using PA to manage OA; whereas Fit and Strong! Plus addresses PA and weight loss management strategies. Maintenance of behavior change is reinforced in both groups during months 3 - 24 through telephone calls and mailed newsletters. Outcomes are assessed at baseline, and 2, 6, 12, 18, and 24 months. Primary outcomes are dietary change at 2 months followed by weight loss at 6 months that is maintained at 24 months. Secondary outcomes assess PA, physical performance, and anxiety/depression. PMID:24316240

  11. Fit and Strong! Plus: design of a comparative effectiveness evaluation of a weight management program for older adults with osteoarthritis.

    PubMed

    Smith-Ray, Renae L; Fitzgibbon, Marian L; Tussing-Humphreys, Lisa; Schiffer, Linda; Shah, Amy; Huber, Gail M; Braunschweig, Carol; Campbell, Richard T; Hughes, Susan L

    2014-03-01

    Osteoarthritis (OA) is the most common chronic condition and principal cause of disability among older adults. The current obesity epidemic has contributed to this high prevalence rate. Fortunately both OA symptoms and obesity can be ameliorated through lifestyle modifications. Physical activity (PA) combined with weight management improves physical function among obese persons with knee OA but evidence-based interventions that combine PA and weight management are limited for this population. This paper describes a comparative effectiveness trial testing an evidence-based PA program for adults with lower extremity (LE) OA, Fit and Strong!, against an enhanced version that also addresses weight management based on the evidence-based Obesity Reduction Black Intervention Trial (ORBIT). Adult participants (n=400) with LE OA, age 60+, overweight/obese, and not meeting PA requirements of ≥ 150 min per week, are randomized to one of the two programs. Both 8-week interventions meet 3 times per week and include 60 min of strength, flexibility, and aerobic exercise instruction followed by 30 min of education/group discussion. The Fit and Strong! education sessions focus on using PA to manage OA; whereas Fit and Strong! Plus addresses PA and weight loss management strategies. Maintenance of behavior change is reinforced in both groups during months 3-24 through telephone calls and mailed newsletters. Outcomes are assessed at baseline, and 2, 6, 12, 18, and 24 months. Primary outcomes are dietary change at 2 months followed by weight loss at 6 months that is maintained at 24 months. Secondary outcomes assess PA, physical performance, and anxiety/depression.

  12. Association of increased monetary cost of dietary intake, diet quality and weight management in Spanish adults.

    PubMed

    Schröder, Helmut; Serra-Majem, Luis; Subirana, Isaac; Izquierdo-Pulido, Maria; Fitó, Montserrat; Elosua, Roberto

    2016-03-14

    Higher monetary diet cost is associated with healthier food choices and better weight management. How changes in diet cost affect changes in diet quality and weight remains unknown. The aim of this study was to assess the impact of changes in individual monetary diet cost on changes in diet quality, measured by the modified Mediterranean diet score recommendations (MDS-rec) and by energy density (ED), as well as changes in weight and BMI. We conducted a prospective, population-based study of 2181 male and female Spaniards aged between 25 and 74 years, who were followed up to the 2009-2010 academic year. We measured weight and height and recorded dietary data using a validated FFQ. Average food cost was calculated from official Spanish government data. We fitted multivariate linear and logistic regression models. The average daily diet cost increased from 3·68(SD0.0·89)€/8·36 MJ to 4·97(SD1·16)€/8·36 MJ during the study period. This increase was significantly associated with improvement in diet quality (Δ ED and Δ MDS-rec; P<0·0001). Each 1€ increase in monetary diet cost per 8·36 MJ was associated with a decrease of 0·3 kg in body weight (P=0·02) and 0·1 kg/m(2) in BMI (P=0·04). These associations were attenuated after adjusting for changes in diet quality indicators. An improvement in diet quality and better weight management were both associated with an increase in diet cost; this could be considered in food policy decisions.

  13. Behavioural weight management programmes for adults assessed by trials conducted in everyday contexts: systematic review and meta-analysis.

    PubMed

    Hartmann-Boyce, J; Johns, D J; Jebb, S A; Summerbell, C; Aveyard, P

    2014-11-01

    This systematic review and meta-analysis of effectiveness trials comparing multicomponent behavioural weight management programmes with controls in overweight and obese adults set out to determine the effectiveness of these interventions implemented in routine practice. To be included, interventions must have been multicomponent, delivered by the therapists who would deliver the intervention in routine practice and in that same context, and must be widely available or feasible to implement with little additional infrastructure or staffing. Searches of electronic databases were conducted, and augmented by screening reference lists and contacting experts (November 2012). Data were extracted by two reviewers, with mean difference between intervention and control for 12-month change in weight, blood pressure, lipids and glucose calculated using baseline observation carried forward. Data were also extracted on adverse events, quality of life and mood measures. Although there were many published efficacy trials, only eight effectiveness trials met the inclusion criteria. Pooled results from five study arms providing access to commercial weight management programmes detected significant weight loss at 12 months (mean difference -2.22 kg, 95% confidence interval [CI] -2.90 to -1.54). Results from two arms of a study testing a commercial programme providing meal replacements also detected significant weight loss (mean difference -6.83 kg, 95% CI -8.39 to -5.26). In contrast, pooled results from five interventions delivered by primary care teams showed no evidence of an effect on weight (mean difference -0.45 kg, 95% CI -1.34 to 0.43). One study testing an interactive web-based intervention detected a significant effect in favour of the intervention at 12 months, but the study was judged to be at high risk of bias and the effect did not persist at 18 months. Few studies reported other outcomes, limiting comparisons between interventions. Few trials have examined the

  14. Be Well: results of a nutrition, exercise, and weight management intervention among at-risk older adults.

    PubMed

    Kogan, Alexis Coulourides; Gonzalez, Jorge; Hart, Bonita; Halloran, Skip; Thomason, Brenda; Levine, Morgan; Enguidanos, Susan

    2013-10-01

    The objective of this article is to test the effectiveness of a multifaceted exercise and nutritional education intervention for chronically ill, community-dwelling older adults. A pre/post cohort design was implemented with measures of physical activity, fitness, depression, and anthropometry collected via 4-month in-person interview and telephone follow-up. The study was conducted at two community-based senior centers in the Los Angeles area and participants (n=62) were older adults aged 60 or older, with multiple chronic conditions, with one or more emergency department visits or hospital admissions in the previous 6 months, and at nutritionally moderate to high risk. The intervention was a fitness program providing nutritional counseling, low-impact exercise, and weight management. Results revealed significant improvements for hours of weekly exercise (Z = -4.3, p < .001), daily walking distance (Z = -5.7, p < .001), performance on fitness tests, depression (Z = 3.9, p < .001), and body measurements were observed. Findings speak to the healthy benefits of exercise and good nutrition as possible alternatives or adjuncts to pharmacotherapy for weight loss and depression.

  15. Naltrexone HCI/bupropion HCI for chronic weight management in obese adults: patient selection and perspectives

    PubMed Central

    Tek, Cenk

    2016-01-01

    Naltrexone, an opiate antagonist, and bupropion, a noradrenergic/dopaminergic antidepressant, have many effects on the reward systems of the brain. These medications impact eating behavior, presumably via their impact on food reward. However, only bupropion induces weight loss in obese individuals, while naltrexone does not have any appreciable effect. The combination of 32 mg of naltrexone and 360 mg of bupropion in a sustained-release combination pill form has been recently approved for obesity treatment. Studies have shown that the combination of these two medications is more effective in inducing weight loss, when combined with lifestyle intervention and calorie reduction, than each individual medicine alone. The naltrexone–bupropion combination, when combined with lifestyle intervention and modest calorie reduction, seems to be quite effective for 6-month and 1-year outcomes for clinically significant weight loss (over 5% of total body weight). These medications are not devoid of serious side effects, however, and careful patient selection can reduce dramatic complications and increase positive outcomes. This paper reviews existing weight loss clinical trials with bupropion and the bupropion–naltrexone combination. Additionally, the rationale for the suggested patient selection and clinical strategies for special patient populations are discussed. PMID:27217728

  16. Academy of Nutrition and Dietetics: standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in adult weight management.

    PubMed

    Jortberg, Bonnie; Myers, Eileen; Gigliotti, Linda; Ivens, Barbara J; Lebre, Monica; Burke March, Susan; Nogueira, Isadora; Nwankwo, Robin; Parkinson, Meredith R; Paulsen, Barbara; Turner, Tonya

    2015-04-01

    Weight management encompasses the inter-relationship of nutrition, physical activity, and health behavior change. Nutrition is key for the prevention and treatment of obesity and chronic disease and maintenance of overall health. Thus, the Weight Management Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (RDNs) in Adult Weight Management as a resource for RDNs working in weight management. This document allows RDNs to assess their current skill levels and to identify areas for further professional development in this expanding practice area. This document describes the current standards for weight management practice for RDNs. The Standards of Practice represent the four steps in the Nutrition Care Process as applied to the care of patients/clients. The Standards of Professional Performance consist of six domains of professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how the standard can be applied to practice. The indicators describe three skill levels (competent, proficient, and expert) for RDNs working in weight management. The Standards of Practice and Standards of Professional Performance are complementary resources for the Registered Dietitian Nutritionist in weight management.

  17. Weight loss and physical activity for disease prevention in obese older adults: an important role for lifestyle management.

    PubMed

    Valencia, Willy Marcos; Stoutenberg, Mark; Florez, Hermes

    2014-10-01

    Weight loss in older adults has been a controversial topic for more than a decade. An obesity paradox has been previously described and the issue of weight status on health outcomes remains a highly debated topic. However, there is little doubt that physical activity (PA) has a myriad of benefits in older adults, especially in obese individuals who are inactive and have a poor cardiometabolic profile. In this review, we offer a critical view to clarify misunderstandings regarding the obesity paradox, particularly as it relates to obese older adults. We also review the evidence on PA and lifestyle interventions for the improvement of cardiorespiratory fitness, which can prevent disease and provide benefits to obese older adults, independent of weight changes.

  18. Yogurt and weight management.

    PubMed

    Jacques, Paul F; Wang, Huifen

    2014-05-01

    A large body of observational studies and randomized controlled trials (RCTs) has examined the role of dairy products in weight loss and maintenance of healthy weight. Yogurt is a dairy product that is generally very similar to milk, but it also has some unique properties that may enhance its possible role in weight maintenance. This review summarizes the human RCT and prospective observational evidence on the relation of yogurt consumption to the management and maintenance of body weight and composition. The RCT evidence is limited to 2 small, short-term, energy-restricted trials. They both showed greater weight losses with yogurt interventions, but the difference between the yogurt intervention and the control diet was only significant in one of these trials. There are 5 prospective observational studies that have examined the association between yogurt and weight gain. The results of these studies are equivocal. Two of these studies reported that individuals with higher yogurt consumption gained less weight over time. One of these same studies also considered changes in waist circumference (WC) and showed that higher yogurt consumption was associated with smaller increases in WC. A third study was inconclusive because of low statistical power. A fourth study observed no association between changes in yogurt intake and weight gain, but the results suggested that those with the largest increases in yogurt intake during the study also had the highest increase in WC. The final study examined weight and WC change separately by sex and baseline weight status and showed benefits for both weight and WC changes for higher yogurt consumption in overweight men, but it also found that higher yogurt consumption in normal-weight women was associated with a greater increase in weight over follow-up. Potential underlying mechanisms for the action of yogurt on weight are briefly discussed.

  19. Excessive Body Weight in Older Adults.

    PubMed

    Porter Starr, Kathryn N; Bales, Connie W

    2015-08-01

    The health challenges prompted by obesity in the older adult population are poorly recognized and understudied. A defined treatment of geriatric obesity is difficult to establish, as it must take into account biological heterogeneity, age-related comorbidities, and functional limitations (sarcopenia/dynapenia). This retrospective article highlights the current understanding of the optimal body mass index (BMI) in later life, addressing appropriate recommendations based on BMI category, age, and health history. The findings of randomized control trials of weight loss/maintenance interventions help one to move closer to evidence-based and appropriately individualized recommendations for body weight management in older adults.

  20. Weight and weddings. Engaged men's body weight ideals and wedding weight management behaviors.

    PubMed

    Klos, Lori A; Sobal, Jeffery

    2013-01-01

    Most adults marry at some point in life, and many invest substantial resources in a wedding ceremony. Previous research reports that brides often strive towards culturally-bound appearance norms and engage in weight management behaviors in preparation for their wedding. However, little is known about wedding weight ideals and behaviors among engaged men. A cross-sectional survey of 163 engaged men asked them to complete a questionnaire about their current height and weight, ideal wedding body weight, wedding weight importance, weight management behaviors, formality of their upcoming wedding ceremony, and demographics. Results indicated that the discrepancy between men's current weight and reported ideal wedding weight averaged 9.61 lb. Most men considered being at a certain weight at their wedding to be somewhat important. About 39% were attempting to lose weight for their wedding, and 37% were not trying to change their weight. Attempting weight loss was more frequent among men with higher BMI's, those planning more formal weddings, and those who considered being the right weight at their wedding as important. Overall, these findings suggest that weight-related appearance norms and weight loss behaviors are evident among engaged men.

  1. Body Weight Management in Adults Under Chronic Stress Through Treatment With Ashwagandha Root Extract: A Double-Blind, Randomized, Placebo-Controlled Trial.

    PubMed

    Choudhary, Dnyanraj; Bhattacharyya, Sauvik; Joshi, Kedar

    2017-01-01

    Chronic stress has been associated with a number of illnesses, including obesity. Ashwagandha is a well-known adaptogen and known for reducing stress and anxiety in humans. The objective of this study was to evaluate the safety and efficacy of a standardized root extract of Ashwagandha through a double-blind, randomized, placebo-controlled trial. A total of 52 subjects under chronic stress received either Ashwagandha (300 mg) or placebo twice daily. Primary efficacy measures were Perceived Stress Scale and Food Cravings Questionnaire. Secondary efficacy measures were Oxford Happiness Questionnaire, Three-Factor Eating Questionnaire, serum cortisol, body weight, and body mass index. Each subject was assessed at the start and at 4 and 8 weeks. The treatment with Ashwagandha resulted in significant improvements in primary and secondary measures. Also, the extract was found to be safe and tolerable. The outcome of this study suggests that Ashwagandha root extract can be used for body weight management in adults under chronic stress.

  2. Socioeconomic Disparities in Emerging Adult Weight and Weight Behaviors

    ERIC Educational Resources Information Center

    VanKim, Nicole A.; Laska, Melissa N.

    2012-01-01

    Objectives: To explore weight, weight behaviors, and tobacco and alcohol use among emerging adults by parental education and financial strain. Methods: Cross-sectional analyses of 2010 survey data from an urban Minnesota public 4-year university and 2-year community college (n=1201). Results: Low parental education was associated with lower…

  3. How College Students Search the Internet for Weight Control and Weight Management Information: An Observational Study

    ERIC Educational Resources Information Center

    Senkowski, Valerie; Branscum, Paul

    2015-01-01

    Background: Few studies have attempted to examine how young adults search for health information on the Internet, especially information related to weight control and weight management. Purpose: The purpose of this study was to determine search strategies that college students used for finding information related to weight control and weight…

  4. The Effectiveness of a Weight Maintenance Intervention for Adults with Intellectual Disabilities and Obesity: A Single Stranded Study

    ERIC Educational Resources Information Center

    Spanos, Dimitrios; Hankey, Catherine R.; Melville, Craig A.

    2016-01-01

    Background: The evidence base for weight management programmes incorporating a weight loss and a weight maintenance phase for adults with intellectual disabilities (ID) is limited. This study describes the weight maintenance phase of a multicomponent weight management programme for adults with intellectual disability and obesity (TAKE 5).…

  5. Intervention Use and Action Planning in a Web-Based Computer-Tailored Weight Management Program for Overweight Adults: Randomized Controlled Trial

    PubMed Central

    van Empelen, Pepijn; Oenema, Anke

    2014-01-01

    Background There are many online interventions aiming for health behavior change but it is unclear how such interventions and specific planning tools are being used. Objective The aim of this study is to identify which user characteristics were associated with use of an online, computer-tailored self-regulation intervention aimed at prevention of weight gain; and to examine the quality of the goals and action plans that were generated using the online planning tools. Methods Data were obtained with a randomized controlled effect evaluation trial in which the online computer-tailored intervention was compared to a website containing generic information about prevention of weight gain. The tailored intervention included self-regulation techniques such as personalized feedback, goal setting, action planning, monitoring, and other techniques aimed at weight management. Participants included 539 overweight adults (mean age 46.9 years, mean body mass index [BMI] 28.03 kg/m2, 31.2% male, 11% low education level) recruited from the general population. Use of the intervention and its planning tools were derived from server registration data. Physical activity, fat intake, motivational factors, and self-regulation skills were self-reported at baseline. Descriptive analyses and logistic regression analyses were used to analyze the results. Results Use of the tailored intervention decreased sharply after the first modules. Visiting the first tailored intervention module was more likely among participants with low levels of fat intake (OR 0.77, 95% CI 0.62-0.95) or planning for change in PA (OR 0.23, 95% CI 0.05-0.97). Revisiting the intervention was more likely among participants high in restrained eating (OR 2.45, 95% CI 1.12-5.43) or low in proactive coping skills for weight control (OR 0.28, 95% CI 0.10-0.76). The planning tools were used by 5%-55% of the participants, but only 20%-75% of the plans were of good quality. Conclusions This study showed that psychological

  6. Evaluation of a multidisciplinary Tier 3 weight management service for adults with morbid obesity, or obesity and comorbidities, based in primary care.

    PubMed

    Jennings, A; Hughes, C A; Kumaravel, B; Bachmann, M O; Steel, N; Capehorn, M; Cheema, K

    2014-10-01

    A multidisciplinary Tier 3 weight management service in primary care recruited patients with a body mass index ≥40 kg·m(-2) , or 30 kg·m(-2) with obesity-related co-morbidity to a 1-year programme. A cohort of 230 participants was recruited and evaluated using the National Obesity Observatory Standard Evaluation Framework. The primary outcome was weight loss of at least 5% of baseline weight at 12 months. Diet was assessed using the two-item food frequency questionnaire, activity using the General Practice Physical Activity questionnaire and quality of life using the EuroQol-5D-5L questionnaire. A focus group explored the participants' experiences. Baseline mean weight was 124.4 kg and mean body mass index was 44.1 kg·m(-2) . A total of 102 participants achieved 5% weight loss at 12 months. The mean weight loss was 10.2 kg among the 117 participants who completed the 12-month programme. Baseline observation carried forward analysis gave a mean weight loss of 5.9 kg at 12 months. Fruit and vegetable intake, activity level and quality of life all improved. The dropout rate was 14.3% at 6 months and 45.1% at 1 year. Focus group participants described high levels of satisfaction. It was possible to deliver a Tier 3 weight management service for obese patients with complex co-morbidity in a primary care setting with a full multidisciplinary team, which obtained good health outcomes compared with existing services.

  7. Evaluation of a multidisciplinary Tier 3 weight management service for adults with morbid obesity, or obesity and comorbidities, based in primary care

    PubMed Central

    Jennings, A; Hughes, C A; Kumaravel, B; Bachmann, M O; Steel, N; Capehorn, M; Cheema, K

    2014-01-01

    A multidisciplinary Tier 3 weight management service in primary care recruited patients with a body mass index ≥40 kg·m−2, or 30 kg·m−2 with obesity-related co-morbidity to a 1-year programme. A cohort of 230 participants was recruited and evaluated using the National Obesity Observatory Standard Evaluation Framework. The primary outcome was weight loss of at least 5% of baseline weight at 12 months. Diet was assessed using the two-item food frequency questionnaire, activity using the General Practice Physical Activity questionnaire and quality of life using the EuroQol-5D-5L questionnaire. A focus group explored the participants' experiences. Baseline mean weight was 124.4 kg and mean body mass index was 44.1 kg·m−2. A total of 102 participants achieved 5% weight loss at 12 months. The mean weight loss was 10.2 kg among the 117 participants who completed the 12-month programme. Baseline observation carried forward analysis gave a mean weight loss of 5.9 kg at 12 months. Fruit and vegetable intake, activity level and quality of life all improved. The dropout rate was 14.3% at 6 months and 45.1% at 1 year. Focus group participants described high levels of satisfaction. It was possible to deliver a Tier 3 weight management service for obese patients with complex co-morbidity in a primary care setting with a full multidisciplinary team, which obtained good health outcomes compared with existing services. PMID:25825858

  8. Practice Policy Statement: Integrating Effective Weight Management Into Practice.

    PubMed

    Edshteyn, Ingrid; Uduhiri, Kelechi A; Morgan, Toyosi O; Rhodes, Katrina L; Sherin, Kevin M

    2016-10-01

    The American College of Preventive Medicine Prevention Practice Committee contributes to policy guidelines and recommendations on preventive health topics for clinicians and public health decision makers. As an update to a previously published statement on weight management counseling of overweight adults, the College is providing a consensus-based recommendation designed to more effectively integrate weight management strategies into clinical practice and to incorporate referrals to effective evidence-based community and commercial weight management programs. The goal is to empower providers to include lifestyle interventions as part of the foundation of clinical practice.

  9. Relationship of childhood weight status to morbidity in adults.

    PubMed

    Abraham, Sidney; Collins, Gretchen; Nordsieck, Marie

    2016-08-01

    A cohort of white males who had attended elementary schools in Hagerstown, Md., between 1923 and 1928, and whose height-weight records for those years were available, was examined during 1961-63. A study of their childhood relative weight at ages 9-13, and of their adult relative weight 35-40 years later, was made in relation to selected physiological variables and diagnosed morbidity.Essential findings were as follows: Childhood relative weight at ages 9-13 had no significant relationship to adult levels of fasting blood sugar, serum cholesterol, beta-lipoprotein, or blood pressure, or to cardiovascular renal disease.Childhood relative weight at ages 9-13 was significantly related to hypertensive vascular disease. The below average weight group experienced a higher prevalence than observed in either average or moderately overweight childhood groups.Approximately 30 percent of the below average weight children became average weight adults and 21 percent became overweight adults. Of the average weight children, approximately 40 percent became overweight adults. Overweight children tended to remain overweight as adults.Adult relative weight of the same cohort, viewed 35-40 years later, was significantly associated with fasting blood sugar, beta-lipoprotein, and systolic and diastolic blood pressure. Elevated levels of each of these variables occurred with greater frequency in the overweight child.Adult relative weight was significantly associated with hypertensive vascular disease and cardiovascular renal disease; the higher prevalence occurred in the overweight adults.The highest risk for hypertensive vascular and cardiovascular renal disease was associated with the persons who acquired their overweight status as adults. The higher prevalence of these diseases among the overweight adults was largely attributable to the adults who moved from a below average childhood weight category to an overweight adult group. The moderately or markedly overweight adults who was

  10. A Second Chance at Health: How a 3D Virtual World Can Improve Health Self-Efficacy for Weight Loss Management Among Adults.

    PubMed

    Behm-Morawitz, Elizabeth; Lewallen, Jennifer; Choi, Grace

    2016-02-01

    Health self-efficacy, or the beliefs in one's capabilities to perform health behaviors, is a significant factor in eliciting health behavior change, such as weight loss. Research has demonstrated that virtual embodiment has the potential to alter one's psychology and physicality, particularly in health contexts; however, little is known about the impacts embodiment in a virtual world has on health self-efficacy. The present research is a randomized controlled trial (N = 90) examining the effectiveness of virtual embodiment and play in a social virtual world (Second Life [SL]) for increasing health self-efficacy (exercise and nutrition efficacy) among overweight adults. Participants were randomly assigned to a 3D social virtual world (avatar virtual interaction experimental condition), 2D social networking site (no avatar virtual interaction control condition), or no intervention (no virtual interaction control condition). The findings of this study provide initial evidence for the use of SL to improve exercise efficacy and to support weight loss. Results also suggest that individuals who have higher self-presence with their avatar reap more benefits. Finally, quantitative findings are triangulated with qualitative data to increase confidence in the results and provide richer insight into the perceived effectiveness and limitations of SL for meeting weight loss goals. Themes resulting from the qualitative analysis indicate that participation in SL can improve motivation and efficacy to try new physical activities; however, individuals who have a dislike for video games may not be benefitted by avatar-based virtual interventions. Implications for research on the transformative potential of virtual embodiment and self-presence in general are discussed.

  11. Economic evaluation of an internet-based weight management program

    Technology Transfer Automated Retrieval System (TEKTRAN)

    To determine whether a behavioral Internet treatment (BIT) program for weight management is a viable, cost-effective option compared with usual care (UC) in a diverse sample of overweight (average body mass index = 29 kg/m2), healthy adults (mean age = 34 years) serving in the US Air Force. Two-grou...

  12. Calorie Estimation in Adults Differing in Body Weight Class and Weight Loss Status

    PubMed Central

    Brown, Ruth E; Canning, Karissa L; Fung, Michael; Jiandani, Dishay; Riddell, Michael C; Macpherson, Alison K; Kuk, Jennifer L

    2016-01-01

    Purpose Ability to accurately estimate calories is important for weight management, yet few studies have investigated whether individuals can accurately estimate calories during exercise, or in a meal. The objective of this study was to determine if accuracy of estimation of moderate or vigorous exercise energy expenditure and calories in food is associated with body weight class or weight loss status. Methods Fifty-eight adults who were either normal weight (NW) or overweight (OW), and either attempting (WL) or not attempting weight loss (noWL), exercised on a treadmill at a moderate (60% HRmax) and a vigorous intensity (75% HRmax) for 25 minutes. Subsequently, participants estimated the number of calories they expended through exercise, and created a meal that they believed to be calorically equivalent to the exercise energy expenditure. Results The mean difference between estimated and measured calories in exercise and food did not differ within or between groups following moderate exercise. Following vigorous exercise, OW-noWL overestimated energy expenditure by 72%, and overestimated the calories in their food by 37% (P<0.05). OW-noWL also significantly overestimated exercise energy expenditure compared to all other groups (P<0.05), and significantly overestimated calories in food compared to both WL groups (P<0.05). However, among all groups there was a considerable range of over and underestimation (−280 kcal to +702 kcal), as reflected by the large and statistically significant absolute error in calorie estimation of exercise and food. Conclusion There was a wide range of under and overestimation of calories during exercise and in a meal. Error in calorie estimation may be greater in overweight adults who are not attempting weight loss. PMID:26469988

  13. Weight management in type 2 diabetes mellitus.

    PubMed

    Siram, Amulya T; Yanagisawa, Robert; Skamagas, Maria

    2010-01-01

    Obesity is a well known risk factor for type 2 diabetes mellitus. Individuals with type 2 diabetes mellitus are at risk for weight gain as a result of multiple influences, including sedentary lifestyle, high-calorie diet, diabetes medications, sociocultural factors, chronic medical and psychiatric illnesses, and a dysregulated enteroendocrine axis. Because both diabetes mellitus and obesity predispose patients to abnormal cardiometabolic profiles and increased cardiovascular disease, management of diabetes mellitus should focus on weight management and optimizing cardiometabolic parameters, concomitant with glycemic control. Lifestyle modification incorporating healthy, calorie-appropriate diets and increased physical activity, in addition to metformin, are central components to diabetes management and weight management. These interventions have been shown to improve body weight, glycemic control, and overall cardiometabolic profile. The weight-neutral and weight-losing diabetes medications include metformin, alpha-glucosidase inhibitors, glucagon-like peptide-1 analogs, dipeptidyl peptidase-4 inhibitors, and amylin analogs. It is essential that providers understand the metabolic and weight effects of diabetes medications in order to develop strategies for managing diabetes mellitus while helping patients maintain or lose weight in order to improve their overall health outcomes.

  14. Healthy Eating and Exercise: Strategies for Weight Management in the Rural Midwest

    ERIC Educational Resources Information Center

    Nothwehr, Faryle; Peterson, N. Andrew

    2005-01-01

    Obesity prevalence has increased dramatically in the United States. Rural areas have been especially affected, yet few weight management studies have been conducted in these populations. This study was designed to assess weight management attitudes and strategies used when rural adults in particular attempt to lose weight, employing measures that…

  15. Internalized weight stigma and its ideological correlates among weight loss treatment seeking adults.

    PubMed

    Carels, R A; Young, K M; Wott, C B; Harper, J; Gumble, A; Hobbs, M Wagner; Clayton, A M

    2009-01-01

    There are significant economic and psychological costs associated with the negative weight-based social stigma that exists in American society. This pervasive anti-fat bias has been strongly internalized among the overweight/obese. While the etiology of weight stigma is complex, research suggests that it is often greater among individuals who embrace certain etiological views of obesity or ideological views of the world. This investigation examined 1) the level of internalized weight stigma among overweight/obese treatment seeking adults, and 2) the association between internalized weight stigma and perceived weight controllability and ideological beliefs about the world ('just world beliefs', Protestant work ethic). Forty-six overweight or obese adults (BMI >or=27 kg/m2) participating in an 18- week behavioral weight loss program completed implicit (Implicit Associations Test) and explicit (Obese Person's Trait Survey) measures of weight stigma. Participants also completed two measures of ideological beliefs about the world ("Just World Beliefs", Protestant Ethic Scale) and one measure of beliefs about weight controllability (Beliefs about Obese Persons). Significant implicit and explicit weight bias was observed. Greater weight stigma was consistently associated with greater endorsement of just world beliefs, Protestant ethic beliefs and beliefs about weight controllability. Results suggest that the overweight/obese treatment seeking adults have internalized the negative weight-based social stigma that exists in American society. Internalized weight stigma may be greater among those holding specific etiological and ideological beliefs about weight and the world.

  16. European Guidelines for Obesity Management in Adults.

    PubMed

    Yumuk, Volkan; Tsigos, Constantine; Fried, Martin; Schindler, Karin; Busetto, Luca; Micic, Dragan; Toplak, Hermann

    2015-01-01

    Obesity is a chronic metabolic disease characterised by an increase of body fat stores. It is a gateway to ill health, and it has become one of the leading causes of disability and death, affecting not only adults but also children and adolescents worldwide. In clinical practice, the body fatness is estimated by BMI, and the accumulation of intra-abdominal fat (marker for higher metabolic and cardiovascular disease risk) can be assessed by waist circumference. Complex interactions between biological, behavioural, social and environmental factors are involved in regulation of energy balance and fat stores. A comprehensive history, physical examination and laboratory assessment relevant to the patient's obesity should be obtained. Appropriate goals of weight management emphasise realistic weight loss to achieve a reduction in health risks and should include promotion of weight loss, maintenance and prevention of weight regain. Management of co-morbidities and improving quality of life of obese patients are also included in treatment aims. Balanced hypocaloric diets result in clinically meaningful weight loss regardless of which macronutrients they emphasise. Aerobic training is the optimal mode of exercise for reducing fat mass while a programme including resistance training is needed for increasing lean mass in middle-aged and overweight/obese individuals. Cognitive behavioural therapy directly addresses behaviours that require change for successful weight loss and weight loss maintenance. Pharmacotherapy can help patients to maintain compliance and ameliorate obesity-related health risks. Surgery is the most effective treatment for morbid obesity in terms of long-term weight loss. A comprehensive obesity management can only be accomplished by a multidisciplinary obesity management team. We conclude that physicians have a responsibility to recognise obesity as a disease and help obese patients with appropriate prevention and treatment. Treatment should be based on

  17. Position of the American Dietetic Association: weight management.

    PubMed

    Seagle, Helen M; Strain, Gladys Witt; Makris, Angela; Reeves, Rebecca S

    2009-02-01

    It is the position of the American Dietetic Association that successful weight management to improve overall health for adults requires a lifelong commitment to healthful lifestyle behaviors emphasizing sustainable and enjoyable eating practices and daily physical activity. Given the increasing incidence of overweight and obesity along with the escalating health care costs associated with weight-related illnesses, health care providers must discover how to effectively treat this complex condition. Food and nutrition professionals should stay current and skilled in weight management to assist clients in preventing weight gain, optimizing individual weight loss interventions, and achieving long-term weight loss maintenance. Using the American Dietetic Association's Evidence Analysis Process and Evidence Analysis Library, this position paper presents the current data and recommendations for weight management. The evidence supporting the value of portion control, eating frequency, meal replacements, and very-low-energy diets are discussed as well as physical activity, behavior therapy, pharmacotherapy, and surgery. Public policy changes to create environments that can assist all populations to achieve and sustain healthful lifestyle behaviors are also reviewed.

  18. Predictors of Weight Loss Maintenance following an Insurance-Sponsored Weight Management Program

    PubMed Central

    Abildso, Christiaan G.; Fitzpatrick, Sean J.

    2014-01-01

    Intentional weight loss among overweight and obese adults (body mass index ≥ 25 kg/m2) is associated with numerous health benefits, but weight loss maintenance (WLM) following participation in weight management programming has proven to be elusive. Many individuals attempting to lose weight join formal programs, especially women, but these programs vary widely in focus, as do postprogram weight regain results. We surveyed 2,106 former participants in a community-based, insurance-sponsored weight management program in the United States to identify the pre, during, and post-intervention behavioral and psychosocial factors that lead to successful WLM. Of 835 survey respondents (39.6% response rate), 450 met criteria for inclusion in this study. Logistic regression analyses suggest that interventionists should assess and discuss weight loss and behavior change perceptions early in a program. However, in developing maintenance plans later in a program, attention should shift to behaviors, such as weekly weighing, limiting snacking in the evening, limiting portion sizes, and being physically active every day. PMID:24738027

  19. Healthy Weights for Healthy Older Adults

    MedlinePlus

    ... Training and Recovery Exercise Topics Fueling Your Workout Benefits of Physical Activity Exercise Nutrition Top Articles Man running - Protein and the ... Tags Food Health Fitness Nutrition Wellness Weight Loss Exercise Dietary Guidelines and ... of Physical Activity For Seniors Latest Content 1 ...

  20. Identifying Correlates of Young Adults' Weight Behavior: Survey Development

    ERIC Educational Resources Information Center

    Larson, Nicole; Neumark-Sztainer, Dianne; Story, Mary; van den Berg, Patricia; Hannan, Peter J.

    2011-01-01

    Objective: To describe the development and psychometric properties of survey measures relevant to eating, physical activity, and weight-related behaviors among young adults. Methods: Focus groups and reliability testing guided the development of the Project EAT-III survey. The final survey was completed by 2287 young adults. Results: The…

  1. Prenatal centrifugation: A model for fetal programming of adult weight?

    NASA Astrophysics Data System (ADS)

    Baer, Lisa A.; Rushing, Linda; Wade, Charles E.; Ronca, April E.

    2005-08-01

    'Fetal programming' is a newly emerging field that is revealing astounding insights into the prenatal origins of adult disease, including metabolic, endocrine, and cardiovascular pathophysiology. In the present study, we tested the hypothesis that rat pups conceived, gestated and born at 2-g have significantly reduced birth weights and increased adult body weights as compared to 1-g controls. Offspring were produced by mating young adult male and female rats that were adapted to 2-g centrifugation. Female rats underwent conception, pregnancy and birth at 2-g. Newborn pups in the 2-g condition were removed from the centrifuge and fostered to non-manipulated, newly parturient dams maintained at 1-g. Comparisons were made with 1-g stationary controls, also cross- fostered at birth. As compared to 1-g controls, birth weights of pups gestated and born at 2-g were significantly reduced. Pup body weights were significantly reduced until Postnatal day (P)12. Beginning on P63, body weights of 2-g-gestated offspring exceeded those of 1-g controls by 7-10%. Thus, prenatal rearing at 2-g restricts neonatal growth and increases adult body weight. Collectively, these data support the hypothesis that 2-g centrifugation alters the intrauterine milieu, thereby inducing persistent changes in adult phenotype.

  2. Weight perception, weight change intentions, and alcohol use among young adults.

    PubMed

    Antin, Tamar M J; Paschall, Mallie J

    2011-03-01

    Obesity and binge drinking are important health issues for young adults in the United States. Several studies have investigated the relationship between these constructs with mixed results. One possible explanation to disentangle this relationship suggests that how people feel about their weight, regardless of their actual weight, may explain some variation in alcohol use. This study (n = 4497) investigated the relationship between two types of body weight concerns--weight perception and weight change intentions--and binge drinking. Controlling for measured body weight, we considered whether body weight concerns increase risk for binge drinking. Findings suggest that women who reported trying to lose weight had an increased risk of binge drinking. Conversely, men who perceived themselves overweight were significantly less likely to participate in binge drinking. We conclude with a discussion of the finding's implications.

  3. Food addiction in adults seeking weight loss treatment. Implications for psychosocial health and weight loss.

    PubMed

    Burmeister, Jacob M; Hinman, Nova; Koball, Afton; Hoffmann, Debra A; Carels, Robert A

    2013-01-01

    The present study examined food addiction symptomology and its relationship to eating pathology and psychological distress among adults seeking weight loss treatment. A primary interest was an examination of the relationship between food addiction symptoms and short-term weight loss. Adults beginning a behavioral weight loss program (N=57) were given the Yale Food Addiction Scale (YFAS) as well as measures of psychological distress, disordered eating, weight bias, and weight-focused attitudes. Weight loss was measured after 7 weeks. Severity of food addiction was related to increased depression, emotional eating, binge eating, anti-fat attitudes, internalized weight bias, body shame, and low eating self-efficacy, but not body satisfaction. Increased food addiction symptomology was also related to less weight lost at 7 weeks. Findings suggest that individuals attempting to lose weight while combating symptoms of food addiction may be especially prone to eating-related pathologies, internalized weight bias, and body shame. Importantly, findings provide evidence that food addiction may undermine efforts to lose weight. The pathology associated with addiction (e.g., tolerance, withdrawal) could make the adoption of more healthful eating habits especially difficult.

  4. Mobile Apps for Weight Management: A Scoping Review

    PubMed Central

    2016-01-01

    Background Obesity remains a major public health concern. Mobile apps for weight loss/management are found to be effective for improving health outcomes in adults and adolescents, and are pursued as a cost-effective and scalable intervention for combating overweight and obesity. In recent years, the commercial market for ‘weight loss apps’ has expanded at rapid pace, yet little is known regarding the evidence-based quality of these tools for weight control. Objective To characterize the inclusion of evidence-based strategies, health care expert involvement, and scientific evaluation of commercial mobile apps for weight loss/management. Methods An electronic search was conducted between July 2014 and July 2015 of the official app stores for four major mobile operating systems. Three raters independently identified apps with a stated goal of weight loss/management, as well as weight loss/management apps targeted to pediatric users. All discrepancies regarding selection were resolved through discussion with a fourth rater. Metadata from all included apps were abstracted into a standard assessment criteria form and the evidence-based strategies, health care expert involvement, and scientific evaluation of included apps was assessed. Evidence-based strategies included: self-monitoring, goal-setting, physical activity support, healthy eating support, weight and/or health assessment, personalized feedback, motivational strategies, and social support. Results A total of 393 apps were included in this review. Self-monitoring was most common (139/393, 35.3%), followed by physical activity support (108/393, 27.5%), weight assessment (100/393, 25.4%), healthy eating support (91/393, 23.2%), goal-setting (84/393, 21.4%), motivational strategies (28/393, 7.1%), social support (21/393, 5.3%), and personalized feedback (7/393, 1.8%). Of apps, 0.8% (3/393) underwent scientific evaluation and 0.3% (1/393) reported health care expert involvement. No apps were comprehensive in the

  5. Socioeconomic status and weight control practices in British adults

    PubMed Central

    Wardle, J; Griffith, J

    2001-01-01

    STUDY OBJECTIVE—Attitudes and practices concerning weight control in British adults were examined to test the hypothesis that variation in concern about weight and deliberate weight control might partly explain the socioeconomic status (SES) gradient in obesity. Higher SES groups were hypothesised to show more weight concern and higher levels of dieting.
SETTING—Data were collected as part of the monthly Omnibus Survey of the Office of National Statistics in March 1999.
PARTICIPANTS—A stratified, probability sample of 2690 households was selected by random sampling of addresses in Britain. One randomly selected person in each household was interviewed at their home.
MAIN RESULTS—As predicted, higher SES men and women had higher levels of perceived overweight, monitored their weight more closely, and were more likely to be trying to lose weight. Higher SES groups also reported more restrictive dietary practices and more vigorous physical activity.
CONCLUSIONS—The results are consistent with the idea that part of the protection against weight gain in higher SES groups could be a higher frequency of weight monitoring, a lower threshold for defining themselves as overweight, and a greater likelihood of deliberate efforts at weight control.


Keywords: socioeconomic status; weight control; obesity PMID:11160173

  6. Choose to change maternity weight management pilot.

    PubMed

    Lilley, Suzanne; Anderson, Kate; Benbow, Elizabeth

    2014-07-01

    Obesity during pregnancy is associated with increased risk of adverse health outcomes during pregnancy. There is limited research available regarding effective interventions during pregnancy for obese women and this is combined with local inadequate service provision to support obese mothers in Greater Manchester (GM). Choose to Change (CTC) aims to develop, deliver and evaluate a community based weight management programme to limit excessive gestational weight gain. Participants (n=73) referred from January to December 2013 by Community Midwifery Teams (>18years) with a BMI >30 attended a healthy lifestyle intervention (1:1 or group) covering nutrition, physical activity and behaviour change over 12weeks. Baseline measures were weight, Body Mass Index (BMI), Blood Pressure, physical activity, dietary habits and psychological questionnaires measuring anxiety, self-esteem and dis-ordered eating. 28 clients were assigned to intervention (group (n=15), 1:1 (n=13). Mean age 29 (SD=5.78), mean BMI at referral was 38.96 (SD=4.87). Descriptive statistics suggest an average weight gain for clients (excluding drop outs n=12) is 0.94kg (SD=6.65). For those who have completed the programme (n=8) average weight gain was 1.03kg (SD=7.71). Results vary according to intervention type 1:1, 0.04kg (SD=8.82kg), group, 1.52kg (SD=3.17kg). Drop-out rate from referral to assessment was 62%, from assessment to intervention 32% and during intervention 26%. Overall the results of the present pilot study indicate that the CTC healthy lifestyle intervention can limit excessive gestational weight gain. CTC is looking at future directions for development including changing the assessment procedure to improve DORs, further analysis of various mediating factors including BMI and intervention type and exploration of post-measurements to show further improved health outcomes as the programme is rolled out across GM.

  7. Differences in eating behaviors between nonobese, weight stable young and older adults.

    PubMed

    Flint, Kelsey M Gilmour; Van Walleghen, Emily L; Kealey, Elizabeth H; VonKaenel, Sandra; Bessesen, Daniel H; Davy, Brenda M

    2008-08-01

    Habitual dietary intake, dietary cognitive restraint (CR), disinhibition and hunger are eating behaviors that influence energy balance in both young and older adults. Since the prevalence of overweight and obesity in older adults is steadily rising, it is important to identify eating behavior adaptations that allow individuals to maintain a healthy body weight with advancing age. The association of age with habitual dietary intake, dietary CR, dishinhibition and hunger was examined in 30 older (60-72 years) and 30 younger (18-25 years) nonobese, weight stable, nondieting healthy adults pair-matched by age group for sex, physical activity level (active >150 min of physical activity per week, sedentary <150 min of physical activity per week) and BMI. Dietary CR was significantly greater and hunger was significantly less in older compared to young adults (both P<0.05). Disinhibition scores, habitual energy and macronutrient intake did not differ between age groups. These results indicate that weight management in older, nonobese adults may be facilitated by increased dietary CR and decreased susceptibility to hunger with age. Additionally, changes in energy and macronutrient intake may not be necessary for successful weight management with advancing age.

  8. Cardiovascular Responses to Psychosocial Stress Reflect Motivation State in Adults Born at Extremely Low Birth Weight

    PubMed Central

    Pyhälä, Riikka; Hovi, Petteri; Räikkönen, Katri; Van Lieshout, Ryan J.; Boyle, Michael H.; Saigal, Saroj; Morrison, Katherine M.; Kajantie, Eero; Schmidt, Louis A.

    2015-01-01

    Background. Adults born extremely preterm appear to have more difficulty managing the stresses of early adulthood than their term-born peers. Objective. To examine the effects of being born at extremely low birth weight (ELBW; birth weight < 1000 g) versus at full term on cardiovascular responses to stress. Method. Cardiovascular responses were elicited during administration of a widely used laboratory stressor, the Trier Social Stress Test (TSST). Results. Term-born adults exhibited a larger decrease in total peripheral resistance and larger increase in cardiac output for TSST performance, reflecting greater resilience, than did ELBW adults. Furthermore, in ELBW participants but not controls, cardiovascular responses were correlated with anxiety, suggesting that their responses reflected feelings of stress. Conclusions. Skills-training and practice with relevant stressors may be necessary to increase the personal resources of ELBW participants for managing stress as they transition to adulthood. PMID:27335948

  9. Management of adult choledochal cysts.

    PubMed Central

    Powell, C S; Sawyers, J L; Reynolds, V H

    1981-01-01

    A review of the English literature reveals a total of 1,337 patients with choledochal cysts. Improved diagnostic techniques to visualize the biliary system are demonstrating an increasing number of unsuspected choledochal cysts in adult patients. Either choledochal cysts remain clinically silent until adulthood or may develop in later life. Experience is reported with adult patients having type I, II, III, and IV choledochal cysts. Type I cysts are preferably managed by excision but cyst anatomy may necessitate choledochoenteric drainage. Type II cysts are treated by excision except for those located within the pancreatic portion of the common bile duct. These are best managed by transduodenal cystoduodenostomy. The type III cyst (choledochocele) should be excised carefully, identifying and preserving the common bile and pancreatic ducts. Type IV cysts include a combination of any one of the first three types of cyst plus the presence of intrahepatic cyst or cysts. Treatment of these cysts is dictated by the type and location of the extrahepatic cyst. Since choledochal cysts are being recognized with increased frequency in adults, surgeons need to be aware of the diagnostic and treatment modalities available for each type of biliary cyst. Images Fig. 3. Fig. 4. Fig. 6. Fig. 7. Fig. 9. Fig. 10. PMID:7235770

  10. Young adult outcomes of very-low-birth-weight children.

    PubMed

    Hack, Maureen

    2006-04-01

    Information on the young adult outcomes of the initial survivors of neonatal intensive care has been reported from the United States, Canada, Australia, Great Britain and other European countries. The studies have varied with regard to whether they were regional or hospital-based, their birth-weight group and gestational age, rates of survival, socio-demographic background, and measures of assessment and types of outcome studied. Despite these differences the overall results reveal that neurodevelopment and growth sequelae persist to young adulthood. Very-low-birth-weight young adults have, with few exceptions, poorer educational achievement than normal-birth-weight controls, and fewer continue with post-high-school study. Rates of employment are, however, similar. There are no major differences in general health status, but the young adults demonstrate poorer physical abilities, higher mean blood pressure and poorer respiratory function. There is no evidence of major psychiatric disorder, although anxiety and depression are reported more often. The young adults report less risk-taking than control populations. They report fairly normal social lives and quality of life. When differences are noted they are usually due to neurosensory disabilities. Longer-term studies are needed to evaluate ultimate educational and occupational achievement. It will also be important to assess the effects of preterm birth, early growth failure and catch-up growth on later metabolic and cardiovascular health.

  11. Weight Management and Exercise for the Cancer Survivor

    PubMed Central

    Rutledge, Laura; Demark-Wahnefried, Wendy

    2017-01-01

    This article describes current evidence-based guidelines for diet and physical activity for cancer survivors, specifically focusing on weight management. We also discuss practical interventions to help survivors undertake behavioral changes to manage their weight. PMID:26991704

  12. Therapy and Weight Management (For Teens)

    MedlinePlus

    ... Staying at a Healthy Weight Healthy Weight: Your Personal Plan How Can I Get Back on My Weight-Loss Plan? How Can I Get Motivated to Exercise? Dealing With Feelings When You're Overweight Emotional ...

  13. Correlates of Body Mass Index, Weight Goals, and Weight-Management Practices among Adolescents

    ERIC Educational Resources Information Center

    Paxton, Raheem J.; Valois, Robert F.; Drane, J. Wanzer

    2004-01-01

    The study examined associations among physical activity, cigarette smoking, body mass index, perceptions of body weight, weight-management goals, and weight-management behaviors of public high school adolescents. The CDC Youth Risk Behavior Survey provided a cross-sectional sample (n = 3,089) of public high school students in South Carolina.…

  14. Introduction of the transtheoretical model and organisational development theory in weight management: A narrative review.

    PubMed

    Wu, Ya-Ke; Chu, Nain-Feng

    2015-01-01

    Overweight and obesity are serious public health and medical problems among children and adults worldwide. Behavioural change has been demonstrably contributory to weight management programs. Behavioural change-based weight loss programs require a theoretical framework. We will review the transtheoretical model and the organisational development theory in weight management. The transtheoretical model is a behaviour theory of individual level frequently used for weight management programs. The organisational development theory is a more complicated behaviour theory that applies to behavioural change on the system level. Both of these two theories have their respective strengths and weaknesses. In this manuscript, we try to introduce the transtheoretical model and the organisational development theory in the context of weight loss programs among population that are overweight or obese. Ultimately, we wish to present a new framework/strategy of weight management by integrating these two theories together.

  15. Tools for Successful Weight Management in Primary Care

    PubMed Central

    Turer, Christy Boling

    2015-01-01

    Obesity is one of the most pervasive and costly public-health problems. Clinicians need effective tools to address weight management in primary care, including evaluation and communication methods, guideline-based weight-management interventions, and safe and effective weight-loss medications and surgery. The objective of this Grand-Rounds presentation is to provide practicing clinicians with the latest information regarding effective ways to care for and communicate with patients about weight loss; evidence-based guidelines for selecting weight-management therapies; and safety, efficacy, and adverse effects of weight-loss medications and surgery. PMID:26218666

  16. Effect of phentermine on weight reduction in a pediatric weight management clinic.

    PubMed

    Ryder, J R; Kaizer, A; Rudser, K D; Gross, A; Kelly, A S; Fox, C K

    2017-01-01

    Phentermine is the most widely prescribed obesity medication in adults, yet studies of its use in the pediatric population are limited. We conducted a retrospective chart review of adolescents with obesity treated in a pediatric weight management clinic to examine the weight loss effectiveness of phentermine added to standard of care (SOC) lifestyle modification therapy versus SOC alone. All patients receiving phentermine plus SOC (n=25) were matched with a comparison group receiving only SOC (n=274). Differences at 1, 3 and 6 months were evaluated using generalized estimated equations adjusting for age, sex and baseline body mass index (BMI) and robust variance standard error estimates for confidence intervals and P-values. Phentermine use was associated with a greater percent change in BMI at 1 month (-1.6%; 95% confidence interval (CI): -2.6, -0.6%; P=0.001), 3 months (-2.9%; 95% CI: -4.5, -1.4%; P<0.001) and 6 months (-4.1%; 95% CI: -7.1, -1.0%; P=0.009) compared with SOC alone, with no differences in systolic or diastolic blood pressure between groups. Heart rate was higher at all time-points in the phentermine plus SOC compared with SOC-only group. These data suggest that short-term use of phentermine added to SOC may enhance weight loss in adolescents with obesity in the clinical setting.

  17. Guide for Managers of Adult Education Programs.

    ERIC Educational Resources Information Center

    Hudson River Center for Program Development, Glenmont, NY.

    This document is intended to help adult education program managers throughout New York become oriented to the world of adult education, handle their new responsibilities as program managers, and obtain up-to-date information to assist them in making educational and administrative decisions. The following are among the topics discussed in the…

  18. Evidence for efficacy and effectiveness of changes in eating frequency for body weight management.

    PubMed

    Kant, Ashima K

    2014-11-01

    In self-reported diets of free living individuals, frequent eating is associated with higher energy intake, yet beliefs about the possible beneficial effect of higher eating frequency for managing body weight persist. Prospective cohort studies and controlled trials of manipulation of eating frequency published by 31 December 2012 were reviewed to assess whether variation in eating frequency may be an adjunct to weight management. Four prospective cohort studies were identified; 2 of these included adults followed for 10 y and 2 followed pre-adolescent/adolescent girls for 6 or 10 y. Within each age category, the findings of the 2 studies were contradictory. Six controlled trials with adult subjects serving as their own controls found no significant changes in body weight due to manipulation of eating frequency interventions lasting 6-8 wk. In 6 additional intervention trials of 8-52 wk duration, free-living adults were counseled to change the eating frequency of self-selected food intake with no significant differences in weight loss attributable to eating frequency. Overall, the consistency of the null findings from controlled trials of manipulation of eating frequency for promoting weight loss suggests that beliefs about the role of higher eating frequency in adult weight management are not supported by evidence. Interpretation of the evidence from published observational studies is complicated by differences in definition of eating frequency and limited knowledge of systematic and random errors in measurement of eating frequency.

  19. Diet in the management of weight loss

    PubMed Central

    Strychar, Irene

    2006-01-01

    Obesity is an established risk factor for numerous chronic diseases, and successful treatment will have an important impact on medical resources utilization, health care costs, and patient quality of life. With over 60% of our population being overweight, physicians face a major challenge in assisting patients in the process of weight loss and weight-loss maintenance. Low-calorie diets can lower total body weight by an average of 8% in the short term. These diets are well-tolerated and characterize successful strategies in maintaining significant weight loss over a 5-year period. Very-low-calorie diets produce a more rapid weight loss but should only be used for fewer than 16 weeks because of clinical adverse effects. Diets that are severely restricted in carbohydrates (3%–10% of total energy intake) and do not emphasize a reduction of energy intake may be effective in reducing weight in the short term, but there is no evidence that they are sustainable or innocuous in the long term because their high saturated-fat content may be atherogenic. Fat restriction in a weight-loss regimen is beneficial, but the optimal percentage has yet to be determined. Longitudinal trials are needed to resolve these issues. In this article I discuss the evidence for and pitfalls of various types of weight-loss diets and identify issues that physicians need to address in weight loss and weight-loss maintenance. PMID:16389240

  20. Patient-specific FDG dosimetry for adult males, adult females, and very low birth weight infants

    NASA Astrophysics Data System (ADS)

    Niven, Erin

    Fluorodeoxyglucose is the most commonly used radiopharmaceutical in Positron Emission Tomography, with applications in neurology, cardiology, and oncology. Despite its routine use worldwide, the radiation absorbed dose estimates from FDG have been based primarily on data obtained from two dogs studied in 1977 and 11 adults (most likely males) studied in 1982. In addition, the dose estimates calculated for FDG have been centered on the adult male, with little or no mention of variations in the dose estimates due to sex, age, height, weight, nationality, diet, or pathological condition. Through an extensive investigation into the Medical Internal Radiation Dose schema for calculating absorbed doses, I have developed a simple patient-specific equation; this equation incorporates the parameters necessary for alterations to the mathematical values of the human model to produce an estimate more representative of the individual under consideration. I have used this method to determine the range of absorbed doses to FDG from the collection of a large quantity of biological data obtained in adult males, adult females, and very low birth weight infants. Therefore, a more accurate quantification of the dose to humans from FDG has been completed. My results show that per unit administered activity, the absorbed dose from FDG is higher for infants compared to adults, and the dose for adult women is higher than for adult men. Given an injected activity of approximately 3.7 MBq kg-1, the doses for adult men, adult women, and full-term newborns would be on the order of 5.5, 7.1, and 2.8 mSv, respectively. These absorbed doses are comparable to the doses received from other nuclear medicine procedures.

  1. Perceptions of Body Weight, Weight Management Strategies, and Depressive Symptoms among US College Students

    ERIC Educational Resources Information Center

    Harring, Holly Anne; Montgomery, Kara; Hardin, James

    2010-01-01

    Objective: To determine if inaccurate body weight perception predicts unhealthy weight management strategies and to determine the extent to which inaccurate body weight perception is associated with depressive symptoms among US college students. Participants: Randomly selected male and female college students in the United States (N = 97,357).…

  2. Weight Gain Prevention: Identifying Theory-Based Targets for Health Behavior Change in Young Adults

    PubMed Central

    Strong, Kathryn A.; Parks, Serena L.; Anderson, Eileen; Winett, Richard; Davy, Brenda M.

    2008-01-01

    Young adults attending college are more vulnerable to weight gain than the general population. We sought to identify health behavior change targets related to weight management in college students. Based on the social cognitive theory model for health behavior change, we investigated the health-related lifestyle behaviors and physiological characteristics of this population. Forty-three college students (18.3±0.1 years) completed a series of quantitative assessments (body weight and composition, cardiorespiratory fitness, diet and activity habits) and structured qualitative assessments (structured interview or focus group). Participants were predominantly normal-weight (mean BMI=22.2±0.4 kg/m2) and fit (VO2max = 50.5±1.5 ml/kg/min). However, healthy eating and physical activity were not considered high priorities, despite having ample free time, high exercise self-efficacy, positive outcome expectations for exercise, and a desire to exercise more. Participants reported that regularly engaging in exercise was difficult. This may have been due to poor planning/time management, satisfaction with body image, lack of accountability and feelings of laziness. Dietary patterns generally met recommendations but were low in fruits, vegetables and whole grains. Social support for exercise and healthy dietary habits were important factors associated with health behaviors. Students reported a decline in exercise and dietary habits relative to high school, which may contribute to college weight gain. Our results suggest that this population may not have adequate self-regulatory skills, such as planning and self-monitoring, to maintain healthy behaviors in the college environment. Dietitians working with young adults attending college may use these findings to guide the behavioral therapy component of their weight management medical nutrition therapy goals and outcomes. PMID:18926139

  3. Self-Management Patient Education and Weight Loss

    ERIC Educational Resources Information Center

    Stombaugh, Angela M.

    2010-01-01

    Self-management of a disease is defined as "having or being able to obtain, the skills and resources necessary to best accommodate to the chronic disease and its consequences" (Holman & Lorig, 1992, p. 309). Self-management has been used in the management of several chronic conditions and this model may be useful in the management of weight loss.…

  4. Effectiveness of Hypnosis as an Adjunct to Behavioral Weight Management.

    ERIC Educational Resources Information Center

    Bolocofsky, David N.; And Others

    1985-01-01

    Subjects (N=109) completed a behavioral weight-management program either with or without the addition of hypnosis. Both interventions resulted in significant weight reduction. At the eight-month and two-year follow-ups, the hypnosis clients showed significant additional weight loss and were more likely to have achieved and maintained their…

  5. Can weight management programs in worksites reduce the obesity epidemic?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Worksites can potentially be important locations for weight management programs that contribute to curbing the national obesity epidemic. In published studies, weight loss programs targeting overweight and obese employees have been relatively more effective for weight loss than programs for preventi...

  6. Exercise Clothing for Children in a Weight-Management Program

    ERIC Educational Resources Information Center

    Carroll, Kate; Alexander, Marina; Spencer, Virginia

    2007-01-01

    This study investigated whether clothing can be perceived as a form of encouragement for success in a weight management exercise program. A small (n = 30) sample of children and parents, enrolled in a weight-management exercise program, responded to a survey instrument that included questions regarding fit and comfort of the clothing children wore…

  7. Holiday Weight Management by Successful Weight Losers and Normal Weight Individuals

    ERIC Educational Resources Information Center

    Phelan, Suzanne; Wing, Rena R.; Raynor, Hollie A.; Dibello, Julia; Nedeau, Kim; Peng, Wanfeng

    2008-01-01

    This study compared weight control strategies during the winter holidays among successful weight losers (SWL) in the National Weight Control Registry and normal weight individuals (NW) with no history of obesity. SWL (n = 178) had lost a mean of 34.9 kg and had kept greater than or equal to 13.6 kg off for a mean of 5.9 years. NW (n = 101) had a…

  8. Blood Pressure in Young Adults Born at Very Low Birth Weight: Adults Born Preterm International Collaboration.

    PubMed

    Hovi, Petteri; Vohr, Betty; Ment, Laura R; Doyle, Lex W; McGarvey, Lorcan; Morrison, Katherine M; Evensen, Kari Anne I; van der Pal, Sylvia; Grunau, Ruth E; Brubakk, Ann-Mari; Andersson, Sture; Saigal, Saroj; Kajantie, Eero

    2016-10-01

    Adults born preterm at very low birth weight (VLBW; <1500 g) have higher blood pressure than those born at term. It is not known whether all VLBW adults are at risk or whether higher blood pressure could be attributed to some of the specific conditions underlying or accompanying preterm birth. To identify possible risk or protective factors, we combined individual-level data from 9 cohorts that measured blood pressure in young adults born at VLBW or with a more stringent birth weight criterion. In the absence of major heterogeneity, we performed linear regression analysis in our pooled sample of 1571 adults born at VLBW and 777 controls. Adults born at VLBW had 3.4 mm Hg (95% confidence interval, 2.2-4.6) higher systolic and 2.1 mm Hg (95% confidence interval, 1.3-3.0) higher diastolic pressure, with adjustment for age, sex, and cohort. The difference in systolic pressure was present in men (1.8 mm Hg; 95% confidence interval, 0.1-3.5) but was stronger in women (4.7 mm Hg; 95% confidence interval, 3.2-6.3). Among the VLBW group, blood pressure was unrelated to gestational age, maternal smoking, multiple pregnancy, retinopathy of prematurity, or bronchopulmonary dysplasia. Blood pressure was higher than that of controls among VLBW adults unexposed to maternal preeclampsia. Among those exposed, it was even higher, especially if born appropriate for gestational age. In conclusion, although female sex and maternal preeclampsia are additional risk factors, the risk of higher blood pressure is not limited to any etiologic subgroup of VLBW adults, arguing for vigilance in early detection of high blood pressure in all these individuals.

  9. Developing and Managing Adult Education Budgets.

    ERIC Educational Resources Information Center

    Ericksen, Charles G.

    1993-01-01

    Flexible budgeting can help coordinate and harmonize scarce financial resources in adult education. Budgets can be used as quantitative tools to manage instructional salaries, facilities, supplies, or other program support. (SK)

  10. Postprandial vascular reactivity in obese and normal weight young adults.

    PubMed

    Ayer, Julian G; Harmer, Jason A; Steinbeck, Katherine; Celermajer, David S

    2010-05-01

    As humans spend a significant amount of time in the postprandial state, we examined whether vascular reactivity (a key indicator of cardiovascular health) was different after a high-fat meal in 11 obese (median BMI 46.4, age 32.1 +/- 6.3 years, 7 men) and 11 normal weight (median BMI 22.6) age- and sex-matched controls. At baseline and 1 and 3 h postmeal, blood pressure (BP), heart rate (HR), reactive hyperemia peripheral artery tonometry (RH-PAT) index, radial augmentation index adjusted for HR (AIx75), brachial pulse wave velocity (PWV(b)), glucose, insulin, total and high-density lipoprotein (HDL) cholesterol, and triglycerides were measured. Brachial flow-mediated dilatation (FMD) and, by venous plethysmography, resting and hyperemic forearm blood flows (FBFs) were measured at baseline and 3 h. At baseline, obese subjects had higher systolic BP, HR, resting FBF, insulin and equivalent FMD, RH-PAT, hyperemic FBF, AIx75, PWV(b), glucose, total cholesterol, triglycerides, and lower HDL cholesterol. In obese and lean subjects, FMD at baseline and 3 h was not significantly different (6.2 +/- 1.7 to 5.8 +/- 4.3% for obese and 4.7 +/- 4.1 to 4.3 +/- 3.9% for normal weight, P = 0.975 for group x time). The meal did not produce significant changes in RH-PAT, hyperemic FBF, and PWV(b) in either group (P > 0.1 for the effect of time and for group x time interactions). In conclusion, the vascular responses to a high-fat meal are similar in obese and normal weight young adults. An exaggerated alteration in postprandial vascular reactivity is thus unlikely to contribute importantly to the increased cardiovascular risk of obesity.

  11. The Influence of Sleep Disordered Breathing on Weight Loss in a National Weight Management Program

    PubMed Central

    Janney, Carol A.; Kilbourne, Amy M.; Germain, Anne; Lai, Zongshan; Hoerster, Katherine D.; Goodrich, David E.; Klingaman, Elizabeth A.; Verchinina, Lilia; Richardson, Caroline R.

    2016-01-01

    Study Objective: To investigate the influence of sleep disordered breathing (SDB) on weight loss in overweight/obese veterans enrolled in MOVE!, a nationally implemented behavioral weight management program delivered by the National Veterans Health Administration health system. Methods: This observational study evaluated weight loss by SDB status in overweight/obese veterans enrolled in MOVE! from May 2008–February 2012 who had at least two MOVE! visits, baseline weight, and at least one follow-up weight (n = 84,770). SDB was defined by International Classification of Diseases, Ninth Revision, Clinical Modification codes. Primary outcome was weight change (lb) from MOVE! enrollment to 6- and 12-mo assessments. Weight change over time was modeled with repeated-measures analyses. Results: SDB was diagnosed in one-third of the cohort (n = 28,269). At baseline, veterans with SDB weighed 29 [48] lb more than those without SDB (P < 0.001). On average, veterans attended eight MOVE! visits. Weight loss patterns over time were statistically different between veterans with and without SDB (P < 0.001); veterans with SDB lost less weight (−2.5 [0.1] lb) compared to those without SDB (−3.3 [0.1] lb; P = 0.001) at 6 months. At 12 mo, veterans with SDB continued to lose weight whereas veterans without SDB started to re-gain weight. Conclusions: Veterans with sleep disordered breathing (SDB) had significantly less weight loss over time than veterans without SDB. SDB should be considered in the development and implementation of weight loss programs due to its high prevalence and negative effect on health. Citation: Janney CA, Kilbourne AM, Germain A, Lai Z, Hoerster KD, Goodrich DE, Klingaman EA, Verchinina L, Richardson CR. The influence of sleep disordered breathing on weight loss in a national weight management program. SLEEP 2016;39(1):59–65. PMID:26350475

  12. Management of Antipsychotic-Related Weight Gain

    PubMed Central

    Maayan, Lawrence; Correll, Christoph U.

    2012-01-01

    Despite variations across individuals and agents, antipsychotics are associated with clearly documented weight gain and adverse metabolic effects. Although increased appetite/caloric intake and various receptors, hormones and peptides have been implicated, biological mechanisms contributing to the increase in weight and glucose and lipid abnormalities with antipsychotics are largely unknown. This has hampered the creation of antipsychotics that are free of cardiometabolic effects, even in antipsychotic-naïve/early-phase patients, as well as the development of strategies that can prevent or drastically diminish the adverse cardiometabolic effects. In general, three strategies can reduce the cardiometabolic risk of antipsychotics: 1) switching to a less orexigenenic/metabolically adverse antipsychotic, 2) adjunctive behavioral treatments and 3) adjunctive pharmacologic interventions. However each of these strategies has only been modestly effective. Among different behavioral interventions (N=14, n=746), group and individual treatment, dietary counseling and cognitive-behavioral therapy seem to be similarly effective. Among 15 different pharmacologic strategies (N=35 , n=1,629), only metformin, fenfluramine, sibutramine, topiramate and reboxetine were more effective than placebo, with the most evidence being available for metformin, yet without any head-to-head trials comparing individual pharmacologic interventions. Even in the most successful trials, however, the risk reduction was modest. Weight was not decreased to a pre-treatment level, and despite superiority compared to placebo, weight gain still often occurred, particularly in antipsychotic-naïve patients and when interventions were “preventively” co-initiated with antipsychotics. Future research should focus on combining treatment modalities or agents and on exploring novel mechanism-based interventions. PMID:20586697

  13. Pulse Consumption, Satiety, and Weight Management1

    PubMed Central

    McCrory, Megan A.; Hamaker, Bruce R.; Lovejoy, Jennifer C.; Eichelsdoerfer, Petra E.

    2010-01-01

    The prevalence of obesity has reached epidemic proportions, making finding effective solutions to reduce obesity a public health priority. One part of the solution could be for individuals to increase consumption of nonoilseed pulses (dry beans, peas, chickpeas, and lentils), because they have nutritional attributes thought to benefit weight control, including slowly digestible carbohydrates, high fiber and protein contents, and moderate energy density. Observational studies consistently show an inverse relationship between pulse consumption and BMI or risk for obesity, but many do not control for potentially confounding dietary and other lifestyle factors. Short-term (≤1 d) experimental studies using meals controlled for energy, but not those controlled for available carbohydrate, show that pulse consumption increases satiety over 2–4 h, suggesting that at least part of the effect of pulses on satiety is mediated by available carbohydrate amount or composition. Randomized controlled trials generally support a beneficial effect of pulses on weight loss when pulse consumption is coupled with energy restriction, but not without energy restriction. However, few randomized trials have been conducted and most were short term (3–8 wk for whole pulses and 4–12 wk for pulse extracts). Overall, there is some indication of a beneficial effect of pulses on short-term satiety and weight loss during intentional energy restriction, but more studies are needed in this area, particularly those that are longer term (≥1 y), investigate the optimal amount of pulses to consume for weight control, and include behavioral elements to help overcome barriers to pulse consumption. PMID:22043448

  14. Weight change and all-cause mortality in older adults: A meta-analysis

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This meta-analysis of observational cohort studies examined the association between weight change (weight loss, weight gain, and weight fluctuation) and all-cause mortality among older adults. We used PubMed (MEDLINE), Web of Science, and Cochrane Library to identify prospective studies published in...

  15. Weight management for Mexican American adolescents: school-based program

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective of the current study was to assess change in weight over time for children participating in a school-based weight management program. A total of 47 participants between the ages of 10 and 14 who exceeded the 85th percentile for BMI were randomized into an intensive intervention (II) o...

  16. Link between Food Energy Density and Body Weight Changes in Obese Adults.

    PubMed

    Stelmach-Mardas, Marta; Rodacki, Tomasz; Dobrowolska-Iwanek, Justyna; Brzozowska, Anna; Walkowiak, Jarosław; Wojtanowska-Krosniak, Agnieszka; Zagrodzki, Paweł; Bechthold, Angela; Mardas, Marcin; Boeing, Heiner

    2016-04-20

    Regulating the energy density of food could be used as a novel approach for successful body weight reduction in clinical practice. The aim of this study was to conduct a systemic review of the literature on the relationship between food energy density and body weight changes in obese adults to obtain solid evidence supporting this approach. The search process was based on the selection of publications in the English language listed in public databases. A meta-analysis was performed to combine individual study results. Thirteen experimental and observational studies were identified and included in the final analysis. The analyzed populations consist of 3628 individuals aged 18 to 66 years. The studies varied greatly in terms of study populations, study design and applied dietary approaches. The meta-analysis revealed a significant association between low energy density foods and body weight reduction, i.e., -0.53 kg when low energy density foods were eaten (95% CI: -0.88, -0.19). In conclusions, this study adds evidence which supports the energy density of food as a simple but effective measure to manage weight in the obese with the aim of weight reduction.

  17. Link between Food Energy Density and Body Weight Changes in Obese Adults

    PubMed Central

    Stelmach-Mardas, Marta; Rodacki, Tomasz; Dobrowolska-Iwanek, Justyna; Brzozowska, Anna; Walkowiak, Jarosław; Wojtanowska-Krosniak, Agnieszka; Zagrodzki, Paweł; Bechthold, Angela; Mardas, Marcin; Boeing, Heiner

    2016-01-01

    Regulating the energy density of food could be used as a novel approach for successful body weight reduction in clinical practice. The aim of this study was to conduct a systemic review of the literature on the relationship between food energy density and body weight changes in obese adults to obtain solid evidence supporting this approach. The search process was based on the selection of publications in the English language listed in public databases. A meta-analysis was performed to combine individual study results. Thirteen experimental and observational studies were identified and included in the final analysis. The analyzed populations consist of 3628 individuals aged 18 to 66 years. The studies varied greatly in terms of study populations, study design and applied dietary approaches. The meta-analysis revealed a significant association between low energy density foods and body weight reduction, i.e., −0.53 kg when low energy density foods were eaten (95% CI: −0.88, −0.19). In conclusions, this study adds evidence which supports the energy density of food as a simple but effective measure to manage weight in the obese with the aim of weight reduction. PMID:27104562

  18. Activity/participation Limitation and Weight Loss Among Overweight and Obese US Adults: 1999 to 2002 NHANES

    PubMed Central

    Bish, Connie L.; Blanck, Heidi Michels; Maynard, L. Michele; Serdula, Mary K.; Thompson, Nancy J.; Khan, Laura Kettel

    2007-01-01

    Objective To examine the prevalence and association of activity/participation limitation with trying to lose weight and weight loss practices (eating fewer calories, physical activity, or both) among overweight and obese adults in the United States. Research Methods and Procedures Eligible adults were 20 years of age or older with a body mass index (BMI) ≥ 25 kg/m2 (n = 5608) who responded to standard physical functioning questions included in the 1999–2002 National Health and Nutrition Examination Survey, a continuous survey of the civilian non-institutionalized US population. Results Obese (BMI ≥ 30) men with vs. without activity/participation limitations were more likely to try to lose weight (OR = 1.59, 95% CI 1.05–2.41). This was not the case for overweight women and men (BMI 25–29.9), or obese women. Among adults trying to lose weight, reducing calorie consumption was common (63%–73%, men, 67%–76%, women). Overweight women with vs without activity/participation limitations had significantly reduced likelihood of attaining recommended physical activity (OR = 0.56, 95% CI 0.36–0.89). Obese adults were more likely to try to lose weight if they attributed their limitation to body weight (OR = 1.78, 95% CI 1.11–2.88) or diabetes (OR = 1.86, 95% CI 1.01–3.43) compared to other causes. Overweight and obese adults who attributed activity/participation limitations to mental health, musculoskeletal, or cardiovascular problems were equally likely to attempt weight loss when respondents with each condition were compared to respondents without the condition. Discussion These results verify the importance of adequate subjective health assessment when developing individual weight loss plans, and may help guide weight management professionals in the development and delivery of more personalized care. PMID:18092069

  19. Management of pain in older adults.

    PubMed

    Cavalieri, Thomas A

    2005-03-01

    The elderly are often untreated or undertreated for pain. Barriers to effective management include challenges to proper assessment of pain; underreporting on the part of patients; atypical manifestations of pain in the elderly; a need for increased appreciation of the pharmacokinetic and pharmacodynamic changes of aging; and misconceptions about tolerance and addiction to opioids. Physicians can effectively manage pain in the elderly by understanding different types of pain (nociceptive and neuropathic), and appropriate use of nonopioid, opioid, and adjuvant medications. Opioids have become more widely accepted for treating older adults who have persistent pain, but their use requires physicians have an understanding of prevention and management of side effects, opioid titration and withdrawal, and careful monitoring. Placebo use is unwarranted and unethical. Nonpharmacologic approaches to pain management are essential and include osteopathic manipulative treatment, cognitive behavioral therapy, exercise, and spiritual interventions. The holistic and interdisciplinary approach of osteopathic medicine offers an approach that can optimize effective pain management in older adults.

  20. Diet-Beverage Consumption and Caloric Intake Among US Adults, Overall and by Body Weight

    PubMed Central

    Bleich, Sara N.; Wolfson, Julia A.; Vine, Seanna; Wang, Y. Claire

    2014-01-01

    Objectives. We examined national patterns in adult diet-beverage consumption and caloric intake by body-weight status. Methods. We analyzed 24-hour dietary recall with National Health and Nutrition Examination Survey 1999–2010 data (adults aged ≥ 20 years; n = 23 965). Results. Overall, 11% of healthy-weight, 19% of overweight, and 22% of obese adults drink diet beverages. Total caloric intake was higher among adults consuming sugar-sweetened beverages (SSBs) compared with diet beverages (2351 kcal/day vs 2203 kcal/day; P = .005). However, the difference was only significant for healthy-weight adults (2302 kcal/day vs 2095 kcal/day; P < .001). Among overweight and obese adults, calories from solid-food consumption were higher among adults consuming diet beverages compared with SSBs (overweight: 1965 kcal/day vs 1874 kcal/day; P = .03; obese: 2058 kcal/day vs 1897 kcal/day; P < .001). The net increase in daily solid-food consumption associated with diet-beverage consumption was 88 kilocalories for overweight and 194 kilocalories for obese adults. Conclusions. Overweight and obese adults drink more diet beverages than healthy-weight adults and consume significantly more solid-food calories and a comparable total calories than overweight and obese adults who drink SSBs. Heavier US adults who drink diet beverages will need to reduce solid-food calorie consumption to lose weight. PMID:24432876

  1. An Examination of How People Who Have Lost Weight Communicatively Negotiate Interpersonal Challenges to Weight Management.

    PubMed

    Romo, Lynsey K

    2017-02-02

    The vast majority of Americans are overweight, and those who are able to lose weight typically regain at least the amount they lost. Some people are confronted with sabotage, criticism, and declines in social support during and following weight loss. However, how individuals negotiate these interpersonal barriers is not very well understood. Such an understanding could help individuals maintain their weight loss while minimizing the risk of adverse health or relational consequences. Thus, through a thematic analysis of 40 interviews of people who were identified as previously overweight or obese and a facework lens (Cupach & Metts, 1994; Goffman, 1967), this study examined how people were communicatively able to sustain their weight loss in the face of challenges from friends, family, and colleagues. The investigation found that altered weight management behaviors (particularly healthy eating) can threaten others' face and uncovered several communication strategies people used to prevent and mitigate face threat. To avoid face threat, participants proactively issued cognitive disclaimers about weight management or designated cheat days, accepted but did not consume food, avoided social situations involving food, or ate unhealthy food in smaller portions to assimilate with the in-group. To remediate face threat, participants provided personal choice and health excuses to save face and accomplish their dual goals of maintaining their weight management practices without compromising their relationships.

  2. Mindfulness-Based Interventions for Weight Loss and CVD Risk Management

    PubMed Central

    Fulwiler, Carl; Brewer, Judson A.; Sinnott, Sinead; Loucks, Eric B.

    2017-01-01

    Obesity affects more than one-third of U.S. adults and is a major cause of preventable morbidity and mortality, primarily from cardiovascular disease. Traditional behavioral interventions for weight loss typically focus on diet and exercise habits and often give little attention to the role of stress and emotions in the initiation and maintenance of unhealthy behaviors, which may account for their modest results and considerable variability in outcomes. Stress eating and emotional eating are increasingly recognized as important targets of weight loss interventions. Mindfulness-based interventions were specifically developed to promote greater self-efficacy in coping with stress and negative emotions, and appear to be effective for a variety of conditions. In recent years researchers have begun to study mindfulness interventions for weight loss and CVD risk management. This review describes the rationale for the use of mindfulness in interventions for weight loss and CVD risk management, summarizes the research to date, and suggests priorities for future research.

  3. Body weight and mortality among adults who never smoked.

    PubMed

    Singh, P N; Lindsted, K D; Fraser, G E

    1999-12-01

    In a 12-year prospective study, the authors examined the relation between body mass index (BMI) and mortality among the 20,346 middle-aged (25-54 years) and older (55-84 years) non-Hispanic white cohort members of the Adventist Health Study (California, 1976-1988) who had never smoked cigarettes and had no history of coronary heart disease, cancer, or stroke. In analyses that accounted for putative indicators (weight change relative to 17 years before baseline, death during early follow-up) of pre-existing illness, the authors found a direct positive relation between BMI and all-cause mortality among middle-aged men (minimum risk at BMI (kg/m2) 15-22.3, older men (minimum risk at BMI 13.5-22.3), middle-aged women (minimum risk at BMI 13.9-20.6), and older women who had undergone postmenopausal hormone replacement (minimum risk at BMI 13.4-20.6). Among older women who had not undergone postmenopausal hormone replacement, the authors found a J-shaped relation (minimum risk at BMI 20.7-27.4) in which BMI <20.7 was associated with a twofold increase in mortality risk (hazard ratio (HR) = 2.2, 95% confidence interval (CI) 1.3, 3.5) that was primarily due to cardiovascular and respiratory disease. These findings not only identify adiposity as a risk factor among adults, but also raise the possibility that very lean older women can experience an increased mortality risk that may be due to their lower levels of adipose tissue-derived estrogen.

  4. Designing a Weight Gain Prevention Trial for Young Adults: The CHOICES Study

    ERIC Educational Resources Information Center

    Lytle, Leslie A.; Moe, Stacey G.; Nanney, M. Susie; Laska, Melissa N.; Linde, Jennifer A.; Petrich, Christine A.; Sevcik, Sarah M.

    2014-01-01

    Background: Young adults are at risk for weight gain. Little is known about how to design weight control programs to meet the needs of young adults and few theory-based interventions have been evaluated in a randomized control trial. The Choosing Healthy Options in College Environments and Settings (CHOICES) study was funded to create a…

  5. Knowledge, attitudes and management skills of medical practitioners regarding weight management

    PubMed Central

    2016-01-01

    Background Overweight and obesity have become a global problem. Health professionals are poorly prepared in weight management, which has an effect on their attitudes and management skills with regard to overweight and obese patients. Aim and setting To assess the knowledge, attitudes and management skills of medical practitioners regarding weight management at Odi District Hospital, Gauteng Province, South Africa. Methods We conducted a cross-sectional study on 48 medical practitioners at Odi Hospital between 01 October and 31 October 2013. A self-administered questionnaire was used to assess their knowledge, attitudes and management skills in weight management. The SPSS® statistical software (Version 22) was used for data analysis. A p < 0.05 was considered significant. Results Fifty medical practitioners were recruited, 48 consented to participate and 28 (58.3%) were male. Their categories were community service doctors (3), medical officers (21), registrars (22) and others (2). Thirty-seven (77.1%) never received training in weight management (p < 0.001). Thirty-two (66.7%) regarded weight management as not confined to a dietician (p < 0.001) and 27 (56.2%) regarded weight management as usually unsuccessful (p = 0.004). Forty-seven (97.9%) provided lifestyle modifications and 43 (89.6%) involved the patient’s family in weight management (p < 0.001). More non-registrars [14 (77.8%)] than registrars [8 (38.1%)] measured the body mass index (BMI) routinely (p = 0.013). Conclusion Few medical practitioners received training in weight management. They regarded weight management as usually unsuccessful and lacked confidence in the same owing to lack of training. They provided lifestyle modifications and involved the patient’s family in weight management. Non-registrars measured the BMI routinely. There is a need for training in weight management at undergraduate and post-graduate levels. PMID:28155319

  6. EFFECTS ON BIRTH WEIGHT AND ADULT HEALTH IN RATS PRENATALLY EXPOSED TO TOXICANTS OR UNDERNUTRITION

    EPA Science Inventory

    Low fetal weight is a sensitive indicator of developmental toxicity in animal studies. While low birth weight may be permanent or transitory, the long-term effects of low birth weight on adult health have not been elucidated. Previous research has shown in humans an inverse rela...

  7. American College of Sports Medicine position stand. Appropriate intervention strategies for weight loss and prevention of weight regain for adults.

    PubMed

    Jakicic, J M; Clark, K; Coleman, E; Donnelly, J E; Foreyt, J; Melanson, E; Volek, J; Volpe, S L

    2001-12-01

    In excess of 55% of adults in the United States are classified as either overweight (body mass index = 25-29.9 kg.m(-2)) or obese (body mass index > or = 30 kg.m(-2)). To address this significant public health problem, the American College of Sports Medicine recommends that the combination of reductions in energy intake and increases in energy expenditure, through structured exercise and other forms of physical activity, be a component of weight loss intervention programs. An energy deficit of 500-1000 kcal.d-1 achieved through reductions in total energy intake is recommended. Moreover, it appears that reducing dietary fat intake to <30% of total energy intake may facilitate weight loss by reducing total energy intake. Although there may be advantages to modifying protein and carbohydrate intake, the optimal doses of these macronutritents for weight loss have not been determined. Significant health benefits can be recognized with participation in a minimum of 150 min (2.5 h) of moderate intensity exercise per week, and overweight and obese adults should progressively increase to this initial exercise goal. However, there may be advantages to progressively increasing exercise to 200-300 min (3.3-5 h) of exercise per week, as recent scientific evidence indicates that this level of exercise facilitates the long-term maintenance of weight loss. The addition of resistance exercise to a weight loss intervention will increase strength and function but may not attenuate the loss of fat-free mass typically observed with reductions in total energy intake and loss of body weight. When medically indicated, pharmacotherapy may be used for weight loss, but pharmacotherapy appears to be most effective when used in combination with modifications of both eating and exercise behaviors. The American College of Sports Medicine recommends that the strategies outlined in this position paper be incorporated into interventions targeting weight loss and the prevention of weight regain for

  8. Behavioral Weight Loss and Physical Activity Intervention in Obese Adults with Asthma. A Randomized Trial

    PubMed Central

    Strub, Peg; Xiao, Lan; Lavori, Philip W.; Camargo, Carlos A.; Wilson, Sandra R.; Gardner, Christopher D.; Buist, A. Sonia; Haskell, William L.; Lv, Nan

    2015-01-01

    Rationale: The effect of weight loss on asthma in obese adults warrants rigorous investigation. Objectives: To examine an evidence-based, practical, and comprehensive lifestyle intervention targeting modest weight loss and increased physical activity for asthma control. Methods: The trial randomized 330 obese adults with uncontrolled asthma to receive usual care enhanced with a pedometer, a weight scale, information about existing weight management services at the participating clinics, and an asthma education DVD, or with these tools plus the 12-month intervention. Measurements and Main Results: The primary outcome was change in Asthma Control Questionnaire (ACQ) scores from baseline to 12 months. Participants (mean [SD] age, 47.6 [12.4] yr) were 70.6% women, 20.0% non-Hispanic black, 20.3% Hispanic/Latino, and 8.2% Asian/Pacific Islander. At baseline, they were obese (mean [SD] body mass index, 37.5 [5.9] kg/m2) and had uncontrolled asthma (Asthma Control Test score, 15.1 [3.8]). Compared with control subjects, intervention participants achieved significantly greater mean weight loss (±SE) (intervention, −4.0 ± 0.8 kg vs. control, −2.1 ± 0.8 kg; P = 0.01) and increased leisure-time activity (intervention, 418.2 ± 110.6 metabolic equivalent task–min/wk vs. control, 178.8 ± 109.1 metabolic equivalent task–min/wk; P = 0.05) at 12 months. But between-treatment mean (±SE) differences were not significant for ACQ changes (intervention, –0.3 ± 0.1 vs. control, –0.2 ± 0.1; P = 0.92) from baseline (mean [SD], 1.4 [0.8]), nor for any other clinical asthma outcomes (e.g., spirometric results and asthma exacerbations). Among all participants regardless of treatment assignment, weight loss of 10% or greater was associated with a Cohen d effect of 0.76 and with 3.78 (95% confidence interval, 1.72–8.31) times the odds of achieving clinically significant reductions (i.e., ≥0.5) on ACQ as stable weight (<3% loss or gain from

  9. Is consuming yoghurt associated with weight management outcomes? Results from a systematic review

    PubMed Central

    Eales, J; Lenoir-Wijnkoop, I; King, S; Wood, H; Kok, F J; Shamir, R; Prentice, A; Edwards, M; Glanville, J; Atkinson, R L

    2016-01-01

    Background: Yoghurt is part of the diet of many people worldwide and is commonly recognised as a ‘health food'. Epidemiological studies suggest that yoghurt may be useful as part of weight management programs. In the absence of comprehensive systematic reviews, this systematic review investigated the effect of yoghurt consumption by apparently healthy adults on weight-related outcomes. Methods: An extensive literature search was undertaken, as part of a wider scoping review, to identify yoghurt studies. A total of 13 631 records were assessed for their relevance to weight-related outcomes. Results: Twenty-two publications were eligible according to the review protocol. Cohort studies (n=6) and cross-sectional studies (n=7) all showed a correlation between yoghurt and lower or improved body weight/composition. Six randomised controlled trials (RCTs) and one controlled trial had various limitations, including small size and short duration. One RCT showed significant effects of yoghurt on weight loss, but was confounded by differences in calcium intake. One trial showed nonsignificant weight gain and the remaining five trials showed nonsignificant weight losses that were greater in yoghurt consumers. Conclusions: Yoghurt consumption is associated with lower body mass index, lower body weight/weight gain, smaller waist circumference and lower body fat in epidemiological studies. RCTs suggest weight reduction effects, but do not permit determination of a cause–effect relationship. Well-controlled, adequately powered trials in research and community settings appear likely to identify a modest but beneficial effect of yoghurt consumption for prevention of weight gain and management of obesity. The ready availability of yoghurt (a nutrient-dense food) and its ease of introduction to most diets suggests that educating the public to eat yoghurt as part of a balanced and healthy diet may potentially contribute to improved public health. Future carefully designed RCTs

  10. Managing Status Epilepticus in the Older Adult

    PubMed Central

    Legriel, Stephane; Brophy, Gretchen M.

    2016-01-01

    The aim of this systematic review was to describe particularities in epidemiology, outcome, and management modalities in the older adult population with status epilepticus. There is a higher incidence of status epilepticus in the older adult population, and it commonly has a nonconvulsive presentation. Diagnosis in this population may be difficult and requires an unrestricted use of EEG. Short and long term associated-mortality are high, and age over 60 years is an independent factor associated with poor outcome. Stroke (acute or remote symptomatic), miscellaneous metabolic causes, dementia, infections hypoxemia, and brain injury are among the main causes of status epilepticus occurrence in this age category. The use of anticonvulsive agents can be problematic as well. Thus, it is important to take into account the specific aspects related to the pharmacokinetic and pharmacodynamic changes in older critically-ill adults. Beyond these precautions, the management may be identical to that of the younger adult, including prompt initiation of symptomatic and anticonvulsant therapies, and a broad and thorough etiological investigation. Such management strategies may improve the vital and functional prognosis of these patients, while maintaining a high overall quality of care. PMID:27187485

  11. Weight Management for Athletes and Active Individuals: A Brief Review.

    PubMed

    Manore, Melinda M

    2015-11-01

    Weight management for athletes and active individuals is unique because of their high daily energy expenditure; thus, the emphasis is usually placed on changing the diet side of the energy balance equation. When dieting for weight loss, active individuals also want to preserve lean tissue, which means that energy restriction cannot be too severe or lean tissue is lost. First, this brief review addresses the issues of weight management in athletes and active individuals and factors to consider when determining a weight-loss goal. Second, the concept of dynamic energy balance is reviewed, including two mathematical models developed to improve weight-loss predictions based on changes in diet and exercise. These models are now available on the Internet. Finally, dietary strategies for weight loss/maintenance that can be successfully used with active individuals are given. Emphasis is placed on teaching the benefits of consuming a low-ED diet (e.g., high-fiber, high-water, low-fat foods), which allows for the consumption of a greater volume of food to increase satiety while reducing energy intake. Health professionals and sport dietitians need to understand dynamic energy balance and be prepared with effective and evidence-based dietary approaches to help athletes and active individuals achieve their body-weight goals.

  12. Weight management for veterans: examining change in weight before and after MOVE!

    PubMed

    Dahn, Jason R; Fitzpatrick, Stephanie L; Llabre, Maria M; Apterbach, Greta S; Helms, Rebecca L; Cugnetto, Marilyn L; Klaus, Johanna; Florez, Hermes; Lawler, Tim

    2011-05-01

    In the year 2000, 31% of women and 40% of men receiving outpatient care at Veteran Affairs (VA) medical facilities were overweight (BMI ≥25 and <30 kg/m(2)); 37.4% of women and 32.9% of men were obese (BMI ≥30 kg/m(2)). The purpose of the present study was to assess treatment effects of MOVE! Weight Management Program for Veterans by comparing the trajectory of change in weight postintervention (3, 6, and 12 months postenrollment) to a preintervention period (1, 3, and 5 years before enrollment). The sample consisted of 862 veterans participating in MOVE! at the Miami VA. All veterans participated in a 2-h Self-Management Support (SMS) session, which involved completion of a self-assessment questionnaire and a nutrition education group session. After completing SMS, veterans had the option of continuing with Supportive Group Sessions (SGS), which included 10-weekly group sessions led by a multidisciplinary team. Veterans served as their own controls in the analyses. Veterans gained 2 kg/year before enrolling in MOVE!. There were similar increases in weight across sex, racial/ethnic groups, and treatment condition. Weight for participants in SMS stabilized after enrollment whereas participants in SGS had an average weight loss of 1.6 kg/year. The preintervention slope for weight was significantly different from the postintervention slope, suggesting treatment effect. Findings from this study support the need for a lifestyle modification program such as MOVE! in primary care settings to assist overweight and obese patients in managing their weight.

  13. Social embeddedness in an online weight management programme is linked to greater weight loss.

    PubMed

    Poncela-Casasnovas, Julia; Spring, Bonnie; McClary, Daniel; Moller, Arlen C; Mukogo, Rufaro; Pellegrini, Christine A; Coons, Michael J; Davidson, Miriam; Mukherjee, Satyam; Nunes Amaral, Luis A

    2015-03-06

    The obesity epidemic is heightening chronic disease risk globally. Online weight management (OWM) communities could potentially promote weight loss among large numbers of people at low cost. Because little is known about the impact of these online communities, we examined the relationship between individual and social network variables, and weight loss in a large, international OWM programme. We studied the online activity and weight change of 22,419 members of an OWM system during a six-month period, focusing especially on the 2033 members with at least one friend within the community. Using Heckman's sample-selection procedure to account for potential selection bias and data censoring, we found that initial body mass index, adherence to self-monitoring and social networking were significantly correlated with weight loss. Remarkably, greater embeddedness in the network was the variable with the highest statistical significance in our model for weight loss. Average per cent weight loss at six months increased in a graded manner from 4.1% for non-networked members, to 5.2% for those with a few (two to nine) friends, to 6.8% for those connected to the giant component of the network, to 8.3% for those with high social embeddedness. Social networking within an OWM community, and particularly when highly embedded, may offer a potent, scalable way to curb the obesity epidemic and other disorders that could benefit from behavioural changes.

  14. Psychosocial Stress and Change in Weight Among US Adults

    PubMed Central

    Block, Jason P.; He, Yulei; Zaslavsky, Alan M.; Ding, Lin

    2009-01-01

    The association of psychosocial stress with weight gain may have important implications for clinical practice and workplace and public health interventions. To determine whether multiple domains of psychosocial stress were associated with weight gain from 1995 to 2004, the authors analyzed a nationally representative longitudinal cohort of 1,355 men and women in the United States. Change in body mass index was assessed for multiple domains of psychosocial stress related to work, personal relationships, life constraints, and finances, controlling for other factors associated with weight gain. All analyses were stratified by sex and weighted to account for the complex survey design. Among men with high baseline body mass index, weight gain was associated with increasing levels of psychosocial stress related to job-related demands (P < 0.001 for interaction with baseline body mass index), lack of skill discretion (P = 0.014), lack of decision authority (P = 0.026), and difficulty paying bills (P = 0.004). Among women with high baseline body mass index, weight gain was associated with job-related demands (P < 0.001 for interaction with baseline body mass index), perceived constraints in life (P < 0.001), strain in relations with family (P = 0.016), and difficulty paying bills (P = 0.010). Interventions to address psychosocial stress may limit weight gain among overweight and obese men and women. PMID:19465744

  15. Association of Fecundity With Changes in Adult Female Weight

    PubMed Central

    Gaskins, Audrey J.; Rich-Edwards, Janet W.; Missmer, Stacey A.; Rosner, Bernard; Chavarro, Jorge E.

    2015-01-01

    Objective To evaluate whether weight change since age 18, current body mass index (BMI), and BMI at age 18 are associated with fecundity. Methods Our study included 1,950 women currently attempting pregnancy in the Nurses’ Health Study 3 (2010–2014), a prospective cohort study. Height, current weight, and weight at age 18 were self-reported on the baseline questionnaire. Every 3 to 6 months thereafter, women reported the current duration of their pregnancy attempt. Multivariable accelerated failure time models were used to estimate the time ratios and 95% confidence intervals (CI). Results For every 5 kg increase in body weight from age 18, current duration of pregnancy attempt increased by 5% (95% CI 3, 7%). Compared to women who maintained weight, the adjusted median current duration was 0.5 months shorter in those who lost weight, 0.3 months longer for those who gained 4–9.9 kg and 10–19.9 kg, and 1.4 months longer for those who gained ≥20 kg (p-trend= <0.001). The adjusted time ratio (95% CI) for a 5 kg/m2 increase in current BMI was 1.08 (1.04, 1.12). After multivariable adjustment (including adjustment for current BMI), being underweight at age 18 (BMI < 18.5) was associated with a longer current duration of pregnancy attempt compared to normal weight women (time ratio: 1.25 95% CI 1.07, 1.47); however being overweight or obese at age 18 was not associated with fecundity. Conclusions Gaining weight in adulthood, being overweight or obese in adulthood, and being underweight at age 18 were associated with a modest reduction in fecundity. PMID:26348178

  16. Smartphone applications to aid weight loss and management: current perspectives.

    PubMed

    Sutton, Elizabeth F; Redman, Leanne M

    2016-01-01

    The development and dissemination of smart devices has cultivated a global environment of hyperconnectivity and increased our access to information. The paralleled launch and success of the Mobile Health industry has created a market of commercially available applications or "apps" along with tools or sensors, which allow the user to receive and collect personal health information. Apps and accompanying tools now allow an individual to "self-digitize" and, pertaining to weight management, monitor their body weight, caloric intake, physical activity, and more. These products possess the ability to improve the scalability of traditional in-person weight management services considering their near ubiquity, affordability, and capability to deliver information directly and personally to the user. However, similar to the dietary supplement market, the anecdotal value of these products has driven their popularity and acceptance by the general public without requirement of scientific validation or, in the area of weight management or diet/exercise, validation of the safety and efficacy by the Food and Drug Administration prior to market launch. By conducting a literature and clinical trial search, we found remarkably few active, completed, or published studies testing the efficacy of smart device applications using randomized controlled trials. Research efforts must be focused on illuminating the efficacy of behavioral interventions and remote self-monitoring for weight loss/maintenance treatment with true, randomized controlled trials.

  17. Smartphone applications to aid weight loss and management: current perspectives

    PubMed Central

    Sutton, Elizabeth F; Redman, Leanne M

    2016-01-01

    The development and dissemination of smart devices has cultivated a global environment of hyperconnectivity and increased our access to information. The paralleled launch and success of the Mobile Health industry has created a market of commercially available applications or “apps” along with tools or sensors, which allow the user to receive and collect personal health information. Apps and accompanying tools now allow an individual to “self-digitize” and, pertaining to weight management, monitor their body weight, caloric intake, physical activity, and more. These products possess the ability to improve the scalability of traditional in-person weight management services considering their near ubiquity, affordability, and capability to deliver information directly and personally to the user. However, similar to the dietary supplement market, the anecdotal value of these products has driven their popularity and acceptance by the general public without requirement of scientific validation or, in the area of weight management or diet/exercise, validation of the safety and efficacy by the Food and Drug Administration prior to market launch. By conducting a literature and clinical trial search, we found remarkably few active, completed, or published studies testing the efficacy of smart device applications using randomized controlled trials. Research efforts must be focused on illuminating the efficacy of behavioral interventions and remote self-monitoring for weight loss/maintenance treatment with true, randomized controlled trials. PMID:27486338

  18. University Students' Views of Obesity and Weight Management Strategies

    ERIC Educational Resources Information Center

    Okonkwo, Ononuju; While, Alison

    2010-01-01

    Objective: To investigate the knowledge and views of university students regarding obesity and weight management strategies. Design: Online questionnaire-based survey of undergraduate and postgraduate university students in a large London university with a diverse student population. Method: The survey was administered online and circulated…

  19. Management of Esophageal Perforation in Adults

    PubMed Central

    Kaman, Lileswar; Iqbal, Javid; Kundil, Byju; Kochhar, Rakesh

    2010-01-01

    Perforation of esophagus in the adult is a very morbid condition with high morbidity and mortality. The ideal treatment is controversial. The main causes for esophageal perforation in adults are iatrogenic, traumatic, spontaneous and foreign bodies. The morbidity and mortality rate is directly related to the delay in diagnosis and initiation of optimum treatment. The reported mortality from treated esophageal perforation is 10% to 25%, when therapy is initiated within 24 hours of perforation, but it could rise up to 40% to 60% when the treatment is delayed beyond 48 hours. Primary closure of the perforation site and wide drainage of the mediastinum is recommended if perforation is detected in less than 24 hours. Treatment option for delayed or missed rupture of esophagus is not very clear and is controversial. Recently a substantial number of patients with esophageal perforation are being managed by nonoperative measures. Patients with small perforations and minimal extraesophageal involvement may be better managed by nonoperative treatment Major prognostic factors determining mortality are the etiology and site of the injury, the presence of underlying esophageal pathology, the delay in diagnosis and the method of treatment. For optimum outcome for management of esophageal perforations in adults a multidisciplinary approach is needed. PMID:27942303

  20. Optimal weighted combinatorial forecasting model of QT dispersion of ECGs in Chinese adults.

    PubMed

    Wen, Zhang; Miao, Ge; Xinlei, Liu; Minyi, Cen

    2016-07-01

    This study aims to provide a scientific basis for unifying the reference value standard of QT dispersion of ECGs in Chinese adults. Three predictive models including regression model, principal component model, and artificial neural network model are combined to establish the optimal weighted combination model. The optimal weighted combination model and single model are verified and compared. Optimal weighted combinatorial model can reduce predicting risk of single model and improve the predicting precision. The reference value of geographical distribution of Chinese adults' QT dispersion was precisely made by using kriging methods. When geographical factors of a particular area are obtained, the reference value of QT dispersion of Chinese adults in this area can be estimated by using optimal weighted combinatorial model and reference value of the QT dispersion of Chinese adults anywhere in China can be obtained by using geographical distribution figure as well.

  1. Optimal weighted combinatorial forecasting model of QT dispersion of ECGs in Chinese adults

    NASA Astrophysics Data System (ADS)

    Wen, Zhang; Miao, Ge; Xinlei, Liu; Minyi, Cen

    2016-07-01

    This study aims to provide a scientific basis for unifying the reference value standard of QT dispersion of ECGs in Chinese adults. Three predictive models including regression model, principal component model, and artificial neural network model are combined to establish the optimal weighted combination model. The optimal weighted combination model and single model are verified and compared. Optimal weighted combinatorial model can reduce predicting risk of single model and improve the predicting precision. The reference value of geographical distribution of Chinese adults' QT dispersion was precisely made by using kriging methods. When geographical factors of a particular area are obtained, the reference value of QT dispersion of Chinese adults in this area can be estimated by using optimal weighted combinatorial model and reference value of the QT dispersion of Chinese adults anywhere in China can be obtained by using geographical distribution figure as well.

  2. Time perspective and weight management behaviors in newly diagnosed Type 2 diabetes: a mediational analysis.

    PubMed

    Hall, Peter A; Fong, Geoffrey T; Cheng, Alice Y

    2012-12-01

    The primary objective of the current study was to examine the extent to which domain-specific time perspective predicts weight management behaviors (dietary behavior and physical activity) among those newly diagnosed with Type 2 diabetes. A secondary objective was to test potential mediators of the hypothesized effect (behavioral intention, self-efficacy and control beliefs). A total of 204 adults newly diagnosed (≤6 months) with Type 2 diabetes participated in the study, which included a baseline assessment of domain-general and domain-specific time perspective, as well as strength of intention to perform two weight-management behaviors (dietary choice and physical activity); both weight-management behaviors were assessed again at 6 month follow-up. Hierarchical multiple regression analyses revealed a prospective association between domain-specific time perspective and uptake of weight management behaviors. Individuals with newly diagnosed T2DM possessing a future-oriented time perspective reported making less frequent fatty food choices and greater increases in physical activity over the 6-month follow-up interval. These effects were selectively mediated by intention strength, and not competing social cognitive variables. For both behaviors, the total effects and meditational models were robust to adjustments for demographics, body composition and disease variables. A future-oriented time perspective is prospectively associated with superior uptake of weight management behaviors among those with newly diagnosed Type 2 diabetes. The facilitating effect of future-oriented thinking appears to occur via enhanced strength of intentions to perform weight management behaviors.

  3. Efficacy comparison of medications approved for chronic weight management.

    PubMed

    Kumar, Rekha B; Aronne, Louis J

    2015-04-01

    For the first time, patients who are obese are able to benefit from 5 different FDA approved pharmacologic agents for chronic weight management. Although weight loss from all of these medications was limited to 5% to 10% of total body weight loss in the Phase III clinical trials, patients are capable of losing more weight when a cumulative approach of diet, exercise, and multiple medications are used. A pilot study of adding phentermine to lorcaserin yielded double the weight loss than lorcaserin alone. A higher percentage of total body weight is lost with use of combination phentermine/topiramate compared to orlistat, lorcaserin, and bupropion/naltrexone but there are more contraindications to its use and potential cardiovascular adverse effects due to adrenergic agonism. Lorcaserin and bupropion/naltrexone yielded similar weight loss but carry different adverse effect profiles and interactions with other psychiatric medications may preclude use of one over the other. When choosing a medication for obesity, several factors need to be considered, such as comorbidities, medication interactions, and risk of potential adverse effects.

  4. Phenotypic and genetic associations between lamb growth traits and adult ewe body weights in western range sheep.

    PubMed

    Borg, R C; Notter, D R; Kott, R W

    2009-11-01

    Data from the Montana State University Targhee flock were used to estimate genetic and environmental relationships between lamb BW and adult ewe BW, condition score, and prolificacy. The flock was managed under commercial western range conditions typical of the area. Data included records from 12,154 lambs born to 2,930 dams and 200 rams between 1960 and 2005. Lamb traits included BW at birth and approximately 45 d, 120 d (weaning), 12 mo, and 18 mo of age and fleece characteristics at 12 mo of age. Adult traits included ewe litter size; BW and BCS at weaning, in late gestation, and in early lactation; and adult fleece measurements. Multiplicative factors were used to adjust (pre)weaning lamb BW for effects of age of dam, type of birth and rearing, and lamb sex and to adjust adult litter sizes for effects of ewe age. An animal model was used to estimate genetic relationships. Models for lamb traits included fixed effects of year of birth and, for postweaning data, lamb sex and random additive genetic effects and, for (pre)weaning BW, additive genetic maternal and permanent environmental maternal effects. Models for adult traits included fixed effects of year of birth, year of record, and, when appropriate, numbers of lambs born or born and reared and random additive genetic and animal permanent environmental effects. Heritability estimates for lamb birth weight, 45-d BW, weaning weight, yearling weight, 18-mo BW, fleece weight, staple length, and spinning count were 0.19, 0.07, 0.12, 0.32, 0.38, 0.32, 0.31, and 0.25, respectively. Maternal heritabilities for lamb birth, 45-d, and weaning weights were 0.15, 0.09, and 0.08, respectively. Heritability estimates for adult traits were 0.12 for litter size, averaged 0.43 for BW and 0.13 for body condition, and were 0.44, 0.37, and 0.25 for adult fleece weight, staple length, and spinning count, respectively. Correlations between genetic effects on adult BW and direct and maternal genetic effects on lamb BW ranged from 0

  5. The relationship between smoking, body weight, body mass index, and dietary intake among Thai adults: results of the national Thai Food Consumption Survey.

    PubMed

    Jitnarin, Nattinee; Kosulwat, Vongsvat; Rojroongwasinkul, Nipa; Boonpraderm, Atitada; Haddock, Christopher K; Poston, Walker S C

    2014-09-01

    This study examined the relationship between dietary intake, body weight, and body mass index (BMI) in adult Thais as a function of smoking status. A cross-sectional, nationally representative survey using health and dietary questionnaires and anthropometric measurements were used. Participants were 7858 Thai adults aged 18 years and older recruited from 17 provinces in Thailand. Results demonstrated that smoking is associated with lower weights and BMI. However, when smokers were stratified by smoking intensity, there was no dose-response relationship between smoking and body weight. There is no conclusive explanation for weight differences across smoking groups in this sample, and the results of the present study did not clearly support any of the purported mechanisms for the differences in body weight or BMI. In addition, because the substantial negative health consequences of smoking are far stronger than those associated with modest weight differences, smoking cannot be viewed as an appropriate weight management strategy.

  6. Birth weight and cognitive function in young adult life: historical cohort study.

    PubMed Central

    Sørensen, H. T.; Sabroe, S.; Olsen, J.; Rothman, K. J.; Gillman, M. W.; Fischer, P.

    1997-01-01

    OBJECTIVE: To examine the relation between birth weight and cognitive function in young adult life. DESIGN: Retrospective cohort study based on birth registry data and cognitive function measured during evaluation for military service. SUBJECTS: 4300 Danish conscripts born between 1973 and 1975. MAIN OUTCOME MEASURES: Mean score in the Boerge Prien test of cognitive function; score is the number of correct answers to 78 questions and correlates with full scale intelligence quotient (IQ). RESULTS: Mean score in the Boerge Prien test increased from 39.9 at a birth weight of < or = 2500 g to 44.6 at a birth weight of 4200 g even after adjustment for gestational age and length at birth, maternal age and parity, and other variables. Above a birth weight of 4200 g the test score decreased slightly. CONCLUSION: Birth weight is associated with cognitive performance in young adult life. Interference with fetal growth may influence adult cognitive performance. PMID:9277604

  7. Mobile applications for obesity and weight management: current market characteristics.

    PubMed

    Nikolaou, C K; Lean, M E J

    2017-01-01

    Mobile-Health (mHealth) is the fastest-developing eHealth sector, with over 100 000 health applications (apps) currently available. Overweight/obesity is a problem of wide public concern that is potentially treatable/preventable through mHealth. This study describes the current weight-management app-market. Five app stores (Apple, Google, Amazon, Windows and Blackberry) in UK, US, Russia, Japan and Germany, Italy, France, China, Australia and Canada were searched for keywords: 'weight', 'calorie', 'weight-loss', 'slimming', 'diet', 'dietitian' and 'overweight' in January/February 2016 using App-Annie software. The 10 most downloaded apps in the lifetime of an app were recorded. Developers' lists and the app descriptions were searched to identify any professional input with keywords 'professional', 'dietitian' and 'nutritionist'. A total of 28 905 relevant apps were identified as follows: Apple iTunes=8559 (4634, 54% paid), Google Play=1762 (597, 33.9% paid), Amazon App=13569 (4821, 35.5% paid), Windows=2419 (819, 17% paid) and Blackberry=2596 (940, 36% paid). The 28 905 identified apps focused mainly on physical activity (34%), diet (31%), and recording/monitoring of exercise, calorie intake and body weight (23%). Only 17 apps (0.05%) were developed with identifiable professional input. Apps on weight management are widely available and very popular but currently lack professional content expertise. Encouraging app development based on evidence-based online approaches would assure content quality, allowing healthcare professionals to recommend their use.

  8. Unbearable weight: young adult women's experiences of being overweight.

    PubMed

    Yu-Jen, Chang; Yiing-Mei, Liou; Shuh-Jen, Sheu; Mei-Yen, Chen

    2004-06-01

    Being overweight is a hazard to health. Overweight people have a very negative image due to the marketing strategies for weight reduction and beauty products. Young women establishing self-image, seeking affirmation of social peers, and looking for potential mates are usually concerned about their weight and figure. To investigate the experience of young women who think they are overweight, how they come to think in this way, and the impact of this thinking, this qualitative pilot study conducted semi-structured interviews with five participants. On the basis of the qualitative method, data was subjected to constant comparison and content analysis. The phenomenon can thus be described in three major categories: (1) Social labeling of the overweight - a slim image is overwhelmingly preferred; (2) Pursuing attractiveness or health - a self-struggling process; (3) Weight reduction and self control - an endless struggle. The result of the study suggests there is a need for a competitive image to counter current obsessions with painfully slender figures in society. To protect the public's mental and physical health, nurses should play an active role in weight education based on a deeper and more dynamic understanding of being overweight.

  9. High Blood Pressure in Adults with Disabilities: Influence of Gender, Body Weight and Health Behaviors

    ERIC Educational Resources Information Center

    Lin, Lan-Ping; Liu, Chien-Ting; Liou, Shih-Wen; Hsu, Shang-Wei; Lin, Jin-Ding

    2012-01-01

    The aims of this study were to explore the mean and distribution of systolic and diastolic blood pressure, and to examine the influence of gender, body weight and health behaviors on hypertension in adults with disabilities. We analyzed the 2010 annual community health examination chart of adults with disabilities in east Taiwan. The study samples…

  10. The Attainment of Conservation of Mass, Weight, and Volume in Minimally Educated Adults.

    ERIC Educational Resources Information Center

    Graves, Avis J. Ruthven

    The purpose was to determine whether different levels of education, race, and sex affect the degree of conservation of mass, weight, and volume attained by minimally educated adults. Subjects were 30 white and 30 black females and 30 white and 30 black males enrolled in Adult Basic Education classes, with 40 subjects each at grade levels 0-3, 4-6,…

  11. Liraglutide for weight management: a critical review of the evidence

    PubMed Central

    Mehta, A.; Marso, S. P.

    2016-01-01

    Summary Objective To review the efficacy, safety, and clinical applicability of liraglutide for weight management from phase III clinical trials. Methods A search of the English language literature was performed using PubMed search terms: “liraglutide”, “glucagon‐like peptide‐1 receptor agonist”, and “randomized clinical trial”. Articles and bibliographies relevant to the subject were reviewed and additional references known to the authors were included. Results Five randomized, placebo‐controlled trials of liraglutide for weight management were identified. In addition to recommended diet and physical activity, liraglutide consistently resulted in a 4 to 6 kg weight loss, with a greater proportion of patients achieving at least 5 and 10% weight loss compared with placebo. The most common adverse effects were gastrointestinal and primarily occurred early in the treatment course. Comparative data suggest that weight loss with liraglutide is greater than that seen with orlistat or lorcaserin, but slightly less that seen with phentermine/topiramate. Liraglutide 1.8 mg was recently shown to have cardiovascular benefit in a large outcomes trial; applicability of these results for the 3.0 mg formulation in a more diverse weight loss population at high cardiovascular risk is not currently known. Barriers to real‐world clinical use as a first‐line agent include gastrointestinal side effects, high cost, and need for injection. Conclusions Liraglutide helps to induce and sustain weight loss in patients with obesity. Its efficacy is comparable to other available agents but it offers the unique benefit of improved glycemic control. Additional studies are needed to determine its long term efficacy and safety profile.

  12. Weight control in the management of hypertension. World Hypertension League.

    PubMed Central

    1989-01-01

    This article, which includes a brief description of the mechanisms and some epidemiological findings in obesity and high blood pressure, sums up present knowledge on a complex subject and provides guidance to medical practitioners on the management of obese hypertensive patients. Weight reduction, together with drug therapy in severe and moderate hypertension, and other non-pharmacological methods and continuing observation in mild hypertension are the essential measures to be applied. In addition to the lowering of blood pressure, weight loss offers several other metabolic and haemodynamic benefits. PMID:2670295

  13. Management of Priapism in Adult Men

    PubMed Central

    Ekeke, Onyeanunam N.; Omunakwe, Hannah E.; Eke, Ndu

    2015-01-01

    This study aims to present the management of priapism in adult men in Port Harcourt, Nigeria. All patients who presented with priapism in 2 hospitals in Port Harcourt from July 2007 to April 2014 were prospectively studied. Treatment was assigned based on clinical presentation. Data analyzed included: age on clinical presentation, risk factor, mode, and outcome of management. There were 18 patients aged 17 to 60 years (median age: 30 years). Three patients (16.7%) presented with stuttering priapism. Most of the patients presented after 24 hours of onset. Sixteen patients (89.9%) had hematological disorders. Five patients (27.8%) took suspected aphrodisiac medications. Seven patients (38.9%) were managed conservatively. The rest achieved detumescence following glandulo-cavernous shunting. Erectile function after treatment was satisfactory in 5 patients (27.8%). The commonest cause of priapism in Port Harcourt was hematological disorder. Most of the patients presented late. Prevalence of erectile dysfunction after treatment was high. PMID:25785343

  14. Management of priapism in adult men.

    PubMed

    Ekeke, Onyeanunam N; Omunakwe, Hannah E; Eke, Ndu

    2015-03-01

    This study aims to present the management of priapism in adult men in Port Harcourt, Nigeria. All patients who presented with priapism in 2 hospitals in Port Harcourt from July 2007 to April 2014 were prospectively studied. Treatment was assigned based on clinical presentation. Data analyzed included: age on clinical presentation, risk factor, mode, and outcome of management. There were 18 patients aged 17 to 60 years (median age: 30 years). Three patients (16.7%) presented with stuttering priapism. Most of the patients presented after 24 hours of onset. Sixteen patients (89.9%) had hematological disorders. Five patients (27.8%) took suspected aphrodisiac medications. Seven patients (38.9%) were managed conservatively. The rest achieved detumescence following glandulo-cavernous shunting. Erectile function after treatment was satisfactory in 5 patients (27.8%). The commonest cause of priapism in Port Harcourt was hematological disorder. Most of the patients presented late. Prevalence of erectile dysfunction after treatment was high.

  15. Longitudinal Predictors of Psychiatric Disorders in Very Low Birth Weight Adults

    ERIC Educational Resources Information Center

    Westrupp, E. M.; Northam, E.; Doyle, L. W.; Callanan, C.; Anderson, P. J.

    2012-01-01

    The purpose of this study was to determine risk and protective factors for adult psychiatric disorders in very low birth weight (VLBW, birth weight less than 1,501 g) survivors. 79 of 154 (51%) VLBW subjects recruited at birth were assessed in early adulthood (24-27 years). Participants were screened for a psychiatric disorder; those elevated were…

  16. Weight Loss in Adults with Down Syndrome and with Dementia in Alzheimer's Disease

    ERIC Educational Resources Information Center

    Prasher, V. P.; Metseagharun, T.; Haque, S.

    2004-01-01

    An association between weight loss and Alzheimer's disease has been established in the general population but little information is available regarding this association in people with intellectual disabilities. A 4-year longitudinal study of adults with Down syndrome with and without Alzheimer's disease was undertaken. Age-associated weight loss…

  17. Body Mass Index Self-Perception and Weight Management Behaviors during Late Adolescence

    ERIC Educational Resources Information Center

    Yang, Kyeongra; Turk, Melanie T.; Allison, Virginia L.; James, Khara A.; Chasens, Eileen

    2014-01-01

    Background: This study examined the relationship between actual body weight and self-perceived weight, and how perception of one's weight affects weight management behaviors among US adolescents. Methods: Adolescents ages 16-19 years with objectively-measured weight and height and self-reported perception of weight, weight-loss efforts, and…

  18. Role of Health Coaches in Pediatric Weight Management.

    PubMed

    Rice, Kerrilynn G; Jumamil, Riana B; Jabour, Sarah M; Cheng, Jennifer Kimberly

    2017-02-01

    This study aims to describe patients' and families' perspectives regarding the ideal role and responsibilities of a health coach to facilitate pediatric weight management in the primary care setting. Systematic thematic analysis of semistructured interviews with overweight children and their parents was performed. The majority of participants self-identified as racial/ethnic minorities and were Medicaid eligible. Desired health coaching elements included ( a) customized support and encouragement, including goal setting and maintenance, cultural sensitivity, and consideration of budget and lifestyle; ( b) nutritional guidance, including meal planning, assistance obtaining healthy food, and education and counseling; and ( c) linkage to resources, including social services, physical activity support, and programs for children with special health care needs. We conclude that families' specific needs should be holistically considered in the design of health coaching programs targeting pediatric obesity. Such support may help overcome social and financial barriers to changing health behaviors related to weight management.

  19. Salivary habituation to food stimuli in successful weight loss maintainers, obese and normal-weight adults

    PubMed Central

    Bond, DS; Raynor, HA; McCaffery, JM; Wing, RR

    2017-01-01

    Objective Research shows that slower habituation of salivary responses to food stimuli is related to greater energy intake and that obese (Ob) individuals habituate slower than those of normal weight (NW). No study has examined habituation rates in weight loss maintainers (WLMs) who have reduced from obese to normal weight, relative to those who are Ob or NW. Design Salivation to two baseline water trials and 10 lemon-flavored lollipop trials were studied in 14 WLMs, 15 Ob and 18 NW individuals comparable in age, gender and ethnicity. Linear mixed models were used to compare WLMs with Ob and NW groups. Results Salivation in the WLM and NW groups decreased significantly (for both P <0.005) across trials, indicative of habituation. Salivary responses in the Ob group did not habituate (P=0.46). When compared with Ob group, WLMs showed a quicker reduction in salivation (P<0.05). WLM and NW groups did not differ in habituation rate (P=0.49). Conclusions WLMs have habituation rates that are comparable to NW individuals without previous history of obesity, and show quicker habituation than those who are currently obese. These results suggest that physiological responses to food may ‘normalize’ with successful weight loss maintenance. PMID:20010900

  20. The role of dairy foods and dietary calcium in weight management.

    PubMed

    Van Loan, Marta

    2009-02-01

    Overweight and obesity are the foremost public health problems in the U.S., other industrialized countries, and is rapidly increasing in developing countries. Obesity is a multifaceted disease which requires multiple approaches to successfully combat its increase. Nutritional factors play a key role and include modification of energy balance, intake and expenditure, as well as other factors. Emerging scientific evidence over the past decade suggests that dairy foods may be beneficial when included in a moderate energy restricted diet and possibly for weight maintenance as well. This paper provides a review of some of the scientific evidence that has examined the effect of dairy foods and dietary calcium on weight management. Topic areas presented are observational or retrospective studies with adults as well as children and adolescents; randomized clinical trials on body weight and composition, energy expenditure, substrate oxidation and fecal fat loss; research from animal and in vitro studies provide possible mechanisms of action.

  1. Managing Community Projects for Change. NIACE Lifelines in Adult Learning.

    ERIC Educational Resources Information Center

    Eldred, Jan

    This document presents practical advice to help managers of adult learning projects in communities across the United Kingdom manage their community projects for change. The following topics are discussed in sections 1-12: (1) the benefits of adult learning projects; (2) characteristics of adult learning projects and quality assurance mechanisms;…

  2. Discrepancies in Communication Versus Documentation of Weight-Management Benchmarks

    PubMed Central

    Turer, Christy B.; Barlow, Sarah E.; Montaño, Sergio; Flores, Glenn

    2017-01-01

    To examine gaps in communication versus documentation of weight-management clinical practices, communication was recorded during primary care visits with 6- to 12-year-old overweight/obese Latino children. Communication/documentation content was coded by 3 reviewers using communication transcripts and health-record documentation. Discrepancies in communication/documentation content codes were resolved through consensus. Bivariate/multivariable analyses examined factors associated with discrepancies in benchmark communication/documentation. Benchmarks were neither communicated nor documented in up to 42% of visits, and communicated but not documented or documented but not communicated in up to 20% of visits. Lowest benchmark performance rates were for laboratory studies (35%) and nutrition/weight-management referrals (42%). In multivariable analysis, overweight (vs obesity) was associated with 1.6 more discrepancies in communication versus documentation (P = .03). Many weight-management benchmarks are not met, not documented, or performed without being communicated. Enhanced communication with families and documentation in health records may promote lifestyle changes in overweight children and higher quality care for overweight children in primary care. PMID:28239625

  3. Weight loss in obese adults 65 years and older: A review of the controversy

    PubMed Central

    Waters, Debra L.; Ward, Aimee L.; Villareal, Dennis T.

    2013-01-01

    Obesity in older adults is ubiquitous in many developed countries and is related to various negative health outcomes, making it an important public health target for intervention. However, treatment approaches for obesity in older adults remain controversial due to concerns surrounding the difficulty of behavior change with advancing age, exacerbating the age-related loss of skeletal muscle and bone, and the feasibility of long-term weight maintenance and related health consequences. This review serves to systematically examine the evidence regarding weight loss interventions with a focus on obese (body mass index 30 kg/m2 and above) older adults (aged 65 years and older) and some proposed mechanisms associated with exercise and caloric restriction (lifestyle intervention). Our findings indicate that healthy weight loss in this age group can be achieved through lifestyle interventions of up to a one-year period. Most interventions reviewed reported a loss of lean body mass and bone mineral density with weight loss. Paradoxically muscle quality and physical function improved. Inflammatory molecules and metabolic markers also improved, although the independent and additive effects of exercise and weight loss on these pathways are poorly understood. Using our review inclusion criteria, only one small pilot study investigating long-term weight maintenance and associated health implications was found in the literature. Future research on lifestyle interventions for obese older adults should address the loss of bone and lean body mass, inflammatory mechanisms, and include sufficient follow up to assess long-term weight maintenance and health outcomes. PMID:23403042

  4. The application of the Yerkes-Dodson law in a childhood weight management program: Examining weight dissatisfaction

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Our objective was to determine the effect of dissatisfaction with one's weight on outcomes in a weight management program. Participants included 149 children between the ages of 11 and 14 years who were enrolled in an intensive weight loss intervention. All participants had a body mass index (BMI) ...

  5. Birth weight modifies the association between central nervous system gene variation and adult body mass index.

    PubMed

    Ruiz-Narváez, Edward A; Haddad, Stephen A; Rosenberg, Lynn; Palmer, Julie R

    2016-03-01

    Genome wide association studies have identified ~100 loci associated with body mass index (BMI). Persons with low birth weight have an increased risk of metabolic disorders. We postulate that normal mechanisms of body weight regulation are disrupted in subjects with low birth weight. The present analyses included 2215 African American women from the Black Women's Health Study, and were based on genotype data on 20 BMI-associated loci and self-reported data on birth weight, weight at age 18 and adult weight. We used general linear models to assess the association of individual single-nucleotide polymorphisms (SNPs) with BMI at age 18 and later in adulthood within strata of birth weight (above and below the median, 3200 g). Three SNPs (rs1320330 near TMEM18, rs261967 near PCSK1 and rs17817964 in FTO), and a genetic score combining these three variants, showed significant interactions with birth weight in relation to BMI. Among women with birth weight <3200 g, there was an inverse association between genetic score and BMI; beta-coefficient=-0.045 (95% confidence intervals (CI) -0.104, 0.013) for BMI at age 18, and -0.055 (95% CI -0.112, 0.002) for adult BMI. Among women with birth weight ⩾3200 g, genetic score was positively associated with BMI: beta-coefficient=0.110 (95% CI 0.051, 0.169) for BMI at age 18 (P for interaction=0.0002), and 0.112 (95% CI 0.054, 0.170) for adult BMI (P for interaction<0.0001). Because TMEM18, PCSK1 and FTO are highly expressed in the central nervous system (CNS), our results suggest that low-birth weight may disrupt mechanisms of CNS body weight regulation.

  6. Loss of Weight in Obese Older Adults: A Biomarker of Impending Expansion of Multimorbidity?

    PubMed Central

    Fabbri, Elisa; Tanaka, Toshiko; An, Yang; Zoli, Marco; Bandinelli, Stefania; Guralnik, Jack M.; Simonsick, Eleanor M.; Boyd, Cynthia M.; Studenski, Stephanie A.; Harris, Tamara B.; Ferrucci, Luigi

    2017-01-01

    OBJECTIVES To determine whether weight loss in older adults may be a marker of impending burden of multimorbidity regardless of initial weight, testing the hypotheses that obesity but not overweight in elderly adults is associated with greater number of diseases than normal weight and that obese older adults who lose weight over time have the greatest burden of multimorbidity. DESIGN Longitudinal cohort study (Invecchiare in Chianti Study). SETTING Community. PARTICIPANTS Individuals aged 60 and older at baseline followed for an average of 4 years (N = 1,025). MEASUREMENTS Multimorbidity was measured as number of diagnosed diseases. Baseline body mass index (BMI) was categorized as normal weight (<25.0 kg/m2), overweight (25.0–29.9 kg/m2), and obese (≥30.0 kg/m2). Loss of weight was defined as decrease over time in BMI of at least 0.15 kg/m2 per year. Age, sex, and education were covariates. RESULTS Baseline obesity was cross-sectionally associated with high multimorbidity and greater longitudinal increase of multimorbidity than normal weight (P = .005) and overweight (P < .001). Moreover, obese participants who lost weight over follow-up had a significantly greater increase in multimorbidity than other participants, including obese participants who maintained or gained weight over time (P = .005). In nonobese participants, changes in weight had no effect on changes in multimorbidity over time. Sensitivity analyses confirmed that one specific disease did not drive the association and that competing mortality did not bias the association. CONCLUSION Loss of weight in obese older persons is a strong biomarker of impending expansion of multimorbidity. Older obese individuals who lose weight should receive thoughtful medical attention. PMID:26311068

  7. Management of proximal humerus fractures in adults

    PubMed Central

    Vachtsevanos, Leonidas; Hayden, Lydia; Desai, Aravind S; Dramis, Asterios

    2014-01-01

    The majority of proximal humerus fractures are low-energy osteoporotic injuries in the elderly and their incidence is increasing in the light of an ageing population. The diversity of fracture patterns encountered renders objective classification of prognostic value challenging. Non-operative management has been associated with good functional outcomes in stable, minimally displaced and certain types of displaced fractures. Absolute indications for surgery are infrequent and comprise compound, pathological, multi-fragmentary head-splitting fractures and fracture dislocations, as well as those associated with neurovascular injury. A constantly expanding range of reconstructive and replacement options however has been extending the indications for surgical management of complex proximal humerus fractures. As a result, management decisions are becoming increasingly complicated, in an attempt to provide the best possible treatment for each individual patient, that will successfully address their specific fracture configuration, comorbidities and functional expectations. Our aim was to review the management options available for the full range of proximal humerus fractures in adults, along with their specific advantages, disadvantages and outcomes. PMID:25405098

  8. Medical management of adult transsexual persons.

    PubMed

    Knezevich, Emily L; Viereck, Laura K; Drincic, Andjela T

    2012-01-01

    Gender identity disorder (GID), or transsexualism, is an increasingly recognized medical condition with an expanding body of medical literature to support the use of established therapeutic guidelines. Transsexualism can be effectively managed through exogenous cross-sex hormone administration used to induce development of desired sex characteristics, as well as use of other agents, such as aldosterone antagonists, aimed at decreasing physical characteristics of the undesired sex. Many complications can arise with the use of the available therapies, and these must be considered before determining the appropriate course of action. This review describes methods, including both pharmacotherapy and surgical interventions, for effective medical management of both male and female adults with GID. In addition, specific goals of therapy as well as safety aspects with long-term use of pharmacotherapeutic agents are discussed. This review also discusses some special considerations for treating patients with significant, yet common, comorbid diseases such as human immunodeficiency virus infection, acquired immunodeficiency syndrome, and viral hepatitis, as these conditions may complicate the clinical course and preclude some patients from using certain therapies. Pharmacist involvement in the management of transsexualism can be extremely beneficial to patients and other health care providers. Pharmacists can help determine the appropriate therapy, optimize dosages, monitor for adverse effects, and educate patients on what to expect during their therapy. Pharmacists should become knowledgeable about guidelines and current literature on transsexualism, understand the monitoring parameters for safe and effective therapy, and establish themselves as partners in the collaborative management of this disorder.

  9. The association of dietary patterns and weight change in rural older adults 75 years and older.

    PubMed

    Hsiao, Pao Ying; Mitchell, Diane C; Wood, G Craig; Jensen, Gordon L; Still, Christopher D; Hartman, Terryl J

    2014-01-01

    Little is known about the relationship between weight change and dietary patterns (DP) in older adults, especially in those of advanced age (≥ 75 years). We examined the association of DP with obesity and five-year weight change in community-dwelling older adults (n = 270; mean ± SD age: 78.6 ± 3.9 years). Dietary data were collected from four, random, 24-hour dietary recalls over a 10-month period. Weight change was examined as: (1) 10-pound weight loss; (2) 10-pound weight gain; (3) 10% weight loss; and (4) 10% weight gain. Cluster analysis was used to derive 3 DP ("Health-conscious," "Sweets and dairy," and "Western"). Kaplan-Meier plots and Cox proportional hazards regression models were used. About 39% of participants lost at least 10 pounds during follow up. In the unadjusted model, five-year weight loss was not associated with dietary pattern. However, when stratified by gender, females who were characterized by the Sweets and Dairy and the Western DP were three and two times more likely to lose 10 pounds, respectively, compared to those in the Health-conscious DP (P < 0.05). These observations suggest that it is appropriate to recommend a Health-conscious DP for women 75 years and older who may be at risk for weight loss.

  10. Incarceration and adult weight gain in the National Survey of American Life (NSAL)

    PubMed Central

    Bailey, Zinzi D.; Williams, David R.; Kawachi, Ichiro; Okechukwu, Cassandra A.

    2016-01-01

    The United States has the unenviable distinction of having both the highest obesity rate among Organisation for Economic Co-operation and Development (OECD) member countries and the highest incarceration rate in the world. Further, both are socially patterned by race/ethnicity and socioeconomic position. Incarceration involves various health behaviors that could influence adult weight trajectory. We evaluated the associations between history and duration of adult incarceration and weight gain using the National Survey of American Life (N=6,082 adults residing in the 48 contiguous states between February 2001 and March 2003). We propensity score-matched individuals to control for the probability of having a history of incarceration. To examine the relation between prior incarceration and adult weight gain, we fit gender-stratified generalized estimating equations controlling for propensity of incarceration history, age, education, income, race/ethnicity, and marital status. For males (N=563), incarceration was associated with about a 1.77 kg/m2 lower gain in body mass index (BMI) during adulthood, after adjusting for age, education, income, race/ethnicity, and marital status in addition to the propensity of having a history of incarceration (95% CI: −2.63, −0.92). For females (N=286), no significant overall relationship was found between a history of incarceration and adult weight gain. In subgroup analyses among those with an incarceration history, we found no overall association between duration of incarceration and adult weight gain in men or women. In sensitivity analyses, neither tobacco smoking nor parity changed the results. The results of this study indicate that incarceration is associated with a lower transition of weight gain in males, but not females. PMID:26456214

  11. Amelogenesis imperfecta - lifelong management. Restorative management of the adult patient.

    PubMed

    Patel, M; McDonnell, S T; Iram, S; Chan, M F W-Y

    2013-11-08

    The biggest challenge restorative dentists face in rehabilitating patients with amelogenesis imperfecta (AI) is trying to restore aesthetics, function and occlusal stability while keeping the treatment as conservative as possible. The goals of treatment should be to prolong the life of the patient's own teeth and avoid or delay the need for extractions and subsequent replacement with conventional fixed, removable or implant retained prostheses. In order to achieve these goals a stepwise approach to treatment planning is required starting with the most conservative but aesthetically acceptable treatment. This article discusses the management of AI and presents the various treatment options available for restoring the adult patient who presents to the dentist with AI.

  12. Strategies used during a challenging weighted walking task in healthy adults and individuals with knee osteoarthritis.

    PubMed

    Kubinski, Andrew J; Higginson, Jill S

    2012-01-01

    Knee osteoarthritis (OA) is a disease that affects millions of people. While numerous gait differences have been identified between healthy adults and adults with knee OA under normal and challenging conditions, adults with knee OA have not been studied during a challenging weighted walking task. Investigation of the effect of weighted walking on the initial contact and loading response phases of gait was undertaken in 20 healthy and 20 knee OA subjects ages 40-85 years old walking at 1.0m/s while unweighted and weighted with 1/6th of their body weight in a weight vest. Subjects were grouped according to their Kellgren and Lawrence radiographic score and healthy subjects were age-matched to those with knee OA. ANOVA revealed significant effects for hip flexion angle at initial contact, step length, initial double support percent, and load rate. Post hoc t-tests revealed that subjects with knee OA had a larger initial double support percent and hip flexion angle at initial contact and a decreased load rate compared to unweighted, healthy adults. Also, both groups increased their initial double support percent in response to the challenging weighted walking task, but only the healthy adults increased their hip flexion angle at initial contact and decreased their load rate. During the weighted condition, the knee OA group had a shorter step length compared to the healthy group. Because the knee OA group only made minor compensations to their gait strategy, it appears that they may be unable or prefer not to adjust their gait mechanics due to underlying issues.

  13. Daily Self-Weighing to Control Body Weight in Adults: A Critical Review of the Literature

    PubMed Central

    Pacanowski, Carly R.; Bertz, Fredrik C.; Levitsky, David A.

    2016-01-01

    The objective of this study is to review the history of daily self-weighing for weight control, discuss the possibility that self-weighing may cause adverse psychological symptoms, and propose mechanisms that explain how self-weighing facilitates weight control. A systematic forward (citation) tracking approach has been employed in this study. In the early literature, experimental tests did not demonstrate a benefit of adding daily self-weighing to traditional behavioral modification for weight loss. More recent studies have shown that daily self-weighing combined with personalized electronic feedback can produce and sustain weight loss with and without a traditional weight loss program. Daily self-weighing appears to be effective in preventing age-related weight gain. Apart from these experimental findings, there is considerable agreement that the frequency of self-weighing correlates with success in losing weight and sustaining the weight loss. The early literature suggested frequent self-weighing may be associated with negative psychological effects. However, more recent experimental trials do not substantiate such a causal relationship. In conclusion, daily self-weighing may be a useful strategy for certain adults to prevent weight gain, lose weight, or prevent weight regain after loss. More research is needed to better understand the role of different types of feedback, who benefits most from self-weighing, and at what frequency. PMID:27127719

  14. Essentiality Weighting Models for Wholesale Level Inventory Management

    DTIC Science & Technology

    1988-12-01

    Ii K. U!i ! NAVAL POSTGRADUATE SCHOOL Monterey, California at) 𔃾 CN THESIS ESSENTIALITY WEIGHTING MODELS FOR WIOLESALE LEVEL INTVENTORY MANAGEMENT...REPORT NMBER S) Aa %AVE O: ::" --. . 6 O ; CE ’.’O.󈨞 ’a NAME OF MO%𔄁ORIG ORGANIZAT;ON (If aopilcable) Naval Postgraduate School 54 Naval...Postgraduate School 6c aDDRESS Cr Srate 3-a Z PCaOe eo ADD RESS Ci ty. State. and ZIP Code) Monterey, CA 93943-5000 Monterey, CA 93943-5000 Sa \\ AME 0 ;; X S’-C

  15. Designing a Weight Gain Prevention Trial for Young Adults: The CHOICES Study

    PubMed Central

    Lytle, Leslie A.; Moe, Stacey G.; Nanney, M. Susie; Laska, Melissa N.; Linde, Jennifer A.

    2014-01-01

    Background Young adults are at risk for weight gain. Little is known about how to design weight control programs to meet the needs of young adults and few theory-based interventions have been evaluated in a randomized control trial. The Choosing Healthy Options in College Environments and Settings (CHOICES) study was funded to create a technology-based program for 2-year community college students to help prevent unhealthy weight gain. The purpose of this paper is to: 1) provide a brief background on weight-related interventions in young adults; 2) describe the study design for the CHOICES study, the conceptual model guiding the research and the CHOICES intervention; and 3) discuss implications of this research for health educators. Translation to Health Education Practice Our experiences from the CHOICES study will be useful in suggesting other theory-based models and intervention strategies that might be helpful in programs attempting to prevent unhealthy weight gain in young adults. In addition, this paper discusses important considerations for working with 2-year colleges on this type of health promotion work. PMID:24910855

  16. Weight-Gain Misperceptions and the Third-Person Effect in Black and White College-bound Females: Potential Implications for Healthy Weight Management

    PubMed Central

    Webb, Jennifer B.; Butler-Ajibade, Phoebe; Robinson, Seronda A.; Lee, Shanique J.

    2013-01-01

    Elements of social norm theory and communication theory on the third-person effect may prove useful in efforts to prevent excessive weight gain among emerging adults entering college. The present study explored the associations of race/ethnicity and BMI status with these socio-cognitive factors that may affect first-year weight regulation in a sample of Black (N = 247) and White (N = 94) college-bound females. Participants completed an online survey assessing first-year weight-gain perceived norms along with weight-change expectations and concerns. Results provided evidence of the persistence of the myth of the “Freshman 15”, belief in the typicality of gaining weight during the first year of college, and significant concern about first-year weight gain. Initial findings further revealed a robust third-person effect whereby despite nearly 90% of the sample endorsing that first-year weight gain was common, only 12% expected they would experience weight gain. Main effects of race/ethnicity, BMI status, and their interaction further uncovered distinct patterns of findings. Preliminary results highlight the need for college health officials at both predominantly White as well as minority-serving institutions to adequately address the significant concern over first-year weight gain in conjunction with the desire to lose weight expressed by an appreciable number of incoming college females. Findings also advocate the utility of evaluating social norm theory and the third-person perceptual bias in the context of first-year weight gain to potentially enhance the design and effectiveness of healthy weight management initiatives among ethnically-diverse young women entering college. PMID:23910760

  17. Practical management of acute asthma in adults.

    PubMed

    Hallstrand, Teal S; Fahy, John V

    2002-02-01

    All asthma patients are at risk for acute asthma exacerbations. Moderate to severe exacerbations account for many emergency department visits and subsequent hospitalizations each year. Recent studies have advanced our understanding of the pathogenesis and treatment of acute asthma. The purpose of this review is to provide practical guidance in the assessment and treatment of adults with acute asthma in the hospital setting. Managing patients with acute asthma involves assessing the severity of the exacerbation, implementing measures to rapidly reverse airflow limitation, and instituting therapies that limit the progression of airway inflammation. Some patients may benefit from other supportive measures such as heliox and noninvasive ventilation. If the patient continues to deteriorate and requires mechanical ventilation, then ventilator settings that minimize the risk of hyperinflation should be chosen. After an episode of acute asthma, long-term preventive medications, especially inhaled corticosteroids, should be prescribed and education should be provided to prevent future episodes.

  18. Relations of hedonic hunger and behavioral change to weight loss among adults in a behavioral weight loss program utilizing meal-replacement products.

    PubMed

    Theim, Kelly R; Brown, Joshua D; Juarascio, Adrienne S; Malcolm, Robert R; O'Neil, Patrick M

    2013-11-01

    Greater self-regulatory behavior usage is associated with greater weight loss within behavioral weight loss treatments. Hedonic hunger (i.e., susceptibility to environmental food cues) may impede successful behavior change and weight loss. Adult men and women (N = 111, body mass index M ± SD = 35.89 ± 6.97 kg/m(2)) were assessed before and after a 15-week lifestyle change weight loss program with a partial meal-replacement diet. From pre- to post-treatment, reported weight control behavior usage improved and hedonic hunger decreased, and these changes were inversely related. Individuals with higher hedonic hunger scores at baseline showed the greatest weight loss. Similarly, participants with lower baseline use of weight control behaviors lost more weight, and increased weight control behavior usage was associated with greater weight loss-particularly among individuals with low baseline hedonic hunger. Further study is warranted regarding the significance of hedonic hunger in weight loss treatments.

  19. Spirituality, Religiosity, and Weight Management Among African American Adolescent Males: The Jackson Heart KIDS Pilot Study.

    PubMed

    Bruce, Marino A; Beech, Bettina M; Griffith, Derek M; Thorpe, Roland J

    2016-01-01

    Spirituality and religion have been identified as important determinants of health for adults; however, the impact of faith-oriented factors on health behaviors and outcomes among African American adolescent males has not been well studied. The purpose of this study is to examine the relationship between religiosity and spirituality and obesity-related behaviors among 12-19 year old African American males (N = 105) in the Jackson Heart KIDS Pilot Study. Key variables of interest are church attendance, prayer, daily spirituality, weight status, attempts to lose weight, nutrition, physical activity, and stress. Daily spirituality is associated with whether an individual attempts to lose weight. The results from logistic regression models suggest that daily spirituality increases the odds that African American male adolescents attempt to lose weight (OR = 1.22, CI: 1.07-1.41) and have a history of diet-focused weight management (OR = 1.13, CI: 1.02-1.26). Future studies are needed to further explore the association between religion, spirituality, and obesity-related behaviors.

  20. Weight stigmatization and bias reduction: perspectives of overweight and obese adults.

    PubMed

    Puhl, Rebecca M; Moss-Racusin, Corinne A; Schwartz, Marlene B; Brownell, Kelly D

    2008-04-01

    This study employed qualitative methods with a sample of overweight and obese adults to identify and describe their subjective experiences of weight bias. Participants (274 females and 44 males) completed an online battery of self-report questionnaires, including several open-ended questions about weight stigmatization. These questions asked them to describe their worst experiences of weight stigmatization, their perceptions of common weight-based stereotypes, their feelings about being overweight and their suggestions for strategies to reduce weight stigma in our culture. Participants reported experiencing weight stigma across a range of contexts and involving a variety of interpersonal sources. Close relationship partners (such as friends, parents and spouses) were the most common source of their worst stigmatizing encounters. Participants challenged common weight-based stereotypes (notably, that obese individuals are 'lazy') and reported that they would like the public to gain a better understanding of the difficulties of weight loss, the causes of obesity and the emotional consequences of being stigmatized. Education was reported as the most promising avenue for future stigma-reduction efforts. The experiences and opinions expressed were not significantly different for men versus women or overweight versus obese individuals. A minority of participants expressed beliefs suggestive of self-blame and internalization of weight-based stereotypes. These results indicate that while obese individuals experience weight bias across many domains, more stigma-reduction efforts should target stigmatizing encounters in close relationships, including parents, spouses and friends of obese persons.

  1. Weight change and functional limitations among older adults in North Carolina.

    PubMed

    Carson, April P; Holmes, DaJuanicia N; Howard, Daniel L

    2010-12-01

    There is emerging evidence that weight change during older adulthood is associated with decreased physical function; however, less is known about the association between weight change during middle to older adulthood and physical function. This study assessed the association of weight change between middle and older adulthood and functional limitations among 2,531 older African-American and white participants, ages 65 and older at baseline (1987), from the Piedmont Health Survey of the Elderly. Weight gainers had ≥8% increase in weight, weight losers had >8% decrease in weight, and weight maintainers had <8% increase or decrease between age 50 and baseline. Functional limitations were categorized as none (0), mild (1-3), or severe (4 or more) using items from the activities of daily living scale by Katz and the extremity function scale by Nagi. Modified Poisson regression was used to assess these associations in crude and adjusted analyses. Weight gain and weight loss between age 50 and baseline were associated with severe functional limitations (prevalence ratio (PR) = 1.19, 95% CI: 1.04, 1.36 and PR = 1.58, 95% CI: 1.41, 1.78, respectively) compared to weight maintainers after adjustment for age, race, and gender. These associations were attenuated after additional adjustment for health characteristics, while weaker associations were noted for mild functional limitations. In summary, weight gain and weight loss between middle and older adulthood were associated with severe functional limitations among older adults in North Carolina. Additional research is needed to explore weight change across the life course and its possible effects on physical function later in life.

  2. Resistance training volume, energy balance and weight management: Rationale and design of a 9 month trial

    PubMed Central

    Washburn, Richard A.; Donnelly, Joseph E.; Smith, Bryan K.; Sullivan, Debra K.; Marquis, Janet; Herrmann, Stephen D.

    2012-01-01

    The increased prevalence of obesity and the lack of treatment success both argue for the design and evaluation of strategies to prevent the development of overweight and obesity. To date, the role of resistance training (RT) in this regard is largely unexplored. RT may be effective for weight management as a result of increased fat-free mass (FFM), which may result in increased resting metabolic rate and increased physical activity energy expenditure. However, the literature relative to the efficacy of RT protocols recommended for healthy adults to alter the aforementioned parameters is inconsistent or inadequately evaluated. We will conduct a 9 month randomized controlled efficacy trial to compare changes in body composition (fat mass, FFM, % body fat) and energy balance in response to 2 volumes of RT (1 vs. 3 sets vs. non-exercise control) both at the completion of training (9 months) and 1 year later (body composition). This investigation will be conducted in a sample of healthy, normal and overweight, sedentary, young adult men and women; a group at high risk for development of overweight and obesity. Our results will provide information relative to the minimum volume of RT that may be associated with body weight/fat gain which may inform the development of guidelines for RT to prevent weight gain or to alter body composition. PMID:22446169

  3. Resistance training volume, energy balance and weight management: rationale and design of a 9 month trial.

    PubMed

    Washburn, Richard A; Donnelly, Joseph E; Smith, Bryan K; Sullivan, Debra K; Marquis, Janet; Herrmann, Stephen D

    2012-07-01

    The increased prevalence of obesity and the lack of treatment success both argue for the design and evaluation of strategies to prevent the development of overweight and obesity. To date, the role of resistance training (RT) in this regard is largely unexplored. RT may be effective for weight management as a result of increased fat-free mass (FFM), which may result in increased resting metabolic rate and increased physical activity energy expenditure. However, the literature relative to the efficacy of RT protocols recommended for healthy adults to alter the aforementioned parameters is inconsistent or inadequately evaluated. We will conduct a 9 month randomized controlled efficacy trial to compare changes in body composition (fat mass, FFM, % body fat) and energy balance in response to 2 volumes of RT (1 vs. 3 sets vs. non-exercise control) both at the completion of training (9 months) and 1 year later (body composition). This investigation will be conducted in a sample of healthy, normal and overweight, sedentary, young adult men and women; a group at high risk for development of overweight and obesity. Our results will provide information relative to the minimum volume of RT that may be associated with body weight/fat gain which may inform the development of guidelines for RT to prevent weight gain or to alter body composition.

  4. Design and Implementation of a Randomized Controlled Social and Mobile Weight Loss Trial for Young Adults (project SMART)

    PubMed Central

    Patrick, K; Marshall, SJ; Davila, EP; Kolodziejczyk, JK; Fowler, J; Calfas, KJ; Huang, J; Rock, CL; Griswold, W; Gupta, A; Merchant, G; Norman, GJ; Raab, F; Donohue, M; Fogg, BJ; Robinson, TN

    2014-01-01

    Purpose To describe the theoretical rationale, intervention design, and clinical trial of a two-year weight control intervention for young adults deployed via social and mobile media. Methods A total of 404 overweight or obese college students from three Southern California universities (Mage = 22(±4) years; MBMI=29(±2.8); 70% female) were randomized to participate in the intervention or to receive an informational web-based weight loss program. The intervention is based on behavioral theory and integrates intervention elements across multiple touch points, including Facebook, SMS, smartphone applications, blogs, and e-mail. Participants are encouraged to seek social support among their friends, self-monitor their weight weekly, post their health behaviors on Facebook, and e-mail their weight loss questions/concerns to a health coach. The intervention is adaptive because new theory-driven and iteratively tailored intervention elements are developed and released over the course of the two-year intervention in response to patterns of use and user feedback. Measures of body mass index, waist circumference, physical activity (PA), sedentary behavior (SED), diet, weight management practices, smoking, alcohol, sleep, body image, self-esteem, and depression occur at 6, 12, 18, and 24 months. Currently, all participants have been recruited, and all are in the final year of the trial. Conclusion Theory-driven, evidence-based strategies for PA, SED, and dietary intake can be embedded in an intervention using social and mobile technologies to promote healthy weight-related behaviors in young adults. PMID:24215774

  5. Attitudes of Overweight and Normal Weight Adults Regarding Exercise at a Health Club

    ERIC Educational Resources Information Center

    Miller, Wayne C.; Miller, Todd A.

    2010-01-01

    Objective: To compare attitudes of overweight (OW) and normal weight (NW) adults regarding health club exercise. Design: A 46-item survey (23 pairs of attitude/value statements) measured attitudes toward exercising at a health club 30 minutes, twice a week, for a month. Setting: Survey posted on surveymonkey.com. Respondents (men = 730, women =…

  6. Evaluation of an Approach to Weight Loss in Adults with Intellectual or Developmental Disabilities

    ERIC Educational Resources Information Center

    Saunders, Richard R.; Saunders, Muriel D.; Donnelly, Joseph E.; Smith, Bryan K.; Sullivan, Debra K.; Guilford, Brianne; Rondon, Mary F.

    2011-01-01

    Of 79 overweight adults with intellectual or developmental disabilities who participated in a weight loss intervention, 73 completed the 6-month diet phase. The emphasis in the intervention was consumption of high volume, low calorie foods and beverages, including meal-replacement shakes. Lower calorie frozen entrees were recommended to control…

  7. Evaluation of an approach to weight loss in adults with intellectual or developmental disabilities.

    PubMed

    Saunders, Richard R; Saunders, Muriel D; Donnelly, Joseph E; Smith, Bryan K; Sullivan, Debra K; Guilford, Brianne; Rondon, Mary F

    2011-04-01

    Of 79 overweight adults with intellectual or developmental disabilities who participated in a weight loss intervention, 73 completed the 6-month diet phase. The emphasis in the intervention was consumption of high volume, low calorie foods and beverages, including meal-replacement shakes. Lower calorie frozen entrees were recommended to control portion size. A walking activity was encouraged. Participants attended monthly meetings in which a small amount of cash was exchanged for self-recorded intake and exercise records completed on picture-based forms. Average weight loss was 13.2 pounds (6.3%) of baseline weight at 6 months, with weight loss shown by 64 of the 73 individuals enrolled. Those completing a 6-month follow-up phase showed weight loss of 9.4% of baseline. Increased choice and control are discussed as possible contributors to individual success.

  8. [Weight and height validation for diagnosis of adult nutritional status in southern Brazil].

    PubMed

    Silveira, Erika Aparecida da; Araújo, Cora Luíza; Gigante, Denise Petrucci; Barros, Aluisio J D; Lima, Maurício Silva de

    2005-01-01

    This study evaluated the accuracy of body mass index (BMI) based on self-reported weight and height for predicting adult nutritional status. In a cross-sectional study of 3,934 adults (> 20 years) in Pelotas, Rio Grande do Sul, Brazil, a sub-sample of 140 individuals was drawn and weight and height were measured. From the comparison between "measured" and "reported" BMI, the average reported BMI error was estimated and the associated factors were identified. Regardless of nutritional status, women underestimated their "reported" BMI, while in men this information was accurate. Among women, age and income were associated with underestimated BMI in a multivariate analysis. Thus, women over 50 and with lower income underestimated BMI by more than 2 kg/m2. The use of "reported" BMI to predict adult nutritional status can underestimate prevalence of obesity and overestimate that of overweight in women. Correction minimizes this kind of bias, thereby making the data more accurate.

  9. Frequent Self-Weighing and Visual Feedback for Weight Loss in Overweight Adults

    PubMed Central

    Pacanowski, Carly R.; Levitsky, David A.

    2015-01-01

    Evidence has suggested that self-weighing may be beneficial for weight control in adults, but few studies have independently assessed the contribution of this behavior to weight loss. This study experimentally tested daily self-weighing and visual feedback (the Caloric Titration Method (CTM)) as a weight loss and weight loss maintenance intervention over 2 years. 162 overweight individuals were randomized to the CTM intervention or delayed treatment control group. In year 1, weight change was compared between groups, and in year 2, the control group started using the CTM while the intervention group continued using the CTM for maintenance. A significant difference in weight loss over the first year (CTM n = 70; 2.6 ± 5.9 kg versus control n = 65; 0.5 ± 4.4 kg, p = 0.019) was qualified by a group × gender × time interaction (p = 0.002) such that men lost more weight using the CTM. In year 2, the CTM group maintained their weight and the control group lost an amount similar to the intervention group in year 1. Daily self-weighing and visual feedback facilitated a minimal amount of weight loss and maintenance of this loss. Future research investigating characteristics of those who benefit from this type of self-directed intervention is warranted. PMID:26064677

  10. Association between Indices of Body Composition and Abnormal Metabolic Phenotype in Normal-Weight Chinese Adults.

    PubMed

    Xia, Lili; Dong, Fen; Gong, Haiying; Xu, Guodong; Wang, Ke; Liu, Fen; Pan, Li; Zhang, Ling; Yan, Yuxiang; Gaisano, Herbert; He, Yan; Shan, Guangliang

    2017-04-07

    We aimed to determine the association of indices of body composition with abnormal metabolic phenotype, and to examine whether the strength of association was differentially distributed in different age groups in normal-weight Chinese adults. A total of 3015 normal-weight adults from a survey of Chinese people encompassing health and basic physiological parameters was included in this cross-sectional study. We investigated the association of body composition measured by bioelectrical impedance analysis and conventional body indices with metabolically unhealthy normal-weight (MUHNW) adults, divided by age groups and gender. Associations were assessed by multiple logistic regression analysis. We found abnormal metabolism in lean Chinese adults to be associated with higher adiposity indices (body mass index, BMI), waist circumference, and percentage body fat), lower skeletal muscle %, and body water %. Body composition was differentially distributed in age groups within the metabolically healthy normal weight (MHNW)/MUHNW groups. The impact of factors related to MUHNW shows a decreasing trend with advancing age in females and disparities of factors (BMI, body fat %, skeletal muscle %, and body water %) associated with the MUHNW phenotype in the elderly was noticed. Those factors remained unchanged in males throughout the age range, while the association of BMI, body fat %, skeletal muscle %, and body water % to MUHNW attenuated and grip strength emerged as a protective factor in elderly females. These results suggest that increased adiposity and decreased skeletal muscle mass are associated with unfavorable metabolic traits in normal-weight Chinese adults, and that MUHNW is independent of BMI, while increased waist circumference appears to be indicative of an abnormal metabolic phenotype in elderly females.

  11. Diagnosis and management of urinary tract infection in older adults.

    PubMed

    Rowe, Theresa Anne; Juthani-Mehta, Manisha

    2014-03-01

    Urinary tract infection (UTI) is a commonly diagnosed infection in older adults. Despite consensus guidelines developed to assist providers in diagnosing UTI, distinguishing symptomatic UTI from asymptomatic bacteriuria (ASB) in older adults is problematic, as many older adults do not present with localized genitourinary symptoms. This article summarizes the recent literature and guidelines on the diagnosis and management of UTI and ASB in older adults.

  12. Impact of parental weight status on a school-based weight management programme designed for Mexican-American children

    Technology Transfer Automated Retrieval System (TEKTRAN)

    While overweight and obese children are more likely to have overweight or obese parents, less is known about the effect of parental weight status on children's success in weight management programmes. This study was a secondary data analysis of a randomized controlled trial and investigated the impa...

  13. Deletion of Lkb1 in adult mice results in body weight reduction and lethality.

    PubMed

    Shan, Tizhong; Xiong, Yan; Kuang, Shihuan

    2016-11-08

    Liver kinase B1 (Lkb1) plays crucial roles in development, metabolism and survival. As constitutive knockout of Lkb1 in mice leads to embryonic lethality, whether Lkb1 is required for the growth and survival of adult mice is unclear. Here we address this question using a tamoxifen-inducible Lkb1 knockout (KO) mouse model: Rosa26-Cre(ER): Lkb1(flox/flox) (abbreviated as Rosa-Lkb1). The Rosa-Lkb1 mice exhibited body weight reduction and died within 6 weeks after tamoxifen induction. The body weight reduction was due to reduced weight of various tissues but the brown and white adipose tissues underwent much more pronounced weight reduction relative to the overall body weight reduction. Accordingly, the Rosa-Lkb1 mice had increased blood glucose levels and were intolerant to glucose challenge. Expression levels of adipogenic and lipogenic genes in adipose tissues were also dramatically reduced by Lkb1 deletion. Additionally, Lkb1 deletion reduced lipid deposition and increased expression of mitochondrial (Pgc1a, Cox5b and Cox7a) and hepatic gluconeogenesis related genes (Pepck) in liver. Finally, the Rosa-Lkb1 mice had much reduced oxygen consumption, carbon dioxide production, and energy expenditure. These results demonstrate that Lkb1 plays an important role in maintaining body weight, liver and adipose tissue function, blood glucose homeostasis and survival in adult mice.

  14. Relationships Between Weight, Physical Activity, and Back Pain in Young Adult Women.

    PubMed

    Brady, Sharmayne R E; Hussain, Sultana Monira; Brown, Wendy J; Heritier, Stephane; Billah, Baki; Wang, Yuanyuan; Teede, Helena; Urquhart, Donna M; Cicuttini, Flavia M

    2016-05-01

    Back pain causes enormous financial and disability burden worldwide, which could potentially be reduced by understanding its determinants to develop effective prevention strategies. Our aim was to identify whether modifiable risk factors, weight and physical activity, are predictive of back pain in young adult women.Women born between 1973 and 1978 were randomly selected from the national health insurance scheme database to participate in The Australian Longitudinal Study of Women's Health. Self-reported data on back pain in the last 12 months, weight, height, age, education status, physical activity, and depression were collected in 2000, 2003, 2006, 2009, and 2012. In 2000, 9688 women completed the questionnaire and 83% completed follow-up 12 years later.At baseline, median age was 24.6 years and 41% had self-reported back pain. For every 5 kg higher weight at baseline, there was a 5% (95% confidence interval [CI] 4%-6%) increased risk of back pain over the next 12 years. Higher weight at each survey also predicted back pain risk 3 years later (P < 0.001). The effects of weight on back pain were most significant in those with BMI ≥25 kg/m and were observed at all levels of physical activity. Inadequate physical activity and depression were independent predictors of back pain over the following 12 years (both P < 0.001), after adjusting for age, weight, height, and education status.Back pain is common in community-based young adult women. Higher weight, inadequate levels of physical activity, and depression were all independent predictors of back pain over the following decade. Furthermore, the adverse effects of weight on back pain were not mitigated by physical activity. Our findings highlight the role of both higher weight and physical inactivity in back pain among young women and suggest potential opportunities for future prevention.

  15. Does Cardiorespiratory Fitness Modify the Association between Birth Weight and Insulin Resistance in Adult Life?

    PubMed Central

    Aoyama, Tomoko; Tsushita, Kazuyo; Miyatake, Nobuyuki; Numata, Takeyuki; Miyachi, Motohiko; Tabata, Izumi; Cao, Zhen-Bo; Sakamoto, Shizuo; Higuchi, Mitsuru

    2013-01-01

    Objective Lower birth weight is associated with higher insulin resistance in later life. The aim of this study was to determine whether cardiorespiratory fitness modifies the association of birth weight with insulin resistance in adults. Methods The subjects were 379 Japanese individuals (137 males, 242 females) aged 20–64 years born after 1943. Insulin resistance was assessed using a homeostasis model assessment of insulin resistance (HOMA-IR), which is calculated from fasting blood glucose and insulin levels. Cardiorespiratory fitness (maximal oxygen uptake, VO2max) was assessed by a maximal graded exercise test on a cycle ergometer. Birth weight was reported according to the Maternal and Child Health Handbook records or the subject’s or his/her mother’s memory. Results The multiple linear regression analysis revealed that birth weight was inversely associated with HOMA-IR (β = −0.141, p = 0.003), even after adjustment for gender, age, current body mass index, mean blood pressure, triglycerides, HDL cholesterol, and smoking status. Further adjustments for VO2max made little difference in the relationship between birth weight and HOMA-IR (β = −0.148, p = 0.001), although VO2max (β = −0.376, p<0.001) was a stronger predictor of HOMA-IR than birth weight. Conclusions The results showed that the association of lower birth weight with higher insulin resistance was little modified by cardiorespiratory fitness in adult life. However, cardiorespiratory fitness was found to be a stronger predictor of insulin resistance than was birth weight, suggesting that increasing cardiorespiratory fitness may have a much more important role in preventing insulin resistance than an individual’s low birth weight. PMID:24069257

  16. Perceived weight discrimination in England: a population-based study of adults aged ⩾50 years

    PubMed Central

    Jackson, S E; Steptoe, A; Beeken, R J; Croker, H; Wardle, J

    2015-01-01

    Background: Despite a wealth of experimental studies on weight bias, little is known about weight discrimination at the population level. This study examined the prevalence and socio-demographic correlates of perceived weight discrimination in a large population-based sample of older adults. Methods: Data were from 5307 adults in the English Longitudinal Study of Ageing; a population-based cohort of men and women aged ⩾50 years. Weight discrimination was reported for five domains (less respect/courtesy; treated as less clever; poorer treatment in medical settings; poorer service in restaurants/stores; threatened/harassed) at wave 5 (2010–2011). Height and weight were measured at wave 4 (2008–2009). We used logistic regression to test the odds of weight discrimination in relation to weight status, age, sex, wealth, education and marital status. Results: Perceived weight discrimination in any domain was reported by 4.6% of participants, ranging from 0.8% in the normal-weight participants through 0.9, 6.7, 24.2 and 35.1% in individuals who were overweight or met criteria for class I, II and III obesity. Overall, and in each situation, odds of perceived weight discrimination were higher in younger and less wealthy individuals. There was no interaction between weight status and any socio-demographic variable. Relative to normal-weight participants, odds ratios for any perceived weight discrimination were 1.13 (95% confidence interval 0.53–2.40) in those who were overweight, 8.86 (4.65–16.88) in those with class I obesity, 35.06 (18.30–67.16) in class II obese and 56.43 (27.72–114.87) in class III obese. Conclusions: Our results indicate that rates of perceived weight discrimination are comparatively low in individuals who are overweight or have class I obesity, but for those with class II/III obesity, >10% had experienced discrimination in each domain, and >20% had been treated with less respect or courtesy. These findings have implications for public

  17. Efficacy and Tolerability of an Herbal Formulation for Weight Management

    PubMed Central

    Peerson, Jan; Mishra, Artatrana T.; Mathukumalli, Venkata Sadasiva Rao; Konda, Poorna Rajeswari

    2013-01-01

    Abstract The clinical effects and tolerability of a novel herbal formulation comprising the extracts of Sphaeranthus indicus and Garcinia mangostana were assessed in two similarly designed randomized, double-blind, placebo-controlled, clinical trials in 100 human subjects with a body mass index (BMI) between 30 and 40 kg/m2. Participants were randomized into two groups receiving either 400 mg of herbal blend twice daily or two identical placebo capsules. All subjects received three meals (2000 kcal/day) throughout the study and walked 5 days a week for 30 min. The primary outcome was reduction in body weight. Secondary outcomes were reduction in BMI and in waist and hip circumference. Serum glycemic, lipid, and adiponectin levels were also measured. Ninety-five subjects completed the trials, and data from these two studies were pooled and analyzed. At study conclusion (8 weeks), statistically significant reductions in body weight (5.2 kg; P<.0001), BMI (2.2 kg/m2; P<.0001), as well as waist (11.9 cm; P<.0001) and hip circumferences (6.3 cm; P=.0001) were observed in the herbal group compared with placebo. An increase in serum adiponectin concentration was also found in the herbal group versus placebo (P=.0008) at study conclusion along with reductions in fasting blood glucose (12.2%, P=.01), cholesterol (13.8%, P=.002), and triglyceride (41.6%, P<.0001) concentrations. No changes were seen across organ function panels, multiple vital signs, and no major adverse events were reported. The minor adverse events were equally distributed between the two groups. Our findings suggest that the herbal blend appears to be a well-tolerated and effective ingredient for weight management. PMID:23767862

  18. Relationship between birth weight and adult lung function: controlling for maternal factors

    PubMed Central

    Edwards, C; Osman, L; Godden, D; Campbell, D; Douglas, J

    2003-01-01

    Methods: In 2001 the cohort was assessed for current lung function, smoking status, and respiratory symptoms. Birth details obtained from the Aberdeen Maternity and Neonatal Databank recorded birth weight, gestation, parity, and mother's age and height. Results: 381 subjects aged 45–50 years were traced and tested for lung function; 323 (85%) had birth details available. A significant linear trend (p<0.01) was observed between birth weight and current forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) values (adjusted for height, age, sex, weight, deprivation category (Depcat), childhood group, and smoking status). This trend remained significant after adjusting birth weight for gestation, parity, sex, mother's height and weight (p = 0.01). The relationship between birth weight and FEV1 and FVC remained significant when adjusted for smoking history. There was no association between birth weight and current wheezing symptoms. Conclusion: There is a positive linear trend between birth weight, adjusted for maternal factors, and lung function in adulthood. The strength of this association supports the "fetal origins hypothesis" that impairment of fetal growth is a significant influence on adult lung function. PMID:14645976

  19. DNA Methylation Changes in the IGF1R Gene in Birth Weight Discordant Adult Monozygotic Twins.

    PubMed

    Tsai, Pei-Chien; Van Dongen, Jenny; Tan, Qihua; Willemsen, Gonneke; Christiansen, Lene; Boomsma, Dorret I; Spector, Tim D; Valdes, Ana M; Bell, Jordana T

    2015-12-01

    Low birth weight (LBW) can have an impact on health outcomes in later life, especially in relation to pre-disposition to metabolic disease. Several studies suggest that LBW resulting from restricted intrauterine growth leaves a footprint on DNA methylation in utero, and this influence likely persists into adulthood. To investigate this further, we performed epigenome-wide association analyses of blood DNA methylation using Infinium HumanMethylation450 BeadChip profiles in 71 adult monozygotic (MZ) twin pairs who were extremely discordant for birth weight. A signal mapping to the IGF1R gene (cg12562232, p = 2.62 × 10(-8)), was significantly associated with birth weight discordance at a genome-wide false-discovery rate (FDR) of 0.05. We pursued replication in three additional independent datasets of birth weight discordant MZ pairs and observed the same direction of association, but the results were not significant. However, a meta-analysis across the four independent samples, in total 216 birth-weight discordant MZ twin pairs, showed a significant positive association between birth weight and DNA methylation differences at IGF1R (random-effects meta-analysis p = .04), and the effect was particularly pronounced in older twins (random-effects meta-analysis p = .008, 98 older birth-weight discordant MZ twin pairs). The results suggest that severe intra-uterine growth differences (birth weight discordance >20%) are associated with methylation changes in the IGF1R gene in adulthood, independent of genetic effects.

  20. Measuring Outcomes in Adult Weight Loss Studies That Include Diet and Physical Activity: A Systematic Review

    PubMed Central

    Millstein, Rachel A.

    2014-01-01

    Background. Measuring success of obesity interventions is critical. Several methods measure weight loss outcomes but there is no consensus on best practices. This systematic review evaluates relevant outcomes (weight loss, BMI, % body fat, and fat mass) to determine which might be the best indicator(s) of success. Methods. Eligible articles described adult weight loss interventions that included diet and physical activity and a measure of weight or BMI change and body composition change. Results. 28 full-text articles met inclusion criteria. Subjects, settings, intervention lengths, and intensities varied. All studies measured body weight (−2.9 to −17.3 kg), 9 studies measured BMI (−1.1 to −5.1 kg/m2), 20 studies measured % body fat (−0.7 to −10.2%), and 22 studies measured fat mass (−0.9 to −14.9 kg). All studies found agreement between weight or BMI and body fat mass or body fat % decreases, though there were discrepancies in degree of significance between measures. Conclusions. Nearly all weight or BMI and body composition measures agreed. Since body fat is the most metabolically harmful tissue type, it may be a more meaningful measure of health change. Future studies should consider primarily measuring % body fat, rather than or in addition to weight or BMI. PMID:25525513

  1. Filling the treatment gap in the weight management of overweight and obese patients.

    PubMed

    Gesundheit, N

    2012-07-01

    Approximately two out of three adult Americans are overweight or obese. Despite widespread recognition of this disorder, there has been little progress in the past 20 years in finding effective noninvasive treatments for weight loss. The consequences of obesity are increasingly well recognized and include increases in blood pressure, plasma lipids, the onset of type 2 diabetes, sleep apnea, asthma, osteoarthritis and a variety of cancers. Obesity can increase the rate of pregnancy complications and fetal malformations in normoglycemic women. Current medical approaches to obesity, including intensive lifestyle interventions and drug therapies, have been successful in achieving modest weight loss of 4-7%, less than the 1998 NIH Guidelines target of 10%. Surgical approaches, including laparoscopic adjustable gastric banding, vertical banded gastroplasty and Roux-en-Y gastric bypass, are much more successful, achieving weight loss of 15-50%. A treatment gap therefore exists in the management of obese and overweight patients, because many patients desire and would receive great health benefits by achieving weight loss of 7-15%. This review will discuss the dilemma of the treatment gap and explore possible ways by which it may be filled in the future by the use of innovative approaches.

  2. Weight Management Belief is the Leading Influential Factor of Weight Monitoring Compliance in Congestive Heart Failure Patients

    PubMed Central

    Lu, Min-Xia; Zhang, Yan-Yun; Jiang, Jun-Fang; Ju, Yang; Wu, Qing; Zhao, Xin; Wang, Xiao-Hua

    2016-01-01

    Background Daily weight monitoring is frequently recommended as a part of heart failure self-management to prevent exacerbations. This study is to identify factors that influence weight monitoring compliance of congestive heart failure patients at baseline and after a 1-year weight management (WM) program. Methods This was a secondary analysis of an investigative study and a randomized controlled study. A general information questionnaire assessed patient demographics and clinical variables such as medicine use and diagnoses, and the weight management scale evaluated their WM abilities. Good and poor compliance based on abnormal weight gain from the European Society of Cardiology (> 2 kg in 3 days) were compared, and hierarchical multiple logistic regression analysis was used to identify factors influencing weight monitoring compliance. Results A total of 316 patients were enrolled at baseline, and 66 patients were enrolled after the 1-year WM program. Of them, 12.66% and 60.61% had good weight monitoring compliance at baseline and after 1 year of WM, respectively. A high WM-related belief score indicated good weight monitoring compliance at both time points [odds ratio (OR), 1.043, 95% confidence interval (CI), 1.023-1.063, p < 0.001; and OR, 2.054, 95% CI, 1.209-3.487, p < 0.001, respectively). Patients with a high WM-related practice score had good weight monitoring compliance at baseline (OR, 1.046, 95% CI, 1.027-1.065, p < 0.001), and patients who had not monitored abnormal weight had poor weight monitoring compliance after the 1-year WM program (OR, 0.244, 95% CI, 0.006-0.991, p = 0.049). Conclusions Data from this study suggested that belief related to WM plays an important role in weight monitoring compliance. PMID:27899858

  3. [Surgical management of the adult spastic hand].

    PubMed

    Allieu, Y

    2011-06-01

    The adult spastic hand, of varying causes, but dominated by vascular hemiplegia and brain damage, associates motor disorders and problems of tonus. The variety of forms of brain damage explains the wealth and diversity of the symptoms. These symptoms, often the most serious along with cognitive disorders, justify the expression "central neurological hand". Each case is an individual one. The effect on the hands may be unilateral or bilateral with spasticity involving the fingers/thumb/wrist. The clinical evaluation leading to a decision tree must take into account spasticity, retraction and paralysis, for each muscle. When completed by anesthetic motor blocks, spasticity and/or retraction, damage to extrinsic and/or intrinsic muscles of the fingers may be differentiated. This repeated multidisciplinary evaluation makes it possible to distinguish between "non functional hands", "functional hands" and "potentially functional hands". In the first instance, surgery can only improve the esthetic aspect or facilitate nursing. In the second instance, correcting spasticity may improve function. The treatment of spasticity is based on inhibiting spasticity (by injecting botulinum toxin or surgical motor hyponeurotisation) and reinforcing the non-spastic antagonist muscles via tendon transfer or tenodesis. Surgery is indicated to correct muscular retraction and deformities. The functional indications are highly selective and their limited results only allow a "supporting hand" to be constructed at best. The non-functional indications lead to a codified intervention whose results will greatly improve the management of these patients.

  4. Tweeting it off: characteristics of adults who tweet about a weight loss attempt

    PubMed Central

    Pagoto, Sherry; Schneider, Kristin L; Evans, Martinus; Waring, Molly E; Appelhans, Brad; Busch, Andrew M; Whited, Matthew C; Thind, Herpreet; Ziedonis, Michelle

    2014-01-01

    Objective The purpose of this study was to describe adults who use Twitter during a weight loss attempt and to compare the positive and negative social influences they experience from their offline friends, online friends, and family members. Materials and methods Participants (N=100, 80% female, mean age=37.65, SD=8.42) were recruited from Twitter. They completed a brief survey about their experiences discussing their weight loss attempt with their online and offline friends and provided responses to open-ended questions on the benefits and drawbacks of discussing weight on Twitter, Facebook, and weight-specific social networks. Results Participants rated their connections on Twitter and weight loss-specific social networks to be significantly greater sources of positive social influence for their weight loss (F(3)=3.47; p<0.001) and significantly lesser sources of negative social influence (F(3)=40.39 and F(3)=33.68 (both p<0.001)) than their offline friends, family, and Facebook friends. Greater positive social influence from Twitter and Facebook friends was associated with greater weight loss in participants’ most recent weight loss attempt (r=0.30, r=0.32; p<0.01). The most commonly reported benefits of tweeting about weight loss include social support, information, and accountability. The most common drawbacks reported are that interactions were too brief and lacked personal connection. Discussion People who discuss their weight loss on Twitter report more social support and less negativity from their Twitter friends than their Facebook friends and in-person relationships. Conclusions Online social networks should be explored as a tool for connecting patients who lack weight loss social support from their in-person relationships. PMID:24928175

  5. Does the U.S. Food Stamp Program contribute to adult weight gain?

    PubMed

    Zagorsky, Jay L; Smith, Patricia K

    2009-07-01

    Obesity poses substantial costs both to the individual and society, mainly through its impact on health and labor productivity. Because obesity is more prevalent among the poor some have raised concerns that food assistance programs may encourage excess weight. This paper investigates whether the U.S. Food Stamp Program contributes to adult participants' weight as measured by body mass index (BMI). Results suggest that the typical female food stamp participant's BMI is indeed more than 1 unit higher than someone with the same socioeconomic characteristics who is not in the program. For the average American woman, who is 5 ft 4 in. (1.63 m) tall, this means an increase in weight of 5.8 pounds (2.6 kg). While this association does not prove that the Food Stamp Program causes weight gain, it does suggest that program changes to encourage the consumption of high-nutrient, low-calorie foods should be considered.

  6. Weight-Related Health Behaviors and Body Mass: Associations between Young Adults and Their Parents, Moderated by Parental Authority

    ERIC Educational Resources Information Center

    Niemeier, Brandi S.; Hektner, Joel M.

    2012-01-01

    Background: Parents' behaviors could contribute to the development of their children's weight-related health behaviors. Purpose: Relationships of young adults' (N = 151) and their parents' weight-related behaviors were examined along with parental authority styles. Methods: Questionnaires were completed by young adults and their parents.…

  7. Deprivation, clubs and drugs: results of a UK regional population-based cross-sectional study of weight management strategies

    PubMed Central

    2014-01-01

    Background Despite rising levels of obesity in England, little is known about slimming club and weight loss drug (medication) use or users. In order to inform future commissioning, we report the prevalence of various weight management strategies and examine the associations between slimming club and medication use and age, gender, deprivation and body mass index. Methods A population based cross-sectional survey of 26,113 adults was conducted in South Yorkshire using a self-completed health questionnaire. Participants were asked whether they had ever used the following interventions to manage their weight: increasing exercise, healthy eating, controlling portion size, slimming club, over the counter weight loss medication, or meal replacements. Factors associated with slimming club and weight-loss medication use were explored using logistic regression. Results Over half of the sample was either overweight (36.6%) or obese (19.6%). Obesity was more common in the most deprived areas compared to the least deprived (26.3% vs. 12.0%). Healthy eating (49.0%), controlling portion size (43.4%), and increasing exercise (43.0%) were the most commonly reported weight management strategies. Less common strategies were attending a slimming club (17.2%), meal replacements (3.4%) and weight-loss medication (3.2%). Adjusting for BMI, age, deprivation and long standing health conditions, women were significantly more likely to report ever using a slimming club (adjusted OR = 18.63, 95% CI = 16.52–21.00) and more likely to report ever using over the counter weight-loss medications (AOR = 3.73, 95% CI = 3.10-4.48), while respondents from the most deprived areas were less likely to report using slimming clubs (AOR = 0.60, 95% CI = 0.53-0.68), and more likely to reporting using weight loss medications (AOR =1.38, 95% CI = 1.05-1.82). Conclusion A large proportion of individuals report having used weight management strategies. Slimming clubs and over-the-counter weight loss medication

  8. Interaction Effect between Weight Perception and Comorbidities on Weight Control Behavior in Overweight and Obese Adults: Is There a Sex Difference?

    PubMed

    Hwang, Jun Hyun; Ryu, Dong Hee; Park, Soon-Woo

    2015-08-01

    We investigated the interaction effect between body weight perception and chronic disease comorbidities on body weight control behavior in overweight/obese Korean adults. We analyzed data from 9,138 overweight/obese adults ≥20 yr of age from a nationally representative cross-sectional survey. Multiple logistic regression using an interaction model was performed to estimate the effect of chronic disease comorbidities on weight control behavior regarding weight perception. Adjusted odds ratios for weight control behavior tended to increase significantly with an increasing number of comorbidities in men regardless of weight perception (P<0.05 for trend), suggesting no interaction. Unlike women who perceived their weight accurately, women who under-perceived their weight did not show significant improvements in weight control behavior even with an increasing number of comorbidities. Thus, a significant interaction between weight perception and comorbidities was found only in women (P=0.031 for interaction). The effect of the relationship between accurate weight perception and chronic disease comorbidities on weight control behavior varied by sex. Improving awareness of body image is particularly necessary for overweight and obese women to prevent complications.

  9. Challenges with Diagnosing and Managing Sepsis in Older Adults

    PubMed Central

    Clifford, Kalin M.; Dy-Boarman, Eliza A.; Haase, Krystal K.; Maxvill, Kristen (Hesch); Pass, Steven; Alvarez, Carlos A.

    2016-01-01

    Sepsis in older adults has many challenges that affect rate of septic diagnosis, treatment, and monitoring parameters. Numerous age-related changes and comorbidities contribute to increased risk of infections in older adults, but also atypical symptomatology that delays diagnosis. Due to various pharmacokinetic/pharmacodynamic changes in the older adult, medications are absorbed, metabolized, and eliminated at different rates as compared to younger adults, which increases risk of adverse drug reactions due to use of drug therapy needed for sepsis management. This review provides information to aid in diagnosis as well as offers recommendations for monitoring and treating sepsis in the older adult population. PMID:26687340

  10. Obstructive sleep apnoea in adults: body postures and weight changes interactions.

    PubMed

    Oksenberg, Arie; Dynia, Aida; Nasser, Khitam; Gadoth, Natan

    2012-08-01

    The aim of this work was to study the relationship between changes of body posture dominance and changes of body weight overtime in adults with obstructive sleep apnoea. The participants were 112 non-treated adults with obstructive sleep apnoea who underwent two polysomnographic evaluations at our Sleep Disorders Unit during an average of 6.2years interval. Positional patients - having most of their breathing abnormalities in the supine posture and who became non-positional patients - had a significant gain in weight and a significant increase in apnoea-hypopnoea index, mainly in lateral apnoea-hypopnoea index. On the contrary, non-positional patients who became positional patients had a significant decrease in weight (but less than the increase in weight of positional patients who became non-positional patients) and showed a significant improvement in apnoea-hypopnoea index, again mainly in lateral apnoea-hypopnoea index. These non-positional patients who became positional patients initially had a less severe disease, as judged by apnoea-hypopnoea index, lateral apnoea-hypopnoea index and minimum SaO(2) during non-rapid eye movement sleep, and were less obese than non-positional patients who remained non-positional patients. The later were the patients who showed initially the worst disease and were more obese than the rest of the patients, and their condition did not change significantly over time. Non-positional patients who converted to positional patients showed a decrease in body weight and improvement of obstructive sleep apnoea, while positional patients who converted to non-positional patients showed an increase in body weight and worsening of obstructive sleep apnoea. It appears that weight changes have a modulatory effect on positional dominance, and lateral apnoea-hypopnoea index appears to be a sensitive parameter of these changes.

  11. Decreased Bone Mineral Density in Adults Born with Very Low Birth Weight: A Cohort Study

    PubMed Central

    Hovi, Petteri; Andersson, Sture; Järvenpää, Anna-Liisa; Eriksson, Johan G.; Strang-Karlsson, Sonja; Kajantie, Eero; Mäkitie, Outi

    2009-01-01

    Background Very-low-birth-weight (VLBW, <1,500 g) infants have compromised bone mass accrual during childhood, but it is unclear whether this results in subnormal peak bone mass and increased risk of impaired skeletal health in adulthood. We hypothesized that VLBW is associated with reduced bone mineral density (BMD) in adulthood. Methods and Findings The Helsinki Study of Very Low Birth Weight Adults is a multidisciplinary cohort study representative of all VLBW births within the larger Helsinki area from 1978 to 1985. This study evaluated skeletal health in 144 such participants (all born preterm, mean gestational age 29.3 wk, birth weight 1,127 g, birth weight Z score 1.3), and in 139 comparison participants born at term, matched for sex, age, and birth hospital. BMD was measured by dual energy X-ray absorptiometry at age 18.5 to 27.1 y. Adults born with VLBW had, in comparison to participants born at term, a 0.51-unit (95% confidence interval [CI] 0.28–0.75) lower lumbar spine Z score and a 0.56-unit (95% CI 0.34–0.78) lower femoral neck Z score for areal BMD. These differences remained statistically significant after adjustment for the VLBW adults' shorter height and lower self-reported exercise intensity. Conclusions Young adults born with VLBW, when studied close to the age of peak bone mass, have significantly lower BMD than do their term-born peers. This suggests that compromised childhood bone mass accrual in preterm VLBW children translates into increased risk for osteoporosis in adulthood, warranting vigilance in osteoporosis prevention. Please see later in the article for the Editors' Summary PMID:19707270

  12. Weight management for individuals with intellectual and developmental disabilities: rationale and design for an 18 month randomized trial.

    PubMed

    Donnelly, J E; Saunders, R R; Saunders, M; Washburn, R A; Sullivan, D K; Gibson, C A; Ptomey, L T; Goetz, J R; Honas, J J; Betts, J L; Rondon, M R; Smith, B K; Mayo, M S

    2013-09-01

    Weight management for individuals with intellectual and developmental disabilities (IDD) has received limited attention. Studies on weight management in this population have been conducted over short time frames, in small samples with inadequate statistical power, infrequently used a randomized design, and have not evaluated the use of emerging effective dietary strategies such as pre-packaged meals (PMs). Low energy/fat PMs may be useful in individuals with IDD as they simplify meal planning, limit undesirable food choices, teach appropriate portion sizes, are convenient and easy to prepare, and when combined with fruits and vegetables provide a high volume, low energy dense meal. A randomized effectiveness trial will be conducted in 150 overweight/obese adults with mild to moderate IDD, and their study partners to compare weight loss (6 months) and weight maintenance (12 months) between 2 weight management approaches: 1. A Stop Light Diet enhanced with reduced energy/fat PMs (eSLD); and 2. A recommended care reduced energy/fat meal plan diet (RC). The primary aim is to compare weight loss (0-6 months) and weight maintenance (7-18 months) between the eSLD and RC diets. Secondarily, changes in chronic disease risk factors between the eSLD and RC diets including blood pressure, glucose, insulin, LDL-cholesterol, and HDL-cholesterol will be compared during both weight loss and weight maintenance. Finally, potential mediators of weight loss including energy intake, physical activity, data recording, adherence to the diet, study partner self-efficacy and daily stress related to dietary change will be explored.

  13. Factors Associated With Weight Change in Online Weight Management Communities: A Case Study in the LoseIt Reddit Community

    PubMed Central

    Ribeiro, Antonio; Couto Silva, Ana Paula; Meira Jr, Wagner

    2017-01-01

    Background Recent research has shown that of the 72% of American Internet users who have looked for health information online, 22% have searched for help to lose or control weight. This demand for information has given rise to many online weight management communities, where users support one another throughout their weight loss process. Whether and how user engagement in online communities relates to weight change is not totally understood. Objective We investigated the activity behavior and analyze the semantic content of the messages of active users in LoseIt (r/loseit), a weight management community of the online social network Reddit. We then explored whether these features are associated with weight loss in this online social network. Methods A data collection tool was used to collect English posts, comments, and other public metadata of active users (ie, users with at least one post or comment) on LoseIt from August 2010 to November 2014. Analyses of frequency and intensity of user interaction in the community were performed together with a semantic analysis of the messages, done by a latent Dirichlet allocation method. The association between weight loss and online user activity patterns, the semantics of the messages, and real-world variables was found by a linear regression model using 30-day weight change as the dependent variable. Results We collected posts and comments of 107,886 unique users. Among these, 101,003 (93.62%) wrote at least one comment and 38,981 (36.13%) wrote at least one post. Median percentage of days online was 3.81 (IQR 9.51). The 10 most-discussed semantic topics on posts were related to healthy food, clothing, calorie counting, workouts, looks, habits, support, and unhealthy food. In the subset of 754 users who had gender, age, and 30-day weight change data available, women were predominant and 92.9% (701/754) lost weight. Female gender, body mass index (BMI) at baseline, high levels of online activity, the number of upvotes

  14. Applying a technology‐based system for weight loss in adults with obesity

    PubMed Central

    Lang, W.; Barone Gibbs, B.; Davis, K. K.; Burke, L. E.; Kovacs, S. J.; Portzer, L. A.; Jakicic, J. M.

    2016-01-01

    Summary Objective The aim of this study was to compare an in‐person, group‐based behavioral weight loss intervention to technology‐based interventions in adults with obesity. Methods Adults (N = 39; body mass index: 39.5 ± 2.8 kg m−2; age: 39.9 ± 11.5 years) participated in a 6‐month program with randomization to one of three intervention groups: standard behavioral weight loss, a technology‐based system combined with a monthly intervention telephone call (TECH) or an enhanced technology‐based system combined with a monthly intervention telephone call (EN‐TECH). All groups were prescribed an energy‐restricted diet and physical activity. Assessments occurred at 0, 3 and 6 months. Separate mixed‐effects models using unstructured dependence structure were fit to the outcomes. Results Weight loss (least square means ± standard error) at 6 months was −6.57 ± 1.65 kg in standard behavioral weight loss, −5.18 ± 1.72 kg in TECH and −6.25 ± 1.95 kg in EN‐TECH (p‐value for time effect ≤ 0.0001). A similar pattern was observed for change in body mass index, waist circumference and percent body fat. There was a decrease in total energy intake (p = 0.0005) and percent dietary fat intake (p = 0.0172), and physical activity increased (p = 0.0003). Conclusions Findings provide initial information on the use of technology‐based interventions that include wearable devices combined with brief monthly telephone calls for weight loss in adults with obesity. PMID:27812375

  15. Birth weight, Early Life Course BMI, and Body Size Change: Chains of Risk to Adult Inflammation?

    PubMed Central

    Goosby, Bridget J.; Cheadle, Jacob E.; McDade, Thomas

    2015-01-01

    This paper examines how body size changes over the early life course predict high-sensitivity C-reactive protein in a U.S. based sample. Using three waves of the National Longitudinal Study of Adolescent Health (Add Health), we test the chronic disease epidemiological models of fetal origins, sensitive periods, and chains of risk from birth into adulthood. Few studies link birth weight and changes in obesity status over adolescence and early adulthood to adult obesity and inflammation. Consistent with fetal origins and sensitive periods hypotheses, body size and obesity status at each developmental period, along with increasing body size between periods, are highly correlated with adult CRP. However, the predictive power of earlier life course periods is mediated by body size and body size change at later periods in a pattern consistent with the chains of risk model. Adult increases in obesity had effect sizes of nearly .3sd, and effect sizes from overweight to the largest obesity categories were between .3–1sd. There was also evidence that risk can be offset by weight loss, which suggests that interventions can reduce inflammation and cardiovascular risk, that females are more sensitive to body size changes, and that body size trajectories over the early life course account for African American-and Hispanic-white disparities in adult inflammation. PMID:26685708

  16. Low birth weight may increase body fat mass in adult women with polycystic ovarian syndrome

    PubMed Central

    Minooee, Sonia; Ramezani Tehrani, Fahimeh; Mirmiran, Parvin; Azizi, Fereidoun

    2016-01-01

    Background: Women engaged with polycystic ovarian syndrome (PCOS), as the commonest endocrine disorder, are known to have a specific type of adiposity. Birth weight is among different contributors reported to be responsible for this diversity. Objective: We aimed to compare the relation between birth weight and body fat mass (BFM)/ body lean mass (BLM) in PCOS and their age and body mass index (BMI) matched normal controls. Materials and Methods: In this case-control study, a total number of 70 reproductive aged women, diagnosed with PCOS and 70 age- BMI matched healthy women without hirsutism and/or ovulatory dysfunction were recruited., control group had no polycystic ovaries in ultrasonographic scans. A detailed history of birth weight was taken and was divided into the following categories: <2,500 (low birth weight, LBW) and 2,500-4,000 (normal birth weight; NBW). Results: Results showed that LBW prevalence was higher in women with PCOS than in controls (19.3% (27) vs. 15.7% (22)). Also body fat and lean mass (BFM, BLM) have increased in adult women with PCOS who were born underweight compared to their normal (19.8±9.05 vs. 12.9±4.5, p=0.001 and 48.9±6.9 vs. 43.2±5.8, p=0.004 respectively). Conclusion: Fetal birth weight influences on the adulthood obesity, BFM and BLM. This impact is different among women with and without PCOS. PMID:27326419

  17. Energy Density, Energy Intake, and Body Weight Regulation in Adults12345

    PubMed Central

    Karl, J. Philip; Roberts, Susan B.

    2014-01-01

    The role of dietary energy density (ED) in the regulation of energy intake (EI) is controversial. Methodologically, there is also debate about whether beverages should be included in dietary ED calculations. To address these issues, studies examining the effects of ED on EI or body weight in nonelderly adults were reviewed. Different approaches to calculating dietary ED do not appear to alter the direction of reported relations between ED and body weight. Evidence that lowering dietary ED reduces EI in short-term studies is convincing, but there are currently insufficient data to determine long-term effectiveness for weight loss. The review also identified key barriers to progress in understanding the role of ED in energy regulation, in particular the absence of a standard definition of ED, and the lack of data from multiple long-term clinical trials examining the effectiveness of low-ED diet recommendations for preventing both primary weight gain and weight regain in nonobese individuals. Long-term clinical trials designed to examine the impact of dietary ED on energy regulation, and including multiple ED calculation methods within the same study, are still needed to determine the importance of ED in the regulation of EI and body weight. PMID:25398750

  18. Physical activity, genetic, and nutritional considerations in childhood weight management.

    PubMed

    Bar-Or, O; Foreyt, J; Bouchard, C; Brownell, K D; Dietz, W H; Ravussin, E; Salbe, A D; Schwenger, S; St Jeor, S; Torun, B

    1998-01-01

    Almost one-quarter of U.S. children are now obese, a dramatic increase of over 20% in the past decade. It is intriguing that the increase in prevalence has been occurring while overall fat consumption has been declining. Body mass and composition are influenced by genetic factors, but the actual heritability of juvenile obesity is not known. A low physical activity (PA) is characteristic of obese children and adolescents, and it may be one cause of juvenile obesity. There is little evidence, however, that overall energy expenditure is low among the obese. There is a strong association between the prevalence of obesity and the extent of TV viewing. Enhanced PA can reduce body fat and blood pressure and improve lipoprotein profile in obese individuals. Its effect on body composition, however, is slower than with low-calorie diets. The three main dietary approaches are: protein sparing modified fast, balanced hypocaloric diets, and comprehensive behavioral lifestyle programs. To achieve long-standing control of overweight, one should combine changes in eating and activity patterns, using behavior modification techniques. However, the onus is also on society to reduce incentives for a sedentary lifestyle and over-consumption of food. To address the key issues related to childhood weight management, the American College of Sports Medicine convened a Scientific Roundtable in Indianapolis.

  19. Weight Management Behaviors Used by Active Duty Nurses to Maintain Compliance With Military Weight Control Standards

    DTIC Science & Technology

    2003-05-01

    room, and bulimia (Sweeney & Bonnabeau, 1990). Healthy weight loss techniques Conceptual: Weight loss strategies that include a healthy balance of...shown that these behaviors can lead to more serious eating disorders such as Anorexia or Bulimia . Based on results of previous studies done like this...minimally normal body weight) or bulimia nervosa (repeated episodes of binge eating followed by inappropriate compensatory behaviors)? ___ Yes ___ No

  20. Weight management using the internet: A randomized controlled trial

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Most weight-loss research targets obese individuals who desire large weight reductions. However, evaluation of weight-gain prevention in overweight individuals is also critical as most Americans become obese as a result of a gradual gain of 1-2 pounds per year over many years. This study evaluated t...

  1. Lead Exposure Induces Weight Gain in Adult Rats, Accompanied by DNA Hypermethylation

    PubMed Central

    Zhao, Li; Li, Qin; Cang, Zhen; Chen, Chi; Lu, Meng; Cheng, Jing; Zhai, Hualing; Xia, Fangzhen; Ye, Lin; Lu, Yingli

    2017-01-01

    Objective Previous studies have revealed the association of lead (Pb) exposure with obesity. DNA methylation alteration has been suggested to be one of the regulatory mechanisms of obesity. We aimed to explore whether Pb exposure is related with weight gain and DNA methylation alteration. Methods Male adult 8 week Wistar rats were divided into 5 groups: the normal chow diet (NCD); the NCD+0.05%Pb; the NCD+0.15%Pb; the NCD+0.45%Pb and the high fat diet. Rats were exposed to different dosages of Pb through drinking water for 21 weeks. Body weight, fasted blood glucose level, fasted insulin level, homeostasis assessment of insulin resistance (HOMA-IR) index and lipid profile were detected. Intra-peritoneal glucose tolerance test (IPGTT) was constructed to evaluate the glucose tolerance. Lipid accumulation of liver was detected and liver DNA underwent whole genome bisulfite sequencing. Results The NCD+0.05%Pb group had significantly greater weight, HOMA-IR and triglycerides, and lower glucose intolerance than the NCD group (P <0.05). This group also showed hepatic lipid accumulation. These metabolic changes were not observed in the other two Pb dosage groups. Furthermore, DNA hypermethylation extended along pathways related to glucose and lipid metabolism in NCD+0.05%Pb group. Conclusion Pb exposure resulted in dose-specific weight gain in adult Wistar rats, accompanied by alteration of DNA methylation. PMID:28107465

  2. Childhood cognition and lifetime risk of major depressive disorder in extremely low birth weight and normal birth weight adults.

    PubMed

    Dobson, K G; Schmidt, L A; Saigal, S; Boyle, M H; Van Lieshout, R J

    2016-12-01

    In general population samples, better childhood cognitive functioning is associated with decreased risk of depression in adulthood. However, this link has not been examined in extremely low birth weight survivors (ELBW, <1000 g), a group known to have poorer cognition and greater depression risk. This study assessed associations between cognition at age 8 and lifetime risk of major depressive disorder in 84 ELBW survivors and 90 normal birth weight (NBW, ⩾2500 g) individuals up to 29-36 years of age. The Wechsler Intelligence Scale for Children, Revised (WISC-R), Raven's Coloured Progressive Matrices and the Token Test assessed general, fluid, and verbal intelligence, respectively, at 8 years of age. Lifetime major depressive disorder was assessed using the Mini International Neuropsychiatric Interview at age 29-36 years. Associations were examined using logistic regression adjusted for childhood socioeconomic status, educational attainment, age, sex, and marital status. Neither overall intelligence quotient (IQ) [WISC-R Full-Scale IQ, odds ratios (OR)=0.87, 95% confidence interval (CI)=0.43-1.77], fluid intelligence (WISC-R Performance IQ, OR=0.98, 95% CI=0.48-2.00), nor verbal intelligence (WISC-R Verbal IQ, OR=0.81, 95% CI=0.40-1.63) predicted lifetime major depression in ELBW survivors. However, every standard deviation increase in WISC-R Full-Scale IQ (OR=0.43, 95% CI=0.20-0.92) and Performance IQ (OR=0.46, 95% CI=0.21-0.97), and each one point increase on the Token Test (OR=0.80, 95% CI=0.67-0.94) at age 8 was associated with a reduced risk of lifetime depression in NBW participants. Higher childhood IQ, better fluid intelligence, and greater verbal comprehension in childhood predicted reduced depression risk in NBW adults. Our findings suggest that ELBW survivors may be less protected by superior cognition than NBW individuals.

  3. Development of an Evidence-Based mHealth Weight Management Program Using a Formative Research Process

    PubMed Central

    Whittaker, Robyn; McRobbie, Hayden; Dorey, Enid; Ball, Kylie; Maddison, Ralph; Myers Smith, Katie; Crawford, David; Jiang, Yannan; Gu, Yulong; Michie, Jo; Ni Mhurchu, Cliona

    2014-01-01

    Background There is a critical need for weight management programs that are effective, cost efficient, accessible, and acceptable to adults from diverse ethnic and socioeconomic backgrounds. mHealth (delivered via mobile phone and Internet) weight management programs have potential to address this need. To maximize the success and cost-effectiveness of such an mHealth approach it is vital to develop program content based on effective behavior change techniques, proven weight management programs, and closely aligned with participants’ needs. Objective This study aims to develop an evidence-based mHealth weight management program (Horizon) using formative research and a structured content development process. Methods The Horizon mHealth weight management program involved the modification of the group-based UK Weight Action Program (WAP) for delivery via short message service (SMS) and the Internet. We used an iterative development process with mixed methods entailing two phases: (1) expert input on evidence of effective programs and behavior change theory; and (2) target population input via focus group (n=20 participants), one-on-one phone interviews (n=5), and a quantitative online survey (n=120). Results Expert review determined that core components of a successful program should include: (1) self-monitoring of behavior; (2) prompting intention formation; (3) promoting specific goal setting; (4) providing feedback on performance; and (5) promoting review of behavioral goals. Subsequent target group input confirmed that participants liked the concept of an mHealth weight management program and expressed preferences for the program to be personalized, with immediate (prompt) and informative text messages, practical and localized physical activity and dietary information, culturally appropriate language and messages, offer social support (group activities or blogs) and weight tracking functions. Most target users expressed a preference for at least one text message

  4. Management of Colorectal Cancer in Older Adults.

    PubMed

    Hubbard, Joleen M

    2016-02-01

    Treatment for colorectal cancer should not be based on age alone. Pooled analyses from clinical trials show that fit older adults are able to tolerate treatment well with similar efficacy as younger adults. When an older adult is considered for treatment, the clinical encounter must evaluate for deficits in physical and cognitive function, and assess comorbidities, medications, and the degree of social support, all which have may affect tolerance of treatment. Based on the degree of fitness of the patient, multiple alternatives to aggressive treatment regimens and strategies exist to minimize toxicity and preserve quality of life during treatment.

  5. The effects of two workplace weight management programs and weight loss on health care utilization and costs

    PubMed Central

    Østbye, Truls; Stroo, Marissa; Eisenstein, Eric L.; Dement, John M.

    2015-01-01

    Objectives Compare the impact of two worksite weight management programs, WM (education) and WM+ (education plus counseling), on health care utilization and costs. Secondarily, compare the intervention groups to an observational control group of obese workers. Finally, evaluate the impact of actual weight loss on these outcomes. Methods Estimate the change in the WM and WM+ intervention groups. Using propensity score adjustment compare the two intervention groups with the observational control group; and compare those who lost weight with those who did not. Results No significant differences between the two intervention groups, or between these intervention groups and the observational control group. Those who lost weight reduced their overall health care costs. Conclusion To achieve weight loss and associated morbidity reductions, more extensive and intensive interventions, with more attention to motivation and compliance, are required. PMID:26849260

  6. Effects of food restriction across stages of juvenile and early adult development on body weight, survival and adult life history.

    PubMed

    Wong, J W Y; Kölliker, M

    2014-11-01

    Organisms have to allocate limited resources among multiple life-history traits, which can result in physiological trade-offs, and variation in environmental conditions experienced during ontogeny can influence reproduction later in life. Food restriction may lead to an adaptive reallocation of the limited resources among traits as a phenotypically plastic adjustment, or it can act as an overall constraint with detrimental effects throughout reproductive life. In this study, we investigated experimentally the effects of food restriction during different stages of the juvenile and early adult development on body weight, survival and reproductive success in females and males of the European earwig Forficula auricularia. Individuals either received limited or unlimited access to food across three different stages of development (fully crossed) allowing us to identify sensitive periods during development and to test both additive and interactive effects of food limitation across stages on development and reproduction. Food restriction during the early and late juvenile stage had additive negative effects on juvenile survival and adult body weight. With regard to reproductive success of females which produce up to two clutches in their lifetime, restriction specifically in the late juvenile stage led to smaller first and second clutch size, lower probability of second clutch production and reduced hatching success in the second clutch. Reproductive success of females was not significantly affected when their male mates experienced food restriction during their development. Our findings in general support the 'silver-spoon' hypothesis in that food restriction during juvenile development poses constraints on development and reproduction throughout life.

  7. Sucrose Exposure in Early Life Alters Adult Motivation and Weight Gain

    PubMed Central

    Frazier, Cristianne R. M.; Mason, Peggy; Zhuang, Xiaoxi; Beeler, Jeff A.

    2008-01-01

    The cause of the current increase in obesity in westernized nations is poorly understood but is frequently attributed to a ‘thrifty genotype,’ an evolutionary predisposition to store calories in times of plenty to protect against future scarcity. In modern, industrialized environments that provide a ready, uninterrupted supply of energy-rich foods at low cost, this genetic predisposition is hypothesized to lead to obesity. Children are also exposed to this ‘obesogenic’ environment; however, whether such early dietary experience has developmental effects and contributes to adult vulnerability to obesity is unknown. Using mice, we tested the hypothesis that dietary experience during childhood and adolescence affects adult obesity risk. We gave mice unlimited or no access to sucrose for a short period post-weaning and measured sucrose-seeking, food consumption, and weight gain in adulthood. Unlimited access to sucrose early in life reduced sucrose-seeking when work was required to obtain it. When high-sugar/high-fat dietary options were made freely-available, however, the sucrose-exposed mice gained more weight than mice without early sucrose exposure. These results suggest that early, unlimited exposure to sucrose reduces motivation to acquire sucrose but promotes weight gain in adulthood when the cost of acquiring palatable, energy dense foods is low. This study demonstrates that early post-weaning experience can modify the expression of a ‘thrifty genotype’ and alter an adult animal's response to its environment, a finding consistent with evidence of pre- and peri-natal programming of adult obesity risk by maternal nutritional status. Our findings suggest the window for developmental effects of diet may extend into childhood, an observation with potentially important implications for both research and public policy in addressing the rising incidence of obesity. PMID:18797507

  8. Weight-loss interventions for overweight/obese adults with chronic musculoskeletal pain: a mixed methods systematic review protocol

    PubMed Central

    Cooper, Lesley; Ryan, Cormac; Ells, Louisa Jane; Hamilton, Sharon; Atkinson, Greg; Cooper, Kay; Johnson, Mark I.; Kirwan, John P.; Martin, Denis

    2016-01-01

    Review question/objective The objective of this mixed methods review is to develop an aggregated synthesis of qualitative and quantitative data on weight-loss interventions for overweight/obese adults with chronic musculoskeletal pain in an attempt to derive conclusions and recommendations useful for clinical practice and policy decision making. The objective of the quantitative component of this review is to quantify the effectiveness of weight-loss interventions on weight, pain and physical and/or psychosocial function in overweight/obese adults with chronic musculoskeletal pain. The objectives of the qualitative component of this review are to explore the perceptions and experiences of overweight/obese adults with chronic musculoskeletal pain of the link between their weight and pain, and the effectiveness and appropriateness of weight-loss interventions and sustainability of weight-loss efforts. PMID:27532463

  9. Weight management in obese pets: the tailoring concept and how it can improve results.

    PubMed

    German, Alexander J

    2016-10-20

    Obesity is now recognised as the most important medical disease in pets worldwide. All current strategies for weight management involve dietary energy restriction with a purpose-formulated diet. Whilst current weight management regimes can be successful, outcomes are often disappointing with the rate of weight loss progressively slowing down as time goes on. Success is most challenging for the most obese dogs and cats that are more likely to discontinue the programme before reaching target weight. To improve outcomes, clinicians must focus carefully on better tailoring programmes, paying particular to setting an appropriate target weight so as to maximise the benefits for the individual. In this opinionated review, the author will discuss findings from recent clinical research studies examining weight management in obese dogs and cats. A strategy for tailoring weight management targets will then be discussed, illustrated with case examples.

  10. Childhood growth and adult hypertension in a population of high birth weight.

    PubMed

    Halldorsson, Thorhallur Ingi; Gunnarsdottir, Ingibjorg; Birgisdottir, Bryndis Eva; Gudnason, Vilmundur; Aspelund, Thor; Thorsdottir, Inga

    2011-07-01

    Low birth weight has consistently been associated with increased adult blood pressure. The relative importance of childhood growth is, however, less well established. This study examined sex-specific associations between childhood growth and adult blood pressure in 2120 subjects born from 1921 to 1935 in Reykjavik who were recruited into a longitudinal study in 1967-1991. Size at birth and growth at regular intervals between 8 and 13 years were collected from national archives. Hypertensive males did not differ from normotensive males at birth but were increasingly taller and of higher body mass index between 8 and 13 years. No differences in adult height were observed between hypertensive and normotensive males. For boys, growth-velocity (change in growth per year) for body mass index and height between 8 to 13 years was positively associated (P<0.05) with adult blood pressure. The association for body mass index-velocity was fully accounted for by concurrent body size, whereas height-velocity was independent of birth weight and concurrent body size. Males in the highest compared with the lowest tertile in the height-velocity distribution had 66% increased risks of hypertension (95% CI: 15% to 139% increased risks of hypertension) corresponding with 5.0 mm Hg increase (95% CI: 1.5 to 8.5 mm Hg increase) and 3.1 mm Hg increase (95% CI: 1.1 to 5.0 mm Hg increase) in systolic and diastolic blood pressures, respectively. Hypertensive females weighed less at birth but did not differ markedly from normotensive girls between 8 and 13 years, and no association was observed for growth-velocity. In conclusion, rapid linear growth between 8 and 13 years predicts elevated adult blood pressure in boys. This association is likely to reflect relatively early onset of puberty among hypertensive males.

  11. Optimal management of ADHD in older adults

    PubMed Central

    Torgersen, Terje; Gjervan, Bjorn; Lensing, Michael B; Rasmussen, Kirsten

    2016-01-01

    Background The manifestation of attention-deficit/hyperactivity disorder (ADHD) among older adults has become an interesting topic of interest due to an increasing number of adults aged 50 years and older (≥50 years) seeking assessment for ADHD. Unfortunately, there is a lack of research on ADHD in older adults, and until recently only a few case reports existed. Method A systematic search was conducted in the databases Medline/PubMed and PsycINFO in order to identify studies regarding ADHD in adults ≥50 years. Results ADHD persists into older ages in many patients, but the prevalence of patients fulfilling the criteria for the diagnosis at age ≥50 years is still unknown. It is reason to believe that the prevalence is falling gradually with age, and that the ADHD symptom level is significantly lower in the age group 70–80 years than the group 50–60 years. There is a lack of controlled studies of ADHD medication in adults ≥50 years, but this review suggests that many patients aged ≥50 years experience beneficial effects of pharmacological treatment. The problem with side effects and somatic complications may rise to a level that makes pharmacotherapy for ADHD difficult after the age of 65 years. Physical assessment prior to initiation of ADHD medication in adults ≥50 years should include a thorough clinical examination, and medication should be titrated with low doses initially and with a slow increase. In motivated patients, different psychological therapies alone or in addition to pharmacotherapy should be considered. Conclusion It is essential when treating older adult patients with ADHD to provide good support based on knowledge and understanding of how ADHD symptoms have affected health, quality of life, and function through the life span. Individualized therapy for each elderly patient should be recommended to balance risk–benefit ratio when pharmacotherapy is considered to be a possible treatment. PMID:26811680

  12. Reducing maladaptive weight management practices: developing a psychoeducational intervention program.

    PubMed

    O'Brien, Karina M; LeBow, Michael D

    2007-04-01

    Previous research has addressed the issues of behavior change and eating disorder prevention among adolescents and young women. The current study was designed to evaluate: (a) whether an 8-week psychoeducational intervention can reduce maladaptive weight-management practices in women (University females, N=24) with sub-clinical levels of eating pathology; and (b) whether its implementation reduces the risk of developing more severe eating pathology across time. Participants were randomly assigned to an experimental (EX) group or a self-monitoring control (SMC) group. Statistically significant changes on measures of eating pathology, including the Eating Attitudes Test-26 [Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. (1982). The Eating Attitudes Test: psychometric features and clinical correlates. Psychological Medicine, 12, 871-878]; Forbidden Food Survey [Ruggerio, L., Williamson, D. A., Davis, C. J., Schlundt, D. G., & Carey, M. P. (1988). Forbidden Food Survey: Measure of bulimic's anticipated emotional reactions to specific foods. Addictive Behaviors, 13, 267-274]; and Bulimia Test-Revised [Thelen, M. H., Farmer, J., Wonderlich, S., & Smith, M. (1991). A revision of the bulimia test: The BULIT-R. Journal of Consulting and Clinical Psychology, 3(1), 119-124] were observed, as were changes in body image, as measured by the Body Shape Questionnaire [Cooper, P. J., Taylor, M. J., Cooper, Z., & Fairburn, C. G. (1987). The development and validation of the body shape questionnaire. International Journal of Eating Disorders, 6(4), 485-494]. Additional significant between-group differences in eating behavior, as measured by daily meal records, were also seen. Participants in the EX group evidenced improvements in scores which were significantly different from those observed in the SMC group. Unfortunately, attrition limited the utility of follow up data.

  13. Modest weight loss through a 12-week weight management program with behavioral modification seems to attenuate inflammatory responses in young obese Koreans.

    PubMed

    Lee, AeJin; Jeon, Kyeong Jin; Kim, Min Soo; Kim, Hye-Kyeong; Han, Sung Nim

    2015-04-01

    Obesity has been reported to impair immune functions and lead to low-grade long-term inflammation; however, studies that have investigated the impact of weight loss on these among the young and slightly obese are limited. Thus, we investigated the effect of a 12-week weight management program with behavioral modifications on cell-mediated immune functions and inflammatory responses in young obese participants. Our hypothesis was that weight loss would result in improved immune functions and decreased inflammatory responses. Sixty-four participants (45 obese and 19 normal weight) finished the program. Obese (body mass index ≥25) participants took part in 5 group education and 6 individual counseling sessions. Normal-weight (body mass index 18.5-23) participants only attended 6 individual sessions. The goal for the obese was to lose 0.5 kg/wk by reducing their intake by 300 to 500 kcal/d and increasing their physical activity. Program participation resulted in a modest but significant decrease in weight (2.7 ± 0.4 kg, P < .001) and lipopolysaccharide-stimulated interleukin-1β production (from 0.85 ± 0.07 to 0.67 ± 0.07 ng/mL, P < .05) in the obese. In the obese group, increase in phytohemagglutinin-stimulated interleukin-10 production, a TH2 and anti-inflammatory cytokine, approached significance after program participation (from 6181 ± 475 to 6970 ± 632 pg/mL, P = .06). No significant changes in proliferative responses to the optimal concentration of concanavalin A or phytohemagglutinin were observed in the obese after program participation. Collectively, modest weight loss did not change the cell-mediated immune functions significantly but did attenuate the inflammatory response in young and otherwise healthy obese adults.

  14. Identifying effective healthy weight and lifestyle advertisements: Focus groups with Australian adults.

    PubMed

    Dixon, Helen; Murphy, Michael; Scully, Maree; Rose, Mischa; Cotter, Trish

    2016-08-01

    This study explored adult's attitudes and reactions to a range of television advertisements (ads) promoting healthy weight, physical activity and healthy eating. Twenty-four focus groups (N = 179) were conducted in metropolitan and regional areas of the Australian states of Victoria, New South Wales (NSW) and Queensland, with participants segmented by sex, education (no tertiary, at least some tertiary) and life stage (young adults, parents). Each group was assigned to one of the three advertising streams - Weight, Activity, or Nutrition - where responses to five different ads were explored using semi-structured, moderator-led discussions. Discussion transcripts were qualitatively content analysed using a conventional approach. Four main themes were identified in participants' discussions about the ads' main messages - (i) Why is it a problem? (ii) Who is it a problem for? (iii) What should I do about it? (iv) How do I make the changes? Reactions varied by demographic factors and current weight and lifestyle status. Participants furthest from achieving public health recommendations for weight, diet and activity were motivated by 'what' and 'how' ads involving gentle persuasion and helpful hints. Participants who were closer to meeting these recommendations were motivated by 'why' ads featuring more graphic and emotive content and new information. Findings suggest a strategic approach is important for the development of public health ads promoting healthy weight and lifestyle, with consideration given to the specific communication goals and who the target audience is. This should help ensure an appropriate message is delivered to priority population subgroups in the most informative and motivating manner.

  15. Self-reported Chronic Pain in Young Adults With a Low Birth Weight

    PubMed Central

    Indredavik, Marit S.; Evensen, Kari A.I.; Romundstad, Pål R.; Rygg, Marite

    2017-01-01

    Objective: To investigate self-reported pain in young adults with a low birth weight. Materials and Methods: This study was a part of a long-term follow-up study of preterm very low birth weight (VLBW; birth weight ≤1500 g), term small for gestational age (SGA; birth weight <10th percentile adjusted for sex and parity), and control young adults born during 1986 to 1988. Of the 300 individuals invited, 216 (62 VLBW, 67 term SGA, and 87 controls) completed a pain questionnaire. Of these, 151 (70%) had answered a pain severity question at 19 years. Chronic pain was defined as pain lasting for >6 months and being moderate, severe, or very severe during the past 4 weeks. Results: The prevalence of chronic pain at 26 years was 16% in the VLBW group, 21% in the term SGA group, and 7% in the control group. The VLBW and the term SGA groups had higher odds ratios for chronic pain (crude OR, 2.6; 95% CI, 0.9-7.6 for the VLBW group and crude OR, 3.6; 95% CI, 1.3-9.9 for the term SGA group vs. controls). The main results remained after adjusting for potential confounding factors. Some attenuation was observed when adjusting for anxiety and depressive problems. Moderate to very severe pain increased from 16% to 41% in the term SGA group from 19 to 26 years, whereas less changes were seen in the VLBW and the control groups. Discussion: Results of our study imply that pain should be in focus when conducting long-term follow-up programs of individuals with a low birth weight. PMID:27518485

  16. Effects of Low-Fat Diets Differing in Protein and Carbohydrate Content on Cardiometabolic Risk Factors during Weight Loss and Weight Maintenance in Obese Adults with Type 2 Diabetes.

    PubMed

    Watson, Nerylee; Dyer, Kathryn; Buckley, Jonathan; Brinkworth, Grant; Coates, Alison; Parfitt, Gaynor; Howe, Peter; Noakes, Manny; Murphy, Karen

    2016-05-12

    Despite evidence for the benefits of higher-protein (HP) diets in weight loss, their role in type 2 diabetes mellitus (T2DM) management and weight maintenance is not clear. This randomised study compared the effects of a HP diet (38% carbohydrate, 30% protein, 29% fat) to a isocaloric higher-carbohydrate diet (HC: 53%:21%:23%) on cardiometabolic risk factors for 12 weeks in energy restriction (~30% reduction) followed by 12 weeks of energy balance whilst performing regular exercise. Outcomes were measured at baseline and the end of each phase. Sixty-one overweight/obese adults (BMI (body mass index) 34.3 ± 5.1 kg/m², aged 55 ± 8 years) with T2DM who commenced the study were included in the intention-to-treat analysis including the 17 participants (HP n = 9, HC n = 8) who withdrew. Following weight loss (M ± SEM: -7.8 ± 0.6 kg), there were significant reductions in HbA1c (-1.4% ± 0.1%, p < 0.001) and several cardiometabolic health risk factors. Improvements were sustained for 12 weeks when weight was stabilised and weight loss maintained. Both the HP and HC dietary patterns with concurrent exercise may be effective strategies for weight loss and weight maintenance in T2DM although further studies are needed to determine the longer term effects of weight maintenance.

  17. Association between adult weight gain and colorectal cancer: a dose-response meta-analysis of observational studies.

    PubMed

    Chen, Qi; Wang, Jing; Yang, Jinghui; Jin, Zhichao; Shi, Wentao; Qin, Yingyi; Yu, Feifei; He, Jia

    2015-06-15

    This study investigated the association between adult weight gain and risk of colorectal cancer (CRC). Using terms related to weight gain and CRC, we searched PubMed, Embase and Web of Science for relevant studies published before June 2014. Two evaluators independently selected studies according to the selection criteria, and eight studies were included (three case-control and five cohort studies). Summary estimates were obtained using fixed- or random-effects models. The relative risk (RR) of the association between adult weight gain and CRC was 1.25 (95% confidence interval [CI], 1.10-1.43); the RR was 1.30 (95% CI, 1.14-1.49) for colon cancer (CC) and 1.27 (95% CI, 1.02-1.58) for rectal cancer (RC) for the highest versus lowest category. For every 5-kg increase in adult weight, the risk increased by 5% (RR, 1.05; 95% CI, 1.02-1.09) for CRC, 6% (RR, 1.06; 95% CI, 1.02-1.11) for CC and 6% (RR, 1.06; 95% CI, 1.03-1.08) for RC. The subgroup analyses showed a positive association between adult weight gain and risk of CRC only in men, and the RR was 1.65 (95% CI, 1.42-1.92) for the highest versus lowest category of adult weight gain and 1.10 (95% CI, 1.06-1.15) for a 5-kg increase in adult weight. In conclusion, there is evidence that adult weight gain is associated with an increased risk of CRC. However, the positive association between adult weight gain and risk of CRC is stronger among men than among women.

  18. Adolescent-parent interactions and communication preferences regarding body weight and weight management: a qualitative study

    PubMed Central

    2010-01-01

    Background This study aimed to canvass the nature of adolescent-parent interactions about weight, particularly overweight, and to explore ideas of how to foster supportive discussions regarding weight, both in the home and with family doctors. Methods A market research company was contracted to recruit and conduct a series of separate focus groups with adolescents and unrelated parents of adolescents from low-middle socio-economic areas in Sydney and a regional centre, Australia. Group discussions were audio recorded, transcribed, and then a qualitative content analysis of the data was performed. Results Nine focus groups were conducted; two were held with girls (n = 13), three with boys (n = 18), and four with parents (20 mothers, 12 fathers). Adolescent and parent descriptions of weight-related interactions could be classified into three distinct approaches: indirect/cautious (i.e. focus on eating or physical activity behaviors without discussing weight specifically); direct/open (i.e. body weight was discussed); and never/rarely discussing the subject. Indirect approaches were described most frequently by both adolescents and parents and were generally preferred over direct approaches. Parents and adolescents were circumspect but generally supportive of the potential role for family doctors to monitor and discuss adolescent weight status. Conclusions These findings have implications for developing acceptable messages for adolescent and family overweight prevention and treatment interventions. PMID:20205918

  19. Insulin therapy and type 2 diabetes: management of weight gain.

    PubMed

    McFarlane, Samy I

    2009-10-01

    The potential for insulin-related weight gain in patients with type 2 diabetes presents a therapeutic dilemma and frequently leads to delays in the initiation of insulin therapy. It also poses considerable challenges when treatment is intensified. Addressing insulin-related weight gain is highly relevant to the prevention of metabolic and cardiovascular consequences in this high-risk population with type 2 diabetes. In addition to lifestyle changes (eg, diet and exercise) and available medical interventions to minimize the risk of weight gain with insulin treatment, familiarity with the weight gain patterns of different insulins may help deal with this problem. The use of basal insulin analogs may offer advantages over conventional human insulin preparations in terms of more physiologic time-action profiles, reduced risk of hypoglycemia, and reduced weight gain.

  20. Effects of Maintained Weight Loss on Sleep Dynamics and Neck Morphology in Severely Obese Adults

    PubMed Central

    Hernandez, Teri L.; Ballard, Robert D.; Weil, Kathleen M.; Shepard, Trudy Y.; Scherzinger, Ann L.; Stamm, Elizabeth R.; Sharp, Teresa A.; Eckel, Robert H.

    2011-01-01

    The goals of the study were to determine if moderate weight loss in severely obese adults resulted in 1) reduction in apnea/hypopnea index (AHI), 2) improved pharyngeal patency, 3) reduced total body oxygen consumption (VO2) and carbon dioxide production (VCO2) during sleep, and 4) improved sleep quality. The main outcome was the change in AHI from before to after weight loss. Fourteen severely obese (BMI>40 kg/m2) patients (3 males, 11 females) completed a highly controlled weight reduction program which included 3 months of weight loss and 3 months of weight maintenance. At baseline and post-weight loss, patients underwent pulmonary function testing, polysomnography, and MRI to assess neck morphology. Weight decreased from 134±6.6 kg to 118±6.1 kg (mean ± SEM; F=113.763, p<0.0001). There was a significant reduction in the AHI between baseline and post-weight loss (SUBJECT, F=11.11, p=0.007). Moreover, patients with worse sleep disordered breathing (SDB) at baseline had the greatest improvements in AHI (GROUP, F=9.00, p=0.005). Reductions in VO2 (285±12 to 234±16 ml/min; F=24.85, p<0.0001) and VCO2 (231±9 to 186±12 ml/min; F=27.74, p<0.0001) were also observed, and pulmonary function testing showed improvements in spirometry parameters. Sleep studies revealed improved minimum SaO2 (83.4±61.9% to 89.1±1.2%; F=7.59, p=0.016), and mean SaO2 (90.4±1.1% to 93.8±1.0%; F=6.89, p=0.022), and a significant increase in the number of arousals (8.1±1.4 at baseline, to 17.1±3.0 after weight loss; F=18.13, p=0.001). In severely obese patients, even moderate weight loss (~10%) boasts substantial benefit in terms of the severity of SDB and sleep dynamics. PMID:18948968

  1. Title IX, girls' sports participation, and adult female physical activity and weight.

    PubMed

    Kaestner, Robert; Xin Xu

    2010-02-01

    Arguably, the most important school-based intervention to increase physical activity was Title IX of the Education Amendments of 1972, which led to a 600% increase in girls' sports participation between 1972 and 1978. We studied the effect of this increase in sports participation and athletic opportunities while young on the physical activity and weight of adult women some 20-25 years later. Our results indicate that adult women who were affected by Title IX and had greater opportunity to participate in athletics while young had lower body mass index (BMI) and lower rates of obesity and reported being more physically active than women who were not afforded these opportunities. However, effect sizes were quite modest.

  2. Grip Strength as a Marker of Hypertension and Diabetes in Healthy Weight Adults

    PubMed Central

    Mainous, Arch G.; Tanner, Rebecca J.; Anton, Stephen D.; Jo, Ara

    2015-01-01

    Introduction Muscle strength may play a role in cardiometabolic disease. We examined the relationship between hand grip strength and diabetes and hypertension in a sample of healthy weight adults. Methods In 2015, we analyzed the National Health and Nutrition Examination Survey 2011–2012 for adults aged ≥20 years with healthy BMIs (between 18.5 and <25 kg/m2) and no history of cardiovascular disease (unweighted n=1,469; weighted n=61,672,082). Hand grip strength was assessed with a dynamometer. Diabetes was based on hemoglobin A1c level and reported diabetes diagnosis. Hypertension was based on measured blood pressure and reported hypertension diagnosis. Results Individuals with undiagnosed diabetes compared with individuals without diabetes had lower grip strength (51.9 vs 69.8, p=0.0001), as well as among individuals with diagnosed diabetes compared with individuals without diabetes (61.7 vs 69.8, p=0.008). Mean grip strength was lower among individuals with undiagnosed hypertension compared with individuals without hypertension (63.5 vs 71.5, p=0.008) as well as among individuals with diagnosed hypertension compared with those without hypertension (60.8 vs 71.5, p<0.0001). In adjusted analyses controlling for age, sex, race, smoking status, and first-degree relative with disease, mean grip strength was lower for undiagnosed diabetes (β= −10.02, p<0.0001) and diagnosed diabetes (β= −8.21, p=0.03) compared with individuals without diabetes. In adjusted analyses, grip strength was lower among individuals with undiagnosed hypertension (β= −6.6, p=0.004) and diagnosed hypertension (β= −4.27, p=0.04) compared with individuals without hypertension. Conclusions Among healthy weight adults, combined grip strength is lower in individuals with diagnosed and undiagnosed diabetes and hypertension. PMID:26232901

  3. Management of Adult Education Organisations in Africa

    ERIC Educational Resources Information Center

    Nafukho, Fredrick Muyia; Wawire, Nelson H. W.; Lam, Penina Mungania

    2011-01-01

    Adult education is now considered a mainstream academic discipline in several African countries, and its importance in today's knowledge and "ideas" economies is growing steadily. It is provided by organisations such as public universities, training colleges, corporate universities and employers. The successful operation of educational…

  4. Weight Management and Fruit and Vegetable Intake among US High School Students

    ERIC Educational Resources Information Center

    Lowry, Richard; Lee, Sarah M.; McKenna, Mary L.; Galuska, Deborah A.; Kann, Laura K.

    2008-01-01

    Background: Consumption of fruits and vegetables is often recommended to promote healthy weight. The purpose of this study was to examine associations between fruit and vegetable intake and common weight management behaviors among US high school students who were trying to lose or stay the same weight. Methods: Data from the 1999, 2001, and 2003…

  5. Exploring Weight Management Recommendations across Australian Community Pharmacies Using Case Vignettes

    ERIC Educational Resources Information Center

    Fakih, Souhiela; Marriott, Jennifer L.; Hussainy, Safeera Y.

    2014-01-01

    With the increase in the overweight and obese population, it is critical that pharmacy staff are able to provide weight management advice to women at different stages of their life. This study utilized case vignettes to identify pharmacists' and pharmacy assistants' current weight management recommendations to women of different ages, life stages…

  6. Integration of Nutrient and Activity Analysis Software into a Worksite Weight Management Program.

    ERIC Educational Resources Information Center

    Dennison, Darwin; And Others

    1990-01-01

    A weight management program utilized the participant's own data for the participant to (1) understand energy balance; (2) compare his/her diet with U.S. dietary codes; (3) know which food selections were high in calories, fat, and cholesterol, and low in complex carbohydrates and fiber; and (4) understand weight management. (JD)

  7. Using the health belief model to develop culturally appropriate weight-management materials for African-American women.

    PubMed

    James, Delores C S; Pobee, Joseph W; Oxidine, D'lauren; Brown, Latonya; Joshi, Gungeet

    2012-05-01

    African-American women have the highest prevalence of adult obesity in the United States. They are less likely to participate in weight-loss programs and tend to have a low success rate when they do so. The goal of this project was to explore the use of the Health Belief Model in developing culturally appropriate weight-management programs for African-American women. Seven focus groups were conducted with 50 African-American women. The Health Belief Model was used as the study's theoretical framework. Participants made a clear delineation between the terms healthy weight, overweight, and obese. Sexy, flirtatious words, such as thick, stacked, and curvy were often used to describe their extra weight. Participants accurately described the health risks of obesity. Most believed that culture and genetics made them more susceptible to obesity. The perceived benefits of losing weight included reduced risk for health problems, improved physical appearance, and living life to the fullest. Perceived barriers included a lack of motivation, reliable dieting information, and social support. Motivators to lose weight included being diagnosed with a health problem, physical appearance, and saving money on clothes. Self-efficacy was primarily affected by a frustrated history of dieting. The data themes suggest areas that should be addressed when developing culturally appropriate weight-loss messages, programs, and materials for African-American women.

  8. Incorporating a Weight Management Skills Workshop in Pharmacy Curricula in Australia.

    PubMed

    Um, Irene S; Krass, Ines; Armour, Carol; Gill, Timothy; Chaar, Betty B

    2016-05-25

    Objective. To develop, implement, and evaluate a competency-based weight management skills workshop for undergraduate pharmacy students in an Australian university. Design. A 3-hour workshop titled "Weight Management in Pharmacy" was implemented with a cohort of fourth-year undergraduate pharmacy students (n=180). Learning activities used included case-based learning, hands-on experience, role-play, and group discussion. Assessment. A 22-item attitudinal survey instrument and the validated Obesity Risk Knowledge (ORK-10) scale were administered at baseline and postworkshop to evaluate the impact of this educational workshop. There was significant improvement in the students' ORK scores and students' perceived level of self-confidence in performing weight management skills. Conclusion. An educational workshop designed to enhance professional competencies in weight management ensured graduates were "service-ready" and had the appropriate knowledge, skills, and attributes to deliver patient-centered pharmacy-based weight management services.

  9. Information needs of cancer patients and survivors regarding diet, exercise and weight management: a qualitative study.

    PubMed

    James-Martin, G; Koczwara, B; Smith, E L; Miller, M D

    2014-05-01

    While advanced cancer is often associated with weight loss, curative cancer treatment is often associated with weight gain. Weight gain during treatment may be associated with greater risk of cancer recurrence and development of lifestyle diseases. Currently, limited resources are available to cancer patients focussed on weight control. This study assessed the information needs of patients undergoing curative chemotherapy regarding diet, exercise and weight management for the purpose of developing weight management resources. Focus groups were held with oncology practitioners, patients and survivors to determine current information provision and needs. Focus groups highlighted a perception that information provision regarding diet, exercise and weight management is insufficient and no routine assessment of weight occurs during chemotherapy. Barriers to information provision described included lack of resources and time, and practitioners' uncertainty regarding appropriate messages to provide. Patients wanted more information regarding diet, exercise and weight during treatment time. The findings of this study suggest an increase in provision of diet, exercise and weight management information is needed. This information should be evidence-based and delivered at an appropriate time by the preferred health care professional. It would also be beneficial to implement protocols regarding assessment of weight during treatment.

  10. Fitness but not weight status is associated with projected physical independence in older adults.

    PubMed

    Sardinha, Luis B; Cyrino, Edilson S; Santos, Leandro Dos; Ekelund, Ulf; Santos, Diana A

    2016-06-01

    Obesity and fitness have been associated with older adults' physical independence. We aimed to investigate the independent and combined associations of physical fitness and adiposity, assessed by body mass index (BMI) and waist circumference (WC) with the projected ability for physical independence. A total of 3496 non-institutionalized older adults aged 65 and older (1167 male) were included in the analysis. BMI and WC were assessed and categorized according to established criteria. Physical fitness was evaluated with the Senior Fitness Test and individual test results were expressed as Z-scores. Projected ability for physical independence was assessed with the 12-item composite physical function scale. Logistic regression was used to estimate the odds ratio (OR) for being physically dependent. A total of 30.1 % of participants were classified as at risk for losing physical independence at age 90 years. Combined fitness and fatness analysis demonstrated that unfit older adults had increased odds ratio for being physically dependent in all BMI categories (normal: OR = 9.5, 95 %CI = 6.5-13.8; overweight: OR = 6.0, 95 %CI = 4.3-8.3; obese: OR = 6.7, 95 %CI = 4.6-10.0) and all WC categories (normal: OR = 10.4, 95%CI = 6.5-16.8; middle: OR = 6.2, 95 %CI = 4.1-9.3; upper: OR = 7.0, 95 %CI = 4.8-10.0) compared to fit participants that were of normal weight and fit participants with normal WC, respectively. No increased odds ratio was observed for fit participants that had increased BMI or WC. In conclusion, projected physical independence may be enhanced by a normal weight, a normal WC, or an increased physical fitness. Adiposity measures were not associated with physical independence, whereas fitness is independently related to physical independence. Independent of their weight and WC status, unfit older adults are at increased risk for losing physical independence.

  11. The Effect of High Resistance Weight Training on Reported Pain in Older Adults

    PubMed Central

    Knutzen, Kathleen M.; Pendergrast, Bethany A.; Lindsey, Billie; Brilla, Lorraine R.

    2007-01-01

    The present study examined the effect of a progressive, whole- body, high resistance training program on reported pain in older adults. Ninety-eight participants (60 - 83 years) completed the McGill Pain Questionnaire prior to and after an eight week training period. Seventy-nine of the participants completed a progressive, high resistance training program of 11 different exercises on three days a week. At the end of eight weeks, the training group achieved significant strength gains ranging from 62% -119% (p ≤ 0.005). Pain measures for the training and control groups were compared using an analysis of covariance on post-test pain measures after an adjustment by pre-test scores. (p ≤ 0.05). The training group reported less perceived pain than the control group in four pain measures (overall pain intensity, sensory dimension, miscellaneous pain measures, number of pain descriptors selected). There were no differences reported for the affective or evaluative dimensions of perceived pain, the number of painful areas, or the present pain. Results suggest that eight weeks of progressive, whole-body weight training has a positive impact on perception of pain in older adults. Key pointsImproved strength in older adults had a positive effect on the perception of pain.The number of painful areas identified and self-reported pain qualities were diminished following high resistance weight training.The McGill Pain Questionnaire was an effective tool for measuring changes in pain perception as a result of training. PMID:24149478

  12. Management of recurrent urinary tract infections in healthy adult women.

    PubMed

    Hickling, Duane R; Nitti, Victor W

    2013-01-01

    Recurrence after urinary tract infection (rUTI) is common in adult women. The majority of recurrences are believed to be reinfection from extraurinary sources such as the rectum or vagina. However, uropathogenic Escherichia coli are now known to invade urothelial cells and form quiescent intracellular bacterial reservoirs. Management of women with frequent symptomatic rUTI can be particularly vexing for both patients and their treating physicians. This review addresses available and promising management strategies for rUTI in healthy adult women.

  13. Management of Recurrent Urinary Tract Infections in Healthy Adult Women

    PubMed Central

    Hickling, Duane R; Nitti, Victor W

    2013-01-01

    Recurrence after urinary tract infection (rUTI) is common in adult women. The majority of recurrences are believed to be reinfection from extraurinary sources such as the rectum or vagina. However, uropathogenic Escherichia coli are now known to invade urothelial cells and form quiescent intracellular bacterial reservoirs. Management of women with frequent symptomatic rUTI can be particularly vexing for both patients and their treating physicians. This review addresses available and promising management strategies for rUTI in healthy adult women. PMID:24082842

  14. Adoption of American Heart Association 2020 ideal healthy diet recommendations prevents weight gain in young adults.

    PubMed

    Forget, Geneviève; Doyon, Myriam; Lacerte, Guillaume; Labonté, Mélissa; Brown, Christine; Carpentier, André C; Langlois, Marie-France; Hivert, Marie-France

    2013-11-01

    In 2010, the American Heart Association established the concept of ideal cardiovascular health. Nationally representative data estimated that <1% of Americans meet the seven health metrics required for achieving ideal cardiovascular health, with the main challenge residing in meeting the criteria for an ideal Healthy Diet Score. In a cohort of young adults (N=196), we aimed to investigate the prevalence of ideal cardiovascular health and ideal Healthy Diet Score and its association to weight gain over a 4-year follow-up period. Anthropometric measures, blood pressure, and blood samples were taken according to standardized procedures. Dietary intake was measured by a 3-day food diary and verified by a registered dietitian. We observed that only 0.5% of our sample met the criteria for ideal cardiovascular health and only 4.1% met the criteria for an ideal Healthy Diet Score. The components of the Healthy Diet Score with the lowest observance were consumption of fruits and vegetables (9.7%) and whole grains (14.8%). Meeting zero or one out of five of the Healthy Diet Score components was associated with increased risk of weight gain over 4 years compared with meeting at least two components (P=0.03). With the exception of dietary criteria, prevalence was high for achieving ideal levels of the remaining six cardiovascular health metrics. In conclusion, in this sample of young adults, a very low prevalence of ideal overall cardiovascular health was observed, mainly driven by poor dietary habits, and a poor Healthy Diet Score was associated with increased weight gain.

  15. Effect of ground cinnamon on postprandial blood glucose concentration in normal-weight and obese adults.

    PubMed

    Magistrelli, Ashley; Chezem, Jo Carol

    2012-11-01

    In healthy normal-weight adults, cinnamon reduces blood glucose concentration and enhances insulin sensitivity. Insulin resistance, resulting in increased fasting and postprandial blood glucose and insulin levels, is commonly observed in obese individuals. The objective of the study was to compare declines in postprandial glycemic response in normal-weight and obese subjects with ingestion of 6 g ground cinnamon. In a crossover study, subjects consumed 50 g available carbohydrate in instant farina cereal, served plain or with 6 g ground cinnamon. Blood glucose concentration, the main outcome measure, was assessed at minutes 0, 15, 30, 45, 60, 90, and 120. Repeated-measures analysis of variance evaluated the effects of body mass index (BMI) group, dietary condition, and time on blood glucose. Paired t-test assessed blood glucose at individual time points and glucose area under the curve (AUC) between dietary conditions. Thirty subjects between the ages of 18 and 30 years, 15 with BMIs between 18.5 and 24.9 and 15 with BMIs of 30.0 or more, completed the study. There was no significant difference in blood glucose between the two BMI groups at any time point. However, in a combined analysis of all subjects, the addition of cinnamon to the cereal significantly reduced 120-minute glucose AUC (P=0.008) and blood glucose at 15 (P=0.001), 30 (P<0.001), 45 (P<0.001), and 60 (P=0.001) minutes. At 120 minutes, blood glucose was significantly higher with cinnamon consumption (P<0.001). These results suggest cinnamon may be effective in moderating postprandial glucose response in normal weight and obese adults.

  16. A Psychophysiological Mechanism Underlying Women's Weight-Management Goals: Women Desire and Strive for Greater Weight Loss Near Peak Fertility.

    PubMed

    Meltzer, Andrea L; McNulty, James K; Miller, Saul L; Baker, Levi R

    2015-07-01

    Three studies demonstrated that conception risk was associated with increased motivations to manage weight. Consistent with the rationale that this association is due to ovulatory processes, Studies 2 and 3 demonstrated that it was moderated by hormonal contraceptive (HC) use. Consistent with the rationale that this interactive effect should emerge when modern appearance-related concerns regarding weight are salient, Study 3 used a 14-day diary to demonstrate that the interactive effects of conception risk and HC use on daily motivations to restrict eating were further moderated by daily motivations to manage body attractiveness. Finally, providing evidence that this interactive effect has implications for real behavior, daily fluctuations in the desire to restrict eating predicted daily changes in women's self-reported eating behavior. These findings may help reconcile prior inconsistencies regarding the implications of ovulatory processes by illustrating that such implications can depend on the salience of broader social norms.

  17. Parental perspectives regarding primary-care weight-management strategies for school-age children.

    PubMed

    Turer, Christy Boling; Mehta, Megha; Durante, Richard; Wazni, Fatima; Flores, Glenn

    2016-04-01

    To identify parental perspectives regarding weight-management strategies for school-age children, focus groups were conducted of parents of overweight and obese (body mass index ≥ 85th percentile) 6-12-year-old children recruited from primary-care clinics. Questions focused on the role of the primary-care provider, effective components of weight-management strategies and feasibility of specific dietary strategies. Focus groups were recorded, transcribed and analysed using margin coding and grounded theory. Six focus groups were held. The mean age (in years) for parents was 32, and for children, eight; 44% of participants were Latino, 33%, African-American and 23%, white. Parents' recommendations on the primary-care provider's role in weight management included monitoring weight, providing guidance regarding health risks and lifestyle changes, consistent follow-up and using discretion during weight discussions. Weight-management components identified as key included emphasising healthy lifestyles and enjoyment, small changes to routines and parental role modelling. Parents prefer guidance regarding healthy dietary practices rather than specific weight-loss diets, but identified principles that could enhance the acceptability of these diets. For dietary guidance to be feasible, parents recommended easy-to-follow instructions and emphasising servings over counting calories. Effective weight-management strategies identified by parents include primary-care provider engagement in weight management, simple instructions regarding healthy lifestyle changes, parental involvement and deemphasising specific weight-loss diets. These findings may prove useful in developing primary-care weight-management strategies for children that maximise parental acceptance.

  18. Eating behavior traits and sleep as determinants of weight loss in overweight and obese adults

    PubMed Central

    Filiatrault, M-L; Chaput, J-P; Drapeau, V; Tremblay, A

    2014-01-01

    Objective: To examine the associations between eating behavior traits and weight loss according to sleep quality and duration in adults enrolled in common weight-loss interventions. Methods: Participants included overweight and obese men and women (n=150) (mean±s.d. age, 38.8±8.6 years; mean±s.d. body mass index (BMI), 33.3±3.5 kg m−2) who were subjected to a dietary intervention over a period of 12–16 weeks. Anthropometric measurements, eating behavior traits (Three-Factor Eating Questionnaire), sleep quality (total Pittsburgh Sleep Quality Index (PSQI) score) and sleep duration (hours per night, self-reported from the PSQI) were assessed at both baseline and post intervention. Linear regression analysis was used to quantify the relationships between eating behavior traits and changes in anthropometric markers for all subjects and by sleep categories (short sleep: <7 h per night vs recommended sleep: ⩾7 h per night; poor sleep quality: ⩾5 PSQI score vs good sleep quality: <5 PSQI score). We adjusted for age, sex and baseline BMI in analyses. Results: Baseline eating behavior traits were modest predictors of weight-loss success, but they were all significantly associated with their changes over the weight-loss intervention (P<0.01). The diet intervention induced significant changes in eating behavior traits and even more for those having a non-favorable eating behavior profile at baseline. We observed that changes in flexible control and strategic dieting behavior were constantly negatively associated with changes in body weight and fat mass (P<0.05) for recommended duration sleepers. The change in situational susceptibility to disinhibition was positively associated with the change in fat mass and body weight for those having healthy sleeping habits (P<0.05). For poor quality sleepers, the change in avoidance of fattening foods was negatively associated with changes in adiposity (P<0.05). Conclusion: Eating behavior traits and sleep may act

  19. Evaluation of a Family-Centred Children's Weight Management Intervention

    ERIC Educational Resources Information Center

    Jinks, Annette; English, Sue; Coufopoulos, Anne

    2013-01-01

    Purpose: The purpose of this paper is to conduct an in-depth quantitative and qualitative evaluation of a family-based weight loss and healthy life style programme for clinically obese children in England. Design/methodology/approach: The mixed method case study evaluation used included obtaining pre and post measurements of anthropometry and a…

  20. Influence of sleep timing behavior on weight status and activity patterns in adults with intellectual disabilities.

    PubMed

    Mikulovic, Jacques; Dieu, Olivier; Fardy, Paul S; Bui-Xuan, Gilles; Vanhelst, Jérémy

    2014-12-01

    The aim was to explore the relationship between sleep habits and overweight/obesity, physical activity and sedentary behaviors in French adults with intellectual disabilities. This observational study was conducted on 570 French adults with intellectual deficiency. Sleep habits were analyzed and related to anthropometric measures, physical activity and sedentary behaviors. The study was conducted using a self-administered questionnaire. Participants completed the questionnaire during an interview with the principal investigator. Sleep timing behavior was classified into 4 sleep patterns: Early-bed/Early-rise, Early-bed/Late-rise, Late-bed/Late-rise, and Late-bed/Early-rise. Of 570 eligible participants, 61 were excluded because of missing data on age, weight or height. The number of participants identified in each of the four sleep patterns was as follows: Early-bed/Early-rise, N = 119 (23%), Early-bed/Late-rise, N = 171 (34%), Late-bed/Early-rise, N = 100 (20%), Late-bed/Late-rise N = 119 (23%). Participants who wake up earlier are more active than those who rise late (p < 0.02). Participants who slept later spent more time in sedentary activities than those in the Early rise groups (p < 0.01). The number of obese/overweight participants was also higher in Late-bed/Late rise group. Sleep behavior was associated with overweight/obesity, physical activity and sedentary behavior in adults with intellectual deficiency, independently the sleep duration. Implementing intervention or promotion programs on sleep behaviors should be considered in order to meet the objectives of promoting health on anthropometric characteristics and increased physical activity among these disabled adults.

  1. Economic pressure and health and weight management behaviors in African American couples: A family stress perspective.

    PubMed

    O'Neal, Catherine W; Arnold, Amy Laura; Lucier-Greer, Mallory; Wickrama, K A S; Bryant, Chalandra M

    2015-05-01

    This study extends the family stress model by examining the influence of economic pressure on health and weight management behaviors mediated by depressive symptoms and spousal support among 506 African American married couples. The actor-partner interdependence model accounted for the interdependent nature of relationships. Findings support the family stress model; yet pathways differed slightly for husbands and wives. Economic pressure directly influenced depressive symptoms and spousal support. Spousal support was a buffer against poor health and weight management behaviors for husbands, while depressive symptoms exacerbated poor health and weight management behaviors for wives. These mechanisms have implications for practitioners who promote African American couples' well-being.

  2. Fitness Level is Associated with Sex-Specific Regional Fat Differences in Normal Weight Young Adults

    PubMed Central

    Bosch, Tyler A.; Dengel, Donald R.; Ryder, Justin R.; Kelly, Aaron S.; Chow, Lisa

    2015-01-01

    Objectives To characterize regional body composition and insulin sensitivity differences between young adults who were normal weight with either high or low fitness determined by VO2 peak. We hypothesized that higher fitness levels would be associated with reduced visceral fat (VAT) and improved insulin sensitivity. Design A cross-sectional comparison of normal weight males and females with high or low fitness matched on age and sex. Methods A total of 38 (20M/18F) individuals were recruited for this study. Thirty-two young adults (18M/14F) were matched on age (mean 22.5 ± 3 yrs.) and BMI (22.4 ± 2.4 kg/m2) and sex and classified by high or low fitness based on VO2 peak difference (≥ 8ml/kg/min). Total and regional body composition, including VAT, was measured by Dual Energy X-Ray Absorptiometry (DXA). Insulin sensitivity was measured by hyperinsulinemic-euglycemic clamp. An analysis of variance compared regional body composition and insulin sensitivity between high and low fitness young adults with a normal BMI. Results Higher fitness was associated with significantly lower percent body fat, lower android fat mass and higher insulin sensitivity in males (−7.2%, P<0.001; −0.5kg, P=0.048; 5.6mg/kg (FFM)/min, p=0.002). In females, higher fitness was associated with significantly lower percent body fat, lower leg fat but no difference in insulin sensitivity (−6.7%, P=0.001; −2.7kg, P<0.001; 2.5 mg/kg(FFM)/min, P=0.40). No differences in VAT were observed between high and low fitness groups. Interestingly in females, there was no difference in total lean mass, trunk lean mass or leg lean mass (P=0.59, P=0.17, P=0.99). Conclusion Higher fitness does not influence VAT in normal weight individuals. Sex influenced regional fat and insulin sensitivity differences between high fitness and low fitness groups. PMID:27054196

  3. Effect of weight loss on the rate of muscle protein synthesis during fasted and fed conditions in obese older adults.

    PubMed

    Villareal, Dennis T; Smith, Gordon I; Shah, Krupa; Mittendorfer, Bettina

    2012-09-01

    Although weight loss ameliorates many of the metabolic abnormalities associated with obesity, there has been reluctance to prescribe weight loss in obese, older individuals because of the fear that it will cause debilitating loss of muscle mass and impair physical function. To gain insight into the mechanisms responsible for the weight loss-induced changes in muscle mass, we measured the rate of muscle protein synthesis (by using stable isotope labeled tracer methodology) during basal, postabsorptive conditions and during mixed meal ingestion in eight obese, older adults: (i) before weight loss therapy, (ii) ~3 months after starting the weight loss intervention (i.e., during the active weight loss phase), when subjects had lost ~7% of their initial body weight, and (iii) after they had lost ~10% of their body weight and maintained this new body weight for ~6 months (~12 months after starting the weight loss intervention). The basal muscle protein fractional synthesis rate (FSR) was not affected by weight loss. Mixed meal ingestion stimulated the rate of muscle protein synthesis, and the anabolic response (i.e., increase in the protein synthesis rate above basal values) was greater (P < 0.05) during negative energy balance and active weight loss at 3 months (0.033 ± 0.012%·per hour, mean ± s.e.m.) than during weight maintenance before and at 12 months of weight loss therapy (0.003 ± 0.003 and 0.008 ± 0.012%·per hour, respectively). We conclude that during dietary calorie restriction and weight loss in older adults, the rate of muscle protein synthesis is not impaired. Thus, the loss of muscle mass must be mediated predominately by adverse effects of dietary calorie restriction on muscle proteolysis.

  4. Effects of added fruits and vegetables on dietary intakes and body weight in Scottish adults.

    PubMed

    Whybrow, Stephen; Harrison, Claire L S; Mayer, Claus; James Stubbs, R

    2006-03-01

    An increased consumption of fruits and vegetables (F&V) has been suggested as a way to limit, or even lower, energy and fat intakes. The present study examined the effects of incorporating F&V supplements into the diets of adults who reported consuming <240 g (three portions) of F&V per d on energy and fat intakes, and change in body weight, over 8 weeks using a randomised parallel design. Thirty-four males and twenty-eight females (age 42.6 (sd 11.1) years, BMI 23.7 (sd 2.7) kg/m(2)) were each provided with supplements of 0, 300 or 600 g F&V per d. Food, nutrient and energy intakes were measured before, during and at the end of the supplementation period using 7 d weighed records. Mean daily energy intakes were not different among the three groups before (P = 0.151) or during the supplementation periods (P = 0.407), although changes in energy intakes over the study period tended to be more positive with increasing amounts of F&V supplements (P = 0.078). There was no difference in changes of body weights during the study (P = 0.242). Carbohydrate (P < 0.001), sugar (P < 0.001), fibre (P < 0.001) and weight of food consumed (P = 0.022) increased in the treatment groups. There were no significant differences, or changes, in fat intakes among the three groups. Consumption of mandatory F&V supplements for 8 weeks produced beneficial changes in diet composition, but did not result in lower reported energy or fat intakes, and did not result in loss of body weight.

  5. Migraine management: How do the adult and paediatric migraines differ?

    PubMed Central

    Sonal Sekhar, M.; Sasidharan, Shalini; Joseph, Siby; Kumar, Anand

    2011-01-01

    Migraine is one of the common causes of severe and recurring headache. It may be difficult to manage in primary care settings, where it is under diagnosed and medically treated. Migraine can occur in children as well as in adults and it is three times more common in women than in men. Migraine in children is different from adults in various ways. Migraine management depends on the various factors like duration and severity of pain, associated symptoms, degree of disability, and initial response to treatment. The therapy of children and adolescents with migraines includes treatment modalities for acute attacks, prophylactic medications when the attacks are frequent, and biobehavioural modes of treatment to aid long-term management of the disorder. The long lasting outcome of childhood headaches and progression into adult headaches remains largely unknown. However, it has been suggested that adult migraine may represent a progressive disorder. In children, the progressive nature is uncertain and further investigations into longitudinal outcome and phenotypic changes in childhood headaches have yet to be recognized. Even though paediatric and adult migraines seem to be slightly different from one another, but not enough to categorize either as sole. PMID:23960771

  6. Predictors of Diet-Induced Weight Loss in Overweight Adults with Type 2 Diabetes

    PubMed Central

    Mulder, Monique T.; Verhoeven, Adrie J. M.; van Wietmarschen, Herman; Boessen, Ruud; Pellis, Linette P.; van t Spijker, Adriaan; Timman, Reinier; Ozcan, Behiye; Sijbrands, Eric J. G.

    2016-01-01

    Aims A very low calorie diet improves the metabolic regulation of obesity related type 2 diabetes, but not for all patients, which leads to frustration in patients and professionals alike. The aim of this study was to develop a prediction model of diet-induced weight loss in type 2 diabetes. Methods 192 patients with type 2 diabetes and BMI>27 kg/m2 from the outpatient diabetes clinic of the Erasmus Medical Center underwent an 8-week very low calorie diet. Baseline demographic, psychological and physiological parameters were measured and the C-index was calculated of the model with the largest explained variance of relative weight loss using backward linear regression analysis. The model was internally validated using bootstrapping techniques. Results Weight loss after the diet was 7.8±4.6 kg (95%CI 7.2–8.5; p<0.001) and was independently associated with the baseline variables fasting glucose (B = -0.33 (95%CI -0.49, -0.18), p = 0.001), anxiety (HADS; B = -0.22 (95%CI -0.34, -0.11), p = 0.001), numb feeling in extremities (B = 1.86 (95%CI 0.85, 2.87), p = 0.002), insulin dose (B = 0.01 (95%CI 0.00, 0.02), p = 0.014) and waist-to-hip ratio (B = 6.79 (95%CI 2.10, 11.78), p = 0.003). This model explained 25% of the variance in weight loss. The C-index of this model to predict successful (≥5%) weight loss was 0.74 (95%CI 0.67–0.82), with a sensitivity of 0.93 (95% CI 0.89–0.97) and specificity of 0.29 (95% CI 0.16–0.42). When only the obese T2D patients (BMI≥30 kg/m2; n = 181) were considered, age also contributed to the model (B = 0.06 (95%CI 0.02, 0.11), p = 0.008), whereas waist-to-hip ratio did not. Conclusions Diet-induced weight loss in overweight adults with T2D was predicted by five baseline parameters, which were predominantly diabetes related. However, failure seems difficult to predict. We propose to test this prediction model in future prospective diet intervention studies in patients with type 2 diabetes. PMID:27494531

  7. Medication Management Assessment for Older Adults in the Community

    ERIC Educational Resources Information Center

    Orwig, Denise; Brandt, Nicole; Gruber-Baldini, Ann L.

    2006-01-01

    Purpose: The purpose of this study was to describe the Medication Management Instrument for Deficiencies in the Elderly (MedMaIDE) and to provide results of reliability and validity testing. Design and Methods: Participants were 50 older adults, aged 65 and older, who lived in the community, took at least one prescription medication, and were then…

  8. Management considerations for the adult with congenital adrenal hyperplasia.

    PubMed

    Auchus, Richard J

    2015-06-15

    The congenital adrenal hyperplasias (CAH) are a group of genetic defects in cortisol biosynthesis, most commonly steroid 21-hydroxylase deficiency (21OHD). With the advent of cortisone therapy in the 1960s and newborn screening in the 1990s, most children with 21OHD now reach adulthood. The needs and concerns of adults with 21OHD overlap with those of children, but the focus and approach shift as these patients reach adulthood. Cohort studies suggest that adults with 21OHD experience significant health concerns such as infertility, obesity, short stature, neoplasia, and bone loss, as well as reduced quality of life. Nevertheless, the spectrum of health status and disease severity is broad, but only some of the reasons for these disparities are known. This review will summarize the current state of knowledge and suggested approaches to management adults with classic 21OHD, plus a few major considerations for adults with nonclassic 21OHD.

  9. Management of Adult Acute Myelogenous Leukaemia

    PubMed Central

    Crowther, D.; Powles, R. L.; Bateman, C. J. T.; Beard, M. E. J.; Gauci, C. L.; Wrigley, P. F. M.; Malpas, J. S.; Fairley, G. Hamilton; Scott, Ronald Bodley

    1973-01-01

    Consecutive adult patients admitted to St. Bartholomew's Hospital with acute myelogenous leukaemia have been treated with a remission induction drug schedule consisting of daunorubicin and cytosine arabinoside. Intermittent five-day courses were used in 72 patients, and a complete remission was obtained in 39 patients (54%). An alternative drug schedule in 22 patients resulted in fewer remissions but this may have been due to age differences in the two groups. Age and initial platelet count were found to be important factors in determining the success of remission induction therapy; the older patients and those with low platelet counts responded less well. A series of 23 patients who achieved remissions was divided into two groups; one received intermittent combination chemotherapy as the only form of maintenance, and the other was given weekly immunotherapy in addition to the chemotherapy. The immunotherapy consisted of irradiated allogeneic leukaemic cells and B.C.G. Eight of the 10 patients on chemotherapy alone have already relapsed compared with five out of 13 patients in the immunotherapy group. It is hoped that these promising initial results with this form of maintenance will be confirmed as more patients enter the maintenance trials. PMID:4513355

  10. Memory function and hippocampal volumes in preterm born very-low-birth-weight (VLBW) young adults.

    PubMed

    Aanes, Synne; Bjuland, Knut Jørgen; Skranes, Jon; Løhaugen, Gro C C

    2015-01-15

    The hippocampi are regarded as core structures for learning and memory functions, which is important for daily functioning and educational achievements. Previous studies have linked reduction in hippocampal volume to working memory problems in very low birth weight (VLBW; ≤ 1500 g) children and reduced general cognitive ability in VLBW adolescents. However, the relationship between memory function and hippocampal volume has not been described in VLBW subjects reaching adulthood. The aim of the study was to investigate memory function and hippocampal volume in VLBW young adults, both in relation to perinatal risk factors and compared to term born controls, and to look for structure-function relationships. Using Wechsler Memory Scale-III and MRI, we included 42 non-disabled VLBW and 61 control individuals at age 19-20 years, and related our findings to perinatal risk factors in the VLBW-group. The VLBW young adults achieved lower scores on several subtests of the Wechsler Memory Scale-III, resulting in lower results in the immediate memory indices (visual and auditory), the working memory index, and in the visual delayed and general memory delayed indices, but not in the auditory delayed and auditory recognition delayed indices. The VLBW group had smaller absolute and relative hippocampal volumes than the controls. In the VLBW group inferior memory function, especially for the working memory index, was related to smaller hippocampal volume, and both correlated with lower birth weight and more days in the neonatal intensive care unit (NICU). Our results may indicate a structural-functional relationship in the VLBW group due to aberrant hippocampal development and functioning after preterm birth.

  11. Birth weight, childhood lower respiratory tract infection, and adult lung function

    PubMed Central

    Shaheen, S; Sterne, J; Tucker, J; Florey, C

    1998-01-01

    BACKGROUND—Historical cohort studies in England have found that impaired fetal growth and lower respiratory tract infections in early childhood are associated with lower levels of lung function in late adult life. These relations are investigated in a similar study in Scotland.
METHODS—In 1985-86 a follow up study was carried out of 1070 children who had been born in St Andrew's from 1921 to 1935 and followed from birth to 14 years of age by the Mackenzie Institute for Medical Research. Recorded information included birth weight and respiratory illnesses. The lung function of 239 of these individuals was measured.
RESULTS—There was no association between birth weight and lung function. Pneumonia before two years of age was associated with a difference in mean forced expiratory volume in one second (FEV1) of −0.39 litres (95% confidence interval (CI) −0.67, −0.11; p = 0.007) and in mean forced vital capacity (FVC) of −0.60 litres (95% CI −0.92, −0.28; p<0.001), after controlling for age, sex, height, smoking, type of spirometer, and other illnesses before two years. Similar reductions were seen in men and women. Bronchitis before two years was associated with smaller deficits in FEV1 and FVC. Asthma or wheeze at two years and older and cough after five years were also associated with a reduction in FEV1.
CONCLUSIONS—The relation between impaired fetal growth and lower lung function in late adult life seen in previous studies was not confirmed in this cohort. The deficits in FEV1 and FVC associated with pneumonia and bronchitis in the first two years of life are consistent with a causal relation.

 PMID:9797752

  12. MOVE! multidisciplinary programs: Challenges and resources for weight management treatment in VHA.

    PubMed

    Rosenberger, Patricia H; Ruser, Christopher; Kashaf, Susan

    2011-12-01

    The MOVE! program has been a successful weight management and physical activity initiative from the Veteran's Health Administration. While it embraces a multicomponent approach to weight management, local facilities have primarily focused on the implementation of delivery of MOVE! educational materials to groups or individuals. We discuss additional MOVE!-related weight management efforts within VHA that reflect treatment strategies beyond delivery of these educational materials. First, we present a case study that highlights the special challenges associated with the Veteran overweight/obese population. Second, we describe the implementation of our local, multidisciplinary, individualized weight management clinic as an example of on-the-ground provision of a higher treatment intensity program as part of MOVE!'s multicomponent model. Third, we present program outcomes and consider challenges to program sustainability.

  13. Fatty, Fatty, Two-by-Four: Weight-Teasing History and Disturbed Eating in Young Adult Women

    PubMed Central

    McWilliams, Rita; Byrd-Bredbenner, Carol

    2013-01-01

    Objective. We investigated the long-term effect of weight teasing during childhood. Methods. Young adult women (n = 1533; aged 18–26 years) from 3 large universities participated in a survey (Fall 2009 to Spring 2010) that assessed disturbed eating behaviors; weight status at ages 6, 12, and 16 years; and weight-teasing history. Results. Nearly half of the participants were weight-teased as a child. Participants who experienced childhood weight teasing were significantly more likely to have disturbed eating behaviors now than non–weight-teased peers. As the variety of weight teasing insults recalled increased, so did disturbed eating behaviors and current body mass index. Those who recalled their weight at ages 6, 12, or 16 years as being heavier than average endured weight teasing significantly more frequently and felt greater distress than their lighter counterparts. Conclusions. Weight teasing may contribute to the development of disturbed eating and eating disorders in young women. Health care professionals, parents, teachers, and other childcare givers must help shift social norms to make weight teasing as unacceptable as other types of bullying. To protect the health of children, efforts to make weight teasing unacceptable are warranted. PMID:23327257

  14. Obesity in Childhood Cancer Survivors: Call for Early Weight Management.

    PubMed

    Zhang, Fang Fang; Parsons, Susan K

    2015-09-01

    A high prevalence of obesity and cardiometabolic conditions has been increasingly recognized in childhood cancer survivors. In particular, survivors of pediatric acute lymphoblastic leukemia have been found to be at risk of becoming overweight or obese early in treatment, with increases in weight maintained throughout treatment and beyond. Nutrition plays an important role in the etiology of obesity and cardiometabolic conditions and is among the few modifiable factors that can prevent or delay the early onset of these chronic conditions. However, nutritional intake in childhood cancer survivors has not been adequately examined and the evidence is built on data from small cohorts of survivors. In addition, the long-term impact of cancer diagnosis and treatment on survivors' nutritional intake as well as how survivors' nutritional intake is associated with chronic health conditions have not been well quantified in large-scale studies. Promoting family-based healthy lifestyles, preferably at a sensitive window of unhealthy weight gain, is a priority for preventing the early onset of obesity and cardiometabolic conditions in childhood cancer survivors.

  15. Orange Juice Limits Postprandial Fat Oxidation after Breakfast in Normal-Weight Adolescents and Adults123

    PubMed Central

    Stookey, Jodi Dunmeyer; Hamer, Janice; Espinoza, Gracie; Higa, Annie; Ng, Vivian; Tinajero-Deck, Lydia; Havel, Peter J.; King, Janet C.

    2012-01-01

    Caloric beverages may promote weight gain by simultaneously increasing total energy intake and limiting fat oxidation. During moderate intensity exercise, caloric beverage intake depresses fat oxidation by 25% or more. This randomized crossover study describes the impact of having a caloric beverage with a typical meal on fat oxidation under resting conditions. On 2 separate days, healthy normal-weight adolescents (n = 7) and adults (n = 10) consumed the same breakfast with either orange juice or drinking water and sat at rest for 3 h after breakfast. The meal paired with orange juice was 882 kJ (210 kcal) higher than the meal paired with drinking water. Both meals contained the same amount of fat (12 g). For both age groups, both meals resulted in a net positive energy balance 150 min after breakfast. Resting fat oxidation 150 min after breakfast was significantly lower after breakfast with orange juice, however. The results suggest that, independent of a state of energy excess, when individuals have a caloric beverage instead of drinking water with a meal, they are less likely to oxidize the amount of fat consumed in the meal before their next meal. PMID:22798004

  16. Process Evaluation Results from an Environmentally Focused Worksite Weight Management Study

    ERIC Educational Resources Information Center

    DeJoy, David M.; Wilson, Mark G.; Padilla, Heather M.; Goetzel, Ron Z.; Parker, Kristin B.; Della, Lindsay J.; Roemer, Enid C.

    2012-01-01

    There is currently much interest in exploring environmental approaches to combat weight gain and obesity. This study presents process evaluation results from a workplace-based study that tested two levels of environmentally focused weight management interventions in a manufacturing setting. The moderate treatment featured a set of relatively…

  17. Adjunctive Use of Appetite Suppressant Medications for Improved Weight Management in Bariatric Surgical Patients.

    PubMed

    Jester; Wittgrove; Clark

    1996-10-01

    BACKGROUND: Patients who undergo bariatric surgery sometimes experience late onset or weight gain, when they lapse into negative eating patterns, which adversely affect weight management. Long-term weight management is a process, with a surgical foundation, and requiring adjunctive strategies for best results. We sought to determine if appetite suppressant medications could be safely incorporated into a comprehensive program of weight management. METHODS: Subjects were at least 18 months postoperative, were accessible for weekly follow-up, and weighed at least 9 kg more than their ideal body weight. Phentermine and fenfluramine were prescribed in combination, at the lowest dose necessary to achieve comfortable appetite suppression. RESULTS: Weight losses ranged from 4.5 to 22.7 kg, over a 12-week course of treatment, corresponding to 8-65% of excess body weight. Most side-effects were minor, and did not require cessation of treatment. Two patients discontinued treatment due to side-effects which were unacceptable to them. CONCLUSION: Phentermine and fenfluramine are a safe and useful adjunct to a comprehensive program of weight management.

  18. An AHP-Based Weighted Analysis of Network Knowledge Management Platforms for Elementary School Students

    ERIC Educational Resources Information Center

    Lee, Chung-Ping; Lou, Shi-Jer; Shih, Ru-Chu; Tseng, Kuo-Hung

    2011-01-01

    This study uses the analytical hierarchy process (AHP) to quantify important knowledge management behaviors and to analyze the weight scores of elementary school students' behaviors in knowledge transfer, sharing, and creation. Based on the analysis of Expert Choice and tests for validity and reliability, this study identified the weight scores of…

  19. Undergrad and Overweight: An Online Behavioral Weight Management Program for College Students

    ERIC Educational Resources Information Center

    Harvey-Berino, Jean; Pope, Lizzy; Gold, Beth Casey; Leonard, Heather; Belliveau, Cynthia

    2012-01-01

    Objective: Explore the feasibility of an online behavioral weight management program for college students. Methods: The program focused on behavioral strategies to modify eating and exercise behaviors of students interested in losing weight and/or developing a healthy lifestyle. Specific tools included weekly chat meetings with a facilitator,…

  20. Adherence to a multi-component weight management program for Mexican American adolescents

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This study examined weight loss among Mexican American students in a weight management program. A total of 358 participants completed a 12-week intervention that incorporated four program components: nutrition education (NE), physical activity (PA), sedentary behavior (SB), and a snacking interventi...

  1. Increasing metabolic rate despite declining body weight in an adult parasitoid wasp.

    PubMed

    Casas, Jérôme; Body, Mélanie; Gutzwiller, Florence; Giron, David; Lazzari, Claudio R; Pincebourde, Sylvain; Richard, Romain; Llandres, Ana L

    2015-08-01

    Metabolic rate is a positive function of body weight, a rule valid for most organisms and the basis of several theories of metabolic ecology. For adult insects, however, the diversity of relationships between body mass and respiration remains unexplained. The aim of this study is to relate the respiratory metabolism of a parasitoid with body weight and foraging activity. We compared the metabolic rate of groups of starving and host-fed females of the parasitoid Eupelmus vuilleti recorded with respirometry for 7days, corresponding to the mean lifetime of starving females and over half of the lifetime of foraging females. The dynamics of carbohydrate, lipid and protein in the body of foraging females were quantified with biochemical techniques. Body mass and all body nutrients declined sharply from the first day onwards. By contrast, the CO2 produced and the O2 consumed increased steadily. Starving females showed the opposite trend, identifying foraging as the reason for the respiration increase of feeding females. Two complementary physiological processes explain the unexpected relationship between increasing metabolic rate and declining body weight. First, host hemolymph is a highly unbalanced food, and the excess nutrients (protein and carbohydrate) need to be voided, partially through excretion and partially through respiration. Second, a foraging young female produces eggs at an increasing rate during the first half of its lifetime, a process that also increases respiration. We posit that the time-varying metabolic rate contributions of the feeding and reproductive processes supplements the contribution of the structural mass and lead to the observed trend. We extend our explanations to other insect groups and discuss the potential for unification using Dynamic Energy Budget theory.

  2. Missing an opportunity: the embedded nature of weight management in primary care.

    PubMed

    Asselin, J; Osunlana, A M; Ogunleye, A A; Sharma, A M; Campbell-Scherer, D

    2015-12-01

    The 5As Team study was designed to create, implement and evaluate a flexible intervention to improve the quality and quantity of weight management visits in primary care. The objective of this portion of the study was to explore how primary care providers incorporate weight management in their practice. 5AsT is a randomized controlled trial (RCT) on the implementation of a 6-month 5 As Team (5AsT) intervention designed to operationalize the 5As of obesity management in primary care. Data for the qualitative portion of the study presented here included semi-structured interviews with 29 multidisciplinary team providers and field notes of intervention sessions. Thematic analysis was undertaken. A key pattern that emerged from the data was that healthcare providers usually do not address obesity as a primary focus for a visit. Rather, obesity is embedded in a wide range of primary care encounters for other conditions. Implications were it can take extra time to discuss weight, it can be inappropriate to bring up weight as a topic, and treating risk factors and root causes of obesity have indirect benefits to patient weight management. Our findings have implications for obesity treatment approaches and tools that assume a discreet weight management visit. The embedded nature of obesity management in primary care can be harnessed to leverage multiple opportunities for asking and assessing root causes of obesity, and working longitudinally towards individual health goals.

  3. Metabolic Signatures of Adiposity in Young Adults: Mendelian Randomization Analysis and Effects of Weight Change

    PubMed Central

    Würtz, Peter; Wang, Qin; Kangas, Antti J.; Richmond, Rebecca C.; Skarp, Joni; Tiainen, Mika; Tynkkynen, Tuulia; Soininen, Pasi; Havulinna, Aki S.; Kaakinen, Marika; Viikari, Jorma S.; Savolainen, Markku J.; Kähönen, Mika; Lehtimäki, Terho; Männistö, Satu; Blankenberg, Stefan; Zeller, Tanja; Laitinen, Jaana; Pouta, Anneli; Mäntyselkä, Pekka; Vanhala, Mauno; Elliott, Paul; Pietiläinen, Kirsi H.; Ripatti, Samuli; Salomaa, Veikko; Raitakari, Olli T.; Järvelin, Marjo-Riitta; Smith, George Davey; Ala-Korpela, Mika

    2014-01-01

    Background Increased adiposity is linked with higher risk for cardiometabolic diseases. We aimed to determine to what extent elevated body mass index (BMI) within the normal weight range has causal effects on the detailed systemic metabolite profile in early adulthood. Methods and Findings We used Mendelian randomization to estimate causal effects of BMI on 82 metabolic measures in 12,664 adolescents and young adults from four population-based cohorts in Finland (mean age 26 y, range 16–39 y; 51% women; mean ± standard deviation BMI 24±4 kg/m2). Circulating metabolites were quantified by high-throughput nuclear magnetic resonance metabolomics and biochemical assays. In cross-sectional analyses, elevated BMI was adversely associated with cardiometabolic risk markers throughout the systemic metabolite profile, including lipoprotein subclasses, fatty acid composition, amino acids, inflammatory markers, and various hormones (p<0.0005 for 68 measures). Metabolite associations with BMI were generally stronger for men than for women (median 136%, interquartile range 125%–183%). A gene score for predisposition to elevated BMI, composed of 32 established genetic correlates, was used as the instrument to assess causality. Causal effects of elevated BMI closely matched observational estimates (correspondence 87%±3%; R2 = 0.89), suggesting causative influences of adiposity on the levels of numerous metabolites (p<0.0005 for 24 measures), including lipoprotein lipid subclasses and particle size, branched-chain and aromatic amino acids, and inflammation-related glycoprotein acetyls. Causal analyses of certain metabolites and potential sex differences warrant stronger statistical power. Metabolite changes associated with change in BMI during 6 y of follow-up were examined for 1,488 individuals. Change in BMI was accompanied by widespread metabolite changes, which had an association pattern similar to that of the cross-sectional observations, yet with greater metabolic

  4. Management of Parapneumonic Pleural Effusion in Adults.

    PubMed

    Ferreiro, Lucía; San José, María Esther; Valdés, Luis

    2015-12-01

    Pleural infections have high morbidity and mortality, and their incidence in all age groups is growing worldwide. Not all infectious effusions are parapneumonic and, in such cases, the organisms found in the pleural space are not the same as those observed in lung parenchyma infections. The diagnostic difficulty lies in knowing whether an infectious effusion will evolve into a complicated effusion/empyema, as the diagnostic methods used for this purpose provide poor results. The mainstays of treatment are to establish an early diagnosis and to commence an antibiotic regimen and chest drain as soon as possible. This should preferably be carried out with fine tubes, due to certain morphological, bacteriological and biochemical characteristics of the pleural fluid. Fluid analysis, particularly pH, is the most reliable method for assessing evolution. In a subgroup of patients, fibrinolytics may help to improve recovery, and their combination with DNase has been found to obtain better results. If medical treatment fails and surgery is required, video-assisted thoracoscopic surgery (VATS) is, at least, comparable to decortication by thoracotomy, so should only undertaken if previous techniques have failed. Further clinical trials are needed to analyze factors that could affect the results obtained, in order to define new evidence-based diagnostic and therapeutic strategies that provide more effective, standardized management of this disease.

  5. Nutrigenomic Analysis of Diet-Gene Interactions on Functional Supplements for Weight Management

    PubMed Central

    Lau, Francis C; Bagchi, Manashi; Sen, Chandan; Roy, Sashwati; Bagchi, Debasis

    2008-01-01

    Recent advances in molecular biology combined with the wealth of information generated by the Human Genome Project have fostered the emergence of nutrigenomics, a new discipline in the field of nutritional research. Nutrigenomics may provide the strategies for the development of safe and effective dietary interventions against the obesity epidemic. According to the World Health Organization, more than 60% of the global disease burden will be attributed to chronic disorders associated with obesity by 2020. Meanwhile in the US, the prevalence of obesity has doubled in adults and tripled in children during the past three decades. In this regard, a number of natural dietary supplements and micronutrients have been studied for their potential in weight management. Among these supplements, (–)-hydroxycitric acid (HCA), a natural extract isolated from the dried fruit rind of Garcinia cambogia, and the micronutrient niacin-bound chromium(III) (NBC) have been shown to be safe and efficacious for weight loss. Utilizing cDNA microarrays, we demonstrated for the first time that HCA-supplementation altered the expression of genes involved in lipolytic and adipogenic pathways in adipocytes from obese women and up-regulated the expression of serotonin receptor gene in the abdominal fat of rats. Similarly, we showed that NBC-supplementation up-regulated the expression of myogenic genes while suppressed the expression of genes that are highly expressed in brown adipose tissue in diabetic obese mice. The potential biological mechanisms underlying the observed beneficial effects of these supplements as elucidated by the state-of-the-art nutrigenomic technologies will be systematically discussed in this review. PMID:19452041

  6. Accuracy of Heart Rate Watches: Implications for Weight Management

    PubMed Central

    2016-01-01

    Background Wrist-worn monitors claim to provide accurate measures of heart rate and energy expenditure. People wishing to lose weight use these devices to monitor energy balance, however the accuracy of these devices to measure such parameters has not been established. Aim To determine the accuracy of four wrist-worn devices (Apple Watch, Fitbit Charge HR, Samsung Gear S and Mio Alpha) to measure heart rate and energy expenditure at rest and during exercise. Methods Twenty-two healthy volunteers (50% female; aged 24 ± 5.6 years) completed ~1-hr protocols involving supine and seated rest, walking and running on a treadmill and cycling on an ergometer. Data from the devices collected during the protocol were compared with reference methods: electrocardiography (heart rate) and indirect calorimetry (energy expenditure). Results None of the devices performed significantly better overall, however heart rate was consistently more accurate than energy expenditure across all four devices. Correlations between the devices and reference methods were moderate to strong for heart rate (0.67–0.95 [0.35 to 0.98]) and weak to strong for energy expenditure (0.16–0.86 [-0.25 to 0.95]). All devices underestimated both outcomes compared to reference methods. The percentage error for heart rate was small across the devices (range: 1–9%) but greater for energy expenditure (9–43%). Similarly, limits of agreement were considerably narrower for heart rate (ranging from -27.3 to 13.1 bpm) than energy expenditure (ranging from -266.7 to 65.7 kcals) across devices. Conclusion These devices accurately measure heart rate. However, estimates of energy expenditure are poor and would have implications for people using these devices for weight loss. PMID:27232714

  7. Associations among self-perceived work and life stress, trouble sleeping, physical activity, and body weight among Canadian adults.

    PubMed

    Sampasa-Kanyinga, Hugues; Chaput, Jean-Philippe

    2017-03-01

    We investigated the associations among self-perceived work and life stress, trouble sleeping, physical activity and body weight among Canadian adults, and tested whether trouble sleeping and physical activity moderated the relationship between work/life stress and body weight, and whether work/life stress and physical activity moderated the relationship between trouble sleeping and body weight. Data on 13,926 Canadian adults aged 20years and older were derived from the nationally representative 2012 Canadian Community Health Survey. After adjusting for age, sex, education level, household income, marital status and job insecurity, self-perceived work and life stress and trouble sleeping were associated with a higher BMI. The associations of work and life stress with higher BMI were independent of trouble sleeping and physical activity in addition to other covariates, while that of trouble sleeping and higher BMI was independent of work and life stress. Results further indicated that trouble sleeping among inactive participants was related to a higher BMI; however, this relationship was almost null for adults who self-reported being physically active for about 8h/week. These findings suggest that work and life stress are both associated with excess weight in adults, regardless of physical activity level, while the link of trouble sleeping with BMI varies by physical activity level. Future research is necessary to determine whether reducing work and life stress and improving sleep habits would benefit the prevention of weight gain and obesity.

  8. Conservative Management of a Young Adult with Hip Arthrosis

    PubMed Central

    Cook, Kyle M.; Heiderscheit, Bryan

    2010-01-01

    Study Design Case report Background Clinical practice guidelines regarding the conservative management of degenerative hip conditions in older adults routinely incorporate therapeutic exercise and manual therapy. However, the application of these recommendations to young, active adults is less clear. The purpose of this case report is to describe the management of a young adult with advanced hip arthrosis using a multi-faceted rehabilitation program. Case Description A 28-year old female with severe left hip degeneration per diagnostic imaging was referred to physical therapy. Reduced hip range of motion and strength, sacroiliac joint asymmetries, and a modified Harris Hip Score of 76 were observed. She was seen for 12 visits over a 3-month period and treated with an individualized program including manual therapy, therapeutic exercise, and neuromuscular re-education. Outcome Substantial improvements were noted in pain, hip range of motion and strength and function (modified Harris Hip Score of 97). In addition, she discontinued the use of anti-inflammatory medications and returned to her prior level of activity. Improvements were maintained at a 3 month follow up, with symptom recurrence managed using a self mobilization technique to the left hip and massage to the left iliopsoas. Discussion Degenerative hip conditions are common among older adults but are relatively rare in the younger population. Although it is likely that this patient will experience a return of her symptoms and functional limitations as her hip disease progresses, the immediate improvements may delay the need for eventual surgical management. These outcomes suggest that physical therapy management should be considered in those with an early onset of degenerative hip disease and are consistent with results previously reported in the older population. Level of Evidence Therapy, Level 4 PMID:20026881

  9. Correlations of decision weights and cognitive function for the masked discrimination of vowels by young and old adults.

    PubMed

    Gilbertson, Lynn; Lutfi, Robert A

    2014-11-01

    Older adults are often reported in the literature to have greater difficulty than younger adults understanding speech in noise [Helfer and Wilber (1988). J. Acoust. Soc. Am, 859-893]. The poorer performance of older adults has been attributed to a general deterioration of cognitive processing, deterioration of cochlear anatomy, and/or greater difficulty segregating speech from noise. The current work used perturbation analysis [Berg (1990). J. Acoust. Soc. Am., 149-158] to provide a more specific assessment of the effect of cognitive factors on speech perception in noise. Sixteen older (age 56-79 years) and seventeen younger (age 19-30 years) adults discriminated a target vowel masked by randomly selected masker vowels immediately preceding and following the target. Relative decision weights on target and maskers resulting from the analysis revealed large individual differences across participants despite similar performance scores in many cases. On the most difficult vowel discriminations, the older adult decision weights were significantly correlated with inhibitory control (Color Word Interference test) and pure-tone threshold averages (PTA). Young adult decision weights were not correlated with any measures of peripheral (PTA) or central function (inhibition or working memory).

  10. Correlations of decision weights and cognitive function for the masked discrimination of vowels by young and old adults

    PubMed Central

    Lutfi, Robert A.

    2014-01-01

    Older adults are often reported in the literature to have greater difficulty than younger adults understanding speech in noise [Helfer and Wilber (1988). J. Acoust. Soc. Am, 859–893]. The poorer performance of older adults has been attributed to a general deterioration of cognitive processing, deterioration of cochlear anatomy, and/or greater difficulty segregating speech from noise. The current work used perturbation analysis [Berg (1990). J. Acoust. Soc. Am., 149–158] to provide a more specific assessment of the effect of cognitive factors on speech perception in noise. Sixteen older (age 56–79 years) and seventeen younger (age 19–30 years) adults discriminated a target vowel masked by randomly selected masker vowels immediately preceding and following the target. Relative decision weights on target and maskers resulting from the analysis revealed large individual differences across participants despite similar performance scores in many cases. On the most difficult vowel discriminations, the older adult decision weights were significantly correlated with inhibitory control (Color Word Interference test) and pure-tone threshold averages (PTA). Young adult decision weights were not correlated with any measures of peripheral (PTA) or central function (inhibition or working memory). PMID:25256580

  11. Effects of Weight Loss on Foot Structure and Function in Obese Adults: A Pilot Randomized Controlled Trial

    PubMed Central

    Song, Jinsup; Kane, Reagan; Tango, Dana N.; Vander Veur, Stephanie S.; Furmato, James; Komaroff, Eugene; Foster, Gary D.

    2015-01-01

    Objective To investigate the effects of weight reduction on foot structure, gait, and dynamic plantar loading in obese adults. Design In a 3-month randomized-controlled trial, participants were randomized to receive either a weight loss intervention based on portion-controlled meals or a delayed-treatment control. Participants 41 adults (32 F, 9 M) with a mean + SD age of 56.2 + 4.7 years and a BMI of 35.9 + 4.2 kg/m2. Measurements Arch Height Index (AHI), Malleolar Valgus Index (MVI), spatial and temporal gait parameters, plantar peak pressure (PP) and weight were measured at baseline, 3, and 6 months. Results The intervention group experienced significantly greater weight loss than did the control group (5.9 ± 4.0 kg versus 1.9 ± 3.2 kg, p = 0.001) after 3 months. There were no differences between the groups in anatomical foot structure or gait. However, the treatment group showed a significantly reduced PP than the control group beneath the lateral arch and the metatarsals 4 (all P values < .05) at 3 months. The change in PP correlated significantly with the change in weight at the metatarsal 2 (r=0.57, p=0.0219), metatarsal 3 (r=0.56, p=0.0064) and the medial arch (r=0.26, p<0.0001) at 6 months. Conclusion This was the first RCT designed to assess the effects of weight loss on foot structure, gait, and plantar loading in obese adults. Even a modest weight loss significantly reduced the dynamic plantar loading in obese adults. However, weight loss appeared to have no effects on foot structure and gait. PMID:25245307

  12. Antenatal Weight Management: Women's Experiences, Behaviours, and Expectations of Weighing in Early Pregnancy

    PubMed Central

    Swift, J. A.; Pearce, J.; Jethwa, P. H.; Taylor, M. A.; Ellis, S.; McMullen, S.

    2016-01-01

    The current emphasis on obstetric risk management helps to frame gestational weight gain as problematic and encourages intervention by healthcare professionals. However pregnant women have reported confusion, distrust, and negative effects associated with antenatal weight management interactions. The MAGIC study (MAnaging weiGht In pregnanCy) sought to examine women's self-reported experiences of usual-care antenatal weight management in early pregnancy and consider these alongside weight monitoring behaviours and future expectations. 193 women (18 yrs+) were recruited from routine antenatal clinics at the Nottingham University Hospital NHS Trust. Self-reported gestation was 10–27 weeks, with 41.5% (n = 80) between 12 and 14 and 43.0% (n = 83) between 20 and 22 weeks. At recruitment 50.3% of participants (n = 97) could be classified as overweight or obese. 69.4% of highest weight women (≥30 kg/m2) did not report receiving advice about weight, although they were significantly more likely compared to women with BMI < 30 kg/m2. The majority of women (regardless of BMI) did not express any barriers to being weighed and 40.8% reported weighing themselves at home. Women across the BMI categories expressed a desire for more engagement from healthcare professionals on the issue of bodyweight. Women are clearly not being served appropriately in the current situation which simultaneously problematizes and fails to offer constructive dialogue. PMID:27843648

  13. Making claims: functional foods for managing appetite and weight.

    PubMed

    Blundell, John

    2010-01-01

    Functional food products promote claims such as 'freedom from hunger' and 'feel fuller for longer'. A legislative framework has been established by the European Food Safety Authority to evaluate the validity of such claims: a claim must be substantiated by scientific evidence and should be clearly understood by consumers. Since consumed foods influence appetite by means of a system of physiological satiety signals, functional foods could in principle act by increasing the potency and/or duration of these signals. Importantly, what constitutes a useful action: a reduction in hunger, an increase in fullness, a change in food intake at a meal, an adjustment in daily energy balance or a reduction in body weight? Any claim should not go beyond the scientific evidence of an effect, and methods exist to scientifically evaluate claims. The wording of a claim is, therefore, critical. The difference between a proof of concept and a guarantee of success is an important point that needs to be conveyed to the consumer.

  14. Attitudinal familism predicts weight management adherence in Mexican-American women.

    PubMed

    Austin, Julia L; Smith, Jane Ellen; Gianini, Loren; Campos-Melady, Marita

    2013-06-01

    Adherence to behavioral weight management programs is often limited, especially among ethnic minority populations. The current study examined whether attitudinal familism, or attention to the needs of family above those of the self, predicted poorer adherence to a behavioral weight management program in Mexican-American women. One-hundred overweight or obese Mexican-American women from the southwestern United States were enrolled in a group-based weight loss treatment. Zero-order correlations indicated that general commitment to attitudinal familism, as measured by the Attitudinal Familism Scale, was significantly negatively associated with calorie and physical activity goal completion and marginally negatively associated with session attendance. The results of the current study indicate that researchers may consider addressing familism when developing tailored weight management interventions for Mexican-American women.

  15. Technology-based interventions for weight management: current randomized controlled trial evidence and future directions.

    PubMed

    Kozak, Andrea T; Buscemi, Joanna; Hawkins, Misty A W; Wang, Monica L; Breland, Jessica Y; Ross, Kathryn M; Kommu, Anupama

    2017-02-01

    Obesity is a prevalent health care issue associated with disability, premature morality, and high costs. Behavioral weight management interventions lead to clinically significant weight losses in overweight and obese individuals; however, many individuals are not able to participate in these face-to-face treatments due to limited access, cost, and/or time constraints. Technological advances such as widespread access to the Internet, increased use of smartphones, and newer behavioral self-monitoring tools have resulted in the development of a variety of eHealth weight management programs. In the present paper, a summary of the most current literature is provided along with potential solutions to methodological challenges (e.g., high attrition, minimal participant racial/ethnic diversity, heterogeneity of technology delivery modes). Dissemination and policy implications will be highlighted as future directions for the field of eHealth weight management.

  16. Technology-Assisted Weight Management Interventions: Systematic Review of Clinical Trials

    PubMed Central

    Stephens, Janna; Patel, Angel

    2014-01-01

    Abstract Introduction: More than one-third of U.S. adults are obese, which greatly increases their risks for type 2 diabetes, cardiovascular disease, and some types of cancer. Busy healthcare professionals need effective tools and strategies to facilitate healthy eating and increase physical activity, thus promoting weight loss in their patients. Communication technologies such as the Internet and mobile devices offer potentially powerful methodologies to deliver behavioral weight loss interventions, and researchers have studied a variety of technology-assisted approaches. Materials and Methods: The literature from 2002 to 2012 was systematically reviewed by examining clinical trials of technology-assisted interventions for weight loss or weight maintenance among overweight and obese adults. Results: In total, 2,011 citations from electronic databases were identified; 39 articles were eligible for inclusion. Findings suggest that the use of technology-assisted behavioral interventions, particularly those that incorporate text messaging or e-mail, may be effective for producing weight loss among overweight and obese adults. Conclusions: Only a small percentage of the 39 studies reviewed used mobile platforms such as Android® (Google, Mountain View, CA) phones or the iPhone® (Apple, Cupertino, CA), only two studies incorporated cost analysis, none was able to identify which features were most responsible for changes in outcomes, and few reported long-term outcomes. All of these areas are important foci for future research. PMID:25409001

  17. Managing type 2 diabetes: balancing HbA1c and body weight.

    PubMed

    Mavian, Annie A; Miller, Stephan; Henry, Robert R

    2010-05-01

    Most patients with type 2 diabetes present with comorbid overweight or obesity. Reaching and maintaining acceptable glycemic control is more difficult in overweight and obese patients, and these conditions are associated with increased risk for cardiovascular and other diseases. Glycemic management for these patients is complicated by the fact that insulin and many of the oral medications available to treat type 2 diabetes produce additional weight gain. However, an increasing number of therapeutic options are available that are weight neutral or lead to weight loss in addition to their glycemic benefits. This article evaluates the evidence from clinical trials regarding the relative glycemic benefits, measured in terms of glycated hemoglobin change, versus the impact on body weight of each medication currently approved for type 2 diabetes. In general, the sulfonylureas, thiazolidinediones, and D-phenylalanine derivatives have been shown to promote weight gain. The dipeptidyl peptidase-4 inhibitors are weight neutral, while the biguanides, incretin mimetics, and amylin mimetics promote weight loss. Trials examining the glycemic benefits of the weight loss agents orlistat and sibutramine are also examined. Awareness of this evidence base can be used to inform medication selection in support of weight management goals for patients with type 2 diabetes.

  18. An EASO position statement on multidisciplinary obesity management in adults.

    PubMed

    Yumuk, Volkan; Frühbeck, Gema; Oppert, Jean Michel; Woodward, Euan; Toplak, Hermann

    2014-01-01

    Obesity has proven to be a gateway to ill health. It has already reached epidemic proportions becoming one of the leading causes of death and disability in Europe and world-wide. Obesity plays a central role in the development of a number of risk factors and chronic diseases like hypertension, dyslipidaemia and type 2 diabetes mellitus inducing cardiovascular morbidity and mortality. Therefore weight management plays a central role in controlling the respective risk factors and their consequences. Obesity is a complex condition of multifactorial origin. Biological but also psychological and social factors interfere to lead to excess body weight and its deleterious outcomes. Obesity management cannot focus any more only on weight (and BMI) reduction. More attention is to be paid to waist circumference (or waist-to-hip ratio, especially in females), the improvement in body composition (measured with body composition tracking systems like BOD POD, dual energy X-ray absorptiometry or bioelectrical impedance analysis) which is focusing on ameliorating or maintaining fat-free mass and decreasing fat mass. Management of co-morbidities, improving quality of life and well-being of obese patients are also included in treatment aims. This statement emphasises the importance of a comprehensive approach to obesity management.

  19. Management of gonococcal infection among adults and youth

    PubMed Central

    Pogany, Lisa; Romanowski, Barbara; Robinson, Joan; Gale-Rowe, Margaret; Latham-Carmanico, Cathy; Weir, Christine; Wong, Tom

    2015-01-01

    Abstract Objective To provide recommendations on the management of gonococcal infection among adults and youth. Quality of evidence Treatment recommendations in the Canadian guidelines on sexually transmitted infections are based on review of the literature, as well as the grades of recommendations and the levels of evidence quality determined by a minimum of 2 reviewers. The recommendations are peer-reviewed and require approval by the expert working group. Main message The new key recommendations for managing gonococcal infection among adults and youth include using culture as a diagnostic tool when practical, providing treatment with combination antibiotic therapy (ceftriaxone combined with azithromycin), and promptly reporting all cases with treatment failure to public health. Conclusion Following these new key recommendations might reduce treatment failure, contribute to better surveillance of antibiotic-resistance trends in Neisseria gonorrhoeae, and contribute to the prevention of transmission of multidrug-resistant gonorrhea. PMID:26472793

  20. Genome-wide associations for birth weight and correlations with adult disease.

    PubMed

    Horikoshi, Momoko; Beaumont, Robin N; Day, Felix R; Warrington, Nicole M; Kooijman, Marjolein N; Fernandez-Tajes, Juan; Feenstra, Bjarke; van Zuydam, Natalie R; Gaulton, Kyle J; Grarup, Niels; Bradfield, Jonathan P; Strachan, David P; Li-Gao, Ruifang; Ahluwalia, Tarunveer S; Kreiner, Eskil; Rueedi, Rico; Lyytikäinen, Leo-Pekka; Cousminer, Diana L; Wu, Ying; Thiering, Elisabeth; Wang, Carol A; Have, Christian T; Hottenga, Jouke-Jan; Vilor-Tejedor, Natalia; Joshi, Peter K; Boh, Eileen Tai Hui; Ntalla, Ioanna; Pitkänen, Niina; Mahajan, Anubha; van Leeuwen, Elisabeth M; Joro, Raimo; Lagou, Vasiliki; Nodzenski, Michael; Diver, Louise A; Zondervan, Krina T; Bustamante, Mariona; Marques-Vidal, Pedro; Mercader, Josep M; Bennett, Amanda J; Rahmioglu, Nilufer; Nyholt, Dale R; Ma, Ronald C W; Tam, Claudia H T; Tam, Wing Hung; Ganesh, Santhi K; van Rooij, Frank J A; Jones, Samuel E; Loh, Po-Ru; Ruth, Katherine S; Tuke, Marcus A; Tyrrell, Jessica; Wood, Andrew R; Yaghootkar, Hanieh; Scholtens, Denise M; Paternoster, Lavinia; Prokopenko, Inga; Kovacs, Peter; Atalay, Mustafa; Willems, Sara M; Panoutsopoulou, Kalliope; Wang, Xu; Carstensen, Lisbeth; Geller, Frank; Schraut, Katharina E; Murcia, Mario; van Beijsterveldt, Catharina E M; Willemsen, Gonneke; Appel, Emil V R; Fonvig, Cilius E; Trier, Caecilie; Tiesler, Carla M T; Standl, Marie; Kutalik, Zoltán; Bonàs-Guarch, Sílvia; Hougaard, David M; Sánchez, Friman; Torrents, David; Waage, Johannes; Hollegaard, Mads V; de Haan, Hugoline G; Rosendaal, Frits R; Medina-Gomez, Carolina; Ring, Susan M; Hemani, Gibran; McMahon, George; Robertson, Neil R; Groves, Christopher J; Langenberg, Claudia; Luan, Jian'an; Scott, Robert A; Zhao, Jing Hua; Mentch, Frank D; MacKenzie, Scott M; Reynolds, Rebecca M; Lowe, William L; Tönjes, Anke; Stumvoll, Michael; Lindi, Virpi; Lakka, Timo A; van Duijn, Cornelia M; Kiess, Wieland; Körner, Antje; Sørensen, Thorkild I A; Niinikoski, Harri; Pahkala, Katja; Raitakari, Olli T; Zeggini, Eleftheria; Dedoussis, George V; Teo, Yik-Ying; Saw, Seang-Mei; Melbye, Mads; Campbell, Harry; Wilson, James F; Vrijheid, Martine; de Geus, Eco J C N; Boomsma, Dorret I; Kadarmideen, Haja N; Holm, Jens-Christian; Hansen, Torben; Sebert, Sylvain; Hattersley, Andrew T; Beilin, Lawrence J; Newnham, John P; Pennell, Craig E; Heinrich, Joachim; Adair, Linda S; Borja, Judith B; Mohlke, Karen L; Eriksson, Johan G; Widén, Elisabeth; Kähönen, Mika; Viikari, Jorma S; Lehtimäki, Terho; Vollenweider, Peter; Bønnelykke, Klaus; Bisgaard, Hans; Mook-Kanamori, Dennis O; Hofman, Albert; Rivadeneira, Fernando; Uitterlinden, André G; Pisinger, Charlotta; Pedersen, Oluf; Power, Christine; Hyppönen, Elina; Wareham, Nicholas J; Hakonarson, Hakon; Davies, Eleanor; Walker, Brian R; Jaddoe, Vincent W V; Järvelin, Marjo-Riitta; Grant, Struan F A; Vaag, Allan A; Lawlor, Debbie A; Frayling, Timothy M; Smith, George Davey; Morris, Andrew P; Ong, Ken K; Felix, Janine F; Timpson, Nicholas J; Perry, John R B; Evans, David M; McCarthy, Mark I; Freathy, Rachel M

    2016-10-13

    Birth weight (BW) has been shown to be influenced by both fetal and maternal factors and in observational studies is reproducibly associated with future risk of adult metabolic diseases including type 2 diabetes (T2D) and cardiovascular disease. These life-course associations have often been attributed to the impact of an adverse early life environment. Here, we performed a multi-ancestry genome-wide association study (GWAS) meta-analysis of BW in 153,781 individuals, identifying 60 loci where fetal genotype was associated with BW (P < 5 × 10(-8)). Overall, approximately 15% of variance in BW was captured by assays of fetal genetic variation. Using genetic association alone, we found strong inverse genetic correlations between BW and systolic blood pressure (Rg = -0.22, P = 5.5 × 10(-13)), T2D (Rg = -0.27, P = 1.1 × 10(-6)) and coronary artery disease (Rg = -0.30, P = 6.5 × 10(-9)). In addition, using large -cohort datasets, we demonstrated that genetic factors were the major contributor to the negative covariance between BW and future cardiometabolic risk. Pathway analyses indicated that the protein products of genes within BW-associated regions were enriched for diverse processes including insulin signalling, glucose homeostasis, glycogen biosynthesis and chromatin remodelling. There was also enrichment of associations with BW in known imprinted regions (P = 1.9 × 10(-4)). We demonstrate that life-course associations between early growth phenotypes and adult cardiometabolic disease are in part the result of shared genetic effects and identify some of the pathways through which these causal genetic effects are mediated.

  1. Chia seed does not promote weight loss or alter disease risk factors in overweight adults.

    PubMed

    Nieman, David C; Cayea, Erin J; Austin, Melanie D; Henson, Dru A; McAnulty, Steven R; Jin, Fuxia

    2009-06-01

    The objective of this study was to assess the effectiveness of chia seed (Salvia hispanica L) in promoting weight loss and altering disease risk factors in overweight adults. The hypothesis was that the high dietary fiber and alpha-linolenic (ALA) contents of chia seed would induce a small but significant decrease in body weight and fat and improve disease risk factors. Subjects were randomized to chia seed (CS) and placebo (P) groups, and under single-blinded procedures, ingested 25 g CS or P supplements mixed in 0.25 L water twice daily before the first and last meal for 12 weeks. Ninety nondiseased, overweight/obese men and women between the ages of 20 and 70 years were recruited into the study, with 76 subjects (n = 39 CS, n = 37 P) completing all phases of the study. Pre- and poststudy measures included body mass and composition (dual energy x-ray absorptiometry), inflammation markers from fasting blood samples (C-reactive protein, interleukin 6, monocyte chemoattractant protein 1, and tumor necrosis factor alpha), oxidative stress markers (trolox equivalent antioxidant capacity and plasma nitrite), blood pressure, and a serum lipid profile. Plasma ALA increased 24.4% compared to a 2.8% decrease in CS and P, respectively (interaction effect, P = .012). No group differences were measured for changes in plasma eicosapentaenoic acid and docosahexaenoic acid (interaction effects, P = .420 and .980, respectively). Pre-to-post measures of body composition, inflammation, oxidative stress, blood pressure, and lipoproteins did not differ between CS and P for both sexes. In conclusion, ingestion of 50 g/d CS vs P for 12 weeks by overweight/obese men and women had no influence on body mass or composition, or various disease risk factor measures.

  2. Nutraceuticals for body-weight management: The role of green tea catechins.

    PubMed

    Janssens, Pilou L H R; Hursel, Rick; Westerterp-Plantenga, Margriet S

    2016-08-01

    Green tea catechins mixed with caffeine have been proposed as adjuvants for maintaining or enhancing energy expenditure and for increasing fat oxidation, in the context of prevention and treatment of obesity. These catechins-caffeine mixtures seem to counteract the decrease in metabolic rate that occurs during weight loss. Their effects are of particular importance during weight maintenance after weight loss. Other metabolic targets may be fat absorption and the gut microbiota composition, but these effects still need further investigation in combination with weight loss. Limitations for the effects of green tea catechins are moderating factors such as genetic predisposition related to COMT-activity, habitual caffeine intake, and ingestion combined with dietary protein. In conclusion, a mixture of green tea catechins and caffeine has a beneficial effect on body-weight management, especially by sustained energy expenditure, fat oxidation, and preservation of fat free body-mass, after energy restriction induced body-weight loss, when taking the limitations into account.

  3. [National consensus for management of community acquired pneumonia in adults].

    PubMed

    Saldías P, Fernando; Pérez C, Carlos

    2005-01-01

    Community acquired pneumonia (CAP) is an acute respiratory infection that affects pulmonary parenchyma, and is caused by community acquired microorganisms. In Chile, pneumonia represents the main cause of death due to infectious diseases and is the third specific cause of mortality in adults. In 1999, an experts committee in representation of "Sociedad Chilena de Enfermedades Respiratorias", presented the first National Guidelines for the Treatment of Adult Community Acquired Pneumonia, mainly based in foreign experience and documents, and adapted it to our National Health System Organization. During the last decade, impressive epidemiological and technological changes have occurred, making the update of guidelines for treatment of NAC by several international scientific societies, necessary. These changes include: new respiratory pathogens that are being identified in CAP and affect adult patients (Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila); the increasing senescent adult population that carries multiple co-morbidities; the emergence of antimicrobial resistance among respiratory pathogens associated to massive antibiotic prescription; the development by the pharmaceutical industry of new drugs that are effective for pneumonia treatment (macrolides, ketolides and respiratory fluorquinolones); and the development of new diagnostic techniques for detection of antigens, antibodies, and bacterial DNA by molecular biology, useful in respiratory infections. Based on these antecedents, an Advisory Committee of "Sociedad Chilena de Enfermedades Respiratorias" and "Sociedad Chilena de Infectología" has reviewed the national and international evidence about CAP management in adults in order to update clinical recommendations for our country.

  4. Frontal Electroencephalogram Asymmetry, Salivary Cortisol, and Internalizing Behavior Problems in Young Adults Who Were Born at Extremely Low Birth Weight

    ERIC Educational Resources Information Center

    Schmidt, Louis A.; Miskovic, Vladimir; Boyle, Michael; Saigal, Saroj

    2010-01-01

    The authors examined internalizing behavior problems at middle childhood, adolescence, and young adulthood and brain-based measures of stress vulnerability in 154 right-handed, nonimpaired young adults (M age = 23 years): 71 (30 males, 41 females) born at extremely low birth weight (ELBW; less than 1,000 g) and 83 (35 males, 48 females) controls…

  5. Expectancy, Self-Efficacy, and Placebo Effect of a Sham Supplement for Weight Loss in Obese Adults.

    PubMed

    Tippens, Kimberly M; Purnell, Jonathan Q; Gregory, William L; Connelly, Erin; Hanes, Douglas; Oken, Barry; Calabrese, Carlo

    2014-07-01

    This study examined the role of expectancy in the placebo effect of a sham dietary supplement for weight loss in 114 obese adults with metabolic syndrome. All participants received lifestyle education and were randomized to 1 of 3 conditions: (1) a daily placebo capsule and told that they were taking an active weight loss supplement, (2) daily placebo and told they had a 50% random chance of receiving either the active or placebo, or (3) no capsules. At 12 weeks, weight loss and metabolic outcomes were similar among the 3 groups. Participants in both groups that took capsules showed decreased weight loss self-efficacy and increased expectations of benefit from dietary supplements. Participants not taking capsules showed the opposite. Adverse events were more frequently reported in groups taking capsules than those who were not. These findings suggest that supplements without weight loss effects may have nocebo effects through diminished self-efficacy.

  6. Role of personal factors in women's self-reported weight management behaviour.

    PubMed

    Butler, P; Mellor, D

    2006-05-01

    The aim of this study was to investigate the role of motivation, anxiety and self-efficacy in self-reported behaviour that may be important for weight loss and weight maintenance. One hundred and twenty-nine females aged 18-81 years were recruited from a variety of social, sporting venues and work places within a local community. Participants completed questionnaires assessing their levels of participation and perseverance in weight management activities, their motivation levels, their anxiety levels (State Anxiety Inventory) and their levels of self-efficacy for weight management behaviours. Motivation was found to play a major role in participation in weight management activities. Anxiety and self-efficacy played no significant role. The findings are discussed in relation to previous studies, and directions for future studies are indicated. It is argued that the level of motivation is a key factor that should be taken into account for each individual engaging in women's weight management programmes, and that further research should be undertaken to identify other relevant factors.

  7. Effect of whey protein and glycomacropeptide on measures of satiety in normal-weight adult women.

    PubMed

    Chungchunlam, Sylvia M S; Henare, Sharon J; Ganesh, Siva; Moughan, Paul J

    2014-07-01

    Protein is the most satiating macronutrient and dairy whey protein is thought to be more satiating than other protein sources. The purported satiating effect of whey protein may be attributable to the presence of glycomacropeptide (GMP). The objective of this study was to investigate the role of GMP in the satiating effect of whey protein. Isoenergetic (~1600 kJ) preload drinks contained GMP isolate (86% GMP, "GMP"), whey protein isolate (WPI) with 21% naturally occurring GMP, WPI with 2% naturally present GMP, or maltodextrin carbohydrate ("carbohydrate"). Satiety was assessed in 22 normal-weight adult women by determining the consumption of a test meal provided ad libitum 120 min following ingestion of a preload drink, and also by using visual analogue scales (VAS) for rating feelings of hunger, desire to eat, prospective consumption and fullness (appetite). The ad libitum test meal intake was significantly different between the preload drinks (p = 0.0003), with food intake following ingestion of both WPI preload drinks (regardless of the amount of GMP) being ~18% lower compared with the beverages enriched with carbohydrate or GMP alone. There were no significant differences (p > 0.05) in the VAS-rated feelings of appetite among the four preload drinks. GMP alone did not reduce subsequent food intake compared with a drink enriched with carbohydrate, but whey protein had a greater satiating effect than carbohydrate. The presence of GMP in whey does not appear to be the cause of the observed effect of whey protein on satiety.

  8. Temporal variation in the prevalence of weight and obesity excess in adults: Brazil, 2006 to 2009.

    PubMed

    Gigante, Denise Petrucci; de França, Giovanny Vinícius Araújo; Sardinha, Luciana Monteiro Vasconcelos; Iser, Betine Pinto Moehlecke; Meléndez, Gustavo Velasquez

    2011-09-01

    Overweight and obesity are public health issues that affect an important part of the world population. This study aims at describing the trends in overweight and obesity prevalence rates from 2006 to 2009, by means of telephone surveys in 27 Brazilian cities, with a population aged 18 years or older. The body mass index (BMI) was calculated by the reported height and weight; overweight and obesity were considered as BMI >25 kg/m² and >30 kg/m², respectively. Temporal variation in overweight and obesity prevalence is presented for men and women, according to age group, schooling, stable relationship, and skin color. Poisson regression was used for the analysis. Overweight prevalence was 43.0, 42.7, 44.2 and 46.6%,for each year of the period from 2006 to 2009, respectively. For obesity, in the same period, the trend was: 11.4, 12.7, 13.2 and 13.8%. The temporal trend varied in relation to some demographic and socioeconomic variables. The prevalence was higher among women and young adults. The temporal trend was independent of the relationship status of the interviewees, but the prevalence was higher among white women and those with less years of schooling. The results in this study confirmed the urgent need for effective prevention and control measures, as the increasing trend is occurring in a short period of time, especially among youngsters.

  9. Weight for gestational age and metabolically healthy obesity in adults from the Haguenau cohort

    PubMed Central

    Matta, Joane; Carette, Claire; Levy Marchal, Claire; Bertrand, Julien; Pétéra, Mélanie; Zins, Marie; Pujos-Guillot, Estelle; Comte, Blandine; Czernichow, Sébastien

    2016-01-01

    Background An obesity subphenotype, named ‘metabolically healthy obese’ (MHO) has been recently defined to characterise a subgroup of obese individuals with less risk for cardiometabolic abnormalities. To date no data are available on participants born with small weight for gestational age (SGA) and the risk of metabolically unhealthy obesity (MUHO). Objective Assess the risk of MUHO in SGA versus appropriate for gestational age (AGA) adult participants. Methods 129 young obese individuals (body mass index ≥30 kg/m²) from data of an 8-year follow-up Haguenau cohort (France), were identified out of 1308 participants and were divided into 2 groups: SGA (n=72) and AGA (n=57). Metabolic characteristics were analysed and compared using unpaired t-test. The HOMA-IR index was determined for the population and divided into quartiles. Obese participants within the first 3 quartiles were considered as MHO and those in the fourth quartile as MUHO. Relative risks (RRs) and 95% CI for being MUHO in SGA versus AGA participants were computed. Results The SGA-obese group had a higher risk of MUHO versus the AGA-obese group: RR=1.27 (95% CI 1.10 to 1.6) independently of age and sex. Conclusions In case of obesity, SGA might confer a higher risk of MUHO compared with AGA. PMID:27580829

  10. The adoption of mobile weight management services in a virtual community: the perspective of college students.

    PubMed

    Jen, Wen-Yuan

    2010-05-01

    Obesity among Taiwan college students is increasing every year. To help college students manage their weight, a prototype mobile weight management service system, the We Care for You Virtual Community (WCU VC), was designed, which would provide Web-based and cell-phone-based information services to individual participants. Conducted prior to system implementation, this study identified the factors affecting college student's intention in adopting the WCU VC as part of their weight control program. Employing the Technology Acceptance Model, factors associated with the college student's intention toward WCU VC were explored. Structural equation modeling analysis of collected data revealed that "perceived importance of health management" significantly affected the behavioral intention of adopting WCU VC services. Both "perceived importance of health management" and "perceived ease of use" had an indirect effect via "perceived usefulness" upon user's behavioral intention as well. With this knowledge of factors affecting student intention in participating in a Web-based and cell-phone-based weight control social support VC, a WCU VC system can be designed, which will promote the development of good weight management habits and contribute to the reduction in obesity-related chronic diseases among college students.

  11. Managing gastroesophageal reflux symptoms in the very low-birth-weight infant postdischarge.

    PubMed

    Sherrow, Tammy; Dressler-Mund, Donna; Kowal, Kelly; Dai, Susan; Wilson, Melissa D; Lasby, Karen

    2014-12-01

    Gastroesophageal reflux and gastroesophageal reflux disease symptoms are common challenges for very low-birth-weight infants (<1500 g). These symptoms frequently result in feeding difficulties and family stress. Management of symptoms across healthcare disciplines may not be based on current evidence, and inconsistency can result in confusion for families and delayed interventions. The feeding relationship between infant and caregivers may be impaired when symptoms are persistent and poorly managed. An algorithm for managing gastroesophageal reflux-like symptoms in very low-birth-weight infants (from hospital discharge to 12 months corrected age) was developed through the formation of a multidisciplinary community of practice and critical appraisal of the literature. A case study demonstrates how the algorithm results in a consistent approach for identifying symptoms, applying appropriate management strategies, and facilitating appropriate timing of medical consultation. Application to managing gastroesophageal reflux symptoms in the neonatal intensive care unit will be briefly addressed.

  12. Overweight children and adolescents referred for weight management: are they meeting lifestyle behaviour recommendations?

    PubMed

    Ball, Geoff D C; Lenk, Julie M; Barbarich, Bobbi N; Plotnikoff, Ronald C; Fishburne, Graham J; Mackenzie, Kelly A; Willows, Noreen D

    2008-10-01

    Adopting and maintaining healthy lifestyle behaviours can help overweight boys and girls manage their weight and reduce obesity-related health risks. However, we currently know very little about the lifestyle habits of overweight children and adolescents referred for weight management in Canada and whether or not they are meeting current lifestyle recommendations. The objectives of this study were (i) to determine the demographic characteristics and lifestyle behaviours of overweight children and adolescents referred for clinical weight management, and (ii) to examine sex (boys vs. girls) and (or) age (child vs. youth) differences with respect to the achievement of lifestyle behaviour recommendations. Overweight (age- and sex-specific body mass index > or = 85th percentile) children (n = 27 girls, n = 24 boys) and adolescents (n = 29 girls, n = 19 boys) were referred to and enrolled in weight-management programs at the Pediatric Centre for Weight and Health (PCWH) at the Stollery Children's Hospital (Edmonton, Alta.) from January 2006-September 2007. Information was collected at intake regarding demography, anthropometry, and lifestyle behaviours before participants started a formal weight-management program. Lifestyle behaviour recommendations for nutrition, physical activity, screen time, and sleep were used to determine whether participants were meeting established guidelines. Overall, participants presented with poor lifestyle behaviours. Although most consumed adequate servings of grain products (93.9%) and meat and alternatives (68.7%), few met the serving recommendations for milk and alternatives (31.3%) or vegetables and fruit (14.1%). Physical activity levels were low - 7.4% and 4.1% achieved the recommended time and steps per day goals, respectively. Approximately 1/4 (22.7%) met the screen time recommendation, whereas fewer than 1/2 (47.4%) achieved the nightly sleep duration goal. Sex and age-group comparisons revealed subtle, but potentially important

  13. Barriers to weight management among Emirati women: a qualitative investigation of health professionals' perspectives.

    PubMed

    Ali, Habiba I; Bernsen, Roos M; Baynouna, Latifa M

    Obesity and associated chronic diseases such as type 2 diabetes are highly prevalent in the United Arab Emirates. This qualitative study explored weight management barriers for Emirati women and strategies that can facilitate their weight management efforts. In-depth individual interviews were conducted with a purposive sample of 29 primary health care physicians, dietitians, and nurses in Al Ain and Abu Dhabi medical districts. A modified grounded theory was used to guide data collection and analysis. Interview notes were analyzed thematically and inductively using the NVivo software. The three main emerging themes were barriers, motivators, and suggestions. A number of personal, health care system-related, social and physical barriers to weight management were identified. Participants' suggestions to facilitate weight management for Emirati women included: health awareness programs, policies that support lifestyle changes, and provision of the necessary resources. They recommended peer support and culturally-acceptable programs that provide a holistic approach to obesity prevention and management. This study has useful applications in the development of community-based interventions for the prevention and management of overweight and obesity among women in the United Arab Emirates.

  14. Opportunities for intervention strategies for weight management: global actions on fluid intake patterns.

    PubMed

    Lafontan, Max; Visscher, Tommy L S; Farpour-Lambert, Nathalie; Yumuk, Volkan

    2015-01-01

    Water is an essential nutrient for all physiological functions and particularly important for thermoregulation. About 60% of our body weight is made of water. Under standard conditions (18-20 °C and moderate activity), water balance is regulated within 0.2 % of body weight over a 24-hour period. Water requirement varies between individuals and according to environmental conditions. Concerning considerations related to obesity, the health impact of fluid intake is commonly overlooked. Fluid intake advices are missing in most of food pyramids offered to the public, and water requirements and hydration challenges remain often neglected. The purpose of this paper is to emphasize and discuss the role of water consumption in the context of other important public health measures for weight management. Attention will be focused on fluid intake patterns and hydration-related questions in the context of global interventions and/or physical activity programs settled in weight management protocols.

  15. Diet or exercise interventions vs combined behavioral weight management programs: a systematic review and meta-analysis of direct comparisons.

    PubMed

    Johns, David J; Hartmann-Boyce, Jamie; Jebb, Susan A; Aveyard, Paul

    2014-10-01

    Weight loss can reduce the health risks associated with being overweight or obese. However, the most effective method of weight loss remains unclear. Some programs emphasize physical activity, others diet, but existing evidence is mixed as to whether these are more effective individually or in combination. We aimed to examine the clinical effectiveness of combined behavioral weight management programs (BWMPs) targeting weight loss in comparison to single component programs, using within study comparisons. We included randomized controlled trials of combined BWMPs compared with diet-only or physical activity-only programs with at least 12 months of follow-up, conducted in overweight and obese adults (body mass index ≥25). Systematic searches of nine databases were run and two reviewers extracted data independently. Random effects meta-analyses were conducted for mean difference in weight change at 3 to 6 months and 12 to 18 months using a baseline observation carried forward approach for combined BWMPs vs diet-only BWMPs and combined BWMPs vs physical activity-only BWMPs. In total, eight studies were included, representing 1,022 participants, the majority of whom were women. Six studies met the inclusion criteria for combined BWMP vs diet-only. Pooled results showed no significant difference in weight loss from baseline or at 3 to 6 months between the BWMPs and diet-only arms (-0.62 kg; 95% CI -1.67 to 0.44). However, at 12 months, a significantly greater weight-loss was detected in the combined BWMPs (-1.72 kg; 95% CI -2.80 to -0.64). Five studies met the inclusion criteria for combined BWMP vs physical activity-only. Pooled results showed significantly greater weight loss in the combined BWMPs at 3 to 6 months (-5.33 kg; 95% CI -7.61 to -3.04) and 12 to 18 months (-6.29 kg; 95% CI -7.33 to -5.25). Weight loss is similar in the short-term for diet-only and combined BWMPs but in the longer-term weight loss is increased when diet and physical activity are combined

  16. Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis123

    PubMed Central

    Pan, An; Willett, Walter C; Hu, Frank B

    2013-01-01

    Background: The relation between sugar-sweetened beverages (SSBs) and body weight remains controversial. Objective: We conducted a systematic review and meta-analysis to summarize the evidence in children and adults. Design: We searched PubMed, EMBASE, and Cochrane databases through March 2013 for prospective cohort studies and randomized controlled trials (RCTs) that evaluated the SSB-weight relation. Separate meta-analyses were conducted in children and adults and for cohorts and RCTs by using random- and fixed-effects models. Results: Thirty-two original articles were included in our meta-analyses: 20 in children (15 cohort studies, n = 25,745; 5 trials, n = 2772) and 12 in adults (7 cohort studies, n = 174,252; 5 trials, n = 292). In cohort studies, one daily serving increment of SSBs was associated with a 0.06 (95% CI: 0.02, 0.10) and 0.05 (95% CI: 0.03, 0.07)-unit increase in BMI in children and 0.22 kg (95% CI: 0.09, 0.34 kg) and 0.12 kg (95% CI: 0.10, 0.14 kg) weight gain in adults over 1 y in random- and fixed-effects models, respectively. RCTs in children showed reductions in BMI gain when SSBs were reduced [random and fixed effects: −0.17 (95% CI: −0.39, 0.05) and −0.12 (95% CI: −0.22, −0.2)], whereas RCTs in adults showed increases in body weight when SSBs were added (random and fixed effects: 0.85 kg; 95% CI: 0.50, 1.20 kg). Sensitivity analyses of RCTs in children showed more pronounced benefits in preventing weight gain in SSB substitution trials (compared with school-based educational programs) and among overweight children (compared with normal-weight children). Conclusion: Our systematic review and meta-analysis of prospective cohort studies and RCTs provides evidence that SSB consumption promotes weight gain in children and adults. PMID:23966427

  17. Recruiting and retaining young adults in a weight gain prevention trial: Lessons learned from the CHOICES study

    PubMed Central

    Moe, Stacey G; Lytle, Leslie A; Nanney, Marilyn S; Linde, Jennifer A; Laska, Melissa N

    2015-01-01

    Background/Aims Young adults are at risk for weight gain but little is known about designing effective weight control trials for young adults or how to recruit and retain participants in these programs. The Choosing Healthy Options in College Environments and Settings (CHOICES) study evaluated the effectiveness of a weight gain prevention intervention for 2-year college students. We describe the methods used to recruit and retain the colleges and their students, describe the sample and discuss recommendations for future studies. Methods Students were recruited into a 24-month trial of a weight control intervention with assessment periods at baseline, 4-, 12- and 24-months follow-up. Results We successfully recruited 441 students through partnerships with three 2-year colleges through a variety of campus-based methods. Ultimately, 83.4% of the randomized cohort participated in the 24-month assessment period. Those retained more often were white (p=0.03), compared to those who dropped out or were lost to follow-up; no other socio-demographic factor (e.g., gender, ethnicity, education), BMI, body fat, waist circumference or weight status was observed to differ between randomly assigned groups. Conclusions Two-year colleges and their students are interested in participating in weight-related trials and partnering with universities for research. Researchers must work closely with administrators to identify benefits to their institutions and to resolve student-level barriers to recruitment and retention. Our experiences from the CHOICES study should be useful in identifying effective recruitment and retention methods for weight gain prevention trials among young adults. PMID:26378096

  18. Family-health professional relations in pediatric weight management: an integrative review.

    PubMed

    Farnesi, B C; Ball, G D C; Newton, A S

    2012-06-01

    In this integrative review, we examined contemporary literature in pediatric weight management to identify characteristics that contribute to the relationship between families and health professionals and describe how these qualities can inform healthcare practices for obese children and families receiving weight management care. We searched literature published from 1980 to 2010 in three electronic databases (MEDLINE, PsycINFO and CINAHL). Twenty-four articles identified family-health professional relationships were influenced by the following: health professionals' weight-related discussions and approaches to care; and parents' preferences regarding weight-related terminology and expectations of healthcare delivery. There was considerable methodological heterogeneity in the types of reports (i.e. qualitative studies, review articles, commentaries) included in this review. Overall, the findings have implications for establishing a positive clinical relationship between families and health professionals, which include being sensitive when discussing weight-related issues, using euphemisms when talking about obesity, demonstrating a non-judgmental and supportive attitude and including the family (children and parents) in healthcare interactions. Experimental research, clinical interventions and longitudinal studies are needed to build on the current evidence to determine how best to establish a collaborative partnership between families and health professionals and whether such a partnership improves treatment adherence, reduces intervention attrition and enhances pediatric weight management success.

  19. Can mindfulness influence weight management related eating behaviors? If so, how?

    PubMed

    Tapper, Katy

    2017-03-11

    Mindfulness is increasingly being used for weight management. However, the strength of the evidence for such an approach is unclear; although mindfulness-based weight management programs have had some success, it is difficult to conclude that the mindfulness components were responsible. Research in this area is further complicated by the fact that the term 'mindfulness' is used to refer to a range of different practices. Additionally, we have little understanding of the mechanisms by which mindfulness might exert its effects. This review addresses these issues by examining research that has looked at the independent effects of mindfulness and mindfulness-related strategies on weight loss and weight management related eating behaviors. As well as looking at evidence for effects, the review also considers whether effects may vary with different types of strategy, and the kinds of mechanisms that may be responsible for any change. It is concluded that there is some evidence to support the effects of (a) present moment awareness, when applied to the sensory properties of food, and (b) decentering. However, research in these areas has yet to be examined in a controlled manner in relation to weight management.

  20. Literature review: perceptions and management of body size among normal weight and moderately overweight people.

    PubMed

    Nissen, N K; Holm, L

    2015-02-01

    Improved understanding of how normal weight and moderately overweight people manage their body weight and shape could be used to inform initiatives to prevent and treat obesity. This literature review offers a thorough appraisal of existing research into perceptions and management of own body size among normal weight and moderately overweight people. The studies reported in the 47 publications reviewed here address various themes based on different conceptualizations. The studies point out that normal weight and moderately overweight people are much concerned about their body size, but huge discrepancies are found between their own perceptions and study categorizations. The studies also indicate that normal weight and moderately overweight people are actively engaged in managing their body size through numerous managing strategies, and dieting is widespread. Together the studies do not form a unified and coherent research field, and there is a bias towards North American study populations. Methodological problems were identified in some publications, raising questions about generalizability of the findings. Moreover, only few studies give deeper insight into the specific perceptions and actions. Repeated studies are needed in broader and more differentiated geographical, social and cultural contexts, and longitudinal studies and more in-depth explorations are especially needed.

  1. Apollo Soyuz Test Project Weights and Mass Properties Operational Management System

    NASA Technical Reports Server (NTRS)

    Collins, M. A., Jr.; Hischke, E. R.

    1975-01-01

    The Apollo Soyuz Test Project (ASTP) Weights and Mass Properties Operational Management System was established to assure a timely and authoritative method of acquiring, controlling, generating, and disseminating an official set of vehicle weights and mass properties data. This paper provides an overview of the system and its interaction with the various aspects of vehicle and component design, mission planning, hardware and software simulations and verification, and real-time mission support activities. The effect of vehicle configuration, design maturity, and consumables updates is discussed in the context of weight control.

  2. Management of atypical antipsychotic-induced weight gain in schizophrenic patients with topiramate.

    PubMed

    Lin, Yi-Hsiung; Liu, Chia-Yih; Hsiao, Mei-Chun

    2005-10-01

    Patients treated with atypical antipsychotic drugs commonly gain excess weight. Because obesity is associated with considerable morbidity and decreased life expectancy, treatment of weight gain in these patients is critical. Topiramate, a fairly new anticonvulsant, promotes bodyweight loss in healthy obese subjects, patients with bipolar disorder, and patients with eating disorder. However, there are very few reports about the efficacy of topiramate for weight management in schizophrenic patients. We present the cases of three Taiwanese patients with schizophrenia whose bodyweight increased as a result of atypical antipsychotics treatment, then was controlled by topiramate without aggravation of their psychotic symptoms.

  3. Accelerometer-measured physical activity is not associated with two-year weight change in African-origin adults from five diverse populations

    PubMed Central

    Kliethermes, Stephanie; Plange-Rhule, Jacob; Tong, Liping; Bovet, Pascal; Forrester, Terrence E.; Lambert, Estelle V.; Schoeller, Dale A.; Durazo-Arvizu, Ramon A.; Shoham, David A.; Cao, Guichan; Brage, Soren; Ekelund, Ulf; Cooper, Richard S.; Luke, Amy

    2017-01-01

    Background Increasing population-levels of physical activity (PA) is a controversial strategy for managing the obesity epidemic, given the conflicting evidence for weight loss from PA alone per se. We measured PA and weight change in a three-year prospective cohort study in young adults from five countries (Ghana, South Africa, Jamaica, Seychelles and USA). Methods A total of 1,944 men and women had baseline data, and at least 1 follow-up examination including measures of anthropometry (weight/BMI), and objective PA (accelerometer, 7-day) following the three-year study period. PA was explored as 1-minute bouts of moderate and vigorous PA (MVPA) as well as daily sedentary time. Results At baseline; Ghanaian and South African men had the lowest body weights (63.4 ± 9.5, 64.9 ± 11.8 kg, respectively) and men and women from the USA the highest (93.6 ± 25.9, 91.7 ± 23.4 kg, respectively). Prevalence of normal weight ranged from 85% in Ghanaian men to 29% in USA men and 52% in Ghanaian women to 15% in USA women. Over the two-year follow-up period, USA men and Jamaican women experienced the smallest yearly weight change rate (0.1 ± 3.3 kg/yr; −0.03 ± 3.0 kg/yr, respectively), compared to South African men and Ghanaian women greatest yearly change (0.6.0 ± 3.0 kg/yr; 1.22 ± 2.6 kg/yr, respectively). Mean yearly weight gain tended to be larger among normal weight participants at baseline than overweight/obese at baseline. Neither baseline MVPA nor sedentary time were associated with weight gain. Using multiple linear regression, only baseline weight, age and gender were significantly associated with weight gain. Discussion From our study it is not evident that higher volumes of PA alone are protective against future weight gain, and by deduction our data suggest that other environmental factors such as the food environment may have a more critical role. PMID:28133575

  4. Commonality versus specificity among adiposity traits in normal-weight and moderately overweight adults

    PubMed Central

    Raja, GK; Sarzynski, MA; Katzmarzyk, PT; Johnson, WD; Tchoukalova, Y; Smith, SR; Bouchard, C

    2014-01-01

    BACKGROUND Many adiposity traits have been related to health complications and premature death. These adiposity traits are intercorrelated but their underlying structure has not been extensively investigated. We report on the degree of commonality and specificity among multiple adiposity traits in normal-weight and moderately overweight adult males and females (mean body mass index (BMI) = 22.9 kg m−2, s.d. = 2.4). METHODS A total of 75 healthy participants were assessed for a panel of adiposity traits including leg, arm, trunk, total fat masses and visceral adipose tissue (VAT) derived from dual energy X-ray absorptiometry (DXA), hepatic and muscle lipids from proton magnetic resonance spectroscopy, fat cell volume from an abdominal subcutaneous adipose tissue biopsy (n = 36) and conventional anthropometry (BMI and waist girth). Spearman’s correlations were calculated and were subjected to factor analysis. RESULTS Arm, leg, trunk and total fat masses correlated positively (r = 0.78–0.95) with each other. VAT correlated weakly with fat mass indicators (r = 0.24–0.31). Intrahepatic lipids (IHL) correlated weakly with all fat mass traits (r = 0.09–0.34), whereas correlations between DXA depots and intramyocellular lipids (IMCL) were inconsequential. The four DXA fat mass measures, VAT, IHL and IMCL depots segregated as four independent factors that accounted for 96% of the overall adiposity variance. BMI and waist girth were moderately correlated with the arm, leg, trunk and total fat and weakly with VAT, IHL and IMCL. CONCLUSION Adiposity traits share a substantial degree of commonality, but there is considerable specificity across the adiposity variance space. For instance, VAT, IHL and IMCL are typically poorly correlated with each other and are poorly to weakly associated with the other adiposity traits. The same is true for BMI and waist girth, commonly used anthropometric indicators of adiposity. These results do not support the view that it will be

  5. Nutritional management of older adults with cognitive decline and dementia.

    PubMed

    Ogawa, Sumito

    2014-04-01

    Age-related cognitive decline is a main predictor of disability among elderly people, and with the continued expansion of the aging population and the increase in life expectancy, the prevalence of mild cognitive impairment and dementia represented by Alzheimer's disease (AD), which is a multifactorial neurodegenerative disorder of older adults, have increased. Recent epidemiological and observational studies suggest a relationship exists between lifestyle factors, including nutrition and diet, and cognitive function in aging adults. It is also suggested that malnutrition and nutrient deficiencies are associated with cognitive decline in patients with dementia. There are a variety of nutritional factors, including nutritional status and dietary patterns, that might be associated with cognitive function, and specific micronutrients and dietary components have been suggested to have an association with cognitive function as well. Based on these findings and evidence, evaluation of nutritional state, as well as nutritional intervention, might be able to play a role in the management and prevention of dementia.

  6. Normal total and high molecular weight adiponectin levels in adults with cystic fibrosis.

    PubMed

    Ziai, S; Elisha, B; Hammana, I; Tardif, A; Berthiaume, Y; Coderre, L; Rabasa-Lhoret, R

    2011-12-01

    Cystic fibrosis related diabetes (CFRD) is an important complication of CF that increases mortality. Adiponectin, an adipokine secreted from adipose tissue, plays an important role in fatty acid and glucose metabolism. Lower total adiponectin (TA) levels have been linked to the risk of developing type 2 diabetes. However, studies show that the high molecular weight isoform (HMW), thought to be more active than TA, might be a better indicator of insulin sensitivity. Our aim was to determine the association between HMW and insulin sensitivity in CF subjects and determine if other factors might modulate its levels. Thirteen control subjects and 47 CF adults (16 with normal glucose tolerance, 16 prediabetic and 15 with CFRD) underwent an oral glucose tolerance test. Blood samples were taken at time 0, 30, 60, 90 and 120 min. Body mass index, fibrinogen, glucose and insulin, TA and HMW were measured in every subject. Regression analysis was used to determine the association between TA, HMW and glucose (fasting glucose, 2h glucose and glucose AUC) as well as insulin (fasting insulin, insulin AUC, and Stumvoll insulin sensitivity index) parameters. TA and HMW levels were similar between CF patients and controls and were not associated to insulin sensitivity. TA was negatively associated to insulin AUC (p=0.0108) and 2h glucose (p=0.0116) in controls while these relationships were either weakly negative (p=0.0208) or weakly positive (p=0.0105) in CF patients. Also, HMW was negatively associated to insulin (p=0.00301) and glucose AUC (p=0.0546) in controls whereas these associations were positive in CF patients (p=0.0388, p=0.0232 respectively). In conclusion, our exploratory study on HMW adiponectin demonstrated similar levels of TA and HMW between CF patients and controls and different relationships between forms of adiponectin to glucose metabolism and insulin in CF.

  7. Differences between young and older adults in the control of weight shifting within the surface of support.

    PubMed

    de Vries, Elisabeth A; Caljouw, Simone R; Coppens, Milou J M; Postema, Klaas; Verkerke, Gijsbertus J; Lamoth, Claudine J C

    2014-01-01

    An important reason for falling in elderly is incorrect weight-shifting. In many daily life activities quick and accurate weight-shifting is needed to maintain balance and to prevent from falling. The present study aims to gain more insight in age-related differences in the control of weight-shifting. Nine healthy older adults (70.3 ± 6.9 years) and twelve young adults (20.9 ± 0.5 years) participated in the study. They performed a weight shifting task by moving the body's center of pressure, represented by a red dot on a screen, in different directions, towards targets of different sizes and at different distances projected on a screen. Movement time, fluency and accuracy of the movement were determined. Accuracy was quantified by the number of times the cursor hit the goal target before a target switch was realized (counts on goal) and by the time required to realize a target switch after the goal target was hit by the cursor for the first time (dwelling time). Fluency was expressed by the maximal deviation of the performed path with respect to the ideal path and the number of peaks, or inflections in the performed path. Significant main effects of target size, target distance and age on all outcome measures were found. With decreasing target size, increasing target distance and increasing age, movement time significantly increased and fluency and accuracy significantly decreased (i.e. increased number of peaks, maximal deviation, number of times on the goal target and longer dwelling time around the goal target). In addition, significant interaction effects of size*age and distance*age were found. Older adults needed more time to perform the weight-shifting task and their movements were less fluent and accurate compared to younger adults, especially with increasing task difficulty. This indicates that elderly might have difficulties with executing an adequate adaptation to a perturbation in daily life.

  8. Candy consumption in childhood is not predictive of weight, adiposity measures or cardiovascular risk factors in young adults: the Bogalusa Heart Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There are limited data available on the longitudinal relationship between candy consumption by children on weight and other cardiovascular risk factors (CVRF) in young adults. The present study investigated whether candy consumption in children was predictive of weight and CVRF in young adults. A lo...

  9. Weight management by phone conference call: A comparison with a traditional face-to-face clinic. Rationale and design for a randomized equivalence trial

    PubMed Central

    Lambourne, Kate; Washburn, Richard A.; Gibson, Cheryl; Sullivan, Debra K.; Goetz, Jeannine; Lee, Robert; Smith, Bryan K.; Mayo, Matthew S.; Donnelly, Joseph E.

    2012-01-01

    State-of-the-art treatment for weight management consists of a behavioral intervention to facilitate decreased energy intake and increased physical activity. These interventions are typically delivered face-to-face (FTF) by a health educator to a small group of participants. There are numerous barriers to participation in FTF clinics including availability, scheduling, the expense and time required to travel to the clinic site, and possible need for dependent care. Weight management clinics delivered by conference call have the potential to diminish or eliminate these barriers. The conference call approach may also reduce burden on providers, who could conduct clinic groups from almost any location without the expenses associated with maintaining FTF clinic space. A randomized trial will be conducted in 395 overweight/obese adults (BMI 25–39.9 kg/m2) to determine if weight loss (6 months) and weight maintenance (12 months) are equivalent between weight management interventions utilizing behavioral strategies and pre-packaged meals delivered by either a conference call or the traditional FTF approach. The primary outcome, body weight, will be assessed at baseline, 6, 12 and 18 months. Secondary outcomes including waist circumference, energy and macronutrient intake, and physical activity and will be assessed on the same schedule. In addition, a cost analysis and extensive process evaluation will be completed. PMID:22664647

  10. Weight management by phone conference call: a comparison with a traditional face-to-face clinic. Rationale and design for a randomized equivalence trial.

    PubMed

    Lambourne, Kate; Washburn, Richard A; Gibson, Cheryl; Sullivan, Debra K; Goetz, Jeannine; Lee, Robert; Smith, Bryan K; Mayo, Matthew S; Donnelly, Joseph E

    2012-09-01

    State-of-the-art treatment for weight management consists of a behavioral intervention to facilitate decreased energy intake and increased physical activity. These interventions are typically delivered face-to-face (FTF) by a health educator to a small group of participants. There are numerous barriers to participation in FTF clinics including availability, scheduling, the expense and time required to travel to the clinic site, and possible need for dependent care. Weight management clinics delivered by conference call have the potential to diminish or eliminate these barriers. The conference call approach may also reduce burden on providers, who could conduct clinic groups from almost any location without the expenses associated with maintaining FTF clinic space. A randomized trial will be conducted in 395 overweight/obese adults (BMI 25-39.9 kg/m(2)) to determine if weight loss (6 months) and weight maintenance (12 months) are equivalent between weight management interventions utilizing behavioral strategies and pre-packaged meals delivered by either a conference call or the traditional FTF approach. The primary outcome, body weight, will be assessed at baseline, 6, 12 and 18 months. Secondary outcomes including waist circumference, energy and macronutrient intake, and physical activity and will be assessed on the same schedule. In addition, a cost analysis and extensive process evaluation will be completed.

  11. Peer Group and Text Message-Based Weight-Loss and Management Intervention for African American Women.

    PubMed

    Lee, Sohye; Schorr, Erica; Chi, Chih-Lin; Treat-Jacobson, Diane; Mathiason, Michelle A; Lindquist, Ruth

    2017-03-01

    About 80% of African American (AA) women are overweight or obese. Accessible and effective weight management programs targeting weight loss, weight maintenance and the prevention of weight regain are needed to improve health of AA women. A feasibility study was conducted to examine the feasibility, acceptability, and potential efficacy of a 16-week intervention protocol for weight loss and management that combined daily text messages and biweekly peer group sessions. Modest but statistically significant reductions were detected in weight and body mass index from baseline to 16 weeks. At baseline, 36% of participants were in action and maintenance stages in measures of the stages of change for weight loss and management; this percent increased to 82% at 16 weeks. Findings of this feasibility study provide preliminary evidence of an educational intervention that could motivate women and lead to successful behavior change, and successful weight loss and management for AA women.

  12. Postnatal weight loss in substitute methadone-exposed infants: implications for the management of breast feeding.

    PubMed

    Dryden, Carol; Young, David; Campbell, Nicole; Mactier, Helen

    2012-05-01

    It is widely accepted that maternal drug-exposed infants demonstrate excessive early weight loss, but this has not previously been quantified. Among 354 term, substitute methadone-exposed infants, median maximal weight losses were 10.2% and 8.5% for breast- and formula-fed infants, respectively (p=0.003). Weight loss was less in small for gestational age compared to appropriately grown infants (p<0.001). There was no association between maximal weight loss and plasma sodium concentration (p=0.807). Relative to non-drug exposed infants, weight loss was more marked in formula-fed infants, 48% of whom demonstrated weight loss in excess of the 95th centile (compared to 23% of exclusively breastfed infants; p<0.001). Median weight loss nadir was on day 5, excepting those infants exclusively breastfed (day 4). These data suggest that excessive neonatal weight loss among breastfed infants of drug-misusing mothers does not necessarily reflect poorly established lactation and may help to guide management of breast feeding in this population.

  13. Mobile phone intervention and weight loss among overweight and obese adults: a meta-analysis of randomized controlled trials.

    PubMed

    Liu, Fangchao; Kong, Xiaomu; Cao, Jie; Chen, Shufeng; Li, Changwei; Huang, Jianfeng; Gu, Dongfeng; Kelly, Tanika N

    2015-03-01

    We conducted a meta-analysis of randomized controlled trials to examine the association of mobile phone intervention with net change in weight-related measures among overweight and obese adults. We searched electronic databases and conducted a bibliography review to identify articles published between the inception date of each database and March 27, 2014. Fourteen trials (including 1,337 participants in total) that met the eligibility criteria were included. Two investigators independently abstracted information on study characteristics and study outcomes. Net change estimates comparing the intervention group with the control group were pooled across trials using random-effects models. Compared with the control group, mobile phone intervention was associated with significant changes in body weight and body mass index (weight (kg)/height (m)(2)) of -1.44 kg (95% confidence interval (CI): -2.12, -0.76) and -0.24 units (95% CI: -0.40, -0.08), respectively. Subgroup analyses revealed that the associations were consistent across study-duration and intervention-type subgroups. For example, net body weight changes were -0.92 kg (95% CI: -1.58, -0.25) and -1.85 kg (95% CI: -2.99, -0.71) in trials of shorter (<6 months) and longer (≥6 months) duration, respectively. These findings provide evidence that mobile phone intervention may be a useful tool for promoting weight loss among overweight and obese adults.

  14. Weight Optimization of Active Thermal Management Using a Novel Heat Pump

    NASA Technical Reports Server (NTRS)

    Lear, William E.; Sherif, S. A.

    2004-01-01

    Efficient lightweight power generation and thermal management are two important aspects for space applications. Weight is added to the space platforms due to the inherent weight of the onboard power generation equipment and the additional weight of the required thermal management systems. Thermal management of spacecraft relies on rejection of heat via radiation, a process that can result in large radiator mass, depending upon the heat rejection temperature. For some missions, it is advantageous to incorporate an active thermal management system, allowing the heat rejection temperature to be greater than the load temperature. This allows a reduction of radiator mass at the expense of additional system complexity. A particular type of active thermal management system is based on a thermodynamic cycle, developed by the authors, called the Solar Integrated Thermal Management and Power (SITMAP) cycle. This system has been a focus of the authors research program in the recent past (see Fig. 1). One implementation of the system requires no moving parts, which decreases the vibration level and enhances reliability. Compression of the refrigerant working fluid is accomplished in this scheme via an ejector.

  15. Intense Sweeteners, Appetite for the Sweet Taste, and Relationship to Weight Management.

    PubMed

    Bellisle, France

    2015-03-01

    High intensity, low-energy sweeteners (LES) are used by many consumers in order to limit energy intake and possibly facilitate body weight control. These beneficial effects are often questioned in the scientific and lay media. LES are frequently accused of stimulating and/or maintaining a liking for sweetness which in turn would be deleterious for adequate body weight control. Evidence for the specific effects of LES use on appetite for sweet products will be extracted from observational studies, experimental laboratory studies, randomized controlled trials, and finally brain imaging studies. While many of the existing studies cannot identify any causal links between use of LES and appetite for sweetness, randomized trials in children and adults suggest that use of LES tends to reduce rather than increase the intake of sugar-containing foods and to facilitate, rather than impair, weight loss.

  16. Applying Grounded Theory to Weight Management among Women: Making a Commitment to Healthy Eating

    ERIC Educational Resources Information Center

    Zunker, Christie; Ivankova, Nataliya

    2011-01-01

    In this study we developed a theory grounded in data from women who continued healthy eating behaviors after a weight management program. Participant recruitment was guided by theoretical sampling strategies for focus groups and individual interviews. Inclusion criteria were: African American or Caucasian women aged 30+ who lost [greater than or…

  17. Parent Interest in a School-Based, School Nurse-Led Weight Management Program

    ERIC Educational Resources Information Center

    Kubik, Martha Y.; Lee, Jiwoo

    2014-01-01

    Because one in three children is already overweight or obese, school-based interventions targeting secondary obesity prevention merit consideration. This study assessed parent interest in participating in a school-based, school nurse-led weight management program for young school-aged children. A random sample of parents ("n" = 122) of…

  18. Systematic review and meta analysis of the relationship between whole-grain consumption and weight management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Whole grain is recognized as an important component of a healthy diet, however with the rising incidence of obesity we considered that assessment of the evidence relating to its role in weight management was timely. Objective: This systematic review of the scientific literature and meta...

  19. The school nutrition program's role in weight management of 4th grade elementary students

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We are attempting to uncover the school nutrition program's role in weight management of 4th grade elementary students. Data was collected within a time frame for the food frequency questionnaire (FFQ) set at two months at the WT Cheney Elementary School and South Wood Elementary for 4th grade stud...

  20. The Effect of a "Mindful Restaurant Eating" Intervention on Weight Management in Women

    ERIC Educational Resources Information Center

    Timmerman, Gayle M.; Brown, Adama

    2012-01-01

    Objective: To evaluate the effect of a "Mindful Restaurant Eating" intervention on weight management. Design: Randomized control trial. Setting: Greater metropolitan area of Austin, Texas. Participants: Women (n = 35) 40-59 years old who eat out at least 3 times per week. Intervention: The intervention, using 6 weekly 2-hour, small group…

  1. The Efficacy of a Multifaceted Weight Management Program for Children and Young Adolescents

    ERIC Educational Resources Information Center

    Kihm, Holly Spencer

    2014-01-01

    The incidence of overweight and obesity among children and young adolescents remains unacceptably high and places our youth at risk for several negative outcomes. Recognizing the need for a youth-focused weight management program in our community, the researcher developed, implemented, and evaluated a small pilot study, FitKids. The aims of…

  2. Understanding Weight Management Perceptions in First-Year College Students Using the Health Belief Model

    ERIC Educational Resources Information Center

    Das, Bhibha M.; Evans, Ellen M.

    2014-01-01

    Objective: To examine weight management barriers, using the Health Belief Model, in first-year college students. Participants: First-year college students (n = 45), with data collected in April, May, and November 2013. Methods: Nominal group technique sessions (n = 8) were conducted. Results: First-year students recognize benefits to weight…

  3. A Guide to Care and Management of Very Low Birth Weight Infants. A Team Approach.

    ERIC Educational Resources Information Center

    Semmler, Caryl J., Ed.

    The 14 articles, which make up the bulk of this book provide an interdisciplinary guide to the management of very low birth weight infants. Following an introduction, the first section, titled "Family Considerations," presents three papers discussing, respectively, parent-infant interaction, cultural variables in pediatric care, and parents'…

  4. Body Power! School-Based Weight Management for Middle School Adolescents. Leader's Manual.

    ERIC Educational Resources Information Center

    Dennee, Phyllis M.; And Others

    This leader's manual contains the materials required to present a school-based weight management curriculum that may be offered both in school and outside the school setting for middle-school adolescents. The first section contains instructor information regarding the following topics: need for the program; program objectives; timeline and…

  5. Dissemination of an effective weight management program for Mexican American children in schools

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The rates of child obesity are epidemic in the United States, and Mexican American children are at particular risk. We have found an intensive, multi-component, school-based, weight management intervention to be efficacious at reducing standardized body mass index (zBMI) in overweight children. Our ...

  6. Quality of life in Mexican American children following a weight management program

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Our objective was to evaluate quality of life (QOL) in at-risk for overweight and overweight Mexican American children after participating in 6 months of intensive weight management or self-help. Eighty sixth- and seventh-grade at-risk for overweight (BMI >= 85th to < 95th percentile) and overweight...

  7. Predictors of Low-income, Obese Mothers' Use of Healthful Weight Management Behaviors

    ERIC Educational Resources Information Center

    Chang, Mei-Wei; Nitzke, Susan; Brown, Roger; Baumann, Linda

    2011-01-01

    Objective: To examine the influence of personal and environmental factors on healthful weight management behaviors mediated through self-efficacy among low-income obese mothers. Design: Cross-sectional design. Setting: Special Supplemental Nutrition Program for Women, Infants, and Children in Wisconsin. Participants: Two hundred eighty-four obese…

  8. Integrating user perspectives into the development of a web-based weight management intervention.

    PubMed

    Yardley, L; Williams, S; Bradbury, K; Garip, G; Renouf, S; Ware, L; Dorling, H; Smith, E; Little, P

    2012-10-01

    The objective of this study was to adapt the design of our weight management intervention to the needs, expectations and capabilities of potential users. In study 1, we interviewed 25 people about their experiences of weight management. The findings of these interviews were combined with findings from existing theory and research in a process of 'intervention planning' that informed the design of the intervention. Study 2 comprised in-depth think-aloud studies with a further 16 people interested in using a web-based intervention to manage their weight, in order to elicit reactions to the intervention techniques and materials. In study 1, overly intrusive and restrictive aspects of eating self-regulation were commonly cited reasons for failure to maintain weight management long-term. We therefore designed an intervention with a more flexible approach to autonomous self-regulation. This approach was broadly welcomed in study 2, but there were indications that some participants might have difficulty effectively implementing self-regulation techniques independently. A flexible and autonomous approach to changing eating habits is attractive to potential intervention users but may be difficult for some users to implement successfully.

  9. Clinical management of severe fluorosis in an adult

    PubMed Central

    Farid, Huma; Khan, Farhan Raza

    2012-01-01

    Dental fluorosis is defined as hypomineralisation of enamel resulting from excessive ingestion of fluoride (more than 1 ppm) during tooth development. Mild-to-moderate forms of dental fluorosis are often unnoticed by the patients whereas severe fluorosis presents with dark brown-to-black discolouration of teeth along with enamel pitting and hypoplasia. Such discolouration results in an unpleasing appearance as well as psychological distress to the affected individual. Dental fluorosis can be managed by bleaching, micro/macroabrasion, veneering or crowning. The choice between different treatment options depends on the severity of fluorosis and patients’ aesthetic demands. The aim of this case report was to describe the stepwise oral rehabilitation of an adult with severe fluorosis along with multiple carious teeth. After restoration of carious teeth and extraction of unsalvageable teeth, bleaching and full-coverage restorations were used for the management of fluorosis. PMID:23230244

  10. Patients' experience of a telephone booster intervention to support weight management in Type 2 diabetes and its acceptability.

    PubMed

    Wu, Lihua; Forbes, Angus; While, Alison

    2010-01-01

    We studied the patient experience of a telephone booster intervention, i.e. weekly reinforcement of the clinic advice regarding lifestyle modification advice to support weight loss. Forty six adults with Type 2 diabetes and a body mass index >28 kg/m(2) were randomised into either intervention (n = 25) or control (n = 21) groups. Semi-structured interviews were conducted with the intervention group participants to explore their views and experiences. The patients were satisfied or very satisfied with the telephone calls and most would recommend the intervention to others in a similar situation. The content of the telephone follow-up met their need for on-going support. The benefits arising from the telephone calls included: being reminded to comply with their regimen; prompting and motivating adherence to diabetes self-care behaviours; improved self-esteem; and feeling 'worthy of interest'. The convenience and low cost of telephone support has much potential in chronic disease management.

  11. Smartloss: A Personalized Mobile Health Intervention for Weight Management and Health Promotion

    PubMed Central

    Gilmore, L. Anne; Apolzan, John W; Myers, Candice A; Thomas, Diana M

    2016-01-01

    Background Synonymous with increased use of mobile phones has been the development of mobile health (mHealth) technology for improving health, including weight management. Behavior change theory (eg, the theory of planned behavior) can be effectively encapsulated into mobile phone-based health improvement programs, which is fostered by the ability of mobile phones and related devices to collect and transmit objective data in near real time and for health care or research professionals and clients to communicate easily. Objective To describe SmartLoss, a semiautomated mHealth platform for weight loss. Methods We developed and validated a dynamic energy balance model that determines the amount of weight an individual will lose over time if they are adherent to an energy intake prescription. This model was incorporated into computer code that enables adherence to a prescribed caloric prescription determined from the change in body weight of the individual. Data from the individual are then used to guide personalized recommendations regarding weight loss and behavior change via a semiautomated mHealth platform called SmartLoss, which consists of 2 elements: (1) a clinician dashboard and (2) a mobile phone app. SmartLoss includes and interfaces with a network-connected bathroom scale and a Bluetooth-connected accelerometer, which enables automated collection of client information (eg, body weight change and physical activity patterns), as well as the systematic delivery of preplanned health materials and automated feedback that is based on client data and is designed to foster prolonged adherence with body weight, diet, and exercise goals. The clinician dashboard allows for efficient remote monitoring of all clients simultaneously, which may further increase adherence, personalization of treatment, treatment fidelity, and efficacy. Results Evidence of the efficacy of the SmartLoss approach has been reported previously. The present report provides a thorough description

  12. Integrating mobile technology with routine dietetic practice: the case of myPace for weight management.

    PubMed

    Harricharan, Michelle; Gemen, Raymond; Celemín, Laura Fernández; Fletcher, David; de Looy, Anne E; Wills, Josephine; Barnett, Julie

    2015-05-01

    The field of Mobile health (mHealth), which includes mobile phone applications (apps), is growing rapidly and has the potential to transform healthcare by increasing its quality and efficiency. The present paper focuses particularly on mobile technology for body weight management, including mobile phone apps for weight loss and the available evidence on their effectiveness. Translation of behaviour change theory into weight management strategies, including integration in mobile technology is also discussed. Moreover, the paper presents and discusses the myPace platform as a case in point. There is little clinical evidence on the effectiveness of currently available mobile phone apps in enabling behaviour change and improving health-related outcomes, including sustained body weight loss. Moreover, it is unclear to what extent these apps have been developed in collaboration with health professionals, such as dietitians, and the extent to which apps draw on and operationalise behaviour change techniques has not been explored. Furthermore, presently weight management apps are not built for use as part of dietetic practice, or indeed healthcare more widely, where face-to-face engagement is fundamental for instituting the building blocks for sustained lifestyle change. myPace is an innovative mobile technology for weight management meant to be embedded into and to enhance dietetic practice. Developed out of systematic, iterative stages of engagement with dietitians and consumers, it is uniquely designed to complement and support the trusted health practitioner-patient relationship. Future mHealth technology would benefit if engagement with health professionals and/or targeted patient groups, and behaviour change theory stood as the basis for technology development. Particularly, integrating technology into routine health care practice, rather than replacing one with the other, could be the way forward.

  13. Developing a Web-Based Weight Management Program for Childhood Cancer Survivors: Rationale and Methods

    PubMed Central

    Meagher, Susan; Scheurer, Michael; Folta, Sara; Finnan, Emily; Criss, Kerry; Economos, Christina; Dreyer, ZoAnn; Kelly, Michael

    2016-01-01

    Background Due to advances in the field of oncology, survival rates for children with cancer have improved significantly. However, these childhood cancer survivors are at a higher risk for obesity and cardiovascular diseases and for developing these conditions at an earlier age. Objective In this paper, we describe the rationale, conceptual framework, development process, novel components, and delivery plan of a behavioral intervention program for preventing unhealthy weight gain in survivors of childhood acute lymphoblastic leukemia (ALL). Methods A Web-based program, the Healthy Eating and Active Living (HEAL) program, was designed by a multidisciplinary team of researchers who first identified behaviors that are appropriate targets for weight management in childhood ALL survivors and subsequently developed the intervention components, following core behavioral change strategies grounded in social cognitive and self-determination theories. Results The Web-based HEAL curriculum has 12 weekly self-guided sessions to increase parents’ awareness of the potential impact of cancer treatment on weight and lifestyle habits and the importance of weight management in survivors’ long-term health. It empowers parents with knowledge and skills on parenting, nutrition, and physical activity to help them facilitate healthy eating and active living soon after the child completes intensive cancer treatment. Based on social cognitive theory, the program is designed to increase behavioral skills (goal-setting, self-monitoring, and problem-solving) and self-efficacy and to provide positive reinforcement to sustain behavioral change. Conclusions Lifestyle interventions are a priority for preventing the early onset of obesity and cardiovascular risk factors in childhood cancer survivors. Intervention programs need to meet survivors’ targeted behavioral needs, address specific barriers, and capture a sensitive window for behavioral change. In addition, they should be convenient

  14. Primary care-based, targeted screening programme to promote sustained weight management

    PubMed Central

    Järvenpää, Salme; Kautiainen, Hannu

    2014-01-01

    Abstract Objective. To identify overweight and obese subjects at increased cardiovascular risk in the community, and provide them with lifestyle counselling that is possible to implement in real life. Design. Longitudinal cohort study. Setting. The communities of Harjavalta and Kokemäki in south-western Finland. Subjects. A tape for measurement of waist and a risk factor questionnaire was mailed to home-dwelling inhabitants aged 45–70 years (n = 6013). Of the 4421 respondents, 2752 with at least one cardiovascular risk factor were examined by a public health nurse. For the subjects with high cardiovascular risk (n = 1950), an appointment with a physician was scheduled. The main goal of lifestyle counselling for the 1608 high-risk subjects with BMI ≥ 25 kg/m2 was weight reduction of at least 5%. Among these, 906 had completed self-administrated questionnaires at baseline and form the present study population. Main outcome measure. Success in weight management. Results. At the three-year follow-up visit, 18% of subjects had lost ≥ 5% of their initial weight and 70% had stabilized their weight, while 12% had gained weight ≥ 5%. Newly diagnosed glucose disorder (OR 1.37 [95% CI 1.02–1.84]) predicted success in weight management, whereas depressive symptoms (OR 0.61 [95% CI 0.42–0.90]), excess alcohol use (OR 0.63 [95% CI 0.44–0.90]), and number of drugs used (OR 0.91 [95% CI 0.83–0.99]) at baseline predicted poor outcome. Conclusions. A primary care screening programme to identify overweight or obese individuals can promote sustained weight management. Psychological factors, especially depressive symptoms, are a critical component to consider before attempts to change the lifestyle of an individual. PMID:24592894

  15. Obese women's reasons for not attending a weight management service during pregnancy.

    PubMed

    Olander, Ellinor K; Atkinson, Lou

    2013-10-01

    Evaluations of services targeting obese women's gestational weight gain often report low uptake. Thus it is important to elicit the reasons why obese pregnant women decline to participate in these services and to identify their barriers to participation. Sixteen obese pregnant and postnatal women were interviewed regarding their reasons for declining a group-based service targeting their gestational weight gain. All interviews were recorded, transcribed verbatim and analyzed thematically. Both pragmatic and motivational barriers were identified. The most common practical reasons for not attending the service were its inconvenient location and time, and feeling unable to attend due to work commitments. Pregnancy-specific barriers included decreased mobility and feeling unwell. Motivational barriers included lack of interest and not wanting to focus on one's weight in pregnancy. These findings highlight issues that need to be taken into consideration when designing group-based weight management services for this population.

  16. Management of Relocation in Cognitively Intact Older Adults.

    PubMed

    Hertz, Judith E; Koren, Mary Elaine; Rossetti, Jeanette; Tibbits, Kathryn

    2016-11-01

    Relocation, a major life transition that can affect health positively and negatively, is moving from one permanent home to another. Many older adults will relocate at some time during their life. Relocation is also a complex process that requires careful consideration and planning before the move (i.e., pre-location) and adjustment to the new home after the move (i.e., post-relocation). The current article is a summary of content based on a comprehensive evidence-based practice guideline focused on management of relocation in cognitively intact older adults. The guideline was designed to be used across diverse settings by nurses and other providers. Pre-relocation guidelines include assessment for the need for relocation, interventions prior to moving, and outcomes for evaluation of the pre-relocation process. For post-relocation, content focuses on assessment of risks for not adjusting after the move as well as intervention guidelines to promote adjustment and outcomes for evaluation. Implications include advocacy for older adults by using the guideline, disseminating it, and conducting future research. [Journal of Gerontological Nursing, 42(11), 14-23.].

  17. Frequent self-weighing with electronic graphic feedback to prevent age-related weight gain in young adults

    PubMed Central

    Bertz, Fredrik; Pacanowski, Carly R.; Levitsky, David A.

    2016-01-01

    Background Young adults display substantial weight gain. Preventing this age-related weight gain would reduce overweight and obesity. Objective We evaluated an internet based intervention using Internet-connected scales and graphic email feedback; the Caloric Titration Method (CTM), to reduce age-related weight gain over the course of 1 y among first-year college students. Design First-year college students (n=167) were randomized to (CTM) or control (C) group. Both groups were provided Internet-connected scales. CTM group was instructed to weigh daily, view a weight graph emailed to them after weighing, and try to maintain their weight as indicated in the graph. The C group could weigh at any time, but did not receive feedback. At six months and 1 year the C group were notified to provide weights. Intention to treat analysis, using a mixed model adjusted for baseline weight, BMI and gender was used to analyze the effect of the intervention. Results Baseline Body Mass Index was 22.9 ± 3.0 kg/m2. Frequency of self-weighing (median) was 5 times/week in the CTM group, compared to 1 time/week in C (p<0.001). Ninety-five percent of the CTM participants weighed ≥3 times/week, compared to 15% in C group (p<0.001). After 1 year the C group had gained 1.1 ± 4.4 kg whereas the CTM group lost 0.5 ± 3.7 kg, yielding a significant overall time*group interaction (F=3.39, p=0.035). The difference in weight change between the two groups at 1 year was significant (p=0.004). Weight change of the CTM group was not different from zero whereas weight gain in C group was significant. Retention was 81%. Conclusions The internet based frequent self-weighing CTM system was effective in preventing age-related weight gain in young adults over one year and thus offers promise to reduce overweight and obesity. PMID:26414563

  18. A comparison of low birth weight among newborns of early adolescents, late adolescents, and adult mothers in the Peruvian Amazon.

    PubMed

    Ryan, Julia A; Casapía, Martín; Aguilar, Eder; Silva, Hermánn; Rahme, Elham; Gagnon, Anita J; Manges, Amee R; Joseph, Serene A; Gyorkos, Theresa W

    2011-07-01

    To compare low birth weight (LBW: <2,500 g) between infants born to adolescent and adult mothers in Iquitos, Peru. A random sample of 4,467 records of women who delivered at the Hospital Apoyo Iquitos between 2005 and 2007 was collected from hospital birth registries. Multivariate logistic and linear regression analyses were performed to compare LBW in newborns of adolescents (10-14, 15-19 years) and adults (≥20 years) and then for primiparous mothers with a normal gestational age, adjusting for newborn sex, antenatal care, and location of the mother's residence. A total of 4,384 mothers had had a singleton live birth and 1,501 were primiparous with a normal gestational age. Early and late adolescents had significantly greater odds of having a LBW infant than adults (OR = 2.28, 95%CI: 1.09, 4.78; OR = 1.67, 95%CI: 1.30, 2.14, respectively). For primiparous mothers with a normal gestational age, the same was true only for early adolescents (OR = 3.07, 95%CI: 1.09, 8.61). There were significant differences in mean birth weight between adults (3178.7 g) and both adolescent age groups overall (10-14 years: 2848.9 g; 15-19 years: 2998.3 g) and for primiparous mothers with a normal gestational age (10-14 years: 2900.8 g; 15-19 years: 3059.2 g; ≥20 years: 3151.8 g). Results suggest there is an important difference between adolescent and adult mothers in terms of newborn birth weight, especially among early adolescents. Future research on LBW and possibly other adverse birth outcomes should consider early adolescents as a separate sub-group of higher risk.

  19. Satiety-enhancing products for appetite control: science and regulation of functional foods for weight management.

    PubMed

    Halford, Jason C G; Harrold, Joanne A

    2012-05-01

    The current review considers satiety-based approaches to weight management in the context of health claims. Health benefits, defined as beneficial physiological effects, are what the European Food Safety Authority bases their recommendations on for claim approval. The literature demonstrates that foods that target within-meal satiation and post-meal satiety provide a plausible approach to weight management. However, few ingredient types tested produce the sustainable and enduring effects on appetite accompanied by the necessary reductions in energy intake required to claim satiety/reduction in hunger as a health benefit. Proteins, fibre types, novel oils and carbohydrates resistant to digestion all have the potential to produce beneficial short-term changes in appetite (proof-of-concept). The challenge remains to demonstrate their enduring effects on appetite and energy intake, as well as the health and consumer benefits such effects provide in terms of optimising successful weight management. Currently, the benefits of satiety-enhancing ingredients to both consumers and their health are under researched. It is possible that such ingredients help consumers gain control over their eating behaviour and may also help reduce the negative psychological impact of dieting and the physiological consequences of energy restriction that ultimately undermine weight management. In conclusion, industry needs to demonstrate that a satiety-based approach to weight management, based on single-manipulated food items, is sufficient to help consumers resist the situational and personal factors that drive overconsumption. Nonetheless, we possess the methodological tools, which when employed in appropriate designs, are sufficient to support health claims.

  20. Recognition and management of stroke in young adults and adolescents

    PubMed Central

    Biller, José; Elkind, Mitchell S.; Fullerton, Heather J.; Jauch, Edward C.; Kittner, Steven J.; Levine, Deborah A.; Levine, Steven R.

    2013-01-01

    Approximately 15% of all ischemic strokes (IS) occur in young adults and adolescents. To date, only limited prior public health and research efforts have specifically addressed stroke in the young. Early diagnosis remains challenging because of the lack of awareness and the relative infrequency of stroke compared with stroke mimics. Moreover, the causes of IS in the young are heterogeneous and can be relatively uncommon, resulting in uncertainties about diagnostic evaluation and cause-specific management. Emerging data have raised public health concerns about the increasing prevalence of traditional vascular risk factors in young individuals, and their potential role in increasing the risk of IS, stroke recurrence, and poststroke mortality. These issues make it important to formulate and enact strategies to increase both awareness and access to resources for young stroke patients, their caregivers and families, and health care professionals. The American Academy of Neurology recently convened an expert panel to develop a consensus document concerning the recognition, evaluation, and management of IS in young adults and adolescents. The report of the consensus panel is presented herein. PMID:23946297

  1. Decisional balance for health and weight is associated with whole-fruit intake in low-income young adults.

    PubMed

    Kidd, Tandalayo; Peters, Paula K

    2010-07-01

    Bone health, decreased risk of certain cancers, heart disease, and stroke has been associated with the consumption of fruits. These and other health benefits, such as feeling better and weight loss, have been identified as intrinsic motivators for consumers to increase their consumption of fruits. Thus, if individuals believe more could be gained than lost (decisional balance) by increasing their fruit intake, it is likely that they will consume more. However, despite fruits' positive effect on health, young adults and individuals with low incomes, limited education, or low self-efficacy consume insufficient amounts. To determine variables associated with increased fruit consumption, we hypothesized that decisional balance pros for health and weight would be associated with increased fruit consumption in young adults with low incomes. We surveyed 235 respondents between the ages of 18 and 24 years, with an annual income less than $25,000. Multiple regression analysis measured the impact of the independent variables' (i.e., age, weight satisfaction, income, education, self-efficacy, and pros and cons decisional balance) association with fruit consumption. The decisional balance pros was significantly (F = 2.189, P = .036) associated with overall fruit consumption. Respondents consumed 1.94 +/- 1.64 cups of fruit daily, with fruit juices consumed in greater amounts than any other form of fruit. Decisional balance questions relating to health (P < .05) and weight (P < .01) were significantly related to increased whole fruit intake. Results of this study suggest that decisional balance pros for health and weight can be used to predict whole-fruit consumption in low-income young adults.

  2. Improved Function With Enhanced Protein Intake per Meal: A Pilot Study of Weight Reduction in Frail, Obese Older Adults

    PubMed Central

    Pieper, Carl F.; Orenduff, Melissa C.; McDonald, Shelley R.; McClure, Luisa B.; Zhou, Run; Payne, Martha E.; Bales, Connie W.

    2016-01-01

    Background: Obesity is a significant cause of functional limitations in older adults; yet, concerns that weight reduction could diminish muscle along with fat mass have impeded progress toward an intervention. Meal-based enhancement of protein intake could protect function and/or lean mass but has not been studied during geriatric obesity reduction. Methods: In this 6-month randomized controlled trial, 67 obese (body mass index ≥30kg/m2) older (≥60 years) adults with a Short Physical Performance Battery score of 4–10 were randomly assigned to a traditional (Control) weight loss regimen or one with higher protein intake (>30g) at each meal (Protein). All participants were prescribed a hypo-caloric diet, and weighed and provided dietary guidance weekly. Physical function (Short Physical Performance Battery) and lean mass (BOD POD), along with secondary measures, were assessed at 0, 3, and 6 months. Results: At the 6-month endpoint, there was significant (p < .001) weight loss in both the Control (−7.5±6.2kg) and Protein (−8.7±7.4kg) groups. Both groups also improved function but the increase in the Protein (+2.4±1.7 units; p < .001) was greater than in the Control (+0.9±1.7 units; p < .01) group (p = .02). Conclusion: Obese, functionally limited older adults undergoing a 6-month weight loss intervention with a meal-based enhancement of protein quantity and quality lost similar amounts of weight but had greater functional improvements relative to the Control group. If confirmed, this dietary approach could have important implications for improving the functional status of this vulnerable population (ClinicalTrials.gov identifier: NCT01715753). PMID:26786203

  3. Weight loss during oligofructose supplementation is associated with decreased ghrelin and increased peptide YY in overweight and obese adults2

    PubMed Central

    Parnell, Jill A; Reimer, Raylene A

    2013-01-01

    Background Rodent studies show that oligofructose promotes weight loss, stimulates satiety hormone secretion, reduces energy intake, and improves lipid profiles. Objective Our objective was to examine the effects of oligofructose supplementation on body weight and satiety hormone concentrations in overweight and obese adults. Design This study was a randomized, double-blind, placebo-controlled trial. Forty-eight otherwise healthy adults with a body mass index (in kg/m2) > 25 were randomly assigned to receive 21 g oligo-fructose/d or a placebo (maltodextrin) for 12 wk. Body composition (by dual-energy X-ray absorptiometry); meal tolerance tests, including satiety hormone response; food intake; and subjective appetite ratings were determined. Results There was a reduction in body weight of 1.03 ±0.43 kg with oligofructose supplementation, whereas the control group experienced an increase in body weight of 0.45 ± 0.31 kg over 12 wk (P = 0.01). A lower area under the curve (AUC) for ghrelin (P = 0.004) and a higher AUC for peptide YY (PYY) with oligofructose (P = 0.03) coincided with a reduction in self-reported caloric intake (P ≤ 0.05). Glucose decreased in the oligofructose group and increased in the control group between initial and final tests (P ≤ 0.05). Insulin concentrations mirrored this pattern (P ≤ 0.05). Oligofructose supplementation did not affect plasma active glucagon-like peptide 1 secretion. According to a visual analog scale designed to assess side effects, oligofructose was well tolerated. Conclusions Independent of other lifestyle changes, oligofructose supplementation has the potential to promote weight loss and improve glucose regulation in overweight adults. Suppressed ghrelin and enhanced PYY may contribute in part to the reduction in energy intake. The trial was registered at clinicaltrials.gov as NCT00522353. PMID:19386741

  4. Do weight management interventions delivered by online social networks effectively improve body weight, body composition, and chronic disease risk factors? A systematic review.

    PubMed

    Willis, Erik A; Szabo-Reed, Amanda N; Ptomey, Lauren T; Steger, Felicia L; Honas, Jeffery J; Washburn, Richard A; Donnelly, Joseph E

    2017-02-01

    Introduction Currently, no systematic review/meta-analysis has examined studies that used online social networks (OSN) as a primary intervention platform. Therefore, the purpose of this review was to evaluate the effectiveness of weight management interventions delivered through OSN. Methods PubMed, EMBASE, PsycINFO, Web of Science, and Scopus were searched (January 1990-November 2015) for studies with data on the effect of OSNs on weight loss. Only primary source articles that utilized OSN as the main platform for delivery of weight management/healthy lifestyle interventions, were published in English language peer-reviewed journals, and reported outcome data on weight were eligible for inclusion in this systematic review. Five articles were included in this review. Results One-hundred percent of the studies ( n = 5) reported a reduction in baseline weight. Three of the five studies (60%) reported significant decreases in body weight when OSN was paired with health educator support. Only one study reported a clinical significant weight loss of ≥5%. Conclusion Using OSN for weight management is in its early stages of development and, while these few studies show promise, more research is needed to acquire information about optimizing these interventions to increase their efficacy.

  5. Does Brief Telephone Support Improve Engagement With a Web-Based Weight Management Intervention? Randomized Controlled Trial

    PubMed Central

    Morrison, Leanne; Lloyd, Scott; Phillips, Dawn; Stuart, Beth; Williams, Sarah; Bradbury, Katherine; Roderick, Paul; Murray, Elizabeth; Michie, Susan; Little, Paul; Yardley, Lucy

    2014-01-01

    Background Recent reviews suggest Web-based interventions are promising approaches for weight management but they identify difficulties with suboptimal usage. The literature suggests that offering some degree of human support to website users may boost usage and outcomes. Objective We disseminated the POWeR (“Positive Online Weight Reduction”) Web-based weight management intervention in a community setting. POWeR consisted of weekly online sessions that emphasized self-monitoring, goal-setting, and cognitive/behavioral strategies. Our primary outcome was intervention usage and we investigated whether this was enhanced by the addition of brief telephone coaching. We also explored group differences in short-term self-reported weight loss. Methods Participants were recruited using a range of methods including targeted mailouts, advertisements in the local press, notices on organizational websites, and social media. A total of 786 adults were randomized at an individual level through an online procedure to (1) POWeR only (n=264), (2) POWeR plus coaching (n=247), or (3) a waiting list control group (n=275). Those in the POWeR plus coaching arm were contacted at approximately 7 and 28 days after randomization for short coaching telephone calls aimed at promoting continued usage of the website. Website usage was tracked automatically. Weight was assessed by online self-report. Results Of the 511 participants allocated to the two intervention groups, the median number of POWeR sessions completed was just one (IQR 0-2 for POWeR only, IQR 0-3 for POWeR plus coach). Nonetheless, a substantial minority completed at least the core three sessions of POWeR: 47 participants (17.8%, 47/264) in the POWeR-only arm and 64 participants (25.9%, 64/247) in the POWeR plus coaching arm. Participants in the POWeR plus coaching group persisted with the intervention for longer and were 1.61 times more likely to complete the core three sessions than the POWeR-only group (χ2 1=4.93; OR 1

  6. The Admissions Strategist. Recruiting in the 1980s. No. 11: Enrollment Management and Adult Students.

    ERIC Educational Resources Information Center

    MacGowan, Sandra, Ed.

    1988-01-01

    Information is presented on enrollment management for adult students. Papers presented at various seminars on the subject are compiled as follows: "Enrollment Management: College Recruitment Philosophy for the Eighties" (Don Hossler); "Enrollment Management Without Adult Students: Only Half the Story" (Carol B. Aslanian);…

  7. Determinants of Weight Gain Prevention in Young Adult and Midlife Women: Study Design and Protocol of a Randomized Controlled Trial

    PubMed Central

    2015-01-01

    Background Treatment of overweight and obesity through body weight reduction has been monumentally ineffective as few individuals are able to sustain weight loss. Rather than treating weight gain once it has become problematic, prevention of weight gain over time may be more effective. Objective The aim of this research is to preclude the burden of adult obesity in women by identifying the determinants of weight gain prevention. The objective of this randomized controlled trial (RCT) is to compare a weight gain prevention intervention delivered by the registered dietitian versus counselor. Methods This is a 12-month parallel-arm weight gain prevention RCT designed to increase self-efficacy, self-regulation, outcome expectations and family and social support through the use of a nutrition education intervention in women, aged 18-45 years, from the Urbana-Champaign (Illinois, USA) area. Women have been randomized to registered dietitian, counselor or wait-list control groups (August 2014) and are undergoing weekly nutrition education sessions for four months, followed by monthly sessions for eight months (through August 2015). Outcome measures, including: (1) dietary intake, (2) physical activity, (3) anthropometric and blood pressure measurements, (4) biochemical markers of health, (5) eating behaviors and health perceptions, and (6) mediators of behavior change, were collected before the intervention began (baseline) and will be collected at 3, 6, 9, and 12 months of the study. Results In total, 87 women have been randomized to intervention groups, and 81 women have completed first week of the study. Results are expected in early 2016. Conclusions This RCT is one of the first to examine weight gain prevention in women across normal, overweight, and obese body mass index categories. Results of this research are expected to have application to evidence-based practice in weight gain prevention for women and possibly have implication for policy regarding decreasing the

  8. New loci associated with birth weight identify genetic links between intrauterine growth and adult height and metabolism

    PubMed Central

    Horikoshi, Momoko; Yaghootkar, Hanieh; Mook-Kanamori, Dennis O.; Sovio, Ulla; Taal, H. Rob; Hennig, Branwen J.; Bradfield, Jonathan P.; St. Pourcain, Beate; Evans, David M.; Charoen, Pimphen; Kaakinen, Marika; Cousminer, Diana L.; Lehtimäki, Terho; Kreiner-Møller, Eskil; Warrington, Nicole M.; Bustamante, Mariona; Feenstra, Bjarke; Berry, Diane J.; Thiering, Elisabeth; Pfab, Thiemo; Barton, Sheila J.; Shields, Beverley M.; Kerkhof, Marjan; van Leeuwen, Elisabeth M.; Fulford, Anthony J.; Kutalik, Zoltán; Zhao, Jing Hua; den Hoed, Marcel; Mahajan, Anubha; Lindi, Virpi; Goh, Liang-Kee; Hottenga, Jouke-Jan; Wu, Ying; Raitakari, Olli T.; Harder, Marie N.; Meirhaeghe, Aline; Ntalla, Ioanna; Salem, Rany M.; Jameson, Karen A.; Zhou, Kaixin; Monies, Dorota M.; Lagou, Vasiliki; Kirin, Mirna; Heikkinen, Jani; Adair, Linda S.; Alkuraya, Fowzan S.; Al-Odaib, Ali; Amouyel, Philippe; Andersson, Ehm Astrid; Bennett, Amanda J.; Blakemore, Alexandra I.F.; Buxton, Jessica L.; Dallongeville, Jean; Das, Shikta; de Geus, Eco J. C.; Estivill, Xavier; Flexeder, Claudia; Froguel, Philippe; Geller, Frank; Godfrey, Keith M.; Gottrand, Frédéric; Groves, Christopher J.; Hansen, Torben; Hirschhorn, Joel N.; Hofman, Albert; Hollegaard, Mads V.; Hougaard, David M.; Hyppönen, Elina; Inskip, Hazel M.; Isaacs, Aaron; Jørgensen, Torben; Kanaka-Gantenbein, Christina; Kemp, John P.; Kiess, Wieland; Kilpeläinen, Tuomas O.; Klopp, Norman; Knight, Bridget A.; Kuzawa, Christopher W.; McMahon, George; Newnham, John P.; Niinikoski, Harri; Oostra, Ben A.; Pedersen, Louise; Postma, Dirkje S.; Ring, Susan M.; Rivadeneira, Fernando; Robertson, Neil R.; Sebert, Sylvain; Simell, Olli; Slowinski, Torsten; Tiesler, Carla M.T.; Tönjes, Anke; Vaag, Allan; Viikari, Jorma S.; Vink, Jacqueline M.; Vissing, Nadja Hawwa; Wareham, Nicholas J.; Willemsen, Gonneke; Witte, Daniel R.; Zhang, Haitao; Zhao, Jianhua; Wilson, James F.; Stumvoll, Michael; Prentice, Andrew M.; Meyer, Brian F.; Pearson, Ewan R.; Boreham, Colin A.G.; Cooper, Cyrus; Gillman, Matthew W.; Dedoussis, George V.; Moreno, Luis A; Pedersen, Oluf; Saarinen, Maiju; Mohlke, Karen L.; Boomsma, Dorret I.; Saw, Seang-Mei; Lakka, Timo A.; Körner, Antje; Loos, Ruth J.F.; Ong, Ken K.; Vollenweider, Peter; van Duijn, Cornelia M.; Koppelman, Gerard H.; Hattersley, Andrew T.; Holloway, John W.; Hocher, Berthold; Heinrich, Joachim; Power, Chris; Melbye, Mads; Guxens, Mònica; Pennell, Craig E.; Bønnelykke, Klaus; Bisgaard, Hans; Eriksson, Johan G.; Widén, Elisabeth; Hakonarson, Hakon; Uitterlinden, André G.; Pouta, Anneli; Lawlor, Debbie A.; Smith, George Davey; Frayling, Timothy M.; McCarthy, Mark I.; Grant, Struan F.A.; Jaddoe, Vincent W.V.; Jarvelin, Marjo-Riitta; Timpson, Nicholas J.; Prokopenko, Inga; Freathy, Rachel M.

    2012-01-01

    Birth weight within the normal range is associated with a variety of adult-onset diseases, but the mechanisms behind these associations are poorly understood1. Previous genome-wide association studies identified a variant in the ADCY5 gene associated both with birth weight and type 2 diabetes, and a second variant, near CCNL1, with no obvious link to adult traits2. In an expanded genome-wide association meta-analysis and follow-up study (up to 69,308 individuals of European descent from 43 studies), we have now extended the number of genome-wide significant loci to seven, accounting for a similar proportion of variance to maternal smoking. Five of the loci are known to be associated with other phenotypes: ADCY5 and CDKAL1 with type 2 diabetes; ADRB1 with adult blood pressure; and HMGA2 and LCORL with adult height. Our findings highlight genetic links between fetal growth and postnatal growth and metabolism. PMID:23202124

  9. Wii Fit exer-game training improves sensory weighting and dynamic balance in healthy young adults.

    PubMed

    Cone, Brian L; Levy, Susan S; Goble, Daniel J

    2015-02-01

    The Nintendo Wii Fit is a balance training tool that is growing in popularity due to its ease of access and cost-effectiveness. While considerable evidence now exists demonstrating the efficacy of the Wii Fit, no study to date has determined the specific mechanism underlying Wii Fit balance improvement. This paucity of knowledge was addressed in the present study using the NeuroCom Balance Manager's Sensory Organization Test (SOT) and Limits of Stability (LOS) test. These well-recognized posturography assessments, respectively, measure sensory weighting and dynamic stability mechanisms of balance. Forty healthy, young participants were recruited into two groups: Wii Fit Balance Intervention (WFBI) (n=20) and Control (CON) (n=20). Balance training consisted of seven Wii Fit exer-games played over the course of six consecutive weeks (2-4×/week, 30-45min/day). The WFBI group performed Neurocom testing before and after the intervention, while the CON group was tested along a similar timeline with no intervention. Mixed-design ANOVAs found significant interactions for testing time point and condition 5 of the SOT (p<0.02), endpoint excursion (p<0.01), movement velocity (p<0.02), and response time (p<0.01). These effects were such that greater improvements were seen for the WFBI group following Wii Fit training. These findings suggest that individuals with known issues regarding the processing of multiple sources of sensory information and/or who have limited functional bases of support may benefit most from Wii Fit balance training.

  10. Indicated prevention of adult obesity: reference data for weight normalization in overweight children

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Pediatric obesity is a major risk factor for adult obesity. Indicated prevention--that is, helping overweight or obese youth attain non-overweight status--has been suggested to prevent adult obesity. This study aimed to support the notion of indicated prevention by demonstrating that rel...

  11. Challenges in interdisciplinary weight management in primary care: lessons learned from the 5As Team study.

    PubMed

    Asselin, J; Osunlana, A M; Ogunleye, A A; Sharma, A M; Campbell-Scherer, D

    2016-04-01

    Increasingly, research is directed at advancing methods to address obesity management in primary care. In this paper we describe the role of interdisciplinary collaboration, or lack thereof, in patient weight management within 12 teams in a large primary care network in Alberta, Canada. Qualitative data for the present analysis were derived from the 5As Team (5AsT) trial, a mixed-method randomized control trial of a 6-month participatory, team-based educational intervention aimed at improving the quality and quantity of obesity management encounters in primary care practice. Participants (n = 29) included in this analysis are healthcare providers supporting chronic disease management in 12 family practice clinics randomized to the intervention arm of the 5AsT trial including mental healthcare workers (n = 7), registered dietitians (n = 7), registered nurses or nurse practitioners (n = 15). Participants were part of a 6-month intervention consisting of 12 biweekly learning sessions aimed at increasing provider knowledge and confidence in addressing patient weight management. Qualitative methods included interviews, structured field notes and logs. Four common themes of importance in the ability of healthcare providers to address weight with patients within an interdisciplinary care team emerged, (i) Availability; (ii) Referrals; (iii) Role perception and (iv) Messaging. However, we find that what was key to our participants was not that these issues be uniformly agreed upon by all team members, but rather that communication and clinic relationships support their continued negotiation. Our study shows that firm clinic relationships and deliberate communication strategies are the foundation of interdisciplinary care in weight management. Furthermore, there is a clear need for shared messaging concerning obesity and its treatment between members of interdisciplinary teams.

  12. Effect of a Stepped-Care Intervention Approach on Weight Loss in Adults: The Step-Up Study Randomized Trial

    PubMed Central

    Jakicic, John M.; Tate, Deborah F.; Lang, Wei; Davis, Kelli K.; Polzien, Kristen; Rickman, Amy D.; Erickson, Karen; Neiberg, Rebecca H.; Finkelstein, Eric A.

    2014-01-01

    Context Given the obesity epidemic, effective but resource efficient weight loss treatments are needed. Stepped treatment approaches customize interventions based on milestone completion and can be more effective while costing less to administer than conventional treatment paradigms. Objective We hypothesized that compared to a standard behavioral weight loss intervention (SBWI), a stepped-care weight loss intervention (STEP) would result in greater weight loss. Design Randomized trial with participants enrolled between May 2008 and February 2010. Data collection was completed by September 2011. Setting 2 universities affiliated with academic medical centers. Participants Participants were 363 overweight and obese adults (BMI: 25 to <40 kg/m2; age: 18–55 years; 33% non-white, 83% female) who were randomized to SBWI or STEP interventions. Interventions All participants were placed on a low calorie diet, prescribed increases in physical activity and had group counseling sessions ranging from weekly to monthly during an 18-month time period. SBWI participants were assigned to a fixed program. Among STEP participants, counseling frequency, type, and weight loss strategies could be modified every 3 months in response to observed weight loss as it related to weight loss goals. Main Outcome Measure Mean change in weight over 18 months. Additional outcomes include resting heart rate and blood pressure, waist girth, body composition, fitness, physical activity, dietary intake, and costs. Results Of the 363 participants randomized, 260 participants (71.6%) provided a measure of mean change in weight over 18 months. The 18 month intervention resulted in weight decreasing from 93.1 kg (95% CI: 91.0, 95.2) to 85.6 kg (95% CI: 83.4, 88.0) (p<0.01) in SBWI and from 92.7 kg (95% CI: 90.8, 94.6) to 86.4 kg (95% CI: 84.5, 88.4) in STEP (p<0.01). Percent weight change from baseline to 18 months was −8.1% (95% CI: −9.4, −6.9) in SBWI (p<0.01) and −6.9% (95% CI: −8.0, −5

  13. The Impact of Body Mass Index and Weight Changes on Disability Transitions and Mortality in Brazilian Older Adults

    PubMed Central

    Drumond Andrade, Flávia Cristina; Mohd Nazan, Ahmad Iqmer Nashriq; Lebrão, Maria Lúcia; de Oliveira Duarte, Yeda Aparecida

    2013-01-01

    The aim of this study was to examine the association between body mass index and weight changes on disability transitions and mortality among Brazilian older adults. Longitudinal data from the Health, Well-Being, and Aging in Latin America and the Caribbean Study conducted in São Paulo, Brazil (2000 and 2006), were used to examine the impact of obesity on disability and mortality and of weight changes on health transitions related to disability. Logistic and multinomial regression models were used in the analyses. Individuals who were obese were more likely than those of normal weight to have limitations on activities of daily living (ADL), instrumental activity of daily living (IADL), and Nagi's limitations. Obesity was associated with higher incidence of ADL and IADL limitations and with lower recovery from Nagi's limitations. Compared to those who maintained their weight, those who gained weight experienced higher incidence of ADL and Nagi's limitations, even after controlling for initial body mass index. Higher mortality among overweight individuals was only found when the reference category was “remaining free of Nagi limitations.” The findings of the study underline the importance of maintaining normal weight for preventing disability at older ages. PMID:23691319

  14. Birth weight and adult health in historical perspective: evidence from a New Zealand cohort, 1907-1922.

    PubMed

    Roberts, Evan; Wood, Pamela

    2014-04-01

    We provide new historical evidence on the developmental origins of health and disease in a cohort of boys born between 1907 and 1922 in Wellington, New Zealand. Using a dataset of 1523 birth records that include birth weight and length we find 852 (58%) of the adult cohort in World War II records measuring stature, body mass and blood pressure. On average, the boys weighed 3.5 kg at birth, similar to Australian and American babies of the era, and nearly identical to full-term New Zealand babies in the 1990s. Using OLS regression models we estimate the effect of birth weight on adult stature and systolic blood pressure. We find an increase in birth weight of 1 kg is associated with an increase in stature of 2.6 cm (95% confidence interval [CI] 1.6 cm-3.6 cm), and a decrease in systolic blood pressure of 2.1 mm/Hg (95% CI - 5.00 to 0.67). This is the earliest cohort by fifty years for whom the fetal origins hypothesis has been examined in early adulthood. Our estimates of the effect of birth weight on blood pressure are towards the upper end of the range of published estimates in modern cohorts.

  15. Description and preliminary results from a structured specialist behavioural weight management group intervention: Specialist Lifestyle Management (SLiM) programme

    PubMed Central

    Brown, Adrian; Gouldstone, Amy; Fox, Emily; Field, Annmarie; Todd, Wendy; Shakher, Jayadave; Bellary, Srikanth; Teh, Ming Ming; Azam, Muhammad; John, Reggie; Jagielski, Alison; Arora, Teresa; Thomas, G Neil; Taheri, Shahrad

    2015-01-01

    Background Specialist Lifestyle Management (SLiM) is a structured patient education and self-management group weight management programme. Each session is run monthly over a 6-month period providing a less intensive long-term approach. The groups are patient-centred incorporating educational, motivational, behavioural and cognitive elements. The theoretical background, programme structure and preliminary results of SLiM are presented. Subjects/methods The study was a pragmatic service evaluation of obese patients with a body mass index (BMI) ≥35 kg/m2 with comorbidity or ≥40 kg/m2 without comorbidity referred to a specialist weight management service in the West Midlands, UK. 828 patients were enrolled within SLiM over a 48-month period. Trained facilitators delivered the programme. Preliminary anonymised data were analysed using the intention-to-treat principle. The primary outcome measure was weight loss at 3 and 6 months with comparisons between completers and non-completers performed. The last observation carried forward was used for missing data. Results Of the 828 enrolled within SLiM, 464 completed the programme (56%). The mean baseline weight was 135 kg (BMI=49.1 kg/m2) with 87.2% of patients having a BMI≥40 kg/m2 and 12.4% with BMI≥60 kg/m2. The mean weight change of all patients enrolled was −4.1 kg (95% CI −3.6 to −4.6 kg, p=0.0001) at the end of SLiM, with completers (n=464) achieving −5.5 kg (95% CI −4.2 to −6.2 kg, p=0.0001) and non-completers achieving −2.3 kg (p=0.0001). The majority (78.6%) who attended the 6-month programme achieved weight loss with 32.3% achieving a ≥5% weight loss. Conclusions The SLiM programme is an effective group intervention for the management of severe and complex obesity. PMID:25854970

  16. Benefits of modest weight loss on the management of type 2 diabetes mellitus.

    PubMed

    Lau, David C W; Teoh, Hwee

    2013-04-01

    The epidemic of overweight and obesity is a major driver of the growing prevalence of type 2 diabetes mellitus globally. The risk of type 2 diabetes increases exponentially as body mass index rises above 25 kg/m(2). Obesity currently costs the Canadian economy approximately $7.1 billion annually whereas per capita health care cost for individuals with diabetes are 3 to 4 times that for persons without the disease. Each kilogram of weight lost through health behaviour changes in people with impaired glucose tolerance is associated with a relative diabetes risk reduction of 16%. As 80% to 90% of people with type 2 diabetes are overweight or obese, and adiposity worsens the metabolic and physiologic abnormalities associated with type 2 diabetes, weight loss is recommended as the cornerstone management measure. A modest weight loss of 5% to 10% is an achievable and realistic goal for preventing type 2 diabetes in susceptible individuals and improving glycemic and metabolic control in people with type 2 diabetes. When health behaviour modification fails to achieve glycemic and metabolic goal targets, priority should be given to antihyperglycemic agents that are associated with weight loss or weight neutrality. Every pound of body fat loss matters and every kilogram counts in the management of type 2 diabetes.

  17. Weight-Gain Velocity in Newborn Infants Managed with the Kangaroo Method and Associated Variables.

    PubMed

    Nobre, Raquel Guimarães; de Azevedo, Daniela Vasconcelos; de Almeida, Paulo César; de Almeida, Nádia Maria Girão Saraiva; Feitosa, Francisco Edson de Lucena

    2017-01-01

    Objectives The Kangaroo method helps promote maternal breastfeeding and adequate growth of low birthweight preterm infants. The objective of this study was to analyze the association between weight-gain velocity during use of the Kangaroo method and maternal and infant variables. Methods A nested cross-sectional study in a cohort of newborn infants managed using the Kangaroo method was carried out at a reference center for the method in Brazil. Data on low birthweight and preterm infants managed using the Kangaroo Method (n = 78) and on their respective mothers (n = 70) was collected between January and July 2014. Maternal and infant variables were associated and correlated with weight-gain velocity (g/kg/day) at each phase of the method (p < 0.05). Results Mean weight-gain velocity increased from 0.12 ± 11.11 g/kg/day in the first phase to 13.47 ± 4.84 g/kg/day in the third phase (p < 0.001), and percentage of adequate weight increased at phase 3 (p < 0.001). Birthweight was inversely correlated with weight-gain velocity at phases 1 and 2 of the Kangaroo method. Birthweight of under 1500 g was associated with a lower likelihood of inadequate weight-gain velocity of the newborn at phase 1 (OR = 0.1; 95 % CI 0.01-0.78; p = 0.012). In phase 3, maternal age was directly correlated with weight-gain velocity. Conclusions Weight-gain velocity was associated with maternal (age) and infant (gestational age at birth, birthweight, weight for gestational age at birth, length of hospital stay and five-minute Apgar score) variables. Knowledge of the factors influencing weight-gain velocity and its behavior at each phase of the method can help guide conduct toward potentializing factors that promote adequate weight-gain.

  18. Does diet-induced weight change effect anxiety in overweight and obese adults?

    PubMed

    Eyres, Stacey L; Turner, Anne I; Nowson, Caryl A; Torres, Susan J

    2014-01-01

    Anxiety is the most prevalent type of mental disorder and a significant health concern. Cross-sectional studies have detected a positive association between obesity and anxiety. What is less clear is whether weight loss can reduce anxiety. We sought to answer three questions: 1. Can weight loss improve symptoms of anxiety in the overweight and obese population? 2. Does the macronutrient content of energy-restricted diets that induce weight loss affect anxiety? 3. Is the change in anxiety related to the amount of weight lost? We investigated the findings from seven interventional studies, which induced weight loss by dietary intervention, in overweight and obese individuals, using established anxiety assessment tools. Mean weight loss ranged from 0.7 to 18.6 kg (SD 4.5) and in three of the studies, anxiety fell by 9.2% to 11.4% and did not change in four studies. When macronutrient content was considered, only one of four interventional studies and one pilot study reported a beneficial effect of a moderate-fat diet on anxiety. There appears to be no strong evidence to indicate that diet-induced weight loss has a beneficial effect on anxiety, however, none of the diet-induced weight loss studies assessed had a detrimental effect on anxiety.

  19. Findings from an online behavioural weight management programme provided with or without a fortified diet beverage.

    PubMed

    Haddock, C Keith; Poston, Walker S C; Lagrotte, Caitlin; Klotz, Alicia A; Oliver, Tracy L; Vander Veur, Stephanie S; Foster, Gary D; Jebb, Susan A; Moore, Carmel; Roberts, Susan A; Reeves, Rebecca S; Bolton, Mary Pat; Foreyt, John P

    2014-01-28

    The present multi-centre randomised weight-loss trial evaluated the efficacy of a low-intensity 12-week online behavioural modification programme, with or without a fortified diet beverage using a 2 × 2 factorial design. A total of 572 participants were randomised to: (1) an online basic lifestyle information (OBLI) intervention, consisting of one online informational class about tips for weight management; (2) an online behavioural weight management (OBWM) intervention, entailing 12 weekly online classes focused on weight-loss behaviour modification; (3) an OBLI intervention plus a fortified diet cola beverage (BEV) containing green tea extract (total catechin 167 mg), soluble fibre dextrin (10 g) and caffeine (100 mg) (OBLI+BEV); (4) OBWM+BEV. Assessments included height, weight, dual-energy X-ray absorptiometry-derived body composition, and waist circumference (WC). Attrition was 15·7 %. Intention-to-treat (ITT) models demonstrated a main effect for type of Internet programme, with those assigned to the OBWM condition losing significantly more weight (F= 7·174; P= 0·008) and fat mass (F= 4·491; P= 0·035) than those assigned to the OBLI condition. However, there was no significant main effect for the OBWM condition on body fat percentage (F= 2·906; P= 0·089) or WC (F= 3·351; P= 0·068), and no significant main effect for beverage use or significant interactions between factors in ITT models. A 12-week, low-intensity behaviourally based online programme produced a greater weight loss than a basic information website. The addition of a fortified diet beverage had no additional impact.

  20. Unexplained weight loss in sheep and goats. A guide to differential diagnosis, therapy, and management.

    PubMed

    Sherman, D M

    1983-11-01

    A review of the likely causes of unexplained weight loss in sheep and goats has been presented, with particular emphasis on diagnosis. Through the use of careful clinical examination and knowledge of the likely causes of progressive weight loss, a definitive diagnosis can often be made, although this is not always possible, even with rigorous investigation (Fig. 1). In most cases, establishing a definitive diagnosis will allow the practitioner to institute appropriate therapeutic measures, correct deficient management procedures, or institute suitable prevention and control programs to reduce ongoing or future losses to the client.

  1. "Is there an optimal diet for weight management and metabolic health?"

    PubMed

    Thom, George; Lean, Mike

    2017-02-15

    Individuals can lose body weight and improve health status on a wide range of energy (calorie) restricted dietary interventions. In this paper, we have reviewed the effectiveness of the most commonly utilized diets, including low-fat, low-carbohydrate and Mediterranean approaches in addition to commercial slimming programmes, meal replacements and newly-popularized intermittent fasting diets. We also consider the role of artificial sweeteners in weight management. Low-fat diets tend to improve LDL-cholesterol most, whilst lower-carbohydrate diets may preferentially improve triglycerides and HDL-cholesterol, however differences between diets are marginal. Weight loss improves almost all obesity related co-morbidities and metabolic markers, regardless of the macronutrient composition of the diet, but individuals do vary in preferences and ability to adhere to different diets. Optimizing adherence is the most important factor for weight loss success, and this is enhanced by regular professional contact and supportive behavioral change programs. Maintaining weight losses in the long-term remains the biggest challenge, and is undermined by an 'obesogenic' environment and biological adaptations that accompany weight loss.

  2. The Use of Low-Calorie Sweeteners by Children: Implications for Weight Management123

    PubMed Central

    Foreyt, John; Kleinman, Ronald; Brown, Rebecca J.; Lindstrom, Rachel

    2012-01-01

    The rise in pediatric obesity since the 1970s has been well established in the United States and is becoming a major concern worldwide. As a potential means to help slow the obesity epidemic, low-calorie sweeteners (LCS) have gained attention as dietary tools to assist in adherence to weight loss plans or prevention of excess weight gain. Observational studies tend to show positive correlations between LCS consumption and weight gain in children and adolescents. Although the data are intriguing, these epidemiologic studies do not establish that LCS cause weight gain, because there are likely many lifestyle and genetic differences between children and families who choose to consume LCS and those who do not. Short-term randomized controlled trials have shown LCS use to be BMI neutral or to have modest weight-reducing effects in overweight and obese adolescents. The long-term effects of LCS in children and adolescents are unknown. Some compelling research is currently underway and may provide needed insight into the potential role of LCS in weight management. The paucity of data regarding the effects of LCS use in children and adolescents creates challenges in decision-making for health care providers and parents. PMID:22573780

  3. A Mixed Methods Evaluation of a 12-Week Insurance-Sponsored Weight Management Program Incorporating Cognitive-Behavioral Counseling

    ERIC Educational Resources Information Center

    Abildso, Christiaan; Zizzi, Sam; Gilleland, Diana; Thomas, James; Bonner, Daniel

    2010-01-01

    Physical activity is critical in healthy weight loss, yet there is still much to be learned about psychosocial mechanisms of physical activity behavior change in weight loss. A sequential mixed methods approach was used to assess the physical and psychosocial impact of a 12-week cognitive-behavioral weight management program and explore factors…

  4. Design and Methods of a Synchronous Online Motivational Interviewing Intervention for Weight Management

    PubMed Central

    DiLillo, Vicki; Ingle, Krista; Harvey, Jean Ruth; West, Delia Smith

    2016-01-01

    Background While Internet-based weight management programs can facilitate access to and engagement in evidence-based lifestyle weight loss programs, the results have generally not been as effective as in-person programs. Furthermore, motivational interviewing (MI) has shown promise as a technique for enhancing weight loss outcomes within face-to-face programs. Objective This paper describes the design, intervention development, and analysis of a therapist-delivered online MI intervention for weight loss in the context of an online weight loss program. Methods The MI intervention is delivered within the context of a randomized controlled trial examining the efficacy of an 18-month, group-based, online behavioral weight control program plus individually administered, synchronous online MI sessions relative to the group-based program alone. Six individual 30-minute MI sessions are conducted in private chat rooms over 18 months by doctoral-level psychologists. Sessions use a semistructured interview format for content and session flow and incorporate core MI components (eg, collaborative agenda setting, open-ended questions, reflective listening and summary statements, objective data, and a focus on evoking and amplifying change talk). Results The project was funded in 2010 and enrollment was completed in 2012. Data analysis is currently under way and the first results are expected in 2016. Conclusions This is the first trial to test the efficacy of a synchronous online, one-on-one MI intervention designed to augment an online group behavioral weight loss program. If the addition of MI sessions proves to be successful, this intervention could be disseminated to enhance other distance-based weight loss interventions. Trial Registration Clinicaltrials.gov NCT01232699; https://clinicaltrials.gov/ct2/show/NCT01232699 PMID:27095604

  5. Efficacy of Continuing Education in Improving Pharmacists' Competencies for Providing Weight Management Service: Three-Arm Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Sarayani, Amir; Rashidian, Arash; Gholami, Kheirollah; Torkamandi, Hassan; Javadi, Mohammadreza

    2012-01-01

    Introduction: Weight management is a new public health role for community pharmacists in many countries. Lack of expertise is one of the key barriers to counseling obese patients. We evaluated the comparative efficacy of three alternative continuing education (CE) meetings on weight management. Methods: We designed a randomized controlled trial…

  6. [Contemporary therapeutic management of adult's congenital aortic coarctation].

    PubMed

    da Gama, A Dinis

    2013-01-01

    Adult congenital aortic coarctation is an entity rarely seen in clinical practice. It is commonly diagnosed and managed in the early stages of life, mean in the neo-natal or young children's ages. Some cases however can be overlooked at this scrutinity and become recognizable at later stages, in adulthood, through symptoms and signs resulting from the deep hemodynamic deregulation caused by the disease in the proximal and distal aortic physiology, requiring often imperative therapeutic repair. In this paper, an extensive revision is made on the main pathologic, clinical and diagnostic features of the disease, culminating in a critical analysis on the contemporary therapeutic methods available, which includes the conventional open surgery and the endovascular intervention, which includes the balloon angioplasty, the stenting and the covered stents.

  7. Managing Opioid Abuse in Older Adults: Clinical Considerations and Challenges.

    PubMed

    Loreck, David; Brandt, Nicole J; DiPaula, Bethany

    2016-04-01

    Opioid use disorder is a public health epidemic. There is increasing attention being given to opioid abuse and overdose in the United States. The overall use of illicit substances by older adults is on the rise and in part can be attributed to the aging of Baby Boomers. Furthermore, much attention is being given to prescription opioid drug overdose, but it is important to note that heroin-related deaths have also increased sharply. Heroin use is part of a larger substance abuse problem, with more than nine in 10 individuals who use heroin also using at least one other drug (e.g., cocaine, prescription opioid medication). The current article highlights treatment approaches, namely buprenorphine, buprenorphine/naloxone, and naltrexone; insurance considerations; and resources to aid in understanding and managing this public health crisis.

  8. The role of nurse support within an Internet-delivered weight management intervention: A qualitative study.

    PubMed

    Renouf, Sarah; Bradbury, Katherine; Yardley, Lucy; Little, Paul

    2015-01-01

    This qualitative study explored patients' experiences of nurse support for an Internet-delivered weight management intervention. Eighteen patients who had received either basic or regular nurse support (three or seven contacts, respectively) for the Internet intervention were interviewed. The data were analysed using thematic analysis. The findings suggest that more regular support for Internet interventions may have the potential to inhibit the development of autonomous motivation for weight loss, which might lead to problems in sustaining losses after support ends. Further research is now needed to confirm whether motivation is influenced by frequency of nurse support in Internet interventions in order to inform the development of optimal support which promotes sustained weight loss.

  9. Does that look heavy to you? Perceived weight judgment in lifting actions in younger and older adults

    PubMed Central

    Maguinness, Corrina; Setti, Annalisa; Roudaia, Eugenie; Kenny, Rose Anne

    2013-01-01

    When interpreting other people's movements or actions, observers may not only rely on the visual cues available in the observed movement, but they may also be able to “put themselves in the other person's shoes” by engaging brain systems involved in both “mentalizing” and motor simulation. The ageing process brings changes in both perceptual and motor abilities, yet little is known about how these changes may affect the ability to accurately interpret other people's actions. Here we investigated the effect of ageing on the ability to discriminate the weight of objects based on the movements of actors lifting these objects. Stimuli consisted of videos of an actor lifting a small box weighing 0.05–0.9 kg or a large box weighting 3–18 kg. In a four-alternative forced-choice task, younger and older participants reported the perceived weight of the box in each video. Overall, older participants were less sensitive than younger participants in discriminating the perceived weight of lifted boxes, an effect that was especially pronounced in the small box condition. Weight discrimination performance was better for the large box compared to the small box in both groups, due to greater saliency of the visual cues in this condition. These results suggest that older adults may require more salient visual cues to interpret the actions of others accurately. We discuss the potential contribution of age-related changes in visual and motor function on the observed effects and suggest that older adults' decline in the sensitivity to subtle visual cues may lead to greater reliance on visual analysis of the observed scene and its semantic context. PMID:24324423

  10. Definition and outpatient management of the very low-birth-weight infant with bronchopulmonary dysplasia.

    PubMed

    Groothuis, Jessie R; Makari, Doris

    2012-04-01

    Bronchopulmonary dysplasia (BPD), also known as chronic lung disease of prematurity, is the major cause of pulmonary disease in infants. The pathophysiology and management of BPD have evolved over the past four decades as improved neonatal intensive care unit (NICU) modalities have increased survival rates. The likelihood for developing BPD increases with the degree of prematurity and reaches 25-35% in very low-birth-weight and extremely low-birth-weight infants. BPD affects many organ systems, and infants with BPD are at increased risk for rehospitalization and numerous complications following NICU discharge. The management of BPD and medically related problems, particularly during the first 2 years of life, remains a continuing challenge for parents and healthcare providers. It is important that a multidisciplinary team consisting of the neonatologist/attending physician, primary care physician, and other specialized support staff work in concert and meet regularly to provide continuity of care and accurate patient assessments.

  11. Service learning in a pediatric weight management program to address childhood obesity.

    PubMed

    Kuo, Fengyi; Goebel, Laurie A; Satkamp, Nicole; Beauchamp, Rachel; Kurrasch, Julie M; Smith, Asia R; Maguire, Julia M

    2013-04-01

    This paper describes an inter-professional service learning collaboration and reflects benefits and considerations when incorporating a family-oriented approach in the community-based pediatric weight management program. Because obesity has tremendous consequences on a nation's health and economy, a pediatrician in a community health network has utilized an inter-professional team to implement a pediatric weight management program targeting children between the ages of 8 and 15 years. The team incorporates a culturally sensitive curriculum using a family-oriented approach for obesity prevention and intervention. Physicians, registered dietitians, occupational therapists, nurse practitioners, and mental health professionals assist participants in adopting a healthier lifestyle by addressing physical and psychosocial issues related to obesity, developing a nutrition plan, making healthier food choices, and finding fun ways to be more physically active. Graduate occupational therapy students work closely with the team members to assist delivery of interactive activities and behavior intervention.

  12. Designing dairy desserts for weight management: Structure, physical properties and in vitro gastric digestion.

    PubMed

    Borreani, Jennifer; Llorca, Empar; Quiles, Amparo; Hernando, Isabel

    2017-04-01

    The first aim of this study was to observe the effect of adding dairy proteins and reducing the cream content in order to obtain healthier dairy desserts for use in weight management. The extra-whey protein low-cream sample had the densest, firmest matrix, which is related to increased satiety. The second aim was to investigate the in vitro gastric digestion behavior of whey and casein proteins in a heat-treated semisolid real food. The extra-casein protein sample matrix broke down more slowly than the others because the caseins clotted at the gastric pH. Despite being heated, the whey proteins in the panna cottas were more resistant to pepsin digestion than caseins; this is related with a higher satiety capacity. These findings suggest that the combination of reducing fat content (to obtain a reduced energy density product) and adding whey protein (to increase satiety capacity) allows obtaining dairy desserts for weight management.

  13. Innovations in the Use of Interactive Technology to Support Weight Management

    PubMed Central

    Spruijt-Metz, D.; Wen, C.K.F.; O’Reilly, G.; Li, M.; Lee, S; Emken, B.A.; Mitra, U.; Annavaram, M.; Ragusa, G.; Narayanan, S.

    2015-01-01

    New and emerging mobile technologies are providing unprecedented possibilities for understanding and intervening on obesity-related behaviors in real time. However, the mobile health (mHealth) field has yet to catch up with the fast-paced development of technology. Current mHealth efforts in weight management still tend to focus mainly on short message systems (SMS) interventions, rather than taking advantage of real-time sensing to develop Just-In-Time, Adaptive Interventions (JITAIs). This paper will give an overview of the current technology landscape for sensing and intervening on three behaviors that are central to weight management; diet, physical activity, and sleep. Then five studies that really dig into the possibilities that these new technologies afford will be showcased. We conclude with a discussion of hurdles that mHealth obesity research has yet to overcome, and a future-facing discussion. PMID:26364308

  14. Innovations in the Use of Interactive Technology to Support Weight Management.

    PubMed

    Spruijt-Metz, D; Wen, C K F; O'Reilly, G; Li, M; Lee, S; Emken, B A; Mitra, U; Annavaram, M; Ragusa, G; Narayanan, S

    2015-12-01

    New and emerging mobile technologies are providing unprecedented possibilities for understanding and intervening on obesity-related behaviors in real time. However, the mobile health (mHealth) field has yet to catch up with the fast-paced development of technology. Current mHealth efforts in weight management still tend to focus mainly on short message systems (SMS) interventions, rather than taking advantage of real-time sensing to develop just-in-time adaptive interventions (JITAIs). This paper will give an overview of the current technology landscape for sensing and intervening on three behaviors that are central to weight management: diet, physical activity, and sleep. Then five studies that really dig into the possibilities that these new technologies afford will be showcased. We conclude with a discussion of hurdles that mHealth obesity research has yet to overcome and a future-facing discussion.

  15. Coronary Arteriovenous Fistulas in Adult Patients: Surgical Management and Outcomes

    PubMed Central

    Albeyoglu, Sebnem; Aldag, Mustafa; Ciloglu, Ufuk; Sargin, Murat; Oz, Tugba Kemaloglu; Kutlu, Hakan; Dagsali, Sabri

    2017-01-01

    Objective The aim of this study was to describe the demographic, clinical and anatomic characteristics of coronary arteriovenous fistulas in adult patients who underwent open cardiac surgery and to review surgical management and outcomes. Methods Twenty-one adult patients (12 female, 9 male; mean age: 56.1±7.9 years) who underwent surgical treatment for coronary arteriovenous fistulas were retrospectively included in this study. Coronary angiography, chest X-ray, electrocardiography and transthoracic echocardiography were preoperatively performed in all patients. Demographic and clinical data were also collected. Postoperative courses of all patients were monitored and postoperative complications were noted. Results A total of 25 coronary arteriovenous fistulas were detected in 21 patients; the fistulas originated mainly from left anterior descending artery (n=9, 42.8%). Four (19.4%) patients had bilateral fistulas originating from both left anterior descending and right coronary artery. The main drainage site of coronary arteriovenous fistulas was the pulmonary artery (n=18, 85.7%). Twelve (57.1%) patients had isolated coronary arteriovenous fistulas and 4 (19.4%), concomitant coronary artery disease. Twenty (95.3%) of all patients were symptomatic. Seventeen patients were operated on with and 4 without cardiopulmonary bypass. There was no mortality. Three patients had postoperative atrial fibrillation. One patient had pericardial effusion causing cardiac tamponade who underwent reoperation. Conclusion The decision of surgical management should be made on the size and the anatomical location of coronary arteriovenous fistulas and concomitant cardiac comorbidities. Surgical closure with ligation of coronary arteriovenous fistulas can be performed easily with on-pump or off-pump coronary artery bypass grafting, even in asymptomatic patients to prevent fistula related complications with very low risk of mortality and morbidity.

  16. Exposure–response analyses of liraglutide 3.0 mg for weight management

    PubMed Central

    Overgaard, R. V.; Jacobsen, L. V.; Jensen, C. B.; le Roux, C. W.

    2016-01-01

    Aims Liraglutide 3.0 mg, an acylated GLP‐1 analogue approved for weight management, lowers body weight through decreased energy intake. We conducted exposure‐response analyses to provide important information on individual responses to given drug doses, reflecting inter‐individual variations in drug metabolism, absorption and excretion. Methods We report efficacy and safety responses across a wide range of exposure levels, using data from one phase II (liraglutide doses 1.2, 1.8, 2.4 and 3.0 mg), and two phase IIIa [SCALE Obesity and Prediabetes (3.0 mg); SCALE Diabetes (1.8; 3.0 mg)] randomized, placebo‐controlled trials (n = 4372). Results There was a clear exposure–weight loss response. Weight loss increased with greater exposure and appeared to level off at the highest exposures associated with liraglutide 3.0 mg in most individuals, but did not fully plateau in men. In individuals with overweight/obesity and comorbid type 2 diabetes, there was a clear exposure–glycated haemoglobin (HbA1c) relationship. HbA1c reduction increased with higher plasma liraglutide concentration (plateauing at ∼21 nM); however, for individuals with baseline HbA1c >8.5%, HbA1c reduction did not fully plateau. No exposure–response relationship was identified for any safety outcome, with the exception of gastrointestinal adverse events (AEs). Individuals with gallbladder AEs, acute pancreatitis or malignant/breast/benign colorectal neoplasms did not have higher liraglutide exposure compared with the overall population. Conclusions These analyses support the use of liraglutide 3.0 mg for weight management in all subgroups investigated; weight loss increased with higher drug exposure, with no concomitant deterioration in safety/tolerability besides previously known gastrointestinal side effects. PMID:26833744

  17. Pediatric Weight Management Program Outcomes in a Largely Minority, Low Socioeconomic Status Population

    PubMed Central

    Demeule-Hayes, Michelle; Winters, Matthew W.; Getzoff, Elizabeth A.; Schwimmer, Bradley A.; Rogers, Vicky S.; Scheimann, Ann O.

    2016-01-01

    This article describes the outcomes of a pediatric weight management program for a population primarily composed of minority ethnic groups and those from a lower socioeconomic status group. As these groups are disproportionally affected by pediatric obesity and overweight complicated by higher rates of attrition and poorer response to intervention, it is important that adequate and effective treatment exists for patients in these groups. Further research is needed to analyze the outcomes and attrition in these high-risk populations. PMID:27980446

  18. Gender and genetic contributions to weight identity among adolescents and young adults in the U.S.

    PubMed

    Wedow, Robbee; Briley, Daniel A; Short, Susan E; Boardman, Jason D

    2016-09-01

    In this paper, we investigate the possibility that genetic variation contributes to self-perceived weight status among adolescents and young adults in the U.S. Using samples of identical and fraternal twins across four waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health) study, we calculate heritability estimates for objective body mass index (BMI) that are in line with previous estimates. We also show that perceived weight status is heritable (h(2) ∼ 0.47) and most importantly that this trait continues to be heritable above and beyond objective BMI (h(2) ∼ 0.25). We then demonstrate significant sex differences in the heritability of weight identity across the four waves of the study, where h(2)women = 0.39, 0.35, 0.40, and 0.50 for each wave, respectively, and h(2)men = 0.10, 0.10, 0.23, and 0.03. These results call for a deeper consideration of both identity and gender in genetics research.

  19. Assessment of clinical and economic benefits of weight management with sibutramine in general practice in Germany.

    PubMed

    Brennan, Alan; Ara, Roberta; Sterz, Raimund; Matiba, Bernd; Bergemann, Rito

    2006-12-01

    Obesity is associated with major health risks and a high economic burden impacting on health care systems. This study utilises the latest evidence from randomised clinical trials (RCTs) to explore and to assess the cost effectiveness of sibutramine in combination with diet and lifestyle advice compared to diet and lifestyle advice alone for the treatment of obese subjects without comorbidities at baseline in Germany. New evidence from recently published RCTs and post-marketing surveillance studies, including health economic data as well as quality of life (QoL) data, were used to model the long-term outcomes of weight management with sibutramine in German practice. German healthcare costs and new data from over 8,000 patients were analysed based on a recently published model. These new RCT data were used to model weight losses, proportion of responders to treatment, utilities by weight loss and variability in weight regain post-treatment. Costs and QoL benefits associated with weight loss (using SF-36 data from sibutramine trials), reduced incidence of coronary heart disease (using Framingham equations) and diabetes were used to estimate the cost per quality adjusted life year of sibutramine treatment. For 1,000 patients treated with sibutramine for 1 year, extrapolating outcomes over 4 further years, sibutramine is estimated to save 4.18 CHD events, 2.58 diabetes incident cases and give 51.5 more quality-adjusted life years (QALYs). The cost-utility analysis (CUA) estimates 13,706 euro per QALY gained. Results are sensitive to changes in weight loss, rate of weight regain and discounting rate. Although the non-pharmacological weight management programme in the comparator arm yielded higher weight losses than generally observed in clinical practice, these results demonstrate that additional sibutramine treatment is a cost effective therapy for an obese population without comorbidities in Germany. The CUA results are within the range generally accepted as cost

  20. Adult weight gain, fat distribution and mammographic density in Spanish pre- and post-menopausal women (DDM-Spain).

    PubMed

    Pollán, Marina; Lope, Virginia; Miranda-García, Josefa; García, Milagros; Casanova, Francisco; Sánchez-Contador, Carmen; Santamariña, Carmen; Moreo, Pilar; Vidal, Carmen; Peris, Mercé; Moreno, María Pilar; Vázquez-Carrete, José Antonio; Collado, Francisca; Pedraz-Pingarrón, Carmen; Ascunce, Nieves; Salas-Trejo, Dolores; Aragonés, Nuria; Pérez-Gómez, Beatriz; Ruiz-Perales, Francisco

    2012-07-01

    High mammographic density (MD) is a phenotype risk marker for breast cancer. Body mass index (BMI) is inversely associated with MD, with the breast being a fat storage site. We investigated the influence of abdominal fat distribution and adult weight gain on MD, taking age, BMI and other confounders into account. Because visceral adiposity and BMI are associated with breast cancer only after menopause, differences in pre- and post-menopausal women were also explored. We recruited 3,584 women aged 45-68 years within the Spanish breast cancer screening network. Demographic, reproductive, family and personal history data were collected by purpose-trained staff, who measured current weight, height, waist and hip circumferences under the same protocol and with the same tools. MD was assessed in the left craniocaudal view using Boyd's Semiquantitative Scale. Association between waist-to-hip ratio, adult weight gain (difference between current weight and self-reported weight at 18 years) and MD was quantified by ordinal logistic regression, with random center-specific intercepts. Models were adjusted for age, BMI, breast size, time since menopause, parity, family history of breast cancer and hormonal replacement therapy use. Natural splines were used to describe the shape of the relationship between these two variables and MD. Waist-to-hip ratio was inversely associated with MD, and the effect was more pronounced in pre-menopausal (OR = 0.53 per 0.1 units; 95 % CI = 0.42-0.66) than in post-menopausal women (OR = 0.73; 95 % CI = 0.65-0.82) (P of heterogeneity = 0.010). In contrast, adult weight gain displayed a positive association with MD, which was similar in both groups (OR = 1.17 per 6 kg; 95 % CI = 1.11-1.23). Women who had gained more than 24 kg displayed higher MD (OR = 2.05; 95 % CI = 1.53-2.73). MD was also evaluated using Wolfe's and Tabár's classifications, with similar results being obtained. Once BMI, fat distribution and other confounders were considered

  1. Weight Management Advice for Clients with Overweight or Obesity: Allied Health Professional Survey

    PubMed Central

    Snodgrass, Suzanne J.; Guest, Maya; Kable, Ashley K.; James, Carole; Ashby, Samantha E.; Plotnikoff, Ronald C.; Collins, Clare E.

    2016-01-01

    The prevalence of obesity is increasing. The potential for allied health professionals to intervene through the provision of lifestyle advice is unknown. This study aimed to determine the knowledge, attitudes and practices of health professionals in the provision of dietary and physical activity advice for clients with overweight or obesity. Dietitians, exercise physiologists, nurses, occupational therapists, physiotherapists and psychologists (n = 296) working in New South Wales were surveyed using paper-based and online methods. The majority of health professionals (71%) believed that providing weight management advice was within their scope of practice; 81% provided physical activity advice but only 57% provided dietary advice. Other than dietitians, few had received training in client weight management during their professional qualification (14%) or continuing education (16%). Providing dietary advice was associated with: believing it was within their scope of practice (OR 3.9, 95% CI 1.9–7.9, p < 0.01), training during their entry-level qualification (OR 7.2, 3.2–16.4, p < 0.01) and having departmental guidelines (OR 4.7, 2.1–10.9, p < 0.01). Most health professionals are willing to provide lifestyle advice to clients with overweight or obesity but few have received required training. Developing guidelines and training for in client weight management may potentially impact on rising obesity levels. PMID:27854252

  2. Zonisamide for Weight Reduction in Obese Adults A 1-Year Randomized Controlled Trial

    PubMed Central

    Gadde, Kishore M.; Kopping, Mariko F.; Wagner, H. Ryan; Yonish, Gretchen M.; Allison, David B.; Bray, George A.

    2013-01-01

    SUMMARY Background Obese individuals who have failed to achieve adequate weight loss with lifestyle changes have limited non-surgical therapeutic options. We evaluated the efficacy and tolerability of zonisamide, an antiepileptic drug, for enhancing weight loss in obese patients receiving diet and lifestyle guidance. Methods This was a 1-year randomized, double-blind, placebo-controlled trial conducted between January 2006 and September 2011 at Duke University Medical Center. Patients were 225 obese (mean [SD] body mass index 37.6 [4.9]) women (134 [59.6%]) and men (91 [40.4%]) without diabetes. Interventions were daily dosing with placebo (n=74), zonisamide 200 mg (n=76), orzonisamide 400 mg (n=75), in addition to diet and lifestyle counseling by a dietitian for 1 year. Primary outcome was change in body weight at 1-year. Results Of the 225 randomized patients, 218 (97%) provided 1-year follow-up assessments. Change(least-squares mean) in body weight was -4.0 kg (−3.7%; 95% CI, −5.8 kg to −2.3 kg) for placebo, −4.4 kg (−3.9%; −6.1 to −2.6, P=.79vs placebo) for zonisamide 200 mg, and −7.3 kg (−6.8%; −9.0 to −5.6, P=.009vs placebo) for zonisamide 400 mg. In the categorical analysis,23 (31%) on placebo, 26 (34%; P=.71) on zonisamide 200 mg, and 41 (55%; P=.007) onzonisamide 400 mg achieved ≥5% weight loss; for ≥10% weight loss, the corresponding numbers were 6 (8%), 17 (22%; P=.022), and 24 (32%; P=.001). Gastrointestinal, nervous system and psychiatric adverse events occurred at a higher incidence with zonisamide than with placebo. Conclusion Zonisamide 400 mg/d moderately enhanced weight loss achieved with diet and lifestyle counseling, but had a high incidence of adverse events. PMID:23147455

  3. A Terror Management Perspective on Young Adults' Ageism and Attitudes toward Dementia

    ERIC Educational Resources Information Center

    O'Connor, Melissa L.; McFadden, Susan H.

    2012-01-01

    According to Terror Management Theory as applied to ageism, older adults may be associated with mortality, thereby generating death-thought accessibility, stereotypes, and mixed emotions among younger adults. However, it is unclear how older adults' health conditions, such as dementia, affect ageist attitudes and mortality salience. In the current…

  4. [Recommendations for management of acute pharyngitis in adults].

    PubMed

    Cots, Josep M; Alós, Juan-Ignacio; Bárcena, Mario; Boleda, Xavier; Cañada, José L; Gómez, Niceto; Mendoza, Ana; Vilaseca, Isabel; Llor, Carles

    2016-11-01

    Acute pharyngitis in adults is one of the most common infectious diseases seen in general practitioners' consultations. Viral aetiology is the most common. Among bacterial causes, the main agent is Streptococcus pyogenes or group A β-haemolytic streptococcus (GABHS), which causes 5%-30% of the episodes. In the diagnostic process, clinical assessment scales can help clinicians to better predict suspected bacterial aetiology by selecting patients who should undergo a rapid antigen detection test. If these techniques are not performed, an overdiagnosis of streptococcal pharyngitis often occurs, resulting in unnecessary prescriptions of antibiotics, most of which are broad spectrum. Consequently, management algorithms that include the use of predictive clinical rules and rapid tests have been set up. The aim of the treatment is speeding up symptom resolution, reducing the contagious time span and preventing local suppurative and non-suppurative complications. Penicillin and amoxicillin are the antibiotics of choice for the treatment of pharyngitis. The association of amoxicillin and clavulanate is not indicated as the initial treatment of acute infection. Neither are macrolides indicated as first-line therapy; they should be reserved for patients allergic to penicillin. The appropriate diagnosis of bacterial pharyngitis and proper use of antibiotics based on the scientific evidence available are crucial. Using management algorithms can be helpful in identifying and screening the cases that do not require antibiotic therapy.

  5. Recommendations for management of acute pharyngitis in adults.

    PubMed

    Cots, Josep M; Alós, Juan-Ignacio; Bárcena, Mario; Boleda, Xavier; Cañada, José L; Gómez, Niceto; Mendoza, Ana; Vilaseca, Isabel; Llor, Carles

    2015-01-01

    Acute pharyngitis in adults is one of the most common infectious diseases seen in general practitioners' consultations. Viral aetiology is the most common. Among bacterial causes, the main agent is Streptococcus pyogenes or group A β-haemolytic streptococcus (GABHS), which causes 5%-30% of the episodes. In the diagnostic process, clinical assessment scales can help clinicians to better predict suspected bacterial aetiology by selecting patients who should undergo a rapid antigen detection test. If these techniques are not performed, an overdiagnosis of streptococcal pharyngitis often occurs, resulting in unnecessary prescriptions of antibiotics, most of which are broad spectrum. Consequently, management algorithms that include the use of predictive clinical rules and rapid tests have been set up. The aim of the treatment is speeding up symptom resolution, reducing the contagious time span and preventing local suppurative and non-suppurative complications. Penicillin and amoxicillin are the antibiotics of choice for the treatment of pharyngitis. The association of amoxicillin and clavulanate is not indicated as the initial treatment of acute infection. Neither are macrolides indicated as first-line therapy; they should be reserved for patients allergic to penicillin. The appropriate diagnosis of bacterial pharyngitis and proper use of antibiotics based on the scientific evidence available are crucial. Using management algorithms can be helpful in identifying and screening the cases that do not require antibiotic therapy.

  6. [Recommendations for management of acute pharyngitis in adults].

    PubMed

    Cots, Josep M; Alós, Juan-Ignacio; Bárcena, Mario; Boleda, Xavier; Cañada, José L; Gómez, Niceto; Mendoza, Ana; Vilaseca, Isabel; Llor, Carles

    2015-10-01

    Acute pharyngitis in adults is one of the most common infectious diseases seen in general practitioners' consultations. Viral aetiology is the most common. Among bacterial causes, the main agent is Streptococcus pyogenes or group A β-haemolytic streptococcus (GABHS), which causes 5%-30% of the episodes. In the diagnostic process, clinical assessment scales can help clinicians to better predict suspected bacterial aetiology by selecting patients who should undergo a rapid antigen detection test. If these techniques are not performed, an overdiagnosis of streptococcal pharyngitis often occurs, resulting in unnecessary prescriptions of antibiotics, most of which are broad spectrum. Consequently, management algorithms that include the use of predictive clinical rules and rapid tests have been set up. The aim of the treatment is speeding up symptom resolution, reducing the contagious time span and preventing local suppurative and non-suppurative complications. Penicillin and amoxicillin are the antibiotics of choice for the treatment of pharyngitis. The association of amoxicillin and clavulanate is not indicated as the initial treatment of acute infection. Neither are macrolides indicated as first-line therapy; they should be reserved for patients allergic to penicillin. The appropriate diagnosis of bacterial pharyngitis and proper use of antibiotics based on the scientific evidence available are crucial. Using management algorithms can be helpful in identifying and screening the cases that do not require antibiotic therapy.

  7. Safety and Efficacy of Glucomannan for Weight Loss in Overweight and Moderately Obese Adults

    PubMed Central

    Keithley, Joyce K.; Swanson, Barbara; Mikolaitis, Susan L.; DeMeo, Mark; Zeller, Janice M.; Fogg, Lou; Adamji, Jehan

    2013-01-01

    Background. Few safe and effective dietary supplements are available to promote weight loss. We evaluated the safety and efficacy of glucomannan, a water-soluble fiber supplement, for achieving weight loss in overweight and moderately obese individuals consuming self-selected diets. Methods. Participants were randomly assigned to take 1.33 grams of glucomannan or identically looking placebo capsules with 236.6 mL (8 ounces) of water one hour before breakfast, lunch, and dinner for 8 weeks. The primary efficacy outcome was change in body weight after 8 weeks. Other efficacy outcomes were changes in body composition, hunger/fullness, and lipid and glucose concentrations. Safety outcomes included gastrointestinal symptoms/tolerance and serum liver enzymes and creatinine levels. Results. A total of 53 participants (18–65 years of age; BMI 25–35 kg/m2) were enrolled and randomized. The two groups did not differ with respect to baseline characteristics and compliance with the study supplement. At 8 weeks, there was no significant difference between the glucomannan and placebo groups in amount of weight loss (−.40 ± .06 and −.43 ± .07, resp.) or other efficacy outcomes or in any of the safety outcomes. Conclusions. Glucomannan supplements administered over 8 weeks were well tolerated but did not promote weight loss or significantly alter body composition, hunger/fullness, or lipid and glucose parameters. This trial is registered with NCT00613600. PMID:24490058

  8. Zebra finches and Dutch adults exhibit the same cue weighting bias in vowel perception.

    PubMed

    Ohms, Verena R; Escudero, Paola; Lammers, Karin; ten Cate, Carel

    2012-03-01

    Vocal tract resonances, called formants, are the most important parameters in human speech production and perception. They encode linguistic meaning and have been shown to be perceived by a wide range of species. Songbirds are also sensitive to different formant patterns in human speech. They can categorize words differing only in their vowels based on the formant patterns independent of speaker identity in a way comparable to humans. These results indicate that speech perception mechanisms are more similar between songbirds and humans than realized before. One of the major questions regarding formant perception concerns the weighting of different formants in the speech signal ("acoustic cue weighting") and whether this process is unique to humans. Using an operant Go/NoGo design, we trained zebra finches to discriminate syllables, whose vowels differed in their first three formants. When subsequently tested with novel vowels, similar in either their first formant or their second and third formants to the familiar vowels, similarity in the higher formants was weighted much more strongly than similarity in the lower formant. Thus, zebra finches indeed exhibit a cue weighting bias. Interestingly, we also found that Dutch speakers when tested with the same paradigm exhibit the same cue weighting bias. This, together with earlier findings, supports the hypothesis that human speech evolution might have exploited general properties of the vertebrate auditory system.

  9. Visceral fat and body weight are reduced in overweight adults by the supplementation of Doenjang, a fermented soybean paste

    PubMed Central

    Yang, Ji-Ae; Back, Hyang-Im; Kim, Soo-Ran; Kim, Min-Gul; Jung, Su-Jin; Song, Won O; Chae, Soo-Wan

    2012-01-01

    Various forms of fermented soybean products are well documented for their health benefits. The efficacy of anti-obesogenic effect of Doenjang, one of the most commonly used seasonings in Korean cuisine, has been reported only in animal models; thus, an evaluation of Doenjang needs to be conducted in human studies. We aimed to test the hypothesis that Doenjang supplementation reduces body weight and changes body composition in overweight adults. A total of 51 overweight adults participated in this study. A group of males with BMI ≥ 23 kg/m2 and waist to hip ratio (WHR) ≥ 0.90, and a group of females with BMI ≥ 23 kg/m2 and WHR ≥ 0.85 were randomly assigned to either a Doenjang supplement (9.9 g dry/day) group or a placebo group for a 12-week randomized, double-blind and placebo-controlled study. Anthropometric parameters, abdominal fat distribution by computerized tomography (CT) and blood components were measured before and after the intervention period. After the 12-week study, the Doenjang supplementation group had significant reductions in body weight (kg), body fat mass (kg) and body fat (%) compared to the placebo group, the supplementation of Doenjang resulted in a significant reduction in visceral fat (cm2), although no changes were observed in total and subcutaneous fat are as (cm2), serum lipid profiles and dietary intakes. The present study demonstrated that daily supplementation of 9.9 g dry/day of Doenjang for 12 weeks reduces body weight and visceral fat in overweight adults. PMID:23346302

  10. Distance learning strategies for weight management utilizing social media: A comparison of phone conference call versus social media platform. Rationale and design for a randomized study.

    PubMed

    Willis, Erik A; Szabo-Reed, Amanda N; Ptomey, Lauren T; Steger, Felicia L; Honas, Jeffery J; Al-Hihi, Eyad M; Lee, Robert; Vansaghi, Lisa; Washburn, Richard A; Donnelly, Joseph E

    2016-03-01

    Management of obesity in the context of the primary care physician visit is of limited efficacy in part because of limited ability to engage participants in sustained behavior change between physician visits. Therefore, healthcare systems must find methods to address obesity that reach beyond the walls of clinics and hospitals and address the issues of lifestyle modification in a cost-conscious way. The dramatic increase in technology and online social networks may present healthcare providers with innovative ways to deliver weight management programs that could have an impact on health care at the population level. A randomized study will be conducted on 70 obese adults (BMI 30.0-45.0 kg/m(2)) to determine if weight loss (6 months) is equivalent between weight management interventions utilizing behavioral strategies by either a conference call or social media approach. The primary outcome, body weight, will be assessed at baseline and 6 months. Secondary outcomes including waist circumference, energy and macronutrient intake, and physical activity will be assessed on the same schedule. In addition, a cost analysis and process evaluation will be completed.

  11. Distance learning strategies for weight management utilizing social media: A comparison of phone conference call versus social media platform. Rationale and design for a randomized study

    PubMed Central

    Willis, Erik A.; Szabo-Reed, Amanda N.; Ptomey, Lauren T.; Steger, Felicia L.; Honas, Jeffery J.; Al-Hihi, Eyad M.; Lee, Robert; Vansaghi, Lisa; Washburn, Richard A.; Donnelly, Joseph E.

    2016-01-01

    Management of obesity in the context of the primary care physician visit is of limited efficacy in part because of limited ability to engage participants in sustained behavior change between physician visits. Therefore, healthcare systems must find methods to address obesity that reach beyond the walls of clinics and hospitals and address the issues of lifestyle modification in a cost-conscious way. The dramatic increase in technology and online social networks may present healthcare providers with innovative ways to deliver weight management programs that could have an impact on health care at the population level. A randomized study will be conducted on 70 obese adults (BMI 30.0–45.0 kg/m2) to determine if weight loss (6 months) is equivalent between weight management interventions utilizing behavioral strategies by either a conference call or social media approach. The primary outcome, body weight, will be assessed at baseline and 6 months. Secondary outcomes including waist circumference, energy and macronutrient intake, and physical activity will be assessed on the same schedule. In addition, a cost analysis and process evaluation will be completed. PMID:26883282

  12. Weighting for Health: Management, Measurement and Self-surveillance in the Modern Household

    PubMed Central

    Marland, Hilary

    2016-01-01

    Histories of late nineteenth- and early twentieth-century medicine emphasise the rise of professional and scientific authority, and suggest a decline in domestic health initiatives. Exploring the example of weight management in Britain, we argue that domestic agency persisted and that new regimes of measurement and weighing were adapted to personal and familial preferences as they entered the household. Drawing on print sources and objects ranging from prescriptive literature to postcards and ‘personal weighing machines’, the article examines changing practices of self-management as cultural norms initially dictated by ideals of body shape and function gradually incorporated quantified targets. In the twentieth century, the domestic management of health—like the medical management of illness—was increasingly technologised and re-focused on quantitative indicators of ‘normal’ or ‘pathological’ embodiment. We ask: in relation to weight, how did quantification permeate the household, and what did this domestication of bodily surveillance mean to lay users? PMID:27956758

  13. The distal classification and management of choledochal cyst in adults

    PubMed Central

    Liu, Yanfeng; Sun, Jingxian; Guo, Sen; Liu, Zengli; Zhu, Min; Zhang, Zong-li

    2017-01-01

    Abstract Todani classification is extensively used to guide the surgical strategy of choledochal cysts, but no systematic investigations on the distal management of intrapancreatic choledochal cysts have been conducted. This study reports the distal classification and management of choledochal cysts in adults based on the relation between the cyst and pancreatic duct. Patients with choledochal cyst who underwent operation, including distal management, in our department from January 2009 to December 2014 were retrospectively reviewed. Patients presenting symptoms, coexisting diseases, surgical treatment, perioperative complications, and long-term follow-up according to the distal classification of choledochal cyst were analyzed. A total of 54 patients with choledochal cyst were included in the present retrospective study. Based on the distal classification of choledochal cyst, 39 patients (72.22%) were type 1, 13 patients (24.07%) were type 2, and 2 patients (3.70%) were type 3. Thirty-nine type 1 patients and 10 type 2 patients underwent excision of intrapancreatic choledochal cyst or bile duct. Three type 2 patients received excision of distal cylindrical cyst and papilla, followed by pancreatic duct plasty with duodenum mucosa. One type 3 patient underwent endoscopic sphincteroplasty, and another type 3 patient underwent transduodenal sphincteroplasty. After the operation, 11 patients (20.37%, 11/54) had short-term perioperative complications. The long-term follow-up results showed that the satisfactory rate (excellent and good outcomes) was 95.83%. Current distal classification of choledochal cysts could provide a more targeted strategy for complete excision to eliminate potential dead space within the pancreas, protect the pancreatic duct, and prevent reoperation. PMID:28328818

  14. Long-term Excessive Body Weight and Adult Left Ventricular Hypertrophy Are Linked Through Later Life Body Size and Blood Pressure: The Bogalusa Heart Study.

    PubMed

    Zhang, Huijie; Zhang, Tao; Li, Shengxu; Guo, Yajun; Shen, Wei; Fernandez, Camilo; Harville, Emily W; Bazzano, Lydia A; Urbina, Elaine M; He, Jiang; Chen, Wei

    2017-02-23

    Rationale: Childhood adiposity is associated with cardiac structure in later life, but little is known regarding to what extent childhood body weight affects adult left ventricular geometric patterns through adult body size and blood pressure (BP). Objective: Determine quantitatively the mediation effect of adult body weight and BP on the association of childhood BMI with adult left ventricular hypertrophy (LVH). Methods and Results: This longitudinal study consisted of 710 adults, age 26 to 48 years, who had been examined for BMI and BP measured 4 or more times during childhood and 2 or more times during adulthood, with a mean follow-up period of 28.0 years. After adjusting for age, race and sex, adult BMI had a significant mediation effect (76.4%, p<0.01) on the childhood BMI-adult LV mass index (LVMI) association. The mediation effects of adult systolic BP (SBP, 15.2%), long-term burden (12.1%) and increasing trends of SBP (7.9%) were all significant (p<0.01). Furthermore, these mediators also had significant mediation effects on the association of childhood BMI with adult LVH, eccentric and concentric hypertrophy. Importantly, the mediation effects of adult BMI were all significantly stronger than those of adult SBP on LVMI, LVH and LV remodeling patterns (p<0.01). Additionally, the mediation effect of SBP on concentric hypertrophy was significantly stronger than on eccentric hypertrophy (p<0.01). Conclusions: These findings suggest that increased childhood BMI has long-term adverse impact on subclinical changes in adult cardiac structure, and early life excessive body weight and adult LVH are linked through later life excessive body weight and elevated BP.

  15. Random regression models on Legendre polynomials to estimate genetic parameters for weights from birth to adult age in Canchim cattle.

    PubMed

    Baldi, F; Albuquerque, L G; Alencar, M M

    2010-08-01

    The objective of this work was to estimate covariance functions for direct and maternal genetic effects, animal and maternal permanent environmental effects, and subsequently, to derive relevant genetic parameters for growth traits in Canchim cattle. Data comprised 49,011 weight records on 2435 females from birth to adult age. The model of analysis included fixed effects of contemporary groups (year and month of birth and at weighing) and age of dam as quadratic covariable. Mean trends were taken into account by a cubic regression on orthogonal polynomials of animal age. Residual variances were allowed to vary and were modelled by a step function with 1, 4 or 11 classes based on animal's age. The model fitting four classes of residual variances was the best. A total of 12 random regression models from second to seventh order were used to model direct and maternal genetic effects, animal and maternal permanent environmental effects. The model with direct and maternal genetic effects, animal and maternal permanent environmental effects fitted by quadric, cubic, quintic and linear Legendre polynomials, respectively, was the most adequate to describe the covariance structure of the data. Estimates of direct and maternal heritability obtained by multi-trait (seven traits) and random regression models were very similar. Selection for higher weight at any age, especially after weaning, will produce an increase in mature cow weight. The possibility to modify the growth curve in Canchim cattle to obtain animals with rapid growth at early ages and moderate to low mature cow weight is limited.

  16. The Proposal of Key Performance Indicators in Facility Management and Determination the Weights of Significance

    NASA Astrophysics Data System (ADS)

    Rimbalová, Jarmila; Vilčeková, Silvia

    2013-11-01

    The practice of facilities management is rapidly evolving with the increasing interest in the discourse of sustainable development. The industry and its market are forecasted to develop to include non-core functions, activities traditionally not associated with this profession, but which are increasingly being addressed by facilities managers. The scale of growth in the built environment and the consequential growth of the facility management sector is anticipated to be enormous. Key Performance Indicators (KPI) are measure that provides essential information about performance of facility services delivery. In selecting KPI, it is critical to limit them to those factors that are essential to the organization reaching its goals. It is also important to keep the number of KPI small just to keep everyone's attention focused on achieving the same KPIs. This paper deals with the determination of weights of KPI of FM in terms of the design and use of sustainable buildings.

  17. Household Income during Childhood and Young Adult Weight Status: Evidence from a Nutrition Transition Setting

    ERIC Educational Resources Information Center

    Schmeer, Kammi K.

    2010-01-01

    This article explores whether household income at different stages of childhood is associated with weight status in early adulthood in a nutrition transition setting (a developing country with both underweight and overweight populations). I use multinomial logistic regression to analyze prospective, longitudinal data from Cebu, Philippines.…

  18. Neuro-Cognitive Performance of Very Preterm or Very Low Birth Weight Adults at 26 Years

    ERIC Educational Resources Information Center

    Eryigit Madzwamuse, Suna; Baumann, Nicole; Jaekel, Julia; Bartmann, Peter; Wolke, Dieter

    2015-01-01

    Background: Children born very preterm (VP <32 weeks gestation) and/or with very low birth weight (VBLW <1500 g; subsequently VP/VLBW) have been previously reported to have more cognitive impairment and specific executive functioning problems than term children; however, it remains unclear whether these problems persist into adulthood. This…

  19. Nutritional management of type 2 diabetes mellitus and obesity and pharmacologic therapies to facilitate weight loss.

    PubMed

    Vetter, Marion L; Amaro, Anastassia; Volger, Sheri

    2014-01-01

    Diet plays an integral role in the treatment of type 2 diabetes mellitus (T2DM). Unfortunately, many patients with T2DM do not have access to a registered dietitian or certified diabetes educator, and rates of physician counseling about diet remain low. This article provides an overview of the current recommendations for the nutritional management of T2DM, which are endorsed by the American Diabetes Association (ADA). Medical nutrition therapy, which provides a flexible and individualized approach to diet, emphasizes the total number (rather than the type) of carbohydrate consumed. Because fat intake also affects glycemia and cardiovascular risk, a reduction in daily mono- and polyunsaturated fat intake is recommended for most patients with T2DM. Weight loss plays an important adjunct role in treating patients with T2DM, because the majority of individuals with T2DM are overweight or obese. Patient lifestyle modification, which encompasses diet, physical activity, and behavioral therapy, can be used to facilitate weight loss in conjunction with several different dietary approaches. These include low-carbohydrate, low-fat, low-glycemic index, and Mediterranean diets. Studies have demonstrated that modest weight loss (5%-10% of body weight) is associated with significant improvements in patient measures of glycemic control, lipids, blood pressure, and other cardiovascular risk factors. Furthermore, a modest weight loss of as little as 4.5 kg can result in reducing the glycated hemoglobin level by approximately 0.5%. Pharmacologic agents, when combined with these approaches, may further augment weight loss. Familiarity with these principles can help physicians provide dietary counseling to their patients with T2DM and obesity.

  20. Problem Video Gaming Among Children Enrolled in Tertiary Weight Management Programs.

    PubMed

    Stubblefield, Sam; Datto, George; Phan, Thao-Ly T; Werk, Lloyd N; Stackpole, Kristin; Siegel, Robert; Stratbucker, William; Tucker, Jared M; Christison, Amy L; Hossain, Jobayer; Gentile, Douglas A

    2017-02-01

    Prior studies show seven percent to nine percent of children demonstrate gaming behaviors that affect a child's ability to function (e.g., problem gaming), but none have examined the association between problem gaming and weight status. The objective of this study was to determine the prevalence of problem gaming among children enrolled in tertiary weight management programs. We administered a computer-based survey to a convenience sample of children aged 11-17 years enrolled in five geographically diverse pediatric weight management (PWM) programs in the COMPASS (Childhood Obesity Multi-Program Analysis and Study System) network. The survey included demographics, gaming characteristics, and a problem gaming assessment. The survey had 454 respondents representing a diverse cohort (53 percent females, 27 percent black, 24 percent Hispanic, 41 percent white) with mean age of 13.7 years. A total of 8.2 percent of respondents met criteria for problem gaming. Problem gamers were more likely to be white, male, play mature-rated games, and report daily play. Children in PWM programs reported problem gaming at the same rate as other pediatric populations. Screening for problem gaming provides an opportunity for pediatricians to address gaming behaviors that may affect the health of children with obesity who already are at risk for worsened health and quality of life.

  1. Clinical evaluation of Moro (Citrus sinensis (L.) Osbeck) orange juice supplementation for the weight management.

    PubMed

    Cardile, Venera; Graziano, Adriana Carol Eleonora; Venditti, Alessandro

    2015-01-01

    In the last years, several studies have recently evaluated the beneficial effects of red orange juice (Citrus sinensis (L.) Osbeck) and its active components in weight management and obesity. Moro orange is a cultivar of red orange, particularly rich in active compounds such as anthocyanins, hydroxycinnamic acids, flavone glycosides and ascorbic acid, which displays anti-obesity effects in in vitro and in vivo studies. In this clinical study, the effect of a Moro juice extract (Morosil(®), 400 mg/die) supplementation was evaluated in overweight healthy human volunteers for 12 weeks. Results showed that Moro juice extract intake was able to induce a significant reduction in body mass index (BMI) after 4 weeks of treatment (p < 0.05). Moreover, in subjects treated with Moro extract, body weight, BMI, waist and hip circumference were significantly different from the placebo group (p < 0.05). In conclusion, it could be suggested that the active compounds contained in Moro juice have a synergistic effect on fat accumulation in humans and Moro juice extract can be used in weight management and in the prevention of human obesity.

  2. Self-reported versus measured body height and weight in Polish adult men: the risk of underestimating obesity rates.

    PubMed

    Łopuszańska, Monika; Lipowicz, Anna; Kołodziej, Halina; Szklarska, Alicja; Bielicki, Tadeusz

    2015-01-01

    Background: In some epidemiological studies, self-reported height and weight are often used to save time and money. Self-reported height and weight are commonly used to assess the prevalence of obesity. The aim of this study was to assess the differences between self-reported and measured height and weight in adult men, and to determine how the accuracy of self-reported data depended on age and education. The prevalence of obesity was also calculated based both on self-reported and measured data. Material and methods: Data were collected during two population studies carried out in Wroclaw in 2010. One study included 1,194 19-year-old males who reported for the health examination mandated by the National Conscription Board (younger group). The other group included 355 men between 35 and 80 years old who reported for a ten-year follow-up (older group). Data were analyzed separately for both age groups. Results: Both younger and older subjects overestimated their height by 1.4 cm and 1.0 cm (1.4 cm, 95   %CI: 1.26, 1.51, and 1.0 cm, 95   %CI: 0.85, 1.26, respectively). On average, younger subjects overestimated their weight by 0.7 kilograms (95   %CI: 0.55, 0.92), whereas older subjects underestimated their weight by 0.9 kilograms (95   %CI: –1.15, –0.48). The lower the level of education, the more the subjects overestimated their height. Conclusions: Adult men systematically overestimate their height and underestimate their weight. The magnitude of the inaccuracy depends on level of education. When self-reported data are used, the prevalence of obesity is generally underestimated. Using self-reported data to calculate BMI can lead to a substantial underestimation of the proportion of underweight and obese individuals in a population. Finally, using self-reported values for height in studies on social inequality may lead to false conclusions.

  3. Weight loss in obese older adults increases serum sclerostin and impairs hip geometry but both are prevented by exercise training.

    PubMed

    Armamento-Villareal, Reina; Sadler, Corinn; Napoli, Nicola; Shah, Krupa; Chode, Suresh; Sinacore, David R; Qualls, Clifford; Villareal, Dennis T

    2012-05-01

    We reported that weight loss induces bone loss which is prevented by exercise training; however, the mechanism for this observation remains unclear. Sclerostin, an inhibitor of bone formation, has been found to increase in states of unloading and may mediate the changes in bone metabolism associated with weight loss and exercise. The objective of the study was to determine the effect of lifestyle intervention in obese older adults on sclerostin levels, and on hip geometry parameters. A total of 107 obese (body mass index [BMI] ≥ 30 kg/m(2)) older (≥65 years) adults were randomly assigned to control, diet, exercise, and combined diet-exercise for 1 year. Sclerostin levels were measured by ELISA at baseline, 6 months, and 12 months, while hip geometry parameters were obtained from bone mineral density (BMD) images done by dual-energy X-ray absorptiometry using hip structure analysis at baseline and 12 months. Both the diet and diet-exercise groups had significant decreases in body weight (-9.6% and -9.4%, respectively), whereas weight was stable in the exercise and control groups. Sclerostin levels increased significantly and progressively in the diet group (6.6% ± 1.7% and 10.5% ± 1.9% at 6 and 12 months, respectively, all p < 0.05), whereas they were unchanged in the other groups; in particular, they were stable in the diet-exercise group (0.7% ± 1.6% and 0.4% ± 1.7% at 6 and 12 months, respectively, all p = 0.05). Hip geometry parameters showed significant decreases in cross-sectional area, cortical thickness, and BMD; and increases in buckling ratio at the narrow neck, intertrochanter, and femoral shaft. These negative changes on bone geometry were not observed in the diet-exercise group. Significant correlations between changes in sclerostin and changes in certain hip geometry parameters were also observed (p < 0.05). In conclusion, the increase in sclerostin levels with weight loss that was prevented by exercise may partly

  4. Exercise, appetite and weight management: understanding the compensatory responses in eating behaviour and how they contribute to variability in exercise-induced weight loss.

    PubMed

    King, N A; Horner, K; Hills, A P; Byrne, N M; Wood, R E; Bryant, E; Caudwell, P; Finlayson, G; Gibbons, C; Hopkins, M; Martins, C; Blundell, J E

    2012-04-01

    Does exercise promote weight loss? One of the key problems with studies assessing the efficacy of exercise as a method of weight management and obesity is that mean data are presented and the individual variability in response is overlooked. Recent data have highlighted the need to demonstrate and characterise the individual variability in response to exercise. Do people who exercise compensate for the increase in energy expenditure via compensatory increases in hunger and food intake? The authors address the physiological, psychological and behavioural factors potentially involved in the relationship between exercise and appetite, and identify the research questions that remain unanswered. A negative consequence of the phenomena of individual variability and compensatory responses has been the focus on those who lose little weight in response to exercise; this has been used unreasonably as evidence to suggest that exercise is a futile method of controlling weight and managing obesity. Most of the evidence suggests that exercise is useful for improving body composition and health. For example, when exercise-induced mean weight loss is <1.0 kg, significant improvements in aerobic capacity (+6.3 ml/kg/min), systolic (-6.00 mm Hg) and diastolic (-3.9 mm Hg) blood pressure, waist circumference (-3.7 cm) and positive mood still occur. However, people will vary in their responses to exercise; understanding and characterising this variability will help tailor weight loss strategies to suit individuals.

  5. Varying protein source and quantity does not significantly improve weight loss, fat loss, or satiety in reduced energy diets among midlife adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This pilot study tested whether varying protein source and quantity in a reduced energy diet would result in significant differences in weight, body composition, and renin angiotensin aldosterone system activity in midlife adults. Eighteen subjects enrolled in a 5 month weight reduction study, invol...

  6. Bringing the Adult Learning Experience of Successful Weight Loss Maintenance into Focus: A Narrative Analysis with Implications for Educators and Clinicians

    ERIC Educational Resources Information Center

    Stametz, Rebecca A.

    2013-01-01

    In light of the many social, medical, and political viewpoints on obesity, little is known of the weight loss maintenance experience and the impact on learning processes and outcomes among adults. The purpose of this study was two-fold: a) to explore the experience and meaning-making processes of individuals who have maintained a weight loss and…

  7. Attrition and weight loss outcomes for patients with complex obesity, anxiety and depression attending a weight management programme with targeted psychological treatment.

    PubMed

    McLean, R C; Morrison, D S; Shearer, R; Boyle, S; Logue, J

    2016-04-01

    The objective of the study is to investigate the effect of baseline anxiety and depression, using different definitions for caseness, on attrition and weight outcomes following a multidisciplinary weight management programme. The study design is a prospective observational study. The Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression with 'caseness' scoring ≥11 and severity ≥14. The participants were all patients who began a weight management programme between 1 October 2008 and 30 September 2009 (n = 1838). The setting was the Glasgow and Clyde Weight Management Service (GCWMS), a specialist multidisciplinary service, which aims to achieve a minimum of ≥5 kg weight loss. The results were as follows: patients with HADS score ≥14 were referred to the integrated psychology service for psychological assessment or intervention. Patients with caseness (HADS ≥11) for anxiety (33%) and depression (27%) were significantly younger, heavier, more socio-economically deprived and a higher proportion was female. There was a significant positive correlation between HADS anxiety and depression scores and increasing body mass index (r(2)  = 0.094, P < 0.001 and r(2)  = 0.175, P < 0.001, respectively). Attendance and completion was lower throughout follow-up amongst patients with anxiety or depression. More patients with HADS score ≥11 achieved ≥5 kg or ≥5% weight loss and by 12 months those with anxiety had a significantly higher mean weight loss (P = 0.032). Participants who scored for severe anxiety (HADS ≥14) achieved similar weight loss to those without, whilst participants who scored for severe depression achieved significantly greater weight loss than non-cases at 3, 6 and 12 months of follow-up (P < 0.01). Despite a less favourable case-mix of risk-factors for poor weight loss, patients who scored caseness for severe anxiety or depression and were offered additional psychological input

  8. Impact of birth weight and postnatal diet on the gut microbiota of young adult guinea pigs

    PubMed Central

    Al, Kait; Sarr, Ousseynou; Dunlop, Kristyn; Gloor, Gregory B.; Reid, Gregor; Regnault, Timothy R.H.

    2017-01-01

    Background The gastrointestinal tract (GIT) microbiota is essential to metabolic health, and the prevalence of the Western diet (WD) high in fat and sugar is increasing, with evidence highlighting a negative interaction between the GIT and WD, resulting in liver dysfunction. Additionally, an adverse in utero environment such as placental insufficiency resulting in low birth weight (LBW) offspring, contributes to an increased risk of metabolic diseases such as fatty liver infiltration and liver dysfunction in later life. We sought to understand the potential interactive effects of exposure to a WD upon growing LBW offspring. We postulated that LBW offspring when challenged with a poor postnatal diet, would display an altered microbiota and more severe liver metabolic dysfunction. Methods The fecal microbiota of normal birth weight (NBW) and LBW young guinea pig offspring, weaned onto either a control diet (CD) or WD was determined with 16S rRNA gene next generation sequencing at young adulthood following the early rapid growth phase after weaning. A liver blood chemistry profile was also performed. Results The life-long consumption of WD following weaning into young adulthood resulted in increased total cholesterol, triglycerides and alanine aminotransferase levels in association with an altered GIT microbiota when compared to offspring consuming CD. Neither birth weight nor sex were associated with any significant changes in microbiota alpha diversity, by measuring the Shannon’s diversity index. One hundred forty-eight operational taxonomic units were statistically distinct between the diet groups, independent of birth weight. In the WD group, significant decreases were detected in Barnesiella, Methanobrevibacter smithii and relatives of Oscillospira guillermondii, while Butyricimonas and Bacteroides spp. were increased. Discussion These results describe the GIT microbiota in a guinea pig model of LBW and WD associated metabolic syndrome and highlight several WD

  9. White Paper AGA: POWER - Practice Guide on Obesity and Weight Management, Education and Resources.

    PubMed

    Acosta, Andres; Streett, Sarah; Kroh, Mathew D; Cheskin, Lawrence J; Saunders, Katherine H; Kurian, Marina; Schofield, Marsha; Barlow, Sarah E; Aronne, Louis

    2017-02-24

    The epidemic of obesity continues at alarming rates, with a high burden to our economy and society. The American Gastroenterological Association understands the importance of embracing obesity as a chronic, relapsing disease and supports a multidisciplinary approach to the management of obesity. Because gastrointestinal disorders resulting from obesity are more frequent and often present sooner than type 2 diabetes mellitus and cardiovascular disease, gastroenterologists have an opportunity to address obesity and provide an effective therapy early. Patients who are overweight or obese already fill gastroenterology clinics with gastroesophageal reflux disease and its associated risks of Barrett's esophagus and esophageal cancer, gallstone disease, nonalcoholic fatty liver disease/nonalcoholic steatohepatitis, and colon cancer. Obesity is a major modifiable cause of diseases of the digestive tract that frequently goes unaddressed. As internists, specialists in digestive disorders, and endoscopists, gastroenterologists are in a unique position to play an important role in the multidisciplinary treatment of obesity. This American Gastroenterological Association paper was developed with content contribution from Society of American Gastrointestinal and Endoscopic Surgeons, The Obesity Society, Academy of Nutrition and Dietetics, and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, endorsed with input by American Society for Gastrointestinal Endoscopy, American Society for Metabolic and Bariatric Surgery, American Association for the Study of Liver Diseases, and Obesity Medicine Association, and describes POWER: Practice Guide on Obesity and Weight Management, Education and Resources. Its objective is to provide physicians with a comprehensive, multidisciplinary process to guide and personalize innovative obesity care for safe and effective weight management.

  10. Exploring the Connections between Adult and Management Education

    ERIC Educational Resources Information Center

    Brookfield, Stephen D.; Kalliath, Thomas; Laiken, Marilyn

    2006-01-01

    Stephen Brookfield has written and edited 10 books on adult learning, teaching, and critical thinking. He is a recipient of a number of awards, including the World Award for Literature in Adult Education (in 1986, 1989, 1996, and 2005), the Imogene Okes Award for Outstanding Research in Adult Education (in 1986), and the Leadership Award from the…

  11. Sex-specific associations of low birth weight with adult-onset diabetes and measures of glucose homeostasis: Brazilian Longitudinal Study of Adult Health

    PubMed Central

    Yarmolinsky, James; Mueller, Noel T; Duncan, Bruce B; Chor, Dóra; Bensenor, Isabela M; Griep, Rosane H; Appel, Lawrence J; Barreto, Sandhi M; Schmidt, Maria Inês

    2016-01-01

    Emerging evidence suggests sex differences in the early origins of adult metabolic disease, but this has been little investigated in developing countries. We investigated sex-specific associations between low birth weight (LBW; <2.5 kg) and adult-onset diabetes in 12,525 participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Diabetes was defined by self-reported information and laboratory measurements. In confounder-adjusted analyses, LBW (vs. 2.5–4 kg) was associated with higher prevalence of diabetes in women (Prevalence Ratio (PR) 1.54, 95% CI: 1.32–1.79), not in men (PR 1.06, 95% CI: 0.91–1.25; Pheterogeneity = 0.003). The association was stronger among participants with maternal diabetes (PR 1.60, 95% CI: 1.35–1.91), than those without (PR 1.15, 95% CI: 0.99–1.32; Pheterogeneity = 0.03). When jointly stratified by sex and maternal diabetes, the association was observed for women with (PR 1.77, 95% CI: 1.37–2.29) and without (PR 1.45, 95% CI: 1.20–1.75) maternal diabetes. In contrast, in men, LBW was associated with diabetes in participants with maternal diabetes (PR 1.45, 95% CI: 1.15–1.83), but not in those without (PR 0.92, 95% CI: 0.74–1.14). These sex-specific findings extended to continuous measures of glucose homeostasis. LBW was associated with higher diabetes prevalence in Brazilian women, and in men with maternal diabetes, suggesting sex-specific intrauterine effects on adult metabolic health. PMID:27845438

  12. A controlled trial of reduced meal frequency without caloric restriction in healthy, normal-weight, middle-aged adults123

    PubMed Central

    Stote, Kim S; Baer, David J; Spears, Karen; Paul, David R; Harris, G Keith; Rumpler, William V; Strycula, Pilar; Najjar, Samer S; Ferrucci, Luigi; Ingram, Donald K; Longo, Dan L; Mattson, Mark P

    2009-01-01

    Background Although consumption of 3 meals/d is the most common pattern of eating in industrialized countries, a scientific rationale for this meal frequency with respect to optimal health is lacking. A diet with less meal frequency can improve the health and extend the lifespan of laboratory animals, but its effect on humans has never been tested. Objective A pilot study was conducted to establish the effects of a reduced-meal-frequency diet on health indicators in healthy, normal-weight adults. Design The study was a randomized crossover design with two 8-wk treatment periods. During the treatment periods, subjects consumed all of the calories needed for weight maintenance in either 3 meals/d or 1 meal/d. Results Subjects who completed the study maintained their body weight within 2 kg of their initial weight throughout the 6-mo period. There were no significant effects of meal frequency on heart rate, body temperature, or most of the blood variables measured. However, when consuming 1 meal/d, subjects had a significant increase in hunger; a significant modification of body composition, including reductions in fat mass; significant increases in blood pressure and in total, LDL-, and HDL-cholesterol concentrations; and a significant decrease in concentrations of cortisol. Conclusions Normal-weight subjects are able to comply with a 1 meal/d diet. When meal frequency is decreased without a reduction in overall calorie intake, modest changes occur in body composition, some cardiovascular disease risk factors, and hematologic variables. Diurnal variations may affect outcomes. PMID:17413096

  13. Health and social care management for older adults with multimorbidity: a multiperspective approach.

    PubMed

    Meranius, Martina Summer; Josefsson, Karin

    2017-03-01

    Multimorbidity, a condition common among older adults, may be regarded as a failure of a complex system. The aim of this study was to describe the core components in health and social care management for older adults with multimorbidity. A cross-sectional design included two methods: individual interviews and group discussions. A total of 105 participants included older adults with multimorbidity and their relatives, care staff and healthcare policymakers. Data were analysed using content analysis. The results show that seven core components comprise a multiperspective view of health and social care management for older adults with multimorbidity: political steering, leadership, cooperation, competence, support for relatives, availability and continuity. Steps should be taken to ensure that every older adult with multimorbidity has a treatment plan according to a multiperspective view to prevent fragmentation of their health care. This study provides relevant evidence developing a multiperspective model of health and social care management for older adults with multimorbidity.

  14. Social class and body weight among Chinese urban adults: the role of the middle classes in the nutrition transition.

    PubMed

    Bonnefond, Céline; Clément, Matthieu

    2014-07-01

    While a plethoric empirical literature addresses the relationship between socio-economic status and body weight, little is known about the influence of social class on nutritional outcomes, particularly in developing countries. The purpose of this article is to contribute to the analysis of the social determinants of adult body weight in urban China by taking into account the influence of social class. More specifically, we propose to analyse the position of the Chinese urban middle class in terms of being overweight or obese. The empirical investigations conducted as part of this research are based on a sample of 1320 households and 2841 adults from the China Health and Nutrition Survey for 2009. For the first step, we combine an economic approach and a sociological approach to identify social classes at household level. First, households with an annual per capita income between 10,000 Yuan and the 95th income percentile are considered as members of the middle class. Second, we strengthen the characterization of the middle class using information on education and employment. By applying clustering methods, we identify four groups: the elderly and inactive middle class, the old middle class, the lower middle class and the new middle class. For the second step, we implement an econometric analysis to assess the influence of social class on adult body mass index and on the probability of being overweight or obese. We use multinomial treatment regressions to deal with the endogeneity of the social class variable. Our results show that among the four subgroups of the urban middle class, the new middle class is the only one to be relatively well-protected against obesity. We suggest that this group plays a special role in adopting healthier food consumption habits and seems to be at a more advanced stage of the nutrition transition.

  15. Trends in weight management goals and behaviors among 9th-12th grade students: United States, 1999-2009.

    PubMed

    Demissie, Zewditu; Lowry, Richard; Eaton, Danice K; Nihiser, Allison J

    2015-01-01

    To examine trends in weight management goals and behaviors among U.S. high school students during 1999-2009. Data from six biennial cycles (1999-2009) of the national Youth Risk Behavior Survey were analyzed. Cross-sectional, nationally representative samples of 9th-12th grade students (approximately 14,000 students/cycle) completed self-administered questionnaires. Logistic regression models adjusted for grade, race/ethnicity, and obesity were used to test for trends in weight management goals and behaviors among subgroups of students. Combined prevalences and trends differed by sex and by race/ethnicity and weight status within sex. During 1999-2009, the prevalence of female students trying to gain weight decreased (7.6-5.7 %). Among female students trying to lose or stay the same weight, prevalences decreased for eating less (69.6-63.2 %); fasting (23.3-17.6 %); using diet pills/powders/liquids (13.7-7.8 %); and vomiting/laxatives (9.5-6.6 %) for weight control. During 1999-2009, the prevalence of male students trying to lose weight increased (26.1-30.5 %). Among male students trying to lose or stay the same weight, the prevalence of exercising to control weight did not change during 1999-2003 and then increased (74.0-79.1 %) while the prevalence of taking diet pills/powders/liquids for weight control decreased (6.9-5.1 %) during 1999-2009. Weight management goals and behaviors changed during 1999-2009 and differed by subgroup. To combat the use of unhealthy weight control behaviors, efforts may be needed to teach adolescents about recommended weight management strategies and avoiding the risks associated with unhealthy methods.

  16. Nutritional adequacy of plant-based diets for weight management: observations from the NHANES.

    PubMed

    Farmer, Bonnie

    2014-07-01

    Observational studies have shown that body mass indexes of vegetarians are lower than those of nonvegetarians and that caloric intake of vegetarians is typically lower than that of nonvegetarians, suggesting that a vegetarian diet could be an approach for weight management. However, vegetarians may be at risk of inadequate intakes of certain vitamins and minerals. Population-based studies indicate that vegetarians have lower mean intakes of vitamin B-12 and zinc and higher intakes of fiber, magnesium, and vitamins A, C, and E than do nonvegetarians. Usual intake data suggest a similar prevalence of inadequacy between vegetarians and nonvegetarians for magnesium and vitamins A, C, and E, with both groups at high risk of inadequate intakes of these nutrients. These same data report that vegetarians have a higher prevalence of inadequacy for iron, vitamin B-12, protein, and zinc than do nonvegetarians. Although mean intake data suggest that a vegetarian diet may be a useful approach for weight management, combined with energy restriction it may have a detrimental effect on diet quality. Mean intakes of fiber, vitamins A and C, magnesium, and iron were significantly lower for vegetarians with energy intakes ≥ 500 kcal below Estimated Energy Requirements than for vegetarians who did not restrict energy. Vegetarian diets should be recommended for weight management; however, care should be taken to optimize food intake to provide adequate intakes of nutrients of concern when energy restriction is used in conjunction with a vegetarian dietary pattern. At any caloric amount, vegetarians should optimize intakes of vitamin B-12, zinc, and protein; and both vegetarians and nonvegetarians need to increase intakes of calcium, magnesium, fiber, and vitamins A, C, and E.

  17. A mixed methods approach to improving recruitment and engagement of emerging adults in behavioural weight loss programs

    PubMed Central

    Guthrie, K. M.; Lanoye, A.; Tate, D. F.; Robichaud, E.; Caccavale, L. J.; Wing, R. R.

    2016-01-01

    Summary Objective Emerging adults ages 18–25 are at high risk for obesity, but are markedly underrepresented in behavioural weight loss (BWL) programs and experience lower engagement and retention relative to older adults. Purpose To utilize a mixed methods approach to inform future efforts to effectively recruit and engage this high‐risk population in BWL programs. Methods We used a convergent parallel design in which quantitative and qualitative data were given equal priority. Study 1 (N = 137, age = 21.8 + 2.2, BMI = 30.1 + 4.7) was a quantitative survey, conducted online to reduce known barriers and minimize bias. Study 2 (N = 7 groups, age = 22.3 + 2.2, BMI = 31.5 + 4.6) was a qualitative study, consisting of in person focus groups to gain greater depth and identify contextual factors unable to be captured in Study 1. Results Weight loss was of interest, but weight itself was not a central motivation; an emphasis on overall lifestyle, self‐improvement and fitness emerged as driving factors. Key barriers were time, motivation and money. Recruitment processes should be primarily online with messages tailored specifically to motivations and preferences of this age group. Preferences for a program were reduced intensity and brief, hybrid format with some in‐person contact, individual level coaching, experiential learning and peer support. Key methods of promoting engagement and retention were autonomy and choice, money and creating an optimal default. Conclusions An individually tailored lifestyle intervention that addresses a spectrum of health behaviours, promotes autonomy and emphasizes activity and fitness may facilitate recruitment and engagement in this population better than traditional BWL protocols. PMID:28090339

  18. Hyperleptinemia During Pregnancy Decreases Adult Weight of Offspring and Is Associated With Increased Offspring Locomotor Activity in Mice.

    PubMed

    Pollock, Kelly E; Stevens, Damaiyah; Pennington, Kathleen A; Thaisrivongs, Rose; Kaiser, Jennifer; Ellersieck, Mark R; Miller, Dennis K; Schulz, Laura Clamon

    2015-10-01

    Pregnant women who are obese or have gestational diabetes mellitus have elevated leptin levels and their children have an increased risk for child and adult obesity. The goals of this study were to determine whether offspring weights are altered by maternal hyperleptinemia, and whether this occurs via behavioral changes that influence energy balance. We used 2 hyperleptinemic mouse models. The first was females heterozygous for a leptin receptor mutation (DB/+), which were severely hyperleptinemic, and that were compared with wild-type females. The second model was wild-type females infused with leptin (LEP), which were moderately hyperleptinemic, and were compared with wild-type females infused with saline (SAL). Total food consumption, food preference, locomotor activity, coordinated motor skills, and anxiety-like behaviors were assessed in wild-type offspring from each maternal group at 3 postnatal ages: 4-6, 11-13, and 19-21 weeks. Half the offspring from each group were then placed on a high-fat diet, and behaviors were reassessed. Adult offspring from both groups of hyperleptinemic dams weighed less than their respective controls beginning at 23 weeks of age, independent of diet or sex. Weight differences were not explained by food consumption or preference, because female offspring from hyperleptinemic dams tended to consume more food and had reduced preference for palatable, high-fat and sugar, food compared with controls. Offspring from DB/+ dams were more active than offspring of controls, as were female offspring of LEP dams. Maternal hyperleptinemia during pregnancy did not predispose offspring to obesity, and in fact, reduced weight gain.

  19. Insurance reimbursement in a university-based pediatric weight management clinic.

    PubMed Central

    Griffith, Joan; Gantz, Starr; Lowry, Jill; Dai, Hongying; Bada, Henrietta

    2007-01-01

    OBJECTIVES: To compare third-party payor reimbursement for patients evaluated in a university-based pediatric weight management clinic in central Kentucky. STUDY DESIGN: Demographic and reimbursement data were reviewed for 120 patients evaluated January to December 2004. Statistical analysis included Kruskal-Wallis test and Friedman's test. RESULTS: Overall, median reimbursement was 60%. For new appointments, contracted (56%) and capitated (60%) reimbursements were higher than Medicaid (55%). For established appointments, Medicaid reimbursement (100%) was higher than contracted (37%) and capitated (58%). CONCLUSION: Our data suggest that reimbursement is influenced by regional factors and is improving in central Kentucky. PMID:17913114

  20. Weight loss resistance: a further consideration for the nutritional management of obese Equidae.

    PubMed

    Argo, Caroline McG; Curtis, Gemma C; Grove-White, Dai; Dugdale, Alexandra H A; Barfoot, Clare F; Harris, Patricia A

    2012-11-01

    Evidence-based, weight loss management advice is required to address equine obesity. Changes in body mass (BM), body condition score (BCS), heart (HG) and belly circumference (BG), direct (ultrasonographic) and indirect (D(2)O dilution, bioelectrical impedance analysis [BIA]) measures of body fat as well as indices of insulin resistance (IR) were monitored in 12 overweight (BCS ≥ 7/9) horses and ponies of mixed breed and gender for 16 weeks. Animals were randomly assigned to two groups (Group 1, n=6, BCS 7.6/9 ± 0.6, 489 ± 184.6 kg; Group 2, n=6, BCS 8.1/9 ± 0.6, 479 ± 191.5 kg). Daily dry matter intake (DMI) was restricted to 1.25% BM as one of two, near-isocaloric (DE ∼0.115 MJ/kg BM/day), forage-based diets (Group 1, 0.8% BM chaff-based feed: 0.45% BM hay; Group 2, 1.15% BM hay: 0.1% BM nutrient-balancer). Statistical modelling revealed considerable between-animal heterogeneity in proportional weight losses (0.16-0.55% of Week 1 BM weekly). The magnitude of weight loss resistance (WLR) or sensitivity to dietary restriction was independent of diet or any measured outset variable and was largely (65%) attributed to animal identity. Predicted rates of weight loss decreased over time. BCS and BIA were poor estimates of D(2)O-derived body fat%. Reciprocal changes in depths of retroperitoneal and subcutaneous adipose tissues were evident. Changes in BG were associated with losses in retroperitoneal fat and BM (r(2), 0.67 and 0.79). Indices of IR improved for 9/12 animals by Week 16. For obese animals, weight loss should be initiated by restricting forage DMI to 1.25% BM. Subsequent restriction to 1% BM may be warranted for WLR animals.

  1. Self-Help for Weight Loss in Overweight and Obese Adults: Systematic Review and Meta-Analysis

    PubMed Central

    Jebb, Susan A.; Fletcher, Ben R.; Aveyard, Paul

    2015-01-01

    We conducted a systematic review and meta-analysis investigating the components and effectiveness of self-help weight-loss interventions and their applicability to less-advantaged populations. We searched (November 2013) for randomized controlled trials comparing self-help interventions with each other or with minimal controls in overweight and obese adults, with 6 months or longer follow-up. We calculated mean difference between intervention and control for 6- and 12-month weight change. Twenty-three studies met the inclusion criteria (9632 participants; 39 intervention arms). Intervention participants lost significantly more weight than controls at 6 months (mean difference −1.85 kg; 95% confidence interval [CI] = −2.86, −0.83; 7 studies). No significant effect was detected at 12 months but results were sensitive to the inclusion of 1 study at high risk of bias. Interactive programs appeared more effective than standard ones at 6 months (mean difference −0.94 kg; 95% CI = −1.50, −0.38). Evidence is insufficient to reach conclusions on effectiveness in socioeconomically disadvantaged people, but suggests self-help interventions may be less effective in this group. PMID:25602873

  2. Sleep, obesity, and weight loss in adults: is there a rationale for providing sleep interventions in the treatment of obesity?

    PubMed

    Coughlin, Janelle W; Smith, Michael T

    2014-04-01

    Rates of obesity and sleep disturbances are substantial in adults. A number of cross-sectional, longitudinal, and experimental studies have found that insufficient sleep and possibly longer sleep are associated with obesity and related eating patterns. Methodological discrepancies and limitations in the literature create ambiguity about the nature and potential mechanisms underlying these relationships. Insomnia and circadian patterns in eating and sleeping have also been examined in relation to weight. Although these studies are not as extensive as those examining sleep duration, the extant literature suggests possible associations between obesity and both insomnia (particularly when combined with short sleep duration) and circadian eating behaviours. However, research has only just begun to examine the benefits of combining sleep interventions with obesity treatment. The goal of the current review is to summarize research examining behavioural sleep patterns and disorders in relation to obesity, to discuss methodological considerations, and to provide an overview of studies examining whether addressing sleep disturbances can augment weight loss treatment effects. We conclude that future studies are needed that take into account sleep duration, sleep disorder co-morbidity, and chronobiology to explore the impact of sleep interventions on weight loss.

  3. Effect of short-term weight loss on the metabolic syndrome and conduit vascular endothelial function in overweight adults.

    PubMed

    Brook, Robert D; Bard, Robert L; Glazewski, Lynn; Kehrer, Christine; Bodary, Peter F; Eitzman, Daniel L; Rajagopalan, Sanjay

    2004-04-15

    Impaired vascular endothelial function may be an important mechanism linking obesity to increased cardiovascular risk. We investigated whether short-term weight loss improves conduit artery endothelial dysfunction in overweight adults. Forty-three otherwise healthy overweight patients with a body mass index > or =27 kg/m(2) completed an open-label 3-month trial consisting of a calorie-restricted diet and 120 mg of orlistat taken 3 times daily with meals. Endothelial function and parameters of the metabolic syndrome were measured before and after intervention. Subjects lost 6.6 +/- 3.4% of their body weight. Low-density lipoprotein cholesterol, low-density lipoprotein concentration, fasting insulin, and leptin decreased significantly (all p <0.009), and C-reactive protein decreased (p = 0.22). Conduit vascular function did not change as assessed by flow-mediated dilation (3.86 +/- 3.54 vs 3.74 +/- 3.78%, p = 0.86) and nitroglycerin-mediated dilation (17.18 +/- 5.89 vs 18.87 +/- 7.11%, p = 0.13) of the brachial artery. A moderate degree of weight reduction over 3 months improved the metabolic syndrome profile but not the vascular dysfunction associated with uncomplicated obesity.

  4. Associations between hurtful weight-related comments by family and significant other and the development of disordered eating behaviors in young adults.

    PubMed

    Eisenberg, Marla E; Berge, Jerica M; Fulkerson, Jayne A; Neumark-Sztainer, Dianne

    2012-10-01

    Research has found that weight-teasing is associated with disordered eating in adolescents. This study expands on the existing research by examining associations between hurtful weight comments by family and a significant other and disordered eating in young adults. Data come from 1,902 young adults (mean age 25) who completed surveys in 1998, 2003 and 2009. Correlations were examined between receiving hurtful comments from family and significant others, and four disordered eating behaviors in young adulthood, adjusting for prior disordered eating and prior teasing. Disordered eating behaviors were common in young adulthood, and were associated with hearing hurtful weight-related comments from family members and a significant other, for both females and males. Disordered eating prevention activities, which include messages about the potential harm associated with hurtful weight-related comments, should be expanded to address young adults, and programs may want to target relationship partners.

  5. A pilot study of the body weight of pure-bred client-owned adult cats.

    PubMed

    Kienzle, Ellen; Moik, Katja

    2011-10-01

    A total of 539 pure-bred and seventy-five cats without a pedigree were weighed and scored at cat shows or in veterinary surgeries. Data from normal-weight cats with a body condition score (BCS) of 5 (ideal) were only used. Breeds were grouped into five classes. For female cats, the mean weight for these groups were as follows: very light (2.8 kg); light (3.2 kg); medium (3.5 kg); large (4.0 kg); giant (4.9) kg. For male cats, the corresponding values were 3.6, 4.2, 4.3, 5.1 and 6.1 kg. Siamese/Oriental Shorthair were identified as a very light breed, the Norwegian Forest and the Siberian Cat as a large breed and the Maine Coon as a giant breed. Males and females of the same breed did not always belong to the same class. In some breeds, individuals of the same sex were found in two different classes. The percentage of intact overweight cats (BCS >5) was low (7 % of intact males, 3 % of intact females). Incidence of overweight in neutered cats was 50 % in males and 38 % in females. Among pedigreed cats, there were differences in the incidence of overweight in neutered cats: high in Norwegian Forest Cats (males 75 %, females 50 %) and low in Siamese/Oriental Shorthair Cats (males 25 %, females 1 %). Cats with a BCS of 6, 7 and 8 had on average 120, 154 and 214 % of the normal weight of their breed, respectively.

  6. Adapting a tertiary-care pediatric weight management clinic to better reach Spanish-speaking families.

    PubMed

    Guzman, Angelica; Irby, Megan B; Pulgar, Camila; Skelton, Joseph A

    2012-06-01

    Pediatric obesity continues to be an epidemic, affecting Hispanic children disproportionately. Recent recommendations outline a step-wise approach to the treatment of overweight and obese children, culminating in tertiary-care, multidisciplinary programs. We detail here how our tertiary-care, family-based, pediatric weight management clinic addressed the problem of few Spanish-speaking families enrolling in treatment after referral by adding a Bilingual Case Manager. Utilizing a family-centered, high-contact, personal approach, our program increased the number of Hispanic families enrolling over ten-fold. Further, outcomes in Hispanic families were equal to or better than other racial/ethnic groups. Lessons learned from this experience may benefit other obesity treatment programs trying to improve care of Spanish-speaking families.

  7. Obesity in the Kaiser Permanente Patient Population and Positive Outcomes of Online Weight-Management Programs

    PubMed Central

    Bachman, Keith H; Histon, Trina M; Remmers, Carol

    2007-01-01

    We review what is known about the effects of obesity in the Kaiser Permanente (KP) population and discuss outcomes for two nationally available effective online programs, HealthMedia Balance® (Balance) and 10,000 Steps®. Obese KP patients often have health problems related to overweight and report difficulties with self-care, yet with the proper support, they can avail themselves of effective treatment to manage both obesity and associated conditions that affect quality of life. Clinicians should be aware of potential problems with functional status and self-care in their obese patients, provide brief assessment and advice, and refer obese patients to effective national and regional weight-management programs. PMID:21461090

  8. Changes in Weight Loss, Health Behaviors, and Intentions among 400 Participants Who Dropped out from an Insurance-Sponsored, Community-Based Weight Management Program

    PubMed Central

    Zizzi, Sam J.; Lima Fogaca, Jana; Sheehy, Tammy; Welsh, Myia

    2016-01-01

    The majority of weight management research is based on data from randomized controlled studies conducted in clinical settings. As these findings are translated into community-based settings, additional research is needed to understand patterns of lifestyle change and dropout. The purpose of this study was to examine reasons for and consequences associated with dropout (or removal) from an insurance-funded weight management program. Using a mixed methods approach with objectively measured changes in body weight and attendance along with quantitative and qualitative survey data, patterns of intention and behavior change were explored. The results from a sample of 400 respondents support the idea that there are both positive and negative consequences of program participation. Overall, 1 in 5 respondents lost a clinically significant amount of weight during the program (>5% of baseline body weight) and 1 in 3 experienced a positive consequence, while only 6% expressed a negative outcome of participation. Additionally, nearly 90% of all of the consequences that emerged from the data were positive. Attitude change was a major theme, including positive health intentions, perceived success, learning skills, and new appreciation of exercise. PMID:27413546

  9. Randomized Pilot Study of Cabergoline, a Dopamine Receptor Agonist: Effects on Body Weight and Glucose Tolerance in Obese Adults

    PubMed Central

    Gibson, Charlisa D.; Karmally, Wahida; McMahon, Donald J.; Wardlaw, Sharon L.; Korner, Judith

    2011-01-01

    Aim Dopaminergic hypofunction and hyperprolactinemia have been implicated in the pathogenesis of obesity and glucose intolerance. The aim of this pilot study was to determine the efficacy of cabergoline, a dopamine receptor agonist, on body weight and glucose tolerance in obese non-diabetic persons with normal plasma prolactin levels. Materials and Methods This 16-week double blind, placebo-controlled pilot study randomized non- diabetic obese adults (BMI 30-42 kg/m2) to placebo or cabergoline (0.25 mg twice weekly for 4 weeks followed by 0.5 mg twice weekly for the next 12 weeks). Of 40 subjects enrolled, 29 completed 16 weeks: 16 randomized to placebo, 13 to cabergoline. All subjects were counseled on a 500 kcal/day calorie deficit diet. A 75 gm oral glucose tolerance test was performed at baseline and at 16 weeks. Results As expected, prolactin levels decreased after cabergoline (P<0.001). Weight loss was similar after placebo compared with cabergoline treatment: 1.0 vs 1.2% body weight, respectively. Fasting glucose levels did not differ between groups after treatment, however, 90 minute post-prandial glucose and insulin decreased in the cabergoline group only (P = 0.029). HOMA-IR increased by 40% after placebo, and 1.5% after cabergoline treatment. Conclusions This pilot study suggests that cabergoline therapy may improve glucose tolerance independent of weight loss, however, a larger, longer term study of dopamine receptor agonist therapy in obese individuals is warranted to confirm this finding. PMID:22074059

  10. Safety and toxicological evaluation of Meratrim®: an herbal formulation for weight management.

    PubMed

    Saiyed, Zainulabedin M; Sengupta, Krishanu; Krishnaraju, Alluri V; Trimurtulu, Golakoti; Lau, Francis C; Lugo, James P

    2015-04-01

    Meratrim is a unique dietary ingredient consisting of extracts from Sphaeranthus indicus flower heads and Garcinia mangostana fruit rind. Clinical studies have demonstrated that Meratrim is effective and well-tolerated in weight management. Herein we assessed the broad spectrum safety of Meratrim in a battery of in vitro and animal toxicological studies including a sub-chronic repeated-dose 13-week oral toxicity study to determine the no-observable-adverse-effect-level (NOAEL). The LD50 levels of Meratrim in Sprague-Dawley (SD) rats, as determined by the acute oral and dermal toxicity studies, were >5000 and >2000 mg/kg body weight, respectively. The primary skin and eye irritation tests classified Meratrim as non-irritating to the skin and mildly irritating to the eye. Genotoxicity studies showed that Meratrim is non-mutagenic. In the repeated-dose 13-week oral toxicity study, SD rats were orally gavaged with Meratrim at 0, 250, 500 or 1000 mg/kg/day. No morbidity, mortality, or significant adverse events were observed either during the course of the study or on the 13th week. The NOAEL of Meratrim was concluded to be 1000 mg/kg of body weight/day in male and female SD rats. These results, combined with the tolerability of Meratrim in the human clinical trials, demonstrate the broad spectrum safety of Meratrim.

  11. Mobile Phone and Web 2.0 Technologies for Weight Management: A Systematic Scoping Review

    PubMed Central

    2015-01-01

    Background Widespread diffusion of mobile phone and Web 2.0 technologies make them potentially useful tools for promoting health and tackling public health issues, such as the increasing prevalence of overweight and obesity. Research in this domain is growing rapidly but, to date, no review has comprehensively and systematically documented how mobile and Web 2.0 technologies are being deployed and evaluated in relation to weight management. Objective To provide an up-to-date, comprehensive map of the literature discussing the use of mobile phone and Web 2.0 apps for influencing behaviors related to weight management (ie, diet, physical activity [PA], weight control, etc). Methods A systematic scoping review of the literature was conducted based on a published protocol (registered at PROSPERO: CRD42014010323). Using a comprehensive search strategy, we searched 16 multidisciplinary electronic databases for original research documents published in English between 2004 and 2014. We used duplicate study selection and data extraction. Using an inductively developed charting tool, selected articles were thematically categorized. Results We identified 457 articles, mostly published between 2013 and 2014 in 157 different journals and 89 conference proceedings. Articles were categorized around two overarching themes, which described the use of technologies for either (1) promoting behavior change (309/457, 67.6%) or (2) measuring behavior (103/457, 22.5%). The remaining articles were overviews of apps and social media content (33/457, 7.2%) or covered a combination of these three themes (12/457, 2.6%). Within the two main overarching themes, we categorized articles as representing three phases of research development: (1) design and development, (2) feasibility studies, and (3) evaluations. Overall, articles mostly reported on evaluations of technologies for behavior change (211/457, 46.2%). Conclusions There is an extensive body of research on mobile phone and Web 2

  12. Client Experiences With Dietary, Exercise, and Behavioral Services in a Community-Based Weight Management Program.

    PubMed

    Zizzi, Sam; Kadushin, Peter; Michel, Jesse; Abildso, Christiaan

    2016-01-01

    Compared with randomized trials, community-based interventions are delivered by a wider variety of professionals with varied training backgrounds. When evidence-based programs are scaled into larger formats and disseminated to a wider audience, little is understood about how clients experience these interventions. To understand the experience of clients after meetings with nutrition, exercise, and health behavior professionals, researchers surveyed participants after 6 months in a weight management program. A total of 958 participants were recruited in monthly cohorts beginning September 2011 to complete a program evaluation survey. Qualitative inductive analysis was completed on several open-text items querying respondents as to what they found helpful from meetings with a registered dietitian, personal trainer, and health behavior counselor. Results indicate participants benefitted from gaining knowledge, learning new behavioral skills, or from interpersonal interactions. Findings suggest that the various professional services are valued by clients and that professionals appear to stay within their scope of practice. Implications for those working in weight management are discussed.

  13. Rising Obesity Prevalence and Weight Gain Among Adults Starting Antiretroviral Therapy in the United States and Canada

    PubMed Central

    Jenkins, Cathy A.; Lau, Bryan; Shepherd, Bryan E.; Justice, Amy C.; Tate, Janet P.; Buchacz, Kate; Napravnik, Sonia; Mayor, Angel M.; Horberg, Michael A.; Blashill, Aaron J.; Willig, Amanda; Wester, C. William; Silverberg, Michael J.; Gill, John; Thorne, Jennifer E.; Klein, Marina; Eron, Joseph J.; Kitahata, Mari M.; Sterling, Timothy R.; Moore, Richard D.

    2016-01-01

    Abstract The proportion of overweight and obese adults in the United States and Canada has increased over the past decade, but temporal trends in body mass index (BMI) and weight gain on antiretroviral therapy (ART) among HIV-infected adults have not been well characterized. We conducted a cohort study comparing HIV-infected adults in the North America AIDS Cohort Collaboration on Research and Design (NA-ACCORD) to United States National Health and Nutrition Examination Survey (NHANES) controls matched by sex, race, and age over the period 1998 to 2010. Multivariable linear regression assessed the relationship between BMI and year of ART initiation, adjusting for sex, race, age, and baseline CD4+ count. Temporal trends in weight on ART were assessed using a generalized least-squares model further adjusted for HIV-1 RNA and first ART regimen class. A total of 14,084 patients from 17 cohorts contributed data; 83% were male, 57% were nonwhite, and the median age was 40 years. Median BMI at ART initiation increased from 23.8 to 24.8 kg/m2 between 1998 and 2010 in NA-ACCORD, but the percentage of those obese (BMI ≥30 kg/m2) at ART initiation increased from 9% to 18%. After 3 years of ART, 22% of individuals with a normal BMI (18.5–24.9 kg/m2) at baseline had become overweight (BMI 25.0–29.9 kg/m2), and 18% of those overweight at baseline had become obese. HIV-infected white women had a higher BMI after 3 years of ART as compared to age-matched white women in NHANES (p = 0.02), while no difference in BMI after 3 years of ART was observed for HIV-infected men or non-white women compared to controls. The high prevalence of obesity we observed among ART-exposed HIV-infected adults in North America may contribute to health complications in the future. PMID:26352511

  14. Obesity and weight management in the elderly: a focus on men.

    PubMed

    Han, T S; Wu, F C W; Lean, M E J

    2013-08-01

    The rising rate of overweight/obesity among the ever-growing ageing population is imposing massive and rapidly changing burdens of ill health. The observation that the BMI value associated with the lowest relative mortality is slightly higher in older than in younger adults, mainly through its reduced impact on coronary heart disease, has often been misinterpreted that obesity is not as harmful in the elderly, who suffer a large range of disabling consequences of obesity. All medical consequences of obesity are multi-factorial and most alleviated by modest, achievable weight loss (5-10 kg) with an evidence-based maintenance strategy. But severe obesity, e.g. BMI >40 may demand greater weight loss e.g. >15 kg to reverse type 2 diabetes. Since relatively reduced physical activity and reduced muscle mass (sarcopenic obesity) are common in the elderly, combining exercise and modest calorie restriction optimally reduces fat mass and preserves muscle mass - age presents no obstacle and reducing polypharmacy is a valuable outcome. The currently licensed drug orlistat has no age-related hazards and is effective in a low fat diet, but the risks from bariatric surgery begin to outweigh benefits above age 60. For the growing numbers of obese elderly with diabetes, the glucagon-like peptide-1 (GLP-1) receptor analogue liraglutide appears a safe way to promote and maintain substantial weight loss. Obesity and sarcopenia should be prevented from younger age and during life-transitions including retiral to improve future health outcomes and quality of life, with a focus on those in "obese families".

  15. Relationships of cognitive load on eating and weight-related behaviors of young adults.

    PubMed

    Byrd-Bredbenner, Carol; Quick, Virginia; Koenings, Mallory; Martin-Biggers, Jennifer; Kattelmann, Kendra K

    2016-04-01

    Little is known about the relationship between weight-related behaviors and cognitive load (working memory available to complete mental activities like those required for planning meals, selecting foods, and other health-related decisions). Thus, the purpose of this study was to explore associations between cognitive load and eating behaviors, physical activity, body mass index (BMI), and waist circumference of college students. College students (n=1018) from 13 institutions completed an online survey assessing eating behaviors (e.g., routine and compensatory restraint, emotional eating, and fruit/vegetable intake), stress level, and physical activity level. BMI and waist circumference were measured by trained researchers. A cognitive load score was derived from stress level, time pressure/income needs, race and nationality. High cognitive load participants (n=425) were significantly (P<0.05) more likely to be female, older, and further along in school than those with low cognitive loads (n=593). Compared to low cognitive load participants, high cognitive load participants were significantly more likely to eat <5 cups of fruits/vegetables/day, have greater routine and compensatory restraint, and greater susceptibility to eating in response to external cues and emotional eating. Both males and females with high cognitive load scores had a non-significant trend toward higher BMIs, waist circumferences, and drinking more alcohol than low cognitive load counterparts. In conclusion, cognitive load may be an important contributor to health behaviors. Understanding how cognitive load may affect eating and other weight-related behaviors could potentially lead to improvements in the effectiveness of obesity prevention and intervention programs.

  16. Update on managing generalized anxiety disorder in older adults.

    PubMed

    Clifford, Kalin M; Duncan, Nakia A; Heinrich, Krista; Shaw, Jennifer

    2015-04-01

    With the recent updates to the Diagnostic and Statistical Manual of Mental Disorders (5th edition; DSM-5), there are many questions on how to care for older adults with generalized anxiety disorder (GAD) and other psychiatric conditions. The current article reviews the new changes to the DSM-5 for diagnosis of GAD, discusses new anxiety assessment scales that are validated in older adults, evaluates pharmacological agents that have been studied in older adults for GAD treatment, and provides monitoring recommendations to help those who provide care to older adults experiencing GAD.

  17. Culturally Responsive Pain Management for Black Older Adults.

    PubMed

    Robinson-Lane, Sheria G; Booker, Staja Q

    2017-03-02

    pain for Black older adults has received inadequate attention by health care professionals despite evidence of greater pain intensity, depressive symptoms, and functional disability compared with White American older adults. Pain management for this population may be significantly improved with more careful attention to the provision of culturally responsive care. As professionals concerned with the optimization of health and reduction of suffering throughout the lifespan, nurses have an ethical, moral, and professional responsibility to provide culturally responsive care to the populations they serve-particularly when clear disparities in health exist. By considering how culture affects important health beliefs, values, preferences, and customs, and integrating this understanding into practice, quality of life is likely to be improved. [Journal of Gerontological Nursing, xx(x), xx-xx.].

  18. Osteoporosis in young adults: pathophysiology, diagnosis, and management.

    PubMed

    Ferrari, S; Bianchi, M L; Eisman, J A; Foldes, A J; Adami, S; Wahl, D A; Stepan, J J; de Vernejoul, M-C; Kaufman, J-M

    2012-12-01

    Postmenopausal osteoporosis is mainly caused by increased bone remodeling resulting from estrogen deficiency. Indications for treatment are based on low areal bone mineral density (aBMD, T-score  ≤ -2.5), typical fragility fractures (spine or hip), and more recently, an elevated 10-year fracture probability (by FRAX®). In contrast, there is no clear definition of osteoporosis nor intervention thresholds in younger individuals. Low aBMD in a young adult may reflect a physiologically low peak bone mass, such as in lean but otherwise healthy persons, whereas fractures commonly occur with high-impact trauma, i.e., without bone fragility. Furthermore, low aBMD associated with vitamin D deficiency may be highly prevalent in some regions of the world. Nevertheless, true osteoporosis in the young can occur, which we define as a T-score below -2.5 at spine or hip in association with a chronic disease known to affect bone metabolism. In the absence of secondary causes, the presence of fragility fractures, such as in vertebrae, may point towards genetic or idiopathic osteoporosis. In turn, treatment of the underlying condition may improve bone mass as well. In rare cases, a bone-specific treatment may be indicated, although evidence is scarce for a true benefit on fracture risk. The International Osteoporosis Foundation (IOF) convened a working group to review pathophysiology, diagnosis, and management of osteoporosis in the young, excluding children and adolescents, and provide a screening strategy including laboratory exams for a systematic approach of this condition.

  19. Burkitt lymphoma in adolescents and young adults: management challenges

    PubMed Central

    Dozzo, Massimo; Carobolante, Francesca; Donisi, Pietro Maria; Scattolin, Annamaria; Maino, Elena; Sancetta, Rosaria; Viero, Piera; Bassan, Renato

    2017-01-01

    About one-half of all Burkitt lymphoma (BL) patients are younger than 40 years, and one-third belong to the adolescent and young adult (AYA) subset, defined by an age between 15 and 25–40 years, based on selection criteria used in different reports. BL is an aggressive B-cell neoplasm displaying highly characteristic clinico-diagnostic features, the biologic hallmark of which is a translocation involving immunoglobulin and c-MYC genes. It presents as sporadic, endemic, or epidemic disease. Endemicity is pathogenetically linked to an imbalance of the immune system which occurs in African children infected by malaria parasites and Epstein–Barr virus, while the epidemic form strictly follows the pattern of infection by HIV. BL shows propensity to extranodal involvement of abdominal organs, bone marrow, and central nervous system, and can cause severe metabolic and renal impairment. Nevertheless, BL is highly responsive to specifically designed short-intensive, rotational multiagent chemotherapy programs, empowered by the anti-CD20 monoclonal antibody rituximab. When carefully applied with appropriate supportive measures, these modern programs achieve a cure rate of approximately 90% in the average AYA patient, irrespective of clinical stage, which is the best result achievable in any aggressive lymphoid malignancy to date. The challenges ahead concern the following: optimization of management in underdeveloped countries, with reduction of diagnostic and referral-for-care intervals, and the applicability of currently curative regimens; the development of lower intensity but equally effective treatments for frail or immunocompromised patients at risk of death by complications; the identification of very high-risk patients through positron-emission tomography and minimal residual disease assays; and the assessment in these and the few refractory/relapsed ones of new monoclonals (ofatumumab, blinatumomab, inotuzumab ozogamicin) and new molecules targeting c-MYC and

  20. Management of hyperosmolar hyperglycaemic state in adults with diabetes.

    PubMed

    Scott, A R

    2015-06-01

    Hyperglycaemic hyperosmolar state (HHS) is a medical emergency, which differs from diabetic ketoacidosis (DKA) and requires a different approach. The present article summarizes the recent guidance on HHS that has been produced by the Joint British Diabetes Societies for Inpatient Care, available in full at http://www.diabetologists-abcd.org.uk/JBDS/JBDS_IP_HHS_Adults.pdf. HHS has a higher mortality rate than DKA and may be complicated by myocardial infarction, stroke, seizures, cerebral oedema and central pontine myelinolysis and there is some evidence that rapid changes in osmolality during treatment may be the precipitant of central pontine myelinolysis. Whilst DKA presents within hours of onset, HHS comes on over many days, and the dehydration and metabolic disturbances are more extreme. The key points in these HHS guidelines include: (1) monitoring of the response to treatment: (i) measure or calculate the serum osmolality regularly to monitor the response to treatment and (ii) aim to reduce osmolality by 3-8 mOsm/kg/h; (2) fluid and insulin administration: (i) use i.v. 0.9% sodium chloride solution as the principal fluid to restore circulating volume and reverse dehydration, (ii) fluid replacement alone will cause a fall in blood glucose (BG) level, (iii) withhold insulin until the BG level is no longer falling with i.v. fluids alone (unless ketonaemic), (iv) an initial rise in sodium level is expected and is not itself an indication for hypotonic fluids and (v) early use of insulin (before fluids) may be detrimental; and (3) delivery of care: (i) The diabetes specialist team should be involved as soon as possible and (ii) patients should be nursed in areas where staff are experienced in the management of HHS.

  1. Weight Outcomes of Latino Adults and Children Participating in the Y Living Program, a Family-Focused Lifestyle Intervention, San Antonio, 2012–2013

    PubMed Central

    Liang, Yuanyuan; Yin, Zenong; Esparza, Laura; Lopez, Louis

    2015-01-01

    Introduction US Latinos have disproportionately higher rates of obesity and physical inactivity than the general US population, putting them at greater risk for chronic disease. This evaluation aimed to examine the impact of the Y Living Program (Y Living), a 12-week family-focused healthy lifestyle program, on the weight status of adult and child (aged ≥7 years) participants. Methods In this pretest–posttest evaluation, participants attended twice-weekly group education sessions and engaged in physical activity at least 3 times per week. Primary outcome measures were body mass index ([BMI], zBMI and BMI percentile for children), weight, waist circumference, and percentage body fat. Wilcoxon signed-rank tests and mixed effects models were used to evaluate pretest–posttest differences (ie, absolute change and relative change) for adults and children separately. Results BMI, weight, waist circumference, and percentage body fat improved significantly (both absolutely and relatively) among adults who completed the program (n = 180; all P ≤ .001). Conversely, child participants that completed the program (n = 72) showed no improvements. Intervention effects varied across subgroups. Among adults, women and participants who were obese at baseline had larger improvements than did children who were obese at baseline or who were in families that had an annual household income of $15,000 or more. Conclusion Significant improvements in weight were observed among adult participants but not children. This family-focused intervention has potential to prevent excess weight gain among high-risk Latino families. PMID:26652219

  2. Prematurity, Birth Weight, and Socioeconomic Status Are Linked to Atypical Diurnal Hypothalamic-Pituitary-Adrenal Axis Activity in Young Adults.

    PubMed

    Winchester, Suzy Barcelos; Sullivan, Mary C; Roberts, Mary B; Granger, Douglas A

    2016-02-01

    In a prospective, case-controlled longitudinal design, 180 preterm and fullterm infants who had been enrolled at birth participated in a comprehensive assessment battery at age 23. Of these, 149 young adults, 34 formerly full-term and 115 formerly preterm (22 healthy preterm, 48 with medical complications, 21 with neurological complications, and 24 small for gestational age) donated five saliva samples from a single day that were assayed for cortisol to assess diurnal variation of the hypothalamic-pituitary-adrenal (HPA) axis. Analyses were conducted to determine whether prematurity category, birth weight, and socioeconomic status were associated with differences in HPA axis function. Pre- and perinatal circumstances associated with prematurity influenced the activity of this environmentally sensitive physiological system. Results are consistent with the theory of Developmental Origins of Health and Disease and highlight a possible mechanism for the link between prematurity and health disparities later in life.

  3. Nonpharmacological pain management by ethnically diverse older adults with chronic pain: barriers and facilitators.

    PubMed

    Park, Juyoung; Hirz, Christina E; Manotas, Karen; Hooyman, Nancy

    2013-01-01

    As key players in multidisciplinary health care systems, geriatric social workers must understand the dynamics of pain management among older adults with chronic pain. This study identified perceived barriers to, and facilitators for, utilizing nonpharmacological pain management through face-to-face interviews with 44 ethnically diverse community-dwelling older adults. Constant comparative analysis identified barriers not recognized in prior studies: (a) embarrassment/self-consciousness, (b) unavailability of certain treatments, and (c) lack of faith in effectiveness of nonpharmacological treatments. Most frequently reported facilitators were (a) social support, (b) positive attitude, and (c) available resources. Social workers can provide counseling to motivate older adults to exercise to manage chronic pain and refer them to exercise programs tailored for older adults. To resolve the most frequently reported barrier-transportation-social workers can link older adults with transportation services offered by senior centers or other nonprofit agencies.

  4. Hemadsorption with Adult CytoSorb® in a Low Weight Pediatric Case

    PubMed Central

    Barascu, Ileana; Mc Kenzie Stancu, Samantha

    2017-01-01

    Cytokine adsorber (CytoSorb) has been used successfully as adjunctive treatment for adult patients with elevated cytokine levels in the setting with severe sepsis and septic shock and to reduce blood myoglobin, unconjugated bilirubin, and conjugated bilirubin. In this article we present the case of a nine-month-old male infant who was admitted to the NICU due to sepsis after cardiac surgery, Fallot tetralogy, and multisystem organ failure (MSOF) including liver failure and renal failure which was successfully treated by a combination of continuous hemodiafiltration (HDF) and hemadsorption with CytoSorb. HDF was safe and effective from the first day for urea removal, but the patient's bilirubin levels kept increasing gradually, culminating on the 9th day with a maximum value of 54 mg/dL of total bilirubin and 31.67 mg/dL of direct bilirubin when we performed hemadsorption with CytoSorb. Over the 49-hour period of hemadsorption, the total bilirubin value decreased from 54 to 14 mg/dL, and the patient's general status improved considerably accompanied by a rapid drop of aminotransferases. Hemodynamic status has been improved as well and inotropes dropped rapidly. The patient's ventilation settings improved during CytoSorb treatment permitting weaning the patient from mechanical ventilation after five days of hemadsorption. The patient was discharged home after 34 days of hospitalization, in a good general status. PMID:28127473

  5. Association of sports drinks with weight gain among adolescents and young adults

    PubMed Central

    Field, Alison E.; Sonneville, Kendrin R.; Falbe, Jennifer; Flint, Alan; Haines, Jess; Rosner, Bernard; Camargo, Carlos A.

    2014-01-01

    Objective Sales of regular soda are declining, but sales of other sweetened beverages, such as sports drinks, are increasing. Our objective was to determine the prospective associations between sports drinks and body mass index (BMI) gains among adolescents and young adults. Design and Methods We prospectively followed 4,121 females and 3,438 males in the Growing Up Today Study II, aged 9–16 in 2004, from across the United States. Data was collected by questionnaire in 2004, 2006, 2008, and 2011. Servings per day of various beverages were assessed with a food frequency questionnaire. Results Among the girls, each serving per day of sports drink predicted an increase of 0.3 BMI units (95% confidence interval (CI) CI 0.03–0.54) more than their peers over the next 2–3 years. Among the males, each serving of sports drinks predicted a 0.33 BMI (95% CI 0.09, 0.66) increase. In addition, boys who increased their intake over the 2–3 year interval gained significantly more than their peers during the same time interval. Conclusions Intake of sports drinks predicted larger increases in BMI among both females and males. Our results suggest that school policies focused on obesity prevention should be augmented to restrict sports drinks. PMID:25044989

  6. Weight loss intervention for young adults using mobile technology: design and rationale of a randomized controlled trial – Cell phone Intervention for You (CITY)

    PubMed Central

    Batch, Bryan C.; Tyson, Crystal; Bagwell, Jacqueline; Corsino, Leonor; Intille, Stephen; Lin, Pao-Hwa; Lazenka, Tony; Bennett, Gary; Bosworth, Hayden B.; Voils, Corrine; Grambow, Steven; Sutton, Aziza; Bordogna, Rachel; Pangborn, Matthew; Schwager, Jenifer; Pilewski, Kate; Caccia, Carla; Burroughs, Jasmine; Svetkey, Laura P.

    2014-01-01

    Background The obesity epidemic has spread to young adults, leading to significant public health implications later in adulthood. Intervention in early adulthood may be an effective public health strategy for reducing the long-term health impact of the epidemic. Few weight loss trials have been conducted in young adults. It is unclear what weight loss strategies are beneficial in this population. Purpose To describe the design and rationale of the NHLBI-sponsored Cell Phone Intervention for You (CITY) study, which is a single center, randomized three-arm trial that compares the impact on weight loss of 1) a behavioral intervention that is delivered almost entirely via cell phone technology (Cell Phone group); and 2) a behavioral intervention delivered mainly through monthly personal coaching calls enhanced by self-monitoring via cell phone (Personal Coaching group), each compared to; 3) a usual care, advice-only control condition. Methods A total of 365 community-dwelling overweight/obese adults aged 18–35 years were randomized to receive one of these three interventions for 24 months in parallel group design. Study personnel assessing outcomes were blinded to group assignment. The primary outcome is weight change at 12 months. We hypothesize that each active intervention will cause more weight loss than the usual care condition. Study completion is anticipated in 2014. Conclusions If effective, implementation of the CITY interventions could mitigate the alarming rates of obesity in young adults through promotion of weight loss. PMID:24462568

  7. Associations between eating frequency and energy intake, energy density, diet quality and body weight status in adults from the USA.

    PubMed

    Zhu, Yong; Hollis, James H

    2016-06-01

    To investigate associations between eating frequency and energy intake, energy density, diet quality and body weight status in adults from the USA, combined data from the 2009-2010 and 2011-2012 National Health and Nutrition Examination Survey (NHANES) were used in this study. The first 24-h dietary recall data from eligible participants (4017 men and 3774 women) were used to calculate eating frequency, as well as energy intake, energy density and the Healthy Eating Index 2010 (HEI-2010), as a measure of diet quality. BMI and waist circumference were obtained from the NHANES body measures data. Adjusting for confounding socio-demographic characteristics and lifestyle factors, a higher eating frequency was significantly associated with higher energy intake in both men and women (both P<0·001). A higher eating frequency was also significantly associated with lower energy density in both men and women, regardless of whether beverage or water intake was included in the calculation of energy density (all P<0·01). Moreover, there was a significant positive association between eating frequency and the HEI-2010 total score in both men and women (both P<0·001). Eating frequency was inversely associated with BMI in women (P=0·003), as well as waist circumference in both men (P=0·032) and women (P=0·010). Results from the present study suggested that adults with a higher eating frequency in the USA had a healthier diet with lower energy density and better diet quality, and eating frequency was inversely associated with body weight status.

  8. Successful recruitment and retention strategies for a randomized weight management trial for people with diabetes living in rural, medically underserved counties of South Carolina: the POWER study.

    PubMed

    Parra-Medina, Deborah; D'antonio, Angela; Smith, Sharon M; Levin, Sarah; Kirkner, Gregory; Mayer-Davis, Elizabeth

    2004-01-01

    We evaluated the feasibility of recruiting overweight adults with diabetes, living in rural, medically underserved communities, to a weight management intervention consisting of a 12-month clinical trial of two weight management programs and usual care. The sampling frame consisted of adults ages 45 years and older with clinically diagnosed diabetes from two community health centers. The recruitment process included medical record review, prescreening telephone call, two screening visits, and a randomization visit. Over 1,400 medical records were reviewed; 78.6% met eligibility criteria; 60.1% were contacted for telephone prescreening, and 35.5% remained eligible and were interested in participating. Of these, 187 completed visit 1, 164 completed visit 2, and 143 were randomized. Forty-six people were randomized who entered the study as walk-ins at screening visit 1, resulting in 189 subjects. The final yield was 21.5%. Subject mean age was 60.4 years, mean body mass index was 36.4 kg/m(2), 80% were African-American, and 46.6% had less than a high school education. Retention at 12 months was 81.5%. Successful strategies included partnering with community health centers, positive reinforcement and social supportiveness, monitoring progress, and free transportation. This work provides a useful example of an academic-community partnership designed to reach groups previously considered hard to reach.

  9. Learning to Lose: Weight Loss Classes and Personal Transformation

    ERIC Educational Resources Information Center

    Jarvis, Christine

    2012-01-01

    Adult learning takes place not only in educational organisations, but through participation in leisure and special interest groups. Commercially operated weight management organisations recruit large numbers of adults to their classes to learn how to eat healthily and lose weight. They publish readers' "real life" success stories in their…

  10. The effect of breed slaughter weight and nutritional management on cholesterol content of lamb carcasses.

    PubMed

    Arsenos; Zygoyjannis; Kufidis; Katsaounis; Stamataris

    2000-06-01

    This study was carried out to assess the effect of breed, sex, post-weaning nutrition, live weight at slaughter and their interactions on the cholesterol content in carcass fat of lambs. The carcasses were obtained from lambs of three indigenous Greek dairy breeds of sheep, the Boutsko (B), Serres (S) and Karagouniko (K) breed. After weaning (at approximately 42 days), the lambs of the three breeds had been reared under different conditions of housing and nutritional management in three consecutive experiments between 1992 and 1994. In experiment 1, lambs (males and females) were individually penned and fed ad libitum on a concentrate ration (11.3MJ Metabolizable Energy (ME)/kg DM and 192g crude protein (CP)/kg DM) together with 100g per day of Lucerne hay (8.3MJ ME/kg DM and 182g CP/kg DM). In experiment 2, lambs (males only) were also individually penned but were fed on three different levels of concentrate and ad libitum on Lucerne hay. In experiment 3, lambs (males only) were initially group fed indoors for 63 days on three different levels of concentrate together with ad libitum Lucerne hay, and thereafter the lambs finished on irrigated, sown pasture (Lolium perrene+Trifolium repens). Lambs were assigned to be slaughtered at one of five standard proportions of estimated mature weight for each breed in experiment 1; at three fixed live weights, common for all breeds in experiment 2 and at two fixed proportions of breed mature weight in experiment 3. The right-hand side of the lamb carcasses was minced and 150 lamb carcasses were selected out of a total of 300 minced carcasses. The concentration of total cholesterol content in carcass fat was determined by HPLC in samples of these 150 lamb carcasses. Mean cholesterol content of carcass fat in the three breeds, B, S and K, extracted from the whole ground carcasses samples, was 3.33, 4.41, 3.34mg/g of carcass fat (s.e.d. 0.18), respectively in experiment 1, whereas this content was 3.42, 4.50, 3.59mg/g of carcass

  11. Morning and Evening Blue-Enriched Light Exposure Alters Metabolic Function in Normal Weight Adults

    PubMed Central

    Cheung, Ivy N.; Zee, Phyllis C.; Shalman, Dov; Malkani, Roneil G.; Kang, Joseph; Reid, Kathryn J.

    2016-01-01

    Increasing evidence points to associations between light-dark exposure patterns, feeding behavior, and metabolism. This study aimed to determine the acute effects of 3 hours of morning versus evening blue-enriched light exposure compared to dim light on hunger, metabolic function, and physiological arousal. Nineteen healthy adults completed this 4-day inpatient protocol under dim light conditions (<20lux). Participants were randomized to 3 hours of blue-enriched light exposure on Day 3 starting either 0.5 hours after wake (n = 9; morning group) or 10.5 hours after wake (n = 10; evening group). All participants remained in dim light on Day 2 to serve as their baseline. Subjective hunger and sleepiness scales were collected hourly. Blood was sampled at 30-minute intervals for 4 hours in association with the light exposure period for glucose, insulin, cortisol, leptin, and ghrelin. Homeostatic model assessment of insulin resistance (HOMA-IR) and area under the curve (AUC) for insulin, glucose, HOMA-IR and cortisol were calculated. Comparisons relative to baseline were done using t-tests and repeated measures ANOVAs. In both the morning and evening groups, insulin total area, HOMA-IR, and HOMA-IR AUC were increased and subjective sleepiness was reduced with blue-enriched light compared to dim light. The evening group, but not the morning group, had significantly higher glucose peak value during blue-enriched light exposure compared to dim light. There were no other significant differences between the morning or the evening groups in response to blue-enriched light exposure. Blue-enriched light exposure acutely alters glucose metabolism and sleepiness, however the mechanisms behind this relationship and its impacts on hunger and appetite regulation remain unclear. These results provide further support for a role of environmental light exposure in the regulation of metabolism. PMID:27191727

  12. Morning and Evening Blue-Enriched Light Exposure Alters Metabolic Function in Normal Weight Adults.

    PubMed

    Cheung, Ivy N; Zee, Phyllis C; Shalman, Dov; Malkani, Roneil G; Kang, Joseph; Reid, Kathryn J

    2016-01-01

    Increasing evidence points to associations between light-dark exposure patterns, feeding behavior, and metabolism. This study aimed to determine the acute effects of 3 hours of morning versus evening blue-enriched light exposure compared to dim light on hunger, metabolic function, and physiological arousal. Nineteen healthy adults completed this 4-day inpatient protocol under dim light conditions (<20lux). Participants were randomized to 3 hours of blue-enriched light exposure on Day 3 starting either 0.5 hours after wake (n = 9; morning group) or 10.5 hours after wake (n = 10; evening group). All participants remained in dim light on Day 2 to serve as their baseline. Subjective hunger and sleepiness scales were collected hourly. Blood was sampled at 30-minute intervals for 4 hours in association with the light exposure period for glucose, insulin, cortisol, leptin, and ghrelin. Homeostatic model assessment of insulin resistance (HOMA-IR) and area under the curve (AUC) for insulin, glucose, HOMA-IR and cortisol were calculated. Comparisons relative to baseline were done using t-tests and repeated measures ANOVAs. In both the morning and evening groups, insulin total area, HOMA-IR, and HOMA-IR AUC were increased and subjective sleepiness was reduced with blue-enriched light compared to dim light. The evening group, but not the morning group, had significantly higher glucose peak value during blue-enriched light exposure compared to dim light. There were no other significant differences between the morning or the evening groups in response to blue-enriched light exposure. Blue-enriched light exposure acutely alters glucose metabolism and sleepiness, however the mechanisms behind this relationship and its impacts on hunger and appetite regulation remain unclear. These results provide further support for a role of environmental light exposure in the regulation of metabolism.

  13. Making a Difference: Leading and Managing for Quality Improvement in Adult and Community Learning.

    ERIC Educational Resources Information Center

    Ravenhall, Mark; Kenway, Mike

    This guide looks at demands on leaders and managers in adult and community learning (ACL) in the roles and issues they face in the context of quality improvement (QI). It suggests practical approaches for improving the quality of provision for adults. The guide's design builds on current practice toward the desired state of excellence in all…

  14. The effects of mindfulness training on weight-loss and health-related behaviours in adults with overweight and obesity: A systematic review and meta-analysis.

    PubMed

    Ruffault, Alexis; Czernichow, Sébastien; Hagger, Martin S; Ferrand, Margot; Erichot, Nelly; Carette, Claire; Boujut, Emilie; Flahault, Cécile

    2016-09-19

    The aim of this study was to conduct a comprehensive quantitative synthesis of the effects of mindfulness training interventions on weight-loss and health behaviours in adults with overweight and obesity using meta-analytic techniques. Studies included in the analysis (k=12) were randomised controlled trials investigating the effects of any form of mindfulness training on weight loss, impulsive eating, binge eating, or physical activity participation in adults with overweight and obesity. Random effects meta-analysis revealed that mindfulness training had no significant effect on weight loss, but an overall negative effect on impulsive eating (d=-1.13) and binge eating (d=-.90), and a positive effect on physical activity levels (d=.42). Meta-regression analysis showed that methodological features of included studies accounted for 100% of statistical heterogeneity of the effects of mindfulness training on weight loss (R(2)=1,00). Among methodological features, the only significant predictor of weight loss was follow-up distance from post-intervention (β=1.18; p<.05), suggesting that the longer follow-up distances were associated with greater weight loss. Results suggest that mindfulness training has short-term benefits on health-related behaviours. Future studies should explore the effectiveness of mindfulness training on long-term post-intervention weight loss in adults with overweight and obesity.

  15. Adult-child differences in acoustic cue weighting are influenced by segmental context: Children are not always perceptually biased toward transitions

    NASA Astrophysics Data System (ADS)

    Mayo, Catherine; Turk, Alice

    2004-06-01

    It has been proposed that young children may have a perceptual preference for transitional cues [Nittrouer, S. (2002). J. Acoust. Soc. Am. 112, 711-719]. According to this proposal, this preference can manifest itself either as heavier weighting of transitional cues by children than by adults, or as heavier weighting of transitional cues than of other, more static, cues by children. This study tested this hypothesis by examining adults' and children's cue weighting for the contrasts /ess,aye,smcapi/-/sh,aye,smcapi/, /de/-/be/, /ta/-/da/, and /ti/-/di/. Children were found to weight transitions more heavily than did adults for the fricative contrast /ess,aye,smcapi/-/sh,aye,smcapi/, and were found to weight transitional cues more heavily than nontransitional cues for the voice-onset-time contrast /ta/-/da/. However, these two patterns of cue weighting were not found to hold for the contrasts /de/-/be/ and /ti/-/di/. Consistent with several studies in the literature, results suggest that children do not always show a bias towards vowel-formant transitions, but that cue weighting can differ according to segmental context, and possibly the physical distinctiveness of available acoustic cues.

  16. Your Child's Weight

    MedlinePlus

    ... Parents MORE ON THIS TOPIC Weight Loss Surgery (Bariatric Surgery) Overweight and Obesity Weight and Diabetes Growth Charts ... Losing Weight: Brandon's Story (Video) Managing Your Weight Weight Loss Surgery When Being Overweight Is a Health Problem Who ...

  17. Diurnal Cortisol Patterns and Dexamethasone Suppression Test Responses in Healthy Young Adults Born Preterm at Very Low Birth Weight

    PubMed Central

    Pyhälä, Riikka; Pesonen, Anu-Katriina; Räikkönen, Katri; Järvenpää, Anna-Liisa; Andersson, Sture; Eriksson, Johan G.; Hovi, Petteri; Kajantie, Eero

    2016-01-01

    Background Early life stress, such as painful and stressful procedures during neonatal intensive care after preterm birth, can permanently affect physiological, hormonal and neurobiological systems. This may contribute to altered programming of the hypothalamic-pituitary-adrenal axis (HPAA) and provoke changes in HPAA function with long-term health impacts. Previous studies suggest a lower HPAA response to stress in young adults born preterm compared with controls born at term. We assessed whether these differences in HPAA stress responsiveness are reflected in everyday life HPAA functioning, i.e. in diurnal salivary cortisol patterns, and reactivity to a low-dose dexamethasone suppression test (DST), in unimpaired young adults born preterm at very low birth weight (VLBW; <1500 g). Methods The participants were recruited from the Helsinki Study of Very Low Birth Weight Adults cohort study. At mean age 23.3 years (2.1 SD), 49 VLBW and 36 controls born at term participated in the study. For cortisol analyzes, saliva samples were collected on two consecutive days at 0, 15, 30 and 60 min after wake-up, at 12:00 h, 17:00 h and 22:00 h. After the last salivary sample of the first study day the participants were instructed to take a 0.5 mg dexamethasone tablet. Results With mixed-effects model no difference was seen in overall diurnal salivary cortisol between VLBW and control groups [13.9% (95% CI: -11.6, 47.0), P = 0.31]. Salivary cortisol increased similarly after awakening in both VLBW and control participants [mean difference -2.9% (29.2, 33.0), P = 0.85]. Also reactivity to the low-dose DST (awakening cortisol ratio day2/day1) was similar between VLBW and control groups [-1.1% (-53.5, 103.8), P = 0.97)]. Conclusions Diurnal cortisol patterns and reactivity to a low-dose DST in young adulthood were not associated with preterm birth. PMID:27618620

  18. Expected Satiety: Application to Weight Management and Understanding Energy Selection in Humans.

    PubMed

    Forde, Ciarán G; Almiron-Roig, Eva; Brunstrom, Jeffrey M

    2015-03-01

    Recent advances in the approaches used to quantify expectations of satiation and satiety have led to a better understanding of how humans select and consume food, and the associated links to energy intake regulation. When compared calorie for calorie some foods are expected to deliver several times more satiety than others, and multiple studies have demonstrated that people are able to discriminate between similar foods reliably and with considerable sensitivity. These findings have implications for the control of meal size and the design of foods that can be used to lower the energy density of diets. These methods and findings are discussed in terms of their implications for weight management. The current paper also highlights why expected satiety may also play an important role beyond energy selection, in moderating appetite sensations after a meal has been consumed, through memory for recent eating and the selection of foods across future meals.

  19. Expected Satiety: Application to Weight Management and Understanding Energy Selection in Humans

    PubMed Central

    Forde, Ciarán G.; Almiron-Roig, Eva; Brunstrom, Jeffrey M.

    2016-01-01

    Recent advances in the approaches used to quantify expectations of satiation and satiety have led to a better understanding of how humans select and consume food, and the associated links to energy intake regulation. When compared calorie for calorie some foods are expected to deliver several times more satiety than others, and multiple studies have demonstrated that people are able to discriminate between similar foods reliably and with considerable sensitivity. These findings have implications for the control of meal size and the design of foods that can be used to lower the energy density of diets. These methods and findings are discussed in terms of their implications for weight management. The current paper also highlights why expected satiety may also play an important role beyond energy selection, in moderating appetite sensations after a meal has been consumed, through memory for recent eating and the selection of foods across future meals. PMID:26627096

  20. Birth weight, intrauterine growth restriction and nutritional status in childhood in relation to grip strength in adults: from the 1982 Pelotas (Brazil) birth cohort

    PubMed Central

    Bielemann, Renata Moraes; Gigante, Denise Petrucci; Horta, Bernardo Lessa

    2016-01-01

    Objective The aim of this study was to evaluate the association among birth weight, intrauterine growth, and nutritional status in childhood with grip strength in young adults from the 1982 Pelotas (Brazil) birth cohort. Methods In 1982, the hospital live births of Pelotas were followed. In 2012, grip strength was evaluated using a hand dynamometer and the best of the six measurements was used. Birth weight was analyzed as z-score for gestational age according to Williams (1982) curve. Weight-for-age, weight-for-length/height, and length/height-for-age at 2 and 4 y were analyzed in z-scores according to 2006 World Health Organization Child Growth Standards. Lean mass at 30 y was included as possible mediator using the g-computation formula. Results In 2012, 3701 (68.1%) individuals were interviewed and 3470 were included in the present analyses. An increase of 1 z-score in birth weight was associated with an increase of 1.5 kg in grip strength in males (95% confidence interval, 1.1–1.9). Positive effect of birth weight on grip strength was found in females. Grip strength was greater in individuals who were born with appropriate size for gestational age and positively associated with weight- and length/height-for-age z-score at 2 and 4 y of age. A positive association between birth weight and grip strength was only partially mediated by adult lean mass (50% and 33% of total effect in males and females), whereas direct effect of weight at 2 y was found only in males. Conclusions It is suggested that good nutrition in prenatal and early postnatal life has a positive influence on adult muscle strength. The results from birth weight were suggestive of fetal programming on grip strength measurement. PMID:26678603

  1. A study of abrupt phentermine cessation in patients in a weight management program.

    PubMed

    Hendricks, Ed J; Greenway, Frank L

    2011-07-01

    Phentermine is the most widely used antiobesity drug in the United States. Although no evidence of phentermine addiction has been published, fear that phentermine has addiction potential has contributed to curtailment of its worldwide use in clinical practice. The aim of this study was to evaluate the abuse and addiction potential of long-term phentermine pharmacotherapy in patients in a weight management program. Thirty-five patients in a weight management program who abruptly stopped taking prescribed phentermine on their own initiative were examined using the 18-item Kampman Cocaine Selective Severity Assessment scale modified for phentermine. The Kampman Cocaine Selective Severity Assessment scale has also been modified by McGregor for amphetamines to assess withdrawal from amphetamine in amphetamine-addicted subjects. For comparison, 35 new patients were examined with the same scale before any treatment was initiated. Data from the treated and untreated groups were compared by t test with each other and with published data from amphetamine-addicted subjects. There were no significant differences in individual items or total scores between the patients who stopped phentermine abruptly and the patients who had never taken phentermine. There was a striking and significant difference in individual and total scores between the phentermine-treated subjects and the amphetamine-dependent subjects. Cravings for the substance abused, the hallmark characteristic of substance dependence and withdrawal, were entirely absent in the phentermine-treated subjects. Abrupt cessation of long-term phentermine therapy does not induce amphetamine-like withdrawal. Long-term phentermine therapy does not induce phentermine cravings. Symptoms observed after abrupt phentermine cessation represent loss of therapeutic effect and are not withdrawal.

  2. Understanding and managing cancer-related weight loss and anorexia: insights from a systematic review of qualitative research

    PubMed Central

    Cooper, Christine; Burden, Sorrel T; Cheng, Huilin; Molassiotis, Alex

    2015-01-01

    The aim of this study was to summarize the existing qualitative literature in order to develop the evidence base for understanding and managing weight loss and anorexia, in order to make recommendations for clinical practice. A systematic search was performed to retrieve English language studies using electronic search and manual checks of selected reference lists. Keywords included qualitative, cancer cachexia, weight loss, anorexia, appetite, malnutrition, food, eating, and drinking. The selection and appraisal of papers were undertaken by two reviewers. Twenty-one qualitative articles were included in the review. There were three major findings emerging from the previous qualitative studies including ‘the multidimensionality of weight loss and anorexia experience’, ‘patients and caregivers' responses to coping with weight loss and anorexia’, and ‘clinical assessment and management of weight loss and anorexia’. The literature review revealed the multidimensional nature of cachexia and weight loss experience by patients and caregivers, which was not recognized and adequately managed by healthcare professionals. Future research in this area would be helpful in enabling a deeper understanding of the complexity of cachexia and weight loss experience in order to move forward to develop an optimal model of supportive care for patients and caregivers. PMID:26136417

  3. Optimizing Management of Patients with Adult T Cell Leukemia-Lymphoma

    PubMed Central

    Yared, Jean A.; Kimball, Amy S.

    2015-01-01

    Adult T cell leukemia-lymphoma is a rare disease with a high mortality rate, and is challenging for the clinician. Early allogeneic stem cell transplant can confer durable remission. As novel therapeutic agents become available to treat T cell malignancies, it is increasingly important that medical oncologists, hematologists, and hematopathologists recognize and accurately diagnose adult T cell leukemia-lymphoma. There is no uniform standard of treatment of adult T cell leukemia-lymphoma, and clinical trials remain critical to improving outcomes. Here we present one management approach based on the recent advances in treatment for adult T cell leukemia-lymphoma patients. PMID:26610571

  4. Assistive Technology and Older Adults in Disasters: Implications for Emergency Management.

    PubMed

    McSweeney-Feld, Mary Helen

    2017-02-01

    This article identifies concepts, trends, and policy gaps in the availability and service delivery of assistive technology utilized by older adults in disasters, as well as implications for emergency management planning and shelter administration. Definitions of types of assistive technology, as well as views of older adults using technology as at-risk individuals for emergency management service provision, are provided. An overview of peer-reviewed articles and gray literature is conducted, focusing on publications from 2001 to the present in the United States. Analytical frameworks used by emergency management organizations as well as regulations such as the Americans with Disabilities Act and recent court decisions on emergency shelter accessibility in disasters are reviewed. Research on the use of assistive technology by older adults during disasters is a neglected issue. The current and potential benefits of defining standards for provision and use of assistive technology for older adults during disasters has received limited recognition in emergency management planning. Older adults with disabilities utilize assistive technology to maintain their independence and dignity, and communities as well as emergency services managers need to become more aware of the needs and preferences of these older adults in their planning processes and drills as well as in service delivery during actual events. (Disaster Med Public Health Preparedness. 2017;11:135-139).

  5. Virtual Simulation in Leadership Development Training: The Impact of Learning Styles and Conflict Management Tactics on Adult Learner Performance

    ERIC Educational Resources Information Center

    Putman, Paul G.

    2012-01-01

    Adult learners can develop leadership skills and competencies such as conflict management and negotiation skills. Virtual simulations are among the emerging new technologies available to adult educators and trainers to help adults develop various leadership competencies. This study explored the impact of conflict management tactics as well as…

  6. Lifestyle weight-loss intervention outcomes in overweight and obese adults with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials.

    PubMed

    Franz, Marion J; Boucher, Jackie L; Rutten-Ramos, Stephanie; VanWormer, Jeffrey J

    2015-09-01

    The majority of people with type 2 diabetes are overweight or obese, and weight loss is a recommended treatment strategy. A systematic review and meta-analysis was undertaken to answer the following primary question: In overweight or obese adults with type 2 diabetes, what are the outcomes on hemoglobin A1c (HbA1c) from lifestyle weight-loss interventions resulting in weight losses greater than or less than 5% at 12 months? Secondary questions are: What are the lipid (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides) and blood pressure (systolic and diastolic) outcomes from lifestyle weight-loss interventions resulting in weight losses greater than or less than 5% at 12 months? And, what are the weight and metabolic outcomes from differing amounts of macronutrients in weight-loss interventions? Inclusion criteria included randomized clinical trial implementing weight-loss interventions in overweight or obese adults with type 2 diabetes, minimum 12-month study duration, a 70% completion rate, and an HbA1c value reported at 12 months. Eleven trials (eight compared two weight-loss interventions and three compared a weight-loss intervention group with a usual care/control group) with 6,754 participants met study criteria. At 12 months, 17 study groups (8 categories of weight-loss intervention) reported weight loss <5% of initial weight (-3.2 kg [95% CI: -5.9, -0.6]). A meta-analysis of the weight-loss interventions reported nonsignificant beneficial effects on HbA1c, lipids, or blood pressure. Two study groups reported a weight loss of ≥5%: a Mediterranean-style diet implemented in newly diagnosed adults with type 2 diabetes and an intensive lifestyle intervention implemented in the Look AHEAD (Action for Health in Diabetes) trial. Both included regular physical activity and frequent contact with health professionals and reported significant beneficial effects on HbA1c, lipids, and blood pressure. Five

  7. Financial Success for Young Adults and Recent Graduates: Managing Money, Credit, and Your Future

    ERIC Educational Resources Information Center

    Arrowood, Janet C.

    2006-01-01

    There are numerous financial planning and money management handbooks, but few focus on the needs of young adults between 16 and 25 years of age. Colleges and some high schools are increasingly offering courses covering money management, but the materials are more "economics-focused" than "real-world" focused. Young people are huge consumers who…

  8. Constructing Proxy Variables to Measure Adult Learners' Time Management Strategies in LMS

    ERIC Educational Resources Information Center

    Jo, Il-Hyun; Kim, Dongho; Yoon, Meehyun

    2015-01-01

    This study describes the process of constructing proxy variables from recorded log data within a Learning Management System (LMS), which represents adult learners' time management strategies in an online course. Based on previous research, three variables of total login time, login frequency, and regularity of login interval were selected as…

  9. Sustainable Land Management and Adult Education: Issues for the Stakeholders of Australia's Tropical Savannas.

    ERIC Educational Resources Information Center

    Benson, Rebecca

    1998-01-01

    Sustainable land management is an important consideration for stakeholders in Australia's tropical savannas. Land-management-education providers must deal with issues of access and the impact of values and perceptions on behavior. Adult educators must take on the role of negotiating attitudes and beliefs among stakeholders. (SK)

  10. Chronic disease self-management: views among older adults of Chinese descent.

    PubMed

    Wang, Jing; Matthews, Judith Tabolt

    2010-01-01

    To understand how Chinese culture influences chronic disease self-management, we conducted focus groups with older adults of Chinese descent. Specifically, we explored their perceptions and self-management practices regarding treatment adherence, lifestyle decisions, and patient-provider communication within the context of their culture.

  11. Global integration of the hot-state brain network of appetite predicts short term weight loss in older adult

    PubMed Central

    Paolini, Brielle M.; Laurienti, Paul J.; Simpson, Sean L.; Burdette, Jonathan H.; Lyday, Robert G.; Rejeski, W. Jack

    2015-01-01

    Obesity is a public health crisis in North America. While lifestyle interventions for weight loss (WL) remain popular, the rate of success is highly variable. Clearly, self-regulation of eating behavior is a challenge and patterns of activity across the brain may be an important determinant of success. The current study prospectively examined whether integration across the Hot-State Brain Network of Appetite (HBN-A) predicts WL after 6-months of treatment in older adults. Our metric for network integration was global efficiency (GE). The present work is a sub-study (n = 56) of an ongoing randomized clinical trial involving WL. Imaging involved a baseline food-cue visualization functional MRI (fMRI) scan following an overnight fast. Using graph theory to build functional brain networks, we demonstrated that regions of the HBN-A (insula, anterior cingulate cortex (ACC), superior temporal pole (STP), amygdala and the parahippocampal gyrus) were highly integrated as evidenced by the results of a principal component analysis (PCA). After accounting for known correlates of WL (baseline weight, age, sex, and self-regulatory efficacy) and treatment condition, which together contributed 36.9% of the variance in WL, greater GE in the HBN-A was associated with an additional 19% of the variance. The ACC of the HBN-A was the primary driver of this effect, accounting for 14.5% of the variance in WL when entered in a stepwise regression following the covariates, p = 0.0001. The HBN-A is comprised of limbic regions important in the processing of emotions and visceral sensations and the ACC is key for translating such processing into behavioral consequences. The improved integration of these regions may enhance awareness of body and emotional states leading to more successful self-regulation and to greater WL. This is the first study among older adults to prospectively demonstrate that, following an overnight fast, GE of the HBN-A during a food visualization task is predictive of

  12. Global integration of the hot-state brain network of appetite predicts short term weight loss in older adult.

    PubMed

    Paolini, Brielle M; Laurienti, Paul J; Simpson, Sean L; Burdette, Jonathan H; Lyday, Robert G; Rejeski, W Jack

    2015-01-01

    Obesity is a public health crisis in North America. While lifestyle interventions for weight loss (WL) remain popular, the rate of success is highly variable. Clearly, self-regulation of eating behavior is a challenge and patterns of activity across the brain may be an important determinant of success. The current study prospectively examined whether integration across the Hot-State Brain Network of Appetite (HBN-A) predicts WL after 6-months of treatment in older adults. Our metric for network integration was global efficiency (GE). The present work is a sub-study (n = 56) of an ongoing randomized clinical trial involving WL. Imaging involved a baseline food-cue visualization functional MRI (fMRI) scan following an overnight fast. Using graph theory to build functional brain networks, we demonstrated that regions of the HBN-A (insula, anterior cingulate cortex (ACC), superior temporal pole (STP), amygdala and the parahippocampal gyrus) were highly integrated as evidenced by the results of a principal component analysis (PCA). After accounting for known correlates of WL (baseline weight, age, sex, and self-regulatory efficacy) and treatment condition, which together contributed 36.9% of the variance in WL, greater GE in the HBN-A was associated with an additional 19% of the variance. The ACC of the HBN-A was the primary driver of this effect, accounting for 14.5% of the variance in WL when entered in a stepwise regression following the covariates, p = 0.0001. The HBN-A is comprised of limbic regions important in the processing of emotions and visceral sensations and the ACC is key for translating such processing into behavioral consequences. The improved integration of these regions may enhance awareness of body and emotional states leading to more successful self-regulation and to greater WL. This is the first study among older adults to prospectively demonstrate that, following an overnight fast, GE of the HBN-A during a food visualization task is predictive of

  13. Backpack Weight and the Scaling of the Human Frame

    ERIC Educational Resources Information Center

    O'Shea, Michael

    2014-01-01

    Modeling real-life situations is an important part of introductory physics. Here we consider the question "What is the largest weight of backpack a hiker can manage?" A quick perusal of the Internet suggests that as the weight of a healthy adult increases, the largest backpack weight W[subscript bp] also increases and should be about…

  14. Living Well with Diabetes: a randomized controlled trial of a telephone-delivered intervention for maintenance of weight loss, physical activity and glycaemic control in adults with type 2 diabetes

    PubMed Central

    2010-01-01

    Background By 2025, it is estimated that approximately 1.8 million Australian adults (approximately 8.4% of the adult population) will have diabetes, with the majority having type 2 diabetes. Weight management via improved physical activity and diet is the cornerstone of type 2 diabetes management. However, the majority of weight loss trials in diabetes have evaluated short-term, intensive clinic-based interventions that, while producing short-term outcomes, have failed to address issues of maintenance and broad population reach. Telephone-delivered interventions have the potential to address these gaps. Methods/Design Using a two-arm randomised controlled design, this study will evaluate an 18-month, telephone-delivered, behavioural weight loss intervention focussing on physical activity, diet and behavioural therapy, versus usual care, with follow-up at 24 months. Three-hundred adult participants, aged 20-75 years, with type 2 diabetes, will be recruited from 10 general practices via electronic medical records search. The Social-Cognitive Theory driven intervention involves a six-month intensive phase (4 weekly calls and 11 fortnightly calls) and a 12-month maintenance phase (one call per month). Primary outcomes, assessed at 6, 18 and 24 months, are: weight loss, physical activity, and glycaemic control (HbA1c), with weight loss and physical activity also measured at 12 months. Incremental cost-effectiveness will also be examined. Study recruitment began in February 2009, with final data collection expected by February 2013. Discussion This is the first study to evaluate the telephone as the primary method of delivering a behavioural weight loss intervention in type 2 diabetes. The evaluation of maintenance outcomes (6 months following the end of intervention), the use of accelerometers to objectively measure physical activity, and the inclusion of a cost-effectiveness analysis will advance the science of broad reach approaches to weight control and health

  15. Development of and feedback on a fully automated virtual reality system for online training in weight management skills.

    PubMed

    Thomas, J Graham; Spitalnick, Josh S; Hadley, Wendy; Bond, Dale S; Wing, Rena R

    2015-01-01

    Virtual reality (VR) technology can provide a safe environment for observing, learning, and practicing use of behavioral weight management skills, which could be particularly useful in enhancing minimal contact online weight management programs. The Experience Success (ES) project developed a system for creating and deploying VR scenarios for online weight management skills training. Virtual environments populated with virtual actors allow users to experiment with implementing behavioral skills via a PC-based point and click interface. A culturally sensitive virtual coach guides the experience, including planning for real-world skill use. Thirty-seven overweight/obese women provided feedback on a test scenario focused on social eating situations. They reported that the scenario gave them greater skills, confidence, and commitment for controlling eating in social situations.

  16. The weight management strategies inventory (WMSI). Development of a new measurement instrument, construct validation, and association with dieting success.

    PubMed

    Keller, Carmen; Siegrist, Michael

    2015-09-01

    In an obesogenic environment, people have to adopt effective weight management strategies to successfully gain or maintain normal body weight. Little is known about the strategies used by the general population in daily life. Due to the lack of a comprehensive measurement instrument to assess conceptually different strategies with various scales, we developed the weight management strategies inventory (WMSI). In study 1, we collected 19 weight management strategies from research on self-regulation of food intake and successful weight loss and maintenance, as well as from expert interviews. We classified them under the five main categories of health self-regulation strategies - goal setting and monitoring, prospection and planning, automating behavior, construal, and inhibition. We formulated 93 items. In study 2, we developed the WMSI in a random sample from the general population (N = 658), using reliability and exploratory factor analysis. This resulted in 19 factors with 63 items, representing the 19 strategies. In study 3, we tested the 19-factor structure in a quota (age, gender) sample from the general population (N = 616), using confirmatory factor analysis. A good model fit (CFI = .918; RMSEA = .043) was revealed. Reliabilities and construct validity were high. Positive correlations of most strategies with dieting success and negative correlations of some strategies with body mass index were found among dieters (N = 292). Study 4 (N = 162) revealed a good test-retest reliability. The WMSI assesses theoretically derived, evidence-based, and conceptually different weight management strategies with different scales that have good psychometric characteristics. The scales can also be used for pre- and post measures in intervention studies. The scales provide insights into the general population's weight management strategies and facilitate tailoring and evaluating health communication.

  17. The Use of Algorithms in Assessing and Managing Persistent Pain in Older Adults

    PubMed Central

    Jablonski, Anita M.; DuPen, Anna R.; Ersek, Mary

    2015-01-01

    As the population of the U. S. ages, nurses will care for increasing numbers of older adults, most of whom suffer from at least one chronic illness. Persistent pain associated with many chronic illnesses is of concern because of its detrimental effects on functioning and quality of life. Nurses play a primary role in ensuring that persistent pain is effectively managed and optimal functioning maintained. Successful pain management depends on comprehensive assessment skills, in-depth knowledge of evidence-based pharmacologic and non-pharmacologic treatment strategies appropriate for older adults, continuous re-assessment, and sound decision making. Algorithms developed from evidence-based clinical practice guidelines are tools that can support and enhance nurses’ efforts to assess and manage persistent pain experienced by older adults. This paper introduces the reader to the use of algorithms to guide pain assessment and management and illustrates their use in a case study. PMID:21346465

  18. Management of adult Jehovah's Witness patients with acute bleeding.

    PubMed

    Berend, Kenrick; Levi, Marcel

    2009-12-01

    Because of the firm refusal of transfusion of blood and blood components by Jehovah's Witnesses, the management of Jehovah's Witness patients with severe bleeding is often complicated by medical, ethical, and legal concerns. Because of a rapidly growing and worldwide membership, physicians working in hospitals should be prepared to manage these patients. Appropriate management of a Jehovah's Witness patient with severe bleeding entails understanding of the legal and ethical issues involved, and meticulous medical management, including treatment of hypovolemic shock, local hemostatic interventions, and administration of prohemostatic agents, when appropriate. In addition, high-dose recombinant erythropoietin in combination with supplemental iron may enhance the speed of hemoglobin synthesis.

  19. Clinical variability in cardiovascular disease risk factor screening and management in adolescent and young adult women with polycystic ovary syndrome

    PubMed Central

    Baer, Tamara E.; Milliren, Carly E.; Walls, Courtney; DiVasta, Amy D.

    2014-01-01

    Study Objectives To review the clinical presentation, evaluation and management of normal-weight, overweight and obese adolescent and young adult women with PCOS over 2-year follow-up. Design Retrospective chart review Participants 173 adolescent and young adult women, aged 12–22 years, diagnosed with PCOS Interventions Demographic, health data, and laboratory measures were abstracted from 3 clinic visits: baseline and 1- and 2- year follow-up. Subjects were classified as normal-weight (NW), overweight (OW) or obese (OB). Longitudinal data were analyzed using repeated measures ANOVA. Main Outcome Measures BMI, self-reported concerns, lifestyle changes. Results Most patients (73%) were OW or OB. Family history of type II diabetes was greater in OW (38%) and OB (53%) as compared to NW (22%) patients (p=0.002). Acanthosis nigricans was identified in OW (62%) and OB (21%) patients, but not NW patients (0%; p <0.001). OW and OB patients had higher fasting insulin (p<0.001) and lower HDL cholesterol (p=0.005) than NW patients, although screening rates were low. BMI Z-scores decreased in both OW and OB patients over time (0.07 units/year; p<0.001). Conclusions Most patients with PCOS were OW/OB. Substantial clinical variability existed in CVD screening; among those screened, OW and OB patients had greater CVD risk factors. Despite self-reported concerns about weight and diabetes risk among OW/OB patients, no clinically significant change in BMI percentile occurred. Evidence-based interventions and recommendations for screening tests are needed to address CVD risk in adolescents and young adults with PCOS. PMID:26081478

  20. Military services fitness database: development of a computerized physical fitness and weight management database for the U.S. Army.

    PubMed

    Williamson, Donald A; Bathalon, Gaston P; Sigrist, Lori D; Allen, H Raymond; Friedl, Karl E; Young, Andrew J; Martin, Corby K; Stewart, Tiffany M; Burrell, Lolita; Han, Hongmei; Hubbard, Van S; Ryan, Donna

    2009-01-01

    The Department of Defense (DoD) has mandated development of a system to collect and manage data on the weight, percent body fat (%BF), and fitness of all military personnel. This project aimed to (1) develop a computerized weight and fitness database to track individuals and Army units over time allowing cross-sectional and longitudinal evaluations and (2) test the computerized system for feasibility and integrity of data collection over several years of usage. The computer application, the Military Services Fitness Database (MSFD), was designed for (1) storage and tracking of data related to height, weight, %BF for the Army Weight Control Program (AWCP) and Army Physical Fitness Test (APFT) scores and (2) generation of reports using these data. A 2.5-year pilot test of the MSFD indicated that it monitors population and individual trends of changing body weight, %BF, and fitness in a military population.

  1. Military Services Fitness Database: Development of a Computerized Physical Fitness and Weight Management Database for the U.S. Army

    PubMed Central

    Williamson, Donald A.; Bathalon, Gaston P.; Sigrist, Lori D.; Allen, H. Raymond; Friedl, Karl E.; Young, Andrew J.; Martin, Corby K.; Stewart, Tiffany M.; Burrell, Lolita; Han, Hongmei; Hubbard, Van S.; Ryan, Donna

    2009-01-01

    The Department of Defense (DoD) has mandated development of a system to collect and manage data on the weight, percent body fat (%BF), and fitness of all military personnel. This project aimed to (1) develop a computerized weight and fitness database to track individuals and Army units over time allowing cross-sectional and longitudinal evaluations and (2) test the computerized system for feasibility and integrity of data collection over several years of usage. The computer application, the Military Services Fitness Database (MSFD), was designed for (1) storage and tracking of data related to height, weight, %BF for the Army Weight Control Program (AWCP) and Army Physical Fitness Test (APFT) scores and (2) generation of reports using these data. A 2.5-year pilot test of the MSFD indicated that it monitors population and individual trends of changing body weight, %BF, and fitness in a military population. PMID:19216292

  2. Adult ESL Students' Management of Dialogue Journal Conversation.

    ERIC Educational Resources Information Center

    Dolly, Martha R.

    1990-01-01

    Analysis of adult English-as-a-Second-Language students' dialogue journal communication with their native speaking teacher found that 5 of the 12 conversations analyzed were reciprocal in most of the "move" (sharing of information or opinions unknown by the other) categories, but only 4 were reciprocal in initiating solicits, and only 1 extended…

  3. Managing Programs for Adults Learning English. CAELA Network Brief

    ERIC Educational Resources Information Center

    Rodriguez, Amber Gallup; Burt, Miriam; Peyton, Joy Kreeft; Ueland, Michelle

    2009-01-01

    Programs for adults learning English vary widely in size and scope. Some are large, multilevel programs, such as the Arlington Education and Employment Program (REEP) in Virginia, which has more than 45 staff members, over 100 volunteers, and an array of student services for the 7,500 learners served annually at the program's 7 locations. Others…

  4. Candy consumption was not associated with body weight measures, risk factors for cardiovascular disease, or metabolic syndrome in US adults: NHANES 1999-2004

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There is limited research examining the relationship of candy consumption by adults on diet and health. The purpose of this study was to determine total, chocolate, or sugar candy consumption and their effect on energy, saturated fatty acid and added sugar intake, weight, risk factors for cardiovasc...

  5. Influence of birth weight on white blood cell count in biracial (black-white) children, adolescents, and young adults: the Bogalusa Heart Study.

    PubMed

    Chen, Wei; Srinivasan, Sathanur R; Berenson, Gerald S

    2009-01-15

    The effect of birth weight on white blood cell (WBC) count among blacks and whites was examined in 2,080 children (aged 4-11 years, 57.4% white, and 49.2% male), 892 adolescents (aged 12-17 years, 57.2% white, an