Intake of total, animal and plant protein and subsequent changes in weight or waist circumference in European men and women: the Diogenes project.

PubMed

Halkjær, J; Olsen, A; Overvad, K; Jakobsen, M U; Boeing, H; Buijsse, B; Palli, D; Tognon, G; Du, H; van der A, D L; Forouhi, N G; Wareham, N J; Feskens, E J M; Sørensen, T I A; Tjønneland, A

2011-08-01

As protein is considered to increase thermogenesis and satiety more than other macronutrients, it may have beneficial effects on prevention of weight gain and weight maintenance. The objective of this study is to assess the association between the amount and type of dietary protein, and subsequent changes in weight and waist circumference (WC). 89,432 men and women from five countries participating in European Prospective Investigation into Cancer and Nutrition (EPIC) were followed for a mean of 6.5 years. Associations between the intake of protein or subgroups of protein (from animal and plant sources) and changes in weight (g per year) or WC (cm per year) were investigated using gender and centre-specific multiple regression analyses. Adjustments were made for other baseline dietary factors, baseline anthropometrics, demographic and lifestyle factors and follow-up time. We used random effect meta-analyses to obtain pooled estimates across centres. Higher intake of total protein, and protein from animal sources was associated with subsequent weight gain for both genders, strongest among women, and the association was mainly attributable to protein from red and processed meat and poultry rather than from fish and dairy sources. There was no overall association between intake of plant protein and subsequent changes in weight. No clear overall associations between intakes of total protein or any of the subgroups and changes in WC were present. The associations showed some heterogeneity between centres, but pooling of estimates was still considered justified. A high intake of protein was not found associated with lower weight or waist gain in this observational study. In contrast, protein from food items of animal origin, especially meat and poultry, seemed to be positively associated with long-term weight gain. There were no clear associations for waist changes.

Can(not) take my eyes off it: attention bias for food in overweight participants.

PubMed

Werthmann, Jessica; Roefs, Anne; Nederkoorn, Chantal; Mogg, Karin; Bradley, Brendan P; Jansen, Anita

2011-09-01

The aim of the current study was to investigate attention biases for food cues, craving, and overeating in overweight and healthy-weight participants. Specifically, it was tested whether attention allocation processes toward high-fat foods differ between overweight and normal weight individuals and whether selective attention biases for food cues are related to craving and food intake. Eye movements were recorded as a direct index of attention allocation in a sample of 22 overweight/obese and 29 healthy-weight female students during a visual probe task with food pictures. In addition, self-reported craving and actual food intake during a bogus "taste-test" were assessed. Overweight participants showed an approach-avoidance pattern of attention allocation toward high-fat food. Overweight participants directed their first gaze more often toward food pictures than healthy-weight individuals, but subsequently showed reduced maintenance of attention on these pictures. For overweight participants, craving was related to initial orientation toward food. Moreover, overweight participants consumed significantly more snack food than healthy-weight participants. Results emphasize the importance of identifying different attention bias components in overweight individuals with regard to craving and subsequent overeating.

Instrumentalization of Eating Improves Weight Loss Maintenance in Obesity.

PubMed

Christensen, Bodil Just; Iepsen, Eva Winning; Lundgren, Julie; Holm, Lotte; Madsbad, Sten; Holst, Jens Juul; Torekov, Signe Sørensen

2017-01-01

The purpose of this study was to identify psychosocial determinants for maintaining weight loss. 42 obese individuals who achieved a 12% weight loss before entering a 52-week weight maintenance program were interviewed qualitatively. Psychosocial factors related to weight loss maintenance were identified in two contrasting groups: weight reducers and weight regainers. Groups were defined by health-relevant weight maintenance (additional weight loss > 3% at week 52, n = 9 versus weight gain > 3%, at week 52, n = 20). Weight reducers reported structured meal patterns (p = 0.008), no comfort eating (p = 0.016) and less psychosocial stress (p = 0.04) compared to weight regainers. The ability to instrumentalize eating behavior emerged as an important factor (p = 0.007). Nutritional knowledge, motivation or exercise level did not differ between groups (p > 0.05). Successful weight loss maintenance was associated with an interplay between behavioral, affective and contextual changes. 'Instrumentalization of eating behavior' seems to be an important element in long-term weight maintenance. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Comparing Weight Loss-Maintenance Outcomes of a Worksite-Based Lifestyle Program Delivered via DVD and Face-to-Face: A Randomized Trial.

PubMed

Ing, Claire Townsend; Miyamoto, Robin E S; Fang, Rui; Antonio, Mapuana; Paloma, Diane; Braun, Kathryn L; Kaholokula, Joseph Keawe'aimoku

2018-03-01

Native Hawaiians and other Pacific Islanders have high rates of overweight and obesity compared with other ethnic groups in Hawai'i. Effective weight loss and weight loss-maintenance programs are needed to address obesity and obesity-related health inequities for this group. Compare the effectiveness of a 9-month, worksite-based, weight loss-maintenance intervention delivered via DVD versus face-to-face in continued weight reduction and weight loss maintenance beyond the initial weight loss phase. We tested DVD versus face-to-face delivery of the PILI@Work Program's 9-month, weight loss-maintenance phase in Native Hawaiian-serving organizations. After completing the 3-month weight loss phase, participants ( n = 217) were randomized to receive the weight loss-maintenance phase delivered via trained peer facilitators or DVDs. Participant assessments at randomization and postintervention included weight, height, blood pressure, physical functioning, exercise frequency, and fat intake. Eighty-three face-to-face participants were retained at 12 months (74.1%) compared with 73 DVD participants (69.5%). There was no significant difference between groups in weight loss or weight loss maintenance. The number of lessons attended in Phase 1 of the intervention (β = 0.358, p = .022) and baseline systolic blood pressure (β = -0.038, p = .048) predicted percent weight loss at 12 months. Weight loss maintenance was similar across groups. This suggests that low-cost delivery methods for worksite-based interventions targeting at-risk populations can help address obesity and obesity-related disparities. Additionally, attendance during the weight loss phase and lower baseline systolic blood pressure predicted greater percent weight loss during the weight loss-maintenance phase, suggesting that early engagement and initial physical functioning improve long-term weight loss outcomes.

Protein-induced satiety: effects and mechanisms of different proteins.

PubMed

Veldhorst, M; Smeets, A; Soenen, S; Hochstenbach-Waelen, A; Hursel, R; Diepvens, K; Lejeune, M; Luscombe-Marsh, N; Westerterp-Plantenga, M

2008-05-23

Relatively high protein diets, i.e. diets that maintain the absolute number of grams of protein ingested as compared to before dieting, are a popular strategy for weight loss and weight maintenance. Research into multiple mechanisms regulating body weight has focused on the effects of different quantities and types of dietary protein. Satiety and energy expenditure are important in protein-enhanced weight loss and weight maintenance. Protein-induced satiety has been shown acutely, with single meals, with contents of 25% to 81% of energy from protein in general or from specific proteins, while subsequent energy intake reduction was significant. Protein-induced satiety has been shown with high protein ad libitum diets, lasting from 1 to 6 days, up to 6 months. Also significantly greater weight loss has been observed in comparison with control. Mechanisms explaining protein-induced satiety are nutrient-specific, and consist mainly of synchronization with elevated amino acid concentrations. Different proteins cause different nutrient related responses of (an)orexigenic hormones. Protein-induced satiety coincides with a relatively high GLP-1 release, stimulated by the carbohydrate content of the diet, PYY release, while ghrelin does not seem to be especially affected, and little information is available on CCK. Protein-induced satiety is related to protein-induced energy expenditure. Finally, protein-induced satiety appears to be of vital importance for weight loss and weight maintenance. With respect to possible adverse events, chronic ingestion of large amounts of sulphur-containing amino acids may have an indirect effect on blood pressure by induction of renal subtle structural damage, ultimately leading to loss of nephron mass, and a secondary increase in blood pressure. The established synergy between obesity and low nephron number on induction of high blood pressure and further decline of renal function identifies subjects with obesity, metabolic syndrome and diabetes mellitus II as particularly susceptible groups.

Weight maintenance, behaviors and barriers among previous participants of a university-based weight control program.

PubMed

Befort, C A; Stewart, E E; Smith, B K; Gibson, C A; Sullivan, D K; Donnelly, J E

2008-03-01

To examine weight loss maintenance among previous participants of a university-based behavioral weight management program and to compare behavioral strategies and perceived barriers between successful and unsuccessful maintainers. Previous program participants (n=179) completed mailed surveys assessing current weight, weight control behaviors and perceived barriers to weight loss maintenance. At 14.1+/-10.8 months following completion of treatment, survey respondents were on average 12.6+/-12.6 kg, or 11.3+/-10.7%, below baseline weight; 76.5% of respondents had successfully maintained weight, defined as maintaining a weight loss of at least 5% below baseline. Compared to unsuccessful maintainers, successful maintainers reported practicing four dietary and three physical activity weight control strategies more often and experiencing five barriers to healthy eating and exercise less often. After accounting for time since treatment and maximum weight loss while in treatment, the strongest correlates of successful weight loss maintenance were frequent exercise and perceived difficulty of weight management. Clinically meaningful weight loss maintenance was achieved by the majority of participants. Findings support the literature indicating that physical activity is one of the strongest predictors of successful weight loss maintenance. Findings also suggest that strategies to reduce the level of perceived effort required for long-term weight control may improve maintenance outcomes.

How visual short-term memory maintenance modulates subsequent visual aftereffects.

PubMed

Saad, Elyana; Silvanto, Juha

2013-05-01

Prolonged viewing of a visual stimulus can result in sensory adaptation, giving rise to perceptual phenomena such as the tilt aftereffect (TAE). However, it is not known if short-term memory maintenance induces such effects. We examined how visual short-term memory (VSTM) maintenance modulates the strength of the TAE induced by subsequent visual adaptation. We reasoned that if VSTM maintenance induces aftereffects on subsequent encoding of visual information, then it should either enhance or reduce the TAE induced by a subsequent visual adapter, depending on the congruency of the memory cue and the adapter. Our results were consistent with this hypothesis and thus indicate that the effects of VSTM maintenance can outlast the maintenance period.

The Cognitive Behavioral Approach to Weight Maintenance.

ERIC Educational Resources Information Center

Girdano, Dorothy Dusek

The cognitive behavioral approach to weight maintenance assumes that obese people should be concerned with weight control rather than weight loss, and it embraces both the behavioral approach and a maintenance program which examines risks, value priorities, and the basic principles of weight loss/weight gain. The University of Maryland offers a…

A pilot study comparing two weight loss maintenance interventions among low-income, mid-life women.

PubMed

Samuel-Hodge, Carmen D; Johnston, Larry F; Gizlice, Ziya; Garcia, Beverly A; Lindsley, Sara C; Gold, Alison D; Braxton, Danielle F; Keyserling, Thomas C

2013-07-15

Despite high obesity prevalence rates, few low-income midlife women participate in weight loss maintenance trials. This pilot study aims to assess the effectiveness of two weight loss maintenance interventions in this under-represented population. Low-income midlife women who completed a 16-week weight loss intervention and lost  ≥ 8 lbs (3.6 kg) were eligible to enroll in one of two 12-month maintenance programs. The programs were similar in content and had the same number of total contacts, but were different in the contact modality (Phone + Face-to-Face vs. Face-to-Face Only). Two criteria were used to assess successful weight loss maintenance at 12 months: (1) retaining a loss of  ≥ 5% of body weight from the start of the weight loss phase and (2) a change in body weight of  < 3%, from the start to the end of the maintenance program. Outcome measures of changes in physiologic and psychosocial factors, and evaluations of process measures and program acceptability (measured at 12 months) are also reported. For categorical variables, likelihood ratio or Fisher's Exact (for small samples) tests were used to evaluate statistically significant relationships; for continuous variables, t-tests or their equivalents were used to assess differences between means and also to identify correlates of weight loss maintenance. Overall, during the 12-month maintenance period, 41% (24/58) of participants maintained a loss of  ≥ 5% of initial weight and 43% (25/58) had a <3% change in weight. None of the comparisons between the two maintenance programs were statistically significant. However, improvements in blood pressure and dietary behaviors remained significant at the end of the 12-month maintenance period for participants in both programs. Participant attendance and acceptability were high for both programs. The effectiveness of two pilot 12-month maintenance interventions provides support for further research in weight loss maintenance among high-risk, low-income women. ClinicalTrials.gov Identifier: NCT00288301.

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).…

A pilot study comparing two weight loss maintenance interventions among low-income, mid-life women

PubMed Central

2013-01-01

Background Despite high obesity prevalence rates, few low-income midlife women participate in weight loss maintenance trials. This pilot study aims to assess the effectiveness of two weight loss maintenance interventions in this under-represented population. Methods Low-income midlife women who completed a 16-week weight loss intervention and lost ≥ 8 lbs (3.6 kg) were eligible to enroll in one of two 12-month maintenance programs. The programs were similar in content and had the same number of total contacts, but were different in the contact modality (Phone + Face-to-Face vs. Face-to-Face Only). Two criteria were used to assess successful weight loss maintenance at 12 months: (1) retaining a loss of ≥ 5% of body weight from the start of the weight loss phase and (2) a change in body weight of < 3%, from the start to the end of the maintenance program. Outcome measures of changes in physiologic and psychosocial factors, and evaluations of process measures and program acceptability (measured at 12 months) are also reported. For categorical variables, likelihood ratio or Fisher’s Exact (for small samples) tests were used to evaluate statistically significant relationships; for continuous variables, t-tests or their equivalents were used to assess differences between means and also to identify correlates of weight loss maintenance. Results Overall, during the 12-month maintenance period, 41% (24/58) of participants maintained a loss of ≥ 5% of initial weight and 43% (25/58) had a <3% change in weight. None of the comparisons between the two maintenance programs were statistically significant. However, improvements in blood pressure and dietary behaviors remained significant at the end of the 12-month maintenance period for participants in both programs. Participant attendance and acceptability were high for both programs. Conclusions The effectiveness of two pilot 12-month maintenance interventions provides support for further research in weight loss maintenance among high-risk, low-income women. Trial registration ClinicalTrials.gov Identifier: NCT00288301 PMID:23855318

Improving Weight Maintenance Using Virtual Reality (Second Life)

ERIC Educational Resources Information Center

Sullivan, Debra K.; Goetz, Jeannine R.; Gibson, Cheryl A.; Washburn, Richard A.; Smith, Bryan K.; Lee, Jaehoon; Gerald, Stephanie; Fincham, Tennille; Donnelly, Joseph E.

2013-01-01

Objective: Compare weight loss and maintenance between a face-to-face (FTF) weight management clinic and a clinic delivered via virtual reality (VR). Methods: Participants were randomized to 3 months of weight loss with a weekly clinic delivered via FTF or VR and then 6 months' weight maintenance delivered with VR. Data were collected at baseline…

Association of the FTO and ADRB2 genes with body composition and fat distribution in obese women.

PubMed

Rauhio, Anne; Uusi-Rasi, Kirsti; Nikkari, Seppo T; Kannus, Pekka; Sievänen, Harri; Kunnas, Tarja

2013-10-01

The aim of this study was to investigate whether the polymorphisms of the fat mass and obesity-associated gene (FTO, rs9939609:T>A) and the β2-adrenergic receptor gene (ADRB2, rs1042714:Gln>Glu) are associated with weight loss in dieting obese premenopausal women and the association of these SNPs with body weight, body composition and distribution of fat mass. 75 obese (BMI>30) premenopausal women participated in the intervention including a 3-month weight reduction period and a subsequent 9-month weight maintenance period. Weight and height were measured and BMI calculated. Body composition and fat mass distribution were assessed by dual energy X-ray absorptiometry. At baseline, the AA homozygotes of the FTO gene were 10.1 kg heavier (p=0.031), they had higher BMI (p=0.038), and greater waist and greater hip circumference (p=0.08 and p=0.067, respectively) compared to the TT homozygotes. Gln/Gln carriers of the ADRB2 gene had smaller gynoid fat-% compared with both the Gln/Glu and Glu/Glu carriers (p=0.050 and p=0.009, respectively). The Gln homozygotes had also smaller total body fat-% and higher total body lean mass-% than that of the Glu homozygotes (p=0.018 and p=0.019, respectively). FTO genotype was associated with body weight in general, whereas ADRB2 genotype was associated with fat distribution. However, all women in the study group lost weight similarly independently of their genotypes. Neither the FTO nor ADRB2 genotype had statistically significant effect on weight reduction or weight maintenance. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

A virtual reality intervention (Second Life) to improve weight maintenance: Rationale and design for an 18-month randomized trial.

PubMed

Sullivan, D K; Goetz, J R; Gibson, C A; Mayo, M S; Washburn, R A; Lee, Y; Ptomey, L T; Donnelly, J E

2016-01-01

Despite the plethora of weight loss programs available in the US, the prevalence of overweight and obesity (BMI≥25kg/m(2)) among US adults continues to rise at least, in part, due to the high probability of weight regain following weight loss. Thus, the development and evaluation of novel interventions designed to improve weight maintenance are clearly needed. Virtual reality environments offer a promising platform for delivering weight maintenance interventions as they provide rapid feedback, learner experimentation, real-time personalized task selection and exploration. Utilizing virtual reality during weight maintenance allows individuals to engage in repeated experiential learning, practice skills, and participate in real-life scenarios without real-life repercussions, which may diminish weight regain. We will conduct an 18-month effectiveness trial (6 months weight loss, 12 months weight maintenance) in 202 overweight/obese adults (BMI 25-44.9kg/m(2)). Participants who achieve ≥5% weight loss following a 6month weight loss intervention delivered by phone conference call will be randomized to weight maintenance interventions delivered by conference call or conducted in a virtual environment (Second Life®). The primary aim of the study is to compare weight change during maintenance between the phone conference call and virtual groups. Secondarily, potential mediators of weight change including energy and macronutrient intake, physical activity, consumption of fruits and vegetables, self-efficacy for both physical activity and diet, and attendance and completion of experiential learning assignments will also be assessed. Copyright © 2015 Elsevier Inc. All rights reserved.

A virtual reality intervention (second life) to improve weight maintenance: Rationale and design for an 18 month randomized trial

PubMed Central

Sullivan, DK; Goetz, JR; Gibson, CA; Mayo, MS; Washburn, RA; Lee, Y; Ptomey, LT; Donnelly, JE

2015-01-01

Despite the plethora of weight loss programs available in the US, the prevalence of overweight and obesity (BMI ≥ 25 kg/m2) among US adults continues to rise at least, in part, due to the high probability of weight regain following weight loss. Thus, the development and evaluation of novel interventions designed to improve weight maintenance is clearly needed. Virtual reality environments offer a promising platform for delivering weight maintenance interventions as they provide rapid feedback, learner experimentation, real-time personalized task selection and exploration. Utilizing virtual reality during weight maintenance allows individuals to engage in repeated experiential learning, practice skills, and participate in real-life scenarios without reallife repercussions, which may diminish weight regain. We will conduct an 18-month effectiveness trial (6 months weight loss, 12 months weight maintenance) in 202 overweight/obese adults (BMI 25–44.9 kg/m2). Participants who achieve ≥ 5% weight loss following a 6 month weight loss intervention delivered by phone conference call will be randomized to weight maintenance interventions delivered by conference call or conducted in a virtual environment (Second Life®). The primary aim of the study is to compare weight change during maintenance between the phone conference call and virtual groups. Secondarily, potential mediators of weight change including energy and macronutrient intake, physical activity, consumption of fruits and vegetables, self-efficacy for both physical activity and diet, and attendance and completion of experiential learning assignments will also be assessed. PMID:26616535

Therapeutic drug monitoring of eculizumab: Rationale for an individualized dosing schedule.

PubMed

Gatault, Philippe; Brachet, Guillaume; Ternant, David; Degenne, Danielle; Récipon, Guillaume; Barbet, Christelle; Gyan, Emmanuel; Gouilleux-Gruart, Valérie; Bordes, Cécile; Farrell, Alexandra; Halimi, Jean Michel; Watier, Hervé

2015-01-01

The annual cost of eculizumab maintenance therapy in paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic-uremic syndrome (aHUS) exceeds $300,000 per patient. A better understanding of eculizumab pharmacokinetics and subsequent individual dose adjustment could reduce this cost. We measured the trough eculizumab concentration in 9 patients with maintenance therapy (aHUS, n = 7; PNH, n = 2) and determined: 1) the intra- and inter-individual variability; 2) the influence of weight on eculizumab pharmacokinetics; and 3) the rate of elimination of eculizumab following discontinuation. A one-compartment model was developed to describe the pharmacokinetics of eculizumab and predicted complement activity by body weight. Trough eculizumab concentrations were >50 µg/mL in 9/9, >100 µg/mL in 8/9, and >300 µg/mL in 5/9 of patients. Intra-individual variability was low but eculizumab concentrations, closely correlated with patient weight (R(2) = 0.66, p = 0.034), varied broadly (55 ± 12 to 733 ± 164 µg/mL). Pharmacokinetic modeling showed that the elimination half-life varied greatly, with an increase from 7.8 d in a patient weighing 100 kg to 19.5 d in a 40 kg patient. We predicted that infusions of 1200 mg could be spaced every 4 or 6 weeks in patients weighing <90 and <70 kg, respectively. In this pilot study, the current recommended use of a fixed eculizumab dose for maintenance therapy is associated with excessively high trough concentrations in many patients. Further prospective larger studies are now required to support an individualized schedule adjusted for patient weight and based on the observed trough serum eculizumab concentration.

Therapeutic drug monitoring of eculizumab: Rationale for an individualized dosing schedule

PubMed Central

Gatault, Philippe; Brachet, Guillaume; Ternant, David; Degenne, Danielle; Récipon, Guillaume; Barbet, Christelle; Gyan, Emmanuel; Gouilleux-Gruart, Valérie; Bordes, Cécile; Farrell, Alexandra; Halimi, Jean Michel; Watier, Hervé

2015-01-01

The annual cost of eculizumab maintenance therapy in paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic–uremic syndrome (aHUS) exceeds $300,000 per patient. A better understanding of eculizumab pharmacokinetics and subsequent individual dose adjustment could reduce this cost. We measured the trough eculizumab concentration in 9 patients with maintenance therapy (aHUS, n = 7; PNH, n = 2) and determined: 1) the intra- and inter-individual variability; 2) the influence of weight on eculizumab pharmacokinetics; and 3) the rate of elimination of eculizumab following discontinuation. A one-compartment model was developed to describe the pharmacokinetics of eculizumab and predicted complement activity by body weight. Trough eculizumab concentrations were >50 µg/mL in 9/9, >100 µg/mL in 8/9, and >300 µg/mL in 5/9 of patients. Intra-individual variability was low but eculizumab concentrations, closely correlated with patient weight (R2 = 0.66, p = 0.034), varied broadly (55 ± 12 to 733 ± 164 µg/mL). Pharmacokinetic modeling showed that the elimination half-life varied greatly, with an increase from 7.8 d in a patient weighing 100 kg to 19.5 d in a 40 kg patient. We predicted that infusions of 1200 mg could be spaced every 4 or 6 weeks in patients weighing <90 and <70 kg, respectively. In this pilot study, the current recommended use of a fixed eculizumab dose for maintenance therapy is associated with excessively high trough concentrations in many patients. Further prospective larger studies are now required to support an individualized schedule adjusted for patient weight and based on the observed trough serum eculizumab concentration. PMID:26337866

Changes in glucose-elicited blood metabolite responses following weight loss and long term weight maintenance in obese individuals with impaired glucose tolerance.

PubMed

Geidenstam, Nina; Danielsson, Anders P H; Spégel, Peter; Ridderstråle, Martin

2016-03-01

Weight loss improves insulin sensitivity and glucose tolerance in obese subjects with impaired glucose tolerance (IGT), but the long term dynamic effects on blood metabolites other than glucose during an oral glucose tolerance test (OGTT), are largely unknown. Here, we studied changes in OGTT-elicited metabolite patterns in obese subjects during a diet-induced weight loss study. Blood samples from 14 obese individuals with IGT were collected at 0, 30 and 120 min during a standard 75 g OGTT at baseline (BMI 44 ± 2 kg/m(2)), after weight loss (BMI 36 ± 2 kg/m(2)) and after weight maintenance (BMI 35 ± 2 kg/m(2)). Serum metabolite levels were analyzed by gas chromatography/mass spectrometry and compared to a lean glucose tolerant group. Changes in the OGTT-elicited metabolite patterns occurred differentially during weight loss and weight maintenance. Enhanced suppression of aromatic amino acids were associated with decreased insulinogenic index observed after weight loss (tyrosine: r=0.72, p=0.013; phenylalanine: r=0.63, p=0.039). The OGTT-elicited suppression and/or lack of increase in levels of glutamate, glutamine, isoleucine, leucine, and the fatty acids laurate, oleate and palmitate, improved towards the lean profile after weight maintenance, paralleling an improvement in glucose tolerance. The greater heterogeneity in the response before and after weight loss in the obese, compared to lean subjects, was markedly reduced after weight maintenance. Diet-induced weight loss followed by weight maintenance results in changes in metabolite profiles associated with either hepatic insulin sensitivity or peripheral glucose tolerance. Our results highlight the importance of evaluating the effects of weight loss and weight maintenance separately. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Web-Based Interventions for Weight Loss or Weight Loss Maintenance in Overweight and Obese People: A Systematic Review of Systematic Reviews

PubMed Central

Sorgente, Angela; Manzoni, Gian Mauro; Re, Federica; Simpson, Susan; Perona, Sara; Rossi, Alessandro; Cattivelli, Roberto; Innamorati, Marco; Jackson, Jeffrey B; Castelnuovo, Gianluca

2017-01-01

Background Weight loss is challenging and maintenance of weight loss is problematic. Web-based programs offer good potential for delivery of interventions for weight loss or weight loss maintenance. However, the precise impact of Web-based weight management programs is still unclear. Objective The purpose of this meta-systematic review was to provide a comprehensive summary of the efficacy of Web-based interventions for weight loss and weight loss maintenance. Methods Electronic databases were searched for systematic reviews and meta-analyses that included at least one study investigating the effect of a Web-based intervention on weight loss and/or weight loss maintenance among samples of overweight and/or obese individuals. Twenty identified reviews met the inclusion criteria. The Revised Assessment of Multiple SysTemAtic Reviews (R-AMSTAR) was used to assess methodological quality of reviews. All included reviews were of sufficient methodological quality (R-AMSTAR score ≥22). Key methodological and outcome data were extracted from each review. Results Web-based interventions for both weight loss and weight loss maintenance were more effective than minimal or control conditions. However, when contrasted with comparable non-Web-based interventions, results were less consistent across reviews. Conclusions Overall, the efficacy of weight loss maintenance interventions was stronger than the efficacy of weight loss interventions, but further evidence is needed to more clearly understand the efficacy of both types of Web-based interventions. Trial Registration PROSPERO 2015: CRD42015029377; http://www.crd.york.ac.uk/PROSPERO/display_record.asp? ID=CRD42015029377 (Archived by WebCite at http://www.webcitation.org/6qkSafdCZ) PMID:28652225

The slippery slope: prediction of successful weight maintenance in anorexia nervosa

PubMed Central

Kaplan, A. S.; Walsh, B. T.; Olmsted, M.; Attia, E.; Carter, J. C.; Devlin, M. J.; Pike, K. M.; Woodside, B.; Rockert, W.; Roberto, C. A.; Parides, M.

2015-01-01

Background Previous research has found that many patients with anorexia nervosa (AN) are unable to maintain normal weight after weight restoration. The objective of this study was to identify variables that predicted successful weight maintenance among weight-restored AN patients. Method Ninety-three patients with AN treated at two sites (Toronto and New York) through in-patient or partial hospitalization achieved a minimally normal weight and were then randomly assigned to receive fluoxetine or placebo along with cognitive behavioral therapy (CBT) for 1 year. Clinical, demographic and psychometric variables were assessed after weight restoration prior to randomization and putative predictors of successful weight maintenance at 6 and 12 months were examined. Results The most powerful predictors of weight maintenance at 6 and 12 months following weight restoration were pre-randomization body mass index (BMI) and the rate of weight loss in the first 28 days following randomization. Higher BMI and lower rate of weight loss were associated with greater likelihood of maintaining a normal BMI at 6 and 12 months. An additional predictor of weight maintenance was site; patients in Toronto fared better than those in New York. Conclusions This study found that the best predictors of weight maintenance in weight-restored AN patients over 6 and 12 months were the level of weight restoration at the conclusion of acute treatment and the avoidance of weight loss immediately following intensive treatment. These results suggest that outcome might be improved by achieving a higher BMI during structured treatment programs and on preventing weight loss immediately following discharge from such programs. PMID:18845008

Social facilitation maintenance treatment for adults with obesity: study protocol for a randomised-controlled feasibility study (SFM study).

PubMed

Hilbert, Anja

2016-08-31

The long-term success of non-surgical weight loss treatment in adults with obesity is limited by substantial relapse, and only a few evidence-based weight loss maintenance treatments exist. This clinical trial investigates the feasibility and efficacy of a social facilitation maintenance programme for weight loss maintenance, tailored to meet the needs of obese adults who have undergone a lifestyle weight loss intervention. In a single-centre, open feasibility trial, 72 adults currently or previously obese or overweight who have undergone a lifestyle weight loss intervention are centrally randomised to 4 months of social facilitation maintenance treatment or treatment as a usual control condition. In 16 outpatient group sessions, the social facilitation maintenance treatment, based on a socioecological model and on evidence supporting social facilitation as a key process in maintaining weight loss, focuses on promoting interpersonal relationships to build up a healthy lifestyle for long-term weight loss maintenance. Primary outcome is the amount of weight regain at 6-month follow-up, compared with pre-treatment weight, derived from measured body weight. Secondary outcomes address feasibility, including recruitment, attrition, assessment non-completion, compliance and patients' programme evaluation; and in comparison with pre-weight loss maintenance, social and interpersonal functioning, eating behaviour and physical activity, psychological and physical symptoms, body composition and risk of comorbidity, and quality of life at post-treatment and follow-up assessments. The study was approved by the Ethical Committee at the University of Leipzig (165-13-15072013). The study results will be disseminated through peer-reviewed publications. DRKS00005182. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Macronutrient Content of the Diet: What Do We Know About Energy Balance and Weight Maintenance?

PubMed

Fleming, Jennifer A; Kris-Etherton, Penny M

2016-06-01

The 2013 AHA/ACC Clinical Guideline for the Management of Overweight and Obesity recommends a reduced energy diet for weight loss regardless of the macronutrient content. However, diet composition may affect the maintenance of weight loss. In general, a healthful dietary pattern with reduced portion sizes, low energy dense foods, and physical activity are successful for many. Certain populations, such as those with insulin resistance, may find reductions in carbohydrate and higher levels of unsaturated fats to be more effective and promote greater adherence. Of importance is that metabolic adaptations following weight loss also may impact weight loss maintenance and should be considered in the transition from weight loss to weight stabilization. Thus, weight loss and weight maintenance strategies are both important in an intervention for sustaining long-term behavior change.

A motivation-focused weight loss maintenance program is an effective alternative to a skill-based approach.

PubMed

West, D S; Gorin, A A; Subak, L L; Foster, G; Bragg, C; Hecht, J; Schembri, M; Wing, R R

2011-02-01

Maintaining weight loss is a major challenge in obesity treatment. Individuals often indicate that waning motivation prompts cessation of effective weight management behaviors. Therefore, a novel weight loss maintenance program that specifically targets motivational factors was evaluated. Overweight women (N=338; 19% African American) with urinary incontinence were randomized to lifestyle obesity treatment or control and followed for 18 months. All participants in lifestyle (N=226) received the same initial 6-month group behavioral obesity treatment and were then randomized to (1) a novel motivation-focused maintenance program (N=113) or (2) a standard skill-based maintenance approach (N=113). Weight assessed at baseline, 6 and 18 months. Both treatment groups (motivation-focused and skill-based) achieved comparable 18-month weight losses (-5.48% for motivation-focused vs -5.55% in skill-based, P=0.98), and both groups lost significantly more than controls (-1.51%; P=0.0012 in motivation-focused and P=0.0021 in skill-based). A motivation-focused maintenance program offers an alternative, effective approach to weight maintenance expanding available evidence-based interventions beyond traditional skill-based programs.

Meal replacement with a low-calorie diet formula in weight loss maintenance after weight loss induction with diet alone.

PubMed

Vázquez, C; Montagna, C; Alcaraz, F; Balsa, J A; Zamarrón, I; Arrieta, F; Botella-Carretero, J I

2009-10-01

Weight loss in obesity can reduce morbidity and mortality and benefits persist as long as weight loss is maintained. Weight maintenance is difficult in the long term and new strategies need to be developed to achieve this goal. We aimed to evaluate the efficacy of substituting a low-calorie diet formula for a meal in a weight loss program during the maintenance phase. Randomized paralleled clinical trial including 62 adult patients with at least a 5% weight loss with diet alone for 6 months, randomized to two groups: daily replacement of one meal with a low-calorie diet formula, or dieting alone for another 6 months (weight maintenance phase). Weight maintenance or further weight loss occurred in 83.9% of patients in the intervention group, whereas only in 58.1% in the control group (P=0.025). As a whole, patients in the intervention group lost a further 3.2+/-3.7% of initial weight compared with a 1.3+/-3.6% in the control group (P=0.030). Body fat mass diminished in both groups, with no differences between them (1.6+/-3.5 vs 1.0+/-9.3 kg, respectively, P=0.239), and the same happened with free fat mass (0.9+/-3.3 vs 0.4+/-6.7 kg, respectively, P=0.471). A multivariate logistic regression analysis (R (2)=0.114, P=0.023) retained only the intervention as a predictor of the achievement of weight maintenance with an odds ratio (95% confidence interval) of 3.756 (1.138-12.391). Substitution of a low-calorie diet formula for a meal is an effective measure for weight loss maintenance compared with dieting alone.

Weight Maintenance with Litramine (IQP-G-002AS): A 24-Week Double-Blind, Randomized, Placebo-Controlled Study

PubMed Central

Grube, Barbara; Alt, Felix; Uebelhack, Ralf

2015-01-01

Background. Litramine (IQP-G-002AS) was shown to be effective and safe for weight loss in overweight and obese subjects. However, long-term effectiveness on maintenance of body weight loss has yet to be ascertained. Objective. To assess effect of Litramine on maintenance of body weight loss. Methods. A double-blind, randomised, placebo-controlled trial on overweight and obese patients was conducted over two sites in Germany for 24 weeks. Subjects with documented previous weight loss of 3% over the last 3–6 months were randomised to groups given either Litramine (3 g/day) or a matching placebo. Primary endpoints were difference of mean body weight (kg) between baseline and end of study and maintenance of initially lost body weight in verum group, where maintenance is defined as ≤1% weight gain. Results. Subjects who were taking Litramine lost significantly more body weight compared to the subjects taking placebo who gained weight instead (−0.62 ± 1.55 kg versus 1.62 ± 1.48 kg, p < 0.001). More importantly, 92% of subjects in Litramine group were able to maintain their body weight after initial weight loss, versus 25% in placebo group. No serious adverse events were reported throughout. Conclusion. Litramine is effective and safe for long-term body weight maintenance. Trial Registration. This trial is registered with Clinicaltrials.gov identifier: NCT01505387. PMID:26435849

The effect of training in reduced energy density eating and food self-monitoring accuracy on weight loss maintenance.

PubMed

Lowe, Michael R; Tappe, Karyn A; Annunziato, Rachel A; Riddell, Lynnette J; Coletta, Maria C; Crerand, Canice E; Didie, Elizabeth R; Ochner, Christopher N; McKinney, Shortie

2008-09-01

Failure to maintain weight losses in lifestyle change programs continues to be a major problem and warrants investigation of innovative approaches to weight control. The goal of this study was to compare two novel group interventions, both aimed at improving weight loss maintenance, with a control group. A total of 103 women lost weight on a meal replacement-supplemented diet and were then randomized to one of three conditions for the 14-week maintenance phase: cognitive-behavioral treatment (CBT); CBT with an enhanced food monitoring accuracy (EFMA) program; or these two interventions plus a reduced energy density eating (REDE) program. Assessments were conducted periodically through an 18-month postintervention. Outcome measures included weight and self-reported dietary intake. Data were analyzed using completers only as well as baseline-carried-forward imputation. Participants lost an average of 7.6 +/- 2.6 kg during the weight loss phase and 1.8 +/- 2.3 kg during the maintenance phase. Results do not suggest that the EFMA intervention was successful in improving food monitoring accuracy. The REDE group decreased the energy density (ED) of their diets more so than the other two groups. However, neither the REDE nor the EFMA condition showed any advantage in weight loss maintenance. All groups regained weight between 6- and 18-month follow-ups. Although no incremental weight maintenance benefit was observed in the EFMA or EFMA + REDE groups, the improvement in the ED of the REDE group's diet, if shown to be sustainable in future studies, could have weight maintenance benefits.

Behaviours associated with weight loss maintenance and regaining in a Mediterranean population sample. A qualitative study.

PubMed

Karfopoulou, E; Mouliou, K; Koutras, Y; Yannakoulia, M

2013-10-01

In the US, the National Weight Control Registry revealed lifestyle behaviours shared by weight loss maintainers. In the US and the UK, qualitative studies compared the experiences of weight loss maintainers and regainers. High rates of physical activity, a low-energy/low-fat diet, weight self-monitoring, breakfast consumption and flexible control of eating are well-established maintenance behaviours. The Mediterranean lifestyle has not been studied relative to weight loss maintenance. This study focused on a sample of Greek maintainers and regainers. Maintainers emphasized home-cooked meals; their diet does not appear to be low-fat, as home-cooked Greek meals are rich in olive oil. Having a small dinner is a common strategy among maintainers. Health motives were not mentioned by maintainers. Maintainers, but not regainers, appeared to compensate for emotional eating. Weight loss maintenance is imperative to successful obesity treatment. We qualitatively explored lifestyle behaviours associated with weight regulation, in a sample of Greek volunteers who had lost weight and either maintained or regained it. A 10% intentional loss maintained for at least one year was considered successful maintenance. Volunteers (n = 44, 41% men) formed eight focus groups, four of maintainers and four of regainers. Questions regarded weight loss, weight maintenance or regaining, and beliefs on weight maintenance and regaining. All discussions were tape recorded. Maintainers lost weight on their own, whereas regainers sought professional help. Maintainers exercised during both the loss and maintenance phases, whereas regainers showed inconsistent physical activity levels. Health motives for weight loss were mentioned only by regainers. Emotional eating was a common barrier, but only maintainers compensated for it. Maintainers continuously applied specific strategies to maintain their weight: emphasizing home-cooked meals, high eating frequency, a small dinner, portion size regulation, and sweets' intake regulation. Regainers considered the behaviours leading to weight loss different from their normal lifestyle, and resumed their old habits when the diet was over. However, both groups believed that for long-term success, lifestyle changes need to be permanent. © 2013 The Authors. Clinical Obesity © 2013 International Association for the Study of Obesity.

The effect of a low-fat, high-protein or high-carbohydrate ad libitum diet on weight loss maintenance and metabolic risk factors.

PubMed

Claessens, M; van Baak, M A; Monsheimer, S; Saris, W H M

2009-03-01

High-protein (HP) diets are often advocated for weight reduction and weight loss maintenance. The aim was to compare the effect of low-fat, high-carbohydrate (HC) and low-fat, HP ad libitum diets on weight maintenance after weight loss induced by a very low-calorie diet, and on metabolic and cardiovascular risk factors in healthy obese subjects. Forty-eight subjects completed the study that consisted of an energy restriction period of 5-6 weeks followed by a weight maintenance period of 12 weeks. During weight maintenance subjects received maltodextrin (HC group) or protein (HP group) (casein (HPC subgroup) or whey (HPW subgroup)) supplements (2 x 25 g per day), respectively and consumed a low-fat diet. Subjects in the HP diet group showed significantly better weight maintenance after weight loss (2.3 kg difference, P=0.04) and fat mass reduction (2.2 kg difference, P=0.02) than subjects in the HC group. Triglyceride (0.6 mM difference, P=0.01) and glucagon (9.6 pg ml(-1) difference, P=0.02) concentrations increased more in the HC diet group, while glucose (0.3 mM difference, P=0.02) concentration increased more in the HP diet group. Changes in total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, insulin, HOMAir index, HbA1c, leptin and adiponectin concentrations did not differ between the diets. No differences were found between the casein- or whey-supplemented HP groups. These results show that low-fat, high-casein or whey protein weight maintenance diets are more effective for weight control than low-fat, HC diets and do not adversely affect metabolic and cardiovascular risk factors in weight-reduced moderately obese subjects without metabolic or cardiovascular complications.

Translational research: bridging the gap between long-term weight loss maintenance research and practice.

PubMed

Akers, Jeremy D; Estabrooks, Paul A; Davy, Brenda M

2010-10-01

The number of US adults classified as overweight or obese has dramatically increased in the past 25 years, resulting in a significant body of research addressing weight loss and weight loss maintenance. However, little is known about the potential of weight loss maintenance interventions to be translated into actual practice settings. Thus, the purpose of this article is to determine the translation potential of published weight loss maintenance intervention studies by determining the extent to which they report information across the reach, efficacy/effectiveness, adoption, implementation, and maintenance (RE-AIM) framework. A secondary purpose is to provide recommendations for research based on these findings. To identify relevant research articles, a literature search was conducted using four databases; 19 weight loss maintenance intervention studies were identified for inclusion. Each article was evaluated using the RE-AIM Coding Sheet for Publications to determine the extent to which dimensions related to internal and external validity were reported. Approximately half of the articles provided information addressing three RE-AIM dimensions, yet only a quarter provided information addressing adoption and maintenance. Significant gaps were identified in understanding external validity, and metrics that could facilitate the translation of these interventions from research to practice are presented. Based upon this review, it is unknown how effective weight loss maintenance interventions could be in real-world situations, such as clinical or community practice settings. Future studies should be planned to address how weight loss maintenance intervention programs will be adopted and maintained, with special attention to costs for participants and for program implementation. Copyright © 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Lessons learned about primary weight maintenance and secondary weight maintenance: results from a qualitative study.

PubMed

Reilly, Ann; Mawn, Barbara; Susta, Davide; Staines, Anthony; Browne, Sarah; Sweeney, Mary Rose

2015-06-24

Obesity is now a worldwide problem and Ireland is no exception with approximately two thirds of the adult population now overweight or obese. A recent report has found that 53% of Irish adults aged 50 years and over are classified as centrally obese and at substantially increased risk of metabolic complications. While most studies investigating weight maintenance have been conducted on those who have managed to lose weight and/or achieved weight loss maintenance (secondary weight maintainers), few studies have been undertaken to understand the attitudes, behaviours, motivations and strategies of those who maintain their weight within normal weight ranges over their lifetime, so called primary weight maintainers. This study aims to explore this issue through qualitative exploration of primary weight maintainers in an Irish University. Seven focus groups were conducted (including three single interviews) with 17 participants in total across three different groups, 1) primary weight maintainers, 2) secondary weight maintainers, and 3) those unable to sustain or achieve weight loss. The interviews were transcribed and thematic analysis was applied to interpret the findings. After analyzing the participant's interviews, planning and organization or lack of, emerged as themes across the three groups in varying degrees. Strategizing, perseverance and willpower were seen as integral to weight maintenance and weight loss in groups one and two, these were lacking in group three. Prioritizing exercise and perseverance in maintaining a high level of activity was evident in groups one and two and was lacking in group three. Motivational influences were equal across the groups however, group three found it difficult to turn this into action. Group one had behavioural control of calorie intake maintaining a balance between week and weekend eating. Group three found it difficult to control calorie intake and portion size. Self-image differed across the three groups with cognitive dissonance evident amongst those in group three. This study showed that there are many factors that influence primary weight maintenance. Considering that we live in a society that is predominantly sedentary, predominantly overweight and with poor food choice options facing us every day, fighting our way through to ensure healthy weight maintenance requires active, conscious efforts. The factors identified in this study which are important in healthy weight maintenance are all potentially modifiable with life-coach, nutrition, exercise and cognitive interventions particularly if peer support and a whole family approach are incorporated.

A randomized controlled trial testing an Internet delivered cost-benefit approach to weight loss maintenance.

PubMed

Leahey, Tricia M; Fava, Joseph L; Seiden, Andrew; Fernandes, Denise; Doyle, Caroline; Kent, Kimberly; La Rue, Molly; Mitchell, Marc; Wing, Rena R

2016-11-01

Weight loss maintenance is a significant challenge in obesity treatment. During maintenance the "costs" of adhering to weight management behaviors may outweigh the "benefits." This study examined the efficacy of a novel approach to weight loss maintenance based on modifying the cost-benefit ratio. Individuals who achieved a 5% weight loss (N=75) were randomized to one of three, 10-month maintenance interventions. All interventions were delivered primarily via the Internet. The Standard arm received traditional weight maintenance strategies. To increase benefits, or rewards, for maintenance behaviors, the two cost-benefit intervention conditions received weekly monetary rewards for self-monitoring and social reinforcement via e-coaching. To decrease behavioral costs (boredom) and increase novelty, participants in the cost-benefit conditions also monitored different evidence-based behaviors every two weeks (e.g., Weeks 1 & 2: steps; Week 3 & 4: red foods). The primary difference between the cost-benefit interventions was type of e-coach providing social reinforcement: Professional (CB Pro) or Peer (CB Peer). Study procedures took place in Providence, RI from 2013 to 2014. Retention was 99%. There were significant group differences in weight regain (p=.01). The Standard arm gained 3.5±5.7kg. In contrast, participants in CB Pro and CB Peer lost an additional 1.8±7.0kg and 0.5±6.4kg, respectively. These results suggest that an Internet delivered cost-benefit approach to weight loss maintenance may be effective for long-term weight control. In addition, using peer coaches to provide reinforcement may be a particularly economic alternative to professionals. These data are promising and provide support for a larger, longer trial. Copyright © 2016 Elsevier Inc. All rights reserved.

A randomized controlled trial testing an Internet delivered cost-benefit approach to weight loss maintenance

PubMed Central

Leahey, Tricia M.; Fava, Joseph L.; Seiden, Andrew; Fernandes, Denise; Doyle, Caroline; Kent, Kimberly; La Rue, Molly; Mitchell, Marc; Wing, Rena R.

2016-01-01

Weight loss maintenance is a significant challenge in obesity treatment. During maintenance the “costs” of adhering to weight management behaviors may outweigh the “benefits.” This study examined the efficacy of a novel approach to weight loss maintenance based on modifying the cost-benefit ratio. Individuals who achieved a 5% weight loss (N=75) were randomized to one of three, 10-month maintenance interventions. All interventions were delivered primarily via the Internet. The Standard arm received traditional weight maintenance strategies. To increase benefits, or rewards, for maintenance behaviors, the two cost-benefit intervention conditions received weekly monetary rewards for self-monitoring and social reinforcement via e-coaching. To decrease behavioral costs (boredom) and increase novelty, participants in the cost-benefit conditions also monitored different evidence-based behaviors every two weeks (e.g., Weeks 1 & 2: steps; Week 3 & 4: red foods). The primary difference between the cost-benefit interventions was type of e-coach providing social reinforcement: Professional (CB Pro) or Peer (CB Peer). Study procedures took place in Providence, RI from 2013–2014. Retention was 99%. There were significant group differences in weight regain (p=.01). The Standard arm gained 3.5±5.7kg. In contrast, participants in CB Pro and CB Peer lost an additional 1.8±7.0kg and 0.5±6.4kg, respectively. These results suggest that an Internet delivered cost-benefit approach to weight loss maintenance may be effective for long-term weight control. In addition, using peer coaches to provide reinforcement may be a particularly economic alternative to professionals. These data are promising and provide support for a larger, longer trial. Clinicaltrials.gov Identifier NCT01760486 PMID:27095323

Acceptability of financial incentives for maintenance of weight loss in mid-older adults: a mixed methods study.

PubMed

McGill, Bronwyn; O'Hara, Blythe J; Grunseit, Anne C; Bauman, Adrian; Osborne, Dale; Lawler, Luke; Phongsavan, Philayrath

2018-02-13

Health insurers worldwide implement financial incentive schemes to encourage health-related behaviours, including to facilitate weight loss. The maintenance of weight loss is a public health challenge, and as non-communicable diseases become more prevalent with increasing age, mid-older adults could benefit from programs which motivate weight loss maintenance. However, little is understood about their perceptions of using financial incentives to maintain weight loss. We used mixed methods to explore the attitudes and views of participants who had completed an Australian weight loss and lifestyle modification program offered to overweight and obese health insurance members with weight-related chronic diseases, about the acceptability and usefulness of different types of financial incentives to support weight loss maintenance. An online survey was completed by 130 respondents (mean age = 64 years); and a further 28 participants (mean age = 65 years) attended six focus groups. Both independent samples of participants supported a formalised maintenance program. Online survey respondents reported that non-cash (85.2%) and cash (77%) incentives would be potentially motivating; but only 40.5% reported that deposit contracts would motivate weight loss maintenance. Results of in-depth discussions found overall low support for any type of financial incentive, but particularly deposit contracts and lotteries. Some participants expressed that improved health was of more value than a monetary incentive and that they felt personally responsible for their own health, which was at odds with the idea of financial incentives. Others suggested ongoing program and peer support as potentially useful for weight loss maintenance. If financial incentives are considered for mid-older Australian adults in the health insurance setting, program planners will need to balance the discordance between participant beliefs about the individual responsibility for health and their desire for external supports to motivate and sustain weight loss maintenance.

Weight Suppression Predicts Maintenance and Onset of Bulimic Syndromes at 10-Year Follow-up

PubMed Central

Keel, Pamela K.; Heatherton, Todd F.

2010-01-01

Conflicting results have emerged regarding the prognostic significance of weight suppression for maintenance of bulimic symptoms. This study examined whether the magnitude of weight suppression would predict bulimic syndrome maintenance and onset in college-based samples of men (n=369) and women (n=968) at 10-year follow-up. Data come from a longitudinal study of body weight and disordered eating with high retention (80%). Among those with a bulimic syndrome at baseline, greater weight suppression significantly predicted maintenance of the syndrome, and, among those without a bulimic syndrome at baseline, greater weight suppression predicted onset of a bulimic syndrome at 10-year follow-up in multivariate models that included baseline body mass index, diet frequency, and weight perception. Future research should address mechanisms that could account for the effects of weight suppression over a long duration of follow-up. PMID:20455599

Maintenance of energy expenditure on high-protein vs. high-carbohydrate diets at a constant body weight may prevent a positive energy balance.

PubMed

Martens, E A; Gonnissen, H K; Gatta-Cherifi, B; Janssens, P L; Westerterp-Plantenga, M S

2015-10-01

Relatively high-protein diets are effective for body weight loss, and subsequent weight maintenance, yet it remains to be shown whether these diets would prevent a positive energy balance. Therefore, high-protein diet studies at a constant body weight are necessary. The objective was to determine fullness, energy expenditure, and macronutrient balances on a high-protein low-carbohydrate (HPLC) diet compared with a high-carbohydrate low-protein (HCLP) diet at a constant body weight, and to assess whether effects are transient or sustained after 12 weeks. A randomized parallel study was performed in 14 men and 18 women [mean ± SD age: 24 ± 5 y; BMI (in kg/m(2)): 22.8 ± 2.0] on diets containing 30/35/35 (HPLC) or 5/60/35 (HCLP) % of energy from protein/carbohydrate/fat. Significant interactions between dietary intervention and time on total energy expenditure (TEE) (P = 0.013), sleeping metabolic rate (SMR) (P = 0.040), and diet-induced thermogenesis (DIT) (P = 0.027) appeared from baseline to wk 12. TEE was maintained in the HPLC diet group, while it significantly decreased throughout the intervention period in the HCLP diet group (wk 1: P = 0.002; wk 12: P = 0.001). Energy balance was maintained in the HPLC diet group, and became positive in the HCLP diet group at wk 12 (P = 0.008). Protein balance varied directly according to the amount of protein in the diet, and diverged significantly between the diets (P = 0.001). Fullness ratings were significantly higher in the HPLC vs. the HCLP diet group at wk 1 (P = 0.034), but not at wk 12. Maintenance of energy expenditure on HPLC vs. HCLP diets at a constant body weight may prevent development of a positive energy balance, despite transiently higher fullness. The study was registered on clinicaltrials.gov with Identifier: NCT01551238. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Study design and protocol for a theory-based behavioral intervention focusing on maintenance of weight loss: the Maintenance After Initiation of Nutrition TrAINing (MAINTAIN) study.

PubMed

Voils, Corrine I; Gierisch, Jennifer M; Olsen, Maren K; Maciejewski, Matthew L; Grubber, Janet; McVay, Megan A; Strauss, Jennifer L; Bolton, Jamiyla; Gaillard, Leslie; Strawbridge, Elizabeth; Yancy, William S

2014-09-01

Obesity is a significant public health problem. Although various lifestyle approaches are effective for inducing significant weight loss, few effective behavioral weight maintenance strategies have been identified. It has been proposed that behavior maintenance is a distinct state that involves different psychological processes and behavioral skills than initial behavior change. Previously, we created a conceptual model that distinguishes behavior initiation from maintenance. This model was used to generate Maintenance After Initiation of Nutrition TrAINing (MAINTAIN), an intervention to enhance weight loss maintenance following initiation. The effectiveness of MAINTAIN is being evaluated in an ongoing trial, the rationale and procedures of which are reported herein. Veterans aged ≤ 75 with body mass index ≥ 30 kg/m(2) participate in a 16-week, group-based weight loss program. Participants who lose ≥ 4 kg by the end of 16 weeks (target n = 230) are randomized 1:1 to receive (a) usual care for 56 weeks or (b) MAINTAIN, a theoretically-informed weight loss maintenance intervention for 40 weeks, followed by 16 weeks of no intervention contact. MAINTAIN involves 3 in-person group visits that transition to 8 individualized telephone calls with decreasing contact frequency. MAINTAIN focuses on satisfaction with outcomes, weight self-monitoring, relapse prevention, and social support. We hypothesize that, compared to usual care, MAINTAIN will result in at least 3.5 kg less regain and better relative levels of caloric intake and physical activity over 56 weeks, and that it will be cost-effective. If effective, MAINTAIN could serve as a model for redesigning existing weight loss programs. NCT01357551. Published by Elsevier Inc.

Associations of internet website use with weight change in a long-term weight loss maintenance program.

PubMed

Funk, Kristine L; Stevens, Victor J; Appel, Lawrence J; Bauck, Alan; Brantley, Phillip J; Champagne, Catherine M; Coughlin, Janelle; Dalcin, Arlene T; Harvey-Berino, Jean; Hollis, Jack F; Jerome, Gerald J; Kennedy, Betty M; Lien, Lillian F; Myers, Valerie H; Samuel-Hodge, Carmen; Svetkey, Laura P; Vollmer, William M

2010-07-27

The Weight Loss Maintenance Trial (WLM) compared two long-term weight-maintenance interventions, a personal contact arm and an Internet arm, with a no-treatment control after an initial six-month Phase I weight loss program. The Internet arm focused on use of an interactive website for support of long-term weight maintenance. There is limited information about patterns of website use and specific components of an interactive website that might help promote maintenance of weight loss. This paper presents a secondary analysis of the subset of participants in the Internet arm and focuses on website use patterns and features associated with long-term weight maintenance. Adults at risk for cardiovascular disease (CVD) who lost at least 4 kilograms in an initial 20-week group-based, behavioral weight-loss program were trained to use an interactive website for weight loss maintenance. Of the 348 participants, 37% were male and 38% were African American. Mean weight loss was 8.6 kilograms. Participants were encouraged to log in at least weekly and enter a current weight for the 30-month study period. The website contained features that encouraged setting short-term goals, creating action plans, and reinforcing self-management habits. The website also included motivational modules, daily tips, and tailored messages. Based on log-in and weight-entry frequency, we divided participants into three website use categories: consistent, some, and minimal. Participants in the consistent user group (n = 212) were more likely to be older (P = .002), other than African American (P = .02), and more educated (P = .01). While there was no significant difference between website use categories in the amount of Phase I change in body weight (P = .45) or income (P = .78), minimal website users (n = 75) were significantly more likely to have attended fewer Phase I sessions (P = .001) and had a higher initial body mass index (BMI) (P < .001). After adjusting for baseline characteristics including initial BMI, variables most associated with less weight regain included: number of log-ins (P = .001), minutes on the website (P < .001), number of weight entries (P = .002), number of exercise entries (P < .001), and sessions with additional use of website features after weight entry (P = .002). Participants defined as consistent website users of an interactive behavioral website designed to promote maintenance of weight loss were more successful at maintaining long-term weight loss. NCT00054925; http://clinicaltrials.gov/ct2/show/NCT00054925 (Archived by WebCite at http://www.webcitation.org/5rC7523ue).

Weight control behaviors of highly successful weight loss maintainers: the Portuguese Weight Control Registry.

PubMed

Santos, Inês; Vieira, Paulo N; Silva, Marlene N; Sardinha, Luís B; Teixeira, Pedro J

2017-04-01

To describe key behaviors reported by participants in the Portuguese Weight Control Registry and to determine associations between these behaviors and weight loss maintenance. A total of 388 adults participated in this cross-sectional study. Assessments included demographic information, weight history, weight loss and weight maintenance strategies, dietary intake, and physical activity. Participants lost on average 18 kg, which they had maintained for ~28 months. Their average dietary intake was 2199 kcal/day, with 33 % of energy coming from fat. About 78 % of participants engaged in levels of moderate-plus-vigorous physical activity exceeding 150 min/week (51 % above 250 min/week), with men accumulating 82 more minutes than women (p < 0.05). The most frequently reported strategies for both weight loss and maintenance were keeping healthy foods at home, consuming vegetables regularly, and having daily breakfast. Greater weight loss maintenance was associated with higher levels of physical activity, walking, weight self-monitoring, establishing specific goals, and with reduced portion size use, reduced consumption of carbohydrates, and increased consumption of protein, (p < 0.05). Results indicate that weight loss maintenance is possible through the adoption of a nutritionally-balanced diet and regular participation in physical activity, but also suggest that adopting different (and, to a degree, individualized) set of behavioral strategies is key for achieving success.

System Model Network for Adipose Tissue Signatures Related to Weight Changes in Response to Calorie Restriction and Subsequent Weight Maintenance

PubMed Central

Montastier, Emilie; Villa-Vialaneix, Nathalie; Caspar-Bauguil, Sylvie; Hlavaty, Petr; Tvrzicka, Eva; Gonzalez, Ignacio; Saris, Wim H. M.; Langin, Dominique; Kunesova, Marie; Viguerie, Nathalie

2015-01-01

Nutrigenomics investigates relationships between nutrients and all genome-encoded molecular entities. This holistic approach requires systems biology to scrutinize the effects of diet on tissue biology. To decipher the adipose tissue (AT) response to diet induced weight changes we focused on key molecular (lipids and transcripts) AT species during a longitudinal dietary intervention. To obtain a systems model, a network approach was used to combine all sets of variables (bio-clinical, fatty acids and mRNA levels) and get an overview of their interactions. AT fatty acids and mRNA levels were quantified in 135 obese women at baseline, after an 8-week low calorie diet (LCD) and after 6 months of ad libitum weight maintenance diet (WMD). After LCD, individuals were stratified a posteriori according to weight change during WMD. A 3 steps approach was used to infer a global model involving the 3 sets of variables. It consisted in inferring intra-omic networks with sparse partial correlations and inter-omic networks with regularized canonical correlation analysis and finally combining the obtained omic-specific network in a single global model. The resulting networks were analyzed using node clustering, systematic important node extraction and cluster comparisons. Overall, AT showed both constant and phase-specific biological signatures in response to dietary intervention. AT from women regaining weight displayed growth factors, angiogenesis and proliferation signaling signatures, suggesting unfavorable tissue hyperplasia. By contrast, after LCD a strong positive relationship between AT myristoleic acid (a fatty acid with low AT level) content and de novo lipogenesis mRNAs was found. This relationship was also observed, after WMD, in the group of women that continued to lose weight. This original system biology approach provides novel insight in the AT response to weight control by highlighting the central role of myristoleic acid that may account for the beneficial effects of weight loss. PMID:25590576

Shared weight and dietary changes in parent-child dyads following family-based obesity treatment.

PubMed

Best, John R; Goldschmidt, Andrea B; Mockus-Valenzuela, Danyte S; Stein, Richard I; Epstein, Leonard H; Wilfley, Denise E

2016-01-01

The primary objective was to determine whether children and their participating parents undergoing family-based behavioral treatment (FBT) for obesity show similar dietary changes following treatment, and if so, whether these shared dietary changes explain the similarity in weight change within the parent-child dyad. Data come from a randomized controlled trial of 148 parent-child dyads who completed FBT and were followed over a 2-year maintenance phase. Energy-dense, nutrient-poor foods ("RED" foods) and fruit and vegetable intake were assessed across time. Maintenance of lower RED food intake following FBT predicted weight maintenance in children and in parents (ps < .01), and dietary and weight changes were correlated within parent-child dyads (ps < .01). Most interesting, the similarity in long-term weight maintenance between children and their parents was predicted by the similarity in long-term changes in RED food intake between children and their parents (p < .001). These findings point to the important role of maintaining low energy-dense, nutrient-poor food intake for long-term weight maintenance in children and parents. Furthermore, these results suggest that the correlation between parent and child weight maintenance can be explained in part by similar long-term changes in energy-dense, nutrient-poor food intake. (c) 2015 APA, all rights reserved).

Dietary intakes associated with successful weight loss and maintenance during the Weight Loss Maintenance Trial

PubMed Central

Champagne, Catherine M.; Broyles, Stephanie T; Moran, Laura D.; Cash, Katherine C.; Levy, Erma J.; Lin, Pao-Hwa; Batch, Bryan C.; Lien, Lillian F.; Funk, Kristine L.; Dalcin, Arlene; Loria, Catherine; Myers, Valerie H.

2011-01-01

Background Dietary components effective in weight maintenance efforts have not been adequately identified. Objective To determine impact of changes in dietary consumption on weight loss and maintenance during the Weight Loss Maintenance (WLM) clinical trial. Design WLM was a randomized controlled trial. Successful weight loss participants who completed Phase I of the trial and lost 4kg were randomized to one of three maintenance intervention arms in Phase II and followed for an additional 30 months. Participants/setting The multicenter trial was conducted from 2003–2007. This substudy included 828 successful weight loss participants. Methods Dietary Measures The Block Food Frequency Questionnaire (FFQ) was used to assess nutrient intake levels and food group servings. Carbohydrates, proteins, fats, dietary fiber and fruit/vegetable and dairy servings were utilized as predictor variables. Data collection The FFQ was collected on all participants at study entry (beginning of Phase I). Those randomized to Phase II completed the FFQ at three additional time points; randomization (beginning of Phase II), 12 and 30 months. Intervention The main intervention focused on long term maintenance of weight loss using the Dietary Approaches to Hypertension (DASH) diet. This substudy examined whether changes to specific dietary variables were associated with weight loss and maintenance. Statistical analyses performed Linear regression models that adjusted for change in total energy examined the relationship between changes in dietary intake and weight for each time period. Site, age, race, sex, and a race-sex interaction were included as covariates. Results Participants who substituted protein for fat lost, on average, 0.33 kg per 6-months during Phase I (p<0.0001) and 0.07 kg per 6-months during Phase II (p<0.0001) per 1% increase in protein. Increased intake of fruits and vegetables was associated with weight loss in Phases I and II: 0.29 kg per 6-months (p<0.0001) and 0.04 kg per 6-months (p=0.0062), respectively, per 1-serving increase. Substitution of carbohydrates for fat and protein for carbohydrates were associated with weight loss during both phases. Increasing dairy intake was associated with significant weight loss during Phase II (−0.17 kg per 6-months per 1-serving increase, p=0.0002), but not in Phase I. Dietary fiber revealed no significant findings. Conclusion Increasing fruits, vegetables, and low-fat dairy may help achieve weight loss and maintenance. PMID:22117658

How strongly does appetite counter weight loss? Quantification of the feedback control of human energy intake

PubMed Central

Polidori, David; Sanghvi, Arjun; Seeley, Randy; Hall, Kevin D.

2016-01-01

Objective To quantify the feedback control of energy intake in response to long-term covert manipulation of energy balance in free-living humans. Methods We used a validated mathematical method to calculate energy intake changes during a 52 week placebo-controlled trial in 153 patients treated with canagliflozin, a sodium glucose co-transporter inhibitor that increases urinary glucose excretion thereby resulting in weight loss without patients being directly aware of the energy deficit. We analyzed the relationship between the body weight time course and the calculated energy intake changes using principles from engineering control theory. Results We discovered that weight loss leads to a proportional increase in appetite resulting in eating above baseline by ~100 kcal/day per kg of lost weight – an amount more than 3-fold larger than the corresponding energy expenditure adaptations. Conclusions While energy expenditure adaptations are often thought to be the main reason for slowing of weight loss and subsequent regain, feedback control of energy intake plays an even larger role and helps explain why long-term maintenance of a reduced body weight is so difficult. PMID:27804272

Relationship between volition, physical activity and weight loss maintenance: Study rationale, design, methods and baseline characteristics.

PubMed

Dandanell, Sune; Elbe, Anne-Marie; Pfister, Gertrud; Elsborg, Peter; W Helge, Jørn

2017-05-01

To investigate the relationship between volition, physical activity and weight loss maintenance. We recruited 84 sedentary (maximal oxygen uptake: 25 ± 5 ml/min), overweight and obese (Body mass index (BMI) 38 ± 7 m/h 2 , fat 44 ± 7 %) women ( n = 55) and men ( n = 29) for an interdisciplinary prospective study with follow-up. The change in lifestyle and weight loss is promoted via a 3-month intensive lifestyle intervention at a private health school. The intervention consists of supervised training (1-3 hours/day), a healthy hypo-caloric diet (-500 to -700 kCal/day) and education in healthy lifestyle in classes/groups. The participants' body weight and composition (Dual Energy X-ray absorptiometry), volitional skills (questionnaire), physical activity level (heart rate accelerometer/questionnaire) and maximal oxygen uptake (indirect calorimetry) are to be monitored before, after, and 3 and 12 months after the intervention. At the 12-month follow-up, three different groups will be established: Clinical weight loss maintenance (> 10% weight loss from baseline), moderate weight loss maintenance (1-10% weight loss) and no weight loss (or weight regain). A linear mixed model analysis will be used to compare levels of volitional skills, physical activity and maximal oxygen uptake over time, between the three groups. Correlational analyses will be used to investigate possible associations between volition, maximal oxygen uptake, physical activity level and weight loss maintenance. If specific volitional skills are identified as predictors of adherence to physical activity and success in clinical weight loss maintenance, these can be trained in future intensive lifestyle interventions in order to optimize the success rate.

A randomized study of dietary composition during weight-loss maintenance: Rationale, study design, intervention, and assessment

USDA-ARS?s Scientific Manuscript database

While many people with overweight or obesity can lose weight temporarily, most have difficulty maintaining weight loss over the long term. Studies of dietary composition typically focus on weight loss, rather than weight-loss maintenance, and rely on nutrition education and dietary counseling, rathe...

Caffeine Citrate Dosing Adjustments to Assure Stable Caffeine Concentrations in Preterm Neonates.

PubMed

Koch, Gilbert; Datta, Alexandre N; Jost, Kerstin; Schulzke, Sven M; van den Anker, John; Pfister, Marc

2017-12-01

To identify dosing strategies that will assure stable caffeine concentrations in preterm neonates despite changing caffeine clearance during the first 8 weeks of life. A 3-step simulation approach was used to compute caffeine doses that would achieve stable caffeine concentrations in the first 8 weeks after birth: (1) a mathematical weight change model was developed based on published weight distribution data; (2) a pharmacokinetic model was developed based on published models that accounts for individual body weight, postnatal, and gestational age on caffeine clearance and volume of distribution; and (3) caffeine concentrations were simulated for different dosing regimens. A standard dosing regimen of caffeine citrate (using a 20 mg/kg loading dose and 5 mg/kg/day maintenance dose) is associated with a maximal trough caffeine concentration of 15 mg/L after 1 week of treatment. However, trough concentrations subsequently exhibit a clinically relevant decrease because of increasing clearance. Model-based simulations indicate that an adjusted maintenance dose of 6 mg/kg/day in the second week, 7 mg/kg/day in the third to fourth week and 8 mg/kg/day in the fifth to eighth week assures stable caffeine concentrations with a target trough concentration of 15 mg/L. To assure stable caffeine concentrations during the first 8 weeks of life, the caffeine citrate maintenance dose needs to be increased by 1 mg/kg every 1-2 weeks. These simple adjustments are expected to maintain exposure to stable caffeine concentrations throughout this important developmental period and might enhance both the short- and long-term beneficial effects of caffeine treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

Weight maintenance: challenges, tools and strategies for primary care physicians[Link

PubMed Central

Soleymani, T.; Daniel, S.

2015-01-01

Summary Obesity is recognized as a chronic disease and one of the major healthcare challenges facing us today. Weight loss can be achieved via lifestyle, pharmacological and surgical interventions, but weight maintenance remains a lifetime challenge for individuals with obesity. Guidelines for the management of obesity have highlighted the role of primary care providers (PCPs). This review examines the long‐term outcomes of clinical trials to identify effective weight maintenance strategies that can be utilized by PCPs. Because of the broad nature of the topic, a structured PubMed search was conducted to identify relevant research articles, peer‐reviewed reviews, guidelines and articles published by regulatory bodies. Trials have demonstrated the benefit of sustained weight loss in managing obesity and its comorbidities. Maintaining 5–10% weight loss for ≥1 year is known to ameliorate many comorbidities. Weight maintenance with lifestyle modification – although challenging – is possible but requires long‐term support to reinforce diet, physical activity and behavioural changes. The addition of pharmacotherapy to lifestyle interventions promotes greater and more sustained weight loss. Clinical evidence and recently approved pharmacotherapy has given PCPs improved strategies to support their patients with maintenance of weight loss. Further studies are needed to assess the translation of these strategies into clinical practice. PMID:26490059

Recruitment and Retention for a Weight Loss Maintenance Trial Involving Weight Loss Prior to Randomization

PubMed Central

Grubber, J. M.; McVay, M. A.; Olsen, M. K.; Bolton, J.; Gierisch, J. M.; Taylor, S. S.; Maciejewski, M. L.; Yancy, W. S.

2016-01-01

Abstract Objective A weight loss maintenance trial involving weight loss prior to randomization is challenging to implement due to the potential for dropout and insufficient weight loss. We examined rates and correlates of non‐initiation, dropout, and insufficient weight loss during a weight loss maintenance trial. Methods The MAINTAIN trial involved a 16‐week weight loss program followed by randomization among participants losing at least 4 kg. Psychosocial measures were administered during a screening visit. Weight was obtained at the first group session and 16 weeks later to determine eligibility for randomization. Results Of 573 patients who screened as eligible, 69 failed to initiate the weight loss program. In adjusted analyses, failure to initiate was associated with lower age, lack of a support person, and less encouragement for making dietary changes. Among participants who initiated, 200 dropped out, 82 lost insufficient weight, and 222 lost sufficient weight for randomization. Compared to losing sufficient weight, dropping out was associated with younger age and tobacco use, whereas losing insufficient weight was associated with non‐White race and controlled motivation for physical activity. Conclusions Studies should be conducted to evaluate strategies to maximize recruitment and retention of subgroups that are less likely to initiate and be retained in weight loss maintenance trials. PMID:28090340

Effect of feeding a weight loss food beyond a caloric restriction period on body composition and resistance to weight gain in cats.

PubMed

Floerchinger, Amanda M; Jackson, Matthew I; Jewell, Dennis E; MacLeay, Jennifer M; Hahn, Kevin A; Paetau-Robinson, Inke

2015-08-15

To determine the effect of feeding a food with coconut oil and supplemental L-carnitine, lysine, leucine, and fiber on weight loss and maintenance in cats. Prospective clinical study. 50 overweight cats. The study consisted of 2 trials. During trial 1, 30 cats were allocated to 3 groups (10 cats/group) to be fed a dry maintenance cat food to maintain body weight (group 1) or a dry test food at the same amount on a mass (group 2) or energy (group 3) basis as group 1. During trial 2, each of 20 cats was fed the test food and caloric intake was adjusted to maintain a weight loss rate of 1%/wk (weight loss phase). Next, each cat was fed the test food in an amount calculated to maintain the body weight achieved at the end of the weight loss phase (weight maintenance phase). Cats were weighed and underwent dual-energy x-ray absorptiometry monthly. Metabolomic data were determined before (baseline) and after each phase. During trial 1, cats in groups 2 and 3 lost significantly more weight than did those in group 1. During trial 2, cats lost a significant amount of body weight and fat mass but retained lean body mass during the weight loss phase and continued to lose body weight and fat mass but gained lean body mass during the weight maintenance phase. Evaluation of metabolomic data suggested that fat metabolism was improved from baseline for cats fed the test food. Results suggested that feeding overweight cats the test food caused weight loss and improvements in body condition during the weight maintenance phase, possibly because the food composition improved energy metabolism.

Prospective Relations between Social Comparison Orientation and Weight Loss Outcomes.

PubMed

Arigo, Danielle; Butryn, Meghan L

2018-06-26

Maintenance of weight loss after behavioral intervention tends to be poor, and there is need for an improved understanding of factors that are associated with successful maintenance. Social comparison is known to be a powerful influence on treatment outcomes for group-based behavioral weight loss programs, but little is known about the role of individual differences in social comparison orientation (i.e., tendency to value comparison information) in this context. The goal of this study was to examine prospective relations between social comparison orientation and long-term weight loss outcomes (percent weight loss, aerobic-intensity physical activity) among participants in behavioral weight loss treatment. Participants (n = 161, M Age = 54, M BMI = 34.4░kg/m 2 ) completed a measure of social comparison orientation at pre-treatment baseline. Height and weight were measured in the research center and aerobic-intensity physical activity was assessed via accelerometer at baseline, mid- and end-of-treatment, and at 6 and 12 months post-treatment (representing maintenance). Multilevel models tested prospective relations between comparison orientation and treatment outcomes over time, with emphasis on differences during the post-treatment maintenance phase. Stronger (vs. weaker) general comparison orientation was associated with better maintenance of aerobic-intensity physical activity. However, stronger (vs. weaker) orientation toward comparisons with better-off others (i.e., upward comparison) was associated with less weight loss success during and after treatment. Social comparison orientation thus shows meaningful relations with long-term maintenance of key outcomes in group-based behavioral weight loss treatment, and warrants further investigation in this context.

Similarities and differences between weight loss maintainers and regainers: a qualitative analysis.

PubMed

Reyes, Naomi R; Oliver, Tracy L; Klotz, Alicia A; Lagrotte, Caitlin A; Vander Veur, Stephanie S; Virus, Amy; Bailer, Brooke A; Foster, Gary D

2012-04-01

Obesity is remarkably refractory to treatment. Despite a plethora of quantitative studies, little qualitative research has been conducted on the topic of weight loss maintenance. This study used six focus groups to explore which factors promoted or prevented maintaining weight loss among a diverse, urban population. Eligible participants were those who had intentionally lost ≥10% of their body weight in the past 2 years and were categorized as either "regainers" or "maintainers" using self-reported length of weight maintenance and amount (%) regained. Regainers had regained ≥33% of their weight loss and maintainers had regained ≤15%. Participants (n=29) were predominantly African-American (58.6%) females (65.6%) with a mean age of 46.9±11.2 years. Four themes reflected similarities between regainers and maintainers, and four reflected differences between the groups. Both groups experienced lapses, used clothing fit for feedback on weight status, desired greater support during maintenance, and decreased self-monitoring of food intake over time. When compared with regainers, maintainers more often continued strategies used during weight loss, weighed themselves regularly, and used productive problem-solving skills and positive self-talk. Regainers experienced greater difficulty independently continuing food and exercise behaviors during maintenance, identifying decreased accountability and waning motivation as barriers. These findings suggest that weight loss maintenance efforts can be improved by addressing challenges such as long-term self-monitoring and problem-solving skills, and that maintenance success might depend on how people think as much as what they do. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Brain function predictors and outcome of weight loss and weight loss maintenance.

PubMed

Szabo-Reed, Amanda N; Breslin, Florence J; Lynch, Anthony M; Patrician, Trisha M; Martin, Laura E; Lepping, Rebecca J; Powell, Joshua N; Yeh, Hung-Wen Henry; Befort, Christie A; Sullivan, Debra; Gibson, Cheryl; Washburn, Richard; Donnelly, Joseph E; Savage, Cary R

2015-01-01

Obesity rates are associated with public health consequences and rising health care costs. Weight loss interventions, while effective, do not work for everyone, and weight regain is a significant problem. Eating behavior is influenced by a convergence of processes in the brain, including homeostatic factors and motivational processing that are important contributors to overeating. Initial neuroimaging studies have identified brain regions that respond differently to visual food cues in obese and healthy weight individuals that are positively correlated with reports of hunger in obese participants. While these findings provide mechanisms of overeating, many important questions remain. It is not known whether brain activation patterns change after weight loss, or if they change differentially based on amount of weight lost. Also, little is understood regarding biological processes that contribute to long-term weight maintenance. This study will use neuroimaging in participants while viewing food and non-food images. Functional Magnetic Resonance Imaging will take place before and after completion of a twelve-week weight loss intervention. Obese participants will be followed though a 6-month maintenance period. The study will address three aims: 1. Characterize brain activation underlying food motivation and impulsive behaviors in obese individuals. 2. Identify brain activation changes and predictors of weight loss. 3. Identify brain activation predictors of weight loss maintenance. Findings from this study will have implications for understanding mechanisms of obesity, weight loss, and weight maintenance. Results will be significant to public health and could lead to a better understanding of how differences in brain activation relate to obesity. Copyright © 2014 Elsevier Inc. All rights reserved.

Brain function predictors and outcome of weight loss and weight loss maintenance

PubMed Central

Szabo-Reed, Amanda N.; Breslin, Florence J.; Lynch, Anthony M.; Patrician, Trisha M.; Martin, Laura E.; Lepping, Rebecca J.; Powell, Joshua N.; Yeh, Hung-Wen (Henry); Befort, Christie A.; Sullivan, Debra; Gibson, Cheryl; Washburn, Richard; Donnelly, Joseph E.; Savage, Cary R.

2015-01-01

Obesity rates are associated with public health consequences and rising health care costs. Weight loss interventions, while effective, do not work for everyone, and weight regain is a significant problem. Eating behavior is influenced by a convergence of processes in the brain, including homeostatic factors and motivational processing that are important contributors to overeating. Initial neuroimaging studies have identified brain regions that respond differently to visual food cues in obese and healthy weight individuals that are positively correlated with reports of hunger in obese participants. While these findings provide mechanisms of overeating, many important questions remain. It is not known whether brain activation patterns change after weight loss, or if they change differentially based on amount of weight lost. Also, little is understood regarding biological processes that contribute to long-term weight maintenance. This study will use neuroimaging in participants while viewing food and non-food images. Functional Magnetic Resonance Imaging will take place before and after completion of a twelve-week weight loss intervention. Obese participants will be followed though a 6-month maintenance period. The study will address three aims: 1. Characterize brain activation underlying food motivation and impulsive behaviors in obese individuals. 2. Identify brain activation changes and predictors of weight loss. 3. Identify brain activation predictors of weight loss maintenance. Findings from this study will have implications for understanding mechanisms of obesity, weight loss, and weight maintenance. Results will be significant to public health and could lead to a better understanding of how differences in brain activation relate to obesity. PMID:25533729

Dietary habits and weight maintenance success in high versus low exercisers in the National Weight Control Registry

PubMed Central

Ogden, Lorraine G.; Phelan, Suzanne; Thomas, J. Graham; Hill, James O; Wing, Rena R.; Wyatt, Holly R.

2015-01-01

Background The National Weight Control Registry (NWCR) was established to examine characteristics of successful weight loss maintainers. This study compares the diet and behavioral characteristics and weight regain trajectories of NWCR members with differing physical activity (PA) levels at baseline. Methods Participants (n=3591) were divided into 4 levels of self-reported PA at registry entry (<1000, 1000 to <2250, 2250 to <3500, and ≥3500 kcals/week). We compared self-reported energy intake (EI), macronutrient composition, eating behaviors (dietary restraint, hunger, and disinhibition), weight loss maintenance strategies, and 3 year weight regain between these 4 activity groups. Results Those with the highest PA at registry entry had lost the most weight, and reported lower fat intake, more dietary restraint, and greater reliance on several specific dietary strategies to maintain weight loss. Those in the lowest PA category maintained weight loss despite low levels of PA and without greater reliance on dietary strategies. There were no differences in odds of weight regain at year 3 between PA groups. Conclusions These findings suggest that there is not a “one size fits all strategy” for successful weight loss maintenance and that weight loss maintenance may require the use of more strategies by some individuals than others. PMID:24385447

Effect of feeding a weight loss food beyond a caloric restriction period on body composition and resistance to weight gain in dogs.

PubMed

Floerchinger, Amanda M; Jackson, Matthew I; Jewell, Dennis E; MacLeay, Jennifer M; Paetau-Robinson, Inke; Hahn, Kevin A

2015-08-15

To determine the effect of feeding a food with coconut oil and supplemental L-carnitine, lipoic acid, lysine, leucine, and fiber on weight loss and maintenance in dogs. Prospective clinical study. 50 overweight dogs. The study consisted of 2 trials. During trial 1, 30 dogs were allocated to 3 groups (10 dogs/group) to be fed a dry maintenance dog food to maintain body weight (group 1) or a dry test food at the same amount on a mass (group 2) or energy (group 3) basis as group 1. During trial 2, each of 20 dogs was fed the test food and caloric intake was adjusted to maintain a weight loss rate of 1% to 2%/wk (weight loss phase). Next, each dog was fed the test food in an amount calculated to maintain the body weight achieved at the end of the weight loss phase (weight maintenance phase). Dogs were weighed and underwent dual-energy x-ray absorptiometry monthly. Metabolomic data were determined before (baseline) and after each phase. During trial 1, dogs in groups 2 and 3 lost significantly more weight than did those in group 1. During trial 2, dogs lost a significant amount of body weight and fat mass but retained lean body mass (LBM) during the weight loss phase and continued to lose body fat but gained LBM during the weight maintenance phase. Evaluation of metabolomic data suggested that fat metabolism and LBM retention were improved from baseline for dogs fed the test food. Results suggested that feeding overweight dogs the test food caused weight loss and improvements in body condition during the weight-maintenance phase, possibly because the food composition improved energy metabolism.

Comparison of a low carbohydrate and low fat diet for weight maintenance in overweight or obese adults enrolled in a clinical weight management program

PubMed Central

LeCheminant, James D; Gibson, Cheryl A; Sullivan, Debra K; Hall, Sandra; Washburn, Rik; Vernon, Mary C; Curry, Chelsea; Stewart, Elizabeth; Westman, Eric C; Donnelly, Joseph E

2007-01-01

Background Recent evidence suggests that a low carbohydrate (LC) diet may be equally or more effective for short-term weight loss than a traditional low fat (LF) diet; however, less is known about how they compare for weight maintenance. The purpose of this study was to compare body weight (BW) for participants in a clinical weight management program, consuming a LC or LF weight maintenance diet for 6 months following weight loss. Methods Fifty-five (29 low carbohydrate diet; 26 low fat diet) overweight/obese middle-aged adults completed a 9 month weight management program that included instruction for behavior, physical activity (PA), and nutrition. For 3 months all participants consumed an identical liquid diet (2177 kJ/day) followed by 1 month of re-feeding with solid foods either low in carbohydrate or low in fat. For the remaining 5 months, participants were prescribed a meal plan low in dietary carbohydrate (~20%) or fat (~30%). BW and carbohydrate or fat grams were collected at each group meeting. Energy and macronutrient intake were assessed at baseline, 3, 6, and 9 months. Results The LC group increased BW from 89.2 ± 14.4 kg at 3 months to 89.3 ± 16.1 kg at 9 months (P = 0.84). The LF group decreased BW from 86.3 ± 12.0 kg at 3 months to 86.0 ± 14.0 kg at 9 months (P = 0.96). BW was not different between groups during weight maintenance (P = 0.87). Fifty-five percent (16/29) and 50% (13/26) of participants for the LC and LF groups, respectively, continued to decrease their body weight during weight maintenance. Conclusion Following a 3 month liquid diet, the LC and LF diet groups were equally effective for BW maintenance over 6 months; however, there was significant variation in weight change within each group. PMID:17976244

A Family and Community Focused Lifestyle Program Prevents Weight Regain in Pacific Islanders: A Pilot Randomized Controlled Trial

ERIC Educational Resources Information Center

Kaholokula, Joseph Keawe'aimoku; Mau, Marjorie K.; Efird, Jimmy T.; Leake, Anne; West, Margaret; Palakiko, Donna-Marie; Yoshimura, Sheryl R.; Kekauoha, B. Puni; Rose, Charles; Gomes, Henry

2012-01-01

Preventing weight regain after the loss of excess weight is challenging for people, especially for ethnic minorities in the United States. A 6-month weight loss maintenance intervention designed for Pacific Islanders, called the PILI Lifestyle Program (PLP), was compared with a 6-month standard behavioral weight loss maintenance program (SBP) in a…

A distinct adipose tissue gene expression response to caloric restriction predicts 6-mo weight maintenance in obese subjects.

PubMed

Mutch, David M; Pers, Tune H; Temanni, M Ramzi; Pelloux, Veronique; Marquez-Quiñones, Adriana; Holst, Claus; Martinez, J Alfredo; Babalis, Dimitris; van Baak, Marleen A; Handjieva-Darlenska, Teodora; Walker, Celia G; Astrup, Arne; Saris, Wim H M; Langin, Dominique; Viguerie, Nathalie; Zucker, Jean-Daniel; Clément, Karine

2011-12-01

Weight loss has been shown to reduce risk factors associated with cardiovascular disease and diabetes; however, successful maintenance of weight loss continues to pose a challenge. The present study was designed to assess whether changes in subcutaneous adipose tissue (scAT) gene expression during a low-calorie diet (LCD) could be used to differentiate and predict subjects who experience successful short-term weight maintenance from subjects who experience weight regain. Forty white women followed a dietary protocol consisting of an 8-wk LCD phase followed by a 6-mo weight-maintenance phase. Participants were classified as weight maintainers (WMs; 0-10% weight regain) and weight regainers (WRs; 50-100% weight regain) by considering changes in body weight during the 2 phases. Anthropometric measurements, bioclinical variables, and scAT gene expression were studied in all individuals before and after the LCD. Energy intake was estimated by using 3-d dietary records. No differences in body weight and fasting insulin were observed between WMs and WRs at baseline or after the LCD period. The LCD resulted in significant decreases in body weight and in several plasma variables in both groups. WMs experienced a significant reduction in insulin secretion in response to an oral-glucose-tolerance test after the LCD; in contrast, no changes in insulin secretion were observed in WRs after the LCD. An ANOVA of scAT gene expression showed that genes regulating fatty acid metabolism, citric acid cycle, oxidative phosphorylation, and apoptosis were regulated differently by the LCD in WM and WR subjects. This study suggests that LCD-induced changes in insulin secretion and scAT gene expression may have the potential to predict successful short-term weight maintenance. This trial was registered at clinicaltrials.gov as NCT00390637.

Psychological factors associated with weight loss maintenance: theory-driven practice for nurse practitioners.

PubMed

Valek, Rebecca M; Greenwald, Beverly J; Lewis, Carolyn C

2015-04-01

The authors discuss the psychological factors associated with weight loss maintenance and the use of Pender's health promotion model as a guide for the construction of clinical interventions to address these factors. The psychological factors include internal drive for weight maintenance, ongoing self-monitoring, long-term flexibility, positive mood and emotions, appropriate goals, and management of external stimuli. Nurse practitioners can help combat obesity trends through caring for patients in a holistic manner. Periodic psychological needs-assessments for patients who desire to maintain weight loss may further promote long-term success in weight management. © The Author(s) 2015.

Lorcaserin plus lifestyle modification for weight loss maintenance: Rationale and design for a randomized controlled trial.

PubMed

Tronieri, Jena Shaw; Alfaris, Nasreen; Chao, Ariana M; Pearl, Rebecca L; Alamuddin, Naji; Bakizada, Zayna M; Berkowitz, Robert I; Wadden, Thomas A

2017-08-01

Few studies have examined the efficacy of recently approved medications for chronic weight management in facilitating the maintenance of lost weight. This paper provides an overview of the design and rationale for a trial investigating whether lorcaserin, when combined with behavioral weight loss maintenance sessions (WLM), will facilitate the maintenance of losses of ≥5% of initial weight. In this two-phase trial, participants with obesity will enroll in a 14-week run-in diet program consisting of weekly group lifestyle modification sessions and a 1000-1200kcal/d meal replacement diet. Participants who complete this weight induction phase and lose at least 5% of initial weight will then be randomized to 52weeks of WLM plus lorcaserin or WLM plus placebo. We hypothesize that at 52weeks post randomization, participants assigned to WLM plus lorcaserin will achieve significantly better maintenance of the prior 5% weight loss. We will recruit 182 adults with obesity to participate in the diet run-in, 136 of whom (75%) are expected to become eligible for the randomized controlled trial. Co-primary outcomes include the percentage of participants who maintain a loss of at least 5% of initial weight at week 52 and change in weight (kg) from randomization to week 52. This two-phase design will allow us to determine the potential efficacy of chronic weight management using lorcaserin for maintaining initial losses of at least 5% body weight, induced by the use of a structured meal-replacement diet. This combined approach holds promise of achieving larger long-term weight losses. NCT02388568 on ClinicalTrials.gov. Copyright © 2017 Elsevier Inc. All rights reserved.

Predictors of long-term weight maintenance.

PubMed

Vogels, Neeltje; Diepvens, Kristel; Westerterp-Plantenga, Margriet S

2005-12-01

The purpose of this study was to evaluate available variables of a long-term weight maintenance study to investigate possible factors predisposing to weight regain after a period of weight loss. The Maastricht Weight Maintenance Study is an ongoing longitudinal study of healthy men and women (29 men and 62 women; 18 to 65 years of age; BMI = 30.2 +/- 3.1 kg/m(2)). A variety of parameters were measured before and after a very-low-energy diet and after a follow-up of at least 2 years. Mean weight loss was 7.9 +/- 3.6 kg, and percent weight regain was 113.8 +/- 98.1%. Percent BMI regain was negatively associated with an increase in dietary restraint (r = -0.47, p < 0.05). Percent weight regain was negatively correlated with baseline resting metabolic rate (r = -0.38, p = 0.01) and baseline fat mass (r = -0.24, p = 0.05) and positively correlated with the magnitude of change in body weight (BW) expressed as maximum amplitude of BW (r = 0.21, p < 0.05). In addition, amplitude of BW was positively correlated with the frequency of dieting (r = 0.57, p < 0.01). The best predictors for weight maintenance after weight loss were an increase in dietary restraint during weight loss, a high baseline resting metabolic rate, a relatively high baseline fat mass favoring a fat-free mass-sparing effect during weight loss, a rather stable BW, and a low frequency of dieting. Therefore, BW maintenance after BW loss seems to be a multifactorial issue, including mechanisms that regulate an individuals' energy expenditure, body composition, and eating behavior in such a way that energy homeostasis is maintained.

Beneficial Effects of a Dietary Weight Loss Intervention on Human Gut Microbiome Diversity and Metabolism Are Not Sustained during Weight Maintenance.

PubMed

Heinsen, Femke-Anouska; Fangmann, Daniela; Müller, Nike; Schulte, Dominik M; Rühlemann, Malte C; Türk, Kathrin; Settgast, Ute; Lieb, Wolfgang; Baines, John F; Schreiber, Stefan; Franke, Andre; Laudes, Matthias

2016-01-01

In the present study, we examined the effect of a very low-calorie diet(VLCD)-based obesity program on human gut microbiome diversity and metabolism during weight loss and weight maintenance. Obese subjects underwent 3 months of VLCD followed by 3 months of weight maintenance. A lean and an obese control group were included. The microbiome was characterized by performing high-throughput dual-indexed 16S rDNA amplicon sequencing. At baseline, a significant difference in the Firmicutes/Bacteroidetes ratio between the lean and obese individuals was observed (p = 0.047). The VLCD resulted in significant alterations in gut microbiome diversity from baseline to 3 months (p = 0.0053). Acinetobacter represented an indicator species for the observed effect (indicator value = 0.998, p = 0.006). Metabolic analyses revealed alterations of the bacterial riboflavin pathway from baseline to 3 months (pnom = 0.0078). These changes in diversity and bacterial metabolism induced by VLCD diminished during the weight maintenance phase, despite sustained reductions in body weight and sustained improvements of insulin sensitivity. The present data show that a VLCD is able to beneficially alter both gut microbiome diversity and metabolism in obese humans, but that these changes are not sustained during weight maintenance. This finding might suggest that the microbiome should be targeted during obesity programs. © 2016 The Author(s) Published by S. Karger GmbH, Freiburg.

Caloric Restriction in Older Adults-Differential Effects of Weight Loss and Reduced Weight on Brain Structure and Function.

PubMed

Prehn, Kristin; Jumpertz von Schwartzenberg, Reiner; Mai, Knut; Zeitz, Ulrike; Witte, A Veronica; Hampel, Dierk; Szela, Anna-Maria; Fabian, Sonja; Grittner, Ulrike; Spranger, Joachim; Flöel, Agnes

2017-03-01

Dietary modifications such as caloric restriction (CR) have been suggested as a means to improve memory and prevent age-related decline. However, it is unclear whether those effects remain stable over time or are related specifically to negative energy balance during the weight loss phase of CR. Using a randomized interventional design, we investigated changes in recognition memory and neural correlates in postmenopausal obese women (n = 19): 1) after intense weight loss in the course of a 12-week low-caloric diet (reduced body weight and negative energy balance) and 2) after having sustained the reduced weight over 4 more weeks (reduced body weight, but energy balance equilibrium). Participants were contrasted to a control group (n = 18) instructed not to change dietary habits. In the CR group, we found improved recognition memory, paralleled by increased gray matter volume in inferior frontal gyrus and hippocampus, and augmented hippocampal resting-state functional connectivity to parietal areas. Moreover, effects were specific for transient negative energy balance and could not be detected after subsequent weight maintenance. Our data demonstrate for the first time in humans that beneficial effects of CR on brain structure and function are due to weight loss rather than an overall reduced weight. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The effects of water and non-nutritive sweetened beverages on weight loss and weight maintenance: A randomized clinical trial.

PubMed

Peters, John C; Beck, Jimikaye; Cardel, Michelle; Wyatt, Holly R; Foster, Gary D; Pan, Zhaoxing; Wojtanowski, Alexis C; Vander Veur, Stephanie S; Herring, Sharon J; Brill, Carrie; Hill, James O

2016-02-01

To evaluate the effects of water versus beverages sweetened with non-nutritive sweeteners (NNS) on body weight in subjects enrolled in a year-long behavioral weight loss treatment program. The study used a randomized equivalence design with NNS or water beverages as the main factor in a trial among 303 weight-stable people with overweight and obesity. All participants participated in a weight loss program plus assignment to consume 24 ounces (710 ml) of water or NNS beverages daily for 1 year. NNS and water treatments were non-equivalent, with NNS treatment showing greater weight loss at the end of 1 year. At 1 year subjects receiving water had maintained a 2.45 ± 5.59 kg weight loss while those receiving NNS beverages maintained a loss of 6.21 ± 7.65 kg (P < 0.001 for difference). Water and NNS beverages were not equivalent for weight loss and maintenance during a 1-year behavioral treatment program. NNS beverages were superior for weight loss and weight maintenance in a population consisting of regular users of NNS beverages who either maintained or discontinued consumption of these beverages and consumed water during a structured weight loss program. These results suggest that NNS beverages can be an effective tool for weight loss and maintenance within the context of a weight management program. © 2015 The Authors, Obesity published by Wiley Periodicals, Inc. on behalf of The Obesity Society (TOS).

Interventions for Weight Reduction: Facing the Maintenance Problem

ERIC Educational Resources Information Center

Anderson, Drew A.; Simmons, Angela M.; Milnes, Suzanne M.

2005-01-01

Behavioral treatments are perhaps the cornerstone of modern obesity treatment. Maintenance of weight lost via behavioral treatments has been less than hoped for, however. Weight regain is the result of complex interactions between physiological, behavioral, cognitive, and environmental factors; in this paper we review some of these factors and…

Long-Term Weight Maintenance Strategies Are Experienced as a Burden by Persons Who Have Lost Weight Compared to Persons with a lifetime Normal, Stable Weight.

PubMed

Kruseman, Maaike; Schmutz, Noémi; Carrard, Isabelle

2017-01-01

To assess dietary intake, eating patterns, physical activity and eating behaviors, and to explore strategies and perceptions of the experience of weight maintenance in weight loss maintainers (weight loss maintenance (WLM) ≥ 10% weight loss maintained for ≥1 year) and in matched controls with a lifetime stable normal weight. Volunteers (32) were recruited by a snowball procedure in this cross-sectional, mixed-methods study. Diet, physical activity, and eating behaviors were assessed with validated questionnaires. Strategies and experiences were investigated during interviews. Descriptive coding, thematic analysis (qualitative data) as well as descriptive analysis and t-tests (quantitative data) were performed. Both groups had similar energy and macronutrient consumption. Those in the WLM group reported higher levels of exercise and scored higher on several dimensions of eating disorders. Four themes - 'food choices,' 'quantities and portion control,' 'physical activity', and 'burden' - emerged from the qualitative data. Both groups used similar weight maintenance strategies, but those in the WLM group experienced a higher burden, expressing effortful control which contrasted with the control group's confidence in their internal cues. Our results show an additional burden related with maintaining weight loss compared to keeping a stable normal weight. They provide evidence to devise interventions that will address the difficulty of regulating intake. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

The role of physical activity in producing and maintaining weight loss

PubMed Central

Catenacci, Victoria A; Wyatt, Holly R

2015-01-01

Summary The majority of randomized, controlled trials (RCTs) show only modest weight loss with exercise intervention alone, and slight increases in weight loss when exercise intervention is added to dietary restriction. In most RCTs, the energy deficit produced by the prescribed exercise is far smaller than that usually produced by dietary restriction. In prospective studies that prescribed high levels of exercise, enrolled individuals achieved substantially greater weight loss—comparable to that obtained after similar energy deficits were produced by caloric restriction. High levels of exercise might, however, be difficult for overweight or obese adults to achieve and sustain. RCTs examining exercise and its effect on weight-loss maintenance demonstrated mixed results; however, weight maintenance interventions were usually of limited duration and long-term adherence to exercise was problematic. Epidemiologic, cross-sectional, and prospective correlation studies suggest an essential role for physical activity in weight-loss maintenance, and post hoc analysis of prospective trials shows a clear dose–response relationship between physical activity and weight maintenance. This article reviews the role of physical activity in producing and maintaining weight loss. We focus on prospective, RCTs lasting at least 4 months; however, other prospective trials, meta-analyses and large systematic reviews are included. Limitations in the current body of literature are discussed. PMID:17581621

The role of physical activity in producing and maintaining weight loss.

PubMed

Catenacci, Victoria A; Wyatt, Holly R

2007-07-01

The majority of randomized, controlled trials (RCTs) show only modest weight loss with exercise intervention alone, and slight increases in weight loss when exercise intervention is added to dietary restriction. In most RCTs, the energy deficit produced by the prescribed exercise is far smaller than that usually produced by dietary restriction. In prospective studies that prescribed high levels of exercise, enrolled individuals achieved substantially greater weight loss-comparable to that obtained after similar energy deficits were produced by caloric restriction. High levels of exercise might, however, be difficult for overweight or obese adults to achieve and sustain. RCTs examining exercise and its effect on weight-loss maintenance demonstrated mixed results; however, weight maintenance interventions were usually of limited duration and long-term adherence to exercise was problematic. Epidemiologic, cross-sectional, and prospective correlation studies suggest an essential role for physical activity in weight-loss maintenance, and post hoc analysis of prospective trials shows a clear dose-response relationship between physical activity and weight maintenance. This article reviews the role of physical activity in producing and maintaining weight loss. We focus on prospective, RCTs lasting at least 4 months; however, other prospective trials, meta-analyses and large systematic reviews are included. Limitations in the current body of literature are discussed.

N-of-1 study of weight loss maintenance assessing predictors of physical activity, adherence to weight loss plan and weight change.

PubMed

Kwasnicka, Dominika; Dombrowski, Stephan U; White, Martin; Sniehotta, Falko F

2017-06-01

Behaviour change interventions are effective in supporting individuals to achieve clinically significant weight loss, but weight loss maintenance (WLM) is less often attained. This study examined predictive variables associated with WLM. N-of-1 study with daily ecological momentary assessment combined with objective measurement of weight and physical activity, collected with wireless devices (Fitbit™) for six months. Eight previously obese adults who had lost over 5% of their body weight in the past year took part. Data were analysed using time series methods. Predictor variables were based on five theoretical themes: maintenance motives, self-regulation, personal resources, habits, and environmental influences. Dependent variables were: objectively estimated step count and weight, and self-reported WLM plan adherence. For all participants, daily fluctuations in self-reported adherence to their WLM plan were significantly associated with most of the explanatory variables, including maintenance motivation and satisfaction with outcomes, self-regulation, habit, and stable environment. Personal resources were not a consistent predictor of plan adherence. This is the first study to assess theoretical predictions of WLM within individuals. WLM is a dynamic process including the interplay of motivation, self-regulation, habit, resources, and perceptions of environmental context. Individuals maintaining their weight have unique psychological profiles which could be accounted for in interventions.

Binge Eating Behavior and Weight Loss Maintenance over a 2-Year Period

PubMed Central

Pacanowski, Carly R.; Senso, Meghan M.; Crain, A. Lauren; Sherwood, Nancy E.

2014-01-01

Objective. To investigate the relationship between binge eating behavior and weight loss maintenance over a two-year period in adults. Design. Secondary data analysis using the Keep It Off study, a randomized trial evaluating an intervention to promote weight loss maintenance. Participants. 419 men and women (ages: 20 to 70 y; BMI: 20–44 kg/m2) who had intentionally lost ≥10% of their weight during the previous year. Measurements. Body weight was measured and binge eating behavior over the past 6 months was reported at baseline, 12 months and 24 months. Height was measured at baseline. Results. Prevalence of binge eating at baseline was 19.4% (n = 76). Prevalence of binge eating at any time point was 30.1% (n = 126). Although rate of weight regain did not differ significantly between those who did or did not report binge eating at baseline, binge eating behavior across the study period (additive value of presence or absence at each time point) was significantly associated with different rates of weight regain. Conclusion. Tailoring weight loss maintenance interventions to address binge eating behavior is warranted given the prevalence and the different rates of weight regain experienced by those reporting this behavior. PMID:24891946

Effects of walking or resistance training on weight loss maintenance in obese, middle-aged men: a randomized trial.

PubMed

Borg, P; Kukkonen-Harjula, K; Fogelholm, M; Pasanen, M

2002-05-01

To investigate whether walking or resistance training improves weight maintenance after weight loss when added to dietary counselling. Two months' weight reduction with very-low-energy-diet (VLED) followed by randomization into three groups (control, walking, resistance training) for 6 months' weight maintenance (WM) program and 23 months' unsupervised follow-up. During VLED and WM all groups received similar dietary counselling. The main inclusion criteria were BMI >30 kg/m(2), waist>100 cm and physical inactivity (exercise < or = once a week). Ninety healthy, obese (mean BMI 32.9 kg/m(2) and waist 112.5 cm), 35-50 y-old men started the study and 68 were measured at the end of the study. Weight and body composition assessed by underwater weighing. Exercise diaries and dietary records to assess energy balance. During VLED the mean body weight decreased from 106.0 (s.d. 9.9) kg to 91.7 (9.4) kg. Weight was regained mostly during follow-up and in the end of the study the mean weight in groups was 99.9-102.0 kg. Exercise training did not improve short or long-term weight maintenance when compared to the control group. However, resistance training attenuated the regain of body fat mass during WM (P=0.0l), but not during follow-up. In the combined groups the estimated total energy expenditure (EE) of reported physical activity was associated with less weight regain during WM. EE of 10.1 MJ/week was associated with maintaining weight after weight loss. EE of physical activity tended to decrease after WM in exercise groups due to poor long-term adherence to prescribed exercise. Energy intake seemed to increase during follow-up. Exercise training of moderate dose did not seem to improve long-term weight maintenance because of poor adherence to prescribed exercise.

Weight-loss maintenance for 10 years in the National Weight Control Registry.

PubMed

Thomas, J Graham; Bond, Dale S; Phelan, Suzanne; Hill, James O; Wing, Rena R

2014-01-01

The challenge of weight-loss maintenance is well known, but few studies have followed successful weight losers over an extended period or evaluated the effect of behavior change on weight trajectories. To study the weight-loss trajectories of successful weight losers in the National Weight Control Registry (NWCR) over a 10-year period, and to evaluate the effect of behavior change on weight-loss trajectories. A 10-year observational study of self-reported weight loss and behavior change in 2886 participants (78% female; mean age 48 years) in the NWCR who at entry had lost at least 30 lbs (13.6 kg) and kept it off for at least one year. Data were collected in 1993-2010; analysis was conducted in 2012. Weight loss (kilograms; percent weight loss from maximum weight). Mean weight loss was 31.3 kg (95% CI=30.8, 31.9) at baseline, 23.8 kg (95% CI=23.2, 24.4) at 5 years and 23.1±0.4 kg (95% CI=22.3, 23.9) at 10 years. More than 87% of participants were estimated to be still maintaining at least a 10% weight loss at Years 5 and 10. Larger initial weight losses and longer duration of maintenance were associated with better long-term outcomes. Decreases in leisure-time physical activity, dietary restraint, and frequency of self-weighing and increases in percentage of energy intake from fat and disinhibition were associated with greater weight regain. The majority of weight lost by NWCR members is maintained over 10 years. Long-term weight-loss maintenance is possible and requires sustained behavior change. © 2013 American Journal of Preventive Medicine Published by American Journal of Preventive Medicine All rights reserved.

Weight maintenance as a tight rope walk - a Grounded Theory study.

PubMed

Lindvall, Kristina; Larsson, Christel; Weinehall, Lars; Emmelin, Maria

2010-02-01

Overweight and obesity are considerable public health problems internationally as well as in Sweden. The long-term results of obesity treatment are modest as reported by other studies. The importance of extending the focus to not only comprise obesity treatment but also prevention of weight gain is therefore being emphasized. However, despite the suggested change in focus there is still no consensus on how to prevent obesity or maintain weight. This study reports findings from a qualitative study focusing on attitudes, behaviors and strategies important for primary weight maintenance in a middle-aged population. In depth interviews were conducted with 23 maintainers and four slight gainers in Sweden. The interviews were transcribed and an analysis of weight maintenance was performed using Grounded Theory. Based on the informants' stories, describing attitudes, behaviors and strategies of importance for primary weight maintenance, a model illustrating the main findings, was constructed. Weight maintenance was seen as "a tightrope walk" and four strategies of significance for this "tightrope walk" were described as "to rely on heritage", "to find the joy", "to find the routine" and "to be in control". Eleven "ideal types" were included in the model to illustrate different ways of relating to the main strategies. These "ideal types" described more specific attitudes and behaviors such as; eating food that is both tasteful and nutritious, and choosing exercise that provides joy. However, other somewhat contradictory behaviors were also found such as; only eating nutritious food regardless of taste, and being physically active to control stress and emotions. This study show great variety with regards to attitudes, strategies and behaviors important for weight maintenance, and considerations need to be taken before putting the model into practice. However, the results from this study can be used within primary health care by enhancing the understanding of how people differ in their relation to food and physical activity. It informs health personnel about the need to differentiate advices related to body weight, not only to different sub-groups of individuals aiming at losing weight but also to sub-groups of primary weight maintainers aiming at maintaining weight.

Does body image influence the relationship between body weight and breastfeeding maintenance in new mothers?

PubMed

Swanson, Vivien; Keely, Alice; Denison, Fiona C

2017-09-01

Obese women have lower breastfeeding initiation and maintenance rates than healthy weight women. Research generally focuses on biomedical explanations for this. Psychosocial factors including body image and well-being after childbirth are less well understood as predictors of breastfeeding. In obese and healthy weight women, we investigated changes in body image between 72 hrs post-delivery and 6-8 weeks post-natal, studying how women's body image related to breastfeeding initiation and maintenance. We also investigated how psychological distress was related to body image. Longitudinal semi-structured questionnaire survey. Body image and psychological distress were assessed within 72 hrs of birth and by postal questionnaire at 6-8 weeks, for 70 obese and 70 healthy weight women initiating exclusive (breastmilk only) breastfeeding or mixed feeding (with formula milk) in hospital. Breastfeeding was re-assessed at 6-8 weeks. Obese women were less likely to exclusively breastfeed in hospital and maintain breastfeeding to 6-8 weeks. Better body image was related to maintaining breastfeeding and to lower post-natal psychological distress for all women, but education level was the most significant predictor of maintenance in multivariate regression including body image and weight status. Body image mediated, but did not moderate the relationship between weight and breastfeeding maintenance. Body image was lower overall in obese women, but all women had low body image satisfaction around childbirth, reducing further at 6-8 weeks. Health professionals should consider women's body image when discussing breastfeeding. A focus on breast function over form may support breastfeeding for all women. Statement of contribution What is already known on this subject? Obesity can negatively affect breastfeeding initiation and maintenance, but there is little information about how psychosocial factors affect this relationship. Body image may be an important factor, but has not been studied in relation to breastfeeding maintenance. What does this study add This article examines the influence of body image on obese and healthy-weight women's breastfeeding maintenance at 6-8 weeks. Different aspects of body image mediated but did not moderate the relationship between weight status and breastfeeding maintenance, but in multivariate regression, maternal education level was the most significant predictor. Obese women had poorer body image and were less likely to maintain breastfeeding; however, for all women, body image became more negative in this postpartum period. Interventions should normalize positive aspects of women's postnatal bodies, including function rather than form. Addressing body concerns could encourage new mothers to maintain breastfeeding, irrespective of weight status. © 2017 The British Psychological Society.

Web-Based Interventions Alone or Supplemented with Peer-Led Support or Professional Email Counseling for Weight Loss and Weight Maintenance in Women from Rural Communities: Results of a Clinical Trial

PubMed Central

Pullen, Carol H.; Pozehl, Bunny; Eisenhauer, Christine; Boeckner, Linda S.

2017-01-01

Objective. This trial compared the effectiveness of a web-based only (WO) intervention with web-based supplemented by peer-led discussion (WD) or professional email counseling (WE) across 3 phases to achieve weight loss and weight maintenance in women from underserved rural communities. Methods. 301 women (BMI of 28–45 kg/m2) randomly assigned to groups participated in guided weight loss (baseline to 6 months), guided weight loss and maintenance (6 to 18 months), and self-managed weight maintenance (18 to 30 months). Results. Retention was 88.7%, 76.5%, and 71.8% at 6, 18, and 30 months, respectively. Intent-to-treat analyses demonstrated no group differences in change in weight within any phases. At 6 months, observed mean (SD) weight loss was 5.1 (6.0) kg in WO, 4.1 (5.6) kg in WD, and 6.0 (6.3) kg in WE, with 42%, 38%, and 51%, respectively, meeting ≥ 5% weight loss. These proportions dropped by a third after phase 2 with no further change during phase 3. Conclusion. Web-based interventions assisted women from rural communities in achieving 6-month weight loss, with weight regain by half at 30 months. No group differences were potentially due to the robust nature of the web-based intervention. Trial Registration. This trial is registered with ClinicalTrials.gov NCT01307644. PMID:28480078

Predictors of long-term weight loss in adults with modest initial weight loss, by sex and race.

PubMed

Svetkey, Laura P; Ard, Jamy D; Stevens, Victor J; Loria, Catherine M; Young, Deb Y; Hollis, Jack F; Appel, Lawrence J; Brantley, Phillip J; Kennedy, Betty M; Kumanyika, Shiriki K; Batch, Bryan C; Corsino, Leonor; Lien, Lillian F; Vollmer, William M

2012-09-01

Effective weight management interventions could reduce race-sex disparities in cardiovascular disease (CVD), yet little is known about factors associated with successful weight loss maintenance in race-sex subgroups. In the Weight Loss Maintenance trial (WLM), overweight/obese (BMI 25-45 kg/m(2)) adults who lost ≥4 kg in a 6-month behavioral weight loss intervention (phase I) were randomized into one of three 30-month maintenance interventions (phase II). To investigate predictors in subgroups, randomized groups were combined for this analysis. Of 1,685 phase I participants, 1,032 (61%) entered phase II, including 12% black men (BM), 26% black women (BW), 25% white men (WM), and 37% white women (WW). Weight change over the 36-month study ranged from -2.3% (95% confidence interval = -3.1 to -1.5%) in BW to -4.5% (95% confidence interval = -5.7 to -4.0%) in WM, the result of differential weight loss during phase I. Within race, men lost significantly more weight than women, but within sex group, weight loss did not differ significantly between races. Although participants regained weight during phase II, regain did not differ by race-sex group, and mean weight at the end of the study was significantly lower than phase I entry weight for each subgroup. In regression models, phase I weight loss predicted overall 36-month weight loss in all race-sex groups. Healthy dietary pattern at entry, improvement in dietary pattern, or both were predictive in three of four race-sex groups. Few other variables other than initial weight loss and dietary pattern were predictive. Future research should identify additional modifiable influences on long-term maintenance after a modest weight loss.

Winter protein requirements of bobwhite quail

USGS Publications Warehouse

Nestler, R.B.; Bailey, W.W.; Llewellyn, L.M.; Rensberger, M.J.

1944-01-01

Three experiments involving 714 bobwhite quail were conducted at the Patuxent Research Refuge, Bowie, Maryland, during the winters of 1939-1941 to determine the protein requirement of quail maintained throug'h the winter.....Considering survival, live weights, feed consumption, and subsequent reproduction by the birds, the-9 to 13 per cent levels of crude dietary protein gave as good results as higher levels eggs, which in all cases was over 90 per and in some respects were better.....On the basis of these studies, it is recommended that the winter maintenance diet for bobwhite quail contain . about 11 to 12 per cent of crude protein. The following diet (parts by weight) conforms to these specifications and should be satisfactory:...Ground yellow corn 85.6....Dehvdrated alfalfa leaf meal 5 .O.....Soybean oil meal 7.0.....Special steamed bonemeal 1.2....Salt (or Salt Mixture II,see text) 1.0...Vitamin A and D feeding oil, fortified 0.2.

A one-year resistance training program following weight loss has no significant impact on body composition and energy expenditure in postmenopausal women living with overweight and obesity.

PubMed

Hintze, Luzia Jaeger; Messier, Virginie; Lavoie, Marie-Ève; Brochu, Martin; Lavoie, Jean-Marc; Prud'homme, Denis; Rabasa-Lhoret, Rémi; Doucet, Éric

2018-05-15

Resistance training (RT) has been shown to decrease fat mass (FM), and increase fat-free mass (FFM), which can be a useful for weight loss maintenance. To examine the effects of a 1-year RT intervention on weight loss maintenance following a 6-month dietary weight loss intervention. Following a 6-month dietary weight loss intervention (-6% ± 5.8; 5.05 kg ± 4.45), 70 postmenopausal women living with overweight or obesity were randomized to a control group (n = 34) or a RT group (n = 36) (3×/week first 6 months, 2×/week last 6 months, 70-80% of 1-repetition maximum). Body composition (DXA), abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) (CT scan), resting energy expenditure (EE) (indirect calorimetry), physical activity EE and total daily EE were measured (doubly-labelled water). A total of 54 participants completed the study (control group n = 29; RT group n = 25) and compliance to the RT program was on average 64%. Significant regains were noted for body weight 0.98 (3.71) kg vs. 1.33 (3.94) kg and FM regain 1.32 (2.69) kg vs. 0.81 (3.26) kg in control and RT groups after the 1-year weight maintenance phase. No group differences were noted. Resting EE and total daily EE did not change after the weight maintenance phase, and no differences were observed between groups. Both groups had significantly greater than predicted decrease in resting EE after the 6-month dietary intervention and at the end of the 1-year weight-loss maintenance phase. Our results suggest that a 1-year RT intervention following a 6-month dietary weight loss intervention does not improve weight loss maintenance, body composition or EE in post-menopausal women living with overweight or obesity. Copyright © 2018 Elsevier Inc. All rights reserved.

Diets with High or Low Protein Content and Glycemic Index for Weight-Loss Maintenance

PubMed Central

Larsen, Thomas Meinert; Dalskov, Stine-Mathilde; van Baak, Marleen; Jebb, Susan A.; Papadaki, Angeliki; Pfeiffer, Andreas F.H.; Martinez, J. Alfredo; Handjieva-Darlenska, Teodora; Kunešová, Marie; Pihlsgård, Mats; Stender, Steen; Holst, Claus; Saris, Wim H.M.; Astrup, Arne

2012-01-01

Background Studies of weight-control diets that are high in protein or low in glycemic index have reached varied conclusions, probably owing to the fact that the studies had insufficient power. Methods We enrolled overweight adults from eight European countries who had lost at least 8% of their initial body weight with a 3.3-MJ (800-kcal) low-calorie diet. Participants were randomly assigned, in a two-by-two factorial design, to one of five ad libitum diets to prevent weight regain over a 26-week period: a low-protein and low-glycemic-index diet, a low-protein and high-glycemic-index diet, a high-protein and low-glycemic-index diet, a high-protein and high-glycemic-index diet, or a control diet. Results A total of 1209 adults were screened (mean age, 41 years; body-mass index [the weight in kilograms divided by the square of the height in meters], 34), of whom 938 entered the low-calorie-diet phase of the study. A total of 773 participants who completed that phase were randomly assigned to one of the five maintenance diets; 548 completed the intervention (71%). Fewer participants in the high-protein and the low-glycemic-index groups than in the low-protein–high-glycemic-index group dropped out of the study (26.4% and 25.6%, respectively, vs. 37.4%; P = 0.02 and P = 0.01 for the respective comparisons). The mean initial weight loss with the low-calorie diet was 11.0 kg. In the analysis of participants who completed the study, only the low-protein–high-glycemic-index diet was associated with subsequent significant weight regain (1.67 kg; 95% confidence interval [CI], 0.48 to 2.87). In an intention-to-treat analysis, the weight regain was 0.93 kg less (95% CI, 0.31 to 1.55) in the groups assigned to a high-protein diet than in those assigned to a low-protein diet (P = 0.003) and 0.95 kg less (95% CI, 0.33 to 1.57) in the groups assigned to a low-glycemic-index diet than in those assigned to a high-glycemic-index diet (P = 0.003). The analysis involving participants who completed the intervention produced similar results. The groups did not differ significantly with respect to diet-related adverse events. Conclusions In this large European study, a modest increase in protein content and a modest reduction in the glycemic index led to an improvement in study completion and maintenance of weight loss. (Funded by the European Commission; ClinicalTrials.gov number, NCT00390637.) PMID:21105792

Tailoring a Web-Based Weight Maintenance Intervention for Northern Plains American Indian Public University Students

ERIC Educational Resources Information Center

Hemmingson, Kaitlyn; Lucchesi, Roxanne; Droke, Elizabeth; Kattelmann, Kendra K.

2016-01-01

Objective: High levels of obesity-related health disparities are common among US American Indian (AI) populations. AI public university students often face unique challenges that may contribute to weight gain and related consequences. Few weight maintenance interventions have been developed that meet the needs of AI public university students. The…

The Use of Biosimulation in the Design of a Novel Multi-level Weight Loss Maintenance Program for Overweight Children

PubMed Central

Wilfley, Denise E.; Van Buren, Dorothy J.; Theim, Kelly R.; Stein, Richard I.; Saelens, Brian E.; Ezzet, Farkad; Russian, Angela C.; Perri, Michael G.; Epstein, Leonard H.

2011-01-01

Objective Weight loss outcomes achieved through conventional behavior change interventions are prone to deterioration over time. Basic learning laboratory studies in the area of behavioral extinction and renewal and multi-level models of weight control offer clues as to why newly acquired weight loss skills are prone to relapse. According to these models, current clinic-based interventions may not be of sufficient duration or scope to allow for the practice of new skills across the multiple community contexts necessary to promote sustainable weight loss. Although longer, more intensive interventions with greater reach may hold the key to improving weight loss outcomes, it is difficult to test these assumptions in a time efficient and cost-effective manner. A research design tool that has been increasingly utilized in other fields (e.g., pharmaceuticals) is the use of biosimulation analyses. The present paper describes our research team's use of computer simulation models to assist in designing a study to test a novel, comprehensive socio-environmental treatment approach to weight loss maintenance in children ages 7 to 12 years. Methods Weight outcome data from the weight loss, weight maintenance, and follow-up phases of a recently completed randomized controlled trial (RCT) were used to describe the time course of a proposed, extended multi-level treatment program. Simulations were then conducted to project the expected changes in child percent overweight trajectories in the proposed study. Results A 12.9% decrease in percent overweight at 30 months was estimated based upon the midway point between models of “best-case” and “worst-case” weight maintenance scenarios. Conclusions Preliminary data and further analyses, including biosimulation projections, suggest that our socio-environmental approach to weight loss maintenance treatment is promising and warrants evaluation in a large-scale RCT. Biosimulation techniques may have utility in the design of future community-level interventions for the treatment and prevention of childhood overweight. PMID:20107468

Weight Fluctuation and Cancer Risk in Post-Menopausal Women: The Women’s Health Initiative

PubMed Central

Welti, Laura M.; Beavers, Daniel P.; Caan, Bette J.; Sangi-Haghpeykar, Haleh; Vitolins, Mara Z.; Beavers, Kristen M.

2017-01-01

Background Weight cycling, defined by an intentional weight loss and subsequent regain, commonly occurs in overweight and obese women and is associated with some negative health outcomes. We examined the role of various weight-change patterns during early to mid- adulthood and associated risk of highly prevalent, obesity-related cancers (breast, endometrial, colorectal) in postmenopausal women. Methods 80,943 postmenopausal women (age: 63.4±7.4 years) in the Women’s Health Initiative Observational Study were categorized by self-reported weight change (weight stable; weight gain; lost weight; weight cycled [1–3, 4–6, 7–10, >10 times]) during early to mid- adulthood (18–50 years). Three site-specific associations were investigated using Cox proportional hazard models (age, race/ethnicity, income, education, smoking, alcohol, physical activity, hormone therapy, diet, BMI). Results 7,464 (breast=5,564; endometrial=788; colorectal=1,290) incident cancer cases were identified between September 1994 and August 2014. Compared with weight stability, weight gain was significantly associated with risk of breast cancer (HR=1.11, 1.03–1.20) after adjustment for BMI. Similarly, weight cycling was significantly associated with risk of endometrial cancer (HR=1.23, 1.01–1.49). Weight cycling “4–6 times” was most consistently associated with cancer risk, showing a 38% increased risk for endometrial cancer (95% CI: 1.08–1.76) compared to weight stable women. Conclusions Weight gain and weight cycling were positively associated with risk of breast and endometrial cancer, respectively. Impact These data suggest weight cycling and weight gain increase risk of prevalent cancers in postmenopausal women. Adopting ideal body weight maintenance practices before and after weight loss should be encouraged to reduce risk of incident breast and endometrial cancers. PMID:28069684

Study protocol: the effectiveness and cost effectiveness of a brief behavioural intervention to promote regular self-weighing to prevent weight regain after weight loss: randomised controlled trial (The LIMIT Study).

PubMed

Madigan, Claire D; Jolly, Kate; Roalfe, Andrea; Lewis, Amanda L; Webber, Laura; Aveyard, Paul; Daley, Amanda J

2015-06-04

Although obesity causes many adverse health consequences, modest weight loss reduces the incidence. There are effective interventions that help people to lose weight but weight regain is common and long term maintenance remains a critical challenge. As a high proportion of the population of most high and middle income countries are overweight, there are many people who would benefit from weight loss and its maintenance. Therefore, we need to find effective low cost scalable interventions to help people achieve this. One such intervention that has shown promise is regular self-weighing, to check progress against a target, however there is no trial that has tested this using a randomised controlled design (RCT). The aim of this RCT is to evaluate the effectiveness and cost effectiveness of a brief behavioural intervention delivered by non-specialist staff to promote regular self-weighing to prevent weight regain after intentional weight loss. A randomised trial of 560 adults who have lost ≥ 5 % of their initial body weight through a 12 week weight loss programme. The comparator group receive a weight maintenance leaflet, a diagram representing healthy diet composition, and a list of websites for weight control. The intervention group receive the same plus minimally trained telephonists will ask participants to set a weight target and encourage them to weigh themselves daily, and provide support materials such as a weight record card. The primary outcome is the difference between groups in weight change from baseline to 12 months. If effective, this study will provide public health agencies with a simple, low cost maintenance intervention that could be implemented immediately. ISRCTN52341938 Date Registered: 31/03/2014.

Effects of anti-obesity drugs, diet, and exercise on weight-loss maintenance after a very-low-calorie diet or low-calorie diet: a systematic review and meta-analysis of randomized controlled trials.

PubMed

Johansson, Kari; Neovius, Martin; Hemmingsson, Erik

2014-01-01

Weight-loss maintenance remains a major challenge in obesity treatment. The objective was to evaluate the effects of anti-obesity drugs, diet, or exercise on weight-loss maintenance after an initial very-low-calorie diet (VLCD)/low-calorie diet (LCD) period (<1000 kcal/d). We conducted a systematic review by using MEDLINE, the Cochrane Controlled Trial Register, and EMBASE from January 1981 to February 2013. We included randomized controlled trials that evaluated weight-loss maintenance strategies after a VLCD/LCD period. Two authors performed independent data extraction by using a predefined data template. All pooled analyses were based on random-effects models. Twenty studies with a total of 27 intervention arms and 3017 participants were included with the following treatment categories: anti-obesity drugs (3 arms; n = 658), meal replacements (4 arms; n = 322), high-protein diets (6 arms; n = 865), dietary supplements (6 arms; n = 261), other diets (3 arms; n = 564), and exercise (5 arms; n = 347). During the VLCD/LCD period, the pooled mean weight change was -12.3 kg (median duration: 8 wk; range 3-16 wk). Compared with controls, anti-obesity drugs improved weight-loss maintenance by 3.5 kg [95% CI: 1.5, 5.5 kg; median duration: 18 mo (12-36 mo)], meal replacements by 3.9 kg [95% CI: 2.8, 5.0 kg; median duration: 12 mo (10-26 mo)], and high-protein diets by 1.5 kg [95% CI: 0.8, 2.1 kg; median duration: 5 mo (3-12 mo)]. Exercise [0.8 kg; 95% CI: -1.2, 2.8 kg; median duration: 10 mo (6-12 mo)] and dietary supplements [0.0 kg; 95% CI: -1.4, 1.4 kg; median duration: 3 mo (3-14 mo)] did not significantly improve weight-loss maintenance compared with control. Anti-obesity drugs, meal replacements, and high-protein diets were associated with improved weight-loss maintenance after a VLCD/LCD period, whereas no significant improvements were seen for dietary supplements and exercise.

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.

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 Central

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

2016-01-01

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. PMID:27187457

The role of social support in weight loss maintenance: results from the MedWeight study.

PubMed

Karfopoulou, Eleni; Anastasiou, Costas A; Avgeraki, Evangelia; Kosmidis, Mary H; Yannakoulia, Mary

2016-06-01

The role of social support in weight management is not fully understood, as more support has been linked to both favorable and unfavorable outcomes. We examined social support in relation to weight loss maintenance, comparing between maintainers and regainers of weight loss. The MedWeight study is a Greek registry of people who have intentionally lost ≥10 % of their weight and are either maintaining this loss for over a year (maintainers), or have regained weight (regainers). Demographics and lifestyle habits questionnaires are completed online. Dietary assessment is carried out by two telephone 24 h recalls. Perceived social support was assessed by validated scales examining support from family and friends regarding healthy eating and exercise. 289 maintainers and 122 regainers participated. Regainers received more support compared to maintainers. However, maintainers reported receiving compliments and active participation, whereas regainers receiving verbal instructions and encouragements. Maintainers who received diet support displayed improved dietary intakes, such as lower energy intake; regainers' diet was unaffected by support. Positive, rather than instructive, support appears beneficial in weight loss maintenance.

Maintenance of weight loss: a needs assessment.

PubMed

DePue, J D; Clark, M M; Ruggiero, L; Medeiros, M L; Pera, V

1995-05-01

This study identified facilitators and obstacles to maintenance of weight loss following a very-low-calorie-diet and behavior modification program. A survey was mailed to a random sample of 178 program completers and received a 61% response rate; the most frequent follow-up period was more than 2 years. Twenty-nine percent reported weighing the same (within 10 lbs) or less than the end of their participation in the treatment program (maintainers), while 71% reported their present weight was a mean of 65% higher than their initial weight loss (regainers). Maintainers were significantly more likely to report engaging in regular aerobic exercise, attending a maintenance support group, and confidence in their ability to manage their weight in the future, while regainers were more likely to report stress and motivation as frequent weight management obstacles. Respondents consistently identified the need for low/no cost ongoing support. Maintainers and relapsers reported similar challenges in managing their weight, yet with different results, suggesting the need to identify subgroups for which different post-treatment support options could be applied.

Using focus groups to identify factors affecting healthy weight maintenance in college men.

PubMed

Walsh, Jennifer R; White, Adrienne A; Greaney, Mary L

2009-06-01

Healthful eating and physical activity are important for healthy weight maintenance. The hypothesis for this study was that college-aged men would perceive factors affecting eating and physical activity as both contributing to and inhibiting healthy weight maintenance. The overall objective was to explore how men view weight maintenance in the context of these aspects. Subjects (n = 47, mean age = 20.3 +/- 1.7 years) completed an online survey, including the 51-item Three-Factor Eating Questionnaire, and participated in 1 of 6 focus groups. Three face-to-face and 3 online synchronous groups were conducted using a 15-question discussion guide to identify weight maintenance issues around eating, physical activity, and body perceptions. Weight satisfaction decreased with increase in both dietary restraint and disinhibition. Number of attempts to lose weight was positively associated with BMI (r [44] = .465, P = .01) and dietary restraint (r [44] = .515, P = .01). Findings from both focus group formats were similar. Motivators (sports performance/fitness, self-esteem, attractiveness, long-term health) were similar for eating healthfully and being physically active; however, more motivators to be physically active than to eat healthfully emerged. Enablers for eating healthfully included liking the taste, availability of healthful foods, using food rules to guide intake, having a habit of healthful eating, and internal drive/will. Barriers to healthful eating included fat in dairy foods, fruit and vegetable taste, and quick spoilage. Barriers to being physically active included lack of time/time management, obligations, being lazy, and girlfriends. Results may be used to inform future obesity prevention interventions.

Effects of rye bread enriched with green tea extract on weight maintenance and the characteristics of metabolic syndrome following weight loss: a pilot study.

PubMed

Bajerska, Joanna; Mildner-Szkudlarz, Sylwia; Walkowiak, Jarosław

2015-06-01

We examined whether the incorporation of green tea extract enriched rye bread (GTRB) into the diet can improve weight loss (WL) maintenance and control of abnormalities linked to metabolic syndrome (MS). A total of 55 obese men and women (mean age: 53.0±7.0 years, body mass index: 35.0±5.5 kg m(-2)) were recruited. The study had a single-blind randomized study design and consisted of an 8-week WL phase with low-energy calorie diet, followed by a 12-week weight maintenance (WM) phase. During the WM phase, the subjects were randomized into two groups, receiving either the control rye bread (control group) or the GTRB (intervention group). The ingestion of 280 and 360 g GTRB provided daily totals of 123.2 and 158.4 mg caffeine, and 188.3 and 242.1 mg of epigallocatechin gallate, for women and men, respectively. After the WL phase, subjects lost 7.3±3.1 kg of their baseline body weight. GTRB intake did not significantly influence the maintenance of WL, high-density lipoprotein-cholesterol, triglycerides, and glucose concentrations. Although, it resulted in significant differences (mean difference [95% confidence interval]) between the treatment groups in the maintenance of waist circumference (-1.22 cm [-2.4, -0.02; P=.04]), the results were not clinically meaningful. Nevertheless, the ingestion of GTRB led to the maintenance of lower blood pressure (BP), also the proportion of subjects fulfilling the criteria of MS after the WM phase was lower in the intervention group than in the control group. Although GTRB consumption did not improve significantly the WL maintenance, it resulted in a better control of BP.

Weight maintenance through behaviour modification with a cooking course or neurolinguistic programming.

PubMed

Sørensen, Lone Brinkmann; Greve, Tine; Kreutzer, Martin; Pedersen, Ulla; Nielsen, Claus Meyer; Toubro, Søren; Astrup, Arne

2011-01-01

We compared the effect on weight regain of behaviour modification consisting of either a gourmet cooking course or neurolinguistic programming (NLP) therapy. Fifty-six overweight and obese subjects participated. The first step was a 12-week weight loss program. Participants achieving at least 8% weight loss were randomized to five months of either NLP therapy or a course in gourmet cooking. Follow-up occurred after two and three years. Forty-nine participants lost at least 8% of their initial body weight and were randomized to the next step. The NLP group lost an additional 1.8 kg and the cooking group lost 0.2 kg during the five months of weight maintenance (NS). The dropout rate in the cooking group was 4%, compared with 26% in the NLP group (p=0.04). There was no difference in weight maintenance after two and three years of follow-up. In conclusion, weight loss in overweight and obese participants was maintained equally efficiently with a healthy cooking course or NLP therapy, but the dropout rate was lower during the active cooking treatment.

Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people

PubMed Central

Wieland, L. Susan; Falzon, Louise; Sciamanna, Chris N; Trudeau, Kimberlee J; Folse, Suzanne Brodney; Schwartz, Joseph E; Davidson, Karina W

2014-01-01

Background The World Health Organization (WHO) estimates that the number of obese or overweight individuals worldwide will increase to 1.5 billion by 2015. Chronic diseases associated with overweight or obesity include diabetes, heart disease, hypertension and stroke. Objectives To assess the effects of interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people. Search methods We searched several electronic databases, including CENTRAL, MEDLINE, EMBASE, CINAHL, LILACS and PsycINFO, through 25 May 2011. We also searched clinical trials registries to identify studies. We scanned reference lists of included studies and relevant systematic reviews. Selection criteria Studies were included if they were randomized controlled trials or quasi-randomized controlled trials that evaluated interactive computer-based weight loss or weight maintenance programs in adults with overweight or obesity. We excluded trials if the duration of the intervention was less than four weeks or the loss to follow-up was greater than 20% overall. Data collection and analysis Two authors independently extracted study data and assessed risk of bias. Where interventions, control conditions, outcomes and time frames were similar between studies, we combined study data using meta-analysis. Main results We included 14 weight loss studies with a total of 2537 participants, and four weight maintenance studies with a total of 1603 participants. Treatment duration was between four weeks and 30 months. At six months, computer-based interventions led to greater weight loss than minimal interventions (mean difference (MD) −1.5 kg; 95% confidence interval (CI) −2.1 to −0.9; two trials) but less weight loss than in-person treatment (MD 2.1 kg; 95% CI 0.8 to 3.4; one trial). At six months, computer-based interventions were superior to a minimal control intervention in limiting weight regain (MD −0.7 kg; 95% CI −1.2 to −0.2; two trials), but not superior to infrequent in-person treatment (MD 0.5 kg; 95% −0.5 to 1.6; two trials). We did not observe consistent differences in dietary or physical activity behaviors between intervention and control groups in either weight loss or weight maintenance trials. Three weight loss studies estimated the costs of computer-based interventions compared to usual care, however two of the studies were 11 and 28 years old, and recent advances in technology render these estimates unlikely to be applicable to current or future interventions, while the third study was conducted in active duty military personnel, and it is unclear whether the costs are relevant to other settings. One weight loss study reported the cost-effectiveness ratio for a weekly in-person weight loss intervention relative to a computer-based intervention as USD 7177 (EUR 5678) per life year gained (80% CI USD 3055 to USD 60,291 (EUR 2417 to EUR 47,702)). It is unclear whether this could be extrapolated to other studies. No data were identified on adverse events, morbidity, complications or health-related quality of life. Authors’ conclusions Compared to no intervention or minimal interventions (pamphlets, usual care), interactive computer-based interventions are an effective intervention for weight loss and weight maintenance. Compared to in-person interventions, interactive computer-based interventions result in smaller weight losses and lower levels of weight maintenance. The amount of additional weight loss, however, is relatively small and of brief duration, making the clinical significance of these differences unclear. PMID:22895964

Mediators of weight loss and weight loss maintenance in middle-aged women.

PubMed

Teixeira, Pedro J; Silva, Marlene N; Coutinho, Sílvia R; Palmeira, António L; Mata, Jutta; Vieira, Paulo N; Carraça, Eliana V; Santos, Teresa C; Sardinha, Luís B

2010-04-01

Long-term behavioral self-regulation is the hallmark of successful weight control. We tested mediators of weight loss and weight loss maintenance in middle-aged women who participated in a randomized controlled 12-month weight management intervention. Overweight and obese women (N = 225, BMI = 31.3 +/- 4.1 kg/m(2)) were randomly assigned to a control or a 1-year group intervention designed to promote autonomous self-regulation of body weight. Key exercise, eating behavior, and body image variables were assessed before and after the program, and tested as mediators of weight loss (12 months, 86% retention) and weight loss maintenance (24 months, 81% retention). Multiple mediation was employed and an intention-to-treat analysis conducted. Treatment effects were observed for all putative mediators (Effect size: 0.32-0.79, P < 0.01 vs. controls). Weight change was -7.3 +/- 5.9% (12-month) and -5.5 +/- 5.0% (24-month) in the intervention group and -1.7 +/- 5.0% and -2.2 +/- 7.5% in controls. Change in most psychosocial variables was associated with 12-month weight change, but only flexible cognitive restraint (P < 0.01), disinhibition (P < 0.05), exercise self-efficacy (P < 0.001), exercise intrinsic motivation (P < 0.01), and body dissatisfaction (P < 0.05) predicted 24-month weight change. Lower emotional eating, increased flexible cognitive restraint, and fewer exercise barriers mediated 12-month weight loss (R(2) = 0.31, P < 0.001; effect ratio: 0.37), but only flexible restraint and exercise self-efficacy mediated 24-month weight loss (R(2) = 0.17, P < 0.001; effect ratio: 0.89). This is the first study to evaluate self-regulation mediators of weight loss and 2-year weight loss maintenance, in a large sample of overweight women. Results show that lowering emotional eating and adopting a flexible dietary restraint pattern are critical for sustained weight loss. For long-term success, interventions must also be effective in promoting exercise intrinsic motivation and self-efficacy.

Biochemical, Anthropometric and Lifestyle Factors Related with Weight Maintenance after Weight Loss Secondary to a Hypocaloric Mediterranean Diet.

PubMed

de Luis, Daniel Antonio; Izaola, Olatz; Primo, David; Ovalle, Hilda F; Lopez, Juan Jose; Gomez, Emilia; Ortola, Ana; Aller, Rocio

2017-01-01

The aim of our study was to evaluate the influence of lifestyle factors and molecular biomarkers on the maintenance of the weight lost after a hypocaloric Mediterranean diet. After 3 months on a diet, patients (n = 335) remained with no controlled diet during 3 years and they were revaluated. Using linear regression, in the group of responders, we detected that a positive weight loss at 3 months, serum levels of leptin at 3 months, and each 30 min per week of physical activity were associated with weight loss maintenance. In the model with reduced weight (RW) as dependent variable, a positive weight loss at 3 months was associated with 2.4% RW (95% CI 1.31-8.11; p = 0.015), each unit of serum leptin levels at 3 months with -0.44% RW (95% CI -0.59 to -0.020; p = 0.007), each basal unit homeostasis model assessment for insulin resistance (HOMA-IR) level with -2.32% (95% CI -13.01 to -0.17; p = 0.040), and each 30 min per week of physical activity with 1.58% RW (95% CI 1.08-2.94; p = 0.020). Obese subjects who are on maintenance weight loss after a dietary intervention appear to have a better initial response during the 3 months intervention, more physical activity at 3 years, and lower basal HOMA-IR and leptin after weight loss than those who regain weight. © 2017 S. Karger AG, Basel.

40 CFR 63.9525 - What are the installation, operation, and maintenance requirements for my weight measurement device?

Code of Federal Regulations, 2010 CFR

2010-07-01

..., and maintenance requirements for my weight measurement device? 63.9525 Section 63.9525 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for...

Maintenance Audit through Value Analysis Technique: A Case Study

NASA Astrophysics Data System (ADS)

Carnero, M. C.; Delgado, S.

2008-11-01

The increase in competitiveness, technological changes and the increase in the requirements of quality and service have forced a change in the design and application of maintenance, as well as the way in which it is considered within the managerial strategy. There are numerous maintenance activities that must be developed in a service company. As a result the maintenance functions as a whole have to be outsourced. Nevertheless, delegating this subject to specialized personnel does not exempt the company from responsibilities, but rather leads to the need for control of each maintenance activity. In order to achieve this control and to evaluate the efficiency and effectiveness of the company it is essential to carry out an audit that diagnoses the problems that could develop. In this paper a maintenance audit applied to a service company is developed. The methodology applied is based on the expert systems. The expert system by means of rules uses the weighting technique SMART and value analysis to obtain the weighting between the decision functions and between the alternatives. The expert system applies numerous rules and relations between different variables associated with the specific maintenance functions, to obtain the maintenance state by sections and the general maintenance state of the enterprise. The contributions of this paper are related to the development of a maintenance audit in a service enterprise, in which maintenance is not generally considered a strategic subject and to the integration of decision-making tools such as the weighting technique SMART with value analysis techniques, typical in the design of new products, in the area of the rule-based expert systems.

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…

Effects of anti-obesity drugs, diet, and exercise on weight-loss maintenance after a very-low-calorie diet or low-calorie diet: a systematic review and meta-analysis of randomized controlled trials123

PubMed Central

Neovius, Martin; Hemmingsson, Erik

2014-01-01

Background: Weight-loss maintenance remains a major challenge in obesity treatment. Objective: The objective was to evaluate the effects of anti-obesity drugs, diet, or exercise on weight-loss maintenance after an initial very-low-calorie diet (VLCD)/low-calorie diet (LCD) period (<1000 kcal/d). Design: We conducted a systematic review by using MEDLINE, the Cochrane Controlled Trial Register, and EMBASE from January 1981 to February 2013. We included randomized controlled trials that evaluated weight-loss maintenance strategies after a VLCD/LCD period. Two authors performed independent data extraction by using a predefined data template. All pooled analyses were based on random-effects models. Results: Twenty studies with a total of 27 intervention arms and 3017 participants were included with the following treatment categories: anti-obesity drugs (3 arms; n = 658), meal replacements (4 arms; n = 322), high-protein diets (6 arms; n = 865), dietary supplements (6 arms; n = 261), other diets (3 arms; n = 564), and exercise (5 arms; n = 347). During the VLCD/LCD period, the pooled mean weight change was −12.3 kg (median duration: 8 wk; range 3–16 wk). Compared with controls, anti-obesity drugs improved weight-loss maintenance by 3.5 kg [95% CI: 1.5, 5.5 kg; median duration: 18 mo (12–36 mo)], meal replacements by 3.9 kg [95% CI: 2.8, 5.0 kg; median duration: 12 mo (10–26 mo)], and high-protein diets by 1.5 kg [95% CI: 0.8, 2.1 kg; median duration: 5 mo (3–12 mo)]. Exercise [0.8 kg; 95% CI: −1.2, 2.8 kg; median duration: 10 mo (6–12 mo)] and dietary supplements [0.0 kg; 95% CI: −1.4, 1.4 kg; median duration: 3 mo (3–14 mo)] did not significantly improve weight-loss maintenance compared with control. Conclusion: Anti-obesity drugs, meal replacements, and high-protein diets were associated with improved weight-loss maintenance after a VLCD/LCD period, whereas no significant improvements were seen for dietary supplements and exercise. PMID:24172297

Long-term effects of consumption of a novel fat emulsion in relation to body-weight management.

PubMed

Diepvens, K; Soenen, S; Steijns, J; Arnold, M; Westerterp-Plantenga, M

2007-06-01

To assess weight maintenance after weight loss by consumption of yoghurt with a novel fat emulsion (Olibra) including effects on body composition, resting energy expenditure (REE), fat oxidation, hunger feelings and satiety hormones. A randomized, placebo-controlled, double-blind, parallel design. A 6-week weight loss period (2.1 MJ/day) was followed by 18 weeks weight maintenance with test (Olibra) or placebo yoghurt. Fifty overweight women (age: 18-58 years, body mass index (BMI) 25-32 kg/m2). In weeks 1, 7 and 25, a satiety test with questionnaires and blood samples for analysis of satiety hormones. In weeks 2, 8 and 26, REE, body weight and body composition. During weight maintenance after significant body weight reduction, there was no significant increase in body weight in the test group (1.1+/-3.4 kg); the placebo group did gain weight (3.0+/-3.1 kg, P<0.001). Compared to the placebo group, the test group was less hungry 4 h after yoghurt consumption in week 25 (P<0.05) and showed increased glucagon like peptide-1 values 180 min after yoghurt consumption (week 25 vs week 1, P<0.05). Measured REE as a function of fat-free mass (FFM) was significantly higher than predicted REE (P<0.05) in week 26 for the test group, but not for the placebo group. Fat mass (FM) was significantly more decreased in the test group (6.5+/-4.1 kg) compared to the placebo group (4.1+/-3.6 kg) (week 26 vs week 2, P<0.05). Consumption of Olibra yoghurt improved weight maintenance compared to placebo, which can be explained by the relatively higher REE as a function of FFM, relatively higher decrease in FM and the relatively lower increase in hunger.

Weight gain since menopause and its associations with weight loss maintenance in obese postmenopausal women

PubMed Central

Sénéchal, M; Arguin, H; Bouchard, DR; Carpentier, AC; Ardilouze, JL; Dionne, IJ; Brochu, M

2011-01-01

Objective To examine the association between weight gain since menopause and weight regain after a weight loss program. Methods Participants were 19 obese women who participated in a 15-week weight loss program and a 12-month follow-up. Main outcomes were: body composition, resting metabolic rate, energy intake, energy expenditure, and weight regain at follow-up. Results All body composition measures significantly decreased after intervention (all P ≤ 0.01) while all measures of fatness increased significantly after the 12-month follow-up (P ≤ 0.01). Body weight gain since menopause was associated with body weight regain (r = 0.65; P = 0.003) after follow-up even after adjustment for confounders. Conclusion Weight gain since menopause is associated with body weight regain following the weight loss program. Therefore, weight gain since menopause should be considered as a factor influencing weight loss maintenance in older women. PMID:21966216

Weight gain since menopause and its associations with weight loss maintenance in obese postmenopausal women.

PubMed

Sénéchal, M; Arguin, H; Bouchard, D R; Carpentier, A C; Ardilouze, J L; Dionne, I J; Brochu, M

2011-01-01

To examine the association between weight gain since menopause and weight regain after a weight loss program. Participants were 19 obese women who participated in a 15-week weight loss program and a 12-month follow-up. Main outcomes were: body composition, resting metabolic rate, energy intake, energy expenditure, and weight regain at follow-up. All body composition measures significantly decreased after intervention (all P ≤ 0.01) while all measures of fatness increased significantly after the 12-month follow-up (P ≤ 0.01). Body weight gain since menopause was associated with body weight regain (r = 0.65; P = 0.003) after follow-up even after adjustment for confounders. Weight gain since menopause is associated with body weight regain following the weight loss program. Therefore, weight gain since menopause should be considered as a factor influencing weight loss maintenance in older women.

Long term maintenance of weight loss with non-surgical interventions in obese adults: systematic review and meta-analyses of randomised controlled trials

PubMed Central

Dombrowski, S U; Knittle, K; Avenell, A; Araújo-Soares, V

2014-01-01

Objective To systematically review and describe currently available approaches to supporting maintenance of weight loss in obese adults and to assess the evidence for the effectiveness of these interventions. Design Systematic review with meta-analysis. Data sources Medline, PsycINFO, Embase, and the Cochrane Central Register of Controlled Trials. Study selection Studies were identified through to January 2014. Randomised trials of interventions to maintain weight loss provided to initially obese adults (aged ≥18) after weight loss of ≥5% body weight with long term (≥12 months) follow-up of weight change (main outcome) were included. Study appraisal and synthesis Potential studies were screened independently and in duplicate; study characteristics and outcomes were extracted. Meta-analyses were conducted to estimate the effects of interventions on weight loss maintenance with the inverse variance method and a random effects model. Results are presented as mean differences in weight change, with 95% confidence intervals. Results 45 trials involving 7788 individuals were included. Behavioural interventions focusing on both food intake and physical activity resulted in an average difference of −1.56 kg (95% confidence interval −2.27 to −0.86 kg; 25 comparisons, 2949 participants) in weight regain compared with controls at 12 months. Orlistat combined with behavioural interventions resulted in a −1.80 kg (−2.54 to −1.06; eight comparisons, 1738 participants) difference compared with placebo at 12 months. All orlistat studies reported higher frequencies of adverse gastrointestinal events in the experimental compared with placebo control groups. A dose-response relation for orlistat treatment was found, with 120 mg doses three times a day leading to greater weight loss maintenance (−2.34 kg, −3.03 to −1.65) compared with 60 mg and 30 mg three times a day (−0.70 kg, 95% confidence interval −1.92 to 0.52), P=0.02. Conclusions Behavioural interventions that deal with both diet and physical activity show small but significant benefits on weight loss maintenance. PMID:25134100

Obesity and mental health.

PubMed

Talen, Mary R; Mann, Misty M

2009-06-01

Mental health factors contribute to the onset and maintenance of overweight and obese status in children, adolescents, and adults. Binge eating disorder (BED), body image, self-esteem, mood disorders, and social and family factors affect individuals in different ways and contribute to weight gain and failure in weight loss management. Assessment of these mental health factors and treatment by 1 of several mental health treatment models may not only improve self-worth but also weight loss and maintenance.

Daily Self-Monitoring of Body Weight, Step Count, Fruit/Vegetable Intake and Water Consumption: A Feasible and Effective Long-Term Weight Loss Maintenance Approach

PubMed Central

Akers, Jeremy D.; Cornett, Rachel A.; Savla, Jyoti S.; Davy, Kevin P.; Davy, Brenda M.

2012-01-01

Maintenance of weight loss remains a challenge for most individuals, thus practical and effective weight loss maintenance (WTLM) strategies are needed. A two-group (WEV versus WEV+) 12-month WTLM intervention trial was conducted (June 2007–February 2010) to determine the feasibility and effectiveness of weight loss maintenance intervention for older adults using daily self-monitoring of body weight, step count, fruit/vegetable intake and water consumption. Forty weight-reduced (mean weight lost = 6.7 ± 0.6 kg; BMI 29.2 ± 1.1 kg/m2) individuals aged 63 ± 1 yrs, who had previously participated in a 12-week randomized controlled weight loss intervention trial, were instructed to record daily body weight (Weight), step count (Exercise), and fruit/vegetable intake (Vegetable). Experimental group (WEV+) participants were also instructed to consume 16 floz of water before each main meal (i.e., three times daily), and to record daily water intake. Outcome measures included weight change, diet/physical activity behaviors, theoretical constructs related to health behaviors, and other clinical measures. Statistical analyses included growth curve analyses and repeated measures ANOVA. Over 12 months, there was a linear decline in weight (β = −0.32, P < 0.001) and a quadratic trend (β = 0.02, P < 0.01) over time, but no group difference (β = −0.23, P = 0.08). Analysis of the 365 days of self-reported body weight for each participant determined that weight loss was greater over the study period in WEV+ than WEV, corresponding to weight changes of −0.67 kg and 1.00 kg respectively, and an 87% greater weight loss (β = −0.01, P < 0.01). Overall compliance to daily tracking was 76 ± 5%. Daily self-monitoring of weight, physical activity, and fruit/vegetable consumption is a feasible and effective approach for maintaining weight loss for 12 months, and daily self-monitoring of increased water consumption may provide additional WTLM benefits. PMID:22709772

Body weight maintenance and levels of mutans streptococci and lactobacilli in a group of Swedish women seven years after completion of a Weight Watchers' diet.

PubMed

Köhler, Birgitta; Andreén, Ingrid

2011-01-01

The long-term effect of the WW programme on weight and oral cariogenic bacteria was evaluated after 7 yr. All WW who completed the 8-wk dietary regimen in an earlier study (n=33) and the persons in the reference group (REF) (n=27) were invited to participate. The salivary secretion rate, numbers of mutans streptococci (MS) and lactobacilli (lbc) were determined. The WW were weighed. Sustaining a 5% weight loss from the initial weight was regarded as successful weight maintenance. An interview according to a standardised questionnaire was conducted on medication,the intake of antimicrobial agents, dietary changes and experience of dental caries during the last 7 yr. 25 WW and 21 REF qualified to participate. On a group basis, weight, salivary MS and lbc displayed pre-diet levels after 7yr. 15 of the WW (60%) were below their initial weight. Successful weight maintenance was achieved by 32%. Reported changes in the intake of fat-rich products differed significantly between the WW and the REF. Nine WW reported fewer carious lesions after joining the WW. Ninety per cent of REF did not regard caries as a problem. Comparisons of pre- and post-diet data and 7 yr data indicated short-term compliance and varying outcome in terms of long-term compliance. No association was found between salivary levels of bacteria and long-term weight maintenance on a group basis. However,further well-designed longitudinal studies are required to confirm whether salivary MS could be used on an individual basis to validate reported sucrose intake in a dietary regimen.

Reliability of hunger-related assessments during 24-hour fasts and their relationship to body composition and subsequent energy compensation.

PubMed

Tinsley, Grant M; Moore, M Lane; Graybeal, Austin J

2018-05-01

Many diets employ regular periods of fasting that extend beyond a typical overnight fast (i.e. intermittent fasting [IF]). Evaluation of acute fasting responses provides information concerning the potential theoretical rationale for IF. The purpose of the present investigation was to assess the test-retest reliability of hunger-related variables during 24-hour fasts and the relationship between these variables and body composition, as well as subsequent energy intake (EI) after fasting. Eleven participants (6 F, 5 M) completed two 24-hour fasts after being provided a 3-day standardized weight-maintenance diet. From 16 to 24 h of fasting, participants were directly observed and provided hourly assessments of hunger, desire to eat (DTE), prospective food consumption (PFC), fullness and energy. After the fast, participants were allowed ad libitum food consumption, and compensation was calculated as EI relative to weight-maintenance energy needs. Test-retest reliability for hunger-related assessments at particular durations of fasting was evaluated using intraclass correlation coefficients (ICC), changes in dependent variables were evaluated using ANOVA with repeated measures, and relationships between variables were explored using bivariate correlations. At 16 h of fasting, the ICCs for all hunger-related assessments were statistically significant (r = 0.67-0.91; p ≤ 0.05). However, as the fast progressed, reliability varied substantially. When averaged across the nine measurements, the ICCs were: 0.81 (fullness), 0.74 (PFC), 0.67 (energy), 0.44 (DTE) and 0.36 (hunger). Body fat percentage was significantly correlated with changes in PFC (r = 0.62, p = 0.04), hunger (r = 0.66, p = 0.03), DTE (r = 0.71, p = 0.02), and fullness (r = -0.63, p = 0.04), but not energy (r = -0.16, p = 0.64). Average EI compensation was only 60% of weight-maintenance needs, but substantial variability was observed (7 to 110% compensation). Compensation was significantly correlated with changes in PFC (r = 0.72, p = 0.01), hunger (r = 0.63, p = 0.04) and DTE (r = 0.60, p = 0.05), but not fullness (r = 0.58, p = 0.06) or energy (r = 0.35, p = 0.29). Compensation and body fat percentage were not correlated (r = 0.03, p = 0.94). The percent of energy intake from fat and protein increased after the fast (29.9 to 37.3% and 13.8 to 16.8%; p < 0.05), while the percent of energy intake from carbohydrate decreased (56.4 to 46.0%; p = 0.02). These results may have implications for IF programs. It is possible that the implementation of multiple "test fasts," in which subjective variables and subsequent energy intake are evaluated, could be used to identify candidates who may be more likely to benefit from an IF program. Copyright © 2018 Elsevier Inc. All rights reserved.

Effect of Weight Maintenance on Symptoms of Knee Osteoarthritis in Obese Patients: A Twelve-Month Randomized Controlled Trial

PubMed Central

Christensen, Robin; Henriksen, Marius; Leeds, Anthony R; Gudbergsen, Henrik; Christensen, Pia; Sørensen, Tina J; Bartels, Else M; Riecke, Birgit F; Aaboe, Jens; Frederiksen, Rikke; Boesen, Mikael; Lohmander, L Stefan; Astrup, Arne; Bliddal, Henning

2015-01-01

Objective To compare results of obese patients with knee osteoarthritis (OA) who, after an intensive weight loss regimen, received 1 year of either dietary support (D), a knee-exercise program (E), or “no attention” (C; control group). Methods We conducted a randomized, 2-phase, parallel-group trial. A total of 192 obese participants with knee OA were enrolled; the mean age was 62.5 years and 81% were women with a mean entry weight of 103.2 kg. In phase 1, all participants were randomly assigned to 1 of 3 groups and began a dietary regimen of 400–810 and 1,250 kcal/day for 16 weeks (2 8-week phases) to achieve a major weight loss. Phase 2 consisted of 52 weeks' maintenance in either group D, E, or C. Outcomes were changes from randomization in pain on a 100-mm visual analog scale, weight, and response according to the Outcome Measures in Rheumatology-Osteoarthritis Research Society International criteria. Results Mean weight loss for phase 1 was 12.8 kg. After 1 year on maintenance therapy, the D group sustained a lower weight (11.0 kg, 95% confidence interval [95% CI] 9.0, 12.8 kg) than those in the E (6.2, 95% CI 4.4, 8.1 kg) and C (8.2, 95% CI 6.4, 10.1 kg) groups (P = 0.002 by analysis of covariance [ANCOVA]). Adherence was low in the E group. All groups had statistically significant pain reduction (D: 6.1; E: 5.6; and C: 5.5 mm) with no difference between groups (P = 0.98 by ANCOVA). In each group 32 (50%), 26 (41%), and 33 (52%) participants responded to treatment in the D, E, and C groups, respectively, with no statistically significant difference in the number of responders (P = 0.41). Conclusion A significant weight reduction with a 1-year maintenance program improves knee OA symptoms irrespective of maintenance program. PMID:25370359

Usefulness of a Novel Mobile Diabetes Prevention Program Delivery Platform With Human Coaching: 65-Week Observational Follow-Up

PubMed Central

Michaelides, Andreas; Major, Jennifer; Pienkosz Jr, Edmund; Wood, Meghan; Kim, Youngin

2018-01-01

Background It is widely recognized that the prevalence of obesity and comorbidities including prediabetes and type 2 diabetes continue to increase worldwide. Results from a 24-week Diabetes Prevention Program (DPP) fully mobile pilot intervention were previously published showing promising evidence of the usefulness of DPP-based eHealth interventions on weight loss. Objective This pilot study extends previous findings to evaluate weight loss results of core (up to week 16) and maintenance (postcore weeks) DPP interventions at 65 weeks from baseline. Methods Originally, 140 participants were invited and 43 overweight or obese adult participants with a diagnosis of prediabetes signed up to receive a 24-week virtual DPP with human coaching through a mobile platform. At 65 weeks, this pilot study evaluates weight loss and engagement in maintenance participants by means of repeated measures analysis of variances and backward multiple linear regression to examine predictors of weight loss. Last observation carried forward was used for endpoint measurements. Results At 65 weeks, mean weight loss was 6.15% in starters who read 1 or more lessons per week on 4 or more core weeks, 7.36% in completers who read 9 or more lessons per week on core weeks, and 8.98% in maintenance completers who did any action in postcore weeks (all P<.001). Participants were highly engaged, with 80% (47/59) of the sample completing 9 lessons or more and 69% (32/47) of those completing the maintenance phase. In-app actions related to self-monitoring significantly predicted weight loss. Conclusions In comparison to eHealth programs, this pilot study shows that a fully mobile DPP can produce transformative weight loss. A fully mobile DPP intervention resulted in significant weight loss and high engagement during the maintenance phase, providing evidence for long-term potential as an alternative to in-person DPP by removing many of the barriers associated with in-person and other forms of virtual DPP. PMID:29724709

Predictors of long term weight loss maintenance in patients at high risk of type 2 diabetes participating in a lifestyle intervention program in primary health care: The DE-PLAN study.

PubMed

Gilis-Januszewska, Aleksandra; Barengo, Noël C; Lindström, Jaana; Wójtowicz, Ewa; Acosta, Tania; Tuomilehto, Jaakko; Schwarz, Peter E H; Piwońska-Solska, Beata; Szybiński, Zbigniew; Windak, Adam; Hubalewska-Dydejczyk, Alicja

2018-01-01

Lifestyle interventions in type 2 diabetes (DM2) prevention implementation studies can be effective and lasting. Long-term weight loss maintenance enhances the intervention effect through a significant decrease in diabetes incidence over time. Our objective was to identify factors predicting long-term successful weight reduction maintenance achieved during a DM2 prevention program in patients with high DM2 risk in primary health care. Study participants (n = 263), middle-aged, slightly obese with baseline increased DM2 risk (Finnish Diabetes Risk Score (FINDRISC)>14), but no diabetes were invited to receive 11 lifestyle counselling sessions, guided physical activity sessions and motivational support during 10-months. The study participants had three clinical examinations during the study (baseline, one and three years). Stepwise regression analysis was used to determine demographic, clinical, and lifestyle predictors of weight reduction maintenance two years after the discontinuation of the intervention. Out of 105 patients who completed all three examinations (baseline age 56.6 (standard deviation (SD) = 10.7), body mass index 31.1 kg/m2 (SD = 4.9), FINDRISC 18.6 (SD = 3.1)), 73 patients (70%) showed weight loss during the intervention (mean weight loss 4.2 kg, SD = 5.1). The total weight loss achieved in the maintainers (27 of 73 study participants) two years after the intervention had finished was 6.54 kg (4.47 kg+2.0 kg). The non-maintainers, on the other hand, returned to their initial weight at the start of the intervention (+0.21 kg). In multivariable analysis baseline history of increased glucose (odds ratio (OR) = 3.7; 95% confidence interval (CI) 1.0-13.6) and reduction of total fat in diet during follow-up (OR = 4.3; 95% CI 1.5-12.2) were independent predictors of successful weight loss. Further studies exploring predictors of weight loss maintenance in diabetes prevention are needed to help health care providers to redesign interventions and improve long-term outcomes of real life interventions.

[Weight maintenance after weight loss - how the body defends its weight].

PubMed

Holzapfel, C; Hauner, H

2011-01-01

Mean weight loss of most conservative therapeutic weight loss programmes is about five to six kilograms after one year. In our "obesogenic" environment it is difficult for persons to maintain the new weight. Also continuation of the programme cannot prevent a moderate weight increase in the follow-up year. The reasons for this are not clear: individual lifestyle, environmental and genetic factors may play a role, but also the complex regulatory system of the body "to defend its weight". Nevertheless, for weight maintenance a lifelong change of lifestyle is of critical importance. Concerning nutrition a fat-reduced diet with a decrease of energy density together with regular eating habits and adequate portion size promises the greatest benefit and is likely to allow sufficient satiety. © Georg Thieme Verlag KG Stuttgart · New York.

Weight Fluctuation and Cancer Risk in Postmenopausal Women: The Women's Health Initiative.

PubMed

Welti, Laura M; Beavers, Daniel P; Caan, Bette J; Sangi-Haghpeykar, Haleh; Vitolins, Mara Z; Beavers, Kristen M

2017-05-01

Background: Weight cycling, defined by an intentional weight loss and subsequent regain, commonly occurs in overweight and obese women and is associated with some negative health outcomes. We examined the role of various weight-change patterns during early to mid-adulthood and associated risk of highly prevalent, obesity-related cancers (breast, endometrial, and colorectal) in postmenopausal women. Methods: A total of 80,943 postmenopausal women (age, 63.4 ± 7.4 years) in the Women's Health Initiative Observational Study were categorized by self-reported weight change (weight stable; weight gain; lost weight; weight cycled [1-3, 4-6, 7-10, >10 times]) during early to mid-adulthood (18-50 years). Three site-specific associations were investigated using Cox proportional hazard models [age, race/ethnicity, income, education, smoking, alcohol, physical activity, hormone therapy, diet, and body mass index (BMI)]. Results: A total of 7,464 (breast = 5,564; endometrial = 788; and colorectal = 1,290) incident cancer cases were identified between September 1994 and August 2014. Compared with weight stability, weight gain was significantly associated with risk of breast cancer [hazard ratio (HR), 1.11; 1.03-1.20] after adjustment for BMI. Similarly, weight cycling was significantly associated with risk of endometrial cancer (HR = 1.23; 1.01-1.49). Weight cycling "4 to 6 times" was most consistently associated with cancer risk, showing a 38% increased risk for endometrial cancer [95% confidence interval (CI), 1.08-1.76] compared with weight stable women. Conclusions: Weight gain and weight cycling were positively associated with risk of breast and endometrial cancer, respectively. Impact: These data suggest weight cycling and weight gain increase risk of prevalent cancers in postmenopausal women. Adopting ideal body-weight maintenance practices before and after weight loss should be encouraged to reduce risk of incident breast and endometrial cancers. Cancer Epidemiol Biomarkers Prev; 26(5); 779-86. ©2017 AACR . ©2017 American Association for Cancer Research.

Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures: Psychosocial Domain.

PubMed

Sutin, Angelina R; Boutelle, Kerri; Czajkowski, Susan M; Epel, Elissa S; Green, Paige A; Hunter, Christine M; Rice, Elise L; Williams, David M; Young-Hyman, Deborah; Rothman, Alexander J

2018-04-01

Within the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project, the psychosocial domain addresses how psychosocial processes underlie the influence of obesity treatment strategies on weight loss and weight maintenance. The subgroup for the psychosocial domain identified an initial list of high-priority constructs and measures that ranged from relatively stable characteristics about the person (cognitive function, personality) to dynamic characteristics that may change over time (motivation, affect). This paper describes (a) how the psychosocial domain fits into the broader model of weight loss and weight maintenance as conceptualized by ADOPT; (b) the guiding principles used to select constructs and measures for recommendation; (c) the high-priority constructs recommended for inclusion; (d) domain-specific issues for advancing the science; and (e) recommendations for future research. The inclusion of similar measures across trials will help to better identify how psychosocial factors mediate and moderate the weight loss and weight maintenance process, facilitate research into dynamic interactions with factors in the other ADOPT domains, and ultimately improve the design and delivery of effective interventions. © 2018 The Obesity Society.

Feasibility and indicative results from a 12-month low-energy liquid diet treatment and maintenance programme for severe obesity

PubMed Central

Lean, Michael; Brosnahan, Naomi; McLoone, Philip; McCombie, Louise; Higgs, Anna Bell; Ross, Hazel; Mackenzie, Mhairi; Grieve, Eleanor; Finer, Nick; Reckless, John; Haslam, David; Sloan, Billy; Morrison, David

2013-01-01

Background There is no established primary care solution for the rapidly increasing numbers of severely obese people with body mass index (BMI) > 40 kg/m2. Aim This programme aimed to generate weight losses of ≥15 kg at 12 months, within routine primary care. Design and setting Feasibility study in primary care. Method Patients with a BMI ≥40 kg/m2 commenced a micronutrient-replete 810–833 kcal/day low-energy liquid diet (LELD), delivered in primary care, for a planned 12 weeks or 20 kg weight loss (whichever was the sooner), with structured food reintroduction and then weight-loss maintenance, with optional orlistat to 12 months. Result Of 91 patients (74 females) entering the programme (baseline: weight 131 kg, BMI 48 kg/m2, age 46 years), 58/91(64%) completed the LELD stage, with a mean duration of 14.4 weeks (standard deviation [SD] = 6.0 weeks), and a mean weight loss of 16.9 kg (SD = 6.0 kg). Four patients commenced weight-loss maintenance omitting the food-reintroduction stage. Of the remaining 54, 37(68%) started and completed food reintroduction over a mean duration of 9.3 weeks (SD = 5.7 weeks), with a further mean weight loss of 2.1 kg (SD = 3.7 kg), before starting a long-term low-fat-diet weight-loss maintenance plan. A total of 44/91 (48%) received orlistat at some stage. At 12 months, weight was recorded for 68/91 (75%) patients, with a mean loss of 12.4 kg (SD = 11.4 kg). Of these, 30 (33% of all 91 patients starting the programme) had a documented maintained weight loss of ≥15 kg at 12 months, six (7%) had a 10–15 kg loss, and 11 (12%) had a 5–10 kg loss. The indicative cost of providing this entire programme for wider implementation would be £861 per patient entered, or £2611 per documented 15 kg loss achieved. Conclusion A care package within routine primary care for severe obesity, including LELD, food reintroduction, and weight-loss maintenance, was well accepted and achieved a 12-month-maintained weight loss of ≥15 kg for one-third of all patients entering the programme. PMID:23561690

Feasibility and indicative results from a 12-month low-energy liquid diet treatment and maintenance programme for severe obesity.

PubMed

Lean, Michael; Brosnahan, Naomi; McLoone, Philip; McCombie, Louise; Higgs, Anna Bell; Ross, Hazel; Mackenzie, Mhairi; Grieve, Eleanor; Finer, Nick; Reckless, John; Haslam, David; Sloan, Billy; Morrison, David

2013-02-01

There is no established primary care solution for the rapidly increasing numbers of severely obese people with body mass index (BMI) > 40 kg/m(2). This programme aimed to generate weight losses of ≥15 kg at 12 months, within routine primary care. Feasibility study in primary care. Patients with a BMI ≥40 kg/m(2) commenced a micronutrient-replete 810-833 kcal/day low-energy liquid diet (LELD), delivered in primary care, for a planned 12 weeks or 20 kg weight loss (whichever was the sooner), with structured food reintroduction and then weight-loss maintenance, with optional orlistat to 12 months. Of 91 patients (74 females) entering the programme (baseline: weight 131 kg, BMI 48 kg/m(2), age 46 years), 58/91(64%) completed the LELD stage, with a mean duration of 14.4 weeks (standard deviation [SD] = 6.0 weeks), and a mean weight loss of 16.9 kg (SD = 6.0 kg). Four patients commenced weight-loss maintenance omitting the food-reintroduction stage. Of the remaining 54, 37(68%) started and completed food reintroduction over a mean duration of 9.3 weeks (SD = 5.7 weeks), with a further mean weight loss of 2.1 kg (SD = 3.7 kg), before starting a long-term low-fat-diet weight-loss maintenance plan. A total of 44/91 (48%) received orlistat at some stage. At 12 months, weight was recorded for 68/91 (75%) patients, with a mean loss of 12.4 kg (SD = 11.4 kg). Of these, 30 (33% of all 91 patients starting the programme) had a documented maintained weight loss of ≥15 kg at 12 months, six (7%) had a 10-15 kg loss, and 11 (12%) had a 5-10 kg loss. The indicative cost of providing this entire programme for wider implementation would be £861 per patient entered, or £2611 per documented 15 kg loss achieved. A care package within routine primary care for severe obesity, including LELD, food reintroduction, and weight-loss maintenance, was well accepted and achieved a 12-month-maintained weight loss of ≥15 kg for one-third of all patients entering the programme.

The Resist Diabetes trial: Rationale, design, and methods of a hybrid efficacy/effectiveness intervention trial for resistance training maintenance to improve glucose homeostasis in older prediabetic adults

PubMed Central

Marinik, Elaina L.; Kelleher, Sarah; Savla, Jyoti; Winett, Richard A.; Davy, Brenda M.

2014-01-01

Advancing age is associated with reduced levels of physical activity, increased body weight and fat, decreased lean body mass, and a high prevalence of type 2 diabetes (T2D). Resistance training (RT) increases muscle strength and lean body mass, and reduces risk of T2D among older adults. The Resist Diabetes trial will determine if a social cognitive theory (SCT)-based intervention improves RT maintenance in older, prediabetic adults, using a hybrid efficacy/effectiveness approach. Sedentary, overweight/obese (BMI 25-39.9 kg/m2) adults aged 50-69 (N=170) with prediabetes (impaired fasting glucose and/or impaired glucose tolerance) completed a supervised 3-month RT (2x/wk) Initiation Phase and were then randomly assigned (n=159; 94% retention) to one of two 6-month maintenance conditions: SCT or Standard care. The SCT intervention consisted of faded contacts compared to Standard care. Participants continue RT at an approved, self-selected community facility during maintenance. A subsequent 6-month period involves no contact for both conditions. Assessments occur at baseline and months 3 (post-initiation), 9 (post-intervention), and 15 (six months after no contact). Primary outcomes are prediabetes indices (i.e., impaired fasting and 2-hour glucose concentration) and strength. Secondary measures include insulin sensitivity, beta-cell responsiveness, and disposition index (oral glucose and C-peptide minimal model); adherence; body composition; and SCT measures. Resist Diabetes is the first trial to examine the effectiveness of a high fidelity SCT-based intervention for maintaining RT in older adults with prediabetes to improve glucose homeostasis. Successful application of SCT constructs for RT maintenance may support translation of our RT program for diabetes prevention into community settings. PMID:24252311

Efficacy of Healing meditation in reducing anxiety of individuals at the phase of weight loss maintenance: A randomized blinded clinical trial.

PubMed

Sampaio, Cynthia Vieira Sanches; Lima, Manuela Garcia; Ladeia, Ana Marice

2016-12-01

To verify the efficacy of Healing Meditation in reducing anxiety levels in individuals on a weight loss maintenance program. A randomized, controlled, evaluator-blinded clinical trial, conducted between January and October 2014, with a follow-up of 12 weeks. A weight loss secondary care facility in Salvador, Brazil., of 41 patients at the weight maintenance phase (Mean initial BMI 33.6±4.7kg/m 2 , who had attained a mean BMI of 24.5±1.6kg/m 2 in a median period of 7 months). An 8-week Healing Meditation program (n=20), consisting of a 1h weekly meeting, or for a control group on the waiting list (n=21), in addition to the standard clinical program. Total anxiety was measured by the Hamilton Anxiety Scale (HAM-A), before and after the intervention. Secondary analyses included comparison of the effect of meditation on the somatic and psychic components of the scale. Through an intention to treat analysis, we detected a difference in the mean variation between the intervention and control groups in the total anxiety scores of 7.7 (95% CI 6.3-9.2; Cohen's d=3.41). Means and standard deviations for pre and post intervention anxiety scores were 15.5 (3.4) and 7.8 (2.0) for the intervention group and 14.8 (3.4) and 14.9 (3.4) for the control. Healing meditation significantly reduced the anxiety of obese individuals, in the phase of weight maintenance, suggesting this to be an effective auxiliary resource for weight loss maintenance. Copyright © 2016 Elsevier Ltd. All rights reserved.

Design considerations and rationale of a multi-center trial to sustain weight loss: the Weight Loss Maintenance Trial.

PubMed

Brantley, Phillip; Appel, Lawrence; Hollis, Jack; Stevens, Victor; Ard, Jamy; Champagne, Catherine; Elmer, Patricia; Harsha, David; Myers, Valerie; Proschan, Michael; William, Vollmer; Svetkey, Laura

2008-01-01

The Weight Loss Maintenance Trial (WLM) is a multi-center, randomized, controlled trial that compares the effects of two 30-month maintenance interventions, i.e., Personal Contact (PC) and Interactive Technology (IT) to a self-directed usual care control group (SD), in overweight or obese individuals who are at high risk for cardiovascular disease. This paper provides an overview of the design and methods, and design considerations and lessons learned from this trial. All participants received a 6-month behavioral weight loss program consisting of weekly group sessions. Participants who lost 4 kg were randomized to one of three conditions (PC, IT, or SD). The PC condition provided monthly contacts with an interventionist primarily via telephone and quarterly face-to-face visits. The IT condition provided frequent, individualized contact through a tailored, website system. Both the PC and IT maintenance programs encouraged the DASH dietary pattern and employed theory-based behavioral techniques to promote maintenance. Design considerations included choice of study population, frequency and type of intervention visits, and choice of primary outcome. Overweight or obese persons with CVD risk factors were studied. The pros and cons of studying this population while excluding others are presented. We studied intervention contact strategies that made fewer demands on participant time and travel, while providing frequent opportunities for interaction. The primary outcome variable for the trial was change in weight from randomization to end of follow-up (30 months). Limits to generalizability are discussed. Individuals in need of weight loss strategies may have been excluded due to barriers associated with internet use. Other participants may have been excluded secondary to a comorbid condition. This paper highlights the design and methods of WLM and informs readers of discussions of critical issues and lessons learned from the trial.

Role of fermented beverages in the maintenance of weight loss

PubMed

Monereo Megías, Susana; Arnoriaga Rodríguez, María; Olmedilla Ishishi, Yoko Lucía; Martínez de Icaya, Purificación

2016-07-12

Obesity is a very prevalent disease with multiple chronic complications that decrease or disappear after a small (5-10%) but maintained weight loss. Nevertheless, maintaining weight loss after the treatment is very difficult and it involves one of the biggest challenges to control this epidemic. Although the reasons that contribute to regain the lost weight are diverse and related to the biological response to caloric restriction and the lack of adherence to treatment, up to 20% of the patients are able to keep it off. The keys to success, involve the maintenance of healthy habits, exercise and a reasonable daily calorie intake to allow a normal way of life, without sacrificing the social life. At this point, learning to distinguish food and drink options in a society where social life often revolves around the table is very important. We review the keys to keep the weight off after a diet as well as the role of fermented beverages such as beer, in this process. In conclusion, maintenance the weight loss is harder than losing it. The mild-to-moderate consumption of fermented beverages such as beer is not associated with weight increase.

Using Focus Groups to Identify Factors Affecting Healthful Weight Maintenance in Latino Immigrants

ERIC Educational Resources Information Center

Greaney, Mary L.; Lees, Faith D.; Lynch, Breanna; Sebelia, Linda; Greene, Geoffrey W.

2012-01-01

Objective: To explore (1) how migration influenced physical activity and dietary behaviors among Latino immigrants and (2) participants' perception of concepts related to a Health at Every Size (HAES) approach to weight maintenance (mindful eating, taking care of oneself). Methods: Four focus groups (n = 35), homogenous by sex, were conducted in…

The influence of hunger on meal to pellet intervals in barred owls

USGS Publications Warehouse

Duke, G.E.; Fuller, M.R.; Huberty, B.J.

1980-01-01

1. Barred owls fed at a sub-maintenance (SM) level had significantly (P < 0.01) longer meal to pellet intervals (MPI)/g eaten/kg body weight (BW) than those fed at an above maintenance (AM) level; MPI/g per kg for owls fed at a maintenance (M) level was intermediate but significantly (P < 0.01) different from both SM and AM.2. During SM feeding, MPI/g per kg gradually increased.3. The proportion of a meal occurring in a pellet was less in “hungry” owls whether losing weight (SM) or gaining (AM) as compared to owls maintaining their normal body weight (M).4. SM fed owls appear to be able to increase digestion time as well as thoroughness of digestion.

Contaminant studies in the Sierra Nevadas

USGS Publications Warehouse

Sparling, Don; Fellers, Gary M.

2002-01-01

1. 1. Barred owls fed at a sub-maintenance (SM) level had significantly (P < 0.01) longer meal to pellet intervals (MPI)/g eaten/kg body weight (BW) than those fed at an above maintenance (AM) level; MPI/g per kg for owls fed at a maintenance (M) level was intermediate but significantly (P < 0.01) different from both SM and AM. 2. 2. During SM feeding, MPI/g per kg gradually increased. 3. 3. The proportion of a meal occurring in a pellet was less in ?hungry? owls whether losing weight (SM) or gaining (AM) as compared to owls maintaining their normal body weight (M). 4. 4. SM fed owls appear to be able to increase digestion time as well as thoroughness of digestion.

Effects of Greenselect Phytosome® on weight maintenance after weight loss in obese women: a randomized placebo-controlled study.

PubMed

Gilardini, Luisa; Pasqualinotto, Lucia; Di Pierro, Francesco; Risso, Paolo; Invitti, Cecilia

2016-07-22

Most subjects regain weight after weight loss due to compensatory adaptations finalized to maintain stable body energy stores. Green tea (GT) preparations, which help maintain energy expenditure while dieting could be a useful strategy to facilitate weight maintenance. The usefulness of GT preparations in weight maintenance has been poorly studied so far with conflicting results. This study evaluated if a supplement of GSP and piperine helps obese women to maintain the weight loss obtained with a 3-month lifestyle intervention. In a randomized placebo-controlled study, we examined whether a highly bioavailable GT extract may counteract weight regain after weight loss. Forty obese women (age 50.1 ± 10.1 years, Body Mass Index (BMI) 36.3 ± 2.7 kg/m(2)) underwent a 3-month lifestyle intervention. At the end of the intervention, the women were randomized in two groups for the weight-maintenance phase: 20 of them were prescribed twice a day, for 3 months, with a formula containing 150 mg/dose of Greenselect Phytosome® and 15 mg/dose of pure piperine (GSP group), and 20 were given placebo (P group). Anthropometric measures and body composition were measured before (V-3) and after lifestyle intervention (V0), 1 (V1), 2 (V2), and 3 (V3) months after prescribing supplements and 3 months following the discontinuation of supplements (V6). Lifestyle intervention induced a significant weight reduction in both groups with similar weight change (-6.2 ± 2.6 in GSP group vs. -4.8 ± 3.1 % in P group). In the GSP group, V1 in comparison to V0, had further reduction in weight and fat mass, which remained stable at V2 and V3 and increased at V6. In the P group, weight and fat mass increased from V2 onwards. Weight changes in GSP group and P group from V0 to V3 were -1.0 kg (95 % CI -2.5 to +0.5) and + 0.3 kg (95 % CI -0.9 to +1.6), respectively. The proportion of women with weight loss ≥ 5 % was greater in the GSP group than in the P group (75 % vs. 45 % at V1, and 60 % vs. 30 % at V6, p < 0.05 for both groups). Greenselect Phytosome® devoid of caffeine may have a clinical potential for the maintenance of weight after intentional weight loss. Clinicaltrials.gov NCT02542449 (September 2015).

Financial incentive strategies for maintenance of weight loss: results from an internet-based randomized controlled trial.

PubMed

Yancy, William S; Shaw, Pamela A; Wesby, Lisa; Hilbert, Victoria; Yang, Lin; Zhu, Jingsan; Troxel, Andrea; Huffman, David; Foster, Gary D; Wojtanowski, Alexis C; Volpp, Kevin G

2018-05-25

Financial incentives can improve initial weight loss; we examined whether financial incentives can improve weight loss maintenance. Participants aged 30-80 years who lost at least 5 kg during the first 4-6 months in a nationally available commercial weight loss program were recruited via the internet into a three-arm randomized trial of two types of financial incentives versus active control during months 1-6 (Phase I) followed by passive monitoring during months 7-12 (Phase II). Interventions were daily self-weighing and text messaging feedback alone (control) or combined with a lottery-based incentive or a direct incentive. The primary outcome was weight change 6 months after initial weight loss. Secondary outcomes included weight change 12 months after initial weight loss (6 months after cessation of maintenance intervention), and self-reported physical activity and eating behaviors. Of 191 participants randomized, the mean age was 49.0 (SD = 10.5) years and weight loss prior to randomization was 11.4 (4.7) kg; 92% were women and 89% were White. Mean weight changes during the next 6 months (Phase I) were: lottery -3.0 (5.8) kg; direct -2.8 (5.8) kg; and control -1.4 (5.8) kg (all pairwise comparisons p > 0.1). Weight changes through the end of 12 months post-weight loss (Phase II) were: lottery -1.8 (10.5) kg; direct -0.7 (10.7) kg; and control -0.3 (9.4) kg (all pairwise comparisons p > 0.1). The percentages of participants who maintained their weight loss (defined as gaining ≤1.36 kg) were: lottery 79%, direct 76%, and control 67% at 6 months and lottery 66%, direct 62%, and control 59% at 12 months (all pairwise comparisons p > 0.1). At 6 and 12 months after initial weight loss, changes in self-reported physical activity or eating behaviors did not differ across arms. Compared with the active control of daily texting based on daily home weighing, lottery-based and direct monetary incentives provided no additional benefit for weight loss maintenance.

Prevention of type 2 diabetes through lifestyle modification: is there a role for higher-protein diets?

PubMed

Liu, Amy Y; Silvestre, Marta P; Poppitt, Sally D

2015-11-01

Type 2 diabetes (T2D) incidence is increasing worldwide, driven by a rapidly changing environment and lifestyle and increasing rates of overweight and obesity. Prevention of diabetes is key and is most likely achieved through prevention of weight gain and/or successful long-term weight loss maintenance. Weight loss is readily achievable but there is considerable challenge in maintaining that weight loss over the long term. Lower-fat carbohydrate-based diets are widely used for T2D prevention. This is supported primarily by 3 successful long-term interventions, the US Diabetes Prevention Program, the Finnish Diabetes Prevention Study, and the Chinese Da Qing Study, but evidence is building in support of novel higher-protein (>20% of energy) diets for successful weight loss maintenance and prevention of T2D. Higher-protein diets have the advantage of having relatively low energy density, aiding longer-term appetite suppression, and preserving lean body mass, all central to successful weight loss and prevention of weight regain. Here, we review the carbohydrate-based intervention trials and present mechanistic evidence in support of increased dietary protein for weight loss maintenance and a possible novel role in prevention of dysglycemia and T2D. © 2015 American Society for Nutrition.

Treatment with liraglutide may improve markers of CVD reflected by reduced levels of apoB

PubMed Central

Engelbrechtsen, L.; Lundgren, J.; Wewer Albrechtsen, N. J.; Mahendran, Y.; Iepsen, E. W.; Finocchietto, P.; Jonsson, A. E.; Madsbad, S.; Holst, J. J.; Vestergaard, H.; Hansen, T.

2017-01-01

Summary Background Dislipidaemia and increased levels of apolipoprotein B (apoB) in individuals with obesity are risk factors for development of cardiovascular disease (CVD). The aim of this study was to investigate the effect of weight loss and weight maintenance with and without liraglutide treatment on plasma lipid profiles and apoB. Methods Fifty‐eight individuals with obesity (body mass index 34.5 ± 3.0 kg/m2 [mean ± SD]) were included in this study. After 8 weeks on a very low‐calorie diet (800 kcal/day), participants were randomized to weight maintenance with meal replacements with or without liraglutide (1.2 mg daily) for 1 year. Plasma samples from before and after weight loss and after 1 year of weight maintenance were subjected to nuclear magnetic resonance‐based lipidomics analysis. Results After an 8‐week low‐calorie diet, study participants lost 12.0 ± 2.9 kg (mean ± SD) of their body weight, which was reflected in their lipid profiles (80 out of 124 lipids changed significantly), including reduced levels of apoB, total cholesterol, free cholesterol, remnant cholesterol, triglycerides, low‐density lipoprotein and very low‐density lipoprotein subclasses. After 1 year of maintained weight loss, the majority of the lipids had returned to pre‐weight loss levels even though weight loss was successfully maintained in both groups. Interestingly, apoB levels remained low in the liraglutide treated group (apoB change: 0.03 ± 0.02 mmol/L, p = 0.4) in contrast to an increase in the control group (apoB change: 0.06 ± 0.07 mmol/L, p = 0.02). Conclusion An 8‐week low‐calorie diet, in individuals with obesity, reduced plasma levels of lipids and the atherogenic marker apoB. After 1 year of weight maintenance, only study participants treated with liraglutide maintained reduced levels of apoB, despite similar body weight maintenance. Treatment with liraglutide may therefore reduce apoB levels and thus reflect lower CVD risk. Including apoB measurements in clinical practice when monitoring patients with dislipidemia or CVD might prove to be useful. PMID:29259801

Treatment with liraglutide may improve markers of CVD reflected by reduced levels of apoB.

PubMed

Engelbrechtsen, L; Lundgren, J; Wewer Albrechtsen, N J; Mahendran, Y; Iepsen, E W; Finocchietto, P; Jonsson, A E; Madsbad, S; Holst, J J; Vestergaard, H; Hansen, T; Torekov, S S

2017-12-01

Dislipidaemia and increased levels of apolipoprotein B (apoB) in individuals with obesity are risk factors for development of cardiovascular disease (CVD). The aim of this study was to investigate the effect of weight loss and weight maintenance with and without liraglutide treatment on plasma lipid profiles and apoB. Fifty-eight individuals with obesity (body mass index 34.5 ± 3.0 kg/m 2 [mean ± SD]) were included in this study. After 8 weeks on a very low-calorie diet (800 kcal/day), participants were randomized to weight maintenance with meal replacements with or without liraglutide (1.2 mg daily) for 1 year. Plasma samples from before and after weight loss and after 1 year of weight maintenance were subjected to nuclear magnetic resonance-based lipidomics analysis. After an 8-week low-calorie diet, study participants lost 12.0 ± 2.9 kg (mean ± SD) of their body weight, which was reflected in their lipid profiles (80 out of 124 lipids changed significantly), including reduced levels of apoB, total cholesterol, free cholesterol, remnant cholesterol, triglycerides, low-density lipoprotein and very low-density lipoprotein subclasses. After 1 year of maintained weight loss, the majority of the lipids had returned to pre-weight loss levels even though weight loss was successfully maintained in both groups. Interestingly, apoB levels remained low in the liraglutide treated group (apoB change: 0.03 ± 0.02 mmol/L, p = 0.4) in contrast to an increase in the control group (apoB change: 0.06 ± 0.07 mmol/L, p = 0.02). An 8-week low-calorie diet, in individuals with obesity, reduced plasma levels of lipids and the atherogenic marker apoB. After 1 year of weight maintenance, only study participants treated with liraglutide maintained reduced levels of apoB, despite similar body weight maintenance. Treatment with liraglutide may therefore reduce apoB levels and thus reflect lower CVD risk. Including apoB measurements in clinical practice when monitoring patients with dislipidemia or CVD might prove to be useful.

Yoga practice is associated with attenuated weight gain in healthy, middle-aged men and women.

PubMed

Kristal, Alan R; Littman, Alyson J; Benitez, Denise; White, Emily

2005-01-01

Yoga is promoted or weight maintenance, but there is little evidence of its efficacy. To examine whether yoga practice is associated with lower mean 10-year weight gain after age 45. Participants included 15,550 adults, aged 53 to 57 years, recruited to the Vitamin and Lifestyle (VITAL) cohort study between 2000 and 2002. Physical activity (including yoga) during the past 10 years, diet, height, and weight at recruitment and at ages 30 and 45. All measures were based on self-reporting, and past weight was retrospectively ascertained. Multiple regression analyses were used to examined covariate-adjusted associations between yoga practice and weight change from age 45 to recruitment, and polychotomous logistic regression was used to examine associations of yoga practice with the relative odds of weight maintenance (within 5%) and weight loss (> 5%) compared to weight gain. Yoga practice for four or more years was associated with a 3.1-lb lower weight gain among normal weight (BMI < 25) participants [9.5 lbs versus 12.6 Ibs] and an 18.5-lb lower weight gain among overweight participants [-5.0 lbs versus 13.5 Ibs] (both P for trend <.001). Among overweight individuals, 4+ years of yoga practice was associated with a relative odds of 1.85 (95% confidence interval [CI] 0.63-5.42) for weight maintenance (within 5%) and 3.88 (95% Cl 1.30-9.88) for weight loss (> 5%) compared to weight gain (P for trend .026 and .003, respectively). Regular yoga practice was associated with attenuated weight gain, most strongly among individuals who were overweight. Although causal inference from this observational study is not possible, results are consistent with the hypothesis that regular yoga practice can benefit individuals who wish to maintain or lose weight.

Long-term weight loss maintenance for obesity: a multidisciplinary approach

PubMed Central

Montesi, Luca; El Ghoch, Marwan; Brodosi, Lucia; Calugi, Simona; Marchesini, Giulio; Dalle Grave, Riccardo

2016-01-01

The long-term weight management of obesity remains a very difficult task, associated with a high risk of failure and weight regain. However, many people report that they have successfully managed weight loss maintenance in the long term. Several factors have been associated with better weight loss maintenance in long-term observational and randomized studies. A few pertain to the behavioral area (eg, high levels of physical activity, eating a low-calorie, low-fat diet; frequent self-monitoring of weight), a few to the cognitive component (eg, reduced disinhibition, satisfaction with results achieved, confidence in being able to lose weight without professional help), and a few to personality traits (eg, low novelty seeking) and patient–therapist interaction. Trials based on the most recent protocols of lifestyle modification, with a prolonged extended treatment after the weight loss phase, have also shown promising long-term weight loss results. These data should stimulate the adoption of a lifestyle modification-based approach for the management of obesity, featuring a nonphysician lifestyle counselor (also called “lifestyle trainer” or “healthy lifestyle practitioner”) as a pivotal component of the multidisciplinary team. The obesity physicians maintain a primary role in engaging patients, in team coordination and supervision, in managing the complications associated with obesity and, in selected cases, in the decision for drug treatment or bariatric surgery, as possible more intensive, add-on interventions to lifestyle treatment. PMID:27013897

A review of technology-based interventions to maintain weight loss.

PubMed

Lee, Sohye; Lindquist, Ruth

2015-03-01

For many decades, healthcare providers and researchers have developed weight-loss interventions to help people achieve weight loss. Unfortunately, it is typical for people to lose weight quickly during the intervention period but then slowly regain weight until they return to their approximate baseline. Technology-based maintenance interventions are among the newest approaches to long-term weight loss. Several advantages make technology helpful for maintaining weight loss. The purpose of this article was to review and critique the randomized controlled trials of technology-based weight-loss maintenance interventions (WLMIs) for adults. A systematic search through electronic databases and a manual citation search were conducted. Limited numbers of controlled trials published since 2000 that included randomization, and technology-based WLMIs were identified. The characteristics of the eight studies were diverse. The average score of study design quality was moderate. The results of the effectiveness of technology-based WLMIs were mixed. Technology-based WLMIs are more likely to be effective than usual care but not more effective than personal contact. Based on the review, guidelines were established for the selection and potential success of technology-based WLMIs. The effectiveness of technology-based maintenance interventions for weight loss varied, and potential strategies and approaches are discussed to improve their effectiveness. Further studies are needed to better evaluate and refine the efficacy of technology-based WLMIs.

Dietary and body weight control: therapeutic education, motivational interviewing and cognitive-behavioral approaches for long-term weight loss maintenance.

PubMed

Golay, Alain

2006-01-01

A diet always induces weight loss in the short term. The loss does not depend on the dietary composition but rather on the caloric deficit. However, a drastic diet often induces binge eating disorders and can lead to a weight gain in the long term. A cognitive-behavioral-nutritional approach allows lasting weight loss and best results with low fat diets in the long term. Therapeutic education is a patient-centered humanistic approach which allows patients to be actors in their own treatment and own diet to improve their success in losing weight and their quality of life. Motivational interviewing and cognitive-behavioral approaches are perfect complements to therapeutic education for long-term weight loss maintenance. Finally, the best diet is the one that the patient can follow in the long term.

Comparison of an alternative schedule of extended care contacts to a self-directed control: a randomized trial of weight loss maintenance.

PubMed

Dutton, Gareth R; Gowey, Marissa A; Tan, Fei; Zhou, Dali; Ard, Jamy; Perri, Michael G; Lewis, Cora E

2017-08-15

Behavioral interventions for obesity produce clinically meaningful weight loss, but weight regain following treatment is common. Extended care programs attenuate weight regain and improve weight loss maintenance. However, less is known about the most effective ways to deliver extended care, including contact schedules. We compared the 12-month weight regain of an extended care program utilizing a non-conventional, clustered campaign treatment schedule and a self-directed program among individuals who previously achieved ≥5% weight reductions. Participants (N = 108; mean age = 51.6 years; mean weight = 92.6 kg; 52% African American; 95% female) who achieved ≥5% weight loss during an initial 16-week behavioral obesity treatment were randomized into a 2-arm, 12-month extended care trial. A clustered campaign condition included 12 group-based visits delivered in three, 4-week clusters. A self-directed condition included provision of the same printed intervention materials but no additional treatment visits. The study was conducted in a U.S. academic medical center from 2011 to 2015. Prior to randomization, participants lost an average of -7.55 ± 3.04 kg. Participants randomized to the 12-month clustered campaign program regained significantly less weight (0.35 ± 4.62 kg) than self-directed participants (2.40 ± 3.99 kg), which represented a significant between-group difference of 2.28 kg (p = 0.0154) after covariate adjustments. This corresponded to maintaining 87% and 64% of lost weight in the clustered campaign and self-directed conditions, respectively, which was a significant between-group difference of 29% maintenance of lost weight after covariate adjustments, p = 0.0396. In this initial test of a clustered campaign treatment schedule, this novel approach effectively promoted 12-month maintenance of lost weight. Future trials should directly compare the clustered campaigns with conventional (e.g., monthly) extended care schedules. Clinicaltrials.gov NCT02487121 . Registered 06/26/2015 (retrospectively registered).

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.

Concomitant changes in sleep duration and body weight and body composition during weight loss and 3-mo weight maintenance.

PubMed

Verhoef, Sanne P M; Camps, Stefan G J A; Gonnissen, Hanne K J; Westerterp, Klaas R; Westerterp-Plantenga, Margriet S

2013-07-01

An inverse relation between sleep duration and body mass index (BMI) has been shown. We assessed the relation between changes in sleep duration and changes in body weight and body composition during weight loss. A total of 98 healthy subjects (25 men), aged 20-50 y and with BMI (in kg/m(2)) from 28 to 35, followed a 2-mo very-low-energy diet that was followed by a 10-mo period of weight maintenance. Body weight, body composition (measured by using deuterium dilution and air-displacement plethysmography), eating behavior (measured by using a 3-factor eating questionnaire), physical activity (measured by using the validated Baecke's questionnaire), and sleep (estimated by using a questionnaire with the Epworth Sleepiness Scale) were assessed before and immediately after weight loss and 3- and 10-mo follow-ups. The average weight loss was 10% after 2 mo of dieting and 9% and 6% after 3- and 10-mo follow-ups, respectively. Daytime sleepiness and time to fall asleep decreased during weight loss. Short (≤7 h) and average (>7 to <9 h) sleepers increased their sleep duration, whereas sleep duration in long sleepers (≥9 h) did not change significantly during weight loss. This change in sleep duration was concomitantly negatively correlated with the change in BMI during weight loss and after the 3-mo follow-up and with the change in fat mass after the 3-mo follow-up. Sleep duration benefits from weight loss or vice versa. Successful weight loss, loss of body fat, and 3-mo weight maintenance in short and average sleepers are underscored by an increase in sleep duration or vice versa. This trial was registered at clinicaltrials.gov as NCT01015508.

Tools to support maintenance strategies under soft soil conditions

NASA Astrophysics Data System (ADS)

Lambert, J. W. M.; van Meerten, J. J.; Woning, M. P.; Eijbersen, M. J.; Huber, M.

2015-11-01

Costs for maintenance of infrastructure in municipalities with soft soil underground conditions, are estimated to be almost 40 % higher than in others. As a result, these municipalities meet financial problems that cause overdue maintenance. In some cases municipalities are even afraid to be unable to offer a minimum service level in future. In common, traditional practice, roads and sewerage systems have been constructed in trenches that consist of sandy material that replaces the upper meters of the soft soil. Under influence of its weight, this causes accelerated settlements of the construction. A number of alternative constructions have been developed, e.g. using light-weight materials to limit settlement velocity. In order to limit future maintenance costs, improvement of maintenance strategies is desired. Tools have been and will be developed to support municipalities in improving their maintenance strategies and save money by doing that. A model (BALANS) that weighs the attractiveness of alternative solutions under different soil, environmental and economic circumstances, will be presented.

Design and implementation of an interactive website to support long-term maintenance of weight loss.

PubMed

Stevens, Victor J; Funk, Kristine L; Brantley, Phillip J; Erlinger, Thomas P; Myers, Valerie H; Champagne, Catherine M; Bauck, Alan; Samuel-Hodge, Carmen D; Hollis, Jack F

2008-01-25

For most individuals, long-term maintenance of weight loss requires long-term, supportive intervention. Internet-based weight loss maintenance programs offer considerable potential for meeting this need. Careful design processes are required to maximize adherence and minimize attrition. This paper describes the development, implementation and use of a Web-based intervention program designed to help those who have recently lost weight sustain their weight loss over 1 year. The weight loss maintenance website was developed over a 1-year period by an interdisciplinary team of public health researchers, behavior change intervention experts, applications developers, and interface designers. Key interactive features of the final site include social support, self-monitoring, written guidelines for diet and physical activity, links to appropriate websites, supportive tools for behavior change, check-in accountability, tailored reinforcement messages, and problem solving and relapse prevention training. The weight loss maintenance program included a reminder system (automated email and telephone messages) that prompted participants to return to the website if they missed their check-in date. If there was no log-in response to the email and telephone automated prompts, a staff member called the participant. We tracked the proportion of participants with at least one log-in per month, and analyzed log-ins as a result of automated prompts. The mean age of the 348 participants enrolled in an ongoing randomized trial and assigned to use the website was 56 years; 63% were female, and 38% were African American. While weight loss data will not be available until mid-2008, website use remained high during the first year with over 80% of the participants still using the website during month 12. During the first 52 weeks, participants averaged 35 weeks with at least one log-in. Email and telephone prompts appear to be very effective at helping participants sustain ongoing website use. Developing interactive websites is expensive, complex, and time consuming. We found that extensive paper prototyping well in advance of programming and a versatile product manager who could work with project staff at all levels of detail were essential to keeping the development process efficient. clinicaltrials.gov NCT00054925.

Usefulness of a Novel Mobile Diabetes Prevention Program Delivery Platform With Human Coaching: 65-Week Observational Follow-Up.

PubMed

Michaelides, Andreas; Major, Jennifer; Pienkosz, Edmund; Wood, Meghan; Kim, Youngin; Toro-Ramos, Tatiana

2018-05-03

It is widely recognized that the prevalence of obesity and comorbidities including prediabetes and type 2 diabetes continue to increase worldwide. Results from a 24-week Diabetes Prevention Program (DPP) fully mobile pilot intervention were previously published showing promising evidence of the usefulness of DPP-based eHealth interventions on weight loss. This pilot study extends previous findings to evaluate weight loss results of core (up to week 16) and maintenance (postcore weeks) DPP interventions at 65 weeks from baseline. Originally, 140 participants were invited and 43 overweight or obese adult participants with a diagnosis of prediabetes signed up to receive a 24-week virtual DPP with human coaching through a mobile platform. At 65 weeks, this pilot study evaluates weight loss and engagement in maintenance participants by means of repeated measures analysis of variances and backward multiple linear regression to examine predictors of weight loss. Last observation carried forward was used for endpoint measurements. At 65 weeks, mean weight loss was 6.15% in starters who read 1 or more lessons per week on 4 or more core weeks, 7.36% in completers who read 9 or more lessons per week on core weeks, and 8.98% in maintenance completers who did any action in postcore weeks (all P<.001). Participants were highly engaged, with 80% (47/59) of the sample completing 9 lessons or more and 69% (32/47) of those completing the maintenance phase. In-app actions related to self-monitoring significantly predicted weight loss. In comparison to eHealth programs, this pilot study shows that a fully mobile DPP can produce transformative weight loss. A fully mobile DPP intervention resulted in significant weight loss and high engagement during the maintenance phase, providing evidence for long-term potential as an alternative to in-person DPP by removing many of the barriers associated with in-person and other forms of virtual DPP. ©Andreas Michaelides, Jennifer Major, Edmund Pienkosz Jr, Meghan Wood, Youngin Kim, Tatiana Toro-Ramos. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 03.05.2018.

Vitamin D3 Loading Is Superior to Conventional Supplementation After Weight Loss Surgery in Vitamin D-Deficient Morbidly Obese Patients: a Double-Blind Randomized Placebo-Controlled Trial.

PubMed

Luger, Maria; Kruschitz, Renate; Kienbacher, Christian; Traussnigg, Stefan; Langer, Felix B; Prager, Gerhard; Schindler, Karin; Kallay, Enikö; Hoppichler, Friedrich; Trauner, Michael; Krebs, Michael; Marculescu, Rodrig; Ludvik, Bernhard

2017-05-01

Bariatric patients often suffer from vitamin D deficiency (VDD), and both, morbid obesity and VDD, are related to non-alcoholic fatty liver disease. However, limited data are available regarding best strategies for treating VDD, particularly, in bariatric patients undergoing omega-loop gastric bypass (OLGB). Therefore, we examined the efficacy and safety of a forced vitamin D dosing regimen and intervention effects in liver fibrotic patients. In this double-blind, randomized, placebo-controlled trial, 50 vitamin D-deficient patients undergoing OLGB were randomly assigned to receive, in the first month postoperatively, oral vitamin D 3 (≤3 doses of 100,000 IU; intervention group) or placebo as loading dose (control group) with subsequent maintenance dose (3420 IU/day) in both groups until 6-month visit. Compared with control group, higher increase of 25(OH)D (67.9 (21.1) vs. 55.7 nmol/L (21.1); p = 0.049) with lower prevalence of secondary hyperparathyroidism (10 vs. 24 %; p = 0.045) was observed in intervention group. No (serious) adverse events related to study medication were found. The loading dose regimen was more effective in increasing 25(OH)D in patients with significant liver fibrosis while this was not the case for conventional supplementation (placebo with maintenance dose) (71.5 (20.5) vs. 22.5 nmol/L (13.8); p = 0.022; n = 14). Our findings indicate that a high vitamin D 3 loading dose, in the first month postoperatively, with subsequent maintenance dose is effective and safe in achieving higher vitamin D concentrations in OLGB patients. Unexpectedly, it is more effective in patients with significant liver fibrosis which is of potentially high clinical relevance and requires further investigation.

Commentary on the shifting processes model: a conceptual model for weight management.

PubMed

Pagoto, Sherry; Rodrigues, Stephanie

2013-12-01

Macchi and colleagues propose a theoretical model that merges concepts from the biopsychosocial model and family systems theory to produce a broader framework for understanding weight loss and maintenance (see record 2013-28564-001). The Shifting Processes Model views individual weight loss and maintenance in the context of family dynamics, including family eating and exercise habits, home environment, and family relationships. The authors reason that traditional models put the burden of change on the individual rather than the family system, when the latter is an important context of individual behavior.

Effectiveness of a Low-Calorie Weight Loss Program in Moderately and Severely Obese Patients

PubMed Central

Winkler, Julia K.; Schultz, Jobst-Hendrik; Woehning, Annika; Piel, David; Gartner, Lena; Hildebrand, Mirjam; Roeder, Eva; Nawroth, Peter P.; Wolfrum, Christian; Rudofsky, Gottfried

2013-01-01

Aims To compare effectiveness of a 1-year weight loss program in moderately and severely obese patients. Methods The study sample included 311 obese patients participating in a weight loss program, which comprised a 12-week weight reduction phase (low-calorie formula diet) and a 40-week weight maintenance phase. Body weight and glucose and lipid values were determined at the beginning of the program as well as after the weight reduction and the weight maintenance phase. Participants were analyzed according to their BMI class at baseline (30-34.9 kg/m2; 35-39.9 kg/m2; 40-44.9 kg/m2; 45-49.9 kg/m2; ≥50 kg/m2). Furthermore, moderately obese patients (BMI ℋ 40 kg/m2) were compared to severely obese participants (BMI ≥ 40 kg/m2). Results Out of 311 participants, 217 individuals completed the program. Their mean baseline BMI was 41.8 ± 0.5 kg/m2. Average weight loss was 17.9 ± 0.6%, resulting in a BMI of 34.3 ± 0.4 kg/m2 after 1 year (p ℋ 0.001). Overall weight loss was not significantly different in moderately and severely obese participants. Yet, severely obese participants achieved greater weight loss during the weight maintenance phase than moderately obese participants (−3.1 ± 0.7% vs. −1.2 ± 0.6%; p = 0.04). Improvements in lipid profiles and glucose metabolism were found throughout all BMI classes. Conclusion 1-year weight loss intervention improves body weight as well as lipid and glucose metabolism not only in moderately, but also in severely obese individuals. PMID:24135973

Promoting Healthy Weight with "Stability Skills First": A Randomized Trial

ERIC Educational Resources Information Center

Kiernan, Michaela; Brown, Susan D.; Schoffman, Danielle E.; Lee, Katherine; King, Abby C.; Taylor, C. Barr; Schleicher, Nina C.; Perri, Michael G.

2013-01-01

Objective: Although behavioral weight-loss interventions produce short-term weight loss, long-term maintenance remains elusive. This randomized trial examined whether learning a novel set of "stability skills" before losing weight improved long-term weight management. Stability skills were designed to optimize individuals' current…

An afternoon snack of berries reduces subsequent energy intake compared to an isoenergetic confectionary snack.

PubMed

James, Lewis J; Funnell, Mark P; Milner, Samantha

2015-12-01

Observational studies suggest that increased fruit and vegetable consumption can contribute to weight maintenance and facilitate weight loss when substituted for other energy dense foods. Therefore, the purpose of the present study was to assess the effect of berries on acute appetite and energy intake. Twelve unrestrained pre-menopausal women (age 21 ± 2 y; BMI 26.6 ± 2.6 kg m(-2); body fat 23 ± 3%) completed a familiarisation trial and two randomised experimental trials. Subjects arrived in the evening (~5pm) and consumed an isoenergetic snack (65 kcal) of mixed berries (BERRY) or confectionary sweets (CONF). Sixty min later, subjects consumed a homogenous pasta test meal until voluntary satiation, and energy intake was quantified. Subjective appetite (hunger, fullness, desire to eat and prospective food consumption) was assessed throughout trials, and for 120 min after the test meal. Energy intake was less (P<0.001) after consumption of the BERRY snack (691 ± 146 kcal) than after the CONF snack (824 ± 172 kcal); whilst water consumption was similar (P=0.925). There were no trial (P>0.095) or interaction (P>0.351) effects for any subjective appetite ratings. Time taken to eat the BERRY snack (4.05 ± 1.12 min) was greater (P<0.001) than the CONF snack (0.93 ± 0.33 min). This study demonstrates that substituting an afternoon confectionary snack with mixed berries decreased subsequent energy intake at dinner, but did not affect subjective appetite. This dietary strategy could represent a simple method for reducing daily energy intake and aiding weight management. Copyright © 2015 Elsevier Ltd. All rights reserved.

An exploration of the experiences and perceptions of people who have maintained weight loss.

PubMed

Hindle, L; Carpenter, C

2011-08-01

  In clinical weight-loss trials, the majority of those who lose weight will regain almost all of it within 5 years, yet there is limited evidence about effective strategies to support weight maintenance. The present study aimed to increase understanding of the experiences of those who have been successful at weight maintenance.   This qualitative study used a phenomenological approach. Semi-structured interviews were undertaken with a purposive sample of 10 participants who had maintained a minimum of 10% weight loss for at least 1 year. Interviews were transcribed and then analysed using a foundational thematic approach based on the Colaizzi method.   Participants believed that a more relaxed approach to weight management with realistic, long-term goals was more appropriate for long-term control. They had a strong reason to lose weight often with a medical trigger and had elicited support to help them. Most described the presence of saboteurs. Participants took personal responsibility for their weight management and were in tune with their nutrition and activity needs. Self-monitoring was a strategy commonly used to support this. They described the lack of positive reinforcement in the maintenance phase as a major difficulty.   This small-scale study provides evidence to suggest the importance of a medical prompt to lose weight; planning for how to manage saboteurs and identifying methods of minimising the impact of a reduction in positive reinforcement. It reinforces the importance of many of the strategies known to support the weight-loss phase. © 2011 The Authors. Journal of Human Nutrition and Dietetics © 2011 The British Dietetic Association Ltd.

Interface concerns of ejector integration in V/STOL aircraft

NASA Technical Reports Server (NTRS)

Lowry, R. B.

1979-01-01

A number of areas which have in the past contributed to weight, complexity, and thrust losses in the ejector-powered V/STOL vehicle were identified. Most of these interfaces taken singly do not represent a severe compromise to the vehicle; however, the bottom line is that the sum of compromises and the subsequent effects on performance, flight operations and maintenance have rendered the ejector V/STOL aircraft unattractive. In addition to some of the unique ejector/aircraft integration problems, the vehicle by virtue of having a V/STOL capability, is compromised in other areas. To be successful and acceptable, the advantages must outweight the disadvantages and simplicity with minimum penalties must be the rule. It is concluded that more emphasis must be placed on the ejector/aircraft interface for the concept to be successful.

Impact of Eliminating Anchor Items Flagged from Statistical Criteria on Test Score Classifications in Common Item Equating

ERIC Educational Resources Information Center

Karkee, Thakur; Choi, Seung

2005-01-01

Proper maintenance of a scale established in the baseline year would assure the accurate estimation of growth in subsequent years. Scale maintenance is especially important when the state performance standards must be preserved for future administrations. To ensure proper maintenance of a scale, the selection of anchor items and evaluation of…

Obesity Reduction Black Intervention Trial (ORBIT): Design and Baseline Characteristics

PubMed Central

Stolley, Melinda; Schiffer, Linda; Sharp, Lisa; Singh, Vicky; Van Horn, Linda; Dyer, Alan

2008-01-01

Abstract Background Obesity is associated with many chronic diseases, and weight loss can reduce the risk of developing these diseases. Obesity is highly prevalent among Black women, but weight loss treatment for black women has been understudied until recently. The Obesity Reduction black Intervention Trial (ORBIT) is a randomized controlled trial designed to assess the efficacy of a culturally proficient weight loss and weight loss maintenance program for black women. This paper describes the design of the trial, the intervention, and baseline characteristics of the participants. Methods Two hundred thirteen obese black women aged 30–65 years were randomized to the intervention group or a general health control group. The intervention consists of a 6-month weight loss program followed by a 1-year maintenance program. Weight, dietary intake, and energy expenditure are measured at baseline, 6 months, and 18 months. Results More than 40% of participants had a baseline body mass index (BMI) >40 kg/m2 (class III obesity). Intake of fat and saturated fat was higher and consumption of fruit, vegetables, and fiber was lower than currently recommended guidelines. Self-reported moderate to vigorous physical activity was high (median 85 min/day). However, objectively measured physical activity among a subgroup of participants was lower (median 15 min/day). Conclusions Weight loss among obese black women has received inadequate attention in relation to the magnitude of the problem. Factors that contribute to successful weight loss and more importantly, weight loss maintenance need to be identified. PMID:18774895

Rise of plasma ghrelin with weight loss is not sustained during weight maintenance

USDA-ARS?s Scientific Manuscript database

Ghrelin is postulated to be an orexigenic signal that promotes weight regain after weight loss (WL). However, it is not known whether this putative effect of ghrelin is sustained after weight stabilization. The objective of this study was to investigate the relationship of plasma ghrelin concentrati...

Short-term meal replacements followed by dietary macronutrient restriction enhance weight loss in polycystic ovary syndrome.

PubMed

Moran, Lisa J; Noakes, Manny; Clifton, Peter M; Wittert, Gary A; Williams, Gemma; Norman, Robert J

2006-07-01

Polycystic ovary syndrome (PCOS), a common condition in women, improves with weight loss. Meal replacements in short-term weight loss and strategies for weight maintenance have not been investigated in PCOS. We compared in overweight women with PCOS the effects of meal replacements in short-term weight-loss and longer-term carbohydrate- or fat-restriction strategies on weight maintenance and improvements in reproductive and metabolic variables. Overweight women with PCOS (n = 43; x +/- SD age: 32.1 +/- 5.2 y; weight: 96.1 +/- 18.4 kg) followed an 8-wk weight-loss regimen (2 meal replacements/d, 4904.4 +/- 127 kJ; phase 1) and then a 6-mo weight-maintenance carbohydrate- (<120 g/d) or fat- (<50 g/d) restriction regimen (phase 2). Thirty-four women completed phase 1, and 23 women completed phase 2; the proportion of dropouts was similar in the 2 groups. During phase 1, significant (P < 0.05) reductions in weight (5.6 +/- 2.4 kg), waist circumference (6.1 +/- 2.5 cm), body fat (4.1 +/- 2.2 kg), insulin (2.8 +/- 1.1 mU/L), total testosterone (0.3 +/- 0.7 nmol/L), and free androgen index (3.1 +/- 4.6) occurred; these changes were sustained during phase 2. No significant differences between diet groups were seen for any variables. At 6 mo, both approaches resulted in a net weight loss of 4.7 +/- 4.6 kg. Improvements in menstrual cyclicity occurred for 16 (57.1%) of 28 subjects. Meal replacements are an effective strategy for the short-term management of PCOS. Advice on moderate fat or carbohydrate restriction was equally effective in maintaining weight reduction and improving reproductive and metabolic variables.

Biases in orienting and maintenance of attention among weight dissatisfied women: an eye-movement study.

PubMed

Gao, Xiao; Wang, Quanchuan; Jackson, Todd; Zhao, Guang; Liang, Yi; Chen, Hong

2011-04-01

Despite evidence indicating fatness and thinness information are processed differently among weight-preoccupied and eating disordered individuals, the exact nature of these attentional biases is not clear. In this research, eye movement (EM) tracking assessed biases in specific component processes of visual attention (i.e., orientation, detection, maintenance and disengagement of gaze) in relation to body-related stimuli among 20 weight dissatisfied (WD) and 20 weight satisfied young women. Eye movements were recorded while participants completed a dot-probe task that featured fatness-neutral and thinness-neutral word pairs. Compared to controls, WD women were more likely to direct their initial gaze toward fatness words, had a shorter mean latency of first fixation on both fatness and thinness words, had longer first fixation on fatness words but shorter first fixation on thinness words, and shorter total gaze duration on thinness words. Reaction time data showed a maintenance bias towards fatness words among the WD women. In sum, results indicated WD women show initial orienting, speeded detection and initial maintenance biases towards fat body words in addition to a speeded detection - avoidance pattern of biases in relation to thin body words. In sum, results highlight the importance of the utility of EM-tracking as a means of identifying subtle attentional biases among weight dissatisfied women drawn from a non-clinical setting and the need to assess attentional biases as a dynamic process. Copyright © 2011 Elsevier Ltd. All rights reserved.

Financial Motivation Undermines Maintenance in an Intensive Diet and Activity Intervention

PubMed Central

Moller, Arlen C.; McFadden, H. Gene; Hedeker, Donald; Spring, Bonnie

2012-01-01

Financial incentives are widely used in health behavior interventions. However, self-determination theory posits that emphasizing financial incentives can have negative consequences if experienced as controlling. Feeling controlled into performing a behavior tends to reduce enjoyment and undermine maintenance after financial contingencies are removed (the undermining effect). We assessed participants' context-specific financial motivation to participate in the Make Better Choices trial—a trial testing four different strategies for improving four health risk behaviors: low fruit and vegetable intake, high saturated fat intake, low physical activity, and high sedentary screen time. The primary outcome was overall healthy lifestyle change; weight loss was a secondary outcome. Financial incentives were contingent upon meeting behavior goals for 3 weeks and became contingent upon merely providing data during the 4.5-month maintenance period. Financial motivation for participation was assessed at baseline using a 7-item scale (α = .97). Across conditions, a main effect of financial motivation predicted a steeper rate of weight regained during the maintenance period, t(165) = 2.15, P = .04. Furthermore, financial motivation and gender interacted significantly in predicting maintenance of healthy diet and activity changes, t(160) = 2.42, P = .016, such that financial motivation had a more deleterious influence among men. Implications for practice and future research on incentivized lifestyle and weight interventions are discussed. PMID:22548152

Research requirements for development of regenerative engines for helicopters

DOE Office of Scientific and Technical Information (OSTI.GOV)

Semple, R.D.

1976-12-01

The improved specific fuel consumption of the regenerative engine was compared to a simple-cycle turboshaft engine. The performance improvement and fuel saving are obtained at the expense of increased engine weight, development and production costs, and maintenance costs. Costs and schedules are estimated for the elements of the research and development program. Interaction of the regenerative engine with other technology goals for an advanced civil helicopter is examined, including its impact on engine noise, hover and cruise performance, helicopter empty weight, drive-system efficiency and weight, one-engine-inoperative hover capability, and maintenance and reliability.

Research requirements for development of regenerative engines for helicopters

NASA Technical Reports Server (NTRS)

Semple, R. D.

1976-01-01

The improved specific fuel consumption of the regenerative engine was compared to a simple-cycle turboshaft engine. The performance improvement and fuel saving are obtained at the expense of increased engine weight, development and production costs, and maintenance costs. Costs and schedules are estimated for the elements of the research and development program. Interaction of the regenerative engine with other technology goals for an advanced civil helicopter is examined, including its impact on engine noise, hover and cruise performance, helicopter empty weight, drive-system efficiency and weight, one-engine-inoperative hover capability, and maintenance and reliability.

Successful maintenance of body weight reduction after individualized dietary counseling in obese subjects

PubMed Central

Stelmach-Mardas, Marta; Mardas, Marcin; Warchoł, Wojciech; Jamka, Małgorzata; Walkowiak, Jarosław

2014-01-01

The aim of this study was to describe the effectiveness of individualized dietary counseling in obese subjects based on narrative interview technique on the maintenance of body weight reduction, changes in dietary behaviors, including type of cooking and physical activity. One-hundred subjects out of four-hundred patients met the inclusion criteria. Individually, 45-minute educational program with motivation counseling was performed in 0, 6 and 12 weeks of the study. Patients were advised to follow individually well-balanced diet for 12 weeks. The individuals were asked about the changes in their dietary habits (Food Frequency Questionnaire). The mean percentage of body weight changes from the baseline were as follows: in 6th week- 5.9%, in 12th week - 10.9% and in 52th week - 9.7% (P < 0.0001), however there were no statistically significant changes while comparing body weight in 12th and 52th week. The maintenance of body weight reduction was connected with the dietary habits changes, mainly the type of cooking and increased consumption of vegetable oils. In conclusion, individualized dietary counseling, based on narrative interview technique is an effective intervention for obesity treatment that may help maintain body weight reduction and adapt the pro-healthy changes in type of cooking and sources of dietary fat. PMID:25311271

Successful maintenance of body weight reduction after individualized dietary counseling in obese subjects.

PubMed

Stelmach-Mardas, Marta; Mardas, Marcin; Warchoł, Wojciech; Jamka, Małgorzata; Walkowiak, Jarosław

2014-10-14

The aim of this study was to describe the effectiveness of individualized dietary counseling in obese subjects based on narrative interview technique on the maintenance of body weight reduction, changes in dietary behaviors, including type of cooking and physical activity. One-hundred subjects out of four-hundred patients met the inclusion criteria. Individually, 45-minute educational program with motivation counseling was performed in 0, 6 and 12 weeks of the study. Patients were advised to follow individually well-balanced diet for 12 weeks. The individuals were asked about the changes in their dietary habits (Food Frequency Questionnaire). The mean percentage of body weight changes from the baseline were as follows: in 6th week- 5.9%, in 12th week - 10.9% and in 52th week - 9.7% (P < 0.0001), however there were no statistically significant changes while comparing body weight in 12th and 52th week. The maintenance of body weight reduction was connected with the dietary habits changes, mainly the type of cooking and increased consumption of vegetable oils. In conclusion, individualized dietary counseling, based on narrative interview technique is an effective intervention for obesity treatment that may help maintain body weight reduction and adapt the pro-healthy changes in type of cooking and sources of dietary fat.

Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures: Environmental Domain.

PubMed

Saelens, Brian E; Arteaga, S Sonia; Berrigan, David; Ballard, Rachel M; Gorin, Amy A; Powell-Wiley, Tiffany M; Pratt, Charlotte; Reedy, Jill; Zenk, Shannon N

2018-04-01

There is growing interest in how environment is related to adults' weight and activity and eating behaviors. However, little is known about whether environmental factors are related to the individual variability seen in adults' intentional weight loss or maintenance outcomes. The environmental domain subgroup of the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project sought to identify a parsimonious set of objective and perceived neighborhood and social environment constructs and corresponding measures to include in the assessment of response to adult weight-loss treatment. Starting with the home address, the environmental domain subgroup recommended for inclusion in future weight-loss or maintenance studies constructs and measures related to walkability, perceived land use mix, food outlet accessibility (perceived and objective), perceived food availability, socioeconomics, and crime-related safety (perceived and objective) to characterize the home neighborhood environment. The subgroup also recommended constructs and measures related to social norms (perceived and objective) and perceived support to characterize an individual's social environment. The 12 neighborhood and social environment constructs and corresponding measures provide a succinct and comprehensive set to allow for more systematic examination of the impact of environment on adults' weight loss and maintenance. © 2018 The Obesity Society.

Initial Weight Loss after Restrictive Bariatric Procedures May Predict Mid-Term Weight Maintenance: Results From a 12-Month Pilot Trial.

PubMed

Nikolić, Marko; Kruljac, Ivan; Kirigin, Lora; Mirošević, Gorana; Ljubičić, Neven; Nikolić, Borka Pezo; Bekavac-Bešlin, Miroslav; Budimir, Ivan; Vrkljan, Milan

2015-06-01

Background: Bariatric procedures are effective options for weight loss (WL) in the morbidly obese. However, some patients fail to lose any weight after bariatric surgery, and mid-term weight maintenance is variable. The aim of this study was to investigate whether initial WL could predict mid-term weight maintenance. Methods: Eighty patients were enrolled, of whom 44 were treated with the BioEnterics Intragastric Balloon (BIB), 21 with laparoscopic adjustable gastric lap-banding (LAGB), and 15 with laparoscopic sleeve gastrectomy (LSG). Percentage of body WL and percentage of excess weight loss (EWL) were calculated at baseline and after 1, 3, 6, and 12 months. Successful WL was defined as EWL >20% for patients treated with BIB and >50% for patients treated with LAGB and SG. Results: Success in the 6th and 12th month was achieved in 80% and 58% of patients in the BIB group, 33% and 40% in the LAGB group, and 60% and 73% in the LSG group. In the BIB group, WL in the 1st month correlated positively with WL at the 6th and 12th month, and an initial WL >6.5% best predicted success (sensitivity 50%, specificity 80%). A similar association was observed in the LAGB group at the 6th and 12th month and an initial WL >9.4% best predicted success (sensitivity 90.0%, specificity 81.2%). In patients treated with LSG, WL in the 3rd month correlated positively with EWL at the 6th and 12th month, with a cutoff value of 17% (sensitivity 66.7%, specificity 100%). Conclusions: WL in the 1st month in patients treated with BIB and LAGB and WL in the 3rd month in patients treated with LSG could be used as a prognostic factor to predict mid-term weight maintenance.

Determining optimal approaches for weight maintenance: a randomized controlled trial

PubMed Central

Dale, Kelly S.; McAuley, Kirsten A.; Taylor, Rachael W.; Williams, Sheila M.; Farmer, Victoria L.; Hansen, Paul; Vorgers, Sue M.; Chisholm, Alexandra W.; Mann, Jim I.

2009-01-01

Background Weight regain often occurs after weight loss in overweight individuals. We aimed to compare the effectiveness of 2 support programs and 2 diets of different macronutrient compositions intended to facilitate long-term weight maintenance. Methods Using a 2 × 2 factorial design, we randomly assigned 200 women who had lost 5% or more of their initial body weight to an intensive support program (implemented by nutrition and activity specialists) or to an inexpensive nurse-led program (involving “weigh-ins” and encouragement) that included advice about high-carbohydrate diets or relatively high-monounsaturated-fat diets. Results In total, 174 (87%) participants were followed-up for 2 years. The average weight loss (about 2 kg) did not differ between those in the support programs (0.1 kg, 95% confidence interval [CI] −1.8 to 1.9, p = 0.95) or diets (0.7 kg, 95% CI −1.1 to 2.4, p = 0.46). Total and low-density lipoprotein (LDL) cholesterol levels were significantly higher among those on the high-monounsaturated-fat diet (total cholesterol: 0.17 mmol/L, 95% CI 0.01 to 0.33; p = 0.040; LDL cholesterol: 0.16 mmol/L, 95% CI 0.01 to 0.31; p = 0.039) than among those on the high-carbohydrate diet. Those on the high-monounsaturated-fat diet also had significantly higher intakes of total fat (5% total energy, 95% CI 3% to 6%, p < 0.001) and saturated fat (2% total energy, 95% CI 1% to 2%, p < 0.001). All of the other clinical and laboratory measures were similar among those in the support programs and diets. Interpretation A relatively inexpensive program involving nurse support is as effective as a more resource-intensive program for weight maintenance over a 2-year period. Diets of different macronutrient composition produced comparable beneficial effects in terms of weight loss maintenance. ClinicalTrials.gov trial register no. NCT00128336. PMID:19433812

Dietary patterns in weight loss maintenance: results from the MedWeight study.

PubMed

Karfopoulou, Eleni; Brikou, Dora; Mamalaki, Eirini; Bersimis, Fragiskos; Anastasiou, Costas A; Hill, James O; Yannakoulia, Mary

2017-04-01

The dietary habits contributing to weight loss maintenance are not sufficiently understood. We studied weight loss maintainers in comparison with regainers, to identify the differentiating behaviors. The MedWeight study is a Greek registry of weight loss maintainers and regainers. Participants had intentionally lost ≥10 % of their weight and either had maintained this loss for over a year, or had regained weight. Questionnaires on demographics and lifestyle habits were completed online. Dietary assessment was carried out by two telephone 24-h recalls. Present analysis focused on 361 participants (32 years old, 39 % men): 264 maintainers and 97 regainers. Energy and macronutrient intake did not differ by maintenance status (1770 ± 651 kcal in maintainers vs. 1845 ± 678 kcal in regainers, p = 0.338), although protein intake per kg of body weight was higher in maintainers (1.02 ± 0.39 vs. 0.83 ± 0.28 g/kg in regainers, p < 0.001). Physical activity energy expenditure was greater for maintainers in men (by 1380 kcal per week, p = 0.016), but not women. Salty snacks, alcohol and regular soda were more frequently consumed by men regainers. Principal component analysis identified a healthy dietary pattern featuring mainly unprocessed cereal, fruit, vegetables, olive oil and low-fat dairy. Male maintainers were 4.6 times more likely to follow this healthy pattern compared to regainers (OR 4.6, 95 % CI 2.0-11.0). No similar finding was revealed in women. Other characteristics of maintainers but not of regainers were: involvement in meal preparation and eating at home for men, and a higher eating frequency and slower eating rate for women. Men maintaining weight loss were much more likely to adhere to a healthy eating pattern. Eating at home, involvement in meal preparation, higher eating frequency and slower eating rate were also associated with maintenance. These lifestyle habits of successful maintainers provide target behaviors to improve obesity treatment.

Prevention of Weight Gain Following a Worksite Nutrition and Exercise Program

PubMed Central

Thorndike, Anne N.; Sonnenberg, Lillian; Healey, Erica; Myint-U, Khinlei; Kvedar, Joseph C.; Regan, Susan

2012-01-01

Background Many employers are now providing wellness programs to help employees make changes in diet and exercise behaviors. Improving health outcomes and reducing costs will depend on whether employees sustain lifestyle changes and maintain a healthy weight over time. Purpose To determine if a 9-month maintenance intervention immediately following a 10-week worksite exercise and nutrition program would prevent regain of the weight lost during the program. Design RCT. Setting/participants In 2008, a total of 330 employees from 24 teams completed a 10-week exercise and nutrition program at a large hospital worksite and were randomized by team to maintenance or control (usual care) for 9 months. Intervention Internet support with a website for goal-setting and self-monitoring of weight and exercise plus minimal personal support. Main outcome measures Weight loss, percentage weight loss, time spent in physical activity, and frequency of consumption of fruits/vegetables, fatty foods, and sugary foods at 1 year compared to baseline. One-year follow-up was completed in 2010, and data were analyzed in 2011. Results At 1 year, 238 subjects (72%) completed follow-up assessments. Mean baseline BMI was 27.6 and did not differ between intervention and control. Compared to baseline, both groups lost weight during the 10-week program and maintained 65% of weight loss at 1 year (p<0.001). There was no difference in weight loss between groups at end of the 10-week program (4.8 lbs vs 4.3 lbs, p=0.53 for group×time interaction) or end of maintenance at 1 year (3.4 lbs vs 2.5 lbs, p=0.40 for group×time interaction). All subjects had improvements in physical activity and nutrition (increased fruits/vegetables and decreased fat and sugar intake) at 1 year but did not differ by group. Conclusions An intensive 10-week team-based worksite exercise and nutrition program resulted in moderate weight loss and improvements in diet and exercise behaviors at 1 year, but an Internet-based maintenance program immediately following the 10-week program did not improve these outcomes. PMID:22704742

A qualitative study of successful adolescent and young adult weight losers: implications for weight control intervention.

PubMed

Jensen, Chad D; Duraccio, Kara M; Hunsaker, Sanita L; Rancourt, Diana; Kuhl, Elizabeth S; Jelalian, Elissa; Wing, Rena R

2014-12-01

Our study aims to provide an in-depth analysis of behavioral strategies, psychological factors, and social contributors to adolescent weight loss and weight loss maintenance among participants in the Adolescent Weight Control Registry (AWCR). Qualitative analyses were conducted using semi-structured interview data from 40 participants from the AWCR who successfully lost ≥10 lbs and maintained their weight loss for at least one year. In contrast to existing literature, our findings suggest that primary motivating factors for adolescent weight loss may be intrinsic (e.g., desire for better health, desire to improve self-worth) rather than extrinsic. In addition, life transitions (e.g., transition to high school) were identified as substantial motivators for weight-related behavior change. Peer and parental encouragement and instrumental support were widely endorsed as central to success. The most commonly endorsed weight loss maintenance strategies included attending to dietary intake and physical activity levels, and making self-corrections when necessary. Results from this study highlight considerations for future adolescent weight control treatment development.

Impact of carbohydrates on weight regain.

PubMed

Bosy-Westphal, Anja; Müller, Manfred J

2015-07-01

Research on obesity treatment has shifted its focus from weight loss to weight-loss maintenance strategies. The conventional approach of a low-fat diet is challenged by insights from glycemic effects of carbohydrates on body weight regulation. Metabolic and endocrine adaptations to weight loss that contribute to weight regain involve reduced energy expenditure, increased insulin sensitivity, and enhanced orexigenic signals. This review summarizes the impact of carbohydrates on energetic efficiency, partitioning of weight regain as fat and lean mass, and appetite control. Both the amount and frequency of postprandial glycemia add to body weight regulation after weight loss and strengthen the concept of glycemic index and glycemic load. In addition, dietary fiber and slowly or poorly absorbable functional sugars modify gastrointestinal peptides involved in appetite and metabolic regulation and exert prebiotic effects. Current evidence suggests that a low-glycemic load diet with a preference for low-glycemic index foods and integration of slowly digestible, poorly absorbable carbohydrates may improve weight-loss maintenance. Future studies should investigate the health benefits of low glycemic functional sweeteners (e.g., isomaltulose and tagatose).

Regular self-weighing to promote weight maintenance after intentional weight loss: a quasi-randomized controlled trial.

PubMed

Madigan, Claire D; Aveyard, Paul; Jolly, Kate; Denley, John; Lewis, Amanda; Daley, Amanda J

2014-06-01

Many overweight people take action to lose weight but most regain this weight. To examine the effectiveness of a weight maintenance intervention focused on regular self-weighing after receiving a 12-week weight loss programme. Quasi-randomized controlled trial of 3768 obese or overweight men and women. The intervention group (n = 3290) received two telephone calls, the offer of free weighing scales, encouragement to weigh themselves weekly and record this on a card. The main outcome was change in weight between 3 and 12 months. Using intention to treat analysis both groups regained weight; however, the intervention group on average regained 1.23 kg, whereas the control group regained 1.83 kg. Adjusting for covariates resulted in a mean difference of 0.68 kg (95% CI 0.12, 1.24) at 12-month follow-up. Encouraging people who have recently lost weight to weigh themselves regularly prevents some weight regain. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Reducing breast cancer recurrence with weight loss, a vanguard trial: the Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) Trial.

PubMed

Rock, Cheryl L; Byers, Tim E; Colditz, Graham A; Demark-Wahnefried, Wendy; Ganz, Patricia A; Wolin, Kathleen Y; Elias, Anthony; Krontiras, Helen; Liu, Jingxia; Naughton, Michael; Pakiz, Bilgé; Parker, Barbara A; Sedjo, Rebecca L; Wyatt, Holly

2013-03-01

Breast cancer is the most common invasive cancer among women in developed countries. Obesity is a major risk factor for breast cancer recurrence and mortality in both pre- and postmenopausal women. Co-morbid medical conditions are common among breast cancer survivors. The Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) study is a 4-year randomized clinical trial of 693 overweight/obese women aged ≥21years diagnosed with any early stage breast cancer (stages I[≥1cm]-III) within the previous five years, designed to demonstrate the feasibility of achieving sustained weight loss and to examine the impact of weight loss on quality of life and co-morbidities, and to enable future exploration of biochemical mechanisms linking obesity to lower likelihood of disease-free survival. This trial is strategically designed as a vanguard for a fully-powered trial of women who will be evaluated for breast cancer recurrence and disease-free survival. Participants were recruited between 2010 and 2012 at four sites, had completed initial therapies, and had a body mass index between 25 and 45kg/m(2). The intervention featured a group-based cognitive-behavioral weight loss program with telephone counseling and tailored newsletters to support initial weight loss and subsequent maintenance, with the goal of 7% weight loss at two years. This study has high potential to have a major impact on clinical management and outcomes after a breast cancer diagnosis. This trial initiates the effort to establish weight loss support for overweight or obese breast cancer survivors as a new standard of clinical care. Copyright © 2012 Elsevier Inc. All rights reserved.

Comparison of High-Protein, Intermittent Fasting Low-Calorie Diet and Heart Healthy Diet for Vascular Health of the Obese.

PubMed

Zuo, Li; He, Feng; Tinsley, Grant M; Pannell, Benjamin K; Ward, Emery; Arciero, Paul J

2016-01-01

It has been debated whether different diets are more or less effective in long-term weight loss success and cardiovascular disease prevention among men and women. To further explore these questions, the present study evaluated the combined effects of a high-protein, intermittent fasting, low-calorie diet plan compared with a heart healthy diet plan during weight loss, and weight loss maintenance on blood lipids and vascular compliance of obese individuals. The experiment involved 40 obese adults (men, n = 21; women, n = 19) and was divided into two phases: (a) 12-week high-protein, intermittent fasting, low-calorie weight loss diet comparing men and women (Phase 1) and (b) a 1-year weight maintenance phase comparing high-protein, intermittent fasting with a heart healthy diet (Phase 2). Body weight, body mass index (BMI), blood lipids, and arterial compliance outcomes were assessed at weeks 1 (baseline control), 12 (weight loss), and 64 (12 + 52 week; weight loss maintenance). At the end of weight loss intervention, concomitant reductions in body weight, BMI and blood lipids were observed, as well as enhanced arterial compliance. No sex-specific differences in responses were observed. During phase 2, the high-protein, intermittent fasting group demonstrated a trend for less regain in BMI, low-density lipoprotein (LDL), and aortic pulse wave velocity than the heart healthy group. Our results suggest that a high-protein, intermittent fasting and low-calorie diet is associated with similar reductions in BMI and blood lipids in obese men and women. This diet also demonstrated an advantage in minimizing weight regain as well as enhancing arterial compliance as compared to a heart healthy diet after 1 year.

Comparison of High-Protein, Intermittent Fasting Low-Calorie Diet and Heart Healthy Diet for Vascular Health of the Obese

PubMed Central

Zuo, Li; He, Feng; Tinsley, Grant M.; Pannell, Benjamin K.; Ward, Emery; Arciero, Paul J.

2016-01-01

Aim: It has been debated whether different diets are more or less effective in long-term weight loss success and cardiovascular disease prevention among men and women. To further explore these questions, the present study evaluated the combined effects of a high-protein, intermittent fasting, low-calorie diet plan compared with a heart healthy diet plan during weight loss, and weight loss maintenance on blood lipids and vascular compliance of obese individuals. Methods: The experiment involved 40 obese adults (men, n = 21; women, n = 19) and was divided into two phases: (a) 12-week high-protein, intermittent fasting, low-calorie weight loss diet comparing men and women (Phase 1) and (b) a 1-year weight maintenance phase comparing high-protein, intermittent fasting with a heart healthy diet (Phase 2). Body weight, body mass index (BMI), blood lipids, and arterial compliance outcomes were assessed at weeks 1 (baseline control), 12 (weight loss), and 64 (12 + 52 week; weight loss maintenance). Results: At the end of weight loss intervention, concomitant reductions in body weight, BMI and blood lipids were observed, as well as enhanced arterial compliance. No sex-specific differences in responses were observed. During phase 2, the high-protein, intermittent fasting group demonstrated a trend for less regain in BMI, low-density lipoprotein (LDL), and aortic pulse wave velocity than the heart healthy group. Conclusion: Our results suggest that a high-protein, intermittent fasting and low-calorie diet is associated with similar reductions in BMI and blood lipids in obese men and women. This diet also demonstrated an advantage in minimizing weight regain as well as enhancing arterial compliance as compared to a heart healthy diet after 1 year. PMID:27621707

Longitudinal associations between sleep duration and subsequent weight gain: A systematic review

PubMed Central

Magee, Lorrie

2011-01-01

Objective To systematically examine the relationship between sleep duration and subsequent weight gain in observational longitudinal human studies Methods Systematic review of twenty longitudinal studies published from 2004-October 31, 2010 Results While adult studies (n=13) reported inconsistent results on the relationship between sleep duration and subsequent weight gain, studies with children (n=7) more consistently reported a positive relationship between short sleep duration and weight gain. Conclusion While shorter sleep duration consistently predicts subsequent weight gain in children, the relationship is not clear in adults. We discuss possible limitations of the current studies: 1.) the diminishing association between short sleep duration on weight gain over time after transition to short sleep, 2.) lack of inclusion of appropriate confounding, mediating, and moderating variables (i.e. sleep complaints and sedentary behavior), and 3.) measurement issues. PMID:21784678

Design and Implementation of an Interactive Website to Support Long-Term Maintenance of Weight Loss

PubMed Central

Stevens, Victor J; Brantley, Phillip J; Erlinger, Thomas P; Myers, Valerie H; Champagne, Catherine M; Bauck, Alan; Samuel-Hodge, Carmen D; Hollis, Jack F

2008-01-01

Background For most individuals, long-term maintenance of weight loss requires long-term, supportive intervention. Internet-based weight loss maintenance programs offer considerable potential for meeting this need. Careful design processes are required to maximize adherence and minimize attrition. Objective This paper describes the development, implementation and use of a Web-based intervention program designed to help those who have recently lost weight sustain their weight loss over 1 year. Methods The weight loss maintenance website was developed over a 1-year period by an interdisciplinary team of public health researchers, behavior change intervention experts, applications developers, and interface designers. Key interactive features of the final site include social support, self-monitoring, written guidelines for diet and physical activity, links to appropriate websites, supportive tools for behavior change, check-in accountability, tailored reinforcement messages, and problem solving and relapse prevention training. The weight loss maintenance program included a reminder system (automated email and telephone messages) that prompted participants to return to the website if they missed their check-in date. If there was no log-in response to the email and telephone automated prompts, a staff member called the participant. We tracked the proportion of participants with at least one log-in per month, and analyzed log-ins as a result of automated prompts. Results The mean age of the 348 participants enrolled in an ongoing randomized trial and assigned to use the website was 56 years; 63% were female, and 38% were African American. While weight loss data will not be available until mid-2008, website use remained high during the first year with over 80% of the participants still using the website during month 12. During the first 52 weeks, participants averaged 35 weeks with at least one log-in. Email and telephone prompts appear to be very effective at helping participants sustain ongoing website use. Conclusions Developing interactive websites is expensive, complex, and time consuming. We found that extensive paper prototyping well in advance of programming and a versatile product manager who could work with project staff at all levels of detail were essential to keeping the development process efficient. Trial Registration clinicaltrials.gov NCT00054925 PMID:18244892

[Utilization of feed energy by growing pigs. 3. Energy requirement for the growth and fattening of pigs].

PubMed

Hoffmann, L; Schiemann, R; Jentsch, W

1979-02-01

The test series for the investigation of the energy consumption of growing pigs of the breeds large white and improved land race pig as well as cross breeds of the two breeds in a total of 369 metabolism periods (as described in the first two pieces of information of this publication series -- Hoffmann and others, 1977 and Jentsch and Hoffmann, 1977) were statistically analysed for the purpose of the derivation of the energy requirement for maintenance and the partial energy requirement for growth in order to test the possibilities of the factorial analysis for the derivation of energy requirement values of growing pigs. The dependence of the maintenance requirement of growing pigs (investigations in the live weight range of 10 to 40 kg -- see 1st information--were made with boars those in the live weight range of 30 to 120 kg were made with gelded boars, 2nd information) on the live weight can best be characterised by applying a power exponent of 0,61 or 0,62 for the live weight. A definition is offered to be discussed for the energetic maintenance requirement of productive live stock and laboratory animals as a conventional value. The energy requirement values derived from the doubly-factorial statistical analysis show a satisfactory adaptation to the measured values as such concerning energy intake and observed growth performance of the test animals. The conclusion is drawn that the factorial analysis of the energy requirement (maintenance plus partial performances) results in a better estimate of the requirement of growing animals than the assessment according only to live weight and live weight increase without characterising the energy requirement for partial performances. This is important for the further working on and more exact definition of requirement norms.

eHealth interventions for the prevention and treatment of overweight and obesity in adults: a systematic review with meta-analysis.

PubMed

Hutchesson, M J; Rollo, M E; Krukowski, R; Ells, L; Harvey, J; Morgan, P J; Callister, R; Plotnikoff, R; Collins, C E

2015-05-01

A systematic review of randomized controlled trials was conducted to evaluate the effectiveness of eHealth interventions for the prevention and treatment of overweight and obesity in adults. Eight databases were searched for studies published in English from 1995 to 17 September 2014. Eighty-four studies were included, with 183 intervention arms, of which 76% (n = 139) included an eHealth component. Sixty-one studies had the primary aim of weight loss, 10 weight loss maintenance, eight weight gain prevention, and five weight loss and maintenance. eHealth interventions were predominantly delivered using the Internet, but also email, text messages, monitoring devices, mobile applications, computer programs, podcasts and personal digital assistants. Forty percent (n = 55) of interventions used more than one type of technology, and 43.2% (n = 60) were delivered solely using eHealth technologies. Meta-analyses demonstrated significantly greater weight loss (kg) in eHealth weight loss interventions compared with control (MD -2.70 [-3.33,-2.08], P < 0.001) or minimal interventions (MD -1.40 [-1.98,-0.82], P < 0.001), and in eHealth weight loss interventions with extra components or technologies (MD 1.46 [0.80, 2.13], P < 0.001) compared with standard eHealth programmes. The findings support the use of eHealth interventions as a treatment option for obesity, but there is insufficient evidence for the effectiveness of eHealth interventions for weight loss maintenance or weight gain prevention. © 2015 World Obesity.

Correlates of Successful Response to a Behavioral Weight Control Clinic.

ERIC Educational Resources Information Center

And Others; Gormally, Jim

1980-01-01

Initial weight-loss success was correlated with two severity variables. Persons reporting frequent binge eating and histories of previous dieting weight loss lost the most weight. Persons who were successful at maintenance used frequent exercise. Those who relapsed reported high levels of stress during follow-up. (Author)

7 CFR 801.9 - Tolerances for test weight apparatuses.

Code of Federal Regulations, 2011 CFR

2011-01-01

... PERFORMANCE REQUIREMENTS FOR GRAIN INSPECTION EQUIPMENT § 801.9 Tolerances for test weight apparatuses. The maintenance tolerances for test weight per bushel apparatuses used in performing official inspection services... 7 Agriculture 7 2011-01-01 2011-01-01 false Tolerances for test weight apparatuses. 801.9 Section...

7 CFR 801.9 - Tolerances for test weight apparatuses.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PERFORMANCE REQUIREMENTS FOR GRAIN INSPECTION EQUIPMENT § 801.9 Tolerances for test weight apparatuses. The maintenance tolerances for test weight per bushel apparatuses used in performing official inspection services... 7 Agriculture 7 2010-01-01 2010-01-01 false Tolerances for test weight apparatuses. 801.9 Section...

Key metabolic pathways associated with differences in weight maintenance and gain in mature cow skeletal and adipose tissue

USDA-ARS?s Scientific Manuscript database

During the production year of a cow, the majority of nutrients are used to support maintenance. Differences in feedstuff utilization and metabolism can impact the ability of the cow to meet maintenance requirements. Tissue specific metabolism is critical to energy homeostasis in the animal, and thus...

Potential metabolic pathways associated with differences in weight maintenance and gain in mature cow skeletal and adipose tissue

USDA-ARS?s Scientific Manuscript database

Feed costs are the greatest expenditure for beef cow operations. During the production year of a cow, the majority of nutrients are used to support maintenance. Differences in feedstuff utilization and metabolism can impact the ability of the cow to meet maintenance requirements. The objective of th...

The resist diabetes trial: Rationale, design, and methods of a hybrid efficacy/effectiveness intervention trial for resistance training maintenance to improve glucose homeostasis in older prediabetic adults.

PubMed

Marinik, Elaina L; Kelleher, Sarah; Savla, Jyoti; Winett, Richard A; Davy, Brenda M

2014-01-01

Advancing age is associated with reduced levels of physical activity, increased body weight and fat, decreased lean body mass, and a high prevalence of type 2 diabetes (T2D). Resistance training (RT) increases muscle strength and lean body mass, and reduces risk of T2D among older adults. The Resist Diabetes trial will determine if a social cognitive theory (SCT)-based intervention improves RT maintenance in older, prediabetic adults, using a hybrid efficacy/effectiveness approach. Sedentary, overweight/obese (BMI: 25-39.9 kg/m(2)) adults aged 50-69 (N = 170) with prediabetes (impaired fasting glucose and/or impaired glucose tolerance) completed a supervised 3-month RT (2×/wk) initiation phase and were then randomly assigned (N = 159; 94% retention) to one of two 6-month maintenance conditions: SCT or standard care. The SCT intervention consisted of faded contacts compared to standard care. Participants continue RT at an approved, self-selected community facility during maintenance. A subsequent 6-month period involves no contact for both conditions. Assessments occur at baseline and months 3 (post-initiation), 9 (post-intervention), and 15 (six months after no contact). Primary outcomes are prediabetes indices (i.e., impaired fasting and 2-hour glucose concentration) and strength. Secondary measures include insulin sensitivity, beta-cell responsiveness, and disposition index (oral glucose and C-peptide minimal model); adherence; body composition; and SCT measures. Resist Diabetes is the first trial to examine the effectiveness of a high fidelity SCT-based intervention for maintaining RT in older adults with prediabetes to improve glucose homeostasis. Successful application of SCT constructs for RT maintenance may support translation of our RT program for diabetes prevention into community settings. Copyright © 2013 Elsevier Inc. All rights reserved.

Could habits hold the key to weight loss maintenance? A narrative review.

PubMed

Cleo, G; Isenring, E; Thomas, R; Glasziou, P

2017-10-01

Despite the significance placed on lifestyle interventions for obesity management, most weight loss is followed by weight regain. Psychological concepts of habitual behaviour and automaticity have been suggested as plausible explanations for this overwhelming lack of long-term weight loss success. Interventions that focus on changing an individual's behaviour are not usually successful at changing an individual's habits because they do not incorporate the strategies required to break unhealthy habits and/or form new healthy habits. A narrative review was conducted and describes the theory behind habit formation in relation to weight regain. The review evaluated the effectiveness of using habits as tools to maintain weight loss. Three specific habit-based weight loss programmes are described: '10 Top Tips', 'Do Something Different' and 'Transforming Your Life'. Participants in these interventions achieved significant weight loss compared to a control group or other conventional interventions. Habit-based interventions show promising results in sustaining behaviour change. Weight loss maintenance may benefit from incorporating habit-focused strategies and should be investigated further. © 2017 The British Dietetic Association Ltd.

Physical activity and healthy weight maintenance from childhood to adulthood.

PubMed

Cleland, Verity J; Dwyer, Terence; Venn, Alison J

2008-06-01

The objective of this study was to determine whether change in physical activity was associated with maintaining a healthy weight from childhood to adulthood. This prospective cohort study examined 1,594 young Australian adults (48.9% female) aged 27-36 years who were first examined at age 9-15 years as part of a national health and fitness survey. BMI was calculated from measured height and weight, and physical activity was self-reported at both time points; pedometers were also used at follow-up. Change in physical activity was characterized by calculating the difference between baseline and follow-up z-scores. Change scores were categorized as decreasing (large, moderate), stable, or increasing (large, moderate). Healthy weight was defined in childhood as a BMI less than international overweight cutoff points, and in adulthood as BMI<25 kg/m(2). Healthy weight maintainers were healthy weight at both time points. Compared with those who demonstrated large relative decreases in physical activity, females in all other groups were 25-37% more likely to be healthy weight maintainers, although associations differed according to the physical activity measure used at follow-up and few reached statistical significance. Although younger males whose relative physical activity moderately or largely increased were 27-34% more likely to be healthy weight maintainers than those whose relative physical activity largely decreased, differences were not statistically significant. In conclusion, relatively increasing and stable physical activity from childhood to adulthood was only weakly associated with healthy weight maintenance. Examining personal, social, and environmental factors associated with healthy weight maintenance will be an important next step in understanding why some groups avoid becoming overweight.

The WORD (Wholeness, Oneness, Righteousness, Deliverance): design of a randomized controlled trial testing the effectiveness of an evidence-based weight loss and maintenance intervention translated for a faith-based, rural, African American population using a community-based participatory approach.

PubMed

Yeary, Karen Hye-cheon Kim; Cornell, Carol E; Prewitt, Elaine; Bursac, Zoran; Tilford, J Mick; Turner, Jerome; Eddings, Kenya; Love, ShaRhonda; Whittington, Emily; Harris, Kimberly

2015-01-01

The positive effects of weight loss on obesity-related risk factors diminish unless weight loss is maintained. Yet little work has focused on the translation of evidence-based weight loss interventions with the aim of sustaining weight loss in underserved populations. Using a community-based participatory approach (CBPR) that engages the strong faith-based social infrastructure characteristic of rural African American communities is a promising way to sustain weight loss in African Americans, who bear a disproportionate burden of the obesity epidemic. Led by a collaborative community-academic partnership, The WORD aims to change dietary and physical activity behaviors to produce and maintain weight loss in rural, African American adults of faith. The WORD is a randomized controlled trial with 450 participants nested within 30 churches. All churches will receive a 16-session core weight loss intervention. Half of the churches will be randomized to receive an additional 12-session maintenance component. The WORD is a cultural adaptation of the Diabetes Prevention Program, whereby small groups will be led by trained church members. Participants will be assessed at baseline, 6, 12, and 18 months. A detailed cost-effectiveness and process evaluation will be included. The WORD aims to sustain weight loss in rural African Americans. The utilization of a CBPR approach and the engagement of the faith-based social infrastructure of African American communities will maximize the intervention's sustainability. Unique aspects of this trial include the focus on weight loss maintenance and the use of a faith-based CBPR approach in translating evidence-based obesity interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

Habit-based interventions for weight loss maintenance in adults with overweight and obesity: a randomized controlled trial.

PubMed

Cleo, Gina; Glasziou, Paul; Beller, Elaine; Isenring, Elisabeth; Thomas, Rae

2018-04-23

The objective of this study was to determine whether habit-based interventions are clinically beneficial in achieving long-term (12-month) weight loss maintenance and explore whether making new habits or breaking old habits is more effective. Volunteer community members aged 18-75 years who had overweight or obesity (BMI ≥ 25 kg/m 2 ) were randomized in a single-blind, three-arm, randomized controlled trial. Ten Top Tips (TTT), Do Something Different (DSD), and the attention-only waitlist (WL) control groups were conducted for 12 weeks from July to October 2015. Participants were followed up post-intervention (all groups) and at 6 and 12-month post-intervention (Ten Top Tips and Do Something Different only). The primary outcome was weight-loss maintenance at 12-month follow-up. Secondary outcomes included weight loss at all time points, fruit and vegetable consumption, exercise, wellbeing, depression, anxiety, habit strength, and openness to change. Of the 130 participants assessed for eligibility, 75 adults (mean BMI 34.5 kg/m 2 [SD 6.2]), with a mean age of 51 years were recruited. Assessments were completed post-intervention by 66/75 (88%) of participants and by 43/50 (86%) at 12 months. At post-intervention, participants in the Ten Top Tips (-3.3 kg; 95% CI -5.2, -1.4) and Do Something Different (-2.9 kg; 95% CI -4.3, -1.4) interventions lost significantly more weight (P = < .001) than those on the waitlist control (-0.4 kg; 95% CI -1.2, 0.3). Both intervention groups continued to lose further weight to the 12-month follow-up; TTT lost an additional -2.4 kg (95% CI -5.1, 0.4) and DSD lost -1.7 kg (95% CI -3.4, -0.1). At 12-month post-intervention, 28/43 (65%) of participants in both intervention groups had reduced their total body weight by ≥5%, a clinically important change. Habit-based weight-loss interventions-forming new habits (TTT) and breaking old habits (DSD), resulted in clinically important weight-loss maintenance at 12-month follow-up.

[Which Factors Affect Weight Maintenance? A Qualitative Study with Adolescents and their Parents who have Completed a Ten-months Intervention].

PubMed

Hemetek, U; Ernert, A; Wiegand, S; Bau, A-M

2015-11-01

The alarming increase in the prevalence of childhood obesity is recognised as a major public health concern. Currently, structured multi-modal therapy programmes present the gold standard of therapy strategies for obese children and adolescents. However, effects of these treatments are still a matter of discussion. Failure to isolate and understand the external and internal factors contributing to successful, long-term weight reduction may well be contributing to the ineffectiveness of current treatment interventions. A qualitative approach was chosen in order to identify subjectively perceived resources and barriers to weight maintenance after previous weight reduction. The research question focused on how these resources and barriers affect success of participants. Additionally the question arose as to how and to what extent parents should and could be involved in the therapy process. The results can deliver important starting points for the development of therapy programmes and future research. 7 participants of a weight reduction and maintenance programme and 7 of their parents were interviewed on their personal experiences during and after the treatment. The interviews were analysed based on the qualitative content analysis. Continuous motivation, especially after the initial weight reduction phase, was identified as the strongest predictor of successful weight maintenance. Successful weight maintainers generally showed characteristics of higher self-efficacy, internal motivation concerning physical activity and flexible self-control concerning food intake. Unsuccessful weight gainers stated a lack of motivation concerning physical activity and lost control over their eating habits. Concerning the role of parents in the therapy process, the results show that higher parental involvement does not predict greater success. The general relationship between parents and their children seems to be more significant, especially concerning the issues of responsibility. It is disputable to what extent the post treatment intervention contributed to the development of intrinsic motivation. More attention should be paid to the age (children or adolescents) of participants of therapy programmes, especially concerning the involvement of parents. It is assumed that general aspects of education should be discussed with parents. © Georg Thieme Verlag KG Stuttgart · New York.

Changes in job strain and subsequent weight gain: a longitudinal study, based on the Danish Nurse Cohort.

PubMed

Vesterlund, Gitte Kingo; Keller, Amélie Cléo; Heitmann, Berit Lilienthal

2018-04-01

Obesity as well as job strain is increasing, and job strain might contribute to weight gain. The objective of the current study was to examine associations between longitudinal alterations in the components of job strain and subsequent weight gain. The study was designed as a prospective cohort study with three questionnaire surveys enabling measurement of job-strain alterations over 6 years and subsequent measurements of weight gain after further 10 years of follow-up. ANCOVA and trend analyses were conducted. Job demands were measured as job busyness and speed, and control as amount of influence. Employed nurses in Denmark. We included a sub-sample of 6188 female nurses from the Danish Nurse Cohort, which consisted of the nurses who participated in surveys in 1993, 1999 and 2009. A linear trend in weight gain was seen in nurses who were often busy in 1999 between those who were rarely v. sometimes v. often busy in 1993 (P=0·03), with the largest weight gain in individuals with sustained high busyness in both years. Loss of influence between 1993 and 1999 was associated with larger subsequent weight gain than sustained high influence (P=0·003) or sustained low influence (P=0·02). For speed, no associations were found. Busyness, speed and influence differed in their relationship to subsequent weight gain. A decrease in job influence and a sustained burden of busyness were most strongly related to subsequent weight gain. Focus on job strain reduction and healthy diet is essential for public health.

Mechanisms of Weight Regain following Weight Loss.

PubMed

Blomain, Erik Scott; Dirhan, Dara Anne; Valentino, Michael Anthony; Kim, Gilbert Won; Waldman, Scott Arthur

2013-01-01

Obesity is a world-wide pandemic and its incidence is on the rise along with associated comorbidities. Currently, there are few effective therapies to combat obesity. The use of lifestyle modification therapy, namely, improvements in diet and exercise, is preferable over bariatric surgery or pharmacotherapy due to surgical risks and issues with drug efficacy and safety. Although they are initially successful in producing weight loss, such lifestyle intervention strategies are generally unsuccessful in achieving long-term weight maintenance, with the vast majority of obese patients regaining their lost weight during followup. Recently, various compensatory mechanisms have been elucidated by which the body may oppose new weight loss, and this compensation may result in weight regain back to the obese baseline. The present review summarizes the available evidence on these compensatory mechanisms, with a focus on weight loss-induced changes in energy expenditure, neuroendocrine pathways, nutrient metabolism, and gut physiology. These findings have added a major focus to the field of antiobesity research. In addition to investigating pathways that induce weight loss, the present work also focuses on pathways that may instead prevent weight regain. Such strategies will be necessary for improving long-term weight loss maintenance and outcomes for patients who struggle with obesity.

Lunar robotic maintenance module

NASA Technical Reports Server (NTRS)

Ayres, Michael L.

1988-01-01

A design for a robotic maintenance module that will assist a mobile 100-meter lunar drill is introduced. The design considers the following areas of interest: the atmospheric conditions, actuator systems, power supply, material selection, weight, cooling system and operation.

Positive effect of mushrooms substituted for meat on body weight, body composition, and health parameters. A 1-year randomized clinical trial.

PubMed

Poddar, Kavita H; Ames, Meghan; Hsin-Jen, Chen; Feeney, Mary Jo; Wang, Youfa; Cheskin, Lawrence J

2013-12-01

Reducing energy density (ED) of the diet is an important strategy for controlling obesity. This 1-year, randomized clinical trial examined the effect of substituting mushrooms for red meat ('mushroom diet'), compared to a standard diet ('meat diet'), on weight loss and maintenance among 73 obese adults (64 women, 9 men). The subjects completed anthropometric measurements and 7-day food records four times during a standardized weight loss and maintenance regimen. At the end of the 1-year trial, compared to participants on the standard diet, participants on the mushroom diet (n=36) reported lower intakes of energy (mean ± [SE]=-123 ± 113 kcals) and fat (-4.25 ± 6.88 g), lost more pounds and percentage body weight (-7.03 ± 3.34 lbs, 3.6%), achieved lower body mass index (-1.53 ± 0.36), waist circumference (-2.6 ± 3.5 in.) and percent total body fat (-0.85 ± 0.53), and had lower systolic and diastolic pressure (-7.9 and -2.5 mmHg); their lipid profile and inflammatory markers also improved. After initial weight loss, subjects following the mushroom diet maintained that loss well. Those who completed the full 12-month trial still weighed a mean of 7 lbs less than baseline. Thus, encouraging adults to substitute mushrooms for red meat was a useful strategy for enhancing weight loss, weight maintenance, and health parameters. Copyright © 2013 Elsevier Ltd. All rights reserved.

A structured diet and exercise program promotes favorable changes in weight loss, body composition, and weight maintenance.

PubMed

Kreider, Richard B; Serra, Monica; Beavers, Kristen M; Moreillon, Jen; Kresta, Julie Y; Byrd, Mike; Oliver, Jonathan M; Gutierrez, Jean; Hudson, Geoffrey; Deike, Erika; Shelmadine, Brian; Leeke, Patricia; Rasmussen, Chris; Greenwood, Mike; Cooke, Matthew B; Kerksick, Chad; Campbell, Jessica K; Beiseigel, Jeannemarie; Jonnalagadda, Satya S

2011-06-01

A number of diet and exercise programs purport to help promote and maintain weight loss. However, few studies have compared the efficacy of different methods. To determine whether adherence to a meal-replacement-based diet program (MRP) with encouragement to increase physical activity is as effective as following a more structured meal-plan-based diet and supervised exercise program (SDE) in sedentary obese women. Randomized comparative effectiveness trial. From July 2007 to October 2008, 90 obese and apparently healthy women completed a 10-week university-based weight loss trial while 77 women from this cohort also completed a 24-week weight maintenance phase. Participants were matched and randomized to participate in an MRP or SDE program. Weight loss, health, and fitness-related data were assessed at 0 and 10 weeks on all subjects as well as at 14, 22, and 34 weeks on participants who completed the weight maintenance phase. Data were analyzed by multivariate analysis of variance for repeated measures. During the 10-week weight loss phase, moderate and vigorous physical activity levels were significantly higher in the SDE group with no differences observed between groups in daily energy intake. The SDE group lost more weight (-3.1 ± 3.7 vs -1.6 ± 2.5 kg; P = 0.03); fat mass (-2.3 ± 3.5 vs -0.9 ± 1.6 kg; P = 0.02); centimeters from the hips (-4.6 ± 7 vs -0.2 ± 6 cm; P = 0.002) and waist (-2.9 ± 6 vs -0.6 ± 5 cm; P = 0.05); and, experienced a greater increase in peak aerobic capacity than participants in the MRP group. During the 24-week maintenance phase, participants in the SDE group maintained greater moderate and vigorous physical activity levels, weight loss, fat loss, and saw greater improvement in maximal aerobic capacity and strength. In sedentary and obese women, an SDE-based program appears to be more efficacious in promoting and maintaining weight loss and improvements in markers of health and fitness compared to an MRP type program with encouragement to increase physical activity. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Daily self-monitoring of body weight, step count, fruit/vegetable intake, and water consumption: a feasible and effective long-term weight loss maintenance approach.

PubMed

Akers, Jeremy D; Cornett, Rachel A; Savla, Jyoti S; Davy, Kevin P; Davy, Brenda M

2012-05-01

Maintenance of weight loss remains a challenge for most individuals. Thus, practical and effective weight-loss maintenance (WTLM) strategies are needed. A two-group 12-month WTLM intervention trial was conducted from June 2007 to February 2010 to determine the feasibility and effectiveness of a WTLM intervention for older adults using daily self-monitoring of body weight, step count, fruit/vegetable (F/V) intake, and water consumption. Forty weight-reduced individuals (mean weight lost=6.7±0.6 kg; body mass index [calculated as kg/m²] 29.2±1.1), age 63±1 years, who had previously participated in a 12-week randomized controlled weight-loss intervention trial, were instructed to record daily body weight, step count, and F/V intake (WEV [defined as weight, exercise, and F/V]). Experimental group (WEV+) participants were also instructed to consume 16 fl oz of water before each main meal (ie, three times daily), and to record daily water intake. Outcome measures included weight change, diet/physical activity behaviors, theoretical constructs related to health behaviors, and other clinical measures. Statistical analyses included growth curve analyses and repeated measures analysis of variance. Over 12 months, there was a linear decrease in weight (β=-0.32, P<0.001) and a quadratic trend (β=0.02, P<0.01) over time, but no group difference (β=-0.23, P=0.08). Analysis of the 365 days of self-reported body weight for each participant determined that weight loss was greater over the study period in the WEV+ group than in the WEV group, corresponding to weight changes of -0.67 kg and 1.00 kg, respectively, and an 87% greater weight loss (β=-0.01, P<0.01). Overall compliance to daily tracking was 76%±5%. Daily self-monitoring of weight, physical activity, and F/V consumption is a feasible and effective approach for maintaining weight loss for 12 months, and daily self-monitoring of increased water consumption may provide additional WTLM benefits. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Effects of targeted delivery of propionate to the human colon on appetite regulation, body weight maintenance and adiposity in overweight adults

PubMed Central

Chambers, Edward S; Viardot, Alexander; Psichas, Arianna; Morrison, Douglas J; Murphy, Kevin G; Zac-Varghese, Sagen E K; MacDougall, Kenneth; Preston, Tom; Tedford, Catriona; Finlayson, Graham S; Blundell, John E; Bell, Jimmy D; Thomas, E Louise; Mt-Isa, Shahrul; Ashby, Deborah; Gibson, Glen R; Kolida, Sofia; Dhillo, Waljit S; Bloom, Stephen R; Morley, Wayne; Clegg, Stuart; Frost, Gary

2015-01-01

Objective The colonic microbiota ferment dietary fibres, producing short chain fatty acids. Recent evidence suggests that the short chain fatty acid propionate may play an important role in appetite regulation. We hypothesised that colonic delivery of propionate would increase peptide YY (PYY) and glucagon like peptide-1 (GLP-1) secretion in humans, and reduce energy intake and weight gain in overweight adults. Design To investigate whether propionate promotes PYY and GLP-1 secretion, a primary cultured human colonic cell model was developed. To deliver propionate specifically to the colon, we developed a novel inulin-propionate ester. An acute randomised, controlled cross-over study was used to assess the effects of this inulin-propionate ester on energy intake and plasma PYY and GLP-1 concentrations. The long-term effects of inulin-propionate ester on weight gain were subsequently assessed in a randomised, controlled 24-week study involving 60 overweight adults. Results Propionate significantly stimulated the release of PYY and GLP-1 from human colonic cells. Acute ingestion of 10 g inulin-propionate ester significantly increased postprandial plasma PYY and GLP-1 and reduced energy intake. Over 24 weeks, 10 g/day inulin-propionate ester supplementation significantly reduced weight gain, intra-abdominal adipose tissue distribution, intrahepatocellular lipid content and prevented the deterioration in insulin sensitivity observed in the inulin-control group. Conclusions These data demonstrate for the first time that increasing colonic propionate prevents weight gain in overweight adult humans. Trial registration number NCT00750438. PMID:25500202

Dose-related difference in progression rates of cytomegalovirus retinopathy during foscarnet maintenance therapy. AIDS Clinical Trials Group Protocol 915 Team.

PubMed

Holland, G N; Levinson, R D; Jacobson, M A

1995-05-01

A previous dose-ranging study of foscarnet maintenance therapy for cytomegalovirus retinopathy showed a positive relationship between dose and survival but could not confirm a relationship between dose and time to first progression. This retrospective analysis of data from that study was undertaken to determine whether there was a relationship between dose and progression rates, which reflects the amount of retina destroyed when progression occurs. Patients were randomly given one of two foscarnet maintenance therapy doses (90 mg/kg of body weight/day [FOS-90 group] or 120 mg/kg of body weight/day [FOS-120 group] after induction therapy. Using baseline and follow-up photographs and pre-established definitions and methodology in a masked analysis, posterior progression rates and foveal proximity rates for individual lesions, selected by prospectively defined criteria, were calculated in each patient. Rates were compared between groups. The following median rates were greater for the FOS-90 group (N = 8) than for the FOS-120 group (N = 10): greatest maximum rate at which lesions enlarged in a posterior direction (43.5 vs 12.5 microns/day; P = .002); posterior progression rate for lesions closest to the fovea (42.8 vs 5.5 microns/day; P = .010); and maximum foveal proximity rate for either eye (32.3 vs 3.4 microns/day; P = .031). Patients receiving higher doses of foscarnet have slower rates of progression and therefore less retinal tissue damage during maintenance therapy. A foscarnet maintenance therapy dose of 120 mg/kg of body weight/day instead of 90 mg/kg of body weight/day may help to preserve vision in patients with cytomegalovirus retinopathy.

Two Pilot Randomized Trials To Examine Feasibility and Impact of Treated Parents as Peer Interventionists in Family-Based Pediatric Weight Management.

PubMed

Saelens, Brian E; Scholz, Kelley; Walters, Kelly; Simoni, Jane M; Wright, Davene R

2017-08-01

To examine feasibility and initial efficacy of having previously treated parents serve as peer interventionists in family-based behavioral weight management treatment (FBT). Children aged 7-11 years with overweight/obesity and parents (n = 59 families) were enrolled in one of two pilot trials, the EPICH (Engaging Parents in Child Health) randomized trial comparing professional versus peer FBT delivery or the Parent Partnership trial, which provided professionally delivered FBT to families (first generation) and then randomly assigned first generation parents to either be or not be peer interventionists for subsequent families (second generation). Efficacy (child zBMI change), feasibility, and costs for delivering FBT, and impacts of being a peer interventionist were examined. In EPICH, families receiving professional versus peer intervention had similar decreases in child zBMI and parent BMI, with markedly lower costs for peer versus professional delivery. In Parent Partnership, families receiving peer intervention significantly decreased weight status, with very preliminary evidence suggesting better maintenance of child zBMI changes if parents served as peer interventionists. Previously treated parents were willing, highly confident, and able to serve as peer interventionists in FBT. Two pilot randomized clinical trials suggest parents-as-peer interventionists in FBT may be feasible, efficacious, and delivered at lower costs, with perhaps some additional benefits to serving as a peer interventionist. More robust investigation is warranted of peer treatment delivery models for pediatric weight management.

Maintenance Energy Requirements of Double-Muscled Belgian Blue Beef Cows

PubMed Central

Fiems, Leo O.; De Boever, Johan L.; Vanacker, José M.; De Campeneere, Sam

2015-01-01

Simple Summary Double-muscled Belgian Blue animals are extremely lean, characterized by a deviant muscle fiber type with more fast-glycolytic fibers, compared to non-double-muscled animals. This fiber type may result in lower maintenance energy requirements. On the other hand, lean meat animals mostly have a higher rate of protein turnover, which requires more energy for maintenance. Therefore, maintenance requirements of Belgian Blue cows were investigated based on a zero body weight gain. This technique showed that maintenance energy requirements of double-muscled Belgian Blue beef cows were close to the mean requirements of cows of other beef genotypes. Abstract Sixty non-pregnant, non-lactating double-muscled Belgian Blue (DMBB) cows were used to estimate the energy required to maintain body weight (BW). They were fed one of three energy levels for 112 or 140 days, corresponding to approximately 100%, 80% or 70% of their total energy requirements. The relationship between daily energy intake and BW and daily BW change was developed using regression analysis. Maintenance energy requirements were estimated from the regression equation by setting BW gain to zero. Metabolizable and net energy for maintenance amounted to 0.569 ± 0.001 and 0.332 ± 0.001 MJ per kg BW0.75/d, respectively. Maintenance energy requirements were not dependent on energy level (p > 0.10). Parity affected maintenance energy requirements (p < 0.001), although the small numerical differences between parities may hardly be nutritionally relevant. Maintenance energy requirements of DMBB beef cows were close to the mean energy requirements of other beef genotypes reported in the literature. PMID:26479139

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zawisza, I; Yan, H; Yin, F

Purpose: To assure that tumor motion is within the radiation field during high-dose and high-precision radiosurgery, real-time imaging and surrogate monitoring are employed. These methods are useful in providing real-time tumor/surrogate motion but no future information is available. In order to anticipate future tumor/surrogate motion and track target location precisely, an algorithm is developed and investigated for estimating surrogate motion multiple-steps ahead. Methods: The study utilized a one-dimensional surrogate motion signal divided into three components: (a) training component containing the primary data including the first frame to the beginning of the input subsequence; (b) input subsequence component of the surrogatemore » signal used as input to the prediction algorithm: (c) output subsequence component is the remaining signal used as the known output of the prediction algorithm for validation. The prediction algorithm consists of three major steps: (1) extracting subsequences from training component which best-match the input subsequence according to given criterion; (2) calculating weighting factors from these best-matched subsequence; (3) collecting the proceeding parts of the subsequences and combining them together with assigned weighting factors to form output. The prediction algorithm was examined for several patients, and its performance is assessed based on the correlation between prediction and known output. Results: Respiratory motion data was collected for 20 patients using the RPM system. The output subsequence is the last 50 samples (∼2 seconds) of a surrogate signal, and the input subsequence was 100 (∼3 seconds) frames prior to the output subsequence. Based on the analysis of correlation coefficient between predicted and known output subsequence, the average correlation is 0.9644±0.0394 and 0.9789±0.0239 for equal-weighting and relative-weighting strategies, respectively. Conclusion: Preliminary results indicate that the prediction algorithm is effective in estimating surrogate motion multiple-steps in advance. Relative-weighting method shows better prediction accuracy than equal-weighting method. More parameters of this algorithm are under investigation.« less

Maintaining a clinical weight loss after intensive lifestyle intervention is the key to cardiometabolic health.

PubMed

Dandanell, Sune; Skovborg, Camilla; Præst, Charlotte Boslev; Kristensen, Kasper Bøgh; Nielsen, Malene Glerup; Lionett, Sofie; Jørgensen, Sofie Drevsholt; Vigelsø, Andreas; Dela, Flemming; Helge, Jørn Wulff

Intensive lifestyle interventions (ILI) are criticised for ineffective obesity treatment because weight loss over time is modest and thus of limited clinical relevance. However, a subgroup (5-30%) maintains a clinical weight loss >10%, but it is not clear if cardiometabolic health follows this pattern. The aim was to study the effect of different magnitudes of weight loss maintenance after ILI on cardiometabolic health. Eighty out of 2420 former participants (age: 36±1, BMI: 38±1, (means ±SE)) in an 11-12-week ILI were recruited into 3 groups; clinical weight loss maintenance (>10% weight loss), moderate maintenance (1-10%), and weight regain based on weight loss at follow-up (5.3±0.4years). Weight loss during the ILI was achieved by increased physical activity and hypo-caloric diet. Dual X-ray Absorptiometry, blood sample, skeletal muscle biopsy and VO 2max test were used to determine cardiometabolic health at follow-up. At follow-up, the clinical weight loss maintenance group scored better in the following variables compared to the other groups: BMI (31±1, 33±2, 43±2kg/m 2 ), composition (34±2, 40±1, 49±1% fat), visceral adipose tissue (0.8±0.2, 1.7±0.5, 2.4±0.4kg), plasma triglycerides (0.8±0.2, 1.3±0.4, 1.6±0.3mmol/L), plasma glucose (4.9±0.1, 5.9±0.4, 5.9±0.1mmol/L), Hb1Ac (5.1±0.0, 5.6±0.2, 5.8±0.2%), protein content in skeletal muscle of GLUT4 (1.5±0.2, 0.9±0.1, 1.0±0.1 AU) and hexokinase II (1.6±0.2, 1.0±0.2, 0.7±0.1 AU), citrate synthase activity (155±6, 130±5, 113±5μmol/g/min) and VO 2max (49±1, 43±1, 41±1mL/min/FFM) (p<0.05). Cardiometabolic health is better in participants who have maintained >10% weight loss compared to moderate weight loss and weight regain. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Weight maintenance and additional weight loss with liraglutide after low-calorie-diet-induced weight loss: the SCALE Maintenance randomized study.

PubMed

Wadden, T A; Hollander, P; Klein, S; Niswender, K; Woo, V; Hale, P M; Aronne, L

2013-11-01

Liraglutide, a once-daily human glucagon-like peptide-1 analog, induced clinically meaningful weight loss in a phase 2 study in obese individuals without diabetes. The present randomized phase 3 trial assessed the efficacy of liraglutide in maintaining weight loss achieved with a low-calorie diet (LCD). Obese/overweight participants (≥18 years, body mass index ≥30 kg m(-2) or ≥27 kg m(-2) with comorbidities) who lost ≥5% of initial weight during a LCD run-in were randomly assigned to liraglutide 3.0 mg per day or placebo (subcutaneous administration) for 56 weeks. Diet and exercise counseling were provided throughout the trial. Co-primary end points were percentage weight change from randomization, the proportion of participants that maintained the initial ≥5% weight loss, and the proportion that lost ≥5% of randomization weight (intention-to-treat analysis). ClinicalTrials.gov identifier: NCT00781937. Participants (n=422) lost a mean 6.0% (s.d. 0.9) of screening weight during run-in. From randomization to week 56, weight decreased an additional mean 6.2% (s.d. 7.3) with liraglutide and 0.2% (s.d. 7.0) with placebo (estimated difference -6.1% (95% class intervals -7.5 to -4.6), P<0.0001). More participants receiving liraglutide (81.4%) maintained the ≥5% run-in weight loss, compared with those receiving placebo (48.9%) (estimated odds ratio 4.8 (3.0; 7.7), P<0.0001), and 50.5% versus 21.8% of participants lost ≥5% of randomization weight (estimated odds ratio 3.9 (2.4; 6.1), P<0.0001). Liraglutide produced small but statistically significant improvements in several cardiometabolic risk factors compared with placebo. Gastrointestinal (GI) disorders were reported more frequently with liraglutide than placebo, but most events were transient, and mild or moderate in severity. Liraglutide, with diet and exercise, maintained weight loss achieved by caloric restriction and induced further weight loss over 56 weeks. Improvements in some cardiovascular disease-risk factors were also observed. Liraglutide, prescribed as 3.0 mg per day, holds promise for improving the maintenance of lost weight.

Prevention of weight gain following a worksite nutrition and exercise program: a randomized controlled trial.

PubMed

Thorndike, Anne N; Sonnenberg, Lillian; Healey, Erica; Myint-U, Khinlei; Kvedar, Joseph C; Regan, Susan

2012-07-01

Many employers are now providing wellness programs to help employees make changes in diet and exercise behaviors. Improving health outcomes and reducing costs will depend on whether employees sustain lifestyle changes and maintain a healthy weight over time. To determine if a 9-month maintenance intervention immediately following a 10-week worksite exercise and nutrition program would prevent regain of the weight lost during the program. RCT. In 2008, a total of 330 employees from 24 teams completed a 10-week exercise and nutrition program at a large hospital worksite and were randomized by team to maintenance or control (usual care) for 9 months. Internet support with a website for goal-setting and self-monitoring of weight and exercise plus minimal personal support. Weight loss, percentage weight loss, time spent in physical activity, and frequency of consumption of fruits/vegetables, fatty foods, and sugary foods at 1 year compared to baseline. One-year follow-up was completed in 2010, and data were analyzed in 2011. At 1 year, 238 subjects (72%) completed follow-up assessments. Mean baseline BMI was 27.6 and did not differ between intervention and control. Compared to baseline, both groups lost weight during the 10-week program and maintained 65% of weight loss at 1 year (p<0.001). There was no difference in weight loss between groups at the end of the 10-week program (4.8 lbs vs 4.3 lbs, p=0.53 for group X time interaction) or end of maintenance at 1 year (3.4 lbs vs 2.5 lbs, p=0.40 for group X time interaction). All subjects had improvements in physical activity and nutrition (increased fruits/vegetables and decreased fat and sugar intake) at 1 year but did not differ by group. An intensive 10-week team-based worksite exercise and nutrition program resulted in moderate weight loss and improvements in diet and exercise behaviors at 1 year, but an Internet-based maintenance program immediately following the 10-week program did not improve these outcomes. This study is registered at clinicaltrials.gov NCT00707577. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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

Eakin, Elizabeth G; Reeves, Marina M; Marshall, Alison L; Dunstan, David W; Graves, Nicholas; Healy, Genevieve N; Bleier, Jonathan; Barnett, Adrian G; O'Moore-Sullivan, Trisha; Russell, Anthony; Wilkie, Ken

2010-08-03

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. 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. 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 behaviour change, and will build the evidence base needed to advocate for the translation of this work into population health practice. ACTRN12608000203358.

The importance of body weight and weight management for military personnel.

PubMed

Naghii, Mohammad Reza

2006-06-01

Weight or fat reduction and maintenance among military personnel and attainment of desired body composition and physical appearance are considered important. A high level of body fat has been shown to have an adverse effect on performance in a number of military activities. The effect of rapid weight loss on performance appears to depend on the method of weight loss, the magnitude of weight loss, and the type of exercise or activity performance test used. Personnel who undertake imprudent weight-loss strategies, that is, personnel who try to change their usual body size by chronically restricting their food and fluid intake, may suffer a number of problems. Overweight personnel and their military coaches are just as susceptible to false ideas about weight loss and dieting as the rest of the community. Inappropriate weight loss causes a loss of lean tissue and can reduce, rather than enhance, performance. The understanding and promotion of safe, effective, appropriate weight-loss and weight-maintenance strategies represent important functions of the military system and officials. The greatest likelihood of success requires an integrated program, both during and after the weight-loss phase, in which assessment, increased energy expenditure through exercise and other daily activities, energy intake reduction, nutrition education, lifestyle changes, environmental changes, and psychological support are all components.

Teleoperator Maneuvering System (TMS) benefits assessment study. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

1983-01-01

Teleoperator Maneuvering System (TMS) versus integral spacecraft propulsion, spacecraft maintenance, cost benefits, launch prices, integral propulsion length penalties, remote maintenance versus EVA, potential weight reduction benefits, basing mode, mission models and payload requirements, and program profitability are discussed.

Comparing Costs of Telephone versus Face-to-Face Extended Care Programs for the Management of Obesity in Rural Settings

PubMed Central

Radcliff, Tiffany A.; Bobroff, Linda B.; Lutes, Lesley D.; Durning, Patricia E.; Daniels, Michael J.; Limacher, Marian C.; Janicke, David M.; Martin, A. Daniel; Perri, Michael G.

2012-01-01

Background A major challenge following successful weight loss is continuing the behaviors required for long-term weight maintenance. This challenge may be exacerbated in rural areas with limited local support resources. Objective This study describes and compares program costs and cost-effectiveness for 12-month extended care lifestyle maintenance programs following an initial 6-month weight loss program. Design A 1-year prospective controlled randomized clinical trial. Participants/Setting The study included 215 female participants age 50 or older from rural areas who completed an initial 6-month lifestyle program for weight loss. The study was conducted from June 1, 2003, to May 31, 2007. Intervention The intervention was delivered through local Cooperative Extension Service offices in rural Florida. Participants were randomly-assigned to a 12-month extended care program using either individual telephone counseling (n=67), group face-to-face counseling (n=74), or a mail/control group (n=74). Main Outcome Measures Program delivery costs, weight loss, and self-reported health status were directly assessed through questionnaires and program activity logs. Costs were estimated across a range of enrollment sizes to allow inferences beyond the study sample. Statistical Analyses Performed Non-parametric and parametric tests of differences across groups for program outcomes were combined with direct program cost estimates and expected value calculations to determine which scales of operation favored alternative formats for lifestyle maintenance. Results Median weight regain during the intervention year was 1.7 kg for participants in the face-to-face format, 2.1 kg for the telephone format, and 3.1 kg for the mail/control format. For a typical group size of 13 participants, the face-to-face format had higher fixed costs, which translated into higher overall program costs ($420 per participant) when compared to individual telephone counseling ($268 per participant) and control ($226 per participant) programs. While the net weight lost after the 12-month maintenance program was higher for the face-to-face and telephone programs compared to the control group, the average cost per expected kilogram of weight lost was higher for the face-to-face program ($47/kg) compared to the other two programs (approximately $33/kg for telephone and control). Conclusions Both the scale of operations and local demand for programs are important considerations in selecting a delivery format for lifestyle maintenance. In this study, the telephone format had a lower cost, but similar outcomes compared to the face-to-face format. PMID:22818246

Payload maintenance cost model for the space telescope

NASA Technical Reports Server (NTRS)

White, W. L.

1980-01-01

An optimum maintenance cost model for the space telescope for a fifteen year mission cycle was developed. Various documents and subsequent updates of failure rates and configurations were made. The reliability of the space telescope for one year, two and one half years, and five years were determined using the failure rates and configurations. The failure rates and configurations were also used in the maintenance simulation computer model which simulate the failure patterns for the fifteen year mission life of the space telescope. Cost algorithms associated with the maintenance options as indicated by the failure patterns were developed and integrated into the model.

National Athletic Trainers' Association position statement: safe weight loss and maintenance practices in sport and exercise.

PubMed

Turocy, Paula Sammarone; DePalma, Bernard F; Horswill, Craig A; Laquale, Kathleen M; Martin, Thomas J; Perry, Arlette C; Somova, Marla J; Utter, Alan C

2011-01-01

To present athletic trainers with recommendations for safe weight loss and weight maintenance practices for athletes and active clients and to provide athletes, clients, coaches, and parents with safe guidelines that will allow athletes and clients to achieve and maintain weight and body composition goals. Unsafe weight management practices can compromise athletic performance and negatively affect health. Athletes and clients often attempt to lose weight by not eating, limiting caloric or specific nutrients from the diet, engaging in pathogenic weight control behaviors, and restricting fluids. These people often respond to pressures of the sport or activity, coaches, peers, or parents by adopting negative body images and unsafe practices to maintain an ideal body composition for the activity. We provide athletic trainers with recommendations for safe weight loss and weight maintenance in sport and exercise. Although safe weight gain is also a concern for athletic trainers and their athletes and clients, that topic is outside the scope of this position statement. Athletic trainers are often the source of nutrition information for athletes and clients; therefore, they must have knowledge of proper nutrition, weight management practices, and methods to change body composition. Body composition assessments should be done in the most scientifically appropriate manner possible. Reasonable and individualized weight and body composition goals should be identified by appropriately trained health care personnel (eg, athletic trainers, registered dietitians, physicians). In keeping with the American Dietetics Association (ADA) preferred nomenclature, this document uses the terms registered dietitian or dietician when referring to a food and nutrition expert who has met the academic and professional requirements specified by the ADA's Commission on Accreditation for Dietetics Education. In some cases, a registered nutritionist may have equivalent credentials and be the commonly used term. All weight management and exercise protocols used to achieve these goals should be safe and based on the most current evidence. Athletes, clients, parents, and coaches should be educated on how to determine safe weight and body composition so that athletes and clients more safely achieve competitive weights that will meet sport and activity requirements while also allowing them to meet their energy and nutritional needs for optimal health and performance.

Gastrointestinal Hormones and Bariatric Surgery-induced Weight Loss

PubMed Central

Ionut, Viorica; Burch, Miguel; Youdim, Adrienne; Bergman, Richard N.

2015-01-01

Obesity continues to be a major public health problem in the United States and worldwide. While recent statistics have demonstrated that obesity rates have begun to plateau, more severe classes of obesity are accelerating at a faster pace with important implications in regards to treatment. Bariatric surgery has a profound and durable effect on weight loss, being to date one of the most successful interventions for obesity. Objective To provide updates to the possible role of gut hormones in post bariatric surgery weight loss and weight loss maintenance. Design and Methods The current review examines the changes in gastro-intestinal hormones with bariatric surgery and the potential mechanisms by which these changes could result in decreased weight and adiposity. Results The mechanism by which bariatric surgery results in body weight changes is incompletely elucidated, but it clearly goes beyond caloric restriction and malabsorption. Conclusion Changes in gastro-intestinal hormones, including increases in GLP-1, PYY, and oxyntomodulin, decreases in GIP and ghrelin, or the combined action of all these hormones might play a role in induction and long-term maintenance of weight loss. PMID:23512841

Are Personality Characteristics as Measured by the Temperament and Character Inventory (TCI) Associated with Obesity Treatment Outcomes? A Systematic Review.

PubMed

Dalle Grave, Riccardo; Calugi, Simona; El Ghoch, Marwan

2018-03-01

Some personality traits seem to be associated with obesity, but there is little information available regarding their association with obesity treatment outcomes. The aim of this systematic review was therefore to assess the associations between personality traits-evaluated by means of the Temperament and Character Inventory (TCI)-and outcomes of obesity treatment, including attrition, weight loss, and weight loss maintenance. The PubMed database was searched, and studies were screened as per the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, and data were collated using a narrative approach. Of the 886 articles retrieved, 9 studies assessing personality traits by means of the TCI in participants with obesity met the inclusion criteria and were reviewed. This approach revealed three main findings: (i) only one study found that attrition rate-during a 6-month behavioral weight loss program-is predicted by low reward dependence scores at baseline; (ii) two studies found that lower novelty-seeking and higher self-directedness scores at baseline positively predict short-term weight-loss magnitude; and (iii) four studies found that higher persistence and lower novelty-seeking scores at baseline predicted weight maintenance at 12 and 24 months. Novelty-seeking and self-directedness traits appear to be predictors of short-term weight loss (≤ 6 months), and persistence and novelty-seeking traits may be related to long-term weight loss maintenance (≥ 12 months), although great uncertainty still exists regarding predictors of attrition.

Effects of two commercially available feline diets on glucose and insulin concentrations, insulin sensitivity and energetic efficiency of weight gain.

PubMed

Coradini, M; Rand, J S; Morton, J M; Rawlings, J M

2011-10-01

A low-carbohydrate, high-protein (LCHP) diet is often recommended for the prevention and management of diabetes in cats; however, the effect of macronutrient composition on insulin sensitivity and energetic efficiency for weight gain is not known. The present study compared the effect in adult cats (n 32) of feeding a LCHP (23 and 47 % metabolisable energy (ME)) and a high-carbohydrate, low-protein (HCLP) diet (51 and 21 % ME) on fasting and postprandial glucose and insulin concentrations, and on insulin sensitivity. Tests were done in the 4th week of maintenance feeding and after 8 weeks of ad libitum feeding, when weight gain and energetic efficiency of each diet were also measured. When fed at maintenance energy, the HCLP diet resulted in higher postprandial glucose and insulin concentrations. When fed ad libitum, the LCHP diet resulted in greater weight gain (P < 0.01), and was associated with higher energetic efficiency. Overweight cats eating the LCHP diet had similar postprandial glucose concentrations to lean cats eating the HCLP diet. Insulin sensitivity was not different between the diets when cats were lean or overweight, but glucose effectiveness was higher after weight gain in cats fed the HCLP diet. According to the present results, LCHP diets fed at maintenance requirements might benefit cats with multiple risk factors for developing diabetes. However, ad libitum feeding of LCHP diets is not recommended as they have higher energetic efficiency and result in greater weight gain.

The Benefits of Health Maintenance.

ERIC Educational Resources Information Center

Rosenstein, Alan H.

1987-01-01

The article focuses on the merits of a comprehensive, medically-oriented health maintenance/risk assessment program, and suggests that such conditions as heart disease, cancer, and arteriosclerosis can be prevented or postponed through proper nutrition, weight control, exercise, smoking cessation, and stress management. (Author/CB)

Effects of methyl mercury on reproduction in American kestrels

USGS Publications Warehouse

Albers, P.H.; Koterba, M.T.; Rossmann, R.; French, J.B.; Bennett, R.S.; Bauer, W.C.; Link, W.A.

2006-01-01

Methyl mercury (MeHg) readily passes through biological membranes, accumulates in individuals, and biomagnifies in higher order predators. It is acutely toxic to some birds at 5-15 parts per million (ppm) wet weight in the diet, and it can damage the central nervous system, impair reproduction, and retard growth and development. The effects of MeHg on reproduction in wild raptors are poorly known, and experiments with captive raptors have not included measures of reproductive response. In this study, breeding pairs of captive American kestrels (Falco sparverius) were exposed to environmentally realistic concentrations of MeHg in the diet and their subsequent reproduction was measured. Egg production, incubation performance, and the number of eggs hatched markedly decreased between 3.2 and 4.6 ppm MeHg dry weight in the diet. The percent of eggs hatched declined between 0.75 and 2 ppm MeHg dry weight in the diet and further declined to almost total hatching failure between 3.2 and 4.6 ppm. The number of fledglings and the percent of nestlings fledged were greatly reduced at 0.75 ppm MeHg dry weight in the diet and began a final sharp decline between 2 and 3.2 ppm. Dietary concentrations of > 4.6 ppm MeHg dry weight were associated with total fledging failure. Mercury concentrations in a set of 19 `second-laid? eggs collected from all groups were related to dietary concentrations of MeHg and the reproductive responses of kestrels in each group. Observed percentage declines in fledgling production caused by diets containing >2 ppm MeHg dry weight would result in the production of insufficient numbers of young kestrels for maintenance of wild populations. Concentrations of total Hg in eggs from the highest diet group (5.9 ppm dry weight) were higher than egg concentrations reported for either wild birds or for captive birds fed dry commercial food containing 5 ppm MeHg wet weight.

Pathophysiological role of host microbiota in the development of obesity.

PubMed

Kobyliak, Nazarii; Virchenko, Oleksandr; Falalyeyeva, Tetyana

2016-04-23

Overweight and obesity increase the risk for a number of diseases, namely, cardiovascular diseases, type 2 diabetes, dyslipidemia, premature death, non-alcoholic fatty liver disease as well as different types of cancer. Approximately 1.7 billion people in the world suffer from being overweight, most notably in developed countries. Current research efforts have focused on host and environmental factors that may affect energy balance. It was hypothesized that a microbiota profile specific to an obese host with increased energy-yielding behavior may exist. Consequently, the gut microbiota is becoming of significant research interest in relation to obesity in an attempt to better understand the aetiology of obesity and to develop new methods of its prevention and treatment. Alteration of microbiota composition may stimulate development of obesity and other metabolic diseases via several mechanisms: increasing gut permeability with subsequent metabolic inflammation; increasing energy harvest from the diet; impairing short-chain fatty acids synthesis; and altering bile acids metabolism and FXR/TGR5 signaling. Prebiotics and probiotics have physiologic functions that contribute to the health of gut microbiota, maintenance of a healthy body weight and control of factors associated with obesity through their effects on mechanisms that control food intake, body weight, gut microbiota and inflammatory processes.

Weight loss maintenance in African-American women: a systematic review of the behavioral lifestyle intervention literature

USDA-ARS?s Scientific Manuscript database

African-American women are disproportionally burdened by obesity. Results from behavioral weight loss interventions report that African-American women lose less weight compared to other subgroups but, show improvement in their cardiometabolic risk profile. Unfortunately, the health benefits are not ...

75 FR 64313 - Endocrinologic and Metabolic Drugs Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-19

..., proposed tradename CONTRAVE (naltrexone HCl/bupropion HCl) extended-release tablets, manufactured by Orexigen Therapeutics, Inc., for the treatment of obesity and weight management, including weight loss and maintenance of weight loss in patients with an initial body mass index (BMI) of equal to or greater than 30...

The design and conduct of Keep It Off: An online randomized trial of financial incentives for weight-loss maintenance.

PubMed

Shaw, Pamela A; Yancy, William S; Wesby, Lisa; Ulrich, Victoria; Troxel, Andrea B; Huffman, David; Foster, Gary D; Volpp, Kevin

2017-02-01

Background Obesity continues to be a serious public health challenge. Rates are increasing worldwide, with nearly 70% of the US adults overweight or obese, leading to increased clinical and economic burden. While successful approaches for achieving weight loss have been identified, techniques for long-term maintenance of initial weight loss have largely been unsuccessful. Financial incentive interventions have been shown in several settings to be successful in motivating participants to adopt healthy behaviors. Purpose Keep It Off is a three-arm randomized controlled trial that compares the efficacy of a lottery-based incentive, traditional direct payment incentive, and control of daily feedback without any incentive for weight-loss maintenance. This design allows comparison of a traditional direct payment incentive with one based on behavioral economic principles that consider the underlying psychology of decision-making. Methods Participants were randomized in a 2:1 ratio for each active arm relative to control, with a targeted 188 participants in total. Eligible participants were those aged 30-80 who lost at least 11 lb (5 kg) during the first 4 months of participation in Weight Watchers, a national weight-loss program, with whom we partnered. The interventions lasted 6 months (Phase I); participants were followed for an additional 6 months without intervention (Phase II). The primary outcome is weight change from baseline to the end of Phase I, with the change at the end of Phase II a key secondary endpoint. Keep It Off is a pragmatic trial that recruited, consented, enrolled, and followed patients electronically. Participants were provided a wireless weight scale that electronically transmitted daily self-monitored weights. Weights were verified every 3 months at a Weight Watchers center local to the participant and electronically transmitted. Results Using the study web-based platform, we integrated recruitment, enrollment, and follow-up procedures into a digital platform that required little staff effort to implement and manage. We randomized 191 participants in less than 1 year. We describe the design of Keep It Off and implementation of enrollment. Lessons Learned We demonstrated that our pragmatic design was successful in rapid accrual of participants in a trial of interventions to maintain weight loss. Limitations Despite the nationwide reach of Weight Watchers, the generalizability of study findings may be limited by the characteristics of its members. The interventions under study are appropriate for settings where an entity, such as an employer or health insurance company, could offer them as a benefit. Conclusions Keep It Off was implemented and conducted with minimal staff effort. This study has the potential to identify a practical and effective weight-loss maintenance strategy.

The design and conduct of Keep It Off: An online randomized trial of financial incentives for weight loss maintenance

PubMed Central

Shaw, Pamela A; Yancy, William S; Wesby, Lisa; Ulrich, Victoria; Troxel, Andrea B; Huffman, David; Foster, Gary D; Volpp, Kevin

2016-01-01

Background Obesity continues to be a serious public health challenge. Rates are increasing worldwide, with nearly 70% of US adults overweight or obese, leading to increased clinical and economic burden. While successful approaches for achieving weight loss have been identified, techniques for long-term maintenance of initial weight loss have largely been unsuccessful. Financial incentive interventions have been shown in several settings to be successful in motivating participants to adopt healthy behaviors. Purpose Keep It Off is a three-arm randomized controlled trial that compares the efficacy of a lottery-based incentive, traditional direct payment incentive, and control of daily feedback without any incentive, for weight loss maintenance. This design allows comparison of a traditional direct payment incentive with one based on behavioral economic principles that consider the underlying psychology of decision-making. Methods Participants were randomized in a 2:1 ratio for each active arm relative to control, with a targeted 188 participants total. Eligible participants were those aged 30–80 who lost at least 11 pounds (lb, 5 kilograms (kg)) during the first 4 months of participation in Weight Watchers, a national weight loss program, with whom we partnered. The interventions lasted 6 months (Phase I); participants were followed for 6 additional months without intervention (Phase II). The primary outcome is weight change from baseline to the end of Phase I, with the change at the end of Phase II a key secondary endpoint. Keep It Off is a pragmatic trial that recruited, consented, enrolled and followed patients electronically. Participants were provided a wireless weight scale that electronically transmitted daily self-monitored weights. Weights were verified every 3 months at a Weight Watchers center local to the participant and electronically transmitted. Results Using the study web-based platform, we integrated recruitment, enrollment and follow-up procedures into a digital platform that required little staff effort to implement and manage. We randomized 191 participants in less than one year. We describe the design of Keep It Off and implementation of enrollment. Lessons Learned We demonstrated that our pragmatic design was successful in rapid accrual of participants in a trial of interventions to maintain weight loss. Limitations Despite the nationwide reach of Weight Watchers, the generalizability of study findings may be limited by the characteristics of its members. The interventions under study are appropriate for settings where an entity, such as an employer or health insurance company, could offer them as a benefit. Conclusions Keep It Off was implemented and conducted with minimal staff effort. This study has the potential to identify a practical and effective weight loss maintenance strategy. PMID:27646508

Lactation Biology Symposium: maternal nutrition during early and mid-to-late pregnancy: Comparative effects on milk production of twin-born ewe progeny during their first lactation.

PubMed

Paten, A M; Kenyon, P R; Lopez-Villalobos, N; Peterson, S W; Jenkinson, C M C; Pain, S J; Blair, H T

2013-02-01

Studies using sheep models indicate that the fetal mammary gland is sensitive to maternal nutrition during gestation; however, results have been inconsistent and do not identify critical feeding periods. This study aimed to clarify previous findings by partitioning the period of maternal nutritional manipulation into 2 stages: early and mid-to-late pregnancy. Sixty-six twin-born, twin-bearing ewes, born to dams that were fed either submaintenance, maintenance, or ad libitum during early pregnancy (d 21 to 50 of pregnancy; SmP21-50, MP21-50, or AdP21-50, respectively) and then either maintenance or ad libitum during mid-to-late pregnancy (d 50 to 140 of pregnancy; MP50-140 or AdP50-140, respectively) were milked once a week, starting from d 7 ± 1 postpartum, for 7 subsequent weeks to enable estimation of daily milk yield and composition. Their lambs were weighed weekly. Ewes born to dams fed MP21-50 tended to have greater accumulated milk (P = 0.10), fat (P = 0.07), and NE (P = 0.06) yields over 50 d compared with ewes born to dams fed SmP21-50 and AdP21-50. In contrast, ewes born to dams fed AdP50-140 tended to have greater accumulated milk (P = 0.10) and lactose (P = 0.09) yields compared with ewes born to dams fed MP50-140. Grandoffspring birth weights were unaffected by granddam nutrition during pregnancy. Ewes born to dams fed AdP21-50 weaned lighter lambs (P = 0.05) than ewes born to dams fed AmP21-50 and tended to wean lighter lambs (P = 0.07) than ewes born to dams fed MP21-50 whereas there were no differences between the weaning weights of lambs (P = 0.43) from ewes born to dams fed AdP50-140 and MP50-140. Maintenance nutrition of dams during early pregnancy appears to be associated with an improved lactation performance of ewe offspring. Higher levels of nutrition during mid-to-late pregnancy also appears to improve the first-lactation performance of ewe offspring. Interestingly, although grandoffspring birth weights were unaffected, weaning weight appears to be influenced by granddam early pregnancy nutrition in a manner discordant with the lactational performance of their dam. Results from this study indicate that dam nutrition during early pregnancy can influence the lactational performance of ewe offspring and the BW at weaning of their grandoffspring, which may ultimately affect farmer profits. This highlights the importance of nutritional management of breeding ewes during this period.

Nutritional rehabilitation in anorexia nervosa: review of the literature and implications for treatment

PubMed Central

2013-01-01

Restoration of weight and nutritional status are key elements in the treatment of anorexia nervosa (AN). This review aims to describe issues related to the caloric requirements needed to gain and maintain weight for short and long-term recovery for AN inpatients and outpatients. We reviewed the literature in PubMed pertaining to nutritional restoration in AN between 1960–2012. Based on this search, several themes emerged: 1. AN eating behavior; 2. Weight restoration in AN; 3. Role of exercise and metabolism in resistance to weight gain; 3. Medical consequences of weight restoration; 4. Rate of weight gain; 5. Weight maintenance; and 6. Nutrient intake. A fair amount is known about overall caloric requirements for weight restoration and maintenance for AN. For example, starting at 30–40 kilocalories per kilogram per day (kcal/kg/day) with increases up to 70–100 kcal/kg/day can achieve a weight gain of 1–1.5 kg/week for inpatients. However, little is known about the effects of nutritional deficits on weight gain, or how to meet nutrient requirements for restoration of nutritional status. This review seeks to draw attention to the need for the development of a foundation of basic nutritional knowledge about AN so that future treatment can be evidenced-based. PMID:24200367

First-day newborn weight loss predicts in-hospital weight nadir for breastfeeding infants.

PubMed

Flaherman, Valerie J; Bokser, Seth; Newman, Thomas B

2010-08-01

Exclusive breastfeeding reduces infant infectious disease. Losing > or =10% birth weight may lead to formula use. The predictive value of first-day weight loss for subsequent weight loss has not been studied. The objective of the present study was to evaluate the relationship between weight loss at <24 hours and subsequent in-hospital weight loss > or =10%. For 1,049 infants, we extracted gestational age, gender, delivery method, feeding type, and weights from medical records. Weight nadir was defined as the lowest weight recorded during birth hospitalization. We used multivariate logistic regression to assess the effect of first-day weight loss on subsequent in-hospital weight loss. Mean in-hospital weight nadir was 6.0 +/- 2.6%, and mean age at in-hospital weight nadir was 38.7 +/- 18.5 hours. While in the hospital 6.4% of infants lost > or =10% of birth weight. Infants losing > or =4.5% birth weight at <24 hours had greater risk of eventual in-hospital weight loss > or =10% (adjusted odds ratio 3.57 [1.75, 7.28]). In this cohort, 798 (76.1%) infants did not have documented weight gain while in the hospital. Early weight loss predicts higher risk of > or =10% in-hospital weight loss. Infants with high first-day weight loss could be targeted for further research into improved interventions to promote breastfeeding.

Vitamin D status and weight loss: a systematic review and meta-analysis of randomized and nonrandomized controlled weight-loss trials.

PubMed

Mallard, Simonette R; Howe, Anna S; Houghton, Lisa A

2016-10-01

Obesity is associated with lower concentrations of serum 25-hydroxyvitamin D; however, uncertainty exists as to the direction of causation. To date, meta-analyses of randomized controlled vitamin D-supplementation trials have shown no effect of raising circulating vitamin D on body weight, although several weight-loss-intervention trials have reported an increase in circulating vitamin D after weight reduction. We undertook a systematic review and meta-analysis of randomized and nonrandomized controlled trials to determine whether weight loss compared with weight maintenance leads to an increase in serum 25-hydroxyvitamin D. A systematic search for controlled weight-loss-intervention studies published up to 31 March 2016 was performed. Studies that included participants of any age with changes in adiposity and serum 25-hydroxyvitamin D as primary or secondary outcomes were considered eligible. We identified 4 randomized controlled trials (n = 2554) and 11 nonrandomized controlled trials (n = 917) for inclusion in the meta-analysis. Random assignment to weight loss compared with weight maintenance resulted in a greater increase in serum 25-hydroxyvitamin D with a mean difference of 3.11 nmol/L (95% CI: 1.38, 4.84 nmol/L) between groups, whereas a mean difference of 4.85 nmol/L (95% CI: 2.59, 7.12 nmol/L) was observed in nonrandomized trials. No evidence for a dose-response effect of weight loss on the change in serum 25-hydroxyvitamin D was shown overall. Our results indicate that vitamin D status may be marginally improved with weight loss in comparison with weight maintenance under similar conditions of supplemental vitamin D intake. Although additional studies in unsupplemented individuals are needed to confirm these findings, our results support the view that the association between obesity and lower serum 25-hydroxyvitamin D may be due to reversed causation with increased adiposity leading to suboptimal concentrations of circulating vitamin D. This trial was registered at www.crd.york.ac.uk/PROSPERO/ as CRD42015023836. © 2016 American Society for Nutrition.

Differential Effects of Two Spelling Procedures on Acquisition, Maintenance and Adaption to Reading

ERIC Educational Resources Information Center

Cates, Gary L.; Dunne, Megan; Erkfritz, Karyn N.; Kivisto, Aaron; Lee, Nicole; Wierzbicki, Jennifer

2007-01-01

An alternating treatments design was used to assess the effects of a constant time delay (CTD) procedure and a cover-copy-compare (CCC) procedure on three students' acquisition, subsequent maintenance, and adaptation (i.e., application) of acquired spelling words to reading passages. Students were randomly presented two trials of word lists from…

Effect of intermittent versus continuous energy restriction on weight loss, maintenance and cardiometabolic risk: A randomized 1-year trial.

PubMed

Sundfør, T M; Svendsen, M; Tonstad, S

2018-07-01

Long-term adherence to conventional weight-loss diets is limited while intermittent fasting has risen in popularity. We compared the effects of intermittent versus continuous energy restriction on weight loss, maintenance and cardiometabolic risk factors in adults with abdominal obesity and ≥1 additional component of metabolic syndrome. In total 112 participants (men [50%] and women [50%]) aged 21-70 years with BMI 30-45 kg/m 2 (mean 35.2 [SD 3.7]) were randomized to intermittent or continuous energy restriction. A 6-month weight-loss phase including 10 visits with dieticians was followed by a 6-month maintenance phase without additional face-to-face counselling. The intermittent energy restriction group was advised to consume 400/600 kcal (female/male) on two non-consecutive days. Based on dietary records both groups reduced energy intake by ∼26-28%. Weight loss was similar among participants in the intermittent and continuous energy restriction groups (8.0 kg [SD 6.5] versus 9.0 kg [SD 7.1]; p = 0.6). There were favorable improvements in waist circumference, blood pressure, triglycerides and HDL-cholesterol with no difference between groups. Weight regain was minimal and similar between the intermittent and continuous energy restriction groups (1.1 kg [SD 3.8] versus 0.4 kg [SD 4.0]; p = 0.6). Intermittent restriction participants reported higher hunger scores than continuous restriction participants on a subjective numeric rating scale (4.7 [SD 2.2] vs 3.6 [SD 2.2]; p = 0.002). Both intermittent and continuous energy restriction resulted in similar weight loss, maintenance and improvements in cardiovascular risk factors after one year. However, feelings of hunger may be more pronounced during intermittent energy restriction. www.clinicaltrials.govNCT02480504. Copyright © 2018 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

VLED and formula LED in the management of type 2 diabetes: defining the clinical need and research requirements.

PubMed

Lean, M

2011-02-01

It has been known for many years that substantial weight loss, achieved by bariatric surgery or non-surgical means can mean normalize glucose tolerance. Recent randomized controlled trial evidence indicates that >15 kg weight loss is necessary, to this and it may lead to near normalization (doubling) of life expectancy. Less than 5% of patients achieve this through even the best, evidence-based medical weight management programme (Counterweight http://www.counterweight.org). A weight loss of >15 kg is easily achievable by 8 weeks very low-energy diet (VLED)/LELD (Low energy Liquid-formula Diet) in compliant patients, with little difference between 400 and 800 kcal day(-1) , but weight maintenance after VLED has until recently been so poor that VLED is not, at present, recommended in clinical guidelines. However, mean weight loss close to >15 kg can be maintained 18-24 months using a variety of maintenance strategies. These include a structured reintroduction of foods linked to an education programme with behavioural strategies, intermittent VLED use and prescribable anti-obesity drugs (dexfenfluramine, orlistat, sibutramine). Most of these studies have been in non-diabetic subjects. A new 'curative' paradigm in type 2 diabetes mellitus management, aiming to normalize glucose tolerance and health risks by achieving and maintaining >15 kg loss, as soon as possible after diagnosis, should be highly acceptable to patients, generating many additional Quality Adjusted Life Years (QALYs). It is likely to be highly cost-effective by avoiding the current recommended, mainly palliative, model, using polypharmacy which provides an overall risk reduction of only 5-10%. Clinical trials are on-going to establish the feasibility of delivering formula (LELD) and a maintenance programme to large numbers of patients within routine primary care. There is urgent need, to run similar studies in diabetic patients. New approaches to long-term (lifelong) maintenance of weight loss and a non-diabetic state may include anti-obesity drugs. © 2011 The Author. Clinical Obesity © 2011 International Association for the Study of Obesity.

75 FR 48617 - Airworthiness Directives; Eurocopter Deutschland GmbH (ECD) Model MBB-BK 117 C-2 Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-11

... separation of dynamic weights, severe vibration, and subsequent loss of control of the helicopter. Actions... in-flight incident in which a dynamic weight broke off the control lever leading to considerable... proposed actions are intended to prevent separation of dynamic weights, severe vibration, and subsequent...

Long-term effects of an inpatient weight-loss program in obese children and the role of genetic predisposition-rationale and design of the LOGIC-trial.

PubMed

Rank, Melanie; Siegrist, Monika; Wilks, Désirée C; Haller, Bernhard; Wolfarth, Bernd; Langhof, Helmut; Halle, Martin

2012-03-19

The prevalence of childhood obesity has increased worldwide, which is a serious concern as obesity is associated with many negative immediate and long-term health consequences. Therefore, the treatment of overweight and obesity in children and adolescents is strongly recommended. Inpatient weight-loss programs have shown to be effective particularly regarding short-term weight-loss, whilst little is known both on the long-term effects of this treatment and the determinants of successful weight-loss and subsequent weight maintenance.The purpose of this study is to evaluate the short, middle and long-term effects of an inpatient weight-loss program for children and adolescents and to investigate the likely determinants of weight changes, whereby the primary focus lies on the potential role of differences in polymorphisms of adiposity-relevant genes. The study involves overweight and obese children and adolescents aged 6 to 19 years, who participate in an inpatient weight-loss program for 4 to 6 weeks. It started in 2006 and it is planned to include 1,500 participants by 2013. The intervention focuses on diet, physical activity and behavior therapy. Measurements are taken at the start and the end of the intervention and comprise blood analyses (DNA, lipid and glucose metabolism, adipokines and inflammatory markers), anthropometry (body weight, height and waist circumference), blood pressure, pubertal stage, and exercise capacity. Physical activity, dietary habits, quality of life, and family background are assessed by questionnaires. Follow-up assessments are performed 6 months, 1, 2, 5 and 10 years after the intervention: Children will complete the same questionnaires at all time points and visit their general practitioner for examination of anthropometric parameters, blood pressure and assessment of pubertal stage. At the 5 and 10 year follow-ups, blood parameters and exercise capacity will be additionally measured. Apart from illustrating the short, middle and long-term effects of an inpatient weight-loss program, this study will contribute to a better understanding of inter-individual differences in the regulation of body weight, taking into account the role of genetic predisposition and lifestyle factors. NCT01067157.

Cluster analysis of the national weight control registry to identify distinct subgroups maintaining successful weight loss.

PubMed

Ogden, Lorraine G; Stroebele, Nanette; Wyatt, Holly R; Catenacci, Victoria A; Peters, John C; Stuht, Jennifer; Wing, Rena R; Hill, James O

2012-10-01

The National Weight Control Registry (NWCR) is the largest ongoing study of individuals successful at maintaining weight loss; the registry enrolls individuals maintaining a weight loss of at least 13.6 kg (30 lb) for a minimum of 1 year. The current report uses multivariate latent class cluster analysis to identify unique clusters of individuals within the NWCR that have distinct experiences, strategies, and attitudes with respect to weight loss and weight loss maintenance. The cluster analysis considers weight and health history, weight control behaviors and strategies, effort and satisfaction with maintaining weight, and psychological and demographic characteristics. The analysis includes 2,228 participants enrolled between 1998 and 2002. Cluster 1 (50.5%) represents a weight-stable, healthy, exercise conscious group who are very satisfied with their current weight. Cluster 2 (26.9%) has continuously struggled with weight since childhood; they rely on the greatest number of resources and strategies to lose and maintain weight, and report higher levels of stress and depression. Cluster 3 (12.7%) represents a group successful at weight reduction on the first attempt; they were least likely to be overweight as children, are maintaining the longest duration of weight loss, and report the least difficulty maintaining weight. Cluster 4 (9.9%) represents a group less likely to use exercise to control weight; they tend to be older, eat fewer meals, and report more health problems. Further exploration of the unique characteristics of these clusters could be useful for tailoring future weight loss and weight maintenance programs to the specific characteristics of an individual.

Relapse Prevention in Health Promotion: Strategies and Long-Term Outcome.

ERIC Educational Resources Information Center

Gintner, Gary G.

1988-01-01

Reviews the efficacy of maintenance enhancement procedures to prevent relapse in smoking cessation, weight control, and exercise programs. Presents models of maintenance enhancement, reviews studies that have used relapse prevention strategies, and discusses ways of incorporating relapse prevention techniques into health promotion programs.…

Improving the accuracy and usability of Iowa falling weight deflectometer data : [summary].

DOT National Transportation Integrated Search

2013-05-01

Highway agencies periodically evaluate the structural condition of roads as part of their routine maintenance and rehabilitation activities. The falling-weight deflectometer (FWD) test measures road surface deflections resulting from an applied impul...

Suppressed Fat Appetite after Roux-en-Y Gastric Bypass Surgery Associates with Reduced Brain μ-opioid Receptor Availability in Diet-Induced Obese Male Rats.

PubMed

Hankir, Mohammed K; Patt, Marianne; Patt, Jörg T W; Becker, Georg A; Rullmann, Michael; Kranz, Mathias; Deuther-Conrad, Winnie; Schischke, Kristin; Seyfried, Florian; Brust, Peter; Hesse, Swen; Sabri, Osama; Krügel, Ute; Fenske, Wiebke K

2016-01-01

Brain μ-opioid receptors (MORs) stimulate high-fat (HF) feeding and have been implicated in the distinct long term outcomes on body weight of bariatric surgery and dieting. Whether alterations in fat appetite specifically following these disparate weight loss interventions relate to changes in brain MOR signaling is unknown. To address this issue, diet-induced obese male rats underwent either Roux-en-Y gastric bypass (RYGB) or sham surgeries. Postoperatively, animals were placed on a two-choice diet consisting of low-fat (LF) and HF food and sham-operated rats were further split into ad libitum fed (Sham-LF/HF) and body weight-matched (Sham-BWM) to RYGB groups. An additional set of sham-operated rats always only on a LF diet (Sham-LF) served as lean controls, making four experimental groups in total. Corresponding to a stage of weight loss maintenance for RYGB rats, two-bottle fat preference tests in conjunction with small-animal positron emission tomography (PET) imaging studies with the selective MOR radioligand [ 11 C]carfentanil were performed. Brains were subsequently collected and MOR protein levels in the hypothalamus, striatum, prefrontal cortex and orbitofrontal cortex were analyzed by Western Blot. We found that only the RYGB group presented with intervention-specific changes: having markedly suppressed intake and preference for high concentration fat emulsions, a widespread reduction in [ 11 C]carfentanil binding potential (reflecting MOR availability) in various brain regions, and a downregulation of striatal and prefrontal MOR protein levels compared to the remaining groups. These findings suggest that the suppressed fat appetite caused by RYGB surgery is due to reduced brain MOR signaling, which may contribute to sustained weight loss unlike the case for dieting.

Suppressed Fat Appetite after Roux-en-Y Gastric Bypass Surgery Associates with Reduced Brain μ-opioid Receptor Availability in Diet-Induced Obese Male Rats

PubMed Central

Hankir, Mohammed K.; Patt, Marianne; Patt, Jörg T. W.; Becker, Georg A.; Rullmann, Michael; Kranz, Mathias; Deuther-Conrad, Winnie; Schischke, Kristin; Seyfried, Florian; Brust, Peter; Hesse, Swen; Sabri, Osama; Krügel, Ute; Fenske, Wiebke K.

2017-01-01

Brain μ-opioid receptors (MORs) stimulate high-fat (HF) feeding and have been implicated in the distinct long term outcomes on body weight of bariatric surgery and dieting. Whether alterations in fat appetite specifically following these disparate weight loss interventions relate to changes in brain MOR signaling is unknown. To address this issue, diet-induced obese male rats underwent either Roux-en-Y gastric bypass (RYGB) or sham surgeries. Postoperatively, animals were placed on a two-choice diet consisting of low-fat (LF) and HF food and sham-operated rats were further split into ad libitum fed (Sham-LF/HF) and body weight-matched (Sham-BWM) to RYGB groups. An additional set of sham-operated rats always only on a LF diet (Sham-LF) served as lean controls, making four experimental groups in total. Corresponding to a stage of weight loss maintenance for RYGB rats, two-bottle fat preference tests in conjunction with small-animal positron emission tomography (PET) imaging studies with the selective MOR radioligand [11C]carfentanil were performed. Brains were subsequently collected and MOR protein levels in the hypothalamus, striatum, prefrontal cortex and orbitofrontal cortex were analyzed by Western Blot. We found that only the RYGB group presented with intervention-specific changes: having markedly suppressed intake and preference for high concentration fat emulsions, a widespread reduction in [11C]carfentanil binding potential (reflecting MOR availability) in various brain regions, and a downregulation of striatal and prefrontal MOR protein levels compared to the remaining groups. These findings suggest that the suppressed fat appetite caused by RYGB surgery is due to reduced brain MOR signaling, which may contribute to sustained weight loss unlike the case for dieting. PMID:28133443

Effects of methylmercury on reproduction in American kestrels

USGS Publications Warehouse

Albers, P.H.; Koterba, M.T.; Rossmann, R.; Link, W.A.; French, J.B.; Bennett, R.S.; Bauer, W.C.

2007-01-01

Sixty breeding pairs of captive American kestrels (Falco sparverius) were exposed to a range of sublethal dietary concentrations of mercury (Hg), in the form of methylmercuric chloride, and their subsequent reproduction was measured. Egg production, incubation performance, and the number and percent of eggs hatched decreased markedly between 3.3 and 4.6 mg/kg dry weight of Hg (1.2 and 1.7 mg/kg wet wt), in the diet. The number of fledglings and the percent of nestlings fledged were reduced markedly at 0.7 mg/kg dry weight (0.3 mg/kg wet wt) and declined further between 2 and 3.3 mg/kg dry weight (0.7 and 1.2 mg/kg wet wt). Dietary concentrations of ?4.6 mg/kg dry weight (1.7 mg/kg wet wt) were associated with total fledging failure. The estimated decline in fledged young per pair (24%, Bayesian regression) for kestrels consuming 0.7 mg/kg dry weight (0.3 mg/ kg wet wt) raises concerns about population maintenance in areas subject to high inputs of anthropogenic Hg. Mercury concentrations in 20 second-laid eggs collected from all groups were related to dietary concentrations of Hg, and the Hg concentrations in 19 of these eggs were related to eggs laid and young fledged. Concentrations of Hg in eggs from the highest diet group (5.9 mg/kg dry wt; 2.2 mg/kg wet wt) were higher than egg concentrations reported for either wild birds or for captive birds (nonraptors) fed dry commercial food containing 5 mg/kg methylmercury. Accumulation ratios of Hg from diets to eggs were higher than those reported for feeding studies with other species.

Body weight change since menopause and percentage body fat mass are predictors of subsequent bone mineral density change of the proximal femur in women aged 75 years and older: results of a 5 year prospective study.

PubMed

Blain, H; Carrière, I; Favier, F; Jeandel, C; Papoz, L

2004-07-01

Few studies have evaluated risk factors for bone loss in elderly women. We examined risk factors associated with a 5-year longitudinal change in bone mineral density (BMD) at the hip in healthy women aged 75 years and older. The BMD of 276 women from the French EPIDOS (Epidémiologie des Osteoporoses) study was assessed in Montpellier from 1992 to 1993 and again from 1997 to 1998. BMD was measured at the femoral neck, trochanter, and Ward's area using the same Lunar densitometer. We examined the relationship between clinical and behavioral factors at baseline and their variations during follow-up, with percentage BMD change adjusted for baseline BMD. Depending on the femur subregion studied, a significant decrease in BMD (exceeding the least significant difference, i.e., > 2.8 CV) was observed in 36.2% to 51.1% of women. Multivariate analysis showed that both postmenopausal weight change before baseline and baseline percentage of fat mass were positively correlated with BMD change at the Ward's triangle and the trochanter. Yearly absolute and relative weight changes over the follow-up period were significantly associated with change of trochanter and femoral neck BMD. Our results show that maintenance of body weight throughout the postmenopause period and body fat mass play protective roles against bone loss at the proximal femur in women aged 75 years and older and suggest the value in including assessment of weight change throughout postmenopause and percentage body fat mass in screening programs for elderly women who are at higher risk of accelerated bone loss.

College Students' Motivation to Achieve and Maintain a Healthy Weight

ERIC Educational Resources Information Center

Furia, Andrea C.; Lee, Rebecca E.; Strother, Myra L.; Huang, Terry T-K.

2009-01-01

Objectives: To develop and refine a scale of motivational factors related to healthy weight achievement and maintenance and to examine differences by gender and weight status. Methods: A cross-sectional survey of 300 university students aged 18-24 years. Results: Factor analysis yielded 6 factors--Intrinsic (Cronbach's alpha = 0.73): affective…

A Behavioral Weight Reduction Model for Moderately Mentally Retarded Adolescents.

ERIC Educational Resources Information Center

Rotatori, Anthony F.; And Others

1980-01-01

A behavioral weight reduction treatment and maintenance program for moderately mentally retarded adolescents which involves six phases from background information collection to followup relies on stimulus control procedures to modify eating behaviors. Data from pilot studies show an average weekly weight loss of .5 to 1 pound per S. (CL)

Diet modification for treatment and prevention of obesity.

PubMed

Ness-Abramof, Rosane; Apovian, Caroline M

2006-02-01

The obesity epidemic is best explained by global lifestyle alterations favoring weight gain in a susceptible population. The consumption of calorically dense foods, increased portion sizes, and a decrease in workplace and leisure physical activity most likely accounts for the increase in overweight and obesity worldwide. The cornerstone of overweight and obesity therapy is dietary intervention, but unfortunately most patients eventually regain the weight lost through diet alone. The search for a macronutrient composition that may enhance and help maintain weight loss has brought an abundance of fad diets into the lay literature. According to the available data, weight loss and maintenance of weight loss are dictated by total caloric intake, and not by macronutrient composition. There is epidemiologic data linking sugar-sweetened beverages to adult and childhood obesity, and an inverse relationship between dairy intake and overweight and obesity has also been observed. More research is needed to elucidate mechanisms explaining these relationships. Further research should focus on permanent lifestyle changes that may reverse this growing epidemic. This review will focus on current practices for the dietary management of obesity and to promote weight maintenance.

Green tea catechin plus caffeine supplementation to a high-protein diet has no additional effect on body weight maintenance after weight loss.

PubMed

Hursel, Rick; Westerterp-Plantenga, Margriet S

2009-03-01

Green tea (epigallocatechin gallate + caffeine) and protein each were shown to improve body weight maintenance after weight loss. We investigated the effect of a green tea-caffeine mixture added to a high-protein (HP) diet on weight maintenance (WM) after body weight loss in moderately obese subjects. A randomized, placebo-controlled, double-blind parallel trial was conducted in 80 overweight and moderately obese subjects [age (mean +/- SD): 44 +/- 2 y; body mass index (BMI; in kg/m(2)): 29.6 +/- 2.0] matched for sex, age, BMI, height, body mass, and with a habitually low caffeine intake. A very-low-energy diet intervention during 4 wk was followed by 3 mo of WM; during the WM period, the subjects received a green tea-caffeine mixture (270 mg epigallocatechin gallate + 150 mg caffeine/d) or placebo, both in addition to an adequate protein (AP) diet (50-60 g protein/d) or an HP diet (100-120 g protein/d). Subjects lost 7.0 +/- 1.6 kg, or 8.2 +/- 2.0%, body weight (P < 0.001). During the WM phase, WM, resting energy expenditure, and fat-free mass (FFM) increased relatively in both the HP groups and in the AP + green tea-caffeine mixture group (P < 0.05), whereas respiratory quotient and body fat mass decreased, all compared with the AP + placebo group. Satiety increased only in both HP groups (P < 0.05). The green tea-caffeine mixture was only effective with the AP diet. The green tea-caffeine mixture, as well as the HP diet, improved WM independently through thermogenesis, fat oxidation, sparing FFM, and, for the HP diet, satiety; a possible synergistic effect failed to appear.

Weight cycling and depressive symptoms in diabetes: a community-based study of adults with type 2 diabetes mellitus in Quebec.

PubMed

Messier, Lyne; Elisha, Belinda; Schmitz, Norbert; Gariepy, Geneviève; Malla, Ashok; Lesage, Alain; Boyer, Richard; Wang, JianLi; Strychar, Irene

2014-12-01

The problems of obesity and depression in type 2 diabetes mellitus are well documented, yet the role of weight cycling in relation to these 2 chronic conditions has not been examined. The study objective was to determine whether weight cycling predicts the development of depressive symptoms in the course of 1 year. A cohort study of 1100 adults with type 2 diabetes participating in the Diabetes Health and Well-Being Study (telephone survey using the random-digit-dialling method) had complete data at the 1-year follow up on depressive symptoms (Patient Health Questionnaire 9) and weight cycling frequency (going on a diet and losing >10 kg). At baseline, 56.5% of subjects reported weight cycling on at least 1 occasion in their lifetime; it was found to be associated with baseline body mass index, depression, sex and age (p<0.05). Regression analyses indicated that severe weight cycling (≥4 times) was not associated with the development of major depressive symptoms; however, it was associated with maintaining major depressive symptoms (p=0.038) but significance disappeared after adjusting for body mass index, physical activity, smoking and sociodemographic characteristics. Development and maintenance of major depressive symptoms were associated with physical inactivity (p<0.05); maintenance of major depressive symptoms was also associated with higher body mass index values (p<0.05). Weight cycling is a widespread phenomenon in diabetes. It was associated with depression, but severe cycling was not an independent predictor of the development and maintenance of major depressive symptoms. Clinicians should consider physical inactivity when evaluating and addressing depression in patients with type 2 diabetes. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

A randomised trial comparing low-fat diets differing in carbohydrate and protein ratio, combined with regular moderate intensity exercise, on glycaemic control, cardiometabolic risk factors, food cravings, cognitive function and psychological wellbeing in adults with type 2 diabetes: Study protocol.

PubMed

Watson, Nerylee Ann; Dyer, Kathryn Ann; Buckley, Jonathan David; Brinkworth, Grant David; Coates, Alison Mary; Parfitt, Gaynor; Howe, Peter Ranald Charles; Noakes, Manny; Dye, Louise; Chadwick, Helen; Murphy, Karen Joy

2015-11-01

Hypocaloric low-fat diets, high in protein with moderate carbohydrate (HP) can enhance weight loss, improve glycaemic control and improve cardiometabolic health risk factors in type 2 diabetes mellitus (T2DM). However, it is unclear whether the metabolic benefits observed during weight loss are sustained during energy-balance and weight maintenance. Furthermore, there is a lack of evidence regarding the effect of HP diets on food cravings, cognitive function and psychological wellbeing in T2DM, despite carbohydrate food cravings, cognitive impairment and depression being associated with hyperglycaemia. Overweight/obese adults with T2DM were randomised to consume either a HP diet (n=32, ~32% protein, 33% carbohydrate, 30% fat) or a higher-carbohydrate diet (HC, n=29, ~22% protein, 51% carbohydrate, 22% fat) for 24 weeks with 30 min of moderate intensity exercise five days/week for the study duration. There were 2 phases: a 12 week weight loss phase followed by a 12 week weight maintenance phase. Primary outcome was glycaemic control (glycosylated haemoglobin; HbA1c). Secondary outcomes were cardiometabolic risk factors (body composition, fasting blood pressure, blood lipids, glucose, insulin and C-reactive protein), food cravings, cognitive function (memory; psychomotor and executive function and psychological well-being. Outcomes were measured at baseline and the end of each 12-week intervention phase. Data will be analysed as intention-to-treat using linear mixed effects models. This study will examine the effects of two dietary interventions on health outcomes in T2DM during weight loss and notably following weight maintenance where there is a paucity of evidence. Copyright © 2015. Published by Elsevier Inc.

One-Year Behavioral Treatment of Obesity: Comparison of Moderate and Severe Caloric Restriction and the Effects of Weight Maintenance Therapy.

ERIC Educational Resources Information Center

Wadden, Thomas A.; And Others

1994-01-01

Compared weight losses of 49 obese women assigned to 52-week behavioral program combined with moderate or severe caloric restriction. Those in severe caloric restriction group lost significantly more weight during first 26 weeks but regained some weight. Reports of binge eating declined in both groups, and no relationship was observed between…

The effects of weight loss on relative bone mineral density in premenopausal women.

PubMed

Hamilton, Kara C; Fisher, Gordon; Roy, Jane L; Gower, Barbara A; Hunter, Gary R

2013-03-01

This study compared BMD relative to body weight following a ∼6-month weight loss program and a 1-year weight maintenance phase in premenopausal women and determined whether African American (AA) and European-American (EA) women's BMD respond similarly during weight loss. Premenopausal women (n = 115, 34 ± 5 years) were evaluated in an overweight state (BMI between 27 and 30 kg/m(2) ), following an 800 kcal/day diet/exercise program designed to reduce BMI<25 kg/m(2) , and 1-year following weight loss. BMD relative to body weight (Z-scores) increased after weight loss, but decreased during the 1-year weight maintenance phase. All 1-year follow-up BMD Z-scores were increased (except L1) compared to baseline measurements (P < 0.05). These sites included the hip neck (+0.088, P = 0.014), total hip (+0.099, P = 0.001), L2 (+0.127, P = 0.013), L3 (+0.135, P = 0.014), and L4 (+0.199, P = 0.002). AAs had significantly higher absolute BMD at all sites (P < 0.05) compared to EAs, but no time by race interactions were evident during weight loss (except in L3). These results may indicate that weight loss is safe with regard to bone health for overweight premenopausal women. Copyright © 2013 The Obesity Society.

Equivalent weight loss for weight management programs delivered by phone and clinic.

PubMed

Donnelly, Joseph E; Goetz, Jeannine; Gibson, Cheryl; Sullivan, Debra K; Lee, Robert; Smith, Bryan K; Lambourne, Kate; Mayo, Matthew S; Hunt, Suzanne; Lee, Jae Hoon; Honas, Jeffrey J; Washburn, Richard A

2013-10-01

Face-to-face (FTF) weight management is costly and presents barriers for individuals seeking treatment; thus, alternate delivery systems are needed. The objective of this study was to compare weight management delivered by FTF clinic or group conference calls (phone). Randomized equivalency trial in 295 overweight/obese men/women (BMI = 35.1±4.9, Age = 43.8±10.2, Minority = 39.8%). Weight loss (0-6 months) was achieved by reducing energy intake between 1,200 and 1,500 kcal/day and progressing physical activity (PA) to 300 min/week. Weight maintenance (7-18 months) provided adequate energy to maintain weight and continued 300 min/week of PA. Behavioral weight management strategies were delivered weekly for 6 months and gradually reduced during 7-18 months. A cost analysis provided a comparison of expenses between groups. Weight change from baseline to 6 months was -13.4 ± 6.7% and -12.3 ± 7.0% for FTF clinic and phone, respectively. Weight change from 6-18 months was 6.4 ± 7.0% and 6.4 ± 5.2%, for FTF clinic and phone, respectively. The cost to FTF participants was $789.58 more per person. Phone delivery provided equivalent weight loss and maintenance and reduced program cost. Ubiquitous access to phones provides a vast reach for this approach. Copyright © 2013 The Obesity Society.

Group motivational intervention in overweight/obese patients in primary prevention of cardiovascular disease in the primary healthcare area.

PubMed

Rodríguez Cristóbal, Juan José; Panisello Royo, Josefa Ma; Alonso-Villaverde Grote, Carlos; Pérez Santos, José Ma; Muñoz Lloret, Anna; Rodríguez Cortés, Francisca; Travé Mercadé, Pere; Benavides Márquez, Francisca; Martí de la Morena, Pilar; González Burgillos, Ma José; Delclós Baulies, Marta; Bleda Fernández, Domingo; Quillama Torres, Elida

2010-03-18

The global mortality caused by cardiovascular disease increases with weight. The Framingham study showed that obesity is a cardiovascular risk factor independent of other risks such as type 2 diabetes mellitus, dyslipidemia and smoking. Moreover, the main problem in the management of weight-loss is its maintenance, if it is achieved. We have designed a study to determine whether a group motivational intervention, together with current clinical practice, is more efficient than the latter alone in the treatment of overweight and obesity, for initial weight loss and essentially to achieve maintenance of the weight achieved; and, secondly, to know if this intervention is more effective for reducing cardiovascular risk factors associated with overweight and obesity. This 26-month follow up multi-centre trial, will include 1200 overweight/obese patients. Random assignment of the intervention by Basic Health Areas (BHA): two geographically separate groups have been created, one of which receives group motivational intervention (group intervention), delivered by a nurse trained by an expert phsychologist, in 32 group sessions, 1 to 12 fortnightly, and 13 to 32, monthly, on top of their standard program of diet, exercise, and the other (control group), receiving the usual follow up, with regular visits every 3 months. By addressing currently unanswered questions regarding the maintenance in weight loss in obesity/overweight, upon the expected completion of participant follow-up in 2012, the IMOAP trial should document, for the first time, the benefits of a motivational intervention as a treatment tool of weight loss in a primary care setting. ClinicalTrials.gov Identifier: NCT01006213.

Physical activity in the treatment of the adulthood overweight and obesity: current evidence and research issues.

PubMed

Wing, R R

1999-11-01

The purpose of this paper is to review the evidence on the role of physical activity in the treatment of adult overweight and obesity. Three specific questions are addressed: (1) Does exercise alone produce weight loss? (2) Does exercise in combination with diet produce greater weight loss than diet only? and (3) Does exercise in combination with diet produce better maintenance of weight loss than diet alone? The literature initially identified by the Expert Panel on Clinical Guidelines for the Treatment of Obesity, three key meta analyses, and additional literature searches were used to identify randomized trials related to the three aforementioned topics. These articles were reviewed and tabulated. Six of 10 randomized studies found significantly greater weight loss in exercise alone versus no treatment controls. The magnitude of the effect averaged 1-2 kg. Only 2 of 13 studies found significant differences in initial weight loss for diet plus exercise versus diet only, although almost all studies pointed in this direction. Six studies were identified with maintenance periods of at least 1 yr. In two of the six there were significant long term differences favoring diet plus exercise, but in every study considered the direction of the difference favored diet plus exercise. Other strong evidence showing benefits of exercise for long-term weight loss comes from correlational analyses which consistently find that those individuals who report the greatest exercise have the best maintenance of weight loss. Randomized trials consistently show benefits of exercise for weight loss, but the effects are often modest. This may result from small sample sizes, short study duration, and poor adherence to the exercise prescriptions. To better define the doses and types of exercise that will promote long-term weight loss, it is necessary to develop better ways to measure exercise and promote adherence to exercise.

75 FR 66657 - Airworthiness Directives; Eurocopter Deutschland GmbH Model MBB-BK 117 C-2 Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-29

... of dynamic weights, severe vibration, and subsequent loss of control of the helicopter. DATES... that are intended to prevent separation of dynamic weights, severe vibration, and subsequent loss of... MCAI AD states there was an in- flight incident in which a dynamic weight broke off the [[Page 66658...

77 FR 20518 - Airworthiness Directives; Agusta S.p.A. Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-05

... intended to prevent loss of the blade tip weight, loss of a blade, and subsequent loss of control of the... airworthy blade. This AD is prompted by incidents where a blade tip weight separated from a blade in flight... a blade tip weight separating from a blade in flight, and the subsequent investigation showed that...

First-Day Newborn Weight Loss Predicts In-Hospital Weight Nadir for Breastfeeding Infants

PubMed Central

Bokser, Seth; Newman, Thomas B.

2010-01-01

Abstract Background Exclusive breastfeeding reduces infant infectious disease. Losing ≥10% birth weight may lead to formula use. The predictive value of first-day weight loss for subsequent weight loss has not been studied. The objective of the present study was to evaluate the relationship between weight loss at <24 hours and subsequent in-hospital weight loss ≥10%. Methods For 1,049 infants, we extracted gestational age, gender, delivery method, feeding type, and weights from medical records. Weight nadir was defined as the lowest weight recorded during birth hospitalization. We used multivariate logistic regression to assess the effect of first-day weight loss on subsequent in-hospital weight loss. Results Mean in-hospital weight nadir was 6.0 ± 2.6%, and mean age at in-hospital weight nadir was 38.7 ± 18.5 hours. While in the hospital 6.4% of infants lost ≥10% of birth weight. Infants losing ≥4.5% birth weight at <24 hours had greater risk of eventual in-hospital weight loss ≥10% (adjusted odds ratio 3.57 [1.75, 7.28]). In this cohort, 798 (76.1%) infants did not have documented weight gain while in the hospital. Conclusions Early weight loss predicts higher risk of ≥10% in-hospital weight loss. Infants with high first-day weight loss could be targeted for further research into improved interventions to promote breastfeeding. PMID:20113202

National Athletic Trainers' Association Position Statement: Safe Weight Loss and Maintenance Practices in Sport and Exercise

PubMed Central

Turocy, Paula Sammarone; DePalma, Bernard F.; Horswill, Craig A.; Laquale, Kathleen M.; Martin, Thomas J.; Perry, Arlette C.; Somova, Marla J.; Utter, Alan C.

2011-01-01

Objective: To present athletic trainers with recommendations for safe weight loss and weight maintenance practices for athletes and active clients and to provide athletes, clients, coaches, and parents with safe guidelines that will allow athletes and clients to achieve and maintain weight and body composition goals. Background: Unsafe weight management practices can compromise athletic performance and negatively affect health. Athletes and clients often attempt to lose weight by not eating, limiting caloric or specific nutrients from the diet, engaging in pathogenic weight control behaviors, and restricting fluids. These people often respond to pressures of the sport or activity, coaches, peers, or parents by adopting negative body images and unsafe practices to maintain an ideal body composition for the activity. We provide athletic trainers with recommendations for safe weight loss and weight maintenance in sport and exercise. Although safe weight gain is also a concern for athletic trainers and their athletes and clients, that topic is outside the scope of this position statement. Recommendations: Athletic trainers are often the source of nutrition information for athletes and clients; therefore, they must have knowledge of proper nutrition, weight management practices, and methods to change body composition. Body composition assessments should be done in the most scientifically appropriate manner possible. Reasonable and individualized weight and body composition goals should be identified by appropriately trained health care personnel (eg, athletic trainers, registered dietitians, physicians). In keeping with the American Dietetics Association (ADA) preferred nomenclature, this document uses the terms registered dietitian or dietician when referring to a food and nutrition expert who has met the academic and professional requirements specified by the ADA's Commission on Accreditation for Dietetics Education. In some cases, a registered nutritionist may have equivalent credentials and be the commonly used term. All weight management and exercise protocols used to achieve these goals should be safe and based on the most current evidence. Athletes, clients, parents, and coaches should be educated on how to determine safe weight and body composition so that athletes and clients more safely achieve competitive weights that will meet sport and activity requirements while also allowing them to meet their energy and nutritional needs for optimal health and performance. PMID:21669104

Hepatic sinusoidal obstruction syndrome during maintenance therapy of childhood acute lymphoblastic leukemia is associated with continuous asparaginase therapy and mercaptopurine metabolites.

PubMed

Toksvang, Linea Natalie; De Pietri, Silvia; Nielsen, Stine N; Nersting, Jacob; Albertsen, Birgitte K; Wehner, Peder S; Rosthøj, Steen; Lähteenmäki, Päivi M; Nilsson, Daniel; Nystad, Tove A; Grell, Kathrine; Frandsen, Thomas L; Schmiegelow, Kjeld

2017-09-01

Hepatic sinusoidal obstruction syndrome (SOS) during treatment of childhood acute lymphoblastic leukemia (ALL) has mainly been associated with 6-thioguanine. The occurrence of several SOS cases after the introduction of extended pegylated asparaginase (PEG-asparaginase) therapy in the Nordic Society of Paediatric Haematology and Oncology (NOPHO) ALL2008 protocol led us to hypothesize that PEG-asparaginase, combined with other drugs, may trigger SOS during 6-thioguanine-free maintenance therapy. In children with ALL treated in Denmark according to the NOPHO ALL2008 protocol, we investigated the risk of SOS during methotrexate (MTX)/6-mercaptopurine (6MP) maintenance therapy that included PEG-asparaginase until week 33 (randomized to two- vs. six-week intervals), as well as alternating high-dose MTX or vincristine/dexamethasone pulses every four weeks. Among 130 children receiving PEG-asparaginase biweekly, 29 developed SOS (≥2 criteria: hyperbilirubinemia, hepatomegaly, ascites, weight gain ≥2.5%, unexplained thrombocytopenia <75 × 10 9 l -1 ) at a median of 30 days (interquartile range [IQR]: 17-66) into maintenance (cumulative incidence: 27%). SOS cases fulfilling one, two, or three Ponte di Legno criteria were classified as possible (n = 2), probable (n = 8), or verified (n = 19) SOS, respectively. Twenty-six cases (90%) occurred during PEG-asparaginase treatment, including 21 (81%) within 14 days from the last chemotherapy pulse compared with the subsequent 14 days (P = 0.0025). Cytotoxic 6MP metabolites were significantly higher on PEG-asparaginase compared to after its discontinuation. Time-dependent Cox regression analysis showed increased SOS hazard ratio (HR) for erythrocyte levels of methylated 6MP metabolites (HR: 1.09 per 1,000 nmol/mmol hemoglobin increase, 95% confidence interval: 1.05-1.14). Six-week PEG-asparaginase intervals significantly reduced SOS-specific hazards (P < 0.01). PEG-asparaginase increases cytotoxic 6MP metabolite levels and risk of SOS, potentially interacting with other chemotherapy pulses. © 2017 Wiley Periodicals, Inc.

Metabolic adaptation to weight loss: implications for the athlete

PubMed Central

2014-01-01

Optimized body composition provides a competitive advantage in a variety of sports. Weight reduction is common among athletes aiming to improve their strength-to-mass ratio, locomotive efficiency, or aesthetic appearance. Energy restriction is accompanied by changes in circulating hormones, mitochondrial efficiency, and energy expenditure that serve to minimize the energy deficit, attenuate weight loss, and promote weight regain. The current article reviews the metabolic adaptations observed with weight reduction and provides recommendations for successful weight reduction and long term reduced-weight maintenance in athletes. PMID:24571926

Case Study: The Hunger Pains--Ghrelin, Weight Loss, and Maintenance

ERIC Educational Resources Information Center

Diener, Lynn M.

2013-01-01

This article presents a case study regarding healthy weight loss and the role of the hormone ghrelin in maintaining a lower body weight. This study was designed specifically for use in an introductory college-level physiology course. It addresses the use of the case study in teaching digestion and metabolism, exploring the role of hormones in…

Bottom to Top Approach for Railway KPI Generation

NASA Astrophysics Data System (ADS)

Villarejo, Roberto; Johansson, Carl-Anders; Leturiondo, Urko; Simon, Victor; Seneviratne, Dammika; Galar, Diego

2017-09-01

Railway maintenance especially on infrastructure produces a vast amount of data. However, having data is not synonymous with having information; rather, data must be processed to extract information. In railway maintenance, the development of key performance indicators (KPIs) linked to punctuality or capacity can help planned and scheduled maintenance, thus aligning the maintenance department with corporate objectives. There is a need for an improved method to analyse railway data to find the relevant KPIs. The system should support maintainers, answering such questions as what maintenance should be done, where and when. The system should equip the user with the knowledge of the infrastructure's condition and configuration, and the traffic situation so maintenance resources can be targeted to only those areas needing work. The amount of information is vast, so it must be hierarchized and aggregated; users must filter out the useless indicators. Data are fused by compiling several individual indicators into a single index; the resulting composite indicators measure multidimensional concepts which cannot be captured by a single index. The paper describes a method of monitoring a complex entity. In this scenario, a plurality of use indices and weighting values are used to create a composite and aggregated use index from a combination of lower level use indices and weighting values. The resulting composite and aggregated indicators can be a decision-making tool for asset managers at different hierarchical levels.

Effects of lupin-enriched foods on body composition and cardiovascular disease risk factors: a 12-month randomized controlled weight loss trial.

PubMed

Belski, R; Mori, T A; Puddey, I B; Sipsas, S; Woodman, R J; Ackland, T R; Beilin, L J; Dove, E R; Carlyon, N B; Jayaseena, V; Hodgson, J M

2011-06-01

Regular consumption of diets with increased protein or fibre intakes may benefit body weight and composition and cardiovascular disease risk factors. Lupin flour is a novel food ingredient high in protein and fibre. To investigate the effects of a lupin-enriched diet, during and following energy restriction, on body weight and composition and cardiovascular disease risk factors in overweight individuals. Participants (n = 131) were recruited to a 12-month parallel-design trial. They were randomly assigned to consume lupin-enriched foods or matching high-carbohydrate control foods. All participants underwent 3 months of weight loss, 1 month of weight stabilization and 8 months of weight maintenance. Body weight and composition and cardiovascular disease risk factors were assessed at baseline, 4 and 12 months. Lupin, relative to control, did not significantly influence (mean difference (95% CI)) weight loss at 4 months (0.1 kg (-1.2, 1.4)) and 12 months (-0.6 kg (-2.0, 0.8)), maintenance of weight loss from 4 to 12 months (-0.7 kg (-1.83, 0.48)) or measures of body fat and fat-free mass. Relative to control, 24-h ambulatory systolic (-1.3 mm Hg (-2.4, -0.3), P = 0.016) and diastolic (-1.0 mm Hg (-1.9, -0.2), P = 0.021) blood pressures were lower at 12 months but not at 4 months; fasting insulin concentrations and homeostasis model assessment (HOMA) scores were significantly lower at 4 months (-1.2 mU l(-1) (-1.3, -1.1), P = 0.004 and -0.6 units (-1.0, -0.19), P = 0.004) and 12 months (-1.3 mU l(-1) (-1.4, -1.1), P < 0.001 and -0.7 units (-1.1, -0.24), P = 0.002). A diet higher in protein and fibre derived from lupin-enriched foods does not enhance weight loss or improve the maintenance of weight loss. However, such a diet may provide cardiovascular health benefits in terms of insulin sensitivity and blood pressure.

Challenges in economic modeling of anticancer therapies: an example of modeling the survival benefit of olaparib maintenance therapy for patients with BRCA-mutated platinum-sensitive relapsed ovarian cancer.

PubMed

Hettle, Robert; Posnett, John; Borrill, John

2015-01-01

The aim of this paper is to describe a four health-state, semi-Markov model structure with health states defined by initiation of subsequent treatment, designed to make best possible use of the data available from a phase 2 clinical trial. The approach is illustrated using data from a sub-group of patients enrolled in a phase 2 clinical trial of olaparib maintenance therapy in patients with platinum-sensitive relapsed ovarian cancer and a BRCA mutation (NCT00753545). A semi-Markov model was developed with four health states: progression-free survival (PFS), first subsequent treatment (FST), second subsequent treatment (SST), and death. Transition probabilities were estimated by fitting survival curves to trial data for time from randomization to FST, time from FST to SST, and time from SST to death. Survival projections generated by the model are broadly consistent with the outcomes observed in the clinical trial. However, limitations of the trial data (small sample size, immaturity of the PFS and overall survival [OS] end-points, and treatment switching) create uncertainty in estimates of survival. The model framework offers a promising approach to evaluating cost-effectiveness of a maintenance therapy for patients with cancer, which may be generalizable to other chronic diseases.

Dynamic decision-making for reliability and maintenance analysis of manufacturing systems based on failure effects

NASA Astrophysics Data System (ADS)

Zhang, Ding; Zhang, Yingjie

2017-09-01

A framework for reliability and maintenance analysis of job shop manufacturing systems is proposed in this paper. An efficient preventive maintenance (PM) policy in terms of failure effects analysis (FEA) is proposed. Subsequently, reliability evaluation and component importance measure based on FEA are performed under the PM policy. A job shop manufacturing system is applied to validate the reliability evaluation and dynamic maintenance policy. Obtained results are compared with existed methods and the effectiveness is validated. Some vague understandings for issues such as network modelling, vulnerabilities identification, the evaluation criteria of repairable systems, as well as PM policy during manufacturing system reliability analysis are elaborated. This framework can help for reliability optimisation and rational maintenance resources allocation of job shop manufacturing systems.

Low/No Calorie Sweetened Beverage Consumption in the National Weight Control Registry

PubMed Central

Catenacci, Victoria A.; Pan, Zhaoxing; Thomas, J. Graham; Ogden, Lorraine G.; Roberts, Susan A.; Wyatt, Holly R.; Wing, Rena R.; Hill, James O.

2015-01-01

Objective The aim of this cross-sectional study was to evaluate prevalence of and strategies behind low/no calorie sweetened beverage (LNCSB) consumption in successful weight loss maintainers. Methods An online survey was administered to 434 members of the National Weight Control Registry (NWCR, individuals who have lost ≥13.6 kg and maintained weight loss for > 1 year). Results While few participants (10%) consume sugar-sweetened beverages on a regular basis, 53% regularly consume LNCSB. The top five reasons for choosing LNCSB were for taste (54%), to satisfy thirst (40%), part of routine (27%), to reduce calories (22%) and to go with meals (21%). The majority who consume LNCSB (78%) felt they helped control total calorie intake. Many participants considered changing patterns of beverage consumption to be very important in weight loss (42%) and maintenance (40%). Increasing water was by far the most common strategy, followed by reducing regular calorie beverages. Conclusions Regular consumption of LNCSB is common in successful weight loss maintainers for various reasons including helping individuals to limit total energy intake. Changing beverage consumption patterns was felt to be very important for weight loss and maintenance by a substantial percentage of successful weight loss maintainers in the NWCR. PMID:25044563

Low/no calorie sweetened beverage consumption in the National Weight Control Registry.

PubMed

Catenacci, Victoria A; Pan, Zhaoxing; Thomas, J Graham; Ogden, Lorraine G; Roberts, Susan A; Wyatt, Holly R; Wing, Rena R; Hill, James O

2014-10-01

The aim of this cross-sectional study was to evaluate prevalence of and strategies behind low/no calorie sweetened beverage (LNCSB) consumption in successful weight loss maintainers. An online survey was administered to 434 members of the National Weight Control Registry (NWCR, individuals who have lost ≥13.6 kg and maintained weight loss for > 1 year). While few participants (10%) consume sugar-sweetened beverages on a regular basis, 53% regularly consume LNCSB. The top five reasons for choosing LNCSB were for taste (54%), to satisfy thirst (40%), part of routine (27%), to reduce calories (22%) and to go with meals (21%). The majority who consume LNCSB (78%) felt they helped control total calorie intake. Many participants considered changing patterns of beverage consumption to be very important in weight loss (42%) and maintenance (40%). Increasing water was by far the most common strategy, followed by reducing regular calorie beverages. Regular consumption of LNCSB is common in successful weight loss maintainers for various reasons including helping individuals to limit total energy intake. Changing beverage consumption patterns was felt to be very important for weight loss and maintenance by a substantial percentage of successful weight loss maintainers in the NWCR. Copyright © 2014 The Obesity Society.

Effect of Dilute Apple Juice and Preferred Fluids vs Electrolyte Maintenance Solution on Treatment Failure Among Children With Mild Gastroenteritis: A Randomized Clinical Trial.

PubMed

Freedman, Stephen B; Willan, Andrew R; Boutis, Kathy; Schuh, Suzanne

2016-05-10

Gastroenteritis is a common pediatric illness. Electrolyte maintenance solution is recommended to treat and prevent dehydration. Its advantage in minimally dehydrated children is unproven. To determine if oral hydration with dilute apple juice/preferred fluids is noninferior to electrolyte maintenance solution in children with mild gastroenteritis. Randomized, single-blind noninferiority trial conducted between the months of October and April during the years 2010 to 2015 in a tertiary care pediatric emergency department in Toronto, Ontario, Canada. Study participants were children aged 6 to 60 months with gastroenteritis and minimal dehydration. Participants were randomly assigned to receive color-matched half-strength apple juice/preferred fluids (n=323) or apple-flavored electrolyte maintenance solution (n=324). Oral rehydration therapy followed institutional protocols. After discharge, the half-strength apple juice/preferred fluids group was administered fluids as desired; the electrolyte maintenance solution group replaced losses with electrolyte maintenance solution. The primary outcome was a composite of treatment failure defined by any of the following occurring within 7 days of enrollment: intravenous rehydration, hospitalization, subsequent unscheduled physician encounter, protracted symptoms, crossover, and 3% or more weight loss or significant dehydration at in-person follow-up. Secondary outcomes included intravenous rehydration, hospitalization, and frequency of diarrhea and vomiting. The noninferiority margin was defined as a difference between groups of 7.5% for the primary outcome and was assessed with a 1-sided α=.025. If noninferiority was established, a 1-sided test for superiority was conducted. Among 647 randomized children (mean age, 28.3 months; 331 boys [51.1%]; 441 (68.2%) without evidence of dehydration), 644 (99.5%) completed follow-up. Children who were administered dilute apple juice experienced treatment failure less often than those given electrolyte maintenance solution (16.7% vs 25.0%; difference, -8.3%; 97.5% CI, -∞ to -2.0%; P < .001 for inferiority and P = .006 for superiority). Fewer children administered apple juice/preferred fluids received intravenous rehydration (2.5% vs 9.0%; difference, -6.5%; 99% CI, -11.6% to -1.8%). Hospitalization rates and diarrhea and vomiting frequency were not significantly different between groups. Among children with mild gastroenteritis and minimal dehydration, initial oral hydration with dilute apple juice followed by their preferred fluids, compared with electrolyte maintenance solution, resulted in fewer treatment failures. In many high-income countries, the use of dilute apple juice and preferred fluids as desired may be an appropriate alternative to electrolyte maintenance fluids in children with mild gastroenteritis and minimal dehydration. clinicaltrials.gov Identifier: NCT01185054.

Self-monitoring of spontaneous physical activity and sedentary behavior to prevent weight regain in older adults.

PubMed

Nicklas, Barbara J; Gaukstern, Jill E; Beavers, Kristen M; Newman, Jill C; Leng, Xiaoyan; Rejeski, W Jack

2014-06-01

The objective was to determine whether adding a self-regulatory intervention (SRI) focused on self-monitoring of spontaneous physical activity (SPA) and sedentary behavior to a standard weight loss intervention improved maintenance of lost weight. Older (65-79 years), obese (BMI = 30-40 kg/m(2) ) adults (n = 48) were randomized to a 5-month weight loss intervention involving a hypocaloric diet (DIET) and aerobic exercise (EX) with or without the SRI to promote SPA and decrease sedentary behavior (SRI + DIET + EX compared with DIET + EX). Following the weight loss phase, both groups transitioned to self-selected diet and exercise behavior during a 5-month follow-up. Throughout the 10-months, the SRI + DIET + EX group utilized real-time accelerometer feedback for self-monitoring. There was an overall group by time effect of the SRI (P < 0.01); DIET + EX lost less weight and regained more weight than SRI + DIET + EX. The average weight regain during follow-up was 1.3 kg less in the SRI + DIET + EX group. Individuals in this group maintained approximately 10% lower weight than baseline compared with those in the DIET + EX group whom maintained approximately 5% lower weight than baseline. Addition of a SRI, designed to increase SPA and decrease sedentary behavior, to a standard weight loss intervention enhanced successful maintenance of lost weight. Copyright © 2014 The Obesity Society.

24 CFR 901.30 - Indicator #5, annual inspection of units and systems.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the Environmental Protection Agency; (C) Natural disasters; and (D) Units kept vacant because they... buildings and sites according to the PHA's maintenance plan, including performing the required maintenance... weight of x1. (1) Grade A: The PHA inspected all major systems at 100% of its buildings and sites...

26 CFR 41.4482(b)-1 - Definition of taxable gross weight.

Code of Federal Regulations, 2010 CFR

2010-04-01

... maintenance of the vehicle; and a full complement of lubricants, fuel, and water. It does not include the... oilfield machinery, etc.) mounted on the vehicle for use on construction jobs, in oilfield operations, etc... own motor, for use in the maintenance of the vehicle, or for the accommodation of passengers or others...

How UAPB students eat: Preliminary results

USDA-ARS?s Scientific Manuscript database

The University of Arkansas – Pine Bluff Delta Obesity Prevention Research Project (DOPRP) is focused on nutritional adherence to the dietary guidelines, prevention of excess weight, promotion of healthy eating, and maintenance of a healthy weight during the college years. Adjusting to college life ...

Case Study: Application of Isometric Progressive Resistance Oropharyngeal Therapy Using the Madison Oral Strengthening Therapeutic Device

PubMed Central

Juan, Junerose; Hind, Jacqueline; Jones, Corinne; McCulloch, Timothy; Gangnon, Ron; Robbins, JoAnne

2013-01-01

Purpose Isometric progressive resistance oropharyngeal (I-PRO) therapy improves swallowing function; however, current devices utilize a single sensor that provides limited information or are prohibitively expensive. This single-subject study presents results of I-PRO therapy, detraining, and maintenance using the 5-sensor Madison Oral Strengthening Therapeutic (MOST) device combined with upper esophageal sphincter (UES) dilatation. Methods A 56-year-old female nurse who was 27 months post stroke and subsequent to traditional behavioral interventions and UES dilatations presented limited to gastrostomy tube intake only and expectorating all saliva. She completed 8 weeks of I-PRO therapy, 5 weeks of detraining, and 9 weeks of I-PRO maintenance (reduced frequency) followed by a third UES dilatation post intervention. Data included diet inventory, lingual pressures (MOST), lingual volume (magnetic resonance imaging), postswallow residue (videofl uoroscopy), UES and pharyngeal pressures (high-resolution manometry), and quality of life (QOL). Results Findings after 8 weeks of I-PRO therapy were progression to general oral diet, 15 lb weight gain, increased isometric pressures (Δ >16 kPa) with transference to swallowing pressures, increased lingual volume (8.3%), reduced pharyngeal wall residue (P = .03), increased pharyngeal pressures (Δ > 43 mm Hg) and increased UES opening (nadir) pressures (Δ > 9 mm Hg) with improved temporopressure coordination across the pharynx, and improved QOL. After detraining, decreased isometric pressures and reduced UES opening were noted. After I-PRO maintenance, isometric anterior lingual pressures returned to levels noted after the 8 weeks of intervention. Conclusion I-PRO therapy, facilitated by the MOST device combined with instrumental UES dilatation, improved swallow safety, increased oropharyngeal intake, and facilitated UES opening while enriching QOL. PMID:24091287

Assessing the evidence for weight loss strategies in people with and without type 2 diabetes

PubMed Central

Clifton, Peter

2017-01-01

This review will examine topical issues in weight loss and weight maintenance in people with and without diabetes. A high protein, low glycemic index diet would appear to be best for 12-mo weight maintenance in people without type 2 diabetes. This dietary pattern is currently being explored in a large prevention of diabetes intervention. Intermittent energy restriction is useful but no better than daily energy restriction but there needs to be larger and longer term trials performed. There appears to be no evidence that intermittent fasting or intermittent severe energy restriction has a metabolic benefit beyond the weight loss produced and does not spare lean mass compared with daily energy restriction. Meal replacements are useful and can produce weight loss similar to or better than food restriction alone. Very low calorie diets can produce weight loss of 11-16 kg at 12 mo with persistent weight loss of 1-2 kg at 4-6 years with a very wide variation in long term results. Long term medication or meal replacement support can produce more sustained weight loss. In type 2 diabetes very low carbohydrate diets are strongly recommended by some groups but the long term evidence is very limited and no published trial is longer than 12 mo. Although obesity is strongly genetically based the microbiome may play a small role but human evidence is currently very limited. PMID:29085571

Equivalent weight loss for weight management programs delivered by phone and clinic

PubMed Central

Donnelly, Joseph E.; Goetz, Jeannine; Gibson, Cheryl; Sullivan, Debra K.; Lee, Robert; Smith, Bryan K.; Lambourne, Kate; Mayo, Matthew S.; Hunt, Suzanne; Lee, Jae Hoon; Honas, Jeffrey J.; Washburn, Richard A.

2013-01-01

Objective Face-to-face weight management is costly and presents barriers for individuals seeking treatment; thus, alternate delivery systems are needed. The objective of this study was to compare weight management delivered by face-to-face (FTF) clinic or group conference calls (phone). Design and Methods Randomized equivalency trial in 295 overweight/obese men/women (BMI = 35.1±4.9, Age = 43.8±10.2, Minority = 39.8%). Weight loss (0–6 months) was achieved by reducing energy intake between 1,200– 1,500 kcal/day and progressing physical activity to 300 minutes/week. Weight maintenance (7–18 months) provided adequate energy to maintain weight and continued 300 minutes/week of physical activity. Behavioral weight management strategies were delivered weekly for 6 months and gradually reduced during months 7–18. A cost analysis provided a comparison of expenses between groups. Results Weight change from baseline to 6 months was −13.4 ± 6.7% and −12.3 ± 7.0% for FTF clinic and phone, respectively. Weight change from 6 months to 18 months was 6.4 ± 7.0% and 6.4 ± 5.2%, for FTF clinic and phone, respectively. The cost to FTF participants was $789.58 more person. Conclusions Phone delivery provided equivalent weight loss and maintenance and reduced program cost. Ubiquitous access to phones provides a vast reach for this approach. PMID:23408579

Group motivational intervention in overweight/obese patients in primary prevention of cardiovascular disease in the primary healthcare area

PubMed Central

2010-01-01

Background The global mortality caused by cardiovascular disease increases with weight. The Framingham study showed that obesity is a cardiovascular risk factor independent of other risks such as type 2 diabetes mellitus, dyslipidemia and smoking. Moreover, the main problem in the management of weight-loss is its maintenance, if it is achieved. We have designed a study to determine whether a group motivational intervention, together with current clinical practice, is more efficient than the latter alone in the treatment of overweight and obesity, for initial weight loss and essentially to achieve maintenance of the weight achieved; and, secondly, to know if this intervention is more effective for reducing cardiovascular risk factors associated with overweight and obesity. Methods This 26-month follow up multi-centre trial, will include 1200 overweight/obese patients. Random assignment of the intervention by Basic Health Areas (BHA): two geographically separate groups have been created, one of which receives group motivational intervention (group intervention), delivered by a nurse trained by an expert phsychologist, in 32 group sessions, 1 to 12 fortnightly, and 13 to 32, monthly, on top of their standard program of diet, exercise, and the other (control group), receiving the usual follow up, with regular visits every 3 months. Discussion By addressing currently unanswered questions regarding the maintenance in weight loss in obesity/overweight, upon the expected completion of participant follow-up in 2012, the IMOAP trial should document, for the first time, the benefits of a motivational intervention as a treatment tool of weight loss in a primary care setting. Trial Registration ClinicalTrials.gov Identifier: NCT01006213 PMID:20298557

Protocol and recruitment results from a randomized controlled trial comparing group phone-based versus newsletter interventions for weight loss maintenance among rural breast cancer survivors.

PubMed

Befort, Christie A; Klemp, Jennifer R; Fabian, Carol; Perri, Michael G; Sullivan, Debra K; Schmitz, Kathryn H; Diaz, Francisco J; Shireman, Theresa

2014-03-01

Obesity is a risk factor for breast cancer recurrence and death. Women who reside in rural areas have higher obesity prevalence and suffer from breast cancer treatment-related disparities compared to urban women. The objective of this 5-year randomized controlled trial is to compare methods for delivering extended care for weight loss maintenance among rural breast cancer survivors. Group phone-based counseling via conference calls addresses access barriers, is more cost-effective than individual phone counseling, and provides group support which may be ideal for rural breast cancer survivors who are more likely to have unmet support needs. Women (n=210) diagnosed with Stage 0 to III breast cancer in the past 10 years who are ≥ 3 months out from initial cancer treatments, have a BMI 27-45 kg/m(2), and have physician clearance were enrolled from multiple cancer centers. During Phase I (months 0 to 6), all women receive a behavioral weight loss intervention delivered through group phone sessions. Women who successfully lose 5% of weight enter Phase II (months 6 to 18) and are randomized to one of two extended care arms: continued group phone-based treatment or a mail-based newsletter. During Phase III, no contact is made (months 18 to 24). The primary outcome is weight loss maintenance from 6 to 18 months. Secondary outcomes include quality of life, serum biomarkers, and cost-effectiveness. This study will provide essential information on how to reach rural survivors in future efforts to establish weight loss support for breast cancer survivors as a standard of care. Copyright © 2014 Elsevier Inc. All rights reserved.

L-cysteine suppresses ghrelin and reduces appetite in rodents and humans.

PubMed

McGavigan, A K; O'Hara, H C; Amin, A; Kinsey-Jones, J; Spreckley, E; Alamshah, A; Agahi, A; Banks, K; France, R; Hyberg, G; Wong, C; Bewick, G A; Gardiner, J V; Lehmann, A; Martin, N M; Ghatei, M A; Bloom, S R; Murphy, K G

2015-03-01

High-protein diets promote weight loss and subsequent weight maintenance, but are difficult to adhere to. The mechanisms by which protein exerts these effects remain unclear. However, the amino acids produced by protein digestion may have a role in driving protein-induced satiety. We tested the effects of a range of amino acids on food intake in rodents and identified l-cysteine as the most anorexigenic. Using rodents we further studied the effect of l-cysteine on food intake, behaviour and energy expenditure. We proceeded to investigate its effect on neuronal activation in the hypothalamus and brainstem before investigating its effect on gastric emptying and gut hormone release. The effect of l-cysteine on appetite scores and gut hormone release was then investigated in humans. l-Cysteine dose-dependently decreased food intake in both rats and mice following oral gavage and intraperitoneal administration. This effect did not appear to be secondary to behavioural or aversive side effects. l-Cysteine increased neuronal activation in the area postrema and delayed gastric emptying. It suppressed plasma acyl ghrelin levels and did not reduce food intake in transgenic ghrelin-overexpressing mice. Repeated l-cysteine administration decreased food intake in rats and obese mice. l-Cysteine reduced hunger and plasma acyl ghrelin levels in humans. Further work is required to determine the chronic effect of l-cysteine in rodents and humans on appetite and body weight, and whether l-cysteine contributes towards protein-induced satiety.

l-cysteine suppresses ghrelin and reduces appetite in rodents and humans

PubMed Central

McGavigan, A K; O'Hara, H C; Amin, A; Kinsey-Jones, J; Spreckley, E; Alamshah, A; Agahi, A; Banks, K; France, R; Hyberg, G; Wong, C; Bewick, G A; Gardiner, J V; Lehmann, A; Martin, N M; Ghatei, M A; Bloom, S R; Murphy, K G

2015-01-01

Background: High-protein diets promote weight loss and subsequent weight maintenance, but are difficult to adhere to. The mechanisms by which protein exerts these effects remain unclear. However, the amino acids produced by protein digestion may have a role in driving protein-induced satiety. Methods: We tested the effects of a range of amino acids on food intake in rodents and identified l-cysteine as the most anorexigenic. Using rodents we further studied the effect of l-cysteine on food intake, behaviour and energy expenditure. We proceeded to investigate its effect on neuronal activation in the hypothalamus and brainstem before investigating its effect on gastric emptying and gut hormone release. The effect of l-cysteine on appetite scores and gut hormone release was then investigated in humans. Results: l-Cysteine dose-dependently decreased food intake in both rats and mice following oral gavage and intraperitoneal administration. This effect did not appear to be secondary to behavioural or aversive side effects. l-Cysteine increased neuronal activation in the area postrema and delayed gastric emptying. It suppressed plasma acyl ghrelin levels and did not reduce food intake in transgenic ghrelin-overexpressing mice. Repeated l-cysteine administration decreased food intake in rats and obese mice. l-Cysteine reduced hunger and plasma acyl ghrelin levels in humans. Conclusions: Further work is required to determine the chronic effect of l-cysteine in rodents and humans on appetite and body weight, and whether l-cysteine contributes towards protein-induced satiety. PMID:25219528

Circadian changes in core body temperature, metabolic rate and locomotor activity in rats on a high-protein, carbohydrate-free diet.

PubMed

Yamaoka, Ippei; Hagi, Mieko; Doi, Masako

2009-12-01

Ingestion of a high-protein meal results in body weight loss due to elevated energy expenditure, while also increasing satiety and decreasing subsequent food intake. The present study aimed to clarify the effects of a high-protein, carbohydrate-free diet (HPCFD) on these physiological indicators from a circadian perspective. Rats were given HPCFD or a pair-fed normal protein content diet (20% protein; NPD) for 4 d. The HPCFD group lost more body weight than the NPD group. Oxygen consumption (VO(2)) in the HPCFD group did not change during the experimental period, and tended to be higher during the light (L) phase than in the NPD group. Carbon dioxide production (VCO(2)) during the L phase was higher in the HPCFD group than in the NPD group, where VCO(2) was gradually decreased during the last dark (D) phase and throughout the L phase. The HPCFD group exhibited higher daily core body temperature (T(b)), particularly during the late D phase and throughout the L phase when compared to the NPD group. Locomotor activities during the D phase of the NPD group tended to gradually increase and were thus significantly higher than in the HPCFD group. These results suggest that HPCFD, even if energy intake is insufficient, maintains circadian changes in metabolic rates, resulting in maintenance of elevated daily T(b) and body weight reduction without increasing activity.

40 CFR 85.1412 - Maintenance and submittal of records for equipment certifiers.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the equipment certifier has offered to sell its certified equipment for less than the life cycle cost... during testing of the equipment and subsequent analyses based on that data, including the mileage and the... taken in implementing the quality control plan, and any subsequent analyses of that data; and (6) All in...

Reducing bias in maintenance energy expected progeny difference by accounting for selection on weaning and yearling weights.

PubMed

Williams, J L; Garrick, D J; Speidel, S E

2009-05-01

Maintenance energy requirements of cattle can be predicted from published equations utilizing metabolic BW and milk production potential. Metabolic BW is a function of BW at a constant fat percentage or BCS. Pedigree and performance records can be used in random regression models to predict genetic merit for metabolic BW and milk production potentials. The purpose of this study was to present a methodology for predicting mature cow maintenance energy EPD using mature cow BW and BCS and accounting for prior selection of replacement females at weaning and yearling ages. Variance components were obtained for direct and maternal effects on weaning weight, direct effects on postweaning BW gain, and direct coefficients for random regression on mature weights (MW) adjusted for BCS. These BW were transformed into metabolic BW by taking BW to the power of 0.75, variance components were estimated for metabolic BW, and were then used to predict breeding values from which cow maintenance energy EPD could be derived. Data used in this analysis were obtained from the Red Angus Association of America and limited to herds with MW and corresponding BCS observations. The data set included 52,338 BW records on 21,103 individuals. Weaning and yearling contemporaries to those with MW observations, but with no MW records themselves, were included to account for selection occurring before maturity. Heritability estimates for weaning weight direct, weaning weight maternal, and postweaning BW gain were 0.18 +/- 0.02, 0.16 +/- 0.02, and 0.18 +/- 0.02, respectively. Mature BW observed at 2, 3, 4, 5, and 6 yr of age had heritability estimates of 0.45 +/- 0.03, 0.44 +/- 0.03, 0.49 +/- 0.03, 0.66 +/- 0.04, and 0.62 +/- 0.05, respectively. Correlations between weaning weight direct and MW ranged from 0.65 +/- 0.07 to 0.82 +/- 0.04, and correlations between MW at different ages ranged from 0.95 +/- 0.03 to 0.99 +/- 0.01. The genetic correlations between postweaning BW gain and MW ranged from 0.48 +/- 0.06 to 0.59 +/- 0.06. The 15-yr genetic increase in metabolic BW was 3.6 kg(0.75), greater than the value of 0.23 kg(0.75) obtained from the same data ignoring weaning and yearling contemporaries with unobserved MW, the approach currently used in the derivation of cow maintenance EPD published by the Red Angus Association of America.

Determining the eating habits of UAPB students

USDA-ARS?s Scientific Manuscript database

The UAPB Delta Obesity Research Project is focused on nutritional adherence to the dietary guidelines, prevention of excessive weight, promotion of healthy eating, and maintenance of healthy weight during college years. Adjusting to college life can lead to poor eating and no physical activity for c...

TOXICOLOGICAL HIGHLIGHT (REDOX REDUX: A CLOSER LOOK AT CONCEPTAL LOW MOLECULAR WEIGHT THIOLS)

EPA Science Inventory

Glutathione (GSH) is present as the most abundant low molecular weight thiol (LMWT) in virtually all mitochondria-bearing eucaryotic cells, often at millimolar concentrations (Meister, 1988). Functions of GSH include roles in DNA and protein synthesis, maintenance of cell membra...

Achieving and maintaining asthma control in an urban pediatric disease management program: the Breathmobile Program.

PubMed

Jones, Craig A; Clement, Loran T; Morphew, Tricia; Kwong, Kenny Yat Choi; Hanley-Lopez, Jean; Lifson, Francene; Opas, Lawrence; Guterman, Jeffrey J

2007-06-01

National guidelines suggest that, with appropriate care, most patients can control their asthma. The probabilities of children achieving and maintaining control with ongoing care are unknown. We sought to evaluate the degree to which children in a lower socioeconomic urban setting achieve and maintain control of asthma with regular participation in a disease management program that provides guideline-based care. Interdisciplinary teams of asthma specialists use mobile clinics to offer ongoing care at schools and county clinics. A guideline-derived construct of asthma control is recorded at each visit. Two thousand one hundred eighty-five enrollees were eligible to evaluate the time to first achieve control, and 1591 patients were eligible to evaluate subsequent control maintenance. Depending on severity, 70% to 87% of patients with persistent asthma achieved control by visit 3, and 89% to 98% achieved control by visit 6. Subsequent control maintenance was highly variable. Thirty-nine percent of patients displayed well-controlled asthma (control at >90% of subsequent visits), whereas 13% displayed difficult-to-control asthma (<50% of subsequent visits). Patients from each baseline severity category were found in each group. Maintenance of control was influenced by physician-estimated compliance with the treatment plan, baseline severity, and the interval between clinic visits. Many children can achieve asthma control with regular visit intervals and guideline-based care; however, long-term control can be highly variable among patients in all severity categories. These findings highlight the need and feasibility for systematically tracking each patient's clinical response to individualize therapy and guide the use of population management strategies.

Qualitative analysis of the role of self-weighing as a strategy of weight control for weight-loss maintainers in comparison with a normal, stable weight group.

PubMed

Carrard, Isabelle; Kruseman, Maaike

2016-10-01

Self-weighing seems to have a primary role in weight-loss maintenance. The use of this strategy may help correct even slight weight regain and contribute to long-term weight stability. However, self-weighing has also been associated with negative psychological health consequences in specific subgroups. This study aimed to explore the use and the behavioral and psychological consequences of self-weighing in a group of weight-loss maintainers (WLoMs). We chose a qualitative design to conduct this investigation. Eighteen WLoMs were interviewed and compared to a matched comparison group of 18 participants with a lifelong normal stable weight (NSW). Analyses showed that most WLoMs needed regular self-weighing to be aware of their weight. The weight displayed on the scale helped WLoMs sustain the continuous efforts needed to maintain weight loss and also at times triggered corrective actions that were sometimes drastic. Weight changes generated both negative and positive affect among WLoMs, who could experience anxiety because of self-weighing or have their self-esteem impaired in the case of weight gain. In comparison, the NSW group rarely used self-weighing. They relied on a conscious way of living to control their weight and needed fewer strategies. NSW participants simply went back to their routine when they felt a slight increase in their weight, without experiencing consequences on their mood or self-esteem. Regular self-weighing as a component of weight-loss maintenance should be encouraged to help WLoMs regulate their food and physical activity, provided that potential consequences on psychological well-being, including self-esteem, are screened and addressed when needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Weight loss medications in Canada – a new frontier or a repeat of past mistakes?

PubMed Central

Wharton, Sean; Lee, Jasmine; Christensen, Rebecca AG

2017-01-01

Current methods for the treatment of excess weight can involve healthy behavior changes, pharmacotherapy, and surgical interventions. Many individuals are able to lose some degree of weight through behavioral changes; however, they are often unable to maintain their weight loss long-term. This is in part due to physiological processes that cannot be addressed through behavioral changes alone. Bariatric surgery, which is the most successful treatment for excess weight to date, does result in physiological changes that can help with weight loss and weight maintenance. However, many patients either do not qualify or elect to not have this procedure. Fortunately, research has recently identified changes in neurochemicals (i.e., orexigens and anorexigens) that occur during weight loss and contribute to weight regain. The neurochemicals and hormones may be able to be targeted by medications to achieve greater and more sustained weight loss. Two medications are approved in adjunction to lifestyle management for weight loss in Canada: orlistat and liraglutide. Both medications are able to target physiological processes to help patients lose weight and maintain a greater amount of weight loss than with just behavioral modifications alone. Two other weight management medications, which also target specific physiological processes to aid in weight loss and its maintenance, a bupropion/naltrexone combination and lorcaserin, are currently pending approval in Canada. Nonetheless, there remain significant barriers for health care professionals to prescribe medications for weight loss, such as a lack of training and knowledge in the area of obesity. Until this has been addressed, and we begin treating obesity as we do other diseases, we are unlikely to combat the increasing trend of obesity in Canada and worldwide. PMID:29042804

Activity Related Energy Expenditure, Appetite and Energy Intake: Potential Implications for Weight Management

PubMed Central

Harrington, D.M.; Martin, C.K.; Ravussin, E.; Katzmarzyk, P.T.

2013-01-01

The aim was to investigate relationships between activity related energy expenditure (AREE), appetite ratings and energy intake (EI) in a sample of 40 male (26.4 years; BMI 23.5 kg/m2) and 42 female (26.9 years; BMI 22.4 kg/m2) participants. AREE was expressed as the residual value of the regression between total daily EE (by doubly labeled water) and resting EE (by indirect calorimetry). EI was measured using an ad libitum buffet meal and visual analogue scales measured subjective appetite ratings before and after the meal. AREE was divided into low, middle and high sex-specific tertiles. General linear models were used to investigate differences in appetite ratings and EI across AREE tertiles. Before the meal, males in the high AREE tertile had significantly lower desire to eat and lower prospective food consumption and higher feelings of fullness compared to those in the low tertile. Males in the middle tertile had significantly higher satiety quotients after the meal and lower EI compared to the other tertiles. No significant differences across tertiles were found in females. Sex differences in relationships between AREE, appetite ratings and EI may lead to differing patterns of EI and subsequent weight maintenance. PMID:23523668

Activity related energy expenditure, appetite and energy intake: potential implications for weight management.

PubMed

Harrington, D M; Martin, C K; Ravussin, E; Katzmarzyk, P T

2013-08-01

The aim was to investigate relationships between activity related energy expenditure (AREE), appetite ratings and energy intake (EI) in a sample of 40 male (26.4years; BMI 23.5kg/m(2)) and 42 female (26.9years; BMI 22.4kg/m(2)) participants. AREE was expressed as the residual value of the regression between total daily EE (by doubly labeled water) and resting EE (by indirect calorimetry). EI was measured using an ad libitum buffet meal and visual analogue scales measured subjective appetite ratings before and after the meal. AREE was divided into low, middle and high sex-specific tertiles. General linear models were used to investigate differences in appetite ratings and EI across AREE tertiles. Before the meal, males in the high AREE tertile had significantly lower desire to eat and lower prospective food consumption and higher feelings of fullness compared to those in the low tertile. Males in the middle tertile had significantly higher satiety quotients after the meal and lower EI compared to the other tertiles. No significant differences across tertiles were found in females. Sex differences in relationships between AREE, appetite ratings and EI may lead to differing patterns of EI and subsequent weight maintenance. Copyright © 2013 Elsevier Ltd. All rights reserved.

A community-based lifestyle and weight loss intervention promoting a Mediterranean-style diet pattern evaluated in the stroke belt of North Carolina: the Heart Healthy Lenoir Project.

PubMed

Keyserling, Thomas C; Samuel-Hodge, Carmen D; Pitts, Stephanie Jilcott; Garcia, Beverly A; Johnston, Larry F; Gizlice, Ziya; Miller, Cassandra L; Braxton, Danielle F; Evenson, Kelly R; Smith, Janice C; Davis, Gwen B; Quenum, Emmanuelle L; Elliott, Nadya T Majette; Gross, Myron D; Donahue, Katrina E; Halladay, Jacqueline R; Ammerman, Alice S

2016-08-05

Because residents of the southeastern United States experience disproportionally high rates of cardiovascular disease (CVD), it is important to develop effective lifestyle interventions for this population. The primary objective was to develop and evaluate a dietary, physical activity (PA) and weight loss intervention for residents of the southeastern US. The intervention, given in eastern North Carolina, was evaluated in a 2 year prospective cohort study with an embedded randomized controlled trial (RCT) of a weight loss maintenance intervention. The intervention included: Phase I (months 1-6), individually-tailored intervention promoting a Mediterranean-style dietary pattern and increased walking; Phase II (months 7-12), option of a 16-week weight loss intervention for those with BMI ≥ 25 kg/m(2) offered in 2 formats (16 weekly group sessions or 5 group sessions and 10 phone calls) or a lifestyle maintenance intervention; and Phase III (months 13-24), weight loss maintenance RCT for those losing ≥ 8 lb with all other participants receiving a lifestyle maintenance intervention. Change in diet and PA behaviors, CVD risk factors, and weight were assessed at 6, 12, and 24 month follow-up. Baseline characteristics (N = 339) were: 260 (77 %) females, 219 (65 %) African Americans, mean age 56 years, and mean body mass index 36 kg/m(2). In Phase I, among 251 (74 %) that returned for 6 month follow-up, there were substantial improvements in diet score (4.3 units [95 % CI 3.7 to 5.0]), walking (64 min/week [19 to 109]), and systolic blood pressure (-6.4 mmHg [-8.7 to -4.1]) that were generally maintained through 24 month follow-up. In Phase II, 138 (57 group only, 81 group/phone) chose the weight loss intervention and at 12 months, weight change was: -3.1 kg (-4.9 to -1.3) for group (N = 50) and -2.1 kg (-3.2 to -1.0) for group/phone combination (N = 75). In Phase III, 27 participants took part in the RCT. At 24 months, weight loss was -2.1 kg (-4.3 to 0.0) for group (N = 51) and -1.1 kg (-2.7 to 0.4) for combination (N = 72). Outcomes for African American and whites were similar. The intervention yielded substantial improvement in diet, PA, and blood pressure, but weight loss was modest. clinicaltrials.gov Identifier: NCT01433484.

100 Successful Years of Vertical Lift Gates of Bhatghar Dam—Design, Manufacturing, Erection, and Maintenance: A Case Study

NASA Astrophysics Data System (ADS)

Mahajan, Dinakar Rajaram

2017-09-01

The Bhatghar dam is having 81 vertical lift gates (fixed wheel type) on waste ways. The design of these gates is so beautiful and based on simple principles of science and engineering that these gates outlast for 100 years without failure, performing their intended purpose satisfactorily. It is achieved by meticulous design, manufacturing, erection, subsequent use and maintenance practices. It has become guiding and inspiration for further practices in design, manufacturing, erection, and maintenance for dam gates as well as all other disciplines of engineering today.

26 CFR 41.4482(b)-1 - Definition of taxable gross weight.

Code of Federal Regulations, 2011 CFR

2011-04-01

... or for use in the maintenance of the vehicle; and a full complement of lubricants, fuel, and water... compressor, crane, specialized oilfield machinery, etc.) mounted on the vehicle for use on construction jobs... vehicle by means of its own motor, for use in the maintenance of the vehicle, or for the accommodation of...

Postoperative weight gain during the first year after kidney, liver, heart, and lung transplant: a prospective study.

PubMed

Kugler, Christiane; Einhorn, Ina; Gottlieb, Jens; Warnecke, Gregor; Schwarz, Anke; Barg-Hock, Hannelore; Bara, Christoph; Haller, Hermann; Haverich, Axel

2015-03-01

Studies of all types of organ transplant recipients have suggested that weight gain, expressed as an increase in body mass index (BMI), after transplant is common. To describe weight gain during the first year after transplant and to determine risk factors associated with weight gain with particular attention to type of transplant. A prospective study of 502 consecutive organ transplant recipients (261 kidney, 73 liver, 29 heart, 139 lung) to identify patterns of BMI change. Measurements were made during regular outpatient clinical visits at 2, 6, and 12 months after transplant. Data were retrieved from patients' charts and correlated with maintenance corticosteroid doses. Overall, mean BMI (SD; range) was 23.9 (4.5; 13.6-44.1) at 2 months and increased to 25.4 (4.0; 13.0-42.2) by the end of the first postoperative year. BMI levels organized by World Health Organization categories showed a trend toward overweight/obesity in kidney (53.4%), liver (51.5%), heart (51.7%), and lung (33.1%) patients by 12 months after transplant. BMI changed significantly (P= .05) for all organ types and between all assessment points, except in kidney recipients. Maintenance corticosteroid doses were not a predictor of BMI at 12 months after transplant for most patients. Weight gain was common among patients undergoing kidney, liver, heart, and lung transplant; however, many showed BMI values close to normality at the end of the first year after transplant. In most cases, increased BMI levels were related to obesity before transplant and not to maintenance corticosteroid therapy.

Effects of Maintenance on Quality of Performance of Cryotherapy Devices for Treatment of Precancerous Cervical Lesions.

PubMed

Maza, Mauricio; Figueroa, Ruben; Laskow, Bari; Juárez, Alexa; Alfaro, Karla; Alonzo, Todd A; Felix, Juan C; Gage, Julia C; Cremer, Miriam

2018-01-01

The aim of the study was to evaluate the impact of maintenance on performance of cryosurgical equipment used in El Salvador primary health clinics. Nine gynecological cryotherapy devices used in El Salvador were bench tested against a new machine of the same make and model. The devices were run for five successive double-freeze cycles. The El Salvador machines then received maintenance by a specialized engineer and another double-freeze cycle was performed. Temperature at the device probe tip was recorded throughout each cycle and ballistic gelatin was used as the tissue analogue to measure freeze ball dimensions achieved by the devices. Outcome measures were mean lowest-sustained temperatures and freeze ball mean weight, depth, and diameter. Paired and unpaired t tests were used to compare results premaintenance versus postmaintenance and postmaintenance versus the reference, respectively. Premaintenance versus postmaintenance freeze ball dimensions were significantly different (mean differences in weight = 2.31 g, p = .01; depth = 2.29 mm, p = .03; diameter = 3.51 mm, p = .02). However, postmaintenance dimensions were not significantly different than those of the reference (weight = 7.44 g vs. 8.39 g, p = .07; depth = 10.71 vs. 11.24 mm, p = .1; diameter = 31.38 mm vs. 32.05 mm, p = .3). Postmaintenance, minimum, and lowest-sustained temperatures were within the recommended clinical range. Specialized maintenance was necessary for heavily used cryotherapy devices to perform adequately, highlighting the challenges of gas-based cryotherapy in low- and middle-income countries.

Effect of macronutrient composition on short-term food intake and weight loss.

PubMed

Bellissimo, Nick; Akhavan, Tina

2015-05-01

The purpose of this review is to describe the role of macronutrient composition on the suppression of short-term food intake (FI) and weight loss. The effects of macronutrient composition on short-term FI will be reviewed first, followed by a brief examination of longer-term clinical trials that vary in effects of dietary macronutrient composition on weight loss. The objectives were: 1) to examine the effect of macronutrient composition on the suppression of short-term FI, 2) to determine whether some macronutrient sources suppress FI beyond their provision of energy, 3) to assess the combined effects of macronutrients on FI and glycemic response, and 4) to determine whether knowledge of the effect of macronutrients on short-term FI has led to greater success in spontaneous weight loss, adherence to energy-restricted diets, and better weight maintenance after weight loss. Although knowledge of macronutrient composition on short-term FI regulation has advanced our understanding of the role of diet composition on energy balance, it has yet to lead to greater success in long-term weight loss and weight maintenance. It is clear from this review that many approaches based on manipulating dietary macronutrient composition can help people lose weight as long as they follow the diets. However, only by evaluating the interaction between the physiologic systems that govern FI and body weight may the benefits of dietary macronutrient composition be fully realized. © 2015 American Society for Nutrition.

Influence of maternal age, birth-to-conception intervals and prior perinatal factors on perinatal outcomes.

PubMed

Farahati, M; Bozorgi, N; Luke, B

1993-10-01

This study evaluated the influence of prior perinatal factors on birth weight, length of gestation, and maternal pregravid and postpartum weights in subsequent pregnancies. The study sample included 47 women each with first, second and third pregnancies. Mean pregravid weight increased by 5.2 lb between the first and second pregnancies and by 4.4 lb between the second and third pregnancies. Total weight gain averaged 31 lb for the first pregnancy and 28.4 and 28.3 lb for the second and third pregnancies, respectively. Mean birth weight increased by 111 g between the first and second pregnancies and by 199 g between the second and third pregnancies. Mean gestational age was similar for all three pregnancies, averaging 39.5 weeks. Using stepwise forward multiple regression analyses, we determined that birth weight and length of gestation are both influenced significantly by prior birth weight and length of gestation; subsequent pregravid weight is influenced significantly by prior rate of gain, pregravid weight and postpartum weight; and postpartum weight is significantly influenced by prior rate of gain and birth weight. Comparisons across three pregnancies for the same woman showed that differences in birth-to-conception interval were not associated with higher postpartum weight or subsequent pregravid weight. These data indicate that in healthy, nonsmoking, low-risk women, the maternal and infant outcomes of pregnancies are significantly influenced by prior outcomes but not by either short birth-to-conception interval or greater maternal age.

Weight change later in life and colon and rectal cancer risk in participants in the EPIC-PANACEA study.

PubMed

Steins Bisschop, Charlotte N; van Gils, Carla H; Emaus, Marleen J; Bueno-de-Mesquita, H Bas; Monninkhof, Evelyn M; Boeing, Heiner; Aleksandrova, Krasmira; Jenab, Mazda; Norat, Teresa; Riboli, Elio; Boutron-Rualt, Marie-Christine; Fagherazzi, Guy; Racine, Antoine; Palli, Domenico; Krogh, Vittorio; Tumino, Rosario; Naccarati, Alessio; Mattiello, Amalia; Argüelles, Marcial Vicente; Sanchez, Maria José; Tormo, Maria José; Ardanaz, Eva; Dorronsoro, Miren; Bonet, Catalina; Khaw, Kay-Tee; Key, Tim; Trichopoulou, Antonia; Orfanos, Philippos; Naska, Androniki; Kaaks, Rudolph R; Lukanova, Annekatrin; Pischon, Tobias; Ljuslinder, Ingrid; Jirström, Karin; Ohlsson, Bodil; Overvad, Kim; Landsvig Berentzen, Tina; Halkjaer, Jytte; Tjonneland, Anne; Weiderpass, Elisabete; Skeie, Guri; Braaten, Tonje; Siersema, Peter D; Freisling, Heinz; Ferrari, Pietro; Peeters, Petra H M; May, Anne M

2014-01-01

A moderate association exists between body mass index (BMI) and colorectal cancer. Less is known about the effect of weight change. We investigated the relation between BMI and weight change and subsequent colon and rectal cancer risk. This was studied among 328,781 participants in the prospective European Prospective Investigation into Cancer-Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating study (mean age: 50 y). Body weight was assessed at recruitment and on average 5 y later. Self-reported weight change (kg/y) was categorized in sex-specific quintiles, with quintiles 2 and 3 combined as the reference category (men: -0.6 to 0.3 kg/y; women: -0.4 to 0.4 kg/y). In the subsequent years, participants were followed for the occurrence of colon and rectal cancer (median period: 6.8 y). Multivariable Cox proportional hazards regression analyses were used to study the association. A total of 1261 incident colon cancer and 747 rectal cancer cases were identified. BMI at recruitment was statistically significantly associated with colon cancer risk in men (HR: 1.04; 95% CI: 1.02, 1.07). Moderate weight gain (quintile 4) in men increased risk further (HR: 1.32; 95% CI: 1.04, 1.68), but this relation did not show a clear trend. In women, BMI or weight gain was not related to subsequent risk of colon cancer. No statistically significant associations for weight loss and colon cancer or for BMI and weight changes and rectal cancer were found. BMI attained at adulthood was associated with colon cancer risk. Subsequent weight gain or loss was not related to colon or rectal cancer risk in men or women.

21 CFR 522.1468 - Naproxen for injection.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL.... Five milligrams per kilogram of body weight intravenously followed by maintenance oral therapy of 10 milligrams per kilogram of body weight twice daily for up to 14 consecutive days. (2) Indications for use...

21 CFR 522.1468 - Naproxen for injection.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL.... Five milligrams per kilogram of body weight intravenously followed by maintenance oral therapy of 10 milligrams per kilogram of body weight twice daily for up to 14 consecutive days. (2) Indications for use...

21 CFR 522.1468 - Naproxen for injection.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL.... Five milligrams per kilogram of body weight intravenously followed by maintenance oral therapy of 10 milligrams per kilogram of body weight twice daily for up to 14 consecutive days. (2) Indications for use...

21 CFR 522.1468 - Naproxen for injection.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL.... Five milligrams per kilogram of body weight intravenously followed by maintenance oral therapy of 10 milligrams per kilogram of body weight twice daily for up to 14 consecutive days. (2) Indications for use...

Weight Measurements and Standards for Soldiers, Phase 2

DTIC Science & Technology

2016-10-01

SUPPLEMENTARY NOTES 14. ABSTRACT The specific aims of the study are to: 1) examine body weight and fat changes associated with participation in a...maintenance of changes in body weight, body fat , and fitness after discontinuation of the promotion associated with the H.E.A.L.T.H. program. The study is a...physical fitness, health, weight, body fat 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 26 19a. NAME OF

Can limiting dietary variety assist with reducing energy intake and weight loss?☆

PubMed Central

Raynor, Hollie A.

2013-01-01

Due to the high prevalence of overweight and obesity, developing strategies to improve weight loss and weight loss maintenance is imperative. One dietary environmental variable that has received little attention in being targeted in an intervention to assist with obesity treatment is dietary variety. Experimental research has consistently shown that greater dietary variety increases consumption, with the effect of variety on consumption hypothesized to be a consequence of the differential experience of the more varied sensory properties of food under those conditions with greater dietary variety. As reduced energy intake is required for weight loss, limiting variety, particularly in food groups that are high in energy-density and low in nutrient-density, may assist with reducing energy intake and improving weight loss. A series of investigations, both observational and experimental, were conducted to examine if limiting variety in an energydense, non-nutrient-dense food group, snack foods (i.e., cookies, chips), assisted with reducing energy intake of the food group and improving weight loss. Results of the investigations suggest that a prescription for limiting variety in a food group can be implemented during obesity treatment, limiting variety is associated with the occurrence of monotony, and that reducing food group variety is related to decreased consumption of that food group. Future research is needed to ascertain the long-term effect of prescriptions targeting dietary variety on weight loss and weight loss maintenance. PMID:22450259

Obesity Prevention and Weight Maintenance After Loss.

PubMed

German, Alexander James

2016-09-01

Obesity is one of the most prevalent medical diseases in pets. Outcomes are often disappointing; many animals either fail to reach target weight or regain weight. This article discusses managing obesity, focusing on prevention. It gives guidance on establishing monitoring programs that use regular body weight and condition assessments to identify animals at risk of inappropriate weight gain, enabling early intervention. Weight management in obese animals is a lifelong process. Regular weight and body condition monitoring are key to identifying animals that rebound early, while continuing to feed a therapeutic weight loss diet can help prevent it from happening. Copyright © 2016 Elsevier Inc. All rights reserved.

The Use of Stress-Management Training for Obese Women.

ERIC Educational Resources Information Center

Sternberg, Daniel; Del Porto, Delbert

Stress management training contributes to weight loss, maintenance of weight loss and improved social and occupational functioning in obese women. Data from the Beck Depression Inventory and the Assertiveness Questionnaire indicate that obese persons have poor self-concepts which result in depression which is inversely related to assertiveness.…

Nutritional Therapy.

PubMed

Schwartz, Julie

2016-03-01

This article provides the reader with steps needed to accurately assess patient nutrition behaviors that contribute to weight gain, inability to lose weight, or inability to sustain weight loss. Evidence-based approaches in nutrition therapy that can create the daily energy deficit needed to produce 1/2 to 2 pounds of weight loss per week, and the strategies to create the energy deficit, are presented. To optimize health, long-term weight loss maintenance is needed. The benefits of using a multidisciplinary team approach in treating obesity are highlighted. Copyright © 2016 Elsevier Inc. All rights reserved.

Dietary Management of Obesity: Cornerstones of Healthy Eating Patterns.

PubMed

Smethers, Alissa D; Rolls, Barbara J

2018-01-01

Several dietary patterns, both macronutrient and food based, can lead to weight loss. A key strategy for weight management that can be applied across dietary patterns is to reduce energy density. Clinical trials show that reducing energy density is effective for weight loss and weight loss maintenance. A variety of practical strategies and tools can help facilitate successful weight management by reducing energy density, providing portion control, and improving diet quality. The flexibility of energy density gives patients options to tailor and personalize their dietary pattern to reduce energy intake for sustainable weight loss. Copyright © 2017 Elsevier Inc. All rights reserved.

Major factors for facilitating change in behavioral strategies to reduce obesity

PubMed Central

Dalle Grave, Riccardo; Centis, Elena; Marzocchi, Rebecca; El Ghoch, Marwan; Marchesini, Giulio

2013-01-01

It is very unlikely that our obesity-promoting environment will change in the near future. It is therefore mandatory to improve our knowledge of the main factors associated with successful adoption of obesity-reducing behaviors. This may help design more powerful procedures and strategies to facilitate the adoption of healthy lifestyles in a “toxic” environment favoring the development of a positive energy balance. The aim of this review is to describe the main factors associated with successful adoption of obesity-reducing behaviors and to describe the most recent development, limits, and outcomes of lifestyle modification programs. The evidence regarding predictors of weight loss and weight loss maintenance remains largely incomplete. It is necessary to develop strategies matching treatments to patients’ needs to improve successful weight loss and its maintenance. How to detect and how to address these needs is a continuous, challenging, research problem. PMID:24124398

Minimum Weight Design of a Leaf Spring Tapered in Thickness and Width for the Hubble Space Telescope-Space Support Equipment

NASA Technical Reports Server (NTRS)

Rodriguez, P. I.

1990-01-01

A linear elastic solution to the problem of minimum weight design of cantilever beams with variable width and depth is presented. The solution shown is for the specific application of the Hubble Space Telescope maintenance mission hardware. During these maintenance missions, delicate instruments must be isolated from the potentially damaging vibration environment of the space shuttle cargo bay during the ascent and descent phases. The leaf springs are designed to maintain the isolation system natural frequency at a level where load transmission to the instruments in a minimum. Nonlinear programming is used for the optimization process. The weight of the beams is the objective function with the deflection and allowable bending stress as the constraint equations. The design variables are the width and depth of the beams at both the free and the fixed ends.

The different oscillation patterns of alpha band in the early and later stages of working memory maintenance.

PubMed

Xie, Yuanjun; Feng, Zhengquan; Xu, Yuanyuan; Bian, Chen; Li, Min

2016-10-28

A putative functional role for alpha oscillations in working memory remains controversial. However, recent evidence suggests that such oscillation may reflect distinct phases of working memory processing. The present study investigated alpha band (8-13Hz) activity during the maintenance stage of working memory using a modified Sternberg working memory task. Our results reveal that alpha power was concentrated primarily in the occipital cortex and was decreased during the early stage of maintenance (0-600ms), and subsequently increased during the later stage of maintenance (1000-1600ms). We suggest that reduced alpha power may be involved in focused attention during the working memory maintenance, whereas increased alpha power may reflect suppression of visual stimuli to facilitate internal processing related to the task. This interpretation is generally consistent with recent reports suggesting that variations in alpha power are associated with the representation and processing of information in the discrete time intervals during the working memory maintenance. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Association of gain and loss of weight before and after menopause with risk of postmenopausal breast cancer in the Iowa women's health study.

PubMed

Harvie, Michelle; Howell, Anthony; Vierkant, Robert A; Kumar, Nagi; Cerhan, James R; Kelemen, Linda E; Folsom, Aaron R; Sellers, Thomas A

2005-03-01

Obesity and adult weight gain are well-established risk factors for postmenopausal breast cancer. Although there are a few studies demonstrating the contribution of adult weight gain to breast cancer risk, whether weight gain during a critical time period is specifically associated with risk, or whether subsequent weight loss among women who have gained weight will reduce the excess risk, is not firmly established. We investigated the association of changes in weight (loss or gain in excess of 5% of body weight) using two risk factor models: (a) age 18 to 30 years and age 30 years to menopause and (b) age 30 years to menopause and after the menopause to the baseline study in 1986 on risk of postmenopausal breast cancer in a prospective cohort of 33,660 postmenopausal women in Iowa. Over 15 years of follow-up, 1,987 cases of breast cancer occurred. Data were analyzed using proportional hazards regression models adjusted for established breast cancer risk factors. The most frequently observed pattern of body weight over time was a consistent increase; these women were observed to have the highest rates of breast cancer and served as the reference category for all comparisons. The lowest-risk groups were (a) women who maintained or lost weight from age 18 to 30 years and then lost weight from age 30 years to menopause [risk ratio (RR), 0.36; 95% confidence interval (95% CI), 0.22-0.60] and (b) women who maintained or lost weight from age 30 years to menopause and then lost weight after the menopause (RR, 0.48; 95% CI, 0.22-0.65). Women who gained weight from age 30 years to menopause but then lost weight after the menopause experienced risk reductions (RR, 0.77; 95% CI, 0.64-0.92) although perhaps slightly smaller in magnitude than women who maintained their weight in both time intervals (RR, 0.63; 95% CI, 0.55-0.73). Women who gained weight from age 18 to 30 years and then lost weight from age 30 years to menopause had comparable risk reductions (RR, 0.61; 95% CI, 0.46-0.8) with women who maintained their weight in both time intervals (RR, 0.73; 95% CI, 0.64-0.84). Women who gained weight during the period from age 30 years to menopause but who had stable weight after menopause had rates similar to the reference group. These data suggest prevention of weight gain between age 18 years and menopause or weight loss and maintenance during these years reduces risk of postmenopausal breast cancer.

The Effect of Cognitive Activity on Sleep Maintenance in a Subsequent Daytime Nap.

PubMed

Arzilli, Cinzia; Cerasuolo, Mariangela; Conte, Francesca; Bittoni, Valentina; Gatteschi, Claudia; Albinni, Benedetta; Giganti, Fiorenza; Ficca, Gianluca

2018-01-25

The aim of this study is to assess the effects of a learning task on the characteristics of a subsequent daytime nap. Thirty-eight subjects were administered a control nap (C) and one preceded by a cognitive training session (TR). Relative to C, TR naps showed significantly increased sleep duration with decreased sleep latency, as well as significantly increased sleep efficiency due to reduced awakening frequency. Meaningful trends were also found toward an increase of Stage 2 sleep proportion and a reduction of Stage 1 sleep, percentage of wake after sleep onset (WASO), and frequency of state transitions. Our results indicate that presleep learning favors sleep propensity and maintenance, offering the possibility to explore planned cognitive training as a low-cost treatment for sleep impairments.

Severe anorexia nervosa, co-occurring major depressive disorder and electroconvulsive therapy as maintenance treatment: a case report.

PubMed

Poutanen, Outi; Huuhka, Kaija; Perko, Kaisa

2009-12-21

It is difficult to treat patients who, in addition to having severe anorexia nervosa, also have severe symptoms of major depressive disorder and a tendency for impulsive acting out behaviour. Our case report considers the feasibility of maintenance electroconvulsive therapy in such complicated cases. This is a case report of a woman with anorexia nervosa and co-morbid severe major depressive disorder who was treated with electroconvulsive therapy as a maintenance treatment. The maintenance electroconvulsive therapy was conducted without immediate complications. It had a positive effect on the patient's depressive symptoms and lability and her general wellbeing, although some cognitive deficits were observed. The maintenance electroconvulsive therapy seemed to support recovery in a case of refractory anorexia nervosa and a tendency for labile mood. The symptoms of co-occurring major depressive disorder were partly relieved and maintenance electroconvulsive therapy had some positive effect on weight gain.

ISS ECLSS: 3 Years of Logistics for Maintenance

NASA Technical Reports Server (NTRS)

Shkedi, Brienne; Thompson, Dean

2004-01-01

The International Space Station (ISS) Environmental Control and Life Support System (ECLSS) is designed to be maintainable. During the 3 years since the ISS US Lab became operational, there have been numerous ECLSS Orbital Replacement Units (ORUs) launched and returned to Maintain the ECLSS operation in the US segments. The maintenance logistics have provided tools for maintenance, replaced limited life ORUs and failed ORUs, upgraded ECLSS hardware to improve reliability and placed critical spares onboard prior to need. In most cases, the removed ORUs have been returned for either failure analysis and repair or refurbishment. This paper describes the ECLSS manifesting history and maintenance events and quantifies the numbers of ECLSS items, weights, and volumes.

A Simulation Based Approach for Contingency Planning for Aircraft Turnaround Operation System Activities in Airline Hubs

NASA Technical Reports Server (NTRS)

Adeleye, Sanya; Chung, Christopher

2006-01-01

Commercial aircraft undergo a significant number of maintenance and logistical activities during the turnaround operation at the departure gate. By analyzing the sequencing of these activities, more effective turnaround contingency plans may be developed for logistical and maintenance disruptions. Turnaround contingency plans are particularly important as any kind of delay in a hub based system may cascade into further delays with subsequent connections. The contingency sequencing of the maintenance and logistical turnaround activities were analyzed using a combined network and computer simulation modeling approach. Experimental analysis of both current and alternative policies provides a framework to aid in more effective tactical decision making.

Determination of energy and protein requirements for crossbred Holstein × Gyr preweaned dairy calves.

PubMed

Silva, A L; Marcondes, M I; Detmann, E; Campos, M M; Machado, F S; Filho, S C Valadares; Castro, M M D; Dijkstra, J

2017-02-01

The objective was to quantify the energy and protein nutritional requirements of Holstein × Gyr crossbred preweaned dairy calves until 64 d of age. Thirty-nine Holstein × Gyr crossbred male calves with an average initial live weight (mean ± SEM; for all next values) of 36 ± 1.0 kg were used. Five calves were slaughtered at 4 d of life to estimate the animals' initial body composition (reference group). The remaining 34 calves were distributed in a completely randomized design in a 3 × 2 factorial arrangement consisting of 3 levels of milk (2, 4, or 8 L/d) and 2 levels of starter feed (presence or absence in diet). At 15 and 45 d of life, 4 animals from each treatment were subjected to digestibility trials with total collection of feces (for 72 h) and urine (for 24 h). At 64 d of age, all animals were slaughtered, their gastro-intestinal tract was washed to determine the empty body weight (EBW; kg), and their body tissues were sampled for subsequent analyses. The net energy requirement for maintenance was estimated using an exponential regression between metabolizable energy intake and heat production (both in Mcal/EBW 0.75 per d) and was 74.3 ± 5.7 kcal/EBW 0.75 per d, and was not affected by inclusion of starter feed in the diet. The metabolizable energy requirement for maintenance was determined at the point of zero energy retention in the body and was 105.2 ± 5.8 kcal/EBW 0.75 per d. The net energy for gain was estimated using the EBW and the empty body gain (EBG; kg/d) as 0.0882 ± 0.0028 × EBW 0.75 × EBG 0.9050±0.0706 . The metabolizable energy efficiency for gain (k g ) of the milk was 57.4 ± 3.45%, and the k g of the starter feed was 39.3 ± 2.09%. The metabolizable protein requirement for maintenance was 3.52 ± 0.34 g/BW 0.75 per d. The net protein required for each kilogram gained was estimated as 119.1 ± 32.9 × EBW 0.0663±0.059 . The metabolizable protein efficiency for gain was 77 ± 8.5% and was not affected by inclusion of starter feed in the diet. In conclusion, the energy efficiency for gain of milk is higher than that of starter and the net protein required per unit protein gain increases with empty body weight. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Plasma myostatin is only a weak predictor for weight maintenance in obese adults.

PubMed

Tsioga, M N; Oikonomou, D; Vittas, S; Kalscheuer, H; Roeder, E; Wintgens, K F; Nawroth, P P; Wolfrum, C; Rudofsky, G

2015-09-01

Predicting an individual's success in a non-surgical weight loss approach is a demanding need since obesity is becoming an epidemic burden. A possible predictive marker is myostatin, a member of the transforming growth factor b superfamily, which has been shown to be an important regulator of muscle homeostasis. In the present study, we analyzed myostatin as a marker to predict weight loss of patients that participated in a 2 phased weight reduction program, comprising a weight loss period of 12 weeks and a weight stabilization period of 40 weeks. Therefore, 62 obese individuals with a mean BMI of 40.6 kg/m(2) were included. Plasma myostatin was measured with ELISA at the beginning (T0), after weight loss (T1) and at the end of the program (T2). Although significant weight loss of -23.9±14.9 kg was achieved, myostatin did not change significantly during the program (T0>T1: p=0.46; T1>T2: p=0.70; T0>T2: p=0.57). Myostatin at baseline did neither negatively correlate with the achieved weight loss in the weight reduction phase (T0>T1: r=0.27, p=0.16) nor with weight loss during the whole program (T0>T2: r=0.20, p=0.29). Only a minor correlation with myostatin levels after weight loss with weight regain during maintenance period was detected. (T1>T2: r=-0.37, p=0.05). Plasma myostatin might be suitable in predicting weight regain after marked weight loss, but no association with weight loss was observed in patients undergoing a non-surgical weight loss program. Therefore, myostatin does not seem to be a predictor for success in non-surgical weight loss approaches. © Georg Thieme Verlag KG Stuttgart · New York.

Effects of chronic weight perturbation on energy homeostasis and brain structure in mice

PubMed Central

Ravussin, Y.; Gutman, R.; Diano, S.; Shanabrough, M.; Borok, E.; Sarman, B.; Lehmann, A.; LeDuc, C. A.; Rosenbaum, M.; Horvath, T. L.

2011-01-01

Maintenance of reduced body weight in lean and obese human subjects results in the persistent decrease in energy expenditure below what can be accounted for by changes in body mass and composition. Genetic and developmental factors may determine a central nervous system (CNS)-mediated minimum threshold of somatic energy stores below which behavioral and metabolic compensations for weight loss are invoked. A critical question is whether this threshold can be altered by environmental influences and by what mechanisms such alterations might be achieved. We examined the bioenergetic, behavioral, and CNS structural responses to weight reduction of diet-induced obese (DIO) and never-obese (CON) C57BL/6J male mice. We found that weight-reduced (WR) DIO-WR and CON-WR animals showed reductions in energy expenditure, adjusted for body mass and composition, comparable (−10–15%) to those seen in human subjects. The proportion of excitatory synapses on arcuate nucleus proopiomelanocortin neurons was decreased by ∼50% in both DIO-WR and CON-WR mice. These data suggest that prolonged maintenance of an elevated body weight (fat) alters energy homeostatic systems to defend a higher level of body fat. The synaptic changes could provide a neural substrate for the disproportionate decline in energy expenditure in weight-reduced individuals. This response to chronic weight elevation may also occur in humans. The mouse model described here could help to identify the molecular/cellular mechanisms underlying both the defense mechanisms against sustained weight loss and the upward resetting of those mechanisms following sustained weight gain. PMID:21411766

Adult weight loss diets: metabolic effects and outcomes.

PubMed

Matarese, Laura E; Pories, Walter J

2014-12-01

The global prevalence of overweight and obesity as a public health concern is well established and reflects the overall lack of success in our ability to achieve and maintain a healthy body weight. Being overweight and obese is associated with numerous comorbidities and is a risk factor for several of the leading causes of death, including cardiovascular disease, diabetes mellitus, and many types of cancer. The foundation of treatment has been diet and exercise. There are >1,000 published weight loss diets, with more appearing in the lay literature and the media on a regular basis. The sheer number of existing diet regimens would suggest that no one diet has been universally successful at inducing and maintaining weight loss. Many of these dietary programs are based on sound scientific evidence and follow contemporary principles of weight loss. Others simply eliminate 1 or more of the essential food groups or recommend consumption of 1 type of food at the expense of other foods with little to no supporting evidence. The focus of this review is on weight loss diets, specifically those with the most supporting scientific evidence and those that are most likely to succeed in achievement and maintenance of desirable body weight. The effects of weight loss diets on energy expenditure, body weight, body composition, and metabolic parameters will be evaluated. Ultimately, the best diet is the one the patient will follow and incorporate into his or her daily life for lifelong maintenance of a healthy body weight. © 2014 American Society for Parenteral and Enteral Nutrition.

The roles of body mass and gravity in determining the energy requirements of homoiotherms

NASA Technical Reports Server (NTRS)

Smith, A. H.

1977-01-01

Studies by Kleiber and by Brody in the 1930's established the 3/4 power of body weight as the unit of metabolic size for homoiotherms. Later Kleiber conceived of the energy requirement as a composite function, with a thermoregulatory component that is proportional to heat loss, and an antigravity component that is directly proportional to body weight. Maintenance feed requirements (F) have been measured with groups of small animals chronically exposed to several acceleration fields (G). Analysis of the results leads to an arithmetic relationship between the maintenance requirement and acceleration field strength: F sub G = F sub 0 + kG. When the equations are compared for groups of different body size, F sub 0 tends to vary between the 0.4 and 0.5 power of body mass - and k tends to be the same, irrespective of body mass. These findings tend to confirm the Kleiber concept of a composite nature of homoiotherm maintenance requirements.

Dialysate bicarbonate variation in maintenance hemodiafiltration patients: Impact on serum bicarbonate, intradialytic hypotension and interdialytic weight gain.

PubMed

Viegas, Márcio; Cândido, Cristina; Felgueiras, Joana; Clemente, José; Barros, Sara; Farbota, Rostislav; Vera, Filipa; Matos, Antero; Sousa, Francisco

2017-07-01

The dialysate bicarbonate (DB) influences the acid-base balance in dialysis patients. Very low and high serum bicarbonate (SB) have been related with a higher mortality. Acid-base balance also has been associated with hemodynamic effects in these patients. The trial aim was to compare the effect of DB concentration variation on SB levels in maintenance hemodiafiltration (HDF) patients and the effect on intradialytic hypotension and interdialytic weight gain. A prospective study, with 9 months of follow-up, involving 93 patients, divided in two groups: group 1 and group 2 with a DB of 34 mmol/L and 30 mmol/L, respectively, with monitoring of pre and post HDF SB, intradialytic hypotension, and interdialytic weight gain. Pre dialysis SB was higher in group 1: median concentration of 22.7 mmol/L vs. 21.1 mmol/L (P < 0.001). Post dialysis SB levels were higher in group 1: median concentration of 28.0 mmol/L vs. 25.3 mmol/L (P < 0.001). Post dialysis SB in alkalotic range was only detected in group 1 (51.2% of the patients). No significant differences were detected in intradialytic hypotension rate [28.0 vs. 27.4 episodes per 1000 sessions in group 1 and 2, respectively, (P = 0.906)] or in average interdialytic weight gain [2.9% vs. 3.0% in group 1 and 2, respectively, (P = 0.710)]. DB of 30 mmol/L appears to be associated with SB levels closer to physiological levels than 34 mmol/L. The bicarbonate dialysate, in the tested concentrations, did not appear to have a significant impact on intradialytic hypotension and interdialytic weight gain in maintenance HDF patients. © 2016 International Society for Hemodialysis.

Newborn birth-weight of pregnant women on methadone or buprenorphine maintenance treatment: A national contingency management approach trial.

PubMed

Peles, Einat; Sason, Anat; Schreiber, Shaul; Adelson, Miriam

2017-03-01

Methadone maintenance treatment (MMT) is the gold standard for pregnant women with opioid use disorders. Still, low birth-weights were reported, in particular of mothers who became pregnant before admission to MMT. We studied whether an escalating incentive contingency-management approach may contribute to better newborn birth-weights. A nationwide controlled randomized trial among all Israeli methadone/buprenorphine maintenance treatment (MBMT), newly or already in treatment pregnant women was performed. A modified contingency-management protocol with coupons of escalating value depending upon reduction of drug use, cigarette smoking, and alcohol consumption was compared to standard care arm. Drugs in urine, smoking (Fagerstrom score), alcohol use, and depression were monitored. Thirty-five women had 46 pregnancies. In their first pregnancy, 19 from the contingency-management and 16 from the standard care arms were studied. Contingency-management group as compared to the standard care arm included more newly admitted women (36.8% vs. 6.3%, p = .05), with benzodiazepine and cannabis onset at a younger age, and higher proportion of any drug abuse while pregnant (100% vs. 68.8%, p = .01). Fifteen of the contingency-management and 14 of the control arm gave birth (78.9% vs. 87.5%, p = .3) with similar proportions of normal (>2,500 g) birth-weight (71.4% vs. 61.5%, p = .8). Newborns' birth-weight was comparable among the two study arms indicating no contribution of the contingency-management approach. Small sample and baseline differences between arms might have influenced results. Intensive intervention should be evaluated on a larger scale of participants. (Am J Addict 2017;26:167-175). © 2017 American Academy of Addiction Psychiatry.

Associations between dairy protein intake and body weight and risk markers of diabetes and CVD during weight maintenance.

PubMed

Bendtsen, Line Q; Lorenzen, Janne K; Larsen, Thomas M; van Baak, Marleen; Papadaki, Angeliki; Martinez, J Alfredo; Handjieva-Darlenska, Teodora; Jebb, Susan A; Kunešová, Marie; Pfeiffer, Andreas F H; Saris, Wim H M; Astrup, Arne; Raben, Anne

2014-03-14

Dairy products have previously been reported to be associated with beneficial effects on body weight and metabolic risk markers. Moreover, primary data from the Diet, Obesity and Genes (DiOGenes) study indicate a weight-maintaining effect of a high-protein-low-glycaemic index diet. The objective of the present study was to examine putative associations between consumption of dairy proteins and changes in body weight and metabolic risk markers after weight loss in obese and overweight adults. Results were based on secondary analyses of data obtained from overweight and obese adults who completed the DiOGenes study. The study consisted of an 8-week weight-loss phase and a 6-month weight-maintenance (WM) phase, where the subjects were given five different diets varying in protein content and glycaemic index. In the present study, data obtained from all the subjects were pooled. Dairy protein intake was estimated from 3 d dietary records at two time points (week 4 and week 26) during the WM phase. Body weight and metabolic risk markers were determined at baseline (week -9 to -11) and before and at the end of the WM phase (week 0 and week 26). Overall, no significant associations were found between consumption of dairy proteins and changes in body weight and metabolic risk markers. However, dairy protein intake tended to be negatively associated with body weight gain (P=0·08; β=-0·17), but this was not persistent when controlled for total protein intake, which indicates that dairy protein adds no additional effect to the effect of total protein. Therefore, the present study does not report that dairy proteins are more favourable than other proteins for body weight regulation.

40 CFR 63.9816 - What records must I keep?

Code of Federal Regulations, 2010 CFR

2010-07-01

... with a catalytic oxidizer, records of annual checks of catalyst activity levels and subsequent... approved alternative monitoring method(s) or test procedure(s). (8) Records of maintenance activities and...

40 CFR 63.9816 - What records must I keep?

Code of Federal Regulations, 2011 CFR

2011-07-01

... with a catalytic oxidizer, records of annual checks of catalyst activity levels and subsequent... approved alternative monitoring method(s) or test procedure(s). (8) Records of maintenance activities and...

Distinct lipid profiles predict improved glycemic control in obese, nondiabetic patients after a low-caloric diet intervention: the Diet, Obesity and Genes randomized trial.

PubMed

Valsesia, Armand; Saris, Wim Hm; Astrup, Arne; Hager, Jörg; Masoodi, Mojgan

2016-09-01

An aim of weight loss is to reduce the risk of type 2 diabetes (T2D) in obese subjects. However, the relation with long-term glycemic improvement remains unknown. We evaluated the changes in lipid composition during weight loss and their association with long-term glycemic improvement. We investigated the plasma lipidome of 383 obese, nondiabetic patients within a randomized, controlled dietary intervention in 8 European countries at baseline, after an 8-wk low-caloric diet (LCD) (800-1000 kcal/d), and after 6 mo of weight maintenance. After weight loss, a lipid signature identified 2 groups of patients who were comparable at baseline but who differed in their capacities to lose weight and improve glycemic control. Six months after the LCD, one group had significant glycemic improvement [homeostasis model assessment of insulin resistance (HOMA-IR) mean change: -0.92; 95% CI: -1.17, -0.67)]. The other group showed no improvement in glycemic control (HOMA-IR mean change: -0.26; 95% CI: -0.64, 0.13). These differences were sustained for ≥1 y after the LCD. The same conclusions were obtained with other endpoints (Matsuda index and fasting insulin and glucose concentrations). Significant differences between the 2 groups were shown in leptin gene expression in adipose tissue biopsies. Significant differences were also observed in weight-related endpoints (body mass index, weight, and fat mass). The lipid signature allowed prediction of which subjects would be considered to be insulin resistant after 6 mo of weight maintenance [validation's receiver operating characteristic (ROC) area under the curve (AUC): 71%; 95% CI: 62%, 81%]. This model outperformed a clinical data-only model (validation's ROC AUC: 61%; 95% CI: 50%, 71%; P = 0.01). In this study, we report a lipid signature of LCD success (for weight and glycemic outcome) in obese, nondiabetic patients. Lipid changes during an 8-wk LCD allowed us to predict insulin-resistant patients after 6 mo of weight maintenance. The determination of the lipid composition during an LCD enables the identification of nonresponders and may help clinicians manage metabolic outcomes with further intervention, thereby improving the long-term outcome and preventing T2D. This trial was registered at clinicaltrials.gov as NCT00390637. © 2016 American Society for Nutrition.

Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical Trial.

PubMed

Trepanowski, John F; Kroeger, Cynthia M; Barnosky, Adrienne; Klempel, Monica C; Bhutani, Surabhi; Hoddy, Kristin K; Gabel, Kelsey; Freels, Sally; Rigdon, Joseph; Rood, Jennifer; Ravussin, Eric; Varady, Krista A

2017-07-01

Alternate-day fasting has become increasingly popular, yet, to date, no long-term randomized clinical trials have evaluated its efficacy. To compare the effects of alternate-day fasting vs daily calorie restriction on weight loss, weight maintenance, and risk indicators for cardiovascular disease. A single-center randomized clinical trial of obese adults (18 to 64 years of age; mean body mass index, 34) was conducted between October 1, 2011, and January 15, 2015, at an academic institution in Chicago, Illinois. Participants were randomized to 1 of 3 groups for 1 year: alternate-day fasting (25% of energy needs on fast days; 125% of energy needs on alternating "feast days"), calorie restriction (75% of energy needs every day), or a no-intervention control. The trial involved a 6-month weight-loss phase followed by a 6-month weight-maintenance phase. The primary outcome was change in body weight. Secondary outcomes were adherence to the dietary intervention and risk indicators for cardiovascular disease. Among the 100 participants (86 women and 14 men; mean [SD] age, 44 [11] years), the dropout rate was highest in the alternate-day fasting group (13 of 34 [38%]), vs the daily calorie restriction group (10 of 35 [29%]) and control group (8 of 31 [26%]). Mean weight loss was similar for participants in the alternate-day fasting group and those in the daily calorie restriction group at month 6 (-6.8% [95% CI, -9.1% to -4.5%] vs -6.8% [95% CI, -9.1% to -4.6%]) and month 12 (-6.0% [95% CI, -8.5% to -3.6%] vs -5.3% [95% CI, -7.6% to -3.0%]) relative to those in the control group. Participants in the alternate-day fasting group ate more than prescribed on fast days, and less than prescribed on feast days, while those in the daily calorie restriction group generally met their prescribed energy goals. There were no significant differences between the intervention groups in blood pressure, heart rate, triglycerides, fasting glucose, fasting insulin, insulin resistance, C-reactive protein, or homocysteine concentrations at month 6 or 12. Mean high-density lipoprotein cholesterol levels at month 6 significantly increased among the participants in the alternate-day fasting group (6.2 mg/dL [95% CI, 0.1-12.4 mg/dL]), but not at month 12 (1.0 mg/dL [95% CI, -5.9 to 7.8 mg/dL]), relative to those in the daily calorie restriction group. Mean low-density lipoprotein cholesterol levels were significantly elevated by month 12 among the participants in the alternate-day fasting group (11.5 mg/dL [95% CI, 1.9-21.1 mg/dL]) compared with those in the daily calorie restriction group. Alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or cardioprotection vs daily calorie restriction. clinicaltrials.gov Identifier: NCT00960505.

A trial of reduced carbohydrate diet to improve metabolic outcomes and decrease adiposity in obese peripubertal African American girls: does macronutrient profile matter?

PubMed Central

Casazza, Krista; Cardel, Michelle; Dulin-Keita, Akilah; Hanks, Lynae J.; Gower, Barbara A.; Newton, Anna L.; Wallace, Stephenie

2011-01-01

Objectives Obesity prevalence among African American (AA) girls is higher than that of other groups. As typical calorie-restriction obesity treatment strategies have had limited success, alterations in macronutrient composition might effectively improve metabolic outcomes in this population and impact future body composition trajectories. The objective was to evaluate the efficacy of a moderately restricted carbohydrate (CHO) versus a standard CHO diet on weight/fat loss and metabolic parameters in overweight/obese AA girls aged 9–14 years. Methods A total of 26 AA girls (ranging from 92nd BMI percentile and above) were assigned to either a reduced- (SPEC: 42% calories from CHO, n=12) or a standard- (STAN: 55% of calories from CHO, n=14) CHO diet (protein held constant) for 16-weeks. All meals were provided and clinically tailored to meet the estimated energy requirements (REE × 1.2 in eucaloric phase and REE × 1.2 – 1000kcal in energy deficit phase). The first five-weeks encompassed a eucaloric phase evaluating metabolic changes in the absence of weight change. The subsequent 11-weeks were hypocaloric (1000kcal/d deficit) in effort to promote weight/fat loss. Meal tests were performed during the eucaloric phase for metabolic analyses. Dual-energy x-ray absorptiometry (DXA) was used to evaluate body composition. Results Both groups had reductions in weight/adiposity but the difference did not reach significance. The solid meal test indicated improved glucose/insulin homeostasis on the SPEC diet up to three hours post-ingestion. In addition, significantly lower triglycerides (p<0.001) were observed on the SPEC diet. Conclusions Dietary CHO reduction favorably influences metabolic parameters but did not result in greater weight/fat loss relative to a standard diet in obese AA girls. Future research is needed to determine long-term effectiveness of a reduced CHO diet on glucose and insulin homeostasis and how it may apply to weight maintenance/fat loss during development alone and/or in combination with additional weight loss/metabolic improvement strategies. PMID:22067112

Relevance of Mood Eating Patterns to Maintenance of Weight Loss After Treatment.

ERIC Educational Resources Information Center

Setty, Robert M.; Hawkins, Raymond C.

Relapses in alcoholics, smokers, and heroin users are frequently provoked by stress. Individuals often return to using addictive substances when feeling angry or frustrated as the result of negative mood states, interpersonal conflict, or social pressure. A behavioral weight-control program used to treat 140 overweight college students was…

Maintenance of Cognitive and Behavioral Change Following Weight Loss Programs: Two Examples.

ERIC Educational Resources Information Center

Kalodner, Cynthia R.; DeLucia, Janice L.

The efficacy of behavioral weight loss programs has been systematically evaluated during active treatment and at follow-up intervals. Despite repeated calls for more comprehensive assessment of change, other sources of information about change in behavior, nutritional habits, and thinking patterns are often neglected. These studies examined the…

Long-term maintenance of weight loss after lifestyle intervention in frail, obese older adults.

PubMed

Waters, D L; Vawter, R; Qualls, C; Chode, S; Armamento-Villareal, R; Villareal, D T

2013-01-01

To determine if long-term weight loss with associated improvement in physical and metabolic health can be maintained after lifestyle intervention in frail, obese older adults. Thirty-month follow-up pilot study of a 1-year lifestyle intervention trial. Community. Sixteen frail, obese (body mass index=36±2 kg/m2) older (71±1 yr.) adults. Body weight and composition, physical function, markers of the metabolic syndrome, glucose and insulin response to an oral glucose tolerance test, bone mineral density (BMD), liver and renal function tests, and food diaries. At 30-month follow-up, weight (101.5±3.8 vs. 94.5±3.9 kg) and BMI (36.0 ±1.7 vs. 33.5±1.7 kg/m2) remained significantly below baseline (all p<0.05). No significant change in fat-free mass (56.7±2.1 vs. 56.9±2.2 kg) or appendicular lean mass (24.1±1.0 vs. 24.1±1.1kg, all p>0.05) occurred between 12 months (end of trial) and 30 months. Improvements in the physical performance test (PPT 27±0.7 vs. 30.2±0.6), insulin sensitivity (4.1±0.8 vs. 3.0±0.6), and insulin area under the curve (12484±2042 vs. 9270±1139 min.mg/dl) remained at 30 months compared to baseline (all p<0.05). Waist circumference (116±3 vs. 109±3 cm) and systolic blood pressure (134±6 vs. 123±5 mm HG) remained decreased at 30 months compared to baseline (all p<0.05). Whole body and lumbar spine BMD did not change; however, total hip BMD progressively decreased at 30 months compared to baseline (0.985±.026 vs. 0.941±.024 g/cm2; p<0.05). There were no adverse effects on liver or renal function. Food frequency questionnaire data showed lower overall caloric intake (-619±157 kcal/day) at 30 months compared to baseline (p<0.05). These findings suggest that long-term maintenance of clinically important weight loss is possible in frail, obese older adults. Weight maintenance appears to be achieved through continued caloric restriction. Larger, long-term studies are needed to follow up on these findings and investigate mechanisms and behaviors underlying maintenance of weight loss and physical function.

Challenges of a community based pragmatic, randomised controlled trial of weight loss maintenance.

PubMed

Randell, Elizabeth; McNamara, Rachel; Shaw, Christine; Espinasse, Aude; Simpson, Sharon Anne

2015-12-18

Randomised controlled trials (RCTs) have a reputation for being inherently difficult to deliver as planned and often face unforeseen challenges and delays, particularly in relation to organisational and governance difficulties, participant interest, constraints due to allocation of costs, local investigator interest and lengthy bureaucracy. Recruitment is often difficult and the challenges faced often impact on the cost and delivery of a successful trial within the funded period. This paper reflects upon the challenges faced in delivering a pragmatic RCT of weight loss maintenance in a community setting and suggests some potential solutions. The weight loss maintenance in adults trial aimed to evaluate the impact of a 12 month, individually tailored weight maintenance intervention on BMI 3 years from randomisation. Participants were recruited primarily from participant identification centres (PICs)-GP surgeries, exercise on referral schemes and slimming world. The intervention was delivered in community settings. A recruitment strategy implementation plan was drafted to address and monitor poor recruitment. Delays in opening and recruitment were experienced early on. Some were beyond the control of the study team such as; disagreement over allocation of national health service costs and PIC classification as well as difficulties in securing support from research networks. That the intervention was delivered in community settings was often at the root of these issues. Key items to address at the design stage of future trials include feasibility of eligibility criteria. The most effective element of the recruitment implementation plan was to refocus sources of recruitment and target only those who could fulfil the eligibility criteria immediately. Learnings from this trial should be kept in mind by those designing similar studies in the future. Considering potential governance, cost and research network support implications at the design stage of pragmatic trials of any community-based complex intervention is paramount. The appropriateness and viability of inclusion criteria also require careful consideration as does use of a targeted advertising strategy. ISRCTN35774128, 12/01/2010.

Reproducibility of ad libitum energy intake with the use of a computerized vending machine system123

PubMed Central

Votruba, Susanne B; Franks, Paul W; Krakoff, Jonathan; Salbe, Arline D

2010-01-01

Background: Accurate assessment of energy intake is difficult but critical for the evaluation of eating behavior and intervention effects. Consequently, methods to assess ad libitum energy intake under controlled conditions have been developed. Objective: Our objective was to evaluate the reproducibility of ad libitum energy intake with the use of a computerized vending machine system. Design: Twelve individuals (mean ± SD: 36 ± 8 y old; 41 ± 8% body fat) consumed a weight-maintaining diet for 3 d; subsequently, they self-selected all food with the use of a computerized vending machine system for an additional 3 d. Mean daily energy intake was calculated from the actual weight of foods consumed and expressed as a percentage of weight-maintenance energy needs (%WMEN). Subjects repeated the study multiple times during 2 y. The within-person reproducibility of energy intake was determined through the calculation of the intraclass correlation coefficients (ICCs) between visits. Results: Daily energy intake for all subjects was 5020 ± 1753 kcal during visit 1 and 4855 ± 1615 kcal during visit 2. There were no significant associations between energy intake and body weight, body mass index, or percentage body fat while subjects used the vending machines, which indicates that intake was not driven by body size or need. Despite overconsumption (%WMEN = 181 ± 57%), the reproducibility of intake between visits, whether expressed as daily energy intake (ICC = 0.90), %WMEN (ICC = 0.86), weight of food consumed (ICC = 0.87), or fat intake (g/d; ICC = 0.87), was highly significant (P < 0.0001). Conclusion: Although ad libitum energy intake exceeded %WMEN, the within-person reliability of this intake across multiple visits was high, which makes this a reproducible method for the measurement of ad libitum intake in subjects who reside in a research unit. This trial was registered at clinicaltrials.gov as NCT00342732. PMID:19923376

Weighted LCS

NASA Astrophysics Data System (ADS)

Amir, Amihood; Gotthilf, Zvi; Shalom, B. Riva

The Longest Common Subsequence (LCS) of two strings A and B is a well studied problem having a wide range of applications. When each symbol of the input strings is assigned a positive weight the problem becomes the Heaviest Common Subsequence (HCS) problem. In this paper we consider a different version of weighted LCS on Position Weight Matrices (PWM). The Position Weight Matrix was introduced as a tool to handle a set of sequences that are not identical, yet, have many local similarities. Such a weighted sequence is a 'statistical image' of this set where we are given the probability of every symbol's occurrence at every text location. We consider two possible definitions of LCS on PWM. For the first, we solve the weighted LCS problem of z sequences in time O(zn z + 1). For the second, we prove \\cal{NP}-hardness and provide an approximation algorithm.

Force Management Methods Task II. Volume III. Attack/Fighter/Trainer Aircraft Evaluation of Potential Improved Methods

DTIC Science & Technology

1980-11-01

structural manager. The designation "ASIMISH is used in the subsequent discussions to avoid the impression that a new organization must be created to...mission changes on the structural integrity of the airframe. New maintenance action schedules are created to conform with the operational realities of... created to further divide this information. In fact, the ASIP maintenance action parameters and data for the A-7D ( and other airplanes) is being

Worry or craving? A selective review of evidence for food-related attention biases in obese individuals, eating-disorder patients, restrained eaters and healthy samples.

PubMed

Werthmann, Jessica; Jansen, Anita; Roefs, Anne

2015-05-01

Living in an 'obesogenic' environment poses a serious challenge for weight maintenance. However, many people are able to maintain a healthy weight indicating that not everybody is equally susceptible to the temptations of this food environment. The way in which someone perceives and reacts to food cues, that is, cognitive processes, could underlie differences in susceptibility. An attention bias for food could be such a cognitive factor that contributes to overeating. However, an attention bias for food has also been implicated with restrained eating and eating-disorder symptomatology. The primary aim of the present review was to determine whether an attention bias for food is specifically related to obesity while also reviewing evidence for attention biases in eating-disorder patients, restrained eaters and healthy-weight individuals. Another aim was to systematically examine how selective attention for food relates (causally) to eating behaviour. Current empirical evidence on attention bias for food within obese samples, eating-disorder patients, and, even though to a lesser extent, in restrained eaters is contradictory. However, present experimental studies provide relatively consistent evidence that an attention bias for food contributes to subsequent food intake. This review highlights the need to distinguish not only between different (temporal) attention bias components, but also to take different motivations (craving v. worry) and their impact on attentional processing into account. Overall, the current state of research suggests that biased attention could be one important cognitive mechanism by which the food environment tempts us into overeating.

Evaluation of the nutrient-upgraded rodent food bar for rodent spaceflight experiments.

PubMed

Sun, Gwo-Shing; Tou, Janet C; Liittschwager, Kurt; Herrera, Anna M; Hill, Esther L; Girten, Beverly; Reiss-Bubenheim, Debra; Vasques, Marilyn

2010-01-01

Selection of an appropriate diet for rodent spaceflight experiments is critical and may have significant effects on mission results. The National Aeronautics and Space Administration (NASA) rodent food bar (RFB) was reformulated and designated as the nutrient-upgraded RFB (NuRFB). The objectives of this study were to determine whether the NuRFB nutrient formulation meets the 1995 National Research Council (NRC) nutrient recommendations and whether the NuRFB can be used for short-term (45-d) and long-term (90-d) spaceflight experiments. Nutrient and moisture analyses of the NuRFB were performed. Young (age 13-14 wk) male Sprague-Dawley rats (n=16/group) were individually caged and fed a diet treatment consisting of 1) NuRFB, 2) RFB, or 3) modified AIN-93G containing 4% instead of the 7% fat for 45- or 90-d. At the end of the study, organs were weighted, and serum clinical chemistry indicators of organ function and hematologic measurements were determined. Chemical analysis of the diet ingredients showed that the NuRFB met the 1995 NRC nutrient recommendations for rats. Subsequent animal feeding studies showed that NuRFB was comparable to RFB and modified AIN-93G for supporting rat growth and body weight maintenance. In addition, the safety of the NuRFB for use as a spaceflight diet was indicated by the absence of changes in organ weight or function. Based on the study results, the NuRFB performed similarly to the RFB and met the criteria necessary for short-term and long-term rodent spaceflight experiments. Published by Elsevier Inc.

Promoting weight maintenance with electronic health record tools in a primary care setting: Baseline results from the MAINTAIN-pc trial.

PubMed

Conroy, Molly B; Bryce, Cindy L; McTigue, Kathleen M; Tudorascu, Dana; Gibbs, Bethany Barone; Comer, Diane; Hess, Rachel; Huber, Kimberly; Simkin-Silverman, Laurey R; Fischer, Gary S

2017-03-01

Maintaining weight loss is a significant challenge in combating obesity. The goal of Maintaining Activity and Nutrition through Technology-Assisted Innovation in Primary Care (MAINTAIN-pc) is to evaluate the use of tools delivered through an electronic health record (EHR) and patient portal, with or without health coach support, to help primary care patients maintain weight loss. EHR tools include flowsheets, standardized surveys, and secure patient messaging. Inclusion criteria were age 18-75years, voluntary 5% weight loss in the past 2years with prior BMI≥25kg/m 2 , and no bariatric procedures in past 5years. Participants were randomized 1:1 to tailored online coaching with EHR tracking tools (CC) or EHR tracking tools alone (TO). We screened 721 individuals between October 2013 and February 2015; 194 participants enrolled (98 CC; 96 TO). The most common reasons for not enrolling included lack of interest (56%), not meeting age or weight loss criteria (17%), and no verified prior weight loss (10%). At baseline, participants were 53.4 (SD 12.2) years old, 74% female, and 88% White; 95% reported moderate physical activity. Average weight and BMI at baseline were 189.1 (SD 42.1) lbs and 30.4 (5.9) kg/m 2 , respectively. Pre-weight loss BMI was 34.4 (SD 6.5) kg/m 2 . Participants lost an average of 11.3% (SD 6.6) of their body weight before enrolling. Demographic and clinical characteristics did not differ by randomized group. The study successfully identified and recruited primary care patients with recent voluntary weight loss for participation in a weight maintenance program that uses EHR-based tools. Copyright © 2017 Elsevier Inc. All rights reserved.

Standing economy: does the heterogeneity in the energy cost of posture maintenance reside in differential patterns of spontaneous weight-shifting?

PubMed

Miles-Chan, Jennifer L; Fares, Elie-Jacques; Berkachy, Redina; Jacquet, Philippe; Isacco, Laurie; Schutz, Yves; Montani, Jean-Pierre; Dulloo, Abdul G

2017-04-01

Due to sedentarity-associated disease risks, there is much interest in methods to increase low-intensity physical activity. In this context, it is widely assumed that altering posture allocation can modify energy expenditure (EE) to impact body-weight regulation and health. However, we have recently shown the existence of two distinct phenotypes pertaining to the energy cost of standing-with most individuals having no sustained increase in EE during steady-state standing relative to sitting comfortably. Here, we investigated whether these distinct phenotypes are related to the presence/absence of spontaneous "weight-shifting", i.e. the redistribution of body-weight from one foot to the other. Using indirect calorimetry to measure EE in young adults during sitting and 10 min of steady-state standing, we examined: (i) heterogeneity in EE during standing (n = 36); (ii) EE and spontaneous weight-shifting patterns (n = 18); (iii) EE during spontaneous weight-shifting versus experimentally induced weight-shifting (n = 7), and; (iv) EE during spontaneous weight-shifting versus intermittent leg/body displacement (n = 6). Despite heterogeneity in EE response to steady-state standing, no differences were found in the amount or pattern of spontaneous weight-shifting between the two phenotypes. Whilst experimentally induced weight-shifting resulted in a mean EE increase of only 11% (range: 0-25%), intermittent leg/body displacement increased EE to >1.5 METs in all participants. Although the variability in spontaneous weight-shifting signatures between individuals does not appear to underlie heterogeneity in the energy cost of standing posture maintenance, these studies underscore the fact that leg/body displacement, rather than standing posture alone, is needed to increase EE above the currently defined sedentary threshold.

Heterogeneity of link weight and the evolution of cooperation

NASA Astrophysics Data System (ADS)

Iwata, Manabu; Akiyama, Eizo

2016-04-01

In this paper, we investigate the effect of heterogeneity of link weight, heterogeneity of the frequency or amount of interactions among individuals, on the evolution of cooperation. Based on an analysis of the evolutionary prisoner's dilemma game on a weighted one-dimensional lattice network with intra-individual heterogeneity, we confirm that moderate level of link-weight heterogeneity can facilitate cooperation. Furthermore, we identify two key mechanisms by which link-weight heterogeneity promotes the evolution of cooperation: mechanisms for spread and maintenance of cooperation. We also derive the corresponding conditions under which the mechanisms can work through evolutionary dynamics.

Body weight gain induced by a newer antipsychotic agent reversed as negative symptoms improved.

PubMed

Koga, M; Nakayama, K

2005-07-01

We describe a patient in whom improvement in negative symptoms contributed to early weight loss and subsequent long-term improvement in weight management. Case report. A 26-year-old woman with schizophrenia gained 7 kg over the course of 1 year after starting treatment with olanzapine. However, as negative symptoms gradually improved with treatment, she became motivated to diet and exercise regularly. She quickly lost 9 kg and subsequently maintained optimal weight (55 kg; body mass index, 24.1 kg/m(2) ). Important strategies for minimizing weight gain in patients taking antipsychotic agents include improving negative symptoms of avolition and apathy, regular monitoring of body weight and potential medical consequences of overweight and obesity, and educating the patient about the importance of diet and regular exercise.

The effect of a jail methadone maintenance therapy (MMT) program on inmate recidivism.

PubMed

McMillan, Garnett P; Lapham, Sandra; Lackey, Michael

2008-12-01

To evaluate the effects of a jail-based continuation of methadone maintenance therapy (MMT) on subsequent inmate recidivism risks. Prospective, longitudinal, observational study. A large, Southwestern United States jail that continues MMT for heroin-addicted inmates on MMT at the time of booking. A total of 589 inmates booked between 22 November 2005 (the start date for the MMT program) and 31 October 2006. The outcome measure was time from release to subsequent re-booking in the jail. Predictors included binary dosing with methadone in the jail, final dose received (mg), age, gender, race/ethnicity, previous bookings and days in jail. Random effects Weibull proportional hazards models were fit to the recidivism times to estimate the impact of treatment with MMT in the jail on re-booking risks. There was no statistically significant effect of receiving methadone in the jail or dosage on subsequent recidivism risks (hazard ratio = 1.16; 95% confidence interval = 0.8-1.68). Offering jail-based MMT does not increase recidivism risks by eliminating the deterrent effect of imposed withdrawal, nor does it reduce recidivism in this high-risk population.

Weight management for adolescents with intellectual and developmental disabilities: Rationale and design for an 18month randomized trial.

PubMed

Donnelly, J E; Ptomey, L T; Goetz, J R; Sullivan, D K; Gibson, C A; Greene, J L; Lee, R H; Mayo, M S; Honas, J J; Washburn, R A

2016-11-01

Adolescents with intellectual and developmental disabilities (IDD) are an underserved group in need of weight management. However, information regarding effective weight management for this group is limited, and is based primarily on results from small, non-powered, non-randomized trials that were not conducted in accordance with current weight management guidelines. Additionally, the comparative effectiveness of emerging dietary approaches, such as portion-controlled meals (PCMs) or program delivery strategies such as video chat using tablet computers have not been evaluated. Therefore, we will conduct an 18month trial to compare weight loss (6months) and maintenance (7-18months) in 123 overweight/obese adolescents with mild to moderate IDD, and a parent, randomized to a weight management intervention delivered remotely using FaceTime™ on an iPad using either a conventional meal plan diet (RD/CD) or a Stop Light diet enhanced with PCMs (RD/eSLD), or conventional diet delivered during face-to-face home visits (FTF/CD). This design will provide an adequately powered comparison of both diet (CD vs. eSLD) and delivery strategy (FTF vs. RD). Exploratory analyses will examine the influence of behavioral session attendance, compliance with recommendations for diet (energy intake), physical activity (min/day), self-monitoring of diet and physical activity, medications, and parental variables including diet quality, physical activity, baseline weight, weight change, and beliefs and attitudes regarding diet and physical activity on both weight loss and maintenance. We will also complete a cost and contingent valuation analysis to compare costs between RD and FTF delivery. Copyright © 2016. Published by Elsevier Inc.

The Long-term Outcomes of Sibutramine Effectiveness on Weight (LOSE Weight) study: evaluating the role of drug therapy within a weight management program in a group-model health maintenance organization.

PubMed

Porter, Julie A; Raebel, Marsha A; Conner, Douglas A; Lanty, Frances A; Vogel, Erin A; Gay, Elizabeth C; Merenich, John A

2004-06-01

To assess the benefit of sibutramine hydrochloride monohydrate within a weight management program. Prospective randomized controlled trial in a health maintenance organization. Obese patients (n = 588) starting a weight management program were enrolled. Patients were randomly assigned to participate in the program alone or to participate in the program and receive sibutramine for 12 months. Outcome measures were change in weight, body mass index (BMI), percentage body fat, serum lipids, serum glucose, and blood pressure. At baseline, there was a younger age and higher weight, BMI, and waist circumference in the drug group. There was more degenerative joint disease in the nondrug group. The mean weight loss at 6 months was 6.8 kg (95% confidence interval [CI], -7.4 to -6.1 kg) in the drug group vs 3.1 kg (95% CI, -3.8 to -2.4 kg) (P < .001) in the nondrug group. Weight loss was maintained at 12 months. Significant reductions in BMI, body fat, and waist circumference occurred in the drug group. There were no significant changes in laboratory values or blood pressure. Patients taking sibutramine experienced a significant increase in heart rate (1.7 beats/min [95% CI, 0.5-2.9 beats/min] vs -0.4 beats/min [95% CI, -1.5 to 0.8 beats/min]; P <.004). In this managed care setting, the effectiveness and safety of sibutramine were similar to those observed in randomized, double-blind clinical efficacy trials.

The liberating effect of weight loss supplements on dietary control: a field experiment.

PubMed

Chang, Yevvon Y; Chiou, Wen-Bin

2014-09-01

Taking weight-loss supplements may create illusion of protection against weight gain and thereby loosen subsequent dietary self-control. The current study examined whether taking weight-loss supplement would increase food intake and further tested whether positive attitudes toward supplements would increase susceptibility to overeating. Participants were randomly assigned to take either a known placebo or a purported weight loss supplement (actually, the same placebo). After supplement provision, participants' actual food consumption at a reward buffet lunch was recorded. Compared with controls, participants receiving a purported weight loss supplement ate more food at the reward buffet. Perceived progress toward the goal of weight reduction mediated the connection between use of weight loss supplements and subsequent food consumption. Participants with more positive attitudes toward weight loss supplements were more susceptible to the liberating effect of taking weight loss supplements on food intake. Using weight loss supplements may produce unintended consequences on dietary self-regulation. The public should pay more attention to the notion of psychological liberation when using weight loss supplements. Copyright © 2014 Elsevier Inc. All rights reserved.

Major depressive disorder, antidepressant use, and subsequent 2-year weight change patterns in the Netherlands Study of Depression and Anxiety.

PubMed

Gibson-Smith, Deborah; Bot, Mariska; Milaneschi, Yuri; Twisk, Jos W; Visser, Marjolein; Brouwer, Ingeborg A; Penninx, Brenda W J H

2016-02-01

Although depression and obesity are bidirectionally associated, little is known about weight changes following major depressive disorder (MDD). This study compared 2-year weight changes between patients with current MDD (cMDD), patients with remitted MDD (rMDD), and healthy controls. Additionally, we examined the relationship between antidepressant medication use and 2-year weight change. Data from 2,542 adults aged 18-65 y were sourced from the Netherlands Study of Depression and Anxiety. Data were collected at baseline and after 2, 4, and 6 years (September 2004-April 2013). Depression status (DSM-IV criteria for MDD) was established with the Composite International Diagnostic Interview. Subsequent 2-year weight changes were categorized as weight loss (> 5% loss), weight stable (within 5% weight loss or gain), and weight gain (> 5% gain). The association of depression status with subsequent weight change, with weight stable as reference category, was studied by combining all repeated measurements in a mixed multinomial logistical regression model. cMDD, but not rMDD, was significantly associated with both weight gain and weight loss over a 2-year period after adjustment for covariates (odds ratio [OR] = 1.67; 95% confidence interval [CI], 1.37-2.03; P < .001; and OR = 1.27; 95% CI 1.01-1.61; P = .045, respectively). Antidepressant use was associated with weight gain (SSRIs: OR = 1.26; 95% CI, 1.05-1.52; other antidepressants: OR = 1.36; 95% CI, 1.00-1.84; P < .05 for both), but not after considering depression status. Compared to cMDD patients who lost weight, those who gained weight had lower initial weight, were younger, had more comorbid anxiety disorders, and reported poorer quality of mood and reduced appetite as depressive symptoms. Compared to controls, cMDD participants have greater odds of either gaining or losing weight over a 2-year period, regardless of antidepressant use. © Copyright 2015 Physicians Postgraduate Press, Inc.

Evaluation of diet pattern and weight gain in postmenopausal women enrolled in the Women’s Health Initiative Observational Study

USDA-ARS?s Scientific Manuscript database

It is unclear which of four popular contemporary diet patterns is best for weight maintenance among postmenopausal women. Four dietary patterns were characterised among postmenopausal women aged 49-81 years (mean 63.6 (sd 7.4) years) from the Women's Health Initiative Observational Study: (1) a low-...

Achieving long-term weight maintenance in Mexican-American adolescents with a school-based intervention

USDA-ARS?s Scientific Manuscript database

This study evaluated 24-month outcomes of a school-based intensive lifestyle weight management program targeting overweight Mexican American adolescents. A total of 71 adolescents (32 males, 45.1%) between the ages of 10 and 14 at or above the 85th percentile for body mass index (BMI) were recruited...

Disentangling the contribution of the paretic and non-paretic ankle to balance control in stroke patients.

PubMed

van Asseldonk, Edwin H F; Buurke, Jaap H; Bloem, Bastiaan R; Renzenbrink, Gerbert J; Nene, Anand V; van der Helm, Frans C T; van der Kooij, Herman

2006-10-01

During stroke recovery, restoration of the paretic ankle and compensation in the non-paretic ankle may contribute to improved balance maintenance. We examine a new approach to disentangle these recovery mechanisms by objectively quantifying the contribution of each ankle to balance maintenance. Eight chronic hemiparetic patients were included. Balance responses were elicited by continuous random platform movements. We measured body sway and ground reaction forces below each foot to calculate corrective ankle torques in each leg. These measurements yielded the Frequency Response Function (FRF) of the stabilizing mechanisms, which expresses the amount and timing of the generated corrective torque in response to sway at the specified frequencies. The FRFs were used to calculate the relative contribution of the paretic and non-paretic ankle to the total amount of generated corrective torque to correct sway. All patients showed a clear asymmetry in the balance contribution in favor of the non-paretic ankle. Paretic balance contribution was significantly smaller than the contribution of the paretic leg to weight bearing, and did not show a clear relation with the contribution to weight bearing. In contrast, a group of healthy subjects instructed to distribute their weight asymmetrically showed a one-on-one relation between the contribution to weight bearing and to balance. We conclude that the presented approach objectively quantifies the contribution of each ankle to balance maintenance. Application of this method in longitudinal surveys of balance rehabilitation makes it possible to disentangle the different recovery mechanisms. Such insights will be critical for the development and evaluation of rehabilitation strategies.

Effects of gestational maternal undernutrition on growth, carcass composition and meat quality of rabbit offspring.

PubMed

Symeon, George K; Goliomytis, Michael; Bizelis, Iosif; Papadomichelakis, George; Pagonopoulou, Olga; Abas, Zafeiris; Deligeorgis, Stelios G; Chadio, Stella E

2015-01-01

An experiment was conducted in order to evaluate the effects of gestational undernutrition of rabbit does on growth, carcass composition and meat quality of the offsprings. Thirty primiparous non lactating rabbit does were artificially inseminated and randomly divided in three treatment groups: Control (C; fed to 100% of maintenance requirements throughout gestation, n = 10), early undernourished (EU; fed to 50% of maintenance requirements during days 7-19 of gestation, n = 10) and late undernourished (LU; fed to 50% of maintenance requirements during days 20-27 of gestation, n = 10). During the 4th week of the gestation period, LU does significantly lost weight compared to C and EU groups (P<0.05). At kindling, C does produced litters with higher proportions of stillborn kits (P<0.05) while the total litter size (alive and stillborn kits) was not different among groups (10.7, 12.8 and 12.7 kits in C, EU and LU groups, respectively). Kit birth weight tended to be lower in the LU group. During fattening, body weight and feed intake were not different among offsprings of the three experimental groups. Moreover, the maternal undernutrition did not have any impact on carcass composition of the offsprings in terms of carcass parts and internal organs weights as well as meat quality of L. lumborum muscle (pH24, colour, water holding capacity and shear values) at slaughter (70 days of age). Therefore, it can be concluded that the gestational undernutrition of the mother does not have detrimental effects on the productive and quality traits of the offsprings.

Effects of Gestational Maternal Undernutrition on Growth, Carcass Composition and Meat Quality of Rabbit Offspring

PubMed Central

Symeon, George K.; Goliomytis, Michael; Bizelis, Iosif; Papadomichelakis, George; Pagonopoulou, Olga; Abas, Zafeiris; Deligeorgis, Stelios G.; Chadio, Stella E.

2015-01-01

An experiment was conducted in order to evaluate the effects of gestational undernutrition of rabbit does on growth, carcass composition and meat quality of the offsprings. Thirty primiparous non lactating rabbit does were artificially inseminated and randomly divided in three treatment groups: Control (C; fed to 100% of maintenance requirements throughout gestation, n = 10), early undernourished (EU; fed to 50% of maintenance requirements during days 7–19 of gestation, n = 10) and late undernourished (LU; fed to 50% of maintenance requirements during days 20-27 of gestation, n = 10). During the 4th week of the gestation period, LU does significantly lost weight compared to C and EU groups (P<0.05). At kindling, C does produced litters with higher proportions of stillborn kits (P<0.05) while the total litter size (alive and stillborn kits) was not different among groups (10.7, 12.8 and 12.7 kits in C, EU and LU groups, respectively). Kit birth weight tended to be lower in the LU group. During fattening, body weight and feed intake were not different among offsprings of the three experimental groups. Moreover, the maternal undernutrition did not have any impact on carcass composition of the offsprings in terms of carcass parts and internal organs weights as well as meat quality of L. lumborum muscle (pH24, colour, water holding capacity and shear values) at slaughter (70 days of age). Therefore, it can be concluded that the gestational undernutrition of the mother does not have detrimental effects on the productive and quality traits of the offsprings. PMID:25671602

Ghrelin, leptin, adiponectin, and insulin levels and concurrent and future weight change in overweight, postmenopausal women.

PubMed

Soni, Amy C; Conroy, Molly B; Mackey, Rachel H; Kuller, Lewis H

2011-03-01

Weight loss and maintenance can be particularly challenging for postmenopausal women given the changes in body composition, metabolism, and lifestyle that can accompany the menopausal transition. Peptides mediating energy homeostasis (ghrelin, leptin, adiponectin, and insulin) may play an important role in the weight and body composition changes of postmenopausal women and may in turn be affected by hormone therapy (HT) use. This study examines how success with weight loss may be related to peptides mediating energy homeostasis and HT use. The present analysis involves 200 women from a lifestyle intervention trial in overweight, postmenopausal women for whom data on the peptides ghrelin, leptin, adiponectin, and insulin were collected at 0 and 18 months. Peptide levels were compared with changes in weight from 0 to 18 and from 18 to 30 months. Baseline peptide levels were not significantly related to future weight change. From 0 to 18 months, ghrelin (P = 0.0005) and adiponectin (P ≤ 0.0001) levels increased, whereas leptin (P ≤ 0.0001) and insulin (P = 0.0003) levels decreased with increasing amount of weight loss. However, only leptin change was related to 18-30-month weight change. Women who were on HT at 0 months but discontinued by 18 months had a greater increase in ghrelin level from 0 to 18 months compared with women with continuous HT use or nonuse. In overweight, postmenopausal women, changes in energy homeostasis peptides relate to both concurrent and future weight change. Future studies should continue to address how ghrelin, leptin, insulin, and adiponectin contribute to body composition changes and weight loss maintenance after menopause.

Ghrelin, Leptin, Adiponectin, and Insulin Levels and Concurrent and Future Weight Change in Overweight Postmenopausal Women

PubMed Central

Soni, Amy C.; Conroy, Molly B.; Mackey, Rachel H.; Kuller, Lewis H.

2010-01-01

Objective Weight loss and maintenance can be particularly challenging for postmenopausal women given the changes in body composition, metabolism, and lifestyle that can accompany the menopausal transition. Peptides mediating energy homeostasis (i.e., ghrelin, leptin, adiponectin, and insulin) may play an important role in the weight and body composition changes of postmenopausal women, and may in turn be affected by hormone therapy (HT) use. This study examines how success with weight loss may be related to peptides mediating energy homeostasis and HT use. Methods The present analysis involves 200 women from a lifestyle intervention trial in overweight, postmenopausal women for whom data on the peptides ghrelin, leptin, adiponectin, and insulin were collected at 0 and 18 months. Peptide levels were compared to changes in weight from 0-18 and18-30 months. Results Baseline peptide levels were not significantly related to future weight change. From 0-18 months, ghrelin (p=0.0005) and adiponectin (p=<0.0001) levels increased, while leptin (p=<0.0001), and insulin (p=0.0003) decreased with increasing amount of weight loss. However, only leptin change was related to 18-30 month weight change. Women who were on HT at 0 months but discontinued by 18 months had a greater increase in ghrelin from 0-18 months compared to women with continuous HT use or non-use. Conclusions In overweight, postmenopausal women, changes in energy homeostasis peptides relate to both concurrent and future weight change. Future studies should continue to address the how ghrelin, leptin, insulin, and adiponectin contribute to body composition changes and weight loss maintenance after menopause. PMID:21449093

Internet-Based Recording Service Solves Maintenance Reporting Problems.

ERIC Educational Resources Information Center

Noah, Marilyn

2001-01-01

Details the response to a health threat caused by illegal wastewater disposal in Wisconsin. Traces the identification of the problem, ordinances and policies adopted to guide the remedy, and subsequent monitoring of environmental quality. (DDR)

Maintenance Energy Requirements of Double-Muscled Belgian Blue Beef Cows.

PubMed

Fiems, Leo O; De Boever, Johan L; Vanacker, José M; De Campeneere, Sam

2015-02-13

Sixty non-pregnant, non-lactating double-muscled Belgian Blue (DMBB) cows were used to estimate the energy required to maintain body weight (BW). They were fed one of three energy levels for 112 or 140 days, corresponding to approximately 100%, 80% or 70% of their total energy requirements. The relationship between daily energy intake and BW and daily BW change was developed using regression analysis. Maintenance energy requirements were estimated from the regression equation by setting BW gain to zero. Metabolizable and net energy for maintenance amounted to 0.569 ± 0.001 and 0.332 ± 0.001 MJ per kg BW(0.75)/d, respectively. Maintenance energy requirements were not dependent on energy level (p > 0.10). Parity affected maintenance energy requirements (p < 0.001), although the small numerical differences between parities may hardly be nutritionally relevant. Maintenance energy requirements of DMBB beef cows were close to the mean energy requirements of other beef genotypes reported in the literature.

A Longitudinal Study of Childhood Obesity, Weight Status Change, and Subsequent Academic Performance in Taiwanese Children

ERIC Educational Resources Information Center

Chen, Li-Jung; Fox, Kenneth R.; Ku, Po-Wen; Wang, Ching-Hui

2012-01-01

Backround: This study examined the association among childhood obesity, weight status change, and subsequent academic performance at 6-year follow-up. Methods: First-grade students from one elementary school district in Taichung City, Taiwan were followed for 6 years (N = 409). Academic performance was extracted from the school records at the end…

Higher Weight, Lower Education: A Longitudinal Association between Adolescents' Body Mass Index and Their Subsequent Educational Achievement Level?

ERIC Educational Resources Information Center

Larsen, Junilla K.; Kleinjan, Marloes; Engels, Rutger C. M. E.; Fisher, Jennifer O.; Hermans, Roel

2014-01-01

Background: The purpose of this study was to examine the association between adolescents' body mass index (BMI) z-scores and their subsequent level of schooling, extending previous longitudinal research by using objectively measured weight and height data. Methods: A longitudinal study with 3 study waves (1-year intervals) involving 1248 Dutch…

Application of Entropy Method in River Health Evaluation Based on Aquatic Ecological Function Regionalization

NASA Astrophysics Data System (ADS)

Shi, Yan-ting; Liu, Jie; Wang, Peng; Zhang, Xu-nuo; Wang, Jun-qiang; Guo, Liang

2017-05-01

With the implementation of water environment management in key basins in China, the monitoring and evaluation system of basins are in urgent need of innovation and upgrading. In view of the heavy workload of existing evaluation methods and the cumbersome calculation of multi-factor weighting method, the idea of using entroy method to assess river health based on aquatic ecological function regionalization was put forward. According to the monitoring data of songhua river in the year of 2011-2015, the entropy weight method was used to calculate the weight of 9 evaluation factors of 29 monitoring sections, and the river health assessment was carried out. In the study area, the river health status of the biodiversity conservation function area (4.111 point) was good, the water conservation function area (3.371 point), the habitat maintenance functional area (3.262 point), the agricultural production maintenance functional area (3.695 point) and the urban supporting functional area (3.399 point) was light pollution.

A Pilot Study of Randomized, Head-to-Head of Metformin Versus Topiramate in Obese People With Schizophrenia.

PubMed

Peng, Po-Jui; Ho, Pei-Shen; Tsai, Chia-Kuang; Huang, San-Yuan; Liang, Chih-Sung

A number of research studies support the weight loss effects of metformin and topiramate for obese people with schizophrenia. However, only a few studies have addressed the sustainability of the body weight reduction after discontinuation of these drugs. Moreover, head-to-head studies are still lacking. The study aims to evaluate and compare the efficacy of metformin and topiramate in weight reduction and weight maintenance after discontinuation of these drugs in obese people with schizophrenia. Twenty-two obese inpatients with schizophrenia were recruited and randomized into the metformin group (n = 11; daily dose, 1000 mg) and the topiramate group (n = 11; daily dose, 100 mg). A head-to-head, fixed-dose, and single-blinded design was used. Ten obese patients with schizophrenia of similar sex as that of the treated group were included as the control group. After a 4-month treatment, the metformin group showed a body weight reduction of 3.8 kg, and the topiramate group showed a reduction of 2.7 kg. However, the reduction could be sustained only in the metformin group at 3 and 9 months after metformin discontinuation. Interestingly, 3 months after treatment discontinuation, leptin levels showed a reduction in both metformin (baseline, 25.3 ± 14.7, week 7: 5.7 ± 3.7 ng/mL) and topiramate (baseline: 28.4 ± 16.1, week 7: 9.2 ± 15.5 ng/mL) groups. The trend of weight changes supports the superiority of metformin at 1000 mg/d over topiramate at 100 mg/d in weight reduction and weight maintenance.

Awakening: a qualitative study on maintaining weight loss after bariatric surgery.

PubMed

Liebl, Lori; Barnason, Susan; Brage Hudson, Diane

2016-04-01

To describe the experiences of adults who were successful in maintaining weight loss after bariatric surgery. The majority of studies examine a homogenous demographic group of postbariatric surgical patients who have gone through initial weight loss, which occurs within the first 12-24 months post surgery. Maintenance of weight loss begins 24 months after bariatric surgery; however, there is a paucity of research examining experiences during this period. The lack of conclusive research related to interactions between intrapersonal, behavioural and environmental influences suggests a need to develop a better understanding of patients' experiences related to weight loss maintenance post bariatric surgery. Bandura's Social Cognitive Theory provided the framework for the semi-structured interviews for this qualitative descriptive study. In-person interviews with n = 14 participants who were able to maintain weight loss at least 24 months after a bariatric surgery. Participants experienced an awakening and gained a new perspective on their life. They identified negative attitudes, influences and behaviours and modified their environment to support their desired healthy behaviour. To maintain weight loss, an individual must seek out and be surrounded by positive family and peer support influences. Positive support may provide the opportunity for an individual to place personal health needs as a priority. Therapeutic education and counselling for individuals, couples and families should occur during all phases of bariatric surgery. Communication techniques may empower clients to deflect negative comments and influences in a constructive manner. Support groups should accommodate the various phases of bariatric surgery. Clients should be prepared for how to work through emotions associated with weight fluctuations. © 2016 John Wiley & Sons Ltd.

Leptin Is Required for Glucose Homeostasis after Roux-en-Y Gastric Bypass in Mice.

PubMed

Mokadem, Mohamad; Zechner, Juliet F; Uchida, Aki; Aguirre, Vincent

2015-01-01

Leptin, the protein product of the ob gene, increases energy expenditure and reduces food intake, thereby promoting weight reduction. Leptin also regulates glucose homeostasis and hepatic insulin sensitivity via hypothalamic proopiomelanocortin neurons in mice. Roux-en-Y gastric bypass (RYGB) induces weight loss that is substantial and sustained despite reducing plasma leptin levels. In addition, patients who fail to undergo diabetes remission after RYGB are hypoletinemic compared to those who do and to lean controls. We have previously demonstrated that the beneficial effects of RYGB in mice require the melanocortin-4 receptor, a downstream effector of leptin action. Based on these observations, we hypothesized that leptin is required for sustained weight reduction and improved glucose homeostasis observed after RYGB. To investigate this hypothesis, we performed RYGB or sham operations on leptin-deficient ob/ob mice maintained on regular chow. To investigate whether leptin is involved in post-RYGB weight maintenance, we challenged post-surgical mice with high fat diet. RYGB reduced total body weight, fat and lean mass and caused reduction in calorie intake in ob/ob mice. However, it failed to improve glucose tolerance, glucose-stimulated plasma insulin, insulin tolerance, and fasting plasma insulin. High fat diet eliminated the reduction in calorie intake observed after RYGB in ob/ob mice and promoted weight regain, although not to the same extent as in sham-operated mice. We conclude that leptin is required for the effects of RYGB on glucose homeostasis but not body weight or composition in mice. Our data also suggest that leptin may play a role in post-RYGB weight maintenance.

Applying RE-AIM to the evaluation of FUEL Your Life : a worksite translation of DPP.

PubMed

Brace, Andrea M; Padilla, Heather M; DeJoy, David M; Wilson, Mark G; Vandenberg, Robert J; Davis, Marsha

2015-01-01

Weight management programs are becoming increasingly common in workplace settings; however, few target middle-aged men. The purpose of this article is to describe the process evaluation of a worksite translation of the Diabetes Prevention Program in a predominantly middle-aged male population. The translated program, FUEL Your Life, was largely self-directed, with support from peer health coaches and occupational health nurses. The RE-AIM (Reach Effectiveness Adoption Implementation Maintenance) framework was used to examine the factors that influenced program implementation using data from an environmental assessment, participant surveys, peer health coach surveys, and occupational health nurse interviews. An overwhelming majority of the employees who enrolled in the study were overweight or obese (92%). Overall, the program was effective for weight maintenance; those with higher levels of participation and engagement had better weight loss outcomes. The peer health coach and family elements of the intervention were underused. The program was successful in reaching the intended population; however, the program had limited success in engaging this population. Not surprisingly, weight loss was a function of participant engagement and participation. Increasing participant engagement and participation is important to the success of weight management interventions translated to the worksite setting. Garnering buy-in and support from management can serve to increase the perceived importance of weight management in worksites. With management support, weight management protocols could be integrated as a component of the mandatory safety and health assessments already in place, fostering promotion of healthy weight in the workforce. © 2014 Society for Public Health Education.

Medical weight loss versus bariatric surgery: does method affect body composition and weight maintenance after 15% reduction in body weight?

PubMed

Kulovitz, Michelle G; Kolkmeyer, Deborah; Conn, Carole A; Cohen, Deborah A; Ferraro, Robert T

2014-01-01

The aim of this study was to investigate body composition changes in fat mass (FM) to lean body mass (LBM) ratios following 15% body weight loss (WL) in both integrated medical treatment and bariatric surgery groups. Obese patients (body mass index [BMI] 46.6 ± 6.5 kg/m(2)) who underwent laparoscopic gastric bypass surgery (BS), were matched with 24 patients undergoing integrated medical and behavioral treatment (MT). The BS and MT groups were evaluated for body weight, BMI, body composition, and waist circumference (WC) at baseline and after 15% WL. Following 15% body WL, there were significant decreases in %FM and increased %LBM (P < 0.0001). Additionally, both groups saw 76% of WL from FM, and 24% from LBM indicating a 3:1 ratio of FM to LBM loss during the first 15% reduction in body weight. Finally, no significant differences (P = 0.103) between groups for maintenance of WL at 1 y were found. For both groups, baseline FM was found to be negatively correlated with percentage of weight regained (%WR) at 1 y post-WL (r = -0.457; P = 0.007). Baseline WC and rate of WL to 15% were significant predictors of %WR only in the BS group (r = 0.713; P = 0.020). If followed closely by professionals during the first 15% body WL, patients losing 15% weight by either medical or surgical treatments can attain similar FM:LBM loss ratios and can maintain WL for 1 y. Copyright © 2014 Elsevier Inc. All rights reserved.

Targeting the postpartum period to promote weight loss: a systematic review and meta-analysis.

PubMed

Dodd, Jodie M; Deussen, Andrea R; O'Brien, Cecelia M; Schoenaker, Danielle A J M; Poprzeczny, Amanda; Gordon, Adrienne; Phelan, Suzanne

2018-06-07

Many international clinical guidelines recommend that overweight and obese women lose weight prior to pregnancy to reduce the risk of adverse pregnancy outcomes. Women who have recently given birth and plan future pregnancies are an important target population for preconception weight-loss interventions. A systematic review to evaluate postpartum dietary and/or physical activity interventions to promote weight loss and improve health in a subsequent pregnancy was conducted. Five databases-the Cochrane Central Register of Controlled Trials, MEDLINE (through PubMed), Embase, the Australian New Zealand Clinical Trials Registry, and the International Clinical Trials Registry-were searched using the following terms: preconception, pregnancy, postpartum, pregnancy outcomes, body mass index, weight gain, weight loss, weight change, postpartum weight retention, dietary or lifestyle intervention, and randomiz(s)ed controlled trial. The date of last search was November 2017. Data were extracted from each identified study using a standard form. The primary outcomes were weight loss at the completion of the intervention and at follow-up assessments. Secondary endpoints included maternal and infant outcomes in a subsequent pregnancy. Mean differences (MDs) were calculated for continuous data and risk ratios for dichotomous data, both with 95%CIs. A total of 235 abstracts (193 after duplicates were excluded) were identified, from which 37 manuscripts were selected for full-text review. In total, 27 trials were identified for inclusion. Outcome data were available for approximately 75% of participants (n = 3485). A combined dietary and physical activity intervention provided post partum produced greater postpartum weight loss (MD, -2.49 kg; 95%CI, -3.34 to -1.63 kg [random-effects model]; 12 studies, 1156 women), which was maintained at 12 months post partum (MD, -2.41 kg; 95%CI, -3.89 to -0.93 kg [random-effects model]; 4 studies, 405 women), compared with no intervention. No studies reported maternal or infant health outcomes in a subsequent pregnancy. Providing a postpartum intervention is associated with weight loss after birth, but effects on maternal and infant health in a subsequent pregnancy are uncertain.

Direct but no transgenerational effects of decitabine and vorinostat on male fertility.

PubMed

Kläver, Ruth; Sánchez, Victoria; Damm, Oliver S; Redmann, Klaus; Lahrmann, Elisabeth; Sandhowe-Klaverkamp, Reinhild; Rohde, Christian; Wistuba, Joachim; Ehmcke, Jens; Schlatt, Stefan; Gromoll, Jörg

2015-01-01

Establishment and maintenance of the correct epigenetic code is essential for a plethora of physiological pathways and disturbed epigenetic patterns can provoke severe consequences, e.g. tumour formation. In recent years, epigenetic drugs altering the epigenome of tumours actively have been developed for anti-cancer therapies. However, such drugs could potentially also affect other physiological pathways and systems in which intact epigenetic patterns are essential. Amongst those, male fertility is one of the most prominent. Consequently, we addressed possible direct effects of two epigenetic drugs, decitabine and vorinostat, on both, the male germ line and fertility. In addition, we checked for putative transgenerational epigenetic effects on the germ line of subsequent generations (F1-F3). Parental adult male C57Bl/6 mice were treated with either decitabine or vorinostat and analysed as well as three subsequent untreated generations derived from these males. Treatment directly affected several reproductive parameters as testis (decitabine & vorinostat) and epididymis weight, size of accessory sex glands (vorinostat), the height of the seminiferous epithelium and sperm concentration and morphology (decitabine). Furthermore, after decitabine administration, DNA methylation of a number of loci was altered in sperm. However, when analysing fertility of treated mice (fertilisation, litter size and sex ratio), no major effect of the selected epigenetic drugs on male fertility was detected. In subsequent generations (F1-F3 generations) only subtle changes on reproductive organs, sperm parameters and DNA methylation but no overall effect on fertility was observed. Consequently, in mice, decitabine and vorinostat neither affected male fertility per se nor caused marked transgenerational effects. We therefore suggest that both drugs do not induce major adverse effects-in terms of male fertility and transgenerational epigenetic inheritance-when used in anti-cancer-therapies.

Lifestyle intervention reduces body weight and improves cardiometabolic risk factors in worksites.

PubMed

Salinardi, Taylor C; Batra, Payal; Roberts, Susan B; Urban, Lorien E; Robinson, Lisa M; Pittas, Anastassios G; Lichtenstein, Alice H; Deckersbach, Thilo; Saltzman, Edward; Das, Sai Krupa

2013-04-01

Worksites are potentially effective locations for obesity control because they provide opportunities for group intervention and social support. Studies are needed to identify effective interventions in these settings. We examined the effects of a multicomponent lifestyle intervention on weight loss and prevention of regain in 4 worksites (2 intervention and 2 control sites). Overweight and obese employees (n = 133) enrolled in this pilot worksite-randomized controlled trial with a 0-6-mo weight-loss phase and a 6-12-mo structured weight-maintenance phase. The intervention combined recommendations to consume a reduced-energy, low-glycemic load, high-fiber diet with behavioral change education. Outcome measurements included changes in body weight and cardiometabolic risk factors. The mean ± SEM weight loss was substantial in intervention participants, whereas control subjects gained weight (-8.0 ± 0.7 compared with +0.9 ± 0.5 kg, respectively; P < 0.001), and 89% of participants completed the weight-loss phase. Intervention effects were not significant at the 0.05 level but would have been at the 0.10 level (P = 0.08) in a mixed model in which the worksite nested within group was a random factor. There were also significant improvements in cardiometabolic risk factors in intervention compared with control subjects regarding fasting total cholesterol, glucose, systolic blood pressure, and diastolic blood pressure (P ≤ 0.02 for each). No significant weight regain was observed in participants who enrolled in the structured weight-maintenance program (0.5 ± 0.7 kg; P = 0.65), and overweight and obese employees in intervention worksites who were not enrolled in the weight-loss program lost weight compared with subjects in control worksites (-1.3 ± 0.5 compared with +0.7 ± 0.2 kg, respectively; P = 0.02). Worksites can be effective for achieving clinically important reductions in body weight and improved cardiometabolic risk factors. This trial was registered at clinicaltrials.gov as NCT01470222.

A qualitative investigation of attitudes towards aerobic and resistance exercise amongst overweight and obese individuals.

PubMed

Guess, Nicola

2012-04-25

Most people are not meeting the minimal requirements for physical activity participation, particularly people who are overweight or obese. Numerous initiatives have been developed which aim to increase levels of physical activity in this group, yet little is known about their feelings towards different types of exercise. In particular, resistance exercise may offer unique benefits to people seeking to lose weight, yet no study to date has examined views of resistance exercise amongst the overweight and obese. This qualitative study examined the views and attitudes towards aerobic and resistance exercise amongst overweight and obese individuals engaged in a weight management clinic. 30 overweight and obese patients comprised of 25 females and 5 males, with a mean age of 40.7 years (SD = 15.2) and mean BMI of 33.8 kg/m2 (SD = 7.9) were recruited from a dietetic clinic to take part in baseline focus groups and interviews to assess their views on physical activity. After selecting and participating in a 12 week aerobic- or resistance-exercise program, the participants took part in follow-up interviews. Thematic analysis was then performed on the transcribed focus group and interview data. For the overweight and obese women in this study, weight loss was the primary motivation for physical activity participation. Subsequently, these women perceived a failure to lose weight as strongly affecting their motivation to continue or re-engage in physical activity. Only 3 participants selected the resistance exercise option. The view of resistance exercise as a masculine activity was a dominant theme amongst all participants. A lack of knowledge of how to perform certain exercises emerged as a barrier, but was seen by the participants as surmountable given appropriate instruction. The females in this study cited weight loss as a primary motivation for physical activity participation. This view must be reconciled with the existing knowledge base of physical activity requirements for successful weight loss and maintenance. Participants in this study had little awareness or experience of resistance exercise, and many were fearful of the potential risks.

Research on the Decision Method of Maintenance Materials Direct Supply

NASA Astrophysics Data System (ADS)

Zhu, Qian; Shi, Xiaopei; Liu, Shenyang; Luo, Guangxu; Zhu, Chen

2018-05-01

With the further development of civil military integration, more and more maintenance materials will be supplied by the factory directly. Aiming at the mode condition of maintenance materials factory direct supply, maintenance materials needs equipment support in the process of facing a number of direct supply manufacturers how to decision problems, using AHP, considering many factors optimization of direct supply manufacturers involved, and gives the weights of the evaluation indexes of the direct supply manufacturers to evaluate optimal. Finally, with 4 straights for the manufacturer as an example, considering the various evaluation indexes to carry out evaluation and drawing the correct evaluation of direct supply manufacturers, the best manufacturers direct supply is selected. An example shows that, AHP can provide scientific and theoretical basis to materials factory direct supply security.

Flight Crew Health Maintenance

NASA Technical Reports Server (NTRS)

Gullett, C. C.

1970-01-01

The health maintenance program for commercial flight crew personnel includes diet, weight control, and exercise to prevent heart disease development and disability grounding. The very high correlation between hypertension and overweight in cardiovascular diseases significantly influences the prognosis for a coronary prone individual and results in a high rejection rate of active military pilots applying for civilian jobs. In addition to physical fitness the major items stressed in pilot selection are: emotional maturity, glucose tolerance, and family health history.

Repeated in utero and lactational 2,3,7,8-tetrachlorodibenzo-p-dioxin exposure affects male gonads in offspring, leading to sex ratio changes in F{sub 2} progeny

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ikeda, Masahiko; Tamura, Masashi; Yamashita, Junko

2005-08-15

The effects of in utero and lactational 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on the reproductive system of male rat offspring (F{sub 1}) and the sex ratio of the subsequent generation (F{sub 2}) were examined. Female Holtzman rats were gavaged with an initial loading dose of 400 ng/kg TCDD prior to mating, followed by weekly maintenance doses of 80 ng/kg during mating, pregnancy, and the lactation period. Maternal exposure to TCDD had no significant effects on fetus/pup (F{sub 1}) mortality, litter size, or sex ratio on gestation day (GD) 20 or postnatal day (PND) 2. The TCDD concentration in maternal livers and adipose tissuemore » on GD20 was 1.21 and 1.81 ng/kg, respectively, and decreased at weaning to 0.72 in the liver and 0.84 in the adipose tissue. In contrast, the TCDD concentration in pup livers was 1.32 ng/kg on PND2 and increased to 1.80 ng/kg at weaning. Ventral prostate weight of male offspring was significantly decreased by TCDD exposure on PND28 and 120 compared with that of controls. Weight of the testes, cauda epididymides, and seminal vesicle, and sperm number in the cauda epididymis were not changed by TCDD exposure at PND120. TCDD- or vehicle-exposed male offspring were mated with unexposed females. The sex ratio (percentage of male pups) of F{sub 2} offspring was significantly reduced in the TCDD-exposed group compared with controls. These results suggest that in utero and lactational TCDD exposures affect the development of male gonads in offspring (F{sub 1}), leading to changes in the sex ratio of the subsequent generation (F{sub 2})« less

Effect on 12-week Intensive Dietary and Exercise Program on Weight Reduction and Maintenance in Obese Women with Weight Cycling History.

PubMed

Kwon, Ha Nui; Nam, Sang-Seok; Park, Yoo Kyoung

2017-07-01

This study examined the effect of 12-week intensive dietary and exercise intervention program on body composition and stress-related hormones in obese women and to examine the residual effect after the intervention. The participants of this study were 30 obese women who had a body mass index of over 25 kg/m 2 and over 30% in body fat. They were classified into 2 groups depending on the history of weight cycling (WC); the WC group (≥ ±5% of the original body weight) and the non-weight cycling (NWC) group. Both groups were subject to a nutritional intervention program every 2 weeks with a mandatory exercise intervention for 12 weeks. Thereafter, the nutrition/exercise interventions were ceased for 12 weeks, after which the participants' levels of the hormones relating to energy metabolism and stress, meal intakes, dietary habits, level of knowledge on sodium intake, frequency of sodium intake, and quality of life (QOL) were checked. The changes of body weight were 71.3 ± 5.5 kg (week 0) vs. 65.0 ± 6.6 kg (week 12) vs. 65.6 ± 7.1 kg (week 24) in WC group and 71.6 ± 8.6 kg (week 0) vs. 68.8 ± 9.7 kg (week 12) vs. 70.3 ± 9.4 kg (week 24) in the NWC group. The levels of hormones, meal intakes, and QOL scores were better in the WC group, as adherence to the nutritional intervention was higher. We suggest that that adherence to dietary habits heavily influences weight loss and maintenance in individuals who frequently attempt to lose weight and consequently go through a vicious cycle of weight recycling.

High or low intensity text-messaging combined with group treatment equally promote weight loss maintenance in obese adults.

PubMed

Zwickert, Kristy; Rieger, Elizabeth; Swinbourne, Jessica; Manns, Clare; McAulay, Claire; Gibson, Alice A; Sainsbury, Amanda; Caterson, Ian D

Text-message and e-mail are emerging as potential methods for improving weight outcomes among obese individuals. The optimal volume, frequency, and timing of such interventions are unknown. This study investigated the effect of adjunct technological support on weight and psychological variables after a 3-month cognitive-behaviour therapy (CBT) group intervention. Sixty obese adults were randomised to a CBT programme plus intensive (text-message and e-mail; CBT+ITS) or minimal (text-message only; CBT+MTS) technological support. Assessments occurred at baseline, 3-, 6-, 9-, and 15-months. Outcome variables included weight (kg), body mass index (kg/m 2 ), waist circumference (cm), binge-eating tendencies, weight self-efficacy, and weight control cognitions and behaviours. CBT+ITS (n=31) and CBT+MTS (n=29) participants lost 5.2% (±1.1) and 4.7% (±1.1) of their baseline weight by 3-months, 8.4% (±1.2) and 6.4% (±1.1) by 6-months, 9.6% (±1.3) and 6.4% (±1.3) by 9-months, and sustained a 7.5% (±1.3) and 5.1% (±1.3) loss at 15-months, respectively. There were no significant differences between intensive and minimal support, however, the CBT+ITS group showed a marginal advantage across all anthropometric measures. A low intensity text-message support programme is just as effective as higher intensity technological support for maintaining weight loss in obese adults. This represents a low-cost means of aiding weight loss maintenance without reliance on extended face-to-face treatment. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

[Intensive care of children with DIC syndrome based on the use of low molecular weight heparins].

PubMed

Chuprova, A V; Shmakov, A N; Solov'ev, O N; Anokhina, T Iu; Loskutova, S A; Pinegina, Iu S

2002-01-01

The first section of this paper presents data on low-molecular-weight heparins: pharmacokinetics and pharmacodynamics, advantages in comparison with common heparin. The second section presents the results of fraxiparin and clivarin use in 43 children aged 9 months to 14 years with acute/subacute DIC syndrome of infectious origin. Therapeutic and maintenance doses, the mode of injection of low-molecular-weight heparins, and methods for laboratory monitoring of their efficiency and safety are presented.

Body image and self-esteem among adolescents undergoing an intervention targeting dietary and physical activity behaviors.

PubMed

Huang, Jeannie S; Norman, Gregory J; Zabinski, Marion F; Calfas, Karen; Patrick, Kevin

2007-03-01

To determine the effect of a one-year intervention targeting physical activity, sedentary, and diet behaviors among adolescents on self-reported body image and self-esteem. Health promotion interventions can lead to awareness of health risk and subsequent adoption of beneficial changes in behavior. However, it is possible that interventions targeting behaviors associated with childhood obesity may also increase the likelihood of unhealthy eating and physical activity obsessions and behaviors. Body image and self-esteem were assessed for adolescents participating in the PACE+ study, a randomized controlled trial of a 1-year behavioral intervention targeting physical activity, sedentary, and dietary behaviors. The Body Dissatisfaction subscale of the Eating Disorder Inventory and Rosenberg Self-Esteem scale were used to assess body image and self-esteem, respectively, and measurements were performed at baseline, and at 6 and 12 months. Demographic characteristics and weight status of participants were also ascertained. Analysis of responses was performed via both between-group and within-group repeated measure analyses. There were 657 adolescents who completed all measurements. Body image differences were found for age, gender, and weight status at baseline, whereas self-esteem differences were demonstrated for gender, ethnicity, and weight status. There were no intervention effects on body image or self-esteem for either girls or boys. Self-esteem and body satisfaction did not worsen as a result of participating in the PACE+ intervention for either boys or girls whether or not they lost or maintained their weight or gained weight. Girls assigned to the PACE intervention who experienced weight reduction or weight maintenance at either 6 or 12 months reported improvements in body image satisfaction (p = .02) over time compared with subjects who had experienced weight gain during the 12-month study period. Adverse effects on body satisfaction and self-esteem were not observed among adolescents undergoing this behavioral intervention. These results suggest that a behavioral intervention directed at improving physical activity and diet habits may be safely undertaken by adolescents, including those who are overweight and at risk for overweight, without adverse psychological consequences. Inclusion of specific elements in the intervention that directly addressed body image and self-esteem issues may have reduced the risk for negative psychological effects.

Body Image and Self-Esteem among Adolescents undergoing an Intervention Targeting Dietary and Physical Activity Behaviors

PubMed Central

Huang, Jeannie S.; Norman, Gregory J.; Zabinski, Marion F.; Calfas, Karen; Patrick, Kevin

2007-01-01

Background Health promotion interventions can lead to awareness of health risk and subsequent adoption of beneficial changes in behavior. However, it is possible that interventions targeting behaviors associated with childhood obesity may also increase the likelihood of unhealthy eating and physical activity obsessions and behaviors. Objective To determine the effect of a one-year intervention targeting physical activity, sedentary and diet behaviors among adolescents on self-reported body image and self-esteem. Methods Body image and self-esteem were assessed for adolescents participating in the PACE+ study, a randomized controlled trial of a one-year behavioral intervention targeting physical activity, sedentary, and dietary behaviors. The Body Dissatisfaction subscale of the Eating Disorder Inventory and Rosenberg Self-Esteem scale were used to assess body image and self-esteem respectively, and measurements were performed at baseline, 6 and 12 months. Demographic characteristics and weight status of participants were also ascertained. Analysis of responses was performed via both between-group and within-group repeated measure analyses. Results 657 adolescents completed all measurements. Body image differences were found for age, sex and weight status at baseline, while self-esteem differences were demonstrated for sex, ethnicity and weight status. There were no intervention effects on body image or self-esteem for either girls or boys. Self-esteem and body satisfaction did not worsen as a result of participating in the PACE+ intervention for either boys or girls whether or not they lost or maintained their weight or gained weight. Girls assigned to the PACE intervention who experienced weight reduction or weight maintenance at either 6 or 12-months reported improvements in body image satisfaction (p=0.02) over time compared to subjects who had experienced weight gain during the 12-month study period. Conclusions Adverse effects on body satisfaction and self-esteem were not observed among adolescents undergoing this behavioral intervention. These results suggest that a behavioral intervention directed at improving physical activity and diet habits may be safely undertaken by adolescents, including those who are at risk for overweight and overweight, without adverse psychological consequences. Inclusion of specific elements in the intervention that directly addressed body image and self-esteem issues may have reduced the risk for negative psychological effects. PMID:17321425

Process Evaluation of a School-Based Weight Gain Prevention Program: The Dutch Obesity Intervention in Teenagers (DOiT)

ERIC Educational Resources Information Center

Singh, A. S.; Chinapaw, M. J. M.; Brug, J.; van Mechelen, W.

2009-01-01

Health promotion programs benefit from an accompanying process evaluation since it can provide more insight in the strengths and weaknesses of a program. A process evaluation was conducted to assess the reach, implementation, satisfaction and maintenance of a school-based program aimed at the prevention of excessive weight gain among Dutch…

Protein diets, body weight loss and weight maintenance.

PubMed

Martens, Eveline A P; Westerterp-Plantenga, Margriet S

2014-01-01

The review addresses briefly the relevance of protein diets for body weight loss and weight maintenance. The addition of recent findings on age-dependent protein requirements, specific effects of protein intake and protein source, the relevance of the other dietary macronutrients, especially of 'low-carb', 'protein leverage', the mechanisms of protein-induced satiety, and food-reward makes the review up-to-date. Different effects of protein diets in different age groups result from age-dependent protein requirements that are primarily related to effects on body composition. A protein intake of 0.8 g/kg/day is sufficient to sustain a negative energy balance in adults, irrespective of the protein source. 'Low-carb' diets trace back to the protein-induced effects. Evidence that protein intake drives energy intake as suggested by the 'Protein leverage hypothesis' is scarce and equivocal. Finally, limited protein-induced food reward may affect compliance to a protein diet. An implication of the findings for clinical practice is that a protein intake of 0.8-1.2 g/kg/day is sufficient to sustain satiety, energy expenditure, and fat-free mass, independent of a dietary 'low-carb' content. Limited protein-induced food reward may affect compliance to a protein diet.

Practical session assessments in human anatomy: Weightings and performance.

PubMed

McDonald, Aaron C; Chan, Siew-Pang; Schuijers, Johannes A

2016-07-08

Assessment weighting within a given module can be a motivating factor for students when deciding on their commitment level and time given to study a specific topic. In this study, an analysis of assessment performances of second year anatomy students was performed over four years to determine if (1) students performed better when a higher weighting was given to a set of practical session assessments and (2) whether an improved performance in the practical session assessments had a carry-over effect on other assessment tasks within that anatomy module and/or other anatomy modules that follow. Results showed that increasing the weighting of practical session assessments improved the average mark in that assessment and also improved the percentage of students passing that assessment. Further, it significantly improved performance in the written end-semester examination within the same module and had a carry-over effect on the anatomy module taught in the next teaching period, as students performed better in subsequent practical session assessments as well as subsequent end-semester examinations. It was concluded that the weighting of assessments had significant influences on a student's performance in that, and subsequent, assessments. It is postulated that practical session assessments, designed to develop deep learning skills in anatomy, improved efficacy in student performance in assessments undertaken in that and subsequent anatomy modules when the weighting of these assessments was greater. These deep learning skills were also transferable to other methods of assessing anatomy. Anat Sci Educ 9: 330-336. © 2015 American Association of Anatomists. © 2015 American Association of Anatomists.

Probabilistic modeling of condition-based maintenance strategies and quantification of its benefits for airliners

NASA Astrophysics Data System (ADS)

Pattabhiraman, Sriram

Airplane fuselage structures are designed with the concept of damage tolerance, wherein small damage are allowed to remain on the airplane, and damage that otherwise affect the safety of the structure are repaired. The damage critical to the safety of the fuselage are repaired by scheduling maintenance at pre-determined intervals. Scheduling maintenance is an interesting trade-off between damage tolerance and cost. Tolerance of larger damage would require less frequent maintenance and hence, a lower cost, to maintain a certain level of reliability. Alternatively, condition-based maintenance techniques have been developed using on-board sensors, which track damage continuously and request maintenance only when the damage size crosses a particular threshold. This effects a tolerance of larger damage than scheduled maintenance, leading to savings in cost. This work quantifies the savings of condition-based maintenance over scheduled maintenance. The work also quantifies converting the cost savings into weight savings. Structural health monitoring will need time to be able to establish itself as a stand-alone system for maintenance, due to concerns on its diagnosis accuracy and reliability. This work also investigates the effect of synchronizing structural health monitoring system with scheduled maintenance. This work uses on-board SHM equipment skip structural airframe maintenance (a subsect of scheduled maintenance), whenever deemed unnecessary while maintain a desired level of safety of structure. The work will also predict the necessary maintenance for a fleet of airplanes, based on the current damage status of the airplanes. The work also analyses the possibility of false alarm, wherein maintenance is being requested with no critical damage on the airplane. The work use SHM as a tool to identify lemons in a fleet of airplanes. Lemons are those airplanes that would warrant more maintenance trips than the average behavior of the fleet.

Maintaining vigorous activity attenuates 7-yr weight gain in 8340 runners.

PubMed

Williams, Paul T

2007-05-01

Body weight generally increases with aging in Western societies. Although training studies show that exercise produces acute weight loss, it is unclear whether the long-term maintenance of vigorous exercise attenuates the trajectory of age-related weight gain. Specifically, prior studies have not tested whether the maintenance of physical activity, in the absence of any change in activity, prevents weight gain. Prospective study of 6119 male and 2221 female runners whose running distances changed < 5 km x wk(-1) between baseline and follow-up surveys 7 yr later. On average, men who maintained modest (0-23 km x wk(-1)), intermediate (24-47 km x wk(-1)), or prolonged running distances (> or = 48 km x wk(-1)) all gained weight through age 64; however, those who maintained > or = 48 km x wk(-1) had one half the average annual weight gain of those who maintained < 24 km x wk(-1). For example, between the ages of 35 and 44 in men and 30 and 39 yr in women, those who maintained < 24 km x wk(-1) gained, on average, 2.1 and 2.9 kg more per decade than those averaging > 48 km x wk(-1). Age-related weight gain, and its attenuation by maintained exercise, were both greater in younger than in older men. Men's gains in waist circumference with age, and its attenuation by maintaining running, were the same in older and younger men. Regardless of age, women increased their body weight, waist circumference, and hip circumference over time, and these measurements were attenuated in proportion to their maintained running distance. In both sexes, running disproportionately prevented more extreme increases in weight. As they aged, men and women gained less weight in proportion to their levels of sustained vigorous activity. This long-term beneficial effect is in addition to the acute weight loss that occurs with increased activity.

Endogenous Opioid Mechanisms Are Implicated in Obesity and Weight Loss in Humans.

PubMed

Burghardt, Paul R; Rothberg, Amy E; Dykhuis, Kate E; Burant, Charles F; Zubieta, Jon-Kar

2015-08-01

Successful long-term weight loss is challenging. Brain endogenous opioid systems regulate associated processes; however, their role in the maintenance of weight loss has not been adequately explored in humans. In a preliminary study, the objective was to assess central μ-opioid receptor (MOR) system involvement in eating behaviors and their relationship to long-term maintenance of weight loss. This was a case-control study with follow-up of the treatment group at 1 year after intervention. The study was conducted at a tertiary care university medical center. Lean healthy (n = 7) and chronically obese (n = 7) men matched for age and ethnicity participated in the study. MOR availability measures were acquired with positron emission tomography and [(11)C]carfentanil. Lean healthy men were scanned twice under both fasted and fed conditions. Obese men were placed on a very low-calorie diet to achieve 15% weight loss from baseline weight and underwent two positron emission tomography scans before and two after weight loss, incorporating both fasted and fed states. Brain MOR availability and activation were measured by reductions in MOR availability (nondisplaceable binding potential) from the fed compared with the fasted-state scans. Baseline MOR nondisplaceable binding potential was reduced in obese compared with the lean and partially recovered obese after weight loss in regions that regulate homeostatic, hedonic, and emotional responses to feeding. Reductions in negative affect and feeding-induced MOR system activation in the right temporal pole were highly correlated in leans but not in obese men. A trend for an association between MOR activation in the right temporal pole before weight loss and weight regain 1 year was found. Although these preliminary studies have a small sample size, these results suggest that obesity and diet-induced weight loss impact central MOR binding and endogenous opioid system function. MOR system activation in response to an acute meal may be related to the risk of weight regain.

A longitudinal study of childhood obesity, weight status change, and subsequent academic performance in Taiwanese children.

PubMed

Chen, Li-Jung; Fox, Kenneth R; Ku, Po-Wen; Wang, Ching-Hui

2012-09-01

This study examined the association among childhood obesity, weight status change, and subsequent academic performance at 6-year follow-up. First-grade students from one elementary school district in Taichung City, Taiwan were followed for 6 years (N = 409). Academic performance was extracted from the school records at the end of each grade. Weight and height were measured at the beginning of each grade. A weight change variable was created based on each child's weight status difference at grades 1 and 6. A multivariate linear regression model for predicting academic performance at grade 6 was developed with adjustment for individual characteristics and family factors. A latent growth curve (LGC) showed the association between changes in body mass index (BMI) and in academic performance across a 6-year period. BMI in children increased significantly across 6 years. The rate of increase in BMI over 6 years was higher for children with higher baseline BMIs than it was for children with lower baseline BMIs. However, BMI changes were not significantly associated with changes of academic performance. There was no significant relationship between initial obesity or change in weight status and subsequent academic performance. It appears that either being or becoming overweight/obese did not impact academic achievement for these Taiwanese children. © 2012, American School Health Association.

Schizophrenia and weight management: a systematic review of interventions to control weight.

PubMed

Faulkner, G; Soundy, A A; Lloyd, K

2003-11-01

Weight gain is a frequent side effect of antipsychotic medication which has serious implications for a patient's health and well being. This study systematically reviews the literature on the effectiveness of interventions designed to control weight gain in schizophrenia. A systematic search strategy was conducted of major databases in addition to citation searches. Study quality was rated. Sixteen studies met the inclusion criteria. Five of eight pharmacological intervention studies reported small reductions in weight (<5% baseline body weight). All behavioural (including diet and/or exercise) interventions reported small reductions in, or maintenance of, weight. Weight loss may be difficult but it is not impossible. Given the inconsistent results, the widespread use of pharmacological interventions cannot be recommended. Both dietary and exercise counselling set within a behavioural modification programme is necessary for sustained weight control.

40 CFR 85.1507 - Maintenance of certificate holder's records.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ICI at the time of importation, documents providing evidence of the date of sale subsequent to... imported pursuant to § 85.1505 or § 85.1509; (10) For vehicles not owned by the ICI at the time of...

40 CFR 85.1507 - Maintenance of certificate holder's records.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ICI at the time of importation, documents providing evidence of the date of sale subsequent to... imported pursuant to § 85.1505 or § 85.1509; (10) For vehicles not owned by the ICI at the time of...

40 CFR 85.1507 - Maintenance of certificate holder's records.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ICI at the time of importation, documents providing evidence of the date of sale subsequent to... imported pursuant to § 85.1505 or § 85.1509; (10) For vehicles not owned by the ICI at the time of...

40 CFR 85.1507 - Maintenance of certificate holder's records.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ICI at the time of importation, documents providing evidence of the date of sale subsequent to... imported pursuant to § 85.1505 or § 85.1509; (10) For vehicles not owned by the ICI at the time of...

Effect of a High-Protein, High-Fiber Beverage Preload on Subjective Appetite Ratings and Subsequent Ad Libitum Energy Intake in Overweight Men and Women: A Randomized, Double-Blind Placebo-Controlled, Crossover Study.

PubMed

Sharafi, Mastaneh; Alamdari, Nima; Wilson, Michael; Leidy, Heather J; Glynn, Erin L

2018-06-01

Dietary protein and fiber have been shown to independently improve subjective measures of appetite control. The aim of this study was to determine the acute effects of a high-protein, high-fiber (HP/HFb) beverage taken as a preload compared with an isocaloric lower-protein, lower-fiber (LP/LFb) placebo beverage on subjective appetite ratings and subsequent energy intake at an ad libitum meal in healthy adults. A total of 50 overweight/obese men and women [ n  = 25 men, 25 women; age 30 ± 2 y; body mass index (BMI) 29.6 ± 0.3 kg/m 2 ] received a 160 kcal HP/HFb beverage containing 17 g protein and 6 g fiber on one occasion and an isocaloric LP/LFb placebo beverage containing 1 g protein and 3 g fiber on another occasion in a randomized, double-blind, crossover design. Thirty min after consumption of the beverage preload, an ad libitum pizza meal was provided to be consumed over a 30-min period. Visual analog scales (VAS) were used to assess subjective appetite ratings throughout the testing period. The Revised Restraint Scale (RRS) was used to classify participants as restrained or unrestrained eaters. HP/HFb led to greater reductions in postprandial desire to eat and hunger compared with LP/LFb (both, P  < 0.05) but did not significantly affect postprandial fullness or prospective food consumption. Subsequent meal energy intake tended to be lower after HP/HFb compared with LP/LFb ( P  = 0.09). A subanalysis showed lower energy intake after HP/HFb in older participants (≥25 y) compared with LP/LFb, which was not observed in the younger participants (<25 y). Compared with LP/LFb, a HP/HFb beverage preload reduced hunger, desire to eat, and tended to reduce subsequent food intake. Dietary restraint and age appear to influence subsequent energy intake and should be taken into account when designing nutrition interventions for weight reduction and/or maintenance. This trial was registered at clinicaltrials.gov as NCT02979717.

High Birth Weight and Cognitive Outcomes. NBER Working Paper No. 14524

ERIC Educational Resources Information Center

Cesur, Resul; Rashad, Inas

2008-01-01

While the effects of low birth weight have long been explored, those of high birth weight have been essentially ignored. Economists have analyzed the negative effects that low birth weight might have on subsequent school outcomes, while taking into account unobserved characteristics that may be common to families with low birth weight babies and…

The differential effects of 2% oxygen preconditioning on the subsequent differentiation of mouse and human pluripotent stem cells.

PubMed

Fynes, Kate; Tostoes, Rui; Ruban, Ludmila; Weil, Ben; Mason, Christopher; Veraitch, Farlan S

2014-08-15

A major challenge facing the development of effective cell therapies is the efficient differentiation of pluripotent stem cells (PSCs) into pure populations. Lowering oxygen tension to physiological levels can affect both the expansion and differentiation stages. However, to date, there are no studies investigating the knock-on effect of culturing PSCs under low oxygen conditions on subsequent lineage commitment at ambient oxygen levels. PSCs were passaged three times at 2% O2 before allowing cells to spontaneously differentiate as embryoid bodies (EBs) in high oxygen (20% O2) conditions. Maintenance of mouse PSCs in low oxygen was associated with a significant increase in the expression of early differentiation markers FGF5 and Eomes, while conversely we observed decreased expression of these genes in human PSCs. Low oxygen preconditioning primed mouse PSCs for their subsequent differentiation into mesodermal and endodermal lineages, as confirmed by increased gene expression of Eomes, Goosecoid, Brachyury, AFP, Sox17, FoxA2, and protein expression of Brachyury, Eomes, Sox17, FoxA2, relative to high oxygen cultures. The effects extended to the subsequent formation of more mature mesodermal lineages. We observed significant upregulation of cardiomyocyte marker Nkx2.5, and critically a decrease in the number of contaminant pluripotent cells after 12 days using a directed cardiomyocyte protocol. However, the impact of low oxygen preconditioning was to prime human cells for ectodermal lineage commitment during subsequent EB differentiation, with significant upregulation of Nestin and β3-tubulin. Our research demonstrates the importance of oxygen tension control during cell maintenance on the subsequent differentiation of both mouse and human PSCs, and highlights the differential effects.

Predictors of Being Overweight or Obese in Survivors of Pediatric Acute Lymphoblastic Leukemia (ALL)

PubMed Central

Zhang, Fang Fang; Rodday, Angie Mae; Kelly, Michael J.; Must, Aviva; MacPherson, Cathy; Roberts, Susan B.; Saltzman, Edward; Parsons, Susan K.

2015-01-01

Background A high prevalence of obesity has been increasingly recognized in survivors of pediatric ALL. However, longitudinal patterns of weight change during and after treatment, and associated factors, are less well elucidated. Procedure In a retrospective cohort of 83 pediatric patients with ALL diagnosed between 1985 and 2010, we examined body mass index (BMI) status at several key time points: diagnosis; end of induction; end of consolidation; every 6 months during maintenance; and yearly for up to 5 years post-treatment. Results At diagnosis, 21% were overweight (BMI = 85–94.9th percentile) or obese (BMI ≥95th percentile). At the end of treatment and 5 years post-treatment, approximately 40% were overweight or obese. The mean BMI z-score was 0.2 (58th percentile) at diagnosis and increased significantly during induction (Δ = 0.5, P <0.0001). It increased again during the first 6 months of maintenance (Δ = 0.2, P <0.01) and did not significantly change over the remainder of maintenance (BMI z-score at the end of treatment = 0.8, 79th percentile) and 5 years post-treatment (BMI z-score = 0.7, 76th percentile). High BMI z-score at diagnosis was associated with an increased risk of being overweight/obese at treatment completion (OR = 2.9, 95% CI: 1.6–5.1). Weight gain during treatment was associated with being overweight/obese 5 years post-treatment (OR = 3.8, 95% CI: 1.1–12.5). Conclusion Children with ALL are at risk of becoming overweight/obese early in treatment. Increases in weight are maintained throughout treatment and beyond. Lifestyle interventions are needed targeting weight control early during treatment, particularly for patients overweight/obese at diagnosis and those who experience substantial weight gain during treatment. Pediatr Blood Cancer 2014;61:1263–1269. PMID:24482072

Seniors' body weight dissatisfaction and longitudinal associations with weight changes, anorexia of aging, and obesity: results from the NuAge Study.

PubMed

Roy, Mathieu; Shatenstein, Bryna; Gaudreau, Pierrette; Morais, José A; Payette, Hélène

2015-03-01

We examined longitudinal associations between weight dissatisfaction, weight changes, anorexia of aging, and obesity among 1,793 seniors followed over 4 years between 2003 and 2009. Obesity prevalence (body mass index [BMI] ≥ 30) and prevalence/incidence of weight dissatisfaction, anorexia of aging (self-reported appetite loss), and weight changes ≥5% were assessed. Predictors of weight loss ≥5%, anorexia of aging, and weight dissatisfaction were examined using logistic regressions. Half of seniors experienced weight dissatisfaction (50.6%, 95% confidence interval [CI] = [48.1, 53.1]). Anorexia of aging and obesity prevalence was 7.0% (95% CI = [5.7, 8.3]) and 25.1% (95% CI = [22.9, 27.3]), whereas incidence of weight gain/loss ≥5% was 6.6% (95% CI = [1.3, 11.9]) and 8.8% (95% CI = [3.3, 14.3]). Weight gain ≥5% predicts men's subsequent weight dissatisfaction (odds ratio [OR] = 6.66, 95% CI = [2.06, 21.60]). No other association was observed. Weight dissatisfaction is frequent but not associated with subsequent eating disorders. In men, weight gain predicted weight dissatisfaction. Seniors' weight dissatisfaction does not necessarily equate weight changes. Due to its high prevalence, it is of public health interest to understand how seniors' weight dissatisfaction may impact health. © The Author(s) 2014.

Evaluating an insurance-sponsored weight management program with the RE-AIM Model, West Virginia, 2004-2008.

PubMed

Abildso, Christiaan G; Zizzi, Sam J; Reger-Nash, Bill

2010-05-01

Evaluations of weight management programs in real-world settings are lacking. The RE-AIM model (reach, effectiveness, adoption, implementation, maintenance) was developed to address this deficiency. Our primary objective was to evaluate a 12-week insurance-sponsored weight management intervention by using the RE-AIM model, including short-term and long-term individual outcomes and setting-level implementation factors. Our secondary objective was to critique the RE-AIM model and its revised calculation methods. We created operational definitions for components of the 5 RE-AIM indices and used standardized effect size values from various statistical procedures to measure multiple components or outcomes within each index. We used chi(2) analysis to compare categorical variables and repeated-measures analysis of variance to assess the magnitude of outcome changes over time. On the basis of data for 1,952 participants and surveys completed by administrators at 23 sites, RE-AIM indices ranging from 0 to 100 revealed low program reach and adoption (5.4 and 8.8, respectively), moderate effectiveness (43.8), high implementation (91.4), low to moderate individual maintenance (21.2), and moderate to high site maintenance (77.8). Median (interquartile range) weight loss was 13 lb (6.5-21.4 lb) among participants who completed phase I (12 weeks; 76.5%) and 15 lb (6.1-30.3 lb) among those who completed phase II (1 year; 45.7%). This program had a significant, positive effect on participants and has been sustainable but needs to be expanded for more public health benefit. The RE-AIM model provided a useful framework to determine program strengths and weaknesses and to present them to the insurance agency and public health decision makers.

A rho-like protein is involved in the organisation of the contractile ring in dividing sand dollar eggs.

PubMed

Mabuchi, I; Hamaguchi, Y; Fujimoto, H; Morii, N; Mishima, M; Narumiya, S

1993-11-01

Sand dollar eggs were microinjected with botulinum C3 exoenzyme, an ADP-ribosyltransferase from Clostridium botulinum that specifically ADP-ribosylates and inactivates rho proteins. C3 exoenzyme microinjected during nuclear division interfered with subsequent cleavage furrow formation. No actin filaments were detected in the equatorial cortical layer of these eggs by rhodamine-phalloidin staining. When microinjected into furrowing eggs, C3 exoenzyme rapidly disrupted the contractile ring actin filaments and caused regression of the cleavage furrows. C3 exoenzyme had no apparent effect on nuclear division, however, and multinucleated embryos developed from the microinjected eggs. By contrast, C3 exoenzyme did not affect the organisation of cortical actin filaments immediately after fertilisation. Only one protein (molecular weight 22,000) was ADP-ribosylated by C3 exoenzyme in the isolated cleavage furrow. This protein co-migrated with ADP-ribosylated rhoA derived from human platelets when analysed by two-dimensional gel electrophoresis. These results strongly suggest that a rho-like, small GTP-binding protein is selectively involved in the organisation and maintenance of the contractile ring.

Evaluation of Road Performance Based on International Roughness Index and Falling Weight Deflectometer

NASA Astrophysics Data System (ADS)

Hasanuddin; Setyawan, A.; Yulianto, B.

2018-03-01

Assessment to the performance of road pavement is deemed necessary to improve the management quality of road maintenance and rehabilitation. This research to evaluate the road base on functional and structural and recommendations handling done. Assessing the pavement performance is conducted with functional and structural evaluation. Functional evaluation of pavement is based on the value of IRI (International Roughness Index) which among others is derived from reading NAASRA for analysis and recommended road handling. Meanwhile, structural evaluation of pavement is done by analyzing deflection value based on FWD (Falling Weight Deflectometer) data resulting in SN (Structural Number) value. The analysis will result in SN eff (Structural Number Effective) and SN f (Structural Number Future) value obtained from comparing SN eff to SN f value that leads to SCI (Structural Condition Index) value. SCI value implies the possible recommendation for handling pavement. The study done to Simpang Tuan-Batas Kota Jambi road segment was based on functional analysis. The study indicated that the road segment split into 12 segments in which segment 1, 3, 5, 7, 9, and 11 were of regular maintenance, segment 2, 4, 8, 10, 12 belonged to periodic maintenance, and segment 6 was of rehabilitation. The structural analysis resulted in 8 segments consisting of segment 1 and 2 recommended for regular maintenance, segment 3, 4, 5, and 7 for functional overlay, and 6 and 8 were of structural overlay.

Dietary patterns in patients with advanced cancer: implications for anorexia-cachexia therapy.

PubMed

Hutton, Joanne L; Martin, Lisa; Field, Catherine J; Wismer, Wendy V; Bruera, Eduardo D; Watanabe, Sharon M; Baracos, Vickie E

2006-11-01

Severe malnutrition and wasting are considered hallmarks of advanced malignant disease, and clinical research into anorexia-cachexia therapy and nutritional support for cancer patients is ongoing. However, information on typical dietary intakes and food choices for this population is notably lacking; proposed therapies for anorexia and wasting are not framed within the context of current intake. The objective of the study was to characterize the food intake patterns of patients with advanced cancer. Patients with advanced cancer (n = 151) recruited from a regional cancer center and palliative-care program completed a 3-d dietary record a mean (+/-SD) 8 +/- 7 mo before death. Food items were categorized according to macronutrient content and dietary use and subsequently entered into cluster analysis. Wide variations in intakes of energy (range: 4-53 kcal . kg body wt(-1) . d(-1); x +/- SD: 25.1 +/- 10.0 kcal . kg body wt(-1) . d(-1)) and protein (range: 0.2-2.7 g . kg body wt(-1) . d(-1); x +/- SD: 1.0 +/- 0.4 g . kg body wt(-1) . d(-1)) were observed. Even the subjects with the highest intakes had a recent history of weight loss, which suggests that the diets of those persons were consistently inadequate for weight maintenance. Cluster analysis found 3 dietary patterns that differed in food choice and caloric intake. Low intakes and a high risk of weight loss were associated with decreased frequency of eating and dietary profiles with little variety and unusually high proportions of liquids. These data provide a glimpse into dietary habits toward the end of life. Unique dietary patterns were found in this nutritionally vulnerable patient population.

Treatment of a long-acting anticoagulant rodenticide poisoning cohort with vitamin K1 during the maintenance period

PubMed Central

Long, Jianhai; Peng, Xiaobo; Luo, Yuan; Sun, Yawei; Lin, Guodong; Wang, Yongan; Qiu, Zewu

2016-01-01

Abstract Currently, there are few guidelines for the use of vitamin K1 in the maintenance treatment of long-acting anticoagulant rodenticide (LAAR) poisonings. We explored factors in the treatment of LAAR poisoning during the maintenance period in order to suggest feasible treatment models. Data from 24 cases of anticoagulant rodenticide poisoning in our hospital were collected from January 2013 to May 2016. The patients’ sex, age, coagulation function, total time from poisoning to treatment with vitamin K1 (prehospital time), vitamin K1 sustained treatment time (VKSTT), anticoagulant rodenticide category, and specific poison dosage were collected. Multivariate analysis was used to evaluate the correlation between vitamin K1 dosage and other factors during the maintenance period. Only VKSTT (partial regression coefficient −1.133, 0.59, P = 0.035) had an obvious influence on the therapeutic dose of vitamin K1 required during the maintenance period. After an initial pulse therapy, the bleeding and coagulation functions were stabilized, and the patients were subsequently treated with vitamin K1 during the maintenance period. Over time, the maintenance dose of vitamin K1 (10–120 mg/d, intravenous drip) was gradually decreased and was not related to toxicant concentration. PMID:28002326

Diurnal Salivary Cortisol Patterns Prior to Pregnancy Predict Infant Birth Weight

PubMed Central

Guardino, Christine M.; Schetter, Christine Dunkel; Saxbe, Darby E.; Adam, Emma K.; Ramey, Sharon Landesman; Shalowitz, Madeleine U.

2016-01-01

Objective Elevated maternal psychosocial stress during pregnancy and accompanying changes in stress hormones may contribute to risk of adverse birth outcomes such as low birth weight and preterm birth. Relatedly, research on fetal programming demonstrates intriguing associations between maternal stress processes during pregnancy and outcomes in offspring that extend into adulthood. The purpose of this study was to test whether HPA patterns in mothers during the period between two pregnancies (i.e., the interpregnancy interval) and the subsequent pregnancy predict infant birth weight, a key birth outcome. Methods This study sampled salivary cortisol both before and during pregnancy in a diverse community sample of 142 women in the Community Child Health Network (CCHN) study. Results Using multilevel modeling, we found that flatter diurnal cortisol slopes in mothers during the interval between one birth and a subsequent pregnancy predicted lower infant birth weight of the subsequent child. This interpregnancy cortisol pattern in mothers also correlated with significantly shorter inter-pregnancy intervals, such that women with flatter cortisol slopes had more closely spaced pregnancies. After adding demographic covariates of household income, cohabitation with partner, and race to the model, these results were unchanged. For participants who provided both interpregnancy and pregnancy cortisol data (n = 73), we found that interpregnancy cortisol slopes predicted infant birth weight independent of pregnancy cortisol slopes. Conclusions These novel findings on interpregnancy HPA axis function and subsequent pregnancy outcomes strongly support lifespan health approaches and underscore the importance of maternal stress physiology between pregnancies. PMID:26844584

Weight loss in a UK commercial all meal provision study: a randomised controlled trial.

PubMed

Mellor, D D; Whitham, C; Goodwin, S; Morris, M; Reid, M; Atkin, S L

2014-08-01

Effective approaches are needed to address the increasing prevalence of overweight and obesity. The present study investigated whether all meal provision was a more effective and acceptable method for weight loss than a self-directed diet. This randomised controlled trial recruited 112 men and women with a body mass index in the range 27-35 kg m(-2), who had no comorbidities, from the local area of Hull. Participants were randomised to receive either meal provision or follow a self-directed diet for a 12-week period that resulted in an estimated 2928 kJ day(-1) (700 kcal day(-1)) deficit. A dietitian supervised both dietary interventions. At 12 weeks [mean (SEM)], percentage weight loss in the meal provision group was 6.6% (0.5%) compared to 4.3% (0.6%) for those on the self-directed diet. In terms of clinically relevant weight loss, 61% of participants lost 5% or more of their body weight with meal provision compared to 22% on the self-directed diet (P < 0.001). Weight loss was associated with wellbeing in both groups. Attrition was less apparent with 7% of those participants receiving meal provision withdrawing from the study compared to 41% of those following the self-directed diet (P < 0.001). Meal provision was a more effective and accepted method for weight loss over a 12-week period compared to a self-directed diet. This may in part represent the difference between being given the meal provision food free of charge. However, longer-term maintenance studies need to be undertaken to ascertain their effects on the maintenance of weight loss. © 2013 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association Ltd.

A Fuzzy analytical hierarchy process approach in irrigation networks maintenance

NASA Astrophysics Data System (ADS)

Riza Permana, Angga; Rintis Hadiani, Rr.; Syafi'i

2017-11-01

Ponorogo Regency has 440 Irrigation Area with a total area of 17,950 Ha. Due to the limited budget and lack of maintenance cause decreased function on the irrigation. The aim of this study is to make an appropriate system to determine the indices weighted of the rank prioritization criteria for irrigation network maintenance using a fuzzy-based methodology. The criteria that are used such as the physical condition of irrigation networks, area of service, estimated maintenance cost, and efficiency of irrigation water distribution. 26 experts in the field of water resources in the Dinas Pekerjaan Umum were asked to fill out the questionnaire, and the result will be used as a benchmark to determine the rank of irrigation network maintenance priority. The results demonstrate that the physical condition of irrigation networks criterion (W1) = 0,279 has the greatest impact on the assessment process. The area of service (W2) = 0,270, efficiency of irrigation water distribution (W4) = 0,249, and estimated maintenance cost (W3) = 0,202 criteria rank next in effectiveness, respectively. The proposed methodology deals with uncertainty and vague data using triangular fuzzy numbers, and, moreover, it provides a comprehensive decision-making technique to assess maintenance priority on irrigation network.

Applying Psychological Theories to Promote Long-Term Maintenance of Health Behaviors

PubMed Central

Joseph, Rodney P.; Daniel, Casey L.; Thind, Herpreet; Benitez, Tanya J.; Pekmezi, Dori

2014-01-01

Behavioral health theory provides a framework for researchers to design, implement, and evaluate the effects of health promotion programs. However, limited research has examined theories used in interventions to promote long-term maintenance of health behaviors. The purpose of this review was to evaluate the available literature and identify prominent behavioral health theories used in intervention research to promote maintenance of health behaviors. We reviewed theories used in intervention research assessing long-term maintenance (≥ 6 months post-intervention) of physical activity, weight loss, and smoking cessation. Five prominent behavioral theories were referenced by the 34 studies included in the review: Self-Determination Theory, Theory of Planned Behavior, Social Cognitive Theory, Transtheoretical Model, and Social Ecological Model. Descriptions and examples of applications of these theories are provided. Implications for future research are discussed. PMID:28217036

Parental perception of child’s weight status and subsequent BMIz change: the KOALA birth cohort study

PubMed Central

2014-01-01

Background Parents often fail to correctly perceive their children’s weight status, but no studies have examined the association between parental weight status perception and longitudinal BMIz change (BMI standardized to a reference population) at various ages. We investigated whether parents are able to accurately perceive their child’s weight status at age 5. We also investigated predictors of accurate weight status perception. Finally, we investigated the predictive value of accurate weight status perception in explaining children’s longitudinal weight development up to the age of 9, in children who were overweight at the age of 5. Methods We used longitudinal data from the KOALA Birth Cohort Study. At the child’s age of 5 years, parents filled out a questionnaire regarding child and parent characteristics and their perception of their child’s weight status. We calculated the children’s actual weight status from parental reports of weight and height at ages 2, 5, 6, 7, 8, and 9 years. Regression analyses were used to identify factors predicting which parents accurately perceived their child’s weight status. Finally, regression analyses were used to predict subsequent longitudinal BMIz change in overweight children. Results Eighty-five percent of the parents of overweight children underestimated their child’s weight status at age 5. The child’s BMIz at age 2 and 5 were significant positive predictors of accurate weight status perception (vs. underestimation) in normal weight and overweight children. Accurate weight status perception was a predictor of higher future BMI in overweight children, corrected for actual BMI at baseline. Conclusions Children of parents who accurately perceived their child’s weight status had a higher BMI over time, probably making it easier for parents to correctly perceive their child’s overweight. Parental awareness of the child’s overweight as such may not be sufficient for subsequent weight management by the parents, implying that parents who recognize their child’s overweight may not be able or willing to adequately manage the overweight. PMID:24678601

Research requirements for development of advanced-technology helicopter transmissions. [reduction of maintenance costs

NASA Technical Reports Server (NTRS)

Lemanski, A. J.

1976-01-01

Helicopter drive-system technology which would result in the largest benefit in direct maintenance cost when applied to civil helicopters in the 1980 timeframe was developed. A prototype baseline drive system based on 1975 technology provided the basis for comparison against the proposed advanced technology in order to determine the potential for each area recommended for improvement. A specific design example of an advanced-technology main transmission is presented to define improvements for maintainability, weight, producibility, reliability, noise, vibration, and diagnostics. Projections of the technology achievable in the 1980 timeframe are presented. Based on this data, the technologies with the highest payoff (lowest direct maintenance cost) for civil-helicopter drive systems are identified.

Pultruded composites using soy-based polyurethane resin.

DOT National Transportation Integrated Search

2008-07-01

Fiber Reinforced Polymer (FRP) composites offer inherent advantages over traditional materials with regard to high strength-to-weight ratio, design flexibility, corrosion resistance, low maintenance, and extended service life. FRP materials can be us...

Effect of increasing monensin sodium levels in diets with virginiamycin on the finishing of Nellore cattle.

PubMed

Benatti, João Marcos B; Alves Neto, João Alexandrino; de Oliveira, Ivanna M; de Resende, Flávio D; Siqueira, Gustavo R

2017-11-01

This study evaluated the effect of increasing levels of monensin sodium (MON) in diets with virginiamycin (VM) on the finishing of feedlot cattle. Two hundred and eighty intact male Nellore cattle (348 ± 32 kg body weight, 22 months) received one of the following five diets: control diet (without additives); diet containing VM (25 mg per kg dry matter) combined with 0 (MON0), 10 (MON10), 20 (MON20) or 30 (MON30) mg MON per kg dry matter. During adaptation (28 days), the MON0 diet increased dietary net energy for maintenance and gain compared to the control diet (P = 0.04). The combination of additives linearly reduced dry matter intake, body weight and average daily gain (P < 0.01). Considering the total study period (110 days), there was a trend of greater net energy intake for maintenance (P = 0.09) and hot carcass weight (P = 0.06) for animals fed MON0 compared to the control diet. The combination of additives linearly reduced dry matter intake (P = 0.04) and linearly increased gain : feed and dietary net energy for maintenance and gain (P < 0.01). The combination of VM with MON at a dose of 30 mg/kg dry matter is recommended for Nellore feedlot cattle because it improves the efficiency of energy utilization. © 2017 Japanese Society of Animal Science.

Greater weight loss among men participating in a commercial weight loss program: a pooled analysis of 2 randomized controlled trials.

PubMed

Barraj, Leila M; Murphy, Mary M; Heshka, Stanley; Katz, David L

2014-02-01

Being overweight and obese are significant health concerns for men and women, yet despite comparable needs for effective weight loss and maintenance strategies, little is known about the success of commercial weight loss programs in men. This study tests the hypothesis that men participating in a commercial weight loss program (Weight Watchers) had significantly greater weight loss than men receiving limited support from health professionals for weight loss (controls). A pooled analysis of weight loss and related physiologic parameter data from 2 randomized clinical trials was conducted. After 12 months, analysis of covariance tests showed that men in the commercial program group (n = 85) lost significantly more weight (P < .01) than men in the control group (n = 84); similar significant differences were observed for body mass index and waist circumference. These results suggest that participation in a commercial weight loss program may be a more effective means to lose weight and maintain weight loss. Published by Elsevier Inc.

A 1-D Simulation Analysis of the Development and Maintenance of the 2001 Red Tide of the Ichthyotoxic Dinoflagellate Karenia brevis on the West Florida Shelf

DTIC Science & Technology

2012-04-26

subsequent fish kills supplied additional organic nutrients for utilization by these opportunistic toxic algae. Both nutrient vectors represented organic non...ichthyotoxic levels, rapid decay of subsequent fish kills supplied additional organic nutrients for utilization by these opportunistic toxic algae. Both...HABSIM model (Fig. 2) a positive feedback of the recycled organic nutrients (DON and DOP) from decaying fish , killed by K. brevis. Note that dissolved

Fish consumption and subsequent change in body weight in European women and men.

PubMed

Jakobsen, Marianne U; Dethlefsen, Claus; Due, Karen M; May, Anne M; Romaguera, Dora; Vergnaud, Anne-Claire; Norat, Teresa; Sørensen, Thorkild I A; Halkjær, Jytte; Tjønneland, Anne; Boutron-Ruault, Marie-Christine; Clavel-Chapelon, Francoise; Fagherazzi, Guy; Teucher, Birgit; Kühn, Tilman; Bergmann, Manuela M; Boeing, Heiner; Naska, Androniki; Orfanos, Philippos; Trichopoulou, Antonia; Palli, Domenico; Santucci De Magistris, Maria; Sieri, Sabina; Bueno-de-Mesquita, H B; van der A, Daphne L; Engeset, Dagrun; Hjartåker, Anette; Rodríguez, Laudina; Agudo, Antonio; Molina-Montes, Esther; Huerta, José M; Barricarte, Aurelio; Amiano, Pilar; Manjer, Jonas; Wirfält, Elisabet; Hallmans, Göran; Johansson, Ingegerd; Khaw, Kay-Tee; Wareham, Nicholas J; Key, Timothy J; Chajès, Veronique; Slimani, Nadia; Riboli, Elio; Peeters, Petra H M; Overvad, Kim

2013-01-28

Fish consumption is the major dietary source of EPA and DHA, which according to rodent experiments may reduce body fat mass and prevent obesity. Only a few human studies have investigated the association between fish consumption and body-weight gain. We investigated the association between fish consumption and subsequent change in body weight. Women and men (n 344,757) participating in the European Prospective Investigation into Cancer and Nutrition were followed for a median of 5.0 years. Linear and logistic regression were used to investigate the associations between fish consumption and subsequent change in body weight. Among women, the annual weight change was 5.70 (95 % CI 4.35, 7.06), 2.23 (95 % CI 0.16, 4.31) and 11.12 (95 % CI 8.17, 14.08) g/10 g higher total, lean and fatty fish consumption per d, respectively. The OR of becoming overweight in 5 years among women who were normal weight at enrolment was 1.02 (95 % CI 1.01, 1.02), 1.01 (95 % CI 1.00, 1.02) and 1.02 (95 % CI 1.01, 1.04) g/10 g higher total, lean and fatty consumption per d, respectively. Among men, fish consumption was not statistically significantly associated with weight change. Adjustment for potential over- or underestimation of fish consumption did not systematically change the observed associations, but the 95 % CI became wider. The results in subgroups from analyses stratified by age or BMI at enrolment were not systematically different. In conclusion, the present study suggests that fish consumption has no appreciable association with body-weight gain.

Metabolic and Behavioral Compensations in Response to Caloric Restriction: Implications for the Maintenance of Weight Loss

PubMed Central

Redman, Leanne M.; Heilbronn, Leonie K.; Martin, Corby K.; de Jonge, Lilian; Williamson, Donald A.; Delany, James P.; Ravussin, Eric

2009-01-01

Background Metabolic and behavioral adaptations to caloric restriction (CR) in free-living conditions have not yet been objectively measured. Methodology and Principal Findings Forty-eight (36.8±1.0 y), overweight (BMI 27.8±0.7 kg/m2) participants were randomized to four groups for 6-months; Control: energy intake at 100% of energy requirements; CR: 25% calorie restriction; CR+EX: 12.5% CR plus 12.5% increase in energy expenditure by structured exercise; LCD: low calorie diet (890 kcal/d) until 15% weight reduction followed by weight maintenance. Body composition (DXA) and total daily energy expenditure (TDEE) over 14-days by doubly labeled water (DLW) and activity related energy activity (AREE) were measured after 3 (M3) and 6 (M6) months of intervention. Weight changes at M6 were −1.0±1.1% (Control), −10.4±0.9% (CR), −10.0±0.8% (CR+EX) and −13.9±0.8% (LCD). At M3, absolute TDEE was significantly reduced in CR (−454±76 kcal/d) and LCD (−633±66 kcal/d) but not in CR+EX or controls. At M6 the reduction in TDEE remained lower than baseline in CR (−316±118 kcal/d) and LCD (−389±124 kcal/d) but reached significance only when CR and LCD were combined (−351±83 kcal/d). In response to caloric restriction (CR/LCD combined), TDEE adjusted for body composition, was significantly lower by −431±51 and −240±83 kcal/d at M3 and M6, respectively, indicating a metabolic adaptation. Likewise, physical activity (TDEE adjusted for sleeping metabolic rate) was significantly reduced from baseline at both time points. For control and CR+EX, adjusted TDEE (body composition or sleeping metabolic rate) was not changed at either M3 or M6. Conclusions For the first time we show that in free-living conditions, CR results in a metabolic adaptation and a behavioral adaptation with decreased physical activity levels. These data also suggest potential mechanisms by which CR causes large inter-individual variability in the rates of weight loss and how exercise may influence weight loss and weight loss maintenance. Trial Registration ClinicalTrials.gov NCT00099151 PMID:19198647

Dietary proteins in the regulation of food intake and body weight in humans.

PubMed

Anderson, G Harvey; Moore, Shannon E

2004-04-01

This review presents 4 lines of evidence supporting a role for proteins in the regulation of food intake and maintenance of healthy body weights. It is concluded that the protein content of food, and perhaps its source, is a strong determinant of short-term satiety and of how much food is eaten. Although the role of protein in the regulation of long-term food intake and body weight is less clear, the evidence reviewed suggests that further research to define its role is merited. Such research has the potential to lead to new functional foods, food formulations, and dietary recommendations for achieving healthy body weights.

College students' motivation to achieve and maintain a healthy weight.

PubMed

Furia, Andrea C; Lee, Rebecca E; Strother, Myra L; Huang, Terry T-K

2009-01-01

To develop and refine a scale of motivational factors related to healthy weight achievement and maintenance and to examine differences by gender and weight status. A cross-sectional survey of 300 university students aged 18-24 years. Factor analysis yielded 6 factors-Intrinsic (Cronbach's alpha=0.73): affective motivation, self-efficacy/interest; Extrinsic (Cronbach's alpha=0.68): social reward, peer pressure, lack of choice, and authority influence. Males and normal-weight students showed higher affective motivation and overall intrinsic motivation compared to females and overweight students, (P<.001). Intrinsic motivational factors and gender differences should be considered in developing obesity prevention interventions in this age-group.

Breast cancer survivors' experience of making weight, dietary and physical activity changes during participation in a weight loss intervention.

PubMed

Terranova, Caroline O; Lawler, Sheleigh P; Spathonis, Kym; Eakin, Elizabeth G; Reeves, Marina M

2017-05-01

The aim of this study is to explore breast cancer survivors' experience of a weight loss intervention and identify potential facilitators and barriers of initiating and maintaining weight, dietary or physical activity changes. Fourteen women randomised to and completing the 12-month weight loss intervention completed semi-structured interviews 7.5 ± 0.5 months after intervention completion. An inductive thematic analysis was conducted whereby interviews were independently coded and themes identified. Women were (mean ± SD) 55.6 ± 8.5 years, 30.2 ± 4.6 kg/m 2 and 17.1 ± 3.4 months post-diagnosis at study baseline. Four themes emerged: (1) perceived motivation to participate in the intervention, (2) facilitators, (3) challenges and (4) maintenance of weight loss and behaviour changes. All women noted the impact of social/family environments, either to facilitate (e.g., support from family members) or impede (e.g., major family event) changes. The structure and support of the intervention, particularly accountability to their coach, was also seen as facilitating. Formation of habitual physical activity facilitated dietary changes. Dietary change strategies most perceived to facilitate weight loss were reducing energy intake by dietary self-monitoring, increasing vegetable intake and portion control. Challenges included breast cancer-specific issues such as post-diagnosis weight gain, treatment-related side effects and psychological issues around readiness to change and self-regulation. Diminished accountability following intervention completion impacted the maintenance of weight loss and behaviour changes, notably dietary self-monitoring. Results suggest that formal involvement of a support person (e.g. family member/friend) and referring women to ongoing, community-based services to maintain patient-perceived accountability may be particularly useful strategies for future weight loss intervention trials targeting women with breast cancer.

Carbohydrate intake and glycemic index affect substrate oxidation during a controlled weight cycle in healthy men.

PubMed

Kahlhöfer, J; Lagerpusch, M; Enderle, J; Eggeling, B; Braun, W; Pape, D; Müller, M J; Bosy-Westphal, A

2014-09-01

Because both, glycemic index (GI) and carbohydrate content of the diet increase insulin levels and could thus impair fat oxidation, we hypothesized that refeeding a low GI, moderate-carbohydrate diet facilitates weight maintenance. Healthy men (n=32, age 26.0±3.9 years; BMI 23.4±2.0 kg/m(2)) followed 1 week of controlled overfeeding, 3 weeks of caloric restriction and 2 weeks of hypercaloric refeeding (+50, -50 and +50% energy requirement) with low vs high GI (41 vs 74) and moderate vs high CHO intake (50% vs 65% energy). We measured adaptation of fasting macronutrient oxidation and the capacity to supress fat oxidation during an oral glucose tolerance test. Changes in fat mass were measured by quantitative magnetic resonance. During overfeeding, participants gained 1.9±1.2 kg body weight, followed by a weight loss of -6.3±0.6 kg and weight regain of 2.8±1.0 kg. Subjects with 65% CHO gained more body weight compared with 50% CHO diet (P<0.05) particularly with HGI meals (P<0.01). Refeeding a high-GI diet led to an impaired basal fat oxidation when compared with a low-GI diet (P<0.02), especially at 65% CHO intake. Postprandial metabolic flexibility was unaffected by refeeding at 50% CHO but clearly impaired by 65% CHO diet (P<0.05). Impairment in fasting fat oxidation was associated with regain in fat mass (r=0.43, P<0.05) and body weight (r=0.35; P=0.051). Both higher GI and higher carbohydrate content affect substrate oxidation and thus the regain in body weight in healthy men. These results argue in favor of a lower glycemic load diet for weight maintenance after weight loss.

Nature versus nurture: identical twins and bariatric surgery.

PubMed

Hagedorn, Judith C; Morton, John M

2007-06-01

Genetics and environment both play a role in weight maintenance. Twin studies may help clarify the influence of nature vs nurture in weight loss. We present the largest U.S. experience with monozygotic (MZ) twins undergoing bariatric surgery. We retrospectively reviewed the charts of four sets of MZ twins who underwent Roux-en-Y gastric bypass (RYGBP) surgery and laparoscopic adjustable gastric band (LAGB) placement at three different institutions. BMI and co-morbidities were examined pre- and postoperatively, and laboratory values were recorded. All four sets of twins are female, live together, and have similar professions. Twin cohort 1 had near identical weight loss patterns after open RYGBP surgery in 1996 (preop 146/142 kg; 2 years 82/82; and 10 years 108/107). Twin cohort 1 also both underwent cholecystectomies within the first year postoperatively. Twin cohort 2 underwent laparoscopic RYGBP surgery and also required cholecystectomies in the first postoperative year. Cohort 2 also experienced nearly identical weight loss at 1 year (36.7% vs 37.0% BMI loss). Twin cohort 3 underwent LAGB placement with two different surgeons with differing amounts of weight loss at 6 months (6.5% vs 15.7% BMI loss). Finally, twin cohort 4 underwent laparoscopic RYGBP with 2-year BMI loss of 39% vs 34%. In twin cohort 4, the twin who lost less weight lived apart from her twin and extended family, and her weight loss was less than the twin living with her family. Two sets of MZ twins had identical responses to bariatric surgery. The other two sets of identical twins had differential weight loss results, possibly due to differences in surgical approach and social support. While genetics do exert a strong influence on weight loss and maintenance, this case series demonstrates the potential effect of social support and postoperative management upon postoperative weight loss in the presence of identical genetics.

Feasibility study of a 270V dc flat cable aircraft electrical power distributed system

NASA Astrophysics Data System (ADS)

Musga, M. J.; Rinehart, R. J.

1982-01-01

This report documents the efforts of a one man-year feasibility study to evaluate the usage of flat conductors in place of conventional round wires for a 270 volt direct current aircraft power distribution system. This study consisted of designing electrically equivalent power distribution harnesses in flat conductor configurations for a currently operational military aircraft. Harness designs were established for installation in aircraft airframes which are: (1) All metal, or (2) All composite, or (3) a mixture of both. Flat cables have greater surface areas for heat transfer allowing higher current densities and therefore lighter weight conductors, than with round wires. Flat cables are less susceptible to electromagnetic effects. However, these positive factors are partially offset by installation and maintenance difficulties. This study concludes that the extent of these difficulties can be adequately limited with appropriate modification to present installation and maintenance practices. A comparative analysis of the flat and the round conductor power distribution harnesses was made for weight, cost, maintenance and reliability. The knowledge gained from the design and comparative analysis phases was used to generate design criteria for flat power cable harnesses and to identify and prioritize flat cable harness components and associated production tooling which require development.

Shuttle: Reaction control system. Cryogenic liquid distribution system: Study

NASA Technical Reports Server (NTRS)

Akkerman, J. W.

1972-01-01

A cryogenic liquid distribution system suitable for the reaction control system on space shuttles is described. The system thermodynamics, operation, performance and weight analysis are discussed along with the design, maintenance and integration concepts.

Influence of water drinking on resting energy expenditure in overweight children.

PubMed

Dubnov-Raz, G; Constantini, N W; Yariv, H; Nice, S; Shapira, N

2011-10-01

It was previously demonstrated that drinking water significantly elevates the resting energy expenditure (REE) in adults, and that low water intake is associated with obesity and lesser success in weight reduction. This study addressed the potential of water drinking to increase the REE in children, as an additional tool for weight management. To examine the effect of drinking water on the REE of overweight children. A total of 21 overweight, otherwise-healthy children (age 9.9±1.4 years, 11 males) drank 10 ml kg(-1) cold water (4 °C). REE was measured before and after water ingestion, for 66 min. The main outcome measure was the change in mean REE from baseline values. Immediately after drinking water, there was a transient decrease in REE, from a baseline value of 3.32±1.15 kilojoule (kJ) per min to 2.56±0.66 kJ per min at minute 3 (P=0.005). A subsequent rise in REE was then observed, which was significantly higher than baseline after 24 min (3.89±0.78 kJ/min (P=0.021)), and at most time points thereafter. Maximal mean REE values were seen at 57 min after water drinking (4.16±1.43 kJ per min (P=0.004)), which were 25% higher than baseline. REE was significantly correlated with age, height, weight and fat-free mass; the correlations with maximal REE values after water drinking were stronger than with baseline REE values. This study demonstrated an increase of up to 25% in REE following the drinking of 10 ml kg(-1) of cold water in overweight children, lasting for over 40 min. Consuming the recommended daily amount of water for children could result in an energy expenditure equivalent to an additional weight loss of about 1.2 kg per year. These findings reinforce the concept of water-induced REE elevation shown in adults, suggesting that water drinking could assist overweight children in weight loss or maintenance, and may warrant emphasis in dietary guidelines against the obesity epidemic.

Cardiometabolic Risk Factor Changes Observed in Diabetes Prevention Programs in US Settings: A Systematic Review and Meta-analysis

PubMed Central

Zabetian, Azadeh; Goodman, Michael; Echouffo-Tcheugui, Justin B.; Albright, Ann L.; Gregg, Edward W.; Ali, Mohammed K.

2016-01-01

Background The Diabetes Prevention Program (DPP) study showed that weight loss in high-risk adults lowered diabetes incidence and cardiovascular disease risk. No prior analyses have aggregated weight and cardiometabolic risk factor changes observed in studies implementing DPP interventions in nonresearch settings in the United States. Methods and Findings In this systematic review and meta-analysis, we pooled data from studies in the United States implementing DPP lifestyle modification programs (focused on modest [5%–7%] weight loss through ≥150 min of moderate physical activity per week and restriction of fat intake) in clinical, community, and online settings. We reported aggregated pre- and post-intervention weight and cardiometabolic risk factor changes (fasting blood glucose [FBG], glycosylated hemoglobin [HbA1c], systolic or diastolic blood pressure [SBP/DBP], total [TC] or HDL-cholesterol). We searched the MEDLINE, EMBASE, Cochrane Library, and Clinicaltrials.gov databases from January 1, 2003, to May 1, 2016. Two reviewers independently evaluated article eligibility and extracted data on study designs, populations enrolled, intervention program characteristics (duration, number of core and maintenance sessions), and outcomes. We used a random effects model to calculate summary estimates for each outcome and associated 95% confidence intervals (CI). To examine sources of heterogeneity, results were stratified according to the presence of maintenance sessions, risk level of participants (prediabetes or other), and intervention delivery personnel (lay or professional). Forty-four studies that enrolled 8,995 participants met eligibility criteria. Participants had an average age of 50.8 years and body mass index (BMI) of 34.8 kg/m2, and 25.2% were male. On average, study follow-up was 9.3 mo (median 12.0) with a range of 1.5 to 36 months; programs offered a mean of 12.6 sessions, with mean participant attendance of 11.0 core sessions. Sixty percent of programs offered some form of post-core maintenance (either email or in person). Mean absolute changes observed were: weight -3.77 kg (95% CI: -4.55; -2.99), HbA1c -0.21% (-0.29; -0.13), FBG -2.40 mg/dL (-3.59; -1.21), SBP -4.29 mmHg (-5.73, -2.84), DBP -2.56 mmHg (-3.40, 1.71), HDL +0.85 mg/dL (-0.10, 1.60), and TC -5.34 mg/dL (-9.72, -0.97). Programs with a maintenance component achieved greater reductions in weight (additional -1.66kg) and FBG (additional -3.14 mg/dl). Findings are subject to incomplete reporting and heterogeneity of studies included, and confounding because most included studies used pre-post study designs. Conclusions DPP lifestyle modification programs achieved clinically meaningful weight and cardiometabolic health improvements. Together, these data suggest that additional value is gained from these programs, reinforcing that they are likely very cost-effective. PMID:27459705

Analysis of weight control in Korean adolescents using the transtheoretical model.

PubMed

Chae, Sun-Mi; Kwon, Insook; Kim, Chun-Ja; Jang, Jaecheol

2010-06-01

The purpose of this study was to identify the stages of change, the processes of change, and the decisional balance for weight control, self-efficacy, and other weight control-related variables and to determine the significant factors explaining movements between the stages of change in Korean adolescents. A total of 475 adolescents completed questionnaires and anthropometric measures. The majority of the adolescents were in the precontemplation (42.1%) and contemplation (43.0%) stages. The benefits of weight control (pros), desire for weight change, perceived body shape, and past experience with weight control increased the odds ratio of movement from precontemplation to contemplation. Stimulus control, self-reevaluation, regular exercise, and past experience of weight control significantly influenced the movement to action and maintenance from contemplation. The study results suggest that weight control programs should emphasize significant factors to help adolescents move through the stages of change.

Time-series modeling of long-term weight self-monitoring data.

PubMed

Helander, Elina; Pavel, Misha; Jimison, Holly; Korhonen, Ilkka

2015-08-01

Long-term self-monitoring of weight is beneficial for weight maintenance, especially after weight loss. Connected weight scales accumulate time series information over long term and hence enable time series analysis of the data. The analysis can reveal individual patterns, provide more sensitive detection of significant weight trends, and enable more accurate and timely prediction of weight outcomes. However, long term self-weighing data has several challenges which complicate the analysis. Especially, irregular sampling, missing data, and existence of periodic (e.g. diurnal and weekly) patterns are common. In this study, we apply time series modeling approach on daily weight time series from two individuals and describe information that can be extracted from this kind of data. We study the properties of weight time series data, missing data and its link to individuals behavior, periodic patterns and weight series segmentation. Being able to understand behavior through weight data and give relevant feedback is desired to lead to positive intervention on health behaviors.

Protein-Pacing Caloric-Restriction Enhances Body Composition Similarly in Obese Men and Women during Weight Loss and Sustains Efficacy during Long-Term Weight Maintenance.

PubMed

Arciero, Paul J; Edmonds, Rohan; He, Feng; Ward, Emery; Gumpricht, Eric; Mohr, Alex; Ormsbee, Michael J; Astrup, Arne

2016-07-30

Short-Term protein-pacing (P; ~6 meals/day, >30% protein/day) and caloric restriction (CR, ~25% energy deficit) improves total (TBF), abdominal (ABF) and visceral (VAT) fat loss, energy expenditure, and biomarkers compared to heart healthy (HH) recommendations (3 meals/day, 15% protein/day) in obese adults. Less is known whether obese men and women respond similarly to P-CR during weight loss (WL) and whether a modified P-CR (mP-CR) is more efficacious than a HH diet during long-term (52 week) weight maintenance (WM). The purposes of this study were to evaluate the efficacy of: (1) P-CR on TBF, ABF, resting metabolic rate (RMR), and biomarkers between obese men and women during WL (weeks 0-12); and (2) mP-CR compared to a HH diet during WM (weeks 13-64). During WL, men (n = 21) and women (n = 19) were assessed for TBF, ABF, VAT, RMR, and biomarkers at weeks 0 (pre) and 12 (post). Men and women had similar reductions (p < 0.01) in weight (10%), TBF (19%), ABF (25%), VAT (33%), glucose (7%-12%), insulin (40%), leptin (>50%) and increase in % lean body mass (9%). RMR (kcals/kg bodyweight) was unchanged and respiratory quotient decreased 9%. Twenty-four subjects (mP-CR, n = 10; HH, n = 14) completed WM. mP-CR regained significantly less body weight (6%), TBF (12%), and ABF (17%) compared to HH (p < 0.05). Our results demonstrate P-CR enhances weight loss, body composition and biomarkers, and maintains these changes for 52-weeks compared to a traditional HH diet.

Physical Activity Patterns in the National Weight Control Registry

PubMed Central

Catenacci, Victoria A.; Ogden, Lorraine G.; Stuht, Jennifer; Phelan, Suzanne; Wing, Rena R.; Hill, James O.; Wyatt, Holly R.

2015-01-01

Objective The National Weight Control Registry (NWCR) was established in 1993 to examine the characteristics of those who are successful at weight loss: individuals maintaining a 13.6-kg weight loss for >1 year. The size of the registry has increased substantially since the early descriptions of this group a decade ago. The purpose of this study was to describe in detail the weekly physical activity habits of NWCR members, to examine the relationship between amount of activity and demographic characteristics, and to determine if changes in activity parameters have occurred over time. Methods and Procedures Participants were 887 men and 2,796 women who enrolled in the NWCR between 1993 and 2004. Physical activity was evaluated at registry entry using the Paffenbarger Physical Activity Questionnaire. Results NWCR entrants report an average of 2,621 ± 2,252 kcal/week in physical activity. There is considerable variability in the amount of activity reported: 25.3% report <1,000 kcal/week and 34.9% report >3,000 kcal/week. Activity level on registry entry is related to the magnitude but not the duration of weight loss. The amount of activity reported by men has decreased over time while no significant change was observed in women. Changes in the types of activities most frequently reported were also observed. Discussion Overall, NWCR participants are an extremely physically active group. However, the amount of activity reported is highly variable, making it difficult to develop a single recommendation for the optimum amount of physical activity for weight loss maintenance. A better understanding of individual-specific determinants of how much activity is required for weight loss maintenance ought to be a high research priority. PMID:18223628

Protein-Pacing Caloric-Restriction Enhances Body Composition Similarly in Obese Men and Women during Weight Loss and Sustains Efficacy during Long-Term Weight Maintenance

PubMed Central

Arciero, Paul J.; Edmonds, Rohan; He, Feng; Ward, Emery; Gumpricht, Eric; Mohr, Alex; Ormsbee, Michael J.; Astrup, Arne

2016-01-01

Short-Term protein-pacing (P; ~6 meals/day, >30% protein/day) and caloric restriction (CR, ~25% energy deficit) improves total (TBF), abdominal (ABF) and visceral (VAT) fat loss, energy expenditure, and biomarkers compared to heart healthy (HH) recommendations (3 meals/day, 15% protein/day) in obese adults. Less is known whether obese men and women respond similarly to P-CR during weight loss (WL) and whether a modified P-CR (mP-CR) is more efficacious than a HH diet during long-term (52 week) weight maintenance (WM). The purposes of this study were to evaluate the efficacy of: (1) P-CR on TBF, ABF, resting metabolic rate (RMR), and biomarkers between obese men and women during WL (weeks 0–12); and (2) mP-CR compared to a HH diet during WM (weeks 13–64). During WL, men (n = 21) and women (n = 19) were assessed for TBF, ABF, VAT, RMR, and biomarkers at weeks 0 (pre) and 12 (post). Men and women had similar reductions (p < 0.01) in weight (10%), TBF (19%), ABF (25%), VAT (33%), glucose (7%–12%), insulin (40%), leptin (>50%) and increase in % lean body mass (9%). RMR (kcals/kg bodyweight) was unchanged and respiratory quotient decreased 9%. Twenty-four subjects (mP-CR, n = 10; HH, n = 14) completed WM. mP-CR regained significantly less body weight (6%), TBF (12%), and ABF (17%) compared to HH (p < 0.05). Our results demonstrate P-CR enhances weight loss, body composition and biomarkers, and maintains these changes for 52-weeks compared to a traditional HH diet. PMID:27483317

Kefir drink leads to a similar weight loss, compared with milk, in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women: a randomized controlled trial.

PubMed

Fathi, Yasamin; Faghih, Shiva; Zibaeenezhad, Mohammad Javad; Tabatabaei, Sayed Hamid Reza

2016-02-01

Controversy exists regarding whether increasing dairy intake without energy restriction would lead to weight loss. We aimed to compare the potential weight-reducing effects of kefir drink (a probiotic dairy product) and milk in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women. One hundred and forty-four subjects were assessed for eligibility in this single-center, multi-arm, parallel-group, randomized controlled trial. Of these, seventy-five eligible women aged 25-45 years were randomly assigned to three groups, labeled as control, milk, and kefir, to receive an outpatient dietary regimen for 8 weeks. Subjects in the control group received a diet providing a maintenance level of energy intake, containing 2 servings/day of low-fat dairy products, while those in the milk and kefir groups received a weight maintenance diet, containing 2 additional servings/day (a total of 4 servings/day) of dairy products from low-fat milk or commercial kefir drink, respectively. Anthropometric outcomes including weight, body mass index (BMI), and waist circumference (WC) were measured every 2 weeks. Fifty-eight subjects completed the study. Using analysis of covariance models in the intention-to-treat population (n = 75), we found that at 8 weeks, subjects in the kefir and milk groups had significantly greater reductions in weight, BMI, and WC compared to those in the control group (all p < 0.01). However, no such significant differences were found between the kefir and milk groups. Kefir drink leads to a similar weight loss, compared with milk, in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women. However, further studies are warranted.

High speed ground penetrating radar for road pavement and bridge structural inspection and maintenance : final report.

DOT National Transportation Integrated Search

2016-06-30

The overarching objective of this research is the development of a systematic methodology of employing GPR, including instruments, subsequent data processing and interpretation that can be used regularly as part of a roadway pavement and bridge evalu...

[Thermolabile drugs: pharmacist intervention as a guarantee of cold chain maintenance].

PubMed

Ricote-Lobera, I; Santos-Mena, B; Fraile-Gil, S; Ortiz-Martín, B; Hidalgo-Correas, F J; García-Díaz, B

2014-05-01

To determine whether pharmacist is able to guarantee cold chain maintenance of thermolabile drugs during transport using the available information in the reception process and to compare these results with those obtained in a subsequent intervention phase, in which the manufacturing laboratories were contacted. Intervention study, prospective and comparative"before-after". It was analyzed the storage conditions during transport of all thermolabile drugs received in a 400-bed hospital for 3 months, excluding those from clinical trials. The intervention allowed to ensure cold chain maintenance in 76,5% (n = 488) of received drugs, representing an increase of 41,8% (IC 95% 36,7-46,6%; p < 0,001) compared with the percentage obtained before the intervention. The pharmacist isn't able to ensure the cold chain maintenance of received thermolabile drugs without temperature monitoring device (64,6%). Reports requested from laboratories allowed to increase significantly that percentage. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Aripiprazole for the maintenance treatment of bipolar I disorder: A review.

PubMed

McIntyre, Roger S

2010-01-01

Bipolar disorder is a chronic neuropsychiatric syndrome associated with substantial rates of recurrence, interepisodic dysfunction, comorbidity, and premature mortality. Metabolic comorbidity (eg, overweight, obesity, metabolic syndrome) differentially affects individuals with bipolar disorder and contributes to increased illness-associated morbidity and mortality (ie, cardiovascular disease). Few pharmacologic agents have been approved by the US Food and Drug Administration for the maintenance treatment of bipolar disorder. This paper discusses the metabolic profile of aripiprazole and reviews pivotal registration trials of aripiprazole for the maintenance treatment of adults with bipolar I disorder. MEDLINE was searched for English-language articles published between January 1995 and November 2009. The key search term was aripiprazole, combined with bipolar disorder and maintenance treatment. The review was limited to randomized, controlled registration trials, supplemented by poster presentations involving the registration-trial data sets. Three studies of the efficacy and tolerability of aripiprazole monotherapy in the maintenance treatment of bipolar I disorder were identified by the literature search: a 26-week, randomized, double-blind study and its 74-week extension phase (for a total of 100 weeks of double-blind treatment), and a randomized, double-blind comparison of aripiprazole with placebo and lithium (internal comparator) for up to 12 weeks. After 100 weeks of double-blind treatment, aripiprazole had a minimal effect on body composition and did not disrupt metabolic parameters compared with placebo. The mean (SD) weight change was 0.4 (0.8) kg with aripiprazole and -1.9 (0.8) kg with placebo (P = NS). A clinically significant (> or =7%) increase in weight occurred in 20% of the aripiprazole group and 5% of the placebo group (P = 0.01). Extrapyramidal symptoms were reported in 22% of the aripiprazole group and 15% of the placebo group. The identified trials of aripiprazole primarily enrolled patients during a manic state; no maintenance trials of combination therapy or trials enrolling individuals presenting with an acute depressive episode were identified. The available evidence supports the efficacy and tolerability of aripiprazole in the maintenance treatment of bipolar disorder. The placebo-subtracted differences in body composition and metabolic parameters suggest utility for aripiprazole in the long-term treatment of bipolar disorder. 2010 Excerpta Medica Inc. All rights reserved.

Role of protein synthesis and DNA methylation in the consolidation and maintenance of long-term memory in Aplysia

PubMed Central

Pearce, Kaycey; Cai, Diancai; Roberts, Adam C; Glanzman, David L

2017-01-01

Previously, we reported that long-term memory (LTM) in Aplysia can be reinstated by truncated (partial) training following its disruption by reconsolidation blockade and inhibition of PKM (Chen et al., 2014). Here, we report that LTM can be induced by partial training after disruption of original consolidation by protein synthesis inhibition (PSI) begun shortly after training. But when PSI occurs during training, partial training cannot subsequently establish LTM. Furthermore, we find that inhibition of DNA methyltransferase (DNMT), whether during training or shortly afterwards, blocks consolidation of LTM and prevents its subsequent induction by truncated training; moreover, later inhibition of DNMT eliminates consolidated LTM. Thus, the consolidation of LTM depends on two functionally distinct phases of protein synthesis: an early phase that appears to prime LTM; and a later phase whose successful completion is necessary for the normal expression of LTM. Both the consolidation and maintenance of LTM depend on DNA methylation. DOI: http://dx.doi.org/10.7554/eLife.18299.001 PMID:28067617

Risk-based maintenance of ethylene oxide production facilities.

PubMed

Khan, Faisal I; Haddara, Mahmoud R

2004-05-20

This paper discusses a methodology for the design of an optimum inspection and maintenance program. The methodology, called risk-based maintenance (RBM) is based on integrating a reliability approach and a risk assessment strategy to obtain an optimum maintenance schedule. First, the likely equipment failure scenarios are formulated. Out of many likely failure scenarios, the ones, which are most probable, are subjected to a detailed study. Detailed consequence analysis is done for the selected scenarios. Subsequently, these failure scenarios are subjected to a fault tree analysis to determine their probabilities. Finally, risk is computed by combining the results of the consequence and the probability analyses. The calculated risk is compared against known acceptable criteria. The frequencies of the maintenance tasks are obtained by minimizing the estimated risk. A case study involving an ethylene oxide production facility is presented. Out of the five most hazardous units considered, the pipeline used for the transportation of the ethylene is found to have the highest risk. Using available failure data and a lognormal reliability distribution function human health risk factors are calculated. Both societal risk factors and individual risk factors exceeded the acceptable risk criteria. To determine an optimal maintenance interval, a reverse fault tree analysis was used. The maintenance interval was determined such that the original high risk is brought down to an acceptable level. A sensitivity analysis is also undertaken to study the impact of changing the distribution of the reliability model as well as the error in the distribution parameters on the maintenance interval.

A Randomized Trial of Lorcaserin and Lifestyle Counseling for Maintaining Weight Loss Achieved with a Low-Calorie Diet

PubMed Central

Tronieri, Jena Shaw; Wadden, Thomas A.; Berkowitz, Robert I.; Chao, Ariana M.; Pearl, Rebecca L.; Alamuddin, Naji; Leonard, Sharon M.; Carvajal, Ray; Bakizada, Zayna M.; Pinkasavage, Emilie; Gruber, Kathryn A.; Walsh, Olivia A.; Alfaris, Nasreen

2017-01-01

Objective Improving the maintenance of lost weight remains a critical challenge, which can be addressed by long-term behavioral and/or pharmacological interventions. Methods This study investigated the efficacy of combined behavioral and pharmacological treatment in facilitating weight loss maintenance (WLM) in 137 adults (86.1% female, 68.6% black, BMI=37.0±5.6 kg/m2) who had lost ≥5% of initial weight during a 14-week, low-calorie diet (LCD) program (mean=9.3±2.9%). Participants were randomly assigned to lorcaserin (10 mg BID) or placebo and provided 16 group WLM counseling sessions over 52 weeks. Results At 24 weeks post-randomization, more lorcaserin- than placebo-treated participants maintained ≥5% loss (73.9% vs 57.4%; p=.033), and the former participants lost an additional 2.4±0.8 kg versus a 0.6±0.8 kg gain for placebo (p=.010). However, at week 52, groups did not differ on either co-primary outcome; 55.1% and 42.6%, respectively, maintained ≥5% loss (p=0.110), with gains from randomization of 2.0±0.8 and 2.5±0.8 kg (p=0.630), respectively. From the start of the LCD, groups maintained reductions of 7.8% and 6.6%, respectively (p=0.318). Conclusion Combined behavioral-pharmacologic treatment produced clinically meaningful long-term weight loss in this group of predominantly black participants. Lorcaserin initially improved upon weight loss achieved with WLM counseling, but this advantage was not maintained at 1 year. PMID:20379151

Reliability-based optimization of maintenance scheduling of mechanical components under fatigue

PubMed Central

Beaurepaire, P.; Valdebenito, M.A.; Schuëller, G.I.; Jensen, H.A.

2012-01-01

This study presents the optimization of the maintenance scheduling of mechanical components under fatigue loading. The cracks of damaged structures may be detected during non-destructive inspection and subsequently repaired. Fatigue crack initiation and growth show inherent variability, and as well the outcome of inspection activities. The problem is addressed under the framework of reliability based optimization. The initiation and propagation of fatigue cracks are efficiently modeled using cohesive zone elements. The applicability of the method is demonstrated by a numerical example, which involves a plate with two holes subject to alternating stress. PMID:23564979

Comparison of feed energy costs of maintenance, lean deposition, and fat deposition in three lines of mice selected for heat loss.

PubMed

Eggert, D L; Nielsen, M K

2006-02-01

Three replications of mouse selection populations for high heat loss (MH), low heat loss (ML), and a nonselected control (MC) were used to estimate the feed energy costs of maintenance and gain and to test whether selection had changed these costs. At 21 and 49 d of age, mice were weighed and subjected to dual x-ray densitometry measurement for prediction of body composition. At 21 d, mice were randomly assigned to an ad libitum, an 80% of ad libitum, or a 60% of ad libitum feeding group for 28-d collection of individual feed intake. Data were analyzed using 3 approaches. The first approach was an attempt to partition energy intake between costs for maintenance, fat deposition, and lean deposition for each replicate, sex, and line by multiple regression of feed intake on the sum of daily metabolic weight (kg(0.75)), fat gain, and lean gain. Approach II was a less restrictive attempt to partition energy intake between costs for maintenance and total gain for each replicate, sex, and line by multiple regression of feed intake on the sum of daily metabolic weight and total gain. Approach III used multiple regression on the entire data set with pooled regressions on fat and lean gains, and subclass regressions for maintenance. Contrasts were conducted to test the effect of selection (MH - ML) and asymmetry of selection [(MH + ML)/2 - MC] for the various energy costs. In approach I, there were no differences between lines for costs of maintenance, fat deposition, or protein deposition, but we question our ability to estimate these accurately. In approach II, selection changed both cost of maintenance (P = 0.03) and gain (P = 0.05); MH mice had greater per unit costs than ML mice for both. Asymmetry of the selection response was found in approach II for the cost of maintenance (P = 0.06). In approach III, the effect of selection (P < 0.01) contributed to differences in the maintenance cost, but asymmetry of selection (P > 0.17) was not evident. Sex effects were found for the cost of fat deposition (P = 0.02) in approach I and the cost of gain (P = 0.001) in approach II; females had a greater cost per unit than males. When costs per unit of fat and per unit of lean gain were assumed to be the same for both sexes (approach III), females had a somewhat greater estimate for maintenance cost (P = 0.10). We conclude that selection for heat loss has changed the costs for maintenance per unit size but probably not the costs for gain.

Effect of Web-based lifestyle modification on weight control: a meta-analysis.

PubMed

Kodama, S; Saito, K; Tanaka, S; Horikawa, C; Fujiwara, K; Hirasawa, R; Yachi, Y; Iida, K T; Shimano, H; Ohashi, Y; Yamada, N; Sone, H

2012-05-01

Web-based treatment programs are attractive in primary care because of their ability to reach numerous individuals at low cost. Our aim of this meta-analysis is to systematically review the weight loss or maintenance effect of the Internet component in obesity treatment programs. MEDLINE and EMBASE literature searches were conducted to identify studies investigating the effect of Web-based individualized advice on lifestyle modification on weight loss. Randomized controlled trials that consisted of a Web-user experimental and non-Web user control group were included. Weight changes in the experimental group in comparison with the control group were pooled with a random-effects model. A total of 23 studies comprising 8697 participants were included. Overall, using the Internet had a modest but significant additional weight-loss effect compared with non-Web user control groups (-0.68 kg, P=0.03). In comparison with the control group, stratified analysis indicated that using the Internet as an adjunct to obesity care was effective (-1.00 kg, P<0.001), but that using it as a substitute for face-to-face support was unfavorable (+1.27 kg, P=0.01). An additional effect on weight control was observed when the aim of using the Internet was initial weight loss (-1.01 kg; P=0.03), but was not observed when the aim was weight maintenance (+0.68 kg; P=0.26). The relative effect was diminished with longer educational periods (P-trend=0.04) and was insignificant (-0.20 kg; P=0.75) in studies with educational periods of 12 months or more. The current meta-analysis indicates that the Internet component in obesity treatment programs has a modest effect on weight control. However, the effect was inconsistent, largely depending on the type of usage of the Internet or the period of its use.

Lorcaserin, A 5-HT2C Receptor Agonist, Reduces Body Weight by Decreasing Energy Intake without Influencing Energy Expenditure

PubMed Central

Martin, Corby K.; Redman, Leanne M.; Zhang, Jinkun; Sanchez, Matilde; Anderson, Christen M.; Smith, Steven R.

2011-01-01

Context: Lorcaserin, a selective 5-hydroxytryptamine (5-HT)2C receptor agonist, reduces body weight. It is unclear whether weight loss is due to reduced energy intake (EI) or also to enhanced energy expenditure (EE). Objective: This study tested the effect of lorcaserin on EI and EE. Design, Participants, and Intervention: In a double-blind, randomized, placebo-controlled trial, 57 (39 women) overweight and obese (body mass index, 27–45 kg/m2) adults were randomized to placebo (n = 28) or 10 mg twice daily lorcaserin (n = 29) for 56 d. Weight maintenance was imposed during d 1–7. Beginning on d 8, participants followed a diet and exercise plan targeting a 600 kcal/d deficit. Outcomes: At baseline and after 7 and 56 d of treatment, we measured body weight, body composition (dual x-ray absorptiometry), blood pressure, heart rate, EI at lunch and dinner, subjective appetite ratings, and 24-h EE and 24-h-respiratory quotient (RQ), measured by indirect calorimetry in a respiratory chamber. Results: After 7 d of weight maintenance, EI was significantly (P < 0.01) reduced with lorcaserin but not placebo (mean ± sem for lorcaserin, −286 ± 86 kcal; placebo, −147 ± 89 kcal). After 56 d, lorcaserin resulted in significantly larger reductions in body weight (lorcaserin, −3.8 ± 0.4 kg; placebo, −2.2 ± 0.5 kg; P < 0.01), EI (lorcaserin, −470 ± 87 kcal; placebo, −205 ± 91 kcal; P < .05), and appetite ratings than in placebo. Changes in 24-h EE and 24-h RQ did not differ between groups, even after 24-h EE was adjusted for body weight and composition. Compared with placebo, lorcaserin had no effect on systolic or diastolic blood pressure or heart rate after 56 d. Conclusions: Lorcaserin reduces body weight through reduced EI, not altered EE or RQ. PMID:21190985

Lorcaserin, a 5-HT(2C) receptor agonist, reduces body weight by decreasing energy intake without influencing energy expenditure.

PubMed

Martin, Corby K; Redman, Leanne M; Zhang, Jinkun; Sanchez, Matilde; Anderson, Christen M; Smith, Steven R; Ravussin, Eric

2011-03-01

Lorcaserin, a selective 5-hydroxytryptamine (5-HT)(2C) receptor agonist, reduces body weight. It is unclear whether weight loss is due to reduced energy intake (EI) or also to enhanced energy expenditure (EE). This study tested the effect of lorcaserin on EI and EE. In a double-blind, randomized, placebo-controlled trial, 57 (39 women) overweight and obese (body mass index, 27-45 kg/m(2)) adults were randomized to placebo (n = 28) or 10 mg twice daily lorcaserin (n = 29) for 56 d. Weight maintenance was imposed during d 1-7. Beginning on d 8, participants followed a diet and exercise plan targeting a 600 kcal/d deficit. At baseline and after 7 and 56 d of treatment, we measured body weight, body composition (dual x-ray absorptiometry), blood pressure, heart rate, EI at lunch and dinner, subjective appetite ratings, and 24-h EE and 24-h-respiratory quotient (RQ), measured by indirect calorimetry in a respiratory chamber. After 7 d of weight maintenance, EI was significantly (P < 0.01) reduced with lorcaserin but not placebo (mean ± sem for lorcaserin, -286 ± 86 kcal; placebo, -147 ± 89 kcal). After 56 d, lorcaserin resulted in significantly larger reductions in body weight (lorcaserin, -3.8 ± 0.4 kg; placebo, -2.2 ± 0.5 kg; P < 0.01), EI (lorcaserin, -470 ± 87 kcal; placebo, -205 ± 91 kcal; P < .05), and appetite ratings than in placebo. Changes in 24-h EE and 24-h RQ did not differ between groups, even after 24-h EE was adjusted for body weight and composition. Compared with placebo, lorcaserin had no effect on systolic or diastolic blood pressure or heart rate after 56 d. Lorcaserin reduces body weight through reduced EI, not altered EE or RQ.

49 CFR 236.341 - Latch shoes, rocker links, and quadrants.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Interlocking... downward force not exceeding a man's weight is exerted on the rocker while the lever is in the mid-stroke...

Compost for steep slope erosion.

DOT National Transportation Integrated Search

2008-06-01

This study was initiated to develop guidelines for maintenance erosion control measures for steep slopes. The study focused on evaluating and monitoring KY-31 fescue germination rates using two media treatments 1) 100 percent by weight compost and 2)...

Long-Term Pavement Performance Program falling weight deflectometer maintenance manual

DOT National Transportation Integrated Search

2006-12-01

The Federal Highway Administrations (FHWA) Long-Term Pavement Performance (LTPP) program operates eight Dynatest Model 8000 FWDs to collect deflection data on in-service pavement test sections across North America. LTPP has collected pavement defl...

Weight Loss and the Prevention of Weight Regain: Evaluation of a Treatment Model of Exercise Self-Regulation Generalizing to Controlled Eating.

PubMed

Annesi, James J; Johnson, Ping H; Tennant, Gisèle A; Porter, Kandice J; Mcewen, Kristin L

2016-01-01

For decades, behavioral weight-loss treatments have been unsuccessful beyond the short term. Development and testing of innovative, theoretically based methods that depart from current failed practices is a priority for behavioral medicine. To evaluate a new, theory-based protocol in which exercise support methods are employed to facilitate improvements in psychosocial predictors of controlled eating and sustained weight loss. Women with obesity were randomized into either a comparison treatment that incorporated a print manual plus telephone follow-ups (n = 55) or an experimental treatment of The Coach Approach exercise-support protocol followed after 2 months by group nutrition sessions focused on generalizing self-regulatory skills from an exercise support to a controlled eating context (n = 55). Repeated-measures analysis of variance contrasted group changes in weight, physical activity, fruit and vegetable intake, mood, and exercise- and eating-related self-regulation and self-efficacy over 24 months. Regression analyses determined salient interrelations of change scores over both the weight-loss phase (baseline-month 6) and weight-loss maintenance phase (month 6-month 24). Improvements in all psychological measures, physical activity, and fruit and vegetable intake were significantly greater in the experimental group where a mean weight loss of 5.7 kg (6.1% of initial body weight) occurred at month 6, and was largely maintained at a loss of 5.1 kg (5.4%) through the full 24 months of the study. After establishing temporal intervals for changes in self-regulation, self-efficacy, and mood that best predicted improvements in physical activity and eating, a consolidated multiple mediation model suggested that change in self-regulation best predicted weight loss, whereas change in self-efficacy best predicted maintenance of lost weight. Because for most participants loss of weight remained greater than that required for health benefits, and costs for treatment administration were comparatively low, the experimental protocol was considered successful. After sufficient replication, physician referral and applications within health promotion and wellness settings should be considered.

Weight Loss and the Prevention of Weight Regain: Evaluation of a Treatment Model of Exercise Self-Regulation Generalizing to Controlled Eating

PubMed Central

Annesi, James J; Johnson, Ping H; Tennant, Gisèle A; Porter, Kandice J; McEwen, Kristin L

2016-01-01

Context: For decades, behavioral weight-loss treatments have been unsuccessful beyond the short term. Development and testing of innovative, theoretically based methods that depart from current failed practices is a priority for behavioral medicine. Objective: To evaluate a new, theory-based protocol in which exercise support methods are employed to facilitate improvements in psychosocial predictors of controlled eating and sustained weight loss. Methods: Women with obesity were randomized into either a comparison treatment that incorporated a print manual plus telephone follow-ups (n = 55) or an experimental treatment of The Coach Approach exercise-support protocol followed after 2 months by group nutrition sessions focused on generalizing self-regulatory skills from an exercise support to a controlled eating context (n = 55). Repeated-measures analysis of variance contrasted group changes in weight, physical activity, fruit and vegetable intake, mood, and exercise- and eating-related self-regulation and self-efficacy over 24 months. Regression analyses determined salient interrelations of change scores over both the weight-loss phase (baseline-month 6) and weight-loss maintenance phase (month 6-month 24). Results: Improvements in all psychological measures, physical activity, and fruit and vegetable intake were significantly greater in the experimental group where a mean weight loss of 5.7 kg (6.1% of initial body weight) occurred at month 6, and was largely maintained at a loss of 5.1 kg (5.4%) through the full 24 months of the study. After establishing temporal intervals for changes in self-regulation, self-efficacy, and mood that best predicted improvements in physical activity and eating, a consolidated multiple mediation model suggested that change in self-regulation best predicted weight loss, whereas change in self-efficacy best predicted maintenance of lost weight. Conclusions: Because for most participants loss of weight remained greater than that required for health benefits, and costs for treatment administration were comparatively low, the experimental protocol was considered successful. After sufficient replication, physician referral and applications within health promotion and wellness settings should be considered. PMID:26901268

DKK1 mediated inhibition of Wnt signaling in postnatal mice leads to loss of TEC progenitors and thymic degeneration.

PubMed

Osada, Masako; Jardine, Logan; Misir, Ruth; Andl, Thomas; Millar, Sarah E; Pezzano, Mark

2010-02-08

Thymic epithelial cell (TEC) microenvironments are essential for the recruitment of T cell precursors from the bone marrow, as well as the subsequent expansion and selection of thymocytes resulting in a mature self-tolerant T cell repertoire. The molecular mechanisms, which control both the initial development and subsequent maintenance of these critical microenvironments, are poorly defined. Wnt signaling has been shown to be important to the development of several epithelial tissues and organs. Regulation of Wnt signaling has also been shown to impact both early thymocyte and thymic epithelial development. However, early blocks in thymic organogenesis or death of the mice have prevented analysis of a role of canonical Wnt signaling in the maintenance of TECs in the postnatal thymus. Here we demonstrate that tetracycline-regulated expression of the canonical Wnt inhibitor DKK1 in TECs localized in both the cortex and medulla of adult mice, results in rapid thymic degeneration characterized by a loss of DeltaNP63(+) Foxn1(+) and Aire(+) TECs, loss of K5K8DP TECs thought to represent or contain an immature TEC progenitor, decreased TEC proliferation and the development of cystic structures, similar to an aged thymus. Removal of DKK1 from DKK1-involuted mice results in full recovery, suggesting that canonical Wnt signaling is required for the differentiation or proliferation of TEC populations needed for maintenance of properly organized adult thymic epithelial microenvironments. Taken together, the results of this study demonstrate that canonical Wnt signaling within TECs is required for the maintenance of epithelial microenvironments in the postnatal thymus, possibly through effects on TEC progenitor/stem cell populations. Downstream targets of Wnt signaling, which are responsible for maintenance of these TEC progenitors may provide useful targets for therapies aimed at counteracting age associated thymic involution or the premature thymic degeneration associated with cancer therapy and bone marrow transplants.

Excess thyroid hormone inhibits embryonic neural stem/progenitor cells proliferation and maintenance through STAT3 signalling pathway.

PubMed

Chen, Chunhai; Zhou, Zhou; Zhong, Min; Li, Maoquan; Yang, Xuesen; Zhang, Yanwen; Wang, Yuan; Wei, Aimin; Qu, Mingyue; Zhang, Lei; Xu, Shangcheng; Chen, Shude; Yu, Zhengping

2011-07-01

Hyperthyroidism is prevalent during pregnancy, but little is known about the effects of excess thyroid hormone on the development of embryonic neural stem/progenitor cells (NSCs), and the mechanisms underlying these effects. Previous studies indicate that STAT3 plays a crucial role in determining NSC fate during neurodevelopment. In this study, we investigated the effects of a supraphysiological dose of 3,5,3'-L-triiodothyronine (T3) on the proliferation and maintenance of NSCs derived from embryonic day 13.5 mouse neocortex, and the involvement of STAT3 in this process. Our results suggest that excess T3 treatment inhibits NSC proliferation and maintenance. T3 decreased tyrosine phosphorylation of JAK1, JAK2 and STAT3, and subsequently inhibited STAT3-DNA binding activity. Furthermore, proliferation and maintenance of NSCs were decreased by inhibitors of JAKs and STAT3, indicating that the STAT3 signalling pathway is involved in the process of NSC proliferation and maintenance. Taken together, these results suggest that the STAT3 signalling pathway is involved in the process of T3-induced inhibition of embryonic NSC proliferation and maintenance. These findings provide data for understanding the effects of hyperthyroidism during pregnancy on fetal brain development, and the mechanisms underlying these effects.

Optimisation of maintenance concept choice using risk-decision factor - a case study

NASA Astrophysics Data System (ADS)

Popovic, Vladimir M.; Vasic, Branko M.; Rakicevic, Branislav B.; Vorotovic, Goran S.

2012-10-01

The design of maintenance system and the corresponding logistic support is a very complex process, during which the aim is to find the compromise solutions regarding the relations among different maintenance procedures and the ways of their implementation. As a result of this, various solutions can be adopted, since this is conditioned by a series of important factors and criteria, which can be contradictory sometimes. There are different perspectives on ways of solving practical maintenance problems, that is dilemmas when it comes to the choice of maintenance concept. The principal dilemma is how and when to decide on carrying out maintenance procedures. Should the decision be based on theoretical grounds or experience, how does one reconcile those two extremes, who is to decide upon this? In this article we have offered one, basically new solution as a possibility for maintenance concept choice, based on a significant modification of the widely used failure modes and effects analysis (FMEA) method. This solution is risk-decision factor (RDF). This is a result of seven parameters (of different importance and weight) that have the key impact on the process of production and logistic support. The application of this factor is illustrated by the example of planning, organisation and functioning of the maintenance system applied in The Institute for Manufacturing Banknotes and Coins (ZIN) in Belgrade.

Determination of the bridge maintenance and rehabilitation priority scale in kabupaten Pinrang

NASA Astrophysics Data System (ADS)

Nurdin, Asrul; Kristiawan, S. A.; Dewi, Handayani

2017-01-01

This study attempts to get the support system to help stakeholders and the decision makers in the determination of priorities the maintenance and rehabilitation of the Bridge.The location of the study is done in Kabupaten Pinrang. Bridge damage value is specified using assessment standard Bridge Management System (BMS). There are 13 Bridges by details as follows: good condition with the condition 1 in 6 Bridge, damaged with the condition two as many as five fruit Bridges and there are two Bridges by value condition of three which means need handling rehabilitation. From our observation examination Bridges and it has been obtained the results of then afterward determined the priority scale by using the method Analytic Hierarchy Process. The discussion or interview of 27 respondents in completion question to determines the priorities of handling bridges by three (3) criteria and three sub- criteria with weights each: a condition of damage with weights 0,491 or amounting to 49,1 % followed by criteria policy with weights 0,324 % then criteria volume traffic weight of 0,185 or 18.5 %. Based on the results of this can be concluded that the implementation of a method of Analytic Hierarchy Processing is effective in determining the scale of priorities for the stakeholders. Having acquired value bridge condition and weights of the assessment results of the, then is needed to Analysis of spatial use application ArcGIS to obtain information condition Bridge Map.

Prospective relationships between body weight and physical activity: an observational analysis from the NAVIGATOR study.

PubMed

Preiss, David; Thomas, Laine E; Wojdyla, Daniel M; Haffner, Steven M; Gill, Jason M R; Yates, Thomas; Davies, Melanie J; Holman, Rury R; McMurray, John J; Califf, Robert M; Kraus, William E

2015-08-14

While bidirectional relationships exist between body weight and physical activity, direction of causality remains uncertain and previous studies have been limited by self-reported activity or weight and small sample size. We investigated the prospective relationships between weight and physical activity. Observational analysis of data from the Nateglinide And Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) study, a double-blinded randomised clinical trial of nateglinide and valsartan, respectively. Multinational study of 9306 participants. Participants with biochemically confirmed impaired glucose tolerance had annual measurements of both weight and step count using research grade pedometers, worn for 7 days consecutively. Along with randomisation to valsartan or placebo plus nateglinide or placebo, participants took part in a lifestyle modification programme. Longitudinal regression using weight as response value and physical activity as predictor value was conducted, adjusted for baseline covariates. Analysis was then repeated with physical activity as response value and weight as predictor value. Only participants with a response value preceded by at least three annual response values were included. Adequate data were available for 2811 (30%) of NAVIGATOR participants. Previous weight (χ(2)=16.8; p<0.0001), but not change in weight (χ(2)=0.1; p=0.71) was inversely associated with subsequent step count, indicating lower subsequent levels of physical activity in heavier individuals. Change in step count (χ(2)=5.9; p=0.02) but not previous step count (χ(2)=0.9; p=0.34) was inversely associated with subsequent weight. However, in the context of trajectories already established for weight (χ(2) for previous weight measurements 747.3; p<0.0001) and physical activity (χ(2) for previous step count 432.6; p<0.0001), these effects were of limited clinical importance. While a prospective bidirectional relationship was observed between weight and physical activity, the magnitude of any effect was very small in the context of natural trajectories already established for these variables. NCT00097786. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

40 CFR 86.1725-99 - Maintenance.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) through (e) and subsequent model year provisions. (b) Manufacturers of series hybrid electric vehicles and... the first time the minimum performance level is observed for all battery system components. Possible... system consisting of a light that shall illuminate the first time the battery system is unable to achieve...

40 CFR 86.1725-99 - Maintenance.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) through (e) and subsequent model year provisions. (b) Manufacturers of series hybrid electric vehicles and... the first time the minimum performance level is observed for all battery system components. Possible... system consisting of a light that shall illuminate the first time the battery system is unable to achieve...

40 CFR 86.1725-99 - Maintenance.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) through (e) and subsequent model year provisions. (b) Manufacturers of series hybrid electric vehicles and... the first time the minimum performance level is observed for all battery system components. Possible... system consisting of a light that shall illuminate the first time the battery system is unable to achieve...

40 CFR 86.1725-99 - Maintenance.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) through (e) and subsequent model year provisions. (b) Manufacturers of series hybrid electric vehicles and... the first time the minimum performance level is observed for all battery system components. Possible... system consisting of a light that shall illuminate the first time the battery system is unable to achieve...

Stacking Up

ERIC Educational Resources Information Center

Naylor, Jim

2005-01-01

Chimneys and stacks appear to be strong and indestructible, but chimneys begin to deteriorate from the moment they are built. Early on, no signs are apparent; but deterioration accelerates in subsequent years, and major repairs are soon needed instead of minor maintenance. With proper attention, most structures can be repaired and continue to…

Rucaparib Approved as Maintenance Therapy for Ovarian Cancer

Cancer.gov

FDA has expanded its approval of rucaparib for women with ovarian, fallopian tube, or primary peritoneal cancer. As this Cancer Currents blog post explains, it can now be used to treat women with recurrent disease whose tumors shrank after subsequent treatment with a platinum-based chemotherapy.

46 CFR Sec. 12 - Audit.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false Audit. Sec. 12 Section 12 Shipping MARITIME... TRANSACTIONS UNDER AGENCY AGREEMENTS Reports and Audit Sec. 12 Audit. (a) The owner will audit as currently as possible subsequent to audit by the agent, all documents relating to the activities, maintenance and...

40 CFR 85.2120 - Maintenance and submittal of records.

Code of Federal Regulations, 2010 CFR

2010-07-01

... testing program, including all production part sampling techniques used to verify compliance of the... subsequent analyses of that data; (7) A description of all the methodology, analysis, testing and/or sampling techniques used to ascertain the emission critical parameter specifications of the originial equipment part...

Weight patterns in children with higher risk ALL: A report from the Children's Oncology Group (COG) for CCG 1961.

PubMed

Withycombe, Janice S; Post-White, Janice E; Meza, Jane L; Hawks, Ria G; Smith, Lynette M; Sacks, Nancy; Seibel, Nita L

2009-12-15

This retrospective analysis defined and described patterns and predictors of weight change during treatment in children with acute lymphocytic leukemia (ALL) with high-risk features who received treatment on Children's Cancer Group protocol CCG 1961. Patients (1,638) were enrolled in CCG 1961 from November 1996 to May 2002. Weight was measured as BMI percent (%), specific for age and gender, and defined as 100 x ln(BMI/median BMI). By the end of treatment, 23% of children were obese (BMI >or=95%), compared with 14% at diagnosis. Children who received post-induction intensified therapy (arms C, D, SER with Doxorubicin or Idarubicin) had higher gastrointestinal toxicities and lower BMI% from consolidation through interim maintenance 1. BMI% then increased for all arms between delayed intensification and maintenance 1 or 2. Children who were of Black or Hispanic race, obese at diagnosis, or who had grade 3 or 4 pancreatitis/glucose toxicities during induction had higher BMI% throughout treatment. Children were more likely to be obese at the end of the study if they were aged 5-9 years at diagnosis or female gender. Cranial radiation was not a predictor of obesity. Successful treatment of higher risk childhood ALL was associated with obesity, independent of cranial irradiation. The beginning of maintenance therapy may be the best time to intervene with nutritional and behavioral interventions, particularly for children who are obese or aged 5-9 years at diagnosis, female, Black or Hispanic, or those with metabolic toxicities during induction. (c) 2009 Wiley-Liss, Inc.

Weight Patterns in Children With Higher Risk ALL: A Report From the Children's Oncology Group (COG) for CCG 1961

PubMed Central

Withycombe, Janice S.; Post-White, Janice E.; Meza, Jane L.; Hawks, Ria G.; Smith, Lynette M.; Sacks, Nancy; Seibel, Nita L.

2011-01-01

Background This retrospective analysis defined and described patterns and predictors of weight change during treatment in children with acute lymphocytic leukemia (ALL) with high-risk features who received treatment on Children's Cancer Group protocol CCG 1961. Procedure Patients (1,638) were enrolled in CCG 1961 from November 1996 to May 2002. Weight was measured as BMI percent (%), specific for age and gender, and defined as 100 × ln(BMI/median BMI). Results By the end of treatment, 23% of children were obese (BMI ≥ 95%), compared with 14% at diagnosis. Children who received post-induction intensified therapy (arms C, D, SER with Doxorubicin or Idarubicin) had higher gastrointestinal toxicities and lower BMI% from consolidation through interim maintenance 1. BMI% then increased for all arms between delayed intensification and maintenance 1 or 2. Children who were of Black or Hispanic race, obese at diagnosis, or who had grade 3 or 4 pancreatitis/glucose toxicities during induction had higher BMI% throughout treatment. Children were more likely to be obese at the end of the study if they were aged 5–9 years at diagnosis or female gender. Cranial radiation was not a predictor of obesity. Conclusions Successful treatment of higher risk childhood ALL was associated with obesity, independent of cranial irradiation. The beginning of maintenance therapy may be the best time to intervene with nutritional and behavioral interventions, particularly for children who are obese or aged 5–9 years at diagnosis, female, Black or Hispanic, or those with metabolic toxicities during induction. PMID:19688832

Self-perceived successful weight regulators are less affected by self-regulatory depletion in the domain of eating behavior.

PubMed

Friese, Malte; Engeler, Michèle; Florack, Arnd

2015-01-01

Weight loss and maintenance goals are highly prevalent in many affluent societies, but many weight regulators are not successful in the long term. Research started to reveal psychological mechanisms that help successful weight regulators in being successful. In the present study, we tested the assumption that these mechanisms facilitate successful self-regulation particularly under conditions of self-regulatory depletion. Participants exerted or did not exert self-control in a first task before engaging in a taste test of a tempting but unhealthy food. Participants who had initially exerted self-control ate more than participants in the control condition. This effect was reduced in self-perceived successful weight regulators as compared to perceived unsuccessful self-regulators. A reduced susceptibility to self-regulatory depletion may be an important contributor to long-term weight regulation success in successful weight regulators. Copyright © 2014 Elsevier Ltd. All rights reserved.

Nutrition Interventions for Obesity.

PubMed

Ard, Jamy D; Miller, Gary; Kahan, Scott

2016-11-01

Obesity is a common disorder with complex causes. The epidemic has spurred significant advances in the understanding of nutritional approaches to treating obesity. Although the primary challenge is to introduce a dietary intake that creates an energy deficit, clinicians should also consider targeted risk factor modification with manipulation of the nutrient profile of the weight-reducing diet. These strategies produce significant weight loss and improvements in cardiometabolic risk factors. Future research is needed to better understand how to personalize nutrient prescriptions further to promote optimal risk modification and maintenance of long-term energy balance in the weight-reduced state. Copyright © 2016 Elsevier Inc. All rights reserved.

The NULevel trial of a scalable, technology-assisted weight loss maintenance intervention for obese adults after clinically significant weight loss: study protocol for a randomised controlled trial.

PubMed

Evans, Elizabeth H; Araújo-Soares, Vera; Adamson, Ashley; Batterham, Alan M; Brown, Heather; Campbell, Miglena; Dombrowski, Stephan U; Guest, Alison; Jackson, Daniel; Kwasnicka, Dominika; Ladha, Karim; McColl, Elaine; Olivier, Patrick; Rothman, Alexander J; Sainsbury, Kirby; Steel, Alison J; Steen, Ian Nicholas; Vale, Luke; White, Martin; Wright, Peter; Sniehotta, Falko F

2015-09-22

Effective weight loss interventions are widely available but, after weight loss, most individuals regain weight. This article describes the protocol for the NULevel trial evaluating the effectiveness and cost-effectiveness of a systematically developed, inexpensive, scalable, technology-assisted, behavioural intervention for weight loss maintenance (WLM) in obese adults after initial weight loss. A 12-month single-centre, two-armed parallel group, participant randomised controlled superiority trial is underway, recruiting a total of 288 previously obese adults after weight loss of ≥5 % within the previous 12 months. Participants are randomly assigned to intervention or control arms, with a 1:1 allocation, stratified by sex and percentage of body weight lost (<10 % vs ≥10 %). Change in weight (kg) from baseline to 12 months is the primary outcome. Weight, other anthropometric variables and 7-day physical activity (assessed via accelerometer) measures are taken at 0 and 12 months. Questionnaires at 0, 6 and 12 months assess psychological process variables, health service use and participant costs. Participants in the intervention arm initially attend an individual face-to-face WLM consultation with an intervention facilitator and then use a mobile internet platform to self-monitor and report their diet, daily activity (via pedometer) and weight through daily weighing on wirelessly connected scales. Automated feedback via mobile phone, tailored to participants' weight regain and goal progress is provided. Participants in the control arm receive quarterly newsletters (via links embedded in text messages) and wirelessly connected scales. Qualitative process evaluation interviews are conducted with a subsample of up to 40 randomly chosen participants. Acceptability and feasibility of procedures, cost-effectiveness, and relationships among socioeconomic variables and WLM will also be assessed. It is hypothesised that participants allocated to the intervention arm will show significantly lower levels of weight regain from baseline than those in the control arm. To date, this is the first WLM trial using remote real-time weight monitoring and mobile internet platforms to deliver a flexible, efficient and scalable intervention, tailored to the individual. This trial addresses a key research need and has the potential to make a vital contribution to the evidence base to inform future WLM policy and provision. http://www.isrctn.com/ISRCTN14657176 (registration date 20 March 2014).

Maintenance of weight loss in obese patients after jaw wiring.

PubMed Central

Garrow, J S; Gardiner, G T

1981-01-01

In treatment of obesity restriction of food intake is necessary to achieve good results. Various operations have been devised to prevent patients overeating, but in this study jaw wiring was used to limit food intake. This procedure produces weight loss in obese patients but when the wires are removed the weight is usually regained. This report studied a group of patients whose weight loss was maintained after the wires were removed. A nylon cord fastened round the waist of the patient after weight reduction was found to act as a psychological barrier to weight gain. Seven patients were followed for 4-14 months after removal of jaw wires and regained a mean of only 5.6 kg of the 31.8 kg lost while their jaws were wired. This procedure compares favourably with other treatments for severe obesity. PMID:6783203

A strategic value management approach for energy and maintenance management in a building

NASA Astrophysics Data System (ADS)

Nawi, Mohd Nasrun Mohd; Dahlan, Nofri Yenita; Nadarajan, Santhirasegaran

2015-05-01

Fragmentation process is always been highlighted by the stakeholders in the construction industry as one of the `critical' issue that diminishing the opportunity for stakeholders that involved during the operation and maintenance stage to influence design decisions. Failure of design professionals to consider how a maintenance contractor or facility manager will construct the design thus results in higher operating cost, wastage, defects during the maintenance and operation process. Moving towards team integration is considered a significant strategy for overcoming the issue. Value Management is a style of management dedicated to guiding people and promoting innovation with the aim to improve overall building performance through structured, team-oriented exercises which make explicit, and appraise subsequent decisions, by reference to the value requirements of the clients. Accordingly, this paper discusses the fragmentation issue in more detail including the definition, causes and effects to the maintenance and operation of building and at the same time will highlighted the potential of VM integrated team approach as a strategic management approach for overcoming that issue. It also explores that the team integration strategy alleviates scheduling problems, delays and disputes during the construction process, and, hence, prevent harming the overall building performance.

Level of Service Program for INDOT Operations : APPENDIX F Asset Deficiency Weight Scale

DOT National Transportation Integrated Search

2012-01-01

INDOT has used an inspection program named Maintenance Quality Survey (MQS) to perform a statewide inspection of their roadway assets, rightofway to rightofway. This inspection requires two twoperson teams approximately 18 months to...

Rituximab maintenance for relapsed refractory thrombotic thrombocytopenic purpura.

PubMed

Bhagirath, Vinai C; Kelton, John G; Moore, Jane; Arnold, Donald M

2012-12-01

Rituximab, an anti-CD20 chimeric monoclonal antibody, has been used successfully to treat patients with relapsed or refractory thrombotic thrombocytopenic purpura (TTP); however, the optimal dose and frequency and the role of rituximab maintenance remain uncertain. We describe a 45-year-old woman with chronic relapsing immune thrombocytopenia who responded to rituximab retreatment administered in four doses over the course of 12 months. Previously, she had received four doses of rituximab and sustained a remission for 19 months. During her latest TTP relapse, multiple treatments were administered including rituximab retreatment. After the first dose (375 mg/m2), she developed serum sickness requiring further doses to be deferred. Three subsequent doses were administered at 4-month intervals over the course of 12 months. ADAMTS13 activity was measured by von Willebrand factor (VWF) digestion. ADAMTS13 inhibition was measured by a modification of the VWF digestion assay and anti-ADAMTS13 antibodies were measured by enzyme-linked immunoassay (enzyme-linked immunosorbent assay, American Diagnostica). Clinical and laboratory remission were achieved after one dose of rituximab, with normalization of ADAMTS13 activity and disappearance of ADAMTS13 inhibitor. Three subsequent doses of rituximab were given without incident and the patient remained in remission after 3.5 years of follow-up (2.5 years since her last dose of rituximab). Maintenance dosing of rituximab should be considered in some patients with relapsing TTP. © 2012 American Association of Blood Banks.

Relationship between Body Weight of Primiparous Sows during Late Gestation and Subsequent Reproductive Efficiency over Six Parities

PubMed Central

Kim, Jin Soo; Yang, Xiaojian; Baidoo, Samuel Kofi

2016-01-01

The present study investigated the impact of parity 1 gilt body weight during late gestation (d 109) on subsequent reproductive performance of sows and performance of suckling pigs. A total of 2,404 farrowing records over 6 parities were divided into six groups on the basis of body weight (190, 200, 210, 220, 230, and 240 kg) at d 109 of gestation of 585 gilts. Significant effects (p< 0.05) of body weight on sow retention rate was noticed, with the 210 kg group having the lowest culling rate and highest total number of piglets born alive over the 6 parities. With increase of body weight, a linear increase (p<0.05) in losses of body weight and backfat during the lactation period of parity 1 and a linear decrease (p<0.05) in backfat loss for parities 4 and 6 were found. Compared with light sows, heavy sows had higher (p<0.05) litter weight at birth for parities 1 and 2 and at weaning in parity 1. Sow weaning-to-estrus interval of sows was not influenced (p>0.05) by body weight. In conclusion, maintaining optimal body weight during gestation would be beneficial to sows and suckling piglets. PMID:26954198

Applying economic incentives to increase effectiveness of an outpatient weight loss program (TRIO) - A randomized controlled trial.

PubMed

Finkelstein, Eric A; Tham, Kwang-Wei; Haaland, Benjamin A; Sahasranaman, Aarti

2017-07-01

The prevalence of overweight and obesity has more than doubled in the past three decades, leading to rising rates of non-communicable diseases. This study tests whether adding a payment/rewards (term reward) program to an existing evidence-based weight loss program can increase weight loss and weight loss maintenance. We conducted a parallel-group randomized controlled trial from October 2012 to October 2015 with 161 overweight or obese individuals randomized to either control or reward arm in a 1:2 ratio. Control and reward arm participants received a four month weight loss program at the LIFE (Lifestyle Improvement and Fitness Enhancement) Centre at Singapore General Hospital. Those in the reward arm paid a fee of S$165.00 (1US$ = 1.35S$) to access a program that provided rewards of up to S$660 for meeting weight loss and physical activity goals. Participants could choose to receive rewards as guaranteed cash payments or a lottery ticket with a 1 in 10 chance of winning but with the same expected value. The primary outcome was weight loss at months 4, 8, and 12. 161 participants were randomized to control (n = 54) or reward (n = 107) arms. Average weight loss was more than twice as great in the reward arm compared to the control arm at month 4 when the program concluded (3.4 kg vs 1.4 kg, p < 0.01), month 8 when rewards concluded (3.3 kg vs 1.8 kg, p < 0.05), and at month 12 (2.3 kg vs 0.8 kg, p < 0.05). These results reveal that a payment/rewards program can be used to improve weight loss and weight loss maintenance when combined with an evidence-based weight loss program. Future efforts should attempt to replicate this approach and identify how to cost effectively expand these programs to maximize their reach. This study is registered at www.clinicaltrials.gov (Identifier: NCT01533454). Copyright © 2017 Elsevier Ltd. All rights reserved.

[Effects of dietary habits modifications on selected metabolic parameters during weight loss in obese persons].

PubMed

Ostrowska, Lucyna; Stefańska, Ewa; Jastrzebska, Marta; Adamska, Edyta; Wujek, Anita; Waszczeniuk, Magdalena

2012-01-01

Obesity is a serious social problem, one of the most important health issues of the modern world, especially in industrialized countries. Due to the prevalence obesity is a social disease, chronic and also a risk factor for many diseases such as hypertension, type 2 diabetes mellitus, coronary heart disease, gall stones or cancers. The aim of the study was to examine and evaluation whether the systematic one-year modifications of dietary habits affect the changes in body weight and some metabolic parameters in obese patients. 30 women and 30 men who declared intentions to decrease body weight were examined. The mean age of women was 48 +/- 12.5 years (range 31-72 years), men 51 +/- 13.2 years (range 23-70 years). The questionnaire survey concerning the subject matter was designed in the Department of Dietetics and Clinical Nutrition, Medical University of Bialystok. At the initial and final visit the frequency of some products consumption were assessed and concentrations of some biochemical parameters in the peripheral blood were measured. Women after one-year dietotherapy significantly reduced the incidence of eating: pasta, fruit and vegetable juices, potatoes, ripening cheese, sugar, meat, bacon and lard, butter and cream, and increased incidence of eating dark bread, groats, rice, vegetables and fruit, cottage cheese, fish and vegetable oils. Men significantly reduced the incidence of eating: pasta, potatoes, ripening cheese, sweet beverages, bacon and lard, margarine, and increased the incidence of eating dark bread, groats, rice, vegetables, cottage cheese and fish. After one year the average body weight decrease was 2.8 +/- 7.1 kg in women and 1.4 +/- 3.2 kg in men. The average reduction in waist circumference was 3.6 +/- 6.5 cm in women and 3.6 +/- 4,8 cm in men. HDL cholesterol levels increased significantly in women and not significantly in men. LDL cholesterol and triglyceride levels decreased significantly in both groups. In women systolic blood pressure decreased significantly by on average 9.7 mmHg, diastolic blood pressure by 9.2 mmHg, and in men by 10.9 mmHg and 8.2 mmHg respectively. Systematic nutritional education (every 3 months) may be the hope for effective body weight reduction and subsequent weight loss maintenance.

Women's work. Maintaining a healthy body weight.

PubMed

Welch, Nicky; Hunter, Wendy; Butera, Karina; Willis, Karen; Cleland, Verity; Crawford, David; Ball, Kylie

2009-08-01

This study describes women's perceptions of the supports and barriers to maintaining a healthy weight among currently healthy weight women from urban and rural socio-economically disadvantaged areas. Using focus groups and interviews, we asked women about their experiences of maintaining a healthy weight. Overwhelmingly, women described their healthy weight practices in terms of concepts related to work and management. The theme of 'managing health' comprised issues of managing multiple responsibilities, time, and emotions associated with healthy practices. Rural women faced particular difficulties in accessing supports at a practical level (for example, lack of childcare) and due to the gendered roles they enacted in caring for others. Family background (in particular, mothers' attitudes to food and weight) also appeared to influence perceptions about healthy weight maintenance. In the context of global increases in the prevalence of obesity, the value of initiatives aimed at supporting healthy weight women to maintain their weight should not be under-estimated. Such initiatives need to work within the social and personal constraints that women face in maintaining good health.

40 CFR 85.2120 - Maintenance and submittal of records.

Code of Federal Regulations, 2011 CFR

2011-07-01

... establish, maintain and retain for 5 years the following adequately organized and indexed records: (1...) All data obtained during testing of the part and subsequent analyses based on that data, including the... applicable certification requirements; (6) All data taken in implementing the quality control plan, and any...

40 CFR 85.1412 - Maintenance and submittal of records for equipment certifiers.

Code of Federal Regulations, 2012 CFR

2012-07-01

... years from the date of certification the following adequately organized and indexed records: (1... specifications and any other information necessary to completely describe the equipment; (2) All data obtained during testing of the equipment and subsequent analyses based on that data, including the mileage and the...

40 CFR 85.1412 - Maintenance and submittal of records for equipment certifiers.

Code of Federal Regulations, 2014 CFR

2014-07-01

... years from the date of certification the following adequately organized and indexed records: (1... specifications and any other information necessary to completely describe the equipment; (2) All data obtained during testing of the equipment and subsequent analyses based on that data, including the mileage and the...

40 CFR 85.2120 - Maintenance and submittal of records.

Code of Federal Regulations, 2012 CFR

2012-07-01

... establish, maintain and retain for 5 years the following adequately organized and indexed records: (1...) All data obtained during testing of the part and subsequent analyses based on that data, including the... applicable certification requirements; (6) All data taken in implementing the quality control plan, and any...

40 CFR 85.2120 - Maintenance and submittal of records.

Code of Federal Regulations, 2013 CFR

2013-07-01

... establish, maintain and retain for 5 years the following adequately organized and indexed records: (1...) All data obtained during testing of the part and subsequent analyses based on that data, including the... applicable certification requirements; (6) All data taken in implementing the quality control plan, and any...

40 CFR 85.2120 - Maintenance and submittal of records.

Code of Federal Regulations, 2014 CFR

2014-07-01

... establish, maintain and retain for 5 years the following adequately organized and indexed records: (1...) All data obtained during testing of the part and subsequent analyses based on that data, including the... applicable certification requirements; (6) All data taken in implementing the quality control plan, and any...

Supraventricular tachycardia in a patient receiving ECT, clozapine, and caffeine.

PubMed

Beale, M D; Pritchett, J T; Kellner, C H

1994-09-01

A patient receiving electroconvulsive therapy (ECT), clozapine, and intravenous caffeine sodium benzoate developed supraventricular tachycardia. This was rapidly treated with intravenous verapamil. Subsequent maintenance ECT given without caffeine was well tolerated. We believe the combination of clozapine and caffeine at the time of ECT was responsible for the arrhythmia.

33 CFR 240.6 - General policy.

Code of Federal Regulations, 2012 CFR

2012-07-01

... they generally make reference to flood control “projects,” should be understood to have equivalent... subsequent maintenance of the creditable non-Federal flood control work will not be credited. In the event... GENERAL CREDIT FOR FLOOD CONTROL § 240.6 General policy. (a) Section 104 is applicable only to projects...

33 CFR 240.6 - General policy.

Code of Federal Regulations, 2010 CFR

2010-07-01

... they generally make reference to flood control “projects,” should be understood to have equivalent... subsequent maintenance of the creditable non-Federal flood control work will not be credited. In the event... GENERAL CREDIT FOR FLOOD CONTROL § 240.6 General policy. (a) Section 104 is applicable only to projects...

33 CFR 240.6 - General policy.

Code of Federal Regulations, 2013 CFR

2013-07-01

... they generally make reference to flood control “projects,” should be understood to have equivalent... subsequent maintenance of the creditable non-Federal flood control work will not be credited. In the event... GENERAL CREDIT FOR FLOOD CONTROL § 240.6 General policy. (a) Section 104 is applicable only to projects...

33 CFR 240.6 - General policy.

Code of Federal Regulations, 2011 CFR

2011-07-01

... they generally make reference to flood control “projects,” should be understood to have equivalent... subsequent maintenance of the creditable non-Federal flood control work will not be credited. In the event... GENERAL CREDIT FOR FLOOD CONTROL § 240.6 General policy. (a) Section 104 is applicable only to projects...

33 CFR 240.6 - General policy.

Code of Federal Regulations, 2014 CFR

2014-07-01

... they generally make reference to flood control “projects,” should be understood to have equivalent... subsequent maintenance of the creditable non-Federal flood control work will not be credited. In the event... GENERAL CREDIT FOR FLOOD CONTROL § 240.6 General policy. (a) Section 104 is applicable only to projects...

Weight changes and their associations with demographic and clinical characteristics in risperidone maintenance treatment for schizophrenia.

PubMed

Xiang, Y-T; Wang, C-Y; Ungvari, G S; Kreyenbuhl, J A; Chiu, H F K; Lai, K Y C; Lee, E H M; Bo, Q-J; Dixon, L B

2011-06-01

This study aimed to characterize weight changes in schizophrenia patients taking risperidone as part of a randomized, controlled, open-label clinical trial. A total of 374 patients with schizophrenia who had been clinically stabilized following an acute episode were randomly assigned to a 'no-dose-reduction' group (initial optimal therapeutic doses continued throughout the study), a '4-week group' (initial optimal therapeutic doses continued for 4 weeks followed by a half dose reduction that was maintained until the end of the study) or a '26-week group' (initial optimal therapeutic doses continued for 26 weeks followed by a half dose reduction until the end of the study). Participants were assessed monthly using standardized assessment instruments during the first 6 months, and then every 2 months until the last recruited patient completed the 1-year follow-up. Weight gain was defined as gaining at least 7% of initial body weight, weight loss as losing at least 7% of initial body weight. A BMI <18.5 kg m⁻² was defined as underweight, 18.5-24.9 kg m⁻² as normal range, and ≥ 25 kg m⁻² as overweight or obese. At the end of follow-up, of the patients who started within the underweight range (n=22), 77.3% gained weight, whereas 4.5% lost weight. The corresponding figures were 39.6% and 4.8% in patients who started at normal weight (n=273), respectively, and 17.7% and 17.7% in patients who started at overweight (n=79), respectively. At the same time, 59.1% of the patients who started at underweight range went into the normal weight and 13.6% into the overweight/obese range, respectively, while 24.5% of those who started at normal weight went into the overweight/obese range, and 1.1% into underweight range, respectively; 20.3% of those who started at overweight range went into normal weight at the end of the follow-up. Multiple logistic regression analyses revealed that being underweight or normal weight at study entry predicted weight gain compared to being overweight, whereas being overweight at entry was associated with a higher likelihood of weight loss compared to being normal weight. No correlation was found between weight change and dose reduction. Weight change is a common, long-term, but heterogeneous side effect in risperidone maintenance treatment for stable schizophrenia patients. Special attention should be paid to fluctuations in weight that may occur throughout the course of treatment with risperidone. © Georg Thieme Verlag KG Stuttgart · New York.

Single maintenance and reliever therapy (SMART) of asthma: a critical appraisal.

PubMed

Chapman, Kenneth R; Barnes, Neil C; Greening, Andrew P; Jones, Paul W; Pedersen, S

2010-08-01

The use of a combination inhaler containing budesonide and formoterol as both maintenance and quick relief therapy (SMART) has been recommended as an improved method of using inhaled corticosteroid/long-acting beta agonist (ICS/LABA) therapy. Published double-blind trials show that budesonide/formoterol therapy delivered in SMART fashion achieves better asthma outcomes than budesonide monotherapy or lower doses of budesonide/formoterol therapy delivered in constant dosage. Attempts to compare budesonide/formoterol SMART therapy with regular combination ICS/LABA dosing using other compounds have been confounded by a lack of blinding and unspecified dose adjustment strategies. The asthma control outcomes in SMART-treated patients are poor; it has been reported that only 17.1% of SMART-treated patients are controlled. In seven trials of 6-12 months duration, patients using SMART have used quick reliever daily (weighted average 0.92 inhalations/day), have awakened with asthma symptoms once every 7-10 days (weighted average 11.5% of nights), have suffered asthma symptoms more than half of days (weighted average 54.0% of days) and have had a severe exacerbation rate of one in five patients per year (weighted average 0.22 severe exacerbations/patient/year). These poor outcomes may reflect the recruitment of a skewed patient population. Although improvement from baseline has been attributed to these patients receiving additional ICS therapy at pivotal times, electronic monitoring has not been used to test this hypothesis nor the equally plausible hypothesis that patients who are non-compliant with maintenance medication have used budesonide/formoterol as needed for self-treatment of exacerbations. Although the long-term consequences of SMART therapy have not been studied, its use over 1 year has been associated with significant increases in sputum and biopsy eosinophilia. At present, there is no evidence that better asthma treatment outcomes can be obtained by moment-to-moment symptom-driven use of ICS/LABA therapy than conventional physician-monitored and adjusted ICS/LABA therapy.

Engagement in New Dietary Habits-Obese Women's Experiences from Participating in a 2-Year Diet Intervention.

PubMed

Ahlgren, Christina; Hammarström, Anne; Sandberg, Susanne; Lindahl, Bernt; Olsson, Tommy; Larsson, Christel; Fjellman-Wiklund, Anncristine

2016-02-01

Dietary weight loss interventions most often result in weight loss, but weight maintenance on a long-term basis is the main problem in obesity treatment. There is a need for an increased understanding of the behaviour patterns involved in adopting a new dietary behavior and to maintain the behaviour over time. The purpose of this paper is to explore overweight and obese middle-aged women's experiences of the dietary change processes when participating in a 2-year-long diet intervention. Qualitative semi-structured interviews with 12 overweight and obese women (54-71 years) were made after their participation in a diet intervention programme. The programme was designed as a RCT study comparing a diet according to the Nordic nutrition recommendations (NNR diet) and a Palaeolithic diet (PD). Interviews were analysed according to Grounded Theory principles. A core category "Engagement phases in the process of a diet intervention" concluded the analysis. Four categories included the informants' experiences during different stages of the process of dietary change: "Honeymoon phase", "Everyday life phase", "It's up to you phase" and "Crossroads phase". The early part of the intervention period was called "Honeymoon phase" and was characterised by positive experiences, including perceived weight loss and extensive support. The next phases, the "Everyday life phase" and "It's up to you phase", contained the largest obstacles to change. The home environment appeared as a crucial factor, which could be decisive for maintenance of the new dietary habits or relapse into old habits in the last phase called "Crossroads phase". We identified various phases of engagement in the process of a long-term dietary intervention among middle-aged women. A clear personal goal and support from family and friends seem to be of major importance for long-term maintenance of new dietary habits. Gender relations within the household must be considered as a possible obstacle for women engaging in diet intervention.

Maintenance valine, isoleucine, and tryptophan requirements for poultry.

PubMed

de Lima, M B; Sakomura, N K; Dorigam, J C P; da Silva, E P; Ferreira, N T; Fernandes, J B K

2016-04-01

Poultry maintenance requirements for valine, isoleucine, and tryptophan were measured by nitrogen balance using different unit systems. The nitrogen balance trial lasted 5 d with 48 h of fasting (with roosters receiving only water+sucrose) and the last 72 h for feeding and excreta collection. Forty grams of each diet first-limiting in valine, isoleucine, or tryptophan was fed by tube each day (3 d) to give a range of intakes from 0 to 101, 0 to 119, and 0 to 34 mg/kg BW d of valine, isoleucine, and tryptophan, respectively. A nitrogen-free diet containing energy, vitamins, and minerals, meeting the rooster requirements, was offered ad libitum during these three d. To confirm that the amino acids studied were limiting, a treatment was added with a control diet formulated by adding 0.24 g/kg of L-valine, 0.21 g/kg of L-isoleucine, and 0.10 g/kg of L-tryptophan to the diets with lower amino acid level. Excreta were collected during the last 3 d of the balance period and the nitrogen content of the excreta was analyzed. For each amino acid, a linear regression between nitrogen retention (NR) and amino acid intake was performed. The equations from linear regression were: NR=-98.6 (±10.1)+2.4 (±0.2)×Val, NR=-46.9 (±7.1)+2.3 (±0.1)×Ile, NR=-39.5 (±7.7)+7.3 (±0.4)×Trp; where Val, Ile, and Trp are the intakes of valine, isoleucine, and tryptophan in mg/kg body weight per d, respectively. The valine, isoleucine, and tryptophan required to maintain the body at zero NR were calculated to be 41, 20, and 5 mg/kg body weight per d, respectively. For the system unit mg per kg of metabolic weight, the intake of valine, isoleucine, and tryptophan was 59, 32, and 9, respectively. Considering the degree of maturity of the animal and body protein content (BPm (0.73)×u), the amounts of valine, isoleucine, and tryptophan required for maintenance were calculated to be 247, 134, and 37 mg per unit of maintenance protein (BPm (0.73)×u) per d. Maintenance requirement is more adequately expressed as body protein content. © 2016 Poultry Science Association Inc.

Senecavirus A infection in sows, neonates, and market weight gilts with subsequent protective immunity

USDA-ARS?s Scientific Manuscript database

Objective: The objectives of this study were to 1) characterize SVA infection late-gestation sows, neonates, and market weight gilts and 2) examine protective immunity in late-gestation gilts Methods: For Part 1, 15 market weight gilts were inoculated with SVA, bled regularly, and clinical observat...

HL-20 structural design comparison - Conformal shell versus cylindrical crew compartment

NASA Technical Reports Server (NTRS)

Bush, Lance B.; Wahls, Deborah M.; Robinson, James C.

1993-01-01

Extensive studies have been performed at NASA Langley Research Center (LaRC) on personnel launch systems (PLS) concepts. The primary mission of a PLS is the transport of Space Station crew members from Earth to the Space Station and return. The NASA LaRC PLS studies have led to the design of a lifting body configuration named the HL-20. In this study, two different HL-20 structural configurations are evaluated. The two configurations are deemed the conformal shell and the cylindrical crew compartment. The configurations are based on two different concerns for maintenance and operations. One configuration allows for access to subsystems while on-orbit from the interior, while the other allows for easy access to the subsystems during ground maintenance and operations. For each concept, the total structural weight required to sustain the applied loads is quantified through a structural evaluation. Structural weight for both configurations is compared along with the particular attributes of each. Analyses of both configurations indicate no appreciable weight or load relief advantage of one concept over the other. Maintainability and operability, therefore become the primary discriminator, leading to a choice of a crew compartment configuration.

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 good clinical care, and evidence-based interventions; should focus on realistic goals and lifelong multidisciplinary management. © 2015 S. Karger GmbH, Freiburg.

European Guidelines for Obesity Management in Adults

PubMed Central

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 good clinical care, and evidence-based interventions; should focus on realistic goals and lifelong multidisciplinary management. PMID:26641646

Effects of weight loss and long-term weight maintenance with diets varying in protein and glycemic index on cardiovascular risk factors: the diet, obesity, and genes (DiOGenes) study: a randomized, controlled trial.

PubMed

Gögebakan, Ozlem; Kohl, Angela; Osterhoff, Martin A; van Baak, Marleen A; Jebb, Susan A; Papadaki, Angeliki; Martinez, J Alfredo; Handjieva-Darlenska, Teodora; Hlavaty, Petr; Weickert, Martin O; Holst, Claus; Saris, Wim H M; Astrup, Arne; Pfeiffer, Andreas F H

2011-12-20

We sought to separately examine the effects of either weight loss or diets varying in protein content and glycemic index without further changes in body weight on cardiovascular risk factors within the Diet, Obesity, and Genes study (DiOGenes). DiOGenes is a pan-European controlled dietary intervention study in 932 overweight adults who first lost body weight on an 8-week low-calorie diet and were then randomized to 1 of 5 ad libitum diets for 26 weeks. The diets were either high or low protein or high or low glycemic index in 4 combinations or control. Weight loss (-11.23 kg; 95% confidence interval, -11.54 to -10.92; P<0.001) reduced high-sensitivity C-reactive protein (-1.15 mg/L; 95% confidence interval, -1.30 to -0.41; P<0.001), low- and high-density lipoprotein cholesterol, triglycerides, and blood pressure. During the 26-week weight maintenance period in the intention-to-treat analysis, the further decrease of high-sensitivity C-reactive protein blood levels was -0.46 mg/L greater (95% confidence interval, -0.79 to -0.13) in the groups assigned to low-glycemic-index diets than in those on high-glycemic-index diets (P<0.001). Groups on low-protein diets achieved a -0.25 mg/L greater reduction in high-sensitivity C-reactive protein (95% confidence interval, -0.59 to -0.17) than those on high-protein diets (P<0.001), whereas lipid profiles and blood pressure were not differently affected. This large-scale intervention study clearly separates weight loss from dietary composition-related effects. Low-glycemic-index carbohydrates and, to a lesser extent, low-protein intake may specifically reduce low-grade inflammation and associated comorbidities in overweight/obese adults. http://www.clinicaltrials.gov. Unique identifier: NCT00390637.

Therapeutic drug monitoring of vedolizumab in inflammatory bowel disease: current data and future directions.

PubMed

Ward, Mark G; Sparrow, Miles P; Roblin, Xavier

2018-01-01

The introduction of vedolizumab, a lymphocyte adhesion inhibitor, has expanded the relatively limited therapeutic armamentarium available for Crohn's disease and ulcerative colitis. Despite its effectiveness, both primary nonresponse and secondary loss of response to vedolizumab do occur, as is observed with the use of anti-tumour necrosis factor (TNF) therapy. Further, in a proportion, onset of efficacy may be relatively slow. A large body of data support an exposure-response relationship with anti-TNF drug levels, which has led to therapeutic drug monitoring becoming incorporated into everyday clinical management. The influence of patient and disease factors on the pharmacokinetics of anti-TNF levels, including immunogenicity, has also been examined. The role of therapeutic drug monitoring with vedolizumab is less clear. This review summarizes the available evidence on the pharmacokinetics and pharmacodynamics of vedolizumab in inflammatory bowel disease and how drug levels, immunogenicity and other factors influence clinical outcomes. Vedolizumab clearance is increased with very high body weight and hypoalbuminaemia, but is not influenced by the addition of an immunomodulator. Immunogenicity is uncommon. α4β7 receptor saturation occurs at low serum vedolizumab drug levels, and measuring it alone is insufficient to predict clinical outcomes. Using quartile analysis of vedolizumab drug levels, there appears to be a modest exposure-response relationship during induction. Drug levels at week 6 of approximately >20 μg/ml have been shown to be associated with improved clinical outcomes, including subsequent mucosal healing rates during maintenance and avoiding the need to dose escalate due to lack of response. There are currently insufficient data to support the routine use of therapeutic drug monitoring during maintenance therapy. Further studies to elucidate the role of therapeutic drug monitoring of vedolizumab are needed.

Implementation of Rolling Wheel Deflectometer (RWD) in PMS and Pavement Preservation : Tech Summary

DOT National Transportation Integrated Search

2012-08-01

Evaluation of pavement structural capacity and integrity is an important component of the Pavement Management : System (PMS) to assist in the selection of suitable maintenance and rehabilitation strategies. The falling weight : defl ectometer (FWD) i...

Weighty Research.

ERIC Educational Resources Information Center

Conklin, Aaron R.

1999-01-01

Discusses the selection process for weight-training machines that are user-friendly and provide the best fit for the training facility. Machine factors to consider include ease of maintenance, adjustability, ease of use, its biomechanics, structural strength, the upholstery and finish used, and its safety. (GR)

Cleaning Physical Education Areas.

ERIC Educational Resources Information Center

Griffin, William R.

1999-01-01

Discusses techniques to help create clean and inviting school locker rooms. Daily, weekly or monthly, biannual, and annual cleaning strategies for locker room showers are highlighted as are the specialized maintenance needs for aerobic and dance areas, running tracks, and weight training areas. (GR)

Lightweight solid decks for movable bridges - phase II.

DOT National Transportation Integrated Search

2016-01-01

Movable bridges often include open grid steel deck for its light weight and ease of installation. These decks, however, suffer from poor rideability and high maintenance costs. The primary objective of this research project was to search for a new ge...

Variability in traffic monitoring data : final summary report

DOT National Transportation Integrated Search

1997-08-01

For highway maintenance and planning purposes, each road segment is characterized by its traffic flow [such as the annual average daily traffic (AADT) and the AADT for each vehicle class], by the weight distribution of vehicles that travel on its roa...

Network-level pavement evaluation of Virginia's interstate system using the falling weight deflectometer.

DOT National Transportation Integrated Search

2008-01-01

The Virginia Department of Transportation (VDOT) currently uses the results of automated surface distress surveys to assist in developing pavement maintenance strategies for its interstate and primary roadways. Totaling nearly 27,000 lane-miles, thes...

On the Teaching of a Self-Modification Course

ERIC Educational Resources Information Center

Tasto, Donald L.

1976-01-01

Discusses teaching techniques, course content, strategies, and problems of teaching a behavior modification course to university students. Course target areas include subjects such as anxiety control, fear elimination, weight control, smoking reduction, interpersonal interaction, assertiveness, and exercise maintenance. (Author/DB)

Weight-control behaviors and subsequent weight change among adolescents and young adult females123

PubMed Central

Haines, Jess; Rosner, Bernard; Willett, Walter C

2010-01-01

Background: Little is known about the effectiveness of behavioral strategies to prevent long-term weight gain among adolescents and young adults. Objective: The objective was to assess the relation of dietary and physical activity weight-control strategies, alone and together, with subsequent weight change. Design: This was a prospective study of 4456 female adolescents and young adults aged 14–22 y in the ongoing Growing Up Today Study. Weight-control behaviors, including dietary approaches and physical activity, were self-reported in 2001 and were used to predict weight change from 2001 to 2005. Results: In 2001–2002, 23.7% of female adolescents and young adults were trying to maintain their weight and another 54.4% were trying to lose weight. Approximately 25% used each of the following weight-control strategies: not eating snacks, following low-calorie or low-fat diets, and limiting portion sizes. In addition, 47.7% reported exercising at least occasionally for weight control. During 4 y of follow-up, participants gained an average of 3.3 kg. None of the dietary approaches to weight control predicted less weight change; however, females who exercised ≥5 d/wk gained significantly less weight than did their peers (−0.9 kg; 95% CI: −1.4, −0.4). The most successful strategy for weight-gain prevention among the females was to limit portion sizes (−1.9 kg; 95% CI: −2.6, −1.1) combined with frequent exercise. Conclusions: Our results suggest that physical activity is a necessary strategy for long-term weight control among adolescents and young adult females. Combining dietary weight-control approaches with physical activity is the most effective method for reducing weight gain. PMID:19889827

Androgen signaling in myocytes contributes to the maintenance of muscle mass and fiber type regulation but not to muscle strength or fatigue.

PubMed

Ophoff, Jill; Van Proeyen, Karen; Callewaert, Filip; De Gendt, Karel; De Bock, Katrien; Vanden Bosch, An; Verhoeven, Guido; Hespel, Peter; Vanderschueren, Dirk

2009-08-01

Muscle frailty is considered a major cause of disability in the elderly and chronically ill. However, the exact role of androgen receptor (AR) signaling in muscle remains unclear. Therefore, a postmitotic myocyte-specific AR knockout (mARKO) mouse model was created and investigated together with a mouse model with ubiquitous AR deletion. Muscles from mARKO mice displayed a marked reduction in AR protein (60-88%). Interestingly, body weights and lean body mass were lower in mARKO vs. control mice (-8%). The weight of the highly androgen-sensitive musculus levator ani was significantly reduced (-46%), whereas the weights of other peripheral skeletal muscles were not or only slightly reduced. mARKO mice had lower intra-abdominal fat but did not demonstrate a cortical or trabecular bone phenotype, indicating that selective ablation of the AR in myocytes affected male body composition but not skeletal homeostasis. Furthermore, muscle contractile performance in mARKO mice did not differ from their controls. Myocyte-specific AR ablation resulted in a conversion of fast toward slow fibers, without affecting muscle strength or fatigue. Similar results were obtained in ubiquitous AR deletion, showing lower body weight, whereas some but not all muscle weights were reduced. The percent slow fibers was increased, but no changes in muscle strength or fatigue could be detected. Together, our findings show that myocyte AR signaling contributes to the maintenance of muscle mass and fiber type regulation but not to muscle strength or fatigue. The levator ani weight remains the most sensitive and specific marker of AR-mediated anabolic action on muscle.

Spontaneous motor activity during the development and maintenance of diet-induced obesity in the rat.

PubMed

Levin, B E

1991-09-01

More than 80% of most daily spontaneous activities (assessed in an Omnitech activity monitor) occurred during the last hour of light and 12 h of the dark phase in 8 chow-fed male Sprague-Dawley rats. Thirty additional rats were, therefore, monitored over this 13-h period to assess the relationship of activity to the development and maintenance of diet-induced obesity (DIO) on a diet high in energy, fat and sucrose (CM diet). Nine of 20 rats became obese after 3 months on the CM diet, with 71% greater weight gain than 10 chow-fed controls. Eleven of 20 rats were diet resistant (DR), gaining the same amount of weight as chow-fed rats. Neither initial activity levels nor initial body weights on chow (Period I) differed significantly across retrospectively identified groups. After 3 months on CM diet or chow (Period II), as well as after an additional 3 months after CM diet-fed rats returned to chow (Period III), there were significant inverse correlations (r = -.606 to -.370) between body weight at the time of testing and various measures of movement in the horizontal plane. There was no relationship to dietary content nor consistent correlations of body weight or diet group to vertical movements, an indirect measure of ingestive behavior. Patterns of time spent in the vertical position were significantly different for DIO vs. DR rats in Period III, however. Thus, differences in food intake and metabolic efficiency, rather than differences in nocturnal activity, are probably responsible for the greater weight gain in DIO-prone rats placed on CM diet.(ABSTRACT TRUNCATED AT 250 WORDS)

A Randomized Trial of Lorcaserin and Lifestyle Counseling for Maintaining Weight Loss Achieved with a Low-Calorie Diet.

PubMed

Shaw Tronieri, Jena; Wadden, Thomas A; Berkowitz, Robert I; Chao, Ariana M; Pearl, Rebecca L; Alamuddin, Naji; Leonard, Sharon M; Carvajal, Ray; Bakizada, Zayna M; Pinkasavage, Emilie; Gruber, Kathryn A; Walsh, Olivia A; Alfaris, Nasreen

2018-02-01

Improving the maintenance of lost weight remains a critical challenge, which can be addressed by long-term behavioral and/or pharmacological interventions. This study investigated the efficacy of combined behavioral and pharmacological treatment in facilitating weight loss maintenance (WLM) in 137 adults (86.1% female; 68.6% black; BMI = 37.0 ± 5.6 kg/m 2 ) who had lost ≥ 5% of initial weight during a 14-week low-calorie diet (LCD) program (mean = 9.3 ± 2.9%). Participants were randomly assigned to lorcaserin (10 mg twice a day) or placebo and were provided 16 group WLM counseling sessions over 52 weeks. At 24 weeks post randomization, more lorcaserin-treated than placebo-treated participants maintained a ≥ 5% loss (73.9% vs. 57.4%; P = 0.033), and the lorcaserin-treated participants lost an additional 2.4 ± 0.8 kg versus a 0.6 ± 0.8 kg gain for placebo (P = 0.010). However, at week 52, groups did not differ on either co-primary outcome; 55.1% and 42.6%, respectively, maintained ≥ 5% loss (P = 0.110), with gains from randomization of 2.0 ± 0.8 kg and 2.5 ± 0.8 kg (P = 0.630), respectively. From the start of the LCD, groups maintained reductions of 7.8% and 6.6%, respectively (P = 0.318). Combined behavioral and pharmacological treatment produced clinically meaningful long-term weight loss in this group of predominantly black participants. Lorcaserin initially improved upon weight loss achieved with WLM counseling, but this advantage was not maintained at 1 year. © 2017 The Obesity Society.