The feasibility of using Internet support for the maintenance of weight loss.

This pilot study examined the acceptability and feasibility of conducting a weight loss maintenance intervention over the Internet. Obese adults participated in a 15-week behavioral weight control intervention and were then randomly assigned to one of the following three maintenance conditions: (a) in-person, therapist-led (TL); (b) Internet, therapist-led (I); and (c) control (C). Both maintenance interventions met biweekly for 22 weeks using the same program content. Results showed that TL participants were more likely to attend their meetings and feel more satisfied with their group assignment. However, there were no differences between the TL and I groups in overall attrition or number of peer support contacts made. There was also no significant difference in weight loss between the groups. Thus, the Internet may hold promise as a method for maintaining contact with patients to facilitate long-term behavior change.

Public and health professionals' misconceptions about the dynamics of body weight gain/loss.

Human body energy storage operates as a stock-and-flow system with inflow (food intake) and outflow (energy expenditure). In spite of the ubiquity of stock-and-flow structures, evidence suggests that human beings fail to understand stock accumulation and rates of change, a difficulty called the stock-flow failure. This study examines the influence of health care training and cultural background in overcoming stock-flow failure. A standardized protocol assessed lay people's and health care professionals' ability to apply stock-and-flow reasoning to infer the dynamics of weight gain/loss during the holiday season (621 subjects from seven countries). Our results indicate that both types of subjects exhibited systematic errors indicative of use of erroneous heuristics. Stock-flow failure was found across cultures and was not improved by professional health training. The problem of stock-flow failure as a transcultural global issue with education and policy implications is discussed.

Branched-chain amino Acid plus glucose supplement reduces exercise-induced delayed onset muscle soreness in college-age females.

Supplementation with branched-chain amino acids (BCAAs) has been used to stimulate muscle protein synthesis following exercise. The purpose of this study was to determine if supplementation with BCAAs in combination with glucose would reduce exercise-induced delayed onset muscle soreness (DOMS). Using a double-blind crossover design, 20 subjects (11 females, 9 males) were randomly assigned to either BCAA (n = 10) or placebo (n = 10) groups. Subjects performed a squatting exercise to elicit DOMS and rated their muscle soreness every 24 hours for four days following exercise while continuing to consume the BCAA or placebo. Following a three-week recovery period, subjects returned and received the alternate BCAA or placebo treatment, repeating the same exercise and DOMS rating protocol for the next four days. BCAA supplementation in female subjects resulted in a significant decrease in DOMS versus placebo at 24 hours following exercise (P = 0.018). No significant effect of BCAA supplementation versus placebo was noted in male subjects nor when male and female results were analyzed together. This gender difference may be related to dose per body weight differences between male and female subjects.

Minimal in-person support as an adjunct to internet obesity treatment.

BACKGROUND: Internet-based weight-loss programs appear promising in the short-term but, to date, have not been able to produce the level of weight loss seen in traditional in-person treatment; thus, novel approaches are necessary. Using a combination of interactive technology and in-person support has been beneficial in other areas of medicine. PURPOSE: The aim of this study is to compare 12-month weight-loss outcomes of an Internet-only behavioral weight-loss treatment with the same program supplemented with monthly in-person meetings. METHODS: One hundred and twenty-three participants were randomized to an Internet-only (n = 62) or an Internet + in-person treatment (I+IPS; n = 61). All participants then participated in a 12-month behavioral weight-loss program conducted over the Internet. The groups met online weekly for the first 6 months and biweekly for the second half of the intervention. The I+IPS group had access to the same Web site as the Internet-only group but, once a month, attended an in-person meeting in place of an online chat. Assessments included body weight, program adherence, and social support measures. RESULTS: An intent-to-treat analysis (n = 123) revealed there were no significant Group x Time differences (p = .15) in weight loss at either 6 (-6.8 +/- 7.8 vs. -5.1 +/- 4.8, p = .15) or 12 months (-5.1 +/- 7.1 kg vs. -3.5 +/- 5.1 kg, p = .17, for Internet-only and I+IPS, respectively). Differences between groups for those completing all measures (n = 77) also revealed no significant differences at 6 months (-9.2 +/- 7.0 kg vs. -6.9 +/- 4.2 kg, p = .08) or 12 months (-8.0 +/- 7.5 kg vs. -5.6 +/- 5.5 kg, p = .10 for the Internet-only and I+IPS conditions, respectively). CONCLUSIONS: Supplementation of an Internet weight-loss treatment with monthly in-person meetings did not result in greater weight losses over 12 months. Dynamic, socially supportive, and interactive elements of the Web site may have obviated the need for further interpersonal behavioral counseling.

Weight loss on the web: A pilot study comparing a structured behavioral intervention to a commercial program.

OBJECTIVE: Internet weight loss programs have become widely available as alternatives to standard treatment, but few data are available on their efficacy. This study aimed to investigate the effectiveness of a structured behavioral weight loss website (VTrim) vs. a commercial weight loss website (eDiets.com). RESEARCH METHODS AND PROCEDURES: A randomized, controlled trial was conducted from February 2003 to March 2005, in 124 overweight and obese subjects ages 18 years and older with a BMI of 25 to 39.9 kg/m2 (mean age, 47 +/- 9 years; BMI, 32 +/- 3 kg/m2; 20% men). Analyses were performed for the 88 subjects who had complete follow-up data. Participants were randomly assigned to 12-month VTrim (n = 62) or eDiets.com (n = 62) intervention. VTrim participants had access to a therapist-led structured behavioral weight loss program delivered on-line. eDiets.com subjects had access to a self-help commercial on-line weight loss program. Body weight, social support, and use of website components were measured at 0, 6, and 12 months. RESULTS: Repeated-measures analyses showed that the VTrim group lost significantly more weight than the eDiets.com group at 6 months (8.3 +/- 7.9 kg vs. 4.1 +/- 6.2 kg; p = 0.004) and maintained a greater loss at 12 months (7.8 +/- 7.5 kg vs. 3.4 +/- 5.8 kg; p = 0.002). More participants in the VTrim group maintained a 5% weight loss goal (65% vs. 37.5%; p = 0.01) at 12 months. DISCUSSION: An on-line, therapist-led structured behavioral weight loss website produced greater weight loss than a self-help commercial website. Because commercial sites have great potential public health impact, future research should investigate the feasibility of incorporating a more structured behavioral program into a commercial application.

The effectiveness of web-based, multimedia tutorials for teaching methods of human body composition analysis.

This study examined the effectiveness of a series of Web-based, multimedia tutorials on methods of human body composition analysis. Tutorials were developed around four body composition topics: hydrodensitometry (underwater weighing), dual-energy X-ray absorptiometry, bioelectrical impedance analysis, and total body electrical conductivity. Thirty-two students enrolled in the course were randomly assigned to learn the material through either the Web-based tutorials only ("Computer"), a traditional lecture format ("Lecture"), or lectures supplemented with Web-based tutorials ("Both"). All students were administered a validated pretest before randomization and an identical posttest at the completion of the course. The reliability of the test was 0.84. The mean score changes from pretest to posttest were not significantly different among the groups (65.4 plus minus 17.31, 78.82 plus minus 21.50, and 76 plus minus 21.22 for the Computer, Both, and Lecture groups, respectively). Additionally, a Likert-type assessment found equally positive attitudes toward all three formats. The results indicate that Web-based tutorials are as effective as the traditional lecture format for teaching these topics.

Comparison of Infectious Dose of Listeria monocytogenes F5817 as Determined for Normal Versus Compromised C57B1/6J Mice.

The infectious dose of Listeria monocytogenes F5817, a serotype 4b human patient isolate, was determined following oral challenge in normal and compromised C57B1/6J mice. In an attempt to mimic human populations previously shown to be at risk to ingestion of L. monocytogenes , groups of mice used in this study consisted of the following: mice pretreated with hydrocortisone acetate or cimetidine; pregnant mice (12-14 d gestation); or beige mutants of C57B1/6J mice (deficient in lysosome production within monocytes and granulocytes). Mice were gavaged with varying levels of L. monocytogenes suspended in sterile 11% non-fat milk solids (NFMS). Upon expiration, the spleen, liver, lung, and brain were aseptically removed from mice. Organs were plated on LPM agar, and colonies were enumerated and biochemically confirmed as L. monocytogenes . Mice were considered infected if L. monocytogenes was recovered from at least one of the examined organs. In normal resistant C57B1/6J mice, the infectious dose 50 (ID50) ranged from 3.24-4.55 log10 CFU. In comparison, the ID50 for mice treated with 2.5 mg hydrocortisone acetate/day for 3d prior to infection decreased to 0.41 log10 CFU (range -1.91-2.74 log10 CFU). Administration of 0.25 mg hydrocortisone acetate/day for 3d prior to infection resulted in an ID50 similar to that calculated for normal mice. The ID50 calculated for pregnant mice was 2.48 log10 CFU, a value not significantly different from that of normal control mice. The response of beige mutants and cimetidine treated mice was comparable to that of normal controls, with ID50 values of 4.00 and 3.30 log10 CFU, respectively.

Effect of internet support on the long-term maintenance of weight loss.

OBJECTIVE: To investigate the efficacy of an Internet weight maintenance program. RESEARCH METHODS AND PROCEDURES: Two hundred fifty-five healthy overweight and obese adults (mean +/- SD BMI, 31.8 +/- 4.1 kg/m(2)) men (18%; mean +/- SD age, 45.8 +/- 8.9 yrs) participated in a 6-month behavioral weight control program conducted over interactive television. Treatment was followed by a 12-month weight maintenance program with three conditions: frequent in-person support (F-IPS), minimal in-person support (M-IPS) and internet support (IS). Main outcome measures included body weight, program adherence, and social influence components. RESULTS: There were no significant differences among the groups in weight loss (mean +/- SD) from baseline to 18 months (7.6 +/- 7.3 kg vs. 5.5 +/- 8.9 kg vs. 5.1 +/- 6.5 kg, p = 0.23 for the IS, M-IPS, and F-IPS, respectively). DISCUSSION: Participants assigned to an internet-based weight maintenance program sustained comparable weight loss over 18 months compared with individuals who continued to meet face-to-face. Therefore, the internet appears to be a viable medium for promoting long-term weight maintenance.