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OBJECTIVE: Research has highlighted the potential adverse effects of weight bias internalization (WBI) on adolescents, but there has been little examination of WBI and sources of weight teasing (family, peers, or both) or across racial/ethnic diversity of adolescents. We aimed to examine the relationship between WBI and sources of weight teasing across sociodemographic characteristics and weight status in a diverse community sample of adolescents. METHODS: Data were collected from a U.S. sample of 1859 adolescents aged 10-17 years (59% female; 43% White, 27% Black or African American, and 25% Latino). An online questionnaire was used to assess participants' experiences of weight teasing from family members, peers, or both, and their weight status, weight-related goals, WBI, and sociodemographic characteristics. RESULTS: Adolescents experiencing weight teasing from both family and peers reported the highest levels of WBI, while those reporting no teasing exhibited the lowest levels. These patterns were observed across sex, race/ethnicity, weight status, and weight goals, and persisted after controlling for depressive symptoms. Notably, family influences played a salient role, with adolescents reporting higher WBI if teased by family only compared to teasing from peers only. Sex and racial differences were also observed in adolescents' experiences with weight-based teasing. CONCLUSION: Our study reveals associations between adolescent weight-based teasing, WBI, and sociodemographic factors. Weight-based teasing, whether from family and peers or from family only, was associated with increased WBI. Interventions targeting weight stigma in youth should not be limited to peer-focused efforts, but should also emphasize supportive family communication.
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Grupo Paritario , Humanos , Adolescente , Femenino , Masculino , Niño , Peso Corporal , Encuestas y Cuestionarios , Prejuicio de Peso/psicología , Estados Unidos , Conducta del Adolescente/psicología , Factores Sociodemográficos , Imagen Corporal/psicología , Familia/psicologíaRESUMEN
BACKGROUND: It is not known whether behavioral weight loss can attenuate blood oxygen level-dependent responses to food stimuli. OBJECTIVES: This randomized controlled trial assessed the effects of a commercially available behavioral weight loss program (WW, WeightWatchers) compared to a wait-list control on blood oxygen level-dependent response to food cues. METHODS: Females with obesity ( N = 61) were randomized to behavioral weight loss or wait-list control. At baseline and follow-up, participants completed assessments that included functional magnetic resonance imaging scans to assess response to images of high-calorie foods (HCF) or low-calorie foods (LCF), and neutral objects. RESULTS: There were no significant between-group differences in change from baseline to follow-up in any regions of the brain in response to viewing HCF or LCF. From baseline to follow-up, participants in behavioral weight loss, compared with wait-list control, reported significantly greater increases in desire for LCF. Changes in liking and palatability of LCF and liking, palatability, and desire for HCF did not differ between groups. DISCUSSION: Behavioral weight loss was associated with increased desire for LCF without changes in neural reactivity to food cues. These results suggest that alteration of neurological processes underlying responsiveness to food is difficult to achieve through behavioral weight management alone.
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Señales (Psicología) , Obesidad , Femenino , Humanos , Obesidad/terapia , Terapia Conductista , Encéfalo/fisiología , Alimentos , Imagen por Resonancia Magnética/métodosRESUMEN
Parental communication about body weight with their children is common across diverse families. The current study investigates how parents' feelings about their own bodies, beliefs about body weight, history of weight stigma, and weight-related characteristics contribute to the degree to which they talk about weight - both negatively and positively - with their adolescent children. The study sample was comprised of U.S. parents (N = 1936) from diverse racial/ethnic backgrounds with children aged 10-17 years old. Parents completed an online survey with measures assessing their frequency of engaging in negative and positive weight communication with their children, along with several relevant psychosocial factors (i.e. body satisfaction, experienced weight stigma, associative stigma, body appreciation, beliefs about weight controllability, weight bias internalization). Study findings paint a complex picture, including some psychosocial factors (e.g. weight bias internalization) that are related to both more frequent negative and positive weight communication. Notably, higher levels of associative stigma were related to more frequent negative parental weight comments, and less frequent positive weight socialization. Findings can inform healthcare professionals in raising parents' awareness about how their personal beliefs and feelings about their own weight and their child's weight can contribute to how they engage in communication about weight with their children.
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Comunicación , Padres , Niño , Humanos , Adolescente , Padres/psicología , Estigma Social , Encuestas y Cuestionarios , Peso Corporal , Relaciones Padres-HijoRESUMEN
OBJECTIVE: Research has consistently documented adverse effects of parent weight-related comments on adolescent health. However, little empirical attention has focused on isolating the impact of weight-related comments from mothers versus fathers, and the valence of their comments. The present study examined the extent to which positive and negative weight-related comments from mothers and fathers are related to adolescent health and wellbeing, and whether these associations differ according to adolescent sociodemographic characteristics. METHODS: Data were collected from a diverse sample of 2032 U.S.-based adolescents aged 10-17 years (59% female; 40% White, 25% Black or African American, 23% Latinx). Online questionnaires assessed perceived frequency of negative and positive weight-related comments from mothers and fathers, as well as four indicators of adolescent health and wellbeing: depression, unhealthy weight control behaviors, weight bias internalization (WBI), and body appreciation. RESULTS: More frequent negative weight-related comments from parents were associated with poorer adolescent health and wellbeing, while positive comments contributed to lower levels of WBI and body appreciation; these associations were documented regardless of whether mothers or fathers were the source of such comments, and considerable consistency was demonstrated across adolescent sociodemographic characteristics. CONCLUSION: Findings highlight differences in adolescent health based on how parents discuss their body weight (i.e., negatively or positively), and similarity in associations regardless of whether mothers or fathers are the source of weight communication. These findings reiterate the importance of efforts to educate parents on ways to engage in supportive communication about weight-related health with their children.
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Salud del Adolescente , Relaciones Padres-Hijo , Niño , Adolescente , Humanos , Femenino , Masculino , Padres , Madres , Comunicación , Peso Corporal , PadreRESUMEN
BACKGROUND: Digital behavioral weight loss programs are scalable and effective, and they provide an opportunity to personalize intervention components. However, more research is needed to test the acceptability and efficacy of personalized digital behavioral weight loss interventions. OBJECTIVE: In a 6-month single-arm trial, we examined weight loss, acceptability, and secondary outcomes of a digital commercial weight loss program (WeightWatchers). This digital program included a personalized weight loss program based on sex, age, height, weight, and personal food preferences, as well as synchronous (eg, virtual workshops and individual weekly check-ins) and asynchronous (eg, mobile app and virtual group) elements. In addition to a personalized daily and weekly PersonalPoints target, the program provided users with personalized lists of ≥300 ZeroPoint foods, which are foods that do not need to be weighed, measured, or tracked. METHODS: We conducted a pre-post evaluation of this 6-month, digitally delivered, and personalized WeightWatchers weight management program on weight loss at 3 and 6 months in adults with overweight and obesity. The secondary outcomes included participation, satisfaction, fruit and vegetable intake, physical activity, sleep quality, hunger, food cravings, quality of life, self-compassion, well-being, and behavioral automaticity. RESULTS: Of the 153 participants, 107 (69.9%) were female, and 65 (42.5%) identified as being from a minoritized racial or ethnic group. Participants' mean age was 41.09 (SD 13.78) years, and their mean BMI was 31.8 (SD 5.0) kg/m2. Participants had an average weight change of -4.25% (SD 3.93%) from baseline to 3 months and -5.05% (SD 5.59%) from baseline to 6 months. At 6 months, the percentages of participants who experienced ≥3%, ≥5%, and ≥10% weight loss were 63.4% (97/153), 51% (78/153), and 14.4% (22/153), respectively. The mean percentage of weeks in which participants engaged in ≥1 aspects of the program was 87.53% (SD 23.40%) at 3 months and 77.67% (SD 28.69%) at 6 months. Retention was high (132/153, 86.3%), and more than two-thirds (94/140, 67.1%) of the participants reported that the program helped them lose weight. Significant improvements were observed in fruit and vegetable intake, physical activity, sleep quality, hunger, food cravings, quality of life, and well-being (all P values <.01). CONCLUSIONS: This personalized, digital, and scalable behavioral weight management program resulted in clinically significant weight loss in half (78/153, 51%) of the participants as well as improvements in behavioral and psychosocial outcomes. Future research should compare personalized digital weight loss programs with generic programs on weight loss, participation, and acceptability.
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Terapia Conductista , Calidad de Vida , Adulto , Femenino , Humanos , Masculino , Etnicidad , Ejercicio Físico , FrutasRESUMEN
Rationale: Weight loss is recommended to treat obstructive sleep apnea (OSA).Objectives: To determine whether the initial benefit of intensive lifestyle intervention (ILI) for weight loss on OSA severity is maintained at 10 years.Methods: Ten-year follow-up polysomnograms of 134 of 264 adults in Sleep AHEAD (Action for Health in Diabetes) with overweight/obesity, type 2 diabetes mellitus, and OSA were randomized to ILI for weight loss or diabetes support and education (DSE).Measurements and Main Results: Change in apnea-hypopnea index (AHI) was measured. Mean ± SE weight losses of ILI participants of 10.7 ± 0.7, 7.4 ± 0.7, 5.1 ± 0.7, and 7.1 ± 0.8 kg at 1, 2, 4, and 10 years, respectively, were significantly greater than the 1-kg weight loss at 1, 2, and 4 years and 3.5 ± 0.8 kg weight loss at 10 years for the DSE group (P values ≤ 0.0001). AHI was lower with ILI than DSE by 9.7, 8.0, and 7.9 events/h at 1, 2, and 4 years, respectively (P values ≤ 0.0004), and 4.0 events/h at 10 years (P = 0.109). Change in AHI over time was related to amount of weight loss, baseline AHI, visit year (P values < 0.0001), and intervention independent of weight change (P = 0.01). OSA remission at 10 years was more common with ILI (34.4%) than DSE (22.2%).Conclusions: Participants with OSA and type 2 diabetes mellitus receiving ILI for weight loss had reduced OSA severity at 10 years. No difference in OSA severity was present between ILI and DSE groups at 10 years. Improvement in OSA severity over the 10-year period with ILI was related to change in body weight, baseline AHI, and intervention independent of weight change.
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Apnea Obstructiva del Sueño/terapia , Pérdida de Peso , Programas de Reducción de Peso , Anciano , Femenino , Estudios de Seguimiento , Humanos , Análisis de Intención de Tratar , Estilo de Vida , Masculino , Persona de Mediana Edad , Modelos Estadísticos , Polisomnografía , Índice de Severidad de la Enfermedad , Apnea Obstructiva del Sueño/diagnóstico , Resultado del TratamientoRESUMEN
BACKGROUND: The present study aimed to examine motivations for food choice among long-term weight loss maintainers (WLM) in a widely used commercial weight management program. METHODS: A cross-sectional study was employed where determinants of food choice were measured in the USA using validated scales: Food Choice Questionnaire, Consideration of Future Consequences, and Eating in the Absence of Hunger. Participants were 3806 WLM following a commercial weight management program (WW International, Inc.) who had maintained a weight loss ≥ 9.1 kg (mean 24.7 kg) for 3.3 years and had a body mass index (BMI) of 27.6 kg m2 . A control group of weight stable individuals with obesity (controls; n = 519) had a BMI of 38.9 kg m2 and a weight change < 2.3 kg over the previous 5 years. RESULTS: WLM vs. controls made food decisions more based on health (18.9 vs. 16.3; ηp 2 = 0.052) and weight control (9.9 vs. 7.5; ηp 2 = 0.16) and less based on price (8.4 vs. 9.1; ηp 2 = 0.10). WLM also scored higher than controls with respect to considering future consequences of behaviours (44.3 vs. 38.4; ηp 2 = 0.060) and reported less external eating in the absence of hunger (7.1 vs. 7.5; ηp 2 = 0.058). Standard canonical coefficients indicated that making food choices based on weight (0.717) with less value placed on price (-0.33) and greater consideration of future consequences (0.262) contributed independently and most (overall r = 0.593; p = 0.0001) to discriminating WLM from controls. CONCLUSIONS: In a widely used commercial weight management program, successful WLM reported food decisions based more on weight and less on price and considered future consequences of current behaviours.
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Preferencias Alimentarias , Pérdida de Peso , Índice de Masa Corporal , Estudios Transversales , Humanos , Obesidad/terapiaRESUMEN
BACKGROUND/OBJECTIVES: Despite substantial evidence documenting weight stigma toward people with higher body weight, international comparative studies are lacking in this field. The few studies that have compared weight stigma across different countries focus on explicit weight-biased attitudes rather than people's experiences of weight stigma. The present study conducted a multinational systematic comparison of weight stigma in six countries to assess experiences and interpersonal sources of weight stigma. SUBJECTS/METHODS: Adults (N = 13,996) enrolled in WW International (formerly Weight Watchers), residing in Australia, Canada, France, Germany, the UK, and the US completed identical online anonymous surveys in the dominant language for their country. Surveys assessed their history of experiencing weight stigma, the onset of stigmatizing experiences and associated distress from stigma in different time periods, and interpersonal sources of weight stigma. RESULTS: More than half of participants (55.6-61.3%) across countries reported experiencing weight stigma. Participants with higher BMI were significantly more likely to report weight-stigmatizing experiences than individuals with lower BMI. In all countries, weight stigma experiences were most frequent in childhood and adolescence, with associated distress highest during these time periods. Participants in Germany reported a higher frequency of weight stigma across their whole life, but lower distress associated with stigmatizing experiences, compared to participants in the other five countries. High percentages of participants in each country experienced weight stigma from family members (76.0-87.8%), classmates (72.0-80.9%), doctors (62.6-73.5%), co-workers (54.1-61.7%), and friends (48.8-66.2%). CONCLUSIONS: Weight stigma is prevalent for adults actively engaged in weight management across different Western countries. There were more similarities than differences in the nature, frequency, and interpersonal sources of people's experiences of weight stigma across the six countries in this study. Findings underscore the need for multinational initiatives to address weight stigma and interventions to support individuals engaged in weight management who experience weight mistreatment.
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Internacionalidad , Sobrepeso/psicología , Estigma Social , Adulto , Australia/epidemiología , Canadá/epidemiología , Costo de Enfermedad , Femenino , Francia/epidemiología , Alemania/epidemiología , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Sobrepeso/complicaciones , Encuestas y Cuestionarios , Reino Unido/epidemiología , Estados Unidos/epidemiología , Prejuicio de Peso/etnología , Prejuicio de Peso/psicología , Prejuicio de Peso/estadística & datos numéricosRESUMEN
BACKGROUND: The HEALTHY Study was a multicomponent school-based intervention, designed to prevent type 2 diabetes mellitus (T2DM) in middle-school students. OBJECTIVES: We examined whether the difference in dietary magnesium intake, BMI percentile, and plasma glucose and insulin concentrations from 6th to 8th grade were related in the intervention schools and in the control schools that participated in the HEALTHY Study. METHODS: A total of 2181 ethnically diverse students, from 11.3 to 13.7 y of age, with completed dietary records, BMI percentile, and plasma glucose and insulin concentrations at 6th and 8th grades were included. Dietary magnesium intake was self-reported using the Block Kids FFQ. A hierarchical multiple regression model was used to determine whether the differences in dietary magnesium intake, BMI percentile, and plasma glucose and insulin concentrations from 6th to 8th grades were related, while adjusting for dietary calcium intake and total energy intake. RESULTS: The difference in dietary magnesium intake was significantly related to changes in BMI percentile from 6th to 8th grade in intervention and in control schools [intervention: ß: -0.07; 95% CI: -0.58, -0.02; P = 0.03; R2 (regression coefficient effect size): 0.14; 95% CI for R2: 0.10, 0.17; control: ß: -0.08; 95% CI: -0.63, -0.09; P = 0.01; R2: 0.12; 95% CI for R2: 0.08, 0.15]. The difference in dietary magnesium intake was not related to plasma glucose and insulin concentrations in intervention and in control schools. CONCLUSIONS: We conclude that a multicomponent intervention was associated with reduced risk of T2DM, and that this association may be modulated, in part, by magnesium. The differences in dietary magnesium intake from 6th to 8th grade were negatively related to changes in BMI percentile among middle-school students.
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Diabetes Mellitus Tipo 2 , Magnesio , Glucemia , Índice de Masa Corporal , Diabetes Mellitus Tipo 2/prevención & control , Humanos , Insulina , EstudiantesRESUMEN
BACKGROUND: Data on dietary magnesium intake on the risk of type 2 diabetes mellitus (T2DM) among children and adolescents is limited. AIM: We examined whether dietary magnesium intake was related to body mass index (BMI) percentile, and glycemic indices at baseline and at end of the HEALTHY Study for both intervention and control schools. The HEALTHY Study was a multi-component, school-based intervention, to prevent T2DM in children and adolescents from 6th to 8th grades. METHODS: A secondary data analyses of 2181 ethnically diverse students with completed dietary records, BMI percentile, and plasma insulin and glucose concentrations at baseline (6th grade) and end of study (8th grade) were included from the HEALTHY Study. Dietary magnesium intake was self-reported using the Block Kids Food Frequency Questionnaire. A hierarchical multiple regression model was used to determine the relationships between dietary magnesium intake, BMI percentile, and glycemic indices at baseline and end of the HEALTHY Study, adjusting for magnesium intake from supplements, total energy intake, and fitness level. RESULTS: Dietary magnesium intake was related to BMI percentile at baseline and at end of the HEATHY Study (ß = -0.05, 95% CI = -0.02 to 0, p = 0.04; ß = -0.06, 95% CI = -0.02 to -0.003, p = 0.004); R 2 [regression coefficient effect size] = 0.03; R 2 = 0.06). Dietary magnesium intake was not related to plasma insulin and glucose concentrations at baseline and end of the HEALTHY Study. CONCLUSION: Dietary magnesium intake was inversely related to BMI percentile among middle school students from the HEALTHY Study. Research is required to evaluate the dose-response relationship between fruit and vegetable consumption (good sources of magnesium) and risk of T2DM in children and adolescents. This relationship also needs to be explored among different BMI categories.
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Diabetes Mellitus Tipo 2 , Magnesio , Adolescente , Índice de Masa Corporal , Niño , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/prevención & control , Índice Glucémico , Humanos , Instituciones Académicas , EstudiantesRESUMEN
Objectives. To identify the effect of a Breakfast in the Classroom (BIC) initiative on the foods and drinks students consume in the morning.Methods. Sixteen public schools in Philadelphia, Pennsylvania, that provide universal breakfast participated in a group randomized trial to examine the effects of BIC with complementary nutrition promotion between 2013 and 2016. Control schools (n = 8) offered breakfast in the cafeteria before school. Baseline data were collected from 1362 students in grades 4 to 6. Endpoint data were collected after 2.5 years. Students self-reported the foods and drinks they consumed in the morning.Results. At endpoint, there was no effect of the intervention on breakfast skipping. Nearly 30% of intervention students consumed breakfast foods or drinks from multiple locations, as compared with 21% of control students. A greater proportion of intervention students than control students consumed 100% juice, and a smaller proportion consumed sugar-sweetened beverages and foods high in saturated fat and added sugar.Conclusions. A BIC initiative led to improvements in the types of foods and drinks students consumed in the morning. However, the program did not reduce breakfast skipping and increased the number of locations where students ate.
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Desayuno , Servicios de Alimentación/organización & administración , Instituciones Académicas , Bebidas/clasificación , Niño , Femenino , Alimentos/clasificación , Asistencia Alimentaria , Humanos , Masculino , Philadelphia , Evaluación de Programas y Proyectos de SaludRESUMEN
BACKGROUND: Weight stigma impairs health. Few studies have disentangled the associations of experienced versus internalized stigma with weight-related outcomes. PURPOSE: To examine weight and health variables associated with weight stigma experiences and internalization in the largest-to-date sample of adults in weight management. METHODS: WW (formerly Weight Watchers) members (N = 18,769, 94.6% female, 91.1% white) completed an online survey from 2017 to 2018. Participants reported whether they had experienced weight stigma and, if so, the onset, past-year frequency and distress, and interpersonal sources of stigma. Participants completed the Modified Weight Bias Internalization Scale (WBIS-M) and self-reported: past-year weight and lifetime weight cycles; current self-monitoring behaviors; eating self-efficacy; physical activity; perceived stress; eating to cope; body image; and mental and physical health-related quality-of-life (HRQOL). Participants reported their demographic characteristics, including height and weight to compute body mass index. RESULTS: In logistic and linear regression analyses (controlling for participant characteristics), WBIS-M scores were negatively associated with weight loss, self-monitoring, eating self-efficacy, body image, and mental HRQOL and positively associated with weight gain, weight cycling, perceived stress, and eating to cope (p < .001). Experiencing weight stigma was associated with greater weight loss and less weight gain, although associations with other variables had small effect sizes (absolute ß values < 0.10). WBIS-M scores remained significantly associated with all variables when including stigma onset, frequency/distress, and sources. CONCLUSIONS: Internalized, but not experienced, weight stigma was consistently associated with adverse weight and health factors. Developing and testing interventions targeting internalized stigma in the context of weight management should be a research priority.
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Peso Corporal , Sobrepeso/psicología , Estigma Social , Prejuicio de Peso , Adaptación Psicológica , Adulto , Anciano , Imagen Corporal/psicología , Ejercicio Físico/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida/psicología , Autoimagen , Autoeficacia , Autoinforme , Pérdida de Peso , Programas de Reducción de PesoRESUMEN
BACKGROUND: Coping responses to weight stigma can adversely affect health. Using data from a large commercial weight management sample, this study examined how adults cope with weight stigma, relationships among experienced weight stigma, weight bias internalization, and coping, as well as coping strategies as mediators of the stigma-health relationship. METHOD: Participants were adults enrolled in WW (formerly Weight Watchers) who reported at least one lifetime experience of weight stigma (N = 11,924). Participants completed questionnaires about the type and frequency of stigma experiences, weight bias internalization, strategies used to cope with weight stigma, and health-related quality of life. RESULTS: Active coping, planning, positive reframing, acceptance, emotional support, and exercise avoidance were the most common coping strategies employed in response to acute weight stigma experiences. Weight bias internalization was more strongly associated with coping strategies likely to exacerbate health (e.g., disordered eating, substance use, self-blame) than positive reframing, acceptance, and emotional support. More types of experienced weight stigma (e.g., teasing, unfair treatment) were associated with more frequent use of all coping strategies. Coping strategies did not mediate the stigma-health relationship, and several strategies were associated with poor mental health. CONCLUSION: More types of experiences with weight stigma were associated with more attempts to cope generally, while weight bias internalization was associated with coping strategies which were in turn associated with poor mental health. Developing effective approaches for identifying individuals likely to internalize weight stigma and helping individuals adopt effective coping strategies in response to stigma are important avenues of future research.
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Adaptación Psicológica , Calidad de Vida , Adulto , Peso Corporal , Humanos , Estigma Social , Encuestas y CuestionariosRESUMEN
BACKGROUND/OBJECTIVES: Positive associations have been found between adherence and weight loss in behavioral weight-management interventions. However, less attention has been given to the level of adherence needed to reach clinically significant weight loss. This study examined the levels of adherence associated with a ≥ 5% - < 10% or ≥ 10% weight loss in a community-based, intensive behavioral weight management program, Weight Watchers® (WW), which included three modes of access: (1) 24-weekly WW meetings over 6 months, (2) the WW member website, and (3) the WW mobile application. METHODS: A total of 292 participants were randomized to a WW (n = 147) or a self-help (SH) (n = 145) condition. To assess the impact of adherence, only participants in the WW condition were included in analyses (n = 147). Adherence was defined as use of the three modes of access. Measured heights and weights were obtained at baseline and 6 months. Receiver-operating characteristic curve analyses were conducted to determine the minimal level of adherence associated with clinically significant weight loss. RESULTS: In a 6-month period, increased likelihood of achieving a weight loss ≥ 5% - < 10% was associated with attending approximately one-third (35.4%) of weekly meetings, use of the member website about 25% of days, and use of the mobile application 16.1% of days. Attendance at approximately two-thirds (64.5%) of meetings, use of the member website 41.6% of days, and use of the mobile application 14.7% of days were associated with a clinically significant weight loss of ≥ 10%. Meeting attendance was the strongest predictor of weight loss at 6 months. CONCLUSIONS: Although adherence to a behavioral weight management program was an important predictor of weight loss, extremely high levels were not needed to achieve clinically significant weight loss. These results are important to help patients and treatment providers understand realistic goals for weight management.
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Terapia Conductista , Aplicaciones Móviles , Obesidad/terapia , Cooperación del Paciente/estadística & datos numéricos , Pérdida de Peso , Programas de Reducción de Peso/métodos , Adulto , Anciano , Conductas Relacionadas con la Salud , Humanos , Persona de Mediana Edad , Obesidad/prevención & control , Curva ROC , AutocuidadoRESUMEN
BACKGROUND/OBJECTIVES: The interaction between fasting plasma glucose (FPG) and fasting insulin (FI) concentrations and diets with different carbohydrate content were studied as prognostic markers of weight loss as recent studies up to 6 months of duration have suggested the importance of these biomarkers. SUBJECTS/METHODS: This was a retrospective analysis of a clinical trial where participants with obesity were randomized to an ad libitum low-carbohydrate diet or a low-fat diet with low energy content (1200-1800 kcal/day [≈ 5.0-7.5 MJ/d]; ≤ 30% calories from fat) for 24 months. Participants were categorized (pretreatment) as normoglycemic (FPG < 5.6 mmol/L) or prediabetic (FPG ≥ 5.6-6.9 mmol/L) and further stratified by median FI. Linear mixed models were used to examine outcomes by FPG and FI values. RESULTS: After 2 years, participants with prediabetes and high FI lost 7.2 kg (95% CI 2.1;12.2, P = 0.005) more with the low-fat than low-carbohydrate diet, whereas those with prediabetes and low FI tended to lose 6.2 kg (95% CI -0.9;13.3, P = 0.088) more on the low-carbohydrate diet than low-fat diet [mean difference: 13.3 kg (95% CI 4.6;22.0, P = 0.003)]. No differences between diets were found among participants with normoglycemia and either high or low FI (both P ≥ 0.16). CONCLUSIONS: Fasting plasma glucose and insulin are strong predictors of the weight loss response to diets with different macronutrient composition and might be a useful approach for personalized weight management.
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Glucemia/metabolismo , Dieta Baja en Carbohidratos , Dieta con Restricción de Grasas , Ayuno/sangre , Insulina/sangre , Obesidad/dietoterapia , Pérdida de Peso/fisiología , Adulto , Biomarcadores/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nutrientes , Obesidad/sangre , Obesidad/prevención & control , Medicina de Precisión , Valor Predictivo de las Pruebas , Estudios RetrospectivosRESUMEN
BACKGROUND: Few interventions have shown efficacy to influence key energy balance behaviors during the preschool years. OBJECTIVE: A randomized controlled trial (RCT) was used to evaluate the efficacy of Food, Fun, and Families (FFF), a 12 week authoritative food parenting intervention for mothers with low-income levels, to reduce preschool-aged children's intake of calories from solid fat and added sugar (SoFAS). METHODS: Mothers were randomly assigned to receive FFF (n = 59) or to a delayed treatment control (n = 60). The primary outcome was children's daily energy intake from SoFAS at the end of the 12 week intervention, controlling for baseline levels, assessed by 24-h dietary recalls. Secondary outcomes included children's daily energy intake, children's BMI z-scores, and meal observations of maternal food parenting practices targeted in FFF (e.g. providing guided choices). RESULTS: Participating mothers were predominantly African American (91%), with 39% educated beyond high school and 66% unemployed. Baseline demographics and child SoFAS intakes did not differ by group. Lost to follow-up was 13% and did not differ between groups. At post-intervention, FFF children consumed ~ 94 kcal or 23% less daily energy from SoFAS than children in the control group, adjusting for baseline levels (307.8 (95%CI = 274.1, 341.5) kcal vs. 401.9 (95%CI = 369.8, 433.9) kcal, FFF vs. control; p < 0.001). FFF mothers also displayed a greater number of authoritative parenting practices when observed post-intervention with their child at a buffet-style meal (Wilcoxon z = - 2.54, p = 0.012). Neither child total daily energy intake nor BMI z-scores differed between groups post-intervention. CONCLUSIONS: Findings demonstrate the initial efficacy of an authoritative food parenting intervention for families with low-income to reduce SoFAS intake in early childhood. Additional research is needed to evaluate longer-term effects on diet and growth. TRIAL REGISTRATION: Retrospectively registered at ClinicalTrials.gov : #NCT03646201.
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Dieta , Grasas de la Dieta/administración & dosificación , Azúcares de la Dieta/administración & dosificación , Conducta Alimentaria , Promoción de la Salud/métodos , Responsabilidad Parental , Pobreza , Adulto , Conducta Infantil , Preescolar , Ingestión de Energía , Femenino , Alimentos , Humanos , Masculino , Madres , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenRESUMEN
Cassava brown streak disease (CBSD) is a leading cause of cassava yield losses across eastern and central Africa and is having a severe impact on food security across the region. Despite its importance, relatively little is known about the mechanisms behind CBSD viral infections. We have recently reported the construction of Cassava brown streak virus (CBSV) and Ugandan cassava brown streak virus (UCBSV) infectious clones (IC), which can be used to gain insights into the functions of viral proteins and sequences associated with symptom development. In this study, we perform the first reporter gene tagging of a CBSV IC, with the insertion of green fluorescent protein (GFP) sequence at two different genome positions. Nicotiana benthamiana infections with the CBSV_GFP ICs revealed active CBSV replication in inoculated leaves at 2-5 days post inoculation (dpi) and systemic leaves at 10-14 dpi. We also constructed the chimera CBSV_UCP IC, consisting of the CBSV genome with a UCBSV coat protein (CP) sequence replacement. N. benthamiana infections with CBSV_UCP revealed that the CBSV CP may be associated with high levels of viral accumulation and necrosis development during early infection. These initial manipulations pave the way for U/CBSV ICs to be used to understand U/CBSV biology that will inform vital CBSD control strategies.
Asunto(s)
Manihot/genética , Enfermedades de las Plantas/virología , Potyviridae/genética , Replicación Viral/genética , Evolución Clonal/genética , Abastecimiento de Alimentos , Genoma Viral/genética , Manihot/virología , Filogenia , Enfermedades de las Plantas/genética , Hojas de la Planta/virología , Potyviridae/patogenicidad , Uganda , Proteínas Virales/genéticaRESUMEN
Maintaining dietary self-monitoring during obesity treatment may improve outcomes. As dietary variety is associated with energy intake, understanding the pattern of when new foods and beverages are consumed may assist with identifying when self-monitoring should occur. This study examined dietary variety (total number of differing foods and beverages consumed) from the first 40 days of self-monitoring records reportingâ¯≥â¯3 eating occasions and >600â¯kcal/day from 60 adults (55.9⯱â¯9.1â¯yrs, 35.1⯱â¯5.3â¯kg/m2, 80.0% female, 95.0% white) participating in a smartphone-based, lifestyle intervention. Dietary variety was coded using an ingredient-based approach. Additionally, new flavors of previously consumed items, and modified and non-modified items contributed to variety. Total number of different foods and beverages consumed over 40 coded days (cumulative variety [cv40]); number of days to reach 50%, 75%, and 100% of cv40; cv40 by eating occasions; and mean number of new items consumed on weekdays and weekend days were calculated. CV40 was 145.4⯱â¯33.5. Number of coded days to consume 50%, 75%, and 100% of cv40 was 12.7, 25.1, and 40.0, respectively. Dinner was greater (pâ¯<â¯0.0001) in cv40 (58.6⯱â¯18.5 different items) than other eating occasions, and lunch was greater (pâ¯<â¯0.0001) (38.8⯱â¯10.7 different items) than breakfast and snack. Weekend days had a greater mean number of new items consumed than weekdays, (3.8⯱â¯1.0 items vs. 3.6⯱â¯0.9 items, pâ¯=â¯0.035). Variety of items consumed during obesity treatment is high, and to capture the majority of differing items consumed, at least 4 weeks of detailed recording is needed. After this, to capture new foods and beverages consumed, self-monitoring dinners, lunch, and weekend days may be helpful.
Asunto(s)
Dieta , Conducta Alimentaria , Obesidad/terapia , Bebidas , Desayuno , Registros de Dieta , Ingestión de Energía , Femenino , Humanos , Almuerzo , Masculino , Comidas , Persona de Mediana EdadRESUMEN
Plant virus infectious clones are important tools with wide-ranging applications in different areas of biology and medicine. Their uses in plant pathology include the study of plant-virus interactions, and screening of germplasm as part of prebreeding programmes for virus resistance. They can also be modified to induce transient plant gene silencing (Virus Induced Gene Silencing - VIGS) and as expression vectors for plant or exogenous proteins, with applications in both plant pathology and more generally for the study of plant gene function. Plant viruses are also increasingly being investigated as expression vectors for in planta production of pharmaceutical products, known as molecular farming. However, plant virus infectious clones may pose a risk to the environment due to their ability to reconstitute fully functional, transmissible viruses. These risks arise from both their inherent pathogenicity and the effect of any introduced genetic modifications. Effective containment measures are therefore required. There has been no single comprehensive review of the biosafety considerations for the contained use of genetically modified plant viruses, despite their increasing importance across many biological fields. This review therefore explores the biosafety considerations for working with genetically modified plant viruses in contained environments, with focus on plant growth facilities. It includes regulatory frameworks, risk assessment, assignment of biosafety levels, facility features and working practices. The review is based on international guidance together with information provided by plant virus researchers.
Asunto(s)
Contención de Riesgos Biológicos/normas , Microorganismos Modificados Genéticamente , Virus de Plantas/genética , Plásmidos/genética , Equipos y Suministros , Vectores Genéticos , Laboratorios , Virus de Plantas/patogenicidad , Medición de Riesgo/métodos , Virología/legislación & jurisprudenciaRESUMEN
INTRODUCTION: To examine the prevalence and patterns of tobacco purchases at low-income, urban corner stores. METHODS: Data on tobacco products and other purchases were collected through direct observation of customers' purchases (n=6369) at 120 urban corner stores in Philadelphia, Pennsylvania, from April to September 2012. RESULTS: Overall 13% of corner store purchases included tobacco products. The majority (61%) of tobacco purchases did not include any other products, and 5.1% of all purchases from corner stores included a food or beverage and tobacco product. Approximately 24% of tobacco purchases were for lower-cost tobacco products such as cigars and cigarillos, and nearly 5% of tobacco purchases were an illegal purchase of a single, unpackaged tobacco product that is not intended for individual sale (ie, loosies). There was no difference in the average amount spent on food or beverages when purchased with (US$2.55, 95% CI: 2.21 to 2.88) or without (US$2.55, 95% CI: 2.48 to 2.63) tobacco products. CONCLUSIONS: In low-income, urban corner store settings, 87% of purchases did not include tobacco; most tobacco purchases did not include the sale of non-tobacco items and spending on non-tobacco items was similar whether or not tobacco was purchased. These findings can help inform retail-level tobacco sales decisions, such as voluntary discontinuation of tobacco products or future public health policies that target tobacco sales. The results challenge prevailing assumptions that tobacco sales are associated with sales of other products in corner stores, such as food and beverages.