Sociodemographic and Clinical Predictors of Weight Gain During the First Year of Antiretroviral Therapy among Adults Living With HIV in Urban Tanzania.

Antiretroviral therapy (ART) has improved the survival of people living with HIV (PLHIV) but this success has been accompanied by an increase in noncommunicable diseases. We conducted a prospective cohort study of 4000 adult PLHIV who were initiating ART in Dar es Salaam, Tanzania, to assess weight gain during the first year of treatment and associated sociodemographic and clinical factors. Anthropometric data were collected at ART initiation and monthly follow-up visits. The mean weight gain during the first year of treatment was 2.6 ± 0.3 kg, and the prevalence of overweight or obesity increased from 26.3% at baseline to 40.7%. Female sex, greater household wealth, lower CD4-T-cell counts, higher WHO HIV disease stage, and pulmonary tuberculosis were associated with a greater increase in body mass index (P < .05). Weight gain following ART initiation was common but was greater among females and PLHIV with advanced HIV or comorbidities.

Impact of waitlist weight change on outcomes in heart transplant recipients: a UNOS database analysis.

BACKGROUND: While the effect of pre-transplant weight on patient outcomes following heart transplantation (HTx) has previously been studied, data regarding the impact of dynamic weight change prior to HTx are extremely limited. OBJECTIVES: We sought to elucidate the interaction between HTx listing weight and weight change while waitlisted, and explore how that interaction impacts post-HTx survival in a continuous manner. METHODS: Adult patients listed for HTx from 1987 to 2020 were identified from UNOS database. Three-dimensional restricted cubic spline analysis explored post-HTx survival relative to both changes in BMI/weight and BMI at time of HTx listing. Continuous predictor variables were analyzed with Cox proportional hazards method. RESULTS: 9,628 included patients underwent HTx. Median recipient age was 55 [IQR 46-62] years, and 21% were females. 53% of patients lost while 47% gained weight on the waitlist. Median BMI (27.6 kg/m2 [24.3-31.3] vs. 27.4 kg/m2 [24.2-30.9], paired p < 0.001) and weight (84.8 kg [73.0-98.0] kg vs. 84.4 kg [72.6-96.6], p < 0.001) were similar at listing and transplant. One-year survival was 89.3%. Weight loss over 3 BMI points or 10 kg was associated with higher hazard of death irrespective of listing BMI. In non-obese patients, some weight gain (1-4 BMI points or 5-15 kg) was associated with improved survival. In cachectic patients (BMI < 18.5), failure to gain weight was associated with worse survival. CONCLUSIONS: Impact of weight change varies depending on listing BMI. While a survival benefit is seen in non-obese patients who gain some weight, significant weight loss is associated with poorer survival.

The impact of cohort inclusion/exclusion criteria on pregnancy weight gain chart percentiles.

Pregnancy weight gain standards are charts describing percentiles of weight gain among participants with no risk factors that could adversely affect weight gain. This detailed information is burdensome to collect. We investigated the extent to which exclusion of various pre-pregnancy, pregnancy and postpartum factors impacted the values of pregnancy weight gain percentiles. We examined pregnancy weight gain (kg) among 3178 participants of the US nuMoM2b-Heart Health Study (HHS). We identified five groups of potential exclusion criteria for pregnancy weight gain standards: socio-economic characteristics (group 1), maternal morbidities (group 2), lifestyle/behaviour factors (group 3), adverse neonatal outcomes (group 4) and longer-term adverse outcomes (group 5). We established the impact of different exclusion criteria by comparing the median, 25th and 75th percentiles of weight gain in the full cohort with the values after applying each of the five exclusion criteria groups. Differences > 0·75 kg were considered meaningful. Excluding participants with group 1, 2, 3 or 4 exclusion criteria had no impact on the 25th, median or 75th percentiles of pregnancy weight gain. Percentiles were only meaningfully different after excluding participants in group 5 (longer-term adverse outcomes), which shifted the upper end of the weight gain distribution to lower values (e.g. 75th percentile decreased from 19·6 kg to 17·8 kg). This shift was due to exclusion of participants with excess postpartum weight retention > 5 kg or > 10 kg. Except for excess postpartum weight retention, most potential exclusion criteria for pregnancy weight gain standards did not meaningfully impact chart percentiles.

The structure of motivation: Assessing readiness to change dimensions and their predictive value with the network validation of the Italian version of the Anorexia Nervosa Stages of Change Questionnarie.

OBJECTIVE: Motivation to change is an important predictor for treatment outcomes in individuals with anorexia nervosa (AN), however, the existence and clinical relevance of distinct motivational dimensions are understudied. This study aimed to structurally validate the AN Stage of Change Questionnaire (ANSOCQ) in the Italian adult AN population to identify separate motivational dimensions and their association with clinical variables and outcomes. METHOD: Inpatients and outpatients with AN (N = 300) completed the ANSOCQ and measures assessing eating and depressive psychopathology. Unique Variable Analysis and Exploratory Graph Analysis were employed to identify dimensions in the network structure of ANSOCQ. Cross-sectional associations with clinical variables were assessed in the whole sample. Predictive value on weight and psychopathology was assessed in inpatients. RESULTS: Two dimensions were identified, one comprising items relative to weight gain, and the second items regarding attitudes towards eating, body, and emotional problems. Feelings associated with eating resulted as most central in the network. Higher scores in the first dimension and ANSOCQ total predicted weight gain during hospitalisation. No significant predictors emerged for changes in eating psychopathology. DISCUSSION: These findings confirm the robust psychometric properties of ANSOCQ and provide support for the use of its subdimensions in clinical practice.

Mindfulness and compassion-based programs on eating behavior of post-bariatric surgery patients: A two phased clinical trial protocol.

INTRODUCTION: Weight regain after bariatric surgery remains a relevant and worrisome topic, requiring greater understanding and involvement in research into new adjuvant treatments. This study aims to compare the preliminary effectiveness and feasibility of the Mindfulness-Based Health Promotion and Attachment-Based Compassion Therapy programs as opposed to usual treatments (workshops) on the eating behavior of patients with progressive weight gain after bariatric surgery in Brazilian patients at a private clinic. It was hypothesized that both interventions are feasible and that the self-compassion program may be more effective than the mindfulness program. METHODS: The study will be divided into two phases: a cross-analytical study of those who underwent bariatric surgery and a randomized controlled trial only with the ones who had weight regain. Interventions will be conducted for eight weeks synchronously with three assessment points (baseline, post intervention, and 6-month follow-up), both online. The primary outcome will be a change in eating behavior. Secondary outcomes will include improved quality of life, enhanced body image satisfaction and reduced distortion (Brazilian Silhouette Scales for adults), better weight management (maintenance or weight reduction), increased frequency of activity and monitoring with the surgery team. Qualitative data will also be collected by online identification of a sub-sample of participants. RESULTS: Improvements are expected in eating behavior, weight, reverse progressive weight gain, classification of self-image, quality of life, and levels of mindfulness, self-compassion, and anxiety. CONCLUSION: This study seeks to gather preliminary evidence on the effectiveness of mindfulness and compassion training for the adjunctive treatment of progressive weight gain in post-bariatric patients. Clinical Trials.gov Registration ID: NCT04171713.

Changes in performance, cecal microflora counts and intestinal histology of Japanese quails fed diets containing different fibre sources.

The purpose of this experiment was to investigate how various fiber sources impact the performance, microbial population, and intestinal histology of Japanese quail that was performed in a completely randomized design for 42 days. The dietary treatments involved a fiber-free corn-soybean meal-based diet (control, CTL), and CTL with added levels of sunflower hulls (SFH) and sugar beet pulp (SBP) (20 and 40 g kg-1). Body weight gain (BWG) and feed intake (FI) were recorded weekly. Carcass characteristics, cecal microbial population, blood variables and intestinal histology were measured on the 42 day of age. Adding 40 g kg-1 of SBP led to a significant decrease in body weight gain and an increase in the feed conversion ratio of birds from 1 to 21 days (P < 0.05). The relative weight of the gastrointestinal tract and gizzard increased significantly in birds that consumed SFH. Blood triglyceride concentration decreased with the inclusion of fiber in the diet. However, there was a notable increase in blood cholesterol concentration in the birds that were fed SBP (20 and 40 g kg-1) in comparison to those fed SFH (P < 0.05). The population of E. Coli in the cecum increased significantly in the birds that were fed 4 g kg-1 of SBP as opposed to those fed 20 and 40 g kg-1 of SFH (P < 0.05). The villus height of the jejunum in birds that were fed 20 g kg-1 and 40 g kg-1 of SFH demonstrated a significant increase in comparison to the other treatments (P < 0.05). In general, the findings of this research indicated that the inclusion of 40 g kg-1 of SBP in the diet had a negative impact on performance and other physiological parameters. However, the use of SFH and 20 g kg-1 of SBP yielded similar results to birds in the CTL, and in some cases, even better outcomes.

The effect of Internet-based nutrition education according to Pender's health promotion model on gestational weight gain: Study protocol for a randomized controlled clinical trial.

BACKGROUND: Gestational weight gain (GWG) should be managed appropriately because both inadequate and excessive weight gain have negative health consequences for mother and child. Therefore, we report the study design for investigating the effect of nutrition education based on Pender's health promotion model (HPM) through the smartphone app on GWG. MATERIALS AND METHODS: This randomized controlled trial (RCT) will be performed on the Internet for intervention by uploading text messages, audio, images, and portable document format (PDF) files via a group in one of the virtual messenger networks with the title "Nutrition education research plan." After random allocation, both control and intervention groups will receive the routine prenatal care including dietary recommendations. The data will be collected using a multipart researcher-made questionnaire containing 33 questions including demographic information and Pender's construct parts. The evaluation is performed with pretest, posttest, and measurement of the obtained weight. Paired and independent samples t-tests and analysis of variance (ANOVA) with repeated measurements will be applied to compare mean scores of constructs of Pender's HPM and gained weights. RESULTS: The results of this study will clarify whether the present intervention will be effective on the total gestational weight gain and the weight gained in different weeks of pregnancy compared to the control group. CONCLUSION: The obtained findings of this study might be useful for managing GWG and consequently maternal and neonatal outcomes.

Olanzapine-Induced Weight Gain and Glycolipid Metabolism Aberrations in First-Episode and Antipsychotic-Naïve Schizophrenia Patients: A Longitudinal Study.

OBJECTIVE: Limited research has delved into the comprehensive impact of monotherapy on weight and glycolipid metabolism in schizophrenia (SCZ) patients. Our study aims to longitudinally investigate the multidimensional effects of olanzapine (OLA) monotherapy on weight and glycolipid metabolism in first-episode and antipsychotic-naïve (FEAN) SCZ patients. METHODS: A total of 74 FEAN-SCZ patients were recruited, as well as 58 sex- and age-matched healthy controls. Eligible patients underwent a 4-week OLA treatment regimen, with weight assessments conducted at baseline and week 4. Moreover, lipid profiles and fasting plasma glucose (FPG) were measured at baseline and week 4. Insulin, leptin (LEP), and adiponectin (APN) levels were determined using enzyme-linked immunosorbent assay (ELISA) kits. RESULTS: At baseline, FEAN-SCZ patients showed elevated levels of insulin, low-density lipoprotein (LDL), impaired insulin sensitivity, and reduced levels of APN compared to the healthy controls. Following 4-week OLA treatment, patients showed an increase in body mass index (BMI) of 0.96 kg/m2. Additionally, FPG, quantitative insulin sensitivity check index (QUICKI), HOMA-insulin sensitivity index (HOMA-ISI), and fasting plasma glucose to insulin ratio (G/I) displayed significant decreases, while insulin, HOMA-IR, and LEP levels showed significant increases. Stepwise regression analysis revealed that baseline FPG independently predicted the change in BMI after 4 weeks of OLA treatment. CONCLUSION: FEAN-SCZ patients exhibited pre-existing alterations in glucose homeostasis. After 4 weeks of OLA treatment, SCZ patients experienced significant weight gain, deteriorating insulin resistance, and increased LEP levels. In addition, baseline FPG emerged as a predictor of BMI changes after 4 weeks of OLA treatment.

Evaluation of the productive and reproductive performance of sexual precocity at different ages in Nellore heifers.

This study aimed to investigate the differences between productive and reproductive performance traits of sexually precocious and non-sexually precocious Nellore heifers and to evaluate the genetic correlation of sexual precocity with traits of economic importance. For this purpose, 300,000 Nellore heifers were evaluated for reproductive traits: heifer pregnancy (HP) at 14 (HP14), 18 (HP18), and 24 (HP24) months; heifer rebreeding (HR); number of progenies up to 53 months (NP53); and probability of the cow remaining in the herd until 76 months with at least 3 progenies (Stay). The growth-related traits evaluated included female yearling weight (YW); average daily gain from weaning to yearling (ADGW-Y); weight at maturity (MW); weaning weight of first progeny (WWprog); and female visual scores at yearling for conformation (Conf), precocity (Prec) and muscling (Musc). The effects of female YW and ADGW-Y in six categories on HP14, HP18, and HP24 were analyzed using Generalized linear mixed models (GLMM). Furthermore, a linear mixed model was used to evaluate the impact of HP on WWprog, MW, and reproductive performance (NP53 and Stay). Genetic correlations of HP evaluated in different months with growth and reproductive traits were estimated using a bivariate animal model. Precocious heifers (HP14) were lighter for YW and MW but had greater ADGW-Y than HP18 and HP24. The probability for HP14, HP18, and HP24 increased as the classes of YW and ADGW-Y increased. However, heifers weighing more than 326 kg had a slight reduction in the probability of becoming pregnant at HP14 and HP18. Precocious heifers (HP14 and HP18) produced their first progeny by 3 % lighter than HP24, although they had a greater NP53. Precocious heifers at 18 months (HP18) were 3 % and 6.8 % more likely to remain in the herd than HP14 and HP24 heifers, respectively. Genetic correlations between growth traits (WW, YW, ADGW-Y, and MW) and heifer pregnancy (HP14, HP18, and HP24) ranged from weak (rg = 0.27 ± 0.05) to moderate (rg = -0.47 ± 0.07). The genetic correlation between HR and HP was stronger for HP24 (0.75) against HP14 (0.58) and HP18 (0.64). Although, the genetic correlation between NP53 and Stay with HP14 was higher (rg = 0.53 and 0.45) than those observed for HP18 (rg = 0.46 and 0.38) and HP24 (rg = 0.35 and 0.39). The genetic correlation estimates between HP and visual scores were moderate and favorable for HP14. Selecting HP14 is beneficial for production systems because it increases the NP53 during the productive life without compromising heifer productivity or reproductive performance. However, attention should be given to improving the HR of heifers who become pregnant early.

Garlic (Allium sativum) and mushroom (Agaricus bisporus) powder: Investigation of performance, meat quality, serum profile lipid, and intestinal morphology in broilers.

BACKGROUND: With the ban on the use of antibiotics in poultry nutrition, the opinion of nutritionists turned to their alternatives. Garlic and mushroom are the two important phytobiotic compounds in poultry nutrition. OBJECTIVES: This experiment was done to investigate the effect of garlic powder (GP) and mushroom powder (MP) on the growth performance, meat quality, serum lipid profile, and intestinal morphology of broilers. METHODS: Five hundred and seventy-six one-day-old male Ross 308 broiler chicks were assigned to eight treatments with six replications based on a completely randomized design in a factorial arrangement of 4*2 with four levels of GP (0.00, 0.50, 1.00, 1.50%) and two levels of MP (0.00, 1.00%). RESULTS: No significant effects of GP and MP on the performance were observed. With increasing levels of GP in the diets, the lightness and redness of breast meat decreased and increased, respectively (p < 0.05). The effect of increasing the amount of GP on the reduction of total cholesterol level was similar in the absence or presence of MP. With increasing levels of GP in the diets, the villus height (VH) and VH to crypt depth ratio (VH: CD) increased. The use of MP in the diets significantly increased VH and VH: CD (p < 0.05). CONCLUSION: The addition of GP and MP to the broilers' diets did not have any negative effect on the performance. These pharmaceutic herbs improved intestinal morphology. In addition, increasing the level of GP amended the meat color and reduced the level of serum cholesterol.

Early-pregnancy BMI, maternal gestational weight gain, and asthma and allergic diseases in children.

BACKGROUND: Association of early pregnancy body mass index (BMI) and maternal gestational weight gain (GWG), and asthma and allergic disease in children is unclear. METHODS: We analyzed data from 3176 mother-child pairs in a prospective birth cohort study. Maternal anthropometric measurements in the first and last antenatal clinic visits were obtained through post-delivery questionnaires to calculate early pregnancy BMI and maternal GWG. Asthma and allergic diseases in children by the age of 5 years was assessed using a validated questionnaire. Furthermore, serum samples were analyzed for IgE antibodies to eight allergens. We applied Cox proportional hazards and logistic regression analyses to estimate the association of early pregnancy BMI and maternal GWG (as continuous variables and categorized into quarters), and asthma, atopic eczema, atopic sensitization, and allergic rhinitis in children. RESULTS: Neither early pregnancy BMI nor maternal GWG was associated with asthma and allergic disease in children when analyzed as continuous variables. However, compared to the first quarter of GWG (a rate <0.32 kg/week), mothers in the third quarter (rate 0.42-0.52 kg/week) had children with significantly higher odds of developing atopic eczema (adjusted OR 1.49, 95% CI [1.13-1.96]) by 5 years of age. CONCLUSION: Association of early pregnancy BMI and maternal GWG, and asthma and allergic disease in children, is inconsistent. High maternal GWG may be associated with increased odds of atopic eczema.

The impact of weight gain on antipsychotic nonadherence or discontinuation: A systematic review and meta-analysis.

BACKGROUND: Nonadherence/discontinuation of antipsychotic (AP) medications represents an important clinical issue in patients across psychiatric disorders, including schizophrenia spectrum disorders (SSDs). While antipsychotic-induced weight gain (AIWG) is a reported contributor to nonadherence, a systematic review of the association between AIWG and medication nonadherence/discontinuation has not been explored previously. METHOD: A systematic search was conducted in MEDLINE, EMBASE, PsychINFO, CINAHL, and CENTRAL databases, among others, to help identify all studies which explored adherence, study dropouts, AP switching and/or discontinuations attributable to AIWG among individuals with severe mental illness. A meta-analysis was also completed where applicable. RESULTS: We identified two categories of studies for the meta-analysis. Category 1 included three studies, which compared measures of AP adherence or discontinuation across BMI classes/degrees of self-reported weight gain. When compared to normal weight individuals receiving APs or those who did not report AIWG, individuals who were either overweight or obese or reported weight gain in relation to AP use had an increased odds of AP nonadherence (OR 2.37; 95% CI 1.51-3.73; p = 0.0002). Category 2 had 14 studies which compared measures of discontinuation related to weight gain reported as an adverse effect across different APs. Olanzapine was associated with a 3.32 times (95% CI 2.32-4.74; p < 0.00001) increased likelihood of nonadherence or discontinuation when compared to other APs with lower weight gain liabilities. Similarly, APs with moderate weight gain liability (paliperidone, risperidone, and quetiapine) increased the odds of nonadherence or discontinuation by 2.25 (95% CI 1.31-3.87; p = 0.003) when compared to APs considered to have lower weight gain liability (i.e. haloperidol and aripiprazole). The qualitative summary also confirmed these findings. CONCLUSION: This review and meta-analysis suggests that AIWG influences medication nonadherence/discontinuation, whereby APs with higher weight gain liability are associated with nonadherence/discontinuation. Additional studies are needed to confirm these findings.

Rapid Growth between 0 and 2 Years Old in Healthy Infants Born at Term and Its Relationship with Later Obesity: A Systematic Review and Meta-Analysis of Evidence.

INTRODUCTION: Rapid growth in early childhood has been identified as a possible risk factor for long-term adiposity. However, there is a lack of studies quantifying this phenomenon only in healthy, full-term infants with appropriate birth weight for gestational age. This systematic review and meta-analysis aimed to investigate the association of rapid growth in full-term children up to 2 years of age with adiposity up to 18 years of age. METHODOLOGY: A systematic review of the literature was conducted in PubMed, EMBASE, and Web of Science. RESULTS: 14 studies were included. We were unable to find strong evidence that rapid growth in early childhood is a risk factor for long-term adiposity. Rapid growth in early childhood was associated with taller heights (standardized mean difference: 0.51 (CI: 0.25-0.77)) and higher body mass index (standardized mean difference: 0.50 (CI: 0.25-0.76)) and a higher risk of overweight under 18 years. CONCLUSION: Rapid growth in early childhood in term infants with appropriate birth weight is associated with higher growth, body mass index, and risk of being overweight up to age 18, but further work is needed to identify the associations between early rapid growth and obesity later in adulthood.

Changes in body weight in various population groups in Poland during the COVID-19 pandemic - a comparison of two cross-sectional studies.

INTRODUCTION AND OBJECTIVE: The disruption of daily activities caused by the COVID-19 pandemic had health consequences, especially during peak lockdown periods. The aim of the study is to assess the impact of the first year of the COVID-19 pandemic on the process of weight change among Polish adults. MATERIAL AND METHODS: Two representative studies involving Polish adults aged 18-65 years were conducted, the first in June 2020 (N = 2527, from the perspective of the last 2-3 months), and the second a year later, in June 2021 (N = 2087, covering the last 12 months). Both surveys included two groups of respondents, and conducted using the CAWI method - computer-assisted web interview. RESULTS: In the first period of the COVID-19 pandemic, there were more individuals with obesity than a year later (18.7% vs 19.9%), and more respondents reported weight change in 2020 than in 2021 (53% vs 49.6%). In both surveys, women were more likely to report weight gain than men (p<0.001). Statistically significant factors for weight change in 2020 and 2021 were gender, age, and in 2021, education and relationship status. Multinomial logistic regression showed that BMI, age of 18-29 and 30-49, being male, and education below high school, was significant for weight gain. While for weight loss, BMI, age 18-29 and 30-49, being male, and year of study, were statistically significant. CONCLUSIONS: The findings confirmed that body weight changed throughout the pandemic, depending on the time of the pandemic and selected socio-demographic factors.

Bayesian approach to estimate variance components and genetic parameters of average daily gains and Kleiber ratios in crossbred cattle.

The present study aimed to estimate variance components and genetic parameters of the average daily gains from birth to 3-months (ADG1), 3- to 6-months (ADG2), 6- to 9-months (ADG3) and 9- to 12-months (ADG4) of age and corresponding Kleiber ratios (KR1, KR2, KR3 and KR4, respectively) in Jersey crossbred calves. Data for this study were collected from National Dairy Research Institute, Eastern Regional Station, Kalyani, West Bengal, India during 2013 to 2021. Genetic parameters for the traits were estimated using Bayesian procedure through Gibbs sampling by fitting six animal models. The deviance information criterion (DIC) was employed to determine the most appropriate model for each trait under investigation. Direct heritability estimates for ADGs and KRs ranged from 0.19 (ADG3) to 0.59 (ADG2) and 0.14 (KR3) to 0.72 (KR1), respectively. Significant maternal heritability ( m 2 ) was observed for average daily gains (17-24%) and Kleiber ratios (13-18%) at different age intervals under the best model. Estimates of permanent environmental effects ( c 2 ) of dam for ADG1, ADG2, KR2 and KR4 were only 1-4% of the total phenotypic variance in this study. Large negative estimates of correlations, ranging from -0.87 to -0.98, between direct and maternal ( r a , m ) effects for ADGs and KRs (except KR3) at different age intervals were observed. Total heritability ( h t 2 ) and maternal repeatability ( t m ) of the studied traits ranged 0.05-0.28 and 0.01-0.14, respectively. The moderate to high heritability estimates for all traits in this study indicate the possibility of genetic progress for these traits through selective breeding program.

Role of Hindmilk in Weight Gain of Preterm Low-Birth-Weight Neonates: A Prospective Comparative Study.

Background The significance of low birth weight cannot be overstated when considering the mortality rates during the perinatal and neonatal stages. Babies who were born premature, especially those with extremely low birth weights, have significant health challenges and require adequate feeding to grow and develop well. Specifically, hindmilk is rich in essential nutrients for neonate growth and development. This study aims to evaluate how hindmilk impacts the weight gain and anthropometry (specifically occipitofrontal circumference and length) of preterm low-birth-weight neonates. Methods A prospective comparative study was conducted on 148 preterm low-birth-weight neonates admitted to the neonatal intensive care unit of a tertiary care hospital in Vijayapura, part of Northern Karnataka. Informed consent was taken and scrutinized by the Institutional Review Board of BLDE University (approval number: BLDE(DU)/IEC/653/2022-23). The neonates were categorized as Group 1, which received hindmilk, or Group 2, which received composite milk based on the computer-generated block randomization list by the investigator. Weight gain and anthropometry were measured and analyzed using SPSS Statistics version 20 (IBM Corp., Released 2011; IBM SPSS Statistics for Windows, Version 20.0; Armonk, NY: IBM Corp.) at the end of the study. Results Group 1 neonates exhibited significantly higher mean values for weight at discharge (1664.22 ± 328.9 grams vs. 1542.33 ± 369.24 grams, p = 0.03), head circumference (31.72 ± 2.52 centimeters (cm) vs. 30.76 ± 4.01 cm, p = 0.04), and length (44.10 ± 2.84 cm vs. 42.23 ± 3.76 cm, p = 0.00) compared to Group 2. Conclusion To enhance the growth outcomes of low-birth-weight preterm neonates, selective hindmilk feeding is highly recommended. Hence, it should be adopted in neonatal care to optimize growth and development.

e-Cigarettes, Smoking Cessation, and Weight Change: Retrospective Secondary Analysis of the Evaluating the Efficacy of e-Cigarette Use for Smoking Cessation Trial.

BACKGROUND: While smoking cessation has been linked to substantial weight gain, the potential influence of e-cigarettes on weight changes among individuals who use these devices to quit smoking is not fully understood. OBJECTIVE: This study aims to reanalyze data from the Evaluating the Efficacy of e-Cigarette Use for Smoking Cessation (E3) trial to assess the causal effects of e-cigarette use on change in body weight. METHODS: This is a secondary analysis of the E3 trial in which participants were randomized into 3 groups: nicotine e-cigarettes plus counseling, nonnicotine e-cigarettes plus counseling, and counseling alone. With adjustment for baseline variables and the follow-up smoking abstinence status, weight changes were compared between the groups from baseline to 12 weeks' follow-up. Intention-to-treat and as-treated analyses were conducted using doubly robust estimation. Further causal analysis used 2 different propensity scoring methods to estimate causal regression curves for 4 smoking-related continuous variables. We evaluated 5 different subsets of data for each method. Selection bias was addressed, and missing data were imputed by the machine learning method extreme gradient boosting (XGBoost). RESULTS: A total of 257 individuals with measured weight at week 12 (mean age: 52, SD 12 y; women: n=122, 47.5%) were included. Across the 3 treatment groups, of the 257 participants, 204 (79.4%) who continued to smoke had, on average, largely unchanged weight at 12 weeks, with comparable mean weight gain ranging from -0.24 kg to 0.33 kg, while 53 (20.6%) smoking-abstinent participants gained weight, with a mean weight gain ranging from 2.05 kg to 2.70 kg. After adjustment, our analyses showed that the 2 e-cigarette arms exhibited a mean gain of 0.56 kg versus the counseling alone arm. The causal regression curves analysis also showed no strong evidence supporting a causal relationship between weight gain and the 3 e-cigarette-related variables. e-Cigarettes have small and variable causal effects on weight gain associated with smoking cessation. CONCLUSIONS: In the E3 trial, e-cigarettes seemed to have minimal effects on mitigating the weight gain observed in individuals who smoke and subsequently quit at 3 months. However, given the modest sample size and the potential underuse of e-cigarettes among those randomized to the e-cigarette treatment arms, these results need to be replicated in large, adequately powered trials. TRIAL REGISTRATION: ClinicalTrials.gov NCT02417467; https://www.clinicaltrials.gov/study/NCT02417467.

Position statement of Italian Society of Obesity (SIO): Gestational Obesity.

PURPOSE: Gestational obesity (GO) presents a multifaceted challenge to maternal and fetal health, with an escalating prevalence and far-reaching consequences extending beyond pregnancy. This perspective statement by the Italian Society of Obesity (SIO) provides current insights into the diagnosis, maternal and fetal impacts, and treatment strategies for managing this pressing condition. METHODS: This article provides a comprehensive review of the maternal and fetal effects of GO and provides suggestions on strategies for management. Comprehensive review was carried out using the MEDLINE/PubMed, CINAHL, EMBASE, and Cochrane Library databases. RESULTS: The diagnosis of GO primarily relies on pre-pregnancy body mass index (BMI), although standardized criteria remain contentious. Anthropometric measures and body composition assessments offer valuable insights into the metabolic implications of GO. Women with GO are predisposed to several health complications, which are attributed to mechanisms such as inflammation and insulin resistance. Offspring of women with GO face heightened risks of perinatal complications and long-term metabolic disorders, indicating intergenerational transmission of obesity-related effects. While nutritional interventions are a cornerstone of management, their efficacy in mitigating complications warrants further investigation. Additionally, while pharmacological interventions have been explored in other contexts, evidence on their safety and efficacy specifically for GO remains lacking, necessitating further investigation. CONCLUSION: GO significantly impacts maternal and fetal health, contributing to both immediate and long-term complications. Effective management requires a multifaceted approach, including precise diagnostic criteria, personalized nutritional interventions, and potential pharmacological treatments. These findings underscore the need for individualized care strategies and further research to optimize outcomes for mothers and their offspring are needed. Enhanced understanding and management of GO can help mitigate its intergenerational effects, improving public health outcomes. LEVEL OF EVIDENCE: Level V narrative review.

Promoting Healthy Eating and Activity from the Start: Early Obesity Prevention.

Obesity is a major public health problem that frequently begins in early childhood and persists into later life. While obesity's multifactorial causes and solutions largely lie outside of the individual and family levels, pediatric clinicians can support families with infants in preventing obesity and promoting long-term health and well-being. They can do so by focusing on counseling during well visits on exclusive breastfeeding, limiting bottle size, delaying solid food introduction, avoiding juice and sugar-sweetened beverages, limiting screen time, and promoting physical activity and healthy sleep.