The low-fat imperative

Camp-based immersion treatment for obese, low socioeconomic status, multi-ethnic adolescents

BACKGROUND

Immersion treatment (IT) provided in a camp setting has been shown to promote short-term improvements in weight and health status in obese adolescents. However, evidence of IT's long-term efficacy and efficacy for multi-ethnic and lower socioeconomic status (SES) adolescents is limited.

METHODS

This was a cohort study with a pre/post design and longitudinal follow-up. The intervention was a 19-day camp-based IT program comprising (1) a nutrition curriculum and ad-lib access to a nutritious diet, (2) several hours of physical activity daily, (3) group therapy, and (4) cognitive-behavioral therapy (CBT). This analysis included 52 low-SES adolescents that participated in 2009 and 2010. A subgroup of 33 campers and their families was offered follow-up monthly for 10 months. Primary outcome measures were change in weight-related parameters immediately postcamp and after 10 months of follow-up.

RESULTS

Campers had significant short-term improvements in mean waist circumference (mean [M], 2.6; standard deviation [SD], 3.2 cm), weight (M, 2.6; SD, 1.9 kg), BMI (M, 1.1; SD, 0.9 kg/m2), BMI z-score (M, 0.06; SD, 0.07), and percent overweight (M, 6.1; SD, 4.7). Campers offered follow-up had a modest increase in mean percent overweight (M, 2.0; SD, 8.4) during 10 months of follow-up. However, 33% experienced continuing decline in percent overweight during follow-up, and long-term follow-up was associated with significant overall (precamp vs. end of follow-up) improvements in percent overweight (M, 4.9; SD, 7.2).

CONCLUSIONS

Camp-based IT with CBT is a promising intervention for improving short- and long-term weight status of low-SES adolescents. Additional research is needed to increase long-term efficacy.

Oolichan grease: a unique marine lipid and dietary staple of the north Pacific coast

Oolichan grease, a dietary fat prepared from smelt-like fish, is highly prized by north Pacific coast aboriginal cultures. The composition of oolichan grease is unclear, with one report indicating a high 22:6n-3 content consistent with cold-water marine oils, but another reporting a much lower value. We noted that oolichan grease remains solid up to 15 degrees C, suggesting a low polyunsaturate content. After extracting total lipids from four fresh oolichan fish and four samples of grease, fatty acids were quantitated by high resolution gas chromatography (GC), as were additional samples of fish lipid and grease that were fractionated into triglyceride (TG), phospholipid (PL), and free fatty acids by thin-layer chromatography. In contradistinction to one prior report, we found EPA and DHA in fresh fish total lipids to be 0.9 and 2.2 wt%, respectively, while in the extracted grease, both were reduced to 0.5 wt%. Only the fresh fish PL fraction contained appreciable DHA. The bulk of the grease consisted of saturated fatty acids (30.3 wt%) and mono-unsaturates (55.0 wt%), explaining its high melting point. Excepting its very low omega-6 content (<2 wt%), oolichan grease is quite similar in composition to human adipose TG. Its solid state at environmental temperatures and low peroxidizability index made it suitable for storage and transport, explaining its status as a preferred trade item among regional aboriginal groups.