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Luque V, Feliu A, Closa-Monasterolo R, Muñoz-Hernando J, Ferré N, Gutiérrez-Marín D, Guillen N, Basora J, Hsu P, Alegret-Basora C, Serrano MÀ, Mallafré M, Alejos AM, Balcells EN, Boada À, Paixà S, Mimbrero G, Gil-Mancha S, Tudela-Valls C, Alcazar M, Escribano J. Impact of the motivational interviewing for childhood obesity treatment: The Obemat2.0 randomized clinical trial. Pediatr Obes 2024:e13125. [PMID: 38733242 DOI: 10.1111/ijpo.13125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/19/2023] [Accepted: 04/22/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND AND OBJECTIVE The aim was assessing a short training for healthcare providers on patient-focused counselling to treat childhood obesity in primary care, along with dietitian-led workshops and educational materials. METHODS Randomized clustered trial conducted with paediatrician-nurse pairs (Basic Care Units [BCU]) in primary care centres from Tarragona (Spain). BCUs were randomized to intervention (MI) (motivational interview, dietitian-led education, and educational materials) or control group (SC, standard care). Participants were 8-14-year-old children with obesity, undergoing 1-11 monthly treatment visits during 1 year at primary care centres. The primary outcome was BMI z-score reduction. RESULTS The study included 44 clusters (23 MI). Out of 303 allocated children, 201 (n = 106 MI) completed baseline, final visits, and at least one treatment visit and were included in the analysis. BMI z-score reduction was -0.27 (±0.31) in SC, versus -0.36 (±0.35) in MI (p = 0.036). Mixed models with centres as random effects showed greater reductions in BMI in MI than SC; differences were B = -0.11 (95% CI: -0.20, -0.01, p = 0.025) for BMI z-score, and B = -2.06 (95% CI: -3.89, -0.23, p = 0.028) for BMI %. No severe adverse events related to the study were notified. CONCLUSION Training primary care professionals on motivational interviewing supported by dietitians and educational materials, enhanced the efficacy of childhood obesity therapy.
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Affiliation(s)
- Veronica Luque
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, Tarragona, Spain
- Serra Hunter Fellow, Universitat Rovira i Virgili, Tarragona, Spain
- Institut d'Investigació Sanitària Pere Virgili, Reus, Spain
| | - Albert Feliu
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, Tarragona, Spain
- Institut d'Investigació Sanitària Pere Virgili, Reus, Spain
| | - Ricardo Closa-Monasterolo
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, Tarragona, Spain
| | | | - Natalia Ferré
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, Tarragona, Spain
- Institut d'Investigació Sanitària Pere Virgili, Reus, Spain
| | | | - Núria Guillen
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, Tarragona, Spain
- Salut Sant Joan Reus-Baix Camp, Reus, Spain
| | | | - Pablo Hsu
- Salut Sant Joan Reus-Baix Camp, Reus, Spain
- IDIAPJGol, Reus, Spain
- EAP Sant Pere, Institut Català de la Salut, Reus, Spain
| | | | - M Àngels Serrano
- Pediatrics Department, Hospital Lleuger de Cambrils, Cambrils, Spain
| | - Marta Mallafré
- Pediatrics Department, Hospital Lleuger de Cambrils, Cambrils, Spain
| | - Ana M Alejos
- Pediatrics Department, Hospital Lleuger de Cambrils, Cambrils, Spain
| | - Eva N Balcells
- ABS Alt Camp Est, Institut Català de la Salut, Vilarodona, Spain
| | - Àngels Boada
- ABS Alt Camp Est, Institut Català de la Salut, Vilarodona, Spain
| | - Sandra Paixà
- CAP Marià Fortuny, Salut Sant Joan Reus-Baix Camp, Reus, Spain
| | | | | | | | - Mireia Alcazar
- Institut d'Investigació Sanitària Pere Virgili, Reus, Spain
| | - Joaquín Escribano
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, Tarragona, Spain
- Institut d'Investigació Sanitària Pere Virgili, Reus, Spain
- Salut Sant Joan Reus-Baix Camp, Reus, Spain
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Buller DB, Sussman AL, Thomson CA, Kepka D, Taren D, Henry KL, Warner EL, Walkosz BJ, Woodall WG, Nuss K, Blair CK, Guest DD, Borrayo EA, Gordon JS, Hatcher J, Wetter DW, Kinsey A, Jones CF, Yung AK, Christini K, Berteletti J, Torres JA, Barraza Perez EY, Small A. #4Corners4Health Social Media Cancer Prevention Campaign for Emerging Adults: Protocol for a Randomized Stepped-Wedge Trial. JMIR Res Protoc 2024; 13:e50392. [PMID: 38386396 PMCID: PMC10921336 DOI: 10.2196/50392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Many emerging adults (EAs) are prone to making unhealthy choices, which increase their risk of premature cancer morbidity and mortality. In the era of social media, rigorous research on interventions to promote health behaviors for cancer risk reduction among EAs delivered over social media is limited. Cancer prevention information and recommendations may reach EAs more effectively over social media than in settings such as health care, schools, and workplaces, particularly for EAs residing in rural areas. OBJECTIVE This pragmatic randomized trial aims to evaluate a multirisk factor intervention using a social media campaign designed with community advisers aimed at decreasing cancer risk factors among EAs. The trial will target EAs from diverse backgrounds living in rural counties in the Four Corners states of Arizona, Colorado, New Mexico, and Utah. METHODS We will recruit a sample of EAs (n=1000) aged 18 to 26 years residing in rural counties (Rural-Urban Continuum Codes 4 to 9) in the Four Corners states from the Qualtrics' research panel and enroll them in a randomized stepped-wedge, quasi-experimental design. The inclusion criteria include English proficiency and regular social media engagement. A social media intervention will promote guideline-related goals for increased physical activity, healthy eating, and human papillomavirus vaccination and reduced nicotine product use, alcohol intake, and solar UV radiation exposure. Campaign posts will cover digital and media literacy skills, responses to misinformation, communication with family and friends, and referral to community resources. The intervention will be delivered over 12 months in Facebook private groups and will be guided by advisory groups of community stakeholders and EAs and focus groups with EAs. The EAs will complete assessments at baseline and at 12, 26, 39, 52, and 104 weeks after randomization. Assessments will measure 6 cancer risk behaviors, theoretical mediators, and participants' engagement with the social media campaign. RESULTS The trial is in its start-up phase. It is being led by a steering committee. Team members are working in 3 subcommittees to optimize community engagement, the social media intervention, and the measures to be used. The Stakeholder Organization Advisory Board and Emerging Adult Advisory Board were formed and provided initial input on the priority of cancer risk factors to target, social media use by EAs, and community resources available. A framework for the social media campaign with topics, format, and theoretical mediators has been created, along with protocols for campaign management. CONCLUSIONS Social media can be used as a platform to counter misinformation and improve reliable health information to promote health behaviors that reduce cancer risks among EAs. Because of the popularity of web-based information sources among EAs, an innovative, multirisk factor intervention using a social media campaign has the potential to reduce their cancer risk behaviors. TRIAL REGISTRATION ClinicalTrials.gov NCT05618158; https://classic.clinicaltrials.gov/ct2/show/NCT05618158. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/50392.
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Affiliation(s)
| | - Andrew L Sussman
- University of New Mexico Comprehensive Cancer Care Center, Albuquerque, NM, United States
| | - Cynthia A Thomson
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Deanna Kepka
- College of Nursing and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Douglas Taren
- Section of Nutrition, University of Colorado Denver, Aurora, CO, United States
| | - Kimberly L Henry
- Department of Psychology, College of Natural Sciences, Colorado State University, Fort Collins, CO, United States
| | - Echo L Warner
- College of Nursing and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | | | | | - Kayla Nuss
- Klein Buendel, Golden, CO, United States
| | - Cindy K Blair
- University of New Mexico Comprehensive Cancer Care Center, Albuquerque, NM, United States
| | - Dolores D Guest
- University of New Mexico Comprehensive Cancer Care Center, Albuquerque, NM, United States
| | - Evelinn A Borrayo
- University of Colorado Cancer Center, University of Colorado Denver, Aurora, CO, United States
| | - Judith S Gordon
- College of Nursing, University of Arizona, Tucson, AZ, United States
| | | | - David W Wetter
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | | | - Christopher F Jones
- University of Colorado Cancer Center, University of Colorado Denver, Aurora, CO, United States
| | - Angela K Yung
- College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Kaila Christini
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | | | - John A Torres
- University of New Mexico Comprehensive Cancer Care Center, Albuquerque, NM, United States
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Lee KX, Quek KF, Ramadas A. Dietary and Lifestyle Risk Factors of Obesity Among Young Adults: A Scoping Review of Observational Studies. Curr Nutr Rep 2023; 12:733-743. [PMID: 38038894 DOI: 10.1007/s13668-023-00513-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 12/02/2023]
Abstract
PURPOSE OF REVIEW Obesity is a growing public health concern worldwide, especially among young adults. This scoping review aims to identify and summarize the current evidence on dietary and lifestyle risk factors associated with obesity among young adults. RECENT FINDINGS A scoping review was performed using the PRISMA-ScR guidelines. A systematic search of five electronic databases published from inception to October 2023 was conducted. A total of 46 observational studies met the inclusion criteria and were included in the review. The findings suggest that high intake of energy-dense foods, unhealthy eating habits, poor sleep quality, and increased screen time were significant risk factors for obesity among young adults. In contrast, the association between obesity and sedentary behavior, low physical activity levels, alcohol consumption, and smoking habits was inconclusive. The reviewed evidence suggests that unhealthy dietary habits and lifestyle behaviors are associated with an increased risk of obesity among young adults. The findings highlight the need for further research on these modifiable risk factors to prevent and manage obesity among young adults.
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Affiliation(s)
- Ke Xin Lee
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500, Bandar Sunway, Malaysia
| | - Kia Fatt Quek
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500, Bandar Sunway, Malaysia
| | - Amutha Ramadas
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500, Bandar Sunway, Malaysia.
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Taylor KS, Beeken RJ, Fisher A, Lally P. Did the COVID-19 pandemic impact the dietary intake of individuals living with and beyond breast, prostate, and colorectal cancer and who were most likely to experience change? Support Care Cancer 2023; 31:585. [PMID: 37728860 PMCID: PMC10511549 DOI: 10.1007/s00520-023-08032-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/31/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE The present work investigated dietary changes amongst individuals living with and beyond cancer (LWBC) from before to during the pandemic. To identify those at greatest risk of unhealthy changes, it was further examined whether patterns varied by sociodemographic, health-related, and COVID-19-related characteristics. METHODS This longitudinal cohort study analysed data from 716 individuals LWBC participating in the Advancing Survivorship Cancer Outcomes Trial (ASCOT). Using data provided before and during the pandemic, changes in fruit and vegetable, snack, and alcohol intake were tested using mixed-effect regression models. RESULTS Fruit and vegetable (95%CI: - 0.30; - 0.04) and alcohol consumption (95%CI: - 1.25; - 0.31) decreased, whilst snacking increased (95%CI: 0.19; 0.53). Women and individuals with limited social contact were more likely to reduce fruit and vegetable intake during the pandemic. Women and individuals with poorer sleep quality, limited social contact, and shielding requirements and without higher education were more likely to increase snacking during the pandemic. Individuals with poorer sleep quality, poorer mental health, and regular social contact were more likely to decrease alcohol consumption during the pandemic. CONCLUSIONS Findings suggest decreased intake for fruit, vegetable, and alcohol consumption and increased snack intake in response to the pandemic amongst individuals LWBC. These changes appear to differ across various characteristics, suggesting the pandemic has not equally impacted everyone in this population. Findings highlight the need for targeted post-COVID strategies to support individuals LWBC most adversely affected by the pandemic, including women and socially isolated individuals. This encourages resources to be prioritised amongst these groups to prevent further negative impact of the pandemic. Whilst the findings are statistically significant, practically they appear less important. This is necessary to acknowledge when considering interventions and next steps.
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Affiliation(s)
- Katie S Taylor
- Department of Epidemiology and Public Health, University College London, London, WC1E 7HB, UK
| | - Rebecca J Beeken
- Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9JT, UK.
| | - Abi Fisher
- Department of Behavioural Science and Health, University College London, London, WC1E 7HB, UK
| | - Phillippa Lally
- Department of Psychology, University of Surrey, Guildford, GU2 7XH, UK
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Anderson LN, Alvarez E, Incze T, Tarride JE, Kwan M, Mbuagbaw L. Motivational interviewing to promote healthy behaviors for obesity prevention in young adults (MOTIVATE): a pilot randomized controlled trial protocol. Pilot Feasibility Stud 2023; 9:156. [PMID: 37679845 PMCID: PMC10483727 DOI: 10.1186/s40814-023-01385-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Obesity is a chronic disease and is an established risk factor for other chronic diseases and mortality. Young adulthood is a period when people may be highly amenable to healthy behavior change, develop lifelong healthy behaviors, and when primary prevention of obesity may be feasible. Interventions in early adulthood have the potential for primary or primordial prevention (i.e., preventing risk factors before disease onset). The primary objective of this study is to determine the feasibility of a 6-month behavioral and educational intervention to promote healthy behaviors for obesity prevention among young adults. METHODS This is the study protocol for a pilot randomized controlled trial. Young adults (age 18-29) attending McMaster University, Hamilton, Canada, will be recruited and randomized to either the intervention or control. The intervention will include individual motivational interviewing sessions (online or in-person) with a trained interviewer plus educational materials (based on Canada's food guide and physical activity recommendations). The control group will receive educational materials only. The primary feasibility outcomes that will be evaluated as part of this pilot study include enrollment, retention (≥ 80%), data completion (≥ 80% of weights measured, and surveys completed), and participant satisfaction. Secondary clinical outcomes will include body mass index (BMI) change from baseline to 6 months, physical activity, nutrition risk, health-related quality of life mental health, and economic outcomes. Outcomes will be measured remotely using activity trackers, and online questionnaires at baseline and every 2 months. Risk stratification will be applied at baseline to identify participants at high risk of obesity (e.g., due to family or personal history). Exit questionnaires will collect data on how participants felt about the study and cost analysis will be conducted. DISCUSSION Our pilot randomized controlled trial will evaluate the feasibility of an obesity prevention intervention in early adulthood and will inform future larger studies for obesity prevention. The results of this study have the potential to directly contribute to the primary prevention of several types of cancer by testing an intervention that could be scalable to public health, post-secondary education, or primary care settings. TRIAL REGISTRATION https://clinicaltrials.gov/ct2/show/NCT05264740 . Registered on March 3, 2022.
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Affiliation(s)
- Laura N Anderson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street W, Hamilton, ON, L8S 4L8, Canada.
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, ON, Canada.
- Center for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, ON, Canada.
| | - Elizabeth Alvarez
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street W, Hamilton, ON, L8S 4L8, Canada
- Center for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, ON, Canada
| | - Taylor Incze
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street W, Hamilton, ON, L8S 4L8, Canada
| | - Jean-Eric Tarride
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street W, Hamilton, ON, L8S 4L8, Canada
- Center for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, ON, Canada
- Programs for Assessment of Technology in Health (PATH), The Research Institute of St. Joe's Hamilton, St. Joseph's Healthcare, Hamilton, Canada
| | - Matthew Kwan
- Department of Child and Youth Studies, Brock University, St. Catharines, ON, Canada
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street W, Hamilton, ON, L8S 4L8, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
- Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, ON, Canada
- Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
- Department of Anaesthesia, McMaster University, Hamilton, ON, Canada
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Barriers and facilitators to physical activity for young adult women: a systematic review and thematic synthesis of qualitative literature. Int J Behav Nutr Phys Act 2023; 20:23. [PMID: 36849995 PMCID: PMC9972741 DOI: 10.1186/s12966-023-01411-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 12/22/2022] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Physical activity (PA) has many benefits in preventing diseases and maintaining physical and mental health. Women, in particular, can benefit from regular PA. However, women's PA did not increase over the past decade globally, and the situations faced by women are often gender-specific. Healthy young adult women's PA does not receive as much attention as older women and adolescent girls, yet, they face the same situation of low level of PA. This review aims to explore and synthesise the self-identified barriers and facilitators to young adult women's participation in PA from qualitative research studies and offer suggestions for future studies and programs designed for this population. METHODS A systematic search was conducted in Pubmed, Web of Science, Scopus, Medline, and SPORTDiscus for studies published between January 2000 to February 2022 to identify qualitative studies on the barriers and facilitators of young adult women's PA between ages 18 to 40. The search yielded 694 studies initially, of which 23 were included. The research quality of included studies was appraised using the Critical Appraisal Skills Programme (CASP) tool. Data were extracted and thematically analysed based on the tenets of the social-ecological model (SEM). RESULTS Identified barriers and facilitators were grouped into different levels of the SEM, with the most frequently cited factors being time, body image and societal beauty standards, family duty and social support, religious and cultural norms, organisation and community facilities and environment, safety issues and physical environment. Descriptive data were thematically analysed and synthesised in line with the five levels: body image, health and beauty; multiple roles, support, and PA; religious identity, cultural identity, and PA; safety issues and women's fears. CONCLUSIONS This qualitative synthesis revealed in-depth information on barriers and facilitators influencing young adult women's PA. It highlighted that the factors young adult women face are diverse at different levels yet holistic and intertwined. Future studies on young adult women's PA should address the social-cultural influence and would benefit from applying multilevel strategies employing the SEM model. It is critical to create an open and inclusive environment and offer more opportunities for women. TRIAL REGISTRATION PROSPERO CRD42021290519.
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Hoare JK, Lister NB, Garnett SP, Baur LA, Jebeile H. Weight-neutral interventions in young people with high body mass index: A systematic review. Nutr Diet 2023; 80:8-20. [PMID: 35411702 PMCID: PMC10084274 DOI: 10.1111/1747-0080.12729] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/09/2022] [Accepted: 01/24/2022] [Indexed: 01/10/2023]
Abstract
AIM This systematic review explored the feasibility, acceptability and effect on health outcomes of weight-neutral interventions in health improvement-seeking young people with overweight/obesity. METHODS Six databases were searched to March 2021 for health, but not weight, focused interventions (PROSPERO, CRD42020152671). Eligible studies recruited young people (10-24 years) with overweight/obesity. The studies were described using narrative synthesis, with numerical results summarised. The quality of included studies was assessed using the Joanna Briggs Institute critical appraisal tools. RESULTS Six articles were included, representing three pilot studies. Study 1 (n = 37, 14-17 years) compared a 6-week mindful eating program with single-session lifestyle education; Study 2 (n = 35, 14-17 years) compared 12-week weight-neutral lifestyle education focused on intuitive eating and carbohydrate quality, with/without guided imagery; and Study 3 (n = 33, 12-17 years) compared a 6-week mindfulness intervention with cognitive behavioural therapy in adolescents with depressive symptoms at risk of type 2 diabetes. All interventions explored feasibility (intervention group retention 57%-88%, attendance >80%) and reported interventions were acceptable. Studies 1 and 3 reported no change in mindfulness. Study 2 reported an increase (p < 0.05) in intuitive eating following weight-neutral plus guided imagery (0.32 ± 0.36, Hawks' Scale, score 1-4), compared with weight-neutral alone (0.15 ± 0.29). Study 1 reported decreased body mass index (p < 0.001) following mindful eating (-1.1 kg/m2 ), compared with single-session lifestyle education (+0.7 kg/m2 ); Studies 2 and 3 found no change in body mass index or body mass index z-score. CONCLUSIONS Weight-neutral interventions may be feasible and acceptable in adolescents with overweight/obesity in the short term (≤12 weeks), but data are limited.
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Affiliation(s)
- Johanna K Hoare
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Natalie B Lister
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Sarah P Garnett
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Kids Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Louise A Baur
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Kids Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Weight Management Services, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Hiba Jebeile
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
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8
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Alkhathami K, Soman A, Chandy S, Ramamoorthy B, Alqahtani B. Comparing the effects of retro and forward walking on serum adiponectin levels in obese young adults. J Taibah Univ Med Sci 2023; 18:917-925. [PMID: 36852342 PMCID: PMC9958077 DOI: 10.1016/j.jtumed.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 11/29/2022] [Accepted: 01/18/2023] [Indexed: 01/29/2023] Open
Abstract
Objectives Retro walking or backward walking expends greater energy and places less stress on joints compared with forward walking at a similar speed. This study conducted in obese young men was primarily aimed at comparing the effects of backward walking with forward walking on adiponectin levels. The secondary aim was to describe the effects of concomitant factors, namely C-reactive protein, body mass index (BMI), waist to height ratio, and waist to hip ratio, on adiponectin levels in obese young men. Methods In this randomized comparative study, 102 participants underwent either retro walking or forward walking treadmill training four times a week for 12 weeks before and after which adiponectin, C-reactive protein, BMI, waist to height ratio, and waist to hip ratio were measured. Comparison of the measured values before and after intervention and between the groups was done, and the influence of C-reactive protein, BMI, waist to height ratio, and waist to hip ratio on adiponectin levels was determined. Results Adiponectin levels were significantly increased (p < 0.001) and C-reactive protein, BMI, waist to height ratio, and waist to hip ratio were significantly decreased (p ≤ 0.001) post-intervention. The participants who underwent retro walking training showed a significantly higher change in C-reactive protein levels, BMI, and waist to hip ratio compared to the forward walking group (p < 0.001). Adiponectin levels were influenced by BMI (p < 0.001). Conclusion Retro walking training leads to a greater increase in adiponectin and reduction in C-reactive protein, BMI, waist to height ratio, and waist to hip ratio compared to forward walking, and adiponectin levels are influenced by BMI. Retro walking treadmill training can be preferentially used to decrease cardiovascular risk factors.
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Affiliation(s)
- Khalid Alkhathami
- Department of Health Rehabilitation, College of Applied Medical Sciences, Shaqra University, Shaqra, KSA
| | - Ajith Soman
- Department of Health Rehabilitation, College of Applied Medical Sciences, Shaqra University, Shaqra, KSA,Corresponding address: Department of Health Rehabilitation, College of Applied Medical Sciences, Shaqra University, Shaqra 11961, KSA.
| | - Sunil Chandy
- Department of Clinical Lab Science, College of Applied Medical Sciences, Shaqra University, Shaqra, KSA
| | - Baranitharan Ramamoorthy
- Department of Health Rehabilitation, College of Applied Medical Sciences, Shaqra University, Shaqra, KSA
| | - Bijad Alqahtani
- Department of Health Rehabilitation, College of Applied Medical Sciences, Shaqra University, Shaqra, KSA
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Killeen SL, Byrne DF, Geraghty AA, Yelverton CA, van Sinderen D, Cotter PD, Murphy EF, O’Reilly SL, McAuliffe FM. Recruiting and Engaging Women of Reproductive Age with Obesity: Insights from A Mixed-Methods Study within A Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13832. [PMID: 36360712 PMCID: PMC9658053 DOI: 10.3390/ijerph192113832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
Engaging women with obesity in health-related studies during preconception is challenging. Limited data exists relating to their participation. The aim of this study is to explore the experiences and opinions of women participating in a weight-related, preconception trial. This is an explanatory sequential (quan-QUAL) mixed-methods Study Within A Trial, embedded in the GetGutsy randomized controlled trial (ISRCTN11295995). Screened participants completed an online survey of eight questions (single or multiple choice and Likert scale) on recruitment, motivations and opinions on study activities. Participants with abdominal obesity (waist circumference ≥ 80 cm) were invited to a subsequent semi-structured, online focus group (n = 2, 9 participants) that was transcribed and analyzed using inductive thematic analysis, with a pragmatic epistemological approach. The survey (n = 102) showed the main research participation motivations were supporting health research (n = 38, 37.3%) and wanting health screening (n = 30, 29.4%). Most participants were recruited via email (n = 35, 34.7%) or social media (n = 15, 14.7%). In the FGs, participants valued flexibility, convenience and. research methods that aligned with their lifestyles. Participants had an expanded view of health that considered emotional well-being and balance alongside more traditional medical assessments. Clinical trialists should consider well-being, addressing the interconnectedness of health and incorporate a variety of research activities to engage women of reproductive age with obesity.
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Affiliation(s)
- Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - David F. Byrne
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - Aisling A. Geraghty
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Cara A. Yelverton
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - Douwe van Sinderen
- APC Microbiome Ireland, Biosciences Research Institute, National University of Ireland, T12 K8AF Cork, Ireland
- School of Microbiology, National University of Ireland, T12 K8AF Cork, Ireland
| | - Paul D. Cotter
- APC Microbiome Ireland, Biosciences Research Institute, National University of Ireland, T12 K8AF Cork, Ireland
- Teagasc Food Research Centre, Moorepark, Fermoy, P61 C996 Cork, Ireland
| | - Eileen F. Murphy
- Precision Biotics Ltd. (Novozymes Cork), Cork Airport Business Park, Kinsale Road, T12 D292 Cork, Ireland
| | - Sharleen L. O’Reilly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Fionnuala M. McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
- APC Microbiome Ireland, Biosciences Research Institute, National University of Ireland, T12 K8AF Cork, Ireland
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10
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León E, Tabares M, Baile JI, Salazar JG, Zepeda AP. Eating behaviors associated with weight gain among university students worldwide and treatment interventions: A systematic review. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-8. [PMID: 35834744 DOI: 10.1080/07448481.2022.2089841] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/29/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
Introduction: Emerging adulthood has been described as a period of risk for body weight gain. Several studies have indicated that the positive or negative health behaviors established during this stage, tend to prevail the rest of life. However, there are discrepancies in published studies on weight change in freshmen and there are disagreements on weight gain predictors. The present study reviewed the literature with the aim of knowing the eating behaviors associated with weight gain in university students. Method: A systematic search was conducted in three databases according to the PRISMA method during the months of February to November 2020. Results: 20 articles were included in the review. The main behaviors associated with weight gain were the consumption of sugary drinks, alcohol consumption, low consumption of vegetables and fruits, frequent self-consumption, eating unhealthy and low levels of food regulation.
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Affiliation(s)
- Edgar León
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), Universidad de Guadalajara, Guadalajara, Mexico
| | - Marcela Tabares
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), Universidad de Guadalajara, Guadalajara, Mexico
| | - José Ignacio Baile
- Departamento de Psicología y Salud, Universidad a Distancia de Madrid (UDIMA), Madrid, Spain
| | - José Guadalupe Salazar
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), Universidad de Guadalajara, Guadalajara, Mexico
| | - Ana Patricia Zepeda
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), Universidad de Guadalajara, Guadalajara, Mexico
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11
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Torres-Costoso A, Martínez-Vizcaíno V, Fernández-Rodríguez R, Sequí-Dominguez I, Reina-Gutiérrez S, Núñez de Arenas-Arroyo S, Garrido-Miguel M. Dietary Calcium Intake and Fat Mass in Spanish Young Adults: The Role of Muscle Strength. Nutrients 2021; 13:nu13124498. [PMID: 34960051 PMCID: PMC8705271 DOI: 10.3390/nu13124498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 01/01/2023] Open
Abstract
Obesity is declared as a chronic multifaceted health problem, and young adults may be particularly vulnerable to weight gain. This study aims to identify the role of dietary calcium intake and the muscle strength index in handling excess of fat mass in young adults and to examine if the relationship between dietary calcium intake and fat mass percentage is mediated by muscle strength. A cross-sectional study including 355 Spanish college students (aged 21.05 ± 3.11) was performed during the 2017–2018 academic year. Pearson correlation coefficients were estimated to determine the relationship between dietary calcium intake, fat mass percentage, body mass index, muscle strength components, and total energy intake. ANCOVA models were used to analyze the differences in the muscle strength index by total dietary calcium intake categories, as well as the differences in % fat mass by total dietary calcium intake and muscle strength index categories, controlling for different sets of confounders. A mediator analysis was conducted to test if the relationship between dietary calcium intake and fat mass percentage was explained by muscle strength. Data on the fat mass percentage, dietary calcium intake, and muscle strength index as the sum of the standardized z-score of the standing long jump and z-score of handgrip/weight were collected. The muscle strength index was significantly better in young adults with higher dietary calcium intake. Moreover, the fat mass percentage was significantly lower in those with a higher dietary calcium intake and a better muscle strength index. Finally, the relationship between dietary calcium intake and fat mass percentage was fully mediated by muscle strength (z = −1.90; p < 0.05), explaining 33.33% of this relationship. This study suggests that both a major dietary calcium intake and muscle strength are associated with fat mass percentage. Moreover, muscle strength mediates the link between dietary calcium intake and fat mass percentage. Therefore, both high dietary calcium intake and exercise activities aimed at improving muscle strength levels may help to prevent the cardiometabolic risk associated with an excess of fat mass in young people.
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Affiliation(s)
- Ana Torres-Costoso
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, 45071 Toledo, Spain;
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Vicente Martínez-Vizcaíno
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 3467987, Chile
- Correspondence: ; Tel.: +34-969179100
| | - Rubén Fernández-Rodríguez
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Irene Sequí-Dominguez
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Sara Reina-Gutiérrez
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Sergio Núñez de Arenas-Arroyo
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Miriam Garrido-Miguel
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
- Facultad de Enfermería de Albacete, Universidad de Castilla-La Mancha, 02006 Ciudad Real, Spain
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12
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Napolitano MA, Whiteley JA, Mavredes M, Tjaden AH, Simmens S, Hayman LL, Faro J, Winston G, Malin S, DiPietro L. Effect of tailoring on weight loss among young adults receiving digital interventions: an 18 month randomized controlled trial. Transl Behav Med 2021; 11:970-980. [PMID: 33739422 DOI: 10.1093/tbm/ibab017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Weight loss outcomes among young adults in technology-based programs have been equivocal. The purpose of this study was to deliver digital weight loss treatments to young adults and examine the 6, 12, and 18 month effects on weight loss. Young adults with overweight/obesity (N = 459; 23.3 ± 4.4 years) were recruited from two university sites and randomly assigned to receive through Facebook and text messaging either personalized (TAILORED; n = 150) or generic (TARGETED; n = 152) weight loss information, messages, and feedback or general healthy body content (e.g., body image, sleep; CONTROL; n = 157). The study was powered to detect a 2.1-kg difference at all time points with the primary outcome being 18 months. There was no overall effect of treatment group on 6, 12, or 18 month weight loss (ps = NS). However, at 6 months, those in TAILORED who were highly engaged (completing >66%) lost more weight compared to CONTROL (-2.32 kg [95% confidence intervals: -3.90, -0.74]; p = .004), with the trend continuing at 12 months. A significant baseline body mass index (BMI) by treatment group interaction (p = .004) was observed at 6 months. Among participants in the lowest baseline BMI category (25-27.5 kg/m2), those in TAILORED lost 2.27 kg (-3.86, -0.68) more, and those in TARGETED lost 1.72 kg (-3.16, -0.29) more than CONTROL after adjusting for covariates. Among participants with a BMI between 27.5 and 30 kg/m2, those in TAILORED lost 2.20 kg (-3.90, -0.51) more than participants in TARGETED. Results did not persist over time with no treatment interaction at 12 or 18 months. Initial body weight should be considered when recommending weight loss treatments for young adults. More intensive interventions or stepped care approaches may be needed for young adults with obesity.
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Affiliation(s)
- Melissa A Napolitano
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, 3rd Floor, Washington, DC 20052, USA.,Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, 2nd Floor, Washington, DC 20052, USA
| | - Jessica A Whiteley
- College of Nursing and Health Sciences, The University of Massachusetts at Boston, Boston, MA 02125, USA
| | - Meghan Mavredes
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, 3rd Floor, Washington, DC 20052, USA
| | - Ashley Hogan Tjaden
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
| | - Samuel Simmens
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
| | - Laura L Hayman
- College of Nursing and Health Sciences, The University of Massachusetts at Boston, Boston, MA 02125, USA
| | - Jamie Faro
- Department of Population and Quantitative Health Sciences, The University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Ginger Winston
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, 3rd Floor, Washington, DC 20052, USA.,Medical Faculty Associates, The George Washington University, Washington, DC 20052, USA
| | - Steven Malin
- Departments of Kinesiology and Division of Endocrinology, Metabolism and Nutrition, Rutgers University, New Brunswick, NJ 08901, USA
| | - Loretta DiPietro
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, 2nd Floor, Washington, DC 20052, USA
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Willmott TJ, Pang B, Rundle-Thiele S. Capability, opportunity, and motivation: an across contexts empirical examination of the COM-B model. BMC Public Health 2021; 21:1014. [PMID: 34051788 PMCID: PMC8164288 DOI: 10.1186/s12889-021-11019-w] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 05/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is limited evidence for successful weight gain prevention interventions targeting young adults. Developing effective interventions necessitates a theoretical model that can identify barriers and enablers for healthy eating and physical activity among young adults to support weight management. This study empirically examines the utility of the COM-B model as a framework for intervention planning across two behavioural contexts: eating and physical activity. METHODS A cross-sectional survey research design was employed to empirically test the COM-B model in the contexts of young adult's eating and physical activity behaviours. Informed by the Theoretical Domains Framework, pre-validated measures appropriate for capturing the latency of the COM (Capability, Opportunity, and Motivation) constructs were sourced. Both surveys (eating and physical activity) were administered online to two independent samples of young adults aged 18-35 years. Models were specified and tested using structural equation modelling. RESULTS A total of 582 (mean age = 22.8 years; 80.3% female) and 455 (mean age = 24.9 years; 80.8% female) participants were included in the physical activity and eating analyses, respectively. The COM-B model explained 31% of variance in physical activity behaviour and 23% of variance in eating behaviour. In the physical activity model (N = 582), capability and opportunity were found to be associated with behaviour through the mediating effect of motivation. In the eating model (N = 455), capability was found to be associated with behaviour through the mediating effect of motivation. Capability was also found to mediate the association between opportunity and motivation. Consistencies and variations were observed across both models in terms of COM indicators. CONCLUSIONS Findings support the COM-B model's explanatory potential in the context of young adult's physical activity and eating behaviours. Barriers and enablers underlying young adult's physical activity and eating behaviours were identified that represent potential targets for future intervention design. Further research is needed to validate present study findings across different populations and settings.
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Affiliation(s)
- Taylor Jade Willmott
- Social Marketing @ Griffith, Griffith University, 170 Kessels Road, Nathan, QLD, 4111, Australia.
| | - Bo Pang
- Social Marketing @ Griffith, Griffith University, 170 Kessels Road, Nathan, QLD, 4111, Australia
| | - Sharyn Rundle-Thiele
- Social Marketing @ Griffith, Griffith University, 170 Kessels Road, Nathan, QLD, 4111, Australia
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14
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Behavioral weight loss in emerging adults: Design and rationale for the Richmond Emerging Adults Choosing Health (REACH) randomized clinical trial. Contemp Clin Trials 2021; 107:106426. [PMID: 34044124 DOI: 10.1016/j.cct.2021.106426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/15/2021] [Accepted: 04/28/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND In the U.S., over 40% of 18-25 year olds meet criteria for overweight or obesity. Yet, no large-scale trials have targeted this age group for behavioral weight loss (BWL). Formative data revealed that existing BWL programs do not meet their unique needs and identified motivation as a fundamental barrier for weight management. The goal of the Richmond Emerging Adults Choosing Health (REACH) trial was to test the efficacy of two mHealth lifestyle interventions specifically focused on enhancing motivation, relative to adapted standard. METHODS Participants (N = 381, 18-25 years, body mass index 25-45 kg/m2) will be randomized to 1) adapted BWL (aBWL), 2) aBWL + self-determination theory (aBWL+SDT), or 3) aBWL + behavioral economics (aBWL+BE). All arms will receive a 6-month intervention, delivered via one group session and one individual session, followed by an mHealth platform. Assessments will occur at baseline, 3-months, 6-months (post-treatment) and 12-months (following a no-contact period). The primary aim is to compare weight loss outcomes at 6 months. Secondary aims include changes at 6-months in physical and behavioral cardiometabolic risk factors, as well as psychosocial measures. We will also explore weight loss maintenance, change in hypothesized mediators, and moderators of treatment response. DISCUSSION REACH is the first large-scale BWL trial designed specifically for emerging adults. Further, it will be the first trial to compare a lifestyle intervention grounded in self-determination theory to one rooted in behavioral economics. If clinically significant reductions in adiposity are achieved, findings could inform a scalable treatment model to meet the needs of this vulnerable population. TRIAL REGISTRATION NCT02736981.
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15
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Impacts of lockdown on dietary patterns among youths in China: the COVID-19 Impact on Lifestyle Change Survey. Public Health Nutr 2021; 24:3221-3232. [PMID: 33993895 PMCID: PMC8144820 DOI: 10.1017/s1368980020005170] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective: To assess changes in dietary patterns among youths in China after COVID-19 lockdown. Design: This study was based on the COVID-19 Impact on Lifestyle Change Survey (COINLICS), a national retrospective survey established in early May 2020. The questionnaire was distributed through social media platforms. The sociodemographic information and routine dietary patterns before and after lockdown of participants were investigated. t tests and χ2 tests were used to compare the differences in consumption patterns of twelve major food groups and beverages between sex and across educational levels before and after lockdown. Factor analysis was employed to obtain the main dietary patterns. Settings: China. Participants: A total of 10 082 youths. Results: A significant decrease was observed in the average weekly frequency of rice intake, while significant increases were observed in the frequency of intake of wheat products, other staple foods, fish, eggs, fresh vegetables, preserved vegetables, fresh fruit and dairy products (all P values < 0·01). Heterogeneities of average weekly frequency existed between sex and across educational levels to different extents. The three main dietary patterns derived were loaded most heavily on dairy products, rice and wheat products, separately; the rice pattern became more dominant than the wheat products pattern after lockdown. The frequency of sugar-sweetened beverage consumption had decreased, while the frequency of other beverages had increased. Conclusions: Our timely survey would inform policymakers and health professionals of these significant changes in youths’ dietary patterns after lockdown, with heterogeneities observed to different extents between sex and across educational levels, for better policy-making and public health practice.
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16
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Recruiting and retaining young adults: what can we learn from behavioural interventions targeting nutrition, physical activity and/or obesity? A systematic review of the literature. Public Health Nutr 2021; 24:5686-5703. [PMID: 33722332 DOI: 10.1017/s1368980021001129] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To describe strategies used to recruit and retain young adults in nutrition, physical activity and/or obesity intervention studies, and quantify the success and efficiency of these strategies. DESIGN A systematic review was conducted. The search included six electronic databases to identify randomised controlled trials (RCT) published up to 6 December 2019 that evaluated nutrition, physical activity and/or obesity interventions in young adults (17-35 years). Recruitment was considered successful if the pre-determined sample size goal was met. Retention was considered acceptable if ≥80 % retained for ≤6-month follow-up or ≥70 % for >6-month follow-up. RESULTS From 21 582 manuscripts identified, 107 RCT were included. Universities were the most common recruitment setting used in eighty-four studies (79 %). Less than half (46 %) of the studies provided sufficient information to evaluate whether individual recruitment strategies met sample size goals, with 77 % successfully achieving recruitment targets. Reporting for retention was slightly better with 69 % of studies providing sufficient information to determine whether individual retention strategies achieved adequate retention rates. Of these, 65 % had adequate retention. CONCLUSIONS This review highlights poor reporting of recruitment and retention information across trials. Findings may not be applicable outside a university setting. Guidance on how to improve reporting practices to optimise recruitment and retention strategies within young adults could assist researchers in improving outcomes.
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Zhou J, Xie X, Guo B, Pei R, Pei X, Yang S, Jia P. Impact of COVID-19 Lockdown on Physical Activity Among the Chinese Youths: The COVID-19 Impact on Lifestyle Change Survey (COINLICS). Front Public Health 2021; 9:592795. [PMID: 33614578 PMCID: PMC7890242 DOI: 10.3389/fpubh.2021.592795] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 01/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The study sought to assess the changes in physical activity (PA) and sedentary time among Chinese youths at different stages after the COVID-19 outbreak. Methods: It was based on a retrospective online survey conducted in May 2020. More than 10,000 youths voluntarily recalled their PA-related information at three stages: before COVID-19 (January), during lockdown (February), and after lockdown (May). χ2 tests were conducted to evaluate the significance of the differences in participants' characteristics between sexes, and Wilcoxon Rank Sum tests were performed to examine the significance of differences in changes in PA and sedentary behavior levels between sexes. Results: A total of 8,115 participants were included, with a mean age of 20. The percentage of no PA per week increased significantly and then slightly fell, and that of ≥150 min/week substantially decreased and then rebounded partially (all p < 0.001) (for instance, the percentage of ≥150 min/week of PA total decreased from 38.6 to 19.4%, then rebounded back to 25.3%). Means hours per day spent in sedentary behaviors had significantly increased during lockdown comparing to pre-COVID-19 (all p < 0.001). There were more participants reported reduced PA level than those indicated increased, and more participating youths had their sedentary behavior level increased than those who had it decreased. Conclusions: The study found COVID-19 had both immediate and longer-term impacts on self-reported physical activities and sedentary behaviors among Chinese youths. Relevant efforts should be strengthened to get youths physically moving again.
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Affiliation(s)
- Junmin Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiaofen Xie
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Bing Guo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Rong Pei
- School of Health Caring Industry, Sichuan University of Arts and Science, Dazhou, China
| | - Xiaofang Pei
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
| | - Peng Jia
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China
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18
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Jia P, Liu L, Xie X, Yuan C, Chen H, Guo B, Zhou J, Yang S. Changes in dietary patterns among youths in China during COVID-19 epidemic: The COVID-19 impact on lifestyle change survey (COINLICS). Appetite 2020; 158:105015. [PMID: 33121998 DOI: 10.1016/j.appet.2020.105015] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/31/2020] [Accepted: 10/23/2020] [Indexed: 10/23/2022]
Abstract
Limited studies have focused on how COVID-19 outbreak and thereby lockdown have affected the youth's diet patterns. This study aimed to assess changes in diet patterns among youths in China under the COVID-19 lockdown, based on the COVID-19 Impact on Lifestyle Change Survey (COINLICS), a nationwide retrospective survey distributed via social media platforms during 9-12 May 2020 where 10,082 youth participants in China have voluntarily reported their basic sociodemographic information and routine diet patterns in the months before and after COVID-19 lockdown. We used paired t-tests or χ2 tests to evaluate the significance of differences in consumption patterns of 12 major food groups and beverages across educational levels, between sexes, and before and after COVID-19 lockdown. During the COVID-19 lockdown, significant decreases were observed in the frequency of intake of rice, meat, poultry, fresh vegetables, fresh fruit, soybean products, and dairy products, with significant sex differences (females consuming more rice, fresh vegetables and fruit and less meat, poultry, soybean and dairy products than males). Significant increases were observed in the frequency of consumption of wheat products, other staple foods, and preserved vegetables, with males consuming these foods more frequently than females. Graduate students consumed most foods more frequently except rice and other staple foods and preserved vegetables. The frequency of sugar-sweetened beverage consumption had decreased while frequency of tea drinking had increased. The participating youths' diet patterns had significantly changed during the COVID-19 lockdown, with heterogeneities observed to different extents between sexes and across educational levels. Our findings would inform policy-makers and health professionals of these changes in time for better policy making and public health practice.
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Affiliation(s)
- Peng Jia
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China; International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.
| | - Liang Liu
- College of Cybersecurity, Sichuan University, Chengdu, China
| | - Xiaofen Xie
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Changzheng Yuan
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China; The Children's Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Hui Chen
- The Children's Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, China; College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China
| | - Bing Guo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Junmin Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Shujuan Yang
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China; West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
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Correlations between Excessive Body Mass Index, Body Perception, Physical Activity, and Respiratory Functions among Youths in an Urban Setting of Vietnam. BIOMED RESEARCH INTERNATIONAL 2020; 2020:9627605. [PMID: 32908929 PMCID: PMC7463419 DOI: 10.1155/2020/9627605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/19/2020] [Accepted: 07/27/2020] [Indexed: 11/24/2022]
Abstract
Young adults are susceptible to overweight and obesity and their adverse outcomes. However, limited studies have been conducted to understand this health problem in Vietnamese youths. This study was conducted to examine the rate of overweight and obesity, as well as the relationship between this condition on body perception, physical activity, and respiratory function among young adults in Hanoi, Vietnam. We performed a cross-sectional survey with 367 students aged 18-25 years at the Hanoi University of Pharmacy from June 2017 to June 2018. The result showed that the rate of overweight and obesity in our sample was 16.6%. There were 55.7% of overweight/obese students having the misperception of their body image. Results of multivariate regression analysis showed that overweight/obesity increased nearly three times (OR = 2.8, 95% CI: 1.5-5.0) the ability to be active. Overweight/obese students with physical activity had a better respiratory function. To conclude, this study underlined the associations between overweight and obesity with physical activity, body image, and respiratory function in our young sample. Further longitudinal studies should be warranted to examine their causal relationships.
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Kim J, Kam HJ, Kim Y, Lee Y, Lee JH. Understanding Time Series Patterns of Weight and Meal History Reports in Mobile Weight Loss Intervention Programs: Data-Driven Analysis. J Med Internet Res 2020; 22:e17521. [PMID: 32780028 PMCID: PMC7448179 DOI: 10.2196/17521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/02/2020] [Accepted: 06/03/2020] [Indexed: 01/23/2023] Open
Abstract
Background Mobile apps for weight loss provide users with convenient features for recording lifestyle and health indicators; they have been widely used for weight loss recently. Previous studies in this field generally focused on the relationship between the cumulative nature of self-reported data and the results in weight loss at the end of the diet period. Therefore, we conducted an in-depth study to explore the relationships between adherence to self-reporting and weight loss outcomes during the weight reduction process. Objective We explored the relationship between adherence to self-reporting and weight loss outcomes during the time series weight reduction process with the following 3 research questions: “How does adherence to self-reporting of body weight and meal history change over time?”, “How do weight loss outcomes depend on weight changes over time?”, and “How does adherence to the weight loss intervention change over time by gender?” Methods We analyzed self-reported data collected weekly for 16 weeks (January 2017 to March 2018) from 684 Korean men and women who participated in a mobile weight loss intervention program provided by a mobile diet app called Noom. Analysis of variance (ANOVA) and chi-squared tests were employed to determine whether the baseline characteristics among the groups of weight loss results were different. Based on the ANOVA results and slope analysis of the trend indicating participant behavior along the time axis, we explored the relationship between adherence to self-reporting and weight loss results. Results Adherence to self-reporting levels decreased over time, as previous studies have found. BMI change patterns (ie, absolute BMI values and change in BMI values within a week) changed over time and were characterized in 3 time series periods. The relationships between the weight loss outcome and both meal history and self-reporting patterns were gender-dependent. There was no statistical association between adherence to self-reporting and weight loss outcomes in the male participants. Conclusions Although mobile technology has increased the convenience of self-reporting when dieting, it should be noted that technology itself is not the essence of weight loss. The in-depth understanding of the relationship between adherence to self-reporting and weight loss outcome found in this study may contribute to the development of better weight loss interventions in mobile environments.
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Affiliation(s)
- Junetae Kim
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Republic of Korea.,Cancer Data Center, National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea.,Healthcare AI Team, Healthcare Platform Center, National Cancer Center, Goyang-si, Republic of Korea
| | | | - Youngin Kim
- Noom Inc., New York, NY, United States.,Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yura Lee
- Department of Information Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae-Ho Lee
- Department of Information Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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21
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Kitunen A, Carins J, Rundle-Thiele S. Motivating Military Trainee Healthy Eating: Insight from Two Sites. Foods 2020; 9:foods9081053. [PMID: 32759775 PMCID: PMC7466327 DOI: 10.3390/foods9081053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 12/21/2022] Open
Abstract
This paper investigates eating behaviours and motivations of early career military trainees from two pathways (officer cadets and army recruits) to understand whether, and to what extent, healthful eating behaviours were present, and what motivates eating in general and healthful habits specifically. The study also sought to understand whether groups need strategies that are pathway specific or are transferrable across different trainee populations. Participants were recruited via email to complete an online survey and through in-person invitations to ensure a diverse cross section of trainees (n = 195) and recruits (n = 297). Two-step cluster analysis revealed three distinct segments with education, opportunity and motivation being the most important variables within a wider multivariate segment formation and stepwise linear regression was performed to identify the most optimal model with the least number of predictors for each segment. The ideal model for the uninterested segment contained nine predictors, seven predictors for the Breakfast skippers segment and eight predictors for the Weight conscious segment. This study found that there is room for improvement in the eating habits of military trainees across military training pathways. Eating motivations, and their associations with healthful eating habits, indicate a need for strategies that are broader than instilling or reinforcing health motivations. Strategies that can be implemented to support healthful eating for military trainees include provision of food preparation and cooking skills training, coupled with provision of social support and environments that facilitate healthful eating. Furthermore, three distinct segments were discovered within the trainee population, indicating that strategies for positively changing trainees’ eating behaviours may not need to be pathway specific, rather it may be possible to introduce the same group of segmented strategies across both pathways. Future research directions and limitations are outlined.
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Affiliation(s)
- Anna Kitunen
- Social Marketing @ Griffith, Department of Marketing, Griffith University, 170 Kessels Road, Nathan, QLD 4111, Australia; (J.C.); (S.R.-T.)
- Correspondence: ; Tel.: +61-737-357-673
| | - Julia Carins
- Social Marketing @ Griffith, Department of Marketing, Griffith University, 170 Kessels Road, Nathan, QLD 4111, Australia; (J.C.); (S.R.-T.)
- Food and Nutrition, Land Division, Defence Science and Technology, Scottsdale, TAS 7260, Australia
| | - Sharyn Rundle-Thiele
- Social Marketing @ Griffith, Department of Marketing, Griffith University, 170 Kessels Road, Nathan, QLD 4111, Australia; (J.C.); (S.R.-T.)
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22
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Lifestyle Changes and Weight Gain: A 2-Year Follow-up Study of Japanese Workers. J Occup Environ Med 2020; 62:e318-e327. [PMID: 32730035 DOI: 10.1097/jom.0000000000001888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To examine age-dependent trends in weight and lifestyle changes in Japanese workers. METHODS Using annual health examination data, 60,143 eligible Japanese workers aged 20 to 59 years were examined for their 2-year changes in weight and smoking, eating, exercise, drinking, and sleep habits. RESULTS Young male workers aged 20 to 24 years showed the greatest weight gain and the highest incidence of unhealthy lifestyle habits. Multivariate analyses indicated that quitting "exercise less than two times/week," "walking less than 60 min/d," and "smoking everyday" contributed to weight gain to a considerable extent except in young female workers aged 20 to 24 years. CONCLUSIONS Greater weight gain associated with unhealthy lifestyle changes tended to occur in early rather than middle-to-old adulthood. It is important to deliver health promotion programs targeting young male workers.
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23
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Sharkey T, Whatnall MC, Hutchesson MJ, Haslam RL, Bezzina A, Collins CE, Ashton LM. Effectiveness of gender-targeted versus gender-neutral interventions aimed at improving dietary intake, physical activity and/or overweight/obesity in young adults (aged 17-35 years): a systematic review and meta-analysis. Nutr J 2020; 19:78. [PMID: 32731865 PMCID: PMC7393713 DOI: 10.1186/s12937-020-00594-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 07/23/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Young adulthood has become synonymous with the development of poor lifestyle behaviours associated with an increased risk of preventable chronic disease in later years. Interventions aiming to improve health behaviours may be more engaging and effective if they are targeted to males or females than interventions with a gender-neutral approach. This review will examine the outcome effectiveness of gender-targeted and gender-neutral interventions targeting nutrition, physical activity or overweight/obesity in young adults (17-35 years). METHODS Six electronic databases were searched for randomised controlled trials (RCTs) published up to December 2019 that evaluated nutrition, physical activity and/or overweight/obesity interventions in young adults (17-35 years). An effective intervention was one where the change in one or more primary outcome was positive and statistically significantly different from baseline, compared with control, or if no control comparator, compared with another active intervention. Effectiveness of outcomes was compared between gender-targeted and gender-neutral studies. RESULTS In total 21,582 manuscripts were identified and 107 RCTs were included; 30 gender-targeted studies (28%) and 77 gender-neutral (72%). Most gender-targeted studies were female targeted (n = 22, 73%). Primary outcome/s were adiposity (n = 36, 34%), nutrition (n = 29, 27%), physical activity (n = 28, 26%), or a combination of (n = 14, 14%). A greater proportion of gender-targeted than gender-neutral studies were effective in improving nutrition (n = 6, 100% and n = 17, 74% of studies respectively) and physical activity outcomes (n = 6, 86% and n = 14, 67% respectively), where as a greater proportion of gender-neutral studies were effective in improving adiposity outcomes (n = 13, 59% and n = 5, 36% respectively). None of these differences were statistically significant. Meta-analyses for weight found no significant differences between gender-targeted and gender-neutral studies for weight loss or weight gain prevention studies. Meta-analysis for fruit and vegetable intake demonstrated a significantly greater increase in intervention participants in gender-targeted studies of +158 g/day for > 3 months. CONCLUSIONS Although differences in outcome effectiveness were identified between gender-targeted and gender-neutral studies, these were not significantly different. This is likely due to an insufficient number of studies to detect a difference. The meta-analysis for fruit and vegetable intake findings should be interpreted with caution due to including only two gender-targeted studies. The findings collectively are suggestive of a potential difference requiring further investigation. To truly determine the effectiveness of gender-targeted interventions, well-designed RCTs comparing gender-targeted interventions with gender-neutral and control are needed. REGISTRATION This systematic review is a secondary analysis of studies included in a systematic review examining the effectiveness of interventions targeting nutrition, physical activity, or overweight/obesity in young adults, for which a predefined protocol was registered with PROSPERO (CRD42017075795).
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Affiliation(s)
- Thomas Sharkey
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Australia
| | - Megan C. Whatnall
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Australia
| | - Melinda J. Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Australia
| | - Rebecca L. Haslam
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Australia
| | - Aaron Bezzina
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Australia
| | - Clare E. Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Australia
| | - Lee M. Ashton
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Australia
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24
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LaRose JG, Gorin AA, Fava JL, Bean MK, Lanoye A, Robinson E, Carey K. Using motivational interviewing to enhance emerging adults' engagement in weight loss: The Live Well RVA pilot randomized clinical trial. Obes Sci Pract 2020; 6:460-472. [PMID: 33082988 PMCID: PMC7556426 DOI: 10.1002/osp4.435] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/07/2020] [Accepted: 05/10/2020] [Indexed: 11/15/2022] Open
Abstract
Background Emerging adults (ages 18–25) are at high risk for overweight/obesity, yet traditional adult behavioural weight loss (BWL) interventions do not meet the needs of individuals at this developmental stage. Motivational interviewing (MI) is an evidence‐based approach to promote behaviour change but has not been tested for weight loss in this population. The study aimed to test the feasibility and preliminary efficacy of an MI‐enhanced weight loss programme to promote engagement, retention and weight loss in emerging adults. Methods Emerging adults with overweight/obesity (N = 47, 81% female, 47% racial/ethnic minority, body mass index [BMI] = 33.2 ± 4.6 kg/m2) were randomized to either standard BWL or MI‐enhanced BWL (MIBWL). Weight was assessed objectively at baseline and posttreatment (3 months). Engagement (in‐person session attendance [weeks 1 and 2], online self‐monitoring [weeks 3–12] and online content viewing [weeks 3–12]) was tracked throughout the program. Results Though results did not reach the level of statistical significance, participants in MIBWL demonstrated greater programme engagement (77% vs. 61.0%, p = .11; Cohen d = .48), retention (71% vs. 48.0%, p = .10; Cohen h = .47) and intent‐to‐treat weight loss (−3.3% vs. −2.2%, p = .37; Cohen d = .26) compared with those in BWL. Conclusions Effect sizes suggest that MI might be a viable approach to enhance engagement and retention in weight loss programmes targeting emerging adults. This finding is meaningful, given the documented challenges with engagement and retention in this vulnerable population and the relationship between engagement and better weight loss outcomes. The results of this small pilot study support efforts to replicate these findings within the context of a fully powered trial.
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Affiliation(s)
- Jessica Gokee LaRose
- Department of Health Behavior and Policy Virginia Commonwealth University School of Medicine Richmond Virginia USA
| | - Amy A Gorin
- Department of Psychological Sciences University of Connecticut Mansfield Connecticut USA.,Institute for Collaboration on Health, Intervention, and Policy University of Connecticut Mansfield Connecticut USA
| | - Joseph L Fava
- Weight Control and Diabetes Research Center The Miriam Hospital Providence Rhode Island USA
| | - Melanie K Bean
- Department of Pediatrics Children's Hospital of Richmond at Virginia Commonwealth University Richmond Virginia USA
| | - Autumn Lanoye
- Department of Health Behavior and Policy Virginia Commonwealth University School of Medicine Richmond Virginia USA
| | - Elizabeth Robinson
- Department of Pediatrics Children's Hospital of Richmond at Virginia Commonwealth University Richmond Virginia USA.,Summit Emotional Health Richmond Virginia USA
| | - Kate Carey
- Department of Behavioral and Social Sciences Brown University School of Public Health Providence Rhode Island USA
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25
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Ashton LM, Sharkey T, Whatnall MC, Haslam RL, Bezzina A, Aguiar EJ, Collins CE, Hutchesson MJ. Which behaviour change techniques within interventions to prevent weight gain and/or initiate weight loss improve adiposity outcomes in young adults? A systematic review and meta-analysis of randomized controlled trials. Obes Rev 2020; 21:e13009. [PMID: 32064761 DOI: 10.1111/obr.13009] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/30/2020] [Accepted: 01/30/2020] [Indexed: 12/17/2022]
Abstract
Young adulthood is associated with the highest rate of weight gain compared with any other adult age group. This review evaluates the effectiveness of interventions with adiposity outcomes among young adults and identifies which behaviour change techniques (BCTs) are most effective. BCT utilization was assessed using Michie's 93-item BCT Taxonomy v1. Six electronic databases were searched for randomized controlled trials assessing change in adiposity in young adults (17-35 years) until December 2019; identifying 21,582 articles. Fifty-one studies were included. Meta-analyses for weight (n=19 studies), body mass index (BMI) (n=20 studies), and waist circumference (n=10 studies) demonstrated no significant between-group differences at ≤3 or >3 months. There were no differences between interventions focusing on weight loss or weight-gain prevention. Narrative synthesis showed significant between-group differences in weight change, favouring the intervention in 14/43 (33%) studies. In studies assessing BMI and waist circumference, this was 31% (11/36) and 25% (4/16). Two BCTs had a percentage effectiveness ratio >50% in weight loss interventions; social support (unspecified) and self-monitoring behaviour, and one in weight-gain prevention interventions; and goal-setting (outcome). Findings demonstrate initial potential for these types of BCTs and can help build cumulative evidence towards delivering effective, cost-efficient, and replicable interventions.
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Affiliation(s)
- Lee M Ashton
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Thomas Sharkey
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Megan C Whatnall
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Rebecca L Haslam
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Aaron Bezzina
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Elroy J Aguiar
- Department of Kinesiology, College of Education, University of Alabama, Tuscaloosa, Alabama
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Melinda J Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
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26
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Wilson RE, Marshall RD, Murakami JM, Latner JD. Brief non-dieting intervention increases intuitive eating and reduces dieting intention, body image dissatisfaction, and anti-fat attitudes: A randomized controlled trial. Appetite 2020; 148:104556. [PMID: 31901439 DOI: 10.1016/j.appet.2019.104556] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 11/20/2019] [Accepted: 12/09/2019] [Indexed: 10/25/2022]
Abstract
This study developed and examined a brief dissonance-based non-dieting intervention designed to help college women reject unhealthy dieting behaviors, accept their bodies, and increase healthy eating. Participants included 94 female university students (mean age = 20.6 years; mean BMI = 23.8 kg/m2), randomly assigned either to the non-dieting intervention condition or a brochure control condition. The intervention consisted of two 90-120 min interactive group sessions designed to engender the rejection of dieting, increase body acceptance, and develop healthy eating skills. Assessment measures were collected at baseline, post-treatment, and one-month follow-up. The group sessions produced significant improvements in the intervention group compared to the control group on measures of dieting intention, intuitive eating, body image dissatisfaction, eating concerns, and anti-fat attitudes. These effects were sustained at one-month follow-up. There were also overall improvements over time in dietary intake and mental health-related quality of life across conditions. This study extends the research on non-dieting approaches by using a brief, dissonance-based structure and by applying the intervention to a young adult sample that included participants of normal weight. The findings here indicate that a non-dieting approach is acceptable and feasible, and can result in improvements in eating and weight-related behaviors, in young adult women.
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Affiliation(s)
- Rebecca E Wilson
- Department of Preventive Medicine, Rush University, 1700 W. Van Buren St., Suite 470, Chicago, IL, 60612, USA
| | - Rachel D Marshall
- Department of Psychology, University of Hawai'i at Mānoa, 2500 Campus Road, Honolulu, HI, 96822, USA.
| | - Jessica M Murakami
- VA Pacific Islands Healthcare System, 459 Patterson Road, Honolulu, HI, 96819, USA
| | - Janet D Latner
- Department of Psychology, University of Hawai'i at Mānoa, 2500 Campus Road, Honolulu, HI, 96822, USA
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27
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Abstract
BACKGROUND AND PURPOSE Rates of overweight and obesity in emerging adults are rapidly increasing and associated with many chronic illnesses, quality of life concerns, and increased health care spending. Effective weight management interventions are needed for this population. The purpose of this study was to examine effects of a text-messaging weight loss intervention on motivation, stage of change for weight loss, and BMI. METHODS Overweight and obese emerging adults were enrolled (n = 188) and randomized to control or intervention groups. Weight loss information was delivered via a website to both groups. The intervention group also received daily weight loss-related text messages. Motivation, stage of change, and BMI were assessed online, via self-report at baseline, 4, and 8 weeks. CONCLUSIONS Ninety-five participants were included in the final data analysis. There was a significant increase in motivation and stage of change and decrease in BMI over the study duration, with no significant differences between groups. IMPLICATIONS FOR PRACTICE Nurse practitioners are well positioned to provide innovative weight loss interventions in a variety of settings. These results provide important insights for the design of effective weight loss treatment for emerging adults and support the use of web-based and text message-based interventions.
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28
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Berg C, Larsson C. Dieting, body weight concerns and health: trends and associations in Swedish schoolchildren. BMC Public Health 2020; 20:187. [PMID: 32024489 PMCID: PMC7003420 DOI: 10.1186/s12889-020-8295-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/28/2020] [Indexed: 11/26/2022] Open
Abstract
Background Dieting is a risk factor of both eating disorders and obesity. The aim was to examine time trends of dieting in Swedish adolescents, and explore how dieting and body weight dissatisfaction are related to self-reported health, wellbeing and health behaviours. Methods Analyses of cross-sectional Swedish data from HBSC (Health Behaviour in School-aged Children) surveys 1994–2014. In total, about 30,000 girls and boys in the age of 11, 13 and 15 years participated. Data was collected by using classroom administered questionnaires in 5th, 7th and 9th grade. Logistic regressions was used to analyse secular trends of dieting, and how dieting and body dissatisfaction were associated with self-reported overall health, health behaviours, BMI and various physical, psychological and social aspects of health in 2014. Results Dieting increased from 1994 to 2014 in both girls and boys in all age groups, and in 2014, the prevalence was 14% in girls and 8% in boys. The prevalence of body satisfaction was 65% respectively 69%. Body weight dissatisfaction and dieting were present in all body weight classes and were associated with self-reported poor health and many other negative health aspects. In comparison with the participants that were satisfied with their body weight the odds ratio (95% CI) for self-reported poor health was 3.4 (2.6–4.4) in dieters, 4.9 (3.8–6.4) in participants who perceived a need to lose weight and 2.1 (1.5–2.8) in those who perceived a need to gain weight, when adjusting for age, sex and body weight class. Conclusions When promoting health among school age children body weight dissatisfaction and dieting ought to be considered. Furthermore, it is important to support girls and boys in all weight classes to reach and maintain a healthy body image and weight.
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Affiliation(s)
- Christina Berg
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Box 300, 405 30, Göteborg, Sweden.
| | - Christel Larsson
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Box 300, 405 30, Göteborg, Sweden
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29
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Warschburger P, Zitzmann J. Does an Age-Specific Treatment Program Augment the Efficacy of a Cognitive-Behavioral Weight Loss Program in Adolescence and Young Adulthood? Results from a Controlled Study. Nutrients 2019; 11:nu11092053. [PMID: 31480678 PMCID: PMC6769959 DOI: 10.3390/nu11092053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/22/2019] [Accepted: 08/23/2019] [Indexed: 12/27/2022] Open
Abstract
Research on weight-loss interventions in emerging adulthood is warranted. Therefore, a cognitive-behavioral group treatment (CBT), including development-specific topics for adolescents and young adults with obesity (YOUTH), was developed. In a controlled study, we compared the efficacy of this age-specific CBT group intervention to an age-unspecific CBT group delivered across ages in an inpatient setting. The primary outcome was body mass index standard deviation score (BMI-SDS) over the course of one year; secondary outcomes were health-related and disease-specific quality of life (QoL). 266 participants aged 16 to 21 years (65% females) were randomized. Intention-to-treat (ITT) and per-protocol analyses (PPA) were performed. For both group interventions, we observed significant and clinically relevant improvements in BMI-SDS and QoL over the course of time with small to large effect sizes. Contrary to our hypothesis, the age-specific intervention was not superior to the age-unspecific CBT-approach.
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Affiliation(s)
- Petra Warschburger
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany.
| | - Jana Zitzmann
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
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30
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Time attitudes and mental well-being, psychological, and somatic symptomatology in final year high school students. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-019-00386-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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31
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Willmott T, Pang B, Rundle-Thiele S, Badejo A. Reported theory use in electronic health weight management interventions targeting young adults: a systematic review. Health Psychol Rev 2019; 13:295-317. [PMID: 31161877 DOI: 10.1080/17437199.2019.1625280] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This review assesses the extent of reported theory use in electronic health weight management interventions targeting young adults aged 18-35 years. Twenty-four eligible studies were identified. Two independent reviewers extracted data and coded for theory use using the Theory Coding Scheme. Overall, the mean total use of theory score was 6/23 (SD = 5; Min. = 0, Max. = 17); 17 studies were classified as having weak application of theory, five as moderate, and two as strong. The majority (N = 18) of studies mentioned theory, however, most (N = 14) did not report how intervention techniques related to theoretical base. No study used theory to select intervention recipients and only four used theory to tailor intervention techniques to recipients. Limited studies reported theory testing (N = 6) and no study used intervention results to build and/or refine theory. Results indicate that weight-related outcomes may be enhanced when at least one or more theoretical constructs are explicitly linked to an intervention technique and when theoretical constructs are included in evaluations. Increases in theory application and reporting are needed to assist the scientific research community in systematically identifying which theories work, for whom, how, why, and when; thereby delivering an advanced understanding of how best to apply theory to enhance intervention outcomes.
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Affiliation(s)
- Taylor Willmott
- a Social Marketing @ Griffith, Griffith Business School, Griffith University , Queensland , Australia
| | - Bo Pang
- a Social Marketing @ Griffith, Griffith Business School, Griffith University , Queensland , Australia
| | - Sharyn Rundle-Thiele
- a Social Marketing @ Griffith, Griffith Business School, Griffith University , Queensland , Australia
| | - Abi Badejo
- a Social Marketing @ Griffith, Griffith Business School, Griffith University , Queensland , Australia
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32
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Ashton LM, Sharkey T, Whatnall MC, Williams RL, Bezzina A, Aguiar EJ, Collins CE, Hutchesson MJ. Effectiveness of Interventions and Behaviour Change Techniques for Improving Dietary Intake in Young Adults: A Systematic Review and Meta-Analysis of RCTs. Nutrients 2019; 11:nu11040825. [PMID: 30979065 PMCID: PMC6520715 DOI: 10.3390/nu11040825] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 04/04/2019] [Accepted: 04/09/2019] [Indexed: 12/17/2022] Open
Abstract
Poor eating habits are common during young adulthood and influence chronic disease morbidity. This systematic review evaluates the effectiveness of interventions aiming to improve dietary intake among young adults and, identifies which behaviour change techniques (BCTs) are most effective. Six electronic databases were searched for RCTs published until October 2018, and evaluating behavioural interventions assessing change in dietary intake in young adults (17–35 years). Of the 18,779 articles identified, 54 were included. Forty studies focused on fruit and/or vegetable intake, of which 63% showed a significant between-group difference in favour of the intervention group. Meta-analysis (n = 17) demonstrated a significant increase in fruit and vegetable intake of +68.6 g/day after three months of intervention and +65.8 g/day for interventions >3 months when compared to control. A meta-analysis (n = 5) on total energy intake found no significant differences between groups. The BCTs with the highest effectiveness ratio were habit formation (100%), salience of consequences (83%) and adding objects to the environment (70%). The review highlights the potential of behavioural interventions to improve young adults’ fruit and vegetable intake but was less convincing for other dietary outcomes. Due to the lack of studies including each BCT, the BCTs imperative to success could not be identified.
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Affiliation(s)
- Lee M Ashton
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Thomas Sharkey
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Megan C Whatnall
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Rebecca L Williams
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Aaron Bezzina
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Elroy J Aguiar
- Department of Kinesiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, MA 01003, USA.
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Melinda J Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
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Luque V, Feliu A, Escribano J, Ferré N, Flores G, Monné R, Gutiérrez-Marín D, Guillen N, Muñoz-Hernando J, Zaragoza-Jordana M, Gispert-Llauradó M, Rubio-Torrents C, Núñez-Roig M, Alcázar M, Ferré R, Basora JM, Hsu P, Alegret-Basora C, Arasa F, Venables M, Singh P, Closa-Monasterolo R. The Obemat2.0 Study: A Clinical Trial of a Motivational Intervention for Childhood Obesity Treatment. Nutrients 2019; 11:E419. [PMID: 30781525 PMCID: PMC6413236 DOI: 10.3390/nu11020419] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 02/11/2019] [Accepted: 02/12/2019] [Indexed: 02/07/2023] Open
Abstract
The primary aim of the Obemat2.0 trial was to evaluate the efficacy of a multicomponent motivational program for the treatment of childhood obesity, coordinated between primary care and hospital specialized services, compared to the usual intervention performed in primary care. This was a cluster randomized clinical trial conducted in Spain, with two intervention arms: motivational intervention group vs. usual care group (as control), including 167 participants in each. The motivational intervention consisted of motivational interviewing, educational materials, use of an eHealth physical activity monitor and three group-based sessions. The primary outcome was body mass index (BMI) z score increments before and after the 12 (+3) months of intervention. Secondary outcomes (pre-post intervention) were: adherence to treatment, waist circumference (cm), fat mass index (z score), fat free mass index (z score), total body water (kg), bone mineral density (z score), blood lipids profile, glucose metabolism, and psychosocial problems. Other assessments (pre and post-intervention) were: sociodemographic information, physical activity, sedentary activity, neuropsychological testing, perception of body image, quality of the diet, food frequency consumption and foods available at home. The results of this clinical trial could open a window of opportunity to support professionals at the primary care to treat childhood obesity. The clinicaltrials.gov identifier was NCT02889406.
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Affiliation(s)
- Veronica Luque
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, IISPV, 43201 Reus, Spain.
- Hospital Universitari de Tarragona Joan XXIII, 43007 Tarragona, Spain.
| | - Albert Feliu
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, IISPV, 43201 Reus, Spain.
- Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain.
| | - Joaquín Escribano
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, IISPV, 43201 Reus, Spain.
- Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain.
| | - Natalia Ferré
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, IISPV, 43201 Reus, Spain.
| | - Gemma Flores
- Unitat de Suport a la Recerca Tarragona-Reus, IDIAPJGol, 43204 Reus, Spain.
| | - Raquel Monné
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, IISPV, 43201 Reus, Spain.
- Unitat de Suport a la Recerca Tarragona-Reus, IDIAPJGol, 43204 Reus, Spain.
| | - Desirée Gutiérrez-Marín
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, IISPV, 43201 Reus, Spain.
| | - Núria Guillen
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, IISPV, 43201 Reus, Spain.
- Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain.
| | - Judit Muñoz-Hernando
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, IISPV, 43201 Reus, Spain.
| | - Marta Zaragoza-Jordana
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, IISPV, 43201 Reus, Spain.
| | - Mariona Gispert-Llauradó
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, IISPV, 43201 Reus, Spain.
| | - Carme Rubio-Torrents
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, IISPV, 43201 Reus, Spain.
| | - Mercè Núñez-Roig
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, IISPV, 43201 Reus, Spain.
| | - Mireia Alcázar
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, IISPV, 43201 Reus, Spain.
| | - Raimon Ferré
- Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain.
| | - Josep M Basora
- Unitat de Suport a la Recerca Tarragona-Reus, IDIAPJGol, 43204 Reus, Spain.
| | - Pablo Hsu
- Unitat de Suport a la Recerca Tarragona-Reus, IDIAPJGol, 43204 Reus, Spain.
| | - Clara Alegret-Basora
- Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain.
- Unitat de Suport a la Recerca Tarragona-Reus, IDIAPJGol, 43204 Reus, Spain.
| | - Francesc Arasa
- Hospital Verge de la Cinta, 43500 Tortosa, Tarragona, Spain.
| | | | - Priya Singh
- MRC Elsie Widdowson laboratory, Cambridge CB1 9NL, UK.
| | - Ricardo Closa-Monasterolo
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, IISPV, 43201 Reus, Spain.
- Hospital Universitari de Tarragona Joan XXIII, 43007 Tarragona, Spain.
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Willmott TJ, Pang B, Rundle-Thiele S, Badejo A. Weight Management in Young Adults: Systematic Review of Electronic Health Intervention Components and Outcomes. J Med Internet Res 2019; 21:e10265. [PMID: 30724736 PMCID: PMC6381405 DOI: 10.2196/10265] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 11/23/2018] [Accepted: 12/10/2018] [Indexed: 01/11/2023] Open
Abstract
Background Young adulthood is a vulnerable period for unhealthy lifestyle adoption and excess weight gain. Scant attention has been focused on developing and evaluating effective weight gain prevention strategies for this age group. Electronic health (eHealth) offers potential as a cost-effective means of delivering convenient, individually-tailored, and contextually-meaningful interventions at scale. Objective The primary aim of this systematic review was to locate and synthesize the evidence on eHealth weight management interventions targeting young adults, with a particular focus on (eHealth) intervention components and outcomes. Methods A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search strategy was executed across the following electronic databases: Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, EBSCO, EMBASE, Emerald, Education Resources Information Center, Medical Literature Analysis and Retrieval System Online, Ovid, ProQuest, PsycINFO, PubMed, Science Direct, Scopus, and Web of Science. Furthermore, 2 reviewers independently assessed records for eligibility: peer-reviewed, published in English, and report evaluations of eHealth weight management interventions targeting healthy young adults (aged 18-35 years). Data were then extracted from studies that met the criteria for inclusion. The methodological quality of studies was independently assessed by 2 reviewers using the Effective Public Health Practice Project’s (EPHPP) quality assessment tool. A comprehensive narrative evidence synthesis was then completed. Results Out of the 1301 studies assessed for eligibility, 24 met the criteria for inclusion. According to the EPHPP quality assessment tool, overall, 19 studies were as rated weak, 5 as moderate, and none as strong. The narrative synthesis of intervention outcomes found 8 studies reported positive weight-related outcomes, 4 reported mixed outcomes, and 12 did not report any significant changes in weight-related outcomes. The narrative synthesis of (eHealth) intervention components led to 3 levels of classification. A total of 14 studies were classified as Web-based, 3 as mobile-based, and 7 as multicomponent interventions. Following the narrative synthesis, 5 key strategies were thematically identified: self-regulation (goal setting and self-monitoring), tailored or personalized feedback, contact with an interventionist, social support, and behavioral prompts (nudges and reminders) and booster messages. Conclusions Findings highlight the limited evidence base for eHealth weight management interventions targeting young adults. The complex nature of weight management presents an ongoing challenge for interventionists to identify what works, for whom, how, and when. The quality of the evidence in this review was generally assessed as weak; however, assessment tools such as the EPHPP are principally concerned with what should be and this is seldom equivalent to what works. Thus, while sampling, study design and retention rates will remain key determining factors of reliability and validity, further research attention directed toward the development of guiding tools for community trials is warranted.
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Affiliation(s)
- Taylor Jade Willmott
- Social Marketing @ Griffith, Griffith Business School, Griffith University, Nathan, Australia
| | - Bo Pang
- Social Marketing @ Griffith, Griffith Business School, Griffith University, Nathan, Australia
| | - Sharyn Rundle-Thiele
- Social Marketing @ Griffith, Griffith Business School, Griffith University, Nathan, Australia
| | - Abi Badejo
- Social Marketing @ Griffith, Griffith Business School, Griffith University, Nathan, Australia
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Lanoye A, Grenga A, Leahey TM, LaRose JG. Motivation for weight loss and association with outcomes in a lifestyle intervention: comparing emerging adults to middle aged adults. Obes Sci Pract 2019; 5:15-20. [PMID: 30847223 PMCID: PMC6381300 DOI: 10.1002/osp4.313] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/22/2018] [Accepted: 10/23/2018] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Emerging adults (EAs) ages 18-25 are at high risk for overweight/obesity, but little is known about their motivations for weight loss or how these may differ from those of middle aged adults (MAs) and relate to treatment outcomes. PURPOSE The purpose of this study was to examine potential differences in weight loss motivations between EAs and MAs and determine the association between motivation and engagement/outcomes in a weight loss trial. METHODS Data were pooled from two behavioural weight loss interventions: one targeting EAs (n = 52) and one targeting MAs ages 40-60 (n = 101). Motivation, attendance, dietary self-monitoring and weight change were measured in both trials across 3 months of treatment. RESULTS Emerging adults were less motivated by health concerns than MAs (p < .05). Motivation to lose weight in order to improve appearance was of similar importance for both MAs and EAs but demonstrated differential associations with treatment variables. Appearance-related motivation was associated with higher program engagement for MA but was associated with poorer weight loss for EAs. Overall engagement, weight loss and retention were worse for EAs than MAs (ps < .05). CONCLUSIONS Specific motivations for weight loss were associated with treatment outcomes, but effects varied by developmental stage. Findings of this study highlight the potential differences between motivation to initiate weight loss efforts and motivation to successfully change weight-related behaviours. Future research should explore methods for intervening directly on motivation within the context of weight control interventions among EAs.
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Affiliation(s)
- A. Lanoye
- Department of Health Behavior and PolicyVirginia Commonwealth University School of MedicineRichmondVirginiaUSA
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - A. Grenga
- Weight Control and Diabetes Research Center at the Miriam HospitalProvidenceRhode IslandUSA
| | - T. M. Leahey
- Department of Allied Health SciencesUniversity of ConnecticutStorrsConnecticutUSA
| | - J. G. LaRose
- Department of Health Behavior and PolicyVirginia Commonwealth University School of MedicineRichmondVirginiaUSA
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Crino ND, Parker HM, Gifford JA, Lau KYK, Greenfield EM, Donges CE, O'Dwyer NJ, Steinbeck KS, O'Connor HT. Recruiting young women to weight management programs: Barriers and enablers. Nutr Diet 2018; 76:392-398. [PMID: 30575276 DOI: 10.1111/1747-0080.12505] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 10/25/2018] [Accepted: 11/12/2018] [Indexed: 12/17/2022]
Abstract
AIM Recruiting young women to weight management research programs is difficult. The purpose of this study was to gain insights into the barriers and motivators that influence participation and to explore effective methods of recruitment from the perspective of young women with obesity living in both urban and regional areas. METHODS Semi-structured interviews were used to elicit information from focus groups. The interviews were transcribed, coded and analysed qualitatively. Eight focus groups, which included a total of 27 women, were conducted. Participants had a mean age of 29.1 (±5.1) years and a mean body mass index of 35.8 (±2.9) kg/m2 . RESULTS The barriers to participation were multifaceted and largely similar across urban and regional participants. Fear of judgement and uncertainty about the process were major psychosocial barriers. A lack of tailoring of program content was an important program-related barrier. Physical barriers such as time commitment, cost and access were discussed extensively, particularly in urban groups. The provision of incentives and the use of positive language that focusses on the benefits of the intervention were viewed positively. Physical and virtual methods of recruitment were identified as potentially effective provided they were presented in media that this group is likely to use and can access in a private location. CONCLUSIONS The results of this study provide a greater understanding of the challenges faced by young women in relation to participation in weight management programs and some of the potential methods that could be utilised to facilitate participation.
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Affiliation(s)
- Natalie D Crino
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia
| | - Helen M Parker
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia.,Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia
| | - Janelle A Gifford
- Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia
| | - K Y Karen Lau
- Faculty of Science, University of Sydney, Camperdown, New South Wales, Australia
| | | | - Cheyne E Donges
- School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Nicholas J O'Dwyer
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia.,Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia.,School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Katharine S Steinbeck
- The Children's Hospital at Westmead Clinical School, University of Sydney, New South Wales, Australia
| | - Helen T O'Connor
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia.,Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia
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Gorin AA, Gokee LaRose J, Espeland MA, Tate DF, Jelalian E, Robichaud E, Coward P, Hatley KE, Garcia KR, Lang W, Bahnson J, Lewis CE, Wing RR. Eating pathology and psychological outcomes in young adults in self-regulation interventions using daily self-weighing. Health Psychol 2018; 38:143-150. [PMID: 30550313 DOI: 10.1037/hea0000689] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Self-regulation interventions encouraging daily weighing prevent weight gain in young adults; however, concerns have been raised that such interventions may have undesirable effects on eating pathology, depression, and health-related quality of life (HRQL). The present study examined whether self-regulation interventions and self-weighing frequency were associated with these indices in normal weight individuals and those with overweight or obesity. METHODS Young adults (n = 599), 18-35 years with a body mass index (BMI) 21.0-30.9 kg/m² were randomized to control, self-regulation with small changes (SC) or self-regulation with large changes (LC). Interventions taught frequent self-weighing to guide behavioral changes. SC prescribed daily small decreases in intake and increases in physical activity. LC prescribed a 5- to 10-lb weight loss to buffer against anticipated gains. Psychological indices were assessed at baseline and periodically over 2 years of follow-up. RESULTS There was no evidence that the interventions increased depressive symptoms or compensatory behaviors or decreased HRQL relative to control. LC increased flexible and rigid control and SC decreased disinhibition. Results did not differ by weight status with the exception of rigid control; here, differences between LC and the other conditions were smaller among those with BMI ≥ 25. Greater self-weighing frequency over time was associated with increases in flexible and rigid control, dietary restraint, and improvements in HRQL. CONCLUSIONS The self-regulation interventions and increases in self-weighing had no untoward effects. Encouraging weight gain prevention in young adults through frequent weighing and self-regulation appears to be safe for normal weight young adults and those with overweight. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Amy A Gorin
- Institute for Collaboration on Health, Intervention, and Policy
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Houle-Johnson SA, Kakinami L. Do sex differences in reported weight loss intentions and behaviours persist across demographic characteristics and weight status in youth? A systematic review. BMC Public Health 2018; 18:1343. [PMID: 30514246 PMCID: PMC6280345 DOI: 10.1186/s12889-018-6179-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 11/02/2018] [Indexed: 12/18/2022] Open
Abstract
Background Evidence suggests that young females are more likely to try to lose weight than young males, however whether this sex difference persists across demographic characteristics and weight status is unclear. Further, whether females are more likely than males to try to lose weight using unhealthy weight loss strategies has never been systematically assessed. The objective of this systematic review was to examine the literature on sex differences in weight loss intentions and strategies in children and adolescent observational studies to determine whether sex differences persisted across demographic characteristics (race/ethnicity, grade level) and weight status. Methods Relevant articles published after 1990 were identified using PubMED, Web of Science, and PsycInfo. Searches were conducted in May of 2015 and again in May of 2017. Studies conducted in the US and Canada with participants 18-years old or younger who measured weight loss strategies in the context of weight loss intention were selected. Descriptive statistics were extracted from 19 studies. Results Almost two-thirds of youth reported trying to lose weight. High-school and middle-school aged females reported consistently higher prevalence of weight loss intentions compared to male counterparts, as did Caucasian, African-American, and Hispanic females. The proportion of youth using unhealthy or extreme strategies reached 44 and 13%, respectively, with a similar proportion of males and females endorsing the use of each category of weight loss strategies across studies. Native-American youth reported the highest prevalence (27%) of using extreme strategies. Conclusions Researchers should consider demographic characteristics when reporting prevalence information for weight loss intentions and behaviours, as certain groups might require more targeted public health initiatives. Across characteristics, prevalence ranges were broad for weight loss intentions and use of particular strategies, suggesting the need to standardize and refine data collection and reporting practices in this literature. Electronic supplementary material The online version of this article (10.1186/s12889-018-6179-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stephanie A Houle-Johnson
- Department of Psychology, Concordia University, Montreal, Quebec, Canada.,School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier Private, VNR3088, Ottawa, ON, K1N 9A8, Canada
| | - Lisa Kakinami
- Department of Mathematics and Statistics, Concordia University, 1455 De Maisonneuve Blvd. W., Room S-LB 927, Montreal, QC, H3G 1M8, Canada. .,PERFORM Centre, Concordia University, Montreal, Quebec, Canada.
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Dreber H, Thorell A, Reynisdottir S, Hemmingsson E. Health-Related Quality of Life 5 Years After Roux-en-Y Gastric Bypass in Young (18–25 Years) Versus Older (≥ 26 Years) Adults: a Scandinavian Obesity Surgery Registry Study. Obes Surg 2018; 29:434-443. [DOI: 10.1007/s11695-018-3559-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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40
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Weight loss, adverse events, and loss to follow-up after gastric bypass in young versus older adults: A Scandinavian Obesity Surgery Registry study. Surg Obes Relat Dis 2018; 14:1319-1326. [PMID: 30056048 DOI: 10.1016/j.soard.2018.06.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/16/2018] [Accepted: 06/05/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Young adults display particularly poor weight loss in behavioral obesity treatment; nonetheless, they have seldom been included in bariatric research. OBJECTIVES To compare weight loss, adverse events, and loss to follow-up in young (18-25 yr) versus older (≥26 yr) adults up to 5 years after Roux-en-Y gastric bypass. SETTING Nationwide, register-based study, Sweden. METHODS Prospective registry data (Scandinavian Obesity Surgery Register) were analyzed in young (22.2 yr [standard deviation (SD): 2.1], 81.6% women, mean body mass index 43.7 kg/m2 [SD: 5.4]) and older (42.6 years [SD: 9.6], 82.0% women, mean body mass index 43.4 kg/m2 [SD: 5.0]) adults undergoing Roux-en-Y gastric bypass. Groups were matched for body mass index, sex, and year of surgery. Regression analyses and mixed models were used to compare outcomes between groups. RESULTS A total of 369 young (37.0% of eligible) and 2210 older (46.1%) adults attended the 5-year follow-up. At this time, weight loss was 31.8% in young and 28.2% in older adults (P < .001), with a serious adverse event (Clavien-Dindo ≥3b) being reported in 52 (14.1%) young and 153 (6.9%) older adults (odds ratio = 2.06, 95% confidence interval: 1.45-2.92, P < .001). Loss to follow-up was higher in young versus older adults throughout the study period (range of relative risk = 1.16-1.89, P < .001). CONCLUSIONS While young adults displayed at least equal weight loss as older adults, rates of adverse events were approximately doubled, and loss to follow-up rates were higher. Future studies on the significance of and the etiology behind the higher incidence of serious adverse events are needed. Intensified clinical contact post Roux-en-Y gastric bypass should have the potential to further improve outcomes in young adults.
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Khan S, Barrington G, Bettiol S, Barnett T, Crocombe L. Is overweight/obesity a risk factor for periodontitis in young adults and adolescents?: a systematic review. Obes Rev 2018; 19:852-883. [PMID: 29349893 DOI: 10.1111/obr.12668] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 11/29/2017] [Accepted: 12/07/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Obesity in young adults and adolescents is associated with chronic co-morbidities. This project investigated whether being overweight or obese is a risk factor for periodontitis in adolescents (13-17 years) and young adults (18-34 years). METHODS A search of 12 databases was conducted using Medical Subject Headings/Index and Emtree terms. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, articles published between 2003 and 2016 were screened that reported periodontal and anthropometric measures. The Newcastle-Ottawa Scale was used to appraise the quality of studies. RESULTS Of 25 eligible studies from 12 countries, 17 showed an association between obesity and periodontitis (odds ratios ranged from 1.1 to 4.5). The obesity indicators of body mass index, waist circumference, waist-hip ratio and body fat percentage were significantly associated with measures of periodontitis of bleeding on probing, plaque index, probing depths, clinical attachment loss, calculus, oral hygiene index and community periodontal index. Two prospective cohort studies in the review showed no significant association between obesity and periodontitis, but these studies had limitations of study design and used inappropriate epidemiological diagnostic measures of periodontitis. CONCLUSION There was evidence to suggest that obesity is associated with periodontitis in adolescents and young adults. Systematic Review Registration: PROSPERO Registration Number: CRD42016046507.
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Affiliation(s)
- S Khan
- Centre for Rural Health, University of Tasmania, Hobart, Tas., Australia.,Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia
| | - G Barrington
- School of Medicine, University of Tasmania, Hobart, Tas., Australia
| | - S Bettiol
- School of Medicine, University of Tasmania, Hobart, Tas., Australia
| | - T Barnett
- Centre for Rural Health, University of Tasmania, Hobart, Tas., Australia
| | - L Crocombe
- Centre for Rural Health, University of Tasmania, Hobart, Tas., Australia
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Garbers S, Hunersen K, Nechitilo M, Fisch M, Bell DL, Byrne MW, Gold MA. Healthy Weight and Cardiovascular Health Promotion Interventions for Adolescent and Young Adult Males of Color: A Systematic Review. Am J Mens Health 2018; 12:1328-1351. [PMID: 29808765 PMCID: PMC6142141 DOI: 10.1177/1557988318777923] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Cardiovascular disease is the leading cause of mortality in the United States, accounting for one fourth of deaths. Higher rates of obesity put Hispanic and Black men at increased risk. The American Heart Association cites diet quality, physical activity, and body weight as alterations responsive to health promotion intervention. Prevention strategies need to begin in adolescence and the emerging adulthood years to impact cumulative risk factors. A scoping review identified search terms and this was followed by a systematic review of Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed databases for articles published in English from January 1, 2002, through May 11, 2017. This review explores community-based content, delivery, recruitment, or retention strategies used with young men of color aged 15 to 24 years. Of 17 articles describing 16 individual interventions and 1 describing multiple interventions (with samples ranging from 37 to 4,800), 13 reported significant results in one or more domains. No studies specifically targeted the needs of young men and only three had more than 50% male participants. There was a gap in studies that addressed young men in the ages of interest with most interventions reaching participants aged 11 to 19 years. Cultural tailoring was addressed through recruitment setting, interventionist characteristics, community involvement, and theoretical frameworks such as motivational interviewing that allow individual goal setting. Because young men seek access to preventive health services less than young women, it is suggested that interventions that are community based or use push technology (send information directly to the user) be increased.
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Affiliation(s)
- Samantha Garbers
- 1 Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Kara Hunersen
- 1 Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - Marylynn Fisch
- 2 Columbia University College of Physicians and Surgeons, New York, USA
| | - David L Bell
- 1 Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, New York, NY, USA.,2 Columbia University College of Physicians and Surgeons, New York, USA
| | | | - Melanie A Gold
- 1 Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, New York, NY, USA.,2 Columbia University College of Physicians and Surgeons, New York, USA
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Hutchesson MJ, Callister R, Morgan PJ, Pranata I, Clarke ED, Skinner G, Ashton LM, Whatnall MC, Jones M, Oldmeadow C, Collins CE. A Targeted and Tailored eHealth Weight Loss Program for Young Women: The Be Positive Be Health e Randomized Controlled Trial. Healthcare (Basel) 2018; 6:healthcare6020039. [PMID: 29724054 PMCID: PMC6023329 DOI: 10.3390/healthcare6020039] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 04/18/2018] [Accepted: 04/26/2018] [Indexed: 12/14/2022] Open
Abstract
Young women are gaining weight rapidly. Evidence for effective weight loss interventions targeting young women is lacking. This randomized controlled trial assessed the efficacy and acceptability of a six-month targeted and tailored eHealth weight loss program for young women (Be Positive Be Healthe (BPBH)). Women aged 18–35 years were randomized to BPBH (n = 29) or control (n = 28). BPBH supported participants to modify diet and physical activity behaviours using evidenced-based strategies (e.g., self-monitoring) tailored for young women and delivered using e-health (website, social media, smartphone application, email, text messages). The primary outcome was a change in weight (kg) at six months. Acceptability was assessed via a process evaluation survey and usage of intervention components. No significant between-group differences were observed for weight, with significant mean differences favouring the intervention group observed for body fat (kg) (−3.10 (−5.69, 0.52), p = 0.019) and intakes of alcohol (g) (−0.69 (−1.33, 0.04), p = 0.037), vegetables (% energy/day) (4.71 (−2.20, 7.22), p < 0.001) and energy-dense, nutrient-poor foods (% energy/day) (−9.23 (−16.94, 1.52), p = 0.018). Retention, intervention usage and satisfaction were moderate. BPBH facilitated positive improvements in body fat and dietary intake, but not weight. Intervention acceptability findings support the use of some intervention components (e.g., Facebook, Smartphone app) with young women.
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Affiliation(s)
- Melinda J Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Robin Callister
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Philip J Morgan
- School of Education, Faculty of Education and Arts, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Ilung Pranata
- School of Electrical Engineering and Computing, Faculty of Engineering and Built Environment, University of Newcastle, Callaghan 2308, Australia.
| | - Erin D Clarke
- School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Geoff Skinner
- School of Electrical Engineering and Computing, Faculty of Engineering and Built Environment, University of Newcastle, Callaghan 2308, Australia.
| | - Lee M Ashton
- School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Megan C Whatnall
- School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Mark Jones
- Clinical Research Design and Statistics Support Unit, Hunter Medical Research Institute, New Lambton Heights 2305, Australia.
| | - Christopher Oldmeadow
- Clinical Research Design and Statistics Support Unit, Hunter Medical Research Institute, New Lambton Heights 2305, Australia.
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
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Monroe CM, Turner-McGrievy G, Larsen CA, Magradey K, Brandt HM, Wilcox S, Sundstrom B, West DS. College Freshmen Students' Perspectives on Weight Gain Prevention in the Digital Age: Web-Based Survey. JMIR Public Health Surveill 2017; 3:e71. [PMID: 29025698 PMCID: PMC5658646 DOI: 10.2196/publichealth.7875] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 09/09/2017] [Accepted: 09/10/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND College freshmen are highly vulnerable to experiencing weight gain, and this phenomenon is associated with an increased risk of chronic diseases and mortality in older adulthood. Technology offers an attractive and scalable way to deliver behavioral weight gain prevention interventions for this population. Weight gain prevention programs that harness the appeal and widespread reach of Web-based technologies (electronic health or eHealth) are increasingly being evaluated in college students. Yet, few of these interventions are informed by college students' perspectives on weight gain prevention and related lifestyle behaviors. OBJECTIVE The objective of this study was to assess college freshmen students' concern about weight gain and associated topics, as well as their interest in and delivery medium preferences for eHealth programs focused on these topics. METHODS Web-based surveys that addressed college freshmen students' (convenience sample of N=50) perspectives on weight gain prevention were administered at the beginning and end of the fall 2015 semester as part of a longitudinal investigation of health-related issues and experiences in first semester college freshmen. Data on weight gain prevention-related concerns and corresponding interest in eHealth programs targeting topics of potential concern, as well as preferred program delivery medium and current technology use were gathered and analyzed using descriptive statistics. RESULTS A considerable proportion of the freshmen sample expressed concern about weight gain (74%, 37/50) and both traditional (healthy diet: 86%, 43/50; physical activity: 64%, 32/50) and less frequently addressed (stress: 82%, 41/50; sleep: 74%, 37/50; anxiety and depression: 60%, 30/50) associated topics within the context of behavioral weight gain prevention. The proportion of students who reported interest in eHealth promotion programs targeting these topics was also generally high (ranging from 52% [26/50] for stress management to 70% [35/50] for eating a healthy diet and staying physically active). Email was the most frequently used electronic platform, with 96% (48/50) of students reporting current use of it. Email was also the most frequently cited preferred eHealth delivery platform, with 86% (43/50) of students selecting it. Facebook was preferred by the second greatest proportion of students (40%, 20/50). CONCLUSIONS Most college freshmen have concerns about an array of weight gain prevention topics and are generally open to the possibility of receiving eHealth interventions designed to address their concerns, preferably via email compared with popular social media platforms. These preliminary findings offer a foundation to build upon when it comes to future descriptive investigations focused on behavioral weight gain prevention among college freshmen in the digital age.
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Affiliation(s)
- Courtney M Monroe
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | | | - Chelsea A Larsen
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Karen Magradey
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Heather M Brandt
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Sara Wilcox
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Beth Sundstrom
- Department of Communication, College of Charleston, Charleston, SC, United States
| | - Delia Smith West
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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Abstract
PURPOSE OF REVIEW Emerging adulthood (age 18-25) represents a critical period for weight control: rate of weight gain is greatest during these years and the prevalence of overweight and obesity is estimated to be at least 40% among emerging adults. Unique behavioral, psychosocial, and cognitive risk factors among this population must be specifically addressed within weight management programs. We review extant treatment approaches, including lessons learned from the nascent literature specifically targeting this population. Lastly, we provide suggestions to inform future work in this area. RECENT FINDINGS The EARLY consortium comprises seven clinical trials targeting weight control in young adults age 18-35. Though these studies encompass a broader age range, two of the trials enrolled large numbers of 18-25-year-olds. Results from these trials and other recent pilot trials provide a foundation for next steps with respect to developing weight management interventions for emerging adults. The design of targeted weight control approaches for emerging and young adults has contributed to improved outcomes for this high-risk population. However, suboptimal engagement and variability in response pose challenges. Identifying and intervening on individual-level behavioral and psychological variables may enhance the effects of these adapted treatments.
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Affiliation(s)
- Autumn Lanoye
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, 830 East Main Street, Richmond, VA, 23219, USA
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street Box 842018, Richmond, VA, 23284, USA
| | - Kristal L Brown
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, 830 East Main Street, Richmond, VA, 23219, USA
| | - Jessica G LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, 830 East Main Street, Richmond, VA, 23219, USA.
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Mata F, Treadway M, Kwok A, Truby H, Yücel M, Stout JC, Verdejo-Garcia A. Reduced Willingness to Expend Effort for Reward in Obesity: Link to Adherence to a 3-Month Weight Loss Intervention. Obesity (Silver Spring) 2017; 25:1676-1681. [PMID: 28782916 DOI: 10.1002/oby.21948] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 06/14/2017] [Accepted: 06/26/2017] [Indexed: 01/28/2023]
Abstract
OBJECTIVE This study aimed to (1) compare the willingness to expend effort for rewards between young adults with healthy weight, overweight, and obesity; and (2) to examine how individual differences in the willingness to expend effort for rewards predict adherence to weight loss treatment. METHODS Seventy-three participants completed the Effort Expenditure for Rewards Task (EEfRT). Of those 73 participants, 42 young adults with excess weight took part in a 3-month weight loss treatment after completing the EEfRT. Generalized estimating equation models were used to compare the groups with healthy weight, overweight, and obesity in the EEfRT. Logistic regression models, including the proportion of hard-task choices for each reward probability condition as predictors (12%, 50%, and 88%), were conducted to longitudinally predict adherence in the treatment. RESULTS Young adults with obesity were significantly less willing to expend effort for high-magnitude rewards compared with participants with overweight (P = 0.05). The willingness to expend effort for uncertain rewards (50% probability) was distinguished between completers and dropouts in the weight loss treatment (χ2 = 5.04, P < 0.02). CONCLUSIONS Young adults with obesity, compared with their counterparts with overweight, have diminished motivation to expend effort for obtaining high-magnitude rewards. Less willingness to expend effort for the most uncertain rewards predicts poor adherence to weight loss treatment.
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Affiliation(s)
- Fernanda Mata
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
| | - Michael Treadway
- Department of Psychology, Emory University, Atlanta, Georgia, USA
| | - Alastair Kwok
- Department of Nutrition and Dietetics, Monash University, Melbourne, Australia
| | - Helen Truby
- Department of Nutrition and Dietetics, Monash University, Melbourne, Australia
| | - Murat Yücel
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
| | - Julie C Stout
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
| | - Antonio Verdejo-Garcia
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
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Ashton LM, Morgan PJ, Hutchesson MJ, Rollo ME, Collins CE. Young Men's Preferences for Design and Delivery of Physical Activity and Nutrition Interventions: A Mixed-Methods Study. Am J Mens Health 2017; 11:1588-1599. [PMID: 28675118 PMCID: PMC5675188 DOI: 10.1177/1557988317714141] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Young adult men are under-represented in health research, and little is known about how to reach and engage them in lifestyle interventions. This mixed-methods study aimed to explore young males' preferences for recruitment strategies, content, format (delivery mode and program duration and frequency), and facilitator characteristics for future physical activity and nutrition interventions. Ten focus groups involving 61 men (aged 18-25 years) in the Hunter region, New South Wales, Australia and an online survey distributed within Australia were completed by 282 males (aged 18-25 years). Key focus group themes included a preference for recruitment via multiple sources, ensuring images and recruiters were relatable; intervention facilitators to be engaging and refrain from discussing negative consequences of being unhealthy. Key program content preferences included skill development and individualized goals and feedback. Focus groups and the survey confirmed a preference for multiple delivery modes, including; face-to-face (group and individual), with support using eHealth technologies. Survey results confirmed the most favored program content as: "healthy eating on a budget," "quick and easy meals," and "resistance training." Focus group responses suggested a program duration of ≥6 months, with 2-3 combined face-to-face and supportive eHealth sessions per week. Survey intervention duration preference was 3 months with 4 face-to-face sessions per month. Findings can guide the design, conduct, and evaluation of relevant contemporary physical activity and or nutrition interventions for young men. There is a need to identify the most effective ways to address young men's individual preferences in intervention research.
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Affiliation(s)
- Lee M Ashton
- 1 School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Philip J Morgan
- 2 School of Education, Faculty of Education and Arts, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Melinda J Hutchesson
- 1 School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Megan E Rollo
- 1 School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Clare E Collins
- 1 School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
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Das SK, Brown C, Urban LE, O'Toole J, Gamache MMG, Weerasekara YK, Roberts SB. Weight loss in videoconference and in-person iDiet weight loss programs in worksites and community groups. Obesity (Silver Spring) 2017; 25:1033-1041. [PMID: 28452452 DOI: 10.1002/oby.21854] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 03/03/2017] [Accepted: 03/23/2017] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To examine the association of program delivery factors with weight loss (WL) in enrollees in iDiet® , a commercial WL program. METHODS Data were from 644 adults enrolling in an 11-week group WL program and 461 who reported weight to 11 weeks (complete reporters). Predictors of %WL were analyzed using ANCOVA, including meeting type (in-person vs. videoconference), participant type (worksite employees vs. community members), age, gender, BMI, and payment structure. RESULTS Mean starting BMI was 32.4 ± 7.1 (mean ± SD); WL was 6.1 ± 3.9% in all enrollees in an intention-to-treat analysis and 7.4 ± 3.4% in complete reporters. Videoconference participants, older adults, and enrollees in incentivized programs were more likely to be complete reporters (P < 0.004). %WL at 11 weeks was not associated with gender, starting BMI, or videoconference versus in-person groups. Worksite participants had greater %WL than community participants (+1.2%, P < 0.001), and there was no significant difference in %WL between programs paid by the employee or employer. Greater %WL was achieved by individuals ≥30 versus < 30 years (+2.2%, P < 0.001) and by those enrolling in January-March versus April-June (+1.4%, P = 0.02). CONCLUSIONS iDiet participants had clinically impactful mean WL. The observed high mean WL in worksites and videoconference-delivered programs broadens options for scalable WL program implementation.
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Affiliation(s)
- Sai Krupa Das
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | - Carrie Brown
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | | | - James O'Toole
- Instinct Health Science LLC, Rowley, Massachusetts, USA
| | - Madeleine M Gould Gamache
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | - Yasoma K Weerasekara
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | - Susan B Roberts
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
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49
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Oosterveen E, Tzelepis F, Ashton L, Hutchesson MJ. A systematic review of eHealth behavioral interventions targeting smoking, nutrition, alcohol, physical activity and/or obesity for young adults. Prev Med 2017; 99:197-206. [PMID: 28130046 DOI: 10.1016/j.ypmed.2017.01.009] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 01/17/2017] [Accepted: 01/19/2017] [Indexed: 10/20/2022]
Abstract
A systematic review of randomized control trials (RCT) was undertaken to evaluate the effectiveness of eHealth behavioral interventions aiming to improve smoking rates, nutrition behaviors, alcohol intake, physical activity levels and/or obesity (SNAPO) in young adults. Seven electronic databases were searched for RCTs published in English from 2000 to April 2015 and evaluating eHealth interventions aiming to change one or multiple SNAPO outcomes, and including young adult (18-35years) participants. Of 2,159 articles identified, 45 studies met the inclusion criteria. Most interventions targeted alcohol (n=26), followed by smoking (n=7), physical activity (n=4), obesity (n=4) and nutrition (n=1). Three interventions targeted multiple behaviors. The eHealth interventions were most often delivered via websites (79.5%). Most studies (n=32) compared eHealth interventions to a control group (e.g. waiting list control, minimal intervention), with the majority (n=23) showing a positive effect on a SNAPO outcome at follow-up. Meta-analysis demonstrated a significantly lower mean number of drinks consumed/week in brief web or computer-based interventions compared to controls (Mean Difference -2.43 [-3.54, -1.32], P<0.0001, n=10). Sixteen studies compared eHealth delivery modes, with inconsistent results across target behaviors and technology types. Nine studies compared eHealth to other modes of delivery (e.g. in person) with all finding no difference in SNAPO outcomes between groups at follow-up. This review provides some evidence for the efficacy of eHealth SNAPO interventions for young adults, particularly in the short-term and for alcohol interventions. But there is insufficient evidence for their efficacy in the longer-term, as well as which mode of delivery is most effective.
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Affiliation(s)
- Emilie Oosterveen
- School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre in Physical Activity and Nutrition, Hunter Building (HA12), University of Newcastle, Callaghan, NSW 2308, Australia; Division of Human Nutrition, Wageningen University, The Netherlands
| | - Flora Tzelepis
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia; Hunter New England Population Health, Wallsend, NSW 2287, Australia
| | - Lee Ashton
- School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre in Physical Activity and Nutrition, Hunter Building (HA12), University of Newcastle, Callaghan, NSW 2308, Australia
| | - Melinda J Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre in Physical Activity and Nutrition, Hunter Building (HA12), University of Newcastle, Callaghan, NSW 2308, Australia.
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Ashton LM, Hutchesson MJ, Rollo ME, Morgan PJ, Collins CE. Motivators and Barriers to Engaging in Healthy Eating and Physical Activity. Am J Mens Health 2017; 11:330-343. [PMID: 27923963 PMCID: PMC5675273 DOI: 10.1177/1557988316680936] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 10/25/2016] [Accepted: 10/27/2016] [Indexed: 11/16/2022] Open
Abstract
Many Australian young men (18-25 years) fail to meet recommendations in national dietary or physical activity (PA) guidelines. However, there is a lack of understanding of their perspectives on PA and diet to inform intervention design. This study examined young men's motivators and barriers to healthy eating and PA, along with differences by demographic and behavioral factors. A cross-sectional online survey was completed by 282 men aged 18 to 25 years in Australia. Results identified the most common motivators for healthy eating included improving health (63.5%), body image (52.3%), and increasing energy (32.1%). Motivators for PA included improving body image (44.6%), fitness (44.2%), and health (41.0%). Common barriers to healthy eating were access to unhealthy foods (61.1%), time to cook/prepare healthy foods (55.0%), and motivation to cook healthy foods (50.7%). Barriers for PA included motivation (66.3%), time (57.8%), and cost of equipment/facilities (33.3%). Significant differences ( p < .01) in motivators to healthy eating and/or PA were identified for BMI category, marital status, PA level, alcohol intake, and stress levels. Significant differences were identified for barriers to healthy eating and/or PA by BMI, PA level, stress, and fruit and vegetable intake, assessed using Pearson's chi-square test. Findings suggest that promotion of benefits related to health, appearance/body image, increased energy and fitness, and addressing key barriers including motivation, time, financial restraints, and accessibility of unhealthy foods, could engage young men in improving lifestyle behaviors. Differences by demographic and behavioral factors suggest development of tailored programs to address diversity among young men may be required.
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Affiliation(s)
- Lee M. Ashton
- University of Newcastle, Callaghan, New South Wales, Australia
| | | | - Megan E. Rollo
- University of Newcastle, Callaghan, New South Wales, Australia
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