Weight loss and attrition in overweight and obese young women during a 36- week internet-based lifestyle intervention

Background: Young women are at high risk of weight gain yet few studies have examined the long-term effectiveness of weight loss programs in this group. This study aimed to investigate the effects of a self-directed internet-based lifestyle program on body weight in young women.

Methods: Overweight or obese young women (BMI 33.4 ± 0.3 kg/m2, age 27.8 ± 0.3 years) were initially randomized to General lifestyle advice (G) or Structured lifestyle advice (S) via in-person and website support for 12 weeks (Phase I). After Phase I, all participants were supported through a self-directed internet-based program for 36 weeks (Phase II). The internet-based program included a structured hypocaloric diet, physical activity program, self-monitoring tools, peer group forum and monthly emails. Body weight, energy intake and physical activity were measured at week 0, week 12, week 24 and week 48. Adherence to self-regulatory behaviors was measured at week 48. Mixed model analyses were conducted to determine changes in body weight, energy intake and physical activity.

Results: A total of 203 overweight or obese young women commenced Phase I and 130 commenced Phase II. In Phase I, S group had significantly greater weight loss than G group (4.2 ± 0.6 kg vs 0.6 ± 0.3 kg, P<0.001). In Phase II, both groups had significant weight loss over time without significant group differences (-0.8 ± 1.1kg vs -0.8 ± 0.6, P>0.05). Forty-one percent (53/130) of the participants who commenced Phase II completed the internet-based intervention. Dropouts had a higher baseline BMI, were more likely to be married or in a de facto relationship, and more likely to have at least one child.

Conclusions: A self-directed internet-based program could be effective in providing support in maintaining weight loss on a structured lifestyle program in young women over 36 weeks. Further research is required to maintain engagement in young women who were married/in a de facto relationship or have children.

Measuring the accuracy of self-reported height and weight in a community-based sample of young people

BACKGROUND: Self-reported anthropometric data are commonly used to estimate prevalence of obesity in population and community-based studies. We aim to: 1) Determine whether survey participants are able and willing to self-report height and weight; 2) Assess the accuracy of self-reported compared to measured anthropometric data in a community-based sample of young people.

METHODS: Participants (16-29 years) of a behaviour survey, recruited at a Melbourne music festival (January 2011), were asked to self-report height and weight; researchers independently weighed and measured a sub-sample. Body Mass Index was calculated and overweight/obesity classified as ≥25 kg/m². Differences between measured and self-reported values were assessed using paired t-test/Wilcoxon signed ranks test. Accurate report of height and weight were defined as <2 cm and <2 kg difference between self-report and measured values, respectively. Agreement between classification of overweight/obesity by self-report and measured values was assessed using McNemar's test.

RESULTS: Of 1405 survey participants, 82% of males and 72% of females self-reported their height and weight. Among 67 participants who were also independently measured, self-reported height and weight were significantly less than measured height (p=0.01) and weight (p<0.01) among females, but no differences were detected among males. Overall, 52% accurately self-reported height, 30% under-reported, and 18% over-reported; 34% accurately self-reported weight, 52% under-reported and 13% over-reported. More females (70%) than males (35%) under-reported weight (p=0.01). Prevalence of overweight/obesity was 33% based on self-report data and 39% based on measured data (p=0.16).

CONCLUSIONS: Self-reported measurements may underestimate weight but accurately identified overweight/obesity in the majority of this sample of young people.

Time use clusters of New Zealand adolescents are associated with weight status, diet and ethnicity

OBJECTIVE: To describe New Zealand adolescent time use clusters and correlate cluster profiles. METHODS: Data were from the cross-sectional 2008/2009 National Survey of Children and Young People's Physical Activity and Dietary Behaviours, which surveyed a random sample of 10-16 year-old New Zealanders (study subset n=679). Time use data were collected using the Multimedia Activity Recall for Children and Adults, and collapsed into 17 age-adjusted variables for sex-specific cluster analysis. Cluster associations with socio-demographic, anthropometric, physical activity and dietary variables were analysed. RESULTS: Three time use clusters were discovered for both boys and girls. For boys, the Techno-active cluster was characterised by high levels of team sports and TV; the Quiet movers cluster by transport (active and passive) and quiet time; and the Social studious cluster by reading, study activities and social interaction. The boys' clusters were associated with ethnicity. The girls'Social sporty cluster was characterised by sports and social interaction; the Screenie tasker cluster by TV, computer, chores and work; and the Super studious cluster by reading, study and school-based activities. The girls' time use cluster membership was associated with weight status and serves of extra foods. CONCLUSIONS: Distinct sex-specific time use clusters and correlate profiles exist among NZ adolescents. IMPLICATIONS: These findings may assist the development of targeted time use interventions to improve adolescent health and well-being.

Hair cortisol levels, perceived stress and body mass index in women and children living in socioeconomically disadvantaged neighborhoods: the READI study

Disadvantaged communities provide adverse psychosocial exposures that have been linked to high levels of stress, and this may provide one explanatory pathway linking socioeconomic disadvantage to obesity. This study used hair cortisol analysis to quantify associations between stress and body mass index (BMI), and between hair cortisol and perceived psychological stress levels, in women and children living in socioeconomically disadvantaged neighborhoods. Participants were a volunteer sample of 70 women from the Resilience for Eating and Activity Despite Inequality study, including 30 maternal-child pairs. Women self-reported body weight, height and perceived psychological stress using the Perceived Stress Scale (PSS), and provided hair samples for themselves and their child. Children's body weight and height were measured. Following extraction, hair cortisol levels were measured using enzyme-linked immunosorbent assay. Multiple linear regression models examined associations between stress and BMI, and between hair cortisol and perceived stress levels in women and children. Women's hair cortisol levels were not associated with their BMI or PSS scores. Women's PSS scores were positively associated with their BMI (p = 0.015). Within maternal-child pairs, mothers and children's hair cortisol levels were strongly positively associated (p = 0.006). Maternal hair cortisol levels and PSS scores were unrelated to their child's zBMI. Children's hair cortisol levels were not associated with their zBMI or with their mother's PSS score. Findings suggest that cortisol-based and perceived psychological measures of stress may be distinct among women and children living in disadvantaged neighborhoods. Perceived psychological measures may be more important predictors of weight-related risk.

Correlation of throwing velocity to the results of lower-body field tests in male college baseball players

Baseball-specific athleticism, potential, and performance have been difficult to predict. Increased muscle strength and power can increase throwing velocity but the majority of research has focused on the upper body. The present study sought to determine if bilateral or unilateral lower-body field testing correlates with throwing velocity. Baseball throwing velocity scores were correlated to the following tests: medicine ball (MB) scoop toss and squat throw, bilateral and unilateral vertical jumps, single and triple broad jumps, hop and stop in both directions, lateral to medial jumps, 10- and 60-yd sprints, and both left and right single-leg 10-yd hop for speed in 42 college baseball players. A multiple regression analysis (forward method), assessing the relationship between shuffle and stretch throwing velocities and lower-body field test results determined that right-handed throwing velocity from the stretch position was most strongly predicted by lateral to medial jump right (LMJR) and body weight (BW; R = 0.322), whereas lateral to medial jump left (LMJL; R = 0.688) predicted left stretch throw. Right-handed shuffle throw was most strongly predicted by LMJR and MB scoop (R = 0.338), whereas LMJL, BW, and LMJR all contributed to left-handed shuffle throw (R = 0.982). Overall, this study found that lateral to medial jumps were consistently correlated with high throwing velocity in each of the throwing techniques, in both left-handed and right-handed throwers. This is the first study to correlate throwing velocity with a unilateral jump in the frontal plane, mimicking the action of the throwing stride.

Medical burden, body mass index and the outcome of psychosocial interventions for bipolar depression

Objective: Individuals with bipolar disorder experience a disproportionately high incidence of medical co-morbidity and obesity. These health-related problems are a barrier to recovery from mood episodes and have been linked with unfavorable responses to pharmacological treatment. However, little is known about whether and how these characteristics affect responses to adjunctive psychotherapy. Method: Embedded in the Systematic Treatment Enhancement Program for Bipolar Disorder was a randomized controlled trial of psychotherapy for bipolar depression comparing the efficacy of intensive psychotherapy plus pharmacotherapy with collaborative care (a three-session psycho-educational intervention) plus pharmacotherapy. We conducted a post-hoc analysis to evaluate whether medical burden and body mass index predicted and/or moderated the likelihood of recovery and time until recovery from a depressive episode among patients in the two treatments. Results: Participants who had medical co-morbidity and body mass index data constituted 199 of the 293 patients in the original Systematic Treatment Enhancement Program for Bipolar Disorder trial. Higher medical burden predicted a lower likelihood of recovery from depression in both treatment conditions (odds ratio = 0.89), but did not moderate responses to intensive psychotherapy vs collaborative care. Intensive psychotherapy yielded superior recovery rates for individuals of normal body mass index (odds ratio= 2.39) compared with collaborative care, but not among individuals who were overweight or obese. Conclusion: Medical co-morbidity and body weight impacts symptom improvement and attention to this co-morbidity may inform the development of more personalized treatments for bipolar disorder.

FTO genotype and weight loss: systematic review and meta-analysis of 9563 individual participant data from eight randomised controlled trials

OBJECTIVE:  To assess the effect of the FTO genotype on weight loss after dietary, physical activity, or drug based interventions in randomised controlled trials.

DESIGN:  Systematic review and random effects meta-analysis of individual participant data from randomised controlled trials.

DATA SOURCES:  Ovid Medline, Scopus, Embase, and Cochrane from inception to November 2015.

ELIGIBILITY CRITERIA FOR STUDY SELECTION:  Randomised controlled trials in overweight or obese adults reporting reduction in body mass index, body weight, or waist circumference by FTO genotype (rs9939609 or a proxy) after dietary, physical activity, or drug based interventions. Gene by treatment interaction models were fitted to individual participant data from all studies included in this review, using allele dose coding for genetic effects and a common set of covariates. Study level interactions were combined using random effect models. Metaregression and subgroup analysis were used to assess sources of study heterogeneity.

RESULTS:  We identified eight eligible randomised controlled trials for the systematic review and meta-analysis (n=9563). Overall, differential changes in body mass index, body weight, and waist circumference in response to weight loss intervention were not significantly different between FTO genotypes. Sensitivity analyses indicated that differential changes in body mass index, body weight, and waist circumference by FTO genotype did not differ by intervention type, intervention length, ethnicity, sample size, sex, and baseline body mass index and age category.

CONCLUSIONS:  We have observed that carriage of the FTO minor allele was not associated with differential change in adiposity after weight loss interventions. These findings show that individuals carrying the minor allele respond equally well to dietary, physical activity, or drug based weight loss interventions and thus genetic predisposition to obesity associated with the FTO minor allele can be at least partly counteracted through such interventions.