Mindful Eating and Active Living: Development and Implementation of a Multidisciplinary Pediatric Weight Management Intervention

Pediatric overweight and obesity are significant individual and public health issues that require an innovative approach. While evidence suggests that intensive family-based behavioral lifestyle modification can improve weight status, practical and logistical realities limit the ability of primary healthcare providers to intervene effectively. MEALs (Multidisciplinary Engagement and Learning/Mindful Eating and Active Living) is a family-based mindfulness intervention developed to address pediatric overweight and obesity, while improving healthy lifestyle behaviors through cooking classes. The incorporation of mindfulness, a psychological strategy associated with increased awareness of internal experiences, allows for a focus on the importance of healthy eating along with safe and efficacious kitchen practices. The Template for Intervention Description and Replication (TIDieR) checklist and guide is used to describe the intervention with the intention of providing necessary details to implement the intervention in clinical practice or replicate the intervention for further study. Lessons learned from pilot iterations of the intervention are provided.

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Psychosocial Variables Related to Weight-Related Self-Stigma in Physical Activity among Young Adults across Weight Status

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17010064 ◽

2019 ◽

Vol 17 (1) ◽

pp. 64 ◽

Cited By ~ 9

Author(s):

Xavier C. C. Fung ◽

Amir H. Pakpour ◽

Ya-Ke Wu ◽

Chia-Wei Fan ◽

Chung-Ying Lin ◽

...

Keyword(s):

Physical Activity ◽

Young Adults ◽

Structural Equation ◽

Weight Status ◽

Healthy Lifestyle ◽

Behavioral Control ◽

Healthcare Providers ◽

Model Fit ◽

Equation Modeling ◽

Perceived Behavioral Control

A healthy lifestyle with sufficient physical activity (PA) can contribute to weight management. Yet, many people do not maintain a healthy lifestyle. To explain PA, we propose a model that incorporates the Theory of Planned Behavior (TPB) with weight-related self-stigma. We recruited 325 young adults to complete questionnaires regarding their physical activities, weight-related self-stigma, and TPB factors. We used structural equation modeling to examine the model fit and the path invariance across weight groups. The model showed excellent model fit, but path invariance was not supported. Weight-related self-stigma significantly explained the perceived behavioral control, behavioral intention, and engagement of PA. People without overweight and people with overweight have different considerations for PA. Weight-related self-stigma is important for PA as well. To promote a healthy lifestyle, healthcare providers should provide different suggestions or interventions that suit their patients’ weight-related concerns.

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Development and field evaluation of the INTER-ACT app, a pregnancy and inter-pregnancy coaching app to reduce maternal overweight and obesity: mixed method design (Preprint)

10.2196/preprints.16090 ◽

2019 ◽

Author(s):

Annick Bogaerts ◽

Margriet Bijlholt ◽

Lotte Mertens ◽

Marijke Braeken ◽

Hannelore Vanden Eynde ◽

...

Keyword(s):

Pregnant Women ◽

Healthy Lifestyle ◽

Healthcare Providers ◽

Overweight And Obesity ◽

Care Providers ◽

Female Population ◽

Face To Face ◽

Gestational Weight ◽

Pregnancy And Postpartum ◽

Maternal Overweight

BACKGROUND The inter-pregnancy period is an important window of opportunity to prevent gestational weight retention. Despite an overwhelming number of existing health apps, validated applications to support a healthy lifestyle in women during both pregnancy and postpartum are lacking. OBJECTIVE To describe the development and evaluation of the INTER-ACT app, part of an inter-pregnancy lifestyle coaching module targeting women with previous excessive gestational weight gain. METHODS a mixed methods design to identify needs of healthcare providers and end users, based on 15 semi-structured interviews, two focus groups and two surveys. The user interface was evaluated in a pilot study (n=9). RESULTS Healthcare providers indicate that a mobile app can enhance a healthy lifestyle in pregnant women. Pregnant women preferred graphic displays in the app, weekly notifications and support messages based on their own goals. Both mothers and health care providers reported increased awareness and valued the combination of the app with face-to-face coaching. CONCLUSIONS We report on the development and evaluation process of an application to promote a healthy lifestyle in a specific female population. These women valued the INTER-ACT app because it was offered in combination with face-to-face contact with a caregiver.

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Childhood obesity treatment: targeting parents exclusively v. parents and children

British Journal Of Nutrition ◽

10.1079/bjn20061757 ◽

2006 ◽

Vol 95 (5) ◽

pp. 1008-1015 ◽

Cited By ~ 213

Author(s):

Moria Golan ◽

Vered Kaufman ◽

Danit R. Shahar

Keyword(s):

Childhood Obesity ◽

Parenting Styles ◽

Weight Status ◽

Obese Child ◽

Healthy Lifestyle ◽

Leadership Role ◽

Status Change ◽

Obese Children ◽

Parents And Children ◽

Family Based

There is a consensus that interventions to prevent and treat childhood obesity should involve the family; however, the extent of the child's involvement has received little attention. The goal of the present study was to evaluate the relative efficacy of treating childhood obesity via a family-based health-centred intervention, targeting parents alone v. parents and obese children together. Thirty-two families with obese children of 6–11 years of age were randomised into groups, in which participants were provided for 6 months a comprehensive educational and behavioural programme for a healthy lifestyle. These groups differed in their main agent of change: parents-only v. the parents and the obese child. In both groups, parents were encouraged to foster authoritative parenting styles (parents are both firm and supportive; assume a leadership role in the environmental change with appropriate granting of child's autonomy). Only the intervention aimed at parents-only resulted in a significant reduction in the percentage overweight at the end of the programme (P=0·02) as well as at the 1-year follow-up meeting.The differences between groups at both times were significant (P<0·05). A greater reduction in food stimuli in the home (P<0·05) was noted in the parents-only group. In both groups, the parents' weight status did not change. Regression analysis shows that the level of attendance in sessions explained 28% of the variability in the children's weight status change, the treatment group explained another 10%, and the improvement in the obesogenic load explained 11% of the variability. These results suggest that omittingthe obese child from active participation in the health-centred programme may be beneficial for weight loss and for the promotion of a healthy lifestyle among obese children.

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Perceived Barriers and Facilitators to Healthy Lifestyles and Weight Loss Among Adolescents with Overweight and Obesity: A Qualitative Study

Current Developments in Nutrition ◽

10.1093/cdn/nzaa063_012 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1614-1614

Author(s):

Michelle Cardel ◽

Alexandra Lee ◽

Jackson Dillard ◽

Abhaya Dilip ◽

Darci Miller ◽

...

Keyword(s):

Weight Loss ◽

Qualitative Study ◽

Weight Status ◽

Healthy Lifestyle ◽

Treatment Options ◽

Overweight And Obesity ◽

Perceived Barriers ◽

Barriers And Facilitators ◽

Blood Institute ◽

Management Interventions

Abstract Objectives Obesity in adolescence has reached epidemic proportions around the world, with the prevalence of severe obesity increasing at least four-fold over the last 35 years. Provision of evidence-based treatment options that are tailored and relevant to the needs of adolescents is paramount, yet difficult to tailor because little is known regarding barriers and facilitators to adolescent weight loss. Thus, identification of barriers and facilitators to weight loss among adolescents with overweight/obesity (OW/OB) is needed. The objective of this qualitative study was to assess perceived barriers and facilitators to a healthy lifestyle and weight loss among adolescents with OW/OB. Methods Using 2018–2019 data from eleven focus groups among adolescents aged 14–19 with OW/OB (n = 41; n = 11 boys and n = 30 girls), a moderated, semi-structured focus group guide was used to identify perceived barriers and facilitators to a healthy lifestyle and weight loss. Results Adolescents reported time, access to healthful foods, food cravings, stress, and weight stigma/shaming as barriers to weight loss. Themes around internal and external psychosocial states (support, motivation) and behaviors including modeling, sports, and other physical activities were identified as both barriers and facilitators. Parents were recognized by teens as both helping and hindering weight loss, but overall teens felt their parents were more so facilitators than barriers, particularly as it related to modeling behaviors. Differences were noted by sex, among which girls reported experiencing weight struggles, whereas boys generally stated they did not struggle with weight, despite all participants meeting criterion for OW/OB. Conclusions Adolescent boys and girls with OW/OB perceive their weight status differently and identify a variety of barriers and facilitators to a healthy lifestyle and weight loss. Tailoring adolescent weight management interventions to address these perceived barriers and facilitators, along with noted sex differences, has the potential to improve the quality and effectiveness of adolescent obesity interventions. Funding Sources National Heart, Lung, and Blood Institute, National Institute of Health, WellCare Health Plans.

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Practical Lessons Learned from Adolescent and Parent Experiences Immediately and 12 Months following a Family-Based Healthy Lifestyle Intervention

Childhood Obesity ◽

10.1089/chi.2016.0091 ◽

2016 ◽

Vol 12 (5) ◽

pp. 401-409 ◽

Cited By ~ 1

Author(s):

Erin K. Howie ◽

Alexandra McManus ◽

Kyla L. Smith ◽

Ashley A. Fenner ◽

Leon M. Straker

Keyword(s):

Lifestyle Intervention ◽

Healthy Lifestyle ◽

Lessons Learned ◽

Parent Experiences ◽

Family Based

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POS1309 PREVALENCE AND CORRELATES OF UNDERWEIGHT, OVERWEIGHT AND OBESITY AMONG PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS (JIA): EVIDENCE FROM THE NATIONAL PAEDIATRIC RHEUMATOLOGIC DATABASE (NPRD)

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2058 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 936.2-937

Author(s):

F. Milatz ◽

J. Klotsche ◽

M. Niewerth ◽

J. Hörstermann ◽

D. Windschall ◽

...

Keyword(s):

Physical Activity ◽

Juvenile Idiopathic Arthritis ◽

General Population ◽

Children And Adolescents ◽

Treatment Response ◽

Weight Status ◽

Overweight And Obesity ◽

Age Group ◽

Group 3 ◽

Obesity In Children

Background:In patients with JIA, growth impairment and variance in body composition are well-known long-term complications that may be associated with prolonged drug therapy (e.g. glucocorticoids) as well as impaired physical and psychosocial well-being. An increased accumulation of body fat represents a significant risk factor for metabolic abnormalities and a modifiable variable for a number of comorbidities. Recently, evidence has emerged in favour of the potential negative influence of overweight on the course of the disease and treatment response [1].Objectives:The study aimed a) to estimate the prevalence of underweight, overweight and obesity in children and adolescents with JIA compared to the general population, and b) to investigate correlates of patients’ weight status.Methods:A cross-sectional analysis of physicians’ recorded body weights and heights of patients with JIA enrolled in the NPRD in the year 2019 was performed. Underweight (BMI <10th), overweight (BMI >90th) and obesity (BMI >97th) were defined according to age- and sex-specific percentiles used in the German reference system. For comparison with data from the general population [2], sex- and age-matched pairs of 3-17-year-old patients and controls were generated. A multinomial logistic regression analysis was performed to examine the association between weight status and patients’ clinical and self-reported outcomes.Results:In total, data from 6.515 children and adolescents with JIA (age 11.2 ± 4.1 years, disease duration 4.9 ± 3.8 years, 67% girls, 40% persistent oligoarthritis) were included. Of these, 3.334 (age 5.9 ± 2.1 years, 52.5% girls) could be considered for matched-pair analysis. Compared with the general population, patients underweight, overweight and obesity rates were 10.6% (vs. 8.1%), 8.8% (vs. 8.5%) and 6.1% (vs. 5.7%), respectively. No significant sex differences were found in either group. Largest difference in prevalence was registered for underweight, specifically in the age group 3-6 years (12.9% patients vs. 5.9% controls). Similar to the general population, higher rates of overweight were observed in adolescent patients than in affected children (19.1% age group 11-13 vs. 8.4% age group 3-6). While the highest underweight prevalence was registered in patients with RF+ polyarthritis (16%), patients with Enthesitis-related arthritis (22%), psoriatic arthritis (21%) and systemic JIA (20%) showed the highest overweight rates (including obesity). Younger age (OR = 0.51, 95% CI = 0.31-0.83), more frequent physical activity (OR = 0.92, 95% CI = 0.85-0.99) and high parental vocational education (OR = 0.39, 95% CI = 0.18-0.80) were independently associated with a lower likelihood of being overweight/obese.Conclusion:The overall prevalence of underweight, overweight and obesity in children and adolescents with JIA is comparable to that found in the general population. Behavioural health promotion, including regular physical activity, as part of the treatment strategy in JIA should preventively already begin at preschool age and necessarily be made accessible to patients of all educational levels.References:[1]Giani T et al. The influence of overweight and obesity on treatment response in juvenile idiopathic arthritis. Front Pharmacol 2019;10:637.[2]Schienkiewitz A et al. BMI among children and adolescents: prevalences and distribution considering underweight and extreme obesity. Bundesgesundheitsbl 2019;62:1225–1234.Acknowledgements:The National Paediatric Rheumatological Database has been funded by AbbVie, Chugai, Novartis and GSK.Disclosure of Interests:Florian Milatz: None declared, Jens Klotsche: None declared, Martina Niewerth: None declared, Jana Hörstermann: None declared, Daniel Windschall: None declared, Frank Weller-Heinemann Speakers bureau: Pfizer, AbbVie, SOBI, Roche and Novartis., Frank Dressler: None declared, Rainer Berendes: None declared, Johannes-Peter Haas: None declared, Gerd Horneff: None declared, Kirsten Minden Speakers bureau: Pfizer, AbbVie, Consultant of: Novartis

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Workplace Healthy Lifestyle Determinants and Wellbeing Needs across the Preconception and Pregnancy Periods: A Qualitative Study Informed by the COM-B Model

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084154 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4154

Author(s):

Seonad K. Madden ◽

Claire A. Blewitt ◽

Kiran D. K. Ahuja ◽

Helen Skouteris ◽

Cate M. Bailey ◽

...

Keyword(s):

Healthy Lifestyle ◽

Intervention Development ◽

Health Behavior Change ◽

Overweight And Obesity ◽

Specific Reference ◽

Lifestyle Behaviors ◽

Policy Makers ◽

Health And Wellbeing ◽

Healthy Lifestyle Behaviors ◽

And Control

Overweight and obesity present health risks for mothers and their children. Reaching women during the key life stages of preconception and pregnancy in community settings, such as workplaces, is an ideal opportunity to enable health behavior change. We conducted five focus groups with 25 women aged between 25 and 62 years in order to investigate the determinants of healthy lifestyle behaviors, weight management, and wellbeing needs during the preconception and pregnancy periods in an Australian university workplace. Discussions explored women’s health and wellbeing needs with specific reference to workplace impact. An abductive analytical approach incorporated the capability, opportunity, and motivation of behavior (COM-B) model, and four themes were identified: hierarchy of needs and values, social interactions, a support scaffold, and control. Findings highlight the requirement for greater organization-level support, including top-down coordination of wellbeing opportunities and facilitation of education and support for preconception healthy lifestyle behaviors in the workplace. Interventionists and organizational policy makers could incorporate these higher-level changes into workplace processes and intervention development, which may increase intervention capacity for success.

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Is overweight/obesity a risk factor for atopic allergic disease in prepubertal children? A case–control study

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2021-0051 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Aysel Vehapoglu ◽

Zeynep Ebru Cakın ◽

Feyza Ustabas Kahraman ◽

Mustafa Atilla Nursoy ◽

Ali Toprak

Keyword(s):

Body Weight ◽

Allergic Disease ◽

Weight Status ◽

Normal Weight ◽

Overweight And Obesity ◽

University Hospital ◽

Healthy Children ◽

Prepubertal Children ◽

Body Weight Status ◽

Increased Risk

Abstract Objectives It is unclear whether body weight status (underweight/normal weight/overweight/obese) is associated with allergic disease. Our objective was to investigate the relationship between body weight status (body mass index; BMI) and atopic allergic disease in prepubertal children, and to compare children with atopic allergic diseases with non atopic healthy children. Methods A prospective cross sectional study of 707 prepubertal children aged 3–10 years was performed; the participants were 278 atopic children with physician-diagnosed allergic disease (allergic rhinitis and asthma) (serum total IgE level >100 kU/l and eosinophilia >4%, or positivity to at least one allergen in skin test) and 429 non atopic healthy age- and sex-matched controls. Data were collected between December 2019 and November 2020 at the Pediatric General and Pediatric Allergy Outpatient Clinics of Bezmialem Vakıf University Hospital. Results Underweight was observed in 11.6% of all participants (10.8% of atopic children, 12.2% of healthy controls), and obesity in 14.9% of all participants (18.0% of atopic children, 12.8% of controls). Obese (OR 1.71; 95% CI: 1.08–2.71, p=0.021), and overweight status (OR 1.62; 95% CI: 1.06–2.50, p=0.026) were associated with an increased risk of atopic allergic disease compared to normal weight in pre-pubertal children. This association did not differ by gender. There was no relationship between underweight status and atopic allergic disease (OR 1.03; 95% CI: 0.63–1.68, p=0.894). Conclusions Overweight and obesity were associated with an increased risk of atopic allergic disease compared to normal weight among middle-income and high-income pre pubertal children living in Istanbul.

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Prevalence and risk factors for overweight and obesity: a cross-sectional countrywide study in Burkina Faso

BMJ Open ◽

10.1136/bmjopen-2019-032953 ◽

2020 ◽

Vol 10 (11) ◽

pp. e032953

Author(s):

Seydou Kaboré ◽

Tieba Millogo ◽

Joseph Kouesyandé Soubeiga ◽

Hermann Lanou ◽

Brice Bicaba ◽

...

Keyword(s):

Burkina Faso ◽

Weight Status ◽

Fasting Blood Glucose ◽

Population Based ◽

Overweight And Obesity ◽

Blood Cholesterol ◽

Public Health Issue ◽

Proportional Odds ◽

Cross Sectional ◽

Current Smoking

ObjectiveThe objective of this study was to determine the prevalence and predictors of overweight and obesity in Burkina Faso using a population-based countrywide sample. We hypothesise that there is a significant burden related to overweight/obesity in Burkina Faso.DesignSecondary analysis of a population-based countrywide cross-sectional study.SettingBurkina Faso, all the 13 regions including both rural and urban residential areas.Participants4800 participants of both sexes, aged between 25 and 64 years.Main outcomesOverweight and obesity using body mass index cut-off levels of the WHO.ResultsThe prevalence of overweight and obesity in Burkina Faso were 13.82% (95% CI: 12.25 to 15.55) and 4.84% (95% CI: 3.99 to 5.86), respectively. Among men, the proportional odds of overweight/obesity increase with urban residency (p<0.001), greater age (p<0.002), marital status different from single (p≤0.007) and decrease with current smoking (p=0.009). Among women, the proportional odds of overweight/obesity increase with urban residency (p<0.001), primary educational level (p=0.01), high total blood cholesterol level (p<0.001) and high fasting blood glucose level (p=0.02), and decrease with current smoking (p<0.001).ConclusionOur study showed that nearly one person out of five in the adult population of Burkina has an abnormal weight status with women being more affected than men. Urban residency is a consistent risk factor in both men and women. Alcohol consumption and education were associated with an increased odds in only women. Overnutrition needs to be recognised as an important public health issue in Burkina Faso and nutrition interventions need to be reshaped to account for it.

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Weight Status Influences Carotid Intima-Media Thickness to Executive Function Among Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.1183 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 367-368

Author(s):

Desiree Bygrave ◽

Regina Wright

Keyword(s):

Older Adults ◽

Executive Function ◽

Cognitive Function ◽

Verbal Fluency ◽

Weight Status ◽

Carotid Atherosclerosis ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Overweight And Obesity ◽

Media Thickness

Abstract Carotid atherosclerosis has emerged as an early predictor of reduced cognitive function. Underlying this association are risk factors, such as overweight and obesity, that promote carotid atherosclerosis and poor cognitive outcomes. Given the prevalence of overweight and obesity among older adults, there is a critical need to better understand how atherosclerosis influences cognitive function in the context of elevated weight. To address this gap, the current study examined relations between carotid atherosclerosis (carotid intima-media thickness [IMT]), and attention (Trailmaking Test) and executive function (Verbal Fluency Test) performance, and whether they varied as a function of weight status (body mass index [BMI] classification). Data were analyzed from 162 older adults (mean age = 68.43y, 34% male, 41% African American), free of major disease. Mutliple regression and analysis of variance analyses, adjusted for age, sex, education and mean arterial pressure, showed a statistically significant IMT x BMI interaction for Verbal Fluency performance (p=.04) and a trending IMT x BMI interaction for Trailmaking A performance (p=.05). Simple effects analysis of IMT and Verbal Fluency performance showed that this association was most pronounced among those who are obese. Findings suggest atherosclerosis may influence executive function in the context of obesity among older adults. As the development of carotid atherosclerosis is strongly related to aging, our findings suggest that maintaining a healthy weight may reduce its impact on executive function in older adulthood.

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