Three- and Five-Year Follow-Up of a Combined Inpatient-Outpatient Treatment of Obese Children and Adolescents

Aim. “The combined DAK therapy for obesity in children and adolescents” combines a 6-week inpatient with a 10.5-month outpatient treatment. The aim of the study is to evaluate whether the therapeutic achievements are maintained two and four years after intervention. Method. All subjects who had participated in the 12-month program in 2004/2005 were included in the follow-up study. Body weight, height, and physical fitness were assessed through direct measurements, behaviour, and quality of life by self-report questionnaires. Statistical analysis is based on an intention-to-treat analysis. Results. The response rate after three years was 63.4% and 42.2% after five years. Within three years, participants reduced their BMI-SDS significantly by 0.20 (SD 0.49) and by 0.15 (SD 0.51) within five years. Significant positive changes could be observed with respect to the participants eating behaviour. Similarly, the food intake, particularly the consumption of calorie-reduced beverages, increased significantly while that of nonrecommended foods decreased. Improvement was also seen in the subjective quality of life as well as several aspects of self-perception. Conclusion. Compared to baseline data, significant reduction of BMI-SDS and positive changes of health-related behaviours could be observed even three and five years after the start of the initial program

Three-and Five-Year Follow-Up of a Combined Inpatient-Outpatient Treatment of Obese Children and Adolescents

Aim. "The combined DAK therapy for obesity in children and adolescents" combines a 6-week inpatient with a 10.5-month outpatient treatment. The aim of the study is to evaluate whether the therapeutic achievements are maintained two and four years after intervention. Method. All subjects who had participated in the 12-month program in 2004/2005 were included in the followup study. Body weight, height, and physical fitness were assessed through direct measurements, behaviour, and quality of life by self-report questionnaires. Statistical analysis is based on an intention-to-treat analysis. Results. The response rate after three years was 63.4% and 42.2% after five years. Within three years, participants reduced their BMI-SDS significantly by 0.20 (SD 0.49) and by 0.15 (SD 0.51) within five years. Significant positive changes could be observed with respect to the participants eating behaviour. Similarly, the food intake, particularly the consumption of calorie-reduced beverages, increased significantly while that of nonrecommended foods decreased. Improvement was also seen in the subjective quality of life as well as several aspects of self-perception. Conclusion. Compared to baseline data, significant reduction of BMI-SDS and positive changes of health-related behaviours could be observed even three and five years after the start of the initial program

Cognitive and weight-related correlates of flexible and rigid restrained eating behaviour

Objectives: Examine the association between components of restrained eating, cognitive performance and weight loss maintenance. Methods: 106 women, all members of a commercial slimming organisation for at least 6. months (mean ± SD: 15.7 ± 12.4 months), were studied who, having lost 10.1 ± 9.7 kg of their initial weight, were hoping to sustain their weight loss during the 6. month study. Dietary restraint subcomponents flexible and rigid restraint, as well as preoccupying cognitions with food, body-shape and diet were assessed using questionnaires. Attentional bias to food and shape-related stimuli was measured using a modified Stroop test. Working memory performance was assessed using the N-back test. These factors, and participant weight, were measured twice at 6. month intervals. Results: Rigid restraint was associated with attentional bias to food and shape-related stimuli (r = 0.43, p < 0.001 resp r = 0.49, p < 0.001) whereas flexible restraint correlated with impaired working memory (r = - 0.25, p < 0.05). In a multiple regression analyses, flexible restraint was associated with more weight lost and better weight loss maintenance, while rigid restraint was associated with less weight loss. Conclusions: Rigid restraint correlates with a range of preoccupying cognitions and attentional bias to food and shape-related stimuli. Flexible restraint, despite the impaired working memory performance, predicts better long-term weight loss. Explicitly encouraging flexible restraint may be important in preventing and treating obesity. © 2012 Elsevier Ltd

Impact of different food label formats on healthiness evaluation and food choice of consumers: a randomized-controlled study

Abstract Background Front of pack food labels or signpost labels are currently widely discussed as means to help consumers to make informed food choices. It is hoped that more informed food choices will result in an overall healthier diet. There is only limited evidence, as to which format of a food label is best understood by consumers, helps them best to differentiate between more or less healthy food and whether these changes in perceived healthiness result in changes of food choice. Methods In a randomised experimental study in Hamburg/Germany 420 adult subjects were exposed to one of five experimental conditions: (1) a simple "healthy choice" tick, (2) a multiple traffic light label, (3) a monochrome Guideline Daily Amount (GDA) label, (4) a coloured GDA label and (5) a "no label" condition. In the first task they had to identify the healthier food items in 28 pair-wise comparisons of foods from different food groups. In the second task they were asked to select food portions from a range of foods to compose a one-day's consumption. Differences between means were analysed using ANOVAs. Results Task I: Experimental conditions differed significantly in the number of correct decisions (p Conclusion Different food label formats differ in the understanding of consumers. The current study shows, that German adults profit most from the multiple traffic light labels. Perceived healthiness of foods is influenced by this label format most often. Nevertheless, such changes in perceived healthiness are unlikely to influence food choice and consumption. Attempts to establish the informed consumer with the hope that informed choices will be healthier choices are unlikely to change consumer behaviour and will not result in the desired contribution to the prevention of obesity and diet related diseases.</p

Food offerings on board and dietary intake of European and Kiribati seafarers - cross-sectional data from the seafarer nutrition study -

Abstract Background Overweight and cardiovascular risk factors are a common phenomenon in seafarers. According to internal observation particularly crew members from the Pacific Island State of Kiribati are exposed to a high risk. However, in mixed crews, cultural background plays an important role, influencing food choice, and the actual risk. Methods The Seafarer Nutrition Study (SeaNut study) compared dietary factors in 48 Kiribati and 33 European male seafarers recruited from four merchant ships with a high level of Kiribati manning within a German shipping company. Analysis encompassed the assessment of dietary quality on board, satisfaction with prepared dishes, and individual food intake obtained from 24-h recalls in comparison with nutritional recommendations. Results The overall supply of meat, fat and eggs was more than double, whereas the proportions of fruits, vegetables, dairy products and cereals were much lower than recommended. Based on the reported food choices, both groups, but notably Kiribati seafarers, did not reach reference values as to macronutrient, micronutrient and fiber intake. In addition, satisfaction with the meals served, food preferences and knowledge about a healthy diet varied markedly between Kiribati and Europeans. Conclusions The present analysis of the SeaNut study revealed the necessity of future health intervention programs, including the quality of the food supply as well as information about a healthy diet and adequate food selection. In mixed crews, culture-specific differences should be considered, in order to facilitate the long-term success of interventions. Trial registration German Clinical Trials Registry DRKS00010819 retrospectively. Registered 18 July 2016 (www.germanctr.de)

Cultural differences in food and shape related attitudes and eating behavior are associated with differences of Body Mass Index in the same food environment: cross-sectional results from the Seafarer Nutrition Study of Kiribati and European seafarers on merchant ships

Abstract Background Overweight and obesity is quite prevalent among seafarers. The present study examined differences in BMI and their association with weight, shape and nutrition related attitudes and perceptions among seafarer from Kiribati, a Pacific Island Group, and European origin. Methods The Seafarer Nutrition Study compared 48 Kiribati and 33 European male seafarers from 4 commercial merchant ships. BMI was calculated from measured weight and height. Attitudes to weight, shape and nutrition and disinhibition of control as a characteristic of eating behavior were assessed in a structured interview. Differences between the two groups were examined using t-tests and Chi-square-tests as appropriate. Associations between the variables were examined using Multiple Regression Analysis (MRA) and correlations. Results Kiribati seafarer had significantly higher BMI than Europeans (30.3 ± 4.2 vs. 25.6 ± 3.4; p < 0.001). However, MRA indicated that Kiribati were choosing thinner shapes as being “most similar” to their appearance than Europeans with the same BMI (B = − 1.14; p < 0.05). In addition, Kiribati had significantly higher scores of disinhibition than Europeans (5.6 ± 2.2 vs. 4.3 ± 2.1; p < 0.01), and disinhibition correlated with BMI in the Kiribati (r = 0.39; p < 0.01), but not in the European group (r = 0.17; n.s.). Conclusions For Kiribati seafarers the nutrition situation on board represents a highly tempting westernized food environment. Their tendency to disinhibited eating facilitates overconsumption and weight gain, and self-evaluation of their shapes as being thinner than comparable Europeans may hamper appropriate weight control behavior