Exploring Maternal Factors Linked to Weight Status in Salvadorian Infants

Background: Obesity rates in the US have risen dramatically, especially among Hispanic adults and children. Because of the high prevalence of overweight and obesity in Latino children by preschool age, it is prudent to examine maternal factors potentially linked to weight status during an infant’s first year of life. The literature on risk factors of child obesity has focused primarily on children of Mexican descent, and little research exists for other Latino populations, such as Salvadorans. Objective: To investigate maternal physiologic and infant feeding factors associated with infant overweight and/or obesity in a sample of Salvadoran mother-infant dyads. Methods: A cross-sectional, correlational study, utilizing an ecological framework, was conducted at the 9-12-month well-baby visit in two private pediatric offices on Long Island, New York. Maternal physiologic risk factors and feeding beliefs as well as infant feeding practices during the first 5 months were self-reported by the mothers. Infants birth weight, current weight and recumbent length were retrieved from the electronic charts. Bivariate logistic regression models examined the relationship of the variables with infant weight status, \u3e 85th weight-for-length percentile (WFL) for sex. Results: In this sample of mothers (N=88), 94.3% were born in El Salvador, 92.1% were married, and the mean age was 28.5 years (SD = 5.9 years); 43% of the total sample of infants had a WFL \u3e 85th percentile. After controlling for maternal age, insurance type, income, education, and marital status, no significant associations with infant WFL \u3e 85th percentile at the 9-12-month well-visit were found. Infant feeding practices in the first five months and maternal physiologic risk factors were not associated with infant weight status. Infant birth weight (kg) was the only variable significantly associated with WFL \u3e 85th percentile, p \u3c .05. Conclusion: This is the first study to examine infant weight status in the Salvadoran population. Future studies should objectively investigate infant feeding practices and other potential contributing factors among Salvadoran mother-infant dyads, since nearly half of the infant sample had a WFL \u3e 85th percentile

Comorbidades físicas e psicológicas antes e depois da cirurgia bariátrica : um estudo longitudinal

Introduction: Morbid obesity has multiple implications for psychological and physical health. Bariatric surgery has been selected as the treatment of choice for this chronic disease, despite the controversial impact of the surgery on psychosocial health. The objective of this study was to describe candidates for bariatric surgery and analyze changes in weight, psychopathology, personality, and health problems and complaints at 6- and 12- month follow-up assessments. Methods: Thirty obese patients (20 women and 10 men) with a mean age of 39.17±8.81 years were evaluated in different dimensions before surgery and 6 and 12 months after the procedure. Results: Six and 12 months after bariatric surgery, patients reported significant weight loss and a significant reduction in the number of health problems and complaints. The rates of self-reported psychopathology were low before surgery, and there were no statistically significant changes over time. The conscientiousness, extraversion, and agreeableness dimensions increased, but neuroticism and openness remained unchanged. All changes had a medium effect size. Conclusions: Our results suggest that patients experience significant health improvements and some positive personality changes after bariatric surgery. Even though these findings underscore the role of bariatric surgery as a relevant treatment for morbid obesity, more in-depth longitudinal studies are needed to elucidate the evolution of patients after the procedure.Introdução: A obesidade mórbida tem várias implicações para a saúde psicológica e física. A cirurgia bariátrica tem sido o tratamento de escolha para essa doença crônica, apesar da controvérsia sobre o impacto da cirurgia na saúde psicossocial. O objetivo deste estudo foi descrever candidatos a cirurgia bariátrica e analisar mudanças no peso, psicopatologia personalidade, problemas e queixas de saúde desses pacientes em avaliações realizadas 6 e 12 meses após a cirurgia. Métodos: Trinta pacientes obesos (20 mulheres e 10 homens) com idade média de 39,17±8,81 anos foram avaliados em diferentes dimensões antes da cirurgia e 6 e 12 meses após. Resultados: Aos 6 e 12 meses após a cirurgia bariátrica, os pacientes relataram significativa perda de peso e significativa redução no número de problemas e queixas de saúde. As taxas de psicopatologia autorrelatada foram baixas antes da cirurgia e não sofreram mudanças significativas com o tempo. As dimensões conscienciosidade, extroversão e agradabilidade aumentaram, mas o neuroticismo e a abertura permaneceram inalteradas. Todas as mudanças apresentaram um tamanho de efeito médio. Conclusões: Os nossos resultados sugerem que os pacientes experimentam melhoras significativas em saúde e algumas mudanças positivas de personalidade após a cirurgia bariátrica. Embora esses achados reforcem o papel da cirurgia bariátrica como um tratamento relevante para a obesidade mórbida, mais estudos longitudinais e aprofundados são necessários para elucidar a evolução dos pacientes após a realização do procedimento.(undefined

A cluster-randomised feasibility trial of a children's weight management programme:the Child weigHt mANaGement for Ethnically diverse communities (CHANGE) study

Background: Community-based programmes for children with excess weight are widely available, but few have been developed to meet the needs of culturally diverse populations. We adapted an existing children's weight management programme, focusing on Pakistani and Bangladeshi communities. We report the evaluation of this programme to assess feasibility of programme delivery, acceptability of the programme to participants from diverse communities, and feasibility of methods to inform a future trial. Methods: A cluster-randomised feasibility trial was undertaken in a large UK city. Children's weight management programmes (n = 24) were randomised to be delivered as the adapted or the standard programme (2:1 ratio). Routine data on participant attendance (n = 243) at the sessions were used to estimate the proportion of families completing the adapted and standard programmes (to indicate programme acceptability). Families planning to attend the programmes were recruited to participate in the feasibility study (n = 92). Outcome data were collected from children and parents at baseline, end of programme, and 6 months post-programme. A subsample (n = 24) of those attending the adapted programme participated in interviews to gain their views of the content and delivery and assess programme acceptability. Feasibility of programme delivery was assessed through observation and consultation with facilitators, and data on costs were collected. Results: The proportion of Pakistani and Bangladeshi families and families of all ethnicities completing the adapted programme was similar: 78.8% (95% CI 64.8-88.2%) and 76.3% (95% CI 67.0-83.6%) respectively. OR for completion of adapted vs. standard programme was 2.40 (95% CI 1.32-4.34, p = 0.004). The programme was feasible to deliver with some refinements, and participant interview data showed that the programme was well received. Study participant recruitment was successful, but attrition was high (35% at 6 months). Data collection was mostly feasible, but participant burden was high. Data collection on cost of programme delivery was feasible, but costs to families were more challenging to capture. Conclusions: This culturally adapted programme was feasible to deliver and highly acceptable to participants, with increased completion rates compared with the standard programme. Consideration should be given to a future trial to evaluate its clinical and cost-effectiveness. Trial registration: ISRCTN81798055, registered: 13/05/2014

Randomized trial of achieving healthy lifestyles in psychiatric rehabilitation: the ACHIEVE trial

<p>Abstract</p> <p>Background</p> <p>Overweight and obesity are highly prevalent among persons with serious mental illness. These conditions likely contribute to premature cardiovascular disease and a 20 to 30 percent shortened life expectancy in this vulnerable population. Persons with serious mental illness need effective, appropriately tailored behavioral interventions to achieve and maintain weight loss. Psychiatric rehabilitation day programs provide logical intervention settings because mental health consumers often attend regularly and exercise can take place on-site. This paper describes the Randomized Trial of Achieving Healthy Lifestyles in Psychiatric Rehabilitation (ACHIEVE). The goal of the study is to determine the effectiveness of a behavioral weight loss intervention among persons with serious mental illness that attend psychiatric rehabilitation programs. Participants randomized to the intervention arm of the study are hypothesized to have greater weight loss than the control group.</p> <p>Methods/Design</p> <p>A targeted 320 men and women with serious mental illness and overweight or obesity (body mass index ≥ 25.0 kg/m²) will be recruited from 10 psychiatric rehabilitation programs across Maryland. The core design is a randomized, two-arm, parallel, multi-site clinical trial to compare the effectiveness of an 18-month behavioral weight loss intervention to usual care. Active intervention participants receive weight management sessions and physical activity classes on-site led by study interventionists. The intervention incorporates cognitive adaptations for persons with serious mental illness attending psychiatric rehabilitation programs. The initial intensive intervention period is six months, followed by a twelve-month maintenance period in which trained rehabilitation program staff assume responsibility for delivering parts of the intervention. Primary outcomes are weight loss at six and 18 months.</p> <p>Discussion</p> <p>Evidence-based approaches to the high burden of obesity and cardiovascular disease risk in person with serious mental illness are urgently needed. The ACHIEVE Trial is tailored to persons with serious mental illness in community settings. This multi-site randomized clinical trial will provide a rigorous evaluation of a practical behavioral intervention designed to accomplish and sustain weight loss in persons with serious mental illness.</p> <p>Trial Registration</p> <p>Clinical Trials.gov NCT00902694</p

The Efficacy of Energy-Restricted Diets in Achieving Preoperative Weight Loss for bariatric Pateints: A Systematic Review

The final publication is available at Springer via https://doi.org/10.1007/s11695-018-3451-1In bariatric practice, a preoperative weight loss of at least 5% is recommended. However, the hypocaloric diets prescribed vary and no consensus exists. This study examined the efficacy of preoperative diets in achieving 5% weight loss. From a systematic literature search, eight randomised controlled trials (n = 862) were identified. Half of the trials used a Bvery-low-calorie diet^ whilst the rest employed a Blow-calorie diet^. Only five diets achieved ≥ 5% weight loss over varying durations and energy intakes. By inference, compliance with a 700–1050 kcal (2929–4393 kJ) diet, consisting of moderate carbohydrate, high protein and low/moderate fat, for 3 weeks is likely to achieve 5% weight loss. A low-carbohydrate diet (< 20 g/day) may achieve this target within a shorter duration. Additional research is required to validate these conclusions