Exploring Food Insecurity among Individuals with Serious Mental Illness: A Qualitative Study

Individuals with serious mental illness (SMI) are likely highly vulnerable to food insecurity, yet this issue remains unexplored within this population. METHODS: A mixed method approach to assess the prevalence and underlying factors was conducted. Food security status was assessed within a convenience sample of 72 community-dwelling individuals with SMI. Semi-structured interviews (n=28) and focus groups (n=4) were subsequently conducted. RESULTS: Within the sample, 45.8% were classified as food insecure, with 29.2% identified as very low food secure. While classic food insecurity barriers (e.g. lack of transportation, fixed income, inadequate resources, etc) were identified, these factors were further compounded by symptoms associated with mental illness. CONCLUSIONS: In comparison to national data, this SMI sample was nearly 8 times more likely to report food insecurity. Information discovered during interviews and focus groups will enable researchers to tailor a food security intervention uniquely suited to address the challenges presented within this population

Diet Quality of Overweight and Obese Adults with Intellectual and Developmental Disbilities as Measured by the Healthy Eating Index-2005

BACKGROUND: Little research has been conducted to examine diet quality of overweight and obese adults with intellectual and developmental disabilities (IDD) in the United States. The purpose of this study was to determine diet quality, as measured by the Healthy Eating Index-2005 (HEI-2005), of overweight and obese adults with IDD. METHODS: Data were obtained from community-dwelling overweight individuals. 3-day food records were administered and completed with assistance by staff or family members and then reviewed by a dietitian. All records were analyzed and HEI-2005 was calculated using NDSR output. RESULTS: 178 records were analyzed from 70 subjects (28 male, 42 female; mean age 33.9 ±11.5 years). The mean energy intake was 1928 ± 891 kcals and the mean total HEI-2005 score was 46.7± 11.5. Participants scored the lowest in total fruits, whole grains, dark green and orange vegetables, non-hydrogenated vegetable oils, and sodium. Both male and females had diets deficient in fiber, vitamin A, vitamin D, vitamin E, folate, and potassium. Additionally men were deficient in vitamin K, and women were deficient in calcium. CONCLUSIONS: Overweight and Obese adults with IDD had a lower HEI-2005 score compared to the general population and are at an increased risk of poor diet quality and nutritional deficiencies that could contribute to the development of diabetes, cardiovascular disease, cancer and other health complication

The use of TeleMedicine in the Treatment of Pediatric Obesity: Feasibility and Acceptability

This is the peer reviewed version of the following article: Davis, A. M., James, R. L., Boles, R. E., Goetz, J. R., Belmont, J. and Malone, B. (2011), The use of TeleMedicine in the treatment of paediatric obesity: feasibility and acceptability. Maternal & Child Nutrition, 7: 71–79. doi:10.1111/j.1740-8709.2010.00248.x, which has been published in final form at http://doi.org/10.1111/j.1740-8709.2010.00248.x. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.OBJECTIVE: To assess the feasibility of conducting empirically supported family based pediatric obesity group treatment via telemedicine. METHODS: Seventeen families were randomly assigned to one of two conditions (physician visit, TeleMedicine). Measures included feasibility, satisfaction, and intervention outcome measures such as BMI percentile, and nutrition and activity behaviors. Measures were completed at baseline, post-treatment, and at one-year follow-up. RESULTS: Analyses indicate that both feasibility and satisfaction data regarding the TeleMedicine intervention were positive. Intervention outcome indicates no change in BMI percentile or nutrition and activity behaviors for either treatment group. CONCLUSIONS: A behavioral family-based weight loss intervention delivered via TeleMedicine was well received by both parents and providers. Due to the small sample size, null findings regarding intervention outcome should be interpreted with caution. Future research should focus on methods to increase the impact of this intervention on key outcome variables

The Midwest Exercise Trial for the Prevention of Weight Regain: MET POWeR

Weight reduction in overweight and obese individual’s results in physiological and behavioral changes that make the prevention of weight regain more difficult than either initial weight loss or the prevention of weight gain. Exercise is recommended for the prevention of weight regain by both governmental agencies and professional organizations. To date, the effectiveness of exercise recommendations for the prevention of weight regain has not been evaluated in a properly designed, adequately powered trial. Therefore, we will conduct a randomized trial to evaluate the effectiveness of 3 levels of exercise on the prevention of weight regain, in initially overweight and obese sedentary men and women. Participants will complete a 3 month weight loss intervention of decreased energy intake (EI) and increased exercise (100 minutes/week). Participants achieving clinically significant weight loss (≥ 5% of initial weight), will then be randomly assigned to 12 months of verified exercise at 3 levels (150, 225 or 300 minutes/week). This study will evaluate: 1) the effectiveness of 3 levels of exercise on the prevention of weight regain over 12 months subsequent to clinically significant weight loss (≥ 5%); 2) gender differences in weight regain in response to 3 levels of exercise; and 3) potential compensatory changes in daily physical activity (PA) and EI on weight regain in response to 3 levels of exercise. Results of this investigation will provide information to develop evidenced based recommendations for the level of exercise associated with the prevention of weight regain

Weight management by phone conference call: A comparision with a traditional face-to-face clinic. Rationale and design for a randomized equivalence trial

State-of-the-art treatment for weight management consists of a behavioral intervention to facilitate decreased energy intake and increased physical activity. These interventions are typically delivered face-to-face (FTF) by a health educator to a small group of participants. There are numerous barriers to participation in FTF clinics including availability, scheduling, the expense and time required to travel to the clinic site, and possible need for dependent care. Weight management clinics delivered by conference call have the potential to diminish or eliminate these barriers. The conference call approach may also reduce burden on providers, who could conduct clinic groups from almost any location without the expenses associated with maintaining FTF clinic space. A randomized trial will be conducted in 395 overweight/obese adults (BMI 25–39.9 kg/m2) to determine if weight loss (6 months) and weight maintenance (12 months) are equivalent between weight management interventions utilizing behavioral strategies and pre-packaged meals delivered by either a conference call or the traditional FTF approach. The primary outcome, body weight, will be assessed at baseline, 6, 12 and 18 months. Secondary outcomes including waist circumference, energy and macronutrient intake, and physical activity and will be assessed on the same schedule. In addition, a cost analysis and extensive process evaluation will be completed

Weight management for individuals with intellectual and developmental disabilities: Rationale and design for an 18 month randomized trial

Weight management for individuals with intellectual and developmental disabilities (IDD) has received limited attention. Studies on weight management in this population have been conducted over short time frames, in small samples with inadequate statistical power, infrequently used a randomized design, and have not evaluated the use of emerging effective dietary strategies such as pre-packaged meals (PMs). Low energy/fat PMs may be useful in individuals with IDD as they simplify meal planning, limit undesirable food choices, teach appropriate portion sizes, are convenient and easy to prepare, and when combined with fruits and vegetables provide a high volume, low energy dense meal. A randomized effectiveness trial will be conducted in 150 overweight/obese adults with mild to moderate IDD, and their study partners to compare weight loss (6 months) and weight maintenance (12 months) between 2 weight management approaches: 1. A Stop Light Diet enhanced with reduced energy/fat PMs (eSLD); and 2. A recommended care reduced energy/fat meal plan diet (RC). The primary aim is to compare weight loss (0–6 months) and weight maintenance (7–18 months) between the eSLD and RC diets. Secondarily, changes in chronic disease risk factors between the eSLD and RC diets including blood pressure, glucose, insulin, LDL-cholesterol, and HDL-cholesterol will be compared during both weight loss and weight maintenance. Finally, potential mediators of weight loss including energy intake, physical activity, data recording, adherence to the diet, study partner self-efficacy and daily stress related to dietary change will be explored

College student sleep quality and mental and physical health are associated with food insecurity in a multi-campus study

Objective: To assess the relationship between food insecurity, sleep quality, and days with mental and physical health issues among college students. Design: An online survey was administered. Food insecurity was assessed using the ten-item Adult Food Security Survey Module. Sleep was measured using the nineteen-item Pittsburgh Sleep Quality Index (PSQI). Mental health and physical health were measured using three items from the Healthy Days Core Module. Multivariate logistic regression was conducted to assess the relationship between food insecurity, sleep quality, and days with poor mental and physical health. Setting: Twenty-two higher education institutions. Participants: College students (n 17 686) enrolled at one of twenty-two participating universities. Results: Compared with food-secure students, those classified as food insecure (43·4 %) had higher PSQI scores indicating poorer sleep quality (P \u3c 0·0001) and reported more days with poor mental (P \u3c 0·0001) and physical (P \u3c 0·0001) health as well as days when mental and physical health prevented them from completing daily activities (P \u3c 0·0001). Food-insecure students had higher adjusted odds of having poor sleep quality (adjusted OR (AOR): 1·13; 95 % CI 1·12, 1·14), days with poor physical health (AOR: 1·01; 95 % CI 1·01, 1·02), days with poor mental health (AOR: 1·03; 95 % CI 1·02, 1·03) and days when poor mental or physical health prevented them from completing daily activities (AOR: 1·03; 95 % CI 1·02, 1·04). Conclusions: College students report high food insecurity which is associated with poor mental and physical health, and sleep quality. Multi-level policy changes and campus wellness programmes are needed to prevent food insecurity and improve student health-related outcomes

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements