Understanding Eating and Exercise Behaviors in Post Roux-en-Y Gastric Bypass Patients: A Quantitative and Qualitative Study

Background: Weight regain following gastric bypass (GB) surgery continues to plague many individuals across the United States. However, understanding long-term eating and exercise behaviors to promote and sustain a lower weight following GB surgery is limited. Method: The purpose of this study was to explore the perceptions and attitudes of eating and exercise behaviors associated with weight maintenance in post-GB patients (n = 24) 2 or more years postsurgery. Demographic, anthropometric, and food record data were collected. Focus groups and personal interviews were used to understand behaviors and support systems associated with weight stabilization. Focus groups were audiotaped, transcribed, and organized into common themes. Results: All participants were female, with a mean of 6 years postsurgery, and had a mean age of 51.8 – 10.5 years. The majority were married (71%) and had a college degree (58%). Although the average weight regain postsurgery was estimated at 16.2 – 12.7 kg, most of the women (75%) had maintained a significant weight loss of at least 50% of their excess body weight. Themes associated with weight regain emerging from the focus groups included variable family support and a return to ‘‘old eating habits.’’ Conclusion: Focus group participants identified lack of long-term emotional support from family members and limited community support for weight loss surgery patients

The Medicine Wheel Nutrition Intervention: a Diabetes Education Study with the Cheyenne River Sioux Tribe

OBJECTIVE: The Northern Plains Indians of the Cheyenne River Sioux Tribe have experienced significant lifestyle and dietary changes over the past seven generations that have resulted in increased rates of diabetes and obesity. The objective of this study was to determine if Northern Plains Indians with type 2 diabetes mellitus who are randomized to receive culturally adapted educational lessons based on the Medicine Wheel Model for Nutrition in addition to their usual dietary education will have better control of their type 2 diabetes than a nonintervention, usual care group who received only the usual dietary education from their personal providers.DESIGN: A 6-month, randomized, controlled trial was conducted January 2005 through December 2005, with participants randomized to the education intervention or usual care control group. The education group received six nutrition lessons based on the Medicine Wheel Model for Nutrition. The usual care group received the usual dietary education from their personal providers.PARTICIPANTS: One hundred fourteen Northern Plains Indians from Cheyenne River Sioux Tribe aged 18 to 65 years, with type 2 diabetes.METHODS: Weight, body mass index (BMI), hemoglobin A1c, fasting serum glucose and lipid parameters, circulating insulin, and blood pressure were measured at the beginning and completion. Diet histories, physical activity, and dietary satiety surveys were measured at baseline and monthly through completion. Differences were determined using Student t tests, chi(2) tests, and analysis of variance.RESULTS: The ED group had a significant weight loss ( 1.4 ± 0.4 kg, mean ± standard error {SE}, P ≤ .05) and decrease in BMI (1.0 ± 0.1 means ± SE, P ≤ .05) from baseline to completion. The UC group had no change in weight (0.5 ± 0.5 kg, mean ± SE) or BMI (0.5 ± 0.2, mean ± SE). There were no between group differences due to intervention in calorie, carbohydrate, protein, and fat intake and physical activity.CONCLUSIONS: The culturally based nutrition intervention promoted small but positive changes in weight. Greater frequency and longer duration of educational support may be needed to influence blood glucose and lipid parameters

The Effects of Lean Beef Supplementation on the Iron Status of College Athletes

The purpose of this study was to determine whether weekly supplementation with nine ounces of prepackaged lean beef sticks could maintain the iron status of college endurance athletes. Thirty-four college endurance athletes (20 female, 14 male) were stratified by sex, baseline serum ferritin concentration, and use of iron supplements, and randomized into an intervention (n = 18) or control (n = 16) group. The participants in the intervention group supplemented their usual diet with nine ounces of prepackaged lean beef sticks per week and a daily multivitamin/mineral supplement containing 18 mg iron. The participants in the control group consumed their normal diet and the daily multivitamin/mineral supplement only. Body composition, dietary intake, and blood markers of iron status (hemoglobin, hematocrit, serum iron, serum ferritin, and total iron binding capacity) were measured at baseline and postintervention. A two-way analysis of variance with group and time as treatment factors was used to determine the main effect of beef supplementation on variables measured. None of the participants in this study was categorized as iron deficient at baseline or postintervention. Heme iron intake was significantly greater (P , 0.003) in the intervention group (3.1 ± 0.3 mg per day) than in the control group (1.5 ± 0.3 mg per day) as a result of the intervention. The intervention participants had significant improvements in hematocrit concentrations; there were, however, no differences in blood iron parameters of serum iron, hemoglobin, serum ferritin, or total iron binding capacity as a result of the intervention. The results of this study suggest that daily intake of bioavailable iron may attenuate the effects of exercise on the iron status of endurance athletes

Food Preferences in Patients After Roux-en Y Gastric Bypass Surgery: A Pilot Study Examining Eating Behaviors and Weight Maintenance

In a cross-sectional pilot study, we examined eating behaviors in patients (N= 24) approximately 6 years after gastric bypass surgery. Anthropometric measures, personal interviews, and 7 days of food records were collected. A mean body mass index of 33.7±8 was reported, with 75%(18/24) sustaining a weight loss 50% or more of their excess body weight. A mean total caloric intake of 1429±411 cal was reported: 43% carbohydrate, 17% protein, and 39% fat. Subjects reported “returning to old eating habits” with a diet high in liquid calories (soda, coffee drinks, sports drinks, alcohol), sweets (chocolate, cookies), convenience foods, and fast food consumption

Jumpin’ Jacks: Social Marketing Campaign Aimed to Increase Awareness of Healthful Behavior in South Dakota Fourth Grade Students

This study investigated the influence of utilizing a collegiate mascot as a marketing tool for the promotion of fruit and vegetable intake and physical activity among 4th grade students. The program utilized service learning and formative research for the development of a social marketing campaign comprised of nutrition education and brand marketing. A pre-test/post-test design was used to measure fruit and vegetable intake and physical activity in participants in intervention and control schools. Awareness and understanding of the campaign was assessed post-intervention. There were no changes in fruit and vegetable intake or physical activity. However, 91% of the intervention students were able to correctly report understanding of the campaign messages, and approximately one-third of the participants were able to recall the campaign without any prompts. Results demonstrated how a social marketing campaign can utilize branding techniques to bring about awareness, which is an essential step in initiating behavior change

The Effectiveness of Telemedicine for Weight Management in the MOVE! Program

PURPOSE: To examine the effectiveness of videoconferencing technology for delivering comprehensive weight management treatment.METHODS: This retrospective cohort study was conducted by extraction of data from medical records for the years 2008-2010. The treatment included a series of 12 weekly MOVE!® classes delivered using videoconferencing. Data were extracted from the time of baseline weight to 1 year after baseline weight for the MOVE! participants (n = 60) and from a concurrent control group (n = 60) that did not participate in MOVE! treatment.FINDINGS: Results indicated that the MOVE! group lost weight while the control group gained weight, resulting in a mean difference between the groups of -5.5 ± 2.7 kg (95% CI = -8.0 to -3.0; P \u3c .0001).CONCLUSIONS: These results indicate that videoconferencing is an effective method to provide the MOVE! Weight Management Program to veterans. Weight loss was maintained for one year after baseline in the MOVE! group. This is very promising as weight re-gain is a common issue and these results support using videoconferencing for a long-term weight management treatment option

Assessing Physical Activity Determinants in Urban Settings: Comparison of Perceptions and Environmental Audit Findings

Sedentary lifestyles are a contributor to obesity and urban adolescents are less physically active than rural adolescents. Supportive physical activity environments, understood as the geography, observations, and perceptions of features such as recreational facilities, sidewalks, bike lanes, traffic patterns, etc., have been positively associated with adolescent physical activity behaviors within urban settings. As part of a Socio-Ecological intervention to improve physical activity behavior, the Physical Activity Resource Assessment (PARA), the Active Neighborhood Checklist (ANC), and focus groups were used to assess the physical activity influences within an urban middle school and surrounding community. The assessments suggested that lack of parks, lack of walkability in the streets, perceptions of crime, lack of school programs, parental and peer influences were barriers to physical activity opportunities. The ANC, PARA, and focus groups each added valuable information for program planning to improve adolescent physical activity behavior

Effects of Lean Beef Supplementation on Iron Status, Body Composition and Performance of Collegiate Distance Runners

Iron deficiency is prevalent among endurance athletes, particularly females. Low iron may compromise oxygen delivery and physical performance. Vegetarianism, desire for convenience, and perceived health risks associated with red meat contribute to low bioavailable iron intakes. The purpose of this study was to examine if lean beef supplementation would maintain iron status, improve body composition and increase performance of distance runners after 8 weeks. Twenty-eight (14 female) Division-I cross-country runners were stratified by iron status, use of iron supplements, and gender, and randomized into a control (n = 14) and intervention group. All participants maintained their typical diet and consumed a daily multivitamin, while the intervention group consumed 9 ounces of lean beef weekly. Dietary intake (total iron, heme-iron, protein, zinc), body composition, VO2max, and iron status (hemoglobin, hematocrit, serum iron, serum ferritin, total iron binding capacity [TIBC]) were measured at baseline and post-intervention. The intervention group had greater intakes of total and heme-iron. There were no group differences in amino acids, protein, or calories. Both groups had a significant body fat increase and lean mass decease over time. There was a significant VO2max in- crease over time in both groups. There were no group differences due to the intervention in serum ferritin, hemoglobin, serum iron, and TIBC. There was a significant difference in hematocrit between groups as a result of the intervention. In conclusion, increasing bioavailable iron from red meat may have effects on body composition and maintenance of blood iron markers; however, its direct impact on performance among endurance athletes is unclear

Ignite-Sparking Youth to Create Healthy Communities: A Protocol for a Community-Centered Effort for the Prevention of Adolescent Obesity

Objective: To observe outcomes of a community-centered approach to identifying behavioral and environmental factors that influence overweight and obesity in 6th-8th grade youth in selected lowincome, racial/ethnic communities. Design: Five-year, tri-state, quasi-experimental design with environmental assessments and a questionnaire measuring nutrition and physical activity knowledge and behavior conducted in all communities at pre and post. Setting: Low-income, minority communities targeting 6th-8th grade youth. Participants: One experimental and one control communities will be selected via each state’s Cooperative Extension network through an application and review process with the random selection of participating communities. Intervention(s): Academic institutions will work with community leaders to establish and help support community committees tasked to plan, implement and evaluate one nutrition and one physical activity intervention. Main Outcome Measure(s): Assess environmental changes associated with increased intake and variety of fruits and vegetables; decreased intake of foods high in solid fats and added sugars; and an increase in physical activity among 6th-8th grade youth. Analysis: Baseline and post environmental data and pre and post questionnaire data will be analyzed using t-tests, chi-square, and ANOVA with a p < 0.05 to establish statistical significance

Traditional Open-bay Versus Single-family Room Neonatal Intensive Care Unit: a Comparison of Selected nutrition Outcomes

Background: In contrast to the traditional open-bay–type design of the neonatal intensive care unit (tNICU), infants in developmentally appropriate NICU (dNICU) are housed in individual rooms with greater control of light and noise. Previous reports have documented positive influence of the dNICU in cardiorespiratory status, physiologic stability, and weight gain of the infants. The objective of this study was to explore selected nutrition outcomes of infants in the dNICU versus tNICU. Method: A prospective cohort study was conducted on infants with birth weight of 1500 g or less cared for in dNICU (n = 42) or tNICU (n = 31). Differences between days to reach full parenteral nutrition, full enteral nutrition, or full bottling were determined using analysis of covariance controlling for gestational age, birth weight, and clinical risk index for babies (CRIB) acuity score. Results: There were no differences between the two groups in days to reach full parenteral and bottle feeding. The infants in the dNICU took fewer days to reach full enteral nutrition (20.8 days, 95% confidence intervals [CI]: 17, 24.6 (dNICU) vs 23.3 days, 95% CI: 17.1, 29.6 (tNICU), P = 0.04) than those in the tNICU. Conclusions: Although the two groups of infants only differed in the days to reach full enteral feeding, it is important to remember that the lack of difference may be clinically significant. Clinically, the infants in the dNICU were younger (gestational age) and sicker (CRIB acuity score) than the infants in the tNICU. Consequently, the results of this study support the change to dNICU, as the private room model provides a supportive environment for growth as evidenced by similar nutritional outcome measures. More research is needed to determine the effect of the dNICU on nutrition outcomes