Changes In Weight Status Research Articles

Development and evaluation of the lifestyle intervention “Obeldicks light” for overweight children and adolescents

AimSpecific interventions for overweight but not obese children have not been established yet. Therefore, we developed the methods, materials, and an evaluation protocol for a lifestyle intervention for overweight children based on an intervention for obese children.Subjects and methodsThe 1-year lifestyle intervention “Obeldicks” for obese children, compromised of physical activity plans, nutritional education, and behavioural counselling, including individual psychological care for both children and their parents, was shortened, reducing the amount of exercise training and individual counselling by about 50%, forming a 6-month intervention (“Obeldicks light”).ResultsThe evaluation protocol was based on guidelines and validated instruments with available German healthy normal-weight controls. As the ideal study design, a multicentre randomised controlled trail with the primary outcome change of weight status was identified. As secondary outcomes, improvement of body composition (skinfold thickness, bioimpedance analysis), cardiovascular risk factors (blood pressure, waist circumference), quality of life, dietary habits, eating, exercise, and sedentary behaviour were established. Potential influencing factors for treatment success were identified, such as parental BMI, ethnicity, and socioeconomic status. All proposed instruments were validated in the German representative KiGGS and DONALD study.ConclusionsAdapting a well-established program for obese children to overweight children is an easy way to create a lifestyle intervention for overweight children. Our study protocol using instruments validated in German normal weight cohorts allows evaluating this new intervention.

Interrelationships Among Changes in Leptin, Insulin, Cortisol and Growth Hormone and Weight Status in Youth

Objective: While acute alterations in leptin, insulin, cortisol and growth hormone (GH) levels have been reported in children following weight change interventions, little is known about natural hormonal changes as children grow and how these changes are affected by unprovoked weight status changes. The purpose of this investigation was to compare changes in leptin, insulin, cortisol and GH levels in youth who maintained their weight status vs. those who moved from normal weight to overweight or vice versa. Methods: Data were collected from 120 youth at baseline (9.8±1.0 years) and two years later. Participants were selected from a larger cohort to represent all scenarios of weight status: normal weight [>5th and <85th body mass index (BMI) percentile] at both time points (NN), overweight (≥85th BMI percentile) at both time points (OO), normal weight status who changed to overweight (NO) and overweight status which changed to normal weight (ON). Hormonal concentrations were measured from fasting venous blood. Results: In youth who changed their weight status, there were significant associations (p<0.05) between changes in BMI percentile and changes in leptin, insulin and cortisol (partial R2= 0.35, 0.13 and 0.11, respectively), after accounting for race, sex and changes in pubertal status and aerobic power. Our key findings were that youth who became overweight (NO) showed greater changes for leptin (+205% vs. -21%) and cortisol (-33% vs. +13%), p<0.05 than those who reverted from overweight to normal weight (ON).Conclusion: Natural changes in weight status in youth show a relationship with changes in leptin, insulin and cortisol levels and the hormonal changes appear to be more sensitive to increases, rather than reductions, in weight status. Conflict of interest:None declared.

Young Children's Weight Trajectories and Associated Risk Factors: Results from the Early Childhood Longitudinal Study–Birth Cohort

To estimate the prevalence of U.S. children's overweight risk and obesity at age 9 months and at age 2 years, to assess weight changes between the two periods, and to examine relationships between weight status (i.e., normal, at risk, or obese) changes and demographic variables. Analyses of children's early weight trajectories and related demographic characteristics from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) are presented. United States. The 9-month-old (n = 8900) and 2-year-old (n = 7500) ECLS-B waves were used to generate nationally representative estimates of obese and at-risk children born in 2001. Measures included child's sex, race/ethnicity, socioeconomic status, community locale, geographic region, and weight status. Logistic and multinomial logistic regression models were used to determine the odds of children's demographic characteristics being related to weight persistence, loss, or gain. Approximately one-third of U.S. children were either at risk or obese at 9 months (31.9%) and at 2 years (34.3%). Some children were at greater risk (e.g., Hispanics and low socioeconomic status children), while others had reduced risk (e.g., females and Asian/Pacific Islanders). Additional results from two trajectory models generally corroborated patterns of status change due to weight gain. Between age 9 months and age 2 years, U.S. children consistently moved toward less desirable weight status. Obesity risk was not uniform across demographic subgroups, suggesting that health policy might focus on those children at greatest risk.

The Association of Unintentional Changes in Weight, Body Composition, and Homeostasis Model Assessment Index with Glycemic Progression in Non-Diabetic Healthy Subjects

BackgroundWe performed a retrospective longitudinal study on the effects of changes in weight, body composition, and homeostasis model assessment (HOMA) indices on glycemic progression in subjects without diabetes during a four-year follow-up period in a community cohort without intentional intervention.MethodsFrom 28,440 non-diabetic subjects who participated in a medical check-up program in 2004, data on anthropometric and metabolic parameters were obtained after four years in 2008. Body composition analyses were performed with a bioelectrical impedance analyzer. Skeletal muscle index (SMI, %) was calculated with lean mass/weight×100. Subjects were divided into three groups according to weight change status in four years: weight loss (≤-5.0%), stable weight (-5.0 to 5.0%), weight gain (≥5.0%). Progressors were defined as the subjects who progressed to impaired fasting glucose or diabetes.ResultsProgressors showed worse baseline metabolic profiles compared with non-progressors. In logistic regression analyses, the increase in changes of HOMA-insulin resistance (HOMA-IR) in four years presented higher odds ratios for glycemic progression compared with other changes during that period. Among the components of body composition, a change in waist-hip ratio was the strongest predictor, and SMI change in four years was a significant negative predictor for glycemic progression. Changes in HOMA β-cell function in four years was a negative predictor for glycemic progression.ConclusionIncreased interval changes in HOMA-IR, weight gain and waist-hip ratio was associated with glycemic progression during a four-year period without intentional intervention in non-diabetic Korean subjects.

Emerging targets for the treatment of obesity

Rapid adaptation to a modernized lifestyle, characterized by reduced physical activity and increased consumption of a highcalorie and high-energy food, has resulted in a dramatic rise in the prevalence of being overweight and obese people in most industrialized countries. A recent report by the World Health Organization stated that there are more than one billion overweight adults worldwide, at least 300 million of whom are clinically obese. Obesity is a complex metabolic disorder affecting the whole body which can be attributed to either or both genetic background or environmental factors. Abnormalities in controlling fat content in the body are therefore defined by more than simply eating too much or exercising too little and linked to increased risk of developing a number of common, severe diseases, such as type 2 diabetes, cardiovascular disease, hypertension, stroke, cancer and nonalcoholic fatty liver, which contributes to nonalcoholic steatohepatitis. A weight loss of even a relatively small percentage (5%) has been shown to lead to significant improvement in cardiovascular risk factors in obese patients. However, lifestyle changes alone are usually insufficient to achieve and maintain even such modest weight loss in the morbidly obese. Surgery is a therapeutic option which has been shown to be effective in terms of both weight loss and reduction in morbidity and mortality related to obesity. However, the invasiveness, cost, lack of information on long-term effects and dearth of experienced bariatric surgeons have limited the use of surgery as a treatment option. Safe, effective pharmacological treatment is therefore desirable for patients with associated comorbid conditions who have been unable to maintain a healthy body weight range through diet and exercise alone. However, currently approved pharmacological therapies are limited with regard to efficacy and side-effect profiles, and are unable to achieve such weight maintenance in patients. Given these unmet needs, significant efforts are now being made to characterize molecular mechanisms of obesity that may lead to effective medical treatments and obesity prophylaxis. In this series, we review the therapeutic potential of several novel approaches and molecular targets for treating obesity, focusing on those tissues (brain, adipose, and liver) responsible for obesity. In the first minireview, Wolfgang and Lane focus on the hypothalamic area of the brain and outline the malonyl-CoA hypothesis, which targets the central regulation of energy homeostasis in the whole body. The authors also review the molecular mechanism of the neural system which detects changes in nutrient availability, body weight and adiposity status, focusing on the attractive molecular target CPT1c. The evidence shown in this article underscores the fact that the brain senses and responds to changes in nutrient availability and composition in order to moderate fat content in the body. In the second minireview, Kadomatsu et al. focus primarily on the effect of adipose tissue and liver on obesity and review the functions of novel drug targets ANGPTL2 and ANGPTL6 ⁄AGF, which are structurally similar to but functionally different from angiopoietin, in obesity and obesityrelated metabolic diseases. In the minireview, they discuss in depth that these adipocyte-derived inflammatory mediators may function as key molecules, linking obesity to systemic insulin resistance and circulating levels of these mediators may serve as a marker of obesity-induced metabolic abnormalities in the body. They also outline the function of these two targets that ANGPTL2 activates vascular inflammation and monocyte migration leading to the adipose tissue inflammation, while ANGPTL6/AGF enhances systemic energy expenditure, thereby exerting an anti-obesity effect. In the final minireview, Suwa et al. focus on the novel approach to regulation of adipocyte hyperplasia and describe the molecular functions of the drug target RMI1, which plays a pivotal role in adipocyte hyperplasia in rodents and humans. Recent evidence has indicated that increased adipocyte number is crucial in the development of severe obesity, and these authors present an overview of current findings supporting the notion that RMI1 inhibitor is a promising pharmacological option for controlling adipocyte hyperplasia. We hope that the information presented here about emerging targets functioning in the nerve center and peripheral tissues responsible for obesity will contribute to the research and development of new medicines for treating obesity as well as promoting science in general.

Behavioral and Psychological Factors Associated with 12-Month Weight Change in a Physical Activity Trial

Examining behavioral and psychological factors relating to weight stability over a 1-year period is of public health importance. We conducted a physical activity (PA) intervention trial for women (N = 247; mean age = 47.5 ± 10.7; mean BMI = 28.6 ± 5.3) in which participants were assigned to one of three groups (two PA and one contact-control). By Month 12, participants achieved 140.4 ± 14.82 min of PA/week, with no group differences. Weight status change from baseline to Month 12 was categorized: no change (N = 154; 62.4%); increase (N = 34; 13.8%); decrease (N = 59; 23.9%). Discriminant function analyses indentified two statistically significant dimensions associated with weight change. Dimension 1 was positively weighted by mood (0.73) and self-efficacy (0.79); dimension 2 was positively weighted to change in physical activity (0.58) and fat consumption (0.55). Results provide further evidence for the importance of behavior in long-term weight maintenance, particularly physical activity and dietary fat. These findings also provide evidence for the importance of addressing psychosocial variables, in particular depressed mood and self-efficacy.

Immersion treatment of childhood and adolescent obesity: the first review of a promising intervention

Obese children have attended weight loss camps and residential programmes for more than 40 years. This paper provides the first systematic review of the effects of those programmes. Twenty-two studies met inclusion criteria (targeted and assessed change in weight status, minimal stay of 10 days and nights). Similar components across programmes included controlled diet, activities, nutrition education, and therapy and/or education regarding behaviour change. Participants lost substantial amounts of weight in all 22 studies, as measured by reductions in per cent-overweight during intervention. Eleven programmes included long-term follow-up evaluations. Compared with results highlighted in a recent meta-analysis of out-patient treatments, these immersion programmes produced an average of 191% greater reductions in per cent-overweight at post-treatment and 130% greater reduction at follow-up. Furthermore, mean attrition rates were much lower when compared with standard out-patient treatment. Inclusion of a cognitive-behavioural therapy (CBT) component seemed especially promising; follow-up evaluations showed decreased per cent-overweight at follow-up by an average of 30% for CBT immersion programmes vs. 9% for programmes without CBT. Explanations for the potentially greater impact of immersion relative to out-patient treatments are presented, including possibly differential effects on self-efficacy for both children and their parents.

Migrant networks and pathways to child obesity in Mexico

The purpose of this paper is twofold: 1) to assess the link between migrant networks and becoming overweight or obese and 2) to explore the pathways by which migrant networks may contribute to the increasing overweight and obese population of children in Mexico. Using two waves of the Mexican Family Life Survey (MxFLS), we find that children and adolescents (ages 3 to 15) living in households with migrant networks are at an increased risk of becoming overweight or obese over the period of observation, relative to their peers with no migrant networks. Sedentary behavior and household-level measures of economic wellbeing explain some of the association between networks and changes in weight status, but the role of extended networks remains significant. Community-level characteristics related to migration do not account for any of the observed relationship between household-level networks and becoming overweight or obese.

Interventions Aimed at Decreasing Obesity in Children Younger Than 2 Years

To assess the evidence for interventions designed to prevent or reduce overweight and obesity in children younger than 2 years. MEDLINE, the Cochrane Central Register of Controlled Trials, CINAHL, Web of Science, and references from relevant articles. Included were published studies that evaluated an intervention designed to prevent or reduce overweight or obesity in children younger than 2 years. Extracted from eligible studies were measured outcomes, including changes in child weight status, dietary intake, and physical activity and parental attitudes and knowledge about nutrition. Studies were assessed for scientific quality using standard criteria, with an assigned quality score ranging from 0.00 to 2.00 (0.00-0.99 is poor, 1.00-1.49 is fair, and 1.50-2.00 is good). We retrieved 1557 citations; 38 articles were reviewed, and 12 articles representing 10 studies met study inclusion criteria. Eight studies used educational interventions to promote dietary behaviors, and 2 studies used a combination of nutrition education and physical activity. Study settings included home (n = 2), clinic (n = 3), classroom (n = 4), or a combination (n = 1). Intervention durations were generally less than 6 months and had modest success in affecting measures, such as dietary intake and parental attitudes and knowledge about nutrition. No intervention improved child weight status. Studies were of poor or fair quality (median quality score, 0.86; range, 0.28-1.43). Few published studies attempted to intervene among children younger than 2 years to prevent or reduce obesity. Limited evidence suggests that interventions may improve dietary intake and parental attitudes and knowledge about nutrition for children in this age group. For clinically important and sustainable effect, future research should focus on designing rigorous interventions that target young children and their families.

52 Does Multidisciplinary Group Therapy Improve Outcome in Overweight/Obese Children and Adolescents?

Objectives: Evaluate the impact of ambulatory group therapy (GT) versus individual therapy (IT) on a large group of overweight/obese children and adolescents.Methodology: Self-referred overweight and obese children/adolescents, were invited to participate and randomised to GT or IT for 4 months. GT included physical activity, dietary education and psychological sessions (2×3 hrs/week including 3hrs/ 2 weeks with parents). IT was made to measure and consisted of counselling of the child and its family on healthy lifestyle. Dietary advice and psychological support were available, when deemed necessary. Changes in BMI Z-score, WC-Z-score, glucose and fat metabolism, eating habits, lifestyle, wellbeing and self esteem were investigated. The study was approved by the National Medical Ethical Committee (CNER).Results: 192 children and adolescents participated with informed consent (age range 7-17 years; F: 53.6%). After 4 months, a BMI Z-score reduction was observed with a significantly better outcome in the GT. Positive changes in weight status were observed in 19% of children in the GT compared to 5.9 % of those following IT. Biological parameters show a small change over time but not significantly different between the two groups. Positive changes in eating habits as well as lifestyle were observed more frequently in the GT children, although not all reached statistical significance. Self perceived wellbeing as well as happiness with themselves improved after the GT.Discussion: Overall, GT resulted in slightly better results in almost all domains, however without reaching statistical significance. Sustainability in time and cost/benefit need further follow up.

Childhood Obesity Is the Fuel That Fires Adult Metabolic Abnormalities and Cardiovascular Disease

Childhood ObesityVol. 6, No. 5 Childhood Obesity Is the Fuel That Fires Adult Metabolic Abnormalities and Cardiovascular DiseaseMegan Moriarty-Kelsey and Stephen R. DanielsMegan Moriarty-KelseySearch for more papers by this author and Stephen R. DanielsSearch for more papers by this authorPublished Online:11 Nov 2010https://doi.org/10.1089/chi.2010.0504AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited bySex differences in the prevalence of multiple cardiovascular disease risk factors in schoolchildren: A cross-sectional studyClinical Nutrition ESPEN, Vol. 52Meeting fruit and vegetable consumption and physical activity recommendations among adolescents intending to lose weightPreventive Medicine Reports, Vol. 13School-Based Health Promotion Initiative Increases Children's Physical Activity17 October 2016 | American Journal of Health Education, Vol. 47, No. 6A mixed-methods exploration of implementation of a comprehensive school healthy eating model one year after scale-up20 May 2015 | Public Health Nutrition, Vol. 19, No. 5Parenting style and obesity risk in childrenPreventive Medicine, Vol. 75Parental attachment insecurity predicts child and adult high-caloric food consumption22 April 2015 | Journal of Health Psychology, Vol. 20, No. 5Is there a critical time window for weight loss intervention?15 May 2013 | Nutrition Bulletin, Vol. 38, No. 2Adolescent Obesity, Change in Weight Status, and HypertensionHypertension, Vol. 61, No. 2Is the obesity epidemic worsening the cardiovascular risk factor profile of children? Evidence from two Québec samples measured 10 years apart21 June 2012 | Annals of Human Biology, Vol. 39, No. 4 Volume 6Issue 5Oct 2010 Information©2010 by Mary Ann Liebert, Inc.To cite this article:Megan Moriarty-Kelsey and Stephen R. Daniels.Childhood Obesity Is the Fuel That Fires Adult Metabolic Abnormalities and Cardiovascular Disease.Childhood Obesity.Oct 2010.250-256.http://doi.org/10.1089/chi.2010.0504Published in Volume: 6 Issue 5: November 11, 2010PDF download

Infant temperament and eating style predict change in standardized weight status and obesity risk at 6 years of age

Little research has addressed the relationships among infant temperament, eating styles and obesity risk. To address this gap, we tested whether infant temperament and eating patterns at the age of 1 year are associated with a greater increase in standardized weight status, and greater obesity risk at 6 years of age. A secondary, prospective analysis of the Colorado Adoption Study was conducted. The main predictor variables were infant temperament (that is, emotionality, activity, attention span-persistence, reaction to food and soothability) and eating domains (that is, reactivity to food, predictable appetite and distractability at mealtime) at the age of 1 year, along with the body mass index (BMI) of biological mothers. The outcome measures were child weight and height (length) assessed at ages 1 through 6 years, from which weight-for-length and BMI were computed along with the standardized indexes (z-scores) and percentiles. Overweight/obesity status was computed at each year as well. A primarily White sample of 262 boys and 225 girls, assessed at ages 1 through 6 years, along with their mothers. Among boys, greater attention span-persistence was associated with reduced standardized weight status gain (β=-0.15, P<0.05) and reduced obesity risk (odds ratio (OR)=0.46, P=0.06). Among girls, greater soothability and negative reaction to food were associated with greater standardized weight status gain (β=0.19, P<0.01; and β=0.16, P<0.05, respectively) and increased obesity risk (OR=3.72, P=0.03; and OR=2.81, P=0.08, respectively). Biological mothers' obesity status predicted obesity risk in boys (OR=3.07, P=0.01) and girls (OR=5.94, P=0.03). Male infants with less attention span, and female infants with greater soothability or a more negative food reaction, showed greater increases in standardized weight and were more likely to be overweight/obese at the age of 6 years. The role of infant temperament in pediatric obesity onset warrants greater research.

The Effects of Multisystemic Therapy on Family Support for Weight Loss Among Obese African-American Adolescents: Findings From a Randomized Controlled Trial

To determine whether multisystemic therapy, an intensive, home- and community-based intervention, could increase family support for healthy eating and exercise in obese African-American adolescents. Relationships between changes in family support, weight status, and body fat composition at the end of the trial were also evaluated. A pilot randomized clinical trial was conducted with 49 obese adolescents (body mass index > or = 95th %ile). Participants were randomized to receive multisystemic therapy or Shapedown, a group weight loss intervention. Participants received treatment for 6 months. Data were collected at baseline and 7-month posttest (i.e., treatment termination). Changes in family support for healthy eating and exercise were assessed by self-report questionnaire. Bivariate analyses were used to assess the relationship between change in family support during the trial and youth body mass index, percent overweight, and body fat composition at follow-up. Participation in multisystemic therapy was associated with significantly greater improvements in family encouragement for healthy eating and family participation in exercise and greater decreases in discouraging behavior from family members than Shapedown participation. Increases in family participation in exercise were significantly related to lower youth body mass index, percent overweight, and body fat composition at follow-up. Intensive, home- and community-based treatment increased family support for health behavior changes among obese minority adolescents, and these changes were directly related to weight status. Such health improvements are important for the well-being of a subset of youth who are at high risk for future health complications.

Weight Status Continuity and Change From Adolescence to Young Adulthood: Examining Disease and Health Risk Conditions

This study examined weight status during adolescence and young adulthood, and young adult health condition diagnosis. Data are from 10,439 African-American, Hispanic, and white men and women participating in the National Longitudinal Study of Adolescent Health during Waves 1 (adolescence: ages 12-19) and 3 (young adulthood: ages 19-26). Categories were created differentiating individuals based on their weight status during adolescence and young adulthood: (i) obese during adolescence and young adulthood (i.e., continuously obese), (ii) obese during adolescence only, (iii) obese during young adulthood only, and (iv) never obese. Multilevel random intercept regression models were used to examine the impact of obesity category, sex, and race/ethnicity on young adult asthma, diabetes, high cholesterol, and high blood pressure. Continuous obesity increased the likelihood for young adult disease and health risk conditions compared to individuals who were never obese. Obesity isolated to adolescence (Wave 1) increased the likelihood for high cholesterol and high blood pressure, whereas obesity isolated to young adulthood (Wave 3) also increased the likelihood for diabetes--all increases were relative to nonobese weight status during both periods. Associations varied in direction and degree when sex and race/ethnicity were considered. Findings clarify some of the mixed understandings regarding the associations between age of onset and stability of obesity, and health outcomes with important public health implications. Although results indicate obesity isolated to a single developmental period does have health repercussions, obesity experienced continuously during adolescence and young adulthood greatly intensified risk across all health conditions.

Changes in adipose-derived inflammatory cytokines and chemokines after successful lifestyle intervention in obese children

Obesity has been associated with low-grade chronic systemic inflammation, potentially leading to insulin resistance. This study was designed to examine relationships between cardiovascular risk factors, insulin resistance, and simultaneously measured inflammatory parameters in obese children. We examined serum inflammatory parameters in 115 obese children and 30 normal-weight controls; 62 obese children were followed longitudinally in a 1-year obesity intervention study. Serum concentrations of adipose tissue hormones adiponectin and resistin as well as adipocytokines were assessed. Cross-sectional analysis showed significant correlations between standard deviation score body mass index and resistin ( P = .0004) as well as monocyte chemoattractant protein–1 (MCP-1, P = .04). Increased homeostasis model assessment of insulin resistance index greater than 95th percentile was present in 32% of obese patients, correlating with adiponectin ( r = −0.40, P = .0007). Significant correlations were found between adiponectin and several mediators of inflammation (interleukins [ILs] IL-1 β, IL-6, and IL-8 and tumor necrosis factor– α). In longitudinal analysis, substantial weight loss (change standard deviation score body mass index >0.5) observed after intervention in 29 children was associated with a significant decrease in blood pressure, homeostasis model assessment of insulin resistance index, and serum concentrations of insulin and IL-1 β, IL-8, and MCP-1, but increase of adiponectin (all Ps < .05). In 33 children without substantial weight loss, resistin and MCP-1 levels increased after 1 year. Changes in IL-1 β correlated positively with changes of weight status, interferon- γ, IL-6, IL-8, and tumor necrosis factor– α (all Ps < .01). Our study demonstrates significant correlations between different metabolic risk factors at baseline and after changes of weight status and that weight loss in obese children reduces low-grade inflammation, insulin resistance, and blood pressure.

Changes in stature, weight, and nutritional status with tourism-based economic development in the Yucatan

Over the past 40 years, tourism-based economic development has transformed social and economic conditions in the Yucatan Peninsula, Mexico. We address how these changes have influenced anthropometric indicators of growth and nutritional status in Yalcoba, a Mayan farming community involved in the circular migration of labor in the tourist economy. Data are presented on stature and weight for children measured in 1938 in the Yucatan Peninsula and from 1987 to 1998 in the Mayan community of Yalcoba. In addition, stature, weight and BMI are presented for adults in Yalcoba based on clinic records. Childhood stature varied little between 1938 and 1987. Between 1987 and 1998 average male child statures increased by 2.6 cm and female child statures increased by 2.7 cm. Yet, 65% of children were short for their ages. Between 1987 and 1998, average child weight increased by 1.8 kg. Child BMIs were similar to US reference values and 13% were considered to be above average for weight. Forty percent of adult males and 64% of females were overweight or obese. The anthropometric data from Yalcoba suggest a pattern of stunted children growing into overweight adults. This pattern is found elsewhere in the Yucatan and in much of the developing world where populations have experienced a nutrition transition toward western diets and reduced physical activity levels.

Influence of dietary weight‐loss on vitamins D and K in obese post‐menopausal women

Obese persons are at risk for fat‐soluble vitamin (FSV) insufficiency. It is also plausible that weight loss is associated with change in FSV status. Hence, our aim was to examine associations between change in weight status and change in vitamin D and K status in 89 post‐menopausal obese women (mean±SD BMI=33.1±3.6kg/m2, age=58±6y), following a hypocaloric weight‐loss program. All women received 200IU/d vitamin D3 and 80 mcg/d vitamin K1. On average, baseline serum 25‐hydroxyvitamin‐D (25(OH)D) and vitamin K1 concentrations were within normal ranges (51±18nmol/L, 1.3±1.0nmol/L respectively). After 20‐weeks, women lost 11.1±5.3% of initial body weight and 8.0±3.2kg of fat mass. 25(OH)D increased by 10±14nmol/L (p&lt;0.01, season‐adjusted), but serum vitamin K1 did not change (p=0.85, triglyceride‐adjusted). Using linear models, with change in FSV status as outcomes and change in weight‐status as primary exposures in separate analyses, there was no association between change in 25(OH)D and change in weight, BMI, or fat mass [unstd B(p‐value)= −0.51(0.15), −0.98(0.32), −0.60(0.19) respectively] or between change in serum K1 and change in weight, BMI, or fat mass [unstd B(p‐value)= −0.04(0.17), −0.10(0.16), −0.06(0.10) respectively]. Our data do not suggest moderate weight loss is associated with change in serum measures of vitamin D or K. Supported by NIA R01AGDK20583, P30AG21332 &amp; USDA ARS #58‐1950‐7707.

The Promise of Immersion Treatment for Obese Children and Adolescents in 2009: A Review

Obese children have attended weight loss camps and residential programs for more than 40 years. For this review, 22 studies met inclusion criteria (targeted and assessed change in weight status; minimal stay of 10 days and nights). Compared to results in a recent metaanalysis of outpatient treatments, these immersion programs produced an average of 197% greater reductions in percent-overweight at posttreatment and 130% greater reduction at follow-up. Furthermore, mean attrition rates were much lower when compared to standard outpatient treatment. Inclusion of a cognitive behavior therapy (CBT) component seem especially promising; followup evaluations showed decreased percent-overweight at follow-up by an average of 30% for CBT immersion programs versus 9% for programs without CBT. Explanations for the potentially greater impact of immersion relative to outpatient treatments are presented, including possibly differential effects on self-efficacy for both children and their parents.

Healthy Living Cambridge Kids: A Community‐based Participatory Effort to Promote Healthy Weight and Fitness

The objective of this study was to assess the impact of a community-based healthy weight intervention on child weight and fitness. Cambridge Public Schools (CPS) have monitored BMI and fitness annually since 2000. Annual increases of overweight and obesity from 2000 (37.0%) to 2004 (39.1%), triggered a multidisciplinary team of researchers, educators, health care, and public health professionals to mobilize environmental and policy interventions. Guided by the social-ecological model and community-based participatory research (CBPR) principles, the team developed and implemented Healthy Living Cambridge Kids (HLCK), a multicomponent intervention targeting community, school, family, and individuals. The intervention included city policies and community awareness campaigns; physical education (PE) enhancements, food service reforms, farm-to-school-to-home programs; and family outreach and "BMI and fitness reports". Baseline (2004) to follow-up (2007) evaluation design assessed change in children's weight and fitness status. A cohort of 1,858 K-5th grade children participated: 37.3% black, 14.0% Hispanic, 37.1% white, 10.2% Asian, 1.7% other race; 43.3% were lower income. BMI z-score (0.67-0.63 P < 0.001) and proportion obese (20.2-18.0% P < 0.05) decreased, and mean number of fitness tests (0-5) passed increased (3.7-3.9 P < 0.001). Whereas black and Hispanic children were more likely to be obese at baseline (27.0 and 28.5%, respectively) compared with white (12.6%) and Asian (14.3%) children, obesity among all race/ethnicity groups declined. Concurrent with a 3-year community intervention, modest improvements in obesity and fitness were observed among CPS children from baseline to follow-up. The CBPR approach facilitated sustaining policies and program elements postintervention in this diverse community.

Abstract CN09-03: Capitalizing on the teachable moment of the cancer diagnosis to promote healthful lifestyle changes among women with breast cancer and their daughters: Preliminary findings of the DAMES Trial

Abstract CN09-03: Capitalizing on the teachable moment of the cancer diagnosis to promote healthful lifestyle changes among women with breast cancer and their daughters: Preliminary findings of the DAMES Trial