Healthy Weight Research Articles

The Effect of Multi-Strategy Nutrition Education Programs on Hedonic Hunger and Nutrition Status in Adolescents.

Objective: Increasing the awareness of adolescents about hedonic hunger, understanding the difference between homeostatic hunger and hedonic hunger, and adolescents learning to control themselves to stop excessive food consumption are extremely important for a healthy adulthood. The study aimed to evaluate the effects of the multi-strategy nutrition education programs (MSNEP) on hedonic hunger, food addiction, nutrition literacy, and nutritional status in adolescents. Methods: This study was planned using a pre-test and post-test design. The MSNEP was conducted with 132 adolescents (11-15 years; 69 boys, 63 girls) for 4 weeks (45 min-1 h/session). Data were obtained using questionnaires with face-to-face interviews at pre-education (baseline) and post-education (week 4 and week 8). The survey form included sociodemographic information, nine item short version of Children's Power of Food Scale (C-PFS-9), the Yale Food Addiction Scale for Children 2.0 (YFAS-C 2.0), the Adolescent Nutrition Literacy Scale (ANLS), anthropometric measurements, and 24-hour dietary recall. Results: A decrease in C-PFS-9 total scores was found compared to the baseline (p < 0.001). While the YFAS-C 2.0 score decreased in boys compared to the baseline (p < 0.05), no significant difference was found in girls (p > 0.05). A difference was found in the ANLS scores for girls (p = 0.01), but no difference was found in the scores for boys during the study (p > 0.05). At week 4, the consumption of dairy products, legumes, vegetables and fruits, bread and grains, nuts, and hard-shelled seeds increased compared to the baseline (p < 0.05). Also, daily protein and fiber intake increased (p < 0.05). Accordingly, a higher YFAS-C 2.0 score predicted greater hedonic hunger. A lower ANLS score was a predictor for higher food taste and food available scores. Conclusions: In conclusion, the MSNEP was found to have positive effects on hedonic hunger, food addiction, nutritional literacy, and healthy eating behaviors. The study revealed differences between girls and boys. In order to maintain healthy body weights in adolescents, it is recommended that the MSNEP be provided in schools.

Associations between maternal body mass index and childhood infections in UK primary care: findings from the Born in Bradford birth cohort study

ObjectiveTo explore associations between maternal body mass index (BMI) in early pregnancy and childhood infections.DesignBirth cohort study linked to primary care records.SettingBradford, UK.ParticipantsLive singleton births within the Born in Bradford...

A comparison of principal component analysis, reduced-rank regression, and partial least–squares in the identification of dietary patterns associated with cardiometabolic risk factors in Iranian overweight and obese women

BackgroundAccording to epidemiological studies, unhealthy dietary patterns and lifestyle lead to rising obesity and cardiometabolic diseases in Iran. Hybrid techniques were used to identify a dietary pattern characterized by fiber, folic acid, and carotenoid intake due to their association with cardiometabolic risk factors such as anthropometric measurements, blood pressure, lipid profile, C-Reactive Protein (CRP), Plasminogen Activator Inhibitor (PAI), Homeostatic Model Assessment Index (HOMA Index), cardiometabolic index (CMI), and monocyte chemoattractant protein (MCP-1). So, the objective of the recent study is to compare the reduced-rank regression (RRR) and partial least–squares (PLS) approaches to principal component analysis (PCA) for estimating diet-cardiometabolic risk factor correlations in Iranian obese women.MethodsData on dietary intake was gathered from 376 healthy overweight and obese females aged 18 to 65 years using a 147-item food frequency questionnaire (FFQ). In this cross-sectional study, participants were referred to health centers of Tehran. Dietary patterns were developed using PCA, PLS, and RRR, and their outputs were assessed to identify reasonable patterns connected to cardiometabolic risk factors. The response variables for PLS and RRR were fiber, folic acid, and carotenoid intake.ResultsIn this study, 3 dietary patterns were identified by the PCA method, 2 dietary patterns by the PLS method, and one dietary pattern by the RRR method. High adherence to the plant-based dietary pattern identified by all methods were associated with higher fat free mass index (FFMI) (P < 0.05). Women in the highest tertile of the plant-based dietary pattern identified by PLS had 0.06 mmol/L (95% CI: 0.007,0.66, P = 0.02), 0.36 mmHg (95% CI: 0.14,0.88, P = 0.02), and 0.46 mg/l (95% CI: 0.25,0.82, P < 0.001), lower FBS, DBP, and CRP respectively than women in the first tertile. Also, PLS and RRR-derived patterns explained greater variance in the outcome (PCA: 1.05%; PLS: 11.62%; RRR: 25.28%), while the PCA dietary patterns explained greater variance in the food groups (PCA: 22.81%; PLS: 14.54%; RRR: 1.59%).ConclusionPLS was found to be more appropriate in determining dietary patterns associated with cardiometabolic-related risk factors. Nevertheless, the advantage of PLS over PCA and RRR must be confirmed in future longitudinal studies with extended follow-up in different settings, population groups, and response variables.

Reference data for body composition parameters in normal-weight Polish adolescents: results from the population-based ADOPOLNOR study.

This study provides reference data for body composition in normal (healthy) weight Polish adolescents, providing a contextualised framework that takes into account the unique physiological and environmental factors of the region. These reference data may also be useful for other Central European adolescents. • Adolescence is a period of significant physical growth and increased susceptibility to nutritional problems due to factors such as suboptimal nutrition, unhealthy dietary choices, inadequate physical activity and psychosocial stressors related to body image concerns. • Body composition (BC) parameters, rather than BMI alone, are more effective in identifying nutritional abnormalities and health risks such as eating disorders, obesity and chronic diseases. Existing studies provide reference data for BC parameters, but often do not cover all relevant measures or specific regional populations. • This study provides new age- and sex-specific reference values for a comprehensive range of body composition parameters, including body cell mass (BCM), total body water (TBW) and muscle mass (MM), in addition to fat-free mass (FFM) and fat mass (FM), in a large, ethnically homogeneous, normal-weight population of Polish adolescents aged 10-18years. • These reference values for the normalweight cohort reflect healthy adolescent growth and body composition patterns, minimising bias from abnormal weight status.In addition, they can be applied to other Central European adolescent populations.

Maternal Weight and Gestational Diabetes Impacts on Child Health: A Narrative Review.

Maternal weight and gestational diabetes mellitus (GDM) have significant implications for both maternal and child health. This narrative review explores the intricate relationship between maternal pre-pregnancy weight, gestational weight gain, and GDM, focusing on their short- and long-term effects on child health outcomes. The review highlights evidence linking maternal obesity and GDM to increased risks of adverse outcomes in infants and children, such as macrosomia, neonatal hypoglycemia, childhood obesity, and metabolic disorders. It also discusses the intergenerational transmission of metabolic risk, underscoring the importance of early intervention and prevention strategies in maternal healthcare. Furthermore, the review emphasizes the need for tailored approaches to managing maternal weight and GDM to mitigate potential risks and improve health outcomes for future generations. Key recommendations include promoting healthy preconception weight, monitoring gestational weight gain, and enhancing postnatal follow-up for both mothers and children. This review underscores the critical role of maternal health in shaping the developmental trajectory of offspring and highlights opportunities for healthcare professionals to reduce the long-term impact of GDM on child health.

Body Image and Eating Behaviour in Adolescents Loving Korean Wave Culture

The Korean wave has developed into a popular culture in the global community, especially adolescents in the last two decades. Cultural programs that include idols/bands, movies, dramas, variety shows, and webtoons are in great demand. The image of Korean women can influence adolescents' perceptions of ideal body shapes and eating behaviors. This study aims to analyze correlations between Korean culture viewing habits with body image and eating behavior among adolescents in West Java. This research is a cross-sectional study, conducted in West Java during April 2023 using the online structured questionnaire. The total subjects of this research were 467 adolescents. The results of the study stated that the subjects in this study were women (81.2%), college students (66.6%), Korean show enthusiasts (66.6%), Kpop enthusiasts (68.3%), Kdrama enthusiasts (77.5%), and webtoon enthusiasts (50.3%). Most of them thought that Korean idols were attractive (96.4%), and sometimes they want theirs body shape as their idols (46.5%). There were differences in body image and eating behavior among K-show (p=0.046 &amp;amp; p=0.039), Kpop (p=0.048, p=0.027, p=0.024, &amp;amp; p=0,000), and Kdrama enthusiasts (p=0.026) but there were no differences between enthusiasts of webtoon. Our findings show the Korean wave culture is one of the causes of adolescents experiencing body dissatisfaction, which is an important predictor of eating problems. Awareness of the importance of positive body image and healthy weight control behavior concepts is necessary.

Non-communicable diseases: Opportunities to promote future health during the first 1000 day of life

The Developmental Origins of Health and Disease (DOHaD) framework now underlies the evolution and epigenetics of many non-communicable diseases that develop in adult life. Type 2 diabetes, obesity, hypertension, heart disease and stroke in particular have links back to events during the first 1000 days of life, and as the world is witnessing an epidemic of these conditions, identifying measures able to contribute to reducing the potential for these NCDs to develop in our aging populations becomes all the more important. Parental health at conception and good maternal health and nutrition throughout pregnancy are known to be integral to normal infant development and health in later life, but more recently the central importance of infant nutrition that achieves healthy weight gain has become recognized. In this context, achieving growth patterns for infants that avoid either the onset of obesity or development of stunting during the first 1000 days of life appears to be an achievable goal with significant potential for the avoidance of many NCDs in later life. Hence the relevance of health promotion initiatives to share this knowledge among health care providers and educate parents on the benefits of optimal infant nutrition.

Time-course effects of exercise intervention on executive function in adolescents with obesity.

This study was to investigate the developmental characteristics of executive function (EF) in obese adolescents and the time-course effects of a 14-week exercise intervention combining aerobic exercise and resistance training on EF in this population. The experimental group of 28 obese junior high school students participated in the exercise intervention combining aerobic exercise and resistance training, while the control group of 24 healthy weight junior high school students engaged in the regular recess exercise. EF, including inhibition, working memory, and cognitive flexibility, was assessed 1 week prior to the exercise intervention and at 12 and 14 weeks post-intervention. Changes in EF sub-functions in both groups at different time points during the exercise intervention were analyzed. The findings revealed that obese junior high school students exhibited lower levels of inhibition (p = 0.003, Cohen's d = 0.848) and cognitive flexibility (p = 0.013, Cohen's d = 0.706) compared to their healthy weight peers. The exercise intervention combining aerobic exercise and resistance training led to significant improvements in EF among obese junior high school students, with inhibition (p < 0.01, Cohen's d = 0.713; p = 0.003, Cohen's d = 0.683) and cognitive flexibility (p = 0.001, Cohen's d = 0.797; p < 0.01, Cohen's d = 0.890) showing significant improvement at 12 and 14 weeks post-intervention, and working memory demonstrating significant improvement at 14 weeks (p = 0.004, Cohen's d = 0.710). No significant differences were observed in EF over time in healthy weight junior high school students. Obese adolescents had impaired EF, as evidenced by low levels of the inhibition and cognitive flexibility compared to healthy weight adolescents. The exercise intervention combining aerobic exercise and resistance training had a positive effect on EF of obese adolescents. The time-course effects of the intervention on improvements in inhibition, working memory, and cognitive flexibility varied with intervention duration in obese adolescents, with significant changes in inhibition and cognitive flexibility observed at 12 weeks and significant changes in working memory at 14 weeks.

Prevalence of overweight and obesity, and associations with socio-demographic and etiological factors

Background: Adolescent obesity and overweight (OW) prevalence are rising quickly. The present study was done to assess the prevalence of OW and obesity and its association with demographic and etiological factors. Methods: An observational study including 386 adolescents aged 10-19 years was conducted using a pre-designed questionnaire. Anthropometric measurements of weight (kg) and height (cm) were taken and body mass index (BMI) calculated by weight (kg)/height2(m2). The weight status was classified as underweight (UW) &lt;5th percentile, healthy weight (HW) between the 5th and &lt;85th percentile, OW between &gt;85th and &lt;95th percentile, and obese (OB) equal to or &gt;95th percentile using the CDC percentile ranking for BMI-for-age. Statistical data analysis was done by SPSS software version 20. P&lt;0.05 was considered significant. Results: The mean age of adolescents in early, mid, and late adolescent age groups were 11.52 (1.13), 15.01 (0.82), and 17.72 (0.77) years respectively. The overall mean age of adolescents was 14.19 (2.63) years. The mean weight, height, and BMI of adolescents were 44.84 (11.35) kg, 1.54 (0.12) meters, and 18.91 (3.89) kg/m2 respectively. The prevalence of OW and obesity was 11.7%, and 5.4% respectively. A significant association was found between OW and obesity with upper socioeconomic status (p&lt;0.0001), daily junk food intake (p&lt;0.0001), screen time of more than 2 hours per day (p&lt;0.0001), and no or decreased physical activity (p&lt;0.0001). Conclusions: Adolescent obesity is a prevalent issue that requires early primordial and primary intervention through coordinated policy activities made by policymakers and medical professionals.

Obesity is associated with hyperandrogenemia in a nationally-representative sample of U.S. girls aged 6-18 years.

Studies have associated obesity with peri-pubertal hyperandrogenemia. However, these studies were performed in academic centers and could have been influenced by selection bias. To investigate if free testosterone levels are elevated in peri-pubertal girls with obesity. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2013-2016 databases. 1,299 girls aged 6-18 years residing in U.S. Mean free testosterone concentration (calculated from total testosterone and sex hormone-binding globulin). Among girls aged 6-9 years, mean (95% CI) free testosterone was 0.33 pg/ml (0.28-0.38) in healthy weight girls vs. 0.86 pg/ml (0.67-1.05) in girls with obesity. Among girls aged 10-14 years, free testosterone was 2.29 pg/ml (2.05-2.53) in healthy weight girls vs. 4.10 pg/ml (3.60-4.60) in girls with obesity. Among girls aged 15-18 years, free testosterone was 3.33 pg/ml (2.96-3.70) in healthy weight girls and 5.64 pg/ml (4.93-6.36) in girls with obesity. Girls with obesity in all age groups had higher free testosterone levels compared to healthy weight girls. In each age group, the 95% CIs for free testosterone did not overlap between healthy weight vs. obesity subgroups. A multiple regression model accounted for 42% of the variance in free testosterone (R2=0.42), and both weight and age categories were independent predictors of free testosterone (p<0.0001 for each). In a nationally-representative sample of U.S. girls, obesity is associated with elevated free testosterone, suggesting an important relationship between obesity and peri-pubertal hyperandrogenemia.

Urinary Incontinence and Quality of Life in Women of Central Jordan: A Cross-Sectional Study.

Considering the high prevalence of UI in the rural areas of Jordan and the limited clinical data on its occurrence in central Jordan, this study aims to investigate the prevalence, risk factors, and impact of urinary incontinence (UI) on the quality of life (QoL) of women in central Jordan. This cross-sectional study was conducted from September to December 2022, using online the Incontinence Impact Questionnaire short form (IIQ-7) and Urogenital Distress Inventory short form (UDI-6). Participation was voluntary, and anonymous. Internal consistency was assessed using Cronbach's α. A total of 128 women participated in the study. More than half of the participants (54.33%, N = 69) experienced UI symptoms. Body mass index was the sole statistically significant factor linked to UI. Obese patients had the highest risk (OR 35, CI 95% 2.577-475.308, p < 0.05) compared to those with a healthy weight. Multivariate regression indicated significant associations of severe UI with smoking and vaginal births with a moderate impact of UI on QoL. The study's findings emphasize the need for women's health centers in the center of Jordan to develop comprehensive UI prevention and management programs to improve women's health and well-being.

Yoyo Dieting, Post-Obesity Weight Loss, and Their Relationship with Gut Health.

Excessive body weight is associated with many chronic metabolic diseases and weight loss, so far, remains the gold standard treatment. However, despite tremendous efforts exploring optimal treatments for obesity, many individuals find losing weight and maintaining a healthy body weight difficult. Weight loss is often not sustainable resulting in weight regain and subsequent efforts to lose weight. This cyclic pattern of weight loss and regain is termed "yoyo dieting" and predisposes individuals to obesity and metabolic comorbidities. How yoyo dieting might worsen obesity complications during the weight recurrence phase remains unclear. In particular, there is limited data on the role of the gut microbiome in yoyo dieting. Gut health distress, especially gut inflammation and microbiome perturbation, is strongly associated with metabolic dysfunction and disturbance of energy homeostasis in obesity. In this review, we summarise current evidence of the crosstalk between the gastrointestinal system and energy balance, and the effects of yoyo dieting on gut inflammation and gut microbiota reshaping. Finally, we focus on the potential effects of post-dieting weight loss in improving gut health and identify current knowledge gaps within the field, including gut-derived peptide hormones and their potential suitability as targets to combat weight regain, and how yoyo dieting and associated changes in the microbiome affect the gut barrier and the enteric nervous system, which largely remain to be determined.

Scalable and successful patient portal lifestyle coaching training for primary care clinical staff.

Maintaining a healthy weight postintentional weight loss is crucial for preventing chronic health conditions, yet many regain weight postintervention. Electronic health record (EHR) portals offer a promising avenue for weight management interventions, leveraging patient-primary care relationships. Our previous research demonstrated that coaching alongside self-monitoring improves weight maintenance compared to monitoring alone. Integrating weight management into routine clinical practice by training existing staff could enhance scalability and sustainability. However, challenges such as inconsistent staff qualifications and high coach turnover rates could affect intervention effectiveness. Standardizing services, training, and coaching continuity seem crucial for success. To report on developing, testing, and evaluating an EHR-based coaching training program for clinical staff, guided by an implementation tool for the MAINTAIN PRIME study. Conducted across 14 University of Utah primary care sites, we developed, tested, and evaluated a coaching training for clinical staff. Guided by a planning model and the Predisposing, Enabling, and Reinforcing (PER) tool, stakeholders actively participated in planning, ensuring alignment with clinic priorities. All clinical staff were invited to participate voluntarily. Evaluation measures included staff interest, training effectiveness, confidence, and readiness. Data collection utilized REDCap, with survey results analyzed using descriptive statistics. Despite increased clinical workload and reassignments posed by coronavirus disease 2019, we were able to train 39 clinical staff, with 34 successfully coaching patients. Feedback indicated high readiness and positive perceptions of coaching feasibility. Coaches reported satisfaction with training, support, and enjoyed establishing connections with patients. The PER strategies allowed us to implement a well-received training program found effective by primary care coaches.

Maternal obesity management: a narrative literature review of health policies

Maternal obesity rates are increasing significantly, posing substantial risks to both mothers and their children. This study aims to introduce health policies addressing maternal obesity, identify preventive interventions, and highlight scientific gaps necessitating further research.We identified documents through electronic searches in PubMed, CINAHL Plus, EMBASE, and grey literature sources (ministry of health websites, national gynecology and obstetrics associations) from January 2013 to August 2023, updated in June 2024. The inclusion criteria focused on English-language documents discussing interventions or health policies that promote weight loss through lifestyle changes during pregnancy.A total of 22 documents (10 studies and 12 guidelines) were included. 12 studies (N=1244) identified via databases; included two Clinical Practice Guidelines (CPGs) from Canada and Singapore. Other 10 CPGs sourced from governmental websites and national associations: England (1), Australia (1), New Zealand (1), combined Australia and New Zealand (1), Canada (3), USA (1), Ireland (1), Germany (1). 10 guidelines focused on obesity in pregnancy, two on weight management during pregnancy. Covered interventions across pre-pregnancy, pregnancy, and postpartum periods (9 guidelines); pre-pregnancy and pregnancy (2); exclusively postpartum (1). Seven guidelines offered evidence-based recommendations on maintaining healthy weight in mothers, largely based on expert opinions.Maternal obesity poses significant risks to both mothers and children, underscoring the need for effective health policies and systems. However, few countries have integrated adequate responses into their healthcare policies and guidelines for professionals. Limited evidence exists on optimal practices to improve reproductive health outcomes in obese women. Hence, the crucial need to developing comprehensive guidelines and proactive strategies to manage maternal obesity. These measures can improve outcomes and reduce healthcare costs. Increased focus on research and policymaking is essential to protect the health of mothers and their children.

An evidence-based assessment of the nutritional recommendations for thepreventionof diabetes mellitus.

Thissystematic review presents the most recent scientific knowledge concerningdietary recommendations for T2DM published in the English language by various scientific societies during the past 10years. The recommendations are herein presented and discussed in the light of a critical, evidence-based appraisal aiming to provide a comprehensive guide for the clinician in daily practice. In the case of overweight or obesity, the cornerstone of the primary prevention of T2DM is the combination of a healthy body weight (body mass index < 25kg/m2) or a reduction of fat byat least 7% and the implementation of at least 150min of moderate physical activity per week. Restriction of calories and of dietary fat is recommended, the latter as well as several dietary patterns providing a holistic approach to dieting andall havingbeen correlated with decreased risk of T2DM. Among these dietary patterns are the Mediterranean diet, the DASH diet (Dietary Approaches to Stop Hypertension), the low-glycemic diet, and the HEI-Healthy Eating Index and AHEI-Alternative Healthy Eating Index. Micronutrient deficiencies of, for example, vitamin D, chromium and magnesium, may be associated with insulin resistance in T2DM. Overall, the combination of nutrition through dietary patterns that are mainly plant-based and which emphasize wholegrains, legumes, nuts, fruits, and vegetables and that include only small percentages of refined and processed foods, together with physical activity, has been associated with decreased T2DM risk.

Impact of Nutrition and Exercise on Kidney Health: How to Prevent Kidney Stones?

IntroductionKidney stone disease, characterized by the formation of calculi in the kidneys, is becoming an increasingly common urinary tract disorder in developed countries. Although kidney stone disease may be caused by metabolic disorders, anatomical, functional, and genetic factors, diet plays a crucial role in its formation. Changing dietary habits has become a primary tool in the treatment and prevention of kidney stone disease. ObjectiveThe aim of this study is to present research on the impact of diet and its individual components on the risk of kidney stone formation. Special attention is given to the role of vitamins, minerals, and dietary habits in the pathogenesis and prevention of this condition. Materials and MethodsThe study involves a review of the scientific literature, considering research published in reputable medical and scientific journals regarding the impact of diet on the risk of kidney stones, focusing on key dietary components such as calcium, magnesium, sodium, vitamins C and D, as well as the role of physical activity and proper hydration. ConclusionsA balanced diet, proper hydration and maintaining a healthy body weight are fundamental elements in preventing of kidney stone disease. Adequate hydration is crucial; high fluid intake, especially water, dilutes urine and reduces the concentration of lithogenic substances.Calcium and magnesium intake are particularly important as they influence the absorption and excretion of oxalates, and excessive supplementation with vitamins C and D should be avoided. A diet rich in fruits and vegetables, and the limitation of animal protein and salt, can significantly reduce the risk of kidney stone formation. Ultimately, dietary changes and lifestyle modifications, including weight control and physical activity, play a crucial role in preventing kidney stone disease. However, further research is needed to develop effective dietary guidelines tailored to the individual needs of patients.

Association between body weight and tocilizumab effectiveness in rheumatoid arthritis: results from the BSRBR-RA.

Tocilizumab is an IL-6 receptor humanised monoclonal antibody for the treatment of rheumatoid arthritis (RA) with intravenous (IV) and subcutaneous (SC) preparations available. Only IV tocilizumab is dosed adjusting for weight. Therefore, we aimed to study the association between body weight and the effectiveness of tocilizumab by the route of administration. Patients with RA administered tocilizumab in the BSRBR-RA were included in the analysis and stratified by route of administration. Outcomes included the 6 month change in DAS28, the proportion of patients achieving DAS28 remission, 6-month EULAR response and persistence of the first route of tocilizumab administration. The exposure was every increase in 10 kg of body weight. Adjusted regression models appropriate to outcome were used to study the associations between body weight and outcomes. Multiple imputations accounted for missing data. 2612 patients were included. Body weight was associated with reduced response to SC tocilizumab measured by change in DAS28: adjusted regression coefficient (95% CI) all patients 0.01 (-0.04, 0.07); IV: -0.03, (-0.1, 0.5); SC: 0.1 (0.02, 0.2) but not odds in achieving DAS28 remission or EULAR response. There was no significant association between body weight and the persistence of IV or SC tocilizumab. Body weight was associated with the initial response to SC tocilizumab, although the difference in response was small, but not drug persistence. Physicians should monitor the body weight of patients and consider interventions to promote maintenance of a healthy weight.

Association between healthy lifestyle and frailty in adults and mediating role of weight-adjusted waist index: results from NHANES

BackgroundThe relationship between healthy lifestyle and frailty remains unclear. Healthy weight is crucial for overall well-being, but using body mass index (BMI) to evaluate weight management is inefficient. This study clarifies the association between healthy lifestyle or its factors (non-smoking, moderate drinking, healthy weight, healthy diet, sufficeint physical activity, and non-sedentary) and frailty, and the feasibility of using the weight-adjusted waist index (WWI) reflecting central obesity as an intermediate indicator.MethodsThis study included 4,473 participants from the 2007–2018 National Health and Nutrition Examination Survey (NHANES). Healthy lifestyle quality was assessed by summing the scores of each healthy lifestyle factor. Frailty was assessed using a 49-item frailty index (FI), categorizing participants into robust, pre-frail, and frail. Logistic regression to investigate the association between healthy lifestyle or its factors, WWI, and frailty. Smooth curve fitting and threshold effect analyses were used to elucidate the nonlinear association. Subgroup and two other sensitivity analyses were conducted to confirm the stability of the results. A causal mediation model examined the proportion of frailty mediated by WWI.ResultsThe study identified 13.98% of the participants as frail. Optimal healthy lifestyle and frailty were negatively associated (OR: 0.39, 95%CI: 0.27–0.58). Five healthy lifestyle factors (non-smoking, healthy weight, healthy diet, sufficient physical activity, and non-sedentary) were associated with a lower prevalence of frailty, with odds ratios (OR) ranging from 0.48 to 0.61. We also analyzed the association between a healthy lifestyle and WWI (OR: 0.32, 95%CI: 0.27–0.37), WWI and frailty (OR: 1.85, 95%CI: 1.59–2.16). A positive association between WWI and FI was observed beyond the inflection point (9.99) (OR: 0.03, 95%CI: 0.02–0.03). Subgroup and sensitivity analyses confirmed stable associations between healthy lifestyle, WWI, and frailty. WWI partially mediated the association between a healthy lifestyle and frailty (mediating ratio = 20.50–20.65%).ConclusionsAn optimal healthy lifestyle and positive healthy lifestyle factors are associated with a lower incidence of frailty. WWI may mediate the relationship between a healthy lifestyle and frailty.

Anxiety matters: a pilot lab study into food, weight, and virtual body exposure in anorexia nervosa

BackgroundAnxiety is a core characteristic of anorexia nervosa and a potential target of exposure therapy, which requires a profound understanding of the patients’ fears in order to be successful. The knowledge about fears in anorexia nervosa that should be targeted during exposure therapy can be enriched by laboratory research to the precise emotional and behavioral responses of anorexia nervosa patients when they are exposed to disorder relevant fear stimuli.MethodsIn the laboratory, patients with anorexia nervosa (n = 15) and healthy controls (n = 51) were exposed to 1. their own body weight and a 10% higher body weight on the scale, 2. a standardized lab breakfast, and 3. five virtual bodies with different BMIs ranging from extreme underweight to lower healthy weight. The participants emotional (anxiety, disgust, satisfaction, acceptance) and behavioral responses (calorie consumption) were assessed. Patients with anorexia nervosa but not the healthy controls then received an intensive exposure treatment (~ 30 individual exposure sessions) targeting their individual fears, next to standard care. After the exposure treatment, it was investigated whether the patients’ responses to the laboratory tasks changed.ResultsAcross all tasks, the patients reported more anxiety than healthy controls. The patients also consumed less calories during the breakfast and accepted the different body weights on the scale less than healthy controls. During the virtual body exposure, the patients’ emotional responses did not differ per avatar but they reacted more negatively towards avatars with healthier weights than did healthy controls. After the exposure treatment, the patients reported less fears and they consumed more calories while their BMIs had increased. They were also more accepting of healthier weights.ConclusionsExposure to food-, body- and weight-related stimuli in the laboratory induces emotional reactions in patients with anorexia nervosa that are informative for the identification of exposure therapy treatment targets. In addition, exposure therapy targeting individual fears in patients with anorexia nervosa led to symptom reduction and is a promising intervention for the treatment of anorectic fears, though more research is needed to optimize its efficacy.

Perceived Factors Influencing Postpartum Weight Gain among Nursing Mothers Attending Postnatal Clinic at Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria

This research was carried out to assess the factors influencing postpartum weight gain among nursing mothers attending Post-natal Clinic at Lagos State University Teaching Hospital, Ikeja. Three objectives guided the study which were to identify the factors influencing postpartum weight gain, to assess the perception and attitude towards postpartum weight gain among the nursing mothers. A cross-sectional research design was adopted for the study, in which only one hundred and eighty-eight (188) of them met the inclusion criteria. Questionnaire was the instrument for data collection, data was analyzed using SPSS version 25, and presented on frequency percentage tables. Findings from the study revealed that the perceived factors influencing weight gain after childbirth among nursing mothers was mainly post-natal in nature; due to the use of family planning method 109(57.8%); followed by the consumption of fast food 93(49.3%); and inadequate physical exercise 66(35.2%) as the main factors. Their perceptions towards postpartum weight gain was majorly poor as 139(73.9%) of them affirmed that there is satisfaction with their present weight. An evaluation of their attitude towards weight gain after childbirth revealed an overall negative attitude towards the concept, as majority 132(70.4%) of them agreed that family planning can cause nursing mothers’ weight gain; about half 95(50.7%) of them attested to exercise being necessary after delivery to maintain healthy weight among nursing mothers. The study found a significant relationship between the perception and attitude of nursing mothers towards postpartum weight gain (r = .863; p &lt; .05). Based on these findings, the study concluded that there is an urgent need to positively improve nursing mothers’ perception in order to improve their attitude towards weight gain after birth, through ante-natal health education, sensitization programmes and community mobilization addressing factors negatively influencing mothers’ perception and attitude towards postpartum weight gain especially during the ante-natal period.