Behavioral Weight Loss Research Articles

Anti-cancer and visible-light-driven photocatalyst activities of graphene oxide nanosheets against A549 lung cancer cells and organic dyes

The use of graphene oxide (GO) nanosheets (NSs) in cancer cell treatment is a promising and innovative approach to eradicate lung cancer cells and to adsorb and photodegrade organic dyes in water. XRD results revealed that the produced GO NSs have a high crystallinity and a d-spacing value of 0.87 nm. The FTIR spectrum showed that several oxygen-containing functional groups were introduced at the graphite surface from the exfoliation process. The TGA curve result supported the synthesis of GO NSs from the characteristic weight loss behavior. The wrinkled and fold surface morphology of the synthesized GO NSs was confirmed using FE-SEM and TEM. Subsequently, the assessment of their in vitro anti-oxidant and hydroxyl radical scavenging characteristics revealed that the synthesized GO NSs possessed effective antioxidant properties. The viability of A549 lung cancer cells against GO NSs was found to decrease in a dose-dependent manner and their morphology and nuclear damages was assessed by AO/EB and DAPI staining assays. The increased oxidative stress resulted in greater apoptotic cell death, loss of nuclear integrity, and mitochondrial membrane damage against A549 lung cancer cells. The increasing caspase-3 and caspase-9 activation resulted in more apoptotic cell death and cell cycle arrest as determined by flow cytometry. Further, GO NSs demonstrated moderate photocatalytic activity under visible light irradiation, degrading methylene blue (MB) and bromothymol blue (BTB) dye molecules by 44 and 53.5 %, respectively, after 120 min irradiation. Finally, the present study demonstrated that GO NSs possess excellent anti-cancer and moderate photocatalyst activities.

The Mood-Behavior Model: Assessing Mood-Related Mobilization of Self-Regulation of Weight-Loss Behaviors Within Community-Based Obesity Treatments

Increasing understanding of self-regulation processes within behavioral obesity treatments is required to improve consistently inadequate outcomes. The mood-behavior model proposes that, under conditions of goal striving and mood awareness, enhanced mood will mobilize self-regulation resources. That was tested within community-based obesity treatments where increased exercise might enhance mood, and increased self-regulation could improve weight-loss behaviors. Women with obesity participating in treatments focusing on either moderate exercise and self-regulation (Exercise/Self-Regulation [Exercise/SR] group, n = 42) or education on healthy eating and (to a lesser extent) exercise (Usual Care group, n = 48) were assessed on psychological and behavioral changes over 6 months. Significant overall improvements in negative mood, self-regulation for exercise and controlling eating, exercise, and fruit/vegetable intake were significantly greater in the Exercise/SR group. Using aggregated data ( N = 90), at baseline, negative mood did not significantly predict self-regulation. However, at months 3 and 6, negative mood significantly predicted both self-regulation for exercise and self-regulation for controlling eating. The addition of the group as a predictor significantly increased the explained variances. Increase in self-regulation for exercise significantly mediated the prediction of increased exercise via earlier reduction in negative mood. When group was entered into that model, it significantly moderated the mood-self-regulation and mood-exercise relationships. Increase in self-regulation for controlling eating significantly mediated the prediction of increase in fruit/vegetable intake via reduction in negative mood. Group marginally moderated the mood-self-regulation relationship only. Findings supported viability of the mood-behavior model in a field-based setting and suggested a need to facilitate improved mood to increase participants’ self-regulatory skill usage within obesity treatments.

Longitudinal associations of internalized weight stigma with physical activity and weight loss.

Cross-sectional research has demonstrated that internalized weight stigma (IWS) is associated with less engagement in weight management behaviors, including physical activity. However, limited research has explored longitudinal relationships among IWS, physical activity, and weight loss. This study examined longitudinal associations of changes in IWS, physical activity, and weight and tested whether physical activity mediated the relationship between IWS and weight change. Individuals with obesity and high IWS (N=105) participated in a 72-week behavioral weight loss intervention, with or without a weight stigma intervention. Measures of IWS (Weight Self-Stigma Questionnaire), physical activity (accelerometry and self-report), and weight were collected at baseline and weeks 20, 46 and 72. Correlations examined relationships among changes in variables from baseline to all timepoints, controlling for treatment condition. Mediation, controlling for treatment condition, tested whether IWS reductions during the first 20weeks predicted greater weight loss at weeks 46 and 72 via increased physical activity between weeks 20 and 46 or 72. Decreases in IWS at week 20 were associated with greater week-20 weight loss (r=0.265, p=0.012). Physical activity was not a significant mediator, but greater reductions in IWS at week 20 predicted greater week-46 weight loss with or without controlling for physical activity (WSSQ: b=0.30, confidence interval: 0.12, 0.54). Significant associations were not found at week 72. Initial reductions in IWS were associated with greater week-46 weight loss. Further research should investigate whether reducing IWS early in obesity treatment enhances long-term outcomes. ClinicalTrials.gov (NCT03704064).

Pyrolysis characterization and kinetic analysis of typical coals in western China: effects of coal type, particle size and heating rate

ABSTRACT The three typical coals selected in this study (Shuangyi coal (SY), Hengsheng coal (HS) and Ningxia anthracite (NX)) are widely used in western China, but their pyrolysis characteristics have been less studied. In this study, based on the simultaneous thermal analysis-Fourier transform infrared spectroscopy (STA-FTIR) technique, the effects of different coal types, particle sizes and heating rates on the pyrolysis characteristics of coal powder were investigated. The results showed that the weight loss behaviors of different types of coals with different particle sizes varied, as influenced by the type of coal and heat transfer. When the particle size increased from 170 μm to 380 μm, the weight loss rate decreased by 2.95% and 24.45% for SY and NX coals while increased by 4.81% for HS coals; whereas for the maximum decomposition rate, both SY and HS coals showed an increasing tendency (increased by 2.76% and 9.32%), while NX coals decreased by 21.43%. The R2 of the three coal DTG curves fitted by subcurves was all 0.999, which proved that the nature of coal weight loss was the coupling effect of certain types of chemical reactions or covalent bond breakage. Real-time infrared spectroscopy was combined with covalent bonding to explore the major gas products and their influence by particle size. The activation energies at different temperatures were calculated by the Coats-Redfern method, in which the activation energies of the fast pyrolysis stage of HS coal were 1.68 and 2.75 times higher than those of the other two stages, 1.79 and 3.03 times higher than those of SY coal, and 1.99 and 1.11 times higher than those of NX coal, respectively.

Impact of a Health Coach-Led, Text-Based Digital Behavior Change Intervention on Weight Loss and Psychological Well-Being in Patients Receiving a Procedureless Intragastric Balloon Program: Prospective Single-Arm Study.

Digital health interventions show promise for weight management. However, few text-based behavior change interventions have been designed to support patients receiving intragastric balloons, and none have simultaneously evaluated weight loss, psychological well-being, and behavior change despite the crucial interplay of these factors in weight management. This study aims to assess whether a health coach-led, asynchronous, text-based digital behavior change coaching intervention (DBCCI) delivered to participants receiving an intragastric balloon and its aftercare program was feasible and acceptable to participants and supported improved outcomes, including weight loss, psychological well-being, and lifestyle behavior change conducive to weight loss maintenance. This 12-month, single-arm prospective study enrolled adults aged 21 to 65 years with BMI ≥27kg/m2 receiving a procedureless intragastric balloon (PIGB) at 5 bariatric clinics in the United Kingdom and the Netherlands. Participants received the DBCCI and the clinic-led PIGB aftercare program (remotely delivered) for 6 months after PIGB placement and then no intervention for an additional 6 months. The DBCCI was an evidence-based, personalized intervention wherein health coaches supported participants via exchanged asynchronous in-app text-based messages. Over the 12-month study, we assessed percentage of total body weight loss and psychological well-being via self-administered validated questionnaires (Warwick-Edinburgh Mental Wellbeing Scale, Generalized Anxiety Disorder Scale, Impact of Weight on Quality of Life-Lite-Clinical Trials Version, Loss of Control Over Eating Scale-Brief, Weight Efficacy Lifestyle Questionnaire-Short Form, and Barriers to Being Active Quiz). Participant engagement with and acceptability of the intervention were assessed via self-reported surveys. Overall, 107 participants (n=96, 89.7% female; mean baseline BMI 35.4, SD 5.4kg/m2) were included in the analysis. Mean total body weight loss was 13.5% (SEM 2.3%) at the end of the DBCCI and 11.22% (SEM 2.3%) at the 12-month follow-up (P<.001). Improvements were observed for all psychological well-being measures throughout the 12 months except for the Generalized Anxiety Disorder Scale (improvement at month1) and Barriers to Being Active Quiz (improvements at months3 and 6). Surveys showed high levels of engagement with and acceptability of the DBCCI. This study provides evidence that the health coach-led, asynchronous, text-based DBCCI was engaging and acceptable to participants with overweight and obesity. The DBCCI, delivered alongside the PIGB and its aftercare program, supported improved weight loss outcomes and psychological well-being versus baseline and was associated with lifestyle behavior changes known to help achieve and maintain long-term weight loss and improved health outcomes. Follow-up findings suggest a potential need for longer-term, more intense coaching to focus on weight loss maintenance and support ongoing self-coaching. This could be achieved by leveraging generative artificial intelligence to provide ongoing automated behavior change coaching support to augment human-led care. ClinicalTrials.gov NCT05884606; https://clinicaltrials.gov/study/NCT05884606.

Pyrolysis characteristics of different types of tobacco and its correlation with the released aroma components under heating condition

An in-depth insight into the pyrolysis characteristics of tobacco is of great significance for the utilization of tobacco wastes. The effects of glycerol addition on the pyrolysis characteristics and distribution of aroma components of four types of tobacco was investigated in this study by using thermogravimetry and self-built rapid heating furnace capture and GC-MS analysis. Further, correlation network analysis was used to study the correlation between pyrolysis characteristics and released aroma components. It was found that the thermal weight loss behavior of different samples exhibited both commonalities and differences, the thermal weight loss process could be divided into four stages. After the application of glycerol, the overall performance of all types of tobacco leaves at stage II showed that DTGmax2 and WL2 increased, and glycerol had a relatively obvious effect on the pyrolysis characteristic parameters of flue-cured tobacco. Pyrolysis kinetic analysis based on Coats-Redfern method showed that the activation energy and pre-exponential factor of tobacco samples were decreased after the addition of glycerol. Under the heating condition, the total amount of released aroma components from each type of tobacco followed the order of burley tobacco > flue-cured tobacco >oriental tobacco > yellow sun-cured tobacco. The release amount of heterocyclic and olefins compounds from burley tobacco were higher, while flue-cured tobacco released higher contents of esters, ketones and furans compounds. The addition of glycerol promoted the release of aroma components. In terms of correlation, Tmax2 was negatively correlated with esters, aldehydes, and furans compounds, and positively correlated with DTGmax3. Tmax3 was significantly correlated with a lot of indicators, positively with acids, aldehydes, and furans compounds, but negatively with olefins and heterocyclic compounds.

Understanding the selection of support partners in a behavioral weight loss program

Objective Engaging a support partner during behavioral weight loss (BWL) programs can improve outcomes. However, little information is available about those selected as support partners. The study aimed to (1) characterize support partners and qualities of the relationship, (2) assess differences in relationship dynamics across relationship types, and (3) assess differences in supportive relationships by participant gender. Methods and Measures Upon entering a 24-month BWL program, participants (N = 323) nominated a support person from their existing social networks. Participants completed self-report measures at baseline, including the Working Alliance Inventory and study-specific measures assessing characteristics of the support person and comfort in communicating with them. Results Spouse/partners were chosen by 43.3% of all participants. Among married participants, 80.9% of men and 53.8% of women chose their spouse/partner. Working alliance was lower when the support partner was a spouse/partner versus a friend (p < 0.05, r = −0.19). Comfort talking about exercise with a support partner was higher than talking about eating or weight (p < 0.001, η2 p = 0.05). Conclusion A variety of friends and family can be selected as support partners during BWL. Programs should attend to the unique needs of men versus women when identifying sources of support.

Predictors of parent self-monitoring patterns in a family-based behavioral weight loss treatment program.

Self-monitoring dietary intake is a critical component of family-based intensive health behavior and lifestyle treatment for pediatric obesity, but adherence rates are often low. This study identifies predictors of parent self-monitoring rates during treatment. A secondary analysis of parent self-monitoring data from a randomized controlled trial involving 150 parent-child dyads. Patterns of self-monitoring were identified using a latent class mixed model approach. Logistic regression analyses evaluated predictors of self-monitoring patterns. Latent class models identified two trajectory groups: a high consistent self-monitoring group and a low-decreasing self-monitoring group. When compared to parents in the low group, parents in the high group lost more weight throughout treatment. Children in the high group had a similar trajectory for weight loss; however, the groups were not statistically different. Higher levels of family chaos and poorer family problem-solving skills were associated with higher odds of being in the low group. This study identified two patterns of rates of parent self-monitoring, which were associated with parent weight loss and were differentiated by family chaos and poor problem-solving. These findings suggest that families with high levels of chaos and poor problem-solving could benefit from early intervention to improve outcomes in pediatric obesity treatment programs. Clinicaltrials.gov Identifier: NCT01197443.

Optimising a digitally delivered behavioural weight loss programme: study protocol for a factorial cluster randomised controlled trial

BackgroundDigitally delivered weight loss programmes can provide a convenient, potentially cheaper, and scalable treatment option for people who may need to lose weight. However, outcomes are often inferior to in-person interventions in the long-term. This trial will use principles from the Multiphase Optimisation Strategy (MOST) framework to test whether it can enhance the effectiveness of a commercial digital behavioural weight loss programme. This trial aims to identify an optimised combination of four intervention components to enhance weight loss over a 24-week period. We will also explore which components contribute to improvements in participant retention and engagement with the programme.MethodsApproximately 1400 adults with a BMI > 21 kg/m2 will be enrolled and randomised to one of 16 experimental conditions in a 24 factorial cluster design. The trial will test four intervention components: an introductory video call with the health coach, drop-in webchat sessions with the health coach, goal setting statements, and food diary review and feedback. All participants will receive the core digital behavioural weight loss programme and up to four new intervention components. Participation in the trial will last for 24 weeks. The primary outcome will be weight change at 16 weeks. Other outcomes, measured at 4, 16, and 24 weeks, include programme drop-out and engagement (number of interactions with the three main app functions). Fidelity and acceptability will be assessed using data on component adherence and self-report questionnaires. Decision-making for the enhanced programme will be based on components that contribute to at least a minimal improvement in weight loss, defined as ≥ 0.75kg, alone or in combination with other components.DiscussionThe factorial design is an efficient way to test the efficacy of behavioural components alone, or in combination, to improve the effectiveness of digital weight loss programmes. This trial will test the implementation of the MOST framework in an industry setting, using routinely collected data, which may provide a better way to refine and evaluate these types of interventions in a model of continuous service improvement.Trial registrationTrial registration: ISRCTN, ISRCTN14407868. Registered 5 January 2024, 10.1186/ISRCTN14407868.

Weight loss trends in Korean adolescents (2005-2021): Exploring the impact of measured and self-perceived weight status

ObjectiveThis study aims to assess the trends in the proportions of weight loss efforts among Korean adolescents aged 10–18 years from 2005 to 2021, examining variations based on weight status, to examine factors related to weight loss efforts by weight status, and to evaluate weight loss efforts based on the combination of measured and self-perceived weight status. MethodsComplex sample design analyses were conducted on a dataset comprising 10,760 adolescents, utilizing information from the Korea National Health and Nutrition Examination Survey, a nationally representative dataset. Participants were categorized into non-overweight and overweight groups using a BMI percentile threshold of 85. Results22–29 % of non-overweight adolescents and 54–77 % of adolescents with overweight engaged in weight loss efforts. Among adolescents who attempted to lose weight from 2005 to 2017, 39.5–57.1 % tried both of diet and exercise, 22.7–47.4 % tried exercise alone, and 10.2–26.7 % tried diet alone. Female gender, older age, and higher self-perceived weight status were associated with increased odds of weight loss efforts, irrespective of actual weight status. For adolescents perceiving themselves as obese, the odds of attempting weight loss were 8.32 for non-overweight boys, 2.02 for non-overweight girls, 15.28 for overweight boys, and 5.77 for overweight girls compared to controls who were non-overweight and perceived themselves as not obese. ConclusionWeight loss efforts among Korean adolescents aged 10 to 18 remained consistent irrespective of their actual weight over 16 years. Throughout this period, adolescents who perceived themselves as obese were more likely to attempt weight loss, independent of their true weight status. Hence, subjective weight perception plays a significant role in influencing weight loss behaviors among adolescents.

Technological and sensory characteristics in development of innovative symbiotic boneless dry-cured lamb meat snack

Novel shelf-stable and high-protein meat products that are affordable, convenient, and healthy are hot topic in current food innovation trends. To offer technological databases for developing new functional lamb meat products, this study aimed to evaluate the technological and sensory aspects of dry-cured lamb meat snacks incorporated with the probiotic culture Lactobacillus paracasei and the prebiotic lactulose. Four formulations were analyzed: control (without prebiotic or probiotic); PREB (with 2% lactulose); PROB (with 107 CFU/g of L. paracasei); and SYMB (with 2% lactulose and 107 CFU/g of L. paracasei). Fitted curves revealed that weight-loss behavior during snack ripening was not affected (P > 0.05) by treatments. Snack moisture, water activity, pH, titratable acidity, lipid oxidation, and residual nitrite were affected (P < 0.05) only by ripening time. The target probiotic strain stood out against competitive flora and was detected at 107 CFU/g in the snack-supplemented formulations (PROB and SYMB). In snacks supplemented with prebiotics (PREB and SYMB), the lactulose content was maintained at 2.17%. Significant differences were not observed in the chemical composition, texture profiles, and CIE color indices between the proposed functional snacks and the control. In addition to texture, flavor, and overall impression evaluation, only color attributes were positively impacted (P < 0.05) in the acceptance and multiple comparison tests against the control. The proposed formulation and bench process parameters produced potential nutritionally and sensory-appreciated, microbiologically stable, and safe (multi-hurdle perspective) functional high-protein restructured lamb snacks.

Validation of a laboratory craving assessment and evaluation of 4 different interventions on cravings among adults with overweight or obesity

Food cue reactivity (FCR) is an appetitive trait associated with overeating and weight gain. We developed a laboratory craving assessment to objectively evaluate cognitive aspects of FCR. This study examined the preliminary construct and criterion validity of this craving assessment and evaluated 4 different interventions, 2 of which incorporated cue-exposure treatment for food, on craving over treatment and follow-up. 271 treatment-seeking adults with overweight/obesity (body mass index = 34.6[5.2]; age = 46.5[11.8]; 81.2% female; 61.6% non-Latinx White) completed the Food Cue Responsivity Scale and the laboratory craving assessment, during which they alternated holding and smelling a highly craved food and provided craving ratings over 5 min. Participants were subsequently randomized to 26 treatment sessions over 12-months of ROC, Behavioral Weight Loss (BWL), a combined arm (ROC+) and an active comparator (AC), and repeated the craving assessment at post-treatment and 12-month follow-up. Linear mixed-effects models assessed associations between trial type (holding vs. smelling), trial number, pre-treatment FCR, treatment arm, assessment time point, and craving. Cravings were greater when smelling vs. holding food (b = 0.31, p < 0.001), and cravings decreased over time (b = −0.02, p < 0.001). Participants with higher pre-treatment FCR reported elevated cravings (b = 0.29, p < 0.001). Longitudinally, we observed a significant 3-way interaction in which treatment arm modified the relationship between pre-treatment FCR and craving over time (F(17,5122) = 6.88, p < 0.001). An attenuated FCR-craving relationship was observed in ROC+ and BWL from baseline to post-treatment but was only sustained in BWL at follow-up. This attenuation was also observed in ROC and AC from post-treatment to follow-up. The preliminary validity of this laboratory craving assessment was supported; however, greater craving reductions over time in ROC/ROC+ compared to BWL and AC were not consistently observed, and thus do not appear to fully account for the moderating effect of FCR on weight losses observed in the trial.

Treatment Options and Continuity of Care in Metabolic-associated Fatty Liver Disease: A Multidisciplinary Approach.

The terms non-alcoholic fatty liver disease and non-alcoholic steatohepatitis have some limitations as they use exclusionary confounder terms and the use of potentially stigmatising language. Recently, a study with content experts and patients has been set to change this nomenclature. The term chosen to replace non-alcoholic fatty liver disease was metabolic dysfunction-associated steatotic liver disease (MASLD), which avoids stigmatising and helps improve awareness and patient identification. MASLD is the most common cause of chronic liver disease with an increasing prevalence, accounting for 25% of the global population. It is considered the hepatic manifestation of the metabolic syndrome with lifestyle playing a fundamental role in its physiopathology. Diet change and physical activity are the cornerstones of treatment, encompassing weight loss and healthier behaviours and a holistic approach. In Europe, there is no approved drug for MASLD to date and there is a substantial unmet medical need for effective treatments for patients with MASLD. This review not only provides an update on advances in evidence for nutrition and physical activity interventions but also explores the different therapeutic options that are being investigated and whose development focuses on the restitution of metabolic derangements and halting inflammatory and fibrogenic pathways.

Thermogravimetric analysis on two Bambusa texlitis wastes slow pyrolysis behaviors and kinetics using isoconversional and parallel-reactions models

In this work, the pyrolysis behaviors and kinetics of two bamboo (Bambusa texlitis) wastes were investigated via thermogravimetric analysis. The weight loss behaviors of pyrolysis were studied by curvature of the conversion (α) curves. The curvature of α can depict the characteristic temperatures of pseudo component (hemicellulose, cellulose and lignin) pyrolysis. Model-free model was applied to estimate the apparent activation energies of the pure components for comparison with other kinetic models. Three parallel reaction (TPR) and parallel finite number first-order reaction (FNFOR) models were used for kinetic studies. The first-order TPR model underestimates the apparent activation energies of pseudo components. The nth-order TPR model underestimates the apparent activation energy of lignin and obtains characteristic temperatures that are inconsistent with those of pure lignin. The parallel FNFOR model is more reliable for simulating the kinetics of lignocellulosic biomass pyrolysis. The apparent activation energies of pseudo components depend on the variety of lignocellulosic biomass.

Social media behaviors and body type ideals predict weight loss and food tracking behaviors among recreational climbers

Social media behaviors and body type ideals predict weight loss and food tracking behaviors among recreational climbers

Behavioral weight loss treatment for adults with binge-eating disorder: A qualitative analysis of patients' perspectives and experiences.

Understanding the perspectives of behavioral weight loss (BWL) participants could inform whether, how, and for whom BWL should be offered. All 126 participants in a clinical trial of BWL for adults with binge-eating disorder (BED) and overweight/obesity were contacted about a qualitative study. 45 participants, 11 of whom had dropped out of the parent study, completed qualitative interviews. The interview guide was developed using data from a survey of providers who offer Health at Every Size and other weight-neutral lifestyle interventions. Questions were phrased to invite even the most negative responses. Questions focused on participants' experiences of weight stigma during treatment, perceptions of BWL's calorie and WL goals, and opinions of BWL and weight-neutral interventions. We identified four themes using thematic analysis: (1) BWL did not perpetuate weight stigma. (2) Calorie and WL goals did not exacerbate participants' binge eating. (3) Patients should have the right to pursue any treatment that aligns with their personal goals. (4) BWL can improve participants' overall health. BWL participants with BED and overweight/obesity want others to have access to a program that can reduce both weight and binge eating. Participants emphasized that no treatment works for everyone, and they all agreed that BWL had not perpetuated weight stigma. Fewer than 20% of participants considered the program's calorie and WL goals to be harmful; most participants viewed those goals as achievable and helpful, and many asserted that their participation in BWL had improved their overall health. We interviewed adults with binge-eating disorder and overweight/obesity who had participated in a behavioral weight loss (BWL) program. Our participants wanted others in their position to have access to BWL because it aims to reduce both weight and binge-eating frequency. Efforts should be made to provide patients, clinicians, and policymakers with the knowledge that supervised, evidence-based BWL is an effective and desired treatment choice for this population.

Low-Income Participants' Preference Between Financial Incentives for Behavioral Goals vs Weight Loss Targets and Associations With Behavioral Goal Adherence.

Examine associations between whether participants' were matched to their preferred financial incentive design and behavioral goal adherence in a weight management intervention. Secondary quantitative analysis incorporating qualitative survey data. Primary care clinics in socioeconomically disadvantaged communities in New York City and Los Angeles. 668 participants (mean age 47.7 years, 81.0% female, 72.6% Hispanic) with obesity were enrolled in the Financial Incentives foR Weight Reduction (FIReWoRk) intervention. We explored qualitatively participant's reasons for hypothetically choosing a behavioral goal-directed vs a weight loss outcome-based financial incentive program. Additionally, behavioral adherence to different goals was collected at the 6-month timepoint, categorized by match to preferred financial incentive design. Logistic regression was used to examine if participants with certain demographic and higher psychosocial factors were more likely to choose goal-directed over outcome-based incentives. Additionally, logistic regression was used to test for associations between preference and behavioral adherence, using incentive type as an interaction term. 60.2% of participants preferred the goal-directed incentive, with the majority stating that it was more structured. Married participants were more likely to prefer goal-directed incentives (OR = 1.57, CI = 1.06-2.33, P = .025). Moderation analysis revealed that participants who preferred goal-directed and were matched to goal-directed had greater rates of behavioral adherence for program attendance and self-weighing, but not dietary tracking and physical activity tracking, compared to those who preferred outcome-based and were matched to outcome-based. Receiving one's preferred incentive design may not play a strong role in behavioral goal adherence during financially incentivized weight loss interventions.

Modelling lung infection with Klebsiella pneumoniae after murine traumatic brain injury

Pneumonia is a common comorbidity in patients with severe traumatic brain injury (TBI), and is associated with increased morbidity and mortality. In this study, we established a model of intratracheal Klebsiella pneumoniae administration in young adult male and female mice, at 4 days following an experimental TBI, to investigate how K. pneumoniae infection influences acute post-TBI outcomes. A dose-response curve determined the optimal dose of K. pneumoniae for inoculation (1 x 10^6 colony forming units), and administration at 4 days post-TBI resulted in transient body weight loss and sickness behaviors (hypoactivity and acute dyspnea). K. pneumoniae infection led to an increase in pro-inflammatory cytokines in serum and bronchoalveolar lavage fluid at 24 h post-infection, in both TBI and sham (uninjured) mice. By 7 days, when myeloperoxidase + neutrophil numbers had returned to baseline in all groups, lung histopathology was observed with an increase in airspace size in TBI + K. pneumoniae mice compared to TBI + vehicle mice. In the brain, increased neuroinflammatory gene expression was observed acutely in response to TBI, with an exacerbated increase in Ccl2 and Hmox1 in TBI + K. pneumoniae mice compared to either TBI or K. pneumoniae alone. However, the presence of neuroinflammatory immune cells in the injured brain, and the extent of damage to cortical and hippocampal brain tissue, was comparable between K. pneumoniae and vehicle-treated mice by 7 days. Examination of the fecal microbiome across a time course did not reveal any pronounced effects of either injury or K. pneumoniae on bacterial diversity or abundance. Together, these findings demonstrate that K. pneumoniae lung infection after TBI induces an acute and transient inflammatory response, primarily localized to the lungs with some systemic effects. However, this infection had minimal impact on secondary injury processes in the brain following TBI. Future studies are needed to evaluate the potential longer-term consequences of this dual-hit insult.

Abstract PO4-11-07: Early response to Adaptive Nutrition and Exercise Weight loss (A-NEW) Study for Breast Cancer Survivors with Overweight or Obesity

Abstract BACKGROUND: Obesity is associated with inferior survival and increased risk of recurrence in breast cancer (BC) survivors. In the Look AHEAD trial, 45% of patients attained ≥5% weight loss at 2 months, and those who lost 3-6% of weight at 2 months had higher odds of &amp;gt;5% weight loss at 1 year. Behavioral weight loss (BWL) studies consistently demonstrate that only half of BC survivors lose &amp;gt;5% weight, emphasizing the need for new approaches to aid those not benefiting from BWL alone. We hypothesized that early weight loss could identify BC survivors with excess body weight who may not benefit from BWL alone, and my benefit from the addition of a FDA-approved anti-obesity pharmaceutical agent. METHODS: Women with stage 0-III BC and BMI &amp;gt;27 kg/m2 who completed recommended local therapy and chemotherapy were enrolled in a 6-month BWL program consisting of remote coaching, an online curriculum, and tracking of diet, activity and weight. Patients completed demographic surveys and were weighed in clinic at baseline and 2 months. We used an adaptive design utilizing weight loss at 2 months to identify those with greater likelihood of weight loss at 6 months with BWL alone. Patients with and without ≥5% weight loss at 2 months were stratified as FAST-BWL and SLOW-BWL, respectively. Those in FAST-BWL continued BWL alone for 4 months, while those in SLOW-BWL also receive anti-obesity medication (Contrave®) until end of study. We anticipate 55% of 55 subjects enrolled will be in the SLOW-BWL group, resulting in a sample size of approximately 30 SLOW-BWL women and 25 FAST-BWL women. Simon's two-stage minimax design was used for the SLOW-BWL group. The null hypothesis that the true rate of attaining ≥5% weight loss is 10.9%, which is chosen based on the rate of women attaining ≥5% weight loss in the self-directed arm in the previously conducted POWER-remote study. The null hypothesis will be rejected if 7 or more women are observed in the 30 patients who attain ≥5% weight loss. This design yields a power of 80% at type I error rate of 5% when the true rate of attaining ≥5% weight loss of the baseline weight for the SLOW-BWL women is 29%, a clinical meaningful rate for the SLOW-BWL women group. We performed a descriptive analysis and evaluated outcomes at 2 months. RESULTS: Total enrollment is complete, and at time of presentation, 54 of 55 participants will be at end of study. Mean age at enrollment was 56 [30 -73], and majority were white (73%), postmenopausal (84%), had an ECOG of 0 (77%) and were employed (69%). The median time from diagnosis to enrollment was 3.9 years [0.6-10.0]. Over half received chemotherapy (54%), radiation (73%), and current endocrine therapy (75%); only 13% received prior antiHER2 therapy. Mean baseline weight was 213 (SD 30) pounds and baseline BMI was 35.5 (4.7). Mean HbA1c, total cholesterol, LDL, and triglycerides were 5.6% (0.4), 203 (29), 120 (26), and 135 (64), respectively. After 2 months of the BWL intervention, 14 (27%) attained ≥5% weight loss (FAST-BWL) and 38 (73%) did not (SLOW-BWL). CONCLUSIONS: We have successfully enrolled to this novel adaptive design and will present full data at the conference. Understanding predictors of successful weight loss inform populations that may benefit from anti-obesity medication, and design future studies that allow more patients to achieve significant weight loss. Citation Format: Jennifer Sheng, Amanda Montanari, Jennifer Trost, Mengyang Lu, Justin Mahosky, Sheetal Parida, Amanda Blackford, Dipali Sharma, Marci Laudenslager, Kimberly Gudzune, Janelle Coughlin, Vered Stearns. Early response to Adaptive Nutrition and Exercise Weight loss (A-NEW) Study for Breast Cancer Survivors with Overweight or Obesity [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-11-07.

Feasibility of a Sprague???Dawley Rat Model for Investigating the Effects of Seated Whole-body Vibration.

Vehicular whole-body vibration (WBV) can have long-term adverse effects on human quality of life. Animal models can be used to study pathophysiologic effects of vibration. The goal of this study was to assess animal cooperation and well-being to determine the feasibility of a novel seated rat model for investigating the effects of WBV on biologic systems. Twenty-four male Sprague???Dawley rats were used. The experiment consisted of an acclimation phase, 2 training phases (TrP1 and TrP2), and a testing phase (TeP), including weekly radiographic imaging. During acclimation, rats were housed in pairs in standard cages without vibration. First, experimental (EG; n = 18) and control group 1 (C1; n = 3) rats were placed in a vibration apparatus without vibration, with increasing duration over 5 d during TrP1. EG rats were exposed to vertical random WBV that was increased in magnitude over 5 d during TrP2 until reaching the vibration signal used during TeP (15min, 0.7m??s-2 root mean square, unweighted). C1 rats were placed in the vibration apparatus but received no vibration during any phase. Control group 2 (C2; n = 3) rats remained in the home cages. Cooperation was evaluated with regard to rat-apparatus interactions and position compliance. Behavior, weight, and fecal glucocorticoid metabolite concentrations (fGCM) were used to evaluate animal well-being. We observed good cooperation and no behavioral patterns or weight loss between phases, indicating little or no animal stress. The differences in fGCM concentration between groups indicated that the EG rats had lower stress levels than the control rats in all phases except TrP1. Thus, this model elicited little or no stress in the conscious, unrestrained, seated rats.