Weight Loss Goals Research Articles

Participation of Female Emerging Adults in a Theory- and Evidence-Based Behavioral Weight Loss Program.

Emerging adults are less likely to participate in and more likely to drop out of behavioral weight loss programs. Thirty-five female emerging adults who dropped out of a behavioral weight loss program, Weight Loss For Life, completed an online survey. Main reasons for dropout relate to insufficient behavioral skills and unique characteristics of emerging adults, especially when in college (e.g., citing working and getting good grades to be more important than losing weight). Most desired >50% of program online, having virtual groups, and using small groups to model desirable behaviors. Around $140 and $180 seemed sufficient to them to encourage participation in all scheduled treatment sessions and reaching overall weight loss goal, respectively. Future behavioral weight loss programs for emerging adults may consider helping develop time management and task management, decision-making that focuses on longer term outcomes, and immediate tangible rewards similar to what college students typically receive after they complete each class assignment.

Associations between weight loss difficulty, disordered eating behaviors and poor weight loss outcomes in Arab female university students

Little is known about the impact of eating behaviors on weight management efforts among college students in non-Western settings. This study aimed to explore the relationship between eating behaviors, weight loss outcomes, and perceived weight loss difficulties (PWLD) among young Arab women trying to lose weight. A cross-sectional probability sample was used to recruit female university students aged 18 years and older in the state of Qatar. Participants (N = 937) completed an online survey measuring their attitudes and behaviors towards healthy eating, body image, and weight loss. More than two third (67.2%) reported facing difficulties when trying to lose weight and around one-third (31.2%) screened positive for disordered eating. Chi-squared and logistic regression analyses showed a strong and independent association between unsuccessful weight loss including lack of weight loss or maintenance after weight loss attempts, and PWLD (OR 8.6, p = .002). In addition, eating meals a few hours before sleeping (OR 1.98; p = .02) and having disordered eating (OR 2.28; p = .02) were positively associated with PWLD. BMI, weight loss goal and skipping breakfast were not associated with PWLD after adjustment for all covariates. Future studies are needed to develop better tools to comprehensively assess PWLD and validate against short- and long-term measured weight loss outcomes.

Lifestyle-related advice in the management of obesity: A step-wise approach.

Obesity is a commonly encountered health-care problem that is an independent risk factor for chronic metabolic complications. Primary care physicians are the first point of contact in the management of obesity. Weight management is a step-wise intensification of interventions that initiates with lifestyle modification. Dietary and physical activity advices are integral components of all weight loss consultations and should ideally be imparted by a dietician or a nutritionist. In case of their nonavailability, the onus for lifestyle counseling rests with the physician. The prescription for a low-calorie diet coupled with increased physical activity might seem simple, but the success lies in compliance and sustainability of this advice. Compliance can be enhanced through patient-specific diet and activity plans along with corrections in eating and activity behavior. Barriers in patient's environment must also be addressed to achieve sustainable weight loss. This review covers practical insights in standard lifestyle management techniques, which can help the physicians to set better weight loss goals, adapt to patient specific lifestyle counseling, and apply strategies to enhance compliance for sustained weight loss.

Development of a scale to measure reasons for eating less healthily after exercise: the compensatory unhealthy eating scale

ABSTRACT Objective: Patterns of ‘compensatory eating’ following exercise are likely to be harmful for long-term health and counterproductive for weight loss goals. However, little is known about reasons why people eat unhealthily after exercising. Thus, we aimed to develop a measure that assesses reasons why people engage in compensatory unhealthy eating. Method: A multi-stage approach using exploratory and confirmatory factor analysis was used to develop and replicate a scale and validate its psychometric properties in three different samples. Participants (total N = 814) rated their agreement with statements capturing different reasons for eating less healthily after exercise. Results: Factor analysis revealed four distinct factors underlying compensatory eating: Reward for Effort, Permission to Consume, Need to Consume, and Reduced Self-Control. The resulting Compensatory Unhealthy Eating Scale (CUES) had good internal consistency and convergent validity. Conclusion: The CUES has utility as a tool to assess compensatory eating behaviour. Further research should examine who is most likely to compensate and under what circumstances. Broadening current knowledge of compensatory eating after exercise may facilitate development of strategies to improve health behaviour regulation.

Week-to-week predictors of weight loss and regain.

Despite increased interest in the development of individually tailored weight management programs, little is known about what factors proximally predict weight change. The current study investigated proximal (week-to-week) predictors of weight loss and regain in 74 adults during a 3-month, Internet-based behavioral weight loss program followed by a 9-month "maintenance" period (during which no additional intervention was provided). Participants were asked to self-weigh daily using scales that transmitted weight via the cellular network and to answer a brief questionnaire each week querying mood, behaviors, and cognitions hypothesized to be associated with weight loss and regain. Longitudinal multilevel models demonstrated that weight loss during initial intervention was proximally predicted by (a) greater frequency of self-monitoring weight and caloric intake, consistency between eating choices and weight loss goals, and importance of "staying on track" with these goals and (b) less negative mood, boredom with weight control efforts, hunger, and temptation to eat foods "not on plan" (ps < .05). Greater weight regain after intervention was also proximally predicted by these factors (with effects in the opposite direction) and additionally by less physical activity, less positive mood, more stress, greater temptation to skip planned physical activity, and higher ratings of the amount of effort required to stay on track (ps < .05). Results confirmed the importance of self-monitoring for weight loss and maintenance and identified other key week-to-week predictors of weight change. Results also supported efforts to develop intervention approaches specifically focused on weight loss maintenance. Future research should investigate whether using identified predictors to tailor intervention content and timing can improve weight outcomes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Shared Decision Making and Choice for Bariatric Surgery.

The number of people undergoing bariatric surgery is increasing every year, and their expectations for surgery often differ greatly. The purpose of this study was to develop a patient-centered decision-making aid to help people define their weight loss goals and assist them in discussing their surgical treatment with surgeons. Before the operation, the patients were asked to read the shared decision-making text and conduct a self-assessment. After the operation, we evaluated the program using survey questionnaires. A total of 103 patients were formally included in this study. The results show that patients were very satisfied with the use of patient decision aids (PDAs), with a score of 4.3 points (±0.6), and the postoperative decision-making satisfaction was also very high, at 4.4 points (±0.5), while the postoperative regret score was low, at 1.6 points (±0.6). Their satisfaction with surgical decision making and decision regret were statistically significantly negatively correlated (r = −0.711, p < 0.001). The experience of using PDAs was statistically significantly negatively correlated with decision regret (r = −0.451, p < 0.001); the experience of PDA use was statistically positively correlated with decision satisfaction (r = 0.522, p < 0.001). Patient decision aids are a means of helping patients make informed choices before they seek to undergo bariatric surgery.

Survey of knowledge for diagnosing and managing prediabetes in Latin-America: cross-sectional study

BackgroundPrediabetes has been proposed as a risk factor for the development of type 2 diabetes mellitus (DM2) and cardiovascular disease (CVD). Despite the clinical importance of prediabetes, little is known about the level of knowledge, beliefs and barriers to screening and treating prediabetes amongst care health providers in Latin America. The aim of the present survey was to evaluate the knowledge and beliefs about prediabetes amongst in Latin American health care providers.MethodologyIn a cross-sectional study, we adapted the written survey designed by the Johns Hopkins University group, and applied it to health care providers across Latin America during three meetings, in 2017, and with physicians from primary care centers in Bucaramanga, Colombia convened in 2017. The survey consisted of questions under four headings, diabetes screening, management of prediabetes, pharmacological treatment—metformin use, and demographic information. We perform a descriptive analysis to determine the differences in responses between different medical specialties.ResultsThe majority of the care providers that answered the survey were Colombian physicians, 54.5% of respondents had 10 years or more since completing their training and more women responded. Only 9.5% identified the 12 prediabetes risk factors described in the literature. The most common risk factor identified was a family history of diabetes, followed by overweight, a sedentary lifestyle and dyslipidemia, while ethnicity was the risk factor least commonly. 47.1% answered that laboratory tests to detect prediabetes are fasting glucose and HbA1C, 82.5% correctly identified fasting plasma glucose as the best test, 35.9% correctly responded that to the recommended weight loss goal is 5 to 7% and 49.1% that 150 min is considered the minimum level of physical activity per week. 78% agreed that the identification and treatment of prediabetes is important. 56% believed that patients with prediabetes progress more rapidly to diabetes and 40.6% considered that metformin could reduce the risk of diabetes in patients already diagnosed with prediabetes.ConclusionThese results demonstrate that there are important gaps in the knowledge of the diagnosis, clinical implications and management of prediabetes amongst Latin America health providers.

Achievement of weight loss in patients with overweight during dietetic treatment in primary health care.

IntroductionDietitians are the preferred primary health care professionals for nutritional care in overweight patients. Guidelines for dietitians recommend a weight reduction of ≥ 5% of initial body weight after one year of treatment. The purpose of this study was to evaluate weight change in patients with overweight who were treated by dietitians in Dutch primary health care, and to identify patient characteristics that were associated with it.Materials and methodsThis observational study data was based on real life practice data of patients with overweight during the period 2013–2017, derived from dietetic practices that participated in the Nivel Primary Care Database. Multilevel linear regression analyses were performed to investigate weight change after dietetic treatment and to explore associations with patient characteristics.ResultsIn total, data were evaluated from 56 dietetic practices and 4722 patients with a body mass index (BMI) ≥ 25 kg/m2. The mean treatment time was 3 hours within an average timeframe of 5 months. Overall, patients had a mean weight change of -3.5% (95% CI: -3.8; -3.1) of their initial body weight, and a quarter of the patients reached a weight loss of 5% or more, despite the fact that most patients did not meet the recommended treatment duration of at least one year. The mean BMI change was -1.1 kg/m2 (95% CI: -1.2; -1.0). Higher weight reductions were shown for patients with a higher initial BMI and for patients with a longer treatment time. Sex and age were not associated with weight change, and patients with other dietetic diagnoses, such as diabetes, hypertension, and hypercholesterolemia, had lower weight reductions.ConclusionsThis study showed that dietetic treatment in primary health care coincided with modest weight reduction in patients with overweight. The weight loss goals were not reached for most patients, which was possibly due to a low treatment adherence.

Do Mandated Weight Loss Goals Prior to Bariatric Surgery Improve Postoperative Outcomes?

Most patients pursuing bariatric surgery undergo mandated preoperative weight management programs. The purpose of this study was to assess whether preoperative mandated weight loss goals lead to improved perioperative morbidity, postoperative weight loss, and resolution of comorbidities. Data from patients who underwent primary laparoscopic Roux-en-Y gastric bypass (LRYGB), and laparoscopic sleeve gastrectomy (LSG) between October 2012 and October of 2015 was reviewed. Patients were divided in two groups: those with BMI of 35-45 were not required to achieve a weight loss goal prior to surgery (no-WLG group) while those with BMI > 45 were given a weight loss goal proportionate to their weight (WLG group). Body mass index (BMI), history of diabetes mellitus type-II (DM-II), hypertension (HTN), hyperlipidemia (HLD), and obstructive sleep apnea (OSA) were recorded at baseline and 4 years postoperatively. Length of hospital stay (LOS) and reinterventions were considered proxies for postoperative morbidity. A total of 776 patients, 81.4% LRYGB, were included in the study (age 45.1 ± 11.9). There was no difference in %ΔBMI, DM-II, HDL, HTN, LOS, or reinterventions among the two groups at 4 years postoperatively in both LRNY and LSG patients. This lack of difference persisted even when patients with similar BMI (43-45 vs 45.01-47) were compared. WLG group did not have decreased perioperative morbidity, nor improved weight loss and comorbidity resolution 4 years after surgery. While these findings should also be confirmed by multicenter trials, they question the value of mandated WLG prior to bariatric surgery as they seem ineffective and may limit patient access to surgery.

Managing Holiday Stress, Starting the New Year Well

We will soon be in the midst of holiday season stress, thinking about New Year’s resolutions. Making and keeping New Year’s resolutions is fraught with disappointments (nearly 80% fail by February), so I prefer to challenge myself by setting goals for the year, such as a yearly reading goal. My goal is 52 books per year, and each year has a different accompanying theme such as reading only nonfiction works or women authors or authors of color. I also set a health goal (notice I did not say weight loss goal) to engage in physical activity 5 days each week. In addition, with the help of a health and wellness coach, I also learned to reframe how my health and wellness goals can be an asset to my leadership practice. Beth A. Brooks, PhD, RN, FACHE, was presented with AONE’s Mentor Award in 2017. Dr. Brooks is president & CEO of The Brooks Group, LLC, a Chicago-based career coaching, personal brand, and consulting firm. She can be reached at [email protected]

Baseline Psychosocial and Demographic Factors Associated with Study Attrition and 12-Month Weight Gain in the DIETFITS Trial.

The purpose of this study was to examine correlates of failure-trial attrition and weight gain-in a randomized clinical weight-loss trial. The Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS) trial included 609 adults (18-50 years; BMI 28-40). Participants were randomized to a 12-month healthy low-fat or healthy low-carbohydrate diet for weight loss. At baseline, participants completed psychosocial, demographic, and anthropometric measures. Stepwise logistic regressions identified baseline factors associated with (1) study attrition and (2) among trial completers, weight gain at 12 months. Having higher baseline food addiction and self-efficacywas linked to treatment failure. Being younger, not having a college education, having higher outcome expectations and quality of life, and having lower social functioning and self-control increased the odds of trial attrition. Identifying as other than non-Hispanic white; not being married or cohabitating; having higher cognitive restraint and self-control; and having lower amotivation, family encouragement, and physical limitations increased the odds of gaining weight by treatment's end. Participants' baseline psychosocial and demographic factors may support or impede successful weight loss. Trialists should attend to these factors when designing treatments in order to promote participants' likelihood of completing the trial and achieving their weight-loss goals.

Putting the National Diabetes Prevention Program to Work: Predictors of Achieving Weight-Loss Goals in an Employee Population.

IntroductionDifferences in eligibility criteria and intervention characteristics have limited the generalizability of findings from studies of worksite translations of the National Diabetes Prevention Program (DPP). The objective of our study was to identify factors associated with achievement of the DPP’s 5% weight-loss goal in the Vanderbilt University Medical Center (VUMC) Faculty and Staff Health and Wellness DPP from 2014 to 2017.MethodsWe analyzed data from a DPP worksite translation that adhered to national standards for program quality and intervention fidelity. We compared baseline characteristics and program metrics for participants who did and did not achieve the program’s 5% weight-loss goal, and we developed a multivariable logistic regression model to identify independent predictors of achieving this goal.ResultsOf the 165 employees enrolled in the DPP from 2014 to 2017, 43.6% (n = 72) met the 5% weight-loss goal. Mean (standard deviation) percentage weight loss for the program was 5.2% (6.0%), or 4.8 (6.0) kg. The median (interquartile range) body mass index at baseline was lower among participants who achieved the 5% weight-loss goal than among those who did not (31.6 [29.4–37.4] vs 34.7 [31.5–39.2], P = .009), and participants who achieved the goal reported more physical activity minutes per week (166.0 [135.2–223.0] min vs 128.5 [83.2–169.8] min, P < .001). Session attendance was greater for participants achieving the 5% weight-loss goal (23 [21–25]) sessions vs 18 [12–21] sessions, P < .001). In the adjusted analysis, physical activity and session attendance remained significant predictors of achieving the 5% weight-loss goal.ConclusionSession attendance and physical activity independently predicted achievement of the 5% weight-loss goal in this worksite translation of the DPP. Strategies designed to improve these metrics may increase DPP success rates.

Bariatrik Cerrahi Sonrası Bireylerin İştah Kontrolü ve Yeme Bağımlılıklarının Değerlendirilmesi

Amaç: Bu çalışma, bariatrik cerrahi geçirmiş bireylerin iştah kontrolü ve yeme bağımlılıklarının değerlendirilmesi amacıyla planlanmıştır.&#x0D; Bireyler ve Yöntem: Çalışmaya bariatrik cerrahi geçirmiş 400 birey dahil edilmiştir. Bireylerin sosyo-demografik özellikleri, beslenme alışkanlıkları, bariatrik cerrahi hakkındaki bilgi ve deneyimleri incelenmiştir. Bireylere ‘Aşırı Besin İsteği Ölçeği’ (ABİS) ve ‘Duygusal İştah Anketi’ (DİA) uygulanarak sonuçlar değerlendirilmiştir.&#x0D; Bulgular: Yaş ortalaması 37.6±8.6 yıl olan 334 kadın (%83.5) ve 66 erkek (%16.5) birey çalışmaya katılmıştır. Kadın ve erkek katılımcıların beden kütle indeksi (BKİ) ortalamaları sırasıyla 28.6±5.9 kg/m2 ve 29.6±6.1 kg/m2’dir. Katılımcıların %63.2’sinin daha sağlıklı olmak amacıyla vücut ağırlığı kaybettikleri belirlenmiştir. Katılımcıların %87.8’inin Sleeve Gastrektomi yöntemi ile bariatrik cerrahi geçirdiği ve geçirilen bariatrik cerrahi ameliyatı üzerinden geçen sürenin ortalama 20.0±17.3 ay olduğu belirlenmiştir. Cinsiyete göre bariatrik cerrahi öncesi zayıflama çayları/tozları/ilaçları kullanımı, hastalık durumları ve zayıflama isteğindeki amaçlar arasında istatistiksel açıdan anlamlı farklılıklar saptanmıştır (p&lt;0.05). Katılımcıların vücut ağırlığı değerleri (r=0.131, p=0.009) ve ana öğün sayıları (r=0.160, p=0.001) arttıkça DİA olumsuz toplam puan değerlerinin arttığı, fiziksel aktivite yaptıkları gün sayısı arttıkça DİA olumsuz toplam puan değerlerinin azaldığı saptanmıştır (r=0.264, p=0.000). Ayrıca katılımcıların ABİS toplam puan değerleri arttıkça DİA olumsuz toplam puan değerlerinin de arttığı belirlenmiştir (r=0.448, p=0.000).&#x0D; Sonuç: Bariatrik cerrahi ve iştah kontrolü arasındaki ilişkinin belirlenebilmesi, bu hastaların iştah kontrollerini sağlayabilmeleri ve ileriki dönemde geri ağırlık kazanımının engellenmesi için oldukça önemlidir.

Bariatric surgery in patients with left ventricular assist devices: a safe and effective method of weight loss as a gateway to heart transplantation

BackgroundSevere cardiac disease often warrants intervention to improve cardiac function, such as mechanical support via a left ventricular assist device (LVAD). While this is an effective way of improving myocardial activity, it works synergistically with weight loss. SettingAcademic hospital. ObjectiveThe aim of this study was to evaluate bariatric surgery as an alternative means of weight loss to improve cardiac status. MethodsSix patients with LVADs underwent sleeve gastrectomies (SG) over a 5-year study period (2014–2018). Patient characteristics, cardiac history, operative outcomes, and follow-up was evaluated by univariate analyses. ResultsMedian age at operation was 49.8 years (range, 24–58 yr) with average weight at surgery of 126.6 kg. Average body mass index at time of SG was 41.4 kg/m2. Median hospital length of stay was 8.5 days (range, 4–13 d), with postoperative length of stay of 5.5 days (3–7 d). Total follow-up was 29 months (range, 7–51 mo). Postoperative readmission occurred in 2 patients (33%) without significant adverse outcomes. Four patients (67%) were listed for transplant, 3 within 1 year of LSG. Three patients (50%) underwent orthotopic heart transplant. All patients experienced improved cardiac co-morbidities after SG. ConclusionWe demonstrate that weight loss surgery as a bridge to transplantation for patients with implanted LVADs can be performed in young and middle-aged adults. Although it is limited by sample size, the reported results add to the existing literature highlighting the potential success of bariatric surgery in high-risk patient populations to achieve weight loss goals, impact cardiac co-morbidities, and improve overall quality of life.

Pharmacologic therapy of obesity: mechanisms of action and cardiometabolic effects.

Obesity is a chronic, relapsing, multifactorial disease, which has become a serious threat to public health globally, as the worldwide prevalence of obesity increases exponentially over time. It has been well established that obesity is associated with multiple adverse cardiometabolic effects. Although lifestyle changes are the first line of therapy for obesity, these are often insufficient in attaining weight loss goals. Orlistat, phentermine/topiramate, lorcaserin, naltrexone/bupropion, and liraglutide are agents that have been approved for the treatment of obesity but their effects on cardiometabolic risk factors and outcomes have not been clearly elucidated. Given the detrimental repercussions of obesity on cardiometabolic health, there is a pressing clinical need to fully understand the effects of these agents beyond weight loss alone. Certain previous weight loss drugs have been withdrawn due to safety concerns and this underlines the need for more careful assessment of the effects of the various pharmacologic agents currently used for the treatment of obesity. This review aims to provide an overview of the mechanisms, efficacy, safety and cardiometabolic effects of the currently available pharmacologic agents for weight loss.

To initiate the conversation - Public health nurses' experiences of working with obesity in persons with mobility disability.

AimDeveloping a theory explaining how public health nurses accomplish and adapt counselling in lifestyle habits to decrease obesity in people with mobility disability.DesignEmpirical research ‐ qualitative.MethodClassic grounded theory with face‐to‐face interviews, 2017–2018, using inductive approach to understand public health nurses' intervening experiences with obesity patients.ResultsTo initiate the conversation emerged as the main concern meaning having difficulties initiating conversations about obesity with patients. Public health nurses’ facilitators to communicate lifestyle changes emerged as the pattern generating the theory, which consists of the categories; person‐centeredness in the situation, experience and knowledge, strengthening conditions, access to other professionals and prioritization in everyday work.ConclusionsPublic health nurses hesitate to raise topics of obesity in patients with mobility disability. They advocate increased integration with lifestyle changes in everyday work including multi‐professional cooperation. The implication is testing the emerged theory at primary health care centres.ImpactObesity is more common in people with mobility disability than in those without. There is a need to understand how public health nurses adapt counselling in lifestyle habits. Public health nurses hesitate to talk about obesity with patients in fear of offending anyone. Public health nurses did not distinguish between patients with or without mobility disability. Several facilitators could be helpful initiating conversation with the patients. Public health nurses need more time and resources to facilitate conversation with patients with mobility disability to counsel lifestyle changes.

Case Reports on Diabetes-Related Outcomes for Pregnant Women in the National Diabetes Prevention Program.

Previous interventions to lower diabetes risks among pregnant women have been largely ineffective (1–3), and the identification of effective prevention tools is needed to protect both maternal and child health (4). The National Diabetes Prevention Program (NDPP) is a widely disseminated translation of the highly successful lifestyle change intervention from the Diabetes Prevention Program research study (5,6). The NDPP promotes weight loss of ≥5% through diet and physical activity, benefiting individuals who participate regularly (6). Eighty percent of participants are women (6), but most are beyond child-bearing years (7), and those who are pregnant at enrollment are excluded (8). Increasing enrollment in the NDPP among women of childbearing age has been identified as a priority (7), yet outcomes for those who become pregnant during the year-long program are unknown. To explore whether the NDPP may support beneficial outcomes during pregnancy, we examined case studies of women who became pregnant while participating in the NDPP. We delivered the year-long NDPP intervention in a Denver, Colo., health care system to eligible adults with diabetes risks (i.e., ≥24 kg/m2 and prediabetes, history of gestational diabetes mellitus [GDM], or positive score on a diabetes risk questionnaire [8]). Participants were largely referred by their primary care providers. Trained NDPP coaches led 22–25 group sessions over 1 year following guidelines developed by the Centers for Disease Control and Prevention (9). From March 2013 to March 2018, 924 women participated. Five women who subsequently reported having become pregnant were able to continue, but were no longer prescribed the NDPP’s weight loss goal. This article describes diabetes-related outcomes in pregnancy among three women using medical records available as of May 2018. An additional case was excluded because detailed records were unavailable, and another was excluded because of the early stage of the pregnancy. …

Lack of conflict during food choice is associated with the failure of restrained eating

Restrained eaters tend to sustain a restriction in caloric intake to lose or maintain body weight; however, only a few restrained eaters can achieve the goal of restricting their caloric intake to lose or maintain body weight. Those who are effective restrained eaters habitually adhere to their intentions to avoid eating certain palatable foods, whereas those who are ineffective restrained eaters are generally unable to translate their intentions into behavior. To restrain eating regardless of temptation, an individual must first identify potential conflicts between achieving restrained eating and temptation to eat. Regarding food selections, the association between a lack of conflict between temptation, eating enjoyment, and weight loss or maintenance goals and the failure of restriction of caloric intake remains unknown. The present study used an eye-tracking technique to assess the degree of conflict experienced by effective and ineffective restrained eaters during food choice. Participants were required to choose between pairs of high- and low-calorie foods. The results showed that choosing the low-calorie food was associated with the experience of more conflict, measured by longer response times and more gaze switches, than choosing the high-calorie food. Ineffective restrained eaters experienced less conflict, exhibiting shorter response times and fewer gaze switches, than did effective restrained eaters, which suggests that a failure to restrain eating might be associated with a lack of experience of conflict.

The Differential Effects Of Amount, Intensity, And Mode Of Exercise Training On A Novel Lipoprotein Multimarker Of Insulin Resistance

PURPOSE: To examine the effects of amount, intensity, and mode of exercise training on Lipoprotein Insulin Resistance Index (LP-IR; a relatively new spectroscopic multimarker of insulin resistance) across 10 exercise interventions from the STRRIDE studies. METHODS: A total of 531 men and women with dyslipidemia [STRRIDE I (n=222) and STRRIDE AT/RT (n=142)] or prediabetes [STRRIDE-PD (n=167)] were randomized to either control group or one of 10 exercise interventions, which ranged from doses of 8-22 kcal/kg/week (KKW); intensities of 50-75% V̇O2peak; and durations of 6-9 months. Two groups included resistance training and one group included dietary intervention (weight loss goal of 7%). Fasting blood samples were obtained at both baseline and 16-24 hr after the final exercise bout. NMR spectroscopy was performed at LabCorp to determine LP-IR score, which is comprised of six lipoprotein subclass and size parameters. LP-IR score ranges from 0 (most insulin sensitive) to 100 (most insulin resistant). Paired t-tests determined post- minus pre-intervention change score significance within groups (p<0.05). Study-specific ANCOVA determined differences between groups. RESULTS: The inactive control group did not significantly change LP-IR. After training, seven of the 10 exercise groups significantly improved LP-IR, ranging from -4.0 ± 7.6 to -12.5 ± 14.2. The figure displays change scores across all groups. The Aerobic plus Resistance group resulted in significantly greater change than the Resistance only group in STRRIDE AT/RT. The Moderate plus Diet group had significantly greater LP-IR change than all other groups in STRRIDE-PD. CONCLUSION: On average, STRRIDE interventions improved LP-IR. Our results provide compelling evidence that adding resistance to aerobic training elicits a synergistic training effect on LP-IR. In individuals with prediabetes, incorporating dietary intervention with aerobic training results in the most robust LP-IR improvement.

Eating Competence of Nutrition and Other Academic Majors Enrolled in an Undergraduate Introductory Nutrition Course (P16-008-19)

ObjectivesResearch suggests that nutrition majors tend to have higher rates of eating disordered behavior. The purpose of this study was to examine eating competence between nutrition and other academic majors enrolled in an undergraduate introductory nutrition course. MethodsData were collected between 2015–17 via an ongoing college health survey at a medium-sized, northeastern university (18–24 y, n = 1098; 68% female). Eating competence was determined via the Ellyn Satter Eating Competence Model ecSI 2.0 survey completed as part of an online questionnaire. ecSI items were scored based on the Ellyn Satter Eating Competence Model validated scoring method; total scores range from 0–48. Majors were identified as nutrition, allied health, and other academic majors. Proportional differences between majors were evaluated via chi-square analyses and mean differences were evaluated via ANCOVA with gender and self-reported weight loss goal as covariates. ResultsThere were no differences between mean ecSI scores between nutrition majors, allied-health majors, or all other academic majors (34.4 ± 1.0 vs. 33.9 ± 0.5 vs. 33.0 ± 0.3, P = 0.25). Among all students, males were more eating competent than females (36.0 ± 0.4 vs. 32.0 ± 0.3 P < 0.05). ConclusionsOur findings do not suggest eating competence differs between nutrition and other academic majors. Further research should examine additional factors that influence eating competence among college students. Funding SourcesNew Hampshire Agriculture Experiment Station and USDA National Institute of Food and Agriculture Hatch Project 1010738.