Weight Outcomes Research Articles

The Link between Gentrification, Children’s Egocentric Food Environment, and Obesity

While advocates argue that gentrification changes the neighborhood food environment critical to children’s diet and health, we have little evidence documenting such changes or the consequences for their health outcomes. Using rich longitudinal, individual-level data on nearly 115,000 New York City children, including egocentric measures of their food environment and BMI, we examine the link between neighborhood demographic change (“gentrification”), children’s access to restaurants and supermarkets, and their weight outcomes. We find that children in rapidly gentrifying neighborhoods see increased access to fast food and wait-service restaurants and reduced access to corner stores and supermarkets compared to those in non-gentrifying areas. Boys and girls have higher BMI following gentrification, but only boys are more likely to be obese or overweight. We find public housing moderates the relationship between gentrification and weight, as children living in public housing are less likely to be obese or overweight.

Associations between proximity to gas production activity in counties and birth outcomes across the US

Despite mounting evidence on the health effects of natural gas development (NGD), including hydraulic fracturing (“fracking”), existing research has been constrained to high-producing states, limiting generalizability. To expand the scope of previous research, we examined the associations between prenatal exposure and NGD production activity in 28 states on birth outcomes overall and by race/ethnicity. We linked 2005–2018 county-level microdata natality files on 33,849,409 singleton births from 1984 counties in 28 states with nine-month county-level averages of NGD production by both conventional and unconventional production methods, based on month/year of birth. We estimated linear regression models for birth weight and gestational age and probit models for the dichotomous outcomes of low birth weight, preterm birth, and small-for-gestational age. We subsequently examined interactions between women’s race/ethnicity and NGD production. We found that 53.8% of counties had NGD production activity. A 10% increase in NGD production in a county was associated with a decrease in mean birth weight by 1.48 g (95% CI = −2.60, −0.37), with reductions of 10.19 g (−13.56, −6.81) for infants born to Black women and 2.76 g (−5.05, −0.46) for infants born to Asian women. A 10% increase in NGD production in a county was associated with an increased risk of infants born low birth weight (0.0008; 95% CI = 0.0006, 0.0010) or small-for-gestational age (0.0018; 95% CI = 0.0015, 0.0022), particularly among infants born to Black women. In sum, NGD for energy production has negative impacts on the health of infants, with greatest effects in infants born to minoritized women.

Effects of meeting steps-based and minutes-based physical activity goals on weight loss in online behavioral weight control: seemingly unrelated regression analysis

ABSTRACT Background Behavioral weight loss programs often prescribe physical activity (PA) goals in terms of minutes/week of moderate-to-vigorous PA (MVPA) and steps/day. However, the impact of meeting each type of goal prescription on weight loss is unclear, particularly in digitally-based (eHealth/mHealth) programs. This secondary analysis of a randomized trial examined the effects of meeting steps-based and minutes-based goals on weight loss in an eHealth behavioral weight control program. Methods Adults in the control arm received a 6-month online behavioral weight loss intervention with prescribed weekly goals for daily steps and minutes of MVPA. The number of weeks steps-based and minutes-based goals were met (≥100% and ≥75% thresholds) based on self-reported PA were examined as predictors of 6-month weight loss among those providing weight outcomes (n = 172; 81% of control arm) using a systems regression approach. Results Participants (BMI 35.6 kg/m2; 90.1% female; 48.7 years of age) met weekly goals for MVPA (7.1 ± 6.4 weeks) more often than steps (3.5 ± 5.5 weeks, P < .001). Meeting the steps goals (β = .24, P < .001) and MVPA goals (β = .20, P < .001) were each statistically significant predictors of weight loss at the 100% threshold; their total effects were not statistically different from one another (χ 2 = 1.12, P = .29). Similarly, at the 75% threshold for steps goals (β = .19, P < .001) and MVPA goals (β = .19, P < .001), each independently predicted weight loss; no differences were detected in their total effects (χ2 = .01, P = .92). The probability of reaching ≥5% weight loss was comparable between meeting the steps goals and MVPA goals at both adherence thresholds. Conclusions Greater attainment of PA goals prescribed as steps and minutes of MVPA independently contribute to similar weight loss outcomes in a 6-month online behavioral weight loss intervention. Future research should determine whether promoting adherence to combined steps-based and minutes-based goals produces better weight loss than utilizing either goal alone and identify strategies that improve adherence.

Impacts of Educational Interventions with Support of Mobile App versus Booklet for Patients with Hypertension and Metabolic Syndrome: A Secondary Data Analysis.

Background: Hypertension comorbid with metabolic syndrome could increase the development of adverse cardiovascular events. Educational interventions were effective to improve outcomes in patients. Methods: This was a secondary data analysis of participants with hypertension. The original randomized controlled trial aimed to examine the effect of app and booklet versus control among individuals diagnosed with metabolic syndrome living in the community. A 30-min health education was provided to each participant. In addition to the education, the app group received a mobile app while the booklet group received a booklet. Data were collected at baseline, week 4, week 12, and week 24. Intention-to-treat principle was followed, and generalized estimating equations was employed for data analysis. Results: A total of 118 participants with hypertension and metabolic syndrome were extracted from the three-arm trial data. The sample size was 36, 42, and 40 in the app group, booklet group, and control group, respectively. Compared to the control group, the app group showed a significant reduction on body weight and waist circumference at week 24, while the total exercise and self-efficacy for exercise were increased at week 12 and week 24 but no significant findings were observed in the booklet group. Conclusions: The educational intervention supported with app was superior to the booklet support on the outcomes of body weight, waist circumference, total exercise, and self-efficacy for exercise among patients with hypertension and metabolic syndrome in the community.

Does the neighborhood built environment moderate the effectiveness of a weight-loss intervention for mothers with overweight or obesity? Findings from the Healthy Eating and Active Living Taught at Home (HEALTH) study

BackgroundWomen of childbearing age are vulnerable to weight gain and experience a high prevalence of obesity due to pregnancy and stressors of parenthood. Lifestyle interventions such as the Healthy Eating and Active Living Taught at Home (HEALTH) study have been effective for weight loss; however, little is known about how the built environment (parks, transit, grocery stores, fast food, walkability etc.), where participants live might modify intervention effectiveness. This study examined whether characteristics of the neighborhood built environment modified effectiveness of the HEALTH study on weight loss. MethodsSecondary data analysis was conducted using data from HEALTH. Using GIS, buffers were built around participant addresses to capture distance to and availability of food (grocery store, convenience store, fast food) and urban design and transit (parks, street connectivity, transit) built environment characteristics. Built environment characteristics were dichotomized into low and high density and distance. Likelihood ratio tests for interaction were conducted to determine if built environment characteristics modified intervention effectiveness on Body mass index (BMI) and waist circumference (WC). Mixed effects linear regression models were then run to estimate the effect of the HEALTH intervention on weight outcomes at 24-months across both strata of built environment characteristics. ResultsThe analytic sample (n = 151) had baseline mean BMI 34.9 (SD = 5.8) and mean WC 46.0 cm (SD4.9). All urban design and transit and all food environment characteristics modified HEALTH effectiveness on one or both weight outcomes. The built environment modified the HEALTH intervention such that it was mostly effective for mothers residing in neighborhoods with low transit access, low street connectivity, high park access, and low access to grocery stores, convenience stores, and fast food.ConclusionsResult show the HEALTH was most effective for women residing neighborhoods with built environment characteristics suggestive of suburban neighborhood typology. To maximize impact for mothers residing in all types of neighborhoods, future research should explore scaling up HEALTH in suburban settings, while adapting HEALTH to maximize effectiveness in compact neighborhoods most likely, urban core neighborhoods.

Gestational Outcomes and Birth Weight in Japanese Women at the Upper and Lower limits of the Normal BMI range.

To examine the outcome of gestational blood pressure and birth weight in women with normal pre-pregnancy BMI (18.5-25 kg/m2) who are at the lower and upper limits of this range, i.e., slightly underweight or slightly overweight. Overall, 2,038 Japanese women with low -risk who had delivered during January 2014-December 2016 were classified according to their pre-pregnancy BMI: underweight (< 18.5 kg/m2), slightly underweight (18.5≤BMI<21 kg/m2), normal (21≤BMI<23 kg/m2), slightly overweight (23≤BMI<25 kg/m2) and overweight (≤ 25 kg/m2). Their blood pressure during each trimester and birth weight was evaluated. The slightly overweight group showed a significantly higher blood pressure than the underweight and slightly underweight groups. Birth weight was lower in the slightly underweight than in the slightly overweight group (p<0.01). The incidence rate of "heavy for dates" (HFD) infants was significantly higher in the slightly overweight and overweight groups than in the other groups (p<0.05 and p<0.01, respectively). Weight gain of < 7 kg significantly increased the rate of "light for dates" (LFD) infants, while a weight gain of ≥13 kg significantly increased the rate of HFD infants (p<0.05 and p<0.01, respectively). Blood pressure during pregnancy was ssociated with pre-pregnancy BMI. The birth weight of infants of low-risk pregnant women is affected by both pre-pregnancy BMI and gestational weight gain.

Impact of postnatal nutrition on neurodevelopmental outcome in rat model of intrauterine growth restriction.

There are limited data on nutritional management of infants with intrauterine growth restriction (IUGR). Postnatal protein supplementation for promoting growth is a common clinical practice in neonatology. The present study aims to investigate the consequences of protein supplementation on long-term growth, brain and body weight, brain histology and behavioral outcome in a rat model of IUGR. Twenty-four IUGR-formed rat puppies and 12 healthy puppies were included in the study. IUGR model was established by low (10%) protein diet throughout pregnancy together with intraperitoneal injection of lipopolysaccharide (LPS). Pups were started to be fed with either standard protein (SP), or high protein (HP) diet until postnatal day (PN) 35. Puppies in the control group were given SP diet for 35 days. Six pups from each group were sacrificed at PN7, remaining six were evaluated by Morris water maze test between PN 30 to 35 days and then sacrificed at PN35. Histologic evaluation of brain tissue was performed at PN7 and PN35. IUGR group displayed lower body and brain weights at PN7 when compared with control. At PN35, SP group achieved similar brain/body weight ratios with control, whereas HP group displayed lowest brain/body weight ratio. The number of TUNEL positive cells was significantly higher and myelin basic protein and oligodendrocyte marker O4 immunoreactivity were significantly lower in HP group when compared with SP at PN35. Neuronal density in prefrontal cortex and hippocampus at PN7 were similar among SP and HP groups, but significantly lower in HP group when compared with SP at PN35. SP group displayed better results in the Morris water maze test when compared with HP group. Although postnatal HP support is associated with increase in body weight at PN35, it did not result in better brain/body weight ratios in the rat model of IUGR. In IUGR rats, HP diet was associated with increased apoptosis in brain tissue with lower neuronal density and decreased myelination when compared to SP. Furthermore, better neurodevelopmental scores were achieved by SP diet rather than HP support in IUGR.

Association between hemoglobin A1C response to glucagon-like peptide-1 receptor agonists and hemoglobin A1C and weight outcomes post-bariatric surgery

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a common treatment for type 2 diabetes mellitus (T2D). Endogenous glucagon-like peptide-1 secretion is a proposed mediator of T2D remission following bariatric surgery. We evaluated the association between preoperative response to GLP-1RAs and T2D outcomes following bariatric surgery. Our institution's bariatric surgery database was queried for patients with T2D who had taken a GLP-1RA prior to Roux-en-Y gastric bypass (N = 38) or vertical sleeve gastrectomy (N = 9). Response to GLP-1RAs was defined as change in hemoglobin A1C from initiation of therapy to ∼6 months. Postoperative outcomes included A1C and weight loss at 6 months (N = 44), 1 year (N = 44) and 2 years (N = 38) following surgery. The association between GLP-1RA response and postoperative outcomes was evaluated using multivariable generalized linear mixed models adjusted for postoperative time point, A1C prior to initiation of GLP-1RA, weight and surgery type. Mean A1C at initiation of therapy was 8.3 ± 1.4% and decreased by 1.1 ± 1.5% on GLP-1RA treatment. Greater response to GLP-1RA adjusted for initial A1C was correlated with reduced A1C at 6 months (r = 0.38, p = 0.02) and 2 years (r = 0.42, p = 0.03) but not weight loss following bariatric surgery. Every 1% decrease in A1C on GLP-1RA was associated with 0.30 ± 0.10% reduction in postoperative A1C and doubled odds of normoglycemia with A1C<5.7% (odds ratio: 2.00, 95% confidence interval: 1.12–3.45). Our findings offer preliminary evidence for a potential use of GLP-1RAs in predicting glycemic outcomes following bariatric surgery in patients with T2D. Further studies are needed to continue investigating this relationship. • GLP-1 is a potential mediator of post-bariatric surgery diabetes remission. • Preoperative GLP-1R agonist response is associated with A1C reduction post-bariatric surgery. • No association between GLP-1R agonist response and postoperative weight loss was found. • GLP-1R agonist response may be a predictor of diabetes remission following surgery.

Indulgent Feeding Style Moderates the Association of Food Responsiveness to Body Mass Index Z-scores of Preschoolers

ObjectiveTo investigate the moderating role of caregiver feeding styles in the association between preschool children's food-approaching eating behaviors and body mass index (BMI) z-scores. MethodsThis cross-sectional study examined 81 caregiver-preschooler dyads from low-income neighborhoods in Santiago, Chile. Moderated multiple linear regression analyses were used to determine the moderating effect of the indulgent feeding style in the relation between eating behaviors and BMI z-scores of preschool children. ResultsThe indulgent caregiver feeding style moderated the association between food responsiveness and BMI z-scores of preschoolers. In an indulgent feeding style, food responsiveness was associated with higher child BMI z-scores (β = 0.50; P < 0.001). There was no interaction between enjoyment of food and feeding styles in relation to children's BMI z-scores (β = 0.17; P = 0.58). Conclusions and ImplicationsAn indulgent feeding style can be a risk factor for unhealthy weight outcomes in food responsive preschoolers, but not in those who enjoy food. Educating indulgent parents in the feeding context, and prioritizing children with food-approaching behaviors who are sensitive to external food cues may be effective for approaching childhood obesity.

Acceptability and Feasibility of the Telehealth Bariatric Behavioral Intervention to Increase Physical Activity: Protocol for a Single-Case Experimental Study.

BackgroundRegular physical activity (PA) is recommended to optimize weight and health outcomes in patients who have undergone metabolic and bariatric surgery (MBS). However, >70% of patients have low PA levels before MBS that persist after MBS. Although behavioral interventions delivered face-to-face have shown promise for increasing PA among patients who have undergone MBS, many may experience barriers, preventing enrollment into and adherence to such interventions. Delivering PA behavior change interventions via telehealth to patients who have undergone MBS may be an effective strategy to increase accessibility and reach, as well as adherence.ObjectiveThis paper reports the protocol for a study that aims to assess the feasibility and acceptability of the protocol or methods and the Telehealth Bariatric Behavioral Intervention (TELE-BariACTIV). The intervention is designed to increase moderate-to-vigorous intensity PA (MVPA) in patients awaiting bariatric surgery and is guided by a multitheory approach and a patient perspective. Another objective is to estimate the effect of the TELE-BariACTIV intervention on presurgical MVPA to determine the appropriate sample size for a multicenter trial.MethodsThis study is a multicenter trial using a repeated (ABAB’A) single-case experimental design. The A phases are observational phases without intervention (A1=pre-MBS phase; A2=length personalized according to the MBS date; A3=7 months post-MBS phase). The B phases are interventional phases with PA counseling (B1=6 weekly pre-MBS sessions; B2=3 monthly sessions starting 3 months after MBS). The target sample size is set to 12. Participants are inactive adults awaiting sleeve gastrectomy who have access to a computer with internet and an interface with a camera. The participants are randomly allocated to a 1- or 2-week baseline period (A1). Protocol and intervention feasibility and acceptability (primary outcomes) will be assessed by recording missing data, refusal, recruitment, retention, attendance, and attrition rates, as well as via web-based acceptability questionnaires and semistructured interviews. Data collected via accelerometry (7-14 days) on 8 occasions and via questionnaires on 10 occasions will be analyzed to estimate the effect of the intervention on MVPA. Generalization measures assessing the quality of life, anxiety and depressive symptoms, and theory-based constructs (ie, motivational regulations for PA, self-efficacy to overcome barriers to PA, basic psychological needs satisfaction and frustration, PA enjoyment, and social support for PA; secondary outcomes for a future large-scale trial) will be completed via web-based questionnaires on 6-10 occasions. The institutional review board provided ethics approval for the study in June 2021.ResultsRecruitment began in September 2021, and all the participants were enrolled (n=12). Data collection is expected to end in fall 2023, depending on the MBS date of the recruited participants.ConclusionsThe TELE-BariACTIV intervention has the potential for implementation across multiple settings owing to its collaborative construction that can be offered remotely.International Registered Report Identifier (IRRID)DERR1-10.2196/39633

Racial/ethnic and socioeconomic disparities in weight outcomes, cardiovascular events, and mortality in the look AHEAD trial

BackgroundIntensive lifestyle interventions (ILI) for type 2 diabetes (T2D) improve health outcomes, but participants from different races/ethnicities or socioeconomic status may not benefit equally. MethodsWithin the Look AHEAD trial, we examined achievement of the 7% weight loss goal, as well as secondary weight, cardiovascular, and mortality outcomes, by race/ethnicity and educational attainment (EA). ResultsAmong 4,640 participants (31 % Black or Hispanic, 13 % with less than a high school degree), Black and Hispanic participants were less likely than White participants to achieve 7 % weight loss in both the ILI (45.8 % v. 60.7 %, p < 0.001 and 53.0 % v. 60.7 %, p = 0.01, respectively) and diabetes support and education (DSE) arms. Contrastingly, participants with less than a high school degree were more likely in the ILI but less likely in the DSE arm to achieve this goal, with a significant arm by EA interaction. Hispanic participants and those with lowest EA also experienced decreased mortality in the ILI versus the DSE arm. ConclusionsAll Look AHEAD participant subgroups achieved greater weight loss from ILI; however, Black and Hispanic participants lost less weight than White participants in both arms, while those with lowest EA benefited disproportionately from the ILI compared to participants with higher EA.

Maternal employment and childhood obesity in Russia

Existing research on childhood obesity shows that rising maternal employment is associated with increases in child weight. This paper aims to estimate the effect of maternal employment on childhood obesity in Russia, where obesity has been spreading quickly over the last 20 years. To address the endogeneity of maternal employment and estimate its effect on the weight outcomes of older siblings, I use plausibly exogenous variation in childcare enrolment for the youngest child in the household as an instrumental variable for maternal employment. Based on the Russian Longitudinal Monitoring Survey (RLMS-HSE), the results show that maternal employment leads to an increase in children’s BMI and in their probabilities of becoming overweight and obese. In exploring the potential underlying mechanisms, I find that maternal employment is related to less physical activity, to a higher probability of either watching TV or playing video games, and to poorer dietary habits among children.

303 Overview of Paternal Programming in Livestock Species

Abstract The concept of developmental programming from a maternal standpoint is well established. Perhaps even more impactful, however, is developmental programming that may arise from paternal contributions when single sires are responsible for breeding multiple females. Research in rodent models has shown that paternal obesity, high fat or low protein diets, exercise, stress, and drug and alcohol exposure can lead to epigenetic modifications in sperm and seminal plasma. Some of these changes withstand the extensive remodeling associated with fertilization and early embryo development, culminating in discernable offspring phenotypes that remain present for multiple generations. Certainly, the observations in rodent models related to alterations in offspring body weight, adiposity, metabolic responses, bone density, and reproductive outcomes and function have implications for the livestock industries if similar paternal programming phenomena exist. Livestock production systems are robust and dynamic and many paradigms exist with potential to alter male germ line epigenome, with specific changes likely related to timing of aberrant conditions relative to spermatogenesis and sperm residence in the epididymis. Within the context of routine management systems, our livestock patriarchs can experience major diet and weight changes, transportation and handling stress, environmental extremes, and/or changes in exercise duration, frequency, and intensity. In addition, livestock managers may embrace the concept of delivering specific quantities and types of feedstuffs, and apply other interventions if proven beneficial. Several research groups using livestock models have revealed that epigenetic machinery delivered in sperm and seminal plasma can be altered. A sheep model demonstrated the feeding rumen-protected methionine to rams from weaning to puberty resulted in epigenetic and phenotypic alterations still present in the F2 generation. This presentation will review the status of literature regarding paternal programming, identify knowledge gaps, and suggest areas for future research efforts with potential to enhance production efficiencies of livestock operations.

Inflammation, Executive Function, and Adiposity in Children With or at Risk for Obesity: A Pilot Study.

Obesity is associated with executive function (EF) deficits across the lifespan. Higher body mass index (BMI), obesity severity, and poorer adherence and weight outcomes in obesity treatment have all been associated with EF deficits. Adult literature has begun to emphasize neuroinflammation in obesity as a possible pathway to later cognitive impairment in EF. However, pediatric obesity literature has yet to establish associations between peripheral inflammation and EF. Thus, the present study examined associations and variability in inflammation, EF, and adiposity in children with or at risk for obesity. Additionally, inflammation was examined as a mediator of the relationship between adiposity and EF. Children (N = 39) aged 8-12 years with BMI ≥ 50th percentile were recruited. The NIH Toolbox Cognitive Battery was used to assess performance-based EF. Peripheral inflammation was assessed in fasted sera. Dual-energy X-ray absorptiometry scans were conducted to assess body composition. Linear regression and Hayes' PROCESS Model 4 (Hayes, 2017) were used to evaluate associations between adiposity and inflammation, inflammation and EF, and whether adiposity effects EF through its effect on inflammation. Positive associations were identified between adiposity and inflammation, and negative to null associations were identified between inflammation and EF. Medium indirect effects of adiposity on EF through inflammation were detected. Pilot evidence suggests greater adiposity is linked with greater inflammation, which in turn is associated with less EF in some domains. Directionality and causality cannot yet be established, but with replication, findings may inform efforts to target EF in pediatric obesity.

Dietary patterns and associated factors among pregnant women in Ibadan, Nigeria: Evidence from Ibadan pregnancy cohort study.

Maternal nutrition is vital for an optimal intrauterine environment, foetal development, birth weight, pregnancy and neonatal outcomes. We assessed the maternal dietary patterns using a data-driven technique and the associated sociodemographic factors among pregnant women in Ibadan, Nigeria. Dietary assessment was performed during the enrolment of participants for the Ibadan Pregnancy Cohort Study, a prospective cohort study, conducted among 1745 pregnant women enrolled early in pregnancy (≤ 20 weeks) at four comprehensive obstetric facilities within the Ibadan metropolis. A qualitative food frequency questionnaire was used to assess the pregnant population's intake of food and drinks three months prior to their enrollment. We determined dietary patterns by applying principal component analysis with a varimax rotation. Multivariate analysis was used to investigate the association between sociodemographic factors and dietary patterns at 5% statistical significance. Mean age and gestational age at enrolment were 29.8 (± 5.3) years and 16.4 (±4.2) weeks, respectively. White rice was the most frequently consumed meal [794 (45.5%) daily, 898 (51.4%)] weekly in our study population. Five major dietary patterns were identified, and they accounted for 28.8% of the total variation: "protein-rich diet with non-alcoholic beverages" (15.6%); "fruits" (4.1%); "typical diet with alcohol" (3.8%); "legumes" (2.8%), "refined grains" (2.6%). Maternal education and income were inversely associated with the consumption of a "protein-rich diet with non-alcoholic beverages", "typical diet with alcohol", and "legumes" in a dose-response fashion. Also, employed women had a higher mean intake of fruits [adjusted β: 0.33 (0.02; 0.65) p = 0.040] compared with women without employment. We described five dietary patterns of pregnant women using a data-driven technique, principal component analysis, in Nigeria. We also identified factors influencing maternal dietary patterns, which can inform public health interventions, especially behavioural change communication during antenatal care.

Protective Effect of Prenatal Social Support on the Intergenerational Transmission of Obesity in Low-Income Hispanic Families.

Background: Prepregnancy overweight/obesity (OW/OB) is a strong risk factor for child obesity. Few studies have identified modifiable factors that mitigate this risk. Objective: The objective of this study was to determine if prenatal social support buffers the effect of prepregnancy OW/OB on child birth weight z-score (BWz) and weight-for-age z-score (WFAz) trajectory. Methods: We performed a longitudinal secondary analysis of 524 mother-infant pairs enrolled in a randomized controlled trial of the Starting Early Program, a child obesity prevention program for Hispanic families with low income. Social support was assessed in the third trimester of pregnancy; maternal prepregnancy OW/OB and child WFAz from birth to age 3 years were obtained from medical records. Linear regression and multilevel modeling tested the effects of maternal prepregnancy OW/OB on child weight outcomes, and whether prenatal social support moderated these effects. Results: Prepregnancy OW/OB was associated with significantly higher child BWz (B = 0.23, p = 0.01) and WFAz trajectories (B = 0.19, 0.01). The interaction between social support and prepregnancy OW/OB was negatively related to child BWz (B = -0.26, p = 0.02) and WFAz trajectory (B = -0.40, p = 0.047). Conclusions: Prenatal social support may be protective against the intergenerational transmission of obesity risk. Interventions for the prevention of child obesity should consider incorporating social support into their design. Clinical Trial Registration Number: NCT01541761.

Social determinants of health screening and intervention: A cystic fibrosis quality improvement process.

Lower socioeconomic status is associated with significantly poorer outcomes in weight, lung function, and pulmonary exacerbation rates in people with cystic fibrosis(PwCF). We aim to reduce health disparities and inequities faced by PwCF by screening for and addressing unmet social needs. We aimed to increase routine social determinants of health (SDoH) screening of eligible PwCF from 0% to 95% and follow-up within 2 weeks for those PwCF who screened positive and requested assistance from 0% to 95% by December 31, 2021. The Model for Improvement methodology was used. A process map and a simplified failure mode effects analysis chart were created for the screening and SDoH follow-up process. For those who screened positive for SDoH and requested assistance, follow-up contact was made to offer intervention. Adult PwCF who had at least oneUVAClinic encounter in 2021 were screened for SDoH. The SDoH screening tool included eight domains: housing, food, transportation, utilities, health-care access, medication access, income/employment, and education. Follow-up was completed with all PwCF who screened positive for SDoH. A total of 132 of 142(93.0%) PwCF eligible for screening completed the SDoH screening. Of the PwCF who completed screening, 56 (42.4%) screened positive for SDoH. A follow-up rate of 100% was achieved in June 2021 and maintained through December 2021. Implementing screening for SDOH and follow-up to mitigate social difficulties in adult PwCF at UVA was successful and could be reproduced at other CF care centers.

A Self-Guided Lifestyle Intervention for Young Men: Findings from the ACTIVATE Randomized Pilot Trial.

Young men are at high risk for developing obesity-related health complications, yet are markedly underrepresented in lifestyle interventions. This pilot study examined the feasibility and preliminary efficacy of a lifestyle intervention (self-guided + health risk messaging) targeting young men. 35 young men (Age = 29.3 ± 4.27; BMI = 30.8 ± 4.26; 34% racial/ethnic minority) were randomly assigned to the intervention or delayed treatment control. The intervention (ACTIVATE) included 1 virtual group session, digital tools (wireless scale, self-monitoring app), access to self-paced content via a secure website, and 12 weekly texts to reinforce health risk messaging. Fasted objective weight was assessed remotely at baseline and 12-weeks. Perceived risk was assessed via survey at baseline, 2-week, and 12-week. T-tests were used to compare weight outcomes between arms. Linear regressions examined the association between percent weight change and perceived risk change. Recruitment was successful as evidenced by 109% of target enrollment achieved in a 2-month period. Retention was 86% at 12 weeks, with no differences by arm (p = 0.17). Participants in the intervention arm experienced modest weight loss at 12 weeks, whereas slight gains were observed in the control arm (-1.6% ± 2.5 vs. +0.31% ± 2.8, p = 0.04). Change in perceived risk was not associated with change in percent weight (p > 0.05). A self-guided lifestyle intervention showed initial promise for weight management among young men, but these findings are limited by small sample size. More research is needed to bolster weight loss outcomes while retaining the scalable self-guided approach. NCT04267263 (https://www.clinicaltrials.gov/ct2/show/NCT04267263).

Birth Weight and Early Postnatal Outcomes: Association with the Cord Blood Lipidome.

Being born small or large for gestational age (SGA and LGA, respectively), combined with suboptimal early postnatal outcomes, can entail future metabolic alterations. The exact mechanisms underlying such risks are not fully understood. Lipids are a highly diverse class of molecules that perform multiple structural and metabolic functions. Dysregulation of lipid metabolism underlies the onset and progression of many disorders leading to pathological states. The aim of this pilot study was to investigate the relationships between birth weight, early postnatal outcomes, and cord blood serum lipidomes. We performed a non-targeted lipidomics-based approach to ascertain differences in cord blood lipid species among SGA, LGA, and appropriate-for-GA (AGA) newborns. Moreover, we longitudinally assessed (at birth and at ages of 4 and 12 months) weight and length, body composition (DXA), and clinical parameters. We disclosed distinct cord blood lipidome patterns in SGA, LGA, and AGA newborns; target lipid species distinctly modulated in each SGA, AGA, and LGA individual were associated with parameters related to growth and glucose homeostasis. The distinct lipidome patterns observed in SGA, AGA, and LGA newborns may play a role in adipose tissue remodeling and future metabolic risks. Maternal dietary interventions may potentially provide long-term benefits for the metabolic health of the offspring.

Prenatal health behaviours as predictors of human placental lactogen levels.

Placental lactogen (hPL) is a key hormone of pregnancy responsible for inducing maternal adaptations critical for a successful pregnancy. Low levels of placental lactogen have been associated with lower birth weight as well as symptoms of maternal depression and anxiety. Lower placental lactogen has been reported in women with higher body mass index (BMI) but it is unclear whether prenatal health behaviours predict hPL levels or if hPL is associated with infant weight outcomes. This study utilised data from the longitudinal Grown in Wales cohort, based in South Wales. Participants were recruited at the pre-surgical appointment for an elective caesarean section. This study incorporates data from recruitment, post-delivery and a 12 month follow-up. Measures of maternal serum hPL were available for 248 participants. Analysis included unadjusted and adjusted linear and binary regression. Unadjusted, prenatal smoking and a Health Conscious dietary pattern were associated with hPL levels, however this was lost on adjustment for BMI at booking, Welsh Index of Multiple Deprivation (WIMD) score and placental weight. When stratified by maternal BMI at booking, a Health Conscious dietary pattern remained associated with increased hPL levels in women with a healthy BMI (p=.024, B=.59. 95% CI=.08,1.11) following adjustment for WIMD score and placental weight. When adjusted for a wide range of confounders, maternal hPL was also associated with increased custom birthweight centiles (CBWC) (p=.014, B=1.64. 95% CI=.33,2.94) and increased odds of large for gestational age deliveries (p=<.001, Exp(B)=1.42. 95% CI=1.17,1.72). This study identified that consuming a Health Conscious dietary pattern in pregnancy was associated with increased hPL, within women of a healthy BMI. Moreover, higher hPL levels were associated with increased CBWC and increased odds of delivering a large for gestational age infant. This improves the current limited evidence surrounding the nature of hPL in these areas.