Weighing frequency among working adults: cross-sectional analysis of two community samples

Augmented gut hormone response to feeding in older adults exhibiting low appetite

Age-related changes in gut hormones may play a role in anorexia of ageing. The aim of this study was to determine concentrations of ghrelin, PYY, and GLP-1 in older adults exhibiting an anorexia of ageing phenotype. Thirteen older adults with healthy appetite (OA-HA; 8f, 75 ± 7 years, 26.0 ± 3.2 kg m-2), fifteen older adults with low appetite (OA-LA; 10f, 72 ± 7 years, 23.6 ± 3.1 kg m-2), and twelve young adults (YA; 6f, 22 ± 2 years, 24.4 ± 2.0 kg m-2) completed the study. Healthy appetite and low appetite were determined based on BMI, habitual energy intake, self-reported appetite, and laboratory-assessed ad libitum lunch intake. Participants provided a fasted measure of subjective appetite and blood sample (0 min) before consuming a standardised breakfast (450 kcal). Appetite was measured and blood samples were drawn throughout a 240-min rest period. At 240 min, an ad libitum lunch meal was consumed. Relative intake at lunch (expressed as percentage of estimated total energy requirement) was lower for OA-LA (19.8 ± 7.7%) than YA (41.5 ± 9.2%, p < 0.001) and OA-HA (37.3 ± 10.0%, p < 0.001). Ghrelin suppression was greater for OA-LA (net AUC, -78719 ± 74788 pg mL-1·240min-1) than both YA (-23899 ± 27733 pg mL-1·240min-1, p = 0.016) and OA-HA (-21144 ± 31161 pg mL-1·240min-1, p = 0.009). There were trends for higher GLP-1 concentrations in OA-LA compared with YA at 90 min (8.85 ± 10.4 pM vs. 1.88 ± 4.63 pM, p = 0.073) and 180 min (5.00 ± 4.71 pM vs. 1.07 ± 2.83 pM, p = 0.065). There was a trend for a greater PYY response for OA-LA compared with OA-HA (net AUC p = 0.062). "Anorexigenic response score" - a composite score of gut hormone responses to feeding - showed greater anorexigenic response in OA-LA, compared with YA and OA-HA. No differences were seen in subjective appetite. These observations suggest augmented anorexigenic responses of gut hormones to feeding may be causal mechanisms of anorexia of ageing.

Anorexia of ageing is associated with elevated fasted and lower post-prandial ghrelin, independent of ghrelin O-acyltransferase

The role of ghrelin metabolism in anorexia of ageing is unclear. The aim of this study was to determine acyl-ghrelin, total ghrelin, and ghrelin O-acyltransferase concentrations when fasted and in responses to feeding in older adults exhibiting anorexia of ageing. Twenty-five older adults (OA; 15f, 74 ± 7 years, 24.5 kg·m-2) and twelve younger adults (YA; 6f, 21 ± 2 years, 24.4 kg·m-2) provided a fasted measure of subjective appetite and fasted blood sample (0 min) before consuming a standardised porridge breakfast meal (450 kcal). Appetite was measured every 30 min for 240 min and blood was sampled at 30, 60, 90, 120, 180 and 240 min while participants rested. At 240 min, an ad libitum pasta-based lunch meal was consumed. Older adults were identified as those with healthy appetite (HA-OA) or low appetite (LA-OA), based on habitual energy intake, self-report appetite, BMI, and ad libitum lunch intake. YA ate more at lunch (1108 ± 235 kcal) than HA-OA (653 ± 133 kcal, p = 0.007) and LA-OA (369 ± 168 kcal; p < 0.001). LA-OA, but not HA-OA, had higher fasted concentrations of acyl- and total ghrelin than YA (acyl-ghrelin: 621 ± 307 pg·mL-1 vs. 353 ± 166 pg·mL-1, p = 0.047; total ghrelin: 1333 ± 702 pg·mL-1 vs. 636 ± 251 pg·mL-1, p = 0.006). Acyl-ghrelin (60 min and 90 min) and total ghrelin (90 min) were suppressed to a greater extent for LA-OA than for YA (p < 0.05). No differences were observed in subjective appetite, acyl-to-total ghrelin ratio, or plasma GOAT content (p > 0.1). Higher fasting ghrelin and an augmented ghrelin response to feeding in LA-OA, but not HA-OA, suggests that alterations to ghrelin metabolism are not functions of ageing per se and may be independent causal mechanisms of anorexia of ageing.

Examining demographic and psychosocial factors related to self-weighing behavior during pregnancy and postpartum periods

Black childbearing individuals in the US experience a higher risk of postpartum weight retention (PPWR) compared to their White counterparts. Given that PPWR is related to adverse health outcomes, it is important to investigate predictors of weight-related health behaviors, such as self-weighing (i.e., using a scale at home). Regular self-weighing is an evidence-based weight management strategy, but there is minimal insight into sociodemographic factors related to frequency. The Postpartum Mothers Mobile Study (PMOMS) facilitated longitudinal ambulatory weight assessments to investigate racial inequities in PPWR. Our objective for the present study was to describe self-weighing behavior during and after pregnancy in the PMOMS cohort, as well as related demographic and psychosocial factors. Applying tree modeling and multiple regression, we examined self-weighing during and after pregnancy. Participants (N = 236) were 30.2 years old on average (SD = 4.7), with the majority being college-educated (53.8%, n = 127), earning at least $30,000 annually (61.4%, n = 145), and self-identifying as non-Hispanic White (NHW; 68.2%, n = 161). Adherence to regular self-weighing (at least once weekly) was highest among participants during pregnancy, with a considerable decline after giving birth. Low-income Black participants (earning < $30,000) were significantly less likely to reach a completion rate of ≥ 80% during pregnancy (AOR = 0.10) or the postpartum period (AOR = 0.16), compared to NHW participants earning at least $30,000 annually. Increases in perceived stress were associated with decreased odds of sustained self-weighing after delivery (AOR = 0.79). Future research should consider behavioral differences across demographic intersections, such as race and socioeconomic status, and the impact on efficacy of self-weighing.

Recruiting participants for ergonomic research using self-reported stature and body mass

BACKGROUND

A valid distribution of key anthropometric parameters among participants is often a perquisite of ergonomics research.

OBJECTIVE

In this paper, we investigated the accuracy of self-reported stature and body mass of the population in the Netherlands.

METHODS

Data from 4 experiments was synthesized where in each experiment, participants self-reported their stature and body mass prior to being measured, of which they were not notified before.

RESULTS

Statistical analysis of 249 records indicated that on average, participants overreported their stature by 1.31 cm and underreported their mass by 1.45 kg. This is especially true for people with a BMI≥25.

CONCLUSION

Two models were proposed to adjust the self-reported stature and body mass for ergonomic researchers in a survey or recruitment. Limitations in using the models are highlighted as well.

Limiting Postpartum Weight Retention in Culturally and Linguistically Diverse Women: Secondary Analysis of the HeLP-her Randomized Controlled Trial

Postpartum weight retention (PPWR) contributes to maternal obesity development and is more pronounced in culturally and linguistically diverse (CALD) women. Our antenatal healthy lifestyle intervention (HeLP-her) demonstrated efficacy in reducing PPWR in non-Australian-born CALD women compared with Australian-born women. In this secondary analysis, we aimed to examine differences in the intervention effect on behavioral and psychosocial outcomes between Australian-born and non-Australian-born women and explore factors associated with the differential intervention effect on PPWR. Pregnant women at risk of gestational diabetes (Australian-born n = 86, non-Australian-born n = 142) were randomized to intervention (four lifestyle sessions) or control (standard antenatal care). PPWR was defined as the difference in measured weight between 6 weeks postpartum and baseline (12-15 weeks gestation). Behavioral (self-weighing, physical activity (pedometer), diet (fat-related dietary habits questionnaire), self-perceived behavior changes), and psychosocial (weight control confidence, exercise self-efficacy, eating self-efficacy) outcomes were examined by country of birth. Multivariable linear regression analysis was conducted to assess factors associated with PPWR. The intervention significantly increased self-weighing, eating self-efficacy, and self-perceived changes to diet and physical activity at 6 weeks postpartum in non-Australian-born women, compared with no significant changes observed among Australian-born women. Intervention allocation and decreased intake of snack foods were predictors of lower PPWR in non-Australian-born women. Results indicate that the HeLP-her intervention improved dietary behaviors, contributing to the reduction of PPWR in CALD women. Future translations could prioritize targeting diet while developing more effective strategies to increase exercise engagement during pregnancy in this population.

Self-weighing behavior in individuals with binge-eating disorder

This study examined self-weighing behaviors and correlates in patients with BED. Hypotheses: (1) women would weigh more frequently than men, (2) > weekly weighers would have higher restraint scores than < weekly weighers, (3) the self-weighing-restraint relationship would be stronger in women, (4) self-weighing frequency would be inversely related to BMI, and (5) self-weighing frequency and depression would be independently but not interactively related to BMI. The EDE, administered by trained doctoral-level interviewers, assessed self-weighing and eating-disorder psychopathology in 423 treatment-seeking individuals meeting DSM-5 BED criteria. Self-weighing frequency (1) did not differ by gender (Wald = 1.3; p = .3). (2) > weekly weighers reported significantly higher restraint (2.0±1.2 versus 1.6±1.3; t(421) = 3.1, p = .02). (3) No significant gender*self-weighing interaction on restraint (p = .99). (4) Self-weighing is inversely correlated with BMI (rho = -0.20; p < .001). 5) Self-weighing nor depression, nor self-weighing*depression interaction predicted BMI (p = .51). These analyses lay the groundwork for further investigation of the role of self-weighing in BED treatment.

Workplace pedometer interventions for increasing physical activity

BACKGROUND

The World Health Organization (WHO) recommends undertaking 150 minutes of moderate-intensity physical activity per week, but most people do not. Workplaces present opportunities to influence behaviour and encourage physical activity, as well as other aspects of a healthy lifestyle. A pedometer is an inexpensive device that encourages physical activity by providing feedback on daily steps, although pedometers are now being largely replaced by more sophisticated devices such as accelerometers and Smartphone apps. For this reason, this is the final update of this review.

OBJECTIVES

To assess the effectiveness of pedometer interventions in the workplace for increasing physical activity and improving long-term health outcomes.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Occupational Safety and Health (OSH) UPDATE, Web of Science, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform from the earliest record to December 2016. We also consulted the reference lists of included studies and contacted study authors to identify additional records. We updated this search in May 2019, but these results have not yet been incorporated. One more study, previously identified as an ongoing study, was placed in 'Studies awaiting classification'.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) of workplace interventions with a pedometer component for employed adults, compared to no or minimal interventions, or to alternative physical activity interventions. We excluded athletes and interventions using accelerometers. The primary outcome was physical activity. Studies were excluded if physical activity was not measured.

DATA COLLECTION AND ANALYSIS

We used standard methodological procedures expected by Cochrane. When studies presented more than one physical activity measure, we used a pre-specified list of preferred measures to select one measure and up to three time points for analysis. When possible, follow-up measures were taken after completion of the intervention to identify lasting effects once the intervention had ceased. Given the diversity of measures found, we used ratios of means (RoMs) as standardised effect measures for physical activity.

MAIN RESULTS

We included 14 studies, recruiting a total of 4762 participants. These studies were conducted in various high-income countries and in diverse workplaces (from offices to physical workplaces). Participants included both healthy populations and those at risk of chronic disease (e.g. through inactivity or overweight), with a mean age of 41 years. All studies used multi-component health promotion interventions. Eleven studies used minimal intervention controls, and four used alternative physical activity interventions. Intervention duration ranged from one week to two years, and follow-up after completion of the intervention ranged from three to ten months. Most studies and outcomes were rated at overall unclear or high risk of bias, and only one study was rated at low risk of bias. The most frequent concerns were absence of blinding and high rates of attrition. When pedometer interventions are compared to minimal interventions at follow-up points at least one month after completion of the intervention, pedometers may have no effect on physical activity (6 studies; very low-certainty evidence; no meta-analysis due to very high heterogeneity), but the effect is very uncertain. Pedometers may have effects on sedentary behaviour and on quality of life (mental health component), but these effects were very uncertain (1 study; very low-certainty evidence). Pedometer interventions may slightly reduce anthropometry (body mass index (BMI) -0.64, 95% confidence interval (CI) -1.45 to 0.18; 3 studies; low-certainty evidence). Pedometer interventions probably had little to no effect on blood pressure (systolic: -0.08 mmHg, 95% CI -3.26 to 3.11; 2 studies; moderate-certainty evidence) and may have reduced adverse effects (such as injuries; from 24 to 10 per 100 people in populations experiencing relatively frequent events; odds ratio (OR) 0.50, 95% CI 0.30 to 0.84; low-certainty evidence). No studies compared biochemical measures or disease risk scores at follow-up after completion of the intervention versus a minimal intervention. Comparison of pedometer interventions to alternative physical activity interventions at follow-up points at least one month after completion of the intervention revealed that pedometers may have an effect on physical activity, but the effect is very uncertain (1 study; very low-certainty evidence). Sedentary behaviour, anthropometry (BMI or waist circumference), blood pressure (systolic or diastolic), biochemistry (low-density lipoprotein (LDL) cholesterol, total cholesterol, or triglycerides), disease risk scores, quality of life (mental or physical health components), and adverse effects at follow-up after completion of the intervention were not compared to an alternative physical activity intervention. Some positive effects were observed immediately at completion of the intervention periods, but these effects were not consistent, and overall certainty of evidence was insufficient to assess the effectiveness of workplace pedometer interventions.

AUTHORS' CONCLUSIONS

Exercise interventions can have positive effects on employee physical activity and health, although current evidence is insufficient to suggest that a pedometer-based intervention would be more effective than other options. It is important to note that over the past decade, technological advancement in accelerometers as commercial products, often freely available in Smartphones, has in many ways rendered the use of pedometers outdated. Future studies aiming to test the impact of either pedometers or accelerometers would likely find any control arm highly contaminated. Decision-makers considering allocating resources to large-scale programmes of this kind should be cautious about the expected benefits of incorporating a pedometer and should note that these effects may not be sustained over the longer term. Future studies should be designed to identify the effective components of multi-component interventions, although pedometers may not be given the highest priority (especially considering the increased availability of accelerometers). Approaches to increase the sustainability of intervention effects and behaviours over a longer term should be considered, as should more consistent measures of physical activity and health outcomes.

Effects of Self-Weighing During Weight Loss Treatment: A 6-Month Randomized Controlled Trial

Objective

To examine the effectiveness of self-weighing for weight loss in men for 6 months.

Methods

In the present study, 54 men, mean age of 40.1 ± 11.1 years, with overweight or obesity, were recruited and randomly assigned into two groups: control group (CG), without weight self-monitoring and intervention group (IG), with weight self-monitoring. Both groups received the same nutritional and educational advice and the establishment of a weight target to reach in the weight loss program. Subjects of IG also had individualized motivating content to improve self-management for 24 weeks. Anthropometric indices were measured at baseline and weekly for 24 weeks.

Results

When the group assigned after randomization was introduced in the analysis, its influence was significant in weight loss (F1.52 = 19.465, ± 2 = 0.272, p < 0.001) and in the decrease in body fat percentage (F1.52 = 8,306, ± 2 = 0.132, p < 0.01).

Conclusion

Study results indicate that self-weighing can help patients to lose additional weight. Our findings have implications in the emerging area of the behavioral approach of patients undergoing weight-loss treatment, as well as clinical care processes.

Clinical Trial Registration

www.ClinicalTrials.gov, identifier NCT04032249.