1
|
Hart AR, Beach SRH, Hart CN, Smith JJ, Stansfield BK, Lavner JA. Responsive parenting and Black mothers' postpartum sleep: Secondary analysis of a randomized controlled trial. Health Psychol 2024:2024-52557-001. [PMID: 38330306 DOI: 10.1037/hea0001363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
OBJECTIVE To determine if an intervention designed to enhance early responsive parenting (RP) practices (e.g., reading infant cues, establishing bedtime routines) and promote infant sleep and soothing among Black families has secondary benefits for mothers' postpartum sleep. METHOD This preregistered secondary analysis of the Sleep Strong African American Families randomized controlled trial investigated effects of an RP intervention versus a safety control condition on self-reported maternal sleep difficulties at 8 and 16 weeks postpartum and on actigraph-measured maternal sleep at 8 weeks postpartum. RESULTS The 212 randomized mothers were Black/African American (100%) and non-Hispanic (98.6%) and averaged 22.7 years (SD = 4.5) of age. Among 138 mothers with useable actigraph data, RP mothers had a mean 20 [95% CI: 2, 37] minutes longer actigraph-measured total sleep time than controls at 8 weeks postpartum, after adjusting for age and other covariates likely to influence mothers' sleep (p = .04). Participation in the RP intervention did not significantly impact self-reported sleep difficulties or other actigraph-measured sleep parameters (e.g., efficiency) in either unadjusted or adjusted models, although RP effects on sleep difficulties and sleep efficiency were in the hypothesized directions. CONCLUSIONS Interventions supporting responsive sleep parenting practices to increase infant sleep may also help first-time Black mothers get more sleep themselves during the postpartum period, even without an explicit focus on maternal sleep strategies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Collapse
|
2
|
Ventura AK, Phelan S, Alarcon N, Quintana Diaz A, Sklar JC, Hart CN. A Pilot Feasibility Randomized Controlled Trial of Effects of Opaque Bottles on Maternal Sensitivity, Infant Intake, and Infant Weight Status. J Acad Nutr Diet 2024:S2212-2672(24)00055-8. [PMID: 38331187 DOI: 10.1016/j.jand.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Conventional clear infant feeding bottles provide visual cues about the amount of milk consumed, which may decrease caregivers' sensitivity to infant cues, increase infant intake, and lead to greater infant weight gain. OBJECTIVE This study examined feasibility, adherence, acceptability, and preliminary effectiveness of an intervention in which families received clear vs opaque bottles. DESIGN A pilot feasibility randomized controlled trial was conducted. PARTICIPANTS/SETTING Participants included mothers (N = 76) with young infants (2.9 ± 1.4 months old). Data collection occurred between December 2018 and July 2022 and within San Luis Obispo and Santa Barbara Counties, California. All assessments occurred within participants' homes. INTERVENTION Participants were randomized to use clear (Clear group, n = 38) or opaque (Opaque group, n = 38) bottles for 12 weeks. MAIN OUTCOME MEASURES We assessed feasibility of recruitment and retention, participant perceptions of study bottles, participant adherence to the intervention, maternal sensitivity to cues, infant intake (mL and mL/kg), and infant weight-for-length z-scores (WLZ). STATISTICAL ANALYSES PERFORMED Data were analyzed using linear regression, χ2 analysis, and repeated-measures analysis of variance (ANOVA). RESULTS Of 842 potential participants, 295 (35%) could not be reached after initial contact, 166 (20%) declined to participate, and 305 (36%) were ineligible. Of those who declined, 16 (10%) declined because they did not want to use study bottles. No differences were observed for loss to follow-up for Clear (8 of 38; 21%) vs Opaque (5 of 38; 13%) groups (P = 0.36) or for reported use of assigned bottles for Clear (89.8% ± 24.5% of daily feedings) vs Opaque (90.1% ± 22.1%) groups (P = 0.96). No group differences were observed for sensitivity to cues (P = 0.52) or intake (mL, P = 0.53 or mL/kg, P = 0.56) at follow-up. Opaque group infants had lower WLZ at follow-up compared with Clear group infants (mean difference, 0.47; 95% confidence interval, 0.08, 0.86; ηp2 = 0.17), adjusting for baseline WLZ. CONCLUSIONS Relative to providing clear bottles, providing families with opaque bottles appeared feasible and acceptable, with good adherence. Although preliminary, study findings suggest the potential of opaque bottles to support healthier weight outcomes for bottle-fed infants.
Collapse
Affiliation(s)
- Alison K Ventura
- Department of Kinesiology and Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, CA.
| | - Suzanne Phelan
- Department of Kinesiology and Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, CA
| | - Noemi Alarcon
- Center for Health Research, California Polytechnic State University, San Luis Obispo, CA
| | - Adilene Quintana Diaz
- Center for Health Research, California Polytechnic State University, San Luis Obispo, CA
| | - Jeffrey C Sklar
- Department of Statistics, California Polytechnic State University, San Luis Obispo, CA
| | - Chantelle N Hart
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA
| |
Collapse
|
3
|
Reynolds AM, Spaeth AM, Hale L, Williamson AA, LeBourgeois MK, Wong SD, Hartstein LE, Levenson JC, Kwon M, Hart CN, Greer A, Richardson CE, Gradisar M, Clementi MA, Simon SL, Reuter-Yuill LM, Picchietti DL, Wild S, Tarokh L, Sexton-Radek K, Malow BA, Lenker KP, Calhoun SL, Johnson DA, Lewin D, Carskadon MA. Pediatric sleep: current knowledge, gaps, and opportunities for the future. Sleep 2023; 46:zsad060. [PMID: 36881684 PMCID: PMC10334737 DOI: 10.1093/sleep/zsad060] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/19/2023] [Indexed: 03/09/2023] Open
Abstract
This White Paper addresses the current gaps in knowledge, as well as opportunities for future studies in pediatric sleep. The Sleep Research Society's Pipeline Development Committee assembled a panel of experts tasked to provide information to those interested in learning more about the field of pediatric sleep, including trainees. We cover the scope of pediatric sleep, including epidemiological studies and the development of sleep and circadian rhythms in early childhood and adolescence. Additionally, we discuss current knowledge of insufficient sleep and circadian disruption, addressing the neuropsychological impact (affective functioning) and cardiometabolic consequences. A significant portion of this White Paper explores pediatric sleep disorders (including circadian rhythm disorders, insomnia, restless leg and periodic limb movement disorder, narcolepsy, and sleep apnea), as well as sleep and neurodevelopment disorders (e.g. autism and attention deficit hyperactivity disorder). Finally, we end with a discussion on sleep and public health policy. Although we have made strides in our knowledge of pediatric sleep, it is imperative that we address the gaps to the best of our knowledge and the pitfalls of our methodologies. For example, more work needs to be done to assess pediatric sleep using objective methodologies (i.e. actigraphy and polysomnography), to explore sleep disparities, to improve accessibility to evidence-based treatments, and to identify potential risks and protective markers of disorders in children. Expanding trainee exposure to pediatric sleep and elucidating future directions for study will significantly improve the future of the field.
Collapse
Affiliation(s)
| | - Andrea M Spaeth
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, USA
| | - Lauren Hale
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Ariel A Williamson
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Monique K LeBourgeois
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Sachi D Wong
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Lauren E Hartstein
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Jessica C Levenson
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Misol Kwon
- Division of Sleep Medicine, University of Pennsylvania Perelman School of Medicine, PA, USA
| | - Chantelle N Hart
- The Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA
- The Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Ashley Greer
- The Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Cele E Richardson
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | | | - Michelle A Clementi
- Clinical Sciences, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Stacey L Simon
- Clinical Sciences, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lilith M Reuter-Yuill
- Comprehensive Speech and Therapy Center, Western Michigan University, Kalamazoo, MI, USA
| | - Daniel L Picchietti
- University of Illinois School of Medicine, Carle Illinois College of Medicine, Carle Foundation Hospital, and University of Illinois School of Medicine, Urbana, IL, USA
| | - Salome Wild
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Leila Tarokh
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | | | - Beth A Malow
- Departments of Neurology and Pediatrics, Burry Chair in Cognitive Childhood Development, Vanderbilt University Medical Center, Nashville, TN, USA
- Sleep Disorders Division, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kristina P Lenker
- Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
| | - Susan L Calhoun
- Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Daniel Lewin
- Department of Pulmonary and Sleep Medicine, Children’s National Hospital, Washington, DC, USA
| | - Mary A Carskadon
- Bradley Hospital Sleep Lab, Warren Alpert Medical School, Brown University, Providence, RI, USA
| |
Collapse
|
4
|
Ventura AK, Hart CN, Phelan S, Jelalian E, Wing RR. Associations Between Technology Use, Responsive Feeding, and Child Temperament Among Prior Prenatal Intervention Participants. J Dev Behav Pediatr 2023; 44:e315-e321. [PMID: 37020323 PMCID: PMC10159932 DOI: 10.1097/dbp.0000000000001174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/10/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVES The primary objective was to examine associations between mothers' television and mobile device (TV/MD) use and responsive feeding during an observed mother-toddler mealtime interaction. The secondary objective was to assess whether dimensions of child temperament were associated with mothers' TV/MD use. METHODS Participants from a prenatal lifestyle intervention trial to prevent excess gestational weight gain among women with overweight and obesity (N = 77) were observed during a dinner-time meal when their children were aged 19.4 ± 0.9 months. Trained video coders used the Responsiveness to Child Feeding Cues Scale to rate child strength of early/subtle, positive active, and negative active satiation cues and maternal responsiveness to these cues. Coders also recorded mothers' use of TV/MD. Child temperament was reported by mothers through the Infant Behavior Questionnaire-Revised Very Short Form. RESULTS Twelve percent (n = 9) of mothers used TV/MD during the mealtime interaction. Children whose mothers used TV/MD exhibited stronger early/subtle cues (4.1 ± 0.4) compared with children whose mothers did not use TV/MD (3.4 ± 0.2; p = 0.04). Mothers who used TV/MD exhibited significantly lower responsiveness to child satiation cues (2.0 ± 0.4) than those who did not use TV/MD (3.4 ± 0.2; p = 0.001). Greater child temperamental negative affectivity was associated with a greater likelihood of maternal TV/MD use (OR = 4.80, 95% CI = 1.21, 19.03). CONCLUSION Mothers' TV/MD use was associated with greater child temperamental negative affectivity and lower responsiveness to child cues.
Collapse
Affiliation(s)
- Alison K. Ventura
- Department of Kinesiology & Public Health and Center for Health Research, California Polytechnic State University
| | - Chantelle N. Hart
- Department of Social and Behavioral Sciences and Center for Obesity Research and Education, College of Public Health, Temple University
| | - Suzanne Phelan
- Department of Kinesiology & Public Health and Center for Health Research, California Polytechnic State University
| | - Elissa Jelalian
- Alpert Medical School of Brown University
- Weight Control and Diabetes Research Center, The Miriam Hospital
| | - Rena R. Wing
- Alpert Medical School of Brown University
- Weight Control and Diabetes Research Center, The Miriam Hospital
| |
Collapse
|
5
|
Hart CN, Phelan S, Coffman DL, Jelalian E, Ventura AK, Hodges EA, Hawley N, Fisher JO, Wing RR. Maternal responsiveness and toddler body mass index z-score: Prospective analysis of maternal and child mealtime interactions. Appetite 2023; 180:106348. [PMID: 36272545 DOI: 10.1016/j.appet.2022.106348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/26/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022]
Abstract
Responsive feeding, where parents are guided by children's hunger and satiation cues and provide appropriate structure and support for eating, is believed to promote healthier weight status. However, few studies have assessed prospective associations between observed parental feeding and toddler growth. We characterized toddler growth from 18 to 36 months and, in a subset of families, examined whether observed maternal responsiveness to toddler satiation cues and encouraging prompts to eat at 18 and 24 months were associated with toddler body mass index z-score (BMIz) from 18 to 36 months. Participants included 163 toddlers and their mothers with overweight/obesity who had participated in a lifestyle intervention during pregnancy. Anthropometrics were measured at 18, 24, and 36 months. In a subsample, mealtime interactions were recorded in families' homes at 18 (n = 77) and 24 (n = 75) months. On average, toddler BMIz remained stable from 18 to 36 months with 31.3% (n = 51) categorized with a healthy weight, 56.4% (n = 92) with at risk for overweight and 12.3% (n = 20) with overweight. Fewer maternal prompts to eat at 18 months was associated with both higher probability of having at risk for overweight/overweight (p < .05), and higher child 36-month BMIz (p = .002). Higher child weight status at 12 months was also associated with both higher probability of having at risk for overweight/overweight (p < .05), and higher child 36-month BMIz (p < .001). Neither 24-month maternal prompts nor 18 or 24 month responsiveness to satiation cues were associated with toddler BMIz. In this diverse sample, weight status was relatively stable from 18 to 36 months. Maternal prompts to eat measured earlier in toddlerhood and prior child weight status were associated with toddler BMIz.
Collapse
Affiliation(s)
- C N Hart
- Department of Social and Behavioral Sciences and Center for Obesity Research and Education, College of Public Health, Temple University, USA.
| | - S Phelan
- Department of Kinesiology & Public Health and Center for Health Research, California Polytechnic State University, USA
| | - D L Coffman
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Department of Psychiatry and Human Behavior, USA
| | - E Jelalian
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, USA; Weight Control and Diabetes Research Center, The Miriam Hospital, USA
| | - A K Ventura
- Department of Kinesiology & Public Health and Center for Health Research, California Polytechnic State University, USA
| | - E A Hodges
- School of Nursing, The University of North Carolina at Chapel Hill, USA
| | - N Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, USA
| | - J O Fisher
- Department of Social and Behavioral Sciences and Center for Obesity Research and Education, College of Public Health, Temple University, USA
| | - R R Wing
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, USA; Weight Control and Diabetes Research Center, The Miriam Hospital, USA
| |
Collapse
|
6
|
Hart CN, Hawley NL, Coffman DL, Raynor HA, Carskadon MA, Jelalian E, Owens JA, Spaeth A, Wing RR. Randomized controlled trial to enhance children's sleep, eating, and weight. Pediatr Res 2022; 92:1075-1081. [PMID: 34930967 PMCID: PMC9413537 DOI: 10.1038/s41390-021-01870-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/05/2021] [Accepted: 09/16/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The present study assessed the efficacy of a behavioral intervention to enhance children's sleep and reduce caloric intake and body mass index (BMI) change. METHODS Seventy-eight children 8-11 years old who slept 9.5 h/night or less were randomized to the sleep intervention or to no treatment control. The primary outcome was 2-month change in the actigraph-estimated sleep period; changes in reported caloric intake, percent calories from fat, and BMI/BMI z-score (BMIz) were assessed. RESULTS Children randomized to intervention enhanced their sleep period by 40 ± 7 min/night relative to control (p < 0.001), and were more likely to increase their sleep period by 30 min/night or more (52% versus 15%, p = 0.003). No differences were observed for reported dietary intake or BMI/BMIz. However, in post-hoc analyses collapsing across groups, those who increased sleep by 30 min/night or more had lower BMI (-0.31 kg/m2, p = 0.01) and BMIz (-0.07, p = 0.03) and reported fewer percent calories from fat at 2 months (-2.2%, p = 0.04). CONCLUSIONS A brief behavioral intervention can enhance children's sleep, but did not result in changes in caloric intake or weight status. Enhancing sleep by 30 min/night or more may be beneficial for weight regulation. IMPACT A brief behavioral intervention improved children's nocturnal sleep relative to no treatment control. Given the many benefits of a good night's sleep across domains of functioning, findings have significant implications for children's health and wellbeing. There were no differences between groups on eating behaviors or BMI. However, across groups, children who increased their sleep period by at least 30 min/night, reported reduced intake from fat and evidenced lower BMI at 2 months. Thus, a brief intervention can improve sleep and may have potential benefits for weight regulation.
Collapse
Affiliation(s)
- Chantelle N Hart
- Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA.
- Department of Social and Behavioral Sciences, Temple University, Philadelphia, PA, USA.
| | - Nicola L Hawley
- Department of Chronic Disease Epidemiology, Yale University, New Haven, CT, USA
| | - Donna L Coffman
- Department of Epidemiology and Biostatistics, Temple University, Philadelphia, PA, USA
| | - Hollie A Raynor
- Department of Nutrition, University of Tennessee, Knoxville, TN, USA
| | - Mary A Carskadon
- Psychiatry & Human Behavior, Alpert Medical School of Brown University, Richmond, VA, USA
| | - Elissa Jelalian
- Psychiatry & Human Behavior, Alpert Medical School of Brown University, Richmond, VA, USA
- Weight Control & Diabetes Research Center, The Miriam Hospital, Providence, RI, USA
| | | | - Andrea Spaeth
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, USA
| | - Rena R Wing
- Psychiatry & Human Behavior, Alpert Medical School of Brown University, Richmond, VA, USA
- Weight Control & Diabetes Research Center, The Miriam Hospital, Providence, RI, USA
| |
Collapse
|
7
|
Hart CN, Spaeth AM, Egleston BL, Carskadon MA, Raynor HA, Jelalian E, Owens JA, Considine RV, Wing RR. Effect of changes in children's bedtime and sleep period on targeted eating behaviors and timing of caloric intake. Eat Behav 2022; 45:101629. [PMID: 35390756 PMCID: PMC9730292 DOI: 10.1016/j.eatbeh.2022.101629] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 11/03/2022]
Abstract
Short sleep is associated with obesity risk. Experimental studies with adults and observational studies with children demonstrate that changes in eating, including increased caloric intake from energy-dense foods and sugar-sweetened beverages as well as increased caloric intake in the evening, may partially account for this increased risk. We therefore examined whether experimental changes in children's sleep period lead to changes in reported caloric intake from energy-dense snack foods and sugar-sweetened beverages, and in the evening. Thirty-seven children, 8-11 years old, completed a three-week study that used a within-subject randomized cross-over design. Children slept their typical amount for one week and were subsequently randomized to either increase or decrease their typical amount by 1.5 h/night for one week; the alternate schedule was completed during the third week of the study, creating a 3-h time in bed difference between the increase and decrease conditions. Sleep was monitored with actigraphy, and dietary intake was assessed with 24-hour dietary recalls. Participants reported consuming 35 kcal per day more from sugar-sweetened beverages during the decrease sleep than the increase sleep condition, p = .033. There were no reported differences between conditions from energy-dense snack foods. Although no differences in reported intake were observed earlier in the day, from 2000 h (8:00 PM) and later, children reported consuming 132 kcal more during the decrease sleep condition than the increase condition, p < 0.001. Shortened sleep achieved by delaying bedtimes led to increased caloric intake in the evening and from sugar-sweetened beverages. Clinical Trials Registration: clinicaltrials.gov Identifier: NCT01030107.
Collapse
Affiliation(s)
- Chantelle N. Hart
- Center for Obesity Research and Education and Department of Social and Behavioral Sciences, College of Public Health, Temple University
| | | | | | - Mary A. Carskadon
- E.P. Bradley Hospital Sleep Research Laboratory;,Psychiatry & Human Behavior, Alpert Medical School of Brown University
| | | | - Elissa Jelalian
- Psychiatry & Human Behavior, Alpert Medical School of Brown University;,Weight Control & Diabetes Research Center, The Miriam Hospital
| | - Judith A. Owens
- Department of Neurology at Boston Children’s Hospital and Harvard Medical School
| | | | - Rena R. Wing
- Psychiatry & Human Behavior, Alpert Medical School of Brown University;,Weight Control & Diabetes Research Center, The Miriam Hospital
| |
Collapse
|
8
|
Tripicchio GL, Jones GJ, Hart CN, Hyun M, DeSabato E, Giddings A, Ehrhardt A, Rosenberg E. A digitally enhanced home-based physical activity intervention for high-risk middle school youth during COVID-19. Transl Behav Med 2021; 13:17-24. [PMID: 34850218 PMCID: PMC8690196 DOI: 10.1093/tbm/ibab151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
COVID-19 significantly impacted physical activity among high-risk youth. Camp from Home, a digitally enhanced home-based intervention, was developed to address physical activity disparities among middle school youth during COVID-19. Camp from Home enrolled 62 youth in 54 families from five schools in Philadelphia during the summer of 2020. The 6-week intervention comprised of (1) three home deliveries of "activity kits" including exercise equipment and activity booklets, (2) asynchronous sport and exercise videos posted to a private YouTube channel, and (3) supportive text-messages from health coaches. YouTube analytics and self-report surveys completed by parents and youth at baseline and at the end of programming were used to assess engagement, acceptability, and preliminary efficacy. Youth participants were 12.4 (1.2) years, 38.7% female and 90.3% Black/African American. At follow-up, 41 parents (75.9%) and 34 youth (54.8%) completed measures. Youth self-reported increases in self-efficacy (ΔM(sd) = 0.4(1.0), p = .03) and physical activity (ΔM(sd) = 4.2(7.9), p = .004), despite suboptimal engagement in digital program components. Overall, participants highly rated the program. Activity kits and text-messages from health coaches were rated as most helpful. Most parents (95.1%) and youth (83.8%) expressed interested in participating again in the future. A 6-week digitally enhanced, home-based physical activity intervention was acceptable and feasible among parents and youth during the summer of 2020, with youth reporting improvements in self-efficacy and physical activity. Summer programs are critical for reducing disparities in physical activity and hold potential for addressing key barriers for high-risk youth even outside the context of COVID-19.
Collapse
Affiliation(s)
- Gina L Tripicchio
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA,Correspondence to: GL Tripicchio,
| | - Gareth J Jones
- Department of Sport and Recreation Management, Temple University, Philadelphia, PA, USA
| | - Chantelle N Hart
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA
| | - Moonsup Hyun
- Department of Sport and Recreation Management, Temple University, Philadelphia, PA, USA
| | - Emily DeSabato
- Philadelphia Youth Sports Collaborative, Philadelphia, PA, USA
| | - Amy Giddings
- Department of Sport and Recreation Management, Temple University, Philadelphia, PA, USA
| | - Amanda Ehrhardt
- Department of Sport and Recreation Management, Temple University, Philadelphia, PA, USA
| | - Emily Rosenberg
- Philadelphia Youth Sports Collaborative, Philadelphia, PA, USA
| |
Collapse
|
9
|
Phelan S, Hart CN, Jelalian E, Muñoz-Christian K, Alarcon N, McHugh A, Ventura AK, Wing RR. Effect of prenatal lifestyle intervention on maternal postpartum weight retention and child body mass index z-score at 36 months. Int J Obes (Lond) 2021; 45:1133-1142. [PMID: 33627776 PMCID: PMC8081654 DOI: 10.1038/s41366-021-00784-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 01/19/2021] [Accepted: 02/01/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND/OBJECTIVES We previously reported results from a randomized trial showing that a behavioral intervention during pregnancy reduced excess gestational weight gain but did not impact maternal weight at 12 months. We now examine the longer-term effects of this prenatal intervention on maternal postpartum weight retention and toddler body-mass-index z scores (BMIz) over 36 months. SUBJECTS/METHODS Pregnant women (N = 264; 13.7 weeks' gestation; 41.6% Hispanic) with overweight or obesity were randomized into usual care or prenatal intervention. Anthropometric assessments in mothers and toddlers occurred at baseline, 35 weeks' gestation and after delivery at 6, 12, 18, 24, and 36 months. RESULTS At 36 months, prenatal intervention vs. usual care had no significant effect on the proportion of participants who returned to their early pregnancy weight or below (33.3% vs. 39.5%; p = 0.12) and had no effect on the magnitude of weight retained (2.8 [0.8, 4.8] vs 3.0 kg [1.0, 4.9], respectively; mean difference = 0.14 [-3.0, 2.7]). There was also no statistically significant intervention vs. usual care effect on infant BMIz or skinfold changes over time; toddler BMIz increased by 1.4 [-1.7, 1.0] units in the intervention group and 1.6 [-1.2, 1.8] units in the usual care group from delivery to 36 months (difference = 0.16 [-0.32. 0.63]). The proportion of toddlers at risk for obesity at 36 months was similar in intervention and usual care groups (28/77 [36.4%] vs 30/80 [37.5%]; p = 0.77). CONCLUSIONS Compared with usual care, lifestyle intervention during pregnancy resulted in similar maternal and toddler anthropometric outcomes at 36-months postpartum in a diverse US sample of women with overweight and obesity. To sustain improved maternal weight management initiated during pregnancy, continued intervention during the postpartum years may be needed.
Collapse
Affiliation(s)
- Suzanne Phelan
- California Polytechnic State University, Department of Kinesiology & Public Health, Center for Health Research, San Luis Obispo, CA, USA.
| | - Chantelle N Hart
- Temple University Center for Obesity Research and Education Department of Social and Behavioral Sciences, Philadelphia, PA, USA
| | - Elissa Jelalian
- Warren Alpert Medical School at Brown University Department of Psychiatry and Human Behavior, Providence, RI, USA
| | - Karen Muñoz-Christian
- California Polytechnic State University World Languages & Cultures Department, San Luis Obispo, CA, USA
| | - Noemi Alarcon
- California Polytechnic State University, Department of Kinesiology & Public Health, Center for Health Research, San Luis Obispo, CA, USA
| | - Angelica McHugh
- Warren Alpert Medical School at Brown University Department of Psychiatry and Human Behavior, Providence, RI, USA
| | - Alison K Ventura
- California Polytechnic State University, Department of Kinesiology & Public Health, Center for Health Research, San Luis Obispo, CA, USA
| | - Rena R Wing
- Warren Alpert Medical School at Brown University Department of Psychiatry and Human Behavior, Providence, RI, USA
| |
Collapse
|
10
|
Abstract
A growing body of research supports the potential importance of behavioral and social routines for children's health promotion and obesity risk reduction. Evidence in support of this comes from multiple lines of research, which suggest that specific behavioral routines, namely, eating and sleep routines, may be protective against excessive weight gain and development of pediatric obesity. Emerging work also supports the potential importance of the timing of these behavioral routines. From a circadian perspective, alignment of behavioral and social routines with underlying circadian rhythms may be particularly important for enhancing children's weight regulation. Specifically, engaging in appropriately timed behavioral routines may serve to entrain circadian rhythms that affect metabolism and weight regulation. Thus, in addition to promoting healthier eating, activity, and sleep behaviors for prevention and treatment of pediatric obesity, it may also be important to consider promotion of consistency in, and optimal timing of, these behaviors in an effort to enhance extant prevention and treatment approaches. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
- Chantelle N Hart
- Department of Social and Behavioral Sciences, College of Public Health, Temple University
| | - Elissa Jelalian
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | - Hollie A Raynor
- Department of Nutrition, College of Education, Health and Human Sciences, University of Tennessee
| |
Collapse
|
11
|
Pool AC, Coffman DL, Sarwer DB, LaRose JG, Hart CN. Associations between weight misperception, contextual factors, and weight loss behaviours in young adult men with overweight/obesity. Obes Sci Pract 2020; 6:39-46. [PMID: 32128241 PMCID: PMC7042023 DOI: 10.1002/osp4.382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Young men are less likely to engage in weight loss behaviours than their female counterparts. This may be because of an increased likelihood for young men, particularly young black men, with overweight/obesity to misperceive their weight status. This study examined racial differences in weight status perception accuracy and associations between this perception and weight loss behaviours among young men. Associations between weight loss behaviours and contextual factors were also explored. METHODS Data from 1417 young adult (YA) men with overweight/obesity from the 2007 to 2014 National Health and Nutrition Examination Survey (NHANES) were analysed. Associations between weight status perception accuracy, contextual factors, and weight loss attempts and behaviours were examined with logistic regression. RESULTS YA men with overweight/obesity were more likely to report weight loss attempts and behaviours if they perceived themselves as being overweight (OR = 3.10; 95% CI, 2.18-4.41; P < .01; OR = 3.20, 95% CI, 2.16-4.72, P < .01, respectively). Greater education and income were associated with a greater likelihood of reporting weight loss attempts and healthy weight loss behaviours. Greater reported depressive symptoms were associated with reported weight loss attempts but not healthy weight loss behaviours. There were no differences by race for reported weight loss attempts or behaviours. CONCLUSION Among YA men with overweight/obesity, perceiving oneself as overweight was associated with reporting weight loss attempts and healthy weight loss behaviours. Future research should consider how weight status perception accuracy affects weight loss attempts among YA men and what additional factors may account for racial differences.
Collapse
Affiliation(s)
- Andrew C. Pool
- Center for Parent and Teen CommunicationCraig‐Dalsimer Division of Adolescent Medicine, Children's Hospital of PhiladelphiaPhiladelphiaPennsylvania
| | - Donna L. Coffman
- Department of Epidemiology and BiostatisticsTemple UniversityPhiladelphiaPennsylvania
| | - David B. Sarwer
- Center for Obesity Research and EducationTemple UniversityPhiladelphiaPennsylvania
- Department of Social and Behavioral SciencesTemple UniversityPhiladelphiaPennsylvania
| | - Jessica G. LaRose
- Department of Health Behavior and PolicyVirginia Commonwealth University School of MedicineRichmondVirginia
| | - Chantelle N. Hart
- Center for Obesity Research and EducationTemple UniversityPhiladelphiaPennsylvania
- Department of Social and Behavioral SciencesTemple UniversityPhiladelphiaPennsylvania
| |
Collapse
|
12
|
Carskadon MA, Barker D, Hart CN, Raynor HA, Gredvig-Ardito C, Mason IC, Scheer FAJL. 0155 Circadian and Homeostatic Influences on Caloric Intake: Forced Desynchrony in Healthy Weight, Overweight, and Obese Adolescents. Sleep 2019. [DOI: 10.1093/sleep/zsz067.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | | | | | | | | | - Ivy C Mason
- Medical Chronobiology Program, Brigham and Women’s Hospital, Boston, MA, USA
| | - Frank A J L Scheer
- Medical Chronobiology Program, Brigham and Women’s Hospital, Boston, MA, USA
| |
Collapse
|
13
|
Gebre A, Hawley N, Carskadon M, Raynor H, Jelalian E, Owens J, Wing RR, Hart CN. 0776 A Behavioral Intervention to Enhance Sleep in School-Aged Children: Moderation by Child Routines. Sleep 2019. [DOI: 10.1093/sleep/zsz067.774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Azeb Gebre
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Nicola Hawley
- Department of Chronic Disease Epidemiology, Yale University, New Haven, CT, USA
| | - Mary Carskadon
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Hollie Raynor
- Department of Nutrition, University of Tennessee at Knoxville, Knoxville, TN, USA
| | - Elissa Jelalian
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Judith Owens
- Department of Neurology and Center for Pediatric Sleep Disorders, Boston Children’s Hospital, Waltham, MA, USA
| | - Rena R Wing
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Chantelle N Hart
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA
| |
Collapse
|
14
|
Spaeth AM, Hawley NL, Raynor HA, Jelalian E, Greer A, Crouter SE, Coffman DL, Carskadon MA, Owens JA, Wing RR, Hart CN. Sleep, energy balance, and meal timing in school-aged children. Sleep Med 2019; 60:139-144. [PMID: 30905623 DOI: 10.1016/j.sleep.2019.02.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 01/31/2019] [Accepted: 02/01/2019] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To determine associations among objectively-measured nocturnal sleep time, bedtime and obesogenic behaviors, including dietary intake, timing of intake, and physical activity, in a diverse sample of school-aged children who presented for behavioral treatment to enhance sleep duration. METHODS Eighty-seven children (8-11 y, 66.7% female, zBMI: 0.86 ± 1.0) who self-reported sleeping <9.5 h/night were studied for one week using wrist actigraphy to estimate sleep; hip-worn accelerometers to measure physical activity; and 24 h dietary recalls to capture dietary intake and meal timing. Pearson and Spearman's rho correlations and linear regressions controlling for age, gender and race were used for statistical analyses. RESULTS AND CONCLUSION Mean bedtime was 10:31 PM (±58.2 min) and mean nocturnal sleep time was 7.7 h (±37.5 min). Although later bedtime was associated with shorter sleep time (r = -0.61, p < 0.001), the two variables were differentially related to obesity risk factors. Later bedtime, but not sleep time, correlated with greater daily fat intake, later first meal of the day, and greater after-dinner intake (all p < 0.05). Nocturnal sleep time, but not bedtime, correlated with zBMI (p = 0.04). Both sleep time and later bedtime were associated with a later last meal of the day (all p < 0.05). Findings remained consistent after controlling for demographic factors. In short-sleeping school-aged children, bedtime may be more predictive of dietary obesity risk factors whereas sleep duration may be more predictive of zBMI. Results suggest that health providers should consider both bedtime and sleep duration for reducing obesity risk in children. CLINICAL TRIAL Enhancing Sleep Duration: Effects on Children's Eating and Activity Behaviors, NCT03186508, https://clinicaltrials.gov/ct2/show/NCT03186508.
Collapse
Affiliation(s)
- Andrea M Spaeth
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, USA.
| | - Nicola L Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Hollie A Raynor
- Department of Nutrition, College of Education, Health and Human Sciences, The University of Tennessee-Knoxville, Knoxville, TN, USA
| | - Elissa Jelalian
- Department of Psychiatry and Human Behavior, School of Medicine, Brown University, Providence, RI, USA
| | - Ashley Greer
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Scott E Crouter
- Department of Kinesiology, Recreation and Sport Studies, The University of Tennessee-Knoxville, Knoxville, TN, USA
| | - Donna L Coffman
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Mary A Carskadon
- Department of Psychiatry and Human Behavior, School of Medicine, Brown University, Providence, RI, USA
| | - Judith A Owens
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Rena R Wing
- Department of Psychiatry and Human Behavior, School of Medicine, Brown University, Providence, RI, USA
| | - Chantelle N Hart
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA; Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| |
Collapse
|
15
|
Phelan S, Wing RR, Brannen A, McHugh A, Hagobian T, Schaffner A, Jelalian E, Hart CN, Scholl TO, Muñoz-Christian K, Yin E, Phipps MG, Keadle S, Abrams B. Does Partial Meal Replacement During Pregnancy Reduce 12-Month Postpartum Weight Retention? Obesity (Silver Spring) 2019; 27:226-236. [PMID: 30421864 PMCID: PMC8142600 DOI: 10.1002/oby.22361] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 10/12/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This randomized trial tested whether a behavioral intervention with meal replacements in pregnancy could increase the proportion of women who returned to prepregnancy weight and reduce postpartum weight retention by 12 months after delivery. METHODS Women (N = 264; 13.7 weeks' gestation) with overweight or obesity were randomly assigned to usual care or intervention. The intervention reduced excess gestational weight gain and was discontinued at delivery. At follow-up, 83.7% completed the 12-month assessment. RESULTS Compared with usual care, prenatal intervention had no significant effect on odds of achieving prepregnancy weight (38/128 [29.7%] vs. 41/129 [31.8%]; P = 0.98) or in reducing the magnitude of weight retained (3.3 vs. 3.1 kg; P = 0.82) at 12 months. After delivery, significant (P < 0.0001) declines in meal replacements, practice of weight control behaviors, and dietary restraint were observed in the intervention group. Independent of group, lower gestational weight gain was the strongest predictor of achieving prepregnancy weight at 12 months (P = 0.0008). CONCLUSIONS A prenatal behavioral intervention with meal replacements that reduced pregnancy weight gain had no significant effect on 12-month postpartum weight retention.
Collapse
Affiliation(s)
- Suzanne Phelan
- Department of Kinesiology & Public Health, California Polytechnic State University, San Luis Obispo, California, USA
| | - Rena R Wing
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Anna Brannen
- Department of Kinesiology & Public Health, California Polytechnic State University, San Luis Obispo, California, USA
| | - Angelica McHugh
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Todd Hagobian
- Department of Kinesiology & Public Health, California Polytechnic State University, San Luis Obispo, California, USA
| | - Andrew Schaffner
- Statistics Department, California Polytechnic State University, San Luis Obispo, California, USA
| | - Elissa Jelalian
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Chantelle N Hart
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania, USA
| | - Theresa O Scholl
- Department of Obstetrics and Gynecology, Rowan University, Glassboro, New Jersey, USA
| | - Karen Muñoz-Christian
- Modern Languages Department, California Polytechnic State University, San Luis Obispo, California, USA
| | - Elaine Yin
- Pacific Central Coast Health Centers, Santa Maria Women's Health, Santa Maria, California, USA
| | - Maureen G Phipps
- Department of Obstetrics and Gynecology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Department of Obstetrics and Gynecology, Women & Infants Hospital, Providence, Rhode Island, USA
| | - Sarah Keadle
- Department of Kinesiology & Public Health, California Polytechnic State University, San Luis Obispo, California, USA
| | - Barbara Abrams
- Division of Epidemiology, School of Public Health, University of California at Berkeley, Berkeley, California, USA
| |
Collapse
|
16
|
Fisher JO, Serrano EL, Foster GD, Hart CN, Davey A, Bruton YP, Kilby L, Harnack L, Ruth KJ, Kachurak A, Lawman HG, Martin A, Polonsky HM. Title: efficacy of a food parenting intervention for mothers with low income to reduce preschooler's solid fat and added sugar intakes: a randomized controlled trial. Int J Behav Nutr Phys Act 2019; 16:6. [PMID: 30654818 PMCID: PMC6335764 DOI: 10.1186/s12966-018-0764-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 12/19/2018] [Indexed: 12/17/2022] Open
Abstract
Background Few interventions have shown efficacy to influence key energy balance behaviors during the preschool years. Objective A randomized controlled trial (RCT) was used to evaluate the efficacy of Food, Fun, and Families (FFF), a 12 week authoritative food parenting intervention for mothers with low-income levels, to reduce preschool-aged children’s intake of calories from solid fat and added sugar (SoFAS). Methods Mothers were randomly assigned to receive FFF (n = 59) or to a delayed treatment control (n = 60). The primary outcome was children’s daily energy intake from SoFAS at the end of the 12 week intervention, controlling for baseline levels, assessed by 24-h dietary recalls. Secondary outcomes included children’s daily energy intake, children’s BMI z-scores, and meal observations of maternal food parenting practices targeted in FFF (e.g. providing guided choices). Results Participating mothers were predominantly African American (91%), with 39% educated beyond high school and 66% unemployed. Baseline demographics and child SoFAS intakes did not differ by group. Lost to follow-up was 13% and did not differ between groups. At post-intervention, FFF children consumed ~ 94 kcal or 23% less daily energy from SoFAS than children in the control group, adjusting for baseline levels (307.8 (95%CI = 274.1, 341.5) kcal vs. 401.9 (95%CI = 369.8, 433.9) kcal, FFF vs. control; p < 0.001). FFF mothers also displayed a greater number of authoritative parenting practices when observed post-intervention with their child at a buffet-style meal (Wilcoxon z = − 2.54, p = 0.012). Neither child total daily energy intake nor BMI z-scores differed between groups post-intervention. Conclusions Findings demonstrate the initial efficacy of an authoritative food parenting intervention for families with low-income to reduce SoFAS intake in early childhood. Additional research is needed to evaluate longer-term effects on diet and growth. Trial registration Retrospectively registered at ClinicalTrials.gov: #NCT03646201.
Collapse
Affiliation(s)
- Jennifer O Fisher
- Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA.
| | - Elena L Serrano
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, 327 Wallace Hall, Blacksburg, VA, 24061, USA
| | - Gary D Foster
- Weight Watchers International, 675 6th Ave, New York, NY, USA.,Weight and Eating Disorders Program, University of Pennyslvania, Pennyslvania, USA
| | - Chantelle N Hart
- Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA
| | - Adam Davey
- Department of Behavioral Health and Nutritio, University of Deleware, 385 McDowell Hall, Neward, Newark, DE, 19716, USA
| | - Yasmeen P Bruton
- Department of Obstetrics & Gynecology, Division of Urogynecology, Duke University at Patterson Place, 5324 McFarland Drive, Suite 310, Durham, NC, 27707, USA
| | - Linda Kilby
- LDN. NORTH Inc, Philadelphia WIC program, 1300 W Lehigh Avenue, Philadelphia, PA, 19132, USA
| | - Lisa Harnack
- Division of Epidemiology and Community of Public Health, School of Public Health, University of Minnesota, 1300 S 2nd Street, Room 300 West Bank Office Building, Minneapolis, MN, 55454, USA
| | - Karen J Ruth
- Biostatistics Facility, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA
| | - Alexandria Kachurak
- Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA
| | - Hannah G Lawman
- Division of Chronic Disease Prevention, Philadelphia Department of Public Health, 1101 Market Street, 9th Floor, Philadelphia, PA, 19107, USA
| | - Anna Martin
- Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA
| | - Heather M Polonsky
- Providence Health and Services, Center for Outcomes Research & Education, 5251 NE Gilsan Street, Bldg A, Portland, OR, 97213, USA
| |
Collapse
|
17
|
Demos KE, Sweet LH, Hart CN, McCaffery JM, Williams SE, Mailloux KA, Trautvetter J, Owens MM, Wing RR. The Effects of Experimental Manipulation of Sleep Duration on Neural Response to Food Cues. Sleep 2018; 40:3980278. [PMID: 28977574 DOI: 10.1093/sleep/zsx125] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Despite growing literature on neural food cue responsivity in obesity, little is known about how the brain processes food cues following partial sleep deprivation and whether short sleep leads to changes similar to those observed in obesity. We used functional magnetic resonance imaging (fMRI) to test the hypothesis that short sleep leads to increased reward-related and decreased inhibitory control-related processing of food cues.In a within-subject design, 30 participants (22 female, mean age = 36.7 standard deviation = 10.8 years, body mass index range 20.4-40.7) completed four nights of 6 hours/night time-in-bed (TIB; short sleep) and four nights of 9 hours/night TIB (long sleep) in random counterbalanced order in their home environments. Following each sleep condition, participants completed an fMRI scan while viewing food and nonfood images.A priori region of interest analyses revealed increased activity to food in short versus long sleep in regions of reward processing (eg, nucleus accumbens/putamen) and sensory/motor signaling (ie, right paracentral lobule, an effect that was most pronounced in obese individuals). Contrary to the hypothesis, whole brain analyses indicated greater food cue responsivity during short sleep in an inhibitory control region (right inferior frontal gyrus) and ventral medial prefrontal cortex, which has been implicated in reward coding and decision-making (false discovery rate corrected q = 0.05).These findings suggest that sleep restriction leads to both greater reward and control processing in response to food cues. Future research is needed to understand the dynamic functional connectivity between these regions during short sleep and whether the interplay between these neural processes determines if one succumbs to food temptation.
Collapse
Affiliation(s)
- Kathryn E Demos
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI
| | | | - Chantelle N Hart
- Center for Obesity Research and Education, Department of Public Health, Temple University
| | - Jeanne M McCaffery
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI
| | - Samantha E Williams
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI
| | - Kimberly A Mailloux
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI
| | - Jennifer Trautvetter
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI
| | - Max M Owens
- Center for Obesity Research and Education, Department of Public Health, Temple University
| | - Rena R Wing
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI
| |
Collapse
|
18
|
Lavery AM, Collins BN, Waldman AT, Hart CN, Bar-Or A, Marrie RA, Arnold D, O'Mahony J, Banwell B. The contribution of secondhand tobacco smoke exposure to pediatric multiple sclerosis risk. Mult Scler 2018; 25:515-522. [PMID: 29393768 DOI: 10.1177/1352458518757089] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Pediatric acquired demyelinating syndromes (ADSs) are monophasic (mono-ADS) in 70% of cases and represent the first attack of multiple sclerosis (MS) in 30%. Secondhand tobacco smoke (SHS) exposure has been implicated as a risk factor for adult-onset MS. Little is known about whether SHS presents an additive risk beyond genetic factors and other environmental exposures associated with pediatric MS. METHODS This study examined SHS exposure in 216 children with mono-ADS and 81 children with MS. Interactions between SHS, HLA-DRB1*15 alleles, serum 25-hydroxyvitamin D concentrations, and serological evidence of remote Epstein-Barr virus (EBV) exposure were evaluated. RESULTS SHS exposure was more common in children with MS (37% exposed) compared to mono-ADS (29.5% exposed). Compared to mono-ADS, SHS exposure was not an independent risk factor for MS. When both SHS exposure and HLA-DRB1*15 were present, the odds for MS increased (odds ratio (OR) = 3.7; 95% confidence interval (CI): 1.17-11.9) compared to mono-ADS. Interactions between SHS and vitamin D or EBV did not associate with MS. CONCLUSION Exposure to SHS is a risk factor for central nervous system (CNS) demyelination. Results suggest that SHS exposure and HLA-DRB1*15 interact to increase risk for MS in children diagnosed with mono-ADS.
Collapse
Affiliation(s)
- Amy M Lavery
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA/Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Bradley N Collins
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Amy T Waldman
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Chantelle N Hart
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA/Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Amit Bar-Or
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada/Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ruth Ann Marrie
- Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Douglas Arnold
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Julia O'Mahony
- Institute of Health Policy, Management, and Evaluation, University of Toronto and The Hospital for Sick Children, Toronto, ON, Canada
| | - Brenda Banwell
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| |
Collapse
|
19
|
Phelan S, Wing RR, Brannen A, McHugh A, Hagobian TA, Schaffner A, Jelalian E, Hart CN, Scholl TO, Munoz-Christian K, Yin E, Phipps MG, Keadle S, Abrams B. Randomized controlled clinical trial of behavioral lifestyle intervention with partial meal replacement to reduce excessive gestational weight gain. Am J Clin Nutr 2018; 107:183-194. [PMID: 29529157 PMCID: PMC6455030 DOI: 10.1093/ajcn/nqx043] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 11/21/2017] [Indexed: 12/24/2022] Open
Abstract
Background Behavioral lifestyle interventions during pregnancy can prevent excessive gestational weight gain (GWG) in women with normal weight; however, effective interventions to reduce GWG in ethnically diverse women with obesity are lacking. Objective A randomized controlled trial was conducted to test whether a behavioral lifestyle intervention with partial meal replacement reduces GWG rate in Hispanic and non-Hispanic women with overweight or obesity relative to enhanced usual care. Design Participants (n = 257) were recruited in San Luis Obispo, California, and Providence, Rhode Island, between November 2012 and May 2016. Participants were pregnant (mean ± SD: 13.6 ± 1.8 wk of gestation) with overweight or obesity and had a mean age of 30.3 y; 41.6% of participants were Hispanic. Women were randomly assigned within site and by ethnicity to enhanced usual care (n = 128) or to a behavioral lifestyle intervention with partial meal replacement (n = 129). The primary outcome was GWG per week of observation. Secondary outcomes were proportions exceeding Institute of Medicine (IOM) guidelines for total GWG, changes in weight-control behaviors and cardiovascular disease risk factors, and incidence of pregnancy complications. Study retention was 99.6% (256 of 257). Results The intervention compared with usual care resulted in less mean ± SD weekly GWG (0.33 ± 0.25 compared with 0.39 ± 0.23 kg/wk; P = 0.02) and total GWG (9.4 ± 6.9 compared with 11.2 ± 7.0 kg; P = 0.03) and reduced the proportion of women who exceeded IOM guidelines for total GWG (41.1% compared with 53.9%; P = 0.03). No significant group × time × demographic subgroup (ethnicity, BMI, age, parity, and income) interactions were observed. Among intervention participants, greater meal replacement intake was related to reduced GWG rate (β = -0.07; 95% CI:-0.12, -0.03; P = 0.002). The intervention compared with usual care increased weight-control strategies (P < 0.0001) and cognitive restraint (P < 0.0001) and reduced triglycerides (P = 0.03). Conclusion Prenatal behavioral intervention with partial meal replacement significantly reduced GWG in Hispanic and non-Hispanic women with overweight or obesity. This trial was registered at www.clinicaltrials.gov as NCT01545934.
Collapse
Affiliation(s)
- Suzanne Phelan
- Departments of Kinesiology, Statistics, and Modern Languages, California Polytechnic State University, San Luis Obispo, CA
| | - Rena R Wing
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Providence, RI
| | - Anna Brannen
- Departments of Kinesiology, Statistics, and Modern Languages, California Polytechnic State University, San Luis Obispo, CA
| | - Angelica McHugh
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Providence, RI
| | - Todd A Hagobian
- Departments of Kinesiology, Statistics, and Modern Languages, California Polytechnic State University, San Luis Obispo, CA
| | - Andrew Schaffner
- Departments of Statistics, and Modern Languages, California Polytechnic State University, San Luis Obispo, CA
| | - Elissa Jelalian
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Providence, RI
| | - Chantelle N Hart
- Department of Social and Behavioral Sciences, Temple University Center for Obesity Research and Education, Philadelphia, PA
| | - Theresa O Scholl
- Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey (now Rowan), Glassboro, NJ
| | - Karen Munoz-Christian
- Departments of Modern Languages, California Polytechnic State University, San Luis Obispo, CA
| | - Elaine Yin
- Pacific Central Coast Health Centers, Santa Maria Women's Health, Santa Maria, CA
| | - Maureen G Phipps
- Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University and Women and Infants Hospital, Providence, RI
| | - Sarah Keadle
- Departments of Kinesiology, Statistics, and Modern Languages, California Polytechnic State University, San Luis Obispo, CA
| | - Barbara Abrams
- Division of Epidemiology, University of California at Berkeley School of Public Health, Berkeley, CA
| |
Collapse
|
20
|
Spaeth AM, Hawley NL, Carskadon MA, Raynor HA, Jelalian E, Owens JA, Wing RR, Hart CN. 0993 SLEEP INTERVENTION IMPROVES SELF-CONTROL IN SCHOOL-AGED CHILDREN. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
21
|
Hart CN, Hawley N, Egleston B, Raynor H, Jelalian E, Carskadon MA, Owens J, Wing RR. 0995 BRIEF BEHAVIORAL INTERVENTION ENHANCES CHILDREN’S SLEEP AND IMPROVES WEIGHT STATUS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
22
|
Parthasarathy S, Carskadon MA, Jean-Louis G, Owens J, Bramoweth A, Combs D, Hale L, Harrison E, Hart CN, Hasler BP, Honaker SM, Hertenstein E, Kuna S, Kushida C, Levenson JC, Murray C, Pack AI, Pillai V, Pruiksma K, Seixas A, Strollo P, Thosar SS, Williams N, Buysse D. Implementation of Sleep and Circadian Science: Recommendations from the Sleep Research Society and National Institutes of Health Workshop. Sleep 2016; 39:2061-2075. [PMID: 27748248 PMCID: PMC5103795 DOI: 10.5665/sleep.6300] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 09/26/2016] [Indexed: 01/03/2023] Open
Affiliation(s)
| | - Mary A. Carskadon
- Department of Psychiatry and Human Behavior at the Warren Alpert Medical School of Brown University, Providence, RI
- Centre for Sleep Research, School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, Australia
| | | | | | - Adam Bramoweth
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA
| | - Daniel Combs
- UAHS Center for Sleep and Circadian Sciences, University of Arizona, Tucson, AZ
| | - Lauren Hale
- Department of Family, Population and Preventive Medicine, Stony Brook State University of New York, Stony Brook, Stony Brook, NY
| | | | - Chantelle N. Hart
- Social and Behavioral Sciences and the Center for Obesity Research and Education, College of Public Health, Temple University, Phildelphia, PA
| | - Brant P. Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Sarah M. Honaker
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | | | - Samuel Kuna
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Phildelphia, PA
| | | | - Jessica C. Levenson
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Caitlin Murray
- Psychology Department, Loyola University Chicago, Chicago, IL
| | - Allan I. Pack
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Phildelphia, PA
| | - Vivek Pillai
- Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI
| | - Kristi Pruiksma
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX
| | - Azizi Seixas
- Department of Population Health, NYU School of Medicine, New York, NY
| | - Patrick Strollo
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvannia
| | - Saurabh S. Thosar
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR
| | - Natasha Williams
- Department of Population Health, NYU School of Medicine, New York, NY
| | - Daniel Buysse
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA
| |
Collapse
|
23
|
Abstract
Despite being the focus of widespread public health efforts, childhood obesity remains an epidemic worldwide. Given the now well-documented consequences of obesity for childhood health and psychosocial functioning, as well as associated morbidity in adulthood, identifying novel, modifiable behaviors that can be targeted to improve weight control is imperative. Enhancing children's sleep may show promise in assisting with weight regulation. The present paper describes the development of a brief behavioral sleep intervention for school-aged children, including preliminary findings of this work as well as areas for future study.
Collapse
Affiliation(s)
- Chantelle N Hart
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, 3223 North Broad Street, Philadelphia, PA 19140, USA.
| | - Nicola L Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, 60 College Street, New Haven, CT 06520, USA
| | - Rena R Wing
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital, Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903, USA
| |
Collapse
|
24
|
Demos KE, Hart CN, Sweet LH, Mailloux KA, Trautvetter J, Williams SE, Wing RR, McCaffery JM. Partial sleep deprivation impacts impulsive action but not impulsive decision-making. Physiol Behav 2016; 164:214-9. [PMID: 27267950 DOI: 10.1016/j.physbeh.2016.06.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 06/02/2016] [Accepted: 06/03/2016] [Indexed: 10/21/2022]
Abstract
Sleep deprivation may lead to increased impulsivity, however, previous literature has focused on examining effects of total sleep deprivation (TSD) rather than the more common condition, partial sleep deprivation (PSD) or 'short sleep'. Moreover, it has been unclear whether PSD impacts impulse-related cognitive processes, and specifically if it differentially affects impulsive action versus impulsive decision-making. We sought to determine if short compared to long sleep (6 vs. 9h/night) impacts impulsive action via behavioral inhibition (Go/No-Go), and/or impulsive decision-making processes of risk taking (Balloon Analogue Risk Task [BART]) and preferences for immediate over delayed rewards (Delay Discounting). In a within-subject design, 34 participants (71% female, mean age=37.0years, SD=10.54) were assigned to four consecutive nights of 6h/night (short sleep) and 9h/night (long sleep) in their own home in random counterbalanced order. Sleep was measured via wrist-worn actigraphs to confirm adherence to the sleep schedules (mean short sleep=5.9h, SD=0.3; mean long sleep=8.6h, SD=0.3, p<0.001). The Go/No-Go, BART, and Delay Discounting tasks were completed following both sleep conditions. Participants had more inhibition errors on the Go/No-Go task after short (mean false alarms=19.79%, SD=14.51) versus long sleep (mean=15.97%, SD=9.51, p=0.039). This effect was strongest in participants reporting longer habitual time in bed (p=0.04). There were no differences in performance following long- versus short-sleep for either delay discounting or the BART (p's>0.4). Overall, these results indicate that four days of PSD diminishes behavioral inhibition abilities, but may not alter impulsive decision-making. These findings contribute to the emerging understanding of how partial sleep deprivation, currently an epidemic, impacts cognitive ability. Future research should continue to explore the connection between PSD and cognitive functions, and ways to minimize the occurrence and negative consequences of short sleep.
Collapse
Affiliation(s)
- K E Demos
- Department of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control & Diabetes Research Center, Providence, RI, United States.
| | - C N Hart
- Department of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control & Diabetes Research Center, Providence, RI, United States; Center for Obesity Research & Education, Department of Public Health, Temple University, United States
| | - L H Sweet
- Department of Psychology, University of Georgia, Athens, GA, United States
| | - K A Mailloux
- Department of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control & Diabetes Research Center, Providence, RI, United States
| | - J Trautvetter
- Department of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control & Diabetes Research Center, Providence, RI, United States
| | - S E Williams
- Department of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control & Diabetes Research Center, Providence, RI, United States
| | - R R Wing
- Department of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control & Diabetes Research Center, Providence, RI, United States
| | - J M McCaffery
- Department of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control & Diabetes Research Center, Providence, RI, United States
| |
Collapse
|
25
|
Abstract
Despite being the focus of widespread public health efforts, childhood obesity remains an epidemic worldwide. Given the now well-documented consequences of obesity for childhood health and psychosocial functioning, as well as associated morbidity in adulthood, identifying novel, modifiable behaviors that can be targeted to improve weight control is imperative. Enhancing children's sleep may show promise in assisting with weight regulation. The present paper describes the development of a brief behavioral sleep intervention for school-aged children, including preliminary findings of this work as well as areas for future study.
Collapse
Affiliation(s)
- Chantelle N. Hart
- Center for Obesity Research and Education and Department of Social and Behavioral Sciences, College of Public Health, Temple University
| | - Nicola L. Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health
| | - Rena R. Wing
- Weight Control and Diabetes Research Center, The Miriam Hospital; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| |
Collapse
|
26
|
Zambrano DN, Mindell JA, Reyes NR, Hart CN, Herring SJ. "It's Not All About My Baby's Sleep": A Qualitative Study of Factors Influencing Low-Income African American Mothers' Sleep Quality. Behav Sleep Med 2016; 14:489-500. [PMID: 26488388 PMCID: PMC4840086 DOI: 10.1080/15402002.2015.1028063] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Low-income African American mothers are at particular risk for poor postpartum sleep. This study sought to understand facilitators and barriers that exist to getting a good night's sleep among these high-risk mothers. Semistructured interviews with 18 low-income African Americans (3-6 months postpartum) were conducted. Most mothers described their own sleep quality to be poor, despite the fact that their babies' sleep improved substantially from the newborn period. Mothers kept themselves awake due to their own internal worry and anxiety, along with external factors that were largely independent of babies' sleep, including work and school commitments and the home environment. For the few mothers with good sleep quality, time management and family support were strong facilitators. Findings lay the groundwork for sleep improvement interventions.
Collapse
Affiliation(s)
| | - Jodi A. Mindell
- Department of Psychology, Saint Joseph’s University, Philadelphia, PA
| | - Naomi R. Reyes
- Center for Obesity Research and Education, Departments of Medicine and Public Health, Temple University, Philadelphia, PA
| | - Chantelle N. Hart
- Center for Obesity Research and Education, Departments of Medicine and Public Health, Temple University, Philadelphia, PA
| | - Sharon J. Herring
- Center for Obesity Research and Education, Departments of Medicine and Public Health, Temple University, Philadelphia, PA,Address correspondence and reprint requests to: Sharon J. Herring, MD, MPH, Center for Obesity Research and Education, Temple University School of Medicine, 3223 N. Broad Street, Suite 175, Philadelphia, PA 19140. Telephone: 917-941-8509. Fax: 215-707-6475.
| |
Collapse
|
27
|
Demos KE, Leahey TM, Hart CN, Trautvetter J, Coward PR, Duszlak J, Wing RR. A pilot randomized controlled trial testing the effects of a routine-based intervention on outcomes in a behavioural weight loss programme. Obes Sci Pract 2015; 1:110-118. [PMID: 29071095 PMCID: PMC5523682 DOI: 10.1002/osp4.16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 10/02/2015] [Accepted: 10/09/2015] [Indexed: 12/26/2022] Open
Abstract
Background Structured routines aimed at eating and sleep have been successfully employed in weight loss interventions for children. Although such routines are discussed in lifestyle modification programmes for adults, they are not a primary focus. Purpose The purpose of this study is to determine if establishing healthy eating and sleep routines may improve outcomes in a behavioural weight loss (BWL) intervention. Methods Twenty‐five overweight/obese participants (age = 52.4 ± 9.8; body mass index = 33.5 ± 4.1) were randomly assigned to either a 4‐week routine‐based intervention (ROU) targeting regular eating and sleep or an education control before beginning an 18‐week BWL intervention. Results Routine‐based intervention participants reported adhering to eating routines, with increased ‘on‐schedule’ eating (p = 0.007) and decreased ‘off‐schedule’ eating (p = 0.002) but showed no change in ‘on‐schedule’ sleep (p = 0.74). However, contrary to our hypothesis, ROU participants lost less weight than controls after 6 weeks of BWL (2.3 ± 2.5 vs. 4.6 ± 2.6 kg, p = 0.04) and achieved only modest weight loss over the full 18 weeks (ROU: 3.2 ± 4.6 vs. education control: 5.8 ± 5.7 kg, p = 0.23). Conclusions Focusing initially on establishing healthy sleep and eating routines led to poorer, rather than better, subsequent weight loss outcomes. Further studies using a longer initial intervention period or focusing on only sleep or eating behaviour are needed to determine whether establishing routines for eating and sleep behaviours can enhance weight loss in adults.
Collapse
Affiliation(s)
- K E Demos
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University The Miriam Hospital, Weight Control and Diabetes Research Center Providence, RI USA
| | - T M Leahey
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University The Miriam Hospital, Weight Control and Diabetes Research Center Providence, RI USA.,Department of Allied Health Sciences, College of Agriculture, Health, and Natural Resources University of Connecticut Storrs USA
| | - C N Hart
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University The Miriam Hospital, Weight Control and Diabetes Research Center Providence, RI USA.,Center for Obesity Research and Education, Department of Social and Behavioral Sciences College of Public Health, Temple University Philadelphia USA
| | - J Trautvetter
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University The Miriam Hospital, Weight Control and Diabetes Research Center Providence, RI USA
| | - P R Coward
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University The Miriam Hospital, Weight Control and Diabetes Research Center Providence, RI USA
| | - J Duszlak
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University The Miriam Hospital, Weight Control and Diabetes Research Center Providence, RI USA
| | - R R Wing
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University The Miriam Hospital, Weight Control and Diabetes Research Center Providence, RI USA
| |
Collapse
|
28
|
Roane BM, Van Reen E, Hart CN, Wing R, Carskadon MA. Estimating sleep from multisensory armband measurements: validity and reliability in teens. J Sleep Res 2015; 24:714-21. [PMID: 26126746 PMCID: PMC4626287 DOI: 10.1111/jsr.12317] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 05/16/2015] [Indexed: 01/09/2023]
Abstract
Given the recognition that sleep may influence obesity risk, there is increasing interest in measuring sleep parameters within obesity studies. The goal of the current analyses was to determine whether the SenseWear(®) Pro3 Armband (armband), typically used to assess physical activity, is reliable at assessing sleep parameters. The armband was compared with the AMI Motionlogger(®) (actigraph), a validated activity monitor for sleep assessment, and with polysomnography, the gold standard for assessing sleep. Participants were 20 adolescents (mean age = 15.5 years) with a mean body mass index percentile of 63.7. All participants wore the armband and actigraph on their non-dominant arm while in-lab during a nocturnal polysomnographic recording (600 min). Epoch-by-epoch sleep/wake data and concordance of sleep parameters were examined. No significant sleep parameter differences were found between the armband and polysomnography; the actigraph tended to overestimate sleep and underestimate wake compared with polysomnography. Both devices showed high sleep sensitivity, but lower wake detection rates. Bland-Altman plots showed large individual differences in armband sleep parameter concordance rates. The armband did well estimating sleep overall, with group results more similar to polysomnography than the actigraph; however, the armband was less accurate at an individual level than the actigraph.
Collapse
Affiliation(s)
- Brandy M. Roane
- Department of Internal Medicine, UNT Health Science Center, Fort Worth, TX, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Sleep for Science Research Laboratory of Brown University, Providence, RI, USA
| | - Eliza Van Reen
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Sleep for Science Research Laboratory of Brown University, Providence, RI, USA
- E.P. Bradley Hospital, Providence, RI, USA
| | - Chantelle N. Hart
- Center for Obesity Research and Education Temple University, Philadelphia, PA, USA
| | - Rena Wing
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Mary A. Carskadon
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Sleep for Science Research Laboratory of Brown University, Providence, RI, USA
- E.P. Bradley Hospital, Providence, RI, USA
- Centre for Sleep Research, Department of Psychology, Social Work, and Social Policy, University of South Australia, Adelaide, Australia
| |
Collapse
|
29
|
Hawley NL, Johnson W, Hart CN, Triche EW, Ah Ching J, Muasau-Howard B, McGarvey ST. Gestational weight gain among American Samoan women and its impact on delivery and infant outcomes. BMC Pregnancy Childbirth 2015; 15:10. [PMID: 25643752 PMCID: PMC4324802 DOI: 10.1186/s12884-015-0451-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 01/22/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND As obesity has increased worldwide, so have levels of obesity during pregnancy and excess gestational weight gain (GWG). The aim of this paper was to describe GWG among American Samoan women and examine the association between GWG and four adverse pregnancy and infant outcomes: cesarean delivery, small- and large-for-gestational age (SGA/LGA), and infant overweight/obesity. METHODS Data were extracted from prenatal care records of 632 Samoan women. Mixed-effects growth models were used to produce individual weight-for-gestational week curves from which second and third trimester weight gain was estimated. Binary logistic regression was used to examine associations between GWG and the outcomes of interest. RESULTS Most women were overweight/obese in early pregnancy (86%) and 78% exceeded the Institute of Medicine GWG guidelines. Greater GWG in the second trimester and early pregnancy weight were independently associated with increased odds of a c-section (OR 1.40 [95% CI: 1.08, 1.83]) and OR 1.51 [95% CI: 1.17, 1.95], respectively). Risk of delivering a LGA infant increased with greater third trimester weight gain and higher early pregnancy weight, while second trimester weight gain was negatively associated with SGA. Risk of infant overweight/obesity at 12 months increased with early pregnancy weight (OR: 1.23 [95% CI: 1.01, 1.51]) and infant birthweight. CONCLUSIONS The high levels of pregnancy obesity and excessive GWG in American Samoa suggest that it is important for physicians to encourage women into prenatal care early and begin education about appropriate GWG and the potential risks of excess weight gain for both the mother and baby.
Collapse
Affiliation(s)
- Nicola L Hawley
- Department of Chronic Disease Epidemiology, School of Public Health, Yale University, P.O. Box 208034, New Haven, CT, 06520-8034, USA.
| | | | - Chantelle N Hart
- Center for Obesity Research and Education & the Department of Public Health, Temple University, Philadelphia, USA.
| | - Elizabeth W Triche
- Department of Epidemiology, School of Public Health, Brown University, Providence, USA.
| | - John Ah Ching
- LBJ Tropical Medical Center, Pago Pago, American Samoa, USA.
| | | | - Stephen T McGarvey
- Department of Epidemiology, School of Public Health, Brown University, Providence, USA.
- International Health Institute, School of Public Health, Brown University, Providence, USA.
| |
Collapse
|
30
|
Hart CN, Carskadon MA, Demos KE, Van Reen E, Sharkey KM, Raynor HA, Considine RV, Jones RN, Wing RR. Acute Changes in Sleep Duration on Eating Behaviors and Appetite-Regulating Hormones in Overweight/Obese Adults. Behav Sleep Med 2014; 13:424-36. [PMID: 25105727 PMCID: PMC4706228 DOI: 10.1080/15402002.2014.940105] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
There is considerable interest in the role of sleep in weight regulation, yet few studies have examined this relationship in overweight/obese (OW/OB) adults. Using a within-subject, counterbalanced design, 12 OW/OB women were studied in lab with two nights of short (5 hr time in bed [TIB]) and two nights of long (9 hr TIB) sleep. Hunger, consumption at a buffet, and fasting hormone levels were obtained. Significant polysomnographic differences occurred between conditions in total sleep time and sleep architecture (ps < .001). Percent energy from protein at the buffet increased following short sleep. No differences were observed for total energy intake or measured hormones. Further research is needed to determine how lengthening sleep impacts weight regulation in OW/OB adults.
Collapse
Affiliation(s)
- Chantelle N. Hart
- Department of Public Health and Center for Obesity Research and Education, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA 19140
- Psychiatry & Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, USA
| | - Mary A. Carskadon
- Psychiatry & Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, USA
- E.P. Bradley Hospital Sleep and Chronobiology Laboratory, Brown University, 1011 Veterans Memorial Parkway, East Providence, RI 02915, USA
- Centre for Sleep Research, School of Psychology, Social Work and Social Policy, University of South Australia
| | - Kathryn E. Demos
- Psychiatry & Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, USA
- Weight Control & Diabetes Research Center, The Miriam Hospital, 196 Richmond Street, Providence, RI 02903, USA
| | - Eliza Van Reen
- E.P. Bradley Hospital Sleep and Chronobiology Laboratory, Brown University, 1011 Veterans Memorial Parkway, East Providence, RI 02915, USA
| | - Katherine M. Sharkey
- Psychiatry & Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, USA
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Alpert Medical School of Brown University, Box G-RIH, Providence, RI 02912, USA
| | - Hollie A. Raynor
- Department of Nutrition, University of Tennessee, 1215 W Cumberland Ave, JHB 341, Knoxville, TN 37996-1920
| | - Robert V. Considine
- Division of Endocrinology and Metabolism, Department of Medicine, Indiana University School of Medicine, Gatch Clinical Building, Room 455, 541 N. Clinical Dr., Indianapolis, IN 46202-5111
| | - Richard N. Jones
- Psychiatry & Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, USA
| | - Rena R. Wing
- Psychiatry & Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, USA
- Weight Control & Diabetes Research Center, The Miriam Hospital, 196 Richmond Street, Providence, RI 02903, USA
| |
Collapse
|
31
|
Rancourt D, Barker DH, Sato AF, Lloyd-Richardson EE, Hart CN, Jelalian E. Longitudinal associations among change in overweight status, fear of negative evaluation, and weight-related teasing among obese adolescents. J Pediatr Psychol 2014; 39:697-707. [PMID: 24893862 PMCID: PMC4107576 DOI: 10.1093/jpepsy/jsu033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 04/22/2014] [Accepted: 04/27/2014] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To examine longitudinal bidirectional associations between changes in adolescents' weight status and psychosocial constructs. METHOD 118 obese adolescents aged 13-16 years participated in a behavioral weight control intervention. Percent overweight (OW), fear of negative evaluation (FNE), and frequency of weight-related teasing (WRT) were collected at baseline, end of intervention, and 12 and 24 months post-randomization. 3 multivariate latent change score models were estimated to examine longitudinal cross-lagged associations between: (1) OW and FNE; (2) OW and WRT; and (3) FNE and WRT. RESULTS Decreases in OW were prospectively associated with subsequent decreases in both FNE and WRT; however, changes in FNE and WRT were not prospectively associated with subsequent change in OW. Decreases in FNE were prospectively associated with subsequent decreases in WRT. CONCLUSION Moderate weight loss in the context of a behavioral weight control intervention has positive long-term implications for obese adolescents' peer relations.
Collapse
Affiliation(s)
- Diana Rancourt
- Bradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Department of Psychology, Kent State University, Department of Psychology, University of Massachusetts Dartmouth, Department of Public Health and Center for Obesity Research and Education, Temple University, and Weight Control and Diabetes Research Center/The Miriam Hospital
| | - David H Barker
- Bradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Department of Psychology, Kent State University, Department of Psychology, University of Massachusetts Dartmouth, Department of Public Health and Center for Obesity Research and Education, Temple University, and Weight Control and Diabetes Research Center/The Miriam Hospital
| | - Amy F Sato
- Bradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Department of Psychology, Kent State University, Department of Psychology, University of Massachusetts Dartmouth, Department of Public Health and Center for Obesity Research and Education, Temple University, and Weight Control and Diabetes Research Center/The Miriam Hospital
| | - Elizabeth E Lloyd-Richardson
- Bradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Department of Psychology, Kent State University, Department of Psychology, University of Massachusetts Dartmouth, Department of Public Health and Center for Obesity Research and Education, Temple University, and Weight Control and Diabetes Research Center/The Miriam Hospital
| | - Chantelle N Hart
- Bradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Department of Psychology, Kent State University, Department of Psychology, University of Massachusetts Dartmouth, Department of Public Health and Center for Obesity Research and Education, Temple University, and Weight Control and Diabetes Research Center/The Miriam Hospital
| | - Elissa Jelalian
- Bradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Department of Psychology, Kent State University, Department of Psychology, University of Massachusetts Dartmouth, Department of Public Health and Center for Obesity Research and Education, Temple University, and Weight Control and Diabetes Research Center/The Miriam HospitalBradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Department of Psychology, Kent State University, Department of Psychology, University of Massachusetts Dartmouth, Department of Public Health and Center for Obesity Research and Education, Temple University, and Weight Control and Diabetes Research Center/The Miriam Hospital
| |
Collapse
|
32
|
Hart CN, Carskadon MA, Considine RV, Fava JL, Lawton J, Raynor HA, Jelalian E, Owens J, Wing R. Changes in children's sleep duration on food intake, weight, and leptin. Pediatrics 2013; 132:e1473-80. [PMID: 24190680 DOI: 10.1542/peds.2013-1274] [Citation(s) in RCA: 180] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To examine the effect of experimental changes in children's sleep duration on self-reported food intake, food reinforcement, appetite-regulating hormones, and measured weight. METHODS Using a within-subjects, counterbalanced, crossover design, 37 children, 8 to 11 years of age (27% overweight/obese) completed a 3-week study. Children slept their typical amount at home for 1 week and were then randomized to either increase or decrease their time in bed by 1.5 hours per night for 1 week, completing the alternate schedule on the third week. Primary outcomes were dietary intake as assessed by 24-hour dietary recalls, food reinforcement (ie, points earned for a food reward), and fasting leptin and ghrelin. The secondary outcome was child weight. RESULTS Participants achieved a 2 hour, 21 minute difference in the actigraph defined sleep period time between the increase and decrease sleep conditions (P < .001). Compared with the decrease sleep condition, during the increase condition, children reported consuming an average of 134 kcal/day less (P < .05), and exhibited lower fasting morning leptin values (P < .05). Measured weights were 0.22 kg lower during the increase sleep than the decrease sleep condition (P < .001). There were no differences in food reinforcement or in fasting ghrelin. CONCLUSIONS Compared with decreased sleep, increased sleep duration in school-age children resulted in lower reported food intake, lower fasting leptin levels, and lower weight. The potential role of sleep duration in pediatric obesity prevention and treatment warrants further study.
Collapse
Affiliation(s)
- Chantelle N Hart
- Center for Obesity Research and Education, Temple University, 3223 N Broad St, Suite 175, Philadelphia, PA 19140.
| | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Abstract
Young adults (YA) are at high risk for insufficient sleep and obesity. However, little research has focused on the association between sleep and obesity in this population. The present study examined the association between reported time in bed (TIB) and body mass index (BMI) in YAs. Participants were 250 18-25 year-olds who completed an online survey assessing several factors associated with weight control. After controlling for significant covariates, TIB was significantly associated with BMI. Specifically, "less than 6 hours/night" TIB was associated with increased BMI compared to the referent category (7 to <8 hours/night) (p = .01). Findings demonstrate that young adults who report shorter TIB are more likely to be classified as having higher BMI.
Collapse
Affiliation(s)
- Chantelle N. Hart
- The Weight Control and Diabetes Research Center, The Miriam Hospital, Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903
| | - Jessica Gokee LaRose
- The Weight Control and Diabetes Research Center, The Miriam Hospital, Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903
| | - Joseph L. Fava
- The Weight Control and Diabetes Research Center, The Miriam Hospital, Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903
| | - Brittany James
- The Weight Control and Diabetes Research Center, The Miriam Hospital, Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903
| | - Rena R. Wing
- The Weight Control and Diabetes Research Center, The Miriam Hospital, Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903
| |
Collapse
|
34
|
Hart CN, Fava JL, Subak LL, Stone K, Vittinghoff E, Demos K, O'Brien E, Cairns A, Wing R. Time in Bed is Associated with Decreased Physical Activity and Higher BMI in Women Seeking Weight Loss Treatment. ISRN Obes 2012; 2012. [PMID: 24198999 PMCID: PMC3816962 DOI: 10.5402/2012/320157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Short sleep duration is associated with obesity risk. Despite calls to incorporate strategies to enhance sleep within the context of behavioral weight loss (BWL) treatment, little is known regarding the association between sleep and body mass index (BMI) among individuals presenting for BWL. Moreover, most research has focused on eating pathways linking sleep and BMI, and have not explored how sleep may impact engagement in physical activity. The purpose of the present study was to determine whether, in a sample of women seeking treatment for weight loss, there was an association between reported time in bed (TIB), higher BMI, lower physical activity, and less favorable dietary composition. Prior to randomization, 318 women completed measures of TIB, eating, and activity; weight and height were measured. Findings demonstrated that report of '6 hours or less' TIB/night was associated with higher BMI and lower reported physical activity compared to the referent (>7 to ≤ 8 hours/night). It was not associated with the number of reported calories consumed each day or with the percent of calories consumed from fat, carbohydrates or protein. Better understanding the role of sleep within the context of BWL treatment in women seems warranted.
Collapse
Affiliation(s)
- Chantelle N Hart
- Weight Control and Diabetes Research Center, The Miriam Hospital; Psychiatry and Human Behavior, Alpert Medical School of Brown University; 196 Richmond Street, Providence, RI 02903
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Abstract
Background. School policies limiting the availability of sweetened beverages are often considered to be effective interventions for improving children’s diet and weight-related health. This study was designed to examine the effectiveness of the Rhode Island Healthier Beverage Policy in reducing consumption of unhealthy beverages and in producing changes in children’s weight status. Method. Students in 2 public middle schools in Rhode Island completed self-reported measures of dietary intake and were measured for height and weight prior to and 1 year following the implementation of a state-mandated healthier beverage policy. An inventory of beverages available in vending machines after the beverage policy was implemented provided a measure of adherence with the statewide policy. Results. Both surveyed schools demonstrated compliance with the beverage policy (ie, greater than 70% of available beverages complied). Self-reported consumption of sweetened beverages did not change significantly following policy implementation. Neither average BMI percentile for age and gender nor frequency of children in each weight category changed significantly 1 year after the policy was implemented. Conclusions. Although the healthier beverage policy was effectively implemented, it did not result in changes in self-reported sweetened beverage consumption or weight status 1 year later. Additional school policy and individual-level changes appear to be necessary to effect change in weight and dietary outcomes for children.
Collapse
Affiliation(s)
- Chad D. Jensen
- Brigham Young University, Provo, Utah (CDJ)
- Kent State University, Kent, Ohio (AFS)
- University of Guelph, Guelph, ON, Canada (CMM)
- Alpert Medical School of Brown University; Weight Control & Diabetes Research Center
- The Miriam Hospital, Providence, Rhode Island (CNH)
| | - Amy F. Sato
- Brigham Young University, Provo, Utah (CDJ)
- Kent State University, Kent, Ohio (AFS)
- University of Guelph, Guelph, ON, Canada (CMM)
- Alpert Medical School of Brown University; Weight Control & Diabetes Research Center
- The Miriam Hospital, Providence, Rhode Island (CNH)
| | - C. Meghan McMurtry
- Brigham Young University, Provo, Utah (CDJ)
- Kent State University, Kent, Ohio (AFS)
- University of Guelph, Guelph, ON, Canada (CMM)
- Alpert Medical School of Brown University; Weight Control & Diabetes Research Center
- The Miriam Hospital, Providence, Rhode Island (CNH)
| | - Chantelle N. Hart
- Brigham Young University, Provo, Utah (CDJ)
- Kent State University, Kent, Ohio (AFS)
- University of Guelph, Guelph, ON, Canada (CMM)
- Alpert Medical School of Brown University; Weight Control & Diabetes Research Center
- The Miriam Hospital, Providence, Rhode Island (CNH)
| | - Elissa Jelalian
- Brigham Young University, Provo, Utah (CDJ)
- Kent State University, Kent, Ohio (AFS)
- University of Guelph, Guelph, ON, Canada (CMM)
- Alpert Medical School of Brown University; Weight Control & Diabetes Research Center
- The Miriam Hospital, Providence, Rhode Island (CNH)
| |
Collapse
|
36
|
Abstract
OBJECTIVE This study examined the 24-month outcomes of a randomized controlled trial of a group-based behavioral weight control (BWC) program combined with either activity-based peer intervention or aerobic exercise. METHODS At baseline, 118 obese adolescents (68% female; BMI = 31.41 ± 3.33) ages 13 to 16 years (mean = 14.33; SD = 1.02) were randomized to receive 1 of 2 weight loss interventions. Both interventions received the same 16-week group-based cognitive-behavioral treatment, combined with either aerobic exercise or peer-based adventure therapy. Eighty-nine adolescents (75% of original sample) completed the 24-month follow-up. Anthropometric and psychosocial measures were obtained at baseline, at the end of the 16-week intervention, and at 12 and 24 months following randomization. RESULTS An intent-to-treat mixed factor analysis of variance indicated a significant effect for time on both percent over 50th percentile BMI for age and gender and standardized BMI score, with no differences by intervention group. Post hoc comparisons showed a significant decrease in percent overweight at 4 months (end of treatment), which was maintained at both 12- and 24-month follow-up visits. Significant improvements on several dimensions of self-concept were noted, with significant effects on physical appearance self-concept that were maintained through 24 months. CONCLUSIONS Both BWC conditions were effective at maintaining reductions in adolescent obesity and improvements in physical appearance self-concept through 24-month follow-up. This study is one of the first to document long-term outcomes of BWC intervention among adolescents.
Collapse
Affiliation(s)
- Elizabeth E. Lloyd-Richardson
- Department of Psychology, University of Massachusetts Dartmouth, North Dartmouth, Massachusetts;,Weight Control and Diabetes Research Center, The Miriam Hospital, and
| | - Elissa Jelalian
- Weight Control and Diabetes Research Center, The Miriam Hospital, and,Department of Psychiatry, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, Rhode Island; and
| | - Amy F. Sato
- Department of Psychiatry, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, Rhode Island; and
| | - Chantelle N. Hart
- Weight Control and Diabetes Research Center, The Miriam Hospital, and
| | - Robyn Mehlenbeck
- Center for Psychological Services, George Mason University, Fairfax, Virginia
| | - Rena R. Wing
- Weight Control and Diabetes Research Center, The Miriam Hospital, and
| |
Collapse
|
37
|
Raynor HA, Osterholt KM, Hart CN, Jelalian E, Vivier P, Wing RR. Efficacy of U.S. paediatric obesity primary care guidelines: two randomized trials. Pediatr Obes 2012; 7:28-38. [PMID: 22434737 PMCID: PMC3748796 DOI: 10.1111/j.2047-6310.2011.00005.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 07/27/2011] [Accepted: 08/24/2011] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The objective of this study was to examine the efficacy of U.S. primary care paediatric obesity treatment recommendations, within two randomized trials. METHODS Between November 2005 to September 2007, 182 families (children aged 4-9 years, body mass index [BMI] ≥85th percentile) were recruited for two separate trials and randomized within trial to a 6-month intervention. Each trial had one intervention that increased child growth-monitoring frequency and feedback to families (GROWTH MONITORING). Each trial also had two interventions, combining GROWTH MONITORING with an eight-session, behavioural, parent-only intervention targeting two energy-balance behaviours (Trial 1: reducing snack foods and sugar-sweetened beverages [DECREASE], and increasing fruits, vegetables and low-fat dairy [INCREASE]; Trial 2: decreasing sugar-sweetened beverages and increasing physical activity [TRADITIONAL] and increasing low-fat milk consumption and reducing television watching [SUBSTITUTES]). Child standardized BMI (ZBMI) and energy intake were assessed at 0, 6 and 12 months. RESULTS In both trials, main effects of time were found for ZBMI, which decreased at 6 and 12 months (P < 0.01). In Trial 1, ZBMI reduced from 0 to 6 months, which was maintained from 6 to 12 months (ΔZBMI 0 to 12 months = -0.12 ± 0.22). In Trial 2, ZBMI reduced from 0 to 6 and from 6 to 12 months (ΔZBMI 0-12 months = -0.16 ± 0.31). For energy intake, main effects of time were found in both trials and intake reduced from 0 to 6 months (P < 0.05), with Trial 1 reducing intake from 0 to 12 months (P < 0.05). CONCLUSIONS All interventions improved weight status. Future research should examine effectiveness and translatability of these approaches into primary care settings.
Collapse
Affiliation(s)
- Hollie A. Raynor
- Associate Professor, Department of Nutrition, University of Tennessee, 1215 W. Cumberland Avenue, JHB 341, Knoxville, TN 37996-1920, Tel: 865-974-6259, Fax: 865-974-3491,
| | - Kathrin M. Osterholt
- Contact information during trial: Project Coordinator, The Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond Street, Providence, RI 02903, Tel. 401-793-8951, Fax. 401-793-8944,
| | - Chantelle N. Hart
- Assistant Professor (Research), Psychiatry & Human behavior, The Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Medical School, 196 Richmond Street, Providence, RI 02903, Tel. 401-793-9727, Fax: 401-793-8944,
| | - Elissa Jelalian
- Associate Professor (Research), Psychiatry & Human behavior, The Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Medical School, 196 Richmond Street, Providence, RI 02903, Tel. 401-444-8945, Fax: 401-793-8944,
| | - Patrick Vivier
- Associate Professor, Community Health and Pediatrics, Brown Medical School Box G-S121, Providence, RI 02903 Tel: 401 863 2034Fax: 401 863-3533
| | - Rena R. Wing
- Professor, Psychiatry & Human behavior, The Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Medical School, 196 Richmond Street, Providence, RI 02903, Tel. 401-793-8959, Fax. 401-793-8944,
| |
Collapse
|
38
|
Abstract
OBJECTIVE To determine whether eating, sedentary, and physical activity behaviors differ on weekdays and weekends in a sample of children who are overweight and obese. METHODS Eighty-one children aged 6-9 years old who were overweight or obese and enrolled in a weight management program completed three-day food diaries and three-day Previous Day Physical Activity Recalls (PDPARs) for two weekdays and one weekend day. All data were obtained at baseline prior to intervention delivery. RESULTS Children consumed a greater percentage of calories from fat (t = 2.15, p = 0.04) and fewer fruits (t = 6.83, p < 0.001), vegetables (t = 2.91, p = 0.002), non-nutrient dense (NND) snack foods (t = 5.58, p < 0.001), and sweetened drinks (t = 2.91, p = 0.005) on weekends. Children watched more television (t = 5.25, p < 0.001), expended more energy (t = 4.37, p < 0.001), and spent a greater percentage of time in moderate-to-vigorous physical activity (p < 0.001) on weekends compared to weekdays. CONCLUSIONS Findings demonstrate a number of differences in children's eating and activity habits on weekends and weekdays. They also suggest that attending to differences in food intake and activity habits on weekdays and weekends separately may help to identify periods of high risk, which could be modified with effective intervention approaches. TRIAL REGISTRATION NUMBERS NCT00259324, NCT00200265.
Collapse
Affiliation(s)
- Chantelle N Hart
- Department of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Providence.
| | | | | | | | | |
Collapse
|
39
|
Jelalian E, Sato A, Hart CN. The effect of group-based weight control intervention on adolescent psychosocial outcomes: Perceived peer rejection, social anxiety and self-concept. Child Health Care 2011; 40:197-211. [PMID: 23258948 PMCID: PMC3525356 DOI: 10.1080/02739615.2011.590391] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
This paper examines the effectiveness of group-based weight control treatment on adolescent social functioning. Eighty-nine adolescents who were randomized to group-based cognitive behavioral treatment (CBT) with aerobic exercise (CBT+EXER) or peer enhanced adventure therapy (CBT+PEAT) completed measures of social functioning at baseline, end of treatment, and 12-month follow-up. Results demonstrated significant reductions in adolescent perceptions of peer rejection and social anxiety over time with no significant demonstrated group differences. Improvements in social functioning were related to increases in self-concept dimensions. Findings demonstrate benefits of group-based weight control treatment for enhancing adolescent self-perceived social functioning across multiple domains.
Collapse
Affiliation(s)
- Elissa Jelalian
- Department of Psychiatry, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI
- Weight Control and Diabetes Research Center, The Miriam Hospital, Alpert Medical School of Brown University, Providence, RI
| | - Amy Sato
- Department of Psychiatry, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI
| | - Chantelle N Hart
- Weight Control and Diabetes Research Center, The Miriam Hospital, Alpert Medical School of Brown University, Providence, RI
| |
Collapse
|
40
|
Abstract
The purpose of this review is to provide a comprehensive update of epidemiologic studies that have assessed the association between sleep and obesity risk. Data suggest that short sleep is associated with an increased risk for being or becoming overweight/obese or having increased body fat. Late bedtimes are also a risk factor for overweight/obesity. Findings also suggest that changes in eating pathways may lead to increased body fat. Future experimental studies are needed to enhance our understanding of the underlying mechanisms through which sleep may play a role in the development and maintenance of childhood obesity.
Collapse
Affiliation(s)
- Chantelle N. Hart
- Corresponding author for proof and reprints: Chantelle Hart, Ph.D., Weight Control & Diabetes Research Center, The Miriam Hospital, 196 Richmond Street, Providence, RI 02903; ; 401-793-9727; 401-793-8944 (fax)
| | | | | |
Collapse
|
41
|
Sato AF, Jelalian E, Hart CN, Lloyd-Richardson EE, Mehlenbeck RS, Neill M, Wing RR. Associations between parent behavior and adolescent weight control. J Pediatr Psychol 2011; 36:451-60. [PMID: 21112925 PMCID: PMC3079126 DOI: 10.1093/jpepsy/jsq105] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Revised: 10/19/2010] [Accepted: 10/22/2010] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To evaluate associations between parent behaviors (i.e., parent weight change, self-monitoring of their behavior, and feeding practices and attitudes) and changes in adolescent BMI and weight following 16-weeks of behavioral weight control (BWC) intervention. METHOD Adolescents (N = 86) 13-16 years old and 30-90% overweight (M = 60.54%, SD = 15.10%) who completed BWC intervention and their parents. Adolescents were randomized to 1 of 2 interventions involving 16 consecutive weeks of active treatment with 4 biweekly maintenance sessions. Adolescent weight and BMI were measured at baseline and 16-weeks. Feeding practices were measured at baseline. Parent self-monitoring was measured during the intervention. RESULTS The only independently significant predictor of adolescent BMI change (p < .01) was parent BMI change. Greater parent self-monitoring (p < .01) predicted greater adolescent weight loss. Greater parent pressure to eat predicted less adolescent weight loss (p < .01). CONCLUSIONS Findings highlight the potential importance of parent weight-related behaviors and feeding practices in the context of adolescent BWC.
Collapse
Affiliation(s)
- Amy F Sato
- Department of Psychiatry, Rhode Island Hospital, Alpert Medical School of Brown University, 1, Hoppin Street, Providence, RI 02903, USA.
| | | | | | | | | | | | | |
Collapse
|
42
|
Raynor H, Van Walleghen EL, Osterholt KM, Hart CN, Jelalian E, Wing RR, Goldfield GS. The relationship between child and parent food hedonics and parent and child food group intake in children with overweight/obesity. J Am Diet Assoc 2011; 111:425-30. [PMID: 21338743 PMCID: PMC3058875 DOI: 10.1016/j.jada.2010.12.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Accepted: 09/08/2010] [Indexed: 11/20/2022]
Abstract
Many factors influence children's dietary intake, including children's and parents' food hedonics (liking), and parent intake. This secondary data analysis studied the relationship between child and parent liking, and parent intake and child intake of fruits, vegetables, low-fat dairy, snack foods, and sweetened beverages in 4- to 9-year-old overweight/obese (body mass index ≥85th percentile) children presenting for obesity treatment (September 2005 to September 2007) in Providence, RI. One hundred thirty-five parent-child pairs, with complete baseline dietary (3-day food record) and food group hedonic data were included. Hedonic ratings were mean ratings using a 5-point Likert scale (lower scores represented greater liking of a food group). Children were aged 7.2±1.6 years, 63.0% girls, 12.6% African American, and 17.8% Hispanic, with a mean body mass index z score of 2.3±0.6. Total servings consumed by children over 3 days were: fruits 2.7±3.2, vegetables 3.4±2.5, low-fat dairy 2.4±2.1, snack foods 5.9±4.2, and sweetened beverages 2.7±3.1. After demographic and anthropometric variables were controlled, parent intake was positively related (P<0.05) to child intake of all food groups except sweetened beverages. Child liking was only significantly (P<0.05) related to child intake of vegetables. In young children with obesity/overweight, parent intake was consistently related to child intake. Changing parent intake may be important in helping to change the dietary intake of young children with overweight/obesity.
Collapse
Affiliation(s)
- Hollie Raynor
- Associate Professor, Department of Nutrition, University of Tennessee, 1215 W. Cumberland Avenue, JHB 341, Knoxville, TN 37996-1920, Tel: 865-974-6259, Fax: 865-974-3491
| | - Emily L. Van Walleghen
- Post-doctoral Fellow, Department of Nutrition, University of Tennessee, 1215 W. Cumberland Avenue, JHB 229, Knoxville, TN 37996-1920, Tel: 865-974-0752, Fax: 865-974-3491
| | - Kathrin M. Osterholt
- Project Coordinator, The Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond Street, Providence, RI 02903, Tel. 401-793-8951, Fax. 401-793-8944
| | - Chantelle N. Hart
- Assistant Professor (Research), Psychiatry & Human Behavior, The Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Medical School, 196 Richmond Street, Providence, RI 02903, Tel. 401-793-9727, Fax. 401-793-8944
| | - Elissa Jelalian
- Associate Professor (Research), Psychiatry & Human Behavior, The Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Medical School, 196 Richmond Street, Providence, RI 02903, Tel. 401-444-8945, Fax. 401-793-8944
| | - Rena R. Wing
- Professor, Psychiatry & Human Behavior, The Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Medical School, 196 Richmond Street, Providence, RI 02903, Tel. 401-793-8959, Fax. 401-793-8944
| | - Gary S. Goldfield
- Assistant professor of Pediatrics, Human Kinetics and Psychology, University of Ottawa, Scientist, Healthy Active Living and Obesity Research Group (HALO), CHEO Research Institute. 401 Smyth Rd., Ottawa, ON Canada K1H 8L1, Phone: 613-737-7600, Ext. 3288, Fax: 613-738-4869
| |
Collapse
|
43
|
Hart CN, Jelalian E, Raynor HA, Mehlenbeck R, Lloyd-Richardson EE, Kaplan J, Flynn-O’Brien K, Wing RR. Early patterns of food intake in an adolescent weight loss trial as predictors of BMI change. Eat Behav 2010; 11:217-22. [PMID: 20850055 PMCID: PMC2943148 DOI: 10.1016/j.eatbeh.2010.05.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Revised: 03/31/2010] [Accepted: 05/20/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE To determine whether baseline intake or initial changes in intake of fruits (F), vegetables (V), snack foods (SF), and reduced-calorie snack foods (RCSF) during standard behavioral weight loss treatment predict BMI reductions among overweight adolescents. Given conflicting messages between child and adult weight loss interventions, the role of RCSF in adolescent weight control was of particular interest. METHODS Seventy-two adolescents, 13-16 years old, participating in a 16-week behavioral weight loss trial with diet records at baseline and 4 weeks were included. Height and weight were measured at 0 and 16 weeks. Frequency of intake of F, V, SF, and RCSF were obtained from 7-day food records at 0 and 4 weeks. RESULTS Male gender, higher initial frequency of intake of V and increased frequency of intake of F and RCSF over the first 4 weeks of treatment accounted for 43% of the variance in BMI reduction at 16 weeks (p<.001). CONCLUSIONS Early changes in eating habits, including increased frequency of intake of F and RCSF may promote greater adolescent BMI reductions.
Collapse
Affiliation(s)
- Chantelle N. Hart
- Weight Control & Diabetes Research Center, The Miriam Hospital and the Warren Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903, USA; ; ; ; ;
| | - Elissa Jelalian
- Weight Control & Diabetes Research Center, The Miriam Hospital and the Warren Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903, USA; ; ; ; ;
- Bradley Hasbro Research Center, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, CORO West, Suite 240, 1 Hoppin Street, Providence, RI 02903, USA;
| | - Hollie A. Raynor
- Weight Control & Diabetes Research Center, The Miriam Hospital and the Warren Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903, USA; ; ; ; ;
| | - Robyn Mehlenbeck
- Bradley Hasbro Research Center, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, CORO West, Suite 240, 1 Hoppin Street, Providence, RI 02903, USA;
| | - Elizabeth E. Lloyd-Richardson
- Weight Control & Diabetes Research Center, The Miriam Hospital and the Warren Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903, USA; ; ; ; ;
| | - Jamie Kaplan
- Behavioral Medicine, The Miriam Hospital, Coro West, Suite 240, 1 Hoppin Street, Providence, RI 02903, USA
| | - Katherine Flynn-O’Brien
- Behavioral Medicine, The Miriam Hospital, Coro West, Suite 240, 1 Hoppin Street, Providence, RI 02903, USA
| | - Rena R. Wing
- Weight Control & Diabetes Research Center, The Miriam Hospital and the Warren Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903, USA; ; ; ; ;
| |
Collapse
|
44
|
Jelalian E, Lloyd-Richardson EE, Mehlenbeck RS, Hart CN, Flynn-O’Brien K, Kaplan J, Neill M, Wing RR. Behavioral weight control treatment with supervised exercise or peer-enhanced adventure for overweight adolescents. J Pediatr 2010; 157:923-928.e1. [PMID: 20655544 PMCID: PMC2988988 DOI: 10.1016/j.jpeds.2010.05.047] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Revised: 03/26/2010] [Accepted: 05/26/2010] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the efficacy of behavioral weight control intervention with a peer-enhanced activity intervention versus structured aerobic exercise in decreasing body mass index (BMI) and z-BMI in overweight adolescents. STUDY DESIGN Participants were randomized to 1 of 2 group-based treatment conditions: (1) cognitive behavioral treatment with peer-enhanced adventure therapy or (2) cognitive behavioral weight control treatment with supervised aerobic exercise. Participants included 118 overweight adolescents, ages 13 to 16 years, and a primary caregiver. Changes in BMI, standardized BMI, percent over BMI, and waist circumference were examined. RESULTS Analysis of variance on the basis of intent-to-treat indicated significant decreases in all weight change outcomes at the end of treatment, with significant decreases maintained at the 12-month follow-up. No differences in treatment conditions were observed. Secondary analyses indicated that adherence with attendance and completion of weekly diet records contributed significantly to reductions in BMI. CONCLUSIONS A cognitive behavioral weight control intervention combined with supervised aerobic exercise or peer-enhanced adventure therapy is equally effective in short-term reduction of BMI and z-BMI in overweight adolescents. Adherence, as measured with session attendance and self-monitoring, is a key dimension of weight change.
Collapse
Affiliation(s)
- Elissa Jelalian
- Department of Psychiatry, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI, USA.
| | - Elizabeth E. Lloyd-Richardson
- Weight Control and Diabetes Research Center, The Miriam Hospital, Alpert Medical School of Brown University, Providence, RI, Department of Psychology, University of Massachusetts Dartmouth, North Dartmouth, MA
| | - Robyn S. Mehlenbeck
- Department of Psychiatry, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI
| | - Chantelle N. Hart
- Weight Control and Diabetes Research Center, The Miriam Hospital, Alpert Medical School of Brown University, Providence, RI
| | - Katherine Flynn-O’Brien
- Weight Control and Diabetes Research Center, The Miriam Hospital, Alpert Medical School of Brown University, Providence, RI
| | - Jamie Kaplan
- Weight Control and Diabetes Research Center, The Miriam Hospital, Alpert Medical School of Brown University, Providence, RI
| | - Meghan Neill
- Weight Control and Diabetes Research Center, The Miriam Hospital, Alpert Medical School of Brown University, Providence, RI
| | - Rena R. Wing
- Weight Control and Diabetes Research Center, The Miriam Hospital, Alpert Medical School of Brown University, Providence, RI
| |
Collapse
|
45
|
Raynor HA, Osterholt KM, Hart CN, Jelalian E, Vivier P, Wing RR. Evaluation of active and passive recruitment methods used in randomized controlled trials targeting pediatric obesity. ACTA ACUST UNITED AC 2010; 4:224-32. [PMID: 19922036 DOI: 10.3109/17477160802596189] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Evaluate enrollment numbers, randomization rates, costs, and cost-effectiveness of active versus passive recruitment methods for parent-child dyads into two pediatric obesity intervention trials. METHODS Recruitment methods were categorized into active (pediatrician referral and targeted mailings, with participants identified by researcher/health care provider) versus passive methods (newspaper, bus, internet, television, and earning statements; fairs/community centers/schools; and word of mouth; with participants self-identified). Numbers of enrolled and randomized families and costs/recruitment method were monitored throughout the 22-month recruitment period. Costs (in USD) per recruitment method included staff time, mileage, and targeted costs of each method. RESULTS A total of 940 families were referred or made contact, with 164 families randomized (child: 7.2+/-1.6 years, 2.27+/-0.61 standardized body mass index [zBMI], 86.6% obese, 61.7% female, 83.5% Caucasian; parent: 38.0+/-5.8 years, 32.9+/-8.4 BMI, 55.2% obese, 92.7% female, 89.6% caucasian). Pediatrician referral, followed by targeted mailings, produced the largest number of enrolled and randomized families (both methods combined producing 87.2% of randomized families). Passive recruitment methods yielded better retention from enrollment to randomization (p<0.05), but produced few families (21 in total). Approximately $91,000 was spent on recruitment, with cost per randomized family at $554.77. Pediatrician referral was the most cost-effective method, $145.95/randomized family, but yielded only 91 randomized families over 22-months of continuous recruitment. CONCLUSION Pediatrician referral and targeted mailings, which are active recruitment methods, were the most successful strategies. However, recruitment demanded significant resources. Successful recruitment for pediatric trials should use several strategies. CLINICAL TRIALS REGISTRATION NCT00259324, NCT00200265.
Collapse
Affiliation(s)
- Hollie A Raynor
- The Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | | | | | | | | | | |
Collapse
|
46
|
Mehlenbeck RS, Jelalian E, Lloyd-Richardson EE, Hart CN. Effects of Behavioral Weight Control Intervention on Binge Eating Symptoms Among Overweight Adolescents. Psychol Sch 2009; 46:776-786. [PMID: 24146437 DOI: 10.1002/pits.20416] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This study examined change in binge eating symptoms reported by moderately overweight adolescents following participation in a behavioral weight control intervention. A total of 194 adolescents across two randomized controlled trials participated. Adolescents in both study samples endorsed a mild level of binge eating symptoms at baseline. Results from both Study 1 and Study 2 indicate a significant reduction in binge eating symptoms following participation in a 16-week weight control intervention, F(1,60) = 9.43, p<.01 and F(1,98) = 20.98, p<.01, respectively. Several significant relationships between measures of self-concept and binge eating symptoms were noted, with lower self-concept scores related to higher binge eating symptoms scores at baseline. Changes in binge eating symptoms were also related to changes in physical appearance self-concept, global self-concept and physical self-worth at the end of the intervention. In conclusion, findings from this study support an emerging body of evidence suggesting that dietary restriction, as practiced through participation in a weight control intervention, leads to a reduction in binge eating symptoms among overweight adolescents.
Collapse
Affiliation(s)
- Robyn S Mehlenbeck
- Bradley Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI
| | | | | | | |
Collapse
|
47
|
Abstract
Increasing attention is being focused on potential risk factors that may lead to overweight in children and adolescents and that may, therefore, be important targets for intervention. Historically, children's eating and activity habits have received considerable attention in programmatic research targeted at prevention and treatment of overweight. However, more recent research has found that additional factors may play a role in this growing epidemic. Of particular interest is children's sleep duration. The goal of this article is to review research that has assessed the association between children's sleep duration and overweight risk in an attempt to uncover the potential role of sleep in the growing obesity epidemic. Although shortened sleep duration is associated with increased overweight in children, additional research is needed prior to recommending that children's sleep be increased as a means to address the current obesity epidemic.
Collapse
Affiliation(s)
- Chantelle N Hart
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, The Miriam Hospital, Providence, RI 02903, USA.
| | | |
Collapse
|
48
|
Jelalian E, Hart CN, Rhee K. Treatment of pediatric obesity. Med Health R I 2009; 92:48-49. [PMID: 19288684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
|
49
|
Raynor HA, Jelalian E, Vivier PM, Hart CN, Wing RR. Parent-reported eating and leisure-time activity selection patterns related to energy balance in preschool- and school-aged children. J Nutr Educ Behav 2009; 41:19-26. [PMID: 19161916 PMCID: PMC2654320 DOI: 10.1016/j.jneb.2008.03.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2007] [Revised: 03/06/2008] [Accepted: 03/18/2008] [Indexed: 05/12/2023]
Abstract
OBJECTIVE Compare parent-reported preschool- and school-aged children's eating and leisure-time activity patterns that are proposed to influence energy balance. DESIGN Cross-sectional investigation of children, 2 to 12 years, attending a well visit. SETTING Pediatric private practice/ambulatory pediatric clinic. PARTICIPANTS One hundred seventy-four children: 49% preschool-aged, 54% female, 28% Hispanic, and 34% overweight or at risk for overweight. VARIABLES MEASURED Parent-reported eating/leisure-time behaviors. Height/weight from medical records. ANALYSIS Analyses of covariance/chi-square tests; significance at P RESULTS By parents' report, preschool-aged children consumed more servings/day of low-fat dairy (2.1 +/- 1.6 vs 1.7 +/- 1.5; P < .01), fewer servings/day of sweetened drinks (1.4 +/- 1.9 vs 2.2 +/- 2.6; P < .01) and watched fewer hours/day of weekend TV (2.3 +/- 1. 3 vs 2.7 +/- 1.3; P < .05) than school-aged children. Fewer preschool-aged children consumed salty (14.0% vs 26.1%; P < .05) and sweet (16.3% vs. 29.5%; P < .05) snack food daily, and a greater percentage regularly consumed dinner with a parent (93.0% vs 80.7%; P < .05), as assessed by parent report. CONCLUSIONS AND IMPLICATIONS Parent-reported children's eating/leisure-time patterns that may influence energy balance were less healthful in the school-aged children. However, most children did not meet recommendations, irrespective of age or weight. Interventions for meeting recommendations should start with families with preschool-aged children. Future research should focus on identifying factors that might be contributing to increased reporting of problematic food and leisure-time activity patterns in school-aged children.
Collapse
Affiliation(s)
- Hollie A Raynor
- Department of Nutrition, University of Tennessee, Knoxville, Tennessee 37996, USA.
| | | | | | | | | |
Collapse
|
50
|
Jelalian E, Hart CN, Mehlenbeck RS, Lloyd-Richardson EE, Kaplan JD, Flynn-O'Brien KT, Wing RR. Predictors of attrition and weight loss in an adolescent weight control program. Obesity (Silver Spring) 2008; 16:1318-23. [PMID: 18356834 DOI: 10.1038/oby.2008.51] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate demographic and psychosocial predictors of attrition and weight loss in a behaviorally based adolescent weight control trial. METHODS AND PROCEDURES Adolescents (N = 76) aged 13-16 years and 20-80% overweight (M = 60.56%, s.d. = 15.17%) received standard group-based behavioral treatment as part of a randomized trial comparing different activity interventions for overweight adolescents. Anthropometric and psychosocial measures were obtained at baseline and after the 16-week intervention. RESULTS Higher parent (P < 0.01) and adolescent BMI (P < 0.05) at baseline, as well as ethnic minority status (P < 0.05) were significantly associated with attrition in univariate analyses. Parent BMI remained the only significant predictor of attrition in multivariate analyses. BMI change for completers (N = 62) was highly variable, ranging from -6.09 to +1.62 BMI units. Male gender (P < 0.01) was a significant predictor of reduction in BMI, whereas not being from an ethnic minority group (P < 0.05) and attendance at group sessions (P = 0.05) were associated with > or = 5% absolute weight loss in multivariate analyses. Absolute weight loss during the first 4 weeks of the program was strongly associated with weight loss (pr = 0.44, P < 0.001) during the remainder of the intervention. Psychosocial variables were unrelated to attrition or treatment outcome. DISCUSSION These findings highlight the potential importance of attending to parental BMI in efforts to retain adolescent participants in treatment, as well as the need to develop weight control interventions that are more effective for ethnic minority youth.
Collapse
Affiliation(s)
- Elissa Jelalian
- Department of Psychiatry and Human Behavior, Bradley/Hasbro Children's Research Center, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
| | | | | | | | | | | | | |
Collapse
|