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The number of adults experiencing obesity continues to rise. A significant amount of research has addressed primary prevention interventions within pediatric populations to minimize the onset of obesity. However, research efforts within adult populations have commonly emphasized secondary and tertiary prevention for obesity. Therefore, this scoping review aimed to characterize and identify gaps in primary prevention interventions targeting adult populations at risk for obesity. A scoping review was conducted via PubMed, CINAHL, Cochrane, and PscyINFO. A total of 7216 papers were retrieved. Sixteen articles were included in the review. Seven of the studies included only females in the interventions. Only two studies occurred within the United States. Three studies included multi-modal interventions. Interventions were delivered by dieticians in four studies and nurses in three studies. Fifteen of the studies proved to be effective overall for improving weight-related outcomes. The following themes were revealed through this review: (1) participants were usually female and homogenous; (2) studies frequently occurred outside of the United States; (3) studies most often explored unimodal interventions; (4) dieticians and nurses were the most common intervention providers; and (5) favorable outcomes for reducing weight were demonstrated across studies. This scoping review reveals that primary prevention interventions have the potential to minimize obesity onset in at-risk adult populations. However, evaluation of current interventions shows multiple gaps in population target, intervention origin, intervention type, and provider type. • One of the first reviews to examine gaps in adult obesity primary prevention. • Primary prevention interventions show potential to minimize adult obesity onset. • Existing primary prevention interventions demonstrate gaps in target and type. [ABSTRACT FROM AUTHOR]

Background. The increasing prevalence of overweight among children in the United States presents a national health priority. Higher rates of overweight/obesity among minority women place their children at increased risk. Although increased rates of overweight are observed in 4- to 5-year-old children, they are not observed in 2- to 3-year-old children. Therefore, early prevention efforts incorporating families are critical.Methods. The primary aim of Hip-Hop to Health Jr. is to alter the trajectory toward overweight/obesity among preschool African-American and Latino children. This 5-year randomized intervention is conducted in 24 Head Start programs, where each site is randomized to either a 14-week dietary/physical activity intervention or a general health intervention.Results. This paper presents the rationale and design of the study. Efficacy of the intervention will be determined by weight change for the children and parent/caretaker. Secondary measures include reductions in dietary fat and increases in fiber, fruit/vegetable intake, and physical activity. Baseline data will be presented in future papers.Conclusions. The problem of overweight/obesity is epidemic in the United States. Behaviors related to diet and physical activity are established early in life and modeled by family members. Early intervention efforts addressing the child and family are needed to prevent obesity later in life. This paper describes a comprehensive, family-oriented obesity prevention program for minority preschool children. [Copyright &y& Elsevier]

In this paper we question whether prior cross-national differences in food attitudes still exist and if so, to what extent. Due to societal evolutions such as sedentarism and globalization, international variations in food attitudes may not be as pronounced as currently believed. A cross-sectional web-based survey was carried out in the United States, the United Kingdom, France and Belgium. A total of 2167 respondents (52% women; mean age = 39.0 years, SD = 11.4) participated. To successfully combat obesity, a joint approach focusing on food choice and physical activity is required; therefore we included behavioral measures by means of choice tasks for these two important drivers. Further, the extent to which respondents subscribe to the unhealthy = tasty intuition, together with health and taste interest were investigated. Socio-demographic information and self-reported heights and weights were also incorporated. Logistic regressions were fitted with weight status as the dependent variable and the attitudinal and behavioral measures as independent variables. Our findings indicate that having a higher interest in healthy eating decreases the chance of being overweight (odds = 0.88) and believing that unhealthy food is tasty significantly increases the chance of being obese by 1.18 times. Overall, we find that food attitudes have largely converged across the countries we investigated. [ABSTRACT FROM AUTHOR]

The objective of this paper is to estimate the impact of county-level public transit usage on obesity prevalence in the United States and assess the potential for public transit usage as an intervention for obesity. This study adopts an instrumental regression approach to implicitly control for potential selection bias due to possible differences in commuting preferences among obese and non-obese populations. United States health data from the 2009 Behavioral Risk Factor Surveillance System and transportation data from the 2009 National Household Travel Survey are aggregated and matched at the county level. County-level public transit accessibility and vehicle ownership rates are chosen as instrumental variables to implicitly control for unobservable commuting preferences. The results of this instrumental regression analysis suggest that a one percent increase in county population usage of public transit is associated with a 0.221 percent decrease in county population obesity prevalence at the α=0.01 statistical significance level, when commuting preferences, amount of non-travel physical activity, education level, health resource, and distribution of income are fixed. Hence, this study provides empirical support for the effectiveness of encouraging public transit usage as an intervention strategy for obesity. [ABSTRACT FROM AUTHOR]

Based on a focus group study conducted in New York City (NYC), this paper examines the traditional staples (i.e., nostalgic foods) that Latinas regularly consume in the U.S., along with their beliefs regarding the impact of such foods on weight gain and related body image. Our research findings highlight the "double-bind" of nostalgic foods, defined by Latinas' retention of highly caloric familiar items along with their progressive abandonment of fresh produce and fruits. Despite participants' efforts to eat healthy staples from their homelands, they mostly kept foods perceived as unhealthy (e.g., fatty meats, fried foods). This phenomenon was informed by the "same-food paradox," represented by Latinas' beliefs that the same traditional foods that would make them lose weight in their native countries would lead them to gain weight in the U.S. Our qualitative data show that participants' concerns about their weight gain in the U.S. is in tune with their general body dissatisfaction, as indicated by our quantitative results. Finally, our findings reveal the role of stress in promoting Latinas' deleterious daily habits, including their consumption of fat-saturated snacks. Overall, these results speak to the cultural and structural barriers to healthy eating that financially strapped study participants experienced in NYC. In order to design successful public health interventions targeting Latinas, the nostalgic aspects of food preferences should be considered in conjunction with the barriers that keep them from engaging with healthier lifestyles in the U.S. [ABSTRACT FROM AUTHOR]

Objective: Beverage taxes came into light with increasing concerns about obesity, particularly among youth. Sugar-sweetened beverages have become a target of anti-obesity initiatives with increasing evidence of their link to obesity. Our paper offers a method for estimating revenues from an excise tax on sugar-sweetened beverages that governments of various levels could direct towards obesity prevention. Model: We construct a model projecting beverage consumption and tax revenues based on best available data on regional beverage consumption, historic trends and recent estimates of the price elasticity of sugar-sweetened beverage demand. Results: The public health impact of beverage taxes could be substantial. An estimated 24% reduction in sugar-sweetened beverage consumption from a penny-per-ounce sugar-sweetened beverage tax could reduce daily per capita caloric intake from sugar-sweetened beverages from the current 190–200cal to 145–150cal, if there is no substitution to other caloric beverages or food. A national penny-per-ounce tax on sugar-sweetened beverages could generate new tax revenue of $79 billion over 2010–2015. Conclusion: A modest tax on sugar-sweetened beverages could both raise significant revenues and improve public health by reducing obesity. To the extent that at least some of the tax revenues get invested in obesity prevention programs, the public health benefits could be even more pronounced. [Copyright &y& Elsevier]

Abstract: This paper examines the unexplored link between the prevalence of overweight and obesity and vehicle demand in the United States. Exploring annual sales data of new passenger vehicles at the model level in 48 U.S. counties from 1999 to 2005, we find that new vehicles demanded by consumers are less fuel-efficient on average as a larger share of people become overweight or obese. The OLS results show that a 10 percentage point increase in obesity and overweight reduces the average MPG of new vehicles demanded by 1.4 percent, an effect requiring a 12 cent increase in gasoline prices to counteract. The 2SLS results after controlling for possible endogeneity in overweight and obesity prevalence put those two numbers at 5 percent and 54 cent, respectively. These findings, robust to a variety of specifications, suggest that policies to reduce overweight and obesity can have additional benefits for energy security and the environment. [ABSTRACT FROM AUTHOR]

Abstract: Objective: There has been an increasing realization of the need for environmental interventions to increase physical activity levels in the population. Although promising, the impact of these strategies in reducing obesity-related disparities will be limited by the presence of inequities in the distribution of activity-related resources in the community. Advocacy efforts are critically needed to ensure that all communities benefit from environmental strategies being implemented. Method and results: This paper describes two activist community-based organizations in Southern California, The City Project and Latino Health Access, and their successful efforts to mandate equitable access to public resources critical for reducing obesity-related disparities. Conclusion: Principles for equitable development of public land are also presented as well as lessons learned that can inform future advocacy efforts. [Copyright &y& Elsevier]

: BackgroundPathways, a multicenter study to test the effect of a school-based program to prevent obesity in American Indian children, yielded many benefits and encountered many challenges. This paper explores what we have learned from this study and examines possible future directions.: MethodsInformation presented in this paper is based on formative research, study results, and discussions with staff and investigators.: ResultsSome of the lessons learned relate to having a strong relationship with the tribes, how best to engage the communities, the importance of formative research and achieving standardization in culturally diverse settings, how to incorporate cultural information into curricula, and the importance of family involvement. One of the strengths of the study was the collaborative process that teamed American Indian and non-American Indian investigators and staff. Researchers recognized that they must work in cooperation with research participants including their schools and communities to address challenges, to ensure accurate findings and analyses, and to share benefits.: ConclusionsThe lessons learned from Pathways offer valuable insights for researchers into successful approaches to the challenges inherent in research in American Indian communities, particularly in schools, and how to maximize the benefits of such a study. [Copyright &y& Elsevier]

Abstract: Objectives: This paper presents a new, comprehensive tool for communities to assess opportunities for active living and healthy eating and to mobilize all sectors of society to conquer obesity and chronic disease. Method: Relevant existing tools and input from an expert panel were considered to draft the Community Healthy Living Index (CHLI). CHLI covers five major sectors where people live, work, learn, and play: schools, afterschools, work sites, neighborhoods, and the community-at-large. CHLI and the accompanying procedures enable community teams to assess programs, the physical environment, and policies related to healthy living and to plan improvement strategies. In 2008, with local YMCAs acting as conveners, community assessment teams from six US communities pilot-tested CHLI for cognitive response testing, inter-rater reliability, and implementation feasibility. CHLI was revised to reflect the test results. Results: Pilot analyses demonstrated that the process was feasible, with most questions being interpreted as intended and showing substantial to almost perfect agreement between raters. The final CHLI is being disseminated nationally. Conclusions: Preliminary data illustrate CHLI obtains reliable results and is feasible to implement. CHLI is a promising tool for community-based prevention efforts to draw attention to opportunities for healthy living and create impetus for community changes. [Copyright &y& Elsevier]

: BackgroundThe Pathways study was a randomized, 3-year trial of obesity prevention in American Indian Children. An important goal of the Pathways intervention was to significantly decrease the percentage of calories eaten as fat by the intervention children, relative to controls. This paper reports the effects of the Pathways intervention on dietary intake.: MethodsTwo types of dietary data were analyzed from random samples of children in 41 schools: direct observation of school lunch intake at baseline (2nd grade) and follow-up (5th grade) (n = 470), and 24-hour dietary recalls at follow-up only (n = 620). Nutrient contents of school meals and recalls were calculated by NDS and NDS-R software (University of Minnesota), using vendor products and recipes from each school.: ResultsBased on lunch observations, the intervention was associated with significant decreases in mean percentage of calories from total fat (3.6%) and saturated fat (2.1%) relative to controls, and a significant increase in the percentage of calories from total carbohydrate (3.7%). Compared with the control children, intervention children reported significantly smaller 24-hour intakes of energy (263 kcal), protein (9.5 g), total fat (15.1 g), saturated fat (6.0 g), and polyunsaturated fat (2.3 g); and as a percent of calories, total fat (2.5%) and saturated fat (1.1%). Mean intake of carbohydrates as a percentage of calories was significantly greater in intervention children by 2.5%, compared with controls.: ConclusionsThe Pathways intervention successfully reduced the intake of percent calories from fat and saturated fat, at school lunch and over the whole day. [Copyright &y& Elsevier]