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Marie-Pierre St-Onge,1 Gary Zammit,2 David M Reboussin,3 Samuel T Kuna,4 Mark H Sanders,8 Richard Millman,6 Anne B Newman,5 Thomas A Wadden,4 Rena R Wing,6 F Xavier Pi-Sunyer,1 Gary D Foster7 Sleep AHEAD Research Group*1New York Obesity Research Center, St Luke's/Roosevelt Hospital, New York, NY, USA; 2Clinilabs, New York, NY, USA; 3Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA; 4Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; 5Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA; 6Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA; 7Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA; 8Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, PA, USA*A full list of the members of the Sleep AHEAD Research Group is available in an online appendixPurpose: Some studies have found an association between sleep disturbances and metabolic risk, but none has examined this association in individuals with type 2 diabetes. The objective of this study was to determine the relationship between sleep disturbances and metabolic risk factors in obese patients with type 2 diabetes.Patients and methods: This study was a cross-sectional examination of the relationship between sleep parameters (apnea/hypopnea index [AHI], time spent in various sleep stages) and metabolic risk markers (fasting glucose, hemoglobin A1c, lipids) using baseline data of the Sleep AHEAD cohort. Subjects (n = 305) were participants in Sleep AHEAD (Action for Health in Diabetes), a four-center ancillary study of the Look AHEAD study, a 16-center clinical trial of overweight and obese participants with type 2 diabetes, designed to assess the long-term effects of an intensive lifestyle intervention on cardiovascular events. All participants underwent one night of in-home polysomnography and provided a fasting blood sample. Regression analyses estimated the relationship between sleep variables and metabolic risk factors. Models were adjusted for study center, age, sex, race/ethnicity, waist circumference, smoking, alcohol intake, diabetes duration, and relevant medications.Results: Of 60 associations tested, only one was significant: fasting glucose was associated with sleep efficiency (estimate −0.53 ± [standard error] 0.26, P = 0.041). No associations were found between any of the sleep variables and lipid profile or hemoglobin A1c.Conclusions: The present data show only weak associations between select sleep variables and metabolic risk factors and do not provide strong support for a role of sleep on metabolic abnormalities in obese patients with type 2 diabetes.Keywords: obesity, obstructive sleep apnea, metabolic risk, sleep, diabetes

Objective: The present study assessed the impact of the 2009 food packages mandated by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on perceived sales, product selection and stocking habits of small, WIC-authorized food stores.Design: A cross-sectional study involving in-depth interviews with store managers/owners.Setting: Small, WIC-authorized food stores in eight major cities in the USA.Subjects: Fifty-two store managers/owners who had at least 1 year of experience in the store prior to study participation.Results: The WIC-approved food products (fresh, canned and frozen fruits; fresh, canned and frozen vegetables; wholegrain/whole-wheat bread; white corn/whole-wheat tortillas; brown rice; lower-fat milk (<2 %)) were acquired in multiple ways, although acquisition generally occurred 1-2 times/week. Factors such as customer requests (87 %), refrigerator/freezer availability (65 %) and profitability (71 %) were rated as very important when making stocking decisions. Most managers/owners perceived increases in sales of new WIC-approved foods including those considered most profitable (wholegrain/whole-wheat bread (89 %), lower-fat milk (89 %), white corn/whole wheat tortillas (54 %)), but perceived no changes in sales of processed fruits and vegetables. Supply mechanisms and frequency of supply acquisition were only moderately associated with perceived sales increases.Conclusions: Regardless of type or frequency of supply acquisition, perceived increases in sales provided some evidence for the potential sustainability of these WIC policy efforts and translation of this policy-based strategy to other health promotion efforts aimed at improving healthy food access in underserved communities. [ABSTRACT FROM AUTHOR]

Background: Previous studies comparing low-carbohydrate and low-fat diets have not included a comprehensive behavioral treatment, resulting in suboptimal weight loss.Objective: To evaluate the effects of 2-year treatment with a low-carbohydrate or low-fat diet, each of which was combined with a comprehensive lifestyle modification program.Design: Randomized parallel-group trial. (ClinicalTrials.gov registration number: NCT00143936)Setting: 3 academic medical centers.Patients: 307 participants with a mean age of 45.5 years (SD, 9.7 years) and mean body mass index of 36.1 kg/m(2) (SD, 3.5 kg/m(2)).Intervention: A low-carbohydrate diet, which consisted of limited carbohydrate intake (20 g/d for 3 months) in the form of low-glycemic index vegetables with unrestricted consumption of fat and protein. After 3 months, participants in the low-carbohydrate diet group increased their carbohydrate intake (5 g/d per wk) until a stable and desired weight was achieved. A low-fat diet consisted of limited energy intake (1200 to 1800 kcal/d; Measurements: Weight at 2 years was the primary outcome. Secondary measures included weight at 3, 6, and 12 months and serum lipid concentrations, blood pressure, urinary ketones, symptoms, bone mineral density, and body composition throughout the study.Results: Weight loss was approximately 11 kg (11%) at 1 year and 7 kg (7%) at 2 years. There were no differences in weight, body composition, or bone mineral density between the groups at any time point. During the first 6 months, the low-carbohydrate diet group had greater reductions in diastolic blood pressure, triglyceride levels, and very-low-density lipoprotein cholesterol levels, lesser reductions in low-density lipoprotein cholesterol levels, and more adverse symptoms than did the low-fat diet group. The low-carbohydrate diet group had greater increases in high-density lipoprotein cholesterol levels at all time points, approximating a 23% increase at 2 years.Limitation: Intensive behavioral treatment was provided, patients with dyslipidemia and diabetes were excluded, and attrition at 2 years was high.Conclusion: Successful weight loss can be achieved with either a low-fat or low-carbohydrate diet when coupled with behavioral treatment. A low-carbohydrate diet is associated with favorable changes in cardiovascular disease risk factors at 2 years.Primary Funding Source: National Institutes of Health. [ABSTRACT FROM AUTHOR]

BACKGROUND: Little is known about the comparative effect of weight-loss diets on metabolic profiles during dieting. OBJECTIVE: The purpose of this study was to compare the effect of a low-carbohydrate diet (< or =20 g/d) with a high-carbohydrate diet (55% of total energy intake) on fasting and hourly metabolic variables during active weight loss. DESIGN: Healthy, obese adults (n = 32; 22 women, 10 men) were randomly assigned to receive either a carbohydrate-restricted diet [High Fat; mean +/- SD body mass index (BMI; in kg/m(2)): 35.8 +/- 2.9] or a calorie-restricted, low-fat diet (High Carb; BMI: 36.7 +/- 4.6) for 6 wk. A 24-h in-patient feeding study was performed at baseline and after 6 wk. Glucose, insulin, free fatty acids (FFAs), and triglycerides were measured hourly during meals, at regimented times. Remnant lipoprotein cholesterol was measured every 4 h. RESULTS: Patients lost a similar amount of weight in both groups (P = 0.57). There was an absence of any diet treatment effect between groups on fasting triglycerides or on remnant lipoprotein cholesterol, which was the main outcome. Fasting insulin decreased (P = 0.03), and both fasting (P = 0.040) and 24-h FFAs (P < 0.0001) increased within the High Fat group. Twenty-four-hour insulin decreased (P < 0.05 for both groups). Fasting LDL cholesterol decreased in the High Carb group only (P = 0.003). In both groups, the differences in fasting and 24-h FFAs at 6 wk were significantly correlated with the change in LDL cholesterol (fasting FFA: r = 0.41, P = 0.02; 24-h FFA: r = 0.52, P = 0.002). CONCLUSIONS: Weight loss was similar between diets, but only the high-fat diet increased LDL-cholesterol concentrations. This effect was related to the lack of suppression of both fasting and 24-h FFAs. © 2010 American Society for Nutrition. [ABSTRACT FROM AUTHOR]

BACKGROUND: Diet and physical activity are important factors in the etiology, prevention, and treatment of chronic diseases such as obesity and its associated comorbidities. Accurate measures of diet and activity are critical in understanding how these lifestyle and behavioral factors covary to affect health status. OBJECTIVE: The purpose of this study was to investigate the relation between body mass index (BMI) z score and self-report measures of diet and activity, the Youth/Adolescent Questionnaire (YAQ) and the Youth/Adolescent Activity Questionnaire (YAAQ), respectively. DESIGN: Participants were 1092 students in grades 4 through 6 from 10 schools in a US city in the middle Atlantic region with >or=50% of students eligible for free or reduced-price meals. Students were assessed at baseline and again after 2 y. The relation between self-reported energy intake (YAQ) and activity (physical and sedentary) (YAAQ) and BMI z score was explored from both a cross-sectional and longitudinal perspective. RESULTS: The YAQ (energy intake) and YAAQ (physical and sedentary activity) did not relate to BMI z score in the expected directions from either a cross-sectional or longitudinal perspective. CONCLUSION: In this large, racially diverse sample, the YAQ and the YAAQ were not significantly associated with BMI z score or changes in BMI z score. Copyright © 2008 American Society for Nutrition [ABSTRACT FROM AUTHOR]

Overweight and obesity are major factors contributing to the development of type 2 diabetes mellitus (DM) and cardiovascular disease (CVD). In addition to the many physical and metabolic consequences of obesity, there are also mental health consequences, in particular, the risk for depression. Depression can lead to poor self-care, poor treatment compliance, and possible increased morbidity and mortality from such illnesses as type 2 DM and CVD. Lifestyle modification for the treatment of overweight and obesity is rarely successful over the long term, and use of surgery is limited by eligibility criteria; therefore, researchers and clinicians continue to explore pharmacotherapy, with intense efforts being directed toward the development of agents that, optimally, will reduce weight and simultaneously reduce or eliminate modifiable cardiovascular and metabolic risk factors. Among the promising new agents are the CB(1) receptor antagonists. These agents target receptors of the endocannabinoid system, a neuromodulatory system recently found to influence energy balance, eating behavior, and metabolic homeostasis via central and peripheral mechanisms. In animal and clinical studies, antagonism of CB(1) receptors has resulted in meaningful weight loss and improvement of lipid and glycemic profiles. Thus, these agents may provide a rational and effective approach for the management of not only overweight and obesity but also their metabolic and cardiovascular sequelae. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Numerous reports have suggested that cycles of weight loss and regain (i.e., weight cycling) are associated with adverse health consequences, a concern that may lead some obese individuals to forgo weight control efforts. The present study examined whether weight cycling was associated with a reduction in resting energy expenditure (REE) and with increases in both total and upper body fat. METHOD: REE, body composition, and body fat distribution were measured before and after weight loss, and following full weight regain, in 12 women who before treatment had a mean (+/- SEM) age of 38.8 +/- 3.4 years and weight of 98.0 +/- 3.2 kg. RESULTS: At the end of treatment, patients lost 18.9 +/- 2.6 kg which was comprised of significant decreases in body fat and fat-free mass of 15.2 +/- 2.2 and 3.7 +/- 0.8 kg, respectively (both ps < .001). REE also fell during this time from 1,631 +/- 82 to 1,501 +/- 51 kcal/d (p < .03). All of these measures, however, returned to their baseline values when patients regained their lost weight. Body fat distribution was unchanged throughout the study. DISCUSSION: These results do not support claims that weight cycling adversely affects REE, body composition, or body fat distribution. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare two different methods of assessing binge eating in a sample of 128 obese women enrolled in a weight loss protocol. METHOD: Prior to treatment, participants completed the Binge Eating Scale (BES) and the Questionnaire on Eating and Weight Patterns (QEWP), as well as measures of other relevant constructs. They were then classified as bingers and nonbingers by each method and chance-corrected agreement was calculated. RESULTS: The BES and QEWP identified a small and nearly equal number of subjects as having significant binge eating, but there was only modest overlap between the two groups (kappa of .45). Subgroup comparisons revealed fundamental differences between the BES and QEWP in the assessment of the critical and associated features of binge eating. DISCUSSION: The relative merits of these two approaches to classifying binge eaters and implications for the design of new methods are discussed. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The present study assessed satisfaction with weight, shape, and physical appearance, as well as the frequency of weight reduction efforts, in four well-defined groups of adolescents: (1) normal-weight girls; (2) normal-weight boys; (3) obese girls; and (4) obese boys. METHOD: Subjects were selected from 453 females and 355 males from a parochial school. In addition to the measurements of height and weight, adolescents completed a series of questionnaires on weight and dieting, weight and figure satisfaction, parents' attitudes toward weight, and anxiety. RESULTS: Only 49% of obese boys had tried to lose weight over the past year as compared to 90% of the obese girls (p < .001). Only 13% of the obese boys were currently dieting as compared to 62% of the obese girls (p < .001). Despite the relative equivalence of weight in the obese boys and girls, the boys perceived themselves to be less overweight (p < .05) and happier with their looks (p < .001) than obese girls. Thirty-three percent of normal-weight girls were dieting, and 70% had attempted weight loss over the past year. They were significantly less happy with their weight and figure than were average-weight boys (p < .001) and, remarkably, did not differ significantly from overweight boys on these measures. DISCUSSION: Obese adolescent males, in particular, need to be educated about the potential liabilities of their excess weight and encouraged to take appropriate action to correct it. [ABSTRACT FROM AUTHOR]

Objective: HEALTHY is a 3-year middle school intervention program designed to reduce risk factors for type 2 diabetes. The prevalence of diabetes risk factors at baseline in a cohort of 6,358 sixth-grade students is reported.Research Design and Methods: Forty-two schools at seven U.S. sites were randomly assigned to intervention or control. Students participated in baseline data collection during fall of 2006.Results: Overall, 49.3% of children had BMI >or=85th percentile, 16.0% had fasting blood glucose >or=100 mg/dl (<1% had fasting blood glucose >or=126 mg/dl), and 6.8% had fasting insulin >or=30 microU/ml. Hispanic youth were more likely to have BMI, glucose, and insulin levels above these thresholds than blacks and whites.Conclusions: Sixth-grade students in schools with large minority populations have high levels of risk factors for type 2 diabetes. The HEALTHY intervention was designed to modify these risk factors to reduce diabetes incidence. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Our objective was to enumerate unrecognized former lead smelters in the United States. METHODS: Defunct smelters were identified by historical research. The compiled list was compared with government registries of hazardous sites. Soil samples were taken from 10 sites. RESULTS: Approximately 430 sites were unknown to the federal authorities. Only 5 of 319 sites were known to authorities in the top 8 states. Nine of the 10 sites sampled exceeded residential standards for soil lead level. CONCLUSIONS: Approximately 430 former lead-smelting sites were unrecognized in the United States. Sampling results indicate that the sites may pose a threat to public health. [ABSTRACT FROM AUTHOR]

Nuts (ground and tree) are rich sources of multiple nutrients and their consumption is associated with health benefits, including reduced cardiovascular disease risk. This has prompted recommendations to increase their consumption. However, they are also high in fat (albeit largely unsaturated) and are energy dense. The associations between these properties, positive energy balance, and body weight raise questions about such recommendations. This issue is addressed through a review of the literature pertaining to the association between nut consumption and energy balance. Epidemiological studies document an inverse association between the frequency of nut consumption and BMI. Clinical trials reveal little or no weight change with inclusion of various types of nuts in the diet over 1-6 mo. Mechanistic studies indicate this is largely attributable to the high satiety property of nuts, leading to compensatory responses that account for 65-75% of the energy they provide. Limited data suggest chronic consumption is associated with elevated resting energy expenditure resulting in dissipation of another portion of the energy they provide. Additionally, due to poor bioaccessibility, there is limited efficiency of energy absorption from nuts. Collectively, these mechanisms offset much of the energy provided by nuts. The few trials contrasting weight loss through regimens that include or exclude nuts indicate improved compliance and greater weight loss when nuts are permitted. This consistent literature suggests nuts may be included in the diet, in moderation, to enhance palatability and nutrient quality without posing a threat for weight gain. [ABSTRACT FROM AUTHOR]

BACKGROUND: The prevalence and seriousness of childhood obesity has prompted calls for broad public health solutions that reach beyond clinic settings. Schools are ideal settings for population-based interventions to address obesity. OBJECTIVE: The purpose of this work was to examine the effects of a multicomponent, School Nutrition Policy Initiative on the prevention of overweight (85.0th to 94.9th percentile) and obesity (> 95.0th percentile) among children in grades 4 through 6 over a 2-year period. METHODS: Participants were 1349 students in grades 4 through 6 from 10 schools in a US city in the Mid-Atlantic region with > or = 50% of students eligible for free or reduced-price meals. Schools were matched on school size and type of food service and randomly assigned to intervention or control. Students were assessed at baseline and again after 2 years. The School Nutrition Policy Initiative included the following components: school self-assessment, nutrition education, nutrition policy, social marketing, and parent outreach. RESULTS: The incidences of overweight and obesity after 2 years were primary outcomes. The prevalence and remission of overweight and obesity, BMI z score, total energy and fat intake, fruit and vegetable consumption, body dissatisfaction, and hours of activity and inactivity were secondary outcomes. The intervention resulted in a 50% reduction in the incidence of overweight. Significantly fewer children in the intervention schools (7.5%) than in the control schools (14.9%) became overweight after 2 years. The prevalence of overweight was lower in the intervention schools. No differences were observed in the incidence or prevalence of obesity or in the remission of overweight or obesity at 2 years. CONCLUSION: A multicomponent school-based intervention can be effective in preventing the development of overweight among children in grades 4 through 6 in urban public schools with a high proportion of children eligible for free and reduced-priced school meals. [ABSTRACT FROM AUTHOR]

Behavioral treatment is an approach used to help individuals develop a set of skills to achieve a healthier weight. It is more than helping people to decide what to change; it is helping them identify how to change. The behavior change process is facilitated through the use of self-monitoring, goal setting, and problem solving. Studies suggest that behavioral treatment produces weight loss of 8-10% during the first 6 mo of treatment. Structured approaches such as meal replacements and food provision have been shown to increase the magnitude of weight loss. Most research on behavioral treatment has been conducted in university-based clinic programs. Although such studies are important, they tell us little about the effectiveness of these approaches in settings outside of specialized clinics. Future research might focus more on determining how these behavioral techniques can be best applied in a real-world setting. Copyright © 2005 American Society for Clinical Nutrition [ABSTRACT FROM AUTHOR]

Background: Weight-related conversations are common between adolescents and parents. However, there is limited understanding of how these conversations vary across sociodemographic groups, such as sex, sexual orientation, race/ethnicity, or parents' level of education. This study assessed the prevalence of weight-related communication among adolescents and parents across sociodemographic characteristics, and identified adolescents' preferred sources for these discussions., Methods: Quantitative data were collected through online surveys from two independent U.S., Samples: adolescents aged 10-17 years of age (N = 2032), and parents of children aged 10-17 years of age (N = 1936). Frequency and sources of weight-related communication were assessed. Sociodemographic factors were analysed for their associations with these communication patterns., Results: While few differences emerged based on race/ethnicity or grade level, significant variation was observed for sex, sexual orientation, and parental education. Girls, sexual minority youth, high school students, and those with college-educated parents were more likely to communicate about their own weight, whereas boys were more likely to comment on others' weight. Most adolescents preferred healthcare professionals (71%) and parents (69%) for these conversations, although sexual minority youth preferred mental health professionals considerably more than parents. Among parents, 77% discussed their child's weight, with fathers and Latinx parents engaging more frequently in these conversations, and Black parents engaging least frequently., Conclusion: Weight-related communication is prevalent among adolescents and parents, with variation across sociodemographic characteristics. As healthcare professionals and parents were identified as the preferred sources for weight-related communication by adolescents across sociodemographic groups, it is important that paediatricians and parents are equipped to engage in these conversations without imparting stigma., (© 2024 World Obesity Federation.)

Objective: The objective of this study was to describe weight changes in members of a large-scale telehealth obesity-treatment provider who were using antiobesity medications (AOMs)., Methods: This retrospective observational study analyzed real-world data from adults who initiated AOM treatment with the WeightWatchers (WW) Clinic telehealth program between January 2022 and July 2023 (n = 53,590). The main outcomes were changes in body weight over 12 months, side effects over follow-up, and medication usage patterns., Results: The 53,590 patients who initiated treatment were predominantly female (88.6%), with a mean BMI of 36.9 kg/m 2 . Mean (SD) treatment duration was 5.3 (4.3) months. Program retention rates based on the number of patients whose time from enrollment was at least 3, 6, 9, and 12 months were 78% (n = 39,907/51,247), 63% (n = 25,515/40,203), 58% (n = 15,472/26,794), and 77% (n = 6459/8394), respectively. Average weight loss was 8.9% at 3 months (n = 37,565), 14.1% at 6 months (n = 24,140), 17.7% at 9 months (n = 15,169), and 19.4% at 12 months (n = 6089). Glucagon-like peptide-1 receptor agonist (GLP-1-RA)-based treatments were predominant. Side effects were consistent with the classes of medications used, and frequency declined over time., Conclusions: This real-world analysis of a telehealth-delivered obesity-treatment program demonstrated outcomes consistent with recent phase 3 clinical trials of AOMs, suggesting generalizability beyond clinical trial and in-person settings., (© 2024 The Author(s). Obesity published by Wiley Periodicals LLC on behalf of The Obesity Society.)

Background: Type 2 diabetes (T2D) risk is higher among non-Hispanic black (NHB) and Hispanic individuals, for reasons that are unclear., Aims: With this cross-sectional study, we tested the hypothesis that racial disparities in T2D prevalence can be partially traced to heterogeneity in etiology, as indicated by genetic subtypes that reflect distinct T2D phenotypes., Methods: Using a diverse sample of 361 US adults with T2D (69.5% women; 34.1% NHB; 13.9% Hispanic), we derived genetic risk scores (GRS) representing five distinct T2D pathophysiological pathways from 94 loci: β-cell, proinsulin, obesity, lipodystrophy, and liver/lipid. Genetic predisposition for insulin resistance (IR) was also assessed using a 52-SNP IR risk score., Results: The β-cell and proinsulin scores (as median [IQR]) were higher among NHB participants relative to NHW and Hispanics (β-cell GRS [NHB, 0.842(0.784-0.887) vs. NHW, 0.762(0.702-0.835) and Hispanic, 0.772(0.717-0.848)]); proinsulin GRS (NHB, 1.006[0.973-1.070] vs. NHW, 0.969[0.853-1.044] and Hispanic, 0.976[0.901-1.048]), whereas the liver/lipid and 52-SNP IR scores were higher in both NHB and Hispanic participants versus NHW (liver/lipid GRS [NHB, 1.09(0.78-1.18) and Hispanic, 0.895(0.736-1.227) vs. NHW, 0.794(0.666-1.157)]); 52-SNP IR GRS (NHB, 0.0095[0.009-0.010] and Hispanic, 0.0096 [0.0092-0.0101] vs. NHW, 0.0090[0.0084-0.0095])., Conclusions: Impaired β-cell function may underlie T2D etiology more profoundly in NHB, whereas hepatic dysfunction, lipid metabolism abnormalities, and genetic IR contribute to T2D etiology to a greater degree in both NHB and Hispanics. Further validation of these findings may form the basis for a personalized medicine approach to prevention and treatment of T2D., Competing Interests: Conflicts of Interest MC and GD are employees and shareholders at WW International, Inc., (Copyright © 2024 Instituto Mexicano del Seguro Social (IMSS). Published by Elsevier Inc. All rights reserved.)

Introduction: Strong support for family-based interventions in child and adolescent weight management exists. However, family-based interventions have not been as well documented in adult populations. Given that many adults operate within family systems that could influence their weight management behaviors, research is needed to establish possible family-level variables as intervention targets for adult weight loss programs., Method: This study tested the relationship between family functioning (defined as support and bonding), chaos (defined as disorder in the home), and weight loss in adults with overweight or obesity participating in a behavioral weight-loss program. Participants ( N = 118; baseline mean body mass index 33.8 ± 3.7; 69.5% female; 97.5% White; 67.8% with a combined annual income of $75k or above; 90.7% completed some college or above) were from a randomized controlled trial examining weight loss ripple effects (Gorin et al., 2018) in individuals assigned to either 6 months of WW (formerly Weight Watchers) or a self-guided approach., Results: Higher family support and bonding at baseline were associated with greater percent weight loss at 6 months. Family support and bonding at baseline were associated with lower chaos in the home at 6 months. However, this was moderated by condition such that this association was significant in the WW but not the self-guided group., Discussion: Results provide theoretical support that targeting family dynamics may improve weight loss outcomes in behavioral weight loss programs for adults. Future research should test whether family support, bonding, chaos, or other related variables such as family cohesion and adaptability-focused interventions improve weight loss outcomes for adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: The objective of this study was to evaluate the efficacy of a mobile health (mHealth)-delivered behavioral intervention on changes in postpartum weight and cardiometabolic risk factors (blood pressure [BP], lipids, and hemoglobin A1c) over 12 months., Methods: A randomized controlled trial of 300 African American postpartum people with overweight and obesity enrolled in Philadelphia Women, Infants, and Children (WIC) clinics was conducted. Participants were randomized to usual WIC care (n = 151) or a 12-month mHealth-delivered intervention (n = 149) comprising behavior change goals, interactive self-monitoring text messages, and counseling support., Results: Intervention and usual-care participants did not significantly differ in 12-month mean postpartum weight change (1.1 vs. 1.6 kg, p = 0.5; difference -0.6 kg, 95% CI: -2.3 to 1.2). However, high intervention engagement led to weight loss compared with weight gain among those who were less engaged (-0.6 vs. 2.4 kg, p = 0.01; difference -3.0 kg, 95% CI: -5.4 to -0.6). The intervention reduced systolic BP relative to usual care (-1.6 vs. 2.4 mm Hg, p = 0.02; difference -4.0 mm Hg, 95% CI: -7.5 to -0.5), but this effect did not extend to other cardiometabolic risk factors., Conclusions: Among African American postpartum people enrolled in WIC, an mHealth-delivered intervention reduced systolic BP but not additional cardiometabolic risk factors or weight. Intervention participants with high engagement had significantly better postpartum weight outcomes, and thus, next steps include addressing barriers to engagement., (© 2024 The Obesity Society.)

Objective: Research has highlighted the potential adverse effects of weight bias internalization (WBI) on adolescents, but there has been little examination of WBI and sources of weight teasing (family, peers, or both) or across racial/ethnic diversity of adolescents. We aimed to examine the relationship between WBI and sources of weight teasing across sociodemographic characteristics and weight status in a diverse community sample of adolescents., Methods: Data were collected from a U.S. sample of 1859 adolescents aged 10-17 years (59% female; 43% White, 27% Black or African American, and 25% Latino). An online questionnaire was used to assess participants' experiences of weight teasing from family members, peers, or both, and their weight status, weight-related goals, WBI, and sociodemographic characteristics., Results: Adolescents experiencing weight teasing from both family and peers reported the highest levels of WBI, while those reporting no teasing exhibited the lowest levels. These patterns were observed across sex, race/ethnicity, weight status, and weight goals, and persisted after controlling for depressive symptoms. Notably, family influences played a salient role, with adolescents reporting higher WBI if teased by family only compared to teasing from peers only. Sex and racial differences were also observed in adolescents' experiences with weight-based teasing., Conclusion: Our study reveals associations between adolescent weight-based teasing, WBI, and sociodemographic factors. Weight-based teasing, whether from family and peers or from family only, was associated with increased WBI. Interventions targeting weight stigma in youth should not be limited to peer-focused efforts, but should also emphasize supportive family communication., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Parental communication about body weight with their children is common across diverse families. The current study investigates how parents' feelings about their own bodies, beliefs about body weight, history of weight stigma, and weight-related characteristics contribute to the degree to which they talk about weight - both negatively and positively - with their adolescent children. The study sample was comprised of U.S. parents ( N = 1936) from diverse racial/ethnic backgrounds with children aged 10-17 years old. Parents completed an online survey with measures assessing their frequency of engaging in negative and positive weight communication with their children, along with several relevant psychosocial factors (i.e. body satisfaction, experienced weight stigma, associative stigma, body appreciation, beliefs about weight controllability, weight bias internalization). Study findings paint a complex picture, including some psychosocial factors (e.g. weight bias internalization) that are related to both more frequent negative and positive weight communication. Notably, higher levels of associative stigma were related to more frequent negative parental weight comments, and less frequent positive weight socialization. Findings can inform healthcare professionals in raising parents' awareness about how their personal beliefs and feelings about their own weight and their child's weight can contribute to how they engage in communication about weight with their children.

Background: It is not known whether behavioral weight loss can attenuate blood oxygen level-dependent responses to food stimuli., Objectives: This randomized controlled trial assessed the effects of a commercially available behavioral weight loss program (WW, WeightWatchers) compared to a wait-list control on blood oxygen level-dependent response to food cues., Methods: Females with obesity ( N = 61) were randomized to behavioral weight loss or wait-list control. At baseline and follow-up, participants completed assessments that included functional magnetic resonance imaging scans to assess response to images of high-calorie foods (HCF) or low-calorie foods (LCF), and neutral objects., Results: There were no significant between-group differences in change from baseline to follow-up in any regions of the brain in response to viewing HCF or LCF. From baseline to follow-up, participants in behavioral weight loss, compared with wait-list control, reported significantly greater increases in desire for LCF. Changes in liking and palatability of LCF and liking, palatability, and desire for HCF did not differ between groups., Discussion: Behavioral weight loss was associated with increased desire for LCF without changes in neural reactivity to food cues. These results suggest that alteration of neurological processes underlying responsiveness to food is difficult to achieve through behavioral weight management alone., Competing Interests: A. M. C. reports grants from WW International, Inc. She has also received grants from Eli Lilly and Co. and consulted for Eli Lilly and Co. outside the submitted work. T. A. W. reports serving on advisory boards for Novo Nordisk and WW International, Inc., and receiving grants from Novo Nordisk and Epitomee Medical Ltd. M. I. C. and G. D. F. are current employees and shareholders of WW International, Inc. The other authors have no conflicts of interest to report., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

The objective of this study is to investigate the fate and transport of per-polyfluoroalkyl substances (PFAS) through a high-density polyethylene (HDPE) geomembrane (GM) that is commonly used in landfill composite liner systems. Tests were conducted to measure the sorption and diffusion of per-polyfluoroalkyl substances (PFAS) with varying number of carbons in chain and functional groups on HDPE GM. Perfluoroalkyl carboxyl acids (PFCAs), perfluoroalkyl sulphonic acids (PFSAs), alkyl-sulfonamidoacetic acids (FOSAAs), fluorotelomer sulfonic acids (FtSAs), alkane sulfonamides (FOSA) and ether carboxylic acids (Gen X) were investigated in this study. The partition coefficients (K d ) on HDPE GM ranged from 3.8 to 98.3 L/kg. PFAS with amide and sulfonic functional groups showed stronger sorption than that of PFAS with carboxylic acid functional groups. Molecular weight directly affected the K d for long-chained PFAS whereas the K d of short-chained PFAS was not sensitive to molecular weight. The diffusion coefficients (D g ) of PFCAs and PFSAs through 0.1-mm HDPE GM were found to be in the orders of 10 -18 to 10 -17 m 2 /s. The D g decreased with increasing molar mass and were also observed to be dependent on the functional group. D g of PFSAs was lower than that of PFCAs for similar number of carbons in the chain. The estimated mass flux for PFAS in an intact 1.5-mm HDPE GM varied from 38.7 to 2080.8 ng/m 2 /year whereas the estimated diffusive breakthrough time for PFAS in intact 1.5-mm HDPE was 1526 years or longer., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Per- and polyfluoroalkyl substances (PFAS) constitute a large class of toxic manmade compounds that have been used in many industrial and household products. Dispersion of PFAS in the environment has raised concerns because of their persistence and toxicity for living organisms. Both terrestrial and aquatic plants have been shown to take up PFAS from contaminated soil and groundwater, and to accumulate these compounds inside their tissues. Although PFAS generally exert a low toxicity on plants at environmentally relevant concentrations, they frequently impact biomass growth and photosynthetic activity at higher levels. Uptake, translocation, and toxicity of PFAS in plants have been well covered in literature. Although less attention has been given to the molecular mechanisms underlying the plant response to PFAS, recent studies based on -omics approaches indicate that PFAS affects the plant metabolism even a low concentration. The objective of this review is to summarize the current knowledge about the effects of PFAS on plants at the molecular level. Results from recent transcriptomics, proteomics, and metabolomics studies show that low levels of PFAS induce oxidative stress and affect multiple plant functions and processes, including photosynthesis and energy metabolism. These potentially harmful effects trigger activation of defense mechanisms.

Obesity is a chronic disease that affects more than 650 million adults worldwide. Obesity not only is a significant health concern on its own, but predisposes to cardiometabolic comorbidities, including coronary heart disease, dyslipidemia, hypertension, type 2 diabetes, and some cancers. Lifestyle interventions effectively promote weight loss of 5% to 10%, and pharmacological and surgical interventions even more, with some novel approved drugs inducing up to an average of 25% weight loss. Yet, maintaining weight loss over the long-term remains extremely challenging, and subsequent weight gain is typical. The mechanisms underlying weight regain remain to be fully elucidated. The purpose of this Pennington Biomedical Scientific Symposium was to review and highlight the complex interplay between the physiological, behavioral, and environmental systems controlling energy intake and expenditure. Each of these contributions were further discussed in the context of weight-loss maintenance, and systems-level viewpoints were highlighted to interpret gaps in current approaches. The invited speakers built upon the science of obesity and weight loss to collectively propose future research directions that will aid in revealing the complicated mechanisms involved in the weight-reduced state., (© 2023 The Obesity Society.)

Background: Multicomponent interventions are the first line of treatment for pediatric obesity, but are challenging to access. Mobile health (mHealth) interventions hold promise as they address commonly cited barriers for attending in person programs and have potential for wide scale dissemination. Methods: This retrospective cohort study examined data from youth who enrolled in the Kurbo program, which includes personal health coaching and a mobile app. Hierarchical linear regression was used to examine the impact of baseline percentage of the 95th% percentile for body mass index (%BMIp95), number of coaching sessions, and length of time enrolled in the program on change in %BMIp95, controlling for baseline age and sex. Results: A total of 3500 youth (mean age of 12.79 years, 71.3% female) were included. Youth experienced a 0.70 U decrease in BMI [standard deviation (SD) = 2.19] and a 4.45% decrease (SD = 8.5) in %BMIp95 over a mean of 31.5 weeks. The overall regression model was significant, R 2  = 0.066, F (3,3494) = 77.18, and p  < 0.001. Predictors of decrease in weight status included being female ( b  = -1.11, p  < 0.001), higher baseline %BMIp95, ( b  = -0.58, p  < 0.001), and greater number of coaching sessions ( b  = -0.12, p  < 0.001), while greater time enrolled in the program ( b  = 0.02, p  < 0.001) was associated with less change. Conclusion: Findings suggest a scalable coaching program with integrated digital tools for monitoring diet and activity can lead to significant reductions in weight status. Findings need to be replicated with more rigorous study designs, including a comparison condition and verified assessment of height and weight.