No description available.

No description available.

No description available.

Attention on beverage intake, specifically sugar-sweetened beverages (SSB), has increased in recent years (1). Energy-containing beverages do not provide the same satiety as solid foods, and intake of solid food is not spontaneously reduced when energy-containing beverages are consumed (2,3). This may contribute to positive energy balance (1). Conversely, a reduction in energy intake occurs by replacing SSB with water and may facilitate weight loss (4,5). A valid, reliable and sensitive assessment tool for quantifying beverage consumption and determining its influence on weight status could help advance research on this topic. Three studies were conducted to develop the BEVQ, a self-administered quantitative beverage intake questionnaire. First study (n=105): the 19-item BEVQ's validity was examined by comparing participant's beverage intake to the "gold standard" of dietary intake assessment, food intake records; reliability was assessed by comparing two BEVQ's, administered two weeks apart. The BEVQ demonstrated acceptable validity (R2=0.53, water g; 0.46, 0.61 total beverage g, kcal; 0.49, 0.59 SSB g, kcal) as well as reliability (all correlations P<0.001) (6). Second study (n=1,596): the BEVQ underwent exploratory factor analyses (EFA) to identify the potential to reduce items. Three beverage items, which contributed <10% to total beverage intake g, kcal, were eliminated; EFA identified beer and light beer as a combined category. The refinement led to the 15-item BEVQ, which produced a lower readability score of 4.8 and shorter administration time (~2 min) (7). Third study (n=70): the ability of the BEVQ-15 to detect changes in beverage intake was evaluated by increasing participant water and fruit juice consumption and evaluating BEVQ-15 outcomes before and after the feeding period. Increases in water, juice and total beverage (g) were detected during the intervention period (P<0.001) (8). This rapid, valid, reliable and sensitive beverage intake assessment tool may determine the habitual intake of SSB and other beverages, and evaluate the effectiveness of clinical and public health interventions which aim to address national SSB recommendations. Future work is needed to evaluate the validity and reliability of the BEVQ-15 in children, as well as develop cost-effective noninvasive biomarkers that can objectively estimate intake of specific foods/dietary components (9). / Ph. D.

Seventy-six percent of men and 71% of women over the age of 55 in the United States are considered overweight or obese,1 and the numbers are expected to rise2 especially since the population is aging.3 Aside from various metabolic comorbidities, such as hypertension, dyslipidemia, and coronary artery disease,4 overweight and obesity are also linked to decreased mobility5 and increased rate of falls in elderly,6 all of which may lead to premature death. Furthermore, adults over the age of 65 have 339% greater obesity-related medical expenses compared to younger adults (18-30 years old),7 thus strategies to promote weight management are needed. Belonging to the group of fiber, prebiotics are selectively fermented non-digestible food ingredients that have a favorable impact on the composition and activity of the gut microbiota. Specifically, inulin-type fructans (ITF) including inulin, oligosaccharides, and fructooligosaccharides have been generating interest in the prebiotic area in the past two decades. A lot of attention has been directed at weight management, since ITFs are known to stimulate the excretion of anorectic gut hormones glucagon like peptide-1 and peptide YY upon fermentation in the colon.8 Research done to date has included samples with wide age and BMI ranges, various doses of inulin, as well as different study designs. More investigations are needed in specific populations, such as older adults who might have age-related alterations in gastric emptying.9 This pilot research study investigated the effects of short-term pre-meal inulin consumption (10 g, mixed into 500 ml water) on energy intake (EI) and appetite sensations over a 24-hour period, in overweight and obese middle-aged and older adults (n=7, 55-67 years old), in order to determine the potential role of prebiotics in weight loss and weight management. A randomized crossover design was used, with participants completing both pre-meal inulin and control (500 ml water alone) conditions. There were no differences in EI, gram weight, nor energy density of foods consumed between the inulin and control conditions. However, observed subgroup differences suggest variances in response to the inulin preload related to gender, habitual fiber consumption, cognitive dietary restraint, and BMI status. / Master of Science

The number of overweight adults has risen to two-thirds of the population, thus increases in energy intake, particularly from beverages are of great concern. Sugar-sweetened beverage (SSB) intake has increased by 222 calories in recent decades, which contributes a significant source of added sugars to the American diet. It has been reported that water consumers have a lower overall energy intake (~194 kcals) as compared to non-consumers of water therefore substituting water for SSBs may facilitate weight loss and weight management. Evidence also indicates that diet quality follows a socioeconomic gradient, and that the environment has a powerful influence on beverage consumption. Thus, modifying the food environment could be a promising strategy for promoting healthier beverage consumption behavior. A large portion of the US population spends their day at a worksite making the worksite a viable setting for implementing environmental approaches to promote effective behavior change. At this time, it is unclear if a reduction of SSB intake would be a viable dietary weight management intervention strategy. Therefore, our purpose was to determine if water, SSB intake, SSB energy, total beverage intake, and total beverage energy varies with individual and environmental factors among overweight and obese employees from 28 worksites involved in a randomized controlled weight management trial. These findings may contribute to the development of tailored weight management programs aimed to improve beverage consumption patterns. / Master of Science

Background: Reviews of primary research in developed countries and policy in the UK demonstrate there is a lack of evidence from well conducted RCTs on lifestyle interventions for childhood obesity (NICE 2006, SIGN 2003, Oude Luttikhuis et al. 2009). Objectives: To develop, implement and evaluate the Y W8? family focused childhood obesity treatment programme using a randomized controlled trial. Methods: The programme was developed using Bartholomew’s Intervention Mapping framework. Using this stepped process a needs analysis was undertaken, a steering group formed, focus groups were completed in local schools and interviews took place with parents of obese children. The determinants identified by these processes were combined with relevant theories and information gathered through a literature review to develop the programme. Y W8? is a 12 week course for families with children aged 8–13 years designed to assist with weight management. The RCT was designed as an individually randomised parallel-group trial with a waiting-list control group. Children in the intervention group (n=59) had their height, weight, self-reported physical activity levels, self-reported fruit and vegetable consumption and a measure of self-esteem recorded at pre- and post-assessment, whilst only height and weight was collected from the children in the control group (n=55). Results: Twelve week (post course) results showed a significant difference in change in BMI z-score between the control and intervention group, mean difference = -0.12 (95% CI: 0.09 to 0.16, F (1, 98) = 54.04, p < 0.0005), with the control group increasing and the intervention group decreasing their BMI z-score. Analysis showed this positive effect on weight status did not adversely affect linear growth. For the intervention group 81% of children completed the programme. Implications: This RCT offers evidence to support the use of family-based treatment programmes in the treatment of childhood obesity and displays positive results in the short-term, at a lower cost than similar interventions. The thesis also demonstrates how a public health programme can be implemented and sustained in routine NHS practice.

The aim of this study was to determine the relationship between HRQOL and adherence to an adolescent weight management program and identify variables predictive of increased adherence which are critical to motivating engagement in weight management. This study was a non-experimental, retrospective secondary analysis from aggregate data collected as part of the REWARD Teens program, a weight management program for overweight and obese adolescents. Data from 37 subjects were included in this study. Subject adherence to the program was the primary outcome variable. There was no significant relationship between baseline adolescent or parent-proxy sub-scale or total HRQOL scores with program adherence. A significant positive relationship for improved adherence was found only when change in BMI (p=.023), change of parent-proxy total PedsQL (p=.014), and change in child total PedsQL (p=.007) were present in the regression model. Body mass index and changes in both parent-proxy and child total HRQOL significantly affected attendance. Our findings suggest that baseline HRQOL does not affect program adherence. However, we identified a potentially novel interplay between variables predictive of program adherence. Future studies should focus on elucidating the mechanism by which these factors gained significance in the relationship with adherence when combined, perhaps as mediators or moderators, in order to identify interactions which may function as barriers or facilitators to adherence.

No description available.

The health of the veteran population within the United States has become a matter of ever-increasing concern, and many individuals who have attained veteran status are experiencing health issues following their discharge from the military. Despite such concerns, there are often not enough resources available to assist these individuals to the degree necessary in an expedient manner. The purpose of this case study was to use social cognitive theory to understand the physical activity of veterans following their time in service. Through the use of social cognitive theory, this study explored the thoughts, perceptions, and behaviors of 11 veterans to determine how their physical fitness levels were affected following their time in the service. Data were collected by interview over the course of a 1-month period by visiting the U.S. Department of Veterans Affairs hospital a minimum of 3 days per week and a content analysis of interview transcripts led to the presented results. Results indicated that expectations of physical activity were realistic post service, and self-efficacy and self-control levels were high. Veterans indicated the beneficence of physical activity as a means of promoting overall wellbeing; however, paticipants also indicated dissatisfaction with the available options to them through the U.S. Department of Veterans Affairs. The results provided clear direction as to the steps that can be taken to work to increase the physical activity levels of veterans. Potential social change implications resulting from the study could lead to improvements in understanding of veteran health statuses.