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An environmental intervention to prevent excess weight gain in African-American students: a pilot study.
Newton, RL, Han, H, Anton, SD, Martin, CK, Stewart, TM, Lewis, L, Champagne, CM, Sothern, M, Ryan, D, Williamson, DA
American journal of health promotion : AJHP. 2010;(5):340-3
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Abstract
PURPOSE To examine the influence of an environmental intervention to prevent excess weight gain in African-American children. DESIGN Single-group repeated measures. SETTING The intervention was delivered to a school composed of African-American children. PARTICIPANTS Approximately 45% (N = 77) of enrolled second through sixth grade students. INTERVENTION The 18-month intervention was designed to alter the school environment to prevent excess weight gain by making healthier eating choices and physical activity opportunities more available. MEASURES Body mass index percentile was the primary outcome variable. Body mass index z score was also calculated, and percent body fat, using bioelectrical impedance, was also measured. Total caloric intake (kilocalories) and percent kilocalories from fat, carbohydrate, and protein were measured by digital photography. Minutes of physical activity and sedentary behavior were selfreported. ANALYSIS Mixed-models analysis was used with covarying baseline values. RESULTS Boys maintained, whereas girls increased, percent body fat over 18 months (p = .027). All children decreased percent of kilocalories consumed from total and saturated fat and increased carbohydrate intake and self-reported physical activity during the intervention (p < .025). Body mass index z score, sedentary behavior, and total caloric intake were unchanged. CONCLUSION The program may have resulted in maintenance of percent body fat in boys. The percent body fat in girls steadily increased, despite similar behavioral changes as boys. School-based interventions targeting African-American children should investigate strategies that can be effective across gender.
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Early behavioral adherence predicts short and long-term weight loss in the POUNDS LOST study.
Williamson, DA, Anton, SD, Han, H, Champagne, CM, Allen, R, Leblanc, E, Ryan, DH, Rood, J, McManus, K, Laranjo, N, et al
Journal of behavioral medicine. 2010;(4):305-14
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Abstract
The primary aim of this study was to test the association of early (first 6 months) adherence related to diet, self-monitoring, and attendance with changes in adiposity and cardiovascular risk factors. This study used data from the 24-month POUNDS LOST trial that tested the efficacy of four dietary macronutrient compositions for short-and long-term weight loss. A computer tracking system was used to record data on eight indicator variables related to adherence. Using canonical correlations at the 6 and 24 month measurement periods, early behavioral adherence was associated with changes in percent weight loss and waist circumference at 6 months (R = 0.52) and 24 months (R = 0.37), but was not associated with cardiovascular disease risk factor levels. Early dietary adherence was associated with changes in insulin at 6 months (R = 0.19), but not at 24 months (R = 0.08, ns). Early dietary adherence was not associated with changes in adiposity.
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Wise Mind project: a school-based environmental approach for preventing weight gain in children.
Williamson, DA, Copeland, AL, Anton, SD, Champagne, C, Han, H, Lewis, L, Martin, C, Newton, RL, Sothern, M, Stewart, T, et al
Obesity (Silver Spring, Md.). 2007;(4):906-17
Abstract
OBJECTIVE The Wise Mind pilot study compared the efficacy of an environmental approach for prevention of inappropriate weight gain in children with an active control condition that used an environmental approach for modifying expectancies related to the use of alcohol, tobacco, and drugs. RESEARCH METHODS AND PROCEDURES A total of 670 second to sixth grade students from four schools were enrolled in the study. The study spanned 2 academic years, and 586 students were available for evaluation at the end of the study. Two schools were randomly assigned to each treatment arm. The environmental approach for weight gain prevention focused on modification of eating habits and physical activity, and the active control group focused on modification of expectancies related to substance use. RESULTS Using an intention to treat design, the study found no differences in weight gain prevention between the two interventions. The weight gain prevention program was associated with reduction of total caloric intake, reduction of dietary fat intake, reduction of protein intake, and increased physical activity in comparison with the active control group and relative to baseline. These changes in food intake were attributed to changes in food selections that resulted from modification of school cafeteria menus and food preparation. DISCUSSION The Wise Mind school-based weight gain prevention program induced behavioral changes in healthy eating and physical activity but did not induce significant changes in body weight in comparison with the control arm. Recommendations for future research are provided.