Alexis C. Wojtanowski

The effects of water and non‐nutritive sweetened beverages on weight loss during a 12‐week weight loss treatment program

To compare the efficacy of non‐nutritive sweetened beverages (NNS) or water for weight loss during a 12‐week behavioral weight loss treatment program.

The effects of water and non-nutritive sweetened beverages on weight loss and weight maintenance: A randomized clinical trial

To evaluate the effects of water versus beverages sweetened with non‐nutritive sweeteners (NNS) on body weight in subjects enrolled in a year‐long behavioral weight loss treatment program.

Middle School Student and Parent Perceptions of Government-Sponsored Free School Breakfast and Consumption: A Qualitative Inquiry in an Urban Setting

Universal free access to school breakfast is available in large urban schools, but participation rates are less than half of what they are at lunch. The purpose of this qualitative study was to understand the discrepancy between access and participation in school breakfast in a low-income, urban school district. Youth (n=23) and parents (n=22) were recruited from three middle schools where ≥ 50% of students were eligible for free or reduced-price meals. Parent focus groups (n=2) and student focus groups (n=4) were conducted in the fall/winter of 2009/2010. Content analysis was conducted to code transcripts and a constant comparative technique was used to identify emergent themes. Findings were validated using triangulation methods. The following themes emerged from the student and parent perceptions: sociocultural beliefs, physical availability, economic accessibility, social stigma, and consumption practices. There was agreement between students and parents across most themes, except consumption practices. Students were commonly purchasing food and beverages on the way to school, which was in conflict with parent rules. Parents desired access to copies of the school menus to be more involved in breakfast decisions with their child and students desired input into menu planning and taste testing to overcome school meal quality concerns. Future research aiming to improve participation in the breakfast program should examine the impact of student involvement in school menu planning and environmental modifications to reduce the social stigma associated with the program.

Randomized Controlled Trial Examining the Ripple Effect of a Nationally Available Weight Management Program on Untreated Spouses

For married couples, when one spouse participates in weight loss treatment, the untreated spouse can also experience weight loss. This study examined this ripple effect in a nationally available weight management program.

Initial weight loss goals: have they changed and do they matter?

Nearly 20 years ago, participants in behavioural weight loss programmes reported goals that greatly exceeded the amount of weight typically produced by these programmes. Whether having unrealistic weight loss goals impacts weight loss or attrition is unclear. The intent of the current study was to revisit current weight loss goals and examine whether goals impact outcomes.

Characteristics of tobacco purchases in urban corner stores

Introduction To examine the prevalence and patterns of tobacco purchases at low-income, urban corner stores. Methods Data on tobacco products and other purchases were collected through direct observation of customers’ purchases (n=6369) at 120 urban corner stores in Philadelphia, Pennsylvania, from April to September 2012. Results Overall 13% of corner store purchases included tobacco products. The majority (61%) of tobacco purchases did not include any other products, and 5.1% of all purchases from corner stores included a food or beverage and tobacco product. Approximately 24% of tobacco purchases were for lower-cost tobacco products such as cigars and cigarillos, and nearly 5% of tobacco purchases were an illegal purchase of a single, unpackaged tobacco product that is not intended for individual sale (ie, loosies). There was no difference in the average amount spent on food or beverages when purchased with (US

Weight loss and frequency of body-weight self-monitoring in an online commercial weight management program with and without a cellular-connected ‘smart’ scale: a randomized pilot study

2.55, 95% CI: 2.21 to 2.88) or without (US

Examining the pattern of new foods and beverages consumed during obesity treatment to inform strategies for self-monitoring intake

2.55, 95% CI: 2.48 to 2.63) tobacco products. Conclusions In low-income, urban corner store settings, 87% of purchases did not include tobacco; most tobacco purchases did not include the sale of non-tobacco items and spending on non-tobacco items was similar whether or not tobacco was purchased. These findings can help inform retail-level tobacco sales decisions, such as voluntary discontinuation of tobacco products or future public health policies that target tobacco sales. The results challenge prevailing assumptions that tobacco sales are associated with sales of other products in corner stores, such as food and beverages.

Financial incentive strategies for maintenance of weight loss: results from an internet-based randomized controlled trial

Evaluate the effects of an online commercial weight management program, with and without provision of a ‘smart’ scale with instructions to weigh daily and weekly tailored feedback, on weight loss and the frequency of body‐weight self‐monitoring.

Levels of adherence needed to achieve significant weight loss

Maintaining dietary self-monitoring during obesity treatment may improve outcomes. As dietary variety is associated with energy intake, understanding the pattern of when new foods and beverages are consumed may assist with identifying when self-monitoring should occur. This study examined dietary variety (total number of differing foods and beverages consumed) from the first 40 days of self-monitoring records reporting ≥ 3 eating occasions and >600 kcal/day from 60 adults (55.9 ± 9.1 yrs, 35.1 ± 5.3 kg/m2, 80.0% female, 95.0% white) participating in a smartphone-based, lifestyle intervention. Dietary variety was coded using an ingredient-based approach. Additionally, new flavors of previously consumed items, and modified and non-modified items contributed to variety. Total number of different foods and beverages consumed over 40 coded days (cumulative variety [cv40]); number of days to reach 50%, 75%, and 100% of cv40; cv40 by eating occasions; and mean number of new items consumed on weekdays and weekend days were calculated. CV40 was 145.4 ± 33.5. Number of coded days to consume 50%, 75%, and 100% of cv40 was 12.7, 25.1, and 40.0, respectively. Dinner was greater (p < 0.0001) in cv40 (58.6 ± 18.5 different items) than other eating occasions, and lunch was greater (p < 0.0001) (38.8 ± 10.7 different items) than breakfast and snack. Weekend days had a greater mean number of new items consumed than weekdays, (3.8 ± 1.0 items vs. 3.6 ± 0.9 items, p = 0.035). Variety of items consumed during obesity treatment is high, and to capture the majority of differing items consumed, at least 4 weeks of detailed recording is needed. After this, to capture new foods and beverages consumed, self-monitoring dinners, lunch, and weekend days may be helpful.