Anthony Alfonso

Two-year internet-based randomized controlled trial for weight loss in African-American girls

Objective: A randomized controlled trial tested the efficacy of an internet‐based lifestyle behavior modification program for African‐American girls over a 2‐year period of intervention.

Effect of 6-month calorie restriction and exercise on serum and liver lipids and markers of liver function.

Objective: Nonalcoholic fatty liver disease (NAFLD) and its association with insulin resistance are increasingly recognized as major health burdens. The main objectives of this study were to assess the relation between liver lipid content and serum lipids, markers of liver function and inflammation in healthy overweight subjects, and to determine whether caloric restriction (CR) (which improves insulin resistance) reduces liver lipids in association with these same measures.

Efficacy of an internet-based behavioral weight loss program for overweight adolescent African-American girls

Objective: This randomized controlled trial tested the efficacy of an internetbased lifestyle behavior modification program for weight management in African-American girls. Design: African-American girls were randomly assigned to an interactive behavioral internet program or an internet health education program, the control condition. The behavioral intervention included internet counseling and was highly interactive. The control intervention was a passive (non-interactive) educational program. Parents were also participants in the study. Participants in both treatment groups met in face-to-face sessions on four occasions over the first 12 weeks of a 6-month intervention. Subjects: The study enrolled 57 African-American adolescent girls (ages 11 to 15 years) who were overweight or obese and had at least one biological parent who was obese [body mass index (BMI) >30 kg/m2]. Of the 57 participants, 50 (88%) completed the 6-month trial. Measurements: Outcome data, including BMI, body weight, body composition, dietary intake, and weight loss behaviors were collected at baseline and 6-months later. A computer server tracked utilization of the websites. Participation in the program was measured by number of “hits” on the website. Results: Compared to the control condition, adolescents in the behavioral treatment lost more body fat (group difference =1.6% body fat) and parents lost significantly more body weight (group difference =2.1 kg). Utilization of the behavioral website by adolescents and parents was associated with positive outcome. Dietary fat intake was lowered for adolescents and parents in the behavioral treatment group. Conclusion: An internet-based behavioral intervention was superior to internet-based health education and yielded decreased body fat for adolescent girls and decreased body weight for parents.

Digital photography: A new method for estimating food intake in cafeteria settings

Objective: The primary objective of this study was to test the comparability of digital photography and visual estimation procedures for estimating food intake. Research methods and procedures: The study sample included 71 breakfast meals and 59 lunch meals eaten in a university cafeteria during a single day. A total of 66 different foods were employed as test foods that could be selected by the students. Food selections and plate waste, as estimated by digital photography and visual estimation, were compared. For digital photography, three observers independently estimated portion sizes of each food item based upon digital photographs. One observer estimated portion sizes in the cafeteria setting, using visual estimation, a method that has been validated in other studies. Results: To test the accuracy of the two procedures for measuring food intake, the estimates of food weights derived from both procedures were compared using Bland-Altman regression. In comparison to visual estimation, the digital photography method yielded comparable estimates of food selections, plate waste, and total food intake for seven of nine comparisons. The two methods of estimating food portions yielded comparable results for most (78%) types of foods. The two methods also yielded similar variability. Discussion: These findings suggest that the digital photography method is an alternative to the traditional method of estimating food intake via direct observation.

Psychological adjustment during Army basic training.

This study evaluated changes in depression, anxiety, and stress during Army basic training. During week 1 of training, 139 soldiers from two companies volunteered for participation. In week 8, 93 soldiers were available for retesting. Self-reports of depressive symptoms and perceptions of stressfulness at both assessments fell within the normative range for nonclinical samples, whereas endorsement of anxiety symptoms remained slightly elevated, in the mild range. Women endorsed higher levels of anxiety (F = 8.87, p < 0.01) than did men. No gender or ethnicity differences were noted for changes in psychological distress over time. Regression analyses showed that subjects with the highest levels of initial distress on the anxiety, depression, and stress measures had the most change at the end of 8 weeks of training (r values between 0.61 and 0.39; all p < 0.01). Results suggest that initial levels of psychological distress are slightly elevated for anxiety but most individuals adapt to the stress of basic training, with normal levels of distress by the last week.

Association of body size estimation and age in African-American females

This cross-sectional research study tested the hypothesis that body image estimates of African-American females differ as a function of age. To test this hypothesis, body image estimates of 379 African-American females, ranging in age from 16 to 96 years, were contrasted as a function of age group, while statistically controlling body mass index. Three body size estimates, current body size, ideal body size, and reasonable body size were measured using the Body Image Assessment for Obesity. The discrepancies between current and ideal body size estimates and between current and reasonable body size estimates were also analyzed to assess for differences in body size dissatisfaction. The study found that younger African-American women (16 to 35 years) differed from older African-American women (>35 years) on measures of body size dissatisfaction. Women in the age range of 26 to 35 years reported higher estimates of current body size in comparison to women older than 35 years. The youngest age group (16 to 25 years) reported thinner ideal body size goals in comparison to women who were slightly older (26 to 35 years) and women who were older than 75 years. The pattern of body image estimates across a large age range suggests that younger African-American women, in comparison to older African-American women, may have body images that may make them more susceptible to eating disorders.