Carolyn Dunn

Increasing Fruit and Vegetable Consumption among Preschoolers: Evaluation of Color Me Healthy

OBJECTIVE Determine whether Color Me Healthy (CMH), an interactive nutrition and physical activity program for preschool children, increases fruit and vegetable consumption. DESIGN Intervention study. Data were collected at baseline, 1 week post-intervention, and 3 months post-intervention. SETTING Child care centers. PARTICIPANTS Preschool children (n = 263) in 17 child care centers. INTERVENTION Child care centers were randomly assigned to 1 of 2 conditions; children (n = 165) in 10 centers received the CMH curriculum, and children (n = 98) in 7 centers acted as comparisons and did not receive the curriculum. MAIN OUTCOME MEASURES Process and outcome evaluation. Consumption of fruit and vegetable snacks. ANALYSIS Data were analyzed using repeated-measures analysis of variance and hierarchical linear modeling. RESULTS Children who received CMH significantly increased their consumption of fruit snacks by approximately 20.8% and vegetable snacks by approximately 33.1% between baseline assessment and the assessment conducted 3 months after the completion of the CMH program. Hierarchical linear modeling determined that group assignment (ie, CMH or control) was the only significant predictor of fruit and vegetable consumption. CONCLUSIONS AND IMPLICATIONS Findings suggest that CMH may be used in child care settings for developing healthful eating habits.

Color me healthy, preschoolers moving and eating healthfully.

Carolyn Dunn, PhD,* North Carolina Cooperative Extension, North Carolina State University, Box 7605, Raleigh, NC 27695; Tel: (919) 515-9142; Fax: (919) 515-3483; E-mail: carolyn_dunn@ncsu.edu; Cathy Thomas, MAEd, Physical Activity and Nutrition Branch, North Carolina Division of Public Health, NC; Leslie Pegram, BS, North Carolina Cooperative Extension, North Carolina State University, Raleigh, NC; Dianne Ward, PhD, Department of Nutrition, University of North Carolina-Chapel Hill, Chapel Hill, NC; Susanne Schmal, MPH, North Carolina Cooperative Extension, North Carolina State University, Raleigh, NC

Delivering a Behavior-Change Weight Management Program to Teachers and State Employees in North Carolina

Purpose. To ascertain the effectiveness of a behavior-change weight management program offered to teachers and state employees in North Carolina (NC). Design. Fifteen-week weight management program with premeasures and postmeasures. Setting. State agencies and public K-12 schools in five NC counties. Subjects. A total of 2574 NC state employees enrolled in 141 classes. Intervention. Eat Smart, Move More, Weigh Less (ESMMWL) is a 15-week weight management program delivered by trained instructors. Lessons inform, empower, and motivate participants to live mindfully as they make choices about eating and physical activity. Measures. Height, weight, body mass index (BMI), waist circumference, blood pressure, confidence in ability to eat healthy and be physically active, changes in eating, and physical activity behaviors. Analysis. Descriptive statistics, t-tests, χ2 tests, and analyses of variance. Results. Data are reported for 1341 participants in ESMMWL who completed the program, submitted an evaluation, and had not participated in the program in the past; 89% were female and mean age was 48.8 years. Average BMI and waist circumference decreased significantly. Confidence in eating healthfully and being physically active increased significantly. The percentage of participants with a BMI < 30 kg/m2 increased from 40% to 45% and those with a normal blood pressure increased from 23% to 32.5%. Participants reported being more mindful of what and how much they ate (92%), being more mindful of how much daily physical activity they got (88%), and eating fewer calories (87.3%). Conclusion. This project demonstrated the feasibility of implementing a behavior change–based weight management program at the worksite to achieve positive outcomes related to weight, blood pressure, healthy eating, and physical activity behaviors. Programs such as this have the potential to provide health care cost savings.

Randomized controlled trial targeting obesity-related behaviors: Better Together Healthy Caswell County.

Introduction Collaborative and multilevel interventions to effectively address obesity-related behaviors among rural communities with health disparities can be challenging, and traditional research approaches may be unsuitable. The primary objective of our 15-week randomized controlled pilot study, which was guided by community-based participatory research (CBPR) principles, was to determine the effectiveness of providing twice-weekly access to group fitness classes, with and without weekly nutrition and physical activity education sessions, in Caswell County, North Carolina, a rural region devoid of medical and physical activity resources. Methods Participants were randomly divided into 2 groups: group 1 was offered fitness sessions and education in healthful eating and physical activity; group 2 was offered fitness sessions only. Outcome measures were assessed at baseline and immediately after the intervention. Standardized assessment procedures, validated measures, and tests for analysis of variance were used. Results Of 91 enrolled participants, most were African American (62%) or female (91%). Groups were not significantly different at baseline. Group 1 experienced significantly greater improvements in body mass index (F = 15.0, P < .001) and waist circumference (F = 7.0, P = .01), compared with group 2. Both groups significantly increased weekly minutes of moderate physical activity (F = 9.4, P < .003). Participants in group 1 also had significantly greater weight loss with higher attendance at the education (F = 14.7, P < .001) and fitness sessions (F = 18.5, P < .001). Conclusion This study offers effective programmatic strategies that can reduce weight and increase physical activity and demonstrates feasibility for a larger scale CBPR obesity trial targeting underserved residents affected by health disparities. This study also signifies successful collaboration among community and academic partners engaged in a CBPR coalition.

Using Synchronous Distance-Education Technology to Deliver a Weight Management Intervention

OBJECTIVE To compare the effectiveness of online delivery of a weight management program using synchronous (real-time), distance-education technology to in-person delivery. METHODS Synchronous, distance-education technology was used to conduct weekly sessions for participants with a live instructor. Program effectiveness was indicated by changes in weight, body mass index (BMI), waist circumference, and confidence in ability to eat healthy and be physically active. RESULTS Online class participants (n = 398) had significantly greater reductions in BMI, weight, and waist circumference than in-person class participants (n = 1,313). Physical activity confidence increased more for in-person than online class participants. There was no difference for healthy eating confidence. CONCLUSIONS AND IMPLICATIONS This project demonstrates the feasibility of using synchronous distance-education technology to deliver a weight management program. Synchronous online delivery could be employed with no loss to improvements in BMI, weight, and waist circumference.

Using synchronous distance education to deliver a weight loss intervention: A randomized trial.

To implement a randomized trial to evaluate the effectiveness of a weight loss program delivered using synchronous distance education compared with a wait‐list control group with 6‐month follow‐up.

Price, Nutrition, Time, and Other Trade-Offs A Web-Based Food Value Analysis Application to Compare Foods at Different Levels of Preparation and Processing

Consumers choose to eat different forms of foods based on a wide variety of factors such as price, taste, nutrition, and convenience and, in doing so, make trade-offs among them. A Web-based application for use by nutrition educators was developed to help individuals compare foods prepared from home recipes with those for other forms of food (eg, frozen, canned, dry mix). Foods with a home-recipe form in US Department of Agriculture databases were selected to represent a range of commonly consumed entrées, baked goods, side dishes, fruits, vegetables, desserts, and beverages. Multiple US Department of Agriculture and commercial databases along with other public data sources were used to construct prices, nutrient values, food groups and components, preparation and cooking times, shelf life, and food safety concerns for foods in the database. Per-serving and per-100-g values were constructed for 100 individual foods with a home recipe and 1 or more other forms. The data are available in a Web-based application, located at http://www.foodvalueanalysis.org, allowing comparisons of individual foods or a daily diet constructed from foods in the database. Nutrition educators can use the application to advise individuals in selecting foods to consume to meet dietary guidelines while taking into consideration cost, preparation time, food preparation skills, and individual preferences. For example, the application can be used to evaluate differences in prices of fresh or processed foods, whether home recipe or processed foods are less costly when taking into consideration the value of preparation time, and the differences in nutrients across different forms of foods.

Mindfulness Approaches and Weight Loss, Weight Maintenance, and Weight Regain

Purpose of ReviewThere is an urgent need for effective weight management techniques, as more than one third of US adults are overweight or obese. Recommendations for weight loss include a combination of reducing caloric intake, increasing physical activity, and behavior modification. Behavior modification includes mindful eating or eating with awareness. The purpose of this review was to summarize the literature and examine the impact of mindful eating on weight management.Recent FindingsThe practice of mindful eating has been applied to the reduction of food cravings, portion control, body mass index, and body weight. Past reviews evaluating the relationship between mindfulness and weight management did not focus on change in mindful eating as the primary outcome or mindful eating as a measured variable.SummaryThis review demonstrates strong support for inclusion of mindful eating as a component of weight management programs and may provide substantial benefit to the treatment of overweight and obesity.

Development of a Movement and State Plan for Obesity Prevention, Eat Smart, Move More North Carolina

This report outlines the evolution of the Eat Smart, Move More North Carolina movement and publications in support of the movement, including North Carolinas Plan to Address Obesity: Healthy Weight and Healthy Communities, 2013-2020. This evidence-based plan guides the efforts of many organizations as they work to fulfill the mission of Eat Smart, Move More North Carolina: to reverse the rising tide of obesity and chronic disease among North Carolinians by helping them to eat smart, move more, and achieve a healthy weight.

SNAP-Ed Steps to Health Inspires Third Graders to Eat Smart and Move More

Early school-aged children are an excellent audience for health promotion activities because of their readiness to learn and their potential influence on thedietarypractices of their parents. North Carolina State Universitys Supplemental Nutrition Assistance Program–Education (SNAP-Ed) Steps to Health (STH) Third-Grade Program seeks to educate and inspire limitedresource third-grade students and their families across North Carolina to eat smart and move more.