Catherine M. Champagne

An Environmental Intervention to Prevent Excess Weight Gain in African-American Students: A Pilot Study

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 self-reported. 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.

The impact of continued intervention on weight: Five-year results from the weight loss maintenance trial

In the Weight Loss Maintenance (WLM) Trial, a personal contact (PC) intervention sustained greater weight loss relative to a self‐directed (SD) group over 30 months. This study investigated the effects of continued intervention over an additional 30 months and overall weight change across the entire WLM Trial.

Performance Nutrition Dining Facility Intervention Improves Special Operations Soldiers’ Diet Quality and Meal Satisfaction

Objective: To assess the impact of the Special Operations Forces Human Performance Program dining facility (DFAC) intervention on patron diet quality and meal satisfaction. Design: Nonrandomized, controlled time series study using digital food photography and surveys pre‐post intervention (0, 4, 8, and 12 months). Setting: Two Fort Bragg, NC military installation DFACs. Participants: Volunteers (n = 688 total; n = 573 complete dataset) were US Army active duty soldiers. Intervention: The DFAC intervention included food choice architecture, new performance‐optimizing food recipes to increase nutrient density, revised menus to offer more performance foods daily, and nutrition labeling to influence food choice. Main Outcome Measures: Daily DFAC nutrient intake and Healthy Eating Index (HEI) 2010 scores. Analysis: Descriptive and ANOVA statistical analyses were performed between control and intervention groups and from baseline to 4, 8, and 12 months postintervention (&agr; = .05; 80% power). Results: The intervention resulted in a higher posttest HEI score (60.1 ± 8.8 points; +3.4%; P = .005) and DFAC satisfaction compared with control (49.0 ± 10.4 points; P > .05). Improved intervention HEI scores were attributed to changes in citrus and melon fruit (+46%), red and orange vegetables (+35%), whole grains (+181%), legumes (65%), yogurt (+45%), oils (–26%), and solid fat (–18%) consumption (all P < .05). Conclusions and Implications: These data illustrate that the Special Operations Forces Human Performance Program military DFAC nutrition intervention was feasible to implement and was associated with diet quality improvements. Access to high‐quality ingredients and recipes may improve soldier meal quality and acceptance in other settings and warrants further investigation.

Gut-microbiome-related LCT genotype and 2-year changes in body composition and fat distribution: the POUNDS Lost Trial

Background/objectivesGut microbiome regulates host energy metabolism and adiposity. A recent study identified a genome-wide significant variant in the lactase (LCT) gene that determines gut-microbiome abundance. We investigated whether the LCT variant influenced long-term changes in adiposity among overweight and obese individuals.Subjects/methodsWe included 583 whites with LCT variant rs4988235 (G allele as Bifidobacterium-abundance-increasing allele) who were randomly assigned to one of four weight-loss diets varying in macronutrient contents. Two-year changes in adiposity measures were assessed according to the LCT genotype and weight-loss diets.ResultsWe observed a significant interaction between the LCT genotype and dietary protein intake on changes in whole body total fat mass %, trunk fat %, superficial adipose tissue mass (SAT), visceral adipose tissue mass (VAT), and total adipose tissue mass (TAT) (Pinteractionu2009<u20090.05 for all). In response to high-protein diet, carrying the G allele of LCT variant rs4988235 was associated with greater reduction of whole body total fat mass % (β [SE] –0.9 [0.43], Pu2009=u20090.04), trunk fat % (–1.06 [0.58], Pu2009=u20090.07), SAT (–0.89 [0.42], Pu2009=u20090.04), VAT (–0.63 [0.27], Pu2009=u20090.03), and TAT (–1.69 [0.76], Pu2009=u20090.03). Conversely, increasing numbers of the G allele tended to be related to less reduction of these outcomes in response to low-protein diet.ConclusionsLong-term improvement of body fat composition and distribution was significantly influenced by the Bifidobacterium-related LCT genotype and dietary protein intake. Overweight and obese individuals with the G allele of LCT variant rs4988235 may benefit improving adiposity by eating a low-calorie, high-protein diet.

Nutrition for the Diabetic Child

Integration of a licensed, registered dietitian into the team caring for the diabetic child or adolescent is essential. The majority of nutritional benefit for pediatric T2DM derives from family-based education on healthier lifestyle choices and on appropriate portion size. Dietary education is an ongoing process for families affected by pediatric obesity and T2DM.

Can We Predict Underreported Energy Intake And Evaluate Nutritional Status Accordingly

Abstract Energy expenditure (EE) was measured using the doubly labeled water (DLW) technique in this cross-sectional study of children with equal numbers of blacks and whites; boys and girls; with a wide range of body weights. Food records were kept for the entire 8-day study with nutritionists monitoring school lunch food consumption to improve the accuracy of parent-assisted, student-kept records. Reported energy intake (REI) and other nutrient information were derived from these records. Data were analyzed using ANOVA with the general linear models procedure. Post hoc t-tests were used to determine differences between means. Underreporting (EE - REI) was significant for black children (950±200kcal; p=0.0002). and there was a tendency for underreporting in white children (320±160kcal; p=0.0626). When students were divided into tertiles of body fat, the fattest group had the greatest underreporting of energy intake (1040±240 kcal; p