Melinda R. Stolley

Obese people who seek treatment have different characteristics than those who do not seek treatment.

A group of obese people who had not sought treatment, an obese group who had sought treatment in a professional, hospital-based program, and normal-weight controls (N = 547) were compared in regard to level of psychopathology, binge eating, and negative emotional eating. Because the groups differed significantly on several demographic variables, 3 demographically matched groups were created and compared (n = 177, 59 per group). In the matched subgroups, obese people who had sought treatment reported greater psychopathology and more binge eating than did those who had not sought treatment or did normal-weight controls. Both obese groups (including those who had not sought treatment) endorsed more symptoms of distress, negative emotional eating, overeating, difficulty resisting temptation, and less exercise than did normal-weight controls.

Hip-Hop to Health Jr. for Latino Preschool Children

Objective: Hip‐Hop to Health Jr. was a diet/physical activity intervention designed to reduce gains in BMI (kilograms per meter squared) in preschool minority children.

Mobile phone text messaging to promote healthy behaviors and weight loss maintenance: a feasibility study

There is a need to investigate newer strategies pertaining to the maintenance of healthy behaviors and weight. We investigated the feasibility of mobile phone text messaging to enable ongoing communication with African-American women participating in a weight management program. Ninety-five African-American women participated in this pilot study and received regularly scheduled text messages. Forty-two of these women chose to create 165 personal text messages that included tips on healthy eating and physical activity, as well as reminders to drink water and expressions of encouragement. A commercially available client-based application transmitted these personal messages and general health messages at least three times per week. The software transmitted over 4500 text messages during the first 4 months with 114 returned as undeliverable. Participants expressed generally positive attitudes toward incoming text messages, with only one participant declining to continue after enrollment. This study demonstrated early feasibility and acceptability of text messaging as a method for promoting healthy behaviors for weight maintenance.

Correlates of binge eating in Hispanic, Black, and White women

OBJECTIVE We sought to compare the severity and correlates of binge eating in White, Black, and Hispanic women. METHOD Our sample consisted of 351 (55 White, 179 Black, and 117 Hispanic) women who were assessed on three proposed factors associated with binge eating (weight, depression, and ideal body image). RESULTS Our results showed that binge eating symptoms were more severe in our sample of Hispanic versus Black or White women. Across all ethnic groups, women who binged more were heavier, more depressed, and preferred a slimmer body ideal. Binge eating severity was predicted by weight and depression in Hispanics and by depression in Whites. None of the proposed factors significantly influenced binge eating in Blacks. DISCUSSION These results show ethnic differences in the correlates of binge eating and highlight the need for further comparative research on aberrant eating patterns.

Effects of an Obesity Prevention Program on the Eating Behavior of African American Mothers and Daughters

Cardiovascular disease (CVD) is the number one cause of death in the United States. Obesity is highly related to CVD risk, especially in African American women. This study explored the efficacy of a culturally specific obesity prevention program. Designed for low-income, inner-city African American girls and their mothers, the program addressed the importance of eating a low-fat, low-cholesterol diet and increasing activity. Mother-daughter dyads were randomly assigned to a 12-week treatment or an attention placebo group. Participants were assessed at pre- and posttreatment on dietary intake, including daily fat intake, daily saturated fat intake, percentage of daily calories from fat, and daily cholesterol intake. Results showed significant differences between the treatment and control mothers for daily saturated fat intake and percentage of calories from fat. Differences among treatment and control groups were also noted for the daughters on percentage of daily calories from fat. Implications of the findings for developing culturally specific health risk reduction programs are discussed.

Hip-Hop to Health Jr. Obesity Prevention Effectiveness Trial: postintervention results.

The preschool years offer an opportunity to interrupt the trajectory toward obesity in black children. The Hip‐Hop to Health Jr. Obesity Prevention Effectiveness Trial was a group‐randomized controlled trial assessing the feasibility and effectiveness of a teacher‐delivered weight control intervention for black preschool children. The 618 participating children were enrolled in 18 schools administered by the Chicago Public Schools. Children enrolled in the nine schools randomized to the intervention group received a 14‐week weight control intervention delivered by their classroom teachers. Children in the nine control schools received a general health intervention. Height and weight, physical activity, screen time, and diet data were collected at baseline and postintervention. At postintervention, children in the intervention schools engaged in more moderate‐to‐vigorous physical activity (MVPA) than children in the control schools (difference between adjusted group means = 7.46 min/day, P = 0.02). Also, children in the intervention group had less total screen time (−27.8 min/day, P = 0.05). There were no significant differences in BMI, BMI Z score, or dietary intake. It is feasible to adapt an obesity prevention program to be taught by classroom teachers. The intervention showed positive influences on physical activity and screen time, but not on diet. Measuring diet and physical activity in preschool children remains a challenge, and interventions delivered by classroom teachers require both intensive initial training and ongoing individualized supervision.

Diet and physical activity in childhood cancer survivors: a review of the literature.

Treatment advances have led to a growing population of childhood cancer survivors. Many are at risk for developing treatment-related late effects. Diet and physical activity may affect levels of health risk. A number of papers have examined these behaviors in childhood cancer survivors. The purpose of this study was to provide a review and summary of the published studies in the areas of diet, physical activity, and related interventions among childhood cancer survivors. A systematic search was conducted for studies published prior to October 2009. Descriptive and intervention studies that included survivors of childhood cancers and a measurement of diet and/or physical activity were reviewed. Twenty-six manuscripts met criteria: ten addressed diet; 20 addressed physical activity, and six included intervention studies. Results suggest that childhood cancer survivors engage in health-promoting activities at rates comparable to the general population. Behavioral interventions have mostly targeted physical activity. Results, overall, are not encouraging, due primarily to difficulties recruiting and retaining participants. Although more rigorous studies are needed, recommendations for health-promoting behaviors should be a regular topic of discussion between health care providers and their childhood cancer survivor patients.

Obesity Reduction Black Intervention Trial (ORBIT): Six-Month Results

The Obesity Reduction Black Intervention Trial (ORBIT) is a randomized controlled trial designed to assess the efficacy of a culturally proficient 6‐month weight loss intervention followed by a 1‐year maintenance intervention. This article describes the results of the 6‐month weight loss intervention. Two hundred thirteen obese black women aged 30–65 years were randomized to the intervention group or a general health control group. The intervention consisted of a 6‐month culturally adapted weight loss program that targeted changes in diet and physical activity patterns. Weight, dietary intake, and physical activity were measured at baseline and 6 months. A total of 198 women (93%) completed both the baseline and postintervention assessments. Women in the intervention group lost significantly more weight than women in the control group (P < 0.001). However, weight change was variable within the intervention group, with a maximum weight loss of 19.4% of initial body weight and a maximum weight gain of 6.4% of initial body weight. Women in the intervention group also showed significant improvements in fruit intake (P < 0.01), Healthy Eating Index score (P < 0.001), and moderate (P = 0.05), and vigorous (P < 0.001) physical activity compared to women in the control group. This study demonstrates that a culturally adapted program can successfully promote weight loss in obese black women. However, average weight loss was relatively modest, and weight change varied widely within the intervention group. Further research is needed in order to develop programs that will allow more black women to achieve their weight loss goals.

Hip-Hop to Health Jr., an obesity prevention program for minority preschool children: baseline characteristics of participants

BACKGROUND The prevalence of obesity in the United States is a significant public health problem. Many obesity-related risk factors are more prevalent in minority populations. Given the recalcitrant nature of weight loss interventions for adults, prevention of overweight and obesity has become a high priority. The present study reports baseline data from an obesity prevention intervention developed for minority preschool children. METHODS Hip-Hop to Health Jr. is a 5-year randomized controlled intervention that targets 3- to 5-year-old minority children enrolled in 24 Head Start programs. Our primary aim is to test the effect of the intervention on change in body mass index. Data were collected on sociodemographic, anthropometric, behavioral, and cognitive variables for the children and parents at baseline. RESULTS Participants included 416 black children, 337 black parents, 362 Latino children, and 309 Latino parents. Using body mass index for age and sex > or = the 95th percentile as the definition of overweight, 15% of the black children and 28% of the Latino children were overweight. More than 75% of the parents were either overweight or obese. DISCUSSION The development of interventions to effectively prevent or control obesity early in life is crucial. These data highlight the escalating problem of weight control in minority populations.

Environmental Changes May Be Needed for Prevention of Overweight in Minority Children

In minority populations, those who do not maintain normal weight outnumber those who do; thus, overweight is often the community norm. Compared to many white populations, minority populations are transitioning from poverty, food scarcity, and jobs that require significant amounts of energy expenditure. This may mean food and activity habits of both black and Latino populations may have been developed during a more physically-active era. Caloric restriction and leisure-time physical activity are not routine in minority communities. In these communities, there are often few supermarkets that carry fresh produce, many fast food establishments and small grocery stores that sell high-fat, energy-dense foods, and high neighborhood crime rates that discourage outdoor activities and limit safe places for walking and bicycling, including school routes. Although specific dietary and activity behaviors related to weight control ultimately are undertaken by individuals, our current environment makes such individual choices difficult when it contains substantial barriers to establishing healthy lifestyles. Substantial environmental changes need to be made, especially in minority communities.