Stephen J. Pintauro

Weight loss on the web: A pilot study comparing a structured behavioral intervention to a commercial program.

Objective: Internet weight loss programs have become widely available as alternatives to standard treatment, but few data are available on their efficacy. This study aimed to investigate the effectiveness of a structured behavioral weight loss website (VTrim) vs. a commercial weight loss website (eDiets.com).

Does using the Internet facilitate the maintenance of weight loss

OBJECTIVE: The purpose of this study was to investigate the effectiveness of a weight maintenance program conducted over the Internet.DESIGN: Longitudinal, clinical behavioral weight loss trial with 6-month in-person behavioral obesity treatment followed by a 12-month maintenance program conducted both in-person (frequent in-person support; F-IPS, minimal in-person support; M-IPS) and over the Internet (Internet support; IS).SUBJECTS: A total of 122 healthy, overweight adults (age=48.4±9.6, BMI=32.2±4.5 kg/m2, 18 male)MEASUREMENTS: Body weight, dietary intake, energy expended in physical activity, attendance, self-monitoring, comfort with technology.RESULTS: Results (n=101) showed that weight loss did not differ by condition during treatment (8.0±5 vs 11±6.5 vs 9.8±5.9 kg, P=0.27 for IS, M-IPS and F-IPS, respectively). The IS condition gained significantly more weight than the F-IPS group during the first 6 months of weight maintenance (+2.2±3.8 vs 0±4 kg, P<0.05) and sustained a significantly smaller weight loss than both in-person support groups at the 1 y follow-up (−5.7±5.9 vs −10.4±9.3 vs −10.4±6.3 kg, P<0.05 for IS, M-IPS and F-IPS, respectively). Attendance at maintenance meetings was greater for the F-IPS than the IS condition over the 1 y maintenance program (54 vs 39%, P=0.04). Acceptability of assigned condition was higher for subjects in the F-IPS than IS condition.CONCLUSION: The results of this study suggest that Internet support does not appear to be as effective as minimal or frequent intensive in-person therapist support for facilitating the long-term maintenance of weight loss.

The feasibility of using Internet support for the maintenance of weight loss

This pilot study examined the acceptability and feasibility of conducting a weight loss maintenance intervention over the Internet. Obese adults participated in a 15-week behavioral weight control intervention and were then randomly assigned to one of the following three maintenance conditions: (a) in-person, therapist-led (TL); (b) Internet, therapist-led (I); and (c) control (C). Both maintenance interventions met biweekly for 22 weeks using the same program content. Results showed that TL participants were more likely to attend their meetings and feel more satisfied with their group assignment. Ho wever, there were no differences between the TL and I groups in overall attrition or number of peer support contacts made. There was also no significant difference in weight loss between the groups. Thus, the Internet may hold promise as a method for maintaining contact with patients to facilitate long-term behavior change.

Liver scarring induced by polychlorinated biphenyl administration to mice previously treated with diethylnitrosamine

Abstract Exposure of mice for 8 weeks to drinking water containing diethylnitrosamine (DEN) was accompanied by alterations in hepatocyte structure and varying degrees of liver nonparen-chymal cell (NPC) proliferation. Eighteen and a half weeks after cessation of DEN exposure, there was a 47% incidence of hepatocellular nodules. Centrilobular hepatocyte hypertrophy occurred consistently in mice given intraperitoneal injections of the polychlorinated biphenyl (PCB) mixture Aroclor 1254. PCB administration to mice previously treated with DEN was not accompanied by increases in gross liver nodule incidence above that induced by DEN, but many more developing microscopic nodules within the liver were observed in DEN-treated mice given Aroclor 1254 than in mice treated only with DEN. Aroclor 1254 administration over a 16-week period to mice previously treated with DEN was accompanied by an 83% incidence of severe distortion of liver structure resulting from nodule formation, uneven patterns of hepatocyte growth, and extensive deposition of scar tissue containing proliferating bile ducts. Morphological evidence of intestinal metaplasia was observed in proliferating bile duct-like structures during an early stage of liver adenofibrosis.

Evaluation of a Nutrition and Health Educational Online Computer Program for Older Adults

Background: Many older adults are at increased risk for nutritional deficiencies and foodborne illnesses. The objective of this study was to develop and evaluate the effectiveness of a user-friendly computer application that provides nutrition, food safety, and health information tailored to the needs of older adults. Methods: To determine the effectiveness of the program, a 12-month intervention study was conducted in which subjects were assigned to an experimental (HE-HA) group (access to the computer program) or a control (CON) group (no access to computer program). Computers were placed in each of two Vermont rural congregate meal sites. One site served as the HE-HA group site and the other as the CON site. Forty-one adults congregate meal users (HE-HA group: n=16; CON group: n=25) age ? 55, were recruited to participate in the study. The Nutrition Screening Initiative (NSI) checklist, food behavior checklist, and computer attitude surveys were completed by participants at baseline, 3, and 12 months. Focus groups were conducted between 8 and 9 months. Between and within group over time differences were statistically analyzed by Chi-square analyses and repeated measures ANOVA. Results and Conclusions: A significant positive impact of our program was noted on fruit and vegetable consumption (p < 0.005) and attitude regarding use of computers (p < 0.02). Focus group results indicated that all HE-HA participants claimed to have changed at least one aspect of his/her diet and that the Website contributed to this positive change. They also noted that the help of the “peer mentors” was a significant factor in their positive experience with using the Web application and with the use of computers in general. In this study, we demonstrated the successful use of a nutrition and health computer application in improving both nutrition behavior and computer skills and attitudes in older adults.