Randomized Trial of A Healthy Weight Intervention for Youth with Mental Illness: The Champion Trial

Introduction: Overweight and obesity in youth with serious emotional disturbance (SED) is exceedingly common. In 2015 the AHA called attention to mental illnesses in youth as important risk conditions for early CVD and the need for transformational change in management of overweight and obesity in this group. Our objective was to test a 12-month, innovative healthy weight intervention in youth with SED.Hypothesis: The active intervention is more effective than control in decreasing BMI Z-score compared at 12 m. Method(s): We conducted a two-arm randomized trial in 2 outpatient pediatric mental health settings in 112 youth, ages 8-18 yrs. The active intervention group was offered 12m of in-person and virtual individual weight management sessions led by health coaches who provided guidance on improving diet and increasing physical activity, and engaged parents. Result(s): At baseline, mean (SD) age was 13.0 (2.7) yrs with 46% ages 8-12 and 54% 13-18;55% were male, 46% Black, 39% had household income less than $50K/yr and 31% lived in a single-parent household. Primary diagnoses were ADHD (41%), major depression (23%), and anxiety (23%). Mean BMI Z-score (SD) was 2.0(0.4), BMI 30.4 (6.4) kg/m2.Mean(SD) psychotropic medications were 2.1(1.4).At 12m, 111 (99%) had a follow-up weight;42 were collected after the onset of the COVID pandemic). The intervention group compared to the control group had 0.15 decrease in BMI Z-Score (95% CI 0.26 to 0.04), p<0.007) between baseline and 12 m (Figure) and a 1.43 kg/m2 decrease in BMI (95% CI 2.43, 0.42, p<0.006). Estimated net effect on BMI Z-score for intervention vs. control was enhanced during the pandemic but not statistically different from net effects pre-pandemic (p=0.06). Conclusion(s): A weight control intervention designed for children with SED decreased BMI Z-score substantially over 12 months, including during the COVID-19 pandemic. These results provide empirical evidence in support of weight control programs in a population at high risk for early development of CVD risk factors.

Social stigmatization in the news coverage of obesity in the Spanish press during the pandemic

Introducción: El presente estudio analiza el tratamiento de la obesidad en la prensa española durante el primer año de la pandemia de COVID-19, con el objetivo de conocer cómo se enmarcaron sus informaciones sobre este tema. Metodología: Mediante la metodología del análisis de contenido y con la teoría del framing como referencia, se estudiaron 350 unidades de contenido acerca de obesidad y COVID-19 publicadas en las ediciones digitales de los cuatro diarios españoles impresos de información general más leídos en el año 2020: El País, El Mundo, La Vanguardia y ABC. Resultados: En los contenidos que protagoniza la obesidad prima el encuadre de responsabilidad individual, que atribuye la causa de la obesidad a la persona que la padece y que difunde la idea de que tener sobrepeso es una elección personal. Por el contrario, en aquellos centrados en la COVID-19 predomina el encuadre de responsabilidad colectiva. También se utiliza, aunque de manera minoritaria, lenguaje ofensivo e imágenes que reflejan de forma negativa a personas con obesidad. Discusión: Los medios de comunicación pueden influir en las creencias y actitudes de su audiencia, así como en la toma de decisiones sobre salud. Por ello, la forma en que los medios representan la obesidad es importante para aumentar o reducir la estigmatización hacia las personas que la sufren. Conclusiones: La narrativa que atribuye la causa de la obesidad a la responsabilidad individual fomenta el aumento del estigma social y refuerza los estereotipos basados en el peso, por lo que debería evitarse en los medios de comunicación.Alternate abstract:Introducción: This study analyzes the treatment of obesity in the Spanish press during the first year of the COVID-19 pandemic, to find out how the information on this topic was framed. Methodology: Using the methodology of content analysis and the framing theory as a reference, 350 content units on obesity and COVID-19 published in the digital editions of the four most widely read Spanish generalinformation newspapers in 2020 were analyzed: El País, El Mundo, La Vanguardia, and ABC. Results: In the contents that focus on obesity the individual responsibility frame predominates, attributing the cause of obesity to individual responsibility and disseminating the idea that being overweight is a personal choice. On the other hand, in those centered on COVID-19, the collective responsibility frame predominates. Offensive language and images that reflect negatively on people with obesity are also used, albeit in a minority of cases. Discussion: The media can influence the beliefs and attitudes of its audience, as well as healthcare decision-making. Thus, how the media portrays obesity is important in increasing or reducing the stigmatization of people who suffer from it. Conclusions: The narrative attributing the cause of obesity to individual responsibility fosters increased social stigma and reinforces weight-based stereotypes and should be avoided in the media.

A Curious Case of New-Onset Diabetes

New-onset type 1 diabetes most frequently presents with diabetic ketoacidosis in young patients. A subset of patients with autoimmune type 1 diabetes may present with a slower progression to insulin deficiency and are frequently misdiagnosed with type 2 diabetes. Clinicians should screen for type 1 diabetes in patients who present with hyperglycemia and do not have obvious signs of insulin resistance or obesity. This case report presents an adult patient with hyperglycemia after a hospital admission for coronavirus disease 2019 and the evidence used to diagnose type 1 diabetes with atypical presentation.

Outcome of Veno-Venous Extracorporeal Membrane Oxygenation in Obese COVID-19 Patients Is Not Inferior to Normal Weight Patients

Background: Since late 2019, infections with novel coronavirus SARS-CoV-2 have caused a global pandemic. By now, limited adequate pharmacological therapy exists for severe COVID-19 related acute respiratory distress syndrome (ARDS). Therefore, treatment with veno-venous extracorporeal membrane oxygenation (vv-ECMO) still is considered as an ultimate rescue option. However, especially in obese patients, implantation of vv-EMCO cannulas is challenging and results in these patients are often considered as inferior to normal weight control patients. Method(s): Between 2020 and 2022, a total of 82 patients were treated with vv-ECMO for severe COVID-19-related ARDS in our department. All patients were prospectively enrolled into an institutional database and retrospectively reviewed for the purpose of this study. Patients were divided concerning their body mass index (BMI) (BMI <= 30.0 kg/m2 : control, n = 41;BMI > 30.0 kg/m2 : obesity, n = 41). Result(s): Mean BMI of the control group was 27.0 +/- 2.1 kg/m2 compared with 33.5 +/- 5.3 kg/m2 in obesity group (p < 0.01). Minimum BMI of the whole cohort was 23.0 kg/m2 and maximum BMI 50.0 kg/m2. There were no relevant differences regarding age, gender and the incidence of concomitant diseases, except for diabetes (control: 17.1%, obesity: 41.5%, p = 0.03) and renal insufficiency (control: 22.0%, obesity: 4.9%, p = 0.05) between the two study groups. Peri-interventional incidence of severe device-related adverse events such as bleeding (control: 17.1%, obesity: 25.0%, p = 0.42), ischemic stroke (control: 9.8%, obesity: 10.0%, p > 0.99), intracranial bleeding (control: 22.0%, obesity: 27.5%, p = 0.61), and visceral ischemia (control: 4.9%, obesity: 12.2%, p = 0.43) did not differ with regard to the BMI. Weaning from vv-ECMO was achieved in 39.0% of the obese patients and in 34.0% of the controls (p = 0.82). In-hospital death was observed for 75.6% of the control patients compared with 61.0% for the obesity group (p = 0.24). Conclusion(s): vv-ECMO as ultimate rescue therapy for serve COVID-19-related ARDS is also feasible in obese patients. Although implantation of the cannulas may be more difficult in obese patients, the results regarding weaning rate and survival are encouraging and not inferior to non-obese patients. However, an increased rate of kidney injury in the control group during vv-ECMO support may represent a relevant confounder, which should be investigated in larger study cohorts.

Exploring the Impact of COVID-19 Pandemic on Food Choice Motives: A Systematic Review

The economic crisis caused by the COVID-19 pandemic has effected the global economy, with the main changes expected to affect human life in the future, including food consumption. However, could this pandemic be assumed as a threshold for the suspension of the usual rules behind food choices? This review highlights the changes in food choice motivations before, during, and after the pandemic that have been reported in the literature to date to answer the research question on the changes in food choice motives caused by the pandemic to consumers worldwide. The review comes up with ten key food motives important for consumers, namely health, convenience, sensory appeal, nutritional quality, moral concerns, weight control, mood and anxiety, familiarity, price, and shopping frequency behavior;these motives continue to be significant in the post-pandemic era. Our findings indicate that it is too premature to give definite answers as to what food choice motives in the post-COVID-19 era will be like. Consumers' perceptions and attitudes toward food in the new era are contradictory, depending on the country of the study, the average age, and the sex of the study group. These controversial results illustrate that, for food consumption, motives depend on the population being searched, with changes identified occurring in two directions. The definite answers will be given in three to five years when the new conditions will be clear and a number of studies will have been published. Even though it is too early to fully understand the definite food choice motive changes, defining a "new" index of consumer satisfaction is necessary since it can alter the food sale strategies of retail managers, food companies, and the other parties involved in the agri-food chain.

Dietary intake and eating behavior in the Chilean population during the COVID-19 lockdown

Lockdown and social distancing due to COVID-19 affected the mental health and lifestyle of the population. However, there is insufficient evidence of alterations in eating behavior. Our study seeks to describe the relationship between eating behavior and eating habits among Chilean adults during the confinement period. A sample of 760 Chilean subjects was analyzed, who answered surveys using Google Forms, considering demographic characteristics, social distancing, dietary habits and EB. More than half of the participants consider that their dietary intake increased during confinement. Changes in dietary intake were analyzed according to food group, and a decrease in the consumption of fish, fruits and dairy products was observed, while legumes, processed foods and soft drinks showed an increase, which represents risk factors for the development of cardiovascular diseases. When analyzing eating behavior, a greater difficulty in stopping eating was observed when faced with external stimuli;increased intake associated with complex emotional situations, and when iso-lating the group that decreased their intake of unhealthy foods, a greater ability to limit their intake for weight control was reported. Our results are similar to other studies, and they reinforce that confinement is related to eating behavior, leading to changes in eating habits, which indicates that, at the public health level, post-pandemic nutritional strategies, should be focused on regulating eating behavior in order to guide habits towards healthy eating. Copyright © 2022, Sociedad Chilena de Nutricion Bromatologia y Toxilogica. All rights reserved.

Culinary Medicine - An Experiential Approach to Treatment for Obesity

Background: It is well established that treatment of obesity should focus on improving nutrition for patients. One avenue of teaching patients about nutrition is through culinary medicine. Culinary medicine is an interdisciplinary and experiential approach that has been shown to improve health outcomes. Prior studies have explored the effects of culinary medicine-based interventions on cardiometabolic metrics, but no study to date has examined the role of culinary medicine on weight. Methods: Participants were recruited from a weight management clinic. Inclusion criteria included: BMI >/= 30 kg/m2, age >/= 18, and English-speaking. The intervention was the Goldring Center for Culinary Medicine (GCCM) curriculum. The GCCM curriculum is a 6 week curriculum that teaches culinary skills and the role of nutrition in health. Each session included a 2.5 hour cooking and nutrition didactic session. Due to the Covid-19 pandemic, the curriculum was delivered virtually over Zoom. Participants were given a body weighing scale and ingredients needed for each cooking session. During the course, participants self-reported weights each week. Patients also provided weights 6 months after course completion. Results: We delivered 4 sessions and enrolled 44 patients. 39 participants completed the course. The average starting weight for participants was 225.4 pounds with a BMI of 36.3 kg/m2. The average weight for participants after the curriculum was 221.9 pounds with a BMI of 25.7 kg/m2. The average change in weight for participants was -3.5 pounds (p<0.001) with a change in BMI of -0.6 kg/m2 (p<0.001). The average percent change in weight for participants was -1.6% (p<0.001). 21 participants had 6-month follow up weights. The average change in weight for participants from their start weight to 6 months was -10.7 pounds (p <0.001) with a change in BMI of -1.8 kg/m2 (p<0.001). The average percent change in weight was -4.8% (p<0.001). Conclusions: This culinary medicine intervention led to weight loss in individuals with obesity. Future directions include examining long term maintenance of weight loss as well as the impact of this culinary medicine intervention on cardiometabolic metrics.

Efficacy and Safety Analysis of Setmelanotide as a Novel Treatment for Hypothalamic Obesity

Background: Hypothalamic injury and impaired melanocortin-4 receptor (MC4R) pathway signaling, often a result of surgery or radiation for a benign tumor, may lead to hypothalamic obesity (HO). After injury, sudden weight gain and appetite changes unresponsive to existing therapies develop. Setmelanotide, an MC4R agonist, is approved for chronic weight management in patients with certain MC4R pathway-associated diseases. We report interim results of a Phase 2 study of setmelanotide in HO (NCT04725240). Methods: Patients aged 6-40 years with body mass index (BMI) >95th percentile (children 6 to <18 years) or >35 kg/m2 (adults >18 years) and HO caused by structural hypothalamic damage secondary to craniopharyngioma or other benign brain tumor, surgical resection, and/or chemotherapy were enrolled. The setmelanotide dose was initiated by age, with 2-4 weeks of titration to 3.0 mg once daily, followed by 12-14 weeks at the target dose. The primary endpoint was the proportion of patients achieving >5% BMI reduction at Week 16. A key secondary endpoint was the composite proportion of children with >0.2-point reduction in BMI Z score and adults with >5% weight loss. Hunger was assessed daily using a numerical rating scale, where 0 = not hungry at all and 10 = hungriest possible. Results: Eleven patients were included (baseline mean [SD;range] age, 14.6 [4.8;6-23] years and mean [SD] BMI, 38.7 [5.7] kg/m2). All patients (90% CI, 76.2%-100%) had >5% reduction in BMI (p<0.0001);81.8% (90% CI, 53.0%-96.7%) had >10% reduction (p<0.0001). Mean (range) change in BMI was -17.2% (-37.2%, -6.7%). Mean (SD) change in hunger score was -2.7 (2.6). Frequent adverse events included nausea (63.6%), vomiting (45.5%), diarrhea (36.4%), and COVID-19 (36.4%). Two patients discontinued because of adverse events. Conclusions: These early results warrant continued evaluation of setmelanotide in this population with a high unmet medical need and no approved therapies.

The Relationship Between Mental Health and Weight During the COVID-19 Pandemic: A Longitudinal Study

Background: Depression and anxiety have consistently been associated with obesity in observational studies. However, most studies make between-individual comparisons, which can mask important relationships. Less is known about within-individual associations. To address these limitations, we assessed longitudinal associations of depression, anxiety, and stress scores with self-reported body weight in a large sample at the within- and between-individual level during the COVID-19 pandemic. Methods: Participants from a sub-study of a population-based cohort of UK adults completed monthly mental health and body weight measurements (08/2020-04/2021). We used random intercepts regression models to examine longitudinal associations of depression, anxiety and stress with weight. In sub-group analyses, we included interaction terms of mental health variables with baseline characteristics (age, sex, BMI, education, occupation). Results: In 2133 participants, within-individual variation in depressive symptoms was associated with subsequent weight (0.045kg weight per unit of depression severity, 95% CI 0.021 to 0.069), but we did not find evidence for associations in between-individual analysis, or in analyses of stress and anxiety. In subgroup analyses, we found evidence of a dose-dependent moderation effect of baseline BMI on the within-individual association between depressive symptoms and subsequent weight (baseline BMI 25-29.9 kg/m2: 0.052kg weight per unit of depression severity, 95% CI 0.010-0.094kg;baseline BMI>30 kg/m2: 0.071kg weight per unit of depression severity, 95% CI 0.013-0.129kg). We did not find evidence for reverse causality. Conclusions: In this study, individuals with overweight or obesity were more vulnerable to weight gain following higher-than-usual (for that individual) depressive symptoms than individuals with a healthy BMI. Although causality cannot be inferred, our analysis meets the Bradford-Hill criteria of biological gradient and temporality. Our results suggest that targeting depressive symptoms in individuals with overweight may aid weight management strategies.

Effect of COVID-19 Necessitated Telephone-virtual Verses In-person Delivery of Obesity Care at VA Facility

Background: A vast majority of the VA population is either overweight or obese, which is a serious health concern. Obesity care has been traditionally delivered via in-person clinics. The COVID-19 pandemic forced the delivery of care to be switched to virtual platforms Methods: To study the effectiveness of in-person versus virtual (telephone only) delivery of obesity care, which included behavioral therapy and pharmacotherapy, an observational study was designed to include participants who were either newly enrolled or had previously established care at the VA Move! program in Minneapolis for weight management between the years of 2017 to 2021. These participants were divided into two groups. A transition cohort (obtained in-person care from March 2019 to March 2020, then transitioned to virtual care). A new start cohort (enrolled after March 2020 with virtual care);this group was compared to a separate historical group which obtained in-person care between January 2019 to December 2020. Weight loss was accessed over a 9-month period in both cohorts. Results: The mean weight loss over 9 months was -6.4±18.1 lbs and -2.5±13.3 lbs in the in-person and virtual phases of the transition cohort, respectively, without any significant difference between the two phases (p=0.22). The mean weight loss over 9 months in the new start (virtual) cohort was -14.4±17.0 lbs compared to -16.7±21.0 lbs in the historical cohort, without any significant difference between the two groups (p=0.44). Conclusions: Weight loss with virtual-telephone care was comparable to in-person care in our weight management program.

Impact of Food Order Behavioral Intervention on Weight and Nutrient Intake in Adults With Prediabetes

Background: Consuming the carbohydrate-rich portion of meals after vegetables and proteins (CHO-last food order) reduces postprandial glucose and insulin excursions in patients with prediabetes/diabetes compared to the reverse order (CHO-first food order). We implemented a 16-week behavioral intervention to assess the impact of CHO-last food order on body weight and nutrient intake in prediabetes context. Methods: Adults with BMI>25 and HbA1c 5.7-6.4% were randomized to receive standard nutritional counseling (C) or standard nutritional counseling + CHO-last food order counseling (FO). All subjects received 4 monthly counseling sessions and kept exercise (E) stable for 16 wks. Body weight and diet from 3-day food records were assessed at wks 0 and 16. Due to the pandemic, later participants received some or all their counseling via telemedicine. Results: Of 45 randomized subjects, 39 completed the study (C=21, FO=18). Demographics and wk 0 variables (e.g. weight, HbA1c, and caloric intake) were similar in C and FO, except fiber intake (C 24.9 ±10.6 g vs. FO 18.3±6.4 g, p=0.028). E was similar in C and FO at wks 0 and 16. Body weight declined significantly in the FO group (-3.6 ±5.7 lbs, p=0.017;-1.8% ±2.8, p=0.012) and changed for the C group (-2.6 ±6.8 lbs, p=0.102;-1.6% ±3.5, p=0.048), with statistically similar weight change between groups. At wk 16, only C group reduced daily intake of calories (-292.2±505.9 kcal, p=0.016), fat (-13.0±25.4 g, p=0.029), protein (-15.0±26.3 g, p=0.017), and grains (-1.0 ±1.9 oz-equivalents, p=0.027). FO increased daily intake of vegetables (1.0 ±1.6 cups, p=0.019) and protein (2.5±5.1 oz-eq, p=0.05). There was a significant change in protein intake (FO 10.0 ±34.3 g vs. C -15.0 ±26.3 g, p=0.014). Sensitivity analysis of pre-COVID participants showed greater weight loss in FO vs. C (-5.9 ±5.3 lbs, p=0.003;-1.0 ±6.8 lbs, p=0.608). Conclusions: CHO-last food order behavioral counseling led to greater vegetable and protein intake and favorable weight change. Food order can be a useful strategy for weight management. Further study is needed to discern its clinical impact.

The Impact of Socioecological Factors on Health Behaviors and Body Weight: IWCR

Background: The COVID-19 pandemic was associated with negative eating and physical activity behaviors and increased risk of weight gain among US participants enrolled in the International Weight Control Registry (IWCR). This cross-sectional study examined the impact of socioecological factors (individual, interpersonal, and environmental) on changes in eating behaviors, physical activity, and body weight during the COVID-19 pandemic among IWCR participants. Methods: Participants (n=1,121) self-reported data from December 2020 to October 2021. Online questionnaires were used to assess socioecological factors and two hypothesized mediators: Eating Behavior Score (EBS) and Physical Activity Score (PAS), reflecting changes in eating and physical activity during the COVID-19 pandemic. Mediation analyses using ordinary least squares path analysis were used to test whether EBS and PAS mediated the associations between socioecological factors and changes in body weight. Results: An environment with healthier food choices, low discouragement from family and friends, and stronger healthy eating identity were associated with positive EBS, which was in-turn associated with weight loss. Greater support from family and friends and stronger exercise identity were associated with positive PAS, which was in-turn associated with weight loss. The indirect effects of food environment (IE:-0.21;95%CI: -0.37,-0.05), social support (IE:0.20;95%CI: 0.08, 0.32), and healthy eating identity (IE:-1.81;95%CI: -2.27, -1.42) on weight change through EBS were statistically significant, as were the indirect effects of social support (IE:-0.05;95%CI: -0.09, -0.01) and exercise identity (IE:-0.63;95%CI: -0.89, -0.40) on weight change through PAS. Conclusions: Stronger individual identities for healthy eating and exercise, greater social support, and living in an environment with healthier food choices may positively impact eating behaviors and physical activity, ultimately supporting weight management, in the face of the broad challenges faced during the COVID-19 pandemic.

Social-Ecological Factors Predict College Students’ Physical Activities and Sedentary Behavior

Guided by the socio-ecological model, the aim of this study was to investigate the predictive strengths of individual, social, and physical environmental factors toward different intensities of physical activity (PA;vigorous PA, moderate PA, walking) and sedentary behavior (SB) among college students. A cross-sectional research design was used. There were 287 college students (Mage = 20.75 ± 2.91;54% female) recruited from a public research university in the Southwestern United States. Participants completed previously validated questionnaires assessing their PA, SB, and perceptions of self-efficacy, social support, and physical environment variables. Correlation and hierarchical regression analyses were performed to examine the associations and the relative contributions of those individual, social, and physical environmental factors to PA and SB, respectively. The findings indicated that self-efficacy, social support from friends, and convenience of using exercise facilities were positively correlated with vigorous PA. Self-efficacy and physical environmental factor such as convenience of using exercise facilities were significantly associated with students’ moderate PA. Physical environmental factors, including convenience of using exercise facilities, satisfaction with neighborhood services, ease of walking to public transportation stop, and detached single-family residence were significantly related to walking, while only detached single-family residence was associated to SB. The results highlight PA interventions may do well to focus on the promotion of individual and environmental variables to increase PA in college students. More evidence is needed to determine the relationships between social ecological factors and SB.

Supporting Future Teachers to Promote Computational Thinking Skills in Teaching STEM—A Case Study

In recent years, teachers in various fields, such as science, mathematics, linguistics and others, have been interested in alternative learning strategies as opposed to traditional activities, in order to help students to examine their learning progress. The integration of computational thinking in teaching activities, after returning to face-to-face activities, can meet the needs of students during the COVID-19 pandemic. In this research, two samples of students in their first year of study were recruited for the teacher training program validation for computational skills in STEM education. The training model offers an explanation for the differences between the following two sets of data: the CT modules used in a substantial number of teacher workshops, and the results obtained, which are closely related to the argument that teachers can support students’ lifelong learning by developing computational thinking activities. The results related to the students’ scores may have contributed to their improvement in computational thinking skills and it could be one of the best examples of how to change the ways of learning about 21st century skills and sustainable education.

Myeloid Sarcoma Mimicking Dental Abscess in a Patient with Chronic Myeloid Leukemia: Diagnostic and Therapeutic Dilemma

Chronic myeloid leukemia (CML) is a hematologic malignancy that has significant improvement in its prognosis after the introduction of tyrosine kinase inhibitors. Transformation to accelerated phase or blast phase can happen. Myeloid sarcoma or chloroma is an uncommon extramedullary disease. It is very unusual for patients with CML to develop myeloid sarcoma. We report a young man with CML in the chronic phase who developed myeloid sarcoma. There were many difficulties in the diagnosis of myeloid sarcoma due to the simulation of other more common conditions like infections and other malignancies. In addition, there are treatment challenges because of lack of standardized treatment. The case shed light on this rare complication, the challenging diagnosis, and its implication in patients with CML.

Estimating the impact of weight management treatments on childhood obesity in England

AimsTrials demonstrate that childhood obesity treatments are effective but to varying degrees. Some treatment programmes are less effective (e.g., lifestyle programmes), while others are deemed more effective but invasive (e.g. bariatric surgery). Yet, we know relatively little about the most effective way to implement childhood obesity treatments at a population level. That is: which children would benefit most from treatment and at what age;and at which management tier (e.g., lower tiers are low cost with greater reach, but less effective, while higher tiers are high cost with low reach, but more effective). The main aim of this work was to estimate the potential impact of weight management treatments and interventions on population prevalence and inequalities in childhood obesity in England.MethodsUsing Health Survey for England data, we created a ‘digital twin’ of the English population and identified children with a range of weight status categories (e.g., obesity and extreme obesity), obesity comorbidities (e.g., physical and mental health conditions), and indicators of heightened risk of cardiovascular disease (e.g., blood pressure and cholesterol). Other risk factors for obesity were also identified using sociodemographic data (e.g., level of deprivation, ethnicity, income and region). Using NICE guidelines for treatment eligibility, we estimated the number of children who would be eligible for each management tier of treatment in England;where tier 1 represents interventions in primary care, tier 2 represents community interventions, tier 3 represents pharmaceutical interventions, and tier 4 represents surgical interventions. In Phase 1 of our analysis, in addition to a universal preventative intervention, we modelled a number of scenarios that represented each management tier of treatment with a range of effect sizes (based on the best available evidence) and for varying levels of uptake. We applied these scenarios individually and in combination, before comparing stepped and staged approaches. We presented Phase 1 of our analyses to a stakeholder group consisting of multi-disciplinary academics, practitioners and experts in childhood obesity treatment. Stakeholders were consulted on reasonable treatment effect sizes, levels of uptake and other model parameters in order that we could better inform our scenarios, and where there were gaps in the evidence base. Following this modified Delphi approach, we revised our assumptions and model parameters and are currently undertaking Phase 2 of our analyses.ResultsAnalyses from Phase 1 showed substantially higher prevalences of obesity and severe obesity, compared to other estimates across all age groups and levels of deprivation. Recent data from the National Child Measurement Programme in England suggest that these prevalences have increased following the Covid-19 pandemic. We have not reported summary findings from Phase 1 of this work here as these findings will be superseded upon completion of Phase 2.ConclusionIn this presentation, I plan to present the latest findings from Phase 2 of this work.

Encuesta Nacional de Tendencias de Fitness en España para 2022 (National Survey of Fitness Trends in Spain for 2022)

This is the sixth edition of the National Surveys of Fitness Trends in Spain, which annually reproduces the methodology of the worldwide surveys endorsed by the American College of Sports Medicine (ACSM). The objective of this study is to identify the main trends in the Spanish fitness sector by presenting the results of the Spanish survey for 2022, as well as comparing the results with those obtained in the national and international surveys for 2021. In addition, the possible impact of COVID-19 on the incorporation of technology in the fitness sector in Spain was also analyzed. The survey was electronically sent to 6551 professionals related to the fitness sector, collecting a total of 520 responses (response rate 7.9%), of which 27.3% were women and 72.7% were men. The five most relevant trends for 2022 were, in that order: “employing certificate fitness professional”, “functional fitness training”, “personal training in small groups”, “personal training” and “exercise and weight loss programs”. The trends in the top-20 in Spain for 2022 were very congruent with those of 2021, both in the number of coincidences (18 common trends) and in the positions occupied (9 common trends within the top-10). As in previous years, there was a greater discrepancy between the Spanish survey for 2022 and the worldwide survey for 2021, with only 13 common trends within the top-20 and only two coinciding trends in the top-10. These findings confirm again, in accordance with previous editions, the stability of trends in the Spanish fitness sector and the progressive divergence with worldwide trends. Alternate :Esta es la sexta edición de las Encuestas Nacionales de Tendencias de Fitness en España, que reproducen de forma anual la metodología de las encuestas internacionales promovidas por el Colegio Americano de Medicina del Deporte (ACSM). El objetivo del presente estudio es identificar las principales tendencias en el sector del fitness español mediante la presentación de los resultados de la encuesta realizada para 2022, así como comparar los resultados con los obtenidos en las encuestas nacional e internacional de 2021. Además, también se analizó el posible impacto del COVID-19 en la incorporación de tecnología en el sector del fitness en España. La encuesta fue enviada electrónicamente a un total de 6551 profesionales relacionados con el sector del fitness recogiéndose un total 520 respuestas (tasa de respuesta de 7.9%), de las cuales un 27.3% fueron mujeres. Las cinco tendencias más relevantes para 2022 fueron, por ese orden: “contratación de profesionales certificados”, “entrenamiento funcional de fitness”, “entrenamiento personal en pequeños grupos”, “entrenamiento personal” y “programas de ejercicio y pérdida de peso”. Las tendencias en el top-20 en España para 2022 fueron muy congruentes con las de 2021, tanto en el número de coincidencias (18 tendencias comunes) como en las posiciones ocupadas (dentro del top-10 hubo 9 tendencias comunes a ambas encuestas). Al igual que en años anteriores, se produjo una mayor discrepancia entre la encuesta española para 2022 y la encuesta internacional de 2021, con sólo 13 tendencias comunes dentro del top-20 y únicamente dos coincidencias en el top-10. Estos hallazgos vuelven a confirmar, en consonancia con ediciones anteriores, la estabilidad de las tendencias en el sector del fitness español y la progresiva divergencia con las tendencias internacionales.Alternate :Esta é a sexta edição das Pesquisas Nacionais de Tendências do Fitness na Espanha, que reproduz anualmente a metodologia das pesquisas internacionais promovidas pelo American College of Sports Medicine (ACSM). O objetivo deste estudo é identificar as principais tendências do setor do fitness espanhol, apresentando os resultados do inquérito realizado para 2022, bem como comparando os resultados com os obtidos nos inquéritos nacionais e internacionais de 2021. Além disso, é também analisou o possível impacto do COVID-19 na incorporaà ão de tecnologia no setor de fitness na Espanha. A pesquisa foi enviada eletronicamente a um total de 6.551 profissionais relacionados ao setor de fitness, obtendo um total de 520 respostas (taxa de resposta de 7,9%), das quais 27,3% eram mulheres. As cinco tendências mais relevantes para 2022 foram, nesta ordem: “contratação de profissionais certificados”, “treino de aptidão funcional”, “treino pessoal em pequenos grupos”, “treino pessoal” e “programas de exercício e emagrecimento”. As tendências dos 20 primeiros na Espanha para 2022 foram muito congruentes com as de 2021, tanto no número de coincidências (18 tendências comuns) quanto nas posições ocupadas (entre os 10 primeiros houve 9 tendências comuns a ambas as pesquisas) . Como nos anos anteriores, houve uma maior discrepância entre a pesquisa espanhola para 2022 e a internacional para 2021, com apenas 13 tendências comuns entre os 20 primeiros e apenas duas correspondências entre os 10 primeiros. Estas constatações confirmam mais uma vez, à semelhança das edições anteriores, a estabilidade das tendências do setor do fitness espanhol e a progressiva divergência com as tendências internacionais.

GLOBAL RESEARCH: THE JOURNAL OF THE HEALTH VISITORS' ASSOCIATION

The study could help policymakers amend interventions that improve vaccine confidence, as well as help public health organisations better tailor their communications. bit.ly/JSTP_behaviour_ vaccine_hesitancy ITALY AIR POLLUTION LINKED TO HEIGHTENED RISK OF AUTOIMMUNE DISEASE Long-term exposure to air pollution may be linked to an increased risk of autoimmune disease, including rheumatoid arthritis, research published in RMD Open has found. Long-term exposure to traffic and industrial air pollutants was associated with an approximately 40% higher risk of rheumatoid arthritis, a 20% higher risk of inflammatory bowel disease, and a 15% higher risk of connective tissue diseases. bit.ly/RMDO_pollution_autoimmune_disease NORWAY FAMILY-BASED TREATMENT OF CHILDREN WITH SEVERE OBESITY IMPROVES WEIGHT LOSS Family-based behavioural social facilitation treatment (FBSFT), delivered at an obesity outpatient clinic, improved weight-related outcomes significantly more than treatment as usual (TAU) among children aged six to 18 years with severe obesity, a study has found. Children receiving FBSFT reduced their body mass index standard deviation score and percentage above the International Obesity Task Force cut-off for overweight significantly more than children enrolled in TAU. bit.ly/CO_family_children_obesity NORWAY WOMEN EXPOSED TO ADVERSE CHILDHOOD EXPERIENCES MORE LIKELY TO DEVELOP MS Childhood trauma could be linked to an increased risk of women developing multiple sclerosis (MS) later in life, research suggests.

Did New York City Diabetes Prevention Programs Suffer or Succeed during COVID-Pandemic Lockdowns?

Pandemic restrictions may have affected in-person health education such as the CDC's Diabetes Prevention Program (DPP) . We interviewed staff from New York City (NYC) DPPs to a) document if/how DPPs adapted and served participants during pandemic lockdowns, and b) identify successes and challenges to operating remotely. Interviewees were lifestyle coaches and DPP coordinators representing a public hospital, a national weight loss program, a healthcare center, a community based organization, a health insurance company, a faith-based DPP, and a network of federally qualified health centers. DPPs served participants in Manhattan, Brooklyn, Queens, and the Bronx. Zoom interviews (1hr) were recorded and transcribed. Interviewees received a $50 gift card.DPP host organizations continued to provide DPP services during the pandemic and experienced a number of successes and challenges (Table) . NYC DPPs suffered greatly during COVID-lockdowns and limits on social gathering because they and their participants were unprepared for virtual classes. However, most were successful due to resilient, dedicated, and extraordinarily creative staff. The pandemic highlighted opportunities for successful virtual DPPs in the urban setting, and the need for more robust funding mechanisms, staff support, and technical assistance to ensure sustainability and scalability of the DPP.