Author: slquinlan

Researchers at the University of Georgia have shown that a simple intervention – daily self-weighing – can help people avoid holiday weight gain.

Participants in a 14-week UGA study who weighed themselves daily on scales that also provided graphical feedback showing their weight fluctuations managed to maintain or lose weight during and after the holiday season, while a control group gained weight.

Researchers speculate that participants’ constant exposure to weight fluctuations – along with being able to see a target or goal weight line (their baseline weight) – motivated behavioral change that led to weight maintenance, or in the case of overweight subjects, weight loss.

“Maybe they exercise a little bit more the next day (after seeing a weight increase) or they watch what they’re eating more carefully,” said study author Jamie Cooper, an associate professor in the FACS department of foods and nutrition within the UGA College of Family and Consumer Sciences. “The subjects self-select how they’re going to modify their behavior, which can be effective because we know that interventions are not one-size-fits-all.”

After determining their baseline weight prior to the holidays, participants in an intervention group were told to try not to gain weight above that number, but with no additional instructions as to how to accomplish this goal.

Participants in the control group were given no instructions. A total of 111 adults between the ages of 18 and 65 participated in the study.

Michelle vanDellen, an associate professor in the UGA Department of Psychology and second author on the paper, said the findings support discrepancy theories of self-regulation.

“People are really sensitive to discrepancies or differences between their current selves and their standard or goal,” she said. “When they see that discrepancy, it tends to lead to behavioral change. Daily self-weighing ends up doing that for people in a really clear way.”

Daily self-weighing also has been shown to be effective in preventing weight gain in college freshmen in previous research, but researchers wanted to apply it to another historically dangerous time for weight gain.

With the average American reportedly gaining a pound or two a year, overeating during the holiday season has been identified as a likely contributor to small weight gains that add up over time and can lead to obesity.

“Vacations and holidays are probably the two times of year people are most susceptible to weight gain in a very short period of time,” Cooper said. “The holidays can actually have a big impact on someone’s long-term health.”

Cooper said future research may investigate if daily self-weighing alone – without the graphical feedback – is the driving force behind the behavioral changes that led to weight maintenance.

The fact that subjects knew researchers would be accessing their daily weight data also could have contributed to behavioral change, she said.

What seems clear is the intervention is effective, largely because of its simplicity and adaptability.

“It works really well in the context of people’s busy lives,” vanDellen said. “The idea that people might already have all the resources they need is really appealing.”

The paper, “Daily self-weighing to prevent holiday-associated weight gain in adults,” can be viewed at https://onlinelibrary.wiley.com/doi/10.1002/oby.22454

Sepideh Kaviani of the University of Georgia is first author on the paper.

Researchers at the University of Georgia are using a new statistical model to help guide policy around food access in rural communities.

The study authors wanted to know what conditions needed to be right to increase fruit and vegetable consumption in a rural setting.

The question of how to improve access to fruits and vegetables or even whether increased access translates into higher fruit and vegetable consumption has historically been hard to answer, said corresponding author Janani Thapa, an assistant professor of health policy and management at UGA’s College of Public Health.

“If we know anything, we know that changing behavior is complex, and there isn’t a straight-shot solution,” she said.

Convincing people to add more fruits and vegetables into their daily routine is often met with a variety of barriers, ranging from cost to cultural norms.

Though countless interventions and best practices have been developed to address issues around obesity and access to healthier foods, it can be expensive to get a project off the ground.

And with so many variables at play that could spell an effort’s success or failure, how can rural communities know they are using their resources wisely?

To answer this question, Thapa and her team turned to a new computational technique that can simulate a real-world intervention.

The agent-based model was developed to take into account all the details that can determine a person’s likelihood to engage in a certain behavior, including demographic information, the food local environment, and even health beliefs.

Using participant data from a previous study based in a rural Texas community, the researchers used their model to predict whether they could increase fruit and vegetable consumption by decreasing the driving distance to get to the produce source.

It turns out that they could.

“We found that a five-mile decrease could lead to a 25% increase in fruit and vegetable consumption,” said Thapa.

That doesn’t mean a community has to build a whole new grocery store, she added. That produce source could be something simple, like a farm stand.

The study suggests that this type of modeling can be a cost-effective way to evaluate and guide policymaking around diet-related interventions in rural areas, and Georgia is next.

Thapa and collaborators have begun collecting the data to run a similar simulation in rural Georgia, where they hope their findings will guide residents and policymakers in making changes to improve the health of their community.

Co-authors include Nicole Katapodis and Donglan Zhang with the University of Georgia; Phillipe Giabbanelli with Furman University; Yan Li with the New York Academy of Medicine; and Conrad Iyford with Texas Tech University.

The study appeared in the recent issue of Health Equity and is available online here.

– Lauren Baggett

Posted on August 1, 2019.

A new study from the University of Georgia has found that feeling overworked contributes to a variety of unhealthy behaviors that can cause weight gain.

Results from the study published in the Journal of Health Psychology point to the role work stress can play in our ability to adopt the necessary strategies to maintain a healthy weight.

“We have so many things coming at us every day, and we only have so much energy,” said lead author Heather Padilla, faculty member and researcher in the Workplace Health Group at UGA’s College of Public Health.

Heather Padilla

“When our energy gets used up, we don’t have the energy to make ideal decisions about what we eat.”

When work gets in the way of wellness
Despite the growing presence of workplace-based wellness and weight management programs, over two-thirds of working adults are overweight or obese.

Most worksite programs focus on things like nutrition education, access to healthy foods or access to a gym.

Job demands are rarely, if ever, incorporated into weight loss interventions.

Padilla and her colleagues began to wonder if work stresses might be depleting the mental and physical energy employees needed make changes to their diets or fit in a workout.

So, she decided to look at how workload and burnout impact a person’s nutrition and physical activity choices.

Lacking the energy to make healthy choices
The researchers recruited 1,000 men and women working in full-time jobs to answer questions about their workloads and exhaustion or burnout. They were also asked to report their eating and exercise habits.

The results of their analysis showed that employees with heavier workloads were more likely to emotionally eat, eat without stopping, and reach for fattier foods, and those who were burned out tended to do the same and exercise less.

“Anecdotally, the findings aren’t shocking,” said Padilla, but she said they do point to a greater need to understand how job demands affect issues like obesity.

“We spend so many of our waking hours at work,” she said. “These findings require us to think about how our work affects our health behaviors and self-care.”

Co-authors include Mark Wilson, Robert Vandenberg, Marsha Davis and Malissa Clark.

Childhood obesity is now a global epidemic, and researchers worldwide are searching for sustainable interventions that may halt its progress.

Now, a team of researchers from Fudan University in Shanghai, China, and the University of Georgia have shown that one comprehensive obesity intervention, which integrates family and school participation to encourage healthy eating and exercise habits, can reduce rates of obesity long-term.

The researchers assessed changes to the children’s body mass index one, two and three years following the conclusion of the three-year intervention program.

The initial intervention was based in Shanghai where childhood obesity prevalence ranges between 10 and 15 percent, says Donglan Zhang, one of the study’s authors.

“If you look at childhood obesity problems in China’s megacities, it’s comparable to the U.S.,” said Zhang, who studies health policy at UGA’s College of Public Health.

“This is due to economic development and due to a transition in dietary behaviors. There is a Westernization of food and eating behaviors in China’s big cities.”

The intervention sought to introduce healthy eating behaviors at an early age when habits begin to form.

Like many obesity programs, the intervention began at school. It introduced nutrition education into the classroom, revamped the lunchroom options and established regular exercise for students. The innovation of the program lies with what happened once the students returned home. Acknowledging the role of the home environment, the intervention also trained the students’ parents to support healthy eating habits and exercise outside of school.

The comprehensive nature of the intervention is unique, says Zhang.

“This model in particular recognizes that reducing the obesity rate is not just the responsibility of one institution or environment,” she said. “It should be a joint effort from schools, from families, from communities all together because kids have a lot of [food] environments they’re exposed to.”

In all, almost 1,000 first-grade boys and girls participated in the program. At the end of three years, the program succeeded in helping overweight or obese children lose weight, and it helped children with a healthy weight maintain it.

This is where the story ends for most childhood obesity intervention studies, says Janani Thapa, also with UGA’s College of Public Health. Thapa specializes in childhood obesity interventions and policy.

“What we see in most interventions is a checkmark pattern. The weight tends to decline, and then after the project period ends, we’ll see the weight go back up,” she said.

But that’s not what happened in the three years following the Shanghai intervention.

At each follow-up, the students who participated in the program continued to maintain a healthy BMI compared with students who were not part of the intervention. The effect was even more prominent among girls.

“The current study suggests that it probably requires a minimum of two years to demonstrate a lasting effect,” said Thapa.

Though this work describes the success of an intervention in one setting, the authors say the evidence is strong enough to suggest it could be translated to other settings like the U.S.

“There is the nutrition intervention, there is the physical activity intervention, there are few that have done both,” Thapa pointed out. “The next step would be to try to do the FIS model here in the U.S., and maybe others are trying to do it across the world.”

The study, “A cohort study assessing the sustainable long-term effectiveness of a childhood-obesity intervention in China,” published in the latest International Journal of Epidemiology. It is available online here.

Co-authors include Zhijuan Cao, Jing Hua and Shumei Wang.

– Lauren Baggett

Posted on November 26, 2018.

Most children in the U.S. do not eat enough fruits and vegetables, some eating less than one serving of fruits and vegetables a day, according to the Centers for Disease Control and Prevention. Though there are multiple federal-level policies in place to ensure healthy options in school lunchrooms, these measures can’t guarantee that kids will choose the fruit or vegetable option, let alone eat it.

Now, new research from the University of Georgia suggests that fun can motivate kids to try new foods at lunchtime and ultimately eat more fruits and vegetables.

“There are many ways fun can be brought into the lunchroom,” said Janani Rajbhandari-Thapa, assistant professor of health policy and management at UGA’s College of Public Health and lead author on the study. “The lunchroom is not always thought of as a place where fun can be incorporated.”

Food marketers have been harnessing the power of play and fun for decades. Anyone who has seen an advertisement for kids’ foods—from Happy Meals to cereal—is familiar with how these companies use kid-friendly images and toys to make their products more appealing to children.

Public health interventions are beginning to adopt these tactics by associating healthy foods with kid-friendly images and objects, said Thapa.

Thapa’s study used stickers and small, inexpensive toys to incentivize kids at two low-income elementary schools to choose and eat more servings of fruits and vegetables. Over two weeks, Thapa and her team offered a token to students who selected and ate a fruit or vegetable serving that could be redeemed for a toy.

The students ate 2 1/2 times more servings of fruits and vegetables when the stickers and toys were introduced than they did before the study began.

The important question was whether the students would continue to select and eat more fruits and vegetables after the stickers went away. Thapa designed her intervention so that kids would try new foods and hopefully develop a taste for them.

“After the intervention, they went back to their original lunchroom environment, and we still saw an effect,” said Thapa, suggesting that the students formed a new eating habit that would stay with them for the long term.

Helping kids make the healthier choice in the split second it takes to grab an apple or a cookie is the philosophy of the smarter lunchroom approach, which uses simple, low-cost changes to the lunchroom that will help children make healthier choices.

It’s important to know how effective these policies are, said Thapa, especially in areas where the school is potentially the only place where students can access fresh, healthy foods. The lunchroom plays a vital, day-to-day role in students’ eating habits, and she would like to see more schools incorporate healthy eating interventions into the lunchrooms.

“Having this fun type of atmosphere and learning environment can promote healthy consumption as well as teach them at the same time,” said Thapa.

Thapa is one of eighteen researchers who has received grants from the Cornell Center for Behavioral Economics in Child Nutrition Programs to evaluate Smarter Lunchroom Movements nudge techniques, and she plans to do more studies.

The study, “Nudges to Increase Fruits and Vegetable Consumption: Results from a Field Experiment” appeared in the Journal of Child Nutrition and Management. It is available online here.

Conrad P. Lyford was a co-author on this study.

– Lauren Baggett

Posted on May 29, 2018.

Almost one in three 10-year-olds in Georgia is overweight or obese. With childhood obesity on the rise across the U.S., states and other stakeholders have been exploring policies that may help curb its growth.

A recent study from the University of Georgia has shown that training school cafeteria staff in smarter lunchrooms concepts is a promising first step.

“Federal-level policy makes sure the health foods are served in the school lunchroom, but being served doesn’t translate into being consumed,” said Dr. Janani Thapa, assistant professor of health policy and management at University of Georgia College of Public Health and lead author on the study.

“That’s where the smarter lunchroom idea kicks in, asking can we do basic, low-cost steps that translate nutrition being served into nutrition being consumed.”

Children’s Healthcare of Atlanta’s Strong4Life School Nutrition Program teaches school nutrition managers and staff members how to make changes in the lunchroom that will “nudge” children to make healthier choices. Based partly on marketing principles, the approach aims to make the healthier choices easier to make.

“The steps are as simple as changing where plain milk versus chocolate milk is placed in the lunchroom affects how kids make their choices,” said Dr. Thapa.

Displaying plain milk in front of the other milks in the cooler, for example, has been found to increase the consumption of plain milk. Smarter lunchrooms aim to promote healthy eating one small change at a time, adding up to major reductions in sugar and sodium consumption.

Strong4Life developed a training kit based on smarter lunchroom strategies and launched in-person training for over 800 Georgia public school nutrition managers and staff in 2015. The program packages proven smarter lunchroom techniques into five focus areas that managers can apply easily at no or low cost.

Dr. Thapa’s study evaluated how well the training worked in educating lunchroom staff as well as empowering them to make changes. She found that the majority staff members retained key smarter lunchroom principles three months after receiving training, and most felt capable of applying the techniques in their schools.

Following the training, over 325 staff reported already making significant changes to their lunchroom environment. One fifth had moved plain milk in front of flavored milks, juice and sports drinks in drink coolers, while 12 percent of cafeterias were using signs or stickers to identify healthy choices, and up to 14 percent of lunchrooms were offering some form of price incentives for heathy foods.

It’s important to know how effective these policies are, says Dr. Thapa, especially in areas where the school is potentially the only place where students can access fresh, healthy foods. Yet, the availability of healthy foods is moot if kids aren’t eating it.

“Training school lunchroom staff is just one step in a larger effort to make our school lunchrooms and health eating attractive to kids,” she said