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www.clinicaltrials.gov #NCT01603550.

In healthy young men and women, 2 d of severe calorie deprivation in combination with substantial aerobic exercise adversely affects multiple aspects of mood, but not cognition, in spite of substantial reductions in interstitial glucose concentrations. This trial was registered at clinicaltrials.gov as NCT01603550.

IntroductionEffective, standardized, and easily accessible weight management programs are urgently needed for military beneficiaries. Videoconference interventions have the potential for widespread scaling, and can provide both real time interaction and flexibility in delivery times regardless of location, but there is little information on their effectiveness and acceptability.Materials and MethodsThis study as part of a larger weight loss trial describes the videoconference adaption of Group Lifestyle Balance (GLB) program, a community group-based Diabetes Prevention Program intervention, and provides a comparison of weight loss and meeting attendance between in-person and videoconference delivery modes over 12 weeks in adult family members of military service members. Forty-three participants were enrolled from two military installations and received either the videoconference-adapted or an in-person GLB program in a non-randomized trial design. Differences in program attendance and percent weight lost at 12 weeks were compared by independent samples t-tests and nonparametric methods. Group differences in the percentage of weight lost over the 12-week period were analyzed using a linear mixed model.ResultsAll GLB intervention components were successfully delivered by videoconference with minor adaptations for the different delivery mechanism. Participant retention was 70% and 96% in the in-person and videoconference groups, respectively (p = 0.04). Completing participants in both groups lost a significant percent body weight over the 12 week intervention (p < 0.001) and there was no difference in percent body weight after 12 weeks of intervention (6.2 ± 3.2% and 5.3 ± 3.4% for in-person and videoconference at 12 weeks, respectively; p = 0.60).ConclusionThis study describes the first videoconference adaption of the GLB program for use in military families. Attrition was lower in the videoconference group, and there were a similar levels of weight loss in both groups regardless of delivery modality. Videoconference weight loss interventions are effective and feasible for scaling to support healthy weight management in military as well as civilian populations.

BACKGROUND: Caffeine-containing products and dietary supplements are widely used by military populations, but little is known about their use by aviation personnel. This study assessed self-reported sleep, fitness, work-schedules, and caffeine/energy drink use.METHODS: A standardized survey was conducted in person by study personnel using tablet computers. A total of 188 aircrew members from the Combat Aviation Brigade at Fort Campbell, KY, participated in the survey. Focus groups were conducted with a subset of 47 subjects.RESULTS: The majority of subjects reported their physical fitness, health, and diets were good. They reported sleeping about 6 h per day and stated they needed additional sleep to feel fully rested. Their caffeine consumption averaged 346 ± 23 mg · d−1 with most derived from coffee (139 ± 12 mg · d−1) and energy drinks (110 ± 13 mg · d−1). About half (55%) of participants used energy drinks at least once per week and they consumed greater amounts of caffeine than nonusers. Focus group data indicated crewmembers primarily consumed energy drinks to enhance performance degraded by variations in work schedules and lack of sufficient sleep. Participants expressed a desire for additional education on diets and energy drinks as well as on aeromedical policies governing energy drink and supplement use.CONCLUSIONS: Caffeinated products, including coffee and energy drinks, are routinely used by Army aircrews to increase alertness. Aircrew personnel consider them generally safe, but would like to receive education about these beverages, other dietary issues, and Army policies governing their use in aircrew.Bukhari AS, Caldwell JA, DiChiara AJ, Merrill EP, Wright AO, Cole RE, Hatch-McChesney A, McGraw SM, Lieberman HR. Caffeine, energy beverage consumption, fitness, and sleep in U.S. Army aviation personnel. Aerosp Med Hum Perform. 2020; 91(8):641–650.

Background Lifestyle interventions are the first-line treatment for obesity, but participant weight loss is typically low. Objectives We evaluated the efficacy of an alternative lifestyle intervention [Healthy Weight for Living (HWL)] compared with a modified Diabetes Prevention Program (m-DPP). HWL was based on a revised health behavior change model emphasizing hunger management and the development of healthy food preferences. m-DPP was a standard Diabetes Prevention Program implemented with counselor time matched to HWL. Participants were adult dependents of military personnel and had overweight or obesity. Methods Participants were randomly assigned to HWL (n = 121) or m-DPP (n = 117), delivered primarily by group videoconference with additional midweek emails. The primary outcome was 12-mo weight change. Secondary outcomes included 6-mo changes in cardiometabolic risk factors and diet. Intention-to-treat (ITT) and complete case (CC) analyses were performed using linear mixed models. Results Retention did not differ between groups (72% and 66% for HWL and m-DPP at 12 mo, respectively; P = 0.30). Mean ± SE adjusted 12-mo weight loss in the ITT cohort was 7.46 ± 0.85 kg for HWL and 7.32 ± 0.87 kg for m-DPP (P = 0.91); in the CC cohort, it was 7.83 ± 0.82 kg for HWL and 6.86 ± 0.88 kg for m-DPP (P = 0.43). Thirty-eight percent of HWL and 30% of m-DPP completers achieved ≥10% weight loss (P = 0.32). Improvements in systolic blood pressure, LDL cholesterol, triglycerides, fasting glucose, general health, sleep, and mood were similar across groups; improvements in diastolic blood pressure were greater in m-DPP. Adjusted group mean reductions in energy intake were not significantly different between groups, but HWL participants were more adherent to their dietary prescription for lower glycemic index and high fiber and protein (P = 0.05 to &lt;0.001 for ITT). Conclusions HWL and m-DPP showed equivalent and clinically impactful mean weight loss with cardiometabolic benefits. These results identify an alternative approach for behavioral treatment of overweight and obesity. This trial was registered at clinicaltrials.gov as NCT02348853.

Background Stressors inherent to the military, such as combat exposure, separation from family, and strenuous training, collectively contribute to compromised psychological resilience and greatly impact military performance. Methods This retrospective review of records was conducted to determine whether vitamin D status was associated with diagnoses of depression and if diagnoses differed by geographic location. Results Depression (defined using diagnostic codes) was more prevalent in individuals who were diagnosed with vitamin D deficiency (20.4%) than in individuals who were not (4.2%). After adjustment, vitamin D deficient diagnoses remained significantly associated with depression diagnoses (OR = 1.22; 95% CI, 1.11–1.33, p < 0.001). Furthermore, vitamin D deficient diagnoses were strongly associated with geographic latitude (r2 = 0.92, p = 0.002). Conclusion These results suggest that service members stationed at installations located at northerly latitudes may be at increased risk for vitamin D deficiency. Furthermore, vitamin D deficient service members may be at higher risk for diagnosis of depression. As a number of military service members avoid reporting symptoms or seeking treatment, vitamin D status may be a useful screening tool to identify service members at risk for depression.