BMI has high specificity but low sensitivity to detect excess adiposity and fails to identify over a quarter of children with excess body fat percentage.

The overweight and obesity trends have risen over the past few decades placing significant burdens on healthcare in terms of increased morbidity and cost. Behavioral change therapy is an effective treatment strategy and includes goal setting, self-monitoring, problem solving, and reinforcement tactics. Traditionally, behavior change therapy has been delivered using face-to-face counseling along with paper and pen recording of dietary intake and physical activity. The current advances in technology provide opportunities to deliver interventions using cellphones, internet and active video games. These new methods to deliver behavior change for the management and prevention of obesity are being developed in order to increase access, improve convenience, decrease cost and increase participant engagement. In this review, we present new approaches to promote behavior changes in the management of obesity. Currently available data shows promising results. However, future research is needed to address study limitations and implementation challenges of these innovative interventions.

IntroductionParticipation in regular physical activity (PA) may help maintain bone health as people age. However, most American adults do not engage in the recommended minimum levels of PA, and there are racial/ethnic differences in PA participation. This study aimed to determine whether current physical activity is related to bone density in a racially/ethnically diverse sample after controlling for age, sex, body mass index, poverty–income ratio, tobacco use, vitamin D and calcium intake, and use of osteoporosis medications.MethodsWe obtained data on femoral bone mineral density for 2,819 adults aged 40 to 80 years who self-reported their race/ethnicity on the 2007–2008 National Health and Nutrition Examination Survey. Data on PA levels were obtained by self-report. We used linear regression models to examine the association between PA and bone density for each racial/ethnic group.ResultsA greater percentage of non-Hispanic blacks (60.9%) and Hispanics (53.3%) reported low levels of PA than non-Hispanic whites (45.3%, P < .001). Non-Hispanic blacks (16.3%) and Hispanics (18.5%) had a lower prevalence of osteopenia than non-Hispanic whites (25.5%; P = .01) but were similar in the prevalence of normal and osteoporosis categories when compared with whites. There was a 0.031 g/cm2 difference in bone density between those in the high PA versus the low PA category (P = .003). This association remained (β = 0.027, P < .001) after adjusting for race/ethnicity, sex, body mass index, poverty–income ratio, tobacco use, and use of osteoporosis medications.ConclusionDespite lower levels of activity, blacks and Hispanics were not more likely to have osteoporosis, and high levels of activity were significantly associated with higher bone density even when controlling for race/ethnicity and confounders. The lack of consistency in bone density differences suggests that the cause of the differences maybe multifactorial.

Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis.