ObjectiveTo evaluate the weight loss efficacy of a novel mobile platform delivering the Diabetes Prevention Program.Research Design and Methods43 overweight or obese adult participants with a diagnosis of prediabetes signed-up to receive a 24-week virtual Diabetes Prevention Program with human coaching, through a mobile platform. Weight loss and engagement were the main outcomes, evaluated by repeated measures analysis of variance, backward regression, and mediation regression.ResultsWeight loss at 16 and 24 weeks was significant, with 56% of starters and 64% of completers losing over 5% body weight. Mean weight loss at 24 weeks was 6.58% in starters and 7.5% in completers. Participants were highly engaged, with 84% of the sample completing 9 lessons or more. In-app actions related to self-monitoring significantly predicted weight loss.ConclusionsOur findings support the effectiveness of a uniquely mobile prediabetes intervention, producing weight loss comparable to studies with high engagement, with potential for scalable population health management.
ObjectiveTo determine the effectiveness of controlling maternal gestational weight gain in the second and third trimesters on neonate body composition.Methods210 healthy women with overweight (BMI ≥ 25 < 30) or obesity (BMI ≥30 kg/m2) randomized to a lifestyle intervention (LI) program focused on controlling gestational weight gain through nutrition and activity behaviors or to usual obstetrical care (UC). Infant fat and fat-free mass at birth were measured by air displacement plethysmography (PEAPOD) and by quantitative magnetic resonance (QMR).ResultsAt baseline, there were no between group differences in maternal characteristics (mean (±SD)): age 33.8 (±4.3) years, weight 81.9 (±13.7) kg, BMI 30.4 (±4.5) kg/m2, gestational age at randomization 14.9 (±0.8) wk. GWG was less in the LI group by 1.79 kg (p=0.003) or 0.0501 kg/wk (p=0.002). Compared to UC, LI infants had greater weight (131±59 g p=0.03), fat-free mass (98±45 g; p=0.03) by PEAPOD, and lean mass (105±38 g; p=0.006) by QMR. Fat mass and percentage fat were not significantly different.ConclusionIntervening in women with overweight and obesity through behaviors promoting healthy diet and physical activity to control gestational weight gain resulted in neonates with similar fat and greater fat-free mass.
Fetal body composition is an important determinant of body composition at birth, and it is likely to be an important determinant at later stages in life. The purpose of this work is to provide a comprehensive overview by presenting data from previously published studies that report on body composition during fetal development in newborns and the infant/child through 5 years of age. Understanding the changes in body composition that occur both in utero and during infancy and childhood, and how they may be related, may help inform evidence-based practice during pregnancy and childhood. We describe body composition measurement techniques from the in utero period to 5 years of age, and identify gaps in knowledge to direct future research efforts. Available literature on chemical and cadaver analyses of fetal studies during gestation is presented to show the timing and accretion rates of adipose and lean tissues. Quantitative and qualitative aspects of fetal lean and fat mass accretion could be especially useful in the clinical setting for diagnostic purposes. The practicality of different pediatric body composition measurement methods in the clinical setting is discussed by presenting the assumptions and limitations associated with each method that may assist the clinician in characterizing the health and nutritional status of the fetus, infant and child. It is our hope that this review will help guide future research efforts directed at increasing the understanding of how body composition in early development may be associated with chronic diseases in later life.
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