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Beverages: Making Every Sip Count for Families
SUNDAY, SEPTEMBER 25
RESEARCH & PRACTICE INNOVATIONS: STRATEGIES FOR LIFESTYLE CHANGES (PART 1) Project Healthy Schools Positively Impacts Middle School Students’ Lifestyles
Dietitian and the Media - An Innovative Lifestyle Intervention Program
Author(s): C. M. Fitzgerald,1 J. DuRussel-Weston,1 S. Aaronson,1 L. R. Mitchell,1 L. Palma-Davis,1 B. Rogers,2 R. Gurm,2 C. Goldberg,3 K. A. Eagle3; 1 MHealthy, University of Michigan Health System, Ann Arbor, MI, 2MCORRP, University of Michigan Health System, Ann Arbor, MI, 3Cardiology, University of Michigan Health System, Ann Arbor, MI
Author(s): K. McQueen,1 S. Ratner1,2; 1Healthy Heart Program, St. Paul’s Hospital, Vancouver, BC, Canada, 2Healthy Heart Program, St. Paul’s Hospital, Vancouver, BC, Canada
Learning Outcome: Learners will be able to list multiple ways to affect the school environment to establish healthier eating and activity among students. Background: Recognition of the need to fight the battle against childhood obesity led to the development of Project Healthy Schools (PHS) in 2004. PHS, a community-University of MI collaborative works to reduce childhood obesity and its long-term health risks. PHS integrates sociocognitive and ecological theoretical approaches to changing health-risk behaviors, encouraging healthy habits through education, environmental change, and measurement. Interventions are based on five goals: Eat more fruits/vegetables; Make better beverage choices; Exercise at least 150 minutes each week; Eat less fast/fatty foods; Spend less TV/computer time. Methods: The program includes identifying a school wellness champ, 10 handson classroom activities, creation of school health teams, incentives rewarding behavior change, cafeteria and policy changes. Over 9000 sixth graders participated; almost 2000 of these in research. PHS expanded from one to 15 schools replicating interventions with diverse populations; adjusting to fit each unique setting. Innovative strategies include a Farm to School Program connecting students, healthy foods and local farmers; a volunteer program where university students and parents are trained to provide PHS activities; development of a tool kit for program replication and a program sustainability plan. Results: Pre-and post data collected from students followed for four years shows improvements in heart disease risk factors (total/LDL cholesterol, blood pressure). Students at highest risk appear to get the most benefit. Surveys indicate evidence of adoption of healthier lifestyles with increased consumption of fruits/vegetables and time exercising.
Learning Outcome: The learner will become aware of the novel role for the dietitian in the media in the area of lifestyle changes. The Healthy Heart Program dietitians at St. Paul’s Hospital, Vancouver, Canada, were approached by a National based television station to consult for a six month Diet and Exercise Lifestyle Intervention Program. Ten males, eleven females, ages 19-65, average Body Mass Index 30.1, waist circumference 94.4 cm, were selected by the news reporter and randomized to Glycemic Index, Weight Watchers, Online Food Tracker or Blue Menu Superstore diets. All attended weekly exercise classes and monthly group nutrition classes with the dietitian. Anthropometric measurements were taken. Additional dietary support provided as per diet plan. Participants were followed and stories aired weekly. Nutrition education handouts and recipes were posted on the reporter’s blog. Dietary questionnaires were completed at six months and eighteen months. Average weight loss was 9.3 kg with no significant difference between diets. Main dietary improvements were portion sizes/control, decreased junk foods and increased fruits and vegetables. Only one participant stated that being on TV influenced weight loss. At eighteen months 17/21 completed the dietary questionnaire, 11/21 were weighed and maintained weight loss. Most adhered to the lifestyle modifications made. This program provided a unique opportunity and media exposure for the dietitian. Although all were on commercial weight loss plans, basic nutrition principles were key to both weight loss and maintenance. The dietitian enhanced the importance of healthy eating habits, resulting in long term lifestyle changes. Funding Disclosure: None
Conclusion: Outcomes encourage us to make PHS available to more students, especially high risk populations. Funding Disclosure: FNDTNS: Allen, Am. Heart Assoc., Ann Arbor Community, Atkins, Galens, Thompson, SE MI. CORPS: Borders, Harvard Drug Grp., NuStep, Pfizer Community/Pfizer Global Research, S.I. Co.,UM Health System, UM Medical School. INDIV: L. Hoensheid, A. Sarkar.
Beverages: Making Every Sip Count for Families Author(s): T. P. Robertson,1 D. Robinson,2 T. Bryars,3 A. Luciano2; 1 Dairy Council of California, Irvine, CA, 2Nutrition Services, Orange County Health Care Agency, Santa Ana, CA, 3Healthy for Life, Saint Joseph’s Health Care, Fullerton, CA Learning Outcome: Participants will be able to tailor the tip sheet which promotes water, low-fat milk, and 100% juice, identifies how to read a beverage label, presents appropriate portion reference and provides a list of choose more and choose less often beverages. Background: A Rethink Your Drink (RYD) nutrition education initiative was implemented in Orange County, California to combat obesity by helping residents make healthy beverage choices. The project is an initiative of Orange County Nutrition and Physical Activity Collaborative (NuPAC) and the RYD workgroup and is led by the Network for a Healthy California-Orange County Region. One of the four RYD objectives focused on teaching a wide variety of individuals to use calorie, serving size and sugar content information to evaluate beverage choices. Methods: The workgroup determined there was a need to develop a onepage, low-literacy handout that clearly addressed key education messages as well as barriers to choosing healthier options. Four focus groups were conducted with English and Spanish-speaking parents to identify their concerns. Results: The final RYD handout incorporated a graphic design that presented: 1) a food label highlighting factors to consider on beverage containers, 2) a graphic of an 8-ounce cup, drawn to scale, teaching portion size, 3) a “Drink more often/Drink less often” table to help with goal setting and 4) a section addressing questions commonly asked by parents. The handout was well-received by both educators and audiences of all ages. Conclusion: The handout complements traditional nutrition lessons and clinical counseling and has been successfully used at health fairs and events. Many partners joined together to print nearly 150,000 handouts at a cost-effective, bulk rate price. English, Spanish and Vietnamese versions of the handout can be downloaded from the Dairy Council of California’s website at: www.dairycouncilofca.org/Tools/Downloads/Nutrition_ed.aspx.
Efficacy of Commercial Web-Based Weight Loss: A Randomized Controlled Trial Comparing Programs with Basic Versus Enhanced Features Author(s): C. E. Collins,1 P. J. Morgan,2 P. McElduff,3 R. Callister4; 1School of Health Sciences, The University of Newcastle, Callaghan, Australia, 2School of Education, The University of Newcastle, Callaghan, Australia, 3Hunter Medical Research Institute, School of Medicine and Public Health, The University of Newcastle, Rankin Park, Australia, 4School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, Australia Learning Outcome: Understand the impact that a 12 week web-based weight loss intervention can have on weight change in adults. Innovative approaches to obesity treatment are required given the increasing prevalence and associated health consequences. The aim was to investigate the impact of a 12-week commercially available web-based program, The Biggest Loser Club Australia, on weight loss outcomes in an RCT. Participants (n⫽309, 42% male) were recruited and randomized to a basic online program (B), an enhanced online program which provided additional prompts and personalized feedback (E), or a 3-month wait-list control (C). Height, weight and waist circumference were objectively measured. Mean (⫾SD) age was 42y (⫾10), BMI 32.3 kg/m2 (⫾4), weight 94.0kg (⫾14.6), waist circumference 98.2cm (⫾11.5) and waist-to-height ratio 0.58 (⫾.06). Participants undertook the 12-week online weight loss program between October 2009 and March 2010. Using an intention-to-treat analysis, both intervention groups lost weight while the control group gained weight; B⫽ ⫺2.1kg (⫾3.3), E⫽ ⫺3.0kg (⫾4.1), C⫽ ⫹0.4kg (⫾2.3), P⬍0.0001; with changes in BMI of B ⫽ ⫺0.72 kg/m2 (⫾1.1), E⫽ ⫺1.0(⫾1.4), C⫽ ⫹0.15 (⫾0.82), P⬍0.0001; waist circumference B⫽ ⫺2.0cm (⫾3.5), E⫽ ⫺3.2 (⫾4.7), C⫽ ⫹0.5 (⫾ 3.0), P⬍0.0001 and waist-to-height ratio, B⫽ ⫺0.01 (0.02), E⫽ ⫺0.02 (0.03), C⫽ 0.0 (0.02), P⬍0.0001. There were no differences between the basic and enhanced versions of the program. The findings indicate that use of a commercial web-based weight loss program can achieve clinically important weight loss over 12 weeks but additional features may not increase the degree of weight loss. There is a need to further examine relationships between usage of specific website program features and weight change. Funding Disclosure: Australian Research Council Linkage Grant with SP Health Co PTY, LTD
Funding Disclosure: Network for a Healthy California, Dairy Council of California
Journal of the AMERICAN DIETETIC ASSOCIATION / A-11
RESEARCH & PRACTICE INNOVATIONS: STRATEGIES FOR LIFESTYLE CHANGES (PART 1) Project Healthy Schools Positively Impacts Middle School Students’ Lifestyles
Dietitian and the Media - An Innovative Lifestyle Intervention Program
Author(s): C. M. Fitzgerald,1 J. DuRussel-Weston,1 S. Aaronson,1 L. R. Mitchell,1 L. Palma-Davis,1 B. Rogers,2 R. Gurm,2 C. Goldberg,3 K. A. Eagle3; 1 MHealthy, University of Michigan Health System, Ann Arbor, MI, 2MCORRP, University of Michigan Health System, Ann Arbor, MI, 3Cardiology, University of Michigan Health System, Ann Arbor, MI
Author(s): K. McQueen,1 S. Ratner1,2; 1Healthy Heart Program, St. Paul’s Hospital, Vancouver, BC, Canada, 2Healthy Heart Program, St. Paul’s Hospital, Vancouver, BC, Canada
Learning Outcome: Learners will be able to list multiple ways to affect the school environment to establish healthier eating and activity among students. Background: Recognition of the need to fight the battle against childhood obesity led to the development of Project Healthy Schools (PHS) in 2004. PHS, a community-University of MI collaborative works to reduce childhood obesity and its long-term health risks. PHS integrates sociocognitive and ecological theoretical approaches to changing health-risk behaviors, encouraging healthy habits through education, environmental change, and measurement. Interventions are based on five goals: Eat more fruits/vegetables; Make better beverage choices; Exercise at least 150 minutes each week; Eat less fast/fatty foods; Spend less TV/computer time. Methods: The program includes identifying a school wellness champ, 10 handson classroom activities, creation of school health teams, incentives rewarding behavior change, cafeteria and policy changes. Over 9000 sixth graders participated; almost 2000 of these in research. PHS expanded from one to 15 schools replicating interventions with diverse populations; adjusting to fit each unique setting. Innovative strategies include a Farm to School Program connecting students, healthy foods and local farmers; a volunteer program where university students and parents are trained to provide PHS activities; development of a tool kit for program replication and a program sustainability plan. Results: Pre-and post data collected from students followed for four years shows improvements in heart disease risk factors (total/LDL cholesterol, blood pressure). Students at highest risk appear to get the most benefit. Surveys indicate evidence of adoption of healthier lifestyles with increased consumption of fruits/vegetables and time exercising.
Learning Outcome: The learner will become aware of the novel role for the dietitian in the media in the area of lifestyle changes. The Healthy Heart Program dietitians at St. Paul’s Hospital, Vancouver, Canada, were approached by a National based television station to consult for a six month Diet and Exercise Lifestyle Intervention Program. Ten males, eleven females, ages 19-65, average Body Mass Index 30.1, waist circumference 94.4 cm, were selected by the news reporter and randomized to Glycemic Index, Weight Watchers, Online Food Tracker or Blue Menu Superstore diets. All attended weekly exercise classes and monthly group nutrition classes with the dietitian. Anthropometric measurements were taken. Additional dietary support provided as per diet plan. Participants were followed and stories aired weekly. Nutrition education handouts and recipes were posted on the reporter’s blog. Dietary questionnaires were completed at six months and eighteen months. Average weight loss was 9.3 kg with no significant difference between diets. Main dietary improvements were portion sizes/control, decreased junk foods and increased fruits and vegetables. Only one participant stated that being on TV influenced weight loss. At eighteen months 17/21 completed the dietary questionnaire, 11/21 were weighed and maintained weight loss. Most adhered to the lifestyle modifications made. This program provided a unique opportunity and media exposure for the dietitian. Although all were on commercial weight loss plans, basic nutrition principles were key to both weight loss and maintenance. The dietitian enhanced the importance of healthy eating habits, resulting in long term lifestyle changes. Funding Disclosure: None
Conclusion: Outcomes encourage us to make PHS available to more students, especially high risk populations. Funding Disclosure: FNDTNS: Allen, Am. Heart Assoc., Ann Arbor Community, Atkins, Galens, Thompson, SE MI. CORPS: Borders, Harvard Drug Grp., NuStep, Pfizer Community/Pfizer Global Research, S.I. Co.,UM Health System, UM Medical School. INDIV: L. Hoensheid, A. Sarkar.
Beverages: Making Every Sip Count for Families Author(s): T. P. Robertson,1 D. Robinson,2 T. Bryars,3 A. Luciano2; 1 Dairy Council of California, Irvine, CA, 2Nutrition Services, Orange County Health Care Agency, Santa Ana, CA, 3Healthy for Life, Saint Joseph’s Health Care, Fullerton, CA Learning Outcome: Participants will be able to tailor the tip sheet which promotes water, low-fat milk, and 100% juice, identifies how to read a beverage label, presents appropriate portion reference and provides a list of choose more and choose less often beverages. Background: A Rethink Your Drink (RYD) nutrition education initiative was implemented in Orange County, California to combat obesity by helping residents make healthy beverage choices. The project is an initiative of Orange County Nutrition and Physical Activity Collaborative (NuPAC) and the RYD workgroup and is led by the Network for a Healthy California-Orange County Region. One of the four RYD objectives focused on teaching a wide variety of individuals to use calorie, serving size and sugar content information to evaluate beverage choices. Methods: The workgroup determined there was a need to develop a onepage, low-literacy handout that clearly addressed key education messages as well as barriers to choosing healthier options. Four focus groups were conducted with English and Spanish-speaking parents to identify their concerns. Results: The final RYD handout incorporated a graphic design that presented: 1) a food label highlighting factors to consider on beverage containers, 2) a graphic of an 8-ounce cup, drawn to scale, teaching portion size, 3) a “Drink more often/Drink less often” table to help with goal setting and 4) a section addressing questions commonly asked by parents. The handout was well-received by both educators and audiences of all ages. Conclusion: The handout complements traditional nutrition lessons and clinical counseling and has been successfully used at health fairs and events. Many partners joined together to print nearly 150,000 handouts at a cost-effective, bulk rate price. English, Spanish and Vietnamese versions of the handout can be downloaded from the Dairy Council of California’s website at: www.dairycouncilofca.org/Tools/Downloads/Nutrition_ed.aspx.
Efficacy of Commercial Web-Based Weight Loss: A Randomized Controlled Trial Comparing Programs with Basic Versus Enhanced Features Author(s): C. E. Collins,1 P. J. Morgan,2 P. McElduff,3 R. Callister4; 1School of Health Sciences, The University of Newcastle, Callaghan, Australia, 2School of Education, The University of Newcastle, Callaghan, Australia, 3Hunter Medical Research Institute, School of Medicine and Public Health, The University of Newcastle, Rankin Park, Australia, 4School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, Australia Learning Outcome: Understand the impact that a 12 week web-based weight loss intervention can have on weight change in adults. Innovative approaches to obesity treatment are required given the increasing prevalence and associated health consequences. The aim was to investigate the impact of a 12-week commercially available web-based program, The Biggest Loser Club Australia, on weight loss outcomes in an RCT. Participants (n⫽309, 42% male) were recruited and randomized to a basic online program (B), an enhanced online program which provided additional prompts and personalized feedback (E), or a 3-month wait-list control (C). Height, weight and waist circumference were objectively measured. Mean (⫾SD) age was 42y (⫾10), BMI 32.3 kg/m2 (⫾4), weight 94.0kg (⫾14.6), waist circumference 98.2cm (⫾11.5) and waist-to-height ratio 0.58 (⫾.06). Participants undertook the 12-week online weight loss program between October 2009 and March 2010. Using an intention-to-treat analysis, both intervention groups lost weight while the control group gained weight; B⫽ ⫺2.1kg (⫾3.3), E⫽ ⫺3.0kg (⫾4.1), C⫽ ⫹0.4kg (⫾2.3), P⬍0.0001; with changes in BMI of B ⫽ ⫺0.72 kg/m2 (⫾1.1), E⫽ ⫺1.0(⫾1.4), C⫽ ⫹0.15 (⫾0.82), P⬍0.0001; waist circumference B⫽ ⫺2.0cm (⫾3.5), E⫽ ⫺3.2 (⫾4.7), C⫽ ⫹0.5 (⫾ 3.0), P⬍0.0001 and waist-to-height ratio, B⫽ ⫺0.01 (0.02), E⫽ ⫺0.02 (0.03), C⫽ 0.0 (0.02), P⬍0.0001. There were no differences between the basic and enhanced versions of the program. The findings indicate that use of a commercial web-based weight loss program can achieve clinically important weight loss over 12 weeks but additional features may not increase the degree of weight loss. There is a need to further examine relationships between usage of specific website program features and weight change. Funding Disclosure: Australian Research Council Linkage Grant with SP Health Co PTY, LTD
Funding Disclosure: Network for a Healthy California, Dairy Council of California
Journal of the AMERICAN DIETETIC ASSOCIATION / A-11