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Weight loss treatment influences untreated spouses and the home environment: evidence of a ripple effect.

Int J Obes (Lond). 2008 Sep 2;

Authors: Gorin AA, Wing RR, Fava JL, Jakicic JM, Jeffery R, West DS, Brelje K, Dilillo VG

Objectives:To examine whether a weight loss program delivered to one spouse has beneficial effects on the untreated spouse and the home environment.Methods:We assessed untreated spouses of participants in three sites of Look AHEAD, a multicenter randomized controlled trial evaluating the impact of intentional weight loss on cardiovascular outcomes in overweight individuals with type 2 diabetes. Participants and spouses (n=357 pairs) were weighed and completed measures of diet and physical activity at 0 and 12 months. Spouses completed household food and exercise environment inventories. We examined differences between spouses of participants assigned to the intensive lifestyle intervention (ILI) or to the enhanced usual care (DSE; diabetes support and education).Results:Spouses of ILI participants lost -2.2+/-4.5 kg vs -0.2+/-3.3 kg in spouses of DSE participants (P<0.001). In addition, more ILI spouses lost >/=5% of their body weight than DSE spouses (26 vs 9%, P<0.001). Spouses of ILI participants also had greater reductions in reported energy intake (P=0.007) and percent of energy from fat (P=0.012) than DSE spouses. Spouse weight loss was associated with participant weight loss (P<0.001) and decreases in high-fat foods in the home (P=0.05).Conclusion:The reach of behavioral weight loss treatment can extend to a spouse, suggesting that social networks can be utilized to promote the spread of weight loss, thus creating a ripple effect.International Journal of Obesity advance online publication, 2 September 2008; doi:10.1038/ijo.2008.150.

PMID: 18762804 [PubMed - as supplied by publisher]

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The Healthy Moms Study: The Efficacy of Brief Alcohol Intervention in Postpartum Women.

Alcohol Clin Exp Res. 2008 Jul 1;

Authors: Fleming MF, Lund MR, Wilton G, Landry M, Scheets D

Background: The prevention and treatment of alcohol use disorders among women of reproductive age have been well described. However, there is limited information on women specifically during the postpartum period. This period in a woman’s life is a time of transition and it provides an ideal opportunity for primary care providers to intervene. Purpose: The goal of this report was to present the results of a brief alcohol intervention conducted in 34 obstetrical practices with women seeking routine postpartum care. Methods: A randomized clinical trial was conducted from 2002 to 2005 in a diverse sample of women located in 15 Wisconsin counties. This report presents 6-month follow-up data. Results: A total of 8,706 women were screened for high-risk alcohol use during routine postpartum care with 997 (12%) of these women testing positive for at-risk drinking. A total of 235 women met inclusion criteria and were randomized to either “usual care” or “brief intervention.” The 4-session intervention was delivered by outpatient obstetrical nurses and research staff. The mean age of the women in the sample was 28, 19.3% were from minority groups, 60.8% were married, 53.2% reported current tobacco use, and 17.9% had used marijuana in the previous 30 days. At the 6 month follow-up appointment, there were significant reductions in mean number of total drinks in the previous 28 days (p < 0.013), number of drinking days (p < 0.024) and heavy drinking days (p < 0.019). In addition to a statistical difference between groups, there was a 19% difference in the mean number of drinks and number of drinking days, and a 36% difference in the number of heavy drinking days in favor of the intervention group. Conclusion: The findings of the Healthy Moms Trial support the implementation of brief alcohol intervention during the postpartum period.

PMID: 18627361 [PubMed - as supplied by publisher]

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Continuity in the Midst of Change: Behaviors of Residents Relocated from a Nursing Home Environment to Small Households.

Am J Alzheimers Dis Other Demen. 2008 Jun 30;

Authors: McFadden SH, Lunsman M

A time-sampling procedure was used to observe behaviors of 22 long-term-care residents with dementia (Mini-Mental State Exam median, 11.94; range 0-23) in public areas before and after relocation from a traditional nursing home environment to 2 small household units. Two trained observers noted the occurrence of 19 social behaviors (14 verbal, 5 nonverbal) in which the resident intentionally interacted with another person. Another 19 nonsocial behaviors (16 active, 3 passive) were also coded. Analysis by t tests of 6 groupings of behaviors showed no significant differences before and after relocation, with the exception of nonverbal social interactions. Overall, residents showed consistency in both social and nonsocial behaviors. Results are interpreted in light of personal, social, and environmental continuity despite the many changes associated with the relocation.

PMID: 18591207 [PubMed - as supplied by publisher]

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Atopy, home environment and the risk of childhood-onset type 1 diabetes: a population-based case-control study.

Pediatr Diabetes. 2008 Jun;9(3 Pt 1):191-6

Authors: Cardwell CR, Carson DJ, Yarnell J, Shields MD, Patterson CC

BACKGROUND: The marked increases in the incidence of type 1 diabetes in recent decades strongly suggest the role of environmental influences. These environmental influences remain largely unknown. OBJECTIVE: To investigate atopy and home environment (such as children living at home, sharing a bedroom and house moves) as potential risk factors for type 1 diabetes. SUBJECTS AND METHOD: In Northern Ireland, 175 children with type 1 diabetes and 4859 control children completed a questionnaire on atopy experience, family composition and home environment. Control children from two age groups (6-8 yr old and 13-14 yr old) were identified from randomly selected primary and secondary schools across Northern Ireland. Cases were identified from a population-based type 1 diabetes register. RESULTS: There was little evidence of a difference in the proportion of participants with a history of atopy in the cases compared with controls. There was a significant reduction in the risk of diabetes in children who lived with more siblings {odds ratio (OR) = 0.58 [95% confidence interval (95% CI) 0.39-0.85] in children who lived with three or more siblings compared with one or none} and in children who moved house more often [OR = 0.59 (95% CI 0.40-0.88) in children who moved house twice or more compared with never]. CONCLUSION: The reduced risk of type 1 diabetes in children living with siblings, sharing a bedroom and moving house more often could reflect the protection afforded by exposure to infections in early life and consequently may provide support for the hygiene hypothesis.

PMID: 18547232 [PubMed - in process]

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