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The Eating Disorders In weight-related Therapy (EDIT) Collaboration brings together data from randomised controlled trials of behavioural weight management interventions to identify individual participant risk factors and intervention strategies that contribute to eating disorder risk. We present a protocol for a systematic review and individual participant data (IPD) meta-analysis which aims to identify participants at risk of developing eating disorders, or related symptoms, during or after weight management interventions conducted in adolescents or adults with overweight or obesity. We systematically searched four databases up to March 2022 and clinical trials registries to May 2022 to identify randomised controlled trials of weight management interventions conducted in adolescents or adults with overweight or obesity that measured eating disorder risk at pre- and post-intervention or follow-up. Authors from eligible trials have been invited to share their deidentified IPD. Two IPD meta-analyses will be conducted. The first IPD meta-analysis aims to examine participant level factors associated with a change in eating disorder scores during and following a weight management intervention. To do this we will examine baseline variables that predict change in eating disorder risk within intervention arms. The second IPD meta-analysis aims to assess whether there are participant level factors that predict whether participation in an intervention is more or less likely than no intervention to lead to a change in eating disorder risk. To do this, we will examine if there are differences in predictors of eating disorder risk between intervention and no-treatment control arms. The primary outcome will be a standardised mean difference in global eating disorder score from baseline to immediately post-intervention and at 6- and 12- months follow-up. Identifying participant level risk factors predicting eating disorder risk will inform screening and monitoring protocols to allow early identification and intervention for those at risk.

Background: The National School Lunch Program (NSLP) provides >30 million meals to children daily; however, the specific nutrient composition of NSLP-selected and consumed meals for students from lower income and racial/ethnic minoritized backgrounds is unknown. Aims: To quantify the nutrients in school lunch selection and consumption among students participating in the NSLP and compare these values to nutrient recommendations. Method: Students (1st-5th graders; 98.6% from racial/ethnic minoritized backgrounds; 92.5% NSLP participation) from six Title I elementary schools serving universal free meals participated. Digital images of students' lunch meal selection and consumption were obtained (n = 1,102 image pairs). Plate waste analyses quantified portions consumed. Nutrient composition of students' lunch selection and consumption were calculated and compared with the 2010 Healthy Hunger-Free Kids Act and 2009 Institute of Medicine recommendations. Results: Most lunches selected (59%-97%) met recommendations for all nutrients except for total calories (23%), vitamin C (46%), and dietary fiber (48%). Based on lunch consumption, most students' lunches met recommendations for sodium (98%), protein (55%), calories from fat (82%), and saturated fat (89%); however, few met recommendations for total calories (5%), calcium (8%), iron (11%), vitamin A (18%), vitamin C (16%), and fiber (7%). Discussion: Meals selected met most nutrient recommendations for the majority of children; yet overall consumption patterns reflect suboptimal nutrient intake. Conclusion: Meals served under the NSLP policy mandates align with recommended nutrient patterns, highlighting the importance of maintaining these standards. Strategies to optimize children's intake of nutrient-rich portions of these meals are needed to optimize policy impact.

Objective To examine whether child routines (the consistency or variation in children's daily routines, household responsibilities, discipline routines, and homework routines) moderated the effectiveness of a brief behavioral intervention to enhance sleep in school-aged children. Methods Secondary analysis was conducted with a subset of 66 families with short sleeping (≤9.5 hr/day) children, 8–11 years old (female = 68%; mean age = 9.76, SD  = 1.02) who completed the Child Routines Inventory at baseline and were then randomized to receive a behavioral sleep intervention (n  = 32) or to control (n  = 34). Sleep period was objectively measured using wrist actigraphy at baseline and 2 months post-randomization. Moderation analysis was performed using ordinary least squares regression using the PROCESS macro for SPSS. Results Controlling for sleep period at baseline, treatment condition was significantly related to the sleep period at 2 months post-randomization, with the intervention group achieving a longer sleep period compared to the usual sleep period group (control) (b  = 46.30, p <.01). Intervention response was moderated by child routines (b  = 1.43, p <.05). Specifically, the intervention produced the greatest change in sleep period for children who engaged in greater routine behaviors at baseline than those who engaged in fewer routine behaviors. Conclusions Families that engage in routine behaviors may be better equipped to adopt the behavioral modifications required to get a good night's sleep. The findings highlight the importance of working with families to establish routine behaviors to improve responses to behavioral sleep interventions. [ABSTRACT FROM AUTHOR]

Many schools have salad bars as a means to increase students' fruit and vegetable intake. School nutrition programs experienced drastic changes to the school food environment due to COVID-19. The aim of the current study was to understand cafeteria personnel's experiences related to salad bar implementation before the COVID-19 pandemic and in the current school environment to inform efforts to enhance salad bar sustainability. Seven elementary schools (N = 30 personnel) installed salad bars prior to COVID-19; three of these schools (n = 13 personnel) re-opened salad bars after COVID-19. Cafeteria personnel completed surveys assessing their experiences with salad bars at both time points. Satisfaction with salad bar implementation and training was high pre- and post-COVID-19. Most agreed that salad bars increased students' fruit and vegetable intake, yet had concerns about cleanliness and waste. Perceived job difficulty increased post-COVID-19 (p = 0.01), and satisfaction with student salad bar training decreased (p = 0.001). Additional staff support and greater student training were needed post-COVID-19. Overall, salad bars were viewed favorably; however, more challenges and lower satisfaction were reported following COVID-19. Increasing support for cafeteria personnel is needed for salad bar sustainability and improving the school food environment. [ABSTRACT FROM AUTHOR]

Background: Exercising at a consistent versus variable time of day cross-sectionally relates to greater moderate to vigorous physical activity (MVPA) among weight loss maintainers. This study evaluated the relationships between exercise timing and both MVPA levels and habit strength, as well as stability in exercise timing, over 1 year among maintainers in the National Weight Control Registry. Methods: Participants (n = 709) completed questionnaires assessing exercise timing, MVPA, and exercise automaticity (a measure of habit) at baseline and 1-year follow-up. At each assessment, participants were labeled temporally consistent exercisers if >50% of their exercise sessions per week occurred in one time window: early morning, late morning, afternoon, or evening. Participants exercising consistently during the same window at both assessments were labeled as having stable patterns. Results: Temporally consistent exercise at baseline, regardless of its specific time, related to greater MVPA over time (Ps<.05). Approximately half of temporally consistent exercisers at baseline exhibited stable patterns. Early morning exercise and greater exercise automaticity at baseline predicted stable patterns (Ps<.005). Temporally consistent exercise, especially during the early morning, related to greater automaticity across time (Ps<.01). Conclusions: Consistent exercise timing may help maintainers accrue more MVPA. Consistent early morning exercise was most strongly related to exercise automaticity and routine stability. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore relations between food craving, caloric intake, and body mass index (BMI) changes over the course of an 18-month weight loss trial. Two-hundred two obese adults (mean BMI = 34.9 kg/m.sup.2; mean age = 51.30 years, 92.2% White; 57.8% female) who participated in a behavioral weight loss trial completed measures of food craving, caloric intake, and BMI at baseline, 6 and 18 months. From baseline to 6 months, higher initial food cravings were associated with more gradual and less steep reductions in BMI. Additionally, the relation between changes in food craving and BMI changes varied by levels of change in caloric intake, such that BMI change and change in food cravings were positively associated at low levels of change in caloric intake, but were unrelated at average and high levels of change in caloric intake. Similarly, from baseline to 6 months and from 6 to 18 months, the relation between changes in food craving and BMI changes also varied by initial levels of caloric intake. Explicit clinical targeting of food craving management may be beneficial for individuals beginning weight loss programs, especially for those who report higher levels of food craving at baseline. Baseline caloric intake and change in calorie intake over time may serve as moderators of the relation between food cravings and BMI., Author(s): Joanna Buscemi [sup.1] , Tiffany M. Rybak [sup.2] , Kristoffer S. Berlin [sup.2] , James G. Murphy [sup.2] , Hollie A. Raynor [sup.3] Author Affiliations: (1) Department of Psychology, [...]

Objective: Compare parent-reported preschool- and school-aged children's eating and leisure-time activity patterns that are proposed to influence energy balance. Design: Cross-sectional investigation of children, 2 to 12 years, attending a well visit. Setting: Pediatric private practice/ambulatory pediatric clinic. Participants: One hundred seventy-four children: 49% preschool-aged, 54% female, 28% Hispanic, and 34% overweight or at risk for overweight. Variables Measured: Parent-reported eating/leisure-time behaviors. Height/weight from medical records. Analysis: Analyses of covariance/chi-square tests; significance at P less than or equal to 0.05. Results: By parents' report, preschool-aged children consumed more servings/day of low-fat dairy (2.1 +/- 1.6 vs 1.7 +/- 1.5; P less than 0.01), fewer servings/day of sweetened drinks (1.4 +/- 1.9 vs 2.2 +/- 2.6; P less than 0.01) and watched fewer hours/day of weekend TV (2.3 +/- 1. 3 vs 2.7 +/- 1.3; P less than 0.05) than school-aged children. Fewer preschool-aged children consumed salty (14.0% vs 26.1%; P less than 0.05) and sweet (16.3% vs. 29.5%; P less than 0.05) snack food daily, and a greater percentage regularly consumed dinner with a parent (93.0% vs 80.7%; P less than 0.05), as assessed by parent report. Conclusions and Implications: Parent-reported children's eating/leisure-time patterns that may influence energy balance were less healthful in the school-aged children. However, most children did not meet recommendations, irrespective of age or weight. Interventions for meeting recommendations should start with families with preschool-aged children. Future research should focus on identifying factors that might be contributing to increased reporting of problematic food and leisure-time activity patterns in school-aged children. (Contains 3 tables.)

This study compared weight control strategies during the winter holidays among successful weight losers (SWL) in the National Weight Control Registry and normal weight individuals (NW) with no history of obesity. SWL (n = 178) had lost a mean of 34.9 kg and had kept greater than or equal to 13.6 kg off for a mean of 5.9 years. NW (n = 101) had a body mass index of 18.5-24.9 kg/m[superscript 2]. More SWL than NW reported plans to be extremely strict in maintaining their usual dietary routine (27.3% vs. 0%) and exercise routine (59.1% vs. 14.3%) over the holidays. Main effects for group indicated that SWL maintained greater exercise, greater attention to weight and eating, greater stimulus control, and greater dietary restraint, both before and during the holidays. A Group x Time interaction indicated that, over the holidays, attention to weight and eating declined significantly more in SW than in NW. More SWL (38.9%) than NW (16.7%) gained greater than or equal to 1 kg over the holidays, and this effect persisted 1 month later (28.3% and 10.7%, respectively). SWL worked harder than NW did to manage their weight, but they appeared more vulnerable to weight gain during the holidays. (Contains 2 tables, 2 figures, and 1 footnote.)