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Background: We sought to determine how a low fermentable oligosaccharide, disaccharide, monosaccharide, and polyol (FODMAP) diet (LFD) affected high FODMAP food intake, nutrient intake, and diet quality in children with functional abdominal pain disorders (FAPD). Methods: Children (ages 7–13 years) with Rome IV FAPD began a dietitian‐guided LFD. Three‐day food records were captured at baseline and 2–3 weeks into the LFD. Intake of high FODMAP foods, energy, macronutrients, micronutrients, food groups, and ultra‐processed foods were determined. Key results: Median age of participants was 11 years, and 19/31 (61%) were female. Twenty‐eight (90%) decreased high FODMAP food intake on the LFD: overall median (25–75%) high FODMAP foods/day decreased from 5.7 (3.6–7.3) to 2 (0.3–3.7) (p < 0.001). A more adherent subset (n = 22/71%) of participants consumed on average ≤3 high FODMAP foods per day during the LFD. Baseline nutritional intake and quality were generally poor with several micronutrient deficiencies identified. Diet quality improved on the LFD with increased servings of vegetables and protein and decreased consumption of ultra‐processed foods, trans‐fatty acids, and added sugars. On the LFD, there were significant decreases in total carbohydrates and thiamin (remained within recommended intake) and significant increases in vitamin B6 (p = 0.029), vitamin C (p = 0.019), and vitamin E (p = 0.009). Children more adherent to the LFD further increased vitamin D, magnesium, potassium, and fat servings. Conclusions and Inferences: The majority of children with FAPD on a dietitian‐led LFD successfully decreased high FODMAP food intake. Children with FAPD on the LFD (vs. baseline) modestly improved micronutrient intake and diet quality. [ABSTRACT FROM AUTHOR]

Objective: The study aims were to (1) document the relationship between a history of childhood abuse and weight change during behavioral obesity treatment and (2) estimate the indirect effect of childhood abuse on weight change through binge eating severity.Methods: Participants (n = 431) were enrolled in a behavioral weight-loss intervention. Childhood physical and emotional abuse history and current binge eating severity were self-reported. Percent weight loss at 6 months was calculated using measured weight. Adjusted mediation models examined whether there was an indirect effect of childhood physical and emotional abuse on 6-month percent weight loss that operated through binge eating severity.Results: After covariate adjustment, childhood physical abuse, but not emotional abuse, predicted a lower percent weight loss (B = -1.78%; 95% CI: -3.10% to -0.47%). Although childhood physical and emotional abuse were positively related to baseline binge eating severity, binge eating severity did not mediate the associations between either childhood abuse type and percent weight loss.Conclusions: Individuals with a childhood physical abuse history had a lower percent weight loss than those without such histories during behavioral obesity treatment. This effect was not explained by binge eating severity. Individuals with a history of childhood abuse may benefit from trauma-informed obesity care. [ABSTRACT FROM AUTHOR]

Background: Irritable bowel syndrome (IBS) is linked with lower health‐related quality of life. Cognitive behavioral therapy (CBT) designed for IBS management can improve outcomes but further research of more accessible implementations of this treatment approach for IBS is needed. This study assessed the feasibility of a web‐delivered CBT program among adults with IBS to apply to a future clinical trial. Methods: Twenty‐five participants were randomized to receive an unguided web‐based, CBT program for IBS. The primary outcome was changes in IBS symptom severity (IBS Symptom Severity Scale [IBS‐SSS]). Secondary outcomes included IBS‐specific CBT therapeutic mechanisms of change (GI‐specific anxiety, unhelpful IBS behaviors, and GI‐focused cognitions) and changes in depressive (Patient Health Questionnaire‐9 [PHQ‐9]) and anxiety (Generalized Anxiety Disorder‐7 scale [GAD‐7]) symptom severity. Key Results: Among participants randomized to receive web‐based CBT, the average baseline IBS‐SSS score was 296.3 (SD=100.9). IBS symptom severity significantly improved at 2‐month (p < 0.001) and 3‐month follow‐up (p < 0.0001); the within‐group effect size between baseline and 3‐month follow‐up IBS‐SSS scores was large (d = 1.14) and 63.6% experienced a clinically meaningful improvement (ie, ≥50‐point IBS‐SSS score reduction). GI‐specific anxiety symptoms and cognitions significantly improved at 2‐month follow‐up, as did unhelpful IBS safety behaviors. Additionally, clinically meaningful improvement was observed in depressive and anxiety symptoms at 3‐month follow‐up among participants with symptoms above the clinical threshold (ie, PHQ‐9 ≥ 10 and GAD‐7 ≥ 10, respectively) at baseline. Conclusions & Inferences: These preliminary findings warrant a larger trial to investigate an unguided, web‐based CBT for IBS symptom management that is powered to detect between‐group treatment effects. [ABSTRACT FROM AUTHOR]

Decrease in the level of high-density lipoprotein cholesterol (HDLC) has been observed in women who start dieting, but not in men. Patterns of HDLC change during intentional weight loss through 30-months of follow-up, and their association with changes in anthropometric measurements were examined in obese women (N = 112) and men (N = 100). Missing HDLC values at 6-, 12-, 18-, and 30-month follow-up (N = 16, 34, 55, and 50, respectively) due to dropout were imputed by multiple imputation. Mean ages and BMIs of subjects at baseline were 47.2 years and 34.8 kg/m2 for women, and 50.4 years and 35.0 kg/m2 for men. On average, participants lost weight steadily for 12 months, followed by slow regain. During the first 6 months, HDLC decreased significantly in women (−4.1 mg/dl, P = 0.0007), but not in men. Significant HDLC increases were observed in both men and women from 6- to 12-month follow-up. HDLC changes in women were positively associated with changes in hip circumference from baseline to 12-month independent of changes in triglycerides (TG), glucose, and insulin. Rapid decrease of predominantly subcutaneous fat in the femoral and gluteal area might be associated with HDLC decrease in women during initial weight loss. [ABSTRACT FROM AUTHOR]

Summary: Background: Pediatric primary care is an important setting for addressing obesity prevention. Objective: The Healthy Homes/Healthy Kids 5‐10 randomized controlled trial evaluated the efficacy of an obesity prevention intervention integrating pediatric primary care provider counseling and parent‐targeted phone coaching. Methods: Children aged 5 to 10 years with a BMI between the 70th and 95th percentile and their parents were recruited from pediatric primary care clinics. Participants received well‐child visit provider counseling about obesity and safety/injury prevention and were then randomized to a 14‐session phone‐based obesity prevention (OP; n = 212) or safety and injury prevention contact control (CC; n = 209) intervention. The primary outcome was 12 and 24‐month child BMI percentile. Results: There was no overall significant treatment effect on child BMI percentile. Caloric intake was significantly lower among OP compared with CC participants at 12 months (P < .005). In planned subgroup analyses, OP condition girls had significantly lower BMI percentile (P < .05) and BMI z‐score (P < .02) at 12 and 24 months relative to CC girls and were less likely to be overweight (38.0% vs 53.0%, P < .01) or (obese 3.4% vs 8.8%, P < .10) at follow‐up. Conclusions and Relevance: An obesity prevention intervention integrating brief provider counseling and parent‐targeted phone counseling did not impact 12 and 24‐month BMI status overall but did have a significant impact on BMI in girls. [ABSTRACT FROM AUTHOR]