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Objective: Appetite responses to 3 days of overfeeding (OF) were examined as correlates of longitudinal weight change in adults classified as obesity prone (OP) or obesity resistant (OR).Methods: OP (n = 22) and OR (n = 30) adults consumed a controlled eucaloric and OF diet (140% of energy needs) for 3 days, followed by 3 days of ad libitum feeding. Hunger and satiety were evaluated by visual analog scales. Ghrelin and peptide YY (PYY) levels were measured during a 24-hour inpatient visit on day 3. Body weight and composition were measured annually for 4.0 ± 1.3 years.Results: Dietary restraint and disinhibition were greater in OP than OR (mean difference: 3.5 ± 1.2 and 3.3 ± 0.9, respectively; P < 0.01) participants, and disinhibition was associated with longitudinal weight change (n = 48; r = 0.35; P = 0.02). Compared with the eucaloric diet, energy intake fell significantly in OR participants following OF (P = 0.03) but not in OP (P = 0.33) participants. Twenty-four-hour PYY area under the curve values increased with OF in OR (P = 0.02) but not in OP (P = 0.17) participants. Furthermore, changes in PYY levels with OF correlated with measured energy intake (r = -0.36; P = 0.01).Conclusions: Baseline disinhibition and PYY responses to OF differed between OP and OR adults. Dietary disinhibition was associated with 5-year longitudinal weight gain. Differences in appetite regulation may underlie differences in propensity for weight gain. [ABSTRACT FROM AUTHOR]

PURPOSE: The novel coronavirus pandemic (COVID-19) has resulted in disruptions to daily routines, including physical activity (PA). PA is a behavior that could assist in both prevention of and recovery from SARS-CoV-2 infection. Therefore, the purpose of this study was to evaluate changes in PA and the factors that associate with PA during COVID-19 in a sample of adults from Utah. METHODS: Participants were a sample of 201 adults (52.7% Female; Age: 40.6±18.5 yrs; BMI: 26.7±5.8 kg/m2) living in the state of Utah who were given 3 sets of online questionnaires during the first 3 waves of the COVID-19 pandemic in the US (wave 1: April-July; wave 2: Aug-Sept; wave 3: Oct-Dec). Moderate-to-vigorous physical activity (MVPA) was self-reported at three study time points via the short form International Physical Activity Questionnaire (IPAQ). Self-efficacy for exercise (via the Self-Efficacy for Exercise Scale), self-reported COVID-19 related changes to work/occupation, and working from home were also examined in the relationship with MVPA. A general linear mixed-effects model was used to examine the associations between pandemic wave, self-efficacy, occupation change, and working from home status with MVPA. Effect modification was tested using interaction terms. RESULTS: Individuals who worked from home tended to have lower self-reported log-MVPA compared to those not working from home (b=-0.77; 95%CI= -1.31 - -0.23; p=0.005). However, those who reported only that their work was affected by the pandemic did not exhibit significantly higher or lower log-MVPA (p=0.67). Finally, those with high self-efficacy had higher log- MVPA compared to those with low self-efficacy (b=0.58; 95%CI= 0.04 - 1.12; p=0.034). CONCLUSIONS: These results suggest that MVPA during COVID-19 is affected by specific work-related variables and self-efficacy for PA. These findings can help to inform and establish interventions to improve health outcomes during and after global pandemics, such as COVID-19. [ABSTRACT FROM AUTHOR]

Providing interventions that facilitate improvement of dietary intake and other health behaviors can improve nutrition-related outcomes in adults with overweight or obesity. Medical nutrition therapy (MNT) behavioral interventions require expertise from registered dietitian nutritionists or international equivalents (dietitians), which no other health care provider can provide for adults with obesity. Current evidence supports the role of MNT behavioral interventions for adults with overweight or obesity as an effective treatment option, when appropriate for and desired by the client. This Academy of Nutrition and Dietetics Position Paper describes potential benefits and concerns regarding dietitian-provided MNT behavioral interventions for adults with overweight and obesity and informs dietitians about implications for practice. This Position Paper is supported by a systematic review examining effectiveness of MNT interventions provided by dietitians and by an evidence-based practice guideline. It is the position of the Academy of Nutrition and Dietetics that MNT behavioral interventions for adults (aged 18 years and older) with overweight or obesity should be a treatment option, when appropriate and desired by the client, to improve cardiometabolic, quality of life, and anthropometric outcomes. Dietitians providing MNT recognize the complex contributors to overweight and obesity, and thus individualize interventions, based on a shared decision-making process, and deliver interventions in an inclusive, compassionate, and client-centered manner. Interventions should include collaboration with an interprofessional team when needed. Dietitians strive to increase health equity and reduce health disparities by advocating and providing opportunities for increased access to effective nutrition care services. This position remains in effect until December 31, 2031. [ABSTRACT FROM AUTHOR]

Obesity is associated with a multitude of comorbidities and considerable health care costs. The objective of this review was to examine the efficacy of weight management interventions provided by a registered dietitian or international equivalent (referred to as "dietitian"). This systematic review and meta-analysis of randomized controlled trials (RCTs) examined the effect of weight management interventions provided by a dietitian, compared with usual care or no intervention, on several cardiometabolic outcomes and quality of life in adults with overweight or obesity. MEDLINE, Embase, PsycINFO, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, and CINAHL databases were searched for eligible RCTs published between January 2008 and January 2021 in the English language. Meta-analyses were conducted using a random-effects model, publication bias was assessed using funnel plots and Egger's statistics, and heterogeneity was assessed by interpreting I 2 values. Efficacy of intervention components, such as telehealth or group contacts, were explored in sub-group analyses. Version 2 of the risk-of-bias tool for RCTs was used to assess risk of bias. The Grading of Recommendations Assessment, Development and Evaluation method was used to determine certainty of evidence. This systematic review included 62 RCTs. Compared with control conditions, weight management interventions provided by a dietitian resulted in improved body mass index (mean difference [MD] –1.5; 95% CI –1.74 to –1.26; moderate evidence certainty); percent weight loss (MD –4.01%; 95% CI –5.26% to –2.75%; high evidence certainty); waist circumference (MD –3.45 cm; 95% CI –4.39 to –2.51 cm; high evidence certainty); blood pressure (MD –3.04 mm Hg; 95% CI –5.10 to –0.98 mm Hg and MD –1.99 mm Hg; 95% CI –3.02 to –0.96 mm Hg for systolic blood pressure and diastolic blood pressure, respectively; moderate and low evidence certainty); and quality of life using the 36-Item Short Form Survey (MD 5.84; 95% CI 2.27 to 9.41 and 2.39; 95% CI 1.55 to 3.23 for physical and mental quality of life, respectively; low and moderate evidence certainty). For adults with overweight or obesity, weight management interventions provided by a dietitian are efficacious for improving several examined cardiometabolic outcomes and quality of life. [Display omitted] [ABSTRACT FROM AUTHOR]

Overweight and obesity affect most adults living in the United States and are causally linked to several adverse health outcomes. Registered dietitian nutritionists or international equivalents (dietitians) collaborate with each client and other health care professionals to meet client-centered goals, informed by the best available evidence, and translated through a lens of clinical expertise and client circumstances and preferences. Since the last iteration of the Academy of Nutrition and Dietetics guideline on adult weight management in 2014, considerable research has been conducted and circumstances confronting dietitians have evolved. Thus, updated guidance is needed. The objective of this evidence-based practice guideline is to provide recommendations for dietitians who deliver medical nutrition therapy behavioral interventions for adults (18 years and older) with overweight and obesity to improve cardiometabolic outcomes, quality of life, and weight outcomes, when appropriate for and desired by the client. Recommendations in this guideline highlight the importance of considering complex contributors to overweight and obesity and individualizing interventions to client-centered goals based on specific needs and preferences and shared decision making. The described recommendations have the potential to increase access to care and decrease costs through utilization of telehealth and group counseling as effective delivery methods, and to address other barriers to overweight and obesity management interventions. It is essential for dietitians to collaborate with clients and interprofessional health care teams to provide high-quality medical nutrition therapy interventions using the nutrition care process to promote attainment of client-centered outcomes for adults with overweight or obesity. [ABSTRACT FROM AUTHOR]