Objective: Young adults (YAs) are at high risk for weight gain and show high variability in treatment response. Life events and high perceived stress are common in YAs and could drive less favorable ...outcomes. The goal was to examine whether life events and stress were related to program engagement and weight outcomes in a weight gain prevention trial for YAs. Method: Secondary analysis from the Study of Novel Approaches to Weight Gain Prevention (SNAP), a randomized clinical trial (N = 599, 18-35 years, BMI 21-30 kg/m2). Both intervention arms received 10 in-person sessions over 4 months, with long-term contact via web and SMS. Participants completed the CARDIA life events survey and Cohen Perceived Stress Scale-4 at 0 and 4 months; weight was objectively measured at 0, 4 months, and 1, 2, 3, and 4 years. Results: Participants who experienced more life events prior to study entry had lower session attendance (p < .01) and retention (p < .01), although no differences in weight outcomes were observed (p = .39). Baseline perceived stress followed a similar pattern. Participants who experienced more life events and higher perceived stress during the initial in-person program (0-4 months) appeared to experience less favorable weight outcomes long-term (p = .05 for life events, p = .04 for stress). Very few associations differed by treatment arm. Conclusions: Experiencing more life events and stress was negatively associated with program engagement and may impair long-term weight outcomes for YAs. Future work should consider identifying YAs at highest risk and tailoring interventions to better meet their needs.
•Rotavirus vaccines prevented around 140,000 child deaths in the period 2006-2019.•Relaxing age restrictions prevented up to 17,000 deaths in the period 2013-2019.•Global use of rotavirus vaccines ...could prevent over one-third of rotavirus deaths.
We estimated the global impact of rotavirus vaccines on deaths among children under five years old by year.
We used a proportionate outcomes model with a finely disaggregated age structure to estimate rotavirus deaths prevented by vaccination over the period 2006-2019 in 186 countries. We ran deterministic and probabilistic uncertainty analyses and compared our estimates to surveillance-based estimates in 20 countries.
We estimate that rotavirus vaccines prevented 139,000 under-five rotavirus deaths (95% uncertainty interval 98,000-201,000) in the period 2006-2019. In 2019 alone, rotavirus vaccines prevented 15% (95% uncertainty interval 11-21%) of under-five rotavirus deaths (0.5% of child mortality). Assuming global use of rotavirus vaccines and coverage equivalent to other co-administered vaccines could prevent 37% of under-five rotavirus deaths (1.2% of child mortality). Our estimates were sensitive to the choice of rotavirus mortality burden data and several vaccine impact modeling assumptions. The World Health Organization's recommendation to remove age restrictions in 2012 could have prevented up to 17,000 rotavirus deaths in the period 2013-2019. Our modeled estimates of rotavirus vaccine impact were broadly consistent with estimates from post-vaccination surveillance sites.
Rotavirus vaccines have made a valuable contribution to global public health. Enhanced rotavirus mortality prevention strategies are needed in countries with high mortality in under-5-year-old children.
Objective
Recovery from weight regain is uncommon during weight loss treatment. This study examined whether participants in a weight gain prevention intervention similarly struggle to recover ...following weight gains and which factors predict transitions.
Methods
This is a secondary analysis of data from the Study of Novel Approaches to Weight Gain Prevention (SNAP), a randomized controlled trial comparing two weight gain prevention interventions with a control group. Young adults (n = 599; age 18‐35 years) were followed over 3 years. Markov models identified transition rates in going above and returning below baseline weight across follow‐up. Logistic regressions identified predictors of transitions.
Results
At each time point, approximately double the number of participants who transitioned from below to above baseline transitioned from above to below. The magnitude of weight changes from baseline and the number of weight loss strategies used predicted transitions from below to above and above to below baseline weight (with opposite relationships). Infrequent self‐weighing and lower dietary restraint predicted transitions below to above baseline weight. Treatment arm, demographics, calorie consumption, and physical activity generally did not predict transitions.
Conclusions
Young adults engaging in weight gain prevention struggle to lose gained weight. Alternative strategies are needed to address weight gains in weight gain prevention interventions.
Introduction
Social jetlag (SJL), the discrepancy in sleep timing between weekdays and weekends, is associated with higher BMI and cardiometabolic risk and is common in young adults. We examined ...whether chronic SJL impacts weight gain in young adults participating in a weight gain prevention trial.
Methods
Young adults (n = 599, age 18–35; BMI: 21.0-30.9 kg/m
2
) completed assessments at 0, 4, 12, and 24 months. Multilevel mixed growth models were used to examine (1) associations between demographics and longitudinal SJL and (2) longitudinal SJL as a predictor of weight change and cardiometabolic outcomes. SJL was assessed as a continuous and clinically-significant dichotomous (< vs. ≥2 h) variable.
Results
38% of participants had clinically-significant SJL at ≥ 1 timepoints (Baseline M ± SD = 1.3±0.89). Younger (b=-0.05, p < 0.001), female (b = 0.18, p = 0.037) and Black (compared to White, b = 0.23, p = 0.045) participants were more likely to have greater SJL. Individuals with high SJL (≥ 2 h; between-person effect) were more likely to have greater weight gain over 2 years (b = 0.05, p = 0.028). High SJL did not affect the rate of change in waist circumference or cardiometabolic markers over time.
Conclusions
High SJL is associated with greater weight gain over time. Reducing SJL may positively impact weight status in young adults.
Objective: Despite weight loss challenges in young adulthood, 17% of participants in the Study of Novel Approaches to Weight Gain Prevention (SNAP) weight gain prevention study lost ≥ 5% of their ...body weight at 3 years. These "weight losers" (n = 88) were compared to "weight maintainers" (n = 143), who successfully prevented weight gains by staying within ± 2.5% of their baseline weight at 3 years. Method: Weight losers and maintainers (n = 231; 18-35 years old) were drawn from the SNAP randomized controlled trial (n = 599), which compared two weight gain prevention interventions with a control group. Participants completed anthropometric and psychosocial assessments at baseline, 4 months (end of face-to-face intervention), and 1, 2, and 3 years. Results: Three-year weight losers had significantly greater weight losses than maintainers by 4 months, and weight trajectories continued to diverge. Three-year weight change group was not associated with treatment assignment. At pretreatment, weight losers were heavier, closer to their self-reported highest ever weight, and further away from their self-identified ideal weight. Across treatment, weight losers had greater dietary restraint and autonomous motivation, had lower disinhibition and self-identified ideal weight, and self-weighed more frequently than weight maintainers. Conclusions: Weight gain prevention messaging may be sufficient to initiate weight loss in a subset of young adults who are heavier and closer to their highest weight at baseline. Psychological and behavioral characteristics more consistent with weight loss may explain differences in weight outcomes between losers and maintainers at 3 years. Future studies may consider the effects of weight gain prevention versus weight loss messaging in tailoring weight control interventions for young adults.
