Publications by authors named "Ellen Wingard"

7 Publications

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A Behavioral Lifestyle Intervention to Limit Gestational Weight Gain in Pregnant Women with Overweight and Obesity.

Obesity (Silver Spring) 2021 Feb 22. Epub 2021 Feb 22.

Department of Obstetrics and Gynecology, School of Medicine, University of South Carolina, Columbia, South Carolina, USA.

Objective: This study aimed to evaluate the effects of an antenatal behavioral lifestyle intervention on total gestational weight gain (GWG) and perinatal outcomes.

Methods: Pregnant women with overweight and obesity in South Carolina were recruited into a theory-based randomized controlled trial (n = 112 intervention, n = 105 standard care), which was designed to target weight self-monitoring, increased physical activity, and improved dietary practices.

Results: Participants were racially/ethnically diverse (44% African American). Intervention and standard care participants had similar total GWG at delivery (12.9 ± 6.9 vs. 12.4 ± 8.3 kg, respectively), but intervention participants had a smaller standard deviation (P = 0.04) in total GWG. The treatment effects were moderated by race/ethnicity and prepregnancy BMI. Among African American participants with overweight, intervention participants gained 4.5 kg less, whereas, among African American women with obesity, intervention participants gained 4.1 kg more than standard care participants. Total GWG among White participants was similar regardless of weight status and group assignment. Fewer intervention participants than standard care participants had adverse pregnancy outcomes (P ≤ 0.01).

Conclusions: The behavioral lifestyle intervention favorably impacted GWG in African American participants with overweight but not African American participants with obesity. The intervention's overall favorable impact on perinatal outcomes suggests that the mechanisms beyond total GWG may drive these outcomes.
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http://dx.doi.org/10.1002/oby.23119DOI Listing
February 2021

A randomized controlled trial to prevent excessive gestational weight gain and promote postpartum weight loss in overweight and obese women: Health In Pregnancy and Postpartum (HIPP).

Contemp Clin Trials 2018 03 31;66:51-63. Epub 2018 Jan 31.

Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States; Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.

Background: Interventions to prevent excessive gestational weight gain and promote postpartum weight loss have yielded modest results, particularly in overweight and obese women.

Objectives: To examine the impact of a theory-based lifestyle intervention on gestational weight gain, postpartum weight loss, and related maternal and child outcomes and to examine race differences in these outcomes.

Design: A randomized controlled trial (target N=400; 200 intervention, 200 standard care; 200 African American, 200 white).

Methods: Overweight and obese African American and white women ≤16weeks gestation are recruited from obstetrics and gynecology clinics in South Carolina. Intervention participants receive two in-depth counseling sessions (early pregnancy and postpartum), telephone counseling, behavioral podcasts, and social media support that target weight self-monitoring and increasing physical activity and healthy dietary behavior practices, guided by Social Cognitive Theory. Standard care participants receive monthly mailings and a matched number of podcasts on non-weight related topics. All intervention activities last from ≤18weeks gestation to 6months after delivery. Gestational weight gain is the primary outcome. Secondary outcomes are meeting gestational weight gain guidelines (inadequate, adequate, excessive), weekly rate of gestational weight gain, postpartum weight retention, physical activity and dietary behaviors, health-related quality of life, and offspring adiposity. Participants are assessed at baseline (≤16weeks gestation), 32weeks gestation, and 6 and 12months postpartum, and offspring are assessed at 6 and 12months.

Summary: HIPP is an innovative study that addresses significant gaps in the literature. Primary outcome results are expected in 2019.
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http://dx.doi.org/10.1016/j.cct.2018.01.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5841597PMC
March 2018

Comparative effectiveness of plant-based diets for weight loss: a randomized controlled trial of five different diets.

Nutrition 2015 Feb 18;31(2):350-8. Epub 2014 Oct 18.

Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.

Objective: The aim of this study was to determine the effect of plant-based diets on weight loss.

Methods: Participants were enrolled in a 6-mo, five-arm, randomized controlled trial in 2013 in South Carolina. Participants attended weekly group meetings, with the exception of the omnivorous group, which served as the control and attended monthly meetings augmented with weekly e-mail lessons. All groups attended monthly meetings for the last 4 mo of the study. Diets did not emphasize caloric restriction.

Results: Overweight adults (body mass index 25-49.9 kg/m(2); age 18-65 y, 19% non-white, and 27% men) were randomized to a low-fat, low-glycemic index diet: vegan (n = 12), vegetarian (n = 13), pesco-vegetarian (n = 13), semi-vegetarian (n = 13), or omnivorous (n = 12). Fifty (79%) participants completed the study. In intention-to-treat analysis, the linear trend for weight loss across the five groups was significant at both 2 (P < 0.01) and 6 mo (P < 0.01). At 6 mo, the weight loss in the vegan group (-7.5% ± 4.5%) was significantly different from the omnivorous (-3.1% ± 3.6%; P = 0.03), semi-vegetarian (-3.2% ± 3.8%; P = 0.03), and pesco-vegetarian (-3.2% ± 3.4%; P = 0.03) groups. Vegan participants decreased their fat and saturated fat more than the pesco-vegetarian, semi-vegetarian, and omnivorous groups at both 2 and 6 mo (P < 0.05).

Conclusions: Vegan diets may result in greater weight loss than more modest recommendations.
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http://dx.doi.org/10.1016/j.nut.2014.09.002DOI Listing
February 2015

Randomization to plant-based dietary approaches leads to larger short-term improvements in Dietary Inflammatory Index scores and macronutrient intake compared with diets that contain meat.

Nutr Res 2015 Feb 3;35(2):97-106. Epub 2014 Dec 3.

University of South Carolina, Arnold School of Public Health, Department of Epidemiology and Biostatistics, Cancer Prevention and Control Program, 915 Greene St, Columbia, SC 29208.

Studies have examined nutrient differences among people following different plant-based diets. However, all of these studies have been observational. The aim of the present study was to examine differences in nutrient intake and Dietary Inflammatory Index (DII) scores among overweight and obese (body mass index 25.0-49.9 kg/m(2)) adults randomized to receive dietary instruction on a vegan (n = 12), vegetarian (n = 13), pescovegetarian (n = 13), semivegetarian (n = 13), or omnivorous (n = 12) diet during a 6-month randomized controlled trial. Nutrient intake, nutrient adequacy, and DII score were assessed via two 24-hour dietary recalls (Automated Self-Administered 24-Hour Dietary Recall) at baseline and at 2 and 6 months. Differences in nutrient intake and the DII were examined using general linear models with follow-up tests at each time point. We hypothesized that individuals randomized to the vegan diet would have lower DII scores and greater improvements in fiber, carbohydrate, fat, saturated fat, and cholesterol at both 2 and 6 months as compared with the other 4 diets. Participants randomized to the vegan diet had significantly greater changes in most macronutrients at both time points, including fat and saturated fat, as well as cholesterol and, at 2 months, fiber, as compared with most of the other diet groups (Ps < .05). Vegan, vegetarian, and pescovegetarian participants all saw significant improvements in the DII score as compared with semivegetarian participants at 2 months (Ps < .05) with no differences at 6 months. Given the greater impact on macronutrients and the DII during the short term, finding ways to provide support for adoption and maintenance of plant-based dietary approaches, such as vegan and vegetarian diets, should be given consideration.
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http://dx.doi.org/10.1016/j.nutres.2014.11.007DOI Listing
February 2015

Low glycemic index vegan or low-calorie weight loss diets for women with polycystic ovary syndrome: a randomized controlled feasibility study.

Nutr Res 2014 Jun 24;34(6):552-8. Epub 2014 Apr 24.

Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC.

The aim of this randomized pilot was to assess the feasibility of a dietary intervention among women with polycystic ovary syndrome (PCOS) comparing a vegan to a low-calorie (low-cal) diet. Overweight (body mass index, 39.9 ± 6.1 kg/m(2)) women with PCOS (n = 18; age, 27.8 ± 4.5 years; 39% black) who were experiencing infertility were recruited to participate in a 6-month randomized weight loss study delivered through nutrition counseling, e-mail, and Facebook. Body weight and dietary intake were assessed at 0, 3, and 6 months. We hypothesized that weight loss would be greater in the vegan group. Attrition was high at 3 (39%) and 6 months (67%). All analyses were conducted as intention-to-treat and presented as median (interquartile range). Vegan participants lost significantly more weight at 3 months (-1.8% [-5.0%, -0.9%] vegan, 0.0 [-1.2%, 0.3%] low-cal; P = .04), but there was no difference between groups at 6 months (P = .39). Use of Facebook groups was significantly related to percent weight loss at 3 (P < .001) and 6 months (P = .05). Vegan participants had a greater decrease in energy (-265 [-439, 0] kcal/d) and fat intake (-7.4% [-9.2%, 0] energy) at 6 months compared with low-cal participants (0 [0, 112] kcal/d, P = .02; 0 [0, 3.0%] energy, P = .02). These preliminary results suggest that engagement with social media and adoption of a vegan diet may be effective for promoting short-term weight loss among women with PCOS; however, a larger trial that addresses potential high attrition rates is needed to confirm these results.
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http://dx.doi.org/10.1016/j.nutres.2014.04.011DOI Listing
June 2014

Age-dependent recall bias for material of internal versus external origin.

Cogn Behav Neurol 2003 Sep;16(3):160-9

Division of Neurology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033, USA.

Objective: To learn whether young and aged subjects exhibit different recall biases for internally derived (Internal) versus externally supplied (External) material.

Background: Internally derived knowledge, prized by educators and therapists, can bring about dramatic behavioral change. Such information, seldom assessed on formal memory testing, may be preferentially recalled compared with external-origin material. Under some circumstances, however, subjects may demonstrate a recall advantage for externally supplied over internally generated material.

Method: We compared Internal and External word recall in young and aged subjects with and without explicit intent to remember.

Results: Although overall the young and aged subjects recalled the same number of words, we did find a word-origin recall bias. This recall bias differed by age group (P = 0.005). When not instructed to remember words, the young subjects tended to remember more External words, while aged subjects remembered more Internal words.

Conclusions: The differences in the brain mechanisms mediating Internal versus External recall bias are unknown. However, aging may modify an Internal-External memory bias.
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http://dx.doi.org/10.1097/00146965-200309000-00003DOI Listing
September 2003

Brachioradial pruritus: cervical spine disease and neurogenic/neuropathic [corrected] pruritus.

J Am Acad Dermatol 2003 Apr;48(4):521-4

Division of Dermatology, University of Massachusetts Memorial Medical Center and Medical School, USA.

Background: The main cause of brachioradial pruritus (BRP) is not known but there is evidence to suggest that BRP may arise in the nervous system. Cervical spine disease may be an important contributing factor.

Objective: Our aim was to determine whether spine pathology is associated with BRP.

Methods: Medical charts of patients with BRP seen in the Division of Dermatology of the University of Massachusetts Medical Center between the years of 1993 and 2000 were retrospectively analyzed. On the basis of clinical index of suspicion, some patients had undergone radiography of the spine.

Results: Of 22 patients with BRP, 11 had cervical spine radiographs. The radiographs showed cervical nnspine disease that could be correlated with the location of pruritus in each of these 11 patients.

Conclusions: Patients with BRP may have underlying cervical spine pathology. Whether this association is causal or coincidental remains to be determined.
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http://dx.doi.org/10.1067/mjd.2003.203DOI Listing
April 2003