Publications by authors named "Sarah E Messiah"

124 Publications

COVID Pandemic and Childhood Obesity: A Return to Normal is Too Low a Bar.

Child Obes 2021 Apr;17(3):151-152

Departments of Medicine and Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.

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http://dx.doi.org/10.1089/chi.2021.0069DOI Listing
April 2021

A Family-Based Healthy Lifestyle Intervention: Crossover Effects on Substance Use and Sexual Risk Behaviors.

Prev Sci 2021 Mar 10. Epub 2021 Mar 10.

School of Nursing and Health Studies, University of Miami, Coral Gables, FL, 33146, USA.

This study examined the efficacy of a healthy lifestyle family-based intervention in reducing substance use and sexual risk behaviors compared with prevention as usual over 24 months in Hispanic adolescents. Participants were overweight/obese Hispanic adolescents (N = 280; M age 13.01; SD = .82) in the 7th/8th grade and their primary caregivers. Participants were randomized to either the healthy lifestyle family-based intervention or to the control condition (i.e., referral to community services offered for overweight and/or obese adolescents and their families). Outcomes included adolescent substance use and sexual risk behaviors among adolescents. Intervention effects were found for adolescent alcohol (b = - 0.37, 95% CI = [- 0.49, - 0.26]), marijuana (b = - 1.00, CI = [- 1.22, - 0.78]), and non-prescription drug use (b = - 3.77, CI = [- 6.49, - 1.05]) over 24 months. No significant intervention effects were found for adolescent sexual risk behaviors. Findings suggest that Familias Unidas for Health and Wellness reduces adolescent alcohol, marijuana, and non-prescription drug use across time. ClinicalTrials.gov Identifier: NCT03943628.
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http://dx.doi.org/10.1007/s11121-021-01220-zDOI Listing
March 2021

Telehealth utilization among multi-ethnic patients with obesity during the COVID-19 pandemic.

J Telemed Telecare 2021 Mar 4:1357633X21998211. Epub 2021 Mar 4.

University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, TX, USA.

Introduction: The science of telemedicine has shown great advances over the past decade. However, the field needs to better understand if a change in care delivery from in-person to telehealth as a result of the COVID-19 pandemic will yield durable patient engagement and health outcomes for patients with obesity. The objective of this study was to examine the association of mode of healthcare utilization (telehealth versus in-person) and sociodemographic factors among patients with obesity during the COVID-19 pandemic.

Methods: A retrospective medical chart review identified patients with obesity from a university outpatient obesity medicine clinic and a community bariatric surgery practice. Patients completed an online survey (1 June 2020-24 September 2020) to assess changes in healthcare utilization modality during subsequent changes in infection rates in the geographic area. Logistic regression analysis examined the association of mode of healthcare utilization and key sociodemographic characteristics.

Results: A total of 583 patients (87% female, mean age 51.2 years (standard deviation 13.0), mean body mass index 40.2 (standard deviation 6.7), 49.2% non-Hispanic white, 28.7% non-Hispanic black, 16.4% Hispanic, 7% other ethnicity, 33.1% completed bariatric surgery) were included. Adjusted logistic regression models showed older age was inversely associated with telehealth use (adjusted odds ratio = 0.58, 95% confidence interval 0.34-0.98) and non-Hispanic black were more likely to use telehealth compared to non-Hispanic white (adjusted odds ratio = 1.72, 95% confidence interval 1.05-2.81).

Conclusions: The COVID-19 pandemic is impacting access to healthcare among patients with obesity. Telehealth is an emerging modality that can maintain healthcare access during the pandemic, but utilization varies by age and ethnicity in this high-risk population.
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http://dx.doi.org/10.1177/1357633X21998211DOI Listing
March 2021

Association between asthma and sugar-sweetened beverage consumption in the United States pediatric population.

J Asthma 2021 Mar 10:1-8. Epub 2021 Mar 10.

University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, TX, USA.

Objectives: United States (US) youth consume an average of 10 teaspoons of added sugar from sugar-sweetened beverages (SSB) on any given day. Few population-based studies have examined the association between SSB consumption and asthma in children and adolescents. This study aimed to examine the association between SSB consumption and asthma in the US pediatric population.

Design: Analytical cross-sectional study.

Setting And Participants: A total of 9,938 children aged 2-to-17 years old who participated in the 2011-2016 National Health and Nutrition Examination Surveys. SSB consumption was categorized into 3 groups based on the caloric intake from 24-hour food recall data as follows: 1) no consumption (0 kcal/day); 2) moderate consumption (1-499 kcal/day); and 3) heavy consumption (≥ 500 kcal/day). The primary outcome of interest was self-reported current asthma condition.

Results: Asthma prevalence estimates were significantly higher in heavy (16.4%) and moderate (11.0%) SSB consumers versus non-consumers (7.5%) ( < 0.05 for both comparisons). The adjusted odds of asthma were twice that among children with heavy SSB consumption (aOR 2.01, 95% confidence interval [CI] 1.31-3.08) versus non-SSB consumers. The odds of asthma were higher among those who consumed fruit drinks (aOR 2.51, 95% CI 1.55-4.08), non-diet soft drinks (aOR 1.89, 95% CI 1.23-2.89) and sweet tea (aOR 1.87, 95% CI 1.13-3.09) compared to nondrinkers. The effect was independent of obesity status (-interaction = 0.439).

Conclusions: Findings here suggest a dose-response relationship between SSB intake and asthma diagnosis, therefore controlling SSB consumption may potentially improve pulmonary health risk in the US pediatric population.
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http://dx.doi.org/10.1080/02770903.2021.1895210DOI Listing
March 2021

The authors reply.

Crit Care Med 2021 Mar;49(3):e339-e340

Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.

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http://dx.doi.org/10.1097/CCM.0000000000004869DOI Listing
March 2021

Relationship between parent perception of child anthropometric phenotype and body mass index change among children with developmental disabilities.

World J Pediatr 2021 Feb 19. Epub 2021 Feb 19.

University of Texas Health Science Center at Houston, School of Public Health, Dallas Campus, Dallas, TX, USA.

Background: Preschool-age children with developmental disabilities (DD) have higher prevalence of obesity than children without DD. This study aimed to explore the relationship between parent perception of their children's anthropometric phenotype and child body mass index (BMI) z score change over one school year among preschoolers with DD.

Methods: The analysis consisted of a subsample (N  =  64) of children with DD from a larger randomized controlled trial to test an obesity prevention program in the childcare center setting. Parents ranks their child's anthropometric phenotype on a visual silhouette chart on a scale from 1 (underweight) to 7 (obese) and that rank score is compared to their BMI z score change over one school year.

Results: The majority (75%) of parents with an obese child underestimated their child's anthropometric phenotype while 7% parents with a non-obese child overestimated. Parent overestimation of child anthropometric phenotype status is associated with increased BMI z score change over 1 school year among preschool-age children with disabilities.

Conclusion: Parental overestimation of child anthropometric phenotype status was associated with weight gain in preschool children with DD after one school year.
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http://dx.doi.org/10.1007/s12519-021-00420-5DOI Listing
February 2021

The association between neighborhood quality, youth physical fitness, and modifiable cardiovascular disease risk factors.

Ann Epidemiol 2021 May 14;57:30-39. Epub 2021 Feb 14.

Department of Population Health Sciences, Duke University School of Medicine, Durham, NC; Department of Family Medicine & Community Health, Duke University School of Medicine, Durham, NC. Electronic address:

Purpose: Striking disparities persist in cardiovascular disease risk factors among minority youth. We examined the association between multiple indicators of neighborhood quality and minority youth fitness.

Methods: The primary exposure was the Child Opportunity Index (COI), a measure comprised of indicators that facilitate healthy child development. Outcome data were drawn from the 2018-2019 Fit2Play Study (Miami-Dade County, FL). Hotspot analysis evaluated COI spatial clustering. Generalized linear mixed models examined cross-sectional COI-fitness associations.

Results: The sample included 725 youth (53% Black, 43% Hispanic; 5-17 years). Significant neighborhood quality spatial clusters were identified (Gi* = -4.85 to 5.36). Adjusting for sociodemographics, walkability was associated with lower percentiles in body mass index (BMI) and diastolic blood pressure percentiles (DBP) (β = -5.25, 95% CI: -8.88, -1.62 and β = -3.95, 95% CI: -7.02, -0.89, respectively) for all, lower skinfold thickness (β = -4.83, 95% CI: -9.97, 0.31 and higher sit-ups (β = 1.67, 95% CI: -0.17, 3.50) among girls, and lower systolic blood pressure percentiles (SBP) (β = -4.75, 95% CI: -8.99, -0.52) among boys. Greenspace was associated with higher BMI (β = 6.17, 95% CI: 2.47, 9.87), SBP (β = 3.47, 95% CI: -0.05, 6.99), and DBP (β = 4.11, 95% CI: 1.08, 7.13).

Conclusions: COI indicators were positively associated with youth fitness. Disparities in youth cardiovascular disease risk may be modifiable through community interventions and built environment initiatives targeting select neighborhood factors.
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http://dx.doi.org/10.1016/j.annepidem.2021.02.004DOI Listing
May 2021

Intersection of smoking, e-cigarette use, obesity, and metabolic and bariatric surgery: a systematic review of the current state of evidence.

J Addict Dis 2021 Feb 5:1-19. Epub 2021 Feb 5.

School of Public Health, Dallas Regional Campus, University of Texas Health Science Center, Dallas, TX, USA.

Background: Millions of Americans qualify for metabolic and bariatric surgery (MBS) based on the proportion of the population with severe obesity. Simultaneously, the use of electronic nicotine/non-nicotine delivery systems (ENDS) has become epidemic.

Objective: We conducted a timely systematic review to examine the impact of tobacco and ENDS use on post-operative health outcomes among MBS patients.

Methods: PRISMA guidelines were used as the search framework. Keyword combinations of either "smoking," "tobacco," "e-cigarette," "vaping," or "ENDS" and "bariatric surgery," "RYGB," or "sleeve gastrectomy" were used as search terms in PUBMED, Science Direct, and EMBASE. Studies published in English between January 1990 and June 2020 were screened.

Results: From the 3251 articles found, a total of 48 articles were included in the review. No articles described a relationship between ENDS and post-operative health outcomes in MBS patients. Seven studies reported smokers had greater post-MBS weight loss, six studies suggested no relationship between smoking and post-MBS weight loss, and one study reported smoking cessation pre-MBS was related to post-MBS weight gain. Perioperative use of tobacco is positively associated with several post-surgery complications and mortality in MBS patients.

Conclusions: Combustible tobacco use among MBS patients is significantly related to higher mortality risk and complication rates, but not weight loss. No data currently is available on the impact of ENDS use in these patients. With ENDS use at epidemic levels, it is imperative to determine any potential health effects among patients with severe obesity, and who complete MBS.
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http://dx.doi.org/10.1080/10550887.2021.1874817DOI Listing
February 2021

Substance use, mental health and weight-related behaviours during the COVID-19 pandemic in people with obesity.

Clin Obes 2021 Apr 4;11(2):e12440. Epub 2021 Feb 4.

Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center, School of Public Health, Dallas, Texas, USA.

Studies have shown the negative impact of COVID-19 lockdown orders on mental health and substance use in the general population. The aim of this study was to examine the impact of the COVID-19 pandemic onsubstance use, mental health and weight-related behaviors in a sample of adults with obesity after lockdown orders were lifted (June-September 2020). A retrospective medical chart review identified patients with obesity from one university-based obesity medicine clinic, and two metabolic and bariatric surgery (MBS) practices. Patients who completed an online survey from June 1, 2020 to September 30, 2020 were included. The primary outcome measure was substance use (various drugs, alcohol, tobacco). Substance use and mental health survey questions were based on standardized, validated instruments. A total of 589 patients (83.3% female, mean age 53.6 years [SD 12.8], mean BMI 35.4 [SD 9.1], 54.5% Non-Hispanic white, 22.3% post-MBS) were included. Seventeen patients (2.9%) tested positive for SARS-CoV-2 and 13.5% reported symptoms. Nearly half (48.4%) of the sample reported recreational substance use and 9.8% reported increased use since the start of the pandemic. There was substantial drug use reported (24.3% opioids, 9.5% sedative/tranquilizers, 3.6% marijuana, and 1% stimulants). Patients who reported stockpiling food more (adjusted Odds Ratio [aOR] 1.50, 95% CI 1.03-2.18), healthy eating more challenging (aOR 1.47, 95% CI 1.01-2.16), difficulty falling asleep (aOR 1.64, 95% CI 1.14-2.34), and anxiety (aOR 1.47, 95% CI 1.01-2.14) were more likely to report substance use versus non-users. Results here show that the COVID-19 pandemic is having a deleterious impact on substance use, mental health and weight-related health behaviors in people with obesity regardless of infection status.
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http://dx.doi.org/10.1111/cob.12440DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7988649PMC
April 2021

Objective Measurement of Physical Activity Attributed to a Park-Based Afterschool Program.

J Phys Act Health 2021 Jan 31;18(3):329-336. Epub 2021 Jan 31.

Background: Only 24% of US youth meet physical activity recommendations set by the Centers for Disease Control and Prevention. Research demonstrates that community-based programs provide underresourced minority youth with opportunities for routine physical activity, although limited work draws from accelerometry data. This study objectively assessed youth physical activity attributable to participation (vs nonparticipation) days in a park-based afterschool program in Miami-Dade County, Miami, FL.

Methods: Participants' (n = 66; 60% male; 57% white Hispanic, 25% non-Hispanic black, 14% Black Hispanic, mean age = 10.2 y) physical activity was assessed April to May 2019 over 10 days across 7 park sites using Fitbit (Charge 2) devices. Separate repeated-measures multilevel models were developed to assess the relationship between program daily attendance and total (1) moderate to vigorous physical activity minutes and (2) step counts per day.

Results: Models adjusted for individual-level age, sex, race/ethnicity, poverty, and clustering by park showed significantly higher moderate to vigorous physical activity minutes (β = 25.33 more minutes per day; 95% confidence interval, 7.0 to 43.7, P < .01) and step counts (β = 4067.8 more steps per day; 95% confidence interval, 3171.8 to 4963.8, P < .001) on days when youth did versus did not attend the program.

Conclusions: Study findings suggest that park-based programs may support underserved youth in achieving daily physical activity recommendations.
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http://dx.doi.org/10.1123/jpah.2020-0162DOI Listing
January 2021

The Feasibility of Collecting Longitudinal Cardiovascular and Fitness Outcomes From a Neighborhood Park-Based Fitness Program in Ethnically Diverse Older Adults: A Proof-of-Concept Study.

J Aging Phys Act 2020 Dec 20:1-9. Epub 2020 Dec 20.

This proof-of-concept study examined feasibility of assessing longitudinal changes in body mass index, strength, mobility, and cardiovascular health outcomes in older, racial/ethnic minority adults participating in a park-based physical activity program. Study feasibility was based on follow-through data collection procedures and ability to manage and implement data collection, enrollment, and repeated measures data collection in older adults (≥50 years; n = 380; 45% Hispanic, 41% non-Hispanic Black) over a 28-month period. Mixed models were developed to estimate the effects of program participation over time on participant cardiovascular and fitness outcomes and across poverty and age subgroups. Model estimates adjusted for individual-level sociodemographics showed improvements across each 4 month time point in arm strength (0.55 arm curl; 95% confidence interval [0.33, 0.77]) and systolic (-0.68 mmHg; 95% confidence interval [-1.22, -0.13]) and diastolic (-0.47 mmHg; 95% confidence interval [-0.79, -0.16]) blood pressure. An Age × Poverty interaction found greater improvements in systolic and diastolic blood pressure among younger participants living in low poverty (vs. older in higher poverty). Study of the longitudinal association between fitness class participation and health outcomes was feasible in park-based settings.
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http://dx.doi.org/10.1123/japa.2020-0139DOI Listing
December 2020

Type 2 Diabetes and HbA1c Predict All-Cause Post-Metabolic and Bariatric Surgery Hospital Readmission.

Obesity (Silver Spring) 2021 Jan 20;29(1):71-78. Epub 2020 Nov 20.

School of Public Health, University of Texas Health Science Center, Dallas, Texas, USA.

Objective: The main goal of this analysis was to determine whether type 2 diabetes and hemoglobin A1c (HbA1c) predict all-cause 30-day hospital readmission after metabolic and bariatric surgery (MBS). It was hypothesized that a diagnosis of type 2 diabetes or high HbA1c values would predict all-cause hospital readmission rates post MBS.

Methods: A retrospective analysis from the 2015-2018 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) cohort was completed (N = 744,776); 30,972 participants were readmitted during the 30 days post MBS.

Results: Mean age of the MBSAQIP sample was 45.1 (11.5) years, and the majority were female (80.7%) and non-Hispanic White (59.4%). The all-cause hospital readmission rate was 4.2% and increased by 10% in those with uncontrolled type 2 diabetes (HbA1c > 7.5% [> 58 mmol/mol]); after adjustment, diabetes was not associated with increased readmission. Uncontrolled type 2 diabetes, type 2 diabetes, and prediabetes resulted in less weight loss 30 days post MBS.

Conclusions: These results based on a national MBS cohort showed that uncontrolled type 2 diabetes is associated with a greater likelihood of all-cause hospital readmission and reduced weight loss 30 days post MBS. Both type 2 diabetes and prediabetes were also associated with decreased weight loss 30 days post MBS. These findings highlight the need to classify and optimize glycemic control prior to MBS.
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http://dx.doi.org/10.1002/oby.23044DOI Listing
January 2021

Medicaid expansion and provision of prescription contraception to Medicaid beneficiaries.

Contraception 2021 Mar 17;103(3):199-202. Epub 2020 Nov 17.

Department of Medicine, UT Southwestern Medical Center, Dallas TX, USA.

Introduction: Medicaid expansion increased access to care, but longitudinal patterns of contraception use after the Medicaid expansion have not been described.

Methods: We evaluated the effects of Medicaid expansion on the amount and type of contraceptive prescriptions using the Medicaid State Utilization Dataset.

Results: Overall long-acting reversible contraception (LARC) use increased in both expansion and non-expansion states. In a difference-in-differences analysis, states that expanded Medicaid had no appreciable increase in per-capita prescription rates of LARC (p = 0.26) or short-acting hormonal contraception (p = 0.09) when compared to nonexpansion states.

Discussion: The Medicaid expansion was not associated with a change in per-capita LARC or short-acting hormonal contraception use.
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http://dx.doi.org/10.1016/j.contraception.2020.11.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8011849PMC
March 2021

Results of a Family-Based Intervention Promoting Healthy Weight Strategies in Overweight Hispanic Adolescents and Parents: An RCT.

Am J Prev Med 2020 11 1;59(5):658-668. Epub 2020 Oct 1.

Department of Public Health Sciences, University of Miami, Miami, Florida; Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, Florida; University of Texas Health Science Center, School of Public Health, Dallas, Texas; Center for Pediatric Population Health, UTHealth School of Public Health and Children's Health System of Texas, Dallas, Texas.

Introduction: Hispanic adolescents in the U.S. are disproportionately affected by overweight and obesity compared with their White, non-Hispanic counterparts. This study examines the efficacy of an evidence-based family intervention adapted to target obesity-related outcomes among Hispanic adolescents who were overweight/obese compared with prevention as usual.

Study Design: This study was an RCT.

Setting/participants: Participants were Hispanic adolescents who were overweight/obese (n=280, mean age=13.01 [SD=0.82] years) in the 7th/8th grade and their primary caregivers. Primary caregivers were majority female legal guardians (88% female, mean age=41.88 [SD=6.50] years).

Intervention: Participants were randomized into the family-level obesity-targeted intervention or referral to community services offered for overweight/obese adolescents and families (condition). Data collection began in 2015.

Main Outcome Measures: Primary outcomes included dietary intake (e.g., reduction of sweetened beverages) and past-month moderate-to-vigorous physical activity. Secondary outcomes were BMI and family functioning assessed among adolescents and primary caregivers.

Results: Study analyses (2019) indicated no significant intervention effects for adolescents' primary outcomes. Intervention effects were found for parents' intake of fresh fruits and vegetables (β=0.12, 95% CI=0.02, 0.23), added sugar (β= -0.11, 95% CI= -0.22, -0.004), and sweetened beverages (β= -0.12, 95% CI=-0.23, -0.02), and parents showed decreased BMI (β= -0.05, 95% CI= -0.11, -0.01) at 6 months after baseline compared with usual prevention. Intervention effects were found for adolescent family communication (β=0.13, 95% CI=0.02, 0.24), peer monitoring (β=0.12, 95% CI=0.01, 0.23), and parental involvement (β=0.16, 95% CI=0.06, 0.26) at 6 months after baseline compared with prevention as usual.

Conclusions: This intervention was not effective in improving overweight/obesity-related outcomes in adolescents. The intervention was effective in improving parents' dietary intake and BMI; however, the effects were not sustained in the long term. Other intervention strategies (e.g., booster sessions, increased nutritional information) may be necessary to sustain beneficial effects and extend effects to adolescent participants.

Trial Registration: This study is registered at www.clinicaltrials.gov NCT03943628.
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http://dx.doi.org/10.1016/j.amepre.2020.06.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7577952PMC
November 2020

An Implementation Approach Comparison of a Child Care Center-Based Obesity Prevention Program.

J Dev Behav Pediatr 2021 Feb-Mar 01;42(2):135-145

Department of Pediatrics, University of Miami, Miami, FL.

Objective: To compare the effectiveness of the Healthy Caregivers-Healthy Children (HC2) phase 1 (2011-2014) and 2 (2015-2018) child care center (CCC)-based obesity prevention intervention(s) on child dietary practices and body mass index percentile (PBMI) outcomes over 2 years. Phase 1 was implemented via a university-based research team, and phase 2 was delivered via a train-the-trainers approach (university-based research team trains preschool-based coaches, who in turn train CCC teachers to implement and disseminate HC2).

Methods: Phase 1 and 2 were both cluster randomized controlled trials of the HC2 obesity prevention intervention. Phase 1 was composed of 1224 children in 28 CCCs (12 intervention and 16 control). Phase 2 was composed of 825 children in 24 CCCs (12 intervention and 12 control). Both phases included CCCs serving low-resource, predominantly ethnic minority families.

Results: The mean rate of weekly fruit consumption significantly increased (β = 0.16, p = 0.001) in phase 1, whereas vegetable intake significantly increased (β = 0.16, p = 0.002) in phase 2 intervention CCCs. Fried (β = -0.36, p < 0.001), fast (β = -0.16, p = 0.001), and other unhealthy food (β = -0.57, p < 0.001) consumption significantly decreased in phase 1 only. The mean rate of snack food consumption significantly decreased in phase 2 (β = -0.97, p < 0.001). Mean child PBMI remained in the healthy range over 2 years for all groups in both study phases.

Conclusion: A university-based research team implementation and dissemination approach seemed to be more effective than a train-the-trainers implementation method in improving dietary intake patterns. This finding suggests that CCCs may need robust educational support beyond their existing internal resources for long-term positive dietary intake pattern changes.
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http://dx.doi.org/10.1097/DBP.0000000000000861DOI Listing
August 2019

Prognostic Value of Hypochloremia in Critically Ill Patients With Decompensated Cirrhosis.

Crit Care Med 2020 Nov;48(11):e1054-e1061

Division of Pulmonary/Critical Care, UT Southwestern Medical Center, Dallas, TX.

Objectives: Cirrhosis is frequently complicated by electrolyte disturbances, with prior studies primarily focused on the importance of hyponatremia. Emerging evidence on patients with chronic heart failure and chronic kidney disease has identified hypochloremia as an independent predictor for mortality. This study aimed to investigate the prognostic value of serum chloride and its association with mortality in cirrhotic patients.

Design: Retrospective cohort study.

Setting: The medical ICU at Parkland Memorial Hospital, a tertiary care public health system in Dallas, Texas.

Patients: Adult patients with confirmed diagnosis of decompensated cirrhosis who were admitted to the ICU between March 2015 and March 2017.

Interventions: None.

Measurements And Main Results: Kaplan-Meier analysis and multivariable Cox proportional hazard ratio models were performed to determine the impact of hypochloremia on 180-day mortality. Of the 389 enrolled patients, 133 (34.2%) died within 180 days of ICU admission. Patients with hypochloremia had higher 180-day mortality than those with normochloremia (45.2% vs 26.7%; p < 0.0001). Cumulative survival via the Kaplan-Meier method was significantly lower in the hypochloremic group. Serum chloride was independently associated with 180-day mortality with multivariable adjustment (hazard ratio, 0.95; 95% CI, 0.93-0.98; p = 0.001) or after adjusting for Model for End-stage Liver Disease or Sequential Organ Failure Assessment. Contrarily, the inverse association between serum sodium and mortality no longer existed in all multivariable models.

Conclusions: Serum chloride is independently and inversely associated with short-term mortality in critically ill cirrhotic patients. Hypochloremia, but not hyponatremia, remained associated with mortality with multivariable analyses, suggesting that hypochloremia may account for the mortality risk previously attributed to hyponatremia. These findings signify the prognostic value of serum chloride and potential inclusion of chloride into future cirrhosis prognostic scores.
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http://dx.doi.org/10.1097/CCM.0000000000004620DOI Listing
November 2020

Disparity Between United States Adolescent Class II and III Obesity Trends and Bariatric Surgery Utilization, 2015-2018.

Ann Surg 2020 Sep 15. Epub 2020 Sep 15.

Department of Surgery, University of Miami Miller School of Medicine, USA.

Objectives: Severe obesity is the fastest growing subcategory of obesity in the United States (US) pediatric population. Metabolic and bariatric surgery (MBS) is a safe and effective treatment option for severe obesity. The primary objectives of this analysis were to determine the (1) current US MBS utilization rates in those with severe obesity; and (2) utilization rates and 30-day post-operative outcomes.

Summary Background Data: The 2015-2018 National Health and Nutrition Examination Survey (NHANES) cross-sectional data (N = 19,225) generated US severe obesity prevalence estimates. The 2015-2018 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) longitudinal (30 day) cohort data was used to compare adolescent and adult (N = 760,076) post-operative outcomes and to calculate utilization rates.

Methods: The 2015-2018 youth and adult MBS utilization rates were calculated using MBSAQIP data (numerator) and NHANES data (denominator). Two-sample tests of proportions were performed to compare the MBS utilization rates by age, ethnicity and sex and expressed per 1,000.

Results: Mean age of the analytical MBSAQIP sample was 17.9 (1.15) years in youth (n = 3,846) and 45.1 (11.5) in adults (N = 744,776), majority female (77.4%, 80.7%, respectively) and non-Hispanic white (68.5%, 59.4%, respectively). The overall 2015-2018 MBS utilization rate for youth was 1.81 per 1,000 and 5.56 per 1,000 for adults (P < .001). Adult patients had slightly higher percentage (4.2%) of hospital readmissions compared to youth (3.4%, P = .01) but there were no other post-MBS complication differences. From 2015-2018 the US prevalence of youth severe obesity increased in Hispanics and non-Hispanic blacks (P-trend < .001), but non-Hispanic whites had higher rates of MBS utilization (45.8%) compared to Hispanics (22.7%) and non-Hispanic blacks 14.2% (P = .006).

Conclusions: MBS is an underutilized obesity treatment tool for both youth and adults, and among ethnic minority groups in particular.
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http://dx.doi.org/10.1097/SLA.0000000000004493DOI Listing
September 2020

The COVID-19 cannabis health study: Results from an epidemiologic assessment of adults who use cannabis for medicinal reasons in the United States.

J Addict Dis 2021 Jan-Mar;39(1):26-36. Epub 2020 Sep 15.

University of Texas Health Science Center School of Public Health, Dallas Campus, Dallas, TX, USA.

: Clinical indications for medicinal cannabis include chronic conditions; thus users (MCUs) are at an increased risk of morbidity and mortality resulting from SARS-CoV-2 infection (COVID-19). The study aimed to provide data on cannabis use and self-reported behavioral changes among MCUs with preexisting chronic conditions in response to the pandemic. An internet-based questionnaire was administered to adults ≥18 who self-reported medicinal cannabis use within the past year. Data are from respondents between March 21 and April 23, 2020; response rate was 83.3%. Health conditions and cannabis frequency, route, and patterns of use were assessed via the COVID-19 Cannabis Health Questionnaire (Vidot et al. 2020). Participants ( = 1202) were predominantly non-Hispanic white (82.5%) and 52.0% male (mean age 47.2 years). Mental health (76.7%), pain (43.7%), cardiometabolic (32.9%), respiratory (16.8%), and autoimmune (12.2%) conditions were most reported. Those with mental health conditions reported increased medicinal cannabis use by 91% since COVID-19 was declared a pandemic compared to those with no mental health conditions (adjusted odds ratio: 1.91, 95% CI: 1.38-2.65). 6.8% reported suspected COVID-19 symptoms. Two percent (2.1%) have been tested for COVID-19 with only 1 positive test result. Some MCUs (16%) changed their route of cannabis administration, switching to nonsmoking forms. The majority of MCUs reported at least one preexisting chronic health condition. Over half report fear of COVID-19 diagnosis and giving the virus to someone else; yet only some switched from smoking to nonsmoking forms of cannabis. Clinicians may consider asking about cannabis use among their patients, particularly those with chronic health conditions.
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http://dx.doi.org/10.1080/10550887.2020.1811455DOI Listing
January 2021

Longitudinal Effects of Transportation Vulnerability on the Association Between Racial/Ethnic Segregation and Youth Cardiovascular Health.

J Racial Ethn Health Disparities 2020 Sep 2. Epub 2020 Sep 2.

Department of Pediatrics, University of Miami Miller School of Medicine, 1601 NW 12th Ave, Miami, FL, USA.

Background: Transportation vulnerability (defined as lack of personal/public transportation access) is particularly prevalent in areas with high racial/ethnic segregation where communities typically lack proximity to quality education, jobs, healthy food, playgrounds, and medical care. Prior research has shown an association between residential segregation and youth cardiovascular health, although little work has examined the effects of transportation vulnerability on this relationship.

Methods: Longitudinal mixed methods were used to compare the effects of transportation vulnerability on the association between changes in exposure to residential segregation (defined as the uneven geographic distribution of minorities) and five cardiovascular health outcomes across sex in minority youth for up to four consecutive years of participation in an afterschool fitness program during 2010-2018 (n = 2742; Miami-Dade County, Florida, US).

Results: After accounting for child race/ethnicity, age, year, and poverty, girls with high transportation vulnerability and reduced exposure to segregation (vs. increased or no change in segregation) showed the most improvements across all outcomes, including body mass index percentile (26% (95% CI 23.84, 28.30)), sum of skinfold thicknesses (18% (95% CI 14.90, 20.46)), run time (17% (95% CI 14.88, 18.64)), systolic blood pressure percentile (15% (95% CI 11.96, 17.08)), and diastolic blood pressure percentile (12% (95% CI 9.09, 14.61)).

Conclusion: Transportation inequities related to concentrated racial/ethnic segregation may be an important factor in reducing disparities in youth cardiovascular health, particularly among girls. These study findings provide important longitudinal evidence in support of health interventions to reduce transportation vulnerability for racial/ethnic minority youth in underserved areas.
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http://dx.doi.org/10.1007/s40615-020-00821-8DOI Listing
September 2020

A Preliminary Study on the Influence of Cannabis and Opioid Use on Weight Loss and Mental Health Biomarkers Post-weight Loss Surgery.

Obes Surg 2020 11;30(11):4331-4338

University of Texas Health Science Center School of Public Health, Dallas Campus, Dallas, TX, USA.

Purpose: A subpopulation of weight loss surgery (WLS) patients endorse cannabis and/or opioid use; however, impact on post-WLS anxiety and depression is unclear. This study examined the influence of the independent and combined use of cannabis and opioids on (1) depression and anxiety, (2) duodenum serotonin and cortisol, and (3) total percent weight loss.

Materials And Methods: A cross-sectional analysis was conducted among patients (N = 18) who had biomarkers of serotonin and cortisol collected from the duodenum during WLS. Cannabis and opioid use was determined by self-reported lifetime, past-year, and past 30-day use. The Beck Anxiety Inventory and Depression Inventory-II assessed depression and anxiety symptoms. Total percent weight loss was calculated from pre-WLS and post-WLS weight (kg). Chi-squared analyses and t tests were conducted.

Results: Over a quarter (27.8%) were cannabis-only users and 16.7% used a combination of cannabis and opioids. None reported using only opioids in this sample. Combination users presented with greater depressive symptoms (22.7%, p = 0.01) and greater total percent weight loss (34.1%, p = 0.04) than cannabis users (7.8, 23.2%, respectively). Cannabis users had greater serotonin (p = 0.02) and cortisol (p = 0.01) levels than combination users and never users.

Conclusions: Cannabis users had greater cortisol levels than never users and combination users. Combination users had greater weight loss and depression symptoms than cannabis users. Future studies should consider a larger sample size, utilization of a cohort design to address causality, and examination of the type, dose, and route of cannabis and opioid administration to further understand the impact of the combined use of cannabis and opioids post-WLS.
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http://dx.doi.org/10.1007/s11695-020-04828-2DOI Listing
November 2020

Parent concerns regarding paediatric obesity in community-based programmes serving children with developmental disabilities.

Child Care Health Dev 2020 11 27;46(6):733-740. Epub 2020 Aug 27.

School of Public Health, University of Texas Health Science Center, Houston, Texas, USA.

Background: Previous studies show a higher prevalence of obesity among preschool-age children with developmental disabilities (DDs) versus children who are typically developing (TD). Little is known about parent concerns about obesity in young children with DD. The purpose of this study was to examine concerns regarding paediatric obesity among parents who had a preschool-age child with DD compared with parents with a child who is TD.

Methods: A cross-sectional analysis occurred at baseline entry into one of three community-based programmes. Parents of a child with DD (n = 815) or TD (n = 563) were asked obesity-related questions about their child and in general. Multinomial and logistic regression unadjusted and adjusted models were run to generate the odds of obesity concerns based on disability status.

Results: The average child age was 38 months. Parent concerns about paediatric obesity differed by disability status. Unadjusted odds of parents 'doing anything to control their child's weight' was 38% lower among parents of a child with DD versus TD (OR: 0.62, 95% CI: 0.48, 0.82). The adjusted odds of perceiving that their child was underweight was 83% higher among parents of a child with DD compared with parents of a child who is TD (aOR: 1.83, 95% CI: 1.27, 2.64). Parents of a child with DD were 179% more likely to believe that childhood obesity is a public health problem (aOR: 2.79, 95% CI: 1.88, 3.96). The models were adjusted for age, sex and race/ethnicity.

Conclusions: Findings indicate that parents of preschool-age children with DD are more likely to acknowledge that obesity is a public health concern. Because some parents of children with DD are concerned about their child's weight, families of preschool-age children with DD may be receptive to the delivery of healthy weight strategies in community-based programs.
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http://dx.doi.org/10.1111/cch.12803DOI Listing
November 2020

Ethnic disparities in the e-cigarette use epidemic and childhood asthma in the US.

Pediatr Pulmonol 2020 10 27;55(10):2498-2500. Epub 2020 Jul 27.

Department of Epidemiology, Human Genetics & Environmental Health, University of Texas School of Public Health, Health Science Center, Dallas Campus, Dallas, Texas.

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http://dx.doi.org/10.1002/ppul.24971DOI Listing
October 2020

Association Between Concussion History and Factors Relating to Cognitive, Behavioral, and Emotional Health Among American High School Athletes: A Cross-sectional Analysis.

Am J Sports Med 2020 08 21;48(10):2534-2543. Epub 2020 Jul 21.

Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA.

Background: The cognitive, behavioral, and emotional deficits that may be associated with sports-related concussions among adolescents are unclear.

Purpose: To examine the association between reported concussion history and factors relating to cognitive, behavioral, and emotional health among a population-based sample of US high school-aged adolescents.

Study Design: Cross-sectional study; Level of evidence, 3.

Methods: Participants included a representative sample of US high school student-athletes who reported a concussion history (in the past 12 months) and relevant behaviors/outcomes within 3 domains: cognitive (academics, difficulty concentrating), behavioral (drinking and driving, carrying a weapon, physically fighting, tobacco use, marijuana use, binge drinking), and emotional (symptoms of depression, suicidal thoughts/actions). The adjusted relative odds of experiencing 0 and at least 1, 2, 3, or ≥4 concussions were modeled while mutually adjusting for the behaviors of interest in addition to age, race/ethnicity, and sleep problems. Data were reported in sex stratum.

Results: A total of 13,268 participants were included in the unweighted data set. Overall, 14.5% (95% CI, 12.9%-16.2%) of female and 18.1% (95% CI, 16.4%-19.8%) of male student-athletes had at least 1 concussion in the past 12 months. As compared with those who reported not engaging in any of the behaviors deleterious to health or having had any of the negative health outcomes (composite score of 0), female athletes with composite scores of 1 to 4, 5 to 7, and 8 to 11 were 1.94 (95% CI, 1.55-2.43), 3.13 (95% CI, 2.30-4.33), and 6.05 (95% CI, 3.75-9.75) times more likely to have a recent history of concussions after accounting for relevant factors. As compared with those having a composite score of 0, male athletes with composite scores of 1 to 4, 5 to 7, and 8 to 11 were 2.03 (95% CI, 1.58-2.59), 3.80 (95% CI, 2.71-5.34), and 8.23 (95% CI, 4.91-13.77) times more likely to have a recent history of concussions after accounting for relevant factors.

Conclusion: Self-reported concussions among US high school athletes is related to several deleterious health behaviors and outcomes. These associations should be confirmed in longitudinal analyses.
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http://dx.doi.org/10.1177/0363546520938776DOI Listing
August 2020

Resistance Training in Post-Metabolic and Bariatric Surgery Patients: a Systematic Review.

Obes Surg 2020 10 16;30(10):4071-4080. Epub 2020 Jul 16.

School of Public Health, Department of Epidemiology, Human Genetics & Environmental Sciences, University of Texas Health Science Center at Houston, Dallas, TX, USA.

Resistance exercise guidelines exist for obesity but not for post-metabolic and bariatric surgery (MBS) patients. Therefore, the main goal of the present study is to provide evidence to support resistance exercise guidelines for this population. A secondary goal is to evaluate the available evidence to identify gaps for future research. Nine studies evaluating the effect of resistance exercise post-MBS on strength and body composition were included. Resistance training consistently prevented strength loss and when performed by younger population (~ 35 years) also prevented lean mass loss. Combined exercise, but not strength training independently, was found to promote body fat mass loss. Resistance training should be added to post-MBS exercise programs. Sufficiently powered studies using higher volume resistance training with supportive protein consumption and diverse populations are needed.
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http://dx.doi.org/10.1007/s11695-020-04837-1DOI Listing
October 2020

Comparison of Early Life Obesity-Related Risk and Protective Factors in Non-Hispanic Black Subgroups.

Matern Child Health J 2020 Sep;24(9):1130-1137

Department of Pediatrics, University of Miami, Miami, FL, USA.

Objectives: Previous obesity prevention studies in preschool-age children have included non-Hispanic Black (NHB) children, but few have investigated between-subgroup differences even though there may be cultural risk and protective practice differences, challenging the generalizability of findings. The purpose of this study was to examine differences in early childhood obesity-related factors in NHB subgroups (Haitian, other Caribbean Islander and African-American [AA]) children.

Methods: Baseline data from two randomized controlled trials in 52 childcare centers of which 35 had data to test a preschool-based obesity prevention intervention was analyzed. The sub-sample included 370 caregiver-child dyads; 209 self-identified as AA, 120 as Haitian and 41 as Caribbean Islander/West Indian or mixed race. Multilevel regression models generated outcome estimates for group differences in body mass index (BMI) percentile, birthweight, breastfeeding initiation and duration, bottle feeding duration and age when solid foods were introduced.

Results: Mean BMI percentile was similar for AA, Haitian and Caribbean Islander/West Indian/Multiracial (60.1th percentile, 60.8th percentile, 62.8th percentile, respectively) as was birthweight (6.3, 6.8, and 6.6 lb, respectively). Children of US-born caregivers had significantly lower BMI percentiles (9.13 percentile points) versus foreign-born caregivers. Haitian women were significantly more likely to initiate breastfeeding (64.9%) versus AA (47.6%) and Caribbean Islander/West Indian/Multiracial (62.2%) (p < .01). No significant group differences were found in breastfeeding or bottle feeding duration or age solid foods were introduced.

Conclusions: Findings here suggest that NHB race classification can identify important subgroup behavioral similarities which in turn may inform culturally sensitive strategies to promote early childhood healthy weight. Foreign-born caregivers may benefit from healthy weight promotion information, and as early as possible in their child's development.
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http://dx.doi.org/10.1007/s10995-020-02979-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7423728PMC
September 2020

Family Mealtime Communication in Single- and Dual-Headed Households Among Hispanic Adolescents With Overweight and Obesity.

J Nutr Educ Behav 2020 09 25;52(9):840-849. Epub 2020 Jun 25.

University of Texas Health Science Center, School of Public Health, Dallas, TX; Center for Pediatric Population Health, Children's Health System of Texas and UTHealth School of Public Health, Dallas, TX.

Objective: To investigate the association of adolescent self-report of family mealtime communication on obesity-related behaviors in single- and dual-parent households and by sex in a sample of overweight and obese Hispanic adolescents.

Design: Cross-sectional analysis of a randomized control trial SETTING: Eighteen middle schools in Miami-Dade County, Florida.

Participants: Two-hundred and eighty Hispanic seventh- and eighth-grade students MAIN OUTCOME MEASURES: Physical activity, fruit and vegetable intake, and added sugar intake.

Analysis: Structural equation modeling.

Results: The findings indicate that mealtime communication was associated with fruit and vegetable consumption in boys (β = .30; P = .001; 95% confidence interval [CI], 0.52-2.68) and physical activity in girls (β = .26; P = .010; 95% CI, 0.16-1.30). Moreover, a single-parent household was associated with dietary consumption in boys (fruit and vegetable intake [β= .18; P = .039; 95% CI, 0.02-2.60] but had a moderating effect on fruit and vegetable consumption in girls (β = .21; P = .015; 95% CI, 0.14-2.19).

Conclusions And Implications: Family mealtime communication may impact dietary and physical activity outcomes in Hispanic adolescents with overweight and obesity, but differentially across gender and household parent makeup. These findings, together with the prevalence of single parents, point to the importance of targeting Hispanic single parents as agents of change to promote healthy lifestyle behaviors in their children via positive mealtime interactions.
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http://dx.doi.org/10.1016/j.jneb.2020.03.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492453PMC
September 2020

Estimated Prevalence of Asthma in US Children With Developmental Disabilities.

JAMA Netw Open 2020 06 1;3(6):e207728. Epub 2020 Jun 1.

School of Public Health, University of Texas Health Science Center at Houston, Dallas Campus, Dallas.

Importance: The prevalence of asthma in US children with various developmental disabilities and delays is unclear, including how estimates vary by ethnic group.

Objective: To report asthma prevalence estimates by various disability categories and developmental delays in a diverse sample of the US pediatric population.

Design, Setting, And Participants: This population-based cross-sectional study encompassed a total of 71 811 families with children or adolescents aged 0 to 17 years (hereinafter referred to as children) who participated in the 2016 and 2017 National Survey of Children's Health. Data were collected from June 10, 2016, to February 10, 2017, for the 2016 survey and from August 10, 2017, to February 10, 2018, for the 2017 survey. Data were analyzed from September 20, 2019, to April 5, 2020.

Exposures: Developmental disability, including attention-deficit/hyperactivity disorder, autism spectrum disorder, cerebral palsy, seizure, intellectual and/or learning disability, and vision, hearing, and/or speech delay. Delay was defined as not meeting growth milestones with unknown cause.

Main Outcomes And Measures: Weighted asthma prevalence estimates and 95% CIs were generated for children with and without disabilities.

Results: A total of 71 811 participants (mean [SE] age, 8.6 [0.1] years; 36 800 boys [51.1%; 95% CI, 50.2%-52.0%]; 50 219 non-Hispanic white [51.4%; 95% CI, 50.6%-52.3%]) were included in our final analytical sample, of whom 5687 (7.9%; 95% CI, 7.5%-8.4%) had asthma and 11 426 (15.3%; 95% CI, 14.7%-16.0%) had at least 1 disability. Overall asthma prevalence estimates were 10 percentage points higher in children with a disability (16.1%; 95% CI, 14.3%-17.8%) vs children without a disability (6.5%; 95% CI, 6.0%-6.9%). The odds of asthma were significantly higher in children with a disability (odds ratio [OR], 2.77; 95% CI, 2.39-3.21) or delay (OR, 2.22; 95% CI, 1.78-2.77) vs typically growing children. Adjusted models remained significant for all disability categories (overall adjusted OR, 2.21; 95% CI, 1.87-2.62). Subgroup analyses showed ethnic minorities had a higher prevalence of concurrent asthma and developmental disabilities vs non-Hispanic whites (19.8% [95% CI, 16.6%-23.0%] vs 12.6% [95% CI, 11.1%-14.0%]; P < .001).

Conclusions And Relevance: These results suggest that US children with various developmental disabilities or delay may have higher odds for developing asthma vs their typically developing peers. These findings support asthma screening in pediatric health care settings among patients with developmental disabilities and delays, particularly among those from ethnic minority backgrounds. In addition, very young children with asthma should be screened for disabilities and delays, because temporality cannot be determined by the current data source and analytical approach.
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http://dx.doi.org/10.1001/jamanetworkopen.2020.7728DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298611PMC
June 2020

Impact of COVID-19 stay-at-home orders on weight-related behaviours among patients with obesity.

Clin Obes 2020 Oct 12;10(5):e12386. Epub 2020 Jul 12.

University of Texas Health Science Center, School of Public Health, Dallas, Texas, USA.

How the impact of the COVID-19 stay-at-home orders is influencing physical, mental and financial health among vulnerable populations, including those with obesity is unknown. The aim of the current study was to explore the health implications of COVID-19 among a sample of adults with obesity. A retrospective medical chart review identified patients with obesity from an obesity medicine clinic and a bariatric surgery (MBS) practice. Patients completed an online survey from April 15, 2020 to May 31, 2020 to assess COVID-19 status and health behaviours during stay-at-home orders. Logistic regression models examined the impact of these orders on anxiety and depression by ethnic group. A total of 123 patients (87% female, mean age 51.2 years [SD 13.0]), mean BMI 40.2 [SD 6.7], 49.2% non-Hispanic white (NHW), 28.7% non-Hispanic black, 16.4% Hispanic, 7% other ethnicity and 33.1% completed MBS were included. Two patients tested positive for severe acute respiratory syndrome coronavirus 2 and 14.6% reported symptoms. Then, 72.8% reported increased anxiety and 83.6% increased depression since stay-at-home orders were initiated. Also 69.6% reported more difficultly in achieving weight loss goals, less exercise time (47.9%) and intensity (55.8%), increased stockpiling of food (49.6%) and stress eating (61.2%). Hispanics were less likely to report anxiety vs NHWs (adjusted odds ratios 0.16; 95% CI, 0.05-0.49; P = .009). Results here showed the COVID-19 pandemic is having a significant impact on patients with obesity regardless of infection status. These results can inform clinicians and healthcare professionals about effective strategies to minimize COVID-19 negative outcomes for this vulnerable population now and in post-COVID-19 recovery efforts.
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http://dx.doi.org/10.1111/cob.12386DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7300461PMC
October 2020

Determinants of accurate visual perception of child anthropometric phenotype among ethnically diverse preschool parents in the United States.

Health Soc Care Community 2020 11 8;28(6):2095-2104. Epub 2020 Jun 8.

Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA.

The literature reports that regardless of the high obesity prevalence estimates in young children, parents often do not accurately perceive their child's weight status. The purpose of this analysis was to examine the association between parent/child demographic characteristics including ethnicity, country of birth and years living in the United States and the perception of child's anthropometric phenotype status based on a visual silhouette instrument. Caregiver (n = 456) and child sociodemographic, perception of child anthropometric phenotype status and height/weight measurements were collected in 2015, from 24 childcare centres in Miami, Florida, among children ages 2-to-5 years old. Chi-square analysis determined parent perception accuracy by actual child healthy (
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http://dx.doi.org/10.1111/hsc.13020DOI Listing
November 2020

Relationship between risky behaviors and non-prescription opioid use among Asian American youth.

J Ethn Subst Abuse 2020 Jun 4:1-10. Epub 2020 Jun 4.

University of Texas Health Science Center (UTHealth), Dallas, Texas.

Asian Americans (AA) are a highly understudied population and are often considered the "model minority" for health. However, there is a dearth of research on risky behaviors associated with opioid use in AA teens. Data among AA youth aged 12 to 16 was collected from the 2017 Youth Risk Behavior Surveillance System. Multivariate logistic regression models were run to determine associations between opioid use and risky behaviors, controlling for age and sex. Findings showed that opioid use is significantly associated with weapon carrying, risky sexual behavior, and body image. These conclusions inform public health practice on substance abuse treatment in AA teens.
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http://dx.doi.org/10.1080/15332640.2020.1772931DOI Listing
June 2020