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Baltimore Highlands, MD, United States

Hsieh S.,Behavior and Society | Klassen A.C.,Behavior and Society | Klassen A.C.,Drexel University | Caulfield L.E.,Center for Human Nutrition | And 6 more authors.
Preventive Medicine Reports | Year: 2015

Objective: The purpose of this cross-sectional study was to establish neighborhood built environment correlates of adiposity as measured by dual X-ray absorptiometry. The utility and methodological gains of using this measure for built environment research were further investigated by comparing model fit across parallel models on body mass index z-scores and waist circumference. Methods: Pre-existing data collected from 2001 to 2011 on 576 overweight and obese Hispanic youth were compiled with built environment data, and 2000 census data for analyses conducted in 2012. Walking-distance buffers were built around participants' residential locations. Variables for park space, food access, walkability, and neighborhood socio-cultural aspects were entered into a multivariate regression model predicting percent body fat. Parallel models were built for body mass index z-score, and waist circumference. Results: Significant associations were found between percent body fat and supermarket access for boys, and percent body fat and increased park space and decreased neighborhood linguistic isolation for girls. Neighborhood socio-cultural characteristics accounted for more variance in obesity compared to body mass index z-score or waist circumference. Conclusion: Park access, food environment, and neighborhood socio-cultural characteristics are independent contributors to body fat in children, and the contribution of these risks differs by gender. There are incremental gains to using a more accurate measure of body fat in built environment obesity studies. © 2015. Source

Cheskin L.J.,Johns Hopkins Weight Management Center | Sonzone C.M.,Medifast Inc | Davis L.M.,Villanova University
Neurology: Clinical Practice | Year: 2012

Obesity and excess body fat contribute to both the risk for and progression of several prevalent neurologic conditions. While obesity treatment is not generally considered part of the job description of the neurologist, we summarize the evidence for this important relationship, and describe ways that being mindful of diet and lifestyle factors in the neurologic patient can yield dividends for patient outcomes. Copyright © by AAN Enterprises, Inc. Source

Kahan S.,George Washington University | Cheskin L.J.,Johns Hopkins Weight Management Center
Diabetes Educator | Year: 2012

Purpose: The purpose of this study is to assess the relationship between magnitude of weight loss and improvement in percentage A1C (A1C%) among overweight and obese patients with type 2 diabetes mellitus (DM) undergoing weight reduction. Methods: Case records of patients enrolled in 2 university-based weight management programs were reviewed. Patients were sampled if they had a diagnosis of DM and had at least 1 documented A1C% reduction from their baseline value. Weight loss treatment was individualized and consisted of a calorie-restricted diet, a behavior modification plan, and a plan for increasing physical activity. Patient weights were measured at bimonthly visits. A1C% was measured every 3 months. Results: Seventy-two patients formed the study cohort. Mean baseline body mass index was 35.1 kg/m2, mean age was 52.6 years, and 59% were males. Mean starting A1C% was 8.6. Patients achieved significant mean weight loss (10.7 kg) at study exit. Weight loss of 6.5 kg (4.5% of baseline body weight), 12.2 kg (8.7%), and 15.9 kg (10.3%) was required to reduce A1C% by 0.5, 1, and 1.5, respectively, and it took a mean of 5.6, 8.7, and 10.1 months, respectively, to achieve this. After adjustment for antidiabetic medication intake, for every 10% weight loss, the predicted reduction in A1C% was 0.81. Conclusions: Intentional weight loss of 10% can potentially decrease A1C% by 0.81 among patients with type 2 DM. This finding may be clinically useful in encouraging and counseling a patient attempting weight loss. © 2012 The Author(s). Source

Cheskin L.J.,Johns Hopkins Weight Management Center | Frutchey R.,Global Obesity Prevention Center | Mcdermott A.Y.,Global Obesity Prevention Center | Esposito L.,U.S. National Institutes of Health | And 2 more authors.
Pediatric Obesity | Year: 2016

Background: Research on the types of interventions needed for population-level prevention of childhood obesity in complex societal systems can benefit from greater use of systems-science concepts and tools. Objectives: We report outcomes of a funding programme promoting incorporation of systems-science approaches into studies of imminent policy or environmental changes potentially impacting childhood obesity. Methods: Seven funding cycles over 3 years yielded 172 initial submissions from 29 US states and 25 other countries were analyzed. Results: Submissions focused primarily on aspects of school or child-care settings, parks and recreational settings, or access to healthy food; about half reflected attention to systems perspectives. Conclusions: Analysis of initial submissions as well as the 15 funded projects showed some success in motivating use of systems concepts and tools but suggested the need for a more focused effort to educate and prepare the childhood obesity prevention research community for this potentially crucial type of research. © 2016 The Authors. Source

Wong M.S.,Global Obesity Prevention Center and Johns Hopkins | Nau C.,Global Obesity Prevention Center and Johns Hopkins | Kharmats A.Y.,Global Obesity Prevention Center and Johns Hopkins | Vedovato G.M.,Federal University of Sao Paulo | And 5 more authors.
BMC Public Health | Year: 2015

Background: Product placement influences consumer choices in retail stores. While sugar sweetened beverage (SSB) manufacturers expend considerable effort and resources to determine how product placement may increase SSB purchases, the information is proprietary and not available to the public health and research community. This study aims to quantify the effect of non-SSB product placement in corner stores on adolescent beverage purchasing behavior. Corner stores are small privately owned retail stores that are important beverage providers in low-income neighborhoods - where adolescents have higher rates of obesity. Methods: Using data from a community-based survey in Baltimore and parameters from the marketing literature, we developed a decision-analytic model to simulate and quantify how placement of healthy beverage (placement in beverage cooler closest to entrance, distance from back of the store, and vertical placement within each cooler) affects the probability of adolescents purchasing non-SSBs. Results: In our simulation, non-SSB purchases were 2.8 times higher when placed in the "optimal location" - on the second or third shelves of the front cooler - compared to the worst location on the bottom shelf of the cooler farthest from the entrance. Based on our model results and survey data, we project that moving non-SSBs from the worst to the optional location would result in approximately 5.2 million more non-SSBs purchased by Baltimore adolescents annually. Conclusions: Our study is the first to quantify the potential impact of changing placement of beverages in corner stores. Our findings suggest that this could be a low-cost, yet impactful strategy to nudge this population - highly susceptible to obesity - towards healthier beverage decisions. © 2015 Wong et al. Source

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