Field Notes

Smartphone Intervention Shows No Benefit for Weight Regain Prevention

A scalable, mobile phone–based intervention designed to slow weight regain after an initial weight loss had no significant effect on participants’ weight, according to a study published in PLOS Medicine by Falko Sniehotta, PhD, a professor of behavior medicine and health psychology at Newcastle University in the United Kingdom, and colleagues.

Obesity is a major contributor to preventable life-years lost worldwide, and, while effective behavioral weight loss interventions are available, weight loss often is followed by weight regain. In the new study, researchers carried out a randomized controlled trial involving 288 people from North East England with obesity who recently had lost at least 5% of their body weight. The NULevel intervention consisted of a single face-to-face goal-setting meeting, self-monitoring, and personalized feedback on weight, diet, and physical activity via SMS text messages with embedded links. The control group received standard lifestyle advice via newsletter.

Overall, 264 participants completed the trial. Those participating in the intervention group weighed themselves more frequently and were more physically active. However, the mean weight gain over the 12-month study period was similar in the two groups, with an average of 1.8 kg (95% CI 0.5 to 3.1) gained in the intervention group and 1.8 kg (95% CI 0.6 to 3) gained in the control group. The data suggest that the intervention is unlikely to be considered cost-effective in its current form.

“We conclude that the incremental dose of the NULevel intervention over the active control condition might have been insufficient to affect weight outcomes,” according to the authors. “This research should inform future intervention design decisions regarding delivery modality and intensity.”

— Source: PLOS


Preschoolers With Chronic Constipation Tend to Be Picky Eaters

In the first study of its kind in the United States, researchers found that normally developing preschool children with chronic constipation have underlying sensory issues that contribute to their difficulties with toileting behaviors. These children often are picky eaters who might be overly sensitive to food textures, tastes, or odors. They also might have an exaggerated response to noises, bright lights, or other sensory stimuli. Findings are published in The Journal of Pediatrics.

“Our study is revolutionary, revealing that chronic constipation in young children accompanies heightened sensory sensitivity,” says senior author Mark Fishbein, MD, a pediatric gastroenterologist at Ann & Robert H. Lurie Children’s Hospital of Chicago and an associate professor of pediatrics at Northwestern University Feinberg School of Medicine. “In many cases, chronic constipation might be the first hint that the child also has some sensory issues and could benefit from occupational therapy. Feeding problems due to sensory sensitivities are especially common in these children and they are best addressed when kids are under 5, before maladaptive behaviors become more entrenched.”

In the study, Fishbein and colleagues assessed the differences in sensory processing patterns among 66 children, aged 3 to 5, with chronic constipation and a matched group of 66 controls. They also examined how the children’s sensory profiles correlate to atypical toileting behaviors. They determined that children with chronic constipation showed increased responses to sensory stimuli and increased avoidance behaviors. Heightened oral sensory processing (ie, sensitivity to food textures, tastes, or odors) emerged as the most significant factor in predicting the child’s tendency to behaviors such as withholding stool or overall bathroom avoidance.

“On the surface, the association between oral processing and constipation may not seem intuitive,” Fishbein says. “However, increased sensory sensitivity can create discomfort and lead to avoidance, and we see that response in both food refusal and in the toileting behaviors of children with chronic constipation. Both feeding problems and constipation may develop as a result of sensory processing difficulties.”

Recognition of the association between chronic constipation and sensory sensitivity could transform clinical practice.

“Our study offers an expanded tool kit to clinicians who care for children with chronic constipation,” Fishbein says. “Comprehensive care of these children should include consideration of sensory issues and possible referral to occupational therapy.”

— Source: Ann & Robert H. Lurie Children’s Hospital of Chicago