Few studies have investigated the impact of lifestyle interventions during pregnancy on post-partum weight retention and infant growth. Thirty seven previously non-exercising, overweight or obese pregnant women were randomly assigned to a walking intervention or non-intervention control. For the follow-up study, weight of the mother and weight, length and body composition of the infant were collected at 1 month post-partum (n=37) and 6 months post-partum (n=33). Analysis of variance and linear regression were conducted to determine the differences and association in maternal post-partum weight retention and child outcomes. At 6 months post-partum, weight retention of obese women in the intervention group (Int-OB) was −0.10±8.11 kg; while, obese women in the control group (Con-OB) was 6.35±7.47 kg. A significantly higher percentage of Con-OB women retained more than 5 kg at 6 months post-partum (P=0.046). Even though statistically non-significant between the groups, the growth trend observed among offspring of obese women in the control group was consistently higher than the offspring of obese women in the intervention group from birth to 6-months. Third trimester gestational weight gain rate significantly predicted 6-m weight-for-length z-score after controlling for birth weight, treatment group and pre-pregnancy body mass index (r²=0.31, β=1.75, P=0.03). The reduced post-partum weight retention observed among the obese women in the intervention group may be explained in part by the lifestyle modification during pregnancy.

School Wellness Integration Targeting Child Health (SWITCH^®) is a school wellness implementation initiative focused on building capacity for schools to plan and coordinate wellness programming. Grounded in Social Cognitive Theory (SCT), the purpose of this study was to evaluate the utility of the web-based, self-regulation system on physical activity (PA) behavior outcomes. At pre-test and post-test, students in SWITCH^® schools (n = 8) completed the online Youth Activity Profile (YAP) to assess PA and sedentary behavior (SB). Students (n = 513) were categorized into high or low self-monitoring groups (using a median split) based on their use of the web-based self-regulation platform. Linear mixed models were used to assess differences in moderate-to-vigorous PA (MVPA) and sedentary behavior, with school, classroom, student, time-by-school, and time-by-classroom random effects and main and interaction fixed effects for student self-monitoring, gender, and time. Significant self-monitoring-by-time interactions were observed for estimates of PA F(1, 477) = 5.55, p = 0.02 and SB F(1, 477) = 4.90, p = 0.03. Students in the high self-monitoring group had larger gains in PA per day and larger declines in hours per day of sedentary screen time behavior compared to students in the low self-monitoring group. These findings support the utility of web-based self-regulation for facilitating PA change in youth.

Introduction: The average American diet is high in red and processed meats which increases one's risk for chronic diseases and requires more land and water to produce and yields greater greenhouse gases (GHG) compared to other protein foods. Reduction of red and processed meat intake, such as seen with the Dietary Approaches to Stop Hypertension (DASH diet), could benefit human and environmental health.Objective: The objective of this study is to predict the environmental sustainability of the DASH diet by evaluating the GHG, land use, and water withdrawals from protein foods within the self-selected diets of people who were encouraged to follow the DASH diet.Methods: Dietary data was collected from 380 Midwesterners aged 35-70 years old with hypertension using the Automated Self-Administered 24-Hour (ASA 24) Recall System. DASH diet adherence was measured using a nutrient-based DASH score. GHG, land use, and water withdrawals were obtained using Carnegie Mellon University's Economic Input-Output Life Cycle Assessment (eiolca.net) using the Purchaser model (cradle-to-consumer). Multiple linear regressions were used to view associations between individual DASH nutrient scores and environmental impacts of total, animal, and plant protein foods.Results: Diets that met DASH diet guidelines, as indicated by higher individual DASH nutrient scores, were associated with less GHG and land use from total and animal protein foods but more GHG and land use from plant-protein foods, with a few exceptions. The pattern was not clear for water withdrawals. Diets with the greatest adherence had around 25–50% lower GHG and land use from total protein foods than diets with the lowest adherence. Changes may be due to decreased consumption of total and animal protein foods, selection of animal protein foods with lower environmental impacts, and increased consumption of plant protein foods.Conclusion: Adhering to the DASH diet can promote the consumption of less environmentally demanding protein foods resulting in lower GHG and land use from protein foods. However, claims regarding the sustainability of the entire dietary pattern cannot be determined based off the current study. Regardless, it is evident that environmental impacts should be considered alongside health impacts when selecting, promoting, or recommending a dietary pattern.

Poor dietary choices are a leading cause of preventable chronic disease. Consequently, improving dietary choices is a key public health goal. While several approaches are available to influence dietary choices, consumer education is likely a key to improving the diet. One approach to educating consumers is to provide grocery store tours where consumers are provided with nutrition education where purchasing decisions are often made. At this time, there has been limited research to show the effectiveness of this approach or to develop best practices. A possible barrier to innovation in this area concerns the difficulty to get access to grocery stores to conduct tours. Moreover, these barriers may also hamper research efforts to identify best practices. A possible alternative approach is to create virtual worlds where grocery store tours can be conducted remotely. This present manuscript describes an approach to developing virtual grocery stores as a method for providing nutrition education with a description of the design possibilities.

Background: The purpose of this study was to evaluate the implementation and effectiveness of an ecological, multi-component adolescent obesity prevention intervention called School Wellness Integration Targeting Child Health–Middle School (SWITCH–MS). Methods: Following the effectiveness-implementation hybrid type 3 quasi-experimental design, seven middle schools (377 students) in Iowa, United States, were stratified into “experienced” (n = 3; 110 students) or “inexperienced” (n = 4; 267 students) groups to receive the 12-week SWITCH–MS intervention. To evaluate implementation, school informants (n = 10) responded to a survey and students completed behavioral tracking in the classroom on a website. For effectiveness evaluation, students in 6th, 7th, and 8th grades completed a validated questionnaire before and after intervention, to measure behaviors of physical activity (PA; “Do”), screen-based activity (“View”), and fruits and vegetable consumption (“Chew”). Results: The two groups of schools showed similar levels of implementation for best practices, awareness, and engagement. Behavioral tracking rate favored the experienced schools early on (47.5% vs. 11.7%), but differences leveled off in weeks 3–12 (sustained at 30.1–44.3%). Linear mixed models demonstrated significant time effects for “Do” (at school and out of school; p < 0.01) and “View” behaviors (p = 0.02), after controlling for student- and school-level covariates. Conclusions: This study demonstrates that prior experience with SWITCH–MS may not be a prominent factor for implementation and effectiveness, although greater experience is associated with favorable behavioral tracking when the intervention is first launched.