Background: Mothers who identify as Black or African American are more likely to report depressed moods in late pregnancy and early postpartum and have the lowest rates of human milk feeding compared with all other racial groups in the United States. Internet interventions offer the potential to extend preventative and supportive services as they address key barriers, particularly for those navigating the complex and vulnerable early postpartum period. However, there is limited evidence on the feasibility of such interventions for preventing perinatal mental health disorders and improving human milk feeding outcomes in Black mothers. Objective: This pilot study aimed to assess the feasibility and preliminary findings of a web-based cognitive behavioral therapy–based internet intervention, with and without human milk feeding education and support, to prevent perinatal depression and promote human milk feeding in Black mothers. Methods: Participants were Black-identifying individuals between 20 and 28 weeks of pregnancy with human milk feeding intention and mild to moderate depressive symptoms (Patient Health Questionnaire scores 5-14). Participants were randomized to either Sunnyside, a 6-week cognitive behavioral therapy–based web-based intervention, or Sunnyside Plus, which included additional education and support to promote human milk feeding. Assessments occurred at baseline, third trimester (end of antenatal treatment), 6 weeks postpartum (end of postpartum treatment), and 12 weeks postpartum. The primary focus of this randomized pilot trial was the feasibility and preliminary outcomes of mental health and human milk feeding. Results: A total of 22 tertiary-educated participants were randomized. The mean number of log-ins was 7.3 (SD 5.3) for Sunnyside and 13.8 (SD 10.5) for Sunnyside Plus. Scores of depression and anxiety measures remained below the clinical threshold for referral to treatment in both groups. All the participants initiated human milk feeding (18/18, 100%). Most participants reported at least some human milk feeding at both 6 and 12 weeks postpartum (6/7, 86%; 11/11, 100%, or 10/10, 100%, for Sunnyside and Sunnyside Plus, respectively). Conclusions: The results suggest that tertiary-educated Black mothers at risk for perinatal depression and who intended to human milk feed were receptive to and satisfied with a web-based cognitive behavioral therapy–based internet intervention, with and without human milk feeding education and support. Preliminary findings indicate that both Sunnyside and Sunnyside Plus interventions have the potential to affect symptoms of depression, anxiety, and human milk feeding outcomes. Trial Registration: ClinicalTrials.gov NCT04128202; https://www.clinicaltrials.gov/ct2/show/NCT04128202

Background: In 8 females, 1 will be diagnosed with breast cancer in their lifetime. Although medical advances have increased the likelihood of survival, up to 90% of females will gain weight during and after treatment increasing the risk of breast cancer recurrence and obesity-related comorbidities in survivorship. Behavioral lifestyle interventions focused on diet with or without physical activity can provide breast cancer survivors nonpharmacological options to decrease weight gain and cardiometabolic risk. Method: A PubMed search was conducted to identify all behavioral lifestyle interventions focused on diet or diet combined with physical activity longer than 4 weeks of duration in breast cancer survivors that included body weight as an outcome. This review aims to summarize the effects on body weight, body composition, and cardiometabolic risk markers. Results: The review shows there is high heterogeneity in type and duration of the intervention to affect weight and cardiometabolic risk in survivorship. Calorie restriction with and without physical activity appears to promote weight loss among breast cancer survivors. However, the effects on cardiometabolic factors are less clear. Conclusions: Future studies should be powered for body weight and cardiometabolic effects. Researchers should also consider interventions that (1) are less complex, (2) recruit a more racially and ethnically diverse sample, (3) integrate resistance training, (4) implement the intervention in closer proximity to diagnosis, (5) target weight management in this population before it occurs, and (6) analyze body composition in addition to body weight measurements.

Background: The optimization of treatment for pediatric cancer has increased 5-year survivor rates to over 80%. Currently, there are almost half a million survivors of a pediatric cancer alive in the United States, with numbers increasing worldwide. Despite increased survivorship, pediatric cancer survivors (PCSs) are at high risk for long-term chronic disease, including cardiometabolic dysregulation at an early age due to cancer-related treatments. PCSs often have increased adiposity, perturbation in the gut microbiome, and chronic systemic inflammation compared to age-matched controls. Time-restricted eating (TRE) has emerged as an effective dietary intervention to promote weight loss in individuals with increased adiposity and cardiometabolic disease. Prebiotic supplements may enhance the efficacy of TRE by promoting satiety via the gut microbiome. Given the accessibility of both TRE and prebiotic supplements, this type of dietary intervention may be ideal for young adult PCSs. The purpose of this study was to determine the feasibility and acceptability of 12 weeks of TRE with and without a prebiotic supplement among young adult PCSs. Changes in body weight, body composition, and cardiometabolic disease risk markers were explored. Methods: Feasibility was measured based on recruitment (n = 20), retention (>80%), and adherence to the TRE eating window and prebiotic (>80%), and acceptability was measured based on a validated survey. Body weight, body composition, blood pressure, and additional blood-based cardiometabolic disease risk markers were also measured before and following the intervention. Results: Feasibility was not met based on recruitment (n = 13), but retention and adherence exceeded the a priori hypothesis. Acceptability also met the a priori hypothesis. Improvements were observed in some cardiometabolic disease risk markers, including a significant decrease in fat mass and visceral fat mass in both groups following the intervention. Conclusions: Given the positive outcomes related to retention, adherence, and acceptability, as well as some cardiometabolic disease risk markers, a larger and longer study of TRE and prebiotic supplementation in PCSs is warranted. However, innovative recruitment strategies should be implemented, such as leveraging social media and targeting larger geographical areas, given recruitment challenges.

The population of pediatric cancer survivors (PCSs) in the United States has been steadily increasing over the last decade. However, due to cancer-related treatment and subsequent lifestyle behaviors related to diet and physical activity, PCSs are burdened by accelerated biological aging leading to early onset of chronic diseases. The accelerated aging process may be due to "inflammaging," a phenomenon associated with cardiometabolic disease risk factors, including chronic inflammation and changes in gut microbiome structure and function. This systematic review was conducted to explore the literature as it relates to the impact of diet and/or exercise interventions in survivors of a pediatric cancer on markers of inflammaging and cardiometabolic risk markers. PubMed, CINAHL, and clinicaltrials.gov were searched for relevant interventional trials. Studies were included if they contained 1) an intervention arm that included survivors of a pediatric cancer, 2) an intervention that contained a dietary and/or exercise intervention, and 3) outcomes related to cardiometabolic disease risk or inflammaging. Bias was assessed using the Cochrane "Risk of Bias Tool" or "Risk of Bias In Nonrandomized Studies of Interventions," and extracted data were qualitatively reported. Of the 16 studies identified, 2 studies employed a diet intervention, 6 studies employed an exercise intervention, and the remaining 8 implemented a combined diet and exercise intervention. Exercise was associated with an improvement in glucose homeostasis, yet results were inconsistent across studies. Decreases in body mass index and increases in lean body mass were reported in some diet and exercise interventions. Cautionary interpretation of the outcomes is warranted as the studies had a high risk of bias. Future studies in this area should include trials with a rigorous design, larger sample sizes, and increased accessibility of the intervention to address the chronic disease burden among this group of cancer survivors. The study and protocol were registered in PROSPERO (CRD42024511586).

BACKGROUND Mothers who identify as Black or African American are more likely to report depressed moods in late pregnancy and early postpartum and have the lowest rates of human milk feeding compared with all other racial groups in the United States. Internet interventions offer the potential to extend preventative and supportive services as they address key barriers, particularly for those navigating the complex and vulnerable early postpartum period. However, there is limited evidence on the feasibility of such interventions for preventing perinatal mental health disorders and improving human milk feeding outcomes in Black mothers. OBJECTIVE This pilot study aimed to assess the feasibility and preliminary findings of a web-based cognitive behavioral therapy–based internet intervention, with and without human milk feeding education and support, to prevent perinatal depression and promote human milk feeding in Black mothers. METHODS Participants were Black-identifying individuals between 20 and 28 weeks of pregnancy with human milk feeding intention and mild to moderate depressive symptoms (Patient Health Questionnaire scores 5-14). Participants were randomized to either Sunnyside, a 6-week cognitive behavioral therapy–based web-based intervention, or Sunnyside Plus, which included additional education and support to promote human milk feeding. Assessments occurred at baseline, third trimester (end of antenatal treatment), 6 weeks postpartum (end of postpartum treatment), and 12 weeks postpartum. The primary focus of this randomized pilot trial was the feasibility and preliminary outcomes of mental health and human milk feeding. RESULTS A total of 22 tertiary-educated participants were randomized. The mean number of log-ins was 7.3 (SD 5.3) for Sunnyside and 13.8 (SD 10.5) for Sunnyside Plus. Scores of depression and anxiety measures remained below the clinical threshold for referral to treatment in both groups. All the participants initiated human milk feeding (18/18, 100%). Most participants reported at least some human milk feeding at both 6 and 12 weeks postpartum (6/7, 86%; 11/11, 100%, or 10/10, 100%, for Sunnyside and Sunnyside Plus, respectively). CONCLUSIONS The results suggest that tertiary-educated Black mothers at risk for perinatal depression and who intended to human milk feed were receptive to and satisfied with a web-based cognitive behavioral therapy–based internet intervention, with and without human milk feeding education and support. Preliminary findings indicate that both Sunnyside and Sunnyside Plus interventions have the potential to affect symptoms of depression, anxiety, and human milk feeding outcomes. CLINICALTRIAL ClinicalTrials.gov NCT04128202; https://www.clinicaltrials.gov/ct2/show/NCT04128202

Background: Obesity and prediabetes in older adults are typically treated with weight management and exercise. Time-restricted eating (TRE), shortening the daily eating window, combined with aerobic training (AT) or resistance training (RT), may help reduce fat mass, preserve lean mass, and decrease cardiometabolic risk. Purpose: This pilot study was conducted to assess the feasibility and acceptability of 8-h TRE combined with AT or RT in older adults with prediabetes and obesity. Design: We implemented a 12-week two-arm randomized trial of a self-selected 8-h TRE window (10 AM-6 PM, 11 AM-7 PM, or 12-8 PM) combined with either AT or RT. Methods: Thirty-four participants were randomized to TRE-AT (n = 19) or TRE-RT (n = 15). Data on feasibility (recruitment rate), acceptability (study visit attendance, missing data, and attrition), and adherence (eating window, exercise days, and exercise prescription) were collected, and exploratory measures, including body weight, body composition, dietary intake, and biomarkers, were assessed. Results: Seventy-three percent of the TRE-AT group and 80% of the TRE-RT group completed the trial. Participants in both groups adhered to the 8-h TRE window ∼75% of the time (5.8 days/week) and attended ∼95% of weekly TRE intervention meetings. Participants exercised 81% (TRE-AT) and 88% (TRE-RT) of the days prescribed but adhered to the assigned protocol only 67%-68% of the time. No differences in feasibility or acceptability were found between groups. Only the TRE-AT group showed significant reductions in body weight and BMI from baseline. Conclusions: Eight-hour TRE with AT or RT is feasible and acceptable in older adults with prediabetes and obesity. Future trials should focus on enhancing participant engagement and adherence. Clinical Trial Registration Number: Clinicaltrials.gov NCT05290233.