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Studies of adiposity and cognition’s relationship have been highly mixed, depending on points in the lifespan when adiposity and cognition were measured, primarily with low Black American representation. Therefore, we examined the association between adiposity (from early to mid-life) and mid-life cognition in an Black American (BA) and White American longitudinal cohort to address these literature gaps. The Bogalusa Heart Study has followed participants from childhood to adulthood since 1973. Adiposity was measured via body mass index (BMI) at roughly biannual visits from 1973–2016 and cognition was measured in 1295 participants between 2013- 2016. Cognition included Logical Memory I, II and II Recognition, Digit Spans Forward and Backward, Trail Making Tests A and B, and a global composite. BMI was averaged within age epochs (childhood/adolescence; early adulthood (EA); midlife (M)) with childhood/adolescence BMI as percentiles. Separate linear regression models were run for each cognitive measure (outcome), BMI within one epoch, and sex, race, and education (predictors). All analyses included the 1292 individuals who provided complete data across all epochs. Greater BMI within EA and M was associated with better global cognition (EA: Est. 0.139 S.D./BMI p = 0.000; M: Est. 0.094 S.D./BMI p = 0.022), and Logical Memory I (EA: Est. 0.036 S.D./BMI p = 0.000; M: Est. 0.022 S.D./BMI p = 0.000), II (EA: Est. 0.036 S.D./BMI p = 0.000; M: Est. 0.020 S.D./BMI p = 0.022) and II Recognition (EA: Est. 0.029 S.D./BMI p = 0.000; M: Est. 0.022 S.D./BMI p = 0.000) among men. Among BA, greater BMI within EA and M was associated with better Logical Memory I (EA: Est. 0.022 S.D./BMI p = 0.000; M: Est. 0.019 S.D./BMI p = 0.000) and II (EA: Est. 0.018 S.D./BMI p = 0.042; M: Est. 0.017 S.D./BMI p = 0.000). Greater adiposity from early adulthood to midlife was associated with better memory performance in midlife (associations strongest among men and Black Americans). More anatomically precise measurements of adiposity (e.g., subcutaneous vs. visceral fat) could help clarify the complex adiposity cognition relationship across the lifespan.

This study aims to identify fathers' profiles integrating food parenting practices (FPP) and physical activity parenting practices (PAPP). We analysed cross-sectional data. The fathers completed the reduced FPP and PAPP item banks and socio-demographic and family dynamics (co-parenting and household responsibility) questionnaires. We identified fathers' profiles via latent profile analysis. We explored the influence of social determinants, child characteristics and family dynamics on fathers' profiles using multinomial logistic regression. Online survey in the USA. Fathers of 5-11-year-old children. We analysed data from 606 fathers (age = 38 ± 8·0; Hispanic = 37·5 %). Most fathers self-identified as White (57·9 %) or Black/African American (17·7 %), overweight (41·1 %) or obese (34·8 %); attended college (70 %); earned > $47 000 (62·7 %); worked 40 hrs/week (63·4 %) and were biological fathers (90·1 %). Most children (boys = 55·5 %) were 5-8 years old (65·2 %). We identified five fathers' profiles combining FPP and PAPP: (1) ( 94 (15·5 %)); (2) ( 160 (26·4 %)); (3) ( 117 (19·3 %)); (4) ( 113 (18·6 %)) and (5) ( 122 (20·1 %)). We observed significant associations with race, ethnicity, child characteristics, co-parenting and household responsibility but not with education level, annual income or employment status. We observed significant pairwise differences between profiles in co-parenting and household responsibility, with the presenting higher scores in both measures. Understanding how fathers' FPP and PAPP interact can enhance assessments for a comprehensive understanding of fathers' influences on children's health. Recognising the characteristics and differences among fathers' profiles may enable tailored interventions, potentially improving children's health trajectories.

In this cluster-randomized trial, carried out in an underserved population, the authors hypothesized that a high-intensity lifestyle intervention would result in greater weight loss than usual care. Patients assigned to the high-intensity program lost significantly more weight than patients who received usual care.

African American adults experience a high prevalence of obesity and its associated comorbidities, including diabetes. Church-based interventions have been shown to be effective in decreasing weight in this population. mHealth interventions can address two needs for obesity treatment in this community, including enhancing weight loss and providing wide dissemination. This study aimed to assess the feasibility and efficacy of a church-based weight loss intervention that incorporates mHealth technology. In this study, 8 churches (n=97) were randomly assigned to the intervention or delayed intervention condition (control group). We recruited participants through their respective church. Volunteer church members were trained by study staff to deliver the 10-session, 6-month intervention. Participants in the intervention group attended group sessions and received automated short message service (SMS) text messages designed to reinforce behavioral strategies. Conversely, participants in the delayed intervention condition received SMS text messages related to health conditions relevant for African American adults. We obtained measures of body composition, blood pressure, blood glucose, and cholesterol. We successfully recruited 97 African American adults, with a mean age of 56.0 (SE 10.3) years and a mean body mass index of 38.6 (SE 6.4) kg/m2 (89/97, 91.8% females), who attended the churches that were randomized to the intervention (n=68) or control (n=29) condition. Of these, 74.2% (72/97) of the participants (47/68, 69.1% intervention; 25/29, 86.2% delayed intervention) completed the 6-month assessment. The average intervention group attendance was 55%. There was a significant difference in weight loss (P=.04) between participants in the intervention (-1.5 (SE 0.5) kg) and control (0.11 (SE 0.6) kg) groups. Among participants in the intervention group, the correlation between the number of SMS text messages sent and the percent body fat loss was r=.3 with P=.04. The participants reported high satisfaction with the automated SMS text messages. Automated SMS text messages were well-received by participants, suggesting that more enhanced mHealth technologies are a viable option for interventions targeting African American adults. ClinicalTrials.gov NCT02863887; https://clinicaltrials.gov/ct2/show/NCT02863887 (Archived by WebCite at http://www.webcitation.org/71JiYzizO).

African American men are at a higher risk for serious health conditions such as cardiovascular disease, diabetes, and stroke compared to non-Hispanic White men. Physical activity (PA) is a modifiable health behavior that has been shown to decrease chronic disease risk; yet, PA engagement is alarmingly low in African American men. Interventions to improve PA engagement are effective in a number of populations; however, very few have been tailored to the unique needs of African American men. Even fewer have leveraged mobile health apps, despite African American men's interest in and willingness to use such technologies for health improvement. This comparative effectiveness trial aims to evaluate MobileMen, a PA promotion app tailored to the needs and preferences of African American men. This trial will compare the MobileMen app to a commercially available PA promotion app with similar features but lacks culturally tailored components. We will recruit a sample of \"low active\" (accumulating <7500 steps per day) African American men (n=100) aged >30 years from Baton Rouge, Louisiana, and the surrounding communities. All participants are given a Fitbit Charge 6 wearable activity tracker to assess daily PA and steps and are randomized to either the MobileMen intervention app or the comparator app, which is a commercially available PA tracking app called Stridekick. The Stridekick app has features similar to those in the MobileMen app but was not intentionally designed for African American men. The intervention period is 6 months during which participants will interact with their assigned mobile app. MobileMen includes features such as digital badges earned for PA; tangible prizes like exercise equipment; challenges among participants; goal setting; nutrition; PA; and behavior change educational information in text, audio, and video formats. Participants will complete assessments at baseline and at 6 months post randomization. Assessments include objective measurements of daily steps and minutes of moderate to vigorous PA, quality of life, dietary measures, self-efficacy for fruit and vegetable consumption and PA, and autonomous motivation for PA. This trial is in the start-up phase. The MobileMen app development and usability testing was completed in August 2024. Participant recruitment efforts began in October 2024. The trial and associated data analyses and interpretation are planned to be completed by fall 2025. Mobile apps are a widely accessible means to disseminate culturally tailored PA promotion interventions to various populations, including African American men. MobileMen has the potential to impact PA engagement in African American men, which would dramatically improve the overall health and chronic disease risk in this underrepresented group. ClinicalTrials.gov NCT05621044; https://clinicaltrials.gov/study/NCT05621044. PRR1-10.2196/67809.

It has recently been recommended that sedentary behavior be defined as sitting or reclining activities expending less than 1.5 metabolic equivalents (METs), which is distinct from the traditional viewpoint based on insufficient moderate-vigorous activity or formal exercise. This study was designed to determine the energy expenditure associated with common sedentary behaviors. Twenty-five African American adults (BMI 27.8 ± 5.5) participated in the metabolic chamber study. Participants entered the metabolic chamber in the morning and their basal metabolic rate was estimated. They were fed breakfast and then engaged in four different sedentary behaviors sequentially, lasting 30 minutes each. The activities included reclining, watching TV, reading, and typing on a computer. In the afternoon, the participants were fed lunch and then the activities were repeated. The results show that the energy expenditure values between the morning and afternoon sessions were not significantly different (p = .232). The mean energy expenditure of postprandial reclining (0.97 METs) was slightly, but significantly, lower than postprandial watching TV (p = .021) and typing (p<.001). There were no differences in energy cost (1.03-1.06 METs) between the seated (i.e., reading, typing, watching TV) sedentary activities. The energy expenditure of several common sedentary behaviors was approximately 1.0 METs in the postprandial state. The results support the conclusion that the average energy cost of common sedentary behaviors is narrowly banded around 1.0 METs in the postprandial state.

Background High levels of sedentary behavior and low physical activity are associated with poor health, and the cognitive determinants of these behaviors in children and adolescents are not well understood. To address this gap, we developed a novel, non-verbal, computer-based assessment to quantify the degree to which youth prefer to be sedentary relative to physically active in their leisure time. Methods The Activity Preference Assessment (APA) uses a forced-choice paradigm to understand implicit decision-making processes when presented with common sedentary and physical activities. The APA bias score ranges from − 100 to + 100, with positive scores indicating a relative preference for sedentary activities, and negative scores representing a preference for physical activities. In 60 children ages 8–17 years, we assessed the validity of this behavioral task against a free-choice play observation, accelerometry-measured activity, anthropometrics and body composition, and cardiorespiratory fitness. We explored neighborhood, family, and individual-level factors that may influence implicit activity preferences. Test-retest reliability was assessed over one week. Results The majority of children (67%) preferred sedentary relative to physical activities. APA bias scores were positively associated with sedentary time during free-choice play. In girls, bias scores were negatively associated with average daily MVPA. APA bias scores were positively associated with body fat and negatively associated with cardiorespiratory fitness. These findings were independent of age, sex, and race/ethnicity. Neighborhood access to physical activity spaces, the number of people in the home, perceived physical self-competence (e.g., coordination, strength), and self-reported depressive symptoms were associated with activity preferences. The intra-class correlation for test-retest reliability was r  = 0.59. Conclusions The APA shows promise as a novel tool for quantifying children’s relative preference for sedentary versus physical activities. Implicit bias scores from the APA are clinically meaningful, as shown by significant associations with adiposity and cardiorespiratory fitness. Future longitudinal studies should examine the directionality of the association between preferences and health markers, and the degree to which implicit activity preferences are modifiable. Importantly, the task only takes an average of 10 min to complete, highlighting a potential role as an efficient screening tool for the propensity to be sedentary versus physically active. Trial registration ClinicalTrials.gov NCT03624582 .

Background Low income and low health literacy are associated with poorer health knowledge, health behaviors and poor health outcomes. The effectiveness of health literacy-directed weight loss treatment interventions in primary care clinics is lacking. Objective The aim of this study was to conduct a pragmatic cluster-randomized trial (PROmoting Successful Weight Loss in Primary CarE in Louisiana ([PROPEL]) to test the effectiveness of a 24-month, patient-centered, literacy-directed obesity treatment program delivered within primary care in an underserved population. This study reports the association between health literacy and program effectiveness, examining potential correlates of weight loss related to patient adherence to the program. Methods We randomly assigned 18 clinics to usual care (UC) or a health literacy-directed lifestyle intervention (HLI). The primary outcome was percent weight loss at 24 months. Key Results Of 803 adult participants (84% women; 67% Black), 31% had limited health literacy. Patients in UC lost an average of 0.44%of their enrollment weight after 24 months. Those with adequate literacy lost 0.57% and those with limited literacy lost 0.30%, which was not significantly different. The HLI patient group lost an average of 4.9% of their enrollment weight. Those with adequate literacy lost 5.2% and those with limited literacy, 4.7%, which was not significantly different. The advantage of adequate health literacy was consistent across the 24-month study period, though not significant. Patients in the HLI group with adequate health literacy had greater percent weight loss by a margin of 0.50 ± 0.75 (p = .50), while the UC margin was 0.27 ± 0.84 (p = .74). The percent weight loss difference between HLI and UC groups was 4.6 ± 0.8 (p < .001) among patients with adequate health literacy and 4.4 ± 1.0 (p < .001) among patients with limited health literacy. The difference in percent weight loss between the HLI and UC groups was 0.2 ± 1.1 (p = .84) higher for adequate literacy patients. Conclusions A health literacy directed health coaching intervention in community clinics led to significant weight loss over 24 months but did not vary by level of patient health literacy. [HLRP: Health Literacy Research and Practice. 2024;8(4):e204–e211.] Plain Language Summary Our 2-year health literacy-appropriate obesity treatment program delivered in community clinics was effective in engaging underserved patients with low income and helping them lose weight. The personal health coaching strategy mitigated the impact of low health literacy. Patients who received more in-person coaching sessions lost more weight, suggesting literacy appropriate materials and communication with the health coach are important to weight loss success.

One in 10 preschoolers (aged 3-4 y) meet the three 24-hour Movement Guidelines, that is, (1) physical activity, (2) sedentary screen time, and (3) sleep. The overarching aim of this study is to evaluate the effectiveness and feasibility of a 12-week mobile health home-based intervention on 24-hour movement behaviors in preschoolers who meet few guidelines (zero or 1 guideline). We will conduct a 12-week randomized controlled trial with a wait-list control in 80 families (40 per arm). Preliminary studies in this population informed intervention app content, features, and app development. Behavior change theories, including transfer theory and the multi-process action control framework, helped inform content presentation and topics. Primary outcomes include device-based and parent-report measures of 24-hour movement behaviors, and the secondary outcome is the feasibility and acceptability of the app. Exploratory outcomes include preschoolers' cognitive and motor skills, changes within the home environment, and behavioral control processes. This 2-phase study (K99/R00) received initial funding in March 2022, and preliminary studies were concluded in December 2023. The main grant received institutional review board approval in April 2024, and the grant funding began in May 2024. The study was registered in Clinical Trials in October 2024 and enrolled its first participant in January 2025. As of October 2025, the study has enrolled 39 families. We anticipate the trial will be completed in late 2026. This research is designed to test a novel approach to improve all three 24-hour movement behaviors in preschoolers in home settings by using a mobile app. Results from this study will have implications for future 24-hour movement interventions, our understanding of improving all 3 behaviors, and ultimately, improvements in preschoolers' health. Clinicaltrials.gov NCT06667661; https://clinicaltrials.gov/study/NCT06667661. DERR1-10.2196/75621.

Background Currently there are limited data as to whether dietary intake can be improved during pragmatic weight loss interventions in primary care in underserved individuals. Methods Patients with obesity were recruited into the PROPEL trial, which randomized 18 clinics to either an intensive lifestyle intervention (ILI) or usual care (UC). At baseline and months 6, 12, and 24, fruit and vegetable (F/V) intake and fat intake was determined. Outcomes were analyzed by repeated-measures linear mixed-effects multilevel models and regression models, which included random cluster (clinic) effects. Secondary analyses examined the effects of race, sex, age, and food security status. Results A total of 803 patients were recruited. 84.4% were female, 67.2% African American, 26.1% received Medicaid, and 65.5% made less than $40,000. No differences in F/V intake were seen between the ILI and UC groups at months 6, 12, or 24. The ILI group reduced percent fat at months 6, 12, and 24 compared to UC. Change in F/V intake was negatively correlated with weight change at month 6 whereas change in fat intake was positively associated with weight change at months 6, 12, and 24 for the ILI group. Conclusions The pragmatic weight loss intervention in primary care did not increase F/V intake but did reduce fat intake in an underserved population with obesity. F/V intake was negatively associated with weight loss at month 6 whereas percent fat was positively correlated with weight loss throughout the intervention. Future efforts better targeting both increasing F/V intake and reducing fat intake may promote greater weight loss in similar populations. Trial registration NCT Registration: NCT02561221