DNPA’s Weight Management Research to Practice Series

1. DNPA’s Weight Management Research to Practice Series The R2P Series Translating science to practice

2. R2P Series • The R2P series is a way to address the need for a user-friendly summary of the evidence supporting key topics in weight management. • Each installment in the series consists of two related components.

3. R2P Series Purpose • DNPA responded to requests from funded states and partners for a user-friendly way to stay current on existing evidence supporting relevant weight management topics. • Also interested in ways to address these topics in practice. • Started out with DNPA’s main strategies and expertise and are beginning to expand to other topic areas working with other divisions.

4. R2P Series Process • Scientific review and synthesis of the literature • Consumer tool developed, as appropriate • Clearances - CDC and Dietary Guidelines • Graphics • Final product posted on website and promoted at professional conferences and through email listservs • Professional graphics files available for printing

5. R2P Series Structure • Practitioner piece • Research brief (5 to10 pages) summarizing evidence, not a comprehensive review • Consumer Tool • Shorter (4 to 6 pages) of consumer messages and easy “how to” ideas • Power point presentations • Presentation of the practitioner piece for practitioners to use with colleagues, funders, partners, etc.

6. R2P Series Structure of Practitioner Piece • Background – genesis of topic • Build case of available literature • Review of primary sources • Review of reviews • Identify research gaps • Practice section of practitioner piece • General tips that address all levels of the socio-ecological model • References included

7. R2P Series Structure of Consumer Tool • Translate message of Practitioner piece into consumer friendly messages without changing the scientific basis • Brochure with “tips” • Game board • Gathering of resources, i.e. links to other websites • Open structure to fit each topic best

8. R2P Series Structure of Power Point Presentation Presentation of literature review from practitioner piece • Same message and wording in a presentation format • Includes “notes’ for presenter • Includes all references

9. R2P Series Distribution Current plans for distribution: • Posting on DNPA website • Sending out link through listservs • Presentations at national conferences • Professional Organizations • Printing – when funds are available and with partners • Availability of print ready files

10. R2P Series Excerpts from current practitioner and consumer pieces: 1. Can eating fruits and vegetables help people manage their weight? 2. Do increased portion sizes affect how much we eat? 3. Does drinking beverages with added sugars increase the risk of overweight?

11. R2P Series Can eating fruits and vegetables help people manage their weight? • Concludes that replacing foods of high energy density with foods of low energy density, such as fruits and vegetables, can be an important part of a weight management strategy. • Topics covered include: energy density and volume of food and dietary interventions

12. F&V Practitioner Piece

13. Fruit and Vegetable Consumer Tool

14. Fruit and Vegetable Consumer Tool

15. Can eating fruits and vegetables help people to manage their weight?

16. There are many proposed strategies for losing or maintaining weight. This presentation looks at only one strategy: substituting low-energy-dense fruits and vegetables for foods with high energy density in order to lower the number of calories consumed. References to all studies are in “Can fruits and vegetables help people to manage their weight?” in the CDC Web site: www.cdc.gov/nccdphp/dnpa and in the notes in this electronic PowerPoint presentation.

17. A literature review* found similar findings: • Short-term studies (< 1mo.): Low-energy-dense foods promoted feeling full, reduced hunger, and provided fewer calories. • Long-term studies (> 1mo.): Low-energy-dense foods promoted moderate weight loss. • Studies lasting longer than 6 months: Weight loss was three times greater for people who ate foods of low- energy-density than for people who simply ate low-fat foods. *Yao M, Roberts SB. Dietary energy density and weight regulation. Nutr Rev 2001;59:247-58.

18. Intervention 4: Increased Fruits and Vegetables withDecreased Fat Intake* • Participants consumed a daily diet that included specific amounts of fruits, vegetables, juice and fiber, and provided 15%-20% of energy from fat. After 1 year: • Energy-adjusted intake of vegetables and dietary fiber, but not fruit, was associated with a decrease in body mass index (BMI). • A decrease in percent energy from fat was not associated with a drop in BMI. *Rock CL, Thomson C, Caan BJ, et al. Reduction in fat intake is not associated with weight loss in most women after breast cancer diagnosis: evidence from a randomized controlled trial. Cancer 2001;91:25-34.

19. Research Review • Very few studies examined a direct relationship between eating fruits and vegetables and losing weight. • Some studies had few participants. • Many studies focused on fruits and vegetables in the context of treating high blood pressure or cardiac disease—but also reported on weight loss. • Some studies examined the short-term impact of eating fruits and vegetables on energy intake.

20. R2P Series Do increased portion sizes affect how much we eat? • Examines the science that underlies the notion that large portion sizes have contributed to weight gain among Americans. • Topics covered include: trends in increasing portion sizes, portion size affects how much we consume during an eating occasion, and assessing amount of intake.

21. Portion Size Practitioner Piece

22. Portion Size Consumer Tool

24. R2P Series Does drinking beverages with added sugars increase the risk of overweight? An overview of the following are provided: added sugar and the contribution of sugar-sweetened beverages (SSB) to caloric intake, the association of SSB and body weight, interventions to reduce SSB, contextual factors influencing what we drink.

25. Sugar Sweetened BeveragesPractitioner Piece

26. Sugar Sweetened BeveragesConsumer Tool

27. Sugar Sweetened BeveragesConsumer Tool

28. Sugar Sweetened BeveragesConsumer Tool

29. Sugar Sweetened BeveragesConsumer Tool

30. R2P Series Upcoming topics • Breastfeeding and pediatric overweight • Energy density as a weight management tool • Eating food prepared away from home and weight management • Weight management among those with high blood pressure or high cholesterol • Ideas?

31. R2P Series Core Team Members Mary Ann Fenley Maria Elena Jefferds Mary Serdula Kristen Riehman Sullivan Beth Carlton Tohill