Nutrition Commons^™

Inaccurate Confidence Intervals Reported In “The Healthy Kids & Families Study: Outcomes Of A 24-Month Childhood Obesity Prevention Intervention”, Xingsheng Li, Abu Bakkar Siddique, Lilian Golzarri-Arroyo, Stephanie L Dickinson, Theodore K Kyle, David B Allison

Children’s Nutrition Research Center Staff Publications

No abstract provided.

Expert Panel Curation Of 113 Primary Mitochondrial Disease Genes For The Leigh Syndrome Spectrum, Elizabeth M Mccormick, Kierstin Keller, Julie P Taylor, Alison J Coffey, Lishuang Shen, Danuta Krotoski, Brian Harding, Xiaowu Gai, Marni J Falk, Zarazuela Zolkipli-Cunningham, Shamima Rahman

Children’s Nutrition Research Center Staff Publications

Objective: Primary mitochondrial diseases (PMDs) are heterogeneous disorders caused by inherited mitochondrial dysfunction. Classically defined neuropathologically as subacute necrotizing encephalomyelopathy, Leigh syndrome spectrum (LSS) is the most frequent manifestation of PMD in children, but may also present in adults. A major challenge for accurate diagnosis of LSS in the genomic medicine era is establishing gene-disease relationships (GDRs) for this syndrome with >100 monogenic causes across both nuclear and mitochondrial genomes.

Methods: The Clinical Genome Resource (ClinGen) Mitochondrial Disease Gene Curation Expert Panel (GCEP), comprising 40 international PMD experts, met monthly for 4 years to review GDRs for LSS. The GCEP …

Associations Between Metabolomic Biomarkers Of Avocado Intake And Glycemia In The Multi-Ethnic Study Of Atherosclerosis, Alexis C Wood, Mark O Goodarzi, Mackenzie K Senn, Meghana D Gadgil, Goncalo Graca, Matthew A Allison, Ioanna Tzoulaki, Michael Y Mi, Philip Greenland, Timothy Ebbels, Paul Elliott, Russell P Tracy, David M Herrington, Jerome I Rotter

Faculty, Staff and Students Publications

BACKGROUND: Avocado consumption is linked to better glucose homeostasis, but small associations suggest potential population heterogeneity. Metabolomic data capture the effects of food intake after digestion and metabolism, thus accounting for individual differences in these processes.

OBJECTIVES: To identify metabolomic biomarkers of avocado intake and to examine their associations with glycemia.

METHODS: Baseline data from 6224 multi-ethnic older adults (62% female) included self-reported avocado intake, fasting glucose and insulin, and untargeted plasma proton nuclear magnetic resonance metabolomic features (metabolomic data were available for a randomly selected subset; N = 3438). Subsequently, incident type 2 diabetes (T2D) was assessed over an …

Corrected Analysis Of “The Effects Of Bright Light Treatment On Affective Symptoms In People With Dementia: A 24-Week Cluster Randomized Controlled Trial” That Accounts For Clustering And Nesting Verifies Conclusions, Yasaman Jamshidi-Naeini, Lilian Golzarri-Arroyo, Abu Bakkar Siddique, Colby J Vorland, Miriam Jocelyn Rodriguez, Richard J Holden, David B Allison

Children’s Nutrition Research Center Staff Publications

In this correspondence, we explain the reasoning for invalidity of the analysis choices by Kolberg et al., and provide the results produced using correct statistical procedures for their study design. Reassuringly, we could verify the original conclusions. That is, results of the corrected statistical models are similar to the results of the original analysis. Regardless of the magnitude of difference that corrected statistical methods make, results and conclusions that are derived from invalid methods are unsubstantiated. By verifying the results, we allow the readers to be assured that the published conclusions in the study by Kolberg et al. now rest …

Evaluation Of Acceptability, Functionality, And Validity Of A Passive Image-Based Dietary Intake Assessment Method In Adults And Children Of Ghanaian And Kenyan Origin Living In London, Uk, Modou L Jobarteh, Megan A Mccrory, Benny Lo, Konstantinos K Triantafyllidis, Jianing Qiu, Jennifer P Griffin, Edward Sazonov, Mingui Sun, Wenyan Jia, Tom Baranowski, Alex K Anderson, Kathryn Maitland, Gary Frost

Children’s Nutrition Research Center Staff Publications

Background: Accurate estimation of dietary intake is challenging. However, whilst some progress has been made in high-income countries, low- and middle-income countries (LMICs) remain behind, contributing to critical nutritional data gaps. This study aimed to validate an objective, passive image-based dietary intake assessment method against weighed food records in London, UK, for onward deployment to LMICs.

Methods: Wearable camera devices were used to capture food intake on eating occasions in 18 adults and 17 children of Ghanaian and Kenyan origin living in London. Participants were provided pre-weighed meals of Ghanaian and Kenyan cuisine and camera devices to automatically capture images …

Preface: Causes Of Obesity, Theories, Conjectures And Evidence, David B Allison, Thorkild I A Sørensen, Kevin D Hall, John R Speakman

Children’s Nutrition Research Center Staff Publications

No abstract provided.

Validation Of A Clinical Prediction Rule For Distinguishing Bacterial And Aseptic Meningitis In Pediatric Patients, Amelia L Gurley, Matt Fukuda, Ashwin Sharma, Ethan Lee, Erica Junqueira, Michael Kang, Tommy Y Kim

Children’s Nutrition Research Center Staff Publications

Introduction

The treatments and prognosis of bacterial meningitis differ greatly from those of aseptic meningitis, making early identification and differentiation essential. Several different clinical prediction rules have been developed to distinguish bacterial meningitis from aseptic meningitis. We sought to validate one clinical prediction rule for pediatric patients utilizing a centralized data warehouse that collects daily data from 184 hospitals across the United States.

Methods

We retrospectively collected data on all patients aged 29 days to 14 years who presented to Hospital Corporation of America (HCA) Healthcare hospitals from January 1, 2016, to May 31, 2021, with a diagnosis of meningitis. …

One Cluster Per Condition Is Not A Valid Design In Cluster-Randomized Trials Comment On Wang Et Al The Effect Of Different Physical Exercise Programs On Physical Fitness Among Preschool Children: A Cluster-Randomized Controlled Trial Int J Environ Res Public Health 2023, 20, 4254, Yasaman Jamshidi-Naeini, Armando Pena, Abu Bakkar Siddique, Andrew W Brown, David B Allison

Children’s Nutrition Research Center Staff Publications

Wang et al. [...].

Easy To Miss Large Left Atrial Myxoma, Art Burgess Kelleher, Tara Ní Dhonnchu, Carl Vaughan, Terence M O'Connor

Children’s Nutrition Research Center Staff Publications

No abstract provided.

Genome-Wide Association Studies And Fine-Mapping Identify Genomic Loci For N-3 And N-6 Polyunsaturated Fatty Acids In Hispanic American And African American Cohorts, Chaojie Yang, Jenna Veenstra, Traci M Bartz, Matthew C Pahl, Brian Hallmark, Yii-Der Ida Chen, Jason Westra, Lyn M Steffen, Christopher D Brown, David Siscovick, Michael Y Tsai, Alexis C Wood, Stephen S Rich, Caren E Smith, Timothy D O'Connor, Dariush Mozaffarian, Struan F A Grant, Floyd H Chilton, Nathan L Tintle, Rozenn N Lemaitre, Ani Manichaikul

Faculty, Staff and Students Publications

Omega-3 (n-3) and omega-6 (n-6) polyunsaturated fatty acids (PUFAs) play critical roles in human health. Prior genome-wide association studies (GWAS) of n-3 and n-6 PUFAs in European Americans from the CHARGE Consortium have documented strong genetic signals in/near the FADS locus on chromosome 11. We performed a GWAS of four n-3 and four n-6 PUFAs in Hispanic American (n = 1454) and African American (n = 2278) participants from three CHARGE cohorts. Applying a genome-wide significance threshold of P < 5 × 10

Unraveling The Serotonin Saga: From Discovery To Weight Regulation And Beyond – A Comprehensive Scientific Review, Kristine Conde, Shuzheng Fang, Yong Xu

Faculty, Staff and Students Publications

The prevalence of obesity is rapidly increasing worldwide, while the development of effective obesity therapies lags behind. Although new therapeutic targets to alleviate obesity are identified every day, and drug efficacy is improving, adverse side effects and increased health risks remain serious issues facing the weight-loss industry. Serotonin, also known as 5-HT, has been extensively studied in relation to appetite reduction and weight loss. As a result, dozens of upstream and downstream neural targets of 5-HT have been identified, revealing a multitude of neural circuits involved in mediating the anorexigenic effect of 5-HT. Despite the rise and fall of several …

Identification Of Genetic Variation Influencing Metformin Response In A Multiancestry Genome-Wide Association Study In The Diabetes Prevention Program (Dpp), Josephine H Li, James A Perry, Kathleen A Jablonski, Shylaja Srinivasan, Ling Chen, Jennifer N Todd, Maegan Harden, Josep M Mercader, Qing Pan, Adem Y Dawed, Sook Wah Yee, Ewan R Pearson, Kathleen M Giacomini, Ayush Giri, Adriana M Hung, Shujie Xiao, L Keoki Williams, Paul W Franks, Robert L Hanson, Steven E Kahn, William C Knowler, Toni I Pollin, Jose C Florez, Diabetes Prevention Program Research Group

Children’s Nutrition Research Center Staff Publications

Genome-wide significant loci for metformin response in type 2 diabetes reported elsewhere have not been replicated in the Diabetes Prevention Program (DPP). To assess pharmacogenetic interactions in prediabetes, we conducted a genome-wide association study (GWAS) in the DPP. Cox proportional hazards models tested associations with diabetes incidence in the metformin (MET; n = 876) and placebo (PBO; n = 887) arms. Multiple linear regression assessed association with 1-year change in metformin-related quantitative traits, adjusted for baseline trait, age, sex, and 10 ancestry principal components. We tested for gene-by-treatment interaction. No significant associations emerged for diabetes incidence. We identified four genome-wide …

Metabolomic Profile Of The Healthy Eating Index-2015 In The Multiethnic Study Of Atherosclerosis, Meghana D Gadgil, Alexis C Wood, Ibrahim Karaman, Goncalo Graça, Ioanna Tzoulaki, Victor W Zhong, Philip Greenland, Alka M Kanaya, David M Herrington

Children’s Nutrition Research Center Staff Publications

Background: Poor diet quality is a risk factor for type 2 diabetes and cardiovascular disease. However, knowledge of metabolites marking adherence to Dietary Guidelines for Americans (2015 version) are limited.

Objectives: The goal was to determine a pattern of metabolites associated with the Healthy Eating Index (HEI)-2015, which measures adherence to the Dietary Guidelines for Americans.

Methods: The analysis examined 3557 adult men and women from the longitudinal cohort Multiethnic Study of Atherosclerosis (MESA), without known cardiovascular disease and with complete dietary data. Fasting serum specimens and diet and demographic questionnaires were assessed at baseline. Untargeted 1H 1-dimensional nuclei magnetic …

Factors Associated With Choice Of Behavioural Weight Loss Program By Adults With Obesity, Yasaman Jamshidi-Naeini, Susan B Roberts, Stephanie Dickinson, Arthur Owora, Jon Agley, Roger S Zoh, Xiwei Chen, David B Allison

Children’s Nutrition Research Center Staff Publications

We assessed the preference for two behavioural weight loss programs, Diabetes Prevention Program (DPP) and Healthy Weight for Living (HWL) in adults with obesity. A cross-sectional survey was fielded on the Amazon Mechanical Turk. Eligibility criteria included reporting BMI ≥30 and at least two chronic health conditions. Participants read about the programs, selected their preferred program, and answered follow-up questions. The estimated probability of choosing either program was not significantly different from .5 (N = 1005, 50.8% DPP and 49.2% HWL, p = .61). Participants' expectations about adherence, weight loss magnitude, and dropout likelihood were associated with their choice (p <  .0001). Non-White participants (p = .040) and those with monthly income greater than $4999 (p = .002) were less likely to choose DPP. Participants who had postgraduate education (p = .007), did not report high serum cholesterol (p = .028), and reported not having tried losing weight before (p = .025) were more likely to choose DPP. Those who chose HWL were marginally more likely to report that being offered two different programs rather than one would likely affect their decision to enrol in one of the two (p = .052). The enrolment into DPP and HWL was balanced, but race, educational attainment, income, previous attempt to lose weight, and serum cholesterol levels had significant associations with the choice of weight loss program.

Undisclosed Outcome Switching, Undisclosed Analysis Switching, Inappropriate Rounding, And Selective Reporting Render Paper “Effectiveness Of A Minimally Processed Food-Based Nutritional Counselling Intervention On Weight Gain In Overweight Pregnant Women: A Randomized Controlled Trial” Unreliable, Armando Peña, Mike Gibney, Kevin Hall, Theodore K Kyle, Andrew W Brown, David B Allison

Children’s Nutrition Research Center Staff Publications

No abstract provided.

Pseudohypercreatininemia After Surgery For Aortic Dissection: A Case Report, Ayako Tasaki, Makoto Fukuda, Yuki Ikeda, Masatora Yamasaki, Ikko Yamaguchi, Shinichi Aishima, Motoaki Miyazono

Children’s Nutrition Research Center Staff Publications

Background: Elevated creatinine concentrations often indicate acute renal injury and renal biopsies are considered in this situation. However,pseudohypercreatininemia is potential cause of elevated creatinine concentrations, and invasive interventions should be avoided.

Case presentation: A 54-year-old woman underwent surgery for descending aortic dissection.Nine days postoperatively, her creatinine concentration increased from 1 mg/dl to 5.78 mg/dl (normal range, 0.47-0.7 mg/dl). Azotemia and hyperkalemia were absent and physical examination findings were unremarkable. Cystatin C concentration was 1.56 mg/l (normal range, 0.56-0.8 mg/l) and pseudohypercreatininemia was suspected. Testing with different reagents showed a creatinine concentration of 0.84 mg/dl. Immunoglobulin (Ig)G was markedly elevated, and …

Correcting Calculation And Data Errors Reveals That The Original Conclusions Were Incorrect In “The Best Drug Supplement For Obesity Treatment: A Systematic Review And Network Meta-Analysis”, Xiaoxin Yu, Patrice L Capers, Roger S Zoh, David B Allison

Children’s Nutrition Research Center Staff Publications

The goal of this study was to reproduce and evaluate the reliability of the network meta-analysis performed in the article "The best drug supplement for obesity treatment: A systematic review and network meta-analysis" by Salari et al. In recent years, it has become more common to employ network meta-analysis to assess the relative efficacy of treatments often used in clinical practice. To duplicate Salari et al.'s research, we pulled data directly from the original trials and used Cohen's D to determine the effect size for each treatment. We reanalyzed the data since we discovered significant differences between the data we …

Creativity In Energy Balance, Obesity And Feeding Behavior Research, Some Thoughts, Stephen J French, David B Allison

Children’s Nutrition Research Center Staff Publications

This review provides an overview of examples of especially creative work related to the fields of ingestive behavior, energetics (defined as the study of the acquisition, storage, and use of metabolizable energy by biological organisms and the causes and consequences of such acquisition, storage, and use), and nutrition, focusing on both individual works and discoveries, as well as bodies of works and in some cases the working styles of particular scientists. The paper then discusses some principles extracted from our observations as well as from the literature on creativity pointing out some factors that seem to make for more creative …

Towards A Model Of Biliary Atresia – Pilot Feasibility Study In Newborn Piglets, Thora Wesenberg Helt, Lene Buelund, Lise Borgwardt, Thomas Eriksen, Lars Johansen, Robin De Nijs, Soren Holm, Douglas G Burrin, Thomas Thymann, Vibeke Brix Christensen

Children’s Nutrition Research Center Staff Publications

Biliary atresia (BA) is a rare congenital liver disease with unknown etiology, and it is the most common indication for liver transplantation in children. As BA infants suffer from intestinal malabsorption and neurodevelopmental deficits, it is necessary to identify optimal medical and nutritional strategies using appropriate neonatal animal models. We aim to determine the feasibility of using newborn piglets with surgically induced cholestasis (bile duct ligation (BDL)) to mimic clinical features of BA. Six piglets were subjected to abdominal surgery on day 4 after birth. The bile ducts were ligated, and the piglet were followed for up to 12 days. …

Data Sharing: Putting Nature’S Policy To The Test, Xiwei Chen, Stephanie L Dickinson, Anna L M Macagno, Chelsie M Parker, David B Allison

Children’s Nutrition Research Center Staff Publications

No abstract provided.

Orchestration Of Mirna Patterns By Testosterone And Dietary Tomato Carotenoids During Early Prostate Carcinogenesis In Tramp Mice, Lei Wan, Jennifer M Thomas-Ahner, Dennis K Pearl, John W Erdman, Nancy E Moran, Steven K Clinton

Children’s Nutrition Research Center Staff Publications

Background: The integrative effects of prostate cancer risk factors, such as diet and endocrine status, on cancer-associated miRNA expression are poorly defined.

Objectives: This study aimed to define the influence of androgens and diet (tomato and lycopene) on prostatic miRNA expression during early carcinogenesis in the transgenic adenocarcinoma of the mouse prostate (TRAMP) model.

Methods: Wild type (WT) and TRAMP mice were fed control, tomato-containing, or lycopene-containing diets from 4 to 10 weeks of age. Mice underwent either sham (intact) or castration surgery at 8 wk, and half of the castrated mice received testosterone (2.5 mg/kg body weight/d) at 9 …

Birth Weight Moderates The Association Between Obesity And Mortality Rate, Gregory Pavela, Nengjun Yi, Luis Mestre, Pengcheng Xun, David B Allison

Children’s Nutrition Research Center Staff Publications

Purpose: The strength of the association between obesity and mortality rate (MR) varies by body mass index (BMI) and sociodemographic groups. We test the hypothesis that the association between obesity and MR varies, in part, due to the moderating effect of parental BMI and birth weight.

Methods: Data come from the 1958 National Child Development Study, an ongoing longitudinal dataset initiated in 1958 with baseline measures of birth weight from 18,059 infants born in Great Britain over 1 week. We tested whether the association between BMI and MR was moderated by parental BMI and birth weight using generalized additive proportional …

Comparison Of Female Ovarian Reserve Before Vs After Covid-19 Vaccination, Liubin Yang, Samantha Neal, Tiffany Lee, Andrew Chou, Amy K Schutt, William Gibbons

Children’s Nutrition Research Center Staff Publications

This cohort study examines the association of COVID-19 vaccination with levels of anti-Mullerian hormone and antral follicle count in women seeking fertility treatment.

Lateral Septum As A Melanocortin Downstream Site In Obesity Development, Yuanzhong Xu, Zhiying Jiang, Hongli Li, Jing Cai, Yanyan Jiang, Joshua Otiz-Guzman, Yong Xu, Benjamin R Arenkiel, Qingchun Tong

Faculty, Staff and Students Publications

The melanocortin pathway is well established to be critical for body-weight regulation in both rodents and humans. Despite extensive studies focusing on this pathway, the downstream brain sites that mediate its action are not clear. Here, we found that, among the known paraventricular hypothalamic (PVH) neuron groups, those expressing melanocortin receptors 4 (PVHMc4R) preferably project to the ventral part of the lateral septum (LSv), a brain region known to be involved in emotional behaviors. Photostimulation of PVHMc4R neuron terminals in the LSv reduces feeding and causes aversion, whereas deletion of Mc4Rs or disruption of glutamate release from LSv-projecting PVH neurons …

An Assessment Of How Clinicians And Staff Members Use A Diabetes Artificial Intelligence Prediction Tool: Mixed Methods Study, Winston R Liaw, Yessenia Ramos Silva, Erica G Soltero, Alex Krist, Angela L Stotts

Children’s Nutrition Research Center Staff Publications

Background: Nearly one-third of patients with diabetes are poorly controlled (hemoglobin A1c≥9%). Identifying at-risk individuals and providing them with effective treatment is an important strategy for preventing poor control.

Objective: This study aims to assess how clinicians and staff members would use a clinical decision support tool based on artificial intelligence (AI) and identify factors that affect adoption.

Methods: This was a mixed methods study that combined semistructured interviews and surveys to assess the perceived usefulness and ease of use, intent to use, and factors affecting tool adoption. We recruited clinicians and staff members from practices that manage diabetes. During …

Effectiveness Of Lactation Cookies On Human Milk Production Rates: A Randomized Controlled Trial, Ana M Palacios, Michelle I Cardel, Erik Parker, Stephanie Dickinson, Valerie R Houin, Bridget Young, David B Allison

Children’s Nutrition Research Center Staff Publications

Background: Expensive lactation cookies (LCs) are marketed as milk boosters; however, their effectiveness remains unknown.

Objectives: The objective of this study was to evaluate the effectiveness of the 1-mo daily intake of LCs on changes in objective and subjective milk production and breastfeeding self-efficacy.

Methods: This is a 1-mo, randomized controlled trial among 18-45-y-old exclusively lactating parents of healthy, term, 2-mo-old infants living in the United States from March to December 2021. Participants (n = 176) were randomly assigned to eat daily 56.5 g of either LCs with "galactagogues" (oatmeal, brewer's yeast, flax seeds, and fenugreek) or conventional cookies containing …

Associations Between Avocado Intake And Lower Rates Of Incident Type 2 Diabetes In Us Adults With Hispanic/Latino Ancestry, Alexis C Wood, Mackenzie K Senn, Jerome I Rotter

Faculty, Staff and Students Publications

BACKGROUND/PURPOSE: Hispanic/Latinos in the US are at increased risk for type 2 diabetes (T2D). Data suggest that avocado intake is associated with better glycemic control, but whether this translates to protection from T2D has not been studied. The goal of the current analyses was to examine whether consuming avocados at baseline is associated with lower incident T2D over a six-year period, compared to not consuming avocados at baseline.

SUBJECTS/METHODS: Using data from a large population of US adults with Hispanic ancestry, without known or unknown T2D at baseline (N=6,159), participants were classified as avocado consumers (N=983) or non-consumers (N=5,176) based …

The Effect Of A Pharmaceutical Ghrelin Agonist On Lifespan In C57bl/6j Male Mice: A Controlled Experiment, Kathryn A Kaiser, Inga Kadish, Thomas Van Groen, Daniel L Smith, Stephanie Dickinson, Beate Henschel, Erik S Parker, Andrew W Brown, David B Allison

Children’s Nutrition Research Center Staff Publications

Interventions for animal lifespan extension like caloric restriction (CR) have identified physiologic and biochemical pathways related to hunger and energy-sensing status as possible contributors, but mechanisms have not been fully elucidated. Prior studies using ghrelin agonists show greater food intake but no effect on lifespan in rodent models. This experiment in male C57BL/6J mice tested the influence of ghrelin agonism for perceived hunger, in the absence of CR, on longevity. Mice aged 4 weeks were allowed to acclimate for 2 weeks prior to being assigned (N = 60/group). Prior to lights off daily (12:12 cycle), animals were fed a ghrelin …

Reflection Spectroscopy-Assessed Skin Carotenoids Are Sensitive To Change In Carotenoid Intake In A 6-Week Randomized Controlled Feeding Trial In A Racially/Ethnically Diverse Sample, Stephanie Jilcott Pitts, Nancy E Moran, Melissa N Laska, Qiang Wu, Lisa Harnack, Stacey Moe, Pamela Carr-Manthe, Elizabeth Gates, Jocelyn Chang, Yusuf Zaidi, Abigail Gelineau, Lauren Berg, Neal E Craft

Children’s Nutrition Research Center Staff Publications

Background: Reflection spectroscopy, utilized by the Veggie Meter, is a less-expensive, noninvasive method to quantify skin carotenoids and is a valid approximation of fruit and vegetable (FV) intake. However, it is unknown to what degree Veggie Meter-assessed skin carotenoid score change is responsive to changes in carotenoid intake.

Objectives: This study aimed to evaluate Veggie Meter-assessed skin carotenoid score response in a 6-wk randomized controlled trial of a carotenoid-containing juice to determine whether the Veggie Meter can be used to detect nutritionally relevant changes in carotenoid intake; and to compare skin and plasma carotenoid responses with the 6-wk trial.

Methods: …

Fit24, A Digital Health Intervention To Reduce Type 2 Diabetes Risk Among Hispanic Youth: Protocol For A Feasibility Pilot Study, Erica G Soltero, Callie Lopez, Salma M Musaad, Teresia M O'Connor, Debbe Thompson

Faculty, Staff and Students Publications

BACKGROUND: Poor physical activity (PA) and sleep behaviors in Hispanic adolescents contributes to increased risk for type 2 diabetes. Commonly owned digital devices and services like smartphones and text-messaging are highly used among adolescents and are promising intervention tools for reaching this age group. Personal activity trackers assess activity and sleep, making them ideal tools for addressing these behaviors. We propose to examine the feasibility of a 12-week intervention that uses theoretically grounded text messages and a Fitbit device to improve PA and sleep among Hispanic adolescents with obesity, as compared to a wait-list control group with a Fitbit device …