Browsing by Subject "Overweight"

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  • Uusitupa, Matti; Mustajoki, Pertti; Pietiläinen, Kirsi (2020)
  • Tan, Xiao; Alen, Markku; Wiklund, Petri; Partinen, Markku; Cheng, Sulin (2016)
    Objective: To determine the effect of a six-month aerobic exercise program on home-based sleep quality among overweight and obese men with chronic insomnia symptoms. Methods: Participants were 45 Finnish men (93% had body mass index >= 25) aged 30-65 years, with chronic months) insomnia symptoms as classified by the DSM-IV criteria. Participants were randomized into an exercise (n = 24) or control group (n = 21). The exercise group received six-month aerobic exercise intervention with one to five sessions per week of 30-60 minutes duration. The control group was instructed to maintain habitual lifestyle behaviors during the study period. Seven-night home sleep was measured with a piezoelectric bed sensor and sleep diary. Other assessments included the modified Basic Nordic Sleep Questionnaire, a health and behavior questionnaire, physical activity and diet diaries, anthropometry, fat mass, and physical fitness. Analysis of covariance controlling for baseline values, and repeated-measures analysis of variance were implemented for time-by-group comparisons and within group comparisons, respectively. Results: At six months, the exercise group showed reduced objective sleep onset latency (p = 0.010) and lowered frequency of difficulty initiating sleep (p = 0.021) than controls. Although a time-by-group difference was not significant, exercisers showed shorter objective wake after sleep onset (p = 0.004), reduced subjective nocturnal awakenings (p = 0.010), improved objective sleep efficiency (p <0.001), and improved morning-rated subjective sleep quality (p = 0.042) at six months than baseline. Conclusions: A six-month aerobic exercise can improve sleep, mainly by mitigating difficulty of initiating sleep among overweight and obese men with chronic insomnia symptoms. (C) 2016 Elsevier B.V. All rights reserved.
  • Liimatta, Jani; Utriainen, Pauliina; Voutilainen, Raimo; Jääskeläinen, Jarmo (2020)
  • Kivelä, Antti; Naukkarinen, Jussi (2018)
  • Laine, Merja K.; Kautiainen, Hannu; Gissler, Mika; Pennanen, Pirjo; Eriksson, Johan G. (2021)
    Background The impact of gestational diabetes mellitus (GDM) on the duration of breastfeeding varies between shortening and no impact. Breastfeeding seems to reduce both maternal and offspring risk for type 2 diabetes and offspring risk for overweight or obesity later in life. The aim of our study was to evaluate in primiparous women whether GDM had an influence on the duration of breastfeeding, and further, to evaluate the factors that influenced on the duration of breastfeeding. Methods The study cohort (N = 1089) consisted of all primiparous women with a Finnish background excluding women with pre-existing diabetes mellitus who lived in the city of Vantaa, Finland, gave birth to a singleton living child between 2009 and 2015, and with valid data on breastfeeding available. The diagnosis of GDM was based on a standard 75 g 2-h oral glucose tolerance test. Data were obtained from Finnish national registers and from the medical records of the city of Vantaa. Results No differences were observed in the duration of breastfeeding between women diagnosed with GDM and without GDM, 7.5 (Standard Deviation [SD] 3.7) months versus 7.9 (SD 3.5) months (p = 0.17). Women diagnosed with GDM breastfed boys for a longer duration than girls (maternal age, pre-pregnancy body mass index, marital status, educational attainment, duration of pregnancy, and smoking habits adjusted p = 0.042). Women who breastfed <6 months were younger, were more likely smokers, had shorter education, and higher pre-pregnancy body mass index than women who breastfed over 6 months (p <0.001 for linearity). Conclusions In primiparous women GDM did not influence breastfeeding duration. The positive health effects of breastfeeding should be emphasized especially in young, overweight and less educated women in order to minimize the risk of obesity and type 2 diabetes for themselves and their offspring.
  • Laine, Merja K; Kautiainen, Hannu; Gissler, Mika; Pennanen, Pirjo; Eriksson, Johan G (BioMed Central, 2021)
    Abstract Background The impact of gestational diabetes mellitus (GDM) on the duration of breastfeeding varies between shortening and no impact. Breastfeeding seems to reduce both maternal and offspring risk for type 2 diabetes and offspring risk for overweight or obesity later in life. The aim of our study was to evaluate in primiparous women whether GDM had an influence on the duration of breastfeeding, and further, to evaluate the factors that influenced on the duration of breastfeeding. Methods The study cohort (N = 1089) consisted of all primiparous women with a Finnish background excluding women with pre-existing diabetes mellitus who lived in the city of Vantaa, Finland, gave birth to a singleton living child between 2009 and 2015, and with valid data on breastfeeding available. The diagnosis of GDM was based on a standard 75 g 2-h oral glucose tolerance test. Data were obtained from Finnish national registers and from the medical records of the city of Vantaa. Results No differences were observed in the duration of breastfeeding between women diagnosed with GDM and without GDM, 7.5 (Standard Deviation [SD] 3.7) months versus 7.9 (SD 3.5) months (p = 0.17). Women diagnosed with GDM breastfed boys for a longer duration than girls (maternal age, pre-pregnancy body mass index, marital status, educational attainment, duration of pregnancy, and smoking habits adjusted p = 0.042). Women who breastfed < 6 months were younger, were more likely smokers, had shorter education, and higher pre-pregnancy body mass index than women who breastfed over 6 months (p <  0.001 for linearity). Conclusions In primiparous women GDM did not influence breastfeeding duration. The positive health effects of breastfeeding should be emphasized especially in young, overweight and less educated women in order to minimize the risk of obesity and type 2 diabetes for themselves and their offspring.
  • Mokkala, Kati; Pellonpera, Outi; Roytio, Henna; Pussinen, Pirkko; Ronnemaa, Tapani; Laitinen, Kirsi (2017)
    Background. Increased intestinal permeability with subsequent metabolic endotoxemia, i.e., elevated circulating levels of bacterial lipopolysaccharide, LPS, has been introduced as a novel initiator of obesity related metabolic disturbances in non-pregnant individuals. The objective was to investigate the extent to which intestinal permeability, measured by serum zonulin concentration, is related to metabolic endotoxemia and metabolic risk markers in overweight pregnant women. Methods. This was a cross-sectional study including 100 pregnant overweight women in early pregnancy. Serum zonulin was analyzed using ELISA, and markers for metabolic endotoxemia (LPS), inflammation (high-sensitive C-reactive protein and glycoprotein acetylation GIyA), glucose metabolism (fasting glucose and insulin), and lipid metabolism were measured. Results. Higher serum zonulin concentration associated positively with LPS (P = 0.02), inflammatory markers (P <0.001), insulin (P <0.001), insulin resistance (P <0.001), and triglycerides (P = 0.001), and negatively with insulin sensitivity (P = 0.001) (ANOVA with Tukey's corrections or Kruskal-Wallis nonparametric test with Bonferroni correction for zonulin quartiles). All the observed associations were confirmed (P <0.015) in a linear regression model adjusted with potential confounding factors. Both LPS and GlycA showed positive relationship with insulin resistance, serum insulin, triglycerides, total and LDL-cholesterol and negative relationship with insulin sensitivity (P Conclusions. Our findings suggest that increased serum zonulin concentration, i.e., increased intestinal permeability, contributes to metabolic endotoxemia, systemic inflammation, and insulin resistance in overweight pregnant women. By reinforcingintestinal barrier, it may be possible to manipulate maternal metabolism during pregnancy with subsequent health benefits. (C) 2017 Elsevier Inc. All rights reserved.
  • Matikainen, Niina; Gordin, Daniel; Laine, Merja K. (2018)
  • Vesikansa, Aino; Jokelainen, Jari; Mehtälä, Juha; Mutanen, Katja; Lundqvist, Annamari; Laatikainen, Tiina; Yli-Saukko-oja,; Saukkonen, Tero; Pietiläinen, Kirsi H. (2020)
    Lähtökohdat : Tämän poikkileikkaustutkimuksen tavoitteena oli selvittää lihavuuden yhteyksiä elämänlaatuun ja työkykyyn suomalaisessa aikuisväestössä. Menetelmät : Aineistoon kuului 4 956 FinTerveys 2017 -tutkimuksen terveystarkastukseen satunnaisesti valittua täysi-ikäistä henkilöä. Elämänlaatua eri painoindeksiryhmissä selvitettiin EUROHIS-QOL 8 -¬elämänlaatumittarilla. Koettua psyykkistä ja fyysistä työkykyä sekä työstä poissaolojen määrää kartoitettiin kyselylomakkeella. Tulokset : Ylipainoisten ja lihavien elämänlaatu oli merkitsevästi heikompi kuin normaalipainoisten. Lihavat kokivat fyysisen ja psyykkisen työkykynsä heikommaksi kuin normaalipainoiset ja heillä oli enemmän itse raportoituja poissaoloja työstä. Päätelmät : Lihavuus on yhteydessä yksilön kokemukseen terveydestä sekä hyvinvoinnista ja heikentää työkykyä. Lihavuuden tehokkaalla hoidolla voidaan liitännäissairauksien ehkäisyn lisäksi parantaa väestön työ- ja toimintakykyä sekä elämänlaatua.
  • Koskela-Koivisto, Tiina (2018)
    Lihavuuteen liittyvät hormonaaliset muutokset, erityisesti insuliiniresistenssi, vaikuttavat sekä naisten että miesten lisääntymisterveyteen. Jo 5 %:n painonpudotus voi parantaa merkittävästi hedelmällisyyttä ja pienentää raskaudenaikaisia riskejä. Pysyvät elämäntapamuutokset näyttävät vaikuttavan merkittävästi myös tulevien jälkeläisten terveyteen epigeneettisten mekanismien ja ympäristövaikutusten kautta. Perusterveydenhuolto on keskeisessä asemassa lihavuuden ehkäisyssä ja varhaisessa hoidossa.Tarvitaan moniammatillista yhteistyötä ja toimivia hoitoketjuja.
  • Figueiredo, Rejane Augusta De Oliveira; Roos, Eva; Eriksson, Johan G.; Simola-Strom, Sabina; Weiderpass, Elisabete (2017)
    Aims: Little is known about impact of maternal alcohol and tobacco consumption on adolescents' body size. The purpose of this study was to evaluate whether maternal alcohol or tobacco consumption is associated with their children's body size in adolescence, assessed by Body Mass Index (BMI). Methods: This study was conduct in subjects recruited into the Finnish Health in Teens cohort (Fin-HIT) between 2011 and 2014. A total of 4525 subjects aged between 9 and 14 years and their mothers or female adults responsible for the children were analysed. Relative risks (RR) and 95% confidence intervals (CI) were estimated using Multinomial Logistic Regression. Results: Most children were normal weight (74.5%), 10.6% were underweight and 14.9% were overweight or obese. Among mothers, 50.6% were never smokers, 35.7% were former smokers, and 13.7% were current smokers. Alcohol consumption was classified by Alcohol Use Disorders Identification Test (AUDIT), 12.7% were abstainers (score=0), 65.0% were low-moderate drinkers (scores 1-4) and 22.3% were harmful drinkers (scores. 5). There were statistically significant associations between currently smoking mothers and children's overweight (RR=1.36; 95% CI: 1.05-1.76). There was an inverse association between maternal former smoking and children's underweight (RR=0.70; CI: 0.56-0.87) compared with never smoker mothers. Among children in puberty, abstainer mothers were more likely to have underweight children compared with low-moderate mothers (RR=1.57; 95% CI: 1.03-2.41). Conclusions: Current smoker mothers were associated with children's overweight and former-smoker mothers were inversely associated with the children's underweight. Being an abstainer mother was associated with the children's underweight in puberty stage. If other studies confirm these results, public health interventions aiming at healthy weight of adolescents should target the whole family, not only the adolescents themselves.
  • Kalso, Eija (2018)
    • Krooninen kipu on yleistä. Se heikentää elämänlaatua ja työkykyä ja tulee yhteiskunnalle kalliiksi. • Taustalla on perimään, inflammaatioon ja aivojen plastisuuteen liittyviä sekä psykososiaalisia tekijöitä. • Kivun pitkittymistä voi estää puuttumalla varhain paikallisiin kiputiloihin. Akuutti kipu ja taustasairaudet tulee hoitaa tehokkaasti. • Tärkeää on myös poistaa psykososiaaliset paranemisen esteet. • Elintavat vaikuttavat kivun taustasairauksien syntyyn ja herkistävät kivulle. Terveellisiä elintapoja tulisi tukea lapsuudesta lähtien.
  • Piltonen, Terhi T.; Morin-Papunen, Laure; Tapanainen, Juha S.; Purho, Elina; Uljas-Bärman, Riikka; Arffman, Riikka K. (2020)
    Munasarjojen monirakkulaoireyhtymään liittyy muutakin ¬sairastavuutta kuin ovulaatiohäiriöitä. Se on terveysriski, joka lääkärin tulisi tunnistaa.
  • Svärd, Anna; Lahti, Jouni; Rahkonen, Ossi; Lahelma, Eero; Lallukka, Tea (2016)
    Background: Both obesity and mental health are major public health issues. This study aimed to examine whether overweight and obesity among midlife employees are associated with subsequent psychotropic medication. A further aim was to examine the potential effect of key covariates on the association. Methods: The Helsinki Health Study baseline survey was conducted in 2000-2002 among 40-60-year-old employees of the City of Helsinki, Finland (n = 8960). The participants were classified as of normal weight (18.5-24. 9 kg/m(2)), overweight (25-29.9 kg/m(2)), obese (30-34.9 kg/m(2)) or severely obese (>= 35 kg/m(2)) based on self-reported body mass index. Data on psychotropic medication purchases from baseline to 2009 were derived from registers of the Social Insurance Institution of Finland. The final analysis included 4760 women and 1338 men. Antidepressants and sedatives were examined separately. Covariates included socio-demographic factors, workload, health behaviours, physical functioning, somatic ill-health and psychotropic medication prior to baseline. Hazard ratios (HR) for the first psychotropic medication purchase were calculated using Cox regression analysis. Results: Third of women and quarter of men made at least one psychotropic medication purchase during the follow-up. Adjusting for age, obese (HR = 1.57; 95 % CI = 1.10-2.24) and severely obese (HR = 2.15; 95 % CI = 1.29-3. 56) men were at risk of having psychotropic medication compared to men of normal weight. These associations disappeared after further adjustment. Severe obesity remained associated with subsequent sedative medication among the men even after full adjustment (HR = 2.12; 95 % CI = 1.17-3.84). No associations were found among the women. Conclusions: Obese and severely obese men, but not women, were at risk of psychotropic medication. Further studies are needed to deepen understanding of the relationship between obesity and mental ill-health, and the possible protecting effects of age, employment, and living environment.
  • West, Sammeli; Ollila, Meri-Maija; Franks, Stephen; Piltonen, Terhi; Jokelainen, Jari; Nevalainen, Jaana; Puukka, Katri; Ruokonen, Aimo; Järvelin, Marjo-Riitta; Auvinen, Juha; Tapanainen, Juha S.; Morin-Papunen, Laure (2020)
    Introduction The aim of the study was to determine the association of body mass index (BMI), self-reported symptoms or diagnosis of polycystic ovary syndrome (PCOS), and hyperandrogenemia with the occurrence of gestational diabetes mellitus (GDM) through reproductive life. Material and methods A cohort of women born in 1966 were investigated at ages 14, 31 and 46. Women with self-reported PCOS symptoms (presence of both oligo-amenorrhea and hirsutism) at age 31 or with formally diagnosed polycystic ovaries (PCO)/PCOS by age 46 formed the group of self-reported PCOS (srPCOS, n = 222) and were compared with women without self-reported PCOS symptoms or diagnosis (n = 1357). We investigated also the association of hyperandrogenism (hirsutism or biochemical hyperandrogenism) at age 31 with the occurrence of GDM throughout reproductive life. Results Self-reported PCOS alone was not a risk factor for GDM, but combined with overweight at age 31 (odds ratio [OR] 2.43, 95% confidence interval [CI] 1.22-4.86) or 46 (OR 3.04, 95% CI 1.58-5.83) srPCOS was associated with GDM when compared with normal weight controls. The association disappeared when comparing overweight srPCOS women with overweight controls. However, hyperandrogenemia at age 31, but not hirsutism, was associated with GDM even after adjustment for BMI. Conclusions The increased risk of GDM in women with srPCOS was mostly attributed to overweight or obesity. Importantly, normal weight women with srPCOS did not seem to be at increased risk for developing GDM. However, hyperandrogenemia was associated with GDM even after adjustment for BMI. These findings strengthen the importance of weight management in reproductive-age women and suggest a noteworthy role of hyperandrogenemia in the pathophysiology of GDM.
  • Kaltiala-Heino, Riittakerttu; Lankinen, Vilma; Marttunen, Mauri; Lindberg, Nina; Frojd, Sari (2016)
    Overweight is reportedly a risk factor for being bullied, and body image may mediate this association. Research on associations between overweight and bullying has so far only focused on children and early adolescents. We explored associations between actual and perceived overweight at age 15 and involvement in bullying at ages 15 and 17. A total of 2070 Finnish adolescents responded to a survey at ages 15 and 17. Self-reported weight and height, perceived weight and involvement in bullying were elicited. Being overweight at age 15 was not associated with being bullied or with being a bully at age 15 or 17. Perceived overweight among girls was associated with subsequent involvement in bullying as a bully and in feeling shunned. Weight related bullying may decrease from pre- and early adolescence to middle adolescence. The associations between perceived overweight and self-identification as a bully, and those between perceived overweight and feeling isolated may be explained by the phenomena representing psychological dysfunction. (C) 2016 Elsevier Ltd. All rights reserved.
  • Tikanmaki, Marjaana; Tammelin, Tuija; Vaarasmaki, Marja; Sipola-Leppänen, Marika; Miettola, Satu; Pouta, Anneli; Jarvelin, Marjo-Riitta; Kajantie, Eero (2017)
    Background: Lower levels of physical activity and cardiorespiratory fitness are key risk factors of chronic adult diseases. Physical activity and cardiorespiratory fitness are predicted by birth weight, but the underlying parental and pregnancy-related factors remain largely unknown. We examined how prenatal determinants are associated with physical activity and cardiorespiratory fitness in adolescence. Methods: Of the 16-year-old members of the population-based Northern Finland Birth Cohort 1986 (NFBC 1986), 6682 singletons with no major physical disability reported their amount of physical activity outside school hours, and 4706 completed a submaximal cycle ergometer test assessing cardiorespiratory fitness. Physical activity was expressed as metabolic equivalent hours per week (METh/week) and cardiorespiratory fitness as peak oxygen uptake (ml center dot kg(-1)center dot min(-1)). Prenatal determinants included birth weight, length of gestation, mother's and father's body mass index (BMI), maternal gestational diabetes mellitus (GDM), and maternal hypertension and smoking during pregnancy. Data were analyzed by multiple linear regression. Results: A higher birth weight and longer length of gestation predicted lower levels of physical activity and cardiorespiratory fitness at 16 years, although the association between length of gestation and physical activity was inverse U-shaped. Mother's or father's overweight or obesity before pregnancy were associated with lower levels of their offspring's physical activity and fitness in adolescence. Adjusting for maternal pregnancy disorders and the adolescent's own BMI attenuated the associations with the mother's but not the father's overweight/obesity. Furthermore, maternal GDM predicted lower cardiorespiratory fitness. Conclusions: A high birth weight and parental overweight/obesity are associated with lower levels of both physical activity and cardiorespiratory fitness in adolescence, while maternal GDM and longer length of gestation are associated with lower cardiorespiratory fitness. Both long and short lengths of gestation predict low physical activity.
  • Sairanen, Essi; Tolvanen, Asko; Karhunen, Leila; Kolehmainen, Marjukka; Järvelä-Reijonen, Elina; Lindroos, Sanni; Peuhkuri, Katri; Korpela, Riitta; Ermes, Miikka; Mattila, Elina; Lappalainen, Raimo (2017)
    Objective: Despite the promising results related to intuitive eating, few studies have attempted to explain the processes encouraging this adaptive eating behaviour. The focus of the present study was on exploring mechanisms of change in intuitive eating and weight in acceptance and commitment therapy (ACT) interventions. Mediation provides important information regarding the treatment processes and theoretical models related to specific treatment approaches. The study investigates whether psychological flexibility, mindfulness skills and sense of coherence mediated the interventions' effect on intuitive eating and weight. Design: Secondary analysis of a randomized control trial. Mediation analysis compared two ACT interventions - face-to-face (in a group) and mobile (individually) - with a control group using a latent difference score model. Settings: Data were collected in three Finnish towns. Subjects: The participants were overweight or obese (n 219), reporting symptoms of perceived stress. Results: The effect of the interventions on participants' (i) BMI, (ii) intuitive eating and its subscales, (iii) eating for physical rather than emotional reasons and (iv) reliance on internal hunger and satiety cues was mediated by changes in weight-related psychological flexibility in both ACT groups. Conclusions: These findings suggest that ACT interventions aiming for lifestyle changes mediate the intervention effects through the enhanced ability to continue with valued activities even when confronted with negative emotions and thoughts related to weight.
  • Koski, M.; Naukkarinen, H. (BioMed Central, 2017)
    Abstract Background Obesity has a multifaceted etiology that involves genetic, biological and behavioral factors, body growth, eating habits, energy expenditure and the function of adipose tissue. The present study aimed to expand upon knowledge about the relationships among obesity, emotions and eating habits in severely obese individuals using a case-control method. Methods The subject group consisted of 112 individuals (81 females and 31 males) receiving a permanent disability pension primarily for obesity. The control subjects were randomly selected from the same area and were receiving a disability pension for a different primary illness. The controls were matched with the subjects by the place of residence, sex, age, the time since the pension was granted and occupation. Psychiatric interviews were conducted on all participants. The results were analyzed using the chi-squared test (χ2-test) and the percent distribution. The subject and control groups were compared using the t-test for paired variables. Conditional logistic regression analysis was also conducted. Results The emotional state of eating was significantly associated with quarrels and feelings of loneliness. The subjects suffered from night eating syndrome, which was associated with an increased risk of early retirement. Binge eating syndrome was observed more frequently in the study group. The subjects reported feeling increased hunger compared with the controls. A significant percentage of the subjects had a body mass index of ≥ 40. No differences in eating habits were observed between the groups. Conclusion This study provides information on the relationship between emotions and eating habits in obesity, which is a rarely studied topic. We believe that our study provides a novel and necessary overview of the associations among severe obesity, emotions and eating habits.
  • Järvelä-Reijonen, Elina; Karhunen, Leila; Sairanen, Essi; Muotka, Joona; Lindroos, Sanni; Laitinen, Jaana; Puttonen, Sampsa; Peuhkuri, Katri; Hallikainen, Maarit; Pihlajamaki, Jussi; Korpela, Riitta; Ermes, Miikka; Lappalainen, Raimo; Kolehmainen, Marjukka (2018)
    Background: Internal motivation and good psychological capabilities are important factors in successful eating-related behavior change. Thus, we investigated whether general acceptance and commitment therapy (ACT) affects reported eating behavior and diet quality and whether baseline perceived stress moderates the intervention effects. Methods: Secondary analysis of unblinded randomized controlled trial in three Finnish cities. Working-aged adults with psychological distress and overweight or obesity in three parallel groups: (1) ACT-based Face-to-face (n = 70; six group sessions led by a psychologist), (2) ACT-based Mobile (n = 78; one group session and mobile app), and (3) Control (n = 71; only the measurements). At baseline, the participants' (n = 219, 85% females) mean body mass index was 31.3 kg/m(2) (SD = 2.9), and mean age was 49.5 years (SD = 7.4). The measurements conducted before the 8-week intervention period (baseline), 10 weeks after the baseline (post-intervention), and 36 weeks after the baseline (follow-up) included clinical measurements, questionnaires of eating behavior (IES-1, TFEQ-R18, HTAS, ecSI 2.0, REBS), diet quality (IDQ), alcohol consumption (AUDIT-C), perceived stress (PSS), and 48-h dietary recall. Hierarchical linear modeling (Wald test) was used to analyze the differences in changes between groups. Results: Group x time interactions showed that the subcomponent of intuitive eating (IES-1), i.e., Eating for physical rather than emotional reasons, increased in both ACT- based groups (p = .019); the subcomponent of TFEQ-R18, i.e., Uncontrolled eating, decreased in the Face-to-face group (p = .020); the subcomponent of health and taste attitudes (HTAS), i.e., Using food as a reward, decreased in the Mobile group (p = .048); and both subcomponent of eating competence (ecSI 2.0), i.e., Food acceptance (p = .048), and two subcomponents of regulation of eating behavior (REBS), i.e., Integrated and Identified regulation (p = .003, p = .023, respectively), increased in the Face-to-face group. Baseline perceived stress did not moderate effects on these particular features of eating behavior from baseline to follow-up. No statistically significant effects were found for dietary measures. Conclusions: ACT- based interventions, delivered in group sessions or by mobile app, showed beneficial effects on reported eating behavior. Beneficial effects on eating behavior were, however, not accompanied by parallel changes in diet, which suggests that ACT-based interventions should include nutritional counseling if changes in diet are targeted. (Continued on next page)