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A Mediterranean Diet (MedDiet) nutrition intervention with physical activity was implemented among WTC responders with overweight\/obesity and post\u2010traumatic stress disorder (PTSD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>WTC Health Program members (<jats:italic>N<\/jats:italic>\u00a0=\u00a062), 45\u201365\u00a0years, males 87%, body mass index (BMI) 27\u201345\u00a0kg\/m<jats:sup>2<\/jats:sup> randomized to MedDiet (<jats:italic>n<\/jats:italic>\u00a0=\u00a031) or usual nutrition counseling (<jats:italic>n<\/jats:italic>\u00a0=\u00a031). The 10\u2010week intervention included online nutrition education, text messages, and group experiential cooking; both groups had three in\u2010person individual nutrition counseling. Anthropometrics, serum biomarkers, psychosocial factors, MedDiet score, and PTSD symptoms were assessed at baseline, post\u2010intervention, and 3\u2010months (follow\u2010up). The primary outcome was intervention feasibility and secondary outcomes were within\u2010 and between\u2010group changes of all measures at post\u2010intervention and follow\u2010up. Nonparametric Wilcoxon rank sum tests for between\u2010group comparisons and Wilcoxon signed rank tests for pre\u2010post within\u2010group comparisons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 58(94%) and 46(74%) participants completed the post\u2010intervention and follow\u2010up measurements, respectively. Both groups experienced significant improvements in anthropometrics, MedDiet score, oxidized low\u2010density lipoprotein, and PTSD symptoms. Baseline median (range) were weight 100.42 (73.66\u2013135.17)\u00a0kg, BMI 33.20 (27.50\u201341.75)\u00a0kg\/m<jats:sup>2<\/jats:sup>, and Waist circumference (WC) 109.22 (90.17\u2013150.62)\u00a0cm. Median % weight loss at post\u2010intervention was MedDiet: \u22123% (\u221211%\u20137%), <jats:italic>p<\/jats:italic>\u00a0=\u00a00.0002; Control: \u22121% (\u221213%\u20134%), <jats:italic>p<\/jats:italic>\u00a0=\u00a00.008 and at follow\u2010up MedDiet: \u22122% (\u221214%\u201312%), <jats:italic>p<\/jats:italic>\u00a0=\u00a00.07; Control: \u22122% (\u221220%\u20133%), <jats:italic>p<\/jats:italic>\u00a0=\u00a00.006. The overall BMI was reduced by \u22120.68\u00a0kg\/m<jats:sup>2<\/jats:sup> (\u22124.61\u20132.09)\u00a0kg\/m<jats:sup>2<\/jats:sup> <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001 at post\u2010intervention and by \u22120.60\u00a0kg\/m<jats:sup>2<\/jats:sup> (\u22126.91\u20133.39)\u00a0kg\/m<jats:sup>2<\/jats:sup>, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0009 at follow\u2010up. Overall, median WC was reduced (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001); post\u2010intervention \u22123.81\u00a0cm (\u221233.00\u20133.30)cm and follow\u2010up \u22124.45(\u221238.10\u20134.57)cm. There were group differences in HbA1c (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.019) and serum \u03c96\/\u03c93 (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.029) at post\u2010intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Online intervention with personal counseling was feasible in this population. Improvements in anthropometrics, MedDiet score, selected serum biomarkers and PTSD symptoms were found in both groups; group differences in HbA1c and serum \u03c96\/\u03c93. A larger study with a delayed control is needed to better assess intervention effects.<\/jats:p><\/jats:sec>","DOI":"10.1002\/osp4.725","type":"journal-article","created":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T06:10:39Z","timestamp":1703225439000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Mediterranean diet intervention among World Trade Center responders with post\u2010traumatic stress disorder: Feasibility and outcomes of a pilot randomized controlled trial"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4122-779X","authenticated-orcid":false,"given":"Chrisa","family":"Arcan","sequence":"first","affiliation":[{"name":"Department of Epidemiology School of Population Health Virginia Commonwealth University  Richmond Virginia USA"},{"name":"Department of Family Population and Preventive Medicine Renaissance School of Medicine Stony Brook University  Stony Brook New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Family Population and Preventive Medicine Renaissance School of Medicine Stony Brook University  Stony Brook New York USA"},{"name":"Vertex Pharmaceuticals Incorporated  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Stony Brook World Trade Center Health Plan and Wellness Program Renaissance School of Medicine Stony Brook University  Commack New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Reichardt","sequence":"additional","affiliation":[{"name":"Stony Brook World Trade Center Health Plan and Wellness Program Renaissance School of Medicine Stony Brook University  Commack New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohua","family":"Yang","sequence":"additional","affiliation":[{"name":"Stony Brook World Trade Center Health Plan and Wellness Program Renaissance School of Medicine Stony Brook University  Commack New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean A. 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