201
|
James-Martin G, Baird DL, Hendrie GA. Strategies to Reduce Consumption of Unhealthy Foods and Beverages: Scenario Modeling to Estimate the Impact on the Australian Population's Energy and Nutrient Intakes. J Acad Nutr Diet 2021; 121:1463-1483. [PMID: 33495107 DOI: 10.1016/j.jand.2020.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 11/12/2020] [Accepted: 12/03/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Overconsumption of energy-dense, nutrient-poor "discretionary" foods and beverages can indicate poor diet quality, which is a risk factor for obesity and chronic disease. With 60% of Australians exceeding the recommended intake of discretionary foods, there is a need for interventions to reduce their consumption. OBJECTIVE The objective was to model the impact of 26 specific scenarios to limit discretionary food intake on energy and nutrient intake. DESIGN The scenario modeling analysis was based on reduction strategies targeting portion size, frequency, or variety of discretionary food and beverage items consumed. PARTICIPANTS/SETTING Data from 12,153 respondents aged 2 to 85 years from the 2011-12 Australian National Nutrition and Physical Activity Survey were used. OUTCOME MEASURES The outcome measures were change in servings of discretionary foods and key nutrients (energy, total fat, saturated fat, sugar, alcohol, sodium, trans fat) for the population, and by sex, age group, weight status, and socioeconomic status. STATISTICAL ANALYSES PERFORMED Descriptive and inferential statistical analysis were conducted. RESULTS Scenarios reduced total energy intake by up to 26% across the population as a whole. The removal of discretionary foods (not beverages) resulted in the greatest reduction in servings and energy (74.8% and 25.6%, respectively), followed by the removal of discretionary items in portions greater than 143 kcal (59.1% and 24.3%) and not consuming discretionary items at main meals (51.2% and 17.8%). Targeting single categories of discretionary foods reduced energy intake by an average of 5.6% for the removal of cakes and biscuits, 4.4% for alcohol, and 3.9% for sugar-sweetened beverages. Strategies reduced total fat, saturated fat, and sugar by up to 35%, 38%, and 40% respectively. CONCLUSIONS Strategies that are specific to discretionary food and beverage intake targeting reductions in portion size, frequency, or variety have the potential to reduce energy intake and improve diet quality. These findings have implications for designing interventions with potential to tailor messages to current dietary habits. Exploration of how these strategies could be effectively implemented will be the focus of further research.
Collapse
|
202
|
Bannon CAM, Border D, Hanson P, Hattersley J, Weickert MO, Grossman A, Randeva HS, Barber TM. Early Metabolic Benefits of Switching Hydrocortisone to Modified Release Hydrocortisone in Adult Adrenal Insufficiency. Front Endocrinol (Lausanne) 2021; 12:641247. [PMID: 33776936 PMCID: PMC7992002 DOI: 10.3389/fendo.2021.641247] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 02/09/2021] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To compare metabolic effects of modified release hydrocortisone (MR-HC) with standard hydrocortisone (HC) therapies in adults with Adrenal Insufficiency (AI). METHODS Adult patients (n = 12) with AI, established on HC therapy, were recruited from Endocrinology clinics at University Hospitals Coventry and Warwickshire (UHCW), UK. Baseline (HC) metabolic assessments included fasting serum HbA1C, lipid and thyroid profiles, accurate measures of body composition (BodPod), and 24-h continuous measures of energy expenditure including Sleeping Metabolic Rate (SMR) using indirect calorimetry within the Human Metabolism Research Unit, UHCW. All participants then switched HC to MR-HC with repeat (MR-HC) metabolic assessments at 3 months. Paired-sample t-tests were used for data comparisons between HC and MR-HC assessments: P-value <0.05 was considered significant. RESULTS Following exclusion of 2 participants, analyses were based on 10 participants. Compared with baseline HC data, following 3 months of MR-HC therapy mean fat mass reduced significantly by -3.2 kg (95% CI: -6.0 to -0.4). Mean (SD) baseline HC fat mass vs repeat MR-HC fat mass: 31.9 kg (15.2) vs 28.7 kg (12.8) respectively, P = 0.03. Mean SMR increased significantly by +77 kcal/24 h (95% CI: 10-146). Mean (SD) baseline HC SMR vs repeat MR-HC SMR: 1,517 kcal/24 h (301) vs 1,594 kcal/24 h (344) respectively, P = 0.03. Mean body fat percentage reduced significantly by -3.4% (95% CI: -6.5 to -0.2). Other measures of body composition, energy expenditure, and biochemical analytes were equivalent between HC and MR-HC assessments. CONCLUSIONS In adults with AI, switching from standard HC to MR-HC associates with early metabolic benefits of reduced fat mass and increased SMR.
Collapse
Affiliation(s)
- Christopher A. M. Bannon
- Warwickshire Institute for the Study of Diabetes Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
- NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - Daniel Border
- Warwickshire Institute for the Study of Diabetes Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry, United Kingdom
- NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - Petra Hanson
- Warwickshire Institute for the Study of Diabetes Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
- NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - John Hattersley
- Warwickshire Institute for the Study of Diabetes Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry, United Kingdom
- NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
- Faculty of Health & Life Sciences, Centre of Applied Biological & Exercise Sciences, Coventry University, Coventry, United Kingdom
| | - Martin O. Weickert
- Warwickshire Institute for the Study of Diabetes Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
- NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
- Faculty of Health & Life Sciences, Centre of Applied Biological & Exercise Sciences, Coventry University, Coventry, United Kingdom
| | - Ashley Grossman
- Neuroendocrine Tumour Unit, Royal Free Hospital, London, United Kingdom
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, United Kingdom
| | - Harpal S. Randeva
- Warwickshire Institute for the Study of Diabetes Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
- NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
- Faculty of Health & Life Sciences, Centre of Applied Biological & Exercise Sciences, Coventry University, Coventry, United Kingdom
| | - Thomas M. Barber
- Warwickshire Institute for the Study of Diabetes Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
- NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
- *Correspondence: Thomas M. Barber,
| |
Collapse
|
203
|
Mendoza-Herrera K, Florio AA, Moore M, Marrero A, Tamez M, Bhupathiraju SN, Mattei J. The Leptin System and Diet: A Mini Review of the Current Evidence. Front Endocrinol (Lausanne) 2021; 12:749050. [PMID: 34899599 PMCID: PMC8651558 DOI: 10.3389/fendo.2021.749050] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/29/2021] [Indexed: 01/02/2023] Open
Abstract
Leptin promotes satiety and modulates energy balance and weight. Diet-induced obesity leads to leptin resistance, exacerbating overeating. We reviewed the literature on the relationship between diet and leptin, which suggests that addressing leptin resistance through dietary interventions can contribute counteracting obesity. Albeit some limitations (e.g., limited rigor, small samples sizes), studies in animals and humans show that diets high in fat, carbohydrates, fructose, and sucrose, and low in protein are drivers of leptin resistance. Despite methodological heterogeneity pertaining to this body of literature, experimental studies show that energy-restricted diets can reduce leptinemia both in the short and long term and potentially reverse leptin resistance in humans. We also discuss limitations of this evidence, future lines of research, and implications for clinical and public health translations. Main limitations include the lack of a single universally-accepted definition of leptin resistance, and of adequate ways to accurately measure it in humans. The use of leptin sensitizers (drugs) and genetically individualized diets are alternatives against leptin resistance that should be further researched in humans. The tested very-low-energy intervention diets are challenging to translate into wide clinical or population recommendations. In conclusion, the link between nutritional components and leptin resistance, as well as research indicating that this condition is reversible, emphasizes the potential of diet to recover sensitivity to this hormone. A harmonized definition of leptin resistance, reliable methods to measure it, and large-scale, translational, clinical, and precision nutrition research involving rigorous methods are needed to benefit populations through these approaches.
Collapse
|
204
|
Development and validation of prognostic models to estimate body weight loss in overweight and obese people. NUTR HOSP 2021; 38:511-518. [PMID: 33764152 DOI: 10.20960/nh.03425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Background: predicting weight loss outcomes from information collected from subjects before they start a weight management program is an objective strongly pursued by scientists who study energy balance. Objective: to develop and validate two prognostic models for the estimation of final body weight after a six-month intervention period. Material and methods: the present work was developed following the TRIPOD standard to report prognostic multivariable prediction models. A multivariable linear regression analysis was applied to 70 % of participants to identify the most relevant variables and develop the best prognostic model for body weight estimation. Then, 30 % of the remaining sample was used to validate the model. The study involved a 6-month intervention based on 25-30 % caloric restriction and exercise. A total of 239 volunteers who had participated in the PRONAF study, aged 18 to 50 years, with overweight or obesity (body mass index: 25-34.9 kg/m2), were enrolled. Body composition was estimated by dual-energy X-ray absorptiometry (DXA) and by hand-to-foot bioelectrical impedance (BIA) analysis. Results: prognostic models were developed and validated with a high correlation (0.954 and 0.951 for DXA and BIA, respectively), with the paired t-tests showing no significant differences between estimated and measured body weights. The mean difference, standard error, and 95 % confidence interval of the DXA model were 0.067 ± 0.547 (-1.036-1.170), and those of the BIA model were -0.105 ± 0.511 (-1.134-0.924). Conclusions: the models developed in this work make it possible to calculate the final BW of any participant engaged in an intervention like the one employed in this study based only on baseline body composition variables.
Collapse
|
205
|
Laws R, Love P, Hesketh KD, Koorts H, Denney-Wilson E, Moodie M, Brown V, Ong KL, Browne J, Marshall S, Lioret S, Orellana L, Campbell KJ. Protocol for an Effectiveness-Implementation Hybrid Trial to Evaluate Scale up of an Evidence-Based Intervention Addressing Lifestyle Behaviours From the Start of Life: INFANT. Front Endocrinol (Lausanne) 2021; 12:717468. [PMID: 34975744 PMCID: PMC8715861 DOI: 10.3389/fendo.2021.717468] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 09/21/2021] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Promoting healthy eating and active play in early life is critical, however few interventions have been delivered or sustained at scale. The evaluation of interventions at scale is a crucial, yet under-researched aspect of modifying population-level health behaviours. INFANT is an evidence-based early childhood healthy lifestyle intervention that aims to improve parents' knowledge and skills around promoting optimal energy balance-related behaviours that, in turn, influence children's diet, activity and adiposity. It consists of: 1) Four group sessions delivered via first time parent groups across the first 12 months of life; 2) access to the My Baby Now app from birth to 18 months of age. This research aims to assess real-world implementation, effectiveness and cost-effectiveness of INFANT when delivered at scale across Victoria, Australia. METHODS AND ANALYSIS A hybrid type II implementation-effectiveness trial applying a mixed methods design will be conducted. INFANT will be implemented in collaboration with practice and policy partners including maternal and child health services, population health and Aboriginal health, targeting all local government areas (n=79) in Victoria, Australia. Evaluation is based on criteria from the 'Outcomes for Implementation Research' and 'RE-AIM' frameworks. Implementation outcomes will be assessed using descriptive quantitative surveys and qualitative interviews with those involved in implementation, and include intervention reach, organisational acceptability, adoption, appropriateness, cost, feasibility, penetration and sustainability. Process measures include organizational readiness, fidelity, and adaptation. Effectiveness outcomes will be assessed using a sample of INFANT participants and a non-randomized comparison group receiving usual care (1,500 infants in each group), recruited within the same communities. Eligible participants will be first time primary caregivers of an infant aged 0-3 months, owning a personal mobile phone and able to communicate in English. Effectiveness outcomes include infant lifestyle behaviours and BMIz at 12 and 18 months of age. IMPACT This is the first known study to evaluate the scale up of an evidence based early childhood obesity prevention intervention under real world conditions. This study has the potential to provide generalisable implementation, effectiveness and cost-effectiveness evidence to inform the future scale up of public health interventions both in Australia and internationally. CLINICAL TRIAL REGISTRATION Australian and New Zealand Clinical Trial Registry https://www.anzctr.org.au/, identifier ACTRN12620000670976.
Collapse
Affiliation(s)
- Rachel Laws
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, Australia
- *Correspondence: Rachel Laws,
| | - Penelope Love
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, Australia
| | - Kylie D. Hesketh
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, Australia
| | - Harriet Koorts
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, Australia
| | - Elizabeth Denney-Wilson
- Sydney Nursing School, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Sydney, NSW, Australia
| | - Marj Moodie
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, VIC, Australia
| | - Vicki Brown
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, VIC, Australia
| | - Kok-Leong Ong
- La Trobe Analytics Lab, La Trobe University, Melbourne, VIC, Australia
| | - Jennifer Browne
- Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, VIC, Australia
| | - Sarah Marshall
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, Australia
| | | | | | - Karen J. Campbell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, Australia
| |
Collapse
|
206
|
Ran Z, Xue X, Han L, Terkeltaub R, Merriman TR, Zhao T, He Y, Wang C, Li X, Liu Z, Cui L, Li H, Ji A, Hu S, Lu J, Li C. Decrease in Serum Urate Level Is Associated With Loss of Visceral Fat in Male Gout Patients. Front Endocrinol (Lausanne) 2021; 12:724822. [PMID: 34594303 PMCID: PMC8476917 DOI: 10.3389/fendo.2021.724822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/24/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To clarify the relationship between serum urate (SU) decrease and visceral fat area (VFA) reduction in patients with gout. METHODS We retrospectively analyzed 237 male gout patients who had two sets of body composition and metabolic measurements within 6 months. Subjects included had all been treated with urate-lowering therapy (ULT) (febuxostat 20-80 mg/day or benzbromarone 25-50 mg/day, validated by the medical record). All patients were from the specialty gout clinic of The Affiliated Hospital of Qingdao University. The multiple linear regression model evaluated the relationship between change in SU [ΔSU, (baseline SU) - (final visit SU)] and change in VFA [ΔVFA, (baseline VFA) - (final visit VFA)]. RESULTS ULT resulted in a mean (standard deviation) decrease in SU level (464.22 ± 110.21 μmol/L at baseline, 360.93 ± 91.66 μmol/L at the final visit, p <0.001) accompanied by a decrease in median (interquartile range) VFA [97.30 (81.15-118.55) at baseline, 90.90 (75.85-110.05) at the final visit, p < 0.001]. By multiple regression model, ΔSU was identified to be a significant determinant variable of decrease in VFA (beta, 0.302; p = 0.001). CONCLUSIONS The decrease in SU level is positively associated with reduced VFA. This finding provides a rationale for clinical trials to affirm whether ULT promotes loss of visceral fat in patients with gout.
Collapse
Affiliation(s)
- Zijing Ran
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaomei Xue
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lin Han
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, Qingdao, China
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
| | - Robert Terkeltaub
- San Diego VA Healthcare System, San Diego, CA, United States
- Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Tony R. Merriman
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Division of Clinical Immunology and Rheumatology, University of Alabama Birmingham, Birmingham, AL, United States
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Ting Zhao
- Department of Nutrition, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yuwei He
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Can Wang
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xinde Li
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhen Liu
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lingling Cui
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hailong Li
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
| | - Aichang Ji
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Shuhui Hu
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jie Lu
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, Qingdao, China
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
- *Correspondence: Changgui Li, ; Jie Lu,
| | - Changgui Li
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, Qingdao, China
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
- *Correspondence: Changgui Li, ; Jie Lu,
| |
Collapse
|
207
|
Englert I, Bosy-Westphal A, Bischoff SC, Kohlenberg-Müller K. Impact of Protein Intake during Weight Loss on Preservation of Fat-Free Mass, Resting Energy Expenditure, and Physical Function in Overweight Postmenopausal Women: A Randomized Controlled Trial. Obes Facts 2021; 14:259-270. [PMID: 33975325 PMCID: PMC8255642 DOI: 10.1159/000514427] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/31/2020] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Weight loss in old age increases the risk of sarcopenia caused by the age-related reduction of fat-free mass (FFM). Due to the strong correlation between FFM and resting energy expenditure (REE), the maintenance of this must also be considered. Besides, the physical function (PF) must be maintained. OBJECTIVE The impact of protein intake on changes in FFM, REE, and PF during weight loss in overweight postmenopausal women was investigated. METHODS Fifty-four postmenopausal women (BMI 30.9 ± 3.4; age 59 ± 7 years) were randomized into 2 groups receiving energy-restricted diets with either 0.8 g (normal protein; NP) or 1.5 g protein/kg body weight (high protein; HP) for 12 weeks, followed by a 6-month follow-up phase with an ad libitum food intake. FFM, REE, and PF (strength, endurance, and balance) were measured at baseline, after weight loss, and after follow-up. RESULTS Forty-six women completed the weight loss intervention and 29 were followed up. The weight loss was -4.6 ± 3.6 kg (HP) and -5.2 ± 3.4 kg (NP; both p < 0.001) and the weight regain during follow-up was 1.3 ± 2.8 kg (HP; p = 0.03) and 0.4 ± 2.5 kg (NP; p = 0.39), with no differences between groups. Similar decreases in FFM (-0.9 ± 1.1 [HP] vs. -1.0 ± 1.3 kg [NP]) and REE (-862 ± 569 [HP] vs. -1,000 ± 561 kJ [NP]; both p < 0.001) were observed in both groups. During follow-up, no changes in FFM were detected in either group, whereas in the NP group the REE increased again (+138 ± 296; p = 0.02). The main determinants of FFM loss were the energy deficit and the speed of weight loss. In the NP group, the Short Physical Performance Battery score improved with weight loss (+0.6 ± 0.8; p < 0.001) and handgrip strength decreased (-1.7 ± 3.4 kg; p < 0.001), whereas no changes were observed in the HP group. CONCLUSIONS An HP weight-loss diet without exercise had no impact on preservation of FFM and REE but may help to maintain muscle strength in postmenopausal women.
Collapse
Affiliation(s)
- Isabell Englert
- Fulda University of Applied Sciences, Fulda, Germany
- *Isabell Englert,
| | | | | | | |
Collapse
|
208
|
Lee CL, Liu WJ, Wang JS. Associations of low-carbohydrate and low-fat intakes with all-cause mortality in subjects with prediabetes with and without insulin resistance. Clin Nutr 2020; 40:3601-3607. [PMID: 33390277 DOI: 10.1016/j.clnu.2020.12.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/02/2020] [Accepted: 12/16/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS We investigated the associations of low-carbohydrate and low-fat diets with all-cause mortality in people with prediabetes according to insulin resistance status using data from the National Health and Nutrition Examination Survey (NHANES). METHODS We analyzed the NHANES participants with prediabetes from 2005 to 2008, and their vital status was linked to the National Death Index through the end of 2011. Low-carbohydrate and low-fat diets were defined as ≦40% and ≦30% of calories from carbohydrate and fat, respectively. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to determine insulin resistance. Weighted Cox proportional hazards regression models were used to compare the hazard ratios for the associations of low-carbohydrate and low-fat diets with all-cause mortality. RESULTS Among the 1687 participants with prediabetes, 96 of them had died after a median follow-up of 4.5 years. Participants with a HOMA-IR >3.0 had an increase in all-cause mortality compared with those who had a HOMA-IR ≦3.0 (HR 1.797, 95% CI 1.110 to 2.909, p = 0.019). Participants with ≦40% of calories from carbohydrate and >30% from fat (3.75 per 1000 person-years) had a lower all-cause mortality rate compared with those who had >40% from carbohydrate and >30% from fat (10.20 per 1000 person-years) or >40% from carbohydrate and ≦30% from fat (8.09 per 1000 person-years), with statistical significance observed in those who had a HOMA-IR ≦3.0. CONCLUSIONS A low-carbohydrate intake (≦40%) was associated with a lower all-cause mortality rate in people with prediabetes.
Collapse
Affiliation(s)
- Chia-Lin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taiwan.
| | - Wei-Ju Liu
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
| | - Jun-Sing Wang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Rong Hsing Research Center for Translational Medicine, Institute of Biomedical Science, National Chung Hsing University, Taichung, Taiwan; Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan.
| |
Collapse
|
209
|
Abstract
OBJECTIVE To estimate the daily dietary energy intake for me to maintain a constant body weight. How hard can it be? DESIGN Very introspective study. SETTING At home. In lockdown. (Except every Tuesday afternoon and Saturday morning, when I went for a run.) PARTICIPANTS: Me. n=1. MAIN OUTCOME MEASURES My weight, measured each day. RESULTS Sleeping, I shed about a kilogram each night (1.07 (SD 0.25) kg). Running 5 km, I shed about half a kilogram (0.57 (SD 0.15) kg). My daily equilibrium energy intake is about 10 000 kJ (10 286 (SD 201) kJ). Every kJ above (or below) 10 000 kJ adds (or subtracts) about 40 mg (35.4 (SD 3.2) mg). CONCLUSIONS Body weight data show persistent variability, even when the screws of control are tightened and tightened.
Collapse
Affiliation(s)
- R A Lewis
- School of Physics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong NSW 2522, Australia
| |
Collapse
|
210
|
Duncanson K, Shrewsbury V, Burrows T, Chai LK, Ashton L, Taylor R, Gow M, Ho M, Ells L, Stewart L, Garnett S, Jensen ME, Nowicka P, Littlewood R, Demaio A, Coyle DH, Walker JL, Collins CE. Impact of weight management nutrition interventions on dietary outcomes in children and adolescents with overweight or obesity: a systematic review with meta‐analysis. J Hum Nutr Diet 2020; 34:147-177. [DOI: 10.1111/jhn.12831] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/28/2020] [Accepted: 10/02/2020] [Indexed: 12/19/2022]
Affiliation(s)
- K. Duncanson
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - V. Shrewsbury
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - T. Burrows
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - L. K. Chai
- Health and Wellbeing Queensland Queensland Government Milton QLD Australia
- Centre for Children’s Health Research Institute of Health and Biomedical Innovation Exercise and Nutrition Queensland University of Technology South Brisbane QLD Australia
| | - L. Ashton
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - R. Taylor
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - M. Gow
- Institute of Endocrinology and Diabetes The Children’s Hospital at Westmead Westmead NSW Australia
- Children’s Hospital at Westmead Clinical School The University of Sydney Westmead NSW Australia
| | - M. Ho
- School of Nursing The University of Hong Kong Pokfulam Hong Kong
| | - L. Ells
- School of Clinical and Applied Sciences Leeds Beckett University Leeds UK
- Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence Middlesbrough UK
| | - L. Stewart
- Appletree Healthy Lifestyle Consultancy Perth UK
| | - S. Garnett
- Institute of Endocrinology and Diabetes The Children’s Hospital at Westmead Westmead NSW Australia
- Children’s Hospital at Westmead Clinical School The University of Sydney Westmead NSW Australia
| | - M. E. Jensen
- Priority Research Centre Grow Up Well and Faculty of Health and Medicine The University of Newcastle Callaghan NSW Australia
| | - P. Nowicka
- Department of Food Studies, Nutrition and Dietetics Uppsala University Uppsala Sweden
| | - R. Littlewood
- Health and Wellbeing Queensland Queensland Government Milton QLD Australia
- School of Human Movement and Nutrition Sciences The University of Queensland St Lucia QLD Australia
| | - A. Demaio
- Victorian Health Promotion Foundation Carlton South VIC Australia
| | - D. H. Coyle
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
- The George Institute for Global Health University of New South Wales Sydney NSW Australia
| | - J. L. Walker
- School of Human Movement and Nutrition Sciences The University of Queensland St Lucia QLD Australia
| | - C. E. Collins
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
- The University of Newcastle Centre for Evidence Based Healthcare Informing Research (CEBHIR): a Joanna Briggs Institute Centre of Excellence Callaghan NSW Australia
| |
Collapse
|
211
|
Dent R, McPherson R, Harper ME. Factors affecting weight loss variability in obesity. Metabolism 2020; 113:154388. [PMID: 33035570 DOI: 10.1016/j.metabol.2020.154388] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/19/2020] [Accepted: 09/23/2020] [Indexed: 12/25/2022]
Abstract
Current obesity treatment strategies include diet, exercise, bariatric surgery, and a limited but growing repertoire of medications. Individual weight loss in response to each of these strategies is highly variable. Here we review research into factors potentially contributing to inter-individual variability in response to treatments for obesity, with a focus on studies in humans. Well-recognized factors associated with weight loss capacity include diet adherence, physical activity, sex, age, and specific medications. However, following control for each of these, differences in weight loss appear to persist in response to behavioral, pharmacological and surgical interventions. Adaptation to energy deficit involves complex feedback mechanisms, and inter-individual differences likely to arise from a host of poorly defined genetic factors, as well as differential responses in neurohormonal mechanisms (including gastrointestinal peptides), metabolic efficiency and capacity of tissues, non-exercise activity thermogenesis, thermogenic response to food, and in gut microbiome. A better understanding of the factors involved in inter-individual variability in response to therapies will guide more personalized approaches to the treatment of obesity.
Collapse
Affiliation(s)
- Robert Dent
- Department of Medicine, Division of Endocrinology and The Ottawa Hospital, University of Ottawa, 210 Melrose Ave, Ottawa, ON K1Y 4K7, Canada
| | - Ruth McPherson
- Atherogenomics Laboratory, Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin St., Ottawa, ON K1Y 4W7, Canada
| | - Mary-Ellen Harper
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, Ottawa Institute of Systems Biology, University of Ottawa, 451 Smyth Rd., Ottawa, ON K1H 8M5, Canada.
| |
Collapse
|
212
|
Laurent I, Astère M, Paul B, Liliane N, Li Y, Cheng Q, Li Q, Xiao X. The use of Broca index to assess cut- off points for overweight in adults: A short review. Rev Endocr Metab Disord 2020; 21:521-526. [PMID: 32495251 DOI: 10.1007/s11154-020-09566-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The Broca formula was developed in 1871 by Pierre Paul Broca (a French Army Doctor) to help establish ideal body weight or normal body weight. Initially, the Broca Index (BI) was used to work out the normal weight but was later expanded to ideal Body Weight. Ideal Body weight (kg) = [Height (cm)-100]. The common methods used to explore the levels of adiposity include body mass index (BMI), waist circumference, skinfolds, bioelectrical impedance analysis, dual energy x-ray absorptiometry (DEXA), computerized tomography (CT) and magnetic resonance imaging (MRI). Even though there have been several anthropometric measurements discoveries to assess obesity, BMI is still widely used in many clinic centers around the world. It remains simple and relatively inexpensive to measure and easily obtainable in non-laboratory settings. In this review, we will summarize the common methods used to measure body fat and their limitations. Second, we will show the correlation that may exist between Broca Index and BMI cutoffs. Last, we will underline some potential clinical usefulness that may present Broca index in assessing body fat.
Collapse
Affiliation(s)
- Irakoze Laurent
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Faculty of Medicine, Burundi University, Bujumbura, Burundi
| | - Manirakiza Astère
- Faculty of Medicine, Burundi University, Bujumbura, Burundi
- Department of Oncology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | | | - Nkengurutse Liliane
- Ministry of Public Health, Epidemiological Emergency Service, Bujumbura, Burundi
| | - Yue Li
- The Chongqing Key Laboratory of Translational Medicine in Major Metabolic Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Qingfeng Cheng
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Qifu Li
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Xiaoqiu Xiao
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
- The Chongqing Key Laboratory of Translational Medicine in Major Metabolic Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China.
| |
Collapse
|
213
|
Buckland NJ, Swinnerton LF, Ng K, Price M, Wilkinson LL, Myers A, Dalton M. Susceptibility to increased high energy dense sweet and savoury food intake in response to the COVID-19 lockdown: The role of craving control and acceptance coping strategies. Appetite 2020; 158:105017. [PMID: 33161044 PMCID: PMC8580210 DOI: 10.1016/j.appet.2020.105017] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/15/2020] [Accepted: 10/31/2020] [Indexed: 01/02/2023]
Abstract
Emerging evidence indicates that for some people, the COVID-19 lockdowns are a time of high risk for increased food intake. A clearer understanding of which individuals are most at risk of over-eating during the lockdown period is needed to inform interventions that promote healthy diets and prevent weight gain during lockdowns. An online survey collected during the COVID-19 lockdown (total n = 875; analysed n = 588; 33.4 ± 12.6 years; 82% UK-based; mostly white, educated, and not home schooling) investigated reported changes to the amount consumed and changes to intake of high energy dense (HED) sweet and savoury foods. The study also assessed which eating behaviour traits predicted a reported increase of HED sweet and savoury foods and tested whether coping responses moderated this relationship. Results showed that 48% of participants reported increased food intake in response to the COVID-19 lockdown. There was large individual variability in reported changes and lower craving control was the strongest predictor of increased HED sweet and savoury food intake. Low cognitive restraint also predicted greater increases in HED sweet snacks and HED savoury meal foods. Food responsiveness, enjoyment of food, emotional undereating, emotional overeating and satiety responsiveness were not significant predictors of changes to HED sweet and savoury food intake. High scores on acceptance coping responses attenuated the conditional effects of craving control on HED sweet snack intake. Consistent with previous findings, the current research suggests that low craving control is a risk factor for increased snack food intake during lockdown and may therefore represent a target for intervention.
Collapse
Affiliation(s)
- Nicola J Buckland
- Department of Psychology, University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield, S1 2LT, United Kingdom.
| | - Lucy F Swinnerton
- Department of Psychology, University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield, S1 2LT, United Kingdom
| | - Kwok Ng
- School of Educational Sciences and Psychology, University of Eastern Finland, 80101, Joensuu, Finland; Physical Activity for Health Research Cluster, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Menna Price
- Department of Psychology, College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, SA2 8PP, United Kingdom
| | - Laura L Wilkinson
- Department of Psychology, College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, SA2 8PP, United Kingdom
| | - Anna Myers
- Sheffield Hallam University, Advanced Wellbeing Research Centre, Olympic Legacy Park, Sheffield, S9 3TU, United Kingdom
| | - Michelle Dalton
- School of Social and Behavioural Sciences, Leeds Trinity University, Horsforth, Leeds, LS18 5HD, United Kingdom
| |
Collapse
|
214
|
Gobbi S, Weber S, Graf G, Hinz D, Asarian L, Geary N, Leeners B, Hare T, Tobler P. Reduced Neural Satiety Responses in Women Affected by Obesity. Neuroscience 2020; 447:94-112. [DOI: 10.1016/j.neuroscience.2020.07.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 03/04/2020] [Accepted: 07/13/2020] [Indexed: 02/08/2023]
|
215
|
Basto-Abreu A, Barrientos-Gutiérrez T, Vidaña-Pérez D, Colchero MA, Hernández-F M, Hernández-Ávila M, Ward ZJ, Long MW, Gortmaker SL. Cost-Effectiveness Of The Sugar-Sweetened Beverage Excise Tax In Mexico. Health Aff (Millwood) 2020; 38:1824-1831. [PMID: 31682510 DOI: 10.1377/hlthaff.2018.05469] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
An excise tax of 1 peso per liter on sugar-sweetened beverages was implemented in Mexico in 2014. We estimated the cost-effectiveness of this tax and an alternative tax scenario of 2 pesos per liter. We developed a cohort simulation model calibrated for Mexico to project the impact of the tax over ten years. The current tax is projected to prevent 239,900 cases of obesity, 39 percent of which would be among children. It could also prevent 61,340 cases of diabetes, lead to gains of 55,300 quality-adjusted life-years, and avert 5,840 disability-adjusted life-years. The tax is estimated to save $3.98 per dollar spent on its implementation. Doubling the tax to 2 pesos per liter would nearly double the cost savings and health impact. Countries with comparable conditions could benefit from implementing a similar tax.
Collapse
Affiliation(s)
- Ana Basto-Abreu
- Ana Basto-Abreu is an assistant professor at the Center for Population Health Research, National Institute of Public Health, in Cuernavaca, Mexico
| | - Tonatiuh Barrientos-Gutiérrez
- Tonatiuh Barrientos-Gutiérrez ( tbarrientos@insp. mx ) is the director of the Center for Population Health Research, National Institute of Public Health
| | - Dèsirée Vidaña-Pérez
- Dèsirée Vidaña-Pérez is a researcher at the Center for Population Health Research, National Institute of Public Health
| | - M Arantxa Colchero
- M. Arantxa Colchero is an associate professor of health economics at the Center for Health Systems Research, National Institute of Public Health
| | - Mauricio Hernández-F
- Mauricio Hernández-F. is a research assistant at the Center for Research and Nutrition Health, National Institute of Public Health
| | - Mauricio Hernández-Ávila
- Mauricio Hernández-Ávila is director of economic and social benefits, Mexican Institute of Social Security, in Mexico City
| | - Zachary J Ward
- Zachary J. Ward is a programmer analyst at the Harvard T. H. Chan School of Public Health, in Boston, Massachusetts
| | - Michael W Long
- Michael W. Long is an assistant professor in the Milken Institute School of Public Health, George Washington University, in Washington, D.C
| | - Steven L Gortmaker
- Steven L. Gortmaker is a professor of the practice of health sociology at the Harvard T. H. Chan School of Public Health
| |
Collapse
|
216
|
Bunten A, Porter L, Burgess-Allen J, Howell-Jones R, Jackson J, Ward D, Staples V, Staples P, Rowthorn H, Saei A, van Schaik P, Tydeman E, Blair P, Hugueniot O, Gold N, Chadborn T. Using behavioural insights to reduce sugar in primary school children's packed lunches in derby; A cluster randomised controlled trial. Appetite 2020; 157:104987. [PMID: 33039508 DOI: 10.1016/j.appet.2020.104987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/15/2020] [Accepted: 10/01/2020] [Indexed: 01/11/2023]
Abstract
Children's packed lunches contain more sugar than school-provided meals. Interventions to improve the provision of healthier packed lunches have modest effects on lunch contents. This cluster randomised controlled trial tested an intervention to encourage healthier provision of packed lunches by parents of primary school children in Derby. Schools were randomised to intervention (n = 8) or control (n = 9) using blocked random allocation. In the intervention group, parents of children who brought packed lunches to school in years 3-6 (age 7-11 years) received three bundles of materials (including packed lunch planner, shopping list, information on sugar content of popular lunchbox items and suggestions for healthier swap alternatives) in bookbags/lunchboxes over a 4-week period. Control parents received no materials. Photos of lunchbox contents were taken at baseline, immediately post-intervention and at three-month follow-up. A parental survey aimed to assess capability, opportunity and motivation for packing a healthier lunchbox. No intervention effects were observed for primary outcomes (presence and number of sugary snacks or chilled sugary desserts). The intervention had a significant impact on one secondary outcome (increased number of healthier "swap" items suggested in intervention materials) immediately post-intervention, but this effect had disappeared at three-month follow-up. No intervention effects were found on survey variables. Parent comments revealed that materials were either received positively (as they reinforced existing behaviours) or negatively (as they were not perceived to be helpful or appropriate). The results of this study suggest that providing educational materials and resources to parents of primary school children in Derby was not sufficient to increase provision of healthier packed lunches. Future research should investigate how behavioural science can support families to improve the nutritional content of primary school children's lunchboxes.
Collapse
Affiliation(s)
- Amanda Bunten
- Public Health England Behavioural Insights, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Lucy Porter
- Public Health England Behavioural Insights, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK.
| | | | - Rebecca Howell-Jones
- Public Health England Behavioural Insights, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | | | - Derek Ward
- Medical School, University of Lincoln, Brayford Way, Brayford Pool, Lincoln, LN6 7TS, UK; Public Health Division, Adult Care and Community Wellbeing, Lincolnshire County Council, County Offices, Newland, Lincoln, LN1 1YL, UK
| | - Vicki Staples
- University of Derby, Kedleston Road, Derby, DE22 1GB, UK
| | - Paul Staples
- University of Derby, Kedleston Road, Derby, DE22 1GB, UK
| | - Harriet Rowthorn
- Public Health England Behavioural Insights, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK; Department of Psychology, University of Warwick, Coventry, CV4 7AL, UK
| | - Ayoub Saei
- Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Paul van Schaik
- School of Social Sciences and Law, Teesside University, Campus Heart, Southfield Rd, Middlesbrough, TS1 3BX, UK
| | - Elizabeth Tydeman
- Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Penny Blair
- Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Orla Hugueniot
- Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Natalie Gold
- Public Health England Behavioural Insights, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Tim Chadborn
- Public Health England Behavioural Insights, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| |
Collapse
|
217
|
Cawley J, Frisvold D, Jones D. The impact of sugar-sweetened beverage taxes on purchases: Evidence from four city-level taxes in the United States. HEALTH ECONOMICS 2020; 29:1289-1306. [PMID: 33463850 DOI: 10.1002/hec.4141] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 04/07/2020] [Accepted: 06/30/2020] [Indexed: 06/12/2023]
Abstract
Since 2017, many US cities have implemented taxes on sugar-sweetened beverages to decrease consumption of sugary beverages and raise revenue. We analyze household receipt data to examine the impact of taxes on households' beverage purchases in the four largest US cities with such taxes: Philadelphia, PA; San Francisco, CA; Seattle, WA; and Oakland, CA. We compare changes in monthly household purchases in the treatment cities with changes in two comparison groups: (1) areas adjacent to the treatment cities or (2) a matched set of households nationally. An increase in the tax rate of 1 cent per ounce decreases household purchases of taxed beverages by 53.0 ounces per month (12.2%). This impact is consistent with a reduction in individual consumption of 5 calories per day per household member and eventual reduction in weight of 0.5 pounds. However, the decline was concentrated in Philadelphia, where the tax decreased purchases by 27.7%. There was no change in purchases of taxed beverages in the other three cities combined.
Collapse
Affiliation(s)
- John Cawley
- Department of Policy Analysis and Management and Department of Economics, Cornell University and NBER, Ithaca, NY, USA
| | - David Frisvold
- Department of Economics, University of Iowa and NBER, Iowa City, IA, USA
| | - David Jones
- Health Research Division, Mathematica Policy Research, Cambridge, MA, USA
| |
Collapse
|
218
|
Lee CL, Liu WJ, Wang JS. Association of diurnal calorie trajectory with all-cause mortality: Findings from the National Health and Nutrition Examination Survey. Clin Nutr 2020; 40:1920-1925. [PMID: 32988651 DOI: 10.1016/j.clnu.2020.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/27/2020] [Accepted: 09/07/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND & AIMS The effect of diurnal variation in energy intake on mortality has not been reported. We investigated the effect of diurnal calorie trajectory on all-cause mortality using data from the National Health and Nutrition Examination Survey (NHANES). METHODS Participants in the NHANES from 1999 to 2010 were analyzed. We calculated daily energy intake and the two-hourly calorie intake according to dietary interview questionnaires, in which timing of meals, as well as energy and nutritional components of each food were recorded. The daily energy intake and the two-hourly calorie intake were divided by body weight to determine tertiles of daily energy intake and diurnal calorie trajectories, respectively. Three diurnal calorie trajectories (reference group, excess dinner, and high-calorie) were identified. The mortality data were linked to the National Death Index through the end of 2011. Cox proportional hazards models were used to compare the overall mortality among different groups. RESULTS Among the 14,356 participants included in our analyses, 886 (6.2%) of them died after a median follow-up of 4.4 years. Daily energy intake tertiles were not associated with all-cause mortality in the fully adjusted model. In contrast, high-calorie trajectory was associated with a higher risk of mortality (hazard ratio 3.128, 95% CI 1.175 to 8.330, p = 0.024) compared with the reference group after adjustment for relevant factors. CONCLUSIONS A diurnal high-calorie trajectory was associated with a higher risk of mortality, compared with the reference group. The effect of a large evening meal on mortality merits further investigation.
Collapse
Affiliation(s)
- Chia-Lin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Wei-Ju Liu
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
| | - Jun-Sing Wang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Rong Hsing Research Center for Translational Medicine, Institute of Biomedical Science, National Chung Hsing University, Taichung, Taiwan; Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan.
| |
Collapse
|
219
|
Neuser MP, Kühnel A, Svaldi J, Kroemer NB. Beyond the average: The role of variable reward sensitivity in eating disorders. Physiol Behav 2020; 223:112971. [DOI: 10.1016/j.physbeh.2020.112971] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 04/30/2020] [Accepted: 05/13/2020] [Indexed: 01/13/2023]
|
220
|
Heinitz S, Hollstein T, Ando T, Walter M, Basolo A, Krakoff J, Votruba SB, Piaggi P. Early adaptive thermogenesis is a determinant of weight loss after six weeks of caloric restriction in overweight subjects. Metabolism 2020; 110:154303. [PMID: 32599082 PMCID: PMC7484122 DOI: 10.1016/j.metabol.2020.154303] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/22/2020] [Accepted: 06/25/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Adaptive thermogenesis during prolonged energy deficit refers to the greater than expected reduction in energy expenditure (EE) independent of concomitant loss of metabolically active body mass. OBJECTIVE As inter-individual variability in the magnitude of adaptive thermogenesis may influence the extent of energy deficit thereby predicting the amount of weight reduction, we investigated whether early adaptive thermogenesis is a determinant of weight loss after 6 weeks of daily 50% caloric restriction in an inpatient setting. DESIGN AND METHODS The current study reports the results of an exploratory, secondary analysis in overweight but otherwise healthy subjects (n = 11, 7 men, 35 ± 9y, BMI = 40 ± 7 kg/m2, body fat = 63.3 ± 5.3%). Body composition and 24-h EE (24hEE) measurement in a whole-room indirect calorimeter were used to calculate the magnitude of adaptive thermogenesis while on caloric restriction after 1, 3 and 6 weeks. Energy deficit during caloric restriction was quantified via food, stool, and urine bomb calorimetry. Fasting hormonal concentrations (FT4, FT3, FGF21, leptin) were obtained at baseline and at weeks 3 and 6 during caloric restriction. RESULTS The magnitude of adaptive thermogenesis in 24hEE after 1 week of caloric restriction was -178 ± 137 kcal/day (mean ± SD), was overall stable during and following caloric restriction, and demonstrated remarkable intra-individual consistency. A relatively greater decrease in 24hEE of 100 kcal/d after 1 week of caloric restriction was associated on average with reduced energy deficit by 8195 kcal over 6 weeks and predicted 2.0 kg less weight loss, of which 0.5 kg was fat mass, after 6 weeks. No correlations were found between hormonal concentrations and weight loss. CONCLUSIONS The extent of weight loss is influenced by the magnitude of adaptive thermogenesis in the early stage of caloric restriction. Although these results need replication in larger study groups with adequate statistical power, targeting adaptive thermogenesis may help to optimize long-term interventions in obesity therapy.
Collapse
Affiliation(s)
- Sascha Heinitz
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, 4212 North 16th Street, Phoenix, AZ 85016, USA; Department of Internal Medicine, Clinic for Endocrinology, Nephrology and Rheumatology, University of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany; Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Philipp-Rosenthal-Strasse, 27, 04103 Leipzig, Germany
| | - Tim Hollstein
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, 4212 North 16th Street, Phoenix, AZ 85016, USA
| | - Takafumi Ando
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, 4212 North 16th Street, Phoenix, AZ 85016, USA
| | - Mary Walter
- Clinical Research Core Laboratory, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA
| | - Alessio Basolo
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, 4212 North 16th Street, Phoenix, AZ 85016, USA
| | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, 4212 North 16th Street, Phoenix, AZ 85016, USA
| | - Susanne B Votruba
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, 4212 North 16th Street, Phoenix, AZ 85016, USA
| | - Paolo Piaggi
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, 4212 North 16th Street, Phoenix, AZ 85016, USA; Department of Information Engineering, University of Pisa, Pisa 56122, Italy.
| |
Collapse
|
221
|
Albalawi A, Hambly C, Speakman JR. Frequency of Restaurant, Delivery and Takeaway Usage Is Not Related to BMI among Adults in Scotland. Nutrients 2020; 12:E2501. [PMID: 32825066 PMCID: PMC7551913 DOI: 10.3390/nu12092501] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/12/2020] [Accepted: 08/14/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The frequency of visits to restaurants has been suggested to contribute to the pandemic of obesity. However, few studies have examined how individual use of these restaurants is related to Body Mass Index (BMI). AIM To investigate the association between the usage of different types of food outlets and BMI among adults in Scotland. METHOD The study was cross-sectional. Participants completed an online survey for seven consecutive days where all food purchased at food outlets was reported each day. We explored the relationship between BMI and usage of these food outlets. RESULTS The total number of participants that completed the survey was 681. The BMI of both males and females was not related to frequency of use of Full-Service Restaurants (FSRs), Fast-Food Restaurants (FFRs), delivery or takeaways, when assessed individually or combined (TFOs = total food outlets). CONCLUSION These cross-sectional data do not support the widespread belief that consumption of food out of the home at fast-food and full-service restaurants, combined with that derived from deliveries and takeaways, is a major driver of obesity in Scotland.
Collapse
Affiliation(s)
- Ahmad Albalawi
- School of Biological Sciences, University of Aberdeen, Tillydrone Ave, Aberdeen AB24 2TZ, UK; (A.A.); (C.H.)
| | - Catherine Hambly
- School of Biological Sciences, University of Aberdeen, Tillydrone Ave, Aberdeen AB24 2TZ, UK; (A.A.); (C.H.)
| | - John R. Speakman
- School of Biological Sciences, University of Aberdeen, Tillydrone Ave, Aberdeen AB24 2TZ, UK; (A.A.); (C.H.)
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Development Biology, Chinese Academy of Sciences, Beijing 100101, China
- Centre of Excellence in Animal Evolution and Genetics, Chinese Academy of Sciences, Kunming 650223, China
| |
Collapse
|
222
|
Kao KE, Jones AC, Ohinmaa A, Paulden M. The health and financial impacts of a sugary drink tax across different income groups in Canada. ECONOMICS AND HUMAN BIOLOGY 2020; 38:100869. [PMID: 32442926 DOI: 10.1016/j.ehb.2020.100869] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 03/16/2020] [Accepted: 03/20/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Overconsumption of sugar-sweetened beverages (SSBs) contributes to childhood and adult obesity and numerous related diseases, including heart disease, strokes, cancers, and type 2 diabetes. It also increases healthcare costs. Sugary drink taxes have been implemented in several countries to curb sugar intake. However, there is a concern that sugary drink taxes are regressive. This study assessed the health and financial impacts of a simulated sugary drink tax across different income groups in Canada. METHODS A proportional multi-state life table-based Markov model simulated the 2016 Canadian population by income quintile. The model applied a 20 % tax on sugary drinks and determined the effects on type 2 diabetes and BMI-related diseases compared to no intervention. The income-specific parameters modelled included: population demographics; cross- and own-price elasticities; mean BMI; sugary drink consumption; mortality; and disease epidemiology. RESULTS A 20 % sugary drink tax was estimated to reduce the consumption of sugary drinks by an average of around 15 %, with a greater reduction in the lowest income quintile. The estimated mean reduction in BMI ranged from 0.21 to 0.33, dependent upon sex and income quintile; these reductions were greater among the lower income quintiles for both females and males. The 20 % sugary drink tax was estimated to avert approximately 690,000 DALYs over a lifetime among the 2016 Canadian adult population; estimated DALYs averted were approximately 156,000, 140,000, 137,000, 134,000, and 125,000 for the lowest through to the highest income quintile, respectively. Lifetime health care savings were estimated to be $2.27bn, $2.16bn, $2.17bn, $2.12bn, and $1.98bn for the lowest through to the highest income quintile, respectively. The estimated annual tax burden for the 2016 Canadian population was $1.4bn. The average absolute tax burden was estimated to be $39.00 to $44.30 per person, with the middle-income quintile bearing the heaviest absolute tax burden. The lowest income quintile would pay the highest proportion of income in tax, implying that the tax is regressive. CONCLUSIONS Low-income Canadians would gain the most health benefit from a sugary drinks tax. However, the lowest income quintile would also pay the largest proportion of income in tax. A tax on sugary drinks is therefore financially regressive but forecast to reduce health disparities across Canada.
Collapse
Affiliation(s)
- Kai-Erh Kao
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405 - 87 Ave, Edmonton, Alberta, T6G 1C9, Canada
| | - Amanda C Jones
- Department of Public Health, University of Otago, PO Box 7343, Newtown, Wellington 6242, New Zealand
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405 - 87 Ave, Edmonton, Alberta, T6G 1C9, Canada
| | - Mike Paulden
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405 - 87 Ave, Edmonton, Alberta, T6G 1C9, Canada.
| |
Collapse
|
223
|
Changes in dietary patterns when females engage in a weight management programme and their ability to meet Scientific Advisory Committee on Nutrition’s fibre and sugar recommendations. Public Health Nutr 2020; 23:2189-2198. [DOI: 10.1017/s1368980019004762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:To investigate how dietary patterns (DP) change following engagement in a weight management programme. Using the DP identified, to study their relationship with weight loss achieved and ability to meet the Scientific Advisory Committee on Nutrition’s 2015 fibre and sugar recommendations.Design:Secondary analysis of FFQ data, which collected dietary information at two time points: retrospectively before (T0) and presently during (T1) Slimming World’s programme, was analysed. Principal component analysis derived the DP present.Setting:Online FFQ, hosted by Slimming World (SW) in the UK.Participants:Female SW members (n 325; 17–68 years old).Results:At T0, two DP, ‘plant based’ and ‘processed meat and sugar added by the consumer’ were identified. At T1, three DP were identified, ‘high meat’, ‘high fat salt and sugar (HFSS) products’ and ‘nuts and oils’. Participants with a diet low in ‘HFSS products’ lost significantly more weight (P for trend = 0·001), were more likely to consume breakfast (P = 0·021) and consumed less free sugar compared with high ‘HFSS product’ consumers. Those initially presenting with a low ‘plant based’ diet score lost more weight at T1 (P for trend = 0·046). With engagement, mean fibre intake increased from 24·3 to 32·4 g/d (P < 0·001) and free sugar intake decreased from 12·6 to 8·7 % total dietary energy (P < 0·001).Conclusions:An individual’s DP before and with engagement in a weight management programme may indicate their weight loss success. Advising reduced HFSS product intake may aid initial weight loss. SW appears to promote dietary changes towards UK fibre and sugar recommendations.
Collapse
|
224
|
Developing evidence-based behavioural strategies to overcome physiological resistance to weight loss in the general population. Proc Nutr Soc 2020; 78:576-589. [PMID: 31670628 DOI: 10.1017/s0029665119001083] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Physiological and behavioural systems are tolerant of excess energy intake and responsive to energy deficits. Weight loss (WL) changes body structure, physiological function and energy balance (EB) behaviours, which resist further WL and promote subsequent weight regain. Measuring and understanding the response of EB systems to energy deficits is important for developing evidence-based behaviour change interventions for longer-term weight management. Currently, behaviour change approaches for longer-term WL show modest effect sizes. Self-regulation of EB behaviours (e.g. goal setting, action plans, self-monitoring, relapse prevention plans) and aspects of motivation are important for WL maintenance. Stress management, emotion regulation and food hedonics may also be important for relapse prevention, but the evidence is less concrete. Although much is known about the effects of WL on physiological and psychological function, little is known about the way these dynamic changes affect human EB behaviours. Key areas of future importance include (i) improved methods for detailed tracking of energy expenditure, balance and by subtraction intake, using digital technologies, (ii) how WL impacts body structure, function and subsequent EB behaviours, (iii) how behaviour change approaches can overcome physiological resistance to WL and (iv) who is likely to maintain WL or relapse. Modelling physiological and psychological moderators and mediators of EB-related behaviours is central to understanding and improving longer-term weight and health outcomes in the general population.
Collapse
|
225
|
Maurer S, Harms M, Boucher J. The colorful versatility of adipocytes: white-to-brown transdifferentiation and its therapeutic potential in humans. FEBS J 2020; 288:3628-3646. [PMID: 32621398 DOI: 10.1111/febs.15470] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/17/2020] [Accepted: 06/29/2020] [Indexed: 12/22/2022]
Abstract
Brown and brite adipocytes contribute to energy expenditure through nonshivering thermogenesis. Though these cell types are thought to arise primarily from the de novo differentiation of precursor cells, their abundance is also controlled through the transdifferentiation of mature white adipocytes. Here, we review recent advances in our understanding of the regulation of white-to-brown transdifferentiation, as well as the conversion of brown and brite adipocytes to dormant, white-like fat cells. Converting mature white adipocytes into brite cells or reactivating dormant brown and brite adipocytes has emerged as a strategy to ameliorate human metabolic disorders. We analyze the evidence of learning from mice and how they translate to humans to ultimately scrutinize the relevance of this concept. Moreover, we estimate that converting a small percentage of existing white fat mass in obese subjects into active brite adipocytes could be sufficient to achieve meaningful benefits in metabolism. In conclusion, novel browning agents have to be identified before adipocyte transdifferentiation can be realized as a safe and efficacious therapy.
Collapse
Affiliation(s)
- Stefanie Maurer
- Bioscience Metabolism, Research and Early Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Matthew Harms
- Bioscience Metabolism, Research and Early Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Jeremie Boucher
- Bioscience Metabolism, Research and Early Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.,Lundberg Laboratory for Diabetes Research, University of Gothenburg, Gothenburg, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
226
|
Fagerberg P, Klingelhoefer L, Bottai M, Langlet B, Kyritsis K, Rotter E, Reichmann H, Falkenburger B, Delopoulos A, Ioakimidis I. Lower Energy Intake among Advanced vs. Early Parkinson's Disease Patients and Healthy Controls in a Clinical Lunch Setting: A Cross-Sectional Study. Nutrients 2020; 12:E2109. [PMID: 32708668 PMCID: PMC7400863 DOI: 10.3390/nu12072109] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 02/07/2023] Open
Abstract
Unintentional weight loss has been observed among Parkinson's disease (PD) patients. Changes in energy intake (EI) and eating behavior, potentially caused by fine motor dysfunction and eating-related symptoms, might contribute to this. The primary aim of this study was to investigate differences in objectively measured EI between groups of healthy controls (HC), early (ESPD) and advanced stage PD patients (ASPD) during a standardized lunch in a clinical setting. The secondary aim was to identify clinical features and eating behavior abnormalities that explain EI differences. All participants (n = 23 HC, n = 20 ESPD, and n = 21 ASPD) went through clinical evaluations and were eating a standardized meal (200 g sausages, 400 g potato salad, 200 g apple purée and 500 mL water) in front of two video cameras. Participants ate freely, and the food was weighed pre- and post-meal to calculate EI (kcal). Multiple linear regression was used to explain group differences in EI. ASPD had a significantly lower EI vs. HC (-162 kcal, p < 0.05) and vs. ESPD (-203 kcal, p < 0.01) when controlling for sex. The number of spoonfuls, eating problems, dysphagia and upper extremity tremor could explain most (86%) of the lower EI vs. HC, while the first three could explain ~50% vs. ESPD. Food component intake analysis revealed significantly lower potato salad and sausage intakes among ASPD vs. both HC and ESPD, while water intake was lower vs. HC. EI is an important clinical target for PD patients with an increased risk of weight loss. Our results suggest that interventions targeting upper extremity tremor, spoonfuls, dysphagia and eating problems might be clinically useful in the prevention of unintentional weight loss in PD. Since EI was lower in ASPD, EI might be a useful marker of disease progression in PD.
Collapse
Affiliation(s)
- Petter Fagerberg
- Department of Biosciences and Nutrition, Karolinska Institutet, 171 77 Stockholm, Sweden; (B.L.); (I.I.)
| | - Lisa Klingelhoefer
- Department of Neurology, Technical University Dresden, 01099 Dresden, Germany; (L.K.); (E.R.); (H.R.); (B.F.)
| | - Matteo Bottai
- Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden;
| | - Billy Langlet
- Department of Biosciences and Nutrition, Karolinska Institutet, 171 77 Stockholm, Sweden; (B.L.); (I.I.)
| | - Konstantinos Kyritsis
- Electrical and Computer Engineering Department, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (K.K.); (A.D.)
| | - Eva Rotter
- Department of Neurology, Technical University Dresden, 01099 Dresden, Germany; (L.K.); (E.R.); (H.R.); (B.F.)
| | - Heinz Reichmann
- Department of Neurology, Technical University Dresden, 01099 Dresden, Germany; (L.K.); (E.R.); (H.R.); (B.F.)
| | - Björn Falkenburger
- Department of Neurology, Technical University Dresden, 01099 Dresden, Germany; (L.K.); (E.R.); (H.R.); (B.F.)
| | - Anastasios Delopoulos
- Electrical and Computer Engineering Department, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (K.K.); (A.D.)
| | - Ioannis Ioakimidis
- Department of Biosciences and Nutrition, Karolinska Institutet, 171 77 Stockholm, Sweden; (B.L.); (I.I.)
| |
Collapse
|
227
|
The effect of food taxes and subsidies on population health and health costs: a modelling study. LANCET PUBLIC HEALTH 2020; 5:e404-e413. [DOI: 10.1016/s2468-2667(20)30116-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/03/2020] [Accepted: 05/06/2020] [Indexed: 11/17/2022]
|
228
|
Seconda L, Egnell M, Julia C, Touvier M, Hercberg S, Pointereau P, Lairon D, Allès B, Kesse-Guyot E. Association between sustainable dietary patterns and body weight, overweight, and obesity risk in the NutriNet-Santé prospective cohort. Am J Clin Nutr 2020; 112:138-149. [PMID: 31725157 DOI: 10.1093/ajcn/nqz259] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 09/20/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Improving the sustainability of current food systems may prevent future public health, environmental, and social concerns. OBJECTIVE Our objective was to investigate the associations between sustainable dietary patterns, assessed using the Sustainable Diet Index (SDI), and the risk of obesity, overweight, and weight gain in French adults, with a prospective design. METHODS In 2014, the SDI was computed among 15,626 participants of the NutriNet-Santé study (of whom 76% were women) using data collected within the BioNutriNet project. The SDI ranges from 4 (lowest sustainability) to 20 points and includes 4 subindexes representing the 4 pillars of a sustainable diet. Longitudinal data of weight and height were collected yearly from 2014 to 2018. We used mixed models to estimate the associations between sex-specific quintiles (Qs) of the SDI and weight change and Cox proportional hazard models with different levels of adjustments to assess the association between sex-specific Qs of the SDI and risk of obesity and overweight (mean follow-up time: 2.8 y). RESULTS At baseline, a higher percentage of participants with overweight was observed in the first SDI Q, reflecting the lowest sustainable dietary patterns (Q1), than in Q5 (29.83% compared with 12.71%). Compared with Q5, a slight increase (at the population level) of almost 160 g/y was observed in Q1, whereas weight remained relatively stable among participants in other Qs. In total, 281 incident cases of obesity and 777 cases of overweight were identified during the follow-up. Participants in Q1 had a higher risk of obesity and overweight than participants in Q5 (HR comparing Q1 with Q5: 4.03; 95% CI: 2.42, 6.10; P-trend < 0.001; and HR comparing Q1 with Q5: 1.49; 95% CI: 1.13, 1.95; P-trend < 0.001, respectively). CONCLUSIONS The findings support a potential protective role for more sustainable diets to prevent the risk of weight gain, overweight, and obesity.This trial was registered at clinicaltrials.gov as NCT03335644.
Collapse
Affiliation(s)
- Louise Seconda
- Paris 13 University, Research Team in Nutritional Epidemiology, Epidemiology and Statistics Center Sorbonne Paris Cité, National Institute for Health and Medical Research (U1153), National Institute for Agricultural Research (U1125), National Conservatory of Arts and Crafts, COMUE Sorbonne Paris Cité, Bobigny, France.,Environment and Energy Management Agency, Angers, France
| | - Manon Egnell
- Paris 13 University, Research Team in Nutritional Epidemiology, Epidemiology and Statistics Center Sorbonne Paris Cité, National Institute for Health and Medical Research (U1153), National Institute for Agricultural Research (U1125), National Conservatory of Arts and Crafts, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Chantal Julia
- Paris 13 University, Research Team in Nutritional Epidemiology, Epidemiology and Statistics Center Sorbonne Paris Cité, National Institute for Health and Medical Research (U1153), National Institute for Agricultural Research (U1125), National Conservatory of Arts and Crafts, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Mathilde Touvier
- Paris 13 University, Research Team in Nutritional Epidemiology, Epidemiology and Statistics Center Sorbonne Paris Cité, National Institute for Health and Medical Research (U1153), National Institute for Agricultural Research (U1125), National Conservatory of Arts and Crafts, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Serge Hercberg
- Paris 13 University, Research Team in Nutritional Epidemiology, Epidemiology and Statistics Center Sorbonne Paris Cité, National Institute for Health and Medical Research (U1153), National Institute for Agricultural Research (U1125), National Conservatory of Arts and Crafts, COMUE Sorbonne Paris Cité, Bobigny, France.,Public Health Department, Avicenne Hospital, Bobigny, France
| | | | - Denis Lairon
- Aix Marseille University, National Institute for Health and Medical Research, National Institute for Agricultural Research, C2VN, Marseille, France.,Timone Faculty of Medicine, Marseille, France
| | - Benjamin Allès
- Paris 13 University, Research Team in Nutritional Epidemiology, Epidemiology and Statistics Center Sorbonne Paris Cité, National Institute for Health and Medical Research (U1153), National Institute for Agricultural Research (U1125), National Conservatory of Arts and Crafts, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Paris 13 University, Research Team in Nutritional Epidemiology, Epidemiology and Statistics Center Sorbonne Paris Cité, National Institute for Health and Medical Research (U1153), National Institute for Agricultural Research (U1125), National Conservatory of Arts and Crafts, COMUE Sorbonne Paris Cité, Bobigny, France
| |
Collapse
|
229
|
Salgado MV, Penko J, Fernandez A, Konfino J, Coxson PG, Bibbins-Domingo K, Mejia R. Projected impact of a reduction in sugar-sweetened beverage consumption on diabetes and cardiovascular disease in Argentina: A modeling study. PLoS Med 2020; 17:e1003224. [PMID: 32722677 PMCID: PMC7386620 DOI: 10.1371/journal.pmed.1003224] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 06/22/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Sugar-sweetened beverage (SSB) consumption is associated with obesity, diabetes, and hypertension. Argentina is one of the major consumers of SSBs per capita worldwide. Determining the impact of SSB reduction on health will inform policy debates. METHODS AND FINDINGS We used the Cardiovascular Disease Policy Model-Argentina (CVD Policy Model-Argentina), a local adaptation of a well-established computer simulation model that projects cardiovascular and mortality events for the population 35-94 years old, to estimate the impact of reducing SSB consumption on diabetes incidence, cardiovascular events, and mortality in Argentina during the period 2015-2024, using local demographic and consumption data. Given uncertainty regarding the exact amount of SSBs consumed by different age groups, we modeled 2 estimates of baseline consumption (low and high) under 2 different scenarios: a 10% and a 20% decrease in SSB consumption. We also included a range of caloric compensation in the model (0%, 39%, and 100%). We used Monte Carlo simulations to generate 95% uncertainty intervals (UIs) around our primary outcome measures for each intervention scenario. Over the 2015-2024 period, a 10% reduction in SSBs with a caloric compensation of 39% is projected to reduce incident diabetes cases by 13,300 (95% UI 10,800-15,600 [low SSB consumption estimate]) to 27,700 cases (95% UI 22,400-32,400 [high SSB consumption estimate]), i.e., 1.7% and 3.6% fewer cases, respectively, compared to a scenario of no change in SSB consumption. It would also reduce myocardial infarctions by 2,500 (95% UI 2,200-2,800) to 5,100 (95% UI 4,500-5,700) events and all-cause deaths by 2,700 (95% UI 2,200-3,200) to 5,600 (95% UI 4,600-6,600) for "low" and "high" estimates of SSB intake, respectively. A 20% reduction in SSB consumption with 39% caloric compensation is projected to result in 26,200 (95% UI 21,200-30,600) to 53,800 (95% UI 43,900-62,700) fewer cases of diabetes, 4,800 (95% UI 4,200-5,300) to 10,000 (95% UI 8,800-11,200) fewer myocardial infarctions, and 5,200 (95% UI 4,300-6,200) to 11,000 (95% UI 9,100-13,100) fewer deaths. The largest reductions in diabetes and cardiovascular events were observed in the youngest age group modeled (35-44 years) for both men and women; additionally, more events could be avoided in men compared to women in all age groups. The main limitations of our study are the limited availability of SSB consumption data in Argentina and the fact that we were only able to model the possible benefits of the interventions for the population older than 34 years. CONCLUSIONS Our study finds that, even under conservative assumptions, a relatively small reduction in SSB consumption could lead to a substantial decrease in diabetes incidence, cardiovascular events, and mortality in Argentina.
Collapse
Affiliation(s)
- M. Victoria Salgado
- Centro de Estudios de Estado y Sociedad (CEDES), Ciudad de Buenos Aires, Argentina
- * E-mail:
| | - Joanne Penko
- Center for Vulnerable Populations, University of California San Francisco, San Francisco, California, United States of America
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America
| | - Alicia Fernandez
- Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Jonatan Konfino
- Centro de Estudios de Estado y Sociedad (CEDES), Ciudad de Buenos Aires, Argentina
| | - Pamela G. Coxson
- Center for Vulnerable Populations, University of California San Francisco, San Francisco, California, United States of America
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America
| | - Kirsten Bibbins-Domingo
- Center for Vulnerable Populations, University of California San Francisco, San Francisco, California, United States of America
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America
- Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Raul Mejia
- Centro de Estudios de Estado y Sociedad (CEDES), Ciudad de Buenos Aires, Argentina
| |
Collapse
|
230
|
Basto-Abreu A, Torres-Alvarez R, Reyes-Sánchez F, González-Morales R, Canto-Osorio F, Colchero MA, Barquera S, Rivera JA, Barrientos-Gutierrez T. Predicting obesity reduction after implementing warning labels in Mexico: A modeling study. PLoS Med 2020; 17:e1003221. [PMID: 32722682 PMCID: PMC7386611 DOI: 10.1371/journal.pmed.1003221] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/24/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND In October 2019, Mexico approved a law to establish that nonalcoholic beverages and packaged foods that exceed a threshold for added calories, sugars, fats, trans fat, or sodium should have an "excess of" warning label. We aimed to estimate the expected reduction in the obesity prevalence and obesity costs in Mexico by introducing warning labels, over 5 years, among adults under 60 years of age. METHODS AND FINDINGS Baseline intakes of beverages and snacks were obtained from the 2016 Mexican National Health and Nutrition Survey. The expected impact of labels on caloric intake was obtained from an experimental study, with a 10.5% caloric reduction for beverages and 3.0% caloric reduction for snacks. The caloric reduction was introduced into a dynamic model to estimate weight change. The model output was then used to estimate the expected changes in the prevalence of obesity and overweight. To predict obesity costs, we used the Health Ministry report of the impact of overweight and obesity in Mexico 1999-2023. We estimated a mean caloric reduction of 36.8 kcal/day/person (23.2 kcal/day from beverages and 13.6 kcal/day from snacks). Five years after implementation, this caloric reduction could reduce 1.68 kg and 4.98 percentage points (pp) in obesity (14.7%, with respect to baseline), which translates into a reduction of 1.3 million cases of obesity and a reduction of US$1.8 billion in direct and indirect costs. Our estimate is based on experimental evidence derived from warning labels as proposed in Canada, which include a single label and less restrictive limits to sugar, sodium, and saturated fats. Our estimates depend on various assumptions, such as the transportability of effect estimates from the experimental study to the Mexican population and that other factors that could influence weight and food and beverage consumption remain unchanged. Our results will need to be corroborated by future observational studies through the analysis of changes in sales, consumption, and body weight. CONCLUSIONS In this study, we estimated that warning labels may effectively reduce obesity and obesity-related costs. Mexico is following Chile, Peru, and Uruguay in implementing warning labels to processed foods, but other countries could benefit from this intervention.
Collapse
Affiliation(s)
- Ana Basto-Abreu
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Rossana Torres-Alvarez
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Francisco Reyes-Sánchez
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Romina González-Morales
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Francisco Canto-Osorio
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - M. Arantxa Colchero
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | | |
Collapse
|
231
|
Ananthapavan J, Sacks G, Brown V, Moodie M, Nguyen P, Veerman L, Mantilla Herrera AM, Lal A, Peeters A, Carter R. Priority-setting for obesity prevention-The Assessing Cost-Effectiveness of obesity prevention policies in Australia (ACE-Obesity Policy) study. PLoS One 2020; 15:e0234804. [PMID: 32559212 PMCID: PMC7304600 DOI: 10.1371/journal.pone.0234804] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 06/02/2020] [Indexed: 12/27/2022] Open
Abstract
The aim of the ACE-Obesity Policy study was to assess the economic credentials of a suite of obesity prevention policies across multiple sectors and areas of governance for the Australian setting. The study aimed to place the cost-effectiveness results within a broad decision-making context by providing an assessment of the key considerations for policy implementation. The Assessing Cost-Effectiveness (ACE) approach to priority-setting was used. Systematic literature reviews were undertaken to assess the evidence of intervention effectiveness on body mass index and/or physical activity for selected interventions. A standardised evaluation framework was used to assess the cost-effectiveness of each intervention compared to a 'no intervention' comparator, from a limited societal perspective. A multi-state life table Markov cohort model was used to estimate the long-term health impacts (quantified as health adjusted life years (HALYs)) and health care cost-savings resulting from each intervention. In addition to the technical cost-effectiveness results, qualitative assessments of implementation considerations were undertaken. All 16 interventions evaluated were found to be cost-effective (using a willingness-to-pay threshold of AUD50,000 per HALY gained). Eleven interventions were dominant (health promoting and cost-saving). The incremental cost-effectiveness ratio for the non-dominant interventions ranged from AUD1,728 to 28,703 per HALY gained. Regulatory interventions tended to rank higher on their cost-effectiveness results, driven by lower implementation costs. However, the program-based policy interventions were generally based on higher quality evidence of intervention effectiveness. This comparative analysis of the economic credentials of obesity prevention policies for Australia indicates that there are a broad range of policies that are likely to be cost-effective, although policy options vary in strength of evidence for effectiveness, affordability, feasibility, acceptability to stakeholders, equity impact and sustainability. Implementation of these policies will require sustained co-ordination across jurisdictions and multiple government sectors in order to generate the predicted health benefits for the Australian population.
Collapse
Affiliation(s)
- Jaithri Ananthapavan
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Gary Sacks
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Vicki Brown
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Marj Moodie
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Phuong Nguyen
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Lennert Veerman
- School of Medicine, Griffith University, Gold Coast, Australia
| | - Ana Maria Mantilla Herrera
- Queensland Centre for Mental Health Research, Brisbane, Australia
- School of Public Health, The University of Queensland, Brisbane, Australia
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
| | - Anita Lal
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Anna Peeters
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Rob Carter
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
| |
Collapse
|
232
|
Mizdrak A, Cobiac LJ, Cleghorn CL, Woodward A, Blakely T. Fuelling walking and cycling: human powered locomotion is associated with non-negligible greenhouse gas emissions. Sci Rep 2020; 10:9196. [PMID: 32513974 PMCID: PMC7280492 DOI: 10.1038/s41598-020-66170-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 05/15/2020] [Indexed: 12/31/2022] Open
Abstract
Reducing motorized transport and increasing active transport (i.e. transport by walking, cycling and other active modes) may reduce greenhouse gas (GHG) emissions and improve health. But, active modes of transport are not zero emitters. We aimed to quantify GHG emissions from food production required to fuel extra physical activity for walking and cycling. We estimate the emissions (in kgCO2e) per kilometre travelled for walking and cycling from energy intake required to compensate for increased energy expenditure, and data on food-related GHG emissions. We assume that persons who shift from passive modes of transport (e.g. driving) have increased energy expenditure that may be compensated with increased food consumption. The GHG emissions associated with food intake required to fuel a kilometre of walking range between 0.05 kgCO2e/km in the least economically developed countries to 0.26 kgCO2e/km in the most economically developed countries. Emissions for cycling are approximately half those of walking. Emissions from food required for walking and cycling are not negligible in economically developed countries which have high dietary-related emissions. There is high uncertainty about the actual emissions associated with walking and cycling, and high variability based on country economic development. Our study highlights the need to consider emissions from other sectors when estimating net-emissions impacts from transport interventions.
Collapse
Affiliation(s)
- Anja Mizdrak
- Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme (BODE 3), Department of Public Health, University of Otago (Wellington), 23 Mein Street, Newtown, Wellington, New Zealand.
| | - Linda J Cobiac
- Centre for Population Approaches to Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, United Kingdom
| | - Christine L Cleghorn
- Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme (BODE 3), Department of Public Health, University of Otago (Wellington), 23 Mein Street, Newtown, Wellington, New Zealand
| | - Alistair Woodward
- Epidemiology and Biostatistics, Department of Population Health, University of Auckland, Auckland, New Zealand
| | - Tony Blakely
- Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme (BODE 3), Department of Public Health, University of Otago (Wellington), 23 Mein Street, Newtown, Wellington, New Zealand.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| |
Collapse
|
233
|
Liu J, Mozaffarian D, Sy S, Lee Y, Wilde PE, Abrahams-Gessel S, Gaziano T, Micha R. Health and Economic Impacts of the National Menu Calorie Labeling Law in the United States: A Microsimulation Study. Circ Cardiovasc Qual Outcomes 2020; 13:e006313. [PMID: 32493057 DOI: 10.1161/circoutcomes.119.006313] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Excess caloric intake is linked to weight gain, obesity, and related diseases, including type 2 diabetes mellitus and cardiovascular disease (CVD). Obesity incidence is rising, with nearly 3 in 4 US adults being overweight or obese. In 2018, the US federal government finalized the implementation of mandatory labeling of calorie content on all menu items across major chain restaurants nationally as a strategy to support informed consumer choice, reduce caloric intake, and potentially encourage restaurant reformulations. Yet, the potential health and economic impacts of this policy remain unclear. METHODS AND RESULTS We used a validated microsimulation model (CVD-PREDICT) to estimate reductions in CVD events, diabetes mellitus cases, gains in quality-adjusted life years, costs, and cost-effectiveness of the menu calorie labeling intervention, based on consumer responses alone, and further accounting for potential industry reformulation. The model incorporated nationally representative demographic and dietary data from National Health and Nutrition Examination Surveys 2009 to 2016; policy effects on consumer diets and body mass index-disease effects from published meta-analyses; and policy effects on industry reformulation, policy costs (policy administration, industry compliance, and reformulation), and health-related costs (formal and informal healthcare costs, productivity costs) from established sources or reasonable assumptions. We modeled change in calories to change in weight using an established dynamic weight-change model, assuming 50% of expected calorie reductions would translate to long-term reductions. Findings were evaluated over 5 years and a lifetime from healthcare and societal perspectives, with uncertainty incorporated in both 1-way and probabilistic sensitivity analyses. Between 2018 and 2023, implementation of the restaurant menu calorie labeling law was estimated, based on consumer response alone, to prevent 14 698 new CVD cases (including 1575 CVD deaths) and 21 522 new type 2 diabetes mellitus cases, gaining 8749 quality-adjusted life years. Over a lifetime, corresponding values were 135 781 new CVD cases (including 27 646 CVD deaths), 99 736 type 2 diabetes mellitus cases, and 367 450 quality-adjusted life years. Assuming modest restaurant item reformulation, both health and economic benefits were estimated to be about 2-fold larger than based on consumer response alone. The consumer response alone was estimated to be cost-saving by 2023, with net lifetime savings of $10.42B from a healthcare perspective and $12.71B from a societal perspective. Findings were robust in a range of sensitivity analyses. CONCLUSIONS Our national model suggests that the full implementation of the US calorie menu labeling law will generate significant health gains and healthcare and societal cost-savings. Industry responses to modestly reformulate menu items would provide even larger additional benefits.
Collapse
Affiliation(s)
- Junxiu Liu
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (J.L., D.M., Y.L., P.E.W., R.M.)
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (J.L., D.M., Y.L., P.E.W., R.M.)
| | - Stephen Sy
- Brigham and Women's Hospital, Boston, MA (S.S., T.G.)
| | - Yujin Lee
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (J.L., D.M., Y.L., P.E.W., R.M.)
| | - Parke E Wilde
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (J.L., D.M., Y.L., P.E.W., R.M.)
| | | | - Tom Gaziano
- Brigham and Women's Hospital, Boston, MA (S.S., T.G.).,Harvard T.H. Chan School of Public Health, Boston, MA (S.A.-G., T.G.)
| | - Renata Micha
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (J.L., D.M., Y.L., P.E.W., R.M.)
| | | |
Collapse
|
234
|
Papathanasiou T, Strathe A, Agersø H, Lund TM, Overgaard RV. Impact of dose-escalation schemes and drug discontinuation on weight loss outcomes with liraglutide 3.0 mg: A model-based approach. Diabetes Obes Metab 2020; 22:969-977. [PMID: 32009288 PMCID: PMC7317899 DOI: 10.1111/dom.13985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/20/2020] [Accepted: 01/27/2020] [Indexed: 02/06/2023]
Abstract
AIMS To investigate the impact on weight loss of the treatment changes in overweight or obese people that may be needed in case of gastrointestinal (GI) tolerability issues during escalation of the glucagon-like peptide-1 analogue liraglutide. MATERIALS AND METHODS The individual longitudinal body weight data from the main trial periods of three phase II/III trials in overweight or obese patients (56-week treatment with once-daily liraglutide 1.2, 1.8, 2.4 or 3.0 mg or placebo, n = 4952) were analysed using a non-linear mixed-effect modelling approach. Individual pharmacokinetic profiles were derived based on published pharmacokinetic models. Baseline body weight, baseline glycated haemoglobin (HbA1c), age, gender, diabetes status (no diabetes, prediabetes or type 2 diabetes), race and trial region were investigated as covariates. As a form of external validation, the model was used to predict the weight regain after treatment cessation at week 56 (data not included in model development). RESULTS A pharmacokinetic/pharmacodynamic model provided an adequate description of the weight loss trajectories for all studied doses. Gender and diabetes status were identified as the most influential covariates, and an underlying seasonal weight fluctuation was identified. Slower than that recommended, one-week dose-escalation algorithms led up to 2 weeks slower initial weight loss but similar long-term weight loss trajectories. CONCLUSIONS The relationship between liraglutide systemic exposure and weight loss was successfully established in overweight or obese people. The model could predict the time course of weight regain after treatment cessation and suggests that GI tolerability can be mitigated by slower escalation with only minor impact on the weight loss trajectory.
Collapse
Affiliation(s)
- Theodoros Papathanasiou
- Novo Nordisk A/S, Quantitative Clinical PharmacologySøborgDenmark
- Department of Drug Design and Pharmacology, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Anders Strathe
- Novo Nordisk A/S, Quantitative Clinical PharmacologySøborgDenmark
| | - Henrik Agersø
- Novo Nordisk A/S, Quantitative Clinical PharmacologySøborgDenmark
| | - Trine Meldgaard Lund
- Department of Drug Design and Pharmacology, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | | |
Collapse
|
235
|
Sacks G, Kwon J, Ananthapavan J. The Application of an Evidence Framework for Obesity Prevention at the Population-Level. Curr Obes Rep 2020; 9:150-158. [PMID: 32266649 DOI: 10.1007/s13679-020-00376-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW To review existing frameworks for assessing the evidence of effectiveness of obesity prevention interventions, and discuss the application of a custom-developed evidence framework to inform an obesity prevention priority-setting study in Australia. RECENT FINDINGS There are a wide range of frameworks for grading evidence. However, most frameworks are not well suited to assess the effectiveness of obesity prevention interventions because they do not include processes to synthesise evidence from multiple study designs and outcome measures. The key features of the Obesity Prevention Evidence Assessment (OPEA) Framework are: [1] separately assessed weight-, diet- and physical activity-related outcomes; [2] consideration of the balance of evidence from multiple study types; and [3] a summary indication of the degree of certainty of intervention effectiveness. Evidence frameworks that recognise the complexities of obesity prevention research can support decision-makers in prioritising actions to address obesity alongside broader priority-setting considerations.
Collapse
Affiliation(s)
- Gary Sacks
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
| | - Janelle Kwon
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Jaithri Ananthapavan
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| |
Collapse
|
236
|
The Effects of Carbohydrate-Restricted Dietary Patterns and Physical Activity on Body Weight and Glycemic Control. Curr Atheroscler Rep 2020; 22:20. [PMID: 32468247 DOI: 10.1007/s11883-020-00838-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW Carbohydrate (CHO)-restricted dietary patterns (very-low-CHO < 25-50 g CHO/day; low CHO 50-130 g CHO/day) and physical activity are used for weight loss and type 2 diabetes (T2D) prevention and management. This review discusses evidence for effects of these lifestyle therapies on body weight and glycemic control. RECENT FINDINGS Evidence supports the view that CHO-restricted interventions may be more effective than high-CHO, low-fat (HCLF) interventions in the short term for weight loss and glycemic control, but both produced similar levels of weight loss and glycemic control by 12 months. CHO-restricted dietary patterns resulted in a decreased use of diabetes medications. Benefits of CHO restriction were achieved at intakes that did not induce ketosis. Physical activity increases insulin sensitivity and reduces pancreatic beta-cell load, enhancing the effect of weight loss to delay or prevent T2D. A CHO-restricted dietary pattern may be a reasonable option for weight loss and T2D management for some individuals. Physical activity enhances weight management and cardiometabolic health.
Collapse
|
237
|
Brand-Miller J. Challenging the dogma. Int J Obes (Lond) 2020; 44:1631-1632. [PMID: 32444770 PMCID: PMC7243212 DOI: 10.1038/s41366-020-0601-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 04/30/2020] [Accepted: 05/12/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Jennie Brand-Miller
- Charles Perkins Centre and School of Life and Environmental Sciences, University of Sydney, Camperdown, NSW, Australia.
| |
Collapse
|
238
|
Al Abdi T, Andreou E, Papageorgiou A, Heraclides A, Philippou E. Personality, Chrono-nutrition and Cardiometabolic Health: A Narrative Review of the Evidence. Adv Nutr 2020; 11:1201-1210. [PMID: 32407537 PMCID: PMC7490156 DOI: 10.1093/advances/nmaa051] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/23/2019] [Accepted: 04/16/2020] [Indexed: 12/21/2022] Open
Abstract
Growing evidence suggests that personality traits play a role in obesity and cardiometabolic health. In addition, irregularity of food intake has emerged as a potential risk factor for obesity, cardiovascular disease, and metabolic syndrome. Recent studies suggest that when we eat, termed "chrono-nutrition," may be as important to what we eat. This concept covers 3 aspects: 1) irregularity of energy intake in meals (varying amounts of energy intake throughout the day and at different times from one day to the next), 2) frequency (number of meals per day), and 3) timing of food intake (actual time of day). A narrative review was conducted to identify literature evaluating the effect of personality on chrono-nutrition and subsequently obesity and cardiometabolic health. The search focused on research published since 2000 in MEDLINE using the search terms "personality," "chrono-nutrition," "cardiometabolic," "BMI," "obesity," and "metabolic rate." Findings indicate an inverse relation between conscientiousness and obesity, with people who are more conscientious having a lower risk of obesity. Furthermore, time of day of energy intake has been linked to obesity, since meals consumed in the evening have been associated with lower resting metabolic rate. Inconsistent timing and frequency of meals have also been linked to increased body weight and worse cardiometabolic health. Together, the data indicate that eating meals at the same time every day at regular intervals might be the reason why those who score high in conscientiousness are able to maintain a healthier weight. Despite the reviewed observational evidence, there is an apparent gap in the existing literature on the interplay between personality, chrono-nutrition, and obesity and particularly on how dietary interventions should be designed considering different personality traits. Future research is needed to clarify this association and how it interacts with other factors, thus elucidating the role of chrono-nutrition in health.
Collapse
Affiliation(s)
- Tamara Al Abdi
- Human Nutrition Department, Qatar University, Doha, Qatar
| | - Eleni Andreou
- Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus
| | - Alexia Papageorgiou
- Department of Primary Care and Population Health, University of Nicosia, Nicosia, Cyprus
| | - Alexandros Heraclides
- Department of Primary Care and Population Health, University of Nicosia, Nicosia, Cyprus
| | - Elena Philippou
- Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus
- Department of Nutritional Sciences, King's College London, London, United Kingdom
- Address correspondence to EP (E-mail: )
| |
Collapse
|
239
|
Watanabe D, Yoshida T, Watanabe Y, Yamada Y, Kimura M. A U-Shaped Relationship Between the Prevalence of Frailty and Body Mass Index in Community-Dwelling Japanese Older Adults: The Kyoto-Kameoka Study. J Clin Med 2020; 9:jcm9051367. [PMID: 32384756 PMCID: PMC7290950 DOI: 10.3390/jcm9051367] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/16/2020] [Accepted: 04/29/2020] [Indexed: 12/12/2022] Open
Abstract
The relationship between body mass index (BMI) and frailty remains unclear. Using two validated frailty assessment tools, this study aimed to investigate the relationship between the prevalence of frailty and BMI in Japanese older adults. This cross-sectional study used baseline data of 7191 individuals aged ≥65 years, living in Kameoka City, Kyoto, Japan. The BMI was calculated based on self-reported height and body weight, and classified into six categories. Frailty was defined using two validated assessment tools, the Fried phenotype (FP) model and Kihon Checklist (KCL). We evaluated the relationship between frailty and BMI using a multivariate restricted cubic spline logistic regression. The prevalence of frailty defined using the FP model was 25.3%, 19.6%, 14.3%, 12.4%, 12.6%, and 19.4% for each BMI category of <18.5, 18.5–19.9, 20.0–22.4, 22.5–24.9, 25.0–27.4, and ≥27.5 kg/m2, respectively. The spline model showed a significant U-shaped relationship between BMI and the prevalence of frailty defined using both, KCL and FP models. This study found that the BMI range corresponding to lowest prevalence of frailty defined using both tools was 21.4–25.7 kg/m2. Thus, a healthy BMI may reduce the prevalence of frailty, and the risk of frailty needs to be evaluated in individuals who are underweight or overweight.
Collapse
Affiliation(s)
- Daiki Watanabe
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan; (T.Y.); (Y.W.); (Y.Y.)
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto 621-8555, Japan;
- Correspondence:
| | - Tsukasa Yoshida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan; (T.Y.); (Y.W.); (Y.Y.)
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto 621-8555, Japan;
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Senior Citizen’s Welfare Section, Kameoka City Government, Kyoto 621-8501, Japan
| | - Yuya Watanabe
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan; (T.Y.); (Y.W.); (Y.Y.)
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Faculty of Health and Sports Science, Doshisha University, Kyoto 610-0394, Japan
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan; (T.Y.); (Y.W.); (Y.Y.)
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto 621-8555, Japan;
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Misaka Kimura
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto 621-8555, Japan;
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| |
Collapse
|
240
|
How Could Peers in Online Health Community Help Improve Health Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17092995. [PMID: 32357406 PMCID: PMC7246899 DOI: 10.3390/ijerph17092995] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 12/21/2022]
Abstract
Human behavior is the largest source of variance in health-related outcomes, and the increasingly popular online health communities (OHC) can be used to promote healthy behavior and outcomes. We explored how the social influence (social integration, descriptive norms and social support) exerted by online social relationships does affect the health behavior of users. Based on an OHC, we considered the effect of three types of social relationships (friendship, mutual support group and competing group) in the OHC. We found that social integration, descriptive norms and social support (information and emotional support) from the OHC had a positive effect on dietary and exercise behavior. Comparing the effects of different social relationships, we found that the stronger social relationship—friendship—had a stronger effect on health behavior than the mutual support group and competing group. Emotional support had a stronger effect on health behavior than informational support. We also found that the effects of social integration and informational support became stronger as membership duration increased, but the effects of the descriptive norms and emotional support became smaller. This study extended the research on health behavior to the online social environment and explored how the social influence exerted by various social relationships in an OHC affected health behavior. The results could be used for guiding users to make use of online social relationships for changing and maintaining healthy behavior, and helping healthcare websites improve their services.
Collapse
|
241
|
Venema TAG, Kroese FM, Verplanken B, de Ridder DTD. The (bitter) sweet taste of nudge effectiveness: The role of habits in a portion size nudge, a proof of concept study. Appetite 2020; 151:104699. [PMID: 32277952 DOI: 10.1016/j.appet.2020.104699] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 03/02/2020] [Accepted: 04/04/2020] [Indexed: 10/24/2022]
Abstract
Seemingly insignificant daily practices, such as sugar usage in tea, can have a great accumulated impact on societal issues, such as obesity. That is why these behaviours are often the target of nudge interventions. However, when these behaviours are performed frequently they may turn into habits that are difficult to change. The aim of the current study was to investigate whether a portion size nudge has the potential to work in accordance with (instead of against) existing habits. Specifically, it was tested whether a portion size nudge would be more effective in reducing the amount of sugar added to tea, when people have a strong habit of adding a fixed amount of teaspoons of sugar to a cup of tea. The study (N = 123) had a mixed factorial design with teaspoon size (reduced size vs. control) as a within-subject factor, and habit disruption context condition (hot tea vs. cold tea) as a between-subjects factor. A paired t-test indicated that this nudge reduced sugar intake on average by 27% within subjects. When the context allowed for automatic enactment of the habit, the effectiveness of this nudge was moderated by habit strength. Surprisingly, the nudge effect was actually less pronounced when people had a strong habit. Implications for effective nudge interventions are discussed.
Collapse
Affiliation(s)
- Tina A G Venema
- Utrecht University, Social Health and Organizational Psychology, 3508 TC, Utrecht, the Netherlands; Aarhus University, Department of Psychology and Behavioural Sciences, Denmark.
| | - Floor M Kroese
- Utrecht University, Social Health and Organizational Psychology, 3508 TC, Utrecht, the Netherlands
| | - Bas Verplanken
- Bath University, Department of Psychology, Bath, BA2 7AY, UK
| | - Denise T D de Ridder
- Utrecht University, Social Health and Organizational Psychology, 3508 TC, Utrecht, the Netherlands
| |
Collapse
|
242
|
Wireless optogenetics protects against obesity via stimulation of non-canonical fat thermogenesis. Nat Commun 2020; 11:1730. [PMID: 32265443 PMCID: PMC7138828 DOI: 10.1038/s41467-020-15589-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 03/18/2020] [Indexed: 12/17/2022] Open
Abstract
Cold stimuli and the subsequent activation of β-adrenergic receptor (β-AR) potently stimulate adipose tissue thermogenesis and increase whole-body energy expenditure. However, systemic activation of the β3-AR pathway inevitably increases blood pressure, a significant risk factor for cardiovascular disease, and, thus, limits its application for the treatment of obesity. To activate fat thermogenesis under tight spatiotemporal control without external stimuli, here, we report an implantable wireless optogenetic device that bypasses the β-AR pathway and triggers Ca2+ cycling selectively in adipocytes. The wireless optogenetics stimulation in the subcutaneous adipose tissue potently activates Ca2+ cycling fat thermogenesis and increases whole-body energy expenditure without cold stimuli. Significantly, the light-induced fat thermogenesis was sufficient to protect mice from diet-induced body-weight gain. The present study provides the first proof-of-concept that fat-specific cold mimetics via activating non-canonical thermogenesis protect against obesity. Cardiovascular risks of cold exposure and the subsequent activation of the β3-AR pathway limit the application of beige fat thermogenesis for the treatment of obesity. Here, the authors show that optogenetics light-activated Ca2+ cycling in adipocytes triggers a fat-specific “cold-mimetic” thermogenesis response protecting mice against diet-induced obesity.
Collapse
|
243
|
Wieland ML, Njeru JW, Okamoto JM, Novotny PJ, Breen-Lyles MK, Goodson M, Porraz Capetillo GD, Molina LE, Sia IG. Association of social network factors with weight status and weight loss intentions among hispanic adults. J Behav Med 2020; 43:155-165. [PMID: 31894451 PMCID: PMC7071972 DOI: 10.1007/s10865-019-00131-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 12/17/2019] [Indexed: 01/02/2023]
Abstract
Hispanic adults have the highest obesity prevalence in the United States, but little is known about weight-related social network influences. A community-based sample of 610 Hispanic participants completed height/weight and a survey. The proportion of overweight or obese (OW/OB) network members was higher for OW/OB respondents compared to normal weight respondents. Participants with high weight loss intentions reported more positive social norms for weight control, social support, and social cohesion. If most or all of OW/OB participant's social contacts were trying to lose weight, the odds that they were likely to try to lose weight was four times higher than other participants. The relationship between weight loss intentions and number of social contacts trying to lose weight was strongly mediated by social norms for weight control and social support. These results suggest that social contacts and functional network characteristics may impact weight status and weight control intentions among Hispanic adults.
Collapse
Affiliation(s)
- Mark L Wieland
- Department of Medicine, Mayo Clinic, Rochester, MN, USA.
- Division of Community Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Jane W Njeru
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
- Division of Community Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Janet M Okamoto
- Department of Health Sciences Research, Mayo Clinic, Scottsdale, AZ, USA
| | - Paul J Novotny
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | | | - Miriam Goodson
- Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
| | - Graciela D Porraz Capetillo
- Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
- Department of Language Services, Mayo Clinic, Rochester, MN, USA
| | - Luz E Molina
- Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
- Department of Language Services, Mayo Clinic, Rochester, MN, USA
| | - Irene G Sia
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
244
|
Saner C, Tassoni D, Harcourt BE, Kao KT, Alexander EJ, McCallum Z, Olds T, Rowlands AV, Burgner DP, Simpson SJ, Raubenheimer D, Senior AM, Juonala M, Sabin MA. Evidence for Protein Leverage in Children and Adolescents with Obesity. Obesity (Silver Spring) 2020; 28:822-829. [PMID: 32144892 DOI: 10.1002/oby.22755] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 01/06/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim of this study was to test the protein leverage hypothesis in a cohort of youth with obesity. METHODS A retrospective study was conducted in a cohort of youth with obesity attending a tertiary weight management service. Validated food questionnaires revealed total energy intake (TEI) and percentage of energy intake from carbohydrates (%EC), fats (%EF), and proteins (%EP). Individuals with a Goldberg cutoff ≥ 1.2 of the ratio of reported TEI to basal metabolic rate from fat-free mass were included. A subgroup had accelerometer data. Statistics included modeling of percentage of energy from macronutrients and TEI, compositional data analysis to predict TEI from macronutrient ratios, and mixture models for sensitivity testing. RESULTS A total of 137 of 203 participants were included (mean [SD] age 11.3 [2.7] years, 68 females, BMI z score 2.47 [0.27]). Mean TEI was 10,330 (2,728) kJ, mean %EC was 50.6% (6.1%), mean %EF was 31.6% (4.9%), and mean %EP was 18.4% (3.1%). The relationship between %EP and TEI followed a power function (L coefficient -0.48; P < 0.001). TEI was inversely associated with increasing %EP. In the subgroup with < 60 min/d of moderate to vigorous physical activity (n = 48), lower BMI z scores were associated with higher %EP and moderate %EC. CONCLUSIONS In youth with obesity, protein dilution by either carbohydrates or fats increases TEI. Assessment of dietary protein may be useful to assist in reducing TEI and BMI in youth with obesity.
Collapse
Affiliation(s)
- Christoph Saner
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Endocrinology, The Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Medicine, University of Turku, Turku, Finland
| | - Daniella Tassoni
- Department of Endocrinology, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Brooke E Harcourt
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Endocrinology, The Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Kung-Ting Kao
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Endocrinology, The Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Erin J Alexander
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Endocrinology, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Zoe McCallum
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Endocrinology, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Timothy Olds
- Alliance for Research in Exercise Nutrition and Activity (ARENA), Sansom Institute, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Alex V Rowlands
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - David P Burgner
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Stephen J Simpson
- Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
- School of Life and Environmental Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - David Raubenheimer
- Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
- School of Life and Environmental Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Alistair M Senior
- Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
- School of Life and Environmental Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Markus Juonala
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Medicine, University of Turku, Turku, Finland
| | - Matthew A Sabin
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Endocrinology, The Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
245
|
Summan A, Stacey N, Birckmayer J, Blecher E, Chaloupka FJ, Laxminarayan R. The potential global gains in health and revenue from increased taxation of tobacco, alcohol and sugar-sweetened beverages: a modelling analysis. BMJ Glob Health 2020; 5:e002143. [PMID: 32337082 PMCID: PMC7170424 DOI: 10.1136/bmjgh-2019-002143] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 02/11/2020] [Accepted: 02/15/2020] [Indexed: 12/25/2022] Open
Abstract
Introduction Globally, a growing burden of morbidity and mortality is attributable to lifestyle behaviours, and in particular to the consumption of tobacco, alcohol and sugar-sweetened beverages (SSB). In low-income and middle-income countries, this increased disease burden falls on already encumbered and resource-constrained healthcare systems. Fiscal policies, specifically taxation, can lower consumption of tobacco, alcohol and SSB while raising government revenues. Methods We simulated the health and economic effects of taxing cigarettes, alcohol and SSB over 50 years for 30-79 years old populations using separate mathematical models for each commodity that incorporated country-level epidemiological, demographic and consumption data. Based on data availability, national-level health effects of higher tobacco, alcohol and SSB taxes were simulated in 141, 166 and 176 countries, respectively, which represented 92%, 97% and 95% of the global population, respectively. Economic effects for tobacco, alcohol and SSB were estimated for countries representing 91%, 43% and 83% of the global population, respectively. These estimates were extrapolated to the global level by matching countries according to income level. Results Over 50 years, taxes that raise the retail price of tobacco, alcoholic beverages and SSB by 20% could result in a global gain of 160.7 million (95% uncertainty interval (UI): 96.3 to 225.2 million), 227.4 million (UI: 161.2 to 293.6 million) and 24.3 million (UI: 15.7 to 35.4 million) additional life years, respectively. Conclusion Excise tax increases on tobacco, alcohol and SSB can produce substantial health gains by reducing premature mortality while raising government revenues, which could be used to increase public health funding.
Collapse
Affiliation(s)
- Amit Summan
- Center for Disease Dynamics, Economics & Policy, Washington, District of Columbia, USA
| | - Nicholas Stacey
- Priority Cost Effective Lessons for Systems Strengthening, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Evan Blecher
- Health Policy Center, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Frank J Chaloupka
- Health Policy Center, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Ramanan Laxminarayan
- Center for Disease Dynamics, Economics & Policy, Washington, District of Columbia, USA
- Princeton Environmental Institute, Princeton University, Princeton, NJ, USA
| |
Collapse
|
246
|
Blakely T, Nghiem N, Genc M, Mizdrak A, Cobiac L, Mhurchu CN, Swinburn B, Scarborough P, Cleghorn C. Modelling the health impact of food taxes and subsidies with price elasticities: The case for additional scaling of food consumption using the total food expenditure elasticity. PLoS One 2020; 15:e0230506. [PMID: 32214329 PMCID: PMC7098589 DOI: 10.1371/journal.pone.0230506] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 03/03/2020] [Indexed: 11/24/2022] Open
Abstract
Background Food taxes and subsidies are one intervention to address poor diets. Price elasticity (PE) matrices are commonly used to model the change in food purchasing. Usually a PE matrix is generated in one setting then applied to another setting with differing starting consumptions and prices of foods. This violates econometric assumptions resulting in likely mis-estimation of total food consumption. In this paper we demonstrate this problem, canvass possible options for rescaling all consumption after applying a PE matrix, and illustrate the use of a total food expenditure elasticity (TFEe; the expenditure elasticity for all food combined given the policy-induced change in the total price of food). We use case studies of: NZ$2 per 100g saturated fat (SAFA) tax, NZ$0.4 per 100g sugar tax, and a 20% fruit and vegetable (F&V) subsidy. Methods We estimated changes in food purchasing using a NZ PE matrix applied conventionally, and then with TFEe adjustment. Impacts were quantified for pre- to post-policy changes in total food expenditure and health adjusted life years (HALYs) for the total NZ population alive in 2011 over the rest of their lifetime using a multistate lifetable model. Results Two NZ studies gave TFEe’s of 0.68 and 0.83, with international estimates ranging from 0.46 to 0.90 (except a UK outlier of 0.04). Without TFEe adjustment, total food expenditure decreased with the tax policies and increased with the F&V subsidy–implausible directions of shift given economic theory and the external TFEe estimates. After TFEe adjustment, HALY gains reduced by a third to a half for the two taxes and reversed from an apparent health loss to a health gain for the F&V subsidy. With TFEe adjustment, HALY gains (in 1000’s) were: 1,805 (95% uncertainty interval 1,337 to 2,340) for the SAFA tax; 1,671 (1,220 to 2,269) for the sugar tax; and 953 (453 to 1,308) for the F&V subsidy. Conclusions If PE matrices are applied in settings beyond where they were derived, additional scaling is likely required. We suggest that the TFEe is a useful scalar, but we also encourage other researchers to examine this issue and propose alternative options.
Collapse
Affiliation(s)
- Tony Blakely
- Population Interventions Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
- * E-mail:
| | - Nhung Nghiem
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Murat Genc
- Department of Economics, University of Otago, Dunedin, New Zealand
| | - Anja Mizdrak
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Linda Cobiac
- Nuffield Department of Population Health, Oxford University, Oxford, United Kingdom
| | - Cliona Ni Mhurchu
- National Institute of Health Innovation, University of Auckland, Auckland, New Zealand
| | - Boyd Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Peter Scarborough
- Nuffield Department of Population Health, Oxford University, Oxford, United Kingdom
| | - Christine Cleghorn
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| |
Collapse
|
247
|
Basolo A, Hohenadel M, Ang QY, Piaggi P, Heinitz S, Walter M, Walter P, Parrington S, Trinidad DD, von Schwartzenberg RJ, Turnbaugh PJ, Krakoff J. Effects of underfeeding and oral vancomycin on gut microbiome and nutrient absorption in humans. Nat Med 2020; 26:589-598. [PMID: 32235930 DOI: 10.1038/s41591-020-0801-z] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 02/13/2020] [Indexed: 02/07/2023]
Abstract
Direct evidence in humans for the impact of the microbiome on nutrient absorption is lacking. We conducted an extended inpatient study using two interventions that we hypothesized would alter the gut microbiome and nutrient absorption. In each, stool calorie loss, a direct proxy of nutrient absorption, was measured. The first phase was a randomized cross-over dietary intervention in which all participants underwent in random order 3 d of over- and underfeeding. The second was a randomized, double-blind, placebo-controlled pharmacologic intervention using oral vancomycin or matching placebo (NCT02037295). Twenty-seven volunteers (17 men and 10 women, age 35.1 ± 7.3, BMI 32.3 ± 8.0), who were healthy other than having impaired glucose tolerance and obesity, were enrolled and 25 completed the entire trial. The primary endpoints were the effects of dietary and pharmacological intervention on stool calorie loss. We hypothesized that stool calories expressed as percentage of caloric intake would increase with underfeeding compared with overfeeding and increase during oral vancomycin treatment. Both primary endpoints were met. Greater stool calorie loss was observed during underfeeding relative to overfeeding and during vancomycin treatment compared with placebo. Key secondary endpoints were to evaluate the changes in gut microbial community structure as evidenced by amplicon sequencing and metagenomics. We observed only a modest perturbation of gut microbial community structure with under- versus overfeeding but a more widespread change in community structure with reduced diversity with oral vancomycin. Increase in Akkermansia muciniphila was common to both interventions that resulted in greater stool calorie loss. These results indicate that nutrient absorption is sensitive to environmental perturbations and support the translational relevance of preclinical models demonstrating a possible causal role for the gut microbiome in dietary energy harvest.
Collapse
Affiliation(s)
- Alessio Basolo
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Phoenix, AZ, USA.
| | - Maximilian Hohenadel
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Phoenix, AZ, USA
| | - Qi Yan Ang
- Department of Microbiology and Immunology, University of California, San Francisco, CA, USA
| | - Paolo Piaggi
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Phoenix, AZ, USA
| | - Sascha Heinitz
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Phoenix, AZ, USA.,Department of Medicine, Division of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany.,Helmholtz Institute for Metabolic Obesity and Vascular Research (HI-MAG), Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany
| | - Mary Walter
- Clinical Core Laboratory, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Peter Walter
- Clinical Mass Spectrometry Core, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD, USA
| | - Shannon Parrington
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Phoenix, AZ, USA
| | - Donovan D Trinidad
- Department of Microbiology and Immunology, University of California, San Francisco, CA, USA
| | | | - Peter J Turnbaugh
- Department of Microbiology and Immunology, University of California, San Francisco, CA, USA. .,Chan Zuckerberg Biohub, San Francisco, CA, USA.
| | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Phoenix, AZ, USA.
| |
Collapse
|
248
|
Willems R, Pil L, Lambrinou CP, Kivelä J, Wikström K, Gonzalez-Gil EM, De Miguel-Etayo P, Nánási A, Semánová C, Van Stappen V, Cardon G, Tsochev K, Iotova V, Chakarova N, Makrilakis K, Dafoulas G, Timpel P, Schwarz P, Manios Y, Annemans L. Methodology of the health economic evaluation of the Feel4Diabetes-study. BMC Endocr Disord 2020; 20:14. [PMID: 32164685 PMCID: PMC7066818 DOI: 10.1186/s12902-019-0471-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 12/09/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The clinical and economic burden of type 2 diabetes mellitus on society is rising. Effective and efficient preventive measures may stop the increasing prevalence, given that type 2 diabetes mellitus is mainly a lifestyle-driven disease. The Feel4Diabetes-study aimed to tackle unhealthy lifestyle (unhealthy diet, lack of physical activity, sedentary behaviour, and excess weight) of families with a child in the first grades of elementary school. These schools were located in regions with a relatively low socio-economic status in Belgium, Bulgaria, Finland, Greece, Hungary and Spain. Special attention was paid to families with a high risk of developing type 2 diabetes mellitus. METHODS The aim of this paper is to describe the detailed methodology of the intervention's cost-effectiveness analysis. Based on the health economic evaluation of the Toybox-study, both a decision analytic part and a Markov model have been designed to assess the long-term (time horizon of 70 year with one-year cycles) intervention's value for money. Data sources used for the calculation of health state incidences, transition probabilities between health states, health state costs, and health state utilities are listed. Intervention-related costs were collected by questionnaires and diaries, and attributed to either all families or high risk families only. CONCLUSIONS The optimal use of limited resources is pivotal. The future results of the health economic evaluation of the Feel4Diabetes-study will contribute to the efficient use of those resources.
Collapse
Affiliation(s)
- Ruben Willems
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, Entrance 42 – Floor 4, 9000 Ghent, Belgium
| | - Lore Pil
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, Entrance 42 – Floor 4, 9000 Ghent, Belgium
| | - Christina-Paulina Lambrinou
- Department of Nutrition and Dietetics, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
| | - Jemina Kivelä
- Department of Public Health Solutions, National Institute for Health and Welfare, Mannerheimintie 166, 00271 Helsinki, Finland
| | - Katja Wikström
- Department of Public Health Solutions, National Institute for Health and Welfare, Mannerheimintie 166, 00271 Helsinki, Finland
| | - Esther M. Gonzalez-Gil
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain
- Institute of Nutrition and Food Technology, Center of Biomedical Research, University of Granada, Granada, Spain
| | - Pilar De Miguel-Etayo
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragon (IA2), Zaragoza, Spain
- Instituto de Investigacion Sanitaria Aragón (IIS Aragon), University of Zaragoza, Zaragoza, Spain
- Centro de Investigacion Biomedica en Red de Fisiopatologia de la Obesidad y Nutricion (CIBERObn), University of Zaragoza, Zaragoza, Spain
| | - Anna Nánási
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, 400 Hungary
| | - Csilla Semánová
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, 400 Hungary
| | - Vicky Van Stappen
- Department of Movement and Sports Sciences, Ghent University, Campus Dunant, Watersportlaan 2, 9000 Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Campus Dunant, Watersportlaan 2, 9000 Ghent, Belgium
| | - Kaloyan Tsochev
- Department of Paediatrics, Medical University Varna, 1 Hr. Smirnenski Blvd, 9010 Varna, Bulgaria
| | - Violeta Iotova
- Department of Paediatrics, Medical University Varna, 1 Hr. Smirnenski Blvd, 9010 Varna, Bulgaria
| | - Nevena Chakarova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, Sofia, Bulgaria
| | | | - George Dafoulas
- National and Kapodistrian University of Athens, 17 Ag. Thoma St, 11527 Athens, Greece
| | - Patrick Timpel
- Department for Precention and Care of Diabetes, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Peter Schwarz
- Department for Precention and Care of Diabetes, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
- Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technische Universitat Dresden, Dresden, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, 70 El Venizelou Ave, 176 71 Kallithea, Athens, Greece
| | - Lieven Annemans
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, Entrance 42 – Floor 4, 9000 Ghent, Belgium
| | | |
Collapse
|
249
|
Hu J, Wang Z, Tan BK, Christian M. Dietary polyphenols turn fat “brown”: A narrative review of the possible mechanisms. Trends Food Sci Technol 2020. [DOI: 10.1016/j.tifs.2020.01.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
250
|
Griffith R, O'Connell M, Smith K, Stroud R. What's on the Menu? Policies to Reduce Young People's Sugar Consumption. FISCAL STUDIES 2020; 41:165-197. [PMID: 32612314 PMCID: PMC7319480 DOI: 10.1111/1475-5890.12194] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Young people in the UK consume far above the maximum recommended levels of added sugar. It is likely that neither they nor their parents fully take account of the future health, social and economic costs of this high sugar consumption. This provides a rationale for policy intervention. The majority of young people's added sugar consumption occurs in the home, where purchases are typically made by parents. This means that understanding the purchase decisions of adults is important for policy design, even if the policies aim to reduce the consumption of young people. We discuss the merits of popular policies, including taxes, advertising restrictions and restrictions on the availability of specific foods, and we identify promising avenues for future research.
Collapse
Affiliation(s)
| | | | - Kate Smith
- Institute for Fiscal StudiesUniversity College London
| | | |
Collapse
|