A powerful test for Balaam's design

Design, analysis, and interpretation of treatment response heterogeneity in personalized nutrition and obesity treatment research

It is increasingly assumed that there is no one-size-fits-all approach to dietary recommendations for the management and treatment of chronic diseases such as obesity. This phenomenon that not all individuals respond uniformly to a given treatment has become an area of research interest given the rise of personalized and precision medicine. To conduct, interpret, and disseminate this research rigorously and with scientific accuracy, however, requires an understanding of treatment response heterogeneity. Here, we define treatment response heterogeneity as it relates to clinical trials, provide statistical guidance for measuring treatment response heterogeneity, and highlight study designs that can quantify treatment response heterogeneity in nutrition and obesity research. Our goal is to educate nutrition and obesity researchers in how to correctly identify and consider treatment response heterogeneity when analyzing data and interpreting results, leading to rigorous and accurate advancements in the field of personalized medicine.

Evaluation of active dried yeast in the diets of feedlot steers-I: Effects on feeding performance traits, the composition of growth, and carcass characteristics1

The use of active dried yeast (ADY) in the diets of feedlot steers may improve feed efficiency, growth performance, and reduce days on feed. Strategic timing of ADY inclusion in the diet may increase feed conversion or aid in the dietary transition from growing to finishing diets. One hundred twenty steers, blocked by weight, were fed four diets for 164 d: grower (70 d), first transition diet (7 d), second transition diet for (7 d), and finisher (80 d) in a GrowSafe System. Four treatment sequences of ADY inclusion were evaluated in a Balaam's design where steers were fed a control diet before and after the grower phase (CC), control before and ADY after the grower phase (CY), ADY before and control after the grower phase (YC), and ADY before and after the grower phase (YY). A random coefficients model was used to evaluate the following variables of interest: feeding performance and growth traits, including biometric measurements and carcass ultrasound measurements, and carcass characteristics. Treatment was a fixed effect and block was a random effect. Treatment did not affect feeding performance or behavior (P ≥ 0.14). The rate of change of biometric measurements were not different (P ≥ 0.16) across treatment groups except for rib girth circumference, which was greater for the YY and CY groups intermediate for the CC group and least for the YC group (0.828 and 0.809 vs. 0.751 vs. 0.666 cm/d, respectively; P < 0.01). Faster growth rates of rib girth circumference resulted in larger final measurements for steers that were finished on ADY (P < 0.01). Ultrasound measurements (backfat, LM area, intra-muscular fat, and rump fat) were not different across treatments (P ≥ 0.15). However, there was a tendency for the YC group to have a slower rate of back fat deposition than other treatment groups (P = 0.09). Steers' final shrunk BWs did not differ (P = 0.61), but shrink percentage was greater for CC than for YY groups (3.7% vs. 2.7%, respectively; P = 0.05). Carcass characteristics were not different across treatments (P ≥ 0.20). Crude fat, CP, ash and moisture analyses of the 9th to 11th rib section were not different across treatments, and there was no difference in adjusted final shrunk BW (P ≥ 0.45). Feeding the ADY strain used in this study to growing and finishing feedlot steers increased rib girth circumference development rate and reduced shrink loss without affecting feeding behavior, feeding performance, or carcass characteristics.

Evaluation of active dried yeast in the diets of feedlot steers. II. Effects on rumen pH and liver health of feedlot steers1

The objective of this trial was to determine the benefits of supplementing active dried yeast (ADY; 3 × 1010 CFU/d of Saccharomyces cerevisiae) in diets of growing and finishing steers on ruminal pH and liver health, and evaluate the relationship of these variables with performance traits. Growing beef steers (n = 120) were blocked by weight (i.e., heavy and light) and allocated to 1 of 4 pens in an automated feed intake monitoring system. Steers were fed either control (CON; no ADY) or ADY supplemented in 4 sequential diets: grower diet from days 0 to 70, 2 step up diets (STEP1 and STEP2) for 7 d each, and finishing diet from days 85 to 164. Indwelling rumen boli were administered to monitor rumen pH during days 56 to 106 during the dietary transition. An exchange of pen assignment, within block, occurred on day 70 resulting in 4 final treatment (TRT) assignments: steers fed CON before and after the exchange (CC; n = 30), steers fed CON before and ADY after the exchange (CY; n = 30), steers fed ADY before and CON after the exchange (YC; n = 30), and steers fed ADY (YY; n = 30). Ruminal parameters were analyzed as a randomized complete block design with repeated measures of day, diet and TRT as fixed effects, and block as random effects, using 2 approaches: preliminary analysis of the means or drift analysis (DA; units change from basal values over time). Ruminal pH duration (DUR) below 6.0 (P = 0.05) and 5.8 (P = 0.05) was greater for CY steers than CC steers. Acidosis bout prevalence (pH < 5.6 for 180 consecutive minutes; P < 0.01) and bout DUR (P = 0.05) were greater for CY than other TRT groups. The DA indicated that the ruminal pH variables range, variance, and amplitude of steers in the YC group drifted further from basal pH values than CY and YY steers during the dietary transition (P ≤ 0.02), indicating that removing ADY during the dietary transition was not favorable, but including ADY may reduce ruminal fluctuation. Steers with fewer days experiencing bouts (DEB) had numerically greater ADG (P = 0.11) and tended to have greater G:F (P = 0.06). Liver abscess severity negatively affected ADG (P = 0.04). However, liver abscess severity was not affected by DEB (P = 0.90). There is evidence to suggest that the addition of the specific ADY strain in the diets of beef cattle during the dietary transition may aid in ruminal stabilization, but our study did not find evidence that acidosis bouts were related to abscess prevalence or severity.