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Gupta A, Rana K, Gupta M, Kaur M, Khanna P. Effect of health promotion interventions on small portion size consumption behavior among college students. Indian J Public Health 2023; 67:435-441. [PMID: 37929387 DOI: 10.4103/ijph.ijph_103_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Background Large food portion size is contributing toward overweight and obesity rates and has been found directly proportional to increase in portion size. Objectives The study was done to see the effect of health promotion intervention on small portion size consumption behavior using multitheory model (MTM). Materials and Methods A quasi-experimental study was conducted among students of age groups 18 - 21 years in two different colleges from North India between 2019 to 2020. About 150 participants in the intervention group as well as control group were selected and health promotion intervention in the form of motivational group counseling, one-to-one counseling, Power Point presentations, lectures, and messages were given to participants in intervention group. Difference in difference of proportions for meal consumption behavior and the difference in the difference of means for body mass index, waist-hip ratio and for constructs of MTM for portion size consumption behavior were calculated. Paired t-test was used to test the significance between the continuous variables. Results There was a significant reduction (46% vs. 11%, P < 0.001) in proportion of participants consuming large portion-sized meals in the intervention group as compared to the control group. The mean change in constructs (participatory dialogues,behavioral confidence, change in physical environment, emotional transformation and practice for change) for portion size consumption behavior of participants in the intervention and control groups at base line and end line was found statistically significant. Conclusion MTM is a useful tool for health promotion and health education to predict the initiation and sustenance of health behavior change.
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Affiliation(s)
- Atul Gupta
- Senior Resident, Department of Community Medicine, Shri Lal Bahadur Shastri Government Medical College and Hospital, Mandi, Himachal Pradesh, India
| | - Kirtan Rana
- Assistant Professor, Department of Community Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Madhu Gupta
- Professor, Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manmeet Kaur
- Professor, Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Poonam Khanna
- Associate Professor, Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Crane NT, Butryn ML, Gorin AA, Lowe MR, LaFata EM. Overlapping and distinct relationships between hedonic hunger, uncontrolled eating, food craving, and the obesogenic home food environment during and after a 12-month behavioral weight loss program. Appetite 2023; 185:106543. [PMID: 36940743 PMCID: PMC10121957 DOI: 10.1016/j.appet.2023.106543] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/24/2023] [Accepted: 03/17/2023] [Indexed: 03/23/2023]
Abstract
Hedonic hunger, reward-driven eating outside of biological need, is a newer construct in eating behavior research. During behavioral weight loss (BWL), greater improvements in hedonic hunger are associated with higher weight loss, but it remains unclear if hedonic hunger predicts weight loss independent of more well-established, similar constructs (uncontrolled eating and food craving). Research also is needed to understand how hedonic hunger interacts with contextual factors (e.g., obesogenic food environment) during weight loss. Adults (N = 283) in a 12-month randomized controlled trial of BWL were weighed at 0, 12, and 24 months, and completed questionnaires assessing hedonic hunger, food craving, uncontrolled eating, and the home food environment. All variables improved at 12 and 24 months. Decreases in hedonic hunger at 12 months were associated with higher concurrent weight loss, but not when accounting for improvements in craving and uncontrolled eating. At 24 months, reduction in craving was a stronger predictor of weight loss than hedonic hunger, but improvement in hedonic hunger was a stronger predictor of weight loss than change in uncontrolled eating. Changes to the obesogenic home food environment failed to predict weight loss, regardless of levels of hedonic hunger. This study adds novel information on the individual and contextual factors associated with short- and long-term weight control, which can help refine conceptual models and treatment strategies.
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Affiliation(s)
- Nicole T Crane
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA, 19104, United States.
| | - Meghan L Butryn
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA, 19104, United States
| | - Amy A Gorin
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, J.Ryan Building, 2006 Hillside Road, Storrs, CT, 06269, United States
| | - Michael R Lowe
- Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA, 19104, United States
| | - Erica M LaFata
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA, 19104, United States
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3
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Gayoso L, Goni L, de la O V, Domper J, C R, Ruiz-Canela M, Etxeberria U. An intensive culinary intervention programme to empower type 2 diabetic patients in cooking skills: The SUKALMENA pilot study. Int J Gastron Food Sci 2023. [DOI: 10.1016/j.ijgfs.2023.100721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
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4
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Shrodes JC, Williams A, Nolan TS, Radabaugh JN, Braun A, Kline D, Zhao S, Brock G, Garner JA, Spees CK, Joseph JJ. Feasibility of Cooking Matters for Diabetes: A 6-week Randomized, Controlled Cooking and Diabetes Self-Management Education Intervention. J Acad Nutr Diet 2023; 123:492-503.e5. [PMID: 35944873 PMCID: PMC10909744 DOI: 10.1016/j.jand.2022.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 07/08/2022] [Accepted: 07/24/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Diabetes self-management education and support is the cornerstone of diabetes care, yet <10% of adults with diabetes manage their condition successfully. Feasible interventions are needed urgently. OBJECTIVE Our aim was to assess the feasibility of a cooking intervention with food provision and diabetes self-management education and support. DESIGN This was a waitlist-controlled, randomized trial. PARTICIPANTS/SETTING Thirteen adults with type 1 or type 2 diabetes who participated in Cooking Matters for Diabetes (CMFD) participated in 2 focus groups. INTERVENTION CMFD was adapted from Cooking Matters and the American Diabetes Association's diabetes self-management education and support intervention into a 6-week program with weekly lesson-aligned food provisions. MAIN OUTCOME MEASURES Feasibility was evaluated quantitatively and qualitatively along the following 5 dimensions: demand, acceptability, implementation, practicality, and limited efficacy. STATISTICAL ANALYSIS Two coders extracted focus group themes with 100% agreement after iterative analysis, resulting in consensus. Administrative data were analyzed via descriptive statistics. RESULTS Mean (SD) age of focus group participants was 57 (14) years; 85% identified as female; 39% identified as White; 46% identified as Black; and income ranged from <$5,000 per year (15%) to $100,000 or more per year (15%). Mean (SD) baseline hemoglobin A1c was 8.6% (1.2%). Mean attendance in CMFD was 5 of 6 classes (83%) among all participants. Demand was high based on attendance and reported intervention utilization and was highest among food insecure participants, who were more likely to report using the food provisions and recipes. Acceptability was also high; focus groups revealed the quality of instructors and interaction with peers as key intervention strengths. Participant ideas for implementation refinement included simplifying recipes, lengthening class sessions, and offering more food provision choices. Perceived effects of the intervention included lower hemoglobin A1c and body weight and improvements to health-related quality of life. CONCLUSIONS The CMFD intervention was feasible according to the measured principles of demand, acceptability, implementation, practicality, and limited efficacy.
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Affiliation(s)
- Jennifer C Shrodes
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus, Ohio
| | - Amaris Williams
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus, Ohio
| | - Timiya S Nolan
- The Ohio State University College of Nursing, Columbus, Ohio
| | - Jessica N Radabaugh
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus, Ohio
| | - Ashlea Braun
- Department of Nutritional Sciences, School of Education and Human Sciences, Oklahoma State University, Stillwater, Oklahoma
| | - David Kline
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Songzhu Zhao
- Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, Ohio
| | - Guy Brock
- Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, Ohio
| | - Jennifer A Garner
- The School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, Ohio; The John Glenn College of Public Affairs, The Ohio State University, Columbus, Ohio
| | - Colleen K Spees
- Division of Medical Dietetics, The Ohio State University College of Medicine, Columbus, Ohio
| | - Joshua J Joseph
- The Ohio State University College of Medicine, Columbus, Ohio.
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Oliveira TW, Pereira PPDS, Fonseca LA, de Oliveira LML, Pereira DS, Neira CPD, Figueiredo ACMG. Use of Information and Communication Technologies among Adults in Weight Control: Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14224809. [PMID: 36432496 PMCID: PMC9696910 DOI: 10.3390/nu14224809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/16/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022] Open
Abstract
Information and communication technologies are part of our day-to-day life in the execution of all activities, including health care. However, it is not known how much the use of technologies can contribute to the adoption of healthy lifestyle habits. Thus, the objective of this study was to analyze whether the use of information and communication technologies contributes to weight control among adults when compared to the traditional approach method. The search was performed in November 2021 in eight electronic databases in addition to gray literature bases. The quality of the studies was assessed using the Cochrane risk of bias tool. The standardized mean difference was used for the meta-analytic measurement using the random effects model using the Dersimonian-Laid method in the Stata statistical package version 17. The body mass index of the intervention group decreased by an average of 0.56 (95% CI: -0.83; -0.30) when compared to the control group. When comparing the before and after groups, the intervention group also had a greater reduction in BMI (summarized mean: -0.83; 95% CI: -1.40; -0.26). Information and communication technologies contribute to the reduction of the body mass index in the adult population when compared to the traditional model of monitoring. Prospero registration: number 42020186340.
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Affiliation(s)
- Thatiana Wanessa Oliveira
- Health Care Research Laboratory, Federal University of Rondônia, Br 364, Porto Velho 76801-059, Brazil
| | - Priscilla Perez da Silva Pereira
- Health Care Research Laboratory, Federal University of Rondônia, Br 364, Porto Velho 76801-059, Brazil
- Correspondence: ; Tel.: +55-69-992586851
| | - Leonice Antunes Fonseca
- Health Care Research Laboratory, Federal University of Rondônia, Br 364, Porto Velho 76801-059, Brazil
| | | | - Dauster Souza Pereira
- Centro Interdisciplinar de Novas Tecnologias na Educação (CINTED), Federal Institute of Rondônia, Avenida Lauro Sodré, 6500, Porto Velho 76804-124, Brazil
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Sponselee HCS, ter Beek L, Renders CM, Robroek SJW, Steenhuis IHM, Kroeze W. Stakeholders' Perceptions Regarding Adaptation and Implementation of Existing Individual and Environmental Workplace Health Promotion Interventions in Blue-Collar Work Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13545. [PMID: 36294131 PMCID: PMC9603088 DOI: 10.3390/ijerph192013545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/03/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Blue-collar workers often have disadvantageous health statuses and might therefore benefit from a combination of individual and environmental workplace health promotion interventions. Exploring stakeholders' perceived facilitators and barriers regarding the combined implementation of these interventions in blue-collar work settings is important for effective implementation. A qualitative study consisting of 20 stakeholder interviews within six types of organisations in The Netherlands was conducted. The potential implementation of the evidence-based individual intervention SMARTsize and the environmental intervention company cafeteria 2.0 was discussed. Data were analysed using thematic analysis with a deductive approach. Five main themes emerged: (1) the availability of resources, (2) professional obligation, (3) expected employee cooperation, (4) the compatibility of the proposed health interventions, and (5) the content of implementation tools and procedures. Generally, stakeholders expressed a sense of professional obligation toward workplace health promotion, mentioning that the current societal focus on health and lifestyle provided the perfect opportunity to implement interventions to promote healthy eating and physical activity. However, they often perceived the high doses of employees' occupational physical activity as a barrier. We recommend co-creating interventions, implementation tools, and processes by involving stakeholders with different professional backgrounds and by adapting communication strategies at diverse organisational levels.
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Affiliation(s)
- Hanne C. S. Sponselee
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
| | - Lies ter Beek
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
| | - Carry M. Renders
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
| | - Suzan J. W. Robroek
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3015 GD Rotterdam, The Netherlands
| | - Ingrid H. M. Steenhuis
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
| | - Willemieke Kroeze
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
- Care for Nutrition and Health Group, School of Nursing, Christian University of Applied Sciences, 6717 JS Ede, The Netherlands
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Cáceres NA, Yu Q, Capaldi J, Diniz MA, Raynor H, Foster GD, Seitz AR, Salvy SJ. Evaluating environmental and inhibitory control strategies to improve outcomes in a widely available weight loss program. Contemp Clin Trials 2022; 119:106844. [DOI: 10.1016/j.cct.2022.106844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/10/2022] [Accepted: 06/29/2022] [Indexed: 11/16/2022]
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Vinayachandran G, Patel N, Mathavaswami V, Subitha L. Food portion size educational programme in a workplace setting in Puducherry - Is it effective? J Family Med Prim Care 2021; 10:3368-3373. [PMID: 34760759 PMCID: PMC8565166 DOI: 10.4103/jfmpc.jfmpc_849_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/01/2021] [Accepted: 07/09/2021] [Indexed: 11/04/2022] Open
Abstract
Background: Consuming larger portion sizes, i.e., in excess of a typically recommended serving size, has been attributed to the obesity epidemic. The workplace acts as an efficient target for health promotion activities. Aims: To assess the effectiveness of a food portion size educational programme in increasing knowledge among the employees of a software company in Puducherry. Methodology: An interventional study was conducted with a pre-post design. A single group of software company employees (N = 120), age ≥30 years selected by simple random sampling was included in the study. The intervention consisted of a health education programme on the portion sizes of common food items including fruits and vegetables. A self-administered questionnaire was used to collect information on personal and sociodemographic details. Self-regulation on eating was assessed using the Self-Regulation of Eating Behaviour Questionnaire (SREBQ). Results: The mean age of the study participants was 27 ± 5 years. Most of the participants were males, i.e., 72 (60%). Of the total, 55 (47.8%) participants were obese and 18 (15.7%) were overweight. The median number of meals and snacks consumed by the participants was 3 (1–3) and 1 (1–2), respectively. The median (interquartile range [IQR]) knowledge scores of the food portion size significantly increased from 9 (0–16) to 14 (5–19) (P < 0.05). Conclusions: This study has demonstrated that an educational intervention in the workplace setting is feasible and effective in increasing the knowledge of food portion size over a short term.
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Affiliation(s)
- Gopika Vinayachandran
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Namita Patel
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Vijayageetha Mathavaswami
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - L Subitha
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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9
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Vargas-Alvarez MA, Navas-Carretero S, Palla L, Martínez JA, Almiron-Roig E. Impact of Portion Control Tools on Portion Size Awareness, Choice and Intake: Systematic Review and Meta-Analysis. Nutrients 2021; 13:nu13061978. [PMID: 34207492 PMCID: PMC8229078 DOI: 10.3390/nu13061978] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/12/2021] [Accepted: 05/15/2021] [Indexed: 02/04/2023] Open
Abstract
Portion control utensils and reduced size tableware amongst other tools, have the potential to guide portion size intake but their effectiveness remains controversial. This review evaluated the breadth and effectiveness of existing portion control tools on learning/awareness of appropriate portion sizes (PS), PS choice, and PS consumption. Additional outcomes were energy intake and weight loss. Published records between 2006–2020 (n = 1241) were identified from PubMed and WoS, and 36 publications comparing the impact of portion control tools on awareness (n = 7 studies), selection/choice (n = 14), intake plus related measures (n = 21) and weight status (n = 9) were analyzed. Non-tableware tools included cooking utensils, educational aids and computerized applications. Tableware included mostly reduced-size and portion control/calibrated crockery/cutlery. Overall, 55% of studies reported a significant impact of using a tool (typically smaller bowl, fork or glass; or calibrated plate). A meta-analysis of 28 articles confirmed an overall effect of tool on food intake (d = –0.22; 95%CI: –0.38, –0.06; 21 comparisons), mostly driven by combinations of reduced-size bowls and spoons decreasing serving sizes (d = –0.48; 95%CI: –0.72, –0.24; 8 comparisons) and consumed amounts/energy (d = –0.22; 95%CI: –0.39, –0.05, 9 comparisons), but not by reduced-size plates (d = –0.03; 95%CI: –0.12, 0.06, 7 comparisons). Portion control tools marginally induced weight loss (d = –0.20; 95%CI: –0.37, –0.03; 9 comparisons), especially driven by calibrated tableware. No impact was detected on PS awareness; however, few studies quantified this outcome. Specific portion control tools may be helpful as potentially effective instruments for inclusion as part of weight loss interventions. Reduced size plates per se may not be as effective as previously suggested.
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Affiliation(s)
- M. Angeles Vargas-Alvarez
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain; (M.A.V.-A.); (S.N.-C.)
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain;
| | - Santiago Navas-Carretero
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain; (M.A.V.-A.); (S.N.-C.)
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain;
- Navarra Institute for Health Research (IdiSNa), 31008 Pamplona, Spain
- CIBERobn, Obesity and Nutrition, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Luigi Palla
- Department of Public Health and Infectious Diseases, University of Rome La Sapienza, 00185 Rome, Italy;
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - J. Alfredo Martínez
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain;
- CIBERobn, Obesity and Nutrition, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Eva Almiron-Roig
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain; (M.A.V.-A.); (S.N.-C.)
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain;
- Navarra Institute for Health Research (IdiSNa), 31008 Pamplona, Spain
- Correspondence: ; Tel.: +34-948-425-600
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Rationale and development of a manualised dietetic intervention for adults undergoing psychological treatment for an eating disorder. Eat Weight Disord 2021; 26:1467-1481. [PMID: 32686057 DOI: 10.1007/s40519-020-00955-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/04/2020] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Due to the current dearth of literature regarding dietetic treatment for patients with an eating disorder (ED), no manualised dietetic interventions exist to enable the testing of dietetic treatments in this population. This paper aims to: (1) describe the rationale and development of a manualised dietetic intervention for adults undergoing concurrent psychological treatment for an ED; and (2) provide an overview of the feasibility testing of this intervention. METHODS Current best evidence to date for dietetic treatment in EDs was utilised to develop a manualised dietetic intervention for feasibility testing alongside outpatient psychological 'treatment as usual'. RESULTS The developed intervention consists of five, dietitian-delivered outpatient sessions: (1) getting started; (2) mechanical eating and dietary rules; (3) estimating portion sizes and social eating; (4) maximising your meal plan and meal preparation; and (5) review and treatment planning as well as pre- and post-intervention assessments. CONCLUSION This paper is intended as a resource for clinicians and researchers in the conduct of future studies examining dietetic treatment for patients with an ED. LEVEL OF EVIDENCE Level V, description of a new manualised, reproducible dietetic intervention.
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11
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Christensen LD, Averbuch B. Dealing with excess consumption: Moving beyond redeem, replace and reduce. INTERNATIONAL JOURNAL OF FOOD DESIGN 2020. [DOI: 10.1386/ijfd_00012_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Our current consumption patterns cause high levels of CO2 emissions. Encouraging sustainable lifestyle changes is one tool among many to reduce emissions. Looking towards the public health literature, we identify three strategies for dealing with excess consumption: redeem, replace and reduce. We highlight the benefits and challenges that individuals face when employing these strategies. Finally, we present a promising approach to moving beyond individual-level strategies and their challenges.
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12
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Almiron-Roig E, Forde CG, Hollands GJ, Vargas MÁ, Brunstrom JM. A review of evidence supporting current strategies, challenges, and opportunities to reduce portion sizes. Nutr Rev 2019; 78:91-114. [DOI: 10.1093/nutrit/nuz047] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Abstract
Although there is considerable evidence for the portion-size effect and its potential impact on health, much of this has not been successfully applied to help consumers reduce portion sizes. The objective of this review is to provide an update on the strength of evidence supporting strategies with potential to reduce portion sizes across individuals and eating contexts. Three levels of action are considered: food-level strategies (targeting commercial snack and meal portion sizes, packaging, food labels, tableware, and food sensory properties), individual-level strategies (targeting eating rate and bite size, portion norms, plate-cleaning tendencies, and cognitive processes), and population approaches (targeting the physical, social, and economic environment and health policy). Food- and individual-level strategies are associated with small to moderate effects; however, in isolation, none seem to have sufficient impact on food intake to reverse the portion-size effect and its consequences. Wider changes to the portion-size environment will be necessary to support individual- and food-level strategies leading to portion control.
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Affiliation(s)
- Eva Almiron-Roig
- E. Almiron-Roig and M. Ángeles Vargas are with the Centre for Nutrition Research, University of Navarra, Pamplona, Spain
- E. Almiron-Roig is with the Navarra Institute for Health Research (IdiSNa), Pamplona, Spain
| | - Ciaran G Forde
- C.G. Forde is with the Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Singapore
| | - Gareth J Hollands
- G.J. Hollands is with the Behaviour and Health Research Unit, University of Cambridge, Cambridge, United Kingdom
| | - M Ángeles Vargas
- E. Almiron-Roig and M. Ángeles Vargas are with the Centre for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Jeffrey M Brunstrom
- J.M. Brunstrom is with the Nutrition and Behaviour Unit, School of Psychological Science, and the National Institute for Health Research, Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, United Kingdom
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13
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Chao AM, Wadden TA, Walsh OA, Gruber KA, Alamuddin N, Berkowitz RI, Shaw Tronieri J. Perceptions of a large amount of food based on binge-eating disorder diagnosis. Int J Eat Disord 2019; 52:801-808. [PMID: 30927476 PMCID: PMC6609473 DOI: 10.1002/eat.23076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/11/2019] [Accepted: 03/11/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study examined what adults with binge-eating disorder (BED) and obesity perceived as the threshold for a large amount of food and how their evaluations compared to ratings by participants with obesity but without BED. METHOD This was a cross-sectional study of 150 participants with obesity. BED was assessed using the Questionnaire on Eating and Weight Patterns and confirmed via interview. Participants completed the Eating Patterns Questionnaire and Eating Inventory. RESULTS Participants with BED had significantly higher thresholds for a large amount of food relative to those without BED. Compared to participants without BED, those with BED had significantly higher thresholds on 13 of the 22 food items. In the overall sample, being male and having higher hunger scores were associated with greater thresholds. DISCUSSION Individuals with obesity and BED had larger portion standards than participants without BED. Individuals with BED may benefit from interventions targeted toward decreasing perceptions of portion sizes.
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Affiliation(s)
- Ariana M. Chao
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, Philadelphia, PA, USA;,Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Thomas A. Wadden
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Olivia A. Walsh
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Kathryn A. Gruber
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Naji Alamuddin
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Robert I. Berkowitz
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA;,Children’s Hospital of Philadelphia, Department of Child and Adolescent Psychiatry and Behavioral Science, Philadelphia, PA, USA
| | - Jena Shaw Tronieri
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
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14
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Barata‐Cavalcanti O, Ty D, Novelli W, Costa S, Huang TT. Informing a roadmap for cross-sectoral collaboration on portion size management as a national strategy to improve population nutrition - a Delphi study. Obes Sci Pract 2019; 5:189-202. [PMID: 31275593 PMCID: PMC6587328 DOI: 10.1002/osp4.331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Addressing food portion sizes is a key untapped opportunity to help tackle obesity. This study sought to inform the agenda of a national movement involving diverse sectors to manage portion sizes in packaged foods, restaurants, cafeterias and prepared foods in grocery stores. METHODS A Delphi study was conducted with representatives from public health, private-sector food companies and academia that formed a panel of experts (n = 32). Three iterative rounds of surveys were administered over 3 months. The surveys gathered opinions on psychological mindsets affecting portion size choice, eating habits, portion perception and distortion, passive overconsumption and challenges and advantages of this tool to improve population nutrition. The survey also inquired about visions for a future food environment. After every round, responses were analysed and questions narrowed to reach group consensus on specific items in the subsequent round. RESULTS Although many experts fear that portion size interventions might be perceived as paternalistic, 91% of respondents agreed stealth interventions were preferable. Seventy-three per cent of experts believed that the most impactful portion size intervention was product reformulation while smaller packages were the most effective intervention according to only 28% of experts. The majority of the panel (59%) also believed that creating an artificial stopping point in packages was the best strategy to reduce food consumption. Finally, the study found that one of the most complex aspects of establishing a multi-sector collaboration for obesity prevention was to ascertain trust in the private sector's ability to balance profit versus social responsibility.[Corrections added on 21 March 2019, after first online publication: The percentage of experts who believed that small packages were the most effective intervention has been changed from "16%" to "28%".]. CONCLUSION This study informs the agenda of a cross-sectoral, coordinated movement to tackle obesity through a combination of changing social norms, individual behaviours and industry practices around portion size. Although cross-sectoral collaboration for non-communicable disease prevention is encouraged by different organizations, strategic efforts to define a common agenda on portion size have been limited thus far. This research highlights important strategies in portion size interventions and steps needed for the success of such a movement, as part of a wider effort across sectors and stakeholders to halt and reverse obesity rates in the USA.
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Affiliation(s)
- O. Barata‐Cavalcanti
- Center for Systems and Community Design, Graduate School of Public Health and Health PolicyCity University of New YorkNew YorkNYUSA
| | - D. Ty
- Global Social Enterprise Initiative, McDonough School of BusinessGeorgetown UniversityWashingtonDCUSA
| | - W. Novelli
- Global Social Enterprise Initiative, McDonough School of BusinessGeorgetown UniversityWashingtonDCUSA
| | - S. Costa
- Center for Systems and Community Design, Graduate School of Public Health and Health PolicyCity University of New YorkNew YorkNYUSA
| | - T. T.‐K. Huang
- Center for Systems and Community Design, Graduate School of Public Health and Health PolicyCity University of New YorkNew YorkNYUSA
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15
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Heideman WH, Rongen FC, Bolleurs C, Govers E, Kroeze W, Steenhuis IHM. Facilitators and barriers to a dietitian-implemented blended care weight-loss intervention (SMARTsize): a qualitative study. J Hum Nutr Diet 2019; 32:338-348. [PMID: 30891851 PMCID: PMC6593710 DOI: 10.1111/jhn.12641] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Dietitians play an important role in the intervention and prevention of being overweight and obesity. More and more blended care interventions are being implemented. The present study aimed to evaluate the delivery by Dutch dietitians of a multicomponent, evidence-based weight-loss programme (SMARTsize), including counselling for relapse prevention. The aim of this qualitative study was to identify facilitators and barriers to the delivery of SMARTsize. METHODS Nine semi-structured interviews were conducted with 10 dietitians who participated in a larger implementation study. Each interview was recorded and transcribed verbatim. Determinants of theory of implementation, including characteristics of the user, the innovation, organisational context and setting, and innovation strategy guided interviews and analysis. Data were coded and analysed using the framework approach. RESULTS According to dietitians, the SMARTsize intervention had a positive influence on patients. The main implementation facilitators were the availability of implementation materials, such as a manual, training in relapse prevention and social support from other dietitians. The main barriers to implementation were organisation and financial reimbursement of cooking classes, the belief that patients need more individual counselling in the starting phase, and the unsuitability for people with low levels of health literacy. CONCLUSIONS Most dietitians considered that implementation of the SMARTsize intervention consisting of e-health, written information and cooking classes and face-to-face counselling is challenging but feasible. Further development of the SMARTsize intervention and implementation tools is needed to lower experienced barriers. It is also recommended that a version of the intervention to be developed that is suitable for patients with lower levels of health literacy.
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Affiliation(s)
- W H Heideman
- Department of Health Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - F C Rongen
- Department of Health Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - C Bolleurs
- Dutch Association of Dietitians, Houten, The Netherlands
| | - E Govers
- Amstelring and Dutch Knowledge Centre of Dietitians on Obesity (KDOO), Amsterdam, The Netherlands
| | - W Kroeze
- Department of Health Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - I H M Steenhuis
- Department of Health Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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16
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Bucher T, Rollo ME, Smith SP, Dean M, Brown H, Sun M, Collins C. Position paper on the need for portion-size education and a standardised unit of measurement. Health Promot J Austr 2019; 28:260-263. [PMID: 27745570 DOI: 10.1071/he15137] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 08/31/2016] [Indexed: 11/23/2022] Open
Abstract
Large portion sizes contribute to weight gain in western societies. Portion-size interventions, aids and education can be effective in helping prevent weight gain, but consumers are unsure what appropriate portions are and express confusion about existing guidelines. A lack of clarity about suggested serving size recommendations is a major barrier to food portion-size control. Therefore, standardised measurement units and unambiguous terminologies are required. This position paper summarises the evidence regarding the impact and importance of portion-size education and estimation, and outlines strategies for improving consumer understanding and application of this through the development of an international food measurement system and a range of appropriate portion control tools. In this position paper, the authors call for the standardisation of food volume measurement terminologies, units, implementation recommendations, as well as consumer education. The target audience for this paper includes nutrition and behavioural researchers, policy makers, and stakeholders who potentially influence and implement changes in national food measurement systems, which in turn impact on consumer choice.
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Affiliation(s)
- Tamara Bucher
- Nutrition and Dietetics, School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Megan E Rollo
- Nutrition and Dietetics, School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Shamus P Smith
- School of Electrical Engineering and Computer Science, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Moira Dean
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast BT9 5AG, UK
| | - Hannah Brown
- Nutrition and Dietetics, School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Mingui Sun
- Departments of Neurosurgery, Electrical and Computer Engineering, and Bioengineering, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Clare Collins
- Nutrition and Dietetics, School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
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17
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Kroeze W, Rongen F, Eykelenboom M, Heideman W, Bolleurs C, Govers E, Steenhuis I. A Process Evaluation of a Multi-Component Intervention in Dutch Dietetic Treatment to Improve Portion Control Behavior and Decrease Body Mass Index in Overweight and Obese Patients. Nutrients 2018; 10:E1717. [PMID: 30423953 PMCID: PMC6265690 DOI: 10.3390/nu10111717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 11/01/2018] [Accepted: 11/06/2018] [Indexed: 11/16/2022] Open
Abstract
The SMARTsize intervention embeds an evidence-based portion control intervention in regular dietetic care. This intervention was evaluated to explore (1) which patients participated, (2) the implementation process, and (3) the outcomes of the intervention. The intervention was evaluated with an observational study design including measures at baseline, and three, six, and nine months after the start of the program. Data concerning the process (participation, dose delivered, dose received, satisfaction) and the outcomes (self-efficacy, intention, portion control strategies, and Body Mass Index (BMI) were collected with forms and questionnaires filled out by dietitians and patients. Descriptive analyses, comparison analyses, and cluster analyses were performed. Patients were mainly obese, moderately to highly educated women of Dutch ethnicity. Use of the intervention components varied from 50% to 100% and satisfaction with the SMARTsize intervention was sufficient to good (grades 7.2⁻8.0). Statistically significant (p < 0.001) improvements were observed for self-efficacy (+0.5), portion control strategies (+0.7), and BMI (-2.2 kg/m²), with no significant differences between patients with or without counselling. Three clusters of patients with different levels of success were identified. To conclude, implementing an evidence-based portion control intervention in real-life dietetic practice is feasible and likely to result in weight loss.
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Affiliation(s)
- Willemieke Kroeze
- Department of Health Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam and Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands.
- Department Care for Nutrition and Health, School of Nursing, Christian University of Applied Sciences, 6717 JS Ede, The Netherlands.
| | - Frédérique Rongen
- Department of Health Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam and Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands.
| | - Michelle Eykelenboom
- Department of Health Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam and Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands.
| | - Wieke Heideman
- Department of Health Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam and Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands.
| | - Claudia Bolleurs
- Dutch Association of Dietitians, De Molen 93, 3995 AW Houten, The Netherlands.
| | - Ellen Govers
- Dutch Knowledge Centre of Dietitians on Obesity (KDOO), 1065 AC Amsterdam, The Netherlands.
| | - Ingrid Steenhuis
- Department of Health Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam and Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands.
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18
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Eykelenboom M, van Stralen MM, Poelman MP, Steenhuis IHM. Patterns of weight loss and their determinants in a sample of adults with overweight and obesity intending to lose weight. Nutr Diet 2018; 77:240-246. [PMID: 30402896 DOI: 10.1111/1747-0080.12489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 07/24/2018] [Accepted: 09/14/2018] [Indexed: 12/13/2022]
Abstract
AIM Weight loss success is highly variable among individuals. Cluster analysis contributes to future intervention development by recognising this individual variability and identifying different weight loss patterns. Identifying determinants that differentiate between these patterns would explain the source of variability. Thus, we aimed to identify weight loss patterns and their determinants in adults with overweight and obesity. METHODS The present study is a secondary analysis of data from the PortionControl@HOME study. The weight of 175 adults was measured at 0, 3 and 12 months and potential determinants were self-reported using validated questionnaires at 0 and 3 months. Weight loss patterns were identified based on percent weight change during Phase 1 (0-3 months) and Phase 2 (3-12 months) using cluster analysis. Determinants were assessed using multinomial logistic regression. RESULTS We identified three weight loss patterns: (i) low success, demonstrating low weight loss achievement, (ii) moderate success, demonstrating successful weight loss in Phase 1 followed by partial regain in Phase 2 and (iii) high success, demonstrating weight loss in Phase 1 followed by continued weight loss in Phase 2. Compared to the moderate success pattern, the low success pattern was negatively associated with power of food at baseline (i.e. the appetitive drive to consume highly palatable food) (odds ratio, OR = 0.42, 95% CI = 0.21-0.86) and change in portion control behaviour (i.e. the use of behavioural strategies to control the amount of food consumed) (OR = 0.28, 95% CI = 0.10-0.78). CONCLUSIONS Three weight loss patterns were identified in adults with overweight and obesity. Adults with greater power of food and increased portion control behaviour were less likely to exhibit an unsuccessful weight loss pattern.
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Affiliation(s)
- Michelle Eykelenboom
- Department of Health Sciences, Amsterdam Public Health Research Institute, VU Amsterdam, Amsterdam, the Netherlands
| | - Maartje M van Stralen
- Department of Health Sciences, Amsterdam Public Health Research Institute, VU Amsterdam, Amsterdam, the Netherlands
| | - Maartje P Poelman
- Department of Health Sciences, Amsterdam Public Health Research Institute, VU Amsterdam, Amsterdam, the Netherlands.,Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, the Netherlands
| | - Ingrid H M Steenhuis
- Department of Health Sciences, Amsterdam Public Health Research Institute, VU Amsterdam, Amsterdam, the Netherlands
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19
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Polak R, Tirosh A, Livingston B, Pober D, Eubanks JE, Silver JK, Minezaki K, Loten R, Phillips EM. Preventing Type 2 Diabetes with Home Cooking: Current Evidence and Future Potential. Curr Diab Rep 2018; 18:99. [PMID: 30218282 DOI: 10.1007/s11892-018-1061-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW Various dietary regimes have proven effective in preventing diabetes, yet its prevalence is growing. This review's goals are to examine the relationship between home cooking and diabetes and to present the literature on home cooking education programs as a novel strategy to improve adherence to healthy nutrition, thus decreasing the risk of diabetes. RECENT FINDINGS Consumption of home-cooked food is linked to healthier nutrition and decreased risk of diabetes. Further, home cooking interventions have a short-term positive impact on nutritional intake of both children and adults, and on diabetes prevention. Well-designed randomized controlled studies are needed to rigorously evaluate the long-term impact of home cooking interventions on cooking behavior, dietary intake, diabetes, and healthcare costs. Culinary education is an emerging field that aims to change nutrition education paradigms. Clinicians can empower patients to adopt home cooking by role modeling home cooking themselves, including home cooking content in their medical encounters, and through comprehensive lifestyle medicine interventions.
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Affiliation(s)
- Rani Polak
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Institute of Lifestyle Medicine, Spaulding Rehabilitation Hospital, 300, 1st Avenue, Boston, MA, 02129, USA.
- Lifestyle Medicine Center, Sheba Medical Center, Tel Hashomer, Israel.
| | - Amir Tirosh
- Endocrinology Institute, Sheba Medical Center, Tel Hashomer, Israel
| | | | - David Pober
- Department of Medicine, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
| | - James E Eubanks
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, USA
| | - Julie K Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, 300, 1st Avenue, Boston, MA, 02129, USA
- Massachusetts General Hospital, Boston, MA, USA
- Brigham and Women's Hospitals, Boston, MA, USA
| | - Kaya Minezaki
- School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Roni Loten
- The Institute of Biochemistry, Food and Nutrition Science; The Robert H. Smith Faculty of Agriculture Food and the Environment, The Hebrew University of Jerusalem, Jerusalem, Israel
- The Joseph Sagol Neuroscience Center Tel Hashomer, Tel Hashomer, Israel
| | - Edward M Phillips
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Institute of Lifestyle Medicine, Spaulding Rehabilitation Hospital, 300, 1st Avenue, Boston, MA, 02129, USA
- Massachusetts General Hospital, Boston, MA, USA
- Brigham and Women's Hospitals, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
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20
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Potential psychological & neural mechanisms in binge eating disorder: Implications for treatment. Clin Psychol Rev 2018; 60:32-44. [DOI: 10.1016/j.cpr.2017.12.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 12/13/2017] [Accepted: 12/20/2017] [Indexed: 02/08/2023]
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21
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Almiron-Roig E, Navas-Carretero S, Emery P, Martínez JA. Research into food portion size: methodological aspects and applications. Food Funct 2018; 9:715-739. [PMID: 29219156 DOI: 10.1039/c7fo01430a] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Portion sizes for certain foods have been increasing dramatically in recent years alongside obesity rates, concurring with the phenomenon of the portion size effect (more is consumed when more is offered). Portion size may be defined based on different purposes such as for dietary assessment, or therapeutic advice or food labelling, resulting in a variety of measurement methods and specifications. This situation has resulted in disagreements on establishing portion size recommendations by manufacturers, food distributors, restaurants, health professionals and policy makers, contributing to confusion amongst consumers on the amounts of food to be consumed, and potentially increasing the likelihood of overeating and other obesity-related behaviours. Such variability is also reflected in the research field making comparison across studies on portion size difficult. The aim of this review is to provide an overview of definitions and methods used in research to evaluate portion-size related outcomes, including methods to estimate amounts consumed by individuals as part of dietary assessment; methods to analyse cognitive mechanisms related to portion size behaviour; and methods to evaluate the impact of portion size manipulations as well as individual plus environmental factors on portion size behaviour. Special attention has been paid to behavioural studies exploring portion size cognitive processes given the lack of previous methodological reviews in this area. This information may help researchers, clinicians and other stakeholders to establish clearer definitions of portion size in their respective areas of work and to standardise methods to analyse portion size effects.
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Affiliation(s)
- Eva Almiron-Roig
- Universidad de Navarra, Centre for Nutrition Research, Irunlarrea 1, 31008, Pamplona, Spain.
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22
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Reicks M, Kocher M, Reeder J. Impact of Cooking and Home Food Preparation Interventions Among Adults: A Systematic Review (2011-2016). JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:148-172.e1. [PMID: 28958671 DOI: 10.1016/j.jneb.2017.08.004] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 08/02/2017] [Accepted: 08/14/2017] [Indexed: 05/09/2023]
Abstract
OBJECTIVE To update a review of the impact of interventions for adults that included a cooking component on diet, health, and psychosocial outcomes. DESIGN A total of 3,047 records were identified by searching MEDLINE, Agricola, Web of Science, and the Cochrane Central Register of Controlled Trials (January, 2011 to March, 2016). A total of 34 articles met inclusion and exclusion criteria for analysis. Study description and outcomes were extracted and synthesized to generate conclusions regarding impact. RESULTS Less than half of the studies included a control group. The most common intended outcomes were improvements in fruit and/or vegetable intake and weight. The majority of studies showed positive dietary behavior changes and improvements in cooking confidence and knowledge. Limitations included the lack of a control group, no follow-up past after intervention, the use of nonvalidated assessment instruments, and small convenience samples. DISCUSSION Findings were similar to a previous review regarding positive impact on dietary and cooking confidence outcomes. Clinical and weight outcomes were addressed in more studies included in the current review than in the previous 1; however, limitations were similar. CONCLUSIONS AND IMPLICATIONS Intervention design and assessment tools need to be strengthened in intervention studies with cooking components.
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Affiliation(s)
- Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN.
| | - Megan Kocher
- Library Science, University of Minnesota Libraries, St. Paul, MN
| | - Julie Reeder
- State of Oregon Special Supplemental Nutrition Program for Women, Infants, and Children, Portland, OR
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23
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Hollywood L, Surgenor D, Reicks M, McGowan L, Lavelle F, Spence M, Raats M, McCloat A, Mooney E, Caraher M, Dean M. Critical review of behaviour change techniques applied in intervention studies to improve cooking skills and food skills among adults. Crit Rev Food Sci Nutr 2017; 58:2882-2895. [PMID: 28678613 DOI: 10.1080/10408398.2017.1344613] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Cooking and food skills interventions have grown in popularity; however, there is a lack of transparency as to how these interventions were designed, highlighting a need to identify and understand the mechanisms of behavior change so that effective components may be introduced in future work. This study critiques cooking and food skills interventions in relation to their design, behavior change techniques (BCTs), theoretical underpinnings, and outcomes. METHODS A 40-item CALO-RE taxonomy was used to examine the components of 59 cooking and food skills interventions identified by two systematic reviews. Studies were coded by three independent coders. RESULTS The three most frequently occurring BCTs identified were #1 Provide information on consequences of behavior in general; #21 Provide instruction on how to perform the behavior; and #26 Prompt Practice. Fifty-six interventions reported positive short-term outcomes. Only 14 interventions reported long-term outcomes containing BCTs relating to information provision. CONCLUSION This study reviewed cooking and food skills interventions highlighting the most commonly used BCTs, and those associated with long-term positive outcomes for cooking skills and diet. This study indicates the potential for using the BCT CALO-RE taxonomy to inform the design, planning, delivery and evaluation of future interventions.
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Affiliation(s)
- Lynsey Hollywood
- a Department of Hospitality and Tourism Management, Ulster Business School , Ulster University , Coleraine , UK
| | - Dawn Surgenor
- a Department of Hospitality and Tourism Management, Ulster Business School , Ulster University , Coleraine , UK
| | - Marla Reicks
- b Department of Food Science and Nutrition , University of Minnesota , St Paul , Minnesota , USA
| | - Laura McGowan
- c Institute for Global Food Security, School of Biological Sciences , Queen's University Belfast , Belfast , UK
| | - Fiona Lavelle
- c Institute for Global Food Security, School of Biological Sciences , Queen's University Belfast , Belfast , UK
| | - Michelle Spence
- c Institute for Global Food Security, School of Biological Sciences , Queen's University Belfast , Belfast , UK
| | - Monique Raats
- d Food, Consumer Behaviour and Health Research Centre, School of Psychology , University of Surrey , Guildford , UK
| | - Amanda McCloat
- e Department of Home Economics , St Angela's College , Sligo , Ireland
| | - Elaine Mooney
- e Department of Home Economics , St Angela's College , Sligo , Ireland
| | - Martin Caraher
- f Department of Sociology, School of Arts and Social Sciences, City , University of London , Belfast , UK
| | - Moira Dean
- c Institute for Global Food Security, School of Biological Sciences , Queen's University Belfast , Belfast , UK
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24
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Rollo ME, Bucher T, Smith SP, Collins CE. ServAR: An augmented reality tool to guide the serving of food. Int J Behav Nutr Phys Act 2017; 14:65. [PMID: 28499433 PMCID: PMC5429537 DOI: 10.1186/s12966-017-0516-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 04/22/2017] [Indexed: 02/04/2023] Open
Abstract
Background Accurate estimation of food portion size is a difficult task. Visual cues are important mediators of portion size and therefore technology-based aids may assist consumers when serving and estimating food portions. The current study evaluated the usability and impact on estimation error of standard food servings of a novel augmented reality food serving aid, ServAR. Methods Participants were randomised into one of three groups: 1) no information/aid (control); 2) verbal information on standard serving sizes; or 3) ServAR, an aid which overlayed virtual food servings over a plate using a tablet computer. Participants were asked to estimate the standard serving sizes of nine foods (broccoli, carrots, cauliflower, green beans, kidney beans, potato, pasta, rice, and sweetcorn) using validated food replicas. Wilcoxon signed-rank tests compared median served weights of each food to reference standard serving size weights. Percentage error was used to compare the estimation of serving size accuracy between the three groups. All participants also performed a usability test using the ServAR tool to guide the serving of one randomly selected food. Results Ninety adults (78.9% female; a mean (95%CI) age 25.8 (24.9–26.7) years; BMI 24.2 (23.2–25.2) kg/m2) completed the study. The median servings were significantly different to the reference portions for five foods in the ServAR group, compared to eight foods in the information only group and seven foods for the control group. The cumulative proportion of total estimations per group within ±10%, ±25% and ±50% of the reference portion was greater for those using ServAR (30.7, 65.2 and 90.7%; respectively), compared to the information only group (19.6, 47.4 and 77.4%) and control group (10.0, 33.7 and 68.9%). Participants generally found the ServAR tool easy to use and agreed that it showed potential to support optimal portion size selection. However, some refinements to the ServAR tool are required to improve the user experience. Conclusions Use of the augmented reality tool improved accuracy and consistency of estimating standard serve sizes compared to the information only and control conditions. ServAR demonstrates potential as a practical tool to guide the serving of food. Further evaluation across a broad range of foods, portion sizes and settings is warranted.
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Affiliation(s)
- Megan E Rollo
- School of Health Sciences, Priority Research Centre for Physical Activity & Nutrition, ATC Building, University of Newcastle, Callaghan, NSW, 2308, Australia.
| | - Tamara Bucher
- School of Health Sciences, Priority Research Centre for Physical Activity & Nutrition, ATC Building, University of Newcastle, Callaghan, NSW, 2308, Australia.,Institute for Environmental Decisions, ETH Zurich, Zurich, Switzerland
| | - Shamus P Smith
- School of Electrical Engineering and Computing, University of Newcastle, Callaghan, Australia
| | - Clare E Collins
- School of Health Sciences, Priority Research Centre for Physical Activity & Nutrition, ATC Building, University of Newcastle, Callaghan, NSW, 2308, Australia
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25
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Butryn ML, Forman EM, Lowe MR, Gorin AA, Zhang F, Schaumberg K. Efficacy of environmental and acceptance-based enhancements to behavioral weight loss treatment: The ENACT trial. Obesity (Silver Spring) 2017; 25:866-872. [PMID: 28337847 PMCID: PMC5404972 DOI: 10.1002/oby.21813] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 02/03/2017] [Accepted: 02/07/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study was designed to compare weight loss through a traditional behavioral treatment (BT) approach that integrated skills for managing the obesogenic food environment (BT + E) with an approach that integrated environmental and acceptance-based skills (BT + EA). Moderators were examined as an exploratory aim. METHODS Adults (N = 283) were randomly assigned to treatment condition and provided with 26 group-based sessions over the course of 12 months. Weight was measured in the clinic at months 0, 6, and 12. RESULTS Change in weight over time did not significantly differ by condition. However, race significantly moderated the effect of condition on weight loss (P = 0.04), such that African-American participants lost less weight than non-Hispanic white participants in the BT (6.2% vs. 11.5%) and BT + E conditions (6.6% vs. 12.2%), but weight loss in these two groups was similar in the BT + EA condition (9.4% vs. 11.5%). Among African Americans, rates of achieving a clinically significant weight loss (i.e., > 5%) at 12 months were higher in BT + EA (80%) than BT (57%) or BT + E (48%) (P = 0.04). CONCLUSIONS This innovative behavioral approach shows promise for treatment of African Americans, which is notable given the lack of progress to date addressing racial disparities in obesity intervention efficacy.
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Affiliation(s)
- Meghan L Butryn
- Psychology Department, Drexel University, Philadelphia, Pennsylvania, USA
| | - Evan M Forman
- Psychology Department, Drexel University, Philadelphia, Pennsylvania, USA
| | - Michael R Lowe
- Psychology Department, Drexel University, Philadelphia, Pennsylvania, USA
| | - Amy A Gorin
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Fengqing Zhang
- Psychology Department, Drexel University, Philadelphia, Pennsylvania, USA
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Peckmezian T, Hay P. A systematic review and narrative synthesis of interventions for uncomplicated obesity: weight loss, well-being and impact on eating disorders. J Eat Disord 2017; 5:15. [PMID: 28469914 PMCID: PMC5410702 DOI: 10.1186/s40337-017-0143-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 03/22/2017] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Most weight loss research focuses on weight as the primary outcome, often to the exclusion of other physiological or psychological measures. This study aims to provide a holistic evaluation of the effects from weight loss interventions for individuals with obesity by examining the physiological, psychological and eating disorders outcomes from these interventions. METHODS Databases Medline, PsycInfo and Cochrane Library (2011-2016) were searched for randomised controlled trials and systematic reviews of obesity treatments (dietary, exercise, behavioural, psychological, pharmacological or surgical). Data extracted included study features, risk of bias, study outcomes, and an assessment of treatment impacts on physical, psychological or eating disorder outcomes. RESULTS From 3628 novel records, 134 studies met all inclusion criteria and were evaluated in this review. Lifestyle interventions had the strongest evidence base as a first-line approach, with escalation to pharmacotherapy and bariatric surgery in more severe or complicated cases. Quality of life was the most common psychological outcome measure, and improved in all cases where it was assessed, across all intervention types. Behavioural, psychological and lifestyle interventions for weight loss led to improvements in cognitive restraint, control over eating and binge eating, while bariatric surgery led to improvements in eating behaviour and body image that were not sustained over the long-term. DISCUSSION Numerous treatment strategies have been trialled to assist people to lose weight and many of these are effective over the short-term. Quality of life, and to a lesser degree depression, anxiety and psychosocial function, often improve alongside weight loss. Weight loss is also associated with improvements in eating disorder psychopathology and related measures, although overall, eating disorder outcomes are rarely assessed. Further research and between-sector collaboration is required to address the significant overlap in risk factors, diagnoses and treatment outcomes between obesity and eating disorders.
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Affiliation(s)
| | - Phillipa Hay
- Foundation Chair of Mental Health and Centre for Health Research, School of Medicine, Western Sydney University, Parramatta, Australia
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Rolls BJ, Roe LS, James BL, Sanchez CE. Does the incorporation of portion-control strategies in a behavioral program improve weight loss in a 1-year randomized controlled trial? Int J Obes (Lond) 2017; 41:434-442. [PMID: 27899807 PMCID: PMC5340595 DOI: 10.1038/ijo.2016.217] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 10/28/2016] [Accepted: 11/13/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND/OBJECTIVES Controlling food portion sizes can help reduce energy intake, but the effect of different portion-control methods on weight management is not known. In a 1-year randomized trial, we tested whether the efficacy of a behavioral weight-loss program was improved by incorporating either of the two portion-control strategies instead of standard advice about eating less. SUBJECTS/METHODS The Portion-Control Strategies Trial included 186 women with obesity (81%) or overweight (19%). Participants were randomly assigned to one of three equally intensive behavioral programs, consisting of 19 individual sessions over 12 months. The Standard Advice Group was instructed to eat less food while making healthy choices, the Portion Selection Group was instructed to choose portions based on the energy density using tools such as food scales and the Pre-portioned Foods Group was instructed to structure meals around pre-portioned foods such as single-serving main dishes, for which some vouchers were provided. In an intention-to-treat analysis, a mixed-effects model compared weight loss trajectories across 23 measurements; at month 12, weight was measured for 151 participants (81%). RESULTS The trajectories showed that the Pre-portioned Foods Group initially lost weight at a greater rate than the other two groups (P=0.021), but subsequently regained weight at a greater rate (P=0.0005). As a result, weight loss did not differ significantly across groups at month 6 (mean±s.e. 5.2±0.4 kg) or month 12 (4.5±0.5 kg). After 1 year, measured weight loss averaged 6% of baseline weight. The frequency of using portion-control strategies initially differed across groups, then declined over time and converged at months 6 and 12. CONCLUSIONS Incorporating instruction on portion-control strategies within a 1-year behavioral program did not lead to a greater weight loss than standard advice. Using pre-portioned foods enhanced early weight loss, but this was not sustained over time. Long-term maintenance of behavioral strategies to manage portions remains a challenge.
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Affiliation(s)
- B J Rolls
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - L S Roe
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - B L James
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - C E Sanchez
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
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Abstract
PURPOSE OF REVIEW The aim of this review is to provide an overview of (1) underlying mechanisms of the effect of portion size on energy intake, (2) external factors explaining the portion size effect and (3) interventions and measurements aimed at food portion size. RECENT FINDINGS Previous studies have shown that portion sizes have increased in recent decades. Many experimental studies have been conducted to unravel the mechanisms underlying the portion-size effect on food intake (e.g. the appropriateness mechanism, the 'unit bias' mechanism, the 'previous experience/expectation' mechanism, the 'visual cue' mechanism and the 'bite size' mechanism). In addition, external factors have been found to drive food portion selection and consumption (e.g. value for money, mindless eating, levels of awareness, estimation bias. Research on several interventions (ranging from 'providing information' to 'eliminating choice') have been conducted, but remain scarce, especially intervention studies in which portion size is a key focus in weight loss. Moreover, only three new instruments with respect to portion control behavior have been developed. There is considerable evidence for the portion-size effect on energy intake. However, the work on interventions targeting portion size and measurements for portion control behavior are limited. Moreover, from the literature it is not yet clear what type of interventions work best, for whom and in what context.
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Affiliation(s)
- Ingrid Steenhuis
- Department of Health Sciences, Faculty of Earth & Life Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Maartje Poelman
- Department of Human Geography and Spatial Planning, Utrecht University, Heidelberglaan 2, PO Box 80115, 3508 TC, Utrecht, The Netherlands
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Sharma M, Catalano HP, Nahar VK, Lingam V, Johnson P, Ford MA. Using multi-theory model to predict initiation and sustenance of small portion size consumption among college students. Health Promot Perspect 2016; 6:137-44. [PMID: 27579257 PMCID: PMC5002880 DOI: 10.15171/hpp.2016.22] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 06/23/2016] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Consumption of large portion sizes is contributing to overweight and obesity.College students are a vulnerable group in this regard. The purpose of this study was to use multi-theory model (MTM) to predict initiation and sustenance of small portion size consumption in college students. METHODS A total of 135 students at a large Southern US University completed a 35-item valid (face, content, and construct) and reliable (internally consistent) survey electronically in a cross-sectional design. The main outcome measures were intention to start eating small portion sizes and continuing to eat small portion sizes. Only those students who ate large portion sizes during the past 24 hours were included. RESULTS Step wise multiple regression showed that initiation of small portion size consumption was explained by participatory dialogue (advantages outweighing disadvantages), behavioral confidence, age, and gender (adjusted R(2) = 0.37, P < 0.001). Males were less likely to initiate small portion size consumption than females (β = -0.185, 95% CI = -0.71- -0.11). Regarding sustenance, emotional transformation, changes in social environment, and race were the significant predictors (adjusted R(2) = 0.20, P < 0.001). Whites were less likely to sustain small portion size change than other races (β = -0.269, 95% CI = -0.97 - -0.26). CONCLUSION Based on this study's findings, MTM appears to be a robust theoretical framework for predicting small portion size consumption behavior change. Interventions in this regard need to be designed.
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Affiliation(s)
- Manoj Sharma
- Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
| | - Hannah Priest Catalano
- Public Health Studies, School of Health and Applied Human Sciences, University of North Carolina Wilmington, NC, USA
| | - Vinayak K Nahar
- Department of Health, Physical Education, and Exercise Science, School of Allied Health Sciences, Lincoln Memorial University, Harrogate, TN, USA; Department of Health, Exercise Science & Recreation Management, School of Applied Sciences, University of Mississippi, MS, USA
| | - Vimala Lingam
- Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
| | - Paul Johnson
- Department of Management, School of Business Administration, University of Mississippi, MS, USA
| | - M Allison Ford
- Department of Health, Exercise Science & Recreation Management, School of Applied Sciences, University of Mississippi, MS, USA
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The pack size effect: Influence on consumer perceptions of portion sizes. Appetite 2016; 96:225-238. [DOI: 10.1016/j.appet.2015.09.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 09/21/2015] [Accepted: 09/22/2015] [Indexed: 12/21/2022]
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Appelhans BM, French SA, Pagoto SL, Sherwood NE. Managing temptation in obesity treatment: A neurobehavioral model of intervention strategies. Appetite 2015; 96:268-279. [PMID: 26431681 DOI: 10.1016/j.appet.2015.09.035] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 08/26/2015] [Accepted: 09/28/2015] [Indexed: 12/31/2022]
Abstract
Weight loss outcomes in lifestyle interventions for obesity are primarily a function of sustained adherence to a reduced-energy diet, and most lapses in diet adherence are precipitated by temptation from palatable food. The high nonresponse and relapse rates of lifestyle interventions suggest that current temptation management approaches may be insufficient for most participants. In this conceptual review, we discuss three neurobehavioral processes (attentional bias, temporal discounting, and the cold-hot empathy gap) that emerge during temptation and contribute to lapses in diet adherence. Characterizing the neurobehavioral profile of temptation highlights an important distinction between temptation resistance strategies aimed at overcoming temptation while it is experienced, and temptation prevention strategies that seek to avoid or minimize exposure to tempting stimuli. Many temptation resistance and temptation prevention strategies heavily rely on executive functions mediated by prefrontal systems that are prone to disruption by common occurrences such as stress, insufficient sleep, and even exposure to tempting stimuli. In contrast, commitment strategies are a set of devices that enable individuals to manage temptation by constraining their future choices, without placing heavy demands on executive functions. These concepts are synthesized in a conceptual model that categorizes temptation management approaches based on their intended effects on reward processing and degree of reliance on executive functions. We conclude by discussing the implications of our model for strengthening temptation management approaches in future lifestyle interventions, tailoring these approaches based on key individual difference variables, and suggesting high-priority topics for future research.
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Affiliation(s)
- Bradley M Appelhans
- Department of Preventive Medicine, Rush University Medical Center, 1700 W Van Buren St, Suite 470, Chicago, IL 60612, USA; Department of Behavioral Sciences, Rush University Medical Center, 1645 W Jackson Blvd Suite 400, Chicago, IL 60612, USA.
| | - Simone A French
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S 2nd Street, Suite 300, Minneapolis, MN 55454, USA.
| | - Sherry L Pagoto
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
| | - Nancy E Sherwood
- HealthPartners Institute for Education and Research, 8170 33rd Ave S, Mail Stop 23301A, Bloomington, MN 55425, USA.
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Johnston M. What more can we learn from early learning theory? The contemporary relevance for behaviour change interventions. Br J Health Psychol 2015; 21:1-10. [DOI: 10.1111/bjhp.12165] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
OBJECTIVE The aim of the present study was to gain insight into (i) processed snack-food availability, (ii) processed snack-food salience and (iii) the size of dinnerware among households with overweight gatekeepers. Moreover, associations between gatekeepers' characteristics and in-home observations were determined. DESIGN A cross-sectional observation of home food environments was conducted as part of a baseline measurement of a larger study. SETTING Home food environments of overweight and obese gatekeepers in the Netherlands. SUBJECTS Household gatekeepers (n 278). Mean household size of the gatekeepers was 3.0 (SD 1.3) persons. Mean age of the gatekeepers was 45.7 (SD 9.2) years, 34.9% were overweight and 65.1% were obese. Of the gatekeepers, 20.9% had a low level of education and 42.7% had a high level of education. RESULTS In 70% of the households, eight or more packages of processed snack foods were present. In 54% of the households, processed snack foods were stored close to non-processed food items and in 78% of households close to non-food items. In 33% of the households, processed snack foods were visible in the kitchen and in 15% of the households processed snack foods were visible in the living room. Of the dinnerware items, 14% (plates), 57% (glasses), 78% (dessert bowls), 67% (soup bowls) and 58% (mugs) were larger than the reference norms of the Netherlands Nutrition Centre Foundation. Older gatekeepers used significantly smaller dinnerware than younger gatekeepers. CONCLUSIONS Environmental factors endorsing overconsumption are commonly present in the home environments of overweight people and could lead to unplanned eating or passive overconsumption.
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