Limitations in the assessment of dietary energy intake by self-report

Energy-Adjusted Dietary Inflammatory Index and Diabetes Risk in Postmenopausal Hispanic Women

BACKGROUND

Type 2 diabetes is a major public health concern in the United States and worldwide. The dietary inflammatory index (DII) and the energy-adjusted DII (E-DII) are tools that assess dietary inflammation. Previous evidence suggests that obesity can modify the association between inflammation and disease.

OBJECTIVE

The aim of this study was to evaluate the association between the DII/E-DII and incident diabetes in self-identified Hispanic women from the Women's Health Initiative (WHI). The secondary aim was to evaluate whether obesity modifies the association between the DII/E-DII scores and incident diabetes.

DESIGN

Participants were from the WHI Observational Study and the Clinical Trial Components (except women from the treatment arm in the Dietary Modification Trial) conducted among postmenopausal women in the United States. DII/E-DII scores were calculated from a self-administered food frequency questionnaire at baseline that included 122 food items, of which 12 are representative of Hispanic eating patterns.

PARTICIPANTS/SETTINGS

Participants included 3,849 postmenopausal women who self-identified as Hispanic that were recruited for the WHI from 1993 to 1998 at 40 US clinical centers.

MAIN OUTCOME MEASURES

The outcome was incident diabetes.

STATISTICAL ANALYSIS PERFORMED

Cox regression models were used to assess the association between DII/E-DII and incident diabetes. Models were adjusted for age at baseline, lifestyle-related risk factors, known type 2 diabetes mellitus (T2DM) risk factors, and neighborhood socioeconomic status. Interaction was tested between the DII/E-DII scores and obesity.

RESULTS

The incidence of diabetes was 13.1% after a median follow-up of 13 years. Higher E-DII scores were associated with a higher risk of incident diabetes (hazard ratio [HR], 1.09; 95% confidence interval [CI], 1.04-1.14). There was no interaction between E-DII scores and obesity (P = 0.73).

CONCLUSIONS

Pro-inflammatory diets, as measured by higher E-DII scores, were associated with a higher risk of incident diabetes. Future research is needed for understanding how the inflammatory potential of diets can be decreased.

Prevalence of micronutrient inadequacy differs by severity of food insecurity among adults living in Canada in 2015

Household food insecurity is generally associated with poorer quality diets in Canada, but whether household food insecurity heightens the probability of inadequate micronutrient intakes is unknown. The objective of this research was to investigate how prevalence of micronutrient inadequacy differed by severity of household food insecurity among adults in Canada. Using the 2015 Canadian Community Health Survey Nutrition, this study included participants aged 19-64 years who completed up to two 24 h dietary recalls and provided details about household food insecurity (n = 9486). Children and older adults were not included due to sample size limitations. Usual micronutrient intake distributions were estimated by a four-level measure of food insecurity status using the National Cancer Institute method. Welch's t tests assessed differences in prevalence of inadequacy for selected micronutrients. Prevalence differed for some micronutrients among those living in marginally and moderately food insecure compared to food-secure households. The greatest differences in prevalence of inadequacy were observed between severely food-insecure and food-secure households: vitamin A (60.0%, SE = 11.9 vs. 40.6%, SE = 2.7, p < 0.0001), vitamin B6 (42.7%, SE = 9.1 vs. 12.8%, SE = 2.5, p < 0.0001), folate (39.4%, SE = 10.0 vs. 15.9%, SE = 2.2, p < 0.0001), vitamin C (63.3%, SE = 5.2 vs. 29.1%, SE = 2.8, p < 0.0001), calcium (78.6%, SE = 6.4 vs. 58.7%, SE = 1.3, p < 0.0001), magnesium (75.6%, SE = 9.5 vs. 48.7%, SE = 1.2, p < 0.0001), and zinc (34.9%, SE = 10.0 vs. 23.2%, SE = 2.4, p = 0.0009). Apparent underreporting also differed by severity of food insecurity, with increased underreporting observed with worsening food insecurity. The probability of inadequate micronutrient intakes among adults rises sharply with more severe household food insecurity in Canada.

A literature review of biomarkers used for diagnosis of relative energy deficiency in sport

Introduction

The review aims to summarize the markers used in diagnosing relative energy deficiency in sport (REDs) and compare them with the REDs CAT2 score.

Methods

A systematic search was performed in the PubMed, Web of Science, and SPORTDiscus databases during April 2023. The descriptors used were "athlete" AND "REDs," along with respective entry terms. The selection process followed the PRISMA 2020 recommendations, identifying 593 records, from which 13 studies were ultimately selected. Seventy-nine markers were identified and categorized into six groups: bone mineral density (BMD), metabolic resting rate, blood biomarkers, anthropometrics, nutritional intake, and performance parameters. The most frequently utilized biomarkers included BMD, anthropometric parameters (e.g., body mass index, body mass, and fat mass), and the triiodothyronine (T3) concentration.

Results

According to the REDs CAT2 pointed indicators, the biomarkers varied among the studies, while 7 out of the 13 included studies achieved a ≥60% agreement rate with this tool. The prevalence of low energy availability, an etiological factor in the development of REDs, was detected in 4 out of 13 studies, with an average of 39.5%.

Conclusion

In conclusion, this review highlights the most commonly used markers in diagnosing REDs, such as BMD, anthropometric parameters, and T3 hormone concentration. Due to the current inconsistencies, standardizing diagnostic methodologies is crucial for future research. By focusing on widely used markers, this review aids future research planning and result interpretation and points out the ongoing need for methodological consistency in evolving diagnostic tools.

Systematic Review Registration

https://www.crd.york.ac.uk/, PROSPERO (CRD42022320007).

Dietary Biodiversity and Diet Quality in Dutch Adults

Dietary biodiversity, defined as the variety of consumed plants, animals and other organisms, can be measured by dietary species richness (DSR). This study investigated associations between DSR and diet quality in Dutch adults. Dietary intake data of 2078 Dutch participants, aged 19 to 79 years, were collected by the Dutch National Food Consumption Survey between 2012 and 2016 via two non-consecutive 24-h dietary recalls. DSR scores were calculated based on the total count of unique species consumed per individual over the two measurement days. An overall DSR score and separate scores for fruit and vegetable species consumption were calculated. The Dutch Healthy Diet index 2015 (DHD15-index) was used to measure diet quality. Linear regression analyses were performed to investigate associations between DSR scores and DHD15-index. Analyses were stratified by age and adjusted for relevant confounders. In total, 157 unique species were identified within the investigated food groups. On average, individuals consumed 13 unique species over two days (SD 4.55). For every additional species consumed, the DHD15-index increased by 1.40 points (95%CI 1.25-1.55). Associations between DSR and DHD15-index were higher in younger adults. DSR fruit showed the strongest associations with DHD15-index (β 4.01 [95%CI 3.65-4.38]). Higher DSR scores are associated with higher diet quality in Dutch adults. These newly developed DSR scores create opportunities for further research to explore the implications of dietary biodiversity in Western diets on health and related outcomes.

Dietary intake of polish organic and conventional fruit growers and their life partners - a pilot study

Diet is one of the elements that contribute to health and quality of life. There are significant discrepancies between the diets of people living in different regions, with different beliefs, or with different approaches to sustainability and ecology. There is a lack of research on dietary intake among organic and conventional fruit growers. The aim of our study was to examine the diets of orchardists and their immediate life partners in terms of meeting energy requirements, nutrient intake and fulfillment of dietary recommendations in this group. Fifty-three participants (28 in the organic group and 25 in the conventional group) took part in the study. Dietary data were obtained using the 3-day dietary record. Body mass and height were measured and BMI was calculated. Physical activity was estimated using a questionnaire method. The study group was aged 44 ± 8 years, with a body weight of 84 ± 16 kg and a height of 172 ± 9 cm. The mean BMI was 28 ± 4 kg/m2. Mean energy intake with diet was 2170 ± 606 kcal/day with needs of 3002 (1991-5144) kcal/day. A significant proportion of the study group did not fulfill their calcium and vitamin D requirements. In addition, a significant proportion of the conventional fruit growers did not cover their needs for potassium, magnesium and vitamins: E, C, and folate. Both groups had too high an intake of cholesterol and saturated fatty acids, and too low an intake of polyunsaturated fatty acids. In conclusion, the orchardists' diets mostly provided adequate amounts of nutrients, with inadequate intakes of calcium, vitamin D, cholesterol, and fatty acids. The diets of organic fruit growers were significantly richer in selected nutrients.

The impact of body composition on the degree of misreporting of food diaries

BACKGROUND/OBJECTIVES

Accurate assessments of energy intake (EI) are needed in lifestyle interventions to guarantee a negative energy balance (EB), thereby losing weight. This study aimed (1) to compare objectively measured and self-reported EI and (2) to determine the predictors of underreporting divided by sex, adiposity and BMI category.

METHODS

Seventy-three participants [mean (SD): 43.7 (9.2) years, BMI = 31.5 (4.5) kg/m2, 37% females] of the Champ4Life intervention were included in this study. EI was measured using the "intake-balance method" and self-reported through 3-day food records. Fat mass (FM) and fat-free mass (FFM) were measured by dual-energy X-ray absorptiometry. Bland-Altman analysis was performed to compare both EI assessments.

RESULTS

Self-reported EI was lower than measured EI during both neutral (-355 kcal/d) and negative EB (-570 kal/day). While no significant trends were observed for EI evaluation in either neutral (p = 0.315) or negative EB (p = 0.611), limits of agreement were wide (-1720 to 1010 and -1920 to 779 kcal/day, respectively). In females, the degree of misreporting (kcal/day and %) was predicted by weight (p = 0.032 and p = 0.039, respectively) and FM (p = 0.029 and p = 0.037, respectively). In males, only BMI (p = 0.036) was a predictor of misreporting (kcal/day).

CONCLUSION

Self-reported EI did not agree with measured EI. Our results show that larger body size was associated with higher levels of underestimation for EI (females only). Nevertheless, misreporting EI is a complex issue involving more associations than merely body composition. A deeper understanding could inform counseling for participants filling out food records in other to reduce misreporting and improve validity.

Audience segmentation of New Zealand cat owners: Understanding the barriers and drivers of cat containment behavior

Free-roaming companion cats have a detrimental impact on the environment and are at risk of harm. Despite these negative impacts, it is the norm in New Zealand (NZ) to allow companion cats to roam freely and only a minority of cat owners practice cat containment. This study firstly sought to identify what factors act as barriers and drivers of NZ owners' participation in cat containment, and secondly whether NZ owners could be segmented into unique audiences based on the factors predicting their cat containment behavior. It was hypothesized that cat owners with greater capability, opportunity, and motivation to perform cat containment would have greater cat containment intentions and behavior. Furthermore, it was expected that at least three segments of cat owners would exist in NZ which differed significantly in the set of capability, opportunity and motivational factors predicting their cat containment behavior. A quantitative online cross-sectional survey of 395 NZ cat owners was conducted, measuring containment intentions and behavior, and capability, opportunity, and motivation to perform cat containment. Results from bivariate correlations and multiple regression demonstrated that capability, opportunity, and motivational factors predicted increased cat containment intentions and behavior. Latent profile analysis identified four distinct segments of cat owners with unique COM profiles; engaged (6%), receptive (17%), ambivalent (48%), and opposed (30%). Validation analysis demonstrated that these groups all differed significantly in their cat containment intentions and behaviors. From these findings theoretically grounded behavior change interventions can be developed to target the causes of non-participation in cat containment for each of the identified cat owner segments, thereby improving the management of free-roaming cats in NZ.

Artificial intelligence in diabetes management: Advancements, opportunities, and challenges

The increasing prevalence of diabetes, high avoidable morbidity and mortality due to diabetes and diabetic complications, and related substantial economic burden make diabetes a significant health challenge worldwide. A shortage of diabetes specialists, uneven distribution of medical resources, low adherence to medications, and improper self-management contribute to poor glycemic control in patients with diabetes. Recent advancements in digital health technologies, especially artificial intelligence (AI), provide a significant opportunity to achieve better efficiency in diabetes care, which may diminish the increase in diabetes-related health-care expenditures. Here, we review the recent progress in the application of AI in the management of diabetes and then discuss the opportunities and challenges of AI application in clinical practice. Furthermore, we explore the possibility of combining and expanding upon existing digital health technologies to develop an AI-assisted digital health-care ecosystem that includes the prevention and management of diabetes.

Is the energy balance explanation of the obesity epidemic wrong?

There is a striking discrepancy in both U.S and the U.K data between obesity rates, which are increasing, and self-reported food consumption rates, which are decreasing. There are two possible explanations for this discrepancy, namely that the widely accepted energy balance interpretation of obesity is wrong or that food consumption data are somehow biased. In a comment entitled "Obesity-an unexplained epidemic", Mozzafarian (2022) challenged the Energy Balance Model (EBM) and argued for a need to replace it with a novel biological theory. This challenge is premature, because there are psychological explanations for this discrepancy, namely that individuals with overweight and obesity underreport their food consumption and that this tendency has increased in recent years. To support these hypotheses, U.S and U.K data are reviewed that used the Doubly Labeled Water method (DLW), which is the gold standard for estimating energy expenditure. Such studies find not only consistent evidence of underreporting, but also that the discrepancy between measured energy expenditure and reported calorie consumption increased over time. Two psychological explanations for this pattern are discussed.

Patterns of home cooking practices among participants in a behavioral weight loss program: A latent class analysis

Cooking education is a popular approach to health promotion; however, the relationship between specific cooking practices, diet and weight loss is not well understood. The goal of this study was to 1) evaluate the relationship between cooking practices, dietary behaviors, and weight loss after a weight loss intervention and 2) identify patterns of cooking practices and their implications on weight loss. Using a quasi-experimental, single-arm cohort study design, we analyzed data from 249 adults with overweight/obesity who were participating in a weight loss program. Participants self-reported demographics, height and weight, and diet and physical activity behaviors. The Health Cooking Questionnaire 2 (HCQ2) was used to collect information on cooking practices post intervention. The HCQ2 responses were used to generate Healthy Cooking Index (HCI) scores, a summative measure of cooking practices with the potential to influence health. Latent Class Analysis (LCA) was utilized to define distinct patterns of cooking behaviors. Cooking patterns and HCI scores were examined relative to participant demographics, dietary behaviors, and weight loss. HCI scores post-intervention were positively associated with age, weight loss, and favorable dietary behaviors in this study. The LCA revealed three distinct patterns of cooking behavior (Red Meat Simple, Vegetarian Simple, Health & Taste Enhancing). The Red Meat Simple cooking pattern was associated with less weight loss compared to other patterns. The findings of this study set the foundation for more research on cooking education as a method for improving weight loss outcomes in the context of behavioral interventions.

Lack of compensation of energy intake explains the success of alternate day feeding to produce weight loss

BACKGROUND AND AIMS

This study was designed to obtain daily weighed food intake of participants engaged in Alternate Day Feeding (ADF). Prior ADF studies have used self-reported food intake, a method that has received criticism for its limited accuracy.

SUBJECTS AND METHODS

Forty-nine university students received academic credit for participating in the study. Following a 10-day baseline period, participants underwent ADF for the next 8 days. Restricted daily intake to ∼ 75% of baseline food intake levels was followed by ad libitum intake on alternate days. Food intake was weighed before and after each meal. Daily body weight was also tracked.

INTERVENTION

After the baseline period, participants underwent 8 days of ADF during which they consumed ∼ 75% of baseline energy intake by weight followed by ad libitum intake on alternate days. The trial concluded with 2 additional days of ad libitum feeding, for a total study duration of 10 days.

RESULTS

Daily food intake was constant during the baseline period (slope = -0.93 g/d, p = 0.56), and did not differ significantly (995 g (95% CI [752, 1198]) from the total consumed on ad libitum ADF days (951 g (95% CI [777, 1227]). Intake on ad libitum days did not show a trend to increase during the intervention. Body weight declined significantly during ADF.

CONCLUSIONS

ADF produces significant weight loss because food intake does not increase on ad libitum feeding days to compensate for reduced intake on restricted energy days. Data are consistent with prior work that suggests humans do not fully compensate for imposed deficits in energy intake.

Dietary intake and nutritional status of people with epilepsy: A systematic review

PURPOSE

In people with epilepsy achieving optimal dietary intake may be hampered by psychological and physical comorbidities associated with seizures, medication use, socioeconomic disadvantage and the use of therapeutic diets. This systematic review aimed to evaluate the reported dietary intake and nutritional status of children and adults with epilepsy.

METHODS

A systematic literature search was completed across Ovid MEDLINE, EMBASE and CINAHL (all from inception to 4 November 2021). We included studies that reported dietary intake in adults and children diagnosed with epilepsy compared with local reference ranges, control groups or general populations. Studies using interventions and therapeutic diets were excluded. Risk of bias was assessed using the Study Quality Assessment Tools by the National Heart, Lung and Blood Institute. A descriptive analysis was performed due to the heterogenous nature of the data.

RESULTS

The initial search returned 1214 articles. Full-text screening was completed for 98 studies and 19 studies met eligibility criteria and were included for extraction. These comprised of seven paediatric studies, eight adult studies and four studies that included both adult and paediatric cohorts. Sample size of cases in each study ranged from 17 to 3,220. Vitamin A, C, D and folate were the most frequently reported vitamins. Calcium, iron and zinc were the most commonly reported minerals. Most studies showed that people with epilepsy had poorer dietary intake and nutritional status compared with control groups or reference standards.

CONCLUSION

There were limited studies on dietary intake and nutritional status in people with epilepsy. Most available studies suggested poorer status compared to non-epilepsy controls. The development of a validated dietary assessment tool specifically for epilepsy cohorts would enable comparison of findings across studies, and aid with appropriately tailoring nutrition advice to individuals with epilepsy.

Efficacy of progressive versus severe energy restriction on body composition and strength in concurrent trained women

PURPOSE

This study evaluated the concurrent training (CT) effect in combination with either progressive energy restriction (PER) or severe energy restriction (SER) on body composition and strength-related variables in resistance-trained women.

METHODS

Fourteen women (29.5 ± 3.8 years; 23.8 ± 2.8 kg·m^-2) were randomly assigned to a PER (n = 7) or SER (n = 7) group. Participants performed an 8-week CT program. Pre- and post-intervention measures of fat mass (FM) and fat-free mass (FFM) were assessed by dual-energy X-ray absorptiometry and strength-related variables were assessed through 1-repetition maximum (in the squat and bench press) and countermovement jump.

RESULTS

Significant reductions in FM were observed in PER and SER (Δ = - 1.7 ± 0.4 kg; P =  < 0.001; ES = - 0.39 and Δ = - 1.2 ± 0.6 kg; P = 0.002; ES = - 0.20, respectively). After correcting FFM for fat-free adipose tissue (FFAT), no significant differences for this variable were found either in PER (Δ = - 0.3 ± 0.1; P = 0.071; ES = - 0.06) or in SER (Δ = - 0.2 ± 0.1; P = 0.578; ES = - 0.04). There were no significant changes in the strength-related variables. No between-group differences were found in any of the variables.

CONCLUSION

A PER has similar effects to a SER on body composition and strength in resistance-trained women performing a CT program. Given that PER is more flexible and thus may enhance dietary adherence, it might be a better alternative for FM reduction compared to SER.

Effect of aerobic exercise and low-carbohydrate high-fat diet on glucose tolerance and android/gynoid fat in overweight/obese women: A randomized controlled trial

The study was designed to compare the effects of weight loss induced by a low-carbohydrate-high-fat diet or a normal diet, with and without exercise, on glucose tolerance measured as area under the curve (AUC), and android (A) and gynoid (G) fat distribution. The study was registered at clinicaltrials.gov; NCT04100356. In total, 57 women classified as overweight or obese (age 40 ± 3.5 years, body mass index 31.1 ± 2.6 kg/m²) were randomly assigned and completed a 10-week intervention using a low-carbohydrate high-fat diet or a normal diet, with or without aerobic interval exercise. An equal deficit of 700 kcal/day was prescribed, either restricting the diet only, or moderately restricting diet and including three 50-min high-intensity bicycle sessions per week. There were thus four groups: normal diet (NORM); low-carbohydrate-high-fat diet (LCHF); normal diet with exercise (NORM-EX); and low-carbohydrate-high-fat diet with exercise (LCHF-EX). Linear mixed models was used to assess differences between groups. With all groups pooled, the intervention resulted in a weight loss of 6.7 ± 2.5% (p < 0.001). The intervention did not result in differences between groups in AUC glucose, nor in fasting glucose or indicis for insulin resistance such as Homeostatic Model Assessment, Matsuda Insulin Sensitivity Index, insulinogenic index and disposition index. Post-intervention android fat was lower in LCHF than NORM (3,223 ± 727 vs. 2,533 ± 535 g, p = 0.041). LCHF reached a lower A/G ratio than NORM (0.94 ± 0.12 vs. 1.04 ± 0.09, p = 0.011) and LCHF-EX (0.94 ± 0.12 vs. 1.09 ± 0.09, p < 0.001) after the intervention. LCHF resulted in lower android fat mass compared to NORM and the lowest A/G ratio compared to the other matched groups, but with no accompanying improvement in AUC glucose. In conclusion, although all groups achieved improvements in glucose tolerance, no superior effect was observed with the LCHF diet, neither with nor without exercise.

Machine Learning in Nutrition Research

Data currently generated in the field of nutrition are becoming increasingly complex and high-dimensional, bringing with them new methods of data analysis. The characteristics of machine learning (ML) make it suitable for such analysis and thus lend itself as an alternative tool to deal with data of this nature. ML has already been applied in important problem areas in nutrition, such as obesity, metabolic health, and malnutrition. Despite this, experts in nutrition are often without an understanding of ML, which limits its application and therefore potential to solve currently open questions. The current article aims to bridge this knowledge gap by supplying nutrition researchers with a resource to facilitate the use of ML in their research. ML is first explained and distinguished from existing solutions, with key examples of applications in the nutrition literature provided. Two case studies of domains in which ML is particularly applicable, precision nutrition and metabolomics, are then presented. Finally, a framework is outlined to guide interested researchers in integrating ML into their work. By acting as a resource to which researchers can refer, we hope to support the integration of ML in the field of nutrition to facilitate modern research.

European mature adults and elderly are moving closer to the Mediterranean diet-a longitudinal study, 2013-19

BACKGROUND

The decreasing adherence in Mediterranean Diet (M.D.) during the last decades has been attributed to social, cultural and economic factors. However, recent efforts to improve dietary habits and the economic improvement might be reversing this trend. We analyze the changes in M.D. adherence between 2013 and 2019 among a sample of European mature adults and the elderly.

METHODS

Using data from the Survey of Health, Ageing and Retirement in Europe for adults over 50 years old, we designed a longitudinal cohort study with a sample of participants from waves 5 (2013) and 8 (2019/20). Logistic regressions were used to model the consumption of M.D. adherence as a function of the year. We then stratified the analyses by education, age and transitions in economic status, employment and self-perceived health.

RESULTS

There was in 2019/20 a significant increase in the M.D. adherence (10.8% vs. 14.3%, OR = 1.367, P < 0.01). The rise was mainly related to the decrease of meat and fish (38.4% vs. 30.5%, OR = 0.703, P < 0.01) and growth of legumes and eggs intake (36.3% vs. 41.8%, OR = 1.260 P < 0.01). The results were consistent in all European regions and most sociodemographic groups. Younger people with higher income and education had a greater rise in adherence.

CONCLUSIONS

Our analysis shows a generalized growth in adherence to the M.D. across most socioeconomic subpopulations and countries in Europe, suggesting a shift to healthier diet patterns. The more noticeable increase among affluent, educated and healthy respondents, may further entrench dietary and health inequalities.

Longitudinal Evidence of a Vicious Cycle Between Nucleus Accumbens Microstructure and Childhood Weight Gain

PURPOSE

Pediatric obesity is a growing public health concern. Previous work has observed diet to impact nucleus accumbens (NAcc) inflammation in rodents, measured by the reactive proliferation of glial cells. Recent work in humans has demonstrated a relationship between NAcc cell density-a proxy for neuroinflammation-and weight gain in youth; however, the directionality of this relationship in the developing brain and association with diet remains unknown.

METHODS

Waist circumference (WC) and NAcc cell density were collected in a large cohort of children (n > 2,000) participating in the Adolescent Brain Cognitive Development (ABCD) Study (release 3.0) at baseline (9-10 y) and at a Year 2 follow-up (11-12 y). Latent change score modeling (LCSM) was used to disentangle contributions of baseline measures to two-year changes in WC percentile and NAcc cellularity. In addition, the role of NAcc cellularity in mediating the relationship between diet and WC percentile was assessed using dietary intake data collected at Year 2.

RESULTS

LCSM indicates that baseline WC percentile influences change in NAcc cellularity and that baseline NAcc cell density influences change in WC percentile. NAcc cellularity was significantly associated with WC percentile at Year 2 and mediated the relationship between dietary fat consumption and WC percentile.

CONCLUSIONS

These results implicate a vicious cycle whereby NAcc cell density biases longitudinal changes in WC percentile and vice versa. Moreover, NAcc cell density may mediate the relationship between diet and weight gain in youth. These findings suggest that diet-induced inflammation of reward circuitry may lead to behavioral changes that further contribute to weight gain.

Skeletal muscle gene expression in older adults with type 2 diabetes mellitus undergoing calorie-restricted diet and recreational sports training - a randomized clinical trial

AIMS

This study aimed to evaluate the impact of a 12-week calorie-restricted diet and recreational sports training on gene expressions IL15, ATROGIN1 and MURF-1 in skeletal muscle of T2D patients.

METHODS

Older adults with T2D (n = 39, 60 ± 6.0 years, BMI 33.5 ± 0.6 kg/m²) were randomly allocated to Diet+Soccer (DS), Diet+Running (DR) or Diet (D). The training sessions were moderate-to-high-intensity and performed 3 × 40 min/week for 12-weeks. Gene expression from vastus lateralis muscle obtained by qRT-PCR, dual-energy X-ray and fasting blood testing measurements were performed before and after 12-weeks. Statistical analysis adopted were two-way ANOVA and Paired t-test for gene expression, and RM-ANOVA test for the remainder variables.

RESULTS

Total body weight was reduced in ~4 kg representing body fat mass in all groups after 12-weeks (P < 0.05). HbA1c values decreased in all groups post-intervention. Lipids profile improved in the training groups (P < 0.05) after 12-weeks. ATROGIN1 and MURF-1 mRNA reduced in the DS (1.084 ± 0.14 vs. 0.754 ± 1.14 and (1.175 ± 0.34 vs. 0.693 ± 0.12, respectively; P < 0.05), while IL15 mRNA increased in the DR (1056 ± 0,12 vs. 1308 ± 0,13; P < 0.05) after 12-weeks intervention.

CONCLUSION

Recreational training with a moderate calorie-restricted diet can downregulates the expression of atrophy-associated myokines and increases the expression of anti-inflammatory gene IL15.

Nutritional quality of calorie restricted diets in the CALERIE™ 1 trial

OBJECTIVES

The aim was to determine the nutritional adequacy of calorie restricted (CR) diets during CR interventions up to 12 months.

METHODS

The Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy (CALERIE™) phase 1 trial consisted of 3 single-site studies to test the feasibility and effectiveness of CR in adults without obesity. After baseline assessments, participants who were randomized to a CR intervention received education and training from registered dietitians on how to follow a healthful CR diet. Food diaries were completed at baseline and during the CR interventions (~6, 9, and 12 months) when participants were self-selecting CR diets. Diaries were analyzed for energy, macronutrients, fiber, 11 vitamins, and 9 minerals. Nutritional adequacy was defined by sex- and age-specific Estimated Average Requirement (EAR) or Adequate Intake (AI) criteria for each nutrient. Diet quality was evaluated using the PANDiet diet quality index.

RESULTS

Eighty-eight CR participants (67% women, age 40 ± 9 y, BMI 27.7 ± 1.5 kg/m²) were included in the analysis. Dietary intake of fiber and most vitamins and minerals increased during CR. More than 90% of participants achieved 100% of EAR or AI during CR for 2 of 4 macronutrients (carbohydrate and protein), 6 of 11 vitamins (A, B1, B2, B3, B6, B12), and 6 of 9 minerals assessed (copper, iron, phosphorus, selenium, sodium, zinc). Nutrients for which <90% of participants achieved adequacy included fiber, omega-3 fatty acids, vitamins B5, B9, C, E, and K, and the minerals calcium, magnesium, and potassium. The PANDiet diet quality index improved from 72.9 ± 6.0% at baseline to 75.7 ± 5.2% during CR (p < 0.0001).

CONCLUSION

Long-term, calorie-restricted diets were nutritionally equal or superior to baseline ad libitum diets among adults without obesity. Our results support modest calorie restriction as a safe strategy to promote healthy aging without compromising nutritional adequacy or diet quality.

A Qualitative Analysis of the Remote Food Photography Method and the Automated Self-Administered 24-hour Dietary Assessment Tool for Assessing Children's Food Intake Reported by Parent Proxy

BACKGROUND

Accuracy and participant burden are two key considerations in the selection of a dietary assessment tool for assessing children's full-day dietary intake.

OBJECTIVE

The aim of this study was to identify barriers experienced by parents and burden when using two technology-based measures of dietary intake to report their child's intake: the Remote Food Photography Method (RFPM) and the Automated Self-Administered 24-hour Dietary Assessment Tool (ASA24).

DESIGN

Qualitative, semistructured, focus groups were conducted with parents who served as proxy reporters of their child's dietary intake using the two different dietary assessment methods (ie, RFPM and ASA24) 1 week apart.

PARTICIPANTS/SETTING

This study was conducted in 2019 and included 32 parents of children aged 7 to 8 years in Colorado and Louisiana.

MAIN OUTCOME MEASURES

Barriers adhering to the protocol and burden with the RFPM and ASA24.

QUALITATIVE ANALYSES

Qualitative content analysis and Atlas.ti software were used to analyze and interpret focus group data.

RESULTS

For the RFPM, parents described missing photos due to unobserved intake, forgetting to capture images, disruption of mealtimes, and child embarrassment when meals were photographed at school. For the ASA24, parents described the time commitment as the main source of burden and the need to expand the food database to include additional ethnic foods and restaurant items. The main strengths were ease of use for the RFPM and the consolidated workload for the ASA24.

CONCLUSIONS

The barriers experienced by parents and burden differed by method, highlighting the importance of considering the unique characteristics of each assessment tool when designing a pediatric dietary assessment study and interpreting findings.

Sex differences and shifts in body composition, physical activity, and total energy expenditure across a 3-month expedition

OBJECTIVES

An energetically demanding environment like a wilderness expedition can lead to potent stressors on human physiology and homeostatic balance causing shifts in energy expenditure and body composition. These shifts likely have consequences on overall health and performance and may potentially differ by sex. It is therefore critical to understand the potential differential body composition and energy expenditure changes in response to a novel and challenging environment in both males and female bodies.

METHODS

Data were collected from 75 healthy individuals (female = 41; ages 18-53) throughout a 3-month long expedition in the American Rockies. Body mass, body fat, and lean muscle mass were measured before, during, and after the course. Physical activity intensity and energy expenditure were also measured in a subset of participants using the wGT3X-BT Actigraph wrist monitor and an accompanying Bluetooth heart rate monitor.

RESULTS

Over the 3-month period, individuals initially experienced declines in body mass, body fat percentage, and lean muscle mass. Participants partially rebounded from these deficits to maintain overall body mass with a slight recomposition of body fat and lean muscle mass. Our data also demonstrated that sex moderated total energy expenditure, where females experienced a modest decline whereas males experienced an increase in energy expenditure from the beginning to the end of the course.

CONCLUSIONS

Understanding changes in energy storage in the body and variation in energy expenditure between sexes during a 3-month expedition has critical implications for maintaining health and performance in an energetically demanding environment where resources may be scarce.

The Associations of Plasma Carotenoids and Vitamins With Risk of Age-Related Macular Degeneration: Results From a Matched Case-Control Study in China and Meta-Analysis

Background and Purpose

Data from studies support a beneficial effect of carotenoids and vitamins on an age-related macular degeneration (AMD) risk. However, studies on the relations between blood levels of these nutrients and AMD are limited and provided conflicting results. The objective of this case-control study and meta-analysis was to examine whether the blood concentrations of carotenoids and vitamins were associated with the risk of AMD.

Methods

A total of 164 cases of AMD and an equal number of controls are individually matched according to age and gender among the participants, who provided blood samples in the Xi'an Eye Study. Plasma carotenoids and vitamins were measured using reversed-phase high-performance liquid chromatography. Bonferroni-corrected covariate-adjusted conditional logistic regression were used to estimate AMD risk by category of these nutrients in the multivariable-adjusted model. Nine studies were identified for the meta-analysis and calculated pooled risk estimates by means of a random-effects model.

Results

Plasma concentrations of examined carotenoids and vitamins were significantly lower in patients with AMD than those in controls. Plasma concentrations of examined carotenoids and vitamins were significantly lower in patients with AMD than those in controls. After a multivariate adjustment for body mass index, blood cholesterol, and other lifestyle risk factors, higher lutein/zeaxanthin content in plasma was significantly associated with a decreased risk of AMD, and the odds ratio (OR) comparing the top and bottom tertiles was 0.21 (95% CI: 0.05, 0.84; P_trend = 0.024). Associations for β-carotenes (OR: 0.11; 95% CI: 0.02, 0.50; P_trend < 0.001), and β-cryptoxanthin (OR: 0.08, 95% CI: 0.02, 0.39; P_trend < 0.001) were similar to that for lutein/zeaxanthin. Inverse associations were also observed for a higher level of retinol (OR: 0.14, 95% CI: 0.03, 0.61; P_trend = 0.006) and α-tocopherol (OR: 0.25, 95% CI: 0.06, 0.98; P_trend = 0.006). In the meta-analysis, a protective effect was detected for AMD among the participants with high blood lutein/zeaxanthin level (OR: 0.53, 95% CI: 0.40, 0.72, P < 0.001), compared to those with low level. Similar inverse associations were seen for β-carotene (OR: 0.48, 95% CI: 0.28, 0.84, P = 0.010), β-cryptoxanthin (OR: 0.48, 95% CI: 0.23, 1, P = 0.049), lycopene (OR: 0.70, 95% CI: 0.54, 0.90, P = 0.006) and α-tocopherol (OR: 0.50, 95% CI: 0.31, 0.81, P = 0.005).

Conclusions

Results of the case-control study were consistent with findings from the meta-analysis, indicating that higher concentrations of carotenoids and vitamins were inversely associated with the AMD risk. Our finding supports the current notion that these nutrients are likely to affect the development of AMD and may help to refine the strategies for the prevention of age-related eye diseases.

Eating breakfast is associated with weight loss during an intensive lifestyle intervention for overweight/obesity

OBJECTIVE

This study examined whether breakfast consumption frequency (BCF) is associated with weight-loss outcomes in the Look AHEAD (Action for Health in Diabetes) trial.

METHODS

Data from a subset of participants (n = 3,915) from Look AHEAD, a randomized trial comparing intensive lifestyle intervention (ILI) to diabetes support and education (DSE) in adults with overweight/obesity and type 2 diabetes, were analyzed. BCF was collected by yearly questionnaire. Multivariable linear regression models were used to estimate the association between average BCF and percentage weight change over 4 years, controlling for baseline sociodemographic, anthropometric, and diabetes-related variables. In separate models, adjustment for diet (n = 915) and physical activity level (n = 837) was performed in a subset of participants.

RESULTS

Four-year average BCF was similar in DSE (n = 1,916) and ILI (n = 1,999) arms (p = 0.14). Each 1-day higher average BCF was associated with an additional 0.5% weight loss in the ILI arm (p < 0.0001) but not in the DSE arm (p = 0.58). This association in the ILI arm remained significant after adjustment for diet (p = 0.02) but not after adjustment for physical activity (p = 0.36).

CONCLUSIONS

Breakfast consumption was associated with greater weight loss in the active treatment group of an ILI, which may be mediated by increased physical activity.

United States Dietary Trends Since 1800: Lack of Association Between Saturated Fatty Acid Consumption and Non-communicable Diseases

We reviewed data on the American diet from 1800 to 2019. Methods: We examined food availability and estimated consumption data from 1800 to 2019 using historical sources from the federal government and additional public data sources. Results: Processed and ultra-processed foods increased from <5 to >60% of foods. Large increases occurred for sugar, white and whole wheat flour, rice, poultry, eggs, vegetable oils, dairy products, and fresh vegetables. Saturated fats from animal sources declined while polyunsaturated fats from vegetable oils rose. Non-communicable diseases (NCDs) rose over the twentieth century in parallel with increased consumption of processed foods, including sugar, refined flour and rice, and vegetable oils. Saturated fats from animal sources were inversely correlated with the prevalence of NCDs. Conclusions: As observed from the food availability data, processed and ultra-processed foods dramatically increased over the past two centuries, especially sugar, white flour, white rice, vegetable oils, and ready-to-eat meals. These changes paralleled the rising incidence of NCDs, while animal fat consumption was inversely correlated.

Consumption of Sugar-Sweetened or Artificially Sweetened Beverages and Semen Quality in Young Men: A Cross-Sectional Study

BACKGROUND

Existing literature suggests that frequent consumption of sugar-sweetened drinks may be associated with lower semen quality. Studies performed in mice suggest a dose-response relationship between intake of saccharin or aspartame, two artificial sweeteners, and sperm and testis function.

METHODS

A cross-sectional study based on data from The Fetal Programming of Semen Quality (FEPOS) Cohort, including 1047 young men (mean age = 19 years) was performed. Each male participant completed an online questionnaire on health, health behavior and diet, and provided a semen sample. The associations between consumption of sugar-sweetened or artificially sweetened beverages (moderate ≥ 3 days/week; infrequent < 3 days/week) and semen quality were analyzed using a multivariable, negative, binomial regression model.

RESULTS

Sugar-sweetened or artificially sweetened beverage consumption was not strongly associated with either semen volume, sperm concentration, total sperm count or total motility in young men. The proportion of morphologically normal sperm was 11% lower (0.89 (95% CI 0.76, 1.04)) for moderate (≥3 days/week) consumption of artificially sweetened beverages relative to infrequent (<3 days/week).

CONCLUSION

Consumption of sugar-sweetened or artificially sweetened beverages, at the levels present in this study had limited effect on the measured markers of semen quality in young men.

Systematic Review of Nutritional Recommendation Systems

In recent years, the promotion of healthy habits, and especially diet-oriented habits, has been one of the priority interests of our society. There are many apps created to count calories based on what we eat, or to estimate calorie consumption according to the sport we do, or to recommend recipes, but very few are capable of giving personalized recommendations. This review tries to see what studies exist and what recommendation systems are used for this purpose, over the last 5 years in the main databases. Among the results obtained, it is observed that the existing works focus on the recommendation system (usually collaborative filtering), and not so much on the description of the data or the sample analyzed; the indices used for the calculation of calories or nutrients are not specified. Therefore, it is necessary to work with open data, or well-described data, which allows the experience to be reproduced by third parties, or at least to be comparable. In recent years, the promotion of healthy habits, and especially diet-oriented habits, has been one of the priority interests of our society.

Dietary sugar restriction reduces hepatic de novo lipogenesis in adolescent boys with fatty liver disease

BACKGROUNDHepatic de novo lipogenesis (DNL) is elevated in nonalcoholic fatty liver disease (NAFLD). Improvements in hepatic fat by dietary sugar reduction may be mediated by reduced DNL, but data are limited, especially in children. We examined the effects of 8 weeks of dietary sugar restriction on hepatic DNL in adolescents with NAFLD and correlations between DNL and other metabolic outcomes.METHODSAdolescent boys with NAFLD (n = 29) participated in an 8-week, randomized controlled trial comparing a diet low in free sugars versus their usual diet. Hepatic DNL was measured as percentage contribution to plasma triglyceride palmitate using a 7-day metabolic labeling protocol with heavy water. Hepatic fat was measured by magnetic resonance imaging-proton density fat fraction.RESULTSHepatic DNL was significantly decreased in the treatment group (from 34.6% to 24.1%) versus the control group (33.9% to 34.6%) (adjusted week 8 mean difference: -10.6% [95% CI: -19.1%, -2.0%]), which was paralleled by greater decreases in hepatic fat (25.5% to 17.9% vs. 19.5% to 18.8%) and fasting insulin (44.3 to 34.7 vs. 35.5 to 37.0 μIU/mL). Percentage change in DNL during the intervention correlated significantly with changes in free-sugar intake (r = 0.48, P = 0.011), insulin (r = 0.40, P = 0.047), and alanine aminotransferase (ALT) (r = 0.39, P = 0.049), but not hepatic fat (r = 0.13, P = 0.532).CONCLUSIONOur results suggest that dietary sugar restriction reduces hepatic DNL and fasting insulin, in addition to reductions in hepatic fat and ALT, among adolescents with NAFLD. These results are consistent with the hypothesis that hepatic DNL is a critical metabolic abnormality linking dietary sugar and NAFLD.TRIAL REGISTRYClinicalTrials.gov NCT02513121.FUNDINGThe Nutrition Science Initiative (made possible by gifts from the Laura and John Arnold Foundation, Ambrose Monell Foundation, and individual donors), the UCSD Altman Clinical and Translational Research Institute, the NIH, Children's Healthcare of Atlanta and Emory University's Children's Clinical and Translational Discovery Core, Children's Healthcare of Atlanta and Emory University Pediatric Biostatistical Core, the Georgia Clinical and Translational Science Alliance, and the NIH National Institute of Diabetes, Digestive, and Kidney Disease.

Nutrient Intake and Gut Microbial Genera Changes after a 4-Week Placebo Controlled Galacto-Oligosaccharides Intervention in Young Females

Recent interest in the gut-brain-axis has highlighted the potential of prebiotics to impact wellbeing, and to affect behavioral change in humans. In this clinical trial, we examined the impact of four-weeks daily supplementation of galacto-oligosaccharides (GOS) on self-reported nutrient intake and relationships on gut microbiota in a four-week two-armed parallel double-blind placebo controlled GOS supplement trial in young adult females. Food diaries and stool samples were collected prior to and following 28 days of supplement consumption. It was found that four weeks of GOS supplementation influenced macronutrient intake, as evident by reduced carbohydrate and sugars and increased fats intake. Further analysis showed that the reduction in carbohydrates was predicted by increasing abundances of Bifidobacterium in the GOS group in comparison to the placebo group. This suggests that Bifidobacterium increase via GOS supplementation may help improve the gut microbiota composition by altering the desire for specific types of carbohydrates and boosting Bifidobacterium availability when fiber intake is below recommended levels, without compromising appetite for fiber from food.

Nutritional optimization for female elite football players-topical review

Women's football is an intermittent sport characterized by frequent intense actions throughout the match. The high number of matches with limited recovery time played across a long competitive season underlines the importance of nutritional strategies to meet these large physical demands. In order to maximize sport performance and maintain good health, energy intake must be optimal. However, a considerable proportion of female elite football players does not have sufficient energy intake to match the energy expenditure, resulting in low energy availability that might have detrimental physiologic consequences and impair performance. Carbohydrates appear to be the primary fuel covering the total energy supply during match-play, and female elite football players should aim to consume sufficient carbohydrates to meet the requirements of their training program and to optimize the replenishment of muscle glycogen stores between training bouts and matches. However, several macro- and micronutrients are important for ensuring sufficient energy and nutrients for performance optimization and for overall health status in female elite football players. The inadequacy of macro-and micronutrients in the diet of these athletes may impair performance and training adaptations, and increase the risk of health disorders, compromising the player's professional career. In this topical review, we present knowledge and relevant nutritional recommendations for elite female football players for the benefit of sports nutritionists, dietitians, sports scientists, healthcare specialists, and applied researchers. We focus on dietary intake and cover the most pertinent topics in sports nutrition for the relevant physical demands in female elite football players as follows: energy intake, macronutrient and micronutrient requirements and optimal composition of the everyday diet, nutritional and hydration strategies to optimize performance and recovery, potential ergogenic effects of authorized relevant supplements, and future research considerations.

A Comparison of Total Food Intake at a Personalised Buffet in People with Obesity, before and 24 Months after Roux-en-Y-Gastric Bypass Surgery

Long-term reductions in the quantity of food consumed, and a shift in intake away from energy dense foods have both been implicated in the potent bariatric effects of Roux-en-Y gastric bypass (RYGB) surgery. We hypothesised that relative to pre-operative assessment, a stereotypical shift to lower intake would be observed at a personalised ad libitum buffet meal 24 months after RYGB, driven in part by decreased selection of high energy density items. At pre-operative baseline, participants (n = 14) rated their preference for 72 individual food items, each of these mapping to one of six categories encompassing high and low-fat choices in combination with sugar, complex carbohydrate or and protein. An 18-item buffet meal was created for each participant based on expressed preferences. Overall energy intake was reduced on average by 60% at the 24-month buffet meal. Reductions in intake were seen across all six food categories. Decreases in the overall intake of all individual macronutrient groups were marked and were generally proportional to reductions in total caloric intake. Patterns of preference and intake, both at baseline and at follow-up appear more idiosyncratic than has been previously suggested by verbal reporting. The data emphasise the consistency with which reductions in ad libitum food intake occur as a sequel of RYGB, this being maintained in the setting of a self-selected ad libitum buffet meal. Exploratory analysis of the data also supports prior reports of a possible relative increase in the proportional intake of protein after RYGB.

Disparities in Adult Fast-Food Consumption in the U.S. by Race and Ethnicity, National Health and Nutrition Examination Survey 2017-2018

INTRODUCTION

This study provides the most recent estimates for fast-food consumption in the U.S., overall and by race/ethnicity and age.

METHODS

Data from adults (aged ≥20 years, N=3,560) in the National Health and Nutrition Examination Survey, 2017-2018, were used to identify the (1) percentage of adults consuming fast food, (2) estimated mean percentage of calories consumed from fast food, and (3) estimated mean total calories consumed from fast food on a typical day. Intake was measured by in-person, 24-hour dietary recall. Analysis was conducted in 2020.

RESULTS

During 2017-2018, fast food was consumed by 36.5% of adults on a typical day, accounting for 13.8% of daily calories, an average of 309 kcal/day. More non-Hispanic Black adults consumed fast food (42.6%), consumed the largest percentage of daily calories from fast food (17.4%), and consumed the greatest number of daily calories from fast food (381 kcal/day) than adults of other racial/ethnic groups. Young non-Hispanic Black adults had the highest level of fast-food consumption, and this was significantly higher than that among Mexican Americans: percentage consuming fast food (53.5% vs 42.5%, p=0.02) and percentage of calories from fast food (24.1% vs 16.8%, p=0.03). Young non-Hispanic Black adults consumed the highest total fast-food calories, which were significantly higher than that among non-Hispanic Asian young adults (526 kcal vs 371 kcal, p=0.04). No significant differences in the study outcomes were observed by race/ethnicity and age compared with non-Hispanic White adults of the same group.

CONCLUSIONS

Fast-food consumption among adults in the U.S. is high, particularly among young non-Hispanic Black adults.

Evaluation of the Diet Tracking Smartphone Application Keenoa™: A Qualitative Analysis

Keenoa™ is a novel Canadian diet application (app) currently used by Canadian dietitians to collect diet-related data from clients. The goal of this study was to evaluate Keenoa™ based on user feedback and compare it to a conventional pen and paper method. One hundred and two participants were recruited and randomly assigned to record their diets using this application for 3 nonconsecutive days. Following this, participants were invited to complete an online "exit" survey. Seventy-two subjects responded, with 50 completing an open-ended question asking for general feedback about the app. Data were reviewed and 3 main themes emerged: strengths, challenges, and future recommendations. Strengths associated with the app consisted of picture recognition software, the additional commentary feature, and the overall pleasant data collection process. Challenges that were identified included inconsistencies with the barcode scanning features, the limited food database, time to enter food details, and software issues. Future recommendations included using a larger food database, pairing dietary intake with physical activity monitoring, and having accessible nutritional data. Despite these limitations, participants preferred using mobile apps to record diet compared with traditional written food diaries.

Exploring Pathways of Socioeconomic Inequity in Vegetable Expenditure Among Consumers Participating in a Grocery Loyalty Program in Quebec, Canada, 2015-2017

Vegetable consumption remains consistently low despite supportive policy and investments across the world. Vegetables are available in great variety, ranging in their processing level, availability, cost, and arguably, nutritional value. A retrospective longitudinal study was conducted in Quebec, Canada to explore pathways of socioeconomic inequity in vegetable expenditure. Data was obtained for consumers who participated in a grocery loyalty program from 2015 to 2017 and linked to the 2016 Canadian census. Vegetable expenditure share (%) was examined as a fraction of the overall food basket and segmented by processing level. Panel random effects and tobit models were used overall and to estimate the stratified analysis by median income split. Consumers allocated 8.35% of their total food expenditure to vegetables, which was mostly allocated to non-processed fresh (6.88%). Vegetable expenditure share was the highest in early winter and lowest in late summer. In the stratified analysis, the low-income group exhibited less seasonal variation, allocated less to fresh vegetables, and spent more on canned and frozen compared to the high-income group. Measures of socioeconomic status were all significant drivers of overall vegetable consumption. Consumers with high post-secondary education in the low-income group spent 2% more on vegetables than those with low education. The complexity of observed expenditure patterns points to a need for more specific vegetable consumption guidelines that include provisions by processing level. Implications for education, marketing, intersectional policies, and the role of government are discussed. Governments can scale present efforts and catalyze health-promoting investments across local, state, national, and global food systems.

Effect of Fecal Microbiota Transplantation Combined With Mediterranean Diet on Insulin Sensitivity in Subjects With Metabolic Syndrome

Background

Recent studies demonstrate that a Mediterranean diet has beneficial metabolic effects in metabolic syndrome subjects. Since we have shown that fecal microbiota transplantation (FMT) from lean donors exerts beneficial effects on insulin sensitivity, in the present trial, we investigated the potential synergistic effects on insulin sensitivity of combining a Mediterranean diet with donor FMT in subjects with metabolic syndrome.

Design

Twenty-four male subjects with metabolic syndrome were put on a Mediterranean diet and after a 2-week run-in phase, the subjects were randomized to either lean donor (n = 12) or autologous (n = 12) FMT. Changes in the gut microbiota composition and bacterial strain engraftment after the 2-week dietary regimens and 6 weeks post-FMT were the primary endpoints. The secondary objectives were changes in glucose fluxes (both hepatic and peripheral insulin sensitivity), postprandial plasma incretin (GLP-1) levels, subcutaneous adipose tissue inflammation, and plasma metabolites.

Results

Consumption of the Mediterranean diet resulted in a reduction in body weight, HOMA-IR, and lipid levels. However, no large synergistic effects of combining the diet with lean donor FMT were seen on the gut microbiota diversity after 6 weeks. Although we did observe changes in specific bacterial species and plasma metabolites, no significant beneficial effects on glucose fluxes, postprandial incretins, or subcutaneous adipose tissue inflammation were detected.

Conclusions

In this small pilot randomized controlled trial, no synergistic beneficial metabolic effects of combining a Mediterranean diet with lean donor FMT on glucose metabolism were achieved. However, we observed engraftment of specific bacterial species. Future trials are warranted to test the combination of other microbial interventions and diets in metabolic syndrome.

Food insecurity increases energetic efficiency, not food consumption: an exploratory study in European starlings

Food insecurity—defined as limited or unpredictable access to nutritionally adequate food—is associated with higher body mass in humans and birds. It is widely assumed that food insecurity-induced fattening is caused by increased food consumption, but there is little evidence supporting this in any species. We developed a novel technology for measuring foraging, food intake and body mass in small groups of aviary-housed European starlings (Sturnus vulgaris). Across four exploratory experiments, we demonstrate that birds responded to 1–2 weeks of food insecurity by increasing their body mass despite eating less. Food-insecure birds therefore increased their energetic efficiency, calculated as the body mass maintained per unit of food consumed. Mass gain was greater in birds that were lighter at baseline and in birds that faced greater competition for access to food. Whilst there was variation between experiments in mass gain and food consumption under food insecurity, energetic efficiency always increased. Bomb calorimetry of guano showed reduced energy density under food insecurity, suggesting that the energy assimilated from food increased. Behavioural observations of roosting showed inconsistent evidence for reduced physical activity under food insecurity. Increased energetic efficiency continued for 1–2 weeks after food security was reinstated, indicating an asymmetry in the speed of the response to food insecurity and the recovery from it. Future work to understand the mechanisms underlying food insecurity-induced mass gain should focus on the biological changes mediating increased energetic efficiency rather than increased energy consumption.

How Digital Food Affects Our Analog Lives: The Impact of Food Photography on Healthy Eating Behavior

Obesity continues to be a global issue. In recent years, researchers have started to question the role of our novel yet ubiquitous use of digital media in the development of obesity. With the recent COVID-19 outbreak affecting almost all aspects of society, many people have moved their social eating activities into the digital space, making the question as relevant as ever. The bombardment of appetizing food images and photography – colloquially referred to as “food porn” – has become a significant aspect of the digital food experience. This review presents an overview of whether and how the (1) viewing, (2) creating, and (3) online sharing of digital food photography can influence consumer eating behavior. Moreover, this review provides an outlook of future research opportunities, both to close the gaps in our scientific understanding of the physiological and psychological interaction between digital food photography and actual eating behavior, and, from a practical viewpoint, to optimize our digital food media habits to support an obesity-preventive lifestyle. We do not want to rest on the idea that food imagery’s current prevalence is a core negative influence per se. Instead, we offer the view that active participation in food photography, in conjunction with a selective use of food-related digital media, might contribute to healthy body weight management and enhanced meal pleasure.

Factors Associated with Favorable Changes in Food Preferences After Bariatric Surgery

PURPOSE

Bariatric surgery may shift food preferences towards less energy-dense foods. Eating behavior is multifactorial, and the mechanisms driving changes in food preferences could be a combination of a physiological response to surgery and social and psychological factors. This exploratory study aimed to identify potential factors explaining the variation in changes in food preferences after bariatric surgery.

MATERIALS AND METHODS

Physiological, social, and psychological data were collected before, 6 weeks or 6 months after surgery. All variables were analyzed in combination using LASSO regression to explain the variation in changes in energy density at an ad libitum buffet meal 6 months after bariatric surgery (n=39).

RESULTS

The following factors explained 69% of the variation in changes in food preferences after surgery and were associated with more favorable changes in food preferences (i.e., a larger decrease in energy density): female gender, increased secretion of glicentin, a larger decrease in the hedonic rating of sweet and fat and a fatty cocoa drink, a lower number of recent life crises, a low degree of social eating pressure, fulfilling the diagnostic criteria for binge eating disorder, less effort needed to obtain preoperative weight loss, a smaller household composition, a lower degree of self-efficacy and a higher degree of depression, nutritional regime competence, and psychosocial risk level.

CONCLUSION

Factors explaining the variation in altered food preferences after bariatric surgery not only include a physiological response to surgery but also social and psychological factors.

Overview of dietary assessment methods for measuring intakes of foods, beverages, and dietary supplements in research studies

Measuring the dietary intakes of individuals for research and monitoring purposes is notoriously challenging and is subject to both random and systematic measurement error. In this review, the strengths and limitations of current methods to assess dietary and supplemental exposures are described. Traditional methods of dietary assessment include food records, food frequency questionnaires, 24-hour recalls, and screening tools; digital and mobile methods that leverage technology are available for these traditional methods. Ultimately, the choice of assessment method is dependent upon the research question, the study design, sample characteristics, and the size of the sample, to name just a few. Despite their challenges, dietary assessment tools are an important dimension of nutrition research and monitoring.

Smartwatch-Based Eating Detection: Data Selection for Machine Learning from Imbalanced Data with Imperfect Labels

Understanding people's eating habits plays a crucial role in interventions promoting a healthy lifestyle. This requires objective measurement of the time at which a meal takes place, the duration of the meal, and what the individual eats. Smartwatches and similar wrist-worn devices are an emerging technology that offers the possibility of practical and real-time eating monitoring in an unobtrusive, accessible, and affordable way. To this end, we present a novel approach for the detection of eating segments with a wrist-worn device and fusion of deep and classical machine learning. It integrates a novel data selection method to create the training dataset, and a method that incorporates knowledge from raw and virtual sensor modalities for training with highly imbalanced datasets. The proposed method was evaluated using data from 12 subjects recorded in the wild, without any restriction about the type of meals that could be consumed, the cutlery used for the meal, or the location where the meal took place. The recordings consist of data from accelerometer and gyroscope sensors. The experiments show that our method for detection of eating segments achieves precision of 0.85, recall of 0.81, and F1-score of 0.82 in a person-independent manner. The results obtained in this study indicate that reliable eating detection using in the wild recorded data is possible with the use of wearable sensors on the wrist.

Effect of a Parent-Focused eHealth Intervention on Children's Fruit, Vegetable, and Discretionary Food Intake (Food4toddlers): Randomized Controlled Trial

Background

In Western countries, children’s diets are often low in fruits and vegetables and high in discretionary foods. Diet in early life tends to track through childhood and youth and even into adulthood. Interventions should, therefore, be delivered in periods when habitual traits are established, as in toddlerhood when children adapt to their family’s diet.

Objective

In this study, we assessed the effect of the Food4toddlers eHealth intervention, which aimed to enhance toddlers’ diets by shaping their food and eating environment.

Methods

The Food4toddlers randomized controlled trial was conducted in Norway in 2017-2018. Parent-child dyads were recruited through social media. In total, 298 parents completed an online questionnaire at baseline (mean child age 10.9 months, SD 1.2). Postintervention questionnaires were completed immediately after the intervention (ie, follow-up 1; mean child age 17.8 months, SD 1.3) and 6 months after the intervention (ie, follow-up 2; mean child age 24.2 months, SD 1.9). The intervention was guided by social cognitive theory, which targets the linked relationship between the person, the behavior, and the environment. The intervention group (148/298, 49.7%) got access to the Food4toddlers website for 6 months from baseline. The website included information on diet and on how to create a healthy food and eating environment as well as activities, recipes, and collaboration opportunities. To assess intervention effects on child diet from baseline to follow-up 1 and from baseline to follow-up 2, we used generalized estimating equations and a time × group interaction term. Between-group differences in changes over time for frequency and variety of fruits and vegetables and frequency of discretionary foods were assessed.

Results

At follow-up 1, a significant time × group interaction was observed for the frequency of vegetable intake (P=.02). The difference between groups in the change from baseline to follow-up 1 was 0.46 vegetable items per day (95% CI 0.06-0.86) in favor of the intervention group. No other significant between-group differences in dietary changes from baseline to follow-up 1 or follow-up 2 were observed. However, there is a clear time trend showing that the intake of discretionary foods increases by time from less than 1 item per week at baseline to more than 4 items per week at 2 years of age (P<.001), regardless of group.

Conclusions

A positive intervention effect was observed for the frequency of vegetable intake at follow-up 1 but not at follow-up 2. No other between-group effects on diet were observed. eHealth interventions of longer duration, including reminders after the main content of the intervention has been delivered, may be needed to obtain long-terms effects, along with tailoring in a digital or a personal form.

Trial Registration

International Standard Randomized Controlled Trial Number (ISRCTN) 92980420; https://doi.org/10.1186/ISRCTN92980420

The effects of gradual vs. rapid weight loss on serum concentrations of myokines and body composition in overweight and obese females

Context: Research has shown the modulations of Follistatin (FST) and Myostatin (MST) following weight loss.Objective: We evaluated the effects of gradual weight loss (GWL) and rapid weight loss (RWL) on serum MST, FST, and body composition in overweight and obese females.Materials and methods: Thirty-six overweight and obese females successfully completed the study interventions: GWL (n = 18) or RWL (n = 18). Serum MST and FST concentrations, as well as anthropometric measurements, were collected at baseline and at the conclusion of each weight loss intervention.Results: MST concentration significantly (p < .05) decreased in the GWL; while FST concentration, body fat percentage and skeletal muscle mass significantly declined in both conditions. The loss in skeletal muscle mass was significantly greater in RWL relative to GWL.Discussion and conclusion: GWL was more effective than RWL in preserving skeletal muscle mass in overweight and obese females. Moreover, GWL leads to declines in MST concentrations.

The Effects of a Nutrition Education Program on Dietary Intake and Biomarkers in HIV+ Adults

Background. People living with HIV (PLWH) have increased risk of cardiovascular disease (CVD). Dietary behavior modification may assist in the treatment of CVD, but the optimal dose of nutrition education is unknown. The current aim was to determine if a weekly 1-hour nutrition education program would improve multiple outcomes among PLWH. Methods. Participants (n = 62) were assessed on dietary intake, serum biomarkers, and physical characteristics at baseline and 3 months, and percent change was calculated. Participants were grouped into 3 attendance categories of the classes: none, fair, or good. Analyses of covariance were performed on the outcomes. Results. Calories, protein, fat, saturated fat, carbohydrate, sugar, added sugar, and glycemic load were significantly different (all P values <.05). Those who attended no class typically had increases in these variables versus those with fair or good attendance. High-density lipoprotein cholesterol (HDL-C; P = .006) and total cholesterol/HDL-C ratio ( P = .083) were different, as those who attended no class or had fair attendance worsened, but those with good attendance improved. Conclusions. Several outcomes improved more so among those with good class attendance versus those with either fair or no attendance. Thus, an interactive nutrition education program may be an effective tool to help improve the health of PLWH.

Starch digestibility modulation significantly improves glycemic variability in type 2 diabetic subjects: A pilot study

BACKGROUND AND AIMS

In type 2 diabetes (T2D) patients, the reduction of glycemic variability and postprandial glucose excursions is essential to limit diabetes complications, beyond HbA1c level. This study aimed at determining whether increasing the content of Slowly Digestible Starch (SDS) in T2D patients' diet could reduce postprandial hyperglycemia and glycemic variability compared with a conventional low-SDS diet.

METHODS AND RESULTS

For this randomized cross-over pilot study, 8 subjects with T2D consumed a controlled diet for one week, containing starchy products high or low in SDS. Glycemic variability parameters were evaluated using a Continuous Glucose Monitoring System. Glycemic variability was significantly lower during High-SDS diet compared to Low-SDS diet for MAGE (Mean Amplitude of Glycemic Excursions, p < 0.01), SD (Standard Deviation, p < 0.05), and CV (Coefficient of Variation, p < 0.01). The TIR (Time In Range) [140-180 mg/dL[ was significantly higher during High-SDS diet (p < 0.0001) whereas TIRs ≥180 mg/dL were significantly lower during High-SDS diet. Post-meals tAUC (total Area Under the Curve) were significantly lower during High-SDS diet.

CONCLUSION

One week of High-SDS Diet in T2D patients significantly improves glycemic variability and reduces postprandial glycemic excursions. Modulation of starch digestibility in the diet could be used as a simple nutritional tool in T2D patients to improve daily glycemic control. REGISTRATION NUMBER: in clinicaltrials.gov: NCT03289494.

A Pilot Study of Gut-Brain Signaling After Octreotide Therapy for Unintentional Weight Loss After Esophagectomy

BACKGROUND

Recurrence-free patients after esophageal cancer surgery face long-term nutritional consequences, occurring in the context of an exaggerated postprandial gut hormone response. Acute gut hormone suppression influences brain reward signaling and eating behavior. This study aimed to suppress gut hormone secretion and characterize reward responses and eating behavior among postesophagectomy patients with unintentional weight loss.

METHODS

This pilot study prospectively studied postoperative patients with 10% or greater body weight loss (BWL) beyond 1 year who were candidates for clinical treatment with long-acting octreotide (LAR). Before and after 4 weeks of treatment, gut hormone secretion, food cue reactivity (functional magnetic resonance imaging), eating motivation (progressive ratio task), ad libitum food intake, body composition, and symptom burden were assessed.

RESULTS

Eight patients (7 male, age: mean ± SD 62.8 ± 9.4 years, postoperative BWL: 15.5 ± 5.8%) participated. Octreotide LAR did not significantly suppress total postprandial plasma glucagon-like peptide-1 response at 4 weeks (P = .08). Postprandial symptom burden improved after treatment (Sigstad score median [range]: 12 [2-28] vs 8 [3-18], P = .04) but weight remained stable (pre: 68.6 ± 12.8 kg vs post: 69.2 ± 13.4 kg, P = .13). There was no significant change in brain reward system responses, during evaluation of high-energy or low-energy food pictures, nor their appeal rating. Moreover, treatment did not alter motivation to eat (P = .41) nor ad libitum food intake(P = .46).

CONCLUSION

The protocol used made it feasible to characterize the gut-brain axis and eating behavior in this cohort. Inadequate suppression of gut hormone responses 4 weeks after octreotide LAR administration may explain the lack of gut-brain pathway alterations. A higher dose or shorter interdose interval may be required to optimize the intervention.

Increased adiposity in children with obesity is associated with low red blood cell omega-3 fatty acid status and inadequate polyunsaturated fatty acid dietary intake

The association between total dietary fat intake and measures of body fatness in children with obesity remains inconsistent. This study aimed to determine whether dietary long-chain polyunsaturated fatty acids (LCPUFA) and LCPUFA status relate to body composition in children with obesity. Children (n = 63, 9.0 ± 0.2 year, BMI Z-score 3.1 ± 0.2) were divided into tertiles of percentage body fat assessed by dual-energy X-ray absorptiometry. Diet was assessed 3-days food diaries. Fatty acid proportions in red blood cells (RBC) were measured by gas chromatography. Data stratified by sex and Tanner stages were compared with a MIXED model ANOVA. Associations between RBC fatty acid status and dietary intakes were examined with Spearman correlation. Moderate correlations were observed between RBC eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) proportions, dietary EPA and DHA (r = 0.39, P < .05) as well as fish servings (r = 0.33, P < .05). Dietary LCPUFA did not differ among tertiles. Children in tertile 3 had lower RBC α-linolenic acid (-40%) and EPA + DHA (-15%) proportions adjusted for age, Tanner stages and race compared with tertile 1. The lower omega-3 LCPUFA status in children with greater adiposity is consistent with suboptimal intakes of omega-3 LCPUFA and fish in the diet.

Signaling pathways of dietary energy restriction and metabolism on brain physiology and in age-related neurodegenerative diseases

Several laboratory animal models have shown that dietary energy restriction (ER) can promote longevity and improve various health aspects in old age. However, whether the entire spectrum of ER-induced short- and long-term physiological and metabolic adaptions is translatable to humans remains to be determined. In this review article, we present recent evidence towards the elucidation of the impact of ER on brain physiology and in age-related neurodegenerative diseases. We also discuss modulatory influences of ER on metabolism and overall on human health, limitations of current experimental designs as well as future perspectives for ER trials in humans. Finally, we summarize signaling pathways and processes known to be affected by both aging and ER with a special emphasis on the link between ER and cellular proteostasis.

Displacing Sedentary Behaviour with Light Intensity Physical Activity Spontaneously Alters Habitual Macronutrient Intake and Enhances Dietary Quality in Older Females

Displacing Sedentary Behaviour (SB) with light intensity physical activity (LIPA) is increasingly viewed as a viable means of health enhancement. It is, however, unclear whether any behavioural compensations accompany such an intervention. Therefore, the aim of this study was to identify any dietary changes that accompany SB displacement. We hypothesised that SB displacement would improve dietary quality. Thirty-five elderly females (73 ± 5 years) were randomly allocated to one of three groups: (1) sedentary behaviour fragmentation (SBF) (n = 14), (2) continuous LIPA (n = 14), or (3) control (n = 7). Habitual diet (four-day food diary) and physical behaviour (accelerometery) were assessed at weeks 0 and 8. Out of 45 nutrients examined, only glucose exhibited a group × time interaction (p = 0.03), mediated by an exclusive reduction following SBF (-31%). SBF was also the sole experimental group to increase nutrients promoting bone health (SBF: 17%, LIPA: -34%. control: 21%), whereas both experimental groups consumed more nutrients promoting anabolism (SBF: 13%, LIPA: 4%, control: -34%) (z-scores). New ambulators (n = 8) also consumed more nutrients promoting bone health (16%)/anabolism (2%) (z-scores), including significantly increased Zinc intake (p = 0.05, 29%). Displacing SB with LIPA improves dietary quality in older females. Furthermore, SB fragmentation appears advantageous for various dietary outcomes.

Comparison of whole egg v. egg white ingestion during 12 weeks of resistance training on skeletal muscle regulatory markers in resistance-trained men

Eggs are considered a high-quality protein source for their complete amino acid profile and digestibility. Therefore, this study aimed to compare the effects of whole egg (WE) v. egg white (EW) ingestion during 12 weeks of resistance training (RT) on the skeletal muscle regulatory markers and body composition in resistance-trained men. Thirty resistance-trained men (mean age 24·6 (sd 2·7) years) were randomly assigned into the WE + RT (WER, n 15) or EW + RT (EWR, n 15) group. The WER group ingested three WE, while the EWR group ingested an isonitrogenous quantity of six EW per d immediately after the RT session. Serum concentrations of regulatory markers and body composition were measured at baseline and after 12 weeks. Significant main effects of time were observed for body weight (WER 1·7, EWR 1·8 kg), skeletal muscle mass (WER 2·9, EWR 2·7 kg), fibroblast growth factor-2 (WER 116·1, EWR 83·2 pg/ml) and follistatin (WER 0·05, EWR 0·04 ng/ml), which significantly increased (P < 0·05), and for fat mass (WER -1·9, EWR -1·1 kg), transforming growth factor-β1 (WER -0·5, EWR -0·1 ng/ml), activin A (WER -6·2, EWR -4·5 pg/ml) and myostatin (WER -0·1, EWR -0·06 ng/ml), which significantly decreased (P < 0·05) in both WER and EWR groups. The consumption of eggs absent of yolk during chronic RT resulted in similar body composition and functional outcomes as WE of equal protein value. EW or WE may be used interchangeably for the dietary support of RT-induced muscular hypertrophy when protein intake is maintained.

Gastric bypass in female rats lowers concentrated sugar solution intake and preference without affecting brief-access licking after long-term sugar exposure

In rodents, Roux-en-Y gastric bypass (RYGB) decreases intake of, and preference for, foods or fluids that are high in sugar. Whether these surgically induced changes are due to decreases in the palatability of sugar stimuli is controversial. We used RYGB and sham-operated (SHAM) female rats to test the influence of prolonged ingestive experience with sugar solutions on the motivational potency of these stimuli to drive licking in brief-access (BA) tests. In experiment 1, RYGB attenuated intake of, and caloric preference for, 0.3 M sucrose during five consecutive, 46-h two-bottle tests (TBTs; sucrose). A second series of TBTs (5 consecutive, 46-h tests) with 1.0 M sucrose revealed similar results, except fluid preference for 1.0 M sucrose also significantly decreased. Before, between, and after the two series of TBTs, two sessions of BA tests (30 min; 10-s trials) with an array of sucrose concentrations (0 and 0.01-1.0 M) were conducted. Concentration-dependent licking and overall trial initiation did not differ between surgical groups in any test. In a similar experimental design in a second cohort of female rats, 0.6 and 2.0 M glucose (isocaloric with sucrose concentrations in experiment 1) were used in the TBTs; 0 and 0.06-2.0 M glucose were used in the BA tests. Outcomes were similar to those for experiment 1, except RYGB rats initiated fewer trials during the BA tests. Although RYGB profoundly affected intake of, and caloric preference for, sugar solutions and, with high concentrations, fluid preference, RYGB never influenced the motivational potency of sucrose or glucose to drive concentration-dependent licking in BA tests.