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Bailey CP, Boyd P, Shams-White MM, Czajkowski SM, Nebeling L, Reedy J, O’Connor SG. Time-Restricted Eating in Community-Dwelling Adults: Correlates of Adherence and Discontinuation in a Cross-Sectional Online Survey Study. J Acad Nutr Diet 2023:S2212-2672(23)01760-4. [PMID: 38110176 PMCID: PMC11180216 DOI: 10.1016/j.jand.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 11/15/2023] [Accepted: 12/13/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Time-restricted eating (TRE), a type of intermittent fasting in which all daily calories are consumed within a window of ≤12 hours, is hypothesized to promote long-term weight management because of its relative simplicity. OBJECTIVE This study reports correlates of adherence among community-dwelling adults currently or formerly following a TRE dietary strategy. DESIGN A 25-minute cross-sectional online survey was developed, including questions about TRE perceptions, behaviors, motivators and drivers, and demographics. The survey was administered in February 2021 via Prolific, an online platform for sample recruitment and survey dissemination. PARTICIPANTS Eligibility criteria included US adult ages 18+ who currently or formerly (past 3 months) followed TRE (ie, consumed all daily calories within a window of ≤12 hours) for a minimum of 1 week. STATISTICAL ANALYSES χ2 tests and analysis of covariance (ANCOVA; adjusting for sex and age) compared responses between current and former followers. RESULTS Current followers (n = 296, mean [SD]: 34.2 ± 12.2y) were older than former followers (n = 295, mean [SD]: 31.1 ± 10.9 y) and practiced TRE for longer (median: 395 vs 90 days, P < 0.001). Current followers reported more success with meeting TRE goals (P ≤ 0.015), were less likely to report TRE concerns (P < 0.001), and more likely to report TRE satisfaction (P < 0.001). Four TRE motivators were more important among current (vs former) followers: weight maintenance, health (not weight), improved sleep, and preventing disease (P ≤ 0.017); weight loss was more important among former (vs current) followers (P = 0.003). Among adherence drivers, ability to work from home and the impact of COVID-19 were reported as more helpful for TRE adherence among current compared with former followers (P ≤ 0.028). CONCLUSIONS TRE motivators and drivers differed between current and former followers; interventions tailored to individuals' preferences and circumstances may benefit TRE adherence.
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Affiliation(s)
- Caitlin P. Bailey
- The George Washington University Milken Institute School of Public Health, Washington, D.C., USA | Behavioral Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Patrick Boyd
- Division of Cancer Control & Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Marissa M. Shams-White
- Division of Cancer Control & Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Susan M. Czajkowski
- Division of Cancer Control & Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Linda Nebeling
- Division of Cancer Control & Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Jill Reedy
- Division of Cancer Control & Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Sydney G. O’Connor
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, MD, USA
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Barrett AC, Johnson KP, Halabi ME, Parkman HP. Meal-eating characteristics among patients with symptoms of gastroparesis: Relationships to delays in gastric emptying. Neurogastroenterol Motil 2023; 35:e14661. [PMID: 37639226 DOI: 10.1111/nmo.14661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/16/2023] [Accepted: 07/31/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND Patients with symptoms of gastroparesis (Gp) often modify their diets and consume small meals. However, the relationship between patients' eating behavior and their gastric emptying is not well understood. This study describes meal-eating characteristics of patients with Gp symptoms and relates them to severity of emptying delay. METHODS Adult patients with Gp symptoms underwent 4-h gastric emptying scintigraphy and completed questionnaires including the Patient Assessment of GI Symptoms, a nutrition and diet questionnaire, and the Meal Patterns Questionnaire. KEY RESULTS Of 119 patients with Gp symptoms, 35 had normal gastric emptying (≤10% gastric retention at 4 h), 26 mildly delayed (>10%-20%), 28 moderately delayed (>20%-35%), and 30 severely delayed (>35%). Most patients (85%) reported eating small meals with an average of 2.4 meals per day. The most common reasons for stopping eating a meal were feeling full (83%), nausea (46%), and abdominal pain (31%). As gastric emptying worsened, patients increasingly made diet modifications such as low-fat, low-fiber, Gp diet, oral supplements, and blenderized meals (r = 0.309, p = 0.0007). Postprandial fullness lasted for 351 ± 451 min for patients with severely delayed emptying versus 207 ± 173 min for patients with normal emptying (p = 0.19). CONCLUSIONS & INFERENCES Meal-eating characteristics were found to vary with severity of gastric retention. Patients with severely delayed gastric emptying reported the longest duration of postprandial fullness. Dietary modification increased significantly with gastric retention. These meal-eating characteristics are important to understand as they impact on dietary education given to Gp patients for symptom management.
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Affiliation(s)
- Alexandra C Barrett
- Section of Gastroenterology, Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Kathleen P Johnson
- Section of Gastroenterology, Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Maan El Halabi
- Section of Gastroenterology, Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Henry P Parkman
- Section of Gastroenterology, Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, USA
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Reister EJ, Mattes RD. No apparent effects of a viscous, superabsorbent hydrogel on appetite, energy intake, or fecal excretion in overweight adults. Physiol Behav 2022; 243:113643. [PMID: 34767836 DOI: 10.1016/j.physbeh.2021.113643] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 10/19/2022]
Abstract
As the obesity epidemic continues, there is a great need for safe and effective weight loss aids. A superabsorbent hydrogel device administered as a capsule demonstrates potential for weight loss, but its mechanism of action remains unclear. The present study's goal was to determine the mechanisms of action of the hydrogel through the investigation of its effects on appetitive sensations, eating behavior, energy intake, and fecal excretion of energy. Overweight and obese adults (n = 18) participated in a double-blind, randomized, crossover-design study in which they were provided all meals for a week in a supervised setting (i.e., controlled-feeding) and were required to either consume the hydrogel or a placebo with 16-oz of water 20 min before lunch and dinner. No differences in appetite (all, p > 0.05), total fecal nitrogen excretion (p = 0.74), total fecal fat excretion (p = 0.54), or total fecal energy excretion (p = 0.76) were identified when comparing the hydrogel to a placebo. Affect towards food (i.e., mood, emotions) was more positive in the hydrogel group compared with the placebo group. A subset of the controlled-feeding group (n = 10) then participated in another double-blind, randomized, crossover-design study in which they provided their own food for a week (i.e., free-feeding) and were required to either consume the hydrogel or a placebo with 16-oz of water 20 min before lunch and dinner. No differences in appetite (all, p > 0.05), energy intake (p = 0.95), diet quality (all, p > 0.05), or eating behavior (all, p > 0.05) were determined when comparing the hydrogel to the placebo. Future studies with greater statistical power should confirm these findings and investigate other potential mechanisms of action of the hydrogel.
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Affiliation(s)
- Evan J Reister
- Department of Nutrition Science, Ingestive Behavior Research Center, Purdue University, 700W State Street, West Lafayette, IN 47907-2059, USA
| | - Richard D Mattes
- Department of Nutrition Science, Ingestive Behavior Research Center, Purdue University, 700W State Street, West Lafayette, IN 47907-2059, USA.
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The Personal Food Systems of Pre-Season NCAA Division 1 High-Contact, Low-Contact, and Non-Contact College Athletes. Nutrients 2021; 13:nu13113670. [PMID: 34835926 PMCID: PMC8623026 DOI: 10.3390/nu13113670] [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: 09/16/2021] [Revised: 10/06/2021] [Accepted: 10/12/2021] [Indexed: 11/17/2022] Open
Abstract
Previous research indicates that dietary habits may differ between athletes of different sports. In this cross-sectional study, we hypothesize meal frequency, food choices, and food preferences will significantly differ between contact types. The participants were athletes (n = 92; men: n = 57, body fat percent (BF%): 14.8 ± 8.4%, body mass index (BMI): 25.5 ± 5.5 kg·m-2; women: n = 36, BF%: 26.7 ± 7.3%, BMI: 22.3 ± 2.7 kg·m-2) from high-contact (HCS), low-contact (LCS), and non-contact (NCS) sports. Meal frequency, food preference, and food choice questionnaires assessed factors influencing dietary habits. Dual-energy X-ray absorptiometry (DXA) measured lean body mass, fat mass, and body fat. A GLM multivariate analysis was used with significance accepted at p < 0.05. Significant body composition differences were observed between genders (p < 0.001) and among sports (p < 0.001). Dinner (83.7%), lunch (67.4%), and breakfast (55.4%) were the most frequently eaten meals, followed by evening snack (17.8%), afternoon snack (15.2%), and morning snack (8.7%). Greater preferences for starches were observed for HCS (p = 0.04; η2 = 0.07) and for a greater preference for vegetables was found for NCS (p = 0.02; η2 = 0.09). Significant differences also existed in the importance of health (p = 0.04; η2 = 0.07), weight control (p = 0.05; η2 = 0.11), natural content (p = 0.04; η2 = 0.07), and price (p = 0.04; η2 = 0.07). These results support our hypothesis that food choices and food preferences differ between contact types. This may help sports dieticians create more individualized nutrition programs.
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Rynders CA, Thomas EA, Zaman A, Pan Z, Catenacci VA, Melanson EL. Effectiveness of Intermittent Fasting and Time-Restricted Feeding Compared to Continuous Energy Restriction for Weight Loss. Nutrients 2019; 11:nu11102442. [PMID: 31614992 PMCID: PMC6836017 DOI: 10.3390/nu11102442] [Citation(s) in RCA: 175] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/27/2019] [Accepted: 10/05/2019] [Indexed: 12/22/2022] Open
Abstract
The current obesity epidemic is staggering in terms of its magnitude and public health impact. Current guidelines recommend continuous energy restriction (CER) along with a comprehensive lifestyle intervention as the cornerstone of obesity treatment, yet this approach produces modest weight loss on average. Recently, there has been increased interest in identifying alternative dietary weight loss strategies that involve restricting energy intake to certain periods of the day or prolonging the fasting interval between meals (i.e., intermittent energy restriction, IER). These strategies include intermittent fasting (IMF; >60% energy restriction on 2-3 days per week, or on alternate days) and time-restricted feeding (TRF; limiting the daily period of food intake to 8-10 h or less on most days of the week). Here, we summarize the current evidence for IER regimens as treatments for overweight and obesity. Specifically, we review randomized trials of ≥8 weeks in duration performed in adults with overweight or obesity (BMI ≥ 25 kg/m2) in which an IER paradigm (IMF or TRF) was compared to CER, with the primary outcome being weight loss. Overall, the available evidence suggests that IER paradigms produce equivalent weight loss when compared to CER, with 9 out of 11 studies reviewed showing no differences between groups in weight or body fat loss.
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Affiliation(s)
- Corey A Rynders
- Department of Medicine, Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
- Eastern Colorado Veterans Affairs Geriatric Research, Education, and Clinical Center, Denver, CO 80045, USA.
| | - Elizabeth A Thomas
- Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
| | - Adnin Zaman
- Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
| | - Zhaoxing Pan
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
| | - Victoria A Catenacci
- Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
| | - Edward L Melanson
- Department of Medicine, Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
- Eastern Colorado Veterans Affairs Geriatric Research, Education, and Clinical Center, Denver, CO 80045, USA.
- Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
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