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Aittola K, Karhunen L, Männikkö R, Järvelä-Reijonen E, Mikkonen S, Absetz P, Kolehmainen M, Schwab U, Harjumaa M, Lindström J, Lakka T, Tilles-Tirkkonen T, Pihlajamäki J. Enhanced Eating Competence Is Associated with Improved Diet Quality and Cardiometabolic Profile in Finnish Adults with Increased Risk of Type 2 Diabetes. Nutrients 2021; 13:nu13114030. [PMID: 34836283 PMCID: PMC8624442 DOI: 10.3390/nu13114030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 01/15/2023] Open
Abstract
Eating competence (EC) is characterized by positive attitudes towards food and eating, having regular meals, eating a variety of foods, and internally regulated eating. We investigated the associations of changes in EC with changes in lifestyle, anthropometrics and biomarkers of glucose and lipid metabolism in 2291 adults at increased risk of type 2 diabetes as part of the StopDia study conducted in primary healthcare. EC and diet quality were assessed with validated digital questionnaires. During the intervention, the participants received either (1) the digital lifestyle intervention, (2) the combined digital and face-to-face group-based lifestyle intervention, or (3) standard care. EC increased among the participants independent of the intervention type. Increase in EC was associated with an increase in diet quality, high-density lipoprotein (HDL) cholesterol, and with a decrease in body mass index and waist circumference, regardless of baseline EC. Of the subdomains of EC, the contextual skills, food acceptance and eating attitudes were associated with various of these changes. Our results thus suggest that EC could be a potential target in lifestyle interventions aiming to improve the cardiometabolic health of people at type 2 diabetes risk.
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Affiliation(s)
- Kirsikka Aittola
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland; (L.K.); (R.M.); (E.J.-R.); (P.A.); (M.K.); (U.S.); (T.T.-T.); (J.P.)
- Correspondence: ; Tel.: +358-50-5167269
| | - Leila Karhunen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland; (L.K.); (R.M.); (E.J.-R.); (P.A.); (M.K.); (U.S.); (T.T.-T.); (J.P.)
| | - Reija Männikkö
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland; (L.K.); (R.M.); (E.J.-R.); (P.A.); (M.K.); (U.S.); (T.T.-T.); (J.P.)
- Endocrinology and Clinical Nutrition, Department of Medicine, Kuopio University Hospital, 70029 Kuopio, Finland
| | - Elina Järvelä-Reijonen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland; (L.K.); (R.M.); (E.J.-R.); (P.A.); (M.K.); (U.S.); (T.T.-T.); (J.P.)
| | - Santtu Mikkonen
- Department of Applied Physics, University of Eastern Finland, 70211 Kuopio, Finland;
| | - Pilvikki Absetz
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland; (L.K.); (R.M.); (E.J.-R.); (P.A.); (M.K.); (U.S.); (T.T.-T.); (J.P.)
- Collaborative Care Systems Finland, 00270 Helsinki, Finland
| | - Marjukka Kolehmainen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland; (L.K.); (R.M.); (E.J.-R.); (P.A.); (M.K.); (U.S.); (T.T.-T.); (J.P.)
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland; (L.K.); (R.M.); (E.J.-R.); (P.A.); (M.K.); (U.S.); (T.T.-T.); (J.P.)
- Endocrinology and Clinical Nutrition, Department of Medicine, Kuopio University Hospital, 70029 Kuopio, Finland
| | - Marja Harjumaa
- VTT Technical Research Centre of Finland Ltd., 02044 Espoo, Finland;
| | - Jaana Lindström
- Department of Public Health and Welfare, National Institute for Health and Welfare, 00271 Helsinki, Finland;
| | - Timo Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland;
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, 70029 Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, 70100 Kuopio, Finland
| | - Tanja Tilles-Tirkkonen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland; (L.K.); (R.M.); (E.J.-R.); (P.A.); (M.K.); (U.S.); (T.T.-T.); (J.P.)
| | - Jussi Pihlajamäki
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland; (L.K.); (R.M.); (E.J.-R.); (P.A.); (M.K.); (U.S.); (T.T.-T.); (J.P.)
- Endocrinology and Clinical Nutrition, Department of Medicine, Kuopio University Hospital, 70029 Kuopio, Finland
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Dutheil F, Chaplais E, Vilmant A, Courteix D, Duche P, Abergel A, Pfabigan DM, Han S, Mobdillon L, Vallet GT, Mermillod M, Boudet G, Obert P, Izem O, Miolanne-Debouit M, Farigon N, Pereira B, Boirie Y. Stress management in obesity during a thermal spa residential programme (ObesiStress): protocol for a randomised controlled trial study. BMJ Open 2019; 9:e027058. [PMID: 31874865 PMCID: PMC7008425 DOI: 10.1136/bmjopen-2018-027058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Stress and obesity are two public health issues. The relationship between obesity and stress is biological through the actions of stress on the major hormones that regulate appetite (leptin and ghrelin). Many spa resorts in France specialise in the treatment of obesity, but no thermal spa currently proposes a specific programme to manage stress in obesity. The ObesiStress protocol has been designed to offer a new residential stress management programme. This thermal spa treatment of obesity implements stress management strategies as suggested by international recommendations. METHODS AND ANALYSIS 140 overweight or obese participants with a Body Mass Index of >25 kg/m2 and aged over 18 years will be recruited. Participants will be randomised into two groups: a control group of usual practice (restrictive diet, physical activity and thermal spa treatment) and an intervention group with stress management in addition to the usual practice. In the present protocol, parameters will be measured on five occasions (at inclusion, at the beginning of the spa (day 0), at the end of the spa (day 21), and at 6 and 12 months). The study will assess the participants' heart rate variability, cardiac remodelling and function, electrodermal activity, blood markers, anthropometric profile, body composition, psychology and quality of life via the use of questionnaires and bone parameters. ETHICS AND DISSEMINATION The ObesiStress protocol complies with the ethics guidelines for Clinical Research and has been approved by the ethics committee (CPP Sud-Est VI, Clermont-Ferrand - ANSM: 2016-A01774-47). This study aimed to highlight the efficacy of a 21-day thermal spa residential programme of stress management in obesity through objective measurements of well-being and cardiovascular morbidity. Results will be disseminated during several research conferences and articles published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03578757.
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Affiliation(s)
- Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Preventive and Occupational Medicine, WittyFit, Clermont-Ferrand, France
| | - Elodie Chaplais
- Université de Lorraine, Laboratory "Development, Adaption and Disability" (DevAH - EA 3450), Nancy, France
- University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Biostatistics Unit, Clinical research and Innovation Department (DRCI), Biostatistics, Clermont-Ferrand, France
| | - Audrey Vilmant
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Preventive and Occupational Medicine, WittyFit, Clermont-Ferrand, France
| | - Daniel Courteix
- Université Clermont Auvergne, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P - EA 3533), Clermont-Ferrand, France
| | - Pascale Duche
- Université de Toulon, Laboratory of Impact of Physical Activity on Health (IAPS), Toulon, France
| | - Armand Abergel
- Université Clermont Auvergne, CNRS, UMR 6284, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Hepatology Gastroenterology, Clermont-Ferrand, France
| | - Daniela M Pfabigan
- School of Psychological and Cognitive Sciences, PKU-IDG/McGovern Institute for Brain Research, Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Shihui Han
- School of Psychological and Cognitive Sciences, PKU-IDG/McGovern Institute for Brain Research, Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Laurie Mobdillon
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, Clermont-Ferrand, France
| | - Guillaume T Vallet
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, Clermont-Ferrand, France
| | - Martial Mermillod
- Université Grenoble Alpes, Université Savoie Mont Blanc, LPNC, CNRS, Grenoble, France
- Institut Universitaire de France, Paris, France
| | - Gil Boudet
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Preventive and Occupational Medicine, WittyFit, Clermont-Ferrand, France
| | - Philippe Obert
- Université d'Avignon, Laboratory of Cardiovascular Pharm-ecology (LaPEC EA4278), Avignon, France
| | - Omar Izem
- Université d'Avignon, Laboratory of Cardiovascular Pharm-ecology (LaPEC EA4278), Avignon, France
| | - Magalie Miolanne-Debouit
- University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Unit of Human Nutrition, Clermont-Ferrand, France
| | - Nicolas Farigon
- University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Unit of Human Nutrition, Clermont-Ferrand, France
| | - Bruno Pereira
- University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Biostatistics Unit, Clinical research and Innovation Department (DRCI), Biostatistics, Clermont-Ferrand, France
| | - Yves Boirie
- Université Clermont Auvergne, INRA, CRNH, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Unit of Human Nutrition, Clermont-Ferrand, France
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Cole RE, Meyer SA, Newman TJ, Kieffer AJ, Wax SG, Stote K, Madanat H. The My Body Knows When Program Increased Intuitive Eating Characteristics in a Military Population. Mil Med 2019; 184:e200-e206. [DOI: 10.1093/milmed/usy403] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 10/20/2018] [Indexed: 12/17/2022] Open
Abstract
Abstract
Introduction
The purpose of this pilot study was to assess the effectiveness of the revised My Body Knows When (MBKW) program to promote intuitive eating behaviors within a sample of a military population through an online or in-person delivery mode.
Materials and Methods
Fifty-six overweight or obese adults (70% female); military service members (20%), retirees (38%) and family (42%) participated in the 10-week MBKW program at two military installations from 2012 to 2014. Body Mass Index, Intuitive Eating Scale-2 (IES-2; 23-item) and Motivation for Eating scale (MFES; 43-item) were collected at baseline and 10-weeks. Data were stratified by sex. Descriptive data were reported as mean ± standard deviation (SD), frequency, or percentage. A paired t-test was conducted with data at baseline and 10 weeks (α = 0.05, 80% power).
Results
Participants were predominantly female (70%); mean age of 51 ± 13 years; and BMI of 34.1 ± 5.5 kg/m2. There were no demographic, MFES, or IES-2 baseline differences between groups (in-person vs. online) or location. All subjects were collapsed into one group for a pre-post MBKW implementation assessment due to small sample size despite the original intent to stratify by online and in-person grouping. At 10 weeks, the remaining 26 participants exhibited a significant improvement (mean ± SD) in BMI (−0.4 ± 0.6 kg/m2; p = 0.012), environmental/social eating score (2.7 ± 0.4 points [pts]; −0.5 pt change; p < 0.001), emotional eating score (2.2 ± 0.5 pts; −0.6 pt change; p = 0.001), unconditional permission to eat score (3.4 ± 0.4 pts; +0.3 pt change; p = 0.017), eating for physical rather than emotional eating score (3.7 ± 0.8 pts; +1.0 pt change; p < 0.001), and reliance on hunger and satiety cues score (3.6 ± 0.5 pts; +0.8 pt change; p = 0.001). High attrition rates at the 10-week follow-up assessment precluded accurate assessment of long-term intervention effects.
Conclusions
The MBKW program was associated with improved intuitive eating behaviors and with less external eating influence on behavior; however, a larger sample is required to assess the effectiveness of MBKW delivery mode. Modest weight loss was attained but testing the efficacy of the MBKW program in a large diverse sample with alternate scenarios may be worthwhile (e.g., primary prevention against weight gain, or during weight maintenance to prevent weight regain).
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Affiliation(s)
- Renee E Cole
- U.S. Military-Baylor Graduate Program in Nutrition, AMEDD C&S, HRCoE, 3599 Winfield-Scott Rd, JBSA-Fort Sam Houston, TX
| | - Stephanie A Meyer
- U.S. Military-Baylor Graduate Program in Nutrition, AMEDD C&S, HRCoE, 3599 Winfield-Scott Rd, JBSA-Fort Sam Houston, TX
| | - Taylor J Newman
- U.S. Military-Baylor Graduate Program in Nutrition, AMEDD C&S, HRCoE, 3599 Winfield-Scott Rd, JBSA-Fort Sam Houston, TX
- Army Specialist Corps Office of the Chief, 3630 Stanley Road, Suite 276, JBSA-Fort Sam Houston, TX
| | - Adam J Kieffer
- U.S. Military-Baylor Graduate Program in Nutrition, AMEDD C&S, HRCoE, 3599 Winfield-Scott Rd, JBSA-Fort Sam Houston, TX
| | - Sarah G Wax
- U.S. Military-Baylor Graduate Program in Nutrition, AMEDD C&S, HRCoE, 3599 Winfield-Scott Rd, JBSA-Fort Sam Houston, TX
- Moncrief Army Health Clinic, 4500 Stuart St, Fort Jackson, SC
| | - Kim Stote
- Health Sciences, State University of New York, Empire State College, 113 West Ave, Saratoga Springs, NY
| | - Hala Madanat
- Graduate School of Public Health, San Diego State University, 5000 Campanile Dr, MC 4162, San Diego, CA
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