Preoccupation with Body Weight and Under-Reporting of Energy Intake in Female Japanese Nutrition Students

The Impact of Weight Bias and Stigma on the 24 h Dietary Recall Process in Adults with Overweight and Obesity: A Pilot Study

People with overweight and obesity tend to both underreport dietary energy intake and experience weight stigma. This exploratory pilot study aimed to determine the relationship between weight bias and weight stigma and energy intake reporting accuracy. Thirty-nine weight-stable adults with BMI ≥ 25 completed three 24 h dietary recalls; indirect calorimetry to measure resting metabolic rate; a survey measuring weight stigma, psychosocial constructs, and physical activity; and a semi-structured qualitative interview. Multiple linear regression was used to determine if weight bias internalization, weight bias toward others, and experiences of weight stigma were predictive of the accuracy of energy reporting. A thematic analysis was conducted for the qualitative interviews. Weight stigma was reported by 64.1% of the sample. Weight stigma constructs did not predict the accuracy of energy intake reporting. People with obesity underreported by a mean of 477 kcals (p = 0.02). People classified as overweight overreported by a mean of 144 kcals, but this was not significant (p = 0.18). Participants reported a desire to report accurate data despite concerns about reporting socially undesirable foods. Future research should quantify the impact of weight stigma on energy reporting in 24 h recalls using a larger, more diverse sample size and objective measures like doubly labeled water for validation.

Relationship between underreporting of energy intake and blood ketone levels in Japanese women with obesity: A retrospective study

Underreporting is a problem in dietary surveys, and data on Japanese individuals with obesity are lacking. In addition, in dietary surveys of individuals with obesity, underreporting and extreme energy restrictive practices for short periods of time have been reported, and blood total ketone levels (ketone bodies) may be able to distinguish between these factors. The present study aimed to examine the relationship between underreporting [energy intake (EI)/basal metabolic rate estimate (BMR)] and ketone bodies in obese Japanese women. The participants included 91 women with obesity aged 47±9 years with a body mass index (BMI) of 29.8±3.9 kg/m² who met the exclusion criteria out of 164 individuals who participated in an institutional cohort study baseline survey between September 2006 and September 2015. The current study defined the relationship between EI/BMR, BMI and the participants' ketone body levels. EI/BMR <1.35 and ketone body level <1.0 mmol/l was defined as underreporters, while EI/BMR <1.35 and ketone body level ≥1.0 mmol/l was defined as energy-restricted reporters based on previous research. The EI/BMR of the participants was 1.44±0.32, and 25.3% had an abnormally high level of ketone bodies. Multiple regression analysis indicated that ketone bodies were explanatory variables for EI/BMR. Analysis using EI/BMR and ketone bodies estimated that 26.4% were underreporters and 12.1% were energy-restricted reporters. There were no significant differences in reported energy intake, carbohydrate intake (g/day), and percentage carbohydrate (%) between the underreporters and energy-restricted reporters. In conclusion, low EI/BMR was associated with high ketone body levels in Japanese women with obesity. The combination of EI/BMR and ketone bodies may distinguish between or screen for underreporters and energy-restricted reporters during a dietary survey.

Mediterranean Diet, a Posteriori Dietary Patterns, Time-Related Meal Patterns and Adiposity: Results from a Cross-Sectional Study in University Students

The transition to university is connected to potentially obesogenic dietary changes. Our aim was to assess the relation of Mediterranean diet adherence, and a posteriori dietary and meal patterns with adiposity in Greek students at the University of the Peloponnese. A total of 346 students (269 women) participated. Anthropometry was performed, and a food frequency questionnaire was administered. The MedDietScore was higher in women and was not linearly related to adiposity. Principal component analysis revealed six patterns: (1) legumes/vegetables/fruits/tea/dairy/whole grains, (2) juice/sodas/liquid calories, (3) olive oil/fats, (4) meat/poultry/fish, (5) alcohol/eggs/dairy and (6) fast foods/sweets. Patterns 4 and 6 were related to overweight/obesity probability (OR = 1.5, 95% CI: 0.995-2.538 and OR = 2.5, 95% CI: 1.07-6.06, respectively) and higher waist circumference (men). Men "early eaters" (breakfast/morning/afternoon snack) had a higher MedDietScore and lower overweight probability (OR = 0.47, 95% CI: 0.220-1.020). Poor meal and dietary patterns relate to overweight and central obesity, which is important for targeted health promotion programs.

Relationship between body mass index and masticatory factors evaluated with a wearable device

Numerous studies have evaluated the relationship between eating behavior and obesity, however few studies have objectively assessed eating behavior. Additionally, the association of masticatory behaviors with masticatory performance remains unclear. This study aimed to verify the relationship between masticatory performance and behavior measured by a wearable masticatory counter, and BMI. 365 healthy adults participated. Mastication behaviors, i.e. number of chews and bites, chewing rate, and chewing time, were measured using wearable masticatory counter while consuming one rice ball (100 g). Masticatory performance was evaluated using testing gummy jelly. Lifestyle habits including exercise, walking, and breakfast, were surveyed by questionnaire. The correlation coefficients between masticatory behaviors and performance and BMI were analyzed. Furthermore, multiple regression analysis was performed. The number of chews showed positive correlation with chewing rate, number of bites and chewing time, but no correlation with masticatory performance. BMI had weak but significant negative correlation with number of chews, bites, chewing time, and masticatory performance, but had no correlation with chewing rate. Multiple regression analysis revealed that BMI was associated with sex, age, number of chews, bites, masticatory performance, and walking speed. In conclusion, masticatory behavior and performance were not interrelated, but both were independently associated with BMI weakly.

Impact of Inadequate Calorie Intake on Mortality and Hospitalization in Stable Patients with Chronic Heart Failure

Malnutrition is highly prevalent in patients with heart failure (HF), but the precise impact of dietary energy deficiency on HF patients' clinical outcomes is not known. We investigated the associations between inadequate calorie intake and adverse clinical events in 145 stable outpatients with chronic HF who had a history of hospitalization due to worsening HF. To assess the patients' dietary pattern, we used a brief self-administered diet-history questionnaire (BDHQ). Inadequate calorie intake was defined as <60% of the estimated energy requirement. In the total chronic HF cohort, the median calorie intake was 1628 kcal/day. Forty-four patients (30%) were identified as having an inadequate calorie intake. A Kaplan-Meier analysis revealed that the patients with inadequate calorie intake had significantly worse clinical outcomes including all-cause death and HF-related hospitalization during the 1-year follow-up period versus those with adequate calorie intake (20% vs. 5%, p < 0.01). A multivariate logistic regression analysis showed that inadequate calorie intake was an independent predictor of adverse clinical events after adjustment for various factors that may influence patients' calorie intake. Among patients with chronic HF, inadequate calorie intake was associated with an increased risk of all-cause mortality and rehospitalization due to worsening HF. However, our results are preliminary and larger studies with direct measurements of dietary calorie intake and total energy expenditure are needed to clarify the intrinsic nature of this relationship.

Cross-Sectional Survey of Graduate Clinical Nutrition Students Describing Dietary Choices and Recommendations

Objectives: Little data exists describing the dietary habits of nutrition students, including whether students' personal dietary choices influence their clinical recommendations. Study objectives were to: (1) Identify common dietary choices made by nutrition students, (2) determine students' rationale for choosing or avoiding specific diets, (3) identify key factors used to make dietary recommendations.Methods: An anonymous online survey was distributed to graduate-level clinical nutrition students who were attending five American universities. Data collected included demographics, current diet, reasons for following the current diet, reasons for recommending diets, and degree completion status. Percentage of diets chosen and rationale for dietary decisions were compared. Diets chosen and recommended were stratified and compared by degree completion status via chi-square test.Results: 208 participants completed the survey. The top diets students reported following were Whole Foods/Unprocessed (49%) and Gluten-Free (16%), followed by Vegan/Vegetarian (13%) and Paleo (12.5%). The top reasons identified for choosing a personal diet were health optimization and food allergy/intolerance/sensitivity. The top factors used to make dietary recommendations were clients' preferences/resources and results of laboratory testing. A Whole Foods/Unprocessed diet was also selected by the largest proportion of students as one they would recommend to clients-97% of students early in their program and 98.3% of students late in their program would recommend it to a client.Conclusion: A Whole Foods/Unprocessed diet was the most followed diet and the one most likely to be recommended to future clients, irrespective of students' degree completion progress.

Characterization, Nutrient Intake, and Nutritional Status of Low-Income Students Attending a Brazilian University Restaurant

In Brazilian universities, the university restaurant (UR) is essential in supporting students to complete their courses, as the UR offers free or low-cost food. In this sense, this research aimed to evaluate public policy effectiveness in offering food to low-income students attending the UR of the University of Brasília. This cross-sectional study compared low-income students (participating in the Student Assistance Program—Group 1) and students that did not participate in the Program (Group 2). Researchers assessed food consumption through direct observation of students while serving their plates at UR (in all meals consumed at UR) and completed food consumption with diet recalls for the meals outside the UR. In total, three complete days, including one weekend day, were evaluated for each student. Researchers also evaluated the participants’ body mass composition and body fat percentage. The results of the comparisons between the evaluated groups showed that the groups presented similar intakes. Only sodium intake was significantly different for males, being higher for Group 1. The median sodium consumption among females and males in group 1 was 55% and 119%, respectively, above the upper limit (UL). In Group 2, sodium intake levels reached consumption percentages above UL by 36% for females and 79% for males. The prevalence of inadequate sodium consumption was 100% for both genders and groups. Extra salt was added to dishes by 19.7% of the students. For females, only fiber ingestion was statistically different, with higher intake for Group 1. The other evaluated parameters showed similarities among groups for each gender. The statistical analysis revealed a significant difference in the consumption of calories, fibers, sodium, iron, and calcium for the students who had three meals at the UR in the two weekdays. There was a statistical difference in nutrients for those who had three meals in the UR, reinforcing the importance of the UR’s meals. The current food and nutrition policy at the UR proved to be extremely important in university students’ lives and in maintaining healthy nutritional aspects. However, changes in sodium use, more calcium intake, and less cholesterol consumption should receive attention to better balance dietary elements of the food offered. Dish preparation should be carefully followed to ensure the quality of the food for university students.