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Teixeira B, Oliveira A, Poinhos R, Afonso C. Adolescents' Perceptions About Healthy and Sustainable Diets: A Qualitative School-Based Study in Portugal. Ecol Food Nutr 2024; 63:387-405. [PMID: 38836632 DOI: 10.1080/03670244.2024.2363893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
In this qualitative study, we explored Portuguese adolescents' perceptions of diet, sustainability, and health through six focus group discussions (FGDs). Fifty-five adolescents (10-18 years) participated. FGDs focused on sustainability in food choices and its health impact, with our primary interest in their perceptions. Results showed a limited comprehension of "sustainable/sustainability," especially among younger participants. Those aware of sustainability recognized its diverse aspects, including health, economic, and ecological domains. Some adolescents recognized the link between health and sustainability in their diets, emphasizing the need for food literacy. These findings emphasize the importance of public health and sustainable policies among Portuguese adolescents.
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Affiliation(s)
- Beatriz Teixeira
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), [Laboratory for Integrative and Translational Research in Population Health (ITR)], Porto, Portugal
| | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), [Laboratory for Integrative and Translational Research in Population Health (ITR)], Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Rui Poinhos
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Claudia Afonso
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), [Laboratory for Integrative and Translational Research in Population Health (ITR)], Porto, Portugal
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Gozukara Bag HG, Yagin FH, Gormez Y, González PP, Colak C, Gülü M, Badicu G, Ardigò LP. Estimation of Obesity Levels through the Proposed Predictive Approach Based on Physical Activity and Nutritional Habits. Diagnostics (Basel) 2023; 13:2949. [PMID: 37761316 PMCID: PMC10529319 DOI: 10.3390/diagnostics13182949] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/04/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Obesity is the excessive accumulation of adipose tissue in the body that leads to health risks. The study aimed to classify obesity levels using a tree-based machine-learning approach considering physical activity and nutritional habits. Methods: The current study employed an observational design, collecting data from a public dataset via a web-based survey to assess eating habits and physical activity levels. The data included gender, age, height, weight, family history of being overweight, dietary patterns, physical activity frequency, and more. Data preprocessing involved addressing class imbalance using Synthetic Minority Over-sampling TEchnique-Nominal Continuous (SMOTE-NC) and feature selection using Recursive Feature Elimination (RFE). Three classification algorithms (logistic regression (LR), random forest (RF), and Extreme Gradient Boosting (XGBoost)) were used for obesity level prediction, and Bayesian optimization was employed for hyperparameter tuning. The performance of different models was evaluated using metrics such as accuracy, recall, precision, F1-score, area under the curve (AUC), and precision-recall curve. The LR model showed the best performance across most metrics, followed by RF and XGBoost. Feature selection improved the performance of LR and RF models, while XGBoost's performance was mixed. The study contributes to the understanding of obesity classification using machine-learning techniques based on physical activity and nutritional habits. The LR model demonstrated the most robust performance, and feature selection was shown to enhance model efficiency. The findings underscore the importance of considering both physical activity and nutritional habits in addressing the obesity epidemic.
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Affiliation(s)
- Harika Gozde Gozukara Bag
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya 44280, Turkey;
| | - Fatma Hilal Yagin
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya 44280, Turkey;
| | - Yasin Gormez
- Department of Management Information Systems, Faculty of Economics and Administrative Sciences, Sivas Cumhuriyet University, Sivas 58140, Turkey;
| | - Pablo Prieto González
- Sport Sciences and Diagnostics Research Group, GSD-HPE Department, Prince Sultan University, Riyadh 11586, Saudi Arabia;
| | - Cemil Colak
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya 44280, Turkey;
| | - Mehmet Gülü
- Department of Sports Management, Faculty of Sport Sciences, Kirikkale University, Kirikkale 71450, Turkey;
| | - Georgian Badicu
- Department of Physical Education and Special Motricity, Transilvania University of Brasov, 00152 Brasov, Romania;
| | - Luca Paolo Ardigò
- Department of Teacher Education, NLA University College, Linstows Gate 3, 0166 Oslo, Norway;
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3
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Poklar Vatovec T, Jenko Pražnikar Z, Petelin A. Adherence and Sociodemographic Determinants of Adherence to the Mediterranean Diet among Slovenian Adults and the Elderly. Nutrients 2023; 15:3219. [PMID: 37513637 PMCID: PMC10384731 DOI: 10.3390/nu15143219] [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: 06/14/2023] [Revised: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
The Mediterranean diet (MD) is considered a model for good health, and is promoted worldwide as one of the healthiest dietary patterns. Despite the MD's health benefits, the literature suggests that adherence to the MD tends to be in decline in most populations worldwide, including those in the Mediterranean region. The aim of this study was to investigate adherence to the MD, and its main sociodemographic and lifestyle factors, in the Slovenian population. Using a nationwide cross-sectional food consumption survey (SI.Menu), data were collected from a general questionnaire, from the 14-item MD adherence screener (14-MEDAS score), and from a questionnaire on the dietary habits of 850 adults and elderly people. The mean MEDAS score for the total study sample was 5.6 (SD 2.1), indicating a low adherence to the MD among the Slovenian population. The adherence to the MD was higher among women (OR = 1.534; 95% Cl 1.156-2.034), those with a university degree (OR = 1.527; 1.098-2.125; compared to those with no university degree), those who lived in a suburb or city (OR = 1.511; 1.016-2.249; OR = 1.568; 1.122-2.191; compared with those who lived in a village), non-smokers (OR = 1.561; 1.380-1.830; compared with smokers), and those who lived in the western part of Slovenia (OR = 1.558; 1.170-2.074; compared with those who lived in eastern Slovenia). Adherence to the MD in the Slovenian population is low, and is strongly related to educational level, gender, geographic region, place of residence, and smoking status. The frequency of the consumption of different food groups is also closely related.
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Affiliation(s)
- Tamara Poklar Vatovec
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia
| | - Zala Jenko Pražnikar
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia
| | - Ana Petelin
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia
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Dimopoulou M, Vareltzis P, Floros S, Androutsos O, Bargiota A, Gortzi O. Development of a Functional Acceptable Diabetic and Plant-Based Snack Bar Using Mushroom ( Coprinus comatus) Powder. Foods 2023; 12:2702. [PMID: 37509794 PMCID: PMC10379996 DOI: 10.3390/foods12142702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Consumers' growing concern about health and well-being has led to increased interest in functional foods. This research aims to evaluate the physicochemical and antioxidant properties of a functional plant-based (PB) snack bar enriched with Coprinus comatus powder. The snack bar formulations exhibited a wide range of flavor and textural characteristics. Two PB snack bars and four commercial bars were evaluated by a consumer panel of healthy volunteers (n = 20). The PB snack bar scored 'like extremely' on the 9-point hedonic scale. External preference mapping determined that sweetness, flavors, cohesiveness, gumminess, and adhesion had the greatest influence on consumer acceptability. Water content, ash, protein, fat, carbohydrate, reducing sugar, resistant starch, and dietary fiber were measured. Nutritional content was enhanced (omega 3, fiber and protein), and samples were shelf life stable (aw < 0.29; moisture content < 10%). In addition, the PB snack bar underwent simulated digestion according to the INFOGEST protocol, and from the comparative evaluation, the PB snack can be seen to control the post-prandial glycemic responses, as observed by the different degree of reducing sugars released via the matrix. The PB snack bar can be further functionally enhanced by the addition of their unique ingredients such as Coprinus comatus. Coprinus comatus powder is claimed to benefit glycemic control in diabetes and has attracted growing interest in terms of its potential use in natural products with possible health benefits.
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Affiliation(s)
- Maria Dimopoulou
- Department of Agriculture Crop Production and Rural Environment, School of Agricultural Sciences, University of Thessaly, 38446 Volos, Greece;
| | - Patroklos Vareltzis
- Laboratory of Food and Agricultural Industries Technologies, Chemical Engineering Department, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (P.V.); (S.F.)
| | - Stylianos Floros
- Laboratory of Food and Agricultural Industries Technologies, Chemical Engineering Department, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (P.V.); (S.F.)
| | - Odysseas Androutsos
- Lab of Clinical Nutrition and Dietetics (CND-Lab), Department of Nutrition & Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece;
| | - Alexandra Bargiota
- Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, School of Health Sciences, University Hospital of Larissa, University of Thessaly, 41334 Larissa, Greece
| | - Olga Gortzi
- Department of Agriculture Crop Production and Rural Environment, School of Agricultural Sciences, University of Thessaly, 38446 Volos, Greece;
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Lee M, Bradbury J, Yoxall J, Sargeant S. Is dietary quality associated with depression? An analysis of the Australian longitudinal study of women's health data. Br J Nutr 2022; 129:1-8. [PMID: 35894291 PMCID: PMC10024974 DOI: 10.1017/s0007114522002410] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/14/2022] [Accepted: 07/21/2022] [Indexed: 11/06/2022]
Abstract
Depression is a chronic and complex condition experienced by over 300 million people worldwide. While research on the impact of nutrition on chronic physical illness is well documented, there is growing interest in the role of dietary patterns for those experiencing symptoms of depression. This study aims to examine the association of diet quality (Dietary Questionnaire for Epidemiological Studies version 2) and depressive symptoms (Centre for Epidemiological Studies for Depression short form) of young Australian women over 6 years at two time points, 2003 (n 9081, Mean age = 27·6) and 2009 (n 8199, Mean age = 33·7) using secondary data from the Australian Longitudinal Study on Women's Health. A linear mixed-effects model found a small and significant inverse association of diet quality on depressive symptoms (β = -0·03, 95 % CI (-0·04, -0·02)) after adjusting for covarying factors such as BMI, social functioning, alcohol and smoking status. These findings suggest that the continuation of a healthy dietary pattern may be protective of depressive symptoms. Caution should be applied in interpreting these findings due to the small effect sizes. More longitudinal studies are needed to assess temporal relationships between dietary quality and depression.
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Affiliation(s)
- Megan Lee
- Bond University, Gold Coast Campus, Robina, Australia
| | - Joanne Bradbury
- Southern Cross University, Gold Coast Campus, Coolangatta, Australia
| | - Jacqui Yoxall
- Southern Cross University, Lismore Campus, Lismore, Australia
| | - Sally Sargeant
- Southern Cross University, Gold Coast Campus, Coolangatta, Australia
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van Weelden W, Seed PT, Antoun E, Godfrey KM, Kitaba NT, Lillycrop KA, Dalrymple KV, Sobczyńska-Malefora A, Painter RC, Poston L, White SL, Flynn AC. Folate and vitamin B12 status: associations with maternal glucose and neonatal DNA methylation sites related to dysglycaemia, in pregnant women with obesity. J Dev Orig Health Dis 2022; 13:168-176. [PMID: 33972006 PMCID: PMC7612506 DOI: 10.1017/s2040174421000246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Recent studies implicate maternal gestational diabetes mellitus (GDM) in differential methylation of infant DNA. Folate and vitamin B12 play a role in DNA methylation, and these vitamins may also influence GDM risk. The aims of this study were to determine folate and vitamin B12 status in obese pregnant women and investigate associations between folate and vitamin B12 status, maternal dysglycaemia and neonatal DNA methylation at cytosine-phosphate-guanine sites previously observed to be associated with dysglycaemia. Obese pregnant women who participated in the UK Pregnancies Better Eating and Activity Trial were included. Serum folate and vitamin B12 were measured at the oral glucose tolerance test (OGTT) visit. Cord blood DNA methylation was assessed using the Infinium MethylationEPIC BeadChip. Regression models with adjustment for confounders were used to examine associations. Of the 951 women included, 356 (37.4%) were vitamin B12 deficient, and 44 (4.6%) were folate deficient. Two-hundred and seventy-one women (28%) developed GDM. Folate and vitamin B12 concentrations were not associated with neonatal DNA methylation. Higher folate was positively associated with 1-h plasma glucose after OGTT (β = 0.031, 95% CI 0.001-0.061, p = 0.045). There was no relationship between vitamin B12 and glucose concentrations post OGTT or between folate or vitamin B12 and GDM. In summary, we found no evidence to link folate and vitamin B12 status with the differential methylation of neonatal DNA previously observed in association with dysglycaemia. We add to the evidence that folate status may be related to maternal glucose homoeostasis although replication in other maternal cohorts is required for validation.
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Affiliation(s)
- Wenneke van Weelden
- Amsterdam University Medical Center – location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Paul T. Seed
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London
| | - Elie Antoun
- Human Development and Health, Faculty of Medicine, University of Southampton, UK
| | - Keith M. Godfrey
- Human Development and Health, Faculty of Medicine, University of Southampton, UK
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Negusse T. Kitaba
- Human Development and Health, Faculty of Medicine, University of Southampton, UK
| | - Karen A. Lillycrop
- Centre for Biological Sciences, Faculty of Natural and Environmental Sciences, University of Southampton, Southampton, UK
| | - Kathryn V. Dalrymple
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London
| | - Agata Sobczyńska-Malefora
- Nutristasis Unit, Viapath, St. Thomas’ Hospital, London, UK
- Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Rebecca C. Painter
- Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lucilla Poston
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London
| | - Sara L. White
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London
| | - Angela C. Flynn
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London
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Is it possible to model the impact of calorie-reduction interventions on childhood obesity at a population level and across the range of deprivation: Evidence from the Avon Longitudinal Study of Parents and Children (ALSPAC). PLoS One 2022; 17:e0263043. [PMID: 35100299 PMCID: PMC8803143 DOI: 10.1371/journal.pone.0263043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background Simulated interventions using observational data have the potential to inform policy and public health interventions where randomised controlled trials are not feasible. National childhood obesity policy is one such area. Overweight and obesity are primarily caused by energy-rich and low-nutrient diets that contribute to a positive net energy imbalance. Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), we investigated whether causal modelling techniques could be applied to simulate the potential impact of policy-relevant calorie-reduction interventions on population prevalence and inequalities in obesity in childhood. Methods Predicted probabilities of obesity at age 11 (UK90 cut offs) were estimated from logistic marginal structural models (MSM) accounting for observed calorie consumption at age 7 and confounding, overall and by maternal occupational social class. A series of population intervention scenarios were modelled to simulate daily calorie-reduction interventions that differed in effectiveness, targeting mechanism and programme uptake level. Results The estimated effect of maternal social class on obesity after accounting for confounding and observed calorie intake was provided by the controlled direct effect (CDE), in which, 18.3% of children were living with obesity at age 11 years,. A universal simulation to lower median intake to the estimated average requirement (EAR) (a 6.1% reduction in daily calories) with 75% uptake reduced overall obesity prevalence by 0.6%; there was little impact on inequalities. A targeted intervention to limit consumption to the EAR for children with above average intake reduced population obesity prevalence at 11 years by 1.5% but inequalities remained broadly unchanged. A targeted intervention for children of low-income families reduced prevalence by 0.7% and was found to slightly reduce inequalities. Conclusions MSMs allow estimation of effects of simulated calorie-reduction interventions on childhood obesity prevalence and inequalities, although estimates are limited by the accuracy of reported calorie intake. Further work is needed to understand causal pathways and opportunities for intervention. Nevertheless, simulated intervention techniques have promise for informing national policy where experimental data are not available.
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Williamson M, Moustaid-Moussa N, Gollahon L. The Molecular Effects of Dietary Acid Load on Metabolic Disease (The Cellular PasaDoble: The Fast-Paced Dance of pH Regulation). FRONTIERS IN MOLECULAR MEDICINE 2021; 1:777088. [PMID: 39087082 PMCID: PMC11285710 DOI: 10.3389/fmmed.2021.777088] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 10/27/2021] [Indexed: 08/02/2024]
Abstract
Metabolic diseases are becoming more common and more severe in populations adhering to western lifestyle. Since metabolic conditions are highly diet and lifestyle dependent, it is suggested that certain diets are the cause for a wide range of metabolic dysfunctions. Oxidative stress, excess calcium excretion, inflammation, and metabolic acidosis are common features in the origins of most metabolic disease. These primary manifestations of "metabolic syndrome" can lead to insulin resistance, diabetes, obesity, and hypertension. Further complications of the conditions involve kidney disease, cardiovascular disease, osteoporosis, and cancers. Dietary analysis shows that a modern "Western-style" diet may facilitate a disruption in pH homeostasis and drive disease progression through high consumption of exogenous acids. Because so many physiological and cellular functions rely on acid-base reactions and pH equilibrium, prolonged exposure of the body to more acids than can effectively be buffered, by chronic adherence to poor diet, may result in metabolic stress followed by disease. This review addresses relevant molecular pathways in mammalian cells discovered to be sensitive to acid - base equilibria, their cellular effects, and how they can cascade into an organism-level manifestation of Metabolic Syndromes. We will also discuss potential ways to help mitigate this digestive disruption of pH and metabolic homeostasis through dietary change.
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Affiliation(s)
- Morgan Williamson
- Department of Biological Sciences, Texas Tech University, Lubbock, TX, United States
| | - Naima Moustaid-Moussa
- Department of Nutrition Sciences, Texas Tech University, Lubbock, TX, United States
- Obesity Research Institute, Texas Tech University, Lubbock, TX, United States
| | - Lauren Gollahon
- Department of Biological Sciences, Texas Tech University, Lubbock, TX, United States
- Department of Nutrition Sciences, Texas Tech University, Lubbock, TX, United States
- Obesity Research Institute, Texas Tech University, Lubbock, TX, United States
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Entrena-Durán F, Baldan-Lozano H, Valdera-Gil JM. Students' Knowledge of Healthy Food and Their Actual Eating Habits: A Case Study on the University of Granada (Spain). FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2021. [DOI: 10.3389/fsufs.2021.687574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This article focuses on an analysis of the discourses produced during 34 semi-structured interviews (17 men and 17 women) conducted at the University of Granada (Spain) with undergraduate, Master, and Ph.D. students. The interviewees were between 20 and 44 years old. It was observed that the fact of having a high educational level did not prevent University students from eating unhealthily. There is a gap between the fact that 97.1% of 34 students interviewed (that is, 33 of them) know what healthy food is and their self-perception about whether or not what they are eating is healthy, since in 41.2% of them said self-perception is negative. This gap narrows as the interviewees' age increases and their socio-economic and vital situation is stabilizing which favors that their eating habits become more regular and healthier. Thus, all the interviewees aged 27 or over self-perceived that they were eating healthily. But the biggest differences are those that have to do with the gender of interviewees. Thus, while 23.5% of women interviewed perceived that they were not eating healthy, 76.5% of them felt that they were eating healthy. However, among the men interviewed, these percentages were somehow reversed, in such a way that 58.8% of them believed that they were not eating healthy, compared to 41.2% of them who indicated that they were eating healthy. Therefore, the investigation revealed that women tend to have the best chances of assuming healthy eating habits. Male students living outside the family home or without female partners exhibited greater feeding problems, while females living under similar conditions tended to display healthier eating habits. This is related to the fact that women have traditionally been in charge of acquiring and preparing food. So, women's food education has not been restricted to the mere transmission to them of knowledge about what healthy food is, but from their childhood they were food trained through their active involvement in practical experiences. Obviously, the solution proposed to this male disadvantage is to not perpetuate macho gender stereotypes that assign women the role of home caregivers, but to seek that both women and men have the opportunity and the duty to experience equally those practical experiences that involve the tasks of the acquisition and preparation of food. Working to achieve a situation like this, not only promotes progress in gender equality, but also helps to overcome the lower training of men to perform the tasks inherent in their diet.
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Sequential transfer learning based on hierarchical clustering for improved performance in deep learning based food segmentation. Sci Rep 2021; 11:813. [PMID: 33436650 PMCID: PMC7803986 DOI: 10.1038/s41598-020-79677-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 12/10/2020] [Indexed: 11/08/2022] Open
Abstract
Accurately segmenting foods from optical images is a challenging task, yet becoming possible with the help of recent advances in Deep Learning based solutions. Automated identification of food items opens up possibilities of useful applications like nutrition intake monitoring. Given large variations in food choices, Deep Learning based solutions still struggle to generate human level accuracy. In this work, we propose a novel Sequential Transfer Learning method using Hierarchical Clustering. This novel approach simulates a step by step problem solving framework based on clustering of similar types of foods. The proposed approach provides up to 6% gain in accuracy compared to traditional network training and generated a robust model performing better in challenging unseen cases. This approach is also tested for segmenting foods in Danish school children meals for dietary intake monitoring as an application.
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11
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Jaca A, Iwu C, Durão S, Onyango AW, Wiysonge CS. Understanding the underlying drivers of obesity in Africa: a scoping review protocol. BMJ Open 2020; 10:e040940. [PMID: 33177144 PMCID: PMC7661354 DOI: 10.1136/bmjopen-2020-040940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The worldwide prevalence of obesity and overweight has doubled since 1980, such that approximately a third of the world's population is reported as obese or overweight. Obesity rates have increased in all ages and both sexes irrespective of geographical area, ethnicity or socioeconomic status. Due to the high prevalence, related health consequences and costs of childhood and adult obesity, there is a need to comprehensively identify and assess the major underlying drivers of obesity and overweight in the African context. METHODS AND ANALYSIS This scoping review will be carried out as per the methodological outline by Arksey and O'Malley. The search strategy will be developed and search performed in the Scopus and PubMed electronic databases. In the first search, we will identify concepts that are used as an equivalent to obesity and overweight. Subsequently, we will search for studies comprising of search terms on the underlying factors that drive the development of obesity and overweight. Lastly, we will check reference lists for additional publications. Abstracts and full-text studies will independently be screened by two authors. ETHICS AND DISSEMINATION The proposed study will generate evidence from published data and hence does not require ethics approval. Evidence generated from this review will be disseminated through journal publications and conference presentations.
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Affiliation(s)
- Anelisa Jaca
- Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa
| | - Chinwe Iwu
- Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Solange Durão
- Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa
| | - Adelheid W Onyango
- Department of Nutrition for Health and Development, World Health Organization, Brazzaville, Congo
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Department of Global Health, Stellenbosch University, Cape Town, South Africa
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12
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Ahuja M, Sathiyaseelan T, Wani RJ, Fernandopulle P. Obesity, food insecurity, and depression among females. Arch Public Health 2020; 78:83. [PMID: 32959002 PMCID: PMC7495400 DOI: 10.1186/s13690-020-00463-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 09/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nutritional psychiatry is an emerging field of research and it is currently exploring the impact of nutrition and obesity on brain function and mental illness. Prior studies links between obesity, nutrition and depression among women. However, less is known how food insecurity may moderate that relationship. METHODS Data were employed from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003. Two logistic regression models were Logistic regression was used to determine the association between obesity, gender, food insecurity, and past year Major Depressive Disorder (MDD). We then stratified by gender, and tested the association between obesity and past year MDD, and if food insecurity moderated the association. RESULTS Obesity was associated with an increased risk for past year Major Depressive Disorder (MDD) among females (AOR = 1.35; 95% CI 1.17-1.55) and was not associated among males (AOR = 1.07; 95% CI, 0.86-1.32). Women who reported that reported both obesity and food insecurity reported higher odds of past year MDD episode (AOR = 3.16; 95% CI, 2.36-4.21, than women who did not report food insecurity (AOR = 1.08; 95% CI, 1.02-1.38). CONCLUSION With rising rates of mental health problems, females should be closely monitored to understand how poor diets, food insecurity, and obesity play a role in mental health outcomes. It is recommended that clinicians and treatment providers consider the patient's diet and access to nutritious foods when conducting their assessment.
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Affiliation(s)
- Manik Ahuja
- College of Public Health, East Tennessee State University, 41B Lamb Hall, Johnson City, TN 37614 USA
| | | | - Rajvi J. Wani
- College of Public Health, University of Nebraska Medical Center, Omaha, NE USA
| | - Praveen Fernandopulle
- Psychiatry and Behavioral Sciences Department, East Tennessee State University, Johnson City, TN USA
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Llanaj E, Vincze F, Kósa Z, Sándor J, Diószegi J, Ádány R. Dietary Profile and Nutritional Status of the Roma Population Living in Segregated Colonies in Northeast Hungary. Nutrients 2020; 12:nu12092836. [PMID: 32947945 PMCID: PMC7551568 DOI: 10.3390/nu12092836] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/07/2020] [Accepted: 09/14/2020] [Indexed: 12/14/2022] Open
Abstract
Nutrition studies among Roma are scarce and to date no quantified dietary data are available. This report provides, for the first time, quantified dietary data and comprehensive anthropometric information for the Hungarian Roma (HR) population, with Hungarian general (HG) adults as reference. Data were obtained from a complex comparative health survey, involving 387 and 410 subjects of HR and HG populations, respectively. Using corporal measurements, body composition indicators were constructed, while daily nutrient intakes were evaluated in comparison with internationally accepted guidelines on nutrient requirements and recommended intakes. Associations between Roma ethnicity and nutrient intakes, as well as odds of achieving dietary recommendations were explored using regression models, adjusted for relevant covariates (i.e., age, gender, education, marital status and perceived financial status). Results showed occasional differences for selected nutrient intakes between the groups, with HR's intake being less favorable. Total fat intake, predominantly animal-sourced, exceeded recommendations among HR (36.1 g, 95% confidence interval (CI): 35.2-37.0) and was not dissimilar to HG group (37.1 g, 95% CI: 36.3-38.0). Sodium intake among HR was significantly lower (5094.4 mg, 95% CI: 4866.0-5322.8) compared to HG (5644.0 mg, 95% CI: 5351.9-5936.0), but significantly greater than recommended intake in both groups. HR had greater estimated body fatness (25.6-35.1%) and higher average body mass index (BMI, 27.7 kg/m2, 95% CI: 26.9-28.4), compared to HG. In addition, HR had lower odds of achieving dietary recommendations (odds ratio (OR) = 0.81, 95% CI: 0.67-0.97, p < 0.05). Findings warrant further research, while highlighting the importance of establishing and integrating Roma nutrition into national surveillance and monitoring systems for key dietary risk factors.
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Affiliation(s)
- Erand Llanaj
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary; (E.L.); (F.V.); (J.S.)
- Doctoral School of Health Sciences, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary
| | - Ferenc Vincze
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary; (E.L.); (F.V.); (J.S.)
- Doctoral School of Health Sciences, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary
| | - Zsigmond Kósa
- Department of Methodology for Health Visitors and Public Health, Faculty of Health, University of Debrecen, Sóstói street 2–4, H-4400 Nyíregyháza, Hungary;
| | - János Sándor
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary; (E.L.); (F.V.); (J.S.)
| | - Judit Diószegi
- MTA-DE-Public Health Research Group, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary;
| | - Róza Ádány
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary; (E.L.); (F.V.); (J.S.)
- MTA-DE-Public Health Research Group, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary;
- Correspondence: ; Tel.: +36-52-512-765 (ext. 77147)
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14
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Diószegi J, Pikó P, Kósa Z, Sándor J, Llanaj E, Ádány R. Taste and Food Preferences of the Hungarian Roma Population. Front Public Health 2020; 8:359. [PMID: 32850590 PMCID: PMC7417305 DOI: 10.3389/fpubh.2020.00359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 06/24/2020] [Indexed: 12/23/2022] Open
Abstract
Background: In Central, Eastern, and Southern Europe, the Roma population is the largest and the most vulnerable and disadvantaged minority. Behind their unfavorable health status, harmful health behaviors, such as unhealthy diet is also supposed to exist. Methods: In the framework of a complex health study, individuals from the Hungarian general (n = 410) and Roma populations (n = 387) were randomly selected. In the survey portion of the study, sweet, fat, salty, and bitter taste preferences were ascertained by question items measuring taste and food preferences. Preference for sweet vs. salty foods was also analyzed. Questions from the Hungarian version of the European Health Interview Survey were included, to characterize fruit and vegetable consumption and to determine the quantity of sugars added to consumed foods and beverages and the frequency of salting without tasting the food. Data were analyzed using STATA 9.0 statistical software. Results: Roma reported significantly less frequent consumption of fresh fruits (OR = 1.70, 95% CI: 1.22-2.35, p = 0.002) and vegetables (OR = 1.74, 95% CI: 1.25-2.41, p = 0.001) than the Hungarian subjects. Representatives of the Hungarian Roma population reported adding higher quantities of sugars to consumed foods and beverages (OR = 1.68, 95% CI: 1.10-2.56, p = 0.016) and preferred sweet snacks vs. salty ones (OR = 0.53 for salty snacks, 95% CI: 0.37-0.78, p = 0.001) and had higher preferences for sweet foods (OR = 1.51, 95% CI: 1.08-2.11, p = 0.015). They salted their food without tasting it more often (OR = 2.18, 95% CI: 1.64-2.88, p < 0.001). They had lower preferences for bitter tasting raw kohlrabi (OR = 0.56, 95% CI: 0.41-0.80, p = 0.001), grapefruit (OR = 0.47, 95% CI: 0.34-0.64, p < 0.001), black coffee (OR = 0.50, 95% CI: 0.34-0.73, p < 0.001), and dark chocolate (OR = 0.63, 95% CI: 0.46-0.84, p = 0.006). No significant results in terms of ethnicity were found on for fatty and salty food preference and other bitter-tasting vegetables. Conclusions: Roma diet may be linked to taste preferences predisposing to unhealthy eating habits. This assumption needs further studies on their dietary behavior. In order to design potentially effective intervention programs targeting Roma populations, it is essential to identify individual, environmental, social, cultural, and behavioral factors and as well as their complex interplay that may affect dietary intake and behaviors.
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Affiliation(s)
- Judit Diószegi
- MTA-DE Public Health Research Group, Public Health Research Institute, University of Debrecen, Debrecen, Hungary
| | - Péter Pikó
- MTA-DE Public Health Research Group, Public Health Research Institute, University of Debrecen, Debrecen, Hungary
| | - Zsigmond Kósa
- Department of Methodology for Health Visitors and Public Health, Faculty of Health, University of Debrecen, Nyíregyháza, Hungary
| | - János Sándor
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Erand Llanaj
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
- Public Health Research Institute, University of Debrecen, Debrecen, Hungary
| | - Róza Ádány
- MTA-DE Public Health Research Group, Public Health Research Institute, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
- Public Health Research Institute, University of Debrecen, Debrecen, Hungary
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15
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Frontela-Saseta C, González-Bermúdez CA, García-Marcos L. Diet: A Specific Part of the Western Lifestyle Pack in the Asthma Epidemic. J Clin Med 2020; 9:E2063. [PMID: 32630168 PMCID: PMC7408793 DOI: 10.3390/jcm9072063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/22/2020] [Accepted: 06/27/2020] [Indexed: 01/04/2023] Open
Abstract
The Western lifestyle is a complex concept that includes the diet as the main axis of different factors which contribute to a detrimental effect on health, lower life expectancy and low quality-of-life. This type of diet is characterized by being high in calories, mainly provided by saturated fats, and rich in sugars that can lead to changes in immune cells and their responsiveness, by different mechanisms that have yet to be totally clarified. Inflammatory processes are perpetuated through different pathways, in which adipose tissue is a major factor. High fat stores in overweight and obesity accumulate energy but the endocrine function is also producing and releasing different bioactive compounds, adipokines, known to be pro-inflammatory and which play an important role in the pathogenesis of asthma. This review therefore explores the latest evidence regarding the adverse effect of the Western diet on adipose tissue inflammation and its causative effect on the asthma epidemic.
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Affiliation(s)
- Carmen Frontela-Saseta
- Department of Food Science and Nutrition, Faculty of Veterinary Sciences, Regional Campus of International Excellence “Campus Mare Nostrum”, 30100 Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University of Murcia, 30003 Murcia, Spain; (C.A.G.-B.); (L.G.-M.)
| | - Carlos A. González-Bermúdez
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University of Murcia, 30003 Murcia, Spain; (C.A.G.-B.); (L.G.-M.)
| | - Luis García-Marcos
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University of Murcia, 30003 Murcia, Spain; (C.A.G.-B.); (L.G.-M.)
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16
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Moreira-Pais A, Ferreira R, Neves JS, Vitorino R, Moreira-Gonçalves D, Nogueira-Ferreira R. Sex differences on adipose tissue remodeling: from molecular mechanisms to therapeutic interventions. J Mol Med (Berl) 2020; 98:483-493. [PMID: 32152705 DOI: 10.1007/s00109-020-01890-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/08/2020] [Accepted: 02/26/2020] [Indexed: 12/13/2022]
Abstract
Sexual dimorphism greatly influences adipose tissue remodeling, which is characterized by changes in the activity, number, and/or size of adipocytes in response to distinct stimuli, including lifestyle and anti-obesity drugs. This sex dependence seems to be due to the anatomical and endocrine disparities between men and women. At the molecular level, sex hormones are believed to mediate such differences and involve estrogen and androgen receptor-induced gene expression. The signaling pathways that regulate adipose tissue metabolism and function include peroxisome proliferator-activated receptor gamma, uncoupling protein 1 (UCP1), 5' adenosine monophosphate-activated protein kinase (AMPK), and mitochondrial oxidative phosphorylation (OXPHOS), among other molecular players. Sex hormone-related pathways also interplay with adrenergic signaling, probably the most well-characterized molecular mechanism implicated in the remodeling of white adipose tissue. This review overviews and integrates the signaling pathways behind sexual dimorphism in adipose tissue remodeling, hoping to increase the knowledge on the pathogenesis of diseases, such as obesity and related comorbidities, and consequently, to drive future studies to investigate the regulation of this tissue homeostasis, either in men or women.
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Affiliation(s)
- Alexandra Moreira-Pais
- QOPNA & LAQV, Department of Chemistry, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal. .,CIAFEL, Faculty of Sports, University of Porto, R. Dr. Plácido da Costa 91, 4200-450, Porto, Portugal.
| | - Rita Ferreira
- QOPNA & LAQV, Department of Chemistry, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - João Sérgio Neves
- Department of Endocrinology, Diabetes and Metabolism, Faculty of Medicine, Centro Hospitalar Universitário de São João, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal.,UnIC, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Rui Vitorino
- UnIC, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal.,Department of Medical Sciences, iBiMED, University of Aveiro, Agra do Crasto, 3810-193, Aveiro, Portugal
| | - Daniel Moreira-Gonçalves
- CIAFEL, Faculty of Sports, University of Porto, R. Dr. Plácido da Costa 91, 4200-450, Porto, Portugal.,UnIC, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Rita Nogueira-Ferreira
- UnIC, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
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Towards the Implementation of a Conceptual Framework of Food and Nutrition Literacy: Providing Healthy Eating for the Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16245041. [PMID: 31835678 PMCID: PMC6950737 DOI: 10.3390/ijerph16245041] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/06/2019] [Accepted: 12/09/2019] [Indexed: 01/01/2023]
Abstract
Existing definitions of food literacy (FL) and nutrition literacy (NL) in particular refer to individual knowledge, motivation, competences, and awareness, which determine the relationship between individuals and food, the food system, and nutrition information. Several authors proposed specific conceptualization of the terms. Nevertheless, the description of analogies and differences between FL and NL is still lacking, as is an integrated framework which highlights the meaning of the concepts. This work aims to describe and discuss evidence provided by the literature in order to develop and propose a comprehensive conceptualization of FL and NL to the scientific community. We systematically reviewed six databases, considering the search terms of FL and NL. We collected the antecedents, components, and consequences of both FL and NL. We underlined and traced similarities of the concepts as well as prerogative features through the content analysis of definitions. We obtained 14 definitions of NL and 12 definitions of FL; 42 papers presented antecedents and 53 papers contained consequences. We observed that NL could be considered a specific form of FL. In addition, we noted that the consequences of NL are included in the subset of the consequences of FL and the conceptual limits of FL correspond to the outcome of healthful diet. We conclude that FL and NL build a multifaceted concept which implies both individual and public perspectives. We propose a conceptualization which could be useful to develop an executive framework aimed at providing healthy eating for the population.
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Morillo Sarto H, Barcelo-Soler A, Herrera-Mercadal P, Pantilie B, Navarro-Gil M, Garcia-Campayo J, Montero-Marin J. Efficacy of a mindful-eating programme to reduce emotional eating in patients suffering from overweight or obesity in primary care settings: a cluster-randomised trial protocol. BMJ Open 2019; 9:e031327. [PMID: 31753880 PMCID: PMC6886952 DOI: 10.1136/bmjopen-2019-031327] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 09/19/2019] [Accepted: 10/24/2019] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Little is known about the applicability of mindfulness-based interventions in Spanish adults with overweight/obesity. The objective of the present study protocol is to describe the methods that will be used in a cluster randomised trial (CRT) that aims to evaluate the effectiveness of a mindfulness eating (ME) programme to reduce emotional eating (EE) in adults with overweight/obesity in primary care (PC) settings. METHODS AND ANALYSIS A CRT will be conducted with approximately 76 adults with overweight/obesity from four PC health centres (clusters) in the city of Zaragoza, Spain. Health centres matched to the average per capita income of the assigned population will be randomly allocated into two groups: 'ME +treatment as usual (TAU)' and 'TAU alone'. The ME programme will be composed of seven sessions delivered by a clinical psychologist, and TAU will be offered by general practitioners. The primary outcome will be EE measured by the Dutch Eating Behaviour Questionnaire (DEBQ) at post test as primary endpoint. Other outcomes will be external and restrained eating (DEBQ), binge eating (Bulimic Investigatory Test Edinburgh), eating disorder (Eating Attitude Test), anxiety (General Anxiety Disorder-7), depression (Patient Health Questionnaire-9), mindful eating (Mindful Eating Scale), dispositional mindfulness (Five Facet Mindfulness Questionnaire) and self-compassion (Self-Compassion Scale). Anthropometric measures, vital signs and blood tests will be taken. A primary intention-to-treat analysis on EE will be conducted using linear mixed models. Supplementary analyses will include secondary outcomes and 1-year follow-up measures; adjusted models controlling for sex, weight status and levels of anxiety and depression; the complier average causal effect of treatment; and the clinical significance of improvements. ETHICS AND DISSEMINATION Positive results of this study may have a significant impact on one of the most important current health-related problems. Approval was obtained from the Ethics Committee of the Regional Authority. The results will be submitted to peer-reviewed journals, and reports will be sent to participants. TRIAL REGISTRATION NUMBER NCT03927534 (5/2019).
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Affiliation(s)
- Hector Morillo Sarto
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
- Basic Psychology Department, Faculty of Psychology, University of Zaragoza, Teruel, Spain
| | - Alberto Barcelo-Soler
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
- Institute of Health Research of Aragon (IIS), Zaragoza, Spain
| | - Paola Herrera-Mercadal
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
- Institute of Health Research of Aragon (IIS), Zaragoza, Spain
| | - Bianca Pantilie
- Oral and Maxillofacial Surgery Department, Miguel Servet University Hospital, Zaragoza, Aragón, Spain
| | - Mayte Navarro-Gil
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
- Institute of Health Research of Aragon (IIS), Zaragoza, Spain
| | - Javier Garcia-Campayo
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
- Institute of Health Research of Aragon (IIS), Zaragoza, Spain
| | - Jesus Montero-Marin
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
- Spanish Association of Mindfulness and Compassion, Zaragoza, Spain
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Walker RJ, Chawla A, Garacci E, Williams JS, Mendez C, Ozieh MN, Egede LE. Assessing the relationship between food insecurity and mortality among U.S. adults. Ann Epidemiol 2019; 32:43-48. [PMID: 30799207 DOI: 10.1016/j.annepidem.2019.01.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 01/25/2019] [Accepted: 01/28/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE Significant evidence supports a relationship between food insecurity and health, but little work has investigated its relationship on all-cause mortality within a high resource country, such as the United States. METHODS Data from the 2003-2010 National Health and Nutrition Examination Survey was matched to National Death Index information. Cox models were used to study the relationship between mortality and food insecurity, adjusting for relevant covariates in a sequential manner (demographics, comorbidities, lifestyle variables, body mass index). Food insecurity was used as dichotomous and as four categories. RESULTS Of 20,918 participants, 11.6% (representing 208,789,244 U.S. residents) were food insecure. When food insecurity was dichotomized, there was 49% higher odds of mortality after adjusting for demographics (HR, 1.49; 95% CI, 1.19-1.87). After adjusting for comorbidities, the HR remained significant, but lost significance with adjustment for lifestyle factors and body mass index (HR, 1.15; 95% CI, 0.94-1.42). However, marginal food security lost significance after adjustment for lifestyle variables. CONCLUSIONS Food insecurity significantly impacts all-cause mortality in the United States; however, lifestyle may explain this relationship. Interventions should account for level of severity when creating targeted programs.
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Affiliation(s)
- Rebekah J Walker
- Division of General Internal Medicine, Department of Medicine, Froedtert and The Medical College of Wisconsin, Milwaukee; Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee
| | | | - Emma Garacci
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee
| | - Joni S Williams
- Division of General Internal Medicine, Department of Medicine, Froedtert and The Medical College of Wisconsin, Milwaukee; Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee
| | - Carlos Mendez
- Division of General Internal Medicine, Department of Medicine, Froedtert and The Medical College of Wisconsin, Milwaukee; Division of Diabetes and Endocrinology, Clement J. Zablocki VA Medical Center, Milwaukee, WI
| | - Mukoso N Ozieh
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee; Division of Nephrology, Department of Medicine, Froedtert and The Medical College of Wisconsin, Milwaukee; Division of Nephrology, Clement J. Zablocki VA Medical Center, Milwaukee, WI
| | - Leonard E Egede
- Division of General Internal Medicine, Department of Medicine, Froedtert and The Medical College of Wisconsin, Milwaukee; Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee.
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Greydanus DE, Agana M, Kamboj MK, Shebrain S, Soares N, Eke R, Patel DR. Pediatric obesity: Current concepts. Dis Mon 2018; 64:98-156. [DOI: 10.1016/j.disamonth.2017.12.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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