1
|
Ewers B, Blond MB, Bruun JM, Vilsbøll T. Effects of basic carbohydrate counting versus standard dietary care for glycaemic control in type 2 diabetes (The BCC Study): a randomised, controlled trial. Nutr Diabetes 2024; 14:47. [PMID: 38937460 PMCID: PMC11211433 DOI: 10.1038/s41387-024-00307-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 06/14/2024] [Accepted: 06/18/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Clinical guidelines recommend basic carbohydrate counting (BCC), or similar methods to improve carbohydrate estimation skills and to strive for higher consistency in carbohydrate intake potentially improving glycaemic control. However, evidence for this approach in type 2 diabetes (T2D) is limited. OBJECTIVE To examine the efficacy of a structured education program in BCC as add-on to standard dietary care on glycaemic control in individuals with T2D. METHODS The BCC Study was a randomized, controlled, open-label, parallel-group trial. Individuals with T2D aged 18-75 years with glycated haemoglobin A1c (HbA1c) 53-97 mmol/mol (7.0-11.0%) were randomly assigned (1:1) to BCC or standard dietary care. The primary outcomes were differences in changes in HbA1c or glycaemic variability (calculated as mean amplitude of glycaemic excursions [MAGE]) between groups after six months of intervention. RESULTS Between September 2018 and July 2021, 48 participants were randomly assigned, 23 to BCC and 25 to standard dietary care. Seven participants did not receive the allocated intervention. From a baseline-adjusted mean of 65 mmol/mol (95% CI 62-68 [8.1%, 7.8-8.4]), HbA1c changed by -5 mmol/mol (-8 to -1 [-0.5%, -0.7 to -0.1]) in BCC and -3 mmol/mol (-7 to 1 [-0.3%, -0.6 to 0.1]) in standard care with an estimated treatment effect of -2 mmol/mol (-7 to 4 [-0.2%, -0.6 to 0.4]); p = 0.554. From a baseline-adjusted mean of 4.2 mmol/l (3.7 to 4.8), MAGE changed by -16% (-33 to 5) in BCC and by -3% (-21 to 20) in standard care with an estimated treatment effect of -14% (-36 to 16); p = 0.319. Only median carbohydrate estimation error in favour of BCC (estimated treatment difference -55% (-70 to -32); p < 0.001) remained significant after multiple testing adjustment. CONCLUSIONS No glycaemic effects were found but incorporating BCC as a supplementary component to standard dietary care led to improved skills in estimating carbohydrate intake among individuals with T2D.
Collapse
Affiliation(s)
- Bettina Ewers
- Department of Clinical and Translational Research, Steno Diabetes Center Copenhagen, Herlev, Denmark.
| | - Martin B Blond
- Department of Clinical and Translational Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Jens M Bruun
- Steno Diabetes Center Aarhus, Aarhus, Denmark
- Department of Clinical Medicine, University of Aarhus, Aarhus, Denmark
| | - Tina Vilsbøll
- Department of Clinical and Translational Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
2
|
Dias SB, Oikonomidis Y, Diniz JA, Baptista F, Carnide F, Bensenousi A, Botana JM, Tsatsou D, Stefanidis K, Gymnopoulos L, Dimitropoulos K, Daras P, Argiriou A, Rouskas K, Wilson-Barnes S, Hart K, Merry N, Russell D, Konstantinova J, Lalama E, Pfeiffer A, Kokkinopoulou A, Hassapidou M, Pagkalos I, Patra E, Buys R, Cornelissen V, Batista A, Cobello S, Milli E, Vagnozzi C, Bryant S, Maas S, Bacelar P, Gravina S, Vlaskalin J, Brkic B, Telo G, Mantovani E, Gkotsopoulou O, Iakovakis D, Hadjidimitriou S, Charisis V, Hadjileontiadis LJ. Users' Perspective on the AI-Based Smartphone PROTEIN App for Personalized Nutrition and Healthy Living: A Modified Technology Acceptance Model (mTAM) Approach. Front Nutr 2022; 9:898031. [PMID: 35879982 PMCID: PMC9307489 DOI: 10.3389/fnut.2022.898031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/31/2022] [Indexed: 12/02/2022] Open
Abstract
The ubiquitous nature of smartphone ownership, its broad application and usage, along with its interactive delivery of timely feedback are appealing for health-related behavior change interventions via mobile apps. However, users' perspectives about such apps are vital in better bridging the gap between their design intention and effective practical usage. In this vein, a modified technology acceptance model (mTAM) is proposed here, to explain the relationship between users' perspectives when using an AI-based smartphone app for personalized nutrition and healthy living, namely, PROTEIN, and the mTAM constructs toward behavior change in their nutrition and physical activity habits. In particular, online survey data from 85 users of the PROTEIN app within a period of 2 months were subjected to confirmatory factor analysis (CFA) and regression analysis (RA) to reveal the relationship of the mTAM constructs, i.e., perceived usefulness (PU), perceived ease of use (PEoU), perceived novelty (PN), perceived personalization (PP), usage attitude (UA), and usage intention (UI) with the users' behavior change (BC), as expressed via the acceptance/rejection of six related hypotheses (H1-H6), respectively. The resulted CFA-related parameters, i.e., factor loading (FL) with the related p-value, average variance extracted (AVE), and composite reliability (CR), along with the RA results, have shown that all hypotheses H1-H6 can be accepted (p < 0.001). In particular, it was found that, in all cases, FL > 0.5, CR > 0.7, AVE > 0.5, indicating that the items/constructs within the mTAM framework have good convergent validity. Moreover, the adjusted coefficient of determination (R 2) was found within the range of 0.224-0.732, justifying the positive effect of PU, PEoU, PN, and PP on the UA, that in turn positively affects the UI, leading to the BC. Additionally, using a hierarchical RA, a significant change in the prediction of BC from UA when the UI is used as a mediating variable was identified. The explored mTAM framework provides the means for explaining the role of each construct in the functionality of the PROTEIN app as a supportive tool for the users to improve their healthy living by adopting behavior change in their dietary and physical activity habits. The findings herein offer insights and references for formulating new strategies and policies to improve the collaboration among app designers, developers, behavior scientists, nutritionists, physical activity/exercise physiology experts, and marketing experts for app design/development toward behavior change.
Collapse
Affiliation(s)
- Sofia Balula Dias
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Lisbon, Portugal
| | | | - José Alves Diniz
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Lisbon, Portugal
| | - Fátima Baptista
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Lisbon, Portugal
| | - Filomena Carnide
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Lisbon, Portugal
| | | | | | | | | | | | | | - Petros Daras
- Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Anagnostis Argiriou
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Konstantinos Rouskas
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Saskia Wilson-Barnes
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Kathryn Hart
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Neil Merry
- OCADO Technology, London, United Kingdom
| | | | | | - Elena Lalama
- Department of Endocrinology, Diabetes and Nutrition and German Institute of Human Nutrition, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Pfeiffer
- Department of Endocrinology, Diabetes and Nutrition and German Institute of Human Nutrition, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Anna Kokkinopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Maria Hassapidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Ioannis Pagkalos
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Elena Patra
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Roselien Buys
- Department of Rehabilitation Sciences and Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Véronique Cornelissen
- Department of Rehabilitation Sciences and Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Ana Batista
- Sport Lisboa Benfica Futebol, Lisbon, Portugal
| | | | - Elena Milli
- Polo Europeo della Conoscenza, Verona, Italy
| | | | - Sheree Bryant
- European Association for the Study of Obesity (EASO), Middlesex, United Kingdom
| | - Simon Maas
- AgriFood Capital BV, Hertogenbosch, Netherlands
| | | | | | - Jovana Vlaskalin
- BioSense Institute, Research and Development Institute for Information Technology in Biosystems, Novi Sad, Serbia
| | - Boris Brkic
- BioSense Institute, Research and Development Institute for Information Technology in Biosystems, Novi Sad, Serbia
| | | | - Eugenio Mantovani
- Research Group on Law, Science, Technology and Society, Faculty of Law & Criminology, Vrije Universiteit Brussel, Ixelles, Belgium
| | - Olga Gkotsopoulou
- Research Group on Law, Science, Technology and Society, Faculty of Law & Criminology, Vrije Universiteit Brussel, Ixelles, Belgium
| | - Dimitrios Iakovakis
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stelios Hadjidimitriou
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Charisis
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Leontios J. Hadjileontiadis
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Biomedical Engineering, Healthcare Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| |
Collapse
|
3
|
Edenbrandt AK, Ewers B, Storgaard H, Smed S. Dietary changes based on food purchase patterns following a type 2 diabetes diagnosis. Public Health Nutr 2022; 25:1-12. [PMID: 35713020 PMCID: PMC9991834 DOI: 10.1017/s1368980022001409] [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: 08/18/2021] [Revised: 03/17/2022] [Accepted: 05/30/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The study explores whether type 2 diabetes (T2D) diagnosis affects food consumption patterns in line with the dietary recommendations provided to individuals in relation to a diagnosis. DESIGN Based on detailed food purchase data, we explore which dietary changes are most common following a T2D diagnosis. Changes are investigated for several energy-adjusted nutrients and food groups and overall adherence to dietary guidelines. SETTING We use data on diagnosis of T2D and hospitalisation in relation to T2D for a sample of adult Danes registered in the official patient register. This is combined with detailed scanner data on food purchases, which are used as a proxy for dietary intake. PARTICIPANTS We included 274 individuals in Denmark who are diagnosed during their participation in a consumer panel where they report their food purchases and 16 395 individuals who are not diagnosed. RESULTS Results suggest some changes in dietary composition following diagnosis, as measured by a Healthy Eating Index and for specific food groups and nutrients, although the long-term effects are limited. Socio-economic characteristics are poor predictors of dietary changes following diagnosis. Change in diet following diagnosis vary with the pre-diagnosis consumption patterns, where individuals with relatively unhealthy overall diets prior to diagnosis improve overall healthiness more compared to individuals with relatively healthy diets prior to diagnosis. CONCLUSIONS Adherence to dietary advice is low, on average, but there is large variation in behavioural change between the diagnosed individuals. Our results stress the difficulty for diagnosed individuals to shift dietary habits, particularly in the long term.
Collapse
Affiliation(s)
- Anna Kristina Edenbrandt
- Department of Economics, Swedish University of Agricultural Sciences, Uppsala750 07Sweden
- University of Copenhagen, Department of Food and Resource Economics, Copenhagen, Denmark
| | - Bettina Ewers
- Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | | | - Sinne Smed
- University of Copenhagen, Department of Food and Resource Economics, Copenhagen, Denmark
| |
Collapse
|
4
|
Loochi SA, Demol S, Nagelberg N, Lebenthal Y, Phillip M, Yackobovitch-Gavan M. Gonadotropin releasing hormone analogue therapy in girls with idiopathic precocious puberty/early-fast puberty: dynamics in adiposity indices, eating habits and quality of life. J Pediatr Endocrinol Metab 2021; 34:373-383. [PMID: 33609438 DOI: 10.1515/jpem-2020-0471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 01/02/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND The impact of gonadotropin-releasing-hormone-analogue (GnRHa) treatment on weight and body composition is controversial. Exploring the nutritional, psychological patterns of this population may aid to clarify this propensity to gain weight. This prospective observational study aimed to evaluate longitudinal changes in adiposity, nutrition and quality of life in girls with central precocious/early-fast puberty (CPP/EFP) during GnRHa treatment. METHODS Thirty-two GnRHa-treated girls with CPP/EFP and 27 prepubertal girls (7-10 years) were included in the analysis. Outcome measures assessed at baseline for CPP/EFP and the control groups and during up to two years of GnRHa treatment for the CPP/EFP group, included anthropometrics, body-composition, basal-metabolic-rate (BMR), 3-day food-diaries, child eating-behavior questionnaire, and pediatric quality-of-life questionnaire (PedsQL). RESULTS Girls with CPP/EFP had higher pretreatment BMI-SDS, fat percentages, waist circumference and waist-per-height (p<0.01 for all), and lower psychosocial functioning than controls (p<0.05). Changes in anthropometric and body composition measurements indicated a gradual increase in adiposity and a decrease in muscle mass (p<0.001 for all). Dynamics in body composition could not be explained by the participants' self-reported dietary patterns and physical activity levels or by the measured BMR, which revealed an adequate and relatively low energy intake as compared to energy requirements. A gradual decline in physical functioning (PedsQL) after one and two years of GnRHa treatment was observed (p<0.001). CONCLUSIONS Our findings highlight the need for comprehensive surveillance in girls with CPP/EFP. Dynamics in weight status and body composition during GnRHa treatment indicate the need for tailored nutritional and physical activity counseling aimed at preventing obesity.
Collapse
Affiliation(s)
- Shiran Abargil Loochi
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharon Demol
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Nessia Nagelberg
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Yael Lebenthal
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Moshe Phillip
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Yackobovitch-Gavan
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| |
Collapse
|
5
|
Kalam F, Gabel K, Cienfuegos S, Wiseman E, Ezpeleta M, Pavlou V, Varady KA. Changes in subjective measures of appetite during 6 months of alternate day fasting with a low carbohydrate diet. Clin Nutr ESPEN 2021; 41:417-422. [PMID: 33487299 DOI: 10.1016/j.clnesp.2020.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 09/01/2020] [Accepted: 10/05/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Alternate day fasting (ADF) has been shown to lower body weight and improve subjective appetite by increasing fullness. What remains unknown, however, is whether carbohydrate restriction during ADF would provide additional weight loss benefits by helping to lower hunger as well. Accordingly, this study examined the effect of 6-months of ADF combined with a low carbohydrate diet on fasting and postprandial appetite ratings. METHODS Adults with obesity (n = 31) participated in ADF (600 kcal "fast day" alternated with an ad libitum "feast day") with a low-carbohydrate background diet (30% carbohydrates, 35% protein, and 35% fat). The 6-month trial consisted of a 3-month weight loss period followed by a 3-month weight maintenance period. RESULTS After 6-months of an ADF-low carbohydrate diet, body weight decreased (P < 0.01) by 6.2 ± 1.0 kg, relative to baseline. Subjective hunger and fullness did not change throughout the study. Fasting insulin decreased (P < 0.05) by 3.3 ± 1.3 μlU/mL by month 6, relative to baseline. Fasting glucose and insulin resistance, remained unchanged over the course of the study. Hunger and fullness were not related to body weight, glucoregulatory factors or energy intake. CONCLUSIONS These findings suggest that ADF combined with a low carbohydrate diet is not associated with any changes in appetite, relative to baseline. TRIAL REGISTRATION Clinicaltrials.gov, NCT03528317.
Collapse
Affiliation(s)
- Faiza Kalam
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Kelsey Gabel
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Sofia Cienfuegos
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Eric Wiseman
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Mark Ezpeleta
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Vasiliki Pavlou
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Krista A Varady
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA.
| |
Collapse
|
6
|
Kord-Varkaneh H, Nazary-Vannani A, Mokhtari Z, Salehi-sahlabadi A, Rahmani J, Clark CCT, Fatahi S, Zanghelini F, Hekmatdoost A, Okunade K, Mirmiran P. The Influence of Fasting and Energy Restricting Diets on Blood Pressure in Humans: A Systematic Review and Meta-Analysis. High Blood Press Cardiovasc Prev 2020; 27:271-280. [DOI: 10.1007/s40292-020-00391-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 05/14/2020] [Indexed: 12/12/2022] Open
|
7
|
Daley A, Jolly K, Madigan C, Griffin R, Roalfe A, Lewis A, Nickless A, Aveyard P. A brief behavioural intervention to promote regular self-weighing to prevent weight regain after weight loss: a RCT. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundAlthough behavioural weight loss treatments can be effective, long-term maintenance of this weight loss remains a critical challenge because the vast majority of people will regain their lost weight over time. The period after initial weight loss is the time when people are at the highest risk of weight regain.ObjectiveThe primary aim of this study was to evaluate the effectiveness and cost-effectiveness of a brief behavioural intervention delivered by non-specialist call centre staff to promote regular self-weighing to prevent weight regain after intentional weight loss.DesignRandomised controlled trial.SettingWest Midlands, UK.ParticipantsAdults were recruited if they had attended a local authority-funded weight management programme and had lost ≥ 5% of their starting weight by the end of their weight loss programme.InterventionsThe intervention group received three brief support telephone calls, delivered by non-specialist call centre staff (from a third-sector community organisation), that encouraged setting a weight maintenance target of ≤ 1 kg of weight gain from current weight, which was to be assessed by daily self-weighing and recording weight on a record card, together with regular text messages. Participants were asked to return to their weight loss plan if they gained > 1 kg above their target weight. The usual-care group received a standard weight maintenance leaflet, the infographic EatWell Plate and a list of useful websites pertaining to weight management.Main outcome measuresThe primary outcome was the difference between the groups in mean weight change (kg) from baseline to 12 months. The secondary outcomes included the proportion of participants in each group who had regained < 1 kg in weight at the 3- and 12-month follow-up points.ResultsA total of 813 potential participants were screened, 583 of whom were eligible and randomised (usual care,n = 292; intervention,n = 291). A total of 94% and 89% of participants completed follow-up at 3 and 12 months, respectively. At 12 months, the mean unadjusted weight change was +0.39 kg for the intervention group and –0.17 kg for the usual-care group, an adjusted difference of 0.53 kg [95% confidence interval (CI) –0.64 to 1.71 kg]. At 12 months, 134 (45.9%) and 130 (44.7%) participants regained ≤ 1 kg of their baseline weight in the usual-care and intervention groups, respectively (odds ratio 0.96, 95% CI 0.69 to 1.33). As the intervention was ineffective, we did not pursue a cost-effectiveness analysis.ConclusionsBrief behavioural telephone support delivered by non-specialist workers to promote target-setting and daily self-weighing and recording of weight does not prevent weight regain after intentional weight loss. Specifically, as target-setting and daily self-weighing did not increase conscious cognitive restraint, people may need more intensive interventions to promote the use of behavioural techniques that help people maintain lost weight.Trial registrationCurrent Controlled Trials ISRCTN52341938.FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 7, No. 7. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Amanda Daley
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Claire Madigan
- Primary Care Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Ryan Griffin
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Andrea Roalfe
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Amanda Lewis
- Department of Population Health Sciences, University of Bristol, Bristol, UK
| | - Alecia Nickless
- Primary Care Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| |
Collapse
|
8
|
Ewers B, Trolle E, Jacobsen SS, Vististen D, Almdal TP, Vilsbøll T, Bruun JM. Dietary habits and adherence to dietary recommendations in patients with type 1 and type 2 diabetes compared with the general population in Denmark. Nutrition 2019; 61:49-55. [PMID: 30684852 DOI: 10.1016/j.nut.2018.10.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 10/12/2018] [Accepted: 10/14/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVES The aim of the present study was to examine dietary habits and adherence to dietary recommendations in adult patients with type 1 diabetes (T1D) and type 2 diabetes (T2D) compared with the general population in Denmark. METHODS The study was cross-sectional and included 426 patients with T1D and 348 patients with T2D recruited from an outpatient diabetes clinic in the capital region of Denmark. Dietary habits were assessed by a food frequency questionnaire and compared with dietary data from 2,899 participants without diabetes from the Danish National Survey of Dietary Habits and Physical Activity. RESULTS Patients with diabetes had a 20-50% lower intake of added sugar and alcohol, and a 10-20% higher intake of fibre and vegetables compared with the general population (p<0.001 for all). Patients with T2D had a 37% lower intake of alcohol compared with T1D (p<0.001). Adherence to dietary recommendations (e.g. fibre, saturated fat, vegetables, fruit and fish) were low in all groups but lowest in the general population. CONCLUSION The Danish diet is too high in saturated fat and too low in dietary fibre, vegetable, fruit and fish compared to dietary recommendations in both patients with diabetes and the general population. However, our data demonstrate that patients with diabetes consume a healthier diet compared to the general population: Limiting the intake of added sugar and alcohol, and increasing the intake of vegetables and dietary fibre.
Collapse
Affiliation(s)
- Bettina Ewers
- Steno Diabetes Center Copenhagen, Gentofte, Denmark.
| | - Ellen Trolle
- The National Food Institute, Technical University of Denmark, Soeborg, Denmark
| | | | | | | | - Tina Vilsbøll
- Steno Diabetes Center Copenhagen, Gentofte, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens Meldgaard Bruun
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark; Department of Medicine, Randers Regional Hospital, Denmark
| |
Collapse
|
9
|
Energy depletion by 24-h fast leads to compensatory appetite responses compared with matched energy depletion by exercise in healthy young males. Br J Nutr 2018; 120:583-592. [DOI: 10.1017/s0007114518001873] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
AbstractAlthough there is a growing interest for the effects of intermittent fasting on energy balance, this study aimed to compare appetite, energy intake and food reward responses with an energy depletion induced either by 24-h food restriction or an equivalent deficit with exercise in healthy males. In all, twelve healthy lean males (21·5 (sd 0·5) years old; BMI: 22·5 (sd 1·7) kg/m2) participated in this study. Body composition, aerobic capacity, food preferences and energy intake were assessed. They randomly completed three conditions: (i) no depletion (CON); (ii) full 24-h energy restrictions (Def-EI); and (iii) exercise condition (Def-EX). Ad libitum energy intake and food reward were assessed at the end of each session. Appetite feelings were assessed regularly. Ad libitum energy intake was higher on Def-EI (7330 (sd 2975) kJ (1752 (sd 711) kcal) compared with that on CON (5301 (sd 1205) kJ (1267 (sd 288) kcal)) (P<0·05), with no difference between CON and Def-EX (6238 (sd 1741) kJ (1491 (sd 416) kcal) (P=0·38) and between Def-EX and Def-EI (P=0·22). There was no difference in the percent energy ingested from macronutrients. Hunger was lower on CON and Def-EX compared with Def-EI (P<0·001). Satiety was higher on CON and Def-EI compared with that on Def-EX (P<0·001). There was a significant interaction condition × time for food choice fat bias (P=0·04), showing a greater preference for high-fat v. low-fat food during Def-EI and Def-EX. Although 24-h fasting leads to increased energy intake at the following test meal (without total daily energy intake difference), increased hunger profile and decreased post-meal food choice fat bias, such nutritional responses are not observed after a similar deficit induced by exercise.
Collapse
|
10
|
Murakami K, Livingstone MBE. Greenhouse gas emissions of self-selected diets in the UK and their association with diet quality: is energy under-reporting a problem? Nutr J 2018; 17:27. [PMID: 29466993 PMCID: PMC5822528 DOI: 10.1186/s12937-018-0338-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 02/13/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND While the admittedly limited number of epidemiological findings on the association between diet-related greenhouse gas emissions (GHGE) and diet quality are not always consistent, potential influence of bias in the estimation of diet-related GHGE caused by misreporting of energy intake (EI) has not been investigated. This cross-sectional study evaluated diet-related GHGE in the UK and their association with diet quality, taking account of EI under-reporting. METHODS Dietary data used were from the National Diet and Nutrition Survey rolling programme 2008/2009-2013/2014, in which 4-day food diaries were collected from 3502 adults aged ≥19 years. Diet-related GHGE were estimated based on 133 food groups, using GHGE values from various secondary sources. Diet quality was assessed by the healthy diet indicator (HDI), Mediterranean diet score (MDS) and Dietary Approaches to Stop Hypertension (DASH) score. EI misreporting was assessed as reported EI divided by estimated energy requirement (EI:EER). RESULTS Mean value of daily GHGE was 5.7 kg carbon dioxide equivalents (CO2eq), which is consistent with those reported from a number of national representative samples in other European countries. Mean EI:EER was 0.74. Assuming that all the dietary variables were misreported in proportion to the misreporting of EI, the mean value of the misreporting-adjusted diet-related GHGE was 8.2 kg CO2eq/d. In the entire population, after adjustment for potential confounders (i.e., age, sex, ethnicity, socioeconomic classification, smoking status and physical activity), diet-related GHGE were inversely associated with HDI and DASH score but not with MDS. However, with further adjustment for EI:EER, diet-related GHGE showed inverse associations with all three measures of diet quality. Similar associations were observed when only under-reporters (EI:EER < 0.70; n = 1578) were analysed. Conversely, in the analysis including only plausible reporters (EI:EER 0.70-1.43; n = 1895), diet-related GHGE showed inverse associations with all diet quality measures irrespective of adjustment. CONCLUSIONS With taking account of EI under-reporting, this study showed inverse associations between diet-related GHGE and diet quality not only in the entire sample but also in the separate analyses of plausible reporters and under-reporters, as well as potential underreporting of diet-related GHGE.
Collapse
Affiliation(s)
- Kentaro Murakami
- Interfaculty Initiative in Information Studies, University of Tokyo, Tokyo, 113 0033, Japan.
| | | |
Collapse
|
11
|
Maffeis C, Schutz Y, Fornari E, Marigliano M, Tomasselli F, Tommasi M, Chini V, Morandi A. Bias in food intake reporting in children and adolescents with type 1 diabetes: the role of body size, age and gender. Pediatr Diabetes 2017; 18:213-221. [PMID: 26990505 DOI: 10.1111/pedi.12376] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 01/15/2016] [Accepted: 02/11/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND An assessment of total daily energy intake is helpful in planning the overall treatment of children with type 1 diabetes (T1D). However, energy intake misreporting may hinder nutritional intervention. AIMS To assess the plausibility of energy intake reporting and the potential role of gender, body mass index (BMI) z-score (z-BMI), disease duration and insulin requirement in energy intake misreporting in a sample of children and adolescents with T1D. METHODS The study included 58 children and adolescents aged 8-16 yr with T1D. Anthropometry, blood pressure and glycated hemoglobin (HbA1c) were measured. Subjects were instructed to wear a SenseWear Pro Armband (SWA) for 3 consecutive days, including a weekend day and to fill out with their parents a weighed dietary record for the same days. Predicted energy expenditure (pEE) was calculated by age and gender specific equations, including gender, age, weight, height and physical activity level (assessed by SWA). The percent reported energy intake (rEI)/pEE ratio was used as an estimate of the plausibility of dietary reporting. RESULTS Misreporting of food intake, especially under-reporting, was common in children and adolescents with T1D: more than one-third of participants were classified as under-reporters and 10% as over-reporters. Age, z-BMI and male gender were associated with the risk of under-reporting (model R2 = 0.5). Waist circumference was negatively associated with the risk of over-reporting (model R2 = 0.25). CONCLUSIONS Children and adolescents with T1D frequently under-report their food intake. Age, gender and z-BMI contribute to identify potential under-reporters.
Collapse
Affiliation(s)
- Claudio Maffeis
- Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy
| | - Yves Schutz
- Department of Integrative Physiology, University of Fribourg, Fribourg, Switzerland
| | - Elena Fornari
- Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy
| | - Marco Marigliano
- Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy
| | - Francesca Tomasselli
- Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy
| | - Mara Tommasi
- Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy
| | - Veronica Chini
- Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy
| | - Anita Morandi
- Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy
| |
Collapse
|
12
|
Fuller NR, Fong M, Gerofi J, Ferkh F, Leung C, Leung L, Zhang S, Skilton M, Caterson ID. Comparison of an electronic versus traditional food diary for assessing dietary intake-A validation study. Obes Res Clin Pract 2017; 11:647-654. [PMID: 28420588 DOI: 10.1016/j.orcp.2017.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 03/14/2017] [Accepted: 04/01/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Paper-based estimated food diaries are often used in research to collect dietary data, despite this method being burdensome for both participants and researchers. Such food diaries are often time consuming, labour intensive, and rely on participant literacy and therefore may lead to greater rates of under-reporting. METHODS This study assessed the validity of the 'Boden Food Plate', a novel web-based electronic application, compared to a paper-based three-day estimated food diary. Participants were also asked to rate their satisfaction with the new electronic diary. Sixty-seven participants with overweight or obesity completed both the electronic and paper-based diaries at two different time-points. RESULTS Baseline BMI of participants (mean±standard deviation (SD)) was 30.4±2.9kg/m2, body weight was 87.6±13.4kg, and age was 42.3±7.7years. Fifty four percent (n=41) of the cohort were female. Bland Altman plots for total energy, and percentage of total energy intake from fat, carbohydrate, and protein, indicated wide limits of agreement between the two methods of dietary data collection, and in some analyses there were a few cases that did not lie within the 95% confidence intervals. Approximately 70% of participants rated the electronic food diary as easier to use and more fun when compared to the traditional paper-based estimated food diary. CONCLUSION Innovative and visual dietary collection applications such as the 'Boden Food Plate' provide an enjoyable and interactive means of measuring nutritional intake in a time efficient manner. Further validation studies incorporating micronutrient analysis and to improve the applications validity are warranted.
Collapse
Affiliation(s)
- Nicholas R Fuller
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia.
| | - Mackenzie Fong
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia
| | - James Gerofi
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia
| | - Fatima Ferkh
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia
| | - Chloris Leung
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia
| | - Lisa Leung
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia
| | - Shaoyu Zhang
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia
| | - Michael Skilton
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia
| | - Ian D Caterson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia
| |
Collapse
|
13
|
Abstract
BACKGROUND Roux-en-Y gastric bypass (GBP) and sleeve gastrectomy (SG) have increased dramatically, potentially increasing the prevalence of nutritional deficiencies. The aim of this study was to analyze the effects of food restriction during the first year after bariatric surgery (BS) on nutritional parameters. METHODS Twenty-two and 30 obese patients undergoing GBP and SG were prospectively followed at baseline and 3, 6, and 12 months after BS (N = 14 and N = 19 at T12). We evaluated food intake and nutrient adequacy (T0, T3, T12), as well as serum vitamin and mineral concentration (T0, T3, T6, T12). RESULTS At baseline, GBP and SG patients had similar clinical characteristics, food intake, nutrient adequacy, and serum concentration. The drastic energy and food reduction led to very low probabilities of adequacy for nutrients similar in both models (T3, T12). Serum analysis demonstrated a continuous decrease in prealbumin during the follow-up, indicating mild protein depletion in 37 and 38% of GBP patients and 57 and 52% of SG patients, respectively, at T3 and T12. Conversely, despite the low probabilities of adequacy observed at T3 and T12, systematic multivitamin and mineral supplementation after GBP and SG prevented most nutritional deficiencies. CONCLUSIONS GBP and SG have comparable effects in terms of energy and food restriction and subsequent risk of micronutrient and protein deficiencies in the first year post BS. Such results advocate for a cautious monitoring of protein intake after GPB and SG and a systematic multivitamin and mineral supplementation in the first year after SG.
Collapse
|
14
|
Aron-Wisnewsky J, Verger EO, Bounaix C, Dao MC, Oppert JM, Bouillot JL, Chevallier JM, Clément K. Nutritional and Protein Deficiencies in the Short Term following Both Gastric Bypass and Gastric Banding. PLoS One 2016; 11:e0149588. [PMID: 26891123 PMCID: PMC4758752 DOI: 10.1371/journal.pone.0149588] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 02/01/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The number of morbidly obese patients undergoing bariatric surgery (BS) has increased dramatically in recent years. Therefore, monitoring food intake and its consequences in terms of nutritional status is necessary to prevent nutritional deficiencies. The aim of this study was to analyze the effect of food restriction on nutritional parameters in the short-term (≤3 months) period after BS in morbid obesity. METHOD In a prospective study, we followed 22 obese women who underwent Roux-en-Y gastric bypass (GBP) or adjustable gastric banding (AGB) at baseline (T0) and 1 (T1) and 3 (T3) months after surgery. We evaluated food intake, nutrient adequacy and serum concentrations of vitamins and minerals known to be at risk for deficiency following BS. RESULTS Before surgery, we observed suboptimal food intakes, leading to a risk of micronutrient deficiencies. Serum analysis confirmed nutritional deficiencies for iron and thiamine for 27 and 23% of the patients, respectively. The drastic energy and food reduction seen in the short term led to very low probabilities of adequacy for nutrients equivalent across both surgeries. Serum analysis demonstrated a continuous decrease in prealbumin during the follow-up, indicating mild protein depletion in 21 and 57% of GBP patients and 50 and 63% of AGB patients, respectively, at T1 and T3. Regarding vitamins and minerals, systematic supplementation after GBP prevented most nutritional deficiencies. By contrast, AGB patients, for whom there is no systematic supplementation, developed such deficiencies. CONCLUSIONS Our results suggest that cautious monitoring of protein intake after BS is mandatory. Furthermore, AGB patients might also benefit from systematic multivitamin and mineral supplementation at least in the short term.
Collapse
Affiliation(s)
- Judith Aron-Wisnewsky
- Institute of Cardiometabolism and Nutrition, ICAN, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière hospital, Nutrition department, F-75013, Paris, France
- Sorbonne Universités, UPMC University Paris 06, UMR_S 1166 I, ICAN, Nutriomics team, F-75005, Paris, France
- INSERM, UMR_S U1166, NutriOmics team, F-75013, Paris, France
| | - Eric O Verger
- Institute of Cardiometabolism and Nutrition, ICAN, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière hospital, Nutrition department, F-75013, Paris, France
- INSERM, UMR_S U1166, NutriOmics team, F-75013, Paris, France
| | - Carine Bounaix
- Sorbonne Universités, UPMC University Paris 06, UMR_S 1166 I, ICAN, Nutriomics team, F-75005, Paris, France
- INSERM, UMR_S U1166, NutriOmics team, F-75013, Paris, France
| | - Maria Carlota Dao
- Institute of Cardiometabolism and Nutrition, ICAN, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière hospital, Nutrition department, F-75013, Paris, France
- INSERM, UMR_S U1166, NutriOmics team, F-75013, Paris, France
| | - Jean-Michel Oppert
- Institute of Cardiometabolism and Nutrition, ICAN, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière hospital, Nutrition department, F-75013, Paris, France
| | - Jean-Luc Bouillot
- Assistance Publique-Hôpitaux de Paris, Visceral surgery Department, Ambroise Paré Hospital, 92100 Boulogne-Billancourt, France
| | - Jean-Marc Chevallier
- Assistance Publique-Hôpitaux de Paris, Visceral surgery Department, Hopital Europeen Georges Pompidou, F-75015, Paris, France
| | - Karine Clément
- Institute of Cardiometabolism and Nutrition, ICAN, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière hospital, Nutrition department, F-75013, Paris, France
- Sorbonne Universités, UPMC University Paris 06, UMR_S 1166 I, ICAN, Nutriomics team, F-75005, Paris, France
- INSERM, UMR_S U1166, NutriOmics team, F-75013, Paris, France
| |
Collapse
|
15
|
LaVerda NL, Goldsmith DF, Alavanja MCR, Hunting KL. Pesticide Exposures and Body Mass Index (BMI) of Pesticide Applicators From the Agricultural Health Study. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2015; 78:1255-1276. [PMID: 26479458 DOI: 10.1080/15287394.2015.1074844] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Endocrine-disrupting chemicals, including pesticides, may be associated with weight gain. This is the first longitudinal study to examine a potential association between weight gain and pesticides using data on 8,365 male pesticide applicators from the Agricultural Health Study (AHS) cohort established in 1993. The relationship between total cumulative days of exposure to pesticide functional/chemical classes and to the four most frequently used individual pesticides was studied in relation to body mass index (BMI) at the time of 5-yr follow-up (beginning in 1998) with the length of the exposure period dating back to age 20 yr. Multiple regression, Spearman correlation, ordinal logistic regression, and logistic regression models all utilized a Bonferroni-adjusted p value, were adjusted for relevant covariates, and were stratified by state of residence (Iowa/North Carolina) and presence/absence of weight-related health conditions. Adjusted multiple regression yielded statistically significant positive parameter estimates for the study sample and Iowa subgroups with consistent findings for triazine herbicides and atrazine: Change in BMI per 100 cumulative pesticide exposure days ranged from 0.07 to 0.11 for triazine herbicides and from 0.10 to 0.19 for atrazine. Ordinal logistic regression compared normal weight with overweight and with obese using the zero exposure category as referent. Statistically significant adjusted odds ratios identified for the study sample and both state subgroups for the highest level of atrazine exposure ranged from 1.4 to 1.7. Further investigation is warranted to evaluate the associations identified here.
Collapse
Affiliation(s)
- Nancy L LaVerda
- a Department of Environmental and Occupational Health , Milken Institute School of Public Health, George Washington University , Washington , DC , USA
| | - David F Goldsmith
- a Department of Environmental and Occupational Health , Milken Institute School of Public Health, George Washington University , Washington , DC , USA
- c Department of Human Science , Georgetown University , Washington , DC , USA
| | | | - Katherine L Hunting
- a Department of Environmental and Occupational Health , Milken Institute School of Public Health, George Washington University , Washington , DC , USA
| |
Collapse
|
16
|
Funtikova AN, Gomez SF, Fitó M, Elosua R, Benítez-Arciniega AA, Schröder H. Effect of energy under-reporting on secular trends of dietary patterns in a mediterranean population. PLoS One 2015; 10:e0127647. [PMID: 26023775 PMCID: PMC4449204 DOI: 10.1371/journal.pone.0127647] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 04/17/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Diet is an important factor in the prevention of chronic diseases. Analysis of secular trends of dietary patterns can be biased by energy under-reporting. Therefore, the objective of the present study was to analyse the impact of energy under-reporting on dietary patterns and secular trends in dietary patterns defined by cluster analysis. DESIGN AND METHODS Two cross-sectional population-based surveys were conducted in Spain, in 2000 and 2005, with 3058 and 6352 participants, respectively, aged 25 to 74 years. Validated questionnaire was used to collect dietary data. Cluster analysis was run separately for all participants, plausible energy reporters (PER), and energy under-reporters (EUR) to define dietary patterns. RESULTS Three clusters, "healthy", "mixed" and "western", were identified for both surveys. The "mixed" cluster was the predominant cluster in both surveys. Excluding EUR reduced the proportion of the "mixed" cluster up to 6.40% in the 2000 survey; this caused secular trend increase in the prevalence of the "mixed" pattern. Cross-classification analysis of all participants and PER' data showed substantial agreement in cluster assignments: 68.7% in 2000 and 84.4% in 2005. Excluding EUR did not cause meaningful (≥ 15%) changes in the "healthy" pattern. It provoked changes in consumption of some food groups in the "mixed" and "western" patterns: mainly decreases of unhealthy foods within the 2000 and increases of unhealthy foods within the 2005 surveys. Secular trend effects of EUR were similar to those within the 2005 survey. Excluding EUR reversed the direction of secular trends in consumption of several food groups in PER in the "mixed" and "western" patterns. CONCLUSIONS EUR affected distribution of participants between dietary patterns within and between surveys, secular trends in food group consumption and amount of food consumed in all, but not in the "healthy" pattern. Our findings emphasize threats from energy under-reporting in dietary data analysis.
Collapse
Affiliation(s)
- Anna N. Funtikova
- Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- PhD program “Foods and Nutrition”, University of Barcelona, Barcelona, Spain
| | - Santiago F. Gomez
- Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Fundación THAO, Barcelona, Spain
| | - Montserrat Fitó
- Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Roberto Elosua
- Cardiovascular Epidemiology and Genetics (EGEC-ULEC), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | - Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- * E-mail:
| |
Collapse
|
17
|
Validation of a pre-coded food diary used among 60-80 year old men: comparison of self-reported energy intake with objectively recorded energy expenditure. PLoS One 2014; 9:e102029. [PMID: 25019949 PMCID: PMC4096592 DOI: 10.1371/journal.pone.0102029] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 06/13/2014] [Indexed: 11/30/2022] Open
Abstract
Objective To validate energy intake (EI) estimated from a pre-coded food diary (PFD) against energy expenditure (EE) measured with a valid physical activity monitor (SenseWear Pro3 Armband) and to evaluate whether misreporting was associated with overweight/obesity in a group of elderly men. Methods Forty-seven healthy Norwegian men, 60–80 years old, completed the study. As this study was part of a larger intervention study, cross-sectional data were collected at both baseline and post-test. Participants recorded their food intake for four consecutive days using food diaries and wore SenseWear Pro3 Armband (SWA) during the same period. Only participants with complete data sets at both baseline and post-test were included in the study. Results The group average EI was 17% lower at baseline and 18% lower at post-test compared to measured EE. Mean difference from Bland-Altman plot for EI and EE was −1.5 MJ/day (±1.96 SD: −7.0, 4.0 MJ/day) at baseline and −1.6 MJ/day (−6.6, 3.4 MJ/day) at post-test. The intraclass correlation coefficient (ICC) was 0.30 (95% CI: 0.02, 0.54, p = 0.018) at baseline and 0.34 (0.06, 0.57, p = 0.009) at post-test. Higher values of underreporting was shown among overweight/obese compared to normal weight participants at both baseline and post-test (p≤ 0.001), respectively. Conclusions The results indicate that the PFD could be a useful tool for estimating energy intake in normal weight elderly men. On the other hand, the PFD seems to be less suitable for estimating energy intake in overweight/obese elderly men.
Collapse
|
18
|
Murakami K, Livingstone MBE. Eating frequency in relation to body mass index and waist circumference in British adults. Int J Obes (Lond) 2014; 38:1200-6. [PMID: 24406480 DOI: 10.1038/ijo.2014.1] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 12/09/2013] [Accepted: 01/01/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Inconsistent associations between eating frequency (EF) and adiposity may be mainly due to measurement errors of EF. OBJECTIVE This cross-sectional study examined the association of EF with body mass index (BMI) and waist circumference (WC), by focusing on the confounding of energy misreporting and the effect of exclusion of underreporters (URs). DESIGN Dietary intake was assessed using a 7-day weighed dietary record in 1487 British adults aged 19-64 years. EF was calculated based on all eating occasions (EF(all)), after excluding those providing no energy (EF(energy)), and after excluding those providing <210 kJ of energy (EF(⩾210 kJ)). Energy misreporting was assessed as reported energy intake divided by estimated energy requirement (EI:EER). RESULTS The mean values (1st and 99th percentiles) of EF(all), EF(energy) and EF(⩾210 kJ) were, respectively, 7.8 (3.1, 15.3), 7.2 (2.9, 12.7), and 5.6 (2.3, 10.7) times/day in men and 7.6 (3.0, 13.9), 6.7 (2.7, 12.1), and 4.8 (1.9, 9.1) times/day in women. In the univariate analyses of the entire male population, EF(⩾210 kJ), but not EF(all) and EF(energy), was inversely associated with BMI and WC. After full adjustment (including EI:EER), all three measures of EF were positively associated with BMI and WC. In the univariate analyses of the entire female population, all three measures of EF were inversely associated with BMI and WC. After full adjustment, EF(⩾210 kJ) was positively associated with BMI and WC while EF(all) and EF(energy) showed null associations. When URs (EI:EER <0.665) were excluded, the multivariate analyses showed that EF(all) and EF(energy) were positively associated with BMI in men while EF(⩾210 kJ) was positively associated with BMI and WC in both sexes. CONCLUSIONS We showed positive associations of EF with BMI and WC. Adjustment for EI:EER and the exclusion of URs, as well as definitions of EF, radically affected the results of the analysis.
Collapse
Affiliation(s)
- K Murakami
- 1] Northern Ireland Centre for Food and Health (NICHE), University of Ulster, Coleraine, UK [2] JSPS Postdoctoral Fellow for Research Abroad, Japan Society for the Promotion of Science, Tokyo, Japan
| | - M B E Livingstone
- Northern Ireland Centre for Food and Health (NICHE), University of Ulster, Coleraine, UK
| |
Collapse
|
19
|
Varady KA, Bhutani S, Klempel MC, Kroeger CM, Trepanowski JF, Haus JM, Hoddy KK, Calvo Y. Alternate day fasting for weight loss in normal weight and overweight subjects: a randomized controlled trial. Nutr J 2013; 12:146. [PMID: 24215592 PMCID: PMC3833266 DOI: 10.1186/1475-2891-12-146] [Citation(s) in RCA: 238] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 11/04/2013] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Alternate day fasting (ADF; ad libitum "feed day", alternated with 25% energy intake "fast day"), is effective for weight loss and cardio-protection in obese individuals. Whether these effects occur in normal weight and overweight individuals remains unknown. This study examined the effect of ADF on body weight and coronary heart disease risk in non-obese subjects. METHODS Thirty-two subjects (BMI 20-29.9 kg/m2) were randomized to either an ADF group or a control group for 12 weeks. RESULTS Body weight decreased (P < 0.001) by 5.2 ± 0.9 kg (6.5 ± 1.0%) in the ADF group, relative to the control group, by week 12. Fat mass was reduced (P < 0.001) by 3.6 ± 0.7 kg, and fat free mass did not change, versus controls. Triacylglycerol concentrations decreased (20 ± 8%, P < 0.05) and LDL particle size increased (4 ± 1 Å, P < 0.01) in the ADF group relative to controls. CRP decreased (13 ± 17%, P < 0.05) in the ADF group relative to controls at week 12. Plasma adiponectin increased (6 ± 10%, P < 0.01) while leptin decreased (40 ± 7%, P < 0.05) in the ADF group versus controls by the end of the study. LDL cholesterol, HDL cholesterol, homocysteine and resistin concentrations remained unchanged after 12 weeks of treatment. CONCLUSION These findings suggest that ADF is effective for weight loss and cardio-protection in normal weight and overweight adults, though further research implementing larger sample sizes is required before solid conclusion can be reached.
Collapse
Affiliation(s)
- Krista A Varady
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 West Taylor Street, Room 506 F, Chicago, IL 60612, USA.
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Associations of dietary glycaemic index and glycaemic load with food and nutrient intake and general and central obesity in British adults. Br J Nutr 2013; 110:2047-57. [PMID: 23656860 DOI: 10.1017/s0007114513001414] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Inconsistent associations between dietary glycaemic index (GI) and glycaemic load (GL) and body fatness may be partly due to differences in the underlying dietary patterns or energy under-reporting. In the present study, we examined the cross-sectional associations of dietary GI and GL with food and nutrient intake and general and central obesity, accounting for energy under-reporting. The subjects were 1487 British adults aged 19-64 years. Dietary intake was assessed using a 7 d weighed dietary record. Breads and potatoes were the positive predictive foods for dietary GI, while fruit, other cereals and dairy products were the negative predictors. These foods were similarly identified in the analysis of only acceptable reporters (AR; ratio of reported energy intake:estimated energy requirement within 0·665-1·335) and under-reporters (UR; ratio < 0·665). Dietary GL was closely correlated with carbohydrate intake. Multiple linear regression analyses showed that dietary GI was independently associated with a higher risk of general obesity (BMI ≥ 30 kg/m²) and central obesity (waist circumference ≥ 102 cm in men and ≥ 88 cm in women). Dietary GL was also associated with general (only women) and central obesity. Similarly, in the analysis of AR, the GI showed positive associations with general and central obesity, and, only in women, the GL showed positive associations with general and central obesity. Conversely, in the analysis of UR, the associations were generally weaker and many of them failed to reach statistical significance. In conclusion, we found independent positive associations of dietary GI and GL with general and central obesity in British adults.
Collapse
|
21
|
The Nordic Nutrition Recommendations and prostate cancer risk in the Cancer of the Prostate in Sweden (CAPS) study. Public Health Nutr 2012; 15:1897-908. [PMID: 22463871 DOI: 10.1017/s1368980012000778] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The Nordic Nutrition Recommendations (NNR) aim at preventing diet-associated diseases such as cancer in the Nordic countries. We evaluated adherence to the NNR in relation to prostate cancer (PC) in Swedish men, including potential interaction with a genetic risk score and with lifestyle factors. DESIGN Population-based case-control study (Cancer of the Prostate in Sweden (CAPS), 2001-2002). Using data from a semi-quantitative FFQ, we created an NNR adherence score and estimated relative risks of PC by unconditional logistic regression. Individual score components were modelled separately and potential modifying effects were assessed on the multiplicative scale. SETTING Four regions in the central and northern parts of Sweden. SUBJECTS Incident PC patients (n 1386) and population controls (n 940), frequency-matched on age and region. RESULTS No overall association with PC was found, possibly due to the generally high adherence to the NNR score and its narrow distribution in the study population. Among individual NNR score components, high compared with low intakes of polyunsaturated fat were associated with an increased relative risk of localized PC. No formal interaction with genetic or lifestyle factors was observed, although in stratified analysis a positive association between the NNR and PC was suggested among men with a high genetic risk score but not among men with a medium or low genetic risk score. CONCLUSIONS Our findings do not support an association between NNR adherence and PC. The suggestive interaction with the genetic risk score deserves further investigations in other study populations.
Collapse
|
22
|
Ross LJ, Tapsell LC, Probst Y. Optimizing dietary fat in a weight-loss trial requires advice based on a structured “whole-of-diet” model. Nutr Res 2011; 31:683-90. [DOI: 10.1016/j.nutres.2011.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Revised: 08/23/2011] [Accepted: 08/24/2011] [Indexed: 10/16/2022]
|
23
|
Gregersen NT, Møller BK, Raben A, Kristensen ST, Holm L, Flint A, Astrup A. Determinants of appetite ratings: the role of age, gender, BMI, physical activity, smoking habits, and diet/weight concern. Food Nutr Res 2011; 55:7028. [PMID: 21866221 PMCID: PMC3160809 DOI: 10.3402/fnr.v55i0.7028] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 06/23/2011] [Accepted: 07/01/2011] [Indexed: 12/21/2022] Open
Abstract
Background Appetite measures are often recorded by visual analogue scales (VAS), and are assumed to reflect central nervous system (CNS) perceptions and sensations. However, little is known about how physiological, psychological, social, and cultural factors influence VAS. Objective To investigate whether age, gender, body mass index (BMI), smoking habits, physical activity, diet behaviour, and menstruation cycle are determinants of appetite ratings. Design We investigated appetite ratings in different groups of a population during a single meal test, including 178 healthy women (98) and men (80), aged 20–60 years with a BMI of 18.5–35.0 kg/m2. Subjects consumed an evening meal composed to meet individual requirements of energy content and recommendations regarding macronutrient composition. Before and every half hour until 3 hours after the meal, subjects filled out VAS for satiety, fullness, hunger, and prospective food intake. They also filled in a questionnaire on eating/slimming behaviour. Results Multiple linear regression analyses showed that gender and age were the most powerful predictors of postprandial satiety (p<0.001, adj. R2=0.19) and hunger (p<0.001, adj. R2=0.15). Repeated measures general linear model (GLM) analyses revealed that women felt more satisfied than men (p<0.001) and older subjects felt more satisfied than younger (p<0.01). Furthermore, light/no exercisers felt more satisfied and less hungry than hard/moderate exercisers (p<0.05), but these differences disappeared after adjusting for age and gender. Smokers rated their prospective consumption lower than non-smokers (p<005) and women in the ovulation phase felt less hungry than women in the menstruation phase (p<005). Neither BMI nor diet/weight concern were significantly associated with appetite ratings. Conclusions Appetite ratings differed according to age, gender, and physical activity and to a lesser degree for smoking habits and menstruation cycle. Appetite ratings were not influenced by BMI and diet/weight concern. These factors should be considered when planning studies and analysing data concerning appetite sensations.
Collapse
Affiliation(s)
- Nikolaj T. Gregersen
- Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Frederiksberg, Denmark
- Nikolaj T. Gregersen, Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Rolighedsvej 30, DK-1958 Frederiksberg C, Denmark. Tel: +45 3533 2696. Fax: +45 3533 2483.
| | - Bente K. Møller
- Municipal of Aarhus, Department for Children and Young People (Health and Wellfare), Viby, Denmark
| | - Anne Raben
- Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Søren T. Kristensen
- Metropolitan University College, Department of Nutritional Health, Copenhagen, Denmark
| | - Lotte Holm
- Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Frederiksberg, Denmark
- Faculty of Life Sciences, Institute of Food and Resource Economics, University of Copenhagen, Frederiksberg, Denmark
| | - Anne Flint
- Department of Human Nutrition, The Royal Veterinary and Agricultural University, Novo Nordisk A/S, Søborg, Copenhagen, Denmark
| | - Arne Astrup
- Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Frederiksberg, Denmark
| |
Collapse
|
24
|
A cross-sectional study ontrans-fatty acids and risk markers of CHD among middle-aged men representing a broad range of BMI. Br J Nutr 2011; 106:1245-52. [DOI: 10.1017/s0007114511001474] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Intake oftrans-fatty acids (TFA), especially industrially produced TFA (I-TFA), has been associated with the risk of CHD through influence on serum lipid levels. Other causal pathways remain less investigated. In the present cross-sectional study of middle-aged men representing a broad range of BMI, the association between intake of TFA, I-TFA and ruminant TFA (R-TFA) and obesity-associated risk markers of CHD was assessed. The study comprised 393 Danish men (median age 49 years) with a median BMI of 28·4 kg/m2. Intake of TFA was estimated based on 7 d dietary records, whereas outcomes of interest (waist circumference, sagittal abdominal diameter, percentage of truncal fat, C-reactive protein, IL-6, blood lipids, blood pressure, HbA1c and insulin sensitivity index) were obtained through clinical examination. The associations were assessed by linear regression analysis. The median intake of total TFA among the 393 men was 1·3 g/d, covering a daily I-TFA intake of 0·4 g (10–90th percentile 0·0–1·0) and R-TFA intake of 0·9 g (10–90th percentile 0·4–1·8). Intake of these amounts of TFA showed no significant associations with abdominal fatness, inflammatory markers, blood lipids, blood pressure and insulin homeostasis. Among middle-aged men with a generally low intake of TFA, neither I-TFA nor R-TFA was significantly related to obesity-associated risk markers of CHD. The decreased average intake of I-TFA in Denmark since 1995 is suggested to effectively prevent occurrence of the adverse metabolic changes and health consequences, which have formerly been observed in relation to, especially, I-TFA intake.
Collapse
|
25
|
|