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Rosenau N, Neumann U, Hamblett S, Ellrott T. University Students as Change Agents for Health and Sustainability: A Pilot Study on the Effects of a Teaching Kitchen-Based Planetary Health Diet Curriculum. Nutrients 2024; 16:521. [PMID: 38398844 PMCID: PMC10892560 DOI: 10.3390/nu16040521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/27/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
Global dietary habits are one of the main drivers of climate change. At the same time, they contribute to 11 million premature deaths every year. This raises the question of how the urgently needed transformation of food systems can be realized. Regardless of their degree paths, all university students, in their role as potential future experts and leaders in their fields, can serve as important change agents in society. In this paper, we (a) introduce a university curriculum in a teaching kitchen setting that is based on the planetary health diet (PHD) of the EAT-Lancet Commission, (b) investigate its feasibility, and (c) analyze its effects on the planetary health diet literacy of a pilot cohort of university students enrolled in various degree programs. We developed seven flipped classroom teaching kitchen sessions based on social cognitive theory (SCT), each consisting of a one-hour seminar with student presentations on various nutrition- and sustainability-related key topics, followed by corresponding two-hour hands-on cooking classes. To assess feasibility, specific questions from the official teaching evaluation of the University of Göttingen were analyzed. Changes in self-assessed planetary health diet literacy were measured using a pre- and post-survey. During the pilot phase, 26 students successfully completed the course. A total of 25 participants responded to the teaching evaluation and expressed high satisfaction with the course, the learning outcomes, and the level of demand. A total of 26 participants completed the pre- and post-survey. At the post-intervention, the students rated their planetary health diet literacy as 21 to 98% higher than before their course participation. The findings of this pilot study indicate that the curriculum was well-received and feasible with the target group, and they demonstrate that the course participation increased the university students' self-assessed ability to disseminate strategies for more sustainable and healthy diets. Through replication at other universities worldwide, the teaching kitchen-based planetary health diet curriculum might foster a social shift towards healthier and more climate-friendly food systems.
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Affiliation(s)
- Nicola Rosenau
- Institute for Nutrition and Psychology at the Georg-August-University Göttingen, University Medical Centre, Humboldtallee 32, 37073 Göttingen, Germany
| | - Uwe Neumann
- Culinary Medicine Germany e.V., 48341 Altenberge, Germany;
| | - Stacey Hamblett
- The Teaching Kitchen Collaborative, 101 Middlesex Turnpike, Suite 6, Burlington, MA 01803, USA;
| | - Thomas Ellrott
- Institute for Nutrition and Psychology at the Georg-August-University Göttingen, University Medical Centre, Humboldtallee 32, 37073 Göttingen, Germany
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Böttcher S, Schonebeck LJ, Drösch L, Plogmann AM, Leineweber CG, Puderbach S, Buhre C, Schmöcker C, Neumann U, Ellrott T. Comparison of Effectiveness regarding a Culinary Medicine Elective for Medical Students in Germany Delivered Virtually versus In-Person. Nutrients 2023; 15:4281. [PMID: 37836565 PMCID: PMC10574049 DOI: 10.3390/nu15194281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/30/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023] Open
Abstract
(1) Background: The Culinary Medicine elective at the German medical schools of the universities of Göttingen, Giessen, and Brandenburg is a teaching kitchen-based elective aimed at training medical students on how to improve patient counselling on nutrition and lifestyle medicine topics. This curriculum was either delivered virtually (2021) or in-person (2022/2023). Changes in teaching effectiveness were evaluated. (2) Methods: The elective included seven modules in the teaching kitchen for 3 h each. It consisted of a short introduction and a hands-on interactive cooking part illustrating important dietary principles in different disease groups. The elective was conducted virtually in 2021 in a fully interactive setup using videoconference tools. Students in this cohort attended from their private kitchens whereas students in the in-person cohort (2022/2023) attended the same classes in the teaching kitchen. Standardized comparative self-assessment questionnaires on counselling competencies, nutrition knowledge, eating habits, and mental well-being (WHO-5) before and after the elective were used to determine teaching effectiveness. Paired and unpaired t-tests were performed to evaluate results. (3) Results: A total of 70 students (mean semester 6.3) were included in the virtual cohort, and 80 students (mean semester 6.3) were in the in-person cohort. In both, counselling competencies on 25 nutrition and lifestyle medicine topics increased significantly. Significant changes also occurred in most nutrition knowledge categories. Subjective well-being as well as personal attitudes towards nutrition counselling in medical practice improved significantly during the elective. Healthy eating habits improved in both groups as students ate significantly less unfavourable foods. There were no significant differences between the two groups apart from minor differences in nutrition knowledge. (4) Conclusions: The elective in Culinary Medicine improved students counselling competencies, nutrition knowledge, attitudes, well-being, and eating habits with no relevant difference between virtual and in-person teaching.
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Affiliation(s)
- Selina Böttcher
- Medical Department, Division of Gastroenterology, Oncology, Hematology, Rheumatology and Diabetes, ukrb, Brandenburg Medical School, Theodor Fontane, 16816 Neuruppin, Germany; (C.G.L.); (S.P.); (C.B.); (C.S.)
| | - Louisa Josefa Schonebeck
- Institute for Nutrition and Psychology, Georg-August-University Göttingen Medical Centre, Humboldtallee 32, 37073 Göttingen, Germany;
| | - Laura Drösch
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, 93053 Regensburg, Germany;
| | | | - Can Gero Leineweber
- Medical Department, Division of Gastroenterology, Oncology, Hematology, Rheumatology and Diabetes, ukrb, Brandenburg Medical School, Theodor Fontane, 16816 Neuruppin, Germany; (C.G.L.); (S.P.); (C.B.); (C.S.)
| | - Seraphina Puderbach
- Medical Department, Division of Gastroenterology, Oncology, Hematology, Rheumatology and Diabetes, ukrb, Brandenburg Medical School, Theodor Fontane, 16816 Neuruppin, Germany; (C.G.L.); (S.P.); (C.B.); (C.S.)
| | - Charlotte Buhre
- Medical Department, Division of Gastroenterology, Oncology, Hematology, Rheumatology and Diabetes, ukrb, Brandenburg Medical School, Theodor Fontane, 16816 Neuruppin, Germany; (C.G.L.); (S.P.); (C.B.); (C.S.)
| | - Christoph Schmöcker
- Medical Department, Division of Gastroenterology, Oncology, Hematology, Rheumatology and Diabetes, ukrb, Brandenburg Medical School, Theodor Fontane, 16816 Neuruppin, Germany; (C.G.L.); (S.P.); (C.B.); (C.S.)
- Faculty of Health Sciences, Joint Faculty of the Brandenburg, University of Technology, Brandenburg Medical School and University of Potsdam, 14469 Potsdam, Germany
| | - Uwe Neumann
- Culinary Medicine Germany e.V., 48341 Altenberge, Germany;
| | - Thomas Ellrott
- Institute for Nutrition and Psychology, Georg-August-University Göttingen Medical Centre, Humboldtallee 32, 37073 Göttingen, Germany;
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Schankweiler P, Raddatz D, Ellrott T, Hauck Cirkel C. Correlates of Food Addiction and Eating Behaviours in Patients with Morbid Obesity. Obes Facts 2023; 16:465-474. [PMID: 37544305 PMCID: PMC10601678 DOI: 10.1159/000531528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 05/31/2023] [Indexed: 08/08/2023] Open
Abstract
INTRODUCTION Food addiction (FA) is a promising construct regarding the multifactorial aetiology of obesity and the search for therapeutic approaches. However, there is an ongoing debate regarding the overlap/differentiation with eating disorders and the classification as a substance- or behaviour-related addiction. Energy-dense foods, especially those combining carbohydrates and fat, are associated with addictive eating and suspected of playing a role in the genesis of FA. This study aims to further understand the clinical significance of FA and to identify possible therapeutic targets. A special focus is set on potentially addictive foods (combination of carbohydrates and fat). METHODS Based on the Yale Food Addiction Scale 2.0, a cohort of 112 German adults with morbid obesity was divided into two sub-samples (patients with and without FA), which were examined for differences in the variables listed below. RESULTS The prevalence of FA was 25%. Patients meeting criteria for FA showed higher degrees of hunger, emotional, binge, and night eating than patients without FA. In addition, hunger and disinhibition were found to be significant predictors of FA. FA was not associated with sex, age, body mass index (BMI), cognitive restraint, rigid and flexible control, prevalence of substance use, age of onset of obesity, stress level, level of social support, reduction of BMI during a weight loss programme, or programme withdrawal rate. There was no significant difference in the consumption of foods rich in both carbohydrates and fat, nor of fat or carbohydrates alone. CONCLUSION FA can be considered as a sub-phenotype of obesity, occurring in approximately 25% of obesity cases. Dysfunctional emotional coping mechanisms associated with low distress tolerance showed to be significantly related to FA and should be targeted therapeutically. Behavioural interventions should include a bio-psycho-social model. Binge eating episodes were found to be characteristic for FA and the already stated overlap between FA and binge eating behaviour can be confirmed. The results do not support a decisive difference due to a substance-related component of FA. Despite this, the existence of FA as a distinct entity cannot be excluded, as not all patients with FA exhibit binges.
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Affiliation(s)
- Pia Schankweiler
- Institute for Nutrition and Psychology at the Georg-August-University Göttingen, University Medical Center Göttingen, Göttingen, Germany
| | - Dirk Raddatz
- Clinic for Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Göttingen, Germany
| | - Thomas Ellrott
- Institute for Nutrition and Psychology at the Georg-August-University Göttingen, University Medical Center Göttingen, Göttingen, Germany
| | - Carolin Hauck Cirkel
- Institute for Nutrition and Psychology at the Georg-August-University Göttingen, University Medical Center Göttingen, Göttingen, Germany
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Rademacher J, Raddatz D, Ellrott T. Influence of food images with different macronutrient compositions on serum ghrelin levels: Analysis in healthy males. Obes Sci Pract 2022; 8:328-337. [PMID: 35664245 PMCID: PMC9159557 DOI: 10.1002/osp4.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 11/16/2021] [Accepted: 11/21/2021] [Indexed: 12/02/2022] Open
Abstract
Objective Serum concentrations of the orexigenic hormone ghrelin fluctuate in anticipation of food intake. Moreover, presentation of food images causes an increase in serum ghrelin levels. Thus, the visual system may have a quantifiable role in the development of hunger via the endocrine system. The influence of macronutrient visualization on ghrelin has not yet been investigated. Methods In four separate sessions, ghrelin concentrations, insulin, and glucose levels were compared before and after the presentation of different pictures to 14 male participants. Pictures included neutral, non‐food‐related items or isocaloric dishes whose macronutrient composition corresponded predominately to protein/fat, simple carbohydrates, or complex carbohydrates. Results While pre/post ghrelin concentrations numerically increased in all sessions, significant increases were only observed following neutral and protein/fat pictures. The differences were not significant between food groups and compared to neutral images. Insulin levels decreased in all groups, but no significant differences were observed between sessions. The glucose concentrations were within the euglycemic range. Conclusion The results did not reproduce the induction of ghrelin secretion in different food images. Therefore, it is unclear whether the visual perception of food influences ghrelin secretion or whether separation into macronutrients changes the hormone response. Further research is required to differentiate the interactions of sensory‐specific satiety.
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Affiliation(s)
- Jan‐Gerd Rademacher
- Department of Nephrology and Rheumatology University Medical Center Göttingen Göttingen Germany
| | - Dirk Raddatz
- Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology University Medical Center Göttingen Göttingen Germany
| | - Thomas Ellrott
- Institute for Nutrition and Psychology University Medical Center Göttingen Göttingen Germany
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Hauck C, Schipfer M, Ellrott T, Cook B. The relationship between food addiction and patterns of disordered eating with exercise dependence: in amateur endurance athletes. Eat Weight Disord 2020; 25:1573-1582. [PMID: 31654288 PMCID: PMC7581610 DOI: 10.1007/s40519-019-00794-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 10/03/2019] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Examine the prevalence and potential relationships among food addiction (FA)-as measured by Yale Food Addiction Scale 2.0 (YFAS 2.0), eating disorders (ED)-as measured by Eating Disorder Diagnostic Scale (EDDS)-and exercise dependence (EXD)-as measured by Questionnaire to Diagnose Exercise Dependence in Endurance Sports (FESA), for the first time worldwide, in amateur endurance athletes. METHODS A total of 1022 German-speaking endurance athletes (44% male, Ø 36 years, Ø BMI 23 kg/m2) replied to an online questionnaire consisting of demographics, related parameters, and the German versions of YFAS 2.0, EDDS, and FESA. RESULTS Prevalence of FA, ED, and EXD was 6.2, 6.5, and 30.5%. The probability for FA increases with BMI, thoughts about food and EXD score, and decreases with age and when an ED is present. People with FA and people with ED vs. people with both, FA&ED, differed significantly in this cohort. Strong significant relationships were found between FA and EXD (X2 (1) = 15.117, p < 0.001, n = 1022). CONCLUSIONS A considerable number of amateur endurance athletes may suffer from FA. The association between FA and EXD is stronger than between ED and EXD, indicating FA as a potentially more relevant subject-than ED-for prevention or therapy in people with EXD. Further studies are needed to investigate parameters and relationships between the possibly involved types of ED, FA, and EXD. LEVEL OF EVIDENCE Level III, well-designed cohort analytic study.
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Affiliation(s)
- Carolin Hauck
- Institute for Nutrition and Psychology at the University of Goettingen, Humboldtallee 32, 37073, Göttingen, Germany.
| | - Melanie Schipfer
- Martin-Luther-University Halle-Wittenberg, Universitaetsplatz 10, 06108, Halle (Saale), Germany.,Profusa Inc., 345 Allerton Avenue, South San Francisco, CA, 94080, USA
| | - Thomas Ellrott
- Institute for Nutrition and Psychology at the University of Goettingen, Humboldtallee 32, 37073, Göttingen, Germany
| | - Brian Cook
- Alsana: An Eating Disorder Recovery Community, 2545 W Hillcrest Dr, Suite 205, Thousand Oaks, CA, 91320, USA
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Hauner H, Moss A, Berg A, Bischoff S, Colombo-Benkmann M, Ellrott T, Kanthak U, Kunze D, Stefan N, Teufel M, Wabitsch M, Wirth A. Adipositas und Diabetes mellitus. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/a-0598-0674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Hans Hauner
- Klinik für Ernährungsmedizin, Klinikum rechts der Isar, Technische Universität München
| | - Anja Moss
- Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Ulm
| | - Aloys Berg
- Institut für Sport und Sportwissenschaft der Universität Freiburg, Freiburg
| | - Stephan Bischoff
- Institut für Ernährungsmedizin, Universität Hohenheim, Stuttgart
| | | | - Thomas Ellrott
- Institut für Ernährungspsychologie, Georg-August-Universität, Göttingen
| | - Ute Kanthak
- Adipositaschirurgie Selbsthilfe Deutschland e. V
| | | | - Norbert Stefan
- Institute of Diabetes Research and Metabolic Diseases IDM, Universitätsklinikum Tübingen
| | - Martin Teufel
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | - Martin Wabitsch
- Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Ulm
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Dellas C, Schäfer K, Rohm I, Lankeit M, Ellrott T, Faustin V, Riggert J, Hasenfuss G, Konstantinides S. Absence of leptin resistance in platelets from morbidly obese individuals may contribute to the increased thrombosis risk in obesity. Thromb Haemost 2017. [DOI: 10.1160/th08-05-0314] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
SummaryClinical studies have shown that elevated leptin levels are an independent cardiovascular risk factor. However, little is known about the existence of platelet resistance to leptin in the setting of obesity. We examined the effects of leptin on platelet aggregation in morbidly obese subjects (n=40; BMI, 41.6 ± 1.1 kg/m2; leptin, 49.7 ± 3.4 ng/ml) in comparison to normal-weight controls (n=36; BMI, 23.3 ± 0.4 kg/m2; leptin, 6.5 ± 0.7 ng/ml).The aggregatory response to increasing concentrations of adenosine diphosphate (ADP) (2, 3, 4, and 5 µM) was significantly increased in platelets from obese compared to lean donors, reflecting a left shift in the dose-response curve. Plasma leptin levels, but not BMI, were significantly higher in subjects with stronger (above the median) compared to weaker (below the median) platelet aggregation at all ADP concentrations tested. In further experiments, stimulation (preincubation) with leptin (500 ng/ml) promoted ADP-induced platelet aggregation by approximately 25%, and there was no difference between platelets from obese and those from lean donors regarding the responsiveness to leptin (p=0.99). Western blotting revealed that leptin induced phosphorylation of JAK2 and STAT3 to a similar extent in platelets from both groups. Expression of potential mediators of leptin resistance (SOCS3 and PTP1B) also did not differ in platelets from obese and control subjects. In conclusion, our data indicate that platelets from obese donors show increased aggregatory response to ADP, and that this might partly be the consequence of increased circulating leptin levels. Platelets from obese donors are not resistant to the enhancing effects of leptin on ADPinduced platelet aggregation.
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Hauner H, Moss A, Berg A, Bischoff S, Colombo-Benkmann M, Ellrott T, Kanthak U, Kunze D, Stefan N, Teufel M, Wabitsch M, Wirth A. Adipositas und Diabetes mellitus. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0043-115965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Hans Hauner
- Klinik für Ernährungsmedizin, Klinikum rechts der Isar, Technische Universität München
| | - Anja Moss
- Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Ulm
| | - Aloys Berg
- Institut für Sport und Sportwissenschaft der Universität Freiburg, Freiburg
| | - Stephan Bischoff
- Institut für Ernährungsmedizin, Universität Hohenheim, Stuttgart
| | | | - Thomas Ellrott
- Institut für Ernährungspsychologie, Georg-August-Universität, Göttingen
| | - Ute Kanthak
- Adipositaschirurgie Selbsthilfe Deutschland e. V
| | | | - Norbert Stefan
- Institute of Diabetes Research and Metabolic Diseases IDM, Universitätsklinikum Tübingen
| | - Martin Teufel
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | - Martin Wabitsch
- Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Ulm
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Hauck C, Weiß A, Schulte EM, Meule A, Ellrott T. Prevalence of 'Food Addiction' as Measured with the Yale Food Addiction Scale 2.0 in a Representative German Sample and Its Association with Sex, Age and Weight Categories. Obes Facts 2017; 10:12-24. [PMID: 28190017 PMCID: PMC5644971 DOI: 10.1159/000456013] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 01/10/2017] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND/AIMS To assess the prevalence and correlates of addictive-like eating behavior in Germany. METHODS The German version of the Yale Food Addiction Scale (YFAS) 2.0 was used to investigate, for the first time, the prevalence of 'food addiction' in a representative sample aged 18-65 years (N = 1,034). RESULTS The prevalence of 'food addiction' measured by the YFAS 2.0 was 7.9%. Individuals meeting criteria for 'food addiction' had higher BMI and were younger than individuals not meeting the threshold. Underweight (15.0%) and obese (17.2%) individuals exhibited the highest prevalence rate of 'food addiction'. Addictive-like eating was not associated with sex, education level, or place of residence. CONCLUSION YFAS 2.0 'food addiction' was met by nearly 8% of the population. There is a non-linear relationship between addictive-like eating and BMI, with the highest prevalence among underweight and obese persons. These findings suggest that 'food addiction' may be a contributor to overeating but may also reflect a distinct phenotype of problematic eating behavior not synonymous with obesity. Further, the elevated prevalence of YFAS 2.0 'food addiction' among underweight individuals may reflect an overlap with eating disorders and warrants attention in future research.
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Affiliation(s)
- Carolin Hauck
- Institute for Nutrition and Psychology, University Medicine Göttingen, Göttingen, Germany, Salzburg, Austria
- *Carolin Hauck, Institute for Nutrition and Psychology, University Medicine Göttingen, Humboldtallee 32, 37073 Göttingen, Germany,
| | - Annegret Weiß
- Institute for Nutrition and Psychology, University Medicine Göttingen, Göttingen, Germany, Salzburg, Austria
| | - Erica Marla Schulte
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA, Salzburg, Austria
| | - Adrian Meule
- Department of Psychology, Center for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Thomas Ellrott
- Institute for Nutrition and Psychology, University Medicine Göttingen, Göttingen, Germany, Salzburg, Austria
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Hauner H, Moss A, Berg A, Bischoff S, Colombo-Benkmann M, Ellrott T, Kanthak U, Kunze D, Stefan N, Teufel M, Wabitsch M, Wirth A. Prävention und Therapie der Adipositas. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0042-114746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- H. Hauner
- Klinik für Ernährungsmedizin, Klinikum rechts der Isar, Technische Universität München
| | - A. Moss
- Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Ulm
| | - A. Berg
- Institut für Sport und Sportwissenschaft der Universität Freiburg, Freiburg
| | - S. Bischoff
- Institut für Ernährungsmedizin, Universität Hohenheim, Stuttgart
| | | | - T. Ellrott
- Institut für Ernährungspsychologie, Georg-August-Universität, Göttingen
| | - U. Kanthak
- Adipositaschirurgie Selbsthilfe Deutschland e. V
| | - D. Kunze
- Kinderendokrinologische Praxis, München
| | - N. Stefan
- Institute of Diabetes Research and Metabolic Diseases IDM, Universitätsklinikum Tübingen
| | - M. Teufel
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | - M. Wabitsch
- Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Ulm
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Abstract
Purpose
– The purpose of this paper is to investigate the effects of the Cancer Society of Lower Saxony’s school-based nutrition education programme “5-a-day for kids”, designed to increase children’s fruit and vegetable consumption. Intervention: the programme included three parts (each 45 minutes): education-based classroom session; food knowledge in a local supermarket; and practical vegetable snack preparation. Additional promoting information materials for parents were provided.
Design/methodology/approach
– A pre-/post-test research design was used for the evaluation. In total, 1,376 pupils (age 7-14, 51 per cent female), their parents and 69 teachers of 35 schools in Lower Saxony participated in the study. The fruit and vegetable intake was measured with the KiGGS-Food Frequency Questionnaire.
Findings
– A Wilcoxon signed-rank test was used to determine the change in fruit and vegetable consumption over three measurements (baseline, one month, three months). No significant positive effect of the intervention was observed with the applied method for the daily intake of fruit and vegetables, neither at month 1 nor at month 3.
Research limitations/implications
– A 135 min school-based intervention does not seem to increase children’s fruit and vegetable consumption. To enhance its effectiveness, the programme may be improved by adding a longitudinal classroom component, extensive parental involvement and/or distribution of free fruit/vegetables every day.
Originality/value
– This is the first evaluation of a 5-a-day-intervention in Germany.
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Hauner H, Moss A, Berg A, Bischoff S, Colombo-Benkmann M, Ellrott T, Kanthak U, Kunze D, Stefan N, Teufel M, Wabitsch M, Wirth A. Prävention und Therapie der Adipositas. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1553575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- H. Hauner
- Institut für Ernährungsmedizin, Klinikum rechts der Isar, Technische Universität München
| | - A. Moss
- Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Ulm
| | - A. Berg
- Institut für Sport und Sportwissenschaft der Universität Freiburg, Freiburg
| | - S. Bischoff
- Institut für Ernährungsmedizin, Universität Hohenheim, Stuttgart
| | | | - T. Ellrott
- Institut für Ernährungspsychologie, Georg-August-Universität, Göttingen
| | - U. Kanthak
- Adipositaschirurgie Selbsthilfe Deutschland e. V
| | - D. Kunze
- Kinderendokrinologische Praxis, München
| | - N. Stefan
- Institute of Diabetes Research and Metabolic Diseases IDM, Universitätsklinikum Tübingen
| | - M. Teufel
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | - M. Wabitsch
- Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Ulm
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Hauner H, Moss A, Berg A, Bischoff S, Colombo-Benkmann M, Ellrott T, Kanthak U, Kunze D, Stefan N, Teufel M, Wabitsch M, Wirth A. Prävention und Therapie der Adipositas. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0034-1385404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- H. Hauner
- Institut für Ernährungsmedizin, Klinikum rechts der Isar, Technische Universität München
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- Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Ulm
| | - A. Berg
- Institut für Sport und Sportwissenschaft der Universität Freiburg, Freiburg
| | - S. Bischoff
- Institut für Ernährungsmedizin, Universität Hohenheim, Stuttgart
| | | | - T. Ellrott
- Institut für Ernährungspsychologie, Georg-August-Universität, Göttingen
| | - U. Kanthak
- Adipositaschirurgie Selbsthilfe Deutschland e. V
| | - D. Kunze
- Kinderendokrinologische Praxis, München
| | - N. Stefan
- Institute of Diabetes Research and Metabolic Diseases IDM, Universitätsklinikum Tübingen
| | - M. Teufel
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | - M. Wabitsch
- Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Ulm
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Ellrott T. Psychologische Aspekte der Ernährung. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1356280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- T. Ellrott
- Institut für Ernährungspsychologie, an der Georg-August-Universität Göttingen, Universitätsmedizin
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Affiliation(s)
- Thomas Ellrott
- Institut für Ernährungspsychologie, Georg August-Universität Gottingen, Universitätsmedizin, Gottingen.
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Affiliation(s)
- T. Ellrott
- Institut für Ernährungspsychologie, an der Georg-August-Universität Göttingen, Universitätsmedizin
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Ellrott T. [Opportunities and limits of influence in food habits]. MMW Fortschr Med 2011; 153:39-41. [PMID: 22145243 DOI: 10.1007/bf03369072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Thomas Ellrott
- Institut für Ernährungspsychologie, Georg-August-Universität Göttingen.
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Bischoff SC, Damms-Machado A, Betz C, Herpertz S, Legenbauer T, Löw T, Wechsler JG, Bischoff G, Austel A, Ellrott T. Multicenter evaluation of an interdisciplinary 52-week weight loss program for obesity with regard to body weight, comorbidities and quality of life--a prospective study. Int J Obes (Lond) 2011; 36:614-24. [PMID: 21673653 PMCID: PMC3322430 DOI: 10.1038/ijo.2011.107] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To determine the effectiveness of a structured multidisciplinary non-surgical obesity therapy program on the basis of a temporary low-calorie-diet for 12 weeks, and additional intervention modules to enhance nutritional education, to increase physical activity and to modify eating behavior. DESIGN Prospective multicenter observational study in obese individuals undergoing a medically supervised outpatient-based 52-week treatment in 37 centers in Germany. SUBJECTS A total of 8296 participants with a body mass index (BMI) of >30 kg m(-2) included within 8.5 years. MEASUREMENTS Main outcome measures were body weight loss, waist circumference (WC), blood pressure, quality of life and adverse events. RESULTS In females, initial body weight was reduced after the 1-year-intervention by 19.6 kg (95% confidence intervals 19.2-19.9 kg) and in males by 26.0 kg (25.2-26.8) according to per protocol analysis of 4850 individuals. Intention-to-treat (ITT) analysis revealed a weight reduction of 15.2 kg (14.9-15.6) in females and 19.4 kg (18.7-20.1) in males. Overall, the intervention resulted in mean reduction in WC of 11 cm; it reduced the prevalence of the metabolic syndrome by 50% and the frequency of hypertension from 47 to 29% of all participants (ITT, all P<0.001). The beneficial effects could be documented for up to 3 years and comprised significant improvement of health-related quality of life. The incidence of adverse effects was low; the only event repeatedly observed and possibly related to either the intervention or the underlying disease was biliary disorders. CONCLUSION The present non-surgical intervention program is a highly effective treatment of obesity grades I-III and obesity-related diseases, and therefore, could be a valuable basis for future weight maintenance strategies required for sustained success.
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Affiliation(s)
- S C Bischoff
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany.
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Ellrott T, Austel A. Multicenter-Evaluation von Teilnehmern mit Prädiabetes und Diabetes an einem ambulanten Gewichtsmanagement-Programm zur Therapie erheblicher Adipositas. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1277523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Dellas C, Schäfer K, Rohm I, Lankeit M, Ellrott T, Faustin V, Riggert J, Hasenfuss G, Konstantinides S. Absence of leptin resistance in platelets from morbidly obese individuals may contribute to the increased thrombosis risk in obesity. Thromb Haemost 2008; 100:1123-1129. [PMID: 19132239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Clinical studies have shown that elevated leptin levels are an independent cardiovascular risk factor. However, little is known about the existence of platelet resistance to leptin in the setting of obesity. We examined the effects of leptin on platelet aggregation in morbidly obese subjects (n = 40; BMI, 41.6 +/- 1.1 kg/m2; leptin, 49.7 +/- 3.4 ng/ml) in comparison to normal-weight controls (n = 36; BMI, 23.3 +/- 0.4 kg/m2; leptin, 6.5 +/- 0.7 ng/ml). The aggregatory response to increasing concentrations of adenosine diphosphate (ADP) (2, 3, 4, and 5 microM) was significantly increased in platelets from obese compared to lean donors, reflecting a left shift in the dose-response curve. Plasma leptin levels, but not BMI, were significantly higher in subjects with stronger (above the median) compared to weaker (below the median) platelet aggregation at all ADP concentrations tested. In further experiments, stimulation (preincubation) with leptin (500 ng/ml) promoted ADP-induced platelet aggregation by approximately 25%, and there was no difference between platelets from obese and those from lean donors regarding the responsiveness to leptin (p = 0.99). Western blotting revealed that leptin induced phosphorylation of JAK2 and STAT3 to a similar extent in platelets from both groups. Expression of potential mediators of leptin resistance (SOCS3 and PTP1B) also did not differ in platelets from obese and control subjects. In conclusion, our data indicate that platelets from obese donors show increased aggregatory response to ADP, and that this might partly be the consequence of increased circulating leptin levels. Platelets from obese donors are not resistant to the enhancing effects of leptin on ADP-induced platelet aggregation.
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Affiliation(s)
- Claudia Dellas
- Department of Cardiology and Pulmonology, Georg August University of Goettingen, Goettingen, Germany
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Abstract
There is a consensus in the scientific community on the diagnostic, health, and economic implications of overweight and obesity, but therapeutic results -- with a negative energy balance as the main concept of pathogenesis -- are limited. Latest scientific studies did change the paradigm: instead of attributing obesity to patients' lack of will power, genetic disposition and environmental factors are now recognized as the main contributors to this epidemic. In consequence, unsuccessful preventive strategies have to be replaced by setting orientated those that focus much more on environmental changes promoting more physical activity and less energy intake. This could even be done by changing relevant laws. Such changes could facilitate individual behaviour changes despite evolutionary predisposition. Acknowledging obesity as a chronic disease would be the first important step.
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Affiliation(s)
- V Pudel
- Ernährungspsychologische Forschungsstelle, Klinik für Psychiatrie und Psychotherapie, Universität Göttingen.
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Abstract
Fifty years of nutrition information and education did not reach their goals. Nutrition-dependent diseases, obesity, and misinformation are still increasing. Cognitive information about nutrition does not induce changes in primary emotion-controlled eating habits. Better knowledge of nutrition on the part of consumers mainly activates their bad conscience when they rate their own eating habits. Future prevention campaigns, which clearly address consumer needs using social marketing principles, will be better able to change eating behavior.
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Affiliation(s)
- V Pudel
- Universität Göttingen, Göttingen.
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Affiliation(s)
- T Ellrott
- Ernährungspsychologische Forschungsstelle, Zentrum Psychologische Medizin, Universität Göttingen
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Pudel V, Ellrott T. [Nutrition behavior in Germany]. Internist (Berl) 1995; 36:1032-9. [PMID: 8543438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- V Pudel
- Ernährungspsychologische Forschungsstelle, Zentrum Psychologische Medizin, Universität Göttingen
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Heinzow B, Ellrott T. [Formic acid in urine--a significant parameter in environmental diagnosis?]. Zentralbl Hyg Umweltmed 1992; 192:455-61. [PMID: 1554404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Reference intervals of formic acid excretion in urine of healthy occupational unexposed adults were determined. Within the range of specific gravity between 1.016-1.032 g/cm3 normalization by creatinine or gravity is unnecessary. The mean formic acid concentration in urine of female and male adults aged 20-80 years was 21 mg/l +/- 30 mg/l (95. percentile 60 mg/l) with slightly higher values in elder persons. Smoking and dietary habits had no influence on formic acid excretion but age was positively correlated with increased concentrations. An oral methanol intake of 10 mg/kg body weight had no significant impact on urine excretion of formic acid. Excretion in the general population is determined by endogenous metabolism of amino acids, purine- and pyrimidine-bases rather than the uptake and metabolism of precursors like formaldehyde. Hence in contrast to recent recommendations in environmental medicine, formic acid in urine is not an appropriate parameter for biological-monitoring of low level exposure to formaldehyde.
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Affiliation(s)
- B Heinzow
- Untersuchungsstelle für Umwelttoxikologie des Landes Schleswig-Holstein, Kiel
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