The effect of increasing consumption of pulses and wholegrains in obese people: a randomized controlled trial.

BACKGROUND: Wholegrain intake is inversely related to weight gain over time, but little information is available on the role of pulses in weight control. OBJECTIVE: To compare weight loss, metabolic outcomes, and nutrient intakes in obese people assigned to a diet rich in pulses and wholegrains or a control diet. METHODS: Randomized controlled study of 18 months with 113 volunteers (body mass index [BMI] ≥ 28 kg/m(2)). Diets were based on guidelines published by the National Heart Foundation of New Zealand. The intervention group was advised to consume 2 serves of pulses and 4 serves of wholegrain foods per day as substitutions for more refined carbohydrates. RESULTS: Fiber intakes were higher, intakes of several vitamins and minerals were better maintained, and dietary glycemic index was lower in the intervention compared with the control group. Mean (standard error [SE]) weight loss at 6 months was 6.0 (0.7) kg and 6.3 (0.6) kg in the control and intervention groups, respectively, and was not different between groups (p > 0.05). Blood pressure, triglycerides, and glycemic load were lowered in both groups compared with baseline. Waist circumference was decreased at 18 months in the intervention compared with the control group (-2.8 cm; 95% confidence interval [CI]: -0.4, -5.1). CONCLUSIONS: Incorporation of pulses and wholegrain foods into a weight loss program resulted in a greater reduction in waist circumference compared with the group consuming a control diet, although no difference in weight loss was noted between groups. Retention of several nutrients was better with the pulse and wholegrain diet.

Oral Health and Dental Students' Perceptions of Their Clinical Learning Environment: A Focus Group Study.

Creating an optimal clinical learning environment poses a challenge to health professions educators. To evaluate and improve the clinical learning environment, it is necessary to understand students' experiences of their environment and the factors they perceive as having an impact on their learning. The aim of this explorative qualitative study was to examine University of Otago Faculty of Dentistry students' perceptions of their clinical learning environment to gain insights into how learning outcomes could be enhanced. In 2015, all approximately 600 students at all levels of the Bachelor of Oral Health and Bachelor of Dental Surgery degrees at the University of Otago, Dunedin, New Zealand, were invited to participate in focus groups. Focus groups facilitated by the faculty education research fellow and another researcher employed for the project were conducted during the second half of the academic year. Transcribed data were analyzed using a general inductive approach. Twenty-one students from all levels of the two programs attended one of six confidential focus groups. Three broad themes were evident in the results from all groups: feedback processes, assessments and grading, and tutor interactions. In the focus groups, students expressed dissatisfaction regarding current feedback practices, types of feedback to benefit learning, consistency in the grading system, and impact of different educators' teaching styles on learning. These results indicated a need for further research and curricular efforts to promote good student-teacher relationships in the clinical learning environment, which are paramount for creating an optimal teaching and learning environment and enhancing student outcomes.

Reasons for wanting to lose weight: different strokes for different folks.

We assessed whether treatment seeking overweight and obese people citing differing reasons for wanting to lose weight also differed in psychosocial characteristics thought to impact on weight loss. Dieting motives, self-esteem, body image, number of dieting attempts in the past two years, and the primary reason for wanting to lose weight were assessed in 106 treatment seeking overweight and obese volunteers (mean (SD) body mass index 35.5 (5.7)kg/m2; age 41.9 (10.8)y). Reasons for wanting to lose weight fell into three broad categories, with 35%, 50%, and 15% of the participants citing appearance, health, and mood, respectively. Participants citing health reasons were happier with their appearance than people citing mood or appearance reasons. Participants citing mood reasons had poorer self-image and self-esteem, a greater preoccupation with being overweight, and had attempted to diet more often than people citing appearance or health. The primary reason for overweight people seeking weight loss may reflect psychosocial differences that impact on successful weight loss. Identifying a person's reasons and motives for weight loss may help in tailoring dietary and psychological components of a weight loss program to the individual.

Dietary counseling to increase natural folate intake: a randomized, placebo-controlled trial in free-living subjects to assess effects on serum folate and plasma total homocysteine.

BACKGROUND: The association between vascular disease and elevated plasma total homocysteine (tHcy) concentrations is caused, in part, by inadequate intakes of dietary folate. Increasing folate intake either through supplements or foods naturally rich in folates has been shown to decrease tHcy concentrations. OBJECTIVE: The aim of this study was to determine whether a similar reduction in tHcy was possible in free-living persons receiving dietary counseling. DESIGN: The study included a 4-wk placebo-controlled dietary intervention trial in which participants consumed either unfortified breakfast cereal (control group) or an extra 350 micro g folate derived from food/d (dietary group). Serum folate and tHcy concentrations in both groups were measured before and after the intervention period, and the concentrations in the dietary group were also measured 17 wk after the intervention period. RESULTS: During the 4-wk intervention, mean dietary folate intake in the dietary group increased from 263 (95% CI: 225, 307) to 618 micro g/d (535, 714), resulting in a mean increase in serum folate of 37% (15%, 63%) and a decrease in tHcy from 12.0 (10.9, 13.3) to 11.3 micro mol/L (10.2, 12.5). A further decrease in tHcy occurred in the dietary group during follow-up, with a final tHcy concentration of 9.7 micro mol/L (8.8, 10.8). CONCLUSIONS: Increasing natural folate intake improved folate status and decreased tHcy concentrations to an extent that may significantly reduce the risk of vascular disease. Dietary modification may have advantages over folic acid fortification because the altered food-consumption patterns lead to increased intakes of several vitamins and minerals and decreased intakes of saturated fatty acids.

Variation in the cholesteryl ester transfer protein (CETP) gene does not influence individual plasma cholesterol response to changes in the nature of dietary fat.

BACKGROUND AND AIMS: Some individuals respond to a greater extent than others to changes in dietary fat and cholesterol even when dietary intake is consistent. A prospective study has been undertaken in which two groups of individuals according to cholesteryl ester transfer protein (CETP) genotype were compared in terms of plasma lipid response to altering the nature of dietary fat in a free-living situation. METHODS AND RESULTS: Following genotyping, 35 individuals with the CETP Taq1 B1B1 genotype were paired with age and sex-matched individuals with one or two CETP B2 alleles, to undertake a single crossover trial with a diet high in saturated fat and a diet high in polyunsaturated fat. There was no washout period between the two 4-week phases. Plasma lipoproteins were measured at the beginning and end of each phase. The difference (95% CI) in plasma LDL-cholesterol concentration at the end of the PUFA and SAFA diets was 0.95 (0.71, 1.19) mmol/l in the CETP B1B1 group and 0.80 (0.57, 1.04) mmol/l in the group with at least one CETP B2 allele. The dietary induced changes in the two genotype groups were not significantly different (p=0.38) from each other. Comparable results were observed for plasma total cholesterol. The high PUFA and SAFA diets did not significantly alter plasma HDL concentration in either of the CETP genotype groups. Response was also similar according to apolipoprotein E genotype (E3E3 vs E4+) and lipoprotein lipase genotype (S447X). CONCLUSIONS: The results of this study do not support previous studies in which CETP genotype predicted plasma LDL-cholesterol response to diet. CETP genotype does not significantly affect the change in plasma total and LDL-cholesterol concentrations that occur when altering the nature of dietary fat. These data suggest that the influence of genetic factors on total and LDL-cholesterol may be relatively small in comparison with the effect of dietary manipulation.