Appealing dish names to nudge diners to more sustainable food choices: a quasi-experimental study.

BACKGROUND: Promoting plant-rich diets, i.e., diets with significantly reduced amounts of animal products, including vegan and vegetarian, is a promising strategy to help address the dual environmental and health crises that we currently face. Appealing dish names could boost interest in plant-rich dishes by attracting diners' attention to them. In this study, a systematic approach to naming plant-rich dishes with appealing descriptors was tested with a quasi-experimental design in four workplace, self-service, buffet-style cafeterias in Chicago, Sydney, São Paulo and Singapore. METHODS: Three different plant-rich dishes were tested at each site. Appealing names were generated systematically through a workshop and emphasized the dish ingredients, origin, flavor and/or the eating experience. Each test dish appeared once in a four-week menu cycle where menu options changed on a daily basis. The cycle was then repeated four times (six times in Chicago) with the total number of showings for each dish to be four (six in Chicago). The dish names alternated between basic and appealing across dish repetitions. For each dish, the food taken per plate was estimated by weighing the overall food taken and dividing it by the plate count in the cafeteria. Data was analysed as percentage change from baseline (i.e., the first showing of each dish that always had a basic name) with linear mixed effects analysis using the lme4 package in R. RESULTS: Overall, appealing dish names significantly increased the amount of food taken per plate by 43.9% relative to baseline compared to basic dish names (54.5% vs. 10.6% increase for appealing vs. basic names, respectively, p = .002). This increase corresponded to a 7% increase in actual grams of food taken per plate. Secondary analysis showed that the effect was site-specific to English-speaking countries only and that there was no substitution effect between plant-rich and meat dishes. CONCLUSIONS: The study tested an approach to creating appealing dish names in a systematic way and indicates that, in some settings, appealing dish titles are a relatively easy, scalable, cost-effective strategy that the food services sector can adopt to shift food choices towards more plant-rich, sustainable ones.

Resilience of three-dimensional sinusoidal networks in liver tissue.

Can three-dimensional, microvasculature networks still ensure blood supply if individual links fail? We address this question in the sinusoidal network, a plexus-like microvasculature network, which transports nutrient-rich blood to every hepatocyte in liver tissue, by building on recent advances in high-resolution imaging and digital reconstruction of adult mice liver tissue. We find that the topology of the three-dimensional sinusoidal network reflects its two design requirements of a space-filling network that connects all hepatocytes, while using shortest transport routes: sinusoidal networks are sub-graphs of the Delaunay graph of their set of branching points, and also contain the corresponding minimum spanning tree, both to good approximation. To overcome the spatial limitations of experimental samples and generate arbitrarily-sized networks, we developed a network generation algorithm that reproduces the statistical features of 0.3-mm-sized samples of sinusoidal networks, using multi-objective optimization for node degree and edge length distribution. Nematic order in these simulated networks implies anisotropic transport properties, characterized by an empirical linear relation between a nematic order parameter and the anisotropy of the permeability tensor. Under the assumption that all sinusoid tubes have a constant and equal flow resistance, we predict that the distribution of currents in the network is very inhomogeneous, with a small number of edges carrying a substantial part of the flow-a feature known for hierarchical networks, but unexpected for plexus-like networks. We quantify network resilience in terms of a permeability-at-risk, i.e., permeability as function of the fraction of removed edges. We find that sinusoidal networks are resilient to random removal of edges, but vulnerable to the removal of high-current edges. Our findings suggest the existence of a mechanism counteracting flow inhomogeneity to balance metabolic load on the liver.

Efficacy and Safety of Once-Daily Insulin Degludec/Insulin Aspart versus Insulin Glargine (U100) for 52 Weeks in Insulin-Naïve Patients with Type 2 Diabetes: A Randomized Controlled Trial.

PURPOSE: The efficacy and safety of insulin degludec/insulin aspart (IDegAsp) once daily (OD) compared with insulin glargine U100 (IGlar) OD over 52 weeks in insulin-naïve adults with type 2 diabetes mellitus (T2DM) was investigated. METHODS: In this open-label, parallel-group treat-to-target trial, participants were randomized (1:1) to receive IDegAsp OD (breakfast, n = 266) or IGlar OD (as per label, n = 264). Participants then entered a 26-week extension phase (IDegAsp OD, n = 192; IGlar OD, n = 221). The primary endpoint was change from baseline to Week 26 in HbA1c. RESULTS: After 26 and 52 weeks, mean HbA1c decreased to similar levels in both groups. After 52 weeks, the mean estimated treatment difference was -0.08% (-0.26, 0.09 95%CI), confirming the non-inferiority of IDegAsp OD versus IGlar OD evaluated at Week 26. After 52 weeks, there was a similar reduction in mean fasting plasma glucose in both treatment groups. The rate of confirmed hypoglycemic episodes was 86% higher (p < 0.0001) whereas the rate of nocturnal hypoglycemia was 75% lower (p < 0.0001) for IDegAsp versus IGlar. CONCLUSION: Nocturnal-confirmed hypoglycemia was higher with IGlar whereas overall and diurnal hypoglycemia were higher with IDegAsp dosed at breakfast. These results highlight the importance of administration of IDegAsp with the main meal of the day, tailored to the individual patient's needs. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01045707 [core]) and NCT01169766 [ext].

Accuracy of the SEVEN continuous glucose monitoring system: comparison with frequently sampled venous glucose measurements.

BACKGROUND: The purpose of this study was to compare the accuracy of measurements obtained from the DexCom SEVEN system with Yellow Springs Instrument (YSI) laboratory measurements of venous blood glucose. METHODS: Seventy-two subjects with insulin-requiring diabetes, aged 18-71, were enrolled in a multicenter, prospective single-arm study. All participants wore the SEVEN continuous glucose monitoring (CGM) system for one, 7-day wear period. Calibration with capillary finger stick measurements was performed 2 hours after sensor insertion and once every 12 hours thereafter. A subset of subjects (28) wore two systems simultaneously to assess precision. All subjects participated in one, 10-hour in-clinic session on day 1, 4, or 7 of the study to compare CGM measurements against a laboratory method (YSI analyzer) using venous measurements taken once every 20 minutes. Carbohydrate consumption and insulin dosing were adjusted in order to obtain a broad range of glucose values. RESULTS: Comparison of CGM measurements with the laboratory reference method (n = 2318) gave mean and median absolute relative differences (ARDs) of 16.7 and 13.2%, respectively. The percentage was 70.4% in the clinically accurate Clarke error grid A zone and 27.5% in the benign error B zone. Performance of the SEVEN system was consistent over time with mean and median ARD lowest on day 7 as compared to YSI (13.3 and 10.2%, respectively). Average sensor time lag was 5 minutes. CONCLUSIONS: Measurements of the DexCom SEVEN system were found to be consistent and accurate compared with venous measurements made using a laboratory reference method over 7 days of wear.