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1.
J Clin Endocrinol Metab ; 107(2): e767-e782, 2022 01 18.
Article in English | MEDLINE | ID: mdl-34460933

ABSTRACT

CONTEXT: The gut-derived peptide hormones glucagon-like peptide-1 (GLP-1), oxyntomodulin (OXM), and peptide YY (PYY) are regulators of energy intake and glucose homeostasis and are thought to contribute to the glucose-lowering effects of bariatric surgery. OBJECTIVE: To establish the metabolomic effects of a combined infusion of GLP-1, OXM, and PYY (tripeptide GOP) in comparison to a placebo infusion, Roux-en-Y gastric bypass (RYGB) surgery, and a very low-calorie diet (VLCD). DESIGN AND SETTING: Subanalysis of a single-blind, randomized, placebo-controlled study of GOP infusion (ClinicalTrials.gov NCT01945840), including VLCD and RYGB comparator groups. PATIENTS AND INTERVENTIONS: Twenty-five obese patients with type 2 diabetes or prediabetes were randomly allocated to receive a 4-week subcutaneous infusion of GOP (n = 14) or 0.9% saline control (n = 11). An additional 22 patients followed a VLCD, and 21 underwent RYGB surgery. MAIN OUTCOME MEASURES: Plasma and urine samples collected at baseline and 4 weeks into each intervention were subjected to cross-platform metabolomic analysis, followed by unsupervised and supervised modeling approaches to identify similarities and differences between the effects of each intervention. RESULTS: Aside from glucose, very few metabolites were affected by GOP, contrasting with major metabolomic changes seen with VLCD and RYGB. CONCLUSIONS: Treatment with GOP provides a powerful glucose-lowering effect but does not replicate the broader metabolomic changes seen with VLCD and RYGB. The contribution of these metabolomic changes to the clinical benefits of RYGB remains to be elucidated.


Subject(s)
Caloric Restriction/statistics & numerical data , Diabetes Mellitus, Type 2/therapy , Gastric Bypass/statistics & numerical data , Gastrointestinal Hormones/administration & dosage , Obesity, Morbid/therapy , Adult , Aged , Blood Glucose/analysis , Caloric Restriction/methods , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/metabolism , Diabetes Mellitus, Type 2/urine , Drug Therapy, Combination/methods , Female , Gastric Bypass/methods , Glucagon-Like Peptide 1/administration & dosage , Humans , Infusions, Subcutaneous , Male , Metabolomics/statistics & numerical data , Middle Aged , Obesity, Morbid/blood , Obesity, Morbid/metabolism , Obesity, Morbid/urine , Oxyntomodulin/administration & dosage , Peptide YY/administration & dosage , Single-Blind Method , Treatment Outcome , Weight Loss , Young Adult
2.
Cancer Med ; 10(14): 4896-4904, 2021 07.
Article in English | MEDLINE | ID: mdl-34145977

ABSTRACT

BACKGROUND: Overweight or obesity is common in endometrial cancer (EC). This study aimed to examine sociodemographic, clinical, and psychosocial characteristics associated with being discontent with current weight and use of weight control methods among long-term EC survivors. METHODS: Women diagnosed with early-stage EC who participated in the Laparoscopic Approach to Cancer of the Endometrium (LACE) trial (n = 516) were invited to complete a long-term follow-up survey at least 4.5 years after treatment. Chi-square test and multivariate logistic regression models adjusted for time since surgery were used to determine factors associated with being discontent with current weight. RESULTS: On average 9 years after surgery, 190/259 (73%) of participants were currently discontent with their weight, and 146 (56%) had used one or more weight loss methods during the past 12 months. Women who were discontent with their weight were more likely to be younger than 70 years (p < 0.000), and used one or more weight loss methods ever or during the past 12 months (p < 0.000). Among the weight loss methods used, exercise (40.1%), meal reductions (52.7%), or fat/sugar reductions (48.5%) were much more commonly reported than fasting (2.6%) or designated weight loss programs (2.3%). CONCLUSIONS: Our study provides evidence that the majority of long-term EC survivors in this clinical trial population are discontent with their weight and over half continue to use multiple methods to lose weight each year. These data indicate that health professionals and lifestyle educators need to assess weight issues, and develop a tailored plan to address the specific needs of long-term survivors to assist them become content with their weight after treatment for EC.


Subject(s)
Body Weight , Cancer Survivors/psychology , Endometrial Neoplasms/psychology , Survivorship , Weight Loss , Adult , Age Factors , Aged , Aged, 80 and over , Caloric Restriction/statistics & numerical data , Cancer Survivors/statistics & numerical data , Diet, Reducing/statistics & numerical data , Exercise/statistics & numerical data , Female , Follow-Up Studies , Humans , Logistic Models , Middle Aged , Surveys and Questionnaires , Time Factors
3.
Nutrients ; 13(4)2021 Apr 05.
Article in English | MEDLINE | ID: mdl-33916366

ABSTRACT

Although intermittent calorie restriction (ICR) has become popular as an alternative weight loss strategy to continuous calorie restriction (CCR), there is insufficient evidence on diet quality during ICR and on its feasibility over longer time periods. Thus, we compared dietary composition and adherence between ICR and CCR in a follow-up analysis of a randomized trial. A total of 98 participants with overweight or obesity [BMI (kg/m2) 25-39.9, 35-65 years, 49% females] were randomly assigned to ICR, operationalized as a "5:2 diet" (energy intake: ~100% on five non-restricted (NR) days, ~25% on two restricted (R) days), or CCR (daily energy intake: ~80%). The trial included a 12-week (wk) intervention phase, and follow-up assessments at wk24, wk50 and wk102. Apart from a higher proportion of energy intake from protein with ICR vs. CCR during the intervention (wk2: p < 0.001; wk12: p = 0.002), there were no significant differences with respect to changes in dietary composition over time between the groups, while overall adherence to the interventions appeared to be good. No significant difference between ICR and CCR regarding weight change at wk102 was observed (p = 0.63). However, self-reported adherence was worse for ICR than CCR, with 71.1% vs. 32.5% of the participants reporting not to or only rarely have followed the regimen to which they were assigned between wk50 and wk102. These results indicate that within a weight management setting, ICR and CCR were equivalent in achieving modest weight loss over two years while affecting dietary composition in a comparable manner.


Subject(s)
Body Weight Maintenance , Caloric Restriction/methods , Obesity/diet therapy , Overweight/diet therapy , Patient Compliance/statistics & numerical data , Adult , Caloric Restriction/statistics & numerical data , Female , Follow-Up Studies , Humans , Male , Middle Aged , Self Report/statistics & numerical data , Treatment Outcome , Weight Loss
4.
CMAJ Open ; 9(2): E317-E323, 2021.
Article in English | MEDLINE | ID: mdl-33795221

ABSTRACT

BACKGROUND: A gluten-free diet (GFD) is required for the management of some conditions, whereas some Canadians may follow a GFD for discretionary reasons. We sought to estimate the prevalence of Canadians who adhere to a GFD, identify factors associated with adherence to a GFD, and describe and compare the location of food preparation and consumption for those who follow a GFD, those who report no dietary avoidances and those reporting other dietary avoidances. METHODS: We used cross-sectional data from the 2015 Canadian Community Health Survey - Nutrition (n = 20 487). Demographic variables included sex, age group, ethnicity, highest level of household education and income adequacy. The relations between respondent characteristics and report of a GFD were estimated using logistic regression. Respondents were further categorized as avoiding dietary gluten, other dietary avoidances and no dietary avoidances. RESULTS: An estimated 1.9% of Canadians follow a GFD. Women had 2 times higher odds (odds ratio [OR] 2.08, 95% confidence interval [CI] 1.32 to 3.27) of reporting a GFD than men. After adjustment for income adequacy, household education, sex, age group and ethnicity, residents of Ontario and Quebec had about half the odds (OR 0.52, 95% CI 0.31 to 0.87, and OR 0.55, 95% CI 0.32 to 0.94, respectively) of reporting a GFD compared with residents of Atlantic Canada. Canadians who followed a GFD consumed significantly fewer calories from foods prepared at restaurants than both Canadians who reported no dietary avoidances and those who reported dietary avoidances other than gluten. Canadians following a GFD reported that 2.0% (95% CI 1.1% to 2.9%) of their daily kilocalories were from foods prepared at restaurants, compared with 6.7% (95% CI 5.4% to 7.9%) for Canadians reporting 1 or more dietary avoidances other than gluten, and 6.4% (95% CI 6.0% to 6.9%) for those reporting no avoidances. INTERPRETATION: The estimated 1.9% prevalence of dietary gluten avoidance likely includes individuals with celiac disease, wheat allergies and nonceliac gluten sensitivity, as well as individuals excluding gluten in the management of irritable bowel syndrome or for reasons related to dietary trends. Canadians eating GFDs consume fewer daily calories from restaurant-prepared foods than other Canadians, which may have social implications.


Subject(s)
Attitude to Health , Celiac Disease , Diet, Gluten-Free , Glutens/adverse effects , Health Knowledge, Attitudes, Practice , Patient Compliance/statistics & numerical data , Wheat Hypersensitivity , Caloric Restriction/statistics & numerical data , Canada/epidemiology , Celiac Disease/epidemiology , Celiac Disease/prevention & control , Celiac Disease/psychology , Cross-Sectional Studies , Diet, Gluten-Free/methods , Diet, Gluten-Free/psychology , Diet, Gluten-Free/statistics & numerical data , Feeding Behavior , Female , Humans , Male , Nutrition Surveys , Prevalence , Sex Factors , Socioeconomic Factors , Wheat Hypersensitivity/epidemiology , Wheat Hypersensitivity/prevention & control , Wheat Hypersensitivity/psychology
5.
Nutr Rev ; 79(10): 1114-1133, 2021 09 07.
Article in English | MEDLINE | ID: mdl-33608718

ABSTRACT

CONTEXT: Whether dietary restraint and dieting are risk factors associated with eating disorders has not been explored in the context of pediatric weight management. OBJECTIVE: To review associations between dietary pediatric weight management, dietary restraint, dieting, and eating disorder risk. DATA SOURCES, SELECTION, AND EXTRACTION: Four databases - MEDLINE, EMBASE, Cochrane Library, and PsycINFO - were searched to May 2020 to identify pediatric weight management interventions with a dietary component for children and adolescents with overweight or obesity. The review was limited to studies reporting dietary restraint and/or dieting at preintervention, postintervention, and/or follow-up. Screening and quality assessment were conducted in duplicate, and data extraction was completed by 1 reviewer and cross-checked for accuracy. Data extracted included study characteristics, dietary restraint/dieting, and eating disorder-related outcomes (including disordered eating, body image, self-esteem, depression, and anxiety). RESULTS: A total of 26 papers, representing 23 studies, were included. Of these, 20 studies reported on dietary restraint, which increased (10 postintervention, 6 follow-up) or remained unchanged (7 postintervention, 5 follow-up), and 5 studies reported on dieting, which increased (1 study), remained unchanged (2 studies) or decreased (2 studies) postintervention. All studies that reported on other eating disorder risk factors (eg, binge eating, body dissatisfaction, and depression) and weight-related outcomes found improvement or no change postintervention or at follow-up. CONCLUSION: The results of this review suggest that current measures of dietary restraint and dieting are not associated with eating disorder risk within the context of pediatric weight management; however, long-term data is limited. In addition, those current measures may not be suitable risk markers. Concerns about dietary restraint and dieting leading to eating disorders should not prevent access to quality care for young people with obesity. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. 2017 CRD42017069488.


Subject(s)
Body Weight Maintenance , Caloric Restriction , Feeding Behavior , Feeding and Eating Disorders , Adolescent , Body Weight Maintenance/physiology , Caloric Restriction/statistics & numerical data , Child , Diet/statistics & numerical data , Feeding and Eating Disorders/epidemiology , Humans , Obesity/prevention & control , Overweight/prevention & control , Risk Factors
6.
Nutrients ; 12(12)2020 Nov 24.
Article in English | MEDLINE | ID: mdl-33255295

ABSTRACT

Athletes who retire from their sporting career face an increase in body weight, leading to overweight or obesity. Simultaneously, a significant number of these athletes meet the criteria of metabolic syndrome. The available literature does not offer clearly defined standards of nutrition for the discussed group of people. In this situation, it seems advisable to develop different standards of dietary behavior typical of athletes finishing their sports careers. For this purpose, the study analyzed two types of diets: the Mediterranean diet and the Calorie Restriction with Optimal Nutrition (CRON) diet based on significant calorie restrictions. Both diets seem to meet the requirements of this group of people.


Subject(s)
Athletes/statistics & numerical data , Caloric Restriction/methods , Caloric Restriction/statistics & numerical data , Diet, Mediterranean/statistics & numerical data , Nutritional Status , Overweight/prevention & control , Retirement , Humans
7.
Nutrients ; 12(6)2020 Jun 22.
Article in English | MEDLINE | ID: mdl-32580282

ABSTRACT

Diet is a factor which can influence both glycaemic variables and body mass. The aim of this study was to compare the influence of a 12-week, well-planned, low-calorie ketogenic diet (LCKD) on hyperglycaemic, hyperinsulinemic and lipid profile in adult, overweight or obese females. Ninety-one females who participated in the study were divided into two groups: a LCKD group who followed a hypocaloric ketogenic diet (8% of carbohydrate, 72% of fat and 20% of proteins) (n = 46), and a control group (CG) (n = 45) who continued their typical diet (50% of carbohydrates, 32% of fat and 18% of proteins). METHODS: Baseline and post-intervention glucose (Gl), insulin (I), glycated haemoglobin (HbA1c), Homeostatic model assessment HOMA-IR, triglycerides (TG) and high-density cholesterol (HDL-C) were evaluated. Also, body mass (BM), waist circumference (WC), hip circumference (HC) and thigh circumference (TC) were measured. RESULTS: Compared with the CG, there were significant changes observed in the LCKD group regarding all biochemical variables. Also, BM, TC, WC and AC changed significantly in the LCKD group compared with the CG. CONCLUSIONS: The 12-week LCKD intervention changed the glucose control variables, body mass, as well as waist, hip and thigh circumferences. A low-calorie ketogenic diet may be recommended for adult females with glucose control variables disturbance and excess body mass.


Subject(s)
Caloric Restriction/statistics & numerical data , Diet, Ketogenic/statistics & numerical data , Glycemic Control/statistics & numerical data , Hyperinsulinism/diet therapy , Obesity/diet therapy , Overweight/diet therapy , Adult , Anthropometry , Blood Glucose/analysis , Body Mass Index , Cholesterol, HDL/blood , Female , Glycated Hemoglobin/analysis , Humans , Hyperinsulinism/physiopathology , Middle Aged , Obesity/physiopathology , Overweight/physiopathology , Triglycerides/blood , Waist Circumference
8.
Psychol Assess ; 32(2): 140-153, 2020 Feb.
Article in English | MEDLINE | ID: mdl-31535875

ABSTRACT

[Correction Notice: An Erratum for this article was reported in Vol 32(2) of Psychological Assessment (see record 2020-04120-001). In the article, there are two errors in the Method section for Study 2. First, in the "Body dissatisfaction" subsection, the range of total scores for the Body-Image Ideals Questionnaire was incorrectly listed as being "between 0 and 99." The correct range is from - 3 to 9. Second, in the "Dieting and bulimia" subsection, the reference for the Eating Attitudes Test (EAT-26) was incorrectly cited as "Garner et al., 1983." Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. E. (1982). The Eating Attitudes Test: Psychometric features and clinical correlates. Psychological Medicine, 12, 871-878. http://dx.doi .org/10.1017/s0033291700049163.] Females are at risk for body image and eating disturbance when they internalize societally prescribed standards of Western beauty. With respect to messages to be thin or muscular, numerous scales are available that measure internalization. However, many women are now receiving messages about the desirability of being both thin and toned, yet no self-report measure of internalization of a fit female body ideal exists. Our aim was to develop a multidimensional tool (i.e., the Fit Ideal Internalization Test; FIIT) useful for assessing women's internalization of the fit ideal (i.e., a lean and toned body ideal). Three studies were conducted, recruiting independent groups of women attending university to complete surveys. In Study 1 (N = 300, age 16-51), women completed the FIIT items, and a 3-factor structure of fit idealization (8 items), fit overvaluation (8 items), and fit behavioral drive (4 items) was established through exploratory factor analysis. Also, items loading highly on each of the factors had good interitem correlations. In Study 2 (N = 354, age 16-63), women completed the 20-item FIIT and validation measures. The 3-factor structure of the FIIT was confirmed, and findings supported convergent, discriminant, and incremental validity of the FIIT subscale scores (and a total score). In Study 3 (N = 67, age 17-50), the 2-week test-retest reliability of the FIIT scores was high. Overall, the 3 FIIT subscales are related but also distinct domains of fit ideal internalization that conform to theory and may be used as individual subscales or potentially as a composite score. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Subject(s)
Attitude to Health , Body Dissatisfaction/psychology , Body Image/psychology , Adolescent , Adult , Anxiety/psychology , Australia , Bulimia/epidemiology , Bulimia/psychology , Caloric Restriction/psychology , Caloric Restriction/statistics & numerical data , Defense Mechanisms , Depression/psychology , Exercise , Factor Analysis, Statistical , Female , Humans , Middle Aged , Perfectionism , Psychological Distress , Psychometrics , Reproducibility of Results , Social Desirability , Surveys and Questionnaires , Young Adult
9.
Eur J Nutr ; 59(3): 1191-1204, 2020 Apr.
Article in English | MEDLINE | ID: mdl-31069458

ABSTRACT

PURPOSE: Mild/moderate maternal calorie restriction during lactation in rats has been associated with a lower predisposition to obesity and a healthier metabolic profile in adult offspring. Here, we aimed to assess the impact of maternal calorie restriction during lactation on milk composition to identify potential candidate components that could be involved in the programming effects in offspring. METHODS: An untargeted metabolomic approach in milk samples from 20%-calorie-restricted lactating (CRL) dams and their controls was performed. Levels of leptin, adiponectin, and irisin hormones in milk were also determined at lactating days 5, 10, and 15. RESULTS: Metabolomic analyses revealed a different metabolite pattern in milk between controls and CRL dams. 29 differential metabolites were tentatively identified (p < 0.05, FC > 1.5). Among them, myo-inositol, which showed greater levels in milk from CRL rats than controls, may be highlighted as one of the biologically plausible candidates that could be related to the beneficial effects of CRL in offspring. Results regarding myo-inositol were validated spectrophotometrically at days 10 and 15 of lactation, and levels in milk were correlated with maternal plasma levels. In addition, milk from CRL dams presented increased levels of adiponectin, decreased levels of irisin, and no changes in leptin levels vs controls throughout lactation. CONCLUSION: These data reveal important changes in milk composition due to calorie restriction during lactation that may be involved in the metabolic programming of the healthier phenotype of adult offspring. However, the possible contribution of the specific components is yet to be determined.


Subject(s)
Caloric Restriction/statistics & numerical data , Lactation/metabolism , Maternal Nutritional Physiological Phenomena , Metabolomics/methods , Milk/metabolism , Animals , Female , Models, Animal , Phenotype , Rats , Rats, Wistar
10.
Mitochondrion ; 51: 62-67, 2020 03.
Article in English | MEDLINE | ID: mdl-31887371

ABSTRACT

Physiochemical differences between mitochondrial DNA (mtDNA) haplogroups that favor oxidative phosphorylation efficiency during periods of caloric limitation can lead to lifespan lengthening when food calories are less abundant. For example, prior work demonstrated that older female haplogroup H carriers had modestly lengthened lifespans beyond 60 years during the Great Depression, a time of caloric limitation in North America. The objective of the current study is to replicate the prior findings in an independent cohort that includes both sexes and younger ages. By determining and cross-referencing the mtDNA genotypes of a culturally homogeneous population isolate to the lifespans of their ancestors, we found that between 1930 and 1939, haplogroup H compared to haplogroup U carriers had a modestly lengthened lifespan (3 years) past 60 years (hazard ratio 2.35; CI95 1.41-3.90; p-value: 0.0029). The lifespan-lengthening association was apparent in both sexes but only after the age of 60. Our results provide further support for the role of mitochondrial genetics in lengthening human lifespan.


Subject(s)
Caloric Restriction/statistics & numerical data , Haplotypes/genetics , Longevity/genetics , Mitochondria/genetics , DNA, Mitochondrial/genetics , Female , Humans , Male , Mitochondria/metabolism , Oxidative Phosphorylation
11.
Obes Surg ; 29(1): 54-60, 2019 01.
Article in English | MEDLINE | ID: mdl-30128643

ABSTRACT

OBJECTIVE: A preoperative very low-calorie diet (VLCD) is a common method to reduce weight before bariatric surgery. However, patient compliance and acceptability are not always known. The aim of this study is to evaluate the effectiveness, compliance, and acceptability of our regimen in a metropolitan academic quaternary care center. METHODS: Patients with a BMI < 50 kg/m2 and a BMI ≥ 50 kg/m2 were instructed to be on a liquid VLCD for 1 week and 2 weeks, respectively. The primary outcome was the amount of weight loss. Secondary outcomes were patient compliance and acceptability of either regimen using a questionnaire for hunger, satisfaction, desire, and deviation for solids. RESULTS: The study included 128 patients. Ninety-four patients were in the BMI < 50 kg/m2 group, and 34 patients were in the BMI ≥ 50 kg/m2 group. The BMI ≥ 50 kg/m2 group had a greater percentage of total weight loss (mean ± SD) than that of the BMI < 50 kg/m2 group without statistical differences (4.4 ± 1.3% vs. 3.8 ± 1.6%, p = 0.072). There were no statistical differences between the groups in terms of hunger, satisfaction with a liquid diet, or satisfaction of eating over drinking. However, hunger sensation (median [IQR]) tended to be higher in the BMI < 50 kg/m2 group than that in the BMI ≥ 50 kg/m2 group (2 [2] vs. 2 [2, 3]; p = 0.06). There was no statistical difference in the percentage of patient compliance between the groups (75.5% [n = 71] vs. 61.8% [n = 21], p = 0.18). CONCLUSIONS: Preoperative liquid VLCD provided a modest amount of weight loss and showed a high rate of patient compliance and acceptability.


Subject(s)
Bariatric Surgery/statistics & numerical data , Caloric Restriction/statistics & numerical data , Obesity, Morbid , Patient Compliance/statistics & numerical data , Weight Loss/physiology , Humans , Obesity, Morbid/diet therapy , Obesity, Morbid/surgery , Prospective Studies , Treatment Outcome
12.
Int J Obes (Lond) ; 43(10): 2028-2036, 2019 10.
Article in English | MEDLINE | ID: mdl-30470804

ABSTRACT

BACKGROUND AND OBJECTIVE: Intermittent energy restriction (IER) is an alternative to continuous energy restriction (CER) for weight loss. There are few long-term trials comparing efficacy of these methods. The objective was to compare the effects of CER to two forms of IER; a week-on-week-off energy restriction and a 5:2 program, during which participants restricted their energy intake severely for 2 days and ate as usual for 5 days, on weight loss, body composition, blood lipids, and glucose. SUBJECTS AND METHODS: A one-year randomized parallel trial was conducted at the University of South Australia, Adelaide, Australia. Participants were 332 overweight and obese adults, ages 18-72 years, who were randomized to 1 of 3 groups: CER (4200 kJ/day for women and 5040 kJ/day for men), week-on-week-off energy restriction (alternating between the same energy restriction as the continuous group for one week and one week of habitual diet), or 5:2 (2100 kJ/day on modified fast days each week for women and 2520 kJ/day for men, the 2 days of energy restriction could be consecutive or non-consecutive). Primary outcome was weight loss, and secondary outcomes were changes in body composition, blood lipids, and glucose. RESULTS: For the 146 individuals who completed the study (124 female, 22 male, mean BMI 33 kg/m2) mean weight loss, and body fat loss at 12 months was similar in the three intervention groups, -6.6 kg for CER, -5.1 kg for the week-on, week-off and -5.0 kg for 5:2 (p = 0.2 time by diet). Discontinuation rates were not different (p = 0.4). HDL-cholesterol rose (7%) and triglycerides decreased (13%) at 12 months with no differences between groups. No changes were seen for fasting glucose or LDL-cholesterol. DISCUSSION AND CONCLUSION: The two forms of IER were not statistically different for weight loss, body composition, and cardiometabolic risk factors compared to CER.


Subject(s)
Caloric Restriction/statistics & numerical data , Diet, Reducing/statistics & numerical data , Energy Intake/physiology , Obesity/prevention & control , Overweight/prevention & control , Weight Loss/physiology , Adult , Aged , Australia/epidemiology , Body Weight Maintenance/physiology , Female , Humans , Male , Middle Aged , Obesity/epidemiology , Overweight/epidemiology , Patient Compliance/statistics & numerical data , Retrospective Studies , Time Factors , Young Adult
13.
Int J Obes (Lond) ; 43(10): 2017-2027, 2019 10.
Article in English | MEDLINE | ID: mdl-30206335

ABSTRACT

BACKGROUND: Intermittent dieting may be an alternative to continuous dieting for weight reduction. OBJECTIVE: To evaluate the effect of intermittent dieting versus continuous dieting on weight and body composition in overweight or obese adults. DESIGN: A systematic review and meta-analysis of randomized controlled trials (RCTs). Five databases were searched until February 2018 for RCTs comparing intermittent versus continuous dieting. Intermittent dieting consisted of two types: regular intermittent was caloric restriction interspersed with days of weight maintenance or ad libitum eating; intensified intermittent was caloric restriction interspersed with days of even lower caloric restriction. Continuous was continual caloric restriction. Primary outcomes were weight, body fat, lean mass, waist circumference, hip circumference, and energy expenditure. Data were pooled by the inverse variance method using random-effects models and expressed as mean differences (MD) and their 95% confidence intervals (CI). RESULTS: Nine trials met the inclusion criteria (n = 782), six comparing regular intermittent vs continuous (n = 553), and three comparing intensified intermittent vs continuous (n = 229). Populations were heterogeneous: obese only in five studies, and overweight or obese (mixed) in four studies. Lean mass was significantly lower in regular intermittent vs continuous (MD -0.86 kg; 95% CI -1.62 to -0.10; p = 0.03). No differences were found for the remaining outcomes for both comparisons (regular intermittent or intensified intermittent vs continuous). There was low heterogeneity of effects across trials. Subgroup effects by time to follow-up, gender, per-protocol versus intention-to-treat, enforced exercise, and diabetes were similar to main analyses. CONCLUSIONS: This systematic review in obese and overweight individuals showed that regular intermittent dieting decreased lean mass compared to continuous dieting. There were no differences in effects for either intermittent vs continuous interventions across all other outcomes. In contrast to previous systematic reviews, this study suggested that lean mass is better preserved in continuous dieting compared to regular intermittent dieting.


Subject(s)
Obesity/prevention & control , Overweight/prevention & control , Weight Loss/physiology , Body Weight , Caloric Restriction/statistics & numerical data , Exercise , Humans , Longitudinal Studies , Obesity/therapy , Overweight/therapy , Randomized Controlled Trials as Topic , Treatment Outcome
14.
Nutrition ; 58: 18-22, 2019 02.
Article in English | MEDLINE | ID: mdl-30273821

ABSTRACT

OBJECTIVES: This analysis aimed to investigate the association among interleukin 6 (IL-6) levels, caloric intake, and working memory and to explore the potential mediators of these associations using the public dataset from the Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy (CALERIE) clinical trial. METHODS: The CALERIE study was designed to evaluate the effects of 2 y of prolonged caloric restriction in humans. Individuals were randomized to caloric restriction (CR; n = 145) or an ad libitum diet (AL; n = 75) for 2 y. The outcome measures used herein were spatial working memory tests (i.e., total number of errors and strategy). Generalized estimating equations were used to assess the effects of treatment, time, and potential moderators (e.g., sleep and physical activities). RESULTS: At baseline, there was an effect of hours of sleep, alcohol intake, and physical activities (i.e., mean total metabolic equivalent of task hours per day [MET-hours/day]) on IL-6 levels. The association between IL-6 and energy intake was moderated by MET-hours/day. The longitudinal analysis indicated that there was an effect of time, but not of treatment, on IL-6 levels, with decreasing values in both the CR and AL groups. Changes in IL-6 levels were associated with changes in working memory performance, but there were no between-group (i.e., CR vs. AL) differences. CONCLUSIONS: We observed an association between changes in IL-6 levels and improvement in spatial working memory tests. IL-6 was associated with higher caloric consumption, poorer sleep quality, and lower levels of physical activity.


Subject(s)
Caloric Restriction/statistics & numerical data , Energy Intake/physiology , Interleukin-6/blood , Memory Disorders/blood , Memory Disorders/physiopathology , Memory, Short-Term/physiology , Adult , Female , Humans , Male , Memory Disorders/diagnosis , Middle Aged , Neuropsychological Tests/statistics & numerical data , Young Adult
15.
Asian Nurs Res (Korean Soc Nurs Sci) ; 12(4): 279-285, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30394353

ABSTRACT

PURPOSE: The purpose of this research was to test the validity and reliability of the Indonesian version of the Dietary Sodium Restriction Questionnaire (DSRQ-I) among patients with hypertension. METHODS: The cross-sectional study enrolled hypertensive patients from a cardiac outpatient department in Indonesia using convenience sampling. Eligible patients received a demographic questionnaire and DSRQ-I during a one-month period of data collection. Content and construct analysis examined the validity, whereas internal consistency assessment checked reliability. Participation required 10-15 minutes on average. RESULTS: One hundred thirty-five patients participated: mostly females (54.1%) and married (82.9%) with mean age of 58.18 ± 10.44 years. The item of content validity index was .97, and subscale content validity index was .81 for DSRQ-I. The Kaiser-Meyer-Olkin test gave a value of .83, indicating adequate sampling, and the Bartlett's test of sphericity reached significant result (p < .001). The principal component analysis indicated three components, with 64.2% explaining variance, including perceived behavioral control (35.5%), attitude (19.3%), and subjective norm (9.4%). Confirmatory factor analysis produced a parsimonious model on the three-factor outcome by removing a single item. The indices of good fit model was achieved at χ2/df = 2.17, goodness fit index = .85, root mean square error of approximation = .09, standardized root mean square means = .07, and Bentler comparative fit index = .90 (p < .001). Cronbach's alpha coefficients for attitude, subjective norm, and perceived behavioral control were .85, .87, and .85, respectively. All interitem and item-total correlations indicated adequate outcome and acceptable result. Consequently, 15 items were determined reliable measurement and included in the final version of DSRQ-I. CONCLUSION: The DSRQ-I is a valid and reliable instrument to measure facilitators and barrier of sodium restriction among hypertensive patients in Indonesia.


Subject(s)
Caloric Restriction/statistics & numerical data , Caloric Restriction/standards , Eating/psychology , Health Knowledge, Attitudes, Practice , Hypertension/prevention & control , Sodium, Dietary/standards , Surveys and Questionnaires/standards , Aged , Cross-Sectional Studies , Female , Humans , Indonesia , Male , Middle Aged , Psychometrics , Reproducibility of Results
16.
Arq. bras. med. vet. zootec. (Online) ; 70(3): 931-938, maio-jun. 2018. tab
Article in Portuguese | LILACS, VETINDEX | ID: biblio-911907

ABSTRACT

Objetivou-se avaliar o desempenho de tambaquis (Colossoma macropomum) submetidos à restrição alimentar e à realimentação em tanques-rede. Durante 60 dias, foram alocados 100 tambaquis (peso inicial de 8,0 ± 0,5g), em 20 tanques-rede. Foram realizados quatro tratamentos: T1=animais alimentados diariamente (controle), T2=alimentados durante seis dias com um dia de restrição de ração (6A/1R), T3=alimentados durante cinco dias com dois dias de restrição (5A/2R) e T4 = alimentados durante quatro dias com três dias de restrição (4A/3R). Os animais foram alimentados duas vezes ao dia, às oito e às 16 horas, até a aparente saciedade, com ração extrusada comercial (42%PB). Utilizaram-se cinco repetições para cada tratamento e cinco peixes por unidade experimental, em um delineamento inteiramente ao acaso. A coleta de dados para avaliação do desempenho produtivo foi feita com base no peso final, no ganho de peso, no consumo médio de ração, na conversão alimentar, no comprimento total, no comprimento padrão, na altura, no índice de cabeça e de perfil, na taxa de eficiência proteica, na taxa de crescimento específico e na sobrevivência. Os resultados foram submetidos à ANOVA e ao teste de Tukey (P≥5). O tratamento 5A/2R apresentou-se como a melhor ferramenta na redução de custos de produção sem prejuízo ao desempenho produtivo de juvenis de tambaqui.


The aim of this research was to evaluate the performance of tambaqui juveniles (Colossoma macropomum) submitted to feed deprivation and refeeding in cages. For 60 days of experimentation, 100 tambaquis were used (initial weight 8.0 ± 0.5g), distributed in 20 cages. The treatments were: T1=daily fed animals (control), T2=fed for six days and one day of restriction (6F/1R), T3=fed for five days and two days of restriction (5F/2R) and T4=fed for four days with three days of restriction (4F/3R). With five replicates each, and five fish for each experimental unit, arranged in a completely randomized design. In accordance with treatments, the fishes were fed twice a day at 08:00am and 4:00pm. The data collection for the performance evaluation was based on final weight, weight gain, average feed intake, alimentary conversion, total length, standard length, height, index head, index profile, protein efficiency rate, specific growth rate and survival at the end of the experimental period. Results were submitted to ANOVA and Tukey test (P≥5). Treatment 5F/2R resulted in the best performance results, which is a tool in reducing production costs without loss in performance of tambaqui juvenile.


Subject(s)
Animals , Animal Feed/analysis , Caloric Restriction/statistics & numerical data , Fishes/growth & development , Fisheries
17.
Hig. aliment ; 31(264/265): 30-37, 27/02/2017.
Article in Portuguese | LILACS | ID: biblio-832657

ABSTRACT

A busca por uma alimentação alternativa é, sem dúvida, uma realidade nos dias de hoje e com isso o consumo de alimentos diet e light vem sofrendo significativo aumento. O objetivo do presente trabalho foi verificar o conhecimento sobre os produtos diet e light, entre os funcionários e universitários de uma instituição particular de ensino superior em São José/SC. A pesquisa utilizou um delineamento transversal com caráter descritivo exploratório e a amostra foi constituída por 363 indivíduos de ambos os sexos, aplicada no primeiro semestre de 2016. Como instrumento de coleta foi adotado um questionário contendo perguntas estruturadas, abordando variáveis socioeconômicas e comportamentais. Os resultados indicam que a maioria é do sexo feminino; 60,6% afirmaram consumir produtos diet e light e 39,4% não consumir e o motivo mais citado para o consumo foi o intuito de ser mais saudável. Dos entrevistados 66,12% relataram saber a diferença entre diet e light, porém com respostas a definições incorretas. Dos alimentos mais consumidos, destaca-se o requeijão, seguido da barra de cereal. Conclui-se que, apesar da maioria ter afirmado saber a diferença entre estes produtos, muitos não sabem a verdadeira definição, possibilitando escolhas erradas que podem refletir na saúde do consumidor.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Food, Formulated , Health Knowledge, Attitudes, Practice , Surveys and Questionnaires , Nutritional Facts , Feeding Behavior , Food Preferences/psychology , Schools , Socioeconomic Factors , Brazil , Caloric Restriction/statistics & numerical data , Diet/statistics & numerical data
18.
Obesity (Silver Spring) ; 24(4): 805-11, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26853430

ABSTRACT

OBJECTIVE: To determine whether weight loss (WL) with 6 weeks of a low-calorie liquid diet as part of a behavioral program (LCDBP) predicts subsequent weight change in response to a laparoscopic Roux-en-Y gastric bypass (RYGB). METHODS: Of 4698 LCDBP patients, 403 went on to RYGB and 222 were evaluable. We determined correlations between percent WL (% WL) in 6 weeks of LCDBP with % WL at 4, 12, 24, 36, and 52 weeks after RYGB. RESULTS: There was a positive correlation between the slope of WL in the first 6 weeks of LCDBP and over 4 and 12 weeks after RYGB: r = 0.15 (CI = 0.003-0.285, P = 0.045) and r = 0.22 (CI = 0.08-0.35, P = 0.0017), respectively. The association was also apparent at 24 weeks in females but not in males. There was a statistically significant correlation between % WL at 26 weeks of LCDBP and 52 weeks postsurgery (r = 0.20, CI = 0.05-0.34, P = 0.01). Finally, % WL at 6 weeks also predicted % WL at 26 weeks of dietary intervention (r = 0.52, CI = 0.40-0.62, P = 2.40 × 10(-14) ). CONCLUSIONS: WL in response to 6 weeks of LCDBP is predictive of weight for at least 12 weeks following RYGB.


Subject(s)
Anastomosis, Roux-en-Y/statistics & numerical data , Caloric Restriction/statistics & numerical data , Gastroplasty/statistics & numerical data , Obesity, Morbid/surgery , Weight Loss , Adult , Cohort Studies , Female , Humans , Male , Middle Aged , Models, Statistical
19.
Obes Surg ; 25(10): 1886-92, 2015 Oct.
Article in English | MEDLINE | ID: mdl-25702144

ABSTRACT

BACKGROUND: The purpose of this study was to compare the effects of intensive nutritional care (INC) and laparoscopic adjustable gastric banding (LAGB) on nocturnal non-invasive ventilation (NIV) requirement in obese patients using short-, medium-, and long-term follow-up data. METHODS: This prospective randomized controlled trial included obese patients with obstructive sleep apnea (OSA) treated by NIV. Patients were randomized to the INC and LAGB groups. The primary endpoint was the theoretical rate of weaning from NIV at years 1 and 3. Data were also collected from patients 10 years after randomization. RESULTS: Sixty-three patients were randomized. The rate of weaning from NIV did not differ significantly between the LAGB and INC groups at year 1 (35 vs. 13%) or year 3 (14 vs. 21%). Percentages of excess weight loss were greater in the LAGB group than in the INC group at years 1 (33 vs. 15%, p = 0.002) and 3 (27 vs. 8%, p = 0.014). Decreases in the apnea-hypopnea index were observed in the LAGB group from baseline to year 1 (-44%, p = 0.001) and from baseline to year 3 (-26%, p = 0.044). After 10 years, the weaning rate was low and similar between groups. CONCLUSION: LAGB was not superior to INC for weaning from NIV at 1 and 3 years in obese patients with OSA.


Subject(s)
Caloric Restriction , Gastroplasty , Noninvasive Ventilation , Obesity, Morbid/diet therapy , Obesity, Morbid/surgery , Sleep Apnea, Obstructive/therapy , Adult , Caloric Restriction/adverse effects , Caloric Restriction/statistics & numerical data , Female , Follow-Up Studies , Gastroplasty/adverse effects , Gastroplasty/methods , Gastroplasty/statistics & numerical data , Humans , Laparoscopy/adverse effects , Laparoscopy/methods , Laparoscopy/statistics & numerical data , Male , Middle Aged , Noninvasive Ventilation/adverse effects , Noninvasive Ventilation/statistics & numerical data , Obesity, Morbid/complications , Obesity, Morbid/epidemiology , Patient Compliance/statistics & numerical data , Sleep Apnea, Obstructive/epidemiology , Sleep Apnea, Obstructive/etiology , Treatment Outcome , Weight Loss
20.
Diabetes Care ; 37(12): 3345-55, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25414390

ABSTRACT

OBJECTIVE: Diet is the cornerstone treatment of patients with gestational diabetes mellitus (GDM), but its role in maternal and newborn outcomes has been scarcely studied. The purpose of this study was to analyze the efficacy of dietary interventions on maternal or newborn outcomes in patients with GDM. RESEARCH DESIGN AND METHODS: A systematic review and meta-analysis of randomized clinical trials (RCTs) of dietary intervention in GDM or pregnancy with hyperglycemia was performed. MEDLINE, Embase, ClinicalTrials.gov, Cochrane, and Scopus were searched through to March 2014. The main evaluated maternal outcomes were proportion of patients using insulin and proportion of cesarean delivery; the newborn outcomes were proportion of macrosomia and hypoglycemia and newborn weight. RESULTS: From 1,170 studies, nine RCTs, including 884 women aged 31.5 years (28.7-33.2) with 27.4 weeks (24.1-30.3) of gestation, were eligible. We divided the RCTs according to the type of dietary intervention: low glycemic index (GI) (n = 4; 257 patients), total energy restriction (n = 2; 425 patients), low carbohydrates (n = 2; 182 patients), and others (n = 1; 20 patients). Diet with low GI reduced the proportion of patients who used insulin (relative risk 0.767 [95% CI 0.597, 0.986]; P = 0.039) and the newborn birth weight (weight mean differences -161.9 g [95% CI -246.4, -77.4]; P = 0.000) as compared with control diet. Total restriction and low carbohydrate diets did not change either maternal or newborn outcomes. CONCLUSIONS: A low GI diet was associated with less frequent insulin use and lower birth weight than control diets, suggesting that it is the most appropriate dietary intervention to be prescribed to patients with GDM.


Subject(s)
Diabetes, Gestational/diet therapy , Diabetes, Gestational/epidemiology , Pregnancy Outcome/epidemiology , Randomized Controlled Trials as Topic/statistics & numerical data , Adult , Birth Weight , Caloric Restriction/statistics & numerical data , Cesarean Section/statistics & numerical data , Diet, Carbohydrate-Restricted/statistics & numerical data , Female , Humans , Infant, Newborn , Pregnancy
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