Impact of the feedback provided by a gastric electrical stimulation system on eating behavior and physical activity levels.

OBJECTIVE: The closed-loop gastric electrical stimulation (CLGES) abiliti® system provides tailored gastric electrical stimulation activated by food entry into the stomach and sensor-based data to medical professionals. The aim of this study was to analyze behavior changes using sensor-based food intake and activity data in participants treated with the CLGES system. METHODS: Food intake and activity data (3D accelerometer) were downloaded at baseline and monthly/bimonthly for 12 months in a subset of patients with obesity (N = 45) participating in a multicenter trial with CLGES. Measured food intake parameters included the number of intakes during allowed and disallowed periods, nighttime intakes, and between-meal snacks (average/d). Activity parameters included time in different levels of physical activity (min/d), sleep/sedentary (h/d), and estimated energy expenditure (EE). RESULTS: Weight loss at 12 months averaged 15.7 ± 7.7% of the baseline body weight. Stable reduction in the number of disallowed meals and between-meal snacks (P < 0.05), an increase in all levels of physical activity (P < 0.001), and an increase in activity-based EE (303 ± 53 kcal/d on average, P < 0.001) were seen. CONCLUSIONS: Significant improvement in eating and activity was seen in participants. It is hypothesized that feedback of the sensor-based data induced behavioral changes and contributed to weight loss in patients treated with CLGES.

Psychosocial, behavioural, pedagogical, and nutritional proposals about how to encourage eating a healthy breakfast.

BACKGROUND: Even if more and more evidences have highlighted the importance of breakfast in the growth and development of children, from 10 to 30% of US and European children and adolescents regularly skip breakfast. Thus, there is still a lot to be done before breakfast becomes a daily habit. The aim of this paper is to try and understand how it is possible to overcome the real or imaginary difficulties associated with skipping breakfast by psychosocial, behavioural, pedagogical and nutritional proposals. DISCUSSION: Schools are the best context where perform healthy interventions because it is here that children learn about the importance of good health at an age when the school still plays a major role in their education. Some school interventions, based on solid theories as the Self Determination Theory and the Behaviour Analysis, have been implemented in the last years to promote health behaviour such as intake of fruit and vegetables and physical activities. Cognitive behaviour therapy is the most closely monitored type of treatment/cure for obesity in randomised controlled trials. Moreover some associations such as the National Association of Food Science Specialists have drawn an own method to encourage food education at school and promote the importance of prevention. These projects could be used as starting point to perform interventions focus on breakfast. SUMMARY: Increase the consumption of breakfast between children is very important. Efforts should be done to drawn new school projects based on scientific-evidences.

Breakfast: a multidisciplinary approach.

BACKGROUND: The role of breakfast as an essential part of an healthy diet has been only recently promoted even if breakfast practices were known since the Middle Age. The growing scientific evidences on this topic are extremely sector-based nevertheless breakfast could be regarded from different point of views and from different expertises. This approach, that take into account history, sociology, anthropology, medicine, psychology and pedagogy, is useful to better understand the value of this meal in our culture. The aim of this paper was to analyse breakfast-related issues based on a multidisciplinary approach with input by specialists from different fields of learning. DISCUSSION: Breakfast is now recommended as part of a diet because it is associated with healthier macro- and micronutrient intakes, body mass index and lifestyle. Moreover recent studies showed that breakfast improves cognitive function, intuitive perception and academic performance. Research demonstrates the importance of providing breakfast not only to children but in adults and elderly too. Although the important role breakfast plays in maintaining the health, epidemiological data from industrialised countries reveal that many individuals either eat a nutritionally unhealthy breakfast or skip it completely. SUMMARY: The historical, bio-psychological and educational value of breakfast in our culture is extremely important and should be recognized and stressed by the scientific community. Efforts should be done to promote this practice for the individual health and well-being.

Intestinal and multivisceral transplantation: dynamics of nutritional management and functional autonomy.

OBJECTIVE: The objective of this study was to describe the dynamics of nutrition management of intestinal transplant recipients and allograft functional autonomy. METHODS: Intestinal absorptive functions and recipient nutritional status were monitored during the 12-month study period. Absorption was evaluated with D-xylose absorption and fecal fat excretion. Indices for nutrition were body weight, anthropometric measures, and serum albumin. RESULTS: Before transplant, all patients were total parenteral nutrition (TPN) dependent and well nourished. By the first postoperative month, all 22 recipients were tolerating enteral feeding. By 3 months, all recipients had begun oral feeding, with 13 off TPN and 7 off enteral feeds. By 6 months, 16 recipients were off TPN, and by the end of the 12th month, 17 (77%) were free of TPN. Although all 22 recipients were completely weaned off TPN during the first posttransplant year, 10 required temporary reinstitution of therapy at different points. Full nutritional autonomy was achieved at 3 months by 3 recipients, at 6 months by 8 recipients, and at 12 months by 12 (55%) recipients. CONCLUSIONS: These results reflect our early experience that led to surgical refinement of the operation and evolution of the recipient postoperative management. Nonetheless, even in this initial cohort, most of the engrafted intestines restored the recipient nutritional autonomy, and all survivors remained well nourished.

Temperament and character in obese women with and without binge eating disorder.

Obesity is a serious disorder and its treatment involves dietitians, psychologists, and psychiatrists, often with a poor outcome. The role of psychiatric issues in obesity is equivocal, and so is the fact whether emotional and behavioral disturbances are causes or consequences of an individual's overweight condition. We performed a study that included 120 obese women (59 with binge eating disorder [BED] and 61 with non-BED) according to specific selection criteria, and compared to 80 healthy controls. Body mass index (BMI) was calculated for all patients and they were assessed with the Temperament and Character Inventory (TCI). Despite the fact that obese patients with BED and without BED display a similar personality profile, those with BED show lower scores in Self-Directedness (SD). Both groups of obese patients differ from nonobese controls in Novelty Seeking (NS), Harm Avoidance (HA), Cooperativeness (C), and SD. SD seems to be the strongest predictor for the development of BED. The idea that two distinct groups of obese patients exist is supported. Moreover, as regards personality, a lower SD and a higher risk of Personality Disorders were found in obese BED patients. Different severities of overweight do not seem to relate to a specific personality susceptibility.