Behaviour Change Techniques in Computerized Cognitive Training for Cognitively Healthy Older Adults: A Systematic Review.

We aimed to describe behaviour change techniques (BCT) used in trials evaluating computerised cognitive training (CCT) in cognitively healthy older adults, and explore whether BCTs are associated with improved adherence and efficacy. The 90 papers included in a recent meta-analysis were reviewed for information about adherence and use of BCTs in accordance with the Behaviour Change Taxonomy. Studies using a specific BCT were compared with studies not using that BCT on efficacy (difference in Hedges' g [Δg]) using three level meta-regression models and on median adherence using the Wilcoxon test. The median number of BCTs per study was 3 (interquartile range [IQR] = 2-5). 'Feedback on behaviour' (if provided by a person; Δg = -0.19, 95% confidence interval [CI] = -0.31;-0.07) and 'non-specific reward' (Δg = -0.19, CI = -0.34;-0.05) were associated with lower efficacy. Certain BCTs that involve personal contact may be beneficial, although none were statistically significantly associated with greater efficacy. The median percentage of adherence was 90% (IQR = 81-95). Adherence was higher in studies using the BCT 'self-monitoring of behaviour' and lower in studies using the BCT 'graded tasks' than studies not using these BCTs (p < 0.001). These findings provide first evidence that BCTs can influence both adherence to and efficacy of CCT programs in cognitively healthy older adults.

Acute-on-chronic effects of fatty acids on intestinal triacylglycerol-rich lipoprotein metabolism.

Postprandial triacylglycerol (TAG) metabolism is an important metabolic state that has been associated with cardiovascular disease. The magnitude of the postprandial TAG response is determined by dietary fat composition, which alters intestinal and hepatic TAG-rich lipoprotein (TRL) metabolism. Caco-2 cell monolayers are morphologically and physiologically similar to the human intestinal enterocytes, hence they are a good model to study intestinal lipoprotein metabolism. To date only the acute effect of fatty acid composition on intestinal TRL metabolism in Caco-2 cells has been investigated. Little is known of the effect of habitual, or chronic, dietary fat composition on intestinal TRL metabolism. Using the Caco-2 cell model, the present study investigated the acute-on-chronic effect of fatty acid composition on TRL metabolism. Caco-2 cells were grown in the presence of 0.05 mm-palmitic acid (PA; 16 : 0), -oleic acid (OA; 18 : 1n-9),-eicosapentaenoic acid (EPA; 20 : 5n-3) or no fatty acid (control) for 19 d, then one of four acute treatments (control (bovine serum albumin (BSA; 5 g/l)) or BSA (5 g/l) plus 0.5 mm-PA, -OA or -EPA) were administered for 22 h. Significant acutexchronic interactions for the effect of fatty acid composition on cellular TAG:secreted de novo TAG, and cellular de novo TAG:de novo phospholipid were observed. Thus the effect of a fatty acid was determined by the duration of exposure to the fatty acid intervention. Acute PA treatment increased de novo TAG synthesis, but chronic PA supplementation did not. Acute and chronic OA treatments increased de novo TAG secretion. For EPA, chronic supplementation had the greatest effect on TAG synthesis and secretion. The acute-on-chronic effects of fatty acids on apolipoprotein B metabolism were relatively minor compared with the changes noted for TRL lipid composition. The present study shows that the Caco-2 cell model is valuable for studying intestinal TRL metabolism and that fatty acids modulate this process, the nature of which can be determined by the length of exposure of the cell to the fatty acid.

Chronic but not acute treatment with conjugated linoleic acid (CLA) isomers (trans-10, cis-12 CLA and cis-9, trans-11 CLA) affects lipid metabolism in Caco-2 cells.

Conjugated linoleic acid (CLA) has profound effects on hepatic and adipocyte lipid metabolism, but little is known about its effects on intestinal lipid metabolism. We investigated the acute (22 h) and acute-after-chronic (22 h after 19 d) effects of trans-10, cis-12 CLA (t10,c12-CLA) and cis-9, trans-11 CLA (c9, t11-CLA) on triacylglycerol (TAG)-rich lipoprotein (TRL) metabolism, de novo TAG, phospholipid (PL) ((14)C-glycerol) and apolipoprotein B (apoB) ((35)S-methionine) synthesis and secretion, in the colon carcinoma (Caco-2) cell model of intestinal lipoprotein metabolism. Acute treatment with either CLA isomer did not affect TRL metabolism. However, chronic t10,c12-CLA and c9,t11-CLA supplementation followed by acute palmitic acid (PA) treatment increased the ratio of cellular to secreted de novo TAG (cTAG/sTAG) (P < or = 0.03) as a result of increased cellular de novo TAG levels. Chronic Caco-2 cell t10,c12-CLA supplementation, prior to the acute oleic acid (OA) treatment, significantly increased (P = 0.005) the ratio of cellular de novo TAG to de novo PL (cTAG/cPL), to a greater extent than that following chronic linoleic acid (LA) (P = 0.001) or c9,t11-CLA supplementation (P = 0.005). Again, this effect was attributed to increased cellular de novo TAG synthesis. Neither CLA isomer affected the ratio of secreted de novo TAG to de novo PL (sTAG/sPL). No effects on Caco-2 cell apoB synthesis and secretion were observed after acute or chronic CLA treatments. In conclusion, chronic t10,c12-CLA supplementation modulated intestinal TRL metabolism, by increasing cellular de novo TAG synthesis but had no effect on de novo TAG secretion in Caco-2 cells.