Changes in Adolescents' Dietary Intake Following the Initiation of an 8-Week Exercise Program.

Purpose: To assess changes in dietary intake of adolescents following an 8-week aerobic exercise program.Methods: Twenty-six adolescents (14-18 years) participated in an 8-week aerobic exercise program on cycle ergometer at their high school in Quebec, Canada. Twenty-four hour recalls were collected pre- and post-intervention. A two-way repeated measures ANOVA and paired sample t-tests were used to assess differences in energy and dietary intake parameters (food quantity, diet quality, eating patterns) between pre- and postintervention.Results: A decrease in total daily energy intake (-287.8 kcal, P = 0.007), in meal size at lunch (-110.1 g, P = 0.02) and dinner (-143.7 g, P = 0.03), in food density at breakfast (-1.8 kcal/g, P = 0.04), in daily carbohydrate intake (-56.1 g, P = 0.005), and in percentage of energy intake consumed at school (-5.1%, P = 0.04) were observed following initiation of an aerobic exercise program. No change in healthy eating index scores or percentage of energy from processed foods was observed.Conclusions: Changes in energy intake, food quantity, and eating pattern but not diet quality (Healthy Eating Index or food processing scores) were observed following the initiation of an aerobic exercise program. Nutrition interventions may be needed, in addition to an exercise program, to target diet quality and promote healthy eating habits in adolescents.

Weight Communication: How Do Health Professionals Communicate about Weight with Their Patients in Primary Care Settings?

This study aimed to investigate how health professionals (HPs) communicate about weight with their patients. Semi-structured interviews were conducted with 33 health professionals (7 family physicians, 13 nurse practitioners, and 13 dietitians) working in multidisciplinary healthcare settings in Canada. Thematic analysis revealed four main approaches used by HPs to communicate about weight: 1) Analyzing patient perspectives, 2) focusing on overall health rather than weight, 3) directly addressing the topic, and 4) avoiding the topic. The approach chosen was influenced by HPs' outlook on obesity; for example, those who believed obesity to be a chronic disease did not hesitate to communicate about weight. However, some HPs who reported having obesity mentioned avoiding the topic of weight with their patients and emphasized the importance of establishing a trusting relationship with patients before addressing the topic. The approach chosen by HPs also seemed to be influenced by patient receptiveness, level of readiness, and motivation. Weight communication can be sensitive and the approach used to begin the topic of weight may differ based on patient- and HP factors. Future clinical practice guidelines may benefit from shifting toward communicating about modifiable risk factors rather than weight.

Dietitians' Perspectives on the Impact of Multidisciplinary Teams and Electronic Medical Records on Dietetic Practice for Weight Management.

Purpose: To understand the perception of dietitians regarding the effects of multidisciplinary settings and Electronic Health Records (EHRs) on their dietetic practice for weight management. Methods: Individual semi-structured interviews were conducted with 14 dietitians working in multidisciplinary settings in Ontario. All interviews were audio recorded and transcribed verbatim. Two researchers coded the data independently using a thematic analysis approach. All themes emerged inductively and were refined iteratively. Results: Most dietitians believed that working in a multidisciplinary setting allowed for interprofessional collaboration and time-effective referrals. Multidisciplinary clinics were perceived to improve patient care due to convenient scheduling, consistent messaging, and ongoing support. However, some dietitians reported instances of conflicting approaches and beliefs regarding weight management across health professionals. Dietitians suggested ways to address these conflicting approaches through clinical meetings and education. EHRs were perceived to allow for collaboration through facilitated communication and knowledge exchange; however, lack of interoperability between EHR platforms across different types of health care settings was perceived to be a barrier for optimal care. Conclusions: Overall, multidisciplinary settings were perceived to positively impact dietitians' practices for weight management as they allow for interprofessional collaboration. Consistency in health messaging across health professionals should be emphasized through knowledge exchange.

Dietitians' perspectives on patient barriers and enablers to weight management: An application of the social-ecological model.

AIM: Dietitians are nutrition experts who conduct nutrition assessments and provide support to patients seeking to manage their weight. The aim of the present study was to assess dietitians' perspectives on the barriers and enablers encountered by patients during their weight management journey. METHODS: Fourteen individual semi-structured interviews were conducted over a 3-month period in 2017 with dietitians working in Ontario, Canada. All interviews were audio-recorded and transcribed verbatim. Two researchers coded the data independently using a directed content analysis approach. RESULTS: Emerging themes were classified at societal, community, relationship, individual levels of the social-ecological model (SEM). Barriers included low socioeconomic status, 'go big or go home approach', lack of knowledge and cooking skills, lack of time, emotional eating, unsupportive home and work environments, discrimination and weight bias, lack of communication between health professionals, and low accessibility to healthy foods. Enablers included community programs, workplaces promoting healthy behaviours, and ongoing clinical support. Dietitians mentioned that patients encounter many barriers that may coexist and hinder weight management and/or maintenance of lost weight. CONCLUSIONS: Communication between health team members and ongoing patient support in the clinical setting are required. A whole-of-government, whole-of-society approach is needed to target the various aforementioned barriers at various level of the SEM.

Watching television or listening to music while exercising failed to affect post-exercise food intake or energy expenditure in male adolescents.

Watching television or listening to music while exercising can serve as motivating factors, making it more pleasant to exercise for some people. However, it is unknown whether these stimuli influence food intake and/or physical activity energy expenditure (PAEE) for the remainder of the day, potentially impacting energy balance and weight control. We examined the effects of watching television or listening to music while exercising on post-exercise energy intake and expenditure. Our study was a randomized crossover design, in which 24 male adolescents (mean age: 14.9 ±â€¯1.1 years) completed three 30-min experimental conditions consisting of walking/jogging on a treadmill at 60% of heart rate reserve while (1) watching television; (2) listening to music; or (3) exercising with no other stimulus (control). An ad libitum lunch was offered immediately after the experimental conditions, and a dietary record was used to assess food intake for the remainder of the day. An Actical accelerometer was used to estimate PAEE until bedtime. The primary outcome measure was post-exercise energy intake and expenditure (kJ). We found that exercising while watching television or listening to music did not significantly affect post-exercise energy intake or energy expenditure. Exercising on a treadmill was found to be significantly more enjoyable while watching television than with no stimulus present. Ratings of perceived exertion were not significantly different between conditions. Overall, our results suggest that watching television or listening to music while exercising does not impact post-exercise energy intake or expenditure in male adolescents, which may have positive implications for adolescents who may need additional motivation to participate in physical activity.