An Academia-Industry Partnership for Planning and Executing a Community-Based Feeding Study.

A research team from Boston Children's Hospital and Harvard Medical School conducted a community-based feeding study in collaboration with Framingham State University (FSU) and Sodexo, the food service contractor at FSU. The study was a randomized controlled trial, implemented on the FSU campus. For the final year of the study, a satellite feeding site was established at Assabet Valley Regional Technical High School. The purpose of the study was to assess the biological effects of different macronutrient diets. An academia-industry partnership was developed to overcome common challenges associated with hospital-based feeding studies. Benefits included the following: a study site outside of Boston (reducing inconvenience for participants), access to a large commercial kitchen and study-specific kiosk (promoting efficiency), collaboration with Sodexo chefs (ensuring palatability of meals), and opportunity to procure food from contracted vendors. The research (academia) and food service (industry) teams worked together to design, plan, and execute intervention protocols using an integrated approach. During execution, the research team was primarily responsible for overseeing treatment fidelity, whereas the food service team provided culinary expertise, with a strong focus on hospitality and food quality. The study was conducted in 3 cohorts between August 2014 and May 2017. Participants received all of their food for ∼30 wk, totaling >160,000 meals. For all 3 cohorts combined, 234 participants provided informed consent, 229 started a standard run-in weight-loss diet, 164 lost a mean ± SD 12% ± 2% of baseline body weight and were randomly assigned to different macronutrient diets for weight-loss maintenance, and 148 completed the study. During the final and largest cohort, as many as 114 participants received daily meals concurrently. The daily cost per participant for preparation and service of weighed meals and snacks was ∼$65. This academia-industry partnership provides a model for controlled feeding protocols in nutrition research, potentially with enhanced cost-effectiveness, practicality, and generalizability. This trial was registered at http://www.clinicaltrials.gov as NCT02068885.

Altering portion sizes and eating rate to attenuate gorging during a fast food meal: effects on energy intake.

OBJECTIVE: Eating large amounts of food at a rapid rate, defined as gorging, may contribute to excess energy intake. We aimed to evaluate whether altering portion sizes and eating rate could decrease energy intake during an extra-large fast food meal. METHODS: Subjects were adolescents (n = 18), 13 to 17 years of age, who reported eating fast food > or =1 time per week. BMI exceeded the 80th percentile for all subjects. Three feeding conditions were evaluated with a crossover design. Total amounts and types of foods and beverage served during the meal were held constant across conditions, equaling approximately 125% of that consumed during a baseline assessment visit when subjects were offered unlimited amounts. The meal (chicken nuggets, French fries, and cola) was presented as 1 large serving at a single time point (condition A, standard), portioned into 4 smaller servings presented at a single time point (condition B, effects of portioning), or portioned into 4 smaller servings presented at 15-minute intervals (condition C, effects of portioning and eating rate). Energy intake across conditions was compared by using analysis of variance. RESULTS: Energy intake was not significantly different, whether expressed in kilojoules (mean +/- SEM: condition A, 5552 +/- 357 kJ; condition B, 5321 +/- 433 kJ; condition C, 5762 +/- 500 kJ) or relative to total daily energy expenditure (mean +/- SEM: condition A, 51.9 +/- 3.5%; condition B, 48.2 +/- 4.0%; condition C, 53.0 +/- 4.3%). CONCLUSIONS: Adolescents consumed approximately 50% of energy needs regardless of manipulations in portion sizes and eating rate to attenuate gorging. This finding suggests that nutritional factors inherent to fast food, such as low levels of dietary fiber, high palatability, high energy density, high fat content, high glycemic load, and high content of sugar in liquid form promote excess energy intake.

Effects of an ad libitum low-glycemic load diet on cardiovascular disease risk factors in obese young adults.

BACKGROUND: The optimal nutritional approach for the prevention of cardiovascular disease among obese persons remains a topic of intense controversy. Available approaches range from conventional low-fat to very-low-carbohydrate diets. OBJECTIVE: The aim of this pilot study was to evaluate the efficacy of an ad libitum low-glycemic load diet, without strict limitation on carbohydrate intake, as an alternative to a conventional low-fat diet. DESIGN: A randomized controlled trial compared 2 dietary treatments in obese young adults (n = 23) over 12 mo. The experimental treatment emphasized ad libitum consumption of low-glycemic-index foods, with 45-50% of energy from carbohydrates and 30-35% from fat. The conventional treatment was restricted in energy (250-500 kcal/d deficit) and fat (<30% of energy), with 55-60% of energy from carbohydrate. We compared changes in study outcomes by repeated-measures analysis of log-transformed data and expressed the results as mean percentage change. RESULTS: Body weight decreased significantly over a 6-mo intensive intervention in both the experimental and conventional diet groups (-8.4% and -7.8%, respectively) and remained below baseline at 12 mo (-7.8% and -6.1%, respectively). The experimental diet group showed a significantly greater mean decline in plasma triacylglycerols than did the conventional diet group (-37.2% and -19.1%, respectively; P = 0.005). Mean plasminogen activator inhibitor 1 concentrations decreased (-39.0%) in the experimental diet group but increased (33.1%) in the conventional diet group (P = 0.004). Changes in cholesterol concentrations, blood pressure, and insulin sensitivity did not differ significantly between the groups. CONCLUSION: An ad libitum low-glycemic load diet may be more efficacious than a conventional, energy-restricted, low-fat diet in reducing cardiovascular disease risk.