Exploring Australian night shift workers' food experiences within and outside of the workplace: a qualitative photovoice study.

OBJECTIVE: Night shift workers are at a 20 to 40 % increased risk of metabolic diseases, which may be associated with their disrupted eating patterns. This qualitative study explores factors that influence night shift workers' eating habits, within and outside of the workplace, to identify target areas for health promotion strategies. PARTICIPANTS AND SETTING: Eligible participants resided in Australia, working at least three overnight shifts per month. DESIGN: The photovoice method was used, whereby participants were asked to take photos that represent their typical eating habits. These photos were incorporated as prompts in a semi-structured interview, which explored factors influencing eating habits on night shifts and days-off and perceptions and enablers to healthy eating. RESULTS: Ten participants completed the study. Thematic analysis generated four main themes, which were mapped onto the Social Ecological Model (SE Model). Aligned with the SE Model, our results show night shift workers' eating habits are influenced by intrapersonal, interpersonal and (work) organisational levels. Participants reported that at work, appropriate food preparation facilities are required to enable healthy food choices. Poor shift work rostering leads to prolonged fatigue on days-off, limiting their ability and motivation to engage in healthy eating. Consequently, night shift workers seem to require additional supports from their social networks and enhanced food literacy skills, in order to adopt/ maintain healthy eating behaviours. CONCLUSIONS: Night shift work creates individual and environmental barriers to healthy eating, which are present during and outside of work. Health promotion strategies for this population should include multiple approaches to address these barriers.

The Effect of Commencing Rotating Shift Work on Diet and Body Composition Changes in Graduate Paramedics: A Longitudinal Mixed Methods Study.

Objectives: Diet quality often changes as shift workers adjust to atypical work schedules, however, limited research exists examining the early effects of starting rotating shift work on diet and body composition. This study explored dietary behavior changes occurring in graduate paramedics during the first year of exposure to rotating shift work, and investigated dietary intake, diet quality and anthropometric changes over two years.Methods: Participants from a graduate paramedic cohort in Melbourne, Australia were approached after two years of shift work for study inclusion. Using a mixed method study approach, the qualitative component comprised individual in-depth interviews to explore perceived dietary behavior changes experienced over the first year of shift work. Interview transcripts were thematically analyzed and guided by the COM-B model (capability, opportunity, motivation, and behavior) and theoretical domains framework (TDF). Diet quality and dietary intake were quantitatively assessed by the Australian Eating SurveyTM at baseline, one year, and two years, along with body weight, waist circumference, and body mass index (BMI) to monitor changes.Results: Eighteen participants were included in the study. From the interviews, participants reported: 1. food choices are driven by wanting to fit in with coworker food habits, 2. food choices and mealtimes are unpredictable and 3. paramedics try to make healthy food choices but give in to less healthy options. While daily energy intake and diet quality scores did not differ in the first two years of shift work, daily energy from takeaway foods significantly increased (mean difference (MD): 2.96% EI; 95% CI: 0.44 - 5.48; p = 0.017) and increases in weight (MD: 2.96 kg; 95% CI: 0.89-5.04; p = 0.003), BMI (MD: 1.07 kg/m2; 95% CI: 0.26 - 1.87; p = 0.006) and waist circumference (MD: 5.07 cm; 95% CI: 1.25-8.89; p = 0.006) were also evident at two years.Conclusions: This study contributes new information on dietary changes and the current early trajectory of unintentional weight gain and takeaway reliance occurring within a graduate paramedic cohort over two years of shift work. To reduce the unintended metabolic consequences commonly observed with rotating shift schedules, workplaces could improve access to healthier food options and enable behavioral support/education to address nutrition-related health risks.

Sex Differences in Bone Health Among Indian Older Adults with Obesity, Sarcopenia, and Sarcopenic Obesity.

Age-related changes in fat and lean mass contribute to bone health, but these associations may be influenced by sex and ethnicity. This study investigated sex-specific associations of obesity and sarcopenia with bone mineral density (BMD) and bone mineral apparent density (BMAD) among Indian older adults. 1057 adults aged ≥ 50 years were included. Dual-energy X-ray absorptiometry (DXA) measured BMD at the hip, spine and whole-body, and BMAD was calculated as BMD/√bone area. Obesity was defined by body fat percentage (cut points; > 25% for men and > 35% for women), and sarcopenia was defined using the revised Asian Working Group for Sarcopenia classification with low hand grip strength (< 28 kg for men and < 18 kg for women) and appendicular lean mass index (< 7.0 kg/m2 for men and < 5.4 kg/m2 for women). Participants were classified into four groups: controls (no obesity or sarcopenia), obesity, sarcopenia, or sarcopenic obesity. Linear regression (ß-coefficients and 95%CI) analyses were performed with adjustments for age, smoking status, protein intake, and socioeconomic status. Prevalence of sarcopenia (37%) and sarcopenic obesity (6%) were higher in men than women (17% and 4%, respectively). Compared with controls, men with obesity had lower whole-body BMD and BMAD, but women with obesity had higher hip and spine BMD and BMAD (all p < 0.05). Men, but not women, with sarcopenic obesity, had lower hip and whole-body BMD and BMAD (all p < 0.05) than controls. Men with sarcopenia had lower BMD and BMAD at the hip only, whereas women had lower BMD at all three sites and had lower BMAD at the hip and spine (all p < 0.05), compared with controls. Obesity, sarcopenia, and sarcopenic obesity have sex-specific associations with BMD and BMAD in Indian older adults. With the aging population in India, it is important to understand how body composition contributes to poor bone health among older adults.

The Impact of Meal Timing on Risk of Weight Gain and Development of Obesity: a Review of the Current Evidence and Opportunities for Dietary Intervention.

PURPOSE OF REVIEW: The aim of this short review is to provide an updated commentary on the current literature examining the impact of meal timing on obesity and weight gain in adults. The potential mechanisms, including novel and emerging factors, behind timing of food intake across the 24-h period in the development of obesity, and dietary strategies manipulating meal timing to ameliorate weight gain are also explored. RECENT FINDINGS: Dietary patterns that feature meal timing outside of the regular daytime hours can contribute to circadian disruption as food is metabolised in opposition to internal daily rhythms and can feedback on the timekeeping mechanisms setting these rhythms. Epidemiological evidence examining the impact of late meal timing patterns is beginning to suggest that eating at night increases the risk of weight gain over time. Mechanisms contributing to this include changes to the efficiency of metabolism across the day, and dysregulation of appetite hormone and gut microbiota by mis-timed meals. When meals are eaten, in relation to the time of day, is increasingly considered of importance when implementing dietary change in order to address the growing burden of obesity, although further research is required in order to determine optimal patterns.

A scoping review of chronotype and temporal patterns of eating of adults: tools used, findings, and future directions.

Circadian rhythms, metabolic processes and dietary intake are inextricably linked. Timing of food intake is a modifiable temporal cue for the circadian system and may be influenced by numerous factors, including individual chronotype - an indicator of an individual's circadian rhythm in relation to the light-dark cycle. This scoping review examines temporal patterns of eating across chronotypes and assesses tools that have been used to collect data on temporal patterns of eating and chronotype. A systematic search identified thirty-six studies in which aspects of temporal patterns of eating, including meal timings; meal skipping; energy distribution across the day; meal frequency; time interval between meals, or meals and wake/sleep times; midpoint of food/energy intake; meal regularity; and duration of eating window, were presented in relation to chronotype. Findings indicate that, compared with morning chronotypes, evening chronotypes tend to skip meals more frequently, have later mealtimes, and distribute greater energy intake towards later times of the day. More studies should explore the difference in meal regularity and duration of eating window amongst chronotypes. Currently, tools used in collecting data on chronotype and temporal patterns of eating are varied, limiting the direct comparison of findings between studies. Development of a standardised assessment tool will allow future studies to confidently compare findings to inform the development and assessment of guidelines that provide recommendations on temporal patterns of eating for optimal health.

Assessment of Cardiometabolic Health, Diet and Physical Activity in Helicopter Rescue Paramedics.

Objective: Shift work is an established risk factor for weight gain, cardiovascular disease, Type II diabetes mellitus, and impaired health-related quality of life (HRQoL). Prolonged exposure to shift work is common in paramedics and other emergency medical service (EMS) providers. Sub-populations of EMS workers may have varying health outcomes when exposed to shift work, but the reasons for this have not been investigated. We sought to describe cardiometabolic health, dietary patterns, physical activity, and health-related quality of life (HRQoL) in a sample of experienced intensive care flight paramedics (ICFPs) working for a Helicopter Emergency Medical Service (HEMS).Methods: Fifteen paramedics (median age 45, IQR 42-48 years) were recruited to undertake a range of health assessments. These included a food frequency questionnaire to assess dietary patterns, sampling of biomarkers to determine cardiometabolic health risk, maximal aerobic capacity assessment via treadmill running and assessment of HRQoL via the SF-36 survey. In an extension of the study protocol, ten of the fifteen participants wore a physical activity monitor for one year.Results: Median (IQR) weight was 79.9 (72.3-89.3) kg, body fat percentage 23.3 (21.9-26.5) %, body mass index (BMI) 25.1 (21.9-27.4) kg.m2, and waist to height ratio 0.48 (0.45-0.54). Dietary analyses showed high discretionary food intake. Biomarkers of cardiometabolic health risk were all within normal range. HRQoL was 86.2/100 for physical health and 85.1/100 for mental health. V̇O2max was 47.0 (43.0-54.6) mL.kg-1.min-1. The ten participants that wore activity monitors completed 11,235 (8334-15,380) steps per day and undertook 50 (12-98) minutes per day/350 (84-686) minutes per week of moderate to vigorous physical activity. The least amount of physical activity was conducted on day shifts.Conclusions: For ICFPs included in this study, HRQoL, cardiometabolic and physical activity outcomes are representative of good health. Although shift work influences the amount of physical activity, ICFPs exceeded minimum recommendations even when rostered to duty. Despite lengthy careers in EMS, ICFPs demonstrate an excellent health profile that is likely due to high physical activity levels and healthy BMI. This information may be useful in guiding health interventions in the wider EMS workforce.

Cardiometabolic, Dietary and Physical Health in Graduate Paramedics during the First 12-Months of Practice - A Longitudinal Study.

Objective: Shift work is an established risk factor for poor health yet is necessary for paramedics to provide continuous care to the public. It is unknown how early into a career shift work may begin to impact health. This study sought to identify changes in cardiometabolic health, diet, aerobic capacity, physical activity and health-related quality of life (HRQoL) in graduate paramedics during the first 12-months of their career.Methods: Fifty-six paramedics with no history of regular shift work (28 female, 28 male; median age 24.5, IQR 23-26 years) were recruited for this study. Dietary patterns (food frequency questionnaires) and HRQoL (36-Item Short Form Questionnaire) were assessed at baseline, 6- and 12-months. Body weight, body mass index (BMI) and blood samples (fasting lipids, glucose, insulin and C-reactive protein) were measured at baseline and 12-months to ascertain cardiometabolic health risk. A subset of participants (n = 19; 10 female, 9 male) wore a physical activity monitor for 12 months and completed baseline and 12-month maximal aerobic capacity assessments (V̇O2max).Results: Body weight and BMI decreased in males and increased in females (-0.7% versus 1.7%, p = 0.02). HRQoL and dietary intake did not change over 12-months, except for a small decrease in fat intake (-1%). Consumption of core/healthy foods was lower than recommended at all timepoints. Biomarkers of cardiometabolic health were within normal range and did not change over 12-months, excepting insulin where a small non-significant increase was seen (+0.5 mIU/L, p = 0.61). Baseline V̇O2max was 41.4 (37.1-49.1) ml.kg-1.min-1, with no change noted at 12-months. Comparison of quarterly physical activity data showed no difference in steps per day (p = 0.47) or moderate to vigorous physical activity (MVPA, p = 0.92) across the 12-months. Paramedics completed less MVPA on day shifts compared to rostered days off (-14.68 minutes, p = 0.04).Conclusions: Dietary patterns, HRQoL, cardiometabolic health, aerobic capacity and physical activity levels did not change meaningfully in the first year of practice. Some dietary behaviors and physical activity levels could be improved and may mitigate health effects of exposure to shift work. Long-term follow-up of this group may aid in developing programs to enhance health for paramedics and other health workers.

Does rearranging meal times at night improve cardiovascular risk factors? An Australian pilot randomised trial in night shift workers.

BACKGROUND AND AIMS: Shift workers face an increased risk of cardiovascular disease (CVD), type-2 diabetes and obesity. Eating during the night is a likely contributing factor, as it coincides with the time at which postprandial metabolism is least efficient. In this pilot randomised crossover trial, we examine the effects of a short overnight fast on CVD risk markers (primarily postprandial triglyceride and glucose response) of night shift workers. METHODS AND RESULTS: Night shift workers with abdominal obesity underwent 4-week intervention and control periods, separated by ≥ 2 weeks washout. In the intervention period, an overnight fast (0100 h-0600 h) was implemented, by redistributing 24-h energy intake. Usual dietary habits were followed in the control period. Outcomes between intervention and control were compared using mixed effects linear regression models. Nineteen adults completed the trial [13 females, mean (±SD) age 41 ± 10 years, BMI 30.7 ± 5.7 kg/m2]. Postprandial triglyceride and glucose response post intervention were not different to post control. The overnight fast was well-tolerated by participants with an adherence rate of 95%, assessed by weekly 24-h dietary recalls. Exploratory analysis indicates lower mean body weight post intervention compared to post control (mean difference: -0.9 kg, 95% CI: -1.3 to -0.4). CONCLUSIONS: Night shift workers who habitually ate during their night shifts were able to rearrange their meal times to maintain a small overnight fast, which may have promoted small weight changes. This warrants further investigation into the role of meal timing in mitigating the metabolic consequences of night shift work. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (http://anzctr.org.au/) registered on the 30th May 2017 (ACTRN12617000791336).

Effect of macronutrient composition on meal-induced thermogenesis in adolescents with obesity.

PURPOSE: Manipulation of meal macronutrient may be a useful way to modulate meal-induced thermogenesis (MIT) to induce increases in energy expenditure. The objective of this study was to examine in adolescents with obesity and of healthy weight and the effect of a high protein and high carbohydrate meal on MIT. METHODS: An acute cross-over study with adolescents aged 11-19 years was undertaken. Participants consumed in random order, a high 79% carbohydrate (HCHO), and a high 55% protein (HP) meal (adjusted to 25% of energy requirements). MIT and subjective appetite were assessed for 4 h postprandial and an ad libitum lunch served. Data calculated as total AUC and expressed as mean ± SEM. RESULTS: Thirteen adolescents with obesity (mean BMI z score 2.3 ± 0.1) and 13 healthy weight (BMI z score 0.0 ± 0.2) participated. Mean MIT (% of energy intake) was greater after the HP (8.19 ± 0.709%) compared with the HCHO meal (4.36 ± 0.480%) (p < 0.001). The HP compared with the HCHO meal promoted greater fullness (12,994 ± 1208 vs 11,186 ± 1220 mm/4 h) (p = 0.016) and decreased hunger (8868 ± 1315 vs 10984 mm ± 1438 mm/4 h) (p = 0.007). These effects observed were independent of body weight. CONCLUSIONS: High protein meals can increase MIT and fullness and reduce hunger compared with high carbohydrate meals in adolescents with obesity. Future research is warranted to determine if MIT can be targeted through manipulation of dietary choices to support weight management strategies. TRIAL REGISTRATION: This study is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR). Trial ID: ACTRN12612001066875.

Do marine algal polyphenols have antidiabetic, antihyperlipidemic or anti-inflammatory effects in humans? A systematic review.

Cardiovascular disease and type 2 diabetes are leading causes of morbidity and mortality globally. Marine algal polyphenols have potential to reduce the risk of these conditions, however, little is known about their impact in humans. This systematic review investigates the antidiabetic, antihyperlipidemic and anti-inflammatory effects of marine polyphenols in humans. Scopus, Medline, PsychInfo, Embase and Cochrane Library databases were searched in November 2016. Eligible studies included (1) human adults, (2) marine polyphenol intervention, (3) blood lipid, glucose, insulin or inflammatory marker outcomes, and (4) were a randomized-controlled trial. One postprandial cross-over trial and four parallel design trials were included involving 271 adults. Analysis across studies was performed using Cohen's d effect sizes. Supplementation with polyphenol-rich extracts had small-to-medium positive effects on fasting blood glucose, total cholesterol and LDL-cholesterol; however, there is inadequate evidence as yet to confirm if these are consistent effects. Further randomized-controlled trials should investigate polyphenols from Ecklonia cava and other macroalgal sources, to determine if there is a role for marine polyphenols in reducing the risk factors of chronic disease in humans. (PROSPERO registration number CRD42015016890).

An emerging trend in functional foods for the prevention of cardiovascular disease and diabetes: Marine algal polyphenols.

Marine macroalgae are gaining recognition among the scientific community as a significant source of functional food ingredients. Due to the harsh environments in which macroalgae survive, they produce unique bioactive compounds that are not found in terrestrial plants. Polyphenols are the predominant bioactive compound in brown algae and are accountable for the majority of its biological activity. Phlorotannins are a type of polyphenol that are unique to marine sources and have exhibited protective effects against hyperglycemia, hyperlipidemia, inflammation and oxidative stress, known risk factors for cardiovascular disease and diabetic complications, in cell culture, animal studies and some human studies. This review updates the information on marine polyphenols, with a particular focus on phlorotannins and their potential health benefits in relation to the prevention and treatment of risk factors for type 2 diabetes and cardiovascular diseases.

Evaluation of a Commercially Delivered Weight Management Program for Adolescents.

OBJECTIVE: To evaluate a commercially available, structured short-term weight management program designed for adolescents with obesity delivered by nonhealth professionals. STUDY DESIGN: A multisite parallel-group randomized controlled trial was conducted to evaluate a commercial 12-week lifestyle behavioral program in commercial weight management centers in Australia. Eligible participants (13-17 years, body mass index (BMI) z score ?1.282 with no presenting morbidities) were randomized (n?=?88) to intervention or wait-list, and the program was delivered by consultants at participating weight management centers. The primary outcome was change in BMI z score. Secondary outcomes included the psychometric variables quality of life, body-esteem, and self-esteem. Data was analyzed according to intention-to-treat principles. RESULTS: Of 74 participants who consented to enter the study, 66 provided baseline anthropometric data and 12-week data were available for 55 individuals (74%). A significantly greater decrease in BMI z score in the intervention group (n?=?32) was observed when compared with the wait-list control group, mean difference (MD)?=??0.27?kg/m2; 95% CI, ?0.37,?0.17; P?

Systematic Review and Meta-Analysis: The Impact of Multicomponent Weight Management Interventions on Self-Esteem in Overweight and Obese Adolescents.

Objective: Building self-esteem in overweight adolescents is key to long-term weight management; yet, self-esteem is rarely a key outcome of adolescent weight management interventions. This systematic review investigates the impact of multicomponent weight management interventions on self-esteem in overweight and obese adolescents. Method: Six databases were searched in December 2014. Eligible studies met the following criteria: (1) randomized controlled trial, (2) overweight or obese participants, (3) adolescents (10-19 years), (4) multicomponent weight management intervention, (5) reported self-esteem and weight changes. Results: Thirteen studies with 1,157 overweight or obese adolescents, aged 10-19 years, were included. Meta-analyses showed no significant change in self-esteem (0.27 [-0.04, 0.59]), but body mass index z -score reduced following intervention (-0.17 [-0.22, -0.11]). Conclusion: The lack of change in self-esteem suggests weight loss alone is insufficient to improve self-esteem. Multicomponent weight management interventions require a specific focus on self-esteem to improve this outcome in overweight and obese adolescents.

Postprandial Plasma Phospholipids in Men Are Influenced by the Source of Dietary Fat.

BACKGROUND: Postprandial lipemia represents a risk factor for chronic diseases, including type 2 diabetes. Little is known about the effect of dietary fat on the plasma lipidome in the postprandial period. OBJECTIVE: The objective of this study was to assess the effect of dairy fat and soy oil on circulating postprandial lipids in men. METHODS: Men (40-60 y old, nonsmokers; n = 16) were randomly assigned in a crossover design to consume 2 breakfast meals of dairy-based or soy oil-based foods. The changes in the plasma lipidome during the 4-h postprandial period were analyzed with electrospray ionization tandem mass spectrometry and included 316 lipid species in 23 classes and subclasses, representing sphingolipids, phospholipids, glycerolipids, and sterols. RESULTS: Nonparametric Friedman tests showed significant changes in multiple plasma lipid classes, subclasses, and species in the postprandial period after both dairy and soy meals. No difference was found in triglyceridemia after each meal. However, 6 endogenous lipid classes increased after dairy but decreased after soy (P < 0.05), including ether-linked phospholipids and plasmalogens and sphingomyelin (not present in soy), dihexosylceramide, and GM3 ganglioside. Phosphatidylcholine and phosphatidylinositol were not affected by the soy meal but were significantly elevated after the dairy meal (8.3% and 16%, respectively; P < 0.05). CONCLUSIONS: The changes in postprandial plasma phospholipids in men relate to the diet composition and the relative size of the endogenous phospholipid pools. Despite similar lipemic responses as measured by changes in triglyceride concentrations, the differential responses to dairy and soy meals derived through lipidomic analysis of phospholipids suggest differences in the metabolism of soybean oil and dairy fat. The increased concentrations of plasmalogens, with potential antioxidant capacity, in the postprandial period after dairy but not soy meals may represent a further important difference in the response to these sources of fat. The trial was registered at www.anzctr.org.au as ACTRN12610000562077.

Study protocol: evaluation of 'JenMe', a commercially-delivered weight management program for adolescents: a randomised controlled trial.

BACKGROUND: Early lifestyle intervention with overweight and obese adolescents could help to avoid serious health events in early adulthood, ultimately alleviating some of the strain on the public health system due to obesity-related morbidity. Commercial weight loss programs have wide reach into the community setting, and have demonstrated success in long term weight management in adults, beyond that of current public health care. Commercial weight-management programs have not been evaluated as a method of delivery for overweight and obese adolescents. This study aims to evaluate the efficacy of a new adolescent weight management program in a commercial environment. METHODS: One hundred and forty adolescents, 13 to 17 years old, will be randomised to either a weight management program intervention or a wait-listed group for 12 weeks. The commercial program will consist of a combined dietary and lifestyle approach targeting improved health behaviours for weight-loss or weight-stability. Participants will be overweight or obese (above the 85(th) percentile for BMI) and without existing co-morbidities. Outcome measures will be assessed at baseline and after 12 weeks. Primary outcome measures will be changes in BMI Z-score and waist-height ratio. Secondary outcome measures will include changes in behaviour, physical activity and psychosocial wellbeing. Intervention participants will be followed up at 6 months following completion of the initial program. Ethics approval has been granted from the Monash University Human Research Ethics Committee (CF11/3687-2011001940). DISCUSSION: This independent evaluation of a weight management program for adolescents, delivered in a commercial setting, will provide initial evidence for the effectiveness of such programs; which may offer adolescents an avenue of weight-management with ongoing support prior to the development of obesity related co-morbidities. TRIAL REGISTRATION: The protocol for this study is registered with the International Clinical Trials Registry ISRCTN13602313.

Supplementation with calcium and short-chain fructo-oligosaccharides affects markers of bone turnover but not bone mineral density in postmenopausal women.

This 24-mo randomized, double-blind, controlled trial aimed to examine whether supplementation with a natural marine-derived multi-mineral supplement rich in calcium (Ca) taken alone and in conjunction with short-chain fructo-oligosaccharide (scFOSs) has a beneficial effect on bone mineral density (BMD) and bone turnover markers (BTMs) in postmenopausal women. A total of 300 non-osteoporotic postmenopausal women were randomly assigned to daily supplements of 800 mg of Ca, 800 mg of Ca with 3.6 g of scFOS (CaFOS), or 9 g of maltodextrin. BMD was measured before and after intervention along with BTMs, which were also measured at 12 mo. Intention-to-treat ANCOVA identified that the change in BMD in the Ca and CaFOS groups did not differ from that in the maltodextrin group. Secondary analysis of changes to BTMs over time identified a greater decline in osteocalcin and C-telopeptide of type I collagen (CTX) in the Ca group compared with the maltodextrin group at 12 mo. A greater decline in CTX was observed at 12 mo and a greater decline in osteocalcin was observed at 24 mo in the CaFOS group compared with the maltodextrin group. In exploratory subanalyses of each treatment group against the maltodextrin group, women classified with osteopenia and taking CaFOS had a smaller decline in total-body (P = 0.03) and spinal (P = 0.03) BMD compared with the maltodextrin group, although this effect was restricted to those with higher total-body and mean spinal BMD at baseline, respectively. Although the change in BMD observed did not differ between the groups, the greater decline in BTMs in the Ca and CaFOS groups compared with the maltodextrin group suggests a more favorable bone health profile after supplementation with Ca and CaFOS. Supplementation with CaFOS slowed the rate of total-body and spinal bone loss in postmenopausal women with osteopenia-an effect that warrants additional investigation. This trial was registered at www.controlled-trials.com as ISRCTN63118444.

Effects of (Poly)phenols on Circadian Clock Gene-Mediated Metabolic Homeostasis in Cultured Mammalian Cells: A Scoping Review.

Circadian clocks regulate metabolic homeostasis. Disruption to our circadian clocks, by lifestyle behaviors such as timing of eating and sleeping, has been linked to increased rates of metabolic disorders. There is now considerable evidence that selected dietary (poly)phenols, including flavonoids, phenolic acids and tannins, may modulate metabolic and circadian processes. This review evaluates the effects of (poly)phenols on circadian clock genes and linked metabolic homeostasis in vitro, and potential mechanisms of action, by critically evaluating the literature on mammalian cells. A systematic search was conducted to ensure full coverage of the literature and identified 43 relevant studies addressing the effects of (poly)phenols on cellular circadian processes. Nobiletin and tangeretin, found in citrus, (-)-epigallocatechin-3-gallate from green tea, urolithin A, a gut microbial metabolite from ellagitannins in fruit, curcumin, bavachalcone, cinnamic acid, and resveratrol at low micromolar concentrations all affect circadian molecular processes in multiple types of synchronized cells. Nobiletin emerges as a putative retinoic acid-related orphan receptor (RORα/γ) agonist, leading to induction of the circadian regulator brain and muscle ARNT-like 1 (BMAL1), and increased period circadian regulator 2 (PER2) amplitude and period. These effects are clear despite substantial variations in the protocols employed, and this review suggests a methodological framework to help future study design in this emerging area of research.

Time of day and glycaemic response in pregnant women: A gap in current guidelines?

BACKGROUND & AIMS: Advice to monitor and distribute carbohydrate intake is a key recommendation for treatment of gestational diabetes, but fails to consider circadian regulation of glucose homeostasis. In the non-pregnant state, glucose responses to a meal at night-time are significantly higher than during the day and are associated with an increased risk of developing type 2 diabetes. However, the impact of night time eating on postprandial glucose in pregnancy is uncertain. Using a systematic approach we explored postprandial glucose responses to dietary intake at night compared to during the day in pregnant women. METHODS: Searches were conducted in four databases (Ovid MEDLINE, Ovid Embase, CINAHL plus and Scopus), in September 2022 (updated, June 2023). Eligible studies reported on postprandial glucose at a minimum of two times a day, after identical meals or an oral glucose tolerance test, in pregnant women with or without gestational diabetes. Publication bias was assessed using the ROBINS-I tool. RESULTS: Four eligible studies were retrieved. Two studies reported within group comparison of two timepoints, and observed reduced glucose tolerance in the afternoon compared to the morning in pregnant women, irrespective of diabetes status. The other two studies meeting inclusion criteria did not report time of day comparisons. CONCLUSION: It is unclear as to whether the higher (and extended) postprandial glucose levels observed at night in non-pregnant populations are observed in pregnancy. Clinical studies are needed to explore the impact of circadian rhythmicity on glucose metabolism during pregnancy, and the implications of current dietary advice on when and what to eat for management of gestational diabetes.

Conceptualizing weight management for night shift workers: A mixed-methods systematic review.

Shift workers have an increased risk of obesity and metabolic conditions. This mixed-methods systematic literature review on night shift workers aimed to: (1) identify barriers/enablers of weight management; (2) examine effectiveness of weight management interventions; and (3) determine whether interventions addressed enablers/barriers. Six databases were searched, articles screened by title/abstract, followed by full-text review, and quality assessment. Eligible qualitative studies documented experiences of behaviors related to weight change. Eligible quantitative studies were behavior change interventions with weight/body mass index outcomes. A thematic synthesis was undertaken for qualitative studies using the social-ecological model (SEM). Interventions were synthesized narratively including: weight/body composition change; components mapped by behavior change taxonomy; and SEM. A synthesis was undertaken to identify if interventions addressed perceived enablers/barriers. Eight qualitative (n = 169 participants) and 12 quantitative studies (n = 1142 participants) were included. Barriers predominated discussions: intrapersonal (time, fatigue, stress); interpersonal (work routines/cultural norms); organizational (fatigue, lack of: routine, healthy food options, breaks/predictable work); community (lack of healthy food options). The primary outcome for interventions was not weight loss and most did not address many identified enablers/barriers. One intervention reported a clinically significant weight loss result. Weight loss interventions that address barriers/enablers at multiple SEM levels are needed.