Healthy Eating, Aerobic and Resistance Training in Youth (HEARTY): study rationale, design and methods. The insulin sensitivity response is determined by the interaction between the G972R polymorphism of the insulin receptor substrate 1 gene and dietary fat. Study protocol for a multi-component kindergarten-based intervention to promote healthy diets in toddlers: a cluster randomized trial A study of diet and breast cancer prevention in Canada: why healthy women participate in controlled trials Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. Diet quality and weight change among overweight and obese postpartum women enrolled in a behavioral intervention program. Smartphone Applications for Promoting Healthy Diet and Nutrition: A Literature Review. Sustainability of health and lifestyle improvements following a non-dieting randomised trial in overweight women. Three consecutive weeks of nutritional ketosis has no effect on cognitive function, sleep, and mood compared with a high-carbohydrate, low-fat diet in healthy individuals: a randomized, crossover, controlled trial. Design and Evaluation of a Computer Game to Promote a Healthy Diet for Young Adults A prospective study of variety of healthy foods and mortality in women. Dietary Patterns and Cognitive Health in Older Adults: A Systematic Review. Is caloric restriction associated with development of eating-disorder symptoms? Results from the CALERIE trial. Psychosocial correlates of eating behavior in children and adolescents: a review Study protocol to investigate the effect of a lifestyle intervention on body weight, psychological health status and risk factors associated with disease recurrence in women recovering from breast cancer treatment [ISRCTN08045231] Short-term diets enriched in stearic or palmitic acids do not alter plasma lipids, platelet aggregation or platelet activation status Examining the Psychological Pathways to Behavior Change in a Group-Based Lifestyle Program to Prevent Type 2 Diabetes Children’s Healthy Living (CHL) Program for remote underserved minority populations in the Pacific region: rationale and design of a community randomized trial to prevent early childhood obesity Multiple health behaviors in an ethnically diverse sample of adults with risk factors for cardiovascular disease. A parallel randomized trial on the effect of a healthful diet on inflammageing and its consequences in European elderly people: Design of the NU-AGE dietary intervention study Does a Healthy Diet Help Weight Management Among Overweight and Obese People? A Prospective Study of Diet Quality and Mental Health in Adolescents Early food for future health: a randomized controlled trial evaluating the effect of an eHealth intervention aiming to promote healthy food habits from early childhood
PURPOSE The objective of the Healthy Eating Aerobic and Resistance Training in Youth ( HEARTY ) trial ( Clinical Trials . Gov # NCT00195858 ) was to examine the effects of resistance training , with and without aerobic training , on percent body fat in sedentary , post-pubertal overweight or obese adolescents aged 14 - 18 years . This paper describes the HEARTY study rationale , design and methods . METHODS After a 4-week supervised low-intensity exercise run-in period , 304 overweight or obese adolescents with a body mass index≥85th percentile for age and sex were r and omized to 4 groups for 22 weeks ( 5 months ) : diet+aerobic exercise , diet+resistance exercise , diet+combined aerobic and resistance exercise , or a diet only waiting-list control . All participants received dietary counseling design ed to promote healthy eating with a maximum daily energy deficit of -250 kcal . OUTCOMES The primary outcome is percent body fat measured by Magnetic Resonance Imaging . Secondary outcomes include changes in anthropometry , regional body composition , resting energy expenditure , cardiorespiratory fitness , musculoskeletal fitness , cardiometabolic risk markers , and psychological health . SUMMARY To our knowledge , HEARTY is the largest clinical trial examining effects of aerobic training , resistance training , and combined aerobic and resistance training on changes in adiposity and cardiometabolic risk markers in overweight and obese adolescents . The findings will have important clinical implication s regarding the role that resistance training should play in the management of adolescent obesity and its co-morbidities SCOPE Insulin resistance , a condition associated with type 2 diabetes mellitus , results from the interaction of environmental and genetic factors . The aim of this study was to explore the influence of the G972R polymorphism at the insulin receptor substrate 1 gene on insulin sensitivity in a healthy young population . Furthermore , we examined whether the presence of this single nucleotide polymorphism ( SNP ; GR or GG ) interacts with dietary fat to modulate insulin sensitivity . METHODS AND RESULTS Fifty-nine healthy volunteers consumed three diets during 4 wk each following a r and omized crossover design : a saturated fatty acid diet , a low-fat and high carbohydrate ( CHO ) diet or a MUFA diet . For each diet , we investigated peripheral insulin sensitivity with the insulin suppression test . Steady-state plasma glucose and plasma-free fatty acids concentrations were significantly lower in GR subjects after the intake of a CHO diet , than did homozygous GG subjects ( p<0.05 ) . However , no differences were observed after consuming the two other diets . CONCLUSIONS Insulin sensitivity increased in GR subjects for the G972R polymorphism at the insulin receptor substrate 1 gene locus , after intake of a CHO diet . Increased knowledge of how these and other genes influence insulin sensitivity should increase the underst and ing of personalized nutrition Background There is concern about the lack of diversity in children ’s diets , particularly low intakes of fruit and vegetables and high intakes of unhealthy processed food . This may be a factor in the rising prevalence of obesity . A reason for the lack of diversity in children ’s diets may be food neophobia . This study aim ed to promote a healthy and varied diet among toddlers in kindergarten . The primary objectives were to reduce food neophobia in toddlers , and promote healthy feeding practice s among kindergarten staff and parents . Secondary objectives were to increase food variety in toddlers ’ diets and reduce future overweight and obesity in these children . Methods This is an ongoing , cluster r and omized trial . The intervention finished in 2014 , but follow-up data collection is not yet complete . Eighteen r and omly selected kindergartens located in two counties in Norway with enrolled children born in 2012 participated in the intervention . The kindergartens were matched into pairs based on background information , and r and omly assigned to the intervention or control groups . A 9-week multi-component intervention was implemented , with four main elements : 1 ) kindergarten staff implemented a pedagogical tool ( Sapere method ) in daily sessions to promote willingness to try new food ; 2 ) kindergarten staff prepared and served the toddlers a cooked lunch from a menu corresponding to the pedagogical sessions ; 3 ) kindergarten staff were encouraged to follow 10 meal principles on modeling , responsive feeding , repeated exposure , and enjoyable meals ; and 4 ) parents were encouraged to read information and apply relevant feeding practice s at home . The control group continued their usual practice s. Preference taste tests were conducted to evaluate behavioral food neophobia , and children ’s height and weight were measured . Parents and staff completed question naires before and after the intervention . Data have not yet been analyzed . Discussion This study provides new knowledge about whether or not a Sapere-sensory education and healthy meal intervention targeting children , kindergarten staff , and parents will : reduce levels of food neophobia in toddlers ; improve parental and kindergarten feeding practice s ; improve children ’s dietary variety ; and reduce childhood overweight and obesity . Trial registration IS RCT N74823448 DOI 10.1186/IS RCT Little research has been undertaken to determine why healthy people agree to enroll in r and omized controlled trials of cancer prevention . This study describes the beliefs of Canadian women participating in a trial design ed to determine the effect of reducing dietary fat on the development of breast cancer . Healthier eating , nutritional counseling , contributing to science , and helping others were the most frequently cited advantages of participation . Weight control and general better health were specifically associated with the dietary regimens . Attending appointments and difficulties when eating out were the main disadvantages of participation . Suggestions that would promote adherence to the trial protocol also were elicited . Responses cited most often included opportunities to meet other participants , more nutritional counseling ( particularly psychological tips ) , up date s about the trial , and more recipes  . Attention should be paid to these suggestions as they characterize some of the major determinants of adherence behavior OBJECTIVE The Arthritis , Diet , and Activity Promotion Trial ( ADAPT ) was a r and omized , single-blind clinical trial lasting 18 months that was design ed to determine whether long-term exercise and dietary weight loss are more effective , either separately or in combination , than usual care in improving physical function , pain , and mobility in older overweight and obese adults with knee osteoarthritis ( OA ) . METHODS Three hundred sixteen community-dwelling overweight and obese adults ages 60 years and older , with a body mass index of > or = 28 kg/m(2 ) , knee pain , radiographic evidence of knee OA , and self-reported physical disability , were r and omized into healthy lifestyle ( control ) , diet only , exercise only , and diet plus exercise groups . The primary outcome was self-reported physical function as measured with the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) . Secondary outcomes included weight loss , 6-minute walk distance , stair-climb time , WOMAC pain and stiffness scores , and joint space width . RESULTS Of the 316 r and omized participants , 252 ( 80 % ) completed the study .  Adherence was as follows : for healthy lifestyle , 73 % ; for diet only , 72 % ; for exercise only , 60 % ; and for diet plus exercise , 64 % . In the diet plus exercise group , significant improvements in self-reported physical function ( P < 0.05 ) , 6-minute walk distance ( P < 0.05 ) , stair-climb time ( P < 0.05 ) , and knee pain ( P < 0.05 ) relative to the healthy lifestyle group were observed . In the exercise group , a significant improvement in the 6-minute walk distance ( P < 0.05 ) was observed . The diet-only group was not significantly different from the healthy lifestyle group for any of the functional or mobility measures . The weight-loss groups lost significantly ( P < 0.05 ) more body weight ( for diet , 4.9 % ; for diet plus exercise , 5.7 % ) than did the healthy lifestyle group ( 1.2 % ) . Finally , changes in joint space width were not different between the groups . CONCLUSION The combination of modest weight loss plus moderate exercise provides better overall improvements in self-reported measures of function and pain and in performance measures of mobility in older overweight and obese adults with knee OA compared with either intervention alone BACKGROUND Postpartum weight retention is a risk factor for long-term weight gain . Encouraging new mothers to consume a healthy diet may result in weight loss . OBJECTIVE To assess predictors of diet quality during the early postpartum period ; to determine whether diet quality , energy intake , and lactation status predicted weight change from 5 to 15 months postpartum ; and to determine whether an intervention improved diet quality , reduced energy intake , and achieved greater weight loss compared with usual care . DESIGN R and omized clinical trial ( KAN-DO : Kids and Adults Now-Defeat Obesity ) , a family- and home-based , 10-month , behavioral intervention to prevent childhood obesity , with secondary aims to improve diet and physical activity habits of mothers to promote postpartum weight loss . PARTICIPANTS Overweight/obese , postpartum women ( n=400 ) , recruited from 14 counties in the Piedmont region of North Carolina .  INTERVENTION Eight education kits , each mailed monthly ; motivational counseling ; and one group class . METHODS Anthropometric measurements and 24-hour dietary recalls collected at baseline ( approximately 5 months postpartum ) and follow-up ( approximately 10 months later ) . Diet quality was determined using the Healthy Eating Index-2005 ( HEI-2005 ) . STATISTICAL ANALYSES Descriptive statistics , χ(2 ) , analysis of variance , bi- and multivariate analyses were used . RESULTS At baseline , mothers consumed a low- quality diet ( HEI-2005 score=64.4 ± 11.4 ) . Breastfeeding and income were positive , significant predictors of diet quality , whereas body mass index was a negative predictor . Diet quality did not predict weight change . However , total energy intake , not working outside of the home , and breastfeeding duration /intensity were negative predictors of weight loss . There were no significant differences in changes in diet quality , decreases in energy intake , or weight loss between the intervention ( 2.3 ± 5.4 kg ) and control ( 1.5 ± 4.7 kg ) arms . CONCLUSIONS The family-based intervention did not promote postpartum weight loss . Reducing energy intake , rather than improving diet quality , should be the focus of weight-loss interventions for overweight/obese postpartum women BACKGROUND Rapid developments in technology have encouraged the use of smartphones in health promotion research and practice . Although many applications ( apps ) relating to diet and nutrition are available from major smartphone platforms , relatively few have been tested in research studies in order to determine their effectiveness in promoting health . METHODS In this article , we summarize data on the use of smartphone applications  for promoting healthy diet and nutrition based upon bibliographic search es in PubMed and CINAHL with relevant search terms pertaining to diet , nutrition , and weight loss through August 2015 . RESULTS A total of 193 articles were identified in the bibliographic search es . By screening abstract s or full-text articles , a total of three relevant qualitative studies and 9 r and omized controlled trials were identified . In qualitative studies , participants preferred applications that were quick and easy to administer , and those that increase awareness of food intake and weight management . In r and omized trials , the use of smartphone apps was associated with better dietary compliance for lower calorie , low fat , and high fiber foods , and higher physical activity levels ( p=0.01 - 0.02 ) which result ed in more weight loss ( p=0.042-<0.0001 ) . DISCUSSION Future studies should utilize r and omized controlled trial research design s , larger sample sizes , and longer study periods to better establish the diet and nutrition intervention capabilities of smartphones . There is a need for culturally appropriate , tailored health messages to increase knowledge and awareness of health behaviors such as healthy eating . Smartphone apps are likely to be a useful and low-cost intervention for improving diet and nutrition and addressing obesity in the general population . Participants prefer applications that are quick and easy to administer and those that increase awareness of food intake and weight management OBJECTIVE To compare three non-dieting interventions that focused on lifestyle change rather than weight loss , in terms of the sustainability of improvements in lifestyle behaviors , psychological well-being and medical symptoms at 2 years . METHOD In Dunedin , New Zeal and in 2002/2003 , 225 obese/overweight women ( BMI > or = 28 ; 25 - 68 years ) participated in a r and omised , intention-to-treat trial comparing two group programs ( P1 , P2 ) and a self-guided mail-delivered program ( P3 ) . Only P1 included intensive relaxation response training . All three non-dieting interventions involved a 10-week program , followed by an eight-month support phase . Participants completed baseline , 1-year and 2-year assessment s. Outcomes included behavioral , psychological and medical symptom measures and a composite success score . RESULTS 118 participants completed the 2-year follow-up . Only among P1 participants were the reductions in psychological distress and medical symptoms achieved at 1 year , also maintained at 2 years . At 2 years , P1 participants had significantly greater increases in stress management behaviors than those in P2 ( p<0.05 ) , and significantly greater success scores than those in P3 ( p<0.05 ) . In all three programs , mean weight was unchanged at 2 years . CONCLUSION Inclusion of relaxation response training in a healthy lifestyle program facilitates long-term maintenance of psychological and medical symptom improvements even in the absence of weight loss BACKGROUND The high-fat ketogenic diet ( KD ) has become an increasingly popular diet not only in overweight/obese population s , or those with clinical conditions , but also in healthy non-overweight population s. OBJECTIVE Because there are concerns about the association between high-fat diets and cognitive decline , this study aim ed to determine the effects of a KD compared with an isocaloric high-carbohydrate , low-fat ( HCLF ) diet on cognitive function , sleep , and mood in healthy , normal-weight individuals . METHODS Eleven healthy , normal-weight participants ( mean age : 30 ± 9 y ) completed this r and omized , controlled , crossover study . Participants followed 2 isocaloric diets-an HCLF diet ( 55 % carbohydrate , 20 % fat , and 25 % protein ) and a KD ( 15 % carbohydrate , 60 % fat , and 25 % protein)-in a r and omized order for a minimum of 3 wk , with a 1-wk washout period between diets . Measures of β-hydroxybutyrate confirmed that all participants were in a state of nutritional ketosis during post-KD assessment s ( baseline : 0.2 ± 0.2 mmol/L ; KD : 1.0 ± 0.5 mmol/L ; washout : 0.2 ± 0.1 mmol/L ; and HCLF : 0.3 ± 0.2 mmol/L ) . Cognitive function was assessed using a vali date d , psychological computer-based test battery before and after each diet . Subjective measures of mood and sleep were also monitored throughout the study using vali date d scales . RESULTS Three weeks of sustained nutritional ketosis , compared with the HCLF diet , had no effect on speed and accuracy responses in tasks design ed to measure vigilance ( speed : P = 0.39 , Cohen 's d = 0.26 ; accuracy : P = 0.99 , Cohen 's d = 0.04 ) , visual learning and memory ( speed : P = 0.99 , Cohen 's d = 0.04 ; accuracy : P = 0.99 , Cohen 's d = 0.03 ) , working memory ( speed : P = 0.62 , Cohen 's d = 0.26 ; accuracy : P = 0.98 , Cohen 's d = 0.07 ) , and executive function ( speed : P = 0.60 , Cohen 's d = 0.31 ; accuracy : P = 0.90 , Cohen 's d = 0.19 ) . Likewise , mood , sleep quality , and morning vigilance did not differ ( P > 0.05 ) between the dietary interventions . CONCLUSION The results of our r and omized , crossover , controlled study suggest that 3 wk of sustained nutritional ketosis had no effect on cognitive performance , mood , or subjective sleep quality in a sample of healthy individuals . This trial was registered in the Pan African Clinical Trial Registry as PACTR201707002406306 This article reports the development and evaluation of a computer game ( RightWay Café ) as a special medium to promote a healthy diet for young adults . Structural features of computer games , such as interactive tailoring , role playing , the element of fun , and narrative , were operationalized in the RightWay Café game to afford behavior rehearsal in a safe and entertaining way . Theories such as the health belief model , social cognitive theory , and theory of reasoned action guided the content design of the game to influence mediators of behavior change , including self-efficacy , perceived benefits , perceived barriers , and behavior change intention . A r and omized controlled evaluation study with pretest , posttest , and follow-up design demonstrated that this game was effective in teaching nutrition and weight management knowledge and increasing people 's self-efficacy and perceived benefits of healthy eating , as well as their intention to be on a healthy diet . Limited long-term effects were also found : participants in the game-playing group had greater self-efficacy than participants in the control group after 1 month . This study vali date s the computer game – based approach to health promotion for young adults . Limitations and implication s are also discussed BACKGROUND To assess the overall influence of diet on health and disease in epidemiological studies , the habitual diet of the study participants has to be captured as a pattern rather than individual foods or nutrients . The simplest way to describe dietary preferences is to separate foods considered beneficial to health from foods considered to promote disease , and separate individuals on the basis of their regular consumption of these foods . METHODS We used data from 59 038 women participating in the prospect i ve Mammography Screening Cohort in Sweden to investigate the influence of variety of healthy and less healthy foods on all-cause and cause-specific mortality . RESULTS Women who followed a healthy diet defined as consumption of a high variety of fruits , vegetables , whole grain breads , cereals , fish , and low fat dairy products had a significantly lower mortality than women who consumed few of these foods ( 3710 deaths total ) . Women who reported regularly consuming 16 - 17 healthy foods had a 42 % lower all-cause mortality ( 95 % CI : 32 - 50 % ) compared to women reporting consumption of 0 - 8 healthy foods with any regularity ( P for trend < 0.0001 ) . For each additional healthy food consumed the risk of death was about 5 % lower ( 95 % CI : 4 - 6 % ) . Cardiovascular mortality was particularly low among women who reported consuming a high variety of healthy foods . A less healthy diet defined as consumption of a high variety of red meats , refined carbohydrates and sugars , and foods high in saturated or trans fats was not directly associated with a higher overall mortality . However , women who reported consuming many less healthy foods were significantly more likely to die from cancer than those who consumed few less healthy foods . CONCLUSIONS A healthy diet can affect longevity . It appears more important to increase the number of healthy foods regularly consumed than to reduce the number of less healthy foods regularly consumed While the role of diet and nutrition in cognitive health and prevention of dementia  in older adults has attracted much attention , the efficacy of different dietary patterns remains uncertain . Previous review s have mainly focused on the Mediterranean diet , but either omitted other dietary patterns , lacked more recent studies , were based on cross-sectional studies , or combined older and younger population s. We followed PRISMA guidelines , and examined the efficacy of current research from r and omized controlled trials and cohort studies on the effects of different dietary patterns . We review ed the Mediterranean diet , Dietary Approach to Stop Hypertension ( DASH ) diet , the Mediterranean-DASH diet Intervention for Neurodegenerative Delay ( MIND ) diet , Anti-inflammatory diet , Healthy diet recommended by guidelines via dietary index , or Prudent healthy diets generated via statistical approaches , and their impact on cognitive health among older adults . Of 38 studies , the Mediterranean diet was the most investigated with evidence supporting protection against cognitive decline among older adults . Evidence from other dietary patterns such as the MIND , DASH , Anti-inflammatory , and Prudent healthy diets was more limited but showed promising results , especially for those at risk of cardiovascular disease . Overall , this review found positive effects of dietary patterns including the Mediterranean , DASH , MIND , and Anti-inflammatory diets on cognitive health outcomes in older adults . These dietary patterns are plant-based , rich in poly- and mono-unsaturated fatty acids with lower consumption of processed foods . Better underst and ing of the underlying mechanisms and effectiveness is needed to develop comprehensive and practical dietary recommendations against age-related cognitive decline among older adult OBJECTIVE This study tested a secondary hypothesis of the CALERIE trial ( Heilbronn et al. , 2006 ) that a 12-month period of intentional dietary restriction would be associated with an increase in eating disorder symptoms . DESIGN To test this hypothesis , 48 overweight adults were r and omly assigned to four treatment arms in a 12-month study : ( 1 ) 25 % calorie restriction , ( 2 ) 12.5 % calorie restriction and 12.5 % increased energy expenditure by structured exercise , ( 3 ) low-calorie diet , and ( 4 ) healthy diet ( no-calorie restriction ) . MAIN OUTCOME MEASURES Primary outcome measures for the study were changes in : eating disorder symptoms , mood , dietary restraint , body weight , and energy balance . RESULTS All three dietary restriction arms were associated with increased dietary restraint and negative energy balance , but not with increased ED symptoms or other harmful psychological effects . Participants in the three calorie restriction arms lost significant amounts of body weight . The psychological and behavioral effects were maintained during a 6-month follow-up period . CONCLUSION These results did not support the hypothesis that caloric restriction causes increased eating disorder symptoms in overweight adults . In general , caloric restriction had either benign or beneficial psychological and behavioral effects Background Underst and ing the correlates of dietary intake is necessary in order to effectively promote healthy dietary behavior among children and adolescents . A literature review was conducted on the correlates of the following categories of dietary intake in children and adolescents :  Fruit , Juice and Vegetable Consumption , Fat in Diet , Total Energy Intake , Sugar Snacking , Sweetened Beverage Consumption , Dietary Fiber , Other Healthy Dietary Consumption , and Other Less Healthy Dietary Consumption in children and adolescents . Methods Cross-sectional and prospect i ve studies were identified from PubMed , PsycINFO and PsycArticles by using a combination of search terms . Quantitative research examining determinants of dietary intake among children and adolescents aged 3–18 years were included . The selection and review process yielded information on country , study design , population , instrument used for measuring intake , and quality of research study . Results Seventy-seven articles were included . Many potential correlates have been studied among children and adolescents . However , for many hypothesized correlates substantial evidence is lacking due to a dearth of research . The correlates best supported by the literature are : perceived modeling , dietary intentions , norms , liking and preferences . Perceived modeling and dietary intentions have the most consistent and positive associations with eating behavior . Norms , liking , and preferences were also consistently and positively related to eating behavior in children and adolescents . Availability , knowledge , outcome expectations , self-efficacy and social support did not show consistent relationships across dietary outcomes . Conclusion This review examined the correlates of various dietary intake ; Fruit , Juice and Vegetable Consumption , Fat in Diet , Total Energy Intake , Sugar Snacking , Sweetened Beverage Consumption , Dietary Fiber , Other Healthy Dietary Consumption , and Other Less Healthy Dietary Consumption in cross-sectional and prospect i ve studies for children and adolescents . The correlates most consistently supported by evidence were perceived modeling , dietary intentions , norms , liking and preferences . More prospect i ve studies on the psychosocial determinants of eating behavior using broader theoretical perspectives should be examined in future research Background Breast cancer survivors often encounter physiological and psychological problems related to their diagnosis and treatment that can influence long-term prognosis . The aim of this research is to investigate the effects of a lifestyle intervention on body weight and psychological well-being in women recovering from breast cancer treatment , and to determine the relationship between changes in these variables and biomarkers associated with disease recurrence and survival . Methods / design Following ethical approval , a total of 100 patients will be r and omly assigned to a lifestyle intervention ( incorporating dietary energy restriction in conjunction with aerobic exercise training ) or normal care control group . Patients r and omised to the dietary and exercise intervention will be given individualised healthy eating dietary advice and written information and attend moderate intensity aerobic exercise sessions on three to five days per week for a period of 24 weeks . The aim of this strategy is to induce a steady weight loss of up to 0.5 Kg each week . In addition , the overall quality of the diet will be examined with a view to ( i ) reducing the dietary intake of fat to ~25 % of the total calories , ( ii ) eating at least 5 portions of fruit and vegetables a day , ( iii ) increasing the intake of fibre and reducing refined carbohydrates , and ( iv ) taking moderate amounts of alcohol . Outcome measures will include body weight and body composition , psychological health status ( stress and depression ) , cardiorespiratory fitness and quality of life . In addition , biomarkers associated with disease recurrence , including stress hormones , estrogen status , inflammatory markers and indices of innate and adaptive immune function will be monitored . Discussion This research will provide valuable information on the effectiveness of a practical , easily implemented lifestyle intervention for evoking positive effects on body weight and psychological well-being , two important factors that can influence long-term prognosis in breast cancer survivors . However , the added value of the study is that it will also evaluate the effects of the lifestyle intervention on a range of biomarkers associated with disease recurrence and survival . Considered together , the results should improve our underst and ing of the potential role that lifestyle-modifiable factors could play in saving or prolonging lives Objective : To determine whether healthy males who consumed increased amounts of dietary stearic acid compared with increased dietary palmitic acid through the consumption of commercially available foods , exhibited any changes in plasma lipids , platelet aggregation or platelet activation status . Design : A r and omised cross-over dietary intervention . Subjects and interventions : Nine free-living healthy males consumed two experimental diets ( stearic acid enriched , diet S , and palmitic acid enriched , diet P ) for 3 weeks in a r and omised cross-over design separated by a 3 week washout phase . The diets consisted of ∼30 % of energy as fat ( 30 % of which was derived from the treatment diets ) providing ∼13 g/day as stearic acid and 17 g/day as palmitic acid on diet S and ∼7 g/day as stearic acid and 22 g/day as palmitic acid on diet P. The dietary ratio of stearic to palmitic acids was 0.76 on diet S compared with 0.31 on diet P. Blood sample s were collected on days 0 and 21 of each dietary period . Results : LDL cholesterol levels and platelet aggregation response to the agonist ADP were significantly decreased ( P<0.025 ) in subjects on diet S compared with day 0 . Apart from that , there were no significant changes in plasma lipids , platelet aggregation , mean platelet volume and platelet reactivity between diets . There were no significant changes in stearic or palmitic acid levels in plasma phospholipid or triacylglycerol . There was a significant difference in palmitic acid levels in platelet phospholipids between the two diets . Conclusions : Use of commonly available foods led to a 27 % increase in stearic acid ( diet S ) and a 19 % increase in palmitic acid ( diet P ) , on diets S and P respectively , and no significant differences between the two diets in plasma lipoprotein concentrations , platelet aggregation or platelet activation status . Sponsorship : Grant and chocolate donated from Effem Foods , Pty Ltd , Australia OBJECTIVE To examine the psychological process of lifestyle change among adults at risk for type 2 diabetes . RESEARCH DESIGN AND METHODS A r and omized control trial in which 307 volunteers ( intervention , n = 208 ; wait control , n = 99 ) diagnosed with prediabetes completed a  six-session group-based intervention to promote healthier living . Participants ’ motivation to change , diet and exercise self-efficacy , mood , knowledge about diabetes , activity levels , healthy eating , waist circumference , and weight were assessed before and after the program . RESULTS Participation in the program was associated with significant increases in healthy eating and physical activity , reductions in waist and weight , and improvements in motivation , positive mood , self-efficacy , and knowledge . Examination of the pathways to lifestyle change showed that the educational aspect of the program increased activity levels because it increased diabetes knowledge and improved mood . Eating behavior was not mediated by any of the psychological variables . Improvements in diet and physical activity were , in turn , directly associated with changes in weight and waist circumference . CONCLUSIONS Although the program significantly improved motivation , self-efficacy , and mood , its impact on knowledge uniquely explained the increase in physical activity .  Group-based programs that are tailored to lifestyle behaviors may provide a cost-effective method of diabetes prevention , but more research is needed to explain why they improve healthy eating Background Although surveillance data are limited in the US Affiliated Pacific , Alaska , and Hawaii , existing data suggest that the prevalence of childhood obesity is similar to or in excess of other minority groups in the contiguous US . Strategies for addressing the childhood obesity epidemic in the region support the use of community-based , environmentally targeted interventions . The Children ’s Healthy Living Program is a partnership formed across institutions in the US Affiliated Pacific , Alaska , and Hawaii to design a community r and omized environmental intervention trial and a prevalence survey to address childhood obesity in the region through affecting the food and physical activity environment . Methods / Design The Children ’s Healthy Living Program community r and omized trial is an environmental intervention trial in four matched-pair communities in American Samoa , the Commonwealth of the Northern Mariana Isl and s , Guam , and Hawaii and two matched-pair communities in Alaska . A cross-sectional sample of children ( goal n = 180 ) in each of the intervention trial communities is being assessed for outcomes at baseline and at 24 months ( 18 months post-intervention ) . In addition to the collection of the participant-based measures of anthropometry , diet , physical activity , sleep and acanthosis nigricans , community assessment s are also being conducted in intervention trial communities . The Freely Associated States of Micronesia ( Federated States of Micronesia , and Republics of Marshall Isl and s and Palau ) is only conducting elements of the Children ’s Healthy Living Program sampling framework and similar measurements to provide prevalence data . In addition , anthropometry information will be collected for two additional communities in each of the 5 intervention jurisdictions to be included in the prevalence survey . The effectiveness of the environmental intervention trial is being assessed based on the RE- AIM ( reach , effectiveness , adoption , implementation , maintenance ) framework . Discussion The Children ’s Healthy Living Program environmental trial is design ed to focus on capacity building and to maximize the likelihood of sustainable impact on childhood obesity-related behaviors and outcomes . The multiple measures at the individual , community , and environment levels are design ed to maximize the likelihood of detecting change . This approach enhances the likelihood for identifying and promoting the best methods to promote health and well-being of the children in the underserved US Affiliated Pacific Region . Trial registration NIH clinical trial # BACKGROUND Health behaviors of adults living with cardiovascular disease ( CVD ) risk factors affect additional risk , where lifestyle behavioral choices become even more important in controlling disease and preventing additional negative health outcomes . In addition , both lifestyle behaviors and CVD risk factor prevalence can vary by ethnicity . OBJECTIVE We compared multiple health behaviors of adults with diabetes , hypertension , high cholesterol , and obesity to the behaviors of adults without those conditions in a diverse ethnic sample to determine if significant differences existed between groups . METHODS Data were obtained from  30-minute r and om-digit-dial telephone surveys in 2007 ( n = 3607 ) . All data were self-reports . Healthy behaviors  included meeting recommendations for intake of fruits and vegetables ; consuming low or very low amounts of dietary fat ; eating breakfast six or seven days per week ; having a healthy diet ; and meeting recommendations for walking , moderate , and vigorous physical activity . Unhealthy behaviors included  frequent consumption of soda and fast food , smoking , binge drinking ,  and high stress .  RESULTS More than 6 % of respondents had diabetes , 15.9 % had hypertension , 16.4 % had high cholesterol , and 18.5 % were obese . Significantly fewer healthy and more unhealthy behaviors were reported for those who had CVD risk factors than were reported by those who did not have such conditions . Ethnic differences in CVD risk factor prevalence and health behaviors existed as well ( p < 0.001 ) . Logistic regression models indicated that not eating a healthy diet ( odds ratio [ OR ] = 1.82 ) was a significant predictor for diabetes ; not eating a healthy diet ( OR = 1.52 ) and not doing vigorous physical activity ( OR = 1.79 ) were significant predictors for hypertension ; consumption of high amounts of dietary fat ( OR = 1.70 ) and of fast food ( OR = 1.51 ) were significant predictors for high cholesterol levels ; and not eating a healthy diet ( OR = 1.52 ) , high consumption of dietary fat ( OR = 2.20 ) , not eating breakfast ( OR = 1.33 ) and not performing vigorous physical activity ( OR = 1.63 ) , but less consumption of fast food ( OR = 0.64 ) were significant predictors for obesity . CONCLUSIONS Specifically tailored and culturally sensitive interventions that address multiple health behaviors may be necessary for these high-risk population BACKGROUND The proportion of European elderly is expected to increase to 30 % in 2060 . Combining dietary components may modulate many processes involved in ageing . So , it is likely that a healthful diet approach might have greater favourable impact on age-related decline than individual dietary components . This paper describes the design of a healthful diet intervention on inflammageing and its consequences in the elderly . METHODS The NU-AGE study is a parallel r and omized one-year trial in 1250 apparently healthy , independently living European participants aged 65 - 80 years . Participants are r and omised into either the diet group or control group . Participants in the diet group received dietary advice aim ed at meeting the nutritional requirements of the ageing population . Special attention was paid to nutrients that may be inadequate or limiting in diets of elderly , such as vitamin D , vitamin B12 , and calcium . C-reactive protein is measured as primary outcome . DISCUSSION The NU-AGE study is the first dietary intervention investigating the effect of a healthful diet providing targeted nutritional recommendations for optimal health and quality of life in apparently healthy European elderly . Results of this intervention will provide evidence on the effect of a healthful diet on the prevention of age related decline A r and omized dietary intervention trial across 4 years examined diet , weight , and obesity incidence ( body mass index [ BMI ] ≥ 30 kg/m2 ) differences between study groups . Participants were 1,510 breast cancer survivors with BMI ≥ 25 kg/m2 at entry .  Dietary intake  was assessed yearly by telephone ; weight and height were measured at clinic visits . Intervention participants consumed more fruit , vegetables , and fiber and less energy from fat than control participants during follow-up cross-sectionally ( p < .0001 ) and longitudinally ( p < .0001 ) ; weight did not differ between study groups at any follow-up visit , and significant weight change difference was observed between groups only in the 1st year ( p < .0001 ) . Diet and weight results remained unchanged after stratifying by age and BMI . No difference in obesity incidence was found during follow-up ( p > .10 ) among overweight members of either study group . Without specific efforts to reduce total energy intake , dietary modification does not reduce obesity or result in long-term weight loss Objectives A number of cross-sectional and prospect i ve studies have now been published demonstrating inverse relationships between diet quality and the common mental disorders in adults . However , there are no existing prospect i ve studies of this association in adolescents , the onset period of most disorders , limiting inferences regarding possible causal relationships . Methods In this study , 3040 Australian adolescents , aged 11–18 years at baseline , were measured in 2005–6 and 2007–8 . Information on diet and mental health was collected by self-report and anthropometric data by trained research ers . Results There were cross-sectional , dose response relationships identified between measures of both healthy ( positive ) and unhealthy ( inverse ) diets and scores on the emotional subscale of the Pediatric Quality of Life Inventory ( PedsQL ) , where higher scores mean better mental health , before and after adjustments for age , gender , socio-economic status , dieting behaviours , body mass index and physical activity . Higher healthy diet scores at baseline also predicted higher PedsQL scores at follow-up , while higher unhealthy diet scores at baseline predicted lower PedsQL scores at follow-up . Improvements in diet quality were mirrored by improvements in mental health over the follow-up period , while deteriorating diet quality was associated with poorer psychological functioning . Finally , results did not support the reverse causality hypothesis . Conclusion This study highlights the importance of diet in adolescence and its potential role in modifying mental health over the life course . Given that the majority of common mental health problems first manifest in adolescence , intervention studies are now required to test the effectiveness of preventing the common mental disorders through dietary modification Background Childhood overweight and obesity is a global public health challenge . Primary prevention initiatives targeting parents have been called for to encourage a positive feeding environment and healthy eating habits that may lay a good foundation for future health . At the same time , there is a need for interventions which combine accessibility and scalability with cost effectiveness . Today ’s parents are extensive Internet-users , but only a few r and omized controlled trials have investigated the use of Internet to promote healthy eating habits in early childhood . In Early Food for Future Health we have developed and will evaluate an Internet-based tool for parents of children between 6 and 12 months , aim ing to increase knowledge about infant nutrition and foster protective feeding behavior . Methods During springtime 2016 , parents of children aged between 3 and 5 months were recruited through Norwegian child health centres and announcements on Facebook . After completing the baseline question naire , 718 parents were individually r and omized to intervention- or control group . The intervention group received monthly emails with links to an age-appropriate web-site when their child was between 6 and 12 months . The control group received ordinary care from the child health centres . The data - collection is ongoing . All participants will be followed up at ages 12 and possibly 24 and 48 months , with question naires relating to eating behaviour and feeding practice s , food variety and diet quality . Discussion Providing guidance and counseling to parents of infants is an important task for health authorities and the public child health services . Early Food for Future health is an intervention focusing on promoting early healthy food-habits which may prevent childhood overweight and obesity . If proven to be effective , Early Food for Future Health can be used by parents and public health nurses for supplementary guidance on feeding practice s and diet . This study has the potential to provide greater insight and underst and ing regarding early parental feeding practice s , child eating behavior and the development and efficacy of Internet-based public health interventions .Trial registration IS RCT N13601567
RESULTS Our findings suggest that consumers have a relatively poor underst and ing of a healthy diet .
The literature also demonstrates that there is poor evidence on the health protective effects of single foods or nutrients .
We further show that low SES is the single consistent risk factor for not adhering to a healthy diet .
Our review of the literature on determinants demonstrates that intentions , habits , self-regulatory skills , and the social and physical environment are the most important determinants of a healthy diet , which are in turn amenable to change by intervention strategies with varying levels of effectiveness .
Educational interventions generally show a limited effect on practising a healthy diet whereas interventions targeting habitual behaviour and /or the physical environment seem more promising .
In view of the large number of people who are concerned about their diets and make attempts to change their dietary patterns , we conclude that it is crucial to gain a better underst and ing of both the automatic and environmental influences that are responsible for people not acting upon their good intentions for diet change
OBJECTIVE To discuss healthy diet from a psychological perspective by considering definitions of healthy diet in terms of consumer underst and ing ; the health effects of specific dietary elements in terms of overweight and ( chronic ) illness ; the prevalence of healthy diet ; the psychological and environmental determinants of healthy diet ; and the psychological interventions that have been design ed to promote healthy diet .