bluuebunny/crossref_metadata_2025 huggingface dataset:
How Health‐Related Signs Unexpectedly Promote Healthy Choices: Long‐term Conclusion for Nordic Cafeteria
Authors: Wansink Brian , Karevold Knut Ivar , Kallbekken Steffen , Tran Huy
Published: November 2023

Signs promoting healthy choices are becoming increasingly common in restaurants and buffets. Although some people avoid foods with healthy signs, could these signs guide them to take other healthy foods that do not have such signs? In analyzing the food taken by 4,521 guests at lunch buffets we found that when health‐related signs (“Eat Smart”) were placed on Bean Salad, the percent of guests who selected this salad decreased by 3.1% but the percent of guests who selected the Hot Vegetable side dishes (foods with no signs) increased by 15.5%. While adding health‐related signs may not benefit the healthy options that these signs are associated with, it can increase the selection of healthy foods in other areas of the buffet. Furthermore, placing healthy options with contrasting dishes, such as hot vegetables with hot meat, could stimulate the consumption of these healthy foods.

Support or Funding Information

Nordic Choice Hotels, Eat Forum, and GreeNudge.
State of Hypertension, Diabetes Mellitus and Anemia among Residents of Selected Communities in Ghana
Authors: Tandoh Marina Aferiba , Johnson Evan , Anderson Alex Kojo
Published: November 2023

Background

With the increasing number of chronic diseases such as hypertension, diabetes and obesity in developing countries, it is a common expectation that people would be more aware of these conditions through education leading to early diagnosis and effective management of these conditions. The objective of this paper is to report the prevalence of undiagnosed hypertension, diabetes and anemia among residents of selected communities in Ghana.

Method

The data comes from a community screening and education exercise on hypertension, diabetes and anemia in Ghana as part of the University of Georgia Summer Service Learning Program in Ghana. Hypertension was defined as blood pressure greater than 140/90, diabetes as fasting blood glucose ≥126 mg/dL and severe anemia as hemoglobin <8 g/dL.

Results

A total of 976 participants, 37.9% males and 62.1% females >18 years were screened. Mean age of participants was 46.25±17.14 (males: 44.90±17.38 vs females: 47.07±16.96; p=0.056) years, BMI was 25.44±5.26 (males: 23.13±3.81 vs females: 26.85±5.52; p<0.0001) kgm−2 and hemoglobin was 12.04±2.22 (males: 13.03±2.17 vs females: 11.43±2.02; p<0.0001) g/dL. At the time of screening, 93.4% reported fasting, while 3.1% and 12.6% reported existing diagnosis for diabetes and hypertension, respectively. Almost half (47.8%) were either overweight or obese, 27.0% screened hypertensive while 33.2% and 34.0% screened pre‐diabetes and diabetes respectively. Also, 28.8% males compared to 37.8% females screened diabetes (P=0.015), while 28.2% males compared to 26.2% screened hypertensive (p=0.635). 31.0% of those who screened diabetes also screened hypertensive (P<0.053). There were differences in BMI, and undiagnosed anemia, diabetes and hypertension by community where the screening took place. The likelihood of screening diabetes (p<0.0001) and hypertensive (P<0.025) increased with age.

Conclusion

The high rates of undiagnosed diabetes and hypertension observed in this screening exercise calls for public health education with a focus on lifestyle habits and health seeking behaviors among Ghanaians.

Support or Funding Information

Georgia Experimental Agricultural Station (HATCH # GEO00701)
Supermarket Interventions that Encourage Sustainable Healthy Habits: Long Term Learning of Fresh Fish Sales in Grocery Stores
Authors: Wansink Brian , Karevold Knut Ivar , Tran Huy
Published: November 2023

Guiding shoppers to purchase healthier and more environmentally sustainable food – such as fresh fish instead of beef – could possibly be accomplished by offering new selections at new prices or by changing the structure, signage, and service within a store itself. Of the 581 Norwegian grocery stores included in this long‐term study, 437 stores applied the treatment condition (changes were made to structure, signage, service, selections, and packaging), 144 stores applied the changes in new selections and packaging of fresh fish only. The average sales volumes per week before and after intervention (changes made in structure, signage and service) were compared. The sales period was between the 1st week of 2011 and the 43rd week of 2014. The process of changes in store structures may vary among the treatment stores but within 2013. In general, compared between the sales of the first 50 and the second 50 weeks, the changes in fish selections and packaging increased sales of fish by 124% (p<0.001). Furthermore, by comparing sales of control and treatment group after the intervention period, we found that the stores that changed structures, signage, and service sold 18.89% (p<0.001) more of fresh fish than the control stores did. The sales of beef went up slightly when stores introduced new structure. This combined approach can be a win‐win solution for both consumers whose health benefits might link to purchasing and consuming healthier food and retailers that want to increase their profits through sales of fresh fish.
Nutrition Knowledge and Dietary Practices among Pre‐Adolescent Children (6–11years Old) in Rural South Africa.
Authors: Abu Brenda Ariba Zarhari , Oldewage‐Theron Wilna , Abdulkadir Egal
Published: November 2023

Objective

The objective of this study was to assess the nutrition knowledge and associated dietary practices among pre‐adolescents (6 to 11 years of age) in rural South Africa.

Methods

The current study was a cross sectional survey using quantitative methods for data collection. Nutrition Knowledge was measured using a numbered scale with list of test questions. Correct answers were scored. Dietary practices were assessed using food list in nine food groups a week prior to the interview and categorized into dietary diversity scores. The 24hour recalls were assessed for adequate inadequate intake using estimated average requirement (EAR). SPSS version 23.0 was used for data analysis.

Results

Generally (N=105), 54 (51.4%) female compared to male pre‐adolescents in the study. There was more female caregiver among both much younger pre‐adolescents (6–8years) and older (9–11years) pre‐adolescents. Almost 90.0% of their caregivers were women. Older pre‐adolescent were significantly (p<0.05) better able to indicate that fruits and vegetables be washed before eating, indicated the types of exercise and the importance of eating breakfast compared to the younger ones. There was significant (p<0.05) difference in the intake of average intake for chlorine, vitamin A, vitamin D and fibre intake (both soluble and insoluble). Average intake for vitamin C for both groups was 23.65 (14.85; 34.70) mg.

Conclusion

The younger pre‐adolescents had lower knowledge and dietary intake. The preparation for adolescence must begin from younger years since healthy eating for this age is vital for the required growth and changes during adolescence.

Support or Funding Information

This work was funded by Department of Science and Technology (DTI) and the Centre for Scientific and Industrial Research (CSIR) in South Africa.
Overweight and obesity in Mexican children and adolescents: Data from National Nutrition and Health Surveys in 2016
Authors: Cuevas‐Nasu Lucia , Levy Teresa Shamah , Arcos Marco Antonio Avila , Gomez Ignacio Mendez , Dommarco Juan Rivera
Published: November 2023

Objective

To update national statistics for overweight and obesity prevalence among the school‐age and adolescent population in Mexico with the results of the Half‐Way National Health and Nutrition Survey (ENSANUT MC by its initials in Spanish), 2016.

Methods

ENSANUT MC is a national survey based on a multistage, stratified design. It is representative of the urban and rural areas and the four regions of Mexico: north, central, south and Mexico City, and is comparable with the national surveys conducted in Mexico since 1988. In 2016, the sample consisted of 3184 school‐age children (15 million 803 thousand subjects aged 5–11years) and 2581 adolescents (aged 12–19 years) totaling over 18 million subjects. Measurements included weight and height. Body mass index (BMI) z‐scores were estimated by age and sex. Overweight (OW) and obesity (O) were classified as BMIs greater than +1 SD and +2 WHO, respectively. Prevalences were adjusted for study design.

Results

Among school‐age children, 17.9% (95%CI: 15.2–21.1) were OW and 15.3% (95%CI: 12.5–18.6) O. This represented a total of 33.2% (5 million 253 thousand) OW schoolchildren versus 34.4% in 2012. Prevalence predominated among 10–11‐y‐olds and was 6 percentage points (PPs) higher in urban than in rural areas. Among adolescents, 22.4% (95%CI: 19.5, 25.6) and 13.9% (95%CI: 11.4, 16.8) presented OW and O, respectively. Compared to 2012, the overall OW+O in adolescents declined only 1 PP (35%).

Conclusion

OW+O prevalence rates in children and adolescents constitute the most recent estimates in Mexico. From 2012 to 2016, prevalence declined significantly in children. This may be the result of the health policies implemented to prevent OW and O in Mexico.

Support or Funding Information

Supported by Ministery of Health, Mexico.
First Foods Are Frequently Selected Most but in Smaller Amounts: Long‐Term from Nordic Cafeteria
Authors: Wansink Brian , Karevold Knut Ivar , Tran Huy
Published: November 2023

Food order influences what people select on single occasion, but does it persist over the long term, does it influence what else people select, does it influence how much food is served, and whether health‐related signage can influence food choice behaviors? Over a three‐month period, food choice behaviors (what to select and how much to serve) of 16,185 conference guests from nine hotels in Norway and Sweden were collected and analyzed using three different conditions. The first two switched the placement of fish and beef in the serving line, and the third condition placed health‐related signs (“Eat Smart”) on the fish dish. The targeted foods were fish, beef, and hot vegetables (beef side dish). In general, people more frequently selected the food that was placed first, but served themselves a smaller amount. When fish was placed first in line, 7% fewer diners selected beef; however, those who selected beef served themselves 37% more. When fish was placed second, 1% fewer diners selected fish; however, who selected fish served themselves 32% more. When fish was features with “Eat Smart” signage, 7% more people selected fish and they took 12% more. This study shows that the order of food might influence what people select and how much they take. While first food is selected more often, the amount is often overlooked. First food could be seen as a “sample” item that turned people to eat a sampling amount while the last food could be seen as “last chance” increasing the served amount. Also, the presence of signage benefited choices and the served amount of food that it attached to.
Development of A Health Education Curriculum to Reduce the Risk of Obesity Among Hispanic School‐Age Children
Authors: Mejia Maximino Alfredo , Coria‐Navia Anneris , Uriegas‐Mejia Griselda , Brown‐Fraser Sherine C , Uriegas Sergio E , de Jesus Martinez Maria , Sanchez Albert , Acosta Maria Elena , Ramirez Armando E , Reyes Rembrandt E , Hernandez Yadyra C , Camacho Dacia Y , Morrow Gregg , Krivak Gretchen
Published: November 2023

Background

Childhood obesity is a major global public health problem which disproportionately affects Hispanic children. Therefore, there is a need to develop culturally sensitive curricula to deliver school‐based interventions targeting Hispanic children. The Amate, Activate, Cuidate, Comparte (AACC) [Love Yourself, Activate Yourself, Take Care of Yourself, and Share] curricula is a culturally sensitive health education model to prevent obesity among Hispanic children in elementary school settings. This model was developed and pilot‐tested. Preliminary data shows this model to be promising to prevent childhood obesity among school‐aged children.

Methods

The AACC curriculum targets ten key lifestyle behaviors and school lunch modifications. Both are aimed to increase nutrient‐dense meals and energy expenditure through physical activity. The curriculum has a cognitive‐emotive‐behavioral approach which is grounded on social cognitive theory, positive psychology and pedagogical principles. Love is the underlying principle to elicit and regulate motivation to adopt and maintain healthy eating behaviors and physical activity. The nutrition curriculum consists of six classes, each consisting of two sessions. The first session provides the cognitive skills, elicits motivation, preparing the child for informed decision making to choose, commit, and engage in healthy behaviors. Each child sings and signs a pledge maintaining supervised behavioral records for two weeks. The follow up class session aims at providing social support, feedback and elicit commitment to continue practicing the intended behavior. The curriculum targets increasing consumption water, fruits, vegetables, whole grains, vegetable proteins and physical activity while reducing sweetened drinks and screen time. Emphasis is given in temperance (including stop eating at 80% of feeling full) to moderate the consumption of healthy foods and limit/avoid consumption of less healthy foods.

Results/Conclusion

The AACC curriculum has been well received by teachers, children. Parents of other schools are requesting implementation of this program in their schools. Policy makers are supporting the program.

Support or Funding Information

Secretaria de Salud de Tamaulipas Secretaria de Educacion Publica de Tamaulipas Office of Research and Creative Scholarship.
The Locus of Control and Likelihood of Success: Evidence from School Lunchrooms
Authors: Gabrielyan Gnel , Greene Katherine , Just David R. , Wansink Brian
Published: November 2023

Obesity rates are all time high in the U.S. and children are the most affected group. To fight the obesity epidemic, researchers have tried to identify various strategies to increase the consumption of healthier items. USDA plays an important role in providing nutrition to children since it provides meals to more than 30 million children each day. This makes school environment a perfect platform to target the obesity and improve dietary quality of children.

In order to qualify for a reimbursable meal, schools must qualify for some requirements proposed by USDA. Part of this requirement is to make sure students take either a fruit or a vegetable. However, the question remains whether forcing entities (i.e., schools) to implement a new technology is more efficient than giving them a list of potential techniques to choose from. The purpose of this study is to identify the impact of an availability of a choice to adopters compared to those who are not given a choice. Thus we analyze the effectiveness of various scenarios: no changes made, schools choose a technology to implement, and they are given a fixed program to follow. Data is collected in upstate New York. Preliminary results show implementing strategies are usually more efficient than not changing anything. However, giving schools a choice, overall, provides better outcome in terms of fruit and vegetable selection.
Development and Dissemination of a Learner‐Centered Nutrition Curriculum for School Nutrition Services Staff
Authors: Jones Anna M , Bergman Jacqueline J , Briggs Marilyn , Brian Kelley , Zidenberg‐Cherr Sheri
Published: November 2023

The purpose of this study was to develop, pilot, and disseminate a nutrition education curriculum for school nutrition services staff. Backwards design was utilized to develop lessons centered around learning objectives and key concepts such as nutrients in foods, portion sizes, physical activity, influences on food choices, and local school wellness policies, with applications to the National School Lunch Program throughout. Lessons were piloted in workshops held in August 2014, and April and May 2015 in two school districts in Northern California. Following the conclusion of the workshops, the curriculum was revised based on participant feedback and researcher observations. The final curriculum, comprising eight lessons, was disseminated at six regional train‐the‐trainer workshops held throughout California. Participants in these workshops were primarily school nutrition program directors and managers. At the end of the workshops, questionnaires to obtain feedback were administered to participants. Results (n=44) indicate the curriculum was well received by train‐the‐trainer participants; 93.2% of respondents indicated that they planned to use some of the lessons or teaching strategies presented in the workshops. A follow‐up survey was sent to all participants to determine if they had used any of the lessons to train their staff, and if yes, the results of the implementation. The survey had a response rate of 53.3% (n=57). Approximately half (50.1%) of respondents had used at least one lesson in their district, while 64.3% indicated they definitely or probably will use the curriculum, 28.6% stated they might or might not and 7.1% indicated probably not. Of those who used the curriculum, 21 responded to the Likert scale question “Overall, how would you say the lessons went?” Among these respondents, 61.9% selected very well, 23.8% selected somewhat well, and 14.3% selected okay. Zero respondents indicated the lessons went somewhat or very poorly. Overall, the results demonstrate that this curriculum has potential utility; further research should be conducted to evaluate effectiveness at improving nutrition knowledge, self‐efficacy, and other outcomes.

Support or Funding Information

Funding was provided in part by the California Department of Education.
Branding Techniques and Their Impact on Healthy Selection in School Cafeterias
Authors: Gabrielyan Gnel , Wansink Brian , Just David R. , Hanks Andrew S. , Brumberg Adam
Published: November 2023

Obesity rates are already at a high level in both developed and developing countries and it is projected to further increase in the next decade or so. An increase in consumption of energy‐dense foods, bigger portion‐size, a lack of physical activity and, subsequently, energy imbalance are cited as some of the main reasons for obesity epidemic. Researchers argue that children are the most vulnerable group to obesity epidemic since they are very sensitive to nutritional impulses and lack of self‐control. There are programs targeted to children to increase healthier consumption in school cafeterias. The purpose of this study is to analyze the impact of various marketing/branding techniques on a selection and consumption of fruits and vegetables in school cafeterias. The preliminary results show that using branding techniques increased fruit selection by more than 200% in all grade levels and fruit consumption in elementary and middle schools. We also observed an increase in vegetable selection in middle schools and vegetable consumption in high schools. The intervention also had a positive impact on white milk selection in all schools.
A Systematic Review of Randomized Clinical Trials Examining Effects of Breakfast Composition on Weight Outcomes among Children and Adolescents
Authors: Fu Zhuxuan , Almahmassani Hiya , Chung Mei , Cook Chad
Published: November 2023

Objective

To systematically review and synthesize published clinical trials examining effects of breakfast composition on weight outcomes among children and adolescents.

Methods

A comprehensive literature search on Pubmed, Cochrane Central Register of Controlled Trials, and Web of Science (date of inception to February, 2016) was performed to identify relevant randomized controlled trials in children and adolescents. Abstracts and potentially relevant full‐text articles were doubly screened against pre‐defined eligibility criteria. Risk of bias (ROB) assessment was conducted using the Cochrane ROB tool. Due to high heterogeneity of interventions, only qualitative synthesis was performed.

Results

Of 485 abstracts screened, 5 studies met inclusion criteria. When data were reported: Interventions ranged from 12 to 20 weeks, with sample sizes ranging from 25 to 178 including roughly equal number of males/females with a range of mean ages from 6 to 20 y. Interventions included: high vs. low glycemic breakfasts; 1 serving/d of cereal at breakfast and as a snack + increasing walking at least 2000 steps/d vs. maintenance of usual eating and step patterns; 1 serving of ready‐to‐eat cereal (RTEC) vs. 2 servings of RTEC vs. 1 serving of RTEC + nutrition education vs. no treatment; steamed bread vs. egg breakfast; and normal protein cereal‐based breakfast vs. high protein pork‐based breakfast vs. skipping breakfast. All studies found significant differences in weight outcomes between groups but results across studies were not comparable.

Conclusion

Although observational data suggest an inverse association between breakfast consumption and BMI among children and adolescents, there appears to be insufficient evidence from randomized clinical trials to support a specific breakfast composition for weight management in this population. Future trials should improve dropout rate and use blinded outcome ascertainment.

Support or Funding Information

Unrestricted grant was provided by Biofortis
Education Level Influences Weight‐Related Cognitions and Behaviors of Parents with Preschoolers
Authors: Eck Kaitlyn , Quick Virginia , Martin‐Biggers Jennifer , Delaney Colleen , Byrd‐Bredbenner Carol
Published: November 2023

Education level has been linked to weight‐related health outcomes where those of lower education often have greater weight‐related health risks. This study examined the effects of parents' education level on weight‐related cognitions and behaviors. Parents of preschoolers (N=655) completed an online survey assessing weight‐related cognitions and behaviors. Participants were 32.6±5.7SD years, mostly white (60%), and had varying education levels (i.e., Low [high school or less (n=95)]; Middle [some post‐secondary education (n=245)]; High [bachelor's degree or higher (n=315)]). ANOVA and post‐hoc tests revealed that low‐education and middle‐education level parents had significantly (p<0.05) higher BMIs than high‐education level parents (30.22±7.33SD, 29.88±7.58SD vs. 26.44±6.15SD), and their children had significantly higher BMI‐for‐age z‐scores (1.48±2.30SD low‐education vs. 0.53±1.42SD high‐education). High‐education parents had significantly greater household food security (F=25.6, p<0.001), ate healthier diets (i.e., lower percent calories from fat [36.17±6.20SD vs. 38.39±6.94SD; 37.45±5.71SD], fewer calories from sugar‐sweetened beverages/day [77.7±104.3SD vs. 151.7±148.2SD; 113.44±115.88SD]), and likely modeled healthy dietary behaviors as their children also consumed significantly fewer calories from sugar‐sweetened beverages/day (27.7±45.1SD vs. 48±50.5SD; 44.37±50.46SD) than both low‐education and mid‐education parents. High‐education parents also were significantly more likely to plan family meals compared to low‐education parents; however, low‐education and mid‐education parents were more willing to invest time, energy, and effort in preparing family meals than high‐education parents. Low‐education and mid‐education parents were significantly more likely to overtly control their child's food intake and timing of when they ate, and low‐education parents allowed more child screentime minutes/day (660±939SD vs. 427±758SD) than high‐education parents. Findings indicate important differences in weight‐related cognitions and behaviors suggesting childhood obesity prevention outreach interventions need to consider weight‐related practices may differ by parent education level and tailor interventions based on education level.

Support or Funding Information

USDA NIFA #2011‐68001‐30170
Eating Frequency and the Role of Snacking on Weight of Minority Preschool Children
Authors: Charvet Andrea , Huffman Fatma G.
Published: November 2023

The objective of this study was to understand the influence of eating episodes and snack quality on body weight of preschool children ages 3 to 5 years participating in the Broward County Special Supplementation Nutrition Program for Women, Infants, and Children (WIC). A secondary objective was to explore select obesity risk factors as potential confounding factors. Data was collected from 7 Broward County Health Department WIC clinics over 4 months. The researcher interviewed the participant's authorized representative and extracted additional data from the WIC data system. BMI‐for‐age percentiles were used to separate children into weight categories according to CDC guidelines, which were further combined into under/normal weight and overweight/obese for data analysis. A total of 200 participants [91 boys (45.5%) and 109 girls (54.5%)] were enrolled. When distributed into weight categories, 4% of the children were underweight, 64.5% normal weight, 16.5% overweight and 15% were obese. Most children consumed 3 meals (96.5%) and between 2 to 3 snacks per day (32.5% and 36.5% respectively). Preliminary data analysis of the relationship between eating frequency and weight category was not significant. Initial data analysis of snack quality completed to date looked into fruits and vegetables and beverage intakes. Average number of times a child eats fruits and vegetables per day was not significantly different between under/normal weight children and overweight/obese children (1.44±0.83 vs. 1.43±0.76 and 0.79±0.66 vs. 0.71±0.59 respectively). The overweight/obese children were consuming significantly more sweetened beverages than the under/normal weight group (6.94±8.47 oz/day vs. 4.86±7.16 oz/day, p=0.024) and significantly less water (17.55±6.15 oz/day vs. 18.40±9.18 oz/day, p=0.016). Mostly the intake of sugar‐sweetened juices was significantly higher in the overweight/obese group when compared to the under/normal weight group (5.67±7.91 oz/day vs. 3.86±6.34 oz/day, p=0.009). This finding suggests that the intake of sweetened beverages at a very young age needs to be addressed. According to our results, eating frequency appears appropriate across weight categories and does not predict weight status.

Support or Funding Information

A.C. was supported by NIH/NIGMS R25 GM061347. Support to conduct the study was provided by the Dietetics and Nutrition research foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Effects of Dried Apple Consumption on Body Composition, Inflammatory Markers and Lipid Profile in Overweight and Obese Children
Authors: Nagarajan Pavithra , Tunstall Ashley , Almaiman Lama , Cabalbag Conralyn , Metti Dina , Hong Mee Young , Kern Mark , Hooshmand Shirin
Published: November 2023

Childhood obesity increases the risk for many metabolic conditions in adulthood and has been a focus of many public health efforts in the United States. Consumption of fruit and dietary fiber reduces the risk of chronic diseases such as cardiovascular diseases (CVD). The objective of this study was to examine whether dried apple consumption may promote weight loss and improve metabolic markers in overweight and obese children. Thirty‐eight overweight or obese children age 10 to 16 years were randomly assigned to one of two groups: twice daily 120 kcal serving of a) a dried apple snack or b) a refined carbohydrate‐rich snack (muffins) for eight weeks. Body weight, height and waist circumference were determined at an initial visit and after eight weeks. Body composition was assessed using dual‐energy X‐ray absorptiometry (DXA) and Bod Pod. Blood samples were collected at baseline and the final visit to measure serum cholesterol, triglycerides, glucose, insulin, proinsulin, total adiponectin, C‐reactive protein, total antioxidant, superoxide dismutase, and glutathione peroxidase. Body weight did not change significantly in the apple group but increased for the muffin group (p<0.01). Height increased significantly over the 8‐week period (p < 0.01) in both groups asserting the fact that growth occurs very fast in this age group. Bod Pod results showed that fat free mass remained unchanged in the apple group, while fat‐free mass increased significantly in the muffin group (p < 0.01). DXA indicated increased (p < 0.05) trunk fat mass for the muffin group only. HDL‐cholesterol concentration increased (p < 0.05) after the eight‐week treatment within the apple group. Other biochemical markers were not significantly different between groups. In conclusion, apple snacks did not promote adiposity; in contrast, a refined snack such as muffin tended to increase truncal fat and lean body mass. Additionally, apple consumption increased HDL‐C concentration, which is associated with decreased CVD risk. These results demonstrate the need for similar research in other populations or for a longer duration.

Support or Funding Information

Funded by U.S. Apple Association
Does Monitoring Your Hunger Via Blood Glucose Help You Eat To Appetite And Lose Weight?
Authors: Jospe Michelle R , Taylor Rachael W , Athens Josie , Roy Melyssa , Brown Rachel C
Published: November 2023

Background

“Hunger training” aims to teach people to eat according to their appetite rather than in response to their environment or emotions. As many overweight adults have a blunted sense of hunger and satiety, blood glucose measurement provides an objective indicator of hunger and a guide for when one should eat. While hunger training has been shown to be feasible in the short term, little research has examined the effect of adherence to hunger training on weight loss and eating behavior. We aimed to i) identify which measures of adherence are most important for predicting weight loss with hunger training, and ii) examine how adherence to hunger training over six months affected weight and eating behavior.

Methods

This was an exploratory, secondary analysis from a weight loss intervention where 50 overweight or obese adults were randomized to hunger training. Five indices of adherence were chosen a priori to examine which best predicted weight loss with hunger training. The most predictive adherence measure was then used to examine the effect of different levels of adherence on weight and eating behaviors.

Results

36 participants remained in the study at 6 months. Frequency of booklet entry was the most predictive adherence measure associated with weight loss. The 15/36 participants who completed more than 60 days (out of a recommended 63 days) lost 6.3 percentage points (95% CI 3.1, 9.5; p<0.001) more weight than those who filled in less. There was no significant difference in weight loss between participants who completed 0–30 days (n=13) and those who completed 31–60 days (n=5) (p=0.115). Participants who completed more than 60 days had an increase in intuitive eating score (p=0.042), and a decrease in both emotional eating (p<0.001) and external eating (p=0.029), compared to those who completed 30 days or less.

Conclusion

Hunger training can teach people to eat according to their physical hunger and yields clinically significant weight loss and improvements in eating behavior in those who can sufficiently adhere to this novel method.

Support or Funding Information

University of Otago Research Grant
Umami taste perception following dietary glutamate supplementation
Authors: Noel Corinna A. , Dando Robin
Published: November 2023

Habitual consumption of sweet, salt, or fat diminishes subsequent perceived taste intensity, and shifts preference to higher concentrations. It is unknown whether such an effect occurs with umami, the taste for savory, which arises from protein or amino acid consumption. While the appetitive tastes for sweet, salt and fat have been heavily studied, umami is firmly the least characterized basic taste, despite its relevance to our diet, food choice, and metabolic health. The objective of this study was to assess the effect of repeated consumption of umami stimuli on taste perception in a randomized controlled study design. 59 healthy, non‐restrained subjects aged 18–54 supplemented their regular diet with a vegetable broth daily for one month; the treatment group drank an umami‐rich monosodium glutamate (MSG) supplemented broth, while the control group drank the same broth without MSG, matched for sodium content. Groups were balanced for sex and glutamate consumption, a proxy for umami taste stimulation, evaluated with a diet history questionnaire prior to testing. Suprathreshold intensity ratings for umami, sweet, and salty were assessed via the general Labeled Magnitude Scale (gLMS) throughout supplementation. The MSG broth was rated as more intensely umami in initial testing (average difference between groups=9.9 gLMS units, 95% CI=[1.4,18.5], p=0.024), as would be expected, although not more salty. Once supplementation commenced, this difference in umami perception of the broths disappeared, implying that umami taste was desensitized through habitual consumption. Specifically after one week of supplementation, the MSG group perceived umami in the broth to be 23.8% less intense compared to week 1 (average decrease=7.0 gLMS units, 95% CI=[1.3,12.7], p=0.010). No changes were observed in the control group for umami, or in either group for sweet or salty tastes over the same time period. These results suggest that umami taste can be selectively modulated by a diet high in glutamate in a relatively short period of time, in an effect similar to the relation between diet and taste of salt, sugar, and fat, and may have consequences for food choice and underlying metabolic health.

Support or Funding Information

N/A
Femur Cortical Bone Mineral Content is Increased with High Protein Intake during Ad libitum but not Energy Restricted Conditions in Obese Female Zucker Rats
Authors: Marszewski Phillip , Hennigar Stephen R , Kelley Alyssa M , Anderson Bradley J , McClung James P , Gaffney‐Stomberg Erin
Published: November 2023

Weight loss reduces fractional calcium absorption (FCA) and bone mineral density (BMD) in humans. Further, high protein (HP) diets improve FCA during energy adequacy and are associated with attenuated BMD loss during weight loss. Whether the mechanism by which a high protein diet can attenuate reductions in BMD during weight loss is due to improved FCA is unknown.

The objective of this study was to determine whether HP diets attenuate bone loss during energy restriction (ER) in an obese rat model and whether the effects are due to improved FCA. Eight week old female obese Zucker rats (Leprfa+/fa+; n=48) were randomly assigned to one of four groups (n=12/group): ad libitum 14% kcals protein (AL), ad libitum 35% kcals protein (AL+HP), ER 14% kcals protein (ER), and ER 35% kcals protein (ER+HP). ER groups were fed 60% of the feed intake consumed by the AL group (i.e., 40% restriction), but diets were matched for the following micronutrients: calcium (Ca), phosphorous, iron, and zinc. After 9 weeks, rats were placed in metabolic cages to collect urine and feces, and apparent Ca absorption and retention were calculated from Ca intake and fecal and urinary Ca excretion during the final 4 days. At week 10, rats were sacrificed and blood and tissues collected for biochemical analyses. Femur and tibia bones underwent peripheral quantitative computed tomography scanning. Effects of energy (E), protein (P), and their interaction (ExP) were analyzed by ANOVA (SPSS, v21).

Body weight did not differ between the groups at baseline, but at week 10 ER rats weighed significantly less than AL rats (p<0.001), and the AL+HP group weighed more than the AL group (ExP, p<0.05). Total and cortical content were lower in ER compared to AL groups (p<0.05) at all bone sites scanned. Cortical content (p<0.001) and periosteal circumference (p<0.001) were both greater in the AL+HP group compared to AL groups even after controlling for body weight, while no effects of protein level were observed during ER. Contrary to the hypothesis, apparent Ca absorption (35.7 ± 10.6 and 22.8 ± 8.7%, p<0.001) and retention (32.9 ± 10.6 and 19.6 ± 9.1%, p<0.001) were both higher during ER compared to AL, and the bone resorption marker C‐terminal telopeptide of type I collagen was lower during ER (p=0.001). Unlike humans, Ca absorption increased in female obese Zucker rats during ER. Beneficial effects of HP diets on bone content were only observed during AL conditions and not explained by FCA suggesting some adaptation to the HP diet occurred during the 10 weeks.

Support or Funding Information

The views expressed in this abstract are those of the authors and do not reflect the official policy of the Department of the Army, Department of Defense, or the U.S. Government.
Red Sweet Cherry Ameliorates Inflammation in Obese Diabetic (db/db) Mice
Authors: Noratto Giuliana , Chew Boon P. , Mertens‐Talcott Susanne U.
Published: November 2023

We studied the possible protective effect of cherry intake on metabolic syndrome and diabetes complications using the obese diabetic (db/db) mouse model. Mice (4–5 week old) were fed an agar‐based AIN‐93G diet supplemented with 0 (obese control), 5 or 10% cherry powder. Corn starch replaced cherry powder to maintain isocaloric content of the diets. In addition, a lean group fed same diet as obese control served as the lean control. At the end of 12 weeks, mice were euthanized; blood and organs were collected to analyze endpoint biomarkers of disease and inflammation using standard analytical protocols. Food intake, body mass index (BMI), body weight, and fasting blood glucose were similar among obese, 5% and 10% cherry groups and were higher than the lean group (p < 0.05). These results are consistent with liver, kidney, and heart weights and with mesenteric and epididymal fat. However, cecum tissue weight was higher (p < 0.05) in 10% cherry (0.3 ± 0.1 g/animal) compared to obese, lean, and 5% cherry groups (0.11–0.19 g/animal); weight of cecum content was higher in the 5% and 10% cherry groups compared to obese and lean groups. This indicates an effect of cherry fiber and may suggest an improvement in circulating lipids.

Plasma concentrations of monocyte chemoattractant protein (MCP)‐1, leptin, insulin, resistin, and plasminogen activator inhibitor (PAI)‐1 were generally similar among obese and cherry groups and higher than the lean group. Interestingly, plasma interleukin (IL)‐6 in obese mice (98 ± 34 ρg/mL, mean ± SE) tended to be higher than in the 5 and 10% cherry groups (34 ± 13.4 and 25 ± 8 ρg/mL, respectively), but did not reach significance due to high variability among animal subjects. IL‐6 was higher (p< 0.05) in all db/db groups compared to lean group (13 ±2 ρg/mL).

Therefore, cherry intake may help decrease inflammation induced by obesity and hyperglycemia. Further studies are needed to investigate the potential protective effect of cherries against obesity and diabetes complications.

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Washington State Department of Agriculture and Washington State Fruit Commission
Effects of Dietary Vitamin D Deficiency and High Fat Feeding on Adiposity, Food Intake, and Cortical Serotonin in Mature Mice
Authors: Wang Yang , Shapses Sue A , Bello Nicholas T , Miller Joshua W
Published: November 2023

Low circulating hydroxycholecalciferol (25OHD) is commonly found in obese individuals, due at least in part to volume dilution of vitamin D in adipose tissue. However, whether vitamin D deficiency contributes to obesity and exacerbates related metabolic outcomes is unclear. To address this question, female retired breeder C57BL/6J mice (~8mo old) were ad libitum fed a high‐fat diet (HFD – 45% of energy as fat) containing low (100 IU/kg), normal (1,000 IU/kg), or high (10,000 IU/kg) vitamin D content. After 10wk, mice fed the HFD with low D diet had greater energy intake, weight gain, fat mass, and hepatic fat than the HFD normal D and high D groups (P < 0.05). To follow‐up and to assess a potential mechanism underlying our findings, we designed a second experiment to examine whether serotonin indices in the frontal cortex were affected by low D intake. Mice were fed either a normal fat diet (NFD – 10% of energy as fat) or the HFD, with each diet containing low or normal vitamin D. By the end of the experiment, both HFD and low D attenuated serum 25OHD (P < 0.05). While the HFD‐low D intake appeared to increase weight and adiposity compared to the HFD‐normal D diet, this was not significant in this second experiment. However, low D intake, regardless of the presence of HFD, lowered gene expression of 1α‐hydroxylase Cyp27b1 and frontal cortex serotonin concentrations in the brain (P < 0.05). There was no effect of the diets on expression of serotonin‐related markers in the hypothalamic arcuate nucleus and dorsal raphe regions. Taken together, these findings suggest that both HFD and low D intake lower circulating 25OHD, while supplemental vitamin D has no effect on preventing HFD‐induced obesity. While we found that vitamin D deficiency had inconsistent effects on food intake and weight gain, our findings suggest that low D also lowers cortical serotonin concentration. Whether low vitamin D status regulates appetite, depression, and other cognitive outcomes via serotonergic mechanisms should be explored further.

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Rutgers Nutritional Sciences
Comparison of Body Fat Measurement Using Bioimpedance or Plicometry in Normal and Obese Subjects: An Internal Validation Study
Authors: Castro‐Sanchez Francisco Humberto , Valenzuela‐Rubio Nancy Guadalupe , Vergara‐Jimenez Marcela
Published: November 2023

Plicometry and bioimpedance are the cheapest and safest methods to evaluate Body Fat (BF). Bioimpedance has demonstrated to be as good as DEXA to evaluate BF in obese (OB) and is estimated that is even a better method in normal weight (NW) subjects. Plicometry has also a good relation with DEXA, but needs to be executed by an experimented and certified operator. The aim of the present study was to assess the accuracy between bioimpedance or the plicometry methods in the BF measurement in obese and normal weight subjects. Body fat was evaluated in 19 OB and 19 NW subjects (taking 200 measurements per group within 11 weeks), for the bioimpedance method a Body Composition Analyzer Tanita BC‐418 (Japon) was used and for the plicometry a Harpenden Skindfold Caliper, (England). Biceps, triceps, subscapular and suprailiac skinfolds were measured and BF was calculated with siri equation, using Durnin‐Womersley equation to calculate body density. Data was analyzed using STATA, 13.0 with and a P <0.05 was considered significant. Data is presented in medians and quartils (median, q1–q3). In OB subjects, BF values were statistically different compered by plicometry (37.1, 29.7–39.4) and bioimpedance (41.5, 33.6–43.6). In NW subjects, BF values were statistically different using plicometry (21.6, 10.1–27.) and biompedance (19.8, 16.25–25.35). Variability between methods was higher in OB (3.78, 0.93–5.94) than NW subjects (1.5, 0.3–3.9). Comparing by gender and the BMI category, OB males and females, as well as NW females, had statistically different BF results, and no differences were found in NW males. Even though, the results were not statistically similar, by analyzing both methods, a less than 10% difference was obtained between them, which clinically mean that both methods are accurate enough.

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ICT SA de CV
A Comparison of Protein and Fiber Content in 52 Chain Restaurant Menus
Authors: Wang Yu , Lau Rebecca , Brown Diamond S. , Cino Janette , Jung Rebecca , Mizuki Mayu , Wang Mengli , You Shengwen , Nakamura Manabu T.
Published: November 2023

Background

Over the past decade, obesity prevalence has remained high in the U.S. and is associated with multiple chronic diseases such as hypertension, type 2 diabetes, and cardiovascular diseases. American consumers today are eating out more frequently than before, thus making healthy food choices for maintaining weight challenging.

Objectives

1) Develop an effective visualization of nutrition information of restaurant menus for consumer use, and 2) compare quality of menus among chain restaurants.

Methods

Nutrition data of menu items available online were obtained from 52 chain restaurants. Two important nutrients for preventing overeating, protein and fiber, in each menu item were analyzed. A previous study has shown that displaying graphical nutrition information in a cafeteria improved consumer purchasing behaviors compared to numerical based presentation. Based on the study, the protein % of total calorie and grams of fiber per 100 kcal of all menu items from each restaurant were plotted together with a box showing a target range (16–32% protein and 1.4–2.8 g fiber/kcal). To compare quality of menus among restaurants, we divided the graph into six blocks based on varying protein and fiber per calorie: block 1, both protein and fiber below target; block 2, either protein or fiber is on target but not both; block 3, both protein and fiber in the target range; block 4, fiber exceeds the target range but protein below target; block 5, protein exceeds target but fiber below target; and block 6, both protein and fiber beyond the target.

Results

Some restaurants had more than 200 menu items, making a plot of all the menu items in a graph difficult to use. Dividing a menu into sub‐categories in a logical manner would solve the problem. Another issue was that selecting a right combination is difficult without the assistance of interactive software although foods outside of the target can be used to create an on‐target meal. We found that the majority of menu items fell into blocks 1, 2 and 4, which are the high protein‐low fiber and low protein‐low fiber ranges. Relatively few items, less than 10 on average, fell into the target range or beyond. We found that fiber was the limiting nutrient in creating adequate combinations. Across all restaurants, relatively few menu items contained significant fiber content per calorie. For most of the restaurants, it is possible to make combinations with balanced protein and fiber content within the target range; however, these capabilities vary among restaurants.

Conclusions

With further modifications, an interactive visual aid can be created for customers to select healthy choices when eating out. Because most chain restaurants analyzed offer a small number of healthy items, choosing healthy options while eating out is possible.

Support or Funding Information

USDA NIFA ILLU‐698‐376