bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delivery of a 3-month Mediterranean diet and physical activity lifestyle intervention via artificial-intelligence chatbot, can achieve behaviour change: MedLiPal pilot-study
Authors: Murphy Karen , Davis Courtney , Curtis Rachel , Maher Carol 
Published: June 2020

AbstractPoor diet and physical inactivity are leading modifiable causes of death and chronic disease. Robust evidence confirms that the Mediterranean diet (MedDiet) reduces mortality and cardiovascular disease risk, and promotes healthy longevity. However, MedDiet interventions are typically resource intensive, requiring regular face-to-face visits, in a one-on-one or small group setting. The rapid growth of Artificial-Intelligence (chatbot) technology has created new possibilities for low-cost, personalised health behaviour programs. We aimed to assess whether a 12-week MedDiet and physical activity intervention delivered entirely via technology (chatbot, website, wrist-worn activity tracker) could result in health behaviour change in 30 adults aged 57 ± 8 years. Volunteers’ height, body weight, waist circumference and blood pressure were measured in clinic at baseline, week 6 and 12. Introduction of the MedDiet and physical activity recommendations were conducted through a website with short videos and written sections assisted by the chatbot. Participants were encouraged to interact with the chatbot program at least weekly for 12-weeks. The MedDiet component of the program was modelled on the MedLey trial, whilst physical activity used step count goal-setting using a Garmin Vivofit 4 wrist-worn tracker. Diet and self-reported physical activity outcomes were measured using the 14-point MedDiet questionnaire and Active Australia Survey. The study achieved 93% retention over the 12-weeks and with excellent user engagement and satisfaction. There was a significant increase in the MedDiet score from 3 ± 3.5 (out of 14) at baseline, to 11 ± 3 at weeks 6 and 12, (p < 0.001). Weekly moderate-to-vigorous physical activity minutes increased from 135 ± 196 at baseline, to 210 ± 233 and 300 ± 433 mins, at weeks 6 and 12, respectively, (p < 0.001). Waist circumference decreased from 99 ± 28 to 98 ± 27 and 96 ± 25 cm, at weeks 6 and 12, respectively, (p < 0.001). BMI decreased from 29 ± 10 to 28 ± 9 at week 6 and 28 ± 10 at week 12 (P < 0.05). There was no change in blood pressure. Our pilot data confirm that the chatbot together with informational website and wearable intervention approach achieved excellent user satisfaction and preliminary efficacy of behaviour change across a 12-week period. Further research employing a randomized-controlled design, and high quality outcome measures is warranted to confirm efficacy and sustainability of behaviour change. However, these early results suggest that this innovative, comprehensive chatbot-based approach may be an appealing and feasible strategy suitable for mass-dissemination to assist dietary and physical activity related behaviour, leading to a widespread reduction in risk factors for chronic disease.
A Tailored Habits-based Dietary Intervention Combined With Oral Rehabilitation on Partially Dentate Older Adults: Nutritional Impact
Authors: McCrum Leigh-Ann , Mckenna Gerry , Woodside Jayne , McGowan Laura , Watson Sinead 
Published: June 2020

AbstractIntroductionReplacing missing teeth alone is not enough to engender dietary behaviour change amongst older adults. Whilst there is a body of evidence to support oral rehabilitation in conjunction with dietary advice, this is currently limited to edentate patients even though the majority of older adults are now partially dentate. One approach proven to change long-term food behaviours but is novel in this population is habit-formation. Consequently, this study developed and tested a habit-based tailored dietary intervention, in conjunction with oral rehabilitation amongst partially dentate older adults.Materials and methodsA pilot randomised control trial was conducted on 57 partially dentate older patients. Participants were randomised to an intervention group (habits-based dietary intervention) or a control group and followed up for 8 months. The intervention group attended four meetings with a trained researcher to target habit-formation around 3 dietary domains (fruit/vegetables, wholegrains, healthy proteins). The primary outcome measure was self-reported automaticity for developing healthy habits and habit formation was assessed using the Self-Report Behavioural Automaticity Index (SRBAI). Preliminary analysis was conducted on n = 36 participants between baseline and 8 month follow up.ResultsPreliminary results showed that SRBAI scores and self-reported frequency of days doing habits in the intervention group for all tailored dietary habits was significant between baseline and follow up visits (p < 0.001). There were moderate positive correlations between automaticity and habit adherence (Fruit/vegetables rho = 0.43, p = 0.09: Wholegrains rho = 0.44, p = 0.08: Healthy Proteins rho = 0.52, p = 0.03) for the intervention group. Automaticity trends were increased in the intervention group for all 3 dietary habits compared to the control group but, other than wholegrain (p = 0.005), between group differences were non-significant (p > 0.05). BMI decreased in the intervention group (29.6 to 28.7 kg/m2) compared to a non-significant increase in the control group (27.7 to 27.8 kg/m2) (p = 0.08). There were slight increases in Mini Nutritional Assessment mean change scores (0.19 intervention: 0.32 control) for both groups, however between-group differences were not statistically significant (p = 0.9). Greater improvements in food intake around dietary habits were observed in the intervention group (Fruit/vegetables:108 g Fibre 4g: Protein 11g) compared to the control group (Fruit/vegetables -17g: Fibre 2g: Protein -4g).DiscussionPreliminary results demonstrate the success of a habit-based dietary intervention coupled with oral rehabilitation in positively influencing dietary behaviours and other nutritional outcomes in partially dentate older adults.
Loss of adipose tissue mass during chemotherapy predicts reduced survival in patients with colorectal cancer treated with palliative intent
Authors: Sullivan Erin Stella , Daly Louise E. , Bhuachalla Éadaoin B Ní , Cushen Samantha J. , Power Derek G. , Ryan Aoife M 
Published: June 2020

AbstractObesity is an established risk factor for colorectal cancer (CRC), however little is known about changes in body composition during chemotherapy and its impact on survival. The aim of this study was to examine in patients with CRC: (1) The prevalence of abnormal body composition phenotypes, (2) The impact of baseline body composition on overall survival, (3) Changes in body composition throughout treatment and its impact on overall survival.A prospective study of adult CRC patients undergoing chemotherapy between 2012–2016 was conducted. Longitudinal changes in body composition were examined using computed tomography (CT) images at two timepoints (interval 7 months, IQR: 5–9 months) using paired t-tests. Sarcopenia and low muscle attenuation (MA) were defined using published cut-offs. Cox proportional-hazards models were used to estimate mortality hazard ratios, adjusted for known prognostic covariates – stage, age, sex, performance status & systemic inflammation.In total, 268 patients were recruited (66% male, mean age 63 years) and 51% were undergoing chemotherapy with a palliative intent. At baseline, 4% were underweight (BMI < 20 kg/m2), 38% had a normal BMI, and 58% were overweight/obese. Despite this, 38% had cancer cachexia, 34% were sarcopenic and 43% had low MA. Neither sarcopenia, sarcopenic obesity nor cachexia at baseline predicted survival. Over 100 days, 68% were muscle stable (± 1 kg), while 25% lost > 1 kg and 7% gained > 1 kg. Fat mass remained stable ± 1 kg in 49%, while 28% lost > 1 kg and 23% gained > 1 kg. When adjusted for known prognostic covariates, baseline BMI (20–25 kg/m2) in those having palliative chemotherapy was independently associated with reduced survival compared to those with BMI indicating overweight (BMI 25–30 kg/m2) [HR: 1.80 (95% CI: 1.04–3.14), p = 0.037]. In those undergoing chemotherapy with palliative intent, a loss of > 6.4% subcutaneous fat (Q1 SAT) over 100 days was predictive of poor survival versus those with small losses, remaining stable or gaining SAT (Q2-4), independent of changes in muscle mass [HR: 2.22 (95% CI: 1.07–4.62), p = 0.033].Patients with CRC, particularly those treated with a palliative intent, experience significant losses in muscle and fat mass during chemotherapy. Loss of SAT mass during palliative chemotherapy is prognostic of poor survival, independent of changes in muscle mass. Baseline BMI in the overweight range confers a survival advantage. Nutritional strategies to prevent or attenuate weight loss during chemotherapy are advisable especially in the context of advanced CRC.
Developing food-based dietary guidelines for 1–5 year old children: a protocol for use in population health globally
Authors: Lyons O.C. , McNulty H. , Kerr M.A. , Ward F. , Livingstone M.B.E. , Saul I. , Flynn M.A.T. 
Published: June 2020

AbstractEarly childhood is a well-established critical period for growth and development, potentially impacting on life-long health. Healthy dietary habits formed during the transition from a predominantly milk-based to a food-based diet track into later life. Globally, there is no established process for developing food-based dietary guidelines (FBDG) for 1–5 year old children. This study aims to establish a protocol for developing FBDG for 1–5 year old children for use in population health globally.Foods consumed by > 10% of consumers aged 1–5 years (at each eating occasion) were identified by secondary analysis of the Irish National Pre-School Nutrition Survey (NPNS; 2012). Consultations were held with registered dietitians to update the NPNS data and reflect current dietary habits. Dietary modelling, based on healthy eating principles, was conducted on boys (n30) and girls (n30) at five percentiles on the World Health Organisation (WHO) growth charts (0.4th; 25th; 50th; 75th; 99.6th) and at six age time-points (1y; 1.5y; 2y; 3y; 4y and 5y). Intake targets were identified for energy, macronutrients and 6 key micronutrients. For those with inadequate nutrient intakes, key contributing foods were identified and used in the modelling.Dietary modelling yielded 640 four-day food intake patterns. For 1–3 year olds, especially those < 25th growth percentile, iron was identified as an at-risk nutrient as the intake target was not achieved. For all 1–5 year olds, vitamin D was identified as an at-risk nutrient. Red meat and iron-fortified cereal (> 12mg/100g) were identified as key contributors to iron intake. A combination of red meat (30 g, 3 days/week) and iron-fortified cereal (30 g, 5 days/week) resolved inadequate iron intakes for 1–3 year olds, except those < 25th growth percentile. For those children, the additional inclusion of 4 mg iron from use of iron-fortified milk (1.2mg/100mL) or a low-dose iron supplement (7 mg, 4 days/week) resulted in adequate iron intakes. For all children aged 1–5 years, vitamin D intakes improved by including a daily 5μg vitamin D supplement, but still did not reach the intake target.Worldwide, significant resources are invested in assessing growth and development of 1–5 year olds. This study provides a protocol for developing FBDG to meet nutritional needs of 1–5 year olds at various growth parameters (age and percentiles), using WHO charts. This enables the provision of practical food-based interventions to nutritionally vulnerable children. Using national dietary data, this approach can be applied for developing FBDG specific to a country's needs.
Early infant feeding practices in Ireland; current and secular analyses of infant feeding in two prospective birth cohort studies
Authors: Hemmingway Andrea , Fisher Dawn , Berkery Teresa , Kiely Mairead E 
Published: June 2020

AbstractRecognised as the optimum infant feeding method, breastfeeding affords substantial health benefits to mother and infant. Exclusive breastfeeding is recommended to 6 months, with continuation thereafter. In Ireland, data indicates that 60% breastfeed to any extent at hospital discharge and 40% do so at 3 months. However, nationally collected data is limited in detail, particularly with regard to breastfeeding continuation. The ongoing Cork-based COMBINE birth cohort study recruited 456 participants between 2015 and 2017. Through interviewer-led questionnaires, research midwives collected feeding data at hospital discharge, 1, 2, 4, 6 and 9 months of age. Infant feeding was classed as breast (breastmilk as main milk source), combination (both breastmilk and infant formula daily) or infant formula only feeding. Adherence to the World Health Organisation (WHO) recommendation to exclusively breastfeed (breastmilk only, no infant formula, supplementary fluids or solid foods) was examined longitudinally. To explore secular changes, breastfeeding rates in COMBINE were compared to the BASELINE birth cohort study, which recruited participants (n = 2116) between 2008 and 2011 in the same setting. In COMBINE, 75% of mothers provided any breastmilk (breast or combination) at hospital discharge, of whom 44% breastfed only. Two-fifths (40%), one-third (33%) and one-quarter (24%) breastfed at 1, 4 and 6 months, respectively. Combination feeding of breastmilk and infant formula was prevalent at discharge (31%) and 1 month (20%). Advice from healthcare professionals (31%) and concern baby was hungry (30%) were commonly reported reasons for this practice and throughout the study, mothers who combination fed were more likely to stop breastfeeding altogether than those who breastfed (all P < 0.001). Infant formula only feeding increased from 25% at discharge to 40% at 1 month, 49% at 2 months and 74% at 9 months. Half (45%) of mothers who breastfed did so for less than 4 months and insufficient milk/growth faltering was the most commonly cited reason for cessation (27%). The rate of WHO-defined exclusive breastfeeding was 40% from birth to discharge, 22% to 1 month, 15% to 4 months and 2% to 6 months. The breastfeeding (breastmilk as main milk source) rate at discharge did not differ between our two birth cohorts (44 vs. 40%, P = 0.23), but was significantly higher in COMBINE compared to BASELINE at 2 (36 vs. 27%) and 6 (24 vs. 12%) months (both P < 0.05). While these data provide evidence of some progress towards longer breastfeeding durations, there remains much scope to improve infant feeding practices in Ireland.
A prospective investigation of plant foods, dietary fibre and ischaemic heart disease in the EPIC cohort
Authors: Perez-Cornago Aurora , Crowe Francesca L. , Appleby Paul N. , Key Timothy J 
Published: June 2020

AbstractIntroductionThere is evidence that plant-based diets might be associated with a lower risk of IHD; however, previous studies have not reported on intake of subtypes of fruit and vegetables and sources of dietary fibre. This study aims to assess the associations of major plant foods, their subtypes and dietary fibre with risk of ischaemic heart disease (IHD) in the European Prospective Investigation into Cancer and Nutrition (EPIC)-CVD Consortium.Material and methodsWe conducted a prospective analysis of 490,311 men and women in ten European countries without a history of myocardial infarction or stroke at recruitment. Dietary intake was assessed using validated questionnaires and calibrated with 24-hour recall data. Cox regression models, adjusted for IHD risk factors, were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsDuring a mean of 12.6 years follow-up, we documented 8504 myocardial infarction cases or deaths from IHD. Participants consuming at least eight portions (80 grams each) of fruits and vegetables a day had a 10% lower risk of IHD (HR 0.90, 95% CI: 0.82–0.98) compared with those consuming fewer than three portions a day. The risk of IHD was 6% (95% CI 0.90–0.99; P-trend = 0.009) lower for a 200 g/day higher intake of fruit and vegetables combined, 3% (0.95–1.00; P-trend = 0.021) lower for a 100 g/ day higher fruit intake, and 8% (0.86–0.97; P-trend = 0.006) lower for a 50 g/ day higher intake of bananas. Moreover, risk of IHD was 9% (0.83–0.99; P-trend = 0.032) lower for a 10g/ day higher intake of nuts and seeds, and 10% (0.82–0.98; P-trend = 0.020) lower for a 10g/ day higher intake of total dietary fibre. No associations were observed between legumes, total vegetables and other subtypes of fruit and vegetables and IHD risk.DiscussionThe results from this large prospective study suggest that higher intakes of fruit and vegetables combined, total fruit, bananas, nuts and seeds, and total fibre are associated with a lower risk of IHD. Given the observational design of this study, causality and potential mechanisms should be further investigated.
Effect of almonds consumption on anthropometric measurements and blood parameters in overweight and obese females in a weight reduction program
Authors: Ünal Sabiha İrem , Pekcan Ayla Gulden 
Published: June 2020

AbstractNuts are good sources of dietary fiber, magnesium, polyunsaturated fats, vitamin E, and antioxidants, all of which may have health benefits and associated with increased sensations of satiety and could have beneficial effects on weight control. This study aims to determine the effects of a balanced hypocaloric almond (30 g/day) enriched diet (AED) compared to a balanced hypocaloric almond free diet (AFD) on anthropometric measurements and blood parameters. Study was a 3-months, randomized, controlled trial with four serial measurements on 32 overweight and obese (BMI: ≥ 25 kg/m2) women, aged 25–50 years. The subjects were randomly divided into two groups (16 AED and 16 AFD). Individualized hypocaloric diets of AED considering the energy recommendation, 30 g/day of almonds was added as a snack. Demographic characteristics, nutritional habits, physical activity levels of subjects were determined by a questionnaire. 24-hour dietary intakes for 3 consecutive days (one day week-end) were recorded at the beginning, 1rd, 2nd, and 3rd months of the study. Anthropometric measurements (height, body weight, waist, hip and neck circumferences) were taken and body composition was determined by Bioelectrical Impedance Analysis (BIA), BMI, waist/hip circumference ratio (WHR) and waist circumference/height ratio (WHtR) were calculated. Fasting blood glucose, insulin level, HbA1c, HOMA-IR, total cholesterol, triglycerides, serum iron, haemoglobin, TSH, CRP were determined prior to and at the end (3rd month) of the study. At the beginning of the study no statistically significant difference was found between anthropometric measurements of the groups (p > 0.05). Body weight, BMI, waist, hip circumferences, WHR, WHtR, percentage of body fat, body fat mass were decreased significantly in almond and control groups compared with the beginning and 1rd, 2nd., 3rd months of the study (p = 0.001). Significant reductions in HbA1c and LDL-cholesterol levels were determined in almond group (p < 0.05). Statistically significant differences were found in insulin, HDL-cholesterol, triglycerides and HOMA-IR levels compared to the prior and end of study in both groups (p < 0.05). Balanced hypocaloric diet caused weight loss and improvements in anthropometric and blood parameters in both groups, but better improvement was determined with almond enriched diet. Almonds as a snack could be recommended as a healthy choice in weight reduction diets. Almonds fiber and protein content may have beneficial effects on weight reduction.
Factors that Influence Stunting in Children Aged 6–59 Months in Kapiri-Mposhi District, Zambia
Authors: Chipili Given , Msuya John 
Published: June 2020

AbstractStunting has remained a challenge in Zambia. Poor nutrition in early life of children below the age five has a great effect on stunting. This paper looked at other factors that can influence stunting among children aged 6–59 months. A cross-sectional survey was conducted in Kapiri-Mposhi district among 100 children aged 6–59 months. This study was part of the macro study Implementation of Nutrition-sensitive Agriculture in the Central Province of Zambia.” We looked at four factors, which included, the Mothers age, level of mother's education, Family size and marital status. These factors where compared to the nutrition status of children (Stunting). We used descriptive and binary logistic regression analysis to assess the factors that influence stunting. The prevalence of stunting was found to be 21%, wasting was 9% and underweight was 2%.This study found that Children who were born from teenage mothers were likely to be stunted (P < 0.02) than those from older mothers. In addition, we also found that there was a significant relationship between family size and stunting (P < 0.01). Most families that had over eight member were likely to have stunted children than those we had less. This study did not find any association between the mother's level of education or marital status and stunting in Kapiri-Mposhi district. Family size and mother's age are associated to stunting in Kapiri-Mposhi district.
Diet quality as a predictor of healthy and cardiometabolic disease-free life expectancy between ages 50 to 85
Authors: Lagström Hanna , Stenholm Sari , Akbararly Tasnime , Pentti Jaana , Vahtera Jussi , Kivimäki Mika , Head Jenny 
Published: June 2020

AbstractPoor dietary quality is one of the leading modifiable risk factor for premature mortality worldwide. People live longer than ever, but spend more years with illness and disability although the ultimate goal is to increase healthy years of life. Less research has considered the role of dietary habits in relation to health or cardiometabolic disesase-free life expectancy (LE). This study investigate the association of diet quality with healthy and cardiometabolic disease-free LE between ages 50 and 85. The study comprised 8,075 participants of the Whitehall II study. Diet quality was assessed with Alternative Healthy Eating Index (AHEI) 2010 at phases 3, 5 and 7 and took the measure of diet closest to age of 50 years for each participant. We utilized repeat measures of self-rated health and cardiometabolic disease from the first observation when participants were aged 50 years or older. In the analyses the AHEI-2010 total score was categorized in to quintiles, where the lowest quintile represents unhealthiest diet quality and highest quintiles healthiest diet. Multistate life table models were used to estimate healthy and cardiometabolic disease-free LE from age 50 to 85 years for each category of AHEI-2010 quintiles and three occupational position group. Participants in the highest AHEI-2010 quintile lived 3.6 years longer in good health and 2.7 years longer without cardiometabolic diseases than participants in the lowest quintile of the AHEI-2010. Higher diet quality associated with an increased healthy and cardiometabolic disease-free LE was observed across different occupational positions: Men in highest occupational position and highest AHEI-2010 quintile lived 9.4 years longer with good health compared to lowest occupational position and lowest AHEI-2010 quintile and for women the corresponding difference was 8.2 years. In terms of proportion of years spent without cardiometabolic diseases ranged from 77% (high occupational position and highest AHEI-2010) to 57% (low occupational position and lowest AHEI-2010) in men and from 82% to 70% in women. The difference in years lived healthy across AHEI-2010 quintiles was most remarkable in persons with low occupation status. Healthier dietary habits are associated with longer healthy and longer cardiometabolic disease-free LE between ages 50 and 85. Attention to poor diet should be paid especially among people in the lowest occupational position.