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Effects of a Self-Prepared Carbohydrate-Reduced High-Protein Diet on Cardiovascular Disease Risk Markers in Patients with Type 2 Diabetes.
Alzahrani, AH, Skytte, MJ, Samkani, A, Thomsen, MN, Astrup, A, Ritz, C, Frystyk, J, Holst, JJ, Madsbad, S, Haugaard, SB, et al
Nutrients. 2021;(5)
Abstract
We previously observed beneficial effects of a carbohydrate-reduced, high-protein (CRHP) diet on cardiovascular risk markers in patients with type 2 diabetes mellitus (T2DM) in a crossover 2 × 6-week trial, when all food was provided to subjects as ready-to-eat meals. Here, we report the results from a 6-month open label extension: 28 patients with T2DM were instructed to self-prepare the CRHP diet with dietetic guidance. At weeks 0, 6, 12, and 36, fasting and postprandial (4-h meal test) blood samples were collected for measurements of total, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triacylglycerol (TG), apolipoproteins A1 and B, non-esterified fatty acids (NEFA), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6. Diurnal blood pressure and heart rate were also assessed. At the end of the study (week 36), concentrations of fasting total and LDL-cholesterol, fasting and postprandial NEFA and TG, and fasting apolipoprotein-B, CRP and TNF-α concentrations were significantly lower compared with week 0 (p < 0.05). A significant decrease in diurnal heart rate was also observed. From week 12 to 36, an increase in HDL-cholesterol and apolipoprotein-A1 concentrations and a further reduction in fasting and postprandial NEFA (p < 0.05) were found. These changes were independent of minor fluctuations in body weight. We conclude that the substitution of dietary carbohydrate for protein and fat has beneficial effects on several cardiovascular risk markers in patients with T2DM, which are maintained or augmented over the next 6 months when patients select and prepare the CRHP diet on their own in a dietitian-supported setting.
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Branched-Chain Amino Acids in relation to food preferences and insulin resistance in obese subjects consuming walnuts: A cross-over, randomized, double-blind, placebo-controlled inpatient physiology study.
Tuccinardi, D, Perakakis, N, Farr, OM, Upadhyay, J, Mantzoros, CS
Clinical nutrition (Edinburgh, Scotland). 2021;(5):3032-3036
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Abstract
BACKGROUND&AIMS: To assess whether the concentrations of circulating Branched-Chain Amino Acids (BCAAs) change after walnut consumption and, whether these changes are associated with alterations in markers of insulin resistance and food preferences. METHODS In a crossover, randomized, double-blind, placebo-controlled study, ten subjects participated in two 5-day inpatient study admissions, during which they had a smoothie containing 48 g walnuts or a macronutrient-matched placebo smoothie without nuts every morning. Between the two phases there was a 1-month washout period. RESULTS Fasting valine and isoleucine levels were reduced (p = .047 and p < .001) and beta-hydroxybutyrate levels were increased after 5-days of walnut consumption compared to placebo (p = .023). Fasting valine and isoleucine correlated with HOMA-IR while on walnut (r = 0.709, p = .032 and r = 0.679, p = .044). The postprandial area under the curve (AUC) of leucine in response to the smoothie consumption on day 5 was higher after walnut vs placebo (p = .023) and correlated negatively with the percentage of Kcal from carbohydrate and protein consumed during an ad libitum buffet meal consumed the same day for lunch (r = -0.661, p = .037; r = -0.628, p = .05, respectively). CONCLUSION The fasting and postabsorptive profiles of BCAAs are differentially affected by walnut consumption. The reduction in fasting valine and isoleucine may contribute to the longer-term benefits of walnuts on insulin resistance, cardiovascular risk and mortality, whereas the increase in postabsorptive profiles with walnuts may influence food preference. TRIAL REGISTRATION CLINICALTRIALS.GOV: Number: NCT02673281, Website: https://clinicaltrials.gov/ct2/show/NCT02673281.
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Unwrapping nutrition: Exploring the impact of hospital food and beverage packaging on plate waste/intake in older people.
Bell, AF, Tapsell, LC, Walton, K, Batterham, M
Appetite. 2020;:104463
Abstract
Food and beverage packaging is increasingly used in hospital food service provision. Previous research has identified that the packaging used in New South Wales hospitals can be difficult to open by older adults. As older adults experience high rates of malnutrition, it is important to understand the effects of packaging on actual consumption of food and fluids. The aim of this study was to explore the impact of hospital food and beverage packaging on dietary intakes of 62 independently living older people (65 years and over) in a university simulated hospital ward in NSW, Australia. Participants were allocated to either a breakfast and snack meal or a lunch and snack meal on two occasions one week apart. Meals were served in a shared ward environment and each participant experienced a 'sealed' and 'pre-opened' meal and snack condition. The nutritional status of participants was measured using the Mini Nutritional Assessment - Short Form (MNA®-SF) and intake was estimated through an aggregated plate waste method. Overall findings were not significant for dietary intakes and the 'sealed' versus 'pre-opened' conditions. However, for the seven participants classified by the MNA®-SF as 'at risk' of malnutrition, packaging impeded intake for breakfast (η2 = -0.34) and the high protein snack (cheese and biscuits) (η2 = -0.24) meals. This finding has implications for the provision of packaged high protein snacks (cheese portions) and breakfast meals for the older inpatient. Further research is required for nutritionally compromised and frail older people in the hospital environment to investigate the impact of packaging on food and beverage consumption in detail.
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The effect of spatial location of calorie information on choice, consumption and eye movements.
Robertson, DA, Lunn, PD
Appetite. 2020;:104446
Abstract
We manipulated the presence and spatial location of calorie labels on menus while tracking eye movements. A novel "lab-in-the-field" experimental design allowed eye movements to be recorded while participants chose lunch from a menu, unaware that their choice was part of a study. Participants exposed to calorie information ordered 93 fewer calories (11%) relative to a control group who saw no calorie labels. The difference in number of calories consumed was greater still. The impact was strongest when calorie information was displayed just to the right of the price, in an equivalent font. The effects were mediated by knowledge of the amount of calories in the meal, implying that calorie posting led to more informed decision-making. There was no impact on enjoyment of the meal. The eye-tracking data suggested that the spatial arrangement altered individuals' search strategies while viewing the menu. This research suggests that the spatial location of calories on menus may be an important consideration when designing calorie posting legislation and policy.
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5.
Healthiness or calories? Side biases in food perception and preference.
Manippa, V, Giuliani, F, Brancucci, A
Appetite. 2020;:104552
Abstract
The visual perception of a product and the ability to categorize it play a central role in food choice. People's opinion of the healthiness and caloric content of a food is influenced substantially by its appearance. Despite that, few studies have analyzed i) which one of the two dimensions of caloric content and healthiness is preferred to categorize food, ii) if these dimensions are mapped on the individuals' horizontal space, and iii) if such biases could influence food preferences. Therefore, through 4 experiments, we investigated which dimension, healthiness or caloric content, is more often used to categorize foods. We also evaluated whether a healthiness/caloric content side bias could be able to influence food preferences. We found that foods were mainly categorized as "Healthy" or "High-calorie" and the latter label was used more often when presented on the right of a foodstuff. Also, foods were categorized as healthier when the "Healthy" label was anchored to the left and the "Unhealthy" one to the right side of a visual analogue scale. Then, we found a more positive evaluation of transformed food when the key assigned to the "Pleasant" choice was on the right compared to the left. Lastly, we found that when presented on the left side, low-calorie was preferred compared to high-calorie food. Our findings shed light on both the fields of food categorization and side biases in food perception and preferences, suggesting the possibility to use these biases to promote a healthy diet and emphasizing the importance of considering this potential confounder in experimental setups.
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The influence of attractiveness and convenience cues on food appeal in adults with and without ADHD.
Hershko, S, Cortese, S, Ert, E, Aronis, A, Maeir, A, Pollak, Y
Appetite. 2020;:104679
Abstract
OBJECTIVE Previous research on adults with ADHD revealed high rates of overweight and obesity, as well as unhealthy diet habits. Other studies demonstrated that social-affective contexts can influence food choice. This study examines the sensitivity of adults with ADHD to cues of food attractiveness and convenience, for healthy and unhealthy foods. METHOD One hundred and seventy-two university students with (n = 59) and without (n = 113) ADHD, aged 19-40, participated in the study. Participants rated the level of appeal of 32 pictures of healthy and unhealthy foods, which varied in the degree of attractiveness and convenience. RESULTS The findings reveal a higher level of appeal of attractive food items compared to non-attractive ones (p < .001), as well as of convenient compared to non-convenient food items (p = .005). Type of diagnostic group did not have an effect on the level of appeal. CONCLUSION Increasing the attractiveness and convenience of food items increased the level of appeal for both students with and without ADHD. These findings emphasize the importance of environmental health intervention to potentially reduce abnormal eating pattern in the ADHD adult population, which may contribute in preventing the reported higher risk of obesity in this population.
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Influence of front-of-pack labelling and regulated nutrition claims on consumers' perceptions of product healthfulness and purchase intentions: A randomized controlled trial.
Franco-Arellano, B, Vanderlee, L, Ahmed, M, Oh, A, L'Abbé, M
Appetite. 2020;:104629
Abstract
Mandatory front-of-pack (FOP) labelling was proposed in Canada to highlight foods with high contents of sugars, sodium and/or saturated fats, which would be displayed on labels along with the mandatory Nutrition Facts table and voluntary nutrition claims. In an online survey, participants (n = 1997) were randomized to one of four FOP labelling conditions: 1) control, 2) warning label, 3) health star rating or 4) traffic light labelling. Participants were shown four drinks (a healthier drink with or without a disease risk reduction claim, a healthier drink with or without a nutrient content claim, a less healthy drink with or without a disease risk reduction claim and a less healthy drink with or without a nutrient content claim) in random order and one at a time. Participants rated perceived product healthfulness and purchase intentions using a 7-point Likert scale. Participants could access the Nutrition Facts table while viewing labels. Results showed less healthy drinks displaying any FOP labelling were perceived as less healthy compared to the control. In healthier drinks, health star rating and traffic light labelling created a 'halo' effect, which was not observed with warning labels. Similar results were observed with purchase intentions. Drinks displaying a disease risk reduction claim were perceived as healthier than those without (p < 0.001) regardless of product's healthfulness. The effect of a nutrient content claim was not significantly different. The effect of FOP labelling and claims was mitigated for those who used the Nutrition Facts table. FOP labelling was likely helpful for consumers with different levels of health literacy. Overall, FOP labelling had significantly stronger influence than nutrition claims on consumers' perceptions; however, the effect of each FOP label varied on healthier and less healthy drinks.
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An event-related potential study of consumers' responses to food bundles.
Qiu, R, Qi, Y, Wan, X
Appetite. 2020;:104538
Abstract
We conducted two event-related potentials (ERP) experiments to investigate consumers' responses to different types of food bundles. In Experiment 1, the participants were instructed to indicate their wanting of a three-yogurt bundle when their neural activity was recorded. The results of self-report wanting scores revealed that the participants wanted bundles consisting of their favorite yogurt products more than those of disliked products. Such a difference in self-report scores was also indexed by the N2 in frontal brain and the P1 in the left hemisphere. By contrast, bundles consisting of three different yogurt products elicited a smaller amplitude of the N2 than bundles consisting of two favorite products and one disliked product, but these two types of bundles received comparable wanting scores. Moreover, we asked the participants in Experiment 2 to perform a visual discrimination task on these bundles, and did not found these effects on the N2 or the P1. Collectively, these results revealed neural activities underlying consumers' responses to food rewards, and demonstrated the role of individuals' variety-seeking tendency in wanting process.
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The Multiple Food Test: Development and validation of a new tool to measure food choice and applied nutrition knowledge.
Schreiber, M, Bucher, T, Collins, CE, Dohle, S
Appetite. 2020;:104647
Abstract
Assessing individual food choices within health and nutrition related research is challenging and there is a strong need for valid and reliable instruments. In this paper, we introduce the Multiple Food Test as a new tool for measuring food choices and applied nutrition knowledge. The Multiple Food Test has the format of an image selection task. Part one of the Multiple Food Test consists of 18 trials in which participants are presented with sets of four food items and asked to choose one item they would prefer to consume (choice scale). In part two, participants saw the same 18 trials and were asked to indicate which of the items presented they perceived as being the healthiest (applied knowledge scale). Results across three studies (total N = 666) indicate that both subscales of the Multiple Food Test have good psychometric properties. Healthier choices were significantly associated with implicit theories of health, healthy eating frequency and importance (Study 1), a stronger health versus taste motive (Study 1 and 2), self-control, and habitual fruit and vegetable intake (Study 2). In Study 3, choices in the Multiple Food Test positively predicted actual food choices. The applied knowledge scale showed agreement with an existing nutrition knowledge scale, and higher scores were associated with higher levels of self-control (Study 2). The Multiple Food Test presents new opportunities to evaluate underlying variables and interventions that influence food choice or eating behavior.
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Blending dark green vegetables with fruits in commercially available infant foods makes them taste like fruit.
Bakke, AJ, Carney, EM, Higgins, MJ, Moding, K, Johnson, SL, Hayes, JE
Appetite. 2020;:104652
Abstract
Vegetables are an important but under consumed part of a healthy diet. There is growing interest in promoting vegetable acceptance and consumption among infants to help establish life-long healthy eating patterns. A recent survey of commercial baby food products in the United States by Moding and colleagues revealed a lack of variety in the types of vegetables offered. Most notably, there were no commercially available single, dark green vegetable products. Instead, dark green vegetables were often mixed with fruits or red/orange vegetables (e.g., squash) that provide additional sweetness. In order for liking for vegetables to be learned, the flavors from the vegetables must still be perceptible within the mixture. Thus, the objective of the research reported here was to understand the sensory profiles of vegetable-containing Stage 2 infant products commercially available in the United States and how ingredient composition affects flavor profiles. We performed descriptive analysis to quantitatively profile the sensory properties of 21 commercial vegetable-containing infant foods and one prepared in our laboratory. Eleven experienced panelists participated in 14.5 h of lexicon generation and training prior to rating all 22 products (in triplicate) for 14 taste, flavor, and texture attributes. Products that contained fruit were not only sweeter than products that did not contain fruit but were also higher in fruit flavors and lower in vegetable flavors. In general, sensory profiles were driven by the first ingredient in the product. Because few products had dark green vegetables as a first ingredient, dark green vegetable flavor was not prevalent in this category. This suggests the sensory profiles of commercially available infant vegetables foods may not be adequate to facilitate increased acceptance of green vegetables.