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The relationship between dietary restraint and deficits in reasoning about causes of obesity.
Husted, M, Seiss, E, Banks, AP
Psychology & health. 2019;(12):1504-1522
Abstract
Objective: Increased levels of dietary restraint are associated with deficits on many cognitive tasks. Less is known about how individual differences in restraint influences complex cognition such as reasoning which is the focus of this research.Design: Two experimental studies are reported. In study 1, participants (n = 158) completed a causal conditional reasoning task with statements about weight-related and general causal relationships. Study 2 replicated and extended study 1. Participants (n = 108) completed a causal conditional reasoning task focusing on behavioural causes of weight change or general statements.Main outcome measure: Causal conditional reasoning task performance.Results: In study 1, levels of dietary restraint were negatively associated with reasoning abilities for weight-related statements only. Study 2 replicated the negative association between dietary restraint and reasoning finding the effect in both weight-related, and general, causal judgements.Conclusion: The novel findings show that individual differences in dietary restraint have a wider relationship with cognition than previously demonstrated. Results tentatively support theoretical explanations of a reduction in cognitive capacity, rather than differences in belief, explaining reasoning deficits. These findings open an interesting avenue for research and might have implications for effective decision making about personal health behaviours, such as food choice.
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Randomized Clinical Trial: A Normocaloric Low-Fiber Diet the Day Before Colonoscopy Is the Most Effective Approach to Bowel Preparation in Colorectal Cancer Screening Colonoscopy.
Alvarez-Gonzalez, MA, Pantaleon, MA, Flores-Le Roux, JA, Zaffalon, D, Amorós, J, Bessa, X, Seoane, A, Pedro-Botet, J, ,
Diseases of the colon and rectum. 2019;(4):491-497
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Abstract
BACKGROUND Clinical guidelines recommend either a clear-liquid diet or a low-fiber diet for colonoscopy preparation. Participants in a screening program are usually motivated healthy individuals in which a good tolerability is important to improve adherence to potential surveillance colonoscopies. OBJECTIVE Our aim was to assess whether or not a normocaloric low-fiber diet followed the day before a screening colonoscopy compromises the efficacy of bowel cleansing and may improve the tolerability of bowel preparation. DESIGN This is a randomized, endoscopist-blinded, noninferiority clinical trial. SETTINGS The study was conducted at a tertiary care center. PATIENTS A total of 276 consecutive participants of the Barcelona colorectal cancer screening program were included. INTERVENTION Participants were randomly assigned to a clear-liquid diet or a normocaloric low-fiber diet the day before the colonoscopy. Both groups received 4 L of polyethylene glycol in a split-dose regimen. MAIN OUTCOME MEASURES Primary outcome was the adequate bowel preparation rate measured with the Boston bowel preparation scale. Secondary outcomes included tolerability, fluid-intake perception, hunger, side effects, and acceptability. RESULTS Participants in both groups were similar in baseline characteristics. Adequate bowel preparation was achieved in 89.1% vs 95.7% in clear-liquid diet and low-fiber diet groups, showing not only noninferiority, but also superiority (p = 0.04). Low-fiber diet participants reported less fluid-intake perception (p = 0.04) and less hunger (p = 0.006), with no differences in bloating or nausea. LIMITATIONS The single-center design of the study could limit the external validity of the results. The present findings may not be comparable to other clinical settings. CONCLUSION A normocaloric low-fiber diet the day before a screening colonoscopy achieved better results than a clear-liquid diet in terms of adequate colon preparation. Moreover, it also improved the perception of hunger and excessive fluid intake. Registered at clinicaltrials.gov: NCT02401802. See Video Abstract at http://links.lww.com/DCR/A829.
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Health coaching to encourage obese adults to enroll in commercially-available weight management programs: The path to health study.
Heredia, NI, Lee, M, Hwang, KO, Reininger, BM, Fernandez, ME, McNeill, LH
Contemporary clinical trials. 2019;:1-9
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Physicians are recommended to screen and refer obese patients to weight management programs (WMPs). There are often limited referral options for physicians, though commercially-available WMPs could be a potential solution. The purpose of this study (Path to Health) was to evaluate the efficacy of health coaching to promote enrollment in commercially-available WMPs through a two-arm, RCT with obese patients (n = 168) randomly assigned to intervention (n = 84) or control groups (n = 84). Intervention participants received phone health coaching to help them select and enroll in WMPs. We collected data on program enrollment, weight, self-reported physical activity (PA), and fruit and vegetable (FV) intake at baseline, 3- and 6-months. We used logistic regression to assess the intervention effect on enrollment in WMPs and longitudinal regression models to evaluate the effect on weight change, PA and FV intake. The average age was 54.7 years, 59% were female and 43% were Black and 49% were White. At 6 months, 39% of the intervention group (vs. 29% of control) had enrolled in WMPs. We found no longitudinal intervention effect on weight, PA and FV intake. We found that there was more weight loss for those who completed ≥4 calls as compared to those who completed <4 calls. We also found significant dose response relationships for PA and FV intake at 3 months. In this study, we found that phone health coaching was successful in increasing obese adults' enrollment in commercially-available WMPs and that there was a dose response relationship for weight and behavioral outcomes.
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Dietary changes in a diabetes prevention intervention among people with prediabetes: the Diabetes Community Lifestyle Improvement Program trial.
Ford, CN, Weber, MB, Staimez, LR, Anjana, RM, Lakshmi, K, Mohan, V, Narayan, KMV, Harish, R
Acta diabetologica. 2019;(2):197-209
Abstract
AIMS: Diabetes prevention interventions have been less successful in Asian Indians compared to other populations, which may be due in part to dietary differences. The objective of this study was to determine the impact of a diabetes prevention intervention on diet and risk of diabetes in Asian Indians at high risk. METHODS Data were included from the Diabetes Community Lifestyle Improvement Program (D-CLIP), a randomized control trial to prevent diabetes in overweight/obese Asian Indian adults (20-65 years) with prediabetes. Respondents received standard treatment (control; n = 283) or a 6-month intervention (n = 295) that included education and support to reduce intakes of fat and total calories (kilocalories; kcal). Diet was ascertained using a food frequency questionnaire, and incident diabetes was determined from annual 2-h plasma glucose post-oral glucose tolerance test or biannual fasting plasma glucose. RESULTS There were 485 (control 240; intervention 245) respondents with complete diet data at baseline. At 6 months, the intervention was associated with decreased intake of total energy (- 185.6 kcal/day; 95% CI - 353.6, - 17.5 kcal/day) and refined cereals (- 7.2 g/1000 kcal; 95% CI - 12.7, - 1.7 g/1000 kcal), and increased intakes of fruits and vegetables (33.4 g/1000 kcal; 95% CI 16.0, 50.8 g/1000 kcal). The intervention group was half (HR 0.49; 95% CI 0.25, 0.94) as likely to develop diabetes at 1 year, and the hazard was significantly attenuated (12.2%; P = 0.015) with adjustment for fruits and vegetable intake. CONCLUSION The D-CLIP decreased the total energy intake and increased the intakes of fruits and vegetables, and reduced the 1-year incidence of diabetes by half. TRIAL REGISTRATION Clinicaltrails.gov # NCT01283308.
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Assessment of Quality and Readability of Internet Dietary Information on Irritable Bowel Syndrome.
Alfaro-Cruz, L, Kaul, I, Zhang, Y, Shulman, RJ, Chumpitazi, BP
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2019;(3):566-567
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Diet plays an important role for patients with irritable bowel syndrome (IBS). For medical conditions such as IBS, the Internet is a primary source of health information.1 However, recent evidence suggests that Internet health information may have several flaws including being extremely discrepant, of poor quality, and inaccurate.2 Therefore, our objectives were to evaluate both the quality and reading level of Internet dietary recommendations for both pediatric and adult IBS.
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Crohn's Disease Exclusion Diet Plus Partial Enteral Nutrition Induces Sustained Remission in a Randomized Controlled Trial.
Levine, A, Wine, E, Assa, A, Sigall Boneh, R, Shaoul, R, Kori, M, Cohen, S, Peleg, S, Shamaly, H, On, A, et al
Gastroenterology. 2019;(2):440-450.e8
Abstract
BACKGROUND & AIMS Exclusive enteral nutrition (EEN) is recommended for children with mild to moderate Crohn's disease (CD), but implementation is challenging. We compared EEN with the CD exclusion diet (CDED), a whole-food diet coupled with partial enteral nutrition (PEN), designed to reduce exposure to dietary components that have adverse effects on the microbiome and intestinal barrier. METHODS We performed a 12-week prospective trial of children with mild to moderate CD. The children were randomly assigned to a group that received CDED plus 50% of calories from formula (Modulen, Nestlé) for 6 weeks (stage 1) followed by CDED with 25% PEN from weeks 7 to 12 (stage 2) (n = 40, group 1) or a group that received EEN for 6 weeks followed by a free diet with 25% PEN from weeks 7 to 12 (n = 38, group 2). Patients were evaluated at baseline and weeks 3, 6, and 12 and laboratory tests were performed; 16S ribosomal RNA gene (V4V5) sequencing was performed on stool samples. The primary endpoint was dietary tolerance. Secondary endpoints were intention to treat (ITT) remission at week 6 (pediatric CD activity index score below 10) and corticosteroid-free ITT sustained remission at week 12. RESULTS Four patients withdrew from the study because of intolerance by 48 hours, 74 patients (mean age 14.2 ± 2.7 years) were included for remission analysis. The combination of CDED and PEN was tolerated in 39 children (97.5%), whereas EEN was tolerated by 28 children (73.6%) (P = .002; odds ratio for tolerance of CDED and PEN, 13.92; 95% confidence interval [CI] 1.68-115.14). At week 6, 30 (75%) of 40 children given CDED plus PEN were in corticosteroid-free remission vs 20 (59%) of 34 children given EEN (P = .38). At week 12, 28 (75.6%) of 37 children given CDED plus PEN were in corticosteroid-free remission compared with 14 (45.1%) of 31 children given EEN and then PEN (P = .01; odds ratio for remission in children given CDED and PEN, 3.77; CI 1.34-10.59). In children given CDED plus PEN, corticosteroid-free remission was associated with sustained reductions in inflammation (based on serum level of C-reactive protein and fecal level of calprotectin) and fecal Proteobacteria. CONCLUSION CDED plus PEN was better tolerated than EEN in children with mild to moderate CD. Both diets were effective in inducing remission by week 6. The combination CDED plus PEN induced sustained remission in a significantly higher proportion of patients than EEN, and produced changes in the fecal microbiome associated with remission. These data support use of CDED plus PEN to induce remission in children with CD. Clinicaltrials.gov no: NCT01728870.
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Effect of Diet on the Gut Microbiota: Rethinking Intervention Duration.
Leeming, ER, Johnson, AJ, Spector, TD, Le Roy, CI
Nutrients. 2019;(12)
Abstract
The human gut is inhabited by trillions of microorganisms composing a dynamic ecosystem implicated in health and disease. The composition of the gut microbiota is unique to each individual and tends to remain relatively stable throughout life, yet daily transient fluctuations are observed. Diet is a key modifiable factor influencing the composition of the gut microbiota, indicating the potential for therapeutic dietary strategies to manipulate microbial diversity, composition, and stability. While diet can induce a shift in the gut microbiota, these changes appear to be temporary. Whether prolonged dietary changes can induce permanent alterations in the gut microbiota is unknown, mainly due to a lack of long-term human dietary interventions, or long-term follow-ups of short-term dietary interventions. It is possible that habitual diets have a greater influence on the gut microbiota than acute dietary strategies. This review presents the current knowledge around the response of the gut microbiota to short-term and long-term dietary interventions and identifies major factors that contribute to microbiota response to diet. Overall, further research on long-term diets that include health and microbiome measures is required before clinical recommendations can be made for dietary modulation of the gut microbiota for health.
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The year in cardiology 2018: prevention.
Reiner, Ž, Laufs, U, Cosentino, F, Landmesser, U
European heart journal. 2019;(4):336-344
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Effects of eating with an augmented fork with vibrotactile feedback on eating rate and body weight: a randomized controlled trial.
Hermsen, S, Mars, M, Higgs, S, Frost, JH, Hermans, RCJ
The international journal of behavioral nutrition and physical activity. 2019;(1):90
Abstract
BACKGROUND Eating rate is a basic determinant of appetite regulation: people who eat more slowly feel sated earlier and eat less. A high eating rate contributes to overeating and potentially to weight gain. Previous studies showed that an augmented fork that delivers real-time feedback on eating rate is a potentially effective intervention to decrease eating rate in naturalistic settings. This study assessed the impact of using the augmented fork during a 15-week period on eating rate and body weight. METHODS In a parallel randomized controlled trial, 141 participants with overweight (age: 49.2 ± 12.3 y; BMI: 31.5 ± 4.48 kg/m2) were randomized to intervention groups (VFC, n = 51 or VFC+, n = 44) or control group (NFC, n = 46). First, we measured bite rate and success ratio on five consecutive days with the augmented fork without feedback (T1). The intervention groups (VFC, VFC+) then used the same fork, but now received vibrotactile feedback when they ate more than one bite per 10 s. Participants in VFC+ had additional access to a web portal with visual feedback. In the control group (NFC), participants ate with the fork without either feedback. The intervention period lasted four weeks, followed by a week of measurements only (T2) and another measurement week after eight weeks (T3). Body weight was assessed at T1, T2, and T3. RESULTS Participants in VFC and VFC+ had a lower bite rate (p < .01) and higher success ratio (p < .0001) than those in NFC at T2. This effect persisted at T3. In both intervention groups participants lost more weight than those in the control group at T2 (p < .02), with no rebound at T3. CONCLUSIONS The findings of this study indicate that an augmented fork with vibrotactile feedback is a viable tool to reduce eating rate in naturalistic settings. Further investigation may confirm that the augmented fork could support long-term weight loss strategies. TRIAL REGISTRATION The research reported in this manuscript was registered on 4 November 2015 in the Netherlands Trial Register with number NL5432 ( https://www.trialregister.nl/trial/5432 ).
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Renewed: Protocol for a randomised controlled trial of a digital intervention to support quality of life in cancer survivors.
Krusche, A, Bradbury, K, Corbett, T, Barnett, J, Stuart, B, Yao, GL, Bacon, R, Böhning, D, Cheetham-Blake, T, Eccles, D, et al
BMJ open. 2019;(3):e024862
Abstract
INTRODUCTION Low quality of life is common in cancer survivors. Increasing physical activity, improving diet, supporting psychological well-being and weight loss can improve quality of life in several cancers and may limit relapse. The aim of the randomised controlled trial outlined in this protocol is to examine whether a digital intervention (Renewed), with or without human support, can improve quality of life in cancer survivors. Renewed provides support for increasing physical activity, managing difficult emotions, eating a healthier diet and weight management. METHODS AND ANALYSIS A randomised controlled trial is being conducted comparing usual care, access to Renewed or access to Renewed with brief human support. Cancer survivors who have had colorectal, breast or prostate cancer will be identified and invited through general practice searches and mail-outs. Participants are asked to complete baseline measures immediately after screening and will then be randomised to a study group; this is all completed on the Renewed website. The primary outcome is quality of life measured by the European Organization for Research and Treatment of Cancer QLQ-c30. Secondary outcomes include anxiety and depression, fear of cancer recurrence, general well-being, enablement and items relating to costs for a health economics analysis. Process measures include perceptions of human support, intervention usage and satisfaction, and adherence to behavioural changes. Qualitative process evaluations will be conducted with patients and healthcare staff providing support. ETHICS AND DISSEMINATION The trial has been approved by the NHS Research Ethics Committee (Reference 18/NW/0013). The results of this trial will be published in peer-reviewed journals and through conference presentations. TRIAL REGISTRATION NUMBER ISRCTN96374224; Pre-results.