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Estimating the effect of calorie menu labeling on calories purchased in a large restaurant franchise in the southern United States: quasi-experimental study.
Petimar, J, Zhang, F, Cleveland, LP, Simon, D, Gortmaker, SL, Polacsek, M, Bleich, SN, Rimm, EB, Roberto, CA, Block, JP
BMJ (Clinical research ed.). 2019;:l5837
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Abstract
OBJECTIVE To evaluate whether calorie labeling of menus in large restaurant chains was associated with a change in mean calories purchased per transaction. DESIGN Quasi-experimental longitudinal study. SETTING Large franchise of a national fast food company with three different restaurant chains located in the southern United States (Louisiana, Texas, and Mississippi) from April 2015 until April 2018. PARTICIPANTS 104 restaurants with calorie information added to in-store and drive-thru menus in April 2017 and with weekly aggregated sales data during the pre-labeling (April 2015 to April 2017) and post-labeling (April 2017 to April 2018) implementation period. MAIN OUTCOME MEASURES Primary outcome was the overall level and trend changes in mean purchased calories per transaction after implementation of calorie labeling compared with the counterfactual (ie, assumption that the pre-intervention trend would have persisted had the intervention not occurred) using interrupted time series analyses with linear mixed models. Secondary outcomes were by item category (entrees, sides, and sugar sweetened beverages). Subgroup analyses estimated the effect of calorie labeling in stratums defined by the sociodemographic characteristics of restaurant census tracts (defined region for taking census). RESULTS The analytic sample comprised 14 352 restaurant weeks. Over three years and among 104 restaurants, 49 062 440 transactions took place and 242 726 953 items were purchased. After labeling implementation, a level decrease was observed of 60 calories/transaction (95% confidence interval 48 to 72; about 4%), followed by an increasing trend of 0.71 calories/transaction/week (95% confidence interval 0.51 to 0.92) independent of the baseline trend over the year after implementation. These results were generally robust to different analytic assumptions in sensitivity analyses. The level decrease and post-implementation trend change were stronger for sides than for entrees or sugar sweetened beverages. The level decrease was similar between census tracts with higher and lower median income, but the post-implementation trend in calories per transaction was higher in low income (change in calories/transaction/week 0.94, 95% confidence interval 0.67 to 1.21) than in high income census tracts (0.50, 0.19 to 0.81). CONCLUSIONS A small decrease in mean calories purchased per transaction was observed after implementation of calorie labeling in a large franchise of fast food restaurants. This reduction diminished over one year of follow-up.
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Cannabis effects on lipoproteins.
Lazarte, J, Hegele, RA
Current opinion in lipidology. 2019;(2):140-146
Abstract
PURPOSE OF REVIEW The endocannabinoid system affects several physiological functions. A family of endocannabinoid receptors is susceptible to cannabis constituents. Cannabis is widely used in our society and following its recent legalization in Canada, we focus on how exposure to cannabis and pharmacologic cannabinoid receptor type 1 (CB1) inhibition affect lipoprotein levels. RECENT FINDINGS Several groups have reported that exposure to cannabis does not increase weight despite the marked increase in caloric intake. In observational studies, the effect of smoked cannabis exposure on plasma lipids is variable. Some studies in specific patient populations with longer exposure to cannabis seemed to identify slightly more favorable lipoprotein profiles in the exposed group. Several larger controlled clinical trials using orally administered rimonabant, a CB1 receptor antagonist, have consistently shown relative improvements in weight and plasma levels of triglyceride and high-density lipoprotein cholesterol among patients receiving the treatment. SUMMARY The widely variable findings on the relationship of cannabis in various forms with plasma lipids preclude any definitive conclusions. Cannabis has complex effects on the cardiovascular system and its effects on lipid profile must be considered in this overall context. Further properly controlled research is required to better understand this topic.
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Hydration status affects thirst and salt preference but not energy intake or postprandial ghrelin in healthy adults: A randomised crossover trial.
Carroll, HA, Templeman, I, Chen, YC, Edinburgh, R, Burch, EK, Jewitt, JT, Povey, G, Robinson, TD, Dooley, WL, Buckley, C, et al
Physiology & behavior. 2019;:112725
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Abstract
BACKGROUND Few studies have investigated the effect of hydration status on appetite for food in healthy adults. Prior work suggests hydration status does not alter appetite or energy intake, with mixed findings regarding appetite hormone secretion. However, an extensive investigation into both the psychological and physiological appetitive responses to hydration status has never been conducted. OBJECTIVE To investigate the effect of hydration status on multiple facets of appetite. DESIGN After 3 days pre-trial standardization, a range of appetite tasks were conducted when hypohydrated (HYPO) and euhydrated (EUHY) in 16 healthy participants (8 men). Hydration status was manipulated via dehydration in a heat tent for 60 min and subsequent fluid restriction (HYPO) or replacement (EUHY). The next day, a food reward computer task was completed followed by an ad libitum pasta meal. Pre- and post-prandial visual analogue scales assessing hunger, fullness, and flavour desires (sweet, salty, savoury and fatty) were additionally completed. Blood samples were taken the previous day before the hydration interventions in a euhydrated state, and in the fasted and post-prandial state during HYPO and EUHY. RESULTS HYPO induced -1.9 ± 1.2% body mass change, compared to -0.2 ± 0.6% , with accompanying changes in markers of hypohydration which were not seen during EUHY. A higher desire for foods was associated with a higher water content but the association was weaker in EUHY compared to HYPO, (β= -0.33 mm/g of food water content, p < 0.001) in the food reward task. Visual analogue scales showed similar hunger and fullness between interventions, but during HYPO there was consistently higher thirst (average range in difference 27-32 mm across all time points) and lower fasted desire for salt (-23, 95% CI -10, -35 mm). Ad libitum energy intake (HYPO 1953 ± 742 kJ, EUHY 2027 ± 926 kJ; p = 0.542) and post-prandial ghrelin concentrations (HYPO 180 ± 65 pg mL-1, EUHY 188 ± 71 pg mL-1; p = 0.736) were similar by hydration status. CONCLUSIONS An acute manipulation to hydration status altered desire for salt and foods of differing water contents, but did not influence energy intake at an ad libitum pasta meal. Further research should investigate whether these appetites would alter food choice.
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Timing of high-intensity intermittent exercise affects ad libitum energy intake in overweight inactive men.
Panissa, VLG, Julio, UF, St-Pierre, DH, Tavares da Silva Gomes, A, Caldeira, RS, Lira, FS, Takito, MY, Franchini, E
Appetite. 2019;:104443
Abstract
The present study sought to clarify the impact of exercise intensity and timing on energy intake and appetite-related blood variables. Fourteen inactive overweight men were included in the study. Firstly, maximal aerobic power (MAP) was measured. Then, participants randomly performed 5 experimental sessions consisting of 30 min of steady-state exercise (SSE) at 50% of MAP, high-intensity intermittent exercise (HIIE) with 30s repetitions at MAP and 30s of passive recovery or no exercise (CTRL). Sessions were performed 1h (SSE1h and HIIE1h) or 2.5h (SSE2.5h and HIIE2.5h) after the consumption of a standardized breakfast. An ad libitum buffet was offered 3.5h after the completion of the breakfast. Absolute energy intake (EI) and relative energy intake (REI) (relative energy intake = energy intake - energy expenditure from exercise) were measured. Appetite (hunger, fullness and desire for specific foods) scores and circulating concentration of insulin and IL-6 were determined at 1h, 1.75h, 2.5h and 3.25h after breakfast while lactate was measured post-exercise. EI was greater after the CTRL session compared to HIIE2.5h (5045.9 ± 1873.5 kJ vs. 3716.1 ± 1688.7 kJ). REI was greater for the CTRL session (5045.9 ± 1873.5 kJ) than HIIE1h (3386.5 ± 1660.1 kJ), HIIE2.5h (2508.5 ± 1709.3 kJ) and SSE2.5h (3426.6 ± 1788.0 kJ). Higher hunger scores were observed following the CRTL session with respect to those of HIIE2.5h. Insulin and IL-6 concentrations were greater after HIIE1h and SSE1h with respect to those obtained after HIIE2.5h, SSE2.5h and CTRL. Lactate concentrations were higher in HIIE1h and HIIE2.5h compared to those of SSE1h and SSE2.5h. These results show that HIIE performed 2.5h after a breakfast reduced appetite (hunger scores) and EI through mechanism that need to be characterized. This approach can be applied to individuals aiming to create an energetic deficit.
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Energy balance in obese, mechanically ventilated intensive care unit patients.
Vest, MT, Newell, E, Shapero, M, McGraw, P, Jurkovitz, C, Lennon, SL, Trabulsi, J
Nutrition (Burbank, Los Angeles County, Calif.). 2019;:48-53
Abstract
OBJECTIVES The aims of this study were, first, to compare the predicted (calculated) energy requirements based on standard equations with target energy requirement based on indirect calorimetry (IC) in critically ill, obese mechanically ventilated patients; and second, to compare actual energy intake to target energy requirements. METHODS We conducted a prospective cohort study of mechanically ventilated critically ill patients with body mass index ≥30.0 kg/m2 for whom enteral feeding was planned. Clinical and demographic data were prospectively collected. Resting energy expenditure was measured by open-circuit IC. American Society of Parenteral and Enteral Nutrition (APSPEN)/Society of Critical Care Medicine (SCCM) 2016 equations were used to determine predicted (calculated) energy requirements. Target energy requirements were set at 65% to 70% of measured resting energy expenditure as recommended by ASPEN/SCCM. Nitrogen balance was determined via simultaneous measurement of 24-h urinary nitrogen concentration and protein intake. RESULTS Twenty-five patients (mean age: 64.5 ± 11.8 y, mean body mass index: 35.2 ± 3.6 kg/m2) underwent IC. The mean predicted energy requirement was 1227 kcal/d compared with mean measured target energy requirement of 1691 kcal/d. Predicted (calculated) energy requirements derived from ASPEN/SCCM equations were less than the target energy requirements in most cases. Actual energy intake from enteral nutrition met 57% of target energy requirements. Protein intake met 25% of target protein requirement and the mean nitrogen balance was -2.3 ± 5.1 g/d. CONCLUSIONS Predictive equations underestimated target energy needs in this population. Further, we found that feeding to goal was often delayed resulting in failure to meet both protein and energy intake goals.
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Appetite Regulations After Sprint Exercise Under Hypoxic Condition in Female Athletes.
Kojima, C, Kasai, N, Ishibashi, A, Murakami, Y, Ebi, K, Goto, K
Journal of strength and conditioning research. 2019;(7):1773-1780
Abstract
Kojima, C, Kasai, N, Ishibashi, A, Murakami, Y, Ebi, K, and Goto, K. Appetite regulations after sprint exercise under hypoxic condition in female athletes. J Strength Cond Res 33(7): 1773-1780, 2019-The present study determined changes in appetite-regulating hormones and energy intake after high-intensity interval exercise (HIIT) under hypoxic conditions (HYP) in trained female athletes. Fifteen female athletes completed 3 trials on different days of either HIIT under HYP, HIIT under normoxic conditions (NOR), or rest in normoxia (CON). Exercise trials consisted of 2 successive sets of 8 repeated bouts of a 6-second maximal sprint separated by a 30-second rest. Blood samples were obtained to measure plasma acylated ghrelin, glucagon-like peptide-1 (GLP-1), and metabolite concentrations. Energy intake during an ad libitum buffet meal test was evaluated 30 minutes after exercise or rest. Plasma acylated ghrelin concentrations decreased significantly after exercise (p ≤ 0.001), but no difference was observed between the HYP and NOR. Plasma GLP-1 concentrations did not differ after exercise, with no difference between the HYP and NOR. Although absolute energy intake in the HYP (634 ± 67 kcal) and NOR (597 ± 63 kcal) was significantly lower than that in the CON (756 ± 63 kcal, p = 0.006), no difference was observed between the HYP and NOR. These results show that HIIT under hypoxic and NOR lowered plasma acylated ghrelin concentrations and energy intake.
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Structured, aerobic exercise reduces fat mass and is partially compensated through energy intake but not energy expenditure in women.
Myers, A, Dalton, M, Gibbons, C, Finlayson, G, Blundell, J
Physiology & behavior. 2019;:56-65
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BACKGROUND Exercise-induced weight loss is often less than expected and highly variable in men and women. Behavioural compensation for the exercise-induced energy deficit could be through energy intake (EI), non-exercise physical activity (NEPA) or sedentary behaviour (SB). We investigated this issue in women. METHODS Twenty-four overweight [body mass index (BMI) M = 27.9 kg/m2, SD = 2.7] women [age M = 33.1 years, SD = 11.7] completed 12-weeks of supervised exercise (5×500kcal per week) in a non-randomised, pre-post intervention study. Body mass (BM), waist circumference (WC), body composition, resting metabolic rate (RMR), total daily EI, individual meals, appetite sensations and appetite-related peptides were measured at baseline (week 0) and post-intervention (week 12). Free-living physical activity (PA) and SB were measured (SenseWear) at baseline, week 1 and 10 of the exercise intervention, and at post-intervention (week 13). RESULTS Following the 12-week exercise intervention BM [p = .04], BMI [p = .035], WC [p < .001] and fat mass (FM) [p = .003] were significantly reduced, and fat-free mass (FFM) significantly increased [p = .003]. Total [p = .028], ad libitum [p = .03] and snack box EI [p = .048] were significantly increased and this was accompanied by an increase in hunger [p = .01] and a decrease in fullness [p = .03] before meals. The peptides did not explain changes in appetite [p > .05]. There was no compensatory reduction in NEPA [p > .05] and no increase in SB, rather there was a decrease in SB during the exercise intervention [p = .03]. CONCLUSIONS Twelve-weeks of supervised aerobic exercise resulted in a significant reduction in FM and an increase in FFM. Exercise increased hunger and EI which only partially compensated for the increase in energy expenditure. There was no evidence for a compensatory reduction in NEPA or an increase in SB. Dietary intervention, as an adjunct to exercise, may offset the compensatory increase in EI and result in a greater reduction in BM. TRIAL REGISTRATION Our trial was retrospectively registered on the International Standard Randomised Controlled Trials Registry (ISRCTN78021668, 27th September 2016) and can be found here: https://doi.org/10.1186/ISRCTN78021668.
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Validation of energy intake recorded by a 7-day pre-coded food diary against measured energy expenditure in a group of Norwegian adults.
Johansen, AMW, Myhre, JB, Hjartåker, A, Andersen, LF
PloS one. 2019;(4):e0215638
Abstract
The aim of this study was to validate energy intake (EI) reported by a pre-coded food diary (PFD) against energy expenditure (EE) measured by the ActiReg system consisting of an activity and position monitor and a calculation program (ActiCalc). Dietary intake was recorded by the PFD and EE was measured by the ActiReg system over a 7-day period. One hundred and twenty adult participants completed the study, 42 men and 78 women. The average group EI was 17% lower compared to measured EE. The 95% limits of agreement were 6.7 and -2.9 MJ/day. Of all participants, 68% were classified as acceptable reporters, 29% as underreporters and only 3% as overreporters. Fifty percent of the men and 30% of the women were classified into the same quartile for EI and EE, whereas 5% of both men and women were ranked in the opposite quartile by the two methods (weighted kappa coefficient = 0.29). Pearson correlation coefficient between reported EI and measured EE was 0.49 (p<0.001). High BMI was related to larger underreporting when EE was low. Furthermore, this study found that PFD underestimates EI on the group level with an average of 17% and showed large variation in the validity of the PFD on the individual level.
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Homeostatic and neurocognitive control of energy intake in response to exercise in pediatric obesity: a psychobiological framework.
Thivel, D, Finlayson, G, Blundell, JE
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2019;(2):316-324
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While energy intake and energy expenditure have long been studied independently, the alarming progression of obesity has led to a more integrative approach to energy balance considering their potential interactions. Although the available literature concerned with the effect of chronic and acute exercise on energy intake and appetite control in adults is considerable, these questions remain less explored among children and adolescents. Based on the search of four databases (Medline, Embase, PsycINFO and Cochrane Library; articles published until May 2018), the objective of this review is to summarize and discuss the effect of acute and chronic physical exercise on energy intake and appetite control in children and adolescents with obesity, and to identify the physiological and neurocognitive signals and pathways involved. Evidence suggested that acute intensive exercise has the potential to reduce subsequent energy intake in children and adolescents with obesity but not healthy weight, through both peripheral (mainly gastro-peptides) and neurocognitive (neural responses to food cues) pathways. The nutritional responses to chronic physical activity remain less clear and require further consideration, especially from an anti-obesity perspective.
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Effects of a Multi-Ingredient Energy Supplement on Cognitive Performance and Cerebral-Cortical Activation.
Daou, M, Sassi, JM, Miller, MW, Gonzalez, AM
Journal of dietary supplements. 2019;(2):129-140
Abstract
This study assessed whether a multi-ingredient energy supplement (MIES) could enhance cerebral-cortical activation and cognitive performance during an attention-switching task. Cerebral-cortical activation was recorded in 24 young adults (12 males, 12 females; 22.8 ± 3.8 yrs) via electroencephalography (EEG) both at rest and during the attention-switching task before (pretest) and 30 min after (posttest) consumption of a single serving of a MIES (MIES-1), two servings of a MIES (MIES-2), or a placebo (PL) in a double-blinded, randomized crossover experimental design. EEG upper-alpha power was assessed at rest and during the task, wherein d' (Z[hit rate]-Z[false alarm rate]) and median reaction time (RT) for correct responses to targets on attention-hold and attention-switch trials were analyzed. For both d' and RT, the Session (MIES-1, MIES-2, PL) × Time (pretest, posttest) interaction approached statistical significance (p = .07, η2p = 0.106). Exploring these interactions with linear contrasts, a significant linear effect of supplement dose on the linear effect of time was observed (ps ≤.034), suggesting the pretest-to-posttest improvement in sensitivity to task target stimuli (d') and RT increased as a function of supplement dose. With respect to upper-alpha power, the Session × Time interaction was significant (p < .001, η2p = 0.422). Exploring this interaction with linear contrasts, a significant linear effect of supplement dose on the linear effect of time was observed (p < .001), suggesting pretest-to-posttest increases in cerebral-cortical activation were a function of supplement dose. In conclusion, our findings suggest that MIES can increase cerebral-cortical activation and RT during task performance while increasing sensitivity to target stimuli in a dose-dependent manner.