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Statistical Approaches for the Analysis of Combined Health-Related Factors in Association with Adult Cognitive Outcomes: A Scoping Review.
Dingle, SE, Bujtor, MS, Milte, CM, Bowe, SJ, Daly, RM, Torres, SJ
Journal of Alzheimer's disease : JAD. 2023;(4):1147-1171
Abstract
BACKGROUND Dementia prevention is a global health priority, and there is emerging evidence to support associations between individual modifiable health behaviors and cognitive function and dementia risk. However, a key property of these behaviors is they often co-occur or cluster, highlighting the importance of examining them in combination. OBJECTIVE To identify and characterize the statistical approaches used to aggregate multiple health-related behaviors/modifiable risk factors and assess associations with cognitive outcomes in adults. METHODS Eight electronic databases were searched to identify observational studies exploring the association between two or more aggregated health-related behaviors and cognitive outcomes in adults. RESULTS Sixty-two articles were included in this review. Fifty articles employed co-occurrence approaches alone to aggregate health behaviors/other modifiable risk factors, eight studies used solely clustering-based approaches, and four studies used a combination of both. Co-occurrence methods include additive index-based approaches and presenting specific health combinations, and whilst simple to construct and interpret, do not consider the underlying associations between co-occurring behaviors/risk factors. Clustering-based approaches do focus on underlying associations, and further work in this area may aid in identifying at-risk subgroups and understanding specific combinations of health-related behaviors/risk factors of particular importance in the scope of cognitive function and neurocognitive decline. CONCLUSION A co-occurrence approach to aggregating health-related behaviors/risk factors and exploring associations with adult cognitive outcomes has been the predominant statistical approach used to date, with a lack of research employing more advanced statistical methods to explore clustering-based approaches.
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Diet-Induced Weight Loss Has No Effect on Psychological Stress in Overweight and Obese Adults: A Meta-Analysis of Randomized Controlled Trials.
Booth, AO, Wang, X, Turner, AI, Nowson, CA, Torres, SJ
Nutrients. 2018;(5)
Abstract
The effect of weight loss on psychological stress is unknown. The study aimed to investigate the effect of diet-induced weight loss in overweight and obese adults on psychological measures of stress through a meta-analysis of randomized controlled trials (RCTs). Databases including Medline Complete, Embase and PsycINFO were searched up to February 2018 for diet-induced weight loss RCTs, which included self-reported assessment of psychological stress. The mean difference between the intervention and control group of changes in stress (intervention-baseline) was used. Ten RCTs were included with 615 participants (502 women, age range 20⁻80 years). Overall, there was no change in stress (mean difference -0.06, 95% CI: -0.17, 0.06, p = 0.33) and no change in the five studies with a significant reduction in weight in the intervention group compared to a control group that lost no weight (mean difference in weight -3.9 Kg, 95% CI: -5.51, -2.29, p < 0.0001; mean difference in stress 0.04, 95% CI: -0.17, 0.25, p = 0.71). For all analyses, there was low heterogeneity. The benefits of weight loss for those who are overweight and obese do not appear to either increase or reduce psychological stress at the end of the weight loss period.
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Does diet-induced weight change effect anxiety in overweight and obese adults?
Eyres, SL, Turner, AI, Nowson, CA, Torres, SJ
Nutrition (Burbank, Los Angeles County, Calif.). 2014;(1):10-5
Abstract
Anxiety is the most prevalent type of mental disorder and a significant health concern. Cross-sectional studies have detected a positive association between obesity and anxiety. What is less clear is whether weight loss can reduce anxiety. We sought to answer three questions: 1. Can weight loss improve symptoms of anxiety in the overweight and obese population? 2. Does the macronutrient content of energy-restricted diets that induce weight loss affect anxiety? 3. Is the change in anxiety related to the amount of weight lost? We investigated the findings from seven interventional studies, which induced weight loss by dietary intervention, in overweight and obese individuals, using established anxiety assessment tools. Mean weight loss ranged from 0.7 to 18.6 kg (SD 4.5) and in three of the studies, anxiety fell by 9.2% to 11.4% and did not change in four studies. When macronutrient content was considered, only one of four interventional studies and one pilot study reported a beneficial effect of a moderate-fat diet on anxiety. There appears to be no strong evidence to indicate that diet-induced weight loss has a beneficial effect on anxiety, however, none of the diet-induced weight loss studies assessed had a detrimental effect on anxiety.
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Does personality affect dietary intake?
Lunn, TE, Nowson, CA, Worsley, A, Torres, SJ
Nutrition (Burbank, Los Angeles County, Calif.). 2014;(4):403-9
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Abstract
The purpose of this review is to evaluate the evidence for an association between the Big Five dimensions of personality, dietary intake, and compliance to dietary recommendations. Poor diet is a known risk factor for overweight and obesity and associated chronic lifestyle diseases and it has been proposed that personality may be linked to dietary choices. Findings from cross-sectional surveys from different countries and cultures show a positive association between Openness and consumption of fruits and vegetables and between Conscientiousness and healthy eating. Although no evidence has been found that personality dimensions are associated with adherence to dietary recommendations over time, Conscientiousness is associated with a number of prosocial and health-promoting behaviors that include avoiding alcohol-related harm, binge-drinking, and smoking, and adherence to medication regimens. With emerging evidence of an association between higher Conscientiousness and lower obesity risk, the hypothesis that higher Conscientiousness may predict adoption of healthy dietary and other lifestyle recommendations appears to be supported.