Obesity represents a major health problem in the United States and is associated with increased prevalence of cardiovascular (CV) disease risk factors. Physical activity (PA) and exercise training ...(ET) are associated with reduced CV risk, improved cardiometabolic risk factors, and facilitated weight loss through creating a negative energy balance. Clinicians need to counsel overweight and obese patients on how much PA/ET is needed to promote weight loss and weight loss maintenance. This will help establish realistic expectations and maximize improvements in CV risk factors. Although the minimum guidelines for aerobic PA (150 min of moderate or 75 min of vigorous physical activity per week) can improve CV health, these levels are generally inadequate for clinically significant weight loss or weight maintenance without caloric restriction. The purpose of this review is to evaluate the role of ET to promote clinically significant weight loss and promote weight maintenance. In particular, we will evaluate the likelihood of weight loss from ET programs composed of aerobic training only, resistance training only and programs that combine diet and ET. We will also explore the role of PA in promoting short-term and long-term weight maintenance.
The Scored Patient-Generated Subjective Global Assessment (PG-SGA) is used internationally as the reference method for proactive risk assessment (screening), assessment, monitoring and triaging for ...interventions in patients with cancer. This review aims to explain the rationale behind and data supporting the PG-SGA, and to provide an overview of recent developments in the utilization of the PG-SGA and the PG-SGA Short Form.
The PG-SGA was designed in the context of a paradigm known as 'anabolic competence'. Uniquely, the PG-SGA evaluates the patient's status as a dynamic rather than static process. The PG-SGA has received new attention, particularly as a screening instrument for nutritional risk or deficit, identifying treatable impediments and guiding patients and professionals in triaging for interdisciplinary interventions. The international use of the PG-SGA indicates a critical need for high-quality and linguistically validated translations of the PG-SGA.
As a 4-in-1 instrument, the PG-SGA can streamline clinic work flow and improve the quality of interaction between the clinician and the patient. The availability of multiple high-quality language versions of the PG-SGA enables the inclusion of the PG-SGA in international multicenter studies, facilitating meta-analysis and benchmarking across countries.
Objectives
To determine whether lifestyle factors, measured late in life, could compress the disabled period toward the end of life.
Design
Community‐based cohort study of older adults followed from ...1989 to 2015.
Setting
Four U.S. communities.
Participants
Community‐living men and women aged 65 and older (N = 5,248, mean age 72.7 ± 5.5, 57% female, 15.2% minority) who were not wheelchair dependent and were able to give informed consent at baseline.
Measurements
Multiple lifestyle factors, including smoking, alcohol consumption, physical activity, diet, body mass index (BMI), social networks, and social support, were measured at baseline. Activities of daily living (ADLs) were assessed at baseline and throughout follow‐up. Years of life (YoL) was defined as years until death. Years of able life (YAL) was defined as years without any ADL difficulty. YAL/YoL%, the proportion of life lived able, was used to indicate the relative compression or expansion of the disabled period.
Results
The average duration of disabled years was 4.5 (out of 15.4 mean YoL) for women and 2.9 (out of 12.4 mean YoL) for men. In a multivariable model, obesity was associated with 7.3 percentage points (95% confidence interval (CI) = 5.4–9.2) lower YAL/YoL% than normal weight. Scores in the lowest quintile of the Alternate Healthy Eating Index were associated with a 3.7% (95% CI = 1.6–5.9) lower YAL/YoL% than scores in the highest quintile. Every 25 blocks walked in a week was associated with 0.5 percentage points (95% CI = 0.3–0.8) higher YAL/YoL%.
Conclusion
The effects of healthy lifestyle factors on the proportion of future life lived free of disability indicate that the disabled period can be compressed, given the right combination of these factors.
Summary Background & Aims The only available treatment for Celiac Disease (CD) is lifelong adherence to gluten free (GF)-diet. However, GF-diet may lead to possible nutrient unbalance resulting in ...improper nutritional quality of diet. The aim of this study is to evaluate the nutritional quality of GF-diet. Methods MEDLINE®/PubMed and Cochrane Library were electronically searched for articles published between 1990/01/01 and 2015/09/01. Results GF-diet was found to be poor in alimentary fiber due in particular to the necessary avoidance of several kind of foods naturally rich in fiber (i.e. grain) and the low content of fiber of GF product that are usually made with starches and/or refined flours. Micronutrients are also found to be poor, in particular Vit.D, Vit. B12 and folate, in addition to some minerals such as Iron, Zinc, Magnesium and Calcium. Moreover, an inadequate macronutrient intake was reported related above all to the focus on the avoidance of gluten that often leaving back the importance of nutritional quality of the choice. In particular, it was found an higher content of both saturated and hydrogenated fatty acids and an increase in the glycemic index and glycemic load of the meal. Conclusions Despite the GF-diet is necessary in celiac disease treatment and the attention is on gluten avoidance, the evaluation of nutritional quality of the diet must be considered. Moreover, educational strategies based on the relationship between nutrients & food and human health could be developed to optimize the therapeutic approach in celiac patients.
This systematic review aims to explain the heterogeneity in results of interventions to promote physical activity and healthy eating for overweight and obese adults, by exploring the differential ...effects of behaviour change techniques (BCTs) and other intervention characteristics.
The inclusion criteria specified RCTs with ≥ 12 weeks' duration, from January 2007 to October 2014, for adults (mean age ≥ 40 years, mean BMI ≥ 30). Primary outcomes were measures of healthy diet or physical activity. Two reviewers rated study quality, coded the BCTs, and collected outcome results at short (≤6 months) and long term (≥12 months). Meta-analyses and meta-regressions were used to estimate effect sizes (ES), heterogeneity indices (I
) and regression coefficients.
We included 48 studies containing a total of 82 outcome reports. The 32 long term reports had an overall ES = 0.24 with 95% confidence interval (CI): 0.15 to 0.33 and I
= 59.4%. The 50 short term reports had an ES = 0.37 with 95% CI: 0.26 to 0.48, and I
= 71.3%. The number of BCTs unique to the intervention group, and the BCTs goal setting and self-monitoring of behaviour predicted the effect at short and long term. The total number of BCTs in both intervention arms and using the BCTs goal setting of outcome, feedback on outcome of behaviour, implementing graded tasks, and adding objects to the environment, e.g. using a step counter, significantly predicted the effect at long term. Setting a goal for change; and the presence of reporting bias independently explained 58.8% of inter-study variation at short term. Autonomy supportive and person-centred methods as in Motivational Interviewing, the BCTs goal setting of behaviour, and receiving feedback on the outcome of behaviour, explained all of the between study variations in effects at long term.
There are similarities, but also differences in effective BCTs promoting change in healthy eating and physical activity and BCTs supporting maintenance of change. The results support the use of goal setting and self-monitoring of behaviour when counselling overweight and obese adults. Several other BCTs as well as the use of a person-centred and autonomy supportive counselling approach seem important in order to maintain behaviour over time.
PROSPERO CRD42015020624.
This paper provides an analysis of the role of prices in determining food purchases and nutrition using very detailed transaction-level observations for a large, nationally-representative sample of ...US consumers over the period 2002–2007. Using product-specific nutritional information, we develop a new method of partitioning the product space into relevant nutritional clusters that define a set of nutritionally-bundled goods, which parsimoniously characterize consumer choice sets. We then estimate a large utility-derived demand system over this joint product-nutrient space that allows us to calculate price and expenditure elasticities. Using our structural demand estimates, we simulate the role of product taxes on soda, sugar-sweetened beverages, packaged meals, and snacks, and nutrient taxes on fat, salt, and sugar. We find that a 20% nutrient tax has a significantly larger impact on nutrition than an equivalent product tax, due to the fact that these are broader-based taxes. However, the costs of these taxes in terms of consumer utility are only about 70 cents per household per day. A sugar tax in particular is a powerful tool to induce healthier nutritive bundles among consumers.
The dietary flavonoids, especially their glycosides, are the most vital phytochemicals in diets and are of great general interest due to their diverse bioactivity. Almost all natural flavonoids exist ...as their O-glycoside or C-glycoside forms in plants. The dietary flavonoid C-glycosides have received less attention than their corresponding O-glycosides. This review summarizes current knowledge regarding flavonoid C-glycosides and their influence on human health. Among the flavonoid C-glycosides, flavone C-glycosides, especially vitexin, isoorientin, orientin, isovitexin and their multiglycosides are more frequently mentioned than others. Flavonoid C-monoglycosides are poorly absorbed in human beings with very few metabolites in urine and blood and are deglycosylated and degraded by human intestinal bacteria in colon. However, flavonoid C-multiglycosides are absorbed unchanged in the intestine and distributed to other tissues. Flavonoid C-glycosides showed significant antioxidant activity, anticancer and antitumor activity, hepatoprotective activity, anti-inflammatory activity, anti-diabetes activity, antiviral activity, antibacterial and antifungal activity, and other biological effects. It looks like that the C-glycosylflavonoids in most cases showed higher antioxidant and anti-diabetes potential than their corresponding O-glycosylflavonoids and aglycones. However, there is a lack of in vivo data on the biological benefits of flavonoid C-glycosides. It is necessary to investigate more on how flavonoid C-glycosides prevent and handle the diseases.
Oxidative Balance Scores (OBSs) are tools that have emerged to evaluate the global balance of individuals' oxidation-reduction status. The aim was to compare OBSs available in the literature ...regarding their characteristics and associations with chronic diseases in epidemiological studies. Studies that developed OBSs were searched in PubMed until August 2018. A total of 21 OBSs were identified. These OBSs presented different scoring schemes and different types of anti- and pro-oxidant components, including dietary factors (dietary intake and/or nutrient biomarkers), lifestyle factors, and medications. Most OBSs were based on over 10 components, and some included only dietary factors. Few considered weighted components in the score. Only three OBSs were validated as potential surrogates of oxidative balance through inflammation and OS-related biomarkers. Notably, all the OBSs were associated-to a varying degree-with a reduced risk of cardiovascular diseases, chronic kidney disease, colorectal adenomas, and different cancer types (colorectal and breast cancer), as well as with all-cause and cancer-related mortality. For other outcomes, e.g., prostate cancer, contradictory results were reported. In summary, there is a great heterogeneity in the definition of OBSs. Most studies are concordant in supporting that excessive OS reflected by a lower OBS has deleterious effects on health. Unified criteria for defining the proper OBSs, valuable to gauge OS-related aspects of the diet and lifestyle that may lead to adverse health outcomes, are needed.
To assess Mediterranean diet (MD) adherence and food insecurity (FI) among university students in Greece.
A non-probability sample of 236 students was recruited from Athens and Thessaloniki during ...2016. FI was assessed with the Household Food Insecurity Access Scale and MD adherence with the MEDAS questionnaire. Mean MEDAS score of the sample was 6.4 ± 1.9, with women demonstrating greater MD adherence compared to men (p = 0.016) and Dietetics students exhibiting increased score compared to the rest (p ≤ 0.001). A low proportion of participants were food-secure (17.8%), 45.3% were severely food-insecure, 22.0% experienced moderate FI and the remaining 14.8% had low FI. Participants studying in the city they grew up exhibited lower FI compared to those studying in other cities (p = 0.009), while, additionally, a trend was noted for increased FI among students with an unemployed family member (p = 0.05). Students working night shifts had lower MD adherence and increased FI compared to the rest (p = 0.004 and p = 0.003, respectively). The same pattern was observed among participants who smoked (p = 0.003 for MD adherence and p = 0.009 for FI, respectively). Multivariate regression analyses did not reveal any connections between FI categories, waist circumference or BMI, but showed an inverse relationship between severe FI and MD adherence.
The majority of the surveyed university students from Greece demonstrate some degree of FI, with a great proportion being severely food-insecure. Increased FI is inversely associated with MD adherence.
•Low MD adherence is observed among Greek university students.•The majority of the university students surveyed demonstrate some form of food insecurity.•Food insecurity and MD adherence are negatively correlated.
Advanced glycosylation end products (AGEs) and N-nitrosamines (NAs) are common hazards in the processing of meat products. AGEs are produced by Maillard reaction and fat oxidation during processing ...and storage, whereas NAs are produced by nitrosation after the addition of nitrite during meat processing. They may have some relevance to human diseases, such as diabetes and cancer. Literature revealed that the contents of fat and protein in meat products and processing methods have a remarkable influence on the formation of AGEs and NAs. These two hazardous substances can be detected in a variety of meat products, and adding antioxidants can effectively inhibit the production of AGEs and NAs. This paper reviews the formation mechanism, influencing factors, detection methods, and inhibition methods of AGEs and NAs in meat products and discusses their exposure values in meat products to provide reference for people's healthy diet and understand and control the levels of AGEs and NAs in meat products.
•Food components, processing and preservation methods are strongly correlated with the formation of AGEs and NAs in foods.•AGEs and NAs have formation pathways and various detection methods.•Antioxidant substances such as polyphenols can inhibit the formation of AGEs and NAs.•AGEs and NAs are exposed to different levels and there is a correlation between the production of both.
PDF
