Changes In Fat Intake Research Articles

The dietary changes during Ramadan and their impact on anthropometry, blood pressure, and metabolic profile.

The effect of Ramadan intermittent fasting (RIF) on the metabolic profile, anthropometry and blood pressure has been investigated in multiple studies. However, it is still unknown to what extent changes in nutrient intakes contribute to these changes. This observational study was conducted in London (UK) in 2019. The study collected diverse data from a community-based sample in London before and during/after Ramadan. Collected data included a 3-day food diary (before and during Ramadan), as well as blood samples, anthropometric measurements and blood pressure (before and after Ramadan). The food diary was translated into nutritional data using nutrition software "Nutritics." The changes in nutrient intakes were investigated using a mixed-effects regression model. The impact of adjusting for nutrient intake change was investigated on the absolute difference of metabolites (Nightingale platform), systolic/diastolic blood pressure and anthropometric measures. The study collected data on food intake before and during Ramadan from 56 participants; the mean age was 44.7 ± 17.3, and 51.8% (n = 29) were females. We found a change in the intake of 11 nutritional factors, glucose, fructose, betaine, sugars, sugars as monosaccharide equivalents, lutein/zeaxanthin, starch, starch as monosaccharide equivalents, proline, glutamic acid and lycopene. No changes in quantities or proportions of macronutrients, carbohydrates, protein and fat. Mainly, the changes in diet during Ramadan are characterized by more consumption of sugars (62%, p < 0.001) and a lower intake of starch (-21%, p = 0.012). The changes in 14 metabolite levels (two glycolysis-related metabolites, one amino acid, two ketone bodies, two triglyceride, six lipoprotein subclasses, and an inflammation marker) after Ramadan were partially associated with some changes in nutrient intakes during Ramadan, especially betaine, fructose, glucose, starches and sugars. The lutein/zeaxanthin intake change explained inversely 14% of systolic blood pressure changes. Moreover, BMI and weight changes were partially explained by changes in intake of fat (7%; 9%), monounsaturated fat (6%; 7%), starch (8%; 9%), and starch as monosaccharide equivalents (8%; 9%) intakes in a direct relationship. Diet changes during Ramadan were associated partially with the observed changes in the metabolic profile, blood pressure and anthropometry. This confirms the changes associated with RIF in the metabolic profile, blood pressure and anthropometry are not an absolute physiological response to the diet transition occurring during Ramadan.

Dietary intake during a pragmatic cluster-randomized weight loss trial in an underserved population in primary care

BackgroundCurrently there are limited data as to whether dietary intake can be improved during pragmatic weight loss interventions in primary care in underserved individuals.MethodsPatients with obesity were recruited into the PROPEL trial, which randomized 18 clinics to either an intensive lifestyle intervention (ILI) or usual care (UC). At baseline and months 6, 12, and 24, fruit and vegetable (F/V) intake and fat intake was determined. Outcomes were analyzed by repeated-measures linear mixed-effects multilevel models and regression models, which included random cluster (clinic) effects. Secondary analyses examined the effects of race, sex, age, and food security status.ResultsA total of 803 patients were recruited. 84.4% were female, 67.2% African American, 26.1% received Medicaid, and 65.5% made less than $40,000. No differences in F/V intake were seen between the ILI and UC groups at months 6, 12, or 24. The ILI group reduced percent fat at months 6, 12, and 24 compared to UC. Change in F/V intake was negatively correlated with weight change at month 6 whereas change in fat intake was positively associated with weight change at months 6, 12, and 24 for the ILI group.ConclusionsThe pragmatic weight loss intervention in primary care did not increase F/V intake but did reduce fat intake in an underserved population with obesity. F/V intake was negatively associated with weight loss at month 6 whereas percent fat was positively correlated with weight loss throughout the intervention. Future efforts better targeting both increasing F/V intake and reducing fat intake may promote greater weight loss in similar populations.Trial registrationNCT Registration: NCT02561221

Examining the Effect of a 1-yr Lifestyle Intervention on Cardiometabolic and Inflammatory Biomarkers in Youth with Overweight or Obesity: A Pilot Study

ABSTRACT Physical activity and healthy eating are key to managing overweight/obesity but may not induce adequate improvements in biomarkers of health. Characterizing the effect of behavioral interventions on cardiometabolic and inflammatory biomarkers could help guide a personalized approach to lifestyle change; however, little is known about the relationship between lifestyle changes and biomarkers in youth with overweight/obesity. We sought to determine how cardiometabolic and inflammatory biomarkers change in metabolically healthy youth with overweight/obesity in response to a 1-yr-long physical activity and healthy eating lifestyle intervention. Fifty children (8.7 ± 1.1 yr, 52% male) provided complete data on physical activity, dietary intake, body composition, blood pressure, and fasting biomarkers (insulin, glucose, triglycerides, cholesterol, adiponectin, resistin, interleukin-6, and tumor necrosis factor α). A series of t-tests were conducted to assess change over time, with a series of ordinary least squares regressions conducted to examine the association between change in markers responsive to the intervention and changes in macronutrient intake and physical activity, controlling for sex and change in percent body fat. Significant health-enhancing changes were seen over 1 yr in moderate and vigorous physical activity, percent body fat, macronutrient intake, insulin, and inflammatory markers, whereas sedentary time and resistin increased and light physical activity decreased. When change in biomarkers was regressed on behavior changes and change in percent body fat, changes in carbohydrate intake and body fat predicted change in insulin, change in fat intake predicted change in adiponectin, and change in carbohydrate intake predicted interleukin-6 in fully adjusted models. A lifestyle intervention over 1 yr was effective in producing positive changes in moderate and vigorous physical activity, macronutrient intake, insulin, and inflammatory markers, but these changes were not associated with changes in physical activity. Macronutrient changes were modestly associated with changes in insulin, resistin, and interleukin-6.

The effect of TTM-based nutrition education on decisional balance, self-efficacy and processes of change for fat intake

PurposeThe purpose of this study is to determine how transtheoretical model (TTM) constructions change through nutrition education for fat intake modification among overweight and obese women living in Shazand city, Iran.Design/methodology/approachA semi-experimental design with intervention and control groups (50 women in each group) was performed. TTM constructions for dietary fat intake were measured through a questionnaire in four phases: before the intervention, immediately, one month and six months after the intervention. Participants in two groups were classified into inactive and active subgroups, based on their determined stage of change. Then in the intervention group, each subgroup received a separate education program of five or eight sessions for the active and inactive subgroups, respectively.FindingsThe intervention resulted in significant progress in participants' stage of change compared to the control group (p = 0.002). Also, it resulted in an increase in the self-efficacy and decisional balance scores in both of the intervention subgroups, with these effects being more pronounced in the inactive subgroup, and these significant differences, compared to the control group, remained in the third and fourth phases. The intervention also positively impacted the behavioral processes, but this effect was not so long-lasting and decreased after six months.Originality/valueThe results indicated the intervention effectiveness and the necessity of planning educational interventions to change fat consumption behavior. This study provides further insight into effective and sustainable nutrition education strategies based on behavioral change stages rather than traditional approaches. These methods should be used to design group interventions to change individuals' health behavior in future works.

Effectiveness of information technology-enabled 'SMART Eating' health promotion intervention: A cluster randomized controlled trial.

BackgroundUnhealthy dietary behaviour–high intake of fat, sugar, and salt, and low intake of fruits and vegetables–is a major risk factor for chronic diseases. There is a lack of evidence-based interventions to promote healthy dietary intake among Indian populations. Therefore, we tested the effectiveness of an information technology-enabled ‘SMART Eating’ intervention to reduce the intake of fat, sugar and salt, and to increase the intake of fruits and vegetables.MethodsIn Chandigarh, a North Indian city, a cluster randomized controlled trial was implemented in twelve geographical clusters, based on the type of housing (i.e., LIG: Low-income group; MIG; Middle-income group, and HIG: High-income group–a proxy for socio-economic status). Computer-generated randomization was used to allocate clusters to intervention and comparison arms after pairing on the basis of socioeconomic status and geographical distance between clusters. The sample size was 366 families per arm (N = 732). One adult per family was randomly selected as an index case to measure the change in the outcomes. For behaviour change, a multi-channel communication approach was used, which included information technology–short message service (SMS), email, social networking app and ‘SMART Eating’ website, and interpersonal communication along with distribution of a ‘SMART Eating’ kit—kitchen calendar, dining table mat, and measuring spoons. The intervention was implemented at the family level over a period of six months. The comparison group received pamphlets on nutrition education. Outcome measurements were made at 0 and 6 months post-intervention at the individual level. Primary outcomes were changes in mean dietary intakes of fat, sugar, salt, and fruit and vegetables. Secondary outcomes included changes in body mass index (BMI), blood pressure, haemoglobin, fasting plasma glucose (FPG), and serum lipids. Mixed-effects linear regression models were used to determine the net change in the outcomes in the intervention group relative to the comparison group.ResultsParticipants’ mean age was 53 years, a majority were women (76%), most were married (90%) and 51% had completed a college degree. All families had mobile phones, and more than 90% of these families had access to Internet through mobile phones. The intervention group had significant net mean changes of -12.5 g/day (p<0.001), -11.4 g/day (p<0.001), -0.5 g/day (p<0.001), and +71.6 g/day (p<0.001) in the intake of fat, sugar, salt, and fruit and vegetables, respectively. Similarly, significant net changes occurred for secondary outcomes: BMI -0.25 kg/m2, diastolic blood pressure -2.77 mm Hg, FPG -5.7 mg/dl, and triglycerides -24.2mg/dl. The intervention had no effect on haemoglobin, systolic blood pressure, low-density lipoprotein cholesterol, or high-density lipoprotein cholesterol.ConclusionThe IT-enabled ‘SMART Eating’ intervention was found to be effective in reducing fat, sugar, and salt intake, and increasing fruit and vegetable consumption among urban adults from diverse socio-economic backgrounds.Trial registrationClinical Trial Registry of India CTRI/2016/11/007457.

Fat Quantity and Quality, as Part of a Low-Fat, Vegan Diet, Are Associated with Changes in Body Composition, Insulin Resistance, and Insulin Secretion. A 16-Week Randomized Controlled Trial.

Macronutrient composition of the diet influences the development of obesity and insulin resistance. The aim of this study was to assess the role of dietary fat quantity and fatty acid composition in body composition, insulin resistance, and insulin secretion. An open parallel randomized trial design was used. Overweight participants (n = 75) were randomized to follow a low-fat vegan (n = 38) or control diet (n = 37) for 16 weeks. Dual X-ray absorptiometry was used to measure body composition. Insulin resistance was assessed with the Homeostasis Model Assessment (HOMA-IR) index. Insulin secretion was assessed after stimulation with a liquid breakfast (Boost Plus, Nestle, Vevey, Switzerland). Self-reported 3-day diet records were used to assess dietary intake. A linear regression model was used to test the relationship between fat intake and body composition, insulin resistance, and insulin secretion. Changes in fat intake expressed as percent of total energy consumed correlated positively with changes in fat mass (r = 0.52; p < 0.001; and 0.347; p = 0.006, respectively), even after adjustment for changes in body-mass index (BMI) and energy intake (0.33; p = 0.01). Decreased intakes of C18:0 (r = 0.37, p = 0.004) and CLA-trans-10-cis12 (r = 0.40, p = 0.002), but increased intake of C18:2 (r = −0.40, p = 0.002) and C18:3 (p = −0.36, p = 0.006), were associated with a decrease in HOMA-IR, independent on changes in BMI and energy intake. The main fatty acids associated with changes in fasting insulin secretion were C12:0 (r = −0.31, p = 0.03), and TRANS 16:1 (r = −0.33, p = 0.02), both independent on changes in BMI and energy intake. Our findings demonstrate that, in the context of a low-fat vegan diet, decreased intake of saturated and trans fats and increased relative content of polyunsaturated fatty acids, particularly linoleic and α-linolenic acids, are associated with decreased fat mass and insulin resistance, and enhanced insulin secretion.

GDF15 acts synergistically with liraglutide but is not necessary for the weight loss induced by bariatric surgery in mice

ObjectiveAnalogues of GDF15 (Growth Differentiation Factor 15) are promising new anti-obesity therapies as pharmacological treatment with GDF15 results in dramatic reductions of food intake and body weight. GDF15 exerts its central anorexic effects by binding to the GFRAL receptor exclusively expressed in the Area Postrema (AP) and the Nucleus of the Solitary Tract (NTS) of the hindbrain. We sought to determine if GDF15 is an indispensable factor for other interventions that cause weight loss and which are also known to act via these hindbrain regions. MethodsTo explore the role of GDF15 on food choice we performed macronutrient intake studies in mice treated pharmacologically with GDF15 and in mice having either GDF15 or GFRAL deleted. Next we performed vertical sleeve gastrectomy (VSG) surgeries in a cohort of diet-induced obese Gdf15-null and control mice. To explore the anatomical co-localization of neurons in the hindbrain responding to GLP-1 and/or GDF15 we used GLP-1R reporter mice treated with GDF15, as well as naïve mouse brain and human brain stained by ISH and IHC, respectively, for GLP-1R and GFRAL. Lastly we performed a series of food intake experiments where we treated mice with targeted genetic disruption of either Gdf15 or Gfral with liraglutide; Glp1r-null mice with GDF15; or combined liraglutide and GDF15 treatment in wild-type mice. ResultsWe found that GDF15 treatment significantly lowered the preference for fat intake in mice, whereas no changes in fat intake were observed after genetic deletion of Gdf15 or Gfral. In addition, deletion of Gdf15 did not alter the food intake or bodyweight after sleeve gastrectomy. Lack of GDF15 or GFRAL signaling did not alter the ability of the GLP-1R agonist liraglutide to reduce food intake. Similarly lack of GLP-1R signaling did not reduce GDF15's anorexic effect. Interestingly, there was a significant synergistic effect on weight loss when treating wild-type mice with both GDF15 and liraglutide. ConclusionThese data suggest that while GDF15 does not play a role in the potent effects of VSG in mice there seems to be a potential therapeutic benefit of activating GFRAL and GLP-1R systems simultaneously.

Protocol for a cluster randomised controlled trial on information technology-enabled nutrition intervention among urban adults in Chandigarh (India): SMART eating trial

ABSTRACTNutrition is an important determinant of health. At present, nutrition programs in India mainly emphasize improving maternal and child nutrition. Adult nutrition has not received due attention, though diseases like hypertension and diabetes are largely preventable through changes in dietary and physical activity behaviour. Little is known about the best approaches to improve dietary behaviours, especially the role of modern information technology (IT) in health education. We describe the protocol of the SMART Eating (Small, Measurable and Achievable dietary changes by Reducing fat, sugar and salt consumption and Trying different fruits and vegetables) health promotion intervention. A Cluster Randomised Controlled Trial will evaluate the effect of an IT-enabled intervention on nutrition behaviour among urban adults of Chandigarh, India. Formative research using a qualitative exploratory approach was undertaken to inform the intervention. The IT-enabled intervention programme includes website development, Short Message Service (SMS), e-mail reminders and interactive help by mobile and landline phones. The IT-enabled intervention will be compared to the traditional nutrition education program of distributing pamphlets in the control group. The primary outcome will be the percentage of study participants meeting the dietary intake guidelines of the National Institute of Nutrition, Hyderabad, India and the change in intake of fat, sugar, salt, fruit and vegetables after the intervention. The difference in differences method will be used to determine the net change in dietary intakes resulting from the interventions. Measurements will be made at baseline and at 6 months post-intervention, using a food frequency questionnaire. The formative research led to the development of a comprehensive intervention, focusing on five dietary components and using multi-channel communication approach including the use of IT to target urban North Indians from diverse socio-economic backgrounds. The Cluster Randomised Controlled Trial design is suitable for evaluating the effectiveness of this IT-enabled intervention for dietary behaviour change.

Lipid Metabolism and Survival Across the Frontotemporal Dementia-Amyotrophic Lateral Sclerosis Spectrum: Relationships to Eating Behavior and Cognition

Patients with frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) exhibit changes in eating behavior that could potentially affect lipid levels. This study aimed to document changes in lipid metabolism across the ALS-FTD spectrum to identify potential relationships to eating behavior (including fat intake), cognitive change, body mass index (BMI), and effect on survival. One hundred and twenty-eight participants were recruited: 37 ALS patients, 15 ALS patients with cognitive and behavioral change (ALS-Plus), 13 ALS-FTD, 31 behavioral variant FTD, and 32 healthy controls. Fasting total cholesterol, low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL) and triglyceride levels were measured and correlated to eating behavior (caloric, fat intake), cognitive change, and BMI; effect on survival was examined using cox regression analyses. There was a spectrum of lipid changes from ALS to FTD with increased triglyceride (p < 0.001), total cholesterol/HDL ratio (p < 0.001), and lower HDL levels (p = 0.001) in all patient groups compared to controls. While there was no increase in total cholesterol levels, a higher cholesterol level was found to correlate with 3.25 times improved survival (p = 0.008). Triglyceride and HDL cholesterol levels correlated to fat intake, BMI, and measures of cognition and disease duration. A spectrum of changes in lipid metabolism has been identified in ALS-FTD, with total cholesterol levels found to potentially impact on survival. These changes were mediated by changes in fat intake, and BMI, and may also be mediated by the neurodegenerative process, offering the potential to modify these factors to slow disease progression and improve survival.

Determinants of lifestyle behavior change to prevent type 2 diabetes in high-risk individuals

BackgroundAlthough there are many effective lifestyle interventions for type 2 diabetes (T2DM) prevention, insight into effective intervention pathways, especially of long-term interventions, is often lacking. This study aims to provide insight into the effective intervention pathways of the SLIMMER diabetes prevention intervention using mediation analyses.MethodsIn total, 240 participants at increased risk of T2DM were included in the analyses over 18 months. The intervention was a combined lifestyle intervention with a dietary and a physical activity (PA) component. The primary and secondary outcomes were change in fasting insulin (pmol/L) and change in body weight (kg) after 18 months, respectively. Firstly, in a multiple mediator model, we investigated whether significant changes in these outcomes were mediated by changes in dietary and PA behavior. Secondly, in multiple single mediator models, we investigated whether changes in dietary and PA behavior were mediated by changes in behavioral determinants and the participants’ psychological profile. The mediation analyses used linear regression models, where significance of indirect effects was calculated with bootstrapping.ResultsThe effect of the intervention on decreased fasting insulin was 40% mediated by change in dietary and PA behavior, where dietary behavior was an independent mediator of the association (34%). The effect of the intervention on decreased body weight was 20% mediated by change in dietary and PA behavior, where PA behavior was an independent mediator (17%). The intervention significantly changed intake of fruit, fat from bread spread, and fiber from bread. Change in fruit intake was mediated by change in action control (combination of consciousness, self-control, and effort), motivation, self-efficacy, intention, and skills. Change in fat intake was mediated by change in action control and psychological profile. No mediators could be identified for change in fiber intake. The change in PA behavior was mediated by change in action control, motivation, and psychological profile.ConclusionThe effect of the SLIMMER intervention on fasting insulin and body weight was mediated by changes in dietary and PA behavior, in distinct ways. These results indicate that changing dietary as well as PA behavior is important in T2DM prevention.

癌と脂質栄養

Cancer is a major cause of mortality worldwide, and epidemiological studies have shown the influence of lifestyle -related factors, mainly nutritional factors, on its development. Compared with Western countries, Japan has had a low incidence of nutritionally related cancer, e.g., colon, breast, and prostate cancer, and a high incidence of gastric cancer. However, the dietary habits and lifestyle of Japanese have changed markedly, and the incidence of nutritionally related cancer is rapidly approaching that of Western countries. Among dietary factors, a high intake of fat is clearly associated with an increased risk of colon and breast cancer in epidemiological and experimental animal studies. Furthermore, the effects of the type of fatty acids have also been investigated in several rodent colon and breast cancer models. In general, linoleic acid enhances whereas n-3 fatty acids decrease chemical-induced colon and breast carcinogenesis. However, regarding the protective effects of n-3 polyunsaturated fatty acids on colon and breast cancer, evidence from human epidemiological studies is inconsistent. Null findings of epidemiological studies could result from several factors, and one of the important factors influencing the inconsistent results of epidemiological studies between dietary fatty acids and colon and breast cancer may be the length of follow-up. Some studies showed that a temporal change in fat intake coincided with the incidence of colon and breast cancer approximately 15 to 25 years later. It may be important to improve the Westernized dietary habits of young Japanese generations to protect against nutritionally related cancer.

Predictors of dietary change among those who successfully lost weight in phase I of the Weight Loss Maintenance Trial.

Dietary changes occurring during weight loss interventions can vary. The present study tested if pretreatment psychosocial, dietary and demographic factors were associated with changes in fat intake and fruit and vegetable intake during a weight loss intervention. This analysis includes participants who lost at least four kilograms during the initial six month weight loss phase (phase I) of the Weight Loss Maintenance Trial, a group format behavioural intervention emphasising a low-fat diet and increased physical activity. Multiple linear regression was used to determine associations between pretreatment psychosocial, dietary, physical activity, and demographic variables and changes from pretreatment to six months in fat intake and fruit and vegetable intake. Participants (n = 1032) were 63.4% female, 62.4% non-African American, and had a mean age of 55.6 and BMI of 34.1 kg/m2. Being African American (P < 0.0001) and higher baseline kilojoule intake (P < 0.01) were associated with smaller reductions in fat intake. Being African American (p < 0.001) and older age (P = 0.02) were associated with smaller increases in fruit and vegetable intake, whereas a history of 10 or more past weight loss episodes of at least 10 lb (4.5 kg; P < 0.01) was associated with greater increases. Few psychosocial factors examined contributed to variability in dietary change. Even when achieving meaningful weight losses during a behavioural weight loss intervention, African Americans may make fewer beneficial changes in fat and fruit and vegetable intake than non-African Americans.

Changes in fat but not fruit and vegetable intakes linked with body weight change in Mexican women immigrants in Quebec

The objective of the present study was to identify dietary parameters for predicting body weight change (ΔBW) in Mexican-born women (Mexicans) following immigration to Quebec City, Canada. Methods: Changes in fruit (ΔF), vegetable (ΔV), fruit and vegetable (ΔFV), and fat (ΔFat) intake were assessed according to post-immigration periods (1-5 years, 6-10 years, 11-20 years) using a food frequency questionnaire (FFQ). Anthropometric measures were also conducted in 87 Mexicans (study group) and 88 native-born Quebecers (comparison group) aged 18-65 years. Associations were calculated using full and partial robust regression models adjusting for potential confounders (origin, education, income, age, length of residence in Quebec City). Results: There was no difference in ΔBW between the groups. Body weight (BW) increased significantly in both Mexican (5.5 ± 0.9 kg, P P β = 0.03, P = 0.003), but not correlated with origin, ΔF, or ΔV. ΔBW was negatively associated with education (β = –4.33, P = 0.007) and positively associated with length of residence (β = 0.3, P = 0.003). Partial models indicated ΔF (β = –1.35, P β = –1.04, P = 0.0001), and ΔFV (β = –2.27, P β = 0.16, P = 0.04) was positively associated with ΔFat. Conclusions: Change in body weight could be predicted by length of residence, education, and change in fat intake in Mexican immigrant women and native-born Quebecers whereas changes in fruit and vegetable intakes could be predicted by Mexican or Quebec origin.

Lipidprofil ved lavkarbokosthold hos friske

Many Norwegians have embraced the low-carb trend and choose butter and bacon instead of brown bread and carrots. This entails a dramatic change in the total intake of fat and the intake of saturated fat. We have investigated how a low-carb diet can affect the lipid profile in healthy adults with a normal bodyweight. Seven healthy female participants with normal bodyweight underwent a four-week trial of a low-carb diet (< 20-25 grams of carbohydrates/day). Daily diet registrations were made during the trial period, and diet data for three randomly selected days were included in the estimates. Blood samples and weight data were collected as fasting values prior to and after the intervention. Standardised diet data were available for six participants. On a low-carb diet, the energy intake from carbohydrates accounted for a median of 3 (spread: 2-5) per cent of the total energy intake. The intake of fat accounted for 71 (67-78) per cent of total energy, while protein accounted for 26 (19-31) of total energy intake. At baseline, the median value of total cholesterol was 4.1 mmol/L (dispersion: 3.3-5.7) and LDL cholesterol was 2.2 (1.8-3.4) mmol/L. The values increased to 5.2 (3.7-8.8) mmol/L and 3.1 (1.9-6.2) mmol/L for total and LDL cholesterol respectively. The absolute changes correspond to a percentage increase in total cholesterol of 33 (14-71)% and in LDL cholesterol of 41 (9-84)%. Median weight change amounted to -1.2 kg (-2.8-0.6). A diet with little carbohydrate and a great deal of protein and fat resulted in a considerably heightened level of total cholesterol and LDL cholesterol in young, healthy women with a normal bodyweight. The findings indicate that a low-carb diet may have a negative impact on individual risk profiles. However, the study is small-scale and the results must be interpreted with caution.

Mediating effects of home-related factors on fat intake from snacks in a school-based nutrition intervention among adolescents

The purpose of the present study was to investigate if the effects of the parental component of a school-based intervention on dietary fat intake from snacking were mediated by changes in home-related factors. A random sample of 10 schools with 2232 pupils aged 11-15 years was randomly assigned to one of two intervention groups [one with (n = 1226) and one without a parental component (n = 1006)]. Fat intake, home availability of low-fat foods and parental encouragement and support to eat a low-fat diet were assessed with validated self-administered questionnaires. Mediation was assessed with the product-of-coefficient test. Changes in home-related determinants were significantly related to changes in fat intake from snacks; therefore, school-based obesity programmes on adolescents should try to address these determinants. In the present study, one of the three investigated home-related factors, namely parental support, was affected by the parental component intervention. Decreases in parental support were prevented. These changes in parental support were found to mediate the parental intervention effects on changes in fat intake from snacks. Home-related factors appear to be related to changes in adolescents' snacking behaviours, therefore, school-based obesity programmes should target them. Nevertheless, more research is needed concerning effectively addressing the other determinants.

Web-Based Risk Communication and Planning in an Obese Population: Exploratory Study

BackgroundA healthy diet, low in saturated fat and high in fiber, is a popular medical recommendation in preventing cardiovascular disease (CVD). One approach to motivating healthier eating is to raise individuals’ awareness of their CVD risk and then help them form specific plans to change.ObjectivesThe aim was to explore the combined impact of a Web-based CVD risk message and a fully automated planning tool on risk perceptions, intentions, and saturated fat intake changes over 4 weeks.MethodsOf the 1187 men and women recruited online, 781 were randomly allocated to one of four conditions: a CVD risk message, the same CVD risk message paired with planning, planning on its own, and a control group. All outcome measures were assessed by online self-reports. Generalized linear modeling was used to analyze the data.ResultsSelf-perceived consumption of low saturated fat foods (odds ratio 11.40, 95% CI 1.86–69.68) and intentions to change diet (odds ratio 21.20, 95% CI 2.6–172.4) increased more in participants allocated to the planning than the control group. No difference was observed between the four conditions with regard to percentage saturated fat intake changes. Contrary to our expectations, there was no difference in perceived and percentage saturated fat intake change between the CVD risk message plus planning group and the control group. Risk perceptions among those receiving the CVD risk message changed to be more in line with their age (change in slopeindividual = 0.075, P = .01; change in slopecomparative = 0.100, P = .001), whereas there was no change among those who did not receive the CVD risk message.ConclusionThere was no evidence that combining a CVD risk message with a planning tool reduces saturated fat intake more than either alone. Further research is required to identify ways in which matching motivational and volitional strategies can lead to greater behavior changes.Trial RegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 91154001; http://www.controlled-trials.com/ISRCTN91154001 (Archived by WebCite at http://www.webcitation.org/62sBoGeOO)

Study on transition of dietary patterns in Jiangsu province, 1989–2009, China

To study the longitudinal transition of dietary patterns among residents in one of the richer provinces in China, Jiangsu Province from 1989 to 2009, we used a subpopulation of adults aged 18 and older in 6 cities and counties from China Health and Nutrition Survey. Experienced physicians collected detailed dietary data by weighing method in combination with 3 consecutive 24‐hour recalls. All statistical analyses were conducted using SAS version 8.0. There were a decrease in the consumption of grain and a significant increase in animal foods. While energy and protein met the Chinese national Reference Nutrient Intake (RNI), there were marked changes in fat intake and a rapid increase in the consumption of dairy products and the proportion of energy intake from fat, mainly from vegetable oils. A reduction of the gaps in calcium intake below the Chinese RNI occurred. The prevalence of overweight and obesity (BMI≥24) among men increased almost fivefold from 9.4% in 1989 to 41.1% in 2009, with an acceleration in the annual prevalence level increase over the past decade. Hypertension over this period grew from 7.8% in men and 4.8% in women to 37.6% and 30.8% respectively in 2009. The dietary transition in Jiangsu has seen a marked shift in the sources of calories with a marked increase of dietary fat. Overweight, obesity and hypertension are increasingly prevalent.This study was supported by NIH (R01‐HD30880) and Fogarty International Center, NIH (5D43TW007709).

Testing an integrated model of the theory of planned behaviour and self-determination theory for different energy balance-related behaviours and intervention intensities

The aim of the study was to test the relations between constructs from the self-determination theory (autonomous and controlled motivation), the theory of planned behaviour (attitudes, self-efficacy, and intentions), and behaviour change within a theoretically integrated model. Additionally, the aim was to test if these relations vary by behaviour (physical activity or dietary behaviour) or intervention intensity (frequency). It was a randomized controlled trial with a 'usual care' condition (medical screening only) and an intervention condition (medical screening+access to a website and coaching). Participants in the latter condition could freely determine their own intervention intensity. Participants (N= 287) completed measures of the theoretical constructs and behaviour at baseline and after the first intervention year (N= 236). Partial least squares path modelling was used. Changes in autonomous motivation positively predicted changes in self-efficacy and intentions towards a healthy diet. Changes in controlled motivation positively predicted changes in attitudes towards physical activity, changes in self-efficacy, and changes in behavioural intentions. The intervention intensity moderated the effect of self-efficacy on intentions towards physical activity and the relationship between attitude and physical activity. Changes in physical activity were positively predicted by changes in intentions whereas desired changes in fat intake were negatively predicted by the intervention intensity. Important relations within the theoretically integrated model were confirmed but others were not. Moderation effects were found for behaviour and intervention intensity.

Surfing depth on a behaviour change website: Predictors and effects on behaviour

The primary objectives of the present study were to gain insight into website use and to predict the surfing depth on a behaviour change website and its effect on behaviour. Two hundred eight highly educated adults from the intervention condition of a randomised trial received access to a medical intervention, individual coaching (by e-mail, post, telephone or face-to-face) and a behaviour change website. Website use (e.g. surfing depth, page view duration) was registered. Online questionnaires for physical activity and fat intake were filled out at baseline and after 6 months. Hierarchical linear regression was used to predict surfing depth and its effect on behaviour. Seventy-five per cent of the participants visited the website. Fifty-one and fifty-six per cent consulted the physical activity and fat intake feedback, respectively. The median surfing depth was 2. The total duration of interventions by e-mail predicted deeper surfing (β = 0.36; p < 0.001). Surfing depth did not predict changes in fat intake (β = −0.07; p = 0.45) or physical activity (β = −0.03; p = 0.72). Consulting the physical activity feedback led to more physical activity (β = 0.23; p = 0.01). The findings from the present study can be used to guide future website development and improve the information architecture of behaviour change websites.

Langkettige Omega-3-Fettsäuren in der Perinatalzeit: Empfehlungen zur Zufuhr

Fetal and infant growth and tissue development depend on a balanced nutrient supply. Long-chain polyunsaturated fatty acids (LC-PUFA) are essential compounds of structural lipids in brain and retina and are important for pregnancy and infant outcomes. Supported by the European Commission, the Perinatal Lipid Nutrition Project (PeriLip) and The Early Nutrition Programming Project (EARNEST) developed evidence consensus recommendations on dietary fat intake in pregnancy and lactation based on a systematic review of available evidence and a formal consensus process, which were also supported by several international scientific organizations. It is concluded there is no evidence to support changes in the dietary intake of fat (% of energy) and of the relative contribution of saturated, monounsaturated and polyunsaturated fatty acids in pregnancy and lactation, as compared to recommended intakes for the general population. However, a regular supply of long-chain omega-fatty acids is recommended in view of a significant risk reduction of early preterm birth as well as support of optimal visual and cognitive development of the fetus and child. An average daily intake of at least 200 mg docosahexaenoic acid (DHA) during pregnancy and lactation should be approached. This recommended intake can be met by consuming one to two portions of oily sea fish per week. For healthy term infants, breastfeeding is the preferred feeding. If exclusive breastfeeding cannot be achieved, an infant formula should be provided with DHA levels between 0.2 and 0.5 weight percent of total fat, and with the minimum amount of arachidonic acid (AA) equivalent to the DHA content. Dietary inadequacies should be screened for during pregnancy, and individual counselling be offered if needed.