Daily Caloric Intake Research Articles

A Pilot Study of a Novel Dietary Intervention Targeting Ultra-Processed Food Intake.

Ultra-processed foods (UPFs) are harmful to health but ubiquitous in the modern food environment, comprising almost 60% of the average American diet. This study assessed the feasibility, acceptability, and preliminary efficacy of a novel behavioral intervention designed to reduce UPF intake. Fourteen adults participated in an 8-week pilot intervention, which consisted of weekly group sessions, individual meal planning sessions, and financial support. Dietary intake was assessed using three Automated Self-Administered 24-h Dietary Recalls (ASA24) at both baseline and post-treatment. The intervention was highly feasible and acceptable. Qualitative data demonstrated that participants were enthusiastic about the benefits of reducing UPF intake and found the intervention highly valuable. Participants reduced average daily calories from UPF by 48.9%, number of UPFs consumed by almost half, total daily calorie intake by 612 calories/day, sodium consumption by 37% and sugar consumption by 50%. There were no significant changes in fruit or vegetable intake. Participants lost an average of 3.5kg (SD=3.0kg). This pilot data suggests that behavioral interventions to reduce UPF intake will be well-received and are capable of success despite the barriers of the United States food environment. Future research should prioritize behavioral interventions targeting UPF consumption alongside policy changes.

The Role of Diet in Tympanostomy Tube Otorrhea.

The objective of this study was to evaluate the role of diet quality in children with tympanostomy tube placement (TTP) complicated by tympanostomy tube otorrhea (TTO). Three-day 24-hour diet recall. Tertiary care medical center. Children between the ages of 2 to 6 years old with TTP performed 6 months to 2 years prior to enrollment were included. Children with a history of Down syndrome, cleft palate, craniofacial syndromes, known immunodeficiency, g-tube dependent, or a non-English speaking family were excluded. The primary outcome variable was TTO. The primary predictor was total caloric intake measured by percent estimated energy rate (%EER). A total of 120 families completed the 3-day diet recall. The median age was 27 months (interquartile range: 7.9-68.5), with 57% male sex. Most children reported dietary intake within the recommended range percent intake for carbohydrates and fat and less than recommended range for percent vitamin D. Within this cohort 63 (52.5%) participants had >1 TTO episode and 57 (47.5%) 1 TTO episode. Children with an EER% that was average or high were at higher odds of >1 TTO episodes compared to participants with a low EER% with ORs of 4.6 (95% confidence interval [CI]: 1.4, 15.6) and 5.7 (95% CI: 1.5, 22.1) respectively. Children with a typical or high total daily caloric intake are approximately 5 to 6 times more likely to have multiple TTO episodes compared to those with low intake.

A comparative study of the effects of crude chicory and inulin on gut health in weaning piglets

Dysfunction of the host-microbial balance and an impaired intestinal barrier can trigger inflammation and increase the antigen penetration. Inulin, commonly extracted from chicory root, is a prebiotic beneficial to gut health. The objective of this study was to compare the effect of chicory flour to inulin on gut health, few weeks after weaning. Two dose-dependent experiments (E1 and E2) were performed sequentially, each consisting of 80 castrated male piglets, weaned at day 21 and subsequently divided in 3 groups with ad libitum feed: control (Ctrl), inulin (INU) and crude chicory flour (CHI). For INU and CHI groups, a daily supplementation with the equated ‘inulin content’ increasing weekly was done by oral force-feeding, while the Ctrl groups received an isotonic sucrose solution. For E1, these doses were 1.5 g/day, 2 g/day and 2.5 g/day in W1, W2 and W3, respectively. For E2, these doses were 3 g/day, 4 g/day and 5 g/day in W1, W2 and W3, respectively. For each experiment at W0, W1 and W3, eight piglets per group were euthanized to assess gut structural and functional parameters. In E1, the CHI had lower average daily calorie intake (kcal/day) only at W3, while in E2 it was consistently lower than Ctrl and INU. In W3 of E2, CHI showed improved villi-to-crypt ratio and lower diarrhea occurrence than INU and Ctrl. Both supplemented groups in E2 showed higher butyrate production and lower D-xylose permeability (W3), compared to Ctrl. Interestingly, in E2, CHI had a more dominant effect on increasing the abundance of health promoting genera like Catenisphaera, Butyricicoccus, etc. and decreasing harmful genera like Erysipelotrichaceae_UCG-002 and Turicibacter. In E2, on W3 several inflammatory target genes (CXCL10, IL18, TNFα) and inflammation signalling genes (MyD88, NFκB1) were downregulated in ileum of INU and CHI. In colon, both chicory and inulin, proved to be beneficial, as the inflammation signalling and inflammatory targets genes NFκB1, DEFβ4A, TLR2 and IFNα were significantly downregulated. Therefore, crude chicory flour might also be a promising cost-effective alternative supplement to improve gut health in weaned piglets.

Exogenous application of wood vinegar improves rice yield and quality by elevating photosynthetic efficiency and enhancing the accumulation of total soluble sugars

Rice is an important cereal crop for over half of the world population and essential for food security, especially in developing countries where it constitutes a substantial part of daily caloric intake. Wood vinegar, obtained from biomass pyrolysis and rich in organic acids, phenols, esters, sugars, and alcohols, promotes crop growth and productivity. Its diverse composition offers an eco-friendly and cost-effective growth promoter and improves stress tolerance in different crops; however, its optimal application timings in rice cultivation remain underexplored. Our study investigated the effects of wood vinegar on rice growth, photosynthetic efficiency, chlorophyll contents, soluble sugars, phenolics, grain chalkiness, and yield at different stages and combinations such as tillering (T), jointing (J), flowering (F), grain filling (G), T + J, T + F, T + G, J + F, J + G, F + G, T + J + F, T + J + G, T + F + G, and J + F + G. Our results indicate that wood vinegar application at T + J + F stages significantly enhanced the photosynthetic rate by promoting gaseous exchange, chlorophyll contents, and SPAD index when compared with control. Additionally, total soluble sugars (9.71 mg g−1) and phenolics (2.4 mg g−1) levels were noticeably induced during wood vinegar application as compared with corresponding control. Besides, this treatment also elevated the yield by up to 32.4%, reduced grain chalkiness, and enhanced head rice percentage. Taken together, these findings suggest that wood vinegar supports sustainable agriculture by improving crop yield and quality, offering considerable benefits to farmers.

Planetary health diet in Malaysia: Recommendations for healthier people and planet

Food systems both influence and are influenced by environmental changes. Adopting a Planetary Health Diet (PHD) approach could alleviate the burden of food systems on the environment whilst increasing food security for the population. Here, we assess how the current Malaysian dietary guidelines and dietary intake compares to the PHD and investigate the relationship between the PHD, calorie intake, and food insecurity in Malaysia. We compared the percent of daily calorie intake by food group between the PHD, the Malaysian Dietary Guidelines 2020, and estimated dietary intake from publicly available data. Additionally, the Planetary Health Diet Index (PHDI) was used to compare alignment to the PHD across ethnicity, gender, and area of residence. Spearman's correlation tests assessed aggregated correlations between the PHD, daily calorie intake, and food insecurity. Compared to the PHD, the Malaysian diet lacked in legumes (3.6 % vs 23.0 % of daily calorie intake). There was an overconsumption of grains & tubers (53.1 % vs 34.0 %), added sugars (12.4 % vs 4.8 %), and meat (11.7 % vs 4.5 %). The ethnic Indian diet was most closely aligned to the PHD, with a PHDI score of 69.1 compared to the overall score of 46.2. The national dietary guidelines were well aligned to the PHD, however, a large proportion of recommended daily calorie intake was unaccounted for in the guidelines (43.4 %). Encouraging more whole grain and legumes and reducing meat and added sugar intake could help align Malaysian diets with the PHD, benefiting the health and wellbeing of people and their environment.

Food security and nutritional vulnerability in Comoros: The impact of Russia-Ukraine conflict.

The Sustainable Development Goal 2 aims to eradicate hunger. However, many small island developing states (SIDS) face challenges in achieving this goal due to their reliance on the global market and susceptibility to crises. This paper focuses on Comoros, one of the least studied SIDS located in the Indian Ocean, to examine its food security and nutritional vulnerability. The findings reveal that Comoros experiences limited access to sufficient and nutritious diets, which are excessive in fat and deficient in key micronutrients. This situation is similar to other SIDS in the Pacific and the Caribbean, which also exhibit the convergence of the malnutrition triple burden. This paper further assesses the impact of changing food prices during the initial year of the Russia-Ukraine conflict on food security and nutrition in Comoros, serving as a case study for SIDS. Using microsimulations, we estimate the effects on food access, sufficiency, and adequacy at the household level. The results indicate a decline in food access and purchasing power for all households, particularly the poorer and rural. Additionally, food sufficiency has markedly decreased, leading to an additional 5,000 households (3.3% of all households) experiencing inadequate daily calorie intake. The study also highlights a reduction in the consumption of organ meats, fruits, and vegetables, resulting in decreased daily iron and folate intakes. This is particularly concerning given the high prevalence of anemia among women in Comoros and other SIDS. To address these challenges, policies promoting the consumption of fresh, nutrient-rich foods with low fat content are crucial to mitigate the malnutrition triple burden and curb the increasing trend of non-communicable diseases in these countries.

The Impact of Trendy Diets on Nutritional Imbalance and Health Risks

In nowadays society people are focusing on their well-being and appearance more than ever. Social media has amplified almost every detail on daily occasions, however, such additional attention may not necessarily be beneficial for everyone. Influencers post pictures of their perfect physique and use them for more attention and followers. Among all the so-called ‘secrets’, people are most curious about what they eat and how they eat to look that stunning. Compared to tiring gym sessions and boring lectures about anatomy and physiology, a brand-new revolutionary recipe is far more appealing. The trendy recipes are beneficial to some people who have special needs such as those who are obese, type-II diabetes patients, people who suffer from cardiovascular diseases, etc. Such recipes greatly altered the proportions of the different essential nutrients to improve some symptoms that are occurring due to an imbalance of nutrition. However, such a diet may be beneficial to the human body in the short run by adjusting the daily calorie intake and controlling the categories of food in each sitting, in the long run, it would lead to another malfunction of the body due to nutrition imbalance.

Temporal and Spatial Dynamics of Anthracnose (Colletotrichum sublineolum) Disease on Selected Sorghum Genotypes at Assosa Zone, Western Ethiopia

Background Over 500 million people worldwide rely on sorghum as a main food crop. About 10% of the daily caloric intake of households in Ethiopia’s northwest and eastern regions, including Benishangul Gumuz, comes from sorghum. A hemi-biotrophic fungal pathogen called Colletotrichum sublineolum caused anthracnose disease is among the biotic constraints of sorghum production. Methods Ten selected sorghum genotypes were assessed for sorghum anthracnose severity and its temporal and spatial dynamics on field plots in the districts of Assosa and Bambasi. The performance of the chosen sorghum genotypes was assessed using the following metrics: AUDPC, disease progress rate, yield-related trait, sorghum grain yield, and mean severity index. Anthracnose severity was evaluated using a 1–5 disease rating scale and assessments conducted at seven consecutive time points. Results Ten genotypes of sorghum were examined in the districts of Assosa and Bambasi, with mean anthracnose severity index ranging from 60-77 PSI and 53-82 PSI, respectively. AUDPC varied from 351 to 470 % days and 316 to 499 % days at Assosa and Bambasi districts, respectively. Bambasi district achieved a larger grain yield than the Assosa district. Assosa-1 demonstrated a significant level of disease pressure, yet the current investigation found that this genotype is the highest performing genotype in both locations. Conclusions There is a considerable positive link between the severity of anthracnose and the weekly total rainfall and relative humidity. At both trial sites, Mersa-1 continuously produced higher grain yields and reduced disease levels. Breeders might utilize the Baco Striga sorghum genotype as a check line in a breeding effort to resist anthracnose disease because it shown a high vulnerability to the disease at both locations.

Late eating is associated with poor glucose tolerance, independent of body weight, fat mass, energy intake and diet composition in prediabetes or early onset type 2 diabetes

This study investigates the impact of habitual late calorie intake on glucose metabolism in adults with overweight or obesity and diet or metformin-controlled prediabetes or type 2 diabetes independently of body weight, fat mass, energy intake or diet composition. Participants (n = 26) were classified as Later Eaters (LE) if ≥45% daily calories were consumed after 5 pm and Early Eaters (EE) if not, based on daily caloric intake assessed over 2-wk. EE and LE did not differ in anthropometrics or daily energy intake, but LE consumed more carbohydrates (p = 0.038) and fats (p = 0.039) after 5 pm. Fasting glucose, insulin, and C-peptide did not differ between groups but LE exhibited higher glucose concentrations after an oral glucose tolerance test (p = 0.001), even after adjusting for body weight, fat mass, energy intake and diet composition (p < 0.05). Glucose results remained when participants with T2D were excluded (p = 0.031). After diabetes status adjustment, differences in glucose concentrations were higher in LE for time 30 (p = 0.028) and 60 min (p = 0.036). LE, compared to EE, had poorer glucose tolerance, independent of body weight, fat mass, daily energy intake and diet composition. ClinicalTrials.gov: NCT04465721.

Determining food intake, the requirement, and weighing the relative risk between food secure and insecure households in rural areas of Ethiopia: The case of West Hararghe zone

The severity of food insecurity in Ethiopia is among the worst globally, with record-breaking food assistance needs by various factors. This study tries to uncover various aspects of food security related to food availability, food access, food utilization and food stability dimensions of food security. The study was executed in the west Hararghe zone of the Oromia region of Ethiopia. Its main objective was to determine the food security status of households, with specific objectives aiming at computing individual daily kilo calorie intake, determining the average food requirement, comparing the relative risk between food secure and insecure households and identifying factors that affect household food security status. A multi-stage sampling procedure, involving the purposive selection of; the Zone and Woreda, and a simple random selection of households, to draw the required number of representative sample respondents, was adopted. Hence, from 4163 total households, 134 were selected for collecting primary data. Data were analyzed using descriptive statistics, relative risk analysis using Cohorts and independent tests using ANOVA. Food security status was measured using the Household Food Balance Model (HFBM). Using this model, the study obtained 1973 kilo calories per individual per day intake and 2108 kilo calorie as their requirement, which indicated households were energy deficient by 135 kilo calorie with 2-sided-value &lt; 0.1 critical level (t= -1.747, df =133 &amp; sig2-sided. 0.083). Independent test results showed that farm income (at p-value &lt; 0.1), gross product (at p-value &lt; 0.05), age of household head (at p-value &lt; 0.1), years of owning land (at p &lt; 0.1) and family size (at p-value &lt; 0.1) contributed significantly to food security status. Cross-tabulation showed a linear relationship between food security and higher education level (at p-value &lt; 0.05), which urges a concern in improving farming societies’ literacy to the desired level. In the study areas, about 91.8% of the population produces crops depending on the seasonal rainfall and their daily kilo calorie consumed depends on it; this is statistically correlated with the food insecurity problem at p-value &lt; 0.1 critical level (lambada = 1.75 &amp; sig. = 0.08). Therefore, to tackle the food insecurity problem, alternative method of crop production should be devised such as the establishment of irrigation schemes, water harvesting structures, and water conservation practices, among others. Key words: food security, calorie requirement, food availability, relative risk

Correlation of calorie intake with 24-hour urinary urea nitrogen level changes in critically ill patients at RSUI Depok, Indonesia

Calorie together with protein intake has been proven to be important factors that play a role in critically ill patients. Hypermetabolism in the early acute phase increases energy expenditure and calorie requirement. Insufficient calorie intake will increase protein degradation for gluconeogenesis, which can be assessed by the level of 24-hour urinary urea nitrogen (UUN). Adequate daily calorie intake is expected to improve the UUN level in patients. This study aims to investigates the correlation of calorie intake with UUN level changes in critically ill patients.

Dietary recommendations for bariatric patients

Over the past few decades, obesity has become a growing public health problem worldwide. The goal of fighting obesity is to improve health. Sustained weight loss of more than 10% of the total body weight improves the course of many obesity-related diseases, as well as the quality of life. The high effectiveness of bariatric surgery in the treatment of obesity in achieving significant and sustained weight loss has been demonstrated in several studies. In most centers where bariatric surgery is performed, the recommendation for preoperative weight loss is followed. The enlarged left lobe of the liver makes it difficult to access the stomach and, accordingly, prevents technically correct operation. Weight loss before bariatric surgery reduces the risk of complications in the postoperative period, and therefore preoperative preparation in the form of hypocaloric nutrition and regular physical activity is recommended for patients, considering concomitant pathology. One of the problems in the postoperative period is the need to change the usual lifestyle and diet due to the need to follow the recommendations of the attending physician. This can lead to a decrease in the quality of life after surgery due to psychoemotional overstrain. The nutrition of bariatric patients implies significant changes associated with a decrease in the amount of food consumed, difficulty in assimilation of nutrients, and the poverty of flavors offered up to this day in the specialized nutrition market. With the help of food products within the framework of low-calorie diets, it becomes almost impossible to feed such a patient without reducing their nutritional value. In 2024, balanced low-calorie nutrition OPTIFAST® (OPTIFAST) appeared on the Russian market, which has proven itself worldwide for more than 50 years and has shown its effectiveness and safety in more than 80 international clinical trials with a high level of evidence. OPTIFAST provides the patient with all the necessary nutrients and allows you to manage the daily calorie intake, gives the patient a feeling of satiety necessary for high adherence to a low-calorie diet, which is indicated for patients with obesity and overweight.

Biochemical and nutritional determinants of non-alcoholic fatty liver disease in Omani adult patients: a case-control study

Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is a risk factor for atherosclerosis, diabetes, kidney disease, and liver cirrhosis. Limited research exists on the biochemical and nutritional elements influencing NAFLD among adult patients in Oman. Objective: This study aimed to characterize the biochemical parameters and nutritional factors of Omani adults diagnosed with NAFLD at the Diwan Polyclinic in Muscat, Oman. Methods: This retrospective case–control study included 104 participants (52 cases and 52 controls) who have 2 or more risk factors for NAFLD and were referred to the Radiology department from January 2021 to January 2022 for abdominal ultrasound after Internal Medicine consultations. A validated scale, incorporating a semi-quantitative food frequency questionnaire, was employed. Results: The study revealed a significantly higher risk of NAFLD among men (69%) compared to women (31%). A common characteristic among participants was a prior diabetes diagnosis, 61.5% of the case group and 65% of the control group. While average liver enzyme levels were within the normal range for both groups, alanine transaminase levels were notably elevated in the case group. The case group exhibited a significantly higher average caloric intake than the control group. Conclusion: NAFLD is significantly more common among men. Alanine transaminase is significantly high in NAFLD group, which might be considered as a biochemical marker for NAFLD, but further investigations are needed. Moreover, high daily caloric intake is directly related to NAFLD.

The Effect of Iron Therapy on Plasma Ghrelin and Leptin Levels in Egyptian Children with Iron Deficiency Anemia

Abstract Background Iron deficiency (ID) is the most common micronutrient deficiency and the most common cause of anemia worldwide. It is known that iron deficiency anemia effects appetite and growth negatively. The aim of this study was to investigate the effect of iron therapy on appetite and plasma ghrelin and leptin levels in children with nutritional iron deficiency anemia. Methods A prospective interventional study was done on 40 iron deficient pediatric patients diagnosed by CBC and Iron profile aged between 12 to 60 months. All 40 cases were given oral iron therapy (5mg/kg). Anthropometric measures and appetite score subjectively by mother were done before and after iron therapy. Caloric intake was calculated specially protein, Fat and CHO before and after treatment. Serum Ghrelin and Leptin done by ELISA Kit ;Specimen Collected whether Serum or plasma. Results The median rang (IQR) plasma ghrelin level was 1 (0.9 - 1.25) mg/mL before therapy and it increased to 3.6 (2.65 – 4.8) mg/mL (p &amp;lt; 0.001) while the median plasma leptin level decreased from 2.05 (1.4 – 3.2) ng/mL to 0.41 (0.3 – 0.65) ng/mL (p &amp;lt; 0.01) after therapy. The amount of daily caloric intake, carbohydrate and protein intake were significantly increased after therapy (p &amp;lt; 0.001). Body weight was correlated with plasma ghrelin levels before and after therapy significantly. There was a positive correlation for Ghrelin with TIBC and UIBC (r = 0.387, p-value = 0.014) (r = 0.388, p-value = 0.033) respectively. Conclusions In conclusion, the findings of our study indicate that plasma ghrelin level increases and leptin level decreases in children with iron deficiency anemia after iron therapy. The increase in appetite and improvement of growth in iron deficiency anemia might result from decreased leptin and increased plasma ghrelin levels after treatment.

Cytotoxic Effect of Bajong LN Rice Methanol Extract on Human Squamous Cell Carcinoma, ORL-48

Oral squamous cell carcinoma (OSCC), a major oral cancer, significantly challenges treatments and impacts patient quality of life; current therapies often cause severe side effects, highlighting the urgent need for gentler alternatives. Rice stands as one of the primary cereal grains providing the daily caloric intake for more than half of the global population. Extensive research has demonstrated the significant health benefits derived from rice, attributed to its abundance of bioactive compounds. This study endeavours to explore the potential cytotoxic effects of Bajong LN rice, a pigmented purple rice indigenous to Sarawak, on human squamous cell carcinoma, ORL-48 cells. Cells were cultured in complete DMEM/F-12 media and incubated under standard culture conditions. Upon reaching 80% confluency, the cells were treated to varied concentrations (ranging from 0 μg/ml to 2000 μg/ml) of Bajong LN rice methanol extract (BLN-ME) and cisplatin. Subsequently, the cells were incubated for 48 and 72 hours, and their cytotoxicity was assessed using the MTS assay. Results demonstrated that cisplatin inhibited ORL-48 cells with an IC50 of 7.483 μg/ml and 3.877 μg/ml; and an IC80 of 40.649 μg/ml; and 17.543 μg/ml for 48 and 72 hours, respectively. Correspondingly, BLN-ME exhibited a notable cytotoxic effect against ORL-48 cells at 48- and 72-hour intervals, with an IC50 of 354.4 μg/ml and 342.0 μg/ml; and an IC80 of 450.3 μg/ml and 423.63 μg/ml, respectively. The cytotoxic activity of BLN-ME against ORL-48 cells was observed in both a time and dose-dependent manner. Morphological analysis and the Trypan blue exclusion assay corroborated the MTS assay's findings. Our preliminary findings provide the first scientific evidence of the cytotoxic effect of BLN-ME specifically against human squamous cell carcinoma, ORL-48 cells. This study suggests the potential of BLN-ME as a promising anti-cancer agent, presenting opportunities for further investigation into its underlying cytotoxic mechanisms.

Effects of calorie-restricted diet on health state and intestinal flora in Hashimoto's thyroiditis patients: Study protocol for a randomized controlled trial.

Hashimoto's thyroiditis (HT) is an autoimmune disease, characterized by abnormal elevation in thyroid peroxidase antibody and/or thyroglobulin antibody. In recent decades, HT disease has become more and more widespread. Patients always report multiple symptoms, even though their thyroid hormone levels are kept in normal ranges. However, no treatment exists to effectively reduce the levels of thyroid antibodies. Our study aims to determine whether calorie-restricted diet is helpful in improving health of HT patients. This is a 3-month randomized controlled trial. HT patients will be randomized into a calorie-restricted (CR) group or a calorie-unrestricted control group. All the participants will be instructed to consume a diet that includes a combination of 45-55% calories from carbohydrates, 20-30% from fats, and 15-25% from proteins, according to current Chinese Dietary Guidelines. Participants in CR group need to limit their calories intake equal to their basal energy expenditure, which means that their daily caloric intake will be limited by about 20-30%. The study population is planned to be 66 HT patients aged 18 to 65 years. The primary outcome is change of thyroid antibody levels from baseline. Secondary outcomes include the changes of non-hypothyroid symptoms scores, thyroid function indexes, morphology of thyroid, T lymphocyte subpopulations, inflammatory biomarkers and lipids from baseline to 12 weeks. This trial will have implications for nutrition treatment policy in regard to thyroid antibodies control, immune dysfunction and related non-hypothyroid symptoms improvement among HT patients.

Screening for undernutrition in gastric bypass: a case study of four patients in the Marrakech Tensift Al Haouz region, Morocco

Undernutrition presents a major risk to patients’ health and well-being following gastric bypass surgery. After undergoing this surgery, the nutritional status of three women and one man was examined in this study. Follow-up visits were used to measure weight, body composition, and biological and biochemical data. After 3 months of follow-up after gastric bypass surgery, our findings revealed a reduction in muscle mass. The average loss of muscle mass was 4.375±1.470 kg. Their initial body mass index, which was 45.01 kg/m2, on average, dropped to 28.38 kg/m2. Significant drops were observed in the mean levels of albumin and pre-albumin (albumin: 38.6 g/L to 24.8 g/L, pre-albumin: 195 mg/L to 113 mg/L). In our study, patients with micronutritional deficiencies and gastric bypass demonstrated a significant and adaptive reduction in daily caloric intake. Early identification of undernutrition makes it possible to assess its severity and, as part of the patient’s overall follow-up, to implement appropriate nutritional management.

Perception of Paediatricians and Families about Nutritional Supplements: Acceptance, Tolerability and Satisfaction in Malnourished Children (PerceptiONS Jr Study).

Malnutrition is a common situation in the Spanish paediatric population. Malnourished children may benefit from different strategies, including dietary modifications or nutritional supplements (NS). It is important to know the different factors that can influence treatment tolerance and adherence, and their impact on nutrition monitoring. To explore the perception of doctors who prescribe nutritional supplements (NS) in children and to investigate different factors involved in tolerance and adherence. A cross-sectional, descriptive observational study based on an ad hoc electronic survey designed to study doctors' perceptions of at least five of their children with NS and their families, subjected to outpatient follow up. Variables included were the socio-demographic variables of the doctors and children, nutritional status of the patients, amount and characteristics of NS (hyper-caloric oral with fibre (HOFF), oral peptide (OPF) and hyper-caloric infant (HIF)), route of administration, perceived benefits, satisfaction, palatability, adherence, and acceptance. 815 patients aged 0-16 years (mean 10.6 years; SD 7.8) were included. A proportion of 64% received HOFF, 16% FOP, and 20% HIF. A proportion of 84% received exclusive oral NS. Total daily calorie intake prescribed with NS ranged from 30-75% in 48.2% of cases, though it was significantly higher in children under 6 months of age. Improvement in overall condition, nutritional status and quality of life was observed in 82%, 79.5%, and 80% of subjects. Improvement in tolerance and digestive symptoms was reported in 83.5% and 72% of subjects. The degree of satisfaction and acceptance of NS was very good in 80% of cases, with taste being the most influential factor (82.3%). Adherence was adequate in more than 60%, and smell was the most significant feature in lack of adherence (55%). The flavour of the best-accepted supplement was chocolate (44%). A total of 97% of prescribing doctors would recommend the same formula again. In our study, prescribing doctors and families perceived an excellent benefit from the use of the prescribed formulas, improved quality of life, high satisfaction, acceptance, and adherence. The positive factors for adequate adherence were sufficient information about the formulations and their benefits, and continuity of care during follow-up. Prescribing doctors would recommend supplement use again given the perceived benefits and satisfaction.

A non-randomized comparison of engagement and outcomes for in-person versus virtual delivery of the Partner2Lose weight management trial.

Existing behavioral weight management interventions produce clinically meaningful weight loss. The onset of the COVID-19 pandemic led to the quick transition of such interventions from in-person to virtual platforms. This provided a unique opportunity to compare engagement and outcomes for an in-person versus virtually delivered weight management intervention. A non-randomized comparison of engagement and weight outcomes was performed between two cohorts who participated in a weight management intervention in person (N=97) versus three who participated virtually via videoconference (N=134). Various metrics of engagement were examined, including group class and individual phone call attendance and duration, and retention for weight assessments. Behavioral targets of daily caloric intake and step-counts and the clinical weight outcome were explored. Cohorts (mean [standard deviation] age 47.3 (11.5), 67.1% women: 86.8% White) that participated virtually attended more group sessions (p<0.001) and had maintenance telephone calls that were of a longer duration (p<0.001). No other engagement or weight outcomes significantly differed by delivery modality. Virtual weight management programs are promising and may generate similar outcomes to those delivered in-person. Future research should seek to understand how best to promote and sustain engagement in virtual interventions.

Outcomes from Partner2Lose: a randomized controlled trial to evaluate 24-month weight loss in a partner-assisted intervention

BackgroundPartner support is associated with better weight loss outcomes in observational studies, but randomized trials show mixed results for including partners. Unclear is whether teaching communication skills to couples will improve weight loss in a person attempting weight loss (index participant).PurposeTo compare the efficacy of a partner-assisted intervention versus participant-only weight management program on 24-month weight loss.MethodsThis community-based study took place in Madison, WI. Index participants were eligible if they met obesity guideline criteria to receive weight loss counseling, were aged 18–74 years, lived with a partner, and had no medical contraindications to weight loss; partners were aged 18–74 years and not underweight. Couples were randomized 1:1 to a partner-assisted or participant-only intervention. Index participants in both arms received an evidence-based weight management program. In the partner-assisted arm, partners attended half of the intervention sessions, and couples were trained in communication skills. The primary outcome was index participant weight at 24 months, assessed by masked personnel; secondary outcomes were 24-month self-reported caloric intake and average daily steps assessed by an activity tracker. General linear mixed models were used to compare group differences in these outcomes following intent-to-treat principles.ResultsAmong couples assigned to partner-assisted (n = 115) or participant-only intervention (n = 116), most index participants identified as female (67%) and non-Hispanic White (87%). Average baseline age was 47.27 years (SD 11.51 years) and weight was 106.55 kg (SD 19.41 kg). The estimated mean 24-month weight loss was similar in the partner-assisted (2.66 kg) and participant-only arms (2.89 kg) (estimated mean difference, 0.23 kg [95% CI, -1.58, 2.04 kg], p=0.80). There were no differences in 24-month average daily caloric intake (estimated mean difference 50 cal [95% CI: -233, 132 cal], p=0.59) or steps (estimated mean difference 806 steps [95% CI: -1675, 64 steps], p=0.07). The percentage of participants reporting an adverse event with at least possible attribution to the intervention did not differ by arm (partner-assisted: 9%, participant-only, 3%, p = 0.11).ConclusionsPartner-assisted and individual weight management interventions led to similar outcomes in index participants.Trial registrationClinicaltrials.gov NCT03801174, January 11, 2019.