Diet Program Research Articles

Abstract P422: Lifestyle Intervention Improved Blood Pressure and Cardiovascular Disease Biomarkers in Patients With Chronic Kidney Disease and Resistant Hypertension: Insights From the TRIUMPH Randomized Clinical Trial

Introduction: Evidence is limited regarding the effect of lifestyle modification on health outcomes in patients with chronic kidney disease (CKD). Hypothesis: We hypothesized that lifestyle modification involving the DASH diet, exercise and weight loss would improve blood pressure (BP) and cardiovascular disease (CVD) biomarkers in CKD patients with resistant hypertension. Methods: The Treating Resistant Hypertension Using Lifestyle Modification to Promote Health (TRIUMPH) trial randomized patients with resistant hypertension to either a 16-week cardiac rehabilitation (CR) facility-based lifestyle modification program involving thrice weekly aerobic exercise and weekly classes on DASH diet and behavioral weight loss (C-LIFE) or to a standard education and physician advice (SEPA) control condition. We conducted a secondary analysis involving participants with CKD. CKD was defined as having eGFR <60 mL/min/1.73 m 2 or albuminuria at baseline. Primary outcome was mean change in clinic systolic BP. Secondary outcomes were mean changes in clinic diastolic BP, 24-hour ambulatory BP, and CVD biomarkers including baroreflex sensitivity (BRS), high-frequency heart rate variability, flow-mediated dilation, pulse wave velocity, and left ventricular mass index. Results: Ninety-seven (69%) of 140 TRIUMPH participants were considered to have CKD. Mean age was 62 years, 57% self-identified as Black race, 67% were male, and the majority (82%) had CKD stage 3. Participants with CKD randomized to C-LIFE achieved greater reduction in clinic SBP and greater improvement in BRS compared to SEPA. There were no differences between groups in ambulatory BP or other CVD biomarkers. Conclusions: A structured 16-week diet, exercise and weight management program conducted in a CR setting improved BP and resting BRS in resistant hypertension patients with CKD. Future studies are needed to confirm the beneficial effect of multi-component lifestyle modification on CVD biomarkers in CKD and to determine the persistence of benefit over time.

Functional nutrition option patients with non-alcoholic fatty liver disease

The results of a study of the clinical efficacy of dietary treatment in patients with non-alcoholic liver disease (NAFLD) with the additional inclusion of a new specialized nutritional functional dietary product “A mixture of essential nutrients multicomponent dry” (SENMS) in the product content of the standard D3 diet are presented. 75 patients with NAFLD were examined (39 - study group, 36 - control group). The patients in the study group received 6 g of SENMS daily for 2 weeks, consisting of 6 ingredients that are sources of biologically active substances: inulin, green tea extract, dry red wine extract, L-carnitine, grape seed extract, coenzyme Q10. As a result of the conducted study, it was proved that the SEMS in patients with NAFLD contributed to a faster decrease in the severity of hepatic parenchymal inflammation compared with the control, improved cholesterol metabolism, lipid peroxidation, and quality of life indicators of patients. In conclusion, the expediency of using a new specialized functional dietary food product “A mixture of essential nutrients multicomponent dry” in dietary treatment programs for patients with NAFLD was noted.

The interplay of body composition, pain intensity, and psychological status in Egyptian patients with knee osteoarthritis

BackgroundThere is a clear relationship between poor mental health, obesity, and osteoarthritis (OA). Individuals who experience symptoms of anxiety and depression are more likely to report higher levels of pain and disability in OA. In addition, higher body mass index (BMI) levels can contribute to additional pain and disability in individuals with OA. We aimed to explore the interplay of Body composition, pain intensity, and psychological status in Egyptian patients with knee OA.ResultsThis cross-sectional study included 60 patients with Knee OA diagnosed clinically according to the American College of Rheumatology (ACR) criteria. Body composition measurement was performed with an InBody analyzer. Pain was assessed by the pain visual analog scale (VAS), disability was measured with Western Ontario and McMaster Universities Osteoarthritis (WOMAC) scores, and depressed mood and/or anxiety was measured by the Hospital Anxiety and Depression Scale (HADS). Body mass index (BMI), total body fat (TBF) %, fat mass (FM), and fat mass index (FMI) were positively correlated with pain and disability in patients with knee OA. TBF% was positively correlated with depression and anxiety.ConclusionsThis study has shed light on the association between mental disorders, body composition measurements, knee pain, and disability. Interventions to treat osteoarthritis in elderly patients should focus on treating mood changes such as anxiety and depression, psychological support, and controlling body mass with proper diet and exercise programs.

Effect of Carbohydrate Diet Program on Urine Ketone Positivity with A Long Time on A Diet of One until Three Years

Carbohydrate diet is a diet pattern that reduces carbohydrate consumption. Therefore, the body will use fat as an alternative energy source. The continuous use of fat causes the accumulation of fatty acids so it is often the cause of ketone positivity in the urine. Objective: Find out the effect of a carbohydrate diet program on the positivity of urine ketones. Method this research is an analytic observational study with a cross-sectional approach. The sample used was urine from respondents who had been on a carbohydrate diet for 1 year, 2 years, and 3 years, then urine ketones were examined using the dipstick method. Data analysis was carried out using the Chi-Square test with a confidence value (α = 0.05). Result: The sample in this study amounted to 45 samples, with a total of 23 samples of positive ketones and 22 samples of negative ketones. The results of the Chi-Square test obtained an Asymp.sig value of 0.009 <0.05 (α) which indicates that the carbohydrate diet program has a significant effect on the positivity of urine ketones. The carbohydrate diet program affects urine ketone levels.

Is the NHS low-calorie diet programme delivered as planned? An observational study examining adherence of intervention delivery to service specification.

Obesity and Type 2 Diabetes Mellitus (T2DM) are chronic conditions with significant personal, societal, and economic impacts. Expanding on existing trial evidence, the NHS piloted a 52-week low-calorie diet programme for T2DM, delivered by private providers using total diet replacement products and behaviour change support. This study aimed to determine the extent to which providers and coaches adhered to the service specification outlined by NHS England. An observational qualitative study was conducted to examine the delivery of both one-to-one and group-based delivery of programme sessions. Observations of 122 sessions across eight programme delivery samples and two service providers were completed. Adherence to the service specification was stronger for those outcomes that were easily measurable, such as weight and blood glucose, while less tangible elements of the specification, such as empowering service users, and person-centred delivery were less consistently observed. One-to-one sessions were more successful in their person-centred delivery, and the skills of the coaches delivering the sessions had a strong impact on adherence to the specification. Overall, the results show that there was variability by provider and delivery mode in the extent to which sessions of the NHS Low-Calorie Diet Programme reflected the intended service specification. In subsequent programmes it is recommended that one-to-one sessions are used, with accompanying peer support, and that providers improve standardised training and quality assurance to ensure specification adherence.

The Prostate Cancer Active Lifestyle Study (PALS): A randomized controlled trial of diet and exercise in overweight and obese men on active surveillance.

Active surveillance (AS) is increasingly used to monitor patients with lower risk prostate cancer (PCa). The Prostate Cancer Active Lifestyle Study (PALS) was a randomized controlled trial to determine whether weight loss improves obesity biomarkers on the causal pathway to progression in patients with PCa on AS. Overweight/obese men (body mass index >25kg/m2) diagnosed with PCa who elected AS were recruited. The intervention was a 6-month, individually delivered, structured diet and exercise program adapted from the Diabetes Prevention Program with a 7% weight loss goal from baseline. Control participants attended one session reviewing the US Dietary and Physical Activity Guidelines. The primary outcome was change in glucose regulation from baseline to the end of the 6-month intervention, which was measured by fasting plasma glucose, C-peptide, insulin, insulin-like growth factor 1, insulin-like growth factor binding protein-3, adiponectin, and homeostatic model assessment for insulin resistance. Among 117 men who were randomized, 100 completed the trial. The mean percentage weight loss was 7.1% and 1.8% in the intervention and control arms, respectively (adjusted between-group mean difference, -6.0kg; 95% confidence interval, -8.0, -4.0). Mean percentage changes from baseline for insulin, C-peptide, and homeostatic model assessment for insulin resistance in the intervention arm were -23%, -16%, and -25%, respectively, compared with +6.9%, +7.5%, and +6.4%, respectively, in the control arm (all p for intervention effects ≤ .003). No significant between-arm differences were detected for the other biomarkers. Overweight/obese men with PCa undergoing AS who participated in a lifestyle-based weight loss intervention successfully met weight loss goals with this reproducible lifestyle intervention and experienced improvements in glucose-regulation biomarkers associated with PCa progression.

Level of adherence to diet and physical activity among menopausal women and influencing factors in Jordan: a descriptive cross-sectional study.

During menopause, a woman's lifestyle may change significantly, which will have implications on her quality of life. Women will experience menopause for more than a third of their life; therefore, maintaining good health during this period is crucial. A healthy diet and physical activity can help women maintain their health during menopause. Hence, assessing adherence to a healthy diet and physical activity among menopausal women is important. This study aims to assess the degree of adherence to a healthy diet and physical activity of menopausal women in Jordan and determine the most influential factors. A descriptive cross-sectional design was used in this study, and an online self-administered questionnaire was sent to 299 menopausal women selected through simple random sampling. A valid and reliable questionnaire was used to assess the menopausal women's adherence to a healthy diet and physical activity. The questionnaire consisted of 14 items covering two domains: 12 questions for the diet domain and two questions for the physical activity domain. Descriptive statistics were obtained, mean weight and body mass index (BMI) were calculated, and stepwise regression was conducted for the data analysis. The overall degree of adherence to a healthy diet and physical activity of the women was moderate (49.25, SD = 7.17). Most of the participants reported eating refined food items once a month or less (n = 188, 62.9%) and not exercising weekly (n = 119, 39.8%), and only a few reported eating refined food items at least once a day (n = 5, 1.7%) and exercising 5-6 times a week (n = 15, 5%). The regression analysis showed that age (B = 0.145, p = 0.014), having two children (B = 0.123, p = 0.034) and completing primary or secondary education (B = 0.120, p = 0.038) were statistically significant and the strongest predictors of adherence. The predictors accounted for 68% of the variance in adherence to a healthy diet and physical activity (R2 = 0.068, F [343.54] = 7.123, p = 0.000). The majority of the middle-aged menopausal women in this study showed moderate adherence to a healthy diet and physical activity. Age, having two children and completing primary or secondary education were associated with degree of adherence to a healthy diet and physical activity. Therefore, healthcare intervention, such as physical activity and dietary control programs, should target women in this age group and stage in life.

The role of plant-based foods in brain aging and the role of digital technologies in healthy aging training

This literature review surveys the correlation between the aging of the human brain and the effect of plant-based diets. The search, study and analysis of relevant published research papers revealed that while some cognitive functions remain stable or even improve with advancing age (e.g., crystalline intelligence and judgment abilities), most healthy adults experience age-related declines in a variety of cognitive functions, including spatial orientation, episodic memory, processing speed, language, decision-making abilities, judgment, and abstract thinking. These damaging cognitive changes are amplified and accelerated by common age-related progressive neurodegenerative diseases such as depression and dementia. However, it has become clear that foods and diverse nutrients are biologically interactive, acting in coordination rather than as single physiological agents, hence the true benefit of adherence to the dietary pattern is likely to be due to a complex environment of beneficial effects rather than the contribution of individual components. The current research data suggests that following a healthy dietary programme, such as the Mediterranean diet with the addition of foods rich in fiber, vitamin complexes, minerals and trace elements (strawberries, blueberries, grape juice, etc.) are key factors in increasing the likelihood of healthy brain aging.

P721 Dutch Crohn’s disease patients’ (pediatric and adult) perspectives of CDED diet and Modulife program

Abstract Background The Crohn’s Disease Exclusion Diet (CDED) with partial enteral nutrition can induce remission in patients with mild-to-moderate Crohn’s disease. As adherence is the key of (possibly) success of a medical therapy and CDED might be a complicated diet to perform, we aimed to investigate patients’ experience with CDED and the available tools (Modulife programme) to improve patientcare. Methods All mild-to-moderate active Crohn’s disease (CD) (adult and pediatric) patients treated with CDED as nutritional therapy as part of their medical treatment at Amsterdam UMC between 2019-2022 were approached for this retrospective qualitative study. A structured telephone interview was conducted by a dedicated dietician/doctor with the patients and/or parent/guardian in case of children. Questions about CDED-experience and Modulife program were either measured with the NET Promotor Score (NPS -100 - +100), as yes/no answer options or with 5-point likert scales (1=strongly agree/always to 5=strongly disagree/never). Lastly, patients were asked to evaluate the effectiveness of CDED on complaints and experience on a scale from 0-10. Results 44 patients (33 pediatric/11 adults; 26 women) participated in the interviews. The majority (61%) of the pediatric patients started CDED at diagnosis. The remaining 39% started 1-11 years (median 3[IQR 2-5]) after diagnosis at an age of 7-17 years (median 15[IQR 12-16]). 91% of the adult patients started CDED 3-37 years (median 11[IQR 4-28]) after diagnosis and only 1 immediately after diagnosis at an median age of 48 [IQR 33-60] (range: 19-69). The majority of the pediatric participants would recommend CDED to others (77%) and consider to start the diet again (55%). All of the adults would recommend CDED to others and consider to start CDED again. The NPS scores on CDED experiences are shown in figure 1. The median score for the effect of the diet on complaints was 8[IQR 5-9] (range 0-10) and 7[IQR 6-7](range 2-8.5) for experience. The majority of the patients (75%) used the Modulife program always or often during therapy and did (strongly) agree that the Modulife program was helpful. A NPS of 31 was given for recommending the app to others. The recipes-feature was the most used and most esteemed part of the app and was assessed with a good NPS of 27 for recommendation to others. Conclusion The majority of the pediatric and all of the adult participants would recommend CDED to others and would reconsider starting the diet again. CDED is better assessed by adults (positive NPS) then children and/or their parents (negative NPS). Most of the patients, assess the Modulife programme very positively and the majority would rate this as helpful in performing the diet.

Effects of different black soldier fly larvae products on slow-growing broiler performance and carcass characteristics

Black soldier fly (BSF) larvae have gained significant attention as ingredients for poultry feed to improve value chain circularity and sustainability. BSF larvae contain bioactive compounds which can potentially improve broiler health and thereby performance. However, the functionality of bioactive compounds likely depends on how larvae are processed prior to feeding and to which extent larvae products are included in the diet. This may explain the variable results reported in literature on broiler performance and carcass characteristics when feeding them different types of BSF larvae products at different inclusion levels. Therefore, the present research aimed to investigate the effects of different BSF larvae products and inclusion levels in diets on performance and carcass characteristics of slow-growing broilers.The experiment started with 1,728 one-day-old slow-growing male broilers (Hubbard JA757). Nine dietary treatments were used, each replicated eight times. One group of broilers was given a control diet. The following BSF larvae products were investigated: live larvae, a combination of BSF larvae meal and oil mimicking the nutritional composition of the live larvae, and BSF larvae meal and oil separately. All insect products were tested at two inclusion levels. All diet programs were nutritionally comparable (isoenergetic and based on balanced levels of digestible essential amino acids). During the seven-week trial, several performance parameters and carcass characteristics were measured.The results show that comparable or better broiler performance was achieved with the inclusion of BSF larvae products in the diets compared to the control. Based on the feed conversion ratio (FCR), the unprocessed larvae product and the highest inclusion level led to the most favorable results. Carcass characteristics remained unchanged when BSF larvae products were used in the diets compared to the control group, indicating favorable production output. The BSF larvae products investigated seem suitable feed ingredients for broilers at the current levels tested, generating performance benefits.

The Impact of Dietary Factors on the Relief of Bowel Dysfunction Among Patients with Rectal Cancer After the Sphincter-Saving Surgery-A Prospective Cohort Study.

The study aims at exploring the impact of dietary intake on the relief of bowel dysfunction among patients with rectal cancer after the sphincter-saving surgery. A prospective cohort design was used. A total of 299 patients were followed up at a tertiary hospital in East China between April 2020 and July 2021. Postoperative food intake was assessed with a food frequency questionnaire, and bowel dysfunction was assessed with Memorial Sloan Kettering Cancer Center's bowel function scale. The generalized estimating equation and the generalized additive mixed model were used to analyze the collected data. The average daily intake of livestock and poultry meats and dairy products during the first 6 months after sphincter-saving surgery was significantly associated with the relief of bowel dysfunction. Bowel dysfunction was relieved most quickly among patients who consumed 40.81 to 59.1g/d of livestock and poultry meat during the first 3 months after surgery. Bowel dysfunction improved more slowly during the first 6 months after surgery among patients who consumed greater than 107.11g/d dairy products than among patients who consumed 0g/d dairy products. The impact of dietary factors on bowel dysfunction observed in this study added to the limited evidence about the specific effects of consuming foods and nutrients on defecation dysfunction, and these results provided a theoretical basis for the use of dietary modification programs aimed at relieving bowel dysfunction as soon as possible.

Normalisation and equity of referral to the NHS Low Calorie Diet programme pilot; a qualitative evaluation of the experiences of health care staff

BackgroundHealth and wellbeing can be profoundly impacted by both obesity and type 2 diabetes, while the normalisation and equity of care for people living with these non-communicable diseases remain as challenges for local health systems. The National Health Service Low Calorie Diet programme in England, aims to support people to achieve type 2 diabetes remission, while also reducing health inequalities. We have explored the experiences of health care staff who have made a referral to the LCD programme, while identifying effective and equitable delivery of programme referrals, and their normalisation into routine care.MethodsNineteen individual semi-structured interviews were completed health care staff in the first year of the Low Calorie Diet programme. Interviewees were purposively sampled from the ten localities who undertook the Low Calorie Diet programme pilot. Each interview explored a number of topics of interest including communication and training, referrals, equity, and demands on primary care, before being subjected to a thematic analysis.ResultsFrom the data, five core themes were identified: Covid-19 and the demands on primary care, the expertise and knowledge of referrers, patient identification and the referral process, barriers to referrals and who gets referred to the NHS LCD programme. Our findings demonstrate the variation in the real world settings of a national diabetes programme. It highlights the challenge of COVID-19 for health care staff, whereby the increased workload of referrals occurred at a time when capacity was curtailed. We have also identified several barriers to referral and have shown that referrals had not yet been normalised into routine care at the point of data collection. We also raise issues of equity in the referral process, as not all eligible people are informed about the programme.ConclusionsReferral generation had not yet been consistently normalised into routine care, yet our findings suggest that the LCD programme runs the risk of normalising an inequitable referral process. Inequalities remain a significant challenge, and the adoption of an equitable referral process, normalised at a service delivery level, has the capacity to contribute to the improvement of health inequalities.

Effects of a Comprehensive Dietary Intervention Program, Promoting Nutrition Literacy, Eating Behavior, Dietary Quality, and Gestational Weight Gain in Chinese Urban Women with Normal Body Mass Index during Pregnancy.

In urban Chinese women with normal body weight during pregnancy, we implemented a comprehensive dietary intervention program aimed at enhancing nutrition literacy, dietary quality, and gestational weight gain. The methods included both online and offline health education on prenatal nutrition, weekly weight monitoring, family back education practices, and real-time dietary guidance. The intervention was delivered to randomly assigned control and intervention group participants from gestational week 12 to week 24. The intervention group (n = 44; 100% complete data) showed significant differences (mean (SD)) compared to the control group (n = 42; 95.5% complete data) in nutrition literacy (53.39 ± 6.60 vs. 43.55 ± 9.58, p < 0.001), restrained eating (31.61 ± 7.28 vs. 28.79 ± 7.96, p < 0.001), Diet Quality Distance (29.11 ± 8.52 vs. 40.71 ± 7.39, p < 0.001), and weight gain within the first 12 weeks of intervention (4.97 ± 1.33 vs. 5.98 ± 2.78, p = 0.029). However, there was no significant difference in the incidence of gestational diabetes (2 (4.5%) vs. 4 (9.5%), p = 0.629). Participants in the intervention group reported an overall satisfaction score of 4.70 ± 0.46 for the intervention strategy. These results emphasize the positive role of comprehensive dietary intervention in promoting a healthy diet during pregnancy.

Commercial provider staff experiences of the NHS low calorie diet programme pilot: a qualitative exploration of key barriers and facilitators

BackgroundThe National Health Service Type 2 Diabetes Path to Remission programme in England (known as the NHS Low Calorie Diet programme when piloted) was established to support people living with excess weight and Type 2 Diabetes to lose weight and improve their glycaemic control. A mixed method evaluation was commissioned to provide an enhanced understanding of the long-term cost effectiveness of the pilot programme, its implementation, equity and transferability across broad and diverse populations. This study provided key insights on implementation and equity from the service providers’ perspective.MethodsThirteen focus groups were conducted with commercial providers of the programme, during the initial pilot rollout. Participants were purposively sampled across all provider organisations and staff roles involved in implementing and delivering the programme. Normalisation Process Theory (NPT) was used to design the topic schedule, with the addition of topics on equity and person-centredness. Data were thematically analysed using NPT constructs with additional inductively created codes. Codes were summarised, and analytical themes generated.ResultsThe programme was found to fulfil the requirements for normalisation from the providers’ perspective. However, barriers were identified in engaging GP practices and receiving sufficient referrals, as well as supporting service users through challenges to remain compliant. There was variation in communication and training between provider sites. Areas for learning and improvement included adapting systems and processes and closing the gap where needs of service users are not fully met.ConclusionsThe evaluation of the pilot programme demonstrated that it was workable when supported by effective primary care engagement, comprehensive training, and effective internal and external communication. However, limitations were identified in relation to programme specifications e.g. eligibility criteria, service specification and local commissioning decisions e.g. pattern of roll out, incentivisation of general practice. A person-centred approach to care is fundamental and should include cultural adaptation(s), and the assessment and signposting to additional support and services where required.

Evaluating the Applicability and Appropriateness of ChatGPT as a Source for Tailored Nutrition Advice: A Multi-Scenario Study

Background: In the rapidly evolving domain of healthcare technology, the integration of advanced computational models has opened up new possibilities for personalized nutrition guidance. The emergence of sophisticated language models, such as Chat Generative Pre-training Transformer (ChatGPT), offers potential in providing interactive and tailored dietary advice. However, concerns remain about the applicability and appropriateness of ChatGPT's recommendations, especially for those with distinct health conditions. Objectives: This study aimed to evaluate the reliability of ChatGPT as a source of nutritional advice. Methods: Three hypothetical scenarios representing various health conditions were presented alongside precise dietary requirements. ChatGPT was tasked to generate personalized dietary programs, encompassing meal timing, specific caloric portions (measured in grams and spoons), as well as alternative meal options for each scenario. Following this, ChatGPT’s generated dietary programs underwent a thorough review by a multidisciplinary team of nutritionist, specialist physicians and clinical researchers. The evaluation focused on the programs' suitability, alignment with dietary standards, consideration of individual health factors, and additional guidance Safety. Results: ChatGPT demonstrated its ability to generate various options of meal plans in accordance with basic nutrition principles. However, there are apparent issues with the recommended individual macronutrient distribution, handling health conditions, drug interactions, and setting realistic weight loss goals. Conclusions: While ChatGPT exhibits promise as a dietary program generator, its application for intervention should be restricted to certified nutrition professionals. Until July 2023, it is not advisable for patients to engage in self-prescription using ChatGPT version 3.5, owing to its inability to provide professional knowledge and acceptable guidance, particularly for individuals with co-existing conditions. The prevailing absence of clinical reasoning highlights the importance of employing ChatGPT solely as a tool, rather than relying on it as an autonomous decision-maker. Its lack of clinical reasoning highlighted the need for human intervention and expert collaboration for precise personalized evaluations.

Long-term Favorable Efficacy of Regular and Repeated Hospitalizations with a Personalized Diet and Exercise Treatment for Steatotic Liver Disease.

Objective The long-term impact of personalized diet and exercise programs for steatotic liver disease (SLD) remains unclear. Materials The subjects of this retrospective cohort study included 104 consecutive Japanese patients with SLD. The long-term treatment efficacy of personalized diet and exercise treatment was evaluated two years after the start of observation. Regular and repeated hospitalizations every 6 months (RRH group, n=23) indicated the 4 times of the number of hospitalizations, and irregular hospitalizations (IH group, n=56) showed the 1 to three times. The group without hospitalization was defined as the no hospitalization group (NH group, n=25). To balance confounding biases, the difference in treatment efficacy between the RRH and IH groups was evaluated using propensity score (PS)-matched analysis. A diet of 25 to 30 kcal/kg multiplied by ideal body weight (BW) daily, and aerobic and resistance exercise (exercise intensity of 4 to 5 metabolic equivalents daily, respectively) was performed for 6 days. Results At 2 years compared to baseline, the decrease rates of liver function tests, HbA1c, and physical findings in the RRH group were significantly higher than those in the NH or IH groups by multiple comparisons. According to the liver function tests and physical findings, the rate of decrease in the RRH group (17 cases) was significantly higher than that in the IH group (17 cases) using a PS-matched analysis. Conclusion The present study indicated the long-term favorable efficacy of personalized diet and exercise programs for SLD. In particular, this RRH program was effective in improving the findings of liver function tests and might help to sustain diet and exercise.

The effects of dietary net energy on grow-finish performance and carcass characteristics of male market pigs managed with immunological castration (Improvest).

The objective was to determine the effects of dietary net energy (NE) during the grow-finish period on live performance and carcass characteristics of intact male pigs managed with immunological castration (Improvest) compared with physically castrated (PC) male pigs. The 101-d study began when 1,008 pigs (504 intact male pigs and 504 PC male pigs; 10wk old) were allocated by weight to 48 pens with 21 intact males or 21 PC males per pen. Three dietary NE treatments were fed to pigs using five dietary phases (dietary programs were formulated according to standardized ileal digestible lysine requirements of Improvest males or PC males) to provide an average of 2,212 kcal/kg (low NE), 2,337 kcal/kg (medium NE), or 2,462 kcal/kg (high NE). The experiment was designed and analyzed as a 2 × 3 factorial with main effects of Improvest management and NE. For the overall study period, there were no significant interactions between Improvest management and NE (P ≥ 0.19) for average daily feed intake (ADFI), average daily gain (ADG), or gain:feed (G:F). There were also no significant interactions between Improvest management and NE (P ≥ 0.06) for carcass characteristics. Improvest males consumed less feed (5.3% lower ADFI; P < 0.01), grew faster (5.1% greater ADG; P < 0.01), and were more efficient (11.2% greater G:F; P < 0.01) compared with PC males. Hot carcass weight (HCW) did not differ (P = 0.16) between Improvest males and PC males (attributed to 1.6 percentage unit lower dressing percentage for Improvest males; P < 0.01); however, Improvest males were leaner (0.9mm less backfat and 0.65% greater predicted lean yield; P < 0.01) compared with PC males. For the overall study period, pigs fed low NE and medium NE diets consumed 7.5% and 4.6% more feed (P < 0.01) than pigs fed high NE diets, respectively, and pigs fed low NE diets grew 1.7% slower (P < 0.02) than pigs fed medium NE and high NE diets. This resulted in pigs fed low NE diets having 4.4% lower G:F compared with pigs fed medium NE and 8.6% lower G:F compared with pigs fed high NE diets (P < 0.01). Pigs fed low NE had 3.0kg lighter (P < 0.01) HCW compared with medium NE, while high NE had intermediate HCW that did not differ from the other two treatments. Overall, typical Improvest response levels for live performance and carcass characteristics when compared with PC males were achieved for each of the NE treatments evaluated in this study.

Comparison of Health Status and Life Satisfaction According to Food Security in Single-Person Households of Elderly Population.

This study analyzed the 2019 Community Health Survey data to compare and analyze the health levels and life satisfaction of single-person elderly households based on food security. The final study subjects were 15,606 single-person elderly individuals aged 65 and above. These subjects were classified based on their response to food security into three groups: food sufficient-diverse, food sufficient-not diverse, and food insufficient. The study results showed that the proportion of the food insufficient group among single-person elderly households was 7.4% for men and 10.6% for women, with a slightly higher rate for female elderly. Both male and female elderly over 80 years of age, with low education levels, and basic living support recipients showed significantly higher proportions in the sufficient-not diverse and food insufficient groups. For male elderly, significant differences were observed in subjective health status and oral health level in the food insufficient group, and for female elderly, stress levels also showed significant differences. Life satisfaction scores were generally lower for female elderly compared to male, and significant differences were found in both male and female elderly based on food security. Common factors that significantly influence life satisfaction among single-person elderly households, both male and female, include food security, subjective health status, and living environment satisfaction, with food security being the most impactful factor. The study suggests that it is necessary to include these significant factors in the development of various social activity programs, such as dietary programs, to enhance life satisfaction and food security of single-person elderly households.

Nutrition and diet programs are like fingerprints!

Üsküdar University Faculty of Health Sciences Head of Nutrition and Dietetics Department Assoc. Prof. Müge Arslan made important statements about rapid weight loss and shock diets.

Sustained Long-Term Significant Weight Reduction by Empagliflozin in an Adult Female Patient

Abstract A patient with diabetes and morbid obesity had her body weight increased considerably for more than 15 years, even with exercise and diet programs. She was started on metformin and empagliflozin. Treatment with metformin and empagliflozin induced weight loss of 36 kg (−27.9%) for the first 21 months, and afterward, metformin was discontinued due to gastrointestinal upset and the patient continued empagliflozin only. In the next 15 months, the patient lost further 10 kg, and hence the patient experienced a total weight loss of 46 kg (−35.6%) in a period of 3 years, bringing a remarkable change in her quality of life.