Diet Program Research Articles

Age-dependent effects of lockdown and post-lockdown periods on HbA1c during the COVID-19 pandemic: A 3-year longitudinal cohort study.

The impact of COVID-19 lockdown on glycemic control in patients with diabetes mellitus (DM) remains unclear. This study aimed to investigate the effects of lockdown measures on the metabolic parameters of patients with DM, with particular emphasis on geriatric populations. In this retrospective, longitudinal cohort study, 1224 patients were analyzed. Three periods were identified to examine the effects of the lockdown: pre-lockdown, lockdown, and post-lockdown. Each period spanned 1-year. Within each 1-year period, at least 2 measurements were taken at least 3 months apart, and their arithmetic mean was calculated. Only patients who presented to the hospital for DM management during all 3 periods were included in the study. While HbA1c levels significantly increased in patients over 65 years old during the lockdown period (P = .017), we observed a significant decrease in HbA1c levels in patients under 65 years old (P = .014). Upon further stratification of patients over 65 by age groups, HbA1c levels increased the most among those aged 75 to 85 years, with a significant rise also observed in those aged 65 to 75 years during the lockdown. However, there was no change in HbA1c levels for patients over 85 years old during the lockdown. These findings highlight the need for careful monitoring of elderly patients with DM during lockdown periods, facilitated via home care or telehealth services. Structured diet and exercise programs should also be provided for at home adherence.

Effect of a dietary iron education programme on iron status and intelligence quotient score among schoolchildren in Phatthalung province, southern Thailand

Introduction: The aim of the study was to determine the effect of a dietary iron education programme (DIEP) on children’s iron status and intelligence quotient (IQ) score. Methods: This pre-test post-test quasi-experimental study with followup utilised the Health Belief Model (HBM). Participants were children who had iron deficiency (ID) (serum ferritin <30 µg/L), with anaemia (haemoglobin 80.0 – 114.0 g/L) or without, and their caregivers. The DIEP incorporated group talks, presentations, game-based learning, and cooking. Knowledge of ID and dietary iron, caregivers’ perceptions of preventing anaemia and ID in their children, and children’s dietary intake, iron status, and IQ score (based on 60-question items adjusted for age) were determined. Statistical tests (one-way MANOVA, Friedman’s two-way ANOVA by ranks, Wilcoxon signed-rank test, Monte Carlo exact test) determined differences between pre-test, post-test, and follow-up. Results: A total of 32 child-caregiver dyads completed the study; 6.3% (n=2) of children met the Thai dietary reference intake for iron at pre-test versus 28.1% (n=9) at post-test (p=0.039) and 31.3% (n=10) at follow-up (p=0.021). Almost half of the children (n=15) who had ID at pre-test were iron replete at post-test and half (n=16) were iron replete at follow-up (p<0.001). Median IQ scores improved from pre-test to posttest (109.0 vs. 116.0; p=0.010) and were similar at post-test and follow-up (116.0 vs. 117.0; p=0.952). Conclusion: Iron status and IQ score improved following the implementation of DIEP. We recommend that this programme serves as a model for similar interventions in other schools.

THE ASSESSMENT OF KNOWLEDGE REGARDING DIETARY PATTERN IN DIABETIC PREGNANT WOMAN

Gestational diabetes mellitus (GDM) poses significant risks to maternal and fetal health, and proper dietary management is critical in mitigating these complications. In Pakistan, knowledge gaps and socio-economic barriers often limit adherence to recommended dietary practices. Objectives: To assess knowledge regarding dietary patterns among diabetic pregnant women in a tertiary care setting in Pakistan and identify barriers to effective dietary management. Methods: This cross-sectional study included 154 diabetic pregnant women receiving antenatal care at Sheikh Zayed Hospital, Lahore. Data were collected using a structured questionnaire assessing demographics, dietary knowledge, and perceived barriers. Descriptive and inferential analyses were performed using SPSS version 25, with a p-value <0.05 considered statistically significant. Results: Most participants (37.7%) had good knowledge of carbohydrate intake, while 26.0% demonstrated excellent understanding. Meal planning awareness was moderate in 44.2% of participants. Healthcare providers were the primary source of information (59.7%), yet barriers such as lack of knowledge (32.5%) and limited access to healthy foods (29.2%) were prevalent. Significant gaps in knowledge and practice were identified, particularly among underweight and overweight/obese women. Conclusion: This study underscores the need for structured dietary education programs tailored to the cultural and socio-economic context of Pakistan. Integrating nutritional counseling into antenatal care can enhance knowledge and improve dietary practices, reducing the risks associated with gestational diabetes.

DASH Diet Versus Intermittent Fasting on Insulin Resistance in NAFLD Patients

objectives: To compare between intermittent fasting and DASH diet on glycemic profile in non-alcoholic fatty liver patients. Methods:60 (men and women) prediabetic nonalcoholic fatty liver patients participated in this study; assigned randomly to three groups: Group (A): intermittent fasting time-restricted feeding (TRF) subjects consumed 100 % of their energy needs in an 8 hours period of time each day, with their caloric intake divided into three meals consumed at 1 p.m., 4 p.m., and 8 p.m. schedule (8-hr daily eating period, the remaining 16 hours per 24-hour period made up the fasting period). Group (B): the dietary approach to stop hypertension (DASH) subjects consumed 100 % of their energy needs divided into three meals consumed at 8 a.m., 1 p.m., and 8 p.m. (12-hr eating period). Group (C): control group; all subjects didn’t follow any diet regimen or calorie deficit. all participants subjected to 30 minutes moderate aerobic exercise on treadmill. Subjects tested before and after 8 weeks of the study. Results: The nonalcoholic fatty liver patients in Group B received DASH diet program more improved fasting glucose reduction percentage (18.25%), followed by patients in Group A (14.79%) received intermittent fasting program, and then those in Group C (2.55%) control group & Group B received DASH diet program more improved HOMA IR reduction percentage (62.88%), followed by patients in Group A (45.23%) received intermittent fasting program, and then those in Group C (6.77%) received control group. Conclusion; both Dash & IF are effective therapeutic approach to control insulin resistance in NAFLD patients, prevention strategy for diabetes type 2.

Effects of a Telenutrition Weight Loss Program Supported with Telemonitoring and Telehealth Coaching on Anthropometric and Biochemical Measures in Overweight and Obese Adults: A Pilot Randomized Controlled Trial

Background/Objectives: Telenutrition has been reported to enable dietitians to support outpatients remotely in an accessible and convenient state. The literature shows that both telemonitoring and health coaching are effective approaches for achieving a greater impact on weight loss and the client’s compliance with their diet. The purpose of the present study was to assess the impact of a telenutrition weight loss program on weight reduction, supported with telemonitoring and health coaching. Methods: A pilot randomized controlled trial was conducted among overweight and obese adults. The control group (n = 11) received a hypocaloric and tailored diet via telenutrition. The intervention group (n = 18) also received a hypocaloric and tailored diet via telenutrition, but it was supported with weekly telemonitoring and monthly telehealth coaching. Results: Participants who joined the intervention group showed a reduction in weight, BMI, fat %, visceral fat, and WC, whereas participants in the control group only displayed a reduction in WC after a period of 3 months. Comparing between the groups, a greater reduction in weight, BMI, fat %, and visceral fat was seen in the intervention group. Furthermore, muscle % was significantly higher in the intervention group after a period of 3 months. At the 6-month follow-up, the intervention group still showed promising results, but they were not significant. Conclusions: Our data indicate that the integration of the three approaches of telenutrition, telemonitoring, and health coaching in dietary weight loss programs can have significant impacts on weight loss in obese and overweight individuals.

Individual and socio-psychological characteristics as predictors of physical activity among men living with overweight and obesity taking part in the Aussie Fans in Training weight management behaviour change programme

Background: Sufficient physical activity (PA) is important to reduce the risk of men developing chronic diseases and to improve mental health. The effectiveness of PA programmes can vary, however, among men. Individual and socio-psychological characteristics may affect the level of men’s PA before starting a behaviour change programme as well as changes in PA during the programme. Aims: The primary objective of this study was to examine the role of individual and socio-psychological characteristics in predicting men’s (a) accelerometer-assessed PA (step count and moderate to vigorous PA [MVPA]) upon presentation to a behaviour change programme and (b) changes in PA (step count and MVPA) during a behaviour change programme. Methods: A total of 109 men (mean age = 45.5 years, SD = 7.8 years, mean body mass index = 34.5 kg/m2, SD = 5.1 kg/m2) who participated in the Australian Fans in Training 3-month PA and dietary behaviour change programme in 2018 participated in this study. Before and after completing the 12-week programme, men completed assessments including individual (age, weight) and socio-psychological (psychological needs support, psychological needs satisfaction, positive affect and negative affect) characteristics. We used regression analysis to examine the relationship between these variables and PA. Results: At baseline, men’s weight (β = –.36, p < .001) and positive affect (β = .29, p < .01) were significant predictors of step count. At baseline, men’s weight (β = –.21, p < .05) and negative affect (β = .23, p < .05) were significant predictors of MVPA, though the overall model did not display statistical significance. The overall regression models did not significantly predict changes in either step count or MVPA pre- to post-programme. Conclusion: The influence of weight and positive and negative affect in predicting PA outcomes suggests that tailoring men’s health behaviour change interventions to individual circumstances and needs could enhance their effectiveness for some men.

A pilot study of a virtual reality (VR)-based dietary education program in individuals at risk of or with type 2 diabetes

A pilot study of a virtual reality (VR)-based dietary education program in individuals at risk of or with type 2 diabetes

Impact of Continuous Glucose Monitoring Versus Blood Glucose Monitoring to Support a Carbohydrate-Restricted Nutrition Intervention in People with Type 2 Diabetes.

Introduction: Low- and very-low-carbohydrate eating patterns, including ketogenic eating, can reduce glycated hemoglobin (HbA1c) in people with type 2 diabetes (T2D). Continuous glucose monitoring (CGM) has also been shown to improve glycemic outcomes, such as time in range (TIR; % time with glucose 70-180 mg/dL), more than blood glucose monitoring (BGM). CGM-guided nutrition interventions are sparse. The primary objective of this study was to compare differences in change in TIR when people with T2D used either CGM or BGM to guide dietary intake and medication management during a medically supervised ketogenic diet program (MSKDP) delivered via continuous remote care. Methods: IGNITE (Impact of Glucose moNitoring and nutrItion on Time in rangE) study participants were randomized to use CGM (n = 81) or BGM (n = 82) as part of a MSKDP. Participants and their care team used CGM and BGM data to support dietary choices and medication management. Glycemia, medication use, ketones, dietary intake, and weight were assessed at baseline (Base), month 1 (M1), and month 3 (M3); differences between arms and timepoints were evaluated. Results: Adults (n = 163) with a mean (standard deviation) T2D duration of 9.7 (7.7) years and HbA1c of 8.1% (1.2%) participated. TIR improved from Base to M3, 61-89% for CGM and 63%-85% for BGM (P < 0.001), with no difference in change between arms (P = 0.26). Additional CGM metrics also improved by M1, and improvements were sustained through M3. HbA1c decreased by ≥1.5% from Base to M3 for both CGM and BGM arms (P < 0.001). Diabetes medications were de-intensified based on change in medication effect scores from Base to M3 (P < 0.001). Total energy and carbohydrate intake decreased (P < 0.001), and participants in both arms lost clinically significant weight (P < 0.001). Conclusion: Both the CGM and BGM arms saw similar and significant improvements in glycemia and other diabetes-related outcomes during this MSKDP. Additional CGM-guided nutrition intervention research is needed.

The relationship between the BMI value of children and the financial situation of families, as well as the age of children

Aim: The research aimed to establish whether the family’s financial situation had an impact on the BMI values of the children studied, to determine the link between the family’s financial situation, the child’s age and the frequency children were given selected foodstuffs, as well as to verify whether the frequency of consumption of selected foodstuffs has an impact on children’s BMI values. Methods: BMI values were calculated for each child. Dietary habits were studied using a developed proprietary questionnaire. The questionnaire contained a list of products from 12 food groups, wherein vegetables and fruit were analysed separately, but without a division into those rich in vitamin C and carotene. Results: Analysis of the study group according to financial situation showed, to name a few, that the median consumption of fish, cold meats and potatoes among children from families declaring their financial situation as average was lower than that in the remaining groups. Children with a good financial situation consumed eggs and poultry statistically significantly more often than those with an average financial situation, and significantly less often - cakes and biscuits. Children over 11 years old consumed ready sauces (ketchup, mayonnaise) more often than younger children. Conclusion: The consumption of particular foodstuffs was affected by the families’ financial situation and the age of children. Children from families with an average financial situation consumed vegetables less often than the remaining children. Despite there being no effect of the frequency of particular foodstuffs consumption on BMI, one in five people were overweight. It is crucial that the healthy lifestyles and proper diet programmes are implemented in educational establishments.

The effect of diet-induced weight-loss on subcutaneous adipose tissue expression of genes associated with thyroid hormone action

Background & AimsWe have recently demonstrated that subcutaneous adipose tissue (SAT) expression of genes associated with thyroid hormone (TH) action is altered in obesity and insulin resistance. The aim of the present study was to examine the effect of diet-induced weight-loss on SAT expression of genes associated with TH action. MethodsThe study group comprised 38 individuals with overweight/obesity, which completed 12-week dietary intervention program. Hyperinsulinemic-euglycemic clamp and SAT biopsy were performed before and after the program. Fifteen normal-weight individuals were examined at baseline only. ResultsOverweight/obese individuals had lower free thyroxine (fT4) and higher free triiodothyronine (fT3)/fT4 ratio, lower SAT TH receptor isoforms (TRα and TRβ, encoded by THRA and THRB, respectively) and peroxisome proliferator-activated receptor γ coactivator 1α (PPARGC1A) mRNA expression and higher SAT type II and type III iodothyronine deiodinase (encoded by DIO2 and DIO3, respectively) and nuclear receptor corepressor (NCOR1) mRNA expression in comparison with normal-weight individuals. Diet-induced weight loss resulted in a decrease in fT3 and fT3/fT4 ratio and an increase in SAT THRA, THRB and PPARGC1A. SAT NCOR1 and forkhead box protein O1 (FOXO1) decreased only in individuals, who lost at least 10 kg (n=20). Higher increase in insulin sensitivity after weight loss was associated with a lower decrease in fT3/fT4 ratio. ConclusionsDiet-induced weight loss partly reverses alterations in SAT expression of genes associated with TH action. Responses of circulating TH and SAT expression of genes associated with TH action to diet-induced weight loss are related to body weight and insulin sensitivity.

Changes in anthropometry, adiposity, and inflammation in Black and White women engaged in intentional weight loss.

We examined associations among changes in anthropometry, regional adiposity, and inflammatory markers in Black and White women participating in intentional weight loss. A total of 104 women with BMI ≥ 25 kg/m2 self-selected bariatric surgery (n = 66) or a diet and exercise program (n = 38). Anthropometric, dual-energy x-ray absorptiometry-quantified regional adiposity, and inflammatory markers (C-reactive protein [CRP], tumor necrosis factor α [TNF-α], soluble TNF receptor I [sTNFRI], sTNFRII, interleukin [IL]-6, and soluble IL-1 receptor antagonist) were measured at baseline and 6 months. Weight, BMI, visceral adipose tissue, and regional (android and gynoid) adiposity declined in the bariatric surgery group. Among bariatric surgery participants, Black women experienced declines of lesser magnitude in terms of weight and BMI than White women, but changes in regional adiposity and visceral adipose tissue did not differ. In the bariatric surgery group, decreases in weight and BMI were associated with decreases in CRP and IL-6 among White women, but not Black women. Decreases in weight, BMI, and android fat were associated with increases in TNF-α, sTNFRI, and sTNFRII among Black women, but not White women. Decreases in anthropometry and adiposity were observed among Black and White bariatric surgery participants; however, associations among changes in adiposity, anthropometry, and inflammation differed by race.

Exploring the effect of diet programs on the behavior of Sudanese children with autism and the prevalence and association of gastrointestinal symptoms: a multi-center cross-sectional study.

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by social difficulties, speech and nonverbal communication issues, and restricted behaviors. Nutritional issues, such as food allergies and intolerances, can affect children with ASD. This study aimed to evaluate the impact of diet programs on ASD behavior and gastrointestinal symptoms, which would be considered as a starting point to increase the family's knowledge about how to practice healthy and suitable dieting for their children. The study was a cross-sectional observational study on 45 children with an autism spectrum disorder in four centers aged 2-18 in Khartoum state. Data was collected through an interview questionnaire, which included sociodemographic, diet, gastrointestinal, and behavioral assessments. The data was analyzed using SPSS to find the correlation between the various variables. Independent t-test, Analysis of Variance, and Mann-Whitney test were used in univariant analysis to assess the association between study variables, while multiple linear regression was used in multivariant analysis for the same purpose. The study involved a large number of children with autism spectrum disorder (ASD), with 80% being male and 73.3% being school-aged. Most had parents as guardians and 71.1% were in intermediate financial status. About 20% were overweight or obese, and 57.8% did not have a specific diet program. Food selectivity was prevalent, with 22.7% having allergies to milk and wheat. ASD children experienced vomiting, gastric reflux, abdominal pain, and changes in stool characteristics. A significant link was found between financial status, behavioral status and gastrointestinal changes. High financial status was significantly different from intermediate and low statuses based on behavioral changes. However, no significant association was found in multivariant analysis. The study found that ASD children generally have good nutritional health, with a higher degree of dietary selection. The financial status of guardians significantly influenced behavioral and gastrointestinal changes in the children. Further interventional studies are recommended to assess the direct impact of diet programs on these symptoms.

The needs and prioritization of nutrition and dietary support for individuals with disabilities: an exploratory study

Objectives: Based on a survey of officers, social workers, and dietitians involved in managing nutrition and welfare policies or projects for vulnerable groups in local governments or private welfare institutions, this study aimed to assess the need for nutritional and dietary support policies and programs for persons with disabilities (PWD), as well as to identify appropriate support measures. Methods: An online survey was conducted from March 2 to 15, 2021. The survey included 20 questions exploring perspectives on the nutritional status of PWD, their need for nutritional and dietary support policies and programs, and the prioritization of appropriate support measures. A total of 132 responses were analyzed. Results: Approximately 68.9% of the respondents rated the nutritional status of PWD as “bad” or “very bad.” A substantial number identified “difficulty in purchasing ingredients, cooking, and preparing meals independently due to disability,” and “limited knowledge about nutrition and recipes necessary for maintaining a healthy and balanced diet” as the primary challenges in the dietary and nutritional management of this population. Additionally, 97.0% of the respondents deemed that the introduction of nutritional and dietary support policies and programs for PWD was “needed” or “very much needed.” Priority strategies to implement and strengthen these policies and systems included the “development of customized programs and services tailored to the needs and demands of the target population” and the “establishment of a dedicated department with specialized personnel.” Conclusion: Comprehensive nutritional and dietary support policies and programs should be actively implemented to ensure a healthy and stable diet for PWD, tailored to meet their actual needs and demands.

An educational needs analysis of sustainable dietary education for nutrition teachers: an application of the IPA, Borich needs assessment and The locus for focus model

Objectives: This study aimed to investigate the importance and performance levels of sustainable dietary education across the health, environment, and society domains as perceived by nutrition teachers and evaluate the needs and priorities for sustainable dietary education.Methods: An online survey was conducted for 151 nutrition teachers in Jeollanam-do. The survey included 20 questions across the health, environment, and society domains. The data were analyzed using a paired-sample t-test, the importance-performance analysis (IPA), the Borich needs assessment model, and the locus for focus model. Results: Overall, the average importance levels of the 20 items of sustainable dietary education were significantly higher than their average performance levels (4.44 vs. 3.68). The examination of each educational domain revealed that although the importance of education in the health domain was recognized and actively practiced by the nutrition teachers, the performance was comparatively lower in the environment and society domains. The Borich needs assessment and the locus for focus model identified education on biodiversity conservation, plant-based protein, and the use of local food as the top-priority group in the environment domain along with fair and ethical food, food security, regional food culture, food policy and trade, and family dining culture as the second-priority group in the society domain.Conclusions: The results of this study underscore the need to support the nutrition teachers’ perception and practice of sustainable dietary education in the environment and society domains. We believe that the educational needs and priorities proposed in this study will be considered in the future development and modification of sustainable dietary education programs.

The Role of Greek Olive Leaf Extract in Patients with Mild Alzheimer's Disease (the GOLDEN Study): A Randomized Controlled Clinical Trial.

Background: Olive leaves are a significant source of biophenols, which have a beneficial impact on cognitive performance. Objective: To examine, for the first time, in humans the effect of the daily consumption of a beverage containing olive leaf extract (OLE) versus a Mediterranean diet (MeDi) on patients diagnosed with mild Alzheimer's Disease (AD), in addition to their regular treatment. Methods: A randomized clinical trial compared OLE's effects on cognitive and functional performance in 55 mild AD patients. Each participant was randomly assigned to two groups: (1) Group 1 was given olive leaves for making a daily beverage and MeDi instructions through monthly diet programs; (2) Group 2 received only the MeDi instructions. After six months, all participants underwent a second neuropsychological evaluation. Results: Group 1 participants had statistically significantly higher MMSE scores compared to Group 2 with a p-value of 0.0135. Specifically, the mean MMSE difference in patients receiving OLE was close to 0, indicating no memory deterioration, whereas in controls it was -4.1, indicative of cognitive decline. The remaining neuropsychological assessments (FRSSD, FUCAS, ADAS-Cog, CDR, GDS, and NPI) revealed better results in the OLE group, except for GDS, which showed no change, but without statistically significant differences between the two groups.

A 6-month randomised controlled trial to compare the effectiveness of telenutrition v. telenutrition supported by telemonitoring and health coaching in a weight loss programme: a study protocol.

One of the main challenges in weight loss programmes is compliance with diet and achievement of sustainable changes in eating habits and lifestyles. Most clients desire to lose weight quickly, rather than looking at long-term changes. The literature suggests applying telenutrition, owing to its convenience and easy access in combination with both telemonitoring and health coaching, where confounding factors in the diet are tackled. A 6-month randomised controlled trial will be conducted to compare the effectiveness of telenutrition v. telenutrition supported by weekly telemonitoring and monthly health coaching in a weight loss programme. Participants are obese and overweight adults of both sex groups, aged 20-50 years who will be randomised to join a control or an intervention group. A total of three visits will be scheduled for all participants: at baseline, after three months and after six months. This study aims to answer the question of whether participants following a weight loss programme supported by telemonitoring and health coaching will increase their weight loss and compliance to the diet in comparison with the control group. This will be the first trial to assess the impact of integrating telemonitoring and health coaching in weight loss programmes, including the evaluation of associated confounding factors such as general nutrition education, eating behaviour, sensory modalities and hunger, and stress. This trial will support dietary weight loss programmes, contribute to the emerging field of telenutrition and provide advice for clinical dietitians and health coaches to work together to help individuals lose and maintain weight.

Current Status of Diabetes Prevention and Control in China and Early-Stage Intervention Strategies

In recent years, the prevalence of diabetes in China has continued to rise, with the adult prevalence expected to reach 12.8% by 2023. To control this trend, the government has introduced several policies and invested substantial funds in the prevention and treatment of diabetes, achieving certain results. Prediabetes is a stage where blood glucose metabolism can still be restored. For individuals in this stage, dietary and exercise intervention programs are recommended to prevent or delay the onset of diabetes, improve quality of life, and reduce the burden of disease on individuals, families, and society.

Effect of plastic-free diet, education and Bisphenol A exposure feedback on urine BPA in adolescent

Abstract Background BPA is an endocrine disrupting chemical and is mostly taken orally. Adolescence is the critical sensitivity to these chemicals is maximum. This study was conducted to compare the effects of a plastic-free diet program, plastic-free diet education program and BPA exposure feedback on urine BPA levels in adolescents with high use of packaged products. Methods The first phase of the two-phase study is descriptive, the second phase is a single-centre, single-blind, three-arm non-randomized experimental design. The study was conducted at Antalya/Türkiye in the 2022-2023 academic year, and in the first stage, adolescents with high use of plastic packaged products and low attitudes towards healthy nutrition were identified. In the second stage, participants were assigned to the group-1 (n = 36), group-2 (n = 36) and group-3 (n = 36) by simple random sampling method. An eight-week plastic-free diet program was applied to the group 1, plastic-free diet education program and BPA exposure feedback was given to the group-2, and only BPA exposure feedback was given to the group-3. Plastic Packaged Product Usage Survey, Attitude Scale towards Healthy Nutrition, and spot urine samples were used to collect data. Results It was found that 2% of adolescents used low plastic packaging, 34% medium, 57% high, and 7% very high. Pre-posttest urine BPA levels ng/ml (µg/g creatinine) were 1.98 (2.54), 1.43 (1.51) in the intervention1 group, respectively; 1.91 (2.35), 1.43 (1.47) in the intervention2 group; It was found to be 1.97 (2.49) and 1.49 (1.66) in the intervention3 group. The effect sizes of pre-posttest BPA/creatinine values were calculated as 1.38, 1.13 and 1.09 in intervention1-2-3 groups, respectively. Conclusions All three interventions (plastic-free diet program, plastic-free diet education program and BPA exposure feedback) were effective in reducing urinary BPA levels, reducing plastic-packaged product use levels, and increasing attitudes towards healthy eating. Key messages • Since all three interventions are effective in reducing adolescents’ urinary BPA levels, it may be recommended to use the intervention appropriate to the field conditions. • In the post-tests, the use of plastic packaged products by adolescents in all three groups decreased and their attitudes towards healthy nutrition increased.

The Effect of a Multidisciplinary Lifestyle Intervention Program on Apelin-12, Vaspin and Resistin Concentrations in Children and Adolescents with Overweight and Obesity.

Background: Obesity in childhood and adolescence has reached epidemic proportions in recent decades. Methods: In the present study, we determined the concentrations of apelin-12, vaspin and resistin in 106 children and adolescents with overweight or obesity before and after the implementation of a multidisciplinary, personalized lifestyle intervention program of diet, sleep and exercise for 1 year. All subjects attended our Center for the Prevention and Management of Overweight and Obesity in Childhood and Adolescence. Results: Following the lifestyle intervention, there were significant decreases in BMI (p < 0.01), apelin-12 (p < 0.05) and resistin (p < 0.01) concentrations, and an increase in vaspin (p < 0.01) concentration. Glucose was the best positive predictor of apelin-12 (b = 0.236, p < 0.05), and osteopontin was the best negative predictor of changes in apelin-12 (b = -0.299, p < 0.05). Vaspin correlated positively with adiponectin (b = 0.29, p < 0.05), while vitamin D (b = 0.621, p < 0.05) was the best positive predictor of vaspin. BMI z score (b = -0.794, p < 0.05), HDL (b = -0.284, p < 0.05) and HbA1C (b = -0.262, p < 0.05) were the best negative predictors of changes in vaspin. BMI z score was the best positive predictor of resistin (b = 0.437, p < 0.05). Conclusions: These findings suggest that apelin-12, vaspin and resistin correlate with indices of obesity, glucose, lipids and bone metabolism, while interaction with other proteins, such as osteopontin and adiponectin, was also noted. Therefore, apelin-12, vaspin and resistin may be used as biomarkers in children and adolescents with overweight and obesity.

Obesity medicine provider-directed health coaching in a commercial weight loss program: Proof of concept

BackgroundObesity remains a leading serious chronic disease and cause of death in the U.S. Despite previous research in diets (i.e., caloric restriction), physical activity levels, and biochemical markers, no studies to date have investigated the combination of an obesity medicine physician with a health coach alongside a commercial program for reducing body weight. As a result, this pilot study aims to assess the relationship between a commercial diet program and health and wellness coaching (HWC) for weight reduction outcomes when delivered in conjunction with an obesity medicine physician chronic disease care model, as a proof-of-concept study. MethodsThis 24-week proof-of-concept study was pragmatic, being an unblinded, unrandomized, uncontrolled, longitudinal, observational study. Its purpose was to assess participant weight reduction from a commercial weight reduction program using a pre-packaged portion-controlled reduced-calorie diet while meeting with a health coach and obesity medicine physician for counseling and support. Participants in the sample underwent a commercial weight reduction program through dietary control while meeting with an HWC. A repeated measures ANOVA was conducted to determine the weight reduction trends across a 24-week program. ResultsThis study included n = 53 participants; a majority were white females (n = 45; 85 %), with an average (SD) age of 50.3 (12.2) years. There was a significant improvement in weight reduction (21.8 ± 9.4 lbs. WL) seen throughout the 24-week program (F (7, 364) = 33.129, p < 0.001), with a large effect (η2 = 0.922). ConclusionThis proof-of-concept project found that Obesity Medicine Physician-directed, portion-controlled meals and HWC can improve weight reduction across a 24-week program using portioned-controlled meals. Confirmation of these findings and their clinical significance requires a follow-up randomized, controlled clinical trial using validated assessment tools.