Improvement In Dietary Patterns Research Articles

Education Intervention Has the Potential to Improve Short-Term Dietary Pattern among Older Adults with Undernutrition.

Low-cost educational interventions to improve dietary pattern is a pragmatic solution to prevent undernutrition in low- and middle-income countries. A prospective nutritional education intervention was conducted among older adults aged 60 years or above with undernutrition with 60 people in each intervention and control group. The objective was to develop and evaluate the efficacy of a community-based nutrition education intervention to improve the dietary pattern of older adults with undernutrition in Sri Lanka. The intervention consisted of two modules to improve the diversity, the variety of diet, and the serving sizes of food consumed. The primary outcome was the improvement of the Dietary Diversity Score (DDS) and the secondary outcomes were the Food Variety Score and Dietary Serving Score, which was assessed using the 24 h dietary recall. The mean difference in scores between the two groups was compared using the independent sample t-test at baseline, two weeks and three months post-intervention. Baseline characteristics were comparable. After two weeks, only the difference in DDS between the two groups was statistically significant (p = 0.002). However, this was not sustained at three months (p = 0.08). This study concludes that nutrition education interventions have the potential for short-term improvement in dietary patterns in older adults in a Sri Lanka setting.

The improvement of healthy habits in patients with severe mental disorders: the LIFESTYLE trial

IntroductionThe impact of unhealthy lifestyle behaviors is significant in the general population, being associated with chronic physical conditions, reduced life expectancy and increased healthcare costs. This impact is higher in patients with severe mental disorders (SMD). In fact, SMD patients present higher rates of obesity, metabolic syndrome, diabetes, and cardiovascular diseases compared to the general population. The relationship between physical and mental health is multifactorial and includes side effects of many psychotropic drugs, sedentary behaviors, reduction of physical exercise, smoking, and substance abuse. Finally, illness-related factors, including cognitive impairment, reduced psychosocial functioning, social isolation, and self-stigma, can significantly impact on patients’ physical health.ObjectivesThis study, coordinated by the Department of Psychiatry of the University of Campania “L. Vanvitelli”, aims to test the efficacy of a lifestyle group intervention, compared to a brief psycho-educational intervention, in improving healthy habits in a real-world sample of patients with SMD.Methods401 patients were recruited and randomly allocated to receive the experimental or the control intervention. Inclusion criteria were age between 18 and 65 years; primary diagnosis of schizophrenia, schizoaffective disorder, delusional disorder, other psychotic disorders, major depressive disorder, or bipolar disorder according to the DSM-5; BMI≥ 25. At baseline and 6 months post-randomization all patients were administered: SCID-5, BPRS, MATRICS, MCCB, IPAQ and a questionnaire on lifestyle behaviors developed by the Italian National Institute of Health.Results206 patients were allocated to the experimental group and 195 in the control one, of which 43.3% had a main diagnosis of bipolar disorder, 29.9% of psychosis and 26.9% of major depression. Patients were mainly female (57%), with a mean age of 45.6±11.8 years and with an educational level of 11.7±2.9 years. All patients were treated with at least one psychotropic drug. About 29.4% of patients reported performing physical activity regularly, while only 3.7% performed at least 75 min of vigorous physical activity per week. Patients practicing physical activity report higher levels of perceived satisfaction with the quality of life compared with non-active patients (p < 0.005). A general improvement in dietary patterns from T0 to T1 was found in patients receiving the experimental intervention. We found an increased weekly intake of fish (p < .001), vegetables (p < .05) and fresh fruit (p < .01). Moreover, we also found a reduction of junk food (p <.05) and of weekly consumption of cereals (p < .01).ConclusionsOur findings show that patients with SMD can improve their lifestyle behaviors with appropriate support. There is the need to implement similar interventions clinical practice to reduce the mortality gap in patients with SMD.Disclosure of InterestNone Declared

Effect of Regular Swimming Training and Healthy Dietary Pattern on Endocrine-Related Indicators in Autism Spectrum Disorder – A New Insight

Background: Autism spectrum disorder (ASD), is a neuro-developmental disorder that is mainly characterized by social interaction impairments. Health-related challenges including weight abnormalities and hormonal impairment seem to have a higher prevalence in ASD individuals. The purpose of this study was to assess the effect of aquatic training and diet modification according to recommended guidelines on endocrine-related indicators including growth parameters and IGF-1 in teenage and young individuals with ASD. Methods: 5 individuals diagnosed with ASD (age = 14.86 ± 1.22) participated in regular aquatic sessions for 12 weeks, 2 sessions per week which lasted 60 min in each session. Body weight, stature, body mass index (BMI), and IGF-1 were measured before and after the study. Caregivers and healthcare centers to which the participants were referred for their therapeutic purposes, were given booklets and brochures regarding nutritional recommendations published by health authorities. Results: All of the participants were overweight (BMI = 27.98 ± 1.44). There was a significant improvement in body weight, BMI, and IGF-1 levels after the study (p ≤0.05). Although, there was no significant improvement in dietary pattern (p = 0.3) despite reported improvements recorded by families regarding food variety and consumed food groups. Conclusion: Aquatic training and diet modification can improve growth and health-related indicators in individuals with ASD.

Body size dissatisfaction associated with dietary pattern, overweight, and physical activity in adolescents - a cross-sectional study.

This study analyzed the association of body size dissatisfaction with body mass index, dietary pattern, and physical activity in adolescents. A sample of 1,074 participants between 10-17years was recruited. Body size dissatisfaction was assessed by silhouettes scale. Dietary pattern, physical activity, and socioeconomic status were assessed by questionnaires. Body mass index was objectively measured. Body size dissatisfaction prevalence was 77.0%, where 29.8% desired to increase body size and 47.2% desired to decrease body size. Adolescents who desired to increase body size were more likely to consume vegetables and sweets, and less likely to be in highest quartile of physical activity than satisfied adolescents. Those adolescents who desired to reduce body size were more likely to have low fruit consumption and low vegetables consumption than satisfied adolescents. Health actions aiming to reduce body dissatisfaction in adolescents should address the improvement of dietary pattern and physical activity engagement, considering the desire to increase or to decrease body size, once were differently associated in this study. This article is protected by copyright. All rights reserved.

Testosterone-Associated Dietary Pattern Predicts Low Testosterone Levels and Hypogonadism.

Obesity and low serum testosterone (T) levels are interrelated and strongly influenced by dietary factors, and their alteration entails a great risk of hypogonadism. Substantial evidence suggests a bidirectional relationship between nutrient metabolism (e.g., glucose, lipids, and iron) and T levels in men; however, T-related dietary patterns remain unclear. This study investigated the dietary patterns associated with serum total T levels and its predictive effect on hypogonadism and the body composition. Anthropometry, blood biochemistry, and food frequency questionnaires were collected for 125 adult men. Dietary patterns were derived using a reduced rank regression from 32 food groups. Overall prevalence rates of central obesity and hypogonadism were 48.0% and 15.7%, respectively. An adjusted linear regression showed that age, insulin, red blood cell (RBC) aggregation, and transferrin saturation independently predicted serum total T levels (all p < 0.01). The total T-related dietary pattern (a high consumption of bread and pastries, dairy products, and desserts, eating out, and a low intake of homemade foods, noodles, and dark green vegetables) independently predicted hypogonadism (odds ratio: 5.72; 95% confidence interval: 1.11‒29.51, p < 0.05) for those with the highest dietary pattern scores (Q4) compared to those with the lowest (Q1). Scores were also negatively correlated with the skeletal muscle mass (p for trend = 0.002) but positively correlated with the total body fat mass (p for trend = 0.002), visceral fat mass (p for trend = 0.001), and to a lesser extent, subcutaneous fat mass (p for trend = 0.035) after adjusting for age. Randomized controlled trials are needed to confirm that improvement in dietary pattern can improve T levels and reduce hypogonadism.

The effect of a lifestyle intervention on pregnancy and postpartum dietary patterns determined by factor analysis.

Optimizing maternal diet during pregnancy improves maternal and infant health. This study assessed the effect of an antenatal lifestyle intervention for women with overweight or obesity on dietary patterns during pregnancy and post partum. This study is a secondary analysis of a randomized controlled trial in which pregnant women (BMI ≥ 25 kg/m2 ) received lifestyle advice (n = 943) or standard care (n = 924). Dietary pattern analysis was undertaken using factor analysis with comparisons between trial entry and 28 weeks, 36 weeks, and 4 months post partum. The dietary pattern analysis revealed two distinct patterns: "prudent" and "Western." There was a significant difference between groups in the change over time for both patterns (P < 0.001). For the prudent score, the lifestyle group had higher scores at all times after trial entry compared with standard care, while for the Western score, the lifestyle group had a lower score at 28 weeks. The intervention effect differed based on trial entry BMI (P = 0.043) and smoking (P = 0.019), with higher prudent scores for women with obesity compared with overweight and smokers compared with nonsmokers. The provision of an antenatal lifestyle intervention for women with overweight and obesity was associated with an improvement in dietary patterns that persisted post partum. This has important implications for the future consideration of optimal dietary intervention components to include in antenatal lifestyle interventions.

Subtropical fruits grown in Spain and elsewhere: A comparison of mineral profiles

Large quantities of essential minerals are present in subtropical fruits, which constitute a valuable, if relatively unknown, source of dietary micronutrients, and consumption of these foods is tending to increase. Our aim in this study was to investigate the mineral composition (Ca, P, Na and K) of Spanish-grown subtropical fruits in comparison with that of similar fruits sourced elsewhere. The contribution of these fruits to total daily mineral intake per capita in Spain and to mineral intake per regular fruit size was also estimated. The results obtained showed the mineral content of the Spanish-origin samples to be comparable to that of those from other countries, except for avocados, in which the concentrations of P and K were noticeably higher in the non-Spanish fruits (530 vs. 196 and 5260 vs. 3664mg/kg, respectively). The contribution of subtropical fruits to daily mineral intake in adults was estimated to be 2–7% for Ca and P, approximately 10% for K and negligible for Na. In conclusion, subtropical fruits of Spanish origin present a balanced mineral composition and the consumption of these fruits is recommended as a means of increasing the intake of essential minerals (especially in a population such as that of Spain, where there is considerable room for improvement in dietary patterns).

Inappropriate Dietary and Occupational Patterns: Major Risk Factors Associated With Brucellosis in the Area Covered by Karaj Health Center No. 2

Background: Brucellosis is one of the most common diseases among humans and livestock. Using contaminated and unpasteurized dairy products, having contact with infected livestock and, in general, inappropriate dietary patterns, as well as lack of hygiene, can be noted as the most common modes of transmission for such a disease. Objectives: Since the establishment of Alborz province in Iran and, accordingly, Alborz university of medical sciences, Karaj, Iran, there has been no study on the epidemiological situation of the disease. Therefore, the present study examines the epidemiology of Brucellosis at Karaj Health center No. 2, Karaj, Iran, during 2011 - 2012. Patients and Methods: This research was a cross-sectional descriptive study, on patients with Brucellosis, during 2011 - 2012, in the area covered by Karaj health center No. 2, Karaj, Iran. The data about all suspected cases, collected from polyclinic, laboratories and health centers, and confirmed by Wright, combs Wright and 2ME tests were reviewed. After recording the demographic data and laboratory results, they were entered into STATA 11 software and analyzed. Results: The number of patients reported in this study was 67. The incidence of the disease during 2011 - 2012 was, respectively, 3.75 and 4.6 per hundred thousand and the average incidence of the disease was 4.2 per hundred thousand. The highest rate of infection, in terms of occupation, was found among ranchers (40.29%). In 100% of the cases, there was a history of consumption of cottage cheese, fresh cow milk or other unpasteurized dairy products. Considering the incidence season, most cases of the disease (38.80%) had occurred in the spring. In terms of gender, 56.71% were male and 43.28% of patients were female. As well, in terms of age, more 50% of the patients were in the age groups of 31 - 40 and 41 - 50 years old. Conclusions: Given the occurrence of more cases of the disease among individuals with risk factors, such as consumers of unpasteurized dairy products, as well as ranchers, it seems that healthcare education, isolation of the places where animals are kept from humans, livestock vaccination, and, particularly, improvement of dietary patterns are effective in reducing the incidence of the disease.

Dietary quality among men and women in 187 countries in 1990 and 2010: a systematic assessment.

SummaryBackgroundHealthy dietary patterns are a global priority to reduce non-communicable diseases. Yet neither worldwide patterns of diets nor their trends with time are well established. We aimed to characterise global changes (or trends) in dietary patterns nationally and regionally and to assess heterogeneity by age, sex, national income, and type of dietary pattern.MethodsIn this systematic assessment, we evaluated global consumption of key dietary items (foods and nutrients) by region, nation, age, and sex in 1990 and 2010. Consumption data were evaluated from 325 surveys (71·7% nationally representative) covering 88·7% of the global adult population. Two types of dietary pattern were assessed: one reflecting greater consumption of ten healthy dietary items and the other based on lesser consumption of seven unhealthy dietary items. The mean intakes of each dietary factor were divided into quintiles, and each quintile was assigned an ordinal score, with higher scores being equivalent to healthier diets (range 0–100). The dietary patterns were assessed by hierarchical linear regression including country, age, sex, national income, and time as exploratory variables.FindingsFrom 1990 to 2010, diets based on healthy items improved globally (by 2·2 points, 95% uncertainty interval (UI) 0·9 to 3·5), whereas diets based on unhealthy items worsened (−2·5, −3·3 to −1·7). In 2010, the global mean scores were 44·0 (SD 10·5) for the healthy pattern and 52·1 (18·6) for the unhealthy pattern, with weak intercorrelation (r=–0·08) between countries. On average, better diets were seen in older adults compared with younger adults, and in women compared with men (p<0·0001 each). Compared with low-income nations, high-income nations had better diets based on healthy items (+2·5 points, 95% UI 0·3 to 4·1), but substantially poorer diets based on unhealthy items (−33·0, −37·8 to −28·3). Diets and their trends were very heterogeneous across the world regions. For example, both types of dietary patterns improved in high-income countries, but worsened in some low-income countries in Africa and Asia. Middle-income countries showed the largest improvement in dietary patterns based on healthy items, but the largest deterioration in dietary patterns based on unhealthy items.InterpretationConsumption of healthy items improved, while consumption of unhealthy items worsened across the world, with heterogeneity across regions and countries. These global data provide the best estimates to date of nutrition transitions across the world and inform policies and priorities for reducing the health and economic burdens of poor diet quality.FundingThe Bill & Melinda Gates Foundation and Medical Research Council.

Predictors of Long‐Term Weight Loss in Adults With Modest Initial Weight Loss, by Sex and Race

Effective weight management interventions could reduce race-sex disparities in cardiovascular disease (CVD), yet little is known about factors associated with successful weight loss maintenance in race-sex subgroups. In the Weight Loss Maintenance trial (WLM), overweight/obese (BMI 25-45 kg/m(2)) adults who lost ≥4 kg in a 6-month behavioral weight loss intervention (phase I) were randomized into one of three 30-month maintenance interventions (phase II). To investigate predictors in subgroups, randomized groups were combined for this analysis. Of 1,685 phase I participants, 1,032 (61%) entered phase II, including 12% black men (BM), 26% black women (BW), 25% white men (WM), and 37% white women (WW). Weight change over the 36-month study ranged from -2.3% (95% confidence interval = -3.1 to -1.5%) in BW to -4.5% (95% confidence interval = -5.7 to -4.0%) in WM, the result of differential weight loss during phase I. Within race, men lost significantly more weight than women, but within sex group, weight loss did not differ significantly between races. Although participants regained weight during phase II, regain did not differ by race-sex group, and mean weight at the end of the study was significantly lower than phase I entry weight for each subgroup. In regression models, phase I weight loss predicted overall 36-month weight loss in all race-sex groups. Healthy dietary pattern at entry, improvement in dietary pattern, or both were predictive in three of four race-sex groups. Few other variables other than initial weight loss and dietary pattern were predictive. Future research should identify additional modifiable influences on long-term maintenance after a modest weight loss.

The effect of personal lifestyle intervention among health care providers on their patients and clinics; the Promoting Health by Self Experience (PHASE) randomized controlled intervention trial

ObjectiveTo determine the effect of self-experience multidisciplinary lifestyle intervention on health care providers (HCPs), patients and clinics. MethodsWe randomized 15 primary-care clinics (serving 93,821 members), matched by patient profile, to provide the HCPs, either intervention or control HMO program. We followed personally 77 HCPs and 496 patients, and evaluated clinical measurement rate (CMR) changes (January–September 2010; Israel). ResultsHCPs within the intervention group demonstrated personal improvement in health initiative attitudes (p<0.05 vs. baseline), and a decrease in salt intake (p<0.05 vs. control). HCP intervention group's patients exhibited overall improvement in dietary patterns, specifically in salt, red meat (p<0.05 vs. baseline), fruit, and vegetable (p<0.05 vs. control) intake. Height, lipids, HbA1C and CMR increased within the intervention group's clinics (p<0.05 vs. baseline) with increased referral to angiography tests (p<0.05 vs. control). Within the intervention group, HCPs' salt pattern improvement was associated with increased lipid CMR (r=0.71; p=0.048), and lower HCPs' body weight was associated with increased blood pressure (r=−0.81; p=0.015) and lipid (r=−0.69; p=0.058) CMR. ConclusionsHCPs' personal lifestyles are directly correlated with their clinical performance. Interventions to promote health through HCP's self-experience are valuable and somewhat haloed to patients and clinics, suggesting an adjunct strategy in primary prevention.

Nutrition education and counselling as strategic interventions to improvehealth outcomes in adult outpatients with HIV: a literature review

Malnutrition poses a significant risk for people living with HIV and accelerates disease progression. This is because adequate nutrition is essential for optimal immune function. This article discusses research on the role and use of nutrition education or counselling as a strategic intervention to improve health outcomes through better health behaviour in adult outpatients with HIV. Ten studies (five quantitative and five qualitative) met the inclusion criteria of the literature review. The findings of the studies related to the following outcomes of nutrition interventions: increases in fat-free and lean body mass; offsetting the adverse effects of HIV infection in patients with a low CD4 cell count; significant improvement in dietary patterns with resultant greater adherence to HIV medications and fewer side effects; and agreement on the importance of addressing the nutrition concerns. The article discusses the five prominent themes that emerged from the literature review: 1) ethical issues in HIV/AIDS research; 2) the role of health and culture in nutrition interventions; 3) HIV stigma and its impact on nutrition interventions; 4) the socioeconomics of HIV and AIDS; and 5) food security and emotional wellbeing among persons with HIV. Although the evidence base is limited and raises questions about key aspects of the quality of the research conducted to date, the overall results show that providing HIV-positive adults with culturally relevant and practical nutrition strategies can improve health outcomes, health behaviour and quality of life. Current and future nutrition interventions for persons with HIV disease should be targeted, sustainable, and rigorously evaluated. There is an urgent need for research on this topic in developing countries, particularly African ones, which are some of the most affected by HIV.

An effective lifestyle intervention in overweight children: Findings from a randomized controlled trial on “Obeldicks light”

Randomized controlled trials (RCT) have demonstrated the effectiveness of lifestyle interventions in obese children. However, the effectiveness of interventions for overweight, but no obese children has not been demonstrated yet by RCTs. A total of 66 overweight (BMI>90th< or =97th percentile) children (mean age 11.5+/-1.6 years, 58% females, mean BMI 23.4+/-1.5kg/m(2)) were randomized into a control group (CG) (n=32; no intervention for a duration of 6 months) or intervention group (IG) (n=34; 6 months intervention "Obeldicks light" based on physical activity, nutrition education, and behaviour counselling). BMI, waist circumference, skinfold thickness, bioimpedance analyses, blood pressure, physical activity based on questionnaires, and three-day-weighed dietary records were determined at baseline (T0) and 6 months (T1) later. Degree of overweight was calculated as BMI-SDS. Comparisons were performed on an intention-to-treat approach. The drop-out rate was 3% in IG and 16% in CG. At T1, 94% of the children in IG decreased their BMI-SDS and 24% of them were normal weight. The changes between T0 and T1 in BMI-SDS differed significantly (p<0.001) between IG and CG (CG: +0.05+/-0.19 BMI-SDS; IG: -0.26+/-0.22 BMI-SDS). Similar findings were observed for blood pressure, waist circumference, skinfold thickness, and fat mass based on bioimpedance analyses. In the IG, energy, fat and sugar intake decreased significantly between T0 and T1, while no significant changes were observed in the CG. The lifestyle intervention was associated with an improvement of dietary patterns and was effective in reducing degree of overweight, fat mass, waist circumference, and blood pressure.

Understanding the Maze of Nutrition Symbols and Nutrition Labeling Systems

First, there were nutrition labels. Then came nutrition claims, which point to a food's particular nutrition property.1 Now, in an attempt to simplify food products' nutritional qualities even more for consumers, a variety of nutrition symbols and nutrition labeling systems are being developed by health experts, grocery stores, and food manufacturers. This article reviews these nutrition labeling systems to help diabetes dietitians and other health care providers help their clients maximize their use of these systems to make healthier food choices. Nutrition labeling is based on the premise that providing consumers more information can help them understand the nutrient content of foods, which will lead them to improve their purchase decisions and eat a healthier diet.2-5 Consumers prefer nutrition labeling that is easy to interpret and use.6 Although the appearance of calories and number of servings on a food label may seem straightforward to the average consumer, it is still complex; consumers struggle to make sense of calories in the context of individual differences of energy expenditure6 and number of calories in a portion.7 Nutrition information can also be confusing when it comes to specific nutrients, as is the case with fats. Although knowledge about trans fats has reached a similar level as knowledge about saturated fat and resulted in improved self-reported behaviors related to grocery shopping, consumers still struggle to properly identify food sources of trans fats.8 As a result of consumer confusion, organizations are trying to create new ways to help consumers weave through the maze of nutrition information at the grocery store. Although the expectation is that these new labeling systems will help consumers purchase and eat more nutritious foods, there is no clear evidence to date of their positive effect on the improvement of dietary patterns.5 Table …

Dietary carbohydrate intake is associated with cardiovascular disease risk in Korean: Analysis of the third Korea National Health and Nutrition Examination Survey (KNHANES III)

BackgroundIt is widely recognized that dietary factors play important roles in the development of cardiovascular disease (CVD). We evaluated the association between carbohydrate intake and CVD risk factors, using data from the third Korea National Health and Nutrition Examination Survey (KNHANES III). MethodsA nationally representative sample of Korean adults (1536 men, 2235 women), aged 20 to 69 years, was divided into three groups according to carbohydrate intake (% of energy), based on the Dietary Reference Intakes (DRI, 55–70% of energy) for Koreans. Then, we examined whether excessive carbohydrate intake was related to CVD risk factors. ResultsMean carbohydrate intake (% of energy) was 72.8% (321 g/day), above the DRI for Korean adults (55–70%). A high carbohydrate intake (>70% of energy) was associated with higher BMI, blood pressure, fasting glucose, triglycerides, and LDL-cholesterol levels in women. After adjusting for covariates, such as age, energy intake, alcohol consumption, smoking status, and physical activity, high carbohydrate intakes (>70% of energy) were significantly associated with diabetes mellitus and low HDL-cholesterol (HDL-C) in women. In men, however, only total cholesterol was inversely associated with high carbohydrate intake. ConclusionHigher carbohydrate intakes than the DRI for Koreans were significantly associated with diabetes mellitus and low HDL-C levels in women. These results suggest that improvement of dietary patterns may be an important approach to the prevention of CVD in Korean women.