Ingestion Of Meal Research Articles

Effects of levothyroxine substitution therapy on hunger and food intake in individuals with hypothyroidism.

In individuals with hypothyroidism and overweight, levothyroxine substitution therapy is often expected to cause weight loss due to its effect on resting energy expenditure. However, despite levothyroxine-induced enhancement of resting energy expenditure, fat mass loss is rarely seen after levothyroxine substitution therapy. The mechanism behind this conundrum is unknown. The aim of the study was to assess the effect of levothyroxine therapy on hunger sensations and ad libitum food intake in individuals with hypothyroidism. Prospective cohort study of 18 newly diagnosed hypothyroid women (thyroid-stimulating hormone (TSH) >10 mU/L). Participants were investigated at diagnosis, after normalization of TSH (<4.0 mU/L), and after 6 months of successful treatment. Eighteen age and body mass index-matched healthy controls were also included. Hypothyroid individuals were treated with levothyroxine according to European Thyroid Association guidelines. Changes in hunger sensation were assessed using visual analog scales (cm) before and during a standardized mixed meal test, and food intake was measured during a subsequent ad libitum meal (g). After 6 months of levothyroxine therapy, mean resting energy expenditure was increased by 144 kcal/day (10%) (P < 0.001). Weight loss was comprised of 0.8 kg fat-free mass while fat mass remained unchanged. Fasting hunger sensation increased from a mean of 4.5 (s.d. 2.2) cm to 5.5 (s.d. 2.2) cm (P = 0.047). The numerical increase in ad libitum meal intake did not reach statistical significance. Our data suggest that levothyroxine-induced hunger may be a culprit in the lack of fat mass loss from levothyroxine therapy.

Acute Statin Withdrawal Does not Interfere With the Improvements of a Session of Exercise in Postprandial Metabolism.

The risk for atherogenic plaque formation is high after ingestion of meals in individuals with high blood lipid levels (ie, dyslipidemia). Statins and exercise reduce the rise of blood triglyceride concentrations after a meal, but the effect of their combination is unclear. In a randomized crossover design, 11 individuals with dyslipidemia and metabolic syndrome treated with statins underwent a mixed-meal (970 ± 111 kcal, 24% fat, and 34% carbohydrate) tolerance test. Plasma lipid concentrations, fat oxidation, glucose, and glycerol kinetics were monitored immediately prior and during the meal test. Trials were conducted with participants under their habitual statin treatment and 96 hours after blinded statin withdrawal. Trials were duplicated after a prolonged bout of low-intensity exercise (75 minutes at 53 ± 4% maximal oxygen consumption) to study the interactions between exercise and statins. Statins reduced postprandial plasma triglycerides from 3.03 ± 0.85 to 2.52 ± 0.86 mmol·L-1 (17%; P = .015) and plasma glycerol concentrations (ie, surrogate of whole-body lipolysis) without reducing plasma free fatty acid concentration or fat oxidation. Prior exercise increased postprandial plasma glycerol levels (P = .029) and fat oxidation rates (P = .024). Exercise decreased postprandial plasma insulin levels (241 ± 116 vs 301 ± 172 ρmol·L-1; P = .026) but not enough to increase insulin sensitivity (P = .614). Neither statins nor exercise affected plasma glucose appearance rates from exogenous or endogenous sources. In dyslipidemic individuals, statins reduce blood triglyceride concentrations after a meal, but without limiting fat oxidation. Statins do not interfere with exercise lowering the postprandial insulin that likely promotes fat oxidation. Last, statins do not restrict the rates of plasma incorporation or oxidation of the ingested glucose.

Late meal intake is associated with abdominal obesity and metabolic disorders related to metabolic syndrome: A chrononutrition approach using data from NHANES 2015–2018

Chrononutrition is an emerging area that suggests that late eating time is associated with poor nutritional and metabolic outcomes. However, epidemiological studies are scarce on this topic. The aim of this study was to characterize the chrononutrition patterns in a large and representative US population (NHANES 2015-2016 and 2017-2018) of adults and elderly and investigate their association with obesity and metabolic disorders that make up the metabolic syndrome. A total of 7379 adults and elderly individuals were included in the analysis. Meal timing data were collected through two 24-h dietary recalls in both cycles. Poisson regression adjusted for confounders was used to evaluate the association between chrononutrition variables (eating duration and tertiles of first and last meal timing, eating midpoint and eating occasions) and obesity, abdominal obesity and metabolic parameters from metabolic syndrome. Adults with a longer eating duration (>12h) had a higher prevalence of abdominal obesity (IRR, 1.15; 95% CI, 1.03-1.28) when compared with those who ate their meals in a shorter eating duration (≤12h). In addition, adults in the third tertile of the time of the last meal (mean 22:03) had a higher prevalence of abdominal obesity (IRR, 1.12; 95% CI, 1.01-1.25) compared to first tertile. Adults with later eating midpoints (second and third tertile) had a higher prevalence of elevated fasting glucose (IRR, 1.30; 95% CI, 1.07-1.59 and IRR, 1.65; 95% CI, 1.22-2.22, respectively). Among the elderly, participants with a longer eating duration (>12h) had a higher prevalence of elevated triglycerides (IRR, 2.74; 95% CI, 1.25-5.96) when compared with those elderly who ate their meals in a shorter eating duration (≤12h). These findings suggest that a long eating duration and late first and last meal timing are chrononutrition patterns associated with cardiometabolic risks in free-living Americans.

Relationships among intragastric meal distribution during gastric emptying scintigraphy, water consumption during water load satiety testing, and symptoms of gastroparesis.

Gastric emptying scintigraphy (GES) measures total gastric retention after a solid meal and can assess intragastric meal distribution (IMD). Water load satiety test (WLST) measures gastric capacity. Both IMD immediately after meal ingestion [ratio of proximal gastric counts after meal ingestion to total gastric counts at time 0 (IMD0)] and WLST (volume of water ingested over 5 min) are indirect measures of gastric accommodation. In this study, IMD0 and WLST were compared with each other and to symptoms of gastroparesis to gauge their clinical utility for assessing patients with symptoms of gastroparesis. Patients with symptoms of gastroparesis underwent GES to obtain gastric retention and IMD0, WLST, and filled out patient assessment of upper GI symptoms. A total of 234 patients with symptoms of gastroparesis were assessed (86 patients with diabetes, 130 idiopathic, 18 postfundoplication) and 175 (75%) delayed gastric emptying. Low IMD0 <0.568 suggesting initial rapid transit to the distal stomach was present in 8% and correlated with lower gastric retention, less heartburn, and lower volumes consumed during WLST. Low WLST volume (<238 mL) was present in 20% and associated with increased severity of early satiety, postprandial fullness, loss of appetite, and nausea. Low IMD0 is associated with less gastric retention and less heartburn. Volume of water consumed during WLST, while associated with IMD0, has associations with early satiety, postprandial fullness, loss of appetite, and nausea. Thus, IMD0 and WLST appear to overlap somewhat in their assessment of gastric physiology in adults with symptoms of gastroparesis but relate to different dyspeptic symptoms.NEW & NOTEWORTHY IMD0 and WLST were assessed for their clinical utility in assessing patients with symptoms of gastroparesis. Low IMD0 is associated with less gastric retention and less heartburn. Volume of water consumed during WLST, while associated with IMD0, has associations with early satiety, postprandial fullness, loss of appetite, and nausea. IMD0 and WLST appear to overlap somewhat in their assessment of gastric physiology in adults with symptoms of gastroparesis but relate to different dyspeptic symptoms.

Further evidence for sensitivity to energy density and a two-component model of meal size: Analysis of meal calorie intakes in Argentina and Malaysia

Previously, we demonstrated a non-linear association between meal caloric intake and meal energy density (ED, kcal/g) in data from a controlled trial in the US and from free-living participants in the UK [1]. In both datasets, meal caloric intake increased with ED in lower energy-dense meals (below ∼1.75 kcal/g) and decreased in higher energy-dense meals (above ∼1.75 kcal/g). In the current study, we sought to explore whether this pattern extends to data from free-living participants in Argentina (N = 2738 meals) and Malaysia (N = 4658 meals). Again, a significant breakpoint was found in both the Argentinean (2.04 kcal/g (SE = 0.06)) and Malaysian (2.17 kcal/g (SE = 0.06)) datasets with mean centered meal caloric intake increasing with ED below the breakpoint and decreasing above the breakpoint. These results lend further support for our two-component theoretical model of meal size (g) in which a volume signal is dominant in lower energy-dense meals and a calorie-content signal is dominant in higher energy-dense meals. Together, our research adds to evidence supporting human sensitivity to calories and exposes a complexity in the correspondence between meal energy content and meal size in everyday (non-manipulated) meals. Further research is needed to provide causal evidence for this sensitivity and whether individual variation impacts meal size and energy balance.

A Novel Functional Refined Olive Oil, Enhanced with Orange Peel Extract, Modulates Postprandial LDL-Cholesterol Responses in Individuals at Cardiometabolic Risk: A Pilot Randomized, Controlled, Cross-Over Nutritional Intervention

Olive oil, as the main source of polyphenols in the Mediterranean diet pattern, is mentioned to show remarkable postprandial bioactivity, contributing to the reduction of cardiometabolic risk factors. In recent years, the consumption of refined olive oil, instead of other olive oil classes, led to a reduced intake of polyphenols from the usual diet. This controlled, human nutritional intervention investigated whether the enhancement of refined olive oil with orange peel extract may modulate postprandial lipemia, glycemia, and oxidative stress in individuals at cardiometabolic risk. In a cross-over framework, 21 participants aged 30–65 years, who met the eligibility criteria, received a fat and carbohydrate meal of mashed potatoes, homogenized with refined olive oil (50 mL) or the functional olive oil, enhanced with 10% orange peel extract, intervening a washout week. Blood draws were performed in fasting, 30 min, 1.5 h, and 3 h after the meal intake. Plasma lipids, glucose, uric acid, and total plasma antioxidant capacity, according to the FRAP method, were measured at each timepoint. A significant reduction of LDL-cholesterol was observed, 1.5 h and 3 h after the functional meal intake, compared to non-significant changes after the control meal (p &lt; 0.05). No other statistically significant interactions were detected to the remaining biomarkers (p &gt; 0.05). Further investigation is needed for safer conclusions about the postprandial modulation of cardiometabolic risk factors by the functional olive oil enhanced with orange peel extract.

InsNET: Accurate Basal and Bolus Insulin Dose Prediction for Closed Loop Diabetes Management.

It has been demonstrated that closed-loop diabetes management results in better glycemic control and greater compliance than open-loop diabetes management. Deep learning models have been used to implement different components of artifical pancreas. In this work, a novel deep learning model InsNET has been proposed to estimate the basal and bolus insulin level and insulin bolus in patients with type I diabetes utilizing subcutaneous insulin infusion pumps for closed loop diabetes management system. The proposed InsNET is formed with a Wide-Deep combination of LSTM and GRU layers. Additionally, physical activity level has been included as an input in comparison to previous models where only past glucose levels (CGM), meal intake (CHO) and past insulin dosage were used as inputs. The proposed model was tested on In-silico data, and it achieved a Mean Absolute Error (MAE) of 0.002 and Root Mean Squared Error (RMSE) of 0.007 for UVA/Padova Dataset and MAE of 0.001 and RMSE OF 0.003 for mGIPsim Dataset.Clinical relevance- Insulin dose determination is an important as aspect of artificial pancreas. This work describes a deep learning model to determine accurate basal and bolus insulin dosage.

Comment on: “After Dinner Rest a While, After Supper Walk a Mile? A Systematic Review with Meta-analysis on the Acute Postprandial Response to Exercise Before and After Meal Ingestion in Healthy Subjects and Patients with Impaired Glucose Tolerance”

Comment on: “After Dinner Rest a While, After Supper Walk a Mile? A Systematic Review with Meta-analysis on the Acute Postprandial Response to Exercise Before and After Meal Ingestion in Healthy Subjects and Patients with Impaired Glucose Tolerance”

Bariatric Surgery Alters the Postprandial Recovery From Hypoglycemia, Mediated by Cholinergic Signal.

Rerouted gut after Roux-en-Y gastric bypass (GB) and, to a lesser degree, after sleeve gastrectomy (SG) leads to larger glucose excursion and lower nadir glucose, predisposing individuals to hypoglycemia. Despite prandial hyperglucagonemia, endogenous glucose production response to hypoglycemia is reduced after GB or SG. Parasympathetic nervous system (PNS) activity plays a key role in regulation of glucose kinetics and islet cell function. We examined the effect of acute PNS blockade on counterregulatory glucose and islet cell response to meal ingestion during insulin-induced hypoglycemia among GB, SG, and control subjects who had not had gastric surgery. Our findings demonstrate that cholinergic signal is critical in the recovery from hypoglycemia by meal ingestion in humans who have not had gastric surgery, although prandial PNS-mediated physiologic responses to hypoglycemia are differentially changed by GB and SG.

2'-fucosyllactose alone or combined with resistant starch increases circulating short-chain fatty acids in lean men and men with prediabetes and obesity.

Infusion of short-chain fatty acids (SCFA) to the distal colon beneficially affects human substrate and energy metabolism. Here, we hypothesized that the combination of 2'-fucosyllactose (2'-FL) with resistant starch (RS) increases distal colonic SCFA production and improves metabolic parameters. In this randomized, crossover study, 10 lean (BMI 20-24.9 kg/m2) and nine men with prediabetes and overweight/obesity (BMI 25-35 kg/m2) were supplemented with either 2'-FL, 2'-FL+RS, or placebo one day before a clinical investigation day (CID). During the CID, blood samples were collected after a overnight fast and after intake of a liquid high-fat mixed meal to determine plasma SCFA (primary outcomes). Secondary outcomes were fasting and postprandial plasma insulin, glucose, free fatty acid (FFA), glucagon-like peptide-1, and peptide YY concentrations. In addition, fecal SCFA and microbiota composition, energy expenditure and substrate oxidation (indirect calorimetry), and breath hydrogen excretion were determined. In lean men, supplementation with 2'-FL increased postprandial plasma acetate (P = 0.017) and fasting H2 excretion (P = 0.041) compared to placebo. Postprandial plasma butyrate concentration increased after 2'-FL and 2'-FL+RS as compared to placebo (P < 0.05) in lean men and men with prediabetes and overweight/obesity. Additionally, 2'-FL+RS decreased fasting and postprandial plasma FFA concentrations compared to placebo (P < 0.05) in lean men. Supplementation of 2'-FL with/without RS the day before investigation increased systemic butyrate concentrations in lean men as well as in men with prediabetes and obesity, while acetate only increased in lean men. The combination of 2'-FL with RS showed a putatively beneficial metabolic effect by lowering plasma FFA in lean men, indicating a phenotype-specific effect. nr. NCT04795804.

Iodine-Biofortified Microgreens as High Nutraceutical Value Component of Space Mission Crew Diets and Candidate for Extraterrestrial Cultivation.

The success of Space missions and the efficacy of colonizing extraterrestrial environments depends on ensuring adequate nutrition for astronauts and autonomy from terrestrial resources. A balanced diet incorporating premium quality fresh foods, such as microgreens, is essential to the mental and physical well-being of mission crews. To improve the nutritional intake of astronaut meals, two levels of potassium iodide (KI; 4 µM and 8 µM) and an untreated control were assessed for iodine (I) biofortification, and overall nutraceutical profile of four microgreens: tatsoi (Brassica rapa L. subsp. narinosa), coriander (Coriandrum sativum L.), green basil, and purple basil (Ocimum basilicum L.). A dose-dependent increase in I was observed at 8 µM for all species, reaching concentrations of 200.73, 118.17, 93.97, and 82.70 mg kg-1 of dry weight, in tatsoi, coriander, purple basil, and green basil, respectively. Across species, I biofortification slightly reduced fresh yield (-7.98%) while increasing the antioxidant activity (ABTS, FRAP, and DPPH). LC-MS/MS Q extractive orbitrap analysis detected 10 phenolic acids and 23 flavonoids among microgreen species. The total concentration of phenolic acids increased (+28.5%) in purple basil at 8 µM KI, while total flavonoids in coriander increased by 23.22% and 34.46% in response to 4 and 8 µM KI, respectively. Both doses of KI increased the concentration of total polyphenols in all species by an average of 17.45%, compared to the control.

Meal intake in an adult Moroccan population: determinants and implications for weight status.

In recent decades, the Moroccan population has changed its dietary practices, particularly those related to meal-taking. It is about irregular meal schedules, reduced frequency and shorter time of meal taking times, as well as a decrease in family meal-taking. All these factors are likely to influence its nutritional status. The aim is to study meal-taking practices, their determinants and their implications on weight status. In this study, meal-taking practices are defined by the regularity of the schedule, the frequency and the duration of the meals as well as the family commensality. This work data are part of a study conducted among 507 households in the region of Rabat-SaléKenitra in Morocco, with a validated conceptual and methodological framework. The questionnaire was completed with one member of each household and the body mass index (BMI) was determined by an impedance meter. The main results indicate that the majority of the surveyed population was aged 35 years (59%), female (52%), urban (70%), with a BMI ≥25 kg/m2 (51%), took usually three meals a day (89%), spent less than 90 minutes a day in meals and snacks (60%), had irregular meal schedule (69%), and usually eat at least two meals or snacks a day with family (49%). The univariate analysis showed that urban area was a factor favoring variations of meal times, the male sex was a factor favoring three meals a day, the level of higher education was a factor penalizing the daily duration of meals, and that marital status "married" was a factor favoring family commensality. In addition, variable meal times were revealed as a factor contributing to overweight/obesity, and meal times ≥90 min were revealed as a protective factor of overweight/obesity. The study identified factors associated with meal times, frequency and duration. The results obtained will serve as a basis for the development of educational actions for a change in behavior conducive to health.

Pan-alimentary assessment of motility, luminal content, and structures: an MRI-based framework

Background Gastrointestinal symptoms originating from different segments overlap and complicate diagnosis and treatment. In this study, we aimed to develop and test a pan-alimentary framework for the evaluation of gastrointestinal (GI) motility and different static endpoints based on magnetic resonance imaging (MRI) without contrast agents or bowel preparation. Methods Twenty healthy volunteers (55.6 ± 10.9 years, BMI 30.8 ± 9.2 kg/m2) underwent baseline and post-meal MRI scans at multiple time points. From the scans, the following were obtained: Gastric segmental volumes and motility, emptying half time (T50), small bowel volume and motility, colonic segmental volumes, and fecal water content. Questionnaires to assess GI symptoms were collected between and after MRI scans. Key results We observed an increase in stomach and small bowel volume immediately after meal intake from baseline values (p<.001 for the stomach and p=.05 for the small bowel). The volume increase of the stomach primarily involved the fundus (p<.001) in the earliest phase of digestion with a T50 of 92.1 ± 35.3 min. The intake of the meal immediately elicited a motility increase in the small bowel (p<.001). No differences in colonic fecal water content between baseline and 105 min were observed. Conclusion & Inferences We developed a framework for a pan-alimentary assessment of GI endpoints and observed how different dynamic and static physiological endpoints responded to meal intake. All endpoints aligned with the current literature for individual gut segments, showing that a comprehensive model may unravel complex and incoherent gastrointestinal symptoms in patients.

P06-015-23 Hedonic and Calorie Reduction Effects of Prior Miracle Fruit Application on Meal Intakes in Korean American Adults With Diabetes or Prediabetes: A Randomized Crossover Trial

P06-015-23 Hedonic and Calorie Reduction Effects of Prior Miracle Fruit Application on Meal Intakes in Korean American Adults With Diabetes or Prediabetes: A Randomized Crossover Trial

Transition to Freshly-Prepared School Meals: Impacts on Meal Appeal, Student Participation, Intake, Food and Packaging Waste and School Finances

Transition to Freshly-Prepared School Meals: Impacts on Meal Appeal, Student Participation, Intake, Food and Packaging Waste and School Finances

A practical approach based on learning-based model predictive control with minimal prior knowledge of patients for artificial pancreas

Background and objectivesComplete identification of the glucose dynamics for a patient generally requires prior clinical procedures and several measurements for the patient. However, these steps may not be always feasible. To address this limitation, we propose a practical approach integrating learning-based model predictive control (MPC), adaptive basal and bolus injections, and suspension with minimal requirements of prior knowledge of the patient. MethodsThe glucose dynamic system matrices were periodically updated using only input values, without any pretrained models. The optimal insulin dose was calculated based on a learning-based MPC algorithm. Meal detection and estimation modules were also introduced. The basal and bolus insulin injections were fine-tuned using the performance of glucose control from the previous day. To validate the proposed method, evaluations with 20 virtual patients from a type 1 diabetes metabolic simulator were employed. ResultsTime-in-range (TIR) and time-below-range (TBR) were 90.8% (84.1% – 95.6%) and 0.3% (0% – 0.8%), as represented by the median, first (Q1), and third quartiles (Q3), respectively, when meal intakes were fully announced. When one out of three meal intake announcements was missing, TIR and TBR were 85.2% (75.0% – 88.9%) and 0.9% (0.4% – 1.1%), respectively. ConclusionsThe proposed approach obviates the need for prior tests from patients and shows effective regulation of blood glucose levels. From the perspective of practical implementation in clinical environments, to deal with minimal prior information of the patient, our study demonstrates how essential clinical knowledge and learning-based modules can be integrated into a control framework for an artificial pancreas.

Ingestion of vegetable salads before rice inhibits the increase in postprandial serum glucose levels in healthy subjects.

This study aims to confirm the "vegetable-first" effect. In addition, because we aimed dietary fiber in vegetable salad, the effect after the ingestion of vegetable salad extract (vegetable salad from which solids have been removed) before carbohydrates on postprandial serum glucose level was also evaluated. A total of 13 healthy men were given meals after one-night of fasting: rice-vegetable salad, vegetable salad-rice, and vegetable salad extract-rice. Blood samples were taken at 0, 30, 45, 60, 90, and 120min after the ingestion of the test meal to measure serum glucose levels. Serum glucose levels were significantly lower after 45 and 60min in the vegetable salad-rice group compared to the rice-vegetable salad group. No significant difference was found between the vegetable salad extract-rice group and the vegetable salad-rice/rice-vegetable salad group. The result suggested that it might be important to ingest vegetables to obtain the "vegetable-first" effect.

Short-term effects of milk (both unpasteurized and pasteurized) on active adolescence hemoglobin

Milk consumption is one of the beverages options for the recovery phase. On the basis of the manufacturing procedure, raw and pasteurized cow's milk are distinguished, but no one has investigated the effect of milk consumption on the hemoglobin levels of active people; some studies only analyze the effect of milk consumption on fitness and recovery advantages. Objective: The aim of this study is to compare the hemoglobin levels of active adolescents who consumed fresh cow's milk versus pasteurized milk for three consecutive weeks. It is intended that the three-week treatment will have a good effect on hemoglobin levels, hence enhancing physical performance. Methods: Using a quasi-experimental study with a Pretest-Posttest Randomized-Groups Design for three consecutive weeks of milk feeding twice daily per group. Twenty-four university football players were divided into three groups using the approach of purposive sampling: the fresh cow's milk (SSS) group, the pasteurized milk (SP) group, and the mineral water control group (K). The tool utilized to measure body composition is the Karada Scan Body Fat Omron HBF-356, while the Easy Touch GCHb is used to collect data on hemoglobin. Subjects participated voluntarily and were willing to have blood tested through capillaries before, immediately after, and 30 minutes after exercise. The analysis data uses paired t-test and ANOVA calculations to find differences within and between groups. Results: Hemoglobin immediately after exercise (0) in the post-test (three weeks after treatment) increased significantly (0.020 &lt; 0.05) compared to hemoglobin before exercise (-) in the pre-test (before three weeks of intervention) in all three groups (fresh milk, pasteurized milk, and mineral water). Upon further examination, it was determined that there was a highly significant difference in hemoglobin levels (0.010 &lt; 0.05) between fresh cow's milk and pasteurized milk immediately after exercise (0) in the post-test (after three weeks of treatment). In contrast, there were no significant differences (p-value &gt; 0.05) for the remaining calculations, both within and between subgroups.Conclusions: After three consecutive weeks of milk consumption, there was no significant variation in the amount of hemoglobin in the blood. To optimize the different elements that can affect the acceleration of the increase in hemoglobin in the blood, it is recommended that further study be conducted to intervene with milk and additional meal intake alongside physical activity.

138-LB: A Retrospective Algorithm to Identify Meal Intakes from CGM Time Series

The accurate assessment of dietary behavior in clinical trials, including number and size of meal intakes, is essential to evaluate participants’ metabolic health which, in turn, might reflect an increased risk for developing diabetes. Traditional dietary assessments leverage handwritten/digital food logs, which are error-prone and time-consuming for both users and investigators. Instead, glucose timeseries unobtrusively collected by CGM could provide objective measures of meals’ consumption. Here we present a new algorithm to retrospectively identify meal intakes using CGM data only. In the Geriatric Anorexia Study (NCT04858932), 50 healthy individuals (26 females, mean±SD age: 72.26±5.02 years, BMI: 24.96±3.33 kg/m2) were monitored in free-living conditions for 2 weeks with the Abbott FreeStyle Libre Pro, and recorded meal intakes using the Renpho Smart Food Scale. After removal of days with &amp;lt;2 meals recorded, a total of 1132 meals over 365 days were available for analysis. To identify meal intakes, the proposed algorithm scans CGM data, identifies local maxima, and measures their prominence, i.e., the relative height with respect to a neighborhood window of length L. Peaks with prominence higher than Pmin are labeled as meals. Subject data was divided into a ~70% training set (n=31, 775 meals), where L and Pmin are tuned, and ~30% test set (n=12, 357 meals), where the algorithm is evaluated in terms of absolute percent error (APE) between number of recorded and detected meals. Across subjects, mean±sd daily APE is 25.1±9.70%. Similar values hold when considering only subjects with &amp;lt;3.5 meals/day (n=6, 144 meals, APE=24.5±13.2%) and ≥3.5 meals/day (n=6, 213 meals, APE=25.5±6.93%), demonstrating the reliability of the algorithm to identify the number of meals in subjects with different dietary behaviors. These results evidence the suitability of CGM for the automatic quantification of meal intakes. Further assessment of the algorithm should be performed using more controlled meal intake recordings. Disclosure N. Camerlingo: Employee; Pfizer Inc. A. Messere: None. M. Santamaria: None. C. Demanuele: None. D. Caouette: Employee; Pfizer Inc. K. C. Thomas: None. N. Shaafi kabiri: None. D. Psaltos: Employee; Pfizer Inc. F. Karahanoglu: None. S. Khan: None. I. Messina: Research Support; Pfizer Inc. M. Wicker: None. M. Kelly: Research Support; Pfizer Inc. H. Zhang: Employee; Pfizer Inc.

819-P: Impact of Meal Bolus Timing and Bedtime Snacking on Glycemic Control in Hospitalized Patients

Background: Basal-bolus insulin is the standard of care to treat hyperglycemia in hospitalized patients in the non-ICU setting. Matching insulin with food is a barrier to achieving blood glucose (BG) goals. The glycemic impact of a snack at bedtime without prandial insulin and delayed meal-time bolus in the hospital has not been previously explored. Methods: The InFi study is an ongoing randomized controlled open-label trial comparing Fiasp vs aspart in hospitalized patients using the Dexcom G6 PRO CGM to assess postmeal glycemic outcomes. We performed an interim analysis of 100 subjects to assess the impact of bedtime snacks on fasting POC glucose (FG) and the impact of delayed meal bolus on postprandial sensor glucose (PPSG) time in range (TIR) 70-180 mg/dL. Meal intake was determined by a CGM heuristic, insulin bolus time by barcoded EMR. Results: Four hour post-meal TIR was 54% for on-time boluses (n=119) vs 25% with bolus delay of &amp;gt;5 minutes (n=86), p &amp;lt;0.001. Evening snacking (9pm-12am) was associated with higher FG levels, 201 vs 158 mg/dL (N=30, 50), p = 0.03. Conclusion: Delayed meal-time insulin bolusing is common in hospitalized patients and results in a significant reduction in post-meal TIR. Evening snacking is a significant cause of overnight hyperglycemia. Given the importance of BG control, hospitals should work to optimize meal insulin delivery and develop strategies to address bedtime food intake. Disclosure S.Alexanian: Research Support; Novo Nordisk. M.C.Cheney: None. J.Bello ramos: None. N.L.Spartano: Research Support; Novo Nordisk. H.Wolpert: Consultant; Abbott Diabetes, Employee; Eli Lilly and Company. D.W.Steenkamp: Research Support; Abbott Diabetes, Novo Nordisk. Funding Novo Nordisk (ISS-001295)