Kcal Day Research Articles

The effectiveness of an mHealth intervention ondiabetes risk factors and body composition.

Early identification and lifestyle intervention is beneficial for people with risk for diabetes. The aim of this study was to evaluate the risk of type 2 diabetes (T2D) in healthy overweight or obese women using the FINDRISC score and a twelve-week long mobile app-based lifestyle intervention.Fifty-four subjects were involved and forty-eight were analysed, n = 28 in the intervention group (online group: OG) and n = 20 in the control group (CG). Body composition was assessed using the InBody 720 device and diabetes risk was evaluated with the Finnish Diabetes Risk Questionnaire. The calorie intake and macronutrients were evaluated by a 3-day diary. Group differences and pre- and post-results were analysed using student t-tests by TIBCO Statistica 13.40.14.Significantly decreased body mass index (28.0 ± 2.5 kg m-2 vs 25.8 ± 4.3 kg m-2, P = 0.00), body fat percentage (37.5 ± 6.3% vs 34.1 ± 5.9%, P = 0.03), waist circumference (100.8 ± 7.2 cm vs 94.7 ± 8.2 cm, P= 0.00) and visceral fat (124.0 ± 29.2 cm³ vs 109.0 ± 24.6 cm³, P = 0.04) were found in the OG. By the end of the programme, both groups showed significant decrease in food consumption, daily calorie intake (OG: 2,348.6 ± 348.0 vs 1,483.1 ± 114.4, CG: 2,372.4 ± 464.2 vs 1,654.1 ± 201.3 kcal day-1, P = 0.00), fibre(OG: 19.5 ± 3.7 vs 26.1 ± 3.4, CG: 17.8 ± 3.9 vs 22.0 ± 4.8 g day-1, P = 0.00) and cholesterol consumption (OG: 365.2 ± 58.9 vs 266.2 ± 65.8, CG: 377.4 ± 72.1 vs 269.2 ± 42.7 mg day-1, P = 0.00). OGhad a more significant reduction in body mass index (P = 0.03) and body fat percentage (P = 0.04) values at the end of the programme compared to the control group.In this study, it was found that mHealth intervention is a useful and effective method in the Hungarian female population. Further studies are needed to investigate modifications of this intervention to achieve more health-related effects.

Cappuccino-flavored dulce de leche: Development, characterization and correlation analysis

The objective was to develop cappuccino-flavored dulce de leche (DL), and to evaluate the effect of the different contents of instant coffee and cocoa powder on the proximate composition, physicochemical and sensorial characteristics. Six cappuccino sweet formulations were produced, differing in concentrations of instant coffee (2.5, 5.0 and 7.5 g) and cocoa powder (50, 100 and 150 g). The addition of cocoa powder and instant coffee added value to DL-based formulations. Calories ranged from 300.80 to 302.88 kcal 100 g−1, which is equivalent to approximately 15% of a balanced diet at 2000 kcal day−1 (100 g portion). The calories parameter was also positively correlated (p < 0.05) with the concept of high sensory acceptance, especially in terms of color and appearance. The average of the grades received in the sensory acceptance attributes pointed to hedonic terms between “I liked it moderately” and “I liked it extremely”. Therefore, formulations with 100 and 150 g cocoa powder were better accepted (acceptability >90%) and purchase intentions, represented by the term “would certainly buy” > 60%. The elaboration of cappuccino sweet was feasible, being able to be a nutritious and tasty gastronomic option for the tables of different social classes.

Combined Approach: FFQ, DII, Anthropometric, Biochemical and DNA Damage Parameters in Obese with BMI ≥ 35 kg m-2.

Although obesity with its comorbidities is linked with higher cancer risk, the data on genome stability in the obese/severely obese are scarce. This is the first study with three DNA damage assessment assays (Fpg-modified and alkaline comet assays and micronucleus cytome assay) performed on a severely obese population (n = 53) where the results were compared with daily intake of food groups, nutrient intake, dietary inflammatory index (DII), and anthropometric and biochemical parameters usually measured in obese individuals. Results demonstrated the association between DNA damage levels and a decrease in cell proliferation with anthropometric measurements and the severity of obese status, together with elevated levels of urates, inorganic phosphates, chlorides, and hs troponin I levels. DII was connected with oxidative DNA damage, while BMI and basal metabolic rate (BMR) were associated with a decrease in cell proliferation and DNA damage creation. Measured daily BMR and calculated daily energy intake from the food frequency questionnaire (FFQ) demonstrated no significant difference (1792.80 vs. 1869.86 kcal day-1 mean values). Groups with higher DNA damage than expected (tail intensity in comet assay >9% and >12.4%, micronucleus frequency >13), consumed daily, weekly, and monthly more often some type of food groups, but differences did not show a clear influence on the elevated DNA damage levels. Combination of all three DNA damage assays demonstrated that some type of damage can start earlier in the obese individual lifespan, such as nuclear buds and nucleoplasmic bridges, then comes decrease in cell proliferation and then elevated micronucleus frequencies, and that primary DNA damage is not maybe crucial in the overweight, but in severely obese. Biochemically changed parameters pointed out that obesity can have an impact on changes in blood cell counts and division and also on genomic instability. Assays were able to demonstrate groups of sensitive individuals that should be further monitored for genomic instability and cancer prevention, especially when obesity is already connected with comorbidities, 13 different cancers, and a higher mortality risk with 7-10 disease-free years loss. In the future, both DNA damage and biochemical parameters should be combined with anthropometric ones for further obese monitoring, better insight into biological changes in the severely obese, and a more individual approach in therapy and treatment. Patients should also get a proper education about the foodstuff with pro- and anti-inflammatory effect.

Balancing the scales: Preliminary investigation of total energy expenditure and daily metabolizable energy intake in Matschie’s tree kangaroo (Dendrolagus matschiei)

Matschie’s tree kangaroo (Dendrolagus matschiei) is an endangered arboreal marsupial native to Papua New Guinea. Detailed field studies of its behavior and ecology are scarce due largely to its occupation of remote cloud forests and cryptic nature. Although this species has been in human care since the 1950s, much of its biology is still unknown. The current ex situ population is not sustainable due to health and reproductive problems, believed to stem largely from issues with diet and obesity. To better assess potential discrepancies between energy requirements and energy intake, we sought to 1) quantify total energy expenditure (TEE) of two zoo-housed Matschie’s tree kangaroos (body mass = 9.0–9.7 kg) on a diet composed largely of leafy browse; 2) quantify food and macronutrient intake, apparent dry matter macronutrient digestibility, and metabolizable energy (ME) intake over a 14-month period; and 3) test for seasonal changes in ME intake due to seasonal differences in the varieties of leafy browse offered. Using the doubly labeled water method, we determined TEE for the female (288 kcal day -1) and male (411 kcal day -1). Resulting mean TEE was well below the expected value for marsupials and macropods (i.e., ~60% of the expected value based on body mass). The mean calculated ME intakes for the female and male were 307 kcal day-1 and 454 kcal day-1, respectively. There were significant seasonal differences in ME intakes, driven by reduced intake in the autumn. These results demonstrate that Matschie’s tree kangaroos can be maintained at healthy body weights and conditions on fiber-rich and browse-heavy diets. Our findings contribute important insights into tree kangaroo energetics and physiology and can be applied to help reformulate the diet of Matschie’s tree kangaroos at captive facilities to improve population health and sustainability.

Sugars measured enzymatically in a fasting overnight urine sample are not sensitive biomarkers of dietary added sugar intake in postmenopausal women.

Restricting dietary sugar is a leading recommendation, but limited biomarkers assessing intake exist. Although 24-h urinary sucrose (U-Suc) and urinary fructose (U-Fruc) excretion has been used with mixed success, collection is burdensome. This study aimed to test the sensitivity of an enzymatic assay of U-Suc and U-Fruc to detect changing added sugar intake using low-burden overnight urine samples in 30 postmenopausal women. Women consumed usual dietary intake during day 1 and usual intake plus a sugar sweetened beverage during day 2. Weighed, photographed food records assessed intake. Enzymatic assay measured U-Suc and U-Fruc from fasting overnight samples; liquid chromatography mass spectrometry (LC-MS) validated U-Suc findings. Dietary added sugars increased significantly during day 2 (p < 0.001), but urinary sugars were not significantly increased. Enzymatic assay detected urinary sugars in 75% (U-Suc) and 35% (U-Fruc) of samples. Dietary sucrose was not associated with U-Suc, however dietary fructose was significantly associated with U-Fruc [β = 0.031; p < 0.05] among women with detectable urinary sugars. Participants with detectable U-Fruc consumed more energy from added sugars [12.6% kcal day 1; 21.5% kcal day 2] than participants with undetectable U-Fruc [9.3% kcal day 1; 17.4% kcal day 2], p < 0.05. Using LC-MS, U-Suc predicted sucrose and added sugar intake [β = 0.017, β = 0.013 respectively; both p < 0.05]. Urinary sugars measured enzymatically from overnight urine samples were not sensitive biomarkers of changing added sugar intake in postmenopausal women. However, urinary fructose measured by enzymatic assay or LC-MS may differentiate low versus high added sugar consumers.

Pecan-enriched diets increase energy expenditure and fat oxidation in adults at-risk for cardiovascular disease in a randomised, controlled trial.

Research indicates that diets enriched with unsaturated fatty acids improve energy metabolism, although studies on tree nuts, which are a rich source of those fats, are limited. The present study aimed to examine the impact of daily pecan consumption for 8 weeks on energy metabolism in adults with hypercholesterolaemia or at higher risk for cardiovascular disease (CVD) (body mass index ≥ 28 kgm-2 ). For this randomised, controlled trial, 56 sedentary adults were randomised into one of three treatments for an 8-week intervention: two pecan groups and a nut-free control group (n = 18). The ADD group (n = 16) consumed pecans as part of a free-living diet, whereas the SUB group (n = 18) substituted the pecans for isocaloric foods from their habitual diet. At baseline and 8 weeks, a high saturated fat meal was consumed along with indirect calorimetry measurements at fasting and for 4 h postprandially to determine changes in resting metabolic rate (RMR), diet induced thermogenesis (DIT) and substrate utilisation (primary outcomes). Forty-seven participants completed the trial and were included in analyses. In the SUB group, there was an increase in fasting RMR (1607 ± 117 to 1701 ± 114 kcalday-1 ; p = 0.01) and fasting fat oxidation (0.83 ± 0.08 to 0.99 ± 0.08 g/15 min; p = 0.009) and a decrease in fasting respiratory exchange ratio (0.85 ± 0.01 to 0.83 ± 0.01; p = 0.05) from pre- to post-intervention. In the ADD group, there was an increase in postprandial DIT (p < 0.001). There were no changes within the control group or between groups for any outcome measure. Daily consumption of pecans may increase select measures of energy expenditure and fat oxidation in adults at-risk for CVD.

Energy deficiency impairs resistance training gains in lean mass but not strength: A meta-analysis and meta-regression.

Short-term energy deficits impair anabolic hormones and muscle protein synthesis. However, the effects of prolonged energy deficits on resistance training (RT) outcomes remain unexplored. Thus, we conducted a systematic review of PubMed and SportDiscus for randomized controlled trials performing RT in an energy deficit (RT+ED) for ≥3weeks. We first divided the literature into studies with a parallel control group without an energy deficit (RT+CON; Analysis A) and studies without RT+CON (Analysis B). Analysis A consisted of a meta-analysis comparing gains in lean mass (LM) and strength between RT+ED and RT+CON. Studies in Analysis B were matched with separate RT+CON studies for participant and intervention characteristics, and we qualitatively compared the gains in LM and strength between RT+ED and RT+CON. Finally, Analyses A and B were pooled into a meta-regression examining the relationship between the magnitude of the energy deficit and LM. Analysis A showed LM gains were impaired in RT+ED vs RT+CON (effect size (ES) = -0.57, p =0.02), but strength gains were comparable between conditions (ES = -0.31, p =0.28). Analysis B supports the impairment of LM in RT+ED (ES: -0.11, p =0.03) vs RT+CON (ES: 0.20, p<0.001) but not strength (RT+ED ES: 0.84; RT+CON ES: 0.81). Finally, our meta-regression demonstrated that an energy deficit of ~500kcal · day-1 prevented gains in LM. Individuals performing RT to build LM should avoid prolonged energy deficiency, and individuals performing RT to preserve LM during weight loss should avoid energy deficits >500kcalday-1 .

Sex, Food, and the Gut Microbiota: Disparate Response to Caloric Restriction Diet with Fiber Supplementation in Women and Men.

Dietary-based strategies are regularly explored in controlled clinical trials to provide cost-effective therapies to tackle obesity and its comorbidities. The article presents a complementary analysis based on a multivariate multi-omics approach of a caloric restriction intervention (CRD) with fiber supplementation to unveil synergic effects on body weight control, lipid metabolism, and gut microbiota. The study explores fecal bile acids (BAs) and short-chain fatty acids (SCFAs), plasma BAs, and fecal shotgun metagenomics on 80 overweight participants of a 12-week caloric restriction clinical trial (-500kcal day-1 ) randomly allocated into fiber (10g day-1 inulin + 10g day-1 resistant maltodextrin) or placebo (maltodextrin) supplementation groups. The multi-omic data integration analysis uncovered the benefits of the fiber supplementation and/or the CRD (e.g., increase of Parabacteroides distasonis and fecal propionate), showing sex-specific effects on either adiposity and fasting insulin; effects thought to be linked to changes of specific gut microbiota species, functional genes, and bacterially produced metabolites like SCFAs and secondary BAs. This study identifies diet-microbe-host interactions helping to design personalised interventions. It also suggests that sex perspective should be considered routinely in future studies on dietary interventions efficacy. All in all, the study uncovers that the dietary intervention is more beneficial for women than men.

The effect of 10 days of energy-deficit diet and high-intensity exercise training on the plasma high-density-lipoprotein (HDL) level among healthy collegiate males

ABSTRACT An energy-deficit (ED) diet increases lipid mobilisation, while endurance exercise improves lipid profile by promoting formation of high-density lipoproteins (HDLs) among moderately active population. However, it is not clear whether ED with high-intensity exercise training can improve lipid profiles. Therefore, 20 recreationally active males (20.3 ± 2.7 years old with peak oxygen consumption (O2peak) of 2.8 ± 0.2 L min−1) with HDL concentration of 1.44 ± 0.32 mmol L−1, were evenly allocated to either an ED group (1590 ± 79 kcal day−1: 40% of total caloric omitted at lunchtime) or a control (CON) group (2570 ± 139 kcal day−1). Participants in both groups performed high-intensity cycling at 90% O2peak at a constant workload for 8 min, 2 h after breakfast on day D0, D2, D4, D6, D8 and D10 (Dn is day number), after which blood samples were collected. In ED, compared to D0, triglycerides (TG) decreased on D6-10 (p < .01) while total low-density lipoprotein (LDL), total cholesterol (TC) increased on D2-10, while HDL progressively increased on D6-10 (p = .01) with a final value of 1.67 ± 0.24 mmol L−1. In CON, there were no changes in TG, TC and HDL while LDL was reduced on D8-10 (p = .01). Moreover, the proportions of TC/HDL and LDL/HDL increased in ED on D2-10 and D2-8 (p = .05), respectively, while LDL/HDL in CON was reduced on D8-10 (p = .01). In brief, 10 days of ED and a series of high-intensity exercise sessions show progressive elevation of HDL which suggest longer period is required to observe changes in lipid ratios.

Impact of weight management nutrition interventions on dietary outcomes in children and adolescents with overweight or obesity: a systematic review with meta‐analysis

The impact of obesity interventions on dietary intake in children and adolescents with overweight or obesity is unclear. This systematic review aimed to investigate the impact of the dietary component of weight management interventions on the change in diet in children and adolescents with overweight or obesity. Eligible randomised controlled trials (RCTs) published between 1975 and 2020 were identified by a systematic search following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Meta-analyses of eligible study outcomes were performed using statistical software. A multilevel random effects model was used with three significant random effects fitted using restricted maximum likelihood estimation. This review identified 109 RCTs, including 95 that reported at least one statistically significant dietary outcome change and 14 reporting no significant dietary change. Results from the meta-analyses (n=29 studies) indicated that, compared to control groups, intervention groups achieved significantly greater reductions in mean total energy intake at ≤6months (-194kcalday-1 , 95% confidence interval=-275.80 to -112.90kcalday-1 , P<0.001) and up to 12months (-112kcalday-1 95% confidence interval=-218.92 to -5.83kcalday-1 ) P=0.038), increases in fruit and/or vegetable intakes over 2-12months (n=34, range +0.6 to +1.5 servingsday-1 ) and reductions in consumption of sugar-sweetened beverages (n=28, range -0.25 to -1.5servingsday-1 ) at 4-24months follow-up. Obesity interventions with a dietary component have a modest but sustained impact on reducing total energy intake and improving intakes of specific food groups in children and adolescents with overweight or obesity. High quality RCTs that are powered to detect change in diet as a primary outcome are warranted.

'I have been all in, I have been all out and I have been everything in-between': A 2-year longitudinal qualitative study of weight loss maintenance.

Qualitative studies investigating weight management experiences are usually cross-sectional or of short duration, which limits understanding of the long-term challenges. Eleven women [mean (SD) age 44.9(9.8)years; body mass index 40.3(4.0)kg m-2 ] participated in this longitudinal qualitative study, which included up to 20weeks of total diet replacement (825-853kcal day-1 ) and ongoing support for weight loss maintenance (WLM), to 2years. Semi-structured interviews were conducted at baseline and programme end, as well as at key intervals during the intervention. Questions examined five theoretical themes: motivation, self-regulation, habits, psychological resources and social/environmental influences. Data were coded and analysed in nvivo (https://qsrinternational.com/nvivo) using the framework method. In total, 64 interviews were completed (median, n=6 per participant). Mean (SD) weight loss was 15.7(9.6)kg (14.6% body weight) at 6months and 9.6(9.9)kg (8.8% body weight) at 2years. The prespecified theoretical model offered a useful framework to capture the variability of experiences. Negative aspects of obesity were strong motivations for weight loss and maintenance. Perceiving new routines as sustainable and developing a 'maintenance mindset' was characteristic of 'Maintainers', whereas meeting emotional needs at the expense of WLM goals during periods of stress and negative mood states was reported more often by 'Regainers'. Optimistic beliefs about maintaining weight losses appeared to interfere with barrier identification and coping planning for most participants. People tended to be very optimistic about WLM without acknowledging barriers and this may undermine longer-term outcomes. The potential for regain remained over time, mainly as a result of emotion-triggered eating to alleviate stress and negative feelings. More active self-regulation during these circumstances may improve WLM, and these situations represent important targets for intervention.

Under-reporting of the energy intake in patients with type 2 diabetes.

In patients with type 2 diabetes mellitus (DM), an accurate assessment of food intake is essential for clinical nutritional management. Tools such as the food frequency questionnaire (FFQ) and 24-h food record (24HR) identify dietary habits in support of dietary planning. However, it is possible that these tools have reporting errors with respect to assessing food intake, particularly energy intake (EI). A cross-sectional study was conducted in patients with type 2 DM. EI was assessed by the FFQ and 24HR tools. Resting energy expenditure (REE) was measured by indirect calorimetry. Data were analysed using a kappa test, t-test and Spearman's correlation coefficients. Under-reporting was assessed using the EI/REE ratio. Patients with values <1.18 and <1.10 for FFQ and 24HR, respectively, were considered as under-reporting. We evaluated 55 patients [mean (SD) 62.7(5.3)years old, duration of diabetes 11.2(7.3)years, 52.7% female]. The mean (SD) EI assessed by FFQ was 1797.7(641.3) and as assessed by 24HR was 1624(484.8)kcalday-1 . The mean (SD) REE was 1641.3(322.3)kcalday-1 . The mean (SD) ratios FFQ/REE and 24HR/REE were 1.11(0.38) and 1.01(0.30), respectively. The tools showed a moderate agreement for under-reporting of EI (kappa=0.404; P=0.003). Moderate and positive correlations between REE were observed with FFQ (r=0.321; P=0.017) and 24HR (r=0.364; P=0.006). According to the tools, the under-reporting was observed in approximately 65% of patients. The majority of patients with type 2 DM under-reported their calorie intake, as assessed by FFQ and 24HR. REE showed a positive correlation with both tools.

Short-term very low caloric intake causes endothelial dysfunction and increased susceptibility to cardiac arrhythmias and pathology in male rats.

New Findings What is the central question of this study? What are the effects of a 2 week period of severe food restriction on vascular reactivity of resistance arteries and on cardiac structure and function? What is the main finding and its importance? This study showed, for the first time, that a 2 week period of severe food restriction in adult male Fischer rats caused endothelial dysfunction in mesenteric arteries and increased the susceptibility to ischaemia–reperfusion‐induced arrhythmias and cardiac pathology. Our findings might have ramifications for cardiovascular risk in people who experience periods of inadequate caloric intake. Severe food restriction (sFR) is a common dieting strategy for rapid weight loss. Male Fischer rats were maintained on a control (CT) or sFR (40% of CT food intake) diet for 14 days to mimic low‐calorie crash diets. The sFR diet reduced body weight by 16%. Haematocrits were elevated by 10% in the sFR rats, which was consistent with the reduced plasma volume. Mesenteric arteries from sFR rats had increased sensitivity to vasoconstrictors, including angiotensin II [maximum (%): CT, 1.30 ± 0.46 versus sFR, 11.5 ± 1.6; P < 0.0001; n = 7] and phenylephrine [maximum (%): CT, 78.5 ± 2.8 versus sFR, 94.5 ± 1.7; P < 0.001; n = 7] and reduced sensitivity to the vasodilator acetylcholine [EC50 (nm): CT, 49.2 ± 5.2 versus sFR, 71.6 ± 6.8; P < 0.05; n = 7]. Isolated hearts from sFR rats had a 1.7‐fold increase in the rate of cardiac arrhythmias in response to ischaemia–reperfusion and more cardiac pathology, including myofibrillar disarray with contractions and cardiomyocyte lysis, than hearts from CT rats. The sFR dietary regimen is similar to very low‐calorie commercial and self‐help weight‐loss programmes, which provide ∼800–1000 kcal day−1. Therefore, these findings in rats warrant the study of cardiovascular function in individuals who engage in extreme dieting or are subjected to bouts of very low caloric intake for other reasons, such as socioeconomic factors and natural disasters.

Human Energy Expenditure in Anthropology and Beyond

ABSTRACTHumans have successfully inhabited every continent on this planet. Our ability to survive and thrive in such a wide range of environments is fascinating, particularly from an energetic perspective. As knowledge of human total energy expenditure (TEE, kcal day−1) has deepened, so too has the ability to interpret observable patterns in human metabolic physiology and apply these interpretations to our evolutionary history. This review examines the basic components of human TEE as well as the interactions among these components. This is followed by a discussion of two recent theories regarding limits on the amount of calories used and how those limits may mediate life‐history variables. Finally, this review provides a look ahead into the lesser explored areas of human TEE, suggesting future areas of research. The ability to measure how much energy humans expend and how they allocate that energy is a powerful tool that enables anthropologists to understand not only our past but also our present. [energy expenditure, thermoregulation, life history]

Physical inactivity and excessive sucrose consumption are associated with higher serum lipids in subjects with Taq1B CETP polymorphism.

Dyslipidaemias result from the interaction between genetic and environmental factors, including diet disequilibrium and physical inactivity. Among the genetic factors associated with serum lipids, the Taq1B CETP polymorphism has been investigated. The B1 allele has been considered as a risk factor for dyslipidaemia because of its association with greater CETP levels and higher serum triglycerides. The present study aimed to determine the role of the Taq1B polymorphism with lipid and anthropometric variables and its interaction with diet and physical activity. In total, 215 subjects were enrolled in this cross-sectional study. Diet intake was evaluated using a 3-day food consumption record and physical activity was determined in accordance with World Health Organization recommendations. The Taq1B CETP polymorphism was determined by allelic discrimination. Subjects with the B1B2/B2B2 genotype, who had a sucrose consumption ≥5% of the total kcal day-1 , had higher levels of total cholesterol (TC) [165.55 (142.21-188.89)mg dL-1 versus 200.19 (184.79-215.60)mg dL-1 ; P for interaction=0.034] and low-density lipoprotein [99.29 (75.52-123.05)mg dL-1 versus 128.64 (113.59-143.69)mg dL-1 ; P for interaction=0.037] than subjects with the B1B1 genotype. Subjects who did not perform physical activity and had the B1B2/B2B2 genotype showed significantly higher levels of TC [177.48 (161.36-193.60)mg dL-1 versus 194.49 (185.43-203.56)mg mL-1 ; P for interaction=0.033] than subjects with the B1B1 genotype. We provide evidence that subjects with inadequate environmental factors carriers of the polymorphic genotype had higher serum lipid levels than subjects with the B1B1 genotype.

A systematic review of UK-based long-term nonsurgical interventions for people with severe obesity (BMI ≥35kgm-2 ).

IntroductionThe aim of this project was to systematically review UK evidence on the effectiveness of long‐term (≥12 months) weight management services (WMSs) for weight loss and weight maintenance for adults (≥16 years) with severe obesity (body mass index ≥35 kg m−2), who would generally be eligible for Tier 3 services.MethodsFour data sources were searched from 1999 to October 2018. ResultsOur searches identified 20 studies, mostly noncomparative studies: 10 primary care interventions, nine in secondary care specialist weight management clinics and one commercial setting intervention. A programme including a phase of low energy formula diet (810–833 kcal day−1) showed the largest mean (SD) weight change at 12 months of –12.4 (11.4) kg for complete cases, with 25.3% dropout. Limitations or differences in evaluation and reporting (particularly for denominators), unclear dropout rates, and differences between participant groups in terms of comorbidities and psychological characteristics, made comparisons between WMSs and inferences challenging.ConclusionsThere is a persistent and clear need for guidance on long‐term weight data collection and reporting methods to allow comparisons across studies and services for participants with severe obesity. Data could also include quality of life, clinical outcomes, adverse events, costs and economic outcomes. A randomised trial comparison of National Health Service Tier 3 services with commercial WMSs would be of value.

Real-Time Model Predictive Control of Human Bodyweight Based on Energy Intake

The number of overweight people reached 1.9 billion in 2016. Lifespan decrease and many diseases have been linked to obesity. Efficient ways to monitor and control body weight are needed. The objective of this work is to explore the use of a model predictive control approach to manage bodyweight in response to energy intake. The analysis is performed based on data obtained during the Minnesota starvation experiment, with weekly measurements on body weight and energy intake for 32 male participants over the course of 27 weeks. A first order dynamic auto-regression with exogenous variables model exhibits the best prediction, with an average mean relative prediction error value of 1.01 ± 0.02% for 1 week-ahead predictions. Then, the performance of a model predictive control algorithm, following a predefined bodyweight trajectory, is tested. Root mean square errors of 0.30 ± 0.06 kg and 9 ± 3 kcal day−1 are found between the desired target and simulated bodyweights, and between the measured energy intake and advised by the controller energy intake, respectively. The model predictive control approach for bodyweight allows calculating the needed energy intake in order to follow a predefined target bodyweight reference trajectory. This study shows a first possible step towards real-time active control of human bodyweight.

Impact of a Complementary Feeding (CF) Intervention on Nutrient Intake and Prevalence of Adequate Diet Among 12-month-old Infants in Rural Zimbabwe (P10-028-19)

ObjectivesTo assess the effectiveness of a complementary feeding (CF) intervention comprised of behavior-change communication (BCC) and small-quantity lipid-based nutrient supplement (SQLNS) on the intake of macro- and micronutrients and prevalence of adequate diet between the intervention (CF) and nonintervention (non-CF) group of a trial in rural Zimbabwe. MethodsWe conducted a sub-study within the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial. The CF group received BCC messages on CF and SQLNS supplementation from 6 to 18 months. The SQLNS was provided in 20 g –1 day sachets each contributing about118 kcal day–1. To measure nutrient intake, we conducted multi pass 24-hour dietary recalls among a randomly selected sample of 195 caregivers when their infants were 12 months old. For 10% of the sample a second dietary recall was conducted 1–3weeks after the first one. The CF (n = 100) group was compared with the non-CF group (n = 95) for differences in macro- and micronutrients intake including SQLNS and from non-supplement foods only. Prevalence of dietary adequacy was assessed using the measurement-error method and also compared between the CF and non-CF group. ResultsDietary energy intake was significantly (P = 0.014) higher among CF (470 kcal/day) than non-CF (395 kcal/day) infants. The CF group also had significantly (all P < 0.001) higher intakes of all micronutrients assessed, which included vitamin A, folate, calcium, iron and zinc. Intakes of all macro- and micronutrients from non-supplement foods did not differ significantly between the CF groups, which suggests that there was no additional effect of the BCC intervention on consumption and no replacement of non-supplement foods by SQLNS. The prevalence of dietary adequacy was significantly higher in the CF intervention arm for all nutrients. ConclusionsThe CF intervention improved macro- and micronutrient intake and prevalence of adequate diet. This difference resulted from the SQLNS supplementation with no additional benefit from the BCC intervention. Funding SourcesSupported by the Bill & Melinda Gates Foundation, the UK Department for International Development and Borlaug LEAP fellowship.

Modern dietary guidelines for healthy pregnancy; maximising maternal and foetal outcomes and limiting excessive gestational weight gain

Maternal dietary habits influence maternal and foetal health, representing a pathway for intervention to maximise pregnancy outcomes. Advice on energy intake is provided on a trimester basis, with no additional calories required in the first trimester and an additional 340 kcal d−1 and 452 kcal d−1 needed for the second and third trimesters. Energy intake depends on pre-gravid body mass index (BMI); underweight women are recommended an increase of 150, 200 and 300 kcal d−1 during the first, second and third trimester, normal weight women an increase of 0, 350 and 500 kcal d−1 and obese women an increase of 0, 450 and 350 kcal day−1. The recommendations for carbohydrate and protein intake are 175 g d−1 and 0.88–1.1 g kgBM d−1, with no change to fat intake. The number of pre-gravid obese women is rising; therefore, we need to regulate weight in women of childbearing age and limit gestational weight gain to within the recommended ranges [overweight women 6.8–11.3 kg and obese women 5.0–9.1 kg]. This can be achieved using nutritional interventions, as dietary changes have been shown to help with gestational weight management. As pregnancy has been identified as a risk factor for the development of obesity, normal weight women should gain 11.5–16.0 kg during pregnancy. While some research has shown that dietary interventions help to regulate gestational weight gain and promote postpartum weight loss to some extent, future research is needed to provide safe and effective guidelines to maximise these effects, while benefitting maternal and foetal health.

The effect of 10 days of intermittent fasting on Wingate anaerobic power and prolonged high-intensity time-to-exhaustion cycling performance

Many physically active individuals have undertaken intermittent fasting to reduce their daily caloric intake. However, abstaining from meals for a specific length of time may lead to the acute disturbance of highly carbohydrate-dependent exercise performance. The purpose of this study was to observe the effect of 10 days of intermittent fasting on high-intensity type exercises, Wingate anaerobic (WT) and prolonged high-intensity time-to-exhaustion (HIT) cycling test. Twenty participants were randomised into an intermittent fasting (FAS) and a control group (CON). One day after baseline data collection on Day-0 where participants consumed their recommended daily caloric intake (FAS = 2500 ± 143 kcal day−1; CON = 2492 ± 20 kcal day−1) served over a course of five meals, the FAS group consumed only four meals where 40% was restricted by the omission of lunch (FAS = 1500 ± 55 kcal day−1). This diet was then continued for 10 days. Data on exercise performance and other dependent variables were collected on Day-2, -4, -6, -8 and -10. A reduction in WT power in the FAS group was observed on Day-2 (821.74 ± 66.07 W) compared to Day-0 (847.63 ± 95.94 W) with a moderate effect size (p < .05, ES = 0.4), while HIT time-to-exhaustion performance declined over the 10 days with a trend of recovery from a large to a minimum effect size (p < .05, ES = 0.8–0.3). Body weight and triglyceride were consistently reduced in the FAS group (p < .01). The present study suggests that intermittent fasting must exceed 10 days to ensure that high-intensity performance does not deteriorate because this length of time seems to be required for effective adaptation to the new dietary regimen.