Low-calorie Meal Research Articles

A low-calorie meal replacement improves body composition and metabolic parameters in shift workers with overweight and obesity: a randomized, controlled, parallel group trial

BackgroundShift work has been identified as a risk factor for several chronic health conditions including obesity. This study evaluated the impact of a low-calorie meal replacement (MR) as a dinner substitute on body composition and metabolic parameters in shift workers with overweight and obesity.MethodsAn 8-week parallel, randomized controlled trial was conducted on overweight and obese shift workers in a large hospital. An intervention group (IG) (n = 25) was provided with a low-calorie MR shake (∼200 kcal) as a replacement for dinner, every day for 8 weeks, while the control group (CG) (n = 25) continued their habitual diet. Anthropometric measurements, body composition, biochemical, and lifestyle data were assessed at the first and last visits. Analyses were done per protocol (PP) and by intention to treat (ITT).ResultsOver the study duration, both groups displayed moderate changes in anthropometric measurements and body composition, although these were not statistically significant according to the PP analysis. In the ITT analysis, apart from the hip circumference (HC), all other anthropometric parameters demonstrated significant group and time interactions, suggesting the advantageous effects of the meal replacement over the study period (P < 0.05). HDL and VLDL cholesterol measures showed significant main effects, influenced by both group (P = 0.031) and time (P = 0.050) respectively. The most pronounced dietary shift in the IG was a reduction in carbohydrate consumption and an increase in protein intake. Throughout the study, the meal replacement was well-tolerated, with no adverse events reported.ConclusionsThe meal replacement dietary intervention appears to offer beneficial health effects over time. Extended research is crucial to understand the broader implications of meal replacements across diverse populations.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12622000231741. Registered on 09 February 2022. https://www.anzctr.org.au/ACTRN12622000231741.aspx.

A Primary Care–Based Weight Navigation Program

Evidence-based weight management treatments (WMTs) are underused; strategies are needed to increase WMT use and patients' weight loss. To evaluate the association of a primary care-based weight navigation program (WNP) with WMT use and weight loss. This cohort study comprised a retrospective evaluation of a quality improvement program conducted from October 1, 2020, to September 30, 2021. Data analysis was performed from August 2, 2022, to March 7, 2024. Adults with obesity and 1 or more weight-related condition from intervention and control sites in a large academic health system in the Midwestern US were propensity matched on sociodemographic and clinical factors. WNP, in which American Board of Obesity Medicine-certified primary care physicians offered weight-focused visits and guided patients' selection of preference-sensitive WMTs. Primary outcomes were feasibility measures, including rates of referral to and engagement in the WNP. Secondary outcomes were mean weight loss, percentage of patients achieving 5% or more and 10% or more weight loss, referral to WMTs, and number of antiobesity medication prescriptions at 12 months. Of 264 patients, 181 (68.6%) were female and mean (SD) age was 49.5 (13.0) years; there were no significant differences in demographic characteristics between WNP patients (n = 132) and matched controls (n = 132). Of 1159 WNP-eligible patients, 219 (18.9%) were referred to the WNP and 132 (11.4%) completed a visit. In a difference-in-differences analysis, WNP patients lost 4.9 kg more than matched controls (95% CI, 2.11-7.76; P < .001), had 4.4% greater weight loss (95% CI, 2.2%-6.4%; P < .001), and were more likely to achieve 5% or more weight loss (odds ratio [OR], 2.90; 95% CI, 1.54-5.58); average marginal effects, 21.2%; 95% CI, 8.8%-33.6%) and 10% or more weight loss (OR, 7.19; 95% CI, 2.55-25.9; average marginal effects, 17.4%; 95% CI, 8.7%-26.2%). Patients in the WNP group were referred at higher rates to WMTs, including bariatric surgery (18.9% vs 9.1%; P = .02), a low-calorie meal replacement program (16.7% vs 3.8%; P < .001), and a Mediterranean-style diet and activity program (10.6% vs 1.5%; P = .002). There were no between-group differences in antiobesity medication prescribing. The findings of this cohort study suggest that WNP is feasible and associated with greater WMT use and weight loss than matched controls. The WNP warrants evaluation in a large-scale trial.

Weight Loss Treatment and Longitudinal Weight Change Among Primary Care Patients With Obesity

Among individuals with obesity, 5% or greater weight loss can improve health. Weight management treatments (WMT) include nutrition counseling, very low-calorie meal replacement (MR), antiobesity medications (AOM), and bariatric surgery; however, little is known about how these WMT are associated with weight change among individual patients and populations. To characterize weight status and WMT use among primary care patients and assess associations between WMT and weight trajectories. Retrospective, population-based cohort study of primary care patients from 1 academic health system in Michigan between October 2015 and March 2020 using cross-sectional analysis to compare obesity prevalence and WMT utilization. For patients with obesity and WMT exposure or matched controls, a multistate Markov model assessing associations between WMT and longitudinal weight status trajectories was used. Data were analyzed from October 2021 to October 2023. Cross-sectional exposure was year: 2017 or 2019. Trajectory analysis exposures were WMT: nutrition counseling, MR, AOM, and bariatric surgery. Cross-sectional analysis compared mean body mass index (BMI), obesity prevalence, and, among patients with obesity, prospective WMT use. The trajectory analysis examined longitudinal weight status using thresholds of ±5% and 10% of baseline weight with primary outcomes being the 1-year probabilities of 5% or greater weight loss for each WMT. Adult patients (146 959 participants) consisted of 83 636 female participants (56.9%); 8940 (6.1%) were Asian, 14 560 (9.9%) were Black, and 116 664 (79.4%) were White. Patients had a mean (SD) age of 49.6 (17.7) years and mean (SD) BMI of 29.2 (7.2). Among 138 682 patients, prevalence of obesity increased from 39.2% in 2017 to 40.7% in 2019; WMT use among patients with obesity increased from 5.3% to 7.1% (difference: 1.7%; 95% CI, 1.3%-2.2%). In a multistate model (10 180 patients; 33 549 patient-years), the 1-year probability of 5% or greater weight loss without WMT exposure was 15.6% (95% CI, 14.3%-16.5%) at reference covariates. In contrast, the probability of 5% or greater weight loss was more likely with year-long exposures to any WMT (nutrition counseling: 23.1%; 95% CI, 21.3%-25.1%; MR: 54.6%; 95% CI, 46.5%-61.2%; AOM: 27.8%; 95% CI, 25.0%-30.5%; bariatric surgery: 93.0%; 95% CI, 89.7%-95.0%). In this cohort study of primary-care patients with obesity, all WMT increased the patient-level probability of achieving 5% or greater weight loss, but current rates of utilization are low and insufficient to reduce weight at the population level.

Translation of a Diabetes Remission Service into Australian Primary Care: Findings from the Evaluation of DiRECT-Australia.

The Diabetes Remission Clinical Trial (DiRECT) study demonstrated that an intensive and structured weight management program in UK primary care resulted in high rates of diabetes remission in adults with recent onset type 2 diabetes mellitus (T2DM). This study was aimed at evaluating the translation of the DiRECT intervention into an Australian primary care setting. All patients enrolled in the DiRECT-Australia Type 2 Diabetes Remission Service in a region of Sydney (Macarthur region, South Western Sydney, Australia) were included. Eligible participants were aged 20-70 years, noninsulin treated, with T2DM of ≤6 years' duration, and body mass index (BMI) ≥ 27 kg/m2. Total diet replacement of 825-853 kcal/day using meal replacements was implemented for 12 weeks, followed by an ongoing structured program until 52 weeks, with regular follow-up with a general practitioner, dietitian, and/or practice nurse. Of 39 recruited participants, 32 (82.1%) and 27 (69.2%) completed 12 weeks and 52 weeks of the structured program, respectively. Decrease in weight by -12.0 kg (95% CI: -9.6, -14.4; p < 0.001) and -9.1 kg (95% CI: -5.2, -12.9; p < 0.001) and decrease in glycated haemoglobin (HbA1c) by -1.1% (95% CI: -0.6, -1.6; p < 0.001) and -0.6% (95% CI: -0.1, -1.1; p = 0.013) were observed at 12 and 52 weeks, respectively. At the end of 12 and 52 weeks, 93.8% (30/32) and 55.6% (15/27) of those with follow-up data met the criteria for diabetes remission, respectively. Quality of life and wellbeing scores increased over the course of 12 weeks, remaining significantly higher at 52 weeks. Participants reported they would be willing to pay A$92.50 (95% CI: A$75.80, A$109.30) per fortnight for the low-calorie meal replacement shakes. These findings support the feasibility of a structured diabetes remission service in an Australian primary care setting to achieve improvements in glycaemia, weight, and quality of life and wellbeing, and suggest a substantial willingness to pay for diet replacement products among participants.

Impact of lifestyle modification on nonalcoholic fatty liver with prediabetes and type 2 diabetes

Prediabetes is characterized by impaired glucose uptake and insulin sensitivity in the muscle, as well as a significant risk of developing diabetes, chronic renal disease, cardiovascular disease, and death. A definite bidirectional connection exists between pre-diabetes, diabetes, and NAFLD. The presence of NAFLD is associated with the subsequent development of new-onset type 2 diabetes (T2DM). There was a 6-fold rise in new-onset diabetes in people whose fatty liver severity progressed from mild to moderate or severe over 5 years, and a decrease in T2DM incidence comparable to that in those without steatosis. Insulin resistance is a common pathophysiological mechanism across metabolic illnesses, including prediabetes, diabetes, and NAFLD. As a result, better names for metabolically linked metabolic fatty liver disease have been considered. Lifestyle is the cornerstone of treatment for patients with prediabetes, T2DM, and NAFLD. Several significant randomized controlled trials show that a customized low-calorie meal plan and behavioral change are highly effective in preventing or delaying prediabetes, type 2 diabetes, and improving other cardiometabolic markers (such as blood pressure, lipids, and inflammation). Several drugs already approved for the treatment of prediabetes and diabetes are beneficial for NAFLD/NASH.

Short-Term Effects of Weight-Loss Meal Replacement Programs with Various Macronutrient Distributions on Gut Microbiome and Metabolic Parameters: A Pilot Study.

It has emerged the gut microbiome is crucially linked to metabolic health and obesity. Macronutrient distribution has been discussed as a key parameter in weight-loss programs, but little is known about its impact on the gut microbiome. We investigated the effects of weight-loss meal replacement programs with different macronutrient ratios on the gut microbiota and metabolic parameters in subjects with overweight and obesity. Three low-calorie meal replacement programs with different ratios of carbohydrates, proteins, and lipids were designed: a balanced diet (Group B, 60:15:30), a high-lipid-low-carbohydrate diet (Group F, 35:20:55), and a protein-enriched diet (Group P, 40:25:35). Sixty overweight or obese participants were provided with the meals twice daily for 3 weeks. In all groups, diet intervention resulted in reduced body weight and BMI. The relative abundance of Bacteroidetes and Firmicutes phyla decreased and increased, respectively, which increased the Firmicutes/Bacteroidetes (F/B) ratio in all subjects, particularly in Groups B and P. Alpha- and beta-diversity were augmented at the phylum level in Group P. In conclusion, short-term interventions with weight-loss meal replacement programs increased butyrate-producing bacteria and the F/B ratio. Moreover, the protein-enriched diet significantly increased alpha- and beta-diversity compared to the balanced diet and the high-lipid-low-carbohydrate diet.

A qualitative exploration of the experiences of shift workers participated in a low-calorie meal replacement dietary intervention

ObjectivesShift work is associated with various health challenges, including obesity and metabolic disturbances. To address these concerns, a randomised controlled clinical trial was conducted to evaluate the efficacy of a...

The effect of food and acid-reducing agents on the pharmacokinetic profile of capivasertib: Results from a randomised, cross-over study.

This two-part, adaptive study assessed the effect of food and an acid-reducing agent (rabeprazole) on the pharmacokinetics (PK) and safety of capivasertib, a potent AKT inhibitor, in clinical development for cancer treatment. In Part 1, healthy participants (n=24) were randomised to receive single-dose capivasertib after overnight fasting, a high-fat, high-calorie meal and with rabeprazole post-overnight fasting in one of six treatment sequences. Based on Part 1 results, a new group of participants (n=24) were randomised (Part 2) to receive capivasertib after overnight fasting, a low-fat, low-calorie meal and modified fasting (food restricted from 2 hours before dosing to 1 hour post-dose) in one of six treatment sequences. Blood samples were collected for PK analyses. Following a high-fat, high-calorie meal, capivasertib exposure increased versus overnight fasting (geometric mean ratio [GMR 90% CI]: area under the concentration-time curve [AUCinf ] 1.32 [1.22, 1.43]; maximum concentration [Cmax ] 1.23 [1.08, 1.41]), but was comparable to that post-modified fasting (GMR: AUCinf 1.13 [0.99, 1.29]; Cmax 0.85 [0.70, 1.04]). AUCinf was similar and Cmax was lower with/without rabeprazole (GMR: AUCinf 0.94 [0.87, 1.02]); Cmax 0.73 [0.64, 0.84]). Capivasertib exposure was similar after a low-fat, low-calorie meal versus overnight fasting (GMR: AUCinf 1.14 [1.05, 1.25]; Cmax 1.21 [0.99, 1.48]) or modified fasting (GMR: AUCinf 0.96 [0.88, 1.05]; Cmax 0.86 [0.70, 1.06]). Safety was consistent with that in larger trials. This study demonstrates that administering capivasertib with food or acid-reducing agents does not lead to clinically relevant PK or safety profile changes.

P24-008-23 The Evaluation of Culturally Appropriate, Low-Calorie Meal Replacement Shakes in a Small Island Developing State

P24-008-23 The Evaluation of Culturally Appropriate, Low-Calorie Meal Replacement Shakes in a Small Island Developing State

Влияние пищевого термогенеза низкокалорийной углеводной нагрузки на энерготраты покоя

Basal metabolic rate (BMR) differs from resting energy expenditure (REE) by less than 10 %, the latter being measured under similar conditions, but after a low-calorie meal. Presently, the two terms are used interchangeably, although resting energy expenditure is the preferred one. However, the cycling to exhaustion test commonly used in assessing the physical performance of elite athletes should not follow a 12-hour fasting. Consequently, the subjects are given a standardized low-calorie highcarbohydrate breakfast before the test, which, according to the authors, does not distort the obtained REE values. Therefore, the aim of this study was to determine the thermic effect of a standardized high-carbohydrate meal on resting energy expenditure and body composition. Materials and methods. The anthropometry and body composition were analysed in healthy young men (n = 10) using the ACCUNIQ BC380 system; REE was assessed using indirect calorimetry; the thermic effect of a low-calorie high-carbohydrate breakfast was calculated as a difference between fasting REE and postprandial metabolism. Results. The research showed that a high-carbohydrate (91 %) food intake (250–300 kcal) produces no significant effect on REE. The meal’s thermic effect was 36.0 ± 5.7 kcal, which increased REE (1887.2 ± 111.7 kcal) by 2 % compared to baseline BMR (1851.2 ± 106.0 kcal). In the subjects, REE varied depending on the total amount of water in the body (p = 0.038), fat mass (p = 0.021), and an energy substrate (carbohydrate) intake (р = 0.046). Thus, in people, including athletes, it is acceptable to measure REE after a high-carbohydrate breakfast that does not exceed 300 kcal.

A Scoping Review of Trials Designed to Achieve Remission of Type 2 Diabetes with Lifestyle Intervention Alone: Implications for Sub-Saharan Africa.

According to the International Diabetes Federation, sub-Saharan Africa is experiencing the highest anticipate increase in the prevalence of type 2 diabetes (T2D) in the world and has the highest percent of people living with T2D who are undiagnosed. Therefore, diagnosis and treatment need prioritization. However, pharmacological hypoglycemics are often unavailable and bariatric surgery is not an option. Therefore, the ability to induce T2D remission through lifestyle intervention alone (LSI-alone) needs assessment. This scoping review evaluated trials designed to induce T2D remission by LSI-alone. PubMed, Embase, Cochrane, and CINAHL databases were searched for trials designed to induce T2D remission through LSI-alone. Of the 928 identified, 63 duplicates were removed. With abstract review, 727 irrelevant articles were excluded. After full-text review, 112 inappropriate articles were removed. The remaining 26 articles described 16 trials. These trials were published between 1984 and 2021 and were conducted in 10 countries, none of which were in Africa. Remission rates varied across trials. Predictors of remission were 10% weight loss and higher BMI, lower A1C and shorter T2D duration at enrollment. However, LSI-alone regimens for newly diagnosed and established T2D were very different. In newly diagnosed T2D, LSI-alone were relatively low-cost and focused on exercise and dietary counseling with or without calorie restriction (~1500 kcal/d). Presumably due to differences in cost, LSI-alone trials in newly diagnosed T2D had higher enrollments and longer duration. For established T2D trials, the focus was on arduous phased dietary interventions; phase 1: low-calorie meal replacement (<1000 kcal/day); phase 2: food re-introduction; phase 3: weight maintenance. In short, LSI-alone can induce remission in both newly diagnosed and established T2D. To demonstrate efficacy in Africa, initial trials could focus on newly diagnosed T2D. Insight gained could provide proof of concept and a foundation in Africa on which successful studies of LSI-alone in established T2D could be built.

Abstract P352: A Review of Trials Designed to Achieve Diabetes Remission With Lifestyle Intervention Alone: Implications for Sub-Saharan Africa

Introduction: As the prevalence of type 2 diabetes (T2D) in sub-Saharan Africa rises and pharmacological hypoglycemics are often unavailable or prohibitively expensive, the ability to induce T2D remission through medication-free lifestyle interventions (LSI) needs urgent assessment. Objective: This scoping review evaluated trials designed to induce T2D remission by LSI without hypoglycemic medications. Methods: Using a combination of controlled vocabulary terms and key words specific to each database, PubMed, Embase, Cochrane, and CINAHL databases were searched for trials designed induce diabetes remission through LSI alone and were published before September 16, 2021. Of the 928 identified, 63 duplicates were removed. After title and abstract review, 727 irrelevant articles were excluded. After full-text review 112 inappropriate articles were removed. The remaining 26 articles described 16 trials. So each trial would be represented by one article, the latest publication from each trial was included. Of the 16 trials, 7 trials were on newly-diagnosed, treatment-naïve T2D and 9 trials were on established T2D with LSI initiated after discontinuation of medications. Results: The 16 trials were published between 1984 and 2021. They were conducted in 10 different countries. None were conducted in Sub-Saharan Africa. Median number of participants was 180 and 20 for the newly-diagnosed and established T2D respectively. Median duration was 5 years for newly-diagnosed T2D and 5 months for established T2D. For newly-diagnosed T2D, LSI involved dietary counseling with or without calorie restriction (~1500 kcal/d) and exercise. For established T2D trial the main focus was dietary intervention most often divided into 3 phases; Phase 1: low-calorie meal replacement; Phase 2: food re-introduction; and Phase 3: weight maintenance. Median remission rate for the 16 trials was 55%. The consensus across trials was with or without exercise, T2D remission requires diet modification and weight loss. Predictors of remission were: higher BMI and lower A1C at enrollment, shorter T2D at enrolment, and a 10% loss of baseline weight. Nonglycemic benefits of LSI included improved blood pressure, renal function and lipid profile as well as enhanced quality of life. Conclusions: LSI without medications can induce remission in both newly-diagnosed and established T2D. In sub-Saharan Africa, LSI as the initial therapeutic option needs exploration.

Meal replacement as a weight loss strategy for night shift workers with obesity: a protocol for a randomized controlled trial

BackgroundShift work is considered a risk factor for a number of chronic health conditions including obesity. Weight reduction in obese patients lowers the risk for cardiovascular disease, diabetes, certain cancers, and mortality. Achieving a negative energy balance by providing low-calorie meal replacements is widely used for weight management. This study aims to evaluate the impact of a low-calorie “meal-replacement” on the weight and metabolic parameters of shift workers with obesity.MethodsThis trial will be conducted in a parallel, randomized controlled design for a period of 8 weeks. A total of 44 shift workers with body mass index over 25 kg/m2 will be recruited after assessing eligibility. Participants will be randomly assigned to the test and control groups on a 1:1 ratio. The intervention group (N = 22) will be provided with a low-calorie (~200 kcal) meal replacement shake as dinner, and the control group (N = 22) will continue their habitual diets. The visits and the evaluations will be done as follows: screening (visit 0), 4 weeks (visit 1), and 8 weeks (visit 2). Anthropometric measurements will be taken at 0, 4, and 8 weeks. Body composition, biochemical parameters, dietary intake, and physical activity will be assessed during the first and the last visit.OutcomesThe primary outcome will be the proportion of participants that had a 5% body weight loss from baseline. The secondary outcomes will be post-intervention changes in other metabolic parameters.DiscussionTo our knowledge, this is one of the first randomized controlled trials evaluating the effects of a meal replacement as the night meal for weight loss in shift workers with obesity. Moreover, improvement of metabolic parameters in shift workers will be an added benefit to this high-risk group.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12622000231741. Registered on 09 February 2022.

Intra- and inter-subject variability in gastric pH following a low-fat, low-calorie meal

Food can alter drug bioavailability through gastric pH changes. Time spent at gastric pH ranges is reported here, including variability data following ingestion of a light, mixed, 260 kcal meal. pH data was obtained for 20 healthy subjects undergoing SmartPill™ wireless motility capsule investigations on three separate visits. Gastric phase pH was sorted into pH < 2, 2–3, 3–4, 4–5 and > 5. All visits and all subjects were pooled to determine median time (25-75th percentiles) in minutes. Gastric emptying time was 176 (137–205) min with the majority of time, 111 (67 – 163), spent at pH < 2. Times spent at pH 2–3 and 3–4 were similar: 17 (5.7 – 35.6) and 18 (7.2–29.3). Time spent at pH 4–5 was 9 (1.3–20.6) and at pH > 5 was 0.7 (0–4.4). Intra-subject variability as determined by robust coefficient of variation (RCV)% was 30 % for pH < 2, 57 % for pH 2–3, 71 % for pH 3–4, 106 % for pH 4–5 and 144 % for pH > 5. Inter-subject variability RCV% was 49 % for pH < 2, 89 % for pH 2–3, 54 % for pH 3–4, 97 % for pH 4–5 and 148 % for pH > 5. Inter-subject variability can be up to approximately twofold higher than intra-subject variability at the lower pH ranges.

Viscoelastic or Viscoplastic Glucose Theory (VGT #80): Applying VGT Energy Theories to Study the Residual Effect on Body Weight and Postprandial Plasma Glucose by Comparing Two Different Periods of Rich and Heavy Meals and Hyperglycemic Meals Based on GH-Method: Math-Physical Medicine (No. 670)

The author celebrated his birthday with a lunch party on 1/16/2022, where he consumed 20% of a large cake slice. His finger-pierced postprandial plasma glucose (PPG) level reached 171 mg/dL after that luncheon. Over several days, he noticed that his overall PPG levels were persistently higher. Out of curiosity regarding the possible extent of the residual effect on his PPG due to a single hyperglycemic meal, he then queried his ~5000 meals database for the high carbs/sugar meals with hyperglycemic PPG (hyper-PPG) levels above 170 mg/dL. He identified 20 independent hyper-PPG meals over 4 years, Y2018 - Y2022. Next, he grouped his extracted PPG and carbs/sugar data into two separate periods: the period containing 10 days of PPG data before the hyper-PPG day and the post-period containing 10 days of PPG data including the hyper-PPG day. He conducted his research work regarding the special hyper-PPG phenomenon and wrote paper No. 586, VGT#7. Its conclusion is that during these 4 years, any single hyper-PPG meal had a residual effect of approximately 10 days. This phenomenon would eventually dissipate with considerable effort. Since 1/1/2021, the author has maintained his body weight (BW) below 170 lbs. (BMI below 25) for ~1.5 years. On 4/5/2022, he traveled to a different city where he consumed his favorite local meals (rich and heavy) for a couple of days. This incident pushed his BW to 171.4 lbs. with a BMI of 25.3 on 4/7/2022. During the following 40 days, he has tried many weight-reduction techniques, including intermittent fasting, low-calorie meals, reduced food portions, increased exercise level, and good quality sleep to decrease his BW. Finally, on 5/16/2022, he successfully reduced his weight to 169.2 lbs. with a BMI of 24.3 (see figure below). This long, arduous process took 40 days which indicates the hyper-weight scenario had a residual effect of around 40 days. Therefore, he decides to conduct another VGT energy analysis of this hyper-weight scenario to make a direct comparison against his previous hyper-PPG scenario study. In this article, he selected BW values as the strain (ε) and the BW change rate as the strain rate (dε/dt), multiplied by his average food quantity amount (m9a) i.e., viscosity factor (η), as his stress (σ), to construct the desired stress-strain diagram. He used the following defined VGT energy equation from the disciplines of engineering and physics to address this unique “time-dependency characteristic” of biomedical symptoms and causes to establish stress-strain diagrams (i.e. cause-symptom diagram) in a space domain (SD):

DAYA TERIMA BOLU LAPIS KOJO UBI JALAR KUNING SEBAGAI SNACK RENDAH KALORI DAN PENAMBAH SERAT

Background: Obesity was defined as abnormal or excessive fat accumulation that can impair health. One strategy to overcome the problem of obesity was to provide low-calorie foods. One of the local foods that can be used as a low-calorie meal and fiber enhancers was the yellow sweet potato cake with kojo layer. The purpose:This study aims to determine the best formulation of yellow sweet potato cake with kojo layer.&#x0D; Methods: This study used an experimental design with a non-factorial completely randomized design (CRD). The ingredients used were yellow sweet potato, wheat flour, eggs, stevia sugar, salt, margarine, and low-fat milk Results: The results showed that the selected yellow sweet potato cake with kojo layer with F2 treatment (60% addition of yellow sweet potato) with a total energy content of 197.39 Kcal, 13.55% protein, 2.11% fat, 31.05% carbohydrate (per 100 grams). Conclusion: Yellow sweet potato kojo layer sponge can be used as a low -calorie food alternative and fiber enhancers.

Innovative functional products development as an element for the Russian Federation population health preservation

The agricultural development priorities and the agro-industrial complex for the Russian Federation Food Security Doctrine implementation are considered. It was determined that, among other things, the development of new specialized and functional food products was included in the list of priority areas of fundamental scientific research for 2021-2030. It has been shown that the population of the Russian Federation with low-calorie food products, which are based on domestic agricultural raw materials, meets the interests of the state as a whole: about 12% of the total health care budget in the world is spent on solving the problem of diabetes mellitus, in the Russian Federation - 569 billion rubles a year. The main trends in the development of innovative functional products presented by various researchers are systematized. The authors consider innovative functional products on the example of low-calorie meals from the public health viewpoint. The prospects for the use of sweeteners for the development of low-calorie sweet dishes for the diabetes prevention are assessed. Experimental data on the selection of the optimal combination of sweeteners are presented. Optimal characteristics are possessed by a mixture of aspartame-sodium saccharinate-sucralose in a ratio of 3: 2: 1, which has a synergistic effect of 12%. A complex supplement is proposed, including a mixture of Dolceta sweeteners and apple pectin. Low-calorie mass-market meals have been developed.

Trends of development of hotel and restaurant economy of Zaporizhzya region in the context of strategy formation

The article substantiates the need to study trends in the hotel and restaurant industry of the Zaporozhye region in the context of strategy formation. Today, the domestic hospitality industry is developing rapidly, especially in large industrial and financial centers of the country. But the significance of this segment for the domestic economy is much lower than in developed countries. It is noted that the efficiency of the hotel and restaurant industry depends on many external and internal factors that have a broad impact on the further development of the hospitality industry. The hotel and restaurant business is actively developing, finding new quality features and new impulses of its development, but in recent years a number of unresolved issues have accumulated. An analysis of the economic situation and trends in the hotel and restaurant industry of the region on the basis of statistical data of the Main Department of Statistics of Zaporozhye region and the State Statistics Service of Ukraine. The dynamics of the number of accommodation facilities in the Zaporozhye region is studied. As a result, the following trends were identified: the number of hotel establishments in 2019 decreased significantly, due to numerous inspections and non-compliance of hotels with the European level, which led to fierce competition between the hotel industry. The offers of tourist services of Zaporizhia region for 2017-2019 are analyzed. The capacity utilization rate in 2019 is lower than in 2017-2018. This indicates not quite uneven filling of seats by seasons and the creation of a significant number of reserve seats in case of seasonal increase number of guests. It is noted that the largest number of hotels and restaurants in the region falls on Berdyansk, Melitopol districts and the city of Zaporozhye. This is due to the fact that Berdyansk and Melitopol districts are the main recreational and resort complexes in the region with the largest tourist flows. The analysis of the dynamics of the number of restaurants for 2017-2019 in the Zaporozhye region and the dynamics of restaurants in the cities of regional importance of the Zaporozhye region. It is noted that in recent years there has been a steady reduction in the network of restaurants owned by legal entities. This is due to the growing number of enterprises owned by individual entrepreneurs, as well as the closure of canteens at industrial and other facilities. Regarding the solution of problems of development of hotel economy of the Zaporozhye area it is offered to provide a number of strategic tasks. The perspective directions of development in the sphere of restaurant business in the region are generalized. There will be trends: national cuisines, companies offering craft dishes, the implementation of a healthy diet, cooking in the presence of the customer, from farm products, cooking low-calorie meals, using low-temperature modes and opening restaurants in casual format, a kind of factories and markets.

Eating self-efficacy changes in individuals with type 2 diabetes following a structured lifestyle intervention based on the transcultural Diabetes Nutrition Algorithm (tDNA): A secondary analysis of a randomized controlled trial.

ObjectiveEating self-efficacy behavior is an important predictor of successful lifestyle intervention. This secondary analysis evaluated the changes in eating self-efficacy behavior in patients with type 2 diabetes (T2D) and overweight/obesity following structured lifestyle intervention based on the Malaysian customized transcultural Diabetes Nutrition Algorithm (tDNA).MethodsPatients with T2D and overweight/obesity (n = 230) were randomized either into the tDNA group which included a structured low-calorie meal plan using normal foods, incorporation of diabetes-specific meal replacements, and an exercise prescription or usual T2D care (UC) for 6 months. Patients in the tDNA group also received either counseling with motivational interviewing (tDNA-MI) or conventional counseling (tDNA-CC). The UC group received standard dietary and exercise advice using conventional counseling. Eating self-efficacy was assessed using a locally validated Weight Efficacy Lifestyle (WEL) questionnaire. All patients were followed up for additional 6 months’ post-intervention.ResultsThere was a significant change in WEL scores with intervention over one-year [Group X Time effect: F = 51.4, df = (3.4, 318.7), p<0.001]. Compared to baseline, WEL scores improved in both the tDNA groups with significantly higher improvement in the tDNA-MI group compared to the tDNA-CC and UC groups at 6 months (tDNA-MI: 25.4±2.1 vs. tDNA-CC: 12.9±2.8 vs. UC: -6.9±1.9, p<0.001). At 12 months’ follow-up, both the tDNA groups maintained improvement in the WEL scores, with significantly higher scores in the tDNA-MI group than tDNA-CC group, and the UC group had decreased WEL scores (tDNA-MI: 28.9±3.1 vs. tDNA-CC: 11.6±3.6 vs. UC: -13.2±2.1, p<0.001). Patients in the tDNA-MI group with greater weight loss and hemoglobin A1C reduction also had a higher eating self-efficacy, with a similar trend observed in comparative groups.ConclusionEating self-efficacy improved in patients with T2D and overweight/obesity who maintained their weight loss and glycemic control following a structured lifestyle intervention based on the Malaysian customized tDNA and the improvement was further enhanced with motivational interviewing.Clinical trialThis randomized clinical trial was registered under National Medical Research Registry, Ministry of Health Malaysia with registration number: NMRR-14-1042-19455 and also under ClinicalTrials.gov with registration number: NCT03881540.

Nutritional profile of nigiri sushi meal and the usage of citrate synthase activity as freshness parameter

The aim of the study was to access the influence of nigiri sushi meal ingredients ratio on its weight, nutritional profile, physic-chemical characteristics (crude protein, lipid content, ash content, salt content, phosphorus content and thiobarbituric acid assay) and to estimate the usage of citrate synthase activity as freshness index of seafood used for sushi preparation. Nutrition composition of nigiri sushi is highly influence by rice/seafood ratio. Inclusion of processed seafood in sushi can influence significantly weight and consequently nutritional profile of nigiri sushi meal as well. Shrimp cooking resulted in 16.45±3.29% weight loss in whole non-deveined shrimp and 13.03±3.40% in non-deveined shrimp tail. Nigiri sushi meal prepared with salmon and tuna fish can be recognized as good sources of seafood. Nigiri sushi meal can be considered as a low-calorie meal (nigiri salmon: 716.13±24.18 kJ/100g; nigiri tuna: 638.12±10.64 kJ/100g; nigiri shrimp: 672.06 ± 8.72 kJ/100g) but on the contrary it cannot be considered as low salt content meal (nigiri salmon: 0.97±0.04%; nigiri tuna: 0.89±0.10%; nigiri shrimp: 1.06±0.13%). Citrate synthase activity (CSA) increases after each freezing/thawing cycle and at the end (4th cycle) were 5.29±0.67 μmol/mL/min and 6.67±0.63 μmol/mL/min in tuna and salmon samples, respectively. CSA can be recognized as reliable enzymatic kit indicator for fish freshness determination in nigiri sushi meal.