Low-calorie Diet Research Articles

Metabolic significance of nutritional treatment before and after bariatric surgery: a systematic review

Introduction: According to the American Society for Metabolic and Bariatric Surgery (ASMBS), the rate of bariatric surgery (BS) increased from 158 thousand in 2011 to 196 thousand in 2015. Lifestyle modifications, such as healthy eating and correct physical activity programs, can improve surgical results. Thus, the most important aspect in the medical management of bariatric patients refers to nutritional management. Objective: It was to carry out a systematic review to list the main approaches and significance of nutritional treatment before and after bariatric surgery, to mitigate the metabolic damage caused by nutrient deficits. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from August to October 2024 in the Web of Science, Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 127 articles were found. A total of 45 articles were evaluated in full and 30 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 25 studies with a high risk of bias and 27 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=62.5%>50%. It was concluded that the most important aspects of the medical management of bariatric patients refer to nutritional management. Before bariatric surgery, nutritional status should be checked and preoperative weight loss may be attempted. Very low-calorie diets and very low-calorie ketogenic diets are often prescribed in the last few months before surgery. It was observed that the recommendations were gathered to assist in individualized clinical practice in the nutritional management of patients with obesity, including nutritional management. Iron status can be affected by inflammation of adipose tissue and increased expression of the systemic iron-regulating protein hepcidin. The postoperative recommendation for vitamin B12 (cobalamin) should be 350-500 micrograms/1000 micrograms monthly, and postoperative folate (folic acid) should be 1,000 micrograms per day.

Preoperative Nutrition in Bariatric Surgery: A Narrative Review on Enhancing Surgical Success and Patient Outcomes

Bariatric surgery has become the preferred treatment for individuals with morbid obesity. Nutrition is key in optimizing surgical outcomes by reducing risks and enhancing recovery. Preoperative strategies, such as reducing body fat, decreasing liver size, and improving metabolic profiles, have been shown to facilitate safer surgical procedures with fewer complications. This narrative review aims to provide an analysis of the fundamental role of preoperative nutritional management in improving bariatric surgery outcomes, emphasizing the importance of addressing specific nutritional challenges to enhance surgical safety, recovery, and overall health. Preoperative nutritional interventions focus on correcting comorbidities and nutritional deficiencies, particularly hypovitaminosis and micronutrient imbalances, through a multidisciplinary approach involving nutritionists and other healthcare professionals. These interventions not only prepare patients for the physiological demands of surgery but also initiate a period of adaptation to new dietary habits, aiming to improve long-term compliance and mitigate risks such as postoperative weight regain and dumping syndrome. Adopting dietary changes, such as very low-calorie or ketogenic diets 6–12 weeks before surgery, enhances adherence to postoperative restrictions and overall surgical success. Future research should focus on developing comprehensive guidelines for preoperative nutritional care to improve patient outcomes globally.

The Effect of Intermittent Fasting Diet in Comparison With Low-Calorie Diet on Inflammation, Lipid Profile, Glycemic Index, Liver Fibrosis in Patients With Metabolic-Associated Fatty Liver Disease (MAFLD): A Randomized Controlled Trial

The Effect of Intermittent Fasting Diet in Comparison With Low-Calorie Diet on Inflammation, Lipid Profile, Glycemic Index, Liver Fibrosis in Patients With Metabolic-Associated Fatty Liver Disease (MAFLD): A Randomized Controlled Trial

The effect of lutein supplementation combined with a low-calorie diet on pro-oxidant/antioxidant balance and serum levels of adiponectin and leptin in the middle-aged obese individuals: A randomized clinical trial

The effect of lutein supplementation combined with a low-calorie diet on pro-oxidant/antioxidant balance and serum levels of adiponectin and leptin in the middle-aged obese individuals: A randomized clinical trial

Role of nutrition in diabetes mellitus and infections

In this editorial, we have commented on the article that has been published in the recent issue of World Journal of Clinical Cases . The authors have described a case of unilateral thyroid cyst and have opined that the acute onset of infection may be linked to diabetes mellitus (DM). We have focused on the role of nutrition in the association between DM and infection. Patients with DM are at a high risk of infection, which could also be attributed to nutrition-related factors. Nutritional interventions for patients with diabetes are mainly based on a low-calorie diet, which can be achieved by adhering to a low-carbohydrate diet. However, dietary fiber supplementation is recommended to maintain the diversity of the gut microbiota. Furthermore, high-quality protein can prevent the increased risk of infection due to malnutrition. Supplementation of vitamins C, vitamins A, vitamins D, and folic acid improves blood sugar control and facilitates immune regulation. Mineral deficiencies augment the risk of infection, but the relationship with diabetes is mostly U-shaped and a good intake should be maintained.

BHSo5 A systematic review of randomized trials of weight loss before hernia surgery

Abstract Introduction Obesity is one of the main modifiable risk factors of outcome following hernia surgery, and is strongly associated with hernia recurrence and complications. For this reason weight loss is strongly recommended before hernia surgery. However, weight loss can be extremely difficult for patients to achieve. A number of interventions have been described, however, the evidence for this before hernia surgery is unclear. The aim of this study was to systematically review the evidence for randomized controlled trials (RCTs) assessing weight loss interventions before hernia surgery. Methods A literature search was performed of the PubMed, EMBASE (https://www.embase.com/) and CENTRAL databases on 30th May 2024 using the following search term: (weight OR obes* OR preoptimization OR prehabilitation OR BMI OR diet OR exercise) and (hernia OR abdominal wall reconstruction) AND randomized. Bibliographies of retrieved articles were searched. Studies were screened and reviewed independently by two authors. Results 2921 articles were identified. After exclusion of duplicates 1707 studies were screened, 20 articles retrieved, and 4 included. Two described the 30 day and 2 year outcomes of a single RCT of non-pharmacological prehabilitation in ventral hernia surgery. Two described RCTs assessing short periods of very low calorie diet before operations which included hernia surgery. Interventions were associated with greater weight loss, with one RCT showing fewer short term complications. Conclusions Weight loss before hernia surgery is strongly recommended, but the evidence for this is limited to 3 RCTs, with just one finding short-term benefit. This highlights the need for dedicated robust RCTs.

Behavior change techniques in low-calorie and very low-calorie diet interventions for weight loss: A systematic review with meta-analysis.

There is limited evidence and clinical guidelines on the behavior change support required for low-calorie diet programs. This systematic review aimed to establish the behavior change technique(s) (BCT) implemented in weight loss interventions (≤1200 kcal/d) and how these contribute to effectiveness. Databases were searched from inception to April 2022. Screening, data extraction, BCT coding, and quality appraisal were conducted in duplicate using the Template for Intervention Description and Replication framework, Behavior Change Technique Taxonomy, and Cochrane Risk of Bias 2 tool. Data were analyzed via narrative synthesis and random effects multi-level meta-analyses. Thirty-two papers reporting on 27 studies were included. Twenty-four BCTs were identified across studies. Eight BCTs were significantly associated with a larger reduction in weight at the end-of-diet time-point; one BCT was statistically significant at the end of weight maintenance. Physical activity, Type 2 Diabetes, and BMI category moderated intervention effects. This is the first meta-analysis to examine how specific BCTs contribute to the effectiveness of low-calorie diets. It is recommended that a) these findings are used to develop clinical guidelines specific to behavioral support in low-calorie diet programs, and b) program commissioners stipulate the use of these BCTs in their service specifications.

The Impact of a Very-Low-Calorie Ketogenic Diet on Monocyte Subsets of Patients with Obesity: A Pilot Study.

Background/Objectives: Obesity is closely linked to chronic low-grade inflammation and the development of cardio-metabolic comorbidities. Monocyte subsets, which are crucial in immune responses, have been reported to be altered in individuals with obesity, potentially exacerbating inflammation. Although very-low-calorie ketogenic diets (VLCKDs) are recognized for their efficacy in promoting weight loss and improving metabolic health, their impact on circulating monocyte subsets remains poorly understood. The objective of our study is to investigate the impact of VLCKDs on monocyte subset distribution in people with obesity. Methods: Thirty-six participants were divided into four groups-healthy controls, individuals with obesity and no dietary intervention, and individuals with obesity following either a low-calorie diet (LCD) or VLCKD for 28 days. Blood samples were analyzed to assess the distribution of classical monocytes (CMs), intermediate monocytes (IMs), and non-classical monocytes (NCMs) using flow cytometry. Results: Individuals with obesity exhibited significant increases in IMs and NCMs, alongside a decrease in CMs compared to healthy controls. The VLCKD led to a notable shift in monocyte distribution, with increased CMs and reduced IMs and NCMs, restoring levels closer to those observed in healthy individuals. In contrast, the LCD group showed no significant changes in monocyte subsets. Conclusions: VLCKDs may exert anti-inflammatory effects by modulating monocyte subset distribution, offering potential therapeutic benefits in mitigating obesity-related inflammation. These preliminary findings suggest that VLCKDs could be an effective strategy for improving immune function in individuals with obesity.

Impact of a very low-calorie ketogenic diet on metabolic and microbiota outcomes in post-bariatric patients and bariatric-Naïve individuals: A comparative pilot study.

To date, bariatric surgery (BS) is the most effective long-term treatment for obesity, but weight regain (WR) is common. The very low-calorie ketogenic diet (VLCKD) is effective for weight loss and may influence gut microbiota (GM) composition, but it has been scarcely evaluated in post-bariatric patients. This study compared the efficacy and safety of a VLCKD in patients with WR post-bariatric surgery (BS+) and in bariatric surgery-naïve patients (BS-). In this prospective, case-control study, 33 patients (15 BS+, 18 BS-) underwent an 8-week-long VLCKD. Outcomes included weight loss, metabolic profile, safety and GM composition. Both groups achieved significant weight loss (BS+: -6.9%, BS-: -8.3%), but the BS+ group showed slightly less metabolic improvement, particularly in insulin resistance and triglycerides. GM composition differed at baseline, reflecting the lasting effects of BS, and VLCKD led to significant changes in both groups. Microbial diversity and specific taxonomic shifts were more pronounced in BS- patients. Mild renal function changes were noted in BS+ patients, though these remained within clinically acceptable ranges. VLCKD is effective in both BS+ and BS- patients, though metabolic and microbial responses may be less robust post-surgery, possibly due to anatomical and physiological changes. Tailored approaches may be therefore needed to optimize outcomes in post-bariatric patients.

Quantitative liver function imaging and whole genome sequencing - Effective modalities for a new era in personalised decision-making for operable colorectal liver metastases?

The optimal strategy for patients with colorectal liver metastases (CRLM) is unclear. The Precision1 prospective, observational trial assessed whether pre-operative functional imaging and whole genome sequencing (WGS), could enhance individualized decision-making. Patients with CRLM considered for hepatectomy were recruited. In addition to standard staging, patients underwent a quantitative multiparametric MRI (mpMRI) scan, to assess liver function. Use of mpMRI to aid surgical decision-making, was prospectively recorded, as were short-term clinical outcomes in patients who underwent hepatectomy. In the first 45 patients, WGS was performed on blood and liver tumour samples collected per-operatively. 95 mpMRI scans were performed in 84 patients, who underwent 87 resections. The mpMRI scan affected surgical decision-making in 41% (39/95) of scans, with 11 undergoing dual-vein embolization, 16 undergoing more conservative parenchymal-sparing surgery, 11 having more extensive surgery, and one patient following a low calorie diet pre-operatively. There were significant (Clavien-Dindo grades 3/4) complications in 5% of patients, no Grade C post-hepatectomy liver failure, and zero 90-day mortality. WGS suggested additional therapeutic options and prognostic factors for 22 of 35 (63%) evaluable patients. Precision1 shows mpMRI can aid surgical decision-making, and optimise clinical outcomes. WGS provides additional information, to further enhance personalised decision-making.

Finding ways to correct nonspecific vaginitis in menopausal women with obesity

Objective — to increase the effectiveness of treatment of nonspecific vaginitis in menopausal women with excess body weight and obesity through long-term lifestyle modification. Materials and methods. 1178 patients aged 45—55 years were examined, including 317 with nonspecific vaginitis, who were divided into 3 study groups: with a healthy body weight, overweight and obesity. Each group was divided into three subgroups of comparison with standard therapy and three study groups that applied long-term lifestyle modification (actively and systematically used behavioral therapy, physical activity and a low-calorie diet) for 6 months. The control group consisted of 72 volunteers. Results and discussion. In the study subgroups of women who used long-term lifestyle modification, recurrences of nonspecific vaginitis were less frequent than in the corresponding comparison subgroups. Thus, after 6 months, in subgroups of women with a healthy body weight, the difference in the frequency of relapses after treatment was 40 % greater (34.2 vs 20.5 %), with excess body weight — 31.1 % (41.2 vs 28.4 %), with obesity — 29.8 % (55.1 vs 38.7 %). A significant deterioration in the state of the microbiota in menopausal patients with increased body weight and the effectiveness of the use of long-term lifestyle modification on its condition were established. It was proven that excess body weight and obesity in women negatively affected the frequency of nonspecific vaginitis, clinical picture, decreased quality of life, and frequency of relapses. Active and systematic use of behavioral therapy, physical activity, and a low-calorie diet in patients with nonspecific vaginitis in menopause had significant advantages in preventing relapses, compared to standard therapy, and in preserving and improving the quality of life of obese patients. Conclusions. Overweight and obese women are more likely than healthy women to suffer from nonspecific vaginitis, which is more severe and recurrent, accompanied by a decrease in quality of life and a disruption of the vaginal and skin biotope. After 6 months in obese postmenopausal women, the use of long-term lifestyle modification contributes to the restoration of the vaginal and skin microbiome, a decrease in the frequency of recurrences of nonspecific vaginitis and an improvement in quality of life compared with subgroups. with standard therapy. The best effect of treatment was observed in women with a healthy body weight, and the worst in the presence of obesity.

Remission of Type 2 Diabetes: Can It Be the Goal of Diabetes Treatment?

The conventional treatment goals for diabetes have focused on glycemic control to prevent complications, based on the understanding that diabetes is an irreversible chronic condition. However, numerous studies have shown that significant weight loss achieved through intensive lifestyle interventions, low-calorie diets, metabolic surgery, and glucagon-like peptide-1–based medications is associated with a high rate of type 2 diabetes remission. Notably, remission is more likely to occur in the early stages of type 2 diabetes, particularly among younger individuals, those with a shorter duration of the disease, better glycemic control, and greater weight loss. Nevertheless, research on diabetes remission among Asian populations, including those in South Korea, remains limited, and further studies are needed. Additionally, the definition of diabetes remission requires ongoing discussion, emphasizing the need for expert opinions and consensus in this area.

2,4-Dinitrophenol is toxic on a low caloric diet but extends lifespan of Drosophila melanogaster on nutrient-rich diets without an impact on metabolism.

Uncouplers of mitochondrial electron transport chain, such as 2,4-dinitrophehol (DNP), can mimic calorie restriction by decreasing efficiency of adenosine triphosphate (ATP) synthesis. However, DNP is also a toxic substance, whose overdosage can be lethal. In the fruit fly, Drosophila melanogaster model, we have found that DNP in concentrations of 0.05-0.2g/L, led to a drastic decrease in fruit fly survival on a low caloric diet (1% sucrose and 1% yeast; 1S-1Y). On the 5S-5Y diet, DNP decreased lifespan of flies reared only in concentration 0.2g/L, whilst on the diet 15S-15Y DNP either did not significantly shortened fruit fly lifespan or extended it. The lifespan extension on the high caloric 15S-15Y diet with DNP was accompanied by lower activity of lactate dehydrogenase and a decrease in activities of mitochondrial respiratory chain complexes I, II, and V, determined by blue native electrophoresis followed by in-gel activity assays. The exposure to DNP also did not affect key glycolytic enzymes, antioxidant and related enzymes, and markers of oxidative stress, such as aconitase activity and amount protein carbonyls. Consumption of DNP-supplemented diet did not affect flies' resistance to heat stress, though made male flies slightly more resistant to starvation compared with males reared on the control food. We also did not observe substantial changes in the contents of metabolic stores, triacylglycerols and glycogen, in the DNP-treated flies. All this suggest that a nutrient-rich diets provide effective protection against DNP, providing a mild uncoupling of the respiratory chain that allows lifespan extension without considerable changes in metabolism.

Is a low-calorie diet (LCD) key to treating type 2 diabetes holistically?

Is a low-calorie diet (LCD) key to treating type 2 diabetes holistically?

Changes in insulin sensitivity and gut peptides 8 and 52 weeks after bariatric surgery or low-calorie diet.

The endocrine consequences of weight loss by bariatric surgery (BS) and caloric restriction are not fully understood but contribute to variable improvements in insulin sensitivity and cardiometabolic health. This study compared changes in insulin sensitivity and plasma concentrations of gut peptides 8 weeks and 1 year after BS and a low-calorie diet (LCD). Nineteen female patients with obesity self-selected BS (gastric bypass [n = 5] or sleeve gastrectomy [n = 7]) or LCD (n = 7) in this parallel-arm, prospective observational study. We assessed insulin sensitivity via a two-step hyperinsulinemic-euglycemic clamp (20 and 80 mU/min/m2 insulin). Plasma glucose, insulin, and gut peptides were measured around a mixed meal tolerance test (400 kcal). Visual analogue scales (VAS) were used to rate subjective appetite sensations. All assessments were conducted at baseline and after 8 weeks and 1 year of intervention. Whole-body insulin sensitivity was unchanged 8 weeks after the intervention. One year after surgery, insulin sensitivity at both 20 and 80 mU/m2/min insulin infusion doses increased with BS weight loss (-33.8% ± 1.4% body weight) but was unchanged in LCD with small weight loss (-3.7% ± 2.0% body weight). Postprandial total PYY increased more following BS while total and acylated ghrelin decreased more following BS compared to LCD. Hunger decreased and fullness increased with BS compared to LCD (p = .037; p = .010, respectively). Insulin sensitivity was improved only 1 year after BS, despite significant weight loss after 8 weeks. Changes in gut peptides after BS paralleled reduced hunger and increased fullness. Most improvements in cardiometabolic health were related to weight loss.

The Effects of High Protein Intake on Cardiovascular Risk Factors and Weight Loss in Low Caloric Diets in Obese Adults: A Systematic Review

Introduction: This systematic review has been undertaken in order to assess the effects of hypocaloric, high- protein diets on weight loss and cardiovascular risk factors such as serum lipid levels in metabolically healthy obese adults. The primary outcomes measured include changes in pre-and post- diet mean BMI, LDL-C, HDL-C, TAG, and TC levels. Methods: Four databases including: Embase, MEDLINE (via PubMed), Cochrane and Web of Science were searched with no restrictions on language or publication period. Clinicaltrials.gov was also searched in order to identify unpublished or on-going studies. Results: Three of four studies included in this systematic review noted a significantly greater loss in pre- and post- diet mean BMI levels in the hypocaloric, high-protein diet group as compared to hypocaloric, non-high protein diets (control). Whilst pre- and post-diet mean LDL-C, HDL-C, TAG, and TC levels did not differ significantly among hypocaloric, high-protein and control diet groups. Conclusion: Hypocaloric, high-protein diets had an unclear effect on blood-lipid levels as compared to control. Weight loss however was significantly greater in the hypocaloric, high-protein group as compared to other hypocaloric, non-high-protein diet groups.

Diet-Induced Obesity Modulates Close-Packing of Triacylglycerols in Lipid Droplets of Adipose Tissue.

Adipose-derived lipid droplets (LDs) are rich in triacylglycerols (TAGs), which regulate essential cellular processes, such as energy storage. Although TAG accumulation and LD expansion in adipocytes occur during obesity, how LDs dynamically package TAGs in response to excessive nutrients remains elusive. Here, we found that LD lipidomes display a remarkable increase in TAG acyl chain saturation under calorie-dense diets, turning them conducive to close-packing. Using high-resolution X-ray diffraction, solid-state NMR, and imaging, we show that beyond size expansion LDs from mice under varied obesogenic diets govern fat accumulation by packing TAGs in different crystalline polymorphs. Consistently, LDs and tissue stiffen for high-calorie-fed mice with more than a 2-fold increase in elastic moduli compared to normal diet. Our data suggest that in addition to expanding, adipocyte LDs undergo structural remodeling by close-packing rigid and highly saturated TAGs in response to caloric overload, as opposed to liquid TAGs in a low-calorie diet. This work provides insights into how lipid packing within LDs can allow for the rapid and optimal expansion of fat during the initial stages of obesity.

Effect of acupuncture on primary hypothyroidism and irregular menstruation in infertile women: a randomised controlled study

IntroductionThis study aimed to examine the impact of acupuncture and a low-caloric diet on primary hypothyroidism and irregular menstruation in infertile women.MethodsSixty infertile women participated in the trial. All women were diagnosed with hypothyroidism, polycystic ovarian syndrome (PCOS), and oligomenorrhea. They were between the ages of 20 and 35, with a BMI between 30 and 34.9 kg/m2. They were divided at random into two equal groups. For four months, a control group was given thyroxine tablets once daily with a low-calorie diet (1200 kcal/day). The study group was given the same treatment and acupuncture sessions, twice a week for four months. BMI, waist, waist-to-stature ratio (WSR), free thyroxine (FT4), thyroid-stimulating hormone (TSH), luteinising hormone (LH), follicle-stimulating hormone (FSH), LH/FSH ratio, menstrual cycle period, and a health-related quality-of-life questionnaire (PCOSQ) were evaluated for all patients.ResultsThere was a significant reduction in waist circumference, WSR, BMI, LH, LH/FSH ratio, TSH, and menstrual cycle period in both groups (<i>p</i> < 0.05) and a significant increase (<i>p</i> < 0.05) in FT4 and PCOSQ scores. Also, there was a significant increase in FSH in the study group. Compared to the control group, the study group revealed a significant reduction (<i>p</i> < 0.05) in waist circumference, WSR, LH, TSH, LH/FSH ratio, menstrual cycle period, and a significant increase in PCOSQ scores and FSH.ConclusionsAdding acupuncture to a low-caloric diet and medical treatment has an effective role in decreasing abdominal adiposity and improving the hormonal profile and menstrual cycle, which in turn improves reproductive health in infertile women with hypothyroidism.

Non-Evidence-Based Dietary Restrictions in Hospital Nutrition and Their Impact on Malnutrition: A Narrative Review of International and National Guidelines

Background: Malnutrition is a major issue in hospitals, impacting over 25% of patients. It can arise from a range of factors, such as chronic underfeeding, diseases, aging, and inappropriate nutritional care. Unnecessary fasting and the use of incorrect dietary prescriptions can also contribute to malnutrition, regardless of a patient’s underlying health conditions. Methods: A search strategy was applied to identify pertinent articles on the prescription and management of therapeutic diets in hospital settings from the last 10 years (2014–2024) using the PubMed database. The following English terms and their combinations were used: hospital diet, non-evidence-based dietary restriction, hospital food service, and therapeutic diets. Only national or international guidelines published in English were considered. Results: The narrative review was developed through the analysis of two guidelines on the prescription and management of therapeutic diets in hospital settings. The main non-evidence-based therapeutic diets that should have limited prescriptions are low-calorie, low-carbohydrate, low-protein, and low-sodium diets because they inevitably lead to a reduction in caloric and/or protein content, limit menu choices, and make recipes less palatable. The preventive total elimination of lactose without diagnostic confirmation should be avoided in the prescription of hospital therapeutic diets for lactose intolerance without symptoms and confirmation of diagnosis. Fasting after surgery should be avoided. The two guidelines differ in part in terminology and the bromatological composition of the diet. Conclusions: The heterogeneity of terminologies and bromatological composition leads to further confusion in determining the correct procedure for managing and prescribing therapeutic diets. Deepening and increasing research in the field of management and prescription of therapeutic diets is necessary to overcome the problem of hospital malnutrition, as the food provided through hospital food service is a very effective medicine for providing calories, macronutrients, and micronutrients.

Digital nudging at the university canteen: an online study with American young adults

Resource scarcity, the effects of climate change, food insecurity, and health issues related to dietary choices have prompted policymakers to develop new strategies to encourage populations to opt for healthy and sustainable (HS) diets. In this context, nudging strategies are promising tools to promote healthy and sustainable dietary behaviors. However, nudges are context-dependent as a specific nudging intervention should be employed in a specific context. This research aims at determining the effects of different nudges on students’ food choices in the context of a hypothetical online pre-ordering system of the college canteen. An experimental study was conducted in the USA with 1400 American college students (18–24 years old). We used a between-subject design with one control and three treatment groups—i.e., a HS logo to identify HS dishes, dish placement (the order in which dishes are displayed on the menu), and a combination of the two nudges. Our main results showed that the logo and logo plus placement led to a significantly increased selection of HS dishes among students who already had strong HS eating behaviors. In addition, individual characteristics (e.g., being flexitarian or vegetarian, being on a low-calorie diet, being a graduate student, and living in dormitories on college campuses) also affected their HS food choices; thus, the population traits, living conditions, and eating habits should be taken into consideration in order to establish successful nudging techniques.