Low-energy Diet Research Articles

Dietary Energy and Protein Levels During the Prelay Period on Production Performance, Egg Quality, Expression of Genes in Hypothalamus-Pituitary-Ovary Axis, and Bone Parameters in Aged Laying Hens.

Nutrition during the pre-lay period takes effect on the production performance in the laying flock. This study evaluated the effects of dietary energy and protein levels in pre-lay diet on performance during the whole laying period and the egg quality, bone quality, and mRNA expression of hypothalamus-pituitary-gonadal (HPG) axis-related genes of hens at the end of the laying cycle. A total of 1,856 15-wk old Hy-Line brown pullets were randomly assigned to one of the four dietary treatments: using a 2 × 2 factorial arrangement with 2 energy levels (2,700 and 2,800 kcal/kg ME, respectively) and 2 protein levels (15 and 16.5% CP, respectively). Pullets were fed ad libitum from 15 to 20 wk and from 20 wk onward, fed with a similar laying diet till 72 wk of age. At 72 wk, the expression of genes in the hypothalamus, pituitary, ovarian, and follicles and bone quality was evaluated. At 72wk, there were no differences in production performance, BW, organ index, and ovarian parameters among the dietary treatments. High-CP diet increased the egg shape index and eggshell thickness (p < 0.05), but the eggshell breaking strength, Haugh unit, and albumen height did not differ among the treatments. Neither dietary energy nor protein level took an effect of bone quality. Low-energy diet increased the mRNA expression of gonadotropin-releasing hormone-1 (GnRH-1) in the hypothalamus (p < 0.05). The mRNA expression level of estrogen receptor-1 (ESR-1) in the hypothalamus and ovary was elevated by the 2,700 ME-15%CP diet (p < 0.05). The expression of cytochrome family 17 subfamily A polypeptide 1 (CYP17A1) in the large white follicle (LWF), small yellow follicles (SYF) and dominant follicle (DF) was decreased by the 2,800 kcal/kg diet (p < 0.05). These results indicate that the prelay diet had no influence on the production performance but had minimal effect on the eggshell characteristics and bone parameters. These results suggest that the energy and protein level of the prelay diet changes the expression of HPG axis-related genes of hens around the end of the laying cycle without changing the circulating sex hormone profile. The effect of prelay diet on the endocrinal adjustment at the end of the laying cycle needs to be investigated further.

Performance and behavior of the progeny of ewes fed with different sources and energy feed

This study aimed to investigate the effects of increased dietary energy intake and different feeds (starch, calcium salts of palm oil, and chromium propionate) in the nutrition of ewes, at gestation and lactation, evaluating the effects on the progeny. Seventy-two Dorper x Santa Inês ewes were allocated in a completely randomized block design, in five treatments. CTL (n=14) with 100% of predicted ME requirement, LOW (n=14) with 90% of predicted ME requirement, ST (n=15) with 110% of predicted ME requirement, and the energy source was starch, ST+Cr (n=15) treatment ST more chromium propionate, and ST+PF (n=14) treatment ST more calcium salts of palm oil. The data were evaluated by the Tukey test, at 5% significance, and behavior analyses by Kruskal-Wallis at 10% significance. Energy levels influenced ewes to body weight (BW), body condition score (BCS), and Famacha® score before and after lambing and during lactation, being that the use of calcium salts of palm oil had greater benefits. Although the dam's diet did not influence the offspring's weight gain, body measurements, BCS, and Famacha® at 260 days old. ST+Cr produced heavier offspring. A lower energy diet negatively influenced the degree of Famacha® on ewes and offspring and mother-lamb behavior. This work showed that diets with 10% less metabolizable energy resulted in ewes with lower body weight and body condition scores during pregnancy and lactation, and the progeny had lower body condition weight. The type of feed affects maternal filial behavior and fetal programming.

Comparing the acceptability of total diet replacement and food-based low energy diets for type 2 diabetes remission amongst South Asians: a public and patient involvement activity

Background: With type 2 diabetes prevalence rising, low energy diets (total diet replacement and food-based low energy diets) are increasingly used to induce weight loss and achieve diabetes remission. The effectiveness of these diets has been primarily tested in the UK white population but not in the south Asian population at high risk of diabetes. Obtaining the opinion of members of the community on what would constitute a culturally acceptable diet is essential for successful interventions aiming to achieve diabetes remission in south Asians. Methods: We organised two patient and public involvement activities in the North West of England to understand views of people from the south Asian population on whether low energy diets (850 Kcal) in the form of total diet replacement or food-based meals, are acceptable dietary interventions to achieve type 2 diabetes remission. Results: Thirteen people, with either type 2 diabetes or having someone with diabetes in the family attended a virtual or a face-to-face meeting. Low energy total diet replacement in the form of soups and shakes was considered unacceptable, while there was a preference for a culturally tailored low energy food-based diet. Ready-made portion controlled catered meals were suggested as a likely approach to improve adherence. Conclusions: This work provided valuable insights to shape a future study looking at the feasibility of a catered meal low-energy dietary intervention to induce T2D remission in primary care within the south Asian population.

Effect of Exogenous Enzymes Cocktail on Performance, Carcass Traits, Biochemical Metabolites, Intestinal Morphology, and Nutrient Digestibility of Broilers Fed Normal and Low-Energy Corn-Soybean Diets.

Simple SummaryCorn and soybean meal (SBM) are the principal sources of energy and protein in poultry feed, respectively. Decreasing feed cost per unit of production and increasing the nutritional value of feed ingredients like corn and SBM are continuous concerns for poultry producers. Corn and SBM-based diets are incompletely digested by poultry due to the presence of non-starch polysaccharides (NSPs), which can obstruct the processes of nutrient digestion and absorption. Poultry does not own endogenous enzymes capable of digesting NSPs. The use of enzyme cocktails (EC) and dietary energy sources are essential topics in the poultry industry because they could enhance nutrient utilization by reducing the harmful effects of NSPs. Therefore, evaluating the efficacy of EC that may improve the feeding value of corn–SBM diets warrants attention. The efficacy of two doses of an EC with multiple enzymatic activities at two levels of dietary metabolizable energy (ME) on the performance of broilers fed corn and SBM-based diets up to 35 days was evaluated. Our results indicate that adequately adjusting dietary ME and using the EC with xylanases, β-glucanases, cellulases, proteases, pectinases, and debranching enzymes activities could enhance the nitrogen-corrected apparent ME of corn and SBMbased diets for broiler chickens and potentially offer economic advantages to producers.Ross 308 broilers in a randomized complete block design with a 2 × 2 factorial treatment arrangement (four treatments with 12 replications of six chicks each) were fed corn and SBMbased diets with two concentrations of metabolizable energy (ME) (normal (positive control, PC) and low (negative control, NC)) and two amounts of enzyme cocktail (EC) (0% and 0.005%) for 35 days. Performance, carcass traits, serum metabolites, ileal histology, and apparent nutrient digestibility were evaluated. Compared with the non-supplemented diet, the use of EC improved feed conversion ratio (FCR) over 26–35 and 0–35 days (p < 0.01), European performance efficiency factor (EPEF) over 26–35 days (p < 0.05), dressing yield (p < 0.01), villus height (p < 0.05), nitrogen-corrected apparent ME (AMEn) (p < 0.01), and serum glucose (p < 0.05). Compared with the NC diet, feeding the PC diet improved FCR over all experimental periods (p < 0.01, p < 0.05, p < 0.05, and p < 0.01, respectively), EPEF over 0–10 days (p < 0.05), and AMEn retention (p < 0.01). To conclude, the AMEn of broilers fed corn and SBM diets could be improved by adequately adjusting dietary ME and using a cocktail of non-starch polysaccharide-degrading enzymes, improving commercial benefits to producers.

Exogenous emulsifiers and multi-enzyme combination improves growth performance of the young broiler chickens fed low energy diets containing vegetable oil

ObjectiveThe present study examined the effects of exogenous emulsifiers and multi-enzyme supplementation into a low energy density diet on growth performance, visceral organ parameters, blood metabolites, ileal morphology, and nutrient digestibility in broiler chickens from hatch to 21 days.MethodsOne hundred and sixty-eight one-day-old Ross 308 broiler chickens were allocated in a completely randomized design to 24 pens and each pen was assigned to one of four dietary treatments to give six replications with seven chickens in a cage. Dietary treatments were: i) positive control with standard energy level (PC); ii) negative control with 100 kcal/kg lower energy of the standard level (NC); iii) NC diet supplemented 0.05% calcium stearoyl-2 lactylate as an emulsifier (NC+E); and iv) NC diet supplemented with both 0.05% calcium stearoyl-2 lactylate and 0.05% multi-enzyme (NC+E+M). Corn and soybean meal-based control diets containing vegetable oil were formulated to meet the Ross 308 nutrition specification. Chickens were fed ad-libitum with the treatment diets and sampling was conducted on day 21.ResultsOur results revealed that emulsifier and multi-enzyme supplementation into NC diets improved (p<0.05) feed efficiency of the broiler chickens compared to the broiler chickens fed NC diets from hatch to 21 days. Supplementation of emulsifier and multi-enzyme into NC diet improved (p<0.05) nutrient digestibility of the broiler chickens. However, emulsifier and multi-enzymesupplementation into diet did not influence (p>0.05) visceral organ weight, blood metabolites, and intestinal morphology in broiler chickens fed NC diets.ConclusionSupplementation of emulsifier and multi-enzyme in the NC diet would support improving growth performance in young broiler chickens with improved feed efficiency and increased nutrient digestibility thereby curtailing the negative impact of energy reduction in the diets.

105 The Impact of Lowering Floor Space Allowance and Dietary Energy Level on Finishing Pigs, from 65 Kg to Market, on Growth Performance

Abstract The objective of this experiment was to evaluate the impact of reducing floor space allowance in finishing hogs with a starting body weight (BW) of 65 ± 2 kg when fed high versus low energy diets on growth performance. Mixed-sex pens (n=88) with 24 ± 1 pigs per pen were blocked by starting BW to a randomized complete block design with eight treatments. These eight treatments formed a 2 x 4 factorial arrangement with 2 energy levels: low (LE, 3270 ±19 kcal/kg ME) vs. high (HE, 3392 ±19 kcal/kg ME) accomplished through fat inclusion; and 4 floor space allowances: 0.60, 0.63, 0.65, 0.67 m2 per pig. Assigned floor space was adjusted by moveable gates in the rear of the pen, which were corrected at each pig removal until the marketing phase. Pen weight and feed disappearance were measured for 2 phases at d 0, 29, and 48 to calculate average daily gain (ADG), average daily feed intake (ADFI), and gain to feed ratio (GF). Data were analyzed by pen (SAS 9.4, Cary, NC) with the repeated measure of phase, and the fixed effects of floor space allowance, dietary energy, and the interaction between. For the overall trial, decreased floor space had no effect (P &amp;gt; 0.1) on ADG, ADFI, or GF (0.36, for all). Energy had a significant effect (P &amp;lt; 0.01) on ADFI (3.17 vs 3.12 kg for LE and HE, respectively) and GF (0.35 and 0.36 for LE and HE, respectively), and tended to impact ADG (1.12 vs 1.13 kg, for LE and HE, respectively; P = 0.08). In conclusion, lowering floor space allowance from 0.67 m2 down to 0.60 m2 did not affect the growth performance of pigs starting at 65 kg. Pigs fed HE diets had 2.86% better GF compared with pigs fed LE diets, however had similar growth and body weight.

How to manage weight loss in women with obesity and PCOS seeking fertility?

Obesity exacerbates the phenotype of polycystic ovarian syndrome (PCOS) including infertility as well as reducing the efficacy and access to fertility treatments. Weight management is, therefore, a key component of treatment for women with PCOS and coexistent obesity. Many women with PCOS describe significant difficulty losing weight and treatment options are limited. The first‐line treatment is lifestyle interventions though the weight loss and any impact on fertility are limited. No one dietary strategy can be preferentially recommended based on current evidence. While very low energy diets can result in significant weight loss the evidence for impact on fertility is limited. Pharmacotherapy, including a range of treatments can result in marked weight loss and there is some evidence of improved rates of conception including spontaneous and in response to assisted reproduction treatment. As with pharmacotherapy, data regarding bariatric surgery is largely from nonrandomized studies and though the significant weight loss is anticipated to improve fertility the available data prevents firm conclusions. Clinicians and patients must consider the magnitude of weight loss to be targeted as well as the anticipated fertility treatment required and the timeline of treatment when deciding upon the personalized weight loss strategy. Clinicians and patients should be confident in targeting the most appropriate treatment early in the patient's management to avoid unnecessary delays.

Comparing effects of obesity treatment with very low energy diet and bariatric surgery after 2 years: a prospective cohort study

ObjectivesTo compare long-term effects and complications of medical treatment (MT) of obesity including very low energy diet with bariatric surgery.Design and settingThis prospective study conducted in a clinical setting recruited...

Effect of prepartum dietary energy density on beef cow energy metabolites, and birth weight and antioxidative capabilities of neonatal calves

The objective of this study was to investigate the effect of prepartum diets that differ in energy density on beef cow energy metabolites and birth weight, immunity and antioxidative capabilities of neonatal calves. On d 0 (approximately 45 d before calving), 90 multiparous Angus cows (BW = 510 ± 16 kg) were randomly allocated into 1 of 9 drylot pens (10 cows/pen). Each pen was randomly assigned to a treatment condition (three pens/treatment), the cows in each treatment were assigned randomly to receive a high-energy (HE) density diet (NEm = 1.67 Mcal/kg of DM), medium-energy (ME) density diet (NEm = 1.53 Mcal/kg of DM), or low-energy (LE) density diet (NEm = 1.36 Mcal/kg of DM). Blood samples were collected − 45, − 21, − 14, and − 7 d from calving, and plasma concentrations of cortisol, glucose, total protein, β-hydroxybutyrate (BHBA), and nonesterified fatty acids (NEFAs) were measured. After calving, the birth weights, body height, body length, thoracic girth and umbilical girth of the calves in each group were recorded, and blood samples were collected for analysis of IgG, IL-2, IL-4, IL-6, total antioxidant capacity, superoxide dismutase, glutathione peroxidase, and maleic dialdehyde levels. The amounts of feed offered and orts were recorded for individual cows 4 d/wk. The results indicated that although dry matter intake (DMI) levels did not differ among the LE, ME, and or HE groups before parturition, the group that received the HE diet had higher plasma glucose concentrations and lower prepartum blood NEFA concentrations than the other groups. Birth weight, body height, thoracic girth, and levels of IL-2, cortisol, total antioxidant capacity, and superoxide dismutase were increased in calves of the HE group compared with those of the LE group. The plasma IL-4 and serum IgG concentrations tended to be decreased in the ME group compared with the HE group, and the ME group had lower maleic dialdehyde concentrations; maleic dialdehyde levels were significantly increased in the LE group compared with the HE group. Overall, these results indicate that feeding of a low-energy diet during the last 45 d before parturition has negative effects on the growth, immunity, and antioxidative capabilities of neonatal calves. Increasing maternal energy density during late gestation may be useful to improve the energy status of cows.

Impact of starting BMI and degree of weight loss on changes in appetite-regulating hormones during diet-induced weight loss.

ObjectiveThe aim of this study was to determine whether the hormone changes following weight loss are proportional to the degree of weight loss and to starting BMI.MethodsA very low‐energy diet was used to achieve 15% weight loss. Fasting and postprandial gut hormones and leptin were measured during a meal test at baseline and at 5% (1%), 10% (2%), and 15% (2.5%) weight loss. Linear mixed‐effects models were used to analyze hormone changes.ResultsFrom baseline to 5% weight loss, decreases were seen in fasting concentrations of leptin (−8.25 ng/mL; p < 0.001), amylin (−21.3 pg/mL; p < 0.001), and glucagon‐like peptide 1 (−59.55 pg/mL; p < 0.001). There was a small further reduction in leptin between 5% and 15% weight loss (−1.88 ng/mL; p = 0.019) but not in glucagon‐like peptide 1 and amylin. Fasting ghrelin showed a significant increase at 10% weight loss (41.64 pg/mL; p = 0.002), with a nonsignificant increase from 10% to 15% loss (26.03 pg/mL; p = 0.065). Postprandial changes in hormone levels were variable. There was no correlation between baseline weight and the degree of hormone changes.ConclusionsThe majority of changes in fasting gut hormones and leptin occurred in early weight loss, with minor further changes up to 15% weight loss. Starting weight did not affect the degree of hormone change.

The impact of lifestyle intervention on left atrial function in type 2 diabetes: results from the DIASTOLIC study

Aerobic exercise training and low energy diets have been shown to improve left ventricular remodelling and diastolic function in adults with type 2 diabetes (T2D), albeit with differential effects. The impact of these lifestyle interventions on left atrial (LA) function, however, has not previously been reported. The DIASTOLIC study was a prospective, randomised, open-label, blind endpoint trial, in which 90 people with obesity and T2D and no prevalent cardiovascular disease were randomised to a 12-week intervention of: (i) routine care, (ii) aerobic exercise training, or (iii) low energy (≈ 810 kcal/day) meal replacement plan (MRP). Cardiac magnetic resonance (CMR) imaging was performed pre- and post-intervention. Image analysis included LA volumes (LAV), emptying fraction (LAEF), and LA strain (LAS) corresponding to LA reservoir (LAS-r), conduit (LAS-cd), and booster pump (LAS-bp) function. 73 participants with T2D (mean age 50 ± 6 years, 62% male, body mass index (BMI) 36.1 ± 5.3 kg/m2) completed the trial and had analysable LA images. There was no significant change in CMR measured LA volumetric function (LAV/LAEF) in any group. The routine care group showed no significant change in BMI or LAS. In the MRP group, there were significant reductions in BMI (4.5 kg/m2) and a significant increase in LAS-r and LAS-bp (29.9 ± 7.0 to 32.3 ± 7.0%, p = 0.036 and 14.6 ± 5.3 to 17.2 ± 3.7%, p = 0.034). The exercise group showed a small reduction in BMI (0.49 kg/m2), with no significant change in LAS. Compared to routine care, weight loss via a 12-week MRP, led to improvements in LA filling and contractile function in adults with T2D and obesity. However, these within-group changes were not statistically significant on between-group comparison.ClinicalTrials.gov Identifier: NCT02590822.

Early Relationships of a Low-Energy Diet With Symptoms of Fibromyalgia.

ObjectivePrevious studies have demonstrated that weight loss has been shown to improve pain in weight‐bearing joints, and more recent studies suggest that weight loss may be accompanied by improvements in pain in non–weight‐bearing regions. In previous work, we demonstrated that these symptoms improve substantially in patients with obesity undergoing 12 weeks of a very low‐energy diet (VLED) restricted to 800 kcal as part of a weight‐loss program. Preclinical models also have shown analgesic effects of calorie restriction. The purpose of the current observational study was to determine the time course and trajectory of improvement in pain and other symptoms, especially during the early phase of a VLED intervention, prior to major weight loss.MethodsParticipants were 195 individuals with obesity who had elevated levels of pain and associated symptoms at baseline (score of ≥4 on Fibromyalgia Survey Criteria) and completed a minimum of 3 weeks of a VLED intervention. The primary outcome was improvement in Fibromyalgia Survey Criteria at week 3. In secondary analyses, we created groups of those showing little/no improvement, moderate improvement, and high improvement (little/no improvement mean, 2.21; SD, 1.02; moderate improvement mean, 2.25; SD, 0.81; high improvement mean, 2.42; SD, 0.95; F2,189 = 1.01, P = 0.37), then compared baseline characteristics.ResultsA large proportion of study participants (72%) experienced symptom reductions of 30% or greater by week 3, but there were no differences in the amount of weight lost at this time point. Those who showed little or no improvement (less than 30%) had a higher body mass index at baseline and were more likely to report a diagnosis of depression (both P < 0.05).ConclusionThis degree of improvement after 3 weeks of a VLED is encouraging. These findings help establish the temporal pattern of symptom improvement associated with caloric restriction and suggest that the palliative effects of this diet are at least partly due to the diet itself, rather than the weight loss that ensues.

"Dietitians May Only Have One Chance"-The Realities of Treating Obesity in Private Practice in Australia.

Introduction: Overweight and obesity are the leading contributors to non-fatal burden of disease in Australia. Very low energy diets (VLEDs) comprising of meal replacement products (MRP) effectively induce substantial weight loss in people with obesity, yet they are rarely used as a first line treatment. Dietitians in private practice are perfectly placed to administer treatments for obesity; however, little is known about the preferred interventions used or their attitudes to incorporating VLEDs and MRPs into their treatments for overweight and obesity. Methods: This study used descriptive qualitative methods to explore accredited practicing dietitians’ (APDs’) perspectives and practices regarding obesity and obesity interventions, including the use of VLEDs and MRPs. Qualitative in-depth semi-structured interviews were conducted with 20 dietitians who had experience in private practice and in treating obesity. Transcribed interviews were analysed thematically using the technique of template analysis. Results: In the context within which dietitians’ practice was found to be a barrier to using evidence-based practice (EBP) for obesity treatment, four overarching themes were found. These were: (1) patient-centred care is the dietitians’ preferred intervention model; (2) VLEDs promote weight loss in specific situations; (3) systemic barriers constrain effective dietetic practice and equitable access to all, and (4) successful outcomes are predicated on working outside of systemic barriers. Conclusion: Dietitians in private practice are well placed and able to provide life-enhancing and evidence-based treatments for overweight and obesity and associated chronic disease in the community. However, systemic barriers need to be addressed to provide equitable access to effective care irrespective of socio-economic status.

Translating Evidence into Practice: A Case Study of Extended Use of a Very Low Energy Diet for Treatment of Co-Morbid Obesity and Chronic Disease

We report the case of a 30-year-old male with significant obesity (body mass index 47 kg/m2) with co-existing moderate obstructive sleep apnoea, hypertension, hypercholesteremia and hypogonadotropic hypogonadism, who was treated with a very-low-energy diet (VLED) and lifestyle modification programme for 12 months. The patient lost weight throughout the entire treatment period (average weight loss was 2.1 kg/week, for a total of 42.7 kg), and showed marked improvement in co-morbidities and no adverse effects. This case demonstrates that prolonged (5-month) use of a VLED, under close medical supervision, is safe and effective in certain patients with obesity.

Comparing the acceptability of total diet replacement and food-based low energy diets for type 2 diabetes remission amongst South Asians: a public and patient involvement activity

Background: With type 2 diabetes prevalence rising, low energy diets (total diet replacement and food-based low energy diets) are increasingly used to induce weight loss and achieve diabetes remission. The effectiveness of these diets has been primarily tested in the UK white population but not in the south Asian population at high risk of diabetes. Obtaining the opinion of members of the community on what would constitute a culturally acceptable diet is essential for successful interventions aiming to achieve diabetes remission in south Asians. Methods: We organised two patient and public involvement activities in the North West of England to understand views of people from the south Asian population on whether low energy diets (850 Kcal) in the form of total diet replacement or food-based meals, are acceptable dietary interventions to achieve type 2 diabetes remission. Results: Thirteen people, with either type 2 diabetes or having someone with diabetes in the family attended a virtual or a face-to-face meeting. Low energy total diet replacement in the form of soups and shakes was considered unacceptable, while there was a preference for a culturally tailored low energy food-based diet. Ready-made portion controlled catered meals were suggested as a likely approach to improve adherence. Conclusions: This work provided valuable insights to shape a future study looking at the feasibility of a catered meal low-energy dietary intervention to induce T2D remission in primary care within the south Asian population.

Restricted dietary pattern may contribute to lowering blood pressure in adolescents with obesity: Study of Cardiovascular Risk in Adolescents.

Dieting is one of the main target factors for interventions that seek to control and prevent rising blood pressure. This study identified dietary patterns and analyzed their association with adolescents' blood pressure. This is a cross-sectional study with a probabilistic and nationally representative sample of adolescents aged 12-17 years, who participated in the Study of Cardiovascular Risk in Adolescents (ERICA), carried out in 2013-2014 with Brazilian adolescents (N = 36 956). Food consumption was assessed by 24 h recall. Dietary patterns were identified using the Reduced Rank Regression method, and considering waist circumference, fasting insulin, and dietary polyunsaturated fat/saturated fat ratio as intermediate variables. Multiple linear regression models stratified by weight were developed; SBP and DBP were the dependent variables, and dietary pattern scores were the independent ones, with adjustment for potential confounding factors. The following patterns were identified: 'Brazilian common', 'Restricted' and 'Added sugar'. The 'Restricted' pattern, which included diet/light foods, chicken and chicken-based dishes, leafy greens, vegetables and spices, red meats and dishes based on red meats and tubers, was inversely associated with SBP (β = -1.55; 95% CI = -2.26 to -0.83) and DBP (β = -1.19; 95% CI = -1.70 to -0.68) in adolescents with obesity. In adolescents with obesity, a low-energy density diet was associated with reduced blood pressure. These findings are consistent with international recommendations for preventing elevated blood pressure.

Animal-based food choice and associations with long-term weight maintenance and metabolic health after a large and rapid weight loss: The PREVIEW study

Low-energy diet replacement is an effective tool to induce large and rapid weight loss and improve metabolic health, but in the long-term individuals often experience significant weight regain. Little is known about the role of animal-based foods in weight maintenance and metabolic health. We aimed to examine longitudinal associations of animal-based foods with weight maintenance and glycaemic and cardiometabolic risk factors. We also modelled replacement of processed meat with other high-protein foods. In this secondary analysis, longitudinal data were analysed from 688 adults (26-70 years) with overweight and prediabetes after 8-week low-energy diet-induced weight loss (≥8% of initial body weight) in a 3-year, multi-centre, diabetes prevention study (PREVIEW). Animal-based food consumption, including unprocessed red meat, processed red meat, poultry, dairy products, fish and seafood, and eggs, was repeatedly assessed using 4-day food records. Multi-adjusted linear mixed models and isoenergetic substitution models were used to examine the potential associations. The available-case analysis showed that each 10-g increment in processed meat, but not total meat, unprocessed red meat, poultry, dairy products, or eggs, was positively associated with weight regain (0.17kg⋅year-1, 95% CI 0.10, 0.25, P<0.001) and increments in waist circumference, HbA1c, and triacylglycerols. The associations of processed meat with HbA1c or triacylglycerols disappeared when adjusted for weight change. Fish and seafood consumption was inversely associated with triacylglycerols and triacylglycerol-glucose index, independent of weight change. Modelled replacement of processed meat with isoenergetic (250-300kJ·day-1 or 60-72kcal·day-1) dairy, poultry, fish and seafood, grains, or nuts was associated with-0.59 (95% CI -0.77,-0.41),-0.66 (95% CI -0.93,-0.40),-0.58 (95% CI -0.88,-0.27), and-0.69 (95% CI -0.96,-0.41) kg·year-1 of weight regain, respectively (all P<0.001) and significant improvements in HbA1c, and triacylglycerols. Higher intake of processed meat, but not total or unprocessed red meat, poultry, dairy products, or eggs may be associated with greater weight regain and more adverse glycaemic and cardiometabolic risk factors. Replacing processed meat with a wide variety of high-protein foods, including unprocessed red meat, poultry, dairy products, fish, eggs, grains, and nuts, could improve weight maintenance and metabolic health after rapid weight loss. This study was registered as ClinicalTrials.gov, NCT01777893.

Does a Higher Protein Diet Promote Satiety and Weight Loss Independent of Carbohydrate Content? An 8-Week Low-Energy Diet (LED) Intervention.

Both higher protein (HP) and lower carbohydrate (LC) diets may promote satiety and enhance body weight (BW) loss. This study investigated whether HP can promote these outcomes independent of carbohydrate (CHO) content. 121 women with obesity (BW: 95.1 ± 13.0 kg, BMI: 35.4 ± 3.9 kg/m2) were randomised to either HP (1.2 g/kg BW) or normal protein (NP, 0.8 g/kg BW) diets, in combination with either LC (28 en%) or normal CHO (NC, 40 en%) diets. A low-energy diet partial diet replacement (LEDpdr) regime was used for 8 weeks, where participants consumed fixed-energy meal replacements plus one ad libitum meal daily. Four-day dietary records showed that daily energy intake (EI) was similar between groups (p = 0.744), but the difference in protein and CHO between groups was lower than expected. Following multiple imputation (completion rate 77%), decrease in mean BW, fat mass (FM) and fat-free mass (FFM) at Week 8 in all was 7.5 ± 0.7 kg (p < 0.001), 5.7 ± 0.5 kg (p < 0.001), and 1.4 ± 0.7 kg (p = 0.054) respectively, but with no significant difference between diet groups. LC (CHO×Week, p < 0.05), but not HP, significantly promoted postprandial satiety during a preload challenge. Improvements in blood biomarkers were unrelated to LEDpdr macronutrient composition. In conclusion, HP did not promote satiety and BW loss compared to NP LEDpdr, irrespective of CHO content.

UK dietitians' attitudes and experiences of formula very low- and low-energy diets in clinical practice.

SummaryDespite evidence that formula very low‐energy diets (VLED) and low‐energy diets (LED) are both effective and safe as treatments for obesity and type 2 diabetes, these diets remain underutilized in the United Kingdom. The aim of this study was to explore UK dietitians' attitudes and experiences of using formula VLED and LED. A cross‐sectional survey was disseminated between September 2019 and April 2020 through websites, social media platforms and dietetic networks using snowball sampling. In total, 241 dietitians responded to the online survey with 152 participants included in the final analysis (female [94.1%], mean age 40.8 years [SD 9.5]; median 12 years [interquartile range 8, 22] within dietetic practice). One hundred and nine (71.7%) participants reported currently using VLED/LED in clinical practice and 43 (28.3%) did not. Those with lower motivation and confidence in implementing VLED/LED in clinical practice were less likely to use them. Cost and adherence were the two highest reported barriers to use. Dietitians perceived VLED/LED were effective, but concerns remained about long‐term effectiveness, particularly for some patient groups. Dietitians also reported that further education, funding and service infrastructure, including access to clinic space and administrative support, were required to help embed VLED/LED into routine clinical practice. With clinical services now regularly offering VLED/LED programmes in the United Kingdom, dietitians are ideally placed to provide long‐term support. However, understanding, reporting and addressing the potential barriers (funding/infrastructure and education) appear to be key requirements in increasing the delivery of VLED/LED programmes nationally.

Effect of multi-enzymes supplementation on growth performance, meat quality, ileal digestibility, digestive enzyme activity and caecal microbiota in broilers fed low-metabolizable energy diet

ObjectiveThis study was conducted to evaluate the effect of using low energy diet with multi-enzymes supplementation on different biological parameters in broilers.MethodsThree hundred Arbor Acres broiler chicks were randomly divided into three groups (Cont, standard metabolizable energy(ME); L-ME, ME reduced by 50 kcal/kg without enzyme; and L-ME-MES, L-ME diet was supplemented with multi-enzymes) with five replicates per group (20 chicks per replicate) at the start of second week. Grower and finisher diets were formulated according to breed specific guide and offered with free access in respective phase (two weeks for grower [8 to 21 d]; two weeks for finisher [22 to 35 d]). External marker method was used to measure the nutrient digestibility. After feeding trial, fifteen birds (one bird per replicate) were selected randomly and slaughtered for samples collection.ResultsThe results exhibited no effect (p>0.05) of dietary treatments on all parameters of growth performance, carcass traits, relative weight of internal organs except bursa and overall parameters of thigh meat quality. Relative weight of bursa was significantly (p<0.05) higher in L-ME than control. Multi-enzymes supplementation in low-ME diet significantly (p<0.05) improved the breast meat pH 24 h, digestibility of crude protein, duodenum weight and length, jejunal morphology, counts of Lactobacillus spp. and Bifidobacterium spp., lipase and protease activities than control. Jejunum length was increased in both L-ME and L-ME-MES treatments than that of the control (p<0.05). Breast meat cooking loss and color lightness was lower in L-ME (p<0.05) than control.ConclusionIt can therefore be concluded that broilers could be reared on low energy diet with supplementation of multi-enzymes without compromising the growth performance. In addition, it is beneficial for other biological parameters of broilers.