Total Meal Research Articles

Malnutrition Diagnosis and Food Consumption in Subacute Post-Stroke Patients During Rehabilitation.

Stroke survivors frequently encounter malnutrition, adversely impacting clinical outcomes. Nevertheless, malnutrition and food consumption in post-stroke patients have not been frequently assessed, and their correlation with rehabilitation outcomes remains inadequately explored. The objective of this observational study was to evaluate malnutrition at admission in these patients, assess food consumption during a six-week rehabilitation program, and analyze their correlation with rehabilitation outcomes. Subacute post-stroke patients were evaluated at admission (T0) and after a six-week rehabilitation treatment (T1). At T0, we assessed clinical and demographic characteristics, and we diagnosed malnutrition according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Weight, BMI, hematochemical parameters, and activities of daily living with the modified Barthel Index (mBI) were evaluated at both T0 and T1; recovery was registered as a change in the mBI (ΔmBI = mBIT1 - mBIT0). Patients' food consumption was recorded through visual plate waste estimation of three meals a day, 5 days a week, for six weeks of hospitalization for rehabilitation. A total of 109 patients completed the study (51 women, mean age 69 ± 11). According to the GLIM criteria, 105 of these patients were at risk of malnutrition, while 43 were malnourished, with 15 severely malnourished. Malnourished patients wasted more food, with respect to non-malnourished patients, as measured by visual plate waste of total meals (25 ± 17% vs. 15 ± 14%; p = 0.001) and reached a lower ΔmBI. A linear regression analysis found a significant correlation between the ΔmBI, the waste of a "second dish", which contained mainly protein, and serum albumin at admission, even after controlling for age. Malnutrition assessed with the GLIM criteria at admission and food consumption are two important nutritional parameters to evaluate in post-stroke patients hospitalized for rehabilitation due to their association with recovery.

A primary care-led weight management intervention for adults with diabetes and obesity: qualitative results from a randomised controlled trial of total meal replacement (DiRECT)

The UK Diabetes Remission Clinical Trial (DiRECT) demonstrated that a weight loss strategy consisting of: (1) 12 weeks total diet replacement; (2) 4 to 6 weeks food reintroduction; and (3) a longer period of weight loss maintenance, is effective in reducing body weight, improving glycaemic control, and facilitating type 2 diabetes remission(1). The DiRECT protocol is now funded for type 2 diabetes management in the UK(2). Type 2 diabetes is a growing problem in Aotearoa New Zealand(3), but the acceptability and feasibility of the DiRECT intervention in our diverse sociocultural context remains unclear. We conducted a randomised controlled trial of DiRECT within a Māori primary healthcare provider in O¯tepoti Dunedin. Forty participants with diabetes and obesity who wanted to lose weight were randomised to receive the DiRECT intervention or usual care. Both groups received the same level of individualised support from an in-house dietitian. We conducted individual, semi-structured interviews with 26 participants after 3 months. Questions explored perspectives and experiences, barriers and facilitators, and future expectations regarding dietary habits and weight loss. Interview transcripts were analysed using inductive thematic analysis(4). Participants struggled with weight management prior to the study. Advice from doctors, friends and whānau, and the internet was prolific, yet often impractical or unclear. The DiRECT intervention was mentally and physically challenging, but rapid weight loss and an improved sense of health and wellbeing enhanced motivation. Participants identified strategies which supported adaptation and adherence. Food reintroduction beyond 3 months was an exciting milestone, but the risk of reverting to previous habits was daunting. Participants feared weight regain and felt ongoing guidance was required for a successful transition to a real-food diet. Conversely, usual care participants described a gradual and ongoing process of health-focused dietary modification. While this approach did support behaviour change, a perceived slow rate of weight loss was often frustrating. Across both interventions, self-motivation and whānau support contributed to perceived success, whereas busy lifestyles, social and cultural norms, and financial concerns presented additional challenges. The role of individualised and non-judgemental dietetic support was a central theme across both groups. In addition to nutrition education and practical guidance, the in-house dietitian offered encouragement and promoted self-acceptance among participants. At 3 months, positive shifts in perspectives surrounding food, health, and sense of self were identified, which participants largely attributed to the level of nutrition support received: a new experience for many. The DiRECT protocol appears an acceptable weight loss approach among New Zealanders with diabetes and obesity, but tailored dietetic and behavioural support must be prioritised in its implementation. Future research should examine the broader health benefits associated with providing greater dietetic support and the cost-effectiveness of employing nutrition-trained health professionals within the primary care workforce.

A primary care-led weight management intervention for adults with diabetes and obesity: quantitative results from a randomised controlled trial of total meal replacement (DiRECT)

Methods to reduce obesity and type 2 diabetes in Aotearoa New Zealand are desperately needed, with obesity one of the greatest predisposing factors for type 2 diabetes as well as heart disease, and certain cancers.1 A recent New Zealand report2 identified several interventions that might benefit people with established diabetes, the most promising being a period of rapid weight loss, followed by supported weight-loss maintenance. Such weight loss has shown to achieve what was previously thought impossible, diabetes remission,3 as well as appreciably reduce the risk of cardiovascular disease and prevent diabetes-related chronic kidney disease, retinopathy, nephropathy, and lower limb amputation.2 While the findings from the studies of low energy total meal replacement diets have stimulated great interest, their use in Aotearoa New Zealand has not been considered. The purpose of this primary-care led intervention therefore was to consider the acceptability and efficacy of such a weight loss programme, DiRECT, in Aotearoa New Zealand. Te Kāika DiRECT is a 12-month study conducted within a Māori primary healthcare provider in O¯tepoti Dunedin. The DiRECT protocol is three months of total meal replacement for rapid weight loss followed by food reintroduction and a longer period of supported weight loss maintenance. Participants were adults with prediabetes or T2 diabetes and obesity wanting to lose weight. Twenty participants (70% female, age 46 (SD 10), BMI 41 (9), HbA1c 51 (11)) were randomised to receive the DiRECT protocol, twenty more (70% female, age 50 (SD 8), BMI 40 (7), HbA1c 54 (14)) were randomised to receive best practice weight loss support (usual care). All participants had the same number of visits with the in-house Dietitian and free access to the onsite gym. Participants in the control group also received regular grocery vouchers to purchase the foods encouraged by healthy eating guidelines. Recruitment began in February, 2022. After the initial three month study period, DiRECT participants reported consuming 3.0MJ (95% CI 1.2 to 4.8MJ) less energy per day than those in usual care. Mean weight loss was 6kg (2.3-9.6kg) greater for DiRECT participants than usual care participants, while medication use and systolic blood pressure (12mmHg (0-24mmHg)) were lower. Continuous glucose monitoring identified that at baseline, participants on average only spent 10% of the day with a blood glucose reading under 8mmol/L (normoglycaemia). After three months, the usual care group spent on average 48% of the day within the normoglycaemic range, while DiRECT participants spent 78% of the day within the normoglycaemic range. Results at 12 months will enable comment on longer term markers of blood glucose control (HbA1c) and diabetes remission rates, as well as indicate if the body weight, medication, and blood pressure improvements observed at three months are sustained.

A Multiobjective Diet Planning Model for Diabetic Patients in the Moroccan Health Context Using Particle Swarm Intelligence

Recommended diets have a central role to play in creating a healthy dietary environment that enables populations to adopt and maintain health-promoting dietary practices. It’s well known that foods with a low glycemic load (GL) help release a concentration of glucose in the blood, These can contribute to the prevention of various glycemia-elated health problems. We aim to address an optimization model for diets in the Moroccan context that controls both glycemic load and total meal costs. The application of a multiple objective particle swarm method which aggregates the problem’s restrictions with optimized objectives functions helps maintain dietary diversity and facilitates the search for trade-offs between objectives and problem-specific requirements.

Weight regain after total meal replacement very low-calorie diet program with and with-out anti-obesity medications.

Very low-calorie diets (VLCDs) employing total meal replacement (TMR) offer substantial short-term weight loss. Concurrently, anti-obesity medications (AOMs) have shown promise as adjunctive treatments when combined with VLCDs. This study aimed to investigate the impact of adjuvant AOMs on weight loss and weight regain within a comprehensive lifestyle program. This is a retrospective study of patients with obesity enrolled in VLCD/TMR programs, specifically the OPTIFAST program. Data from 206 patients (68% women, mean age 52.39±13.05years, BMI 41.71±7.04kg/m2) were analyzed. Of these, 139 received no AOM (AOM-), while 67 received AOMs (AOM+). Total body weight loss percentages (TWL%) at 6 and 18months were -17.87%±7.02 and -12.10%±11.56, respectively. There was no significant difference in 6-month weight loss between theAOM groups. However, the AOM+group exhibited lower weight regain (3.29kg±10.19 vs. 7.61kg±11.96; p=0.006) and weight regain percentage (WR%) (31.5%±68.7 vs. 52.16%±64.4; p=0.04) compared with the AOM- group. The findings highlighted the potential of AOMs and VLCD/TMR as effective strategies for long-term weight management in individuals with obesity.

S1633 Weight Regain After Total Meal Replacement Very Low-Calorie Diet Program With and Without Anti-obesity Medications

S1633 Weight Regain After Total Meal Replacement Very Low-Calorie Diet Program With and Without Anti-obesity Medications

Assessing rural household’s food groups-and-sources and dietary diversity pattern in Malaita Province

Access to and availability of various food sources is not an issue in rural communities. However, there is no guarantee that households are not affected by nutritional inadequacy, which is still a problem in most underdeveloped nations. A mixed-methods study was conducted to determine the HDDS through the snowballing method for the last 12 months’ food groups-and-sources and the 48-h diet recall. Ninety-eight households in two rural communities surrounding Sikwafta (zone one) and Malu’u (zone two) participated in the interview between April and May 2019. The results were then analyzed through SPSS and QDA MINER. The aim is to analyze the household dietary patterns of the communities between the two zones. The study also hypothesizes that the dietary pattern of households has not changed. Results showed that a total of nine food groups were consumed: grain, white roots, tubers, plantains, oils/fats (95.90%), condiments (83.70%), and meat/poultry/sea foods (77.60%). The majority of the food consumed comes from the gardens, followed by other food sources, which make up the average HDDS of five. A correlation analysis found a statistically significant relationship between HDDS and total meal (0.504*), with no relationships between demographics. When comparing 48-h food sources-and-groups to the previous year, there was little to no difference in accessibility and availability. This implies that the majority of households are likely to achieve their nutritional needs within the parameters of their dietary trend. Even though households have adequate access to food, there is a significant need to improve their nutritional needs, even if they consume the average amount of the required food groups.

Specific Blood Plasma Circulating miRs Are Associated with the Physiological Impact of Total Fish Meal Replacement with Soybean Meal in Diets for Rainbow Trout (Oncorhynchus mykiss).

High dietary SBM content is known to induce important physiological alterations, hampering its use as a major FM alternative. Rainbow trout (Oncorhynchus mykiss) juveniles were fed two experimental diets during 9 weeks: (i) a FM diet containing 12% FM; and (ii) a vegetable meal (VM) diet totally devoid of FM and based on SBM (26%). Fish fed the VM diet did not show reduced growth performance when compared with fish fed the FM diet. Nevertheless, fish fed the VM diet had an increased viscerosomatic index, lower apparent fat digestibility, higher aminopeptidase enzyme activity and number of villi fusions, and lower α-amylase enzyme activity and brush border integrity. Small RNA-Seq analysis identified six miRs (omy-miR-730a-5p, omy-miR-135c-5p, omy-miR-93a-3p, omy-miR-152-5p, omy-miR-133a-5p, and omy-miR-196a-3p) with higher expression in blood plasma from fish fed the VM diet. Bioinformatic prediction of target mRNAs identified several overrepresented biological processes known to be associated with high dietary SBM content (e.g., lipid metabolism, epithelial integrity disruption, and bile acid status). The present research work increases our understanding of how SBM dietary content has a physiological impact in farmed fish and suggests circulating miRs might be suitable, integrative, and less invasive biomarkers in fish.

113-OR: The OPTIFAST (OP) Total and Partial Meal Replacement Program Improves Cardiometabolic Risk in Adults With Obesity—Secondary and Exploratory Analysis of the OPTIWIN Study

The effects of weight loss on atherosclerotic cardiovascular disease (ASCVD) risk factors using a partial or total meal replacement program (MRP) are not fully understood. We performed secondary and exploratory analyses of changes in blood pressure (BP), lipids, and global ASCVD risk in a randomized, controlled MRP trial using OP (n=135) compared with a low-calorie food-based (FB) dietary plan (n=138) that resulted in significant weight loss at week (W) 26 (reduction phase) and W52 (maintenance). Baseline characteristics were well balanced (mean [standard deviation] age OP/FB 47 [11]/47 [11] years, BMI 38.4 [5.5]/39.2 [6.2] kg/m2, females 86/79%, 10-year ASCVD risk <5% 87/74%, dysglycemia 52/50%). Changes in risk factors were estimated by a linear mixed model. At W26, systolic/diastolic BP were significantly reduced with OP vs FB (table), and a greater proportion achieved ≤ 130/80 mmHg (66.7% vs 53.6%, OR 2.11 [95% CI 1.10, 4.03], p=0.024). All lipid parameters significantly improved, as did the global ASCVD risk. A similar, but slightly attenuated pattern was observed at W52. In subgroup analysis by age (<40, 40-59, ≥ 60 years), SBP (</≥ 130 mmHg) and sex, greater treatment effects were generally seen with higher SBP and age, and in men. In people with obesity at low ASCVD risk, OP significantly improved CV risk factors and global ASCVD risk. Disclosure J.D.Ard: Advisory Panel; Novo Nordisk, Consultant; Eli Lilly and Company, Intuitive Surgical, Regeneron, Other Relationship; Optum Labs, Weight Watchers International, Research Support; Nestlé Health Science, Boehringer Ingelheim Inc., Epitomee, KVK Tech. I.Neeland: Consultant; Nestlé Health Science, Speaker's Bureau; Boehringer Ingelheim and Eli Lilly Alliance, Bayer Inc. A.E.Rothberg: None. R.Chilton: None. D.De luis: None. A.H.Hawkinson: Employee; Nestlé Health Science. S.S.Cohen: Consultant; Nestlé Health Science. O.Johansen: Employee; Nestlé Health Science. Funding Nestlé Health Science

278-LB: The Effect of Combining Very-Low-Calorie Diet with Semaglutide on Beta-Cell Function in Individuals with Type 2 Diabetes

Type 2 diabetes (T2D) is characterised by the loss of the first phase response of insulin-producing pancreatic beta cells. Recently, Very-low calorie diets (VLCD - defined as less than 800 kilocalories per day) have been shown to restore this first phase response to induce remission of T2D, while Glucagon-like peptide-1 agonists also improve the first phase response by enhancing postprandial insulin secretion. Here, we present interim results of an investigation exploring the effect of combining these two interventions on beta cell function, in individuals with T2D. Eighteen individuals with T2D and body mass index >27kg.m-2 were randomly allocated into 3 groups: i) Semaglutide (S), ii) VLCD (V), and iii) Semaglutide-plus-VLCD (SV). Semaglutide was administered once weekly gradually up titrated to a maximum dose of 1mg and VLCD regime was provided by LighterLife® total meal replacement. Beta cell function was assessed using intravenous glucose tolerance tests (IVGTT) performed at baseline and 12 weeks. First-phase insulin response was calculated as the incremental area under the suprabasal plasma insulin concentration curve during 0-10 minutes of the IVGTT (µU.min.ml-1). Data were analysed using GraphPad Prism 9.5.0 (La Jolla, USA). All groups were equally matched at baseline. Mean weight loss was 6.4, 14.1 and 14.9 kg in S, V and SV, respectively. A significant improvement in first phase response was observed in all groups (S: +398.5; V: +88.4; SV: +547.8 µU.min.ml-1, all p<0.05 vs. baseline). At 12 weeks, first phase response in SV was significantly higher than in V (583.9 vs. 169.2 µU.min.ml-1 respectively, p<0.05). These data suggest that combination of VLCD and Semaglutide results in a significantly greater improvement in first phase response than VLCD alone. This approach could result in a more robust remission of T2D in the longer-term, and may have important implications for the future design of interventions for the clinical management of T2D. Disclosure O. Anyiam: None. B. E. Phillips: None. D. J. Wilkinson: None. K. Smith: None. P. J. Atherton: None. I. R. Idris: None. Funding Medical Research Council Confidence in Concept Scheme

Children with lower ratings of executive functions have a greater response to the portion size effect

Deficits in executive functions (EFs), a set of cognitive processes related to self-regulation, are associated with the development of obesity. Prior studies from our group showed that lower food-cue related activation in brain regions implicated in self-regulation was related to a larger portion size effect. We tested the hypothesis that lower EFs in children would be positively related to the portion size effect. Healthy weight children aged 7–8 y (n = 88), who varied by maternal obesity status, participated in a prospective study. At baseline, the parent primarily in charge of feeding completed the Behavior Rating Inventory of Executive Function (BRIEF2) to assess child EFs, including Behavioral (BRI), Emotional (ERI), and Cognitive (CRI) indices. At 4 baseline sessions, children consumed meals in which the portion sizes of foods (pasta, chicken nuggets, broccoli, and grapes) varied by visit (total meal weight of 769, 1011, 1256, or 1492g). Intake increased with increasing portions in a linear trajectory (p < 0.001). EFs moderated the portion size effect such that lower BRI (p = 0.003) and ERI (p = 0.006) were associated with steeper increases in intake as portions increased. As amount of food increased, children in the lowest functioning tertiles for BRI and ERI increased intake by 35% and 36%, respectively, compared to children in the higher tertiles. Increases in intake among children with lower EFs were for higher- but not lower-energy-dense foods. Thus, in healthy weight children who varied by obesity risk, lower parentally reported EFs were associated with a larger portion size effect, and these results were independent of child and parent weight status. Therefore, EFs may be target behaviors that could be strengthened to help children moderate excess intake in response to large portions of energy-dense foods.

Non-GMO-high oleic soybean meal value addition and studying the functional and reconstitution behavior

ABSTRACT Soy meal, a substantial byproduct of soy-oil processing, is rich in crude protein (44–49%), crude ash (5.2–9.1%), minerals, and vitamins. Only 2% of the total soy meal is consumed by humans, while 97% is utilized for animal feed and other industrial purposes. In this study, we use soy meal from non-genetically modified high oleic (Non-GMO-HO) soybean oil processing to develop value-added food products. In this study, soy meal was spray-dried using 5–15% maltodextrin and gum Arabic as a drying aid because trial investigations revealed that the sticky behavior of soy meal powder, which impacts product yield. The physical properties, such as colour, flowability (m3/h), moisture content (%), water activity (Aw), hygroscopicity (%), reconstitution properties, viscosity (mPa-s), thermal degradation behavior, and particle size distribution, were investigated to analyze the impact of drying aid on the quality of soy meal powder. JMP 14.0.0 Pro software was used to conduct the statistical analysis. Spray-dried soy meal powder can be used in reconstituted beverages, infant formulas, soy-based cookies, meat analogs, carrier agents, and more.

Changes in Meal and Menu Quality at Early Care and Education Programs after Training with Food Service Staff: the FRESH Study

BackgroundPrevalence of obesity in Native American (NA) children is disproportionately high, indicating a higher risk of health disparities. Many children attend early care and education (ECE) programs, presenting an opportune environment to improve meal and menu quality as the intake of healthy foods is associated with lowered risk of childhood obesity. ObjectivesWe aimed to examine the effectiveness of food service staff training on meals and menu quality across NA ECEs. MethodsFood service staff from 9 participating ECE programs attended a 3-h training focused on Child and Adult Care Food Program (CACFP) best practices, and received a tailored, best-practice menu, and healthy recipes. Meals and menus prepared across 1 wk were examined per CACFP serving size assumptions at baseline, 4 mos, 6 mos, and 12 mos for all 9 programs. Healthy Eating Index (HEI), CACFP requirements and best practices achievement, and food substitutions quality (classified into superior, equivalent, and inferior based on the nutritional quality) were calculated. A repeated measures ANOVA model was used to determine the differences across time points. ResultsThe total meal HEI score increased significantly from baseline to 4 mos (71.1 ± 2.1; 78.6 ± 5.0; P = 0.004), but did not differ from baseline to 12 mos. Menu CACFP requirements and best practices achievement did not differ across time points, although achievement with CACFP requirements was already high at baseline. Superior nutrition quality substitutions declined from baseline to 6 mos (32.4 ± 8.9; 19.5 ± 10.9; P = 0.007); however, it did not differ from baseline to 12 mos. Equivalent and inferior quality substitutions did not differ across time points. ConclusionsImplementing a best-practice menu with healthy recipes showed immediate improvements in meal quality. Although the change did not sustain, this study showed evidence of an opportunity to educate and train food service staff. Robust efforts are needed for improving both meals and menus.This trial was registered ClinicalTrials.gov as NCT03251950 (https://clinicaltrials.gov/ct2/show/NCT03251950?cond=food+resource+equity&draw=2&rank=1).

Ready-to-eat cereal is an affordable breakfast option associated with better nutrient intake and diet quality in the US population.

Results from observational studies have reported ready-to-eat cereal (RTEC) consumers have higher dietary quality and nutrient intake compared to consumers of non-RTEC breakfasts or those who do not eat breakfast. Yet, there have been few investigations on the relationship of RTEC to meal costs at breakfast and across the day, which may be one reason some consumers choose to not consume breakfast. The objective of this study is to evaluate the contribution of RTEC consumed at breakfast to nutrient intake and adequacy, diet quality and meal costs in a nationally representative sample of children and adults in the US. Dietary data from 2,259 children (2-18 years) and 4,776 adults (≥19 years) in the National Health and Nutrition Examination Survey (NHANES) 2017-2018 were evaluated to compare nutrient intake, adequacy, dietary quality, and food costs in RTEC breakfast consumers, non-RTEC breakfast consumers and those who did not consume breakfast. RTEC breakfast consumers made up 28% of children and 12% of adults. Children and adults consuming RTEC for breakfast had higher intakes of carbohydrate, dietary fiber, calcium, magnesium, iron, zinc, phosphorus, potassium, B vitamins, vitamins A and D, whole grains, and total dairy compared to consumers of non-RTEC breakfast or no breakfast. There were no differences by breakfast status for sodium, saturated fat, or added sugar, except adults consuming RTEC had lower added sugar intake compared to those who did not consume breakfast. RTEC breakfast consumers were also more likely to meet estimated average requirements (EAR) for intake of several nutrients and had overall higher dietary quality. For children, breakfast meal costs were less for RTEC breakfast compared to non-RTEC breakfast, but total daily meal costs were similar for consumers of RTEC and non-RTEC breakfasts. RTEC breakfasts may contribute to greater nutrient intake and diet quality in children and adults in the US without increasing total daily meal costs.

Postmenopausal women's experiences of weight maintenance following a very low energy diet.

Very low energy diets (VLEDs) effectively induce substantial weight loss in people with obesity, yet they are rarely used as a first line treatment. There is a belief that such diets do not teach the lifestyle behavior changes needed for long-term weight maintenance. However, little is known about the lived experiences of people who have lost weight on a VLED in the long term. This study aimed to explore the behaviors and experiences of postmenopausal women who had followed a 4-month VLED (using total meal replacement products [MRPs]), followed by a food-based, moderately energy-restricted diet for an additional 8months, as part of the TEMPO Diet Trial. Qualitative in-depth semi-structured interviews were conducted with 15 participants at 12 or 24months (i.e., at 8 or 20months post diet completion). Transcribed interviews were analyzed thematically using an inductive approach. Undertaking a VLED was reported by participants to confer advantages in weight maintenance that previous weight loss attempts had not been able to do for them. Firstly, the rapid and significant weight loss, in conjunction with ease of use, was motivational and helped instill confidence in the participants. Secondly, the cessation of a normal diet during the VLED was reported by participants to break weight gain-inducing habits, allowing them to abandon unhelpful habits and to introduce in their place more appropriate attitudes toward weight maintenance. Lastly, the new identity, helpful habits and increased self-efficacy around weight loss supported participants during weight maintenance. Additionally, participants reported that ongoing occasional use of MRPs provided a useful and easy new strategy for countering weight regain and supporting their weight maintenance regimen. Among the participants in this qualitative study, most of whom had maintained a loss of over 10% of their baseline body weight at the time of interview, using a VLED in the context of a clinical weight loss trial conferred confidence, motivation and skills for weight maintenance. These findings indicate that VLEDs with clinical support could be successfully leveraged to set up behaviors that will support weight maintenance in the long term.

Feeding behavior in relation to ovarian cyclicity in cows with no or a short dry period

The objective of this study was to investigate relations between feeding behavior (FB) variables focusing on intake of the basal ration during 3 wk prepartum until 3 wk postpartum, and postpartum onset of luteal activity (OLA) in dairy cows subjected to no (0-d) or a short (30-d) dry period (DP). Feeding behavior of the basal ration intake (concentrate intake excluded) was continuously recorded by computerized feeders for 123 dairy cows and analyzed from 3 wk prepartum to 3 wk postpartum. Cows were subjected to a DP length: 0-d DP (n = 81), or 30-d DP (n = 42). Milk progesterone concentration was determined 3 times per week until 100 DIM to determine OLA, which was classified as early OLA (<21 DIM) and late OLA (≥21 DIM). Relations between FB and OLA class were analyzed using mixed models. During 3 wk prepartum, FB differed between parity class (parity 2 or ≥3 after calving). Cows with a 30-d DP prepartum, regardless of their OLA class, had more visits per meal, higher meal duration, total meal time, total daily feeding time, and lower feed intake and feeding rate compared with cows with 0-d DP. During the first 2 d postpartum, cows with OLA <21 had more visits per day and visits per meal compared with cows with OLA ≥21. During the first 3 wk postpartum, cows within the 30-d DP group with OLA <21 had greater meal size, feed intake, and feeding rate compared with cows with OLA ≥21 of this group. Cows within the 0-d DP group with OLA <21 had higher meal duration, total daily meal time, total daily feeding time, and meal size, but a lower feeding rate compared with cows with OLA ≥21 of this group. Concluding from the current study, cows with OLA <21 had a postpartum FB that reflected a cow with faster recovery from parturition and better adaptation to onset of lactation compared with OLA ≥21. No or a short DP affected prepartum FB, suggesting that prepartum management affects FB. This study provides evidence of different FB between cows with different timing of resumption of ovarian cyclicity.

RF24 | PSUN126 A Very-Low Calorie Diet Can Reduce Insulin Resistance and Cause Remission of Diabetes Mellitus and Hypertriglyceridemia in a Patient With Familial Partial Lipodystrophy Type 2

Abstract Background Lipodystrophy syndromes are associated with inadequate adipocyte capacity that results in an earlier threshold for ectopic deposition and metabolic dysfunction. We have previously reported that patients with familial partial lipodystrophy (FPLD) present with metabolic severity equivalent to what is observed at 8-12 BMI points higher in a population with common obesity. Currently, there is no strong evidence that any specific diet is the preferred treatment, but bariatric surgery has been reported to improve metabolic outcomes in a few patients. Here, we report the effect of an aggressive calorie-restricted diet in a patient with FPLD who showed remarkable benefit after 16 weeks of the intervention. Clinical Case This is a 38-year-old female diagnosed with FPLD type 2, with LMNA p. R482Q mutation who had a history of recurrent pancreatitis, NAFLD, impaired ovulation, and diabetes mellitus. She had a short-term goal of improving her metabolic state rapidly to achieve pregnancy by IVF. Upon presentation, body weight was 81.6kg, BMI 23.2kg/m2, HbA1c 7.7% and triglycerides 215mg/dL. She was started on very-low calorie diet (VLCD) (800 kcal/day) employing a formula total liquid diet meal replacement: 160 kcal per shake (18g total carbohydrates, 15g net carbohydrates, 3.5g fat, and 16g protein) with the goal to reduce body weight by 15% as has been described for patients in the University of Michigan Weight Management Program. After 1 week on diet, she discontinued glucose and lipid lowering therapies. After 12-weeks of VLCD followed by 4 weeks of transition to low-calorie diet (incorporating 3 meal replacements, one meal, and ad libitum non-starchy vegetables), we observed 12.3kg of body weight and a 1.4% decrease in HbA1c. Insulin resistance was reduced by 66.7 and 61.5% (HOMA-IR and ADIPO-IR, respectively). Fasting insulinemia was reduced by 64.2%. We also performed an OGTT with 75g of glucose for 180 min and observed a decrease in the area under the curve of insulin (-33.2%), triglycerides (-40.7%), and free fatty acids (-34%). DEXA scan showed a reduction in total body fat of 16%. Liver fat via the chemical shift MRI method was reduced from 10±2% to 2±1%. She did not experience any adverse events during the intervention. More importantly, her egg retrieval rate and egg quality during IVF were far superior to past attempts. Conclusion This case illustrates the strong effect and safety of a VLCD intervention in a patient with lipodystrophy. We observed rapid reduction in body weight, and in insulin resistance leading to the remission of diabetes mellitus, hypertriglyceridemia and fatty liver disease. Moreover, there was improved response to ovulation induction. Our data encourage the use of this medical approach for other patients with similar metabolic and reproductive abnormalities due to adipose tissue distribution abnormalities. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m., Sunday, June 12, 2022 12:36 p.m. - 12:41 p.m.

Do meal boxes reduce food waste from households?

Household food waste is determined by a complex set of routinized behaviors, and disruption of these routines may allow for a decrease in this vast amount of food waste. The current study examines such a disruption of household routines: the meal box. The potential of meal boxes to diminish different types of household food waste is investigated for the first time, across different countries. After providing a framework comparing the effects of different types of meals on food waste, we subsequently examine the effects of subscription-based food supply (i.e., meal boxes) on total meal waste as well as on the different types of food waste: preparation, cooking, and plate waste. Our dataset contains 8747 meal observations from 955 households in six countries. Results from a Bayesian multilevel hurdle-lognormal model with random intercept show that, overall, meal boxes reduce total meal waste in comparison to traditionally cooked dinners (38% reduction). Meal boxes especially lower the occurrence and amount of pan-and-pot food that is wasted (i.e., cooking waste), and also lower the amount of meal preparation waste, yet lead to a higher occurrence of both preparation and plate waste compared to traditional meals. This shows how differences between meals affect household food waste, something that has received little prior research attention. Furthermore, whereas most prior research has focused on overall household food waste, our study illustrates that distinguishing between different types of household food waste can provide important new insights.

Optimization of Selective Hydrolysis of Cruciferins for Production of Potent Mineral Chelating Peptides and Napins Purification to Valorize Total Rapeseed Meal Proteins.

Preventing oxidation and microbial spoilage are both major concerns in food industries. In this context, this study aimed to valorize the total rapeseed meal proteins with controlled enzymatic proteolysis to generate potent mineral-chelating peptides from cruciferins while keeping intact the antimicrobial napins. Implementation of proteolysis of total rapeseed protein isolate with the Prolyve® enzyme highlighted an interesting selective hydrolysis of the cruciferins. Hence, the mechanism of this particular hydrolysis was investigated through a Design of Experiments method to obtain a model for the prediction of kinetics (cruciferin degradation and napin purity) according to the operating conditions applied. Then, multicriteria optimization was implemented to maximize the napin purity and yield while minimizing both enzymatic cost and reaction time. Antioxidant assays of the peptide fraction obtained under the optimal conditions proved the high metal-chelating activity preservation (EC50 = 247 ± 27 µg) for more than three times faster production. This fraction might counteract lipid oxidation or serve as preventing agents for micronutrient deficiencies, and the resulting purified napins may have applications in food safety against microbial contamination. These results can greatly help the development of rapeseed meal applications in food industries.

Assessing public organic food procurement: the case of Zurich (CH)

Organic food is increasingly promoted among authorities and governments to tackle global sustainability challenges and support an agri-ecological transition. An important policy instrument in this endeavour is the purchase of food or food services by public institutions, the so-called public food procurement (PFP). While PFP policies often promote organic food, few studies quantify the actual share of organic products in PFP systems. This study applies an adapted city food flow analysis to evaluate the organic share of 12 product groups in public catering, using Zurich as a case study. Based on a typology of procurement channels, we show that Zurich’s PFP system is highly centralised with internal coordinated procurement (INT–coord) and external coordinated procurement (EX–coord) providing 70% and 25% of total annual meals respectively. As Zurich procures 11% (INT–coord) and 9% (EX–coord) of organic produce, the city has considerable potential to increase organic PFP. Leverage points to this aim include internal product-specific thresholds, supply development and developments in digital procurement. This study provides a methodology to conceptualise municipal PFP systems and measure city-wide levels of organic PFP. The insights from Zurich offer a blueprint for PFP systems in other municipalities and reveal potential challenges when defining and monitoring organic PFP policies based on total purchases.