Meal Type Research Articles

Towards Safe and Robust Closed-Loop Artificial Pancreas Using Improved PID-Based Control Strategies

Artificial pancreas enhances the life experience for diabetic patients by allowing them to live normally with their glucose levels controlled automatically with minimal or no intervention. For closed-loop glucose controllers to be approved for clinical practice, they have to prove safety under all potential scenarios. One of the biggest challenges of closed-loop glucose control is to handle the distortion caused by meal intake. This challenge becomes more problematic when taking into account the imperfections and limitations of glucose sensors. In this article, we propose new Proportional-Integral-Derivative (PID)-based control strategies for robust glucose control under varying meal conditions. The proposed approaches aim at counteracting the challenges imposed by the large delays incurred in glucose sensing and insulin action. Statistical model checking was utilized to analyze the performance figures and safety properties as compared with existing closed-loop techniques. The results have shown that one of the proposed approaches provide substantial enhancements towards safe and robust glucose control especially under sensor noise. Where, under a typical relative meal size between 75 and 125 (g/100Kg), the proposed approach can satisfy hypoglycemia safety property for 90% of the patients compared to lower than 50% of the patients for the other investigated techniques. These enhancements can be achieved without additional personalized tuning beyond the standard PID control.

Adequacy of the frequency and types of meals consumed by community-dwelling elderly folk in the south of Brazil

The scope of this study was to describe the frequency and types of meals consumed by the elderly in Pelotas (Brazil) and factors associated with the adequacy of meal frequency. A cross-sectional study was carried out with ≥60 years of age individuals. They were asked about daily meals during the week prior to the interview. The adequacy of meals was defined as recommended by the Ministry of Health (at least three main meals and two small snacks per day). The independent variables were sociodemographic, health and food routine characteristics. Prevalence ratios and 95% confidence intervals were calculated using Poisson regression. Of the 1,438 elderly individuals interviewed, about 40% reported consuming four meals a day. Lunch was the most reported meal, followed by breakfast. A total of 30.6% of men and 38.6% of women had adequate frequency of meals (p=0.002). Men with edentulism (total tooth loss) were 35% more likely to eat adequately, while this probability was about 30% lower among non-white women, those without schooling and those who reported a lack of money to buy food. One in each three elderly people met the recommendation of adequate frequency of meals and some sociodemographic characteristics were negatively associated with this habit.

Kualitas Tepung Ikan di Pesisir Pantai Kabupaten Merauke Sebagai Bahan Pakan

Catch fish that are not used as food can be processed into fish flour. The purpose of this study was to analyze fish meal from several types of fish found on the coast of Merauke RegencyThis test is carried out to see the physical and chemical quality.. From the research results of this study obtained the physical quality of fish meal can be which is categorized, both in mixing feed food and storage namely: the average density of 0.58 gr / cm3, surface area 53.88 cm2, pH 6.25, threshold power 1.15 m / sec and stack angle 27.260C, average ash content of 6.31%, protein 65.46%, fat 5.46%, crude fiber 0 and water content an average of 6.32%, These results indicate the quality of fish meal is included in standard I based on the quality of SNI 2013 as feed material. Eight (8) types of fish meal that have low economic value and potential to be developed as feed ingredients include Kaca fish (Kurtus gulliveri, Pasir fish (Platycephalus endrachtensis), Bete-Bete fish (Rhinoprenes pentanemus), Duri Herkules fish (Arius sp), and Duri putih fish (Arius leptaspis).

Effect of Extra Virgin Olive Oil and Butter on Endothelial Function in Type 1 Diabetes.

Post-prandial hyperglycemia can be relevant in developing early manifestations of atherosclerosis. EVOO (Extra Virgin Olive Oil), rich in saturated fatty acids and commonly used in the Mediterranean diet, seems to control post-prandial hyperglycemia better than butter. Subjects with type 1 diabetes are at higher risk of developing cardiovascular disease and show endothelial dysfunction, an early manifestation of atherosclerosis in the first years of the disease. Our study aims to evaluate whether EVOO and butter influence endothelial function in subjects with type 1 diabetes when added to a single high glycemic index (HGI) meal. In this exploratory cross-over study, 10 subjects with type 1 diabetes and 6 healthy subjects were scheduled to receive two types of HGI meals: one enriched with EVOO and one with butter. Before and after each test meal at different time points, all subjects underwent the evaluation of endothelial function by flow-mediated dilation technique, glucose and lipids measurements, and gastric emptying assessment by ultrasound. Flow-mediated dilation significantly increased after EVOO-enriched meal compared with butter in subjects with type 1 diabetes (two-way-repeated measurements ANOVA, p = 0.007). In patients with type 1 diabetes, the add-on of EVOO to HGI meal improves vascular function compared to butter, which has detrimental effects.

Efficiency of fatty acid-enriched dipteran-based meal on husbandry, digestive activity and immunological responses of Nile tilapia Oreochromis niloticus juveniles

This study aimed to compare the enrichment capacity of polyunsaturated fatty acids (PUFA) and the long chain polyunsaturated fatty acids (LC-PUFA) of two dipteran species, Hermetia illucens - black soldier fly (BSF) - and a blowfly, Chrysomya putoria (CP), and to test its influence on growth, digestive activities and immune responses of Nile tilapia. Two types of enriched insect larval meal were produced using larvae cultured either on vegetable substrates (VGS) to formulate two diets rich in linolenic acid (ALA) (BSF/VGD and CP/VGD), or on fish offal substrates (FOS), in order to produce two diets rich in ALA and eicosapentaenoic acid (EPA) (BSF/FOD) or in ALA + EPA and docosahexaenoic acid (DHA) (CP/FOD). These four insect-based diets containing only palm oil as a lipid source were compared to a control diet based on fish meal (FM) and fish oil (FO). After 60 days of feeding, ALA or DHA muscle content of fish fed BSF/VGD or CP/FOD diet was comparable to that of the FMFO diet, and all insect diets increased the EPA muscle levels, except for a reduction by the BSF/VGD one. The CP/FOD diet induced similar fish growth, feed efficiency and protein efficiency ratio compared to the control FMFO diet, while a decrease was observed in fish fed other insect diets. Only BSF/VGD led to a decrease in protein and lipid digestibility. CP or BSF larval meal significantly increased alkaline phosphatase activity regardless of fatty acid (FA) enrichment. The expression level of fads2, fads6 and elovl5 was significantly higher in fish fed the BSF/VGD diet compared to fish fed the FMFO diet. FA-enriched insect diets increased some immune variables such as lysozyme, peroxidase and ACH50 values of fish fed CP/FOD, CP/VGD or BSF/VGD diets. Moreover, the expression level of β-defensin-1 and mhcII genes were significantly higher in fish fed the BSF/FOD diet than the FMFO diet. Also, the expression of the pro-inflammatory gene il-1-β was significantly higher in fish fed FMFO diet than in those fed CP/FOD diet, but comparable to fish fed all other diets. No significant effects were observed for the other tested genes. The results showed a better efficiency in LC-PUFA enrichment of the CP larvae compared to BSF ones, resulting in a higher stimulation of the fish nutrient utilization processes and therefore, a higher growth capacity. Nonetheless, all dipteran larval meal stimulated the immune status whatever the insect species or dietary essential fatty acids.

Clinical investigation of the biopharmaceutical characteristics of nifurtimox tablets – Implications for quality control and application

Nifurtimox is approved in Chagas disease and has been used in endemic countries since the 1960s. Nifurtimox, available as a 120 mg tablet, is administered with food typically three times daily, and dose is adjusted for age and bodyweight. Accurately or reproducibly fragmenting the 120 mg tablet for dose adjustment in young children and those with low bodyweight is problematic. Based on the existing tablet formulation, new nifurtimox 30 mg and 120 mg tablets have been developed in a format that can be divided accurately into 15 mg and 60 mg fragments. In adults with chronic Chagas disease, we investigated whether nifurtimox bioavailability is affected by tablet dissolution rate, and whether different diets affect nifurtimox bioavailability. In an open-label, three-period cross-over study (n=36; ClinicalTrials.gov, NCT03350295), patients randomly received three 30 mg tablet formulations (slow, medium, or fast dissolution; a 4 × 30 mg dose of one formulation per period). In an open-label, four-period cross-over study (n=24; ClinicalTrials.gov, NCT03334838) patients randomly fasted or received one of three meal types (high-fat/high-calorie, low-fat, dairy-based) before ingesting nifurtimox (a 4 × 30 mg dose per period). Acceptance criteria for no difference between groups were 90% confidence intervals (CIs) of exposure ratios in the range 0.8–1.25. Nifurtimox bioavailability was unaffected by tablet dissolution kinetics. Ratios of area under the curve at final assessment (AUC(0–tlast) [90% CI]) were: fast/medium dissolution, 1.061 (0.990–1.137); slow/medium dissolution, 0.964 (0.900–1.033); fast/slow dissolution, 1.100 (1.027–1.179). Compared with a fasting state, nifurtimox bioavailability increased by 73% after a high-fat/high-calorie meal (AUC(0–tlast) ratio [90% CI], 1.732 [1.581–1.898]); smaller increases were seen with the other meal types (low-fat: 1.602 [1.462–1.755]; dairy-based: 1.340 [1.222–1.468]). Although type of diet can affect bioavailability, taking nifurtimox with food is most important.

Effects of Substituting Fish Meal with Two Types of Soybean Meal on Growth, Enzyme Activities, and Intestinal Morphology in Juvenile Rhynchocypris lagowskii

AbstractThis study evaluated the effects of substituting fish meal with common soybean meal (SBM) or extruded soybean meal (ESBM) on growth, digestion, some nonspecific immune markers, and intestinal morphology in juvenile minnow Rhynchocypris lagowskii. In trial 1, five experimental diets were formulated with SBM replacing 0% (fish meal control; SBM0), 12.5% (SBM12.5), 25.0% (SBM25), 37.5% (SBM37.5), and 50.0% (SBM50) of the fish meal. Rhynchocypris lagowskii (6.81 ± 0.19 g) were randomly stocked in 100‐L cylindrical plastic tanks and fed to satiation thrice daily for 56 d. After the feeding trial, there was no significant differences in weight gain ratio (WGR), specific growth rate (SGR), feed efficiency ratio (FER) and protein efficiency ratio (PER), feed conversion ratio (FCR), and feed intake (FI) of the SBM0, SBM12.5, and SBM25 groups. But compared with the control group, WGR, SGR, and FI of the SBM37.5 and SBM50 groups were significantly decreased, FER and PER of the SBM50 group were significantly decreased, and FCR of the SBM50 group was significantly increased. Providing the SBM37.5 and SBM50 diets can significantly reduce the muscle protein content and protease activity of the hepatopancreas and intestine. Aspartate aminotransferase, alanine aminotransferase, lysozyme, and superoxide dismutase activities in the hepatopancreas decreased with increasing dietary SBM levels. Providing the SBM25, SBM37.5, and SBM50 diets caused atrophy, swelling, and rupture of the intestinal mucosal fold and separation of epithelial mucosa from the lamina propria. In trial 2, five experimental diets were formulated with ESBM replacing 0% (fish meal control; ESBM0), 12.5% (ESBM12.5), 25.0% (ESBM25), 37.5% (ESBM37.5), and 50.0% (ESBM50) of the fish meal. Rhynchocypris lagowskii (6.87 ± 0.02 g) were randomly stocked in 100‐L cylindrical plastic tanks and fed to satiation thrice daily for 56 d. After the feeding trial, WGR, FI, SGR, FER, PER, and muscle crude protein content of the ESBM50 group were significantly decreased compared with the control group, and FCR of the ESBM50 group was significantly increased. Meanwhile, the hepatopancreas and intestinal protease activities and the hepatopancreas superoxide dismutase, lysozyme, aspartate aminotransferase, and alanine aminotransferase activities decreased with increasing dietary ESBM levels, and the ESBM50 group was significantly different than the control group. Providing the ESBM37.5 and ESBM50 diets caused atrophy and rupture of intestinal mucosal fold and separation of epithelial mucosa from the lamina propria. These results indicated that SBM could replace 12.5% of fish meal in juvenile R. lagowskii diets, while ESBM could replace 25% of fish meal.

Potential climate benefits of reusable packaging in food delivery services. A Chinese case study

In China, the food delivery packaging waste is increasing due to the rapid growth of the sector and the use of single-use packaging to transport the meals. In addition, the recycling rates of current municipal waste management are low. In this regard, this study aims at estimating the climate change impact of current food delivery packaging and its waste treatment, by performing a Life Cycle Assessment with a cradle-to-grave approach. In addition, this article explores the potential benefits of increasing the current recycling rates, the recycled content of the packaging as well as the use of reusable packaging. For this study, the food packaging of a typical dumpling-based meal of the popular Chinese restaurant Xijiade was selected. Based on this menu and the current Chinese consumption patterns, the food delivery packaging in China would have emitted about 13 million tons of CO2eq. Increasing current recycling rates to 35% would reduce 16% the emissions of single-use packaging, and further decrease (60%) could be found if half of the packaging was made of recycled material. In addition, if single-use packaging was replaced by reusable PP-based packaging (food container and carrier bag), the emissions would potentially be 63% lower than the current situation. In this case, doubling the recycling rates and the recycled content of the reusable food packaging would represent an extra 6 and 17% reduction of emissions, respectively.

708-P: Complexity of Mealtime Insulin Dosing in Free-Living People with T1D: Novel Study with Varied Meal Macronutrient Content

Controlled in-patient studies indicate that high fat/protein meals require more insulin coverage than low fat meals with similar carbohydrate (CHO). However, it is unclear how dietary macronutrient content impacts on glycemic responses and insulin requirements in free-living T1D individuals. Adults with T1D (n=25) (mean±SD age 52±15 yrs, A1C 7.1±0.7%, 39% female) on insulin pump and continuous glucose monitoring (CGM) were enrolled in this 18-week duration study. Participants ate meals with specific macronutrient content (high glycemic index [GI], high fat [HGI-HF]; high GI, low fat [HGI-LF]; low GI, high fat [LGI-HF]; low GI, low fat [LGI-LF]). Meal, CGM, and insulin dosing data were reviewed by the study investigator, who provided dose optimization recommendations. Participants provided dosing and CGM data from 463 meals. Time-in-range (TIR) was similar for all meal types (table, p=0.72). LGI meals required significantly more insulin than HGI meals (p=0.01). Significantly more insulin per gram of CHO was used for LGI-HF vs. all other meal types (mean CHO-to-insulin ratio = 4.5 vs. 8.7 for HGI-HF, 7.6 for HGI-LF, and 5.5 for LGI-LF; p= 0.02). This exploratory study in free-living individuals with T1D highlights the complexity of mealtime insulin dosing, pointing to the need for bolus advisors that incorporate other dietary inputs in addition to CHO.View largeDownload slideView largeDownload slide DisclosureS. S. Edwards: Employee; Self; Eli Lilly and Company, Stock/Shareholder; Self; Eli Lilly and Company. W. Wang: Employee; Self; Eli Lilly and Company. E. Toschi: Consultant; Self; Medtronic. A. Atakov-castillo: None. R. Dewar: None. G. M. Steil: Consultant; Self; Abbott Diabetes, Eli Lilly and Company. H. Wolpert: Employee; Self; Eli Lilly and Company.FundingEli Lilly and Company

Describing Ecological Momentary Assessment Methods for Collecting Dietary Intake in a Racially/Ethnically Diverse Sample

ObjectivesEcological momentary assessment (EMA) is an innovative tool being used in the obesity field to capture real-time information about people’s health. A recent systematic review regarding the use of EMA to assess dietary intake and physical activity in youth found the need for standardized reporting of EMA measures and methods. This presentation will discuss EMA methods used in the NIH-funded Family Matters study, including survey design, registration/technology, EMA protocols, implementation, and lessons learned for future EMA studies. MethodsFamily Matters is an incremental, two-phased (Phase I = 150 participants; Phase II = 627 participants), mixed-methods study conducted with a racially/ethnically diverse and immigrant/refugee sample from largely low-income households. Across two phases, the Family Matters research team designed and administered EMA surveys to parents of 5–9 year olds to measure momentary factors of importance to child weight and weight-related behaviors including parent feeding practices, child eating behaviors, meal preparation, and foods served at family meals. ResultsEMA data allowed for many cutting-edge research questions to be addressed, innovative analyses to be run, and methodological approaches to be advanced. Many diet-related topics were investigated, including 1) the investigation of both within-and across-day relationships between transient and chronic stress and parent feeding practices; 2) parental stress and mood earlier in the day and its association with parent feeding practices later in the day; and 3) family meal characteristics by meal type and day of the week. Additionally, concordance between diet-related EMA measures and objectively collected 24-hour dietary recalls was examined. Family Matters EMA diet-related measures will be presented and related results discussed. ConclusionsThis presentation will be valuable for researchers interested in using EMA for collecting obesity-related measures, such as dietary intake, physical activity, parent feeding practices, and stress/mood. Funding SourcesResearch is supported by grant number R01HL126171 from the National Heart, Lung, and Blood Institute (PI: Berge).

Pharmacokinetics and safety of capmatinib with food in patients with MET-dysregulated advanced solid tumors

In the Phase II GEOMETRY mono-1 study, the potent and selective mesenchymal-epithelial transition (MET) inhibitor capmatinib exhibited considerable efficacy in MET exon 14 skipping (METex14)-mutated metastatic non-small cell lung cancer at a dose of 400 mg BID. The current recommended dose is 400 mg BID in tablet formulation, with or without food. This article reports the pharmacokinetic (PK) profile, safety, and tolerability of capmatinib 300 and 400 mg BID given with food in MET-dysregulated advanced solid tumors. This multicenter, open-label, Phase I study enrolled adult patients with MET-dysregulated advanced solid tumors. In the dose escalation phase, capmatinib tablets were orally administered at a dose of 300 mg BID with food; if tolerated, the dose escalation cohort of 400 mg BID was to be opened to enrollment. In the expansion phase, patients were to be enrolled at the higher of the tolerated doses. Tablets were taken within 30 minutes of an unrestricted meal type, except on cycle 1 day 1 (C1D1) and cycle 1 day 7 (C1D7), when they were given with a high-fat meal. The primary objectives were to determine the higher of the tolerated study doses and assess PK variables, with a secondary objective of safety. Overall, 35 patients (300 mg BID, n=8; 400 mg BID, n=27) with MET-dysregulated advanced solid tumors were enrolled; all patients had received prior antineoplastic therapy, and the most common primary site was lung (45.7%). Among PK-evaluable patients, the median Tmax for capmatinib after administration with a high-fat meal (on C1D1/C1D7) was 4.0 to 5.6 hours across doses. At steady state (C1D7), capmatinib accumulation was low across dose levels (geometric mean of accumulation ratios, 1.29-1.69), with an increase in exposure (AUCtau and Cmax) from 300 to 400 mg BID. There were no occurrences of dose-limiting toxicity. All patients experienced at least 1 adverse event, and treatment-related adverse events occurred in 28 patients (80%; 300 mg BID, n=6; 400 mg BID, n=22), the most frequent of which were fatigue (37.1%) and nausea (34.3%). Capmatinib tablet formulation at a dose of up to 400 mg BID with food is well tolerated in patients with MET-dysregulated advanced solid tumors, with safety observations consistent with the existing profile under fasted conditions. These findings support the capmatinib dosing recommendation of 400 mg BID with or without food. ClinicalTrials.gov identifier: NCT02925104.

Understanding Meal Choices in Young Adults and Interactions with Demographics, Diet Quality, and Health Behaviors: A Discrete Choice Experiment.

Our understanding of meal choices is limited by methodologies that do not account for the complexity of food choice behaviors. Discrete choice experiments (DCEs) rank choices in a decision-making context. This study aimed to rank the relative importance of influences on meal choices in young adults and examine interactions by subgroups. Adults (18-30 y) living in Australia were recruited via social media to complete an Internet-based DCE and survey. Participants were presented with 12 choice sets about a typical weekday meal, consisting of 5 attributes (taste, preparation time, nutrition content, cost, and quality). Diet quality (Dietary Guideline Index) was calculated from brief dietary questions. Conditional logit models ranked meal attributes, including interactions by sex, education, area-level disadvantage, diet quality, and weight status. In total, 577 adults (46% female, mean±SD age 23.8±3.8 y) completed the DCE and survey. Nutrition content was the most important influence on meal choice (B: 1.48; 95% CI: 1.31, 1.64), followed by cost (B: -0.75; 95% CI: -0.87, -0.63), quality (B: 0.58; 95% CI: 0.49, 0.67), taste (B: 0.55; 95% CI: 0.45, 0.65), and preparation time (B: -0.42; 95% CI: -0.52, -0.31). Females, those with higher diet quality, and those with a BMI (in kg/m2) <25 had higher preferences for better nutrition content. Females had higher preferences for better taste and lower preferences for higher-cost meals. Participants with higher education had higher preferences for better nutrition content. Participants living in higher area-level disadvantage areas had higher preferences for longer preparation time. Nutrition content was the most important influence on young adults' meal choices. Preferences differed by sex, socioeconomic position, diet quality, and weight status. Findings show the suitability of DCEs for understanding food choice behaviors in young adults and support the need for meal-based interventions to be tailored according to demographic and health characteristics.

House fly (Musca domestica) larvae meal as an ingredient with high nutritional value: Microencapsulation and improvement of organoleptic characteristics

Insects have potential to become food ingredients, but it is necessary to improve the sensory properties of insects to help them to be better accepted by the population. The purpose of this study was to produce and characterize house fly larval meal (FLM) converted to a micro-encapsulated powder to improve appearance and other organoleptic characteristics. FLM showed high protein (54%) and lipid (22%) content, with a microbiological activity compatible for food purposes. Moreover, the high content of essentials amino acids (lysine, cysteine and leucine) and unsaturated fatty acids (oleic, linoleic and palmitoleic) make FLM a valuable nutritional source. Spray drying was selected to encapsulate FLM (0.5–2% w/v) using maltodextrin (20% w/v) and alginate (0.5% w/v). Encapsulation improved the appearance of FLM, creating a white-beige, monodispersed micro-powder (9 µm in size). Micro-powder with 2% FLM is considered a good source of protein (5.1%). Microencapsulation also dramatically reduced the volatile emissions of FLM. In conclusion, novel FLM micro-powders were developed using a simple and scalable encapsulation technique. The micro-powder with 2% FLM is a good source of protein, has a pleasant appearance similar to vegetable meals and has improved odor compared to typical insect meals. Thus, insect-based food ingredients in micro-powders could become more accepted by the general population.

ESTIMATION OF THE EFFECTIVE DOSES FROM TYPICAL FLUOROSCOPIC EXAMINATIONS WITH BARIUM CONTRAST.

The current study aimed to estimate the effective doses and conversion coefficients (CCs) for typical barium swallow (BS), barium meal (BM) and barium enema (BE) protocols and to evaluate the impact of different examination parameters on the resulting CCs. Data were collected in surgical and therapy departments in St. Petersburg Urban Mariinsky Hospital. Computational models were developed using PCXMC 2.0 software. CCs (μSv×μGy-1×m-2) were estimated, as follows, for over couch and under couch exposure geometries, respectively: 2.3 and 1.7 for BS (surgical department); 2.4 and 2.0 for BM (surgical department); 2.6 and 2.1 for BE (surgical department) 2.5 and 3.8 for BM (therapy department). The effective doses and CCs are mainly influenced by the combination of different fluoroscopic series and X-ray images taken in different projections, the irradiation field size and the energy characteristics of the X-ray beam.

GAMBARAN SISA MAKANAN PASIEN DI RSUD PETALA BUMI PROVINSI RIAU

Background : The high amount of leftover food is a serious problem that must be addressed immediately because the food served in the hospital has taken into account the quantity and quality according to the patient's needs. This also indicates that nutrition services are not achieved. The purpose of this study was to describe the leftover in Petala Bumi Hospital, Riau Province by classifying based on meal time, treatment class, food texture and type of diet. Research Methods : The study used cross sectional design. The population of this study were all patients in room 1 stclass, 2nd class and 3rd class with a total sample of 8 people using purposive sampling method. The leftover was measured using a 6-point Comstock scale for 3 days including breakfast, lunch, dinner, morning and evening snacks. Research Result : The results showed that leftover was mostly found in animal side dishes of the lunch menu (87,5%), blenderized food in first class (100%0, and low-salt and high-fiber diets (100%). Conclusion : The most leftovers are in blenderized foods and low-salt and high-fiber diets.

Performance, nutrient digestibility and selected gut health parameters of broilers fed with black soldier fly, lesser mealworm and yellow mealworm

This study aimed to investigate the effect of feeding three types of insect meal on broilers’ performance and selected gut health parameters. Day-old straight-run Ross 308 broilers (n=600) were group housed in 24 pens and fed diets containing 10% of eitherTenebrio molitor (yellow mealworm, YMW), defattedHermetia illucens (black soldier fly, BSF) orAlphitobius diaperinus (lesser mealworm, LMW), or a control (CTRL) diet for 35 days. Feed intake and gain were recorded at days 14, 28 and 35. On day 13, four broilers from each pen were placed in metabolic cages to determine apparent total tract digestibility after adaptation to 100% of one of three types of insect meal. Birds were killed, and intestinal content was collected on days 22 and 36 for determination of pH, selected groups of intestinal bacteria and short chain fatty acids (SCFA). Footpad lesions were scored on day 36. Birds fed LMW and YMW ate less than birds fed BSF or CTRL, but feed conversion ratio (FCR) was improved when birds were fed LMW. Dry matter digestibility was similar among insects, but differences were observed in ash and fat digestibility and nitrogen retention in which the BSF meal gave the highest digestibility of these nutrients. Birds fed any type of insect meal diet had higher levels ofClostridium perfringens in caecal and ileal digesta. Footpad dermatitis severity was similar between CTRL and insect-supplemented diets. Total SCFA levels as well as butyrate in digesta of birds fed BSF was lower than the levels of these SCFA in the other treatments. The propionate concentrations in caecal and ileal digesta were high for all diets containing insect meal. In conclusion, gain was maintained when feeding BSF but not LMW and YMW due to lower feed intake. Insect meal did not affect indicators of broilers’ gut health.

Virtual Reality App for Treating Eating Behavior in Eating Disorders: Development and Usability Study.

BackgroundAnorexia nervosa is one of the more severe eating disorders, which is characterized by reduced food intake, leading to emaciation and psychological maladjustment. Treatment outcomes are often discouraging, with most interventions displaying a recovery rate below 50%, a dropout rate from 20% to 50%, and a high risk of relapse. Patients with anorexia nervosa often display anxiety and aversive behaviors toward food. Virtual reality has been successful in treating vertigo, anxiety disorder, and posttraumatic stress syndrome, and could potentially be used as an aid in treating eating disorders.ObjectiveThe aim of this study was to evaluate the feasibility and usability of an immersive virtual reality technology administered through an app for use by patients with eating disorders.MethodsTwenty-six participants, including 19 eating disorder clinic personnel and 5 information technology personnel, were recruited through emails and personal invitations. Participants handled virtual food and utensils on an app using immersive virtual reality technology comprising a headset and two hand controllers. In the app, the participants learned about the available actions through a tutorial and they were introduced to a food challenge. The challenge consisted of a meal type (meatballs, potatoes, sauce, and lingonberries) that is typically difficult for patients with anorexia nervosa to eat in real life. Participants were instructed, via visual feedback from the app, to eat at a healthy rate, which is also a challenge for patients. Participants rated the feasibility and usability of the app by responding to the mHealth Evidence Reporting and Assessment checklist, the 10-item System Usability Scale, and the 20-point heuristic evaluation questionnaire. A cognitive walkthrough was performed using video recordings of participant interactions in the virtual environment.ResultsThe mean age of participants was 37.9 (SD 9.7) years. Half of the participants had previous experience with virtual reality. Answers to the mHealth Evidence Reporting and Assessment checklist suggested that implementation of the app would face minor infrastructural, technological, interoperability, financial, and adoption problems. There was some disagreement on intervention delivery, specifically regarding frequency of use; however, most of the participants agreed that the app should be used at least once per week. The app received a mean score of 73.4 (range 55-90), earning an overall “good” rating. The mean score of single items of the heuristic evaluation questionnaire was 3.6 out of 5. The lowest score (2.6) was given to the “accuracy” item. During the cognitive walkthrough, 32% of the participants displayed difficulty in understanding what to do at the initial selection screen. However, after passing the selection screen, all participants understood how to progress through the tasks.ConclusionsParticipants found the app to be usable and eating disorder personnel were positive regarding its fit with current treatment methods. Along with the food item challenges in the current app, participants considered that the app requires improvement to offer environmental and social (eg, crowded room vs eating alone) challenges.

Recipe Components and Parents' Infant and Young Child Feeding Concerns: A Mixed-Methods Study of Recipe Posts Shared in Thai Facebook Groups for Parents.

Social media is increasingly becoming a significant source of information for parents, including about feeding young children. However, little attention has been given to the characteristics of recipes for infants and young children and how they interact with parental perceptions regarding food decisions shared by users on social media. Building on findings related to shared recipe components and parental food choices, between December 2019 and July 2020, this study retrospectively collected 80 shared recipes each from five Thai Facebook groups. This extraction created 379 shared recipes with 1751 peers’ commentaries on the shared recipes’ posts. The shared recipes were classified and components quantified across child age groups, then the textual contents around the reasons behind the food choices were described qualitatively. The results showed that there were differences in meal types, food ingredients, and seasoning used across child age groups. Further analysis found that food allergy awareness was one driving concern behind parental perceptions on food choices in children’s diets. These concerns resulted in delays in the introduction of animal-source foods. Moreover, peers’ commentaries on shared recipes offered a venue for exchanging experiences with food products. Because of the potential influence on parental beliefs and perceptions, further studies are required to understand the impact of existing online communities on actual feeding practices.

Oral semaglutide improves postprandial glucose and lipid metabolism, and delays gastric emptying, in subjects with type 2 diabetes.

AimTo assess the effects of oral semaglutide on postprandial glucose and lipid metabolism, and gastric emptying, in subjects with type 2 diabetes (T2D).Materials and MethodsIn this randomized, double‐blind, single‐centre, crossover trial, subjects with T2D received once‐daily oral semaglutide (escalated to 14 mg) followed by placebo, or vice versa, over two consecutive 12‐week periods. Glucose and lipid metabolism, and gastric emptying (paracetamol absorption) were assessed before and after two types of standardized meals (standard and/or fat‐rich) at the end of each treatment period. The primary endpoint was area under the glucose 0–5‐h curve (AUC0–5h) after the standard breakfast.ResultsFifteen subjects were enrolled (mean age 58.2 years, HbA1c 6.9%, body weight 93.9 kg, diabetes duration 3.1 years; 13 [86.7%] males). Fasting concentrations of glucose were significantly lower, and C‐peptide significantly greater, with oral semaglutide versus placebo. Postprandial glucose (AUC0–5h) was significantly lower with oral semaglutide versus placebo (estimated treatment ratio, 0.71; 95% CI, 0.63, 0.81; p < .0001); glucose incremental AUC (iAUC0–5h/5h) and glucagon AUC0–5h were also significantly reduced, with similar results after the fat‐rich breakfast. Fasting concentrations of triglycerides, very low‐density lipoprotein (VLDL) and apolipoprotein B48 (ApoB48) were significantly lower with oral semaglutide versus placebo. AUC0–8h for triglycerides, VLDL and ApoB48, and triglycerides iAUC0–8h/8h, were significantly reduced after oral semaglutide versus placebo. During the first postprandial hour, gastric emptying was delayed (a 31% decrease in paracetamol AUC0–1h) with oral semaglutide versus placebo. One serious adverse event (acute myocardial infarction) occurred during oral semaglutide treatment.ConclusionOral semaglutide significantly improved fasting and postprandial glucose and lipid metabolism, and delayed gastric emptying.

Days Needed to Characterize the Healthfulness of a Typical Dinner Meal in Direct Observational Research: Mixed Methods Study.

BackgroundPrior research around the home meal environment has demonstrated that family meals are associated with positive health outcomes for children and adolescents. Researchers have begun using direct observational methods to understand key aspects of family meals such as meal healthfulness and family meal frequency to explain the protective nature of family meals. Direct observational research, however, can be resource intensive and also burdensome for participants. Information about the number of days needed to sufficiently characterize typical meal healthfulness using direct observational research methods is needed.ObjectiveThe current study aimed to produce guidance about the number of meals necessary to approximate typical meal healthfulness at the family dinner meal occasion in a direct observational, mixed methods study of the home food environment.MethodsFamilies were recruited between 2012-2013 from primary care clinics in the Minneapolis–St Paul metropolitan area (N=120). A total of 800 meals were collected as part of the Family Meals LIVE! mixed methods study. The Healthfulness of Meal Index was used to evaluate meal dietary healthfulness of foods served at 8 family meal occasions. Participating families were provided an iPad (Apple Inc) and asked to video-record 8 consecutive days of family dinner meals with a minimum of two weekend meals. After the meal, families completed a meal screener, which is a self-reported, open-ended measure of the foods served at the meal.ResultsWeekend and weekday meals differed in their measurement of meal healthfulness, indicating that at least one weekday and one weekend day are necessary to approximate meal healthfulness. Single-day measurement mischaracterized the strength of the relationship between the quality of what was served and intake by almost 50%, and 3 to 4 observation days were sufficient to characterize typical weekly meal healthfulness (r=0.94; P<.001).ConclusionsRelatively few direct observational days of family meals data appear to be needed to approximate the healthfulness of meals across 1 week. Specifically, 1 weekday and 1 weekend observation are needed, including a total of 3 to 4 days of direct observational meal data. These findings may inform future direct observational study designs to reduce both research costs and participant burden in assessing features of the meal environment.