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New study finds financial rewards enhance obesity interventions for teens
A recent study has demonstrated that adolescents suffering from severe obesity achieve a more significant reduction in body mass index (BMI) when meal-replacement therapy is supplemented with financial incentives, as opposed to meal-replacement therapy alone. These findings have been documented in an article published by JAMA Pediatrics.
Justin Ryder, PhD, an associate professor involved in both the Surgery Division of Pediatric Surgery and Pediatrics, collaborated on this research. Ryder highlighted the importance of developing more effective treatments for severe obesity, which currently impacts approximately 20% of children and adolescents in the U.S. The Centers for Disease Control and Prevention defines severe obesity as having a BMI at or above the 95th percentile for one’s age and gender. This condition predisposes individuals to a host of future health issues including adult obesity, cardiovascular diseases, and type two diabetes.
Previous studies have shown that meal replacement therapy (MRT), which replaces regular meals with controlled, pre-portioned meals totalling 1,200 calories per day, tends to be more effective than traditional lifestyle changes for reducing BMI in young people with severe obesity. In light of these findings, the recent study aimed to assess whether the addition of financial incentives would enhance the effectiveness of MRT.
“There’s literature for adults that supports that tying in financial incentives to weight loss or physical activity programs increases adherence, and so we wanted to see whether or not adding financial incentives to a behavioural/nutrition weight loss program using meal replacement therapy would increase adherence and through adherence, increase the efficacy of the treatment,” explained Ryder.
The research involved 126 adolescents, divided into two groups of 63 participants each. For one year, one group received MRT along with financial incentives based on their weight reduction from baseline, while the other group received only the MRT. At the end of the 52-week period, the group that received both MRT and financial incentives exhibited a greater decrease in BMI—by 6 percentage points—and a higher reduction in total body fat mass—4.8 kilograms compared to their counterparts who only received MRT.
Ryder added, “Using a cost-effectiveness analysis, we looked at mean fat mass lost between the two treatments and found that despite providing the additional meal replacements for per pound lost, it was cost-effective to do so.”
The study’s authors also noted the need for the development of interventions that maintain effectiveness beyond a one-year timeframe. “While financial incentives plus MRT appears to be a longer-term strategy than MRT alone, treatment withdrawal will likely result in BMI increase. As such, research is needed to identify strategies that are scalable and feasible in the long term given the chronic nature of obesity,” they mentioned.
This pivotal research was funded by multiple grants from the National Institute of Diabetes and Digestive and Kidney Diseases and the National Institutes of Health National Center for Advancing Translational Sciences. Financial support for the meal programs was provided by Healthy For Life Meals, contributing to the resources necessary for this comprehensive study.
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Research highlights how lifestyle can overcome genetic obesity risks
A groundbreaking study published in “Cell Metabolism” has illuminated the powerful role of lifestyle modifications in mitigating the genetic predisposition to obesity, revealing new avenues for managing this global health challenge.
Obesity has reached pandemic proportions, exacerbated by inactive lifestyles and the consumption of high-calorie diets. The condition is influenced by both heritable and polygenic factors, with numerous metabolic pathways and over a thousand genetic variants playing roles. Traditionally, it was assumed that one’s genetic risk for obesity was unalterable.
Recent gene-environment studies have hinted that certain lifestyle choices might lessen the influence of specific genes linked to obesity. These studies, however, typically focused only on limited genes and lifestyle factors, leaving a gap in understanding the broader interaction between lifestyle habits and genetic predispositions.
This latest research delved into whether lifestyle changes could indeed counteract genetic risks. The study cohort included 338,600 white British participants from the UK Biobank, refined to 337,554 after excluding those lacking essential data. Researchers calculated a polygenic score (PGS) from a genome-wide association study on body mass index (BMI) specific to individuals of European descent. They also developed a healthy lifestyle score based on five factors: alcohol consumption, sleep duration, sedentary behaviour, diet, and physical activity. The study’s primary focus was on new obesity cases, with existing obesity cases as a secondary focus.
The researchers predicted absolute risks using odds ratios (ORs) and hazard ratios (HRs) for both new and existing obesity, relative to PGS percentile and lifestyle factors. These ratios were derived from Cox proportional hazard and logistic regression models. They also calculated the probability of developing obesity by age 75 and identified new obesity-related morbidities (ORMs) from various health data sources.
Analyses showed that high genetic risk and unhealthy lifestyle habits were each linked to higher obesity risks, both independently and combined. The risk was most pronounced in those with both high genetic predisposition and poor lifestyle habits, with a HR of 3.54 compared to those with low genetic risk and healthy lifestyles.
Interestingly, the median likelihood of obesity by age 75 varied significantly with lifestyle: 2.8% in those with poor lifestyles versus 1.7% in those with healthier choices. This pattern was echoed in the analysis of existing obesity cases.
The study also found significant additive interactions between lifestyle and genetic risk in terms of obesity incidence, with consistent results from multiplicative interaction analysis. Importantly, sedentary behaviour was linked to the highest obesity risk, regardless of genetic background. Conversely, individuals with high genetic risk but who maintained healthy lifestyles had similar ORMs to those with lower genetic risk.
Overall, the study underscores the profound impact of healthy lifestyle choices in reducing the risk of obesity and its related health issues, even among those with a high genetic predisposition. These findings advocate for the promotion of active, health-conscious behaviours across all genetic backgrounds as a critical strategy in combating obesity.
This research not only challenges the fatalistic view of genetic determinism but also highlights the empowering role of personal lifestyle choices in managing one’s health.
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New research highlights the obesity-fighting properties of the ketogenic diet
A groundbreaking study recently published in Nature Metabolism has uncovered the protective effects of bile acids (BAs) induced by the ketogenic diet (KD) in the fight against obesity.
Obesity is linked to a myriad of health issues including cardiovascular diseases, cancer, diabetes, and non-alcoholic fatty liver disease. These associations underscore the urgent need for effective treatments to alleviate its extensive health impacts.
The ketogenic diet, recognised for its distinctive metabolic effects, has been proven beneficial in managing refractory epilepsy and other health disorders. Research indicates that changes in gut microbiota and metabolites might play a role in the diet’s protective properties against intestinal inflammation and seizures.
Although it’s clear that gut microbiota and metabolites are pivotal in the metabolic transformations elicited by KD in both rodents and humans, the specific microbes and metabolites responsible remain unidentified.
In the referenced study, the efficacy of KD in obesity prevention was demonstrated through an experimental setup involving mice. These mice were fed either a standard chow diet (CD) or a KD for seven weeks. Results indicated significant reductions in fasting glucose levels and body weight in those on KD. Metabolomics analysis further identified shifts in the metabolic profiles of the KD group, with increases in 22 metabolites and decreases in 18.
A subsequent experiment involved feeding mice with CD, KD, or a methionine-supplemented version of KD (KDM) over seven weeks. The addition of methionine to KD reversed the diet’s reductions in glucose levels and body weight and decreased six taurine-conjugated bile acids in serum. KD alone reduced levels of certain unconjugated BAs, which were restored by KDM.
When gut microbiota were depleted, differences in body weight and glucose levels between KD and KDM groups vanished, highlighting the role of microbiota in these effects. Faecal microbiota transplantation (FMT) from KD-fed to CD-fed mice resulted in weight loss and enhanced glucose tolerance. Conversely, FMT from KDM mice had no significant impact.
Further analyses showed that KD reduced the alpha diversity of gut microbiota, a change reversed by KDM. This diet also affected specific bacterial strains, which were restored by KDM supplementation. Studies on energy absorption revealed that KD-fed mice exhibited higher faecal energy content, suggesting a reduction in calorie absorption.
RNA sequencing of ileal tissues indicated that treatment with specific bile acids (TUDCA or TDCA) downregulated CAR1, a gene associated with obesity. These treatments also diminished lipid accumulation in cells, facilitated weight loss, and decreased intestinal lipid absorption in mice.
In models of diabetes and obesity, treatments with TUDCA and TDCA resulted in weight reduction, lower fasting glucose levels, improved glucose tolerance, and decreased liver fat. Human studies paralleled these findings, showing that lower plasma levels of certain conjugated BAs were associated with higher body mass index and fasting glucose levels.
In conclusion, this study illuminates the potential of the ketogenic diet and targeted bile acid treatments in managing obesity and improving metabolic health through modifications in gut microbiota and metabolic processes.
The findings highlight critical host-gut microbiota interactions and support the use of TUDCA and TDCA as potential therapeutic agents for tackling obesity and its associated complications.
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Natural compound found in olives shown to lower blood sugar and aid weight loss, mouse study shows
A novel study conducted using mice models has highlighted the potential of elenolic acid, a natural compound extracted from olives, in mitigating obesity and type 2 diabetes. This groundbreaking research suggests that elenolic acid could serve as a basis for the development of affordable, safe natural products aimed at managing these prevalent health issues.
In a series of experiments, diabetic mice with obesity administered with elenolic acid orally displayed a significant reduction in body weight and enhanced glucose regulation within just one week. These results were noteworthy when compared to a control group of mice with obesity that did not receive the treatment. Remarkably, the glucose-lowering impact of elenolic acid was on par with liraglutide, an injectable diabetes medication, and surpassed the effectiveness of metformin, a commonly used oral diabetes drug.
Professor Dongmin Liu, the lead researcher and a professor at the Department of Human Nutrition, Foods and Exercise at Virginia Tech, explained the motivation behind their focus on natural compounds. “Lifestyle modifications and public health measures have had limited impact on the rising prevalence of obesity, one of the top risk factors for type 2 diabetes. Available obesity drugs are ineffective in weight loss maintenance, expensive and/or carry potential long-term safety risks. Our goal was to develop safer, cheaper and more convenient multi-targeting agents that can prevent the occurrence of metabolic disorders and type 2 diabetes,” stated Liu.
The research findings will be presented by Dr. Hana Alkhalidy, a scientist in Liu’s laboratory, at NUTRITION 2024, the premier annual event of the American Society for Nutrition.
The team at Virginia Tech has previously investigated various natural compounds targeting molecular aspects of metabolism in critical body parts like the pancreas, muscle, fat tissues, and liver. Their latest strategy focuses on stimulating hormone secretion in the gut, a method that could indirectly improve metabolic functions due to natural products’ generally poor bioavailability.
Their screening identified that elenolic acid, found abundantly in mature olives and extra virgin olive oil, stimulates the release of metabolic hormones GLP-1 and PYY in the gut. These hormones are integral during meals, enhancing satiety and regulating blood sugar and metabolism. The researchers synthesized elenolic acid from its precursor, oleuropein, which proved to be a cost-effective method compared to direct extraction from olives.
Further testing revealed that diabetic mice with obesity treated with elenolic acid for four to five weeks showed a 10.7% reduction in obesity and exhibited glucose levels and insulin sensitivity comparable to healthy, lean mice. Additionally, the treatment significantly curbed food intake and fostered weight loss, effects associated with increased levels of PYY and GLP-1 and decreased expression of agouti-related peptide, a hypothalamic peptide that promotes overeating and weight gain when overexpressed.
“Overall, the study showed that elenolic acid from olives has promising effects on hormone release and metabolic health, particularly in obese and diabetic conditions,” Liu remarked. He noted that the compound mimics the physiological conditions of eating to enhance gut metabolic hormone secretion, thereby helping to regulate energy balance and metabolic health.
Despite these promising results, the researchers cautioned that the concentration of elenolic acid in typical olive products is quite low, implying that the health benefits observed in the study are unlikely to be replicated through consumption of olives and olive oil alone.
The research team is now focused on elucidating the metabolic pathway of elenolic acid, from its absorption to its excretion. This exploration will provide further insights into the compound’s efficacy and safety, paving the way for potential clinical trials.
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Nuts can aid in weight loss efforts, research shows
Nuts, often enjoyed as a topping on morning cereal or as a mid-afternoon nibble, may play a pivotal role in effective weight management strategies, according to new research findings.
A study conducted by the University of South Australia has found that nuts can be a beneficial component of calorie-restricted diets aimed at weight loss. The research, which synthesised data from seven randomised controlled trials, assessed the impact of nut inclusion on weight loss and glycemic control within energy-restricted (ER) diets. The findings indicated that including nuts did not negatively affect weight loss outcomes; on the contrary, it may enhance them.
The analysis revealed that in four out of the seven studies, participants who incorporated between 42 to 84 grams of nuts daily into their ER diets experienced significantly greater weight loss—ranging from an additional 1.4 to 7.4 kilograms—compared to those on similar diets without nuts. This weight loss benefit is thought to stem from nuts’ ability to effectively suppress appetite.
In instances where no discernible difference in weight loss was observed between nut-enriched and nut-free diets, the quantity of nuts included in the diets was generally lower.
This research arrives amidst concerning statistics from the Australian Bureau of Statistics, which indicate that 67% of Australian adults are either overweight or obese. Thus, the study’s insights are particularly timely and relevant.
Professor Alison Coates from UniSA highlighted the nutritional value of nuts, advocating for their inclusion in weight-loss diets. “Many people shun nuts in their diet due to the misconception that their high energy and fat content contribute to weight gain,” Professor Coates explained. However, she clarified that nuts are abundant in healthy unsaturated fats, plant proteins, and dietary fibre, all of which aid in promoting fullness and reducing overeating. She also noted nuts’ association with improved cardiovascular health, better gut health, and enhanced cognitive function.
Despite these benefits, it appears that nut consumption among Australians is less than ideal, with 60% of the population reporting they do not consume any nuts at all.
Professor Coates reassured that, contrary to common fears, nuts do not promote weight gain. “If concerns about weight gain have been deterring people from consuming nuts, they need not worry. Nuts do not lead to weight gain and seem to actually support weight loss efforts,” she asserted.
Dr Sharayah Carter, a co-author of the study, also celebrated the findings. She emphasised the unique flavour and texture profile of nuts, which make them an integral part of many diets, and highlighted their convenience as a healthy snack option. “For those who enjoy nuts, it is heartening to know that they can contribute to achieving weight-loss objectives while also enhancing overall health,” Dr Carter said. She added that health professionals should feel confident in recommending nuts as part of a healthy diet, with no adverse effects on weight management.
This study underscores the role of nuts as a beneficial addition to weight loss diets, helping to debunk myths about their dietary impact while promoting their numerous health advantages.
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Experts outline nutrition recommendations for patients treated with obesity medications
As individuals embark on treatment with anti-obesity medications, they frequently experience a diminished appetite which naturally leads to a reduction in food consumption. Given this reduced intake, ensuring a high quality of diet becomes crucial to meet the nutritional demands within the constraints of lower food consumption. To address these challenges, a team of medical experts has articulated a series of evidence-based nutritional guidelines designed to aid healthcare providers in managing patients on anti-obesity medications. These guidelines are detailed in a comprehensive review published in the journal “Obesity,” titled “Nutritional Considerations with Anti-Obesity Medications.”
Lisa M. Neff, the Executive Director of Global Medical Affairs for Obesity at Eli Lilly and Company, who is also the corresponding author of the review, emphasised the purpose of their findings: “Our evidence-based review aims to equip clinicians with knowledge and tools to help support optimal nutritional and medical outcomes for their patients treated with anti-obesity medications.”
The review advocates for the implementation of the “5A’s Model” (Ask, Assess, Advise, Agree, Assist) in clinical practice. This involves clinicians asking for permission to discuss weight management, conducting thorough assessments—including medical, psychosocial, dietary histories, and physical examinations—and identifying root causes of obesity along with any related complications.
After the assessment, healthcare providers should advise patients on treatment options and set realistic expectations. An agreement should be reached on health and lifestyle goals, with continuous assistance provided to overcome any barriers to effective weight management. Acknowledging the chronic nature of obesity, the review suggests regular follow-ups and referrals to dietitians as necessary.
The nutritional advice detailed in the review includes:
- Energy Intake: Tailor calorie intake based on individual factors such as age, sex, body weight, and activity level, with general recommendations of 1,200 to 1,500 kcal/day for women and 1,500 to 1,800 kcal/day for men during weight loss phases.
- Protein: Intake suggestions range from 60 to 75 g/day, with an upper limit of 1.5 g/kg body weight per day, emphasising sources like beans, nuts, seafood, and lean meats. Meal replacements can also be beneficial.
- Carbohydrates: Should constitute 45% to 65% of total energy, with a focus on whole grains, fruits, and vegetables, limiting added sugars to under 10%.
- Fats: Recommended to make up 20% to 35% of daily intake, with saturated fats kept below 10%, prioritising sources like avocados, fatty fish, and vegetable oils while avoiding high-fat and fried foods.
- Fibre: A daily intake of 21–25 g for women and 30–38 g for men is advised, using sources such as fruits, vegetables, and whole grains.
- Micronutrients: Emphasis on potassium, calcium, vitamin D, iron (for women of childbearing age), and vitamin B12 (in older adults), with a recommendation for increased fruit and vegetable consumption and possible supplementation.
- Fluids: A daily fluid intake of over 2 to 3 litres is encouraged, focusing on water and other low-calorie beverages, while limiting caffeine to avoid its diuretic effects.
Jessica Alvarez, Ph.D., RD, an associate professor of medicine at Emory University School of Medicine, not involved in the research, highlighted the broader implications of the study: “Simply focusing on weight loss is insufficient for optimal health,” she noted. “People with obesity are already at risk for some nutrient deficiencies. This is an important guide acknowledging the need for thorough nutritional assessment before and during treatment with anti-obesity medications.”
Alvarez also pointed out the necessity for detailed dietary guidance to prevent nutrient deficiencies and excessive muscle loss, calling for more rigorous clinical research to establish tailored dietary recommendations for this group.
The review’s methodology included a PubMed search using keywords related to diet, nutrition, and obesity, supplemented by expert consensus and observations from various related studies, including those on bariatric surgery and low-calorie diets. This narrative review underscores the importance of continued monitoring and adaptation of dietary guidelines to suit the evolving landscape of obesity treatment.
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The link between chilli pepper consumption and increased obesity risk
In a detailed study published in Frontiers in Nutrition, researchers investigated the association between the frequency of chilli pepper consumption and the risk of developing obesity. The research used comprehensive data from the 2003-2006 National Health and Nutrition Examination Survey (NHANES), which gathers extensive demographic, health, and nutritional information from various age groups and ethnicities across the U.S.
The study involved 6,138 participants, whose chilli intake frequencies were documented through a food frequency questionnaire. Participants were divided into three groups: those who reported no chilli intake, occasional chilli intake, and frequent chilli intake. The researchers used participants’ height and weight data to calculate BMI, considering a BMI of 30 kg/m^2 or more as having obesity. They also examined a broad range of socio-demographic and lifestyle characteristics as covariates in the analysis.
Results from the questionnaire indicated that 16.8% of the study population reported no chilli intake, 74% had occasional chilli intake, and 9.2% had frequent chilli intake. In terms of lifestyle risk factors related to obesity, percentages of participants reporting current smoking habits, alcohol consumption, hypertension, and diabetes were noted respectively.
The analysis did not initially find significant differences in BMI across the three chilli consumption groups. However, a significant positive correlation emerged between the frequency of chilli intake and the prevalence of obesity. The study adjusted for covariates such as age, sex, ethnicity, educational background, marital status, family income, alcohol intake, physical activity level, diabetes presence, and overall dietary intake, revealing that frequent chilli consumers had significantly higher BMI values by about 0.71 units compared to non-consumers. The most frequent chilli consumers had a 55% greater risk of developing obesity compared to those who did not consume chilli peppers.
Moreover, gender appeared to significantly influence the relationship between chilli intake frequency and BMI, with a more pronounced risk of obesity among female participants and those aged 60 years and older. This finding suggests that frequent intake of chilli could substantially increase BMI and obesity risk in U.S. adults, especially among females. This observation aligns with several large-scale observational studies conducted in Asian countries, where the consumption of chilli peppers is relatively high. It is also hypothesised that chilli peppers are often consumed with high-fat, high-calorie foods, which contribute to unhealthy dietary patterns and weight gain.
Due to the study’s cross-sectional design, it was not possible to establish a causal relationship between chilli intake frequency and obesity risk. Additionally, the survey data did not specify the types of chilli peppers consumed, their spiciness levels, or the exact quantities, which are factors that could potentially influence the association with obesity.
Overall, the findings suggest that reducing the intake of chilli peppers might help mitigate the risk of weight gain and obesity. However, further research, particularly longitudinal studies, is required to explore the complexities of how chilli pepper consumption influences body weight and metabolic health.
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High olive oil consumption linked to reduced risk of dementia-related mortality
Recent research highlights a significant association between high olive oil consumption and a decreased risk of mortality due to dementia, regardless of overall diet quality. This insight comes from a prospective study involving over 92,000 participants, suggesting that an intake of at least 7 grams of olive oil daily — approximately half a tablespoon — is linked with a 28% reduction in the risk of dementia-related death.
The research also examined the health benefits of substituting olive oil for more commonly used fats like margarine and mayonnaise. “Replacing one teaspoon of margarine and mayonnaise with the equivalent amount of olive oil was associated with an 8%-14% lower risk for dementia-related mortality,” Anne-Julie Tessier, RD, PhD, from the Department of Nutrition at Harvard T.H. Chan School of Public Health, shared with Medscape Medical News. She emphasised the advantages of opting for natural products like olive oil over more processed fats, highlighting their potential in reducing the risk of fatal dementia. However, Tessier added, “intervention studies are needed to confirm causal effect and optimal quantity of olive oil intake.”
Published on the 6th of May, 2024, in JAMA Network Open, the study leveraged data from the Nurses’ Health Study and the Health Professionals Follow-Up Study, which tracked over 92,000 participants from 1990 to 2018. These individuals, who were free from cardiovascular disease and cancer at the start, were monitored for dietary habits every four years through a food frequency questionnaire and for dementia-related mortality via death records.
The findings showed no interaction by diet quality scores, meaning the reduced risk associated with olive oil consumption occurred independently of overall diet quality. Tessier pointed out that while typically, “people who use olive oil for cooking or as a dressing have an overall better quality of their diet, but interestingly, we found the association between more olive oil and reduced risk of dementia-related death to be regardless of this factor.”
The study acknowledges several limitations, including its observational nature, which makes it challenging to establish cause and effect. “It is also plausible that higher olive oil intake could be indicative of a healthier diet and higher socioeconomic status, although the results remained consistent after accounting for these factors,” the authors noted.
Commenting on the implications of the findings, Rebecca M. Edelmayer, PhD, senior director of scientific engagement for the Alzheimer’s Association, noted the correlation shown by the study but cautioned against drawing causal conclusions. “It would be wonderful if a particular food could delay or prevent Alzheimer’s disease, but we do not have scientific evidence that these claims are true,” Edelmayer commented. She highlighted the necessity for randomised controlled clinical trials to establish whether any foods, including olive oil, have a scientifically proven beneficial effect on cognitive decline and dementia.
This study underscores a promising link between olive oil intake and a reduced risk of dementia-related death, suggesting potential protective benefits. However, further research, particularly interventional studies, is crucial to confirm these observations and understand the underlying mechanisms more fully.
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Clinical study reveals benefits of probiotics and prebiotics in obesity care and weight management
A groundbreaking study published in Scientific Reports explores the potential benefits of integrating a low-calorie diet rich in fibres, probiotic supplementation, and regular physical exercise on the health and body composition of women with obesity in Egypt.
Obesity is a global health issue affecting diverse populations regardless of socio-economic status, age, ethnicity, or gender. The gut microbiota plays a crucial role in overall well-being by influencing metabolism, vitamin synthesis, immune response, and protection against pathogens.
Dietary modifications have been shown to alter the composition and diversity of gut microbiota, offering new avenues for treating conditions like obesity that are linked to gut health. An imbalance in the gut microbiota, particularly the ratio of Firmicutes to Bacteroidetes (F/B ratio), is commonly associated with obesity, suggesting that restoring balance could serve as an effective intervention.
This longitudinal study investigated the effects of a controlled diet, enhanced with fibre and probiotics, alongside regular physical activity, on women with obesity from Egypt. The cohort comprised 58 participants, with an average age of 47 years and a mean body mass index (BMI) of 38 kg/m². They adhered to a structured weight loss diet that emphasised low carbohydrates and high protein and fibre intake, complemented by 100 grams of probiotic-rich yogurt daily. This regimen was designed to supply 49% of the recommended dietary allowance for calories, with a specific macronutrient breakdown of 58% fat, 42% carbohydrates, and high levels of protein (88%) and fibre (95%).
The selected foods included beans, whole grains, legumes, nuts, various fruits and vegetables, low-fat dairy, eggs, cottage cheese, and lean meats. Researchers monitored several physical attributes such as weight, waist and hip circumference, and skinfold thickness at multiple sites according to the International Biological Programme’s guidelines.
Participants underwent extensive health screenings, excluding those with autoimmune, metabolic, or gastrointestinal disorders, or those on conflicting medications like antibiotics. Key metrics such as body composition, including fat mass and fat-free mass, basal metabolic rate, and various anthropometric measurements were recorded.
Researchers also conducted detailed analyses of blood and faecal samples, the latter to assess changes in gut microbiota post-intervention through gene sequencing and real-time polymerase chain reaction (PCR) techniques. They specifically measured levels of Bifidobacteria, Lactobacillus, and the critical F/B ratio.
Post-intervention results were highly encouraging, with significant improvements in body measurements, composition (including reductions in waist circumference, hip circumference, and skinfold thickness), and critical health markers like leptin, and liver enzymes (AST and ALT). The probiotic intervention led to a marked increase in the populations of beneficial bacteria such as Lactobacillus and Bifidobacteria, and a significant reduction in Firmicutes, thereby improving the F/B ratio.
The study also noted strong negative correlations between the F/B ratio and various body composition and metabolic indicators, suggesting that a better balanced gut microbiota is closely linked to improved health outcomes in individuals with obesity.
The integrated approach of a fibre-rich, low-calorie diet, regular physical activity, and probiotic supplementation not only enhanced body composition and facilitated weight loss but also improved important blood markers associated with obesity. The findings underscore the potential of probiotics to aid in weight management by reducing inflammation, enhancing the gut barrier, and modulating various biological functions.
Regular exercise and the strategic use of probiotic supplements appear to be effective in managing obesity-related health issues, indicating a promising strategy for tackling obesity through gut microbiota modulation.
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Research shows effective parental approaches to managing children’s avid eating behaviours
A recent study, published in the journal Appetite, provides an in-depth exploration of how parents cope with their preschool-aged children’s intense eating behaviours, which are often characterised by an elevated responsiveness to food cues. These eating patterns are closely associated with risks of overweight and obesity in children, making the understanding of parental experiences and strategies essential for developing tailored interventions aimed at promoting healthy eating habits.
The research highlights the significance of recognising eating behavioural patterns in children rather than focusing solely on individual eating behaviours. Through the use of Latent Profile Analysis, researchers have identified various eating profiles among preschoolers. These profiles are typically marked by a pronounced enjoyment of food, emotional overeating, minimal fussiness, reduced sensitivity to satiety signals, and a rapid pace of eating. Genetic factors play a substantial role in these appetitive traits, which are also influenced by environmental interactions, thereby affecting the expression of eating behaviours and the potential for obesity.
Parental feeding practices are pivotal in shaping these behaviours, with key practices involving coercive control, structured feeding, and the support of child autonomy. Qualitative research underscores the challenges parents face in managing feeding interactions, especially with children prone to obesity.
The study forms part of the “Appetite in Preschoolers: Producing Evidence for Tailoring Interventions Effectively” (APPETItE) programme. It adheres to pre-registration and qualitative research reporting guidelines, involving parents of 3-5-year-old children who exhibit these intense eating behaviours. A group of 15 parents participated, providing valuable insights through interviews conducted via video calls. Data collected included demographics, food security, and detailed eating behaviour profiles.
Thematic analysis was employed to inductively scrutinise the interview transcripts, with a focus on parental experiences. This process was rigorous, involving regular discussions and maintained reflexivity to ensure integrity in the analysis. The approach followed the systematic six-step process outlined by Braun and Clarke, fostering a comprehensive understanding of the feeding practices applicable to children with intense eating behaviours.
Four primary themes emerged from the analysis:
- Persistent Hunger: Parents noted their children’s continuous requests for food, with some perceiving this as a natural trait, while others expressed concern. Despite frequent eating, the level of satiety control varied among children, with some lacking a clear ‘stop button’.
- Duty of Parenthood: Parents expressed a strong sense of responsibility to keep their children sufficiently fed and to limit exposure to unhealthy foods. They employed various strategies to regulate food intake, focusing on health implications and setting boundaries.
- Instilling Healthy Habits: There was a concerted effort by parents to foster healthy lifelong eating patterns, provide balanced diets, and educate children on the impact of food on health. Monitoring of food intake throughout the day was common, alongside promoting healthier alternatives and encouraging children’s autonomy in food choices.
- Navigational Strategies: Parents described ‘picking their battles’ by establishing clear rules for eating times and occasionally using coercive feeding practices to alleviate personal stress. They balanced routine with flexibility, sometimes allowing children autonomy in food choices.
The research highlights the effectiveness of an authoritative feeding approach that blends control with warmth and responsiveness. However, some parents also resorted to emotional feeding and the use of food as a reward, which could reinforce intense eating behaviours.
Despite providing rich qualitative insights, the study’s findings are limited by a lack of diversity in the sample and potential self-selection bias, which may affect the generalisability of the results. Future research should incorporate objective measures, such as body mass index, to enhance understanding.
In conclusion, this study illuminates the complex dynamics of feeding children with intense eating behaviours and advocates for responsive, nuanced approaches to foster healthy dietary habits.
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Twenty years of research validates mediterranean diet’s role in lowering hypertension risk
A landmark study published in the European Journal of Clinical Nutrition has shed light on the enduring benefits of the Mediterranean diet in preventing hypertension (HTN) over an extensive 20-year period. Conducted among a group of initially non-hypertensive adults, this research marks a significant step in understanding long-term dietary impacts on health.
Hypertension remains a critical challenge globally, significantly influencing the onset of heart diseases and strokes, predominantly in low- and middle-income nations. Despite advancements in medication that stabilise blood pressure, approximately 30% of adults still suffer from HTN, which escalates both the healthcare costs and mortality associated with cardiovascular diseases (CVD). Lifestyle changes such as adopting balanced diets, regular physical activity, and smoking cessation are crucial for managing and preventing HTN. Official health guidelines recommend diets rich in plant-based foods, healthy fats, and lean proteins while being low in sodium and alcohol. The Mediterranean diet, celebrated since the 1960s for its role in preventing chronic conditions and reducing CVD mortality, has lacked long-term concrete evidence of its efficacy in managing blood pressure, prompting further investigation.
The study in question, known as the ATTICA study, complies with the Declaration of Helsinki and explores CVD incidence among Greek adults. Beginning in 2001-2002 with 4,056 individuals from the Attica region invited to participate, 3,042 agreed, embarking on a two-decade-long health journey. Initial assessments involved detailed face-to-face interviews at homes or workplaces by trained health professionals, who collected extensive socio-demographic, clinical, and biochemical data. Key health measures included fasting blood samples for glucose, insulin, total cholesterol, and high sensitivity C-reactive protein levels, among others. Participants also underwent physical examinations to ensure no pre-existing CVD and to measure blood pressure. Lifestyle factors including diet, exercise, and smoking habits were meticulously recorded, using a validated food frequency questionnaire to evaluate adherence to the Mediterranean diet through the MedDietScore.
Throughout the 20-year study period, participant engagement was maintained through regular follow-ups, with the latest in 2022 assessing 2,169 of the original cohort. This follow-up re-evaluated their health outcomes, including HTN, diabetes, and CVD development, corroborating data through family reports and medical records for deceased participants.
Statistical analyses utilised advanced software to contrast initial and 10-year dietary patterns, identifying four distinct adherence trajectories to the Mediterranean diet. Techniques such as correlation coefficients, chi-squared tests, and logistic regression models were employed to ascertain the connection between dietary adherence and HTN risk, accounting for variables like age, sex, body mass index, lifestyle habits, and initial health status.
Findings revealed that at the start, participants averaged 41 years of age with a near-equal gender distribution and showed moderate adherence to the Mediterranean diet, scoring an average MedDietScore of 27.1. Physically, 63.1% were minimally active, and about half were classified as having overweight or obesity. Early medical evaluations noted a 35.3% prevalence of hypercholesterolemia and a 3.9% incidence of diabetes.
Analysis of initial data highlighted a strong negative correlation between adherence to the Mediterranean diet and both systolic and diastolic blood pressures, indicating that higher dietary adherence correlated with lower blood pressure levels. Over the study’s duration, 314 individuals developed hypertension, representing a 22.2% incidence rate. Those who developed HTN typically were older, predominantly male, had higher obesity rates, poorer cardiometabolic profiles, and greater tobacco use compared to those who remained free from HTN.
In-depth analysis demonstrated that participants with low initial MedDietScore faced significantly higher HTN development rates than those with medium or high adherence levels. Statistical evaluation confirmed that each point increase in MedDietScore at baseline correlated with a 7% decrease in HTN risk over 20 years, a relationship that persisted even after adjusting for demographic and lifestyle factors.
The study also examined changes in diet adherence from the start to the 10-year point, revealing varied patterns. Notably, participants consistently adherent to the Mediterranean diet showed a remarkably lower incidence of HTN, with a 46.5% reduced risk in the fully adjusted model, underscoring the diet’s protective effect against HTN when sustained over time.
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Heightened risk of iron deficiency in children with overweight and obesity
A comprehensive study conducted by the University of Leeds’ nutritional scientists has revealed a significant correlation between overweight and obesity in children and young people and an increased risk of iron deficiency. The research, spearheaded by the School of Food Science and Nutrition, involved a meticulous analysis of numerous medical studies across 44 countries, focusing on individuals under 25 years old. These studies assessed levels of essential vitamins and minerals, including iron, in relation to body weight.
The findings indicated that iron deficiency is prevalent among both underweight and overweight youths. Professor Bernadette Moore of the School of Food Science and Nutrition highlighted the broader implications of these findings, suggesting that “Iron status may be the canary in the coalmine, signalling deeper health issues like prolonged inflammation, which is linked to serious conditions including heart disease, diabetes, and fatty liver.”
Unlike deficiencies in zinc and vitamin A, which were primarily found in undernourished children, iron deficiency in overweight children appears to stem from inflammation that disrupts iron absorption. This research, funded by the UK Biotechnology and Biological Sciences Research Council and published in the ‘BMJ Global Health’ journal on 10 May 2024, marks a significant advancement in understanding the nutritional challenges faced by children with obesity.
The impact of iron deficiency on cognitive functions such as attention, concentration, and memory is well-documented, with potential links to conditions like autism and ADHD. This study is pioneering in its focus on the association of iron deficiency with childhood obesity, an area previously unexplored.
Xiaomian Tan, a doctoral researcher at the University, emphasised the importance of this study, stating, “While the link between undernutrition and deficiency of crucial micronutrients in children’s growth is established, the risks posed by obesity—leading to what can be described as a hidden form of malnutrition—are less understood.”
The study also addresses the broader socio-economic implications. Historically, nutrient deficiencies have been associated with hunger, especially in lower- and middle-income countries where they contribute significantly to child mortality. However, the phenomenon of ‘hidden hunger’—nutrient deficiencies in the context of an energy-dense but nutrient-poor diet—is becoming more prevalent in both affluent and developing nations. This is often linked to diets dominated by ultra-processed foods in wealthier countries and limited dietary variety in poorer regions.
The dual burden of malnutrition and overnutrition is particularly pressing in regions like Africa and Asia, which are undergoing rapid economic changes and dietary shifts towards Western high-sugar, high-fat foods. Between 2000 and 2017, the number of overweight children under five years old rose significantly in these continents, alongside an increase in stunting.
Professor Moore also pointed out the alarming trend in the UK, where one in three children by age 11 have overweight or obesity, which compounds the risk of inflammation-driven iron deficiencies. She advocates for increased physical activity and dietary improvements to mitigate these risks.
The call for further research is clear, with an emphasis on the need for more comprehensive studies that address micronutrient deficiencies within the context of the growing global epidemic of obesity, particularly in regions currently lacking detailed data.
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