-
1.
Developing a Food Exchange System for Meal Planning in Vegan Children and Adolescents.
Menal-Puey, S, Martínez-Biarge, M, Marques-Lopes, I
Nutrients. 2018;11(1)
-
-
-
Free full text
Plain language summary
Children diets are usually planned by their parents; therefore, parents' eating patterns have a large influence on children. The aim of this study was to present a practical tool designed to facilitate meal planning in vegan children and adolescents. The tool is based on exchange foods, allowing the personalization of diet plans according to individual preferences, but ensuring that the resulting menu will provide sufficient macro- and micronutrients. Three age groups were defined according to their nutritional needs (1–3 years, 4–10 years, and 11–17 years). Results show that by choosing the proposed number of portions from each subgroup of foods the requirements of key nutrients in vegan diets are easily met. It is advisable that the requirements of vitamins D and B12 are provided through supplementation. Authors conclude that this food exchange system can be used by health professionals to plan balanced vegan meals. They can also be a useful tool for the education of both vegan families and health professionals.
Abstract
Vegan diets in children need to be adequately planned so they can safely meet children's requirements for growth and development. Adequate and realistic meal planning guidelines should not be difficult to achieve, thanks to the increasing number and availability of natural and fortified vegan foods, which can help children to meet all their nutrients requirements. In order to ensure an adequate supply of key nutrients, families and health professionals need accurate, reliable, and easy-to-use meal planning tools. The aim of this article is to provide a practical approach system to meal planning, based on the same food exchange methodology that has been already published in adults. Daily portions of each food exchange group have been calculated so the resulting menu provides at least 90% of the Dietary Reference Intakes (DRIs) of protein, iron, zinc, calcium, and n-3 fatty acids for each age group, sex, and physical activity level. These diets do not provide enough vitamin B-12 and vitamin D. Although fortified plant drinks, breakfast cereals or plant protein-rich products could provide variable amounts of these two vitamins, B12 supplementation is always recommended and vitamin D supplementation should be considered whenever sun exposure is limited. This tool can be used to plan healthful and balanced vegan diets for children and adolescents.
-
2.
Consumption of ultra-processed foods and body fat during childhood and adolescence: a systematic review.
Costa, CS, Del-Ponte, B, Assunção, MCF, Santos, IS
Public health nutrition. 2018;21(1):148-159
-
-
-
Free full text
-
Plain language summary
Childhood and adolescent obesity has presented a growing prevalence over the last three decades. Consumption of ultra-processed foods has been pointed out as a risk factor for increasing obesity, as measured by body mass index, among both adolescents and adults. The aim of this study was to identify papers on the association between consumption of ultra-processed food and body fat during childhood and adolescence. This study is a systemic review of 26 articles that evaluated groups of ultra-processed foods or specific ultra-processed foods. Results showed positive associations between consumption of ultra-processed foods and body fat levels. Authors conclude that the use of a standardized food classification, which makes it possible to consider the level of food processing, is much needed in future studies in order to uncover the role of such foods in obesity epidemics.
Abstract
OBJECTIVE To review the available literature on the association between consumption of ultra-processed foods and body fat during childhood and adolescence. DESIGN A systematic review was conducted in the PubMed, Web of Science and LILACS databases. Studies that evaluated the association between consumption of ultra-processed food (exposure) and body fat (outcome) during childhood and adolescence were eligible. SUBJECTS Healthy children and adolescents. RESULTS Twenty-six studies that evaluated groups of ultra-processed foods (such as snacks, fast foods, junk foods and convenience foods) or specific ultra-processed foods (soft drinks/sweetened beverages, sweets, chocolate and ready-to-eat cereals) were selected. Most of the studies (n 15) had a cohort design. Consumption was generally evaluated by means of FFQ or food records; and body composition, by means of double indirect methods (bioelectrical impedance analysis and skinfolds). Most of the studies that evaluated consumption of groups of ultra-processed foods and soft drinks/sweetened beverages found positive associations with body fat. CONCLUSIONS Our review showed that most studies have found positive associations between consumption of ultra-processed food and body fat during childhood and adolescence. There is a need to use a standardized classification that considers the level of food processing to promote comparability between studies.
-
3.
New Insights about How to Make an Intervention in Children and Adolescents with Metabolic Syndrome: Diet, Exercise vs. Changes in Body Composition. A Systematic Review of RCT.
Albert Pérez, E, Mateu Olivares, V, Martínez-Espinosa, RM, Molina Vila, MD, Reig García-Galbis, M
Nutrients. 2018;10(7)
-
-
-
Free full text
Plain language summary
Metabolic Syndrome is the term used to group a cluster of health concerns including overweight, obesity, hypertension, elevated cholesterol, blood glucose intolerance and insulin resistance which together can contribute to the development of Type II Diabetes and Cardiovascular Disease. Diagnosis is usually given if a patient has three or more of these conditions however the diagnosis in children and adolescents is often inconsistent, and so guidelines for therapeutic strategies for metabolic syndrome also vary greatly. This review looked at 9 studies of children aged up to 19 years old, all diagnosed with metabolic syndrome, and given dietary, physical, psychological, and pharmacological interventions, to try and understand what the best clinical approach might be. It was found that a balanced diet combined with aerobic and resistance exercise helped to significantly reduce body mass, more so than the trials which included treatment with Metformin. A balance diet included calorie restriction and carbohydrate reduction, carefully planned around the daily exercise program of 2-3 resistance sessions each week and frequent cardio sessions of differing intensity and duration. They concluded that a minimum of 6 months was needed to reach optimal weight loss and body fat loss. Overall, the findings of this study support diet and physical exercise as beneficial clinical interventions, whilst the use of medication is still unclear.
Abstract
OBJECTIVE To record which interventions produce the greatest variations in body composition in patients ≤19 years old with metabolic syndrome (MS). METHOD search dates between 2005 and 2017 in peer reviewed journals, following the PRISMA method (Preferred Reporting Items for Systematic reviews and Meta-Analyses). The selection criteria were: diagnostic for MS or at least a criterion for diagnosis; randomized clinical trials, ≤19 years of age; intervention programs that use diet and/or exercise as a tool (interventions showing an interest in body composition). RESULTS 1781 clinical trials were identified under these criteria but only 0.51% were included. The most frequent characteristics of the selected clinical trials were that they used multidisciplinary interventions and were carried out in America. The most utilized parameters were BMI (body mass index) in kg/m² and BW (body weight) in kg. CONCLUSIONS Most of the clinical trials included had been diagnosed through at least 2 diagnostic criteria for MS. Multidisciplinary interventions obtained greater changes in body composition in patients with MS. This change was especially prevalent in the combinations of dietary interventions and physical exercise. It is proposed to follow the guidelines proposed for patients who are overweight, obese, or have diabetes type 2, and extrapolate these strategies as recommendations for future clinical trials designed for patients with MS.
-
4.
Shared Concerns and Opportunity for Joint Action in Creating a Food Environment That Supports Health.
Sonneville, KR, Rodgers, RF
Nutrients. 2018;11(1)
-
-
-
Free full text
Plain language summary
The food industry is a key player in the creation of a food environment, characterised by the over-abundance and aggressive marketing of engineered foods that may increase risk for eating disorders or negatively impact their remission. The aim of this study is to outline the rationale for leveraging food policy as an approach to eating disorders prevention. This study shows that a critical goal for universal prevention measures is to develop and implement effective policy approaches to limit the food industry’s capacity to continue shaping the food environment. However, discretion is important as an unintended consequence of this position may be the proliferation of food industry practices that might increase eating disorder risk. Authors note that eating disorders experts have a crucial part to play in informing policies targeting the food industry to ensure that such policies do no harm. Furthermore, policy efforts targeting the food industry should be considered as a means of improving universal prevention and decreasing an important environmental risk for eating disorders.
Abstract
The food industry is a for-profit industry with high relevance to universal eating disorders prevention. To date, policy which targets the food industry and food environment has been underutilized in efforts to decrease the incidence of eating disorders and associated risk factors. In contrast, food policy has been extensively leveraged with the aim of reducing the incidence of obesity. While philosophical misalignments with these later efforts may have constituted an obstacle to identifying the food environment as a key target for eating disorders prevention, food policy is an area where shared interests can be found. Specifically, a shared goal of obesity and eating disorders prevention efforts is creating a food environment that supports health, while minimizing the influence of the food industry that profits from the sale of highly palatable, processed foods and "diet" foods and from increasing portions of foods served and eaten.
-
5.
Commissioning guidance for weight assessment and management in adults and children with severe complex obesity.
Welbourn, R, Hopkins, J, Dixon, JB, Finer, N, Hughes, C, Viner, R, Wass, J
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2018;19(1):14-27
-
-
-
Plain language summary
Treating severe and complex obesity requires specialist multi-professional teams for assessment, management and optimizing patients’ health outcomes. The aim of this study was to review existing evidence for defining commissioning and delivery of primary or secondary care weight assessment and management clinics to patients needing specialist care for severe and complex obesity. Twenty-two UK royal colleges and professional organizations were invited to develop the guidance revision according to the NICE-accreditation process. Fifty references were included in the final report. The following additions have been identified as new emergent developments to be included in the guidance: - multi-disciplinary team pathways for children/adolescent patients and their transition to adult care, and - anaesthetic assessment and recommendations for ongoing shared care with general practitioners, as a chronic disease management pathway. Authors indicate that the Guidance Development Group recommends the use of the NICE-accredited commissioning guidance as healthcare services in different countries develop services to manage patients with severe and complex obesity.
Abstract
The challenge of managing the epidemic of patients with severe and complex obesity disease in secondary care is largely unmet. In England, the National Institute of Health and Care Excellence and the National Health Service England have published guidance on the provision of specialist (non-surgical) weight management services. We have undertaken a systematic review of 'what evidence exists for what should happen in/commissioning of: primary or secondary care weight assessment and management clinics in patients needing specialist care for severe and complex obesity?' using an accredited methodology to produce a model for organization of multidisciplinary team clinics that could be developed in every healthcare system, as an update to a previous review. Additions to the previous guidance were multidisciplinary team pathways for children/adolescent patients and their transition to adult care, anaesthetic assessment and recommendations for ongoing shared care with general practitioners, as a chronic disease management pathway.
-
6.
Public Health Nutrition special issue on ultra-processed foods.
Kelly, B, Jacoby, E
Public health nutrition. 2018;21(1):1-4
-
-
Free full text
-
Plain language summary
Food processing-based classification systems have been increasingly acknowledged in reports and commentary from the World Health Organisation, Food and Agriculture Organization of the United Nations, and the Pan American Health Organization. The aim of this issue was to examine the role and utility of food processing-based classification systems in food and nutrition research and public policy. This issue shows that food processing-based classification systems: - offer possibilities for use in public policy as a way to define unhealthful dietary patterns. - may underpin other regulatory strategies for the prevention and control of obesity and diet-related non-communicable diseases by identifying unhealthful foods. - could also be applied in local planning regulations, where these seek to influence the availability or accessibility of foods in local environments Authors conclude that food processing-based classification systems have a great potential for wider application in food policy.
-
7.
Behavioral Weight Loss Intervention for Migraine: A Randomized Controlled Trial.
Bond, DS, Thomas, JG, Lipton, RB, Roth, J, Pavlovic, JM, Rathier, L, O'Leary, KC, Evans, EW, Wing, RR
Obesity (Silver Spring, Md.). 2018;26(1):81-87
-
-
-
Free full text
-
Plain language summary
Migraine is a neurological disease characterized by moderate-to-severe headache and accompanying autonomic, affective, and sensory features. It is also comorbid with several diseases, including obesity. The aim of this study was to assess the impact of a standardized behavioural weight loss (BWL) intervention on migraine headache frequency. This study is a parallel-group, single-blinded randomised controlled trail. The participants were randomized to one of the two groups: BWL or migraine education (ME). Results show that changes in migraine headache frequency at post-treatment and follow-up were not significantly different between the BWL and ME control interventions. In fact, both BWL and ME had significant reductions in monthly migraine headache days from baseline to post-treatment and follow-up. Authors conclude that further research is required to better understand treatment mechanisms and whether BWL can enhance effects of standard pharmacologic and/or non-pharmacologic migraine therapies in patients with comorbid overweight/obesity.
Abstract
OBJECTIVE The objective of this study was to test whether behavioral weight loss (BWL) intervention decreases headaches in women with comorbid migraine and overweight or obesity. METHODS This randomized, single-blind trial allocated women 18 to 50 years old with 4 to 20 migraine days per month and a BMI = 25.0-49.9 kg/m2 to 16 weeks of BWL (n = 54), which targeted exercise and eating behaviors for weight loss, or to migraine education control (ME, n = 56), which delivered didactic instruction on migraine and treatments. Participants completed a 4-week smartphone headache diary at baseline, posttreatment (16-20 wk), and follow-up (32-36 wk). The primary outcome was posttreatment change in migraine days per month, analyzed via linear mixed effects models. RESULTS Of 110 participants randomly assigned, 85 (78%) and 80 (73%) completed posttreatment and follow-up. Although the BWL group achieved greater weight loss (mean [95% CI] in kilograms) than the ME group at posttreatment (-3.8 [-2.5 to -5.0] vs. + 0.9 [-0.4 to 2.2], P < 0.001) and follow-up (-3.2 [-2.0 to -4.5] vs. + 1.1 [-0.2 to 2.4], P < 0.001), there were no significant group (BWL vs. ME) differences (mean [95% CI]) in migraine days per month at posttreatment (-3.0 [-2.0 to -4.0] vs. -4.0 [-2.9 to -5.0], P = 0.185) or follow-up (-3.8 [-2.7 to -4.8] vs. -4.4 [-3.4 to -5.5], P = 0.378). CONCLUSIONS Contrary to hypotheses, BWL and ME yielded similar, sustained reductions in migraine headaches. Future research should evaluate whether adding BWL to standard pharmacological and/or nonpharmacological migraine treatment approaches yields greater benefits.
-
8.
Body mass index, abdominal fatness, weight gain and the risk of psoriasis: a systematic review and dose-response meta-analysis of prospective studies.
Aune, D, Snekvik, I, Schlesinger, S, Norat, T, Riboli, E, Vatten, LJ
European journal of epidemiology. 2018;33(12):1163-1178
-
-
-
Free full text
-
Plain language summary
Psoriasis is an immune-mediated inflammatory skin disease characterised by red, itchy, scaly and flaky skin. Research has shown an association between adiposity and inflammation cytokine release triggered by adipose tissue and increased body mass index and psoriasis. In this meta-analysis, seven prospective studies were included, and the association between BMI, abdominal fat, and psoriasis was examined. According to this meta-analysis, the relative risk of psoriasis increases by 19% for every 5-unit increase in BMI, 24% for a 10 cm increase in waist circumference, 37% for a 0.1-unit increase in waist-to-hip ratio, and 11% for a 5 kg weight gain. The risk of psoriasis was lower for people with a BMI below 20, and it was significantly higher for those with a BMI between 22.5-24. Psoriasis risk was positively associated with waist circumference, waist-to-hip ratio, and weight gain. Psoriasis risk escalates by 2-4 times with an increase in each measure of adiposity. Several potential strategies to reduce the risk of psoriasis are identified in this meta-analysis, including weight loss, dietary factors, and physical activity. To evaluate their effectiveness and develop appropriate strategies, further robust studies are needed. Healthcare professionals can use the results of this study to develop potential therapeutic strategies to reduce the risk of psoriasis by understanding the mechanisms and factors associated with the disease.
Abstract
Greater body mass index (BMI) has been associated with increased risk of psoriasis in case-control and cross-sectional studies, however, the evidence from prospective studies has been limited. We conducted a systematic review and dose-response meta-analysis of different adiposity measures and the risk of psoriasis to provide a more robust summary of the evidence based on data from prospective studies. PubMed and Embase databases were searched for relevant studies up to August 8th 2017. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using a random effects model. The summary relative risk (RR) for a 5 unit increment in BMI was 1.19 (95% CI 1.10-1.28, I2 = 83%, n = 7). The association appeared to be stronger at higher compared to lower levels of BMI, pnonlinearity < 0.0001, and the lowest risk was observed at a BMI around 20. The summary RR was 1.24 (95% CI 1.17-1.31, I2 = 0%, pheterogeneity = 0.72, n = 3) per 10 cm increase in waist circumference, 1.37 (95% CI 1.23-1.53, I2 = 0%, pheterogeneity = 0.93, n = 3) per 0.1 unit increase in waist-to-hip ratio, and 1.11 (95% CI 1.07-1.16, I2 = 47%, pheterogeneity = 0.15, n = 3) per 5 kg of weight gain. Adiposity as measured by BMI, waist circumference, waist-to-hip ratio, and weight gain is associated with increased risk of psoriasis.
-
9.
Effect of a lifestyle intervention in obese infertile women on cardiometabolic health and quality of life: A randomized controlled trial.
van Dammen, L, Wekker, V, van Oers, AM, Mutsaerts, MAQ, Painter, RC, Zwinderman, AH, Groen, H, van de Beek, C, Muller Kobold, AC, Kuchenbecker, WKH, et al
PloS one. 2018;13(1):e0190662
-
-
-
Free full text
Plain language summary
Obesity is linked to increase in cardiovascular and related disease risk factors. The rate of prevalence of obesity in childbearing women is on the increase. Based on these data one of the largest randomised control multicentre Lifestyle study was conducted. The aim of this study was to look into the effects of lifestyle intervention on cardio metabolic risk factors in childbearing obese women. The intervention goal was weight loss of 5-10% within six month. The intervention included caloric restriction and moderate physical activity. The result from the study showed lifestyle intervention among obese infertile women improved cardio metabolic health and also their physical quality of life. The authors concluded that based on data from this study infertile obese women, especially prior to infertility treatment, should be informed of the positive effects of lifestyle intervention of diet and physical activity.
Abstract
BACKGROUND The prevalence of obesity, an important cardiometabolic risk factor, is rising in women. Lifestyle improvements are the first step in treatment of obesity, but the success depends on factors like timing and motivation. Women are especially receptive to advice about lifestyle before and during pregnancy. Therefore, we hypothesize that the pre-pregnancy period provides the perfect window of opportunity to improve cardiometabolic health and quality of life of obese infertile women, by means of a lifestyle intervention. METHODS AND FINDINGS Between 2009-2012, 577 infertile women between 18 and 39 years of age, with a Body Mass Index of ≥ 29 kg/m2, were randomized to a six month lifestyle intervention preceding infertility treatment, or to direct infertility treatment. The goal of the intervention was 5-10% weight loss or a BMI < 29 kg/m2. Cardiometabolic outcomes included weight, waist- and hip circumference, body mass index, systolic and diastolic blood pressure, fasting glucose and insulin, HOMA-IR, hs-CRP, lipids and metabolic syndrome. All outcomes were measured by research nurses at randomization, 3 and 6 months. Self-reported quality of life was also measured at 12 months. Three participants withdrew their informed consent, and 63 participants discontinued the intervention program. Intention to treat analysis was conducted. Mixed effects regression models analyses were performed. Results are displayed as estimated mean differences between intervention and control group. Weight (-3.1 kg 95% CI: -4.0 to -2.2 kg; P < .001), waist circumference (-2.4 cm 95% CI: -3.6 to -1.1 cm; P < .001), hip circumference (-3.0 95% CI: -4.2 to -1.9 cm; P < .001), BMI (-1.2 kg/m2 95% CI: -1.5 to -0.8 kg/m2; P < .001), systolic blood pressure (-2.8 mmHg 95% CI: -5.0 to -0.7 mmHg; P = .01) and HOMA-IR (-0.5 95% CI: -0.8 to -0.1; P = .01) were lower in the intervention group compared to controls. Hs-CRP and lipids did not differ between groups. The odds ratio for metabolic syndrome in the intervention group was 0.53 (95% CI: 0.33 to 0.85; P < .01) compared to controls. Physical QoL scores were higher in the lifestyle intervention group (2.2 95% CI: 0.9 to 3.5; P = .001) while mental QoL scores did not differ. CONCLUSIONS In obese infertile women, a lifestyle intervention prior to infertility treatment improves cardiometabolic health and self-reported physical quality of life (LIFEstyle study: Netherlands Trial Register: NTR1530).
-
10.
Dietary intake of antioxidants and fats in the context of coronary heart disease prevention among elderly people.
Kolarzyk, E, Skop-Lewandowska, A, Jaworska, J, Ostachowska-Gąsior, A, Krzeszowska-Rosiek, T
Annals of agricultural and environmental medicine : AAEM. 2018;25(1):131-136
-
-
-
Free full text
Plain language summary
Coronary heart disease (CHD) remains the leading cause of mortality in developed countries and is rapidly becoming a dominant cause of all deaths worldwide. The most important modifiable risk factor for cardiovascular disease is diet. A diet which includes non-hydrogenated unsaturated fats as the predominant form of dietary fat, whole grains as the main form of carbohydrates, an abundance of fruits and vegetables and adequate omega-3 fatty acids, can offer significant protection against CHD. The primary aim of the study was to estimate a diet's antioxidant capacity and assess the hierarchy of contribution of particular food products to a Dietary Antioxidant Index (DAI). The study included 143 men and women aged 65-80 who were independent and without any physical or mental disability. On average, the DAI of study participants was low, with fruit having the largest contribution. In comparison to results obtained in a previous report by the same authors, the study showed that the participants consumed too little antioxidant food, as well as grains and cereal-based products, fresh herbs and beverages. This study recommends that the elderly population should be advised to consume a well-balanced diet rich in antioxidants originating from fresh fruit, vegetables and wholegrains to reduce the risk of CHD.
Abstract
INTRODUCTION Some literature data indicate that the proper intake of exogenic antioxidants from food and the proper intake of fats can offer significant protection against coronary heart disease. OBJECTIVES The estimation of total antioxidant capacity of food intake on the basis of Dietary Antioxidant Index (DAI), together with an assessment of the contribution of particular food products in DAI, and the evaluation of consumption of all dietary fats and frequency of consumption of products that are a source of fats among elderly people in Krakow, Poland. MATERIAL AND METHODS 143 persons (73 women and 70 men) aged 65-80 were studied. None of them was under specialist medical control, including cardiological control. DAI was investigated on the basis of the Food Frequency Questionnaire (FFQ) which included 145 food items. DAI was measured using the method by Benzi and expressed as FRAP (the ability to reduce Fe3+ to Fe2+, measured in mMol/l). The daily intake of fats was estimated using the 24-h nutritional recall. The frequency of fats consumption was estimated with the usage of FFQ. For statistical analysis, χ2 test was used. RESULTS The mean value of DAI of all studied persons was 34.27 + 11.72 mMol/l. The largest percentage of those studied had FRAP values in the range 25-35 mMol/l. The highest contribution in the total DAI value was found in fruit (36.2%), grains and cereal-based products (23.6%), and beverages (24.0%). The consumption of vegetables was on the fourth position (7.1%). The contribution of the remaining food products was low. The consumption of total fats (about 70g/24h) and saturated fatty acids (14% of energetic value) exceeded the recommendations. The participation of mono-and polyunsaturated fatty acids in the diets was not in accordance with recommendations. The most frequently consumed fats were animal fats (sausages, butter) and cakes, but the consumption of vegetable oils, fish, nuts and seeds of oil plants was too low. CONCLUSIONS The majority of elderly people made mistakes in their nutrition. The enrichment in natural antioxidants of the diets of elderly people and the normalization of their fats consumption should become an important element of primary and secondary prophylaxis of cardiovascular diseases.