The Role of Individualized Exercise Prescription in Obesity Management—Case Study

Introduction: Obesity, or adiposity-based chronic disease (ABCD), is one of the most common health risk factors nowadays. Regular exercise—part of complex lifestyle medicine program—is effective treatment for obesity but is still underestimated. Monitoring andindividualization by an exercise professional is needed to define the accurate dose effect. Materials and Methods: The 30-week lifestyle change program of a 65-year-old male patient (body mass index (BMI) 43.8 kg/m2) was followed by a medical doctor, exercise physiologist, and nutritionist. Over regular controls and blood tests, each training activity was measured with a heart rate monitor watch, and a diet diary was written. Results: Bodyweight decreased by 24.1 kg (18.4%) and BMI to 35.8 kg/m2. Decreased resting heart rate (from 72 bpm to 63 bpm), diastolic blood pressure (from 72 mmHg to 67 mmHg), and increased systolic blood pressure (from 126 mmHg to 135 mmHg) were reported, besides the reduction in antihypertensive and antidiabetic medicines. Blood test results and fitness level improved, and daily steps and time spent training increased. Conclusions: Lifestyle medicine with professional support is an effective and long-term treatment for ABCD. Individualized exercise and nutritional therapy are essential, and wearable technology with telemedicine consultation also has an important role.

Diet’s Cariogenicity and Healthfulness Index (DCHI) - A novel, comprehensive index for children

Background:A realistic and tailored dietary advice plays a vital role in Preventive Dentistry. An appropriate diet analysis forms the bases for a precise dietary advice. Analysis of diet for its cariogenicity is a complex process thus performing a meaningful diet analysis is a challenge in routine clinical practice. Currently, very few tools are available for researchers or clinicians to assess children’s diet relating to caries risk. To the best of our knowledge an index that helps clinician to reduce composite diet diary information to a simple quantifiable interpretation is lacking. The current scientific paper presents a novel index that assesses the cariogenicity and healthfulness of child’s diet objectively and guides the professional to achieve pragmatic diet modification in the prevention of dental caries. Methods:A team comprised of specialist from division of Pediatric dentistry, Community medicine and Diet and Nutrition along with a pilot parent-child population of number 50 were involved in initial structuring of Diet’s Cariogenicity and Healthfulness Index.To obtain cut off values for cariogenicity of diet score a study was carried out with sample of 774 children correlating diet diary with caries status. A Receiver Operating Characteristic curve closest to the ideal of 100% sensitivity and 100% specificity was applied for statistical analysis.Results:Receiver Operating Characteristic curves plotted was 22.5 for diet scores for its cariogenicity. The sensitivity, specificity, and area under the curve of these cut‐off values were 70 and 95.Conclusions:The current scientific paper presents a novel Diet’s Cariogenicity and Healthfulness Index that assesses the cariogenicity and healthfulness of child’s diet objectively so as to guide the professional to achieve a pragmatic diet modification.

Constipation and Its Associated Factors among Patients with Dementia

Constipation is one of the most frequent non-motor problems in older adults. As constipation is commonly ignored by dementia patients, it is not usually reported on time. Constipation has a serious impact on the activity of daily living and quality of life in dementia patients. The relationships between constipation, demographic variables, and the nutritional status of patients with dementia remain unknown. This study aimed to assess the possible factors associated with constipation. This cross-sectional study was conducted at the Kaohsiung Chang Gung Memorial Hospital from January to November 2019. This hospital is a medical center and the main referral hospital of southern Taiwan, serving 3 million inhabitants. In total, 119 patients with dementia were evaluated using the Rome III diagnostic criteria for functional constipation. There were 30 patients with dementia included in the constipation group and 89 patients with dementia included in the no constipation group. Mini-Nutritional Assessment and 3-day diet diary records were employed. The clinical dementia rating score was used to evaluate the severity of dementia in patients of the outpatient clinic. Approximately 25.2% of dementia patients had constipation. Patients in the dementia with constipation group were older, had severer dementia, and displayed a lower water intake. After multivariable adjustment, low liquid consumption was the predictor of constipation among patients with dementia. The findings support the clinical recommendations to treat constipation with an increased liquid intake, but not exercise, in dementia patients.

The Effect of Soluble Fiber Dextrin on Subjective and Physiological Markers of Appetite: A Randomized Trial

Obesity is a leading public health problem throughout the world. The development of foods that increase satiety and reduce food may aid weight management. This study determined the effect of consuming soluble fiber dextrin (SFD) on appetite, appetitive hormones, breath hydrogen and food intake in adults. Forty-three participants completed this study. For each treatment, 50% of the SFD was provided in liquid form as part of breakfast and 50% in solid form as a morning snack. Appetite questionnaires, blood and breath samples were collected immediately before breakfast and at regular intervals during the test session. The participants consumed an ad libitum lunch meal, afternoon snack and dinner meal, and the amount eaten was recorded. Following dinner, participants left the laboratory but were required to keep a diet diary for the remainder of the day. Breath hydrogen concentration was significantly higher following the consumption of SFD compared to control (p < 0.05). There was no observed overall treatment effect of consuming SFD on GLP-1 (Glucagon-Like-Peptide-1), ghrelin, CCK-8 (Cholecystokinin) or PYY3-36 (Petptide YY) (p > 0.05). Moreover, consuming foods containing SFD had no effect on subjective appetite or food intake (p > 0.05). Consuming foods containing SFD increased breath hydrogen but did not influence food intake, appetite or appetitive hormones. However, the limitations of this study may have individually or collectively masked an effect of SFD on food intake and appetite.

Frequency of Yogurt Consumption and Its Association with Dietary Intake and Diet Quality in UK Children and Adults, National Diet and Nutrition Survey 2014–2017

Objectives Yogurt is a popular food in the United Kingdom. It has been reported that yogurt consumption is associated with improved nutrient intake and diet quality in other countries. The objective of this study was to examine frequency of yogurt consumption and its association with dietary intake and diet quality in children and adults in the United Kingdom. Methods Children aged 1.5–18 years old (N = 1912) and adults aged 19 years or older (N = 2064) from the National Diet and Nutrition Survey year 7 to year 9 (2014/15–2016/17) were included in the study. Four-day diet diary data were used to classify participants by frequency of yogurt consumption based on the number of days with yogurt consumption (non-eaters, 0 day; occasional eaters, 1–2 days; regular eaters, 3–4 days). Dietary intake was calculated as the average intake across 4 days for each participant. Associations between frequency of yogurt consumption and dietary intake were assessed by survey multiple linear regression, adjusted for age, gender, equivalized family income levels, and calorie intake. Diet quality was assessed using a modified version of the Nutrient Rich Food Index 9.3. Results Thirty-six % of children and 25% of adults were occasional yogurt eaters and 16% of children and 14% of adults were regular eaters. In children, regular yogurt eaters had significantly higher intake of total energy, total sugar, vitamin A, thiamin, riboflavin, folate, vitamin C, vitamin D, potassium, calcium, magnesium, phosphorus, zinc, iodine, with lower intake of fat, than non-eaters and/or occasional eaters (P &lt; 0.05 for all). Similar results were found in adults except that intake of fat and vitamin A was not different, whereas intake of protein, carbohydrate, vitamin B6, vitamin E, iron, selenium and manganese was also significantly higher, together with significantly lower intake of sodium, in regular yogurt eaters, compare to non-eaters and/or occasional eaters (P &lt; 0.05 for all). Diet quality was positively associated with frequency of yogurt consumption in both children and adults (P &lt; 0.05 for both). Conclusions Frequent yogurt consumption is associated with better dietary intake and diet quality in children and adults in the United Kingdom. Funding Sources The study was funded by the Bell Institute of Health and Nutrition, General Mills, Inc.

Promotion of Healthy Nutrition and Physical Activity Lifestyles for Teenagers: A Systematic Literature Review of The Current Methodologies

Amid obesity problems in the young population and apparent trends of spending a significant amount of time in a stationary position, promoting healthy nutrition and physical activities to teenagers is becoming increasingly important. It can rely on different methodologies, including a paper diary and mobile applications. However, the widespread use of mobile applications by teenagers suggests that they could be a more suitable tool for this purpose. This paper reviews the methodologies for promoting physical activities to healthy teenagers explored in different studies, excluding the analysis of different diseases. We found only nine studies working with teenagers and mobile applications to promote active lifestyles, including the focus on nutrition and physical activity. Studies report using different techniques to captivate the teenagers, including questionnaires and gamification techniques. We identified the common features used in different studies, which are: paper diary, diet diary, exercise diary, notifications, diet plan, physical activity registration, gamification, smoking cessation, pictures, game, and SMS, among others.

Mobile Applications for the Promotion and Support of Healthy Nutrition and Physical Activity Habits: A Systematic Review, Extraction of Features and Taxonomy Proposal

Background: Mobile applications can be used for the monitoring of lifestyles and physical activity. It can be installed in commodity mobile devices, which are currently used by different types of people in their daily activities worlwide . Objective: This paper reviews and categorizes the mobile applications related to diet, nutrition, health, physical activity and education, showing the analysis of 73 mobile applications available on Google Play Store with the extraction of the different features. Methods: The mobile applications were analyzed in relation to each proposed category and their features, starting with the definition of the search keywords used in the Google Play Store. Each mobile application was installed on a smartphone, and validated whether it was researched in scientific studies. Finally, all mobile applications and features were categorized. Results: These mobile applications were clustered into four groups, including diet and nutrition, health, physical activity and education. The features of mobile applications were also categorized into six groups, including diet, anthropometric parameters, social, physical activity, medical parameters and vital parameters. The most available features of the mobile applications are weight, height, age, gender, goals, calories needed calculation, diet diary, food database with calories, calories burned and calorie intake. Conclusion: With this review, it was concluded that most mobile applications available in the market are related to diet, and they are important for different types of people. A promising idea for future work is to evaluate the acceptance by young people of such mobile applications.

Mobile Applications for the Promotion and Support of Healthy Nutrition and Physical Activity Habits: A Systematic Review, Extraction of Features and Taxonomy Proposal

Background: Mobile applications can be used for the monitoring of lifestyles and physical activity. It can be installed in commodity mobile devices, which are currently used by different types of people in their daily activities worlwide . Objective: This paper reviews and categorizes the mobile applications related to diet, nutrition, health, physical activity and education, showing the analysis of 73 mobile applications available on Google Play Store with the extraction of the different features. Methods: The mobile applications were analyzed in relation to each proposed category and their features, starting with the definition of the search keywords used in the Google Play Store. Each mobile application was installed on a smartphone, and validated whether it was researched in scientific studies. Finally, all mobile applications and features were categorized. Results: These mobile applications were clustered into four groups, including diet and nutrition, health, physical activity and education. The features of mobile applications were also categorized into six groups, including diet, anthropometric parameters, social, physical activity, medical parameters and vital parameters. The most available features of the mobile applications are weight, height, age, gender, goals, calories needed calculation, diet diary, food database with calories, calories burned and calorie intake. Conclusion: With this review, it was concluded that most mobile applications available in the market are related to diet, and they are important for different types of people. A promising idea for future work is to evaluate the acceptance by young people of such mobile applications.

Effects of Stevia Extract on Postprandial Glucose Response, Satiety and Energy Intake: A Three-Arm Crossover Trial

Non-nutritive sweeteners (NNS) are suggested to lower energy intake in the diet, but they have been paradoxically involved in the epidemic of obesity and Type 2 diabetes. Stevia is the least studied sweetener. This study aims to investigate the effect of stevia on postprandial glucose levels, appetite and food intake. Methods: 30 participants (20 females/10 males; 26.1 (10.56) years; body mass index (BMI) 23.44 (3.42) Kg/m2) took part in a three-arm crossover trial where they received preloads of water, sugar (60 g) and stevia (1 g) on three different days, followed by an ad libitum pizza lunch. Breakfast was standardised. A one-day diet diary was collected on each test day. Visual analogue scales (VAS) were used to assess subjective feelings of appetite. Blood glucose samples were collected at 30-min intervals until 120 min post lunch. Results: Energy intake did not significantly differ between preloads for ad libitum meals (p = 0.78) and overall day (p = 0.33). VAS scores for hunger and desire to eat (DTE) were lower following stevia preload compared to water (p < 0.05). After adjusting for the sugar preload and calorie content, postprandial glucose levels did not significantly differ between interventions. Conclusion: Stevia lowers appetite sensation and does not further increase food intake and postprandial glucose levels. It could be a useful strategy in obesity and diabetes prevention and management.

Controlling the laxative abuse of anorexia nervosa patients with the Serigaya Methamphetamine Relapse Prevention Program workbook: a case report

Background There is no consensus on effective treatment for laxative abuse in patients with eating disorders. Here, we report the case of a patient with laxative abuse who showed some improvement through an intervention based on the Matrix model. Case presentation A woman diagnosed with anorexia nervosa-binge eating/purging type (AN-BP) steadfastly denied laxative abuse and would not admit to suffering from an eating disorder. This led to low motivation for undergoing conventional psychotherapy, psychoeducation, and cognitive behavioral therapy. These were ineffective and followed by repeated cycles of hospitalization and discharge. The patient’s general condition, as depicted by her laboratory and clinical parameters, deteriorated due to the medical complications resulting from laxative abuse. Focusing on laxative abuse, we considered an intervention for drug addiction. Because the patient could maintain a diet diary and acknowledged laxative abuse as a drug addiction, we introduced the Serigaya Methamphetamine Relapse Prevention Program (SMARPP) workbook as a self-administered treatment. The patient meticulously completed the treatment and experienced a gradual improvement in laxative abuse. She has not been re-hospitalized in 4 years, currently performs household chores, and demonstrates improved social function. Conclusions In patients with AN-BP, the SMARPP workbook may be effective in treating laxative abuse.