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Siddiqui SA, Azmy Harahap I, Suthar P, Wu YS, Ghosh N, Castro-Muñoz R. A Comprehensive Review of Phytonutrients as a Dietary Therapy for Obesity. Foods 2023; 12:3610. [PMID: 37835263 PMCID: PMC10572887 DOI: 10.3390/foods12193610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Obesity is a complex medical condition mainly caused by eating habits, genetics, lifestyle, and medicine. The present study deals with traditional diets like the Mediterranean diet, Nordic diet, African Heritage diet, Asian diet, and DASH, as these are considered to be sustainable diets for curing obesity. However, the bioavailability of phytonutrients consumed in the diet may vary, depending on several factors such as digestion and absorption of phytonutrients, interaction with other substances, cooking processes, and individual differences. Hence, several phytochemicals, like polyphenols, alkaloids, saponins, terpenoids, etc., have been investigated to assess their efficiencies and safety in the prevention and treatment of obesity. These phytochemicals have anti-obesity effects, mediated via modulation of many pathways, such as decreased lipogenesis, lipid absorption, accelerated lipolysis, energy intake, expenditure, and preadipocyte differentiation and proliferation. Owing to these anti-obesity effects, new food formulations incorporating these phytonutrients were introduced that can be beneficial in reducing the prevalence of obesity and promoting public health.
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Affiliation(s)
- Shahida Anusha Siddiqui
- Department of Biotechnology and Sustainability, Technical University of Munich, Essigberg 3, 94315 Straubing, Germany
- German Institute of Food Technologies (DIL e.V.), Prof.-von-Klitzing Str. 7, 49610 Quakenbrück, Germany
| | | | - Priyanka Suthar
- Department of Food Science and Technology, Dr. Y. S. Parmar University of Horticulture and Forestry, Solan 173230, Himachal Pradesh, India;
| | - Yuan Seng Wu
- School of Medical and Life Sciences, Sunway University, Subang Jaya 47500, Malaysia;
| | - Nibedita Ghosh
- Department of Pharmacology, Girijananda Chowdhury University, Guwahati 781017, Assam, India;
| | - Roberto Castro-Muñoz
- Tecnologico de Monterrey, Campus Toluca, Av. Eduardo Monroy Cárdenas 2000, San Antonio Buenavista, Toluca de Lerdo 50110, Mexico
- Department of Sanitary Engineering, Faculty of Civil and Environmental Engineering, Gdansk University of Technology, G. Narutowicza St. 11/12, 80-233 Gdansk, Poland
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Zhao R, Zhao L, Gao X, Yang F, Yang Y, Fang H, Ju L, Xu X, Guo Q, Li S, Cheng X, Cai S, Yu D, Ding G. Geographic Variations in Dietary Patterns and Their Associations with Overweight/Obesity and Hypertension in China: Findings from China Nutrition and Health Surveillance (2015-2017). Nutrients 2022; 14:nu14193949. [PMID: 36235601 PMCID: PMC9572670 DOI: 10.3390/nu14193949] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/14/2022] [Accepted: 09/21/2022] [Indexed: 02/07/2023] Open
Abstract
Regional dietetic cultures were indicated in China, but how dietary patterns geographically varied across China is unknown. Few studies systematically investigated the association of dietary patterns with overweight/obesity and hypertension and the potential mechanism with a national sample. This study included 34,040 adults aged 45 years and older from China Nutrition and Health Surveillance (2015−2017), who had complete outcome data, reliable intakes of calorie and cooking oils, unchanged diet habits, and without diagnosed cancer or cardiovascular disease. Outcomes were overweight/obesity and hypertension. By using the Gaussian finite mixture models, four dietary patterns were identified—common rice-based dietary pattern (CRB), prudent diversified dietary pattern (PD), northern wheat-based dietary pattern (NWB), and southern rice-based dietary pattern (SRB). Geographic variations in dietary patterns were depicted by age−sex standardized proportions of each pattern across 31 provinces in China. We assessed the association of these dietary patterns with outcomes and calculated the proportion mediated (PM) by overweight/obesity in the association of the dietary patterns with hypertension. Evident geographic disparities in dietary patterns across 31 provinces were observed. With CRB as reference group and covariates adjusted, the NWB had higher odds of being overweight/obese (odds ratio (OR) = 1.44, 95% confidence interval (CI): 1.36−1.52, p < 0.001) and hypertension (OR = 1.07, 95%CI: 1.01−1.14, p < 0.001, PM = 43.2%), while the SRB and the PD had lower odds of being overweight/obese (ORs = 0.84 and 0.92, 95%CIs: 0.79−0.89 and 0.85−0.99, p < 0.001 for both) and hypertension (ORs = 0.93 and 0.87, 95%CIs: 0.87−0.98 and 0.80−0.94, p = 0.038 for SRB and p < 0.001 for PD, PMs = 27.8% and 9.9%). The highest risk of overweight/obesity in the NWB presented in relatively higher carbohydrate intake (about 60% of energy) and relatively low fat intake (about 20% of energy). The different trends in the association of protein intake with overweight/obesity among dietary patterns were related to differences in animal food sources. In conclusion, the geographic distribution disparities of dietary patterns illustrate the existence of external environment factors and underscore the need for geographic-targeted dietary actions. Optimization of the overall dietary pattern is the key to the management of overweight/obesity and hypertension in China, with the emphasis on reducing low-quality carbohydrate intake, particularly for people with the typical northern diet, and selection of animal foods, particularly for people with the typical southern diet.
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Affiliation(s)
- Rongping Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Liyun Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, State College, PA 16802, USA
| | - Fan Yang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Yuxiang Yang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Hongyun Fang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Lahong Ju
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Xiaoli Xu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Qiya Guo
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Shujuan Li
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Xue Cheng
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Shuya Cai
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Dongmei Yu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- Correspondence: (D.Y.); (G.D.)
| | - Gangqiang Ding
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- Correspondence: (D.Y.); (G.D.)
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Woodside J, Young IS, McKinley MC. Culturally adapting the Mediterranean Diet pattern - a way of promoting more 'sustainable' dietary change? Br J Nutr 2022; 128:693-703. [PMID: 35734884 PMCID: PMC9346614 DOI: 10.1017/s0007114522001945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Average diet quality is low in the UK and is socioeconomically patterned, contributing to the risk of non-communicable disease and poor health. Achieving meaningful dietary change in the long term is challenging, with intervention required on a number of different levels which reflect the multiple determinants of dietary choice. Dietary patterns have been identified which contribute positively to health outcomes; one of these is the Mediterranean diet (MD) which has been demonstrated to be associated with reduced non-communicable disease risk. Most research exploring the health benefits of the MD has been conducted in Mediterranean regions but, increasingly, research is also being conducted in non-Mediterranean regions. The MD is a dietary pattern that could have positive impacts on both health and environmental outcomes, while being palatable, appetising and acceptable. In this review, we consider the studies that have explored transferability of the MD. To achieve long-term dietary change towards a MD, it is likely that the dietary pattern will have to be culturally adapted, yet preserving the core health-promoting elements and nutritional composition, while considering the food system transition required to support changes at population level. Population-specific barriers need to be identified and ways sought to overcome these barriers, for example, key food availability and cost. This should follow a formal cultural adaptation framework. Such an approach is likely to enhance the extent of adherence in the longer term, thus having an impact on population health.
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Affiliation(s)
- Jayne Woodside
- Centre for Public Health, Institute for Clinical Science A, Grosvenor Road, Belfast, Queen’s University Belfast, BelfastBT12 6BJ, UK
- Institute for Global Food Security, Queen’s University Belfast, Belfast, UK
- Corresponding author: Jayne Woodside, email
| | - Ian S. Young
- Centre for Public Health, Institute for Clinical Science A, Grosvenor Road, Belfast, Queen’s University Belfast, BelfastBT12 6BJ, UK
- Institute for Global Food Security, Queen’s University Belfast, Belfast, UK
| | - Michelle C. McKinley
- Centre for Public Health, Institute for Clinical Science A, Grosvenor Road, Belfast, Queen’s University Belfast, BelfastBT12 6BJ, UK
- Institute for Global Food Security, Queen’s University Belfast, Belfast, UK
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Luo Y, Wang J, Sun L, Gu W, Zong G, Song B, Shen C, Zhou P, Chen Y, Wu Y, Lin H, Zheng H, Ni M, Yang X, Chen Y, Xu X, Zhang J, Shi J, Zhang R, Hu J, Hou H, Lu L, Xu X, Liang L, Liu R, Liu X, Li H, Hong J, Wang W, Lin X, Ning G. Isocaloric-restricted Mediterranean Diet and Chinese Diets High or Low in Plants in Adults With Prediabetes. J Clin Endocrinol Metab 2022; 107:2216-2227. [PMID: 35579171 PMCID: PMC9282247 DOI: 10.1210/clinem/dgac303] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Indexed: 12/02/2022]
Abstract
CONTEXT Calorie restriction plus dietary advice is suggested as a preventive strategy for individuals with obesity and prediabetes; however, optimal diet is still debatable. We aimed to compare the effects of Mediterranean diet (MD) and Chinese diets high or low in plants on body weight and glucose homeostasis among high-risk Chinese. SUBJECTS AND METHODS In this parallel-arm randomized controlled trial, 253 Chinese adults aged 25 to 60 years with a body mass index ≥ 24.0 kg/m2 and fasting blood glucose ≥ 5.6 mmol/L were randomly assigned to 3 isocaloric-restricted diets: MD (n = 84), a traditional Jiangnan diet high in plants (TJD, n = 85), or a control diet low in plants (CD, n = 84). During the 6-month trial, a 5-weekday full-feeding regimen was followed, along with mobile app-based monitoring. Abdominal fat measurement (magnetic resonance imaging), oral glucose tolerance test (OGTT), and continuous glucose monitoring (CGM) were conducted at baseline and 3 and 6 months. RESULTS With a 25% calorie restriction for 6 months, weight deduction was 5.72 kg (95% confidence interval, 5.03-6.40) for MD, 5.05 kg (4.38-5.73) for TJD, and 5.38 kg (4.70-6.06) for CD (Ptime < 0.0001). No between-group differences were found for fasting glucose, insulin, and the Matsuda index from OGTT. Notably, CD had significantly longer time below range (glucose < 3.9 mmol/L) than MD (0.81% [0.21-1.40], P = 0.024) and marginally longer time than TJD (0.56% [-0.03 to 1.15], P = 0.065), as measured by CGM. CONCLUSIONS With the 6-month isocaloric-restricted feeding, TJD and MD achieved comparable weight deduction and improved glucose homeostasis, whereas CD showed a higher risk for hypoglycemia.
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Affiliation(s)
| | - Jiqiu Wang
- Jiqiu Wang, MD, PhD, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Department of Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Rd, Shanghai, 200025, China.
| | | | | | - Geng Zong
- Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Boyu Song
- Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Chongrong Shen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Puchen Zhou
- Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Yufei Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yanpu Wu
- Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Huibin Lin
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - He Zheng
- Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Mengshan Ni
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xiaowei Yang
- Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Yanru Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xinming Xu
- Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Juan Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Juan Shi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Ru Zhang
- SAIC Volkswagen Automotive Company Limited, Shanghai, 201805, China
| | - Jinfen Hu
- SAIC Volkswagen Automotive Company Limited, Shanghai, 201805, China
| | - Hong Hou
- SAIC Volkswagen Automotive Company Limited, Shanghai, 201805, China
| | - Ling Lu
- Key Laboratory of Systems Health Science of Zhejiang Province, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou, 310024, China
- Key Laboratory of Systems Biology, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Hangzhou, 310024, China
| | | | - Liming Liang
- Department of Epidemiology and Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, 02115, USA
| | - Ruixin Liu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xiaoran Liu
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Huaixing Li
- Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Jie Hong
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xu Lin
- Xu Lin, MD, PhD, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, 320 Yue-yang Rd., Shanghai, 200031, China.
| | - Guang Ning
- Correspondence: Guang Ning, MD, PhD, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Department of Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Rd, Shanghai, 200025, China.
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OUP accepted manuscript. Nutr Rev 2022; 80:2017-2028. [DOI: 10.1093/nutrit/nuac020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Sharma SV, McWhorter JW, Chow J, Danho MP, Weston SR, Chavez F, Moore LS, Almohamad M, Gonzalez J, Liew E, LaRue DM, Galvan E, Hoelscher DM, Tseng KC. Impact of a Virtual Culinary Medicine Curriculum on Biometric Outcomes, Dietary Habits, and Related Psychosocial Factors among Patients with Diabetes Participating in a Food Prescription Program. Nutrients 2021; 13:nu13124492. [PMID: 34960044 PMCID: PMC8707163 DOI: 10.3390/nu13124492] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/08/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
Culinary medicine is an evidence-based approach that blends the art of cooking with the science of medicine to inculcate a healthy dietary pattern. Food prescription programs are gaining popularity in the Unites States, as a means to improve access to healthy foods among patient populations. The purpose of this paper is to describe the implementation and preliminary impact of A Prescription for Healthy Living (APHL) culinary medicine curriculum on biometric and diet-related behavioral and psychosocial outcomes among patients with diabetes participating in a clinic-led food prescription (food Rx) program. We used a quasi-experimental design to assess APHL program impact on patient biometric outcome data obtained from electronic health records, including glycosylated hemoglobin (HbA1c), body mass index (BMI), and blood pressure (n = 33 patients in the APHL group, n = 75 patients in the food Rx-only group). Pre-post surveys were administered among those in the APHL group to monitor program impact on psychosocial and behavioral outcomes. Results of the outcome analysis showed significant pre-to-post reduction in HbA1c levels among participants within the APHL group (estimated mean difference = -0.96% (-1.82, -0.10), p = 0.028). Between-group changes showed a greater decrease in HbA1c among those participating in APHL as compared to food Rx-only, albeit these differences were not statistically significant. Participation in APHL demonstrated significant increases in the consumption of fruits and vegetables, fewer participants reported that cooking healthy food is difficult, increased frequency of cooking from scratch, and increased self-efficacy in meal planning and cooking (p < 0.01). In conclusion, the results of our pilot study suggest the potential positive impact of a virtually-implemented culinary medicine approach in improving health outcomes among low-income patients with type 2 diabetes, albeit studies with a larger sample size and a rigorous study design are needed.
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Affiliation(s)
- Shreela V. Sharma
- Department of Epidemiology, Human Genetics & Environmental Sciences, Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, 1200 Pressler, Houston, TX 77030, USA; (J.C.); (M.P.D.); (F.C.); (M.A.)
- Correspondence: ; Tel.: +1-713-500-9344
| | - John W. McWhorter
- Department of Health Promotion Behavioral Sciences, Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, 1200 Pressler, Houston, TX 77030, USA; (J.W.M.); (S.R.W.); (L.S.M.)
| | - Joanne Chow
- Department of Epidemiology, Human Genetics & Environmental Sciences, Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, 1200 Pressler, Houston, TX 77030, USA; (J.C.); (M.P.D.); (F.C.); (M.A.)
| | - Melisa P. Danho
- Department of Epidemiology, Human Genetics & Environmental Sciences, Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, 1200 Pressler, Houston, TX 77030, USA; (J.C.); (M.P.D.); (F.C.); (M.A.)
| | - Shannon R. Weston
- Department of Health Promotion Behavioral Sciences, Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, 1200 Pressler, Houston, TX 77030, USA; (J.W.M.); (S.R.W.); (L.S.M.)
| | - Fatima Chavez
- Department of Epidemiology, Human Genetics & Environmental Sciences, Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, 1200 Pressler, Houston, TX 77030, USA; (J.C.); (M.P.D.); (F.C.); (M.A.)
| | - Laura S. Moore
- Department of Health Promotion Behavioral Sciences, Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, 1200 Pressler, Houston, TX 77030, USA; (J.W.M.); (S.R.W.); (L.S.M.)
| | - Maha Almohamad
- Department of Epidemiology, Human Genetics & Environmental Sciences, Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, 1200 Pressler, Houston, TX 77030, USA; (J.C.); (M.P.D.); (F.C.); (M.A.)
| | - Jennifer Gonzalez
- Population Health, Harris Health System, 4800 Fournace Place, Bellaire, TX 77401, USA; (J.G.); (D.M.L.); (E.G.); (K.C.T.)
| | - Esther Liew
- Food For Change Health Partnerships, Houston Food Bank, 535 Portwall Street, Houston, TX 77029, USA;
| | - Denise M. LaRue
- Population Health, Harris Health System, 4800 Fournace Place, Bellaire, TX 77401, USA; (J.G.); (D.M.L.); (E.G.); (K.C.T.)
| | - Esperanza Galvan
- Population Health, Harris Health System, 4800 Fournace Place, Bellaire, TX 77401, USA; (J.G.); (D.M.L.); (E.G.); (K.C.T.)
| | - Deanna M. Hoelscher
- Department of Health Promotion Behavioral Sciences, Michael & Susan Dell Center for Healthy Living, Austin Regional Campus, University of Texas School of Public Health, 1616 Guadalupe, Austin, TX 78701, USA;
| | - Karen C. Tseng
- Population Health, Harris Health System, 4800 Fournace Place, Bellaire, TX 77401, USA; (J.G.); (D.M.L.); (E.G.); (K.C.T.)
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McWhorter JW, Danho MP, LaRue DM, Tseng KC, Weston SR, Moore LS, Durand C, Hoelscher DM, Sharma SV. Barriers and Facilitators of Implementing a Clinic-Integrated Food Prescription Plus Culinary Medicine Program in a Low-Income Food Insecure Population: A Qualitative Study. J Acad Nutr Diet 2021; 122:1499-1513. [PMID: 34839026 DOI: 10.1016/j.jand.2021.11.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/11/2021] [Accepted: 11/20/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Food prescription and culinary medicine programs are gaining popularity as tools for decreasing food insecurity, increasing personal agency, promoting healthy eating, and reducing the risk of chronic diseases. However, there is a gap in understanding of how health care professionals can deliver evidence-based how-to nutrition information that is tailored for culturally diverse, low-income populations. OBJECTIVE To understand the barriers and facilitators for healthy eating among a low-income, diverse population with diabetes, and the gaps in knowledge and training needed for registered dietitian nutritionists (RDN) to address patient barriers when implementing a food prescription and CM program in a healthcare setting. DESIGN A series of nine focus groups were conducted: six focus groups with patients with diabetes (n = 40) (three in English and three in Spanish) and three focus groups with RDN employees (n = 17). PARTICIPANTS/SETTING A convenience sample of 40 low-income food insecure patients with diabetes receiving care at a diverse, integrated, safety net health care system in an urban setting in Texas and convenience sample of 17 RDN employees. STATISTICAL ANALYSIS All focus group transcripts were examined by independent reviewers and blind catalogued and organized into common themes and subthemes based on constant comparative methodology. Investigator group consensus was reached on emergent themes and subthemes for the respective focus groups. RESULTS Patients reported frustration with mixed dietary messages from different health care providers, lack of culturally inclusive recommendations, and a desire for skills to prepare tasty and healthy food. RDNs desired more training and education in cultural humility, culinary nutrition skills, and behavioral change theory. CONCLUSIONS Our study describes how cultural humility, practical culinary nutrition skills, and consistent and coordinated messaging can help to improve patient nutrition care. Before implementation of a food prescription and culinary medicine program, efforts should promote training of RDN staff in culinary nutrition and related areas to increase acceptability and adherence of the program for patients.
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Affiliation(s)
- John Wesley McWhorter
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, Texas; Nourish Program, UTHealth School of Public Health, Houston, Texas.
| | - Melisa P Danho
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Houston, Texas
| | - Denise M LaRue
- Population Health Transformation, Harris Health System, Houston, Texas
| | - Karen C Tseng
- Population Health Transformation, Harris Health System, Houston, Texas
| | - Shannon R Weston
- Nourish Program, UTHealth School of Public Health, Houston, Texas
| | - Laura S Moore
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, Texas; Nourish Program, UTHealth School of Public Health, Houston, Texas
| | - Casey Durand
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, Texas
| | - Deanna M Hoelscher
- Michael and Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin, Austin, Texas
| | - Shreela V Sharma
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Houston, Texas
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Effects of a Community-Based Behavioral Intervention with a Traditional Atlantic Diet on Cardiometabolic Risk Markers: A Cluster Randomized Controlled Trial ("The GALIAT Study"). Nutrients 2021; 13:nu13041211. [PMID: 33916940 PMCID: PMC8067574 DOI: 10.3390/nu13041211] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/30/2021] [Accepted: 04/03/2021] [Indexed: 12/30/2022] Open
Abstract
The Atlantic diet, the traditional dietary pattern in northern Portugal and northwest Spain, has been related to metabolic health and low ischemic heart disease mortality. The Galiat Study is a randomized controlled trial aimed to assess the effects of the Atlantic diet on anthropometric variables, metabolic profile, and nutritional habits. The dietary intervention was conducted in 250 families (720 adults and children) and performed at a primary care center. Over six months, families randomized to the intervention group received educational sessions, cooking classes, written supporting material, and foods that form part of the Atlantic diet, whereas those randomized to the control group followed their habitual lifestyle. 213 families (92.4%) completed the trial. Adults in the intervention group lost weight as opposed to controls who gained weight (adjusted mean difference -1.1 kg, p < 0.001) and total serum cholesterol (adjusted mean difference -5.2 mg/dL, p = 0.004). Significant differences in favor of the intervention were found in other anthropometric variables and low-density lipoprotein cholesterol, but changes in triglycerides, high-density lipoprotein cholesterol, inflammation markers, blood pressure, and glucose metabolism were not observed. A family-based nutritional intervention based on the Atlantic diet showed beneficial effects on adiposity and the lipid profile.
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Dragomanovich HM, Shubrook JH. Improving Cultural Humility and Competency in Diabetes Care for Primary Care Providers. Clin Diabetes 2021; 39:220-224. [PMID: 33986576 PMCID: PMC8061540 DOI: 10.2337/cd20-0063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Jay H Shubrook
- Touro University College of Osteopathic Medicine, Fairfield, CA
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Guo Y, Bian X, Liu J, Zhu M, Li L, Yao T, Tang C, Ravichandran V, Liao P, Papadimitriou K, Yin J. Dietary Components, Microbial Metabolites and Human Health: Reading between the Lines. Foods 2020; 9:E1045. [PMID: 32756378 PMCID: PMC7466307 DOI: 10.3390/foods9081045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 02/06/2023] Open
Abstract
Trillions of bacteria reside in the human gut and they metabolize dietary substances to obtain nutrients and energy while producing metabolites. Therefore, different dietary components could affect human health in various ways through microbial metabolism. Many such metabolites have been shown to affect human physiological activities, including short-chain fatty acids metabolized from carbohydrates; indole, kynurenic acid and para-cresol, metabolized from amino acids; conjugated linoleic acid and linoleic acid, metabolized from lipids. Here, we review the features of these metabolites and summarize the possible molecular mechanisms of their metabolisms by gut microbiota. We discuss the potential roles of these metabolites in health and diseases, and the interactions between host metabolism and the gut microbiota. We also show some of the major dietary patterns around the world and hope this review can provide insights into our eating habits and improve consumers' health conditions.
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Affiliation(s)
- Yao Guo
- Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha 410006, China; (Y.G.); (X.B.); (J.L.); (M.Z.); (L.L.); (T.Y.); (C.T.)
- Hunan International Joint Laboratory of Animal Intestinal Ecology and Health, College of Life Science, Hunan Normal University, Changsha 410006, China
| | - Xiaohan Bian
- Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha 410006, China; (Y.G.); (X.B.); (J.L.); (M.Z.); (L.L.); (T.Y.); (C.T.)
- Hunan International Joint Laboratory of Animal Intestinal Ecology and Health, College of Life Science, Hunan Normal University, Changsha 410006, China
| | - Jiali Liu
- Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha 410006, China; (Y.G.); (X.B.); (J.L.); (M.Z.); (L.L.); (T.Y.); (C.T.)
- Hunan International Joint Laboratory of Animal Intestinal Ecology and Health, College of Life Science, Hunan Normal University, Changsha 410006, China
| | - Ming Zhu
- Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha 410006, China; (Y.G.); (X.B.); (J.L.); (M.Z.); (L.L.); (T.Y.); (C.T.)
| | - Lin Li
- Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha 410006, China; (Y.G.); (X.B.); (J.L.); (M.Z.); (L.L.); (T.Y.); (C.T.)
| | - Tingyu Yao
- Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha 410006, China; (Y.G.); (X.B.); (J.L.); (M.Z.); (L.L.); (T.Y.); (C.T.)
| | - Congjia Tang
- Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha 410006, China; (Y.G.); (X.B.); (J.L.); (M.Z.); (L.L.); (T.Y.); (C.T.)
| | - Vinothkannan Ravichandran
- State Key Laboratory of Microbial Technology, Shandong University–Helmholtz Institute of Biotechnology, Shandong University, Qingdao 266237, China;
| | - Peng Liao
- Institute of Subtropical Agriculture, Chinese Academy of Sciences, Changsha 410125, China;
| | - Konstantinos Papadimitriou
- Department of Food Science and Technology, School of Agriculture and Food, University of Peloponnese, 22131 Antikalamos, Greece;
| | - Jia Yin
- Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha 410006, China; (Y.G.); (X.B.); (J.L.); (M.Z.); (L.L.); (T.Y.); (C.T.)
- Hunan International Joint Laboratory of Animal Intestinal Ecology and Health, College of Life Science, Hunan Normal University, Changsha 410006, China
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Kanter R, León Villagra M. Participatory Methods to Identify Perceived Healthy and Sustainable Traditional Culinary Preparations across Three Generations of Adults: Results from Chile's Metropolitan Region and Region of La Araucanía. Nutrients 2020; 12:E489. [PMID: 32075055 PMCID: PMC7071181 DOI: 10.3390/nu12020489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 02/03/2020] [Accepted: 02/05/2020] [Indexed: 02/04/2023] Open
Abstract
Traditional diets reflect different cultures and geographical locations, and may provide healthy diet options. In Chile, it is unknown whether traditional culinary preparations are still remembered, let alone consumed. Therefore, we adapted methods to identify traditional culinary preparations for healthy and sustainable dietary interventions. In Chile's Metropolitan Region and the Region of La Araucanía, we collected data on the variety of traditional diets through cultural domain analyses: direct participant observation (n = 5); free listing in community workshops (n = 10); and pile sort activities within semi-structured individual interviews (n = 40). Each method was stratified by age (25-45 year, 46-65 year and ≥ 65 year) and ethnic group (first nations or not). About 600 preparations and single-ingredient foods were identified that differed both in frequency and variety by region. The foods most consumed and liked (n = 24-27) were ranked in terms of sustainability for public nutrition purposes. Methods originally designed to collect information about plants of indigenous peoples can be extended to collect data on the variety of existing traditional culinary preparations, globally. Context, both geographical and cultural, matters for understanding food variety, and its subsequent use in the design of healthy and sustainable diet interventions.
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Affiliation(s)
- Rebecca Kanter
- Department of Nutrition, Faculty of Medicine, University of Chile, Independencia 1027, Santiago 8380453, Chile;
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Incorrect Information. JAMA 2020; 323:573. [PMID: 31930370 PMCID: PMC6990724 DOI: 10.1001/jama.2020.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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