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Klos B, Cook J, Crepaz L, Weiland A, Zipfel S, Mack I. Impact of energy density on energy intake in children and adults: a systematic review and meta-analysis of randomized controlled trials. Eur J Nutr 2023; 62:1059-1076. [PMID: 36460778 PMCID: PMC10030411 DOI: 10.1007/s00394-022-03054-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 11/10/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE The energy density (ED) of a diet can be leveraged to prevent weight gain or treat overweight and obesity. By lowering the ED of the diet, energy intake can be reduced while maintaining portion size. However, a reliable meta-analysis of data from randomized controlled trials (RCTs) is missing. Therefore, this meta-analysis synthesized the evidence of ED manipulation on energy intake in RCTs. METHODS The systematic literature search of multiple databases according to PRISMA criteria considered RCTs investigating the objectively measured energy intake from meals with different ED (lower ED (median 1.1 kcal/g) versus higher ED (median 1.5 kcal/g)) under controlled conditions. Subgroup analyses for age (children versus adults), meal type (preload versus entrée design), and intervention length (1 meal versus > 1 meal) were performed to achieve the most homogeneous result. RESULTS The meta-analysis of 38 included studies demonstrated that lowering ED considerably reduced energy intake - 223 kcal (95% CI: - 259.7, - 186.0) in comparison to the higher ED interventions. As heterogeneity was high among studies, subgroup analyses were conducted. Heterogeneity decreased in subgroup analyses for age and meal type combined, strengthening the results. An extended analysis showed a positive linear relationship between ED and energy intake. Dietary ED did not affect the amount of food intake. CONCLUSION Manipulating ED substantially affects energy intake whereas food intake remains constant. Thus, this approach can be regarded as a powerful tool for weight management through nutrition therapy. Registration on 08/08/2021: CRD42021266653.
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Affiliation(s)
- Bea Klos
- Internal Medicine VI, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Jessica Cook
- Internal Medicine VI, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Letizia Crepaz
- Internal Medicine VI, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Alisa Weiland
- Internal Medicine VI, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Stephan Zipfel
- Internal Medicine VI, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Isabelle Mack
- Internal Medicine VI, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany.
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Calcaterra V, Rossi V, Mari A, Casini F, Bergamaschi F, Zuccotti GV, Fabiano V. Medical treatment of weight loss in children and adolescents with obesity. Pharmacol Res 2022; 185:106471. [PMID: 36174963 DOI: 10.1016/j.phrs.2022.106471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/16/2022] [Accepted: 09/23/2022] [Indexed: 12/01/2022]
Abstract
Obesity remains one of the biggest health problems both in adults and children. Lifestyle modification, including diet and exercise, continues to be the mainstay of obesity prevention and treatment. Unfortunately, lifestyle modifications are often unsuccessful. Pharmacological treatment of obesity in pediatric patients can be applied in selected cases, and not before evidence of failure of the multidisciplinary lifestyle intervention. In this narrative review, we revised the most up-to-date evidence on medical treatment of weight loss in children and adolescents with obesity, including FDA- or EMA-approved and -experimented, not approved, drugs for pediatric population. Multidisciplinary treatment of childhood obesity, regulation of appetite control, energy balance and body weight were also discussed, in order to clarify the indications and mechanism action of drugs. Despite a substantial number of medications used for the treatment of obesity in adults, a limited number of drugs are approved by the drug regulatory agencies for pediatric population. Further research is needed to evaluate the efficacy and safety of novel pharmacological approaches for treatment of pediatric obesity in order to optimize weight management for children and adolescents and limit the development obesity-related comorbidities.
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Affiliation(s)
- Valeria Calcaterra
- Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy; Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
| | - Virginia Rossi
- Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy
| | - Alessandra Mari
- Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy
| | - Francesca Casini
- Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy
| | | | - Gian Vincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy; Department of Biomedical and Clinical Sciences, Università di Milano, 20122 Milan, Italy
| | - Valentina Fabiano
- Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy; Department of Biomedical and Clinical Sciences, Università di Milano, 20122 Milan, Italy.
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3
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García-Muñoz S, Barlińska J, Wojtkowska K, Da Quinta N, Baranda A, Alfaro B, Santa Cruz E. Is it possible to improve healthy food habits in schoolchildren? A cross cultural study among Spain and Poland. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2022.104534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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4
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Avaliação de serious game em programa de enfrentamento da obesidade infantil. ACTA PAUL ENFERM 2021. [DOI: 10.37689/acta-ape/2021ao001045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Mack I, Reiband N, Etges C, Eichhorn S, Schaeffeler N, Zurstiege G, Gawrilow C, Weimer K, Peeraully R, Teufel M, Blumenstock G, Giel KE, Junne F, Zipfel S. The Kids Obesity Prevention Program: Cluster Randomized Controlled Trial to Evaluate a Serious Game for the Prevention and Treatment of Childhood Obesity. J Med Internet Res 2020; 22:e15725. [PMID: 32329742 PMCID: PMC7210499 DOI: 10.2196/15725] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/02/2019] [Accepted: 12/16/2019] [Indexed: 12/12/2022] Open
Abstract
Background Health games provide opportunities for the treatment and prevention of childhood obesity. We developed a motion-controlled serious game for children that addresses 3 core topics of nutrition, physical activity, and stress coping. It is the first serious game that extensively targets the dietary energy density principle (DED-P) in relation to nutrition. The game is intended to provide an additional educational component for the prevention and treatment of obesity in children. Objective The Kids Obesity Prevention study aimed to evaluate the newly developed game and to evaluate how well children are able to understand and apply the DED-P. Methods This cluster randomized controlled trial collected data from 82 primary school children aged 9 to 12 years and their parents at baseline (T0), at 2 weeks after study commencement (T1), and at the 4-week follow-up (T2). The dropout rate was 3.6%. The intervention group (IG) played the game within 2 weeks (2 sessions with different game modules). One part of the game involves selection of food with the lower energy density when presented with a pair of foods. This allows assessment of whether the children have understood the DED-P and whether they can apply it to unknown foods under time pressure. The control group (CG) received a brochure about the food pyramid concept and physical activity. The primary outcome was the gain in knowledge (nutrition and stress coping) and measured with a pretested questionnaire. The secondary outcomes were the maintenance of knowledge, application of the DED-P, feelings during game play, game acceptance, and behavioral measures (physical activity, media consumption, and dietary intake). Results The knowledge score ranging from 0 to 100 increased from T0 (IG: 53 [SD 10], CG: 50 [SD 11]) to T1 (IG: 69 [SD 11], CG: 52 [SD 12]) in IG versus CG (P<.001). At T2, the knowledge score of IG remained at the same level as that of T1. Game data showed that after DED-P education, the classification under time pressure of unknown versus known food pairs according to their DED category was similar (hit rate around 70%). Overall, 95% of the children liked the game very much or much. No group changes were observed at the behavioral level. Conclusions The Kids Obesity Prevention program sustainably increased knowledge in the areas of nutrition and stress coping, and children were able to apply the DED-P. Trial Registration ClinicalTrials.gov NCT02551978; https://clinicaltrials.gov/ct2/show/NCT02551978
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Affiliation(s)
- Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Nadine Reiband
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany.,Department of School Psychology, University of Tübingen, Tübingen, Germany
| | - Carolin Etges
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Sabrina Eichhorn
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Norbert Schaeffeler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Guido Zurstiege
- Department of Media Studies Tübingen, University of Tübingen, Tübingen, Germany
| | - Caterina Gawrilow
- Department of School Psychology, University of Tübingen, Tübingen, Germany
| | - Katja Weimer
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Riyad Peeraully
- Department of Paediatric Surgery, Nottingham Children's Hospital, Nottingham, United Kingdom
| | - Martin Teufel
- LVR-Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, Essen, Germany
| | - Gunnar Blumenstock
- Institute for Clinical Epidemiology and Applied Biometry, University of Tübingen, Tübingen, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
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Using Trials of Improved Practices to identify practices to address the double burden of malnutrition among Rwandan children. Public Health Nutr 2019; 22:3175-3186. [PMID: 31221234 DOI: 10.1017/s1368980019001551] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Low- and middle-income countries (LMIC) are increasingly experiencing the double burden of malnutrition. Studies to identify 'double-duty' actions that address both undernutrition and overweight in sub-Saharan Africa are needed. We aimed to identify acceptable behaviours to achieve more optimal feeding and physical activity practices among both under- and overweight children in Rwanda, a sub-Saharan LMIC with one of the largest recent increases in child overweight. DESIGN We used the Trials of Improved Practices (TIPs) method. During three household visits over 1·5 weeks, we used structured interviews and unstructured observations to collect data on infant and young child feeding practices and caregivers' experiences with testing recommended practices. SETTING An urban district and a rural district in Rwanda. PARTICIPANTS Caregivers with an under- or overweight child from 6 to 59 months of age (n 136). RESULTS We identified twenty-five specific recommended practices that caregivers of both under- and overweight children agreed to try. The most frequently recommended practices were related to dietary diversity, food quantity, and hygiene and food handling. The most commonly cited reason for trying a new practice was its benefits to the child's health and growth. Financial constraints and limited food availability were common barriers. Nearly all caregivers said they were willing to continue the practices and recommend them to others. CONCLUSIONS These practices show potential for addressing the double burden as part of a broader intervention. Still, further research is needed to determine whether caregivers can maintain the behaviours and their direct impact on both under- and overweight.
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Mack I, Sauer H, Weimer K, Dammann D, Zipfel S, Enck P, Teufel M. Perceptions of tableware size in households of children and adolescents with obesity. Eat Weight Disord 2019; 24:585-594. [PMID: 29981003 DOI: 10.1007/s40519-018-0537-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 06/26/2018] [Indexed: 01/16/2023] Open
Abstract
PURPOSE Portion size influences energy intake and is an important factor when developing weight management strategies. The effect of tableware on food intake is less clear, especially in children. To date, the relationship between the body weight of individuals and the tableware used in their households has not been investigated. The aim of this study was to analyze the sizes of tableware in households of children and adolescents with obesity (OBE) in comparison to participants with normal-weight matched for age and gender (NW). METHODS 60 OBE (32 female, 26 male) and 27 NW (12 female, 15 male) aged between 9 and 17 years participated in a structured interview on the tableware used at home. Responses were standardized based on the selection of different sizes of tableware and everyday objects presented to the children. RESULTS In households of NW, larger plates and bowls were used during meals and desserts compared to OBE. OBE drank out of larger bottles. Shapes and sizes of drinkware, the number of children drinking out of bottles and the cutlery used during dessert did not differ between the groups. CONCLUSIONS Drinking out of large bottles may be an unfavourable habit of OBE if they contain sugar-rich liquids. The use of smaller plates and bowls of OBE may result in multiple helpings being consumed and so contribute to an overall increased portion size. LEVEL OF EVIDENCE Level V, Descriptive study.
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Affiliation(s)
- Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, Medical Hospital, University of Tübingen, Osianderstr. 5, 72076, Tübingen, Germany.
| | - Helene Sauer
- Department of Psychosomatic Medicine and Psychotherapy, Medical Hospital, University of Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Katja Weimer
- Department of Psychosomatic Medicine and Psychotherapy, Medical Hospital, University of Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Dirk Dammann
- Fachkliniken Wangen i.A., Children Rehabilitation Hospital for Respiratory Diseases, Allergies and Psychosomatics, Wangen i.A., Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical Hospital, University of Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Paul Enck
- Department of Psychosomatic Medicine and Psychotherapy, Medical Hospital, University of Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, Medical Hospital, University of Tübingen, Osianderstr. 5, 72076, Tübingen, Germany.,LVR-Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, Essen, Germany
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8
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Mack I, Teufel M, Enck P. What role does tableware size play in energy consumption of children and adults? Eat Weight Disord 2019; 24:595-596. [PMID: 30941662 DOI: 10.1007/s40519-019-00682-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 03/19/2019] [Indexed: 11/26/2022] Open
Affiliation(s)
- Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, Tübingen, Germany.
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, Tübingen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Paul Enck
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, Tübingen, Germany
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9
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Food Intake during School Lunch Is Better Explained by Objectively Measured Eating Behaviors than by Subjectively Rated Food Taste and Fullness: A Cross-Sectional Study. Nutrients 2019; 11:nu11030597. [PMID: 30870994 PMCID: PMC6470952 DOI: 10.3390/nu11030597] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 02/27/2019] [Accepted: 02/27/2019] [Indexed: 11/17/2022] Open
Abstract
School lunches contribute significantly to students’ food intake (FI) and are important to their long-term health. Objective quantification of FI is needed in this context. The primary aim of this study was to investigate how much eating rate (g/min), number of food additions, number of spoonfuls, change in fullness, food taste, body mass index (BMI), and sex explain variations in school lunch FI. The secondary aim was to assess the reliability of repeated FI measures. One hundred and three (60 females) students (15–18 years old) were monitored while eating lunch in their normal school canteen environment, following their usual school schedules. A subgroup of students (n = 50) participated in a repeated lunch (~3 months later). Linear regression was used to explain variations in FI. The reliability of repeated FI measurements was assessed by change in mean, coefficient of variation (CV), and intraclass correlation (ICC). The regression model was significant and explained 76.6% of the variation in FI. Eating rate was the strongest explanatory variable, followed by spoonfuls, sex, food additions, food taste, BMI, and change in fullness. All explanatory variables were significant in the model except BMI and change in fullness. No systematic bias was observed in FI (−7.5 g (95% CI = −43.1–28 g)) while individual students changed their FI from −417 to +349 g in the repeated meal (CV 26.1% (95% CI = 21.4–33.5%), ICC 0.74 (95% CI = 0.58–0.84)). The results highlight the importance of objective eating behaviors for explaining FI in a school lunch setting. Furthermore, our methods show promise for large-scale quantification of objectively measured FI and eating behaviors in schools.
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Kairey L, Matvienko-Sikar K, Kelly C, McKinley MC, O'Connor EM, Kearney PM, Woodside JV, Harrington JM. Plating up appropriate portion sizes for children: a systematic review of parental food and beverage portioning practices. Obes Rev 2018; 19:1667-1678. [PMID: 30160009 DOI: 10.1111/obr.12727] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 05/10/2018] [Accepted: 06/04/2018] [Indexed: 12/20/2022]
Abstract
Consumption of larger portion sizes is associated with higher energy intake and weight status in children. As parents play a pivotal role in child feeding, we synthesized literature on 'parental portioning practices' using a mixed methods systematic design to inform future strategies addressing portion sizes served to children. Electronic databases PubMed, EMBASE, SCOPUS, PsycINFO and CINAHL Plus were searched. Two reviewers independently screened 385 abstracts and assessed 71 full-text articles against eligibility criteria: studies assessing portioning of foods or beverages by parent(s) with ≥1 child aged 2-12 years. Narrative synthesis of 14 quantitative studies found that portion sizes parents serve vary substantially and are influenced by amounts parents serve themselves, perceived child hunger and parent and child body size. Thematic synthesis of 14 qualitative studies found that parents serve the portion sizes they learn to be appropriate for their child to be fed. Portioning is influenced by parents' desires for a healthy child with a balanced diet. Future guidance on appropriate portion sizes for children would ideally present recommended portion sizes for first serving, incremental with age. Future research is however needed to assess the adoption and efficacy of providing such guidance to families.
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Affiliation(s)
- L Kairey
- HRB Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland
| | - K Matvienko-Sikar
- HRB Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland
| | - C Kelly
- Health Promotion Research Centre, School of Health Sciences, NUI Galway, Galway, Ireland
| | - M C McKinley
- Northern Ireland Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK
| | - E M O'Connor
- Department of Biological Sciences, and Health Research Institute, University of Limerick, Limerick, Ireland
| | - P M Kearney
- HRB Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland
| | - J V Woodside
- Northern Ireland Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK
| | - J M Harrington
- HRB Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland
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Weimer K, Sauer H, Horing B, Valitutti F, Mazurak N, Zipfel S, Stengel A, Enck P, Mack I. Impaired Gastric Myoelectrical Reactivity in Children and Adolescents with Obesity Compared to Normal-Weight Controls. Nutrients 2018; 10:nu10060699. [PMID: 29857470 PMCID: PMC6024785 DOI: 10.3390/nu10060699] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 05/27/2018] [Accepted: 05/29/2018] [Indexed: 12/30/2022] Open
Abstract
Obesity often has its onset in childhood and can be accompanied by various comorbidities such as functional gastrointestinal disorders and altered gastric myoelectrical activity (GMA). This study investigates whether obesity in childhood and adolescence is already associated with altered GMA, and whether an inpatient weight loss program affects GMA. Sixty children with obesity (OBE) and 27 normal-weight children (NW) (12.9 ± 1.7 years; 51% female) were compared for their GMA at rest, after a stress test, and after a drink-to-full water load test. A continuous electrogastrogram (EGG) was recorded and analyzed with respect to gastric slow waves and tachygastric activity. OBE were examined upon admission (T1) and before discharge (T2) following an inpatient weight loss program; NW served as control group. Compared to NW, children with obesity showed flattened GMA as indicated by lower tachygastric reactivity after stress and water load test at T1. Data of OBE did not differ between T1 and T2. EGG parameters were associated neither with sex, age, and BMI nor with subjective stress and food intake. Children with obesity show impaired gastric myoelectrical reactivity in response to a stress and water load test compared to normal-weight controls, which does not change during an inpatient weight loss program.
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Affiliation(s)
- Katja Weimer
- Clinic for Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, 89081 Ulm, Germany.
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, 72076 Tübingen, Germany.
| | - Helene Sauer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, 72076 Tübingen, Germany.
| | - Bjoern Horing
- Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Francesco Valitutti
- Pediatric Gastroenterology and Liver Unit, Department of Pediatrics, Sapienza University of Rome, 00161 Rome, Italy.
| | - Nazar Mazurak
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, 72076 Tübingen, Germany.
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, 72076 Tübingen, Germany.
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, 72076 Tübingen, Germany.
- Department for Psychosomatic Medicine, Charité Center for Internal Medicine and Dermatology, Charité-Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, 12200 Berlin, Germany.
| | - Paul Enck
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, 72076 Tübingen, Germany.
| | - Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, 72076 Tübingen, Germany.
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12
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Hess JM, Wang Q, Kraft C, Slavin JL. Impact of Agaricus bisporus mushroom consumption on satiety and food intake. Appetite 2017. [PMID: 28647383 DOI: 10.1016/j.appet.2017.06.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Previous studies on mushrooms suggest that they can be more satiating than meat, but this effect has not been studied with protein-matched amounts. The objective of this study was to assess the differences with satiety and ten-day food intake between A. bisporus mushrooms (226 g) and meat (28 g) in a randomized open-label crossover study. Thirty-two healthy participants (17 women, 15 men) consumed two servings of mushrooms or meat for ten days. On the first day, fasted participants consumed protein-matched breakfasts. Participants rated their satiety using visual analogue scales (VAS) at baseline and at regular intervals after the meal. Three hours later, participants were served an ad libitum lunch. Participants were given mushrooms or meat to consume at home for the following nine days. Energy intake was assessed at the ad libitum lunch, and participants also completed diet diaries on the day of the study, day 2, and day 10. Participants reported less hunger (p = 0.045), greater fullness (p = 0.05), and decreased prospective consumption (p = 0.03) after the mushroom breakfast. There were no significant differences in participant ratings of satisfaction (p = 0.10). There were also no statistically significant differences in energy intake at the ad libitum lunch or with the diet diaries from days 1 (p = 0.61), 2 (p = 0.77), or 10 (p = 0.69). Mushroom consumption did increase fiber intake on days 1, 2, and 10 but the difference in fiber consumption was only statistically significant on day 2 (p = 0.0001). The mushroom intervention also did not affect energy intake over the ten day feeding period.
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Affiliation(s)
- Julie M Hess
- Department of Food Science and Nutrition, University of Minnesota, 1334 Eckles Avenue, St. Paul, MN 55108, USA
| | - Qi Wang
- Clinical and Translational Science Institute, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN 55414, USA
| | - Clarissa Kraft
- Department of Food Science and Nutrition, University of Minnesota, 1334 Eckles Avenue, St. Paul, MN 55108, USA
| | - Joanne L Slavin
- Department of Food Science and Nutrition, University of Minnesota, 1334 Eckles Avenue, St. Paul, MN 55108, USA.
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Mack I, Bayer C, Schäffeler N, Reiband N, Brölz E, Zurstiege G, Fernandez-Aranda F, Gawrilow C, Zipfel S. Chances and Limitations of Video Games in the Fight against Childhood Obesity-A Systematic Review. EUROPEAN EATING DISORDERS REVIEW 2017; 25:237-267. [PMID: 28467004 DOI: 10.1002/erv.2514] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 12/18/2016] [Accepted: 02/27/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE AND METHOD A systematic literature search was conducted to assess the chances and limitations of video games to combat and prevent childhood obesity. This search included studies with video or computer games targeting nutrition, physical activity and obesity for children between 7 and 15 years of age. RESULTS The study distinguished between games that aimed to (i) improve knowledge about nutrition, eating habits and exercise; (ii) increase physical activity; or (iii) combine both approaches. Overall, the games were well accepted. On a qualitative level, most studies reported positive effects on obesity-related outcomes (improvement of weight-related parameters, physical activity or dietary behaviour/knowledge). However, the observed effects were small. The games did not address psychosocial aspects. CONCLUSIONS Using video games for weight management exclusively does not deliver satisfying results. Video games as an additional guided component of prevention and treatment programs have the potential to increase compliance and thus enhance treatment outcome. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Carolin Bayer
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Norbert Schäffeler
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Nadine Reiband
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Department of School Psychology, University of Tübingen, Tübingen, Germany
| | - Ellen Brölz
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Department of Sports Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Guido Zurstiege
- Department of Media Studies, University of Tübingen, Tübingen, Germany
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN, ISCIII), Barcelona, Spain
| | - Caterina Gawrilow
- Department of School Psychology, University of Tübingen, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
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14
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Feinle-Bisset C. Upper gastrointestinal sensitivity to meal-related signals in adult humans - relevance to appetite regulation and gut symptoms in health, obesity and functional dyspepsia. Physiol Behav 2016; 162:69-82. [PMID: 27013098 DOI: 10.1016/j.physbeh.2016.03.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 03/08/2016] [Accepted: 03/16/2016] [Indexed: 12/20/2022]
Abstract
Both the stomach and small intestine play important roles in sensing the arrival of a meal, and its physico-chemical characteristics, in the gastrointestinal lumen. The presence of a meal in the stomach provides a distension stimulus, and, as the meal empties into the small intestine, nutrients interact with small intestinal receptors, initiating the release of gut hormones, associated with feedback regulation of gastrointestinal functions, including gut motility, and signaling to the central nervous system, modulating eating behaviours, including energy intake. Lipid appears to have particularly potent effects, also in close interaction with, and modulating the effects of, gastric distension, and involving the action of gut hormones, particularly cholecystokinin (CCK). These findings have not only provided important, and novel, insights into how gastrointestinal signals interact to modulate subjective appetite perceptions, including fullness, but also laid the foundation for an increasing appreciation of the role of altered gastrointestinal sensitivities, e.g. as a consequence of excess dietary intake in obesity, or underlying the induction of gastrointestinal symptoms in functional dyspepsia (a condition characterized by symptoms, including bloating, nausea and early fullness, amongst others, after meals, particularly those high in fat, in the absence of any structural or functional abnormalities in the gastrointestinal tract). This paper will review the effects of dietary nutrients, particularly lipid, on gastrointestinal function, and associated effects on appetite perceptions and energy intake, effects of interactions of gastrointestinal stimuli, as well as the role of altered gastrointestinal sensitivities (exaggerated, or reduced) in eating-related disorders, particularly obesity and functional dyspepsia.
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Affiliation(s)
- Christine Feinle-Bisset
- University of Adelaide Discipline of Medicine, Royal Adelaide Hospital, Adelaide, SA 5000, Australia; National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, SA 5000, Australia.
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15
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Horner K, Lee S. Appetite-related peptides in childhood and adolescence: role of ghrelin, PYY, and GLP-1. Appl Physiol Nutr Metab 2015; 40:1089-99. [PMID: 26466085 DOI: 10.1139/apnm-2015-0050] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
During childhood and adolescence, a number of factors, including age, puberty, sex, race, and body composition, may contribute to differences in satiety, food intake, and appetite-related peptides. These peptides include the orexigenic peptide ghrelin and anorexigenic gut peptides peptide YY (PYY) and glucagon-like peptide-1 (GLP-1). For example, lower fasting ghrelin levels, lower postprandial ghrelin suppression, and blunted PYY and GLP-1 responses to food intake could contribute to a dysregulation of appetite in already obese children and adolescents. Whereas, changes in these peptides observed during puberty could facilitate growth. A greater understanding of the major moderating factors of appetite-related peptides in the pediatric population is essential to improve interpretation of study findings and for effective tailoring of strategies targeting appetite control to individuals. While more studies are needed, there is some evidence to suggest that exercise-based lifestyle interventions could be a potential therapeutic strategy to improve appetite-peptide profiles in overweight and obese children and adolescents. The aim of this review is (i) to discuss the potential moderating factors of ghrelin, PYY, and GLP-1, including age and puberty, sex, race and body composition; and (ii) to examine the effects of exercise interventions on these appetite-related gut peptides in children and adolescents.
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Affiliation(s)
- Katy Horner
- Division of Weight Management and Wellness, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA 15226, USA.,Division of Weight Management and Wellness, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA 15226, USA
| | - SoJung Lee
- Division of Weight Management and Wellness, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA 15226, USA.,Division of Weight Management and Wellness, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA 15226, USA
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