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Wills O, Wright B, Greenwood LM, Solowij N, Schira M, Maller JJ, Gupta A, Magnussen J, Probst Y. Lifestyle management and brain MRI metrics in female Australian adults living with multiple sclerosis: a feasibility and acceptability study. Pilot Feasibility Stud 2024; 10:71. [PMID: 38698454 PMCID: PMC11064336 DOI: 10.1186/s40814-024-01495-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 04/14/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Limited studies of multiple sclerosis (MS) exist whereby magnetic resonance imaging (MRI) of the brain with consistent imaging protocols occurs at the same time points as collection of healthy lifestyle measures. The aim of this study was to test the feasibility, acceptability and preliminary efficacy of acquiring MRI data as an objective, diagnostic and prognostic marker of MS, at the same time point as brain-healthy lifestyle measures including diet. METHODS Participants living with relapsing remitting MS partook in one structural MRI scanning session of the brain, completed two online 24-hour dietary recalls and demographic and self-reported lifestyle questionnaires (e.g. self-reported disability, comorbidities, physical activity, smoking status, body mass index (BMI), stress). Measures of central tenancy and level of dispersion were calculated for feasibility and acceptability of the research protocols. Lesion count was determined by one radiologist and volumetric analyses by a data analysis pipeline based on FreeSurfer software suite. Correlations between white matter lesion count, whole brain volume analyses and lifestyle measures were assessed using Spearman's rank-order correlation coefficient. RESULTS Thirteen female participants were included in the study: eligibility rate 90.6% (29/32), recruitment rate 46.9% (15/32) and compliance rate 87% (13/15). The mean time to complete all required tasks, including MRI acquisition was 115.86 minutes ( ± 23.04), over 4 days. Conversion to usual dietary intake was limited by the small sample. There was one strong, negative correlation between BMI and brain volume (rs = -0.643, p = 0.018) and one strong, positive correlation between physical activity and brain volume (rs = 0.670, p = 0.012) that were both statistically significant. CONCLUSIONS Acquiring MRI brain scans at the same time point as lifestyle profiles in adults with MS is both feasible and accepted among adult females living with MS. Quantification of volumetric MRI data support further investigations using semi-automated pipelines among people living with MS, with pre-processing steps identified to increase automated feasibility. This protocol may be used to determine relationships between elements of a brain-healthy lifestyle, including dietary intake, and measures of disease burden and brain health, as assessed by T1-weighted and T2-weighted lesion count and whole brain volume, in an adequately powered sample. TRIAL REGISTRATION The study protocol was retrospectively registered in the Australia New Zealand Clinical Trials Registry (ACTRN12624000296538).
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Affiliation(s)
- Olivia Wills
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia.
| | - Brooklyn Wright
- School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Lisa-Marie Greenwood
- Illawara Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, 2522, Australia
- School of Medicine and Psychology, Australian National University, Canberra, ACT, Australia
| | - Nadia Solowij
- School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia
- Illawara Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Mark Schira
- School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Jerome J Maller
- General Electric Healthcare, Richmond, Melbourne, Australia
- Monash Alfred Psychiatry Research Centre, Melbourne, VIC, Australia
| | - Alok Gupta
- Illawara Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, 2522, Australia
- Wollongong Diagnostic Imaging Group, Wollongong, NSW, Australia
| | - John Magnussen
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, NSW, 2109, Australia
| | - Yasmine Probst
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia
- Illawara Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, 2522, Australia
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Biltoft-Jensen A, Ygil KH, Knudsen L, Matthiessen J, Fagt S, Trolle E, Nielsen TH, Hansen DM, Licht CL, Martens M, Hambly C, Speakman JR, Christensen T. Validation of the 2 × 24 h recall method and a 7-d web-based food diary against doubly labelled water in Danish adults. Br J Nutr 2023; 130:1444-1457. [PMID: 36805853 PMCID: PMC10511678 DOI: 10.1017/s0007114523000454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/06/2023] [Accepted: 02/13/2023] [Indexed: 02/23/2023]
Abstract
The European Food Safety Authority has suggested that EU countries implement the 2 × 24 h diet recall (2 × 24 h DR) method and physical activity (PA) measurements for national dietary surveys. Since 2000, Denmark has used 7 d food diaries (7 d FD) with PA questionnaires and measurements. The accuracy of the reported energy intakes (EI) from the two diet methods, pedometer-determined step counts and self-reported time spent in moderate-to-vigorous PA (MVPA) were compared with total energy expenditure measured by the doubly labelled water (TEEDLW) technique and with PA energy expenditure (PAEE), respectively. The study involved fifty-two male and sixty-eight female volunteers aged 18-60 years who were randomly assigned to start with either the 24 h DR or the web-based 7 d FD, and wore a pedometer for the first 7 d and filled in a step diary. The mean TEEDLW (11·5 MJ/d) was greater than the mean reported EI for the 7 d FD (9·5 MJ/d (P < 0·01)) but the same as the 2 × 24 h DR (11·5 MJ/d). The proportion of under-reporters was 34 % (7 d FD) and 4 % (2 × 24 h DR). Most participants preferred the 7 d DR as it was more flexible, despite altering their eating habits. Pearson's correlation between steps corrected for cycling and PAEE was r = 0·44, P < 0·01. Spearman's correlation for self-reported hours spent in MVPA and PAEE was r = 0·58, P < 0·01. The 2 × 24 h DR performs better than the existing 7 d FD method. Pedometer-determined steps and self-reported MVPA are good predictors of PAEE in adult Danes.
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Affiliation(s)
- Anja Biltoft-Jensen
- National Food Institute, Technical University of Denmark, Kongens, Lyngby2800, Denmark
| | - Karin Hess Ygil
- National Food Institute, Technical University of Denmark, Kongens, Lyngby2800, Denmark
| | - Lenette Knudsen
- Steno Diabetes Center Copenhagen, Region Hovedstaden, Gentofte, Denmark
| | - Jeppe Matthiessen
- National Food Institute, Technical University of Denmark, Kongens, Lyngby2800, Denmark
| | - Sisse Fagt
- National Food Institute, Technical University of Denmark, Kongens, Lyngby2800, Denmark
| | - Ellen Trolle
- National Food Institute, Technical University of Denmark, Kongens, Lyngby2800, Denmark
| | | | | | - Cecilie Löe Licht
- Center for Cancer Immune Therapy (CCIT), Department of Oncology, Herlev Hospital, Herlev, Denmark
| | | | - Catherine Hambly
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, Scotland, UK
| | - John R. Speakman
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, Scotland, UK
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, People’s Republic of China
| | - Tue Christensen
- National Food Institute, Technical University of Denmark, Kongens, Lyngby2800, Denmark
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Gianfrancesco C, Taylor C, Croot L. Self-completed online dietary recalls as an alternative method of dietary assessment for dietetic outpatient appointments: A feasibility study. J Hum Nutr Diet 2023; 36:126-138. [PMID: 35689467 PMCID: PMC10084435 DOI: 10.1111/jhn.13047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 04/07/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Integrating digital dietary assessment within dietetic care could save time and reduce costs, at the same time as increasing patient engagement. The present study explores the feasibility of implementing a web-based dietary assessment tool, myfood24 (https://www.myfood24.org), into routine healthcare. METHODS This mixed methods feasibility study recruited dietitians and patients from a National Health Service (NHS) hospital outpatient setting. Patients completed and shared three online 24-h dietary recalls in advance, which were used as a dietary assessment by dietitians. Recruitment data were collected and questionnaires on technology, usability, and acceptability were completed. Patient interviews and focus groups with dietitians were conducted. RESULTS Eleven dietitians working in allergy, bariatrics, diabetes, oncology, general, renal, infectious diseases, and coeliac services took part with 39 patients. Recruitment rates were highest in bariatrics and lowest in renal and oncology. Compared to other studies, completion rates were good, with 29 (74.4%) completing three recalls despite lower technology readiness and software usability scores than in similar studies. Illness and difficulty with technology were reasons for non-completion. Opportunity to receive nutritional feedback from the tool and share this with a dietitian motivated patients to complete the record accurately. Consultation times were shortened in approximately one-third of appointments and a higher proportion of time was spent on nutritional education compared to usual practice. However, mean preparation time increased by 13 min per appointment because dietitians found nutritional analysis reports difficult to interpret. CONCLUSIONS It is feasible to introduce a digital dietary assessment tool into NHS dietetic practice. However, further development is needed to ensure that the tool is suitable for healthcare.
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Affiliation(s)
| | - Carolyn Taylor
- Dietetic Department, Sheffield Teaching Hospitals NHSF Trust, Sheffield, UK
| | - Liz Croot
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Silveira SL, Jeng B, Cutter G, Motl RW. Diet Quality Assessment in Wheelchair Users with Multiple Sclerosis. Nutrients 2021; 13:nu13124352. [PMID: 34959904 PMCID: PMC8709288 DOI: 10.3390/nu13124352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Diet quality has not been distinctively examined in wheelchair users with multiple sclerosis (MS). Methods: This cross-sectional study examined the Diet History Questionnaire (DHQ) III and the Automated Self-Administered 24-h (ASA24) Dietary Assessment Tool in 128 wheelchair users with MS. Participants were prompted to complete the DHQ-III and 3 ASA24 recalls during a seven-day data collection period. Healthy Eating Index (HEI)-2015 scores were calculated for DHQ-III and ASA24, and scores were compared with normative values. Spearman’s correlation analyses (rs) estimated the associations between DHQ-III and ASA24 HEI-2015 total and component scores with supportive paired sample t-tests. Results: HEI-2015 scores for DHQ-III and ASA24 were significantly higher than normative values for total score, total protein foods, and added sugar. Correlations between HEI-2015 scores generated using ASA24 and DHQ-III were all statistically significant (range rs = 0.23–0.69); however, significant differences between ASA24 and DHQ-III values were noted for HEI-2015 total score, total fruits, whole fruit, total vegetable, greens and beans, whole grains, seafood and plant protein, refined grains, and saturated fats. Conclusion: This study provided a novel description of diet quality in wheelchair users with MS for guiding future research promoting healthy eating in this population.
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Affiliation(s)
- Stephanie L. Silveira
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL 35209, USA; (B.J.); (R.W.M.)
- Department of Kinesiology, Health Promotion and Recreation, University of North Texas, 1155 Union Circle #310769, Denton, TX 76203, USA
- Correspondence:
| | - Brenda Jeng
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL 35209, USA; (B.J.); (R.W.M.)
| | - Gary Cutter
- Department of Biostatistics, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL 35233, USA;
| | - Robert W. Motl
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL 35209, USA; (B.J.); (R.W.M.)
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 W. Taylor St., Chicago, IL 60612, USA
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