A meta-analysis of food- and nutrition-related research (2023)

Citation Excerpt :

Indeed, some previous studies have demonstrated improvements in nutrition knowledge through weight loss interventions (Brinberg, Axelson, & Price, 2000), especially in lower income populations (Klohe-Lehman et al., 2006; Rustad & Smith, 2013). However, although greater knowledge has been linked to better diet quality (Wardle, Parmenter, & Waller, 2000), a large body of previous literature suggests nutrition knowledge does not differ between individuals with overweight/obesity and those with normal weight (O'Brien and Davies, 2007; Axelson, Federline, & Brinberg, 1985; Shepherd & Stockley, 1987; Shepherd & Towler, 2007; Towler & Shepherd, 1992; Stafleu, Van Staveren, De Graaf, Burema, & Hautvast, 1996). Treatment seeking individuals with obesity typically possess adequate nutrition and diet knowledge (Kaufer-Horwitz et al., 2015) and nutrition knowledge is not sufficient to induce changes in dietary choices (Crites & Aikman, 2005).

Behavioral weight loss (BWL) programs are the recommended treatment for obesity, yet it is unknown whether these programs change one's ability to use self-control in food choices and what specific mechanisms support such change. Using experimental economics methods, we investigated whether changes in dietary behavior in individuals with obesity following BWL are driven by one or more of the following potential mechanisms: changes in the perception of the 1) health or 2) taste of food items, and/or 3) shifting decision weights for health versus taste attributes. Therefore, we compared these mechanisms between obese participants and lifetime normal weight controls (NW) both before and after BWL.

Females with obesity (N=37, mean BMI=33.2) completed a food choice task involving health ratings, taste ratings, and decision-making pre- and post-standard BWL intervention. NW controls (N=30, BMI=22.4) completed the same task.

Individuals with obesity exhibited increased self-control (selecting healthier, less tasty food choices) post-treatment. However, their rates of self-control remained significantly lower than NW. We found no differences in initial health perceptions across groups, and no changes with treatment. In contrast, taste ratings and the relative value of taste versus health decreased following treatment. Although, post-treatment participants continued to perceive unhealthy foods as tastier and used less self-control than NW controls, they showed significant improvements in these domains following a BWL intervention.

To help individuals improve dietary decisions, additional research is needed to determine how to make greater changes in taste preferences and/or the assignment of value to taste versus health attributes in food choices.

Citation Excerpt :

Knowledge and health concerns have been shown to fall behind taste preferences as determinants of food selections and intake [14,28,29] and specifically for adolescents' dairy consumption [16]. Previous studies have reported that knowledge alone has limited influence on adolescents' dietary intake [14,30,31]. Marketing can be a powerful influence on dietary behaviors [2]; however, policies restricting the promotion of candy, restaurant foods, and soft drinks in schools were not associated with the consumption of milk or juice.

Researchers previously examined the relationship between school beverage policies and sugar-sweetened beverage (SSB) consumption. This study addressed a research gap by examining cross-sectional associations between district-level policies and practices and U.S. high school students' consumption of milk and 100% fruit juice.

Data from the 2012 School Health Policies and Practices Study and 2013 Youth Risk Behavior Surveillance System were linked for 12 large urban school districts. Outcome variables were daily milk consumption (≥1 glass/day) and 100% fruit juice consumption (≥1 time/day). Exposure variables were five district policies (i.e., restrict SSB sales, maintain closed campuses, offer/sell healthful alternatives, restrict promotional products, and require nutrition education). Logistic regression models estimated the odds of consuming milk or 100% fruit juice daily, conditional on the policies and adjusting for sex, race/ethnicity, grade level, weight status, and district free/reduced-price lunch eligibility (n= 23,173).

Students in districts that required/recommended restricting the times of SSB sales had 55% higher (adjusted odds ratio [AOR], 1.55; 95% confidence interval [CI], 1.28–1.87) odds of consuming ≥1 glass/day of milk than students in districts without this policy. Closed campus policies were associated with lower odds of consuming milk (AOR, .72; 95% CI, .63–.82) and higher odds of consuming juice (AOR, 1.27; 95% CI, 1.07–1.50). Policies requiring/recommending that districts offer/sell healthful alternatives were associated with lower odds of consuming 100% fruit juice daily.

Results suggest that restricting SSB sales may support adolescents' milk consumption. Future studies should assess whether the implementation of federal standards that further restrict SSB sales in school leads to increased milk consumption.

Nutrition education is one of the main lines of the French nutrition policy that has been undertaken for several years. The underlying hypothesis of this approach is that knowledge improvement is one of the ways likely to contribute to health-enhancing diet and physical activity. The objective of this paper, based on the 2008 Health and nutrition Barometer, is to examine the associations observed between knowledge and behavior with regard to diet and physical activity.

The 2008 Health and nutrition Barometer is a nationally representative telephone survey conducted on 4714 individuals aged 12–75years. For six recommendations of the National Nutrition and Health Program (Programme national nutrition santé [PNNS]), multiple logistic models were used to identify associations between knowledge of these recommendations and behavior, among adults aged 18–75years. For food consumed on the day before the interview, odds ratios were adjusted for sex, age, education level, agglomeration size and region. As bivariate analysis showed that income level was significant for recommended consumption of fish, this variable was introduced among adjustment variables. Similarly, the variable occupation was introduced for physical activity.

A positive association between knowledge of recommendations and nutritional behavior on the day before interview was observed for fruit and vegetables (OR=1.7), dairy products (OR=1.6), and starchy food (OR=1.6). The same was observed for consumption of fish during the 15days before the interview (OR=5.0) and for physical activity during a usual week (OR=1.5) but not for the “meat, seafood and eggs” food group.

Eating habits and physical activity are positively associated with knowledge of nutritional recommendations, mainly acquired via nutritional information and educational actions. Nevertheless, the important differences observed for certain dietary groups between knowledge of recommendations and dietary intake emphasizes the need to further support individual-focused initiatives with health-enhancing environmental strategies.

L’éducation nutritionnelle constitue un des axes de la politique nutritionnelle menée depuis plusieurs années en France. L’hypothèse sous-jacente à cette approche est que l’amélioration des connaissances est un des éléments susceptibles de concourir à une alimentation et à une activité physique favorables à la santé. L’objectif de cet article, basé sur les données du Baromètre santé nutrition 2008, est d’analyser les associations entre la connaissance des recommandations et les comportements en matière d’alimentation et d’activité physique.

Le Baromètre santé nutrition 2008est une enquête déclarative menée par téléphone en population générale (12–75ans; n=4714). Pour six repères du Programme national nutrition santé (PNNS), les associations entre la connaissance de ces recommandations et les comportements en matière d’alimentation et d’activité physique ont été étudiées à l’aide de régressions logistiques multivariées, parmi les adultes âgés de 18à 75ans. Pour les aliments consommés la veille de l’interview, les odds ratios ont été ajustés sur le sexe, l’âge, le niveau de diplôme, la taille d’agglomération et la région. Pour le repère concernant le poisson, le niveau de revenu, significatif en analyse bivariée, a été introduit parmi les variables d’ajustement; la catégorie socioprofessionnelle l’a été pour l’activité physique.

Les résultats mettent en évidence des associations positives entre la connaissance des repères et la fréquence de consommation, la veille de l’interview, de fruits et légumes (OR=1,7), de produits laitiers (OR=1,6) et de féculents (OR=1,6). Sont aussi associés à la connaissance des recommandations la fréquence de consommation de poisson au cours des 15jours précédant l’interview (OR=5,0) et le niveau d’activité physique pratiqué lors d’une semaine habituelle (OR=1,5). Aucun lien significatif n’apparaît en revanche pour les aliments du groupe «viandes et volailles, produits de la pêche, œufs».

Les comportements en matière d’alimentation et d’activité physique sont positivement associés à la connaissance des recommandations nutritionnelles diffusées notamment par le biais d’action d’information et d’éducation nutritionnelles. Les écarts encore importants observés pour certains groupes alimentaires entre les connaissances et les comportements montrent néanmoins la nécessité d’accompagner les leviers d’action individuels par d’autres stratégies visant à rendre l’environnement et l’offre alimentaire plus propices à des comportements favorables à la santé.

Enhanced recovery after surgery protocols aim to improve recovery following urological augmentation and diversion surgery. Based on the positive experiences in adult patients, we evaluated safety and outcomes after implementation of an enhanced recovery after surgery protocol in children undergoing urological augmentation and diversion using small bowel.

Complications, time to stool, time to flatus and total hospital stay of 15 consecutive patients (group 2) were recorded and compared to the data of 15 consecutive patients before the changes in protocol were effective (group 1). The groups were comparable in age (mean 10.93 vs 9.267 years, p = 0.33), gender (p = 0.71) and operative times (387.9 vs 336.5 minutes, p = 0.19).

Compared to the previous protocol involving a mean ± SD of 7.9 ± 1.38 enhanced recovery after surgery items per patient, 15.9 ± 0.26 items per patient were implemented in the new protocol. In group 2 mild bowel related complications were less frequent (1 vs 5, p = 0.168). Time to stool was significantly shorter in group 2 (3.33 vs 5.53 days, p = 0.002), as was time to flatus (2.8 vs 4.73 days, p = 0.002). Total hospital stay in group 2 was 11.93 days, compared to 19.87 days in group 1 (p <0.001), mainly due to more rapid convalescence, although influenced by associated changes in the postoperative protocol as well.

In pediatric augmentation and diversion surgery using small bowel the implementation of an enhanced recovery after surgery protocol is safe and effective, reinforcing faster bowel recovery. We did not observe complications or problems after introducing the new protocol.

In patients at high risk of atherosclerotic cardiovascular diseases (ASCVDs), residual cardiovascular risk persists despite the achievement of target LDL cholesterol levels with statin therapy. It is still unclear whether adding lipid-modifying agent to statin treatment can further improve clinical outcomes.

Randomized controlled trials (RCTs) in terms of adding lipid-modifying agent to statin versus statin monotherapy in patients at high risk of ASCVD were identified by electronic and manual searches. Results were expressed as relative risk (RR) with 95% confidence intervals (CIs).

Eleven RCTs with 109,244 patients were included in this meta-analysis. Overall, the incidences of major adverse cardiovascular events (MACEs) were 9.70% in the statin combination groups and 9.92% in the statin monotherapy groups. No significant difference was observed in the risk of MACEs either in overall (RR 0.99, 95% CI 0.93–1.05, P=0.76) or subgroup analysis (CETP inhibitor: RR 1.07, 95% CI 0.93–1.23, P=0.37; niacin: RR 1.03, 95% CI 0.85–1.25, P=0.79; n−3 fatty acid: RR 0.98, 95% CI 0.88–1.09, P=0.70; fenofibrate: RR 0.93, 95% CI 0.80–1.09, P=0.38), with the exception of the statin/ezetimibe combination subgroup (RR 0.92, 95% CI 0.87–0.97, P=0.004). Adding lipid-modifying agent to statin significantly increased liver injury risk. Adding ezetimibe to statin did not alter side effect profile.

Adding niacin, CETP inhibitors, n−3 fatty acid or fibrates to statin therapy has all failed to achieve a clinical benefit. Adding ezetimibe to statin therapy further lowers LDL-cholesterol safely and translates into a clinical benefit in patients at high risk of ASCVD.

Centrifugation is an alternative assisted technique to improve the efficiency of block freeze concentration. In this study reported the centrifugation to enhance the separation of concentrated solution from frozen fruit juices (blueberry and pineapple) in three cryoconcentration cycles. To force the separation of solutes from the frozen samples we used a centrifuge operated for 10min at 20°C and 4600rpm. This technique has good performance after the third cycle, reaching an increase of approximately 2.5 times the initial concentrations of solids, values close to 0.74kg solute per 1kg initial solute, and approximately 60% of the percentage of concentrate. The performance of block freeze concentration assisted by centrifugation applied to fruit juices was attributed to ice matrix acting as a porous solid through which the concentrated solution percolates through drainage channels of the ice improved by the centrifugal force.

The block freeze concentration allows producing food concentrates with high quality when thawed a frozen solution assisted or not by a technique to enhance the separation efficiency. In this work has applied centrifugation as an assisted technique to improve the efficiency of block freeze concentration applied to fruit juices, obtaining promissory results.