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Weight loss via the telephone – Does it work? A systematic review and meta-analysis
84
M. Pickford
71
10
Elucidating how diet drives gut bacterial composition through computational simulation
Weight loss via the telephone — Does it work? A systematic review and meta-analysis
Mark Read ∗ , Andrew Holmes
Marina M. Reeves ∗ , Charlotte L. Brakenridge, Megan E. Whelan, Elizabeth G. Eakin
The University of Sydney, Darlington, NSW, Australia A growing body of evidence has highlighted the influence of the gut microbial community on host health, with dysbiosis being implicated in diseases as diverse as autism, obesity and colitis. Characterisation of the mechanisms through which the gut microbiota and the hot interact is required to build an understanding of how to effectively manage and manipulate host health. This work employs computational simulation to elucidate the influence of diet composition and feeding regimen on gut bacterial community composition. This modelling work builds on a real mouse study in which 250 mice were administered one of 30 diets. Each diet consists of different ratios of carbohydrate, protein and fat, and in addition, varying quantities of cellulose that adjust the host-accessible nutrient density of the diet. We simulate each mouse in this study, and assess how the diet composition and varying lengths and regularities of feeding versus diet periods drive bacterial community composition. Our simulation explicitly represents individual bacteria as belonging to one of five functional guilds, defined by their preferential access to carbon and nitrogen from a subset of feed-derived protein, cornstarch, dyetrose, or intestinal mucin. We simulate heterogeneous bacterial communities, where individual bacteria compete for limited nutrient resources, have varying growth and death rates, and undergo a stress response in response to periods of nutrient scarcity. Through simulation we can predict how different diets, the periods at which food is eaten, and periods of fasting can influence bacterial community composition. We find that periodic caloric restriction drives a greater relative abundance of bacterial guilds that preferentially access carbon and nitrogen from mucin, and that the benefit to these guilds varies with host diet composition. We can assess the quantities and times at which fibre supplements can be administered to achieve optimal effect in manipulating bacterial community composition. http://dx.doi.org/10.1016/j.orcp.2014.10.152
Cancer Prevention Research Centre, The University of Queensland, Brisbane, Australia Introduction: Weight loss interventions are traditionally delivered face-to-face. Telephone delivery may overcome some barriers to accessing face-to-face programs and provide a useful delivery modality, being ubiquitous, easy to access regardless of geographic location and suitable for long-term contact. We systematically reviewed the evidence on the effectiveness of telephonedelivered weight loss interventions (compared to control and face-to-face) in overweight and obese adults. Initial weight loss interventions and extended care interventions for weight loss maintenance were included. Methods: A structured search of six databases was conducted for articles published until May 2013. Included studies were randomised trials evaluating interventions in adults with the primary aim to achieve weight loss (or weight loss maintenance) and with at least 50% of intervention contacts in one of the study groups delivered via telephone. Two investigators independently reviewed search results for eligible studies and extracted data. Meta-analyses were by fixed effects when studies were homogeneous or random effects (DerSimonian-Laird) when heterogeneity was present. Results: 23 studies involving 7321 participants were eligible. Eighteen studies (5009 participants) evaluating initial weight loss interventions reported telephone versus control (or brief intervention) comparisons of weight loss (kg). Random effects models showed a significant benefit of telephone over control (weighted mean difference [95%CI]: −2.50 [−3.35, −1.65] kg). Five studies (1059 participants) compared telephone with face-to-face intervention, with equivalent contact in each modality. Meta-analysis revealed no significant difference between modalities for initial weight loss (telephone—face-to-face: −0.77 [−1.77, 0.23] kg). Three studies (1610 participants) evaluating extended care interventions reported telephone versus brief intervention comparisons of weight loss maintenance (kg). Random effects mod-
Annual Scientific Meeting els showed significantly less weight regain with the telephone versus brief intervention: −1.68 [−2.39, −0.96] kg. Conclusions: Evidence suggests that telephonedelivered weight loss interventions are effective and can achieve similar weight loss outcomes as those delivered face-to-face. Comparative costeffectiveness studies are needed.
85 a school nutrition policy that supports The NSW Healthy Schools Canteen policy (p < 0.02). Discussion: These results suggest that Principal influence and supportive school policy are important factors in canteens restricting the sale of unhealthy food items and complying with government canteen policy. Therefore it is suggested that interventions should engage school principals and encourage the development of school-based policy.
http://dx.doi.org/10.1016/j.orcp.2014.10.154 61 Is the banning of unhealthy foods at school canteens associated with principal influence or school policy? Kathryn Reilly ∗ , Rebecca Wyse, Serene Yoong, Nicole Nathan Hunter New England Population Health, Wallsend, NSW, Australia Background: Poor diet is a contributing factor to the high prevalence of overweight and obesity among Australian school children [1]. Interventions targeting school canteens have the potential to positively influence children’s diets [2]. Although government policies have been developed to restrict the sale of unhealthy foods, the implementation of such policies has been limited [3]. To date, most implementation support has been targeted towards canteen managers. However, engaging principals may also be important in optimising policy implementation. This study aimed to investigate whether the exclusion of ‘red’ food items on canteen menus is associated with a high degree of principal influence or having a school nutrition policy. Method: Primary school principals in the Hunter New England region, NSW participated in a telephone survey. The NSW Healthy Schools Canteen policy uses a traffic light system to categorise foods. Foods classified as ‘red’ are prohibited for sale. Principals were asked to identify foods usually sold in their canteen from a standard list which included common ‘red’ foods. They were then asked to rate their perceived influence over canteen menus and whether they had a school nutrition policy. Chi-square tests were conducted to determine significant associations with ‘excluding red items’. Results: Of the 413 principals contacted to complete the survey 340 (82%) consented and 276 (67%) had an operational canteen. The exclusion of red foods from canteen menus was significantly associated with: principals having a high degree of influence on canteen menus (p < 0.01), and having
References [1] Summerbell CD, Waters E, Edmunds L, Kelly SAM, Brown T, Campbell KJ. Interventions for preventing obesity in children. Cochrane Database Syst Rev 2005;3(3). [2] Bell A, Swinburn BA. School canteens: using ripples to create a wave of healthy eating. Med J Aust 2005;183(1):5—6. [3] de Silva-Sanigorski A, Breheny T, Jones L, Lacy K, Kremer P, Carpenter L, et al. Government food service policies and guidelines do not create healthy school canteens. Aust N Z J Public Health 2011;35(April (2)):117—21.
http://dx.doi.org/10.1016/j.orcp.2014.10.155 164 The neuro-endocrinology of eating Hendrik Rensburg The Rensburg Clinic, Nedlands, Australia All of the current neurobiological models of feeding behaviour are either implicitly or explicitly founded in a homeostatic/negative feedback philosophy. On closer examination it appears that these models set the trend in current thinking, but are in many ways flawed since it relies on this homeostatic/negative feedback as the basis for research and understanding. A more lateral approach and better understanding are called for to understand this complex system without the constraints of this theory, which borders at times on dogma. It is argued that normal expected homeostatic mechanisms do not apply to the over consumption of food, but only to the under consumption of food, which is an important survival strategy in an erratic food supply situation. The first obstacle is that the system that causes eating behaviour has never been named or even properly identified, while other systems in the body has been recognized and named, even without a full understanding of its biology and physiology. Extensive fragmented research has gone into the ‘‘eating system’’, but because it was not identified and named it remained largely mysterious, which attracted large numbers of psychologists who made it even more enigmatic. This system that initiates eating behaviour is identified as a ded-
M. Pickford
71
10
Elucidating how diet drives gut bacterial composition through computational simulation
Weight loss via the telephone — Does it work? A systematic review and meta-analysis
Mark Read ∗ , Andrew Holmes
Marina M. Reeves ∗ , Charlotte L. Brakenridge, Megan E. Whelan, Elizabeth G. Eakin
The University of Sydney, Darlington, NSW, Australia A growing body of evidence has highlighted the influence of the gut microbial community on host health, with dysbiosis being implicated in diseases as diverse as autism, obesity and colitis. Characterisation of the mechanisms through which the gut microbiota and the hot interact is required to build an understanding of how to effectively manage and manipulate host health. This work employs computational simulation to elucidate the influence of diet composition and feeding regimen on gut bacterial community composition. This modelling work builds on a real mouse study in which 250 mice were administered one of 30 diets. Each diet consists of different ratios of carbohydrate, protein and fat, and in addition, varying quantities of cellulose that adjust the host-accessible nutrient density of the diet. We simulate each mouse in this study, and assess how the diet composition and varying lengths and regularities of feeding versus diet periods drive bacterial community composition. Our simulation explicitly represents individual bacteria as belonging to one of five functional guilds, defined by their preferential access to carbon and nitrogen from a subset of feed-derived protein, cornstarch, dyetrose, or intestinal mucin. We simulate heterogeneous bacterial communities, where individual bacteria compete for limited nutrient resources, have varying growth and death rates, and undergo a stress response in response to periods of nutrient scarcity. Through simulation we can predict how different diets, the periods at which food is eaten, and periods of fasting can influence bacterial community composition. We find that periodic caloric restriction drives a greater relative abundance of bacterial guilds that preferentially access carbon and nitrogen from mucin, and that the benefit to these guilds varies with host diet composition. We can assess the quantities and times at which fibre supplements can be administered to achieve optimal effect in manipulating bacterial community composition. http://dx.doi.org/10.1016/j.orcp.2014.10.152
Cancer Prevention Research Centre, The University of Queensland, Brisbane, Australia Introduction: Weight loss interventions are traditionally delivered face-to-face. Telephone delivery may overcome some barriers to accessing face-to-face programs and provide a useful delivery modality, being ubiquitous, easy to access regardless of geographic location and suitable for long-term contact. We systematically reviewed the evidence on the effectiveness of telephonedelivered weight loss interventions (compared to control and face-to-face) in overweight and obese adults. Initial weight loss interventions and extended care interventions for weight loss maintenance were included. Methods: A structured search of six databases was conducted for articles published until May 2013. Included studies were randomised trials evaluating interventions in adults with the primary aim to achieve weight loss (or weight loss maintenance) and with at least 50% of intervention contacts in one of the study groups delivered via telephone. Two investigators independently reviewed search results for eligible studies and extracted data. Meta-analyses were by fixed effects when studies were homogeneous or random effects (DerSimonian-Laird) when heterogeneity was present. Results: 23 studies involving 7321 participants were eligible. Eighteen studies (5009 participants) evaluating initial weight loss interventions reported telephone versus control (or brief intervention) comparisons of weight loss (kg). Random effects models showed a significant benefit of telephone over control (weighted mean difference [95%CI]: −2.50 [−3.35, −1.65] kg). Five studies (1059 participants) compared telephone with face-to-face intervention, with equivalent contact in each modality. Meta-analysis revealed no significant difference between modalities for initial weight loss (telephone—face-to-face: −0.77 [−1.77, 0.23] kg). Three studies (1610 participants) evaluating extended care interventions reported telephone versus brief intervention comparisons of weight loss maintenance (kg). Random effects mod-
Annual Scientific Meeting els showed significantly less weight regain with the telephone versus brief intervention: −1.68 [−2.39, −0.96] kg. Conclusions: Evidence suggests that telephonedelivered weight loss interventions are effective and can achieve similar weight loss outcomes as those delivered face-to-face. Comparative costeffectiveness studies are needed.
85 a school nutrition policy that supports The NSW Healthy Schools Canteen policy (p < 0.02). Discussion: These results suggest that Principal influence and supportive school policy are important factors in canteens restricting the sale of unhealthy food items and complying with government canteen policy. Therefore it is suggested that interventions should engage school principals and encourage the development of school-based policy.
http://dx.doi.org/10.1016/j.orcp.2014.10.154 61 Is the banning of unhealthy foods at school canteens associated with principal influence or school policy? Kathryn Reilly ∗ , Rebecca Wyse, Serene Yoong, Nicole Nathan Hunter New England Population Health, Wallsend, NSW, Australia Background: Poor diet is a contributing factor to the high prevalence of overweight and obesity among Australian school children [1]. Interventions targeting school canteens have the potential to positively influence children’s diets [2]. Although government policies have been developed to restrict the sale of unhealthy foods, the implementation of such policies has been limited [3]. To date, most implementation support has been targeted towards canteen managers. However, engaging principals may also be important in optimising policy implementation. This study aimed to investigate whether the exclusion of ‘red’ food items on canteen menus is associated with a high degree of principal influence or having a school nutrition policy. Method: Primary school principals in the Hunter New England region, NSW participated in a telephone survey. The NSW Healthy Schools Canteen policy uses a traffic light system to categorise foods. Foods classified as ‘red’ are prohibited for sale. Principals were asked to identify foods usually sold in their canteen from a standard list which included common ‘red’ foods. They were then asked to rate their perceived influence over canteen menus and whether they had a school nutrition policy. Chi-square tests were conducted to determine significant associations with ‘excluding red items’. Results: Of the 413 principals contacted to complete the survey 340 (82%) consented and 276 (67%) had an operational canteen. The exclusion of red foods from canteen menus was significantly associated with: principals having a high degree of influence on canteen menus (p < 0.01), and having
References [1] Summerbell CD, Waters E, Edmunds L, Kelly SAM, Brown T, Campbell KJ. Interventions for preventing obesity in children. Cochrane Database Syst Rev 2005;3(3). [2] Bell A, Swinburn BA. School canteens: using ripples to create a wave of healthy eating. Med J Aust 2005;183(1):5—6. [3] de Silva-Sanigorski A, Breheny T, Jones L, Lacy K, Kremer P, Carpenter L, et al. Government food service policies and guidelines do not create healthy school canteens. Aust N Z J Public Health 2011;35(April (2)):117—21.
http://dx.doi.org/10.1016/j.orcp.2014.10.155 164 The neuro-endocrinology of eating Hendrik Rensburg The Rensburg Clinic, Nedlands, Australia All of the current neurobiological models of feeding behaviour are either implicitly or explicitly founded in a homeostatic/negative feedback philosophy. On closer examination it appears that these models set the trend in current thinking, but are in many ways flawed since it relies on this homeostatic/negative feedback as the basis for research and understanding. A more lateral approach and better understanding are called for to understand this complex system without the constraints of this theory, which borders at times on dogma. It is argued that normal expected homeostatic mechanisms do not apply to the over consumption of food, but only to the under consumption of food, which is an important survival strategy in an erratic food supply situation. The first obstacle is that the system that causes eating behaviour has never been named or even properly identified, while other systems in the body has been recognized and named, even without a full understanding of its biology and physiology. Extensive fragmented research has gone into the ‘‘eating system’’, but because it was not identified and named it remained largely mysterious, which attracted large numbers of psychologists who made it even more enigmatic. This system that initiates eating behaviour is identified as a ded-