Social status and energy intake: a randomized controlled experiment.
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ABSTRACT:
SUBMITTER: Pavela G
PROVIDER: S-EPMC5604843 | biostudies-literature | 2017 Oct
REPOSITORIES: biostudies-literature
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Social status and energy intake: a randomized controlled experiment.
Pavela G G Lewis D W DW Dawson J A JA Cardel M M Allison D B DB
Clinical obesity 20170609 5
While the inverse association between socioeconomic status (SES) and obesity in high gross domestic product countries is well established using observational data, the extent to which the association is due to a true causal effect of SES and, if so, the mechanisms of this effect remain incompletely known. To assess the influence of social status on obesity via energy intake, we randomized individuals to a higher or lower social status and observed subsequent energy intake. College students betwe ...[more]
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Project description:BackgroundThe question of whether neighborhood environment contributes directly to the development of obesity and diabetes remains unresolved. The study reported on here uses data from a social experiment to assess the association of randomly assigned variation in neighborhood conditions with obesity and diabetes.MethodsFrom 1994 through 1998, the Department of Housing and Urban Development (HUD) randomly assigned 4498 women with children living in public housing in high-poverty urban census tracts (in which ≥40% of residents had incomes below the federal poverty threshold) to one of three groups: 1788 were assigned to receive housing vouchers, which were redeemable only if they moved to a low-poverty census tract (where <10% of residents were poor), and counseling on moving; 1312 were assigned to receive unrestricted, traditional vouchers, with no special counseling on moving; and 1398 were assigned to a control group that was offered neither of these opportunities. From 2008 through 2010, as part of a long-term follow-up survey, we measured data indicating health outcomes, including height, weight, and level of glycated hemoglobin (HbA(1c)).ResultsAs part of our long-term survey, we obtained data on body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) for 84.2% of participants and data on glycated hemoglobin level for 71.3% of participants. Response rates were similar across randomized groups. The prevalences of a BMI of 35 or more, a BMI of 40 or more, and a glycated hemoglobin level of 6.5% or more were lower in the group receiving the low-poverty vouchers than in the control group, with an absolute difference of 4.61 percentage points (95% confidence interval [CI], -8.54 to -0.69), 3.38 percentage points (95% CI, -6.39 to -0.36), and 4.31 percentage points (95% CI, -7.82 to -0.80), respectively. The differences between the group receiving traditional vouchers and the control group were not significant.ConclusionsThe opportunity to move from a neighborhood with a high level of poverty to one with a lower level of poverty was associated with modest but potentially important reductions in the prevalence of extreme obesity and diabetes. The mechanisms underlying these associations remain unclear but warrant further investigation, given their potential to guide the design of community-level interventions intended to improve health. (Funded by HUD and others.).
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Project description:PurposeThe 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.MethodsThe 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.ResultsThe 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.ConclusionManipulating 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.
| S-EPMC10030411 | biostudies-literature
Project description:Background/objectivesSeveral previous studies have investigated whether regular walnut consumption positively changes heart-health-related parameters. The aim of this study was to investigate the effects of daily walnut intake on metabolic syndrome (MetS) status and other metabolic parameters among subjects with MetS.Subjects/methodsThis study was a two-arm, randomized, controlled crossover study with 16 weeks of each intervention (45 g of walnuts or iso-caloric white bread) with a 6 week washout period between interventions. Korean adults with MetS (n = 119) were randomly assigned to one of two sequences; 84 subjects completed the trial. At each clinic visit (at 0, 16, 22, and 38 weeks), MetS components, metabolic parameters including lipid profile, hemoglobin A1c (HbA1c), adiponectin, leptin, and apolipoprotein B, as well as anthropometric and bioimpedance data were obtained.ResultsDaily walnut consumption for 16 weeks improved MetS status, resulting in 28.6%-52.8% reversion rates for individual MetS components and 51.2% of participants with MetS at baseline reverted to a normal status after the walnut intervention. Significant improvements after walnut intake, compared to control intervention, in high-density lipoprotein cholesterol (HDL-C) (P = 0.028), fasting glucose (P = 0.013), HbA1c (P = 0.021), and adiponectin (P = 0.019) were observed after adjustment for gender, age, body mass index, and sequence using a linear mixed model.ConclusionA dietary supplement of 45 g of walnuts for 16 weeks favorably changed MetS status by increasing the concentration of HDL-C and decreasing fasting glucose level. Furthermore, consuming walnuts on a daily basis changed HbA1c and circulating adiponectin levels among the subjects with MetS. This trial is registered at ClinicalTrials.gov as NCT03267901.
| S-EPMC6449547 | biostudies-literature
Project description:Alcohol consumption has frequently been purported as a driver of condomless sex and HIV transmission, but to date, experimental evidence for the causal risk-taking impact of alcohol among HIV-positive populations is lacking. The present experiment sought to determine whether acute alcohol consumption has a direct causal impact on condomless sex intentions among HIV-positive men-who-have-sex-with-men (MSM), and to assess whether alcohol's impact differs between MSM who are HIV-positive versus HIV-negative.In a randomized controlled alcohol administration experiment, HIV-positive and HIV-negative MSM were brought into a specialized barroom laboratory and randomly assigned to beverage consumption condition: alcohol (target blood alcohol concentration = 0.080%), placebo alcohol (target blood alcohol concentration = 0.000%), or water (control). Participants then underwent a video-based sexual arousal manipulation (sexually aroused/nonaroused) and indicated their intentions to engage in condom-protected and condomless sexual acts in a standardized paradigm. The primary outcome entailed intentions to engage in condomless receptive and condomless insertive anal sex.A total of 282 MSM (141 HIV-positive; 141 HIV-negative) completed experimental procedures. MSM who received alcohol reported significantly stronger intentions to engage in condomless sex than those who received placebo alcohol or water (F(1,274) = 9.43, P = 0.002). The impact of alcohol did not differ between HIV-positive and HIV-negative MSM (F(1,274) = 1.86, P = 0.174).The present investigation entailed the first risk-focused alcohol administration experiment to involve an HIV-positive sample, and results demonstrated that consuming alcohol had an independent, causal impact on intentions to engage in sexual behaviors that can result in HIV transmission. Findings strongly suggest that alcohol-focused initiatives should be incorporated into HIV prevention efforts.
| S-EPMC5680134 | biostudies-other
Project description:BackgroundPsychological stress negatively influences food intake and food choices, thereby contributing to the development of childhood obesity. Physical activity can also moderate eating behavior and influence calorie intake. However, it is unknown if acute physical activity influences food intake and overall energy balance after acute stress exposure in children. We therefore investigated the impact of acute physical activity on overall energy balance (food intake minus energy expenditure), food intake, and choice in the setting of acute social stress in normal weight (NW) and overweight/obese (OW/OB) children as well as the impact of psychological risk factors.MethodAfter receiving written consent from their parents, 26 NW (BMI < 90(th) percentile) and 24 7-to 11-year-old OW (n = 5)/OB (n = 19, BMI ≥ 90(th) percentile) children were randomly allocated using computer-generated numbers (1:1, after stratification for weight status) to acute moderate physical or to sedentary activity for 30 min. Afterwards, all children were exposed to an acute social stressor. Children and their parents completed self-report questionnaires. At the end of the stressor, children were allowed to eat freely from a range of 12 different foods (6 sweet/6 salty; each of low/high caloric density). Energy balance, food intake/choice and obesity-related psychological risk factors were assessed.ResultsLower overall energy balance (p = 0.019) and a decreased choice of low density salty foods (p < 0.001) in NW children compared with OW/OB children was found after acute moderate physical activity but not sedentary activity. Independent of their allocation, OW/OB children ate more high density salty foods (104 kcal (34 to 173), p = 0.004) following stress. They scored higher on impulsive behavior (p = 0.005), restrained eating (p < 0.001) and parental corporal punishment (p = 0.03), but these psychological factors were not related to stress-induced food intake/choice. Positive parenting tended to be related to lower intake of sweet high density food (-132 kcal, -277 to 2, p = 0.054).ConclusionsIn the setting of stress, acute moderate physical activity can address energy balance in children, a benefit which is especially pronounced in the OW/OB. Positive parenting may act as a protective factor preventing stress-induced eating of comfort food.Trial registrationclinicaltrials.gov NCT01693926 The study was a pilot study of a project funded by the Swiss National Science Foundation (CRSII3_147673).
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Project description:BACKGROUND:Calcium is an important nutrient for the attainment of peak bone mass during adolescence and young adulthood. However, these life phases are characterized as hard to reach for health promotion. Social media platforms offer a promising channel as they are relatively low cost but used ubiquitously by youth. OBJECTIVE:The aim of the CAlcium Nutrition-Dietary Opportunities (CAN-DO) study was to conduct a randomized controlled trial to test the effectiveness of Facebook alone or with text messaging as channels to deliver a theory-based program to encourage optimal calcium intake. METHODS:The intervention was a 3-arm parallel trial. Young adults aged 18 to 25 years were recruited through university and social media for a 6-week trial. Participants were randomized to 1 of the 3 arms (ie, Facebook posts, Facebook posts plus text messages, and control group that received an electronic leaflet containing information on calcium intake). The primary outcome was change in intake of milk and other calcium-rich foods, and secondary outcomes were knowledge, self-efficacy, motivation, and habit formation concerning calcium-rich foods. Changes were assessed before and after the intervention, and the differences in change between groups were compared using multivariate regression models with multiple imputations for missing data. RESULTS:A total of 211 participants (64/211, 30.3% males) participated (mean age 21.4 years, SD 2.1) in this study. At the end of the program, no increase in milk intake (odds ratio [OR] 1.51, 95% CI 0.61-3.75 Facebook; OR 1.77, 95% CI 0.74-4.24 Facebook plus text messages; P=.41) nor calcium-rich food was detected (P=.57). There was a significant improvement in knowledge in the Facebook plus text messages group (P<.001), but habit formation improved less than that in the other 2 groups (P=.01). Our results showed a moderate level of engagement with intervention content and positive qualitative feedback from participants. CONCLUSIONS:The CAN-DO study delivered via Facebook (with the additional support of text messages) was found to improve knowledge and was acceptable among young adults. However, further research is needed to better understand social media engagement and how to optimize the program for participants to be sufficiently motivated to increase their intake of calcium-rich foods. TRIAL REGISTRATION:Australian New Zealand Clinical Trials Registry ACTRN12620000097943; http://www.anzctr.org.au/ACTRN12620000097943.aspx.
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Project description:AIMS:Exenatide is a glucagon-like peptide 1 (GLP-1) mimetic which induces weight loss predominantly, it is presumed, via decreased food intake. However, circulating GLP-1 is also a determinant of energy expenditure. We sought to quantify the effect of exenatide on energy expenditure (EE) and energy intake. MATERIALS AND METHODS:In this single-center, randomized double-blind placebo controlled trial, we randomized 80 healthy, non-diabetic volunteers with obesity (46 women, age: 34.4?±?8.7?y, body fat by DXA: 44.2?±?7.8%) to subcutaneous exenatide 10??g twice daily or placebo. Subjects were admitted to our clinical research unit for measurement of 24?h-EE in a whole-room indirect calorimeter and ad libitum food intake using an automated vending machine paradigm before and after randomization. Furthermore, energy expenditure and ad libitum food intake measures were repeated at 24-week after readmission for 7-day inpatient stay. Body weight was obtained weekly for up to 5?weeks and was recorded at each monthly follow up visit up to 24?weeks. RESULTS:Prior to randomization, participants over ate during the 3-day vending machine period in the whole study group (114.6?±?35.2%), expressed as percentage of weight maintaining energy needs (WMEN) with those who were eventually randomized to exenatide overeating more (121.6?±?37.7%) compared to placebo group (107.6?±?31.5%). In the exenatide group, ad libitum absolute energy intake decreased by 1016.1?±?724.5?kcal/day (95% CI: -1250.9 to -781.2) versus a 245.1?±?710.5?kcal/day (95% CI: -475.4 to -14.7) decrease in placebo (??=?-624.8?Kcal/day, p?<?0.0001) whereas the reduction in ad libitum caloric intake relative to WMEN was a more modest 366.8?±?752.1?kcal/day (95% CI: -614.0 to -119.6) decrease compared to 8.0?±?860.1?kcal/day (95% CI: -286.8 to 270.8) reduction in placebo (??=?-382.3?Kcal/day, p?=?0.03). The decrease was uniform across all macronutrients groups. No differences in 24hEE or substrate oxidation rates were found. In the exenatide group, body weight decreased more over the 5?weeks (??=?-0.039?kg/week, p?=?0.02) and was lower compared to placebo at the end of fifth week (-1.48?±?0.77?kg; 95% CI: -3.02 to 0.05, p?=?0.06). At the 24-week follow up, there was no difference in energy intake between exenatide group and placebo group and the treatment group decreased 24-h EE more compared to placebo (??=?-160.6?Kcal/day, 95% CI: -307.6 to 13.6, p?=?0.03) compared to their pre-randomization measurement. However, this reduction was not present after adjustment for changes in FM and FFM (??=?-87?kcal/day, p?=?0.14). No difference was observed in body weight (??=?-1.72?kg, 95% CI: -5.77 to 2.30, p?=?0.39) in exenatide versus placebo over 24?weeks. CONCLUSION:Compared with placebo, exenatide decreased early ad libitum energy intake but did not change 24?h-EE. However, the reduction was more modest in relative versus absolute terms (i.e. below that needed for WMEN). Thus, although rate of weight change was greater in the exenatide treated subjects at 5?weeks, the absolute difference in weight was not significant. These findings indicate that although exenatide reduces food intake, it may be more beneficial in blunting overeating and thus may serve to more prevent weight regain following initial weight loss.
| S-EPMC6062468 | biostudies-literature
Project description:ObjectiveThis randomized trial experimentally manipulated social status to assess effects on acute eating behavior and 24-hour energy balance.MethodsParticipants (n = 133 Hispanics; age 15-21 years; 60.2% females) were randomized to low social status ("LOW") or high social status ("HIGH") conditions in a rigged game of Monopoly (Hasbro, Inc.). Acute energy intake in a lunchtime meal was measured by food scales. Twenty-four-hour energy balance was assessed via summation of resting metabolic rate (metabolic cart), physical activity energy expenditure (accelerometer), thermic effect of food, and subtraction of twenty-four-hour energy intake (food diary).ResultsIn the total sample, no significant differences were observed by study condition at lunchtime. LOW females consumed a greater percent of lunchtime daily energy needs (37.5%) relative to HIGH females (34.3%); however, this difference was not statistically significant (P = 0.291). In males, however, LOW consumed significantly less (36.5%) of their daily energy needs relative to HIGH males (45.8%; P = 0.001). For 24-hour energy balance, sex differences were nearly significant (P = 0.057; LOW females: surplus +200 kcal; HIGH males: surplus +445 kcal). Food-insecure individuals consumed a nearly significant greater lunchtime percent daily energy than those with food security (40.7% vs. 36.3%; P = 0.0797).ConclusionsThe data demonstrate differential acute and 24-hour eating behavior responses between Hispanic male and female adolescents in experimentally manipulated conditions of low social status.
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Project description:Poorly designed labels and packaging are key contributors to medication errors. To identify attributes of labels and dosing tools that could be improved, we examined the extent to which dosing error rates are affected by tool characteristics (ie, type, marking complexity) and discordance between units of measurement on labels and dosing tools; along with differences by health literacy and language.Randomized controlled experiment in 3 urban pediatric clinics. English- or Spanish-speaking parents (n = 2110) of children ?8 years old were randomly assigned to 1 of 5 study arms and given labels and dosing tools that varied in unit pairings. Each parent measured 9 doses of medication (3 amounts [2.5, 5, and 7.5 mL] and 3 tools [1 cup, 2 syringes (0.2- and 0.5-mL increments)]), in random order. Outcome assessed was dosing error (>20% deviation; large error defined as > 2 times the dose).A total of 84.4% of parents made ?1 dosing error (21.0% ?1 large error). More errors were seen with cups than syringes (adjusted odds ratio = 4.6; 95% confidence interval, 4.2-5.1) across health literacy and language groups (P < .001 for interactions), especially for smaller doses. No differences in error rates were seen between the 2 syringe types. Use of a teaspoon-only label (with a milliliter and teaspoon tool) was associated with more errors than when milliliter-only labels and tools were used (adjusted odds ratio = 1.2; 95% confidence interval, 1.01-1.4).Recommending oral syringes over cups, particularly for smaller doses, should be part of a comprehensive pediatric labeling and dosing strategy to reduce medication errors.
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Project description:IntroductionAn ageing society poses unprecedented challenges to societies. Information and Communication Technologies (ICTs), including Social Networking Sites (SNSs), may contribute to contrast loneliness and social isolation in old age. Despite of the potentialities of SNSs, there is only a handful of studies assessing the causal relationship of SNS use and older people's well-being. This paper aims to provide further evidence on the design of randomised controlled trials exploring the causal impact of SNS use on loneliness and social isolation in old age.Methods and analysisThe Aging in a Networked Society-Social Experiment Study (ANS-SE) is a randomised controlled trial conducted on people aged 75 and over residing in a town located in the Milan area (Italy) aiming to assess the impact of SNS use on loneliness and social isolation (i.e. the primary outcomes of this study). The study is constituted of two stages, i.e. the baseline and the follow up. The experiment is structured into one treatment group and two control groups; the interventions are the attendance to a course on SNS use (T1) and lifestyle education and brain functioning (C1). The inactive control group (C) is constituted of a waiting list. We will perform bivariate and regression analysis.Ethics and disseminationThe study has been approved by the Ethic Committee of the University of Milano Bicocca (prot. 431/2019) and was registered at Clinical Trials.gov (NCT04242628). Written consent was obtained from all respondents. Results from the study will be discussed with the local community and stakeholders, presented in national and international conferences and published in leading peer-review journals. The consent forms, the anonymised dataset, and the relevant statistical codes will be deposited with the Italian Unidata archive, also in charge of releasing the data to the public, upon a short embargo period.
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