scholarly journals Brief support and personalised feedback on food shopping to encourage saturated fat reduction: the PC-SHOP randomised controlled trial

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Carmen Piernas ◽  
Paul Aveyard ◽  
Nerys Astbury ◽  
Jason Oke ◽  
Melina Tsiountsioura ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Primary Care ◽  
Total Energy ◽  
Energy Intake ◽  
Ldl Cholesterol ◽  
Saturated Fat ◽  
Total Energy Intake ◽  
Grocery Shopping ◽  
Food Shopping ◽  
Personalised Feedback

AbstractReducing saturated fat (SFA) intake can lower low-density lipoprotein (LDL)-cholesterol and thereby cardiovascular disease (CVD) but there are no brief interventions sufficiently scalable to achieve this. The Primary Care Shopping Intervention for Cardiovascular Disease Prevention (PC-SHOP) study developed and tested a behavioural intervention to provide health professional (HP) advice alone or in combination with personalised feedback on food shopping, which was delivered using a bespoke tool that created a nutritional profile of the grocery shopping based on loyalty card data from the UK largest supermarket.Participants with raised LDL-cholesterol were randomly allocated to one of three groups: ‘No Intervention’ (n = 17), ‘Brief Support’ (BS, n = 48), ‘Brief Support plus Shopping Feedback’ (BSSF, n = 48). BS consisted of a 10-minute consultation with a nurse to inform and motivate participants to reduce their SFA intake. The BSSF group received brief support as well as personalised feedback on the SFA content of their grocery shopping including lower SFA swaps. The primary outcome was the between-group difference in the change between baseline and 3 months in SFA intake (% total energy intake) adjusted for baseline SFA intake and GP practice. The trial was powered to detect a reduction in SFA of 3% (SD3).There was no evidence of a difference between the groups. Changes in SFA intake from baseline to follow-up were: -0.7% (SD3.5) in BS, -0.9% (SD3.6) in BSSF and -0.1% (SD3.3) with no intervention. Compared to no intervention, the adjusted difference in SFA intake was -0.33%; 95%CI -2.11, 1.44 with BS and -0.11%; 95%CI -1.92, 1.69 with BSSF. There was no significant difference in total energy intake (BS: -152kcal; 95%CI -513, 209; BSSF: -152kcal; 95%CI -516, 211); body weight (BS: -1.0 kg; 95%CI -2.5, 0.5; BSSF: -0.6 kg 95%CI -2.1, 1.0); or LDL-cholesterol (BS: -0.15mmol/L; 95%CI -0.47, 0.16; BSSF: -0.04mmol/L; 95%CI -0.28, 0.36) compared to no intervention.This trial shows that it is feasible to deliver brief advice in primary care to encourage reductions in SFA intake and we have developed a system to provide personalised advice to encourage healthier choices using supermarket loyalty data. This small trial showed no evidence of large benefits but we are unable to exclude more modest benefits. Even a reduction of 1% in SFA intake when replaced by polyunsaturated fat may reduce CVD incidence by 8%, suggesting that a larger trial to assess whether benefits of this size may occur is now warranted.

scholarly journals Sources of excessive saturated fat, trans fat and sugar consumption in Brazil: an analysis of the first Brazilian nationwide individual dietary survey

2012 ◽  
Vol 17 (1) ◽  
pp. 113-121 ◽  
Author(s):  
Rosangela A Pereira ◽  
Kiyah J Duffey ◽  
Rosely Sichieri ◽  
Barry M Popkin
Keyword(s):  
Total Energy ◽  
Energy Intake ◽  
Rural Areas ◽  
Family Income ◽  
Saturated Fat ◽  
Total Sugar ◽  
Total Energy Intake ◽  
Food Groups ◽  
Cross Sectional ◽  
Added Sugars

AbstractObjectiveTo examine the patterns of consumption of foods high in solid fats and added sugars (SoFAS) in Brazil.DesignCross-sectional study; individual dietary intake survey. Food intake was assessed by means of two non-consecutive food records. Foods providing >9·1 % of energy from saturated fat, or >1·3 % of energy from trans fat, or >13 % of energy from added sugars per 100 g were classified as high in SoFAS.SettingBrazilian nationwide survey, 2008–2009.SubjectsIndividuals aged ≥10 years old.ResultsMean daily energy intake was 8037 kJ (1921 kcal), 52 % of energy came from SoFAS foods. Contribution of SoFAS foods to total energy intake was higher among women (52 %) and adolescents (54 %). Participants in rural areas (43 %) and in the lowest quartile of per capita family income (43 %) reported the smallest contribution of SoFAS foods to total energy intake. SoFAS foods were large contributors to total saturated fat (87 %), trans fat (89 %), added sugar (98 %) and total sugar (96 %) consumption. The SoFAS food groups that contributed most to total energy intake were meats and beverages. Top SoFAS foods contributing to saturated fat and trans fat intakes were meats and fats and oils. Most of the added and total sugar in the diet was supplied by SoFAS beverages and sweets and desserts.ConclusionsSoFAS foods play an important role in the Brazilian diet. The study identifies options for improving the Brazilian diet and reducing nutrition-related non-communicable chronic diseases, but also points out some limitations of the nutrient-based criteria.

scholarly journals The impact of restaurant consumption among US adults: effects on energy and nutrient intakes

2014 ◽  
Vol 17 (11) ◽  
pp. 2445-2452 ◽  
Author(s):  
Binh T Nguyen ◽  
Lisa M Powell
Keyword(s):  
Total Energy ◽  
Energy Intake ◽  
Fast Food ◽  
Fixed Effects ◽  
Saturated Fat ◽  
Individual Characteristics ◽  
Total Energy Intake ◽  
Net Energy ◽  
The Impact ◽  
Daily Total

AbstractObjectiveTo examine the effect of fast-food and full-service restaurant consumption on adults’ energy intake and dietary indicators.DesignIndividual-level fixed-effects regression model estimation based on two different days of dietary intake data was used.SettingParallel to the rising obesity epidemic in the USA, there has been a marked upward trend in total energy intake derived from food away from home.SubjectsThe full sample included 12 528 respondents aged 20–64 years who completed 24 h dietary recall interviews for both day 1 and day 2 in the National Health and Nutrition Examination Survey (NHANES) 2003–2004, 2005–2006, 2007–2008 and 2009–2010.ResultsFast-food and full-service restaurant consumption, respectively, was associated with an increase in daily total energy intake of 813·75 kJ (194·49 kcal) and 858·04 kJ (205·21 kcal) and with higher intakes of saturated fat (3·48 g and 2·52 g) and Na (296·38 mg and 451·06 mg). Individual characteristics moderated the impacts of restaurant food consumption with adverse impacts on net energy intake being larger for black adults compared with their white and Hispanic counterparts and greater for middle-income v. high-income adults.ConclusionsAdults’ fast-food and full-service restaurant consumption was associated with higher daily total energy intake and poorer dietary indicators.

scholarly journals Nutritional composition of the diets of South Asian, black African-Caribbean and white European children in the United Kingdom: The Child Heart and Health Study in England (CHASE)

2010 ◽  
Vol 104 (2) ◽  
pp. 276-285 ◽  
Author(s):  
A. S. Donin ◽  
C. M. Nightingale ◽  
C. G. Owen ◽  
A. R. Rudnicka ◽  
M. C. McNamara ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Total Energy ◽  
Energy Intake ◽  
South Asian ◽  
Saturated Fat ◽  
Nutritional Composition ◽  
Total Energy Intake ◽  
Black African ◽  
African Caribbean

In the UK, South Asian adults have increased risks of CHD, type 2 diabetes and central obesity. Black African-Caribbeans, in contrast, have increased risks of type 2 diabetes and general obesity but lower CHD risk. There is growing evidence that these risk differences emerge in early life and that nutritional factors may be important. We have therefore examined the variations in nutritional composition of the diets of South Asian, black African-Caribbean and white European children, using 24 h recalls of dietary intake collected during a cross-sectional survey of cardiovascular health in eighty-five primary schools in London, Birmingham and Leicester. In all, 2209 children aged 9–10 years took part, including 558 of South Asian, 560 of black African-Caribbean and 543 of white European ethnicity. Compared with white Europeans, South Asian children reported higher mean total energy intake; their intakes of total fat, polyunsaturated fat and protein (both absolute and as proportions of total energy intake) were higher and their intakes of carbohydrate as a proportion of energy (particularly sugars), vitamin C and D, Ca and haem Fe were lower. These differences were especially marked for Bangladeshi children. Black African-Caribbean children had lower intakes of total and saturated fat (both absolute and as proportions of energy intake), NSP, vitamin D and Ca. The lower total and saturated fat intakes were particularly marked among black African children. Appreciable ethnic differences exist in the nutritional composition of children's diets, which may contribute to future differences in chronic disease risk.

scholarly journals US dietary guidelines: is saturated fat a nutrient of concern?

2018 ◽  
Vol 53 (22) ◽  
pp. 1393-1396 ◽  
Author(s):  
Zoe Harcombe
Keyword(s):  
Public Health ◽  
Total Energy ◽  
Energy Intake ◽  
Saturated Fat ◽  
Total Energy Intake ◽  
Dietary Guidelines ◽  
Dietary Advice ◽  
Fat Consumption ◽  
Dietary Guidelines For Americans ◽  
Total Fat

US public health dietary advice was announced by the Select Committee on Nutrition and Human needs in 1977 and was followed by UK public health dietary advice issued by the National Advisory Committee on Nutritional Education in 1983. Dietary recommendations in both cases focused on reducing dietary fat intake; specifically to (i) reduce overall fat consumption to 30% of total energy intake and (ii) reduce saturated fat consumption to 10% of total energy intake. The recommendations were an attempt to address the incidence of coronary heart disease. These guidelines have been reiterated in the Dietary Guidelines for Americans since the first edition in 1980. The most recent edition has positioned the total fat guideline with the use of ‘Acceptable Macronutrient Distribution Ranges’. The range given for total fat is 20%–35% and the AMDR for saturated fat is given as <10%—both as a percentage of daily calorie intake. In February 2018, the Center for Nutrition Policy and Promotion announced ‘The US Departments of Agriculture and Health and Human Services currently are asking for public comments on topics and supporting scientific questions to inform our development of the 2020–2025 Dietary Guidelines for Americans’. Public comments were invited on a number of nutritional topics. The question asked about saturated fats was: ‘What is the relationship between saturated fat consumption (types and amounts) during adulthood and risk of cardiovascular disease?’ This article is a response to that question.

scholarly journals Evaluation of an intervention to provide brief support and personalized feedback on food shopping to reduce saturated fat intake (PC-SHOP): A randomized controlled trial

PLoS Medicine ◽  
2020 ◽  
Vol 17 (11) ◽  
pp. e1003385
Author(s):  
Carmen Piernas ◽  
Paul Aveyard ◽  
Charlotte Lee ◽  
Melina Tsiountsioura ◽  
Michaela Noreik ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Primary Care ◽  
Ldl Cholesterol ◽  
Controlled Trial ◽  
Saturated Fat ◽  
Personalized Feedback ◽  
Randomized Controlled ◽  
Brief Advice ◽  
Loyalty Card

Background Guidelines recommend reducing saturated fat (SFA) intake to decrease cardiovascular disease (CVD) risk, but there is limited evidence on scalable and effective approaches to change dietary intake, given the large proportion of the population exceeding SFA recommendations. We aimed to develop a system to provide monthly personalized feedback and healthier swaps based on nutritional analysis of loyalty card data from the largest United Kingdom grocery store together with brief advice and support from a healthcare professional (HCP) in the primary care practice. Following a hybrid effectiveness-feasibility design, we tested the effects of the intervention on SFA intake and low-density lipoprotein (LDL) cholesterol as well as the feasibility and acceptability of providing nutritional advice using loyalty card data. Methods and findings The Primary Care Shopping Intervention for Cardiovascular Disease Prevention (PC-SHOP) study is a parallel randomized controlled trial with a 3 month follow-up conducted between 21 March 2018 to 16 January2019. Adults ≥18 years with LDL cholesterol >3 mmol/L (n = 113) were recruited from general practitioner (GP) practices in Oxfordshire and randomly allocated to “Brief Support” (BS, n = 48), “Brief Support + Shopping Feedback” (SF, n = 48) or “Control” (n = 17). BS consisted of a 10-minute consultation with an HCP to motivate participants to reduce their SFA intake. Shopping feedback comprised a personalized report on the SFA content of grocery purchases and suggestions for lower SFA swaps. The primary outcome was the between-group difference in change in SFA intake (% total energy intake) at 3 months adjusted for baseline SFA and GP practice using intention-to-treat analysis. Secondary outcomes included %SFA in purchases, LDL cholesterol, and feasibility outcomes. The trial was powered to detect an absolute reduction in SFA of 3% (SD3). Neither participants nor the study team were blinded to group allocation. A total of 106 (94%) participants completed the study: 68% women, 95% white ethnicity, average age 62.4 years (SD 10.8), body mass index (BMI) 27.1 kg/m2 (SD 4.7). There were small decreases in SFA intake at 3 months: control = −0.1% (95% CI −1.8 to 1.7), BS = −0.7% (95% CI −1.8 to 0.3), SF = −0.9% (95% CI −2.0 to 0.2); but no evidence of a significant effect of either intervention compared with control (difference adjusted for GP practice and baseline: BS versus control = −0.33% [95% CI −2.11 to 1.44], p = 0.709; SF versus control = −0.11% [95% CI −1.92 to 1.69], p = 0.901). There were similar trends in %SFA based on supermarket purchases: control = −0.5% (95% CI −2.3 to 1.2), BS = −1.3% (95% CI −2.3 to −0.3), SF = −1.5% (95% CI −2.5 to −0.5) from baseline to follow-up, but these were not significantly different: BS versus control p = 0.379; SF versus control p = 0.411. There were small reductions in LDL from baseline to follow-up (control = −0.14 mmol/L [95% CI −0.48, 0.19), BS: −0.39 mmol/L [95% CI −0.59, −0.19], SF: −0.14 mmol/L [95% CI −0.34, 0.07]), but these were not significantly different: BS versus control p = 0.338; SF versus control p = 0.790. Limitations of this study include the small sample of participants recruited, which limits the power to detect smaller differences, and the low response rate (3%), which may limit the generalisability of these findings. Conclusions In this study, we have shown it is feasible to deliver brief advice in primary care to encourage reductions in SFA intake and to provide personalized advice to encourage healthier choices using supermarket loyalty card data. There was no evidence of large reductions in SFA, but we are unable to exclude more modest benefits. The feasibility, acceptability, and scalability of these interventions suggest they have potential to encourage small changes in diet, which could be beneficial at the population level. Trial registration ISRCTN14279335.

scholarly journals Development and Validation of an Index Based on EAT-Lancet Recommendations: The Planetary Health Diet Index

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1698
Author(s):  
Leandro Teixeira Cacau ◽  
Eduardo De Carli ◽  
Aline Martins de Carvalho ◽  
Paulo Andrade Lotufo ◽  
Luis A. Moreno ◽  
...  
Keyword(s):  
Total Energy ◽  
Energy Intake ◽  
Carbon Footprint ◽  
Linear Regression Analysis ◽  
Total Energy Intake ◽  
Dietary Quality ◽  
Cronbach’S Alpha ◽  
Multicenter Cohort Study ◽  
Planetary Health ◽  
Cronbach's Alpha

The EAT-Lancet Commission has proposed a planetary health diet. We propose the development of the Planetary Health Diet Index (PHDI) based on this proposed reference diet. We used baseline dietary data obtained through a 114-item FFQ from 14,779 participants of the Longitudinal Study on Adult Health, a multicenter cohort study conducted in Brazil. The PHDI has 16 components and a score from 0 to 150 points. Validation and reliability analyses were performed, including principal component analyses, association with selected nutrients, differences in means between groups (for example, smokers vs. non-smokers), correlations between components and total energy intake, Cronbach’s alpha, item-item correlations, and linear regression analysis between PHDI with carbon footprint and overall dietary quality. The mean PHDI was 60.4 (95% CI 60.2:60.5). The PHDI had six dimensions, was associated in an expected direction with the selected nutrients and was significantly (p < 0.001) lower in smokers (59.0) than in non-smokers (60.6). Cronbach’s alpha value was 0.51. All correlations between components were low, as well as between components and PHDI with total energy intake. After adjustment for age and sex, the PHDI score remained associated (p < 0.001) with a higher overall dietary quality and lower carbon footprint. Thus, we confirmed the PHDI validity and reliability.

scholarly journals Food consumption of sugarcane workers' families in the Brazilian Northeast

2015 ◽  
Vol 28 (2) ◽  
pp. 175-184
Author(s):  
Vanessa Messias Muniz ◽  
Débora Silva Cavalcanti ◽  
Nayalla Morais de Lima ◽  
Mônica Maria Osório
Keyword(s):  
Food Intake ◽  
Total Energy ◽  
Energy Intake ◽  
Family Members ◽  
Age Groups ◽  
Total Energy Intake ◽  
Dietary Intakes ◽  
Food Groups ◽  
Micronutrient Intake ◽  
Brazilian Northeast

OBJECTIVE: To analyze the food intake of sugarcane workers' family members. METHODS: The food intake of 159 family members of sugarcane workers from Gameleira, Pernambuco, Brazilian Northeast, was investigated by directly weighing the foods on three non-consecutive days. The percent risk of inadequate macro- and micronutrient intakes was analyzed according to the Reference Dietary Intakes. The macronutrients were analyzed in relation to acceptable distribution intervals. The energy consumed from the various food groups was expressed as a ratio of the total energy intake. RESULTS: The median intake of carbohydrates and proteins remained above the Estimated Average Requirement, and all age groups presented a low risk of inadequate carbohydrate and protein intakes. The median intakes of riboflavin, niacin, thiamin, and iron remained above the Estimated Average Requirement for all age groups, but children aged 1-3 years presented a high percent risk of inadequate iron intake. All age groups presented high percent risk of inadequate zinc, calcium, vitamin A, and vitamin C intakes. Grains and derivatives had a greater participation in the total energy intake, especially in men aged 19-30 years. The group "milk and dairy products" had a greater participation in the diet of children aged 1-3 years. CONCLUSION: The low percent risk of inadequate carbohydrate and protein intakes in all age groups was opposed to the high risk of inadequate mineral and vitamin intakes, making the population vulnerable to nutritional disorders caused by excess macronutrient intake and inadequate micronutrient intake.

scholarly journals Results from a dietary survey in an Indian T2DM population: a STARCH study

BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e005138 ◽  
Author(s):  
Shashank R Joshi ◽  
Anil Bhansali ◽  
Sarita Bajaj ◽  
Subodh S Banzal ◽  
Mala Dharmalingam ◽  
...  
Keyword(s):  
Total Energy ◽  
Energy Intake ◽  
Epidemiological Survey ◽  
Total Energy Intake ◽  
Calorie Intake ◽  
Clinical Trial Registry ◽  
Cross Sectional ◽  
Diet Plan ◽  
Registration Number ◽  
The Mean

ObjectiveTo assess the dietary total and complex carbohydrate (CHO) contents in type-2 diabetes mellitus (T2DM) participants in India.SettingWe enrolled 796 participants in this cross-sectional, single-visit, multicentre, two-arm, single-country survey. Participants were enrolled from 10 specialty endocrinology/dialectology centres from five regions of India.ParticipantsA total of 796 participants (Asian) were enrolled in this study (385, T2DM and 409, non-T2DM). Key inclusion criteria—male or female ≥18 years, diagnosed with T2DM ≥12 months (T2DM), and not on any diet plan (non-T2DM).Study outcomePrimary outcome was to find out the percentage of total energy intake as simple and complex CHO from total CHO. Secondary outcomes were to find the differences in percentage of total energy intake as simple CHO, complex CHO, proteins and fats between T2DM and non-T2DM groups. The percentage of T2DM participants adhering to diet plan and showing glycaemic controls were also examined.ResultsThe mean (SD) of total calorie intake per day (Kcal) was 1547 (610, 95% CI 1486 to 1608) and 2132 (1892, 95% CI 1948 to 2316), respectively, for T2DM and non-T2DM groups. In the T2DM group (n=385), the mean (SD) percentage of total energy intake as total CHO, complex CHO and simple CHO was 64.1±8.3 (95% CI 63.3 to 64.9), 57.0±11.0 (95% CI 55.9 to 58.1) and 7.1±10.8 (95% CI 6.0 to 8.2), respectively. The mean (SD) percentage of complex CHO intake from total CHO was 89.5±15.3 (95% CI 88.0 to 91.1). The mean (SD) total protein/fat intake per day (g) was 57.1 (74.0)/37.2 (18.6) and 57.9 (27.2)/55.3 (98.2) in T2DM and non-T2DM groups, respectively.ConclusionsOur study shows that CHO constitutes 64.1% of total energy from diet in T2DM participants, higher than that recommended in India. However, our findings need to be confirmed in a larger epidemiological survey.Trial registration numberNCT01450592 & Clinical Trial Registry of India: CTRI/2012/02/002398.

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