scholarly journals Challenges in Designing and Delivering Diets and Assessing Adherence: A Randomized Controlled Trial Evaluating the 2010 Dietary Guidelines for Americans

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Sridevi Krishnan ◽  
Fanny Lee ◽  
Dustin J Burnett ◽  
Annie Kan ◽  
Ellen L Bonnel ◽  
...  
Keyword(s):  
Dietary Fiber ◽  
Controlled Trial ◽  
Proximate Analysis ◽  
Dietary Guidelines ◽  
Dietary Adherence ◽  
Free Living ◽  
Dietary Guidelines For Americans ◽  
Feeding Trials ◽  
Typical American Diet ◽  
Urinary Nitrogen

ABSTRACT Background Controlled-feeding trials are challenging to design and administer in a free-living setting. There is a need to share methods and best practices for diet design, delivery, and standard adherence metrics. Objectives This report describes menu planning, implementing, and monitoring of controlled diets for an 8-wk free-living trial comparing a diet pattern based on the Dietary Guidelines for Americans (DGA) and a more typical American diet (TAD) pattern based on NHANES 2009–2010. The objectives were to 1) provide meals that were acceptable, portable, and simple to assemble at home; 2) blind the intervention diets to the greatest extent possible; and 3) use tools measuring adherence to determine the success of the planned and implemented menu. Methods Menus were blinded by placing similar dishes on the 2 intervention diets but changing recipes. Adherence was monitored using daily food checklists, a real-time dashboard of scores from daily checklists, weigh-backs of containers returned, and 24-h urinary nitrogen recoveries. Proximate analyses of diet composites were used to compare the macronutrient composition of the composite and planned menu. Results Meeting nutrient intake recommendations while scaling menus for individual energy intake amounts and food portions was most challenging for vitamins D and E, the sodium-to-potassium ratio, dietary fiber, and fatty acid composition. Dietary adherence for provided foods was >95%, with no differences between groups. Urinary nitrogen recoveries were ∼80% relative to nitrogen intake and not different between groups. Composite proximate analysis matched the plan for dietary fat, protein, and carbohydrates. Dietary fiber was ∼2.5 g higher in the TAD composite compared with the planned menu, but ∼7.4 g lower than the DGA composite. Conclusions Both DGA and TAD diets were acceptable to most participants. This conclusion was supported by self-reported consumption, quantitative weigh-backs of provided food, and urinary nitrogen recovery. Dietary adherence measures in controlled-feeding trials would benefit from standard protocols to promote uniformity across studies. The trial is registered at clinicaltrials.gov as NCT02298725.

scholarly journals Free-Living Dietary Intervention Studies: Theory-Based Protocols to Improve Subject Compliance

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1282-1282
Author(s):  
Priscilla Macias ◽  
Celine Heskey
Keyword(s):  
Literature Review ◽  
Intervention Studies ◽  
Dietary Intervention ◽  
Food Group ◽  
Vegetarian Diet ◽  
Dietary Guidelines ◽  
Free Living ◽  
Eating Pattern ◽  
Study Protocols ◽  
Dietary Guidelines For Americans

Abstract Objectives Subject compliance in free-living dietary intervention studies is difficult to achieve. Published studies suggest various theoretically based strategies that can be used to improve compliance. Methods A weight-management dietary intervention for free-living subjects, based on a vegetarian dietary pattern, was created. Development of 7-day menus was conducted using McGraw Hills’ NutritionCalc Plus software. Menus utilized a framework from the 2015–2020 Dietary Guidelines for Americans’ Healthy Vegetarian Eating Pattern (macronutrient ratios and food group servings). A literature review was conducted to identify various counseling and technology strategies that may be effective at increasing subject compliance with their assigned study diet. The findings of the literature review was used to create study protocols. Protocol development for a food demonstration was also explored. Results A 1-week menu cycle for a vegetarian diet intervention was created, including a set of menus each for 1200,1800, and 2000 calories levels. The menus are inclusive of foods and portions that meet the Dietary Guidelines for Americans. Three study protocols were developed for strategies that may improve subject compliance: 1. A nutrition counseling protocol based on motivational interviewing; 2. A technology protocol on use of a dietary-self monitoring app; and 3. A food demonstration protocol highlighting vegetarian recipes. The protocols are designed to be used by study clinicians/dietitians in future intervention studies. Conclusions Theory-based protocols can be used to develop standardized protocols for research studies. These protocols theoretically may help to improve subject compliance. Funding Sources NIH BUILD PODER.

scholarly journals Consumption of a Variety of Vegetables to Meet Dietary Guidelines for Americans’ Recommendations Does Not Induce Sensitization of Vegetable Reinforcement Among Adults with Overweight and Obesity: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Shanon L Casperson ◽  
Lisa Jahns ◽  
Jennifer L Temple ◽  
Katherine M Appleton ◽  
Sara E Duke ◽  
...  
Keyword(s):  
Vegetable Intake ◽  
Vegetable Consumption ◽  
Food Reinforcement ◽  
Controlled Trial ◽  
Overweight And Obesity ◽  
Dietary Guidelines ◽  
Valuable Insight ◽  
Daily Consumption ◽  
Time Interaction ◽  
Dietary Guidelines For Americans

ABSTRACT Background Food reinforcement, or the motivation to obtain food, can predict choice and consumption. Vegetable consumption is well below recommended amounts for adults, so understanding how to increase vegetable reinforcement could provide valuable insight into how to increase consumption. Objectives We sought to determine whether daily consumption of the Dietary Guidelines for Americans (DGA) recommendations for vegetable intake induces sensitization of vegetable reinforcement in adults with overweight and obesity. Methods Healthy adults with a BMI ≥ 25 kg/m2 who consumed ≤1 cup-equivalent of vegetables/day were randomly assigned to a vegetable intervention (VI; n = 55) or an attention control (AC; n = 55) group. The VI consisted of the daily provision of vegetables in the amounts and types recommended by the DGA (∼270 g/day) for 8 weeks. Participants were followed for an additional 8 weeks to assess sustained consumption. Compliance was measured weekly by resonance Raman light-scattering spectroscopy (RRS). Vegetable reinforcement was tested at weeks 0, 8, 12, and 16 using a computer choice paradigm. Results In the VI group, RRS intensity increased from week 0 to 8 (from 22,990 to 37,220), returning to baseline by week 16 (27,300). No change was observed in the AC group. There was no main effect of treatment (P = 0.974) or time (P = 0.14) and no treatment x time interaction (P = 0.44) on vegetable reinforcement. There was no moderating effect of sex (P = 0.07), age (P = 0.60), BMI (P = 0.46), delay discounting (P = 0.24), 6-n-propylthiouracil taster status (P = 0.15), or dietary disinhibition (P = 0.82) on the change in vegetable reinforcement. Conclusions These findings suggest no effects of the provision of a variety of vegetables to meet DGA recommendations for 8 weeks on vegetable reinforcement and highlight the difficulty in increasing vegetable consumption in adults. This trial was registered at clinicaltrials.gov as NCT02585102.

scholarly journals Consumption of Dietary Guidelines for Americans Types and Amounts of Vegetables Increases Subjective Happiness: A Randomized Controlled Trial

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1266-1266
Author(s):  
Angela De Leon ◽  
Lisa Jahns ◽  
James Roemmich ◽  
Shanon Casperson
Keyword(s):  
Vegetable Consumption ◽  
Controlled Trial ◽  
Intervention Group ◽  
Well Being ◽  
Dietary Guidelines ◽  
Attention Control ◽  
Control Group ◽  
Subjective Happiness ◽  
Dietary Guidelines For Americans ◽  
Attention Control Group

Abstract Objectives The health benefits of diets rich in fruits and vegetables (FV) are well established and form the basis of the Dietary Guidelines for Americans (DGA). Furthermore, FV consumption may also exert a positive effect on psychological well-being. This study aimed to assess changes in global subjective happiness when consuming DGA recommended types and amounts of vegetables. It was hypothesized that increased vegetable consumption would increase happiness. Methods This study investigated secondary outcomes of a randomized, parallel, non-blinded controlled trial with a 1:1 allocation ratio to a provided vegetable intervention or attention control group. Men and women aged 18–65 yr, body mass index ≥ 25 kg/m,2 with low habitual vegetable consumption (<1 serving/day) were recruited for this community-based study. The vegetable intervention consisted of an 8-week feeding phase during which participants were provided with vegetables in DGA recommended types and amounts. The attention control group was not provided vegetables but completed the same testing schedule as the vegetable intervention group. The Subjective Happiness Scale (SHS) was used to assess individual perceived happiness before and after the intervention. SHS scores were analyzed using a mixed model analysis of variance both with and without baseline SHS scores as a covariate. Results A significant interaction between treatment and visit (P = 0.005) revealed greater happiness at week 8 than at baseline in the vegetable intervention group but no change in the attention control group. When adjusted for baseline scores, a significant effect of treatment (P = 0.005) was found with greater happiness scores in the vegetable intervention group compared to the attention control group post intervention (P < 0.001). Conclusions Greater subjective happiness was observed after increasing vegetable consumption to meet DGA recommendations. Funding Sources USDA-ARS #5450–51,530-057–00D.

scholarly journals The Dietary Guidelines for Americans (2020–2025): Pulses, Dietary Fiber, and Chronic Disease Risk—A Call for Clarity and Action

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4034
Author(s):  
Henry J. Thompson
Keyword(s):  
Chronic Disease ◽  
Dietary Fiber ◽  
Disease Risk ◽  
Dietary Guidelines ◽  
Chronic Disease Risk ◽  
Dietary Guidelines For Americans

The 2020–2025 Dietary Guidelines for Americans (DGA) were recently released [...]

Sign in / Sign up

Export Citation Format

Share Document