scholarly journals A feasibility study to test a novel approach to dietary weight loss with a focus on assisting informed decision making in food selection

2021 ◽  
Author(s):  
Mindy Lee ◽  
Catherine C Applegate ◽  
Annabelle L Shaffer ◽  
Abrar Emamaddin ◽  
John W Erdman ◽  
...  
Keyword(s):  
Decision Making ◽  
Weight Loss ◽  
Food Selection ◽  
Informed Decision ◽  
Informed Decision Making ◽  
Fiber Density ◽  
Improvement Program ◽  
Novel Approach ◽  
Dietary Weight Loss ◽  
Protein Density

Obesity is a significant contributor to the development of chronic diseases, some of which can be prevented or reversed by weight loss. However, dietary weight loss programs have shortcomings in success rate and magnitude or sustainability of weight loss. The objective of the Individualized Diet Improvement Program (iDip) was to test the feasibility of a novel approach that helps individuals self-select a sustainable diet for weight loss and maintenance instead of providing weight loss products or rigid diet instructions to follow. The iDip study consisted of 22 dietary improvement sessions over 12 months with six months of follow-up. Daily weights were collected, and a chart summarizing progress was provided weekly. Six 24-hour dietary records were collected, and dietary feedback was provided in the form of a protein-fiber plot, in which protein/energy and fiber/energy of foods were plotted two-dimensionally together with a target box specific to weight loss or maintenance. An exit survey was conducted at 12 months. Twelve (nine female, 46.3±3.1 years (mean±SE)) of the initial 14 participants (BMI>28 kg/m2) completed all sessions. Mean percent weight loss (n=12) at six and 12 months was -4.9%±1.1 (p=0.001) and -5.4%±1.7 (p=0.007), respectively. Weight loss varied among individuals at 12 months; top and bottom halves (n=6 each) achieved -9.7%±1.7 (p=0.0008) and -1.0%±1.4 weight loss, respectively. The 24-hour records showed a significant increase in protein density from baseline to final (4.1g/100kcal±0.3 vs. 5.7g/100kcal±0.5 (p=0.008)). Although mean fiber density showed no significant change from the first month (1.3g/100kcal±0.1), the top half had significantly higher fiber/energy intake than the bottom half group. The survey suggested that all participants valued the program and its individualized approach. In conclusion, half of the participants successfully lost >5% and maintained the lost weight for 12 months without strict diet instructions, showing the feasibility of the informed decision-making approach.

scholarly journals Increased Protein Density During Weight Loss Is Correlated with Reduced Abdominal Obesity and Body Mass Index and Improved Body Composition

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1687-1687
Author(s):  
Annabelle Shaffer ◽  
Mindy Lee ◽  
Catherine Applegate ◽  
Nouf Alfouzan ◽  
John Erdman ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Composition ◽  
Waist Circumference ◽  
Abdominal Obesity ◽  
Fat Mass ◽  
Dietary Treatment ◽  
Adult Males ◽  
Fiber Density ◽  
Improvement Program ◽  
Protein Density

Abstract Objectives There is a clear link between abdominal obesity and chronic diseases. Dietary changes leading to substantial weight loss reduce obesity and improve health; however, no viable dietary treatment program exists that produces clinically significant, cost-effective, and sustainable weight loss. To test the hypothesis that a diet dense in lean proteins and fiber is inversely associated with abdominal obesity while maintaining skeletal muscle mass (SMM), we evaluated the correlation between mean protein and fiber density and changes in BMI, waist circumference and SMM during weight loss. Methods Thirty adult males and females participated in this ongoing, 2-year dietary weight loss program. The Individualized Dietary Improvement Program focused on reducing caloric intake and increasing protein (7–11 g/100 kcal) and fiber (1.8–3.2 g/100 kcal) density to desired ranges. Participants attended 19 group educational sessions, 3 individual counseling appointments, self-weighed daily, and submitted monthly 24-hour dietary recalls. BMI, waist circumference and body composition (InBody) measurements were collected at baseline and after 6 months. Results At 6 months, 25 participants (24–70y) remained in the study with 18 completing all body measurements. Mean weight loss (n = 25) was −2.2 ± 0.5 BMI points (–5.2 ± 1.3% of initial body weight) and mean waist circumference reduction (n = 18) was −6.5 ± 1.3 cm from baseline. Significant increases in protein and fiber density were seen from baseline to month 2 (P < 0.05). There were direct inverse associations between mean protein density and both reduced waist circumference (P < 0.01) and reduced BMI (P < 0.01). Fiber intake had no significant impact on weight loss, and maintenance of SMM did not significantly correlate with mean protein density. However, only 11.0 ± 3.2% of weight lost was due to the loss of SMM, supporting the efficacy of the program. A significant positive correlation (P < 0.01) existed between fat mass loss and protein density, with 74.3 ± 4.7% of excess body fat accounting for total weight lost. Conclusions Increased protein density correlates with accelerated loss of fat mass, greater reductions in abdominal adiposity, and may protect SMM from degradation during weight loss. Funding Sources This research is supported by the NIBIB of the NIH and the USDA NIFA.

scholarly journals Going Beyond Panaceas: The Diversity of Land Observatory Forms in Africa

Land ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. 70 ◽  
Author(s):  
Quentin Grislain ◽  
Jeremy Bourgoin ◽  
Ward Anseeuw ◽  
Perrine Burnod ◽  
Eva Hershaw ◽  
...  
Keyword(s):  
Decision Making ◽  
Participant Observation ◽  
Video Conferencing ◽  
Analytical Framework ◽  
Informed Decision ◽  
Informed Decision Making ◽  
Information Production ◽  
Dynamic Data ◽  
Ex Post ◽  
Ex Ante

In recent decades, mechanisms for observation and information production have proliferated in an attempt to meet the growing needs of stakeholders to access dynamic data for the purposes of informed decision-making. In the land sector, a growing number of land observatories are producing data and ensuring its transparency. We hypothesize that these structures are being developed in response to the need for information and knowledge, a need that is being driven by the scale and diversity of land issues. Based on the results of a study conducted on land observatories in Africa, this paper presents existing and past land observatories on the continent and proposes to assess their diversity through an analysis of core dimensions identified in the literature. The analytical framework was implemented through i) an analysis of existing literature on land observatories, ii) detailed assessments of land observatories based on semi-open interviews conducted via video conferencing, iii) fieldwork and visits to several observatories, and iv) participant observation through direct engagement and work at land observatories. We emphasize that the analytical framework presented here can be used as a tool by land observatories to undertake ex-post self-evaluations that take the observatory’s trajectory into account, or in the case of proposed new land observatories, to undertake ex-ante analyses and design the pathway towards the intended observatory.

scholarly journals A referral aid for smoking cessation interventions in primary care: study protocol for a randomized controlled trial

2021 ◽  
Vol 22 ◽  
Author(s):  
Daniëlle N. Zijlstra ◽  
Jean W.M. Muris ◽  
Catherine Bolman ◽  
J. Mathis Elling ◽  
Vera E.R.A. Knapen ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Smoking Cessation ◽  
Cost Effectiveness ◽  
Structural Equation ◽  
Controlled Trial ◽  
Linear Regression Analysis ◽  
Informed Decision ◽  
Equation Modeling ◽  
Informed Decision Making

Abstract Background: To expedite the use of evidence-based smoking cessation interventions (EBSCIs) in primary care and to thereby increase the number of successful quit attempts, a referral aid was developed. This aid aims to optimize the referral to and use of EBSCIs in primary care and to increase adherence to Dutch guidelines for smoking cessation. Methods: Practice nurses (PNs) will be randomly allocated to an experimental condition or control condition, and will then recruit smoking patients who show a willingness to quit smoking within six months. PNs allocated to the experimental condition will provide smoking cessation guidance in accordance with the referral aid. Patients from both conditions will receive questionnaires at baseline and after six months. Cessation effectiveness will be tested via multilevel logistic regression analyses. Multiple imputations as well as intention to treat analysis will be performed. Intervention appreciation and level of informed decision-making will be compared using analysis of (co)variance. Predictors for appreciation and informed decision-making will be assessed using multiple linear regression analysis and/or structural equation modeling. Finally, a cost-effectiveness study will be conducted. Discussion: This paper describes the study design for the development and evaluation of an information and decision tool to support PNs in their guidance of smoking patients and their referral to EBSCIs. The study aims to provide insight into the (cost) effectiveness of an intervention aimed at expediting the use of EBSCIs in primary care.

scholarly journals Research use at the Ministry of Health in Burkina Faso: the decision-makers’ perspective

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Christian Dagenais
Keyword(s):  
Decision Making ◽  
Knowledge Transfer ◽  
Burkina Faso ◽  
Informed Decision ◽  
Communication Strategy ◽  
Decision Makers ◽  
Research Use ◽  
Informed Decision Making ◽  
Ministry Of Health ◽  
Policy Makers

Abstract Background Despite the increased emphasis placed on the use of evidence for policy development, relatively few initiatives have been developed to support evidence-informed decision-making, especially in West Africa. Moreover, studies examining the conditions under which policy-makers use research-based evidence are still scarce, but they show that their attitudes and opinions about research are one of the main determinants of such use. In February 2017, Burkina Faso’s Minister of Health planned to create a unit to promote evidence-informed decision-making within the ministry. Before the unit was set up, documenting the attitudes towards research at the highest levels of his Ministry appeared profitable to the unit’s planning. Method Individual interviews were conducted by the author with 14 actors positioned to consider evidence during decision-making from the Burkina Faso’s Minister of health cabinet. An interview grid was used to explore several themes such as attitudes towards research, obstacles and facilitators to research use, example of research use in decision-making and finally, ways to increase decision-makers’ participation in knowledge transfer activities. Interviews were partially transcribed and analysed by the author. Results The results show a mixed attitude towards research and relatively little indication of research use reported by respondents. Important obstacles were identified: evidence inaccessibility, lack of implementation guidelines, absence of clear communication strategy and studies’ lack of relevance for decision-making. Many suggestions were proposed such as raising awareness, improving access and research communication and prioritizing interactions with researchers. Respondents agree with the low participation of decision-makers in knowledge transfer activities: more leadership from the senior officials was suggested and greater awareness of the importance of their presence. Conclusions The conclusion presents avenues for reflection and action to increase the potential impact of the knowledge transfer unit planned within the Ministry of Health of Burkina Faso. This innovative initiative will be impactful if the obstacles identified in this study and policy-makers’ preferences and needs are taken into account during its development and implementation.

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