Perspective : Time-restricted eating—integrating the what with the when

Time-restricted eating (TRE) is a popular dietary strategy that emphasizes the timing of meals in alignment with diurnal circadian rhythms, permitting ad libitum energy intake during a restricted (∼8–10 h) eating window each day. Unlike energy-restricted diets or intermittent fasting interventions that focus on weight loss, many of the health-related benefits of TRE are independent of reductions in body weight. However, TRE research to date has largely ignored what food is consumed (i.e., macronutrient composition and energy density), overlooking a plethora of past epidemiological and interventional dietary research. To determine some of the potential mechanisms underpinning the benefits of TRE on metabolic health, future studies need to increase the rigor of dietary data collected, assessed, and reported to ensure a consistent and standardized approach in TRE research. This Perspective article provides an overview of studies investigating TRE interventions in humans and considers dietary intake (both what and when food is eaten) and their impact on selected health outcomes (i.e., weight loss, glycemic control). Integrating existing dietary knowledge about what food is eaten with our recent understanding on when food should be consumed is essential to optimize the impact of dietary strategies aimed at improving metabolic health outcomes

High dietary fat intake increases fat oxidation and reduces skeletal muscle mitochondrial respiration in trained humans.

High-fat, low-carbohydrate (CHO) diets increase whole-body rates of fat oxidation and down-regulate CHO metabolism. We measured substrate utilization and skeletal muscle mitochondrial respiration to determine whether these adaptations are driven by high fat or low CHO availability. In a randomized crossover design, 8 male cyclists consumed 5 d of a high-CHO diet [>70% energy intake (EI)], followed by 5 d of either an isoenergetic high-fat (HFAT; >65% EI) or high-protein diet (HPRO; >65% EI) with CHO intake clamped at <20% EI. During the intervention, participants undertook daily exercise training. On d 6, participants consumed a high-CHO diet before performing 100 min of submaximal steady-state cycling plus an ∼30-min time trial. After 5 d of HFAT, skeletal muscle mitochondrial respiration supported by octanoylcarnitine and pyruvate, as well as uncoupled respiration, was decreased at rest, and rates of whole-body fat oxidation were higher during exercise compared with HPRO. After 1 d of high-CHO diet intake, mitochondrial respiration returned to baseline values in HFAT, whereas rates of substrate oxidation returned toward baseline in both conditions. These findings demonstrate that high dietary fat intake, rather than low-CHO intake, contributes to reductions in mitochondrial respiration and increases in whole-body rates of fat oxidation after a consuming a high-fat, low-CHO diet.-Leckey, J. J., Hoffman, N. J., Parr, E. B., Devlin, B. L., Trewin, A. J., Stepto, N. K., Morton, J. P., Burke, L. M., Hawley, J. A. High dietary fat intake increases fat oxidation and reduces skeletal muscle mitochondrial respiration in trained humans

Research Exploring Physical Activity in Care Homes (REACH): study protocol for a randomised controlled trial

Background: As life expectancy increases and the number of older people, particularly those aged 85 years and over, expands there is an increase in demand for long-term care. A large proportion of people in a care home setting spend most of their time sedentary, and this is one of the leading preventable causes of death. Encouraging residents to engage in more physical activity could deliver benefits in terms of physical and psychological health, and quality of life. This study is the final stage of a programme of research to develop and preliminarily test an evidence-based intervention designed to enhance opportunities for movement amongst care home residents, thereby increasing levels of physical activity. Methods/design: This is a cluster randomised feasibility trial, aiming to recruit at least 8–12 residents at each of 12 residential care homes across Yorkshire, UK. Care homes will be randomly allocated on a 1:1 basis to receive either the intervention alongside usual care, or to continue to provide usual care alone. Assessment will be undertaken with participating residents at baseline (prior to care home randomisation) and at 3, 6, and 9 months post-randomisation. Data relating to changes in physical activity, physical function, level of cognitive impairment, mood, perceived health and wellbeing, and quality of life will be collected. Data at the level of the home will also be collected and will include staff experience of care, and changes in the numbers and types of adverse events residents experience (for example, hospital admissions, falls). Details of National Health Service (NHS) usage will be collected to inform the economic analysis. An embedded process evaluation will obtain information to test out the theory of change underpinning the intervention and its acceptability to staff and residents. Discussion: This feasibility trial with embedded process evaluation and collection of health economic data will allow us to undertake detailed feasibility work to inform a future large-scale trial. It will provide valuable information to inform research procedures in this important but challenging area

Modulation of Androgen Receptor Signaling in Hormonal Therapy-Resistant Prostate Cancer Cell Lines

Background: Prostate epithelial cells depend on androgens for survival and function. In (early) prostate cancer (PCa) androgens also regulate tumor growth, which is exploited by hormonal therapies in metastatic disease. The aim of the present study was to characterize the androgen receptor (AR) response in hormonal therapy-resistant PC346 cells and identify potential disease markers. Methodology/Principal Findings: Human 19K oligoarrays were used to establish the androgen-regulated expression profile of androgen-responsive PC346C cells and its derivative therapy-resistant sublines: PC346DCC (vestigial AR levels), PC346Flu1 (AR overexpression) and PC346Flu2 (T877A AR mutation). In total, 107 transcripts were differentially-expressed in PC346C and derivatives after R1881 or hydroxyflutamide stimulations. The AR-regulated expression profiles reflected the AR modifications of respective therapy-resistant sublines: AR overexpression resulted in stronger and broader transcriptional response to R1881 stimulation, AR down-regulation correlated with deficient response of AR-target genes and the T877A mutation resulted in transcriptional response to both R1881 and hydroxyflutamide. This AR-target signature was linked to multiple publicly available cell line and tumor derived PCa databases, revealing that distinct functional clusters were differentially modulated during PCa progression. Differentiation and secretory functions were up-regulated in primary PCa but repressed i

PATCH: posture and mobility training for care staff versus usual care in care homes: study protocol for a randomised controlled trial

Background: Residents of care homes have high levels of disability and poor mobility, but the promotion of health and wellbeing within care homes is poorly realised. Residents spend the majority of their time sedentary which leads to increased dependency and, coupled with poor postural management, can have many adverse outcomes including pressure sores, pain and reduced social interaction. The intervention being tested in this project (the Skilful Care Training Package) aims to increase the awareness and skills of care staff in relation to poor posture in the older, less mobile adult and highlight the benefits of activity, and how to skilfully assist activity, in this group to enable mobility and reduce falls risk. Feasibility work will be undertaken to inform the design of a definitive cluster randomised controlled trial. Methods: This is a cluster randomised controlled feasibility trial, aiming to recruit at least 12–15 residents at each of 10 care homes across Yorkshire. Care homes will be randomly allocated on a 1:1 basis to receive either the Skilful Care Training Package alongside usual care or to continue to provide usual care alone. Assessments will be undertaken by blinded researchers with participating residents at baseline (before care home randomisation) and at three and six months post randomisation. Data relating to changes in physical activity, mobility, posture, mood and quality of life will be collected. Data at the level of the home will also be collected and will include staff experience of care and changes in the numbers and types of adverse events residents experience (for example, hospital admissions, falls). Details of NHS service usage will be collected to inform the economic analysis. An embedded process evaluation will explore intervention delivery and its acceptability to staff and residents. Discussion: Participant uptake, engagement and retention are key feasibility outcomes. Exploration of barriers and facilitators to intervention delivery will inform intervention optimisation. Study results will inform progression to a definitive trial and add to the body of evidence for good practice in care home research. Trial registration: ISRCTN Registry, ISRCTN50080330. Registered on 27 March 2017

Attitudes and Opinions of Parents towards Water-Only Drink Policy at Junior Triathlon Events

Rates of childhood obesity within Australia continue to rise, with consumption of sugar-sweetened beverages one contributing factor. Community sport provides an opportunity to implement policies promoting water as the beverage of choice. However, the attitudes of parents toward a water-only policy are not known. This cross-sectional study aimed to investigate parents&rsquo; opinions towards beverage consumption and a water-only policy. Data were collected from participants (n = 159) using an investigator-designed questionnaire, administered using iPads, at a junior Triathlon Victoria event. Water was the most popular beverage provided before (75%), during (85%) and after (61%) sport. Parents were more likely to provide sports drinks to children older than 14 years (27%). Three-quarters (77%) of parents reported having received no information regarding hydration requirements. Parents rated the importance of hydration prior to, during and after a triathlon as high (9.08 &plusmn; 1.2, 8.76 &plusmn; 1.3 and 9.30 &plusmn; 0.4 out of 10, respectively). Parents were supportive of a water-only policy at all junior triathlon events and all junior sporting events (7.94 &plusmn; 1.3 and 7.86 &plusmn; 1.9, respectively). There was less support for a water-only policy for adult triathlons (6.40 &plusmn; 3.1). A water-only drink policy at junior sport is viewed positively by parents. This warrants further research and policy development to facilitate behaviour change

Exploring general and sports nutrition and food knowledge in elite male Australian athletes

Nutrition knowledge is believed to influence nutritional intake, which in turn influences performance in elite athletes. There is currently no published data on the nutrition knowledge of elite Australian Football (AF) players. The purpose of this study was to gain insight into the current level of general and sports nutrition knowledge in elite male AF athletes. Forty six elite male AF players (23.5 ± 2.8 years) answered 123 questions relating to five areas of nutrition knowledge: dietary recommendations, sources of nutrients, choosing everyday foods, alcohol and sports nutrition. Demographic details and perceptions of nutrition knowledge were collected for all participants. The mean nutrition knowledge score was 74.4 ± 10.9 (60.5%). The highest score was obtained in sports nutrition section (17.9 ± 3.0, 61.7%). The dietitian was selected as the first source of information by 98% of athletes, with club trainer and teammates as second choice for 45.7% and 23.9% of athletes, respectively. The majority of athletes correctly answered questions regarding recommendations to increase fruit and vegetable intake and decrease fat intake (95.6%, 91.1% and 93.3% correct respectively). While 80% of the athletes were aware fat intake should predominately be made up of unsaturated fat, they were less able to identify food sources of unsaturated fats (35.6% and 24.4% correct for statements regarding monounsaturated and polyunsaturated fats, respectively). Broad nutrition messages and recommendations appear to be well understood; however, gaps in nutrition knowledge are evident. A better understanding of nutrition knowledge in athletes will allow nutrition education interventions to target areas in need of improvement

Intake of boiled potato in relation to cardiovascular disease risk factors in a large norwegian cohort : The HUNT study

Overall potato consumption is positively associated with cardiovascular disease (CVD) risk factors, such as measures of adiposity. However, few studies have explicitly stated the preparation method of potatoes, which may impact these associations. We examined cross-sectional associations between self-reported dietary intake of boiled potatoes and levels of body mass index, waist circumference, blood pressure, and blood lipids among 43,683 participants in the HUNT Study, Norway in 2006–2008. All estimated associations were adjusted for possible imbalance in age, sex, physical activity, smoking, intake of other foods and alcohol between categories of boiled potato consumption. Overall, there were no large differences in mean levels of CVD risk factors between categories of boiled potato consumption. Compared to the reference group of individuals who consumed boiled potatoes less than once/week, those who reported eating boiled potatoes every day had slightly higher prevalence of high waist circumference (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.05–1.29), high triglycerides levels (OR 1.20, 95% CI 1.07–1.34), and metabolic syndrome (OR 1.17, 95% CI 1.03–1.33). In summary, consumption of boiled potatoes showed weak and small associations with the CVD risk factors under study, but the cross-sectional design prevents us from drawing any firm conclusion

A systematic review of athletes' and coaches' nutrition knowledge and reflections on the quality of current nutrition knowledge measures

Nutrition knowledge can influence dietary choices and impact on athletic performance. Valid and reliable measures are needed to assess the nutrition knowledge of athletes and coaches. Objectives: (1) To systematically review the published literature on nutrition knowledge of adult athletes and coaches and (2) to assess the quality of measures used to assess nutrition knowledge. Data Sources: MEDLINE, CINAHL, SPORTDiscuss, Web of Science, and SCOPUS. Study Selection: 36 studies that provided a quantitative measure of nutrition knowledge and described the measurement tool that was used were included. Data extraction: Participant description, questionnaire description, results (mean correct and responses to individual items), study quality, and questionnaire quality. Data synthesis: All studies were of neutral quality. Tools used to measure knowledge did not consider health literacy, were outdated with regards to consensus recommendations, and lacked appropriate and adequate validation. The current status of nutrition knowledge in athletes and coaches is difficult to ascertain. Gaps in knowledge also remain unclear, but it is likely that energy density, the need for supplementation, and the role of protein are frequently misunderstood. Conclusions: Previous reports of nutrition knowledge need to be interpreted with caution. A new, universal, up-to-date, validated measure of general and sports nutrition knowledge is required to allow for assessment of nutrition knowledge