Effets de la consommation de légumineuses sur les composantes du syndrome métabolique chez la femme

Tableau d’honneur de la Faculté des études supérieures et postdoctorales, 2009-2010Les travaux présentés dans ce mémoire avaient pour objectif d'évaluer les effets de la consommation de légumineuses chez les femmes présentant au moins deux composantes du syndrome métabolique. Au total, 134 participantes ont été assignées aléatoirement à consommer 750 ml de légumineuses hebdomadairement ou des repas témoins sans légumineuses, durant 16 semaines. Les composantes primaires et secondaires du syndrome métabolique ont été mesurées durant l'intervention alimentaire. Une augmentation significative de l'apport en fibres alimentaires et une diminution significative de l'apport en cholestérol alimentaire ont été observées dans le groupe avec légumineuses. Aucune différence significative entre les groupes n'a été observée entre les groupes pour toutes les composantes du syndrome métabolique. Toutefois, une diminution de la concentration plasmatique de fibrinogène a été observée seulement dans le groupe avec légumineuses. En conclusion, l'ajout de 750 ml de légumineuses hebdomadairement dans l'alimentation n'a pas produit d'effets significatifs sur les composantes du syndrome métabolique

Manger avec sa tête ou selon ses sens : perceptions et comportements alimentaires

Alors que la prévalence de l’obésité a augmenté dans la population, l’idéalisation de la minceur peut mener à une préoccupation excessive à l’égard du poids corporel. Le contrôle du poids est une pratique fréquente, surtout auprès des femmes. Même si une faible perte de poids a des effets positifs à court terme sur les maladies chroniques associées à l’obésité, le succès à long terme des diètes amaigrissantes est négligeable. Perdre du poids est loin d’être banal, puisque certaines adaptations physiologiques peuvent se manifester et persister pour ramener le corps à son poids initial. Au niveau psychologique, les personnes qui limitent volontairement leur prise alimentaire peuvent notamment ressentir un sentiment de privation lié à la restriction cognitive, c’est-à-dire manger moins que ce qui est souhaité ou se priver de manger les aliments souhaités. Les diètes amaigrissantes et l’approche restrictive pour perdre du poids montrent des limites et ce constat amène à envisager des solutions de rechange efficaces à long terme. C’est dans ce contexte que s’inscrivent les travaux présentés dans cette thèse, qui tentent de répondre à cette problématique, via : 1) une étude expérimentale auprès de 352 hommes et femmes; et 2) un essai clinique randomisé auprès de 50 femmes restreintes. La première étude qui réfère aux perceptions cognitives des aliments, a évalué l’effet des allégations nutritionnelles verbales sur les perceptions d’un aliment et sur la prise alimentaire, de même que l'influence du genre, du poids corporel et de la restriction cognitive sur ces variables. Les résultats ont montré que les allégations nutritionnelles ont influencé les perceptions « santé » et « engraissante » d’un aliment, sans modifier les comportements mesurés par la prise alimentaire. La deuxième étude qui réfère aux perceptions sensorielles des aliments, a évalué les effets d’une intervention sensorielle sur les attitudes et les comportements alimentaires, la confiance en ses signaux de faim et de satiété, de même que le nombre et le type de mots utilisés pour décrire un aliment. Les résultats ont montré que l’intervention sensorielle a amélioré certains comportements et attitudes liés aux aliments et à l’acte alimentaire, sans exacerber d’autres comportements non souhaitables comme la restriction cognitive. L’intervention sensorielle a aussi aidé les femmes restreintes à être plus objectives à propos des aliments, ce qui pourrait faciliter une alimentation plus intuitive. Les résultats de ces travaux suggèrent que la dimension cognitive de l’alimentation ne devrait pas être surévaluée au détriment de la dimension sensorielle.While the prevalence of obesity has increased in the population, the thin-idealization can lead to concerns about body weight. Dieting is a common practice, especially among women. Even if a small weight loss has positive effects in the short term on obesity-related problems, success of energy-restricted diets is negligible over the long term. Losing weight is not without consequence, since some physiological adaptations can occur and persist over time, and may promote weight regain after diet-induced weight loss. One psychological consequence of dieting may be described as the perceived deprivation related to cognitive restraint, i.e. feeling of not eating what or as much as one would like. Energy-restricted diet and restrictive approach to lose weight show limits and this fact leads to consider effective alternatives in the long term. It is in this context that the work of the present thesis has been conducted, through: 1) an experimental study among 352 men and women; and 2) a randomized clinical trial among 50 restrained women. The first study focused on the cognitive perceptions of foods and the purposes were to investigate the impact of nutrition claims on food perceptions and intake, as well as the influence of gender, body weight and the level of restrained eating on these variables. The results showed that nutrition claims were effective in changing perceived “healthiness” and “fatteningness” of a food, but these changes in perceptions did not translate into a change in the food behaviors, as measured by food intake. The second study focused on the sensory perceptions of food and the purposes were to investigate whether a sensory-based intervention can influence eating-related attitudes and behaviors, reliance on physical signals for hunger and satiety, as well as the number and the type of terms used to describe a food. The results have shown that the sensory intervention has improved some eating-related attitudes and behaviors, without exacerbating other undesirable behaviors such as restrained eating. Then, the sensory-based intervention has also helped restrained women to be more objective about food, which may facilitate a more intuitive approach to eating. The results of this work suggest that the cognitive dimension of food should not be overrated at the expense of the sensory dimension

Sensory-based nutrition pilot intervention for women

Negative effects of restrained eating (ie, concerns about dieting and weight control) have been observed in eating behaviors. Such findings underscore the need to develop more positive approaches to promote healthy eating behaviors. The objectives of this pilot randomized controlled trial were to investigate and determine whether sensory-based intervention influenced eating-related attitudes and behaviors among restrained women, as well as reliance on physical signals for hunger and satiety. Between January and September 2011, data were collected using validated questionnaires (Restraint Scale, Three-Factor Eating Questionnaire, Mindful Eating Questionnaire, and Intuitive Eating Scale) at baseline (T=1), the end of the intervention period (T=2), and 12 weeks post intervention (T=3). At T=1, women (n=50) from Quebec City, Canada, were randomly assigned to an intervention group (sensory-based intervention) or a waiting list control group. Statistical analyses were conducted using mixed models, including the group, time, and group-by-time interaction. Women from the intervention group showed a significant decrease in Three-Factor Eating Questionnaire-Disinhibition and a significant increase in Mindful Eating Questionnaire-Disinhibition at T=2 vs T=3 (P=0.02 and P=0.02, respectively) and at T=3 vs T=1 (P=0.003 and P=0.002, respectively). Women from the intervention group also showed a significant increase in Intuitive Eating Scale-Unconditional Permission to Eat at T=2 vs T=1 (P<0.0001) and at T=3 vs T=1 (P<0.0001). These preliminary data suggest that sensory-based intervention can be a promising approach to improve eating-related attitudes and behaviors among restrained women, without exacerbating other behaviors such as restrained eating

‘‘Healthy,’’ ‘‘diet,’’ or ‘‘hedonic’’ : how nutrition claims affect food-related perceptions and intake?

The main purpose of this study was to investigate the impact of nutrition claims on food perceptions and intake among adult men and women, during ad libitum snacks. In a three (healthy vs. diet vs. hedonic) by two (normal-weight vs. overweight/obese) by two (unrestrained vs. restrained eaters) factorial design, 164 men and 188 women were invited to taste and rate oatmeal-raisin cookies. Despite the fact that the cookies were the same in all conditions, they were perceived as being healthier in the “healthy” condition than in the “diet” and “hedonic” conditions. The caloric content was estimated as higher by participants in the “hedonic” than in the “healthy” condition, by women than by men, and by restrained than by unrestrained eaters. Although measured ad libitum cookie intake did not differ as a function of experimental condition, overweight restrained men ate more than did women from each BMI and restraint category. Conversely, overweight restrained women ate less than did men from each BMI and restraint category. In conclusion, our manipulations of healthiness and “fatteningness” of food were effective in changing perceptions, but were not in changing behavior

Effect of sensory-based intervention on the increased use of food-related descriptive terms among restrained eaters

The goals of this pilot randomized controlled trial were to investigate and determine whether sensorybased intervention influenced the number and type of terms (descriptive and hedonic) used by restrained women to describe a certain food, and whether changes in the number of descriptive terms were associated with changes in intuitive eating. We collected data at baseline (T = 1), at the end of the intervention period (T = 2), and at 12 weeks post-intervention (T = 3) using the descriptive form and Intuitive Eating Scale (IES). At T = 1, 50 women were randomly assigned to an intervention group (sensory-based intervention) or a control group (waiting list). To determine the effect of intervention over time on the number of descriptive and hedonic terms, we conducted statistical analyses using mixed models. To determine associations between Intuitive Eating Scale subscales and the number of descriptive terms, we also calculated Spearman correlation coefficients. We noted a significant group-by-time interaction for descriptive terms associated with all senses (p < 0.04), except for a sight-related trend (p = 0.06). In comparison with T = 1, intervention group women at T = 2 and T = 3 showed a significant increase in descriptive terms associated with smell (p = 0.0002 and p = 0.03, respectively), taste (p = 0.001 and p = 0.01, respectively) and hearing (p = 0.04 and p = 0.0003, respectively). Among intervention group women, we noted a positive correlation between changes (T = 3 vs. T = 2) in the number of descriptive terms used and changes in reliance on internal hunger and satiety cues (r = 0.48; p = 0.04), as well as between changes (T = 3 vs. T = 1) in the number of descriptive terms used and changes in unconditional permission to eat (r = 0.45; p = 0.05). Overall, these data show that sensory-based intervention may help restrained women become more objective and enjoyably connected to food and their own bodies, which may promote a more intuitive approach to eating

Genome wide SNP comparative analysis between EGFR and KRAS mutated NSCLC and characterization of two models of oncogenic cooperation in non-small cell lung carcinoma

<p>Abstract</p> <p>Background</p> <p>Lung cancer with EGFR mutation was shown to be a specific clinical entity. In order to better understand the biology behind this disease we used a genome wide characterization of loss of heterozygosity and amplification by Single Nucleotide Polymorphism (SNP) Array analysis to point out chromosome segments linked to <it>EGFR </it>mutations. To do so, we compared genetic profiles between <it>EGFR </it>mutated adenocarcinomas (ADC) and <it>KRAS </it>mutated ADC from 24 women with localized lung cancer.</p> <p>Results</p> <p>Patterns of alterations were different between <it>EGFR </it>and <it>KRAS </it>mutated tumors and specific chromosomes alterations were linked to the <it>EGFR </it>mutated group. Indeed chromosome regions 14q21.3 (p = 0.027), 7p21.3-p21.2 (p = 0.032), 7p21.3 (p = 0.042) and 7p21.2-7p15.3 (p = 0.043) were found significantly amplified in EGFR mutated tumors. Within those regions 3 genes are of special interest <it>ITGB8</it>, <it>HDAC9 </it>and <it>TWIST1</it>. Moreover, homozygous deletions at <it>CDKN2A </it>and LOH at <it>RB1 </it>were identified in <it>EGFR </it>mutated tumors. We therefore tested the existence of a link between EGFR mutation, CDKN2A homozygous deletion and cyclin amplification in a larger series of tumors. Indeed, in a series of non-small-cell lung carcinoma (n = 98) we showed that homozygous deletions at <it>CDKN2A </it>were linked to <it>EGFR </it>mutations and absence of smoking whereas cyclin amplifications (<it>CCNE1 </it>and <it>CCND1</it>) were associated to <it>TP53 </it>mutations and smoking habit.</p> <p>Conclusion</p> <p>All together, our results show that genome wide patterns of alteration differ between <it>EGFR </it>and <it>KRAS </it>mutated lung ADC, describe two models of oncogenic cooperation involving either <it>EGFR </it>mutation and <it>CDKN2A </it>deletion or cyclin amplification and <it>TP53 </it>inactivating mutations and identified new chromosome regions at 7p and 14q associated to EGFR mutations in lung cancer.</p

Instruments to assess the perception of physicians in the decision-making process of specific clinical encounters: a systematic review

<p>Abstract</p> <p>Background</p> <p>The measurement of processes and outcomes that reflect the complexity of the decision-making process within specific clinical encounters is an important area of research to pursue. A systematic review was conducted to identify instruments that assess the perception physicians have of the decision-making process within specific clinical encounters.</p> <p>Methods</p> <p>For every year available up until April 2007, PubMed, PsycINFO, Current Contents, Dissertation Abstracts and Sociological Abstracts were searched for original studies in English or French. Reference lists from retrieved studies were also consulted. Studies were included if they reported a self-administered instrument evaluating physicians' perceptions of the decision-making process within specific clinical encounters, contained sufficient description to permit critical appraisal and presented quantitative results based on administering the instrument. Two individuals independently assessed the eligibility of the instruments and abstracted information on their conceptual underpinnings, main evaluation domain, development, format, reliability, validity and responsiveness. They also assessed the quality of the studies that reported on the development of the instruments with a modified version of STARD.</p> <p>Results</p> <p>Out of 3431 records identified and screened for evaluation, 26 potentially relevant instruments were assessed; 11 met the inclusion criteria. Five instruments were published before 1995. Among those published after 1995, five offered a corresponding patient version. Overall, the main evaluation domains were: satisfaction with the clinical encounter (n = 2), mutual understanding between health professional and patient (n = 2), mental workload (n = 1), frustration with the clinical encounter (n = 1), nurse-physician collaboration (n = 1), perceptions of communication competence (n = 2), degree of comfort with a decision (n = 1) and information on medication (n = 1). For most instruments (n = 10), some reliability and validity criteria were reported in French or English. Overall, the mean number of items on the modified version of STARD was 12.4 (range: 2 to 18).</p> <p>Conclusion</p> <p>This systematic review provides a critical appraisal and repository of instruments that assess the perception physicians have of the decision-making process within specific clinical encounters. More research is needed to pursue the validation of the existing instruments and the development of patient versions. This will help researchers capture the complexity of the decision-making process within specific clinical encounters.</p

Manger avec sa tête ou selon ses sens: Perceptions et comportements alimentaires

Alors que la prévalence de l’obésité a augmenté dans la population, l’idéalisation de la minceur peut mener à une préoccupation excessive à l’égard du poids corporel. Le contrôle du poids est une pratique fréquente, surtout auprès des femmes. Même si une faible perte de poids a des effets positifs à court terme sur les maladies chroniques associées à l’obésité, le succès à long terme des diètes amaigrissantes est négligeable. Perdre du poids est loin d’être banal, puisque certaines adaptations physiologiques peuvent se manifester et persister pour ramener le corps à son poids initial. Au niveau psychologique, les personnes qui limitent volontairement leur prise alimentaire peuvent notamment ressentir un sentiment de privation lié à la restriction cognitive, c’est-à-dire manger moins que ce qui est souhaité ou se priver de manger les aliments souhaités. Les diètes amaigrissantes et l’approche restrictive pour perdre du poids montrent des limites et ce constat amène à envisager des solutions de rechange efficaces à long terme. C’est dans ce contexte que s’inscrivent les travaux présentés dans cette thèse, qui tentent de répondre à cette problématique, via: 1) une étude expérimentale auprès de 352 hommes et femmes; et 2) un essai clinique randomisé auprès de 50 femmes restreintes. La première étude qui réfère aux perceptions cognitives des aliments, a évalué l’effet des allégations nutritionnelles verbales sur les perceptions d’un alimen