Validation of screening questions and symptom coherence of night eating in the Swedish Twin Registry

Background Screening criteria have been used to estimate the prevalence of night eating syndrome (NES), but no validation studies have been conducted. Method We examined the validity of two screening questions for NES using a structured interview with adults enrolled in the Swedish Twin Study of Adults: Genes and Environment (STAGE) study. We also examined the coherence of the proposed diagnostic criteria for NES. A total of 416 participants (men = 179; women = 237) completed the interview and reported complete data for study inclusion. Results The following values were calculated for the screening items after confirmation by interview for men and women, respectively: Positive predictive value =.66 and.67, negative predictive value =.52 and.45, sensitivity =.62 and.63, and specificity =.56 and.50. As increasingly stringent diagnostic criteria were applied to the sample, prevalence of NES dropped. Nocturnal ingestions were more likely to co-occur with other NES symptoms than evening hyperphagia, which occurred frequently, but often in isolation; women were more likely to report a co-occurrence of symptoms than men, who were not likely to report distress related to NES symptoms. Conclusion In sum, almost two-thirds of participants were correctly identified as having NES (without considering distress or impairment) if they answered positively on the screening questions, and about half of the participants were correctly identified as not having NES when answering negatively on the screening questions. Although self-report questions are somewhat informative, a structured interview remains the gold standard for diagnosing NES

The effect of protein and glycemic index on children's body composition: the DiOGenes randomized study

OBJECTIVE: To investigate the effect of protein and glycemic index (GI) on body composition among European children in the randomized, 6-month dietary intervention DiOGenes (diet, obesity, and genes) family-based study. PATIENTS AND METHODS: In the study, 827 children (381 boys and 446 girls), aged 5 to 18 years, completed baseline examinations. Families with parents who lost >= 8% of their weight during an 8-week run-in low-calorie diet period were randomly assigned to 1 of 5 ad libitum diets: low protein (LP)/low glycemic index (LGI); LP/high GI (HGI); high protein (HP)/LGI; HP/HGI; and control diet. The target difference was 15 GI U between the LGI/HGI groups and 13 protein percentage points between the LP/HP groups. There were 658 children examined after 4 weeks. Advice on food-choice modification was provided at 6 visits during this period. No advice on weight loss was provided because the focus of the study was the ability of the diets to affect outcomes through appetite regulation. Anthropometric measurements and body composition were assessed at baseline, week 4, and week 26. RESULTS: In the study, 465 children (58.1%) completed all assessments. The achieved differences between the GI and protein groups were 2.3 GI U and 4.9 protein percentage points, respectively. The LP/HGI group increased body fat percentage significantly more than the other groups (P = .040; partial eta(2) = 0.039), and the percentage of overweight/obese children in the HP/LGI group decreased significantly during the intervention (P = .031). CONCLUSIONS: Neither GI nor protein had an isolated effect on body composition. However, the LP/HGI combination increased body fat, whereas the HP/LGI combination was protective against obesity in this sample of children

A multicentre weight loss study using a low-calorie diet over 8 weeks: regional differences in efficacy across eight European cities

PRINCIPLES: The efficacy of low-calorie diets (LCDs) has not been investigated in large-scale studies or among people from different regions, who are perhaps unaccustomed to such methods of losing weight. The aim of the present study was to investigate changes in obesity measures among overweight/obese adults from eight European cities (from Northern, Central and Southern Europe) during the 8-week LCD phase of the DiOGenes study (2006–2007), a family-based, randomised, controlled dietary intervention. METHODS: 938 overweight/obese adults completed baseline examinations and underwent an 8-week LCD, providing 3.3–4.2 MJ/day to replace all meals. Anthropometric measurements and body composition were assessed at baseline and post-LCD. RESULTS: 773 (82.4%) adults (mean age, 43.1 y) completed the LCD successfully. The highest drop-out rate was observed in Southern (24.9%) and the lowest in Northern (13.3%) European cities. Overall, the LCD induced favourable changes in all outcomes, including an approximate 11.0% reduction in body weight and body fat percentage. Changes in outcomes differed significantly between regions, with North- and Central-European cities generally achieving higher percentage reductions in most anthropometric measurements assessed. Nonetheless, participants in Southern Europe reduced their body fat percentage significantly more than participants in Northern Europe (–11.8 vs. –9.5%, P = 0.017). CONCLUSIONS: The LCD significantly improved anthropometric and body composition measurements in all cities participating in DiOGenes

New alkylresorcinol metabolites in spot urine as biomarkers of whole grain wheat and rye intake in a Swedish middle-aged population

Background/objectives: Studies on the health effects of whole grains typically use self-reported intakes which are prone to large measurement errors. Dietary biomarkers that can provide an objective measure of intake are needed. New alkylresorcinol (AR) metabolites (3,5-dihydroxycinnamic acid (DHCA), 2-(3,5-dihydroxybenzamido)acetic acid (DHBA-glycine) and 5-(3,5-dihydroxyphenyl) pentanoic acid (DHPPTA)) in 24 h urine samples have been suggested as biomarkers for whole grain (WG) wheat and rye intake but remain to be evaluated in spot urine samples. Subjects/methods: The reproducibility of the new AR metabolites (DHCA, DHBA-glycine and DHPPTA) was investigated in 4 repeated samples over a period of 2 wk in spot urine from 40 Swedish men and women enroled in the SCAPIS-study, after adjustment of creatinine. Metabolite concentrations were correlated with total whole grain intake estimated during the same period. Results: The medium-term reproducibility determined for DHCA, DHPPTA and DHBA-glycine varied from moderate to excellent (intra-class correlation coefficient = 0.35–0.67). Moreover, DHCA and DHBA-glycine were independently associated with self-reported total WG intake (β = 0.18, P = 0.08 and β = 0.18, P = 0.02, respectively) and all metabolites except for DHPPA were higher among women. Conclusions: This study supports the idea of using AR metabolites in one or several spot urine samples as biomarkers of whole grain intake. These findings need to be confirmed in different populations

The Effect of Protein and Glycemic Index on Children's Body Composition: The DiOGenes Randomized Study

OBJECTIVE: To investigate the effect of protein and glycemic index (GI) on body composition among European children in the randomized, 6-month dietary intervention DiOGenes (diet, obesity, and genes) family-based study. PATIENTS AND METHODS: In the study, 827 children (381 boys and 446 girls), aged 5 to 18 years, completed baseline examinations. Families with parents who lost >/=8% of their weight during an 8-week run-in low-calorie diet period were randomly assigned to 1 of 5 ad libitum diets: low protein (LP)/low glycemic index (LGI); LP/high GI (HGI); high protein (HP)/LGI; HP/HGI; and control diet. The target difference was 15 GI U between the LGI/HGI groups and 13 protein percentage points between the LP/HP groups. There were 658 children examined after 4 weeks. Advice on food-choice modification was provided at 6 visits during this period. No advice on weight loss was provided because the focus of the study was the ability of the diets to affect outcomes through appetite regulation. Anthropometric measurements and body composition were assessed at baseline, week 4, and week 26. RESULTS: In the study, 465 children (58.1%) completed all assessments. The achieved differences between the GI and protein groups were 2.3 GI U and 4.9 protein percentage points, respectively. The LP/HGI group increased body fat percentage significantly more than the other groups (P = .040; partial eta(2) = 0.039), and the percentage of overweight/obese children in the HP/LGI group decreased significantly during the intervention (P = .031). CONCLUSIONS: Neither GI nor protein had an isolated effect on body composition. However, the LP/HGI combination increased body fat, whereas the HP/LGI combination was protective against obesity in this sample of children

Experience and acceptability of diets of varying protein content and glycemic index in an obese cohort: results from the Diogenes trial.

Background/Objectives:To investigate acceptability and tolerability of different protein and glycemic index (GI) content aimed at weight following a phase of rapid weight loss, as part of a large pan-European intervention trial.Subjects/Methods:The Diogenes study (www.diogenes- consisted of an initial 8-week rapid weight-loss phase (800-1000 followed by a 6-month weight maintenance intervention with five varying in protein and GI content. Measurement of a range of outcomes experience of the Diogenes diets in terms of acceptability, experience were recorded via end of day questionnaires throughout the change during the initial weight loss phase weakly, but positively with acceptability of the programme (r range=-0.08 to 0.2, P</=0.05, four of five dimensions). Success at weight maintenance positively with acceptance of the programme (r range=-0.21 to -0.34, P<0.001, n=540 five dimensions). The diets with higher protein content were more the low protein (LP) diets, however, no differences between the high vs diets were found concerning acceptability and suggest that moderately high protein diets, compared with LP diets, are acceptable diets for weight control in overweight individuals.European Clinical Nutrition advance online publication, 19 June 2013; doi:10.1038/ejcn.2013.99

The effect of protein and glycemic index on children's body composition: the DiOGenes randomized study

OBJECTIVE: To investigate the effect of protein and glycemic index (GI) on body composition among European children in the randomized, 6-month dietary intervention DiOGenes (diet, obesity, and genes) family-based study. PATIENTS AND METHODS: In the study, 827 children (381 boys and 446 girls), aged 5 to 18 years, completed baseline examinations. Families with parents who lost >= 8% of their weight during an 8-week run-in low-calorie diet period were randomly assigned to 1 of 5 ad libitum diets: low protein (LP)/low glycemic index (LGI); LP/high GI (HGI); high protein (HP)/LGI; HP/HGI; and control diet. The target difference was 15 GI U between the LGI/HGI groups and 13 protein percentage points between the LP/HP groups. There were 658 children examined after 4 weeks. Advice on food-choice modification was provided at 6 visits during this period. No advice on weight loss was provided because the focus of the study was the ability of the diets to affect outcomes through appetite regulation. Anthropometric measurements and body composition were assessed at baseline, week 4, and week 26. RESULTS: In the study, 465 children (58.1%) completed all assessments. The achieved differences between the GI and protein groups were 2.3 GI U and 4.9 protein percentage points, respectively. The LP/HGI group increased body fat percentage significantly more than the other groups (P = .040; partial eta(2) = 0.039), and the percentage of overweight/obese children in the HP/LGI group decreased significantly during the intervention (P = .031). CONCLUSIONS: Neither GI nor protein had an isolated effect on body composition. However, the LP/HGI combination increased body fat, whereas the HP/LGI combination was protective against obesity in this sample of children

A multicentre weight loss study using a low-calorie diet over 8 weeks: regional differences in efficacy across eight European cities

PRINCIPLES: The efficacy of low-calorie diets (LCDs) has not been investigated in large-scale studies or among people from different regions, who are perhaps unaccustomed to such methods of losing weight. The aim of the present study was to investigate changes in obesity measures among overweight/obese adults from eight European cities (from Northern, Central and Southern Europe) during the 8-week LCD phase of the DiOGenes study (2006–2007), a family-based, randomised, controlled dietary intervention. METHODS: 938 overweight/obese adults completed baseline examinations and underwent an 8-week LCD, providing 3.3–4.2 MJ/day to replace all meals. Anthropometric measurements and body composition were assessed at baseline and post-LCD. RESULTS: 773 (82.4%) adults (mean age, 43.1 y) completed the LCD successfully. The highest drop-out rate was observed in Southern (24.9%) and the lowest in Northern (13.3%) European cities. Overall, the LCD induced favourable changes in all outcomes, including an approximate 11.0% reduction in body weight and body fat percentage. Changes in outcomes differed significantly between regions, with North- and Central-European cities generally achieving higher percentage reductions in most anthropometric measurements assessed. Nonetheless, participants in Southern Europe reduced their body fat percentage significantly more than participants in Northern Europe (–11.8 vs. –9.5%, P = 0.017). CONCLUSIONS: The LCD significantly improved anthropometric and body composition measurements in all cities participating in DiOGenes