Effectiveness and Feasibility of a Remote Lifestyle Intervention by Dietitians for Overweight and Obese Adults: Pilot Study

BACKGROUND To tackle the problem of obesity and related diseases in Switzerland, cost-efficient, effective, and innovative primary health care interventions for weight management are required. In this context, Oviva has developed a scalable technology for registered dietitians to counsel overweight and obese patients via a mobile phone app. OBJECTIVE The aim of this study was to evaluate the effectiveness and feasibility of weight loss counseling by dietitians using a mobile phone app for patients with overweight and obesity. METHODS In this pre- and posttest pilot study, overweight and obese adults participated in a 1-year behavioral intervention to lose weight through remote counseling by dietitians in the German-speaking part of Switzerland. The study started in April 2016 and finished in May 2018. Participants received individual counseling through the app and the exchange with the dietitian focused on regular feedback on photo-based food log, motivation, and education. The contents were tailored to the individual lifestyle goal set. The predefined intensity of remote counseling decreased during the year. Group chat could be used. The outcomes examined were changes in weight (primary outcome), hemoglobin A1c, fasting glucose, fasting insulin, triglyceride, high-density lipoprotein cholesterol, blood pressure (BP), body mass index (BMI), waist circumference, body fat, and responses to a self-administered questionnaire with questions regarding participants' physical activity, dietary assessment, and health-related quality of life. Changes were tested at baseline, after 3 months, and after 12 months, as well as between the third and the 12th month. RESULTS In total, 36 women and 7 men, with a mean age of 40.6 years, participated and 36 participants completed the study. Median weight change after the first 12 weeks was -3.8 kg (range: -15 to 2.4 and P<.001), between week 12 and week 52 it was -1.1 kg (range: -9.7 to 7 and P=.08), and the median change during the entire period of intervention was -4.9 kg (range: -21.9 to 7.5 and P<.001). Furthermore, changes in BMI, waist circumference, body fat, and BP between baseline and 12 weeks and between baseline and 52 weeks were also significant. Significant changes in certain eating habits were also demonstrated (higher frequency of vegetable, fruit, and breakfast consumption and lower frequency of alcohol, sweet, and fat consumption). CONCLUSIONS In addition to the professional skills of a dietitian, a profession-specific app such as Oviva can provide effective support that meets the needs of dietitians and clients on the long path of behavioral change and sustainable weight reduction. TRIAL REGISTRATION ClinicalTrials.gov NCT02694614; https://clinicaltrials.gov/ct2/show/NCT02694614 (Archived by WebCite at http://www.webcitation.org/76gYkGOIc)

Mastleistung und Fleischqualität von männlichen Legehybriden bei Fütterung unterschiedlicher Proteinquellen

The effects of genotype and protein source on the performance of male layer hybrids compared to a fattening strain were investigated. The layer hybrids Lohmann Brown (LB, n = 90, male), Lohmann Selected Leghorn (LSL, n = 90, male) and the fattening hybrid Hubbard JA-757 (HUB, n = 90, mixed sex) were divided into three feeding groups: 1) commercial feed with 25,5 % soybean cake (Control), 2) control diet + alfalfa meal ad lib. (Alf-ext) and 3) control diet inclusive 12 % replace of soybean cake by alfalfa meal (Alf-int). Fattening periods were 63, 91 and 104 days for HUB, LB and LSL, respectively. Final weights were influenced by the interaction of genotype and feed (HUB 1843, LB 1871, LSL 1631 g). Highest daily weight gains showed HUB, followed by LB and LSL, not influenced by the diet. For LB and LSL, the proportions of leg muscle were higher than for HUB, while LB had lower proportions of breast muscles. Diet did not affect these parameters. Regarding meat quality, the maximum shear force of the right breast muscle was lower for HUB and LSL compared to LB and was not influenced by the diet. Breast raw protein and raw fat contents were higher for chicken fed Alf-int than Alf-ext

Performance d’engraissement de poulets mâles nourris avec différentes sources de protéines

Les performances de croissance de mâles d’hybrides de ponte recevant une alimentation comportant des sources et des teneurs différentes en protéines ont été étudiées dans trois essais d’engraissement. Par rapport aux hybrides d’engraissement Hubbard JA 757 (HUB), les poulets mâles des génotypes Lohmann Braun (LB) et Lohmann Selected Leghorn (LSL) présentent une moins bonne performance d’engraissement. Le poids vif, la prise de poids journalière et le poids à l’abattage sont influencés par le génotype. Les mâles LB présentent cependant de nets avantages en termes de performance par rapport aux mâles LSL. Le remplacement partiel du soja par de la farine de luzerne verte dans les rations, qui s’accompagne d’une réduction de l’apport en protéines, entraîne une perte de rendement, en particulier pour la lignée HUB. À l’inverse, le passage à des rations à plus faible teneur en protéines s’est avéré avantageux pour le génotype LB, ce qui offre la possibilité pour l’engraissement de poulets mâles de compenser, par la composition de la ration, la moindre efficacité alimentaire des mâles

Mastleistung von Bruderhähnen bei Fütterung mit unterschiedlichen Proteinquellen

In drei Mastversuchen wurden die Wachstumsleistungen männlicher Legehybriden bei Fütterung mit unterschiedlichen Proteinquellen und -gehalten untersucht. Der Vergleich der Genotypen Lohmann Braun (LB) und Lohmann Selected Leghorn (LSL) mit dem Masthybriden Hubbard JA 757 (HUB) zeigte, dass die Bruderhähne erwartungsgemäss geringere Mastleistungen aufwiesen. Sowohl die Lebendgewichte und täglichen Zunahmen als auch die Schlachtgewichte wurden vom Genotyp beeinflusst. Die LB-Hähne wiesen jedoch deutliche Vorteile in den Leistungen gegenüber den LSL-Tieren auf. Der partielle Ersatz von Soja durch Luzernegrünmehl in den Rationen, der mit einer Proteinreduktion einhergeht, führte vor allem bei HUB zu Leistungseinbussen. Im Gegensatz dazu konnten für den Genotyp LB Vorteile in der Umsetzung von Rationen mit reduziertem Proteingehalt festgestellt werden, was für die Mast der Bruderhähne die Möglichkeit bietet, mit der Rationsgestaltung der niedrigen Effizienz der Tiere entgegenzuwirken

Intra- and inter-rater reliability of joint range of motion tests using tape measure, digital inclinometer and inertial motion capturing

Background In clinical practice range of motion (RoM) is usually assessed with low-cost devices such as a tape measure (TM) or a digital inclinometer (DI). However, the intra- and inter-rater reliability of typical RoM tests differ, which impairs the evaluation of therapy progress. More objective and reliable kinematic data can be obtained with the inertial motion capture system (IMC) by Xsens. The aim of this study was to obtain the intra- and inter-rater reliability of the TM, DI and IMC methods in five RoM tests: modified Thomas test (DI), shoulder test modified after Janda (DI), retroflexion of the trunk modified after Janda (DI), lateral inclination (TM) and fingertip-to-floor test (TM). Methods Two raters executed the RoM tests (TM or DI) in a randomized order on 22 healthy individuals while, simultaneously, the IMC data (Xsens MVN) was collected. After 15 warm-up repetitions, each rater recorded five measurements. Findings Intra-rater reliabilities were (almost) perfect for tests in all three devices (ICCs 0.886–0.996). Inter-rater reliability was substantial to (almost) perfect in the DI (ICCs 0.71–0.87) and the IMC methods (ICCs 0.61–0.993) and (almost) perfect in the TM methods (ICCs 0.923–0.961). The measurement error (ME) for the tests measured in degree (°) was 0.9–3.3° for the DI methods and 0.5–1.2° for the IMC approaches. In the tests measured in centimeters the ME was 0.5–1.3cm for the TM methods and 0.6–2.7cm for the IMC methods. Pearson correlations between the results of the DI or the TM respectively with the IMC results were significant in all tests except for the shoulder test on the right body side (r = 0.41–0.81). Interpretation Measurement repetitions of either one or multiple trained raters can be considered reliable in all three devices

Fatty Acid Metabolite Profiling Reveals Oxylipins as Markers of Brown but Not Brite Adipose Tissue

Metabolites of omega-6 and omega-3 polyunsaturated fatty acids are important signaling molecules implicated in the control of adipogenesis and energy balance regulation. Some of these metabolites belonging to the group of oxylipins have been associated with non-shivering thermogenesis in mice mediated by brown or brite adipose tissue. We aimed to identify novel molecules with thermogenic potential and to clarify the relevance of these findings in a translational context. Therefore, we characterized and compared the oxylipin profiles of murine and human adipose tissues with different abundance of brown or brite adipocytes. A broad panel of 36 fatty acid metabolites was quantified in brown and white adipose tissues of C57BL/6J mice acclimatized to different ambient temperatures and in biopsies of human supraclavicular brown and white adipose tissue. The oxylipin profile of murine brite adipose tissue was not distinguishable from white adipose tissue, suggesting that adipose tissue browning in vivo is not associated with major changes in the oxylipin metabolism. Human brown and white adipose tissue also exhibited similar metabolite profiles. This is in line with previous studies proposing human brown adipose tissue to resemble the nature of murine brite adipose tissue representing a heterogeneous mixture of brite and white adipocytes. Although the global oxylipin profile served as a marker for the abundance of thermogenic adipocytes in bona fide brown but not white adipose tissue, we identified 5-HETE and 5,6-EET as individual compounds consistently associated with the abundance of brown or brite adipocytes in human BAT and murine brite fat. Further studies need to establish whether these candidates are mere markers or functional effectors of thermogenic capacity

BMP4 gene therapy enhances insulin sensitivity but not adipose tissue browning in obese mice

Bone morphogenetic protein 4 (BMP4) adeno-associated viral vectors of serotype 8 (AAV8) gene therapy targeting the liver prevents the development of obesity in initially lean mice by browning the large subcutaneous white adipose tissue (WAT) and enhancing energy expenditure. Here, we examine whether this approach could also reduce established obesity. Dietary-induced obese C57BL6/N mice received AAV8 BMP4 gene therapy at 17-18 weeks of age. They were kept on a high-fat diet and phenotypically characterized for an additional 10-12 weeks. Following termination, the mice underwent additional characterization in vitro. Surprisingly, we observed no effect on body weight, browning of WAT, or energy expenditure in these obese mice, but whole-body insulin sensitivity and glucose tolerance were robustly improved. Insulin signaling and insulin-stimulated glucose uptake were increased in both adipose cells and skeletal muscle. BMP4 also decreased hepatic glucose production and reduced gluconeogenic enzymes in the liver, but not in the kidney, in addition to enhancing insulin action in the liver. Our findings show that BMP4 prevents, but does not reverse, established obesity in adult mice, while it improves insulin sensitivity independent of weight reduction. The BMP antagonist Noggin was increased in WAT in obesity, which may account for the lack of browning