Dieting self-efficacy : its relation to situational and long-term dieting success

Questionnaires were constructed to measure dieter's beliefs in their abilities to (1) adhere to a diet in eating situations, (2) perform various dieting behaviors, and (3) reach their dieting goals. The three questionnaires were called the Situation-, Behavior-, and Goal-Based Dieting Self-Efficacy Scales.Preliminary work examined the reliability of the three scales. The Situtation-Based scale demonstrated a high level of test-retest reliability over a two to four week period in the two college samples. Examination of scale intercorrelations in the clinical sample indicated that the scales were correlated at only a low level, suggesting that the scales measure different aspects of the construct of dieting self-efficacy.Results of the laboratory studies demonstrated that the Situation-Based scale was a significant predictor of how much dieters ate in response to two different types of challenges to their diets, high calorie preloads and a depressed mood induction.The ability of the three scales to predict weight changes was examined in the clinical sample. Only the Goal-Based scale was found to predict weight change.In summary, the present study adds to the body of literature supporting goal-based dieting self-efficacy as a significant predictor of weight change during dieting attempts. Suggestions were offered about ways to apply this finding to clinical practice, in the areas of patient selection and treatment prescription.The present research was limited in the following ways. The laboratory studies were limited by the narrow range of subjects, and the artificiality of the eating situation. Future research should extend this finding with other populations, as well as methodologies for examining the relation between dieting self-efficacy and eating in real-life situations. The clinical study was limited by the absence of a follow-up assessment. Future research must examine the ability of dieting self-efficacy to predict weight change over longer periods of time. Finally, suggestions were made concerning the importance of future research attempting to clarify the construct of dieting self-efficacy, particularly research aimed at determining the relation between responses to these questionnaires and the actual cognitive processes engaged in by dieters in eating situations, and over the course of their weight control efforts. (Abstract shortened with permission of author.

Plasma Metabolomics Predicts Chemotherapy Response in Advanced Pancreatic Cancer.

Pancreatic cancer (PC) is one of the deadliest cancers. Developing biomarkers for chemotherapeutic response prediction is crucial for improving the dismal prognosis of advanced-PC patients (pts). To evaluate the potential of plasma metabolites as predictors of the response to chemotherapy for PC patients, we analyzed plasma metabolites using high-performance liquid chromatography-mass spectrometry from 31 cachectic, advanced-PC subjects enrolled into the PANCAX-1 (NCT02400398) prospective trial to receive a jejunal tube peptide-based diet for 12 weeks and who were planned for palliative chemotherapy. Overall, there were statistically significant differences in the levels of intermediates of multiple metabolic pathways in pts with a partial response (PR)/stable disease (SD) vs. progressive disease (PD) to chemotherapy. When stratified by the chemotherapy regimen, PD after 5-fluorouracil-based chemotherapy (e.g., FOLFIRINOX) was associated with decreased levels of amino acids (AAs). For gemcitabine-based chemotherapy (e.g., gemcitabine/nab-paclitaxel), PD was associated with increased levels of intermediates of glycolysis, the TCA cycle, nucleoside synthesis, and bile acid metabolism. These results demonstrate the feasibility of plasma metabolomics in a prospective cohort of advanced-PC patients for assessing the effect of enteral feeding as their primary source of nutrition. Metabolic signatures unique to FOLFIRINOX or gemcitabine/nab-paclitaxel may be predictive of a patient's response and warrant further study

Strategies to Optimize Participation in Diabetes Prevention Programs following Gestational Diabetes: A Focus Group Study

<div><p>Objective</p><p>We performed a qualitative study among women within 5 years of Gestational Diabetes (GDM) diagnosis. Our aim was to identify the key elements that would enhance participation in a type 2 diabetes (DM2) prevention program.</p><p>Research Design and Methods</p><p>Potential participants received up to three invitation letters from their GDM physician. Four focus groups were held. Discussants were invited to comment on potential facilitators/barriers to participation and were probed on attitudes towards meal replacement and Internet/social media tools. Recurring themes were identified through qualitative content analysis of discussion transcripts.</p><p>Results</p><p>Among the 1,201 contacted and 79 eligible/interested, 29 women attended a focus group discussion. More than half of discussants were overweight/obese, and less than half were physically active. For DM2 prevention, a strong need for social support to achieve changes in dietary and physical activity habits was expressed. In this regard, face-to-face interactions with peers and professionals were preferred, with adjunctive roles for Internet/social media. Further, direct participation of partners/spouses in a DM2 prevention program was viewed as important to enhance support for behavioural change at home. Discussants highlighted work and child-related responsibilities as potential barriers to participation, and emphasized the importance of childcare support to allow attendance. Meal replacements were viewed with little interest, with concerns that their use would provide a poor example of eating behaviour to children.</p><p>Conclusions</p><p>Among women within 5 years of a GDM diagnosis who participated in a focus group discussion, participation in a DM2 prevention program would be enhanced by face-to-face interactions with professionals and peers, provision of childcare support, and inclusion of spouses/partners.</p></div

Focus group participant characteristics.

<p>24 of 29 participants completed an exit questionnaire and 13 had blood tests following pregnancy that permitted computation of a measure of insulin resistance.</p>#<p>Regular physical activity defined as an activity performed at a moderate intensity for a total of 30 minutes throughout the day on most days of the week OR vigorous activity 3 times a week for 20 minutes at a time.</p>€<p>Homeostasis Model Assessment–Insulin resistance (HOMA-IR), Matsuda Index and 1 hour post cibum (1 hr PC) were calculated for 13 participants who underwent 75 g oral glucose tolerance testing with 4 time points at the McGill University Health Centre; HOMA-IR ≥3.6 imply possible hepatic insulin resistance if concomitantly overweight/obese; Matsuda Index ≥3.0 imply possible whole body insulin resistance (Stern SE et al., Diabetes 2005; <a href="http://mmatsuda.diabetes-smc.jp/english.html" target="_blank">http://mmatsuda.diabetes-smc.jp/english.html</a>); 1 hr PC ≥8.61 mmol/L (155 mg/dl) is a marker of cardiovascular risk and insulin resistance (Bardini et al., Diabetes Care 2010).</p

Participant flow.

<p>Participant flow.</p