Leptin and acute appetite control

Moderate physical activity and snack intake suppress the appetite of obese and lean women acutely. The associations between circulating leptin and appetite-satiety ratings suggest that there is some physiological involvement of leptin in short-term appetite regulation in response to physical activity-induced factors but only in obese women. The exercise-related factors considered in this thesis as possible mediators of leptin action were catecholamines, fatty acids, glucose and insulin. Adrenaline is unlikely to be the exercise factor responsible for the coupling between leptin and satiety since adrenaline infusion stimulated an increase in subsequent energy intake in obese women. Labetalol decreased circulating FFA and increased glucose concentrations, which confirms at least b-adrenoceptor blockade. Any conclusion with respect to the a- adrenoceptor blockade should be drawn with caution since labetalol, an a/b blocker, has greater affinity for b- than a-adrenoceptors. No differences in appetite/satiety sensations were found following exercise with adrenoceptor blockade compared to exercise alone. This indicates that the observed anorexic effect of exercise on appetite in obese women was not mediated by b-adrenoceptors. Noradrenaline is another possible exercise factor that could mediate the coupling between leptin and appetite in obese women since it is known that leptin and noradrenaline (NA) have common hypothalamic targets (e.g. NPY) and their effects are mediated by a-1 adrenoceptors. Labetalol probably was not a sufficiently strong a-adrenoceptor blocker to investigate such effects. A study of a more selective a1-adrenoceptor antagonist might be helpful in the investigation of the interaction between leptin and NA in the regulation of eating. Study 4: In endurance-trained athletes a short term detraining increases postprandial plasmin leptin, induces insulin resistance but has no effect on appetite/satiety ratings. The results of the present studies implicate leptin, insulin, insulin resistance and noradrenergic factors in the control of eating following exercise and detraining

Exploring the Perceived Barriers to Following a Mediterranean Style Diet in Childbearing Age: A Qualitative Study.

A considerable amount of research has focused on interventions in pregnancy to promote health in current and future generations. This has yielded inconsistent results and focus has turned towards improving health in the preconception period. Promotion of healthy dietary patterns similar to a Mediterranean diet in the preconception years has been suggested as a dietary strategy to prevent maternal obesity and optimize offspring health. However, it is uncertain whether adoption is acceptable in women of childbearing age. This qualitative study aims to investigate the perceived barriers to following a Mediterranean diet in women of childbearing age. Semi-structured focus groups were used to generate deep insights to be used to guide the development of a future intervention. Nulliparous women aged between 20 and 47 years were recruited (n = 20). Six focus groups were digitally audio recorded and transcribed verbatim by the researcher. Thematic analysis was used to analyze data, which occurred in parallel with data collection to ascertain when data saturation was reached. Five core themes were identified: Mediterranean diet features, perceived benefits, existing dietary behavior and knowledge, practical factors, and information source. The present study highlights that a Mediterranean diet is acceptable to childbearing-aged women, and the insights generated will be helpful in developing an intervention to promote Mediterranean diet adoption

The association between perceived stress and diet quality in women of childbearing age: A systematic review

Poor diet quality is a major cause of maternal obesity and associated with adverse metabolic effects for mother and offspring. Psychological stress can increase intake of unhealthy dietary choices (e.g. highly palatable, energy dense diet), but no study has investigated the association between stress and diet quality in women of childbearing age. This systematic review of the association between psychological stress and diet quality used the PEO (Population, Exposure, and Outcome) model. Medline, CINAHL, Scopus, Cochrane Library, Web of Science, and Sciencedirect were searched (October 2018 - January 2019). From 139,552 hits, 471 papers were screened, but only 8 studies met our inclusion criteria: English language, stress (exposure) measured in combination with diet quality (outcome), healthy women (18-49 years of age (population). Data extraction was determined by the PEO. Quality assessment used CASP tool for Cohort studies. The review included eight studies from USA (n=6), Egypt (n=1), and Iran (n=1). The six cross-sectional and two longitudinal studies were published between 2011 and 2017 and had a total of 3,982 participants. Studies were heterogeneous in methods: three used food frequency questionnaires to assess dietary intake while the others used 24-hour dietary recalls. Diet quality was measured using different indices: Alternate Healthy Eating Index (n=2), Healthy Eating Index (n=2), Dietary Approach to Stop Hypertension (DASH) Diet Index (n=2), Dietary Quality Index- Pregnancy (n=2), and Dietary Guideline Adherence Index (n=1). Only one study used three diet quality indices. No study explored dietary patterns using factor analysis and other statistical techniques. Most studies used the perceived stress scale to measure stress; however, there were differences regarding the use of this scale to form a continuous or categorical variable (with varying cut-off scores) perceived stress, whereas no study reported biological response to stress. Outcomes also varied in direction of association; no association (n=4), negative association (n=3), mixed results (n=1). This review is the first to systematically examine association between stress and diet quality in women of childbearing age; there was heterogeneity in measures of diet quality and study designs. Future studies that explore diet quality/patterns should include both diet indices and factor analysis and additionally measure biological markers of both dietary intake and stress

Adherence to community based group exercise interventions for older people: A mixed-methods systematic review.

OBJECTIVE: Lifelong physical activity provides some of the best prospects for ageing well. Nevertheless, people tend to become less physically active as they age. This systematic review assessed the views and adherence of participants attending community based exercise programmes of ≥6month's duration. METHOD: Searches were carried out in eight online scientific databases (January 1995-May 2014) to identify relevant primary studies. Studies were assessed for quality and data extracted. Results were synthesised thematically and narratively. Qualitative findings were compared against quantitative studies. RESULTS: A total of 2958 studies were identified and screened against the inclusion/exclusion criteria. Ten studies met the inclusion criteria (five quantitative, three qualitative and two mixed-methods study designs). None were excluded on the basis of quality. Six key themes were identified from the qualitative studies as important for adherence to group exercise programmes: social connectedness, participant perceived benefits, programme design, empowering/energising effects, instructor and individual behaviour. The mean adherence rate of studies with comparable measures was (69.1% SD 14.6). When the views of participants from the qualitative synthesis were juxtaposed against the quantitative studies, programme design was a common feature across all studies. CONCLUSION: Evidence surrounding these programmes is limited both in terms of long-term adherence measures and the views of participants. However, based on limited findings there is some indication that community based group exercise programmes have long-term adherence rates of almost 70%. Incorporating the views of older people into programme designs may provide guidance for innovative interventions leading to sustained adherence

Combining a high DHA multi-nutrient supplement with aerobic exercise: protocol for a randomised controlled study assessing mobility and cognitive function in older women.

There is a complex interplay between cognition and gait in older people, with declines in gait speed coexisting with, or preceding cognitive decline. Omega-3 fatty acids, B vitamins, vitamin E, phosphatidylserine, and Ginkgo Biloba show promise in preserving mobility and cognitive function in older adults. Exercise benefits mobility and there is evidence suggesting positive interactions between exercise and omega-3 fatty acids on physical and cognitive function in older adults. Non-frail or pre-frail females aged ≥60 years are included in a randomized placebo controlled study. Intervention groups are: high DHA multi-nutrient supplement and exercise, placebo supplement and exercise, high DHA multi-nutrient supplement, and placebo supplement. Dietary supplementation is 24 weeks. The exercise intervention, two cycle ergometer classes per week, is for the final 12 weeks. The primary outcome is habitual walking speed, secondary outcomes include gait variables under single and dual task, five times sit to stand, verbal and spatial memory, executive function, interference control and health related quality of life. Blood fatty acids, serum homocysteine, dietary intake, physical activity, and verbal intelligence are measured to assess compliance and control for confounding factors. The study is registered at www.clinicaltrials.gov (NCT03228550)

Effects of a high DHA multi-nutrient supplement and exercise on mobility and cognition in older women (MOBILE): A randomized semi-blinded placebo controlled study

© 2020, The Author(s). This is an author produced version of a paper accepted for publication in the BRITISH JOURNAL OF NUTRITION uploaded in accordance with the publisher’s self- archiving policy. The final published version (version of record) is available online at the link. Some minor differences between this version and the final published version may remain. We suggest you refer to the final published version should you wish to cite from it

Exploration of Perceptions and Attitudes of Couples in the Preconception Period in Relation to Healthy Eating and Healthy Body Weight: A Qualitative Study.

Evidence suggests that parental overweight/obesity during the preconception period, which can be a year before conception [1], may adversely affect offsprings’ metabolic health in later life [2]. This study aimed to explore couples’ perceptions toward healthy eating and lifestyles in the preconception period, which can help inform the development of targeted interventions. Eight pregnancy-planning couples were recruited using purposive–snowballing sampling and participated in a semi-structured online interview. Recordings were anonymised, transcribed verbatim, and analysed using phenomenological thematic analysis [3]. Couples’ mean overall age was 34.3 years, and BMI was 26.8 kg/m2, while the majority held a postgraduate degree (n = 9). Data analysis revealed seven themes: mental health matters; lifestyle behaviours that could change; physical health matters; establishing healthier habits; all things diet; preconception knowledge; and need for guidance. Data indicated limited preconception knowledge, particularly evident in men. During our interview, most men realised that men’s preconception period can be important, indicating a lack of knowledge, and expressed interest in learning more: “…I would be happy also to ask for a professional advice, I’m just not sure if I would before this interview-if I would consider it necessary, now I do to be honest…”. The main motivators for making any dietary or lifestyle changes were to support maternal health, offer the “best start” to their child, and ensure they did the best they could to support a pregnancy. Most participants looked for information online when unsure and would welcome an online educational tool with opportunities to ask questions. Many explained that it is important to avoid information overload, while a few explained they did not look for information at all. Stress was a significant factor affecting efforts to implement changes (diet, smoking, body weight, sleep, exercise) and was one of the main behaviours that participants wanted to manage. Based on the results of this study, there is a paucity of knowledge around men’s preconception health. An online interactive education tool could support couples in the preconception period to achieve healthier habits

The Effects of Multi-Nutrient Formulas containing a Combination of Omega-3 Polyunsaturated Fatty Acids and B vitamins on Cognition in the older adult: A Systematic Review and Meta-analysis

There is now evidence to suggest that there may be an interaction between B vitamins and omega-3 polyunsaturated fatty acids (PUFAs), with suggestions that increasing intake of both nutrients simultaneously may benefit cognition in older adults. The aim of this systematic review was to investigate whether supplementation with a combination of omega-3 PUFAs and B vitamins can prevent cognitive decline in older adults. Randomised control trials conducted in older adults that measured cognitive function were retrieved. The included trials provided a combination of omega-3 PUFAs and B vitamins alone, or in combination with other nutrients. Trials that provided omega-3 PUFAs alone and also measured B vitamin status or provided B vitamin supplementation alone and measured omega-3 PUFA status were also included. The databases searched were The Cochrane Library, EMBASE, CINAHL, Scopus, and MEDLINE. A total of 14 papers were included in the analysis (n=4913; age: 60-70 y; follow up 24 weeks to 4 years). The meta-analysis results found a significant benefit of nutrient formulas, which included both omega-3 PUFAs and B vitamins alongside other nutrients, versus placebo on global cognition assessed using composite scores from a neuropsychological test battery (G=0.23, P=0.002), global cognition using single measures of cognition (G=0.28, P=0.004) and episodic memory (G=0.32, P=0.001). The results indicate that providing a combination of omega-3 PUFA and B vitamins as part of a multi-nutrient formula benefits cognition in older adults versus a placebo, the potential for an interaction between these key nutrients should be considered in future experimental work

Adherence to community based group exercise interventions for older people: A mixed-methods systematic review

a b s t r a c t a r t i c l e i n f o Objective. Lifelong physical activity provides some of the best prospects for ageing well. Nevertheless, people tend to become less physically active as they age. This systematic review assessed the views and adherence of participants attending community based exercise programmes of ≥6 month's duration. Method. Searches were carried out in eight online scientific databases (January 1995-May 2014) to identify relevant primary studies. Studies were assessed for quality and data extracted. Results were synthesised thematically and narratively. Qualitative findings were compared against quantitative studies. Results. A total of 2958 studies were identified and screened against the inclusion/exclusion criteria. Ten studies met the inclusion criteria (five quantitative, three qualitative and two mixed-methods study designs). None were excluded on the basis of quality. Six key themes were identified from the qualitative studies as important for adherence to group exercise programmes: social connectedness, participant perceived benefits, programme design, empowering/energising effects, instructor and individual behaviour. The mean adherence rate of studies with comparable measures was (69.1% SD 14.6). When the views of participants from the qualitative synthesis were juxtaposed against the quantitative studies, programme design was a common feature across all studies. Conclusion. Evidence surrounding these programmes is limited both in terms of long-term adherence measures and the views of participants. However, based on limited findings there is some indication that community based group exercise programmes have long-term adherence rates of almost 70%. Incorporating the views of older people into programme designs may provide guidance for innovative interventions leading to sustained adherence

Perceived stress and diet quality in women of reproductive age: a systematic review and meta-analysis

Background: Poor diet quality is associated with obesity-related morbidity and mortality. Psychological stress can increase unhealthy dietary choices, but evidence pertinent to women of reproductive age remains unclear. This paper systematically reviewed the literature to determine the association between psychological stress and diet quality in women of reproductive age. Methods: Medline, CINAHL, Scopus, Cochrane Library, Web of Science, and Sciencedirect were searched. Data extraction was determined by the PEO. Inclusion criteria consisted of: English language, stress (exposure) measured in combination with diet quality (outcome), healthy women of reproductive age (18–49 years old (population)). Observational studies, due to the nature of the PEO, were included. Quality assessment used the Risk of Bias in Non-randomised Studies from the Cochrane Handbook of Systematic Reviews of Interventions. Meta-analysis was conducted using random-effect model to estimate the Fisher’s z transformed correlation between stress and diet quality with 95% confidence interval (CI). Results: From 139,552 hits, 471 papers were screened; 24 studies met the inclusion criteria and were conducted in different countries: 8 studies on diet quality and 16 on food intake and frequency of consumption. Studies of diet quality consisted of six cross-sectional and two longitudinal designs with a total of 3982 participants. Diet quality was measured with diverse indices; Alternate Healthy Eating Index (n = 2), Healthy Eating Index (n = 2), Dietary Approach to Stop Hypertension (DASH) Diet Index (n = 2), Dietary Quality Index- Pregnancy (n = 2), and Dietary Guideline Adherence Index (n = 1). Most studies used Cohen’s perceived stress scale and no study measured biological stress response. After sensitivity analysis, only 5 studies (3471 participants) were included in the meta-analysis. Meta-analysis revealed a significant negative association between stress and diet quality with substantial heterogeneity between studies (r = − 0.35, 95% CI [− 0.56; − 0.15], p value < 0.001, Cochran Q test P < 0.0001, I2 = 93%). The 16 studies of food intake and frequency of consumption were very heterogeneous in the outcome measure and were not included in the meta-analysis. These studies showed that stress was significantly associated with unhealthy dietary patterns (high in fat, sweets, salt, and fast food and low in fruits, vegetables, fish, and unsaturated fats). Conclusion: Future studies that explore diet quality/patterns should include both diet indices and factor analysis and measure biological markers of stress and dietary patterns simultaneously