Special Issue "Dietary Management of Obesity"

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (31 May 2018)

Special Issue Editor

Guest Editor
Prof. Margaret A. Allman-Farinelli

Charles Perkins Centre, D17, School of Life and Environmental Sciences, University of Sydney, Sydney, NSW 2006, Australia
Website | E-Mail
Interests: obesity prevention; diet; health promotion; young adults

Special Issue Information

Dear Colleagues,

Diet is fundamental to the prevention and management of obesity. In this Special Issue, we are seeking unpublished work across the breadth of nutrition research on obesity. This includes dietary interventions for the prevention and management of overweight and obesity across the lifecycle from birth through childhood, adolescence, young, middle and older aged adults. Studies for primary management of obesity using diet and more complex interventions for those with comorbidities and additional therapies will be included. The dietary management of patients after bariatric surgery is a growing area of interest and submissions in this area are welcomed. Research that examines differences in nutritional composition, very low calorie diets, dietary patterns, such as Mediterranean or Nordic diets, and diet quality is covered by this Special Issue. Studies using innovative technology, traditional clinical trials and observational studies will be considered.

Prof. Dr. Margaret A. Allman-Farinelli
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 550 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • diet
  • nutrition
  • overweight
  • obesity
  • intervention
  • preventive health

Published Papers (7 papers)

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Research

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Open AccessArticle
How Effective Are Dietitians in Weight Management? A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Received: 13 November 2018 / Revised: 24 January 2019 / Accepted: 30 January 2019 / Published: 1 February 2019
Cited by 1 | PDF Full-text (875 KB) | HTML Full-text | XML Full-text
Abstract
Effective, evidence-based strategies to prevent and treat obesity are urgently required. Dietitians have provided individualized weight management counselling for decades, yet evidence of the effectiveness of this intervention has never been synthesized. The aim of this study was to examine the effectiveness of [...] Read more.
Effective, evidence-based strategies to prevent and treat obesity are urgently required. Dietitians have provided individualized weight management counselling for decades, yet evidence of the effectiveness of this intervention has never been synthesized. The aim of this study was to examine the effectiveness of individualized nutrition care for weight management provided by dietitians to adults in comparison to minimal or no intervention. Databases (Cochrane, CINAHL plus, MedLine ovid, ProQuest family health, PubMed, Scopus) were searched for terms analogous with patient, dietetics and consultation with no date restrictions. The search yielded 5796 unique articles, with 14 randomized controlled trials meeting inclusion criteria. The risk of bias for the included studies ranged from unclear to high. Six studies found a significant intervention effect for the dietitian consultation, and a further four found significant positive change for both the intervention and control groups. Data were synthesized through random effects meta-analysis from five studies (n = 1598) with weight loss as the outcome, and from four studies (n = 1224) with Body Mass Index (BMI) decrease as the outcome. Groups receiving the dietitian intervention lost an additional 1.03 kg (95% CI:−1.40; −0.66, p < 0.0001) of weight and 0.43 kg/m2 (95% CI:−0.59, −0.26; p < 0.0001) of BMI than those receiving usual care. Heterogeneity was low for both weight loss and BMI, with the pooled means varying from 1.26 to −0.93 kg and −0.4 kg/m2 for weight and BMI, respectively, with the removal of single studies. This study is the first to synthesize evidence on the effectiveness of individualized nutrition care delivered by a dietitian. Well-controlled studies that include cost-effectiveness measures are needed to strengthen the evidence base. Full article
(This article belongs to the Special Issue Dietary Management of Obesity)
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Open AccessFeature PaperArticle
Rationale and Protocol for a Randomized Controlled Trial Comparing Fast versus Slow Weight Loss in Postmenopausal Women with Obesity—The TEMPO Diet Trial
Received: 22 May 2018 / Revised: 11 July 2018 / Accepted: 12 July 2018 / Published: 20 July 2018
Cited by 1 | PDF Full-text (557 KB) | HTML Full-text | XML Full-text
Abstract
Very low energy diets (VLEDs), commonly achieved by replacing all food with meal replacement products and which result in fast weight loss, are the most effective dietary obesity treatment available. VLEDs are also cheaper to administer than conventional, food-based diets, which result in [...] Read more.
Very low energy diets (VLEDs), commonly achieved by replacing all food with meal replacement products and which result in fast weight loss, are the most effective dietary obesity treatment available. VLEDs are also cheaper to administer than conventional, food-based diets, which result in slow weight loss. Despite being effective and affordable, these diets are underutilized by healthcare professionals, possibly due to concerns about potential adverse effects on body composition and eating disorder behaviors. This paper describes the rationale and detailed protocol for the TEMPO Diet Trial (Type of Energy Manipulation for Promoting optimal metabolic health and body composition in Obesity), in a randomized controlled trial comparing the long-term (3-year) effects of fast versus slow weight loss. One hundred and one post-menopausal women aged 45–65 years with a body mass index of 30–40 kg/m2 were randomized to either: (1) 16 weeks of fast weight loss, achieved by a total meal replacement diet, followed by slow weight loss (as for the SLOW intervention) for the remaining time up until 52 weeks (“FAST” intervention), or (2) 52 weeks of slow weight loss, achieved by a conventional, food-based diet (“SLOW” intervention). Parameters of body composition, cardiometabolic health, eating disorder behaviors and psychology, and adaptive responses to energy restriction were measured throughout the 3-year trial. Full article
(This article belongs to the Special Issue Dietary Management of Obesity)
Open AccessFeature PaperArticle
Recruitment Strategies for a Randomised Controlled Trial Comparing Fast Versus Slow Weight Loss in Postmenopausal Women with Obesity—The TEMPO Diet Trial
Received: 12 June 2018 / Revised: 2 July 2018 / Accepted: 3 July 2018 / Published: 6 July 2018
Cited by 1 | PDF Full-text (536 KB) | HTML Full-text | XML Full-text
Abstract
Current research around effective recruitment strategies for clinical trials of dietary obesity treatments have largely focused on younger adults, and thus may not be applicable to older populations. The TEMPO Diet Trial (Type of Energy Manipulation for Promoting [...] Read more.
Current research around effective recruitment strategies for clinical trials of dietary obesity treatments have largely focused on younger adults, and thus may not be applicable to older populations. The TEMPO Diet Trial (Type of Energy Manipulation for Promoting optimal metabolic health and body composition in Obesity) is a randomised controlled trial comparing the long-term effects of fast versus slow weight loss on body composition and cardio-metabolic health in postmenopausal women with obesity. This paper addresses the recruitment strategies used to enrol participants into this trial and evaluates their relative effectiveness. 101 post-menopausal women aged 45–65 years, with a body mass index of 30–40 kg/m2 were recruited and randomised to either fast or slow weight loss. Multiple strategies were used to recruit participants. The total time cost (labour) and monetary cost per randomised participant from each recruitment strategy was estimated, with lower values indicating greater cost-effectiveness and higher values indicating poorer cost-effectiveness. The most cost-effective recruitment strategy was word of mouth, followed (at equal second place) by free publicity on TV and radio, and printed advertorials, albeit these avenues only yielded 26/101 participants. Intermediate cost-effective recruitment strategies were flyer distribution at community events, hospitals and a local tertiary education campus, internet-based strategies, and clinical trial databases and intranets, which recruited a further 40/101 participants. The least cost-effective recruitment strategy was flyer distribution to local health service centres and residential mailboxes, and referrals from healthcare professionals were not effective. Recruiting for clinical trials involving postmenopausal women could benefit from a combination of recruitment strategies, with an emphasis on word of mouth and free publicity via radio, TV, and print media, as well as strategic placement of flyers, supplemented with internet-based strategies, databases and intranets if a greater yield of participants is needed. Full article
(This article belongs to the Special Issue Dietary Management of Obesity)
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Open AccessArticle
A Targeted and Tailored eHealth Weight Loss Program for Young Women: The Be Positive Be Healthe Randomized Controlled Trial
Received: 4 April 2018 / Revised: 18 April 2018 / Accepted: 26 April 2018 / Published: 2 May 2018
Cited by 2 | PDF Full-text (1469 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Young women are gaining weight rapidly. Evidence for effective weight loss interventions targeting young women is lacking. This randomized controlled trial assessed the efficacy and acceptability of a six-month targeted and tailored eHealth weight loss program for young women (Be Positive Be Health [...] Read more.
Young women are gaining weight rapidly. Evidence for effective weight loss interventions targeting young women is lacking. This randomized controlled trial assessed the efficacy and acceptability of a six-month targeted and tailored eHealth weight loss program for young women (Be Positive Be Healthe (BPBH)). Women aged 18–35 years were randomized to BPBH (n = 29) or control (n = 28). BPBH supported participants to modify diet and physical activity behaviours using evidenced-based strategies (e.g., self-monitoring) tailored for young women and delivered using e-health (website, social media, smartphone application, email, text messages). The primary outcome was a change in weight (kg) at six months. Acceptability was assessed via a process evaluation survey and usage of intervention components. No significant between-group differences were observed for weight, with significant mean differences favouring the intervention group observed for body fat (kg) (−3.10 (−5.69, 0.52), p = 0.019) and intakes of alcohol (g) (−0.69 (−1.33, 0.04), p = 0.037), vegetables (% energy/day) (4.71 (−2.20, 7.22), p < 0.001) and energy-dense, nutrient-poor foods (% energy/day) (−9.23 (−16.94, 1.52), p = 0.018). Retention, intervention usage and satisfaction were moderate. BPBH facilitated positive improvements in body fat and dietary intake, but not weight. Intervention acceptability findings support the use of some intervention components (e.g., Facebook, Smartphone app) with young women. Full article
(This article belongs to the Special Issue Dietary Management of Obesity)
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Open AccessFeature PaperArticle
The Healthfulness of Entrées and Students’ Purchases in a University Campus Dining Environment
Received: 20 February 2018 / Revised: 19 March 2018 / Accepted: 21 March 2018 / Published: 22 March 2018
Cited by 1 | PDF Full-text (270 KB) | HTML Full-text | XML Full-text
Abstract
The purpose of this study is to determine the availability of “more healthful” (MH) versus “less healthful” (LH) entrée items in the campus dining and if students’ purchases are reflective of what is offered. This is an observational study in which purchases of [...] Read more.
The purpose of this study is to determine the availability of “more healthful” (MH) versus “less healthful” (LH) entrée items in the campus dining and if students’ purchases are reflective of what is offered. This is an observational study in which purchases of the available entrée items in the campus dining at South Dakota State University in one academic year were collected and categorized as either MH or LH according to the American Heart Association guidelines. Chi-square tests were used to determine the differences between the proportion of purchased MH and LH versus those available. Odds ratio estimates with 95% confidence limits were used to determine the associations between the demographics and MH and LH purchases. Of the total entrée items available, 15.0% were MH and 85.0% were LH. In the fall, 8.0% of purchases were MH and 92.0% purchases were LH as compared to 8.9% MH and 91.1% LH in the spring. Whites were less likely than non-whites to purchase a MH entrée. Females were two times more likely to choose MH entrées than males. The campus dining offerings and students’ purchases of entrees were primarily LH. Work with campus dining providers to create profitable, yet healthful, dining entrees is needed to improve the healthfulness of offerings. Full article
(This article belongs to the Special Issue Dietary Management of Obesity)

Review

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Open AccessReview
Defining the Optimal Dietary Approach for Safe, Effective and Sustainable Weight Loss in Overweight and Obese Adults
Received: 11 May 2018 / Revised: 25 June 2018 / Accepted: 26 June 2018 / Published: 28 June 2018
Cited by 1 | PDF Full-text (235 KB) | HTML Full-text | XML Full-text
Abstract
Various dietary approaches with different caloric content and macronutrient composition have been recommended to treat obesity in adults. Although their safety and efficacy profile has been assessed in numerous randomized clinical trials, reviews and meta-analyses, the characteristics of the optimal dietary weight loss [...] Read more.
Various dietary approaches with different caloric content and macronutrient composition have been recommended to treat obesity in adults. Although their safety and efficacy profile has been assessed in numerous randomized clinical trials, reviews and meta-analyses, the characteristics of the optimal dietary weight loss strategy remain controversial. This mini-review will provide general principles and practical recommendations for the dietary management of obesity and will further explore the components of the optimal dietary intervention. To this end, various dietary plans are critically discussed, including low-fat diets, low-carbohydrate diets, high-protein diets, very low-calorie diets with meal replacements, Mediterranean diet, and diets with intermittent energy restriction. As a general principle, the optimal diet to treat obesity should be safe, efficacious, healthy and nutritionally adequate, culturally acceptable and economically affordable, and should ensure long-term compliance and maintenance of weight loss. Setting realistic goals for weight loss and pursuing a balanced dietary plan tailored to individual needs, preferences, and medical conditions, are the key principles to facilitate weight loss in obese patients and most importantly reduce their overall cardiometabolic risk and other obesity-related comorbidities. Full article
(This article belongs to the Special Issue Dietary Management of Obesity)
Open AccessFeature PaperReview
Strategies to Engage Adolescents in Digital Health Interventions for Obesity Prevention and Management
Received: 4 June 2018 / Revised: 18 June 2018 / Accepted: 19 June 2018 / Published: 21 June 2018
Cited by 2 | PDF Full-text (502 KB) | HTML Full-text | XML Full-text
Abstract
Obesity is one of the greatest health challenges facing today’s adolescents. Dietary interventions are the foundation of obesity prevention and management. As adolescents are digital frontrunners and early adopters of technology, digital health interventions appear the most practical modality for dietary behavior change [...] Read more.
Obesity is one of the greatest health challenges facing today’s adolescents. Dietary interventions are the foundation of obesity prevention and management. As adolescents are digital frontrunners and early adopters of technology, digital health interventions appear the most practical modality for dietary behavior change interventions. Despite the rapid growth in digital health interventions, effective engagement with adolescents remains a pertinent issue. Key strategies for effective engagement include co-designing interventions with adolescents, personalization of interventions, and just-in-time adaptation using data from wearable devices. The aim of this paper is to appraise these strategies, which may be used to improve effective engagement and thereby improve the dietary behaviors of adolescents now and in the future. Full article
(This article belongs to the Special Issue Dietary Management of Obesity)
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