Nanette Stroebele-Benschop

Gender Differences in the Outcome of Obesity Treatments and Weight Loss Maintenance - A Systematic Review

Obesity is one of the major health concerns of today. The aim of the study was to review existing literature comparing gender differences in Weight Loss (WL) and Weight Loss Maintenance (WLM). A systematic review of published studies (to November 2009) examining WL and WLM and provided results separated by gender was conducted. Two reviewers selected studies for inclusion, assessed quality, and extracted data. The database search identified 1072 references for screening and 229 were selected for possible inclusion. A search update in August 2011 identified an additional 186 references and 62 were selected for possible inclusion. Fifty-four studies were included. Seventeen studies included surgical WL procedures and 37 studies examined nonsurgical WL treatments. For both types of WL treatment, about half of the studies reported higher absolute WL in men whereas the other half of the studies reported no gender differences. The majority of the 12 studies on WLM reported no gender differences. Meta-analysis revealed higher relative weight loss in men compared to women. WL treatment outcome appears to be in favour of WL in men. More research attention should be paid to gender specifics regarding WL treatment and WLM.

Environmental Strategies to Promote Food Intake in Older Adults: A Narrative Review

ABSTRACT Aging is often accompanied by lower intakes of food energy and consequent negative effects on health. To some extent this is due to declines in physiological ability, including the sensory responsiveness to regulate food intake. Fortunately, environmental factors may still influence food intake in older adults. Factors such as social facilitation, modeling, and nutrition knowledge and skills have been shown to stimulate their food intake. While environmental factors such as the eating location, portion size, food presentation, and labeling are known to influence eating behavior, their effectiveness in stimulating food intake in older persons is not well delineated. It is suggested that improving the environmental stimuli that promote food intake is a viable strategy to overcome age-related declines in nutrient intakes. This strategy is so promising that further research is warranted.

Prevalence of food insecurity among food bank users in Germany and its association with population characteristics

The prevalence of food insecurity (FI) among food bank users in many European countries is unknown. The study aims to examine FI prevalence and associated population characteristics among this particular group of disadvantaged people in Germany. Food insecurity status was assessed among 1033 adult food bank users with a mean age of 53 years (57% female, 43% male) in Germany in 2015 using the food insecurity experience scale (FIES). About half of the participants (55.8%) were single with no children and born in Germany. Over 37% had a self-reported BMI of 30 kg/m2 or above and 37.4% indicated to smoke. Over 70% of the food bank users can be described as food insecure. Of those, about 35% were considered mildly food insecure. Almost 30% were categorized as moderately food insecure while over 7% were categorized as severely food insecure. Significant associations with food insecurity were found for gender, age, subjective health status, smoking, duration of food bank use, school education and family type. Among this socially disadvantaged population, food insecurity is highly prevalent and public health efforts should be focusing on this vulnerable population taken into account the identified population and behavioral characteristics associated with food insecurity.

The influence of music type and transmission mode on food intake and meal duration: An experimental study

The influence of auditory stimuli and their transmission mode on food intake and meal duration was assessed in healthy adults (73 male, 74 female) under laboratory conditions. The participants (18–30 years old) were randomized to one of five lunch groups. Five conditions were compared: eating in silence (control condition), eating while listening to background music via loudspeakers, eating while listening to background music via headphones, eating while listening to pop songs with English vocals and eating while listening to pop songs with German vocals. Results showed no association between listening to songs with different emotion-arousing potential and the amount of food consumed. Within-group comparisons revealed longer meal durations while listening to English music and unfamiliar background music via headphones than while listening to familiar German pop songs. The difference with the control condition just failed to reach significance. No differences were found for transmission mode. Further studies to examine the influence of music on food intake and eating behaviour, especially under controlled conditions, are needed.

Migration Background Influences Consumption Patterns Based on Dietary Recommendations of Food Bank Users in Germany

People with low income tend to eat less balanced than people with higher income. This seems to be particularly the case for people with migration background. This cross-sectional study examined the relation of consumption patterns of 597 food bank users with different migration background in Germany. Questionnaires were distributed assessing sociodemographic information and consumption patterns. Analyses were conducted using binary logistic regressions. Models were controlled for age, gender, type of household and education. The group of German food bank users consumed fewer fruits and vegetables and less fish compared to all other groups with migration background (former USSR, Balkan region, Middle East). A significant predictor for fruit and vegetable consumption was migration status. Participants from the former USSR consumed less often SSBs compared to the other groups. Dietary recommendations for low income populations should take into consideration other aspects besides income such as migration status.

First come, first served. Does pouring sequence matter for consumption?

Various environmental factors associated with eating and drinking affect peoples food choice and food intake. Lately, the role of tableware has been studied in more detail. The aim of this study was to determine whether pouring sequence of food components affects portion size. Study 1 invited participants to pour a beverage containing both apple juice and sparkling water. Pouring apple juice first increased juice by almost 25% compared to pouring water first. Pouring water first increased water by almost 19% compared to pouring juice first confirming our hypothesis that pouring sequence affects the ratio poured. Study 2 asked participants to prepare themselves a snack containing cereals with milk. Within-subject comparisons revealed that pouring milk before cereals significantly increased both milk and cereal amounts resulting in larger overall portion size compared to pouring cereals before adding milk. Habitual tendencies for preparing foods causing a perception bias or a perception bias itself could be possible explanations for the divergent study findings. These findings show for the first time the influence of pouring and preparation sequence on portion size.

Predictors of Meeting Physical Activity and Fruit and Vegetable Recommendations in 9-11-Year-Old Children.

Objective: Childhood obesity represents a significant public health problem. This study examined physical activity and nutrition behaviours and attitudes of 9–11-year-olds, and factors influencing these behaviours. Design: Study participants recorded pedometer steps for 7 days and completed physical activity enjoyment, food attitudes and food frequency questionnaires. Fruit and vegetable sales data were collected from schools. The setting for the study was elementary schools in metropolitan Denver, Colorado (USA). Method: Logistic regression was used to determine significant predictors of meeting physical activity/fruit and vegetable intake recommendations. Results: Overall, 42.0% of boys and 44.1% of girls met step count recommendations. Further, 30.9% of boys and 32.8% of girls met step count requirements associated with low risk for overweight/obesity. Enjoyment of physical activity significantly predicted achieving recommendations. Overall, 66.4%, 51.3% and 65.8% of 9–11-year-olds achieved adequate fruit, vegetable, or fruit and vegetable intake, respectively. Enjoyment of fruit/vegetable consumption, perceived parental intake and encouragement and cups of vegetables purchased predicted achieving adequate intake. Conclusion: The majority of young people aged 9–11 years failed to meet step count recommendations to prevent the risk for overweight/obesity. A significant proportion also failed to achieve adequate fruit and/or vegetable intake. Future programmes and interventions should affect multiple environments in order to improve child enjoyment of physical activity and fruit/vegetable intake in order to improve the physical, mental and emotional health of children.

Students’ adherence to dietary recommendations and their food consumption habits:

Background: Habitual behavior rather than intention has been linked to food intake patterns. Aim: The purpose of this study was to examine the adherence to dietary recommendations in university students and to analyze whether habit strength predicts food consumption. Methods: A student sample of the University (University of Hohenheim) was recruited (n = 103; age range 18–30 years). Habit strength for consuming the food groups fruits, vegetables, whole grains, milk, meat, convenience foods, sugary and savory snacks, water and sugar-sweetened beverages was measured using a questionnaire. Food intake was measured via a self-administered online food frequency survey two weeks later, which was then compared to dietary recommendations. For associations of habit strength and consumption, Kendall’s Tau-c correlation coefficient was calculated. Results: The majority of students failed to meet the recommendations for all food groups except meat, eggs, oil, fat, and water. Only 4.2% of men (15.4% of women) consumed the recommended daily amount of vegetables. Fruit recommendations were met by 20.8% of men (43.6% of women). Habit strength was significantly associated with the consumption of most food groups. Conclusion: Adhering to dietary recommendations appeared to be difficult. Educational efforts should be undertaken to improve students’ diet considering habit strength as an important determinant of food intake.

The impact of providing fruits and vegetables to socially disadvantaged men

ABSTRACT Worldwide, food banks offer foods for free (e.g. USA) or at nominal costs (e.g. Germany), to people in need, but nothing is known about their impact on fruit and vegetable (FV) intake. Study aims were to examine whether (1) German male food bank users have a higher FV intake (variety and amount) compared to non-food bank users and whether (2) providing fresh FV for free, which participants personally selected, can increase FV intake among men in dependence of their food bank use. For the first question, a cross-sectional design and for the second, a longitudinal design (randomized intervention study) were chosen. Sociodemographic variables and dietary patterns (Food Frequency questionnaire and FV variety questionnaire) were assessed at baseline and dietary patterns were evaluated again after the intervention. The intervention consisted of providing two daily portions of fresh FV each week for 4 weeks. In total, 52 men participated. Men using a food bank regularly consumed a significantly larger FV variety than non-food bank or infrequent food bank users. The provision of free FV improved intake among social disadvantaged men, whereby particularly non-food bank users benefited from the intervention. Using a food bank that offers fresh produce might be a promising public health approach.

The German Food Bank System and Its Users—A Cross-Sectional Study

Although food banks are a well-known resource for low-income people struggling to meet their food needs, they have rarely been investigated on a large scale. This study aims to contribute to the actual debate about the potential and limitations of food banks to decrease the prevalence of food insecurity by providing a representative picture of the German food bank system and its users. Publicly accessible data were used to map residents, public welfare recipients, and food banks. In addition, a comprehensive survey was distributed to all 934 “Tafel” food banks. The results show that nearly all residents and welfare recipients have access to at least one food bank located in the districts in which they reside. Differences in the density of food banks exist between eastern and western Germany. Food banks provide mainly healthy fresh food, but they heavily rely on food donations from local retailers and on volunteer labor. Although changes in the number of user households by income seem to mirror trends in the number of welfare recipients, food bank users appear to represent only a fraction of the food-insecure population in Germany. Food banks might have the potential to improve users’ diet and food security, but they are not able to reach all food-insecure residents in Germany.