Does FGF21 Mediate the Potential Decrease in Sweet Food Intake and Preference Following Bariatric Surgery?

The liver-derived hormone fibroblast growth factor 21 (FGF21) has recently been linked to preference for sweet-tasting food. We hypothesized, that surgery-induced changes in FGF21 could mediate the reduction in sweet food intake and preference following bariatric surgery. Forty participants (35 females) with severe obesity (BMI ≥ 35 kg/m²) scheduled for roux-en-y gastric bypass (n = 30) or sleeve gastrectomy (n = 10) were included. Pre- and postprandial responses of intact plasma FGF21 as well as intake of sweet-tasting food assessed at a buffet meal test, the hedonic evaluation of sweet taste assessed using an apple juice with added sucrose and visual analog scales, and sweet taste sensitivity were assessed before and 6 months after bariatric surgery. In a cross-sectional analysis pre-surgery, pre- and postprandial intact FGF21 levels were negatively associated with the hedonic evaluation of a high-sucrose juice sample (p = 0.03 and p = 0.02). However, no changes in pre- (p = 0.24) or postprandial intact FGF21 levels were found 6 months after surgery (p = 0.11), and individual pre- to postoperative changes in pre- and postprandial intact FGF21 levels were not found to be associated with changes in intake of sweet foods, the hedonic evaluation of sweet taste or sweet taste sensitivity (all p ≥ 0.10). In conclusion, we were not able to show an effect of bariatric surgery on circulating FGF21, and individual postoperative changes in FGF21 were not found to mediate an effect of surgery on sweet food intake and preference.     

Effects of Bitter Substances on GI Function,Energy Intake and Glycaemia-Do Preclinical Findings Translate to Outcomes in Humans?

Bitter substances are contained in many plants, are often toxic and can be present in spoiled food. Thus, the capacity to detect bitter taste has classically been viewed to have evolved primarily to signal the presence of toxins and thereby avoid their consumption. The recognition, based on preclinical studies (i.e., studies in cell cultures or experimental animals), that bitter substances may have potent effects to stimulate the secretion of gastrointestinal (GI) hormones and modulate gut motility, via activation of bitter taste receptors located in the GI tract, reduce food intake and lower postprandial blood glucose, has sparked considerable interest in their potential use in the management or prevention of obesity and/or type 2 diabetes. However, it remains to be established whether findings from preclinical studies can be translated to health outcomes, including weight loss and improved long-term glycaemic control. This review examines information relating to the effects of bitter substances on the secretion of key gut hormones, gastric motility, food intake and blood glucose in preclinical studies, as well as the evidence from clinical studies, as to whether findings from animal studies translate to humans. Finally, the evidence that bitter substances have the capacity to reduce body weight and/or improve glycaemic control in obesity and/or type 2 diabetes, and potentially represent a novel strategy for the management, or prevention, of obesity and type 2 diabetes, is explored.     

Does Sodium Intake Induce Systemic Inflammatory Response? A Systematic Review and Meta-Analysis of Randomized Studies in Humans

Experimental studies suggest that sodium induced inflammation might be another missing link leading to atherosclerosis. To test the hypothesis that high daily sodium intake induces systemic inflammatory response in humans, we performed a systematic review according to PRISMA guidelines of randomized controlled trials (RCTs) that examined the effect of high versus low sodium dose (HSD vs. LSD), as defined per study, on plasma circulating inflammatory biomarkers. Eight RCTs that examined CRP, TNF-a and IL-6 were found. Meta-analysis testing the change of each biomarker in HSD versus LSD was possible for CRP (n = 5 studies), TNF-a (n = 4 studies) and IL-6 (n = 4 studies). The pooled difference (95% confidence intervals) per biomarker was for: CRP values of 0.1(−0.3, 0.4) mg/L; TNF-a −0.7(−5.0, 3.6) pg/mL; IL-6 −1.1(−3.3 to 1.1) pg/mL. Importantly, there was inconsistency between RCTs regarding major population characteristics and the applied methodology, including a very wide range of LSD (460 to 6740 mg/day) and HSD (2800 to 7452 mg/day). Although our results suggest that the different levels of daily sodium intake are not associated with significant changes in the level of systemic inflammation in humans, this outcome may result from methodological issues. Based on these identified methodological issues we propose that future RCTs should focus on young healthy participants to avoid confounding effects of comorbidities, should have three instead of two arms (very low, “normal” and high) of daily sodium intake with more than 100 participants per arm, whereas an intervention duration of 14 days is adequate.     

Does Knowledge of Treatment Assignment Affect Patient Report of Symptoms,Function, and Health Status? An Evaluation Using Multiple Myeloma Trials

ObjectivesUnblinded trials are common in oncology, but patient knowledge of treatment assignment may bias response to questionnaires. We sought to ascertain the extent of possible bias arising from patient knowledge of treatment assignment.MethodsThis is a retrospective analysis of data from 2 randomized trials in multiple myeloma, 1 double-blind and 1 open label. We compared changes in patient reports of symptoms, function, and health status from prerandomization (screening) to baseline (pretreatment but postrandomization) across control and investigational arms in the 2 trials. Changes from prerandomization scores at ~2 and 6 months on treatment were evaluated only across control arms to avoid comparisons between 2 different experimental drugs. All scores were on 0- to 100-point scales. Inverse probability weighting, entropy balancing, and multiple imputation using propensity score splines were used to compare score changes across similar groups of patients.ResultsMinimal changes from screening were seen at baseline in all arms. In the control arm, mean changes of <7 points were seen for all domains at 2 and 6 months. The effect of unblinding at 6 months in social function was a decline of less than 6 points (weighting: ?3.09; 95% confidence interval ?8.41 to 2.23; balancing: ?4.55; 95% confidence interval ?9.86 to 0.76; imputation: ?5.34; 95% confidence interval ?10.64 to ?0.04).ConclusionIn this analysis, we did not find evidence to suggest that there was a meaningful differential effect on how patients reported their symptoms, function or health status after knowing their treatment assignment.     

The Impact of Prosocial Television News on Children’s Prosocial Behavior: An Experimental Study in the Netherlands

The aim of this experimental study was to examine whether prosocial behavior in television news affects children’s prosocial intentions and behaviors. In this study, 372 Dutch children (9–13 years old) participated. Children in the experimental condition were exposed to prosocial news showing children organizing a fundraising action for UNICEF. In the control condition, children were exposed to news about UNICEF in which no prosocial behavior was included. Afterwards, children were given the opportunity to donate to UNICEF, which served as an index of prosocial behavior. Prosocial intentions were captured using paper-and-pencil questionnaires. Regression analysis demonstrated that, while controlling for important confounders, children exposed to prosocial news were significantly more willing to help with setting up a project for UNICEF and donated more to UNICEF compared to children who did not watch prosocial news. These findings highlight that prosocial television can function as a tool for positive social change among children.     

Does the Process of Deliberation Change Individuals’ Health State Valuations? An Exploratory Study Using the Person Trade-Off Technique

BackgroundThis article explores two gaps in the health state valuation literature: the effect of processes and the stability of health state valuations, and the existence of preexisting valuations. Stability in health state valuations over time depends on whether preferences are considered to be preexisting (axiom of completeness) and therefore can be gathered reliably, or are constructed during consideration and debate. Under the former, changes in revealed preferences are evidence of poor reliability; under the latter, it is a function of the deliberative process.MethodsThis study explores the effect of deliberation on health state valuations elicited by using the person trade-off technique . Quantitative analysis was used to explore whether respondents changed their responses following deliberation and the impact of change on aggregate health state values. Qualitative methods were used to explore respondents’ views on the elicitation process and the impact of deliberation on their responses.ResultsFollowing discussion and deliberation, 74% of the participants changed their person trade-off valuations and this did have an impact on the aggregate valuations. The qualitative analysis lends some support to the construction of preference assumption.ConclusionsThe results from this exploratory study challenge the notion that individuals have preexisting health state preferences and call for further detailed research in this area. Furthermore, it raises concerns over current practices around preference elicitation exercises, which have tended to be carried out as a solitary exercise without allowing time for respondents to reflect and deliberate on their decisions.     

Does living in a disadvantaged area entail limited opportunities to purchase fresh fruit and vegetables in terms of price, availability, and variety? Findings from the Brisbane Food Study

Understanding the role environmental factors may play in the dietary behaviours of socioeconomic groups is relevant for efforts to reduce health inequalities. In contrast with international research, earlier findings from the Brisbane Food Study (BFS), Australia, found no relationship between area socioeconomic characteristics and dietary behaviours or location of food shops. This paper examines whether the price and availability of fruits and vegetables are socioeconomically patterned using data from the BFS. Fifty census collection districts were randomly sampled and all local (i.e. within 2.5 km) supermarkets, greengrocers and convenience stores were observed. Little or no differences in price and availability were found on the basis of area socioeconomic characteristics.     

An Experimental Study of Medical Error Explanations: Do Apology,Empathy, Corrective Action,and Compensation Alter Intentions and Attitudes?

Medical malpractice lawsuits are a growing problem in the United States, and there is much controversy regarding how to best address this problem. The medical error disclosure framework suggests that apologizing, expressing empathy, engaging in corrective action, and offering compensation after a medical error may improve the provider–patient relationship and ultimately help reduce the number of medical malpractice lawsuits patients bring to medical providers. This study provides an experimental examination of the medical error disclosure framework and its effect on amount of money requested in a lawsuit, negative intentions, attitudes, and anger toward the provider after a medical error. Results suggest empathy may play a large role in providing positive outcomes after a medical error.     

Can a Food Justice Movement Improve Nutrition and Health? A Case Study of the Emerging Food Movement in New York City

In response to increasing obesity, diabetes, and food-related contributions to climate change, many individuals and organizations are mobilizing to advocate for healthier and more just local and national food policies and systems. In this report, we describe and analyze the food movement in New York City, examine tensions within it, and consider its potential role in improving health and nutrition. We conclude by suggesting that public health professionals can amplify the health effects of such movements by creating opportunities for dialog with movement participants, providing resources such as policy-relevant scientific evidence, documenting problems and evaluating policies, and offering technical, political, and organizational development expertise.     

Do Social Support,Self-efficacy and Resilience Influence the Experience of Stress in Ghanaian Orphans? An Exploratory Study

Much of the literature suggests that the availability of certain protective factors can help to buffer the adverse effects of negative life events such as parental loss and the negative experiences surrounding placement in orphanages. Following on from this perspective, the present study explores the influence of perceived social support, self-efficacy and resilience on the stress experience (as measured by the symptoms of depression and anxiety) of 200 children in Accra, Ghana. The sample comprised 100 orphans placed in orphanages and 100 non-orphans – all aged between seven and 17 years. The children completed the Children's Depression Inventory, the Revised Children's Manifest Anxiety Scale, the Multidimensional Scale of Perceived Social Support, the General Self-efficacy Scale and the 14-item Resilience Scale. The results revealed that orphans had significantly stronger perceptions of social support from friends than non-orphans, whereas non-orphans had significantly stronger perceptions of support from families than orphans. However, both the orphans and non-orphans reported high levels of self-efficacy and resilience. Regression analyses also revealed that self-efficacy emerged as a significant positive predictor of resilience for the orphaned children, whereas self-efficacy and perceived social support emerged as significant positive predictors of resilience for the non-orphans. Implications of the findings are discussed.     

Does Nausea and Vomiting of Pregnancy Play a Role in the Association Found Between Maternal Caffeine Intake and Fetal Growth Restriction?

The aim of this study was to explore the relationships between nausea and vomiting in pregnancy and (a) fetal growth restriction; and (b) maternal caffeine metabolism and fetal growth restriction. A cohort of 2,643 pregnant women, aged 18–45 years, attending two UK maternity units between 8 and 12 weeks gestation, was recruited. A validated tool assessed caffeine intake at different stages of pregnancy and caffeine metabolism was assessed from a caffeine challenge test. Experience of nausea and vomiting of pregnancy was self-reported for each trimester. Adjustment was made for confounders, including salivary cotinine as a biomarker of current smoking status. There were no significant associations between fetal growth restriction and nausea and vomiting in pregnancy, even after adjustment for smoking and alcohol intake. There were no significant differences in the relationship between caffeine intake and fetal growth restriction between those experiencing symptoms of nausea and vomiting and those who did not, for either the first (p = 0.50) or second trimester (p = 0.61) after adjustment for smoking, alcohol intake and caffeine half-life. There were also no significant differences in the relationship between caffeine half-life and fetal growth restriction between those experiencing symptoms of nausea and vomiting and those who did not, for either the first trimester (p = 0.91) or the second trimester (p = 0.45) after adjusting for smoking, alcohol intake and caffeine intake. The results from this study show no evidence that the relationship between maternal caffeine intake and fetal growth restriction is modified by nausea and vomiting in pregnancy.     

Using Three Indirect Measures to Assess the Role of Sexuality-Related Associations and Interpretations for Women’s Sexual Desire: An Internet-Based Experimental Study

Archives of Sexual Behavior - Theoretical models emphasize the role of both automatic appraisals (i.e., associations) and conscious appraisals (i.e., interpretations) for sexual desire. Studies on...     

Does the ICECAP-O cover the physical,mental and social functioning of older people in the UK?

Quality of Life Research - The ICEpop CAPability measure for Older people (ICECAP-O) is intended for use in economic evaluations of care services for older people. Although studies support the...     

Does the Internet function like magazines? An exploration of image-focused media,eating pathology,and body dissatisfaction

Research has identified a relation between exposure to thin-ideal magazine and television media images and eating disorder pathology. However, few studies have examined the potential influence of Internet media on eating disorder behaviors and attitudes. This study investigated associations among image-focused media exposure, body dissatisfaction, eating pathology and thin-ideal internalization in a sample of 421 female undergraduates. Undergraduate women spent significantly more time viewing online appearance-oriented media, rather than reading image-focused magazines. Appearance-oriented Internet and television use were associated with eating pathology. Moreover, the association between image-focused Internet use and BD was mediated by thin-ideal internalization. These findings are consistent with those of previous research, and highlight the vulnerability individuals high in thin-ideal internalization might have to media exposure. They also suggest that Internet media use is an important topic to attend to in eating disorders prevention and treatment.     

Comparing the ICERs in Medicine Reimbursement Submissions to NICE and PBAC—Does the Presence of an Explicit Threshold Affect the ICER Proposed?

Objectives

The English National Institute for Health and Care Excellence (NICE) and the Australian Pharmaceutical Benefits Advisory Committee (PBAC) require evidence that a new medicine represents value for money before being publicly funded. NICE has an explicit threshold for cost effectiveness, whereas PBAC does not. We compared the initial incremental cost-effectiveness ratios (ICERs) presented by manufacturers in matched submissions to each decision-making body, with the aim of exploring the impact of an explicit threshold on these ICERs.