Growing evidence supports early eating to control appetite and energy balance but there are few controlled studies to assess the amount and/or type of breakfast meal. This randomised, within-participant, diet intervention examined the effects of higher-fibre (HF) and higher-protein (HP) breakfasts in adults with overweight/obesity. Nineteen healthy adults consumed two randomised 28-d weight loss (WL) diets, as higher-fibre (HFWL) or higher protein (HPWL), with all food provided. Both WL diets were designed as 45 %, 35 % and 20 % of calories to be consumed in the morning, afternoon and evening, respectively. The primary outcome was energy balance, analysed by body weight changes. The secondary outcomes were gut health (assessed by changes in faecal microbiota composition and microbial metabolite concentrations) and subjective appetite assessed with visual analogue scales. There was a diet effect on WL, with mean loss of −4·87 kg and −3·87 kg for the HFWL and HPWL diets, respectively (P = 0·002). The HPWL diet was superior to the HFWL diet for suppressing subjective appetite (P = 0·003). The faecal microbiota analysis showed beneficial groups of bacteria, including bifidobacteria, and the butyrate producers Faecalibacterium and Roseburia, were significantly increased in proportional abundance on the HFWL diet. Breakfast composition has an important role in influencing subjective appetite with the HP diet promoting greater feelings of satiety. The proportional abundance of putatively beneficial groups of gut microbiota was markedly higher on the fibre-enriched diet, which may be preferable for gut health.

While the effects of multidisciplinary weight loss (WL) on resting energy expenditure remain unclear in adolescents with obesity, the potential presence of adaptive thermogenesis (AT) has never been explored, which was the objective of the present work. Twenty-six adolescents (14·1 (sd 1·5) years) with severe obesity completed a 9-month inpatient multidisciplinary intervention followed by a 4-month follow-up. Anthropometric measurements, body composition (dual X-ray absorptiometry) and resting energy expenditure (REE, indirect calorimetry) were assessed before (T0) and after 9 months of WL intervention (T1) and after a 4-month follow-up (T2). AT, at the level of REE, was defined as a significantly lower measured v. predicted (using regression models with baseline data) REE. Two pre-cited REE equations were used, using both fat mass and fat-free mass (FFM) (predicted REE using equation 1) or FFM only (predicted REE using equation 2). Measured and predicted REE significantly decreased between T0 and T1 (P < 0·001) and remained lower at T2 compared with T0 (measured REE: P = 0·017; predicted REE: P < 0·001). Predicted REE using equation 2 was significantly higher than measured REE at T1 (P = 0·012), suggesting the presence of AT. FFM at T0 was negatively correlated with ATp1T1 (Rho = –0·428; P = 0·033) and ATp2T1 (Rho = –0·485; P = 0·014). The variation of FFM between T0 and T1 was negatively correlated with AT at T1 and T2. These preliminary results suggest the existence of AT in response to WL in adolescents with obesity, independently of the degree of WL. AT was associated with subsequent body weight and fat regain, suggesting AT may represent a damper to WL attempts while increasing the adolescents’ risks for subsequent weight and adiposity rebounds.

Current literature has shown that poor sleep patterns and social jet lag (SJL) are associated with obesity and weight gain. However, this area remains underexplored in patients who have undergone bariatric surgery. We hypothesised that higher levels of SJL and poorer sleep patterns are associated with lower weight loss, greater caloric/nutrient intake and poorer metabolic outcomes following surgery. This study aims to assess the associations of SJL and subjective sleep with anthropometric, metabolic and dietary parameters during the first year following bariatric surgery. SJL, sleep quality and daytime sleepiness were measured in 122 patients (77 % women; median age 33·0 [28·0 – 41·7]). SJL was estimated by the absolute difference between the midpoint of sleep and wake times on weekdays and weekends. Daytime sleepiness and sleep quality were evaluated using the Epworth Sleepiness Scale (Epworth) and the Pittsburgh Sleep Quality Index, respectively. Multiple linear regressions were employed to evaluate the associations of SJL, sleep quality and daytime sleepiness with weight loss, metabolic and dietary outcomes. Independent variables were negatively associated with weight loss after surgery: SJL at 6 months and 1 year; sleep quality at all time points and sleepiness after one year (P < 0·05). SJL was positively associated with calorie and protein intake after 1-year post-surgery (P < 0·05). Our results show that higher SJL and poorer sleep patterns are associated with worse anthropometric, metabolic and dietary outcomes after bariatric surgery. These findings reinforce the importance of addressing variables related to biological rhythms to optimise post-surgical outcomes in bariatric patients.

Intermittent energy-restricted diets are used amongst women with overweight and obesity and a healthy weight. For those with overweight and obesity weight control is typically achieved through daily energy restriction (DER) which has reduced adherence and attenuated metabolic benefits over time. Several intermittent energy restriction (IER) regimens have been developed aiming to promote maintained weight loss and additional weight independent metabolic benefits including the 5:2 diet, alternate day fasting (ADF) and time-restricted eating (TRE). This review summarises the potential benefits or harms of these regimens for managing women’s health. 5:2 and ADF diets have equivalent long term (≥ 6-month) adherence, weight loss and metabolic benefits to DER. Current limited evidence suggests IER is a safe weight loss intervention for women which does not affect reproductive or bone health, increase eating disorders or disturb sleep. Adherence and weight loss with both IER and DER are lower amongst younger women compared to older women and men. Weight loss with ADF and TRE has, respectively, improved symptoms of polycystic ovarian syndrome and premenstrual syndrome, but there is no evidence of weight-independent effects of IER on these conditions. There is little evidence of the benefits and/or harms of IER amongst healthy weight women in whom there is a greater potential for adverse effects on reproductive and bone health, fat free mass, eating disorders and sleep. Further research benefits of IER for weight control and metabolic health as well as harms are required.

The potential influence of the timing of eating on body weight regulation in humans has attracted substantial research interest. This review aims to critically evaluate the evidence on timed eating for weight loss, considering energetic and behavioural components of the timing of eating in humans. It has been hypothesised that timed eating interventions may alter energy balance in favour of weight loss by enhancing energy expenditure, specifically the thermic effect of food. This energetic effect has been suggested to explain greater weight loss which has been observed with certain timed eating interventions, despite comparable self-reported energy intakes to control diets. However, timed eating interventions have little impact on total daily energy expenditure, and the apparent effect of time of day on the thermic effect of food largely represents an artefact of measurement methods that fail to account for underlying circadian variation in RMR. Differences in weight loss observed in free-living interventions are more likely explainable by real differences in energy intake, notwithstanding similar self-reported energy intakes. In addition, the energetic focus tends to overlook the role of behavioural factors influencing the timing of eating, such as appetite regulation chronotype-environment interactions, which may influence energy intake under free-living conditions. Overall, there is scant evidence that timed eating interventions are superior to general energy restriction for weight loss in humans. However, the role of behavioural factors in influencing energy intake may be relevant for adherence to energy-restricted diets, and this aspect remains understudied in human intervention trials.

An assessment of systemic inflammation and nutritional status may form the basis of a framework to examine the prognostic value of cachexia in patients with advanced cancer. The objective of the study was to examine the prognostic value of the Global Leadership Initiative on Malnutrition criteria, including BMI, weight loss (WL) and systemic inflammation (as measured by the modified Glasgow Prognostic Score (mGPS)), in advanced cancer patients. Three criteria were examined in a combined cohort of patients with advanced cancer, and their relationship with survival was examined using Cox regression methods. Data were available on 1303 patients. Considering BMI and the mGPS, the 3-month survival rate varied from 74 % (BMI > 28 kg/m2) to 61 % (BMI < 20 kg/m2) and from 84 % (mGPS 0) to 60 % (mGPS 2). Considering WL and the mGPS, the 3-month survival rate varied from 81 % (WL ± 2·4 %) to 47 % (WL ≥ 15 %) and from 93 % (mGPS 0) to 60 % (mGPS 2). Considering BMI/WL grade and mGPS, the 3-month survival rate varied from 86 % (BMI/WL grade 0) to 59 % (BMI/WL grade 4) and from 93 % (mGPS 0) to 63 % (mGPS 2). When these criteria were combined, they better predicted survival. On multivariate survival analysis, the most highly predictive factors were BMI/WL grade 3 (HR 1·454, P = 0·004), BMI/WL grade 4 (HR 2·285, P < 0·001) and mGPS 1 and 2 (HR 1·889, HR 2·545, all P < 0·001). In summary, a high BMI/WL grade and a high mGPS as outlined in the BMI/WL grade/mGPS framework were consistently associated with poorer survival of patients with advanced cancer. It can be readily incorporated into the routine assessment of patients.

Weight loss results in obligatory reductions in energy expenditure (EE) due to loss of metabolically active fat-free mass (FFM). This is accompanied by adaptive reductions (i.e. adaptive thermogenesis) designed to restore energy balance while in an energy crisis. While the ‘3500-kcal rule’ is used to advise weight loss in clinical practice, the assumption that EE remains constant during energy restriction results in a large overestimation of weight loss. Thus, this work proposes a novel method of weight-loss prediction to more accurately account for the dynamic trajectory of EE. A mathematical model of weight loss was developed using ordinary differential equations relying on simple self-reported inputs of weight and energy intake to predict weight loss over a specified time. The model subdivides total daily EE into resting EE, physical activity EE, and diet-induced thermogenesis, modelling obligatory and adaptive changes in each compartment independently. The proposed model was tested and refined using commercial weight-loss data from participants enrolled on a very low-energy total-diet replacement programme (LighterLife UK, Essex). Mathematical modelling predicted post-intervention weight loss within 0.75% (1.07 kg) of that observed in females with overweight or obesity. Short-term weight loss was consistently underestimated, likely due to considerable FFM reductions reported on the onset of weight loss. The best model agreement was observed from 6 to 9 weeks where the predicted end-weight was within 0.35 kg of that observed. The proposed mathematical model simulated rapid weight loss with reasonable accuracy. Incorporated terms for energy partitioning and adaptive thermogenesis allow us to easily account for dynamic changes in EE, supporting the potential use of such a model in clinical practice.

We aimed at quantifying the effects of different tea and coffee on weight loss in adults. We searched PubMed, Scopus, CENTRAL and grey literature sources to July 2024. The study excluded cross-over trials without washout period, those in critically ill patients, pregnant or breast-feeding women, multicomponent interventions and active control groups with tea or coffee. A random-effects network meta-analysis with a Bayesian framework was performed to calculate the mean difference (MD) and 95 % credible intervals (CrIs). The certainty of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach, and risk of bias was assessed using Cochrane tool. Twenty-two randomised controlled trials with 1710 participants (average intervention duration = 10 weeks) were included. Green tea was effective for weight loss compared with placebo (MD: −1·23 kg, 95 % CrI: −2·45, −0·02; low certainty evidence) or water (MD: −1·61 kg, 95 % CrI: −2·90, −0·35; very low certainty evidence), while other beverages (coffee, decaffeinated coffee, green coffee, black tea and sour tea) were not. Green tea was effective for weight loss compared with water in sensitivity analysis of healthy individuals (MD: −3·31 kg, 95 % CrI: −5·83, −1·04). Based on very low to low certainty evidence, green tea drinking may result in a small weight loss in adults. This study mainly focused on weight loss effects of green tea and coffee, with limited data on other teas. Only five trials had longer intervention durations, suggesting future research on long-term effects. Most trials had high bias risk and low certainty, requiring more high-quality trials.

One of the main challenges in weight loss programmes is compliance with diet and achievement of sustainable changes in eating habits and lifestyles. Most clients desire to lose weight quickly, rather than looking at long-term changes. The literature suggests applying telenutrition, owing to its convenience and easy access in combination with both telemonitoring and health coaching, where confounding factors in the diet are tackled. A 6-month randomised controlled trial will be conducted to compare the effectiveness of telenutrition v. telenutrition supported by weekly telemonitoring and monthly health coaching in a weight loss programme. Participants are obese and overweight adults of both sex groups, aged 20–50 years who will be randomised to join a control or an intervention group. A total of three visits will be scheduled for all participants: at baseline, after three months and after six months. This study aims to answer the question of whether participants following a weight loss programme supported by telemonitoring and health coaching will increase their weight loss and compliance to the diet in comparison with the control group. This will be the first trial to assess the impact of integrating telemonitoring and health coaching in weight loss programmes, including the evaluation of associated confounding factors such as general nutrition education, eating behaviour, sensory modalities and hunger, and stress. This trial will support dietary weight loss programmes, contribute to the emerging field of telenutrition and provide advice for clinical dietitians and health coaches to work together to help individuals lose and maintain weight.

The impact of computed tomography-defined sarcopenia on outcomes in head and neck cancer has been well described. Sarcopenic obesity (SO) (depleted muscle mass combined with obesity) may pose a more serious risk than either condition alone. We investigated SO and its impact on survival and critical weight loss (≥ 5 %) in patients with head and neck cancer who received curative radiotherapy (± other modalities). Retrospective analysis of computed tomography cross-sectional muscle at cervical (C3), thoracic (T2) and lumbar (L3) regions was conducted. Patients were grouped by BMI and sarcopenia status based on established thresholds. A total of 413 patients were included for analysis, the majority having oropharyngeal carcinoma (52 %), and 56 % received primary concurrent chemoradiotherapy. The majority of the cohort (65 %) was overweight or obese (BMI ≥ 25 kg/m2). Sarcopenia was found in 43 %, with 65 % having SO (n 116), equating to 28 % of the whole cohort. Critical weight loss was experienced by 58 % (n 238). A significantly higher proportion of patients with SO experienced critical weight loss (n 70 v. 19, P < 0·001) and were four times more likely to do so during treatment (OR 4·1; 95 % CI 1·5, 7·1; P = 0·002). SO was not found to impact on overall or cancer-specific survival; however, in patients with sarcopenia, those with SO had better overall survival (median 9·1 v. 7·0 years; 95 % CI 5·2, 16·8; P = 0·021). SO at the time of presentation in patients with head and neck cancer is predictive of critical weight loss during treatment, and muscle evaluation can be useful in identifying patients at nutritional risk regardless of BMI and obvious signs of wasting.

A procedure based on loss of weight after selective dissolution analysis (SDA) and washing with (NH4)2CO3 was developed for estimating the noncrystalline material content of soils derived from widely different parent materials. After extracting with 0.2 N ammonium-oxalate or boiling 0.5 N NaOH solutions, samples were washed with 1 N (NH4)2CO3 to remove excess dissolution agents and to prevent sample dispersion. The amount of noncrystalline material removed from the sample by the extracting solution was estimated by weighing the leached products dried to constant weight at 110°C. The results match closely with those obtained by chemical analyses of the dissolution product and assignment of the appropriate water. The proposed weight-loss method is less time-consuming than the chemical method, and no assumptions need be made concerning sample homogeneity or water content of the noncrystalline material.

Extractions of whole soil and dispersed clay fractions indicated that noncrystalline material determinations on the clay fractions underestimated the noncrystalline material content for whole soils from 0 to 34%. Acid ammonium oxalate was found to be a much more selective extractant for noncrystalline materials than NaOH.

This study aimed to investigate whether psychological distress, whole-grain consumption and tryptophan metabolism are associated with participants undergoing weight management intervention. Seventy-nine women and men (mean age 49·7 (sd 9·0) years; BMI 34·2(sd 2·5) kg/m2) participated in a 7-week weight-loss (WL) period and in a 24-week weight maintenance (WM) intervention period. Whole-grain consumption was measured using 4 d food diaries. Psychological distress was assessed with the General Health Questionnaire-12 (GHQ), and participants were divided into three GHQ groups based on the GHQ scores before WL. Tryptophan metabolites were determined from the participants’ fasting plasma using liquid chromatography-MS. GHQ scores were not associated with the whole-grain consumption. A positive association was observed between the whole-grain consumption and indole propionic acid (IPA) during the WM (P = 0·033). Serotonin levels were higher after the WL in the lowest GHQ tertile (P = 0·033), while the level at the end of the WM was higher compared with other timepoints in the highest GHQ tertile (P = 0·015 and P = 0·001). This difference between groups was not statistically significant. Furthermore, levels of several tryptophan metabolites changed within the groups during the study. Tryptophan metabolism changed during the study in the whole study group, independently from the level of psychological distress. The association between whole-grain consumption and IPA is possibly explained by the effects of dietary fibre on gut microbiota. This broadens the understanding of the pathways behind the health benefits associated with the intake of whole grains.

Obesity is a significant health issue in Aotearoa; effective and pragmatic strategies to facilitate weight loss are urgently required. Growing recognition of the circadian rhythm’s impact on metabolism has popularised diets like time-restricted eating (TRE)(1). The 16:8 TRE method involves limiting food intake to an 8-hour daily eating window and can lead to weight loss without other substantial changes to diet(2). Nonetheless, TRE requires accountability and tolerating hunger for short periods. Continuous glucose monitors (CGM) are small wearable biofeedback devices that measure interstitial glucose levels scanned via smartphones. By providing immediate feedback on the physiological effects of eating and fasting, CGM use may promote adherence to TRE(3). This pilot study aimed to 1) investigate how CGM affects adherence to TRE and 2) assess the feasibility of CGM use while undertaking TRE. This two-arm randomised controlled trial enrolled healthy adults from Dunedin, assigning them to TRE-only or TRE+CGM groups for 14 days. Successful adherence to TRE was defined a priori as maintaining an 8-hour eating window on 80% of days. CGM feasibility was defined a priori as scanning the glucose monitor thrice daily on 80% of days. Secondary outcomes included well-being, anthropometry, glucose levels, and overall TRE and CGM experiences via semi-structured interviews. Twenty-two participants were randomised into two groups: TRE-only (n = 11) and TRE+CGM (n = 11, with n = 2 excluded from analysis post-randomisation for medical reasons). Participants had a diverse range of ethnicities, the mean age was 32 (+/-14.9) years, and 55% were female. The TRE+CGM group adhered to the 8-hour eating window for an average of 10.0 days (range 2-14) compared with 8.6 days (range 2-14) in the TRE-only group. Both groups had similar mean eating window durations of 8.1 hours. Five (56%) participants in the TRE+CGM group achieved the a priori criteria for TRE adherence, compared to 3 (27%) in the TRE-only group. Participants in the TRE+CGM group performed an average of 8.2 (+/-5.6) daily scans, with n = 7 (78%) of participants meeting the a priori CGM feasibility criteria. Neither group reported consistent adverse psychological impacts in DASS-21 and WHO-5 scores. Interviews highlighted that CGM increased hunger tolerance during fasting as participants felt reassured by their normal glucose levels. CGM aided TRE accountability by acting as a biological tracker of food intake. Participants reported that TRE led to improved energy and self-efficacy, a more productive daily routine, and healthier food choices. Promisingly, 72% of participants would use CGM and undertake TRE in future. This study demonstrates that using CGM while undertaking TRE is feasible and can improve adherence by enhancing hunger tolerance and accountability. Overall, participants experienced increased awareness of eating habits and physiological mechanisms. Over the longer term, this simple and synergistic approach may be a helpful weight loss strategy.