Reply to J Greenberg and D Ibsen et al
Brouwer-Brolsma, Elske M. ; Raben, Anne ; Feskens, Edith J.M. - \ 2019
American Journal of Clinical Nutrition 110 (2019)6. - ISSN 0002-9165 - p. 1512 - 1512.
Protein intake and the incidence of pre-diabetes and diabetes in 4 population-based studies: the PREVIEW project
Sluik, D. ; Brouwer, E.M. ; Berendsen, A.M. ; Mikkilä, V. ; Poppitt, Sally D. ; Silvestre, Marta P. ; Tremblay, A. ; Perusse, L. ; Bouchard, C. ; Raben, Anne ; Feskens, E.J.M. - \ 2019
American Journal of Clinical Nutrition 109 (2019)5. - ISSN 0002-9165 - p. 1310 - 1318.
Background:Data on the relationship between protein intake andthe risk of type 2 diabetes are conflicting.Objectives:We studied prospective associations between the intakeof total, plant-based, and animal protein and the risk of pre-diabetesand diabetes in 4 population-based studies included in the PREVIEWproject.Methods:Analyses were conducted with the use of data from 3 Eu-ropean cohorts and 1 Canadian cohort, including 78,851 participants.Protein intake was assessed through the use of harmonized datafrom food-frequency questionnaires or 3-d dietary records. Cohort-specific incidence ratios (IRs) were estimated for pre-diabetes anddiabetes, adjusting for general characteristics, lifestyle and dietaryfactors, disease history, and body mass index (BMI) and waistcircumference; results were pooled based on a random-effects meta-analysis.Results:Higher total protein intake (g·kg–1·d–1) was associatedwith lower incidences of pre-diabetes and diabetes (pooled IRs: 0.84;95% CI: 0.82, 0.87 and 0.49; 95% CI: 0.28, 0.83, respectively); plant-based protein intake was the main determinant (pooled IRs: 0.83;95% CI: 0.81, 0.86 and 0.53; 95% CI: 0.36, 0.76, respectively).Substituting 2 energy percentage (E%) protein at the expense ofcarbohydrates revealed increased risks of pre-diabetes and diabetes(pooled IRs: 1.04; 95% CI: 1.01, 1.07 and 1.09; 95% CI: 1.01, 1.18,respectively). Except for the associations between intakes of totalprotein and plant-based protein (g·kg–1·d–1) and diabetes, all otherassociations became nonsignificant after adjustment for BMI andwaist circumference.Conclusions:Higher protein intake (g·kg–1·d–1) was associatedwith a lower risk of pre-diabetes and diabetes. Associationswere substantially attenuated after adjustments for BMI and waistcircumference, which demonstrates a crucial role for adiposityand may account for previous conflicting findings. This study wasregistered at ISRCTN as ISRCTN31174892.
The Glycaemic Index-Food-Frequency Questionnaire: Development and Validation of a Food Frequency Questionnaire Designed to Estimate the Dietary Intake of Glycaemic Index and Glycaemic Load : An Effort by the PREVIEW Consortium
Brouwer, E.M. ; Berendsen, A.M. ; Sluik, D. ; Wiel, A.M. van de; Raben, Anne ; Vries, J.H.M. de; Brand-Miller, Jennie ; Feskens, E.J.M. - \ 2019
Nutrients 11 (2019)1. - ISSN 2072-6643
Dietary glycaemic index (GI) and glycaemic load (GL) are indices used to quantify the effect of carbohydrate quality and quantity on postprandial glycaemia. GI/GL-health associations are widely studied but data on the validity of integrated GI/GL measurements are scarce. We evaluated the performance of a food-frequency questionnaire (FFQ) specifically developed to assess GI/GL. In total, 263 Dutch men and 212 women (aged 55 ± 11 years) completed a 58-item GI-FFQ, an 183-item general-FFQ and a 2-day 24 h-recall and donated blood for glycated haemoglobin (HbA1c) determination. The level of agreement between these methods was evaluated by (1) cross-classification, (2) correlations and (3) Bland and Altman plots. The three dietary assessment methods provided comparable mean intake estimates for total carbohydrates (range: 214–237 g/day), mono/disaccharides (100–107 g/day), polysaccharides (114–132 g/day), as well as bread, breakfast cereals, potatoes, pasta, rice, fruit, dairy, cakes/cookies and sweets. Mean (±SD) GI estimates were also comparable between the GI-FFQ (54 ± 3), general-FFQ (53 ± 4) and 24 h-recalls (53 ± 5). Mean (±SD) GI-FFQ GL (117 ± 37) was slightly lower than the general-FFQ GL (126 ± 38) and 24 h-recalls GL (127 ± 37). Classification of GI in quartiles was identical for the GI-FFQ and general-FFQ for 43% of the population (r = 0.58) and with 24 h-recalls for 35% of the population (de-attenuated r = 0.64). For GL, this was 48% (r = 0.65) and 44% (de-attenuated r = 0.74). Correlations between GI and HbA1c were low (r = −0.09 for GI-FFQ, r = −0.04 for general-FFQ and r = 0.07 for 24 h-recalls). In conclusion, compared to a general-FFQ and 24 h-recalls, the GI-FFQ showed a moderate to good relative validity for carbohydrates, carbohydrate-rich foods and GI/GL. No metric predicted HbA1c.
PREVIEW study—Influence of a behavior modification intervention (PREMIT) in over 2300 people with pre-diabetes : Intention, self-efficacy and outcome expectancies during the early phase of a lifestyle intervention
Huttunen-Lenz, Maija ; Hansen, Sylvia ; Christensen, Pia ; Larsen, Thomas Meinert ; Sandø-Pedersen, Finn ; Drummen, Mathijs ; Adam, Tanja C. ; Macdonald, Ian A. ; Taylor, Moira A. ; Martinez, J.A. ; Navas-Carretero, Santiago ; Handjiev, Svetoslav ; Poppitt, Sally D. ; Silvestre, Marta P. ; Fogelholm, Mikael ; Pietiläinen, Kirsi H. ; Brand-Miller, Jennie ; Berendsen, Agnes A.M. ; Raben, Anne ; Schlicht, Wolfgang - \ 2018
Psychology Research and Behavior Management 11 (2018). - ISSN 1179-1578 - p. 383 - 394.
Cognition - Diabetes mellitus - Goals - Habits - Weight loss
Purpose: Onset of type 2 diabetes (T2D) is often gradual and preceded by impaired glucose homeostasis. Lifestyle interventions including weight loss and physical activity may reduce the risk of developing T2D, but adherence to a lifestyle change is challenging. As part of an international T2D prevention trial (PREVIEW), a behavior change intervention supported participants in achieving a healthier diet and physically active lifestyle. Here, our aim was to explore the influence of this behavioral program (PREMIT) on social-cognitive variables during an 8-week weight loss phase. Methods: PREVIEW consisted of an initial weight loss, Phase I, followed by a weight-maintenance, Phase II, for those achieving the 8-week weight loss target of ≥ 8% from initial bodyweight. Overweight and obese (BMI ≥25 kg/m2) individuals aged 25 to 70 years with confirmed pre-diabetes were enrolled. Uni-and multivariate statistical methods were deployed to explore differences in intentions, self-efficacy, and outcome expectancies between those who achieved the target weight loss (“achievers”) and those who did not (“non-achievers”). Results: At the beginning of Phase I, no significant differences in intentions, self-efficacy and outcome expectancies between “achievers” (1,857) and “non-achievers” (163) were found. “Non-achievers” tended to be younger, live with child/ren, and attended the PREMIT sessions less frequently. At the end of Phase I, “achievers” reported higher intentions (healthy eating χ2 (1)=2.57; P <0.008, exercising χ2 (1)=0.66; P <0.008), self-efficacy (F(2; 1970)=10.27, P <0.005), and were more positive about the expected outcomes (F(4; 1968)=11.22, P <0.005). Conclusion: Although statistically significant, effect sizes observed between the two groups were small. Behavior change, however, is multi-determined. Over a period of time, even small differences may make a cumulative effect. Being successful in behavior change requires that the “new” behavior is implemented time after time until it becomes a habit. Therefore, having even slightly higher self-efficacy, positive outcome expectancies and intentions may over time result in considerably improved chances to achieve long-term lifestyle changes.
Demographic and Social-Cognitive Factors Associated with Weight Loss in Overweight, Pre-diabetic Participants of the PREVIEW Study
Hansen, Sylvia ; Huttunen-Lenz, Maija ; Sluik, Diewertje ; Brand-Miller, Jennie ; Drummen, Mathijs ; Fogelholm, Mikael ; Handjieva-Darlenska, Teodora ; Macdonald, Ian ; Martinez, Alfredo J. ; Larsen, Thomas Meinert ; Poppitt, Sally ; Raben, Anne ; Schlicht, Wolfgang - \ 2018
International Journal of Behavioral Medicine 25 (2018)6. - ISSN 1070-5503 - p. 682 - 692.
Behavioral determination - Lifestyle intervention - Social-cognitive factors - Weight loss
Purpose: Weight loss has been demonstrated to be a successful strategy in diabetes prevention. Although weight loss is greatly influenced by dietary behaviors, social-cognitive factors play an important role in behavioral determination. This study aimed to identify demographic and social-cognitive factors (intention, self-efficacy, outcome expectancies, social support, and motivation with regard to dietary behavior and goal adjustment) associated with weight loss in overweight and obese participants from the PREVIEW study who had pre-diabetes. Method: Prospective correlational data from 1973 adult participants were analyzed. The participants completed psychological questionnaires that assessed social-cognitive variables with regard to dietary behavior. Stepwise multiple regression analyses were performed to identify baseline demographic and social-cognitive factors associated with weight loss. Results: Overall, being male, having a higher baseline BMI, having a higher income, perceiving fewer disadvantages of a healthy diet (outcome expectancies), experiencing less discouragement for healthy eating by family and friends (social support), and lower education were independently linked to greater weight loss. When evaluating females and males separately, education was no longer associated with weight loss. Conclusion: The results indicate that a supportive environment in which family members and friends avoid discouraging healthy eating, with the application of a strategy that uses specific behavior change techniques to emphasize the benefits of outcomes, i.e., the benefits of a healthy diet, may support weight loss efforts. Weight loss programs should therefore always address the social environment of persons who try to lose body weight because family members and friends can be important supporters in reaching a weight loss goal.
Objectively measured physical activity and sedentary time are associated with cardiometabolic risk factors in adults with prediabetes : The PREVIEW study
Swindell, Nils ; Mackintosh, Kelly ; Mcnarry, Melitta ; Stephens, Jeffrey W. ; Sluik, Diewertje ; Fogelholm, Mikael ; Drummen, Mathijs ; Macdonald, Ian ; Martinez, J.A. ; Handjieva-Darlenska, Teodora ; Poppitt, Sally D. ; Brand-Miller, Jennie ; Larsen, Thomas M. ; Raben, Anne ; Stratton, Gareth - \ 2018
Diabetes Care 41 (2018)3. - ISSN 0149-5992 - p. 562 - 569.
OBJECTIVE The aim of the present cross-sectional study was to examine the association among physical activity (PA), sedentary time (ST), and cardiometabolic risk in adults with prediabetes. RESEARCH DESIGN AND METHODS Participants (n = 2,326; 25-70 years old, 67% female) from eight countries, with a BMI >25 kg · m22 and impaired fasting glucose (5.6-6.9 mmol · L21) or impaired glucose tolerance (7.8-11.0 mmol · L21 at 2 h), participated. Seven-day accelerometry objectively assessed PA levels and ST. RESULTS Multiple linear regression revealed that moderate-To-vigorous PA (MVPA) was negatively associated withHOMAof insulin resistance (HOMA-IR) (standardizedb =20.078 [95% CI20.128,20.027]), waist circumference (WC) (b =20.177 [20.122,20.134]), fasting insulin (b = 20.115 [20.158, 20.072]), 2-h glucose (b = 20.069 [20.112, 20.025]), triglycerides (b = 20.091 [20.138, 20.044]), and CRP (b = 20.086 [20.127, 20.045]). ST was positively associated with HOMA-IR (b = 0.175 [0.114, 0.236]), WC (b = 0.215 [0.026, 0.131]), fasting insulin (b = 0.155 [0.092, 0.219]), triglycerides (b = 0.106 [0.052, 0.16]), CRP (b = 0.106 [0.39, 0.172]), systolic blood pressure (BP) (b = 0.078 [0.026, 0.131]), and diastolic BP (b = 0.106 [0.39, 20.172]). Associations reported between total PA (counts · min21), and all risk factors were comparable or stronger than for MVPA: HOMA-IR (b = 20.151 [20.194, 20.107]), WC (b = 20.179 [20.224, 20.134]), fasting insulin (b = 20.139 [20.183, 20.096]), 2-h glucose (b = 20.088 [20.131, 20.045]), triglycerides (b = 20.117 [20.162, 20.071]), and CRP (b = 20.104 [20.146, 20.062]). CONCLUSIONS In adults with prediabetes, objectively measured PA and ST were associated with cardiometabolic risk markers. Total PA was at least as strongly associated with cardiometabolic risk markers as MVPA, which may imply that the accumulation of total PA over the day is as important as achieving the intensity of MVPA.
Weight loss decreases self-reported appetite and alters food preferences in overweight and obese adults : Observational data from the DiOGenes study
Andriessen, Charlotte ; Christensen, Pia ; Vestergaard Nielsen, Lone ; Ritz, Christian ; Astrup, Arne ; Meinert Larsen, Thomas ; Martinez, J.A. ; Saris, Wim H.M. ; Baak, Marleen A. van; Papadaki, Angeliki ; Kunesova, Marie ; Jebb, Susan ; Blundell, John ; Lawton, Clare ; Raben, Anne - \ 2018
Appetite 125 (2018). - ISSN 0195-6663 - p. 314 - 322.
Body weight maintenance - Hunger - LCD - Leeds food choice questionnaire - Visual analogue scale - Weight loss
People with obesity often struggle to maintain their weight loss after a weight loss period. Furthermore, the effect of weight loss on appetite and food preferences remains unclear. Hence this study investigated the effect of weight loss on subjective appetite and food preferences in healthy, overweight and obese volunteers. A subgroup of adult participants (n = 123) from the Diet Obesity and Genes (DiOGenes) study (subgroup A) was recruited from across six European countries. Participants lost ≥8% of initial body weight during an 8-week low calorie diet (LCD). Subjective appetite and food preferences were measured before and after the LCD, in response to a standardized meal test, using visual analogue rating scales (VAS) and the Leeds Food Choice Questionnaire (FCQ). After the LCD, participants reported increased fullness (p < 0.05), decreased desire to eat (p < 0.05) and decreased prospective consumption (p < 0.05) after consuming the test meal. An interaction effect (visit x time) was found for hunger ratings (p < 0.05). Area under the curve (AUC) for hunger, desire to eat and prospective consumption was decreased by 18.1%, 20.2% and 21.1% respectively whereas AUC for fullness increased by 13.9%. Preference for low-energy products measured by the Food Preference Checklist (FPC) decreased by 1.9% before the test meal and by 13.5% after the test meal (p < 0.05). High-carbohydrate and high-fat preference decreased by 11.4% and 16.2% before the test meal and by 17.4% and 22.7% after the meal (p < 0.05). No other effects were observed. These results suggest that LCD induced weight loss decreases the appetite perceptions of overweight volunteers whilst decreasing their preference for high-fat-, high-carbohydrate-, and low-energy products.
Milk and dairy products: good or bad for human health? An assessment of the totality of scientific evidence
Thorning, Tanja Kongerslev ; Raben, Anne ; Tholstrup, Tine ; Soedamah-muthu, Sabita S. ; Givens, Ian ; Astrup, Arne - \ 2016
Food and Nutrition Research 60 (2016)1. - ISSN 1654-6628
Background: There is scepticism about health effects of dairy products in the public, which is reflected in an increasing intake of plant-based drinks, for example, from soy, rice, almond, or oat.
Objective: This review aimed to assess the scientific evidence mainly from meta-analyses of observational studies and randomised controlled trials, on dairy intake and risk of obesity, type 2 diabetes, cardiovascular disease, osteoporosis, cancer, and all-cause mortality.
Results: The most recent evidence suggested that intake of milk and dairy productswas associatedwith reduced risk of childhood obesity. In adults, intake of dairy products was shown to improve body composition and facilitate
weight loss during energy restriction. In addition, intake of milk and dairy productswas associatedwith a neutral or reduced risk of type 2 diabetes and a reduced risk of cardiovascular disease, particularly stroke. Furthermore, the
evidence suggested a beneficial effect of milk and dairy intake on bonemineral density but no association with risk of bone fracture. Among cancers, milk and dairy intake was inversely associated with colorectal cancer, bladder
cancer, gastric cancer, and breast cancer, and not associated with risk of pancreatic cancer, ovarian cancer, or lung cancer,while the evidence for prostate cancer riskwas inconsistent.Finally, consumption of milkand dairy products
was not associated with all-cause mortality. Calcium-fortified plant-based drinks have been included as an alternative to dairy products in the nutrition recommendations in several countries. However, nutritionally, cow’s
milk and plant-based drinks are completely different foods, and an evidence-based conclusion on the health value of the plant-based drinks requires more studies in humans.
Conclusion: The totality of available scientific evidence supports that intake of milk and dairy products contribute to meet nutrient recommendations, and may protect against the most prevalent chronic diseases, whereas very few adverse effects have been reported.
Contributors to dietary glycaemic index and glycaemic load in the Netherlands: the role of beer
Sluik, D. ; Atkinson, Fiona S. ; Brand-Miller, J. ; Fogelholm, M. ; Raben, A. ; Feskens, E.J.M. - \ 2016
The British journal of nutrition 115 (2016)7. - ISSN 0007-1145 - p. 1218 - 1225.
Diets high in glycaemic index (GI) and glycaemic load (GL) have been associated with a higher diabetes risk. Beer explained a large proportion of variation in GI in a Finnish and an American study. However, few beers have been tested according to International Organization for Standardization (ISO) methodology. We tested the GI of beer and estimated its contribution to dietary GI and GL in the Netherlands. GI testing of pilsner beer (Pilsner Urquell) was conducted at The University of Sydney according to ISO international standards with glucose as the reference food. Subsequently, GI and GL values were assigned to 2556 food items in the 2011 Dutch food composition table using a six-step methodology and consulting four databases. This table was linked to dietary data from 2106 adults in the Dutch National Food Consumption Survey 2007–2010. Stepwise linear regression identified contribution to inter-individual variation in dietary GI and GL. The GI of pilsner beer was 89 (sd 5). Beer consumption contributed to 9·6 and 5·3 % inter-individual variation in GI and GL, respectively. Other foods that contributed to the inter-individual variation in GI and GL included potatoes, bread, soft drinks, sugar, candy, wine, coffee and tea. The results were more pronounced in men than in women. In conclusion, beer is a high-GI food. Despite its relatively low carbohydrate content (approximately 4–5 g/100 ml), it still made a contribution to dietary GL, especially in men. Next to potatoes, bread, sugar and sugar-sweetened beverages, beer captured a considerable proportion of between-person variability in GI and GL in the Dutch diet.
|The PREVIEW-Population studies: design and methods
Feskens, E.J.M. ; Sluik, D. ; Fogelholm, M. ; Brand-Miller, J. ; Poppit, S. ; Tremblay, A. ; Raben, A. - \ 2013
Annals of Nutrition & Metabolism 63 (2013)Suppl.1. - ISSN 0250-6807 - p. 97 - 98.
The overall objective of PREVIEW population studies is to substantiate the findings in the intervention study with data from five longitudinal population studies from Europe, New Zealand and Canada, covering the entire lifespan. It will be evaluated whether protein intake, glycaemic index (GI), and physical activity, are predictive of diabetes and its cardiovascular consequences. This will add insight into the natural history of diabetes, by considering specific dietary and exercise factors. The following epidemiological studies will be analysed: 1. The Netherlands: LifeLines (2006-ongoing), a three-generation population-based study in 165,000 people 4-90+y and NQplus (2011-ongoing), a survey in n=1,750 people 20-70y, repeated 3 times. 2. Finland: Cardiovascular Risk in Young Finns Study (1980-2012), a survey in n=3,596 people 3-18y at baseline, repeated 8 times. 3. New Zealand: NZ Adult Nutrition Survey (2008/09), a cross-sectional survey in n=4,721 people> 15y. 4. Canada: Quebec Family Study (1978-2002), a 3-phase longitudinal study from ~500 families including ~200 families with one obese member. A common database of these five population studies will be generated. Main exposure variables will be dietary components and physical activity. The outcome will be diabetes prevalence or incidence, and blood glucose parameters. Data-analysis will be conducted with meta-analytical techniques, using a random-effects model to consider heterogeneity among cohorts. Population attributable risks will give an estimate on how much of diabetes risk could theoretically be prevented by modifying these factors. Additionally, given that GI, one of the key exposures, is not routinely available in all food tables, a dedicated questionnaire focusing on assessing GI will be developed. It will be applied to the NQPlus cohort to gain insight into the quality of the GI results. The research described here receives funding from the EU Seventh Framework Programme (FP7/2007-2013) under grant agreement no. 312057.
Is beer consumption related to measures of abdominal and general obesity? A systematic review and meta-analysis
Bendsen, N.T. ; Christensen, R. ; Bartels, E.M. ; Kok, F.J. ; Sierksma, A. ; Raben, A. ; Astrup, A. - \ 2013
Nutrition Reviews 71 (2013)2. - ISSN 0029-6643 - p. 67 - 87.
to-hip ratio - body-mass index - density-lipoprotein cholesterol - moderate alcohol-consumption - randomized controlled-trial - middle-aged men - blood-pressure - weight-gain - waist circumference - risk-factor
A systematic review was conducted to assess the evidence linking beer consumption to abdominal and general obesity. Following a systematic search strategy, 35 eligible observational studies and 12 experimental studies were identified. Regarding abdominal obesity, most observational data pointed towards a positive association or no association between beer intake and waist circumference or waist-to-hip ratio in men, whereas results for women were inconsistent. Data from a subset of studies indicated that beer intake¿>¿500¿mL/day may be positively associated with abdominal obesity. Regarding general obesity, most observational studies pointed towards an inverse association or no association between beer intake and body weight in women and a positive association or no association in men. Data from six experimental studies in men, in which alcoholic beer was compared with low-alcoholic beer, suggested that consumption of alcoholic beer (for 21–126 days) results in weight gain (0.73¿kg; P¿
|Identification of ryegrass (Lolium spp.) using allele frequencies of the PGI-2 and ACP-1 isozyme systems
Booy, G. ; Dreven, F. van; Steverink-Raben, A. - \ 1995
Plant varieties and seeds : an international journal edited by National Institute of Agricultural Botany 6 (1995). - ISSN 0952-3863 - p. 179 - 196.
The effect of raw potato starch on energy expenditure and substrate oxidation.
Tagliabue, A. ; Raben, A. ; Heijnen, M.L. ; Deurenberg, P. ; Pasquali, E. ; Astrup, A. - \ 1995
American Journal of Clinical Nutrition 61 (1995). - ISSN 0002-9165 - p. 1070 - 1075.
|Metabolic effects of resistant starch.
Tagliabue, A. ; Raben, A. ; Heijnen, M.L. ; Deurenberg, P. - \ 1993
International Journal of Obesity 17 (1993)suppl. 2. - ISSN 0307-0565 - p. 52 - 52.
|The 'Exman' project - Experimental manipulations of forest ecosystems.
Rasmussen, L. ; Beier, C. ; Visser, P. de; Breemen, N. van; Kreutzer, K. ; Schierl, R. ; Bredemeier, M. ; Raben, G. ; Farrell, E.P. - \ 1992
In: Responses of forest ecosystems to environmental changes, A. Teller et al. (eds.). Proc. 1st Eur. Symp. Terrestrial ecosystems: forest and woodland. Florence, Italy 1991. Elsevier UK - p. 325 - 334.