Our data show that a reduction in sleep increases energy and fat intakes, which may explain the associations observed between sleep and obesity. If sustained, as observed, and not compensated by increased energy expenditure, the dietary intakes of individuals undergoing short sleep predispose to obesity. This trial is registered at clinicaltrials.gov as NCT00935402.

Low-FODMAP education is effective for long-term IBS management, enables a nutritionally adequate diet, and is broadly acceptable to patients.

Although males exhibit higher adropin levels that are reduced by obesity, aging and markers of insulin resistance are associated with low plasma adropin irrespective of sex.

Trial registration on http://www.clinicaltrials.gov. #NCT00935402.

No abstract

Dietary management is being hailed as an effective strategy for the management of irritable bowel syndrome. Specifically, a diet low in fermentable carbohydrates (FODMAPs) has demonstrated efficacy in approximately 70% of patients. As evidence in support of the low FODMAP diet continues to emerge, there is increasing debate regarding implementation of the diet particularly concerning who should educate patients and how to educate them. Registered dieticians have largely pioneered the evidence that supports the effectiveness of the low FODMAP diet in irritable bowel syndrome, and the diet is recognized as a dietician-led therapy. However, there is an increasing trend for nondietician-led implementation of the diet despite an absence of evidence on both the clinical or cost-effectiveness of such. Additionally, there is a growing requirement for dietetic services to increase capacity in response to increasing referrals, and consequently, there is a need to investigate innovative ways to educate patients whilst maintaining dieticianled intervention. Herein, we review the evidence for delivery of the low FODMAP diet and discuss potentially effective methods for service delivery.The low FODMAP diet is quickly becoming the cornerstone for effective dietary management in irritable bowel syndrome (IBS) with an expanding evidence base to support the clinical efficacy of the diet. It involves dietary restriction of high FODMAP foods for a period of 4-8 weeks followed by systematic reintroduction of individual FODMAPs to tolerance. The therapeutic nature of the low FODMAP diet is based on symptom improvement rather than addressing the underlying pathological cascade; therefore, it is a symptom management strategy and not a cure for IBS. It is a complex dietary strategy, and clinical effectiveness of the low FODMAP diet has been demonstrated using dietitian-led counselling; however, in clinical practice, other less comprehensive and unsubstantiated educational methods are increasingly implemented. Who should deliver the low FODMAP dietClinical guidelines recognize the importance of the low FODMAP diet in the management of IBS.

Excessive gestational weight gain (GWG) and postpartum weight retention (PPWR) may predispose women to the development of obesity. The objective of this systematic review was to evaluate the effectiveness of lifestyle interventions in overweight or obese pregnant and/or postpartum women for managing postpartum weight up to 2 years after giving birth. Eighteen randomised controlled trials were included (2559 participants) and divided into three categories according to the timing of the intervention: pregnancy only (n = 3), postpartum only (n = 12) and pregnancy and postpartum (n = 3). The intervention duration varied from 10 weeks to 10 months and included diet only (n = 5) or diet and physical activity (n = 13). Seven postpartum only interventions reported significant improvements in postpartum weight when compared to the control group. Most of these interventions were short and intensive, lasting 10–16 weeks. One pregnancy only and one pregnancy and postpartum intervention reported reduced PPWR at 6 months. Nine trials did not report an effect of the intervention on postpartum weight. However, of these, four reported associations between GWG and PPWR. This review suggests that successful postpartum weight management is achievable with intensive lifestyle interventions starting in the postpartum period; however, there is insufficient evidence to conclude whether interventions starting in pregnancy are effective. Larger trials utilising comparative methodologies in the pregnancy and postpartum periods are required to inform the development of targeted strategies preventing PPWR or reducing postpartum weight.

BackgroundMedium chain triglycerides (MCT) enhance thermogenesis and may reduce food intake relative to long chain triglycerides (LCT). The goal of this study was to establish the effects of MCT on appetite and food intake and determine whether differences were due to differences in hormone concentrations.MethodsTwo randomized, crossover studies were conducted in which overweight men consumed 20 g of MCT or corn oil (LCT) at breakfast. Blood samples were obtained over 3 h. In Study 1 (n=10), an ad lib lunch was served after 3 h. In Study 2 (n=7), a pre-load containing 10 g of test oil was given at 3 h and lunch was served 1 h later. Linear mixed model analyses were performed to determine the effects of MCT and LCT oil on change in hormones and metabolites from fasting, adjusting for body weight. Correlations were computed between differences in hormones just before the test meals and differences in intakes after the two oils for Study 1 only.ResultsFood intake at the lunch test meal after the MCT pre-load (Study 2) was (mean ± SEM) 532 ± 389 kcal vs. 804 ± 486 kcal after LCT (P < 0.05). MCT consumption resulted in a lower rise in triglycerides (P = 0.014) and glucose (P = 0.066) and a higher rise in peptide YY (P = 0.017) and leptin (P = 0.036) compared to LCT (combined data). Correlations between differences in hormone levels (GLP-1, PYY) and differences in food intake were in the opposite direction to expectations.ConclusionsMCT consumption reduced food intake acutely but this does not seem to be mediated by changes in GLP-1, PYY, and insulin.