Rationale: Obesity is a risk factor for type 2 diabetes (DM2), however not all obese people develop DM2. We explored differences in energy intake and expenditure between obese older adults with and without DM2. Methods: Baseline data from 2 lifestyle interventions with a total of 202 obese older adults were included in the analyses. Obesity was defined as BMI > 30.0, or >27.0 with waist circumference >88 (women) or >102 cm (men). DM2 was confirmed by use of diabetes medication. Subjects were between 55 and 85 years old and 45% was female. Energy intake (EI) was measured by 3-day food diary and physical activity level (PAL) by 3-day movement diary. Resting energy expenditure (REE) was measured using indirect calorimetry and total energy expenditure (TEE) was calculated as REE x PAL. Between group differences were analysed with independent samples T-tests. Results: The obese group with DM2 (n = 117) had more males (67.5% vs 37.6% p < 0.001) and similar BMI (33.3 vs 33.0 kg/m2) compared to the group without DM2 (n = 85). Analyses of males and females separately showed lower PAL in males with DM2 (vs without DM2; 1.37 vs 1.45, p = 0.015), without differences in EI (2055 vs 1953 kcal/d), REE (1970 vs 1929 kcal/d), and TEE (2699 vs 2830 kcal/d). In females with DM2, both PAL (1.38 vs 1.47, p = 0.014) and EI (1543 vs 1839 kcal/d, p = 0.008) were significantly lower, whereas REE (1592 vs 1598 kcal/d) and TEE (2220 vs 2318 kcal/d) did not differ significantly from obese females without DM2. Conclusion: In both males and females, obese older adults with type 2 diabetes showed similar resting and total energy expenditure but lower physical activity level compared to those without DM2. Females with DM2 showed lower energy intake. On average, subjects seem to have a negative energy balance, which is probably due to a combination of underreporting of intake and over-reporting of activity.
Prevention of non-communicable diseases through, among other factors, increasing vegetables and fruit (V&F) intake is a cost-effective strategy for risk reduction but requires behavioral change. Such changes in adolescents benefit from their active involvement. The Food Boost Challenge (FBC) was developed using a participatory action research approach to enhance healthy eating behaviors, namely V&F products among adolescents. The FBC is an innovation process, involving adolescents, (peer) researchers, and food system partners, like non-governmental and commercial organizations. In 2021–2022, 34 partners provided both cash and in-kind contributions to join the FBC community. Phase 1 involved 200 students identifying barriers and drivers for consumption of F&V products among 1000 pre-vocational adolescents, aged 12–20 years. In phase 2, student teams submitted innovative ideas, resulting in 25 concepts fitting into ≥1 of 4 routes: (I) innovative technology for a healthy diet, (II) new food products/concepts for adolescents, (III) hotspots improving the F&V product experience, and (IV) new routes to market. In phase 3, consortia of adolescents, students, and partners were formed to develop 10 selected concepts into prototypes, and phase 4 offered teams a national platform. Results show that the FBC resonates with all stakeholders, generating valuable insights to increase F&V intake. Prototypes in all four routes have been developed. Additionally, other regions in the Netherlands have adopted the FBC approach. Overall, the FBC is an approach that transforms ideas into actionable measures and shows potential to be adapted to promote various healthy eating behaviors among school students.
Optimizing protein intake is a novel strategy to prevent age associated loss of muscle mass and strength in older adults. Such a strategy is still missing for older adults from ethnic minority populations. Protein intake in these populations is expected to be different in comparison to the majority of the population due to several socio-cultural factors. Therefore, the present study examined the dietary protein intake and underlying behavioral and environmental factors affecting protein intake among older adults from ethnic minorities in the Netherlands. We analyzed frequency questionnaire (FFQ) data from the Healthy Life in an Urban Setting (HELIUS) cohort using ANCOVA to describe dietary protein intake in older adults from ethnic minorities in the Netherlands (N = 1415, aged >55 years, African Surinamese, South Asian Surinamese, Moroccan, and Turkish). Additionally, we performed focus groups among older adults from the same ethnic minority populations (N = 69) to discover behavioral and environmental factors affecting protein intake; 40-60% of the subjects did not reach minimal dietary protein recommendations needed to maintain muscle mass (1.0 g/kg bodyweight per day (BW/day)), except for Turkish men (where it was 91%). The major sources of protein originated from animal products and were ethnic specific. Participants in the focus groups showed little knowledge and awareness about protein and its role in aging. The amount of dietary protein and irregular eating patterns seemed to be the major concern in these populations. Optimizing protein intake in these groups requires a culturally sensitive approach, which accounts for specific protein product types and sociocultural factors.
