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Purpose: Manipulation of meal macronutrient may be a useful way to modulate meal-induced thermogenesis (MIT) to induce increases in energy expenditure. The objective of this study was to examine in adolescents with obesity and of healthy weight and the effect of a high protein and high carbohydrate meal on MIT. Method(s): An acute cross-over study with adolescents aged 11-19 years was undertaken. Participants consumed in random order, a high 79% carbohydrate (HCHO), and a high 55% protein (HP) meal (adjusted to 25% of energy requirements). MIT and subjective appetite were assessed for 4 h postprandial and an ad libitum lunch served. Data calculated as total AUC and expressed as mean +/- SEM. Result(s): Thirteen adolescents with obesity (mean BMI z score 2.3 +/- 0.1) and 13 healthy weight (BMI z score 0.0 +/- 0.2) participated. Mean MIT (% of energy intake) was greater after the HP (8.19 +/- 0.709%) compared with the HCHO meal (4.36 +/- 0.480%) (p < 0.001). The HP compared with the HCHO meal promoted greater fullness (12,994 +/- 1208 vs 11,186 +/- 1220 mm/4 h) (p = 0.016) and decreased hunger (8868 +/- 1315 vs 10984 mm +/- 1438 mm/4 h) (p = 0.007). These effects observed were independent of body weight. Conclusion(s): High protein meals can increase MIT and fullness and reduce hunger compared with high carbohydrate meals in adolescents with obesity. Future research is warranted to determine if MIT can be targeted through manipulation of dietary choices to support weight management strategies. Trial registration: This study is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR). Trial ID: ACTRN12612001066875.Copyright © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

Purpose: Manipulation of meal macronutrient may be a useful way to modulate meal-induced thermogenesis (MIT) to induce increases in energy expenditure. The objective of this study was to examine in adolescents with obesity and of healthy weight and the effect of a high protein and high carbohydrate meal on MIT. Method(s): An acute cross-over study with adolescents aged 11-19 years was undertaken. Participants consumed in random order, a high 79% carbohydrate (HCHO), and a high 55% protein (HP) meal (adjusted to 25% of energy requirements). MIT and subjective appetite were assessed for 4 h postprandial and an ad libitum lunch served. Data calculated as total AUC and expressed as mean +/- SEM. Result(s): Thirteen adolescents with obesity (mean BMI z score 2.3 +/- 0.1) and 13 healthy weight (BMI z score 0.0 +/- 0.2) participated. Mean MIT (% of energy intake) was greater after the HP (8.19 +/- 0.709%) compared with the HCHO meal (4.36 +/- 0.480%) (p < 0.001). The HP compared with the HCHO meal promoted greater fullness (12,994 +/- 1208 vs 11,186 +/- 1220 mm/4 h) (p = 0.016) and decreased hunger (8868 +/- 1315 vs 10984 mm +/- 1438 mm/4 h) (p = 0.007). These effects observed were independent of body weight. Conclusion(s): High protein meals can increase MIT and fullness and reduce hunger compared with high carbohydrate meals in adolescents with obesity. Future research is warranted to determine if MIT can be targeted through manipulation of dietary choices to support weight management strategies. Trial registration: This study is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR). Trial ID: ACTRN12612001066875.Copyright © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

Purpose: This study aimed to evaluate the long-term survival of all patients who participated in a pilot randomised trial of an early nutritional intervention for adults with upper gastrointestinal cancer. It also sought to identify factors that predicted patient mortality. Method(s): All participants (n = 21) who were randomised into the original study were followed for a maximum of 5 years and 2 months (final follow-up April 2016). The primary outcome measure was time from date of recruitment until date of death, ascertained by the Victorian Cancer Registry and/or Monash Health Scanned Medical Records. Secondary analyses were conducted to identify factors that adversely affected survival. Result(s): At the end of the follow-up period, three patients were alive in the nutrition intervention group whilst only two patients were living from the standard care group. Visual evaluation of the Kaplan-Meier survival curves demonstrated a possible survival benefit from being exposed to the intervention between 6 months and 1.4 years post-recruitment, though this benefit dissipated soon after. The intervention was not associated with increased survival in univariate analyses, but was after adjustment for other factors found to adversely impact on survival (adjusted hazard ratio 0.12 (95% CI 0.02-0.72) p = 0.02). These factors were being a smoker (14.2 (1.43 to 140.67), p = 0.02); low baseline physical functioning (1.11 (1.01 to 1.21), p = 0.03); high baseline fatigue (1.09 (1.02-1.16), p = 0.007); and high baseline dyspnoea (1.08 (1.02-1.13), p = 0.003). Conclusion(s): Early and intensive nutrition intervention may increase the survival of people with upper gastrointestinal cancer.Copyright © 2017, Springer-Verlag GmbH Germany.

Purpose: This study aimed to evaluate the long-term survival of all patients who participated in a pilot randomised trial of an early nutritional intervention for adults with upper gastrointestinal cancer. It also sought to identify factors that predicted patient mortality. Method(s): All participants (n = 21) who were randomised into the original study were followed for a maximum of 5 years and 2 months (final follow-up April 2016). The primary outcome measure was time from date of recruitment until date of death, ascertained by the Victorian Cancer Registry and/or Monash Health Scanned Medical Records. Secondary analyses were conducted to identify factors that adversely affected survival. Result(s): At the end of the follow-up period, three patients were alive in the nutrition intervention group whilst only two patients were living from the standard care group. Visual evaluation of the Kaplan-Meier survival curves demonstrated a possible survival benefit from being exposed to the intervention between 6 months and 1.4 years post-recruitment, though this benefit dissipated soon after. The intervention was not associated with increased survival in univariate analyses, but was after adjustment for other factors found to adversely impact on survival (adjusted hazard ratio 0.12 (95% CI 0.02-0.72) p = 0.02). These factors were being a smoker (14.2 (1.43 to 140.67), p = 0.02); low baseline physical functioning (1.11 (1.01 to 1.21), p = 0.03); high baseline fatigue (1.09 (1.02-1.16), p = 0.007); and high baseline dyspnoea (1.08 (1.02-1.13), p = 0.003). Conclusion(s): Early and intensive nutrition intervention may increase the survival of people with upper gastrointestinal cancer.Copyright © 2017, Springer-Verlag GmbH Germany.

Purpose: This study aimed to test whether a very early nutrition intervention delivered over the telephone was feasible and could improve outcomes amongst patients with upper gastrointestinal cancer. Methods: Participants with a histologically proven new diagnosis of primary oesophageal or stomach cancer and who were to undergo surgery and/or chemotherapy were randomised to receive either standard nutrition care (SC) or early and intensive nutrition intervention (NI) over the telephone/face-to-face. Participants were followed for 6 months. The primary outcome was quality of life (QoL), assessed using the European Organization for Research and Treatment of Cancer Global Quality of Life questionnaire C30 (EORTC QLQ-C30) and the European Quality of Life Instrument (EQ-5D) tool; secondary outcomes were nutritional status and survival. Results: Twenty-one participants were recruited (11 SC and 10 NI). At baseline, the prevalence of malnutrition was 90 %. Compared with SC, the NI group had a significantly higher EORTC global QoL score at the first mid-study follow-up (coefficient (95 % CI) 21.0 (12.1, 29.9) adjusted for baseline, p < 0.001) and at 26 weeks (28.4 (21.3, 35.4) adjusted for baseline, p < 0.001). Nutritional risk score was lower (p < 0.001), and loss of body weight attenuated (p < 0.001) in the NI group compared with SC. Six deaths occurred during the study, five in the SC group and one in the NI group (p = 0.06). The mean time spent with a dietitian per contact was significantly less for the NI group compared with SC (16(3) vs 40(6) min per dietetic contact, p < 0.001). Conclusions: This pilot study has shown the potential of a novel telephone-based early and intensive dietetic model of care for newly diagnosed upper gastrointestinal cancer patients.Copyright © 2014, Springer-Verlag Berlin Heidelberg.

Purpose: This study aimed to test whether a very early nutrition intervention delivered over the telephone was feasible and could improve outcomes amongst patients with upper gastrointestinal cancer. Methods: Participants with a histologically proven new diagnosis of primary oesophageal or stomach cancer and who were to undergo surgery and/or chemotherapy were randomised to receive either standard nutrition care (SC) or early and intensive nutrition intervention (NI) over the telephone/face-to-face. Participants were followed for 6 months. The primary outcome was quality of life (QoL), assessed using the European Organization for Research and Treatment of Cancer Global Quality of Life questionnaire C30 (EORTC QLQ-C30) and the European Quality of Life Instrument (EQ-5D) tool; secondary outcomes were nutritional status and survival. Results: Twenty-one participants were recruited (11 SC and 10 NI). At baseline, the prevalence of malnutrition was 90 %. Compared with SC, the NI group had a significantly higher EORTC global QoL score at the first mid-study follow-up (coefficient (95 % CI) 21.0 (12.1, 29.9) adjusted for baseline, p < 0.001) and at 26 weeks (28.4 (21.3, 35.4) adjusted for baseline, p < 0.001). Nutritional risk score was lower (p < 0.001), and loss of body weight attenuated (p < 0.001) in the NI group compared with SC. Six deaths occurred during the study, five in the SC group and one in the NI group (p = 0.06). The mean time spent with a dietitian per contact was significantly less for the NI group compared with SC (16(3) vs 40(6) min per dietetic contact, p < 0.001). Conclusions: This pilot study has shown the potential of a novel telephone-based early and intensive dietetic model of care for newly diagnosed upper gastrointestinal cancer patients.Copyright © 2014, Springer-Verlag Berlin Heidelberg.