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Abstract Background People overeat because their hunger directs them to consume more calories than they require. The purpose of this study was to analyze the changes in experience and perception of hunger before and after participants shifted from their previous usual diet to a high nutrient density diet. Methods This was a descriptive study conducted with 768 participants primarily living in the United States who had changed their dietary habits from a low micronutrient to a high micronutrient diet. Participants completed a survey rating various dimensions of hunger (physical symptoms, emotional symptoms, and location) when on their previous usual diet versus the high micronutrient density diet. Statistical analysis was conducted using non-parametric tests. Results Highly significant differences were found between the two diets in relation to all physical and emotional symptoms as well as the location of hunger. Hunger was not an unpleasant experience while on the high nutrient density diet, was well tolerated and occurred with less frequency even when meals were skipped. Nearly 80% of respondents reported that their experience of hunger had changed since starting the high nutrient density diet, with 51% reporting a dramatic or complete change in their experience of hunger. Conclusions A high micronutrient density diet mitigates the unpleasant aspects of the experience of hunger even though it is lower in calories. Hunger is one of the major impediments to successful weight loss. Our findings suggest that it is not simply the caloric content, but more importantly, the micronutrient density of a diet that influences the experience of hunger. It appears that a high nutrient density diet, after an initial phase of adjustment during which a person experiences "toxic hunger" due to withdrawal from pro-inflammatory foods, can result in a sustainable eating pattern that leads to weight loss and improved health. A high nutrient density diet provides benefits for long-term health as well as weight loss. Because our findings have important implications in the global effort to control rates of obesity and related chronic diseases, further studies are needed to confirm these preliminary results.

Background: People overeat because their hunger directs them to consume more calories than they require. The purpose of this study was to analyze the changes in experience and perception of hunger before and after participants shifted from their previous usual diet to a high nutrient density diet. Methods: This was a descriptive study conducted with 768 participants primarily living in the United States who had changed their dietary habits from a low micronutrient to a high micronutrient diet. Participants completed a survey rating various dimensions of hunger (physical symptoms, emotional symptoms, and location) when on their previous usual diet versus the high micronutrient density diet. Statistical analysis was conducted using non-parametric tests. Results: Highly significant differences were found between the two diets in relation to all physical and emotional symptoms as well as the location of hunger. Hunger was not an unpleasant experience while on the high nutrient density diet, was well tolerated and occurred with less frequency even when meals were skipped. Nearly 80% of respondents reported that their experience of hunger had changed since starting the high nutrient density diet, with 51 % reporting a dramatic or complete change in their experience of hunger. Conclusions: A high micronutrient density diet mitigates the unpleasant experience of hunger even though it is low in calories. Hunger is one of the major impediments to successful weight loss. Our findings suggest that it is not simply the calorie content, but more importantly, the micronutrient density of a diet that influences the experience of hunger. It appears that a high nutrient density diet, after an initial phase of adjustment during which a person experiences "toxic hunger" due to withdrawal from pro-inflammatory foods, can result in a sustainable eating pattern that leads to weight loss and improved health. A high nutrient density diet provides benefits for long-term health as well as weight loss. Because our findings have important implications in the global effort to control rates of obesity and related chronic diseases, further studies are needed to confirm these preliminary results. [ABSTRACT FROM AUTHOR]

Background • A high nutrient density (HND) vegetable-based diet offers a dietary model extremely low in saturated fat as well as refined carbohydrates and emphasizes a liberal intake of fresh fruits, vegetables, beans, and nuts. We conducted a retrospective chart review of patients who came to a family practice office seeking nutritional counseling for weight loss. All of these patients were prescribed an HND diet in an extended counseling session with a family physician. Methods • A convenience sample (N=56) of all patients seeking dietary counseling for weight loss from a family practice physician in a 3-year period was included in the chart review. No personal identifying data were recorded. The initial counseling sessions averaged 1 hour in length. Patients were provided with a sample HND daily meal plan and recipes and with verbal and written information about the rationale for the diet. Data recorded from patients' charts at 6-month intervals for up to 2 years of follow-up (when available) included weight, blood pressure, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and cholesterol:HDL ratio. Non-parametric statistical testing using the Friedman rank order (exact) test for κ-related samples was conducted. A follow-up survey on adherence and medication use was completed by 38 patients. Results • Of the 33 patients who returned for follow-up after 1 year, the mean weight loss was 31 lbs (P=.000). Of the 19 patients who returned after 2 years, the mean weight loss was 53 lbs (P=.000), mean cholesterol fell by 13 points, LDL by 15 points, triglycerides by 17 points, and cardiac risk ratio dropped from 4.5 to 3.8. Changes in systolic and diastolic blood pressure were highly significant at all follow-up time intervals (P≤.001). There was a significant correlation between adherence and degree of weight loss (P=.011). Conclusions • Weight loss was sustained in patients who returned for follow-up and was more substantial in those who reported good adherence to the recommendations. However, many patients were lost to follow-up. Favorable changes in lipid profile and blood pressure were noted. An HND diet has the potential to provide sustainable, significant, long-term weight loss and may provide substantial lowering of cardiac risk in patients who are motivated and provided with extended one-on-one counseling and follow-up visits. Development of tools to aid in patient retention is an area for possible further study. Clinical trials with long-term follow-up are needed to further test the therapeutic potential and to examine adherence and follow-up issues related to this dietary approach. An HND diet as demonstrated with this group may be the most health-favorable and effective way to lose weight for appropriately motivated patients. [ABSTRACT FROM AUTHOR]

Three key philosophical issues raised by the science of unitary human beings are analyzed: space and time; causality; and process. Clarification of Rogers' positions in relation to these issues is provided, and areas in need of further development are identified. These issues are of vital significance in the world view of the science of unitary human beings. Scholarly development of the substantive metaphysical implications of the model is invited. [ABSTRACT FROM PUBLISHER]

This article analyzes the philosophical roots of four contemporary nursing theories, Rogers' science of unitary human beings, Newman's theory of expanding consciousness, Watson's theory of caring, and Parse's theory of man-living-health. It is shown that these theories share many common philosophical views, but also maintain some significant differences. With the purpose of contributing to the development of a single metaparadigm for nursing, the following commonly shared themes are identified as forming an appropriate philosophical foundation for the discipline: process, evolution of consciousness, self-transcendence, open systems, harmony, relativity of space-time, pattern, and holism. Views of causality show some divergence between Watson and the other three theorists. Also of particular interest is the finding that Eastern philoso phy has provided an important influence, both direct and indirect, on nursing theory. It is recommended that further philosophical exploration of Indian and Chinese world views be conducted and that the above metaparadigmatic themes be more fully developed in future nursing theory development. [ABSTRACT FROM PUBLISHER]

Describes medically-supervised cases of water-only fasting followed by vegetarian diets. Reduction in pain and inflammatory markers in patients with autoimmune diseases; Indication of the therapeutic potential of the approach; Additional studies that may explain how the treatment induces remission and may clarify the understanding of the pathophysiology of rheumatoid arthritis and other autoimmune illnesses.

A correction to the article "Effect of a high nutrient density diet on long-term weight loss: a retrospective chart review," by B. Sarter and colleagues that was published in the 2008 issue is presented, which discusses the data sets showed on the said article.