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BackgroundThe food industry is responding to a rising demand for plant-based foods by developing and marketing an ever-wider range of vegan and vegetarian products under the banner of "plant-based." Understanding the nutritional properties of these products is critical.ObjectivesTo assess the number, meal type, and nutritional content of products marketed as plant-based (MaPB) from the perspective of the consumer across multiple sectors in the United States, United Kingdom, and Canada.MethodsAn online search for products MaPB was performed across supermarkets, restaurants, food manufacturers, and plant-based meal delivery companies in the United Kingdom, the United States, and Canada using the terms: "vegan," "vegetarian," and "plant-based." Online nutrition data were extracted, and whole meals that comprised >50% of ingredients such as fruits, vegetables, legumes, nuts, and seeds were identified. The nutritional content of dishes MaPB in restaurants was also directly compared with meat-containing dishes.ResultsFurther, 3488 unique products were identified, of which 962 were whole meals and 1137 were a replacement for the main protein component in a meal, including 771 meat alternatives. Across all sectors, 45% of whole meals had >15-g protein, 70% had 10-g fiber per meal, and 86% had

Aim: To identify factors influencing dietary behaviour in shift workers with type 2 diabetes (T2D) working in UK healthcare settings. Methods: Semi‐structured qualitative interviews based on the theoretical domains framework (TDF) were conducted with a convenience sample (n = 15) of shift workers (32–59 years) diagnosed with T2D who worked night shifts as part of a mixed shift schedule. The TDF was applied to analyse transcripts using a combined deductive framework and inductive thematic analysis approach. Identified influences were mapped to the behaviour change technique taxonomy to identify potential strategies to change dietary behaviour in this context. Results: Key barriers to healthy dietary behaviours were access and cost of food available during night work (TDF domain: Environment Context and Resources). Factors identified as both enablers and barriers included: availability of staff facilities and time to take a break, (Environment Context and Resources), the physical impact of night work (Beliefs About Consequences), eating in response to stress or tiredness (Emotion), advance planning of meals/food and taking own food to work (Behavioural Regulation). Potential techniques to address these influences and improve dietary behaviour in this context include: meal planning templates, self‐monitoring and biofeedback, and increasing accessibility and availability of healthier food choices during night shifts. Conclusions: The dietary behaviour of shift workers with T2D is influenced by interacting individual, socio‐cultural and environmental factors. Intervention should focus on environmental restructuring and strategies that enable monitoring and meal planning. [ABSTRACT FROM AUTHOR]

Background: Trials investigating the role of carbohydrate restriction in the management of glycaemia in type 2 diabetes (T2D) have been confounded by multiple factors, including degree of calorie restriction and dietary protein content, as well as by no clear definition of a low‐carbohydrate diet. The present study aimed to provide insight into the relationship between carbohydrate restriction and glycaemia by testing the effect of varying doses of carbohydrate on continuous glucose concentrations within a range of intakes defined as low‐carbohydrate at the same time as controlling for confounding factors. Methods: This was a randomised crossover trial in participants with T2D (HbA1c: 6.6 ± 0.6%, 49 ± 0.9 mmol mol–1) testing five different 6‐day eucaloric dietary treatments with varying carbohydrate content (10%, 15%, 20%, 25%, and 30% kcal). Diets exchanged %kcal from carbohydrate with fat, keeping protein constant at 15% kcal. Daily self‐weighing was employed to ensure weight stability throughout each treatment arm. Between dietary treatments, participants underwent a washout period of at least 7 days and were advised to maintain their habitual diet. Glycaemic control was assessed using a continuous glucose monitoring device. Results: Twelve participants completed the study. There were no differences in 24‐h and post‐prandial sensor glucose concentrations between the 30 and 10%kcal doses (7.4 ± 1.1 mmol L–1 vs. 7.6 ± 1.3 mmol L–1 [p = 0.28] and 8.1 ± 1.5 mmol L–1 vs. 8.5 ± 1.4 mmol L–1 [p = 0.28], respectively). In our exploratory analyses, we did not find any dose–response relationship between carbohydrate intake and glycaemia. A small amount of weight loss occurred in each treatment arm (range: 0.4–1.1 kg over the 6 days) but adjusting for these differences did not influence the primary or secondary outcomes. Conclusions: Modest changes in dietary carbohydrate content in the absence of weight loss at the same time as keeping dietary protein intake constant do not appear to influence glucose concentrations in people with well‐controlled T2D. Summary: This study randomised people with T2D to receive five different doses of carbohydrate from 10% to 30% of calories in random order to see what effect it had on their blood glucose. Key points: Decreasing the carbohydrate content of the diet from 30 to 10%kcal had no detectable effect on blood glucose concentration. There was no observed relationship between the dose of carbohydrate as a %kcal and glucose concentration. It is possible that a low carbohydrate diet needs to be combined with high protein to lower glucose in type 2 diabetes. This study was specifically designed to prevent weight loss and therefore our results do not mean that a low carbohydrate which causes weight loss would not be beneficial for type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background: Blood glucose is higher in people working night shifts compared to day workers. Changes to eating behaviour, activity and sleep patterns in addition to circadian disruption are likely to impact glucose management in night-shift workers with type 2 diabetes. Aim: To investigate current dietary intake and glucose variability during night work, including barriers and facilitators to dietary behaviour in this context. Methods: A mixed-methods case study will be conducted. Shift workers with type 2 diabetes working in a hospital setting will be recruited to this two-part study. Part 1: 70 participants will complete a 10-day observational study collecting data on continuous glucose, diet (self-report diary), sleep and physical activity during a period covering night work, rest days and non-night workdays. Mean glucose concentration and variability, and the mean healthy diet index score, will be compared between days of night work, non-night work and rest, after adjusting for other individual factors (sleep/physical activity/demographics). Part 2: A sample (n~13) will complete semi-structured interviews based on behavioural science frameworks to explore barriers/enablers to dietary behaviour when working night shifts. This will inform a quantitative survey to explore the generalisability of interview findings. Discussion: Findings from Part 1 and 2 will be triangulated to identify potential intervention strategies to address key barriers and enablers to healthier eating, and in turn improved glucose control, in shift workers with type 2 diabetes. This will be facilitated through stakeholder consultation and application of behavioural science frameworks. Shift-Diabetes study registration: ISRCTN11764942. [ABSTRACT FROM AUTHOR]

Increasing 24‐h demand for products, services and health care is resulting in a substantial portion of the workforce engaging in shift work. Observational studies suggest an association between shift work exposure and increased incidence of cardiometabolic disease. Shift workers report less healthy diets compared to day workers. As diet is a modifiable behaviour, it is important to understand how it might mediate the relationship between shift work and health. We reviewed online dietary advice for shift workers by searching for existing guidelines for shift workers published by websites of credible sources, for example institutions or government agencies. Based on the 26 guidelines retrieved, the most common categories of advice were eating patterns (n = 25), general healthy eating and/or specific food groups (n = 22), control of caffeine intake (n = 23) and maintaining hydration/fluid intake (n = 17). Although the majority of publicly available advice for shift workers follows general healthy eating guidelines, there are inconsistencies in the recommendations around the frequency of eating and snacking. Few studies have investigated modification of diet quality in shift workers. With the goal of adding to the evidence base, the Shift‐eat study is a feasibility trial designed to test whether dietary intakes in line with UK healthy eating recommendations during night work improve markers of health (interstitial glucose and heart rate variability) in free‐living shift‐working employees. Shift work is unavoidable and necessary for many industries. With an increasing section of the population employed in jobs requiring shift work, consistent dietary guidance based on evidence from shift‐working populations is urgently needed to support maintenance of health and wellbeing in employees working outside standard daytime hours. [ABSTRACT FROM AUTHOR]

Background: Process evaluations of randomised controlled trials (RCTs) can provide insight and inform us on the intervention implementation, the causal mechanisms and the contextual factors. This will inform about interventions' success or failure due to their implementation or the interventions themselves. We aim to consolidate the methodology from previous process evaluations of complex interventions upon their findings on facilitators and barriers to address the prevention of type 2 diabetes mellitus among women with gestational diabetes mellitus (GDM). Methods: Comprehensive search will be conducted on electronic databases and reference lists of recent reviews for RCTs of complex interventions which address process evaluations of diabetes prevention intervention (DPI) for women with GDM in healthcare settings. There is no restriction on the language of the papers and year of publication until December 2020. Data from each study will be extracted by two reviewers independently using standardised forms. Data extracted include descriptive items on the study design and the outcomes of process evaluations from the three dimensions: (1) implementation; (2) mechanism of impact and (3) context. The quality of the studies will be assessed using mixed methods appraisal tool which is designed for the appraisal of mixed studies in systematic reviews. A narrative and framework analysis of the findings will be presented to inform the contents of a new DPI for women with GDM. Discussion: The findings from this process evaluation findings are valuable in determining whether a complex intervention should be scaled up or modified for other contexts in future plan. It will give deeper understanding of potential challenges and solutions to aid in the implementation of effective DPIs for GDM in Malaysia. [ABSTRACT FROM AUTHOR]