10 results on '"Meaghan E. Kavanagh"'
Search Results
2. The Portfolio Diet and HbA1c in Adults Living with Type 2 Diabetes Mellitus: A Patient-Level Pooled Analysis of Two Randomized Dietary Trials
- Author
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Meaghan E. Kavanagh, Songhee Back, Victoria Chen, Andrea J. Glenn, Gabrielle Viscardi, Zeinab Houshialsadat, John L. Sievenpiper, Cyril W. C. Kendall, David J. A. Jenkins, and Laura Chiavaroli
- Subjects
Portfolio Diet ,dietary portfolio ,diabetes ,glycemic index ,glycaemic index ,glucose control ,Nutrition. Foods and food supply ,TX341-641 - Abstract
(1) Background: The Portfolio Diet, a dietary pattern of cholesterol-lowering foods, is also rich in low glycemic index (GI) foods. While strong evidence supports clinically meaningful reductions in cholesterol, evidence on the relationship between the Portfolio Diet and diabetes management is lacking. (2) Objective: To evaluate the relationship between the Portfolio Diet and glycated hemoglobin (HbA1c) as a determinant of glycemic control among adults living with type 2 diabetes mellitus (T2DM). (3) Methods: Patient-level data was pooled from two randomized dietary trials of low glycemic index interventions compared to high cereal fibre control diets in adults living with T2DM where HbA1c was collected (clinicaltrials.gov identifiers: NCT00438698, NCT00438698). Dietary exposure was assessed using weighed 7-day diet records. Adherence to the Portfolio Diet and its pillars (nuts and seeds, plant protein, viscous fibre, plant sterols, monounsaturated fatty acid [MUFA] oils) was determined using the validated clinical Portfolio Diet Score (c-PDS). Multiple linear regression was used to assess the association between change in the c-PDS and change in HbA1c over 6-months with covariate adjustments. (4) Results: A total of 267 participants, predominantly White (67%) and male (63%), were included, with a mean ± standard error age of 62 ± 0.5 years, baseline BMI of 30.2 ± 0.3 kg/m2, HbA1c of 7.08 ± 0.03%, and a c-PDS of 4.1 ± 0.3 points out of 25. Change in the c-PDS was significantly associated with a change in HbA1c (β: −0.04% per point, 95% CI: −0.07, −0.02, p = 0.001). A 7.5-point (30%) increase in the c-PDS was associated with a 0.3% reduction in HbA1c. Of the individual pillars, a 1-point change in nut and seeds intake (β: −0.07%, 95% CI: −0.12, −0.02, p = 0.009) or in plant protein intake (β: −0.11%, 95% CI: −0.18, −0.03, p = 0.009) was associated with a change in HbA1c. Further analysis of plant protein intake revealed that an increase in dietary pulse intake, a particularly low-GI food, was significantly associated with a reduction in HbA1c (β: −0.24% per 1-cup points cooked pulses (226 g) or 2 c-PDS points, 95% CI: −0.45, −0.03, p = 0.028). (5) Conclusions: Among adults living with T2DM, the Portfolio Diet was associated with lower HbA1c over a 6-month period, predominantly driven by two pillars: nuts and seeds and plant protein, particularly dietary pulses. These data have implications for including the Portfolio Diet in dietary recommendations for glycemic control in T2DM. A trial demonstrating the direct causal effect of the Portfolio Diet in a diverse group is warranted.
- Published
- 2024
- Full Text
- View/download PDF
3. Rationale, Design and Participants Baseline Characteristics of a Crossover Randomized Controlled Trial of the Effect of Replacing SSBs with NSBs versus Water on Glucose Tolerance, Gut Microbiome and Cardiometabolic Risk in Overweight or Obese Adult SSB Consumer: Strategies to Oppose SUGARS with Non-Nutritive Sweeteners or Water (STOP Sugars NOW) Trial and Ectopic Fat Sub-Study
- Author
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Sabrina Ayoub-Charette, Néma D. McGlynn, Danielle Lee, Tauseef Ahmad Khan, Sonia Blanco Mejia, Laura Chiavaroli, Meaghan E. Kavanagh, Maxine Seider, Amel Taibi, Chuck T. Chen, Amna Ahmed, Rachel Asbury, Madeline Erlich, Yue-Tong Chen, Vasanti S. Malik, Richard P. Bazinet, D. Dan Ramdath, Caomhan Logue, Anthony J. Hanley, Cyril W. C. Kendall, Lawrence A. Leiter, Elena M. Comelli, and John L. Sievenpiper
- Subjects
low- and no-calorie sweeteners ,sweetening agents ,sugar-sweetened beverages ,water ,randomized controlled trial ,type 2 diabetes ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Background: Health authorities are near universal in their recommendation to replace sugar-sweetened beverages (SSBs) with water. Non-nutritive sweetened beverages (NSBs) are not as widely recommended as a replacement strategy due to a lack of established benefits and concerns they may induce glucose intolerance through changes in the gut microbiome. The STOP Sugars NOW trial aims to assess the effect of the substitution of NSBs (the “intended substitution”) versus water (the “standard of care substitution”) for SSBs on glucose tolerance and microbiota diversity. Design and Methods: The STOP Sugars NOW trial (NCT03543644) is a pragmatic, “head-to-head”, open-label, crossover, randomized controlled trial conducted in an outpatient setting. Participants were overweight or obese adults with a high waist circumference who regularly consumed ≥1 SSBs daily. Each participant completed three 4-week treatment phases (usual SSBs, matched NSBs, or water) in random order, which were separated by ≥4-week washout. Blocked randomization was performed centrally by computer with allocation concealment. Outcome assessment was blinded; however, blinding of participants and trial personnel was not possible. The two primary outcomes are oral glucose tolerance (incremental area under the curve) and gut microbiota beta-diversity (weighted UniFrac distance). Secondary outcomes include related markers of adiposity and glucose and insulin regulation. Adherence was assessed by objective biomarkers of added sugars and non-nutritive sweeteners and self-report intake. A subset of participants was included in an Ectopic Fat sub-study in which the primary outcome is intrahepatocellular lipid (IHCL) by 1H-MRS. Analyses will be according to the intention to treat principle. Baseline results: Recruitment began on 1 June 2018, and the last participant completed the trial on 15 October 2020. We screened 1086 participants, of whom 80 were enrolled and randomized in the main trial and 32 of these were enrolled and randomized in the Ectopic Fat sub-study. The participants were predominantly middle-aged (mean age 41.8 ± SD 13.0 y) and had obesity (BMI of 33.7 ± 6.8 kg/m2) with a near equal ratio of female: male (51%:49%). The average baseline SSB intake was 1.9 servings/day. SSBs were replaced with matched NSB brands, sweetened with either a blend of aspartame and acesulfame-potassium (95%) or sucralose (5%). Conclusions: Baseline characteristics for both the main and Ectopic Fat sub-study meet our inclusion criteria and represent a group with overweight or obesity, with characteristics putting them at risk for type 2 diabetes. Findings will be published in peer-reviewed open-access medical journals and provide high-level evidence to inform clinical practice guidelines and public health policy for the use NSBs in sugars reduction strategies. Trial registration: ClinicalTrials.gov identifier, NCT03543644.
- Published
- 2023
- Full Text
- View/download PDF
4. Apple Flavonols Mitigate Adipocyte Inflammation and Promote Angiogenic Factors in LPS- and Cobalt Chloride-Stimulated Adipocytes, in Part by a Peroxisome Proliferator-Activated Receptor-γ-Dependent Mechanism
- Author
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Danyelle M. Liddle, Meaghan E. Kavanagh, Amanda J. Wright, and Lindsay E. Robinson
- Subjects
adipocyte ,flavonols ,hypoxia ,inflammation ,obesity ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Adipose tissue (AT) expansion induces local hypoxia, a key contributor to the chronic low-grade inflammation that drives obesity-associated disease. Apple flavonols phloretin (PT) and phlorizin (PZ) are suggested anti-inflammatory molecules but their effectiveness in obese AT is inadequately understood. Using in vitro models designed to reproduce the obese AT microenvironment, 3T3-L1 adipocytes were cultured for 24 h with PT or PZ (100 μM) concurrent with the inflammatory stimulus lipopolysaccharide (LPS; 10 ng/mL) and/or the hypoxia mimetic cobalt chloride (CoCl2; 100 μM). Within each condition, PT was more potent than PZ and its effects were partially mediated by peroxisome proliferator-activated receptor (PPAR)-γ (p < 0.05), as tested using the PPAR-γ antagonist bisphenol A diglycidyl ether (BADGE). In LPS-, CoCl2-, or LPS + CoCl2-stimulated adipocytes, PT reduced mRNA expression and/or secreted protein levels of inflammatory and macrophage chemotactic adipokines, and increased that of anti-inflammatory and angiogenic adipokines, which was consistent with reduced mRNA expression of M1 polarization markers and increased M2 markers in RAW 264.7 macrophages cultured in media collected from LPS + CoCl2-simulated adipocytes (p < 0.05). Further, within LPS + CoCl2-stimulated adipocytes, PT reduced reactive oxygen species accumulation, nuclear factor-κB activation, and apoptotic protein expression (p < 0.05). Overall, apple flavonols attenuate critical aspects of the obese AT phenotype.
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- 2020
- Full Text
- View/download PDF
5. Low-carbohydrate vegan diets in diabetes for weight loss and sustainability: a randomized controlled trial
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David J A, Jenkins, Peter J H, Jones, Mohammad M H, Abdullah, Benoit, Lamarche, Dorothea, Faulkner, Darshna, Patel, Sandhya, Sahye-Pudaruth, Melanie, Paquette, Balachandran, Bashyam, Sathish C, Pichika, Meaghan E, Kavanagh, Pooja, Patel, Fred, Liang, Ramon, Brown, Tiffany, Zhao, Mila, Phan, Gajuna, Mathiyalagan, Shilpa, Tandon, Vladmir, Vuksan, Elena, Jovanovski, John L, Sievenpiper, Cyril W C, Kendall, Lawrence A, Leiter, and Robert G, Josse
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Nutrition and Dietetics ,Medicine (miscellaneous) - Abstract
Low-carbohydrate, high animal fat and protein diets have been promoted for weight loss and diabetes treatment. We therefore tested the effect of a low-carbohydrate vegan diet in diabetes as a potentially healthier and more ecologically sustainable low-carbohydrate option.We sought to compare the effectiveness of a low-carbohydrate vegan diet with a moderate-carbohydrate vegetarian diet on weight loss and metabolic measures in diabetes.One hundred and sixty-four male and female participants with type 2 diabetes were randomly assigned to advice on either a low-carbohydrate vegan diet, high in canola oil and plant proteins, or a vegetarian therapeutic diet, for 3 mo, with both diets recommended at 60% of calorie requirements. Body weight, fasting blood, blood pressure, and 7-d food records, to estimate potential greenhouse gas emissions, were obtained throughout the study with tests of cholesterol absorption undertaken at baseline and end of study on 50 participants.Both low-carbohydrate vegan and vegetarian diets similarly but markedly reduced body weight (-5.9 kg; 95% CI: -6.5, -5.28 kg; and -5.23 kg; 95% CI: -5.84, -4.62 kg), glycated hemoglobin (-0.99%; 95% CI: -1.07, -0.9%; and -0.88%; 95% CI: -0.97, -0.8%), systolic blood pressure (-4 mmHg; 95% CI: -7, -2 mmHg; and -6 mmHg; 95% CI: -8, -3 mmHg), and potential greenhouse gas emissions, but only for potential greenhouse gas emissions was there a significant treatment difference of -0.63 kgCO2/d (95% CI: -0.99, -0.27 kgCO2/d) favoring the low-carbohydrate vegan diet.Low-carbohydrate vegan and vegetarian diets reduced body weight, improved glycemic control and blood pressure, but the more plant-based diet had greater potential reduction in greenhouse gas emissions.Trial registration number: clinicaltrials.gov identifier NCT02245399.
- Published
- 2022
6. Abstract P521: Association Between Dietary Phytosterols and Risk of Cardiovascular Disease Mortality in US Adults: Findings From the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994
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Julianah O Oguntala, Andreea Zurbau, Meaghan E Kavanagh, Andrea Glenn, Laura Chiavaroli, Tauseef A Khan, Sonia Blanco Meija, David J Jenkins, Cyril Kendall, and John L Sievenpiper
- Subjects
Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Introduction: Phytosterols (plant sterols) are naturally occurring components of plant food sources, including vegetable oils, nuts, cereals and legumes. Their chemical structure impedes intestinal cholesterol absorption and regular consumption has been related to lower serum low-density cholesterol (LDL-C), a causal risk factor for cardiovascular disease (CVD). The association between dietary plant sterol intake and CVD has yet to be determined. Objective: We aimed to examine the association of phytosterol consumption in the diet with cardiovascular mortality in US adults the National Health & Nutrition Examination Survey III (NHANES III), 1988-1994. Methods: We conducted a prospective cohort analysis on National Health and Nutrition Examination Survey (NHANES, 1988-1994 [III]), linked with the National Death Index mortality data (2015) to associate dietary phytosterol intake from 24h dietary recall data with CVD mortality. We included 13,004 adults aged ≥20 years who were non-pregnant, free of CVD at baseline and completed ≥1 24h dietary recall with plausible caloric intake data. We excluded individuals with death occurring within 1 year of baseline. We created a database quantifying the phytosterol content of foods in the 24h dietary recall data and estimated usual intake by quintiles using the NCI method. We determined the risk function by regression calibration and estimated CVD mortality risk between the 10 th (Q1) and 90 th (Q5) percentiles of usual intake. Data was adjusted for sex, age, smoking status and ethnicity. Results: Over a mean±SD follow-up period of 21.2±5.1y, 949 CVD deaths occurred in a population with a mean±SD age of 44.2±14.3y, BMI 26.7±4.7 kg/m 2 and mean dietary plant sterol usual intake of 272.3 mg/day. The top sources of dietary phytosterols were from potatoes 23%), wheat and other grains (21%) and beans, legumes and nuts (13%). Mean usual intake plant intake in the 10 th (Q1) and 90 th (Q5) percentiles of the population was 150.1 and 414.0 mg/day. The estimated relative risk for CVD mortality between Q1 (ref) and Q5 was 0.972 (p Conclusions: Preliminary analyses suggest a CVD death risk reduction of 2.8% in the highest versus lowest intakes of dietary plant sterols in the US population. We plan to expand the multivariable model to include the Healthy Eating Index (diet quality) and assess stratification by healthful and unhealthful sources of phytosterols and linear and non-linear dose response analyses to determine the robustness of the association. OSF Registration: osf.io/da4sg Funding: Amgen Scholars Program, Canadian Institutes of Health Research (CIHR), Banting and Best Diabetes Centre (BBDC), Toronto 3D Knowledge Synthesis and Clinical Trials foundation
- Published
- 2023
7. A Web-Based Health Application to Translate Nutrition Therapy for Cardiovascular Risk Reduction in Primary Care (PortfolioDiet.app): Quality Improvement and Usability Testing Study
- Author
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Meaghan E Kavanagh, Laura Chiavaroli, Andrea J Glenn, Genevieve Heijmans, Shannan M Grant, Chi-Ming Chow, Robert G Josse, Vasanti S Malik, William Watson, Aisha Lofters, Candice Holmes, Julia Rackal, Kristie Srichaikul, Diana Sherifali, Erna Snelgrove-Clarke, Jacob A Udell, Peter Juni, Gillian L Booth, Michael E Farkouh, Lawrence A Leiter, Cyril WC Kendall, David JA Jenkins, and John L Sievenpiper
- Subjects
Health Informatics ,Human Factors and Ergonomics - Abstract
Background The Portfolio Diet, or Dietary Portfolio, is a therapeutic dietary pattern that combines cholesterol-lowering foods to manage dyslipidemia for the prevention of cardiovascular disease. To translate the Portfolio Diet for primary care, we developed the PortfolioDiet.app as a patient and physician educational and engagement tool for PCs and smartphones. The PortfolioDiet.app is currently being used as an add-on therapy to the standard of care (usual care) for the prevention of cardiovascular disease in primary care. To enhance the adoption of this tool, it is important to ensure that the PortfolioDiet.app meets the needs of its target end users. Objective The main objective of this project is to undertake user testing to inform modifications to the PortfolioDiet.app as part of ongoing engagement in quality improvement (QI). Methods We undertook a 2-phase QI project from February 2021 to September 2021. We recruited users by convenience sampling. Users included patients, family physicians, and dietitians, as well as nutrition and medical students. For both phases, users were asked to use the PortfolioDiet.app daily for 7 days. In phase 1, a mixed-form questionnaire was administered to evaluate the users’ perceived acceptability, knowledge acquisition, and engagement with the PortfolioDiet.app. The questionnaire collected both quantitative and qualitative data, including 2 open-ended questions. The responses were used to inform modifications to the PortfolioDiet.app. In phase 2, the System Usability Scale was used to assess the usability of the updated PortfolioDiet.app, with a score higher than 70 being considered acceptable. Results A total of 30 and 19 users were recruited for phase 1 and phase 2, respectively. In phase 1, the PortfolioDiet.app increased users’ perceived knowledge of the Portfolio Diet and influenced their perceived food choices. Limitations identified by users included challenges navigating to resources and profile settings, limited information on plant sterols, inaccuracies in points, timed-logout frustration, request for step-by-step pop-up windows, and request for a mobile app version; when looking at positive feedback, the recipe section was the most commonly praised feature. Between the project phases, 6 modifications were made to the PortfolioDiet.app to incorporate and address user feedback. At phase 2, the average System Usability Scale score was 85.39 (SD 11.47), with 100 being the best possible. Conclusions By undertaking user testing of the PortfolioDiet.app, its limitations and strengths were able to be identified, informing modifications to the application, which resulted in a clinical tool that better meets users’ needs. The PortfolioDiet.app educates users on the Portfolio Diet and is considered acceptable by users. Although further refinements to the PortfolioDiet.app will continue to be made before its evaluation in a clinical trial, the result of this QI project is an improved clinical tool.
- Published
- 2021
8. A Web-Based Health Application to Translate Nutrition Therapy for Cardiovascular Risk Reduction in Primary Care (PortfolioDiet.app): Quality Improvement and Usability Testing Study (Preprint)
- Author
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Meaghan E Kavanagh, Laura Chiavaroli, Andrea J Glenn, Genevieve Heijmans, Shannan M Grant, Chi-Ming Chow, Robert G Josse, Vasanti S Malik, William Watson, Aisha Lofters, Candice Holmes, Julia Rackal, Kristie Srichaikul, Diana Sherifali, Erna Snelgrove-Clarke, Jacob A Udell, Peter Juni, Gillian L Booth, Michael E Farkouh, Lawrence A Leiter, Cyril WC Kendall, David JA Jenkins, and John L Sievenpiper
- Abstract
BACKGROUND The Portfolio Diet, or Dietary Portfolio, is a therapeutic dietary pattern that combines cholesterol-lowering foods to manage dyslipidemia for the prevention of cardiovascular disease. To translate the Portfolio Diet for primary care, we developed the PortfolioDiet.app as a patient and physician educational and engagement tool for PCs and smartphones. The PortfolioDiet.app is currently being used as an add-on therapy to the standard of care (usual care) for the prevention of cardiovascular disease in primary care. To enhance the adoption of this tool, it is important to ensure that the PortfolioDiet.app meets the needs of its target end users. OBJECTIVE The main objective of this project is to undertake user testing to inform modifications to the PortfolioDiet.app as part of ongoing engagement in quality improvement (QI). METHODS We undertook a 2-phase QI project from February 2021 to September 2021. We recruited users by convenience sampling. Users included patients, family physicians, and dietitians, as well as nutrition and medical students. For both phases, users were asked to use the PortfolioDiet.app daily for 7 days. In phase 1, a mixed-form questionnaire was administered to evaluate the users’ perceived acceptability, knowledge acquisition, and engagement with the PortfolioDiet.app. The questionnaire collected both quantitative and qualitative data, including 2 open-ended questions. The responses were used to inform modifications to the PortfolioDiet.app. In phase 2, the System Usability Scale was used to assess the usability of the updated PortfolioDiet.app, with a score higher than 70 being considered acceptable. RESULTS A total of 30 and 19 users were recruited for phase 1 and phase 2, respectively. In phase 1, the PortfolioDiet.app increased users’ perceived knowledge of the Portfolio Diet and influenced their perceived food choices. Limitations identified by users included challenges navigating to resources and profile settings, limited information on plant sterols, inaccuracies in points, timed-logout frustration, request for step-by-step pop-up windows, and request for a mobile app version; when looking at positive feedback, the recipe section was the most commonly praised feature. Between the project phases, 6 modifications were made to the PortfolioDiet.app to incorporate and address user feedback. At phase 2, the average System Usability Scale score was 85.39 (SD 11.47), with 100 being the best possible. CONCLUSIONS By undertaking user testing of the PortfolioDiet.app, its limitations and strengths were able to be identified, informing modifications to the application, which resulted in a clinical tool that better meets users’ needs. The PortfolioDiet.app educates users on the Portfolio Diet and is considered acceptable by users. Although further refinements to the PortfolioDiet.app will continue to be made before its evaluation in a clinical trial, the result of this QI project is an improved clinical tool.
- Published
- 2021
9. Apple Flavonols Mitigate Adipocyte Inflammation and Promote Angiogenic Factors in LPS- and Cobalt Chloride-Stimulated Adipocytes, in Part by a Peroxisome Proliferator-Activated Receptor-γ-Dependent Mechanism
- Author
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Meaghan E Kavanagh, Amanda J. Wright, Danyelle M. Liddle, and Lindsay E. Robinson
- Subjects
Lipopolysaccharides ,0301 basic medicine ,medicine.medical_specialty ,obesity ,Lipopolysaccharide ,Phloretin ,Phlorizin ,Anti-Inflammatory Agents ,Peroxisome proliferator-activated receptor ,Adipose tissue ,lcsh:TX341-641 ,Inflammation ,adipocyte ,Article ,Mice ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,3T3-L1 Cells ,Adipocyte ,Internal medicine ,Adipocytes ,medicine ,Animals ,Receptor ,chemistry.chemical_classification ,Nutrition and Dietetics ,hypoxia ,Cobalt ,flavonols ,PPAR gamma ,030104 developmental biology ,Endocrinology ,Adipose Tissue ,chemistry ,inflammation ,Malus ,030220 oncology & carcinogenesis ,Angiogenesis Inducing Agents ,medicine.symptom ,lcsh:Nutrition. Foods and food supply ,Signal Transduction ,Food Science - Abstract
Adipose tissue (AT) expansion induces local hypoxia, a key contributor to the chronic low-grade inflammation that drives obesity-associated disease. Apple flavonols phloretin (PT) and phlorizin (PZ) are suggested anti-inflammatory molecules but their effectiveness in obese AT is inadequately understood. Using in vitro models designed to reproduce the obese AT microenvironment, 3T3-L1 adipocytes were cultured for 24 h with PT or PZ (100 &mu, M) concurrent with the inflammatory stimulus lipopolysaccharide (LPS, 10 ng/mL) and/or the hypoxia mimetic cobalt chloride (CoCl2, 100 &mu, M). Within each condition, PT was more potent than PZ and its effects were partially mediated by peroxisome proliferator-activated receptor (PPAR)-&gamma, (p <, 0.05), as tested using the PPAR-&gamma, antagonist bisphenol A diglycidyl ether (BADGE). In LPS-, CoCl2-, or LPS + CoCl2-stimulated adipocytes, PT reduced mRNA expression and/or secreted protein levels of inflammatory and macrophage chemotactic adipokines, and increased that of anti-inflammatory and angiogenic adipokines, which was consistent with reduced mRNA expression of M1 polarization markers and increased M2 markers in RAW 264.7 macrophages cultured in media collected from LPS + CoCl2-simulated adipocytes (p <, 0.05). Further, within LPS + CoCl2-stimulated adipocytes, PT reduced reactive oxygen species accumulation, nuclear factor-&kappa, B activation, and apoptotic protein expression (p <, 0.05). Overall, apple flavonols attenuate critical aspects of the obese AT phenotype.
- Published
- 2020
- Full Text
- View/download PDF
10. A Web-Based Health Application to Translate Nutrition Therapy for Cardiovascular Risk Reduction in Primary Care (PortfolioDiet.app): Quality Improvement and Usability Testing Study
- Author
-
Meaghan E Kavanagh, Laura Chiavaroli, Andrea J Glenn, Genevieve Heijmans, Shannan M Grant, Chi-Ming Chow, Robert G Josse, Vasanti S Malik, William Watson, Aisha Lofters, Candice Holmes, Julia Rackal, Kristie Srichaikul, Diana Sherifali, Erna Snelgrove-Clarke, Jacob A Udell, Peter Juni, Gillian L Booth, Michael E Farkouh, Lawrence A Leiter, Cyril W C Kendall, David J A Jenkins, and John L Sievenpiper
- Subjects
Medical technology ,R855-855.5 - Abstract
BackgroundThe Portfolio Diet, or Dietary Portfolio, is a therapeutic dietary pattern that combines cholesterol-lowering foods to manage dyslipidemia for the prevention of cardiovascular disease. To translate the Portfolio Diet for primary care, we developed the PortfolioDiet.app as a patient and physician educational and engagement tool for PCs and smartphones. The PortfolioDiet.app is currently being used as an add-on therapy to the standard of care (usual care) for the prevention of cardiovascular disease in primary care. To enhance the adoption of this tool, it is important to ensure that the PortfolioDiet.app meets the needs of its target end users. ObjectiveThe main objective of this project is to undertake user testing to inform modifications to the PortfolioDiet.app as part of ongoing engagement in quality improvement (QI). MethodsWe undertook a 2-phase QI project from February 2021 to September 2021. We recruited users by convenience sampling. Users included patients, family physicians, and dietitians, as well as nutrition and medical students. For both phases, users were asked to use the PortfolioDiet.app daily for 7 days. In phase 1, a mixed-form questionnaire was administered to evaluate the users’ perceived acceptability, knowledge acquisition, and engagement with the PortfolioDiet.app. The questionnaire collected both quantitative and qualitative data, including 2 open-ended questions. The responses were used to inform modifications to the PortfolioDiet.app. In phase 2, the System Usability Scale was used to assess the usability of the updated PortfolioDiet.app, with a score higher than 70 being considered acceptable. ResultsA total of 30 and 19 users were recruited for phase 1 and phase 2, respectively. In phase 1, the PortfolioDiet.app increased users’ perceived knowledge of the Portfolio Diet and influenced their perceived food choices. Limitations identified by users included challenges navigating to resources and profile settings, limited information on plant sterols, inaccuracies in points, timed-logout frustration, request for step-by-step pop-up windows, and request for a mobile app version; when looking at positive feedback, the recipe section was the most commonly praised feature. Between the project phases, 6 modifications were made to the PortfolioDiet.app to incorporate and address user feedback. At phase 2, the average System Usability Scale score was 85.39 (SD 11.47), with 100 being the best possible. ConclusionsBy undertaking user testing of the PortfolioDiet.app, its limitations and strengths were able to be identified, informing modifications to the application, which resulted in a clinical tool that better meets users’ needs. The PortfolioDiet.app educates users on the Portfolio Diet and is considered acceptable by users. Although further refinements to the PortfolioDiet.app will continue to be made before its evaluation in a clinical trial, the result of this QI project is an improved clinical tool.
- Published
- 2022
- Full Text
- View/download PDF
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