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The purpose of this study is to collect and assess the evidence available on the effect of non nutritive sweeteners on appetite, weight and glycemic regulation. As a replacement for sugars, non-nutritive sweeteners (NNSs) are widely being used in different food products with the assumption that these would lower calorie intake and help to manage weight and blood sugar levels better. However, studies using animal models have reported that chronic exposure to NNSs leads to increased food consumption, weight gain and insulin resistance.

Evidence was acquired from systematic reviews or meta-analyses (2016–2021) of relevant clinical studies, especially randomized control trials using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.

The review showed NNSs exposure did not conclusively induce increased food intake or change in subjective appetite ratings. Appetite biomarkers like ghrelin, gastric inhibitory peptide, C-peptide levels and Peptide YY remained mostly unaffected by NNSs. Meta-analyses of human randomized control studies showed a reduced energy intake and body weight. No significant change was seen in blood glucose levels, post-prandial glycemic or insulin response after consumption of NNSs. Adequate evidence is not available to conclusively say that NNSs influence gut health at doses relevant to human use.

Most studies which are prospective cohort, observational and cross-sectional studies suggest that use of NNSs may promote obesity and metabolic syndrome in adults. Such studies are plagued by confounding variables and reverse causation. Mechanistic evidence is mostly based on in-vitro and in-vivo studies. The same causal pathways may not be operative or relevant in humans.

This review of available literature concludes that to achieve specific public health and clinical goals, the safe use of NNSs for the reduction of intakes of free sugars and energy should be explored. This would be possible by educating the consumer about energy compensation and understanding the nutritional content of artificially sweetened products in terms of calories coming from fat and complex carbohydrates used in the product.

This study was, thus, designed with the objective of examining the usefulness of NNSs in human population, especially with respect to insulin regulation, glycemic control and weight management. Well-designed randomized control trials which control for confounding variables are needed to generate high quality evidence.

This study aims to evaluate and summarize the effectiveness of cognitive behavioral therapy (CBT) and internet-based CBT (ICBT) interventions on relapse prevention and severity of symptoms among individuals with major depressive disorder (MDD). CBT is one of the most used and suggested interventions to manage MDD, whereas ICBT is a novel effective proposed approach.

The review was conducted following the preferred reporting items for systematic review and meta-analysis protocol. A comprehensive and extensive search was performed to identify and evaluate the relevant studies about the effectiveness of CBT and ICBT on relapse prevention and severity of symptoms among patients with MDD.

A total of eight research studies met the inclusion criteria and were included in this systematic review. RCT studies were conducted to assess and evaluate the effectiveness of CBT and ICBT on relapse prevention and severity of symptoms among patients with MDD. It has been found that CBT is a well-supported and evidently based effective psychotherapy for managing depressive symptoms and reducing the relapse and readmission rate among patients diagnosed with MDD. The ICBT demonstrated greater improvements in depressive symptoms during major depressive episodes among patients with MDDS. The ICBT program had good acceptability and satisfaction among participants in different countries.

Despite the significant findings from this systematic review, certain limitations should be acknowledged. First, it is important to note that all the studies included in this review were exclusively conducted in the English language, potentially limiting the generalizability of the findings to non-English speaking populations. Second, the number of research studies incorporated in this systematic review was relatively limited, which may have resulted in a narrower scope of analysis. Finally, a few studies within the selected research had small sample sizes, which could potentially impact the precision and reliability of the overall conclusions drawn from this review. The authors recommend that nurses working in psychiatric units should use CBT interventions with patients with MDD.

This paper, a review of the literature gives an overview of CBT and ICBT interventions to reduce the severity of depressive symptoms and prevent patients’ relapse and rehospitalization and shows that CBT interventions are effective on relapse prevention among patients with MDD. In addition, there is still no standardized protocol to apply the CBT intervention in the scope of reducing the severity of depressive symptoms and preventing depression relapse among patients with major depressive disorder. Further research is needed to confirm the findings of this review. Future research is also needed to find out the most effective form and contents of CBT and ICBT interventions for MDD.

CBT is a psychological intervention that has been recommended by the literature for the treatment of major depressive disorder (MDD). It is a widely recognized and accepted approach that combines cognitive and behavioral techniques to assist individuals overcome their depressive symptoms and improve their overall mental well-being. This would speculate that effectiveness associated with several aspects and combinations of different approaches in CBT interventions and the impact of different delivery models are essential for clinical practice and appropriate selection of the interventional combinations.

This systematic review focuses on the various studies that explore the effectiveness of face-to-face CBT and ICBT in reducing depressive symptoms among patients with major depressive disorder. These studies were conducted in different countries such as Iran, Australia, Pennsylvania and the USA.

Nutrition Bio Shield (NBS) supplement is a natural product that is processed from whole wheat grains. This study aims to determine its effects on depression, anxiety, stress and food craving in women with depression and obesity in a double-blind randomized clinical trial.

Fifty-six eligible clients with body mass index ≥ 25 and mild or moderate depression signed the informed consent form. They were randomly assigned to receive daily 5 g of NBS or placebo. The assessments included the depression, anxiety and stress-21 questionnaire, food craving questionnaire, visual analogue scale for appetite, precise anthropometric measurements and body composition analyses. The assessments were conducted at the baseline and repeated after four and eight weeks. One month after the study completion, the participants’ weight was assessed. The authors analyzed the data by independent sample t-test, repeated measures analysis of variance and multivariate analyses of covariance (MANCOVA).

At the baseline, no significant differences were observed between the groups regarding the main and demographic variables. After four weeks, stress reduced significantly in the NBS group (p = 0.04), and after eight weeks, anxiety (p = 0.02), stress (p = 0.008) and food craving (p = 0.05) reduced significantly in the NBS group compared with the placebo. After controlling for the demographic variables and baseline measurements, MANCOVA model revealed a significant effect of NBS in reducing anxiety (Eta-squared = 0.28; p = 0.001) and stress (Eta-squared = 0.19; p = 0.009). Fisher’s exact test showed no significant difference regarding side effects between NBS and placebo (p = 0.47).

NBS supplement is a patent and natural product that is processed from whole wheat grains. This product was efficient in reducing stress and anxiety after controlling for demographic variables and baseline measurements compared with the placebo and was safe.

Today, coronavirus disease-19 (COVID-19) treatment is an evolving process, and synbiotic administration has been suggested as a new therapeutic strategy. This study aims to investigate the effect of synbiotic supplementation in COVID-19 patients.

In this placebo-controlled trial, 80 patients were randomized to receive oral synbiotic capsule (containing fructooligosaccharide and seven bacterial strains; Lactobacillus (L) casei, L. rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, L. acidophilus, Bifidobacterium longum, L. bulgaricus, each one 109 colony-forming units) or placebo for two months. Inflammatory markers (Interleukin-6 [IL-6], C-reactive protein [CRP], erythrocyte sedimentation rate [ESR]) and white blood cell (WBC) count were evaluated at two timepoints (baseline, two months later). The measured variables were adjusted for confounders and analyzed by SPSS v21.0.

All 80 enrolled patients completed the study. The study adherence was good (approximately 70%). The mean changes for IL-6 were not significant (Δ = −0.6 ± 10.4 pg/mL vs Δ = +11.2 ± 50.3 pg/mL, p > 0.05). There were no significant improvements for CRP, ESR and WBC.

Administration of synbiotics for two months did not improve inflammatory markers in COVID-19 patients.

Because of the importance of having enough sleep in life and health, this study aims to determine the effect of vitamin D supplementation on sleep quality and pregnancy symptoms (primary outcomes) and side effects (secondary outcome).

In this triple-blind randomized controlled clinical trial, 88 pregnant women with gestational age of 8–10 weeks and serum vitamin D concentration less than 30 ng/ml were allocated into vitamin D (n = 44) and control (n = 44) groups by blocked randomization method. The vitamin D group received a 4,000 IU vitamin D pill, and the control group received a placebo pill daily for 18 weeks. Independent t-, Mann–Whitney U and ANCOVA tests were used to analyze the data.

The post-intervention mean (SD: standard deviation) of total sleep quality score in the vitamin D and placebo group were 1.94 (2.1) and 4.62 (1.71), respectively. According to the Mann–Whitney U test, this difference between the two groups was statistically significant (p < 0.001). The mean (SD) of pregnancy symptoms in the vitamin D and placebo groups was 23.95 (16.07) and 26.62 (13.84), respectively, and there was no significant difference between the two groups based on ANCOVA test (p = 0.56). Considerable side effects were not observed in any groups.

This study was conducted due to the contradictory results of the effect of vitamin D on sleep quality and the high prevalence of sleep disorders and pregnancy symptoms.

Background/Objectives: Protein-based meal replacements (MR) with viscous soluble fibre are known aids for weight loss. This study aims to compare the effects of new whey and vegan MR containing different amounts of PGX (PolyGlycopleX) on weight loss over 12 weeks, along with a calorie-restricted diet.

Subjects/Methods: Sixty-eight healthy adults of both sexes (53 women; 15 men; average age 47.1 years; BMI 31 ± 7.1 kg/m² and weight 85.05 ± 23.3 kg) were recruited. Participants consumed a whey or vegan MR twice/d (5–10 g/day PGX) with a low-energy diet (1,200 kcal/day), over 12 weeks. Weight, height, waist and hip circumference were recorded (four time periods).

Results: Forty-four participants completed the study. Results showed significant reductions in average body weight and at week 12, whey group was [−7.7 kg ± 0.9 (8.3%), p < 0.001] and vegan group was [−4.5 kg ± 0.8 (6.2%), p < 0.001)]. All participants (n = 44; BMI 27 to 33 kg/m²) achieved significant reductions in body measurements from baseline to week 12; p < 0.001. Conclusions: Supplementation of protein-based MR with PGX and a balanced, low-energy diet, appears to be an effective approach for short-term weight loss.

As the authors were evaluating if the MR as a whole (i.e. with PGX) caused weight loss from baseline over the 12 weeks, no comparators, i.e. just the MR without PGX, were used. Formulation of these new MRs resulted in a whey product with 5 g PGX and a vegan product with 2.5 g PGX. Only 2.5 g PGX could be formulated with the vegan protein due to taste and viscosity limitations. Study participants were not randomized and no control groups (e.g. no MR or MR without PGX but with energy restricted diet) were used. Furthermore, it is not clear whether the sort of protein alone or the combination with a higher amount of PGX (whey with 5 g PGX/serving vs vegan with 2.5 g PGX/serving) has contributed to these significant greater weight-loss effects. This was something the authors were testing, i.e. could only 2.5 g PGX/serving have an effect on weight loss for a vegan MR. These limitations would be somethings to evaluate in a subsequent randomized controlled study. Hence, the results of this study may serve as a good starting point for further sophisticated randomized controlled trials that can demonstrate causality – which the authors acknowledge as one of the fundamental limitations of an observational study design. Participants tracked their calories but adherence and compliance were self-assessed and they were encouraged to keep their exercise routine consistent throughout the study. Hence, these are further limitations. No control group was used in this study to observe the effect of the dietary intervention and/or physical activity on weight loss alone. However, a goal of the authors was to keep this study as close to a real-life situation as possible, where people would not be doing any of these measurements, to see if with minimal supervision or intervention, people can still lose weight and alter their body composition. Furthermore, differences in gender and the corresponding weight loss effects in response to MR-protein-based treatments could be evaluated in follow-up studies.

This study indicates that the consumption of protein-based (animal, whey or plant, pea protein) MR incorporating the highly soluble viscous PGX is beneficial for weight loss when combined with a healthy-balanced, calorie-restricted diet. MRs at either 2.5 g or 5 g per serving (RealEasy^TM with PGX) proved to be a highly effective as a short-term solution for weight loss. The observed results are encouraging, however, further long-term studies (i.e. randomized clinical trials RCT) are needed to confirm the clinical relevance. RCTs should focus on the individual effects of PGX and/or the different protein sources used in MRs, on weight loss and the maintenance of the reduced body weight, and should measure detailed blood parameters (lipid profiles, glucose etc.) as well as collect detailed exercise and food consumption diaries.

To the authors’ knowledge, this is the first study comparing a whey versus vegan, (as pea) protein-based MR that is supplemented with fibre PGX; thus, this work adds information to the already existing literature on fibre (such as PGX) and MRs regarding their combined weight loss effects. The purpose of this study was to observe if the novel protein-based (either whey or vegan versions) MR RealEasy^TM with PGX at 2.5 or 5 g in addition to a calorie-restricted diet (total of 1,200 kcal/day) would aid in weight loss in individuals over a 12-weeks period. Adding increasing amounts of whey protein and soluble fibre can help reduce subsequent ad libitum energy intake which could help adherence to energy restricted diets, but whether similar effects are seen with vegan protein is unclear – this study does aim to address this.

Cybersecurity training plays a decisive role in overcoming the global shortage of cybersecurity experts and the risks this shortage poses to organizations' assets. Seeking to make the training of those experts as efficacious and efficient as possible, this study investigates the potential of visual programming languages (VPLs) for training in cyber ranges. For this matter, the VPL Blockly was integrated into an existing cyber range training to facilitate learning a code-based cybersecurity task, namely, creating code-based correlation rules for a security information and event management (SIEM) system.

To evaluate the VPL’s effect on the cyber range training, the authors conducted a user study as a randomized controlled trial with 30 participants. In this study, the authors compared skill development of participants creating SIEM rules using Blockly (experimental group) with participants using a textual programming approach (control group) to create the rules.

This study indicates that using a VPL in a cybersecurity training can improve the participants' perceived learning experience compared to the control group while providing equally good learning outcomes.

The originality of this work lies in studying the effect of using a VPL to learn a code-based cybersecurity task. Investigating this effect in comparison with the conventional textual syntax through a randomized controlled trial has not been investigated yet.

To date, little research has been undertaken to test the effectiveness of team coaching, with past work focusing on models, frameworks and competencies. This study aimed to examine the effectiveness of team coaching within real world organizational teams and its impact on individual perceptions of team cohesion and psychological safety.

A randomized control trial (RCT) using the comparable interventions: (1) team coaching (intervention) and (2) team facilitation (control) was employed with multiple teams and multiple facilitators, measuring the impact on team cohesion and psychological safety.

The data indicate participants engaging in the team coaching intervention made greater gains in terms of their individual perceptions of psychological safety and team cohesion than individuals who received the team facilitation intervention (T1–T2).

Facilitators should apply a team coaching approach when seeking to address issues of cohesion and psychological safety within workplace teams.

This study provides the first evidence, using an RCT method, of the effectiveness of team coaching as a workplace intervention for enhancing individual perceptions of psychological safety and team cohesion.

This paper aims to examine the effect of sesame oil (SO) on fatigue and mental health status in women with nonalcoholic fatty liver disease (NAFLD) undergoing a weight-loss diet.

In total, 60 women with NAFLD were randomly assigned to receive 30 g/day of either SO (n = 30) or sunflower oil (n = 30). All the patients received a hypocaloric diet (−500 kcal/day) for 12 weeks in a double-blinded controlled trial. Anthropometric indices, dietary intake, physical activity, fatigue and mental health status were measured at the baseline and the trial cessation.

In total, 53 participants completed the intervention. Significant reductions in anthropometric indices were observed in both groups (p-value = 0.001). Following SO, fatigue (p-value = 0.002), anxiety (p-value = 0.011) and depression (p-value = 0.013) scores were significantly reduced, while no significant changes were observed in stress scores.

In summary, the present study was conducted to assess the efficacy of SO consumption on fatigue and mental health status among patients with NAFLD. The results revealed SO consumption significantly reduced fatigue, anxiety and depression scores in comparison with the control group, but not for stress scores. Further clinical trials, different doses, with a longer duration of intervention, in different groups, are necessary to confirm the veracity of the results.