Question 1
Subjects in this study were asked to eat 2 servings of Ready to Eat Oat Cereal each day for 12 weeks. Is this a realistic intervention for the general public trying to lose weight and reduce lipid levels? If you suggest this diet and on week 5 a patient comes in complaining he is sick of his RTE oat cereals, what other foods/interventions would you suggest to keep him on track?
posted by StephHyett @ 5:08 PM
38 comments
38 Comments:
I think this intervention could be realistic if the subjects were severely devoted and motivated to do it right. However, I would suggest having other options with similar nutritional value (like cheerios or bran flakes) for the subjects to use interchangeably for breakfast in order to lower their lipid values
I do think that this is a realistic intervention; however, incorporating RTE oat cereal into an individuals eating pattern is just one of many components associated with a "healthy diet." If the patient is sick of eating RTE cereals, I would recommended alternative food sources of soluble fiber such as beans, apples and berries.
I think that in general it would be realistic, because most people don't eat the right portions so a serving (I'm assuming its a 1/2 cup) would be easy to double for breakfast alone. I could see, however, that they would get bored. Other whole grains cheeros, kashi products, and others that could make it easy to change up the meal. Also, adding different fruit to the cereal can mix it up as well.
Anna --
I think its a great idea to also address other sources of fiber like beans and fruit to help get the fiber in without having to always eat the RTE cereals. That will definitely offer some variety to the diet!
I think that this is a very real possiblity for individuals trying to lose weight. It really reminds me of what Speical K promotes with there products. It would be a simple fix to give him some variety by telling him to eat a product that had similar nutrient content in it two times a day. That may include something like a particular whole wheat bread or pasta making sure that the carb, fat, protein, and fiber content would be the most important components.
Anna,
I think it is very iportant to remember that eating a diet high in fiber is just one component to a healthy diet. There are so many other things to consider like fluid intake, fat, calories, exercise, and even sleep
I definitely think that this is a realistic intervention for the general public trying to lose weight as well as reducing lipid levels. However, it is understandable that 3 months of this may become monotonous for any person that is not used to eating the same thing every day. I would suggest healthy alternative cereals such as Kashi or total, which also have whole grains and fiber in them. If the patient was still not willing to alternate cereals in order to change up his breakfast choices, then I would suggest using 100% whole-grain , whole-wheat bread or a whole-grain English muffin for breakfast. For lunch or dinner the patient could use brown rice instead of white and whole wheat pastas instead of enriched white pastas. That way the patient has many options to choose from.
I think the intervention presented could be realistic but seems to be limited given the recommendation is to simply consume 2 servings of whole grain RTE cereal. Most patients/clients are looking for more than this recommendation (if they are truly ready for change). I also feel there is additional LDL lowering information that could be beneficial for this type of patient such as increasing consumption of omega-3 fatty acids and using mono or polyunsaturated fats in place of saturated/trans fat. This information could be utilized as a second intervention in addition to consuming 2 servings of whole grain RTE cereal.
This intervention, in my opinion is not realistic for the general public. I strongly believe that a certain percentage of determined people could and would follow this diet but when looking at the general public, I feel 2 servings a day of Ready to Eat Oat Cereal for 12 weeks is too large of a step when modifying their life style. I also feel that eating 2 servings a day for 12 weeks would cause people to scare away from oats, grains and cereals because of the large consumption and as dietitians we always stress variety, variety, variety. Along with the recommendation of RTE oat cereals, fiber rich foods such as other whole grains,fruits and vegetables should be brought to attention. When working with a client who needs this form of intervention, this study should be suggested along with a list of varieties of foods in which to choose from, like the various healthful cereals and oatmeal but as mentioned above, other high fiber foods should also be options in order to not scare people away from breaking their diet or ever wanting to eat oats again!
Rachel,
I definitely agree with you that telling someone to eat 2 servings of RTE cereals a day is not enough to really intervene in changing their diet around. I also think it is important to go through which cereals to choose and not choose. As mentioned in the article summary, blood pressure really was not effected and some of this could be due to the fact that many cereals and whole grain products like breads contain a lot of sodium so this would be important to mention. But going along with what Rachel said, just recommending RTE cereals is not enough so mentioning this intervention could be part of another diet but in my opinion, not a diet on it's own.
I believe this is a realistic intervention for the general public. Most people are busy and unwilling to make a huge change at once. This might be a good way to introduce whole grains into the diet, although, I don’t think it’s necessary to consume RTE oat cereal twice a day for 3 months. I would suggest that someone do this for the first couple of weeks or first month, and gradually increase their whole grains from other sources and in other meals then on. Just like many mentioned, Kashi products, bran cereals and shredded wheat would all be great ways to switch up their breakfast meals.
I agree with Rachel that an additional intervention may be needed. Replacing saturated and trans fats with unsaturated fats would be beneficial for those who are ready and willing for change.
Without being part of a study, I imagine that 2 servings of a RTE oat cereal each day would become monotonous for a member of the general public. However, serving sizes of cereal are not very large to begin with, so a patient could most likely eat those two servings at once, and eliminate any repetition throughout their day. On the other hand, if serving size and portion control were the main goals, and those two servings were meant to be eaten at different times of the day, I think a normal person would tire of this cereal long before the 12-week mark. The intervention sounds more like a fad diet, like the “Special K” diet, than a lifestyle change. I would suggest that the patient replace as many of their other grain sources with whole grains, i.e. bread and pasta. If the focus is not solely whole grain, I would suggest the patient try to increase their intake of fruits, and vegetables, and branch out to other fiber-rich cereals as well.
I think that this could be a realistic intervention for someone who is serious about lowering cholesterol levels. I can also see where someone could grow tired of this, as well. For the purpose of this study, I think it works well, but in a real life situation I would recommend other sources of soluble fiber. In addition to the ready-to-eat cereal, the patient could consume nuts, oranges, apples, beans and peas, etc. to achieve the desired effect.
I agree with Rachel W. that consumption of the ready-to-eat cereal should be used as part of an overall intervention. There are additional recommendations that can be made to help lower LDL cholesterol. This could help break up the monotony that one might feel by consuming the cereal on a daily basis.
Bethany, you make a good point about how RDs stress variety in the diet. This diet could work great for some and not so great for others who get bored with the same old choices. It is important to have variety and I definitely agree with you on that.
I agree with Rachel in that this could work well for a primary intervention, but other dietary changes should be enforced to improve others areas of clients/general public health. This diet is a good starting point, but it may not be for everyone and individualization is key!
I think that this intervention could definitely work if the patient was aware of the commitment to eating it daily and liked oat cereal. There are many modifications that can be made to the cereal to make it less monotonous and help if the client is sick of eating the cereal. Some way to alter the cereal is to add fruit, honey, cinnamon, etc. They can also try making their oat servings into other things, such as cereal bars or baking the oats into another products.
Bethany,
I agree with your statement about stressing variety. That is the only problem that I had with this study. I feel that they may be sending the wrong message on how to maintain a healthy lifestyle with food choices if they are pushing the one same food item for three months.
I think that it is realistic in that it is easy to prepare and purchase. However, any diet that repeats the same food day after day will not likely result in sustainable eating-related behavioral changes. The optimal intervention would be to increase ALL kinds of foods with higher levels of soluble fiber. These include fruits and vegetables (apples, carrots, cauliflower, and citrus fruits), nuts, barley, flax seed, dry beans and peas, and oat/oat bran.
I don't think this is a realistic intervention at all and I would hesitate to recommend it. Looking back at the original study, the average weight loss was only 1.7 kg after 12 weeks! Not enough weight loss to motivate anyone. Also, I don't think I could justify asking a client to commit to 2 servings of the same cereal a day for 12 weeks - people have trouble staying on the Special K diet for 2 weeks! If a client asked for replacement suggestions I think I'd steer him/her to oatmeal, bran and fiber-rich fruits and veggies as others have said.
I agree with everyone in their defense against this intervention not being realistic for the general public; however, it is important to keep in mind that 2 servings of ready to eat cereal is really not that much. In concurrence with Rachel's statement, for the general public, I can only assume that that one serving of cereal would actually end up being 2-3 servings. Of course additional information would need to be presented to these patients and the importance of balance, moderation and variety most certainly should be addressed; however, we need to keep in mind the importance of taking baby steps towards better health (perhaps first by incorporating more cereal/fiber rich foods into their diet).
I believe that this intervention is fairly realistic for most individuals. However, as many have already pointed out, 2 servings of RTE oatmeal every single day will become monotonous very fast. I believe that variety is important in any diet, and providing more high fiber options will (hopefully) keep participants 'on track' and prevent 'cheating' or noncompliance with the diet.
Sarah Gervais
Shelby- you make a really good point- there are so many other factors that contribute to weight loss and a healthy lifestyle. I think it is so important to keep this perspective when looking at interventions, it is sometimes hard to look at the 'whole picture' when reading a research article focusing on one component of diet.
Sarah Gervais
I find this to be pretty realistic for the general public. Cereal is a commonly consumed food and it is very easy to prepare. For those who may tire of eating RTE oat cereals every day, I would recommend maybe taking one day off here and there to have a different type of (healthy) breakfast. They could also try oatmeals or different cereals products that have similar health benefits.
Bethany, I really think you have a valid point about people who do complete this diet for 12 weeks shying away from grains afterward. That could definitely happen and obviously that is would not be a positive health outcome for those individuals. I also agree that variety is so important and that it would be crucial to emphasize getting nutrients from a large variety of foods and giving clients several options so they pick and choose what works for them.
I think that this intervention is realistic because it seems simple enough and easy for someone to follow. I do agree with some of the others that have said that it may become boring for the patients. It seems like this could be a good jumping off point to make small changes in someone's diet, but other changes would need to follow to continue improvement.
I agree with Rachel W. about adding other changes to the intervention. Soluble fiber is just one way to help reduce LDL cholesterol. Maybe lowering sat. fat, adding plant sterols, omega 3's, etc would help even more with LDL reduction.
Anna Taylor:
I think this would be a realistic intervention for much of the general public. Americans love their super-sized portions anyway, so I wouldn't be surprised if a member of the general public thought this was a pretty easy way to improve their lipid panel. People like quick fixes, and they don't want to have to do something for the rest of their lives, they want a "diet" that only lasts a couple weeks or months. 12 weeks is realistic, plus they only have to think about their diet for one meal of the day. Sounds like a quick fix to me. I wish there was more of an emphasis on lifestyle changes though, to maintain improvements and needed weight loss.
Anna Taylor said:
Alison~
That's a really good point that a 1.7 lb weight loss isn't enough to motivate hardly anyone. However, any positive lipid panel improvements gleaned during the 12 weeks might be enough to motivate people to continue making small changes in their diet, or at least to keep up with the extra soluble fiber.
I think this intervention is realistic. If I were a participant I would consider preparation and price. Both of which are simple in this case. I would definitely get bored with the RTE cereal during the given time frame. As an RD I would recommend incorporating flax into daily food items and of course increasing fruits and vegetables such as apples and carrots. The purpose of this study is not to promote RTE cereals, therefore; they should have included a variety of sources to incorporate with equivalent amounts of cholesterol lowering contributors.
I don't think asking folks to eat two servings a day of oat RTE is too much to ask, though I agree that cereal alone is not enough to control weight and cholesterol. It's a good first step, however. Maybe if someone tried the oat cereal and saw a decrease in their waist circumference and lipid profile they would be motivated to start other interventions as well.
Nicole-- good call on the cheap and easy to prepare comment. So often people commit to expensive prescription meds before trying other, more practical/sustainable options.
Meredith-- you are right...some aspects of this program do sound like a fad diet. For the purposes of the study, I understand sticking with one cereal for the duration, but in real life and practice it would definitely be a good idea to stress variety and give patients several options. Coming up with ways to get the soluble fiber in at other meals would most likely be beneficial too.
I do think that this is a realistic intervention for the general public. In America, many people do not eat proper portions of food anyway, so one serving of the ready to eat oat cereal for breakfast may not be enough for many people. Therefore, doubling the amount of the cereal at breakfast would be an easy way to get both daily servings in and help with participants feel satisfied. If some people feel that is too large of an amount to eat at once, it would be easy to incorporate one more serving of the cereal in as a snack somewhere during the day. As for patients’ complaints of being tired of eating the RTE oat cereal, breakfast is the one meal of the day when most people eat the same thing everyday anyway. However, if this happens, participants could substitute other cereals high in soluble fiber for the RTE oat cereal.
Amy,
I think you make some excellent points. First of all, I completely agree that the point of this study is not to promote the RTE oat cereal; the participants would have benefited from having other food options with cholesterol lowering properties. I also think you are right about the benefit of low price and easy preparation of the RTE cereal. Unfortunately, in the U.S., people want easy fixes that come with tangible results, and this RTE cereal intervention may be just that for some people.
Melissa -
I definitely agree that there are many modifications that can be made to the cereal to make it less monotonous. It doesn't always have to be the same plain oatmeal. Adding a different fruit everyday or even eating it at a different meal might really help.
I do see how this type of intervention would be beneficial for those most interested in cost and ease of preparation. However, I think that variety and a long-term lifestyle change would be far more advantageous for the general public.
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