Water consumption acutely reduces meal energy intake (EI) among middle‐aged and older adults. Our objectives were to determine if premeal water consumption facilitates weight loss among overweight/obese middle‐aged and older adults, and to determine if the ability of premeal water consumption to reduce meal EI is sustained after a 12‐week period of increased water consumption. Adults (n = 48; 55–75 years, BMI 25–40 kg/m2) were assigned to one of two groups: (i) hypocaloric diet + 500 ml water prior to each daily meal (water group), or (ii) hypocaloric diet alone (nonwater group). At baseline and week 12, each participant underwent two ad libitum test meals: (i) no preload (NP), and (ii) 500 ml water preload (WP). Meal EI was assessed at each test meal and body weight was assessed weekly for 12 weeks. Weight loss was ∼2 kg greater in the water group than in the nonwater group, and the water group (β = −0.87, P < 0.001) showed a 44% greater decline in weight over the 12 weeks than the nonwater group (β = −0.60, P < 0.001). Test meal EI was lower in the WP than NP condition at baseline, but not at week 12 (baseline: WP 498 ± 25 kcal, NP 541 ± 27 kcal, P = 0.009; 12‐week: WP 480 ± 25 kcal, NP 506 ± 25 kcal, P = 0.069). Thus, when combined with a hypocaloric diet, consuming 500 ml water prior to each main meal leads to greater weight loss than a hypocaloric diet alone in middle‐aged and older adults. This may be due in part to an acute reduction in meal EI following water ingestion.

Introduction Energy-containing beverages, specifically sugar-sweetened beverages (SSB), may contribute to weight gain and obesity development. Yet, no rapid assessment tools are available which quantify habitual beverage intake (grams, energy) in adults. Objective Determine the factorial validity of a newly developed beverage intake questionnaire (BEVQ) and identify potential to reduce items. Methods Participants from varying economic and educational backgrounds (n=1,596; age 43±12 yrs; BMI 31.5±0.2 kg/m2) completed a 19-item BEVQ (BEVQ-19). Beverages that contributed <10% to total beverage, or SSB, energy and grams were identified for potential removal. Factor analyses identified beverage categories that could potentially be combined. Regression analyses compared BEVQ-19 outcomes with the reduced version’s (BEVQ-15) variables. Inter-item reliability was assessed using Cronbach’s Alpha. Following BEVQ-15 development, a subsequent study (n=70; age 37±2 yrs; BMI 24.5±0.4 kg/m2) evaluated the relative validity of the BEVQ-15 through comparison of three 24-hour dietary recalls’ (FIR) beverage intake. Results Three beverage items were identified for elimination (vegetable juice, meal replacement drinks, mixed alcoholic drinks); beer and light beer were combined into one category. Regression models using BEVQ-15 variables explained 91–99% of variance in the four major outcomes of the BEVQ-19 (all P<0.001). Cronbach’s Alpha ranged 0.97–0.99 for all outcomes. In the follow-up study, BEVQ-15 and FIR variables were significantly correlated with the exception of whole milk; BEVQ-15 SSB (R2=0.69) and total beverage energy (R2=0.59) were more highly correlated with FIR than previously reported for the BEVQ-19. The BEVQ-15 produced a lower readability score of 4.8, which is appropriate for individuals with a fourth grade education or greater. Conclusion The BEVQ-19 can be reduced to a 15-item questionnaire. This brief dietary assessment tool will enable researchers and practitioners to rapidly (administration time of ~2 min) assess habitual beverage intake, and to determine possible associations of beverage consumption with health-related outcomes, such as weight status.

Consumption of energy-containing beverages may lead to weight gain, yet research investigating this issue is limited. An easily-administered beverage intake assessment tool could facilitate research on this topic. The purpose of this cross-sectional investigation was to determine the validity and reliability of a self-administered beverage intake questionnaire (BEVQ), which estimates mean daily intake of beverages consumed (g, kcals) across 19 beverage categories. Participants (n=105; aged 39±2 yrs) underwent assessments of height, weight, body mass index, and dietary intake using 4-day food intake records (FIR) from June, 2008-June, 2009. The BEVQ was completed at two additional visits (BEVQ1, BEVQ2). Urine samples were collected to objectively determine total fluid intake and encourage accurate self-reporting. Validity was assessed by comparing BEVQ1 with FIR results; reliability was assessed by comparing BEVQ1 and BEVQ2. Analyses included descriptive statistics, bivariate correlations, paired samples t-tests, and independent samples t-tests. Self-reported water and total beverage intake (g) were not different between the BEVQ1 and FIR (mean difference: 129±77g [P=0.096] and 61±106g [P=0.567], respectively). Total beverage and sugar-sweetened beverage (SSB) energy intake were significantly different, although mean differences were small (63 and 44 kcal, respectively). Daily consumption (g) of water (r=0.53), total beverages (r=0.46), and SSB (r=0.49) determined by the BEVQ1 were correlated with reported intake determined by the FIR, as was energy from total beverages (r=0.61) and SSB (r=0.59) (all P<0.001). Reliability was demonstrated, with correlations (P<0.001) detected between BEVQ1 and BEVQ2 results. The BEVQ is a valid, reliable, and rapid self-administered dietary assessment tool.

The subjective nature of self-reported dietary intake assessment methods presents numerous challenges to obtaining accurate dietary intake and nutritional status. This limitation can be overcome by the use of dietary biomarkers, which are able to objectively assess dietary consumption (or exposure) without the bias of self-reported dietary intake errors. The need for dietary biomarkers was addressed by the Institute of Medicine, who recognized the lack of nutritional biomarkers as a knowledge gap requiring future research. The purpose of this article is to review existing literature on currently available dietary biomarkers, including novel biomarkers of specific foods and dietary components, and assess the validity, reliability and sensitivity of the markers. This review revealed several biomarkers in need of additional validation research; research is also needed to produce sensitive, specific, cost-effective and noninvasive dietary biomarkers. The emerging field of metabolomics may help to advance the development of food/nutrient biomarkers, yet advances in food metabolome databases are needed. The availability of biomarkers that estimate intake of specific foods and dietary components could greatly enhance nutritional research targeting compliance to national recommendations as well as direct associations with disease outcomes. More research is necessary to refine existing biomarkers by accounting for confounding factors, to establish new indicators of specific food intake, and to develop techniques that are cost-effective, noninvasive, rapid and accurate measures of nutritional status.

Young adults attending college are more vulnerable to weight gain than the general population. We sought to identify health behavior change targets related to weight management in college students. Based on the social cognitive theory model for health behavior change, we investigated the health-related lifestyle behaviors and physiological characteristics of this population. Forty-three college students (18.3±0.1 years) completed a series of quantitative assessments (body weight and composition, cardiorespiratory fitness, diet and activity habits) and structured qualitative assessments (structured interview or focus group). Participants were predominantly normal-weight (mean BMI=22.2±0.4 kg/m2) and fit (VO2max = 50.5±1.5 ml/kg/min). However, healthy eating and physical activity were not considered high priorities, despite having ample free time, high exercise self-efficacy, positive outcome expectations for exercise, and a desire to exercise more. Participants reported that regularly engaging in exercise was difficult. This may have been due to poor planning/time management, satisfaction with body image, lack of accountability and feelings of laziness. Dietary patterns generally met recommendations but were low in fruits, vegetables and whole grains. Social support for exercise and healthy dietary habits were important factors associated with health behaviors. Students reported a decline in exercise and dietary habits relative to high school, which may contribute to college weight gain. Our results suggest that this population may not have adequate self-regulatory skills, such as planning and self-monitoring, to maintain healthy behaviors in the college environment. Dietitians working with young adults attending college may use these findings to guide the behavioral therapy component of their weight management medical nutrition therapy goals and outcomes.