A cost-effective and interactive way of promoting healthy nutrition behaviors among adolescents is using information and communication technologies (ICTs). We systematically reviewed studies to identify technologies and their main characteristics used for nutritional interventions for adolescents, as well as to evaluate their quality and effectiveness. Our full protocol is available on the PROSPERO website (#CRD42016035882). A search was conducted across five databases for articles describing nutritional interventions that used ICTs designed mainly for healthy adolescents. Randomized controlled trials, quasi-experimental and observational studies, and full and original papers, all of them published from 2005 to 2015, were included. Study quality was assessed by the Effective Public Health Practice Project Quality Assessment Tool. Our search yielded 559 titles and abstracts. Eleven studies met the inclusion criteria. Participants were recruited mostly from schools. Study follow-up ranged from two weeks to two years. Four interventions were based on the Social Cognitive Theory. Interventional strategies included computer games, programs, text messages, and interactive CD-ROMs. Nine studies used computer-mediated ICTs. Five studies focused on multiple behaviors simultaneously. Participants were exposed to interventions only once, daily, weekly, or according to a pre-determined number of lessons. Five studies had significant outcomes. Our quality assessment revealed three studies to be weak due to non-representativeness of their samples and usage of non-validated questionnaires. Besides the heterogeneity and poor quality of the analyzed studies, it can be suggested that long-term interventions for adolescents that make use of frequent exposure to technological resources, and that have a theoretical component aimed at a single health behavior change, tend to be more successful.
While prior research reported altered fuel utilization stemming from pre-exercise modified starch ingestion, the practical value of this starch for endurance athletes who consume carbohydrates both before and during exercise is yet to be examined. The purpose of this study was to determine the effects of ingesting a hydrothermally-modified starch supplement (HMS) before and during cycling on performance, metabolism, and gastrointestinal comfort. In a crossover design, 10 male cyclists underwent three nutritional interventions: (1) a commercially available sucrose/glucose supplement (G) 30 min before (60 g carbohydrate) and every 15 min during exercise (60 g∙h−1); (2) HMS consumed at the same time points before and during exercise in isocaloric amounts to G (Iso HMS); and (3) HMS 30 min before (60 g carbohydrate) and every 60 min during exercise (30 g·h−1; Low HMS). The exercise protocol (~3 h) consisted of 1 h at 50% Wmax, 8 × 2-min intervals at 80% Wmax, and 10 maximal sprints. There were no differences in sprint performance with Iso HMS vs. G, while both G and Iso HMS likely resulted in small performance enhancements (5.0%; 90% confidence interval = ±5.3% and 4.4%; ±3.2%, respectively) relative to Low HMS. Iso HMS and Low HMS enhanced fat oxidation (31.6%; ±20.1%; very likely (Iso); 20.9%; ±16.1%; likely (Low), and reduced carbohydrate oxidation (−19.2%; ±7.6%; most likely; −22.1%; ±12.9%; very likely) during exercise relative to G. However, nausea was increased during repeated sprints with ingestion of Iso HMS (17 scale units; ±18; likely) and Low HMS (18; ±14; likely) vs. G. Covariate analysis revealed that gastrointestinal distress was associated with reductions in performance with Low HMS vs. G (likely), but this relationship was unclear with Iso HMS vs. G. In conclusion, pre- and during-exercise ingestion of HMS increases fat oxidation relative to G. However, changes do not translate to performance improvements, possibly owing to HMS-associated increases in gastrointestinal distress, which is not attenuated by reducing the intake rate of HMS during exercise.
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