Susan B Roberts's research while affiliated with University of Alabama at Birmingham and other places

Publications (277)

Article
Water is essential for survival, but one in three individuals worldwide (2.2 billion people) lacks access to safe drinking water. Water intake requirements largely reflect water turnover (WT), the water used by the body each day. We investigated the determinants of human WT in 5604 people from the ages of 8 days to 96 years from 23 countries using...
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In mammals, trait variation is often reported to be greater among males than females. However, to date, mainly only morphological traits have been studied. Energy expenditure represents the metabolic costs of multiple physical, physiological, and behavioral traits. Energy expenditure could exhibit particularly high greater male variation through a...
Chapter
The energy requirement of a human being is the average amount of available food energy needed to sustain normal body weight and physical activity, and taking into account any special needs causing an increase in requirements associated with children's growth, illness, pregnancy, and lactation. The doubly labeled water method of measuring total ener...
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Background Personalizing approaches to prevention and treatment of obesity will be a crucial aspect of precision health initiatives. However, in considering individual susceptibility to obesity, much remains to be learned about how to support healthy weight management in different population subgroups, environments and geographical locations. Subj...
Article
Dietary energy is the deceptively simple name for the scientific term metabolizable energy. Metabolizable energy is defined as the amount of energy available to the body from food after accounting for the obligatory energy losses, mostly in stool and urine. Most dietary energy comes from dietary fat, protein, and carbohydrate. Dietary energy is use...
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Objective Restaurants may be important settings for interventions to reduce children’s energy intake. The objective of this study was to test the impact of a parent-focused social marketing campaign to promote healthy children’s meals on calories ordered and consumed by children at quick-service restaurants (QSRs). Design Using a repeated cross-se...
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The burden of obesity and chronic disease is increasing in the older US Hispanic/Latino adult population. There is limited evidence on successful weight management strategies as perceived by this population. Assessing barriers and opportunities for weight management using mixed methods is a robust approach to collect in‐depth information that can b...
Article
Background Development of methods to accurately measure dietary intake in free-living situations – restaurants or otherwise – is critically needed to understand overall dietary patterns. Objective This study aimed to develop and test reliability and validity of digital images (DI) for measuring children’s dietary intake in quick-service restaurant...
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In low- and middle-income countries (LMIC), growth impairment is common; however, the trajectory of growth over the course of the first month has not been well characterised. To describe newborn growth trajectory and predictors of growth impairment, we assessed growth frequently over the first 30 days among infants born ≥2000 g in Guinea-Bissau, Ne...
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Lower ambient temperature (Ta) requires greater energy expenditure to sustain body temperature. However, effects of Ta on human energetics may be buffered by environmental modification and behavioral compensation. We used the IAEA DLW database for adults in the USA (n = 3213) to determine the effect of Ta (-10 to +30°C) on TEE, basal (BEE) and acti...
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Objectives There is controversy over the extent to which initial weight loss in behavioral weight control interventions predicts long-term success. In this study, we aimed to identify typical weight trajectories, develop an algorithm to automatically classify participants’ performance, and examine the capacity for long-term prediction of weight los...
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Objectives The effect of calorie restriction (CR) on cognitive function is controversial, and the effects of consuming a healthy dietary pattern during CR have not been investigated. Furthermore, there is no consensus on what dietary pattern may be the most beneficial for cognition. We analyzed the combined effects of CR and self-selected diet on m...
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Objectives Poor meal timing (MT) habits, such as irregular day-to-day eating and eating late at night, increase the risk for weight gain and developing chronic diseases such as type 2 diabetes and cardiovascular disease. We examined two potential barriers to improving MT habits, overall hunger level and time of day of greatest hunger, in relation t...
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Objectives People with physical disabilities (PWD) are at increased risk for developing obesity and weight-related comorbidities compared to the general population. While some barriers to weight loss (WL) are known, many behavioral, environmental, and psychological contributors to WL and weight loss maintenance (WLM) have yet to be identified for P...
Chapter
Lifestyle interventions for weight loss combine support for changing diet and physical activity with weight management education and are considered the first line treatment for obesity. A variety of diet-focused interventions including time-restricted eating are also increasingly being promoted for weight management. This chapter reviews different...
Article
Objectives The aim was to determine the nutritional adequacy of calorie restricted (CR) diets during CR interventions up to 12 months. Methods The Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy (CALERIE™) phase 1 trial consisted of 3 single-site studies to test the feasibility and effectiveness of CR in adults without o...
Article
In the Men’s Lifestyle Validation Study (2011-2013), we examined the validity and relative validity of a physical activity questionnaire (PAQ), web-based 24-hour recalls (ACT24) and accelerometers by multiple comparison methods. Over one year, 609 men completed two PAQs, two 7-day accelerometer measures, one doubly labeled water (DLW)-physical acti...
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Childhood undernutrition is a major health burden worldwide that increases childhood morbidity and mortality and causes impairment in infant growth and developmental delays that can persist into adulthood. The first weeks and months after birth are critical to the establishment of healthy growth and development during childhood. The World Health Or...
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Low total energy expenditure (TEE, MJ/d) has been a hypothesized risk factor for weight gain, but repeatability of TEE, a critical variable in longitudinal studies of energy balance, is understudied. We examine repeated doubly labeled water (DLW) measurements of TEE in 348 adults and 47 children from the IAEA DLW Database (mean ± SD time interval:...
Article
Despite the utility of social cognitive theory for facilitating individual behavior changes needed for initial weight loss, this model has been less effective in facilitating adherence to recommended lifestyle changes required for sustainable weight‐loss maintenance. One potential reason for the limited long‐term effectiveness of lifestyle interven...
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Background: Physical activity may be a way to increase and maintain fat-free mass (FFM) in later life, similar to the prevention of fractures by increasing peak bone mass. Objectives: A study is presented of the association between FFM and physical activity in relation to age. Methods: In a cross-sectional study, FFM was analyzed in relation t...
Article
Background & Aims Unrestrained eating behavior has been thought to be a proxy for diet frequency, timing, and caloric intake. We investigated the association of unrestrained eating with mortality risk in the Nurses’ Health Study prospectively. Methods During follow-up (1994-2016), 21953 deaths were documented among 63999 eligible participants in a...
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A lifetime of change Measurements of total and basal energy in a large cohort of subjects at ages spanning from before birth to old age document distinct changes that occur during a human lifetime. Pontzer et al . report that energy expenditure (adjusted for weight) in neonates was like that of adults but increased substantially in the first year o...
Article
Background: Lifestyle interventions are the first-line treatment for obesity, but participant weight loss is typically low. Objectives: We evaluated the efficacy of an alternative lifestyle intervention [Healthy Weight for Living (HWL)] compared with a modified Diabetes Prevention Program (m-DPP). HWL was based on a revised health behavior chang...
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Understanding the impacts of activity on energy balance is crucial. Increasing levels of activity may bring diminishing returns in energy expenditure because of compensatory responses in non-activity energy expenditures.1, 2, 3 This suggestion has profound implications for both the evolution of metabolism and human health. It implies that a long-te...
Article
Background: Unrestrained eating behavior, as a potential proxy for diet frequency, timing, and caloric intake, has been questioned as a plausible risk factor for digestive system cancers, but epidemiological evidence remains sparse. Objectives: We investigated prospectively the associations between unrestrained eating behavior and digestive syst...
Article
Objectives Emerging evidence suggests that anti-inflammatory dietary patterns may improve depression, stress, and quality of life. Similar benefits are observed during weight loss interventions; however, the effect of combining these dietary patterns with weight loss is not clear. We evaluated the association between dietary inflammation and measur...
Article
Objectives There is persistent controversy over the extent to which different components of energy expenditure disproportionately decrease after weight loss and contribute to weight regain through decreased energy requirements. We conducted a secondary analysis of the CALERIE I study to test the hypothesis that decreased resting metabolic rate (RMR...
Article
The amount of time spent in poor health at the end of life is increasing. This narrative review summarizes consistent evidence indicating that healthy dietary patterns and maintenance of a healthy weight in the years leading to old age are associated with broad prevention of all the archetypal diseases and impairments associated with aging includin...
Article
Physiological adaptations to intentional weight loss can facilitate weight regain. This review summarizes emerging findings on hypothalamic and brainstem circuitry in the regulation of body weight and identifies promising areas for research to improve therapeutic interventions for sustainable weight loss. There is good evidence that body weight is...
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Breastfeeding is the gold standard for feeding infants because of its long-term benefits to health and development, but most infants in the United States are not exclusively breastfed in the first six months. We enrolled 24 infants who were either exclusively breastfed or supplemented with formula by the age of one month. We collected diet informat...
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The doubly labeled water (DLW) method measures total energy expenditure (TEE) in free-living subjects. Several equations are used to convert isotopic data into TEE. Using the International Atomic Energy Agency (IAEA) DLW database (5,756 measurements of adults and children), we show considerable variability is introduced by different equations. The...
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Background Self-monitoring food intake is a cornerstone of national recommendations for health, but existing apps for this purpose are burdensome for users and researchers, which limits use. Objective We developed and pilot tested a new app (COCO Nutritionist) that combines speech understanding technology with technologies for mapping foods to app...
Preprint
BACKGROUND Self-monitoring food intake is a cornerstone of national recommendations for health, but existing applications are burdensome, which limits use. OBJECTIVE We developed and pilot tested a new app (COCO Nutritionist) that combines speech understanding technology with technologies for mapping foods to appropriate food composition codes in...
Article
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(1) Background: The influence of food culture on eating behavior and obesity risk is poorly understood. (2) Methods: In this qualitative study, 25 adults in France with or without overweight/obesity participated in semi-structured interviews (n = 10) or focus groups (n = 15) to examine attitudes to food consumption and external pressures that influ...
Article
Objective There is substantial variability in the effectiveness of group lifestyle interventions for weight loss. We examined associations between intervention weight loss counselors and participant weight loss and program engagement in a structured lifestyle intervention. Methods Data were from 575 adults (87% female, 51 (12) years, baseline BMI:...
Article
Background Emerging research indicates that eating timing may influence dietary intake and metabolic health. However, studies to date have not examined the association of multiple measures of eating timing with both dietary intake and metabolic health in adults with overweight and obesity. Objective To examine the association of multiple measures...
Article
Caloric restriction (CR) is a strategy that attenuates aging in multiple nonhuman species. The Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) trials are part of a research program aiming to test the effects of CR on aging and longevity biomarkers in humans. Building on CALERIE phase 1, CALERIE phase 2 (CALERIE...
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Objective To assess the effects of food supplementation on improving working memory and additional measures including cerebral blood flow in children at risk of undernutrition. Design Randomized controlled trial. Setting 10 villages in Guinea-Bissau. Participants 1059 children aged 15 months to 7 years; children younger than 4 were the primary p...
Article
Objectives Self-monitoring daily dietary intake is recommended for weight loss and weight loss maintenance. However, current online platforms and applications are often burdensome, which may limit use. We conducted a pilot study to evaluate the accuracy of a new application designed to self-monitor dietary intake using natural spoken language (COCO...
Article
Objectives Globally, more than 200 million children under 5 experience wasting and stunting. Wasting and stunting often begin during early infancy and have detrimental impacts on childhood health. Understanding local perspectives on feeding during early infancy might allow the design of interventions to improve early infant growth. The purpose of t...
Article
Objectives The doubly labeled water (DLW) method is the gold standard for assessing total energy expenditure (TEE), but is costly. Questionnaires and prediction equations for TEE are nearly cost-free but research on their validity is scarce. We evaluated the validity of TEE assessed by two questionnaires and two prediction equations in comparison w...
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Objectives Anti-inflammatory diets have been suggested to improve psychological health. This research evaluated the combined effects of consuming an anti-inflammatory diet and caloric restriction (CR) on changes in perceived stress and health-related quality of life in a healthy, non-obese population. Methods We conducted a secondary analysis of t...
Poster
Objectives Cultural factors influence obesity risk, but this relationship has not been systematically studied due to the lack of a validated survey instrument. The objective of this project was to develop a prototype questionnaire to assess the relationship between body mass index (BMI) and sociocultural factors. Methods Interviews and focus group...
Article
Food cravings are a desire for specific foods which, if uncontrolled may lead to excess energy intake and weight gain. However, information on the relation between food cravings, dietary intake, and indices of metabolic health is limited. This study used baseline data from females (n = 229; aged 40.9 ± 0.7 years; BMI 34.7 ± 6.4 kg/m²) who were depe...
Article
Background: Quick-service restaurants (QSRs) serve one-third of US children on any given day, yet no methods can directly measure energy (kcal) consumed in QSRs. Weighed plate waste is one feasible option, but the accuracy is unknown. Objective: The objective of this study was to determine the accuracy of weighed plate waste for measuring childr...
Article
Background: For several cardiometabolic risk factors, values considered within normal range are associated with an increased risk of cardiovascular morbidity and mortality. We aimed to investigate the short-term and long-term effects of calorie restriction with adequate nutrition on these risk factors in healthy, lean, or slightly overweight young...
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Environmental factors such as food availability and variety can function as cues for overeating in individuals susceptible to overweight or obesity, but relatively little is known about other types of environmental factors that may also be important. This qualitative study compared and contrasted categories of internal and external cues through foc...
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Objectives: To evaluate the effectiveness of a novel low-burden behavioral intervention (BI) for weight loss on changes in body weight and cardiometabolic risk factors when implemented with or without meal replacements (MR). Methods: Twelve worksites (≥300 employees each) in the Greater Boston area participated in a cluster-randomized controlled...
Article
Objectives: This study presents the design and implementation of Coco: The Conversational Calorie Counter, a spoken food logging application for iOS. The aim of this work is to reduce the burden on individuals wanting to monitor their food to support healthy eating, as well as individuals with obesity tracking food intake to manage their weight....
Article
Objectives: Undernutrition is prevalent among young children worldwide and is associated with impaired cognition and reduced educational attainment. We conducted a randomized controlled trial to test the effect of a novel supplementary food (regenerative nutrition for enhanced wellness-cognition; RENEW-C) compared to traditional feeding practices...
Article
Objectives: Self-monitoring daily dietary intake is recommended for weight loss, weight maintenance, and healthy eating. However, current tracking methods are often burdensome and result in short-term use. We conducted a pilot study to evaluate the accuracy of a new application designed to self-monitor dietary intake using natural spoken language...
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Introduction Effective, standardized, and easily accessible weight management programs are urgently needed for military beneficiaries. Videoconference interventions have the potential for widespread scaling, and can provide both real time interaction and flexibility in delivery times regardless of location, but there is little information on their...
Article
Background: US national survey data shows fast food accounted for 11% of daily caloric intake in 2007-2010. Objective: To provide a detailed assessment of changes over time in fast-food menu offerings over 30 years, including food variety (number of items as a proxy), portion size, energy, energy density, and selected micronutrients (sodium, cal...
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Objective To measure the energy content of frequently ordered meals from full service and fast food restaurants in five countries and compare values with US data. Design Cross sectional survey. Setting 223 meals from 111 randomly selected full service and fast food restaurants serving popular cuisines in Brazil, China, Finland, Ghana, and India w...
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Gluten-free (GF) eating patterns are frequently perceived to be healthier than gluten-containing (GC) ones, but there has been very little research to evaluate this viewpoint. The effect of GF eating patterns on dietary composition was assessed using two independent approaches. One approach compared macronutrients and typical shortfall nutrients be...
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Food and obesity are undoubtedly linked but the relation is complex. Michael Lean and colleagues discuss what we know, and what we don't know, about weight management © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to.
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Purpose: Programs focused on employee well-being have gained momentum in recent years, but few have been rigorously evaluated. This study evaluates the effectiveness of an intervention designed to enhance vitality and purpose in life by assessing changes in employee quality of life (QoL) and health-related behaviors. Design: A worksite-based ran...
Article
One barrier to achieving healthier eating patterns is the perceived higher cost of healthier food. The objective of this cross-sectional study was to investigate the potential association between cost and the nutrition quality among entrées from casual dining restaurants. Nutrition and price information were collected from 11 restaurants in Boston...
Article
Background: The ability to identify and measure behaviors that are related to weight loss and the prevention of weight regain is crucial to understanding the variability in response to obesity treatment and the development of tailored treatments. Objectives: The overarching goal of the Accumulating Data to Optimally Predict obesity Treatment (AD...
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Background Dietary bioactive compounds capable of improving metabolic profiles would be of great value, especially for overweight individuals undergoing a caloric restriction (CR) regimen. Curcumin (Cur), a possible anti-obesity compound, and piperine (Pip), a plausible enhancer of Cur’s bioavailability and efficacy, may be candidate agents for con...
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Background: Cognitive impairment associated with childhood malnutrition and stunting is generally considered irreversible. Objective: The aim was to test a new nutritional supplement for the prevention and treatment of moderate-acute malnutrition (MAM) focused on enhancing cognitive performance. Methods: An 11-wk, village-randomized, controlled pil...
Article
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Background: Emerging evidence suggests novel roles for bacterially derived vitamin K forms known as menaquinones in health and disease, which may be attributable in part to anti-inflammatory effects. However, the relevance of menaquinones produced by gut bacteria to vitamin K requirements and inflammation is undetermined.Objective: This study aimed...
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Purpose Calorie restriction (CR) improves health span and delays age-related diseases in many species. The multicenter Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) study was the first randomized controlled trial of CR in nonobese humans. The aim of this investigation was to determine the effects of CR on V˙O2...
Article
Two decades of research confirm that weight loss is about burning more calories than you consume—but what you eat is more important than how much you exercise
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Background Nutrition clubs (NC) operate in community settings and provide members with nutrition education and meal replacements for weight management. NC are owned and operated by distributors of Herbalife products. There are over 6200 NC in the US, but there has been no independent assessment of the association of these NC with biomarkers of heal...
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Background: There is no consensus over best approaches to reliably prevent malnutrition in rural communities in low-income countries. Objective: We compared the effectiveness of 2 lipid-based ready-to-use supplementary foods (RUSFs) differing in dairy protein content to improve the nutritional status of mothers and at-risk infants and young chil...
Article
Objective: To examine the association of program delivery factors with weight loss (WL) in enrollees in iDiet(®) , a commercial WL program. Methods: Data were from 644 adults enrolling in an 11-week group WL program and 461 who reported weight to 11 weeks (complete reporters). Predictors of %WL were analyzed using ANCOVA, including meeting type...
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Background Children regularly consume foods from quick-service restaurants (QSR), but little is known about the foods that children order, the calories and nutrients consumed, the accuracy of stated calorie information, or the ability to assess food orders and consumption in QSRs. This study evaluated the feasibility of plate waste collection in QS...
Article
Background: Calorie restriction (CR) retards aging and increases longevity in many animal models. However, it is unclear whether CR can be implemented in humans without adverse effects on body composition. Objective: We evaluated the effect of a 2-y CR regimen on body composition including the influence of sex and body mass index (BMI; in kg/m 2) a...
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Background: Calorie restriction (CR) retards aging and increases longevity in many animal models. However, it is unclear whether CR can be implemented in humans without adverse effects on body composition. Objective: We evaluated the effect of a 2-y CR regimen on body composition including the influence of sex and body mass index (BMI; in kg/m 2) a...
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Interest is rapidly growing around the role of the human gut microbiota in facilitating beneficial health effects associated with consumption of dietary fiber. An evidence map of current research activity in this area was created using a newly developed database of dietary fiber intervention studies in humans to identify studies with the following...
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Background: The effect of whole grains on the regulation of energy balance remains controversial. Objective: We aimed to determine the effects of substituting whole grains for refined grains, independent of body weight changes, on energy-metabolism metrics and glycemic control. Design: The study was a randomized, controlled, parallel-arm controlled...
Article
Background: The nutrition status of primary schoolchildren in Africa has received relatively little attention in comparison to that of younger children. We surveyed primary school students in Guinea-Bissau, a nation that is among the poorest in the world. Objective: Anthropometry and prevalence of anemia and vitamin A deficiency were assessed in...
Article
In Reply Tufan, Soyluk, and Karan identify important questions related to our article¹ demonstrating the effects of calorie restriction on health-related quality of life. In our study, we conclude that, compared with an ad libitum control group, 2 years of calorie restriction in nonobese healthy adults resulted in significant improvements in differ...