TY - JOUR AU - Saslow, R. Laura AU - Krinock, Jamie AU - O'Brien, Alison AU - Raymond, Kaitlyn AU - Bayandorian, Hovig AU - Moskowitz, T. Judith AU - Daubenmier, Jennifer AU - Oliveri, Antonino AU - Marriott, J. Deanna AU - Griauzde, H. Dina AU - Speliotes, K. Elizabeth PY - 2025/1/10 TI - A Very Low?Carbohydrate Program in Adults With Metabolic Dysfunction?Associated Steatotic Liver Disease and Phospholipase Domain?Containing Protein 3 Risk Genotype: Pre-Post Intervention Study JO - JMIR Form Res SP - e60051 VL - 9 KW - metabolic dysfunction?associated steatotic liver disease KW - ketogenic diet KW - low carbohydrate KW - adult KW - genotype KW - insulin KW - insulin resistance KW - metabolic dysfunction KW - dietary pattern KW - type 2 diabetes KW - T2DM KW - single-arm pilot trial KW - liver function test KW - genome KW - non-alcoholic fatty liver disease N2 - Background: Insulin resistance and the G allele of rs738409 interact to create a greater risk of metabolic dysfunction?associated steatotic liver disease. Objective: This study aims to confirm that one promising way to reduce insulin resistance is by following a very low?carbohydrate (VLC) dietary pattern. Methods: Adults with rs738409-GG or -CG with liver steatosis and elevated liver function tests, were taught an ad libitum VLC diet, positive affect and mindful eating skills, goal setting, and self-monitoring and given feedback and coaching for 4 months. We measured liver steatosis, anthropometric, serum metabolic diet adherence, and quality of life measures. Results: In this small pilot trial, of the 11 participants enrolled, 9 (82%) participants completed outcomes. All 11 participants viewed at least 1 session of the intervention, and 8 (73%) participants viewed at least half of the sessions. Among the 9 participants who provided 4-month self-report information, intervention satisfaction was high (mean 6.22, 95% CI 5.58-6.85), with 5 (56%) participants rating the intervention the top score, and 4 (44%) participants reporting they did not plan to stop following the VLC diet. Across participants with a 4-month hepatic liver fat percent measurement, the percent change in liver fat was ?33.17% (95% CI ?86.48 to 20.14), and in only the participants who were adherent to the eating pattern, the percent change in liver fat was ?53.12% (95% CI ?71.25 to ?34.99). Amongst participants with a 4-month hepatic liver fat percent measurement, 6 out of 8 (75%) participants were considered responders, with a relative decline in liver fat ?30%, and of the 9 participants with a 4-month body weight, 9 (100%) participants lost ?5% of their body weight. There were no serious adverse events. Conclusions: Results suggest the feasibility, acceptability, and preliminary efficacy of the VLC intervention in adults with higher genetic risk for metabolic dysfunction?associated steatotic liver disease, although there is a need for further studies given the small sample size and the high risk of substantial biases in this small pilot study. UR - https://formative.jmir.org/2025/1/e60051 UR - http://dx.doi.org/10.2196/60051 ID - info:doi/10.2196/60051 ER - TY - JOUR AU - Adamou, Marios AU - Jones, L. Sarah AU - Kyriakidou, Niki AU - Mooney, Andrew AU - Pattani, Shriti AU - Roycroft, Matthew PY - 2025/1/9 TI - Measuring Self-Reported Well-Being of Physicians Using the Well-Being Thermometer: Cohort Study JO - JMIR Form Res SP - e54158 VL - 9 KW - well-being KW - health care professionals KW - mental health KW - well-being thermometer KW - health care N2 - Background: Advancements in medical science have focused largely on patient care, often overlooking the well-being of health care professionals (HCPs). This oversight has consequences; not only are HCPs prone to mental and physical health challenges, but the quality of patient care may also endure as a result. Such concerns are also exacerbated by unprecedented crises like the COVID-19 pandemic. Compared to other sectors, HCPs report high incidence of stress, depression, and suicide, among other challenging factors that have a significant negative impact on their well-being. Objective: Given these substantial concerns, the development of a tool specifically designed to be used in clinical settings to measure the well-being of HCPs is essential. Methods: A United Kingdom?based cross-sectional pilot study was carried out to measure self-reported well-being in a cohort of 148 physicians, using the newly developed well-being thermometer. The aim of the tool is to allow respondents to develop an individual sense of ?well-being intelligence? thus supporting HCPs to have better insight and control over their well-being and allow insights into how to manage it. The tool consists of 5 well-being domains?health, thoughts, emotions, spiritual, and social. Each domain can be measured individually or combined to produce an overall well-being score. Results: The tool demonstrated good internal consistency; the Cronbach ? in this study was 0.84 for the total scale. Conclusions: Results from this cohort demonstrated that the well-being thermometer can be used to gather intelligence of staff well-being. This is a promising new tool that will assist HCPs to recognize their own well-being needs and allow health care organizations to facilitate change in policies and practices to reflect a better understanding of staff well-being. UR - https://formative.jmir.org/2025/1/e54158 UR - http://dx.doi.org/10.2196/54158 ID - info:doi/10.2196/54158 ER -