Evidence map›Paper›PMID 30466438›Full record

Trial reportBMC pediatrics2018

Using neuroimaging to investigate the impact of Mandolean® training in young people with obesity: a pilot randomised controlled trial.

Elanor C Hinton, Laura A Birch, John Barton, Jeffrey M P Holly, Kalina M Biernacka, Sam D Leary, Aileen Wilson, Olivia S Byrom, Julian P Hamilton-Shield

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC pediatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 15 citations in OpenAlex.

  1. Trial
  2. Review
  3. Structural and Functional Brain Changes in Children and Adolescents With Obesity.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2025
    Review
  4. The Use of Complementary and Alternative Treatments in Adolescent Obesity: A Narrative Review.International journal of environmental research and public health · 2025
    Review
  5. Article
  6. Evidence Base Update on Behavioral Treatments for Overweight and Obesity in Children and Adolescents.Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53 · 2023
    Review
  7. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Elanor C HintonNIHR Bristol Biomedical Research Centre Nutrition Theme, University of Bristol, University Hospitals Bristol Education & Research Centre, Upper Maudlin Street, Bristol, BS2 8AE, UK. elanor.hinton@bristol.ac.uk.ORCID 0000-0003-2793-8552
Laura A BirchNIHR Bristol Biomedical Research Centre Nutrition Theme, University of Bristol, University Hospitals Bristol Education & Research Centre, Upper Maudlin Street, Bristol, BS2 8AE, UK.
John BartonDepartment of Paediatric Endocrinology and Diabetes, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, UK.
Jeffrey M P HollySchool of Translational Health Sciences, IGFs and Metabolic Endocrinology, University of Bristol, Second Floor, Learning and Research, Southmead Hospital, Westbury-on-Trym, Bristol, BS10 5NB, UK.
Kalina M BiernackaSchool of Translational Health Sciences, IGFs and Metabolic Endocrinology, University of Bristol, Second Floor, Learning and Research, Southmead Hospital, Westbury-on-Trym, Bristol, BS10 5NB, UK.
Sam D LearyNIHR Bristol Biomedical Research Centre Nutrition Theme, University of Bristol, University Hospitals Bristol Education & Research Centre, Upper Maudlin Street, Bristol, BS2 8AE, UK.
Aileen WilsonClinical Research and Imaging Centre (CRICBristol), 60 St Michael's Hill, Bristol, BS2 8DX, UK.
Olivia S ByromNIHR Bristol Biomedical Research Centre Nutrition Theme, University of Bristol, University Hospitals Bristol Education & Research Centre, Upper Maudlin Street, Bristol, BS2 8AE, UK.
Julian P Hamilton-ShieldNIHR Bristol Biomedical Research Centre Nutrition Theme, University of Bristol, University Hospitals Bristol Education & Research Centre, Upper Maudlin Street, Bristol, BS2 8AE, UK.
University of Bristol · GBBristol Royal Hospital for Children · GBSouthmead Hospital · GBSt Michael's Hospital · GB

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundSlowing eating rate using the Mandolean® previously helped obese adolescents to self-select smaller portion sizes, with no reduction in satiety, and enhanced ghrelin suppression. The objective of this pilot, randomised trial was to investigate the neural response to food cues following Mandolean® training using functional Magnetic Resonance Imaging (fMRI), and measures of ghrelin, PYY, glucose and self-reported appetite.

methodTwenty-four obese adolescents (11-18 years; BMI ≥ 95th centile) were randomised (but stratified by age and gender) to receive six-months of standard care in an obesity clinic, or standard care plus short-term Mandolean® training. Two fMRI sessions were conducted: at baseline and post-intervention. These sessions were structured as an oral glucose tolerance test, with food cue-reactivity fMRI, cannulation for blood samples, and appetite ratings taken at baseline, 30 (no fMRI), 60 and 90 min post-glucose. As this was a pilot trial, a conservative approach to the statistical analysis of the behavioural data used Cliff's delta as a non-parametric measure of effect size between groups. fMRI data was analysed using non-parametric permutation analysis (RANDOMISE, FSL).

resultsFollowing Mandolean® training: (i) relatively less activation was seen in brain regions associated with food cue reactivity after glucose consumption compared to standard care group; (ii) 22% reduction in self-selected portion size was found with no reduction in post-meal satiety. However, usage of the Mandolean® by the young people involved was variable and considerably less than planned at the outset (on average, 28 meals with the Mandolean® over six-months).

conclusionThis pilot trial provides preliminary evidence that Mandolean® training may be associated with changes in how food cues in the environment are processed, supporting previous studies showing a reduction in portion size with no reduction in satiety. In this regard, the study supports targeting eating behaviour in weight-management interventions in young people. However, given the variable usage of the Mandolean® during the trial, further work is required to design more engaging interventions reducing eating speed.

trial registrationISRCTN, ISRCTN84202126 , retrospectively registered 22/02/2018.

Indexed as

Feeding BehaviorMagnetic Resonance ImagingNeuroimagingAdolescentAppetite RegulationBlood GlucoseBrainChildCuesDietary SugarsFeasibility StudiesFemaleGhrelinGlucose Tolerance TestHumansMaleBlood GlucoseDietary SugarsGhrelinAdolescentsBrainEating ratefMRIObesitySatiety

Identifiers

PMID30466438
PMCPMC6251126
OpenAlexW2901719114

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.