Dietary fiber and body weight

Pulse consumption, satiety, and weight management

The prevalence of obesity has reached epidemic proportions, making finding effective solutions to reduce obesity a public health priority. One part of the solution could be for individuals to increase consumption of nonoilseed pulses (dry beans, peas, chickpeas, and lentils), because they have nutritional attributes thought to benefit weight control, including slowly digestible carbohydrates, high fiber and protein contents, and moderate energy density. Observational studies consistently show an inverse relationship between pulse consumption and BMI or risk for obesity, but many do not control for potentially confounding dietary and other lifestyle factors. Short-term (≤1 d) experimental studies using meals controlled for energy, but not those controlled for available carbohydrate, show that pulse consumption increases satiety over 2-4 h, suggesting that at least part of the effect of pulses on satiety is mediated by available carbohydrate amount or composition. Randomized controlled trials generally support a beneficial effect of pulses on weight loss when pulse consumption is coupled with energy restriction, but not without energy restriction. However, few randomized trials have been conducted and most were short term (3-8 wk for whole pulses and 4-12 wk for pulse extracts). Overall, there is some indication of a beneficial effect of pulses on short-term satiety and weight loss during intentional energy restriction, but more studies are needed in this area, particularly those that are longer term (≥1 y), investigate the optimal amount of pulses to consume for weight control, and include behavioral elements to help overcome barriers to pulse consumption.

Effect of oat bran on time to exhaustion, glycogen content and serum cytokine profile following exhaustive exercise

The aim of this study was to evaluate the effect of oat bran supplementation on time to exhaustion, glycogen stores and cytokines in rats submitted to training. The animals were divided into 3 groups: sedentary control group (C), an exercise group that received a control chow (EX) and an exercise group that received a chow supplemented with oat bran (EX-O). Exercised groups were submitted to an eight weeks swimming training protocol. In the last training session, the animals performed exercise to exhaustion, (e.g. incapable to continue the exercise). After the euthanasia of the animals, blood, muscle and hepatic tissue were collected. Plasma cytokines and corticosterone were evaluated. Glycogen concentrations was measured in the soleus and gastrocnemius muscles, and liver. Glycogen synthetase-α gene expression was evaluated in the soleus muscle. Statistical analysis was performed using a factorial ANOVA. Time to exhaustion of the EX-O group was 20% higher (515 ± 3 minutes) when compared with EX group (425 ± 3 minutes) (p = 0.034). For hepatic glycogen, the EX-O group had a 67% higher concentrations when compared with EX (p = 0.022). In the soleus muscle, EX-O group presented a 59.4% higher glycogen concentrations when compared with EX group (p = 0.021). TNF-α was decreased, IL-6, IL-10 and corticosterone increased after exercise, and EX-O presented lower levels of IL-6, IL-10 and corticosterone levels in comparison with EX group. It was concluded that the chow rich in oat bran increase muscle and hepatic glycogen concentrations. The higher glycogen storage may improve endurance performance during training and competitions, and a lower post-exercise inflammatory response can accelerate recovery.

Effects of Fiber-Fortified Foods on Children With Constipation

The aim of this pilot study was to determine the acceptability of fiber fortification and its effect on gastrointestinal function, abdominal discomfort, and energy and fiber intakes in children with a history of constipation. Participants (n = 13; 2-10 years) were randomly assigned to 3-week fiber and placebo periods in a crossover design. Participants consumed snack foods with or without added pea hull fiber (1.4-3.4 g of fiber per serving), as well as inulin (4.5 g of fiber per day) or maltodextrin control added to beverages. Stool frequency, stool consistency, abdominal pain, and compliance were documented. Fiber fortification improved daily stool frequency (n = 10; 0.54 ± 0.18 vs 0.67 ± 0.26; P = .002) during weeks 2 and 3. No differences between treatments were found for estimated intestinal transit time or abdominal pain. Inulin was consumed more consistently than snacks. Mean energy intake was reduced with fiber versus placebo (n = 12; 1441 ± 285 vs 1307 ± 296 kcal/day; P < .05), and fiber intakes increased significantly (n = 12; 11.1 ± 2.6 vs 17.1 ± 2.5 g/day; P < .001). Fiber fortification was well accepted and significantly increased fiber intakes. Fiber fortification may lower energy intakes in constipated children, although the effect on bowel habits in this convenience sample remains unclear.

The effect of a fibre supplement compared to a healthy diet on body composition, lipids, glucose, insulin and other metabolic syndrome risk factors in overweight and obese individuals

Optimum levels and types of dietary fibre that provide the greatest beneficial effects on metabolic syndrome risk factors in overweight and obese individuals have yet to be determined in clinical trials. The present parallel design study compared the effects of fibre intake from a healthy dietv. a fibre supplement (psyllium) or a healthy diet plus fibre supplement on fasting lipids, glucose, insulin and body composition. Overweight/obese adults were randomised to either control (with placebo), fibre supplement (FIB), healthy eating plus placebo (HLT) or healthy eating plus fibre supplement (HLT–FIB). There was a significant increase in fibre intake in HLT–FIB, HLT and FIB groups up to 59, 31 and 55 g, respectively, at 12 weeks when compared to control (20 g). Weight, BMI and % total body fat were significantly reduced in FIB and HLT–FIB groups, with weight and BMI significantly reduced in the HLT group compared with control at 12 weeks. HLT–FIB and HLT groups had significant reductions in TAG and insulin compared with control at 6 and 12 weeks, and in insulin compared with the FIB group at 12 weeks. The HLT–FIB, HLT and FIB groups all had significant reductions in total cholesterol and LDL-cholesterol compared with control after 6 and 12 weeks. The present study demonstrated that simply adding psyllium fibre supplementation to a normal diet was sufficient to obtain beneficial effects in risk factors. However, a high-fibre diet consisting of a psyllium supplement plus fibre from a healthy diet provided the greatest improvements in metabolic syndrome risk factors.

Short-term effects of a snack including dried prunes on energy intake and satiety in normal-weight individuals

The purpose of this study was to test the hypothesis that a preload including dried prunes consumed as a snack before a meal, compared to an isoenergetic and equal weighed bread product preload would: (a) have greater short-term effect on satiety measured by subsequent ad libitum meal intake, (b) induce greater satiety as assessed by visual analogue scales (VAS), and (c) reduce appetite for dessert offered shortly after lunch. Forty-five healthy, normal-weight subjects participated in this randomised within-subject crossover study. Statistical analysis of the results showed that when subjects consumed the preload that included dried prunes, also consumed less amount of dessert and had lower total energy intake at meal. Additionally, subjects' feeling of hunger, desire and motivation to eat, as assessed with the use of VAS, were lower at all time points between snack and meal. Since macronutrients content of both preloads were similar, the satiating power of prunes could be due to their relatively high fiber content. Identifying meal patterns and foods that promote satiety without increasing considerably the overall energy intake is very important. The addition of dried prunes to a snack seems to promote satiety besides providing valuable nutrients.

In vitro evaluation of the microbiota modulation abilities of different sized whole oat grain flakes

Epidemiological studies and healthy eating guidelines suggest a positive correlation between ingestion of whole grain cereal and food rich in fibre with protection from chronic diseases. The prebiotic potential of whole grains may be related, however, little is known about the microbiota modulatory capability of oat grain or the impact processing has on this ability. In this study the fermentation profile of whole grain oat flakes, processed to produce two different sized flakes (small and large), by human faecal microbiota was investigated in vitro. Simulated digestion and subsequent fermentation by gut bacteria was investigated using pH controlled faecal batch cultures inoculated with human faecal slurry. The different sized oat flakes, Oat 23's (0.53-0.63 mm) and Oat 25's/26's (0.85-1.0 mm) were compared to oligofructose, a confirmed prebiotic, and cellulose, a poorly fermented carbohydrate. Bacterial enumeration was carried out using the culture independent technique, fluorescent in situ hybridisation, and short chain fatty acid (SCFA) production monitored by gas chromatography. Significant changes in total bacterial populations were observed after 24 h incubation for all substrates except Oat 23's and cellulose. Oats 23's fermentation resulted in a significant increase in the Bacteroides-Prevotella group. Oligofructose and Oats 25's/26's produced significant increases in Bifidobacterium in the latter stages of fermentation while numbers declined for Oats 23's between 5 h and 24 h. This is possibly due to the smaller surface area of the larger flakes inhibiting the simulated digestion, which may have resulted in increased levels of resistant starch (Bifidobacterium are known to ferment this dietary fibre). Fermentation of Oat 25's/26's resulted in a propionate rich SCFA profile and a significant increase in butyrate, which have both been linked to benefiting host health. The smaller sized oats did not produce a significant increase in butyrate concentration. This study shows for the first time the impact of oat grain on the microbial ecology of the human gut and its potential to beneficially modulate the gut microbiota through increasing Bifidobacterium population.

Nutritional profiles in a public health perspective: a critical review

Nutritional profiling is defined as 'the science of categorizing foods according to their nutritional composition' and it is useful for food labelling and regulation of health claims. The evidence for the link between nutrients and health outcomes was reviewed. A reduced salt intake reduces blood pressure, but only a few randomized controlled trials have verified the effect of salt on overall and cardiovascular mortality. Evidence linking a reduced fat intake with cardiovascular mortality and obesity is generally non-significant. Studies that have examined the relationship between obesity and diet have produced contrasting results. A simulation exercise that demonstrated that the impact of a reduced salt and fat intake on overall mortality would be negligible in the European population was carried out. Consideration of the literature and the results of this simulation exercise suggest that the introduction of nutritional profiles in Europe would be expected to have a very limited impact on health outcomes.

New hypotheses for the health-protective mechanisms of whole-grain cereals: what is beyond fibre?

Epidemiological studies have clearly shown that whole-grain cereals can protect against obesity, diabetes, CVD and cancers. The specific effects of food structure (increased satiety, reduced transit time and glycaemic response), fibre (improved faecal bulking and satiety, viscosity and SCFA production, and/or reduced glycaemic response) and Mg (better glycaemic homeostasis through increased insulin secretion), together with the antioxidant and anti-carcinogenic properties of numerous bioactive compounds, especially those in the bran and germ (minerals, trace elements, vitamins, carotenoids, polyphenols and alkylresorcinols), are today well-recognised mechanisms in this protection. Recent findings, the exhaustive listing of bioactive compounds found in whole-grain wheat, their content in whole-grain, bran and germ fractions and their estimated bioavailability, have led to new hypotheses. The involvement of polyphenols in cell signalling and gene regulation, and of sulfur compounds, lignin and phytic acid should be considered in antioxidant protection. Whole-grain wheat is also a rich source of methyl donors and lipotropes (methionine, betaine, choline, inositol and folates) that may be involved in cardiovascular and/or hepatic protection, lipid metabolism and DNA methylation. Potential protective effects of bound phenolic acids within the colon, of the B-complex vitamins on the nervous system and mental health, of oligosaccharides as prebiotics, of compounds associated with skeleton health, and of other compounds such as alpha-linolenic acid, policosanol, melatonin, phytosterols and para-aminobenzoic acid also deserve to be studied in more depth. Finally, benefits of nutrigenomics to study complex physiological effects of the 'whole-grain package', and the most promising ways for improving the nutritional quality of cereal products are discussed.

Nutraceuticals in the early infancy

Atherosclerosis disease and its extent in childhood correlate positively with established risk factors, namely obesity, hypercholesterolemia, diabetes mellitus, and hypertension. The safety and efficacy of some dietary interventions to modulate risk factors in childhood are documented by an increasing body of evidence. The present review analyzes nutritional and nutraceutical current strategies addressed to modify some risk factors of atherosclerosis in childhood. In particular, studies concerning nutrients such as fibers, omega-3-fatty acids, vitamin D, antioxidants, and calcium have been evaluated. An overall analysis suggests that some nutraceuticals might represent an attractive tool to lower the development of atherosclerotic-related cardiovascular complication in children. Nevertheless, at this moment, due to the methodological weakness that characterizes the majority of the analyzed studies, nutrients or supplements should not be considered as a therapeutic tool potentially usable for clinical purpose in children at risk for cardiovascular disease.

Consumo de fibra alimentar por crianças e adolescentes com constipação crônica: influência da mãe ou cuidadora e relação com excesso de peso

OBJETIVO: Avaliar a influência da mãe ou da cuidadora sobre o consumo de fibra alimentar por crianças e adolescentes com constipação crônica bem como sua relação com a ocorrência de excesso de peso. MÉTODOS: Estudo transversal com 38 crianças e adolescentes com constipação funcional e suas respectivas cuidadoras. Para análise do consumo de fibra alimentar, foi utilizado o registro alimentar de três dias. Peso e estatura foram aferidos para verificar o estado nutricional. A história familiar de constipação foi investigada. RESULTADOS: A maioria dos pacientes com constipação (89,5%; 34/38) apresentava consumo insuficiente de fibra (inferior à idade +5g). Das 38 cuidadoras, apenas uma (2,6%) apresentou ingestão de fibra superior à recomendação mínima (20g/dia). Excesso de peso foi encontrado em 28,9% (11/38) dos pacientes e em 60,5% (23/38) das suas responsáveis. Associação entre excesso de peso e presença de constipação foi verificada entre as cuidadoras (p=0,046). As crianças e adolescentes do sexo feminino com excesso de peso apresentaram menor ingestão de fibra, comparadas às sem excesso de peso (p=0,011). Nos pacientes do sexo masculino, essa associação não foi observada. O consumo de fibra pelas cuidadoras com excesso de peso foi inferior ao das demais (p=0,027). Observou-se correlação entre consumo de fibra pelas crianças com constipação e suas cuidadoras, nos sexos masculino (r=+0,561; p=0,005) e feminino (r=+0,782; p<0,001). CONCLUSÕES: Observou-se relação entre o consumo de fibra alimentar por crianças e adolescentes com constipação crônica e suas respectivas cuidadoras. O consumo insuficiente de fibra associou-se ao excesso de peso e à presença de constipação no gênero feminino.

Free fatty acid receptor 2 and nutrient sensing: a proposed role for fibre, fermentable carbohydrates and short-chain fatty acids in appetite regulation

The way in which the composition of the diet may affect appetite, food intake and body weight is now receiving considerable attention in a bid to halt the global year-on-year rise in obesity prevalence. Epidemiological evidence suggests that populations who follow a fibre-rich, traditional diet are likely to have a lower body weight and improved metabolic parameters than their Western-diet counterparts. The colonic effects of fibre, and more specifically the SCFA that the fermentation process produces, may play a role in maintaining energy homeostasis via their action on the G-coupled protein receptor free fatty acid receptor 2 (FFA2; formerly GPR43). In the present review, we summarise the evidence for and against the role of FFA2 in energy homeostasis circuits and the possible ways that these could be exploited therapeutically. We also propose that the decline in fibre content of the diet since the Industrial Revolution, particularly fermentable fractions, may have resulted in the FFA2-mediated circuits being under-utilised and hence play a role in the current obesity epidemic.

Wheel access does not attenuate weight gain in mice fed high-fat or high-CHO diets

PURPOSE

To determine the effect of a high-fat or high-carbohydrate diet and running wheel activity on body composition, body mass, and caloric intake in C57Bl/6 mice.

METHODS

At 4 wk of age, five groups of C57Bl/6 mice were housed individually. Two groups had running wheels, whereas the other three groups did not. Within the running wheel groups, FAT-W consumed a high-fat diet (60.3% fat) and CHO-W consumed a high-carbohydrate diet (70.4% carbohydrate). Within the nonrunning groups, FAT consumed the high-fat diet, CHO consumed the high-carbohydrate diet, and the fifth group consumed standard chow. All groups consumed food ad libitum and were exposed to their respective conditions for 12 wk. Wheel activity, food consumption, body mass (BM), and percentage of body fat (%BF) were recorded.

RESULTS

There was no significant difference in %BF or BM at the end of 12 wk between FAT-W and FAT or between CHO-W and CHO (P > 0.05). %BF was significantly higher in both FAT-W (42.9% +/- 0.6%) and FAT (45.9% +/- 0.8%) compared with CHO-W (30.8% +/- 1.4%) or CHO (33.4% +/- 1.0%; P < 0.001). BM was significantly higher in both FAT-W (42.8 +/- 0.7 g) and FAT (44.7 +/- 1.2 g) compared with either CHO-W (32.8 +/- 1.6 g) or CHO (37.1 +/- 0.8; P < 0.01). There was no difference in wheel activity between FAT-W and CHO-W (P > 0.05). Daily caloric intake was higher in both FAT-W (17.0 +/- 0.8 kcal) and FAT (15.9 +/- 0.9 kcal) compared with that in CHO-W (13.9 +/- 0.7 kcal) and CHO (13.6 +/- 0.5 kcal; P < 0.01).

CONCLUSIONS

Access to a running wheel had no protective effect on BM or %BF in C57Bl/6 mice that consumed either a high-fat or a high-carbohydrate diet during a 12-wk period. Access to a running wheel did not affect caloric intake; however, average daily caloric intake was higher in mice on high-fat diets compared with that in mice on a high-carbohydrate diet.

Association of dietary patterns with BMI and waist circumference in a low-income neighbourhood in Brazil

Traditional analysis of food intake usually fails to show an association between energy and nutrient intake and indicators of obesity. The analysis of food patterns can contribute to the understanding of the association between eating habits and anthropometric indicators. A population-based cross-sectional study was carried out on a low-income neighbourhood in the Rio de Janeiro metropolitan area, and 1009 subjects between 20 and 65 years of age completed an FFQ. Dietary patterns were identified by means of factor analysis, and their associations with BMI and waist circumference (WC) were ascertained by applying a linear regression analysis. Three main dietary patterns were identified: a mixed pattern, which included cereals, fish and shrimp, vegetables, roots, fruits, eggs, meat and caffeinated beverages; a Western pattern, which consisted of ‘fast foods’, soft drinks, juices, cakes, cookies, milk and dairy, sweets and snacks; a traditional pattern, which included rice, beans, bread, sugar, fats and salad dressings. After adjusting for age and energy intake, we found that the traditional dietary pattern was inversely associated with BMI (β = − 1·14, P < 0·001) and WC (β = − 14·9, P = 0·002) among females. Additionally, a positive association between the Western pattern and WC (β = 12·8, P = 0·02) was observed for females. A diet based on rice and beans may have a protective role against weight gain in women.

Evaluation of soy hulls as a potential ingredient of functional foods for the prevention of obesity

The prevalence of obesity and its associated health problems is rising to epidemic proportions throughout the world. Soy hulls, an industrial waste from oil extraction, contain a high proportion of fiber--soluble and insoluble--and may be a potential ingredient of functional foods for the prevention of obesity. However, crude soybeans, as do all legumes, present challenges to their use because of intensive antitrypsin and antichimotrypsin activity that impairs normal growth in humans and other mammals, requiring inactivation. To evaluate possible antinutritional effects of soybean hulls, diets with 10 percent fiber from soybean hulls or cellulose were offered to weanling IIMb/Beta obese rats during their prepubertal timeframe. The fact that no significant differences were found in growth, blood parameters nor in fat depots' weight and lipid content plus the proven beneficial effects on obese adult rats suggest that soy hulls may be a useful ingredient of functional foods for the prevention and treatment of human obesity.

Dietary fiber does not displace energy but is associated with decreased serum cholesterol concentrations in healthy children

BACKGROUND

Dietary fiber has health benefits, but fiber recommendations for children are controversial because fiber may displace energy.

OBJECTIVE

The objective was to longitudinally evaluate dietary fiber intake in children and to study associations between growth variables, serum cholesterol concentrations, and intakes of fiber, energy, and nutrients.

DESIGN

Altogether, 543 children from a prospective randomized atherosclerosis prevention trial (the Special Turku Coronary Risk factor Intervention Project; STRIP) participated in this study between the ages of 8 mo and 9 y. The intervention children (n = 264) were counseled to replace part of saturated fat with unsaturated fat. Nutrient intakes, weight, height, and serum total, HDL-, and LDL-cholesterol and triglyceride concentrations were analyzed. Children were divided into 3 groups according to mean dietary fiber intake in foods: low (lowest 10%), high (highest 10%), and average (middle 80%) fiber intakes.

RESULTS

Fiber intake associated positively with energy intake and inversely with fat intake. Children with a high fiber intake received more vitamins and minerals than did children in other groups. In longitudinal growth analyses, weights and heights were similar in all 3 fiber intake groups, and fiber intake (g/d) associated positively with weight gain between 8 mo and 2 y. Serum cholesterol concentrations decreased with increasing fiber intakes. Children in the intervention group had a higher fiber intake than did the control children during the entire follow-up period.

CONCLUSION

Fiber intake did not displace energy or disturb growth between 13 mo and 9 y of age. Serum cholesterol values correlated inversely with fiber intake, which indicated that part of the cholesterol-lowering intervention effect in the STRIP project may have been explained by dietary fiber.

Appetite control: methodological aspects of the evaluation of foods

This report describes a set of scientific procedures used to assess the impact of foods and food ingredients on the expression of appetite (psychological and behavioural). An overarching priority has been to enable potential evaluators of health claims about foods to identify justified claims and to exclude claims that are not supported by scientific evidence for the effect cited. This priority follows precisely from the principles set down in the PASSCLAIM report. The report allows the evaluation of the strength of health claims, about the effects of foods on appetite, which can be sustained on the basis of the commonly used scientific designs and experimental procedures. The report includes different designs for assessing effects on satiation as opposed to satiety, detailed coverage of the extent to which a change in hunger can stand alone as a measure of appetite control and an extensive discussion of the statistical procedures appropriate for handling data in this field of research. Because research in this area is continually evolving, new improved methodologies may emerge over time and will need to be incorporated into the framework. One main objective of the report has been to produce guidance on good practice in carrying out appetite research, and not to set down a series of commandments that must be followed.

Added soluble fiber enhances the satiating power of low-energy-density liquid yogurts

BACKGROUND

Low-energy-density foods with high satiating power may be useful tools for weight management. Energy density of yogurts can range from 0.4 to 1.8 kcal/g.

OBJECTIVE

To test the effects of added inulin, a soluble fiber, on the satiating properties of low-energy-density and high-energy-density yogurt beverages (16 oz or 472 mL).

DESIGN

The study followed a within-subject preload design with repeated measures. Each participant completed six conditions, presented in a counterbalanced order.

SUBJECTS

Participants were 18 men and 20 women, aged 18 to 35 years.

INTERVENTION

The experimental conditions were two high-energy-density yogurt beverages (440 kcal; 0.9 kcal/g) and two low-energy-density yogurt beverages (180 kcal; 0.4 kcal/g) with or without inulin (6 g) and an equal volume of orange juice (180 kcal). A no beverage control condition was used as well.

MAIN OUTCOME MEASURES

Repeated ratings of hunger, fullness, and desire to eat and energy consumption at the lunch meal served 120 minutes post-ingestion were the main measures.

STATISTICAL ANALYSES PERFORMED

Repeated measures analyses of variance were used to analyze motivational ratings and energy and nutrient intakes at the test meal.

RESULTS

Yogurt beverages and liquid orange juice significantly suppressed appetite and promoted satiety relatively to the no beverage condition. Yogurt beverages had greater satiating power than did orange juice, as evidenced by higher satiety ratings and reduced energy intakes at lunch. The satiating power of low-energy-density yogurt with inulin was comparable to that of high-energy-density yogurt.

CONCLUSIONS

Energy presented in liquid form can have satiating power. Added fiber can potentiate the satiating properties of low-energy-density liquid yogurts. Adding fiber to low-energy-density foods may be an effective way to suppress appetite and control food intake.

Effects of increasing dietary protein and fibre intake with lupin on body weight and composition and blood lipids in overweight men and women

BACKGROUND

Lupin kernel flour (LKF) is a novel food ingredient that is high in protein and fibre. We have previously shown that partial substitution of refined wheat-derived carbohydrate in bread with protein and fibre from LKF can reduce appetite and energy intake acutely. In addition, several studies have suggested that lupin may reduce cholesterol concentrations and benefit glucose and insulin metabolism.

AIM

The aim of this study was to investigate the effects on body weight and composition and blood lipids, glucose and insulin of an ad libitum LKF-enriched diet higher in dietary protein and fibre.

SUBJECTS AND METHODS

A total of 88 overweight and obese men and women were recruited for a 16-week parallel-design randomized controlled trial. Participants replaced 15-20% of their usual daily energy intake with white bread (control) or LKF-enriched bread (lupin) in an ad libitum diet. Measurements of body weight and composition, and fasting blood biochemical measurements were performed at baseline and 16 weeks. The primary analysis included 74 participants (37 per group) who completed the intervention.

RESULTS

At baseline, mean (+/-s.d.) body mass index and total cholesterol were 30.6+/-3.5 kg m(-2) and 5.37+/-0.94 mmol l(-1), respectively. Estimated (mean between-group difference (95% confidence interval)) protein (13.7 (2.28, 25.0) g per day) and fibre (12.5 (8.79, 16.2) g per day) intakes were higher during the intervention with lupin than with control. For lupin relative to control, the net effects on body weight (-0.4 (-1.3, 0.6) kg), fat mass (-0.5 (-1.1, 0.2) kg) and percentage (-0.5 (-1.1, 0.1)%), plasma leptin (-1.66 (-4.91, 1.59) ng ml(-1)) and adiponectin (0.20 (-0.73, 1.13) mg l(-1), as well as serum total cholesterol (-0.08 (-0.38, 0.22) mmol l(-1)), triglycerides (0.09 (-0.10, 0.21) mmol l(-1)), glucose (0.10 (-0.11, 0.30) mmol l(-1)) and insulin (0.40 (-1.20, 2.00) mU l(-1)) were not significant.

CONCLUSIONS

This study does not support the proposal that an ad libitum diet enriched in LKF resulting in moderate changes in both protein and fibre intakes can benefit body weight and composition or fasting blood lipids, glucose and insulin concentrations in overweight men and women with mildly elevated total cholesterol concentrations.

Slowly digestible starch: concept, mechanism, and proposed extended glycemic index

Starch is the major glycemic carbohydrate in foods, and its nutritional property is related to its rate and extent of digestion and absorption in the small intestine. A classification of starch into rapidly digestible starch (RDS), slowly digestible starch (SDS), and resistant starch (RS) based on the in vitro Englyst test is used to specify the nutritional quality of starch. Both the RDS and RS fractions have been extensively studied while there are only limited studies on the intermediate starch fraction of SDS, particularly regarding its structural basis and slow digestion mechanism. The current understanding of SDS including its concept, measurement method, structural basis and mechanism, physiological consequences, and approaches to make SDS is reviewed. An in vivo method of extended glycemic index (EGI) is proposed to evaluate its metabolic effect and related health consequences.

Effect of fenugreek fiber on satiety, blood glucose and insulin response and energy intake in obese subjects

Eighteen healthy obese subjects participated in a single blind, randomized, crossover study of three test breakfasts, containing 0 g (control), 4 g or 8 g of isolated fenugreek fiber. Subjects recorded ratings of hunger, satiety, fullness and prospective food consumption using visual analog scales (VAS) every 30 min for 3.5 h. Postprandial blood glucose and insulin responses were measured. Energy intake from an ad libitum lunch buffet and for the remainder of the day was assessed. The 8 g dose of fenugreek fiber significantly increased mean ratings of satiety and fullness, and reduced ratings of hunger and prospective food consumption (P < 0.05). Palatability was significantly reduced with increasing doses of fenugreek fiber (P < 0.05). No differences were observed for area under the curve (AUC) for blood glucose among treatments. An increase in insulin AUC was found with 8 g fenugreek fiber. Energy intake at an ad libitum lunch buffet was significantly lower for 8 g than 4 g fenugreek fiber, but not significantly different from control, although there was a trend towards a lower intake (p = 0.11). No differences were observed for energy intake for the remainder of the day. Fenugreek fiber (8 g) significantly increased satiety and reduced energy intake at lunch, suggesting it may have short-term beneficial effects in obese subjects. Satiety results were not related to postprandial blood glucose.

Structural differences among alkali-soluble arabinoxylans from maize (Zea mays), rice (Oryza sativa), and wheat (Triticum aestivum) brans influence human fecal fermentation profiles

Human fecal fermentation profiles of maize, rice, and wheat bran and their dietary fiber fractions released by alkaline-hydrogen peroxide treatment (principally arabinoxylan) were obtained with the aim of identifying and characterizing fractions associated with high production of short chain fatty acids and a linear fermentation profile for possible application as a slowly fermentable dietary fiber. The alkali-soluble fraction from maize bran resulted in the highest short chain fatty acid production among all samples tested, and was linear over the 24 h fermentation period. Size-exclusion chromatography and (1)H NMR suggested that higher molecular weight and uniquely substituted arabinose side chains may contribute to these properties. Monosaccharide disappearance data suggest that maize and rice bran arabinoxylans are fermented by a debranching mechanism, while wheat bran arabinoxylans likely contain large unsubstituted xylose regions that are fermented preferentially, followed by poor fermentation of the remaining, highly branched oligosaccharides.

Dietary fiber supplements: effects in obesity and metabolic syndrome and relationship to gastrointestinal functions

Dietary fiber is a term that reflects a heterogeneous group of natural food sources, processed grains, and commercial supplements. Several forms of dietary fiber have been used as complementary or alternative agents in the management of manifestations of the metabolic syndrome, including obesity. Not surprisingly, there is a great variation in the biological efficacy of dietary fiber in the metabolic syndrome and body weight control. Diverse factors and mechanisms have been reported as mediators of the effects of dietary fiber on the metabolic syndrome and obesity. Among this array of mechanisms, the modulation of gastric sensorimotor influences appears to be crucial for the effects of dietary fiber but also quite variable. This report focuses on the role, mechanism of action, and benefits of different forms of fiber and supplements on obesity and the metabolic syndrome, glycemia, dyslipidemia, and cardiovascular risk and explores the effects of dietary fiber on gastric sensorimotor function and satiety in mediating these actions of dietary fiber.

Design and methods for testing a simple dietary message to improve weight loss and dietary quality

BACKGROUND

The current food pyramid guidelines have been criticized because of their complexity and the knowledge required for users to understand the recommendations. Simplification of a dietary message to focus on a single key aspect of dietary quality, e.g., fiber intake, may make the message much easier to comprehend and adhere, such that respondents can achieve greater weight loss, better dietary quality and overall metabolic health.

METHODS AND DESIGN

This is a randomized controlled clinical trial with two equal sized arms. In total, 240 obese adults who meet diagnostic criteria for the metabolic syndrome will be randomized to one of the two conditions: 1) a high fiber diet and 2) the American Heart Association (AHA) diet. In the high fiber diet condition, patients will be given instruction only on achieving daily dietary fiber intake of 30 g or more. In the AHA diet condition, patients will be instructed to make the several dietary changes recommended by the AHA 2006 guidelines. The trial examines participant weight loss and dietary quality as well as changes in components of the metabolic syndrome, inflammatory biomarkers, low-density lipoprotein cholesterol levels, insulin levels, and glycosolated hemoglobin. Potential mediators, i.e., diet adherence and perceived ease of the diet, and the intervention effect on weight change will also be examined.

DISCUSSIONS

The purpose of this paper is to outline the study design and methods for testing the simple message of increasing dietary fiber. If the simple dietary approach is found efficacious for weight loss; and, improves dietary quality, metabolic health, and adherence, it might then be used to develop a simple public health message.

TRIAL REGISTRATION

NCT00911885.

Effects of fruit consumption on body mass index and weight loss in a sample of overweight and obese dieters enrolled in a weight-loss intervention trial

OBJECTIVE

Fruit and vegetable consumption is an important part of a healthy diet and assumed to aid in the reduction of energy intake and body weight. Fruits and vegetables may display differential effects on weight and weight loss; however, the effects of the two food groups have rarely been investigated separately.

METHODS

The present study focused on the effects of fruit consumption on body weight and weight loss in a sample of 77 overweight and obese dieters enrolled in an intervention program. Food consumption was assessed at baseline by food diaries and after the introduction of nutrition software through electronic food records. Body weight and additional physiologic outcomes were assessed three times, once before the intervention and again at the 3- and 6-mo follow-ups.

RESULTS

Vegetable and fruit consumption differed in their associations with body weight and weight loss. Although vegetable consumption increased as a result of the intervention (P<0.01), fruit consumption did not. However, only fruit consumption was associated with body mass index, showing an inverse relation with body weight in cross-sectional and longitudinal analyses (r=-0.27 to -0.44). The relation between fruit consumption and body weight remained significant after controlling for age, gender, physical activity level, and daily macronutrient consumption (DeltaR(2)=0.06-0.13). Further, increases in fruit consumption were associated with subsequent weight loss, controlling for the same covariates (DeltaR(2)=0.05-0.07).

CONCLUSION

The results indicate unique contributions of fruit consumption to the management of body weight and indicate that a separation of effects for fruit and vegetable food groups may be warranted.

Fiber facts: benefits and recommendations for individuals with type 2 diabetes

In randomized controlled trials, viscous soluble fibers have demonstrated acute and long-term metabolic improvements in type 2 diabetes, such as reductions in hemoglobin A1c, fasting and post-prandial glycemia, insulinemia, and cardiovascular risk factors. In addition, they may be helpful in weight control through promoting feelings of fullness. Increasing consumption of foods containing fiber or use of fiber supplements could play an important role in managing diabetes with positive outcomes on vascular complications and reduced cardio-vascular disease risk.

Whole-grain intake and cereal fiber are associated with lower abdominal adiposity in older adults

Foods high in dietary fiber may play an important role in regulating body weight. Few observational studies have examined the relationship between dietary fiber from different sources and body fat in older adults. Our objectives were to examine the associations among grain intake (whole and refined), dietary fiber and fiber sources, and body fat among older adults. We used data from 434 free-living adults (177 men and 257 women) aged between 60 and 80 y. Dietary intake was estimated from a 126-item semiquantitative FFQ. Percent body fat and percent trunk fat mass were measured by whole-body dual-energy X-ray absorptiometry. After adjustment for covariates, whole-grain intake was inversely associated with BMI [26.8 kg/m(2) (25.7-28.1) vs. 25.8 kg/m(2) (24.6-27.1), (95% CI); P-trend = 0.08], percent body fat [34.5% (32.7-36.3) vs. 32.1% (30.1-34.1); P-trend = 0.02], and percent trunk fat mass [43.0% (40.4-45.5) vs. 39.4% (36.7-42.1); P-trend = 0.02] in the lowest compared with the highest quartile category of whole-grain intake. Refined grain intake was not associated with any measure of body fat distribution. Cereal fiber was inversely associated with BMI [27.3 kg/m(2) (26.1-28.6) vs. 25.4 kg/m(2) (24.3-26.7); P-trend = 0.012], percent body fat [34.7% (32.8-36.6) vs. 31.5% (29.4-33.5); P-trend = 0.004], and percent trunk fat mass [42.8% (40.2-45.4) vs. 37.8% (35.0-40.6); P-trend = 0.001]. No significant association was observed between intakes of total fiber, vegetable or fruit fiber, and body composition measurements. Higher intakes of cereal fiber, particularly from whole-grain sources, are associated with lower total percent body fat and percent trunk fat mass in older adults.

Frequency of fiber-rich food intake and associated factors in a Southern Brazilian population

The objective of this study was to verify the frequency of fiber-rich food intake and evaluate its association with socioeconomic, demographic and behavioral characteristics. A city representative sample was selected and 3,993 subjects (> 10 years) were interviewed. The study used the Block Screening Questionnaire. A majority of subjects - 65.6% (95%CI: 64.2-67.1) - presented an inadequate intake frequency. Adjusted analysis for the overall sample showed an increased risk of inadequate frequency among men, adolescents, people of lower socioeconomic levels, current smokers, those insufficiently active and those having fewer than four daily meals. Age group-stratified analysis showed that among adolescents, living alone was a risk factor; for adults, risk factors were sex (male), current smoker, insufficiently active and fewer than four daily meals and; among the elderly they were male and being a current smoker. A lower socioeconomic level was associated to the outcome in all groups. Although the inadequate frequency of intake is very common in this population, teenagers are at a higher risk, pointing to a need for public health actions targeting this particular age group.

Mediterranean diet and metabolic syndrome: the evidence

Background

The Mediterranean diet has long been related to a lower cardiovascular disease risk; however, more recent evidences also indicate that it has a favourable effect on adiposity and type 2 diabetes.

Design

Review of the available literature in relation to Mediterranean diet and metabolic syndrome.

Results

Several components of Mediterranean diet patterns have been inversely related with body mass index. They are considered to be modulators of insulin resistance, can exert beneficial effects on blood pressure, improve atherogenic dyslipidemia or attenuate the inflammatory burden associated with metabolic syndrome. Furthermore, a lower prevalence of metabolic syndrome has been associated with dietary patterns rich in fruits and vegetables, nuts, olive oil, legumes and fish, moderate in alcohol and low in red meat, processed meat, refined carbohydrates and whole-fat dairy products.

Conclusions

There is much evidence suggesting that the Mediterranean diet could serve as an anti-inflammatory dietary pattern, which could help to fight diseases related to chronic inflammation, including metabolic syndrome.

Are school employees role models of healthful eating? Dietary intake results from the ACTION worksite wellness trial

BACKGROUND

Little is known about the dietary intake of school employees, a key target group for improving school nutrition.

OBJECTIVE

To investigate selected dietary variables and weight status among elementary school personnel.

DESIGN

Cross-sectional, descriptive study.

SUBJECTS/SETTING

Elementary school employees (n=373) from 22 schools in a suburban parish (county) of southeastern Louisiana were randomly selected for evaluation at baseline of ACTION, a school-based worksite wellness trial.

METHODS

Two 24-hour dietary recalls were administered on nonconsecutive days by registered dietitians using the Nutrition Data System for Research. Height and weight were measured by trained examiners and body mass index calculated as kg/m(2).

STATISTICAL ANALYSES PERFORMED

Descriptive analyses characterized energy, macronutrient, fiber, and MyPyramid food group consumption. Inferential statistics (t tests, analysis of variance, chi(2)) were used to examine differences in intake and compliance with recommendations by demographic and weight status categories.

RESULTS

Approximately 31% and 40% of the sample were overweight and obese, respectively, with higher obesity rates than state and national estimates. Mean daily energy intake among women was 1,862+/-492 kcal and among men was 2,668+/-796 kcal. Obese employees consumed more energy (+288 kcal, P<0.001) and more energy from fat (P<0.001) than those who were normal weight. Approximately 45% of the sample exceeded dietary fat recommendations. On average, only 9% had fiber intakes at or above their Adequate Intake, which is consistent with the finding that more than 25% of employees did not eat fruit, 58% did not eat dark-green vegetables, and 45% did not eat whole grains on the recalled days. Only 7% of employees met the MyPyramid recommendations for fruits or vegetables, and 14% of the sample met those for milk and dairy foods.

CONCLUSIONS

These results suggest that greater attention be directed to understanding and improving the diets of school employees given their high rates of overweight and obesity, poor diets, and important role in student health.

Dietary fiber and associations with adiposity and fasting insulin among college students with plausible dietary reports

OBJECTIVE

We examined dietary fiber intake, food sources of dietary fiber, and relation of dietary fiber to body composition and metabolic parameters in college students with plausible dietary reports.

METHODS

Students (18-24 y of age) provided data on anthropometry, fasting blood chemistries, and body composition (bioelectric impedance). Diet and physical activity were assessed with the Diet History Questionnaire and the International Physical Activity Questionnaire. Plausible dietary reporters were identified (+/-1 SD cutoffs for reported energy intake as a percentage of predicted energy requirement). Multiple regression analyses were conducted with the total (n = 298) and plausible (n = 123) samples, adjusting for age, race, sex, smoking status, physical activity, energy intake, and fat-free mass (where applicable).

RESULTS

Food sources of dietary fiber were similar in men and women. In the plausible sample compared with the total sample, dietary fiber was more strongly associated with fat mass (beta = -0.24, P < 0.001), percentage of body fat (beta = -0.23, P < 0.001), body mass index (beta = -0.11, P < 0.01), waist circumference (beta = -0.67, P < 0.05), and fasting insulin (beta = -0.15, P < 0.001). When the effect of sex was investigated, dietary fiber was inversely related to fasting insulin and fat mass in men and women and inversely related to percentage of body fat, body mass index, and waist circumference in men only (P < 0.05).

CONCLUSION

Inclusion of implausible dietary reports may result in spurious or weakened diet-health associations. Dietary fiber is negatively associated with fasting insulin levels in men and women and consistently associated with adiposity measurements in men.

Particle size and fraction of wheat bran influence short-chain fatty acid production in vitro

Whole grains are associated with decreased risk of chronic disease and decreased risk of obesity. Several mechanisms may be involved including SCFA production via fibre fermentation in the colon. The aim of the present study was to evaluate the role of wheat bran particle size (large/coarse v. small/fine) and wheat bran fraction (whole bran v. aleurone v. aleurone by-product) in SCFA production using a batch in vitro fermentation system with human faecal inoculum. Five samples were compared: large-particle bran, small-particle bran, aleurone, coarse by-product, fine by-product. Fine by-product produced the greatest SCFA concentrations. By-product (both coarse and fine) produced greater SCFA concentrations than bran (both large and small particle sizes). Aleurone produced SCFA concentrations similar to small-particle bran. The molar percentage of butyrate at 24 h was significantly greater for large-particle bran than the other samples. Small/fine particle size and by-product fraction of bran increased SCFA production compared with large/coarse particle size, and aleurone and whole bran. Bran characteristics and composition should be considered when manufacturing foods due to the diversity of physiological effects.

A hypocaloric diet enriched in legumes specifically mitigates lipid peroxidation in obese subjects

Legume intake could specifically protect against lipid peroxidation in addition to the effects associated to weight loss when included in hypocaloric diets. Thus, 30 obese subjects (age: 36 +/- 8 years and BMI: 32.0 +/- 5.3 kg/m(2)) were nutritionally treated by a 8-week energy restriction ( - 30% energy expenditure) with a legume enriched diet (4 days/week servings, [image omitted] ) or without legumes (control diet (CD), [image omitted] ). Body weight, circulating cholesterol, oxidized LDL (ox-LDL), malondialdehyde (MDA) and urinary 8-isoprostane F(2alpha) (8-iso-PGF(2alpha)) were measured at baseline and at endpoint. After the nutritional intervention, all obese subjects lost weight, specially those individuals who followed the legumes-enriched diet as compared to the CD ( - 7.7 +/- 3 vs. - 5.3 +/- 2.7%; p = 0.023), which was accompanied by marked decreases in total cholesterol levels (p < 0.001) and statistically significant diet-related reductions on plasma ox-LDL, plasma MDA and urinary 8-iso-PGF(2alpha) output. Therefore, a balanced diet with moderate caloric restriction including 4 day/week legume servings empowered the oxidative stress improvement related to weight loss through a reduction in lipid peroxidation as compared to a control hypocaloric diet.

Reduced energy intake at breakfast is not compensated for at lunch if a high-insoluble-fiber cereal replaces a low-fiber cereal

BACKGROUND

In cohort studies, insoluble fiber has been associated with a reduced risk of obesity and diabetes; however, compared with soluble fiber, its role in the regulation of short-term food intake (FI) and satiety has received little attention.

OBJECTIVE

Our aim was to compare the effects of a high-insoluble-fiber (HF) cereal with a low-fiber (LF) cereal on FI, subjective appetite (SA), and plasma glucose (PG) in healthy individuals.

DESIGN

Males and females (n = 32) were randomly assigned to consume 60 g of either HF (26 g insoluble fiber, 120 kcal) or LF (1 g fiber, 217 kcal) breakfast cereal. Pre- and postlunch SA and PG were measured regularly for 4 h, and ad libitum FI was measured at 3 h.

RESULTS

The prelunch SA area under the curve did not differ between the 2 cereals, but when expressed as change in appetite per kilocalorie of cereal, HF suppressed SA more than did LF (-17.6 +/- 1.8 compared with -10.0 +/- 1.1 mm . min . kcal(-)(1), respectively; P < 0.01). Lunchtime FI did not differ between cereals, but cumulative energy intake (cereal + lunch) was lower after the HF than after the LF cereal (1330 +/- 57 compared with 1422 +/- 66 kcal, respectively; P = 0.01). The prelunch PG area under the curve (P < 0.0001) and the immediate postlunch PG (P = 0.01) were lower after HF cereal consumption.

CONCLUSIONS

An HF breakfast cereal contributes to a cumulative reduction in breakfast and lunch energy intake, possibly due to its high satiety value per kilocalorie. A short-term benefit of the HF cereal, compared with LF cereal, was lower PG concentration before and immediately after lunch.

Plant foods and plant-based diets: protective against childhood obesity?

The objective of this article is to review the epidemiologic literature examining the role of plant foods and plant-based diets in the prevention of childhood obesity. Available data suggest a protective effect of ready-to-eat cereal on risk of obesity, although prospective studies are still needed. Studies on fruit and vegetables; grains other than cereal; high-protein foods, including beans, legumes, and soy; fiber; and plant-based dietary patterns are inconsistent or generally null. The evidence base is limited, and most studies are fraught with methodologic limitations, including cross-sectional design, inadequate adjustment for potential confounders, and lack of consideration of reporting errors, stage of growth, and genetic influences. Well-designed prospective studies are needed. The lack of evidence showing an association between plant-based diets and childhood obesity does not mean that such diets should not be encouraged. Plant foods are highlighted in the Dietary Guidelines for Americans, and children do not meet the current recommendations for most plant foods. Although the advice to consume a plant-based, low-energy-dense diet is sound, ethical questions arise concerning the relatively high price of these diets in the United States and the way in which such diets are perceived in other parts of the world. Reducing the burden of childhood obesity, eliminating health disparities, and preventing the further spread of the disease around the globe will require not only policy interventions to ensure that plant foods are affordable and accessible to children of all income levels but also awareness of sociocultural norms that affect consumption.

Socioeconomic characteristics, dietary and lifestyle patterns, and health and weight status of older adults in NHANES, 1999-2002: a comparison of Caucasians and African Americans

There are disparities among older Caucasian and African American adults in many areas. The study used data from the National Health and Nutrition Examination Survey conducted from 1999 to 2002 and compared the self-reported dietary intakes, physical activity, and economic and health status of Caucasian (N = 1,398) and African American (N = 354) adults aged 65 years and older. Regression models and t-tests (alpha = 0.05) were used for comparisons. More African Americans than Caucasians lived in low-income households (40.4% vs. 21.3%), lived in households that were not fully food-secure (15.6% vs. 4.9%), watched five or more hours of television (34% vs. 20%), and were told that they had diabetes (10% vs. 4%) or high blood pressure (67 % vs. 52 %). They consumed 253 fewer calories than Caucasians. About 75 % of African American women were overweight. Our findings indicate that for those greater than 65 years of age, low-income African Americans are at a greater risk for poor nutrition and chronic health conditions than Caucasians.

Increasing total fiber intake reduces risk of weight and fat gains in women

Research investigating fiber intake and changes in weight over time has not controlled for important covariates, especially physical activity. Moreover, studies have rarely examined the influence of fiber on changes in body fat, only weight. Hence, this study was conducted to determine whether changes in fiber intake (total, soluble, and insoluble) influence risk of gaining weight and body fat over time. Another objective was to examine the influence of age, energy intake, activity, season, and other potential confounders. A prospective cohort design was used and 252 women completed baseline and follow-up assessments 20 mo apart. Diet was measured using 7-d weighed food records. Fiber was expressed per 1000 kcal (4187 kJ). Body fat was assessed via the Bod Pod and physical activity was measured using accelerometers over 7 consecutive days. Across the 20 mo, almost 50% of the women gained weight and fat. For each 1 g increase in total fiber consumed, weight decreased by 0.25 kg (P = 0.0061) and fat decreased by 0.25 percentage point (P = 0.0052). Controlling for potential confounders did not affect the relationships, except changes in energy intake, which weakened the associations by 24-32%. Soluble and insoluble fibers were borderline predictors of changes in weight and fat. In conclusion, increasing dietary fiber significantly reduces the risk of gaining weight and fat in women, independent of several potential confounders, including physical activity, dietary fat intake, and others. Fiber's influence seems to occur primarily through reducing energy intake over time.

Suppressive effect of cellulose on osmotic diarrhea caused by maltitol in healthy female subjects

Using a single-group time-series design, we determined that osmotic diarrhea caused by maltitol ingestion was suppressed by the addition of not only soluble but also insoluble dietary fiber in healthy humans. We then clarified that cellulose delayed gastric emptying in rats. Twenty-seven healthy volunteers ingested maltitol step-wise at doses of 15, 20, 25, 30, 35, 40 and 45 g from small to large amounts. Within that range of ingested amounts, 22 out of 27 subjects experienced osmotic diarrhea from maltitol ingestion, and the minimal dose level of maltitol that induced osmotic diarrhea (MMD) was established for each subject. When 5 g of cellulose was added to the MMD, osmotic diarrhea was suppressed in 13 out of 19 subjects (68.4%), while partially hydrolyzed alginate-Na (PHA-Na), a soluble dietary fiber, suppressed osmotic diarrhea in 10 out of 20 subjects (50.0%). When a mixed solution of cellulose and maltitol was administered to rats, the gastric emptying of maltitol was significantly delayed at 30 and 60 min after administration (p=0.019, p=0.013), respectively. PHA-Na also significantly delayed gastric emptying at 30 min (p=0.013). In conclusion, cellulose can suppress the osmotic diarrhea caused by maltitol ingestion in humans and delay the gastric emptying of maltitol in rats. A new physiological property of cellulose was clarified in this study.

Can a small-changes approach help address the obesity epidemic? A report of the Joint Task Force of the American Society for Nutrition, Institute of Food Technologists, and International Food Information Council

The continued rise in obesity rates in most countries suggests that current programs and initiatives designed to combat obesity have not been successful in reversing the obesity epidemic. Obesity rates are increasing because of a gradual weight gain in most populations. There has been little long-term success in treating established obesity through lifestyle change, perhaps because of the large permanent changes in diet and physical activity required to keep weight off. An alternative strategy to address the obesity epidemic involves not focusing on weight loss but promoting small changes in diet and physical activity to initially prevent further weight gain. With the use of this strategy, obesity rates could first be stabilized in most populations and then, over time, decrease gradually. Supporting data show that small reductions in conscious energy intake and increases in physical activity can reduce excessive weight gain. The opportunity exists to use the small-changes approach to bring different stakeholders together to create a national initiative to address the global epidemic of obesity. The Joint Task Force of the American Society for Nutrition, Institute of Food Technologists, and International Food Information Council believe that a small-changes framework, aimed at helping people make conscious small changes in lifestyle behaviors, in combination with efforts by the private sector to gradually "ratchet down" some of the environmental factors that have contributed to excessive energy intake and the declining rates of physical activity, can be successful in reducing obesity rates. Such an initiative would benefit from the support of educational and social marketing campaigns developed with governmental input and support.

Impact of a lignan-rich diet on adiposity and insulin sensitivity in post-menopausal women

There has been a growing interest in lignans, a class of phyto-oestrogens, because of their potentially favourable effects on human health. The aim of the present study was to compare the metabolic profile of post-menopausal women consuming various amounts of dietary lignans. Phyto-oestrogen intake was assessed using a 3-d dietary record analysed with a Canadian food phyto-oestrogen content data table in 115 post-menopausal women (age 56·8 (sd 4·4) years and BMI 28·5 (sd 5·9) kg/m2). Plasma enterolactone (ENL), the major biologically active metabolite of dietary lignans, was determined by time-resolved fluoroimmunoassay. Anthropometrics, abdominal adipose tissue areas (computed tomography), body composition (hydrostatic weighing) and insulin sensitivity (hyperinsulinaemic–euglycaemic clamp) were measured in all women. Women in the high dietary lignan intake subgroup (n 29) had a significantly lower BMI and total body fat mass, as well as a better glucose disposal rate (GDR; P < 0·05), compared with women in the low lignan intake subgroup (n 28). The majority of women with the highest dietary lignan intake were also in the highest quartile of plasma ENL (59 %). Women in the highest ENL quartile had a significantly lower BMI (26·1 (sd 4·4) v. 30·4 (sd 6·9) kg/m2, P < 0·05), total body fat mass (24·8 (sd 9·8) v. 33·3 (sd 13·3) kg, P < 0·05), 2 h postload glycaemia (5·5 (sd 0·9) v. 5·7 (sd 0·8) nmol/l, P < 0·05) and a higher GDR (8·3 (sd 2·7) v. 5·5 (sd 2·8), P < 0·01) compared with women in the lowest ENL quartile. In conclusion, women with the highest ENL concentrations had a better metabolic profile including higher insulin sensitivity and lower adiposity measures.

A meta-analysis of psycho-behavioral obesity interventions among US multiethnic and minority adults

OBJECTIVE

The present review examines efficacious psycho-behavioral interventions in preventing weight gains or reducing weight among US multiethnic and minority adults as few studies were conducted to review such interventions to date.

METHODS

Data were examined from 24 controlled intervention studies, representing 23 programs and involving 13,326 adults. Studies were identified through manual and online search of databases that include MEDLINE, Academic Search Premier, ERIC, PsycARTICLES, SPORTDiscus, and CINAHL Plus.

RESULTS

Whereas one-component (n=5, d=0.08, 90% CI=-0.04, 0.35) and two-component interventions (n=13, d=0.22, 90% CI=0.05, 0.40) showed a low mean effect size, three-component interventions (n=6, d=0.52, 90% CI=0.39, 0.65) showed a moderate effect size. Interventions conducted in individual sessions (n=15, d=0.40, 90% CI=0.24, 0.56) showed a higher mean effect size than group interventions (n=9, d=0.08, 90% CI=-0.04, 0.30) although the confidence intervals overlapped.

CONCLUSIONS

The study results indicate that future obesity prevention interventions targeting multiethnic and minority adults might benefit from incorporating individual sessions, family involvement, and problem solving strategies into multi-component programs that focus on lifestyle changes.