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Murphy J, Moullec G, Santosa S. Factors associated with adipocyte size reduction after weight loss interventions for overweight and obesity: a systematic review and meta-regression. Metabolism 2017; 67:31-40. [PMID: 28081776 DOI: 10.1016/j.metabol.2016.09.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 09/08/2016] [Accepted: 09/26/2016] [Indexed: 02/07/2023]
Abstract
AIMS Enlarged adipocytes are a prime feature of adipose tissue dysfunction, and may be an appropriate target to decrease disease risk in obesity. We aimed to assess the change in adipocyte size in response to lifestyle and surgical weight loss interventions for overweight or obesity; and to explore whether certain participant and intervention characteristics influence this response. METHODS We systematically searched MEDLINE, EMBASE, CINAHL and Cochrane electronic databases to identify weight loss studies that quantified adipocyte size before and after the intervention. Using meta-regression analysis, we assessed the independent effects of weight loss, age, sex, adipocyte region, and intervention type (surgical vs. lifestyle) on adipocyte size reduction. We repeated the model as a sensitivity analysis including only the lifestyle interventions. RESULTS Thirty-five studies met our eligibility criteria. In our main model, every 1.0% weight loss was associated with a 0.64% reduction in adipocyte size (p=0.003); and adipocytes from the upper body decreased 5% more in size than those in the lower body (p=0.009). These relationships were no longer significant when focusing only on lifestyle interventions. Moreover, age, sex and intervention type did not independently affect adipocyte size reduction in either model. CONCLUSIONS Weight loss in obese individuals is consistently associated with a decrease in adipocyte size that is more pronounced in upper-body adipocytes. It remains to be clarified how biological differences and intervention characteristics influence this relationship, and whether it corresponds with reductions in other aspects of adipose tissue dysfunction and disease risk.
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Affiliation(s)
- Jessica Murphy
- Department of Exercise Science, Concordia University, 7141 Sherbrooke St. W., Montreal, Quebec, Canada, H4B 1R6; Nutrition, Obesity and Metabolism Laboratory, PERFORM Centre, Concordia University, 7200 Sherbrooke St. W., Montreal, Quebec, Canada, H4B 1R6; Centre de Recherche - Axe Maladies Chroniques, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Ile-de-Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 Gouin Blvd. W., Montreal, Quebec, Canada, H4J 1C5
| | - Grégory Moullec
- Centre de Recherche - Axe Maladies Chroniques, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Ile-de-Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 Gouin Blvd. W., Montreal, Quebec, Canada, H4J 1C5; École de Santé Publique - Département de Médecine Sociale et Preventive, Université de Montréal, 7101 du Parc Ave., Montreal, Quebec, Canada, H3N 1X9
| | - Sylvia Santosa
- Department of Exercise Science, Concordia University, 7141 Sherbrooke St. W., Montreal, Quebec, Canada, H4B 1R6; Nutrition, Obesity and Metabolism Laboratory, PERFORM Centre, Concordia University, 7200 Sherbrooke St. W., Montreal, Quebec, Canada, H4B 1R6; Centre de Recherche - Axe Maladies Chroniques, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Ile-de-Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 Gouin Blvd. W., Montreal, Quebec, Canada, H4J 1C5.
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102
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Martinez JA, Wertheim BC, Thomson CA, Bea JW, Wallace R, Allison M, Snetselaa L, Chen Z, Nassir R, Thompson PA. Physical Activity Modifies the Association between Dietary Protein and Lean Mass of Postmenopausal Women. J Acad Nutr Diet 2017; 117:192-203.e1. [PMID: 27914915 PMCID: PMC5276713 DOI: 10.1016/j.jand.2016.10.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 10/04/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Maintenance of lean muscle mass and related strength is associated with lower risk for numerous chronic diseases of aging in women. OBJECTIVE Our aim was to evaluate whether the association between dietary protein and lean mass differs by physical activity level, amino acid composition, and body mass index categories. DESIGN We performed a cross-sectional analysis of a prospective cohort. PARTICIPANTS/SETTING Participants were postmenopausal women from the Women's Health Initiative with body composition measurements by dual-energy x-ray absorptiometry (n=8,298). MAIN OUTCOME MEASURES Our study measured percent lean mass, percent fat mass, and lean body mass index. STATISTICAL ANALYSES PERFORMED Linear regression models adjusted for scanner serial number, age, calibrated energy intake, race/ethnicity, neighborhood socioeconomic status, and recreational physical activity were used to determine the relationship between protein intake and body composition measures. Likelihood ratio tests and stratified analysis were used to investigate physical activity and body mass index as potential effect modifiers. RESULTS Biomarker-calibrated protein intake was positively associated with percent lean mass; women in the highest protein quintile had 6.3 percentage points higher lean mass than the lowest quintile (P<0.001). This difference rose to 8.5 percentage points for physically active women in the highest protein quintile (Pinteraction=0.023). Percent fat mass and lean body mass index were both inversely related to protein intake (both P<0.001). Physical activity further reduced percent fat mass (Pinteraction=0.022) and lean body mass index (Pinteraction=0.011). Leucine intake was associated with lean mass, as were branched chain amino acids combined (both P<0.001), but not independent of total protein. All associations were observed for normal-weight, overweight, and obese women. CONCLUSIONS Protein consumption up to 2.02 g/kg body weight daily is positively associated with lean mass in postmenopausal women. Importantly, those that also engage in physical activity have the highest lean mass across body mass index categories.
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Affiliation(s)
- Jessica A. Martinez
- Department of Nutritional Sciences, University of Arizona Cancer Center, University of Arizona, Tucson, AZ, phone: (520) 626-6326,
| | - Betsy C. Wertheim
- University of Arizona Cancer Center, Tucson, AZ, phone: (520) 777-1666,
| | - Cynthia A. Thomson
- Mel & Enid Zuckerman College of Public Health, University of Arizona Cancer Center, University of Arizona, Tucson, AZ, phone: (520) 940-1759
| | - Jennifer W. Bea
- Department of Nutritional Sciences, University of Arizona Cancer Center Tucson, AZ, phone: (520) 626-0912,
| | - Robert Wallace
- Department of Epidemiology, MD, MSc, University of Iowa, Iowa City, IA, phone: (319) 384-1551,
| | - Matthew Allison
- Department of Family Medicine and Public Health, University of California, San Diego, CA, phone: (858) 822-7671,
| | - Linda Snetselaa
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, phone: (319) 384-1553,
| | - Zhao Chen
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, phone: (520) 626-901,
| | - Rami Nassir
- Department of Biochemistry and Molecular Medicine, University of California, Davis, CA phone: (530) 754-6016,
| | - Patricia A. Thompson
- Department of Pathology, Stony Brook University, Stony Brook, NY, phone: (631) 444-6818,
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103
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Gomez-Arbelaez D, Bellido D, Castro AI, Ordoñez-Mayan L, Carreira J, Galban C, Martinez-Olmos MA, Crujeiras AB, Sajoux I, Casanueva FF. Body Composition Changes After Very-Low-Calorie Ketogenic Diet in Obesity Evaluated by 3 Standardized Methods. J Clin Endocrinol Metab 2017; 102:488-498. [PMID: 27754807 DOI: 10.1210/jc.2016-2385] [Citation(s) in RCA: 144] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 10/12/2016] [Indexed: 02/04/2023]
Abstract
CONTEXT Common concerns when using low-calorie diets as a treatment for obesity are the reduction in fat-free mass, mostly muscular mass, that occurs together with the fat mass (FM) loss, and determining the best methodologies to evaluate body composition changes. OBJECTIVE This study aimed to evaluate the very-low-calorie ketogenic (VLCK) diet-induced changes in body composition of obese patients and to compare 3 different methodologies used to evaluate those changes. DESIGN Twenty obese patients followed a VLCK diet for 4 months. Body composition assessment was performed by dual-energy X-ray absorptiometry (DXA), multifrequency bioelectrical impedance (MF-BIA), and air displacement plethysmography (ADP) techniques. Muscular strength was also assessed. Measurements were performed at 4 points matched with the ketotic phases (basal, maximum ketosis, ketosis declining, and out of ketosis). RESULTS After 4 months the VLCK diet induced a -20.2 ± 4.5 kg weight loss, at expenses of reductions in fat mass (FM) of -16.5 ± 5.1 kg (DXA), -18.2 ± 5.8 kg (MF-BIA), and -17.7 ± 9.9 kg (ADP). A substantial decrease was also observed in the visceral FM. The mild but marked reduction in fat-free mass occurred at maximum ketosis, primarily as a result of changes in total body water, and was recovered thereafter. No changes in muscle strength were observed. A strong correlation was evidenced between the 3 methods of assessing body composition. CONCLUSION The VLCK diet-induced weight loss was mainly at the expense of FM and visceral mass; muscle mass and strength were preserved. Of the 3 body composition techniques used, the MF-BIA method seems more convenient in the clinical setting.
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Affiliation(s)
| | - Diego Bellido
- Division of Endocrinology, Complejo Hospitalario Universitario de Ferrol and Coruña University, 15405 Ferrol, Spain
| | - Ana I Castro
- Division of Endocrinology, Department of Medicine, and
- Centro de Investigacion Biomedica en Red de Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Instituto Salud Carlos III, 15706 Santiago de Compostela, Spain
| | | | - Jose Carreira
- Family Medicine, Sanitary Area of Ferrol, 15405 Ferrol, Spain
| | - Cristobal Galban
- Intensive Care Division, Complejo Hospitalario Universitario de Santiago, 15706 Santiago de Compostela, Spain
| | - Miguel A Martinez-Olmos
- Division of Endocrinology, Department of Medicine, and
- Centro de Investigacion Biomedica en Red de Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Instituto Salud Carlos III, 15706 Santiago de Compostela, Spain
| | - Ana B Crujeiras
- Division of Endocrinology, Department of Medicine, and
- Centro de Investigacion Biomedica en Red de Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Instituto Salud Carlos III, 15706 Santiago de Compostela, Spain
| | - Ignacio Sajoux
- Medical Department PronoKal Group, 08009 Barcelona, Spain; and
| | - Felipe F Casanueva
- Division of Endocrinology, Department of Medicine, and
- Centro de Investigacion Biomedica en Red de Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Instituto Salud Carlos III, 15706 Santiago de Compostela, Spain
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104
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Veum VL, Laupsa-Borge J, Eng Ø, Rostrup E, Larsen TH, Nordrehaug JE, Nygård OK, Sagen JV, Gudbrandsen OA, Dankel SN, Mellgren G. Visceral adiposity and metabolic syndrome after very high-fat and low-fat isocaloric diets: a randomized controlled trial. Am J Clin Nutr 2017; 105:85-99. [PMID: 27903520 DOI: 10.3945/ajcn.115.123463] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 10/28/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Different aspects of dietary pattern, including macronutrient and food profiles, may affect visceral fat mass and metabolic syndrome. OBJECTIVE We hypothesized that consuming energy primarily from carbohydrate or fat in diets with similar food profiles would differentially affect the ability to reverse visceral adiposity and metabolic syndrome. DESIGN Forty-six men (aged 30-50 y) with body mass index (in kg/m2) >29 and waist circumference >98 cm were randomly assigned to a very high-fat, low-carbohydrate (VHFLC; 73% of energy fat and 10% of energy carbohydrate) or low-fat, high-carbohydrate (LFHC; 30% of energy fat and 53% of energy carbohydrate) diet for 12 wk. The diets were equal in energy (8750 kJ/d), protein (17% of energy), and food profile, emphasizing low-processed, lower-glycemic foods. Fat mass was quantified with computed tomography imaging. RESULTS Recorded intake of carbohydrate and total and saturated fat in the LFHC and VHFLC groups were 51% and 11% of energy, 29% and 71% of energy, and 12% and 34% of energy, respectively, with no difference in protein and polyunsaturated fatty acids. Mean energy intake decreased by 22% and 14% in the LFHC and VHFLC groups. The diets similarly reduced waist circumference (11-13 cm), abdominal subcutaneous fat mass (1650-1850 cm3), visceral fat mass (1350-1650 cm3), and total body weight (11-12 kg). Both groups improved dyslipidemia, with reduced circulating triglycerides, but showed differential responses in total and low-density lipoprotein cholesterol (decreased in LFHC group only), and high-density lipoprotein cholesterol (increased in VHFLC group only). The groups showed similar reductions in insulin, insulin C-peptide, glycated hemoglobin, and homeostasis model assessment of insulin resistance. Notably, improvements in circulating metabolic markers in the VHFLC group mainly were observed first after 8 wk, in contrast to more acute and gradual effects in the LFHC group. CONCLUSIONS Consuming energy primarily as carbohydrate or fat for 3 mo did not differentially influence visceral fat and metabolic syndrome in a low-processed, lower-glycemic dietary context. Our data do not support the idea that dietary fat per se promotes ectopic adiposity and cardiometabolic syndrome in humans. This study was registered at clinicaltrials.gov as NCT01750021.
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Affiliation(s)
- Vivian L Veum
- Department of Clinical Science.,KG Jebsen Centre for Diabetes Research, Department of Clinical Science, and.,Hormone Laboratory and
| | - Johnny Laupsa-Borge
- Department of Clinical Science.,Hormone Laboratory and.,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | | | - Espen Rostrup
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Terje H Larsen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | | | - Ottar K Nygård
- Department of Clinical Science.,KG Jebsen Centre for Diabetes Research, Department of Clinical Science, and.,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Jørn V Sagen
- Department of Clinical Science.,KG Jebsen Centre for Diabetes Research, Department of Clinical Science, and.,Hormone Laboratory and
| | | | - Simon N Dankel
- Department of Clinical Science, .,KG Jebsen Centre for Diabetes Research, Department of Clinical Science, and.,Hormone Laboratory and
| | - Gunnar Mellgren
- Department of Clinical Science, .,KG Jebsen Centre for Diabetes Research, Department of Clinical Science, and.,Hormone Laboratory and
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105
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Andersson A, Bryngelsson S. Towards a healthy diet: from nutrition recommendations to dietary advice. SCANDINAVIAN JOURNAL OF FOOD & NUTRITION 2016. [PMCID: PMC2606986 DOI: 10.1080/17482970701284338] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The scientific knowledge regarding dietary fat, carbohydrate and protein, and food for the youngest and oldest people, was presented by key scientists in the field at a symposium arranged in Uppsala on 14 December 2006. The quality of fat and carbohydrates, rather than the total amount, was emphasized. It was more difficult, however, to reach conclusions about the preferred type of dietary protein. Recent dietary recommendations, main activities and key messages to the public in the Nordic countries, and a 5 year programme to decrease salt intake in Sweden were also presented. Some practical aspects on how to implement the recommendations in the population were highlighted. In many aspects the Nordic countries join together in similar simplified advice to the population. The symposium is summarized in this report.
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Affiliation(s)
- Agneta Andersson
- Clinical Nutrition and MetabolismDepartment of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
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106
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Harris C, Buyken A, von Berg A, Berdel D, Lehmann I, Hoffmann B, Koletzko S, Koletzko B, Heinrich J, Standl M. Prospective associations of meat consumption during childhood with measures of body composition during adolescence: results from the GINIplus and LISAplus birth cohorts. Nutr J 2016; 15:101. [PMID: 27919271 PMCID: PMC5139017 DOI: 10.1186/s12937-016-0222-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 11/29/2016] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Higher meat and protein intakes have been associated with increased body weight in adults, but studies evaluating body composition are scarce. Furthermore, our knowledge in adolescents is limited. This study aimed to investigate the prospective associations of intakes of different meat types, and their respective protein contents during childhood, with body composition during adolescence. METHODS Dietary (using food frequency questionnaires) and body composition (measured by bioelectrical impedance) data were collected from the 10- and 15-year follow-up assessments respectively, of the GINIplus and LISAplus birth cohort studies. Sex-stratified prospective associations of meat and meat protein intakes (total, processed, red meat and poultry) with fat mass index (FMI) and fat free mass index (FFMI), were assessed by linear regression models (N = 1610). RESULTS Among males, higher poultry intakes at age 10 years were associated with a higher FMI at age 15 years [β = 0.278 (SE = 0.139), p = 0.046]; while higher intakes of total and red meat were prospectively associated with higher FFMI [0.386 (0.143), p = 0.007, and 0.333 (0.145), p = 0.022, respectively]. Additionally in males, protein was associated with FFMI for total and red meat [0.285 (0.145) and 0.356 (0.144), respectively]. CONCLUSIONS Prospective associations of meat consumption with subsequent body composition in adolescents may differ by sex and meat source.
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Affiliation(s)
- Carla Harris
- Institute of Epidemiology I, Helmholtz Zentrum München – German Research Centre for Environmental Health, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany
| | - Anette Buyken
- DONALD Study, IEL – Nutritional Epidemiology, University of Bonn, Dortmund, Germany
| | - Andrea von Berg
- Research Institute, Department of Pediatrics, Marien-Hospital, Wesel, Germany
| | - Dietrich Berdel
- Research Institute, Department of Pediatrics, Marien-Hospital, Wesel, Germany
| | - Irina Lehmann
- Core Facility ‘Studies’, Helmholtz Zentrum für Umweltforschung UFZ, Leipzig, Germany
- Department of Environmental Immunology, Helmholtz Zentrum für Umweltforschung UFZ, Leipzig, Germany
| | - Barbara Hoffmann
- Institute of Occupational, Social and Environmental Medicine, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany
| | - Sibylle Koletzko
- Ludwig Maximilians-Universität München, Dr. von Hauner Children’s Hospital, Munich, Germany
| | - Berthold Koletzko
- Ludwig Maximilians-Universität München, Dr. von Hauner Children’s Hospital, Munich, Germany
| | - Joachim Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München – German Research Centre for Environmental Health, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich (LMU), Munich, Germany
| | - Marie Standl
- Institute of Epidemiology I, Helmholtz Zentrum München – German Research Centre for Environmental Health, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany
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107
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van den Broek M, de Heide LJM, Veeger NJGM, van der Wal-Oost AM, van Beek AP. Influence of dietary protein and its amino acid composition on postoperative outcomes after gastric bypass surgery: a systematic review. Nutr Rev 2016; 74:749-773. [PMID: 27864536 DOI: 10.1093/nutrit/nuw042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
CONTEXT Bariatric surgery is an effective method to reduce morbid obesity. Nutritional counseling is essential to achieve maximal treatment success and to avoid long-term complications. Increased dietary protein intake may improve various postoperative results. OBJECTIVE The aim of this systematic review is to examine the relationship between intake of dietary protein or supplementation with amino acids and postoperative outcomes after gastric bypass surgery. DATA SOURCES A systematic literature search was conducted in 4 electronic databases: Cochrane, Embase, PubMed, and Scopus. STUDY SELECTION The initial search retrieved 7333 hits, which included 2390 duplicates. DATA EXTRACTION Tweny-three studies with varying study designs, interventions, and outcomes were included. RESULTS Studies did not provide convincing evidence of a beneficial effect on any postoperative outcome. CONCLUSIONS The study of the influence of protein and its amino acid composition represents an important developing domain of knowledge and warrants further attention considering the popularity of bariatric surgery. Future studies should include a clear description of the quantity and composition of proteins and amino acids in the diet or supplement.
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Affiliation(s)
- Merel van den Broek
- M. van den Broek and L.J.M. de Heide are with the Department of Internal Medicine, Medical Center Leeuwarden, Leeuwarden, the Netherlands. N.J.G.M. Veeger is with the Department of Epidemiology, Medical Center Leeuwarden, Leeuwarden, the Netherlands. N.J.G.M. Veeger is with the Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. A.M. van der Wal-Oost is with the MCL Academy, Medical Center Leeuwarden, Leeuwarden, the Netherlands. A.P. van Beek is with the Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - Loek J M de Heide
- M. van den Broek and L.J.M. de Heide are with the Department of Internal Medicine, Medical Center Leeuwarden, Leeuwarden, the Netherlands. N.J.G.M. Veeger is with the Department of Epidemiology, Medical Center Leeuwarden, Leeuwarden, the Netherlands. N.J.G.M. Veeger is with the Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. A.M. van der Wal-Oost is with the MCL Academy, Medical Center Leeuwarden, Leeuwarden, the Netherlands. A.P. van Beek is with the Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Nic J G M Veeger
- M. van den Broek and L.J.M. de Heide are with the Department of Internal Medicine, Medical Center Leeuwarden, Leeuwarden, the Netherlands. N.J.G.M. Veeger is with the Department of Epidemiology, Medical Center Leeuwarden, Leeuwarden, the Netherlands. N.J.G.M. Veeger is with the Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. A.M. van der Wal-Oost is with the MCL Academy, Medical Center Leeuwarden, Leeuwarden, the Netherlands. A.P. van Beek is with the Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Alies M van der Wal-Oost
- M. van den Broek and L.J.M. de Heide are with the Department of Internal Medicine, Medical Center Leeuwarden, Leeuwarden, the Netherlands. N.J.G.M. Veeger is with the Department of Epidemiology, Medical Center Leeuwarden, Leeuwarden, the Netherlands. N.J.G.M. Veeger is with the Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. A.M. van der Wal-Oost is with the MCL Academy, Medical Center Leeuwarden, Leeuwarden, the Netherlands. A.P. van Beek is with the Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - André P van Beek
- M. van den Broek and L.J.M. de Heide are with the Department of Internal Medicine, Medical Center Leeuwarden, Leeuwarden, the Netherlands. N.J.G.M. Veeger is with the Department of Epidemiology, Medical Center Leeuwarden, Leeuwarden, the Netherlands. N.J.G.M. Veeger is with the Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. A.M. van der Wal-Oost is with the MCL Academy, Medical Center Leeuwarden, Leeuwarden, the Netherlands. A.P. van Beek is with the Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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108
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Webel AR, Sattar A, Funderburg NT, Kinley B, Longenecker CT, Labbato D, Alam SK, McComsey GA. Alcohol and dietary factors associate with gut integrity and inflammation in HIV-infected adults. HIV Med 2016; 18:402-411. [PMID: 27860212 DOI: 10.1111/hiv.12442] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2016] [Indexed: 12/19/2022]
Abstract
OBJECTIVES HIV-infected adults have heightened monocyte activation and inflammation, at least partially as a consequence of altered gut integrity. The role of dietary factors in microbial translocation and inflammation and their downstream effect on markers of cardiovascular disease (CVD) have not been explored. Our purpose was to describe the longitudinal dietary patterns of HIV-infected adults, and to examine the relationship between dietary intake, gut integrity, inflammation and subclinical markers of CVD in HIV-infected adults. METHODS We conducted a secondary analysis of 147 HIV-infected participants in a 96-week randomized clinical trial of rosuvastatin as primary CVD prevention. Dietary intake was assessed using dietary recall; plasma gut integrity, monocyte activation and inflammation markers were measured using an enzyme-linked immunosorbent assay (ELISA); and CVD risk was assessed using carotid ultrasound and the coronary artery calcium score. Linear mixed models were used to analyse longitudinally measured biomarkers. RESULTS The median age was 45 years and 78% of patients were male. At baseline, participants consumed a mean (standard deviation) of 108 (70) g of fat daily, 19 (15.6) g of fibre, 266 (186) g of carbohydrates and 15.6 (5.9) g of protein; 45% of the sample consumed alcohol. Over time, alcohol consumption was associated with several markers of gut integrity and inflammation (all P < 0.05). CONCLUSIONS HIV-infected adults in a contemporary, high-resource setting have poor dietary patterns. Alcohol use was associated with worse gut integrity and increased inflammation, while other aspects of diet (fibre, carbohydrates and fat) were not. These data add to growing evidence illustrating the need for a better understanding of the effect of lifestyle factors on comorbidities in HIV-infected adults.
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Affiliation(s)
- A R Webel
- Case Western Reserve University, Cleveland, OH, USA.,Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - A Sattar
- Case Western Reserve University, Cleveland, OH, USA.,Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - N T Funderburg
- School of Health and Rehabilitation Sciences, Division of Medical Laboratory Science, The Ohio State University, Columbus, OH, USA
| | - B Kinley
- Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | - C T Longenecker
- Case Western Reserve University, Cleveland, OH, USA.,University Hospitals Harrington Heart & Vascular Institute, Cleveland, OH, USA
| | - D Labbato
- Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | - Sm Khurshid Alam
- Case Western Reserve University, Cleveland, OH, USA.,Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - G A McComsey
- Case Western Reserve University, Cleveland, OH, USA.,Rainbow Babies and Children's Hospital, Cleveland, OH, USA
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109
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Paired editorial: Inadequate protein intake following laparoscopic sleeve gastrectomy surgery is associated with a greater fat free mass loss. Surg Obes Relat Dis 2016; 13:109-110. [PMID: 27720194 DOI: 10.1016/j.soard.2016.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 08/04/2016] [Indexed: 11/20/2022]
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110
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Porter Starr KN, Pieper CF, Orenduff MC, McDonald SR, McClure LB, Zhou R, Payne ME, Bales CW. Improved Function With Enhanced Protein Intake per Meal: A Pilot Study of Weight Reduction in Frail, Obese Older Adults. J Gerontol A Biol Sci Med Sci 2016; 71:1369-75. [PMID: 26786203 PMCID: PMC5018561 DOI: 10.1093/gerona/glv210] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 10/27/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Obesity is a significant cause of functional limitations in older adults; yet, concerns that weight reduction could diminish muscle along with fat mass have impeded progress toward an intervention. Meal-based enhancement of protein intake could protect function and/or lean mass but has not been studied during geriatric obesity reduction. METHODS In this 6-month randomized controlled trial, 67 obese (body mass index ≥30kg/m(2)) older (≥60 years) adults with a Short Physical Performance Battery score of 4-10 were randomly assigned to a traditional (Control) weight loss regimen or one with higher protein intake (>30g) at each meal (Protein). All participants were prescribed a hypo-caloric diet, and weighed and provided dietary guidance weekly. Physical function (Short Physical Performance Battery) and lean mass (BOD POD), along with secondary measures, were assessed at 0, 3, and 6 months. RESULTS At the 6-month endpoint, there was significant (p < .001) weight loss in both the Control (-7.5±6.2kg) and Protein (-8.7±7.4kg) groups. Both groups also improved function but the increase in the Protein (+2.4±1.7 units; p < .001) was greater than in the Control (+0.9±1.7 units; p < .01) group (p = .02). CONCLUSION Obese, functionally limited older adults undergoing a 6-month weight loss intervention with a meal-based enhancement of protein quantity and quality lost similar amounts of weight but had greater functional improvements relative to the Control group. If confirmed, this dietary approach could have important implications for improving the functional status of this vulnerable population (ClinicalTrials.gov identifier: NCT01715753).
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Affiliation(s)
- Kathryn N Porter Starr
- Center for the Study of Aging, Duke University Medical Center, Durham, North Carolina. Geriatric Research, Education, and Clinical Center, Durham VA Medical Center, North Carolina.
| | - Carl F Pieper
- Center for the Study of Aging, Duke University Medical Center, Durham, North Carolina. Department of Biostatistics and Bioinformatics
| | - Melissa C Orenduff
- Center for the Study of Aging, Duke University Medical Center, Durham, North Carolina
| | | | - Luisa B McClure
- Center for the Study of Aging, Duke University Medical Center, Durham, North Carolina
| | - Run Zhou
- Department of Biostatistics and Bioinformatics
| | - Martha E Payne
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
| | - Connie W Bales
- Center for the Study of Aging, Duke University Medical Center, Durham, North Carolina. Geriatric Research, Education, and Clinical Center, Durham VA Medical Center, North Carolina. Department of Medicine, and
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111
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Gibson AA, Franklin J, Pattinson AL, Cheng ZGY, Samman S, Markovic TP, Sainsbury A. Comparison of Very Low Energy Diet Products Available in Australia and How to Tailor Them to Optimise Protein Content for Younger and Older Adult Men and Women. Healthcare (Basel) 2016; 4:healthcare4030071. [PMID: 27657150 PMCID: PMC5041072 DOI: 10.3390/healthcare4030071] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 08/24/2016] [Accepted: 09/08/2016] [Indexed: 12/21/2022] Open
Abstract
Very low energy diets (VLED) are efficacious in inducing rapid weight loss but may not contain adequate macronutrients or micronutrients for individuals with varying nutritional requirements. Adequate protein intake during weight loss appears particularly important to help preserve fat free mass and control appetite, and low energy and carbohydrate content also contributes to appetite control. Therefore, the purpose of this study was to compare the nutritional content (with a focus on protein), nutritional adequacy and cost of all commercially-available VLED brands in Australia. Nutritional content and cost were extracted and compared between brands and to the Recommended Dietary Intake (RDI) or adequate intake (AI) of macronutrients and micronutrients for men and women aged 19-70 years or >70 years. There was wide variability in the nutritional content, nutritional adequacy and cost of VLED brands. Most notably, even brands with the highest daily protein content, based on consuming three products/day (KicStart™ and Optislim(®), ~60 g/day), only met estimated protein requirements of the smallest and youngest women for whom a VLED would be indicated. Considering multiple options to optimise protein content, we propose that adding pure powdered protein is the most suitable option because it minimizes additional energy, carbohydrate and cost of VLEDs.
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Affiliation(s)
- Alice A Gibson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Sydney 2006, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
| | - Janet Franklin
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown 2050, Australia.
| | - Andrea L Pattinson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Sydney 2006, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
| | - Zilvia G Y Cheng
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Sydney 2006, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
| | - Samir Samman
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand.
- School of Life and Environmental Sciences, The University of Sydney, Sydney 2006, Australia.
| | - Tania P Markovic
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Sydney 2006, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown 2050, Australia.
| | - Amanda Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Sydney 2006, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
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112
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Egan B. Protein intake for athletes and active adults: Current concepts and controversies. NUTR BULL 2016. [DOI: 10.1111/nbu.12215] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- B. Egan
- School of Health and Human Performance; Dublin City University; Dublin Ireland
- Food for Health Ireland; University College Dublin; Dublin Ireland
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113
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Krishnan S, Hendriks HFJ, Hartvigsen ML, de Graaf AA. Feed-forward neural network model for hunger and satiety related VAS score prediction. Theor Biol Med Model 2016; 13:17. [PMID: 27387922 PMCID: PMC4936290 DOI: 10.1186/s12976-016-0043-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 06/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An artificial neural network approach was chosen to model the outcome of the complex signaling pathways in the gastro-intestinal tract and other peripheral organs that eventually produce the satiety feeling in the brain upon feeding. METHODS A multilayer feed-forward neural network was trained with sets of experimental data relating concentration-time courses of plasma satiety hormones to Visual Analog Scales (VAS) scores. The network successfully predicted VAS responses from sets of satiety hormone data obtained in experiments using different food compositions. RESULTS The correlation coefficients for the predicted VAS responses for test sets having i) a full set of three satiety hormones, ii) a set of only two satiety hormones, and iii) a set of only one satiety hormone were 0.96, 0.96, and 0.89, respectively. The predicted VAS responses discriminated the satiety effects of high satiating food types from less satiating food types both in orally fed and ileal infused forms. CONCLUSIONS From this application of artificial neural networks, one may conclude that neural network models are very suitable to describe situations where behavior is complex and incompletely understood. However, training data sets that fit the experimental conditions need to be available.
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Affiliation(s)
- Shaji Krishnan
- Risk Analysis for Products In Development, TNO, Utrechtseweg 48, P.O. Box 360, Zeist, 3700 AJ, The Netherlands. .,Top Institute Food and Nutrition, Nieuwe Kanaal 9A, Wageningen, 6709 PA, The Netherlands.
| | - Henk F J Hendriks
- Top Institute Food and Nutrition, Nieuwe Kanaal 9A, Wageningen, 6709 PA, The Netherlands
| | - Merete L Hartvigsen
- Department of Endocrinology and Internal Medicine, Aarhus University, Tage-Hansens Gade 2, Aarhus C, DK-8000, Denmark
| | - Albert A de Graaf
- Risk Analysis for Products In Development, TNO, Utrechtseweg 48, P.O. Box 360, Zeist, 3700 AJ, The Netherlands.,Top Institute Food and Nutrition, Nieuwe Kanaal 9A, Wageningen, 6709 PA, The Netherlands
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114
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Stonehouse W, Wycherley T, Luscombe-Marsh N, Taylor P, Brinkworth G, Riley M. Dairy Intake Enhances Body Weight and Composition Changes during Energy Restriction in 18-50-Year-Old Adults-A Meta-Analysis of Randomized Controlled Trials. Nutrients 2016; 8:nu8070394. [PMID: 27376321 PMCID: PMC4963870 DOI: 10.3390/nu8070394] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 06/07/2016] [Accepted: 06/22/2016] [Indexed: 01/09/2023] Open
Abstract
Background/Aims: A meta-analysis of randomized controlled trials (RCTs) was performed to investigate the effects of dairy food or supplements during energy restriction on body weight and composition in 18–50-year-old. Methods: RCTs ≥ 4 weeks comparing the effect of dairy consumption (whole food or supplements) with control diets lower in dairy during energy restriction on body weight, fat and lean mass were identified by searching MEDLINE, EMBASE, Pubmed, Cochrane Central and World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) until March 2016. Reports were identified and critically appraised in duplicate. Data were pooled using random-effects meta-analysis. Chi2- and I2-statistics indicated heterogeneity. Dose effect was assessed using meta-regression analysis. GRADE guidelines were used to rate the quality (QR) of the evidence considering risk of bias, inconsistency, indirectness, imprecision, publication bias and effect estimates. Results: 27 RCTs were reviewed. Participants consumed between 2 and 4 standard servings/day of dairy food or 20–84 g/day of whey protein compared to low dairy control diets, over a median of 16 weeks. A greater reduction in body weight (−1.16 kg [−1.66, −0.66 kg], p < 0.001, I2 = 11%, QR = high, n = 644) and body fat mass (−1.49 kg [−2.06, −0.92 kg], p < 0.001, I2 = 21%, n = 521, QR = high) were found in studies largely including women (90% women). These effects were absent in studies that imposed resistance training (QR = low-moderate). Dairy intake resulted in smaller loss of lean mass (all trials pooled: 0.36 kg [0.01, 0.71 kg], p = 0.04, I2 = 64%, n = 651, QR = moderate). No between study dose-response effects were seen. Conclusions: Increased dairy intake as part of energy restricted diets resulted in greater loss in bodyweight and fat mass while attenuating lean mass loss in 18–50-year-old adults. Further research in males is needed to investigate sex effects.
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Affiliation(s)
- Welma Stonehouse
- Commonwealth Scientific Industrial Research Organisation, Adelaide 5000, South Australia, Australia.
| | - Thomas Wycherley
- School of Health Sciences, University of South Australia, Adelaide 5000, South Australia, Australia.
| | - Natalie Luscombe-Marsh
- Commonwealth Scientific Industrial Research Organisation, Adelaide 5000, South Australia, Australia.
| | - Pennie Taylor
- Commonwealth Scientific Industrial Research Organisation, Adelaide 5000, South Australia, Australia.
| | - Grant Brinkworth
- Commonwealth Scientific Industrial Research Organisation, Adelaide 5000, South Australia, Australia.
| | - Malcolm Riley
- Commonwealth Scientific Industrial Research Organisation, Adelaide 5000, South Australia, Australia.
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115
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Impact of a High-Fat or High-Fiber Diet on Intestinal Microbiota and Metabolic Markers in a Pig Model. Nutrients 2016; 8:nu8050317. [PMID: 27223303 PMCID: PMC4882729 DOI: 10.3390/nu8050317] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 05/03/2016] [Accepted: 05/16/2016] [Indexed: 12/18/2022] Open
Abstract
To further elaborate interactions between nutrition, gut microbiota and host health, an animal model to simulate changes in microbial composition and activity due to dietary changes similar to those in humans is needed. Therefore, the impact of two different diets on cecal and colonic microbial gene copies and metabolic activity, organ development and biochemical parameters in blood serum was investigated using a pig model. Four pigs were either fed a low-fat/high-fiber (LF), or a high-fat/low-fiber (HF) diet for seven weeks, with both diets being isocaloric. A hypotrophic effect of the HF diet on digestive organs could be observed compared to the LF diet (p < 0.05). Higher gene copy numbers of Bacteroides (p < 0.05) and Enterobacteriaceae (p < 0.001) were present in intestinal contents of HF pigs, bifidobacteria were more abundant in LF pigs (p < 0.05). Concentrations of acetate and butyrate were higher in LF pigs (p < 0.05). Glucose was higher in HF pigs, while glutamic pyruvic transaminase (GPT) showed higher concentrations upon feeding the LF diet (p < 0.001). However, C-reactive protein (CRP) decreased with time in LF pigs (p < 0.05). In part, these findings correspond to those in humans, and are in support of the concept of using the pig as human model.
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116
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Genoni A, Lyons-Wall P, Lo J, Devine A. Cardiovascular, Metabolic Effects and Dietary Composition of Ad-Libitum Paleolithic vs. Australian Guide to Healthy Eating Diets: A 4-Week Randomised Trial. Nutrients 2016; 8:E314. [PMID: 27223304 PMCID: PMC4882726 DOI: 10.3390/nu8050314] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 05/16/2016] [Accepted: 05/17/2016] [Indexed: 01/22/2023] Open
Abstract
(1) BACKGROUND: The Paleolithic diet is popular in Australia, however, limited literature surrounds the dietary pattern. Our primary aim was to compare the Paleolithic diet with the Australian Guide to Healthy Eating (AGHE) in terms of anthropometric, metabolic and cardiovascular risk factors, with a secondary aim to examine the macro and micronutrient composition of both dietary patterns; (2) METHODS: 39 healthy women (mean ± SD age 47 ± 13 years, BMI 27 ± 4 kg/m²) were randomised to either the Paleolithic (n = 22) or AGHE diet (n = 17) for four weeks. Three-day weighed food records, body composition and biochemistry data were collected pre and post intervention; (3) RESULTS: Significantly greater weight loss occurred in the Paleolithic group (-1.99 kg, 95% CI -2.9, -1.0), p < 0.001). There were no differences in cardiovascular and metabolic markers between groups. The Paleolithic group had lower intakes of carbohydrate (-14.63% of energy (E), 95% CI -19.5, -9.7), sodium (-1055 mg/day, 95% CI -1593, -518), calcium (-292 mg/day 95% CI -486.0, -99.0) and iodine (-47.9 μg/day, 95% CI -79.2, -16.5) and higher intakes of fat (9.39% of E, 95% CI 3.7, 15.1) and β-carotene (6777 μg/day 95% CI 2144, 11410) (all p < 0.01); (4) CONCLUSIONS: The Paleolithic diet induced greater changes in body composition over the short-term intervention, however, larger studies are recommended to assess the impact of the Paleolithic vs. AGHE diets on metabolic and cardiovascular risk factors in healthy populations.
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Affiliation(s)
- Angela Genoni
- School of Medical and Health Sciences, Edith Cowan University, Perth 6027, Australia.
| | - Philippa Lyons-Wall
- School of Medical and Health Sciences, Edith Cowan University, Perth 6027, Australia.
| | - Johnny Lo
- School of Science, Edith Cowan University, Perth 6027, Australia.
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Perth 6027, Australia.
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117
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Mycoprotein reduces energy intake and postprandial insulin release without altering glucagon-like peptide-1 and peptide tyrosine-tyrosine concentrations in healthy overweight and obese adults: a randomised-controlled trial. Br J Nutr 2016; 116:360-74. [PMID: 27198187 PMCID: PMC4910676 DOI: 10.1017/s0007114516001872] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Dietary mycoprotein decreases energy intake in lean individuals. The effects in overweight individuals are unclear, and the mechanisms remain to be elucidated. This study aimed to investigate the effect of mycoprotein on energy intake, appetite regulation, and the metabolic phenotype in overweight and obese volunteers. In two randomised-controlled trials, fifty-five volunteers (age: 31 (95 % CI 27, 35) years), BMI: 28·0 (95 % CI 27·3, 28·7) kg/m2) consumed a test meal containing low (44 g), medium (88 g) or high (132 g) mycoprotein or isoenergetic chicken meals. Visual analogue scales and blood samples were collected to measure appetite, glucose, insulin, peptide tyrosine-tyrosine (PYY) and glucagon-like peptide-1 (GLP-1). Ad libitum energy intake was assessed after 3 h in part A (n 36). Gastric emptying by the paracetamol method, resting energy expenditure and substrate oxidation were recorded in part B (n 14). Metabonomics was used to compare plasma and urine samples in response to the test meals. Mycoprotein reduced energy intake by 10 % (280 kJ (67 kcal)) compared with chicken at the high content (P=0·009). All mycoprotein meals reduced insulin concentrations compared with chicken (incremental AUClow (IAUClow): -8 %, IAUCmedium: -12 %, IAUChigh: -21 %, P=0·004). There was no significant difference in glucose, PYY, GLP-1, gastric emptying rate and energy expenditure. Following chicken intake, paracetamol-glucuronide was positively associated with fullness. After mycoprotein, creatinine and the deamination product of isoleucine, α-keto-β-methyl-N-valerate, were inversely related to fullness, whereas the ketone body, β-hydroxybutyrate, was positively associated. In conclusion, mycoprotein reduces energy intake and insulin release in overweight volunteers. The mechanism does not involve changes in PYY and GLP-1. The metabonomics analysis may bring new understanding to the appetite regulatory properties of food.
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118
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Simmons E, Fluckey JD, Riechman SE. Cumulative Muscle Protein Synthesis and Protein Intake Requirements. Annu Rev Nutr 2016; 36:17-43. [PMID: 27215586 DOI: 10.1146/annurev-nutr-071813-105549] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Muscle protein synthesis (MPS) fluctuates widely over the course of a day and is influenced by many factors. The time course of MPS responses to exercise and the influence of training and nutrition can only be pieced together from several different investigations and methods, many of which create unnatural experimental conditions. Measurements of cumulative MPS, the sum synthesis over an extended period, using deuterium oxide have been shown to accurately reflect muscle responses and may allow investigations of the response to exercise, total protein intake requirements, and interaction with protein timing in free-living experimental conditions; these factors have yet to be carefully integrated. Such studies could include clinical and athletic populations to integrate nutritional and exercise recommendations and help guide their revisions to optimize the skeletal muscle function that is so important to overall health.
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Affiliation(s)
- Erin Simmons
- Department of Nutrition and Food Science, Texas A&M University, College Station, Texas 77843; ,
| | - James D Fluckey
- Department of Health and Kinesiology, Texas A&M University, College Station, Texas 77843;
| | - Steven E Riechman
- Department of Nutrition and Food Science, Texas A&M University, College Station, Texas 77843; , .,Department of Health and Kinesiology, Texas A&M University, College Station, Texas 77843;
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119
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Parr EB, Coffey VG, Cato LE, Phillips SM, Burke LM, Hawley JA. A randomized trial of high-dairy-protein, variable-carbohydrate diets and exercise on body composition in adults with obesity. Obesity (Silver Spring) 2016; 24:1035-45. [PMID: 26931302 DOI: 10.1002/oby.21451] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 12/09/2015] [Accepted: 12/12/2015] [Indexed: 12/31/2022]
Abstract
OBJECTIVE This study determined the effects of 16-week high-dairy-protein, variable-carbohydrate (CHO) diets and exercise training (EXT) on body composition in men and women with overweight/obesity. METHODS One hundred and eleven participants (age 47 ± 6 years, body mass 90.9 ± 11.7 kg, BMI 33 ± 4 kg/m(2) , values mean ± SD) were randomly stratified to diets with either: high dairy protein, moderate CHO (40% CHO: 30% protein: 30% fat; ∼4 dairy servings); high dairy protein, high CHO (55%: 30%: 15%; ∼4 dairy servings); or control (55%: 15%: 30%; ∼1 dairy serving). Energy restriction (500 kcal/day) was achieved through diet (∼250 kcal/day) and EXT (∼250 kcal/day). Body composition was measured using dual-energy X-ray absorptiometry before, midway, and upon completion of the intervention. RESULTS Eighty-nine (25 M/64 F) of 115 participants completed the 16-week intervention, losing 7.7 ± 3.2 kg fat mass (P < 0.001) and gaining 0.50 ± 1.75 kg lean mass (P < 0.01). There was no difference in the changes in body composition (fat mass or lean mass) between groups. CONCLUSIONS Compared to a healthy control diet, energy-restricted high-protein diets containing different proportions of fat and CHO confer no advantage to weight loss or change in body composition in the presence of an appropriate exercise stimulus.
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Affiliation(s)
- Evelyn B Parr
- Mary MacKillop Institute for Health Research, Centre for Exercise and Nutrition, Australian Catholic University, Melbourne, Australia
| | - Vernon G Coffey
- Bond Institute of Health and Sport, Bond University, Gold Coast, Queensland, Australia
| | - Louise E Cato
- Department of Sports Nutrition, Australian Institute of Sport, Canberra, Australia
| | - Stuart M Phillips
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Louise M Burke
- Mary MacKillop Institute for Health Research, Centre for Exercise and Nutrition, Australian Catholic University, Melbourne, Australia
- Department of Sports Nutrition, Australian Institute of Sport, Canberra, Australia
| | - John A Hawley
- Mary MacKillop Institute for Health Research, Centre for Exercise and Nutrition, Australian Catholic University, Melbourne, Australia
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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120
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Mok A, Haldar S, Lee JCY, Leow MKS, Henry CJ. Postprandial changes in cardiometabolic disease risk in young Chinese men following isocaloric high or low protein diets, stratified by either high or low meal frequency - a randomized controlled crossover trial. Nutr J 2016; 15:27. [PMID: 26979583 PMCID: PMC4793530 DOI: 10.1186/s12937-016-0141-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 02/24/2016] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Cardio-Metabolic Disease (CMD) is the leading cause of death globally and particularly in Asia. Postprandial elevation of glycaemia, insulinaemia, triglyceridaemia are associated with an increased risk of CMD. While studies have shown that higher protein intake or increased meal frequency may benefit postprandial metabolism, their combined effect has rarely been investigated using composite mixed meals. We therefore examined the combined effects of increasing meal frequency (2-large vs 6-smaller meals), with high or low-protein (40 % vs 10 % energy from protein respectively) isocaloric mixed meals on a range of postprandial CMD risk markers. METHODS In a randomized crossover study, 10 healthy Chinese males (Age: 29 ± 7 years; BMI: 21.9 ± 1.7 kg/m(2)) underwent 4 dietary treatments: CON-2 (2 large Low-Protein meals), CON-6 (6 Small Low-Protein meals), PRO-2 (2 Large High-Protein meals) and PRO-6 (6 Small High-Protein meals). Subjects wore a continuous glucose monitor (CGM) and venous blood samples were obtained at baseline and at regular intervals for 8.5 h to monitor postprandial changes in glucose, insulin, triglycerides and high sensitivity C-reactive protein (hsCRP). Blood pressure was measured at regular intervals pre- and post- meal consumption. Urine was collected to measure excretion of creatinine and F2-isoprostanes and its metabolites over the 8.5 h postprandial period. RESULTS The high-protein meals, irrespective of meal frequency were beneficial for glycaemic health since glucose incremental area under the curve (iAUC) for PRO-2 (185 ± 166 mmol.min.L(-1)) and PRO-6 (214 ± 188 mmol.min.L(-1)) were 66 and 60 % lower respectively (both p < 0.05), compared with CON-2 (536 ± 290 mmol.min.L(-1)). The iAUC for insulin was the lowest for PRO-6 (13.7 ± 7.1 U.min.L(-1)) as compared with CON-2 (28.4 ± 15.6 U.min.L(-)1), p < 0.001. There were no significant differences in postprandial responses in other measurements between the dietary treatments. CONCLUSIONS The consumption of composite meals with higher protein content, irrespective of meal frequency appears to be beneficial for postprandial glycemic and insulinemic responses in young, healthy Chinese males. Implications of this study may be useful in the Asian context where the consumption of high glycemic index, carbohydrate meals is prevalent. TRIAL REGISTRATION NCT02529228 .
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Affiliation(s)
- Alexander Mok
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, 14 Medical Drive, #07-02, Singapore, 117599 Singapore
| | - Sumanto Haldar
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, 14 Medical Drive, #07-02, Singapore, 117599 Singapore
| | - Jetty Chung-Yung Lee
- School of Biological Sciences, Kadoorie Biological Sciences Building, The University of Hong Kong, Pok Fu Lam Road, Hong Kong, SAR China
| | - Melvin Khee-Shing Leow
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, 14 Medical Drive, #07-02, Singapore, 117599 Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore, 117609 Singapore
- Division of Medicine, Department of Endocrinology, Tan Tock Seng Hospital, 11, Jalan Tang Tock Seng, Singapore, 308433 Singapore
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, 14 Medical Drive, #07-02, Singapore, 117599 Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore, 117609 Singapore
- Department of Biochemistry, National University of Singapore, 8 Medical Drive, Singapore, 117596 Singapore
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121
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Longland TM, Oikawa SY, Mitchell CJ, Devries MC, Phillips SM. Higher compared with lower dietary protein during an energy deficit combined with intense exercise promotes greater lean mass gain and fat mass loss: a randomized trial. Am J Clin Nutr 2016; 103:738-46. [PMID: 26817506 DOI: 10.3945/ajcn.115.119339] [Citation(s) in RCA: 142] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 12/16/2015] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND A dietary protein intake higher than the Recommended Dietary Allowance during an energy deficit helps to preserve lean body mass (LBM), particularly when combined with exercise. OBJECTIVE The purpose of this study was to conduct a proof-of-principle trial to test whether manipulation of dietary protein intake during a marked energy deficit in addition to intense exercise training would affect changes in body composition. DESIGN We used a single-blind, randomized, parallel-group prospective trial. During a 4-wk period, we provided hypoenergetic (~40% reduction compared with requirements) diets providing 33 ± 1 kcal/kg LBM to young men who were randomly assigned (n = 20/group) to consume either a lower-protein (1.2 g · kg(-1) · d(-1)) control diet (CON) or a higher-protein (2.4 g · kg(-1) · d(-1)) diet (PRO). All subjects performed resistance exercise training combined with high-intensity interval training for 6 d/wk. A 4-compartment model assessment of body composition was made pre- and postintervention. RESULTS As a result of the intervention, LBM increased (P < 0.05) in the PRO group (1.2 ± 1.0 kg) and to a greater extent (P < 0.05) compared with the CON group (0.1 ± 1.0 kg). The PRO group had a greater loss of fat mass than did the CON group (PRO: -4.8 ± 1.6 kg; CON: -3.5 ± 1.4kg; P < 0.05). All measures of exercise performance improved similarly in the PRO and CON groups as a result of the intervention with no effect of protein supplementation. Changes in serum cortisol during the intervention were associated with changes in body fat (r = 0.39, P = 0.01) and LBM (r = -0.34, P = 0.03). CONCLUSIONS Our results showed that, during a marked energy deficit, consumption of a diet containing 2.4 g protein · kg(-1) · d(-1) was more effective than consumption of a diet containing 1.2 g protein · kg(-1) · d(-1) in promoting increases in LBM and losses of fat mass when combined with a high volume of resistance and anaerobic exercise. Changes in serum cortisol were associated with changes in body fat and LBM, but did not explain much variance in either measure. This trial was registered at clinicaltrials.gov as NCT01776359.
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Affiliation(s)
- Thomas M Longland
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Canada
| | - Sara Y Oikawa
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Canada
| | - Cameron J Mitchell
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Canada
| | - Michaela C Devries
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Canada
| | - Stuart M Phillips
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Canada
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Kim JE, O'Connor LE, Sands LP, Slebodnik MB, Campbell WW. Effects of dietary protein intake on body composition changes after weight loss in older adults: a systematic review and meta-analysis. Nutr Rev 2016; 74:210-24. [PMID: 26883880 DOI: 10.1093/nutrit/nuv065] [Citation(s) in RCA: 142] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
CONTEXT The impact of dietary protein on body composition changes after older adults purposefully lose weight requires systematic evaluation OBJECTIVE : This systematic review and meta-analysis assessed the effects of protein intake (< 25% vs ≥ 25% of energy intake or 1.0 g/kg/d) on energy restriction-induced changes in body mass, lean mass, and fat mass in adults older than 50 years. DATA SOURCES PubMed, Cochrane, Scopus, and Google Scholar were searched using the keywords "dietary proteins," "body composition," "skeletal muscle," and "muscle strength." STUDY SELECTION Two researchers independently screened 1542 abstracts. DATA EXTRACTION Information was extracted from 24 articles. DATA SYNTHESIS Twenty randomized control trials met the inclusion criteria. CONCLUSION Older adults retained more lean mass and lost more fat mass during weight loss when consuming higher protein diets.
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Affiliation(s)
- Jung Eun Kim
- J.E. Kim, L.E. O'Connor, and W.W. Campbell are with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA. L.P. Sands is with the Department of Human Development, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA. M.B. Slebodnik is with the Arizona Health Sciences Library, University of Arizona, Tuscon, USA
| | - Lauren E O'Connor
- J.E. Kim, L.E. O'Connor, and W.W. Campbell are with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA. L.P. Sands is with the Department of Human Development, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA. M.B. Slebodnik is with the Arizona Health Sciences Library, University of Arizona, Tuscon, USA
| | - Laura P Sands
- J.E. Kim, L.E. O'Connor, and W.W. Campbell are with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA. L.P. Sands is with the Department of Human Development, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA. M.B. Slebodnik is with the Arizona Health Sciences Library, University of Arizona, Tuscon, USA
| | - Mary B Slebodnik
- J.E. Kim, L.E. O'Connor, and W.W. Campbell are with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA. L.P. Sands is with the Department of Human Development, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA. M.B. Slebodnik is with the Arizona Health Sciences Library, University of Arizona, Tuscon, USA
| | - Wayne W Campbell
- J.E. Kim, L.E. O'Connor, and W.W. Campbell are with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA. L.P. Sands is with the Department of Human Development, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA. M.B. Slebodnik is with the Arizona Health Sciences Library, University of Arizona, Tuscon, USA.
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Voortman T, Braun KVE, Kiefte-de Jong JC, Jaddoe VWV, Franco OH, van den Hooven EH. Protein intake in early childhood and body composition at the age of 6 years: The Generation R Study. Int J Obes (Lond) 2016; 40:1018-25. [PMID: 26975442 DOI: 10.1038/ijo.2016.29] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 01/06/2016] [Accepted: 01/13/2016] [Indexed: 01/02/2023]
Abstract
BACKGROUND Previous studies suggest that high protein intake in infancy leads to a higher body mass index (BMI) in later childhood. We examined the associations of total, animal and vegetable protein intake in early childhood with detailed measures of body composition at the age of 6 years. METHODS This study was performed in 2911 children participating in a population-based cohort study. Protein intake at the age of 1 year was assessed with a validated food-frequency questionnaire and was adjusted for total energy intake. At the children's age of 6 years, we measured their anthropometrics and body fat (with dual-energy X-ray absorptiometry). We calculated age- and sex-specific s.d. scores for BMI, fat mass index (FMI) and fat-free mass index (FFMI). RESULTS After adjustment for confounders, a 10 g per day higher total protein intake at 1 year of age was associated with a 0.05 s.d. (95% confidence interval (CI) 0.00, 0.09) higher BMI at age 6. This association was fully driven by a higher FMI (0.06 s.d. (95%CI 0.01, 0.11)) and not FFMI (-0.01 s.d. (95%CI -0.06, 0.05)). The associations of protein intake with FMI at 6 years remained significant after adjustment for BMI at the age of 1 year. Additional analyses showed that the associations of protein intake with FMI were stronger in girls than in boys (P for interaction=0.03), stronger among children who had catch-up growth in the first year of life (P for interaction<0.01) and stronger for intake of animal protein (both dairy and non-dairy protein) than protein from vegetable sources. CONCLUSIONS Our results suggest that high protein intake in early childhood is associated with higher body fat mass, but not fat-free mass. Future studies are needed to investigate whether these changes persist into adulthood and to examine the optimal range of protein intake for infants and young children.
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Affiliation(s)
- T Voortman
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - K V E Braun
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - J C Kiefte-de Jong
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Leiden University College, The Hague, The Netherlands
| | - V W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - O H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - E H van den Hooven
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Mateo-Gallego R, Marco-Benedí V, Perez-Calahorra S, Bea AM, Baila-Rueda L, Lamiquiz-Moneo I, de Castro-Orós I, Cenarro A, Civeira F. Energy-restricted, high-protein diets more effectively impact cardiometabolic profile in overweight and obese women than lower-protein diets. Clin Nutr 2016; 36:371-379. [PMID: 26875447 DOI: 10.1016/j.clnu.2016.01.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 12/17/2015] [Accepted: 01/24/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND & AIMS High-protein energy-restricted diets have demonstrated efficacy in promoting weight loss in overweight and obesity. However, the protein percentage that achieves optimal efficacy and acceptability remains unknown. We sought to assess the effects of three energy-reduced diets with different percentages of calories from protein (20%, 27%, and 35%) on weight loss and lipids. Secondary outcomes included diet acceptability and compliance. METHODS Six-month, randomized study included women aged 18-80 years with BMI of 27.5-45 kg/m2 and who were not taking lipid-lowering drugs. We randomly assigned 91 women to one of three calorie-reduced diets with: protein, 20%, 27%, or 35% (80% from animal protein); carbohydrates, 50%, 43%, or 35%; fat, 30%. Dietary intervention involved individual visits with a nutritionist every 2 weeks during the first 3 months. We performed a follow-up visit at 6 months. RESULTS Eighty women aged 44.0 ± 9.08 years with BMI of 37.7 ± 3.39 kg/m2 completed the study. At 3 months, weight loss was -8.16 ± 4.18 kg, -9.66 ± 5.28 kg, and -10.7 ± 4.28 kg in the 20%, 27%, and 35%-protein groups, respectively (P = 0.16). These figures slightly and homogeneously increased at 6 months. Around 65% of women following 35%-protein diet lost ≥10% of body weight vs. ∼33% in 20%-protein group (P = 0.023). Significant decreases occurred in fat mass, lipids and insulin resistance, especially in the 35%-protein group (P < 0.05 vs. 20% protein). This improvement was not fully explained by weight loss. Triglyceride change was negatively correlated with animal-protein intake. All groups provided similar responses to an acceptance, palatability, and satisfaction questionnaire. CONCLUSIONS An energy-restricted diet with 35% protein, mostly of animal origin, more effectively impacts cardiometabolic profile than an energy-restricted diet with lower protein content although no clear benefit between diets in terms of overall weight loss was observed. The high-protein diet displayed an excellent safety profile and acceptability. This trial was registered in ClinicalTrials.gov as NCT02160496. CLINICAL TRIAL REGISTRATION The clinical trial has been registered in ClinicalTrials.gov (Identifier: NCT02160496).
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Affiliation(s)
- Rocío Mateo-Gallego
- Unidad Clínica y de Investigación en Lípidos y Aterosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
| | - Victoria Marco-Benedí
- Unidad Clínica y de Investigación en Lípidos y Aterosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Sofía Perez-Calahorra
- Unidad Clínica y de Investigación en Lípidos y Aterosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana M Bea
- Unidad Clínica y de Investigación en Lípidos y Aterosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Lucía Baila-Rueda
- Unidad Clínica y de Investigación en Lípidos y Aterosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Itziar Lamiquiz-Moneo
- Unidad Clínica y de Investigación en Lípidos y Aterosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Isabel de Castro-Orós
- Unidad Clínica y de Investigación en Lípidos y Aterosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana Cenarro
- Unidad Clínica y de Investigación en Lípidos y Aterosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Fernando Civeira
- Unidad Clínica y de Investigación en Lípidos y Aterosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
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Willey S, Walsh JK. Outcomes of a Mobile Health Coaching Platform: 12-Week Results of a Single-Arm Longitudinal Study. JMIR Mhealth Uhealth 2016; 4:e3. [PMID: 26747611 PMCID: PMC4723727 DOI: 10.2196/mhealth.4933] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 09/02/2015] [Accepted: 10/09/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The number of mobile health coaching applications is expanding at a rapid rate. An application that uses a guiding intelligence to deliver an individualized structured program has the potential to provide a significant benefit. However, there are few studies of this approach that examine multiple clinical outcomes in a longitudinal manner. OBJECTIVE The objective of the study was to conduct a 12-week evaluation of participants using the YouPlus Health mobile coaching platform, specifically examining the effects on body weight, waist measurement, blood pressure, lipid profile, glycohemoglobin (A1C), and maximum volume of oxygen consumption (VO2 max). METHODS A quasi-experimental research design was used. This included a single-arm pre and post intervention assessment of outcomes. Participants underwent a 12-week intervention in which they received the entirety of the mobile health coaching program via an application on their mobile phones and were evaluated in the same physician's office setting every two weeks. Data regarding app usage was continuously collected and maintained in a database. RESULTS 10 subjects were enrolled in and completed the pilot study. The mean weight loss was 13.5 lbs. which represented 7.3% of baseline (P=.005). Mean waist circumference was reduced by 7.2 cm or 6.6% of baseline (P=.005). Both systolic (SBP) and diastolic (DBP) blood pressure measures were significantly lower after 12 weeks of intervention. Mean SBP fell 18.6 mmHg (P=.005) and mean DBP declined 6.4 mmHg (P=.005). VO2 max increased by an average of 3.13 ml/kg/min from baseline to study end (P=.005). From baseline to end-of-study HDL levels increased significantly by 4.0 mg/dL (P=.04) Total cholesterol, LDL, triglycerides, and glycohemoglobin (A1C) trended in the desired direction but did not meet statistical significance. All of the participants in the study completed the necessary in-app tutorials and also completed the in-app questions and received feedback. Every individual completed the appropriate amount of program levels necessary to give the specifics of the program, and the mean weekly app open rate ranged from 5.1 to 18.4. CONCLUSIONS Users of the YouPlus Health mobile coaching platform experienced significant reductions in body weight, waist circumference, and both systolic and diastolic blood pressures, while attaining significant increases in HDL and VO2 Max.
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Affiliation(s)
- Steven Willey
- St. Luke's Hospital, Chesterfield, MO, United States.
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Sartorius B, Sartorius K, Aldous C, Madiba TE, Stefan C, Noakes T. Carbohydrate intake, obesity, metabolic syndrome and cancer risk? A two-part systematic review and meta-analysis protocol to estimate attributability. BMJ Open 2016; 6:e009301. [PMID: 26729382 PMCID: PMC4716256 DOI: 10.1136/bmjopen-2015-009301] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Linkages between carbohydrates, obesity and cancer continue to demonstrate conflicting results. Evidence suggests inconclusive direct linkages between carbohydrates and specific cancers. Conversely, obesity has been strongly linked to a wide range of cancers. The purpose of the study is to explore linkages between carbohydrate intake and cancer types using a two-step approach. First the study will evaluate the linkages between carbohydrate intake and obesity, potentially stratified by metabolic syndrome status. Second, the estimated attributable fraction of obesity ascribed to carbohydrate intake will be multiplied against obesity attributable fractions for cancer types to give estimated overall attributable fraction for carbohydrate versus cancer type. METHODS AND ANALYSIS We will perform a comprehensive search to identify all possible published and unpublished studies that have assessed risk factors for obesity including dietary carbohydrate intake. Scientific databases, namely PubMed MEDLINE, EMBASE, EBSCOhost and ISI Web of Science will be searched. Following study selection, paper/data acquisition, and data extraction and synthesis, we will appraise the quality of studies and risk of bias, as well as assess heterogeneity. Meta-weighted attributable fractions of obesity due to carbohydrate intake will be estimated after adjusting for other potential confounding factors (eg, physical inactivity, other dietary intake). Furthermore, previously published systematic reviews assessing the cancer-specific risk associated with obesity will also be drawn. These estimates will be linked with the attributability of carbohydrate intake in part 1 to estimate the cancer-specific burden that can be attributed to dietary carbohydrates. This systematic review protocol has been developed according to the 'Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) 2015'. ETHICS AND DISSEMINATION The current study will be based on published literature and data, and, as such, ethics approval is not required. The final results of this two part systematic review (plus multiplicative calculations) will be published in a relevant international peer-reviewed journal. TRIAL REGISTRATION NUMBER PROSPERO CRD42015023257.
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Affiliation(s)
- B Sartorius
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
- University of KwaZulu-Natal Gastrointestinal Cancer Research Centre (GICRC), Durban, KwaZulu-Natal, South Africa
| | - K Sartorius
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
- University of KwaZulu-Natal Gastrointestinal Cancer Research Centre (GICRC), Durban, KwaZulu-Natal, South Africa
- Faculty of Commerce, University of the Witwatersrand, Johannesburg, South Africa
| | - C Aldous
- University of KwaZulu-Natal Gastrointestinal Cancer Research Centre (GICRC), Durban, KwaZulu-Natal, South Africa
- School of Clinical Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - T E Madiba
- University of KwaZulu-Natal Gastrointestinal Cancer Research Centre (GICRC), Durban, KwaZulu-Natal, South Africa
- School of Clinical Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - C Stefan
- University of KwaZulu-Natal Gastrointestinal Cancer Research Centre (GICRC), Durban, KwaZulu-Natal, South Africa
- South African Medical Research Council, Cape Town, South Africa
| | - T Noakes
- Division of Exercise Science and Sports Medicine, University of Cape Town
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Stentz FB, Brewer A, Wan J, Garber C, Daniels B, Sands C, Kitabchi AE. Remission of pre-diabetes to normal glucose tolerance in obese adults with high protein versus high carbohydrate diet: randomized control trial. BMJ Open Diabetes Res Care 2016; 4:e000258. [PMID: 27843552 PMCID: PMC5093372 DOI: 10.1136/bmjdrc-2016-000258] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 08/19/2016] [Accepted: 09/16/2016] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Remission of pre-diabetes to normal is an important health concern which has had little success in the past. This study objective was to determine the effect on remission of pre-diabetes with a high protein (HP) versus high carbohydrate (HC) diet and effects on metabolic parameters, lean and fat body mass in prediabetic, obese subjects after 6 months of dietary intervention. RESEARCH DESIGN AND METHODS We recruited and randomized 24 pre-diabetes women and men to either a HP (30% protein, 30% fat, 40% carbohydrate; n=12) or HC (15% protein, 30% fat, 55% carbohydrate; n=12) diet feeding study for 6 months in this randomized controlled trial. All meals were provided to subjects for 6 months with daily food menus for HP or HC compliance with weekly food pick-up and weight measurements. At baseline and after 6 months on the respective diets oral glucose tolerance and meal tolerance tests were performed with glucose and insulin measurements and dual energy X-ray absorptiometry scans. RESULTS After 6 months on the HP diet, 100% of the subjects had remission of their pre-diabetes to normal glucose tolerance, whereas only 33.3% of subjects on the HC diet had remission of their pre-diabetes. The HP diet group exhibited significant improvement in (1) insulin sensitivity (p=0.001), (2) cardiovascular risk factors (p=0.04), (3) inflammatory cytokines (p=0.001), (4) oxidative stress (p=0.001), (5) increased percent lean body mass (p=0.001) compared with the HC diet at 6 months. CONCLUSIONS This is the first dietary intervention feeding study, to the best of our knowledge, to report 100% remission of pre-diabetes with a HP diet and significant improvement in metabolic parameters and anti-inflammatory effects compared with a HC diet at 6 months. TRIAL REGISTRATION NUMBER NCT0164284.
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Affiliation(s)
- Frankie B Stentz
- Departments of Medicine , The University of Tennessee Health Science Center , Memphis, Tennessee , USA
| | - Amy Brewer
- Departments of Medicine , The University of Tennessee Health Science Center , Memphis, Tennessee , USA
| | - Jim Wan
- Departments of Preventive Medicine , The University of Tennessee Health Science Center , Memphis, Tennessee , USA
| | - Channing Garber
- Departments of Medicine , The University of Tennessee Health Science Center , Memphis, Tennessee , USA
| | - Blake Daniels
- Departments of Medicine , The University of Tennessee Health Science Center , Memphis, Tennessee , USA
| | - Chris Sands
- Departments of Medicine , The University of Tennessee Health Science Center , Memphis, Tennessee , USA
| | - Abbas E Kitabchi
- Departments of Medicine , The University of Tennessee Health Science Center , Memphis, Tennessee , USA
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Tahavorgar A, Vafa M, Shidfar F, Gohari M, Heydari I. Beneficial effects of whey protein preloads on some cardiovascular diseases risk factors of overweight and obese men are stronger than soy protein preloads – A randomized clinical trial. JOURNAL OF NUTRITION & INTERMEDIARY METABOLISM 2015. [DOI: 10.1016/j.jnim.2015.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Anastasiou CA, Karfopoulou E, Yannakoulia M. Weight regaining: From statistics and behaviors to physiology and metabolism. Metabolism 2015; 64:1395-407. [PMID: 26362728 DOI: 10.1016/j.metabol.2015.08.006] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 08/09/2015] [Accepted: 08/11/2015] [Indexed: 12/31/2022]
Abstract
Achieving maintenance of weight loss is crucial to combat obesity. However, most individuals tend to regain weight. Data from successful maintainers show that they remain vigilant and constantly apply techniques to oppose the course of regaining. On the other hand, current advances in obesity research show that the reduced obese state is a state of altered physiology in terms of energy balance. This review describes the physiological adaptations occurring after weight loss that predispose to regaining. Specifically, changes regarding body composition, hormonal background, energy expenditure and control of food intake are discussed. Moreover, metabolites that can act as regain predictors and dietary techniques to oppose regaining are presented.
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Affiliation(s)
- Costas A Anastasiou
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
| | - Eleni Karfopoulou
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
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Karl JP, Roberts SB, Schaefer EJ, Gleason JA, Fuss P, Rasmussen H, Saltzman E, Das SK. Effects of carbohydrate quantity and glycemic index on resting metabolic rate and body composition during weight loss. Obesity (Silver Spring) 2015; 23:2190-8. [PMID: 26530933 PMCID: PMC4634125 DOI: 10.1002/oby.21268] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 07/22/2015] [Accepted: 07/23/2015] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To examine the effects of diets varying in carbohydrate and glycemic index (GI) on changes in body composition, resting metabolic rate (RMR), and metabolic adaptation during and after weight loss. METHODS Adults with obesity (n = 91) were randomized to one of four provided-food diets for 17 weeks. Diets differed in percentage energy from carbohydrate (55% or 70%) and GI (low or high) but were matched for protein, fiber, and energy. Body weight, body composition, RMR, and metabolic adaptation (measured RMR-predicted RMR) were measured during weight loss and subsequent weight stability. RESULTS No effect of dietary carbohydrate content or GI on body weight loss or percentage of weight lost as fat mass (FM) was observed. Measured RMR was significantly lower (-226 kJ/day [95% CI: -314 to -138 kJ/day], P < 0.001) than predicted RMR following weight loss, but this difference was attenuated after 5 weeks of weight stability. Metabolic adaptation did not differ by dietary carbohydrate content or GI and was not associated with weight regain 12 months later. CONCLUSIONS Moderate-carbohydrate and low-GI diets did not preferentially reduce FM, preserve lean mass, or attenuate metabolic adaptation during weight loss compared to high-carbohydrate and high-GI diets.
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Affiliation(s)
| | - Susan B. Roberts
- Corresponding author: Susan B. Roberts, 711 Washington St, Rm 1313, Boston, MA 02111, Phone: +1 617-556-3237, Fax: +1 617-556-3344,
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Abstract
The aim of our article was to review the current literature on the effects of metabolic (re) programming on childhood obesity. PubMed/MEDLINE was the data source used to track the studies. Descriptors applied: children obesity, epigenetic, metabolic programming, exercise and nutrition. The focus was to analyze and discuss the international findings on the theme. The gathering of the papers was performed between June and August 2014. The search of articles with the descriptors used found 33.054 studies. In all, 5.709 studies were selected by crossing chosen keywords. Among these, after careful reading of the titles, 712 papers were considered potential as references. After applying inclusion/exclusion criteria, 50 studies were selected from 132 eligible abstracts. Most studies linked the development and treatment of obesity from epigenetically stimulated metabolic programming during the early stages of pregnancy and life. This review provides theoretical basis to the understanding that the programmed development of childhood obesity may be linked to early exposure to environmental factors, such as (nutrition and regular practice of exercise) and stimulus can epigenetically alter the modulation of the obesogenic metabolic behavior during pregnancy and the developmental stages of children and/or postpone the pathophysiologic disease stage to adulthood.
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Tinsley GM, La Bounty PM. Effects of intermittent fasting on body composition and clinical health markers in humans. Nutr Rev 2015; 73:661-74. [PMID: 26374764 DOI: 10.1093/nutrit/nuv041] [Citation(s) in RCA: 197] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Intermittent fasting is a broad term that encompasses a variety of programs that manipulate the timing of eating occasions by utilizing short-term fasts in order to improve body composition and overall health. This review examines studies conducted on intermittent fasting programs to determine if they are effective at improving body composition and clinical health markers associated with disease. Intermittent fasting protocols can be grouped into alternate-day fasting, whole-day fasting, and time-restricted feeding. Alternate-day fasting trials of 3 to 12 weeks in duration appear to be effective at reducing body weight (≈3%-7%), body fat (≈3-5.5 kg), total cholesterol (≈10%-21%), and triglycerides (≈14%-42%) in normal-weight, overweight, and obese humans. Whole-day fasting trials lasting 12 to 24 weeks also reduce body weight (≈3%-9%) and body fat, and favorably improve blood lipids (≈5%-20% reduction in total cholesterol and ≈17%-50% reduction in triglycerides). Research on time-restricted feeding is limited, and clear conclusions cannot be made at present. Future studies should examine long-term effects of intermittent fasting and the potential synergistic effects of combining intermittent fasting with exercise.
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Affiliation(s)
- Grant M Tinsley
- Correspondence: G.M. Tinsley is with the Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA. P.M. LaBounty is with the Department of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, Texas, USA.
| | - Paul M La Bounty
- Correspondence: G.M. Tinsley is with the Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA. P.M. LaBounty is with the Department of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, Texas, USA
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133
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Coleman CD, Kiel JR, Mitola AH, Langford JS, Davis KN, Arterburn LM. Effectiveness of a Medifast meal replacement program on weight, body composition and cardiometabolic risk factors in overweight and obese adults: a multicenter systematic retrospective chart review study. Nutr J 2015; 14:77. [PMID: 26245279 PMCID: PMC4527127 DOI: 10.1186/s12937-015-0062-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 07/23/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Recent medical guidelines emphasize the importance of actively treating overweight and obesity with diet and lifestyle intervention to achieve ≥ 5% weight loss in a 6-month period. Commercial programs offer one approach provided there is evidence of their efficacy and safety. This study was conducted to evaluate the effectiveness of the Medifast® 4 & 2 & 1 Plan™ on weight loss, body composition and cardiometabolic risk factors in overweight and obese adults. METHODS A systematic retrospective chart review of 310 overweight and obese clients following the Medifast 4 & 2 & 1 Plan at one of 21 Medifast Weight Control Centers® was conducted. Data were recorded electronically and key data points were independently verified. The primary endpoint was change from baseline body weight at 12 weeks. Within group paired t-tests were used to examine changes from baseline in a completers population. Differences between gender and age subgroups were examined using bivariate t-tests and mixed model regression analyses. RESULTS For the primary endpoint at 12 weeks, body weight among completers (n = 185) was reduced by a mean of 10.9 ± 5.6 kg (-10.1%, p < 0.0001), and at 24 weeks (n = 81) mean weight was reduced by 16.0 ± 7.9 kg (-14.3%). At 12 and 24 weeks, 85% and 96% of those remaining on the plan, respectively, had lost ≥ 5% of their baseline body weight. Lean mass was preserved to within 5% of baseline throughout the 24 weeks, and fat mass represented ≥ 80% of the body weight lost from 12 weeks onward. Men, women, seniors (≥ 65 years), and non-seniors (<65 years) all had significant weight reductions with preservation of lean mass. Significant improvements in blood pressure, pulse and waist-to-hip ratio were observed. Mean weight regain among the subset who entered a formal maintenance phase was <2% during an average follow-up of 34 weeks. The meal plan was well tolerated, and program adherence was >85%. CONCLUSIONS The 4 & 2 & 1 Plan used at Medifast Weight Control Centers was effective for weight loss, preservation of lean mass and improvement in cardiometabolic risk factors. The plan was generally well tolerated in a broad population of overweight and obese adults. #NCT02150837.
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Affiliation(s)
- Christopher D Coleman
- Department of Scientific and Clinical Affairs, Medifast, Inc, 11445 Cronhill Drive, Owings Mills, MD, 21117, USA.
| | - Jessica R Kiel
- Department of Scientific and Clinical Affairs, Medifast, Inc, 11445 Cronhill Drive, Owings Mills, MD, 21117, USA
| | | | - Janice S Langford
- Department of Scientific and Clinical Affairs, Medifast, Inc, 11445 Cronhill Drive, Owings Mills, MD, 21117, USA
| | - Kevin N Davis
- Department of Scientific and Clinical Affairs, Medifast, Inc, 11445 Cronhill Drive, Owings Mills, MD, 21117, USA
| | - Linda M Arterburn
- Department of Scientific and Clinical Affairs, Medifast, Inc, 11445 Cronhill Drive, Owings Mills, MD, 21117, USA
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134
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Sharples AP, Hughes DC, Deane CS, Saini A, Selman C, Stewart CE. Longevity and skeletal muscle mass: the role of IGF signalling, the sirtuins, dietary restriction and protein intake. Aging Cell 2015; 14:511-23. [PMID: 25866088 PMCID: PMC4531066 DOI: 10.1111/acel.12342] [Citation(s) in RCA: 145] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2015] [Indexed: 12/11/2022] Open
Abstract
Advancing age is associated with a progressive loss of skeletal muscle (SkM) mass and function. Given the worldwide aging demographics, this is a major contributor to morbidity, escalating socio-economic costs and ultimately mortality. Previously, it has been established that a decrease in regenerative capacity in addition to SkM loss with age coincides with suppression of insulin/insulin-like growth factor signalling pathways. However, genetic or pharmacological modulations of these highly conserved pathways have been observed to significantly enhance life and healthspan in various species, including mammals. This therefore provides a controversial paradigm in which reduced regenerative capacity of skeletal muscle tissue with age potentially promotes longevity of the organism. This paradox will be assessed and considered in the light of the following: (i) the genetic knockout, overexpression and pharmacological models that induce lifespan extension (e.g. IRS-1/s6K KO, mTOR inhibition) versus the important role of these signalling pathways in SkM growth and adaptation; (ii) the role of the sirtuins (SIRTs) in longevity versus their emerging role in SkM regeneration and survival under catabolic stress; (iii) the role of dietary restriction and its impact on longevity versus skeletal muscle mass regulation; (iv) the crosstalk between cellular energy metabolism (AMPK/TSC2/SIRT1) and survival (FOXO) versus growth and repair of SkM (e.g. AMPK vs. mTOR); and (v) the impact of protein feeding in combination with dietary restriction will be discussed as a potential intervention to maintain SkM mass while increasing longevity and enabling healthy aging.
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Affiliation(s)
- Adam P. Sharples
- Stem Cells, Ageing & Molecular Physiology Unit; Research Institute for Sport and Exercise Sciences (RISES); Exercise Metabolism and Adaptation Research Group (EMARG); Liverpool John Moores University; Tom Reilly Building Liverpool L3 3AF UK
| | - David C. Hughes
- Stem Cells, Ageing & Molecular Physiology Unit; Research Institute for Sport and Exercise Sciences (RISES); Exercise Metabolism and Adaptation Research Group (EMARG); Liverpool John Moores University; Tom Reilly Building Liverpool L3 3AF UK
- Department of Neurobiology, Physiology and Behavior; University of California; Davis California CA 95616 USA
| | - Colleen S. Deane
- MRC/ARUK Centre of Excellence for Musculoskeletal Ageing Research; School of Medicine; University of Nottingham; Royal Derby Hospital; Derby DE22 3DT UK
- School of Health and Social Care; Bournemouth University; Bournemouth BH12 5BB UK
| | - Amarjit Saini
- Department of Physiology and Pharmacology; Karolinska Institutet; Stockholm 171 77 Sweden
| | - Colin Selman
- Glasgow Ageing Research Network (GARNER); Institute of Biodiversity, Animal Health and Comparative Medicine; College of Medicine, Veterinary and Life Sciences; University of Glasgow; Glasgow G12 8QQ UK
| | - Claire E. Stewart
- Stem Cells, Ageing & Molecular Physiology Unit; Research Institute for Sport and Exercise Sciences (RISES); Exercise Metabolism and Adaptation Research Group (EMARG); Liverpool John Moores University; Tom Reilly Building Liverpool L3 3AF UK
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135
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Nakamura Y, Ueshima H, Okuda N, Miura K, Kita Y, Miyagawa N, Yoshita K, Nakagawa H, Sakata K, Saitoh S, Okamura T, Okayama A, Choudhry SR, Rodriguez B, Masaki KH, Chan Q, Elliott P, Stamler J. Relationship of three different types of low-carbohydrate diet to cardiometabolic risk factors in a Japanese population: the INTERMAP/INTERLIPID Study. Eur J Nutr 2015; 55:1515-24. [PMID: 26119583 DOI: 10.1007/s00394-015-0969-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 06/16/2015] [Indexed: 01/28/2023]
Abstract
PURPOSE Low-carbohydrate diets (LCD) are a popular dietary strategy for weight reduction. The effects of LCD on long-term outcome vary depending on type of LCD, possibly due to the fact that effects on cardiometabolic risk factors may vary with different types of LCD. Accordingly, we studied these relations. METHODS We assessed serum concentrations of high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc), high-sensitivity C-reactive protein (CRP), total cholesterol, glycated hemoglobin, and uric acid, and nutrient intakes by standardized methods in men and women ages 40-59 years from four population samples of Japanese in Japan (553 men and 544 women, combined). For people consuming usual, animal-based, and plant-based LCDs, we calculated LCD scores, based on relative level of fat, protein, and carbohydrate, by modifying the methods of Halton et al. Instead of calculating scores based on animal or vegetable fat, we used saturated fatty acids (SFA) or monounsaturated fatty acids (MUFA) + polyunsaturated fatty acids (PUFA). RESULTS In multivariate regression analyses with adjustment for site, age, sex, BMI, smoking, alcohol intake, physical activity, and years of education, all three LCD scores were significantly positively related to HDLc (all P < 0.001), but not to LDLc. The plant-based LCD score was significantly inversely related to log CRP (coefficient = -0.010, P = 0.018). CONCLUSIONS All three LCD scores were significantly positively related to HDLc. The plant-based LCD score was significantly inversely related to CRP. Carbohydrate intake below 50 % of total energy with higher intakes of vegetable protein and MUFA + PUFA, and lower intakes of SFA may be favorable for reducing cardiometabolic risk factors.
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Affiliation(s)
- Yasuyuki Nakamura
- Department of Food Science and Human Nutrition, Faculty of Agriculture, Ryukoku University, 1-5 Yokotani, Seta Oe-cho, Otsu City, Shiga Prefecture, 520-2194, Japan. .,Department of Health Science, Shiga University of Medical Science, Otsu, Japan.
| | - Hirotsugu Ueshima
- Department of Health Science, Shiga University of Medical Science, Otsu, Japan
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Katsuyuki Miura
- Department of Health Science, Shiga University of Medical Science, Otsu, Japan
| | | | - Naoko Miyagawa
- Department of Health Science, Shiga University of Medical Science, Otsu, Japan
| | - Katsushi Yoshita
- Department of Food Science and Nutrition, Osaka City University, Osaka, Japan
| | - Hideaki Nakagawa
- Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, Japan
| | - Kiyomi Sakata
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Iwate, Japan
| | - Shigeyuki Saitoh
- School of Health Sciences, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan
| | - Akira Okayama
- Research Center for Lifestyle-Related Diseases, Tokyo, Japan
| | - Sohel R Choudhry
- Department of Epidemiology and Research, National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
| | - Beatriz Rodriguez
- John A Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Kamal H Masaki
- John A Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Queenie Chan
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Paul Elliott
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Jeremiah Stamler
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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136
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Abstract
Thermodynamics dictates that for body weight (i.e. stored substrate) loss to occur a person must ingest less energy than they expend. Athletes, who owing to their oftentimes large daily energy expenditures, may have greater flexibility than non-athletes in this regard; however, they may also have different goals for weight loss. In particular, weight lost may be less important to an athlete than from which compartment the weight is lost: fat or lean. A critical question is thus, what balance of macronutrients might promote a greater fat loss, a relative retention of lean mass, and still allow athletic performance to remain uncompromised? It is the central thesis of this review that dietary protein should be a nutrient around which changes in macronutrient composition should be framed. The requirement for protein to sustain lean mass increases while in negative energy balance and protein, as macronutrient, may have advantages with respect to satiety during energy balance, and it may allow greater fat loss during a negative energy balance. However, athletes should be mindful of the fact that increasing dietary protein intake while in negative energy balance would come at the ‘expense’ of another macronutrient. Most recently there has been interest in lower carbohydrate diets, which may not allow performance to be sustained given the importance of dietary carbohydrate in high-intensity exercise. The relative merits of higher protein diets for athletes are discussed.
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137
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Gorgey AS, Caudill C, Sistrun S, Khalil RE, Gill R, Castillo T, Lavis T, Gater DR. Frequency of Dietary Recalls, Nutritional Assessment, and Body Composition Assessment in Men With Chronic Spinal Cord Injury. Arch Phys Med Rehabil 2015; 96:1646-53. [PMID: 26047531 DOI: 10.1016/j.apmr.2015.05.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 05/16/2015] [Accepted: 05/24/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To assess different frequencies of dietary recalls while evaluating caloric intake and the percentage of macronutrients in men with spinal cord injury (SCI) and to examine the relations between caloric intake or percentage of macronutrients and assessment of whole and regional body composition using dual-energy x-ray absorptiometry. DESIGN Cross-sectional and longitudinal. SETTING Laboratory and hospital. PARTICIPANTS Men with chronic (>1 y postinjury) motor complete SCI (N=16). INTERVENTIONS Participants were asked to turn in a 5-day dietary recall on a weekly basis for 4 weeks. The averages of 5-, 3-, and 1-day dietary recalls for caloric intake and percentage of macronutrients (carbohydrates, fat, protein) were calculated. Body composition was evaluated using whole-body dual-energy x-ray absorptiometry. After overnight fast, basal metabolic rate (BMR) was evaluated using indirect calorimetry and total energy expenditure (TEE) was estimated. MAIN OUTCOME MEASURES Caloric intake, percentage of macronutrients, BMR, and body composition. RESULTS Caloric intake and percentage of macronutrients were not different after using 5-, 3-, and 1-day dietary recalls (P>.05). Caloric intake was significantly lower than TEE (P<.05). The percentage of fat accounted for 29% to 34% of the whole and regional body fat mass (P=.037 and P=.022). The percentage of carbohydrates was positively related to the percentage of whole-body lean mass (r=.54; P=.037) and negatively related to the percentage of fat mass. CONCLUSIONS The frequency of dietary recalls does not vary while evaluating caloric intake and macronutrients. Total caloric intake was significantly lower than the measured BMR and TEE. Percentages of dietary fat and carbohydrates are related to changes in body composition after SCI.
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Affiliation(s)
- Ashraf S Gorgey
- Spinal Cord Injury Service and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, VA; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA.
| | - Caleb Caudill
- Spinal Cord Injury Service and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, VA; College of Health and Human Performance, Virginia Commonwealth University, Richmond, VA
| | - Sakita Sistrun
- Clinical and Transitional Research Center, Virginia Commonwealth University, Richmond, VA
| | - Refka E Khalil
- Spinal Cord Injury Service and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, VA
| | - Ranjodh Gill
- Endocrinology Service, Hunter Holmes McGuire VA Medical Center, Richmond, VA; Endocrinology Service, Virginia Commonwealth University, Richmond, VA
| | - Teodoro Castillo
- Spinal Cord Injury Service and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, VA
| | - Timothy Lavis
- Spinal Cord Injury Service and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, VA; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA
| | - David R Gater
- Department of Physical Medicine and Rehabilitation, Penn State Milton S. Hershey Medical Center, Hershey, PA
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138
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Performance Enhancing Diets and the PRISE Protocol to Optimize Athletic Performance. J Nutr Metab 2015; 2015:715859. [PMID: 25949823 PMCID: PMC4408745 DOI: 10.1155/2015/715859] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 03/03/2015] [Indexed: 12/14/2022] Open
Abstract
The training regimens of modern-day athletes have evolved from the sole emphasis on a single fitness component (e.g., endurance athlete or resistance/strength athlete) to an integrative, multimode approach encompassing all four of the major fitness components: resistance (R), interval sprints (I), stretching (S), and endurance (E) training. Athletes rarely, if ever, focus their training on only one mode of exercise but instead routinely engage in a multimode training program. In addition, timed-daily protein (P) intake has become a hallmark for all athletes. Recent studies, including from our laboratory, have validated the effectiveness of this multimode paradigm (RISE) and protein-feeding regimen, which we have collectively termed PRISE. Unfortunately, sports nutrition recommendations and guidelines have lagged behind the PRISE integrative nutrition and training model and therefore limit an athletes' ability to succeed. Thus, it is the purpose of this review to provide a clearly defined roadmap linking specific performance enhancing diets (PEDs) with each PRISE component to facilitate optimal nourishment and ultimately optimal athletic performance.
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139
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Ooi EM, Adams LA, Zhu K, Lewis JR, Kerr DA, Meng X, Solah V, Devine A, Binns CW, Prince RL. Consumption of a whey protein-enriched diet may prevent hepatic steatosis associated with weight gain in elderly women. Nutr Metab Cardiovasc Dis 2015; 25:388-395. [PMID: 25638597 DOI: 10.1016/j.numecd.2014.11.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 11/24/2014] [Accepted: 11/25/2014] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND AIMS Protein consumption has been associated with cardio-metabolic benefits, including weight loss and improved insulin sensitivity, and may have potential benefits for individuals with fatty liver disease (FLD). We investigated the effect of increasing dietary protein intake from whey relative to carbohydrate on hepatic steatosis. METHODS AND RESULTS A two-year randomized, double-blind, placebo-controlled trial of 30 g/day whey protein-supplemented beverage (protein) or an energy-matched low-protein high-carbohydrate beverage (control) for cardio-metabolic and bone health in 219 healthy elderly women, recruited from the Western Australian general population. Hepatic steatosis was quantified using computed tomographic liver-to-spleen (L/S) ratio. FLD was defined as liver-to-spleen difference <10 Hounsfield units. At baseline, FLD prevalence was 11.4%. Control and protein groups were similar in body mass index (BMI), insulin resistance, L/S ratio and FLD prevalence at baseline. At two-years, dietary protein increased by 20 g in the protein, but not the control, group. Total energy intake and physical activity remained similar between groups. At two-years, BMI and FLD prevalence increased in both groups, with no between group differences. L/S ratio increased in control, but not protein, group at two-years, with no between group differences. In a within group comparison, change in BMI correlated with changes in L/S ratio in control (r = 0.37, P = 0.0007), but not with protein group (r = 0.04, P = 0.73). CONCLUSION Increasing dietary protein intake from whey relative to carbohydrate does not reduce weight, hepatic steatosis or the prevalence of FLD in elderly women. However, it may prevent worsening of hepatic steatosis associated with weight gain. CLINICAL TRIALS REGISTRATION Australian New Zealand Clinical Trials Registry (Registration no. ACTRN012607000163404).
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Affiliation(s)
- E M Ooi
- School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
| | - L A Adams
- School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; Department of Gastroenterology and Hepatology, Sir Charles Gairdner Hospital, Perth, Australia
| | - K Zhu
- School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - J R Lewis
- School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - D A Kerr
- Curtin Health Innovation Research Institute & School of Public Health, Curtin University, Perth, Australia
| | - X Meng
- Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Adelaide, SA, Australia
| | - V Solah
- Curtin Health Innovation Research Institute & School of Public Health, Curtin University, Perth, Australia
| | - A Devine
- School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia
| | - C W Binns
- Curtin Health Innovation Research Institute & School of Public Health, Curtin University, Perth, Australia
| | - R L Prince
- School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, WA, Australia
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140
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Devries MC, Phillips SM. Supplemental Protein in Support of Muscle Mass and Health: Advantage Whey. J Food Sci 2015; 80 Suppl 1:A8-A15. [DOI: 10.1111/1750-3841.12802] [Citation(s) in RCA: 182] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 12/01/2014] [Indexed: 02/06/2023]
Affiliation(s)
- Michaela C. Devries
- Exercise Metabolism Research Group (EMRG); Dept. of Kinesiology; McMaster Univ; 1280 Main St. W, IWC E210 Hamilton ON L8S 4K1 Canada
| | - Stuart M. Phillips
- Exercise Metabolism Research Group (EMRG); Dept. of Kinesiology; McMaster Univ; 1280 Main St. W, IWC E210 Hamilton ON L8S 4K1 Canada
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141
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Holzapfel C, Eichhorn C, Hauner H. [Reducing and maintaining body weight - trends and evidence]. MMW Fortschr Med 2015; 157:54-60. [PMID: 25743671 DOI: 10.1007/s15006-015-2548-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Christina Holzapfel
- Institut für Ernährungsmedizin, Klinikum rechts der Isar Technische Universität München, München, Deutschland
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142
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Maslova E, Halldorsson TI, Astrup A, Olsen SF. Dietary protein-to-carbohydrate ratio and added sugar as determinants of excessive gestational weight gain: a prospective cohort study. BMJ Open 2015; 5:e005839. [PMID: 25670731 PMCID: PMC4325128 DOI: 10.1136/bmjopen-2014-005839] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To examine the relation between the protein:carbohydrate (P/C) ratio and added sugar intake in pregnancy and gestational weight gain (GWG). DESIGN A prebirth cohort including 103 119 pregnancies enrolled between 1996 and 2003. SETTING All women in Denmark were eligible to participate if they spoke Danish and were planning to carry to term.The pregnant women were recruited and enrolled during their first antenatal visit (6-10 weeks of gestation). PARTICIPANTS Participants included women with live-born singletons and complete data on dietary intake and GWG, leaving 46 262 women for the analysis. EXPOSURE Macronutrient intake was quantified using a validated food frequency questionnaire administered in the 25th week of gestation. The P/C ratio and added sugar intake were examined in quintiles. PRIMARY OUTCOME MEASURES GWG was based on self-reported weight in gestational weeks 12 and 30 and defined as gain in g/week. We used multivariable linear regression, including adjusting for pre-pregnancy body mass index, to calculate relative change in GWG and 95% CI. RESULTS Average GWG was 471(224) g/week. The adjusted weight gain was 16 g/week lower (95% CI 9 to 22, p for trend <0.001) in the highest (Q5) versus lowest (Q1) quintile of the P/C ratio (∼3% average reduction across the entire pregnancy). Weight gain for those with >20%E vs <12%E from protein was 36 g/week lower (95% CI 20 to 53, p for trend <0.0001; ∼8% average reduction). A high P/C ratio was inversely related to intake of added sugars. Added sugar consumption was strongly associated with GWG (Q5 vs Q1: 34, 95% CI 28 to 40 g/week, p for trend <0.0001). CONCLUSIONS A high P/C ratio was associated with reduced GWG. This association appeared to be partly driven by a decrease in intake of added sugar. These results are consistent with randomised trials in non-pregnant participants. A dietary intervention targeting an increased P/C ratio with emphasis on reducing added sugar can contribute to reducing excessive GWG.
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Affiliation(s)
- Ekaterina Maslova
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
| | - Thorhallur I Halldorsson
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
- Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Reykjavik, Iceland
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavik, Iceland
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Sjurdur F Olsen
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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143
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Hector AJ, Marcotte GR, Churchward-Venne TA, Murphy CH, Breen L, von Allmen M, Baker SK, Phillips SM. Whey protein supplementation preserves postprandial myofibrillar protein synthesis during short-term energy restriction in overweight and obese adults. J Nutr 2015; 145:246-52. [PMID: 25644344 DOI: 10.3945/jn.114.200832] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Higher dietary energy as protein during weight loss results in a greater loss of fat mass and retention of muscle mass; however, the impact of protein quality on the rates of myofibrillar protein synthesis (MPS) and lipolysis, processes that are important in the maintenance of muscle and loss of fat, respectively, are unknown. OBJECTIVE We aimed to determine how the consumption of different sources of proteins (soy or whey) during a controlled short-term (14-d) hypoenergetic diet affected MPS and lipolysis. METHODS Men (n = 19) and women (n = 21) (age 35-65 y; body mass index 28-50 kg/m(2)) completed a 14-d controlled hypoenergetic diet (-750 kcal/d). Participants were randomly assigned, double blind, to receive twice-daily supplements of isolated whey (27 g/supplement) or soy (26 g/supplement), providing a total protein intake of 1.3 ± 0.1 g/(kg · d), or isoenergetic carbohydrate (25 g maltodextrin/supplement) resulting in a total protein intake of 0.7 ± 0.1 g/(kg · d). Before and after the dietary intervention, primed continuous infusions of L-[ring-(13)C6] phenylalanine and [(2)H5]-glycerol were used to measure postabsorptive and postprandial rates of MPS and lipolysis. RESULTS Preintervention, MPS was stimulated more (P < 0.05) with ingestion of whey than with soy or carbohydrate. Postintervention, postabsorptive MPS decreased similarly in all groups (all P < 0.05). Postprandial MPS was reduced by 9 ± 1% in the whey group, which was less (P < 0.05) than the reduction in soy and carbohydrate groups (28 ± 5% and 31 ± 5%, respectively; both P < 0.05) after the intervention. Lipolysis was suppressed during the postprandial period (P < 0.05), but more so with ingestion of carbohydrate (P < 0.05) than soy or whey. CONCLUSION We conclude that whey protein supplementation attenuated the decline in postprandial rates of MPS after weight loss, which may be of importance in the preservation of lean mass during longer-term weight loss interventions. This trial was registered at clinicaltrials.gov as NCT01530646.
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Affiliation(s)
- Amy J Hector
- Exercise Metabolism Research Group, Departments of Kinesiology and
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- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Mark von Allmen
- Exercise Metabolism Research Group, Departments of Kinesiology and
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144
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Abstract
BACKGROUND Obesity results from a chronic positive energy balance. THERAPY A reduction of energy intake is the first and most effective option for weight reduction. In recent years a variety of new nutritional concepts for weight loss have been developed and evaluated. Apart from the classical low-fat energy-restricted diet, low carbohydrate and high protein diets have also been established. RESULTS Comparative studies showed that weight loss depends on the extent of energy restriction rather than on macronutrient composition. Due to the high variability in dietary habits the management of obesity should be problem-oriented and patient-centered.
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145
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Rankin JW. Effective Diet and Exercise Interventions to Improve Body Composition in Obese Individuals. Am J Lifestyle Med 2015. [DOI: 10.1177/1559827613507879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Because higher body fat and lower lean mass is associated with excess morbidity and mortality, health care teams need specific science-based recommendations to advise clients on lifestyle approaches to alter body composition. Combining exercise with modest energy restriction is recommended to cause up to 20% more weight and fat loss, improved function, and reduced lean mass loss than modification of diet alone. The optimal diet for developing a leaner body composition is one that is modestly reduced in energy and contains lower fat and higher protein than average. Aerobic exercise alone may cause minimal change in body weight (1%-3%) and fat if greater than 250 min/wk. Higher intensity or duration of exercise can cause more substantial fat loss but may have poor long-term compliance. Resistance exercise boosts lean body mass and improves some health indicators but generally does not cause fat loss. In summary, consumption of a low-fat (20%-25% of energy), moderately high-protein (>1.2 g/kg and up to 20%-25% of energy) diet with modestly reduced energy (500-1000 kcal/d) combined with aerobic (3-5 d/wk, at least 250 min/wk) and resistance exercise (2 d/wk) can improve body composition to reduce clinically relevant risks associated with obesity.
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Affiliation(s)
- Janet Walberg Rankin
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg Virginia
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146
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McGrice M, Don Paul K. Interventions to improve long-term weight loss in patients following bariatric surgery: challenges and solutions. Diabetes Metab Syndr Obes 2015; 8:263-74. [PMID: 26150731 PMCID: PMC4485844 DOI: 10.2147/dmso.s57054] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Bariatric surgery aims to provide long-term weight loss and improvement in weight-related comorbidities. Unfortunately, some patients do not achieve predicted weight loss targets and many regain a portion of their lost weight within 2-10 years postsurgery. A review of the literature found that behavioral, dietary, psychological, physical, and medical considerations can all play a role in suboptimal long-term weight loss. Recommendations to optimize long-term weight loss include ensuring that the patient understands how the procedure works, preoperative and postoperative education sessions, tailored nutritional supplements, restraint with liquid kilojoules, pureed foods, grazing and eating out of the home, an average of 60 minutes of physical activity per day, and lifelong annual medical, psychological, and dietary assessments.
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Affiliation(s)
- Melanie McGrice
- Nutrition Plus Enterprises, Melbourne, VIC, Australia
- Correspondence: Melanie McGrice, Nutrition Plus Enterprises, PO Box 9064, South Yarra, Melbourne, VIC 3141, Australia, Tel +61 1300 438 550, Email
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147
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The role of higher protein diets in weight control and obesity-related comorbidities. Int J Obes (Lond) 2014; 39:721-6. [PMID: 25540980 PMCID: PMC4424378 DOI: 10.1038/ijo.2014.216] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 09/18/2014] [Accepted: 09/24/2014] [Indexed: 12/25/2022]
Abstract
The importance of the relative dietary content of protein, carbohydrate and the type of carbohydrate (that is, glycemic index (GI)) for weight control under ad libitum conditions has been controversial owing to the lack of large scale studies with high diet adherence. The Diet, Obesity and Genes (DioGenes) European multicentre trial examined the importance of a slight increase in dietary protein content, reduction in carbohydrate and the importance of choosing low (LGI) vs high GI (HGI) carbohydrates for weight control in 932 obese families. Only the adults underwent a diet of 800 kcal per day for 8 weeks, and after losing ~11kg they were randomized to one of five energy ad libitum diets for 6 months. The diets differed in protein content and GI. The high-protein (HP) diet groups consumed 5.4% points more energy from protein than the normal protein (NP) groups, and the LGI diet groups achieved 5.1% lower GI than the HGI groups. The effect of HP and LGI was additive on weight loss and maintenance, and the combination was successful in preventing weight regain and reducing drop-out rate among the adults after the 11kg weight loss. This diet also reduced body fatness and prevalence of overweight and obesity among their children and had consistent beneficial effects on blood pressure, blood lipids and inflammation in both parents and children. After 1 year, mainly the HP effects were maintained. Putative genes have been identified that suggest this diet to be particularly effective in 67% of the population. In conclusion, the DioGenes diet has shown to be effective for prevention of weight regain and for weight reduction in overweight children under ad libitum conditions. The less-restrictive dietary approach fits into a normal food culture, and has been translated into popular diet and cook books in several languages.
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148
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Abstract
With regular practice, resistance exercise can lead to gains in skeletal muscle mass by means of hypertrophy. The process of skeletal muscle fiber hypertrophy comes about as a result of the confluence of positive muscle protein balance and satellite cell addition to muscle fibers. Positive muscle protein balance is achieved when the rate of new muscle protein synthesis (MPS) exceeds that of muscle protein breakdown (MPB). While resistance exercise and postprandial hyperaminoacidemia both stimulate MPS, it is through the synergistic effects of these two stimuli that a net gain in muscle proteins occurs and muscle fiber hypertrophy takes place. Current evidence favors the post-exercise period as a time when rapid hyperaminoacidemia promotes a marked rise in the rate of MPS. Dietary proteins with a full complement of essential amino acids and high leucine contents that are rapidly digested are more likely to be efficacious in this regard. Various other compounds have been added to complete proteins, including carbohydrate, arginine and glutamine, in an attempt to augment the effectiveness of the protein in stimulating MPS (or suppressing MPB), but none has proved particularly effective. Evidence points to a higher protein intake in combination with resistance exercise as being efficacious in allowing preservation, and on occasion increases, in skeletal muscle mass with dietary energy restriction aimed at the promotion of weight loss. The goal of this review is to examine practices of protein ingestion in combination with resistance exercise that have some evidence for efficacy and to highlight future areas for investigation.
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149
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Devassy JG, Caligiuri SPB, Mayengbam S, Ibrahim NHM, Zahradka P, Taylor CG, House JD, Aukema HM. Dietary restriction in moderately obese rats improves body size and glucose handling without the renal and hepatic alterations observed with a high-protein diet. Appl Physiol Nutr Metab 2014; 40:334-42. [PMID: 25781199 DOI: 10.1139/apnm-2014-0399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Obesity is increasing worldwide, and high-protein (HP) diets are widely used for weight loss. However, the overall safety of HP diets is not well established in obese individuals, who make up a significant proportion of the population. To evaluate the health effects of an HP diet in obesity, obesity-prone (OP) Sprague-Dawley rats were given high-fat diets for 12 weeks to induce obesity. Following this, for 8 more weeks, these rats were given either a normal-protein (NP) (15% of energy) or an HP (35% of energy) diet ad libitum, or the NP diet at a restricted level to achieve body weights similar to those of the HP group (pair-weighted (PW) group). Obesity-resistant (OR) control rats were also given the NP diet throughout the feeding period. The HP-OP group had higher food intake but lower body weight, improved glucose handling, and lowered serum haptoglobin compared with the NP-OP group. These benefits were also observed in PW-OP rats. In addition, PW-OP rats had less fat accumulation when compared with NP-OP rats, and an improved Lee index, lower liver size, and lower serum alanine aminotransferase when compared with HP-OP rats. On the other hand, kidney size, proteinuria, and serum homocysteine were increased in HP-OP rats compared with NP-OP rats, whereas PW-OP rats did not experience these effects. These results indicate that in obese rats, more benefits are obtained via dietary restriction with an NP diet and without some of the potentially detrimental effects of an HP diet.
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Affiliation(s)
- Jessay G Devassy
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada., Canadian Centre for Agri-Food Research in Health and Medicine, Winnipeg, MB R2H 2A6, Canada
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150
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Low-carbohydrate diets and cardiovascular and total mortality in Japanese: a 29-year follow-up of NIPPON DATA80. Br J Nutr 2014; 112:916-24. [PMID: 25201302 DOI: 10.1017/s0007114514001627] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Long-term safety of consuming low-carbohydrate diets (LCD) in Asian populations, whose carbohydrate intake is relatively high, is not known. In the present study, the association of LCD with CVD and total mortality was assessed using data obtained in the NIPPON DATA80 (National Integrated Project for Prospective Observation of Non-communicable Disease and Its Trends in the Aged 1980) during 29 years of follow-up. At baseline in 1980, data were collected from study participants aged ≥ 30 years from randomly selected areas in Japan. LCD scores were calculated based on the percentage of energy as carbohydrate, fat and protein, estimated by 3 d weighed food records. A total of 9200 participants (56% women, mean age 51 years) were followed up. During the follow-up, 1171 CVD deaths (52% in women) and 3443 total deaths (48% in women) occurred. The multivariable-adjusted hazard ratio (HR) for CVD mortality using the Cox model comparing the highest v. lowest deciles of LCD score was 0·60 (95% CI 0·38, 0·94; P(trend) = 0·021) for women and 0·78 (95% CI 0·58, 1·05; P(trend) = 0·079) for women and men combined; the HR for total mortality was 0·74 (95% CI 0·57, 0·95; P(trend) = 0·029) for women and 0·87 (95% CI 0·74, 1·02; P(trend) = 0·090) for women and men combined. None of the associations was statistically significant in men. No differential effects of animal-based and plant-fish-based LCD were observed. In conclusions, moderate diets lower in carbohydrate and higher in protein and fat are significantly inversely associated with CVD and total mortality in women.
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