Can the controversial relationship between dietary calcium and body weight be mechanistically explained by alterations in appetite and food intake?

Exploring the Potential Benefits of Natural Calcium-Rich Mineral Waters for Health and Wellness: A Systematic Review

This systematic review investigates the potential health and wellness benefits of natural calcium-rich mineral waters. It emphasizes the importance of dietary calcium sourced from natural mineral waters in promoting bone health, maintaining cardiovascular function, aiding in weight management, and enhancing overall well-being. The review process involved the comprehensive analysis of peer-reviewed articles, clinical trials, and experimental studies published within the last decade. Findings reveal that consuming calcium-rich mineral water can contribute significantly to daily calcium intake, particularly for those with lactose intolerance or individuals adhering to plant-based diets. The unique bioavailability of calcium from such waters also appears to enhance absorption, thus potentially offering an advantage over other calcium sources. The potential benefits extend to the cardiovascular system, with some studies indicating a reduction in blood pressure and the prevalence of cardiovascular diseases. Emerging evidence suggests that calcium-rich mineral water might have a role in body weight management, though further research is needed. The review identifies several areas requiring additional research, such as the potential interaction between calcium-rich mineral water and other dietary components, the effects on populations with specific health conditions, and the long-term effects of consumption. In conclusion, natural calcium-rich mineral waters show promise as a readily accessible and bioavailable sources of dietary calcium, potentially beneficial for a broad range of individuals. However, further investigation is required to fully understand its range of health impacts and define optimal intake levels.

The effects of whole milk compared to skim milk and apple juice consumption in breakfast on appetite and energy intake in obese children: a three-way randomized crossover clinical trial

Background

A limited number of studies have examined the effect of dairy on satiety and short-term energy intake among children; furthermore we are not aware of any study comparing high and low-fat dairy products regarding their effect on appetite and short-term energy intake. Our objective was to assess the effect skim milk (SM) compared to whole milk (WM) and apple juice (AJ) on satiety and energy intake at lunch among 10-12 y children with obesity.

Methods

Fifty children with obesity who aged 10-12 y were randomized to consume a fixed content breakfast with 240 ml of SM, AJ, or WM for two consecutive days. The study was a three-way randomized crossover study; therefore each participant served as his/her own control. The total appetite, hunger, fullness, desire to eat and prospective consumption were measured using a visual analogue scale (VAS) before breakfast and every one hour after breakfast until a freely consumed lunch. VAS scores and energy intakes were compared using repeated measures procedure.

Results

Forty-eight participants (24 girls and 24 boys) completed the study. The energy intake was not different between SM, AJ and WM periods (adjusted mean ± standard error (SE) of energy intake: SM = 831.27 ± 30.64 Kcal, AJ = 794.92 ± 28.72 Kcal, WM = 798.87 ± 24.09 Kcal; P = 0.56). The effect was the same for either gender. Children reported higher satiety score 4 h after drinking WM with breakfast compared with SM (P < 0.05). The same association was found only in girls. Furthermore, SM significantly reduced appetite compared to AJ, 2 h after preloads in girls (P < 0.05).

Conclusions

Full-fat milk may have favorable effects on satiety but not energy intake in subsequent meal compared to skim milk among the children with obesity. Future studies with longer follow-up periods are needed to confirm these results.

Trial registration

The study protocol was registered with the Iranian registry of clinical trials on 9th October 2016 (registration ID: IRCT2016072012571N5).

Supplementation with dairy calcium and/or flaxseed fibers in conjunction with orlistat augments fecal fat excretion without altering ratings of gastrointestinal comfort

Background

Orlistat is a lipase inhibitor which reduced absorption of dietary fat by ~30% thereby inducing a weight loss; however, side effects occur as a consequence of increased colonic fat content. To test the hypothesis that most gastrointestinal side events induced by treatment with orlistat could be prevented/ameliorated by concomitant use of natural dietary components, flaxseed fiber (FF) and/or dairy calcium (Ca), binding liquid fats to more solid complexes.

Methods

A randomized controlled dietary intervention study. Thirty-eight obese adults completed a 1-week run-in period, where all participants were treated with orlistat (60 mg t.i.d) and were hereafter randomized to 12 weeks dietary supplementation with/without 5 g FF (FF+/FF-) and/or 1200 mg dairy calcium (Ca+/Ca-) in conjunction with orlistat. All feces were collected for 3 days, and diet was recorded for 5 days, during run-in and week 4. The primary end-point, gastrointestinal symptoms, was assessed biweekly. At baseline and after 12 weeks, cardiometabolic risk markers and anthropometrics were evaluated as secondary end-points.

Results

Both FF and Ca increased fecal fat excretion (P = 0.02 and P = 0.04, respectively). Although fecal fat excretion increased by ~100% in the FF+/Ca + group, and only by ~12% in the FF-/Ca + group, no interaction between FF and Ca was present, suggesting an additive effect. The fecal fat excretion was ~10 g/d higher with FF and Ca (~25 g/d) compared to fecal fat excretion with orlistat alone (~15 g/d). Mean ratings of severity of diarrhea tended to increase with Ca (P = 0.03) but not with FF. No other gastrointestinal symptoms, or a composite score of symptoms, were affected by the dietary supplements. Body weight was reduced in all groups but did not differ between groups, whereas waist circumference was most reduced in the FF+/Ca + group. No effects of dietary supplements on cardiometabolic risk factors were observed, except a slight increase in diastolic blood pressure (P = 0.03) with FF, but not Ca.

Conclusions

Our results do not support an improvement in orlistat-induced gastrointestinal side effects by concomitant use of FF and Ca. However, fecal fat excretion was increased with both FF and Ca in the absence of a worsening of symptoms, warranting further studies powered to detect potential additive weight loss effects.

Trial registration

Ethical Committee of the Capital Region of Denmark reg. no. H-1-2010-110, 02-11-2010 database no. NCT01320228, 21-03-2011.

Electronic supplementary material

The online version of this article (doi:10.1186/s12986-017-0164-8) contains supplementary material, which is available to authorized users.

Effect of dairy calcium from cheese and milk on fecal fat excretion, blood lipids, and appetite in young men

BACKGROUND

Calcium from different dairy sources might affect blood lipids and fecal fat excretion differently because of differences in the food matrix and nutritional composition.

OBJECTIVE

We investigated whether milk- and cheese-based diets with similar calcium contents affect a saturated fatty acid-induced increase in blood lipids differently.

DESIGN

Fifteen healthy, young men participated in a randomized 3 × 2-wk crossover study in which the following 3 isocaloric diets that were similar in fat contents and compositions were compared: control diet [nondairy diet (~500 mg Ca/d)], milk diet [semiskimmed milk-based diet (1700 mg Ca/d)], and cheese diet [semihard cow-cheese-based diet (1700 mg Ca/d)]. Blood was drawn before and after each period, and feces were collected for 5 d during each period.

RESULTS

Saturated fatty acid-induced increases in total and low-density lipoprotein (LDL) cholesterol were lower with the milk diet (mean ± SD: 0.57 ± 0.13 and 0.53 ± 0.11 mmol/L, respectively) (P < 0.01) and cheese diet (0.41 ± 0.15 and 0.47 ± 0.12 mmol/L, respectively) (P < 0.05) than with the control diet (0.89 ± 0.12 and 0.84 ± 0.11 mmol/L, respectively). Fecal fat excretion increased more with the consumption of both the milk (5.2 ± 0.4 g/d) and cheese (5.7 ± 0.4 g/d) diets than with the control diet (3.9 ± 0.3 g/d) (P < 0.001). Changes in blood pressure, high-density lipoprotein cholesterol, triglycerides, and lipid ratios did not differ.

CONCLUSIONS

Compared with the control diet, milk- and cheese-based diets attenuated saturated fatty acid-induced increases in total and LDL cholesterol and resulted in increased fecal fat excretion; however, effects of milk and cheese did not differ. Because the diets contained similar amounts of saturated fat, similar increases in total and LDL cholesterol could be expected; however, both milk and cheese attenuated these responses, which seem to be explained by their calcium contents. This trial was registered at clinicaltrials.gov as NCT01317251.

Low dietary calcium and obesity: a comparative study in genetically obese and normal rats during early growth

PURPOSE

A low calcium intake (LCaI) may predispose to obesity, and excessive fat mass may be detrimental to bone. The impact of Ca inadequacy would be greater in subjects predisposed to obesity. LCaI effect on obesity development during the rapid growth period was compared in two strains of rats: spontaneously obese IIMb/β (O) and Wistar (W). Pregnant rats were fed 0.5% (N) or 0.2% (L) of Ca (OLCa, ONCa, WLCa and WNCa). Male pups were fed the maternal diet until day 60.

METHODS

Body composition, lipid profile, glucose homeostasis, 25 hydroxyvitamin D, Ca-phosphorus, and bone metabolism were evaluated.

RESULTS

BW and body fat were higher, whereas body protein was lower in OLCa versus ONCa (p < 0.05). OLCa presented the highest body fat, glucose, non-HDL and total cholesterol, TGL, insulin levels, and HOMA-IR, liver weight, and adipose perigonadal plus retroperitoneal pads (p < 0.05). WLCa did not exhibit an increase BW and only showed a slight change in body composition with minor biochemical alterations compared to WNCa (p < 0.05). Osteocalcin, CTX, and proximal tibia and lumbar spine BMDs were lower in O than in W rats fed the same Ca diet (p < 0.05). Body ash and Ca content, and total skeleton BMC/BW were lower in OLCa and WLCa versus their corresponding NCa groups (p < 0.05).

CONCLUSION

The negative effect of a low Ca diet on fat mass accumulation and lipid profile may be more evident in rats predisposed to obesity. Nevertheless, low CaI interferes with the normal glucose homeostasis leading to an increase in insulin resistance. Low CaI during early growth may be an obesogenic factor that may persist into adult life and may account for the development of obesity and some of its co-morbidities.

Effect of a dairy- and calcium-rich diet on weight loss and appetite during energy restriction in overweight and obese adults: a randomized trial

BACKGROUND/OBJECTIVES

A diet rich in dairy and calcium (Ca) has been variably associated with improvements in body composition and decreased risk of type 2 diabetes. Our objective was to determine if a dietary pattern high in dairy and Ca improves weight loss and subjective appetite to a greater extent than a low dairy/Ca diet during energy restriction in overweight and obese adults with metabolic syndrome.

SUBJECTS/METHODS

A total of 49 participants were randomized to one of two treatment groups: Control (low dairy, ≈ 700 mg/day Ca, -500 kcal/day) or Dairy/Ca (high dairy, ≈ 1400 mg/day Ca, -500 kcal/day) for 12 weeks. Body composition, subjective ratings of appetite, food intake, plasma satiety hormones, glycemic response and inflammatory cytokines were measured.

RESULTS

Control (-2.2 ± 0.5 kg) and Dairy/Ca (-3.3 ± 0.6 kg) had similar weight loss. Based on self-reported energy intake, the percentage of expected weight loss achieved was higher with Dairy/Ca (82.1 ± 19.4%) than Control (32.2 ± 7.7%; P=0.03). Subjects in the Dairy/Ca group reported feeling more satisfied (P=0.01) and had lower dietary fat intake (P=0.02) over 12 weeks compared with Control. Compared with Control, Dairy/Ca had higher plasma levels of peptide tyrosine tyrosine (PYY, P=0.01) during the meal tolerance test at week 12. Monocyte chemoattractant protein-1 was reduced at 30 min with Dairy/Ca compared with Control (P=0.04).

CONCLUSIONS

In conclusion, a dairy- and Ca-rich diet was not associated with greater weight loss than control. Modest increases in plasma PYY concentrations with increased dairy/Ca intake, however, may contribute to enhanced sensations of satisfaction and reduced dietary fat intake during energy restriction.

Effect of dietary calcium (Ca) on body composition and Ca metabolism during growth in genetically obese (β) male rats

INTRODUCTION

Obese β rats may be a suitable model to evaluate the association between calcium intake (CaI) and obesity during growth.

OBJECTIVE

The present study comparatively evaluated Ca absorption and retention, and changes in body composition in spontaneously genetically obese (β) male rats fed three different dietary Ca levels: high 0.9% (HCa); normal: 0.5% (NCa); low: 0.2% (LCa).

METHODS

Pregnant rats were fed isocaloric diets which varied in Ca content only. Male pups continued feeding the same maternal diet until postnatal day 60. The percentage of Apparent Ca absorption (CaA %), Ca balance (CaB), body composition, glucose, triglycerides (TGL), and insulin levels were evaluated.

RESULTS

Food consumption and body weight (BW) were higher in Group LCa than in Groups NCa and HCa (p < 0.01); no differences were observed between the latter two groups. Group LCa presented the highest body fat, liver weight, perigonadal and retroperitoneal fat (p < 0.05); conversely, body ashes and total skeleton bone mineral content were significantly lower compared with animals in both the NCa (p < 0.01) and HCa groups (p < 0.01). CaB (mg/day) reached a plateau at the highest CaI (mg/day) value (r = 0.985, p < 0.001). CaA%, serum glucose, insulin, and TGL levels rose as CaI decreased (p < 0.01).

CONCLUSIONS

Although further studies are required, low Ca consumption in this strain of rats could modulate BW inducing changes in several lipid metabolism parameters, which in turn lead to an increase in body fat.

Functional food and satiety. Impact of a satiating context effect on appetite control of non-obese men

The aim of this study was to verify if the addition of satiating nutrients and a satiating context effect could influence appetite sensations, spontaneous energy intake and food appreciation under conditions of standardized energy density of a meal. Eighteen non-obese men were submitted to a control, a satiating, and a context effect condition composed of a standardized breakfast and an ad libitum test lunch (macaroni entrée plus chocolate cake). The satiating macaroni contained more proteins, unsaturated fats, fibres and calcium than the control macaroni despite similar energy density, appearance and palatability. In the context effect condition, participants believed they were eating "a highly satiating macaroni", but were served the control macaroni. Appreciation of the macaronis, quantities of macaroni and cake consumed and 4-h satiating potential were measured for each condition. Quantities of macaroni and dessert consumed did not differ between conditions. Satiating potential was greater for the context effect meal compared to the control and/or the satiating meals up to 4h after its consumption. The context effect macaroni obtained higher appreciation rates than the control and the satiating macaronis. The context effect may positively influence the appreciation toward a meal and contribute to increase its satiety potential for many hours.

Micronutrients in pregnancy: current knowledge and unresolved questions

Micronutrient status is increasingly recognized to play an important role in the health and well-being of pregnant women and in the development and long-term health of the offspring. On 26th - 28th February 2009, The Child Health Foundation invited leading experts in this area to a scientific workshop at Obergurgl, Austria to review and critically discuss current knowledge, to identify issues that may need to be addressed in future recommendations, and to highlight priorities and opportunities for future research. This report summarizes updated key conclusions of the workshop with regards to micronutrients' intake and physiological role related to mother, placenta and fetus, as well as relevance for adverse pregnancy and long-term outcomes.

Milk supplementation facilitates appetite control in obese women during weight loss: a randomised, single-blind, placebo-controlled trial

Dairy products provide Ca and protein which may facilitate appetite control. Conversely, weight loss is known to increase the motivation to eat. This randomised controlled trial verified the influence of milk supplementation on appetite markers during weight loss. Low Ca consumer women participated in a 6-month energy-restricted programme (-2508 kJ/d or -600 kcal/d) and received either a milk supplementation (1000 mg Ca/d) or an isoenergetic placebo (n 13 and 12, respectively). Fasting appetite sensations were assessed by visual analogue scales. Anthropometric parameters and fasting plasma concentrations of glucose, insulin, leptin, ghrelin and cortisol were measured as well. Both groups showed a significant weight loss (P < 0·0001). In the milk-supplemented group, a time x treatment interaction effect showed that weight loss with milk supplementation induced a smaller increase in desire to eat and hunger (P < 0·05). Unlike the placebo group, the milk-supplemented group showed a lower than predicted decrease in fullness (-17·1 v. -8·8; -2·7 v. 3·3 mm, P < 0·05, measured v. predicted values, respectively). Even after adjustment for fat mass loss, changes in ghrelin concentration predicted those in desire to eat (r 0·56, P < 0·01), hunger (r 0·45, P < 0·05) and fullness (r -0·40, P < 0·05). However, the study did not show a between-group difference in the change in ghrelin concentration in response to the intervention. These results show that milk supplementation attenuates the orexigenic effect of body weight loss.

Skim milk compared with a fruit drink acutely reduces appetite and energy intake in overweight men and women

BACKGROUND

Several studies show that proteins, including whey and casein, are more satiating than carbohydrates. It follows that skim milk would be more satiating than sugar-rich beverages. However, this has yet to be shown.

OBJECTIVE

The objective was to investigate the effects of drinking skim milk in comparison with a fruit drink at breakfast on self-reported postmeal satiety and energy intake at lunch.

DESIGN

In a randomized crossover trial, 34 overweight women (n = 21) and men (n = 13) attended 2 sessions 1 wk apart. At each session, participants consumed a fixed-energy breakfast together with either 600 mL skim milk (25 g protein, 36 g lactose, <1 g fat; 1062 kJ) or 600 mL fruit drink (<1 g protein, 63 g sugar, <1 g fat; approximately 1062 kJ). Participants provided satiety ratings throughout the morning. Four hours after breakfast they consumed an ad libitum lunch, and energy intake was assessed.

RESULTS

Participants consumed significantly less energy at lunch after consuming skim milk (mean: 2432 kJ; 95% CI: 2160, 2704 kJ) than after consuming the fruit drink (mean: 2658 kJ; 95% CI: 2386, 2930 kJ), with a mean difference of approximately 8.5% (P < 0.05). In addition, self-reports of satiety were higher throughout the morning after consumption of skim milk than after consumption of the fruit drink (P < 0.05) with the differences becoming larger over the 4 h (P < 0.05).

CONCLUSION

Consumption of skim milk, in comparison with a fruit drink, leads to increased perceptions of satiety and to decreased energy intake at a subsequent meal. This trial was registered with the Australian New Zealand Clinical Trials Registry at (www.anzctr.org.au) as ACTRN12608000510347.