Randomized controlled trial assessing two commercial weight loss programs in adults with overweight or obesity

Objective

Lifestyle interventions remain the cornerstone for obesity treatment. Commercial programs offer one weight loss approach, yet the efficacy of few such programs have been rigorously investigated. The purpose of this study was to evaluate the efficacy of two commercial weight-loss programs, both utilizing pre-portioned meal replacements (MRs) and different levels of behavioural support, compared to a self-directed control diet in adults with overweight and obesity.

Methods

In this 16-week study, participants were randomized to the low-calorie OPTAVIA® 5&1 Plan® with telephone coaching (OPT), the reduced-calorie Medifast® 4&2&1 self-guided plan (MED), or a self-directed, reduced-calorie control diet. Differences in weight, body composition (DXA) and body circumferences, all measured monthly, were assessed by analysis of covariance with sex and baseline measures as covariates.

Results

Of 198 participants randomized (80.8% female, BMI 34.2 kg/m², 45.7 years), 92.3% completed the study. The OPT and MED groups had significantly greater reductions in body weight (-5.7% and - 5.0%, respectively, p < 0.0001), fat and abdominal fat mass (p < 0.0001) and waist and hip circumferences (p ≤ 0.003) than control at 16 weeks. Weight change was correlated with MR usage and completion of coaching support calls.

Conclusions

Both structured commercial programs were more efficacious than a self-directed, reduced-calorie diet for weight loss and other anthropometric measures. Evidence-based commercial programs can be an important tool to help adults with overweight and obesity lose clinically relevant amounts of weight.

Low cost digester monitoring under realistic conditions: Rural use of biogas and digestate quality

The purpose of this work was to assess the behaviour of anaerobic digestion of cattle manure in a rural digester under realistic conditions, and estimate the quality and properties of the digestate. The data obtained during monitoring indicated that the digester operation was stable without risk of inhibition. It produced an average of 0.85Nm³biogas/d at 65.6% methane, providing an energy savings of 76%. In addition, the digestate contained high nutrient concentrations, which is an important feature of fertilizers. However, this method requires post-treatment due to the presence of pathogens.

Development of the olfactory system in turbot (Psetta maxima L.)

We have examined the histogenesis of the olfactory system during turbot development using histological and immunohistochemical methods. Proliferating cell nuclear antigen (PCNA) immunohistochemistry was used to detect dividing cells, whereas calretinin (CR) immunohistochemistry was used to distinguish some neuronal components of the olfactory system. Around hatching, the olfactory placode of embryos transforms into an olfactory pit, which enlarges progressively during development. In metamorphic turbots, the right olfactory organ moves to the tip of the head. Each olfactory chamber opens to the external medium by two nostrils and accessory nasal sacs develop during metamorphosis. The order of birth of olfactory receptor cells in the sensory epithelium follows the pattern of most teleosts: ciliated cells differentiate prior to microvillous cells in turbot larvae, and crypt cells are generated during metamorphosis. Axons of olfactory sensory neurons reach the rostral forebrain by hatching, and calretinin-immunoreactive (CR-ir) glomerular fields were apparent during the subsequent larval development. During metamorphosis olfactory bulbs become strongly distorted by head torsion and glomeruli acquire asymmetric organization. The spatio-temporal course of proliferation in the olfactory system reveals changes in the distribution of dividing cells in the sensory epithelium throughout the developmental period investigated. In the olfactory bulb, proliferative activity becomes restricted to the ventral periventricular zone in turbot larvae, as well as in metamorphic specimens.

[Colonoscopic diagnosis]

Between 1974 and 1992, we perform 3,054 colonoscopies for diagnosis in 2,770 patients, both of sexes, between the ages of 1 and 101 yr, most of them over the fifth decade of life. In 300 procedures the bowel cleansing was made with the standard method of liquid diet and enemas, and in the other 2,754 with the oral administration of saline solution 9% with optimal results. We get the sedation of patients with the intravenous administration of diazepam 10mg, or pethidine 50 mg, or midazolam 2.5 to 5 mg, and in children with ketamine and the anesthesiologist assistance. In 95% of the procedures we can see the cecum and the ileum; the diagnosis was abnormal in 52.78% of cases, normal in 45.20%, and insufficient in 02.02% specially for a bad cleansing of the bowel. In the abnormal group, the most frequent diseases we diagnose were: polyps, cancer, diverticular disease, and specific inflammatory disease of the bowel like TBC, radiation proctosigmoiditis, amebiasis, and non-specific bowel disease: "colitis", ulcerative proctocolitis, erosive colitis, and Crohn's disease. Colonoscopy is a very important method for diagnosis of colon diseases, alone or complementary of double contrast X-ray of the colon.

Effects of a few food diet in attention deficit disorder

Seventy-eight children, referred to a diet clinic because of hyperactive behaviour, were placed on a 'few foods' elimination diet. Fifty nine improved in behaviour during this open trial. For 19 of these children it was possible to disguise foods or additives, or both, that reliably provoked behavioural problems by mixing them with other tolerated foods and to test their effect in a placebo controlled double blind challenge protocol. The results of a crossover trial on these 19 children showed a significant effect for the provoking foods to worsen ratings of behaviour and to impair psychological test performance. This study shows that observations of change in behaviour associated with diet made by parents and other people with a role in the child's care can be reproduced using double blind methodology and objective assessments. Clinicians should give weight to the accounts of parents and consider this treatment in selected children with a suggestive medical history.