Is a calorie a calorie?

The aim of this review was to evaluate data regarding potential thermodynamic mechanisms for increased rates of weight loss in subjects consuming diets high in protein and/or low in carbohydrate. Studies that compared weight loss and energy expenditure in adults consuming diets high in protein and/or low in carbohydrate with those in adults consuming diets low in fat were reviewed. In addition, studies that measured the metabolizable energy of proteins, fats, and carbohydrates were reviewed. Diets high in protein and/or low in carbohydrate produced an approximately equal to 2.5-kg greater weight loss after 12 wk of treatment. Neither macronutrient-specific differences in the availability of dietary energy nor changes in energy expenditure could explain these differences in weight loss. Thermodynamics dictate that a calorie is a calorie regardless of the macronutrient composition of the diet. Further research on differences in the composition of weight loss and on the influence of satiety on compliance with energy-restricted diets is needed to explain the observed increase in weight loss with diets high in protein and/or low in carbohydrate.     

Estimating a constant WTP for a QALY—a mission impossible?

Economic evaluations are an important input to decision-making and priority-setting in the health care sector. Measuring preferences for health improvements, as the demand-side value (willingness to pay) of gaining a quality-adjusted life year (QALY), is one relevant component in the interpretation of the results from health economic evaluations. Our article addresses whether willingness to pay for a QALY (WTP-Q) is sensitive to the size of the health differences and the probability for improvement. We use data from a contingent valuation survey based on 1400 respondents conducted in the spring of 2014. The results show that the expectation of sensitivity to scope, or higher WTP to the larger expected quality of life improvement, is not supported. We find WTP-Q values that conform reasonably well to previous studies in Sweden.     

Leadership and achieving a vision--how does a profession lead a nation?

The author examines the role of leadership in achieving a new vision for health promotion. Leadership challenges and threats, and contemporary views on leadership are reviewed to frame the opportunity available to the health promotion profession to change national health policy. He concludes by describing the actions every professional can take to play a leadership role in helping to achieve the new vision articulated in this special issue.     

Will PSOs be a disaster or a dream?

The healthcare landscape is littered with failed attempts by hospitals and physicians to manage insurance risk. This year's survey of managed-care plans shows 12 of 30 provider-owned HMOs lost money in 1997. And Modern Healthcare's news pages have chronicled recent losses at more than 20 provider-owned plans. With provider-sponsored organizations in the pipeline, the question is: Will they be a dream or are they a disaster in the making?     

PURLs: Add a fibrate to a statin?

For most patients with diabetes and dyslipidemia, adding a fibrate does not improve cardiovascular outcomes.