Short-term effects of moderate alcohol consumption on lipid metabolism and energy balance in normal men

The short-term effects of moderate alcohol consumption on energy balance, serum lipids, and lipoproteins were studied in eight healthy middle-aged men (age 30 to 47 years and body mass index 23.1 to 27.7 w/h2). A crossover dietary trial included two isocaloric periods without (20% protein, 50% carbohydrate, 30% fat) or with alcohol (12% protein, 29% carbohydrate, 25% fat, 75 g of alcohol as red wine). Each period lasted 2 weeks. The body weight of the subjects remained stable over the study. Fasting blood glucose, serum insulin, total cholesterol, and LDL cholesterol were similar at the end of both dietary periods. Mean values of serum total triglyceride (108 +/- 18 v 85 +/- 24 mg/dL, P less than 0.05), VLDL-Tg (88 +/- 24 v 73 +/- 16 mg/dL, NS), and total HDL cholesterol (49.4 +/- 6.0 v 43.4 +/- 5.5 mg/dL, P less than 0.05) were higher after the diet with alcohol than without alcohol. The increase of HDL cholesterol was primarily due to that of HDL2 cholesterol (10.4 +/- 5.1 v 5.7 +/- 3.9 mg/dL, P less than 0.05). The concentration of apoprotein A-I, A-II, and B averaged 104 +/- 17 v 89 +/- 16 mg/dL, 33 +/- 4 v 28 +/- 8 mg/dL, P less than 0.02, and 111 +/- 24 v 105 +/- 33 mg/dL after the diets with and without alcohol, respectively. Adipose tissue LPL activity increased in six of the eight volunteers during the diet with alcohol. Resting metabolic rate, postprandial energy expenditure, and postprandial responses of blood glucose, serum insulin, triglyceride, and plasma FFA were similar after the both diets.(ABSTRACT TRUNCATED AT 250 WORDS)     

Moderate weight loss and sulfonylurea treatment of non-insulin-dependent diabetes mellitus. Combined effects

Hypocaloric liquid formula diets were given for one month to 20 moderately obese patients with non-insulin-dependent diabetes mellitus divided into two equal groups; group 1 was treated with weight loss alone; group 2 received glipizide in addition to the hypocaloric diet. Mean weight loss was similar in the two groups (6.5 +/- 0.6 v 6.4 +/- 0.5 kg) and was associated with a statistically significant fall in mean fasting plasma glucose values from 293 +/- 15 to 232 +/- 24 mg/dL (group 1) and from 281 +/- 15 to 152 +/- 7 mg/dL (group 2). This was associated with 13% (group 1) and 36% (group 2) decrements in total postprandial glucose response. Neither fasting nor postprandial insulin levels changed significantly with weight loss, but estimates of insulin-stimulated glucose disposal demonstrated a 15% (group 1) and 42% (group 2) improvement. Finally, fasting plasma cholesterol and triglyceride concentrations fell significantly in both groups.     

Comparison of serum cholesterol in children fed high,moderate, or low cholesterol milk diets during neonatal period

The long-term effects of milk diets in infancy on the blood serum cholesterol concentrations were studied in 97 school children 7–12 yr of age. Detailed histories were available for these children with respect to their diets during infancy. The major criterion for inclusion in the study was milk (human milk, cow's milk, or commercial formula) as the exclusive source of diet cholesterol during the first 3 mo of life. Fasting blood cholesterol and triglycerides were measured in these 97 school children, and the current diets of 29 of the 97 were evaluated for daily cholesterol intake. A 7-day diet diary was recorded, the food intake was measured and analyzed for nutrients, and validity of the diets was verified by determination of urinary nitrogen excretion. Results of the study showed that the school children fed a low cholesterol formula during infancy had a mean serum cholesterol value 7–12 yr later that was lower than the mean values of the groups fed greater amounts of cholesterol in infancy. Analysis of current diets of 29 of the 97 school children showed that their current dietary intake of cholesterol did low. Dietary intake of cholesterol did not have a noticeable effect on the serum cholesterol levels of the 29 children.     

The effect of dietary lysine to arginine ratio on cholesterol kinetics in rabbits

The effect of varying the compositions of dietary proteins on the relative cholesterolaemic effects of animal and vegetable proteins was investigated in rabbits. In experiments using high fat diets, the amino acid compositions of dietary proteins (soya or casein) were altered by blending them 1:1 (w/w) with gelatin. This reduced the differences in amino acid compositions and also made soya more and casein less hypercholesterolaemic. In experiment 2a, soya protein was compared with dried skim milk in low fat diets and in experiment 2b, these proteins were supplemented with lysine or arginine, respectively, so that the lysine:arginine ratio of soya was similar to dried skim milk and vice-versa. Serum cholesterol was significantly higher in milk-fed than soya-fed rabbits and was not influenced by reversing the lysine:arginine ratio. In the three experiments, parameters of cholesterol kinetics were estimated from the die-away curve of injected [4 14-C]cholesterol. There were no significant effects of diet on the parameters of cholesterol kinetics. It was concluded that the lysine:arginine ratio of the diet is not the major determinant of the cholesterolaemic properties of proteins, but that the overall amino acid composition is primarily concerned.     

The short- and long-term effects of a low-fat, cholesterol-free, hypocaloric diet on serum triglyceride and cholesterol distribution in severely obese humans

The effect of weight loss on serum triglycerides (TG), and total, HDL, and LDL cholesterol was measured retrospectively over a 9-month period in 14 obese patients who lost at least 90 lbs on a very-low-calorie, nearly fat-free, formula diet of 300-450 cal/day. These measurements were repeated in seven of these patients during the first 3 months of stable weight maintenance. Changes in total, LDL and HDL cholesterol were biphasic during the hypocaloric diet, showing a decrease during the first 3 months, and subsequently approaching or reaching baseline values. No further change occurred in total cholesterol, LDL cholesterol, or HDL cholesterol during the subsequent weight maintenance phase. Triglycerides decreased by the first month of this diet and remained low throughout the entire 9-month period of caloric restriction and during a 3-month period of weight maintenance. Percentage changes in TG and HDL-C during the first 3 months of hypocaloric diet were inversely correlated with their baseline values, those with the highest initial values showing the greatest decrease, and those with the lowest values showing an increase. These results demonstrate the importance of obtaining multiple specimens over time in interpreting the effect of hypocaloric diets on serum lipids.     

Effect of lactose content of nonfat milk diets on male rat serum lipids and lipoproteins

The lactose content of a semisynthetic diet containing 45% of calories as nonfat milk powder was modified by enzymatic hydrolysis with beta-galactosidase or bacterial fermentation with yogurt cultures. Three milk-based diets and a stock diet were fed for 28 days to male rats derived from the Sprague-Dawley strain. Energy consumption, growth rate, feed efficiency, liver weight, liver cholesterol and liver triglyceride concentrations were not significantly different between the four diets. At day 28 serum cholesterol and serum triglyceride concentrations were not different between the milk-based diets. No hypocholesterolemic effect of the milk-based diets was seen at any time compared to the stock diet. Two of four electrophoretic lipoprotein fractions varied with the lactose content of the milk-based diet. The faster alpha lipoprotein decreased while the slower alpha lipoprotein increased with decreasing content of dietary lactose. These data indicate that lactose differs from its constituent monosaccharides, galactose and glucose, in its effect on lipoprotein levels, even though total serum cholesterol and triglycerides do not differ.     

The influence of caloric restriction on serum prolactin.

Nine obese female patients were placed on a liquid formula diet containing 320 kcal (1.34 MJ), 31 g protein, 44 g carbohydrate, 1.5 g fat, vitamins and essential minerals for a period of four weeks under metabolic-ward conditions. The diet was tolerated well in all patients and mean weight loss was 2.49 kg per week during the four-week period. Basal serum prolactin levels were normal (2.9 +/- 0.6 ng/ml) and did not show any change during this period. In six patients a TRH test was performed before and during caloric restriction. The maximal increment of PRL after TRH was significantly lowered during dietary treatment: 53.2 +/- 16.2 vs. 32.3 +/- 11.6 ng/ml; mean +/- s.e.m.; P less than 0.025). No change was observed in the serum TSH responset to TRH before and during caloric restriction. Dietary restriction suppresses prolactin synthesis and secretion as measured in response to TRH in obese female patients.     

The effect of combining plant sterols, soy protein, viscous fibers, and almonds in treating hypercholesterolemia

Reductions in low-density lipoprotein-cholesterol (LDL-C) result from diets containing almonds, or diets that are either low in saturated fat or high in viscous fibers, soy proteins, or plant sterols. We have therefore combined all of these interventions in a single diet (portfolio diet) to determine whether cholesterol reductions could be achieved of similar magnitude to those reported in recent statin trials which reduced cardiovascular events. Twenty-five hyperlipidemic subjects consumed either a portfolio diet (n=13), very low in saturated fat and high in plant sterols (1.2 g/1,000 kcal), soy protein (16.2 g/1,000 kcal), viscous fibers (8.3 g/1,000 kcal), and almonds (16.6 g/1,000 kcal), or a low-saturated fat diet (n=12) based on whole-wheat cereals and low-fat dairy foods. Fasting blood, blood pressure, and body weight were obtained at weeks 0, 2, and 4 of each phase. LDL-C was reduced by 12.1% +/- 2.4% (P<.001) on the low-fat diet and by 35.0% +/- 3.1% (P<.001) on the portfolio diet, which also reduced the ratio of LDL-C to high-density lipoprotein-cholesterol (HDL-C) significantly (30.0% +/- 3.5%; P<.001). The reductions in LDL-C and the LDL:HDL-C ratio were both significantly lower on the portfolio diet than on the control diet (P<.001 and P<.001, respectively). Mean weight loss was similar on test and control diets (1.0 kg and 0.9 kg, respectively). No difference was seen in blood pressure, HDL-C, serum triglycerides, lipoprotein(a) [Lp(a)], or homocysteine concentrations between diets. Combining a number of foods and food components in a single dietary portfolio may lower LDL-C similarly to statins and so increase the potential effectiveness of dietary therapy.     

Influences of diet and postnatal age on the lipid composition of red blood cell membrane in newborn infants

The fatty acid and cholesterol contents of tissue membranes are determinants of their stability and functionality. This study was designed to evaluate the influences of diet and postnatal age on the polyunsaturated fatty acid (PUFA) composition of erythrocyte membrane phospholipid fractions and on the red blood cell membrane cholesterol and phosphorus contents in newborn infants during the 1st month of life. A group of infants was fed on human milk and another group on adapted milk formula. Blood samples were obtained at birth, from cord blood, and at 7 and 30 days of age. Long-chain w6 PUFA declined with advancing age in all membrane phosphoglycerides and sphingomyelin (SM) in those infants fed formula. w6 PUFA also decreased in phosphatidylcholine (PC) and phosphatidylserine (PS) in infants fed human milk and were maintained constant in phosphatidylethanolamine (PE) and SM. w3 PUFA were less affected by postnatal age. PE and SM showed significantly higher percentages of w6 and w3 long-chain PUFA in infants fed human milk than in those fed formula. Membrane cholesterol content increased in all infants from birth to 1 month of life but phosphorus levels were unaffected by diet and postnatal age. These results suggest that diets with a low content of long-chain PUFA, such as adapted cow's milk formulas, may induce changes in membrane functionality and that incorporation of PUFA to the diet in amounts similar to those found in human milk should be considered at least in early life.     

Ileal transposition surgery attenuates the increased efficiency of weight gain on a high-fat diet

High-fat diets enhance weight gain in rats and humans. Ileal transposition surgery (IT) causes long-term weight loss on ad libitum food intake. This study was designed to study the effect of high-fat diets on weight loss following ileal transposition surgery. We weight matched 40 rats, performed IT or sham IT, and fed defined high-carbohydrate (12 percent kcal as fat) or high-fat (45 percent kcal as fat) diets for 15 weeks postsurgery (N = 10/group, data are means +/- s.e.m.). Overall, IT rats ate less than sham IT rats, 9587 +/- 304 v. 10,615 +/- 356 kcal (39.6 +/- 1.2 v. 43.8 +/- 1.5 MJ) (P less than 0.01), and gained less weight (-14 +/- 7.8 v. 46 +/- 13.7 g) (P less than 0.01). Sham IT rats had similar food intakes on the two diets, but body weights were increased on the high-fat diet. However, the IT rats on the high-fat diet did not gain more weight or have higher efficiency of weight gain than did the IT rats on the high-carbohydrate diet. We conclude that ileal transposition attenuates the increased efficiency of weight gain usually associated with consumption of a high-fat diet. The mechanisms of this decreased metabolic efficiency are unclear.     

Short-term effects of substituting protein for carbohydrate in the diets of moderately hypercholesterolemic human subjects

The short-term effects on plasma lipoprotein lipids of substituting meat and dairy protein for carbohydrate in the diets of 10 free-living moderately hypercholesterolemic human subjects (four men, six women) were studied under closely supervised dietary control during the consumption of constant, low intakes of fat and cholesterol and the maintenance of stable body weight as well as constant fiber consumption. Subjects were randomly allocated to either the high or low protein diets (mean, 23% v 11% of energy as protein, 24% as fat, and 53% v 65% as carbohydrate) and then switched to the other diet for another 4 to 5 weeks. Mean fasting plasma high-density lipoprotein cholesterol (HDL-C) was significantly higher by 12% +/- 4% (0.97 +/- 0.08 v 0.89 +/- 0.08 mmol/L, P less than .01), whereas mean total cholesterol (TC) was lower by 6.5% +/- 1.3% (5.7 +/- 0.3 v 6.1 +/- 0.3 mmol/L, P less than .001), mean low-density lipoprotein-cholesterol (LDL-C) lower by 6.4% +/- 2.0% (4.5 +/- 0.2 v 4.8 +/- 0.2 mmol/L, P less than .02), mean total triglycerides (TG) lower by 23% +/- 5% (1.7 +/- 0.1 v 2.4 +/- 0.3 mmol/L, P less than .02), and mean high versus low protein diet. Mean values for LDL-C were significantly lower during weeks 3 to 5 of the high protein diet than during either weeks 1 to 5 or weeks 1 to 2 of the high protein diet (4.3 +/- 0.3, 4.5 +/- 0.2, and 4.7 +/- 0.3 mmol/L, respectively, P less than .05) and 11% +/- 3% lower than on low protein diet, P less than .005. The ratio of plasma LDL-C to HDL-C was consistently lower by 17% +/- 3% during the high versus low protein diet (4.9 +/- 0.5 v 5.8 +/- 0.5, P less than .001). Lowering plasma TC and LDL-C and total TG and VLDL-TG and increasing HDL-C by chronic isocaloric substitution of dietary for carbohydrate may enhance the cardiovascular risk reduction obtained by restriction of dietary fat and cholesterol.     

Formula diet in the treatment of moderate obesity

To evaluate the effect of the popular use of formula diets in the treatment of moderate obesity two regimens have been standardized: (1) formula diet replacing three of five daily meals (partial meal replacement (PMR, 1000 kcal (4.19 MJ] and (2) formula diet taken as five pre-meals (pre-meal satiation, PMS greater than or equal to 565 kcal (greater than or equal to 2.37 MJ]. Weight loss and compliance have been evaluated in a prospective 12 weeks randomized clinical trial with allocation to one of the two regimens or to a control group treated with a 1000 kcal (4.19 MJ) conventional diet (CD). CD and PMR were supported by diethylpropion (Dobesin) individually dosaged by the patient. No anorexic drugs was given to the PMS-group. Of 136 consecutively admitted patients 120 were included. After 12 weeks the median weight loss was 7.0, 8.4 and 6.1 kg in the CD-, PMR- and PMS-group, respectively (no significant differences between the groups (P much greater than 0.02]. Thirteen percent dropped out. Consumption of diethylpropion was significantly lower in the PMR-group compared with the CD-group (median 0.15 and 0.60 tablets of 25 mg per d, respectively). Even among selected sub-groups only few subjects obtained a relevant weight loss through continued treatment after the initial 12 weeks. No serious side-effects to the treatments were observed.     

Effect of shellfish consumption on cholesterol absorption in normolipidemic men

Noncholesterol marine sterols, abundant in molluscan shellfish, could inhibit cholesterol absorption. Eight normolipidemic males were fed for 3 weeks each three natural food diets in which a mixture of oysters and clams, crab, or chicken was served as the primary source of animal protein. The diets were equalized for caloric distribution, cholesterol, and n-3 fatty acids, leaving the noncholesterol marine sterols in the oyster/clam diet (444 mg/2,000 kcal) as the potential lipid-modifying variable. Cholesterol absorption was measured by plasma isotope ratio after doses of oral 14C- and intravenously infused 3H-labeled cholesterol. Cholesterol absorption was lower (42 +/- 4%) during the oyster/clam diet than during the chicken (54 +/- 3%, P less than 0.01) or crab (55 +/- 3%, P less than 0.01) diet periods. There was no difference between the chicken and crab diet periods. Total plasma cholesterol and triglycerides, very low density lipoprotein cholesterol and triglycerides, and low density and high density lipoprotein (HDL) cholesterol were not significantly different between any of the diets. The ratio of the HDL2-/HDL3-cholesterol was higher following the oyster/clam diet (0.46 +/- 0.09) than the chicken diet (0.32 +/- 0.06, P less than 0.05). Plasma and red cell membrane n-3 fatty acids were not significantly different among the three diets, but red cell membrane n-3 fatty acids increased as a function of time regardless of dietary sequence.     

Dietary omega-3 fatty acids prevent carbohydrate-induced hypertriglyceridemia

Dietary fish oils rich in omega-3 fatty acids are remarkably hypotriglyceridemic in both normal and hypertriglyceridemic subjects. This present study was designed to examine the hypothesis that dietary fish oils could prevent the usual sharp increase in plasma triglyceride and very low-density lipoprotein (VLDL) levels that occur physiologically after the induction by a high-carbohydrate diet. Seven healthy volunteers consumed three experimental liquid formula diets: the baseline diet (45% fat, 10% protein, 45% carbohydrate) and two high-carbohydrate diets (15% fat, 10% protein, 75% carbohydrate), one as a control diet and the other containing fish oil. The baseline and control dietary fats were a mixture of peanut oil and cocoa butter, whereas the fish oil diet contained high levels of omega-3 fatty acids. The plasma triglyceride levels rose from 105 mg/dL during baseline diet to 194 mg/dL during the high-CHO control diet (P less than 0.005). VLDL triglyceride levels increased from 69 to 156 mg/dL (P less than 0.005) and VLDL cholesterol from 18 to 34 mg/dL (P less than 0.005). When fish oil was substituted for the control fats, plasma triglyceride levels fell from 194 to 75 mg/dL (P less than 0.005), VLDL triglyceride and cholesterol levels were reduced from 156 to 34 mg/dL (P less than 0.005) and from 34 to 12 mg/dL (P less than 0.005), respectively. These effects were noted by two to three days after beginning the fish oil diet. Thus, dietary omega-3 fatty acids from fish oil rapidly and markedly reduced VLDL triglyceride levels even in the face of a high-carbohydrate diet.(ABSTRACT TRUNCATED AT 250 WORDS)     

Use of an amino-acid-based formula in the treatment of cow's milk protein allergy and multiple food allergy syndrome

Food allergy to cow's milk proteins (APLV) is frequently found in young infants. Treatment is by starting an elimination diet. Different substitution products have been proposed: soya milk, partial hydrolysate of the proteins of lactoserum, powdered casein hydrolysate, hydrolysed soya and pork collagen. Allergic reactions to soya milk, hydrolysates of lactoserum proteins, powdered casein hydrolysates and hydrolysates of soya have been described. The study that we present evaluates the effect on the natural development of these allergies of a formula based on amino-acids (Neocate) in 26 patients who presented a syndrome of multiple allergies one of which was a food allergy to milk. Twenty-five of them had a severe atopic dermatitis, isolated (14 cases), or associated with gastro-intestinal troubles (6) break in the growth curve (5), anaphylactic reactions (2), one asthma (1). One child had a chronic diarrhoea associated with a weight plateau. Evaluation 2 or 3 months later showed a significant improvement of the atopic dermatitis. Return of the stature-weight growth was noted in 4 children from 5, the check in one was reported as due to a initially unrecognised allergy to gluten. The recovery of the APLV was shown by double-blind oral provocation test in 20/23 children between 11 and 37 months (22 +/- 9). Duration of administration of Neonate was between 6 to 19 months (12 + 5) months. This study confirmed the beneficial effect of the amino-acid formula on weight gain, gastro-intestinal troubles and development of atopic dermatitis. The level of recovery of APLV of 86% at the age of 2 years is better than that reported in the syndrome of multiple food allergies of 22%. The influence of this diet on the development of other food allergies remains to be evaluated.     

A metabolic ward study of a high protein, very-low-energy diet

Seven obese women were placed on a liquid formula diet providing 560 kcal (2.4 MJ) and 70 g protein daily and studied under metabolic ward conditions for four weeks. The diet was well tolerated and hunger sensations were minimal. Mean weight loss was 10.47 kg for the four weeks. A positive nitrogen balance was achieved within two weeks in most patients, but despite this serum prealbumin levels fell as did the excretion of 3-methylhistidine in the urine. Plasma beta-hydroxybutyrate and urate levels rose during the first two weeks but remained constant thereafter. The characteristic decrease in plasma triiodothyronine levels and increase in reverse triiodothyronine levels seen with fasting and other very-low-calorie diets were also observed with this diet. Potassium losses were minimal and no changes in electrocardiograms were seen. This diet would appear to be an acceptable, effective and safe means of achieving rapid weight loss in obesity.     

Consumption of a controlled low-fat diet containing olestra for 9 months improves health risk factors in conjunction with weight loss in obese men: the Ole' Study

OBJECTIVE: To compare the effects of a standard American diet, a traditional low-fat diet, and a low-fat diet containing the fat substitute olestra on risk factors for heart disease and diabetes. DESIGN: A 9-month, double-blind, randomized, parallel-arm, feeding study comparing three diets: (1). control (33% fat), (2). fat-reduced (FR; 25% fat), and (3). fat-substituted (FS) where olestra replaced 1/3 of dietary fat (33% lipid and 25% digestible fat). Subjects were allowed to adjust their total energy intake as desired, allowing weight to fluctuate. SUBJECTS: A total of 37 healthy, obese men (age 36.7+/-1.3 y; body mass index 30.8+/-0.4 kg/m(2)). MEASUREMENTS: Body weight and composition by dual-energy X-ray absorptiometry, blood pressure, serum lipids, lipoproteins, hemostatic factors, glucose, insulin, and leptin at baseline and every 3 months. RESULTS: The FS group lost 6.27 kg of body weight by 9 months vs 4.0 kg in the control and 1.79 kg in the FR groups. There was a significant diet main effect on cholesterol (P=0.002), low-density lipoprotein cholesterol (P=0.003), and triglycerides (P=0.01), all of which decreased in the FS group but not the other groups by 9 months. Apolipoprotein B (ApoB) increased in the FR and control groups but was unchanged in the FS group (diet main effect P=0.04). High-density lipoprotein (HDL) cholesterol increased in all groups over 9 months (time main effect P=0.0001). Time main effects were also observed for cholesterol, ApoA1, ApoB, Factor VII, diastolic blood pressure, and glucose. After adjustment for % fat loss at 9 months, the effects of diet on change in risk factors remained significant only for triglycerides. DISCUSSION: Consumption of a low-fat diet containing olestra for 9 months produced significant improvement in cardiovascular risk factors, an effect largely explained by weight loss. Long-term low-fat diet consumption with or without olestra does not decrease HDL cholesterol.     

A comparison of the influence of a high-fat diet enriched in monounsaturated fatty acids and conventional diet on weight loss and metabolic parameters in obese non-diabetic and Type 2 diabetic patients.

AIMS: The aim of our study was to compare the influence of a hypocaloric, high-fat diet enriched with MUFA (M) and conventional diet (C) on weight loss and metabolic parameters in obese non-diabetic and obese Type 2 diabetic subjects over a 3-month period. It was our hypothesis that the enriched diet would be more effective in decreasing blood glucose and glycated haemoglobin (HbA(1c)) than the control diet. METHODS: Twenty-seven Type 2 diabetic patients (54.5 +/- 3.5 years; DM), treated with diet or oral glucose-lowering agents, and 31 obese non-diabetic subjects (53.6 +/- 3.5 years; OB) were randomized to M or C. Individual calculations of energy requirements were based on the formula: [resting energy expenditure (REE) x 1.5] - 600 kcal. Subjects were assessed by a dietitian every 2 weeks and by a physician every month. Statistical analyses were carried out between the four groups--DM/M, DM/C, OB/M and OB/C--using pair Student's test and anova. RESULTS: After 3 months, body weight, waist-hip ratio, total body fat, levels of C-peptide, triglycerides and homeostasis model assessment (HOMA) decreased in all four groups (P < 0.01). However, fasting blood glucose and HbA(1c) decreased (P < 0.01) and high-density lipoprotein cholesterol increased significantly only in the DM/M group (P < 0.05). In general, M was well tolerated. CONCLUSIONS: Individualized M and C diets were successful in improving metabolic and anthropometric parameters in both the obese non-diabetic and the Type 2 diabetic subjects. Although the superiority of the higher fat diet did not reach statistical significance, the decline in blood glucose and HbA(1c) in the Type 2 diabetic group on M was encouraging.     

Cholesterol metabolism and body composition in women: the effects of moderate weight loss

OBJECTIVE: To determine how moderate weight loss protocol through diet and exercise may affect changes in body composition, to determine the effects of weight loss on cholesterol metabolism and to examine the relationship between cholesterol metabolism and changes in body composition. DESIGN: Thirty-five otherwise healthy, hypercholesterolemic women completed a 24-week weight loss study. A 20% decrease in energy intake through diet and a 10% increase in energy expenditure by exercise were combined with motivational strategies to encourage weight loss. The diet was self-selected and comprised of 50-60% carbohydrates, 20% protein and <30% fat. RESULTS: Participants lost an average of 11.7+/-2.5 kg (P<0.001). Whole body and regional losses in tissue mass occurred after weight loss. After weight loss, cholesterol fractional synthesis rate (FSR) decreased (P=0.003) 3.86+/-9.33%, whereas rates of cholesterol absorption and turnover did not change (3.31+/-19.4%, P=0.32 and -0.01+/-6.20%, P=0.75, respectively). Changes in cholesterol turnover were positively correlated (r=0.44, P=0.01) with changes in FSR. Reductions in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were predictive (beta=-5.04, r=0.38; P=0.03, and beta=-147, r=0.40; P=0.03, respectively) of increases in cholesterol turnover. Losses in skeletal muscle (SM) and upper-body SM predicted (beta=6.82, r=0.36; P=0.04 and beta=14.7, r=0.41; P=0.01, respectively) decreases in cholesterol absorption. CONCLUSIONS: Decreases in cholesterol synthesis after moderate weight loss are not compensated for by changes in cholesterol absorption or turnover. Changes in regional body composition were associated with variations in cholesterol metabolism. Understanding how weight loss affects cholesterol metabolism will help identify more effective treatment routes for overweight individuals undergoing weight loss resulting in earlier and more intensive therapy for the associated dyslipidemia.     

Comparison of 4 diets of varying glycemic load on weight loss and cardiovascular risk reduction in overweight and obese young adults: a randomized controlled trial

BACKGROUND: Despite the popularity of low-glycemic index (GI) and high-protein diets, to our knowledge no randomized, controlled trials have systematically compared their relative effects on weight loss and cardiovascular risk. METHODS: A total of 129 overweight or obese young adults (body mass index, > or =25 [calculated as weight in kilograms divided by the square of height in meters]) were assigned to 1 of 4 reduced-fat, high-fiber diets for 12 weeks. Diets 1 and 2 were high carbohydrate (55% of total energy intake), with high and low GIs, respectively; diets 3 and 4 were high protein (25% of total energy intake), with high and low GIs, respectively. The glycemic load was highest in diet 1 and lowest in diet 4. Changes in weight, body composition, and blood chemistry profile were studied. RESULTS: While all groups lost a similar mean +/- SE percentage of weight (diet 1, -4.2% +/- 0.6%; diet 2, -5.5% +/- 0.5%; diet 3, -6.2% +/- 0.4%; and diet 4, -4.8% +/- 0.7%; P = .09), the proportion of subjects in each group who lost 5% or more of body weight varied significantly by diet (diet 1, 31%; diet 2, 56%; diet 3, 66%; and diet 4, 33%; P = .01). Women on diets 2 and 3 lost approximately 80% more fat mass (-4.5 +/- 0.5 [mean +/- SE] kg and -4.6 +/- 0.5 kg) than those on diet 1 (-2.5 +/- 0.5 kg; P = .007). Mean +/- SE low-density-lipoprotein cholesterol levels declined significantly in the diet 2 group (-6.6 +/- 3.9 mg/dL [-0.17 +/- 0.10 mmol/L]) but increased in the diet 3 group (+10.0 +/- 3.9 mg/dL [+0.26 +/- 0.10 mmol/L]; P = .02). Goals for energy distribution were not achieved exactly: both carbohydrate groups ate less fat, and the diet 2 group ate more fiber. CONCLUSION: Both high-protein and low-GI regimens increase body fat loss, but cardiovascular risk reduction is optimized by a high-carbohydrate, low-GI diet.