Consumption of Low-Fat Dairy Products and Energy and Protein Intake in Cancer Patients at Risk of Malnutrition

Current nutritional guidelines encourage the reduction of fat intake from animal sources like dairy products. The aim was to determine whether the consumption of low-fat dairy is related to poorer dietary intake and nutritional status in cancer patients at risk of malnutrition. This cross-sectional included patients with solid or hematological malignancies at risk of malnutrition. Nutritional status was studied using Subjective Global Assessment, anthropometry, and grip strength. Dietary intake was evaluated with a 24-h recall and dairy consumption with a structured questionnaire. Seventy-four patients were recruited; 71.6% males of 64.8 yr, most with gastrointestinal malignancies. Only 37.8% consumed whole milk, and 61.4% consumed whole yogurt. Reasons for consumption of low-fat dairies were healthy diet (58.0%), hypercholesterolemia (20.0%), and digestive intolerance (10.0%). There were similar rates of malnutrition according the type of dairy (whole 60.9% vs. low-fat 66.7%, P = 0.640). Low-fat dairies were related to a reduction in energy (whole 1980.1 kcal vs. low-fat 1480.9, P = 0.007) and protein intake (whole 86.0 g vs. low-fat 63.0 g, P = 0.030).     

Integrated nutritional, hormonal, and metabolic effects of recombinant human growth hormone (rhGH) supplementation in trauma patients

An anabolic stimulus is needed in addition to conventional nutritional support in the catabolic “flow” phase of severe trauma. One promising therapy appears to be rhGH infusion which has direct as well as hormonal mediated substrate effects. We investigated on a whole-body level, the basic metabolic effects of trauma within 48–60 h after injury in 20 severely injured (injury severity score [ISS] = 31 ± 2), highly catabolic (N LOSS = 19 ± 2 g/d), hypermetabolic (resting energy expenditure [REE] = 141 ± 5% basal energy expenditure [BEE]), adult (age 46 ± 5 y) multiple-trauma victims, before starting nutrition therapy and its modification after 1 wk of rhGH supplementation with TPN (1.1 × REE calories, 250 mg N·kg⁻¹·d⁻¹). Group H (n = 10) randomly received at 8:00 a.m. on a daily basis rhGH (0.15 mg·kg⁻¹·d⁻¹) and Group C (n = 10) received the vehicle of infusion. Protein metabolism (turnover, synthesis and breakdown rates, and N balance); glucose kinetics (production, oxidation, and recycling); lipid metabolism, (lipolysis and fat oxidation rates), daily metabolic and fuel substrate oxidation rate (indirect calorimetry); and plasma levels of hormones, substrates, and amino acids were quantified. In group H compared to group C: N balance is less negative (−41 ± 18 vs −121 ± 19 mg N·kg⁻¹·d⁻¹, P = 0.001); whole body protein synthesis rate is 28 ± 2% (P = 0.05) higher; protein synthesis efficiency is higher (62 ± 2% vs 48 ± 3%, P = 0.010); plasma glucose level is significantly elevated (256 ± 25 vs 202 ± 17 mg/dL, P = 0.05) without affecting hepatic glucose output (1.51 ± 0.20 vs 1.56 ± 0.6 mg N·kg⁻¹·min⁻¹), glucose oxidation and recycling rates; significantly enhanced rate of lipolysis (P = 0.006) and free fatty acid reesterification (P = 0.05); significantly elevated plasma levels of anabolic GH, IGF-1, IGFBP-3, and insulin; trauma induced counter-regulatory hormone (cortisol, glucagon, catecholamines) levels are not altered; trauma induced hypoaminoacidemia is normalized (P < 0.05) and 3-methylhistidine excretion is significantly low (P < 0.001). Improved plasma IGF-1 levels in Group H compared with Group C account for protein anabolic effects of adjuvant rhGH and may be helpful in promoting tissue repair and early recovery. Skeletal muscle protein is spared by rhGH resulting in the stimulation of visceral protein breakdown. The hyperglycemic, hyperinsulinemia observed during rhGH supplementation may be due to defective nonoxidative glucose disposal, as well as inhibition of glucose transport activity into tissue cells. The simultaneous operation of increased lipolytic and reesterification processes may allow the adipocyte to respond rapidly to changes in peripheral metabolic fuel requirements during injury. This integral approach helps us to better understand the mechanism of the metabolic effects of rhGH.     

Peer Modeling Influences Girls' Snack Intake

Previous studies indicate that the presence of peers influences children's food consumption. It is assumed that one factor producing this effect in children is child modeling of food intake. The present study assesses the effect of a video model on the food intake of overweight (n=22) and nonoverweight (n=22) preadolescent girls. A 2 (weight status)×2 (small vs large serving size) factorial design was used to test the hypothesis that youth model others' food intake. Serving sizes were manipulated by showing a video model selecting and consuming either a small or a large serving of cookies. Results indicate a main effect of serving size condition, F(1,40)=5.1, P<0.05 (d=0.65; 95% confidence interval: 0.35 to 0.65), and a main effect of weight status, F(1,40)=4.9, P<0.05 (d=0.63; 95% confidence interval: 0.35 to 0.65). Participants exposed to the large serving-size condition consumed more cookies than participants exposed to the small serving-size condition and overweight participants consumed considerably more cookies than nonoverweight participants. The interaction of weight status by serving-size condition did not reach statistical significance (P=0.2). These results suggest that peer-modeling influences overweight and nonoverweight preadolescent girls' snack consumption.     

Dietary Intake and Counseling, Weight Maintenance, and the Course of HIV Infection

Objective To define relationships among dietary intake and counseling, weight maintenance, and the clinical course of patients infected with the human immunodeficiency virus(HIV).Design A prospective cohort study in an HIV clinic in a county hospital.Subjects HIV-infected patients (68 with and 40 without acquired immunodeficiency syndrome [AIDS]) who had a good performance status and no chronic diarrhea were assessed at entry to the study and after 6 months. The following assessments were made: energy and nutrient intake based on 7-day food records, anthropometric measurements, immunologic function as lymphocyte T-cell subpopulations (ratio of CD4 to CD8), and serum cholesterol level. Patients were monitored to determine clinical outcome.Intervention All patients received standardized dietary counseling designed to address identified intake deficiencies and maintain body weight.Main outcome measures Changes in energy and nutrient intake, body weight, and clinical outcome (ie, time to AIDS-defining illness and overall survival time).Statistical analyses performed Group differences (HIV group vs AIDS group) were sought using χ² analyses and Student's t test. A multivariate regression model was used to determined the best predictors of clinical outcome.Results At baseline, total energy intake (based on 30 kcal/kg usual body weight) was adequate in both HIV and AIDS patients (101±4% and 103±5% [mean±standard deviation] of need, respectively). Despite dietary counseling and continued maintenance of energy intake, body weight, serum cholesterol level, and CD4 level progressively decreased. Consequently, saturated fat intake was found to be inversely related (P<.01) to serum cholesterol level. Clinical outcome (after 3.5 years) was associated with baseline ratio of CD4 to CD8 (P<.0001), weight (P<.01), and serum cholesterol level (P<.001). Multivariate analysis related ratio of CD4 to CD8 (P<.001) and weight maintenance (P<.001) to favorable outcome in the final model.Applications Weight loss in patients with HIV infection is independently prognostic of clinical outcome, and development of hypocholesterolemia is not favorable for clinical outcome. Because weight loss progresses despite conventional dietary counseling to identify energy need, interventions earlier in the disease course should be considered along with increased target levels for energy intake. J Am Diet Assoc. 1995; 95:428–432, 435.     

Comparison of blood lipids, lipoproteins, anthropometric measures, and resting and exercise cardiovascular responses in children, 6–7 years old

The purpose of this investigation was to determine sex differences and interrelationships in anthropometric, blood lipids and lipoproteins, steady rate and maximal bicycle ergometric measures in boys (N = 38) and girls (N= 28) ages 6 to 7 years. After adjusting for a significantly (P < 0.05) higher sum of skinfold measure for the girls, significant (P < 0.05) sex differences were obtained for high-density lipoprotein cholesterol (HDL-C), resting heart rate, and steady-rate heart rate. Lower HDL-C values (43.3 vs 49.6 mg/dl) for the girls accounted for their lower cholesterol since no sex differences were found for low-density lipoprotein cholesterol (LDL-C). Following 4 min of steady-rate bicycling at 90 kgm, girls had higher heart rates (131 vs 119 beats·min⁻¹ whereas no differences (P> 0.05) existed in preexercise and maximal heart rates. Multiple regression analyses resulted in weak but significant (P < 0.05) prediction equations for cholesterol and cumulative work performed on the bicycle. A significant (P < 0.05) negative correlation between HDL-C vs triglycerides (r = 0.46) was obtained for the girls. These data indicate that sex differences exist for selected ergometric, anthropometric, and blood lipid and lipoprotein measures as early as 6 years. Also, the association among blood lipid and lipoprotein measures may differ between boys and girls.     

The Gustaf Study: Repeated, Telephone-Administered 24-hour Dietary Recalls of Obese and Normal-Weight Men — Energy and Macronutrient Intake and Distribution Over the Days of The Week

Objective A dietary survey of obese and control men was conducted through 24-hour dietary recalls administered by telephone at 12 times selected randomly over a period of 3 months. Energy and macronutrient intake and distribution were studied for all days of the week.Subjects Eighty-six obese men, 20 to 60 years old, body mass index (BMI)= 37.7±4.4 (mean±standard deviation) from the waiting list of the outpatient clinic and 61 normal-weight (BMI= 23.0±1.9), age-matched men selected randomly from the Stockholm County Census Bureau.Main outcome measures Energy and macronutrient intake, intakes by energy tertiles, and distribution over the days of the week.Statistical analyses Nonparametric tests were used because of skewed distribution of most food data.Results A median daily energy intake of 2,700 kcal was found in both groups. The obese men reported a higher protein (P<.001) and a lower alcohol (P<.001) intake than the control subjects. Both groups reported a maximum intake of energy and macronutrients on Saturdays. When separated into tertiles according to reported energy intake, the obese men in tertile 3 reported a higher intake from fat (% energy, P<.001) and a lower intake from protein (P<.01) compared with men in tertile 1. Normal-weight men in tertile 3 reported a higher intake from fat (% energy, P<.01) compared with men in tertile 1.Conclusions When reported energy intake was compared with calculated total daily energy expenditure, there was a greater discrepancy in the obese group than in the control group. The normal-weight men may have had a special interest in food and health, and this group may not reflect the population at large. J Am Diet Assoc. 1996; 96:686–692.     

Dried plums (prunes) reduce atherosclerosis lesion area in apolipoprotein E-deficient mice

Dried plums are a fruit high in pectin with substantial antioxidant activity. Previous studies in rats and man indicate that dried plums or plum fibre lower liver and plasma cholesterol, respectively. The apoE-deficient mouse, which develops atherosclerotic lesions rapidly when fed cholesterol, was used to determine the ability of dried plums to reduce atherosclerosis. Diets containing 0.15% cholesterol and either 0 (B+C), 4.75% (Lo DP) or 9.5% (Hi DP) dried plum powder were fed for 5 months. An additional group fed the basal diet without cholesterol (B-C) was included as a negative control. Arterial trees were dissected, stained to visualize lesions, and lesion area was quantitated by imaging software. Urinary thiobarbituric acid-reactive substances (TBARS) excretion and serum amyloid P-component (SAP) were measured as indicators of oxidative stress and inflammation, respectively. Final serum cholesterol was significantly increased and serum TAG decreased in the B+C group and dried plum groups relative to the B-C group. Percentage arterial tree atherosclerotic lesion area was significantly lower in the B-C and Lo DP groups compared to the B+C group (P<0.05), with a trend for a difference between the B+C and Hi DP groups (P=0.075). SAP concentration was significantly lower in the B-C and Lo DP groups with the Hi DP group trending lower than the B+C group. Urinary TBARS excretion did not differ among the groups. These results suggest that consuming dried plums may help slow the development of atherosclerosis.     

No Effect of Added Sugar Consumed at Median American Intake Level on Glucose Tolerance or Insulin Resistance

Excess sugar consumption may promote adverse changes in hepatic and total body insulin resistance. Debate continues over the effects of sugars at more typically consumed levels and whether the identity of the sugar consumed is important. In the present study participants (20–60 years old) were randomly assigned to one of five groups, three that consumed low fat milk with added fructose containing sugars in amounts equivalent to the 50th percentile of fructose consumption (US), one which consumed low-fat milk sweetened with glucose, and one unsweetened low-fat milk control group. The intervention lasted ten weeks. In the entire study population there was less than 1 kg increase in weight (73.6 ± 13.0 vs. 74.5 ± 13.3 kg, p < 0.001), but the change in weight was comparable among groups (p > 0.05). There were no changes in fasting glucose (49 ± 0.4 vs. 5.0 ± 0.5 mmol/L), insulin (56.9 ± 38.9 vs. 61.8 ± 50.0 pmol/L), or insulin resistance, as measured by the Homeostasis Model Assessment method (1.8 ± 1.3 vs. 2.0 ± 1.5, all p > 0.05). These data suggest that added sugar consumed at the median American intake level does not produce changes in measures of insulin sensitivity or glucose tolerance and that no sugar has more deleterious effects than others.     

Changing patterns of susceptibilities of blood, urinary and respiratory pathogens in Hong Kong

The incidence and antimicrobial susceptibility of organisms isolated from blood, urine and respiratory specimens at a teaching hospital in Hong Kong were studied retrospectively from 1986–1993. The incidence of Gram-positive bacteraemia, particularly coagulase-negative staphylococci (CNS), increased significantly from 33·6 to 47·3% (P < 0.001) while that of Gram-negative bacteraemia fell from 60·0 to 47·0% (P < 0.001). Among blood isolates, methicillin resistance of CNS increased from 17·0 to 58·0% (P < 0.001) and cefuroxime resistance of Enterobacter spp. increased from 21·0 to over 50% (P < 0.001). Among urinary isolates, cefuroxime resistance of Klebsiella spp. (11·0 to 24·0%, P < 0.001) and Enterobacter spp. (32·0 to 75·0%, P < 0.001) increased. Nalidixic acid resistance among Gram-negative urinary isolates, except Proteus mirabilis, rose by three- to sixfold. For Streptococcus pneumoniae, isolated from the respiratory tract, penicillin resistance increased dramatically (2 to 18%, P < 0.001). For respiratory isolates of Haemophilus influenzae, ampicillin resistance increased from 17·0 to 29·0% (P < 0.001). These data are useful in guiding empirical treatment of nosocomial infections.     

A Low-Fat Intake and Greater Activity Level are Associated With Lower Weight Regain 3 Years After Completing a Very–Low-Calorie Diet

Objective To examine the roles of diet, exercise, and lifestyle factors in determining long-term weight regain after weight loss with a very–low-calorie diet (VLCD).Subjects Twenty-seven of 38 women who lost weight with a VLCD.Design Graduates of a weight loss intervention study returned for follow-up 3 years after program completion. Percentage of initial weight loss that was regained was correlated with subjects’ fat intake (assessed via 7-day food records and a Diet Habit Survey), energy intake (assessed via 7-day food records), activity level and lifestyle factors (assessed via questionnaires) that are supportive of weight loss maintenance.Statistical analyses performed Regression analysis was used to assess the relationship of weight regain with fat intake, activity level, and energy intake. Contingency table analysis was used to assess the association between weight regain and lifestyle factors.Results Subjects followed experienced a −20.7 kg±9.2 kg (−19.2%±7%) (mean±standard deviation) weight change during the original VLCD program and a 13.9 kg±11.3 kg (76.6%±52.1%) weight change 3 years post-VLCD. Fat intake, assessed by a 7-day food diary, was positively correlated with weight regain at 3 years (r=0.66, P=.0004). Less weight regain was also seen with a lower percent fat intake as reflected by a higher Diet Habit Survey score (r=−0.55, P=.004). Women with the lowest tertile of reported fat intake (<25% of energy) from the Diet Habit Survey regained the least amount of weight (P=.05). Activity level was negatively correlated with weight regain (r=−0.53, P=.005). After correction for multiple comparisons, there was no association between total energy intake and weight regain. Lifestyle factors were also not associated with weight regain.Applications/conclusions Identifying strategies to maintain weight loss is crucial because of the negative health effects and increasing prevalence of obesity. For women who have lost weight on a VLCD, limiting dietary fat intake and maintaining physical activity are both important factors for the prevention of weight regain. To promote better weight loss outcomes, registered dietitians should help clients who have lost weight limit their fat intake to less than 30% of energy and encourage high activity levels. J Am Diet Assoc. 2002;102:1252–1256.     

Daily apple versus dried plum: impact on cardiovascular disease risk factors in postmenopausal women

BackgroundEvidence suggests that consumption of apple or its bioactive components modulate lipid metabolism and reduce the production of proinflammatory molecules. However, there is a paucity of such research in human beings.ObjectiveWomen experience a lower rate of cardiovascular disease before menopause compared with men. However, after the onset of menopause, the risk of cardiovascular disease increases drastically due to ovarian hormone deficiency. Hence, we conducted a 1-year clinical trial to evaluate the effect of dried apple vs dried plum consumption in reducing cardiovascular disease risk factors in postmenopausal women.DesignOne-hundred sixty qualified postmenopausal women were recruited from the greater Tallahassee, FL, area during 2007-2009 and were randomly assigned to one of two groups: dried apple (75 g/day) or dried plum (comparative control). Fasting blood samples were collected at baseline, 3, 6, and 12 months to measure various parameters. Physical activity recall and 7-day dietary recall were also obtained.ResultsNeither of the dried fruit regimens significantly affected the participants' reported total energy intake throughout the study period. On the contrary, women who consumed dried apple lost 1.5 kg body weight by the end of the study, albeit not significantly different from the dried plum group. In terms of cholesterol, serum total cholesterol levels were significantly lower in the dried apple group compared with the dried plum group only at 6 months. Although dried plum consumption did not significantly reduce serum total cholesterol and low-density lipoprotein cholesterol levels, it lowered their levels numerically by 3.5% and 8%, respectively, at 12 months compared with baseline. This may explain the lack of significance observed between the groups. However, within the group, women who consumed dried apple had significantly lower serum levels of total cholesterol and low-density lipoprotein cholesterol by 9% and 16%, respectively, at 3 months compared with baseline. These serum values were further decreased to 13% and 24%, respectively, after 6 months but stayed constant thereafter. The within-group analysis also reported that daily apple consumption profoundly improved atherogenic risk ratios, whereas there were no significant changes in lipid profile or atherogenic risk ratios as a result of dried plum consumption. Both dried fruits were able to lower serum levels of lipid hydroperoxide and C-reactive protein. However, serum C-reactive protein levels were significantly lower in the dried plum group compared with the dried apple group at 3 months.ConclusionsThere were no significant differences between the dried apple and dried plum groups in altering serum levels of atherogenic cholesterols except total cholesterol at 6 months. However, when within treatment group comparisons are made, consumption of 75 g dried apple (about two medium-sized apples) can significantly lower atherogenic cholesterol levels as early as 3 months. Furthermore, consumption of dried apple and dried plum are beneficial to human health in terms of anti-inflammatory and antioxidative properties.     

Whey Protein Drink Ingestion before Breakfast Suppressed Energy Intake at Breakfast and Lunch,but Not during Dinner,and Was Less Suppressed in Healthy Older than Younger Men

Ageing is associated with changes in feeding behavior. We have reported that there is suppression of energy intake three hours after whey protein drink ingestion in young, but not older, men. This study aimed to determine these effects over a time period of 9 h. Fifteen younger (27 ± 1 years, 25.8 ± 0.7 kg/m²) and 15 older (75 ± 2 years, 26.6 ± 0.8 kg/m²) healthy men were studied on three occasions on which they received, in a randomized order, a 30 g/120 kcal, 70 g/280 kcal whey-protein, or control (~2 kcal) drink. Ad-libitum energy intake (sum of breakfast, lunch, and dinner) was suppressed in a protein load responsive fashion (P = 0.001). Suppression was minimal at breakfast, substantial at lunch (~−16%, P = 0.001), no longer present by dinner, and was less in older than younger men (−3 ± 4% vs. −8 ± 4%, P = 0.027). Cumulative protein intake was increased in the younger and older men (+20% and +42%, P < 0.001). Visual analogue scale ratings of fullness were higher and desire to eat and prospective food consumption were lower after protein vs. control, and these effects were smaller in older vs. younger men (interaction effect P < 0.05). These findings support the use of whey-protein drink supplements in older people who aim to increase their protein intake without decreasing their overall energy intake.     

Predicting Achievement of a Low-Fat Diet: A Nutrition Intervention for Adults with Low Literacy Skills

Background.This paper identifies factors that predict achievement of a low-fat diet among 242 California adults with low literacy skills, following their participation in the Stanford Nutrition Action Program (SNAP), a randomized classroom-based nutrition intervention trial (1993–1994).Methods.The intervention classes received a newly developed curriculum that focuses on reducing dietary fat intake (SNAP); the control classes received an existing general nutrition (GN) curriculum. Data were collected at baseline and 3 months postintervention. This hypothesis-generating analysis uses a signal detection method to identify mutually exclusive groups that met the goal of a low-fat diet, defined as <30% of calories from total fat, at 3 months postintervention.Results.Three mutually exclusive groups were identified. Twenty-three percent of Group 1, participants with high baseline dietary fat (>60 g) who received either the GN or the SNAP curriculum, met the postintervention goal of <30% of calories from total fat. Thirty-four percent of Group 2, participants with moderate baseline dietary fat (≤60 g) who received the GN curriculum, were successful. Sixty percent of Group 3, participants with moderate baseline dietary fat who received the SNAP curriculum, were successful. Members of Group 3 also significantly increased their intake of vegetables, grains, and fiber.Conclusions.Within this population of adults with low literacy skills, a large proportion of those with moderate baseline dietary fat who participated in the SNAP classes met the postintervention criteria for a low-fat diet. A much smaller proportion of those with high baseline dietary fat were successful, suggesting that this group may benefit from different, more intensive, or longer-term interventions.     

Effects of Information about Fat Content on Food Preferences in Pre-adolescent Children

The acceptance and sensory characteristics of standard and reduced-fat cookies were evaluated either with or without fat-content information by pre-adolescent children. Results indicate that acceptance ratings were not affected by the fat content or information about fat content when evaluated on nine-point scales. However, when asked to choose which cookie they liked better and to predict how many cookies they would eat (in forced-choice questions), fat content and information about fat content had a significant effect on cookie preference and prospective intake. When no information was available, subjects preferred the cookie with the higher fat content; when information was presented, subjects' preference shifted to the reduced-fat cookie. When asked which cookie they would choose to eat for dessert with hypothetical lunches, a similar shift in choice was observed following a low-fat lunch. The low-fat label was also associated with an increase in perceived healthiness relative to the high-fat label, as indicated on “good for me” scales. The effects of fat content information on cookie preference and prospective consumption were seen in pre-adolescents who indicated a “high concern” for the health consequences of dietary fat. Cookie preference and prospective intake of subjects who indicated a “low concern” were not affected by fat content labeling. Results suggest that fat content and information about fat content may affect food preference and intake in pre-adolescent children.     

The hemagglutination inhibition antibody responses to an inactivated influenza vaccine among healthy adults: with special reference to the prevaccination antibody and its interaction with age

The immunogenicity of the trivalent split-virus influenza vaccine was investigated among 70 healthy adults (mean age: 48.5, range: 36–68). The vaccine antigens were: A/Yamagata/32/89 (H1N1); A/Beijing/352/89 (H3N2); and B/Bangkok/163/90. Regarding the entire sample, the vaccine induced a tenfold or more rise on the average in the hemagglutination inhibition (HAI) antibody to each antigen. The response rates (greater than or equal to a fourfold rise) were about 90% or more among those with a prevaccination titer ≤1:64 (equivalent to ≤1:16 on the Western scale: in Japan, the HAI titers are expressed by the final, and not the initial, dilution of the serum; from hereon our findings will be expressed using the Japanese scale), whereas they were 0–50% at ≥1:128. Thus, the prevaccination titer was negatively associated with antibody induction. The achievement rates (postvaccination titer ≥1:128) among those with a prevaccination titer <1:16 remained at 48–68%. Regarding the analysis of variance, a significant effect on antibody induction was indicated for the prevaccination titer (P≤0.002), but not for age (P≥0.425). The interaction between the prevaccination titer and age was significant for A/Yamagata (P=0.030), while it was also suggestive for A/Beijing (P=0.054): as age increased, those with no preexisting antibody (<1:16) showed greater titer rises, in contrast to the smaller rises among those with a titer ≥1:16. Based on the attack survey conducted separately, the vaccine efficacy on influenza-like illnesses with fever ≥37°C and ≥37.5°C was calculated to be 16% (95% confidence interval: −66% to 57%) and 37% (−55% to 74%), respectively.     

The relationship between child and parent food hedonics and parent and child food group intake in children with overweight/obesity

Many factors influence children's dietary intake, including children's and parents' food hedonics (liking), and parent intake. This secondary data analysis studied the relationship between child and parent liking, and parent intake and child intake of fruits, vegetables, low-fat dairy, snack foods, and sweetened beverages in 4- to 9-year-old overweight/obese (body mass index ≥85th percentile) children presenting for obesity treatment (September 2005 to September 2007) in Providence, RI. One hundred thirty-five parent-child pairs, with complete baseline dietary (3-day food record) and food group hedonic data were included. Hedonic ratings were mean ratings using a 5-point Likert scale (lower scores represented greater liking of a food group). Children were aged 7.2±1.6 years, 63.0% girls, 12.6% African American, and 17.8% Hispanic, with a mean body mass index z score of 2.3±0.6. Total servings consumed by children over 3 days were: fruits 2.7±3.2, vegetables 3.4±2.5, low-fat dairy 2.4±2.1, snack foods 5.9±4.2, and sweetened beverages 2.7±3.1. After demographic and anthropometric variables were controlled, parent intake was positively related (P<0.05) to child intake of all food groups except sweetened beverages. Child liking was only significantly (P<0.05) related to child intake of vegetables. In young children with obesity/overweight, parent intake was consistently related to child intake. Changing parent intake may be important in helping to change the dietary intake of young children with overweight/obesity.     

A Worksite Program for Overweight Middle-Aged Men Achieves Lesser Weight Loss With Exercise Than With Dietary Change

Objective To compare changes in total and regional body composition using dual energy X-ray absorptiometry (DEXA) after subjects lost weight through change in diet or exercise.Design A 12-month, randomized, controlled study of two weight-loss interventions — low-fat diet ad libitum or moderate, unsupervised exercise — in free-living, middle-aged men. Compliance was determined at monthly measurement sessions through food records and activity logs; DEXA scans were performed every 3 months.Subjects/setting Fifty-eight overweight men (mean body mass INDEX=29.0±2.6; mean AGE=43.4±5.7 years) recruited from a national corporation were assigned randomly to diet, exercise, or control groups.Interventions One group reduced dietary fat to 26.4% of energy intake but kept activity unchanged; another group self-selected aerobic exercise (three sessions per week at 65% to 75% maximum heart rate) but kept diet unchanged. A control group maintained weight.Main outcome measures At 12 months, measurements of weight, total and regional fat mass and lean mass, energy intake, and percentage dietary fat; physical activity indexes. Statistical analyses Results were analyzed using paired t tests and analysis of variance.Results Mean weight loss was 6.4±3.3 kg in dieters and 2.6+3.0 kg in exercisers; control subjects maintained weight. DEXA scans revealed that 40% of dieters’ weight loss was lean tissue; more than 80% of weight lost by exercisers was fat. Exercisers maintained limb lean tissue and lost fat mass.Conclusions Greater total weight and lean tissue loss occurred when subjects lost weight through a low-fat diet consumed ad libitum than when subjects participated in unsupervised aerobic exercise. Use of DEXA enabled identification of progressive total and regional changes in fat and lean tissue. J Am Diet Assoc. 1997; 97:37–42.     

Dried fruit consumption is associated with improved diet quality and reduced obesity in US adults: National Health and Nutrition Examination Survey, 1999-2004

Epidemiological studies examining potential associations between dried fruit consumption, diet quality, and weight status are lacking. The goal of this study was to examine the association of dried fruit consumption with nutrient intake, diet quality, and anthropometric indicators of overweight/obesity. A secondary analysis of dietary and anthropometric data collected from adult (19+ years) participants (n = 13 292) of the 1999-2004 National Health and Nutrition Examination Survey was conducted. Dried fruit consumers were defined as those consuming amounts ? cup-equivalent fruit per day or more and identified using 24-hour recalls. Diet quality was measured using the Healthy Eating Index 2005. Covariate-adjusted means, SEs, prevalence rates, and odds ratios were determined to conduct statistical tests for differences between dried fruit consumers and nonconsumers. Seven percent of the population consumed dried fruit. Mean differences (P < .01) between consumers and nonconsumers in adult shortfall nutrients were dietary fiber (+6.6 g/d); vitamins A (+173 μg retinol activity equivalent per day), E (+1.5 mg α-tocopherol per day), C (+20 mg/d), and K (+20 mg/d); calcium (+103 mg/d); phosphorus (+126 mg/d); magnesium (+72 mg/d); and potassium (+432 mg/d). Dried fruit consumers had improved MyPyramid food intake, including lower solid fats/alcohol/added sugars intake, and a higher solid fats/alcohol/added sugars score (11.1 ± 0.2 vs 8.2 ± 0.1) than nonconsumers. The total Healthy Eating Index 2005 score was significantly higher (P < .01) in consumers (59.3 ± 0.5) than nonconsumers (49.4 ± 0.3). Covariate-adjusted weight (78.2 ± 0.6 vs 80.7 ± 0.3 kg), body mass index (27.1 ± 0.2 vs 28.1 ± 0.2), and waist circumference (94.0 ± 0.5 vs 96.5 ± 0.2 cm) were lower (P < .01) in consumers than nonconsumers, respectively. Dried fruit consumption was associated with improved nutrient intakes, a higher overall diet quality score, and lower body weight/adiposity measures.     

Short-term hypocaloric nutrition but not bed rest decrease insulin sensitivity and IGF-I bioavailability in healthy subjects: The importance of glucagon

Hyperinsulinemic, normoglycemic clamps were performed before and after 24 h of either hypocaloric nutrition or bed rest in healthy subjects. Decreased insulin sensitivity and insulin-like growth factor-I (IGF-I) bioavailibility, as measured by the serum IGF-I/insulin-like growth factor binding protein-1 (IGFBP-1) ratio, was found after fasting, whereas no metabolic changes were found after bed rest. Glucagon seems to be a key regulator of IGFBP-1 after brief hypocaloric nutrition. Hypocaloric nutrition and immobilization may add to the catabolic response to surgery and other trauma. Presently, six healthy subjects were studied before and after a 24-h period of hypocaloric nutrition (200 kcal/24 h, fast) or immobilization (bed rest) using the hyperinsulinemic (0.8 mU · kg⁻¹ · min⁻¹), normoglycemic (4.5 mmol/L) clamp, indirect calorimetry, and circulating levels of substrates and hormones. After fast, body weight decreased (P < 0.05), and nitrogen balance was negative (−10 ± 1 g urea nitrogen/24 h). Basal levels of free fatty acids, glucagon, and IGFBP-1 increased (P < 0.05), whereas c-peptide levels and the IGF-I/IGFBP-1 ratio decreased (P < 0.05). However, no change was found in basal levels of IGF-I or substrate oxidation. Furthermore, changes (%) in basal levels of glucagon after fast correlated to IGFBP-1 (r = 1.0, P < 0.05), whereas the suppressibility of IGFBP-1 by insulin was maintained at normal levels. During clamps, glucose infusion rates (GIR) decreased after fast (−43 ± 13%, mean ± SEM, P < 0.001). Although not significant, clamp levels of fat oxidation tended to increase and glucose oxidation tended to decrease. Levels of IGFBP-1 during clamps were higher as compared with the control clamp (P < 0.05). No adverse metabolic changes were seen after bed rest, and no change in GIR during clamps were seen as compared with the control measurement (0 ± 14%). After brief hypocaloric nutrition, insulin sensitivity is reduced, whereas IGF-I bioavailibility is reduced by an increase in levels of IGFBP-1. Glucagon seems to contribute to the increase in IGFBP-1 during these conditions.