Dairy calcium is related to changes in body composition during a two-year exercise intervention in young women

OBJECTIVE: Relationships between micronutrients and dairy product intake and changes in body weight and composition over two years were investigated. DESIGN: Two year prospective non-concurrent analysis of the effect of calcium intake on changes in body composition during a two year exercise intervention. SUBJECTS: 54 normal weight young women, 18 to 31 years of age. MEASURES OF OUTCOME: Mean intakes of nutrients of interest were determined from three-day diet records completed at baseline and every six months for two years. The change in total body weight and body composition (assessed by dual x-ray absorptiometry) from baseline to two years was also determined. RESULTS: Total calcium/kilocalories and vitamin A together predicted (negatively and positively, respectively) changes in body weight (R2 = 0.19) and body fat (R2 = 0.27). Further, there was an interaction of calcium and energy intake in predicting changes in body weight, such that, only at lower energy intakes, calcium intake (not adjusted for energy) predicted changes in body weight. CONCLUSIONS: Regardless of exercise group assignment, calcium adjusted for energy intake had a negative relationship and vitamin A intake a positive relationship with two year changes in total body weight and body fat in young women aged 18 to 31 years. Thus, subjects with high calcium intake, corrected by total energy intake, and lower vitamin A intake gained less weight and body fat over two years in this randomized exercise intervention trial.     

Diet Composition Related to Body Fat in a Multivariate Study of 203 Men

Objective To assess whether usual diet (especially intake of dietary fat, carbohydrate, and fiber) was related to body fat percentage in healthy men.Design A written questionnaire provided data on demographic and lifestyle characteristics. Dietary fat, carbohydrate, protein, and fiber intakes were analyzed using the National Cancer Institute food frequency questionnaire. Percentage of body fat was determined using three-site skinfold measurements, and a submaximal treadmill test was used to estimate aerobic fitness.Subjects Subjects were 203 healthy men (14.0±5.3% mean body fat) aged 21 to 71 years. The subjects were chosen from randomly selected districts within Utah County and volunteered for free diet and fitness evaluations.Statistical analysis Multiple regression analysis determined the extent to which the individual diet components predicted body composition before and after controlling for energy intake, fitness level, body weight, and age. Multivariate analysis of variance was used to compare relative body fat groups in regard to dietary variables.Results Reported intakes of carbohydrate (P=.0085, R²=.022), complex carbohydrate (P=.0127,R²=.024), and fiber (P=.002, R²=.03) were inversely associated with body fat after controlling for age, energy intake, and fitness level. Energy intake was positively related to body fat after controlling for age, fitness level, and body weight. When subjects were separated into low-, moderate-, and high-body-fat groups, the fattest subjects reported eating significantly more dietary fat (P=.05) and less carbohydrate (P=.01), complex carbohydrate (P=.01), and fiber (P=.005) than the leanest subjects. No significant difference in reported energy intake was noted across body fat groups.Applications Composition of the diet may play a role in obesity beyond energy intake in men over the long-term. Lifestyle changes for men should probably include modifications in diet composition, especially increased consumption of foods high in complex carbohydrate and fiber. J Am Diet Assoc. 1996; 96:771–777.     

Association of Calcium Intake and Adiposity in Postmenopausal Women

Objective: The purpose of this study was to examine the relationship between calcium intake and 1) body composition and 2) body fat distribution in postmenopausal women.

Methods: Archived data from a previous study including forty-nine Caucasian women, aged 51–73 and at least three years postmenopausal, were used for analysis. Data included medical and diet history from a questionnaire, average nutrient intake from computerized analysis of a 3-day diet record, anthropometric measures including height, weight, body mass index (BMI), waist circumference, and waist-to-hip ratio (WHR). Calcium intake represented both food and supplement sources of calcium. Lean and fat mass were determined from dual energy x-ray absorptiometry (DXA) total body scans, and abdominal fat mass was defined as fat mass between the top of the iliac crest and L1 on the DXA scan.

Results: Subjects were 60.5 ± 0.9 y/o with an average BMI of 26.9 ± 0.7 and percent body fat of 42.8 ± 1.2. Average calcium intake was 1151 ± 83 g/d. There was a significant inverse relationship between calcium intake and percent body fat (r = ?0.36, p < 0.01) and abdominal fat mass (r = ?0.25, p < 0.05), but there was no significant correlation between calcium intake and body mass index, fat mass, lean mass, waist circumference, or WHR. When kcalories were controlled, the inverse correlation between dietary calcium intake and percent body fat remained (r = ?0.24, p < 0.05). Total fat was significantly greater (p < 0.05) in the low dairy intake (1–2 servings/d) vs. high dairy intake group (3–4 servings/d), but there were no significant differences between the groups in other body composition variables.

Conclusions: Increased calcium intake was associated with lower percent body fat and higher dairy intake was associated with lower fat mass in postmenopausal women, but there was no association between calcium intake and body fat distribution measures in this population.     

Weight Loss is Correlated with an Improved Lipoprotein Profile in Obese Postmenopausal Women

Background: Changes in plasma lipid and lipoprotein distributions that occur after menopause increase the risk of cardiovascular disease in women, especially in those who are overweight.

Objective: The purpose of this study was to evaluate the impact of a nine-month weight reduction program on plasma lipids, dietary intake and abdominal fat obesity.

Design: A partial crossover design was used to study a weight loss treatment consisting of Phentermine hydrochloride (Fastin®, SmithKline Beecham Pharmaceuticals, Philadelphia, PA) therapy plus a low energy diet (5040 kJ/d). Forty-seven obese, postmenopausal Caucasian women (BMI of 30–38 kg/m²) were randomized into two groups, both of which received drug and diet treatment over six months. However, Group I started the intervention program three months later than Group II. Plasma total, HDL and LDL cholesterol and triacylglycerol were measured, body composition was assessed by anthropometry and dual energy x-ray absorptiometry, and food frequency records were collected at four timepoints.

Results: Over nine months, women in Group II reduced body weight (14.4%), lowered plasma concentrations of LDL cholesterol (14% to 26%) and triacylglycerol (15%) and raised plasma HDL cholesterol concentration (15%). These plasma lipid changes decreased the total cholesterol/HDL cholesterol ratio from 4.3 to 3.2. All subjects decreased abdominal fat measurements and energy and cholesterol intakes, as well as percentage of energy derived from total and saturated fat during the study. Most subjects also increased dietary fiber consumption.

Conclusion: Both weight loss and diet modifications are associated with an improved plasma lipid profile in obese postmenopausal women.     

Relative Weight,Weight Loss Efforts and Nutrient Intakes among Health-Conscious Vegetarian,Past Vegetarian and Nonvegetarian Women Ages 18 to 50.

Objective: To compare relative weight, weight loss efforts and nutrient intakes among similarly health-conscious vegetarian, past vegetarian and nonvegetarian premenopausal women.

Methods: Demographic data, lifestyle practices and weight loss efforts (by questionnaire), body mass index (BMI;kg/m²) and dietary intake (via multiple-pass 24-hour diet recall) were compared in a convenience sample of 90 current vegetarians, 35 past vegetarians and 68 nonvegetarians.

Results: Age (31.9 ± 8.8), educational attainment, smoking status, alcohol use, physical activity and perceived health status were similar among the three groups of women. BMI did not differ by dietary pattern and averaged 23.7 ± 4.7 for all women combined. Participants had intentionally lost ≥ 10 pounds a mean of 2.1 times, and 39% of women perceived themselves to be overweight; again, no differences were observed among dietary groups. Dietary intakes of vegetarians and current nonvegetarians were consistent with current recommendations for macronutrient composition (<30% fat, <10% saturates). Compared to current nonvegetarians, current vegetarians had lower intakes of protein, saturated fat, cholesterol, niacin, vitamins B₁₂ and D, and higher fiber and magnesium intakes. Vegetarians’ mean vitamin B₁₂ and D intakes were well below recommendations.

Conclusions: Relative weight and weight loss efforts do not differ by dietary pattern among similarly health-conscious vegetarian and nonvegetarian women. The only differences in nutrient intake with potential health implications were vitamins D and B₁₂.     

The Influence of Calcium Consumption on Weight and Fat Following 9 Months of Exercise in Men and Women

Background: There is some evidence that calcium consumption improves weight loss during energy restriction but the effects of calcium consumption in conjunction with chronic exercise are unknown.

Objective: The purpose of the study was to determine the degree to which calcium consumption influences weight and fat weight change as a result of 9 months of verified supervised exercise in the absence of energy restriction.

Methods: Participants were 50 previously sedentary, overweight and moderately obese men (n=20) and women (n=30). Exercise of moderate intensity was performed for 45 min/d, 5 d/wk, under supervision. Diet intake was ad libitum and was measured for energy, macronutrient and micronutrient composition at baseline, 4 and 9 months by use of observer recorded weighed plate waste and multiple-pass 24-h dietary recall procedures.

Results: Average calcium consumption was 987 ± 389 mg/day for men and 786 ± 276 mg/day for women. Weight change over the 9 months was ?4.6 ± 4.6 kg for men and 0.2 ± 3.3 kg for women. Calcium consumption was associated with weight change (r =?0.47, p<0.05) in men. The calcium to protein ratio was associated with weight change (r=0.56) and fat weight change (r=?0.53) in men. There was no observed association between calcium and weight or fat weight change in women.

Conclusion: Weight and fat weight loss as a result of nine months of moderate intensity exercise may be improved by increased calcium consumption in men but was not observed in women.     

Differences in Food Intake among Obese and Nonobese Women and Men with Type 2 Diabetes

Objective: Weight reduction is a key goal for the prevention of vascular complications in obese individuals with type 2 diabetes, but a nutritionally balanced intake is also important in this regard. We compared dietary intakes and vitamin supplement use between obese and nonobese women and men with type 2 diabetes to identify gaps in adherence to nutritional management guidelines.

Methods: We analyzed data from a longitudinal study of adults with type 2 diabetes, wherein participants were assessed once per season over 1 year. Dietary data were collected using a validated semiquantitative, self-administered food-frequency questionnaire. Given the absence of seasonal variations in anthropometric variables and dietary intake, data from multiple visits were averaged for each individual. Associations of both intake of fruit and vegetables and nutrients related to cardiovascular disease risk were compared between obese (body mass index ≥ 30 kg/m²) and nonobese individuals through multivariable linear regression with adjustments for age, education, and energy intake.

Results: Among the 200 participants (93 women and 107 men), 53% of women and 43% of men were obese. Compared with nonobese women, obese women consumed more saturated fat (mean difference, 1.2% of total energy intake; 95% confidence interval [CI], 3% to 2.2%) and sodium (mean difference, 0.3 g; 95% CI, 0.04 to 0.5 g), and they had a lower intake of fiber (mean difference, ?2.7 g; 95% CI, ?4.4 to ?0.9 g) and magnesium (mean difference, ?33.6 mg; 95% CI, ?55.2 to ?12.0 g). No differences in dietary intake were observed between obese and nonobese men, but the intakes of men overall were similar to those of obese women. Compared with nonobese participants, fewer obese individuals used vitamin/mineral supplements (women: 37% vs 48%, men: 26% vs 38%).

Conclusions: Obese women and both obese and nonobese men appeared to have poorer dietary quality compared with nonobese women. Our findings support the need to emphasize dietary composition in addition to weight control in diabetes.     

Consumption of whole-grain cereals during weight loss: effects on dietary quality, dietary fiber, magnesium, vitamin B-6, and obesity

OBJECTIVE: While various weight-management approaches produce weight loss, they may differ in dietary quality. We monitored changes in nutrient intakes in overweight and obese subjects on three different weight-management programs. DESIGN: Randomized clinical trial (pilot study) with two 12-week phases: phase 1, weekly counseling; phase 2, monitoring only. SUBJECTS/SETTING: One hundred eighty nonsmoking, sedentary overweight and obese adults began this outpatient study; 134 (body mass index [calculated as kg/m(2)]=30.9+/-2.4; age=42.3+/-1.2 years) were used in analyses. INTERVENTION: Twenty-four weeks of exercise only (control group), hypocaloric diet plus exercise, or hypocaloric diet with fiber-rich whole-grain cereals plus exercise. MAIN OUTCOME MEASURES: At weeks 0, 12, and 24, diet quality was assessed by 3-day food records and body weight was measured. STATISTICAL ANALYSES PERFORMED: Three-way analysis of variance with repeated measures. RESULTS: The hypocaloric diet with fiber-rich whole-grain cereals plus exercise decreased energy intake more than exercise only (P=0.032). By week 12, the hypocaloric diet with fiber-rich whole-grain cereals plus exercise and the hypocaloric diet plus exercise decreased total fat more than exercise only, which was sustained in the hypocaloric diet with fiber-rich whole-grain cereals plus exercise at 24 weeks (P<0.001). At weeks 12 and 24, the hypocaloric diet with fiber-rich whole-grain cereals plus exercise reduced saturated fat intake more than exercise only. The hypocaloric diet with fiber-rich whole-grain cereals plus exercise increased total fiber, insoluble fiber (both P<0.001), magnesium (P=0.004), and vitamin B-6 (P=0.002) intakes more than the hypocaloric diet plus exercise and exercise only. Calcium and vitamin E intakes were inadequate in all groups. Weight loss was similar in the hypocaloric diet with fiber-rich whole-grain cereals plus exercise and the hypocaloric diet plus exercise. CONCLUSIONS: Weight-reduction strategies may be associated with reduced intake of micronutrients, such as calcium and vitamin E. However, a hypocaloric diet with fiber-rich whole-grain cereal is effective for improving or maintaining other aspects of dietary quality during weight loss.     

中国9省(区)2000－2011年成年女性膳食营养素摄入变化趋势

目的 了解中国成年女性膳食营养素摄入变化。方法 使用“中国健康与营养调查”2000－2011年数据,结合《中国居民膳食营养素参考摄入量速查手册(2013版)》,分析9省(区)25~55岁成年女性膳食能量及主要营养素摄入变化趋势。结果 2000－2011年9省(区)成年女性膳食能量和蛋白质摄入达到推荐量的人群比例不断下降,碳水化合物供能比过低(<50.0%)和脂肪供能比过高(>30.0%)的人群比例大幅增加。随时间变化,维生素和矿物质摄入状况同样不容乐观,多数微量营养素的达标比例过低,且该比例仍在继续下降。2011年成年女性能量和蛋白质摄入达到膳食推荐量的比例分别为43.0%和54.4%,碳水化合物供能比过低和脂肪供能比过高的比例分别为40.2%和63.8%;维生素A、硫胺素、核黄素、烟酸、维生素C和维生素E摄入达到推荐值的比例分别为25.2%、10.7%、6.9%、54.9%、24.3%和88.5%;钙、镁、铁、锌和硒的摄入量达到推荐值的比例分别为3.3%、23.6%、50.9%、75.7%和13.3%。结论 中国9省(区)成年女性膳食营养状况仍需改善,建议开展有针对性的营养教育和干预。     

Effects of Various Forms of Calcium on Body Weight and Bone Turnover Markers in Women Participating in a Weight Loss Program

Objective: This study examined the effects of calcium intake on body weight, body fat, and markers of bone turnover in pre-menopausal adult women undergoing a 12 week weight loss program of diet and exercise.

Methods: Subjects were prescribed a 12 week diet with a 500 Kcal restriction containing about 750 mg calcium/day, exercised 3 times/week, and were given either placebo capsules, capsules of calcium lactate or calcium phosphate (daily dose about 800 mg calcium), or low fat milk (daily dose about 800 mg calcium). Subjects completed and returned daily diet diaries weekly.

Results: Daily calcium intake in mg from diet records + supplement assignment was: 788 ± 175 (placebo), 1698 ± 210 (Ca lactate), 1566 ± 250 (Ca phosphate), 1514 ± 225 (milk)(no significant differences among the calcium and milk groups). Each group had statistically significant changes in body weight (p < 0.01), but there were no significant differences among groups for the weight loss: 5.8 ± 0.8 kg (placebo), 4.1 ± 0.7 kg (Ca lactate), 5.4 ± 1.3 kg (Ca phosphate), 4.2 ± 0.8 kg (milk). Body fat was changed significantly in each group (p < 0.01), with milk group showing a little less change than the other groups. Serum bone specific alkaline phophatase activity, a bone synthesis marker, increased similarly in all groups (p < 0.001 within groups, no significance for changes among groups). In contrast, the Ca lactate group, but not other groups, had a drop in urine values for alpha helical peptide, a bone resorption marker (p < 0.05).

Conclusion: For the conditions of this study, increased calcium intake, by supplement or milk, did not enhance loss of body weight or fat, though calcium lactate supplementation lowered values for a marker of bone degradation.     

Assessment of Energy Intake Underreporting by Doubly Labeled Water and Observations on Reported Nutrient Intakes in Children

Objective To compare reported energy intake with energy expenditure using doubly labeled water (DLW). Additionally, we compared reported nutrient intakes of our subject population with national survey population data from the third National Health and Nutrition Examination Survey (NHANES III).Design This was a cross-sectional study of children, balanced by race and gender, primarily characterized by 4 body types: lean, obese, centrally fat, or peripherally fat.Subjects/setting Children (n=118; mean age=10 years) kept 8-day food records, with nutritionists recording weekday school lunch intakes. These subjects, assisted by their parents, recorded all breakfasts, dinners, snacks, and weekend lunches.Statistical analyses performed Data were analyzed using least squares analysis of variance with the general linear models procedure. Tukey's test was used for multiple comparisons of predicted treatment means.Results Mean daily energy intake was underreported by 17% to 33% of energy expenditure. The tendency to underreport increased with age. Underreporting occurred in all groups and subgroups studied. Reported mean intakes of vitamin A, vitamin E, vitamin B-6, calcium, zinc, and copper were less than 70% of the Recommended Dietary Allowance (RDA) for African-American girls, whereas African-American boys reported similarly low intakes of copper. On average, white girls reported intakes less than 70% of the RDA for zinc and copper, whereas white boys reported low intakes of copper (60% of the RDA). Reported intakes in general were somewhat lower than those reported in NHANES III.Applications/conclusions Dietetics professionals may modify the nutritional advice they give to patients/subjects based on food intake records and other data. For children, particularly, it is imperative that ethnic and gender differences be taken into consideration and that all foods eaten be accounted for as much as possible. J Am Diet Assoc. 1998;98:426-430,433.     

Higher amounts of body fat are associated with inadequate intakes of calcium and vitamin D in African American women

Calcium and vitamin D are associated with obesity. We hypothesized that African American women with higher calcium and vitamin D intakes would have lower body fat compared with women with lower calcium and vitamin D intakes. This cross-sectional study included 100 premenopausal African American women aged 18 to 40 years with a spectrum of body mass indices (17.3-46.7 kg/m²). Dietary information was obtained using 24-h recalls. Total body fat was determined by dual-energy x-ray absorptiometry and reported as percentage body fat (%BF). Subjects' data were divided into 2 groups (n = 50 per group) based on the median quartile of %BF, and differences were determined using independent t tests. Women with at least 37.9%BF had mean calcium (mg per day ± SD) and vitamin D intakes (µg per day ± SD) of 528.6 ± 146.0 and 3.8 ± .9, respectively. In comparison, women with lower %BF (<37.9%) had higher (P < .001) calcium and vitamin D intakes of 911.5 ± 208.3 and 5.0 ± 0.8, respectively. Partial correlation coefficients (controlling for the confounding variables of fat, carbohydrate, and protein intakes) indicated significant (P < 0.001) inverse associations between calcium intake and %BF (r = −.666), and vitamin D and %BF (r = −.460) in the 100 women. In conclusion, women with lower intakes of calcium and vitamin D were more likely to exhibit excessive adiposity compared with women with higher intakes.     

Calcium and Vitamin D Disparities Are Related to Gender,Age, Race,Household Income Level,and Weight Classification but Not Vegetarian Status in the United States: Analysis of the NHANES 2001–2008 Data Set

Objective: Adequate calcium and vitamin D intakes are critical during all life cycle stages. This study aimed to characterize usual intakes of calcium and vitamin D from food and dietary supplements in specific subpopulations of Americans so that fortification/enrichment and supplementation efforts may be targeted toward populations who are truly in need.

Methods: The National Cancer Institute method was used to estimate usual intakes of calcium and vitamin D by source and compared usual intakes to the established Dietary Reference Intakes for U.S. residents aged ≥4 years using National Health and Nutrition Examination Survey 2001–2002, 2003–2004, 2005–2006, and 2007–2008 data sets.

Results: These results showed for the first time that low-income, overweight, and/or obese minority populations may be at greater risk of calcium and vitamin D insufficiency. Children aged 4–8 years were more likely to obtain recommended dairy intakes compared with older children and adults of all ages. Food intakes of calcium decreased with age in adults. Adults who used supplemental calcium showed a lower prevalence of insufficiency. Calcium and vitamin D intakes from food and dietary supplements were not related to vegetarian status. Excessive intakes of calcium and vitamin D above the tolerable upper intake level were low among all studied populations and “overnutrification” was not widely present across these analyses.

Conclusions: Age- and gender-specific supplementation and modest use of fortification with calcium and vitamin D may be warranted for targeting certain subpopulations, particularly older adults, teenagers, minorities, and those who are low income and overweight and/or obese.

Practical Application: This study aimed to characterize usual intakes of calcium and vitamin D from food and dietary supplements in specific subpopulations of Americans so that fortification/enrichment and supplementation efforts may be better targeted. Low-income, overweight, and/or obese minority populations may be at a greater risk of calcium and vitamin D insufficiency.     

Dietary Intakes of Adolescents Living in Edirne,Turkey

Objective: To assess the dietary intakes of the adolescents in the area of Edirne, Turkey.

Design: Cross-sectional, prospective, epidemiological study.

Settings and Subjects: Our study group consists of 1944 adolescents aged between 12 to 17 years; 940 females and 1004 males.

Interventions: Three-day self-reported food records were collected from the subjects and evaluated by a nutrient database program. Reported nutrient intake data were analyzed for gender differences. Minitab statistical program was used to compare nutritional data of subjects.

Results: Energy, calcium, magnesium, folic acid, vitamins A, E, thiamine, and fiber intakes of whole adolescents, and also iron intakes of female adolescents were most likely to be inadequate compared with the recommendations. Iron, calcium, folic acid, thiamine, and fiber intakes were below two thirds of RDA/DRI in a large proportion of the adolescents. The intakes of protein, riboflavin, vitamin C, phosphorus and zinc were found to be adequate in a large percentage of the subjects. Forty eight percent of females and 60.1 % of males were below 2/3 of the RDA for energy.

Conclusion: Pediatricians and dietitians should train the adolescents living in our region and our country on practical strategies for making healthy food choices rich in nutrient content relative to energy value to ensure intakes that approach the recommendations.     

Consumption of Whole-Grain Cereals during Weight Loss: Effects on Dietary Quality, Dietary Fiber, Magnesium, Vitamin B-6, and Obesity

Objective

While various weight-management approaches produce weight loss, they may differ in dietary quality. We monitored changes in nutrient intakes in overweight and obese subjects on three different weight-management programs.

Design

Randomized clinical trial (pilot study) with two 12-week phases: phase 1, weekly counseling; phase 2, monitoring only.

Subjects/setting

One hundred eighty nonsmoking, sedentary overweight and obese adults began this outpatient study; 134 (body mass index [calculated as kg/m²]=30.9±2.4; age=42.3±1.2 years) were used in analyses.

Intervention

Twenty-four weeks of exercise only (control group), hypocaloric diet plus exercise, or hypocaloric diet with fiber-rich whole-grain cereals plus exercise.

Main Outcome Measures

At weeks 0, 12, and 24, diet quality was assessed by 3-day food records and body weight was measured.

Statistical Analyses Performed

Three-way analysis of variance with repeated measures.

Results

The hypocaloric diet with fiber-rich whole-grain cereals plus exercise decreased energy intake more than exercise only (P=0.032). By week 12, the hypocaloric diet with fiber-rich whole-grain cereals plus exercise and the hypocaloric diet plus exercise decreased total fat more than exercise only, which was sustained in the hypocaloric diet with fiber-rich whole-grain cereals plus exercise at 24 weeks (P<0.001). At weeks 12 and 24, the hypocaloric diet with fiber-rich whole-grain cereals plus exercise reduced saturated fat intake more than exercise only. The hypocaloric diet with fiber-rich whole-grain cereals plus exercise increased total fiber, insoluble fiber (both P<0.001), magnesium (P=0.004), and vitamin B-6 (P=0.002) intakes more than the hypocaloric diet plus exercise and exercise only. Calcium and vitamin E intakes were inadequate in all groups. Weight loss was similar in the hypocaloric diet with fiber-rich whole-grain cereals plus exercise and the hypocaloric diet plus exercise.

Conclusions

Weight-reduction strategies may be associated with reduced intake of micronutrients, such as calcium and vitamin E. However, a hypocaloric diet with fiber-rich whole-grain cereal is effective for improving or maintaining other aspects of dietary quality during weight loss.     

Lower Fat Intake as a Predictor of Initial and Sustained Weight Loss in Obese Subjects Consuming an Otherwise ad Libitum Diet

Objective To determine what predicts initial and sustained weight loss in subjects consuming a reduced-fat diet ad libitum and the relationship between achieved level of fat intake and weight loss.Design Placebo arm of a randomized, controlled trial of a weight-loss drug (dexfenfluramine) in the context of an ad libitum, reduced-fat, diet.Subjects Thirty-nine subjects (initial mean body mass index±standard deviation=34.9±3.4; body mass index is calculated as kg/m²) from the placebo group who completed the 9-month study.Intervention Dietary assessment and education (month 0) followed by monthly meetings during the single intervention of reducing fat intake (months 1 through 6); one follow-up at 9 months.Main outcome measures Initial weight loss (first 3 months) and sustained weight loss (over 9-month period).Statistics Dietary intake, body size, exercise levels, age, and gender were included in multiple regression linear models of initial and sustained weight loss if they were significant independent predictors.Results Greater initial weight loss was associated with a greater decrease in fat intake and a lower achieved fat intake at 3 months. Greater sustained weight loss was associated with a lower achieved fat intake, a higher baseline waist circumference, and higher moderate-intensity exercise levels (months 3 and 6). Weight loss occurred in all subjects who reported a fat intake of 40 g/day or less.Applications The obese persons most likely to achieve and sustain weight loss on an ad libitum, reduced-fat diet are those who can substantially reduce fat intake, those with high initial levels of abdominal fat, and those who undertake regular moderate-intensity exercise. A target of less than 40 g fat per day might be an appropriate goal to ensure weight loss, but dietary underreporting and the difficulty of sustaining very-low-fat intakes need to be considered. J Am Diet Assoc. 1998;98:35-39.     

Diet,feeding practices,and anthropometry of children and adolescents with cerebral palsy and their siblings

ObjectiveWe investigated growth and nutrition in children and adolescents with cerebral palsy (CP) in comparison with their healthy siblings.MethodsThis was a case–control, single observational investigation of 16 pairs of children with CP and their healthy siblings. Stature, weight, skinfolds, and selected circumferences were measured, and Z-scores, percentage of body fat (calipers), and body mass index were calculated. Diet and feeding practices were recorded for 3 d.ResultsNo differences were observed in the macronutrient distribution of energy intake, with participants with CP covering 75% of their energy requirements. Subjects with CP demonstrated low vitamin A, biotin, folate, vitamin K, and copper intakes. The healthy siblings inadequately consumed vitamin E and both groups followed diets low in zinc. Iron was marginal for the CP group, but calcium was consumed adequately by all. The participants with CP demonstrated lower body weight, body mass index, percentage of body fat, weight-for-age Z-score, and triceps skinfold (P ≤ 0.001), decreased height-for-age Z-score (P ≤ 0.008), lower body mass index Z-score (P ≤ 0.002), and smaller circumferences. Praise rewards were more often used in children with CP (P ≤ 0.049) but threats to withdraw food were applied only to the healthy siblings (P ≤ 0.021). When usual intakes were considered, participants with a greater degree of motor impairment were closer to meeting their energy needs.ConclusionThe diets of participants with CP were in the majority energy deficient. The highest energy intakes were demonstrated by the most severely impaired subjects. A tendency was recorded within each household for the adequacy/inadequacy in energy intake, concerning both siblings.     

Body composition,energy and protein intake of Nigerian University athletes

Ten athletes and ten non‐athletes participated in the study. Non‐athletes were taller and heavier than the athletes. The weighed inventory technique was used in the dietary study. Body composition parameters were calculated from anthropometric and skinfold thickness measurements. Mean daily energy intakes were 2531 ±554 and 2493 ±379 kcal while protein intake were 53.61 ± 11.60g and 57.24±14.87g for athletes and non‐athletes respectively. Total skinfold thickness, total body fat and body mass index were higher in the non‐athletes than the athletes. Other parameters determined included lean body mass, optimum and relative weights. The study was designed to compare the body composition and energy intake of athletes with those of non‐athletes having similar body height and weight.     

Gestational nutrition improves outcomes of vaginal deliveries in Jordan: an epidemiologic screening

Adequate and balanced nutrition during gestation is essential for achieving healthy pregnancy outcomes. This retrospective survey tested the hypothesis that maternal nutrition (macronutrients intake, micronutrients intake, and weight gain) during gestation will impact gestational outcomes (gestational age, birth weight, and labor spontaneity). The objectives of this study were to test the impact of macronutrients and micronutrients consumed during gestation, pregestational weight and weight gain during gestation on gestational age, birth weight, and labor spontaneity among Jordanian women. Study participants (n = 700) were recruited from a women's hospital in northern Jordan. Data were collected using structured interviews. Dietary determinants examined in the study included daily intake of macronutrients (energy, carbohydrate, protein, fat, and n-3 and n-6 fatty acids) and micronutrients (zinc, calcium, folate, vitamin C, vitamin A, and vitamin B6), pregestational body mass index, total weight gain, and weight gain pattern during pregnancy. Dietary data were obtained from a semiquantitative food frequency questionnaire. Mean (SEM) daily intakes of energy, carbohydrate, and protein were 10894 (138) Kj, 320 (3.8) g, and 90 (0.95) g, respectively; with fat contributing 36% of total energy. Average daily energy and carbohydrate intake during pregnancy were related negatively to gestational age (P < .05). Pregestational body mass index was associated positively with gestational age and birth weight (P < .05). Intakes of vitamin A and calcium had significant relationships with birth weight. Daily intakes of zinc, calcium, vitamin B6, and n-3 and n-6 fatty acids were associated with labor spontaneity. Dietary factors consumed during pregnancy are associated with pregnancy outcomes.     

Maternal nutritional status may be stressed by seasonal fluctuations in food availability: Evidence from rural women in Kenya

The effect of seasonal changes in household food availability on the dietary intakes and the nutritional status of 24 lactating women from smallholder rural households in Nakuru district Kenya, were investigated over a 15-month period in 1992/93 agricultural cycle. Dietary intakes and body weights were measured on monthly basis. Significant seasonal differences were found in intakes of calcium, vitamin A, vitamin C, riboflavin, and niacin respectively (P < 0.01), as well as in the intake of protein, iron, and thiamin (P < 0.05), but not with energy and fat intake. Large interseasonal weight losses of 5.6 kg (about 9%) at the rate of 1.1 kg/month, were observed between baseline measurements and the peak of the lean months when the energy intakes were 36.7 kcal/kg/day and protein at 1.1 g/kg/day. About 50% of the lost weight (2.8 kg) were recovered during the harvest months of January and February, when energy intakes improved to 41.0 kcal/kg/day, and protein to 1.2 g/kg/day. However, further weight losses of 1.6 kg or 0.5 kg/month occurred in the immediate postharvest months between March and June. While much of the weight loss may have been due to reduced energy intake during periods of food scarcity, part of the lost weight may have been due to increased energy requirement as a result of lactation and to increased physical activities. Further investigations are recommended.