A Comparison of Meal Replacements and Medication in Weight Maintenance after Weight Loss

Objective: To compare the use of meal replacements or medication during weight maintenance subsequent to weight loss using a very low-energy diet (VLED) in overweight or obese adults.

Design: Participants followed a liquid VLED of 2177 kJ for 12 weeks followed by 4 weeks of re-orientation to solid foods. Participants were randomized at week 16 to receive either meal replacements or Orlistat both combined with a structured meal plan containing an energy value calculated to maintain weight loss.

Subjects: Sixty-four women (age = 49.9 ± 10 y, weight = 101.6 ± 17.1 kg, height = 164.9 ± 6.0 cm, BMI = 36.7 ± 5.4 kg/m²) and 28 men (age = 53.7 ± 9.6 y, weight = 121.8 ± 16.0 kg, height = 178.7 ± 5.6 cm, BMI = 37.8 ± 4.9 kg/m²) completed a 1 year weight management program. Behavioral weight management clinics included topics on lifestyle, physical activity (PA), and nutrition. Participants met for 90 min weekly for 26 weeks, and then biweekly for the remaining 26 weeks.

Outcomes: Minutes of PA, fruits and vegetables (FV), and pedometer steps were recorded on a daily basis and reported at each group meeting. Body weight was obtained at each group meeting.

Results: During VLED, the MR group decreased body weight by 22.8 ± 6.1 kg and the Orlistat group decreased body weight by 22.3 ± 6.1 kg. During weight maintenance, there was no significant group by time interaction for body weight, PA, FV consumption, or pedometer steps. At week 16, the meal replacement group had a body weight of 85.4 ± 14.3 kg that increased to 88.1 ± 16.5 kg at 52 weeks (p < 0.05). At week 16, the Orlistat group had a body weight of 85.7 ± 17.9 kg that increased to 88.5 ± 20.3 kg at 52 weeks (p < 0.05).

Conclusions: Subsequent to weight loss from a VLED, meal replacements and Orlistat treatments were both effective in maintaining weight significantly below baseline levels over a 52 week period of time. Meal replacements may be a viable alternative strategy to medications for weight maintenance.     

Lipid Responses to a Dietary Docosahexaenoic Acid Supplement in Men and Women with Below Average Levels of High Density Lipoprotein Cholesterol

Objective: To assess fasting lipid responses to a docosahexaenoic acid (DHA) supplement in men and women with below-average levels of high-density lipoprotein (HDL) cholesterol.

Methods: This randomized, double-blind, controlled clinical trial included 57 subjects, 21–80 years of age, with fasting HDL cholesterol concentrations ≤44 mg/dL (men) and ≤54 mg/dL (women), but ≥35 mg/dL. Subjects were randomly assigned to receive either 1.52 g/day DHA from capsules containing DHA-rich algal triglycerides or olive oil (control) for six weeks.

Results: There were no significant differences between groups in baseline lipid values. The DHA supplemented group showed significant changes [?43 (DHA) vs. ?14 (controls) mg/dL, p = 0.015] and percent changes [?21% (DHA) vs. ?7% (controls), p = 0.009] in triglycerides, total (12 vs. 3 mg/dL; p = 0.021 and 6% vs. 2%; p = 0.018) and low-density lipoprotein (17 vs. 3 mg/dL; p = 0.001 and 12% vs. 3%; p = 0.001) cholesterol concentrations, and in the triglyceride to HDL cholesterol ratio (?1.33 vs. ?0.50, p = 0.010), compared with controls. In addition, there was a significant reduction in the percentage of LDL cholesterol carried by small, dense particles in the DHA supplemented group (changes = ?10% vs. ?3%, p = 0.025).

Conclusions: Supplementation with 1.52 g/d of DHA in men and women with below-average HDL cholesterol concentrations raised the LDL cholesterol level, but had favorable effects on triglycerides, the triglyceride/HDL cholesterol ratio and the fraction of LDL cholesterol carried by small, dense particles. Further research is warranted to evaluate the net impact of these alterations on cardiovascular risk.     

Using text messages to promote health in African-Americans: #HeartHealthyandCancerFree*

Objectives: African-Americans are vulnerable to both cancer and cardiovascular disease (CVD) due to intricately connected risk factors. Use of text messages is an innovative method to provide health information to reduce these risks. The aim of this study was to test the feasibility and acceptability of a text messaging intervention to reduce CVD and cancer risk factors in African-Americans.

Design: We developed an intervention using text messages culturally tailored for African-Americans over age 50 who were at risk (one or more modifiable risk factors) for CVD and/or cancer. Sociodemographic data, biologic measures, cancer screening practices, and general health status were assessed. Group interviews were conducted to assess feasibility and acceptability.

Results: Participants were primarily female (69%), aged 58?±?5 years, who were married (59%) and worked full time (56%). In terms of feasibility and acceptability, themes of encouragement through text messages received and a desire for a longer study period emerged from group interviews with participants. Participants experienced significant decreases in waist circumference (41?±?5 vs 40?±?5, p?=?.002), systolic blood pressure (147?±?25?mmHg vs 138?±?20?mmHg, p?=?.009), diastolic blood pressure (87?±?16?mmHg vs 82?±?10?mmHg, p?=?.02), total cholesterol (194?±?35?mg/dL vs 173?±?32?mg/dL, p?p?=?.015). Five participants had colorectal cancer screening, two had prostate cancer screening, and four had mammograms.

Conclusions: Use of text messages was widely accepted among participants. Significant CVD risk reductions and increased cancer screenings were noted. Future studies should incorporate innovative strategies such as text messaging in promoting health in vulnerable populations.     

Author Index to Volume 6

Objective: To look for associations between changes in LDL cholesterol and baseline characteristics of patients receiving dietary therapy for hypercholesterolemia.

Methods: Ninety-six hypercholesterolemic individuals aged 30–65 from three primary care clinics and a worksite clinic received counseling by a physician and/or a dietitian for lifestyle and dietary modifications. Baseline nutritional intake was evaluated using three-day food diaries. Lipoprotein levels were evaluated at six weeks and thereafter every three months for one year. Partial (adjusted) correlations (β) were calculated between baseline parameters (demographic, anthropometric, nutritional and laboratory) and changes of LDL cholesterol for the short and long term (three and 12 months).

Results: The average LDL cholesterol level decreased by 6 ± 10% (p < 0.001) at the end of 12 months. This reduction was positively correlated with baseline LDL cholesterol level (β = +0.4, p = 0.001), and negatively correlated with the baseline BMI (β = ?0.2, p < 0.05) and saturated fat intake (β = ?0.3, p < 0.05). The differences between low and high subgroups of baseline LDL cholesterol, BMI and saturated fat intake became apparent only after six to twelve months of therapy and probably result from varying levels of adherence to the dietary regimen. A significant correlation was found between the change in LDL cholesterol after six weeks and the change in LDL cholesterol after 12 months (β = 0.4, p < 0.001).

Conclusions: The probability of successfully reducing LDL cholesterol with dietary therapy can be predicted by baseline LDL cholesterol level, BMI and saturated fat intake, as well as by the response to dietary changes within six weeks of therapy.     

Cholesterol-Lowering Efficacy of Plant Sterols in Low-Fat Yogurt Consumed as a Snack or with a Meal

Objective: Plant sterols (PS) consumed as a snack may not have the same cholesterol-lowering potential as when consumed with a meal due to poor solubilization. It was hypothesized that the consumption of a single dose, low-fat yogurt rich in PS (1.6 g/d) with a meal over an afternoon snack will lead to favourable changes in plasma lipids, plasma PS concentrations, and cholesterol synthesis without negatively affecting α-tocopherol or carotenoids levels.

Methods: Twenty-six hyperlipidemic males and females completed the randomized trial of three phases (control, single PS dose consumed with a meal, or single PS dose as an afternoon snack) while consuming controlled, low-fat diets. Plasma lipids, cholesterol synthesis rates, plasma PS and serum fat-soluble antioxidants were measured at baseline and after 4 weeks.

Results: Endpoint total cholesterol (TC) levels after the PS snack phase were decreased (p = 0.04) (5.30 ± 0.2 mmol/L) compared to the control phase (5.53 ± 0.2 mmol/L). However, endpoints for TC (5.37 ± 0.2 mmol/L) for PS dose with a meal were comparable to control phase. Low-density lipoprotein-cholesterol tended to be different (p = 0.06) at the end of the intervention phases (3.51 ± 0.1, 3.43 ± 0.1, and 3.33 ± 0.1 mmol/L; control, meal and snack, respectively). Cholesterol fractional synthesis rates were higher (p = 0.007) by 25.8% and 19.5% at the end of the snack and meal phases, respectively, compared with the control phase. Plasma campesterol and β-sitosterol concentrations, adjusted for TC, were higher (p < 0.01) in the snack phase (2.30 ± 0.3 and 0.54 ± 0.1 μmol/mmol, respectively) and in the meal phase (2.00 ± 0.3 and 0.51 ± 0.1 μmol/mmol, respectively) when compared to the control phase (1.81 ± 0.3 and 0.40 ± 0.1 μmol/mmol, respectively). No changes in α-tocopherol or carotenoids levels were detected after adjusting for TC, for all phases.

Conclusion: These results indicate that a single dose of PS in low-fat yogurt, provided as a snack, lowers cholesterol levels but does not alter fat-soluble vitamin or carotenoid concentrations in hyperlipidemic participants.     

Effects of Supplementation with Beef or Whey Protein Versus Carbohydrate in Master Triathletes

Objective: The present study compares the effect of ingesting hydrolyzed beef protein, whey protein, and carbohydrate on performance, body composition (via plethysmography), muscular thickness, and blood indices of health, including ferritin concentrations, following a 10-week intervention program.Methods: After being randomly assigned to one of the following groups—beef, whey, or carbohydrate—24 master-age (35–60 years old) male triathletes (n = 8 per treatment) ingested 20 g of supplement mixed with plain water once a day (immediately after training or before breakfast). All measurements were performed pre- and postinterventions.Results: Only beef significantly reduced body mass (p = 0.021) along with a trend to preserve or increase thigh muscle mass (34.1 ± 6.1 vs 35.5 ± 7.4 mm). Both whey (38.4 ± 3.8 vs 36.9 ± 2.8 mm) and carbohydrate (36.0 ± 4.8 vs 34.1 ± 4.4 mm) interventions demonstrated a significantly (p < 0.05) decreased vastus medialis thickness Additionally, the beef condition produced a significant (p < 0.05) increase in ferritin concentrations (117 ± 78.3 vs 150.5 ± 82.8 ng/mL). No such changes were observed for the whey (149.1 ± 92.1 vs 138.5 ± 77.7 ng/mL) and carbohydrate (149.0 ± 41.3 vs 150.0 ± 48.1 ng/mL) groups. Furthermore, ferritin changes in the beef group were higher than the modification observed in whey (p < 0.001) and carbohydrate (p = 0.025) groups. No differences were found between whey and carbohydrate conditions (p = 0.223). No further changes were observed.Conclusion: Ingesting a hydrolyzed beef protein beverage after workout or before breakfast (nontraining days) can be effective in preserving thigh muscle mass and in improving iron status in male master-age triathletes.     

Bioaccessibility of pistachio polyphenols,xanthophylls, and tocopherols during simulated human digestion

ObjectiveThe bioaccessibility of bioactives from pistachios has not been previously evaluated. In the present study we quantified the release of polyphenols, xanthophylls (lutein), and tocopherols from pistachios (raw pistachios, roasted salted pistachios, and muffins made with raw pistachios) during simulated human digestion.MethodsA dynamic gastric model of digestion that provides a realistic and predictive simulation of the physical and chemical processing and accurately mimics the residence time and the luminal environment within the human stomach was used for the digestion studies.ResultsMore than 90% of the polyphenols were released in the gastric compartment, with virtually total release in the duodenal phase. No significant differences were observed between raw shelled and roasted salted pistachio. The presence of a food matrix (muffin) decreased the bioaccessibility of protocatechuic acid (78%) and luteolin (36%). Almost 100% bioaccessibility of lutein and tocopherols was found after duodenal digestion, with no difference among the three samples.ConclusionThe rapid release of the assayed bioactives in the stomach maximizes the potential for absorption in the duodenum and contributes to the beneficial relation between pistachio consumption and health-related outcomes.     

Effect of High vs Standard Early Parenteral Amino Acid Supplementation on the Growth Outcomes in Very Low Birth Weight Infants

Background: The goal of this study was to evaluate the effect of 2 different strategies for parenteral amino acid (AA) supplementation in the range of standard doses (>1.0–1.5 g/kg/d) on growth outcomes in very low birth weight (VLBW) infants. Materials and Methods: The unit policy of AA doses on the first day of life changed from 1.5 g/kg/d (n = 56; standard protein group, SP, in 2008) to 3.0 g/kg/d (n = 53; high protein group, HP, in 2009) with a daily advance to a target dose of 3.5–4.0 g/kg/d. Daily nutritive and laboratory profiles were collected for the initial 14 days, and patient weight, height, and head circumference on postnatal day 14 and again at 36 weeks, 6 months, and 12 months of corrected age were evaluated. Results: During the first 14 days, AA intake was greater in the HP group than in the SP group (2.9 ± 0.4 vs 2.6 ± 0.4 g/kg/d, P < .001). The HP group demonstrated a lower peak plasma glucose level during the first 3 days (116 ± 24 vs 137 ± 39 mg/dL) and a higher serum urea nitrogen level for the first 14 postnatal days than the SP group (19.2 ± 7.0 vs 14.8 ± 6.7 mg/dL) (both P < .01). From birth to postnatal 14 days and to 36 weeks, 6 months, and 12 months of corrected age, the z score changes in all growth parameters did not differ between the 2 groups. Conclusion: In the range of the standard AA protocol, there was no dose‐response relationship between the early AA doses and the growth outcomes in VLBW infants.     

Randomized Placebo-Controlled Trial of Guava Juice as a Source of Ascorbic Acid to Reduce Iron Deficiency in Tarahumara Indigenous Schoolchildren of Northern Mexico

Objective: Assess the efficacy of a 10-week consumption of guava juice on the iron status of children with mild iron deficiency anemia.

Methods: Ninety-five boarding school children aged 6–9 years identified as anemic were randomly allocated to receive 300 mL of natural guava juice containing ～200 mg of ascorbic acid (AA) or placebo (guava-flavored juice free of AA) with the main meal (5 d/wk). Information about dietary intake was collected at weeks 3, 5, and 7 at school and household levels. Changes in hemoglobin (Hb) and plasma ferritin (PF) among the subsample iron deficient at baseline (n = 33) were the main outcomes.

Results: Iron and phytic acid intakes at school and at home did not differ between groups. Baseline Hb and PF were 11.9 ± 0.5 g/dL and 8.2 ± 3.6 ng/mL for the guava, and 11.4 ± 1.1 g/dL and 7.4 ± 4.6 ng/mL for the placebo group (Hb: p = 0.08; PF: p = 0.31); at week 10 of the study, corresponding values were 13.1 ± 0.9 g/dL and 17.9 ± 10.3 ng/mL (n = 16), and 12.3 ± 1.3 g/dL and 15.4 ± 5.8 ng/mL (n = 12) (Hb: p = 0.05; PF: p = 0.21). With analysis of variance (ANOVA) for repeated measures, the guava group had 0.64 g/dL higher Hb (CI₉₅, 0.18–1.11; p = 0.01) and 2.47 ng/mL higher PF (CI₉₅, ?1.04 to 5.98; p = 0.12) compared with the placebo group.

Conclusion: Guava juice providing 200 mg AA at one meal on each school day had a marginal effect on Hb and PF concentrations in children consuming high-phytate diets fortified with iron.     

Novel natural food colourant G8000 benefits LDL- and HDL-cholesterol in humans

Abstract

The aim of this study was to investigate the phenolic composition of a natural food colourant (G8000?) as well as its effects on plasma markers after 28-day consumption by healthy individuals at a dietary dose (70?g). Parameters of total cholesterol and its fractions, triglycerides and plasma enzymes biomarkers of muscle injury were measured. Major compounds identified in G8000? by ESI-MS showed the presence of anthocyanins, organic acids, phenolic acids as well as monosaccharides. HDL levels significantly increased from 43?±?10.2?mg/dL to 95?±?16.9?mg/dL. LDL levels significantly decreased from 110?±?40.9?mg/dL to 69?±?39?mg/dL (p?<?0.001). No significant statistical differences (p?>?0.05) were observed for total cholesterol, triglycerides and VLDL. After the intake, plasma enzyme CK-MB decreased from 20?±?12.1 U/L to 10?±?1.9 U/L while LDH levels increased from 275?±?124.4 U/L to 317?±?114.7 U/L (p?<?0.005). No significant differences were observed for CK levels. Taken together, dietary intake of natural colourant G8000? was able to exert beneficial effects on atherosclerosis biomarkers.     

China: transformations of its cuisine,a prelude to understanding its people.

Objective:Familial hypercholesterolemia (FH) is a predominantly inherited disorder, which contributes to a defect of the LDL-cholesterol receptor. For adults with familial hypercholesterolemia (FH), it is known that a supplementary diet of monounsaturated fatty acids reduces elevated levels of total cholesterol and LDL-cholesterol and may further increase HDL-cholesterol. In particular the reduced intake of dietary fat reduces total serum cholesterol and LDL-cholesterol in the range of 10% to 15% and inhibits LDL-oxidation. Once the diagnosis of familial hypercholesterolemia is made in early childhood a supplementary diet with rapeseed oil should be started as early as possible to prevent development of atherosclerosis and subsequent complications. So far there are no reports of a lipid lowering diet enriched with rapeseed oil in children and adolescents.

Methods:Seventeen children and young adolescents (male = 6, female = 11, ages 4 to 19 years) diagnosed with FH were enrolled in this study. They received dietary training and a classical low fat/low cholesterol diet enriched with rapeseed oil over five months. In the first two months they received orally mean 15 g/day (8–23 g/day), for the remaining three months mean 22 g/day (15–30 g/day) rapeseed oil. The calculation of the three-days dietary protocols showed the following characteristics: 29.5% calories from fat, 14.3% calories from protein and 54.6% calories from carbohydrates. The subjects had six sessions of dietary counseling, and serum lipids levels and lipoprotein(a) were estimated; each month’s diet adherence was controlled by a dietitian and discussed with the patients and their families during this five-month study.

Result:During five months of rapeseed oil diet serum triglycerides decreased by 29% (119.2 ± 62.8 mg/dL vs. 84.9 mean ± 39.7 mg/dL), VLDL-cholesterol by 27% (23 ± 12 mg/dL vs. 17 ± 8 mg/dL), total cholesterol by 10% (233 ± 35 mg/dL vs. 213 ± 36 mg/dL), LDL-cholesterol by 7% (151 ± 31 mg/dL vs. 142 ± 31 mg/dL). HDL-cholesterol (59 ± 15 mg/dL vs. 57 ± 11 mg/dL) and Lp(a) (29.8 ± 36.3 mg/dL vs. 32.6 ± 40.7 mg/dL) were not changed significantly. The diet was well accepted; in most families a sustained change was reported.

Conclusions:Our results indicate that in children and adolescents with FH a lipid-lowering diet with rapeseed oil has a similar effect on total serum cholesterol and LDL-cholesterol compared to classical cholesterol reduction diets (step I). However, an additional pronounced effect on lowering of triglycerides and VLDL-cholesterol can be observed.     

Antidiabetic Effect of Rosella-Stevia Tea on Prediabetic Women in Yogyakarta,Indonesia

Background: Rosella tea (Hibiscuss sabdariffa. Linn) with stevia sweetener (Stevia rebaudiana Bertoni) is a combined herbal drink that is expected to have antidiabetic effect by lowering glucose levels in people with diabetes and prediabetes. This research investigates the effect of rosella-stevia tea to decrease fasting blood glucose (FBG) and 2 hours postprandial blood glucose (2-hour postprandial BG) level in prediabetic women.

Method: This is quasi-experimental research with control and treatment (rosella-stevia tea) group. Each group consists of 12 prediabetic women aged 30–60 years. Rosella-stevia tea (5 g rosella powder, 125 mg stevia sweetener) was administered to the treatment group twice a day for 14 days.

Result: Rosella-stevia tea consumption affects blood glucose levels. Rosella-stevia tea consumption significantly lowered the FBG level (from 111.25 ± 7.20 mg/dL to 88.58 ± 13.19 mg/dL; p < 0.01) but not the 2-hour postprandial BG level (from 123.25 ± 37.61 mg/dL to 106.92 ± 18.82 mg/dL). There are no significant differences in the control group (FBG level from 106.00 ± 5.27 mg/dL to 102.08 ± 8.36, and 2-hour postprandial BG level from 119.83 ± 16.43 mg/dL to 128.00 ± 23.54 mg/dL).

Conclusion: Rosella-stevia tea consumption can lower the FBG level but not the 2-hour postprandial BG level in prediabetic women.     

Adiponectin Gene Variant rs3774261, Effects on Lipid Profile and Adiponectin Levels after a High Polyunsaturated Fat Hypocaloric Diet with Mediterranean Pattern

The role of ADIPOQ gene variants on metabolic improvements after weight change secondary to different hypocaloric diets remained unclear. We evaluate the effect of rs3774261 of ADIPOQ gene polymorphism on biochemical improvements and weight change after high polyunsaturated fat hypocaloric diet with a Mediterranean dietary pattern for 12 weeks. A population of 361 obese subjects was enrolled in an intervention trial with a calorie restriction of 500 calories over the usual intake and 45.7% of carbohydrates, 34.4% of fats, and 19.9% of proteins. The percentages of different fats was; 21.8% of monounsaturated fats, 55.5% of saturated fats, and 22.7% of polyunsaturated fats. Before and after intervention, an anthropometric study, an evaluation of nutritional intake and a biochemical evaluation were realized. All patients lost weight regardless of genotype and diet used. After 12 weeks with a similar improvement in weight loss (AA vs. AG vs. GG); total cholesterol (delta: −28.1 ± 2.1 mg/dL vs. −14.2 ± 4.1 mg/dL vs. −11.0 ± 3.9 mg/dL; p = 0.02), LDL cholesterol (delta: −17.1 ± 2.1 mg/dL vs. −6.1 ± 1.9 mg/dL vs. −6.0 ± 2.3 mg/dL; p = 0.01), triglyceride levels (delta: −35.0 ± 3.6 mg/dL vs. 10.1 ± 3.2 mg/dL vs. −9.7 ± 3.1 mg/dL; p = 0.02), C reactive protein (CRP) (delta: −2.3 ± 0.1 mg/dL vs. −0.2 ± 0.1 mg/dL vs. −0.2 ± 0.1 mg/dL; p = 0.02), serum adiponectin (delta: 11.6 ± 2.9 ng/dL vs. 2.1 ± 1.3 ng/dL vs. 3.3 ± 1.1 ng/dL; p = 0.02) and adiponectin/leptin ratio (delta: 1.5 ± 0.1 ng/dL vs. 0.3 ± 0.2 ng/dL vs. 0.4 ± 0.3 ng/dL; p = 0.03), improved only in AA group. AA genotype of ADIPOQ variant (rs3774261) is related with a significant increase in serum levels of adiponectin and ratio adiponectin/leptin and decrease on lipid profile and C-reactive protein (CRP).     

The Effects of Coenzyme Q10 Supplementation on Glucose Metabolism,Lipid Profiles,Inflammation, and Oxidative Stress in Patients With Diabetic Nephropathy: A Randomized,Double-Blind,Placebo-Controlled Trial

Objective: Data on the effects of coenzyme Q10 (CoQ10) supplementation on glucose metabolism, lipid profiles, inflammation, and oxidative stress in subjects with diabetic nephropathy (DN) are scarce. This research was done to determine the effects of CoQ10 supplementation on metabolic status in subjects with DN.

Methods: This randomized double-blind placebo-controlled clinical trial was done in 50 subjects with DN. Participants were randomly assigned into two groups to intake either 100 mg/day CoQ10 supplements (n = 25) or placebo (n = 25) for 12 weeks. Fasting blood samples were obtained at first and after 12-week intervention to quantify metabolic profiles.

Results: After 12 weeks of treatment, compared with the placebo, CoQ10 supplementation resulted in significant decreases in serum insulin levels (?3.4 ± 6.8 vs +0.8 ± 6.4 µIU/mL, p = 0.02), homeostasis model of assessment-estimated insulin resistance (?1.0 ± 2.0 vs +0.2 ± 1.8, p = 0.03), homeostasis model of assessment-estimated B cell function (?12.3 ± 26.3 vs +3.5 ± 23.1, p = 0.02) and HbA1c (?1.1 ± 1.0 vs ?0.1 ± 0.2%, p < 0.001), and a significant improvement in quantitative insulin sensitivity check index (+0.009 ± 0.01 vs ?0.006 ± 0.01, p = 0.01). In addition, CoQ10 supplementation significantly decreased plasma malondialdehyde (MDA) (?0.6 ± 0.5 vs +0.5 ± 1.0 µmol/L, p < 0.001) and advanced glycation end products levels (AGEs) (?316.4 ± 380.9 vs +318.6 ± 732.0 AU, p < 0.001) compared with the placebo. Supplementation with CoQ10had no significant impacts on fasting plasma glucose (FPG), lipid profiles, and matrix metalloproteinase-2 (MMP-2) compared with the placebo.

Conclusions: Taken together, our study demonstrated that CoQ10 supplementation for 12 weeks among DN patients had favorable effects on glucose metabolism, MDA, and AGEs levels, but unchanged FPG, lipid profiles, and MMP-2 concentrations.     

Weight Loss Is More Important Than the Diet Type in Improving Adiponectin Levels Among Overweight/Obese Adults

Objective: The study objective was to compare the effect of a standard calorie- and fat-restricted diet (STD-D) and a calorie- and fat-restricted lacto-ovo-vegetarian diet (LOV-D) on total and high-molecular-weight (HMW) adiponectin levels after 6 months of behavioral intervention.

Design: This study is an ancillary study to a randomized clinical trial.

Subjects: Subjects included 143 overweight/obese adults (STD-D = 79; LOV-D = 64).

Intervention: Both groups received the same standard behavioral intervention; the only difference was that LOV-D participants were instructed to eliminate meat, poultry, and fish from their diet.

Measures: Weight, dietary intake with the 3-day food diary, and total and HMW adiponectin levels were measured.

Results: Both groups significantly increased total (STD-D +7.2 ± 17.8%; LOV-D +9.4 ± 21.8%) and HMW adiponectin levels (STD-D +18.5 ± 32.9%; LOV-D +15.8 ± 34.5%; ps < 0.05) with no significant differences between the groups. We found significant associations between weight loss and increases in total (β (SE) = ?.071(.27); p = 0.003) and HMW adiponectin (β (SE) = ?1.37(.47); p = 0.001) levels independent of the diet type. Weight loss at the higher quartile was associated with improvements of adiponectin levels (p < 0.05).

Conclusion: Weight loss was associated with increased total and HMW adiponectin levels regardless of the diet type. Enhancing weight loss may be a means to improve adiponectin levels.     

Effect of Micronutrient-Fortified Milk on Zinc Intake and Plasma Concentration in Adolescent Girls

Objective: To assess the effect of dietary fortified milk with zinc and other micronutrients on zinc intake and plasma zinc content of adolescent girls.

Methods: The study included 108 schoolgirls (12–18 years old) from northwest Mexico, randomly assigned to either the control group (CG; n = 55) or the intervention group consuming a regular diet plus fortified milk (MG; n = 53). At the beginning of the study, age, weight, and height were measured. Food intake by the 24-hour recall method and plasma zinc levels assessed by absorption spectrophotometry were determined before and after 27 days of fortified milk intake.

Results: At baseline, no significant group-related differences were observed for energy, protein intake, zinc intake, and plasma zinc level (p > 0.05), and 35.2% of participant girls did not achieve their zinc requirement. After 27 days of treatment, there were no significant differences in energy and protein intake between groups (p > 0.05). Zinc intake was higher for MG than CG (16.7 ± 8.3 mg/d vs 10.5 ± 6.4 mg/d; p < 0.01), and there was a lower proportion of low zinc intake in MG than for CG (7 vs 16, respectively; p = 0.04). In addition, plasma zinc improved in the MG (116.6 ± 26.9 μg/dL, p < 0.01) compared with CG (98.5 ± 26.6 μg/dL), and it was mainly attributed to the fortified milk intake, as the main dietary zinc contributor.

Conclusion: Fortified milk intake is effective in increasing both intake and plasma zinc levels of adolescent Mexican girls; therefore, it could be an adequate strategy for zinc deficiency prevention or correction among adolescent girls.     

Editorial

Aim: Compare the long-term effects of an energy-restricted very low-carbohydrate, high-fat (LC) diet with an isocaloric high-carbohydrate, low-fat (HC) diet on exercise tolerance and capacity in overweight and obese adults.

Methods: Seventy-six adults (25 males; age 49.2 ± 1.1 years; BMI 33.6 ± 0.5 kg/m²) were randomized to either a hypocaloric (6–7 MJ/day) LC diet (35% protein, 4% carbohydrate, 61% fat) or isocaloric HC diet (24% protein, 46% carbohydrate, 30% fat) for 52 weeks. Pre- and postintervention, participants’ body weight and composition, handgrip, and isometric knee extensor strength were assessed and participants performed an incremental exercise test to exhaustion.

Results: Forty-three participants completed the study (LC = 23; HC = 20). Overall, peak relative oxygen uptake increased (+11.3%) and reductions occurred in body weight (?14.6%), body fat percentage (?6.9% [absolute]), isometric knee extensor strength (?12.4%), handgrip strength (?4.5%), and absolute peak oxygen uptake (?5.2%; p ≤ 0.02 time for all) with no diet effect (p ≥ 0.18). During submaximal exercise, rating of perceived exertion did not change in either group (p = 0.16 time, p = 0.59 Time × Group). Compared to the HC diet, the LC diet had greater reductions in respiratory exchange ratio (LC ?0.04 ± 0.01, HC ?0.00 ± 0.01; p = 0.03), and increased fat oxidation (LC 15.0 ± 5.3% [of energy expenditure], HC 0.5 ± 3.9%; p = 0.04).

Conclusion: In overweight and obese patients, an LC diet promoted greater fat utilization during submaximal exercise. Both an LC diet and an HC diet had similar effects on aerobic capacity and muscle strength, suggesting that long-term consumption of an LC weight loss diet does not adversely affect physical function or the ability to perform exercise.     

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.     

Short-term Effects of Green Tea on Blood Pressure,Endothelial Function,and Metabolic Profile in Obese Prehypertensive Women: A Crossover Randomized Clinical Trial

Background: Green tea consumption has been inversely associated with cardiovascular disease (CVD) in epidemiological studies. Although some interventional trials suggest that green tea has beneficial effects on CVD risk factors, such as hypertension and obesity, others have failed to show such benefits.

Aims: To evaluate the short-term effects of green tea on blood pressure, endothelial function, metabolic profile, and inflammatory activity in obese prehypertensive women.

Methods: This study was a crossover, randomized, double-blind, placebo-controlled clinical trial. Participants were randomly allocated to receive daily 3 capsules containing either 500 mg of green tea extract (GTE) or a matching placebo for 4 weeks, with a washout period of 2 weeks between treatments. Each GTE capsule contained 260 mg of polyphenols. At the beginning and at the end of each treatment, participants were submitted to evaluation of blood pressure (ambulatory blood pressure monitoring, ABPM), endothelial function (Endo-PAT 2000 and cellular adhesion molecules), nutritional parameters, metabolic profile, and biomarkers of inflammation.

Results: Twenty women age 41.1 ± 8.4 years completed the study. After 4 weeks of GTE supplementation in comparison with placebo, there was a significant decrease (p < 0.05) in systolic blood pressure at 24 hours (?3.61 ± 1.23 vs 1.05 ± 1.34 mmHg), daytime (?3.61 ± 1.26 vs 0.80 ± 1.57 mmHg), and nighttime (?3.94 ± 1.70 vs 1.90 ± 1.66 mmHg). Changes in diastolic blood pressure and in all other parameters did not present a significant difference between GTE and placebo.

Conclusion: The findings of this study suggest that in obese prehypertensive women, short-term daily intake of GTE may decrease blood pressure.     

Heme Iron Concentrate and Iron Sulfate Added to Chocolate Biscuits: Effects on Hematological Indices of Mexican Schoolchildren

Objective: Food fortification is one of the most effective strategies for increasing iron intake in the population. A simple blind trial was conducted to compare the effect of 2 forms of iron fortification and assess the changes in hemoglobin and iron status indices among preschool children from rural communities.

Methods: Hemoglobin was evaluated in 47 children aged 3–6 years old. For 72 days (10-week period), children ate Nito biscuits. Thirteen pupils with elevated hemoglobin levels were assigned to the biscuit control group, and pupils with hemoglobin equal to 13.5 mg/dL or less were randomly allocated to consume fortified biscuits with a heme iron concentrate (n = 15) or iron sulfate (n = 19). Changes in hemoglobin, plasma ferritin, and other hematological indices were evaluated with analysis of variance (ANOVA) for repeated measurements.

Results: Except mean corpuscular hemoglobin concentrations (+1.27 ± 2.25 g/dL), hematological indices increased significantly across the study: Mean corpuscular volume (+2.2 ± 1.0 f/dL), red blood cells (+0.30 ± 0.37 M/μL), mean corpuscular hemoglobin (+1.8 ± 1.74 pg), hemoglobin (+1.68 ± 0.91 g/dL), hematocrit (+3.43% ± 3.03%), and plasma ferritin (+18.38 ± 22.1 μg/L) were all p < 0.05. After 10 weeks, the adjusted effect of the iron-fortified chocolate biscuits in the hemoglobin levels was higher than the control group (+1.1 ± 0.2 g/dL) but no difference was found between consumers of fortified biscuits with heme iron concentrate or iron sulfate (+1.9 ± 0.2 g/dL and +2.0 ± 0.2 g/dL, respectively).

Conclusion: Heme iron concentrate and iron sulfate were equally effective in increasing Hb levels and hematological indices. Processed foods were shown to be an effective, valuable, and admissible intervention to prevent anemia in preschool children.