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Child obeseSeveral B vitamins play important roles in the metabolism of carbohydrates, proteins, fats, and the health of mitochondria, which are involved in energy metabolism. Previous research has indicated that insufficient micronutrient intake can be a contributing factor in childhood obesity, but the results of research have been somewhat inconsistent.

In a new study published in the Journal of Nutrition, researchers examined the associations between serum vitamin B12 and folate concentrations, and intakes of select B vitamins with body fat. Subjects included 1,131 Mexican American children 8-15 yrs. of age who participated in the National Health and Nutrition Examination Survey (NHANES) 2001-2004. Blood samples were analyzed for serum vitamin B12 and folate levels, and dietary questionnaire responses provided information concerning B vitamin intake. Dexa scans of fat mass and total body fat mass were used along with BMI as measures of body fat.

Body mass index, trunk fat mass and total body fat mass increased with age, but children with higher serum levels of B12 and folate had lower measures of BMI, trunk fat and total body fat. Children with normal weight had higher serum B12 levels compared to overweight or obese children. Analysis of B vitamin intake showed that children with higher intakes of thiamin (B1) and riboflavin (B2) were more likely to have a healthy BMI and lower body trunk fat mass.

The results of this study showing the inverse relationship between the status of B12, folate, riboflavin and thiamin suggest that these micronutrients may play a role in the risk reduction of childhood obesity.

Source:
Inong R Gunanti et al. J Nutr. 2014 Dec; 144(12):2027-33. doi: 10.3945/jn.114.201202.

Healthy ManIt is known that a high glycemic index (GI) carbohydrate content in the diet increases insulin levels and can potentially impair fat oxidation. In a new study published in the European Journal of Clinical Nutrition, researchers theorized that refeeding a low GI, moderate carbohydrate diet would improve chances of weight maintenance.

The study involved 32 healthy young men (average 26 years of age) who were not overweight (average BMI 23 kg/m2). For one week, they were overfed at a level of 50% higher than their caloric needs, followed by a three-week caloric restricted diet (-50% of their energy needs). They were then overfed for two weeks at +50% of energy requirement, and given either a low GI (41) or high GI diet (74) and moderate versus high carbohydrate (CHO) intake (50% vs 65% of energy intake). Fat mass and adaptation of fasting macronutrient oxidation were measured.

During the first overfeeding, the subjects gained an average of 1.9 kg body weight, followed by an average weight loss of 6.3 kg while on caloric restricted diet. During the last overfeeding the subjects gained back an average of 2.8 kg. Subjects eating the higher CHO (65%) diet gained more body weight compared to the 50% CHO diet, especially when eating the high GI meals. Re-feeding the high GI diet impaired fat oxidation compared to the low GI diet. The impairment in fasting fat oxidation was correlated with regain in fat mass and body weight. Metabolic impairment after eating the 50% CHO was not significant.

The results of this study show that both higher GI and higher carbohydrate intake can negatively affect fat oxidation leading to body weight regain in healthy men. A lower glycemic index and glycemic load diet enhances the ability to maintain weight after weight loss.

Source:
J Kahlhöfer et al.; European Journal of Clinical Nutrition (2014); 68:1060–1066; doi:10.1038/ejcn.2014.132.

Fruit-shake

A new study found that calcium and vitamin D supplementation may be beneficial in facilitating fat loss for people adopting to an energy-restricted diet.

Dietary calcium, a non-energy-supplying nutrient, has been identified as playing a pivotal role in the regulation of energy and lipid metabolism. Observational studies have demonstrated calcium intake is inversely associated with body weight, dyslipidemia, type 2 diabetes and hypertension. Higher vitamin D intake and elevated level of serum 25(OH)D have been reported to be related to lower adiposity and metabolic health

A new study investigated the effect of calcium plus vitamin D3 (calcium+D) supplementation on anthropometric and metabolic profiles during energy restriction in healthy, overweight (BMI>=24) and obese (BMI>=28) adults with very-low calcium consumption (<600mg/day).

Forty-three subjects were randomly assigned in an open-label, randomized controlled trial to receive either an energy-restricted diet (−500 kcal/d) supplemented with 600 mg elemental calcium and 125 IU vitamin D3 or energy restriction alone for 12 weeks.  Repeated measurements of variance were performed to evaluate the differences between groups for changes in body weight, BMI, body composition, waist circumference, and blood pressures, as well as plasma TG, TC, HDL, LDL, glucose and insulin concentrations.

The study showed a significantly greater decrease in fat mass loss in the calcium + D group  than in the control group, and no significant difference in body weight change between the two groups. The calcium + D group also exhibited greater decrease in visceral fat mass and visceral fat area.  No significant difference was detected for changes in metabolic variables.

These results indicate that, among overweight and obese people with very-low intake levels of calcium, calcium plus vitamin D3 supplementation for 12 weeks may assist fat loss when combined with a energy restriction diet with 500 Cal/day of calorie deficit.

Source: Zhu et al. Nutrition Journal 2013, 12:8

A recently clinical study, published in Obesity and Weight Management, confirmed that positive lifestyle modification program can significantly improve outcomes in people with metabolic syndrome.

Metabolic Syndrome is characterized by central obesity and clustering of cardiovascular risk factors including abnormal or impaired glucose tolerance, raised triglycerides, decreased HDL cholesterol (good cholesterol), elevated blood pressure, and insulin resistance. Studies have shown that the numbers for new cases of pre-diabetes and metabolic syndrome are on the rise, which will have a major impact on the health of Australians. There is an urgent need to develop lifestyle intervention programs for people with metabolic syndrome to prevent the progression of their disease.

Researchers at the University of Colorado Denver conducted a clinical study to evaluate the health outcomes of a 12-week lifestyle modification program. Sixty people with metabolic syndrome were recruited and participated in a 12-week online lifestyle intervention program that prescribed a low-glycemic diet including meal replacement and nutrition bars, nutritional supplementation, and moderate exercise.

At the end of the 12-week intervention program, participants lost an average weight of 5.5 kg. Measures of glycemic control are also improved significantly during the study. Fasting insulin was reduced by 32.3% and 120-minute insulin during an oral glucose tolerance test was reduced by 43.6%. Insulin sensitivity was increased as evidenced by a reduction in the homeostatic model assessment (HOMA) index (by 31.6%) and an increase in the insulin sensitivity index. There were also significant improvements in triglycerides, total cholesterol, and blood pressure, and more than one-third of the participants no longer met the criteria for metabolic syndrome.

This study demonstrates that lifestyle modification program that combines a low-glycemic diet, nutritional supplements, and moderate exercise can successfully produce meaningful weight loss, significant improvements in glycemic control, and significant reductions in risk factors for heart disease in individuals with metabolic syndrome.

Holly Wyatt, a physician and faculty member of the University of Colorado’s Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, oversaw the study. “This is a very promising program that produced some very positive changes in the cardiovascular risk factors associated with the metabolic syndrome,” Dr. Wyatt said. “The shifts in dietary habits to calorically restricted low-glycemic meals and the modest increases in physical activity not only were effective but also are realistic behavioral changes many people can make.”

Source:
Holly R. Wyatt et al; Obesity and Weight Management. August 2009:167-173

 

Weight control strategies that are both safe and effective are needed to reduce the rate of the current obesity epidemic. People incorporating fortified meal replacements are more likely to have adequate essential nutrient intakes compared to a group following a more traditional food group diet.

A study published in the Nutrition Journal compared the macronutrient and micronutrient levels in the foods chosen by women following two different weight reduction programs.

Ninety-six generally healthy overweight or obese women randomly placed into two treatment groups:

  • Traditional Food Group (TFG); or
  • A Meal Replacement Group (MRG).

The MRG included the use of 1-2 meal replacement drinks or bars per day. Both groups aimed to restrict energy levels to approximately 1,300 calories per day.

After one year, weight loss was not significantly different between the groups, and both groups had macronutrient (Carbohydrate:Protein:Fat) ratios that were within the ranges recommended. Both groups experienced an improved dietary pattern with respect to decreased saturated fat, cholesterol, and sodium, with increased total servings/day of fruits and vegetables. However, the TFG had a significantly lower dietary intake of several vitamins and minerals compared to the MRG and were at greater risk for inadequate intake.

Although both groups successfully lost weight while improving overall dietary adequacy, the group incorporating fortified meal replacements tended to have a more adequate essential nutrient intake compared to the group following a more traditional food group diet.

This study supports the need to incorporate fortified foods and/or dietary supplements while following an energy-restricted diet for weight loss.

Source:
Ashley JM et al. Nutr J. 2007 Jun 25; 6:12.

 

Weight control strategies that are both safe and effective are needed to reduce the rate of the current obesity epidemic. People incorporating fortified meal replacements are more likely to have adequate essential nutrient intakes compared to a group following a more traditional food group diet.

A study published in the Nutrition Journal compared the macronutrient and micronutrient levels in the foods chosen by women following two different weight reduction programs.

Ninety-six generally healthy overweight or obese women randomly placed into two treatment groups: Traditional Food Group (TFG) or a Meal Replacement Group (MRG). The MRG included the use of 1-2 meal replacement drinks or bars per day. Both groups aimed to restrict energy levels to approximately 1,300 calories per day. After one year, weight loss was not significantly different between the groups, and both groups had macronutrient (Carbohydrate:Protein:Fat) ratios that were within the ranges recommended. Both groups experienced an improved dietary pattern with respect todecreased saturated fat, cholesterol, and sodium, with increased total servings/day of fruits and vegetables. However, the TFG had a significantly lower dietary intake of several vitamins and minerals compared to the MRG and were at greater risk for inadequate intake.

Although both groups successfully lost weight while improving overall dietary adequacy, the group incorporating fortified meal replacements tended to have a more adequate essential nutrient intake compared to the group following a more traditional food group diet. This study supports the need to incorporate fortified foods and/or dietary supplements while following an energy-restricted diet for weight loss.

Source:
Ashley JM et al. Nutr J. 2007 Jun 25; 6:12.

The prevalence of overweight and obesity in adolescents is increasing worldwide.  Studies have shown that obese children and adolescents have an increased prevalence of metabolic risk factors for cardiovascular disease, type 2 diabetes, and, more recently, fatty liver disease.

In parallel with increasing prevalence of obesity in adolescents, it is expected that long-term morbidity in this population will increase.  A recent Australian research investigated the association between measures of adiposity (body mass index and waist circumference) and risk factors for heart disease, type 2 diabetes, fatty liver disease, and the clustering of risk factors in middle adolescence.

496 year 10 students (mean age – 15.4 years) in the Sydney metropolitan area were included in this study.  Blood samples were collected for biomarker studies including lipids (HDL and LDL cholesterol, triglycerides), insulin and glucose, liver health (ALT and GGT), high-sensitivity CRP (a marker for inflammation and risk predictor for cardiovascular disease), and blood pressure.

The study found that:

  • The prevalence of overweight and obesity in adolescent boys was 27.6%, based on BMI (body mass index calculated as weight in kilograms divided by height in meters squared), and 20.0% based on waist circumference cut points. The prevalence of overweight and obesity in adolescent girls was 19.4% based on BMI and 18.0% based on waist circumference.
  • Adolescent boys are more likely to have multiple risk factors than adolescent girls, particularly if they are overweight or obese.
  • 95% of obese and 80% of overweight adolescent boys had at least 1 risk factor.
  • Obese adolescent boys and girls were significantly more likely to have 2 or more risk factors than non-overweight adolescents.
  • The cardiovascular risk factors were relatively common, with high blood pressure being the most prevalent risk factor in adolescent boys (22.1%) and girls (10.8%).
  • Low HDL cholesterol levels and elevated high sensitivity-CRP levels were also relatively common, with 10.7% of adolescent boys and 3.9% of adolescent girls having low HDL cholesterol levels and 7.5% of adolescent boys and 8.6% of adolescent girls having high hs-CRP levels.
  • 4.5% of adolescent boys and 6.3% of adolescent girls have abnormal LDL cholesterol level.

Analysis on the clustering of risk factors indicates that Insulin, ALT, GGT, HDL cholesterol, high-sensitivity CRP, and blood pressure were significantly associated with overweight and obesity in adolescent boys. In adolescent girls, insulin, high-density lipoprotein cholesterol, and high-sensitivity C-reactive protein were significantly associated with overweight and obesity.

Previous studies suggested that the presence of more than 1 risk factor in childhood presents an increased risk of cardiovascular disease in adulthood.  Identifying adolescents at risk for long-term morbidity and offering early intervention may improve long-term outcomes.

Source:
Elizabeth Denney-Wilson et al (2008); Arch Pediatr Adolesc Med. 162(6):566-573

Health authorities worldwide have uniformly stressed the importance of diet and lifestyle as the primary means of lowering serum lipids and coronary heart disease (CHD) risk.  Combining foods with known cholesterol-lowering properties can help to reduce serum cholesterol effectively under metabolically controlled conditions.

To assess the effect of a dietary portfolio on percentage change in low-density lipoprotein cholesterol (LDL-C), Canadian researchers conducted a parallel-design study of 351 participants with
Hyperlipidemia, from 4 participating academic centers across Canada randomized between June 2007 and February 2009.

Participants received dietary advice for 6 months on either a low-saturated fat therapeutic diet (control) or a dietary portfolio that emphasized dietary incorporation of plant sterols, soy protein, viscous fibers, and nuts. Routine dietary portfolio involved 2 clinic visits over 6 months and intensive dietary portfolio involved 7 clinic visits over 6 months.

The study found that Percentage LDL-C reductions for each dietary portfolio (13%) were significantly more than the control diet (3%).  A diet rich in soy, fibre, plant sterol, and nuts did better at lowering levels of LDL than a diet low in saturated fats such as low fat dairy, suggesting that certain cholesterol-friendly foods can be more effective in lowering levels of LDL, or ‘bad cholesterol’ than foods merely low in saturated fats.

Dr. David Jenkins, the lead author concludes that “This study indicated the potential value of using recognized cholesterol-lowering foods in combination”.  Such dietary approach may have clinical application, and clinicians may consider recommending to patients.

Source:
David J. A. Jenkins et al; JAMA August 2011; Vol 306(8): 831-839

Although 70% Alaskan Eskimos are overweight or obese, they did not show the same risk factors for heart disease as the US population.  They also had a lower prevalence of diabetes.  The latest study suggested that an Omega-3 rich diet may offer protection against some of the harmful effects of obesity.

It has been known that Omega-3 fatty acids are associated with favorable, and obesity with unfavorable, concentrations of chronic disease risk biomarkers.

In a cross-sectional study, the researchers analyzed data from 330 people living in the Yukon Kuskokwim Delta region of south-west Alaska, who typically consume around 20 times as much omega-3 fats from fish as the average American.  They have similar overweight and obesity levels to those in the US overall but their prevalence of type 2 diabetes is significantly lower, at 3.3% versus 7.7%.

The researchers examined whether high eicosapentaenoic (EPA) and docosahexaenoic (DHA) acid intakes, measured as percentages of total red blood cell (RBC) fatty acids, modify associations of obesity with chronic disease risk biomarkers.

The study found that those with the highest levels of the omega-3 fish oils docosahexaenoic acid and eicosapentaenoic acid had the lowest triglyceride and C-reactive protein levels.  High RBC EPA and DHA were associated with attenuated dyslipidemia and low-grade systemic inflammation among overweight and obese persons. This may help inform recommendations for Omega-3 fatty acid intakes in the reduction of obesity-related disease risk.

Source:
Z Makhoul et al; European Journal of Clinical Nutrition; advance online publication 23 March 2011; doi: 10.1038/ejcn.2011.39

23 April 2011

In white adults, being overweight or obese (and possibly underweight) is associated with increased all-cause mortality. All-cause mortality is generally lowest with a BMI of 20.0 to 24.9.

A high body-mass index (BMI) is associated with increased mortality from cardiovascular disease and certain cancers, but the precise relationship between BMI and all-cause mortality remains uncertain.

A large analysis reported in the December 2, 2010 issue of the New England Journal of Medicine confirms the relationship between being overweight or obese and a greater risk of dying from all causes.

An international team of researchers pooled data from 19 prospective studies totalling 1,462,958 white male and female participants between the ages of 19 and 84.  Body mass index (BMI), calculated by dividing a person’s weight in kilograms by the square of their height in meters, was determined for all subjects. The participants were followed for periods that ranged from 7 to 28 years, during which 160,087 deaths occurred.

Upon enrollment, the average BMI was 26.2.  Compared with women whose body mass index was between 22.5 and 24.9, having a BMI of 25 to 29.9 correlated with a 13 percent greater risk of death over the follow-up period.  This risk rose with increasing body mass index categories, with women whose BMI was 40 to 49.9 having 2.5 times the risk of death from all causes than those with a BMI of 22.5 to 24.9.  Risks among men were similar. Although a small risk of death was also observed for those whose BMI was below 20, the authors suggest that the finding was in part caused by pre-existing disease.

To learn more or to calculate your BMI, please visit the following link:
http://www.nhlbisupport.com/bmi/

Source:
de Gonzalez AB, Phil D, et al. 2010. N Engl J Med 363:2211-9.

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