Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men

Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
New England Journal of Medicine (Impact Factor: 55.87). 06/2011; 364(25):2392-404. DOI: 10.1056/NEJMoa1014296
Source: PubMed

ABSTRACT Specific dietary and other lifestyle behaviors may affect the success of the straightforward-sounding strategy "eat less and exercise more" for preventing long-term weight gain.
We performed prospective investigations involving three separate cohorts that included 120,877 U.S. women and men who were free of chronic diseases and not obese at baseline, with follow-up periods from 1986 to 2006, 1991 to 2003, and 1986 to 2006. The relationships between changes in lifestyle factors and weight change were evaluated at 4-year intervals, with multivariable adjustments made for age, baseline body-mass index for each period, and all lifestyle factors simultaneously. Cohort-specific and sex-specific results were similar and were pooled with the use of an inverse-variance-weighted meta-analysis.
Within each 4-year period, participants gained an average of 3.35 lb (5th to 95th percentile, -4.1 to 12.4). On the basis of increased daily servings of individual dietary components, 4-year weight change was most strongly associated with the intake of potato chips (1.69 lb), potatoes (1.28 lb), sugar-sweetened beverages (1.00 lb), unprocessed red meats (0.95 lb), and processed meats (0.93 lb) and was inversely associated with the intake of vegetables (-0.22 lb), whole grains (-0.37 lb), fruits (-0.49 lb), nuts (-0.57 lb), and yogurt (-0.82 lb) (P≤0.005 for each comparison). Aggregate dietary changes were associated with substantial differences in weight change (3.93 lb across quintiles of dietary change). Other lifestyle factors were also independently associated with weight change (P<0.001), including physical activity (-1.76 lb across quintiles); alcohol use (0.41 lb per drink per day), smoking (new quitters, 5.17 lb; former smokers, 0.14 lb), sleep (more weight gain with <6 or >8 hours of sleep), and television watching (0.31 lb per hour per day).
Specific dietary and lifestyle factors are independently associated with long-term weight gain, with a substantial aggregate effect and implications for strategies to prevent obesity. (Funded by the National Institutes of Health and others.).

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    ABSTRACT: A number of animal and human investigations have demonstrated that dietary supplementation with non-digestible carbohydrates (NDC) improves appetite regulation and bodyweight. These positive metabolic effects have been linked to the elevated production of short chain fatty acids (SCFAs) through fermentation of NDC by the colonic microbiota. Of the principle SCFAs, propionate has the highest affinity for free fatty acid receptor 2 (FFAR2), which is expressed on colonic L-cells and upon stimulation secretes anorectic hormones. Augmenting colonic propionate is therefore an attractive target to improve appetite regulation and, as part of the BBSRC DRINC initiative, we developed a novel dietary molecule, inulin-propionate ester that we demonstrate increases colonic propionate levels in humans. Our further studies with inulin-propionate ester in human volunteers suggest that dietary interventions that enhance colonic propionate levels may be a strategy to improve appetite regulation and weight management at the population level.
    Nutrition Bulletin 09/2015; 40(3). DOI:10.1111/nbu.12157
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    • "However, some epidemiologic studies examining the association between dietary folate intake and leukocyte DNA methylation in healthy subjects reported null associations (Moore et al. 2008; Choi et al. 2009; Zhang et al. 2011a). The Mediterranean diet (MD) is widely recognized to be the optimal diet for disease prevention and for good health, and independently of energy and macronutrient intakes, a better adherence to MD is associated with lower obesity risk (Mozaffarian et al. 2011; Martı`nez-Gonzàlez et al. 2012; Barchitta et al. 2014b). Focusing on dietary patterns, a recent study reported that a high intake of dark green vegetables was associated with LINE-1 hypermethylation in a cancer-free population (Zhang et al. 2011a). "
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    ABSTRACT: Several dietary agents, such as micronutrient and non-nutrient components, the so-called bioactive food components, have been shown to display anticancer properties and influence genetic processes. The most common epigenetic change is DNA methylation. Hypomethylation of long interspersed elements (LINE-1) has been associated with an increased risk of several cancers, although conflicting findings have also been observed. The aim of the present study was to test the hypothesis that a low adherence to the Mediterranean diet (MD) and folate deficiency may cause LINE-1 hypomethylation in blood leukocytes of healthy women, and thus genomic instability. One hundred and seventy-seven non-pregnant women were enrolled. Mediterranean diet score (MDS) and folate intake were calculated using a food frequency questionnaire. LINE-1 methylation level was measured by pyrosequencing analysis in three CpG sites of LINE-1 promoter. According to MDS, only 9.6 % of subjects achieved a high adherence to MD. Taking into account the use of supplements, there was a high prevalence of folate deficiency (73.4 %). Women whose consumption of fruit was below the median value (i.e., <201 gr/day) were 3.7 times more likely to display LINE-1 hypomethylation than women whose consumption was above the median value (OR 3.7; 95 % CI 1.4-9.5). Similarly, women with folate deficiency were 3.6 times more likely to display LINE-1 hypomethylation than women with no folate deficiency (OR 3.6; 95 % CI 1.1-12.1). A dietary pattern characterized by low fruit consumption and folate deficiency is associated with LINE-1 hypomethylation and with cancer risk.
    Genes & Nutrition 09/2015; 10(5):480. DOI:10.1007/s12263-015-0480-4 · 2.79 Impact Factor
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    • "Our findings are consistent with studies from high-income countries that have assessed the influence on obesity of foods that could be classified as ultra-processed. In the US, positive associations have been seen between consumption of potato chips, SSBs, and processed meat and long-term weight gain; with protective associations of unprocessed or minimally processed foods such as fruits, vegetables, nuts, and yogurt (Mozaffarian et al., 2011). Also, a 15-year prospective study showed that fast food consumption among young adults was directly associated with changes in body weight and insulin resistance (Pereira et al., 2005). "
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    ABSTRACT: Objectives: The aim of this study was to evaluate the relationship between the consumption of ultra-processed foods and obesity indicators among Brazilian adults and adolescents. Methods: We used cross-sectional data on 30,243 individuals aged ≥10years from the 2008-2009 Brazilian Dietary Survey. Food consumption data were collected through 24-h food records. We classified food items according to characteristics of food processing. Ultra-processed foods were defined as formulations made by the food industry mostly from substances extracted from foods or obtained with the further processing of constituents of foods or through chemical synthesis, with little if any whole food. Examples included candies, cookies, sugar-sweetened beverages, and ready-to-eat dishes. Regression models were fitted to evaluate the association of the consumption of ultra-processed foods (% of energy intake) with body-mass-index, excess weight, and obesity status, controlling for socio-demographic characteristics, smoking, and physical activity. Results: Ultra-processed foods represented 30% of the total energy intake. Those in the highest quintile of consumption of ultra-processed foods had significantly higher body-mass-index (0.94kg/m(2); 95% CI: 0.42,1.47) and higher odds of being obese (OR=1.98; 95% CI: 1.26,3.12) and excess weight (OR=1.26; 95% CI: 0.95,1.69) compared with those in the lowest quintile of consumption. Conclusion: Our findings support the role of ultra-processed foods in the obesity epidemic in Brazil.
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