To determine whether a very low-fat diet (<15% of energy intake) consumed ad libitum during an 8-month period can achieve weight loss of 5% to 10% of initial body weight while still providing adequate intakes of other essential nutrients.
Longitudinal, 8-month, ad libitum, free living, very low-fat diet trial.
Fifty-four of the sixty-four healthy postmenopausal women recruited completed the entire study (age 59+/-8 years, BMI=29.6+/-6.3). Twenty-four of these women used hormone replacement therapy, thirty women did not.
Weekly sessions aimed at teaching and reinforcing a very low-fat intake diet for eight months. MAIN: outcome measures Body weight, percent body fat, waist-to-hip ratio, resting energy expenditure, respiratory quotient, and nutrient intakes derived from 7-day food records at the beginning and at 2, 4, 6, and 8 months of the study. Statistical analysis performed Repeated measures analysis of variance and Tukey post hoc analysis were used to analyze significant differences in mean data (P<.05).
Fat intake decreased from 33.2+/-7.5% to 11+/-4% over the 8-month intervention period (P<.00001). Weight loss was 6.0 kg+/- 4.2 kg (P<.000038), an 8% weight change, and decrease in percent body fat of 2.7%+/-0.2% (P< or =.000046). Weight correlated better with the self-reported fat intake (r=0.321, P<.01) than the energy intake (r=0.263, P<.05) at baseline. Fiber intake increased from 16 g+/-0.6 g to 23 g+/-0.2 g (P<.0005). All micronutrient intakes remained at or above preintervention ranges, except for a decrease in vitamin E intake from 8.1 mg+/-4.0 mg to 3.7 mg+/-1.1 mg (P<.0005) on the very low-fat diet and linoleic acid from 6.3%+/-1.5% to 2.5%+/-0.7% (P<.000001) with no significant reduction in linolenic acid. Hormone replacement was not associated with the amount of weight loss.
This study demonstrates that adherence to a very low-fat diet consumed ad libitum causes weight loss in the 5% to 10% range and a reduction of body fat. These reductions, along with the observed decreases in fat intake, are associated with improved health outcomes. Because of the decreased vitamin E and n-3 fatty acid intake, emphasis on foods high in these nutrients may need to be encouraged for those consuming a very low-fat diet.
[Show abstract][Hide abstract] ABSTRACT: Crohn's disease and ulcerative colitis are chronic dis- abling inflammatory bowel diseases (IBDs). Although the causes of IBD are unknown, defects in innate and adaptive immune pathways have been identified and biological therapies that target key molecules have been designed. Infliximab, a chimeric immunoglobulin (Ig)G1 monoclonal antibody to tumor necrosis factor, dramatically improved treatment of patients with Crohn's disease and ulcerative colitis. Infliximab has achieved treatment goals such as mucosal healing and decreasing the need for hospitalizations and surgeries. Although several anti-tumor necrosis factor therapies have been developed, there is a great need for drugs that target other pathways. Natalizumab, an antibody against the integrin 4 subunit, blocks leukocyte adhe- sion and has reached the clinic in the United States but has not been approved in the European Union; other anti-adhesion molecules currently are under develop- ment. Additional approaches under clinical develop- ment include therapeutics that target cytokines, such as interleukin-12/23, as well as those that block T-cell sig- naling. The use of recombinant human proteins, in- cluding immunoregulatory cytokines and growth fac- tors, has not been successful so far. The efficacy of each therapy must be shown in carefully designed clinical programs. Biological therapies carry a definite safety risk, so their place in treatment algorithms must be defined carefully.
[Show abstract][Hide abstract] ABSTRACT: Abstract During aging a reduction of energy metabolism, energy intake and fat free mass can be seen. Some elderly patients experience more,pronounced,body weight loss that may,lead to malnutrition states. The reasons for the unintentional body weight loss, that often accompanies chronic disease, are poorly understood. A combination of poor nutritional state and impaired physical function increases the risk for dependency,in the daily living and further deterioration of health. Treatment needs to focus on the one hand of optimizing disease management,and on the other on nutrition and physical function. The aim of this thesis was to study several nutrition related parameters in frail elderly people and try to gain a deeper understanding,of the mechanisms,contributing to the nutritional problems in elderly patients, also focusing on treatment and follow-up. This was done by analyzing energy intake, body composition and energy metabolism in both nursing home patients and free-living, frail elderly individuals. Individualized nutritional treatments were applied and analyzed longitudinally. In the free-living group,a three-month randomized,controlled trial (RCT) with four arms was performed (nutritional treatment, physical training, both combined or control). The results showed that energy intake was low (mean total intake below 1600 kcal/day, mean
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