Does a Healthy Diet Help Weight Management Among Overweight and Obese People?

Cancer Prevention and Control Program, Moores Cancer Center, University of California, San Diego, La Jolla, CA 92093-0901, USA.
Health Education & Behavior (Impact Factor: 2.23). 05/2009; 36(3):518-31. DOI: 10.1177/1090198108314617
Source: PubMed


A randomized dietary intervention trial across 4 years examined diet, weight, and obesity incidence (body mass index [BMI] > or = 30 kg/m(2)) differences between study groups. Participants were 1,510 breast cancer survivors with BMI > or = 25 kg/m(2) at entry. Dietary intake was assessed yearly by telephone; weight and height were measured at clinic visits. Intervention participants consumed more fruit, vegetables, and fiber and less energy from fat than control participants during follow-up cross-sectionally (p < .0001) and longitudinally (p < .0001); weight did not differ between study groups at any follow-up visit, and significant weight change difference was observed between groups only in the 1st year (p < .0001). Diet and weight results remained unchanged after stratifying by age and BMI. No difference in obesity incidence was found during follow-up (p > .10) among overweight members of either study group. Without specific efforts to reduce total energy intake, dietary modification does not reduce obesity or result in long-term weight loss.

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    • "They may also reflect longer term influences (over a period of years) of vegetables and fruit on body weight. Cohort studies show either an inverse association between vegetable or fruit consumption and body weight and some studies showing a null result [32, 33]. Again this may be consistent with our finding of a small negative effect on body weight of greater vegetable and fruit consumption. "
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    ABSTRACT: Increased vegetable and fruit consumption is encouraged to promote health, including the maintenance of a healthy body weight. Population health strategies (e.g. 5-A-Day or similar campaigns and subsidies on vegetables or fruit) that emphasize increased consumption may theoretically lead to increased energy intake and weight gain. We undertook a systematic review of trials that sought to increase vegetable and fruit consumption, in the absence of advice or specific encouragement to remove other foods from the diet, to understand the effect on body weight and energy intake. We included only randomised controlled trials. We pooled data using a random effects model for two outcomes: change in body weight and change in energy intake. Sensitivity and secondary analyses were also undertaken, including a one-study removed analysis and analysis by study sub-type to explore sources of heterogeneity. A total of eight studies, including 1026 participants, were identified for inclusion in the review. The mean study duration was 14.7 weeks (range four to 52 weeks). The mean difference in vegetable and fruit consumption between arms was 133 g (range 50 g to 456 g). The mean change in body weight was 0.68 kg (95% CI: 0.15-1.20; n = 8; I2 for heterogeneity = 83%, p = 0.01) less in the “high vegetable and fruit” intake arms than in the “low vegetable and fruit intake” arms. There was no significant difference in measured change daily energy intake between the two arms (368 kJ; 95% CI: -27 to 762, comparing high vs low; n = 6; I2 = 42%, p = 0.07). Promoting increased fruit and vegetable consumption, in the absence of specific advice to decrease consumption of other foods, appears unlikely to lead to weight gain in the short-term and may have a role in weight maintenance or loss. Longer studies or other methods are needed to understand the long-term effects on weight maintenance and loss.
    Full-text · Article · Aug 2014 · BMC Public Health
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    ABSTRACT: The favorable prognosis for early stage breast cancer survivors may be a reason for the minimal research regarding their quality of life. Prior research has observed more long-term weight gain among early stage survivors compared to cancer-free women of a similar age. It would be useful to study survivors' perceptions and reported behaviors regarding diet and exercise to see if there is a correlation with previous studies. A sample of 700 breast cancer survivors from Ohio and Michigan was randomly selected from the Northwest Ohio affiliate of the Susan G. Komen For the Cure mailing list and sent a survey for completion. 389 survivors completed the survey and among Stage 1 (50/197 = 25.4%) and Stage 2 survivors (24/105 = 22.9%), a small proportion had a positive correlation between self-reported dietary behaviors and their perceived benefits of eating fruits and vegetables. Similar correlations were observed between their self-reported exercise behaviors and their perceived benefits of exercise (Stage 1: 36/197 = 18.3%, Stage 2: 18/105 = 17.1%). Regardless of stage, a small proportion of survivors' self-reported dietary and exercise behaviors match their perceived benefits of diet and exercise. Factors such as access, motivation, and lack of co-morbidities among early stage survivors may prevent them from living healthier post-diagnosis. More thorough dietary and clinical measurements will provide greater certainty. Thus, innovative, sustainable programs must be accessible and provide motivation and social support from family, friends, and other survivors to truly improve quality of life.
    Full-text · Article · Nov 2010 · Breast cancer
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    ABSTRACT: Optimum levels and types of dietary fibre that provide the greatest beneficial effects on metabolic syndrome risk factors in overweight and obese individuals have yet to be determined in clinical trials. The present parallel design study compared the effects of fibre intake from a healthy diet v. a fibre supplement (psyllium) or a healthy diet plus fibre supplement on fasting lipids, glucose, insulin and body composition. Overweight/obese adults were randomised to either control (with placebo), fibre supplement (FIB), healthy eating plus placebo (HLT) or healthy eating plus fibre supplement (HLT-FIB). There was a significant increase in fibre intake in HLT-FIB, HLT and FIB groups up to 59, 31 and 55 g, respectively, at 12 weeks when compared to control (20 g). Weight, BMI and % total body fat were significantly reduced in FIB and HLT-FIB groups, with weight and BMI significantly reduced in the HLT group compared with control at 12 weeks. HLT-FIB and HLT groups had significant reductions in TAG and insulin compared with control at 6 and 12 weeks, and in insulin compared with the FIB group at 12 weeks. The HLT-FIB, HLT and FIB groups all had significant reductions in total cholesterol and LDL-cholesterol compared with control after 6 and 12 weeks. The present study demonstrated that simply adding psyllium fibre supplementation to a normal diet was sufficient to obtain beneficial effects in risk factors. However, a high-fibre diet consisting of a psyllium supplement plus fibre from a healthy diet provided the greatest improvements in metabolic syndrome risk factors.
    Full-text · Article · Jan 2011 · The British journal of nutrition
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