Article

Kefir drink leads to a similar weight loss, compared with milk, in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women: a randomized controlled trial

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Abstract

Purpose: Controversy exists regarding whether increasing dairy intake without energy restriction would lead to weight loss. We aimed to compare the potential weight-reducing effects of kefir drink (a probiotic dairy product) and milk in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women. Methods: One hundred and forty-four subjects were assessed for eligibility in this single-center, multi-arm, parallel-group, randomized controlled trial. Of these, seventy-five eligible women aged 25-45 years were randomly assigned to three groups, labeled as control, milk, and kefir, to receive an outpatient dietary regimen for 8 weeks. Subjects in the control group received a diet providing a maintenance level of energy intake, containing 2 servings/day of low-fat dairy products, while those in the milk and kefir groups received a weight maintenance diet, containing 2 additional servings/day (a total of 4 servings/day) of dairy products from low-fat milk or commercial kefir drink, respectively. Anthropometric outcomes including weight, body mass index (BMI), and waist circumference (WC) were measured every 2 weeks. Results: Fifty-eight subjects completed the study. Using analysis of covariance models in the intention-to-treat population (n = 75), we found that at 8 weeks, subjects in the kefir and milk groups had significantly greater reductions in weight, BMI, and WC compared to those in the control group (all p < 0.01). However, no such significant differences were found between the kefir and milk groups. Conclusions: Kefir drink leads to a similar weight loss, compared with milk, in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women. However, further studies are warranted.

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... Twenty-two included studies examined the relationship between consumption of yogurt and cultured fermented milk and weight and body composition 70,93-113 ; 5 were RCTs, 96,107,108,112,113 9 were cohort studies, 94,100-102, 104,106,109-111 and 8 were CS studies. 70,81,[93][94][95][97][98][99]105 Six studies 96,97,107,108,112,113 were positive quality and focused on body composition, weight loss, obesity, and muscle soreness. The remaining 16 studies 70,[98][99][100][101][102][103][104][105][106][109][110][111] were neutral quality. ...
... The remaining 16 studies 70,[98][99][100][101][102][103][104][105][106][109][110][111] were neutral quality. In 21 of the 22 studies, [93][94][95][97][98][99][100][101][102][103][104][105][106][107][108][109][110][111][112][113] subjects were fed yogurt, and in the remaining study 96 they were fed kefir. Eighteen of the 22 studies 94-107, 109-111,113 reported a favorable outcome for weight control or positive body composition effect, and 4 studies 70,93,108,112 reported no effect. ...
... The 6 positive-quality studies comprised 5 RCTs 96,107,108,112,113 and one CS study. 97 Three of the positive-quality RCTs evaluated body composition changes with yogurt consumption; in one trial subjects were fed bifidobacteria-fermented milk, while in another they were fed kefir. ...
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Consumption of yogurt and other fermented products is associated with improved health outcomes. Although dairy consumption is included in most dietary guidelines, there have been few specific recommendations for yogurt and cultured dairy products. A qualitative systematic review was conducted to determine the effect of consumption of fermented milk products on gastrointestinal and cardiovascular health, cancer risk, weight management, diabetes and metabolic health, and bone density using PRISMA guidelines. English language papers in PubMed were searched, with no date restrictions. In total, 1057 abstracts were screened, of which 602 were excluded owing to lack of appropriate controls, potential biases, and experimental design issues. The remaining 455 papers were independently reviewed by both authors and 108 studies were included in the final review. The authors met regularly to concur, through consensus, on relevance, methods, findings, quality, and conclusions. The included studies were published between 1979 and 2017. From the 108 included studies, 76 reported a favorable outcome of fermented milks on health and 67 of these were considered to be positive or neutral quality according to the Academy of Nutrition and Dietetics' Quality Criteria Checklist. Of the 32 remaining studies, the study outcomes were either not significant (28) or unfavorable (4), and most studies (18) were of neutral quality. A causal relationship exists between lactose digestion and tolerance and yogurt consumption, and consistent associations exist between fermented milk consumption and reduced risk of breast and colorectal cancer and type 2 diabetes, improved weight maintenance, and improved cardiovascular, bone, and gastrointestinal health. Further, an association exists between prostate cancer occurrence and dairy product consumption in general, with no difference between fermented and unfermented products. This article argues that yogurt and other fermented milk products provide favorable health outcomes beyond the milk from which these products are made and that consumption of these products should be encouraged as part of national dietary guidelines. Systematic review registration: PROSPERO registration no. CRD42017068953.
... Three trials assessed probiotics delivered in capsules, 26,35,36,38 6 studies evaluated probiotics in powder, [29][30][31]33,34,39,50 6 studies evaluated yogurt, fermented milk, or cheese enriched with probiotics, 25,32,37,40,41,46,47,51,52 and 1 study assessed probiotics contained in a kefir beverage. 27,28 Three trials evaluated synbiotics in capsules [42][43][44][45] or sachet powder. 48 Most of the trials used nonactive comparators, that is, products that contained no probiotics or synbiotics, or placebo. ...
... 48 Most of the trials used nonactive comparators, that is, products that contained no probiotics or synbiotics, or placebo. 25,27,28,32,37,[40][41][42]46,47,51,52 Six RCTs assessed more than 2 randomized groups in the study. Agerholm-Larser et al 25 evaluated 5 groups: 3 groups received fermented milk with different strains of probiotics, 1 control group received fermented milk with organic acid, and another control group received placebo tablets. ...
... Four studies included female participants only. [27][28][29][30][35][36][37] Five trials included patients with comorbidities other than excess weight: type 2 diabetes treated with insulin, 39 type 2 diabetes and concomitant coronary artery disease, 49 nonalcoholic liver disease, 40,41 hypertension, 46,47 and metabolic syndrome. 42 Eight studies included healthy participants only, despite such participants being overweight or obese. ...
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Context: Recent evidence suggests that modulation of the gut microbiota may contribute to body weight control. Objective: This systematic review aimed to assess the effects of oral supplementation with probiotics or synbiotics on body weight, body mass index (BMI), and waist circumference in overweight and obese adults (BMI ≥ 25 kg/m2). Data sources: Five electronic databases-PubMed, Embase, Cochrane Library/CENTRAL, LILACS, and Web of Science-were searched from inception to August 2017. No language restrictions were applied. Study selection: Randomized and quasi-randomized parallel trials that assessed the effects of oral supplementation with probiotics or synbiotics vs any other intervention but bariatric surgery or fecal transplantation in overweight or obese adults were selected. Data extraction: Three teams of 2 authors independently assessed risk of bias and extracted data from the included trials. Data were pooled using inverse-variance random-effects meta-analyses. The quality of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. Results: Nineteen randomized trials (28 publications, 1412 participants) were included. There were no differences in mean body weight change [mean difference (MD), -0.54 kg; 95%CI, -1.09 to 0.01; I2 = 0%; moderate quality of evidence) or mean BMI change (MD, -0.19 kg/m2; 95%CI, -0.43 to 0.04; I2 = 51%; low quality of evidence) between groups who received probiotics or synbiotics and control groups. Oral supplementation with probiotics or synbiotics reduced mean waist circumference compared with control (MD, -0.82 cm; 95%CI, -1.43 to -0.21; I2 = 46%; low quality of evidence). Conclusions: The findings suggest that oral supplementation with probiotics or synbiotics has a small effect to reduce waist circumference but no effect on body weight or BMI, although the quality of evidence is low to moderate. Therefore, the current evidence is not definitive. Large-scale trials are needed and may help to better inform clinical practice. Systematic review registration: PROSPERO registration number CRD42018075126.
... The participants were divided into 3 groups: group 1 (control) received a diet of two portions of dairy products with low fat content, in addition to energy maintenance foods; group 2 (milk) and group 3 (kefir), received a weight maintenance diet containing two additional servings/day of skimmed milk products or commercial kefir drink respectively. Only 58 people completed the study for 8 weeks [39]. ...
... Fathi et al. [39] found that both showed a reduction in waist circumference, weight and body mass index, so this shows that there were no differences between them. However, the study carried out by Kim et al. [40] found that animals supplemented with kefir reduced weight and pro-inflammatory markers, showed small accumulations of fat around the liver and improving liver damage; thus kefir showed an improvement in obesity and liver disease. ...
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The amount of available information in the media grows continuously and, frequently, it does not have a basis in the scientific literature. In the area of food and nutrition, the contents are available on social media profiles, websites and blogs, which usually appoint some foods as “superfoods” – able of curing diseases or inhibiting their development – or, on the other hand, classifying other foods as the cause of damage to health. Kefir-based products can be classified in the first category, being considered a “superfood” by the media. Thus, the aim of this study is to search for information about kefir in digital media and to evaluate such information based on scientific articles. The contents were collected from 50 websites or blogs, using Google as a search tool. The data obtained were divided into 25 positive categories and 5 negative categories. One made a comparison with the scientific literature. Analyzing the information about kefir, the majority has a scientific basis, however, digital media put the research data in a superficial way, without clear information to readers.
... Unfortunately, in many developing countries it is not so noteworthy and only a limited number of women are working in management and decision making positions. In other words, only 2.8 percent of managerial jobs in the country are dedicated to women (Fathi et al., 2016). According to statistics provided and from another perspective, the presence of women in managerial positions could improve the performance of management and organization (Salloum et al., 2016). ...
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Background: The aim of this study has been to investigate the relationship between social factors and the promotion of women to management position in sport organizations in Iran. Method: Regarding the objective, this study is practical and regarding the method of implementation, it is descriptive, the population of this research in 2021, includes all the staff of the Youth and Sports Office of West Azerbaijan of Iran up to 216 people. Using Morgan's tables 136 subjects were selected through stratified random sampling as the sample. In order to collect data, the questionnaires of social factors of the promotion of women to management positions were used, the validity of which was confirmed by experts and its reliability was obtained to be 0.86 through Cronbach's alpha test. Results: The results indicate that there is a positive significant relationship between gender and gender discrimination and women's promotion to the position of management in sport organizations. In addition, there is also a positive significant relationship between the elimination of conflict between work and family and also family support and women's promotion to manage mint positions in sports organizations. Conclusions: However, it appears that women are still faced with gender equity issues in sports governance, athletic media representation, and perception in sports. Therefore, the field of sport management should continue to work towards a level of quality that truly treats women as equals, offers them equal opportunity, and permits them to feel equal in sport management and athletic participation.
... On the other hand, St-Onge et al. showed that 500 mL/day of kefir consumption for four weeks had no effect on lipid profile [40]. Furthermore, Fathi et al. showed that two servings of kefir in a day during eight weeks led a similar improvement both in lipid profile and weight management compared with milk [41,42]. The variation in response to the kefir consumption could be mainly explained by the variation of kefir composition, and the characteristics of study samples in different studies. ...
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Several health-promoting effects of kefir have been suggested, however, there is limited evidence for its potential effect on gut microbiota in metabolic syndrome This study aimed to investigate the effects of regular kefir consumption on gut microbiota composition, and their relation with the components of metabolic syndrome. In a parallel-group, randomized, controlled clinical trial setting, patients with metabolic syndrome were randomized to receive 180 mL/day kefir (n = 12) or unfermented milk (n = 10) for 12 weeks. Anthropometrical measurements, blood samples, blood pressure measurements, and fecal samples were taken at the beginning and end of the study. Fasting insulin, HOMA-IR, TNF-α, IFN-γ, and systolic and diastolic blood pressure showed a significant decrease by the intervention of kefir (p ≤ 0.05, for each). However, no significant difference was obtained between the kefir and unfermented milk groups (p > 0.05 for each). Gut microbiota analysis showed that regular kefir consumption resulted in a significant increase only in the relative abundance of Actinobacteria (p = 0.023). No significant change in the relative abundance of Bacteroidetes, Proteobacteria or Verrucomicrobia by kefir consumption was obtained. Furthermore, the changes in the relative abundance of sub-phylum bacterial populations did not differ significantly between the groups (p > 0.05, for each). Kefir supplementation had favorable effects on some of the metabolic syndrome parameters, however, further investigation is needed to understand its effect on gut microbiota composition.
... Epidemiological studies have shown that low intake of calcium is a risk factor for incidence of obesity. It is due to the consequence of insoluble salts of calcium with fatty acids and bile salts which affect the fat absorption from intestinal epithelial cells and hence decreasing the digestible energy from diet [24]. The rate of mortality from cardiovascular diseases around the globe is increasing and it has high prevalence in developed countries as fat is major constitute of western diet regimes. ...
Article
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Dairy products are enriched with the combination of vital nutrients which are almost unable to attain through dairy-free diets and hence it is very unlikely for people taking dairy-free diet to meet recommended daily intake of calcium. In-spite of extensive documentation of stupendous benefits of healthy bones some people avoid to adding dairy products to their diet owing to contrary belief that dairy products are detrimental to health, especially those who are overweight, are at risk of suffering from cardiovascular diseases, intolerance to lactose and are suffering from osteoarthritis or rheumatoid arthritis. This review will serve as strategic partner for health specialists to prompt the intake of dairy products into their balance diet. The people who are suffering with lactose intolerance and arthritis may not totally avoid dairy products from their diet. Low fat dairy products, do not enhance the chances of cardiovascular disease. It is believed to be safe to take around three servings of dairy foods each day and they will deliver good benefits for the health of bones.
... Epidemiological studies have shown that low intake of calcium is a risk factor for incidence of obesity. It is due to the consequence of insoluble salts of calcium with fatty acids and bile salts which affect the fat absorption from intestinal epithelial cells and hence decreasing the digestible energy from diet [24]. The rate of mortality from cardiovascular diseases around the globe is increasing and it has high prevalence in developed countries as fat is major constitute of western diet regimes. ...
... Epidemiological studies have shown that low intake of calcium is a risk factor for incidence of obesity. It is due to the consequence of insoluble salts of calcium with fatty acids and bile salts which affect the fat absorption from intestinal epithelial cells and hence decreasing the digestible energy from diet [24]. The rate of mortality from cardiovascular diseases around the globe is increasing and it has high prevalence in developed countries as fat is major constitute of western diet regimes. ...
Article
Full-text available
Dairy products are enriched with the combination of vital nutrients which are almost unable to attain through dairy-free diets and hence it is very unlikely for people taking dairy-free diet to meet recommended daily intake of calcium. In-spite of extensive documentation of stupendous benefits of healthy bones some people avoid to adding dairy products to their diet owing to contrary belief that dairy products are detrimental to health, especially those who are overweight, are at risk of suffering from cardiovascular diseases, intolerance to lactose and are suffering from osteoarthritis or rheumatoid arthritis. This review will serve as strategic partner for health specialists to prompt the intake of dairy products into their balance diet. The people who are suffering with lactose intolerance and arthritis may not totally avoid dairy products from their diet. Low fat dairy products, do not enhance the chances of cardiovascular disease. It is believed to be safe to take around three servings of dairy foods each day and they will deliver good benefits for the health of bones.
... The kefir beer treatment resulted in greater weight loss as compared to the control beer group and even with the group receiving the kefir suspension (P < 0.001), which is an intriguing finding that is probably linked to the combined antioxidant and probiotic activities of kefir beer. Weight loss was recently found by Fathi, Faghih, Zibaeenezhad, and Tabatabaei (2015) in a study with overweight women after drinking milky kefir. In addition, a significant decrease in body weight was observed in male rats treated with beer containing xanthohumol (Legette et al., 2013). ...
Article
Full-text available
Kefir grown in molasses was activated to ferment malt for the production of beer. As kefir and beer are known to exhibit some beneficial health properties, anti-inflammatory and anti-ulcerogenic activities of a beer made with kefir were assessed using rat paw edema and ethanol-induced gastric ulcer model, respectively. The polyphenol content presented in the beers was evaluated by HPLC, whereas serum cholesterol, triacylglycerol, HDL cholesterol, ALT, AST, catalase and glutathione peroxidase of treated animals were determined by molecular absorption. The results revealed similar levels of beer polyphenols and serum markers among all treated animals, but marked decreases in inflammatory and ulcerogenic responses in the group treated with kefir beer, and with a control beer modified with aqueous kefiran. Scanning electron microscopy showed a coating layer on the stomach of animals treated only with kefir-based samples. These results suggest a functionality of a specialty beer made with kefir as single fermenter.
... Another study conducted in overweight and obese premenopausal women found that, while kefir consumption was able to improve total-C and LDL-C levels, these improvements were not significantly different from those observed in a control group which received low-fat milk [50]. The authors also observed the same effect in regard to weight loss, BMI, and waist circumference, with both kefir and low-fat milk resulting in similar improvements when compared with the control group [51]. St-Onge et al. also observed that kefir consumption for 4 weeks in hyperlipidemic men had no effect on plasma total-C levels and the rest of the lipid profiles when compared with a milk control [52]. ...
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Purpose of review: This review summarizes recent animal and human trials examining the potential for kefir to improve obesity, type 2 diabetes, dyslipidemia, and non-alcoholic fatty liver disease (NAFLD). Evidence for pathways affected and suggestions of possible mechanisms of action are also considered. Recent findings: Human trials examining the ability of kefir to recapitulate metabolic health benefits previously observed in rodent models have found mixed results. Kefir has long been associated with improvements in health including obesity, diabetes, NAFLD, and dyslipidemia in preventative animal trials. While recent evidence from human trials supports a positive role of kefir in modulating diabetes-related markers, the impact of kefir consumption on markers of dyslipidemia, NAFLD, and body composition has been for the most part contradictory to animal findings. Variability in organisms for kefir fermentation poses a significant challenge in making meaningful comparisons. Recommendations for future well-controlled animal and human research are provided.
... Kefir is proclaimed to contain more than 600 unique peptides and to offer multiple health benefits, such as improved lipid profile, angiotensin-converting enzyme inhibition, tumor suppression, and antimicrobial and anti-inflammatory activity [56]. There is, however, insufficient evidence from RCTs to substantiate these claims [29,[57][58][59]. ...
Article
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Probiotic yogurt is suggested as a nutritional approach in type 2 diabetes (T2D) and obesity. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating the effects of probiotic yogurt on glycemic outcomes in T2D or obesity. The databases used to search for RCTs included Medline and Scopus. The RCTs were eligible if outcomes included selected glycemic markers. In nine eligible trials, 237 and 235 subjects were in treatment (probiotic yogurt) and control (mostly conventional yogurt) groups, respectively. There was no significant difference for pooled unstandardized mean difference (USMD) hemoglobin A1c (HbA1c) by probiotic yogurt compared with the control in T2D (USMD: −0.366; 95% CI: −0.755, 0.024, p = 0.066) and obesity (USMD: 0.116, 95% CI: −0.007, 0.238, p = 0.065). Similarly, there were no effects of probiotic yogurt on fasting blood glucose, fasting insulin, or insulin resistance (estimated by homeostatic model assessment of insulin resistance (HOMA-IR)) in either T2D or obesity. In conclusion, the present meta-analysis has not demonstrated the benefits of consuming probiotic compared with conventional yogurt for improving glucose control in patients with diabetes or obesity. Larger trials are needed to verify the benefits of probiotic and/or conventional yogurt or other probiotic fermented milk (e.g., kefir) on glycemic markers in patients with diabetes and obesity.
... W czasie eksperymentu osoby badane przestrzegały diety normokalorycznej dostarczającej 2000 kcal/d. Po upływie 8 tygodni istotnemu zmniejszeniu uległy masa ciała oraz BMI odpowiednio o -1,4 kg i -0,6 kg/m 2 w porównaniu do grupy kontrolnej (n = 20), która przyjmowała dwie porcje niskokalorycznych produktów mlecznych w ciągu dnia [16]. W przytoczonych badaniach oceniano wpływ różnych rodzajów bakterii probiotycznych na zmianę wskaźników antropometrycznych, nierzadko odmienny był także czas trwania interwencji, który wynosił od 3 tygodni do 6 miesięcy, a także stężenie probiotyku w suplementowanym produkcie (10 6 -10 11 CFU). ...
Article
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Obesity is a chronic disease, which is often accompanied by disorders of the carbohydrates and lipid metabolism, as well as metabolic complications concerning the circulatory system. It is a disorder of homeostasis of energy transformation, caused by excessive supply of energy contained in food which exceeds the needs of the body, consequently leading to increased storage of excess kilocalories in the form of adipose tissue. The incidence of obesity in the world has more than doubled between 1980 and 2014 and currently affects more than 600 million people. This is primarily due to increased food availability, a sedentary lifestyle, as well as a high-fat and high-carbohydrate diet. These facts are a consequence of socio-economic changes which took place in recent decades. One of the factors that can play an important role in the prevention of obesity or reduction of excessive body weight is the modification of intestinal microbiota composition. Recent studies have shown that a diverse, properly functioning microbiota secures the adequate use of energy supplied with food and suitable storage in the body. Probiotic bacteria can contribute to weight loss in two ways. First of all, microbiota of people characterized by the correct quantitative and qualitative composition is much more energy-efficient and contributes to the increased excretion of undigested food residues as compared to the microbiome of people diagnosed with intestinal dysbiosis. Weight reduction due to taking probiotics may also be related to its effect on the regulation of carbohydrate and lipid metabolism in the organism. This article reviews the current clinical studies on the potential relationship between intestinal microbiota and changes in anthropometric parameters concerning people with excessive body weight.
... Gobel et al. (2012) showed that probiotic intervention with Ls-33 was not shown any beneficial effect on parameters related to the metabolic syndrome in obese adolescents (26), but in the study conducted on obese persons, it was observed that BMI index decreased in the group with probiotic cheese consumption and hypocaloric diet (27). Fathi et al. showed kefir drink cause similar weight loss in comparison with milk in premenopausal obese women (28). However, our study was not consistent with Fathi et al. study in BMI index. ...
Article
Background: Probiotic fermented milk is one of the most beneficial foods. The main purpose of this study was to investigate the effect of probiotic fermented milk on the serum level of insulin and homocysteine in the type 2 diabetes patients. Methods: This study was done in 60 patients with type 2 diabetes. The intervention group received 600 mL of probiotic fermented milk (kefir) daily and control group received 600 mL of conventional fermented milk daily for 8 weeks. Food intake, anthropometric indices, serum parameters were assessed at the beginning and at the end of the study. The statistical analysis was done by the use of SPSS software (Ver.13). Results: The mean of serum insulin level did not reduce significantly after the intervention in probiotic fermented milk group, and there was no significant difference between the two groups. The mean of HOMA-IR decreased significantly in probiotic fermented milk group after intervention and there was a significant difference between the two groups after intervention. The mean of quickie increased in probiotic fermented milk group, but this increase was not significant. Also, there was not significant difference between the two groups after intervention. The mean of homocysteine level decresead significantly in patients with probiotic fermented milk and conventional fermented milk consumption. Conclusions: By considering the effect of probiotic fermented milk on some risk factors of cardiovascular disease in diabetic patients, probiotic foods may be useful as an adjuvant therapy in diabetic patients.
... The literature search identified 800 unique citations whereof 774 were excluded because of irrelevant content or non-English language (Fig. 1). Of the 26 articles which were full text screened, a total of 11 articles did not meet the criteria of inclusion either because the independent effects of probiotics on outcomes were not possible to estimate (23)(24)(25)(26)(27)(28)(29)(30), the probiotic species were not defined (31) or the patients had undergone gastric bypass (32) or lacked sufficient information on the outcomes of interest (33). Finally, 15 articles were included in the systematic review and meta-analysis (34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48). ...
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A systematic review and meta-analysis of randomized controlled trials was conducted to examine the effects of probiotic supplementation on body weight, body mass index (BMI), fat mass and fat percentage in subjects with overweight (BMI 25-29.9 kg m À2) or obesity (BMI ≥30 kg m À2). MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched for studies published between 1946 and September 2016. A meta-analysis, using a random effects model, was performed to calculate the weighted mean difference between the intervention and control groups. Of 800 studies identified through the literature search, 15 were finally included. The studies comprised a total of 957 subjects (63% women), with the mean BMI being 27.6 kg m À2 and the duration of the interventions ranging from 3 to 12 weeks. Administration of probiotics resulted in a significantly larger reduction in body weight (weighted mean difference [95% confidence interval]; À0.60 [À1.19, À0.01] kg, I 2 = 49%), BMI (À0.27 [À0.45, À0.08] kg m À2 , I 2 = 57%) and fat percentage (À0.60 [À1.20, À0.01] %, I 2 = 19%), compared with placebo; however, the effect sizes were small. The effect of probiotics on fat mass was non-significant (À0.42 [À1.08, 0.23] kg, I 2 = 84%).
... In a study, the weight-reducing effect of the kefir dairy drink in a randomized control trial of overweight or obese premenopausal women was examined. (Fathi et al., 2016). Subjects were fed either a control diet (low fat dairy products 2 servings/day) or milk (4 servings/day) or kefir drink diet (4 servings/day) for 8 weeks. ...
Article
Obesity is recognized globally as a major mortality risk factor due to its involvement in other metabolic complications like insulin resistance, type 2 diabetes mellitus, and several cancers. It is linked with consumption of excessive calories and their less expenditure. Different strategies (diet control, pharmacological interventions, and surgery) have been tried to treat obesity. However, these strategies cannot permanently cure obesity, which was evident by bodyweight regain with above treatments. Literature suggests that probiotics play a major role in the management of obesity and associated diseases. According to World Health Organization, probiotics are defined as “live micro-organisms which when administered in adequate amounts confer health benefits on the host”. Role of probiotic organisms on carbohydrate and lipid metabolism has been extensively studied and discussed below. However, contradictory results have been reported in the context of probiotics role in obesity that observed no effect on body weight and feed intake (Ji et al., 2012; Kumar et al., 2012). Administration of probiotics in the form of fermented milk, lyophilized cells, dahi (Indian traditional fermented milk) and yogurt in clinical and animal models have been studied for their anti-obesity effects. Oral administration of different lactobacilli strains viz., PL60, PL62, and GG to a high-fat diet (HFD) fed mice shown a decrease in the body weight gain, visceral fat and hepatic enzymes (Lee et al., 2006, 2007). In our study, dahi prepared by using the probiotic strain Lactobacillus casei NCDC19 had shown positive effects in the obesity management in mice model (Rather et al., 2014). Moreover, combination of several probiotics (Streptococcus Thermophilus, Bifidobacterium, and Lactobacillus) also showed reduction in the body weight gain via short chain fatty acid (butyrate) production by stimulating glucagon like peptide in leptin deficient obese mice (Yadav et al., 2013). Similarly, significant results have been reported with probiotic strains such as Lactobacillus gasseri SBT2055 (Kadooka et al., 2010, 2013; Ogawa et al., 2014), Bifidobacterium bifidum W23, Bifidobacterium lactis W51, Enterococcus faecium W54, Lactobacillus acidophilus W22, Lactobacillus brevis W63 and Lactococcus lactis W58 in human subjects (Lamprecht et al., 2012). While, contradictory results were also observed in this area and these results might be due to strain dependent, type of diet and different animal models (Ji et al., 2012; Kumar et al., 2012). In the recent past, research was focused towards cocktail of herbs and prebiotics with probiotics to treat metabolic complications. Dietary incorporation of prebiotic galacto-oligosaccharides (GOS) and whey protein isolate in HFD fed mice resist the increase in blood glucose levels, insulin resistance and liver glycolytic enzymes (Kavadi et al., 2017) whereas herbal ingredients such as Aloe vera (AV) and Gymnema sylvestre (GS) supplementation to HFD fed animals had similar results (Pothuraju et al., 2016a,b). Studies addressing the role of herbs and their active ingredients as alternative therapies for the treatment of obesity and its associated metabolic diseases are also reviewed (Pothuraju et al., 2014, 2016a,b). A comprehensive understanding obtained from all these studies indicates that administration of prebiotics alone is not a good criterion to treat obesity effectively. Probiotic bacteria can efficiently proliferate and survive in the presence of prebiotics that acts as a selective substrate for these organisms in the colon (Singh et al., 2012). In our previous study, among the different strains of Lactobacillus rhamnosus screened for potential probiotic attributes (acid/bile tolerance, cell surface hydrophobicity, and anti-microbial activity), NCDC17 strain have been reported to potential probiotic properties. In addition, a significant stimulation of the growth of NCDC17 was observed when cultured in the presence of prebiotic almond (2% w/v) as compared to inulin (Singh et al., 2012). In another study, we have used AV and NCDC 19 as a synbiotic combination to study its effects on angiotensin-converting enzyme (ACE) activity. Addition of AV powder (0.5 and 1% w/v) to NCDC 19 exhibited a significant increase in ACE activity (Basannavar et al., 2014). In a recent finding, administration of AV and GS alone or in combination with NCDC 17 and Lactobacillus Plantarum NCDC 625 to HFD fed mice resulted in significant reduction in body weight gain, glucose levels, insulin resistance along with proinflammatory makers (TNFa and IL-6) (Pothuraju et al., 2015, 2016a,b). These results could be related to one or more of the possible mechanisms viz. increased pancreatic insulin secretion by AV; binding of gymnemic acids present in GS glucose receptor, which might have prevented its intestinal absorption (Pothuraju et al., 2015) or else prevention of lipid absorption by phytosterols found in the herbs. In addition, active components present in herbs may act as energy source for the growth of probiotic microorganisms, which further led to antiobese effects. However, the exact molecular mechanisms involved in anti-obese effects of prebiotics/herbal ingredients and probiotics is yet to known and should be a future target to treat the metabolic disorders.
... In a study, the weight-reducing effect of the kefir dairy drink in a randomized control trial of overweight or obese premenopausal women was examined. (Fathi et al., 2016). Subjects were fed either a control diet (low fat dairy products 2 servings/day) or milk (4 servings/day) or kefir drink diet (4 servings/day) for 8 weeks. ...
... The kefir beer treatment resulted in greater weight loss as compared to the control beer group and even with the group receiving the kefir suspension (P < 0.001), which is an intriguing finding that is probably linked to the combined antioxidant and probiotic activities of kefir beer. Weight loss was recently found by Fathi, Faghih, Zibaeenezhad, and Tabatabaei (2015) in a study with overweight women after drinking milky kefir. In addition, a significant decrease in body weight was observed in male rats treated with beer containing xanthohumol (Legette et al., 2013). ...
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This study was conducted to evaluate the effects of the ethanolic extract of Passiflora edulis leaves on blood glucose, protein glycation, NADPH oxidase activity and macrophage phagocytic capacity after Candida albicans exposure in diabetic rats. The Passiflora edulis Sims leaves were dried to 40°C, powdered, extracted by maceration in 70% ethanol, evaporated under reduced pressure and lyophilised. The biochemical tests performed were total phenolic content (TP) as determined by the Folin-Ciocalteu assay, trapping potential DPPH assay and total iron-reducing potential. Diabetes was induced by alloxan injection. Protein glycation was determined by AGE and fructosamine serum concentrations. Extracttreated diabetic animals demonstrated lower fructosamine concentrations compared with the diabetic group. Our results suggest that ethanolic Passiflora edulis Sims leaf extraction may have beneficial effects on diabetes and may improve glycaemic control in diabetic rats. © 2015, Faculdade de Ciencias Farmaceuticas (Biblioteca). All rights reserved.
... However, the effect of probiotics to control the body weight and related clinical indicators in healthy adults with obesity are remaining unclear. Several randomized controlled studies evaluated the effects of probiotics on body weight control, lipid profiles, and glycemic control and gave conflicting results; several studies suggest that probiotics play an important role in the prevention of obesity [13][14][15][16][17][18][19], while other studies hold different views [20][21][22]. Studies indicated that overweight/obesity is usually associated with elevated levels of plasma lipid profiles concomitant with impaired glucose metabolism [23,24]. ...
Article
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Background: The prevalence of overweight/obesity in adults is raised to 39%, which is nearly tripled more than 1975. The alteration of the gut microbiome has been widely accepted as one of the main causal factors. To find an effective strategy for the prevention and treatment of overweight/obesity, a systematic review and meta-analysis were designed. Methods: In this study, we systematically reviewed the article published from January 2008 to July 2018 and conducted a meta-analysis to examine the effects of probiotics on body weight control, lipid profile, and glycemic control in healthy adults with overweight or obesity. The primary outcomes were body weight, body mass index (BMI), waist circumference, fat mass, fat percentages, plasma lipid profiles, and glucose metabolic parameters. Results: We systematically searched PubMed, Embase, and the Web of Science and identified 1248 articles, and 7 articles which were manually searched by the references of included studies and previously systematic reviews. Twelve randomized controlled trials (RCTs), including 821 participants, were included in the meta-analysis via full-text screening. Probiotics supplementation resulted in a statistical reduction in body weight (WMD [95% CI]; -0.55 [-0.91, -0.19] kg), BMI (WMD [95% CI]; -0.30 [-0.43, -0.18] kg m-2), waist circumference (WMD [95% CI]; -1.20 [-2.21, -0.19] cm), fat mass (WMD [95% CI]; -0.91 [-1.19, -0.63] kg), and fat percentage (WMD [95% CI]; -0.92 [-1.27, -0.56] %) compared with control groups. As expected, the metabolic parameters were improved significantly, with a pooled standardized mean difference in TC (SMD [95% CI]; -0.43 [-0.80, -0.07]), LDL-C (SMD [95% CI]; -0.41 [-0.77, -0.04]), FPG (SMD [95% CI]; -0.35 [-0.67, -0.02]), insulin (SMD [95% CI]; -0.44 [-0.84, -0.03]), and HOMA-IR (SMD [95% CI]; -0.51 [-0.96, -0.05]), respectively. The changes in TG (SMD [95% CI]; 0.14 [-0.23, 0.50]), HDL-C (SMD [95% CI]; -0.31 [-0.70, 0.07]), and HbA1c (SMD [95% CI]; -0.23 [-0.46, 0.01]) were not significant. Conclusion: This study suggests that the probiotics supplementation could potentially reduce the weight gain and improve some of the associated metabolic parameters, which may become an effective strategy for the prevention and treatment of obesity in adult individuals.
... In contrast, McNamara et al. (1989) showed that BW in 18 men remained constant throughout a 3 dietary-phase study (11 weeks in total) without differences between a low-fat yoghurt-and low-fat milksupplemented diet over the 4 week phase. A recent study compared the weight-loss effect of a low-dairy control diet (2 servings/d) with the same diet plus 2 servings/d of kefir drink (a probiotic dairy product) (kefir group), or 2 servings/d of milk (milk group) in 58 overweight women (Fathi et al., 2016). Women in the 8-week high kefir and milk diets lost significantly more weight, BMI and WC than those in the control group, but kefir did not cause any additional weight loss than milk. ...
Chapter
The prevalence of obesity has reached epidemic proportions globally, and the trend is especially alarming in children and adolescents. Dairy products provide a range of nutrients that are important to health but contribute to overconsumed nutrients such as fat and saturated fat. Data from existing reviews on the role of dairy products in the development of obesity in childhood and adulthood are inconsistent. This chapter reviews the totality of evidence and the justification for the current approach of limiting dairy in the diet to reduce or prevent obesity or weight gain. The majority of data available from longitudinal and intervention studies in adults provide evidence of neutral associations between intakes of milk and other dairy products, and body weight and adiposity measures. Similar results were found for children and adolescents, while there is limited data for older adults. Although the mechanisms have not been clearly elucidated, they include effects on energy and fat balance, fatty acid absorption, appetite, and the metabolic activity of gut microbiota. In conclusion, although inconsistencies exist, there is little evidence to support the justification for limiting dairy in the diet on the grounds that they may promote obesity.
... et al., (2007) explained that the bodyweight of the diabetic rats which induced experimentally by streptozotocin decreased comparing with the normal rats. Yasamin et al., (2016) observed in their study that Kefir drink leads to a similar weight loss, compared with milk in overweight or obese premenopausal women.A total of 13 studies revealed the effects of probiotic supplementation consumption and found that the administration of probiotics was associated with a significantly larger reduction in BMI and weight loss (Borgeraas et al., 2018). Zemel et al., (2004) hypothesized that a dairy-rich diet containing kefir drink would lead to a greater weight loss, as kefir drink might have the antiobesity properties of dairy products and probiotics in combination. ...
... These authors observed that the intake of water kefir increased the TC, TGA, LDL-c, and very-lowdensity lipoproteins (VLDL) concentrations and decreased the high-density lipoprotein cholesterol (HDL-c) concentration as compared to diabetic rats. It is elucidated that milkkefir as well as the consumption of kefir decreases weight gain and reduces liver damage in high-fat diet-fed mice by modulation of the gut microbiota ); attenuates lipid deposition in LDL -/mice influencing the progressive reduction of atherosclerosis (Santanna et al. 2017), and improves serum lipid profile in overweight or obese premenopausal women (Fathi et al. 2016;Fathi et al. 2017). There is a gap in the literature regarding the results obtained with water-kefir; however, all of these results together can demonstrate that water-kefir can also provide an anti-hyperlipidemic effect. ...
Article
Functional foods are foods that, in addition to having nutrients, contain in their composition ingredients that act specifically on body functions associated with the control and reduction of the risk of developing some diseases. In this sense, kefir, a group of microorganisms in symbiosis, mainly yeasts and lactic acid bacteria, stands out. The trend of ingesting kefir has been focused on the development of products that serve specific consumers, such as those who are lactose-intolerant, vegans and vegetarians, and consumers in general who seek to combine the consumption of functional products with the improvement of their health and lifestyle. This overview provides an insight into kefir, presenting the technological process to produce a nondairy beverage and evidence of the benefits of its use to reduce the risk of disease. We also discuss regulatory aspects of products fermented using kefir. Until now, the use of kefir (isolated microorganism, kefiran, or fermented product) has demonstrated the potential to promote an increase in the number of bifidobacteria in the colon and an increase in the glycemic control while reducing the blood cholesterol and balancing the intestinal microbiota, which helps in reducing constipation and diarrhea, improving intestinal permeability, and stimulating and balancing the immune system. However, the literature still has gaps that need to be clarified, such as the consumption dose of kefir or its products to cause some health benefit.
... Compared to the control group, kefir intake resulted in a significant weight loss of ~2.5 kg after 8 weeks. 45 Bioengineered B. subtilis also demonstrated anti-obesity property by enhancing butyric acid production. The administration of bioengineered B. subtilis compared to wild B. subtilis resulted in reduced food intake and lower body weight in the animal model of obesity. ...
... In those reviews and studies, drinking plain milk was not associated with BMI or BMI z-scores in children, though it increased caloric intake and energy density at meals. A systematic review [36] and a randomized controlled trial [43] also indicate that drinking milk is not linked to increased risk of overweight and obesity in adults. Finally, the Scientific Report of the 2020-2025 Dietary Guidelines Advisory Committee (DGAC) notes that consuming low-fat dairy foods as part of a healthy eating pattern has beneficial impacts on outcomes related to growth, size, body composition, and obesity in adults (moderate evidence) and children (limited evidence) [3]. ...
Article
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Most Americans do not meet dairy food recommendations from the 2015 Dietary Guidelines for Americans (DGA). This study assesses differences in nutrient intake between Americans who meet recommendations for dairy intake and those who do not, using data from the National Health and Nutrition Examination Survey from 2013-2014 and 2015-2016 (n = 5670 children ages 2-18 years and n = 10,112 adults ages 19+). Among children and adults, those meeting dairy food recommendations were significantly more likely to have adequate intake (% above Estimated Average Requirement (EAR)) of calcium, magnesium, phosphorus, riboflavin, vitamin A, vitamin B12, and zinc and consume above the Adequate Intake (AI) for potassium and choline than Americans not meeting dairy recommendations, regardless of age, sex, or race/ethnicity. Americans meeting dairy recommendations were also more likely to exceed recommendations for sodium and saturated fat but consume less added sugars. Nearly 60% of Americans 2 years and older not meeting dairy recommendations consumed calcium and magnesium below the EAR. Only about 20% of Americans who did not meet dairy recommendations consumed above the AI for potassium. Dairy foods make important and unique contributions to dietary patterns, and it can be difficult to meet nutrient needs without consuming recommended amounts of dairy foods.
... Peláez, M. Martínez-Cuesta, & T. Requena, 2019;Ranadheera et al., 2010). Clinical trials evaluating the effects of probiotic yogurt or other PFMP on anthropometric indices or weight loss, have produced inconsistent results (Fathi, Faghih, Zibaeenezhad, & Tabatabaei, 2016;Hütt et al., 2015;Madjd et al., 2016;Omar, Chan, Jones, Prakash, & Jones, 2013). Kadooka et al. in a randomized controlled trial, found a significant lowering effect of Lactobacillus gasseri SBT2055 in fermented milk on abdominal adiposity (Kadooka et al., 2013). ...
Article
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Current evidence suggests that gut dysbiosis has a pivotal role in progression of obesity. Probiotics fermented milk products (PFMP) by influencing the functions of gut microbiota might bring protective effects against obesity; however, findings of available randomized controlled trials (RCTs) are conflicting. The aim of this study was systematically review and analyse RCTs assessing the effects of PFMP supplementation on anthropometric indices. PubMed, Scopus, ISI Web of science and Cochrane Library were searched up to August 2020. A total of 19 RCTs (with 22 treatment arms) were included and reporting data about PFMP and body weight (BW), body mass index (BMI), waist circumference (WC) and body fat percentage (BF%) were analyzed. Two authors independently extracted the data and assessed the risk of bias using the Cochran risk of bias tool PFMP intervention indicated a significant reduction in BW and BMI. Although this reduction in WC and BF% were non-significant. PFMP provide new opportunities to manage obesity.
... On the other hand, St-Onge et al. showed that 500 mL/day of kefir consumption for four weeks had no effect on lipid profile [40]. Furthermore, Fathi et al. showed that two servings of kefir in a day during eight weeks led a similar improvement both in lipid profile and weight management compared with milk [41,42]. The variation in response to the kefir consumption could be mainly explained by the variation of kefir composition, and the characteristics of study samples in different studies. ...
Article
Circadian misalignment induced by disruptions in sleep/wake cycle or feeding/fasting cycle has been linked with both metabolic health, including energy homeostasis and insulin sensitivity(Reference Morris, Yang and Garcia1) and alterations in gut microbiome(Reference Qin, Li and Cai2). This study aimed to examine the potential associations among sleep quality, night eating behaviour and gut microbiome composition in patients with metabolic syndrome. This is a secondary analysis of data collected for a randomized controlled clinical trial(Reference Bellikci-Koyu, Yurekli and Akyon3). The cross-sectional analysis was performed using the baseline data of twenty-one patients with metabolic syndrome (37-64 years; 16 females) who completed the Pittsburgh Sleep Quality Index Questionnaire (PSQI) for the evaluation of sleep quality and the Night Eating Questionnaire (NEQ) for the assessment of behavioural and psychological symptoms of night eating syndrome. Participants also provided stool samples for 16S ribosomal RNA gene sequencing analysis. Descriptive statistics, Spearman's correlation and partial correlation tests were computed using IBM SPSS Statistics 23 software. Partial correlation coefficients were calculated with adjustment for age, sex, body mass index and dietary fibre intake. The median of PSQI score was 3.0 with a range of 1.0-17.0 and median score on NEQ was 16.0 (6.0-34.0). Sleep disturbances and night eating syndrome were observed in 4 (19.0%) and 6 (28.6%) participants, respectively. PSQI score was correlated with the NEQ score (r = 0.571, p = 0.007), confirming a relationship between sleep quality and night eating behaviour. Sleep quality and night eating syndrome were associated with similar microbiome profiles. At the phylum level, poor sleep quality was correlated with higher relative abundance of Verrucomicrobia and Proteobacteria (r = 0.789 and r = 0.833 respectively, both p < 0.001), but lower relative abundance of Bacteroidetes (r = −0.569, p = 0.017). At the sub-phylum levels, poor sleep quality was correlated with Alistipes (r = 0.535, p = 0.027) and Erysipelotrichaceae (r = 0.821, p < 0.001) abundance. Similarly, the relative abundance of phyla Proteobacteria (r = 0.501, p = 0.040), and genus Alistipes (r = 0.595, p = 0.012) were associated with night eating behaviour. Partial correlations suggested that the relationships between bacterial abundance and night eating behaviour were not independent of sleep quality (r = 0.039, p = 0.886 for Proteobacteria; r = 0.413, p = 0.111 for Alistipes). This study suggests associations between gut microbiome composition and circadian disruptions induced by sleep disturbances or eating late at night. The associations between night eating behaviour and gut microbiome may be due in part to poor sleep quality. These data suggest that not only does eating at night, but also the sleep disruptions that result from this activity, may contribute to alterations in gut microbiome. Further research is required to identify the potential bidirectional relationship between circadian rhythms and gut microbiome that may affect overall health.
... These data are in accordance with previous studies, where it was suggested that similar programs have a positive impact on the reduction of BMI and body fat [7,51,52]. Recent studies demonstrated that the intake of dairy products, such as milk and kefir, promoted higher body fat loss and lean mass gain in weight loss [53,54]. We recorded no significant differences between BMI, body fat and waist circumference loss between the WLPB and WLP groups since both recorded equal calorie consumption, which was confirmed by the calorie intake checks (Table 3). ...
Article
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Weight loss interventions with probiotics have favourable effects on gut microbiota composition and derived metabolites. However, little is known about whether the consumption of natural probiotics, such as Bryndza cheeses, brings similar benefits. The purpose of the study was to find the effect of short-term weight loss programs and Bryndza cheese consumption on the structure of the gut microbiota, microbiota-derived metabolites and body composition in middle-aged women. We conducted a randomised controlled intervention study. Twenty-two female participants with a body fat percentage ≥25% underwent a short weight loss program (4 weeks). Subjects were randomised to either the control or intervention group according to diet. The intervention group comprised 13 participants, whose diet contained 30 g of “Bryndza” cheese daily (WLPB). The control group comprised nine participants without the regular consumption of Bryndza cheese (WLP) in their diet. Both interventions lead to a significant and favourable change of BMI, body fat, waist circumference and muscle mass. Moreover, the relative abundance of Erysipelotrichales significantly increased in both groups. However, the relative abundance of lactic acid bacteria (Lactobacillales, Streptococcaceae, Lactococcus and Streptococcus) significantly increased only in the WLPB group. Furthermore, short-chain fatty acid producers Phascolarctobacterium and Butyricimonas increased significantly in the WLPB group. A short-term weight loss program combined with Bryndza cheese consumption improves body composition and increases the abundance of lactic acid bacteria and short-chain fatty acid producers in middle-aged women.
... Several other randomized controlled trials [303][304][305][306][307] and one non-randomized controlled trial [308] showed no beneficial effect on body weight with an increased amount of dairy products in (energy restricted and energy non-restricted) diets. A cross sectional study in Ireland reported significantly lower BMI and body fat mass associated with higher total dairy consumption [309]. ...
Technical Report
Given the limited amount of current evidence linking total water intake to health outcomes, further data would be needed to guide evidence-based recommendations on water intake. In particular, scientific evidence on the levels of long-term water intake needed to reduce the risk of common chronic diseases is currently limited.
... Specifically, butyrate is the primary source of energy for colonocytes and is involved in maintaining the epithelial barrier function [50,51]. Increased fecal SCFAs were also observed in human kefir-intervention studies [52]. Along with increases in beneficial SCFAs, kefir reduced by-products of protein and nitrogen metabolism. ...
Article
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Fermentation is an ancient food preservation process, and fermented products have been traditionally consumed in different cultures worldwide over the years. The interplay between human gut microbiota, diet and host health is widely recognized. Diet is one of the main factors modulating gut microbiota potentially with beneficial effects on human health. Fermented dairy products have received much attention, but other sources of probiotic delivery through food received far less attention. In this research, a combination of in vitro tools mimicking colonic fermentation and the intestinal epithelium have been applied to study the effect of different pasteurized and non-pasteurized water kefir products on gut microbiota, epithelial barrier function and immunomodulation. Water kefir increased beneficial short-chain fatty acid production at the microbial level, reduced detrimental proteolytic fermentation compounds and increased Bifidobacterium genus abundance. The observed benefits are enhanced by pasteurization. Pasteurized products also had a significant effect at the host level, improving inflammation-induced intestinal epithelial barrier disruption and increasing IL-10 and IL-1β compared to the control condition. Our data support the potential health benefits of water kefir and demonstrate that pasteurization, performed to prolong shelf life and stability of the product, also enhanced these benefits.
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In this landmark e-book of Frontiers of Nutrition, the authors from several Latin American nations provide findings that seed a plant-based research agenda for Latin America. Cairo et al. provide findings clearly showing how obesity and overweight have reached the rural areas of Brazil. The emergence of processed and ultra-processed foods in diet patterns across the lifespan in Latin America is shown in pre-schoolers in Chile by Araya et al. and reviewed for the entire region by Matos et al.. Despite these strong trends, there remains a paucity of research infrastructure in Latin America for culturally tailored dietary intervention trials to reverse the nutrition transition away from cultural diets based on minimally processed whole plant foods and fewer animal products. The supplement continues the build of this emergent research infrastructure for dietary intervention. Sanchez Urbano et al. provide evidence of the feasibility and acceptability of dietary intervention advice in the Latin American context. Loureiro et al. provide insights from diet patterns in Brazilian adults, and Contreras-Guillén et al. is innovating dietary recall methods for Argentina. Figueroa et al. tackle the question of whether a plant-based Mediterranean diet can be adapted for the Latin American region. Taken together, the supplement articles herein are a stride forward in the path to reverse the nutrition transition that is creating a sizable noncommunicable disease burden in Latin America.
Article
Background: Controversy exists as to whether the lipid-lowering properties of kefir drink (a fermented probiotic dairy product) in animal models could be replicated in humans. Objective: To assess and compare the potential lipid-lowering effects of kefir drink with low-fat milk in a dairy-rich diet in overweight or obese premenopausal women. Methods: In this 8-week, single-center, multiarm, parallel-group, outpatient, randomized controlled trial, 75 eligible Iranian women aged 25 to 45 years were randomly allocated to kefir, milk, or control groups. Women in the control group received a weight-maintenance diet containing 2 servings/d of low-fat dairy products, whereas subjects in the milk and kefir groups received a similar diet containing 2 additional servings/d (a total of 4 servings/d) of dairy products from low-fat milk or kefir drink, respectively. At baseline and study end point, serum levels/ratios of total cholesterol (TC), low- and high-density lipoprotein cholesterol (LDLC and HDLC), triglyceride, Non-HDLC, TC/HDLC, LDLC/HDLC, and triglyceride/LDLC were measured as outcome measures. Results: After 8 weeks, subjects in the kefir group had significantly lower serum levels/ratios of lipoproteins than those in the control group (mean between-group differences were -10.4 mg/dL, -9.7 mg/dL, -11.5 mg/dL, -0.4, and -0.3 for TC, LDLC, non-HDLC, TC/HDLC, and LDLC/HDLC, respectively; all P < .05). Similar results were observed in the milk group. However, no such significant differences were found between the kefir and milk groups. Conclusion: Kefir drink causes a significant yet similar improvement in serum lipid profile, compared with low-fat milk, in a dairy-rich diet in overweight or obese premenopausal women.
Article
Kefir is fermented milk produced from grains that comprise a specific and complex mixture of bacteria and yeasts that live in a symbiotic association. The nutritional composition of kefir varies according to the milk composition, the microbiological composition of the grains used, the time/temperature of fermentation and storage conditions. Kefir originates from the Caucasus and Tibet. Recently, kefir has raised interest in the scientific community due to its numerous beneficial effects on health. Currently, several scientific studies have supported the health benefits of kefir, as reported historically as a probiotic drink with great potential in health promotion, as well as being a safe and inexpensive food, easily produced at home. Regular consumption of kefir has been associated with improved digestion and tolerance to lactose, antibacterial effect, hypocholesterolaemic effect, control of plasma glucose, anti-hypertensive effect, anti-inflammatory effect, antioxidant activity, anti-carcinogenic activity, anti-allergenic activity and healing effects. A large proportion of the studies that support these findings were conducted in vitro or in animal models. However, there is a need for systematic clinical trials to better understand the effects of regular use of kefir as part of a diet, and for their effect on preventing diseases. Thus, the present review focuses on the nutritional and microbiological composition of kefir and presents relevant findings associated with the beneficial effects of kefir on human and animal health.
Article
Metabolic syndrome has become a major health hazard of the modern world. Studies investigating the effects of traditional fermented foods on metabolic syndrome are limited. We hypothesized that regular kefir consumption could improve the anthropometrical measurements, glycemic control, lipid profile, blood pressure, and inflammatory status in patients with metabolic syndrome. Sixty-two participants were randomly assigned to receive either 180 ml/d probiotic kefir or unfermented milk for 12 weeks. Dietary intake, anthropometrical measurements, biochemical status, and blood pressure were assessed at the baseline and end of weeks 4, 8, and 12. Serum apolipoprotein A1 (ApoA1) concentration increased by 3.4% in the kefir group, while it decreased by 2.4% in the milk group in 12 weeks (p=0.03). A subgroup analysis for participants with low-density lipoprotein cholesterol (LDL-C) levels >130 mg/dl showed that serum LDL-C and apolipoprotein B (ApoB) concentrations (7.6% and 5.4% respectively) significantly decreased with kefir consumption compared to the baseline values at the 12th week (p<0.05), but not compared to milk consumption (p>0.05). Both milk and kefir consumptions were associated with lower systolic and diastolic blood pressure compared to the baseline (p<0.05). The 12-week kefir administration also decreased the serum tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6), interleukin 10 (IL-10), interferon-gamma (IFN-γ), and homocysteine concentrations significantly (p<0.05). In conclusion, regular dairy consumption as a part of a well-balanced diet can provide favorable effects in the management of metabolic syndrome, and probiotic kefir may deserve a special interest among dairy products. This trial was registered at clinicaltrials.gov (NCT03966846).
Article
Scope: Effects of dairy consumption on body weight and body composition have been inconsistently observed in randomized control trials (RCTs). Our meta-analysis aimed to systematically evaluate the effects of dairy consumption on body weight and body composition among the adults. Methods and results: We conducted a comprehensive search of the Cochrane Library, PubMed and Embase databases of the relevant studies from 1966 to Mar 2017 regarding dairy consumption on body weight and body composition including of body fat, lean mass and waist circumference (WC). The summary results were pooled by using a random-effects meta-analysis. 37 RCTs with 184,802 participants were included in this meta-analysis. High dairy intervention increased body weight (0.01, 95% CI: -0.25, 0.26, I(2) = 78.3%) and lean mass (0.37, 95% CI: 0.11, 0.62, I(2) = 83.4%); decreased body fat (-0.23, 95% CI: -0.48, 0.02, I(2) = 78.2%) and WC (-1.37, 95% CI: -2.28, -0.46, I(2) = 98.9%) overall. In the subgroup analysis, consumption of dairy products increased body weight (0.36, 95% CI: 0.01, 0.70, I(2) = 83.1%) among participants without energy restriction. Dairy consumption decreased body weight (-0.64, 95% CI: -1.05, -0.24, I(2) = 60.2%), body fat (-0.56, 95%CI: -0.95, -0.17, I(2) = 66.6%) and waist circumference (-2.18, 95%CI: -4.30, -0.06, I(2) = 99.0%) among the adults with energy restriction. Conclusions: This meta-analysis suggests a beneficial effect of energy-restricted dairy consumption on body weight and body composition. However, high dairy consumption in the absence of caloric restriction may increase body weight. This article is protected by copyright. All rights reserved.
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The aim of the work was to study the association of overweight and obesity with the consumption of basic types of dairy products among the adult population of Russia. Data from the survey of the diet of adult members of 45,000 households, conducted in 2013 by the Federal Service of State Statistics in all regions of the country, have been used. The actual consumption of food among all members of the surveyed households was studied by 24-hour (daily) diet recall in April and September 2013. The body mass index was calculated on the basis of self-esteem by respondents of body weight and height. It was shown that average daily intake of kefir, yogurt and cottage cheese was higher in women, while consumption ofdrinkingmilk and cheeseswas higher for men. Consumption of drinking milk and kefir in men and women was much higher in groups with overweight and obesity than with normal body weight. Consumption of yogurt, on the contrary, was much less in people of both sexes with overweight and obesity. Consumption of milk, kefir and cottage cheese increased with age, while consumption of yogurt and cheeses, on the contrary, decreased with age. The data of the variation statistics indicated the existence of a relationship between obesity and consumption of individual dairy products. However, the dependence of these same parameters on age reduced the reliability and evidentiary strength of the results of the variation analysis, since the prevalence of obesity increases significantly with age. To study the association of dairy consumption and the spread of obesity, a logistic regression model was used with the calculation of the odd ratio of the risk of obesity in the consumption of dairy products with adjustment for age, education level and per capita family income. The results of the association analysis, with adjustment for socio-demographic variables, unambiguously showed a significant reduction in the risk of obesity in persons of both sexes consuming yoghurt (OR mean 0.76; CI 0.71; 0.82; p<0.001), cottage cheese (OR mean 0.88; CI 0.85; 0.91;p<0.001), as well as in women with consumption of drinking milk (OR mean 0.87; CI 0.84; 0.91; p<0.001). The increase in the risk of obesity was observed only in men with consuming kefir (OR mean 1.08; CI 1.01; 1.16; p-0.023) or hard cheeses (OR mean 1.14; CI 1.08; 1.20; p<0.001) with adjustment for socio-demographic variables.
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Kefir, fonksiyonel gıdalardan probiyotikler alt kolunun önemli bir üyesi olup, içe-riğinde birçok faydalı maya ve bakteri bulunduran, fermente bir süt ürünüdür. Ke-fir, B1 ve B12 vitamini, kalsiyum, amino asitler, folik asit ve K vitamininden zen-gindir. İyi bir fosfor ve biyotin kaynağıdır. Kefir ilaveli diyetler kullanılarak yapı-lan çalışmalarda antikanserojenik, antibakteriyel, immunolojik, hipokolesterole-mik, gastrointestinal ve metabolik faydalar görüldüğü belirtilmiştir. Ayrıca besin alımının süt ürünleri ve bunların bileşenleriyle düzenlenmesi, obezite pandemisinin önlenmesi ve yönetimine katkıda bulunma potansiyeline sahiptir. Kefir, bu etkile-rinin yanı sıra değişik beslenme ve büyüme faktörlerini içermesi bakımından her yaştan insan tarafından tüketilebilir. Yüksek besin değeri ve sağlık üzerine etkile-rinden dolayı prematüre bebeklerin, çocukların, hamilelerin, bakıma muhtaç kişile-rin, destek tedaviye ihtiyacı olanların, laktoz intoleransı olan kişilerin ve yaşlıların günlük diyetlerinde kefir tüketmeleri tavsiye edilir. Ayrıca sporcularda immün yetmezlik sorunlarında ve kas kontraksiyon bozukluklarına neden olan mineral eksikliklerinin tamamlanmasında diyete büyük destek sağlar. Kefir, sağlığa olan faydalarıyla ilgili yeni araştırmalar sonucunda giderek popüler hale gelmektedir. Gelecekte yapılacak çalışmalarla kefirin tedavi edici ve besleyici özellikleri daha çok ortaya konulacaktır.
Chapter
Fermented foods have a profound probiotic value and share an integral part of age-old wisdom from ancient civilizations across the globe. Over decades of human history the pioneering practice of food fermentation has added taste to cultural ethos and has expanded significantly from household level to gradually improve the available food resources combat the hidden hunger. Consumer demand for these healthier foods with balanced nutrient profile along with metabolic, health, functional, nutritional, and nutraceutical benefits has gained pace that been derived from anecdotal evidence of their effect against chronic diseases. Fermented foods act as a sink of beneficial microorganisms with various health-promoting functions like preventing intestinal tract infections, decreasing cholesterol level, enhancing lactose metabolism, immunity, calcium absorption, protein digestibility, synthesis of vitamins (vitamin B, nicotinic acid, and folic acid), and counteracting effect of foodborne pathogens. Most of the fermented foods are derived from fruits, vegetables, dairy and some are cereal based as well. In this chapter, some explorative information on traditional fermented fruit, vegetable, dairy, and rice-based foods and beverages has been assembled to illustrate their functional aspects. The chapter deals with production, traditional processing, probiotic and therapeutic values of various probiotic dairy-based foods like cheese, yoghurt, and kefir; some plant-based foods that are widely consumed (kimchi, sauerkraut, pickles, kombucha, kefir, tempeh, yoghurt, miso, etc.); and various South Indian traditional cuisines like idli and dosa to encourage entrepreneurs to develop large-scale production and meet the growing market demand of functional foods.
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Background & Aims Evidence suggests that gut microbiota is a potential factor in the pathophysiology of both obesity and related metabolic disorders. While individual randomized controlled trials (RCTs) have evaluated the effects of probiotics on adiposity and cardiovascular disease (CVD) risk factors in subjects with overweight and obesity, the results are inconsistent. Thus, this systematic review and meta-analysis aimed to evaluate the effects of probiotic supplementation on body weight, body adiposity and CVD risk markers in overweight and obese subjects. Methods A systematic search for RCTs published up to December 2020 was conducted in MEDLINE (via PubMed), EMBASE, Scopus and LILACS. Meta-analysis using a random-effects model was chosen to analyze the impact of combined trials. Results Twenty-six RCTs (n=1720) were included. Data pooling showed a significant effect of probiotics in reducing body weight (MD:-0.70kg; 95%CI:-1.04,-0.35kg; P<0.0001), body mass index (BMI) (MD:-0.24kg/m²; 95%CI:-0.35,-0.12kg/m²; P=0.0001), waist circumference (WC) (MD:-1.13cm; 95%CI:-1.54,-0.73cm; P<0.0001), fat mass (MD:-0.71kg; 95%CI:-1.10,-0.32kg; P=0.0004), tumor necrosis factor-α (MD:-0.16pg/ml; 95%CI:-0.24,-0.08pg/ml; P=0.0001), insulin (MD:-0.85mcU/ml; 95%CI:-1.50,-0.21mcU/ml; P=0.010), total cholesterol (MD:-0.16mmol/l; 95%CI:-0.26,-0.05mmol/l; P=0.003) and LDL (MD:-0.09mmol/l; 95%CI:-0.16,-0.03mmol/l; P=0.006) compared with control groups. There was a significant decrease in body weight, BMI and WC in studies using both single and multi-bacterial species. Decreases in body adiposity parameters were only observed in studies using a probiotic dose of ≥ 10¹⁰ CFU and for ≥ 8 weeks duration. Conclusions The present meta-analysis suggests that probiotics consumption may be helpful for improving body weight, body adiposity and some CVD risk markers in individuals with overweight and obesity. The review was registered on PROSPERO (International prospective register of systematic reviews): CRD42020183136.
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In the last decades changes in the pattern of health and disease in Latin America and in the world has been observed, with an increase in cases of chronic non-communicable diseases. Changes in intestinal microbiota composition can contribute to the development of these diseases and be useful in their management. In this context, the consumption of fermented foods with probiotic properties, such as kefir, stands out due to its gut microbiota-modulating capacity. There is an increasing interest in the commercial use of kefir since it can be marketed as a natural beverage containing health-promoting bacteria and has been gaining international popularity in Latin America. Also the consumption of these drinks in Latin America seems to be even more relevant, given the socioeconomic situation of this population, which highlights the need for disease prevention at the expense of its treatment. In this narrative review, we discuss how kefir may work against obesity, diabetes mellitus, liver disease, cardiovascular disorders, immunity, and neurological disorders. Peptides, bioactive compounds and strains occurring in kefir, can modulate gut microbiota composition, low-grade inflammation and intestinal permeability, which consequently may generate health benefits. Kefir can also impact on the regulation of organism homeostasis, with a direct effect on the gut-brain axis, being a possible strategy for the prevention of metabolic diseases. Further studies are needed to standardize these bioactive compounds and better elucidate the mechanisms linking kefir and intestinal microbiota modulation. However, due to the benefits reported, low cost and ease of preparation, kefir seems to be a promising approach to prevent and manage microbiota-related diseases in Latin America and the rest of the world.
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The prevalence and incidence of obesity, and associated complications, such as type 2 diabetes, in the Middle East and north Africa (MENA) region rank among the highest in the world. Little is known about the effectiveness of dietary weight loss interventions conducted in the MENA region. We conducted a systematic review of randomized clinical trials aiming to assess the effectiveness of dietary interventions for weight loss in the adult population originating from and residing in the MENA region. In accordance with PRISMA guidelines, PubMed, CINAHL, Cochrane, and EMBASE were systematically searched for randomized controlled trials (RCT) using dietary interventions for weight loss conducted in the MENA region. RCTs examining weight loss as an outcome in adults (≥ 18 years old) were included. The Cochrane Collaboration tool for assessing risk of bias was used to ascertain the quality of the eligible RCTs and the Template for Intervention Description and Replication for population health and policy interventions (TIDieR‐PHP) checklist was used to evaluate the reporting of the interventions. Twenty‐nine RCTs including 2792 adults from five countries in the MENA region met the search criteria. Study participants were predominantly middle‐aged females. Duration of follow up was mostly 3 months or less. Weight loss ranged from −0.7 to 16 kg across all intervention groups and the average weight loss was 4.8 kg. There was paucity of description of the weight loss interventions and variations amongst studies did not allow a meta‐analysis of findings. It was not possible to draw firm conclusions on the effectiveness of dietary weight loss interventions in the region. High quality studies using more structured interventions of longer duration with standardized outcome measures are needed in the MENA region to support clinical practice with evidence‐based interventions for obesity.
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Background Endothelial dysfunction is commonly present in estrogen-deficient states, e.g., after menopause. In the search for alternatives to hormone replacement therapy (HRT), treatments based on phytoestrogens or in non-hormonal mechanisms have been under evaluation. Objective Here we aim to present an overview of innovative potential treatments for endothelial dysfunction in estrogen-deficient states, introducing our own preliminary data about the probiotic kefir. Methods We conducted a review based on a PubMed database search for keywords of interest (Menopause, Ovariectomy, Vascular dysfunction, Hot flashes, Metformin, Statins, Phytoestrogens, Omega-3, Vitamin D, Probiotics). Results Vascular parameters were found to be improved by both metformin and statins through pleiotropic effects, being related to a decrease in oxidative stress and restoration of the nitric oxide pathway. Phytoestrogens such as genistein and resveratrol have also been shown to improve vascular dysfunction, which seems to involve their estrogenic-like actions. Omega-3, vitamin D and its analogues, as well as probiotics, have shown similar vascular beneficial effects in both postmenopausal women and an animal model of ovariectomy (OVX), which could be related to antioxidant and/or anti-inflammatory effects. Moreover, our preliminary data on the probiotic kefir treatment in OVX rats suggested a vascular antioxidant effect. In particular, some evidence point to statins and vitamin D having anti-atherogenic effects. Conclusion Pleiotropic effects of common medications and natural compounds could have a therapeutic potential for endothelial dysfunction in estrogen-deficient states. They could, therefore, work as future complementary or alternative treatments to HRT.
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Kefir and its related products are renowned nutraceutical dairy products produced through fermentation of yeasts and bacteria naturally present in grains of kefir. The nutritional attributes of this self-carbonated beverage are due to presence of vital nutrients such as carbohydrates, proteins, minerals, vitamins, and some nutraceutical components. Antimicrobial activity, better gut health, anticarcinogenic activity, control on serum glucose and cholesterol, control on lactose intolerance and better immune system can be achieved through its regular consumption. Moreover, on the one side kefir is good dietetic beverage, and of particular interest of athletes, and on the other side the whole kefir is good for feeding small babies and pre-schoolers for good tolerance against disease and quick weight gain. Lots of works have been done on kefir from a health point of view. This study summarizes all the data that have been compiled to date. The purpose of this review is to gather information about microbiological, chemical, nutritional, and therapeutic aspects of kefir and kefir-like products to provide justification for its consumption. This review leads us to conclude that kefir begins a new dawn of food for the mankind.
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Kefir is a fermented milk beverage. The milk fermentation is achieved by the of kefir grains, a cluster of microorganisms held together by a polysaccharide matrix named kefiran. Kefir grains are an example of symbiosis between yeast and bacteria. They have been used over years to produce kefir, a fermented beverage that is consumed all over the world, although its origin is Caucasian. A vast variety of different species of organisms forming the kefir grains, comprising yeast and bacteria, have been isolated and identified. Kefir is a probiotic food. Probiotics have shown to be beneficial to health, being presently of great interest to the food industry. Kefir has been accredited with antibacterial, antifungal and antitumoural activities among other beneficial attributes. This review includes a critical revision of the microbiological composition of kefir along with its beneficial properties to human health.
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Recent data from this laboratory demonstrate that increasing adipocyte intracellular Ca(2+) results in a coordinated stimulation of lipogenesis and inhibition of lipolysis. We have also noted that increasing dietary calcium of obese patients for 1 year resulted in a 4.9 kg loss of body fat (P<0.01). Accordingly, we tested the possibility that calcitrophic hormones may act on adipocytes to increase Ca(2+) and lipid metabolism by measuring the effects of 1, 25-(OH)(2)-D in primary cultures of human adipocytes, and found significant, sustained increases in intracellular Ca(2+) and a corresponding marked inhibition of lipolysis (EC(50) approximately 50 pM; P<0.001), suggesting that dietary calcium could reduce adipocyte mass by suppressing 1,25-(OH)(2)-D. To test this hypothesis, we placed transgenic mice expressing the agouti gene specifically in adipocytes on a low (0.4%) Ca/high fat/high sucrose diet either unsupplemented or with 25 or 50% of the protein replaced by non-fat dry milk or supplemented to 1.2% Ca with CaCO(3) for 6 wk. Weight gain and fat pad mass were reduced by 26-39% by the three high calcium diets (P<0.001). The high calcium diets exerted a corresponding 51% inhibition of adipocyte fatty acid synthase expression and activity (P<0.002) and stimulation of lipolysis by 3. 4- to 5.2-fold (P<0.015). This concept of calcium modulation of adiposity was further evaluated epidemiologically in the NHANES III data set. After controlling for energy intake, relative risk of being in the highest quartile of body fat was set to 1.00 for the lowest quartile of Ca intake and was reduced to 0.75, 0.40, and 0.16 for the second, third, and fourth quartiles, respectively, of calcium intake for women (n=380;P<0.0009); a similar inverse relationship was also noted in men (n=7114; P<0.0006). Thus, increasing dietary calcium suppresses adipocyte intracellular Ca(2+) and thereby modulates energy metabolism and attenuates obesity risk.
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Randomisation is the process of assigning clinical trial participants to treatment groups. Randomisation gives each participant a known (usually equal) chance of being assigned to any of the groups. Successful randomisation requires that group assignment cannot be predicted in advance.
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Background: Previous results suggested that increased intake of dairy calcium is associated with reduced weight and fat mass. Objective: The purpose of this study was to determine whether long-term increases in consumption of dairy calcium alter body weight and fat mass in young, healthy women. Design: We used a randomized, 1-y intervention for dairy calcium. Subjects were 155 young (aged 18–30 y), healthy, normal-weight women with intake of dietary calcium < 800 mg/d and energy intake ≤ 2200 kcal/d. Women were randomly assigned to 1 of 3 groups: 1) control: continue established dietary intake; 2) medium dairy: substitute dairy products to achieve intake of calcium of ≈1000–1100 mg/d and maintain isocaloric intake; 3) high dairy: substitute dairy products to achieve intake of calcium of 1300–1400 mg/d and maintain isocaloric intake. The main outcome measures were 1-y changes in body weight (in kg) and fat mass (in kg). One hundred thirty-five women completed the trial. Results: Mean intakes of calcium during the intervention were 742.4 ± 321.5, 1026.4 ± 311.3, and 1131.29 ± 337.2 mg/d for the control, medium-dairy, and high-dairy groups, respectively (P < 0.0001). No significant differences were observed in the mean 1-y change in body weight between the control, medium-dairy, and high-dairy groups (0.8 ± 2.8, 0.7 ± 3.0, and 1.5 ± 4.1 kg, respectively; P = 0.45). No significant differences were observed in the mean 1-y change in fat mass between the control, medium-dairy, and high-dairy groups (−0.5 ± 2.5, 0.3 ± 2.7, and 0.5 ± 3.5 kg, respectively; P = 0.26). Conclusion: Increased intake of dairy products does not alter body weight or fat mass in young, healthy women over 1 y.
Article
The role of protein in body-weight regulation has been under-exposed so far. Recent findings suggest that protein plays a key role in the regulation of food intake through satiety, which is related to diet-induced thermogenesis. Protein also plays a key role in body weight regulation through its effect on thermogenesis and body composition. A high percentage of energy from dietary protein limits body-weight (re)gain through its satiety and energy-inefficiency. This may imply that the recommendations for protein intake would increase, while total energy intake may decrease. This does not only hold for the energy-balance situation, but also during a negative energy balance, i.e. during weight loss, and during weight maintenance thereafter. In the long term, satiety still is sustained despite a low energy intake. Furthermore, the contributions of an improved body composition and a continuously increased thermogenesis support long-term weight maintenance.
Article
Purpose: In Europe, only a few population-based studies have been conducted on obesity in different countries at the same time using homogeneous methodologies. We provide updated information on the prevalence of overweight and obesity in Europe, using data from a pan-European survey. Methods: We considered data from a representative cross-sectional study conducted in 2010 in 16 European countries (i.e., Albania, Austria, Bulgaria, Czech Republic, Croatia, England, Finland, France, Hungary, Ireland, Italy, Latvia, Poland, Romania, Spain, and Sweden), using a uniform protocol and comparable methods, on a total of 14,685 adults (aged ≥ 18 years) providing information on self-reported height and weight. Results: Almost half of the interviewed European adults (47.6%) were overweight or obese (54.5% in men and 40.8% in women), and 12.8% (14.0% in men and 11.5% in women) were obese. Obesity prevalence was lower in Western/Southern (11.1%) than in Central/Eastern (12.4%) and Northern European countries (18.0%). It ranged from 7.6% in Italy to more than 20% in Croatia (21.5%) and England (20.1%). Prevalence of obesity significantly increased with age and decreased with level of education. As compared to never smokers, obesity was less frequent in current smokers and more frequent in male, but not female, ex-smokers. Conclusions: The lowest prevalence of obesity was observed in Mediterranean countries, particularly in Italy and France. Intervention to control obesity in Europe should focus on subgroups with higher prevalence of obesity, including adults of lower socioeconomic status and male ex-smokers.
Article
Energy balance is an equilibrium between the amount of energy extracted from the diet and the amount expended. Selective pressures throughout evolution have programmed animals to protect energy stores through the accumulation of adipose tissue; as diets have changed and energy-dense foods have become readily available, obesity rather than malnutrition has become the primary concern in developed nations. Nevertheless, factors other than the types of food and their availability appear to be important. Recent evidence suggests that the gut microbiota play a role in energy harvest, storage, and expenditure. The preponderance of the evidence demonstrates that germ-free mice are protected against obesity and that the transfer of gut microbes from conventionally raised animals results in dramatic increases in body fat content and insulin resistance. Moreover, the composition of the gut microbiota has been shown to differ in lean and obese humans and animals and to change rapidly in response to dietary factors. The gut microbiota may also influence the development of conditions characterized by low-level inflammation, such as obesity and type 2 diabetes, through systemic exposure to bacterial lipopolysaccharide derived from the intestinal microbiota. Together, these data suggest that modification of the gut microbiota may be a relevant therapeutic avenue for obesity and other metabolic disorders.
Article
Kefir is a fermented milk beverage. The milk fermentation is achieved by the use of kefir grains, a cluster of microorganisms held together by a polysaccharide matrix named kefiran. Kefir grains are an example of symbiosis between yeast and bacteria. They have been used over years to produce kefir, a fermented milk beverage that is consumed all over the world, although its origin is Caucasian. A vast variety of different species of organisms forming the kefir grains, comprising yeast and bacteria, have been isolated and identified. Kefir is a probiotic food. Probiotics have shown to be beneficial to health, being presently of great interest to the food industry. Kefir has been accredited with antibacterial, antifungal and antitumoural activities among other beneficial attributes. This review includes a critical revision of the microbiological composition of kefir along with its beneficial properties to human health.
Article
Consumption of fermented milk (FM) containing a probiotic, Lactobacillus gasseri SBT2055 (LG2055), previously showed a reduction in abdominal adiposity in a randomised controlled trial (RCT) using FM with 108 colony-forming units (cfu) of LG2055/g. However, whether the effectiveness is observed at lower concentrations, the recommended minimum or intermediate levels of probiotics (106 or 107cfu/g, respectively), remains to be examined. A multi-centre, double-blind, parallel-group RCT was conducted using 210 healthy Japanese adults with large visceral fat areas (80·2-187·8 cm2). They were balanced for their baseline characteristics and randomly assigned to three groups receiving FM containing 107, 106 or 0 (control) cfu LG2055/g of FM, and were asked to consume 200 g FM/d for 12 weeks. Abdominal visceral fat areas, which were determined by computed tomography, at week 12, changed from baseline by an average of - 8·5 % (95 % CI - 11·9, - 5·1; P< 0·01) in the 107 dose group, and by - 8·2 % (95 % CI - 10·8, - 5·7; P< 0·01) in the 106 dose group. Other measures including BMI, waist and hip circumferences, and body fat mass were also significantly decreased from baseline at week 12 in both groups; interestingly, the cessation of taking FM for 4 weeks attenuated these effects. In the control group, none of these parameters significantly decreased from baseline. These findings demonstrate that consumption of LG2055 at doses as low as the order of 108cfu/d exhibited a significant lowering effect on abdominal adiposity, and suggest that constant consumption might be needed to maintain the effect.
Article
Obesity is a metabolic disorder afflicting people globally. There has been a pivotal advancement in the understanding of the intestinal microbiota composition and its implication in extraintestinal (metabolic) diseases. Therefore, any agent modulating gut microbiota may produce an influential effect in preventing the pathogenesis of disease. Probiotics are live microbes that, when administered in adequate amounts, have been shown to confer health benefits to the host. Over the years, probiotics have been a part of the human diet in the form of different fermented foods consumed around the world. Their influence on different physiologic functions in the host is increasingly being documented. The antiobesity potential of probiotics is also gaining wide attention because of increasing evidence of the role of gut microbiota in energy homeostasis and fat accumulation. Probiotics have also been shown to interact with the resident bacterial members already present in the gut by altering their properties, which may also affect the metabolic pathways involved in the regulation of fat metabolism. The underlying pathways governing the antiobesity effects of probiotics remain unclear. However, it is hoped that the evidence presented and discussed in this review will encourage and thus drive more extensive research in this field.
Article
Purpose: To comprehensively review the data on the relationship between the consumption of dairy fat and high-fat dairy foods, obesity, and cardiometabolic disease. Methods: We have conducted a systematic literature review of observational studies on the relationship between dairy fat and high-fat dairy foods, obesity, and cardiometabolic disease. We have integrated these findings with data from controlled studies showing effects of several minor dairy fatty acids on adiposity and cardiometabolic risk factors, and data on how bovine feeding practices influence the composition of dairy fat. Results: In 11 of 16 studies, high-fat dairy intake was inversely associated with measures of adiposity. Studies examining the relationship between high-fat dairy consumption and metabolic health reported either an inverse or no association. Studies investigating the connection between high-fat dairy intake and diabetes or cardiovascular disease incidence were inconsistent. We discuss factors that may have contributed to the variability between studies, including differences in (1) the potential for residual confounding; (2) the types of high-fat dairy foods consumed; and (3) bovine feeding practices (pasture- vs. grain-based) known to influence the composition of dairy fat. Conclusions: The observational evidence does not support the hypothesis that dairy fat or high-fat dairy foods contribute to obesity or cardiometabolic risk, and suggests that high-fat dairy consumption within typical dietary patterns is inversely associated with obesity risk. Although not conclusive, these findings may provide a rationale for future research into the bioactive properties of dairy fat and the impact of bovine feeding practices on the health effects of dairy fat.
Article
Dietary calcium plays a key role in the regulation of energy metabolism and obesity risk. This appears to be mediated primarily by dietary calcium modulation of circulating calcitriol, which in turn regulates adipocyte intracellular calcium ([Ca2+]i). Increased [Ca2]i stimulates lipogenic gene expression and activity and inhibits lipolysis, resulting in increased adipocyte lipid accumulation. Since calcitriol stimulates adipocyte Ca2+ influx, low calcium diets promote adiposity, while dietary calcium-suppression of calcitriol reduces adiposity. These concepts are confirmed in controlled rodent studies as well as by epidemiological and clincial trial data, all of which confirm protection from obesity with high calcium intakes. Moreover, dairy sources of calcium exert markedly greater effects which are most likely attributable to additional bioactive compounds in dairy which act synergistically with calcium to attenuate adiposity.
Article
ABSTRACT Recent research has shown the marked differences in association with disease between obesity localized to the abdominal respectively to the gluteal-femoral regions. In this review systematic analyses were performed of the associations between obesity (body mass index, BMI) or abdominal obesity (increased waist-over-hip circumference ratio, WHR) on the one hand, and a number of disease end points, and their risk factors, as well as other factors on the other, WHR was associated with cardiovascular disease, premature death, stroke, non-insulin-dependent diabetes mellitus and female carcinomas. In contrast, BMI tended to be negatively correlated to cardiovascular disease, premature death, and stroke, but positively to diabetes. The established risk factors for these end points were found to correlate to WHR, while this was often not the case with BMI. BMI was positively correlated only to insulin, triglycerides and blood pressure. Together with diabetes mellitus, this seems to constitute a metabolic group of conditions which are thus associated with BMI. Androgens (in women), and perhaps Cortisol, seem to be positively, and progesterone negatively correlated to WHR. The WHR was also positively associated with sick leave, several psychological maladjustments, psychosomatic and psychiatric disease. Attempts were made to interpret these findings. In a first alternative an elevation of FFA concentration, produced from abdominal adipose tissue, was considered to be the trigger factor for the pathologic aberrations associated with abdominal distribution of body fat. When obesity is added, the metabolic aberrations may be exaggerated. In a second alternative adrenal cortex hyperactivity was tested as the cause. When combined with the FFA hypothesis, this might explain many but not all of the findings. It seems possible to produce an almost identical syndrome in primates by defined experimental stress. Women with high WHR were found to have a number of symptoms of poor coping to stress. It was therefore suggested that part of the background to this syndrome might be a hypothalamic arousal syndrome developing with stress. It was concluded that obesity and abdominal distribution of adipose tissue constitute two separate entities with different pathogenesis, clinical consequences and probably treatment.
Article
This study was aimed to assess the beneficial effects on metabolic syndrome of functional yogurt NY-YP901 (Namyang Dairy Product Co. Ltd and Nutra R&BT Inc., Seoul, Korea) supplemented with mixture of Streptococcus thermophilus, Lactobacillus acidophilus, Bifidobacterium infantis and extra-ingredients containing Bifidobacterium breve (CBG-C2), Enterococcus faecalis FK-23, fibersol-2 and so on. This study was designed as an 8-week randomized, double-blind, placebo-controlled, parallel study. Treatment and control groups consumed a functional yogurt NY-YP901 (150 ml) and a placebo yogurt twice a day, respectively, for 8 weeks. Body weight and body mass index (BMI), blood pressure, lipid profiles, fasting glucose with HbA1C and waist circumference were measured before and after treatment. Inclusion criteria were healthy individuals between the ages 20-65 years old who submitted an informed consent. During the period August 2009 to December 2009, 101 healthy participants (31 males and 70 females) finished the study. Treatment group were 53 individuals, and the control group were 48 individuals. In the treatment group consuming NY-YP901, statistically significant beneficial changes were observed in body weight (treatment group vs control group=-0.24±1.50 vs +0.64±1.39 kg, P<0.05), BMI (-0.10±0.58 vs +0.24±0.50 kg/m(2), P<0.05 ) and low-density lipoprotein (LDL)-cholesterol (-7.71±14.14 vs -0.43±15.32 mg/dl, P<0.05) after 8 weeks. The change in other parameters was not different between the treatment and the control groups. The functional yogurt NY-YP901 reduced LDL-cholesterol, body weight and BMI in the subjects at a 300-ml consumption daily for 8 weeks. From these findings, regular intake of functional yogurt NY-YP901 may be consequently related to improve metabolic syndrome.
Article
A comprehensive literature search was undertaken to examine the relationship between dairy consumption and overweight/obesity in prospective cohort studies. A literature search from 1980 through to April 2010 was conducted. Nineteen cohort studies met all the inclusion criteria and were included in the systematic review. Of the 19 cohort studies, 10 were among children and adolescents (aged 2 to 14 years, n = 53 to 12,829, follow-up 8 months to 10 years) and nine among adults (aged 18 to 75 years, n = 248 to 42,696, follow-up 2 years to 12 years). A range of dairy food exposure measures were used. Eight studies (three out of 10 studies involving children and five out of nine studies involving adults) showed a protective association against increasing weight gain (measured in various ways); one reported a significant protective association only among men who were initially overweight; seven reported no effect; one reported an increased risk (among children), and two reported both a decreased and increased risk, depending on the dairy food type. The evidence from prospective cohort studies for a protective effect of dairy consumption on risk of overweight and obesity is suggestive but not consistent, making firm conclusions difficult.
Article
Energy homeostasis is regulated by twin factors, energy intake and energy expenditure. Obesity arises when these two factors are out of balance. Recently, the microflora residing in the human gut has been found to be one of the influential factors disturbing energy balance. Recent interest in this field has led to use of the term "gut microbiome" to describe the genomes of trillions of microbes residing in the gut. Metagenomic studies have shown that the human gut microbiome facilitates fermentation of indigestible carbohydrates to short-chain fatty acids that provide excess energy to the body, thus contributing to the obese phenotype. Alteration in the ratio of Bacteroidetes and Firmicutes drives a change in fermentation patterns that could explain weight gain. Therefore, changes in the gut microbiome (induced by antibiotics or dietary supplements) may be helpful in curbing the obesity pandemic. This review provides information on the expansive role the gut microbiome is believed to play in obesity and other related metabolic disorders.
Article
Epidemiologic studies have shown that a high calcium intake is related to lower body weight, fat, and serum lipids in obese individuals. However, clinical studies have shown inconclusive results. The present study was conducted to determine if dairy or calcium supplementation alters body composition or serum lipids in Puerto Rican obese adults without dietary energy restriction or exercise. A 21-wk randomized clinical trial was conducted in 30 obese adults, aged 21-50 y, with usual calcium intakes <700 mg/d. Subjects were randomly assigned to the following: high dairy (∼ 1300 mg/d of calcium from dairy products by substituting foods); high calcium (∼ 1300 mg/d of calcium; ∼ 700 mg/d from diet and 600 mg/d from a supplement); or placebo. Subjects were asked to continue their established dietary intake (except for the high dairy group) and their physical activity during the study. Body weight was measured monthly; body fat, bone, and serum lipids (total cholesterol, high-density lipoprotein, low-density lipoprotein, and triacylglycerol) were measured at baseline and at 21 wk. Pairwise differences in study endpoints among the groups were assessed using ANOVA and post-hoc analysis. Grand mean calcium intake was 1200 ± 370 (median 1187) mg/d in the high dairy group, 1171 ± 265 (median 1165) mg/d in the high calcium group, and 668 ± 273 (median 691) mg/d in the control group, which was significantly lower compared to the two treatment groups (P < 0.001). There were no significant group effects in any of the outcome variables. A high dairy or calcium diet alone did not alter body composition or serum lipids profile in a sample of Puerto Rican obese adults.
Article
Conjugated linoleic acid (CLA), a family of fatty acids found in beef, dairy foods and dietary supplements, reduces adiposity in several animal models of obesity and some human studies. However, the isomer-specific antiobesity mechanisms of action of CLA are unclear, and its use in humans is controversial. This review will summarize in vivo and in vitro findings from the literature regarding potential mechanisms by which CLA reduces adiposity, including its impact on (a) energy metabolism, (b) adipogenesis, (c) inflammation, (d) lipid metabolism and (e) apoptosis.
Article
To examine the role of commercially available kefir, a fermented milk similar to yogurt but containing different fermentation microbes, in preventing antibiotic-associated diarrhea (AAD). Probiotics have shown some promise in preventing AAD. A double-blinded randomized placebo-controlled allocation concealment clinical trial. Primary care patients in the Washington, DC, metropolitan area. A total of 125 children aged 1 to 5 years presenting to primary care physicians. Intervention Kefir drink or heat-killed matching placebo. Main Outcome Measure The primary outcome was the incidence of diarrhea during the 14-day follow-up period in children receiving antibiotics. There were no differences in the rates of diarrhea per group, with 18% in the active group and 21.9% in the placebo group (relative risk, 0.82; 95% confidence interval, 0.54-1.43). Additionally, there were no differences in any secondary outcomes among the groups. However, there were some interesting interactions among initial health at enrollment, age of participants, and sex that require further study. In our trial, kefir did not prevent AAD. Further independent research on the potential of kefir needs to be conducted.
Article
Observational studies have found that dietary calcium intake is inversely related to body weight and body fat mass. One explanatory mechanism is that dietary calcium increases faecal fat excretion. To examine the effect of calcium from dietary supplements or dairy products on quantitative faecal fat excretion, we performed a systematic review with meta-analysis. We included randomized, controlled trials of calcium (supplements or dairy) in healthy subjects, where faecal fat excretion was measured. Meta-analyses used random-effects models with changes in faecal fat excreted expressed as standardized mean differences, as the studies assessed the same outcome but measured in different ways. An increased calcium intake resulted in increased excretion of faecal fat by a standardized mean difference of 0.99 (95% confidence intervals: 0.63–1.34; P < 0.0001; expected to correspond to ∼2g day−1) with moderate heterogeneity (I2 = 49.5%) indicating some inconsistency in trial outcomes. However, the dairy trials showed homogeneous outcomes (I2=0%) indicating consistency among these trials. We estimated that increasing the dairy calcium intake by 1241 mg day−1 resulted in an increase in faecal fat of 5.2 (1.6–8.8) g day−1. In conclusion, dietary calcium has the potential to increase faecal fat excretion to an extent that could be relevant for prevention of weight (re-)gain. Long-term studies are required to establish its potential contribution.
Article
To examine whether dietary changes and the consumption of dairy products fortified with calcium and vitamin D3 versus the use of a calcium supplement alone could have any effect on anthropometric and body composition indices of postmenopausal women over a 12-month period. 101 healthy postmenopausal women were randomized to a dietary intervention group (DG: n=39), receiving approximately 1200 mg of calcium and 7.5 microg of vitamin D3 per day via fortified dairy products and attending biweekly dietary and lifestyle intervention sessions; a calcium supplemented group (CaG: n=26) receiving a total of 1200 mg calcium per day; and a control group who continued with their usual diet (CG: n=36). Dietary, physical activity, anthropometric, body composition and distribution (based on DXA) data were collected at baseline and after 12 months of intervention. No significant differences were observed in the mean 12-month changes in certain anthropometric (i.e. weight, BMI) and DXA (i.e. total body fat and lean mass) indices between groups. However, the DG was found to have a lower decrease in mid-arm muscle circumference (P<0.001) and a lower increase in the sum of skinfolds' thickness (P=0.042) compared with the CaG and the CG. Furthermore, the DG was also found to have a greater decrease in the percentage of legs' fat mass (P=0.025) and a higher increase in the percentage of legs' lean mass (P=0.012) compared with the two other groups. The application of a holistic intervention approach combining nutrition and lifestyle counseling with consumption of fortified dairy products for 12 months was found to have favourable changes in certain anthropometric and body composition indices compared to calcium supplementation alone.
Article
A growing body of evidence supports an antiobesity effect of dairy products; however, the mechanisms remain unclear. The objective of this study was to explore possible intestinal mechanisms by which dairy delivers an antiobesity effect. The human intestinal cell line, NCI-H716, was used to test the hypothesis that branched-chain amino acids and dairy proteins regulate satiety hormone secretion and modulate genes involved in fatty acid and cholesterol metabolism. In dose-response (0.5%, 1.0%, 2.0%, and 3.0%) studies, the effect of leucine, isoleucine, valine, skim milk, casein, and whey on glucagon-like peptide-1 release and the expression of selected genes were tested. Leucine, isoleucine, skim milk, and casein stimulated glucagon-like peptide-1 release (P < 0.05). Isoleucine and whey downregulated the expression of intestinal-type fatty acid binding protein (i-FABP), fatty acid transport protein 4 (FATP4), Niemann-Pick C-1-like-1 protein (NPC1L1), acetyl-coenzyme A carboxylase (ACC), fatty acid synthase (FAS), sterol regulatory element-binding protein-2 (SREBP-2), and 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR; P < 0.05). Leucine and valine downregulated the expression of NPC1L1, ACC, FAS, SREBP-2, and HMGCR (P < 0.05). Casein downregulated the expression of i-FABP, FATP4, ACC, FAS, SREBP-2, and HMGCR (P < 0.05). Skim milk downregulated the expression of ACC, FAS, and SREBP-2, but not i-FABP, FATP4, and NPC1L1. This work suggests that the antiobesity effect of dairy may be mediated, at least in part, by integration of events that promote glucagon-like peptide-1 secretion and inhibit expression of genes involved in intestinal fatty acid and cholesterol absorption and synthesis.
Article
We examined the independent and combined effects of a multi-component exercise program and calcium-vitamin-D(3)-fortified milk on bone mineral density (BMD) in older men. Exercise resulted in a 1.8% net gain in femoral neck BMD, but additional calcium-vitamin D(3) did not enhance the response in this group of older well-nourished men. This 12-month randomised controlled trial assessed whether calcium-vitamin-D(3)-fortified milk could enhance the effects of a multi-component exercise program on BMD in older men. Men (n = 180) aged 50-79 years were randomised into: (1) exercise + fortified milk; (2) exercise; (3) fortified milk; or (4) controls. Exercise consisted of high intensity progressive resistance training with weight-bearing impact exercise. Men assigned to fortified milk consumed 400 mL/day of low fat milk providing an additional 1,000 mg/day calcium and 800 IU/day vitamin D(3). Femoral neck (FN), total hip, lumbar spine and trochanter BMD and body composition (DXA), muscle strength 25-hydroxyvitamin D and parathyroid hormone (PTH) were assessed. There were no exercise-by-fortified milk interactions at any skeletal site. Exercise resulted in a 1.8% net gain in FN BMD relative to no-exercise (p < 0.001); lean mass (0.6 kg, p < 0.05) and muscle strength (20-52%, p < 0.001) also increased in response to exercise. For lumbar spine BMD, there was a net 1.4-1.5% increase in all treatment groups relative to controls (all p < 0.01). There were no main effects of fortified milk at any skeletal site. A multi-component community-based exercise program was effective for increasing FN BMD in older men, but additional calcium-vitamin D(3) did not enhance the osteogenic response.
Article
The effect of dietary calcium on vertebral bone mass in women is controversial. In a randomized study we have investigated the effect of dietary modification in the form of dairy products on vertebral bone mass in 30- to 42-yr-old premenopausal women over a 3-yr period. Twenty women increased their dietary calcium intake by an average of 610 mg/day (P less than 0.03) for 3 yr, while 17 age- and weight-matched women served as controls. Calcium intake was monitored by 3-day diet histories and 24-h urinary calcium excretion. The consumption of the dairy products did not alter serum calcium or PTH levels or the fasting urinary calcium to creatinine ratio. Twenty-four-hour urinary calcium excretion increased by 28% (P less than 0.03) in the supplemented women. Dairy product intake was accompanied by increased dietary fat intake, but there were no statistically significant changes in serum cholesterol, low density lipoprotein cholesterol, or high density lipoprotein cholesterol levels. The vertebral bone density in the women consuming increased calcium did not change over the 3-yr period (-0.4 +/- 0.9%). In contrast, the vertebral bone density in the control women declined (-2.9 +/- 0.8%; P less than 0.001) and was significantly lower than that in the supplemented group at 30 and 36 months. The study suggests that dietary modification in the form of dairy products retards vertebral bone loss in premenopausal women. Therefore, increased calcium intake in estrogen-replete premenopausal women may prevent age-related bone loss.
Article
Recent research has shown the marked differences in association with disease between obesity localized to the abdominal respectively to the gluteal-femoral regions. In this review systematic analyses were performed of the associations between obesity (body mass index, BMI) or abdominal obesity (increased waist