RESUMEN
BACKGROUND: Consumption of dairy foods has been associated with lower blood pressure in certain populations. OBJECTIVE: This study examined the effects of dairy foods on blood pressure (BP) and intracellular calcium ((Ca)(i)) and the dependence of BP changes on changes in (Ca)(i). DESIGN: Twenty-three stage 1 hypertensive adults were fed the following 3 experimental diets (5 wk each) in a randomized cross-over design study; a dairy-rich, high fruits and vegetables diet (D-FandV; 30% fat, 7% saturated fat (SFA), 3.4 servings/d dairy), a high fruits and vegetables diet (FandV; 30% fat, 7% SFA, 0.4 servings/d dairy), and an average Western diet (control; 36% fat, 15% SFA, 0.4 servings/d dairy). Systolic (SBP) and diastolic (DBP) BP, calcium regulatory hormones, and erythrocyte (Ca)(i) were determined. RESULTS: SBP and DBP were significantly reduced by approximately 2 mm Hg following both D-F&V and F&V diets vs. the control (P < 0.05). The D-F&V diet significantly lowered 1,25-dihydroxyvitaminD compared with the F&V and control diets (P < 0.01). Serum calcium, parathyroid hormone, calcitonin, and renin activity were unchanged. The D-F&V diet lowered (Ca)(i) vs. the other two diets (P < 0.01), and this change correlated with the fall in DBP (r = 0.52, P < 0.05). Subjects who responded to the D-F&V diet by significantly reducing (Ca)(i) exhibited significantly greater net decreases in DBP on the D-F&V vs. the F&V (-2.8 +/- 1.0 mm Hg) and control diets (-5.4 +/-1.0 mm Hg; diet x group interaction, P < 0.02). CONCLUSION: Consumption of dairy foods beneficially affects (Ca)(i), resulting in improved BP in a subgroup defined by (Ca)(i) response.
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Presión Sanguínea/efectos de los fármacos , Calcio de la Dieta/uso terapéutico , Calcio/metabolismo , Productos Lácteos , Dieta , Hipertensión/dietoterapia , Vitamina D/análogos & derivados , Adulto , Anciano , Calcio de la Dieta/metabolismo , Calcio de la Dieta/farmacología , Estudios Cruzados , Femenino , Humanos , Masculino , Persona de Mediana Edad , Método Simple Ciego , Vitamina D/sangre , Adulto JovenRESUMEN
OBJECTIVE: Examine the acceptability of sodium-reduced research diets. DESIGN: Randomized crossover trial of three sodium levels for 30 days each among participants randomly assigned to one of two dietary patterns. PARTICIPANTS/SETTING: Three hundred fifty-four adults with prehypertension or stage 1 hypertension who were participants in the Dietary Approaches to Stop Hypertension (DASH-Sodium) outpatient feeding trial. INTERVENTION: Participants received their assigned diet (control or DASH, rich in fruits, vegetables, and low-fat dairy products), each at three levels of sodium (higher, intermediate, and lower) corresponding to 3,500, 2,300, and 1,200 mg/day (150, 100, and 50 mmol/day) per 2,100 kcal. MAIN OUTCOME MEASURES: Nine-item questionnaire on liking and willingness to continue the assigned diet and its level of saltiness using a nine-point scale, ranging from one to nine. STATISTICAL ANALYSES PERFORMED: Generalized estimating equations to test participant ratings as a function of sodium level and diet while adjusting for site, feeding cohort, carryover effects, and ratings during run-in. RESULTS: Overall, participants rated the saltiness of the intermediate level sodium as most acceptable (DASH group: 5.5 for intermediate vs 4.5 and 4.4 for higher and lower sodium; control group: 5.7 for intermediate vs 4.9 and 4.7 for higher and lower sodium) and rated liking and willing to continue the DASH diet more than the control diet by about one point (ratings range from 5.6 to 6.6 for DASH diet and 5.2 to 6.1 for control diet). Small race differences were observed in sodium and diet acceptability. CONCLUSIONS: Both the intermediate and lower sodium levels of each diet are at least as acceptable as the higher sodium level in persons with or at risk for hypertension.
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Dieta Hiposódica/psicología , Hipertensión/dietoterapia , Aceptación de la Atención de Salud , Satisfacción del Paciente , Sodio en la Dieta/administración & dosificación , Negro o Afroamericano/psicología , Presión Sanguínea/efectos de los fármacos , Estudios Cruzados , Productos Lácteos , Dieta Hiposódica/métodos , Relación Dosis-Respuesta a Droga , Femenino , Frutas , Humanos , Masculino , Persona de Mediana Edad , Sodio en la Dieta/efectos adversos , Encuestas y Cuestionarios , Verduras , Población Blanca/psicologíaRESUMEN
CONTEXT: Prolonged calorie restriction increases life span in rodents. Whether prolonged calorie restriction affects biomarkers of longevity or markers of oxidative stress, or reduces metabolic rate beyond that expected from reduced metabolic mass, has not been investigated in humans. OBJECTIVE: To examine the effects of 6 months of calorie restriction, with or without exercise, in overweight, nonobese (body mass index, 25 to <30) men and women. DESIGN, SETTING, AND PARTICIPANTS: Randomized controlled trial of healthy, sedentary men and women (N = 48) conducted between March 2002 and August 2004 at a research center in Baton Rouge, La. INTERVENTION: Participants were randomized to 1 of 4 groups for 6 months: control (weight maintenance diet); calorie restriction (25% calorie restriction of baseline energy requirements); calorie restriction with exercise (12.5% calorie restriction plus 12.5% increase in energy expenditure by structured exercise); very low-calorie diet (890 kcal/d until 15% weight reduction, followed by a weight maintenance diet). MAIN OUTCOME MEASURES: Body composition; dehydroepiandrosterone sulfate (DHEAS), glucose, and insulin levels; protein carbonyls; DNA damage; 24-hour energy expenditure; and core body temperature. RESULTS: Mean (SEM) weight change at 6 months in the 4 groups was as follows: controls, -1.0% (1.1%); calorie restriction, -10.4% (0.9%); calorie restriction with exercise, -10.0% (0.8%); and very low-calorie diet, -13.9% (0.7%). At 6 months, fasting insulin levels were significantly reduced from baseline in the intervention groups (all P<.01), whereas DHEAS and glucose levels were unchanged. Core body temperature was reduced in the calorie restriction and calorie restriction with exercise groups (both P<.05). After adjustment for changes in body composition, sedentary 24-hour energy expenditure was unchanged in controls, but decreased in the calorie restriction (-135 kcal/d [42 kcal/d]), calorie restriction with exercise (-117 kcal/d [52 kcal/d]), and very low-calorie diet (-125 kcal/d [35 kcal/d]) groups (all P<.008). These "metabolic adaptations" (~ 6% more than expected based on loss of metabolic mass) were statistically different from controls (P<.05). Protein carbonyl concentrations were not changed from baseline to month 6 in any group, whereas DNA damage was also reduced from baseline in all intervention groups (P <.005). CONCLUSIONS: Our findings suggest that 2 biomarkers of longevity (fasting insulin level and body temperature) are decreased by prolonged calorie restriction in humans and support the theory that metabolic rate is reduced beyond the level expected from reduced metabolic body mass. Studies of longer duration are required to determine if calorie restriction attenuates the aging process in humans. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT00099151.
Asunto(s)
Restricción Calórica , Longevidad/fisiología , Sobrepeso/fisiología , Estrés Oxidativo/fisiología , Adulto , Composición Corporal , Índice de Masa Corporal , Temperatura Corporal , Daño del ADN , Fragmentación del ADN , Sulfato de Deshidroepiandrosterona/metabolismo , Metabolismo Energético , Ejercicio Físico , Femenino , Glucosa/metabolismo , Humanos , Insulina/metabolismo , Masculino , Persona de Mediana Edad , DescansoRESUMEN
BACKGROUND: The cholesterol-lowering abilities of rice bran's fiber and oil apart from its fatty acid composition remain unclear. OBJECTIVE: The objective of the study was to assess the effects of defatted rice bran and rice bran oil in an average American diet on blood lipids in moderately hypercholesterolemic persons. DESIGN: Study 1 used a parallel-arm design. Twenty-six healthy volunteers consumed a diet with 13-22 g dietary fiber/d for 3 wk, and then 13 of the volunteers were switched to a diet with defatted rice bran to double the fiber intake for 5 wk. Study 2 was a randomized, crossover, 10-wk feeding study performed in 14 volunteers who consumed a diet with rice bran oil (1/3 of the total dietary fat) substituted for an oil blend that had a fatty acid composition similar to that of the rice bran oil. Serum lipids and factor VII were measured in both studies. RESULTS: Defatted rice bran did not lower lipid concentrations. In study 2, total cholesterol was significantly lower with consumption of the diet containing rice bran oil than with consumption of the control diet. Moreover, with consumption of the rice bran oil diet, LDL cholesterol decreased by 7% (P < 0.0004), whereas HDL cholesterol was unchanged. CONCLUSIONS: Rice bran oil, not fiber, lowers cholesterol in healthy, moderately hypercholesterolemic adults. There were no substantial differences in the fatty acid composition of the diets; therefore, the reduction of cholesterol was due to other components present in the rice bran oil, such as unsaponifiable compounds.
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Dieta , Hipercolesterolemia/dietoterapia , Oryza , Adulto , Estudios Cruzados , Método Doble Ciego , Femenino , Humanos , Lipoproteínas/sangre , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Although reductions in total and saturated fat consumption are recommended to reduce the risk of cardiovascular disease, individual variability in plasma lipid responses exists. OBJECTIVE: Our aim was to determine the effect of adiposity and insulin resistance on the lipoprotein response to diets lower in total and saturated fat than the average American diet (AAD). DESIGN: A randomized, double-blind, 3-period crossover controlled feeding design was used to examine the effects on plasma lipids of 3 diets that differed in total fat: the AAD [designed to contain 38% fat and 14% saturated fatty acids (SFAs)], the Step I diet (30% fat with 9% SFAs), and the Step II diet (25% fat with 6% SFAs). The diets were fed for 6 wk each to 86 free-living, healthy men aged 22-64 y at levels designed to maintain weight. RESULTS: Compared with the AAD, the Step I and Step II diets lowered LDL cholesterol by 6.8% and 11.7%, lowered HDL cholesterol by 7.5% and 11.2%, and raised triacylglycerols by 14.3% and 16.2%, respectively. The Step II diet response showed significant positive correlations between changes in both LDL cholesterol and the ratio of total to HDL cholesterol and baseline percentage body fat, body mass index, and insulin. These associations were largely due to smaller reductions in LDL cholesterol with increasing percentage body fat, body mass index, or insulin concentrations. Subdivision of the study population showed that the participants in the upper one-half of fasting insulin concentrations averaged only 57% of the reduction in LDL cholesterol with the Step II diet of the participants in the lower half. CONCLUSION: Persons who are insulin resistant respond less favorably to Step II diets than do those who are insulin sensitive.
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Tejido Adiposo/metabolismo , Enfermedades Cardiovasculares/dietoterapia , LDL-Colesterol/sangre , Dieta con Restricción de Grasas , Resistencia a la Insulina , Obesidad/fisiopatología , Adulto , Índice de Masa Corporal , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/epidemiología , HDL-Colesterol/sangre , Estudios Cruzados , Grasas de la Dieta/administración & dosificación , Método Doble Ciego , Humanos , Insulina/sangre , Insulina/metabolismo , Masculino , Persona de Mediana Edad , Obesidad/sangre , Obesidad/dietoterapia , Factores de Riesgo , Triglicéridos/sangreRESUMEN
Trans-fatty acids have been implicated as a risk factor for cardiovascular disease and diabetes. In addition, a polymorphism at codon 54 (Ala54Thr) in the fatty acid-binding protein 2 (FABP2) gene has been suggested to modify an interaction between dietary fat and insulin sensitivity. We examined the postprandial metabolic profiles after meals enriched with C18:1trans- relative to a similar meal with C18:1cis-fatty acid in individuals who were either FABP2 Ala54 homozygotes or Thr54 carriers. Moderately overweight men and women ate 2 breakfast test meals, separated by 1 week, each providing 40% of their daily energy requirement and containing 50% of energy as fat. In one meal, 10% of energy was from C18:1trans, and in the other meal, the C18:1trans was replaced with C18:1cis. Metabolic parameters were assessed during an 8-hour period. Insulin and C-peptide levels increased more after the C18:1trans meal, and this was associated with a greater fall in free fatty acids. Postprandial glucose levels and oxidation of fatty acids and carbohydrate were not different between the 2 test meals. The Thr54 allele for FABP2 increased the rise in postprandial glucose but not triacylglycerols. Fractional triacylglycerol synthetic rates were higher after consumption of the C18:1trans meal relative to the C18:1cis meal only in Thr54 carriers. These data show that a single meal enriched with C18:1trans-fatty acids can significantly increase insulin resistance, and that in the presence of the FABP2 Thr54 allele, may contribute to increased partitioning of glucose to triacylglycerols and insulin resistance.
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Glucemia/análisis , Grasas de la Dieta/administración & dosificación , Proteínas de Unión a Ácidos Grasos/genética , Lípidos/sangre , Obesidad/metabolismo , Adulto , Péptido C/análisis , Ácidos Grasos no Esterificados/sangre , Femenino , Genotipo , Humanos , Insulina/sangre , Masculino , Persona de Mediana Edad , Periodo Posprandial , Triglicéridos/sangreRESUMEN
In well-controlled feeding studies, participants are expected to adhere to a strict diet by consuming only and all foods provided by the research kitchen. They may find adherence more of a challenge with certain study design features. To assess this we mailed a post-study anonymous questionnaire to participants who had completed one of eight controlled feeding studies at the Pennington Biomedical Research Center, Baton Rouge, LA. Of the 154 respondents, more than 90% always or usually adhered to the diet. Of those who did not adhere, many deviated fewer than four times. Eating all of the foods provided was a greater challenge than refraining from eating foods not allowed. Diet assignment, the allowance of alcohol, and a self-selected Saturday meal affected adherence. The results of this research may be useful in designing controlled feeding studies. Our data indicate that diet adherence is good, and because deviations are few, they are unlikely to jeopardize study results.
Asunto(s)
Dietética , Ingestión de Alimentos , Cooperación del Paciente , Investigación/normas , Adulto , Ensayos Clínicos como Asunto , Femenino , Humanos , Masculino , Planificación de Menú , Control de Calidad , Investigación/estadística & datos numéricos , Proyectos de Investigación , Encuestas y Cuestionarios , Factores de Tiempo , Estados UnidosRESUMEN
OBJECTIVE: Diets high in total and saturated fat are associated with insulin resistance. This study examined the effects of feeding monounsaturated, saturated, and trans fatty acids on insulin action in healthy adults. RESEARCH DESIGN AND METHODS: A randomized, double-blind, crossover study was conducted comparing three controlled 4-week diets (57% carbohydrate, 28% fat, and 15% protein) enriched with different fatty acids in 25 healthy men and women. The monounsaturated fat diet (M) had 9% of energy as C18:1cis (oleic acid). The saturated fat diet (S) had 9% of energy as palmitic acid, and the trans fatty acid diet (T) had 9% as C18:1trans. Body weight was kept constant throughout the study. After each diet period, insulin pulsatile secretion, insulin sensitivity index (S(I)) by the minimal model method, serum lipids, and fat oxidation by indirect calorimetry were measured. RESULTS: Mean S(I) for the M, S, and T diets was 3.44 +/- 0.26, 3.20 +/- 0.26, and 3.40 +/- 0.26 x 10(-4) min(-1). microU(-1). ml(-1), respectively (NS). S(I) decreased by 24% on the S versus M diet in overweight subjects but was unchanged in lean subjects (NS). Insulin secretion was unaffected by diet, whereas total and HDL cholesterol increased significantly on the S diet. Subjects oxidized the least fat on the M diet (26.0 +/- 1.5 g/day) and the most fat on the T diet (31.4 +/- 1.5 g/day) (P = 0.02). CONCLUSIONS: Dietary fatty acid composition significantly influenced fat oxidation but did not impact insulin sensitivity or secretion in lean individuals. Overweight individuals were more susceptible to developing insulin resistance on high-saturated fat diets.
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Resistencia a la Insulina/fisiología , Insulina/metabolismo , Ácido Oléico/administración & dosificación , Ácido Palmítico/administración & dosificación , Adulto , Peso Corporal , Estudios Cruzados , Grasas Insaturadas en la Dieta/administración & dosificación , Método Doble Ciego , Femenino , Humanos , Secreción de Insulina , Masculino , Ácidos Oléicos , Oxidación-ReducciónRESUMEN
BACKGROUND: Nuts appear to have cardiovascular benefits but their effect in diabetic patients is unclear. OBJECTIVE: The objective was to assess effects of almond-enriched diets on insulin sensitivity and lipids in patients with normoglycemia or type 2 diabetes. DESIGN: Study 1 assessed the effect of almonds on insulin sensitivity in 20 free-living healthy volunteers who received 100 g almonds/d for 4 wk. Study 2 was a randomized crossover study that compared 4 diets in 30 volunteers with type 2 diabetes: 1) high-fat, high-almond (HFA; 37% total fat, 10% from almonds); 2) low-fat, high-almond (LFA; 25% total fat, 10% from almonds); 3) high-fat control (HFC; 37% total fat, 10% from olive or canola oil); and 4) low-fat control (LFC; 25% total fat, 10% from olive or canola oil). After each 4-wk diet, serum lipids and oral glucose tolerance were measured. RESULTS: In study 1, almond consumption did not change insulin sensitivity significantly, although body weight increased and total and LDL cholesterol decreased by 21% and 29%, respectively (P < 0.05). In study 2, total cholesterol was lowest with the HFA diet (4.46 +/- 0.14, 4.52 +/- 0.14, 4.63 +/- 0.14, and 4.63 +/- 0.14 mmol/L with the HFA, HFC, LFA, and LFC diets, respectively; P = 0.0004 for fat level). HDL cholesterol was significantly lower with the almond diets (P = 0.002); however, no significant effect of fat source on LDL:HDL was observed. Glycemia was unaffected. CONCLUSIONS: Almond-enriched diets do not alter insulin sensitivity in healthy adults or glycemia in patients with diabetes. Almonds had beneficial effects on serum lipids in healthy adults and produced changes similar to high monounsaturated fat oils in diabetic patients.
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Diabetes Mellitus Tipo 2/metabolismo , Dieta , Glucosa/metabolismo , Insulina/metabolismo , Lípidos/sangre , Prunus , Adulto , Peso Corporal , LDL-Colesterol/sangre , Estudios Cruzados , Diabetes Mellitus Tipo 2/fisiopatología , Grasas de la Dieta/administración & dosificación , Grasas de la Dieta/farmacología , Ácidos Grasos Monoinsaturados/administración & dosificación , Ácidos Grasos Monoinsaturados/farmacología , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Masculino , Persona de Mediana Edad , Aceite de Oliva , Aceites de Plantas/administración & dosificación , Aceites de Plantas/farmacología , Aceite de Brassica napus , Valores de ReferenciaRESUMEN
The Dietary Approaches to Stop Hypertension (DASH) diet substantially lowers blood pressure and reduces blood lipid levels. The DASH diet menus were designed to reach beneficial levels of fiber, potassium, magnesium, and calcium, and therefore contain more fruits, vegetables, and whole grains relative to the control menus, and consequently more phytochemicals. Using the US Department of Agriculture food composition databases, the polyphenol, carotenoid, and phytosterol contents of the diets used in the DASH study were estimated. When compared with the control diet, the DASH diet is higher in flavonols, flavanones, flavan-3-ols, beta-carotene, beta-cryptoxanthin, lycopene, lutein+zeaxanthin, and phytosterols. Flavone levels are similar, whereas isoflavones are present in a small amount in the DASH diet. The roles of these compounds in disease risk reduction are becoming recognized. It therefore is possible that the health benefits of the DASH diet are partially attributable to the phytochemicals and might extend beyond cardiovascular disease risk reduction.
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Carotenoides/análisis , Dieta Hiposódica , Flavonas/análisis , Hipertensión/dietoterapia , Isoflavonas/análisis , Fitosteroles/análisis , Presión Sanguínea/efectos de los fármacos , Bases de Datos Factuales , Grasas de la Dieta/administración & dosificación , Fibras de la Dieta/administración & dosificación , Análisis de los Alimentos , Frutas/química , Humanos , Estudios Multicéntricos como Asunto , Verduras/químicaRESUMEN
Dietary intervention studies of human beings produce valuable information regarding dietary effects on biological processes and risk factors for chronic diseases. Using the well-controlled feeding approach, participants consume only foods that have been precisely prepared in a research kitchen, whereas in behavioral counseling studies, participants self-select their foods within guidelines. Because controlled feeding studies meticulously control experimental diets, they are intellectually and logistically challenging to conduct. They afford exciting opportunities for dietetic professionals in designing protocols, developing budgets, and collaborating in multidisciplinary research teams. Research dietitians use food composition data and chemical analysis of menus to prepare research diets with precision. They determine the energy requirements of subjects and adjust diets as required, most often for weight maintenance, throughout the study. All people involved in research must be attentive to the ethical treatment of the study participants while motivating them to adhere to the protocol requirements. Dietitians possess many of these skills, but may require training specific to well-controlled feeding studies. Information related to the conduct of controlled feeding studies has recently become more accessible. We provide an overview of well-controlled feeding study methodologies, proficiencies for planning and implementing these studies, and training resources.
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Dieta , Dietética/normas , Ensayos Clínicos Controlados Aleatorios como Asunto , Proyectos de Investigación , Dieta/normas , Dietética/educación , Femenino , Análisis de los Alimentos , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Planificación de Menú , Cooperación del Paciente , Competencia Profesional , Control de Calidad , Ensayos Clínicos Controlados Aleatorios como Asunto/ética , Ensayos Clínicos Controlados Aleatorios como Asunto/normas , Investigación , Proyectos de Investigación/normasRESUMEN
A thorough quality assurance (QA) program upholds the integrity of nutrition research studies by yielding reliable data and results. Continually evaluating the implementation of a procedure against a goal and making adjustments when needed enhance the quality of a study's conduct and outcomes. Controlled diet studies require QA processes at various steps beginning with the screening of study participants, through diet preparation and delivery to data collection. Staff training and observations with monitoring activities, are important so tasks are completed according to protocol. When several clinical sites participate as partners in a controlled diet study, uniform procedures must be followed and a formal standardized QA program will assist. The Dietary Approaches to Stop Hypertension (DASH)-Sodium study employed such a program, described in this article, that included training staff, observing procedures, monitoring data for completeness and accuracy, evaluating processes, giving feedback, and documenting that tasks were done according to protocol. Furthermore, QA processes were used in the areas of participant screening, orientation, diet adherence, food procurement and preparation, and exit interviews. Other researchers may implement similar activities to ensure quality in their nutrition research programs.
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Dieta Hiposódica/normas , Hipertensión/dietoterapia , Evaluación de Procesos y Resultados en Atención de Salud , Ensayos Clínicos Controlados Aleatorios como Asunto/normas , Cloruro de Sodio Dietético/administración & dosificación , Estudios de Cohortes , Culinaria , Manipulación de Alimentos/métodos , Humanos , Entrevistas como Asunto , Cooperación del Paciente , Control de CalidadRESUMEN
This research project evaluated changes in food selections, food intake, and body weight during 8 weeks of basic combat training (BCT). During the first week of BCT, 139 soldiers from two companies volunteered for participation in the study. In the eighth week of BCT, 92 soldiers were available for retesting. A digital photography method for measuring food selections and food intake was developed for this study. Fruit intake of soldiers was very low at the beginning and end of BCT. Food intake for grains and milk products was low during the first week of BCT but improved by the end of BCT. Average body weight decreased during the 8 weeks of BCT, but heavier soldiers tended to lose weight and thinner soldiers tended to gain weight. These findings suggest that the overall effect of BCT was a trend toward improvement of healthy eating and healthy body weight.
Asunto(s)
Peso Corporal , Ingestión de Alimentos , Personal Militar , Adulto , Femenino , Preferencias Alimentarias , Humanos , Masculino , Educación y Entrenamiento Físico , Estados UnidosRESUMEN
OBJECTIVE: We evaluated the effects of mixed meals differing in glycemic index (GI) and carbohydrate content on postprandial serum glucose and insulin response, hunger, and satiety over the course of a 12-h day. RESEARCH DESIGN AND METHODS: In this randomized crossover trial, 26 overweight or obese adults received four diets in random order (high GI, high carbohydrate [HGI-HC]; high GI, low carbohydrate [HGI-LC]; low GI, high carbohydrate [LGI-HC]; and low GI, low carbohydrate [LGI-LC]). All meals were prepared by a metabolic kitchen. Participants received breakfast, lunch, and dinner over the course of a 12-h day. Primary outcomes were postprandial serum glucose and insulin quantified as area under the curve. Hunger, fullness, and satiety were assessed by visual analog scale. RESULTS: The HGI-LC, LGI-HC, and LGI-LC diets significantly reduced glucose and insulin area under the curve compared with the HGI-HC diet (P < 0.001 for all comparisons). There were no significant differences in ratings of hunger, fullness, or satiety between the different dietary treatments. CONCLUSIONS: Reducing the GI or carbohydrate content of mixed meals reduces postprandial glycemia and insulinemia, and these changes can be sustained over the course of an entire day. However, there were no differences in subjective hunger and satiety ratings between the diets. These results demonstrate that maintaining a low GI or glycemic load diet is an effective method of controlling serum glucose and insulin levels.
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Carbohidratos de la Dieta/farmacología , Índice Glucémico , Saciedad/efectos de los fármacos , Adolescente , Adulto , Anciano , Glucemia/efectos de los fármacos , Glucemia/metabolismo , Femenino , Humanos , Insulina/sangre , Masculino , Persona de Mediana Edad , Periodo Posprandial , Adulto JovenRESUMEN
BACKGROUND: Phytosterol supplementation of 2 g/d is recommended by the National Cholesterol Education Program to reduce LDL cholesterol. However, the effects of different intakes of phytosterol on cholesterol metabolism are uncertain. OBJECTIVE: We evaluated the effects of 3 phytosterol intakes on whole-body cholesterol metabolism. DESIGN: In this placebo-controlled, crossover feeding trial, 18 adults received a phytosterol-deficient diet (50 mg phytosterols/2000 kcal) plus beverages supplemented with 0, 400, or 2000 mg phytosterols/d for 4 wk each, in random order. All meals were prepared in a metabolic kitchen; breakfast and dinner on weekdays were eaten on site. Primary outcomes were fecal cholesterol excretion and intestinal cholesterol absorption measured with stable-isotope tracers and serum lipoprotein concentrations. RESULTS: Phytosterol intakes (diet plus supplements) averaged 59, 459, and 2059 mg/d during the 3 diet periods. Relative to the 59-mg diet, the 459- and 2059-mg phytosterol intakes significantly (P < 0.01) increased total fecal cholesterol excretion (36 +/- 6% and 74 +/- 10%, respectively) and biliary cholesterol excretion (38 +/- 7% and 77 +/- 12%, respectively) and reduced percentage intestinal cholesterol absorption (-10 +/- 1% and -25 +/- 3%, respectively). Serum LDL cholesterol declined significantly only with the highest phytosterol dose (-8.9 +/- 2.3%); a trend was observed with the 459-mg/d dose (-5.0 +/- 2.1%; P = 0.077). CONCLUSIONS: Dietary phytosterols in moderate and high doses favorably alter whole-body cholesterol metabolism in a dose-dependent manner. A moderate phytosterol intake (459 mg/d) can be obtained in a healthy diet without supplementation. This trial was registered at clinicaltrials.gov as NCT00860054.
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Colesterol/metabolismo , Fitosteroles/farmacología , Adolescente , Adulto , Anciano , Presión Sanguínea , Índice de Masa Corporal , LDL-Colesterol/sangre , Estudios Cruzados , Dieta , Suplementos Dietéticos , Femenino , Humanos , Persona de Mediana Edad , Fitosteroles/administración & dosificación , Fitosteroles/sangre , Adulto JovenRESUMEN
Atypical antipsychotic medications like olanzapine (OLZ) induce weight gain and increase the risk of diabetes in patients with schizophrenia. The goal of this study was to assess potential mechanisms of OLZ-induced weight gain and accompanying metabolic effects. Healthy, lean, male volunteers received OLZ and placebo (PBO) in a randomized, double-blind, crossover study. In periods 1 and 2, subjects received OLZ (5 mg for 3 days then OLZ 10 mg for 12 days) or matching PBO separated by a minimum 12-day washout. Twenty-four hour food intake (FI), resting energy expenditure (REE), activity level, metabolic markers, and insulin sensitivity (IS) were assessed. In total, 30 subjects were enrolled and 21 completed both periods. Mean age and BMI were 27 years (range: 18-49 years) and 22.6 +/- 2.2 kg/m(2), respectively. Relative to PBO, OLZ resulted in a 2.62 vs. 0.08 kg increase in body weight (P < 0.001) and 18% (P = 0.052 or 345 kcal) increase in FI. Excluding one subject with nausea and dizziness on the day of OLZ FI measurement, the increase in FI was 547 kcal, (P < 0.05). OLZ increased REE relative to PBO (113 kcal/day, P = 0.003). Significant increases in triglycerides, plasminogen activator inhibitor-I (PAI-I), leptin, and tumor necrosis factor-alpha (TNF-alpha) were observed. No significant differences in activity level or IS were observed. This study provides evidence that OLZ pharmacology drives the early increase in weight through increased FI, without evidence of decreased energy expenditure (EE), activity level, or short-term perturbations in IS.
Asunto(s)
Antipsicóticos/efectos adversos , Metabolismo Basal/efectos de los fármacos , Benzodiazepinas/efectos adversos , Biomarcadores/sangre , Ingestión de Energía/efectos de los fármacos , Aumento de Peso/efectos de los fármacos , Adolescente , Adulto , Método Doble Ciego , Ejercicio Físico , Humanos , Resistencia a la Insulina , Leptina/sangre , Masculino , Persona de Mediana Edad , Olanzapina , Inhibidor 1 de Activador Plasminogénico/sangre , Valores de Referencia , Triglicéridos/sangre , Factor de Necrosis Tumoral alfa/sangre , Adulto JovenRESUMEN
Bed rest has been used as a model to simulate the effects of space flight on bone metabolism. Thyroid hormones accelerate bone metabolism. Thus, supraphysiologic doses of this hormone might be used as a model to accelerate bone metabolism during bed rest and potentially simulate space flight. The objective of the study was to quantitate the changes in bone turnover after low doses of triiodothyronine (T(3)) added to short-term bed rest. Nine men and 5 women were restricted to bed rest for 28 days with their heads positioned 6 degrees below their feet. Subjects were randomly assigned to receive either placebo or oral T(3) at doses of 50 to 75 microg/d in a single-blind fashion. Calcium balance was measured over 5-day periods; and T(3), thyroxine, thyroid-stimulating hormone, immunoreactive parathyroid hormone, osteocalcin, bone alkaline phosphatase, and urinary deoxypyridinoline were measured weekly. Triiodothyronine increased 2-fold in the men and 5-fold in the women during treatment, suppressing both thyroxine and thyroid-stimulating hormone. Calcium balance was negative by 300 to 400 mg/d in the T(3)-treated volunteers, primarily because of the increased fecal loss that was not present in the placebo group. Urinary deoxypyridinoline to creatinine ratio, a marker of bone resorption, increased 60% in the placebo group during bed rest, but more than doubled in the T(3)-treated subjects (P < .01), suggesting that bone resorption was enhanced by treatment with T(3). Changes in serum osteocalcin and bone-specific alkaline phosphatase, markers of bone formation, were similar in T(3)- and placebo-treated subjects. Triiodothyronine increases bone resorption and fecal calcium loss in subjects at bed rest.
Asunto(s)
Reposo en Cama , Calcio/metabolismo , Vuelo Espacial , Triyodotironina/farmacología , Simulación de Ingravidez , Adulto , Reposo en Cama/efectos adversos , Calcio/análisis , Calcio/orina , Heces/química , Femenino , Gravedad Alterada , Humanos , Masculino , Persona de Mediana Edad , Hormona Paratiroidea/metabolismo , Placebos , Método Simple Ciego , Tirotropina/sangre , Tirotropina/metabolismo , Tiroxina/farmacología , Triyodotironina/administración & dosificaciónRESUMEN
The objective of this study was to determine whether vitamin supplementation during long-term (36 wk) ingestion of olestra supplemented with vitamin E could prevent decreases in vitamin E, vitamin A, and carotenoids. This was a 36-wk study of 37 healthy males randomly assigned to consume a control diet composed of 33% energy from fat, a similar diet in which one third of the energy from fat had been replaced with olestra, or a fat-reduced (25% of energy from fat) diet. Subjects also ingested a daily multivitamin (Centrum). Serum concentrations of alpha-tocopherol, retinol, beta-carotene, lycopene, and lutein + zeaxanthin were analyzed by HPLC. Subjects eating the olestra-containing diet had substantial decreases in serum beta-carotene, lycopene, and lutein + zeaxanthin, which occurred by 12 wk; these changes were found despite correcting for serum total cholesterol or BMI. Serum beta-carotene and lycopene concentrations were below the lower limit of the reference range (<0.186 and <0.298 mumol/L, respectively) at one or more time points. The slight decline in serum alpha-tocopherol concentration, significant at 24 wk, was caused by the decline in serum cholesterol. Retinol concentrations decreased with time in all 3 groups, but were not affected by olestra. We conclude that supplementation with a multivitamin containing vitamins A and E was adequate to prevent olestra-induced decrease in serum alpha-tocopherol and retinol. Olestra-induced decreases in serum beta-carotene, lycopene, and lutein + zeaxanthin were not prevented by the vitamin supplement used in this study.
Asunto(s)
Carotenoides/sangre , Grasas Insaturadas en la Dieta/administración & dosificación , Sustitutos de Grasa/administración & dosificación , Ácidos Grasos/administración & dosificación , Sacarosa/análogos & derivados , Sacarosa/administración & dosificación , Vitamina A/sangre , Vitamina E/sangre , Vitaminas/administración & dosificación , Adulto , Dieta con Restricción de Grasas , Grasas Insaturadas en la Dieta/efectos adversos , Grasas Insaturadas en la Dieta/farmacología , Esquema de Medicación , Combinación de Medicamentos , Sustitutos de Grasa/efectos adversos , Sustitutos de Grasa/farmacología , Ácidos Grasos/efectos adversos , Ácidos Grasos/farmacología , Humanos , Masculino , Persona de Mediana Edad , Sacarosa/efectos adversos , Sacarosa/farmacología , Vitaminas/farmacologíaRESUMEN
OBJECTIVE: To examine in two separate studies the effects of replacing dietary fat with Olestra on body composition and weight change in healthy young men and women. METHODS: Ten healthy, lean young men participated in Study One that was a 22-day single blind, within-subject design. After a control diet (40% fat) for eight days Study One subjects received an Olestra-substituted diet (31% metabolizable fat) for 14 days. Study Two was a randomized parallel-arm clinical trial with 15 healthy, lean and overweight young women. These subjects were randomly assigned to receive a control diet (40% fat), an Olestra-containing diet (31% metabolizable fat) or a reduced-fat diet (31% fat) for 10 weeks. All foods were provided to the subjects, and energy intakes were not restricted. The primary endpoint in both studies was change from baseline in body weight. In Study Two, body composition was measured by dual energy x-ray absorptiometry. In both studies, food intake and nutrient compensation were assessed. RESULTS: In Study One fat substitution by Olestra resulted in a significant 1.7 kg weight loss from baseline. In Study Two, change in body weight and body fat from baseline were statistically significant in all groups, but the group with Olestra lost significantly more weight from baseline (-5.0 kg) than the other two groups. In Study One there was partial compensation for the decreased energy intake, while in Study Two, compensation was seen only for those on the reduced-fat diet. CONCLUSION: Replacement of 1/3 of dietary fat with Olestra in periods of up to 10 weeks results in weight loss in men and women.