Impact of improved fat-meat products consumption on anthropometric markers and nutrient intakes of male volunteers at increased cardiovascular risk / Impacto del consumo de productos cárnicos con calidad grasa mejorada sobre marcadores antropométricos e ingesta de nutrientes en voluntarios con riesgo cardiovascular elevado

Introduction: meat products have been recognized to be adequate matrix for incorporating functional ingredients. The impact of meat products formulated by replacing animal fat with a combination of olive, linseed and fish oils on energy and nutrient intakes and anthropometric measurements were tested in a non-randomized-controlled-sequential study. Methods: eighteen male volunteers at high-CVD risk consumed weekly 200 g frankfurters and 250 g pâtés during three 4-wk periods (reduced fat (RF); n3-enriched-RF (n-3RF), and normal fat (NF)), separated by 4-wk washout. Energy and nutrient intakes, healthy eating index (HEI), and anthropometric changes were evaluated. Results: body fat mass rate-of-change and the waist/ hip ratio significantly differs (p=0.018 and p=0.031, respectively) between periods, decreasing body fat mass, waist circumference and waist/hip ratio in RF period and increasing body fat mass in NF one (all p=0.05). Significant inverse correlations were observed between rate-of-change of BMI and ideal body weight with dietary carbohydrate/SFA ratio in n-3RF period (p=0.003 and p=0.006, respectively). Initial diets presented low HEIs (means<60). Carbohydrate, fat and protein energy contribution was 40%, 41%, and 16%, respectively. More than 33% of volunteers did not initially cover 70% of several minerals and vitamins RDAs. Product consumption improved dietary Zn, Ca, retinol equivalent, folate and vitamin B12 contents in all periods, and ameliorated n-3 PUFA contents and n-6/n-3 PUFA ratio over the n-3RF period. Conclusion: improved-fat meat products appear as functional foods for overweight/obeses since their consumption improved selected body-fat markers, without affecting HEI, macronutrient and energy but their n-3 PUFA and n6/n3 ratio intakes (AU)

Introducción: la carne es una matriz adecuada para la inclusión de ingredientes funcionales. En un estudio no secuencial controlado y aleatorio se evaluó el impacto del consumo de productos cárnicos, en los que se sustituyó la grasa animal por una combinación de aceite de oliva, de linaza y de pescado, sobre la ingesta de energía y nutrientes y sobre los marcadores antropométricos. Métodos: dieciocho voluntarios con elevado riesgo cardiovascular consumieron semanalmente 200 g de salchichas tipo frankfurt y 250 g de paté durante tres períodos sucesivos de 4 semanas (bajo en grasa (RF); enriquecidos en n-3 (n-3RF), y grasa normal (NF)), separados por un lavado de 4 semanas. Se evaluó la ingesta de nutrientes y energía, el índice de alimentación saludable (HEI) y los cambios antropométricos. Resultados: hubo diferencias significativas entre períodos para las tasas de cambio de la grasa corporal y de la relación cintura/cadera (p=0,018 y p=0,031, respectivamente), disminuyendo la masa grasa, el perímetro de la cintura y la relación cintura/cadera en el periodo RF, e incrementándose la grasa corporal en el periodo NF (todos p=0,05). En el período n-3RF las tasas de cambio de IMC y del peso ideal correlacionaron inversa y significativamente (p=0.003 y p=0.006, respectivamente) con el cociente hidratos de carbono/AGS. El HEI inicial de las dietas fue muy bajo (valor medio <60). La contribución energética de carbohidratos, grasa y proteínas fue 40%, 41% y 16%, respectivamente. Más del 33% de los voluntarios no cubrían al inicio el 70% de las RDA para minerales y vitaminas. La intervención mejoró en todos los períodos la ingesta de Zn, Ca, equivalentes de retinol, folatos y vitamina B12. En el período n-3RF incrementó los AGPn-3 y redujo el cociente n-6/n-3. Conclusión: los productos cárnicos con menos grasa o enriquecidos en AGP n-3 son alimentos funcionales para personas con sobrepeso/obesidad, ya que su consumo mejora los marcadores de grasa corporal, los niveles de AGP n-3 y el cociente n-6/n-3 sin afectar al HEI ni a la ingesta de energía y macronutrientes (AU)

Structured triacylglycerol containing behenic and oleic acids suppresses triacylglycerol absorption and prevents obesity in rats.

BACKGROUND: Dietary 1(3)-behenoyl-2,3(1)-dioleoyl-rac-glycerol (BOO) has been reported to inhibit pancreatic lipase activity in vitro and suppress postprandial hypertriacylglycerolemia in humans. In the present study, the anti-obesity activities of BOO and its inhibitory effects on lymphatic triacylglycerol (TAG) absorption were investigated in rats. METHODS: In Experiment 1, rats were fed either BOO or soybean oil (SO) diet for 6 weeks. In the BOO diet, 20% of SO was replaced with an experimental oil rich in BOO. In Experiments 2 and 3, rats cannulated in the thoracic duct were administered an emulsions containing trioleoylglycerol (OOO) or an oil mixture (OOO:BOO, 9:1). Tri[1-14C]oleoylglycerol (14C-OOO) was added to the emulsions administered in Experiment 3. RESULTS: No observable differences were detected in food intake or body weight gain between the BOO and SO groups in Experiment 1. Plasma and liver TAG concentrations and visceral fat weights were significantly lower in the BOO group than in the SO group. The apparent absorption rate of fat was significantly lower in the BOO group than in the SO group. In Experiment 2, the lymphatic recovery of oleic and behenic acids was significantly lower at 5 and 6 h after BOO administration than after OOO administration. In Experiment 3, the lymphatic recovery of 14C-OOO was significantly lower at 5 and 6 h after BOO administration than after OOO administration. CONCLUSIONS: These results suggest that BOO prevents deposition of visceral fat and hepatic TAG by lowering and delaying intestinal absorption of TAG.

Olestra is associated with slight reductions in serum carotenoids but does not markedly influence serum fat-soluble vitamin concentrations.

BACKGROUND: The 1996 Food and Drug Administration approval of the fat substitute olestra (sucrose polyester) called for active postmarketing surveillance because preapproval studies showed that olestra may lower circulating concentrations of fat-soluble nutrients such as vitamins and carotenoids. OBJECTIVE: The objective of the Olestra Post-Marketing Surveillance Study was to examine whether customary consumption of olestra-containing savory snacks was associated with changes in serum fat-soluble vitamin and carotenoid concentrations among free-living persons in geographically and ethnically distinct US cities. DESIGN: Adults (n = 2535) and their children aged 12-17 y (n = 272) in Baltimore, Minneapolis, and San Diego attended clinic visits during which data were collected on diet, savory snack consumption, lifestyle, and anthropometric indexes. Blood samples were drawn to assay carotenoids and vitamins A, D, E, and K. Data and blood samples were collected both before and after the nationwide introduction of olestra. General estimating equations were used in multivariate-adjusted models that examined olestra's association with the specified serum nutrients. RESULTS: Compared with no intake, the top 2 tertiles of olestra use in adults were associated with circulating carotenoid concentrations that were modestly but significantly lower (4.3% to 22.4%). There were no significant associations of olestra with any serum nutrients among adolescents. CONCLUSIONS: This active postmarketing surveillance study of a food additive suggests that small decreases in serum fat-soluble nutrients are attributable to olestra use. Although health outcomes were not measured here, it is unlikely that these small changes in nutrient measures would adversely affect health.

Position of the American Dietetic association: fat replacers.

It is the position of the American Dietetic Association that the majority of fat replacers, when used in moderation by adults, can be safe and useful adjuncts to lowering the fat content of foods and may play a role in decreasing total dietary energy and fat intake. Moderate use of low-calorie, reduced-fat foods, combined with low total energy intake, could potentially promote dietary intake consistent with the objectives of Healthy People 2010 and the 2005 Dietary Guidelines for Americans . The obesity epidemic in the nation has been attributed to energy imbalance, mainly because of increased food consumption and/or sedentary lifestyle, or both. Evidence suggests that lowering total energy intake along with a reduction in total fat intake can have a substantial impact on body weight and risk of chronic diseases. Fat replacers are used to provide some or all of the functional properties of fat, while providing fewer calories than the fat being replaced, and are used in a variety of products, from baked goods to frozen desserts. Fat replacers can be effective only if they lower the total caloric content of the food and if the consumer uses these foods as part of a balanced meal plan. Consumers should not be led to believe that fat- and calorie-reduced products can be consumed in unlimited amounts. Fat replacers are most useful when they help with calorie control and when their use encourages the consumption of foods delivering important nutrients.

Health risks, past usage, and intention to use weight loss products in normal weight women with high and low body dysphoria.

OBJECTIVE: There are many health risks involved with the use of weight loss products by normal weight women. The mass media may compound this problem through the promotion of weight loss products and a thin body size. This study tested women's perceptions of different weight loss product ads to determine if body dysphoria (i.e., an over concern with body size and shape in normal weight people) was associated with risk beliefs, past behaviors, and intention toward using weight loss products. METHOD: Normal weight women (age range = 18-41 yr), who were classified as either high (n=45) or low (n=43) on a measure of body dysphoria, rated different weight loss products according to their perception of health risks, past behavior, and their intention to consume the products. These products were a dietary fat substitute (olestra), a prescription obesity medication (sibutramine), and an over-the-counter appetite suppressant (phenylpropanolamine). RESULTS: High body dysphoric women reported higher intentions to use the products as well as increased prior use of two of the three weight loss products. High body dysphoric women did not believe that these weight loss products were harmless. They recognized potential health risks associated with using such products, but nonetheless, expressed intention to use these weight loss products at a higher frequency. Also, several variables related to body image were found to effectively discriminate normal weight women at risk for abusing weight loss products. DISCUSSION: This study found that women who do not need to lose weight but have significant body image concerns were willing to use potentially harmful weight loss products despite the knowledge that such products might pose significant health risks. Techniques utilized by advertising regulatory agencies such as warning labels did not have a strong deterrent effect for stated intentions to use the products. Implications of these findings for public health policy issues were discussed.

A 9-mo randomized clinical trial comparing fat-substituted and fat-reduced diets in healthy obese men: the Ole Study.

BACKGROUND: Dietary fat has been implicated as a risk factor for cardiovascular disease and obesity. OBJECTIVE: We evaluated the effect on body weight, body fat, lipids, glucose, and insulin of replacing dietary fat with olestra in moderately obese men. DESIGN: Forty-five healthy overweight men were randomly assigned to 1 of 3 diets: control diet (33% fat), fat-reduced diet (25% fat), or fat-substituted diet (one-third of dietary fat replaced by olestra to achieve a diet containing 25% metabolizable fat). Body fat was measured by dual-energy X-ray absorptiometry and visceral and subcutaneous abdominal fat by computed tomography. RESULTS: Thirty-six men completed the 9-mo study. Body weight and body fat in the fat-substituted group declined by a mean (+/- SEM) of 6.27 +/- 1.66 and 5.85 +/- 1.34 kg, respectively, over 9 mo compared with 3.8 +/- 1.34 and 3.45 +/- 1.0 kg in the control group and 1.79 +/- 0.81 and 1.68 +/- 0.75 kg in the fat-reduced diet group. At 9 mo, the mean difference in body fat between the fat-reduced and fat-substituted groups was -4.19 +/- 1.19 kg (95% CI: -6.57, -1.81), that between the control and fat-substituted groups was -2.55 +/- 1.21 kg (-0.13, -4.97), and that between the control and fat-reduced groups was 1.63 +/- 1.18 kg (3.96, -0.70). The men eating the fat-reduced diet asked for almost no extra foods, in contrast with the significantly higher requests (P < 0.05) from both of the other 2 groups. CONCLUSION: Replacement of dietary fat with olestra reduces body weight and total body fat when compared with a 25%-fat diet or a control diet containing 33% fat.

A role for olestra in body weight management.

Olestra is a fat substitute made from fatty acids esterified to sucrose and can be used in the preparation of virtually any food made with fat. Foods made with olestra retain the mouthfeel, palatability and satiating effects of their full-fat counterparts without providing any digestible energy. Because olestra provides no energy, it has the potential to be a useful tool in weight loss and weight maintenance. Short-term studies of olestra replacement in foods demonstrate that fat replacement leads to a net reduction in fat intake. When excess total energy is available, fat replacement also reduces total energy intake in lean and obese men and women. In longer-term studies in which olestra is incorporated into the daily diet, there is an incomplete compensation for the fat energy replaced by olestra. When overweight men consumed olestra as part of a varied diet over nine months, weight loss continued for the duration of the study, whereas individuals receiving a typical low-fat diet regained most of the initial weight lost. Other studies are underway to examine the usefulness of olestra in long-term weight maintenance following weight loss. Post-marketing surveillance of olestra foods in the United States indicates that substitution of olestra for only 1-2 g of fat d-1 may be sufficient to prevent the average weight gain reported in adults of 0.5-1.0 kg year-1.

Severe 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) intoxication: clinical and laboratory effects.

A variety of health effects have been attributed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), but little information is available on the course of a verified high-level TCDD intoxication. In this paper we describe two cases of heavy intoxication with TCDD and present a 2-year follow-up including clinical, biochemical, hematologic, endocrine, and immunologic parameters monitored in two women, 30 and 27 years of age, who suffered from chloracne due to TCDD intoxication of unknown origin. Patient 1, who had the highest TCDD level ever recorded in an individual (144,000 pg/g blood fat), developed severe generalized chloracne, whereas in the second patient, despite heavy intoxication (26,000 pg/g blood fat), only mild facial acne lesions occurred. Both patients initially experienced nonspecific gastrointestinal symptoms. In Patient 1 we observed a moderate elevation of blood lipids, leukocytosis, anemia, and secondary amenorrhoea. The laboratory parameters in Patient 2 were all normal. Despite the high TCDD levels, apart from chloracne, only few clinical and biochemical health effects were observed within the first 2 years after TCDD intoxication.

Low-fat/calorie foods: current state and perspectives.

Low-fat/calorie products were originally developed for diabetics and people with specific health problems and they were considerably expensive. Nowadays, consumers' demand for low-fat/calorie products has significantly raised in an attempt to limit health problems, to lose or stabilize their weight, and to work within the frame of a healthier diet. The food industry has been confronted with a new challenge in order to satisfy consumers; development of low-fat/calories products with acceptable sensory characteristics and competitive price, by preferably employing the conventional processing equipment and in agreement with current strict legislation. The role of fat replacers and sugar substitutes in the successful manufacture of these products is crucial.

Role of fat replacers in diabetes medical nutrition therapy.

Foods with fat replacers have the potential to help people with diabetes reduce total and saturated fat intake and may therefore, in time, reduce the increased prevalence of dyslipidemia in type 2 diabetes. However, for these foods to have any potential benefit to people with diabetes, people with diabetes must learn to use them appropriately. People with diabetes should receive self-management training on how to identify ingredients that are fat replacers on labels, how to use the food label to determine serving sizes, and how to incorporate these foods into their food/meal plan, along with the selection of a wide variety of nutritious foods. Health professionals and people with diabetes need to keep current with the ever-changing market-place, available food products, and growing body of scientific literature. Additional research is needed to assess the impact of the use of fat replacers on the macronutrient content of the diet, metabolic parameters related to diabetes, and potential health and nutrition benefits for the person with diabetes.

Update on the pharmacotherapy of obesity.

OBJECTIVE: To review recent developments in the pharmacotherapy of obesity, including the agents currently approved for use in the management of obesity and those under development. DATA SOURCES: A MEDLINE search from January 1990 to July 1997 was conducted to identify English literature available on the pharmacotherapy of obesity. The search was supplemented by a review of the bibliographies of identified literature. STUDY SELECTION: All controlled and uncontrolled trials were reviewed. When available, double-blind, placebo-controlled trials were used preferentially. DATA EXTRACTION: Agents were reviewed with regard to mechanism of action, clinical trial data regarding efficacy, adverse effects, pharmacokinetics, drug interactions, and contraindications where information was available. Study design, selected population, results, and adverse effect information were included. DATA SYNTHESIS: The anorexiants currently available or under development for the management of obesity regulate food intake and satiety via the adrenergic and/or serotonergic pathways. Clinical trials have shown a 10-15% weight loss can typically be anticipated; however, little long-term safety and efficacy data are available. Adverse events tend to be mild and self-limiting, but serious adverse events can occur. Treatment options under development include thermogenic agents, digestive inhibitors, and analogs and antagonists of hormones that regulate food intake and satiety. CONCLUSIONS: Several mechanisms to control weight are currently under investigation for the management of obesity. Since obesity is a chronic condition, further studies should be conducted to evaluate the long-term safety and efficacy of these agents and the role of combination therapy using different modalities.

The role of low-fat diets and fat substitutes in body weight management: what have we learned from clinical studies?

The introduction of low-fat, high-complex carbohydrate diets far the prevention and treatment of obesity was based on the causal link established between dietary fat and body fatness. Observational and mechanistic studies show that because fat possesses a lower satiating power than carbohydrate and protein, a diet rich in fat can increase energy intake. The propensity to gain weight is enhanced in susceptible persons, particularly sedentary people who have a genetic predisposition to obesity. Low-fat diets cause weight loss proportional to pretreatment body weight in a dose dependent manner; that is, weight loss is correlated positively to the reduction in dietary fat content. A reduction of 10% fat energy produces an average 5-kg weight loss in obese persons. As with traditional caloric counting diets, obese persons lose weight only if they adhere to the prescribed low-fat diet. Failure to achieve a weight loss and to maintain it may be attributed in part to lack of adherence to the diet. After a major weight loss, an ad libitum low-fat diet program appears to be superior to caloric counting in maintaining the weight loss 2 years later. Replacing some fat with protein instead of carbohydrate may increase the weight loss further. Moreover, fat substitutes may make it easier to prevent and treat obesity by making the diet palatable. More randomized, controlled, long-term dietary intervention studies are warranted to identify the optimal diet composition for the treatment of obesity.