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Download Effect of Energy-reduced Diets High in Dairy
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Weighing The Evidence: What Is The Role of Milk Products in Healthy Weights? SUMMARIES Effect of Energy-reduced Diets High in Dairy Products and Fiber on Weight Loss in Obese Adults Thompson WG, Holdman NR, Janzow DJ et al. Obes Res 2005;13:1344-1353. OBJECTIVE KEY FINDING To examine if the effect of a high-dairy diet on weight loss would be enhanced with a high-fiber, low glycemic diet. There was substantial weight loss and fat loss with calorie restriction, increased exercise, and close follow-up with a dietitian. Weight loss in diets with moderate or high dairy calcium intake did not differ. A daily calcium intake of 800 mg (or 2 dairy servings) may be sufficient to enhance weight loss. Above this level, no additional effects are seen. The addition of high-fiber, low-glycemic foods to the high-dairy diet did not result in additional weight loss or fat loss. STUDY DETAILS – Randomized trial of 90 obese subjects; 72 completers and 53 adherers (compliant with diet and exercise requirements more than 75% of the time) – Subjects first completed a 2-week run-in period (weight maintenance) during which they kept daily food records and exercise logs – Diets were designed to provide a calorie deficit of 500 kcal/day over a 48-week period. Caloric goals were readjusted at 12, 24 and 36 weeks to further weight loss – Subjects were instructed to exercise (i.e., brisk walking, treadmill or exercise bicycle) at least 30 minutes four times a week during the study – Baseline characteristics of the 3 groups did not differ Study Diets Moderatedairy – Energy deficit of 500 kcal – 2 servings dairy/day 800 mg calcium High-dairy – Energy deficit of 500 kcal 1400 mg calcium – 4 servings dairy/day (at least 2 of which were fluid milk) High-fiber, – Same as the high-dairy plus high-dairy increased fiber (via whole grains, 1400 mg calcium fruit and vegetables) and a reduction in glycemic index (foods with a glycemic index >100 were discouraged) RESULTS – All three diets resulted in significant and comparable weight loss (9%, intent-to-treat; 11% completers; 12% adherers), fat loss and trunk fat loss – Most of the weight loss in all three groups occurred in the first 24 weeks – There were no significant differences in weight loss or fat loss between the 800 or 1400 mg dairy calcium diets in the completers – There were also no significant differences in weight loss or fat loss in the high-calcium, highfiber, low-glycemic index diet and the 800 mg dairy calcium diet – This study did not have a low-calcium group (<600 mg/day) with which to compare results – Significant improvements were seen in the lipid profile (increased HDL, decreased total and LDL cholesterol), high-sensitivity C-reactive protein, leptin, fasting glucose, and insulin in all diet groups, but not between groups – Further work needs to be done to compare diets low in dairy products (400 to 600 mg calcium daily) with diets that are moderate (800 to 1000 mg) and high (1200 to 1400 mg) in dairy products 8 Weighing The Evidence: What Is The Role of Milk Products in Healthy Weights? Progression of weight loss over 48 weeks (completers) Moderate-dairy diet (n=26) 10.0 ± 6.8 Completer weight loss (kg) Fat loss by DEXA* (kg) 7.5 ± 6.6 Trunk fat loss by DEXA (kg) 4.4 ± 3.9 Change in waist 8.8 ± 6.3 circumference (cm) Change in hip 7.1 ± 6.6 circumference (cm) High-dairy diet (n=22) 11.8 ± 6.1 9.0 ± 6.0 4.7 ± 3.9 High-fiber, high-dairy diet (n=24) 10.6 ± 7.9 8.5 ± 7.8 4.9 ± 4.6 p value 11.6 ± 6.1 11.0 ± 7.6 0.34 8.9 ± 4.3 8.5 ± 6.6 0.18 0.45 0.58 0.95 * Dual-energy x-ray absorptiometry (DEXA), waist, and hip circumference data are for completers. No statistically significant differences were seen in the intention-to-treat or in the adherer analysis for any of these parameters. Thompson et al. 2005 Thompson WG, Holdman NR, Janzow DJ et al. Obes Res 2005;13:1344-1353. 2