A Diet Enriched with Red Sorghum Flaked Biscuits, Compared to a Diet Containing White Wheat Flaked Biscuits, Does Not Enhance the Effectiveness of an Energy-Restricted Meal Plan in Overweight and Mildly Obese Adults Effectiveness of alternative listening devices to conventional hearing aids for adults with hearing loss: a systematic review protocol Obesity and Presenteeism: The Impact of Body Mass Index on Workplace Productivity An Intensive Lifestyle Intervention Is an Effective Treatment of Morbid Obesity: The TRAMOMTANA Study—A Two-Year Randomized Controlled Clinical Trial Behavioral Economic Purchase Tasks to Estimate Demand for Novel Nicotine/tobacco Products and Prospectively Predict Future Use: Evidence From The Netherlands. Comparison of high-fat and high-protein diets with a high-carbohydrate diet in insulin-resistant obese women Restructuring physical micro-environments to reduce the demand for meat: a systematic review and qualitative comparative analysis The effect of low-fat versus whole-fat dairy product intake on blood pressure and weight in young normotensive adults. Well-being and morbid obesity in women: a controlled therapy evaluation. Use of nonprescription weight loss products: results from a multistate survey. A randomized double-blind placebo-controlled clinical trial of a product containing ephedrine, caffeine, and other ingredients from herbal sources for treatment of overweight and obesity in the absence of lifestyle treatment Hypotensive effects of solitary addition of conventional nonfat dairy products to the routine diet: a randomized controlled trial. One-year outcome of a combination of weight loss therapies for subjects with type 2 diabetes: a randomized trial. Effects of non-fat dairy products added to the routine diet on vascular function: a randomized controlled crossover trial. Effect of energy-reduced diets high in dairy products and fiber on weight loss in obese adults. Ready-to-eat cereal products as meal replacements for weight loss The effects of intermittent compared to continuous energy restriction on glycaemic control in type 2 diabetes; a pragmatic pilot trial. Cost-Effectiveness of Sequential Therapy with Tumor Necrosis Factor Antagonists in Early Rheumatoid Arthritis A Motivation-Focused Weight Loss Maintenance Program is an Effective Alternative to a Skill-Based Approach Food advertising, children’s food choices and obesity: interplay of cognitive defences and product evaluation: an experimental study Soy isoflavones in the prevention of menopausal bone loss and menopausal symptoms: a randomized, double-blind trial. Increased Consumption of Dairy Foods and Protein during Diet- and Exercise-Induced Weight Loss Promotes Fat Mass Loss and Lean Mass Gain in Overweight and Obese Premenopausal Women1234 Testing strategies to increase use of chloroquine chemoprophylaxis during pregnancy in Malaŵi.
abstract Objectives : Whole grain sorghum is a promising ingredient in foods , especially those targeting satiety and weight control . This study aim ed to test weight loss effects of a whole grain red sorghum product incorporated into an energy-restricted diet . Methods : Sixty subjects ( 46 females ) were r and omized to either a sorghum ( intervention ) or white wheat ( control ) group , receiving 45 g of flaked cereal biscuits to include daily in their prescribed diets for 12 weeks . Primary outcome was weight loss . Secondary outcomes included plasma glucose , glycosylated hemoglobin ( HbA1c ) , insulin , total cholesterol , high-density lipoprotein cholesterol ( HDL-c ) , low-density lipoprotein cholesterol ( LDL-c ) , triacylglycerides ( TAG ) , interleukin (IL)-1β , IL-6 , IL-8 , tumor necrosis factor alpha ( TNF-α ) , high-sensitivity C-reactive protein ( hs-CRP ) , and total antioxidant capacity ( TAC ; measured at 0 and 12 weeks ) . Results : After 12 weeks , there were no significant differences in weight loss or any clinical variables between a wheat control and sorghum cereal group in an energy-restricted diet . Equivalent amounts of weight were lost ( p = 0.369 ) in both groups , and the majority of clinical indices such as fasting glucose , insulin , cholesterol , and key inflammatory biomarkers showed significant beneficial changes over time ( p < 0.05 ) . Conclusions : Although both groups experienced significant weight loss and general improvement in a number of clinical measures , no effects appeared specifically related to sorghum consumption . Further clinical trials are necessary to establish an evidence base for weight loss effects from chronic sorghum intake . Sorghum represents a viable , gluten-free grain alternative in the formulation of novel food products Introduction Hearing loss is a major public health concern , affecting over 11 million people in the UK . While hearing aids are the most common clinical intervention for hearing loss , the majority of people that would benefit from using hearing aids do not take them up . Recent technological advances have led to a rapid increase of alternative listening devices to conventional hearing aids . These include hearing aids that can be customised using a smartphone , smartphone-based ‘ hearing aid ’ apps , personal sound amplification products and wireless hearing products . However , no systematic review has been published evaluating whether alternative listening devices are an effective management strategy for people with hearing loss . Methods and analysis The objective of this systematic review is to assess whether alternative listening devices are an effective intervention for adults with hearing loss . Methods are reported according to the Preferred Reporting Items for Systematic review s and Meta-analyses Protocol s ( PRISMA -P ) 2015 checklist . Retrospective or prospect i ve studies , r and omised controlled trials , non-r and omised controlled trials , and before-after comparison studies will be eligible for inclusion . We will include studies with adult participants ( ≥18 years ) with a mild or moderate hearing loss . The intervention should be an alternative listening device to a conventional hearing aid ( comparison ) . Studies will be restricted to outcomes associated with the consequences of hearing loss . We will search relevant data bases to identify published , completed but unpublished and ongoing trials . The overall quality of included evidence will be evaluated using the GRADE system , and meta- analysis performed if appropriate . Ethics and dissemination No ethical issues are foreseen . The findings will be reported at national and international conferences , primarily audiology , and ear , nose and throat , and in a peer- review ed journal using the PRISMA guidelines . Review registration number PROSPERO CRD4201502958 Objective : To examine whether obesity is associated with increased presenteeism ( health-related limitations at work ) . Methods : R and omly selected manufacturing employees ( n = 341 ) were assessed via height and weight measures , demographic survey , wage data , and the Work Limitations Question naire . The Work Limitations Question naire measures productivity on four dimensions . Analyses of variance and analyses of covariance were computed to identify productivity differences based on body mass index ( BMI ) . Results : Moderately or extremely obese workers ( BMI ≥35 ) experienced the greatest health-related work limitations , specifically regarding time needed to complete tasks and ability to perform physical job dem and s. These workers experienced a 4.2 % health-related loss in productivity , 1.18 % more than all other employees , which equates to an additional $ 506 annually in lost productivity per worker . Conclusions : The relationship between BMI and presenteeism is characterized by a threshold effect , where extremely or moderately obese workers are significantly less productive than mildly obese workers Bariatric surgery is currently the most effective therapy to induce weight loss in morbidly obese patients . Objective . This controlled , clinical trial with a two-year intervention was aim ed at comparing the efficacy of two nonsurgical approaches versus bariatric surgery , on body weight changes and metabolic parameters in morbidly obese patients . Methods . Patients were r and omized to an Intensive Lifestyle Intervention ( ILI ) ( n = 60 ) or Conventional Obesity Therapy ( COT ) ( n = 46 ) . The ILI group received behavioral therapy and nutritional counseling . The COT group received st and ard medical treatment . They were compared with a third group , Surgical Obesity Group ( SOG ) ( n = 37 ) . Results . Patients who received ILI had a greater percentage of weight loss than patients receiving COT ( −11.3 % versus −1.6 % ; p < 0.0044 ) . Interestingly 31.4 % of patients included in the ILI group were no longer morbidly obese after just six months of intervention , increasing to 44.4 % after 24 months of intervention . The percentage weight loss in SOG was −29.6 % after that same period of time . Conclusions . ILI was associated with significant weight loss when compared to COT , in a group of patients with obesity .  An ILI approach could be an alternative therapy to patients with obesity , who are not c and i date s to undergo bariatric surgery . This trial is registered with EudraCT 2009 - 013737 - 24 INTRODUCTION The dem and for alternative nicotine/tobacco products is not well established . This paper uses a behavioral economic approach to test whether smokers have differential dem and for conventional factory-made , electronic , and very low nicotine content cigarettes ( FMCs/ECs/VLNCs ) and uses the prospect i ve cohort design to test the predictive validity of dem and indices on subsequent use of commercially available FMCs and ECs . METHODS Daily smokers ( ≥16 years ) from the Netherl and s completed an online survey in April 2014 ( N = 1215 ) . Purchase tasks were completed for FMCs , ECs , and VLNCs . Participants indicated the number of cigarettes they would consume in 24 h , across a range of prices ( 0 - 30 euro ) . The relationship between consumption and price was quantified into four indices of dem and ( intensity , Pmax , breakpoint , and essential value ) . A follow-up survey in July 2015 measured  FMC and EC use . RESULTS At baseline , greater dem and was observed for FMCs relative to ECs and VLNCs across all dem and indices , with no difference between ECs and VLNCs . At follow-up , greater baseline FMC dem and ( intensity , essential value ) was associated with lower quit rates and higher relapse . EC dem and ( Pmax , breakpoint , essential value ) was positively associated with any  EC  use between survey waves , past 30 day EC use , and EC purchase between waves . CONCLUSIONS Smokers valued FMCs more than ECs or VLNCs , and FMCs were less sensitive to price increases . Dem and indices predicted use of commercially available products over a 15 month period . To serve as viable substitutes for FMCs , ECs and VLNCs will need to be priced lower than FMCs . IMPLICATION S Purchase tasks can be adapted for novel nicotine/tobacco products as a means to efficiently quantify dem and and predict use . Among current daily smokers , the dem and for ECs and VLNCs is lower than FMCs Aims /hypothesisA diet low in saturated fatty acids and rich in wholegrains , vegetables and fruit is recommended in order to reduce the risk of obesity , cardiovascular disease and type 2 diabetes mellitus . However there is widespread interest in high-fat ( “ Atkins Diet ” ) and high-protein ( “ Zone Diet ” ) alternatives to the conventional high-carbohydrate , high-fibre approach . We report on a r and omised trial that compared these two alternative approaches with a conventional diet in overweight insulin-resistant women . Methods Ninety-six normoglycaemic , insulin-resistant women ( BMI > 27 kg/m2 ) were r and omised to one of three dietary interventions : a high-carbohydrate , high-fibre ( HC ) diet , the high-fat ( HF ) Atkins Diet , or the high-protein ( HP ) Zone Diet . The experimental approach was design ed to mimic what might be achieved in clinical practice : the recommendations involved advice concerning food choices and were not prescriptive in terms of total energy . There were supervised weight loss and weight maintenance phases ( 8 weeks each ) , but there was no contact between the research team and the participants during the final 8 weeks of the study . Outcome was assessed in terms of body composition and indicators of cardiovascular and diabetes risk . Results Body weight , waist circumference , triglycerides and insulin levels decreased with all three diets but , apart from insulin , the reductions were significantly greater in the HF and HP groups than in the HC group . These observations suggest that the popular diets reduced insulin resistance to a greater extent than the st and ard dietary advice did . When compared with the HC diet , the HF and HP diets were shown to produce significantly ( p<0.01 ) greater reductions in several parameters , including weight loss ( HF −2.8 kg , HF −2.7 kg ) , waist circumference ( HF −3.5 cm , HF −2.7 cm ) and triglycerides ( HF −0.30 mmol/l , HF −0.22 mmol/l ) . LDL cholesterol decreased in individuals on the HC and HP diets , but tended to fluctuate in those on the HF diet to the extent that overall levels were significantly lower in the HP group than in the HF group ( −0.28 mmol/l , 95 % CI 0.04–0.52 , p=0.02 ) . Of those on the HF diet , 25 % showed a > 10 % increase in LDL cholesterol , whereas this occurred in only 13 % of subjects on the HC diet and 3 % of those on the HP diet . Conclusions /interpretationIn routine practice a reduced-carbohydrate , higher protein diet may be the most appropriate overall approach to reducing the risk of cardiovascular disease and type 2 diabetes . To achieve similar benefits on a HC diet , it may be necessary to increase fibre-rich wholegrains , legumes , vegetables and fruits , and to reduce saturated fatty acids to a greater extent than appears to be achieved by implementing current guidelines . The HF approach appears successful for weight loss in the short term , but lipid levels should be monitored . The potential deleterious effects of the diet in the long term remain a concern Summary Background Reducing meat consumption could help to protect the natural environment and promote population health . Interventions restructuring physical micro-environments might help to change habitual behaviour . We synthesis ed the scientific evidence pertaining to whether , and which , interventions restructuring physical micro-environments effectively reduce the dem and for meat . Methods We did a systematic review of quantitative studies evaluating the effectiveness of interventions restructuring physical micro-environments  to reduce the dem and for meat . We identified relevant records by search ing six electronic data bases ( CAB Abstract s , Embase , PsycINFO , Science Citation Index , MEDLINE , and Dissertations & Theses ) on Aug 31 , 2017 , contacting experts , screening publicly accessible online re sources , and search ing references . We included studies that evaluated the effectiveness of interventions restructuring physical micro-environments  to reduce the dem and for meat , defined as the actual or intended consumption , purchase , or selection of meat in real or virtual environments . We extracted data pertaining to the study sample s , the interventions , and meat dem and at the follow-up closest to intervention completion and at the longest follow-up , with the former representing our primary outcome . We synthesis ed data narratively and did a qualitative comparative analysis to identify configurations of intervention characteristics associated with , and those not found to be associated with , significant reductions in meat dem and . Our Systematic Review is registered with PROSPERO , number CRD42017081532 . Results Of 10 733 titles and abstract s screened for eligibility , we assessed 60 full papers and included 14 papers reporting on 18 studies with 22 intervention conditions . Three interventions reducing the portion size of meat servings reduced meat consumption in r and omised trials . Three interventions providing meat alternatives with supporting educational material were associated with reduced meat dem and in pre-post design studies . Three of four interventions altering the sensory properties ( eg , visual presentation ) of meat or meat alternatives at point of purchase reduced meat dem and in r and omised trials . Four interventions repositioning meat products to be less prominent at point of purchase were associated with lower meat dem and , but only two such interventions reached statistical significance in a r and omised trial and a multiple treatment reversal design . Only one of five interventions manipulating the description of meat or meat alternatives at point of purchase was associated with lower meat dem and in a multiple treatment reversal design . Evidence from r and omised trials evaluating a pricing intervention or interventions restructuring several aspects of micro-environments was too scarce or inconsistent to be conclusive . The results from our qualitative comparative analysis supported the findings of this narrative synthesis . Interpretation Some interventions restructuring physical micro-environments could help to promote lower dem and for meat . Interventions reducing portion sizes of meat servings , providing meat alternatives , or changing the sensory properties of meat and meat alternatives at point of purchase offered the most promise in the context of experimental studies . Funding None BACKGROUND Epidemiologic and experimental studies suggest that higher intake of dairy products could be associated with lower risk of hypertension and obesity . Differences in nutrient composition of distinct dairy products suggest that their effect on these outcomes might be heterogeneous . However , little experimental research has examined the potentially different effects of low- and whole-fat dairy products on blood pressure ( BP ) and weight change . The present study aim ed to assess whether supplementing diets with low- or whole-fat dairy products would differentially affect BP levels and weight . METHODS A r and omised crossover trial in 45 normotensive volunteers ( 18 - 24 years old , 49 % female ) was conducted . Participants alternatively received 3.5 servings/day of whole-fat or low-fat dairy products ( milk and yogurt ) in addition to their usual diet during two 8-week periods , with a 4-week washout period between both interventions . Weight and BP were measured at the beginning and end of each intervention . RESULTS Whole-fat dairy supplementation significantly increased systolic BP [ 2.1 mmHg , 95 % confidence interval ( CI ) = 0.1 - 4.0 , P = 0.04 ] and weight ( 1.0 kg , 95 % CI = 0.5 - 1.5 , P = 0.0002 ) , but not diastolic BP ( P = 0.34 ) . Weight and BP did not change significantly after the low-fat dairy intervention ( P > 0.10 ) . There were no significant differences in the effect of low-fat or whole-fat dairy products on BP ( P > 0.60 ) , but whole-fat dairy increased weight significantly compared to low-fat dairy ( 1.2 kg , 95 % CI = 0.5 - 1.8 , P = 0.0007 ) . CONCLUSIONS In a young nonhypertensive population , dietary supplementation with whole-fat dairy products , compared to low-fat dairy , was associated with weight gain . No differential effects were observed for levels of BP OBJECTIVE Morbidly obese individuals are unlikely to reach and maintain normative weights . Thus , interventions aim ed at alleviating corollary problems , independent of attempts at weight loss , are appropriate . A cognitive group treatment program ( CT ) was developed which incorporated a nondieting approach , regular exercise , and use of alternative coping skills . Weight loss per se was not a focus of the intervention . The purpose of the current work was to evaluate this program in a controlled , comparative treatment outcome study . METHOD Sixty-two obese women with a history of treatment failures were r and omly assigned to the CT program , a behavior therapy weight loss program ( BT ) , or a wait-list control group . RESULTS For CT participants , depression , anxiety , and eating-related psychopathology decreased significantly over the course of treatment while perceptions of self-control increased ; BT and control subjects showed no significant changes in these variables . Women in both active treatment groups lost significant amounts of weight , while members of the control group showed a nonsignificant increase in weight . At 6-month follow-up , treatment benefits were maintained . DISCUSSION Findings suggest that interventions not directly aim ed at weight loss can enhance psychological well-being and thus may be appropriate for some obese women CONTEXT Lifestyle changes to lose weight can be difficult ; hence , both prescription and nonprescription diet products are appealing . Usage patterns of the nonprescription products phenylpropanolamine ( PPA ) and ephedra are of particular interest because of recent safety concerns . OBJECTIVE To estimate the prevalence of overall and specific  nonprescription weight loss product  use by demographic characteristics , prescription diet pill use , diabetic status , and lifestyle choices . DESIGN AND SETTING The Behavioral Risk Factor Surveillance System , a r and om-digit telephone survey conducted in 1998 in 5 states : Florida , Iowa , Michigan , West Virginia , and Wisconsin . PARTICIPANTS Population -based sample of 14 679 noninstitutionalized adults 18 years or older . MAIN OUTCOME MEASURES Prevalence of nonprescription weight loss product use in 1996 - 1998 . RESULTS Seven percent reported overall  nonprescription weight loss product use , 2 % reported PPA use , and 1 % reported ephedra product use . Overall use was especially common among young obese women ( 28.4 % ) . Moreover , 7.9 % of normal-weight women reported use . There was no difference in  nonprescription weight loss product use by daily consumption of fruits and vegetables ; however , more users than nonusers reported being physically active ( for those who exercised > /=30 minutes 5 times per week , odds ratio , 1.5 ; 95 % confidence interval , 1.2 - 2.0 ) . Among prescription weight loss product users , 33.8 % also took nonprescription product .  CONCLUSIONS With increasing rates of obesity ,  nonprescription product  use is likely to increase . Clinicians should know about their patients ' use of both prescription and nonprescription weight loss products OBJECTIVE : To evaluate the efficacy and side effects of an herbal formulation to promote weight loss , as compared to placebo . DESIGN : 12-week multicenter double-blind , placebo-controlled , r and omized parallel groups design . Study conducted at three clinical sites in New York State . Subjects were r and omized to receive either the ‘ active ’ product or a ‘ placebo ’ supplement for 12 weeks . Minimal steps were taken to influence lifestyle changes with regard to diet or exercise . SUBJECTS : 102 overweight/obese ( 30 < BMI ≤39.9 kg/m2 ) volunteers between the ages of 18 and 65 y . MAIN OUTCOME MEASURES : Weight , percent body fat , fat mass , waist circumference , BMI , blood pressure , and pulse measured at 2 days , 1 week , 2 weeks , 4 weeks , 8 weeks , and 12 weeks postr and omization . RESULTS : Subjects receiving the ‘ active ’ treatment experienced , on average , an additional 1.5 kg of weight loss compared with subjects receiving the placebo . In addition , subjects receiving the ‘ active ’ treatment experienced greater reductions in BMI and waist circumference over the 12-week period . No differences were observed with respect to percent body fat , fat mass , diastolic or systolic blood pressure , pulse , the occurrence of any adverse event , or the occurrence of any presumed treatment-related adverse event . Testing of the study product by two independent laboratories indicated that it had only approximately half of the intended amount of ephedrine alkaloids and caffeine . CONCLUSIONS : Over the 12-week trial , subjects on the active treatment experienced significantly greater weight loss than subjects on placebo , without an increase in blood pressure , pulse , or the rate of adverse events . These benefits were achieved in the absence of any lifestyle treatment to change dietary or exercise behavior and with lower doses of ephedrine alkaloids and caffeine than those commonly utilized BACKGROUND The high consumption of low-fat and nonfat dairy products is associated with reduced risk of high blood pressure . OBJECTIVE We aim ed to investigate whether the solitary addition of nonfat dairy products to the normal routine diet was capable of lowering blood pressure in middle-aged and older adults with elevated blood pressure . DESIGN With the use of a r and omized , crossover intervention- study design , 49 adults ( 56 % women ) with elevated blood pressure ( mean ± SEM age : 53 ± 2 y ; systolic blood pressure : 135 ± 1 ; diastolic blood pressure : 80 ± 1 mm Hg ) underwent a high-dairy condition ( + 4 servings conventional nonfat dairy products/d ) and isocaloric no-dairy condition ( + 4 servings fruit products/d ) in which all dairy products were removed . Both dietary conditions lasted 4 wk with a 2-wk washout before crossing over into the alternate condition . RESULTS The high-dairy condition produced reductions in systolic blood pressure ( 135 ± 1 to 127 ± 1 mm Hg ) and pulse pressure ( 54 ± 1 to 48 ± 1 mm Hg ) ( both P < 0.05 ) . The hypotensive effects were observed within 3 wk after the initiation of the dietary intervention and in both casual seated and ambulatory ( 24-h ) measurements ( P < 0.05 ) . Pulse pressure was increased after the removal of all dairy products in the no-dairy condition ( 54 ± 1 to 56 ± 1 mm Hg ; P < 0.05 ) . There were no changes in diastolic blood pressure after either dietary condition . CONCLUSION We concluded that the solitary manipulation of conventional dairy products in the normal routine diet would modulate blood pressure in middle-aged and older adults with prehypertension and hypertension . This trial was registered at clinical trials.gov as NCT01577030 OBJECTIVE The purpose of this study was to evaluate the effects of a combination weight loss program using intermittent low-calorie diets , energy-controlled meal replacement products , and sibutramine on weight loss , diabetes control , and cardiovascular risk factors in overweight or obese subjects with type 2 diabetes . RESEARCH DESIGN AND METHODS Overweight or obese individuals with type 2 diabetes treated with diet or oral medication were r and omly assigned to either a st and ard therapy or combination therapy group . Both groups received a st and ardized program to facilitate weight loss . The combination therapy group also received 10 - 15 mg sibutramine daily , low-calorie diets using meal replacement products for 1 week every 2 months , and between low-calorie diet weeks , once daily use of meal replacement product and snack bars to replace one usual meal and snack . Primary outcome measures were changes in body weight , glycemic control , plasma lipids , blood pressure , pulse , and body composition at 1 year . RESULTS At 1 year , combination therapy , compared with st and ard therapy , result ed in significantly more weight loss ( -7.3 + /- 1.3 kg vs. -0.8 + /- 0.9 kg , P < 0.001 ) and reduction in HbA(1c ) ( -0.6 + /- 0.3 vs. 0.0 + /- 0.2 % , P = 0.05 ) . Combination therapy result ed in reduced requirement for diabetes medications and decreased fat mass and lean body mass . A 5-kg decrease in weight at 1 year was associated with a decrease of 0.4 % in HbA(1c ) ( P = 0.006 ) . Changes in fasting glucose , lipids , pulse , and blood pressure did not differ between groups . CONCLUSIONS This combination weight loss  program result ed in greater weight loss and improved diabetes control compared with a st and ard weight loss program in overweight or obese subjects with type 2 diabetes BACKGROUND AND AIMS High consumption of low- and non-fat dairy products is associated with reduced risk of high blood pressure ( BP ) and central arterial stiffness . However , interventional studies to determine if the addition of non-fat dairy products to the diet is capable of reducing central BP and improving vascular function are lacking . The aim of this study was to determine if the solitary addition of non-fat dairy products to the normal routine diet would reduce central BP and improve vascular function in middle-aged and older adults with elevated BP . METHODS AND RESULTS Using a r and omized , crossover intervention study design , forty-nine adults ( 44 % men , 53 ± 2 years , 170 ± 2 cm , 88 ± 3 kg ; mean ± SEM ) with elevated BP ( 134 ± 1/81 ± 1 mm Hg ) underwent a High Dairy condition ( + 4 servings/day of conventional non-fat dairy products ) and No Dairy condition ( + 4 servings/day fruit products ) in which all dairy products were removed . Both dietary conditions lasted 4 weeks with a 2-week washout before crossing over into the alternate condition . The High Dairy condition produced reductions in central systolic BP ( -3 ± 1 mm Hg ) and carotid-femoral pulse wave velocity ( -0.5 ± 0.1 m/sec ) , with a concomitant increase in brachial flow-mediated dilation ( + 1.1 ± 0.4 % ) and cardiovagal baroreflex sensitivity ( + 5 ± 1 ms/mm Hg ) ( P < 0.05 for all vs. baseline ) . In the No Dairy condition , brachial flow-mediated dilation was reduced ( -1.0 ± 0.1 % , P < 0.05 vs. baseline ) . CONCLUSIONS The solitary manipulation of conventional dairy products in the normal routine diet modulates levels of central BP and vascular function in middle-aged and older adults with elevated BP . CLINICAL TRIAL REGISTRATION clinical trials.gov Identifier : NCT01577030 OBJECTIVE Studies suggest that high-dairy and high-fiber/low-glycemic index diets may facilitate weight loss , but data are conflicting . The effects on weight loss and body fat of a high-dairy diet and a diet high in dairy and fiber and low in glycemic index were compared with a st and ard diet . RESEARCH METHODS AND PROCEDURES Ninety obese subjects were recruited into a r and omized trial of three diets design ed to provide a calorie deficit of 500 calories/d over a 48-week period . The study compared a moderate ( not low)-calcium diet with a high-calcium diet . RESULTS Seventy-two subjects completed the study . Significant weight and fat loss occurred with all three diets . A diet with 1400 mg of calcium did not result in greater weight ( 11.8 + /- 6.1 kg ) or fat ( 9.0 + /- 6.0 kg ) loss than a diet with 800 mg of calcium ( 10.0 + /- 6.8 and 7.5 + /- 6.6 kg , respectively ) . A diet with 1400 mg of calcium , increased fiber content , and fewer high-glycemic index foods did not result in greater weight ( 10.6 + /- 6.8 kg ) or fat ( 8.5 + /- 7.8 kg ) loss than the st and ard diet with 800 mg of calcium . Lipid profile , high-sensitivity C-reactive protein , leptin , fasting glucose , and insulin improved significantly , but there were no significant differences between the experimental diets and the control diet . DISCUSSION We found no evidence that diets higher than 800 mg of calcium in dairy products or higher in fiber and lower in glycemic index enhance weight reduction beyond what is seen with calorie restriction alone Objective To test the effectiveness of three commercially available partial meal replacement products on weight-loss outcomes . Methods In a r and omized controlled clinical trial , 164 eligible overweight and obese adults ( ages 18–65 years ; body mass index ≥25 kg/m2 ) were r and omly assigned to a Control group ( CN ) or to one of three intervention groups , including ‘ Cereal Substitution plus Nutrient Bar ’ ( CB ) , ‘ Cereal and Waffle Substitution plus Nutrient Bar ’ ( CWB ) , and ‘ Cereal Substitution , no Nutrient Bar ’ ( CR ) . Results Compared with the CN group , the CB , CWB , and CR groups evidence d significantly greater reductions in weight , body mass index , waist , hip , and thigh measurements , and the CB and CR groups evidence d significantly greater reductions in percentage body fat . Despite strong adherence ( 88 % ) and retention ( 80 % ) , the groups did not differ in cardiovascular risk profile , mood , or satiety . Conclusions A variety of ready-to-eat cereal products may be safely and effectively used as meal replacements in weight-loss programs AIMS Weight loss improves glycaemic control in type 2 diabetes mellitus ( T2DM ) . However , as achieving and maintaining weight loss is difficult , alternative strategies are needed . Our primary aim was to investigate the effects of intermittent energy restriction ( IER ) compared to continuous energy restriction ( CER ) on glycated haemoglobin A1c ( HbA1c ) . Secondary aims were to assess effects on weight loss , body composition , medication changes and subjective measures of appetite . Using a 2-day IER method , we expected equal improvements to HbA1c and weight in both groups . METHOD Sixty-three overweight or obese participants ( BMI 35.2±5kg/m2 ) with T2DM ( HbA1c 7.4±1.3 % ) ( 57mmol/mol ) were r and omised to a 2-day severe energy restriction ( 1670 - 2500kJ/day ) with 5days of habitual eating , compared to a moderate CER diet ( 5000 - 6500kJ/day ) for 12weeks . RESULTS At 12weeks HbA1c ( -0.7±0.9 % P<0.001 ) and percent body weight reduction ( -5.9±4 % P<0.001 ) was similar in both groups with no group by time interaction . Similar reductions were also seen for medication dosages , all measures of body composition and subjective reports of appetite . CONCLUSIONS In this pilot trial , 2days of IER compared with CER result ed in similar improvements in glycaemic control and weight reduction offering a suitable alternative treatment strategy Objective To estimate the comparative lifetime cost-effectiveness of sequenced therapy with tumor necrosis factor ( TNF ) antagonists as the initial therapeutic intervention for patients with early rheumatoid arthritis ( RA ) . Methods Because patients with RA switch regimens many times throughout the course of disease , sequenced therapeutic interventions were modeled , continuing until the last effective agent failed or death occurred . The model used published clinical outcomes from short-term , r and omized controlled trials . Direct treatment costs and costs of lost productivity were modeled for each of 5 alternative treatment sequences . Incremental cost-effectiveness ratios are expressed as quality -adjusted lifeyears ( QALY ) gained . Results Treatment sequences that included TNF antagonists produced a greater number of QALY than conventional disease modifying antirheumatic drug regimens alone . The cost-effectiveness of sequenced therapy initiated with adalimumab plus methotrexate ( MTX ) extendedly dominated both infliximab-plus-MTX – initiated and etanercept sequences . The cost of adalimumab plus MTX per QALY was US $ 47,157 excluding productivity losses , and $ 19,663 including productivity losses . A supplementary sequence that incorporated adalimumab-plus-MTX – initiated first-line therapy followed by another TNF antagonist as second-line therapy was modeled ; this sequence result ed in additional QALY gained and extendedly dominated all single-TNF strategies . Conclusion Of the 3 single-TNF antagonist sequences , the adalimumab-plus-MTX – initiated sequence was cost-effective in producing the greatest number of QALY . Multiple TNF strategies , such as the supplementary sequence modeled in this analysis , may be cost-effective in producing even greater health gain Objective : Maintaining weight loss is a major challenge in obesity treatment . Individuals often indicate that waning motivation prompts cessation of effective weight management behaviors . Therefore , a novel weight loss maintenance program that specifically targets motivational factors was evaluated . Design : Overweight women ( N=338 ; 19 % African American ) with urinary incontinence were r and omized to lifestyle obesity treatment or control and followed for 18 months . All participants in lifestyle ( N=226 ) received the same initial 6-month group behavioral obesity treatment and were then r and omized to ( 1 ) a novel motivation-focused maintenance program ( N=113 ) or ( 2 ) a st and ard skill-based maintenance approach (N=113).Main Outcome Measure : Weight assessed at baseline , 6 and 18 months . Results : Both treatment groups ( motivation-focused and skill-based ) achieved comparable 18-month weight losses ( −5.48 % for motivation-focused vs −5.55 % in skill-based , P=0.98 ) , and both groups lost significantly more than controls ( −1.51 % ; P=0.0012 in motivation-focused and P=0.0021 in skill-based ) . Conclusions : A motivation-focused maintenance program offers an alternative , effective approach to weight maintenance exp and ing available evidence -based interventions beyond traditional skill-based programs . Trial Registration : clinical trials.gov identifier : NCT00091988 Objectives : To investigate the role of product evaluations , nutritional and persuasion knowledge on children ’s food choices conducted because of limited evidence about the role of product evaluations on consumer choices in conjunction with cognitive defences . Design : A r and omised controlled 2 × 2 factorial experiment with an exposure to a food and a control ( toy ) advertisement conducted in a non-laboratory setting at an annual event traditionally visited by families . Subjects : Children aged 7–13 years with biometric/weight data representative of the general Australian population . Measurements : Height and weight ( converted into body mass index z-scores ) measured in addition to children ’s nutritional and persuasion knowledge , product evaluations , age and gender . Results : The factors that undermine children ’s cognitive defences relate to taste , social appeal of foods and low nutritional and persuasion knowledge . An interplay between the above-mentioned factors was also observed , identifying four groups among young consumers , alluding to a complex and at times impulsive nature of children ’s decisions : ( 1 ) knowledgeable children with less positive product evaluations choosing a healthy snack ; ( 2 ) knowledgeable but hedonism-oriented children seeking peer conformity choosing an advertised product ; ( 3 ) knowledgeable children who chose a snack belonging to the same product category ; and ( 4 ) less knowledgeable children with positive product evaluations and low nutritional knowledge choosing snacks from the advertised product category . Obese children were more likely to belong to a cluster of less knowledgeable and hedonism-oriented children . Conclusions : The problem of consumption of less healthy foods is complex and multiple factors need to be considered by health practitioners , social marketers and parents to address the issue of childhood obesity . Nutritional knowledge alone is not sufficient to ensure children make healthier food choices and emphasis should also be placed on persuasion knowledge education , targeting of peer norms , self-efficacy and stricter regulation of advertising aim ed at children BACKGROUND Concerns regarding the risk of estrogen replacement have result ed in a significant increase in the use of soy products by menopausal women who , despite the lack of evidence of the efficacy of such products , seek alternatives to menopausal hormone therapy . Our goal was to determine the efficacy of soy isoflavone tablets in preventing bone loss and menopausal symptoms . METHODS The study design was a single-center , r and omized , placebo-controlled , double-blind clinical trial conducted from July 1 , 2004 , through March 31 , 2009 . Women aged 45 to 60 years within 5 years of menopause and with a bone mineral density T score of -2.0 or higher in the lumbar spine or total hip were r and omly assigned , in equal proportions , to receive daily soy isoflavone tablets , 200 mg , or placebo . The primary outcome was changes in bone mineral density in the lumbar spine , total hip , and femoral neck at the 2-year follow-up . Secondary outcomes included changes in menopausal symptoms , vaginal cytologic characteristics , N -telopeptide of type I bone collagen , lipids , and thyroid function . RESULTS After 2 years , no significant differences were found between the participants receiving soy tablets ( n = 122 ) and those receiving placebo ( n = 126 ) regarding changes in bone mineral density in the spine ( -2.0 % and -2.3 % , respectively ) , the total hip ( -1.2 % and -1.4 % , respectively ) , or the femoral neck ( -2.2 % and -2.1 % , respectively ) . A significantly larger proportion of participants in the soy group experienced hot flashes and constipation compared with the control group . No significant differences were found between groups in other outcomes . CONCLUSIONS In this population , the daily administration of tablets containing 200 mg of soy isoflavones for 2 years did not prevent bone loss or menopausal symptoms . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00076050 Weight loss can have substantial health benefits for overweight or obese persons ; however , the ratio of fat : lean tissue loss may be more important . We aim ed to determine how daily exercise ( resistance and /or aerobic ) and a hypoenergetic diet varying in protein and calcium content from dairy foods would affect the composition of weight lost in otherwise healthy , premenopausal , overweight , and obese women . Ninety participants were r and omized to 3 groups ( n = 30/group ) : high protein , high dairy ( HPHD ) , adequate protein , medium dairy ( APMD ) , and adequate protein , low dairy ( APLD ) differing in the quantity of total dietary protein and dairy food- source protein consumed : 30 and 15 % , 15 and 7.5 % , or 15 and < 2 % of energy , respectively . Body composition was measured by DXA at 0 , 8 , and 16 wk and MRI ( n = 39 ) to assess visceral adipose tissue ( VAT ) volume at 0 and 16 wk . All groups lost body weight ( P < 0.05 ) and fat ( P < 0.01 ) ; however , fat loss during wk 8–16 was greater in the HPHD group than in the APMD and APLD groups ( P < 0.05 ) . The HPHD group gained lean tissue with a greater increase during 8–16 wk than the APMD group , which maintained lean mass and the APLD group , which lost lean mass ( P < 0.05 ) . The HPHD group also lost more VAT as assessed by MRI ( P < 0.05 ) and trunk fat as assessed by DXA ( P < 0.005 ) than the APLD group . The reduction in VAT in all groups was correlated with intakes of calcium ( r = 0.40 ; P < 0.05 ) and protein ( r = 0.32 ; P < 0.05 ) . Therefore , diet- and exercise-induced weight loss with higher protein and increased dairy product intakes promotes more favorable body composition changes in women characterized by greater total and visceral fat loss and lean mass gain The widespread problem of low and non-compliance to antimalarial chemoprophylaxis during pregnancy dem and s that attention be focused on alternative approaches to programming , product acceptability and dem and for preventive services . This study describes the testing of three interventions to determine their effect on use of  chloroquine  ( currently the most widely used drug for chemoprophylaxis ) during pregnancy . The strategies evolved from community-based formative research undertaken to learn about the local concept of malaria and issues surrounding malaria prevention and treatment during pregnancy . The result ing interventions were tested in four clinics , and included a change in the health education message given during antenatal sessions , distribution of a sugar-coated chloroquine tablet , and an intervention combining the two strategies . The results showed a 45 % increase in  chloroquine use when the health education message was changed , and a 64 % increase when the product was changed . High use levels were maintained with the combined intervention ; an additive effect was seen . The study shows that improving the product was the most important factor in increasing the use of the program , and that changing the health education message can also make an impact on use
There was no significant difference between the groups in the studies regarding L-carnitina and flaxseed .
There is a lack of evidence regarding quality studies justifying the use of alternative products for weight loss
OBJECTIVE The high dem and for obesity treatment and conventional therapies ' lack of effectiveness increases the use of alternative products .
This study was aim ed at assessing evidence from r and omised clinical trials regarding the effectiveness of alternative weight-loss products ' ingredients .