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SUBJECT: AJCN Nov 2012

1. Treatment of obesity BMI >40 or 100 pounds overweight. Obesity affects more than one-third of adults (35.7%) and ∼17% of children and adolescents. Forecasts based on a linear time trend suggest that by 2030, 51% of the population will be obese (2). In 2008, the cost of obesity hit a high of $147 billion, or ∼9% of annual health care expenses. A one-percentage-point cut from the projected trend of obesity over the next 2 decades will save America an estimated $85 billion. If prevalence were to remain at 2010 levels, the combined obesity-attributable savings in medical expenditures over the next 2 decades would be ∼$550 billion (2). The most cost-effective way to intervene is through nutritional changes that produce durable weight loss via realistic and sustainable goals, ie, those that improve or reverse obesity-related chronic diseases. On the basis of prior data, a reasonable target is 10% of baseline weight per person (4). This can be achieved through medical treatment of severe obesity (5). After 1 y, mean (±SD) weight changes were −11.4 ± 9.1 kg with the VLCD (18% dropout), −6.8 ± 6.4 kg with the LCD (23% dropout), and −5.1 ± 5.9 kg with the restricted normal-food diet (26% dropout). In an adjusted analysis, the VLCD group lost 2.8 kg (95% CI: 2.5, 3.2) and 3.8 kg (95% CI: 3.2, 4.5) more than did the LCD and restricted normal-food groups, respectively.

2. Sugar intake, esp. fructose, has risen from 20 pounds to 160 lbs/person/year. Simple sugar intake in the United States has increased from 20 pounds (lb)/y per person in the mid-1800s to 120 lb/y per person in 1996 and stands at 160 lb/y per person today (4). Fructose represents ∼50% of simple sugar intake, or ∼10% of total caloric intake in the average US diet—the largest macronutrient change over the past generation. This is not from eating apples. The consumption of sweetened beverages constitutes the major change in fructose intake and represents, on average, a 16-oz soft drink per person per day in the United States.

3. Our data refute the existence of a healthy obese phenotype. Insulin sensitive-obese individuals showed increased cardiometabolic risk. The existence of unhealthy Normal weight phenotypes is supported by their increased risk of incident hyperglycemia, fatty liver, cardiovascular events, and death.

4. "Saving money" of supplemental nutrition assistance in the US provides low-quality diets increasing health care costs.

5. Proper nutrition when pregnant may play an important role in the offspring's risk of future disease.

6. Calcium supplementation of boys in late childhood reduced stature. Calcium supplementation of boys in late childhood advanced the age of peak height velocity and resulted in shorter adult stature in a population in whom low calcium intakes and delayed puberty are common.

7. Tea consumption reduces cancer risk. In comparison with women who never drank tea, regular tea intake (mostly green tea) was associated with reduced risk of all digestive system cancers combined (HR: 0.86; 95% CI: 0.74, 0.98), and the reduction in risk increased as the amount and years of tea consumption increased.

8. Trans fatty acid intake increases LDL and decreases HDL.

9. Introduction of a school fruit program is associated with reduced frequency of consumption of unhealthy snacks.

10. Vitamin K intake reduces diabetes risk. Risk of incident diabetes was 17% lower for each additional intake of 100 μg phylloquinone/d. Moreover, subjects who increased their dietary intake of vitamin K during the follow-up had a 51% reduced risk of incident diabetes.

11. High red meat, especially charred, increases colorectal polyps.

12. Fish oil reduces adipose tissue and inflammation in obese people.

13. Lutein and zeaxanthin may help brain in addition to eyesight. Memory scores and rate of learning improved significantly in the combined-treatment group, who also showed a trend toward more efficient learning.

14. Vitamin A required for immune system. This review discusses evidence from experimental studies that RA promotes the differentiation of regulatory T cells, which help to suppress inflammatory reactions, and plays a significant role in normal mucosal immunity by modulating T cell activation and regulating cell trafficking. RA also promotes antibody responses to T cell–dependent antigens. Conversely, in a state of vitamin A deficiency, inflammatory T cell reactions may be inadequately opposed and therefore become dominant.

- Roc, Nutrition Investigator
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"one of the strongest and most consistent findings in behavioral medicine is the relationship between positive emotions and health."-Richie Davidson, The Emotional Life of Your Brain


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