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A nonrestrictive, weight loss diet focused on fiber and lean protein increase.
Zhang, L, Pagoto, S, Olendzki, B, Persuitte, G, Churchill, L, Oleski, J, Ma, Y
Nutrition (Burbank, Los Angeles County, Calif.). 2018;:12-18
Abstract
OBJECTIVE We examined the feasibility and acceptability of a non-restrictive diet that was focused on increasing dietary fiber and lean protein intake for weight loss. METHODS Dietary intake was assessed using three randomly selected 24-h dietary recalls. Fifteen obese adults enrolled in a 12-wk study that included six biweekly individual dietary counseling sessions to attain a daily goal of higher fiber (35 g/d) and lean protein (0.8 g/kg/d of individual's ideal body weight) intake. Feasibility was determined by retention and attendance and dietary adherence was measured. RESULTS One participant dropped out of the study before the 12-wk assessment visit. Fourteen participants completed all six counseling sessions and one participant completed five sessions. At week 12, 93% of participants approved of the diet and 92% of participants did not feel hungry while on the diet. Mean fiber intake increased by 6.8 g/d (95% confidence interval [CI], 3.2 to 10.5 g/d) and total protein intake increased by 5.7 g/d (95% CI, -3.7 to 15.0 g/d). The mean change in energy intake was -265.5 kcal/d (95% CI, -454.8 to -76.2 kcal/d). The dietary quality score as measured by the Alternative Healthy Eating Index increased by 6.1 (95% CI, 1.5 to 10.7). The mean change in weight was -2.2% (95% CI, -3.6 to -0.7%). CONCLUSIONS A diet that promotes increased fiber and lean protein intake demonstrates feasibility and high acceptability ratings, which resulted in calorie and weight reductions and an improvement of the dietary quality.
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Single-component versus multicomponent dietary goals for the metabolic syndrome: a randomized trial.
Ma, Y, Olendzki, BC, Wang, J, Persuitte, GM, Li, W, Fang, H, Merriam, PA, Wedick, NM, Ockene, IS, Culver, AL, et al
Annals of internal medicine. 2015;(4):248-57
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Abstract
BACKGROUND Few studies have compared diets to determine whether a program focused on 1 dietary change results in collateral effects on other untargeted healthy diet components. OBJECTIVE To evaluate a diet focused on increased fiber consumption versus the multicomponent American Heart Association (AHA) dietary guidelines. DESIGN Randomized, controlled trial from June 2009 to January 2014. (ClinicalTrials.gov: NCT00911885). SETTING Worcester, Massachusetts. PARTICIPANTS 240 adults with the metabolic syndrome. INTERVENTION Participants engaged in individual and group sessions. MEASUREMENTS Primary outcome was weight change at 12 months. RESULTS At 12 months, mean change in weight was -2.1 kg (95% CI, -2.9 to -1.3 kg) in the high-fiber diet group versus -2.7 kg (CI, -3.5 to -2.0 kg) in the AHA diet group. The mean between-group difference was 0.6 kg (CI, -0.5 to 1.7 kg). During the trial, 12 (9.9%) and 15 (12.6%) participants dropped out of the high-fiber and AHA diet groups, respectively (P = 0.55). Eight participants developed diabetes (hemoglobin A1c level ≥6.5%) during the trial: 7 in the high-fiber diet group and 1 in the AHA diet group (P = 0.066). LIMITATIONS Generalizability is unknown. Maintenance of weight loss after cessation of group sessions at 12 months was not assessed. Definitive conclusions cannot be made about dietary equivalence because the study was powered for superiority. CONCLUSION The more complex AHA diet may result in up to 1.7 kg more weight loss; however, a simplified approach to weight reduction emphasizing only increased fiber intake may be a reasonable alternative for persons with difficulty adhering to more complicated diet regimens. PRIMARY FUNDING SOURCE National Heart, Lung, and Blood Institute.
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Dietary intervention targeting increased fiber consumption for metabolic syndrome.
Merriam, PA, Persuitte, G, Olendzki, BC, Schneider, K, Pagoto, SL, Palken, JL, Ockene, IS, Ma, Y
Journal of the Academy of Nutrition and Dietetics. 2012;(5):621-3
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Design and methods for testing a simple dietary message to improve weight loss and dietary quality.
Merriam, PA, Ma, Y, Olendzki, BC, Schneider, KL, Li, W, Ockene, IS, Pagoto, SL
BMC medical research methodology. 2009;:87
Abstract
BACKGROUND The current food pyramid guidelines have been criticized because of their complexity and the knowledge required for users to understand the recommendations. Simplification of a dietary message to focus on a single key aspect of dietary quality, e.g., fiber intake, may make the message much easier to comprehend and adhere, such that respondents can achieve greater weight loss, better dietary quality and overall metabolic health. METHODS AND DESIGN This is a randomized controlled clinical trial with two equal sized arms. In total, 240 obese adults who meet diagnostic criteria for the metabolic syndrome will be randomized to one of the two conditions: 1) a high fiber diet and 2) the American Heart Association (AHA) diet. In the high fiber diet condition, patients will be given instruction only on achieving daily dietary fiber intake of 30 g or more. In the AHA diet condition, patients will be instructed to make the several dietary changes recommended by the AHA 2006 guidelines. The trial examines participant weight loss and dietary quality as well as changes in components of the metabolic syndrome, inflammatory biomarkers, low-density lipoprotein cholesterol levels, insulin levels, and glycosolated hemoglobin. Potential mediators, i.e., diet adherence and perceived ease of the diet, and the intervention effect on weight change will also be examined. DISCUSSIONS The purpose of this paper is to outline the study design and methods for testing the simple message of increasing dietary fiber. If the simple dietary approach is found efficacious for weight loss; and, improves dietary quality, metabolic health, and adherence, it might then be used to develop a simple public health message. TRIAL REGISTRATION NCT00911885.
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Inclusion of guar gum and alginate into a crispy bar improves postprandial glycemia in humans.
Williams, JA, Lai, CS, Corwin, H, Ma, Y, Maki, KC, Garleb, KA, Wolf, BW
The Journal of nutrition. 2004;(4):886-9
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Abstract
A novel induced viscosity fiber (IVF) crispy bar was formulated with the viscous dietary fibers alginate and guar gum. To evaluate the glycemic response and gastrointestinal tolerance to IVF crispy bars, nondiabetic healthy adult subjects (n = 48) were studied in a randomized, double-masked, crossover design. The control crispy bars and IVF crispy bars were identical except for the 2 dietary fibers contained in the experimental (IVF) bars. After an overnight fast, subjects consumed test bars containing 50 g carbohydrate. Their capillary blood glucose response was determined for 180 min postprandially. When subjects consumed IVF, the incremental blood glucose excursions were reduced (P < 0.05) at 15, 30, 45, and 120 min. At 180 min, the subjects' blood glucose concentration was maintained above the basal blood glucose concentration for both bars. Compared with controls, the incremental peak blood glucose concentration was reduced (P < 0.001) 30% when subjects consumed IVF. When subjects consumed IVF, the positive incremental area under the curve for glucose was reduced (P < 0.01) by 33% compared with controls. In the 24-h postprandial period after each treatment, the frequency and intensity of gastrointestinal tolerance symptoms did not differ. In conclusion, compared with a control crispy bar, the IVF crispy bar attenuated the postprandial glycemic excursion without gastrointestinal intolerance in healthy adult subjects.
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Change in women's diet and body mass following intensive intervention for early-stage breast cancer.
Hebert, JR, Ebbeling, CB, Olendzki, BC, Hurley, TG, Ma, Y, Saal, N, Ockene, JK, Clemow, L
Journal of the American Dietetic Association. 2001;(4):421-31
Abstract
OBJECTIVE To determine the effectiveness of an intensive dietary intervention on diet and body mass in women with breast cancer. DESIGN Randomized clinical trial. SUBJECTS 172 women aged 20 to 65 years with stage I or II breast cancer. INTERVENTION A 15-session, mainly group-based and dietitian-led nutrition education program (NEP) was compared to a mindfulness-based stress reduction clinic program (SRC); or usual supportive care (UC). MAIN OUTCOME MEASURES Dietary fat, complex carbohydrates, fiber, and body mass were measured. STATISTICAL ANALYSIS In addition to descriptive statistics, analysis of variance was conducted to test for differences according to intervention group. RESULTS Of the 157 women with complete dietary data at baseline, 149 had complete data immediately postintervention (at 4 months) and 146 had complete data at 1 year. Women randomized to NEP (n = 50) experienced a large reduction in fat consumption (5.8% of energy as fat) at 4 months and much of this reduction was preserved at 1 year (4.1% of energy) (both P < .0002) vs no change in either SRC (n = 51) or UC (n = 56). A 1.3-kg reduction in body mass was evident at 4 months in the NEP group (P = .003) vs no change in the SRC and UC groups. Women who had higher-than-average expectations of a beneficial effect of the intervention experienced larger changes. APPLICATIONS Dietitians' use of group nutrition interventions appear to be warranted. Increasing their effectiveness and maintaining high levels of adherence may require additional support, including the involvement of significant others, periodic individual meetings, or group booster sessions.