Red yeast rice significantly reduces total cholesterol, LDL cholesterol, and total triacylglycerol concentrations compared with placebo and provides a new, novel, food-based approach to lowering cholesterol in the general population.

A traditional lifestyle intervention using meal replacements can be effective for weight control and reduction in risk of chronic disease in the physician's office setting as well as in the dietitian-led group setting.

To assess whether bioelectrical impedance analysis (BIA) provides clinically useful information on body composition beyond that obtained from measuring height and weight, we clinically classified 306 obese patients (233 females and 73 males) into tertiles of increasing fat-free mass estimated by BIA. Because fat-free mass by BIA is an estimate of lean body mass, the lowest tertile was clinically defined as sarcopenic obesity (reduced lean body mass), as contrasted with proportionate or muscular obesity in the next two tertiles. Fat mass in patients in each of the above tertiles based on BIA was then compared with fat mass estimated by using the equations of Garrow and Webster with body mass index (weight/height2). BIA-estimated fat mass was 4.3 kg greater in the sarcopenic group (n = 102) than predicted from body mass index. Fat mass predicted by BIA in the proportionate (n = 102) and muscular (n = 102) groups differed by less than the SEE of fat mass predicted by BMI. In premenopausal women at increased risk of breast cancer BIA showed a high prevalence of sarcopenic obesity (28/30) in these women at normal body mass indexes. Thus, BIA may be clinically useful for demonstrating sarcopenic obesity, but additional studies are needed to determine the metabolic and clinical significance of sarcopenic obesity.

30 to 50 years old) were randomized into three interventions: group A, a dietitian-led intervention; group B, a dietitian-led intervention incorporating MRs; and group C, a clinical office-based intervention incorporating MRs. In year 1, groups A and B attended 26 group sessions, whereas group C received the same educational materials during 26 10-minute office visits with a physician-nurse team. In year 2, participants attended monthly group seminars and drop-in visits with a dietitian. Results: For the 74 subjects completing year 1, weight loss in the office-based group C was as effective as the traditional dietitian-led group A (4.3 Ϯ 6.5% vs. 4.1 Ϯ 6.4%), while group B maintained a significantly greater weight loss (9.1 Ϯ 8.9%; p Ͻ 0.02; mean Ϯ SD). For the 43 subjects completing year 2, group B showed significant differences in the percentage of weight loss (Ϫ8.5 Ϯ 7.0%) compared with group A (Ϫ1.5 Ϯ 5.0%) and group C (Ϫ3.0 Ϯ 7.0%; p Ͻ 0.001). Discussion: Study results showed that a traditional weight loss intervention incorporating MRs was effective as a weight loss tool in the medical office practice and in the dietitian-led group setting.

BackgroundSafe and effective weight control strategies are needed to stem the current obesity epidemic. The objective of this one-year study was to document and compare the macronutrient and micronutrient levels in the foods chosen by women following two different weight reduction interventions.MethodsNinety-six generally healthy overweight or obese women (ages 25–50 years; BMI 25–35 kg/m2) were randomized into a Traditional Food group (TFG) or a Meal Replacement Group (MRG) incorporating 1–2 meal replacement drinks or bars per day. Both groups had an energy-restricted goal of 5400 kJ/day. Dietary intake data was obtained using 3-Day Food records kept by the subjects at baseline, 6 months and one-year. For more uniform comparisons between groups, each diet intervention consisted of 18 small group sessions led by the same Registered Dietitian.ResultsWeight loss for the 73% (n = 70) completing this one-year study was not significantly different between the groups, but was significantly different (p ≤ .05) within each group with a mean (± standard deviation) weight loss of -6.1 ± 6.7 kg (TFG, n = 35) vs -5.0 ± 4.9 kg (MRG, n = 35). Both groups had macronutrient (Carbohydrate:Protein:Fat) ratios that were within the ranges recommended (50:19:31, TFG vs 55:16:29, MRG). Their reported reduced energy intake was similar (5729 ± 1424 kJ, TFG vs 5993 ± 2016 kJ, MRG). There was an improved dietary intake pattern in both groups as indicated by decreased intake of saturated fat (≤ 10%), cholesterol (<200 mg/day), and sodium (< 2400 mg/day), with increased total servings/day of fruits and vegetables (4.0 ± 2.2, TFG vs 4.6 ± 3.2, MRG). However, the TFG had a significantly lower dietary intake of several vitamins and minerals compared to the MRG and was at greater risk for inadequate intake.ConclusionIn this one-year university-based intervention, both dietitian-led groups successfully lost weight while improving overall dietary adequacy. The group incorporating fortified meal replacements tended to have a more adequate essential nutrient intake compared to the group following a more traditional food group diet. This study supports the need to incorporate fortified foods and/or dietary supplements while following an energy-restricted diet for weight loss.

Background. Low fat, high fiber dietary interventions that decrease blood estrogen levels may reduce breast cancer risk. Asian women consuming their traditional low fat, high fiber diets have lower blood estrogen levels before and after menopause and lower rates of breast cancer compared with Western women. The current controlled feeding study of premenopausal women was designed to determine the effects of a very low fat (10% of calories) and high fiber (35–45g/day) diet on blood estrogen levels and menstrual function. Method. Twelve healthy premenopausal women with regular ovulatory cycles were followed for 3 months. Subjects consumed a diet providing 30% of their energy from fat and 15–25 g of dietary fiber per day for 1 month, and they consumed a very low fat, high fiber ad libitum diet providing 10% of their energy from fat and 25–35 g of dietary fiber per day for 2 months. Results. At the end of the second month of the very low fat, high fiber diet, there was a significant reduction in serum estrone and estradiol levels during the early follicular and late luteal phases. There were no significant changes observed in serum estrone sulfate, sex hormone binding globulin, or progesterone. Despite a significant decrease in serum estradiol and estrone levels after 2 months of a very low fat, high fiber diet, there was no interference with ovulation or the magnitude of the midcycle leuteinizing hormone surge. Small changes in menstrual cycle length of up to 3 days were not ruled out due to the small sample size of the study. Conclusions. A very low fat, high fiber diet in healthy premenopausal women can reduce estradiol and estrone levels without affecting ovulation, thereby providing a rationale for the prevention of breast cancer through a very low fat, high fiber diet.

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The weight loss observed (approximately 10% of body weight) is significant and has been associated with important health benefits particularly for patients with hypertension and non-insulin dependent diabetes. The potential advantages of using meal replacements for mild obesity include wide availability to aid compliance, low cost and minimal professional intervention.