Unprocessed red meat in the dietary treatment of obesity: a randomized controlled trial of beef supplementation during weight maintenance after successful weight loss.

BACKGROUND: Consumption of unprocessed red meat in randomized trials has no adverse effects on cardiovascular risk factors and body weight, but its physiological effects during weight loss maintenance are not known. OBJECTIVES: We sought to investigate the effects of healthy diets that include small or large amounts of red meat on the maintenance of lost weight after successful weight loss, and secondarily on body composition (DXA), resting energy expenditure (REE; indirect calorimetry), and cardiometabolic risk factors. METHODS: In this 5-mo parallel randomized intervention trial, 108 adults with BMI 28-40 kg/m2 (45 males/63 females) underwent an 8-wk rapid weight loss period, and those who lost ≥8% body weight (n = 80) continued to ad libitum weight maintenance diets for 12 wk: a moderate-protein diet with 25 g beef/d (B25, n = 45) or a high-protein diet with 150 g beef/d (B150, n = 35). RESULTS: In per protocol analysis (n = 69), mean body weight (-1.2 kg; 95% CI: -2.1, -0.3 kg), mean fat mass (-2.7 kg; 95% CI: -3.4, -2.0 kg), and mean body fat content (-2.6%; 95% CI: -3.1, -2.1%) decreased during the maintenance phase, whereas mean lean mass (1.5 kg; 95% CI: 1.0, 2.0 kg) and mean REE (51 kcal/d; 95% CI: 15, 86 kcal/d) increased, with no differences between groups (all P > 0.05). Results were similar in intention-to-treat analysis with multiple imputation for dropouts (20 from B150 compared with 19 from B25, P = 0.929). Changes in cardiometabolic risk factors were not different between groups, the general pattern being a decrease during weight loss and a return to baseline during weight maintenance (and despite the additional mild reduction in weight and fat mass). CONCLUSIONS: Healthy diets consumed ad libitum that contain a little or a lot of unprocessed beef have similar effects on body weight, energy metabolism, and cardiovascular risk factors during the first 3 mo after clinically significant rapid weight loss.

[Obesity: one of this century's greatest health challenge?]. / Adipositas: en af århundredets største sundhedsudfordringer?

The prevalence of overweight and obesity exceed 50% in many European countries. Obesity is responsible for 2-8% of all health costs and 10-13% of all deaths in Europe. Only a fraction of patients obtain a medically relevant weight loss of 5-10% through lifestyle intervention. Surgery is limited to severe obesity and is very costly; therefore pharmaceuticals are a relevant alternative. Such treatment is hampered by the lack of official guidelines and a relatively limited effect compared to the expectations of patients as well as medical staff. Guidelines and official subsidies are debated.

[Fast food promotes weight gain]. / Fastfood fremmer fedme--sekundaerpublikation.

The total amounts of fat in a fast food menu consisting of French fries and fried Chicken Nuggets from McDonald's and KFC, respectively, bought in 35 different countries vary from 41 to 71 gram. In most countries the menu contained unacceptably high amounts of industrially-produced trans fat which contributes to an increased risk of ischaemic heart disease, weight gain, abdominal fat accumulation and type 2 diabetes. The quality of the ingredients in fast food ought to be better and the size of the portions smaller and less energy-dense so that frequent fast food meals do not increase the risk of obesity and diseases among customers.

[A meta-analysis of the efficacy and safety of the anti-obesity agent Rimonabant]. / Vurdering af effekt og sikkerhed ved rimonabant som farmakologisk behandling af adipositas. En metaanalyse--sekundaerpublikation.

A meta-analysis of all randomised controlled trials examining the efficacy and safety of the anti-obesity agent Rimonabant (Acomplia, 20 mg/d) found an efficacy of 4.7 kg (4.1-5.3) more weight loss after one year compared to placebo. Rimonabant increased the risk of adverse events, including depressive episodes and anxiety, despite depressive symptoms being an exclusion criterion in these trials. This, combined with an increased risk of suicidality during Rimonabant treatment, warrants increased awareness from prescribing physicians.

[High levels of industrially produced trans fatty acids in popular fast food - but not in Denmark--secondary publication]. / Højt indhold af industrielt producerede transfedtsyrer i populaere fødevarer--men ikke i Danmark--sekundaerpublikation

An intake of trans-fatty acids of 5 grams per day is associated with an increase of 25% in the risk of ischemic heart disease. In 2004 Denmark, as the first country in the world, introduced a limitation on the content of industrially produced trans-fatty acids in foods. The amount in a "high-trans menu" consisting of popular foods was, from 2001 to 2005, reduced in Denmark from 30 g to <1 g. The amount in the same menu bought in countries within and outside the European Union is 20-40 g. During a period of just a few years, Denmark has thus eliminated a risk factor for ischemic heart disease without noticeable side effects for consumers. This risk factor is, however, still present in many other countries.

[Obesity in Denmark--why has it not gone so badly?]. / Adipositas i Danmark--hvorfor er det ikke gået så galt?

In the Western world the number of obese people is increasing, but in Denmark the incidence is not on the same scale as in the USA. Although several factors may be of importance, Danes are more physically active and their intake of beverages with added sugar is less than in the American population.

[Alternative causes of obesity]. / Alternative årsager til fedme.

The prevailing understanding of the causes of obesity is based on the disturbance of the thermodynamic law of energy balance, primarily through increased intake or decreased expenditure of energy. Alternative causes of obesity, which still respect the law but also allow for primary fat accumulation, are: virus infection of fat cells, energy supply from bacterial fermentation of indigestible food components, psychosocial factors mediated by psychoneuroendocrine pathways, sleeplessness or poor quality of sleep and early life programming, in addition to the well-known and proven genetic programming.

[The importance of physical activity and fitness in avoiding the complications of obesity]. / Betydning af fysisk aktivitet og fitness for fedmens komplikationer.

We have reviewed whether the complications of obesity can be attributed to low levels of physical activity and fitness, or if fatness per se has adverse effects on health. In both observational and interventional studies, fatness and inactivity seem to be independent risk factors. Abdominal obesity is a predictor of cardiovascular disease, which is independent of low fitness level, and obesity affects other risk factors adversely than inactivity does. However, physical activity does reduce the risk of type 2 diabetes and heart disease. It is concluded that both inactivity and obesity have an adverse effect on health.

[Drug treatment of obesity]. / Medikamentel behandling af fedme.

Acceptable adverse effects and a clinical relevant weight loss of 3 to 5 kilograms have been found in long-term randomized clinical trials for sibutramine (Reductil) and orlistat (Xenical); these drugs may be prescribed for treatment of obesity for a duration of one and four years, respectively. This also seems to be the case for rimonabant (Acomplia), which is expected to receive approval in 2005 or 2006. However, until data on morbidity and mortality are available from RCTs, there is no absolute indication for prescribing drugs for treatment of obesity.