Cardiometabolic Indices after Weight Loss with Calcium or Dairy Foods: Secondary Analyses from a Randomized Trial with Overweight/Obese Postmenopausal Women.

The role of dairy foods and calcium/vitamin D supplements in cardiometabolic diseases is unknown. The objective of this secondary analysis is to investigate cardiometabolic risk factors changes after a 6-month weight-loss intervention in overweight/obese postmenopausal women divided in three groups: Ca+vitamin D supplements (S); low-fat dairy foods (D; 4−5 servings/day); or control/placebo pills (C), as complements to hypocaloric diets. The original study focused on bone/body composition. This analysis included blood pressure (BP), and serum triglycerides, lipids (including apoproteins Apo1 and ApoB), adipokines, and C-reactive protein in n = 97 participants who finished with complete data points. Systolic BP decreased 5.1%, 4.8%, and 1.8% in S, D, and C groups, respectively (p < 0.05 for S and D vs. baseline and vs. C at 6 months). Reduction in triglycerides and ratio of total cholesterol (TC)/high-density lipoproteins cholesterol (HDL-C) was the highest in S, while the reduction in TC and LDL-C was the highest in D group (all p < 0.05). Leptin and ApoB significantly decreased and adiponectin and ApoA1 increased in all groups. In conclusion, although the C group's participants experienced an improvement in some of the cardiometabolic indices with weight loss, those in the S and D groups showed significantly better results in most of the outcomes, indicating the beneficial effects of low-fat dairy foods and/or Ca+vitamin D intake as complements to a hypocaloric diet.

Role of Calcium and Low-Fat Dairy Foods in Weight-Loss Outcomes Revisited: Results from the Randomized Trial of Effects on Bone and Body Composition in Overweight/Obese Postmenopausal Women.

Several studies have investigated the possibility of dairy foods and calcium (Ca) mediating weight and body composition, but a consensus has not been reached. We aimed to investigate weight-loss-related outcomes during intervention with low-fat dairy foods or Ca + vitamin D supplements, both as complements to hypocaloric diets. Overweight/obese Caucasian, early-postmenopausal women (n = 135) were recruited for a 6 month energy-restricted weight loss study complemented with either low-fat dairy foods (D; 4-5 servings/day), or Ca + vitamin D supplements (S); both to amount a total of ~1500 mg/day and 600 IU/day of Ca and vitamin D, respectively, or placebo pills (C). Bone mineral density (BMD) and lean and fat tissue were measured by Lunar iDXA. Serum and urinary markers of bone turnover were analyzed. Diet and physical activity were assessed with 3-day records. Participants on average lost ~4%, ~3%, and ~2% of body weight, fat, and lean tissue, respectively. The significantly better outcomes were noticed in participants in the D group regarding body composition (fat loss/lean tissue preservation) and in participants in the S group regarding the BMD outcomes, compared to those in the C group. Therefore, increasing low-fat dairy foods to 4-5 servings/day and/or increasing Ca & vitamin D intake by supplements (in those who are at the borderline dietary intake) may be beneficial for weight loss/maintenance and may lead to more favorable bone and body composition outcomes in postmenopausal women during moderate weight loss.

Physical performance in relation to body composition and bone mineral density in healthy, overweight, and obese postmenopausal women.

BACKGROUND AND PURPOSE: Diminished physical performance can be detrimental among the older adults, causing falls and subsequent fractures, loss of independence, and increased morbidity and mortality rates. Therefore, it is important to maintain functional ability from the early onset of aging. The purpose of this study was to investigate the relationship between physical performance measures and body composition (bone, fat, and lean mass) in healthy, overweight and obese, early postmenopausal white women. METHODS: A total of 97 participants aged 56.0 (4.4) years (mean (SD)) with body mass index of 31.0 (4.6) kg/m(2) were included. Weight and height were recorded and 3 days of dietary records and physical activity were collected. Dual-energy x-ray absorptiometry measurements for body composition and bone mineral density were performed. Fasting blood samples were used for serum 25-hydroxy vitamin D (25OHD) analysis. Measures of physical performance included handgrip strength, 8-meter walking speed, one-leg-stance time, 8-foot Timed Get-Up-and-Go Test, and chair sit-to-stand test. RESULTS: Results showed that higher lean mass was related to better physical performance on items assessing body strength, including handgrip (r ranged from 0.22 to 0.25, P < .05) while higher body fat was related to the poorer physical performance in each of the assessed measures. Bone mineral density of the forearm was positively related to the handgrip strength (r = 0.207, P < .05). In regression analyses (controlled for age, weight, height, serum 25OHD status, calcium intake, physical activity, and smoking), fat mass of the lower extremities was inversely related to walking speed, one-leg-stance time, and Get-Up-and-Go measures, all crucial for mobility (r(2) = 0.13-0.23, P < .05). CONCLUSIONS: Overall, higher fat and lower lean mass was related to poorer physical performance, while forearm bone mineral density was related to the handgrip strength only. Further investigation may be beneficial for a better understanding of how body composition may prevent decline in physical performance among overweight/obese, mid-age, and older women.

Dairy product intake is inversely associated with metabolic syndrome in Korean adults: Anseong and Ansan cohort of the Korean Genome and Epidemiology Study.

The objective of this study was to examine the relationship between dairy product intake and the incidence of metabolic syndrome (MetS) and its components among middle-aged Koreans. We examined 7,240 adults aged 40-69 yr without MetS at baseline over a 45.5-month follow-up period. They were taken from the Anseong and Ansan cohort of the Korean Genome and Epidemiology Study. Dairy product intake including milk, yogurt, and cheese was assessed with food frequency questionnaire. At the follow-up, the incidence of MetS was 17.1%. The incidences of MetS components were as follows: low HDL cholesterol (16.2%), abdominal obesity (14.0%), hypertriglyceridemia (13.8%), hyperglycemia (13.3%), and hypertension (13.1%). Adjusting for potential confounders, dairy product consumption frequency was inversely associated with the risk of MetS and abdominal obesity. Hazard ratio (HR) (95% confidence interval) for dairy product consumption more than 7 times/week compared to never was 0.75 (0.64-0.88, P for trend < 0.001) for MetS and 0.73 (0.61-0.88, P for trend < 0.001) for abdominal obesity. HR for milk intake was 0.79 for MetS and 0.82 for abdominal obesity. The results of this study suggest that daily intake of dairy products protects against the development of MetS, particularly abdominal obesity, in middle-aged Koreans.

Measures for a closer-to-real estimate of dietary exposure to total mercury and lead in total diet study for Koreans.

Previous Korean total diet studies (KTDSs) have estimated dietary exposure to toxic chemicals based on 110-120 representative foods selected from over 500 foods appeared in the Korea National Health & Nutrition Examination Surveys (KNHANES), which would result in a possible underestimation. In order to find measures for a closer-to-real estimate of dietary exposure to heavy metals, this study examined the feasibility of mapping foods to the representative foods in the KTDS by comparing estimates. In mapping, those foods not analyzed in the 2009 KTDS (443 out of 559 foods appeared in the 2007 KNHANES) were mapped to the 114 representative foods used in the 2009 KTDS based on the closeness in regards to biological systematics and morphological similarity. Dietary exposures to total mercury and lead were re-estimated using the content of total mercury and lead in 114 foods analyzed in the 2009 KTDS, food intake, and individual's own body weight for respondents in the 2007 KNHANES instead of mean body weight of Koreans used in the 2009 KTDS. The re-estimates of exposure with mapping were approximately 50% higher than the original estimates reported in the 2009 KTDS. In addition, mapping enabled the comparison of percentile distribution of the exposure among populations of different age groups. In conclusion, estimates via mapping resulted in a more comprehensive estimation of dietary exposure to heavy metals present in foods that Koreans consume.

Validation of body adiposity index as a measure of obesity in overweight and obese postmenopausal white women and its comparison with body mass index.

OBJECTIVE: The purpose of this study was to evaluate whether the recently developed body adiposity index (BAI) in Mexican American and African American women could be validated in postmenopausal American white women and to determine if it is a better obesity classification measure than body mass index (BMI) is in the latter population. METHODS: Total body percentage adiposity (%adiposity) measured by dual-energy x-ray absorptiometry (DXA) was compared with total body %adiposity predicted by BAI in 187 overweight/obese postmenopausal white women (mean ± SD %adiposity, 45.9 ± 4.9% and 38.3 ± 6.2% for DXA and BAI, respectively). SPSS 19.0 and Medcalc 11.6.1.0 were used to conduct Pearson's correlations (r), paired t test, receiver operating curve, and Lin's concordance coefficient (ρc) and to create Bland and Altman's limit-of-agreement plot. RESULTS: Pearson's correlation analysis revealed a strong association between DXA %adiposity and BAI (r = 0.78, P < 0.001), DXA %adiposity and BMI (r = 0.75, P < 0.001), and BMI and BAI (r = 0.90, P < 0.001). Bias correction factor was 0.51 between DXA %adiposity and BAI. Paired t test showed a significant mean difference between measurements (P < 0.0001), and the plot showed that BAI underestimated DXA %adiposity by 7.56%. Concordance coefficient (ρc = 0.39; 95% CI, 0.33-0.46) revealed a poor agreement strength. There was no difference between the area under the curve statistic for BAI and BMI. CONCLUSION: Based on our results, BAI has limitations for use in a clinical setting in overweight/obese postmenopausal white women but may be practical for research applications and eventually developed into an easy method to estimate overweight/obesity in other settings.

Self-efficacy improves weight loss in overweight/obese postmenopausal women during a 6-month weight loss intervention.

The objective was to examine the relationship between self-efficacy and subsequent weight loss during a 6-month weight loss intervention in 90 white early postmenopausal healthy women. We hypothesized that participants with higher self-efficacy scores, either at baseline or follow-up, would lose more weight than those with lower scores. Each participant received a balanced meal plan with reduced energy intake. Nutritional and behavioral sessions were provided every 2 weeks during the first 3 months. Weight and height were measured at baseline, every 2 weeks in the first 3 months, and at month 6. Three-day dietary and physical activity records and Weight Efficacy Lifestyle Questionnaire were completed at the same intervals. At month 6, participants lost 3.6 ± 4.1 kg or 4.4% (mean ± SD) and decreased in weight from 82.2 ± 11.1 kg to 77.6 ± 11.4 kg (P < .001). When participants were divided into groups based on weight loss success (<5% or ≥5% of initial weight), logistic regression (controlling for age, energy intake, physical activity, attendance at group sessions, and previous weight loss attempts) demonstrated that higher self-efficacy for the Availability of Food subscale of Weight Efficacy Lifestyle Questionnaire (95% confidence interval, 1.03-1.17) and total self-efficacy (95% confidence interval, 1.00-1.04) were associated with a greater likelihood of losing 5% or more of initial weight. Overall, participants who had higher total self-efficacy and self-efficacy to resist eating when food was available were able to lose more weight. Therefore, cognitive-behavioral efforts promoting self-efficacy may be useful for bolstering individual's confidence to resist eating under various conditions and thereby improve weight loss outcomes.

Vitamin D status and Framingham risk score in overweight postmenopausal women.

BACKGROUND: Epidemiologic studies have suggested associations between vitamin D status and coronary heart disease (CHD) risk. The purpose of this work was to determine if vitamin D status was predictive of CHD risk assessed by Framingham risk score (FRS) in overweight, Caucasian, postmenopausal women, using the baseline data collected in a clinical trial. METHODS: The study comprised 178 women aged 42-67 years (mean±standard deviation [SD] 55.7±4.3). Fasting serum was used to analyze blood lipids and vitamin D. The status of the latter was determined based on serum 25-hydroxyvitamin D [25(OH)D], with inadequacy defined as serum 25(OH)D <75 nmol/L (or <50.0 nmol/L, per new Institute of Medicine recommendations). Usual dietary intake and activity were assessed using 3-day food and 2-day activity records, respectively. Education, medical history, blood pressure, and anthropometric measures were obtained as well. Season was determined based on date of blood draw. RESULTS: Mean serum 25(OH)D concentration was 65.3±27.5 nmol/L (range 7.0-147.6 nmol/L); 66% (n=118) and 32% (n=57) of subjects were vitamin D insufficient [25(OH)D <75 nmol/L or <50 nmol/L, respectively] of which 14% (n=25) were vitamin D deficient [25(OH)D <37.5 nmol/L]. Body mass index (BMI) was a significant negative and dietary vitamin D positive predictor of 25(OH)D. In hierarchical regression, FRS was predicted by education level only. No association was observed between 25(OH)D and FRS (p=0.981). CONCLUSIONS: Serum 25(OH)D concentrations were inversely associated with BMI, but no relationship with FRS was found. Given the physiologic importance of vitamin D, further investigations aimed at determining the effects of obesity and heart disease on vitamin D requirements are warranted.

Relationship of Physical Performance with Body Composition and Bone Mineral Density in Individuals over 60 Years of Age: A Systematic Review.

The purpose of this review was to examine the relationship between physical performance and body composition measurements, including fat/muscle mass and bone mineral density (BMD) in individuals ≥60 years of age. Various measurements used to assess body composition, BMD, and physical performance (PP) were discussed as well. Medline/PubMed, CINAHL, and SCIE were used to identify articles. After limiting the search for age and kind of physical performance measures, 33 articles were evaluated. Higher fat mass was associated with poorer physical performance while higher muscle mass was a predictor of better physical performance, especially in the lower extremities. Additionally, evidence showed that higher muscle fat infiltration was a determinant of poorer physical performance. BMD was shown to be a good predictor of physical performance although the relationship was stronger in women than in men. Developing standardized methods for PP measurements could help in further investigation and conclusions of its relationship with body composition.