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Great Diets For Weight Reduction Text
Great Diets For Weight Reduction Text
Great Diets For Weight Reduction Text
Great Diets For Weight Reduction Text
Great Diets For Weight Reduction Text
Great Diets For Weight Reduction Text
Great Diets For Weight Reduction Text
Great Diets For Weight Reduction Text
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Great Diets For Weight Reduction Text

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Das sind Textbausteine zum Vortrag "Diets for Weight Reduction". Es werden Studien und Abstracts und sonstige Kommentare und Bemerkungen aufgefuehrt.

Das sind Textbausteine zum Vortrag "Diets for Weight Reduction". Es werden Studien und Abstracts und sonstige Kommentare und Bemerkungen aufgefuehrt.

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  • 1. Diet and/or behavior modification: Long-term results -5 -5 0 0 WEight change (kg) WEight change (kg) -5 -5 -10 -10 VLCD VLCD Modified diet + behavior Modified diet + behavior modification modification -15 -15 VLCD + behavior modification VLCD + behavior modification -20 -20 1 1 2 2 3 3 4 4 5 5 Intervention Intervention Years after intervention Years after intervention (adapdet from Wadden TA. Ann Intern Med 1993; 119:688-93) (adapdet from Wadden TA. Ann Intern Med 1993; 119:688-93) Ann Intern Med. 1993 Oct 1;119(7 Pt 2):688-93. Links Treatment of obesity by moderate and severe caloric restriction. Results of clinical research trials. Wadden TA. Syracuse University, New York. Recent studies of the treatment of obesity by moderate and severe caloric restriction show that patients treated in randomized trials using a conventional 1200 kcal/d reducing diet, combined with behavior modification, lose approximately 8.5 kg in 20 weeks. They maintain approximately two thirds of this weight loss 1 year later. Patients treated under medical supervision using a very-low-calorie diet (400 to 800 kcal/d) lose approximately 20 kg in 12 to 16 weeks and maintain one half to two thirds of this loss in the following year. Both dietary interventions are associated with increasing weight regain over time, although regain can be minimized with the recognition that obesity, in many cases, is a chronic condition that requires continuing care. Patients who participate in a formal weight-loss maintenance program, exercise regularly, or both are likely to achieve the best long-term results. PMID: 8363198 [PubMed - indexed for MEDLINE]
  • 2. Comparison of Energy Densities Prentice AM et al Obes Rev. 2003 Nov;4(4):187-94 Obes Rev. 2003 Nov;4(4):187-94. Links Fast foods, energy density and obesity: a possible mechanistic link. Prentice AM, Jebb SA. MRC International Nutrition Group, London School of Hygiene and Tropical Medicine, UK. andrew.prentice@ishtm.ac.uk Fast foods are frequently linked to the epidemic of obesity, but there has been very little scientific appraisal of a possible causal role. Here we review a series of studies demonstrating that the energy density of foods is a key determinant of energy intake. These studies show that humans have a weak innate ability to recognise foods with a high energy density and to appropriately down-regulate the bulk of food eaten in order to maintain energy balance. This induces so called 'passive over-consumption'. Composition data from leading fast food company websites are then used to illustrate that most fast foods have an extremely high energy density. At some typical outlets the average energy density of the entire menus is approximately 1100 kJ 100 g(-1). This is 65% higher than the average British diet (approximately 670 kJ 100 g(-1)) and more than twice the energy density of recommended healthy diets (approximately 525 kJ 100 g(-1)). It is 145% higher than traditional African diets (approximately 450 kJ 100 g(-1)) that probably represent the levels against which human weight regulatory mechanisms have evolved. We conclude that the high energy densities of many fast foods challenge human appetite control systems with conditions for which they were never designed. Among regular consumers they are likely to result in the accidental consumption of excess energy and hence to promote weight gain and obesity. PMID: 14649369 [PubMed - indexed for MEDLINE]
  • 3. Consistent weight loss in clinical trials Weight loss (%) Placebo + Xenical + diet diet 12 p<0.001 p<0.001 10.2% p<0.001 10 9.7% 8.8% 8 6.1% 6.6% 6 5.8% 4 2 0 Sjöström Rössner Davidson Sjöström L et al Lancet. 1998 Jul 18;352(9123):167-72 Rössner S et al Obes Res. 2000 Jan;8(1):49-61 Davidson MH et al JAMA. 1999 Jan 20;281(3):235-42 Lancet. 1998 Jul 18;352(9123):167-72.Related Articles, Links Comment in: Lancet. 1998 Jul 18;352(9123):160-1. Lancet. 1998 Oct 31;352(9138):1473-4. Lancet. 1998 Oct 31;352(9138):1473; author reply 1474. Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. European Multicentre Orlistat Study Group. Sjostrom L, Rissanen A, Andersen T, Boldrin M, Golay A, Koppeschaar HP, Krempf M. Sahlgrenska University Hospital, Goteborg, Sweden. BACKGROUND: We undertook a randomised controlled trial to assess the efficacy and tolerability of orlistat, a gastrointestinal lipase inhibitor, in promoting weight loss and preventing weight regain in obese patients over a 2-year period. METHODS: 743 patients (body-mass index 28-47 kg/m2), recruited at 15 European centres, entered a 4-week, single- blind, placebo lead-in period on a slightly hypocaloric diet (600 kcal/day deficit). 688 patients who completed the lead-in were assigned double-blind treatment with orlistat 120 mg (three times a day) or placebo for 1 year in conjunction with the hypocaloric diet. In a second 52- week double-blind period patients were reassigned orlistat or placebo with a weight maintenance (eucaloric) diet. FINDINGS: From the start of lead-in to the end of year 1, the orlistat group lost, on average, more bodyweight than the placebo group (10.2% [10.3 kg] vs 6.1% [6.1 kg]; LSM difference 3.9 kg [p<0.001] from randomisation to the end of year 1). During year 2, patients who continued with orlistat regained, on average, half as much weight as those patients switched to placebo (p<0.001). Patients switched from placebo to orlistat lost an additional 0.9 kg during year 2, compared with a mean regain of 2.5 kg in patients who continued on placebo (p<0.001). Total cholesterol, low-density lipoprotein (LDL) cholesterol, LDL/high-density lipoprotein ratio, and concentrations of glucose and insulin decreased more in the orlistat group than in the placebo group. Gastrointestinal adverse events were more
  • 4. common in the orlistat group. Other adverse symptoms occurred at a similar frequency during both treatments. INTERPRETATION: Orlistat taken with an appropriate diet promotes clinically significant weight loss and reduces weight regain in obese patients over a 2-year period. The use of orlistat beyond 2 years needs careful monitoring with respect to efficacy and adverse events. Publication Types: Clinical Trial Multicenter Study Randomized Controlled Trial PMID: 9683204 [PubMed - indexed for MEDLINE] Obes Res. 2000 Jan;8(1):49-61.Related Articles, Links Weight loss, weight maintenance, and improved cardiovascular risk factors after 2 years treatment with orlistat for obesity. European Orlistat Obesity Study Group. Rossner S, Sjostrom L, Noack R, Meinders AE, Noseda G. Obesity Unit, Huddinge Hospital, Stockholm, Sweden. stephan.rossner@medhs.ki.se OBJECTIVE: To determine the effect of orlistat, a new lipase inhibitor, on long-term weight loss, to determine the extent to which orlistat treatment minimizes weight regain in a second year of treatment, and to assess the effects of orlistat on obesity-related risk factors. RESEARCH METHODS AND PROCEDURES: This was a 2-year, multicenter, randomized, double-blind, placebo-controlled study. Obese patients (body mass index 28 to 43 kg/m2) were randomized to placebo or orlistat (60 or 120 mg) three times a day, combined with a hypocaloric diet during the first year and a weight maintenance diet in the second year of treatment to prevent weight regain. Changes in body weight, lipid profile, glycemic control, blood pressure, quality of life, safety, and tolerability were measured. RESULTS: Orlistat- treated patients lost significantly more weight (p<0.001) than placebo-treated patients after Year 1 (6.6%, 8.6%, and 9.7% for the placebo, and orlistat 60 mg and 120 mg groups, respectively). During the second year, orlistat therapy produced less weight regain than placebo (p = 0.005 for orlistat 60 mg; p<0.001 for orlistat 120 mg). Several obesity-related risk factors improved significantly more with orlistat treatment than with placebo. Orlistat was generally well tolerated and only 6% of orlistat-treated patients withdrew because of adverse events. Orlistat leads to predictable gastrointestinal effects related to its mode of action, which were generally mild, transient, and self-limiting and usually occurred early during treatment. DISCUSSION: Orlistat administered for 2 years promotes weight loss and minimizes weight regain. Additionally, orlistat therapy improves lipid profile, blood pressure, and quality of life. Publication Types: Clinical Trial Multicenter Study Randomized Controlled Trial PMID: 10678259 [PubMed - indexed for MEDLINE]
  • 5. JAMA. 1999 Jan 20;281(3):235-42.Related Articles, Links Erratum in: JAMA 1999 Apr 7;281(13):1174. Comment in: JAMA. 1999 Jan 20;281(3):278-80. Weight control and risk factor reduction in obese subjects treated for 2 years with orlistat: a randomized controlled trial. Davidson MH, Hauptman J, DiGirolamo M, Foreyt JP, Halsted CH, Heber D, Heimburger DC, Lucas CP, Robbins DC, Chung J, Heymsfield SB. Chicago Center for Clinical Research, Ill, USA. CONTEXT: Orlistat, a gastrointestinal lipase inhibitor that reduces dietary fat absorption by approximately 30%, may promote weight loss and reduce cardiovascular risk factors. OBJECTIVE: To test the hypothesis that orlistat combined with dietary intervention is more effective than placebo plus diet for weight loss and maintenance over 2 years. DESIGN: Randomized, double-blind, placebo-controlled study conducted from October 1992 to October 1995. SETTING AND PARTICIPANTS: Obese adults (body mass index [weight in kilograms divided by the square of height in meters], 30-43 kg/m2) evaluated at 18 US research centers. INTERVENTION: Subjects received placebo plus a controlled-energy diet during a 4-week lead-in. On study day 1, the diet was continued and subjects were randomized to receive placebo 3 times a day or orlistat, 120 mg 3 times a day, for 52 weeks. After 52 weeks, subjects began a weight-maintenance diet, and the placebo group (n = 133) continued to receive placebo and orlistat-treated subjects were rerandomized to receive placebo 3 times a day (n = 138), orlistat, 60 mg (n = 152) or 120 mg (n = 153) 3 times a day, for an additional 52 weeks. MAIN OUTCOME MEASURES: Body weight change and changes in blood pressure and serum lipid, glucose, and insulin levels. RESULTS: A total of 1187 subjects entered the protocol, and 892 were randomly assigned on day 1 to double-blind treatment. For intent-to-treat analysis, 223 placebo-treated subjects and 657 orlistat-treated subjects were evaluated. During the first year orlistat-treated subjects lost more weight (mean +/- SEM, 8.76+/-0.37 kg) than placebo-treated subjects (5.81+/-0.67 kg) (P<.001). Subjects treated with orlistat, 120 mg 3 times a day, during year 1 and year 2 regained less weight during year 2 (3.2+/-0.45 kg; 35.2% regain) than those who received orlistat, 60 mg (4.26+/- 0.57 kg; 51.3% regain), or placebo (5.63+/-0.42 kg; 63.4% regain) in year 2 (P<.001). Treatment with orlistat, 120 mg 3 times a day, was associated with improvements in fasting low-density lipoprotein cholesterol and insulin levels. CONCLUSIONS: Two-year treatment with orlistat plus diet significantly promotes weight loss, lessens weight regain, and improves some obesity-related disease risk factors. Publication Types: Clinical Trial Multicenter Study Randomized Controlled Trial PMID: 9918478 [PubMed - indexed for MEDLINE]
  • 6. Xenical: Long-term weight reduction Veränderung Körpergewicht (%) 0 Placebo Xenical® 60mg -2 Xenical® 120mg *p<0.01 -4 -6 -8 -10 -4 0 10 20 30 40 52 60 70 80 90 104 Sjöström L et al Lancet. 1998 Jul 18;352(9123):167-72 Lancet. 1998 Jul 18;352(9123):167-72.Related Articles, Links Comment in: Lancet. 1998 Jul 18;352(9123):160-1. Lancet. 1998 Oct 31;352(9138):1473-4. Lancet. 1998 Oct 31;352(9138):1473; author reply 1474. Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. European Multicentre Orlistat Study Group. Sjostrom L, Rissanen A, Andersen T, Boldrin M, Golay A, Koppeschaar HP, Krempf M. Sahlgrenska University Hospital, Goteborg, Sweden. BACKGROUND: We undertook a randomised controlled trial to assess the efficacy and tolerability of orlistat, a gastrointestinal lipase inhibitor, in promoting weight loss and preventing weight regain in obese patients over a 2-year period. METHODS: 743 patients (body-mass index 28-47 kg/m2), recruited at 15 European centres, entered a 4-week, single- blind, placebo lead-in period on a slightly hypocaloric diet (600 kcal/day deficit). 688 patients who completed the lead-in were assigned double-blind treatment with orlistat 120 mg (three times a day) or placebo for 1 year in conjunction with the hypocaloric diet. In a second 52- week double-blind period patients were reassigned orlistat or placebo with a weight maintenance (eucaloric) diet. FINDINGS: From the start of lead-in to the end of year 1, the orlistat group lost, on average, more bodyweight than the placebo group (10.2% [10.3 kg] vs 6.1% [6.1 kg]; LSM difference 3.9 kg [p<0.001] from randomisation to the end of year 1). During year 2, patients who continued with orlistat regained, on average, half as much weight as those patients switched to placebo (p<0.001). Patients switched from placebo to orlistat lost an additional 0.9 kg during year 2, compared with a mean regain of 2.5 kg in patients who continued on placebo (p<0.001). Total cholesterol, low-density lipoprotein (LDL) cholesterol, LDL/high-density lipoprotein ratio, and concentrations of glucose and insulin decreased more
  • 7. in the orlistat group than in the placebo group. Gastrointestinal adverse events were more common in the orlistat group. Other adverse symptoms occurred at a similar frequency during both treatments. INTERPRETATION: Orlistat taken with an appropriate diet promotes clinically significant weight loss and reduces weight regain in obese patients over a 2-year period. The use of orlistat beyond 2 years needs careful monitoring with respect to efficacy and adverse events. Publication Types: Clinical Trial Multicenter Study Randomized Controlled Trial PMID: 9683204 [PubMed - indexed for MEDLINE] Xenical: XENDOS-results Placebo + Xenical + (kg) 0 lifestyle modification lifestyle modification –3 –4,1 kg –6 –6,9 kg –9 p<0.001 vs. Placebo –12 0 52 104 156 208 Woche Torgerson JS et al Diabetes Care. 2004 Jan;27(1):155-61 Diabetes Care. 2004 Jan;27(1):155-61.Related Articles, Links Erratum in: Diabetes Care. 2004 Mar;27(3):856. XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Torgerson JS, Hauptman J, Boldrin MN, Sjostrom L. Department of Body Composition and Metabolism, Sahlgrenska University Hospital, Goteborg, Sweden. OBJECTIVE: It is well established that the risk of developing type 2 diabetes is closely linked to the presence and duration of overweight and obesity. A reduction in the incidence of type 2 diabetes with lifestyle changes has previously been demonstrated. We hypothesized that
  • 8. adding a weight-reducing agent to lifestyle changes may lead to an even greater decrease in body weight, and thus the incidence of type 2 diabetes, in obese patients. RESEARCH DESIGN AND METHODS: In a 4-year, double-blind, prospective study, we randomized 3,305 patients to lifestyle changes plus either orlistat 120 mg or placebo, three times daily. Participants had a BMI >/=30 kg/m2 and normal (79%) or impaired (21%) glucose tolerance (IGT). Primary endpoints were time to onset of type 2 diabetes and change in body weight. Analyses were by intention to treat. RESULTS: Of orlistat-treated patients, 52% completed treatment compared with 34% of placebo recipients (P < 0.0001). After 4 years' treatment, the cumulative incidence of diabetes was 9.0% with placebo and 6.2% with orlistat, corresponding to a risk reduction of 37.3% (P = 0.0032). Exploratory analyses indicated that the preventive effect was explained by the difference in subjects with IGT. Mean weight loss after 4 years was significantly greater with orlistat (5.8 vs. 3.0 kg with placebo; P < 0.001) and similar between orlistat recipients with impaired (5.7 kg) or normal glucose tolerance (NGT) (5.8 kg) at baseline. A second analysis in which the baseline weights of subjects who dropped out of the study was carried forward also demonstrated greater weight loss in the orlistat group (3.6 vs. 1.4 kg; P < 0.001). CONCLUSIONS: Compared with lifestyle changes alone, orlistat plus lifestyle changes resulted in a greater reduction in the incidence of type 2 diabetes over 4 years and produced greater weight loss in a clinically representative obese population. Difference in diabetes incidence was detectable only in the IGT subgroup; weight loss was similar in subjects with IGT or NGT [correction]. Publication Types: Clinical Trial Randomized Controlled Trial PMID: 14693982 [PubMed - indexed for MEDLINE]

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