Cola Research Articles

Correlation between cola consumption and bone mineral density among Puerto Ricans living in the greater Boston area (257.7)

Correlation between Cola Consumption and Bone Mineral Density among Puerto Ricans Living in the Greater Boston Area Aziza Jamal‐Allial1,Katherine L. Tucker21Health Sciences, Bouvé College of Health Sciences; Northeastern University. Boston, MA. 2Clinical Laboratory & Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA.Several studies have investigated the relationship between the consumption of soft drinks and bone mineral density (BMD), but results are conflicting. We aimed to study the effect of soft drink consumption on BMD at 4 hip sites in 273 men and 698 women in the Boston Puerto Rican Osteoporosis Study using dual‐energy X‐ray absorptiometry (DXA). Soft drink intakes were captured by food frequency questionnaire (FFQ). The mean intake of soft drinks was 2.2 ± 4.3 and 1.5 ± 3.0 servings/week, for men and women, respectively. Total intake of cola beverages was significantly associated with lower BMD at the total hip (β= ‐0.004, P‐value 0.002), trochanter (β= ‐0.003, P‐value 0.03) and femoral shaft (β= ‐0.01, P‐value 0.0005), but not at the femoral neck. Intake of diet‐cola was also significant at the femoral shaft and approached significance at the total hip and trochanter. In contrast, non‐cola soft drinks were not significantly associated with any hip measure. Our models were adjusted for age, sex, BMI, height, calcium‐vitamin D supplement use, dietary calcium intake, smoking, alcohol use, total energy intake, physical activity, and season of BMD measurement. In conclusion, the effect of cola, but not other soft drinks suggests that phosphoric acid may have a negative effect on bone statusGrant Funding Source: This study was supported by the National Institutes of Health grants P01 AG023394, P50 HL105185 and

Endoscopic removal of gastric bezoars: an easy technique

A 62-year-old man was admitted to our gastroenterology unit complaining of epigastric pain. On February 3, 2012, the patient underwent an upper GI endoscopy (GIF-H180J; Olympus, Tokyo, Japan) that demonstrated antral erosions and a giant bezoar with shiny surface occupying over half of the gastric lumen (Fig. 1A; Video 1, available online at www.giejournal.org). Laboratory tests showed no abnormalities. Initial attempts to soften the bezoar with various drinks such as a cola drink, soda, and pineapple juice every day did not help.

Rate of Atherosclerosis Progression in ApoE−/− Mice Long After Discontinuation of Cola Beverage Drinking

This study was conducted in order to evaluate the effect of cola beverages drinking on atherosclerosisand test the hypothesis whether cola beverages consumption at early life stages might affect the development and progression of atherosclerosis later in life.ApoE−/− C57BL/6J mice (8 week-old) were randomized in 3 groups (n = 20 each) according to free accessto water (W), sucrose sweetened carbonated cola drink(C) or aspartame-acesulfame K sweetened carbonated ‘light’ cola drink (L)for the next 8 weeks. Drinking treatment was ended by switching C and L groups to drinking water. Four mice per group and time were sequentially euthanized: before treatment (8weeks-old), at the end of treatment (16 weeks-old) and after treatment discontinuation (20 weeks-old, 24 weeks-old, 30 week-old mice). Aortic roots and livers were harvested, processed for histology and serial cross-sections were stained. Aortic plaque area was analyzed and plaque/media-ratio was calculated.Early consumption of cola drinks accelerated atherosclerotic plaque progression favoring the interaction between macrophages and myofibroblasts, without the participation of either T lymphocytes or proliferative activity. Plaque/media-ratio varied according to drink treatment (F2,54 = 3.433, p<0.04) and mice age (F4,54 = 5.009, p<0.03) and was higher in C and L groups compared with age-matched W group (p<0.05 at 16 weeks and 20 weeks, p<0.01 at 24 weeks and 30 weeks). Natural evolution of atherosclerosis in ApoE−/− mice (W group) evidenced atherosclerosis acceleration in parallel with a rapid increase in liver inflammation around the 20 weeks of age.Cola drinking within the 8–16 weeks of age accelerated atherosclerosis progression in ApoE−/− mice favoring aortic plaque enlargement (inward remodeling) over media thinning all over the study time. Data suggest that cola drinking at early life stages may predispose to atherosclerosis progression later in life in ApoE−/− mice.

Change in surface roughness of esthetic restorative materials after exposure to different immersion regimes in a cola drink.

Context. An in vitro study carried out to evaluate and compare the effect of Cola drink on surface roughness of esthetic restorative materials. Purpose. To compare the effect of different immersion regimes in a Cola drink on surface roughness of esthetic restorative materials. Method. Two hundred samples were grouped into 4 equal groups of 50 samples each: Group I: conventional glass ionomer, Group II: resin modified glass ionomer, Group III: polyacid-modified resin composite, Group IV: Composite resin. Each group was further subdivided into 5 subgroups of 10 samples each. Subgroup A (Control Subgroup). Samples were kept immersed in artificial saliva. Subgroup B. Samples were immersed in Cola drink once a day. Subgroup C. Samples were immersed in Cola drink, 3 times a day. Subgroup D. Samples were immersed in Cola drink 5 times a day. Subgroup E. Samples were immersed in Cola drink 10 times a day. Each immersion lasted 5 minutes. The immersion protocol was repeated for 7 days. Results. Maximum surface roughness was seen in Group I conventional glass ionomer cement, followed by Group II resin modified glass ionomer, Group III polyacid modified resin composite, and Group IV composite resin samples. Conclusion. Resistance to change in surface roughness is more in resin based restorative materials as compared to glass ionomer based materials.

Effects of three intense sweeteners on fat storage in the C. elegans model

Beverages sweetened with caloric sweeteners (CS), glucose, sucrose or high-fructose corn syrup, are associated with weight gain. Beverages sweetened with intense sweeteners (IS) are marketed as low-calorie substitutes to prevent beverages-associated weight gain. Using Caenorhabditis elegans, the effects on intestinal fat deposition (IFD) and pharyngeal pumping rate (PPR) of cola beverages sweetened with glucose, aspartame, or aspartame plus acesulfame-potassium (AceK) were compared. Control groups received Escherichia coli (OP50) only. Study I: the nematodes received additional glucose- or IS-sweetened beverages. Study II: the nematodes received additional glucose, aspartame, or aspartame plus AceK (AAK). Beverages containing CS or IS (aspartame or AAK) did not alter IFD in wild type (N2) or in daf-16 deficiency. The CS cola increased IFD in sir-2.1 deficiency (P<0.05). The AAK-cola increased IFD in daf-16/daf-2 deficiency and sir-2.1 deficiency (P<0.05). Glucose increased IFD in N2 and daf-16 deficiency (P<0.05). Aspartame showed a tendency towards reduced IFD in N2 and decreased IFD in daf-16/daf-2 deficiency (P<0.05). AAK increased IFD in daf-16 deficiency and sir-2.1 deficiency (P<0.05), and reversed the aspartame-induced reduction in IFD. The aspartame-sweetened cola increased the PPR in daf-16/daf-2 deficiency and daf-16 deficiency (P<0.05); similar results were obtained in N2 with both IS (P<0.05). AAK increased the PPR in daf-16/daf-2, daf-16, and sir-2.1 deficiencies (P<0.05). Thus, IS increased the PPR, a surrogate marker of lifespan. Aspartame may have an independent effect in reducing IFD to assist humans desiring weight loss. AceK may increase IFD in presence of insulin resistance.

Paroxysmal Paralytic Attacks Secondary to Excessive Cola Consumption

We report a rare case of cola-induced hypokalemia presenting as recurrent attacks of lower extremity weakness and falls. Excessive consumption of cola-based drinks has been associated with dental enamel erosion, obesity, and diabetes. There are very few published cases depicting the correlation between cola drinks and hypokalemic manifestations. In our patient an extensive workup was performed, and common causes were ruled out before making the diagnosis of cola-induced hypokalemia. Improvement in the patient's symptoms and electrolyte levels after reducing the consumption of cola-based drinks further confirmed our diagnosis. This case also emphasizes the importance of obtaining a detailed history and consideration of broad differential diagnoses in identifying uncommon but reversible etiologies.

Relationship between artificially sweetened and sugar-sweetened cola beverage consumption during pregnancy and preterm delivery in a multi-ethnic cohort: analysis of the Born in Bradford cohort study

The aim of this study was to investigate the relationship between the intake of sugar-sweetened (SS) and artificially sweetened (AS) cola beverages during pregnancy and the risk of preterm delivery (PTD). At baseline (2007-2010), 8914 pregnant women were recruited to the Born in Bradford birth cohort study at 24-28 weeks of pregnancy. Women completed a questionnaire describing their health and lifestyle behaviours, including their consumption of AS and SS cola beverages reported as cups per day, which were then linked to maternity records. The relationship between SS and AS cola beverage consumption was examined using logistic regression analyses. No relationship was observed between daily AS cola beverage consumption and PTD. Women who drank four cups per day of SS cola beverages had higher odds of a PTD when compared with women who did not consume these beverages daily. We conclude that high daily consumption of SS cola beverages during pregnancy is associated with increases in the rate of PTD.

Sodium fluoride and casein phosphopeptide-amorphous calcium phosphate cream plus sodium fluoride efficacy in preventing enamel erosion in a simulated oral environment study model.

The aim of this study was to evaluate the effectiveness of dentifrices containing high concentrations of sodium fluoride (NaF) and casein phosphopeptide-amorphous calcium phosphate cream plus fluoride (CPP-ACPF) in prevention of the erosion in a simulated oral environment study model. Fifteen flat human enamel specimens were polished and half of the surfaces were protected with adhesive tape. Initial Knoop microhardness (KHN) and surface roughness (SR) were measured, and specimens were assigned to four groups: Control (placebo toothpaste - G1); CPP-ACPF (G2), NaF 1450 ppm (G3), and NaF 5000 ppm (G4). Enamel surfaces were brushed 3 times daily in association with demineralization-remineralization cycles (5s in cola drink + 5s in artificial saliva/10 cycles/twice daily) and the specimens were maintained in a salivary flow simulator apparatus. After 14 days, KHN and SR were measured again, and the enamel surfaces were analyzed by scanning electronic microscopy (SEM). Data were analyzed using the two-way ANOVA and Student-Newman-Keuls multiple range test (α =0.05). All the tested groups presented a decrease in KHN after 14 days (P < 0.05). There was no statistical significance among materials tested. Significant increase in SR was observed for all groups. SEM analysis showed morphological alterations with honeycomb structures in enamel surfaces in the four experimental groups. It was concluded that tooth brushing with dentifrices with high concentration of NaF and CPP-ACPF cream was not able to prevent enamel erosion in simulated oral environment.

Sugar content in non-alcoholic beverages and dietary recemmendations for children and adolescents

Increase the intake of sugars among the inhabitants of developed countries is related to, among others, increasing consumption of non-alcoholic beverages, for which the relationship with the epidemic of obesity, particularly among children and adolescents, has been proven. The most frequently cited are non-alcoholic beverages, sweetened glucose-fructose syrup, ie. colas, tonics, ice teas, lemonades. Fruit drinks, fruit juices and nectars are commonly cited as a healthy alternative to non-alcoholic beverages and, however, we do not pay attention to the high content of sugars in these products. Determine the content of sugars in non-alcohollic beverages popular among children and adolescents. 80 non-alcoholic beverages such as cola, tonic, lemonade, ice tea, flavored waters, fruit juices, fruit nectars and fruit drinks. Evaluation of the content of monosaccharides and sucrose was performed by high performance liquid chromatography method (HPLC). In the tested non-alcohollic beverages, monosaccharides ie. glucose and fructose and the disaccharide sucrose were detected in different proportions. The product with the lowest content of the total sugars content was flavored water with lemon flavor based on the mineral water (2.72 g/100 ml). In the group of fruit juices, fruit nectars and fruit drinks highest sugars content have been reported (12.94 g/100 ml for aronia nectar and 12.76 g/100ml for the juice of pomegranate and grapes). Significant monosaccharides and sucrose content in the tested non-alcohollic beverages tends to claim that their manufacturers should be obliged to place warnings on the labels addressed to patients suffering from disorders of carbohydrate metabolism. Educational programs for children and adolescents with diabetes should include information about the content of a large amount of sugars in fruit products: fruit juices, fruit drinks and fruit nectar.

Effect of Miswak versus Fluoridated and Non-Fluoridated Tooth Pastes on Enamel Subjected to Cola Beverage : Study Using Scanning Electron Microscope Attached with Energy Dispersive X-Ray Analysis

Effect of Miswak versus Fluoridated and Non-Fluoridated Tooth Pastes on Enamel Subjected to Cola Beverage : Study Using Scanning Electron Microscope Attached with Energy Dispersive X-Ray Analysis

Protective effect of calcium nanophosphate and CPP-ACP agents on enamel erosion

The aim of this study was to assess the effect of different remineralizing agents on enamel microhardness (KHN) and surface topography after an erosive challenge. Forty-eight human enamel specimens (4 × 4 mm) were randomly assigned to 4 groups: control (no treatment), fluoride varnish, calcium nanophosphate paste and casein phosphopeptide-amorphous calcium phosphate paste (CPP-ACP). Both pastes were applied for 5 minutes, and fluoride varnish, for 24 h. Four daily erosive cycles of 5 minutes of immersion in a cola drink and 2 h in artificial saliva were conducted for 5 days. KHN readings were performed at baseline and after 5 days. The percentage of enamel hardness change (%KHN) was obtained after erosion. The surface topography was evaluated by atomic force microscopy (AFM). The data were tested using ANOVA, Tukey's and paired-T tests (p < 0.05). After an erosive challenge, there was no statistically significant difference between the control (96.8 ± 11.4 KHN / 72.4 ± 3.0%KHN) and the varnish (91.7 ± 14.1 KHN / 73.4 ± 5.5%KHN) groups. The nanophosphate group showed lower enamel hardness loss (187.2 ± 27.9 / 49.0 ± 7.9%KHN), compared with the CPP-ACP group (141.8 ± 16.5 / 60.6 ± 4.0%KHN), and both were statistically different from the varnish and the control groups. AFM images showed a rough surface for the control and the varnish groups, a non-homogeneous layer with globular irregularities for CPP-ACP, and a thick homogeneous layer for the nanophosphate group. None of the agents provided protection against the development of erosion; however, nanophosphate paste was able to reduce enamel surface softening after the erosive challenge.

Metabolic disturbances and worsening of atherosclerotic lesions in ApoE-/- mice after cola beverages drinking

BackgroundAtherosclerosis is a major health burden. Metabolic disorders had been associated with large consumption of soft drinks. The rising incidence of atherosclerosis and metabolic alterations warrants the study of long-term soft drink consumption’ effects on metabolism and atherosclerosis in genetic deficiency of apolipoprotein E which typically develops spontaneous atherosclerosis and metabolic alterations.MethodsApoE-/- mice were randomized in 3 groups accordingly with free access to: water (W), regular cola (C) or light cola (L). After 8 weeks, 50% of the animals in each group were euthanized (Treatment: W8, C8, L8). The remaining mice (all groups) drank water for 8 weeks and were euthanized (Washout: W16, C16, L16). Body weight and food and drink consumption were periodically measured. Blood was collected (biochemistry). At autopsy, transverse aortic sinus sections were serially cut and stained (histomorphometry); livers and kidneys were processed (microscopy). MANOVA (identification of variance factors) was followed by ANOVA and LSD tests (within-factor differences between levels). Conventionally a p< 0.05 was considered significant.ResultsTreatment increased drinking volumes (vs W8: 4 fold C8, p<0.0001; +47% L8, p<0.02). Only C reduced eating amounts (–54%, p<0.05 vs W8). I). Compared with W8: C8 developed hyperglycemia (+43%, p<0.03) and increased non-HDL cholesterol (+54%, p<0.05); L8 showed decreased glycemia (–15%, p<0.05 vs W8) and increased creatinine (2.5 fold, p<0.04), urea (+74, p<0.03) and aspartate-aminotransferase (2.8 fold, p<0.05). Hypercreatininemia was observed in L16 (2.7 fold vs W16, p<0.05). Hypertriglyceridemia (+91%, p<0.008) and hyperuremia (+68%, p<0.03) developed over time of study (age). II). Treatment caused plaque area increase (vs W8: 28% C8, p<0.02 and 50% L8, p<0.01; vs W16: 43% C16, p<0.05 and 68% L16, p<0.02) and stenosis (vs W8: 38% C8, p<0.04 and 57% L8, p<0.01; vs W16: 71% C16, p<0.01 and 46% L16, p<0.04). Age also caused plaque area increase (56%, p<0.04). Treatment- and age-effects on plaque enlargement were additive.ConclusionCola beverages caused atherosclerotic lesions’ enlargement with metabolic (C) or non metabolic disturbances (L). ApoE-/- mice were particularly sensitive to L treatment. These findings may likely relate to caramel colorant and non-nutritive sweeteners in cola drinks and have potential implications in particularly sensitive individuals.

Cariogenic potential in relation to plaque pH among non-alcoholic beverages: A comparative study

Background: Consumption of beverages has increased exponentially among youth. The aim of present study is to evaluate the cariogenicity of various beverages. Methods: Eighty subjects were divided into caries free (subjects having DMFT=0) and caries active groups (subjects having DMFT>0). Each group was further equally divided in five groups randomly: cola drink (CD), fruit juice (FJ), energy drink (ED), diet cola (DC) and non-sugar fruit juice (NSFJ). Acidity of the drink and plaque pH variations at particular time intervals (1, 5, 10, 15 and 30 minutes) was measured using digital pH meter. Comparisons were done using ANOVA and Turkey’s post hoc test by SPSS version 12. Results: All beverages showed fall in pH initially. Among them, cola and energy drink emerged to be highly cariogenic as they could not recover from critical pH when tested next at 5 minute interval. When comparing all caries free subgroups, significant results were reported at 1, 5 and 15 minutes with p values of 0.00, 0.01 and 0.03 respectively. While comparing all caries active subgroups, significant results were reported at 1, 5 and 10 minutes with p values of 0.03, 0.00 and 0.00 respectively. While comparing mean plaque pH values of caries free and caries active subgroup, highly significant differences were found for cola and energy drink group. Conclusion: The beverages and fruit juices seem to be having significant cariogenic potential. Emphasis should be on reduced consumption of these drinks. School based intervention programs are recommended.

Caffeinated sugar-sweetened beverages and common physical complaints in Icelandic children aged 10–12 years

ObjectiveConsumption of caffeinated sugar-sweetened beverages (CSSBs) among children and adolescents has increased markedly in recent years but the consequence of their consumption is not well understood. The objective of this study was to assess the prevalence of CSSBs in children aged 10–12years and examine the relationship between CSSBs and common physical complaints. MethodsData from the 2013 cross-sectional population school survey Youth in Iceland (N=11,267, response rate: 90.1%, girls 49.7%) was used to assess the prevalence of cola and energy drink consumption and associations to headaches, stomachaches, sleeping problems and low appetite. ResultsAround 19% of boys and 8% of girls reported consuming cola drinks on a daily basis and 7% of boys and 3% of girls reported consuming energy drinks. A general trend of a dose–response relationship was observed between CSSBs and physical complaints for both types of beverages. These relationships were generally stronger for energy drinks than cola drinks. ConclusionOur findings call into question the acceptability, availability, and marketing of CSSBs to 10–12year-old children and adolescents. For validation purposes replications of these analyses are needed in other parts of the world, including studies using prospective longitudinal designs.

Is phosphorus intake that exceeds dietary requirements a risk factor in bone health?

Phosphorus intake in excess of the nutrient needs of healthy adults is thought to disrupt hormonal regulation of phosphorus (P), calcium (Ca), and vitamin D, contributing to impaired peak bone mass, bone resorption, and greater risk of fracture. Elevation of extracellular phosphorus due to excessive intake is thought to be the main stimulus disrupting phosphorus homeostasis in healthy individuals, as it is in renal disease even when intake is modest. If high serum phosphorus is the critical link to the effect of high phosphorus intake on bone health, the issue could be addressed through epidemiologic or dietary studies. However, several confounding factors, including problems estimating accurate phosphorus intake, the influence of a low dietary Ca:P ratio, the acidic nature of phosphorus, the rapid rate of absorption and greater phosphorus bioavailability from processed food such as cola drinks, and circadian fluctuation in serum phosphorus, make this question difficult to address using conventional study designs. These confounding factors are considered in this review, exploring whether phosphorus intake exceeding nutrient needs in healthy individuals disrupts phosphorus regulation and negatively affects bone accretion or loss. Specific attention is given to phosphorus intake from processed foods rich in phosphorus additives, which significantly contribute to phosphorus intake.

Effect of Diet and Nutrient on Cell Signaling: Is the Tissue the Main Issue, Proposes Dr. Wilson?

Western diet is characterized with energy dense, refined, ready prepared foods with a high glycemic index (e.g. refined starches; bread, biscuits, candies, cornflakes, pizza, potato chips, cola drinks and sugar) and unhealthy lipids (e.g. trans fats, saturated fat , w-6 rich oils) poor in w-3 fatty acids, phytochemicals and fiber that are abundant in the Mediter- ranean type of diet. Western type of diets are known to predispose inflammation and increase in free fatty acids causing endothelial cell and beta cell dysfunction leading to the epidemic of cardiovascular diseases (CVDs). The cell signaling and the changes in cell membrane properties of the tissues induced by dietary lipids may have important consequences on the development of obesity, atherosclerosis and hypertension. The structural properties and function of cell membrane proteins appear to be modified in hypertensive humans and animal models of hypertension and atherosclerosis. Diet in- duced alterations in membrane lipid composition of hypertensive subjects have been associated with alterations in the transmembrane fluxes of Na + and K + , including Na + -Li + countertransport, which is a marker of essential hypertension, and in cell signaling proteins that participate in the control of blood pressure. It has been demonstrated that dietary lipids have an effect on membrane lipid composition and cell signaling proteins. Since changes in the dietary lipid composition yield to variations in the biophysical properties of the plasma membrane, it is likely that cellular functional changes could result from alterations in the structure of the lipid membrane properties under influence of the diet. Thus, the changes in mem- brane properties induced by dietary lipids may have important consequences on blood pressure regulation. The Mediterra- nean diet has been associated with changes in membrane structure and function. Consumption of olive oil-rich diets in- creases the concentration of oleic acid in plasma membrane lipids of different rat and human cells, with beneficial conse- quences on membrane functionality. In contrast, very little is currently known regarding the effects of nuts, another key ingredient of such diets, on membrane lipid composition and structure. CVD, diabetes mellitus and obesity, that are asso- ciated with increased production of thromboxane A2(TXA2), leukotrienes, prostacyclin, interleukins-1 and 6, tumor ne- crosis factor-alpha and C-reactive proteins in the tissues, is the major issue. Increased dietary intake of w-6 fatty acids is known to enhance all these biomarkers as well as atherogenicity of cholesterol in the tissues which have adverse pro- inflammatory effects resulting in CAD. Mediterranean diet rich in fruits, vegetables, nuts, mustard oil, and olive oil char- acterized with low w-6/w-3 ratio in the diet, can modulate inflammation and endothelial dysfunction of the tissues and may be protective against risk of coronary artery disease (CAD) and all-cause mortality. Inflammation appears to be an important unifying hypothesis, because in the absence of inflammation in the tissues, total cholesterol and other lipids may have neutral effects in the arterial tissues and myocardium. Therefore, it seems that endothelial dysfunction and in- flammation in the tissue is the main issue for treatment.

Association of Wealth and Mortality Due to Cardiovascular Diseases Thank You. Dr. Wilson

Industrialization and urbanization may be associated with increase in income, resulting in increased consump- tion of ready-prepared Western foods, meat and eggs and cola drinks and decreased intake of traditional foods; whole grains, and vegetables. There is also associated greater use of automobiles causing sedentary behaviours, due to decreased occupational physical activity. These diet and lifestyle factors predispose obesity and central obesity which is a risk factor of cardiovascular diseases (CVDs) mortality.

Cola as bad for teeth as crack

Cola as bad for teeth as crack

Applications and functions of food‐grade phosphates

Food-grade phosphates are used in the production of foods to function as buffers, sequestrants, acidulants, bases, flavors, cryoprotectants, gel accelerants, dispersants, nutrients, precipitants, and as free-flow (anticaking) or ion-exchange agents. The actions of phosphates affect the chemical leavening of cakes, cookies, pancakes, muffins, and doughnuts; the even melt of processed cheese; the structure of a frankfurter; the bind and hydration of delicatessen meats; the fluidity of evaporated milk; the distinctive flavor of cola beverages; the free flow of spice blends; the mineral content of isotonic beverages; and the light color of par-fried potato strips. In the United States, food-grade phosphates are generally recognized as safe, but use levels have been defined for some foods by the Code of Federal Regulations, specifically Titles 9 and 21 for foods regulated by the U.S. Department of Agriculture (USDA) and the U.S. Food and Drug Administration (FDA), respectively. Standards for food purity are defined nationally and internationally in sources such as the Food Chemicals Codex and the Joint Food and Agriculture Organization and World Health Organization (FAO/WHO) Expert Committee on Food Additives.

Findings from an online behavioural weight management programme provided with or without a fortified diet beverage

The present multi-centre randomised weight-loss trial evaluated the efficacy of a low-intensity 12-week online behavioural modification programme, with or without a fortified diet beverage using a 2×2 factorial design. A total of 572 participants were randomised to: (1) an online basic lifestyle information (OBLI) intervention, consisting of one online informational class about tips for weight management; (2) an online behavioural weight management (OBWM) intervention, entailing 12 weekly online classes focused on weight-loss behaviour modification; (3) an OBLI intervention plus a fortified diet cola beverage (BEV) containing green tea extract (total catechin 167mg), soluble fibre dextrin (10g) and caffeine (100mg) (OBLI+BEV); (4) OBWM+BEV. Assessments included height, weight, dual-energy X-ray absorptiometry-derived body composition, and waist circumference (WC). Attrition was 15·7%. Intention-to-treat (ITT) models demonstrated a main effect for type of Internet programme, with those assigned to the OBWM condition losing significantly more weight (F=7·174; P=0·008) and fat mass (F=4·491; P=0·035) than those assigned to the OBLI condition. However, there was no significant main effect for the OBWM condition on body fat percentage (F=2·906; P=0·089) or WC (F=3·351; P=0·068), and no significant main effect for beverage use or significant interactions between factors in ITT models. A 12-week, low-intensity behaviourally based online programme produced a greater weight loss than a basic information website. The addition of a fortified diet beverage had no additional impact.