Decrease In Fat Intake Research Articles

Lipid Responses to Weight Loss

The Health Promotion Partnership Weight Management Program consists of a 12-week intensive phase (4 hour/week) and a 12 week tapering phase (1/2–1 hour/week) with interventions including diet (20–25%kcal/fat), exercise (15–45minutes/4x/week), and behavior management. Subjects (N=23) completing one 12-week intensive session participated in a study of lipid responses to the program. Subjects were predominantly Caucasian (100%), female (73%), college graduates (77%), with a mean age of 50±8 years and BMI of 33±5. Subjects lost weight (mean=−6.1±3.9kg, t22df =7.4, p<.001), body fat (mean=−2.512.4% fat, t22df =5.0, p<.001), decreased fat intake (mean=−6±10.8% kcal, t21df =2.6, p<.01), saturated fat intake (mean=−5.8±12.2g, t21df =2.2, p<.05) and energy intake (−272±605 kcal, t21df =2.1, p<.05). Although subjects did not improve aerobic capacity, their fitness improved measured by time on treadmill (mean= 102±123 seconds, t22df =3.8, p<.01). Most lipid values changed, total cholesterol (baseline mean=221±50mg/dl, 12-week mean=210±48, t22df, =2.4, p<.05), LDL cholesterol (baseline mean= 145±43mg/dl, 12-week mean= 133±38, t22df =2.7, p<.01), total HDL cholesterol (baseline mean=48.9±14mg/dl, 12-week mean=46.1±11, t22df=2.1, p<.05), HDL2 cholesterol (baseline mean= 19.1±10mg/dl, 12-week mean= 14.5±8, t22df =3.2, p<.01); however, HDL3 cholesterol and triglycerides did not change. In conclusion, the weight management program was associated with favorable improvements in health behaviors as well as changes in serum lipids, however the decrease in HDL, particularly in HDL2, raises concerns about lipid responses to weight loss.

Toilet training.

Toilet training.

Influence of dietary fat on the nutrient intake and growth of children from 1 to 5 y of age: the Special Turku Coronary Risk Factor Intervention Project

Excessive decreases in fat intake in young children have been linked with low intakes of energy and nutrients and possible growth failure. We evaluated nutrient intakes and growth of healthy children with different fat intakes during the first 5 y of life. In the Special Turku Coronary Risk Factor Intervention Project (STRIP), 7-mo-old children were randomly assigned to an intervention aimed at reduced consumption of saturated fat and cholesterol (n = 540) or to a control group (n = 522). This analysis comprises data for children for whom > or = 6 of 8 possible 3-4-d food records were available (n = 730; 353 females). Children were divided according to fat intake pattern (percentage of energy) between the ages of 13 mo and 5 y into groups with continuously high fat intake (5% of children), increasing fat intake (5%), continuously low fat intake (5%), decreasing fat intake (5%), and average fat intake (80%). Children's energy and nutrient intakes and growth were then compared by analysis of variance. Fat intake at 13 mo of age was particularly low (21% of energy) in the increasing fat intake group and in the continuously low fat intake group (22% of energy at 13 mo; 26% of energy at 5 y). Growth of children in all 5 fat intake groups, however, was not significantly different throughout the study period. Intakes of vitamins and minerals, except of vitamin D, met recommended dietary allowances in all fat intake groups. Nutrient intakes and growth were not significantly different in children whose fat intake patterns differed between 13 mo and 5 y of age.

Is dieting good for you?: Prevalence, duration and associated weight and behaviour changes for specific weight loss strategies over four years in US adults.

This present study describes weight control strategies used by a heterogeneous sample of US adults and their associations with weight and behaviour change over time. A prospective cohort study. Participants for this study were 1120 US adults recruited from the community who enrolled in a three-year intervention study to examine methods for preventing age-related weight gain. Measured body weight and self-reported behaviours related to body weight (dieting practices, dietary intake and physical activity) were completed annually for four years. Over 70% reported using each of the following dieting strategies at least once in four years: increase exercise (82.2%); decrease fat intake (78.7%); reduce food amount (78.2%); and reduce calories (73.2%). Cumulative duration of use of these behaviours was brief (for example, even the most common behaviours were used only 20% of the time). Global reports of dieting were not predictive of weight change over time. However, a dose-response relationship was observed between reported duration of use of several specific weight loss strategies over the four years and change in behaviours and weight gain. These findings suggest that public health recommendations for weight control may need to place greater emphasis on persistence of weight control behaviours.

Weight control behaviors among adult men and women: cause for concern?

To examine gender differences in weight control behaviors; their duration and the consistency of their use over a 3-year period; and variations of these behaviors by body mass index (BMI). The study population included 714 women and 229 men participating in a community-based weight gain prevention program who completed surveys about their weight control behaviors annually for 3 years. General dieting behaviors (e.g., current, regular, and past dieting), dietary restraint (using Restrained Eating subscale of the Three-Factor Eating Questionnaire), and specific weight control practices (e.g., increasing exercise, skipping meals, and taking laxatives) were assessed. Women were more likely than men to report weight control behaviors, with particularly strong associations found between gender and "history of dieting" (odds ratio = 8.1) and "participation in an organized weight loss program" (odds ratio = 11.7). Among both genders, exercise was the most frequently reported specific weight loss practice (66% of women and 53% of men), followed by decreasing fat intake (62% of women and 48% of men). The use of at least one unhealthy weight control behavior over the past year was reported by 22% of the women and 17% of the men. Gender differences were not found for duration of use of most of the specific weight control practices over the past year, or for consistency of general dieting behaviors and dietary restraint over time. Although both gender and BMI were strongly associated with dieting behaviors, interactions between gender and BMI on prevalence rates of dieting were not significant. Although weight control behaviors were more prevalent among women than men, in general, large gender differences were not found in the types of behaviors used and the duration and consistency of their use. The high percentages of adults using healthy methods of weight control was encouraging. However, there is still cause for concern, in that unhealthy weight control practices were also reported by a significant percentage of the population.

What to Do when a Patient with Exocrine Pancreatic Insufficiency Does Not Respond to Pancreatic Enzyme Substitution

In the majority of patients, pancreatin microsphere preparations containing 25,000–40,000 FIP units of lipase will lead to a clinical improvement and reduction of steatorrhea in patients with exocrine pancreatic insufficiency. In patients failing to respond, the following stepwise procedure is recommended: increasing enzyme dosage; checking the patient’s compliance; reevaluating the diagnosis; and as a last resort to decrease fat intake or adding H₂-blockers or proton pump inhibitors. Although this stepwise procedure is time-consuming, it is necessary to prevent in patients not responding to pancreatic enzyme substitution the development of late complications of exocrine pancreatic insufficiency.

Very low fat diets.

Very low fat diets.

Lower Fat Intake as a Predictor of Initial and Sustained Weight Loss in Obese Subjects Consuming an Otherwise ad Libitum Diet

Objective To determine what predicts initial and sustained weight loss in subjects consuming a reduced-fat diet ad libitum and the relationship between achieved level of fat intake and weight loss. Design Placebo arm of a randomized, controlled trial of a weight-loss drug (dexfenfluramine) in the context of an ad libitum, reduced-fat, diet. Subjects Thirty-nine subjects (initial mean body mass index±standard deviation=34.9±3.4; body mass index is calculated as kg/m 2) from the placebo group who completed the 9-month study. Intervention Dietary assessment and education (month 0) followed by monthly meetings during the single intervention of reducing fat intake (months 1 through 6); one follow-up at 9 months. Main outcome measures Initial weight loss (first 3 months) and sustained weight loss (over 9-month period). Statistics Dietary intake, body size, exercise levels, age, and gender were included in multiple regression linear models of initial and sustained weight loss if they were significant independent predictors. Results Greater initial weight loss was associated with a greater decrease in fat intake and a lower achieved fat intake at 3 months. Greater sustained weight loss was associated with a lower achieved fat intake, a higher baseline waist circumference, and higher moderate-intensity exercise levels (months 3 and 6). Weight loss occurred in all subjects who reported a fat intake of 40 g/day or less. Applications The obese persons most likely to achieve and sustain weight loss on an ad libitum, reduced-fat diet are those who can substantially reduce fat intake, those with high initial levels of abdominal fat, and those who undertake regular moderate-intensity exercise. A target of less than 40 g fat per day might be an appropriate goal to ensure weight loss, but dietary underreporting and the difficulty of sustaining very-low-fat intakes need to be considered. J Am Diet Assoc. 1998;98:35-39.

Relation between dietary fat and energy and micronutrient intakes

Concern has been raised about the energy and nutrient adequacy of low fat diets for children that aim to prevent cardiovascular disease in Western populations. The diets of 174 randomly...

Identifying individuals with high fat levels and low P:S ratios, in their diets, for intensive dietary intervention.

To assess whether simple scores from a dietary questionnaire could identify those with high dietary fat or low P:S ratio intakes, for intensive dietary intervention. Cross-sectional and longitudinal studies. Community setting in the Hunter Region of New South Wales, Australia. Two random samples of adults 35-69 years from the electoral roll. In the cross-sectional study 287/322 (86%) subjects completed the diet questionnaire and a reference standard questionnaire. In the longitudinal study 546/653 (84%) of subjects completed the diet questionnaire, and had blood cholesterol measured on two occasions, 3 months apart. In the cross-sectional study, the simple scores of total fat intake (Fat Intake Score) and P:S ratio (Unsaturated Score) were compared with the daily intakes of total fat and P:S ratio obtained from the standard questionnaire. In the longitudinal study, changes in the scores were compared with changes in blood total cholesterol. A Fat Intake Score of greater than 125 had the best receiver operator characteristics for identifying high total fat intake (> 100 g/day: sensitivity = 67%, specificity = 70%). An Unsaturated Score of less than 0.3 had the best characteristics for identifying a low P:S ratio (< 0.5: sensitivity = 63%, specificity = 60%). Subjects who decreased Fat Intake Score by one category, had a fall in blood cholesterol of 0.14 mmol L-1 (95% confidence interval (CI) = 0.01-0.26 mmol L-1), while those decreasing by two categories decreased their blood cholesterol by 0.56 mmol L-1 (95% CI = 0.30-0.86 mmol L-1). Subjects increasing their Unsaturated Score category had a fall in blood cholesterol of 0.17 mmol L-1 (95% CI = 0.02-0.32 mmol L-1). Simple dietary scores can identify those with high fat intakes, and monitor changes related to changes in blood cholesterol levels.

Use of Qualitative and Quantitative Methods to Define Behavioral Fat-Reduction Strategies and Their Relationship to Dietary Fat Reduction in the Patterns of Dietary Change Study

Objective The purposes of this study were to identify specific food choice behaviors used to decrease dietary fat intake in a community-dwelling population; assess how people categorize changes to diet; determine whether logical grouping of food intake changes revealed one or more common patterns or strategies used by these participants to decrease fat; and determine which strategies were responsible for the greatest decrease in dietary fat intake in the study population. Design Survey analysis and in-depth interviews were used to quantitatively and qualitatively define dietary change patterns retrospectively in a population who, according to self-report, had decreased their fat intake. Specific food changes made to decrease fat intake, interview statements, and participants' reduction of percentage energy from fat were examined. Setting Interviews were conducted from June 1993 through April 1994. Subjects Included in the study were 145 persons aged 30 to 55 years who reported that they had been decreasing their dietary fat intake for 5 years or more, maintained a healthful diet for at least 5 months, and resided in the United States while changing their diets. Statistical analyses performed Confirmatory factor analysis, reliability analysis, and linear regression analysis were performed. Results Nine fat-reduction strategies were identified. Decrease fat flavorings, decrease “recreational foods,” decrease cooking fat, replace meat, change breakfast, and use fat-modified foods accounted for significant reduction in fat intake. Conclusions People use a variety of dietary changes to reduce their fat intake. These changes can be categorized into strategies according to the way people change their diets. Knowledge of these strategies and their importance in dietary fat reduction can improve and help nutritionists prioritize the messages they convey. J Am Diet Assoc. 1996; 96:1245–1250,1253.

A School-Based Cardiovascular Exercise and Nutrition Program With Parent Participation: An Evaluation Study

This study examined the efficacy of a school-based exercise and nutrition program with a parent component. Second-grade and fourth-grade classrooms were assigned randomly to a treatment and a control group. The school-based treatment program focused on decreasing fat and cholesterol intake and increasingly physical activity with a parent educational component. Children in the treatment group scored significantly higher and demonstrated greater improvement on fitness/nutrition knowledge and on vegetable and fruit servings. Parents who participated in the intervention increased their scores on the fitness/nutrition knowledge test. There also was a significant association between degree of family involvement, higher grain servings, and lower cholesterol intake. The results within the study limitations were interpreted to suggest that the program was primarily effective in enhancing knowledge changes for both children and their parents.

Double jeopardy: workplace hazards and behavioral risks for craftspersons and laborers.

To address three specific questions in a sample of craftspersons and laborers: (1) Do craftspersons and laborers exposed to workplace hazards have higher behavioral risks, such as smoking and high-fat diets, than those with few job risks? (2) Compared to workers with few job risks, do workers exposed to risks on the job have higher intentions to reduce their behavioral risks? (3) Does concern about the level of exposure to risks on the job increase workers' intentions to reduce behavioral risks? A cross-sectional self-administered survey was conducted in participating worksites. Twenty-two predominantly manufacturing worksites in Massachusetts. Craftspersons and laborers responding to the survey and employed in these 22 worksites (completion rate = 61%, N = 1841). By using standardized items, this survey measured self-reported exposure to workplace hazards, concern about job exposures, smoking status, fat and fiber intake, readiness to quit smoking, plans to reduce fat intake, plans to eat more fruits and vegetables, and sociodemographic variables. Workers reporting exposure to chemical hazards on the job were significantly more likely to be smokers than were unexposed workers, even when results were controlled for gender. Compared with unexposed workers, smokers exposed to chemical hazards were significantly more likely to be thinking of quitting or taking action to quit, when results were controlled for gender, race, and education. Among workers exposed to occupational chemical hazards, concern about this exposure was significantly associated with intentions to decrease fat intake and increase fruit and vegetable intake, and, among men, intentions to quit smoking. Efforts aimed at integrating health promotion and health protection are needed to address simultaneously the job risks and personal risks these workers face.

Treatment of dyslipoproteinaemia in diabetes mellitus.

Coronary heart disease (CHD) is the most common cause of premature death in diabetes. Hypercholesterolaemia occurs in diabetes with about the same frequency as in the general population, but it confers a greater risk of CHD in diabetes. Hypertriglyceridaemia and low serum high density lipoprotein (HDL) cholesterol levels are more common in diabetes, particularly non-insulin-dependent diabetes. Nephropathy increases the severity of dyslipoproteinaemia. There remains a reluctance to apply the results of cholesterol-lowering trials to diabetes. No trial has been specifically in diabetes, but this should not constrain the treatment of diabetic patients at clearly high CHD risk. It is suggested that fasting lipids should be measured in all diabetic patients aged less than 70 years with established CHD or whose non-fasting cholesterol is >6.00 mmol I(-1) or triglycerides >3.00 mmol I(-1). For those with raised lipids glycaemic control should be improved, if possible, and dietary therapy aimed at a decrease in fat intake, particularly saturated fat, and weight reduction in the obese. Lipid-lowering drugs are required in patients with CHD and serum cholesterol >5.5 mmol I(-1) with the aim of decreasing non-HDL to <4.00 mmol I(-1). In patients without CHD lipid-lowering drugs should be considered when serum cholesterol exceeds 6.5 mmol I(-1) and the risk of CHD is greater than 20 % over the next 10 years. There is no evidence that pursuing this policy beyond the age of 70 years is beneficial. Diabetic women with dyslipoproteinaemia should, however, be treated in the same way as men. The knowledge that hypertriglyceridaemia and low serum HDL cholesterol are present helps in the assessment of CHD risk and the choice of medication to decrease non-HDL cholesterol, but there is no evidence that their treatment in the absence of raised cholesterol is of benefit.

Large bowel adenomas: Markers of risk and endpoints

In many large bowel chemoprevention trials adenomas have a double duty: they are used to identify subjects at risk for large bowel neoplasia, and also serve as endpoints. Many features of adenomas make them suitable for these tasks. Patients with adenomas are fairly numerous and easy to identify; further, the 'adenoma-carcinoma' sequence suggests that adenomas are logical endpoints. The high recurrence risk among adenoma patients means that a relatively modest number of subjects will suffice for adequate statistical power. The are some limitations to the use of adenomas, however. There is clearly heterogeneity of risk for subsequent cancer. Patients with only small adenomas may have rates of colorectal cancer that are not much greater than those of the general population. Certainly subjects with large adenomas, and those with villous or highly dysplastic adenomas have a higher risk. Often, one would chose the high-risk patients for preventive interventions. Such a strategy makes sense from a risk-benefit point of view. However, from a population perspective, such a strategy may well have only a minor impact on the overall colorectal cancer burden. For more complete population-based prevention, efforts will have to be directed to the numerous individuals who are each at small risk, but who collectively account for most colorectal cancer. For this preventive approach, patients with any adenoma would certainly be part of the target population, and so are sensible subjects in chemoprevention trials. There are similar complexities in consideration of the use of adenomas as endpoints of chemoprevention trials. The adenomas that occur in prevention trials are generally small, and may not be associated with a greatly increased cancer risk. The issue for chemoprevention trials however, is not whether the endpoints are truly intermediate in the causal chain-but whether the intervention under study alters the adenoma recurrence risk to the same extent as it does for colorectal cancer risk. This is a difficult matter to verify, but the limited data available are encouraging. The epidemiology of colorectal adenomas (largely small adenomas) is similar in many regards to that for colorectal cancer itself. Thus to the extent that data are available, one can tentatively conclude that external influences affect adenomas and colorectal cancer similarly. To date, more than ten adenoma prevention trials have reported results. The data have been fairly consistent. Vitamin C (with or without vitamin E) has provided at most a modest protective benefit, except in one small trial in which it was combined with vitamin E and preformed vitamin A. beta-Carotene seems to be without any effect, and interventions to increase fiber and decrease fat intake have not indicated substantial effects. On the other hand, trials among familial polyposis patients have provided evidence for an impact of nonsteroidal anti-inflammatory drugs. Studies in progress have the potential to clarify greatly the preventive potential of the currently promising-but yet unproven-chemopreventive regimens.

Effectiveness of Individual Versus Group Counseling for Clients with Hypercholesterolemia

The development and implementation of effective and cost-effective nutrition and lifestyle intervention programs plays an important role in the treatment of clients with hypercholesterolemia. Since the majority of nutrition education research has focused on individual counseling, this poses the question as to whether there are measurable differences between individual and group counseling methods for clients with hypercholesterolemia. The purposes of this multidisciplinary project were to: 1) compare individual versus group counseling methods using percentage changes in serum cholesterol, knowledge and behavior scores, and satisfaction level as measures of effectiveness; and 2) complete a cost-effectiveness analysis for both interventions. One hundred thirty-one adults with hypercholesterolemia (total cholesterol ≥200mg/dL) were randomly assigned to either individual (n=66) or group (n=65) counseling programs. A standardized five-week cholesterol education program was presented by the same team of counselors (Registered Dietitian and Clinical Nurse Specialist) in both interventions. Participants had their pre- and post-counseling serum cholesterol measured, completed pre- and post-knowledge and behavior questionnaires, and responded to a post-satisfaction questionnaire. Student's paired t-test and analysis of variance were used to detect significant changes within each intervention strategy and compare the two counseling methods. Both intervention methods yielded a significant (P<.001) decrease in total cholesterol, a significant (P<.001) increase in knowledge level, and a significant (P<.001) decrease in fat intake. All of the participants were moderately to extremely satisfied with the counseling that they received. Furthermore, there were no significant (P>.05) differences between group and individual counseling for any of the effectiveness measures. The program benefits and potential savings outweighed the program costs in both interventions; however, group counseling was determined to be more cost-effective. Results of this study indicate that: 1) group education is just as effective as individual counseling in reducing serum cholesterol, improving knowledge, and changing behavior and 2) a multidisciplinary team can provide effective and cost-effective nutrition and lifestyle counseling that can reduce coronary heart disease risk and promote client satisfaction.

Dieting behaviors and weight change history in female adolescents.

The prevalence of dieting, weight change history, and specific weight loss behaviors was examined in a population-based sample of 1,015 female 9th-12th graders. Healthy weight loss behaviors were reported much more frequently than unhealthy weight loss behaviors (e.g., healthy behaviors: exercise = 32.4%, decrease fat intake = 26.0%, reduce snacks = 25.0%, reduce kilocalorie intake = 22.4%; unhealthy behaviors: fasting = 8.1%, diet pills = 5.4%, vomiting = 4.4%). Obesity status and restrained eating scores were positively related to greater history of weight loss episodes, pounds lost, and weight fluctuations and to greater use of healthy weight loss methods and weight loss programs. Implications for public health recommendations regarding dieting and its associated behaviors in female adolescents are discussed.

Exercise training modifies nutrient self-selection in rats

Few studies have examined the effects of exercise training on macronutrient self-selection in rats. It has been observed that trained rats decreased carbohydrate and increased fat and protein intakes. In the present experiment, total energy intake and macronutrient self-selection were examined in adult male rats placed on a self-selection regimen and submitted to 2 h of treadmill exercise daily for 20 days at the beginning of the nocturnal period. Two control groups of rats were examined during the same time: a sedentary group that was food and water deprived during the same 2 h while trained rats were exercising, and a control group that was examined only for body weight gain and 24-h food intake. Food intakes of sedentary and trained rats were continuously recorded. At the end of the experiment, body weight of trained rats was lower than that of sedentary and control rats. The 24-h cumulative intake of trained rats was significantly reduced; this reduction was due to a decrease in fat intake, whereas carbohydrate intake was increased. In sedentary rats, 24-h intake was not modified but fat intake was significantly increased from the beginning to the end of the experiment. During the first 6 h of the night, protein and fat intakes of trained rats were reduced, and carbohydrate ingestion remained the same. Daytime food intake represented only 8.7% of the 24-h intake. Exercise training significantly increased this intake. It is noteworthy that during the middle part of the day (3–9 h) trained rats significantly enhanced protein and carbohydrate ingestion. In sedentary rats during the 3 h preceding fasting, fat intake increased. The present results could be ascribed to an anticipatory phenomenon. In trained rats, an increased carbohydrate intake, early in the light period preceding exercise, might improve exercise endurance, whereas sedentary rats anticipate an obligatory induced fast by increasing fat intake.

Improving dietary behavior: the effectiveness of tailored messages in primary care settings.

To achieve the Healthy People 2000 objectives, public health professionals must develop effective dietary interventions that address psychosocial and behavioral components of change. This study tested the effect of individually computer-tailored messages designed to decrease fat intake and increase fruit and vegetable intake. Adult patients from four North Carolina family practices were surveyed at baseline and then randomly assigned to one of two interventions or to a control group. The first intervention consisted of individually computer-tailored nutrition messages; the second consisted of nontailored nutrition information based on the 1990 Dietary Guidelines for Americans. Patients were resurveyed 4 months postintervention. The tailored intervention produced significant decreases in total fat and saturated fat scores compared with those of the control group (P < .05). Total fat was decreased in the tailored group by 23%, in the nontailored group by 9%, and in the control group by 3%. Fruit and vegetable consumption did not increase in any study group. Seventy-three percent of the tailored intervention group recalled receiving a message, compared with 33% of the nontailored intervention group. Tailored nutrition messages are effective in promoting dietary fat reduction for disease prevention.

Saturated fat intake of elderly women reflects perceived changes in their intake of foods high in saturated fat and complex carbohydrate

The US Public Health Service (1) has identified an increased span of healthy life as a goal for Americans in the 1990s. Cardiovascular disease is prevalent among older women, and its prevention is a key to good health and independence in the later years. Recommendations to decrease fat intake (1–5) are intended to limit intake of saturated fatty acids, the dietary fat most associated with coronary heart disease (5). Elderly American women currently consume about 36% of their energy from fat and between 12% and 13% from saturated fat (6).