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BACKGROUND: Evidence of the effectiveness of treatment for obesity delivered in primary care settings in underserved populations is lacking. METHODS: We conducted a cluster-randomized trial to test the effectiveness of a high-intensity, lifestyle-based program for obesity treatment delivered in primary care clinics in which a high percentage of the patients were from low-income populations. We randomly assigned 18 clinics to provide patients with either an intensive lifestyle intervention, which focused on reduced caloric intake and increased physical activity, or usual care. Patients in the intensive-lifestyle group participated in a high-intensity program delivered by health coaches embedded in the clinics. The program consisted of weekly sessions for the first 6 months, followed by monthly sessions for the remaining 18 months. Patients in the usual-care group received standard care from their primary care team. The primary outcome was the percent change from baseline in body weight at 24 months. RESULTS: All 18 clinics (9 assigned to the intensive program and 9 assigned to usual care) completed 24 months of participation; a median of 40.5 patients were enrolled at each clinic. A total of 803 adults with obesity were enrolled: 452 were assigned to the intensive-lifestyle group, and 351 were assigned to the usual-care group; 67.2% of the patients were Black, and 65.5% had an annual household income of less than $40,000. Of the enrolled patients, 83.4% completed the 24-month trial. The percent weight loss at 24 months was significantly greater in the intensive-lifestyle group (change in body weight, −4.99%; 95% confidence interval [CI], −6.02 to −3.96) than in the usual-care group (−0.48%; 95% CI, −1.57 to 0.61), with a mean between-group difference of −4.51 percentage points (95% CI, −5.93 to −3.10) (P

PURPOSE: Calorie restriction (CR) is an effective treatment for obesity-related liver and metabolic disease. However, CR studies in individuals without obesity are needed to see if CR could delay disease onset. Liver biomarkers indicate hepatic health and are linked to cardiometabolic disease. Our aim was to examine the effects of a two-year CR intervention on liver biomarkers in healthy individuals without obesity. METHODS: The Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) study was a two-year randomized controlled trial. Overall, 218 participants (body mass index: 25.1±1.7 kg/m(2)) were enrolled into control group (n=75) that ate ad libitum (AL) or a CR group (n=143) that aimed to decrease energy intake by 25%. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and bilirubin were measured during the trial. RESULTS: At month 24, relative to the AL group, ALP (−7±1 IU/L; P0.99) or AST (2±2 IU/L; P=0.68) were revealed. However, sex-by-treatment-by-time interactions (P

Rating of perceived exertion (RPE) and respiratory exchange ratio (RER) have previously been associated with acute exercise compensation. This study examined adaptations in the RPE and RER with long-term exercise training in individuals who did (noncompensators) and did not (compensators) lose the expected amount of weight. Participants (n = 110, 71.8% women, means ± SD; age 49 ± 12 yr) completed 24 wk of supervised exercise training at 65–85% V̇o(2peak) to achieve a prescribed dose of 8 kcal·kg body wt(−1)·wk(−1) (8 KKW) or 20 KKW. Participants were categorized as noncompensators (n = 55) or compensators (n = 55) based on the percent of expected weight loss (%EWL) achieved. Changes in RPE and RER during exercise over time (baseline, week 12, week 24) were compared by weight compensation category. Individual %EWL in relation to RPE, RER, and training intensity (%V̇o(2peak)) was evaluated over the same time period. RPE and RER for a given workload decreased from baseline to week 12 and stabilized through week 24, regardless of weight compensation (time P < 0.0001). Noncompensators had a higher RPE relative to heart rate, which was partly explained by higher %V̇o(2peak). RPE and %V̇o(2peak) both positively predicted %EWL, independent of age, sex, and exercise dose. Training intensity and RPE were positively associated with weight loss on the individual level, warranting further investigation into self-selection in exercise-based programs. Understanding individual heterogeneity in training intensity and behavioral responses may improve future weight management efforts that involve exercise. NEW & NOTEWORTHY In sedentary individuals with overweight and obesity, achievement of expected weight loss from long-term exercise training was associated with individual adaptations in perceived exertion. Contrary to our hypothesis, those with higher relative perceived exertion achieved a larger proportion of their expected weight loss, which was partly explained by a higher self-selected exercise training intensity.

Objective: This study aimed to determine whether different measures of habitual physical activity (PA) at baseline predict weight change, weight compensation, and changes in energy intake (EI) during a 24-week supervised aerobic exercise intervention. Methods: Data from 108 participants (78 women; 48.7 [SD: 11.6] years; BMI 31.4 [SD: 4.6] kg/m2), randomly assigned to either the moderate-dose exercise group (8 kcal/kg of body weight per week) or the high-dose exercise group (20 kcal/kg of body weight per week) of the Examination of Mechanisms of Exercise-induced Weight Compensation (E-MECHANIC) trial, were analyzed. Moderate-to-vigorous PA (MVPA), steps per day, and PA energy expenditure (PAEE) were measured with SenseWear armbands (BodyMedia, Pittsburgh, Pennsylvania), and total activity energy expenditure and EI were estimated with doubly labeled water, all over 2 weeks, before and toward the end of the intervention. Multiple linear regression models, adjusted for sex, exercise group, and baseline value of the outcome, were used. Results: Baseline habitual MVPA levels predicted weight change (β = −0.275; P = 0.020), weight compensation (β = −0.238; P = 0.043), and change in EI (β = −0.318; P = 0.001). Associations between baseline PAEE and outcomes were comparable, whereas steps per day and, importantly, total activity energy expenditure (via doubly labeled water) did not significantly predict change in weight-related outcomes. Conclusions: While acknowledging substantial variability in the data, on average, lower baseline habitual MVPA and PAEE levels were associated with less weight loss from exercise, higher compensation, and increased EI.

Arginine is an amino-acid supplement and precursor for nitric-oxide synthesis, which affects various biologic processes. The objective of this study was to determine the effects of arginine supplementation on growth hormone (GH) and metabolic parameters.Thirty physically active, healthy men (age 18-39 y; body mass index: 18.5-25 kg/mArginine levels increased at 1.5 h (146%) and 3.0 h (95%; P ≤ 0.001) and GH (193%) and thyroid-stimulating hormone (TSH; 10%) levels at 24 h (P0.05) after arginine versus placebo consumption. Arginine versus placebo increased glucose levels at 1.5 h (5%) and 3.0 h (3%; P ≤ 0.001). Arginine versus placebo did not affect other dependent measures, including mood state (P0.05), but changes in the urea, glutamate, and citric-acid pathways were observed. Among responders, arginine versus placebo increased GH at 1.5 h (37%), glucose at 1.5 h (4%) and 3.0 h (4%), and TSH at 24 h (9%; P0.05). Responders had higher levels of benzoate metabolites at baseline and 1.5 h, and an unknown compound (X-16124) at baseline, 1.5 h, and 24 h that corresponds to a class of gut microbes (P0.05).Arginine supplementation modestly increased GH, glucose, and TSH levels in younger men. Responders had higher benzoate metabolites and an unknown analyte attributed to the gut microbiome. Future studies should examine whether the increased prevalence of these gut microorganisms corresponds with GH response after arginine supplementation.

We conducted an online survey to examine the preference, expected burden, and willingness of people to use four different methods of assessing food and alcohol intake such as food/drink record, 24-h recall, Remote Food Photography Method© (RFPM, via SmartIntake® app), and a novel app (PortionSize®) that allows the in-app portion size estimation of foods/drinks by the user. For food (N = 1959) and alcohol (N = 466) intake assessment, 67.3% and 63.3%, respectively, preferred the RFPM/SmartIntake®, 51.9% and 53.4% preferred PortionSize®, 48.0% and 49.3% the food records, and 32.9% and 33.9% the 24-h recalls (difference in preference across all methods was p &lt, 0.001 for food and alcohol intake). Ratings of burden and preference of methods were virtually superimposable, and we found strong correlations between high preference and low expected burden for all methods (all ρ ≥ 0.82, all p &lt, 0.001). Willingness (mean (SD)) to use the RFPM/SmartIntake® (food: 6.6 (2.0), alcohol: 6.4 (2.4)) was greater than PortionSize® (food: 6.0 (2.2), alcohol: 6.0 (2.4), 0.001) and 24-h recalls (food: 6.1 (2.2), alcohol: 5.7 (2.7), p &lt, 0.001), but not different from food records (food: 6.6 (2.0), alcohol: 6.5 (2.3), all p ≥ 0.33). Our results can be used in conjunction with existing data on the reliability and validity of these methods in order to inform the selection of methods for the assessment of food and alcohol intake.

Introduction: Our primary aim was to investigate the association between initial weight change and longer-term changes in weight and compensation (predicted weight loss–observed weight loss) during exercise. As secondary aims, we investigated if initial weight change was related to change in cardiometabolic risk markers and energy balance modulators. Methods: Two 6-month randomized controlled exercise trials conducted in individuals with overweight or obesity were analyzed (study 1, n = 312; study 2, n = 102). In both studies, participants in an exercise condition (4 kcal·kg−1·wk−1 [KKW], 8 KKW, 12 KKW, or 20 KKW) were split into tertiles based on percent weight change from baseline to week 4. Tertiles 1 and 3 exhibited the least and most initial weight loss, respectively. Changes in end points were compared between tertiles. Results: At month 6, weight loss was lower in tertile 1 than tertile 3 (study 1: −3.6%, 95% confidence interval [CI] = −4.6 to −2.6; study 2: −1.8%, 95% CI = −3.1 to −0.4; P ≤ 0.034). Tertile 1 also showed greater compensation than tertile 3 in study 1 (3.0 kg, 95% CI = 2.2 to 3.9) and study 2 (1.5 kg, 95% CI = 0.3 to 2.6; P ≤ 0.048). Changes in triglycerides and, in study 1, HDL cholesterol were less favorable in tertile 1 versus tertile 3 (P ≤ 0.043); however, changes in other cardiometabolic markers were similar (P ≥ 0.209). In study 2, tertile 1 increased energy intake and exhibited maladaptive changes in eating behaviors relative to tertile 3 (P < 0.050). No between-tertile differences in cumulative exercise energy expenditure and physical activity were evident (P ≥ 0.321). Conclusions: Less initial weight loss was associated with longer-term attenuated weight loss and greater compensation during aerobic exercise training. Individuals who display less initial weight loss during exercise may require early interventions to decrease compensation and facilitate weight loss.

Objectives To pilot-test a home-based parent training intervention aimed at maintaining body weight among children at risk for obesity (> the 75th body mass index percentile). Methods Sixteen parent–child dyads were randomized to a health education or Developing Relationships that Include Values of Eating and Exercise (DRIVE) intervention arm. The DRIVE curriculum was a structured parenting program to promote healthy weight in children by relying on behavioral principles to promote skill acquisition in the family's natural setting. Body weight and waist circumference were measured at baseline and weeks 9 and 19. Results Body mass index z-score, body weight, and percent body weight increased in children in the health education arm vs DRIVE at weeks 9 and 19. Body weight, percent body weight, and waist circumference decreased in parents in DRIVE vs the health education arm at week 19, whereas no differences were shown at week 9. Conclusions and Implications The DRIVE program mitigated weight gain in a small sample of at-risk children and showed promising results in reducing weight in parents. Home-based interventions emphasizing parent–child interactions are indicated as a practical model to deliver weight management in children.

The physiological and metabolic effects of experimental overfeeding have been extensively studied, yet only few studies have assessed overfeeding effects on eating behaviors and psychological constructs. We analyzed two 8-week overfeeding studies, the PROOF Study (N = 25; 16 males; 16 African American; 24.1 years; 25.1 kg/m2, inpatient) and the EAT Study (N = 35; 29 males; 20 White; 26.7 years; 25.5 kg/m2, free-living). In both studies, participants were overfed 40% above baseline (daily) energy requirements for eight weeks, consuming all meals under direct supervision. We assessed eating attitudes and behaviors, eating disorder symptoms, and body image via validated questionnaires and visual analog scales at baseline, week (W) 4, and W8, and at two (PROOF: W16-Post, W24-Post) and three (EAT: W12-Post, W20-Post, W32-Post) follow-up visits, respectively. Hunger, desire to eat, and food cravings (carbohydrates, total cravings) decreased during overfeeding in both studies (all Cohen's d effect sizes ≥0.3, all p ≤ .048). Depressive symptoms and fear of fatness increased in both studies (all Cohen's d ≥ 0.4, p ≤ .020), though they were still within normal limits (t-scores ~43–49). Body dissatisfaction increased in both studies during overfeeding (all Cohen's d ≥ 0.4, all p ≤ .044) and remained increased during follow-up (PROOF: W16-Post, Cohen's d = 0.9, p = .004; EAT: W12-Post and W20-Post, all Cohen's d ≥ 0.4, all p ≤ .037). Overfeeding was associated with some deleterious effects, though most returned to baseline during follow-up. However, increases in body dissatisfaction remained up to three months post-overfeeding, highlighting the need to address body image disturbance among people who experience weight gain, even if much of the gained weight is subsequently lost. Trial registration The PROOF Study ( ClinicalTrials.gov Identifier NCT00565149 ); the EAT Study ( ClinicalTrials.gov Identifier NCT01672632 ).

Background: Intensive lifestyle interventions (ILIs) are the first-line approach to effectively treat obesity and manage associated cardiometabolic risk factors. Because few people have access to ILIs in academic health centers, primary care must implement similar approaches for a meaningful effect on obesity and cardiometabolic disease prevalence. To date, however, effective lifestyle-based obesity treatment in primary care is limited. We examined the effectiveness of a pragmatic ILI for weight loss delivered in primary care among a racially diverse, low-income population with obesity for improving cardiometabolic risk factors over 24 months. Methods: The PROPEL trial (Promoting Successful Weight Loss in Primary Care in Louisiana) randomly allocated 18 clinics equally to usual care or an ILI and subsequently enrolled 803 (351 usual care, 452 ILI) adults (67% Black, 84% female) with obesity from participating clinics. The usual care group continued to receive their normal primary care. The ILI group received a 24-month high-intensity lifestyle-based obesity treatment program, embedded in the clinic setting and delivered by health coaches in weekly sessions initially and monthly sessions in months 7 through 24. Results: As recently demonstrated, participants receiving the PROPEL ILI lost significantly more weight over 24 months than those receiving usual care (mean difference, −4.51% [95% CI, −5.93 to −3.10]; P P P =0.76). Increases in high-density lipoprotein cholesterol were greater in the ILI than in the usual care group at both time points (mean difference at 24 months, 4.6 mg/dL [95% CI, 2.9–6.3]; P z score) decreased more in the ILI group than in the usual care group at both time points, with significant mean differences of the change of −0.31 (95% CI, −0.47 to −0.14; P P =0.01) at 24 months, respectively. Changes in total cholesterol, low-density lipoprotein cholesterol, triglycerides, and blood pressure did not differ significantly between groups at any time point. Conclusions: A pragmatic ILI consistent with national guidelines and delivered by trained health coaches in primary care produced clinically relevant improvements in cardiometabolic health in an underserved population over 24 months. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02561221.

Objective To test if sugar sweetened beverages (SSBs) and sugar sweetened solids (SSSs) have differential effects on body weight and reward processing in the brain. Methods In a single blind randomized controlled pilot trial (RCT), twenty participants with BMI between 20 and 40 kg/m2 were randomized to consume a 20 fluid ounce soda (SSB, 248 kcal) or the equivalent in solid form (SSS; similar to thick gelatin or gummy candy) daily. At baseline and day 28, fasting body weight and fed-state BOLD fMRI of the brain were assessed. Differences in fMRI signals between views of low-fat (LF (30%)) food, and non-food images were calculated in brain regions implicated in energy homeostasis, taste, and reward. Results All participants in the SSB (6F 4M; 8 Caucasian; 36±14 y, 28.2±5.5 kg/m2; Mean±SD) and SSS (3F 7M; 6 Caucasian; 39±12; 26.3±4.4) groups completed the study. Weight change was 0.27±0.78 kg between SSB and SSS participants. Changes in the fMRI response to LF/HS foods in reward, homeostatic and taste regions tended to not be different between the groups over the four weeks. However, activation of the right substantia nigra increased following the SSB but decreased activation following the SSS in response to LF/HS foods over 28 days (-0.32±0.12). Ratings of wanting for LF/HS foods were correlated with activation in several brain regions, including the OFC. Conclusions Change in weight was modest between the groups in this study. Daily consumption of a SSB over 28 days led to mixed responses to LF/HS foods in areas of the brain associated with reward. Ratings of wanting are correlated with fMRI activation inside an MRI scanner.

Many campaigns promote the preservation and consumption of leftover food items as a critical household strategy to accomplish national consumer food waste reduction goals. We fill a gap in knowledge about the consumption and creation of leftovers in the United States by analyzing data from a pilot study in which 18 subjects tracked food selection, intake, and plate waste across all eating occasions for about one week. Subjects noted which items selected for consumption were leftovers, i.e., previously prepared but uneaten items that were stored for future consumption, and which unfinished items were saved to become leftovers. We found that 12% of items selected for consumption were leftovers while 24% of selected items that were not fully consumed were kept to become a leftover. Leftovers were most frequently vegetables, cheeses, and meats, and most frequently selected on Mondays and for lunch. Regression analyses isolate significant dining patterns with respect to leftovers, including evidence that leftovers were less likely to be fully consumed than non-leftover items, and that larger meals led to more uneaten food. This suggests that strategies to reduce meal size may be most effective in reducing food waste by limiting the creation of leftovers in the first place. Strategies to make leftovers more attractive and appealing may also reduce food waste.

Background: Decreasing selection and consumption of sodium and added sugars in the school cafeteria setting is important to provide optimal nutrition to children. Objective: To determine if Louisiana (LA) Health, a school-based obesity prevention intervention, could successfully reduce children’s selection and consumption of sodium and added sugars during school lunches vs. the control group. Design: Food selection, consumption, and plate waste from student lunches (3 consecutive days) in 33 public schools in rural Louisiana were collected and analyzed using the digital photography of foods method at baseline and after a 28-month obesity prevention intervention (LA Health) beginning in 4th-6th grade (87% of children received free or reduced cost lunch). Selection and consumption of energy, added sugar, and sodium was objectively measured using digital photography of foods. Mixed models, including Race and BMI, were used to determine if change in selection and consumption differed by group. Results: Sodium decreased for selection (−233.1±89.4 mg/lunch, p=0.04) and consumption (−206.3±65.9, mg/lunch) in the intervention (vs. control) by month 18, and in consumption by month 28 (−153.5±66.9 mg/lunch, p=0.03). Change in added sugar consumption decreased in the intervention (vs. control) at month 18 (−3.7±1.6, p=0.05) and at month 28 (−3.5±1.6 tsp/lunch, p=0.05). Conclusions: LA Health decreased the amount of added sugar and sodium selected and consumed, but not plate waste, by month 28. Results highlight the importance of long-term interventions and policies targeting provision and selection to improve dietary patterns in children, with less focus on plate waste. Trial Registration: clinicaltrials.gov NCT00289315 https://clinicaltrials.gov/ct2/show/NCT00289315?term=LA+Health&rank=1

Underserved and minority populations suffer from a disproportionately high prevalence of obesity and related comorbidities. Effective obesity treatment programs delivered in primary care that produce significant weight loss are currently lacking. The purpose of this trial is to test the effectiveness of a pragmatic, high intensity lifestyle-based obesity treatment program delivered within primary care among an underserved population. We hypothesize that, relative to patients who receive usual care, patients who receive a high-intensity, health literacy- and culturally-appropriate lifestyle intervention will have greater percent reductions in body weight over 24 months. Eighteen clinics (N = 803 patients) serving low income populations with a high proportion of African Americans in Louisiana were randomized to the intervention or usual car. Patients in the intervention participate in a high-intensity lifestyle program delivered by health coaches employed by an academic health center and embedded in the primary care clinics. The program consists of weekly (16 in-person/6 telephone) sessions in the first six months, followed by sessions held at least monthly for the remaining 18 months. Primary care practitioners in usual care receive information on weight management and the current Centers for Medicare and Medicaid Services reimbursement for obesity treatment. The primary outcome is percent weight loss at 24 months. Secondary outcomes include absolute 24-month changes in body weight, waist circumference, blood pressure, fasting glucose and lipids, health-related quality of life, and weight-related quality of life. The results will provide evidence on the effectiveness of implementing high-intensity lifestyle and obesity counseling in primary care settings among underserved populations. Trial Registration: ClinicalTrials.gov Identifier NCT02561221

The validity of using the Remote Food Photography Method (RFPM) for measuring food intake of minority preschool children's intake is not well documented.Our aim was to determine the validity of intake estimations made by human raters using the RFPM compared with those obtained by weighing all foods and beverages consumed by 3- to 5-year-old children (weighed method).We conducted a cross-sectional observational study.A convenience sample of 54 3- to 5-year-old Hispanic and African-American children were observed during a 12-hour period at Baylor Metabolic Research Unit between June 2013 and January 2014.All foods/beverages consumed by the children were provided by Baylor research coordinators who took and wirelessly transmitted before-and-after pictures of the trays to trained human raters at the Pennington Biomedical Research Center who estimated grams consumed. Energy and macronutrients were calculated using the Food and Nutrient Database for Dietary Studies or food facts data provided by manufacturers.Paired t test, mean differences, and Bland-Altman limits of agreement were performed.Compared to the weighed method, the rater method significantly overestimated total intake by 34±71 g (P0.0001), with a mean percent error of 2.9% (root mean square error=7.1%), and total energy intake by 75±102 kcal (P0.0001), with a mean percent error of 7.5% (root mean square error=12.3%). The standard error for the macronutrient intakes ranged from 11.0% to 20.2%. The Bland-Altman approach demonstrated a positive slope for the rater method relative to the weighed method for total intake in grams (P=0.006), carbohydrate (P=0.01), and protein (P=0.01) (ie, magnitude of the bias increased with increasing intakes).The rater method overestimated total intake in grams and energy in kilocalories in minority preschool children in a well-controlled condition and needs to be further tested in a free-living environment.

Background Foods that increase obesity risk are ubiquitous in the US food environment. Such foods may be the target of hedonic eating, which may facilitate weight gain and lead to obesity. The study tested whether meal composition during an ad libitum buffet meal was associated with 1-year weight and percent body fat changes among healthy younger adults without obesity. Hyper-palatable foods (HPF) were the study focus; comparisons were conducted with high energy dense (HED) and ultra-processed foods (UPF). Design Younger adults without obesity (N = 82; 43% male; mean age 26.8) completed an ad libitum buffet meal and provided body composition measurements at baseline and 1-year follow up. Multiple regression models tested associations between the proportion of the target food consumed (HPF, HED, or UPF) during the ad libitum meal and 1) weight change and 2) percent body fat change. The proportion of HPF was characterized by HPF group, specifically carbohydrate and sodium (CSOD) foods or fat and sodium (FSOD) foods. Results Participants who consumed a greater proportion of CSOD HPF in their ad libitum buffet meals had significantly greater weight change (b = 0.354, p = .003) and percent body fat change (b = 0.247, p = .036) at 1-year follow up. In contrast, no significant associations were found between the proportion of FSOD HPF, HED, or UPF consumed and anthropometric outcomes (p values = .099-.938). Conclusions Eating a greater proportion of hyper-palatable CSOD foods ad libitum appears to be a pattern of hedonic eating, which may increase an individual's risk for weight and body fat gain in early adulthood.

African Americans (AAs) have a higher obesity risk than Whites, however, it is unclear if appetite-related hormones and food intake are implicated. We examined differences in appetite-related hormones, appetite, and food intake between AAs (n = 53) and Whites (n = 111) with overweight or obesity. Participants were randomized into a control group or into supervised, controlled exercise groups at 8 kcal/kg of body weight/week (KKW) or 20 KKW. Participants consumed lunch and dinner at baseline and follow-up, with appetite and hormones measured before and after meals (except leptin). At baseline, AAs had lower peptide YY (PYY, p &lt, 0.01) and a blunted elevation in PYY after lunch (p = 0.01), as well as lower ghrelin (p = 0.02) and higher leptin (p &lt, 0.01) compared to Whites. Despite desire to eat being lower and satisfaction being higher in AAs relative to Whites (p &le, 0.03), no racial differences in food intake were observed. Compared to Whites, leptin increased in the 8 KKW group in AAs (p = 0.01), yet no other race-by-group interactions were evident. Differences in appetite-related hormones between AAs and Whites exist, however, their influence on racial disparities in appetite, food intake, and obesity within this trial was limited.

PURPOSE: Heart rate recovery (HRR) after exercise is an independent risk factor for cardiovascular disease and mortality. Regular aerobic exercise can improve HRR, yet little is known regarding the dose necessary to promote increases. The aim was to assess the impact of different doses of vigorous-intensity aerobic exercise on HRR in individuals with overweight/obesity. METHODS: Data from 137 sedentary adults with overweight/obesity from E-MECHANIC were analyzed. Participants were randomized to either a moderate-dose exercise group (8 kcal/kg body weight/week; KKW), a high-dose exercise group (20 KKW), or a non-exercise control group. HRR was defined as the difference between peak heart rate (HR) during a graded exercise test and the HR after exactly 1 minute of active recovery at 1.5 mph and level grade. RESULTS: Change in HRR did not differ significantly by exercise group; therefore, the data from both exercise groups were combined. The combined exercise group showed an improvement in HRR of 2.7 bpm (95% CI 0.1, 5.4; p=0.04) compared to the control group. Those participants who lost more weight during the intervention (non-compensators) increased HRR by 6.2 bpm (95% CI 2.8, 9.5; p

BACKGROUND: Identifying reliable predictors of long-term weight loss could lead to improved weight management. OBJECTIVE: To identify predictors. DESIGN: The Diabetes Prevention Program (DPP) was a randomized controlled trial that compared weight loss using placebo, intensive lifestyle intervention, or metformin, and its Outcomes Study (DPPOS) observed patients after the masked treatment phase ended. SETTING: 27 DPP/DPPOS clinics. PARTICIPANTS: Of the 3234 randomized participants, 1066 lost ≥ 5% of their baseline weight during the first year and have been followed for 15 years. MEASUREMENTS: Treatment assignment, personal characteristics, and weight. RESULTS: After 1 year, 289 (28.5%) metformin participants, 640 (62.6%) intensive lifestyle participants, and 137 (13.4%) placebo participants, achieved ≥ 5% weight loss. After the masked treatment phase ended, the mean (95% CI) amount of weight loss relative to baseline that was maintained between years 6 and 15 was 6.2% (5.2, 7.2) for metformin participants, 3.7% (3.1, 4.4) for intensive lifestyle participants, and 2.8% (1.3, 4.4) for placebo participants. Independent predictors of long-term weight loss included greater weight loss during the first year in all study groups, older age and continued use of metformin in the metformin group, older age and not having diabetes or a family history of diabetes in the intensive lifestyle group, and higher baseline fasting plasma glucose in the placebo group. LIMITATION: Post-hoc analysis. Nonrandomized subsets of randomized groups examined after year 1. CONCLUSION: Among those with ≥ 5% 1-year weight loss, the group originally randomized to metformin had the greatest success with weight loss during years 6–15. Older age and the amount of initial weight loss were the most consistent predictors for maintaining long-term weight loss. PRIMARY FUNDING SOURCE: National Institutes of Health. Trial Registration: ClinicalTrials.gov and .

We conducted two studies to test the validity, reliability, feasibility and acceptability of using video chat technology to quantify dietary and pill-taking (i.e. supplement and medication) adherence. In study 1, we investigated whether video chat technology can accurately quantify adherence to dietary and pill-taking interventions. Mock study participants ate food items and swallowed pills, while performing randomised scripted ‘cheating’ behaviours to mimic non-adherence. Monitoring was conducted in a cross-over design, with two monitors watching in-person and two watching remotely by Skype on a smartphone. For study 2, a twenty-two-item online survey was sent to a listserv with more than 20 000 unique email addresses of past and present study participants to assess the feasibility and acceptability of the technology. For the dietary adherence tests, monitors detected 86 % of non-adherent events (sensitivity) in-person v. 78 % of events via video chat monitoring (P=0·12), with comparable inter-rater agreement (0·88 v. 0·85; P=0·62). However, for pill-taking, non-adherence trended towards being more easily detected in-person than by video chat (77 v. 60 %; P=0·08), with non-significantly higher inter-rater agreement (0·85 v. 0·69; P=0·21). Survey results from study 2 (n 1076 respondents; ≥5 % response rate) indicated that 86·4 % of study participants had video chatting hardware, 73·3 % were comfortable using the technology and 79·8 % were willing to use it for clinical research. Given the capability of video chat technology to reduce participant burden and outperform other adherence monitoring methods such as dietary self-report and pill counts, video chatting is a novel and promising platform to quantify dietary and pill-taking adherence.

Activity monitors such as the Actical accelerometer, the Sensewear armband, and the Intelligent Device for Energy Expenditure and Activity (IDEEA) are commonly validated against gold standards (e.g., doubly labeled water, or DLW) to determine whether they accurately measure total daily energy expenditure (TEE) or activity energy expenditure (AEE). However, little research has assessed whether these parameters or others (e.g., posture allocation) predict body weight change over time. The aims of this study were to (i) test whether estimated energy expenditure or posture allocation from the devices was associated with weight change during and following a low-calorie diet (LCD) and (ii) compare free-living TEE and AEE predictions from the devices against DLW before weight change. Eighty-seven participants from 2 clinical trials wore 2 of the 3 devices simultaneously for 1 week of a 2-week DLW period. Participants then completed an 8-week LCD and were weighed at the start and end of the LCD and 6 and 12 months after the LCD. More time spent walking at baseline, measured by the IDEEA, significantly predicted greater weight loss during the 8-week LCD. Measures of posture allocation demonstrated medium effect sizes in their relationships with weight change. Bland–Altman analyses indicated that the Sensewear and the IDEEA accurately estimated TEE, and the IDEEA accurately measured AEE. The results suggest that the ability of energy expenditure and posture allocation to predict weight change is limited, and the accuracy of TEE and AEE measurements varies across activity monitoring devices, with multi-sensor monitors demonstrating stronger validity.

Calorie restriction (CR) enhances longevity in humans who are normal weight, overweight and obese. While dietary regimens can change self-efficacy, eating behaviors, and food cravings in individuals with obesity, the responses of these measures to prolonged CR in individuals who are exclusively not obese is unknown. The aim of this analysis was to test the effects of a two-year CR intervention on self-efficacy and eating attitudes and behaviors in humans without obesity by analyzing data from the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy Phase 2 (CALERIE 2) study. Participants (n = 218, BMI range = 21.3-29.0 kg/m(2)) were randomized to a 25% CR group or an ad libitum (AL) group. Eating attitudes and behaviors and self-efficacy were assessed using validated questionnaires at baseline, 12, and 24 months. Dietary restraint and self-efficacy increased in the CR compared to the AL group (ES ≥ 0.32). Increased self-efficacy was negatively related to weight change (ρ < −0.24). In the CR group, males showed a reduction in cravings for carbohydrates and fats at month 24, whereas females did not. The CR group showed elevations in state hunger, which were transient, and disinhibited eating (ES ≥ 0.37). In individuals without obesity, dietary restraint and self-efficacy could be important in promoting long-term CR for individuals looking to use CR as a tool to improve longevity.

It is unclear whether physical activity changes following long-term overfeeding and in response to different dietary protein intakes. Twenty-five (16 males, 9 females) healthy adults (18–35 yr) with BMI ranging from 19 to 30 kg/m2 enrolled in this inpatient study. In a parallel group design, participants were fed 140% of energy needs, with 5, 15, or 25% of energy from protein, for 56 days. Participants wore an RT3 accelerometer for at least 59 days throughout baseline and during overfeeding and completed 24-h whole room metabolic chamber assessments at baseline and on days 1, 14, and 56 of overfeeding and on day 57, when the baseline energy intake was consumed, to measure percent of time active and spontaneous physical activity (SPA; kcal/day). Changes in activity were also assessed by doubly labeled water (DLW). From accelerometry, vector magnitude (VM), a weight-independent measure of activity, and activity energy expenditure (AEE) increased with weight gain during overfeeding. AEE remained increased after adjusting for changes in body composition. Activity-related energy expenditure (AREE) from DLW and percent activity and SPA in the metabolic chamber increased with overfeeding, but SPA was no longer significant after adjusting for change in body composition. Change in VM and AEE were positively correlated with weight gain; however, change in activity was not affected by protein intake. Overfeeding produces an increase in physical activity and in energy expended in physical activity after adjusting for changes in body composition, suggesting that increased activity in response to weight gain might be one mechanism to support adaptive thermogenesis.

We analyze food-item level data collected from 50 adults from the United States using the Remote Food Photography Method® to provide the first estimates of plate waste gathered from adults across multiple consecutive meals and days in free-living conditions, and during laboratory-based meals with fixed food items and quantities. We find average plate waste in free-living conditions is 5.6 grams (7.7 kcals) per item and that 3.3% of all food selected is returned as plate waste, where the percent waste figure is substantially lower than previously published plate waste estimates gathered primarily from dine-out settings in the United States such as buffets and institutional settings with limited-choice meals (e.g., school cafeterias). Plate waste from the same participants during the laboratory-based meals is significantly higher with an average of 203.2 grams of solid plate waste per meal (531.3 kcals) or 39.1% of the food provided, which is similar to the plate waste percentages found reported in some school cafeteria settings. The amount of plate waste generated in free-living conditions is significantly positively associated with portion size selected for an item. In a multivariate analysis that controls for macronutrient profile, items selected from the vegetables, fats/oils/dressings, and grains categories are associated with significantly greater amounts of plate waste per item. We find no significant associations between free-living plate waste and gender, age, race or body mass index but find that women leave more plate waste in the lab meal where portion sizes are pre-determined by the researcher and similar for all respondents. We discuss possible implications of these findings for programs focused on reducing plate waste and food waste among consumers.

The aim of this study was to determine the validity of energy intake (EI) estimations made using the remote food photography method (RFPM) compared to the doubly labeled water (DLW) method in minority preschool children in a free-living environment.Seven days of food intake and spot urine samples excluding first void collections for DLW analysis were obtained on thirty-nine 3- to 5-year-old Hispanic and African American children. Using an iPhone, caregivers captured before and after pictures of each child's intake, pictures were wirelessly transmitted to trained raters who estimated portion size using existing visual estimation procedures, and energy and macronutrients were calculated. Paired t tests, mean differences, and Bland-Altman limits of agreement were performed.The mean EI was 1,191 ± 256 kcal/d using the RFPM and 1,412 ± 220 kcal/d using the DLW method, resulting in a mean underestimate of 222 kcal/d (-15.6%; P 0.0001) that was consistent regardless of intake. The RFPM underestimated EI by -28.5% in 34 children and overestimated EI by 15.6% in 5 children.The RFPM underestimated total EI when compared to the DLW method among preschoolers. Further refinement of the RFPM is needed for assessing the EI of young children.

Rats offered chow, lard, and 30% sucrose solution (choice) rapidly become obese. We tested metabolic disturbances in rats offered choice, chow+lard, or chow+30% sucrose solution [chow+liquid sucrose (LS)] and compared them with rats fed a composite 60% kcal fat, 7% sucrose diet [high-fat diet (HFD)], or a 10% kcal fat, 35% sucrose diet [low-fat diet (LFD)]. Choice rats had the highest energy intake, but HFD rats gained the most weight. After 23 days carcass fat was the same for choice, HFD, chow+lard, and chow+LS groups. Glucose clearance was the same for all groups during an intraperitoneal glucose tolerance test (GTT) on day 12, but fasting insulin was increased in choice, LFD fed, and chow+LS rats. By contrast, only choice and chow+LS rats were resistant to an intraperitoneal injection of 2 mg leptin/kg on day 17. In experiment 2 choice rats were insulin insensitive during an intraperitoneal GTT, but this was corrected in an oral GTT due to GLP-1 release. UCP-1 protein was increased in brown fat and inguinal white fat in choice rats, and this was associated with a significant increase in energy expenditure of choice rats during the dark period whether expenditure was expressed on a per animal or a metabolic body size basis. The increase in expenditure obviously was not great enough to prevent development of obesity. Further studies are required to determine the mechanistic basis of the rapid onset of leptin resistance in choice rats and how consumption of sucrose solution drives this process.

Very low-density lipoproteins (VLDL) are a class of large lipoprotein synthesized in the liver. The key function of VLDL, in vivo, is to carry triglyceride from the liver to adipose tissue. As a steroidogenic organ, the adrenal gland mainly uses lipoproteins as sources of cholesterol. Although VLDL receptors have been detected in the human adrenal, the function of VLDL in the adrenal gland remains unknown. Herein, we used primary cultures of human and bovine adrenal cells and the adrenocortical cell line H295R as models to determine the effects of VLDL on adrenal steroidogenesis. Our studies revealed that VLDL significantly increased aldosterone synthesis in all of the models tested. This increase was largely due to VLDL's stimulation of the expression of steroidogenic acute regulatory (StAR) protein and aldosterone synthase (CYP11B2). VLDL increased CYP11B2 mRNA expression in a concentration-dependent manner. Effects of VLDL on CYP11B2 transcript levels were not additive with angiotensin II or potassium but were additive with the cAMP pathway agonists ACTH and forskolin. Nifedipine completely inhibited the effects of VLDL on CYP11B2 mRNA, suggesting that calcium is the main signal transduction pathway used by VLDL in adrenal cells. Indeed, VLDL increased cytosolic free calcium levels. An in vivo study conducted in sucrose-fed rats showed a positive correlation between elevated triglyceride (VLDL) levels in plasma and CYP11B2 expression in the adrenal. In conclusion, we have shown that VLDL can stimulate aldosterone synthesis in adrenocortical cells by increasing StAR and CYP11B2 expression, an event likely mediated by a calcium-initiated signaling cascade.

Data are limited concerning the dietary factors that influence appetite control in older adults. This study examined the effects of food form and portion size on appetite in 43 older adults (age: 72 +/- 1 years; BMI: 25.6 +/- 0.3 kg/m(2)). Subjects were assigned to groups based on portion size of the test meal (12.5% (n = 18) vs. 25% (n = 25) of estimated energy need). Subjects randomly consumed, on two separate days, the respective solid or beverage test meal. Appetite sensations and hormonal responses were measured over 4 h. Main effects of food form (P < 0.05) and/or portion size (P < 0.05) were observed for each appetite sensation. Postprandial hunger and desire to eat were greater following beverage vs. solid meal (between 12.5% vs. 25%), whereas fullness was lower after beverage vs. solid meal (P < 0.05). Main effects of food form and/or portion size were observed for glucose, insulin, and ghrelin. Postprandial glucose and insulin concentrations were lower after beverage vs. solid meal (between 12.5% vs. 25%; all comparisons, P < 0.05) whereas beverage meal led to greater 4-h ghrelin vs. solid meal (P = 0.09). No main effects were observed for glucagon-like peptide-1 (GLP-1) or cholecystokinin (CCK). When adjusting for age, food form remained significant for postprandial hunger and fullness; portion size remained significant for postprandial glucose. Greater hunger and reduced satiety with accompanying glucose, insulin, and ghrelin following the beverage vs. solid meals, and to some extent, in smaller vs. larger portions suggest that appetite control is influenced by food form and portion size in older adults. These findings may enhance the development of appropriate dietary strategies that help to regulate energy balance.

This study examined the influences of age and chronic physical activity status on appetite and mood state. Groups of younger inactive, younger active, older inactive, and older active men and women completed questionnaires each waking hour, rating appetite and mood state for 1 day. Maximal oxygen consumption was 20% lower in older than in younger (p < 0.001) subjects, and 32% lower in inactive than in active (p < 0.001) subjects. Mean hunger (older, 4 ± 1; younger, 5 ± 1 arbitrary units (AU); p < 0.01) and desire to eat (older, 3 ± 1; younger, 4 ± 1 AU; p < 0.01) were lower in older than in younger subjects. Nadir arousal was higher for the active subjects (active, 3 ± 1; inactive, 2 ± 1 AU; p < 0.05). Nadir arousal, nadir pleasantness, and mean pleasantness were higher for the older subjects (p < 0.05). Physical activity status does not influence appetite or the age-associated declines in hunger or desire to eat. The increased nadir arousal of the physically active and older groups is consistent with these subjects experiencing less extreme sleepiness.

Background Resistance training (RT) and dietary protein independently influence indexes of whole-body glucose control, though their synergistic effects have not yet been documented. Objective This study assessed the influence of dietary protein intake on RT-induced changes in systemic glucose tolerance and the contents of skeletal muscle insulin signaling proteins in healthy older persons. Design Thirty-six older men and women (age: 61 +/- 1 y) performed RT (3 times/wk for 12 wk) and consumed either 0.9 g protein . kg(-1) . d(-1) [lower-protein (LP) group; approximately 112% of the Recommended Dietary Allowance (RDA)] or 1.2 g protein . kg(-1) . d(-1) [higher-protein (HP) group; approximately 150% of the RDA]; the HP group consumed more total, egg, and dairy proteins. Results After RT, body weight was unchanged; whole-body protein and water masses increased, and fat mass decreased with no significantly different responses observed between the LP and HP groups. The RT-induced improvement in oral glucose tolerance (decreased area under the curve, AUC) was not significantly different between the groups (LP: -28%; HP: -25%). The insulin (-21%) and C-peptide (-14%) AUCs decreased in the LP group but did not change significantly in the HP group. Skeletal muscle insulin receptor, insulin receptor substrate-1, and Akt contents were unchanged, and the amount of atypical protein kinase C zeta/lambda (aPKC zeta/lambda), a protein involved with insulin signaling, increased 56% with RT, independent of protein intake. Conclusion These results support the hypothesis that older persons who consume adequate or moderately high amounts of dietary protein can use RT to improve body composition, oral glucose tolerance, and skeletal muscle aPKC zeta/lambda content without a change in body weight.

Background Attempts to model cumulative intake curves with quadratic functions have not simultaneously taken gustatory stimulation, satiation, and maximal food intake into account. Objective Our aim was to develop a dynamic model for cumulative intake curves that captures gustatory stimulation, satiation, and maximal food intake. Design We developed a first-principles model describing cumulative intake that universally describes gustatory stimulation, satiation, and maximal food intake using 3 key parameters: 1) the initial eating rate, 2) the effective duration of eating, and 3) the maximal food intake. These model parameters were estimated in a study (n = 49) where eating rates were deliberately changed. Baseline data was used to determine the quality of model's fit to data compared with the quadratic model. The 3 parameters were also calculated in a second study consisting of restrained and unrestrained eaters. Finally, we calculated when the gustatory stimulation phase is short or absent. Results The mean sum squared error for the first-principles model was 337.1 ± 240.4 compared with 581.6 ± 563.5 for the quadratic model, or a 43% improvement in fit. Individual comparison demonstrated lower errors for 94% of the subjects. Both sex (P = 0.002) and eating duration (P = 0.002) were associated with the initial eating rate (adjusted R2 = 0.23). Sex was also associated (P = 0.03 and P = 0.012) with the effective eating duration and maximum food intake (adjusted R2 = 0.06 and 0.11). In participants directed to eat as much as they could compared with as much as they felt comfortable with, the maximal intake parameter was approximately double the amount. The model found that certain parameter regions resulted in both stimulation and satiation phases, whereas others only produced a satiation phase. Conclusions The first-principles model better quantifies interindividual differences in food intake, shows how aspects of food intake differ across subpopulations, and can be applied to determine how eating behavior factors influence total food intake.

Rats offered 30% sucrose solution in addition to chow and water become leptin resistant therefore we investigated the effect of sucrose solution consumption on leptin signaling. In Experiment 1 rats were resistant to 3rd ventricle injections of 1.5 μg leptin after 36 days of sucrose and western blot indicated that resistance was associated with increased basal levels of signal transducer and activator of transcription 3 phosphorylation (pSTAT3). In Experiment 2 rats were resistant to a peripheral injection of 2 mg leptin/kg after 26 days of sucrose. Immunohistochemistry indicated that increased basal pSTAT3 was limited to the medial and lateral arcuate nucleus of the hypothalamus. Increased availability of glucose and fructose can stimulate the hexosamine biosynthetic pathway (HBP) which O -GlcNAc-modifies proteins. This has the potential to change protein bioactivity. We tested whether this pathway could account for the leptin resistance. There was no increase in the expression of HBP enzymes in tissues from sucrose rats in Experiment 1, however, direct activation of the HBP with a 3 h intravenous infusion of 30 μmol/kg/min glucosamine significantly increased hypothalamic pSTAT3. Although sucrose consumption and activation of the HBP both increase hypothalamic pSTAT3 experiments described here did not provide evidence of a direct link between sucrose consumption, HBP activity and leptin resistance. Unexpectedly, we found that the HBP enzyme glutamine fructose-6-phosphate amidotransferase (GFAT) in liver and O -GlcNAcase in hypothalamus were increased 30 min after leptin injection in leptin responsive animals, implying a complex interaction between activity of the HBP and leptin responsiveness.

Objective To evaluate the effects of overeating (140% of energy requirements) a high-fat low-energy density diet (HF/LED, 1.05 kcal/g), high-fat high-energy density diet (HF/HED, 1.60 kcal/g), and high-carbohydrate (HC) LED (1.05 kcal/g) for 2-days on subsequent 4-day energy intake (EI), activity levels, appetite, and mood. Design and Methods Using a randomized cross-over design, energy expenditure and EI were standardized during overeating. Results In 20 adults with a mean ± SD BMI of 30.7 ± 4.6 kg/m2, EI was not suppressed until the second day after overeating and accounted for ∼30% of the excess EI. Reductions in EI did not differ among the three diets or across days. Overeating had no effect on subsequent energy expenditure but steps/day decreased after the HC/LED and HF/HED. Sleep time was increased after the HF/HED compared to both LEDs. After overeating a HF/HED vs. HF/LED, carbohydrate cravings, hunger, prospective food consumption, and sadness increased and satisfaction, relaxation, and tranquility decreased. Conclusions Diet type, time, or their interaction had no impact on compensation over 4 days. No adaptive thermogenesis was observed. The HF/HED vs. HF/LED had detrimental effects on food cravings, appetite, and mood. These results suggest short-term overeating is associated with incomplete compensation.

Limited research has suggested that the food form of nutritional supplements (FFNS) and resistance training (RT) influence ingestive behaviour and energy balance in older adults. The effects of the FFNS and RT on acute appetitive, endocrine and metabolic responses are not adequately documented. The present study assessed the effects of the FFNS and RT on postprandial appetite sensations (hunger and fullness), endocrine responses (plasma insulin, cholecystokinin, ghrelin and glucagon-like peptide-1 (GLP-1)), metabolism (glucose, energy expenditure and RER) and food intake (satiation) in older adults. On separate days, eighteen sedentary (Sed) and sixteen RT healthy adults (age 62–84 years) consumed 12·5 % of their energy need as an isoenergetic- and macronutrient-matched solid or beverage. Postprandial responses were assessed over 4 h. No RT × FFNS interactions were observed for any parameter. Fasting cholecystokinin was higher in the RT v. Sed group (P v. beverage intake (P v. beverage intake (P v. Sed group (P v. beverage (P v. beverage (P

To assess the effect of food form (FF) on postprandial (PP) plasma amino acid (AA) concentrations, ten older adults (five men and five women, age 72 (sem 2) years, BMI 26·0 (sem 0·9) kg/m2) consumed, on separate days, energy and macronutrient-matched test meal replacement products (MRP) (approximately 25 % of the subject's daily energy need; approximately 54 % carbohydrate, 21 % protein, 25 % fat) in beverage and solid form. Blood samples were taken during fasting and throughout the 4 h PP period; plasma AA concentrations were assessed using HPLC. Consumption of each MRP led to an increase in total AA, branched-chain AA (BCAA), essential AA (EAA), non-essential AA (NEAA) and leucine concentrations (4 h area under the curve, AUC) (time effect; P P P r 0·25) and glucose (r 0·24) concentrations for the solid MRP but not for the beverage MRP. In conclusion, older adults can achieve higher plasma AA concentrations when a protein-containing MRP is ingested in beverage form. The implications of the higher AA availability on anabolic processes warrant investigation.

Obesity has been associated with increased consumption of sweetened beverages and a high-fat diet. We determined whether the composition of the dry pellet offered with liquid sucrose (LS) and lard influenced the development of obesity. We hypothesized that animals offered LS or LS and lard (choice), in addition to chow or purified low fat diet pellet (LFD; 10% fat), would gain more body fat than controls. We compared the effects of LFD vs. chow on voluntary consumption of LS and lard, serum triglyceride (TG), glucose, and body fat over 21 days. Male Sprague Dawley rats (n=10/group) were offered chow, chow+LS, chow choice, LFD, LFD+LS, LFD choice or solid high-sucrose diet (70% sucrose). Energy intakes of rats fed chow, LFD, and high-sucrose diets were similar. Energy intake was increased by 16% in chow+LS, 15% in LFD+LS, 11% in LFD choice, and 23% in chow choice rats. Chow choice rats consumed 142% more lard than LFD choice rats. Fasting glucose increased in all choice rats compared with the chow and high-sucrose diet rats. Fasting TG increased in LFD choice rats and were ~75% higher than those of chow, LFD, or high-sucrose rats. Chow choice had higher carcass fat than chow, chow+LS, and LFD groups however LFD choice was not different from their controls. Another experiment confirmed rats consumed 158% more lard when given chow choice compared to LFD choice. The diet offered to rats with free access to LS and lard influenced the development of obesity, sucrose and lard selection, and TG.

The effects of increased dietary protein on resistance training (RT)-induced changes in body composition and skeletal muscle fiber size are uncertain in older people.We hypothesized that the ingestion of more animal-based foods, especially eggs, to achieve a higher protein intake would enhance RT-induced changes in body composition.West Lafayette, IN.36 older people (age 61 +/- 1 y; mean +/- SEM).Subjects completed RT three d/wk for 12 weeks, and consumed omnivorous diets that contained either 0.9 +/- 0.1 (lower protein) or 1.2 +/- 0.0 (higher protein) g protein x kg(-1) x d(-1) (12 +/- 3 and 17 +/- 5% of energy intakes, respectively), with the higher protein intake achieved by consuming more eggs, meats, and dairy foods. The lower and higher protein diets contained 213 +/- 21 and 610 +/- 105 mg cholesterol/d, respectively.Strength, body composition, serum lipid-lipoprotein profile, urinary creatinine, skeletal muscle fiber type and size.Among all subjects, over time (i.e. with RT) body weight was unchanged, lean mass (1.1 +/- 0.2 kg) increased, and fat mass (-1.4 +/- 0.2 kg) decreased (all changes P0.05). Regional (i.e. trunk, legs, arms) lean mass increased and fat mass decreased. Whole body muscle mass (24-h urinary creatinine excretion) increased, but skeletal muscle (vastus lateralis) type 1, type 2a, and type 2x fiber cross-sectional areas did not change from baseline. Serum total and LDL cholesterol decreased (P0.05) and HDL cholesterol and triacylglycerol were unchanged. Dietary protein and cholesterol intakes did not influence these responses to RT.Consumption of diets that contained moderately higher protein and variable amounts of cholesterol did not differentially affect body composition, skeletal muscle fiber size, or serum lipid-lipoprotein profile responses to resistance training in older people.