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Background: Evidence from epidemiological studies suggests that higher whole grain intake is associated with improvements in body weight measures. Evidence from randomized controlled intervention studies is controversial., Objective: To assess the scientific evidence, using a descriptive systematic approach, related to the relationship/effects of whole grain on weight management., Methods: Medicine Medical Subject Headings (MeSH) were used to search in Medline and Scopus, dating from 1980 to July 2013. Subsequently, 2 researchers assessed independently the resulting abstracts, using hierarchically targeted selection criteria., Results: A moderate body of evidence from epidemiological studies consistently demonstrates that a higher intake of whole grains is associated with lower body weight, BMI, waist circumference, abdominal adiposity, and weight gain. The evidence from intervention studies is, in comparison, limited and less consistent. Current evidence fails to clearly demonstrate that whole grain intake can contribute to weight loss independent of hypocaloric diets. The lack of consistency in intervention studies may partly be explained by heterogeneity in study duration, types and amounts of whole grain foods included, population, and sample sizes., Conclusions: Future epidemiological and intervention studies are needed to address the limitations observed in the current body of evidence, importantly using a consistent definition of whole grain foods, and the amount of whole grains consumed. Furthermore, studies need to be conducted on diets that potentially include single grains.

Background: Higher whole-grain (WG) intake is associated with a lower prevalence of metabolic syndrome (MetS); however, there is inconsistent clinical evidence with regard to the benefit of WGs compared with refined grains (RGs) on MetS., Objective: We hypothesized that consuming WGs in the place of RGs would improve MetS criteria in individuals with or at risk of MetS., Design: A randomized, controlled, open-label parallel study was conducted in 50 overweight and obese individuals with increased waist circumference and one or more other MetS criteria. Participants consumed a controlled weight-loss diet containing either WG or RG (control) products for 12 wk. Body composition, MetS criteria and related markers, and plasma alkylresorcinols (compliance marker of WG intake) were measured at baseline and at 6 and 12 wk. A subgroup (n = 28) underwent magnetic resonance imaging to quantify subcutaneous and visceral adipose tissue (AT)., Results: Baseline variables were not significantly different between groups; however, the RG group tended to have higher triglycerides and lower high-density lipoprotein (HDL) cholesterol (P = 0.06). Alkylresorcinols increased with consumption of the WG diet and did not change with consumption of the RG diet (time × treatment, P < 0.0001), which showed dietary compliance. There were no differences in anthropometric changes between groups; however, weight, body mass index, and percentage of body AT decreased at both 6 and 12 wk (P < 0.05), and reductions in percentage of abdominal AT occurred by 6 wk and did not change between 6 and 12 wk (P = 0.09). Both glucose (P = 0.02) and HDL cholesterol (P = 0.04) were lower with the consumption of the WG compared with the RG diet. However, when noncompliant individuals (n = 3) were removed, the glucose effect was stronger (P = 0.01) and the HDL-cholesterol effect was no longer significant (P = 0.14)., Conclusions: Replacing RGs with WGs within a weight-loss diet does not beneficially affect abdominal AT loss and has modest effects on markers of MetS. WGs appear to be effective at normalizing blood glucose concentrations, especially in those individuals with prediabetes., (© 2014 American Society for Nutrition.)

Background: There are limited data on the safety of anesthesia-assisted endoscopy by using propofol-mediated sedation in obese individuals undergoing advanced endoscopic procedures (AEPs)., Objective: To study the association between obesity (as measured by body mass index [BMI]) and the frequency of sedation-related complications (SRCs) in patients undergoing AEPs., Design: Prospective cohort study., Setting: Tertiary referral center., Patients: A total of 1016 consecutive patients undergoing AEPs (BMI <30, 730 [72%]; 30-35, 159 [16%]; >35, 127 [12%])., Intervention: Monitored anesthesia sedation with propofol alone or in combination with benzodiazepines and/or opioids., Main Outcome Measurements: SRCs, airway maneuvers (AMs), hypoxemia, hypotension requiring vasopressors, and early procedure termination were compared across 3 groups., Results: There were 203 AMs in 13.9% of patients, hypoxemia in 7.3%, need for vasopressors in 0.8%, and premature termination in 0.6% of patients. Increasing BMI was associated with an increased frequency of AMs (BMI <30, 10.5%; 30-35, 18.9%; >35-26.8%; P < .001) and hypoxemia (BMI <30, 5.3%; 30-35, 9.4%; >35, 13.4%; P = .001); there was no difference in the frequency of need for vasopressors (P = .254) and premature termination of procedures (P = .401). On multivariable analysis, BMI (odds ratio [OR] 2.0; 95% CI, 1.3-3.1), age (OR 1.1; 95% CI, 1.0-1.1), and American Society of Anesthesiologists class 3 or higher (OR 2.4; 95% CI, 1.1-5.0) were independent predictors of SRCs. In obese individuals (n = 286), there was no difference in the frequency of SRCs in patients receiving propofol alone or in combination (P = .48)., Limitations: Single tertiary center study., Conclusions: Although obesity was associated with an increased frequency of SRCs, propofol sedation can be used safely in obese patients undergoing AEPs when administered by trained professionals., (Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.)

Background: A number of diet and exercise programs purport to help promote and maintain weight loss. However, few studies have compared the efficacy of different methods., Objective: To determine whether adherence to a meal-replacement-based diet program (MRP) with encouragement to increase physical activity is as effective as following a more structured meal-plan-based diet and supervised exercise program (SDE) in sedentary obese women., Design: Randomized comparative effectiveness trial., Participants/setting: From July 2007 to October 2008, 90 obese and apparently healthy women completed a 10-week university-based weight loss trial while 77 women from this cohort also completed a 24-week weight maintenance phase., Intervention: Participants were matched and randomized to participate in an MRP or SDE program., Main Outcome Measures: Weight loss, health, and fitness-related data were assessed at 0 and 10 weeks on all subjects as well as at 14, 22, and 34 weeks on participants who completed the weight maintenance phase., Statistical Analyses Performed: Data were analyzed by multivariate analysis of variance for repeated measures., Results: During the 10-week weight loss phase, moderate and vigorous physical activity levels were significantly higher in the SDE group with no differences observed between groups in daily energy intake. The SDE group lost more weight (-3.1 ± 3.7 vs -1.6 ± 2.5 kg; P = 0.03); fat mass (-2.3 ± 3.5 vs -0.9 ± 1.6 kg; P = 0.02); centimeters from the hips (-4.6 ± 7 vs -0.2 ± 6 cm; P = 0.002) and waist (-2.9 ± 6 vs -0.6 ± 5 cm; P = 0.05); and, experienced a greater increase in peak aerobic capacity than participants in the MRP group. During the 24-week maintenance phase, participants in the SDE group maintained greater moderate and vigorous physical activity levels, weight loss, fat loss, and saw greater improvement in maximal aerobic capacity and strength., Conclusions: In sedentary and obese women, an SDE-based program appears to be more efficacious in promoting and maintaining weight loss and improvements in markers of health and fitness compared to an MRP type program with encouragement to increase physical activity., (Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.)