Dairy augmentation of total and central fat loss in obese subjects

Can the controversial relationship between dietary calcium and body weight be mechanistically explained by alterations in appetite and food intake?

The prevalence of obesity has reached epidemic proportions worldwide and the incidence of overweight and obesity continues to rise. Diet plays a significant role in the modulation of body weight and there is some evidence to suggest that calcium or dairy intake may modulate body weight and body fat mass. Several mechanisms through which calcium or dairy products may affect body weight or fat have been suggested, including a possible effect on appetite and food intake. A recent study investigated to what extent people could compensate for increased energy intake from dairy products and found that a 7-day increase in dairy intake had no effect on appetite and no evidence of complete compensation for the raised energy intake. In another study, the effects of altered calcium content of a dairy-based test meal was evaluated in obese subjects; the findings indicated that although a higher calcium content of the meal reduced the extent of post-prandial chylomicron-associated triglyceridemia, there was no effect on appetite-related hormones (CCK, ghrelin, GLP-1, or PPY) or on energy intake from a subsequent ad libitum test meal. Thus, this new evidence does not support the hypothesis that high calcium or dairy intake reduces appetite or food intake.

Dietary calcium and dairy modulation of oxidative stress and mortality in aP2-agouti and wild-type mice

Oxidative and inflammatory stress have been implicated as major contributors to the aging process. Dietary Ca reduced both factors in short-term interventions, while milk exerted a greater effect than supplemental Ca. In this work, we examined the effects of life-long supplemental and dairy calcium on lifespan and life-span related biomarkers in aP2-agouti transgenic (model of diet-induced obesity) and wild-type mice fed obesigenic diets until their death. These data demonstrate that dairy Ca exerts sustained effects resulting in attenuated adiposity, protection against age-related muscle loss and reduction of oxidative and inflammatory stress in both mouse strains. Although these effects did not alter maximum lifespan, they did suppress early mortality in wild-type mice, but not in aP2-agouti transgenic mice.

Dairy protein and leucine alter GLP-1 release and mRNA of genes involved in intestinal lipid metabolism in vitro

OBJECTIVE

A growing body of evidence supports an antiobesity effect of dairy products; however, the mechanisms remain unclear. The objective of this study was to explore possible intestinal mechanisms by which dairy delivers an antiobesity effect. The human intestinal cell line, NCI-H716, was used to test the hypothesis that branched-chain amino acids and dairy proteins regulate satiety hormone secretion and modulate genes involved in fatty acid and cholesterol metabolism.

METHODS

In dose-response (0.5%, 1.0%, 2.0%, and 3.0%) studies, the effect of leucine, isoleucine, valine, skim milk, casein, and whey on glucagon-like peptide-1 release and the expression of selected genes were tested.

RESULTS

Leucine, isoleucine, skim milk, and casein stimulated glucagon-like peptide-1 release (P < 0.05). Isoleucine and whey downregulated the expression of intestinal-type fatty acid binding protein (i-FABP), fatty acid transport protein 4 (FATP4), Niemann-Pick C-1-like-1 protein (NPC1L1), acetyl-coenzyme A carboxylase (ACC), fatty acid synthase (FAS), sterol regulatory element-binding protein-2 (SREBP-2), and 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR; P < 0.05). Leucine and valine downregulated the expression of NPC1L1, ACC, FAS, SREBP-2, and HMGCR (P < 0.05). Casein downregulated the expression of i-FABP, FATP4, ACC, FAS, SREBP-2, and HMGCR (P < 0.05). Skim milk downregulated the expression of ACC, FAS, and SREBP-2, but not i-FABP, FATP4, and NPC1L1.

CONCLUSION

This work suggests that the antiobesity effect of dairy may be mediated, at least in part, by integration of events that promote glucagon-like peptide-1 secretion and inhibit expression of genes involved in intestinal fatty acid and cholesterol absorption and synthesis.

Calcium supplementation does not alter lipid oxidation or lipolysis in overweight/obese women

Based on cell culture and studies in mice, increased dietary calcium appears to stimulate lipolysis and could possibly reduce body adiposity through hormonal influences on adipocyte calcium uptake. In this study, we investigated the effects of 1,500 mg supplemental calcium daily for 3 months on hormones regulating calcium and energy metabolism and rates of lipid oxidation and lipolysis in overweight women. Fifteen overweight (BMI > 25 kg/m(2)) premenopausal women were supplemented with 1,500 mg of calcium, as CaCO(3), per day for 3 months while maintaining their usual diets and activity levels. Baseline and endpoint measurements were obtained after the subjects consumed a standardized 25% fat diet for 4 days. Lipid oxidation was measured by indirect calorimetry, lipolysis by infusion of deuterated glycerol, and body fat by dual-energy X-ray absorptiometry. Urinary calcium, circulating levels of hormones involved in energy and lipid metabolism (insulin, leptin, and adiponectin) or calcium metabolism (25(OH)D, 1,25(OH)(2)D), and parathyroid hormone (PTH)) were also measured. Urinary levels of calcium (P = 0.005) increased and 1,25(OH)(2)D declined (P = 0.03). However other parameters, including body weight, body fat, PTH, insulin, leptin, adiponectin, 25(OH)D, as well as rates of lipid oxidation and lipolysis were not altered by calcium supplementation. Calcium supplementation for 3 months increased urinary calcium excretion, decreased circulating levels of 1,25(OH)(2)-D, but had no effect on rates of lipid oxidation or lipolysis, in these overweight women.

Effects of dairy intake on weight maintenance

BACKGROUND

To compare the effects of low versus recommended levels of dairy intake on weight maintenance and body composition subsequent to weight loss.

DESIGN AND METHODS

Two site (University of Kansas-KU; University of Tennessee-UT), 9 month, randomized trial. Weight loss was baseline to 3 months, weight maintenance was 4 to 9 months. Participants were maintained randomly assigned to low dairy (< 1 dairy serving/d) or recommended dairy (> 3 servings/d) diets for the maintenance phase. Three hundred thirty eight men and women, age: 40.3 +/- 7.0 years and BMI: 34.5 +/- 3.1, were randomized; Change in weight and body composition (total fat, trunk fat) from 4 to 9 months were the primary outcomes. Blood chemistry, blood pressure, resting metabolism, and respiratory quotient were secondary outcomes. Energy intake, calcium intake, dairy intake, and physical activity were measured as process evaluation.

RESULTS

During weight maintenance, there were no overall significant differences for weight or body composition between the low and recommended dairy groups. A significant site interaction occurred with the low dairy group at KU maintaining weight and body composition and the low dairy group at UT increasing weight and body fat. The recommended dairy group exhibited reductions in plasma 1,25-(OH)2-D while no change was observed in the low dairy group. No other differences were found for blood chemistry, blood pressure or physical activity between low and recommended dairy groups. The recommended dairy group showed significantly greater energy intake and lower respiratory quotient compared to the low dairy group.

CONCLUSION

Weight maintenance was similar for low and recommended dairy groups. The recommended dairy group exhibited evidence of greater fat oxidation and was able to consume greater energy without greater weight gain compared to the low dairy group. Recommended levels of dairy products may be used during weight maintenance without contributing to weight gain compared to diets low in dairy products.

TRIAL REGISTRATION

ClinicalTrials.gov NCT00686426.

Dairy calcium supplementation in overweight or obese persons: its effect on markers of fat metabolism

BACKGROUND

Dairy calcium supplementation has been proposed to increase fat oxidation and to inhibit lipogenesis.

OBJECTIVE

We aimed to investigate the effects of calcium supplementation on markers of fat metabolism.

DESIGN

In a placebo-controlled, crossover experiment, 10 overweight or obese subjects who were low calcium consumers received 800 mg dairy Ca/d for 5 wk. After 4 wk, adipose tissue was taken for biopsy for analysis of gene expression. Respiratory exchange, glycerol turnover, and subcutaneous adipose tissue microdialysis were performed for 7 h after consumption of 400 mg Ca or placebo, and the ingestion of either randomized slow-release caffeine (SRC; 300 mg) or lactose (500 mg). One week later, the test was repeated with the SRC or lactose crossover.

RESULTS

Calcium supplementation increased urinary calcium excretion by 16% (P = 0.017) but did not alter plasma parathyroid hormone or osteocalcin concentrations. Resting energy expenditure (59.9 +/- 3.0 or 59.6 +/- 3.3 kcal/h), fat oxidation (58.4 +/- 2.5 or 53.8 +/- 2.2 mg/min), plasma free fatty acid concentrations (0.63 +/- 0.02 or 0.62 +/- 0.03 mmol/L), and glycerol turnover (3.63 +/- 0.41 or 3.70 +/- 0.38 micromol . kg(-1) . min(-1)) were similar with or without calcium, respectively. SRC significantly increased free fatty acid concentrations, resting fat oxidation, and resting energy expenditure. During microdialysis, epinephrine increased dialysate glycerol concentrations by 250% without and 254% with calcium. Expression of 7 key metabolic genes in subcutaneous adipose tissue was not affected by calcium supplementation.

CONCLUSION

Dairy calcium supplementation in overweight subjects with habitually low calcium intakes failed to alter fat metabolism and energy expenditure under resting conditions and during acute stimulation by caffeine or epinephrine.

Recent developments in calcium-related obesity research

The influence of calcium and dairy food intake on energy balance is the object of a growing scientific literature. This manuscript presents the information discussed by subject experts during a symposium on calcium and obesity, initially planned to document in a comprehensive manner the role of calcium and dairy food on energy balance and body composition. This manuscript is organized into 13 propositions statements which either resume the presentation of an invited speaker or integrate recent developments in calcium-related obesity research. More specifically, the effects of calcium and dairy consumption on body weight and adiposity level, appetite, weight loss intervention outcome, lipid-lipoprotein profile and the risk to develop metabolic syndrome are discussed together with the metabolic mechanisms proposed to explain these effects. Taken together, the observations presented in this manuscript suggest that calcium and dairy food intake can influence many components of energy and fat balance, indicating that inadequate calcium/dairy intake may increase the risk of positive energy balance and of other health problems.

Effect of dietary calcium and dairy proteins on the adipose tissue gene expression profile in diet-induced obesity

BACKGROUND/AIMS

Calcium and dairy proteins have been postulated to explain why the intake of dairy products correlates inversely with body mass index in several populations. We have shown that a high-calcium diet with whey protein attenuates weight gain and now we describe the effects of this diet on adipose tissue gene expression.

METHODS

Nine-week-old C57Bl/6J mice were divided into two groups (n = 10/group). The control diet was a standard high-fat diet (60% of energy) low in calcium (0.4%). The whey protein diet was a high-calcium (1.8%), high-fat diet with whey protein. After the 21-week treatment, adipose tissue transcript profiling (2 mice/group) was performed using Affymetrix Mouse Genome 430 2.0.

RESULTS

The high-calcium diet with whey protein altered the expression of 129 genes (+/- 1.2 fold). Quantitative RT-PCR analysis confirmed the significant up-regulation of Adrb3 (p = 0.002) and leptin (p = 0.0019) in the high-calcium whey group. Insulin and adipocytokine signaling pathways were enriched among the up-regulated genes and the fatty acid metabolism pathway among the down-regulated genes.

CONCLUSIONS

High-calcium diet with whey protein significantly modifies adipose tissue gene expression. These preliminary findings reveal that targets of a high-calcium diet with whey protein include genes for Adrb3 and leptin, and help to explain how the intake of dairy products might attenuate obesity.

About unsuspected potential determinants of obesity

The positive energy balance underlying obesity is generally attributed to factors exerting a direct measurable impact on energy intake or expenditure. Thus, sedentariness and (or) excess caloric intake represent the “Big Two” factors on which almost all the attention of health professionals is devoted in preventive and therapeutic programs for obesity. However, recent research reveals that other more discrete factors can also promote a positive energy balance and body fat gain. Accordingly, this paper documents the effects of low micronutrient intake, short sleep duration, knowledge-based work, and organochlorine compounds on components of energy balance and body composition. These effects aid in the understanding as to why modernity accentuates the risk of obesity. Furthermore, they also suggest that body fat gain is not only a problem, but also a solution in maintaining body homeostasis, i.e., a state of optimal body functionality, in the context of modernity and globalization.

Metabolomic changes in fatty liver can be modified by dietary protein and calcium during energy restriction

AIM: To characterise the effect of energy restriction (ER) on liver lipid and primary metabolite profile by using metabolomic approach. We also investigated whether the effect of energy restriction can be further enhanced by modification of dietary protein source and calcium.

METHODS: Liver metabolomic profile of lean and obese C57Bl/6J mice (n = 10/group) were compared with two groups of weight-reduced mice. ER was performed on control diet and whey protein-based high-calcium diet (whey + Ca). The metabolomic analyses were performed using the UPLC/MS based lipidomic platform and the HPLC/MS/MS based primary metabolite platform.

RESULTS: ER on both diets significantly reduced hepatic lipid accumulation and lipid droplet size, while only whey + Ca diet significantly decreased blood glucose (P < 0.001) and serum insulin (P < 0.01). In hepatic lipid species the biggest reduction was in the level of triacylglycerols and ceramides while the level of cholesterol esters was significantly increased during ER. Interestingly, diacylglycerol to phospholipid ratio, an indicator of relative amount of diabetogenic diglyceride species, was increased in the control ER group, but decreased in the whey + Ca ER group (P < 0.001, vs obese). ER on whey + Ca diet also totally reversed the obesity induced increase in the relative level of lipotoxic ceramides (P < 0.001, vs obese; P > 0.05, vs lean). These changes were accompanied with up-regulated TCA cycle and pentose phosphate pathway metabolites.

CONCLUSION: ER-induced changes on hepatic metabolomic profile can be significantly affected by dietary protein source. The therapeutic potential of whey protein and calcium should be further studied.

Calcium plus vitamin D supplementation and fat mass loss in female very low-calcium consumers: potential link with a calcium-specific appetite control

This randomized, double-blind, placebo-controlled study was conducted to compare the effect of a 15-week weight-reducing programme ( − 2900 kJ/d) coupled with a calcium plus vitamin D (calcium+D) supplementation (600 mg elemental calcium and 5 μg vitamin D, consumed twice a day) or with a placebo, on body fat and on spontaneous energy/macronutrient intake. Sixty-three overweight or obese women (mean age 43 years, mean BMI 32 kg/m2) reporting a daily calcium intake < 800 mg participated in present study. Anthropometric variables, resting energy expenditure and spontaneous energy intake were measured before and after the 15-week programme. The calcium+D supplementation induced no statistically significant increase in fat mass loss in response to the programme. However, when analyses were limited to very low-calcium consumers only (initial calcium intake ≤ 600 mg/d,n7 for calcium+D,n6 for placebo), a significant decrease in body weight and fat mass (P < 0·01) and in spontaneous dietary lipid intake (P < 0·05) was observed in the calcium+D but not in the placebo group. In very low-calcium consumers, change in fat mass was positively correlated with change in lipid intake. During the weight-reducing programme, a calcium+D supplementation was necessary in female overweight/obese very low-calcium consumers to reach significant fat mass loss that seemed to be partly explained by a decrease in lipid intake. We propose that this change in lipid intake could be influenced by a calcium-specific appetite control.

Dairy and weight loss hypothesis: an evaluation of the clinical trials

This review evaluates evidence from clinical trials that assessed the effect of dairy product or calcium intake, with or without concomitant energy restriction, on body weight and adiposity. Of 49 randomized trials assessing the effect of dairy products or calcium supplementation on body weight, 41 showed no effect, two demonstrated weight gain, one showed a lower rate of gain, and five showed weight loss. Four of 24 trials report differential fat loss. Consequently, the majority of the current evidence from clinical trials does not support the hypothesis that calcium or dairy consumption aids in weight or fat loss.

Calcium and dairy product modulation of lipid utilization and energy expenditure

OBJECTIVE

The purpose of this study was to investigate the impact of dietary calcium or dairy product intake on total energy expenditure (TEE), fat oxidation, and thermic effect of a meal (TEM) during a weight loss trial.

METHODS AND PROCEDURES

The intervention included a prescribed 500-kcal deficit diet in a randomized placebo-controlled calcium or dairy product intervention employing twenty-four 18 to 31-year-old (22.2+/-3.1 years, mean +/- s.d.) overweight women (75.5+/-9.6 kg). TEM and fat oxidation were measured using respiratory gas exchange after a meal challenge, and TEE was measured by doubly labeled water. Fat mass (FM) and lean mass (fat-free mass (FFM)) were measured by dual-energy X-ray absorptiometry. Subjects were randomized into one of these three intervention groups: (i) placebo (<800 mg/day calcium intake); (ii) 900 mg/day calcium supplement; (iii) three servings of dairy products/day to achieve an additional 900 mg/day.

RESULTS

There were no group effects observed in change in TEE; however, a group effect was observed for fat oxidation after adjusting for FFM (P=0.02). The treatment effect was due to an increase in fat oxidation in the calcium-supplemented group of 1.5+/-0.6 g/h, P=0.02. Baseline 25-hydroxyvitamin D (25OHD) was positively correlated with TEM (R=0.31, P=0.004), and trended toward a correlation with fat oxidation (P=0.06), independent of group assignment. Finally, the change in log parathyroid hormone (PTH) was positively correlated with the change in trunk FM (R=0.27, P=0.03).

DISCUSSION

These results support that calcium intake increases fat oxidation, but does not change TEE and that adequate vitamin D status may enhance TEM and fat oxidation.

Dietary calcium and dairy products modulate oxidative and inflammatory stress in mice and humans

We have recently shown 1alpha,25-dihydroxycholecalciferol increased oxidative stress and inflammatory stress in vitro, whereas suppression of 1alpha,25-dihydroxycholecalciferol with dietary calcium (Ca) decreased oxidative and inflammatory stress in vivo. However, dairy products contains additional factors, such as angiotensin-converting enzyme inhibitors, which may further suppress oxidative and inflammatory stress. Accordingly, this study was designed to study the effects of the short-term (3 wk) basal suboptimal Ca (0.4%), high-Ca (1.2% from CaCO(3)), and high-dairy (1.2% Ca from milk) obesigenic diets on oxidative and inflammatory stress in adipocyte fatty acid-binding protein-agouti transgenic mice. Adipose tissue reactive oxygen species (ROS) production and NADPH oxidase mRNA and plasma malondialdehyde (MDA) were reduced by the high-Ca diet (P < 0.001) compared with the basal diet and ROS and MDA were further decreased by the high-dairy diet (P < 0.001). The high-Ca and -dairy diets also resulted in suppression of adipose tissue tumor necrosis factor alpha and interleukin (IL)-6 mRNA (P = 0.001) compared with the basal diet, whereas an inverse pattern was noted for adiponectin and IL-15 mRNA (P = 0.002). Consequently, we conducted a follow-up evaluation of adiponectin and C-reactive protein (CRP) in archival samples from 2 previous clinical trials conducted in obese men and women. Twenty-four weeks of feeding a high-dairy eucaloric diet and hypocaloric diet resulted in an 11 (P < 0.03) and 29% (P < 0.01) decrease in CRP, respectively (post-test vs. pre-test), whereas there was no significant change in the low-dairy groups. Adiponectin decreased by 8% in subjects fed the eucaloric high-dairy diet (P = 0.003) and 18% in those fed the hypocaloric high-dairy diet (P < 0.05). These data demonstrate that dietary Ca suppresses adipose tissue oxidative and inflammatory stress.

Ethnic differences in dairy and related nutrient consumption among US adults and their association with obesity, central obesity, and the metabolic syndrome

BACKGROUND

Recent studies suggest dairy consumption and associated nutrients may be protective against some of the components of the metabolic syndrome (MetS).

OBJECTIVES

We examined the association between consumption of a variety of dairy products and their related nutrients with obesity, central obesity, and MetS, and attempted to explain some of the ethnic differences in metabolic outcomes through dairy consumption using national data.

DESIGN

Nationally representative indicators of obesity, central obesity, and MetS among US adults were constructed from National Health and Nutrition Examination Survey 1999-2004 data, including direct anthropometric assessments, blood pressure, and laboratory tests. Sample sizes ranged from 4519 for MetS to 14 618 for obesity. Associations between diet (assessed using 24-h recalls) and metabolic and other outcomes were tested using multivariate linear and logistic models and structural equation models.

RESULTS

We found a significant inverse association between intake of whole milk, yogurt, calcium, and magnesium and metabolic disorders. Odds ratios for one more daily serving of yogurt and 100 mg Mg for MetS were 0.40 (95% CI: 0.18, 0.89) and 0.83 (95% CI: 0.72, 0.96), respectively. The opposite was found for intakes of cheese, low-fat milk, and phosphorus. Using structural equation models, ethnic differences in some MetS outcomes, such as body mass index and systolic blood pressure, were partly explained by variations in dairy-related nutrients.

CONCLUSIONS

Various dairy products may have differential associations with metabolic disorders, including obesity. Ethnic differences in dairy consumption may explain in part the ethnic disparities in metabolic disorders in the US population.

A whey-protein supplement increases fat loss and spares lean muscle in obese subjects: a randomized human clinical study

Background

This study evaluated a specialized whey fraction (Prolibra™, high in leucine, bioactive peptides and milk calcium) for use as a dietary supplement to enhance weight loss.

Methods

This was a randomized, double-blind, parallel-arm, 12-week study. Caloric intake was reduced 500 calories per day. Subjects consumed Prolibra or an isocaloric ready-to-mix beverage 20 minutes before breakfast and 20 minutes before dinner. Body fat and lean muscle tissue were measured by dual-energy x-ray absorptiometry (DEXA). Body weight and anthropometric measurements were recorded every 4 weeks. Blood samples were taken at the beginning and end of the study. Statistical analyses were performed on all subjects that completed (completer analysis) and all subjects that lost at least 2.25 kg of body weight (responder analysis). Within group significance was determined at P < 0.05 using a two-tailed paired t-test and between group significance was determined using one way analysis of covariance with baseline data as a covariate.

Results

Both groups lost a significant amount of weight and the Prolibra group tended to lose more weight than the control group; however the amount of weight loss was not significantly different between groups after 12 weeks. Prolibra subjects lost significantly more body fat compared to control subjects for both the completer (2.81 vs. 1.62 kg P = 0.03) and responder (3.63 vs. 2.11 kg, P = 0.01) groups. Prolibra subjects lost significantly less lean muscle mass in the responder group (1.07 vs. 2.41 kg, P = 0.02). The ratio of fat to lean loss (kg fat lost/kg lean lost) was much larger for Prolibra subjects for both completer (3.75 vs. 1.05) and responder (3.39 vs. 0.88) groups.

Conclusion

Subjects in both the control and treatment group lost a significant amount of weight with a 500 calorie reduced diet. Subjects taking Prolibra lost significantly more body fat and showed a greater preservation of lean muscle compared to subjects consuming the control beverage. Because subjects taking Prolibra lost 6.1% of their body fat mass, and because a 5% reduction of body fat mass has been shown to reduce the risk of obesity related disease, the results have practical significance.

Effects of various forms of calcium on body weight and bone turnover markers in women participating in a weight loss program

OBJECTIVE

This study examined the effects of calcium intake on body weight, body fat, and markers of bone turnover in pre-menopausal adult women undergoing a 12 week weight loss program of diet and exercise.

METHODS

Subjects were prescribed a 12 week diet with a 500 Kcal restriction containing about 750 mg calcium/day, exercised 3 times/week, and were given either placebo capsules, capsules of calcium lactate or calcium phosphate (daily dose about 800 mg calcium), or low fat milk (daily dose about 800 mg calcium). Subjects completed and returned daily diet diaries weekly.

RESULTS

Daily calcium intake in mg from diet records + supplement assignment was: 788 +/- 175 (placebo), 1698 +/- 210 (Ca lactate), 1566 +/- 250 (Ca phosphate), 1514 +/- 225 (milk)(no significant differences among the calcium and milk groups). Each group had statistically significant changes in body weight (p < 0.01), but there were no significant differences among groups for the weight loss: 5.8 +/- 0.8 kg (placebo), 4.1 +/- 0.7 kg (Ca lactate), 5.4 +/- 1.3 kg (Ca phosphate), 4.2 +/- 0.8 kg (milk). Body fat was changed significantly in each group (p < 0.01), with milk group showing a little less change than the other groups. Serum bone specific alkaline phophatase activity, a bone synthesis marker, increased similarly in all groups (p < 0.001 within groups, no significance for changes among groups). In contrast, the Ca lactate group, but not other groups, had a drop in urine values for alpha helical peptide, a bone resorption marker (p < 0.05).

CONCLUSION

For the conditions of this study, increased calcium intake, by supplement or milk, did not enhance loss of body weight or fat, though calcium lactate supplementation lowered values for a marker of bone degradation.

The effects of hydralazine on lipolysis in subcutaneous adipose tissue in humans

Recent evidence from animal research and in vitro experiments indicates that changes in dietary calcium intake could cause changes in lipolysis through alterations of the intracellular calcium concentration in adipocytes. The objective of the study was to examine whether the calcium antagonist hydralazine affects blood flow and lipolysis in subcutaneous abdominal adipose tissue in vivo in humans. Three different concentrations of hydralazine (12.2, 24.4, and 48.8 micromol/L) were locally administered in adipose tissue using the microdialysis technique to assess effects on lipolysis and blood flow in subcutaneous adipose tissue in the abdominal region. Subjects from the general community were studied ambulatorily at a university hospital. Eight healthy men (age, 33.1 +/- 3.3 years; body mass index, 24.2 +/- 0.2 kg/m(2)) were recruited by local announcement. Subcutaneous adipose tissue in the abdominal region was perfused with increasing concentrations of hydralazine. The main outcome measures were adipose tissue lipolysis and blood flow. Hydralazine had no effect on ethanol outflow-inflow ratios, but significantly increased interstitial glycerol concentration at the highest concentration (P < .05). The present results indicate that hydralazine increases lipolysis in abdominal subcutaneous adipose tissue in healthy lean subjects, but hydralazine had no significant effects on local blood flow in adipose tissue.

Preliminary study: soy milk as effective as skim milk in promoting weight loss

Calcium from dairy sources is beneficial to weight loss; however, no studies have compared the effects of dairy to nondairy sources of calcium on weight loss. This pilot study explored differences between soy and skim milk on changes in anthropometric values in premenopausal women. In a prospective randomized controlled trial, 14 women with overweight/obesity were randomly assigned to 720 mL soy milk (n=7) or an equivalent volume of skim milk (n=7) daily for 8 weeks. Subjects followed a 500-kcal deficit diet based on metabolic rate data. There were no anthropometric differences between soy and skim milk groups at baseline. Subjects followed an energy-restricted diet; both groups experienced reductions in kilogram weight (4.27+/-2.05 vs 3.76+/-2.25; P=0.668), body fat percent (1.30+/-1.37 vs 1.87+/-1.45; P=0.464), and abdominal circumference (11.28+/-5.23 vs 8.66+/-2.51; P=0.259) while attenuating losses of fat-free mass (1.12+/-1.29 vs 0.43+/-1.12; P=0.299) during the 8-week study. There were no significant differences in weight, fat percent, abdominal circumference, and fat-free mass between groups. To optimize the weight loss effects of calcium, one can consume 720 mL of either soy milk or skim milk daily.

Effect of dairy supplementation on body composition and insulin resistance in mice

OBJECTIVE

This study examined whether yogurt supplementation attenuated the weight gain and insulin resistance in mice fed a moderate-fat diet.

METHODS

Nine-week-old male mice (F1 BTBR x C57Bl6/J) were housed individually for the duration of the study. After initial measurements of body weight and composition, mice were randomly assigned to receive one of two isocaloric diets (19.4% kcal protein, 45.5% kcal carbohydrate, and 35.1% kcal fat). One diet was supplemented with dried yogurt powder (10.75 g/100 g of diet). In the first experiment, mice received the diets for 4 wk, after which body weight and body composition were reassessed. In the second experiment, an insulin tolerance test was performed at week 4 and glucose uptake in gonadal fat was assessed at week 5.

RESULTS

Baseline body weight was not significantly different between control and yogurt mice (P = 0.85). Body weight and fat mass increased significantly over time (P < 0.001) and there was a significant effect of diet on the increase in body weight (P < 0.05) and fat mass (P < 0.001), with the yogurt mice gaining less weight and fat than the control mice. Food intake was not significantly affected by the yogurt supplementation (P = 0.906). Digestive efficiency was significantly lower in the yogurt mice (P < 0.05) due to greater fecal production (P < 0.01). There was no significant effect of diet on the glucose area under the curve during the insulin tolerance test (P = 0.24). Glucose uptake in the gonadal fat was significantly higher in the yogurt mice than in controls under basal (P < 0.05) and insulin-stimulated (P < 0.05) conditions.

CONCLUSION

Yogurt supplementation resulted in less weight and fat gain in mice fed isocaloric diets due to a decrease in digestive efficiency. Yogurt also enhanced the uptake of glucose in fat but did not significantly improve insulin sensitivity.

Calcium consumption and insulin resistance syndrome parameters. Data from the Epidemiological Study on the Insulin Resistance Syndrome (DESIR)

BACKGROUND AND AIM

A number of studies have investigated the role of dietary calcium in lipid metabolism and weight regulation, and the influence of dairy products on the incidence of insulin resistance syndrome. In this study we have examined the relationship between dietary calcium and the established parameters of the insulin resistance syndrome.

METHODS AND RESULTS

The study population (n=4372) was taken from the DESIR (Data from the Epidemiological Study on the Insulin Resistance Syndrome) cohort. Data for parameters relating to the syndrome were recorded, including glucose, serum insulin, triglycerides, HDL-cholesterol, waist circumference and blood pressure. Total energy, calcium and alcohol intake were estimated using a food-frequency questionnaire. Relationships between dietary calcium density and the above parameters were analyzed by multiple linear regression models, adjusted for age, smoking, alcohol consumption and physical activity. From one quartile of calcium density to the next, mean systolic and diastolic blood pressures and insulin concentrations decreased in women by 0.9 mm Hg, 0.5 mm Hg and 2.4%, respectively, and HDL-cholesterol increased by 0.007 mmol/l (all p<0.05) after adjustment for age, smoking, alcohol intake and physical activity. In men, there was an increase of 0.2 kg/m(2) in the body mass index(BMI) and a decrease of 0.4 mm Hg in diastolic blood pressure (both p<0.05).

CONCLUSIONS

These results confirm a beneficial association between dietary calcium and arterial blood pressure, insulin and HDL-cholesterol levels in women, whereas in men there was only a beneficial association with diastolic blood pressure.

High-calcium diet with whey protein attenuates body-weight gain in high-fat-fed C57Bl/6J mice

An inverse relationship between Ca intake and BMI has been found in several studies. It has been suggested that Ca affects adipocyte metabolism via suppressing 1,25-dihydroxycholecalciferol (1,25(OH)2-D3) and decreases fat absorption. We studied the effect of Ca and milk proteins (whey and casein) on body weight in C57Bl/6J mice. Male mice, age 9 weeks, were divided into three groups (ten mice per group) receiving modified high-fat (60% of energy) diets. Two groups received a high-Ca diet (1.8% calcium carbonate (CaCO3)), with casein or whey protein (18% of energy), and one group received a low-Ca diet (0.4% CaCO3) with casein for 21 weeks. Food intake was measured daily and body weight twice per week. Body fat content (by dual-energy X-ray absorptiometry) of all mice and faecal Ca and fat excretion of seven mice/group were measured twice during the study. Final body weight (44.1 (SEM 1.1) g) and body fat content (41.6 (SEM 0.6) %) were significantly lower (P < 0.05) in the high-Ca whey group than in the low-Ca casein group (48.1 (SEM 0.8) g and 44.9 (SEM 0.8) %). Body weight and body fat content of the high-Ca casein group did not differ significantly from the low-Ca casein group even though serum 1,25(OH)2-D3 levels were significantly lower (P < 0.001) in both high-Ca groups than in the low-Ca casein group. Thus changes in serum 1,25(OH)2-D3 do not seem to affect body weight in this animal model. There was a significant difference in fat excretion between the high-Ca whey and low-Ca casein groups (3.9 (SEM 0.9) % in the high-Ca whey v. 1.4 (SEM 0.2) % in the low-Ca casein group; P < 0.05), which may partly explain the effect on body weight.

1Alpha,25-dihydroxyvitamin D3 modulation of adipocyte reactive oxygen species production

OBJECTIVE

We have previously shown 1alpha,25-dihydroxyvitamin D3 [1alpha,25-(OH)2D3] to inhibit mitochondrial uncoupling protein 2 (UCP2) expression in adipocytes and that in vivo suppression of calcitriol levels with calcium-rich diets increases UCP2 expression. Because UCP2 plays a significant role in the clearance of reactive oxygen species (ROS), we studied the effect of calcitriol on ROS production and ROS-induced adipocyte proliferation.

RESEARCH METHODS AND PROCEDURES

ROS production in human and murine adipocytes was stimulated by high glucose (30 mM) or H2O2 (100 nM).

RESULTS

Both approaches resulted in increased ROS production by 27% to 100% (p < 0.05) and increased cell proliferation by 15% to 39% (p < 0.03). These effects were augmented by the addition of mitochondrial uncoupling inhibitor guanosine 5'-diphosphate (GDP; 100 microM) or 1alpha,25-(OH)2D3 (10 nM) and attenuated by UCP2 overexpression, suggesting that inhibition of mitochondrial uncoupling suppresses clearance of ROS and increases adipocyte proliferation. The addition of alpha +/- tocopherol (1 microM) inhibited cell proliferation in adipocytes treated with either H2O2 or high glucose, indicating that ROS plays a major role in the regulation of cell proliferation in adipocytes. Moreover, stimulation of ROS with high glucose and H2O2 resulted in a 2- to 5-fold increase in adipocyte intracellular calcium ([Ca2+]i; p < 0.001), and calcium channel antagonism (nifedipine, 10 microM) suppressed ROS induced calcium influx and cell proliferation, indicating that [Ca2+]i may also regulate ROS production and exert a mitogenic effect in adipocytes.

DISCUSSION

These data support a role of 1alpha,25-(OH)2D3, UCP2, and [Ca2+]i in the regulation of adipocyte ROS production.

Calcium supplements in healthy children do not affect weight gain, height, or body composition

OBJECTIVE

Calcium intake is a potential factor influencing weight gain and may reduce body weight, but the evidence for this in children is conflicting. The aim of this study was to use data from randomized controlled trials to determine whether calcium supplementation in healthy children affects weight or body composition.

RESEARCH METHODS AND PROCEDURES

This study is a systematic review. We identified potential studies by searching the following electronic bibliographic databases: CENTRAL, MEDLINE, EMBASE, CINAHL, AMED, MANTIS, ISI Web of Science, Food Science and Technology Abstracts, and Human Nutrition up until April 1, 2005 and hand-searched relevant conference abstracts. Studies were included if they were placebo-controlled randomized controlled trials of calcium supplementation, with at least 3 months of supplementation, in healthy children and with outcome measures including weight. Meta-analyses were performed using fixed effects models and weighted mean differences for weight and height and standardized mean differences (SMDs) for body composition measures.

RESULTS

There were no statistically significant effects of calcium supplementation on weight [+0.14 kg; 95% confidence interval (CI), -0.28, +0.57 kg], height (+0.22 cm; 95% CI, -0.30, +0.74 cm), body fat (SMD, +0.04; 95% CI, -0.08, +0.15), or lean mass (SMD, +0.14; 95% CI, -0.03, +0.31).

DISCUSSION

There is no evidence to support the use of calcium supplementation as a public health intervention to reduce weight gain or body fat in healthy children. Although our results do not rule out an effect of dietary supplementation with dairy products on weight gain or body composition, there is little evidence to support this hypothesis.

An intervention study of the effects of calcium intake on faecal fat excretion, energy metabolism and adipose tissue mRNA expression of lipid-metabolism related proteins

CONTEXT

In various observational studies, an inverse relation between calcium intake and body weight has been observed. A possible explanation could be an increased calcium excretion through the faeces caused by an increased dietary calcium intake.

OBJECTIVE

To examine whether an increased calcium intake could lead to changes in faecal fat and energy excretion.

DESIGN

Four different isocaloric diets with various calcium contents (400, 1200 and 2500 mg from dairy and 1200 mg from calcium carbonate (1200S)) were administered in a crossover design for 7 days each.

SUBJECTS

Five healthy men and five healthy women (age=28+/-2, body mass index=24.1+/-0.4, body fat%=25.6+/-2.4) were recruited by local announcement.

MEASUREMENTS

At the end of every intervention period, faecal samples were collected for determination of fat, energy and calcium content, blood samples were obtained for determination of relevant blood parameters; and fat samples were obtained for measurement of the mRNA expression. Furthermore, resting energy expenditure and fat oxidation were measured with the ventilated-hood technique.

RESULTS

We observed a non-significant 56% increase in fat excretion (P=0.159) on the 2500 mg diet, compared to the 400 mg diet. The 2500 mg diet significantly reduced the expression of fatty acid synthase (FAS) mRNA (P<0.05) and the calcium content of the diets significantly affected calcium excretion. Furthermore, we saw a significant decrease of serum triglycerides on the 1200S diet (P<0.05).

CONCLUSION

In this study, we observed a trend towards a higher fat excretion on the high-calcium diet, but this difference failed to reach statistical significance. It is possible that the relatively high protein content of the experimental diets increased calcium absorption from the intestine, thus decreasing the amount of calcium available for binding to fat and eliminating possible effects of dietary calcium on fat excretion. Furthermore, we observed decreases in FAS mRNA expression and serum triglycerides as a result of a high calcium intake.

Effect of increased dairy consumption on appetitive ratings and food intake

OBJECTIVE

The influence of dairy product consumption on food intake and appetitive sensations was explored in a cross-over design study with individuals who were habitually low (<1 serving/d) or high (>3 servings/d) dairy consumers.

RESEARCH METHODS AND PROCEDURES

Fifty-eight participants were required to eat one portion of dairy each day (low dairy) or three portions of dairy each day (high dairy) for 7 days. After a 7-day washout period, the opposite treatment condition was completed. Food intake and appetitive ratings were measured on each day of the treatment periods.

RESULTS

During the high-dairy period, participants consumed 209 kcal/d more than during the low dairy period (p < 0.05). There were no significant differences in subjective appetite ratings. Habitual dairy use did not influence either the appetitive or dietary findings.

DISCUSSION

These data indicate that increasing dairy consumption may lead to increased energy intake, which could potentially cause weight gain.

Second meal effects of dietary calcium and vitamin D

OBJECTIVE

To determine the second meal effects of calcium and vitamin D on postprandial glucose, insulin, non-esterified fatty acids (NEFA) and glycerol.

METHODS

Eight volunteers aged (mean+/-s.e.m.) 55.5+/-1.2 years and body mass index 29.0+/-1.6 kg/m(2), completed a randomized within-subject design that compared a low calcium-low vitamin D breakfast and an isocaloric high calcium-high vitamin D breakfast (HCB). Four hours following each breakfast, a very low calcium standard lunch was ingested. Serial blood collections were made on the hour over a duration of 8 h. Postprandial responses were calculated as the percentage change (Delta) from the fasting value for breakfast meals, and the 4th hour breakfast value for each lunch, respectively. Non-parametric tests of significance were employed.

RESULTS

The change in glucose, insulin, serum ionized calcium (iCa(2+)) and intact parathyroid hormone was not different between the two breakfasts, or the two lunches. However, HCB resulted in a lesser suppression of NEFA that significantly carried over to lunch (P=0.036, Wilcoxon test). A similar pattern of change in glycerol did not attain overall statistical significance. DeltaNEFA and Deltaglycerol were related at lunch (Spearman's r=0.52, P=0.04). Relative to breakfast, both lunches resulted in significantly higher glucose and insulin responses (P=0.011, Wilcoxon test).

CONCLUSIONS

The data are suggestive of second meal effects of calcium and vitamin D. Our observations of higher glucose and insulin after lunch may include the involvement of second meal factors as well.

Calcium and body fat in peripubertal girls: cross-sectional and longitudinal observations

OBJECTIVE

The objective was to investigate whether calcium intake is independently associated with body fat in peripubertal girls.

RESEARCH METHODS AND PROCEDURES

A total of 45 healthy premenarcheal girls (initially 10.5 +/- 0.6 years of age) completed a 2-year prospective observational study. Percent body fat and trunk fat (by DXA), height, weight, maturational stage, and eating attitudes (children's Eating Attitudes Test [EAT]) were measured at baseline and at 1 and 2 years. Physical activity (by questionnaire) and calcium intake (by calcium-specific food frequency questionnaire and 3-day food records) were assessed at 6-month intervals.

RESULTS

Girls with 2-year mean calcium intake below and above the median had similar age, height, lean mass, and maturational stage at baseline, but girls below the median had significantly higher baseline percentage body fat (29.3 +/- 10.3% vs. 22.0 +/- 6.8%, p < 0.01) and trunk fat (24.2 +/- 10.6% vs. 15.8 +/- 6.8%, p < 0.01). However, differences were no longer significant when covariates (most notably children's EAT dieting score) were considered. Regression analysis revealed that dieting score was a consistent positive predictor of percentage body and trunk fat at all cross-sectional time-points, accounting for >20% of the variance, but did not predict 2-year change in percentage fat. Calcium intake did not enter longitudinal regression equations for 2-year change in percentage fat.

DISCUSSION

In this group of girls, an inverse cross-sectional association between calcium intake and body fat appeared to result from avoidance of foods high in calcium by girls who were concerned about their body weight or shape. Calcium intake was not associated with change in fat over time.

HUM5007, a novel combination of thermogenic compounds, and 3-acetyl-7-oxo-dehydroepiandrosterone: each increases the resting metabolic rate of overweight adults

This study tested the hypothesis that 3-acetyl-7-oxo-dehydroepiandrosterone alone (7-Keto) and in combination with calcium citrate, green tea extract, ascorbic acid, chromium nicotinate and cholecalciferol (HUM5007) will increase the resting metabolic rate (RMR) of overweight subjects maintained on a calorie-restricted diet. In this randomized, double-blind, placebo-controlled, crossover trial, overweight adults on a calorie-restricted diet were randomized to three 7-day treatment periods with 7-Keto, HUM5007 or placebo. Resting metabolic rate was measured by indirect calorimetry at the beginning and end of each treatment period with a 7-day washout between testing periods. Of 45 subjects enrolled, 40 completed the study (30 women, 10 men; mean age, 38.5 years; mean mass index, 32.0 kg/m(2)). During the placebo treatment, RMR decreased by 3.9% (75+/-111 kcal/day; mean+/-S.D.); however, RMR increased significantly by 1.4% (21+/-115 kcal/day) and 3.4% (59+/-118 kcal/day) during the 7-Keto and HUM5007 treatment periods, respectively (each compared to placebo, P=.001). No significant differences were found between the treatment periods with respect to compliance or adverse events. In this study, the administration of HUM5007 or 7-Keto reversed the decrease in RMR normally associated with dieting. HUM5007 and 7-Keto increased RMR above basal levels and may benefit obese individuals with impaired energy expenditure. HUM5007 and 7-Keto were generally well tolerated and no serious adverse events were reported.

Is higher dairy consumption associated with lower body weight and fewer metabolic disturbances? The Hoorn Study

BACKGROUND

Dairy consumption has been postulated to reduce the risk of obesity and metabolic disturbances.

OBJECTIVE

The aim of this study was to evaluate the associations of dairy consumption with body weight and other components of the metabolic syndrome.

DESIGN

We used cross-sectional data for 2064 men and women aged 50-75 y who participated in the Hoorn Study. The metabolic syndrome was defined according to the National Cholesterol Education Program Expert Panel. Dairy consumption was assessed by using a semiquantitative food-frequency questionnaire.

RESULTS

The median consumption of total dairy products was 4.1 servings/d. After adjustment for potential confounders (ie, dietary factors, physical activity, smoking, income, educational level, and antihypertensive medication), total dairy consumption was significantly associated with lower diastolic blood pressure (beta +/- SE: -0.31 +/- 0.12 mm Hg/serving) and higher fasting glucose concentrations (0.04 +/- 0.02 mmol/L per serving), but not with body weight or other metabolic variables (ie, lipids, postload glucose, or insulin). When different dairy products were distinguished, borderline significant (P < 0.10) inverse associations were observed for dairy desserts, milk, and yogurt with systolic (-1.26 +/- 0.58, -0.57 +/- 0.34, and -1.28 +/- 0.74 mm Hg/serving, respectively) and diastolic (-0.58 +/- 0.31, -0.57 +/- 0.18, and -0.35 +/- 0.40 mm Hg/serving, respectively) blood pressure, whereas cheese consumption was positively associated with body mass index (0.15 +/- 0.08/serving).

CONCLUSION

In an elderly Dutch population, higher dairy consumption was not associated with lower weight or more favorable levels of components of the metabolic syndrome, except for a modest association with lower blood pressure.

Dairy consumption and related nutrient intake in African-American adults and children in the United States: continuing survey of food intakes by individuals 1994-1996, 1998, and the National Health And Nutrition Examination Survey 1999-2000

OBJECTIVE

To establish the first baseline of dairy and related nutrient intake in African Americans, an at-risk population of public health concern in the United States. To document dairy consumption in African Americans by age and sex during 1994-1998 and 1999-2000 and compare it with concomitant dairy, calcium, and related nutrient intakes in non-African-American adults and children.

DESIGN

Duplicate and single 24-hour recalls were analyzed to determine dietary intake during the Continuing Survey of Food Intakes by Individuals 1994-1996, 1998 (CSFII), and the National Health and Nutrition Examination Survey 1999-2000 (NHANES), respectively.

SUBJECTS

African Americans and non-African Americans of all ages who participated in CSFII 1994-1996, 1998, and in NHANES 1999-2000; both surveys are a stratified random sample of the total civilian, noninstitutionalized US population.

STATISTICAL ANALYSIS

Dairy food and nutrient intake per day were quantified according to age, sex, and ethnicity/race from CSFII 1994-1996, 1998, and NHANES 1999-2000. For NHANES, mean intakes from 1-day food records were sample-weighted, and standard errors estimated by the Taylor linearization method of SUDAAN (version 9.0, 2004, RTI International, Research Triangle Park, NC). Usual daily intakes of calcium, magnesium, and phosphorus were based on 2-day intake data from CSFII 1994-1996, 1998, and calculated using Software for Intake Distribution from Iowa State University. The percentage of individuals categorized as not meeting the Estimated Average Requirement for magnesium and phosphorus were calculated in the same way.

RESULTS

CSFII 1994-1996, 1998, and NHANES 1999-2000 data both show that African Americans in all age groups consume fewer mean servings per day of total dairy, milk, cheese, and yogurt than non-African Americans, and have lower mean intakes of calcium, magnesium, and phosphorus. Significant differences were seen for men and women.

CONCLUSIONS

In this analysis, young African-American women did not meet Dietary Reference Intakes for phosphorus, and all African Americans did not meet Dietary Reference Intakes for calcium and magnesium. African Americans in all age groups did not meet dairy recommendations from the 2005 US Dietary Guidelines and the 2004 National Medical Association Consensus Report on the role of dairy and dairy nutrients in the diet of African Americans.

Milk and the metabolic syndrome

The metabolic syndrome is a cluster of metabolic disorders, namely dyslipidaemia, hypertension, obesity and glucose intolerance. Insulin resistance is the core phenomenon. Co-occurrence is associated with increased cardiovascular disease (CVD) risk. Observational studies found no increased CVD risk with increasing consumption of milk and other dairy products. In several studies dairy consumption was inversely associated with the occurrence of one or several facets of the metabolic syndrome. Many dairy components may contribute to the beneficial effects. Milk and particularly whey appeared insulinotropic when given in a single meal, but not in longer-term intervention. Medium chain fatty acids improve insulin sensitivity. Whey proteins, amino acids, medium chain fatty acids and in particular calcium and other minerals may contribute to the beneficial effect of dairy products on body weight and body fat. Peptides, calcium and other minerals reduce blood pressure. Fermented products and probiotic bacteria decrease absorption of cholesterol, sphingomyelin of cholesterol and fat, calcium of cholesterol, bile acids and fat. Proteins, peptides and bacteria may also reduce plasma cholesterol. Lactose, citrate, proteins and peptides improve weight control, blood pressure and plasma lipids indirectly, by improving calcium bioavailability. Furthermore, dairy consumption improves the bioavailability of folate and other secondary plant components.

Effect of dairy calcium or supplementary calcium intake on postprandial fat metabolism, appetite, and subsequent energy intake

BACKGROUND

High calcium intake has been shown to increase fecal fat excretion.

OBJECTIVE

Our aim was to examine whether a high calcium intake from dairy products or from supplements affects postprandial fat metabolism and appetite through fat malabsorption.

DESIGN

Four different isocaloric meals were tested in 18 subjects according to a randomized crossover design. The test meals contained high (HC meal: 172 mg/MJ), medium (MC meal: 84 mg/MJ), or low (LC meal: 15 mg/MJ) amounts of calcium from dairy products or a high amount of calcium given as a calcium carbonate supplement (Suppl meal: 183 mg/MJ). Concentrations of plasma total triacylglycerol, chylomicron triacylglycerol, serum total cholesterol, HDL cholesterol, cholecystokinin, glucagon-like peptide 1, ghrelin, peptide YY, glucose, and insulin and appetite sensation were measured before and at regular intervals until 420 min postprandially.

RESULTS

Dairy calcium significantly diminished the postprandial lipid response. The baseline adjusted area under the curve for chylomicron triacylglycerol was approximately 17% lower after the MC meal (P = 0.02) and approximately 19% lower after the HC meal (P = 0.007) than after the LC meal and approximately 15% lower after the MC meal (P = 0.0495) and approximately 17% lower after the HC meal (P = 0.02) than after the Suppl meal. No consistent effects of calcium on appetite sensation, or on energy intake at the subsequent meal, or on the postprandial responses of cholecystokinin, glucagon-like peptide 1, ghrelin, peptide YY, insulin, or glucose were observed.

CONCLUSIONS

Increased calcium intakes from dairy products attenuate postprandial lipidemia, most probably because of reduced fat absorption, whereas supplementary calcium carbonate does not exert such an effect. This may be due to differences in the chemical form of calcium or to cofactors in dairy products. Calcium did not affect appetite sensation, glucose metabolism, or gut hormone secretion.

Calcium and 1,25-dihydroxyvitamin D3 regulation of adipokine expression

OBJECTIVE

Obesity is associated with elevated oxidative stress and low-grade systemic inflammation. We have demonstrated recently that 1alpha,25-(OH)(2)-D(3) promotes reactive oxygen species production in cultured adipocytes, whereas suppression of 1alpha,25-(OH)(2)-D(3) by increasing dietary calcium down-regulates diet-induced oxidative stress in aP2-agouti transgenic mice. However, whether the anti-obesity effect of dietary calcium plays a role in regulation of obesity-associated inflammation is not clear.

RESEARCH METHODS AND PROCEDURES

We investigated the role of dietary calcium in the regulation of inflammatory cytokine production in aP2-agouti transgenic mice fed low- and high-calcium obesigenic diets and in the modulation of cytokine production by 1alpha,25-(OH)(2)-D(3) in cultured murine and human adipocytes.

RESULTS

The high-calcium diet inhibited the expression of pro-inflammatory factors tumor necrosis factor alpha and interleukin (IL)-6 by 64% and 51%, respectively (p < 0.001), in visceral fat, stimulated the expression of the anti-inflammatory factors IL-15 and adiponectin by 52% (p = 0.001) and 54% (p = 0.025), respectively, in visceral fat, and induced a 2-fold increase in IL-15 expression in soleus muscle (p = 0.01) compared with litter mate controls on a low-calcium diet. 1alpha,25-(OH)(2)-D(3) also markedly stimulated the expression of tumor necrosis factor alpha (p < 0.001) and IL-6 (p = 0.016) in differentiated 3T3-L1 adipocytes and increased IL-6 (p = 0.004) and IL-8 (p < 0.001) production in differentiated human adipocytes. These effects were blocked by calcium channel antagonism with nifedipine.

DISCUSSION

These data demonstrate that 1alpha,25-(OH)(2)-D(3) favors inflammatory cytokine expression and inhibits anti-inflammatory cytokine expression; accordingly, suppression of 1alpha,25-(OH)(2)-D(3) by dietary calcium inhibits adipocyte-derived inflammation associated with obesity.

Association between dairy food consumption and weight change over 9 y in 19,352 perimenopausal women

BACKGROUND

Dairy foods may play a role in the regulation of body weight.

OBJECTIVE

We examined the association between changes in dairy product consumption and weight change over 9 y.

DESIGN

The study was conducted in 19 352 Swedish women aged 40-55 y at baseline. Data on dietary intake, body weight, height, age, education, and parity were collected in 1987-1990 and 1997. The intake frequencies of whole milk and sour milk (3% fat), medium-fat milk (1.5% fat), low-fat milk and sour milk (<or=0.5% fat), cheese, and butter were calculated at baseline and follow-up. The women were categorized into 4 groups according to their intake: 1) constant, <1 serving/d; 2) increased from <1 serving/d to >or=1 serving/d; 3) constant, >or=1 serving/d; and 4) decreased from >or=1 serving/d to <1 serving/d. Odds ratios (ORs) with 95% CIs for an average weight gain of >or=1 kg/y were calculated by using multivariable logistic regression analyses, with group 1 as the reference.

RESULTS

Mean (+/-SD) body mass index (in kg/m2) at baseline was 23.7 +/- 3.5. The constant (>or=1 serving/d) intakes of whole milk and sour milk and of cheese were inversely associated with weight gain; ORs for group 3 were 0.85 (95% CI: 0.73, 0.99) and 0.70 (95% CI: 0.59, 0.84) respectively. No significant associations were seen for the other 3 intake groups. When stratified by BMI, the findings remained significant for cheese and, for normal-weight women only, for whole milk and sour milk.

CONCLUSION

The association between the intake of dairy products and weight change differed according to type of dairy product and body mass status. The mechanism behind these findings warrants further investigation.

Effect of 1-year dairy product intervention on fat mass in young women: 6-month follow-up

OBJECTIVE

Previous results from this laboratory suggest that a 1-year dairy intake intervention in young women does not alter fat mass. The objective of this study was to determine the impact of the 1-year dairy intervention 6 months after completion of the intervention.

RESEARCH METHODS AND PROCEDURES

Previously, normal-weight young women (n = 154) were randomized to one of three calcium intake groups: control (<800 mg/d), medium dairy (1000 to 1100 mg/d), or high dairy (1300 to 1400 mg/d) for a 1-year trial (n = 135 completed). In the current study, 51 women were assessed 6 months after completion of the intervention trial. Body compositions (body fat, lean mass) were measured using DXA. Self-report questionnaires were utilized to measure activity and dietary intake (kilocalories, calcium).

RESULTS

The high-dairy group (n = 19) maintained an elevated calcium intake (1027 +/- 380 mg/d) at 18 months compared with the control group (n = 18, 818 +/- 292; p = 0.02). Mean calcium intake over the 18 months predicted a negative change in fat mass (p = 0.04) when baseline BMI was controlled in regression analysis (model R(2) = 0.11). 25-Hydroxyvitamin D levels were correlated with fat mass at each time-point (baseline, r = -0.41, p = 0.003; 12 months, r = -0.42, p = 0.002; 18 months, r = -0.32, p = 0.02) but did not predict changes in fat mass.

DISCUSSION

Dietary calcium intake over 18 months predicted a negative change in body fat mass. Thus, increased dietary calcium intakes through dairy products may prevent fat mass accumulation in young, healthy, normal-weight women.

Girls' dairy intake, energy intake, and weight status

We explored the relationships among girls' weight status, dairy servings, and total energy intake. The hypothesis that consuming dairy could reduce risk for overweight was evaluated by comparing energy intake and weight status of girls who met or consumed less than the recommended three servings of dairy per day. Participants included 172 11-year-old non-Hispanic white girls, assessed cross-sectionally. Intakes of dairy, calcium, and energy were measured using three 24-hour recalls. Body mass index and body fat measures from dual-energy x-ray absorptiometry were obtained. Because preliminary analyses suggested systematic underreporting of energy intake, the relationships among dairy servings and measures of weight status were examined for the total sample and for subsamples of under-, plausible, and overreporters. Data for the total sample provided support for the hypothesized relationship among weight status, dairy servings, and energy intake. Thirty-nine percent of girls reported consuming the recommended >/=3 servings of dairy per day; these girls also reported higher energy intake but had lower body mass index z scores and body fat than the girls who consumed fewer than three dairy servings each day. Among plausible reporters, no relationship between dairy intake and weight status was noted. This discrepancy may be attributable to a high percentage (45%) of overweight underreporters in the total sample. Our findings reveal that reporting bias, resulting from the presence of a substantial proportion of underreporters of higher weight status, can contribute to obtaining spurious associations between dairy intake and weight status. These findings underscore the need for randomly controlled trials to assess the role of dairy in weight management.

Dairy foods, dietary calcium and obesity: a short review of the evidence

The possible association between dairy products consumption and body weight regulation has been the subject of several recent publications. The interest in this issue arose after biologically plausible mechanisms for this association were identified: most of these suggested a key role for calcium intake from dairy products, although calcium-independent mechanisms have also been proposed. Data from cross-sectional epidemiological studies support the hypothesis that a dairy food-rich diet is associated with lower fat accumulation in adults and children; however, prospective studies and randomised controlled intervention trials have yielded inconsistent results. Different reasons could explain these findings that regard the evaluation of either the "exposure" (i.e. the methodological problems in the assessment of dietary intake of nutrients over a long time) and the "outcome" (i.e. multiple factors involved in the regulation of body weight). Moreover, it could also be hypothesised that high consumption of dairy foods would be a marker of healthier lifestyles, or that nutritional differences exist within dairy products. Available data do not unequivocally support the hypothesis that a causal relationship exists between high dairy food intake--and/or high dietary calcium intake--and lower fat mass deposition. However, research in this field should aim to define the health impact of dairy foods even beyond obesity.

The acute effects of different sources of dietary calcium on postprandial energy metabolism

Dairy Ca intake has been shown to be superior to elemental Ca in increasing the loss of body fat during energy restriction. We questioned whether the mechanisms involved an increase in postprandial energy expenditure, fat oxidation and/or a greater lipolysis. The acute effects of different sources of Ca were examined in eight subjects, aged 47-66 years and BMI 27.6-36.1 kg/m2, in a three-way cross-over study. Subjects were randomly provided breakfast meals either low in dairy Ca and vitamin D (LD; control), high in non-dairy Ca (calcium citrate) but low in vitamin D (HC) or high in dairy Ca and vitamin D (HD). Diet-induced thermogenesis, fat oxidation rates (FOR), carbohydrate oxidation rates (COR), insulin, glucose, NEFA and glycerol were measured hourly over a 6 h postprandial period. Postprandial data were calculated as a change (Delta) from the fasting value. Results showed that DeltaNEFA was significantly different between meals (LD -1.50 (sem 0.26), HC -1.22 (sem 0.32), HD -0.94 (sem 0.27) mmol/l x 6 h; P = 0.035), with a lesser suppression following both high-Ca meals. DeltaFOR was significantly higher following the two high-Ca meals (LD -6.5 (sem 2.2), HC 2.93 (sem 2.34), HD 3.3 (sem 2.5) g x 6 h; P = 0.005), while reciprocally DeltaCOR was significantly lower. DeltaGlycerol was less suppressed following the high-Ca meals but statistical significance was not achieved. No differences in diet-induced thermogenesis, insulin or glucose were observed. Regardless of source, Ca intake acutely stimulated postprandial fat oxidation; and there was a lesser suppression of NEFA following these meals.

Calcium intake and disease prevention

While the fundamental metabolic function of calcium is to serve as a second messenger, coupling intracellular responses to extracellular signals, nutritional deficiency of calcium is manifested at a higher level of organization: 1) depletion of the calcium nutrient reserve; 2) inadequate complexation of digestive byproducts; and 3) collateral effects of hormones produced primarily to compensate for low calcium intake. The first mechanism contributes to the osteoporosis problem, the second to kidney stones and colon cancer, and the third to hypertension, preeclampsia, obesity, and insulin resistance, among others. Adequate calcium intakes (10001500 mg/d) in adults have been shown in controlled trials to lower the risk of osteoporotic fractures, kidney stones, obesity, and hypertension. The best source of calcium is dairy foods, largely because the disorders concerned depend upon multiple nutrients, not just calcium, and dairy provides a broad array of essential nutrients in addition to calcium, and at low cost.

From nutrition scientist to nutrition communicator: why you should take the leap

Media reports about new nutrition research are abundant, but they may confuse the public when unqualified sources are quoted, findings are reported out of context, or results appear to contradict previous studies. The nutrition scientist who conducts the research is best qualified to communicate the findings accurately and within context. Yet, some nutrition scientists hesitate to speak out in the media because of barriers such as a lack of time, media skills, and support from administrators or fear that their results will be miscommunicated or sensationalized. Scientists who do grant media interviews enjoy benefits such as positively affecting the public's eating habits, influencing health and nutrition policy, and receiving heightened attention to their work, which can lead to future research funding. Scientists who want to improve their media skills can seek support from their institution's public relations professionals and can learn from continuing education opportunities at conferences and self-study through articles and other resources.

Low dairy intake in early childhood predicts excess body fat gain

OBJECTIVE

To estimate the effect of dairy intake in early childhood on the acquisition of body fat throughout childhood.

RESEARCH METHODS AND PROCEDURES

Ninety-nine of the original 106 families enrolled in the Framingham Children's Study with a child age to 6 years at baseline were followed into adolescence through yearly clinic visits and periodic data collection throughout each year. Dairy intake for these analyses was derived from a mean of 15 days of diet records per subject collected before age 6. A trained examiner took two measurements each year of height, weight, and triceps, subscapular, suprailiac, and abdominal skinfolds using a standardized protocol. Yearly change in body fat was estimated as the slope of these anthropometry measures from ages 5 to 13 years. Early adolescent body fat was estimated as the mean of all available measurements from 10 to 13 years of age.

RESULTS

Children in the lowest sex-specific tertile of dairy intake during preschool (i.e., <1.25 servings per day for girls and <1.70 servings per day for boys) had significantly greater gains in body fat during childhood. These children with low dairy intakes gained more than 3 additional mm of subcutaneous fat per year in the sum of four skinfold measures. By the time of early adolescence, those in the lowest tertile of dairy intake had a BMI that was approximately two units higher and an extra 25 mm of subcutaneous fat.

DISCUSSION

Suboptimal dairy intakes during preschool in this cohort were associated with greater gains in body fat throughout childhood.

Higher satiety ratings following yogurt consumption relative to fruit drink or dairy fruit drink

OBJECTIVES

To compare the satiating power of semisolid and liquid yogurts with fruit beverages and dairy fruit drinks.

DESIGN AND PROCEDURES

Thirty-two volunteers (16 men and 16 women), ages 18 to 35 years, consumed a 200-kcal preload stimulus on four separate occasions. A tray lunch was presented 90 minutes after the preload and food consumption was measured.

METHODS

The stimuli were: a semisolid yogurt containing pieces of peach and eaten with a spoon (378 g), the same yogurt in a drinkable homogenized form (378 g), a peach-flavored dairy beverage (400 mL), and a peach juice beverage (400 mL). Participants rated hunger, thirst, satiety, and desire to eat at baseline and at 20-minute intervals after ingestion.

RESULTS

The two yogurts (semisolid and liquid) led to lower hunger and higher fullness ratings as compared with the fruit drink or dairy fruit drink. There was no difference in satiety profiles between the yogurt that was eaten with a spoon and the drinkable version. Energy intakes at lunch were the same across all four conditions (mean+/-standard deviation, 806+/-43 kcal).

CONCLUSIONS

The two yogurts were more satiating than the two beverages. However, lower hunger and higher fullness ratings after yogurt consumption did not lead to energy compensation at the next meal.