Fat oxidation and its relation to serum parathyroid hormone in young women enrolled in a 1-y dairy calcium intervention

Meeting 24-Hour Movement and Dietary Guidelines: Prevalence, Correlates and Association with Weight Status among Children and Adolescents: A National Cross-Sectional Study in China

China is confronted with a “double burden” of underweight and overweight/obesity in children and adolescents. This study aimed to investigate the prevalence and correlates of meeting 24 h movement and dietary guidelines among Chinese children and adolescents. Further, the study aimed to examine the association of meeting 24 h movement and dietary guidelines with weight status in Chinese children and adolescents. A total of 34,887 Chinese children and adolescents were involved. Only 2.1% of participants met the 24 h movement guidelines. Compared to those who met all three 24 h movement guidelines, those who only met the sleep duration guideline was significantly associated with a higher risk of underweight (p < 0.05), and those who only met the moderate-to-vigorous physical activity, or screen time guidelines were significantly associated with a higher risk of overweight/obesity (p < 0.05). Compared with those meeting the dietary guidelines, those who did not meet the soft drink intake guideline had a significantly lower risk of underweight (p < 0.05), those who did not meet the fruit intake guideline had a significantly lower risk of overweight/obesity (p < 0.05), and those who did not meet the milk intake guideline showed a significantly higher risk of overweight/obesity (p < 0.001). These findings indicate a significant association between meeting the 24 h movement and dietary guidelines and weight status among Chinese children and adolescents.

Effect of dairy intake with or without energy restriction on body composition of adults: overview of systematic reviews and meta-analyses of randomized controlled trials

CONTEXT

Some studies suggest that consumption of dairy products can aid in weight loss, while others suggest a negative effect or no effect.

OBJECTIVE

An overview of systematic reviews and meta-analyses was conducted to examine the effect of dairy product consumption on changes in body composition.

DATA SOURCES

PRISMA guidelines were followed to ensure transparent reporting of evidence. The MEDLINE, Embase, Cochrane Central Database of Systematic Reviews, and Web of Science databases were searched from inception to April 2018.

STUDY SELECTION

Six systematic reviews and 47 associated meta-analyses (which included the results of 58 different randomized controlled trials) published in English or Spanish and reporting data on dairy intake and changes in weight, fat mass, lean mass, or waist circumference were included.

DATA EXTRACTION

Two authors independently extracted the data and assessed the risk of bias using the AMSTAR2 tool.

RESULTS

Dairy consumption interventions without dietary energy restriction had no significant effects on weight, fat mass, lean mass, or waist circumference. Interventions in energy-restricted settings had significant effects on fat mass and body weight.

CONCLUSIONS

Increasing total dairy intake without energy restriction in adults does not affect body composition. In the context of an energy-restricted diet, however, increased dairy intake results in lower fat mass and body weight but has no conclusive effects on waist circumference or lean mass.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration number CRD42018094672.

Effect of a low energy diet, containing a high protein, probiotic condensed yogurt, on biochemical and anthropometric measurements among women with overweight/obesity: A randomised controlled trial

BACKGROUND & AIMS

The aim of this study was to determine the effect of low energy diet containing condensed processed yogurt (Kashk), as a high protein, calcium and probiotic enriched product, on glycemic control, lipid profile, anthropometric measurements and blood pressure among women with overweight/obesity.

METHODS

70 women with overweight/obesity were randomly assigned to receive either a low energy diet contained 50 g of Kashk (intervention group) or a low energy diet without Kashk (control group) for 8 weeks. Anthropometric, blood pressure and biochemical measurements were obtained before and after the intervention.

RESULTS

Between-group comparisons showed that the intervention group significantly decreased triglycerides (P = 0.013) and low density lipoprotein cholesterol (P = 0.049) levels relative to the control group. Significantly greater reductions in body mass index (P = 0.018), fat percent (P = 0.037) and waist circumference (P = 0.047) were observed in the intervention group compared to control. Within-group comparisons revealed significant reductions in systolic blood pressure (P = 0.035) and weight (P = 0.005) in the intervention group.

CONCLUSIONS

Long-term consumption of Kashk, as a high protein and calcium product enriched with probiotic that is accompanied by a low energy diet, might have beneficial effects on anthropometric and biochemical indices, though more cross-over and parallel blinded trials with placebo groups are needed to confirm these results. (The clinical trial registration number is IRCT2013042913163N1).

Effects of Dairy Products Consumption on Body Weight and Body Composition Among Adults: An Updated Meta-Analysis of 37 Randomized Control Trials

SCOPE

Effects of dairy consumption on body weight and body composition have been inconsistently observed in randomized control trials (RCTs). Our meta-analysis aims to systematically evaluate the effects of dairy consumption on body weight and body composition among the adults.

METHODS AND RESULTS

We conducted a comprehensive search of the Cochrane Library, PubMed, and Embase databases of the relevant studies from 1966 to Mar 2017 regarding dairy consumption on body weight and body composition including body fat, lean mass, and waist circumference (WC). The summary results are pooled by using a random-effects meta-analysis. Thirty-seven RCTs with 184 802 participants are included in this meta-analysis. High dairy intervention increased body weight (0.01, 95% CI: -0.25, 0.26, I² = 78.3%) and lean mass (0.37, 95% CI: 0.11, 0.62, I² = 83.4%); decreased body fat (-0.23, 95% CI: -0.48, 0.02, I² = 78.2%) and WC (-1.37, 95% CI: -2.28, -0.46, I² = 98.9%) overall. In the subgroup analysis, we found that consumption of dairy products increases body weight (0.36, 95% CI: 0.01, 0.70, I² = 83.1%) among participants without energy restriction. Dairy consumption decreases body weight (-0.64, 95% CI: -1.05, -0.24, I² = 60.2%), body fat (-0.56, 95%CI: -0.95, -0.17, I² = 66.6%), and waist circumference (-2.18, 95%CI: -4.30, -0.06, I² = 99.0%) among the adults with energy restriction.

CONCLUSIONS

This meta-analysis suggests a beneficial effect of energy-restricted dairy consumption on body weight and body composition. However, high dairy consumption in the absence of caloric restriction may increase body weight.

Beverage intake in early childhood and change in body fat from preschool to adolescence

BACKGROUND

Childhood obesity is closely associated with adult obesity, hypertension, and cardiovascular disease. This study's aim was to determine the effects of beverage intake patterns on body composition from early childhood into adolescence in the Framingham Children's Study.

METHODS

Multiple sets of 3-day records were used to assess diet over 12 years, beginning in 1987, in 103 non-Hispanic white boys and girls. BMI, waist circumference, and four skinfolds (triceps, subscapular, suprailiac, and abdominal) were measured yearly. Percent body fat was assessed by dual-energy X-ray absorptiometry at end of follow-up. Analysis of covariance and longitudinal mixed modeling were used to control for potential confounding by age, baseline body fat, percent of energy from fat, television/video viewing time, other beverage intakes not included in exposure group, mother's education, and BMI.

RESULTS

Children with the lowest milk intakes in early childhood had 7.4% more body fat in later adolescence than those with higher intakes (30.0% body fat in tertile 1 vs. 22.6% in tertile 3; p=0.0095). Fruit and vegetable juice was similarly protective-those in the highest tertile of fruit and vegetable juice intake during childhood had an 8.0-cm smaller waist circumference at 15-17 years of age, compared with those in the lowest tertile (p=0.0328). There was no relation between sugar-sweetened beverages (SSBs) and percent body fat (p=0.9296) or other outcomes.

CONCLUSIONS

These results suggest that adequate intakes of milk and fruit and vegetable juice may reduce the risk of excess body fat in later childhood and adolescence. Further, modest intakes of SSBs in early childhood may not adversely affect body fat change.

Effect of a dairy- and calcium-rich diet on weight loss and appetite during energy restriction in overweight and obese adults: a randomized trial

BACKGROUND/OBJECTIVES

A diet rich in dairy and calcium (Ca) has been variably associated with improvements in body composition and decreased risk of type 2 diabetes. Our objective was to determine if a dietary pattern high in dairy and Ca improves weight loss and subjective appetite to a greater extent than a low dairy/Ca diet during energy restriction in overweight and obese adults with metabolic syndrome.

SUBJECTS/METHODS

A total of 49 participants were randomized to one of two treatment groups: Control (low dairy, ≈ 700 mg/day Ca, -500 kcal/day) or Dairy/Ca (high dairy, ≈ 1400 mg/day Ca, -500 kcal/day) for 12 weeks. Body composition, subjective ratings of appetite, food intake, plasma satiety hormones, glycemic response and inflammatory cytokines were measured.

RESULTS

Control (-2.2 ± 0.5 kg) and Dairy/Ca (-3.3 ± 0.6 kg) had similar weight loss. Based on self-reported energy intake, the percentage of expected weight loss achieved was higher with Dairy/Ca (82.1 ± 19.4%) than Control (32.2 ± 7.7%; P=0.03). Subjects in the Dairy/Ca group reported feeling more satisfied (P=0.01) and had lower dietary fat intake (P=0.02) over 12 weeks compared with Control. Compared with Control, Dairy/Ca had higher plasma levels of peptide tyrosine tyrosine (PYY, P=0.01) during the meal tolerance test at week 12. Monocyte chemoattractant protein-1 was reduced at 30 min with Dairy/Ca compared with Control (P=0.04).

CONCLUSIONS

In conclusion, a dairy- and Ca-rich diet was not associated with greater weight loss than control. Modest increases in plasma PYY concentrations with increased dairy/Ca intake, however, may contribute to enhanced sensations of satisfaction and reduced dietary fat intake during energy restriction.

Effect of calcium intake on fat oxidation in adults: a meta-analysis of randomized, controlled trials

Calcium intake is likely to increase body fat loss during energy restriction. Part of this effect may be explained by increased fat oxidation in the presence of a similar energy balance, yet studies have not provided a conclusive answer. Therefore a meta-analysis was performed to determine whether chronic or acute high calcium intake increases fat oxidation. Randomized controlled trials of high calcium intake in human adults where measures of fat oxidation were taken were included. A random-effects meta-analysis was performed on outcomes expressed as standardized mean differences. Chronic high calcium intake increased fat oxidation by a standardized mean difference of 0.42 (95% confidence intervals: 0.14, 0.69; P= 0.003; estimated to correspond to an 11% increase), displaying low heterogeneity (I(2) = 18%), which was more prominent when habitual calcium intake was low (<700 mg d(-1) ). Acute high calcium intake increased fat oxidation by a standardized mean difference of 0.41 (0.04, 0.77; P = 0.03), with low heterogeneity (I(2) = 19%), yet sensitivity analysis revealed that this effect was relatively weak. In conclusion, chronic high calcium intake is likely to increase rates of fat oxidation. The effects of acute high calcium intake appear to point in the same direction, but further work is needed to permit a greater degree of certainty.

Associations between 25-hydroxyvitamin D and weight gain in elderly women

BACKGROUND

25-Hydroxyvitamin D [25(OH)D] levels are lower in obese individuals. Determining whether low vitamin D status can predispose weight gain requires a longitudinal study.

METHODS

From a community-based multicenter U.S. prospective cohort of 9704 (Study of Osteoporotic Fractures [SOF]), 4659 women aged ≥65 with baseline 25(OH)D measurement were followed for 4.5 years. They were weighed at baseline and follow-up visits, and a subset (n=1054) had 25(OH)D levels remeasured at follow-up.

RESULTS

Women with 25(OH)D levels ≥30 ng/mL had lower baseline weight (141.6 pounds) compared to women with 25(OH)D levels <30 ng/mL (148.6 pounds) (p<0.001). Overall, 25(OH)D status was not associated with weight change over 4.5 years, although there was a significant interaction between 25(OH)D status and weight change category (loss, gain, stable) (p<0.0001). In women who gained ≥5% weight, those with baseline 25(OH)D levels ≥30 ng/mL gained 16.4 pounds (12.2% of baseline weight) over 4.5 years compared to 18.5 pounds (13.9% of baseline weight) in women with levels <30 ng/mL (p=0.04). In women who lost ≥5% weight or remained stable (<5% weight change), there was no association between 25(OH)D status at baseline and weight change. Among women who gained weight and had 25(OH)D measured at both visits, having sustained or developing 25(OH)D levels ≥30 ng/mL was associated with less weight gain between visits (14.81 vs. 16.34 pounds, p=0.04).

CONCLUSIONS

Higher 25(OH)D levels are associated with lower weight gains, suggesting low vitamin D status may predispose to fat accumulation.

Effects of dairy intake on body weight and fat: a meta-analysis of randomized controlled trials

BACKGROUND

Some intervention studies have suggested that dairy products may influence body weight, but the results remain controversial.

OBJECTIVE

We identified and quantified the effects of dairy consumption on body weight and fat mass from randomized controlled trials (RCTs).

DESIGN

We conducted a comprehensive search of PubMed and EMBASE databases (to April 2012) of English reports of RCTs regarding dairy consumption on body weight, body fat, or body weight and body fat in adults. The results across studies were pooled by using a random-effects meta-analysis.

RESULTS

Twenty-nine RCTs were included with a total of 2101 participants. Overall, consumption of dairy products did not result in a significant reduction in weight (-0.14 kg; 95% CI: -0.66, 0.38 kg; I² = 86.3%). In subgroup analysis, consumption of dairy products reduced body weight in the context of energy restriction or short-term intervention (<1 y) trials but had the opposite effect in ad libitum dietary interventions or long-term trials (≥1 y). Twenty-two RCTs that reported results on body fat showed a modest reduction in the dairy group (-0.45 kg; 95% CI: -0.79, -0.11 kg; I² = 70.9%), and further stratified analysis indicated significant beneficial effects of dairy intervention on body fat in energy-restricted or short-term trials but not in long-term or ad libitum studies.

CONCLUSIONS

This meta-analysis does not support the beneficial effect of increasing dairy consumption on body weight and fat loss in long-term studies or studies without energy restriction. However, dairy products may have modest benefits in facilitating weight loss in short-term or energy-restricted RCTs.

Mechanistic roles for calcium and vitamin D in the regulation of body weight

Low intakes of calcium and inadequate vitamin D status often cluster with higher prevalence rates of obesity. Consequently, there has been much interest in the mechanisms by which calcium and vitamin D could regulate body weight and adiposity. This review has focused on randomized controlled trials (RCTs) that have manipulated these nutrients and studied pathways of energy balance. Overall, there is consistent evidence that calcium and vitamin D increase whole body fat oxidation after single and multiple meals, and that calcium promotes a modest energy loss through increased faecal fat excretion. The evidence is equivocal for a greater diet-induced thermogenesis, increased lipolysis, suppression of key lipogenic enzymes, decreased hunger ratings or reduced energy/macronutrient intake. Emerging evidence suggests a potential improvement in insulin sensitivity following vitamin D that would impinge on food intake and substrate oxidation. However, the very few RCTs on supplemental vitamin D and energy balance have not explored postprandial avenues of the hormone's actions. Future efforts in this area need to define the threshold intake of these nutrients that would maximize metabolic and gastrointestinal outcomes. Such studies would provide a platform for endorsing the non-skeletal role of calcium and vitamin D in human pathophysiology.

Dairy consumption and cardiometabolic health: outcomes of a 12-month crossover trial

Background

A growing body of research suggests that regular consumption of dairy foods may counteract obesity and other components of the metabolic syndrome. However, human intervention trials are lacking. We aimed to determine the cardiometabolic health effects of increasing the consumption of reduced fat dairy foods in adults with habitually low dairy intakes in the absence of energy restriction.

Methods

An intervention trial was undertaken in 61 overweight or obese adults who were randomly assigned to a high dairy diet (HD, 4 serves of reduced fat dairy/day) or a low dairy control diet (LD, ≤1 serve/day) for 6 months then crossed over to the alternate diet for a further 6 months. A range of anthropometric and cardiometabolic parameters including body composition, metabolic rate, blood lipids, blood pressure and arterial compliance were assessed at the end of each diet phase.

Results

Total energy intake was 1120 kJ/day higher during the HD phase, resulting in slight weight gain during this period. However, there were no significant differences between HD and LD in absolute measures of waist circumference, body weight, fat mass or any other cardiometabolic parameter.

Conclusion

Recommended intakes of reduced fat dairy products may be incorporated into the diet of overweight adults without adversely affecting markers of cardiometabolic health.

Trial Registration

The trial was registered with the Australia and New Zealand Clinical Trials Registry (ACTRN12608000538347) on 24th October, 2008.

Calcium, dairy products, and energy balance in overweight adolescents: a controlled trial

BACKGROUND

Dairy product and calcium consumption have been associated with modifying body fat and body weight in children and adults.

OBJECTIVE

In overweight adolescent boys and girls, we aimed to determine the effect of the doubling of habitual calcium intake to the recommended intake from dairy or calcium carbonate on energy balance and purported mechanisms including fecal fat excretion, macronutrient use, and parathyroid hormone suppression.

DESIGN

Twenty-five girls with a mean (±SD) BMI (in kg/m(2)) of 33 ± 5 and 17 boys with a BMI of 28 ± 5, aged 12-15 y, participated in two 3-wk controlled feeding sessions that used a crossover design in random order as a summer research camp. In one session, 756 mg Ca/d was consumed; in the other session, an additional 650 mg Ca/d was provided as dairy or calcium carbonate supplements that were matched to the control in macronutrient content. Total energy and macronutrient intakes were controlled and were the same for the 2 sessions for each subject. Primary outcome measures were energy balance, fecal fat excretion, lipid oxidation, and postprandial energy expenditure.

RESULTS

There were no effects of quantity or source of calcium on energy or fat balance, despite calcium-induced increases (P <0.01) in postprandial serum parathyroid hormone suppression.

CONCLUSION

These data lend little evidence to support the proposed mechanisms for the relation between an increase in calcium intake from calcium carbonate or dairy and weight loss or weight maintenance in children. This trial was registered at clinicaltrials.gov as NCT00592137.

Dairy Foods in a Moderate Energy Restricted Diet Do Not Enhance Central Fat, Weight, and Intra-Abdominal Adipose Tissue Losses nor Reduce Adipocyte Size or Inflammatory Markers in Overweight and Obese Adults: A Controlled Feeding Study

Background. Research on dairy foods to enhance weight and fat loss when incorporated into a modest weight loss diet has had mixed results. Objective. A 15-week controlled feeding study to determine if dairy foods enhance central fat and weight loss when incorporated in a modest energy restricted diet of overweight and obese adults. Design. A 3-week run-in to establish energy needs; a 12-week 500 kcal/d energy reduction with 71 low-dairy-consuming overweight and obese adults randomly assigned to diets: ≤1 serving dairy/d (low dairy, LD) or ≤4 servings dairy/d (adequate dairy, AD). All foods were weighed and provided by the metabolic kitchen. Weight, fat, intra-abdominal adipose tissue (IAAT), subcutaneous adipose tissue (SAT) macrophage number, SAT inflammatory gene expression, and circulating cytokines were measured. Results. No diet differences were observed in weight, fat, or IAAT loss; nor SAT mRNA expression of inflammation, circulating cytokines, fasting lipids, glucose, or insulin. There was a significant increase (P = 0.02) in serum 25-hydroxyvitamin D in the AD group. Conclusion. Whether increased dairy intake during weight loss results in greater weight and fat loss for individuals with metabolic syndrome deserves investigation. Assessment of appetite, hunger, and satiety with followup on weight regain should be considered.

The high serum monocyte chemoattractant protein-1 in obesity is influenced by high parathyroid hormone and not adiposity

CONTEXT

Chronic high levels of PTH may be associated with up-regulation of proteases and cytokines. Monocyte chemoattractant protein-1 (MCP-1) is an inflammatory cytokine, produced predominantly by macrophages and endothelial cells, and is expressed in adipose tissue. More recently it has been shown that PTH administration increases MCP-1 expression in osteoblasts.

OBJECTIVES

Because both PTH and MCP-1 levels are higher in obesity, the goal was to determine whether the high MCP-1 occurs only in the presence of high serum PTH and is independent of adiposity and examine its relationship with bone mineral density (BMD) and turnover.

DESIGN, SETTING, AND PARTICIPANTS

In this case-control clinical design, 111 eligible women were categorized into four groups: leaner women [body mass index (BMI) 23 ± 2 kg/m(2)] with normal or higher PTH and obese (BMI 44 ± 7 kg/m(2)) with normal or higher PTH.

RESULTS

Serum MCP-1 levels were higher (P < 0.01) in the high (PTH = 74.9 ± 27.0 pg/ml, MCP-1 = 421.5 ± 157.0 pg/ml) compared with normal PTH (PTH = 32.5 ± 10.4 pg/ml, MCP-1 = 322.5 ± 97.8 pg/ml) group, independent of BMI. C-reactive protein and adiponectin were influenced only by BMI and not PTH. MCP-1 was positively associated with osteocalcin and propeptide of type 1 collagen in the leaner (r > 0.3, P < 0.05) but not the obese women and was not associated with BMD in either group.

CONCLUSIONS

Together these data suggest that MCP-1 is higher only in the presence of increased PTH and that adiposity alone cannot explain the higher MCP-1 levels in obesity.

Associations between dairy consumption and body weight: a review of the evidence and underlying mechanisms

As the incidence of obesity is reaching 'epidemic' proportions, there is currently widespread interest in the impact of dietary components on body-weight and food intake regulation. The majority of data available from both epidemiological and intervention studies provide evidence of a negative but modest association between milk and dairy product consumption and BMI and other measures of adiposity, with indications that higher intakes result in increased weight loss and lean tissue maintenance during energy restriction. The purported physiological and molecular mechanisms underlying the impact of dairy constituents on adiposity are incompletely understood but may include effects on lipolysis, lipogeneis and fatty acid absorption. Furthermore, accumulating evidence indicates an impact of dairy constituents, in particular whey protein derivatives, on appetite regulation and food intake. The present review summarises available data and provides an insight into the likely contribution of dairy foods to strategies aimed at appetite regulation, weight loss or the prevention of weight gain.

Dairy food consumption and obesity-related chronic disease

Dairy food comprises a range of different products with varying nutritional components. In the context of a healthy diet, dairy food may provide protection against and amelioration of chronic diseases related to obesity. These include overweight, insulin resistance/metabolic syndrome/type 2 diabetes, hypertension/stroke, and cardiovascular disease. Eliciting how dairy food may have this impact represents a challenge for modern nutritional science and requires an integration of knowledge from observational studies of population dietary patterns and disease prevalence, and experimental studies testing the effect of dairy food consumption. It also benefits from the recent identification of biomarkers of dairy fat intake and from mechanistic studies that support the plausibility of the observed effects. Future research might discriminate between types of dairy foods and focus on the synergy provided by the food matrix, rather than simply the component parts of the food.

Postprandial energy metabolism in the regulation of body weight: is there a mechanistic role for dietary calcium?

There has been much interest in the mechanisms by which calcium may attenuate weight gain or accelerate body fat loss. This review focuses on postprandial energy metabolism and indicates that dietary calcium increases whole body fat oxidation after single and multiple meals. There is, as yet, no conclusive evidence for a greater diet induced thermogenesis, an increased lipolysis or suppression of key lipogenic enzyme systems. There is however convincing evidence that higher calcium intakes promote a modest energy loss through increased fecal fat excretion. Overall, there is a role for dietary calcium in human energy metabolism. Future studies need to define threshold intakes for metabolic and gastrointestinal outcomes.

The role of dairy foods and dietary calcium in weight management

Overweight and obesity are the foremost public health problems in the U.S., other industrialized countries, and is rapidly increasing in developing countries. Obesity is a multifaceted disease which requires multiple approaches to successfully combat its increase. Nutritional factors play a key role and include modification of energy balance, intake and expenditure, as well as other factors. Emerging scientific evidence over the past decade suggests that dairy foods may be beneficial when included in a moderate energy restricted diet and possibly for weight maintenance as well. This paper provides a review of some of the scientific evidence that has examined the effect of dairy foods and dietary calcium on weight management. Topic areas presented are observational or retrospective studies with adults as well as children and adolescents; randomized clinical trials on body weight and composition, energy expenditure, substrate oxidation and fecal fat loss; research from animal and in vitro studies provide possible mechanisms of action.

Proposed role of calcium and dairy food components in weight management and metabolic health

Dietary calcium and dairy foods have demonstrated an antiobesity effect in animal studies, observational and population studies, and randomized clinical trials. Moreover, there is a strong theoretical framework to explain the effects of dietary calcium on energy metabolism. The supporting mechanisms include dietary calcium-correcting suboptimal calcium intakes, thereby preventing the endocrine response (parathyroid hormone [PTH] and calcitriol), which favors adipocyte energy storage and inhibits adipocyte loss via apoptosis. Dietary calcium appears to further promote energy loss via formation of calcium soaps in the gastrointestinal tract and thereby modestly reduces net energy absorption. Dietary calcium appears to be responsible for approximately 50% of the antiobesity bioactivity of dairy foods. The additional dairy bioactivity has not been fully identified, but is primarily localized in whey protein. The major components are the angiotensin-converting enzyme (ACE) inhibitor activity of whey proteins and the high concentration of leucine in whey. This high leucine content appears to be primarily responsible for the repartitioning of dietary energy from adipose tissue to skeletal muscle during weight loss, resulting in greater preservation of skeletal muscle and accelerated loss of adipose tissue during negative energy balance. Finally, high-calcium diets suppress obesity-induced oxidative and inflammatory stress independently from its role in modulating adiposity; these effects are similarly augmented by other dairy food components. However, the number of randomized clinical trials conducted is still modest, and a small number have not confirmed significant effects in weight management. Thus, the protective effects of dairy foods against obesity and its comorbidities are promising, but warrant further large-scale studies.

Preponderance of the evidence: an example from the issue of calcium intake and body composition

Meta-analysis is typically applied to studies developed in fairly mature fields, but may be ill-suited for younger fields in which most of the evidence comes from studies that were designed for other endpoints entirely and that are often significantly underpowered for the effect in question. Here, there are no generally accepted methods for getting a grasp on the preponderance of the evidence. In this review, one way of doing so is proposed and the recently emergent literature concerning calcium intake and body composition is used as an illustration of how such an approach might be used.

Dietary intervention with vitamin D, calcium, and whey protein reduced fat mass and increased lean mass in rats

The aim of the current study was to determine the effects and the mechanisms of inclusion of dietary whey protein, high calcium, and high vitamin D intake with either a high-sucrose or high-fat base diets on body composition of rodents. Male Wistar rats were assigned to either no whey protein, suboptimal calcium (0.25%), and vitamin D (400 IU/kg) diet (LD), or a diet containing whey protein, high calcium (1.5%), and vitamin D (10 000 IU/kg) diet (HD), and either high-fat (40% of energy) or high-sucrose (60%) base diets for 13 weeks. Liver tissue homogenates were used to determine [(14)C]glucose and [(14)C]palmitate oxidation. mRNA expression of enzymes related to energy metabolism in liver, adipose, and muscle, as well as regulators of muscle mass and insulin receptor was assessed. The results demonstrated that there was reduced accumulation of body fat mass (P = .01) and greater lean mass (P = .03) for the HD- compared to LD-fed group regardless of the background diet. There were no consistent differences between the LD and HD groups across background diets in substrate oxidation and mRNA expression for enzymes measured that regulate energy metabolism, myostatin, or muscle vascular endothelial growth factor. However, there was an increase in insulin receptor mRNA expression in muscle in the HD compared to the LD groups. In conclusion, elevated whey protein, calcium, and vitamin D intake resulted in reduced accumulation of body fat mass and increased lean mass, with a commensurate increase in insulin receptor expression, regardless of the level of calories from fat or sucrose.

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.

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.

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.

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.

Greater resting energy expenditure and lower respiratory quotient after 1 week of supplementation with milk relative to supplementation with a sugar-only beverage in children

Previous studies have linked overweight to lower milk and calcium consumption and have proposed a role of milk consumption on energy expenditure (EE). The goal of this study was to compare EE and food intake after a meal of either mixed-nutrient or single-nutrient beverage and examine whether supplementation with that beverage for 1 week will impact EE. This was a randomized, controlled crossover study testing the effect of 2 beverages, milk or fruit-flavored beverage, before and after a supplementation period of 1 week on EE. Food intake at a meal after a snack intake of each beverage was assessed at the end of each measurement period. Ten children, aged 9 to 10 years, participated in all of the testing sessions in the study. There was a significant beverage by testing day interaction on daily EE and thermic effect of food (TEF), whereby EE was greater with milk consumption relative to the fruit-flavored beverage on day 8 (P = .0014) and with fruit-flavored beverage consumption on day 1 vs day 8 (P = .01). Similarly, the TEF was greater with milk compared with fruit-flavored beverage consumption on day 8 (P = .0007) and with fruit-flavored beverage consumption on day 1 relative to day 8 (P = .0097). The TEF declined more rapidly during 6 hours after a fruit-flavored beverage than a milk meal (P = .0018). Food intake did not differ after snack consumption of each beverage before and after milk and fruit-flavored beverage supplementation periods. Over the longer term, consumption of milk beverages may have more favorable effects on energy balance in children than consumption of fruit-flavored beverages.

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.

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.

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.