Consider The Evidence: Med/Peds Journal Roundup

August 3, 2006

Actually useful research on dieting?

Filed under: archives of internal medicine, diet, obesity — medblog @ 12:46 pm

ArchIM 6/24 – It is rare enough to see an RCT involving diets, but rarer still to see one with useful results. A study by McMillan-Price in last week’s Archives addressed the issue of diet content. Favor has recently fallen on low glycemic index foods and high protein content. But does this strategy make a difference in weight loss? Yes and No.

The study design divided subjects into 4 groups. Two were high in protein, and two high in carbohydrates. Each pair consisted of a high and low glycemic index group. The overall weight lost was similar in all groups. Bummer, this is starting to look like every other diet trial…

However, LDL levels declined the most in the high-carb, low-glycemic index group, and increased in the high protein, high – GI group. BUT the women in that group (high-protein, high GI) had the greatest number of subjects that lost more than 5% of body weight.

So maybe for women there is something to the Atkins idea as far as weight loss, but this is offset by an increase in cardivascular risk factors(LDL).


July 10, 2006

Decaf Drinkers Deftly Dodge Diabetes

Filed under: archives of internal medicine, caffeine, Coffee, diabetes, diet — medblog @ 11:02 am

ArchivesIM 5/26 – While there has been some recent controversy over the risks and benefits of coffee consumption for diseases such as diabetes and MI, the exact cause for these effects is unknown.

In the current Archives, Pereira et al. present further investigation of this phenomenon using data from an 11-year, 28,000 patient observational trial of post-menopausal women. They found a significant inverse relationship between coffee consumption and incidence of diabetes. In the most comprehensively adjusted model, the results were only significant for decaf drinkers. Unfortunately for the majority, the difference in this model was only significant for drinkers of 4-5, and 6+ cups a day.

Now if they can only explain the purpose of drinking decaf coffee at all, let alone more than six cups of it per day??

March 12, 2006

Soft drinks and pediatric obesity

Filed under: diet, health, pediatrics — medblog @ 10:47 am

Pediatrics 3/06 – Is the availability of sugary sodas contributing to the epidemic of pediatric obesity?
There is plenty of observational data on the subject, but not very many RCTs. An article in the most recent issue of Pediatrics lends some evidence to the argument. Ebbeling et al. investigated whether offering sugar-free beverages changes the diet patterns of children, and whether this leads to a corresponding weight loss. In the study, adolescents in the intervention group were randomly assigned to receive sugar-free beverages delivered to their home.

Among the children who recieved sugar free beverages, the drop in BMI was only significant in those children with a BMI > 30. Children in the intervention group actually lost some weight, while the control subjects gained weight. The results were not incredibly dramatic as the overall effect was less than 1 kg/m^2. However, it is impressive that such a change was caused by just one simple dietary intervention. (more…)

March 11, 2006

Beverage Guidelines stir controversy; Java in JAMA

Filed under: caffeine, Coffee, diet, health, JAMA — medblog @ 6:41 am

A new set of beverage guidelines published in the American Journal of Clinincal Nutririon are causing quite a stir lately. The reccomendations encourage Americans to drink more water or tea and cut back significantly on sweetened sodas. An interesting detail is that the suggestions allow for more beer than lowfat milk on a daily basis. The prominent nutritionists that published the guidelines claim the study was not influenced by funding from the Lipton corporation.

While the above study cites data supporting the safety and possible benefits of caffeine consumption, an article in JAMA addresses the risk of MI from coffee intake. The study by Cornelis et al. links the risk of MI to those that are "slow" caffeine metabolizers. In the study, carriers of a specific CYP1A2 genotype that resulted in slower caffeine metabolism had an increased odds ratio of having an MI if they drank more than 2 cups of coffee per day.

February 9, 2006

Lowfat = Low Yield for preventing CVD? WHI data

Filed under: cardiovascular, diet, JAMA, WHI — medblog @ 6:01 pm

JAMA 2/8 –  Not exactly a home run for the healthy low-fat diet. It is often taken for granted that lowering dietary is key to preventing CVD, and some suggest it may even prevent cancer. However, prospective data on the matter is scarce. This weeks JAMA presents the results of a large RCT on Low-fat diets as part of the Women’s Health Initiative – and the results are not exaclty helping me fight my McDonalds addiction.


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