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      A Change-Point Regression Approach for Efficacy Evaluation of Dietary Supplements

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          Abstract

          In clinical trials for dietary supplements and functional foods, the study population tends to be a mixture of healthy subjects and those who are not so healthy but are not definitely diseased (called “borderline subjects”). For such heterogeneous populations, the t-test and ANCOVA method often fail to provide the desired treatment efficacy. We propose an alternative approach for the efficacy evaluation of dietary supplements and functional foods based on a change-point linear regression model. The model does not require the assumption of a constant treatment effect and provides clinically interpretable results. By employing the AIC-based profile likelihood method, inferences can be made easily using standard statistical software. The proposed method was applied to the Garcinia study data, and the merit of the method was demonstrated by comparing it with traditional methods.

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          Most cited references13

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          Varying-Coefficient Models

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            Estimation of nutrient requirements from growth data.

            Two least squares methods of estimating nutrient requirements from growth data were compared. One method involved fitting a broken line by the method of least squares. The requirement was taken as the abscissa of the breakpoint in the curve. The other method involved fitting an appropriate exponential function to the growth data and estimating the requirement as the abscissa of the point on the fitted curve whose ordinate was 95% of the upper asymptote. For the nine sets of data studied, the broken line provided adequate fits for only six. The nonlinear models provided adequate fits for all the data studied. When both the broken line and the chosen nonlinear model provided adequate fits, the estimated requirements were nearly the same. However, the consistently good fits obtained with the nonlinear models suggest that this approach may generally be more useful.
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              Dietary medium-chain triacylglycerols suppress accumulation of body fat in a double-blind, controlled trial in healthy men and women.

              We investigated the effect of long-term ingestion of dietary medium-chain triacylglycerols (MCT) on body weight and fat in humans. Using a double-blind, controlled protocol, we assessed the potential health benefits of MCT compared with long-chain triacylglycerols (LCT) in 78 healthy men and women [body mass index (BMI) > or = 23 kg/m(2): n = 26 (MCT), n = 30 (LCT); BMI or = 23 kg/m(2), the extent of the decrease in body weight was significantly greater in the MCT group than in the LCT group. In subjects with BMI > or = 23 kg/m(2), the loss of body fat in the MCT group (-3.86 +/- 0.3 kg) was significantly greater than that in the LCT group (-2.75 +/- 0.2 kg) at 8 wk. In addition, in subjects with BMI > or = 23 kg/m(2), the decrease in the area of subcutaneous fat in the MCT group was significantly greater than that in the LCT group at wk 4, 8 and 12. These results suggest that the MCT diet may reduce body weight and fat in individuals (BMI > or = 23 kg/m(2)) more than the LCT diet.
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                Author and article information

                Journal
                J Clin Biochem Nutr
                JCBN
                Journal of Clinical Biochemistry and Nutrition
                the Society for Free Radical Research Japan (Kyoto, Japan )
                0912-0009
                1880-5086
                May 2009
                25 April 2009
                : 44
                : 3
                : 285-290
                Affiliations
                [1 ]FANCL Research Institute, Evaluation Technology Group, 12-13 Kamishinano, Totsuka-ku, Yokohama, Kanagawa 244-0806, Japan
                [2 ]Biostatistics Center, Kurume University, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan
                [3 ]Graduate School of Medical Sciences, Kyushu University Department of Innovative Applied Oncology, 3-1-1 Maidashi Higashi-ku, Fukuoka 812-8582, Japan
                Author notes
                *To whom correspondence should be addressed. Tel: +81-45-820-3519 Fax: +81-45-820-3509 E-mail: kohayamizu@ 123456fancl.co.jp
                Article
                jcbn08-245
                10.3164/jcbn.08-245
                2675022
                19430619
                5794bcae-05dc-423a-9500-f7681eddbcaf
                Copyright © 2009 JCBN

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 6 November 2008
                : 10 December 2008
                Categories
                Original Article

                Biochemistry
                aic,dietary supplements,change-point,clinical trial
                Biochemistry
                aic, dietary supplements, change-point, clinical trial

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