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      Energy compensation following consumption of sugar-reduced products: a randomized controlled trial

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          Abstract

          Purpose

          Consumption of sugar-reformulated products (commercially available foods and beverages that have been reduced in sugar content through reformulation) is a potential strategy for lowering sugar intake at a population level. The impact of sugar-reformulated products on body weight, energy balance (EB) dynamics and cardiovascular disease risk indicators has yet to be established. The REFORMulated foods (REFORM) study examined the impact of an 8-week sugar-reformulated product exchange on body weight, EB dynamics, blood pressure, arterial stiffness, glycemia and lipemia.

          Methods

          A randomized, controlled, double-blind, crossover dietary intervention study was performed with fifty healthy normal to overweight men and women (age 32.0 ± 9.8 year, BMI 23.5 ± 3.0 kg/m 2) who were randomly assigned to consume either regular sugar or sugar-reduced foods and beverages for 8 weeks, separated by 4-week washout period. Body weight, energy intake (EI), energy expenditure and vascular markers were assessed at baseline and after both interventions.

          Results

          We found that carbohydrate ( P < 0.001), total sugars ( P < 0.001) and non-milk extrinsic sugars ( P < 0.001) (% EI) were lower, whereas fat ( P = 0.001) and protein ( P = 0.038) intakes (% EI) were higher on the sugar-reduced than the regular diet. No effects on body weight, blood pressure, arterial stiffness, fasting glycemia or lipemia were observed.

          Conclusions

          Consumption of sugar-reduced products, as part of a blinded dietary exchange for an 8-week period, resulted in a significant reduction in sugar intake. Body weight did not change significantly, which we propose was due to energy compensation.

          Electronic supplementary material

          The online version of this article (doi:10.1007/s00394-015-1028-5) contains supplementary material, which is available to authorized users.

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          Most cited references34

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          Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans.

          Studies in animals have documented that, compared with glucose, dietary fructose induces dyslipidemia and insulin resistance. To assess the relative effects of these dietary sugars during sustained consumption in humans, overweight and obese subjects consumed glucose- or fructose-sweetened beverages providing 25% of energy requirements for 10 weeks. Although both groups exhibited similar weight gain during the intervention, visceral adipose volume was significantly increased only in subjects consuming fructose. Fasting plasma triglyceride concentrations increased by approximately 10% during 10 weeks of glucose consumption but not after fructose consumption. In contrast, hepatic de novo lipogenesis (DNL) and the 23-hour postprandial triglyceride AUC were increased specifically during fructose consumption. Similarly, markers of altered lipid metabolism and lipoprotein remodeling, including fasting apoB, LDL, small dense LDL, oxidized LDL, and postprandial concentrations of remnant-like particle-triglyceride and -cholesterol significantly increased during fructose but not glucose consumption. In addition, fasting plasma glucose and insulin levels increased and insulin sensitivity decreased in subjects consuming fructose but not in those consuming glucose. These data suggest that dietary fructose specifically increases DNL, promotes dyslipidemia, decreases insulin sensitivity, and increases visceral adiposity in overweight/obese adults.
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            Basal metabolic rate studies in humans: measurement and development of new equations.

            CJK Henry (2005)
            To facilitate the Food and Agriculture Organization/World Health Organization/United Nations University Joint (FAO/WHO/UNU) Expert Consultation on Energy and Protein Requirements which met in Rome in 1981, Schofield et al. reviewed the literature and produced predictive equations for both sexes for the following ages: 0-3, 3-10, 10-18, 18-30, 30-60 and >60 years. These formed the basis for the equations used in 1985 FAO/WHO/UNU document, Energy and Protein Requirements. While Schofield's analysis has served a significant role in re-establishing the importance of using basal metabolic rate (BMR) to predict human energy requirements, recent workers have subsequently queried the universal validity and application of these equations. A survey of the most recent studies (1980-2000) in BMR suggests that in most cases the current FAO/WHO/UNU predictive equations overestimate BMR in many communities. The FAO/WHO/UNU equations to predict BMR were developed using a database that contained a disproportionate number--3388 out of 7173 (47%)--of Italian subjects. The Schofield database contained relatively few subjects from the tropical region. The objective here is to review the historical development in the measurement and application of BMR and to critically review the Schofield et al. BMR database presenting a series of new equations to predict BMR. This division, while arbitrary, will enable readers who wish to omit the historical review of BMR to concentrate on the evolution of the new BMR equations. BMR data collected from published and measured values. A series of new equations (Oxford equations) have been developed using a data set of 10,552 BMR values that (1) excluded all the Italian subjects and (2) included a much larger number (4018) of people from the tropics. In general, the Oxford equations tend to produce lower BMR values than the current FAO/WHO/UNU equations in 18-30 and 30-60 year old males and in all females over 18 years of age. This is an opportune moment to re-examine the role and place of BMR measurements in estimating total energy requirements today. The Oxford equations' future use and application will surely depend on their ability to predict more accurately the BMR in contemporary populations.
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              How many steps/day are enough? Preliminary pedometer indices for public health.

              Pedometers are simple and inexpensive body-worn motion sensors that are readily being used by researchers and practitioners to assess and motivate physical activity behaviours. Pedometer-determined physical activity indices are needed to guide their efforts. Therefore, the purpose of this article is to review the rationale and evidence for general pedometer-based indices for research and practice purposes. Specifically, we evaluate popular recommendations for steps/day and attempt to translate existing physical activity guidelines into steps/day equivalents. Also, we appraise the fragmented evidence currently available from associations derived from cross-sectional studies and a limited number of interventions that have documented improvements (primarily in body composition and/or blood pressure) with increased steps/day.A value of 10000 steps/day is gaining popularity with the media and in practice and can be traced to Japanese walking clubs and a business slogan 30+ years ago. 10000 steps/day appears to be a reasonable estimate of daily activity for apparently healthy adults and studies are emerging documenting the health benefits of attaining similar levels. Preliminary evidence suggests that a goal of 10000 steps/day may not be sustainable for some groups, including older adults and those living with chronic diseases. Another concern about using 10000 steps/day as a universal step goal is that it is probably too low for children, an important target population in the war against obesity. Other approaches to pedometer-determined physical activity recommendations that are showing promise of health benefit and individual sustainability have been based on incremental improvements relative to baseline values. Based on currently available evidence, we propose the following preliminary indices be used to classify pedometer-determined physical activity in healthy adults: (i). or=10000 steps/day indicates the point that should be used to classify individuals as 'active'. Individuals who take >12500 steps/day are likely to be classified as 'highly active'.
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                Author and article information

                Contributors
                +44 (0) 118 378 6418 , j.a.lovegrove@reading.ac.uk
                Journal
                Eur J Nutr
                Eur J Nutr
                European Journal of Nutrition
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1436-6207
                1436-6215
                9 September 2015
                9 September 2015
                2016
                : 55
                : 6
                : 2137-2149
                Affiliations
                [1 ]Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading, Berkshire RG6 6AP UK
                [2 ]Institute for Cardiovascular and Metabolic Research (ICMR), Department of Food and Nutritional Sciences, University of Reading, Reading, Berkshire RG6 6AP UK
                Article
                1028
                10.1007/s00394-015-1028-5
                5009173
                26349919
                89846a39-f55a-4a87-8e78-387c67a7c4a6
                © The Author(s) 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 15 January 2015
                : 26 August 2015
                Categories
                Original Contribution
                Custom metadata
                © Springer-Verlag Berlin Heidelberg 2016

                Nutrition & Dietetics
                sugar,sugar-reduced products,obesity,body weight,dietary energy compensation,artificial sweeteners

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