Weight Loss Among Named Diet Programs . Which diet is best remains unclear. Objective. To determine weight loss outcomes for popular diets based on diet class (macronutrient composition) and named diet. Data Sources. Search of 6 electronic databases: AMED, CDSR, CENTRAL, CINAHL, EMBASE, and MEDLINE from inception of each database to April 2. Study Selection. Overweight or obese adults (body mass index . Fact sheets. Fact sheet on obesity and overweight; Facts and figures on childhood obesity; Global Strategy on Diet, Physical Activity and Health. The fundamental. Healthy Diet for Kids. Dietitian, Juliette Kellow gives practical advice on healthy diet for children - to help make sure they don't gain too much. Learn more about the Dukan Diet, a low carb & low fat type 2 diabetes diet plan that provides a long term solution to help you manage your type II diabetes. 1,600-Calorie Lower Carb Diet Plan; How Many Carbs Are in Vodka? Atkins Diet vs. Zone Diet; Role of Coconut Oil in a Low-Carb Diet; Low-Carb Smoothie Recipes. Constipation in infants and children is a common problem. Most causes of acute constipation can include changes in diet, breastfeeding, fever, etc. However, there are. Importance Many claims have been made regarding the superiority of one diet or another for inducing weight loss. Which diet is best remains unclear. Chris Powell’s diet plan is a high quality, effective weight loss plan that can help everyone! Including people who want to lose a few extra pounds and people who. You can use a measurement called a body mass index, or BMI, along with your waist size, to decide whether your weight is dangerous to your health. The BMI is a. Diet.com provides diet, nutrition and fitness solutions. Meet your weight loss goals today! A Bayesian framework was used to perform a series of random- effects network meta- analyses with meta- regression to estimate the relative effectiveness of diet classes and programs for change in weight and body mass index from baseline. Our analyses adjusted for behavioral support and exercise. Main Outcomes and Measures. Weight loss and body mass index at 6- and 1. Weight loss differences between individual diets were minimal. For example, the Atkins diet resulted in a 1. Zone diet at 6- month follow- up. Between 6- and 1. Weight loss differences between individual named diets were small. Looking for a diet plan? Read about types, features, and other must-know topics in our diet plan buying guide to make an informed choice. This supports the practice of recommending any diet that a patient will adhere to in order to lose weight. These programs represent a multibillion dollar industry. Debate regarding the relative merit of the diets is accompanied by advertising claiming which macronutrient composition is superior, such as a low- carbohydrate diet being better than a low- fat diet, and the benefits of accompanying lifestyle interventions. Establishing which of the major named diets is most effective is important because overweight and obese patients often want to know which diet results in the most effective weight loss. Some physiological explanations regarding the merits of different macronutrient compositions, including variable genetic response to diets with different recommended dietary fat intake, make intuitive sense. Low- carbohydrate diets may drive weight loss due to a higher intake of protein, which may induce a stronger satiating effect than fats and carbohydrates. Despite potential biological mechanisms explaining why some popular diets should be better than others, recent reviews suggest that most diets are equally effective,2,5,6 a message very different from what the public hears in advertisements or expert pronouncements. Only a few of the reviews of named diets have used rigorous meta- analytic techniques to provide quantitative estimates of how much better one diet is compared with another. They also relied on aggregating studies comparing one diet with another and did not have the ability to determine the relative performance of diets when they were not directly compared with one another in clinical trials. By not exploring the full range of potential comparisons in a statistically and methodologically rigorous fashion, these reviews could have missed important benefits of specific diets or their compositions. Network meta- analysis facilitates comparison of different diets using all available randomized clinical trial (RCT) data. In the absence of published head- to- head clinical trials of each diet against each other diet, network meta- analysis uses both direct and indirect clinical trial evidence to estimate their relative effects. Using a network meta- analytic approach, we assessed the relative effectiveness of different popular diets in improving weight loss. We included RCTs that reported weight loss or BMI reduction at 3- month follow- up or longer. Named diets were identified through the explicit naming of the brand, the referencing of branded literature, or the naming of a brand as funders of an article reporting weight loss outcomes from the diet. The diet was labeled as brand- like when the diet met the definition of a branded diet, but failed to name or reference the brand in the article. For example, dietary programs that did not refer to Atkins but consisted of less than 4. Atkins were considered Atkins- like. We included dietary programs with recommendations for daily macronutrient, caloric intake, or both for a defined period (. Eligible programs included meal replacement products but had to consist primarily of whole foods and could not include pharmacological agents. Because it is impossible to provide a placebo diet in a clinical trial, eligible control diets included wait- listed controls, no specific assigned diet, or competing dietary programs. The characteristics of eligible branded dietary programs are reported in e. Table 1 in the Supplement. Secondary outcomes included BMI and adverse events. We considered 3 weight loss effect modifiers that were modeled as present or absent if they were included in an overall dietary program: calorie restriction, exercise, and behavioral support. Based on the lowest estimated caloric intake for sedentary adults, we defined calorie restriction as less than 1. Exercise was defined as having explicit instructions for weekly physical activities and simply dichotomized when differences between varying degrees of exercise frequencies appeared to have negligible effects. Diets with at least 2 group or individual sessions per month for the first 3 months were considered as providing behavioral support. Search Strategy. We searched 6 electronic databases: AMED, CDSR, CENTRAL, CINAHL, EMBASE, and MEDLINE from inception of each database to April 2. Search terms included extensive controlled vocabulary and keyword searches for (RCTs) AND (diets) AND (adults) AND (weight loss). The search strategy is available from the authors upon request. We reviewed bibliographies of review articles and eligible trials, and searched the registries of Clinical. Trials. gov and the meta. Register of Controlled Trials. We contacted the named diet companies and individuals working in the field of obesity and weight management to identify additional or unpublished trials. Reviewers resolved disagreements by discussion. We categorized dietary treatment groups in 2 ways: using diet classes (moderate macronutrient distribution, low carbohydrate, and low fat)1. Diet classes were established by macronutrient content (Table 1). We considered the Lifestyle, Exercise, Attitudes, Relationships, and Nutrition (LEARN) diet akin to a usual care comparator because it is based on a popular program among health professionals, many of whom have been trained in or endorse the program because of it’s practicality, it’s emphasis on behavioral modification, and it’s adaptability to various dieters (eg, applied as either a low- fat or moderate macronutrient composition diet). Continuous outcomes were most often reported as mean change, but sometimes were reported as preintervention and postintervention measures or percentage change. In the latter cases, transformations were used to express weight loss and BMI as mean change. When available, we used P values for group differences to derive the standard deviation of change from baseline. Otherwise, we used the pre- and postintervention standard deviations along with a correlation estimated from studies that reported both change and pre- and postintervention results. In the case of percentage change, we assumed independence. The connectivity of each network meta- analysis was described using density, which was calculated as the ratio of the number of treatment pairs with head- to- head evidence over the total number of treatment pairs. Random- effects pairwise meta- analyses (using the method by Der. Simonian and Laird. To determine weight loss outcomes between diets with all potential comparisons between them, we performed Bayesian network meta- analyses among 5 diet class nodes (no diet, moderate macronutrients, low carbohydrate, low fat, usual care) and each of the 1. When P values were used, all tests were 2- sided with a significance level of . All analyses were conducted using Win. BUGS version 1. 4 (Medical Research Council Biostatistics Unit) and R version 3. R Project for Statistical Computing) with the R2. Win. BUGS, xlsx, and the metafor packages. A detailed description of the statistical analysis appears in the e. Methods in the Supplement. The gray literature search identified 2. Of the total, 8. 89 proved potentially relevant for full- text review and 5. RCTs of 1. 1 branded diets proved eligible (e. Figure 1 in the Supplement). The 4. 8 RCTs included 7. SD, 9 years), median weight of 9. SD, 1. 4. 6 kg), and median BMI of 3. SD, 4. 3). The median duration of the diet intervention across trials was 2. The key characteristics of each included trial appear in Table 2. Forty- three trials (n = 5. The 6- month network meta- analyses were categorized according to diet class (e. Figure 2 in the Supplement) and diet brand (e. Figure 3). Moderate macronutrient and low- carbohydrate diets were the most common diet classes; among these, Atkins, Weight Watchers, and Zone were the brands with the most comparisons. Twenty- five trials (n = 5. Figures 2 and 3 in the Supplement). The diet class network meta- analysis at both time points had a density of 1. Because these network meta- analyses were completely connected, all estimated effects were informed by both direct and indirect evidence. Aside from the 4 named diets that were only connected to a single node (Biggest Loser, Jenny Craig, Nutrisystem, and Volumetrics), the 6- and 1. Twenty- nine trials were at low risk of bias and 1. Compared with no diet, low- carbohydrate diets had a median difference in weight loss of 8. A low- carbohydrate diet resulted in increased weight loss compared with other diet classes (LEARN, moderate macronutrient distribution), but was not distinguishable from low- fat diets. At 1. 2- month follow- up, the estimated average weight losses of all diet classes compared with no diet were approximately 1 to 2 kg less than after 6- month follow- up. The diet classes of low fat (7. At 6- month follow- up, the low- carbohydrate diet class had the highest estimated probability of being superior to all other diet classes at 8. Fatty Liver Diet . Today, it affects as many as 1/3 of Americans and is the leading form of liver disease in the United States. Worse yet, it shows no signs of slowing down and threatens to overwhelm liver transplant programs in the coming decade. According to Dr. Michael Curry, a hepatologist at the Beth Israel Deaconess Medical Center in Boston, about 8. In the other 2. 0%, the condition will progress to non alcoholic steatohepatitis (NASH) and about 2. NASH patients will progress to liver cirrhosis and end stage liver disease. In the United States that means as many as 6 million people could be looking for liver transplants in the near future. The fatty liver epidemic is a silent, but very real threat to the health of many Americans and one Dr. Curry believes could overwhelm liver transplant programs and create a situation where we’re simply unable to treat so many patients. But non alcoholic fatty liver disease isn’t just an American problem. Recent reports out of England, Malaysia, and other countries show similar signs that fatty liver could quickly become a worldwide epidemic. Let’s take a closer look at the disease. What is non alcoholic fatty liver disease? Doctors and medical professionals once believed fatty infiltration of the liver leading to liver damage and liver cirrhosis was caused by excessive alcohol consumption. They termed this condition alcoholic fatty liver disease. While it’s true excessive alcohol consumption CAN and DOES cause liver damage, doctors soon realized there was something else going on when they started seeing patients with the same signs of liver damage, but who had no history of alcoholism. This condition soon became known as non alcoholic fatty liver disease. Put simply, non alcoholic fatty liver disease is the accumulation of fat (triglycerides) in liver cells due to non- alcohol related causes that can eventually lead to liver inflammation, liver scarring, liver cancer, complete liver failure, and death. Some of the contributing factors to fatty liver disease include obesity, type II diabetes (diabetes mellitus), metabolic syndrome, high fat, high fructose, and high glycemic diets coupled with a sedentary lifestyle, hypertension (high blood pressure), high cholesterol, medications and toxins, and insulin resistance. Non alcoholic fatty liver disease generally progresses through the following stages: Simple steatosis (fatty liver)Fatty liver with inflammation (non alcoholic steatohepatitis, NASH)Fatty liver with liver hardening and liver scarring (liver cirrhosis)Liver cancer and/or complete liver failure. Death unless a liver transplant is performed. When too much fat accumulates in the liver, it clogs the spaces surrounding hepatocytes (liver cells), causes the liver to become larger and heavier, impairs the livers ability to filter toxins and other harmful substances from the blood, and reduces its ability to metabolize fats. The earliest stage of fatty liver disease, simple steatosis, is usually easily reversed by dietary and lifestyle changes. However, as liver damage becomes more severe, it can lead to cell death and scarring (liver cirrhosis), at which point it often becomes irreversible and requires a liver transplant to save the life of the patient. Why is non alcoholic fatty liver disease so dangerous? Fatty liver disease is closely associated with obesity and according to the Centers for Disease Control and Prevention, two- thirds of Americans are either overweight or obese. This means it’s a very real threat for almost everyone. The disease is so dangerous because it is what the National Institutes of Health refers to as a “silent disease”. Non alcoholic fatty liver disease develops over a long period of time, but many people experience few, if any, symptoms until the condition worsens to non alcoholic steatohepatitis (NASH) or cirrhosis. Some people may experience a dull or aching pain on the right side of their abdomen, but most don’t. This pain is generally associated with the liver growing larger due to inflammation and stretching the lining of the liver or pressing against other organs. Other fatty liver symptoms include a swollen stomach or ankles, vomiting blood, general fatigue, nausea, loss of appetite, and jaundice. Since the condition has few symptoms, it sneaks up on you and many people fail to seek fatty liver disease treatment early on when the condition is often reversible through a proper fatty liver diet and exercise. The Fatty Liver Diet Guide can show you exactly which foods to eat and which to avoid if you have a fatty liver and provides precise fatty liver diet plans and even fatty liver diet recipes for those who want to be proactive at slowing and reversing the condition before it becomes untreatable. To make matters worse, doctors can easily miss the disease even with the help of ultrasounds and CT scans, and even tests for elevated liver enzymes in the bloodstream aren’t 1. Many times the disease is first noticed during routine checkups or during blood tests for other conditions. A liver biopsy is the best way to get a definitive diagnosis. Annual checkups with your doctor are important to help increase the chance a fatty liver is caught early. If left untreated, NAFLD can bring about much more severe symptoms including brain changes (hepatic encephalopathy) that result from harmful toxins reaching the brain. A healthy liver filters these toxins from the blood so they never reach the brain. A damaged liver is unable to do so which can result in things like memory lapses, trouble sleeping, lack of coordination and balance, and damage to other organs of the body. These more severe fatty liver disease symptoms can often be rather alarming. For example, hepatologists such as Dr. Kevin Mullen from the Case Western Reserve University School of Medicine and Dr. Michael Curry from the Beth Israel Deaconess Medical Center in Boston report seeing patients who have: Exhibited symptoms very similar to Alzheimer’s and dementia. Mistakenly put their laundry in the refrigerator. Forgotten events that just took place the same day. Found themselves in a scalding hot shower and forgot how to turn it off. Walked around the neighborhood naked. Although seldom talked about, the liver performs over 5. Thus, maintaining liver health should be a primary concern for everyone. Failing to do so is a true death sentence. Who is at risk of getting non alcoholic fatty liver disease? The short answer to this question is: everyone. Fatty liver disease can affect men, women, and children of all ages and nationalities. It is most commonly found in people who suffer from type II diabetes and those who are overweight and/or obese (particularly around the mid section). A recent study out of England suggests as many as 5. A poor diet coupled with a lack of exercise are the leading culprits. Some experts believe non alcoholic fatty liver disease will become a silent killer for this generation of children if the obesity epidemic is not kept under control. Most experts also agree that the biggest risk factor to developing non alcoholic fatty liver disease is being overweight. This is true for both children and adults. How to treat non alcoholic fatty liver disease. Currently there is no single fatty liver treatment for ridding the body of non alcoholic fatty liver disease. However, if you suffer from a fatty liver or feel you are at risk of developing fatty liver disease, then here are a few guidelines you should follow to help prevent and reverse the condition: Lose weight gradually and keep it off long- term. Stay away from fad diet programs that recommend starvation diets or extreme gastric bypass surgeries that can actually further exasperate a fatty liver. Instead, try programs like Fat Loss Factor and Paleo Burn to target fat in your mid section. Stay active and exercise at least 3. Recent studies show resistance exercises can help improve a fatty liver and may be easier for people who are overweight and/or obese because they put less demand on the cardio- respiratory system. Make dietary changes that limit fat consumption to less than 3. Be cautious of generalized diet advice such as “eat more fruits and vegetables” as some fruits (particularly those containing large amounts of fructose) can be harmful for people with non alcoholic fatty liver disease. See the Fatty Liver Diet Guide and Fatty Liver Bible for specific diet plans and foods that can be used to reduce liver fat and improve fatty liver disease. Smaller, frequent meals are often better than large feasts for fatty liver patients. Antioxidants such as silymarin (found in milk thistle) and vitamins C and E can help improve liver health when taken in the right ratios and dosages. Don’t miss annual health checkups and stay in touch with your doctor on a regular basis. These are important for catching fatty liver disease early and giving you the best chance of beating the disease before it progresses to liver cirrhosis or liver cancer. Reduce strain on the liver by treating related conditions such as type II diabetes and hypertension. Most importantly, if you’re overweight chances are you already have a fatty liver or will develop a fatty liver in the near future. Be proactive in treating non alcoholic fatty liver disease early on and don’t wait for it to worsen before you take action. By then it may already be too late.
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