High Dairy Product Diet Wavers Answers To Adult Obesity

By: Taylor Aasand & Kelsey StultzNovember 2013FSCN 4621W

Taylor Aasand and Kelsey Stultz High Dairy Product Diet Wavers in Answers to Adult Diabetes

ABSTRACT:

Proteins from dairy sources are excellent contributions to a

nutrient balanced diet. Adequate protein intake is essential to healthy living because proteins are involved in nearly every cell function. Scientific evidence has shown that high protein diets support weight loss, but specifically dairy protein and dietary calcium have called for further investigation. The purpose of this systematic review was to assess the effect that a high dairy protein diet has on weight reduction in obese adults. Dairy proteins, calcium intake, and weight loss were key words used in EBSCO and PubMed searches, limited to articles and reviews written within the last 10 years. All five of the random controlled studies found that weight loss was significant in high dairy protein consumption, however, the meta-analysis of 29 studies concluded that high dairy protein intake does not cause a difference in weight loss in obese adults. Overall, this research supports that there is a positive correlation between dairy protein consumption and weight loss. Future research is necessary to investigate the longevity of the maintained weight loss and to examine the specific dairy proteins that are responsible for the correlation. INTRODUCTION: The obesity trend plaguing the United States of America continues to increase at an outstanding rate. Action must be taken to combat the obesity epidemic. According to the Center of Disease Control, over one-third of the American adult population is obese (BMI >30), which is double the percentage of obese adults in 1990.1 Excessive weight gain is one of the leading causes of preventable disease and

conditions, .1 Obesity-related conditions include heart disease, stroke, type 2 diabetes, and certain types of cancerthese are some of the most life threatening conditions impacting our society, today.1 The excess weight is not only affecting the health of individuals but amounting to billions of dollars in medical bills and government expenses as well.1 If nothing is done to reverse the epidemic, more than one billion adults are projected to be obese by 2030.1 There is clearly a desperate need for a solution to the obesity wave plaguing adults, and scientists are beginning to look at dairy product consumption for the answer. Proteins from dairy sources are excellent contributors to a nutrient balanced diet and the support of weight maintenance. Adequate protein intake is essential to healthy living because proteins are involved in nearly every cell function, and they play vital roles in metabolic pathways that support fat reduction. Numerous controlled research studies support a balanced diet being fundamental to a healthy lifestyle, but in order to fight back against a disease as overtaking as obesity, scientists have taken special interests in consumption of dairy products and the select proteins dairy proteins. The purpose of this systematic review was to assess the effect that a high dairy diet, providing high amounts of protein and calcium, has on weight reduction in obese adults. Dairy proteins, calcium intake, and weight loss were key words used in EBSCO and PubMed searches, limited to articles and reviews written within the last 10 years. Five of the random controlled studies found that weight loss was significant in high dairy product consumption; however, another study discusses how multiple variables make it difficult for experts to differentiate between the actual causes of the weight loss. Although the overall trend is a reduction in weight, all of the studies reduced the total caloric intake of

subjects by at least 100 kilocalories a day, so it is not yet possible to draw a conclusion whether or not weight loss in obese adults in truly supported by increases in dairy product consumption alone. BODY: The evidence compiled in this review was strategically chosen to draw conclusions upon whether a high dairy product diet would be beneficial for obese adults. The criteria for a study to be selected depended on its ability to be related to other case studies indifferent to whether they supported or refuted each other. At a mere glance into the literature, a reader might assume that the evidence in each study support the hypothesis that increased dairy protein and calcium intake correlated with weight loss in obese adults because of the mere increase of dairy intake, but sources of protein and calcium is a new and upcoming research field in the fight against obesity. There are different views from the random controlled studies on whether weight loss was significant in high dairy protein and calcium consumption. In addition to these conflicting views, another study discusses the viewpoint of how multiple variables make it difficult for experts to differentiate between the actual causes of the weight loss. In a four-month study, the mean weight loss was 10% in obese adults who were on a 2400 mg/day of dairy and a three-month study found the percentage of weight lost was significantly higher (84.1% higher) than expected.5 The compiled research increased calcium intake from dairy sources by at least 400 mg/calcium a day to support weight loss.5 By analyzing dairy consumption, researchers have also been able to pinpoint the type of weight reduction (lean muscles versus fatty tissue) in subjects. A reduction in fatty tissue is much more useful than loss of lean muscle tissue.2 A loss of mean muscle

tissue could be a sign of malnutrition, which is not as healthy or ideal in the weight reduction process of an obese adult as the loss of fat pads mass.2 A study done by Shi H et al. concluded that fat pads mass in mice decreases after consumption of diets high in diary calcium compared to a diet low in calcium, high in fat and sucrose of equal caloric value.2 The increased calcium intake resulted in greater total and fat pad mass loss due to increased lipolysis and decreased lipogenesis rates compared to the control diets of when the energy intake of obese mice is reduced to 70% of an ad libitum consumption.2 Increased rates of lipolysis breakdown stored fats in adipose tissues to be used as energy. Therefore, a mass reduction results in the mice body composition.2 Zemel et al researched African American obese adults, and found similar results: unintentional weight loss occurred in African American adults one year after being on a higher dairy calcium diet of 1000 mg/day.3 These subjects followed an energy-restricted diet (-2000kJ/day) and increased dairy foods by 1200 to 1300 mg calcium per day.3 After doing so for a year, the experimental group on an energy restricted, high dairy calcium diet (1200 mg a day at least) experienced a greater loss of total body weight and fat mass compared to a calcium-supplemental group given 1200 to 1300 mg calcium per day.3 Both of these groups had greater weight loss than a lowcalcium, placebo treated group on a diet of 400 to 500 mg calcium per day.3 Similar to these two studies, an Israeli research base, Sharar et al, supports the hypothesis of weight loss with added dairy intake.4 A study published in 2007 examined this theory of dairy calcium impacting weight loss specifically in Type 2 diabetic patients.4 The participants were separated into three diet groups, where low fat dairy products could be considered high protein.4 Even though this particular study was not

originally focusing on the effects of dairy calcium, their results supported a newly found hypothesis linking dairy products and dairy calcium to weight loss.4 Shahar et al research results concluded that greater weight loss occurred and was observed by the diabetic patients who consumed a diet high in dairy products over a six month periods compared to the patients who consumed fewer dairy products.4 With the average BMI of the 259 diabetic patients being slightly above 31 kg/m2 , the patients in the highest dairy calcium intake group had a percentage weight change of 8.5 2.9% compared to 7.5 3.3% and 6.4 3.9 for the other two groups. With that said, it is important to note that all participants were on isocaloric-restricted diets.4 However, a study by Bowen et al., and a metanalysis of 29 Randomized Control Trials dig deeper into the reasoning behind the kind of weight that is lost, and why it may not be the most beneficial way to combat the dangers of obesity in adults. Bowen et al research concluded that weight loss was not supported by specific sources of diary consumption.5 The study gathered 50 overweight adults and assigned to either a high dairy diet (2400 mg calcium/day) or a moderate dairy diet (500 mg calcium/day).5 The mean weight loss of 10% observed in both male and females was said to be independent of diet and due solely to restricted caloric intake.5 There was no change in weight when subjects were in a phase of energy balance phase.5 Bowen et al concluded that weight loss was due to the caloric restriction and not from increasing the amount of dairy consumed. Other improvements such as glycemic control, lipid profile, markers of liver and vascular function and blood pressure occurred simply due to the reduction in excessive body fat, independent of the type of dairy products subjects consumed.5 Similarly, The meta-analysis that compiled 29 randomized control trials

delved into the results of studies focusing on the effects of dairy intake and results on body weight and fat. There were 2,101 participants totaling from all of the studies combined, and what was found was that the consumption of dairy products did not result in a significant amount of weight loss, especially when looking at these studies long term.6 The combined weight loss was 0.16 kg, while a short term intervention was only slightly more successful, but seemed to have the adverse effects when the intervention lasted a year or longer.6 It is interesting to note that 22 of the 29 studies analyzed by this study showed significant reduction on body fat only when used co-currently with energy restricted or short term trials. This study does not support increasing dairy product consumption to increase weight loss, but that does not mean there cannot be slight benefit when used with energy-restricted dieting.5 While the mentioned five studies supported or refuted dairy products association improved weight loss, the 2013 study by Jones et al, had intra-study conflicting data. Out of 49 participants who were completing the 12 week study, the participants who were on the high dairy diet (1400mg/day consisting of 500 kcal for dairy) reported they achieved higher weight loss than they and felt more full after eating.7 The control group did not

exceed expectations with their actual weight loss. The most conflicting attribute of this data set is that both groups lost comparable amount of weight - the control group with 2.2 0.5 kg and the high dairy diet group with -3.3 0.6 kg.7 Due to the fact that the actual weight loss in both participating groups was so similar, it is not possible to suggest that consuming more dairy products will lead to increased weight loss, even though participants felt more satiated, as well as, more successful with their weight loss.7

In conclusion, it cannot yet be determined if the validity of consuming greater amounts of dairy products and dairy calcium to increase weight loss due to a variety of factors. Most of these studies included increased dairy product consumption as well as decreased total kilocaloric intake. This complicates the determination if the success was a result to the reduction of calories, the increase in dairy, or a combination of the two. This was the case for the Shahar et al, the Zemel et al, and the Jones et al studies.3,4,7 Additionally, the Jones et al study included self reported energy intake from all participants, as well as, feelings of satiety and hunger. This could make the very little information supporting increasing dairy consumption invalid.7 CONCLUSION: At this point in time, we do not have enough concrete data or evidence fully supporting an increased correlation between dairy product intake and weight loss. More research needs to be done to draw an actual conclusion. Because of the conflicting results founded in the Jones et al study and the conjunction of energy restriction and high dairy intake, we have holes that need to be filled before we have an answer. One way to achieve more success in this area is with further research on this topic. It would be beneficial to include research from randomized control trials with participants who dont display chronic illness, but rather they solely wanted to lose weight to combat obesity. Having published studies that do not restrict the caloric consumption of participants would also be of asset to analyze if increased dairy product consumption can lead to substantial weight loss. Since those studies are not published, we must use what is present as a push for further research into this topic. The interpreted data sets indicate that a diet high in diary products may not be the answer that everyone was hoping for to eradicate obesity. Until further studies are published, consuming a well

balanced diet and regular physical activity will have to suffice until an actual obesity panacea is hypothesized and verified by countless studies.

SOURCES 1. Obesity and Overweight: Topics - DNPAO - CDC. Available at: http://www.cdc.gov/obesity/. Accessed November 4, 2013. 2. Shi H, Dirienzo D, Zemel MB. Effects of dietary calcium on adipocyte lipid metabolism and body weight regulation in energy-restricted aP2-agouti transgenic mice. FASEB J 2001; 15:291293. 3. Zemel MB, Shi H, Greer B, Dirienzo D, Zemel PC. Regulation of adiposity by dietary calcium. FASEB J 2000; 14: 11321138. 4. Shahar DR, Abel R, Elhayany A, Vardi H, Fraser D. Does dairy calcium Intake enhance weightloss among overweight diabetic patients? Diabetes Care. 2007 Mar;30(3): 485-9. 5. Bowen J, Noakes M, Clifton PM. Effect of calcium and dairy foods in High protein, energy-restricted diets on wegith loss and metabolic parameters in overweight adults. Int J Obes. 2005:29(8):957-965. Doi:10.1038/sj.ijo.0802895. 6. Chen M, Pan A, Malik VS, Hu FB. Effects on dairy intake on body weight and fat: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2012 Oct;96(4):735-47. 7. Jones KW, Eller LK, Parnell JA, Doyle-Baker PK, Edwards AL, Reimer RA. Effect of a dairy-and calcium-rich diet on weight loss and appetite during energy restriction in overweight and obese adults; a randomized trial. Eur J Clin Nutr. 2013 Apr;67(4):371-6.

Revision Memo Taylor Aasand and Kelsey Stultz Please attach a revision memo to your revised paper including the following: 1. A summary of the comments and suggestions your peers made about your paper. Our reviewers thought we should go into a little more detail with some of the studies, and fix our grammatical and spelling errors. We also needed to stick to one main topic (we fluctuated between talking about dietary calcium from dairy products and dairy proteins). We decided to be consistent by talking about dairy products and weight loss. We also tried to be more concise with our conclusion about what specifically could be done in future research to gain more promising results. 2. A description of what you changed in moving from the original paper to the revised paper. We listened to what our peer reviewers suggested. We restructured our paper immensely and reworded our sentences for better grammar and flow. We also were consistent with our new topic of increasing dairy proteins and its effect on weight loss. 3. A list of changes you know that you need to make in your final paper, but havent made yet. For our final paper, we think it may be useful to reorganize our studies by paragraph instead of have but still in the sections of studies for dairy products and weight loss and the studies that did not support increasing dairy products and their contributions to weight loss. We think if we broke up those larger paragraphs a bit and went into a bit more detail to link them to other studies, the paper would improve. We just havent made those yet. An even greater emphasis on over-arching points may strengthen the main parts of our paper, which still seem to the fade into the background the more in-depth the paper goes. 4. A brief list of points you would like us to be looking at and specific questions and concerns you have regarding this version of your paper. Please look at the overall structure of the paper and if it makes sense to the reader. Also look to see if our conclusion is strong enough. Do you believe our sources are valid and does each source strengthen our paper? Do you believe we properly and effectively use our sources? Should any part of the paper be eliminated or seems irrelevant? Here are the links to the peer reviews: https://docs.google.com/document/d/1E3jaMbND4WJKvFDOf_INVJcEq6XYvoMrNhof ZQQsOjA/edit?usp=sharing https://docs.google.com/document/d/1NI6CvKNCzEOppwYpnzV4tnV2ASkWW8Br_uz_nhtI6Q/edit?usp=sharing

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