Low carb or low fat diet ?

Diet manakah yang lebih baik, apakah rendah karbohidrat atau rendah lemak ? 

Setelah 2 tahun kedua diet menghasilkan penurunan berat badan, tidak ada perbedaan bermakna pada komposisi tubuh, bone mineral density. Keunggulan diet rendah karbohidrat adalah peningkatan kolesterol-HDL yang signifikan, sehingga lebih menurunkan risiko kardiovaskuler.

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Annals of Internal Medicine vol. 153 no. 3 147-157
August 3, 2010

Weight and Metabolic Outcomes After 2 Years on a Low-Carbohydrate Versus Low-Fat Diet

A Randomized Trial

Gary D. Foster, PhD; Holly R. Wyatt, MD; James O. Hill, PhD;Angela P. Makris, PhD, RD; Diane L. Rosenbaum, BA; Carrie Brill, BS;Richard I. Stein, PhD; B. Selma Mohammed, MD, PhD; Bernard Miller, MD; Daniel J. Rader, MD; Babette Zemel, PhD; Thomas A. Wadden, PhD;Thomas Tenhave, PhD; Craig W. Newcomb, MS; and Samuel Klein, MD

Background: Previous studies comparing low-carbohydrate and low-fat diets have not included a comprehensive behavioral treatment, resulting in suboptimal weight loss.
Objective: To evaluate the effects of 2-year treatment with a low-carbohydrate or low-fat diet, each of which was combined with a comprehensive lifestyle modification program.
Design: Randomized parallel-group trial. (ClinicalTrials.gov registration number:NCT00143936)
Setting: 3 academic medical centers.
Patients: 307 participants with a mean age of 45.5 years (SD, 9.7 years) and mean body mass index of 36.1 kg/m2 (SD, 3.5 kg/m2).
Intervention: A low-carbohydrate diet, which consisted of limited carbohydrate intake (20 g/d for 3 months) in the form of low–glycemic index vegetables with unrestricted consumption of fat and protein. After 3 months, participants in the low-carbohydrate diet group increased their carbohydrate intake (5 g/d per wk) until a stable and desired weight was achieved. A low-fat diet consisted of limited energy intake (1200 to 1800 kcal/d; ≤30% calories from fat). Both diets were combined with comprehensive behavioral treatment.
Measurements: Weight at 2 years was the primary outcome. Secondary measures included weight at 3, 6, and 12 months and serum lipid concentrations, blood pressure, urinary ketones, symptoms, bone mineral density, and body composition throughout the study.
Results: Weight loss was approximately 11 kg (11%) at 1 year and 7 kg (7%) at 2 years. There were no differences in weight, body composition, or bone mineral density between the groups at any time point. During the first 6 months, the low-carbohydrate diet group had greater reductions in diastolic blood pressure, triglyceride levels, and very-low-density lipoprotein cholesterol levels, lesser reductions in low-density lipoprotein cholesterol levels, and more adverse symptoms than did the low-fat diet group. The low-carbohydrate diet group had greater increases in high-density lipoprotein cholesterol levels at all time points, approximating a 23% increase at 2 years.
Limitation: Intensive behavioral treatment was provided, patients with dyslipidemia and diabetes were excluded, and attrition at 2 years was high.
Conclusion: Successful weight loss can be achieved with either a low-fat or low-carbohydrate diet when coupled with behavioral treatment. A low-carbohydrate diet is associated with favorable changes in cardiovascular disease risk factors at 2 years.

Vitamin D dan fungsi kognitif manula

Penelitian ini mendapatkan bahwa kadar vitamin D yang rendah berhubungan dengan penurunan fungsi kognitif pada manula

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Vitamin D and Risk of Cognitive Decline in Elderly Persons

David J. Llewellyn, PhD; Iain A. Lang, PhD; Kenneth M. Langa, MD, PhD; Graciela Muniz-Terrera, PhD;Caroline L. Phillips, MS; Antonio Cherubini, MD; Luigi Ferrucci, MD, PhD; David Melzer, PhD

Arch Intern Med. 2010;170(13):1135-1141. doi:10.1001/archinternmed.2010.173

Background  To our knowledge, no prospective study has examined the association between vitamin D and cognitive decline or dementia.
Methods  We determined whether low levels of serum 25-hydroxyvitamin D (25[OH]D) were associated with an increased risk of substantial cognitive decline in the InCHIANTI population–based study conducted in Italy between 1998 and 2006 with follow-up assessments every 3 years. A total of 858 adults 65 years or older completed interviews, cognitive assessments, and medical examinations and provided blood samples. Cognitive decline was assessed using the Mini-Mental State Examination (MMSE), and substantial decline was defined as 3 or more points. The Trail-Making Tests A and B were also used, and substantial decline was defined as the worst 10% of the distribution of decline or as discontinued testing.
Results  The multivariate adjusted relative risk (95% confidence interval [CI]) of substantial cognitive decline on the MMSE in participants who were severely serum 25(OH)D deficient (levels <25 nmol/L) in comparison with those with sufficient levels of 25(OH)D (75 nmol/L) was 1.60 (95% CI, 1.19-2.00). Multivariate adjusted random-effects models demonstrated that the scores of participants who were severely 25(OH)D deficient declined by an additional 0.3 MMSE points per year more than those with sufficient levels of 25(OH)D. The relative risk for substantial decline on Trail-Making Test B was 1.31 (95% CI, 1.03-1.51) among those who were severely 25(OH)D deficient compared with those with sufficient levels of 25(OH)D. No significant association was observed for Trail-Making Test A.
Conclusion  Low levels of vitamin D were associated with substantial cognitive decline in the elderly population studied over a 6-year period, which raises important new possibilities for treatment and prevention.

Penurunan berat badan mengurangi hot flush

Penelitian ini membuktikan bahwa menurunkan berat badan pada wanita menopause yang overweight dan obes, akan mengurangi hot flushes.

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An Intensive Behavioral Weight Loss Intervention and Hot Flushes in Women

Alison J. Huang, MD; Leslee L. Subak, MD; Rena Wing, PhD; Delia Smith West, PhD; Alexandra L. Hernandez, MPH;Judy Macer, BSc; Deborah Grady, MD; for the Program to Reduce Incontinence by Diet and Exercise Investigators

Arch Intern Med. 2010;170(13):1161-1167. doi:10.1001/archinternmed.2010.162

Background  Higher body mass index is associated with worse hot flushes during menopause but the effect of weight loss on flushing is unclear.
Methods  Self-administered questionnaires were used to assess bothersome hot flushes in a 6-month randomized controlled trial of an intensive behavioral weight loss program (intervention) vs a structured health education program (control) in 338 women who were overweight or obese and had urinary incontinence. Weight, body mass index, abdominal circumference, physical activity, calorie intake, blood pressure, and physical and mental functioning were assessed at baseline and at 6 months. Repeated-measures proportional odds models examined intervention effects on bothersome hot flushes and potential mediating factors.
Results  Approximately half of participants (n = 154) were at least slightly bothered by hot flushes at baseline. Among these women, the intervention was associated with greater improvement in bothersome flushes vs control (odds ratio [OR] for improvement by 1 Likert category, 2.25; 95% confidence interval [CI], 1.20-4.21). Reductions in weight (OR, 1.32; 95% CI, 1.08-1.61; per 5-kg decrease), body mass index (1.17; 1.05-1.30; per 1-point decrease), and abdominal circumference (1.32; 1.07-1.64; per 5-cm decrease) were each associated with improvement in flushing, but changes in physical activity, calorie intake, blood pressure, and physical and mental functioning were not related. The effect of the intervention on flushing was modestly diminished after adjustment for multiple potential mediators (OR, 1.92; 95% CI, 0.95-3.89).
Conclusion  Among women who were overweight or obese and had bothersome hot flushes, an intensive behavioral weight loss intervention resulted in improvement in flushing relative to control.