Das sind Textbausteine zum Vortrag "Hyperprotein Diets". Es werden Studien und Abstracts und sonstige Kommentare und Bemerkungen aufgefuehrt

1. Obesity and heart failure:
cumulative incidence in women
BMI >30 kg/m2
BMI 25.0-29.9kg/m2
BMI 18.5-24.9kg/m2
Kenchaiah S et al N Engl J Med. 2002 Aug 1;347(5):305-13
Dr. C.P. Davis
Obesity and heart failure:
cumulative incidence in men
BMI >30 kg/m2
BMI 25.0-29.9kg/m2
BMI 18.5-24.9kg/m2
Kenchaiah S et al N Engl J Med. 2002 Aug 1;347(5):305-13
Dr. C.P. Davis
N Engl J Med. 2002 Aug 1;347(5):305-13.Related Articles, Links
Comment in:
N Engl J Med. 2002 Aug 1;347(5):358-9.
N Engl J Med. 2002 Dec 5;347(23):1887-9; author reply 1887-9.
N Engl J Med. 2002 Dec 5;347(23):1887-9; author reply 1887-9.
N Engl J Med. 2002 Dec 5;347(23):1887-9; author reply 1887-9.
N Engl J Med. 2002 Dec 5;347(23):1887-9; author reply 1887-9.
N Engl J Med. 2002 Dec 5;347(23):1887-9; author reply 1887-9.

2. Obesity and the risk of heart failure.
Kenchaiah S, Evans JC, Levy D, Wilson PW, Benjamin EJ, Larson MG, Kannel WB,
Vasan RS.
Framingham Heart Study, Framingham, Mass 01702, USA.
BACKGROUND: Extreme obesity is recognized to be a risk factor for heart failure. It is
unclear whether overweight and lesser degrees of obesity also pose a risk. METHODS: We
investigated the relation between the body-mass index (the weight in kilograms divided by the
square of the height in meters) and the incidence of heart failure among 5881 participants in
the Framingham Heart Study (mean age, 55 years; 54 percent women). With the use of Cox
proportional-hazards models, the body-mass index was evaluated both as a continuous
variable and as a categorical variable (normal, 18.5 to 24.9; overweight, 25.0 to 29.9; and
obese, 30.0 or more). RESULTS: During follow-up (mean, 14 years), heart failure developed
in 496 subjects (258 women and 238 men). After adjustment for established risk factors, there
was an increase in the risk of heart failure of 5 percent for men and 7 percent for women for
each increment of 1 in body-mass index. As compared with subjects with a normal body-mass
index, obese subjects had a doubling of the risk of heart failure. For women, the hazard ratio
was 2.12 (95 percent confidence interval, 1.51 to 2.97); for men, the hazard ratio was 1.90 (95
percent confidence interval, 1.30 to 2.79). A graded increase in the risk of heart failure was
observed across categories of body-mass index. The hazard ratios per increase in category
were 1.46 in women (95 percent confidence interval, 1.23 to 1.72) and 1.37 in men (95
percent confidence interval, 1.13 to 1.67). CONCLUSIONS: In our large, community-based
sample, increased body-mass index was associated with an increased risk of heart failure.
Given the high prevalence of obesity in the United States, strategies to promote optimal body
weight may reduce the population burden of heart failure. Copyright 2002 Massachusetts
Medical Society
PMID: 12151467 [PubMed - indexed for MEDLINE]
BMI and age related mortality
2.4 women 2.4 men age
2.2 2.2 50-54
55-59
2.0 2.0
Relative risk
60-64
1.8 1.8
1.6 1.6
1.4 1.4
1.2 1.2
1.0 1.0
0.8 0.8
21 25 29 33 37 41 21 25 29 33 37 41
BMI (kg/m2) BMI (kg/m2)
after Waaler HT Acta Med Scand Suppl. 1984;679:1-56
Dr. C.P. Davis

3. Acta Med Scand Suppl. 1984;679:1-56.Related Articles, Links
Height, weight and mortality. The Norwegian experience.
Waaler HT.
PMID: 6585126 [PubMed - indexed for MEDLINE]
The diet generation
~ 30% of all male and ~ 45% of all female
US citizens are trying to lose weight
Diet books available on Amazon.com: ~
38’000
Many of these books promote some sort of
CHO restriction and hyperprotein diet
– Dr. Atkins’ New Diet Revolution, The
Carbohydrate Addict’s Diet, Protein Power,
Lauri’s Low-Carb Cookbook
Dr. C.P. Davis
JAMA. 1999 Oct 13;282(14):1353-8. Links
Prevalence of attempting weight loss and strategies for controlling weight.
Serdula MK,
Mokdad AH,
Williamson DF,
Galuska DA,
Mendlein JM,
Heath GW.
Division of Nutrition and Physical Activity, National Center for Chronic Disease Prevention
and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341-3717,
USA.
CONTEXT: Overweight and obesity are increasing in the United States. Changes in diet and
physical activity are important for weight control. OBJECTIVES: To examine the prevalence
of attempting to lose or to maintain weight and to describe weight control strategies among
US adults. DESIGN: The Behavioral Risk Factor Surveillance System, a random-digit
telephone survey conducted in 1996 by state health departments. Setting The 49 states (and
the District of Columbia) that participated in the survey. PARTICIPANTS: Adults aged 18
years and older (N = 107 804). MAIN OUTCOME MEASURES: Reported current weights
and goal weights, prevalence of weight loss or maintenance attempts, and strategies used to
control weight (eating fewer calories, eating less fat, or using physical activity) by population
subgroup. RESULTS: The prevalence of attempting to lose and maintain weight was 28.8%

4. and 35.1 % among men and 43.6% and 34.4% among women, respectively. Among those
attempting to lose weight, a common strategy was to consume less fat but not fewer calories
(34.9% of men and 40.0% of women); only 21.5% of men and 19.4% of women reported
using the recommended combination of eating fewer calories and engaging in at least 150
minutes of leisure-time physical activity per week. Among men trying to lose weight, the
median weight was 90.4 kg with a goal weight of 81.4 kg. Among women, the median weight
was 70.3 kg with a goal weight of 59.0 kg. CONCLUSIONS: Weight loss and weight
maintenance are common concerns for US men and women. Most persons trying to lose
weight are not using the recommended combination of reducing calorie intake and engaging
in leisure-time physical activity 150 minutes or more per week.
PMID: 10527182 [PubMed - indexed for MEDLINE]
Comparison of various diets with regard to
Body Fat, Body Protein and Body Water
Loss of body fat, body protein and body water with differend diets
100%
The best
90%
results were
80% 43
achieved 63
56
70% 66 67
with a 79 75
60%
combination 50% 20
of 50 g of 40% 19
proteins, 25 30% 21
23 22
g CHO, and 20% 37
21
18 25
10 g of fat 10% 16 11 11
3 4
0%
TF MF 1 MF 2 MF 3 MF 4 BN 1 SK 1
TF = total fasting; MF = Modifast, BN = formula w ith inferior
protiens; SK = Schrotkur
Wechsler JG et al. Fortschr Med. 1984 Jun 28;102(24):666-8
Dr. C.P. Davis
Fortschr Med. 1984 Jun 28;102(24):666-8.Related Articles, Links
[Modified fasting in the therapy of obesity. A comparison of total fasting and low-calorie
diets of various protein contents]
[Article in German]
Wechsler JG, Wenzel H, Swobodnik W, Ditschuneit H.
Modified fasting represents a successful therapy for obesity without severe side effects. The
daily energy-substitution (1000-1700 kJ) consists of 30-50 g high quality protein, 20-40 g
carbohydrates and small amounts of fat. The mean weight loss is 11-14 kg in a four-week
treatment period. In contrast to total fasting the weight loss achieved with modified fasting
consisted in a percentage of 79% adipose tissue and a minimal protein loss of 3%. The
nitrogen equilibrium was reached after one to three weeks thus avoiding the risks of greater
protein losses.
PMID: 6469179 [PubMed - indexed for MEDLINE]

5. Comparison of different diets with respect to
compliance
Mean Self-reported Dietary Adherence Scores of All 4 Diet Groups, According to Study Month
CHO- Glucose- Calorie- Fat-restriction
restriction restriction restriction
Dansinger ML et al. JAMA. 2005 Jan 5;293(1):43-53
Dr. C.P. Davis
Comparison of different diets with respect to
weight loss
One-Year Changes in Body Weight as a Function of Diet Group and Dietary Adherence Level for
All Study Participants
Dansinger ML et al. JAMA. 2005 Jan 5;293(1):43-53 Dr. C.P. Davis
JAMA. 2005 Jan 5;293(1):43-53.Related Articles, Links
Comment in:
J Fam Pract. 2005 Apr;54(4):306.
JAMA. 2005 Apr 6;293(13):1589-90; author reply 1590-1.
JAMA. 2005 Apr 6;293(13):1590; author reply 1590-1.
JAMA. 2005 Jan 5;293(1):96-7.
Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and
heart disease risk reduction: a randomized trial.

6. Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ.
Division of Endocrinology, Diabetes, and Metabolism, Atherosclerosis Research Laboratory,
Tufts-New England Medical Center, Boston, Mass 02111, USA. mdansinger@tufts-nemc.org
CONTEXT: The scarcity of data addressing the health effects of popular diets is an important
public health concern, especially since patients and physicians are interested in using popular
diets as individualized eating strategies for disease prevention. OBJECTIVE: To assess
adherence rates and the effectiveness of 4 popular diets (Atkins, Zone, Weight Watchers, and
Ornish) for weight loss and cardiac risk factor reduction. DESIGN, SETTING, AND
PARTICIPANTS: A single-center randomized trial at an academic medical center in Boston,
Mass, of overweight or obese (body mass index: mean, 35; range, 27-42) adults aged 22 to 72
years with known hypertension, dyslipidemia, or fasting hyperglycemia. Participants were
enrolled starting July 18, 2000, and randomized to 4 popular diet groups until January 24,
2002. INTERVENTION: A total of 160 participants were randomly assigned to either Atkins
(carbohydrate restriction, n=40), Zone (macronutrient balance, n=40), Weight Watchers
(calorie restriction, n=40), or Ornish (fat restriction, n=40) diet groups. After 2 months of
maximum effort, participants selected their own levels of dietary adherence. MAIN
OUTCOME MEASURES: One-year changes in baseline weight and cardiac risk factors, and
self-selected dietary adherence rates per self-report. RESULTS: Assuming no change from
baseline for participants who discontinued the study, mean (SD) weight loss at 1 year was 2.1
(4.8) kg for Atkins (21 [53%] of 40 participants completed, P = .009), 3.2 (6.0) kg for Zone
(26 [65%] of 40 completed, P = .002), 3.0 (4.9) kg for Weight Watchers (26 [65%] of 40
completed, P < .001), and 3.3 (7.3) kg for Ornish (20 [50%] of 40 completed, P = .007).
Greater effects were observed in study completers. Each diet significantly reduced the low-
density lipoprotein/high-density lipoprotein (HDL) cholesterol ratio by approximately 10%
(all P<.05), with no significant effects on blood pressure or glucose at 1 year. Amount of
weight loss was associated with self-reported dietary adherence level (r = 0.60; P<.001) but
not with diet type (r = 0.07; P = .40). For each diet, decreasing levels of total/HDL
cholesterol, C-reactive protein, and insulin were significantly associated with weight loss
(mean r = 0.36, 0.37, and 0.39, respectively) with no significant difference between diets (P =
.48, P = .57, P = .31, respectively). CONCLUSIONS: Each popular diet modestly reduced
body weight and several cardiac risk factors at 1 year. Overall dietary adherence rates were
low, although increased adherence was associated with greater weight loss and cardiac risk
factor reductions for each diet group.
Publication Types:
Clinical Trial
Randomized Controlled Trial
PMID: 15632335 [PubMed - indexed for MEDLINE]

7. Comparison of Weight Loss
Foster GD et al. N Enlg J Med 2003 22;348(21):2082-90 Dr. C.P. Davis
N Engl J Med. 2003 May 22;348(21):2082-90. Links
Comment in:
N Engl J Med. 2003 May 22;348(21):2057-8.
N Engl J Med. 2003 May 22;348(21):2136-7.
N Engl J Med. 2003 Sep 4;349(10):1000-2; author reply 1000-2.
N Engl J Med. 2003 Sep 4;349(10):1000-2; author reply 1000-2.
A randomized trial of a low-carbohydrate diet for obesity.
Foster GD,
Wyatt HR,
Hill JO,
McGuckin BG,
Brill C,
Mohammed BS,
Szapary PO,
Rader DJ,
Edman JS,
Klein S.
University of Pennsylvania School of Medicine, Philadelphia, PA 19104-3309, USA.
fosterg@mail.med.upenn.edu
BACKGROUND: Despite the popularity of the low-carbohydrate, high-protein, high-fat
(Atkins) diet, no randomized, controlled trials have evaluated its efficacy. METHODS: We
conducted a one-year, multicenter, controlled trial involving 63 obese men and women who
were randomly assigned to either a low-carbohydrate, high-protein, high-fat diet or a low-
calorie, high-carbohydrate, low-fat (conventional) diet. Professional contact was minimal to
replicate the approach used by most dieters. RESULTS: Subjects on the low-carbohydrate diet
had lost more weight than subjects on the conventional diet at 3 months (mean [+/-SD], -
6.8+/-5.0 vs. -2.7+/-3.7 percent of body weight; P=0.001) and 6 months (-7.0+/-6.5 vs. -3.2+/-
5.6 percent of body weight, P=0.02), but the difference at 12 months was not significant (-
4.4+/-6.7 vs. -2.5+/-6.3 percent of body weight, P=0.26). After three months, no significant
differences were found between the groups in total or low-density lipoprotein cholesterol

8. concentrations. The increase in high-density lipoprotein cholesterol concentrations and the
decrease in triglyceride concentrations were greater among subjects on the low-carbohydrate
diet than among those on the conventional diet throughout most of the study. Both diets
significantly decreased diastolic blood pressure and the insulin response to an oral glucose
load. CONCLUSIONS: The low-carbohydrate diet produced a greater weight loss (absolute
difference, approximately 4 percent) than did the conventional diet for the first six months,
but the differences were not significant at one year. The low-carbohydrate diet was associated
with a greater improvement in some risk factors for coronary heart disease. Adherence was
poor and attrition was high in both groups. Longer and larger studies are required to
determine the long-term safety and efficacy of low-carbohydrate, high-protein, high-fat diets.
Copyright 2003 Massachusetts Medical Society
PMID: 12761365 [PubMed - indexed for MEDLINE]
Urinary Ketosis
Foster GD et al. N Enlg J Med 2003 22;348(21):2082-90 Dr. C.P. Davis
N Engl J Med. 2003 May 22;348(21):2082-90. Links
Comment in:
N Engl J Med. 2003 May 22;348(21):2057-8.
N Engl J Med. 2003 May 22;348(21):2136-7.
N Engl J Med. 2003 Sep 4;349(10):1000-2; author reply 1000-2.
N Engl J Med. 2003 Sep 4;349(10):1000-2; author reply 1000-2.
A randomized trial of a low-carbohydrate diet for obesity.
Foster GD,
Wyatt HR,
Hill JO,
McGuckin BG,
Brill C,
Mohammed BS,
Szapary PO,
Rader DJ,
Edman JS,
Klein S.

9. University of Pennsylvania School of Medicine, Philadelphia, PA 19104-3309, USA.
fosterg@mail.med.upenn.edu
BACKGROUND: Despite the popularity of the low-carbohydrate, high-protein, high-fat
(Atkins) diet, no randomized, controlled trials have evaluated its efficacy. METHODS: We
conducted a one-year, multicenter, controlled trial involving 63 obese men and women who
were randomly assigned to either a low-carbohydrate, high-protein, high-fat diet or a low-
calorie, high-carbohydrate, low-fat (conventional) diet. Professional contact was minimal to
replicate the approach used by most dieters. RESULTS: Subjects on the low-carbohydrate diet
had lost more weight than subjects on the conventional diet at 3 months (mean [+/-SD], -
6.8+/-5.0 vs. -2.7+/-3.7 percent of body weight; P=0.001) and 6 months (-7.0+/-6.5 vs. -3.2+/-
5.6 percent of body weight, P=0.02), but the difference at 12 months was not significant (-
4.4+/-6.7 vs. -2.5+/-6.3 percent of body weight, P=0.26). After three months, no significant
differences were found between the groups in total or low-density lipoprotein cholesterol
concentrations. The increase in high-density lipoprotein cholesterol concentrations and the
decrease in triglyceride concentrations were greater among subjects on the low-carbohydrate
diet than among those on the conventional diet throughout most of the study. Both diets
significantly decreased diastolic blood pressure and the insulin response to an oral glucose
load. CONCLUSIONS: The low-carbohydrate diet produced a greater weight loss (absolute
difference, approximately 4 percent) than did the conventional diet for the first six months,
but the differences were not significant at one year. The low-carbohydrate diet was associated
with a greater improvement in some risk factors for coronary heart disease. Adherence was
poor and attrition was high in both groups. Longer and larger studies are required to
determine the long-term safety and efficacy of low-carbohydrate, high-protein, high-fat diets.
Copyright 2003 Massachusetts Medical Society
PMID: 12761365 [PubMed - indexed for MEDLINE]