Making progress on the global crisis of obesity and weight management

No abstract available

Artificial trans fat in popular foods in 2012 and in 2014:a market basket investigation in six European countries

OBJECTIVE: To minimise the intake of industrially produced trans fat (I-TF) and thereby decrease the risk of coronary heart disease (CHD), nearly all European countries rely on food producers to voluntarily reduce the I-TF content in food. The objective of this study was to monitor the change in presence of I-TF in biscuits/cakes/wafers in six countries in South-eastern Europe from 2012 to 2014, including two members of the European Union (Slovenia and Croatia). DESIGN: Three large supermarkets were visited in each of the six capitals in 2012. Pre-packaged biscuits/cakes/wafers were bought if the products contained more than 15 g of total fat per 100 g of product and if partially hydrogenated oil or a similar term was disclosed at the beginning of the ingredients list. These same supermarkets were revisited in 2014 and the same collection procedure was followed. All foods were subsequently analysed for total fat and trans fat in the same laboratory. RESULTS: The number of packages bought in the six countries taken together was 266 in 2012 and 643 in 2014. Some were identical, and therefore only 226 were analysed in 2012 and 434 in 2014. Packages with less than 2% of fat from I-TF went up from 69 to 235, while products with more than 2% (illegal in Denmark) doubled from an average of 33 to an average of 68 products for the six countries, with considerable variation across countries. The per cent of I-TF in total fat decreased slightly, from a mean (SD) of 22 (13) in 2012 to 18 (9) in 2014. CONCLUSIONS: The findings suggest that voluntary reduction of I-TF in foods with high amounts is an ineffective strategy in several European countries. Alternative strategies both within and outside the European Union are necessary to protect all subgroups of the populations against an increased risk of CHD

Medical management of obesity in Scandinavia 2016

Peer reviewe

Systematic review and meta-analysis of dietary carbohydrate restriction in patients with type 2 diabetes

OBJECTIVE: Nutrition therapy is an integral part of self-management education in patients with type 2 diabetes. Carbohydrates with a low glycemic index are recommended, but the ideal amount of carbohydrate in the diet is unclear. We performed a meta-analysis comparing diets containing low to moderate amounts of carbohydrate (LCD) (energy percentage below 45%) to diets containing high amounts of carbohydrate (HCD) in subjects with type 2 diabetes. RESEARCH DESIGN AND METHODS: We systematically reviewed Cochrane library databases, EMBASE, and MEDLINE in the period 2004–2014 for guidelines, meta-analyses, and randomized trials assessing the outcomes HbA1c, BMI, weight, LDL cholesterol, quality of life (QoL), and attrition. RESULTS: We identified 10 randomized trials comprising 1376 participants in total. In the first year of intervention, LCD was followed by a 0.34% lower HbA1c (3.7 mmol/mol) compared with HCD (95% CI 0.06 (0.7 mmol/mol), 0.63 (6.9 mmol/mol)). The greater the carbohydrate restriction, the greater the glucose-lowering effect (R=−0.85, p<0.01). At 1 year or later, however, HbA1c was similar in the 2 diet groups. The effect of the 2 types of diet on BMI/body weight, LDL cholesterol, QoL, and attrition rate was similar throughout interventions. LIMITATIONS: Glucose-lowering medication, the nutrition therapy, the amount of carbohydrate in the diet, glycemic index, fat and protein intake, baseline HbA1c, and adherence to the prescribed diets could all have affected the outcomes. CONCLUSIONS: Low to moderate carbohydrate diets have greater effect on glycemic control in type 2 diabetes compared with high-carbohydrate diets in the first year of intervention. The greater the carbohydrate restriction, the greater glucose lowering, a relationship that has not been demonstrated earlier. Apart from this lowering of HbA1c over the short term, there is no superiority of low-carbohydrate diets in terms of glycemic control, weight, or LDL cholesterol