Diet and physical activity behavior among users of prescription weight loss medications

BACKGROUND: There is limited population-based data on diet and physical activity behaviors and weight loss among users of prescription weight loss medications. Most findings are from clinical settings or from research that includes organized behavioral programs. METHODS: We analyzed data from the 1998 Behavioral Risk Factor Surveillance System, an annual telephone survey conducted in all fifty states, the District of Columbia and Puerto Rico. The sample consisted of 135,435 noninstitutionalized adults aged 18 years old and older. We determined the prevalence and odds of prescription weight loss medication use, odds of 10% weight loss, and among current weight loss medication users, the prevalence and odds for diet and physical activity behaviors. RESULTS: 10.2% of obese women and 3.1% of obese men reported using prescription weight loss medications in the past 2 years. Of users, 28.2% had lost at least 10% of their pretreatment body weight. The odds of losing at least this much weight were higher among women, those who usually consumed ≥ 5 fruits and vegetables daily and those who met physical activity recommendations. Among current prescription weight loss medication users, 26.7% reported both eating fewer calories and meeting recommended leisure-time physical activity levels (<40% of any group met both). Of those meeting both recommendations, almost half (47.2%) had lost 10% of their pretreatment body weight. Of current users, 9% reported using the medications for weight maintenance. CONCLUSIONS: Only 26.7% of prescription weight loss medication users reported following recommended diet and physical activity behaviors. Further research is needed to assess whether behavioral changes are associated with greater weight loss and maintenance among prescription weight loss medication users

Most national, mandatory flour fortification standards do not align with international recommendations for iron, zinc, and vitamin B12 levels

Abstract As national flour fortification standards are one of the policy documents developed to guide food fortification, the objective was to compare national, mandatory wheat and maize flour fortification standards to World Health Organization (WHO) fortification guidelines. For each nutrient in 72 countries' standards, the type of compound was noted as 'yes' if it was included in international guidelines or 'no' if it was not. Nutrient levels in standards were classified as lower than, equal to, or higher than those suggested by WHO. If another food (i.e. rice, oil, milk) was mass fortified with a nutrient categorized as "lower than," the classification was changed to "less than recommendation and included in other mass fortified food". At least 61% of standards included one or more recommended compounds for all nutrients in standards for wheat flour alone (iron, folic acid, vitamin A, zinc, vitamin B12,), wheat and maize flour together (iron, folic acid, vitamin A, zinc, vitamin B12) and maize flour alone (thiamin, riboflavin, niacin, pyridoxine); no country included pantothenic acid in its maize flour standard. For folic acid, vitamin A, thiamin, riboflavin, niacin and pyridoxine, at least 50% of standards (1) met or exceeded WHO suggested levels, or (2) were lower than suggested levels and another food was mass fortified with the specific nutrient in the country. For iron, zinc and vitamin B12, less than 50% of standards met (1) or (2). In conclusion, iron, zinc and vitamin B12 may require the most attention in national fortification standards