[Show abstract][Hide abstract] ABSTRACT: Raisins are widely recommended as good foods and preferred snacks because of their nutrient content. They are rich in dietary fiber, potassium, and many health-promoting phytonutrients and antioxidants. Raisins have a high dietary fiber score. Laboratory studies document that raisins rank in the upper quartile of foods for antioxidant content. Clinical research related to the potential health benefits of raisins has intensified over the past 10 y. Much of this research has focused on blood glucose and insulin responses to raisins compared to other foods or snacks. Meal studies indicate that raisins have a low to moderate glycemic index and a low insulinemic index. Longer term studies suggest that customary intake of raisins is associated with lower postprandial blood glucose values than with equicaloric control foods. Cross-sectional studies suggest that higher levels of dried fruit consumption are associated with lower systolic and diastolic blood pressure than seen with minimal dried fruit use. One clinical study documents that raisin intake over 12 wk is accompanied by a significant reduction in blood pressure. Preliminary results indicate that raisins are associated with increased satiety and decreased food consumption over an 8-h period, but the potential benefits of raisins for weight loss have not been assessed. Raisin intake is accompanied by reductions in serum low-density lipoprotein cholesterol, triglycerides, and oxidized low-density cholesterol values. Thus, raisins have the potential to significantly reduce the risk for developing diabetes or cardiovascular disease.
[Show abstract][Hide abstract] ABSTRACT: Health professionals are in need of more information about the weight-loss outcomes of using commercial weight-loss programs.
A commercial behavioral intervention program using meal replacements, fruits, and vegetables (MR-FV) was compared with usual-care weight-loss counseling.
Obese volunteers were randomly allocated to usual-care weight-loss counseling or participation in an MR-FV standardized behavioral education program. The MR-FV group attended weekly weight-loss classes for 16 weeks and weekly maintenance classes for 8 weeks.
Obese women or men aged 20 to 65 years were recruited from the community through a commercial program provided at a university medical center.
The control group (C group) received weight-management counseling from an experienced dietitian, while the intervention group (MR-FV group) participated in scheduled behavioral weight-loss classes. The MR-FV group participants were encouraged to consume 3 shakes, 2 entrées, and 5 servings of fruits or vegetables daily, and achieve physical activity goals (expend ≥ 8.4 mJ/week); they kept records and placed midweek phone calls. The C group was counseled at baseline, 8 weeks, and 16 weeks.
Both groups were seen at baseline, and 8, 16, and 24 weeks for assessment of weight, risk factors, and side effects.
The primary data analysis was intention to treat.
Thirteen of 16 subjects (81.3%) in the C group and 18 of 22 subjects (81.8%) in the MR-FV group completed the 24-week study. Mean weight losses for the C group were: 1.3% (standard error [SE], 0.9) at 8 weeks; 0.7% (SE, 1.1) at 16 weeks; and 0.7% (SE, 1.1) or 0.7 kg at 24 weeks. Mean weight losses for the MR-FV group were: 8.5% (SE, 0.6) at 8 weeks, 12.5% (SE, 0.9) at 16 weeks, and 13.9% (SE, 1.1) or 13.7 kg at 24 weeks.
A behavioral intervention with a low-energy diet including 5 meal replacements and 5 servings of fruits or vegetables enabled obese individuals to lose 13 kg more than control subjects over a 24-week period.
Postgraduate Medicine 09/2011; 123(5):205-13. · 1.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Prior studies suggest soluble fibers may favorably affect glucose/insulin metabolism.
This prospective, randomized, placebo controlled, double blind, parallel group trial evaluated 50 generally healthy subjects without prior diagnosis of diabetes mellitus (44 completers), who were administered beverages containing placebo (control), lower dose (3 g/d), or higher dose (6 g/d) reduced viscosity barley β-glucan (BBG) extract. Subjects (68% women) mean age 56 years, Body Mass Index (BMI) 32 kg/m2 and baseline fasting plasma glucose 102 mg/dl were instructed to follow a weight-maintaining Therapeutic Lifestyle Changes (TLC) diet and consumed three 11 oz study beverages daily with meals for 12 weeks. The four primary study endpoint measures were plasma glucose and insulin [each fasting and post-Oral Glucose Tolerance Testing (OGTT)].
Compared to placebo, administration of 3 g/d BBG over 12 weeks significantly reduced glucose incremental Area Under the Curve (iAUC) measures during OGTT and 6 g/d BBG over 12 weeks significantly reduced fasting insulin as well as the related homeostasis model assessment of insulin resistance (HOMA-IR). Beverages were generally well tolerated with no serious adverse experiences and no significant differences between groups for adverse experiences. Per protocol instruction, subjects maintained body weight.
These findings suggest 6 g/d BBG consumed in a beverage over 12 weeks may improve insulin sensitivity among hyperglycemic individuals with no prior diagnosis of diabetes mellitus, and who experience no change in body weight.
ClinicalTrials.gov Identifier: NCT01375803.
[Show abstract][Hide abstract] ABSTRACT: Many randomized controlled trials (RCTs) have assessed the effects of soy protein on serum lipoprotein risk factors for coronary heart disease (CHD). This review and meta-analysis assessed the quality of these RCTs and estimated the effects of soy protein consumption on serum lipoproteins.
A comprehensive search using multiple databases was conducted for the years 1996 through 2008 to identify clinical trials related to soy protein intake and serum lipoprotein changes. STUDY ELIGIBILITY: RCTs were assessed that met these requirements: soy protein intake compared with nonsoy protein, provided information on serum low-density lipoprotein (LDL)-cholesterol values, provided no more than 65 g of soy protein daily, and obtained LDL-cholesterol measurements between 4 and 18 weeks of treatment. Randomized parallel and crossover studies were evaluated.
Studies were graded for quality using 12 criteria with a possible maximum grade of 24. Net changes in lipoproteins with soy protein consumption compared with nonsoy control diets were analyzed by meta-analyses and funnel plots. Confidence intervals were constructed using inverse weighting. Analyses compared parallel to crossover studies and studies with lower and higher grades.
Analyses included 20 parallel-design studies and 23 crossover studies. Parallel studies scored significantly higher (p < 0.001) in study quality, with a mean grade of 15.8 (95% confidence interval [CI], 14.3 to 17.3) compared with 10.1 (95% CI, 8.2 to 11.9) for crossover trials. Soy protein intake was associated with net changes in serum LDL-cholesterol values of -0.23 mmol/l (95% CI, -0.28 to -0.18 mmol/l) or a 5.5% reduction in parallel studies and -0.16 mmol/l (95% CI, -0.22 to -0.11 mmol/l) or a reduction of 4.2% with crossover studies (p < 0.001 for parallel vs crossover). In parallel studies, net serum HDL-cholesterol values were 3.2% higher (p < 0.007) with soy vs control, and fasting serum triacylglycerol values were 10.7% lower (p < 0.008) for soy vs control.
Soy protein consumption with a median of 30 g/d was associated with a significant improvement in lipoprotein risk factors for CHD. Compared with crossover RCTs, parallel RCTs had significantly higher quality grades and were associated with significantly greater improvements in serum LDL-cholesterol values. Regular consumption of 1 to 2 servings of soy protein daily (15 to 30 g) has a significant favorable impact on serum lipoprotein risk factors for CHD.
Journal of the American College of Nutrition 04/2011; 30(2):79-91. · 1.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Medical costs of obesity in the United States exceed $147 billion annually with medication costs making a sizable contribution. We examined medication costs associated with substantial weight losses in an intensive behavioral weight loss program. Inclusion criteria were medication use for obesity co-morbidities: hypertension, diabetes, dyslipidemia, degenerative joint disease, or gastroesophageal reflux disease. Group A, 83 obese patients on medications completed 8 weeks of classes, lost 19 kg in 20 weeks. Group B, 100 severely obese patients, lost 59 kg in 45 weeks. Medications were discontinued: Group A, 18%; Group B, 64%. Mean numbers of medications decreased significantly for all co-morbidities. Mean numbers of daily medications, initial and final, respectively were: Group A, total, 3.0 ± 0.2 (mean ± SEM) and 1.7 ± 0.2; Group B, total, 2.5 ± 0.2 and 0.7 ± 0.1. Monthly costs for all medications decreased significantly for all co-morbidities and were as follows: Group A, total, $249 ± 25 and $153 ± 19; Group B: total, $237 ± 27 and $65 ± 12. Medically supervised weight loss is very effective approach for improving cardiovascular risk factors and reducing medical costs.
Current clinical pharmacology. 09/2010; 5(4):232-8.
[Show abstract][Hide abstract] ABSTRACT: Nonalcoholic fatty liver disease (NAFLD) is very prevalent in obese patients. However, increases in serum aminotransferase levels after weight loss have raised clinical concerns. This study documented sequential changes of serum aminotransferase levels for severely obese patients who lost a substantial amount of weight in a behavioral weight loss program. One hundred three severely obese patients who lost > 45.5 kg were treated in our clinic's weight management program. The prevalence of all risk factors except diabetes was higher among those with elevated (AE) baseline serum alanine transferase (ALT) levels than those with normal levels (AN). Weight losses at 8 and 24 weeks were 19.8 and 43.5 kg in the AN group (n = 79 patients) and 21.8 and 45.5 kg in the AE group (n = 24 patients), respectively. Total weight losses after completion of the program were 58.4 kg in the AN group and 57.6 kg in the AE group. The baseline levels for the AN group were: ALT, 25.4 U/L and aspartate aminotransferase (AST)/ALT ratio, 0.87. The baseline levels for the AE group were: ALT, 68.0 U/L and AST/ALT ratio, 0.61. Peak ALT levels were 75.4 U/L in the AN group and 94.0 U/L in the AE group. The final serum ALT levels were 23.7 U/L and 27.3 U/L in the AN and AE groups, respectively. This severely obese population had a very high frequency of ALT elevations with weight loss, but elevations were transient; values usually returned to below baseline levels after substantial weight loss.
Postgraduate Medicine 07/2010; 122(4):206-12. · 1.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A food can be regarded as 'functional' if it can demonstrate a beneficial efficacy on one or more target functions in the body in a convincing way. Beyond adequate nutritional qualities, functional foods should either improve the state of health and wellbeing and/or reduce the risk of disease. Functional foods that are marketed with claims of heart disease reduction focus primarily on the major risk factors, i.e. cholesterol, diabetes and hypertension. Some of the most innovative products are designed to be enriched with 'protective' ingredients, believed to reduce risk. They may contain, for example, soluble fibre (from oat and psyllium), useful both for lowering cholesterol and blood pressure, or fructans, effective in diabetes. Phytosterols and stanols lower LDL-cholesterol in a dose-dependent manner. Soya protein is more hypocholesterolaemic in subjects with very high initial cholesterol and recent data indicate also favourable activities in the metabolic syndrome. n-3 Fatty acids appear to exert significant hypotriacylglycerolaemic effects, possibly partly responsible for their preventive activity. Dark chocolate is gaining much attention for its multifunctional activities, useful both for the prevention of dyslipidaemia as well as hypertension. Finally, consensus opinions about tea and coffee have not emerged yet, and the benefits of vitamin E, garlic, fenugreek and policosanols in the management of dyslipidaemia and prevention of arterial disease are still controversial.
Nutrition Research Reviews 12/2009; 22(2):244-61. · 3.86 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Ghrelin and peptide YY (PYY) are two hormones produced by the gastrointestinal tract that have effects on appetite. However, little is known about their secretion in response to meals high in individual macronutrients in prepubertal children.
We sought to understand how meals high in carbohydrate, protein, and fat affect serum concentrations of total ghrelin and total PYY, hypothesizing that these macronutrients would exert differential effects on their secretion.
This was a cross-sectional study at one tertiary care center.
Subjects were 7- to 11-yr-old healthy normal-weight (NW) and obese (OB) volunteers recruited from local advertisements.
After an overnight fast, the subjects were given a breakfast high in carbohydrate, protein, or fat at 0800 h. Blood samples for total ghrelin and total PYY were taken at baseline, 30 min, and hourly from 0900 to 1200 h.
We assessed postprandial ghrelin suppression and PYY elevation, as well as changes in reported hunger and satiety, after the three test meals.
After the high-protein meal, ghrelin declined gradually in both groups over the study period without subsequent increase, whereas ghrelin suppressed more rapidly to a nadir at 60 min after the high-carbohydrate meal in both NW and OB children, followed by rebound in ghrelin levels. Similarly, after the high-protein meal, PYY concentrations increased steadily over the course of the morning in both groups without decline, whereas PYY levels peaked 30 min after the high-carbohydrate meal in both NW and OB subjects with significant decline thereafter. Ghrelin and PYY responses to the high-fat meal were somewhat intermediate between that observed with high carbohydrate and high protein. The OB children reported higher hunger and lower satiety after the high-carbohydrate meal compared to the NW subjects, whereas appetite ratings were similar between the groups after the high-protein and high-fat meals. Additionally, within the OB group, area under the curve (AUC) analysis revealed significantly greater PYY response, as well as lower AUC hunger and higher AUC satiety, to the high-protein meal than the high-carbohydrate and high-fat meals.
The patterns of secretion of ghrelin and PYY in our study of prepubertal children suggest that they may play a role in the effectiveness of high-protein/low-carbohydrate diets in promoting weight loss.
The Journal of Clinical Endocrinology and Metabolism 10/2009; 94(11):4463-71. · 6.31 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Accurate information about weight loss is not available for most commercial weight-loss programs. Our objective was to obtain accurate assessments of weight outcomes, behavioral data, and side effects for an intensive behavioral weight-loss program using low-energy diets. Weights, behavioral data, and side effects for 173 consecutive patients were assessed. Treatment options were Medically Supervised, using a minimum of five meal replacements per day, and Healthy Solutions, using meal replacements, fruits, and vegetables. Both options included weekly classes, daily records, midweek phone calls, and a minimum physical activity goal of 2,000 kcal/week. The primary outcome was change in body weight with secondary outcomes related to behavioral changes and side effects. Intention-to-treat (ITT) and completer analyses (completed 9 weeks of treatment) were performed. During 13 months, 173 patients met criteria for analysis. They selected either Healthy Solutions: 56 patients (ITT) and 37 completers; or Medically Supervised: 117 patients (ITT) and 93 completers. Mean (+/-standard error) weight losses were: Healthy Solutions: ITT=12.8+/-1.3 kg in 13 weeks and completers=17.0+/-1.4 kg in 18 weeks; Medically Supervised: ITT=16.6+/-1.0 kg in 16 weeks and completers=19.7+/-1.0 kg in 19 weeks. Mean use of meal replacements, fruits, and vegetables exceeded goals. Most side effects were mild and did not affect program continuation. An intensive behavioral weight-loss program using low-energy diets, including five meal replacements daily, is safe and effective.
Journal of the American Dietetic Association 09/2009; 109(8):1417-21. · 3.80 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Glucagon-like peptide 1 (GLP-1) and pancreatic polypeptide (PP) are intestinal hormones that are involved in the post-prandial satiety response. We sought to assess meal-related changes in these hormones in young children and determine whether differences exist between normal weight (NW) and overweight (OW) children.
Seven to 11-year-old healthy NW (n=20) and OW (n=12) volunteers were given a standardized breakfast and lunch following an overnight fast and had measurements of GLP-1 and PP over 9 hours. We characterized whether GLP-1 and PP changed from the pre-prandial to the post-prandial state and whether the serum levels corresponded to reported appetite.
GLP-1 did not increase after eating, did not decline prior to the next meal, and did not correspond to satiety ratings in either group. PP increased post-prandially in OW children after both breakfast and lunch, but in the NW group PP only increased after breakfast. PP levels did not decline in either group as the next meal approached.
In our study of school-age children, feeding had little effect on GLP-1 secretion and a variable effect on serum PP levels. Observed differences in the GLP-1 and PP responses between the NW and OW groups do not suggest there is an intrinsic abnormality in their secretion that causes weight gain.
[Show abstract][Hide abstract] ABSTRACT: Dietary fiber intake provides many health benefits. However, average fiber intakes for US children and adults are less than half of the recommended levels. Individuals with high intakes of dietary fiber appear to be at significantly lower risk for developing coronary heart disease, stroke, hypertension, diabetes, obesity, and certain gastrointestinal diseases. Increasing fiber intake lowers blood pressure and serum cholesterol levels. Increased intake of soluble fiber improves glycemia and insulin sensitivity in non-diabetic and diabetic individuals. Fiber supplementation in obese individuals significantly enhances weight loss. Increased fiber intake benefits a number of gastrointestinal disorders including the following: gastroesophageal reflux disease, duodenal ulcer, diverticulitis, constipation, and hemorrhoids. Prebiotic fibers appear to enhance immune function. Dietary fiber intake provides similar benefits for children as for adults. The recommended dietary fiber intakes for children and adults are 14 g/1000 kcal. More effective communication and consumer education is required to enhance fiber consumption from foods or supplements.
[Show abstract][Hide abstract] ABSTRACT: Substantial evidence indicates that psychosocial stress contributes to hypertension and cardiovascular disease (CVD). Previous meta-analyses of stress reduction and high blood pressure (BP) were outdated and/or methodologically limited. Therefore, we conducted an updated systematic review of the published literature and identified 107 studies on stress reduction and BP. Seventeen trials with 23 treatment comparisons and 960 participants with elevated BP met criteria for well-designed randomized controlled trials and were replicated within intervention categories. Meta-analysis was used to calculate BP changes for biofeedback, -0.8/-2.0 mm Hg (P = NS); relaxation-assisted biofeedback, +4.3/+2.4 mm Hg (P = NS); progressive muscle relaxation, -1.9/-1.4 mm Hg (P = NS); stress management training, -2.3/-1.3 mm (P = NS); and the Transcendental Meditation program, -5.0/-2.8 mm Hg (P = 0.002/0.02). Available evidence indicates that among stress reduction approaches, the Transcendental Meditation program is associated with significant reductions in BP. Related data suggest improvements in other CVD risk factors and clinical outcomes.
Current Hypertension Reports 12/2008; 9(6):520-8. · 3.90 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Existing obesity therapies are limited by safety concerns and modest efficacy reflecting a weight loss plateau. Here, we explore combination therapy with bupropion (BUP), a putative stimulator of melanocortin pathways, and an opioid antagonist, naltrexone (NAL), to antagonize an inhibitory feedback loop that limits sustained weight reduction. In vitro electrophysiologic experiments were conducted to determine the extent to which BUP+NAL stimulated hypothalamic pro-opiomelanocortin (POMC) neurons in mouse brain. A subsequent study further characterized the effect of combination BUP+NAL treatment on food intake in lean and obese mice. Finally, a randomized, blinded, placebo-controlled trial in obese adult subjects was conducted. Randomization included: BUP (300 mg) + NAL (50 mg), BUP (300 mg) + placebo (P), NAL (50 mg) + P or P+P for up to 24 weeks. BUP+NAL stimulated murine POMC neurons in vitro and caused a greater reduction in acute food intake than either monotherapy, an effect consistent with synergism. Combined BUP+NAL provided sustained weight loss without evidence of an efficacy plateau through 24 weeks of treatment. BUP+NAL completers diverged from NAL+P (P < 0.01) and P+P (P < 0.001) at week 16 and from BUP+P by week 24 (P < 0.05). The combination was also well tolerated. Translational studies indicated that BUP+NAL therapy produced synergistic weight loss which exceeded either BUP or NAL alone. These results supported the hypothesis that NAL, through blockade of beta-endorphin mediated POMC autoinhibition, prevents the classic weight loss plateau observed with monotherapies such as BUP. This novel treatment approach (BUP+NAL) holds promise for the treatment of obesity.\
[Show abstract][Hide abstract] ABSTRACT: A correct lifestyle is crucial in the primary and secondary prevention of cardiovascular disease. Innovative nutritional strategies to reduce the main risk factors have been developed including either dietary changes or consumption of specifically targeted functional foods and dietary supplements. These nutraceutical products may also provide an alternative to lipid lowering, antihypertensive, and antidiabetic drugs. Functional foods and beverages have the appearance of normal foods, but contain specific components whose activity on at least one measurable risk factor has been scientifically demonstrated. Dietary supplements, having formulations similar to drugs, allow the delivery of a bioactive ingredient in dosages that exceed those obtainable from food products. Among bioactive components, at present dietary proteins from both vegetable and animal sources are of high interest, because of their specific effects on cholesterolemia and blood pressure. Active peptides have been identified for the latter indication, whereas works is in progress in attempting to identify specific cholesterol lowering peptides.
[Show abstract][Hide abstract] ABSTRACT: Prior clinical trials suggest that the Transcendental Meditation technique may decrease blood pressure of normotensive and hypertensive individuals but study-quality issues have been raised. This study was designed to assess effects of Transcendental Meditation on blood pressure using objective quality assessments and meta-analyses.
PubMed and Cochrane databases through December 2006 and collected publications on Transcendental Meditation were searched. Randomized, controlled trials comparing blood pressure responses to the Transcendental Meditation technique with a control group were evaluated. Primary outcome measures were changes in systolic and diastolic blood pressure after practicing Transcendental Meditation or following control procedures. A specific rating system (0-20 points) was used to evaluate studies and random-effects models were used for meta-analyses.
Nine randomized, controlled trials met eligibility criteria. Study-quality scores ranged from low (score, 7) to high (16) with three studies of high quality (15 or 16) and three of acceptable quality (11 or 12). The random-effects meta-analysis model for systolic and diastolic blood pressure, respectively, indicated that Transcendental Meditation, compared to control, was associated with the following changes: -4.7 mm Hg (95% confidence interval (CI), -7.4 to -1.9 mm Hg) and -3.2 mm Hg (95% CI, -5.4 to -1.3 mm Hg). Subgroup analyses of hypertensive groups and high-quality studies showed similar reductions.
The regular practice of Transcendental Meditation may have the potential to reduce systolic and diastolic blood pressure by approximately 4.7 and 3.2 mm Hg, respectively. These are clinically meaningful changes.
American Journal of Hypertension 04/2008; 21(3):310-6. · 3.40 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Ghrelin and peptide YY (PYY) are two gut hormones that have effects on appetite. Our objectives were to characterize the patterns of secretion of these hormones in response to feeding in school-age children and determine whether there were differences between normal weight (NW) and overweight (OW) subjects.
This was a cross-sectional study at one tertiary care center. Subjects were 7- to 11-year-old healthy NW and OW volunteers recruited from local advertisements. Following an overnight fast, the subjects were given a standardized breakfast and lunch and had nine hourly blood samples for total ghrelin and total PYY. We assessed whether ghrelin and PYY levels changed from the preprandial to postprandial state and corresponded to reported hunger/satiety.
Hunger ratings were similar between the two groups throughout the study period. Ghrelin was not suppressed after eating, did not rise prior to the next meal, and did not correspond to hunger ratings in either group. PYY increased postprandially and decreased preprandially in the NW group, but OW children exhibited this pattern for only part of the day. PYY levels incompletely corresponded to reported satiety in the OW group.
Mixed meal consumption had little effect on ghrelin secretion and a variable effect on PYY secretion in young children in our study. Differences that were observed between the groups do not suggest that an abnormality in their secretion contributes to the development of obesity.
[Show abstract][Hide abstract] ABSTRACT: Alterations in dietary protein intake have an important role in prevention and management of several forms of kidney disease. Using soy protein instead of animal protein reduces development of kidney disease in animals. Reducing protein intake preserves kidney function in persons with early diabetic kidney disease. Our clinical observations led us to the soy-protein hypothesis that "substitution of soy protein for animal protein results in less hyperfiltration and glomerular hypertension with resulting protection from diabetic nephropathy." These components of soy protein may lead to the benefits: specific peptides, amino acids, and isoflavones. Substituting soy protein for animal protein usually decreases hyperfiltration in diabetic subjects and may reduce urine albumin excretion. Limited data are available on effects of soy peptides, isoflavones, and other soy components on renal function on renal function in diabetes. Further studies are required to discern the specific benefits of soy protein and its components on renal function in diabetic subjects.
Asia Pacific Journal of Clinical Nutrition 02/2008; 17 Suppl 1:324-8. · 1.36 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Orlistat, in the 60-mg over-the-counter dose, was recently approved by the FDA. This lipase inhibitor blocks absorption of ~25% of ingested fat and has ~85% of the efficacy of the 120-mg dose for weight loss. Over 16 weeks weight loss with diet and orlistat 60 mg averages ~5% of initial body weight. The 60-mg dose is better tolerated than the 120-mg dose and the gastrointestinal side effects are minimal when individuals consume < 30% of their energy from fat. In addition to facilitating modest weight loss, orlistat use decreases serum LDL-cholesterol values by ~10%. When taken three times daily before meals, orlistat 60 mg modifies lifestyle behavior, encourages lower fat-consumption and sets the stage for other healthy lifestyle changes.
Expert Opinion on Pharmacotherapy 08/2007; 8(11):1733-42. · 2.86 Impact Factor