Beware of Weight Loss Scams… June 2011 Written by Mariane Héroux PhD candidate, MSc., BSc., RHN
A few weeks ago I was approached by a friend who tried to convince me to join the Body By Vi Challenge. He pitched the challenge to me by telling me that he had a way for me to get my dream beamer within the next few months at no cost. Immediately I was skeptical. He then went on to tell me a bit about this 90 day challenge which is meant to help people lose weight, get healthy, and get free stuff (i.e. a BMW). Those of you who know me well would agree that I certainly do not need to lose weight and that I am a total health nut. So why was he pitching this to me? I immediately started doing a bit of research on the challenge to find out what it was all about. I found the website (http://www.visalus.com/bbvi/home/) and in less than 1 minute could tell that this challenge was yet another scam in the nutrition world with a pyramid type scheme. Essentially this challenge lasts 90 days and apparently results in weight loss and happiness. Upon signing up, you select one of 4 challenge kits that contain meal replacements (range from $50-$249). The main product is the shake. Drinking one serving of this shake apparently provides your body with the same nutrition quality that you would obtain from eating: 12 eggs, 1.5 cups of broccoli, 5 peaches, 2 chicken breast, 1.5 cup frozen yogurt, 1.5 cup bran flakes, 18oz tomato juice, 5oz cheddar cheese, 3 cups lima beans, 15 slices whole wheat bread, 30 whole apples, 20 spears of asparagus, 2 cups of sliced mushrooms, 10 celery stalks, 3 pineapples, 3 tomatoes, and 30 prunes! To entice you more, it is mentioned that consuming this much food is equivalent to about 8662 calories and would cost over $100.00 but that you can get all the health benefits of these foods by drinking 1 shake at a cost of under $2.00 per serving (check out the video http://www.youtube.com/watch?v=0OVYGdfEJQo). The question I ponder is: would anyone in their right minds ever eat all that food at once? Our bodies are not meant to consume an overwhelming amount of vitamins, minerals, and other food components (i.e. lycopene, isoflavanoids, antioxidants, etc) all at once. In fact when you consume too many of these at one time they actually compete for absorption in your body and are therefore not utilized optimally.1 It would be completely unnatural to consume so much food at once and it is even more unnatural to consume it all in the form of a “magical” shake. Although I was unable to find the exact ingredients that are used in this “magic” powder known as the Vi-Shape Nutritional Shake Mix, my friend Neil Fine (check out his blog at http://finefitness.ca/) was able to locate them for me (http://www.bodyin90.com/challengepartydocs/ViSalusProductInfo.pdf). Interestingly enough, he had also recently been approached by someone pitching this miracle program to him! Out of pure curiosity and skepticism, Neil went to a “recruitment party” where he got to try a sample of the shake and learn a bit more about the challenge. The ingredients consist of several products that are manmade and therefore unnatural. For example, the ingredient list consists of maltodextrin and sucralose. Now maltodextrin is a food additive and sucralose is a manmade artificial sweetener for which no studies exist looking at its long term effects on the body. Food additives and artificial sweeteners are ingredients that everyone should avoid as they are unnatural!!!!!! These are only two of the ingredients within the product that I do recommend consuming on a daily basis. Neil also mentioned that the program does NOT recommend exercise; in fact some of the ads for it say that weight loss can be achieved without needing to exercise at all. While exercise does help with weight loss,2 it is also extremely important for cardiovascular health, muscular strength, mental health, prevention of several chronic diseases, etc.3 In my opinion, even those who aren’t seeking to lose weight should exercise! In summary, if you want to lose weight or strive to achieve better nutrition and fitness the best way to go about it is to make a lifestyle change whereby you eat healthy natural foods (i.e. fresh vegetables and fruits, lean protein, unprocessed grains) and exercise! Taking unnatural products and paying money for challenges like Body By Vi will not help you achieve a healthy lifestyle change. Losing weight and providing your body with the nutrients it needs should be done with natural sources coming from foods that are as close to their natural states as possible and of course exercise which as I already mentioned helps improve cardiovascular endurance and muscular strength while also decreasing your risk of many ailments.3 So next time someone approaches you about a nutrition challenge or magic pill/powder think twice, do your research, and remember that nothing is healthier than foods that are in their NATURAL states and of course exercise! References 3. Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: the evidence. Cmaj 2006;174(6):801-9. Food, Vitamins, Protein, and More April 2011
Written by Mariane Héroux PhD Candidate, MSc., BSc., R.H.N. How often do you consciously acknowledge the physiological reasons behind eating? Before taking a bite of your food, do you ask yourself if what you are about to eat contains what your body needs to function properly? Sometimes I wonder if people truly comprehend the strong interconnection between the food they eat and their health. I was at the gas station over the weekend and noticed a middle aged man putting premium gasoline into his shiny Benz while eating some sort of giant Twinkie and drinking a coke to wash it down. I highly doubt that you would ever even consider putting a Twinkie and Coke into your car instead of premium or regular gasoline, so why fill your body with processed, nutrient leached foods that do not supply your body with what it needs to function optimally? In my opinion, our bodies are much more valuable than a nice car. After all, if your body doesn’t work you won’t be able to drive your car, so maybe you should take care of yourself better than, or at least as well as, your car or other prized processions. I cannot stress enough the importance of eating foods that are in their natural states or as close to their natural states as possible. All packaged and processed/refined foods have been altered from their natural states and are, for the most part, laden with added chemicals known as preservatives and additives, many of which have been shown to adversely affect health.1 2 I do not understand how one can think that eating a food item with a list of ingredients longer than a poem containing several unpronounceable words is a good idea. Evidently, food companies are going to tell you that the addition of such products to the food supply is “safe,” why would they tell you otherwise? Now don’t get me wrong, they do safety studies on additives/preservatives before putting them into the food supply but studies are rarely long enough in duration to identify any long-term effects the product may have on your health. Furthermore, these studies identify a specific quantity of the preservative or additive that is “safe” and therefore allowed in the food supply. In higher quantities however, many of the products are no longer deemed safe for consumption. What I don’t understand is why anyone wants to put a potentially harmful substance into his/her body even in small quantities? Furthermore, food processing techniques reduce the amount of every known essential vitamin that naturally occurs in the food product being processed.3 In fact, when food processing first began, people actually died from nutritional deficiencies that were entirely created by man as a result of processing. For example, the earlier refining of corn meal, which reduced natural vitamin B-3 and amino acid levels, was so devastating that it produced around 7000 deaths per year in the US for several decades.4 Food processing such as this continues today to an even greater extent however food companies now enrich our food supply to avoid nutrient deficiencies. What this means is that the food is processed resulting in vitamin loss. The food item is then “enriched” by adding vitamins back into the product before packaging and selling it. This is very concerning as vitamins that are added back into the food source are not assimilated by the body the same way naturally occurring vitamins are.5-9 Furthermore, enriching the food supply does not address the loss of other important food components that have been shown to have important health benefits such as phytochemicals and antioxidants.10 11 I often hear people express concerns about supplementing their diet with multivitamins, yet their diets consist of several enriched foods. These people are essentially contradicting themselves, as by eating enriched foods they are simply eating empty calories wrapped around a vitamin supplement. In my opinion, it is best to eat non-processed foods and to SUPPLEMENT your already healthy diet with a multivitamin. This way, not only are you avoiding additives and preservatives in the processed foods but you have the power to select a vitamin supplement that is produced by a reputable manufacturer. You must remember that like many other things, vitamin supplements are NOT all created equal. Quality control across companies varies greatly. Two companies that are well reputed and Canadian are Natural Factors and Progressive (Note that I do not receive any endorsements from these companies I simply like them). I also get a lot of reluctance when it comes to protein powders. People are very uneasy with the idea of using protein powders to make protein shakes and ensure adequate protein intake. However, many of these people do not have a problem with eating protein bars such as the Myoplex bar. I have included the ingredients of a Myoplex bar below as well as the ingredients from pure whey protein powder so that you can compare. As you can see the Myoplex bar is filled with refined sugars, additives, and preservatives. So although you are getting protein from the bar you are also consuming many products that are not conducive to supporting your health. As with vitamins, you have the power to select a protein powder that is PURE and does not contain extra crap (that’s right I said crap). By using a protein powder you have the power to create a uniquely delicious and nutritious protein shake. By blending it with fresh fruits, additives and preservatives are eliminated to produce a healthy and vitamin and protein-rich drink. So what’s the bottom line here? Essentially the physiological reason why we eat is to give our body the nutrients it needs to function optimally, fight off disease, heal, etc. The best way to give your body everything it needs is to eat a wide variety of wholesome foods that are NOT processed, refined and laden with additives and preservatives. Supplementing with a good quality multivitamin/mineral formula and/or good quality protein powder is a good idea but this by no means justifies eating processed and refined foods. You are in charge of what goes in your mouth so why not choose foods that will support your health and wellbeing and help promote longevity? Ingredients in Myoplex Bar vs. Unflavored Protein Powder: Myoplex bar ingredients: MyoPro® Protein Blend (Soy Protein Isolate, Whey Protein Isolate), Corn Syrup, High Fructose Corn Syrup, Polydextrose, Sugar, Tapioca Starch, Fractionated Palm Kernel Oil, Cocoa (Processed With Alkali), Milk Protein Concentrate, Water, Vitamin And Mineral Blend (Calcium Phosphate, Potassium Phosphate, Magnesium Oxide, Potassium Chloride, Ascorbic Acid, DL-Alpha Tocopheryl Acetate, Ferric Orthophosphate, Niacinamide, Calcium Pantothenate, Zinc Oxide, Chromium Citrate, Copper Gluconate, Vitamin A Palmitate, Pyridoxine Hydrochloride, Riboflavin, Thiamine Mononitrate, Folic Acid, Biotin, Potassium Iodide, Cyanocobalamin), Natural And Artificial Flavors, Unsweetened Chocolate, Cocoa, Dextrose, Cocoa Butter, High Oleic-Safflower Oil, Calcium Carbonate, Soy Lecithin, Salt, Guar Gum, Corn Maltodextrin, Sucralose *Note: Notice how high fructose corn syrup is the second ingredient, followed by polydextorse which is another kind of sugar, and then by sugar...three clear signs (of many) to stay away from this product Natural Factors Unflavored Protein Powder Ingredients: Whey protein concentrate (microfiltered, non-denatured), Bromelain, Enzyme Powder (protease, papin, lipase) *Note: Bromelain and enzyme powder are added to help you break down the protein powder and absorb/utilize it efficiently. They are completely natural (e.g. bromelain is found in pineapples). References 1. Tuormaa TE. The adverse effects of food additives on health: a review of the literature with a special emphasis on childhood hyperactivity. Journal of Orthomolecular Medicine 1994;9(4):18. 2. Turkoglu S. Genotoxicity of five food preservatives tested on root tips of Allium cepa L. Mutation research 2007;626(1-2):4-14. 3. Williams AW, Erdman JW. Food processing: nutrition, safety, and quality balances. Modern Nutrition in Health and Disease. 9 ed. Baltimore: William & Wilkins, 1999:423-32. Rethinking Saturated Fats February 2011 Written by Mariane Heroux PhD Candidate, MSc., BSc., RHN When you see the term “Saturated Fats” what is the first think you think of? Do words like “bad,” “unhealthy,” “high cholesterol,” and “heart disease” come to mind? With all of the attention that saturated fats have generated over the past years, it is not surprising that you associate them with negative terms such as those mentioned above…but what if saturated fats weren’t so bad for you after all? Over the years, saturated fats have been given a bad reputation. Numerous studies have suggested that diets high in saturated fats increase the risk of high cholesterol and heart disease.1-4 As a result, dietary guidelines have been created to reflect this risk and recommend that less than 10% of fat intake come from saturated fats. However, numerous studies have also found no association4 5 between the intake of saturated fats and high cholesterol and heart disease - yet the communication of these findings has been somewhat neglected. Before I delve into the research on saturated fats I first want to tell you a little about something called publication bias. This arises from the tendency to publish and report experimental results that are positive (i.e. they show a significant finding) differently from results that are negative (i.e. supporting the null hypothesis) or inconclusive. In the case of saturated fats, Siri-Tarino and colleagues recently stated the following: “Our results suggested publication bias, such that studies with significant associations tended to be received more favourably for publication.”4 This is not surprising and unfortunately happens all too often in the research world. Second I want to take you back to nutrition 101 and give you a refresher on fats, particularly saturated fats. Now I won’t get overly technical, but I will remind you that there are several different kinds of fats including saturated, unsaturated, hydrogenated and trans. Saturated fats occur naturally in our food sources and are solid at room temperature. The main dietary saturated fats are laurate, myristate, palmitate, and stearate.6 Grain-fed animal meats and dairy products are rich sources of palmitate and, to a lesser extent, stearate. Other sources include palm oil, which consists primarily of palmitate, cocoa butter, which is a major source of stearate, and coconut and palm kernel oil, which consist primarily of laurate and myristate.6 Unsaturated fats, which can be classified into mono- and polyunsaturated fats are liquid at room temperature and are found primarily in nuts, seeds, and legumes. These fats have robust studies supporting their numerous health benefits.6-8 When comparing saturated fats to unsaturated fats, the main difference lies in chemical structures; but like saturated fats, unsaturated fats occur naturally in our food sources. Finally, hydrogenated and trans fats do not occur naturally in our food sources. They are created as a result of chemical procedures such as refining processes and are most commonly found in household shortenings and margarines, fried foods, and baked goods. Undoubtedly, these manmade fats are harmful to health and there is strong evidence to support this. 9-11 Now, let’s move on to evaluating research on saturated fats. I am sure you have all heard that saturated fats raise bad cholesterol and put you at risk for heart disease. What you probably haven’t heard is that recent reviews of the literature suggest that numerous contradictory studies have been overlooked and that there is in fact not enough evidence to support these claims. In the last 2 years there have been a couple noteworthy studies conducted providing an evaluation of past research on saturated fats.4 5 12 The general consensus of these reviews is that saturated fats may not be all that bad after all. For example, in their meta-analysis, Siri-Tarino and colleagues reported that there was no sufficient evidence from past prospective epidemiologic studies (the best kind of study next to randomized controlled trials) that concluded that dietary saturated fats were associated with an increased risk of coronary heart disease, stroke, or cardiovascular disease.4 Furthermore a review by Ramsden and colleagues suggested that the reduction of saturated fats from the diet does not appear to be the most important dietary modification for the reduction of heart disease risk.6 In fact, studies have shown that on a per calorie basis, trans fats have a much stronger correlation with heart disease than do saturated fats suggesting that removing these from the diet is most important in heart disease risk reduction.10 11 Furthermore current research suggests that refined carbohydrates, and not saturated fats, increase one’s risk of heart disease.5 13 When removing or decreasing saturated fats from the diet, whether it is in research or in the real world, calories from the decreased nutrient must be replaced with another. Many studies have assessed the risk of heart disease when replacing saturated fats with unsaturated fats. These studies are consistent in showing that the risk of heart disease does indeed decrease when saturated fats are replaced with unsaturated fats.14 15 But let’s think of this realistically for a minute: if a person living in our Western society is to replace calories from saturated fats with another nutrient, chances are they won’t choose unsaturated fats, with the abundance of refined carbohydrates they will most likely choose these. The displacement of calories from saturated fats to calories from refined carbohydrates is potentially more dangerous to health as there is a large body of evidence linking refined carbohydrates to obesity, diabetes, and heart disease.16-18 As mentioned by Hu in his recent editorial, “the obesity epidemic and growing intake of refined carbohydrates have created a “perfect storm” for the development of cadiometabolic disorders. For this reason, reduction of refined carbohydrate intake should be a top public health priority.” 13 Reducing saturated fats too drastically may actually have negative effects on the body, as saturated fats are required for several bodily functions.21 For example, saturated fats are required for calcium to be effectively incorporated into bone. They are also necessary for maintaining immune and brain health. In fact, a diet that skimps on healthy saturated fats robs your brain of the raw materials it needs to function optimally. Furthermore, saturated fats are necessary for proper nerve signalling. Certain saturated fats, particularly those found in coconut oil, function directly as signalling messengers that influence metabolism. These are only a few of the very important bodily functions that saturated fats are necessary for. So the real take home message is that although the majority of your fat intake should come from unsaturated fats, you should not be afraid of incorporating small amounts of saturated fats into your diet, especially those from plant sources such as those found in coconut. You should also try to reduce or eliminate your intake of refined carbohydrates (sweets and fried foods) and lastly, always remember that moderation and variety are key. To achieve optimal health, eat a wide variety of foods that are as close to their natural states as possible. By sticking to this rule you help ensure that you nourish your body with all the nutrients that Mother Nature created and that you stay away from manmade chemicals that are harmful to the body. References 1. Fehily AM, Yarnell JW, Sweetnam PM, Elwood PC. Diet and incident ischaemic heart disease: the Caerphilly Study. The British journal of nutrition 1993;69(2):303-14. Carbohydrate Confusion January 2011
Written by Mariane Héroux PhD Candidate, MSc., BSc., RHN. Time and time again we have read and heard about the dangers of carbohydrates! That’s right, consumption of dreaded carbohydrates are said to result in weight gain, sluggishness, energy loss, etc. Several fad diets such as Atkins focus on these claims and revolve around drastically decreasing carbohydrate intake. But what if I were to tell you that carbohydrates are extremely important for health and that eliminating them is NOT a solution to weight loss or achieving a balanced and healthy lifestyle? What if I were to also tell you that fruits and vegetables are both carbohydrates? How can this be? Fruits and vegetables are healthy and carbohydrates are supposedly bad, right? Hopefully after reading this article you will have a better understanding of good and bad carbohydrates as well as the importance of consuming the healthy kind with a special focus on fruits and veggies! Throughout the article you will quickly see that the importance simply lies in the type of carbohydrate that you choose to consume and that, like so many other things, not all carbohydrates are created equal. First let’s begin with a little review. There are three calorie-providing components in food called macronutrients: carbohydrates, proteins, and fats. Carbohydrates are the main energy source for the body and supply 4 calories per gram. Proteins are essential for proper muscle and cell repair and also supply 4 calories per gram. Finally, fats are essential for vitamin absorption and cell membrane structure and supply 9 calories per gram.1 All foods contain all three of these components but in different ratios. For example, 1 cup of chopped broccoli contains 11.2g of carbohydrates, 3.7g of protein, and 0.64g of fat for a total of 65 calories. Because the majority of macronutrients in broccoli come from carbohydrates, broccoli is considered a carbohydrate. Another carbohydrate example is a Boston Cream doughnut from Tim Horton’s. This food item contains 40g of carbohydrates, 4g of protein and 8g of fat for a whopping 250 calories. In addition to the calorie-providing components of food discussed in the previous paragraph, some foods also contain naturally occurring vitamins, minerals, and phytochemicals; all of which are essential for health and optimal body function.1 2 Broccoli, in its natural state, contains a great deal of vitamins, minerals and phytonutrients and therefore does more than simply provide the body with energy via carbohydrates; it also provides the body with nutrients that are needed for cell function. On the other hand, the ingredients used to make the Boston Cream doughnut have been processed and refined to the point that they contain almost none of these nutrients; providing the body with only calories. I use the term “empty calorie food” to describe such foods, as eating them does not provide you with nutrients that are essential for your body to function. Instead such foods provide your body with nothing but calories…it is essentially the same as eating cardboard only that you would obtain fewer calories with the cardboard. Carbohydrates are dominant in a wide range of foods, both healthy and unhealthy. For example they are dominant in most fruits, vegetables, legumes, and whole grains as well as chips, chocolate, pastries and fast foods. The effects of such foods on the body differ based on a variety of different factors with processing at the forefront. As I mentioned earlier carbohydrates are the body’s main energy source. When consumed, carbohydrates are broken down into glucose, which then goes through several cycles to become adenosine tri-phosphate (ATP), which is the body’s active form of energy. Now you may be wondering why the type of carbohydrate we choose matters if all carbohydrates end up as glucose and eventually ATP anyways? First, carbohydrates come in two forms: simple and complex. Simple carbohydrates are converted into glucose almost instantaneously when consumed whereas the conversion of complex carbohydrates takes more time. Therefore the release of energy when eating simple carbohydrates is very fast whereas the release of energy when eating complex carbohydrates is slow and steady. This explains the energy rise and crash that you experience when you eat certain foods such as chocolate bars. Now, here is where it gets a bit more complicated. Several fruits are considered simple carbohydrates and several pastries are considered complex carbohydrates so choosing which carbohydrate to eat does not simply include classifying the food item as a simple or complex carbohydrate. Instead you should be assessing the nutritional quality of the food. Ask yourself how close to its natural state the food is. In general, the closest a food is to its natural state the more nourishing it is for the body. For example raw, steamed, or grilled vegetables are great sources of carbohydrates that not only provide your body with sustained energy release but also provide your body with a plethora of other nutrients. Veggie chips on the hand are so refined that the nutrients have been leached out, chemicals have been added in, and carbohydrate chains broken, making the conversion to energy very quick. All of this food processing and refining results in an empty calorie food. So when selecting foods, it is important to try to choose food that has undergone the least amount of processing as this will ensure that you reap all of the benefits from the food. You should be eating food products that Mother Nature supplied, not that man has altered through chemical processing. In other words, you should pick the grape over the chocolate covered raisin. This brings me to my second point. As I mentioned above, the accompanying nutrients found in foods are very important to maintain optimal body functioning. Therefore not only will eating a doughnut, cake, or refined white bread result in an energy surge and crash but you also do not nourish your body. On the other hand fruits and vegetables provide your body with good quality carbohydrates that provide energy and nourish your body! Now while several fruits are simple carbohydrates and can result in a surge of energy and then a potential crash, if the fruit is paired with protein the breakdown and energy release will be slowed and you will still obtain all the wonderful benefits of the nutrients found within the fruit. Moreover there are certain times when you may need a surge of energy in which case choosing certain fruits is a much better choice than an energy drink or gel. Finally it is very important to remember that there is a plethora of fruit and vegetable varieties available to us. Variety helps to ensure that your body obtains all of the healthy nutrients it needs! The next thing I want to address are the health effects of carbohydrates. Several good quality studies have been conducted in order to identify food items that have positive or negative effects on health.3-6 These studies all report that individuals with diets high in processed foods including sweets, grains, and protein sources have a much higher risk of several chronic diseases and all cause mortality when compared to those with diets high in vegetables, fruits, whole grains, and non-processed lean protein sources. Interestingly, the healthiest participants in these studies consumed carbohydrates on a regular basis, as did the least healthy participants. The main difference was the type of carbohydrate consumed! Therefore, eating carbohydrates can be beneficial for health, but the type and quality matters. Furthermore, consuming diets high in processed carbohydrates has been related to weight gain7-9 while diets high in fruits and veggies have been shown to promote weight loss.8-10 Consuming diets high in processed carbohydrates actually creates a strain on your metabolic system, exposes you to chemicals, and provides your body with little or no nutrition all of which contribute to the associated health problems just mentioned. So what’s the bottom line? Essentially, your body needs carbohydrates to sustain health and choosing healthy options such as fruits and vegetables is key. Variety and balance are also very important. Second, the amount of carbohydrates, proteins, and fats that one eats will vary from one person to the next. Just as each person has a different learning style, each person has a different eating style. The key is finding what works best for you and your goals! Finally, food quality matters! Remember to eat foods that are as close to their natural state as possible to ensure that you are fueling your body with everything it needs to function optimally. So next time you pick up a doughnut or another nutritionally empty food, think of cardboard because that’s essentially what you are eating. References 1. Dimosthenopoulos C, Kontogianni M, Manglara E. Principles of healthy nutrition. In: Katsilambros N, Dimosthenopoulos C, Kontogianni M, Manglara E, Poulia K, editors. Clinical Nutrition in Practice. Oxford, United Kingdom: Blackwell Publishing Ltd., 2010. 2. Manach C, Hubert J, Llorach R, Scalbert A. The complex links between dietary phytochemicals and human health deciphered by metabolomics. Mol Nutr Food Res 2009;53(10):1303-15. 3. Heroux M, Janssen I, Lam M, Lee DC, Hebert JR, Sui X, et al. Dietary patterns and the risk of mortality: impact of cardiorespiratory fitness. Int J Epidemiol 2010;39(1):197-209. 4. Baxter AJ, Coyne T, McClintock C. Dietary patterns and metabolic syndrome--a review of epidemiologic evidence. Asia Pac J Clin Nutr 2006;15(2):134-42. 5. Kant AK. Dietary patterns and health outcomes. J Am Diet Assoc 2004;104(4):615-35. 6. Newby PK, Tucker KL. Empirically derived eating patterns using factor or cluster analysis: a review. Nutr Rev 2004;62(5):177-203. 7. Rosenheck R. Fast food consumption and increased caloric intake: a systematic review of a trajectory towards weight gain and obesity risk. Obes Rev 2008;9(6):535-47. 8. Esmaillzadeh A, Azadbakht L. Major dietary patterns in relation to general obesity and central adiposity among Iranian women. J Nutr 2008;138(2):358-63. 9. Schulze MB, Fung TT, Manson JE, Willett WC, Hu FB. Dietary patterns and changes in body weight in women. Obesity (Silver Spring) 2006;14(8):1444-53. 10. Vioque J, Weinbrenner T, Castello A, Asensio L, Garcia de la Hera M. Intake of fruits and vegetables in relation to 10-year weight gain among Spanish adults. Obesity 2008;16(3):7. |
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