Background: Ad libitum, low-carbohydrate diets decrease caloric intake and cause weight loss. It is unclear whether these effects are due to the reduced carbohydrate content of such diets or to their ...associated increase in protein intake.
Objective: We tested the hypothesis that increasing the protein content while maintaining the carbohydrate content of the diet lowers body weight by decreasing appetite and spontaneous caloric intake.
Design: Appetite, caloric intake, body weight, and fat mass were measured in 19 subjects placed sequentially on the following diets: a weight-maintaining diet (15% protein, 35% fat, and 50% carbohydrate) for 2 wk, an isocaloric diet (30% protein, 20% fat, and 50% carbohydrate) for 2 wk, and an ad libitum diet (30% protein, 20% fat, and 50% carbohydrate) for 12 wk. Blood was sampled frequently at the end of each diet phase to measure the area under the plasma concentration versus time curve (AUC) for insulin, leptin, and ghrelin.
Results: Satiety was markedly increased with the isocaloric high-protein diet despite an unchanged leptin AUC. Mean (±SE) spontaneous energy intake decreased by 441 ± 63 kcal/d, body weight decreased by 4.9 ± 0.5 kg, and fat mass decreased by 3.7 ± 0.4 kg with the ad libitum, high-protein diet, despite a significantly decreased leptin AUC and increased ghrelin AUC.
Conclusions: An increase in dietary protein from 15% to 30% of energy at a constant carbohydrate intake produces a sustained decrease in ad libitum caloric intake that may be mediated by increased central nervous system leptin sensitivity and results in significant weight loss. This anorexic effect of protein may contribute to the weight loss produced by low-carbohydrate diets.
In 2012, the Minister of Health and other leaders in the Bangladesh government approached Massachusetts General Hospital to establish the country's first bone marrow transplant program at Dhaka ...Medical College Hospital to serve the needs of the people of Bangladesh. Stated goals of this collaboration included a broad focus on the care of oncology patients with a specific emphasis on care of patients with hematologic malignancies and of women with gynecologic cancers. The purpose of this article is to describe the international nursing collaboration between Massachusetts General Hospital, Simmons College, the AK Khan Healthcare Trust in Dhaka, and Dhaka Medical College Hospital that was established to share nursing knowledge and to build specialized professional nursing capacities to deliver high-quality cancer care in the public sector. Over the past 3 years, through the educational programs that have been developed within this collaboration-the Enhanced Specialized Nurse Training Program-the Bangladeshi nurses have received continuing professional development based on Western standards of nursing and have been offering nursing care to patients who have undergone chemotherapy and bone marrow transplantation. The challenges, opportunities, and outcomes of this international collaboration have been highly rewarding and mutually beneficial.
Describes a research project designed to help empower the largely female child welfare staff and clients in a British Columbia child welfare agency by giving them more authority to shape agency ...practice according to their joint plans. (MDM)
This article is based upon a two-year research project in a government child welfare agency in British Columbia involving frontline child welfare workers and women who are single parents. Based upon ...previous research with public child welfare workers, the authors developed several principles that emphasized the importance of female clients and frontline workers having the power to shape practice according to their joint plans. The article reports on the achievements of women who are single parents and of workers once they are given the freedom to redevelop services. The underlying concept—empowerment—is reviewed and a comprehensive definition of the term, based upon client and worker empowerment, is proposed.
Lyme disease, caused by the bite of a deer tick infected with Borrelia burdorferi, has been increasing in distribution and prevalence annually throughout Maine. Worker’s compensation claims for Lyme ...disease have also been increasing steadily since the initial claim made in 1999. This research reviewed Maine worker’s compensation claims for Lyme disease from 1999-2011 to determine trends in state distribution and occupation type. Descriptive statistics were calculated to analyze different distributions of occupational Lyme disease. Occupations with the highest distribution of Lyme disease claims were those requiring workers to spend the majority of their time outdoors. A clear trend of claim distribution was seen, which mirrored that of the State of Maine Lyme disease case surveillance data. With the apparent increase in worker’s compensation claims due to Lyme disease and an increased geographic distribution annually, additional prevention and education efforts should be focused toward the higher risk occupations.
Abstract Background Dietary n-3-polyunsaturated fatty acids (n-3-PUFA) have been shown to reduce body weight and fat mass in rodents as well as in humans in one small short-term study. We conducted ...this controlled randomized dietary trial to test the hypothesis that n-3-PUFA lower body weight and fat mass by reducing appetite and ad libitum food intake and/or by increasing energy expenditure. Methods Twenty-six overweight or moderately obese (body mass index 28–33 kg/m2) men and women were included, and received either a diet rich in n-3-PUFA from both plant and marine sources or a control diet. Diets were administered in an isocaloric fashion for 2 weeks followed by 12 weeks of ad libitum intake. The n-3-PUFA and control diets were identical in all regards except for the fatty acid composition. All foods were provided to subjects, and leftovers were weighed back to assess actual food intake accurately for each day of the study. This design gave us 80% power to detect a difference in weight change between the n-3-PUFA and control diet groups of 2.25 kg at an α-error level of 5%. Results Both groups lost similar amounts of weight when these diets were consumed ad libitum for 12 weeks mean (SD): -3.5 (3.7) kg in the control group vs. -2.8 (3.7) kg in the n-3-PUFA group, F(1,24) = 13.425, p = 0.001 for time effect; F(1,24) = 0.385, p = 0.541 for time × group interaction. Consistent with this finding, we also found no differences between the n-3-PUFA and control groups with regard to appetite as measured by visual analogue scale, ad libitum food intake, resting energy expenditure as measured by indirect calorimetry, diurnal plasma leptin concentrations, or fasting ghrelin concentrations. Conclusion Our results suggest that dietary n-3-PUFA do not play an important role in the regulation of food intake, energy expenditure, or body weight in humans.
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