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      The BROAD study: A randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes

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          Abstract

          Background/Objective:

          There is little randomised evidence using a whole food plant-based (WFPB) diet as intervention for elevated body mass index (BMI) or dyslipidaemia. We investigated the effectiveness of a community-based dietary programme. Primary end points: BMI and cholesterol at 6 months (subsequently extended).

          Subjects:

          Ages 35–70, from one general practice in Gisborne, New Zealand. Diagnosed with obesity or overweight and at least one of type 2 diabetes, ischaemic heart disease, hypertension or hypercholesterolaemia. Of 65 subjects randomised (control n=32, intervention n=33), 49 (75.4%) completed the study to 6 months. Twenty-three (70%) intervention participants were followed up at 12 months.

          Methods:

          All participants received normal care. Intervention participants attended facilitated meetings twice-weekly for 12 weeks, and followed a non-energy-restricted WFPB diet with vitamin B 12 supplementation.

          Results:

          At 6 months, mean BMI reduction was greater with the WFPB diet compared with normal care (4.4 vs 0.4, difference: 3.9 kg m −2 (95% confidence interval (CI)±1), P<0.0001). Mean cholesterol reduction was greater with the WFPB diet, but the difference was not significant compared with normal care (0.71 vs 0.26, difference: 0.45 mmol l −1 (95% CI±0.54), P=0.1), unless dropouts were excluded (difference: 0.56 mmol l −1 (95% CI±0.54), P=0.05). Twelve-month mean reductions for the WFPB diet group were 4.2 (±0.8) kg m 2 BMI points and 0.55 (±0.54, P=0.05) mmol l −1 total cholesterol. No serious harms were reported.

          Conclusions:

          This programme led to significant improvements in BMI, cholesterol and other risk factors. To the best of our knowledge, this research has achieved greater weight loss at 6 and 12 months than any other trial that does not limit energy intake or mandate regular exercise.

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          Most cited references31

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          Analysis and valuation of the health and climate change cobenefits of dietary change.

          What we eat greatly influences our personal health and the environment we all share. Recent analyses have highlighted the likely dual health and environmental benefits of reducing the fraction of animal-sourced foods in our diets. Here, we couple for the first time, to our knowledge, a region-specific global health model based on dietary and weight-related risk factors with emissions accounting and economic valuation modules to quantify the linked health and environmental consequences of dietary changes. We find that the impacts of dietary changes toward less meat and more plant-based diets vary greatly among regions. The largest absolute environmental and health benefits result from diet shifts in developing countries whereas Western high-income and middle-income countries gain most in per capita terms. Transitioning toward more plant-based diets that are in line with standard dietary guidelines could reduce global mortality by 6-10% and food-related greenhouse gas emissions by 29-70% compared with a reference scenario in 2050. We find that the monetized value of the improvements in health would be comparable with, or exceed, the value of the environmental benefits although the exact valuation method used considerably affects the estimated amounts. Overall, we estimate the economic benefits of improving diets to be 1-31 trillion US dollars, which is equivalent to 0.4-13% of global gross domestic product (GDP) in 2050. However, significant changes in the global food system would be necessary for regional diets to match the dietary patterns studied here.
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            Comparison of weight loss among named diet programs in overweight and obese adults: a meta-analysis.

            Many claims have been made regarding the superiority of one diet or another for inducing weight loss. Which diet is best remains unclear.
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              • Article: not found

              Use of RPE-based training load in soccer.

              The ability to accurately control and monitor internal training load is an important aspect of effective coaching. The aim of this study was to apply in soccer the RPE-based method proposed by Foster et al. to quantify internal training load (session-RPE) and to assess its correlations with various methods used to determine internal training load based on the HR response to exercise. Nineteen young soccer players (mean +/- SD: age 17.6 +/- 0.7 yr, weight 70.2 +/- 4.7 kg, height 178.5 +/- 4.8 cm, body fat 7.5 +/- 2.2%, VO2max, 57.1 +/- 4.0 mL x kg x min) were involved in the study. All subjects performed an incremental treadmill test before and after the training period during which lactate threshold (1.5 mmol x L above baseline) and OBLA (4.0 mmol x L) were determined. The training loads completed during the seven training weeks were determined multiplying the session RPE (CR10-scale) by session duration in minutes. These session-RPE values were correlated with training load measures obtained from three different HR-based methods suggested by Edwards, Banister, and Lucia, respectively. Individual internal loads of 479 training sessions were collected. All individual correlations between various HR-based training load and session-RPE were statistically significant (from r = 0.50 to r = 0.85, P < 0.01). The results of this study show that the session-RPE can be considered a good indicator of global internal load of soccer training. This method does not require particular expensive equipment and can be very useful and practical for coaches and athletic trainer to monitor and control internal load, and to design periodization strategies.
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                Author and article information

                Journal
                Nutr Diabetes
                Nutr Diabetes
                Nutrition & Diabetes
                Nature Publishing Group
                2044-4052
                March 2017
                20 March 2017
                1 March 2017
                : 7
                : 3
                : e256
                Affiliations
                [1 ]Royal New Zealand College of General Practitioners , Gisborne, New Zealand
                [2 ]Two Zesty Bananas Limited , Wellington, New Zealand
                [3 ]BROAD Study , Gisborne, New Zealand
                [4 ]Hauora Tairāwhiti , Gisborne, New Zealand
                [5 ]Department Primary Health Care and General Practice, University of Otago , Wellington, New Zealand
                Author notes
                [* ]Royal New Zealand College of General Practice, BROAD study , PO Box 2064, Gisborne 4040, New Zealand. E-mail: Nicholas.samuel.wright@ 123456gmail.com
                Author information
                http://orcid.org/0000-0002-2829-3365
                Article
                nutd20173
                10.1038/nutd.2017.3
                5380896
                28319109
                e29620a8-ac31-4536-9d62-1d9328f629dd
                Copyright © 2017 The Author(s)

                This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article's Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

                History
                : 21 October 2016
                : 20 December 2016
                : 27 December 2016
                Categories
                Original Article

                Endocrinology & Diabetes
                Endocrinology & Diabetes

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