Biomedical subjects

M E Reusser

Publications and source records attributed to M E Reusser.

12 recordsLinked to original sources

PubMed2000

A randomized trial of improved weight loss with a prepared meal plan in overweight and obese patients: impact on cardiovascular risk reduction.

OBJECTIVE: To assess the long-term effects of a prepackaged, nutritionally complete, prepared meal plan compared with a usual-care diet (UCD) on weight loss and cardiovascular risk factors in overweight and obese persons. DESIGN: In this randomized multicenter study, 302 persons with hypertension and dyslipidemia (n = 183) or with type 2 diabetes mellitus (n = 119) were randomized to the nutrient-fortified prepared meal plan (approximately 22% energy from fat, 58% from carbohydrate, and 20% from protein) or to a macronutrient-equivalent UCD. MAIN OUTCOME MEASURES: The primary outcome measure was weight change. Secondary measures were changes in blood pressure or plasma lipid, lipoprotein, glucose, or glycosylated hemoglobin levels; quality of life; nutrient intake; and dietary compliance. RESULTS: After 1 year, weight change in the hypertension/dyslipidemia group was -5.8+/-6.8 kg with the prepared meal plan vs -1.7+/-6.5 kg with the UCD plan (P<.001); for the type 2 diabetes mellitus group, the change was -3.0+/-5.4 kg with the prepared meal plan vs -1.0+/-3.8 kg with the UCD plan (P<.001) (data given as mean +/- SD). In both groups, both interventions improved blood pressure, total and low-density lipoprotein cholesterol levels, glycosylated hemoglobin level, and quality of life (P<.02); in the diabetic group, the glucose level was reduced (P<.001). Compared with those in the UCD group, participants with hypertension/dyslipidemia in the prepared meal plan group showed greater improvements in total (P<.01) and high-density lipoprotein (P<.03) cholesterol levels, systolic blood pressure (P<.03), and glucose level (P<.03); in participants with type 2 diabetes mellitus, there were greater improvements in glucose (P =.046) and glycosylated hemoglobin (P<.02) levels. The prepared meal plan group also showed greater improvements in quality of life (P<.05) and compliance (P<.001) than the UCD group. CONCLUSIONS: Long-term dietary interventions induced significant weight loss and improved cardiovascular risk in high-risk patients. The prepared meal plan simultaneously provided the simplicity and nutrient composition necessary to maintain long-term compliance and to reduce cardiovascular risk.

Adult↗

PubMed2000

The power of food to improve multiple cardiovascular risk factors.

Past research efforts to determine the influence of the diet on cardiovascular health have focused on the individual roles of specific dietary components, and have done so with debatable success. Awareness of the impact and complexity of nutrient interactions has expanded in recent years to include assessment of overall dietary patterns as they contribute to lower cardiovascular disease risk. Several large-scale studies have now demonstrated that whereas manipulations of single nutrients may influence some people with selected conditions, it is improving the total dietary profile that will consistently and beneficially effect multiple cardiovascular risk factors including high blood pressure, plasma lipids, hemoglobin A1c, homocysteine, and weight.

Cardiovascular Diseases↗

PubMed2000

Benefits of dairy product consumption on blood pressure in humans: a summary of the biomedical literature.

The inverse relationship between intake of dairy products and blood pressure levels was first suggested by several epidemiologic surveys in the early 1980's that revealed low calcium intake in populations with increased prevalence of hypertension. Subsequent laboratory and clinical investigations provided further evidence of the association between calcium and blood pressure, but the results of these studies were often inconsistent due to variations in study design and methods, study participants and calcium sources. The recently published results of the large and carefully executed Dietary Approaches to Stop Hypertension Study, "DASH," which demonstrated a dramatic blood-pressure lowering effect of diets rich in dairy products, fruits and vegetables, addressed many of the issues contributing to the inconsistencies in the blood pressure-calcium data. In the following review, we discuss the evolution of the scientific evidence of the association between dietary calcium intake and blood pressure, the findings and significance of the DASH trial and the consensus that now exists among health professionals regarding the importance of adequate dairy product intake for optimal blood pressure regulation.

Blood Pressure↗

PubMed1999

Finding consensus in the dietary calcium-blood pressure debate.

No single study or avenue of investigation can resolve the scientific controversies that entangle efforts to determine the effects of specific nutrients on medical conditions. To reach consensus in this area requires a substantial body of plausible, reproducible and consistent data from various investigative approaches--such as the data that now exist regarding the relationship between dietary calcium and blood pressure. In this paper we describe the plethora of epidemiological and clinical studies and analyses that have been published in the last two years and which cumulatively reveal the consistency of the available data regarding the influence of dietary calcium on blood pressure regulation. Nearly 20 years of investigation in this area has culminated in remarkable and compelling agreement in the data, confirming the need for and benefit of regular consumption of the recommended daily levels of dietary calcium.

Blood Pressure↗

PubMed1999

Increased dietary micronutrients decrease serum homocysteine concentrations in patients at high risk of cardiovascular disease.

BACKGROUND: Elevated blood homocysteine is a risk factor for cardiovascular disease. A 5-micromol/L increase is associated with an approximately 70% increase in relative risk of cardiovascular disease in adults. For patients with established risk factors, this risk is likely even greater. OBJECTIVE: Effects of increased dietary folate and recommended intakes of vitamins B-12 and B-6 on serum total homocysteine (tHcy) were assessed in individuals at high risk of cardiovascular disease. DESIGN: This trial was conducted at 10 medical research centers in the United States and Canada and included 491 adults with hypertension, dyslipidemia, type 2 diabetes, or a combination thereof. Participants were randomly assigned to follow a prepared meal plan (PMP; n = 244) or a self-selected diet (SSD; n = 247) for 10 wk, which were matched for macronutrient content. The PMP was fortified to provide >/=100% of the recommended dietary allowances for 23 micronutrients, including folate. RESULTS: Mean folate intakes at 10 wk were 601 +/- 143 microgram/d with the PMP and 270 +/- 107 microgram/d with the SSD. With the PMP, serum tHcy concentrations fell from 10.8 +/- 5.8 to 9.3 +/- 4.9 micromol/L (P < 0.0001) between weeks 0 and 10 and the change was associated with increased intakes of folate, vitamin B-12, and vitamin B-6 and with increased serum and red blood cell folate and serum vitamin B-12 concentrations. tHcy concentrations did not change significantly with the SSD. CONCLUSIONS: The PMP resulted in increased intakes and serum concentrations of folate and vitamin B-12. These changes were associated with reduced serum tHcy concentrations in persons at high risk of cardiovascular disease.

Adult↗

PubMed1999

Multicenter randomized trial of a comprehensive prepared meal program in type 2 diabetes.

OBJECTIVE: To evaluate the clinical effects of a comprehensive prepackaged meal plan, incorporating the overall dietary guidelines of the American Diabetes Association and other national health organizations, relative to those of a self-selected diet based on exchange lists in free-living individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 202 women and men (BMI < or = 42 kg/m2) whose diabetes was treated with diet alone or an oral hypoglycemic agent were enrolled at 10 medical centers. After a 4-week baseline period, participants were randomized to a nutrient-fortified prepared meal plan or a self-selected exchange-list diet for 10 weeks. On a caloric basis, both interventions were designed to provide 55-60% carbohydrate, 20-30% fat, and 15-20% protein. At intervals, 3-day food records were completed, and body weight, glycemic control, plasma lipids, and blood pressure were assessed. RESULTS: Food records showed that multiple nutritional improvements were achieved with both diet plans. There were significant overall reductions in body weight and BMI, fasting plasma glucose and serum insulin, fructosamine, HbA1c, total and LDL cholesterol, and blood pressure (P < 0.001 or better for all). In general, differences in major end points between the diet plans were not statistically significant. CONCLUSIONS: Glycemic control and cardiovascular risk factors improve in individuals with type 2 diabetes who consume diets in accordance with the American Diabetes Association guidelines. The prepared meal program was as clinically effective as the exchange-list diet. The prepared meal plan has the additional advantages of being easily prescribed and eliminating the complexities of meeting the multiple dietary recommendations for type 2 diabetes management.

Adult↗

PubMed1996

Body weight and blood pressure regulation.

Excess body weight correlates closely with increased blood pressure. Virtually every prospective study of factors that influence blood pressure regulation has identified weight, or body mass index, as the strongest predictor of human blood pressure. In normotensive persons, longitudinal and intervention studies have documented that weight gain, over as short a period as 1-2 mo., is associated with predictable rises in arterial pressure. Conversely, in borderline hypertensive persons, similar types of studies have reported that weight reductions of as little as 4-5 kg result in normalization of blood pressure. During periods of weight loss, decreases in blood pressure are evident within the first 2-3 wk; the greatest proportionate blood pressure change occurs during the earliest phases of weight reduction. The decline in blood pressure with weight loss has been shown to be unrelated to variations in nutrient intake. However, the association between blood pressure decreases and increased amounts of physical activity, which generally accompany weight loss efforts, is less clear. For many overweight individuals, reductions in blood pressure that occur with weight loss may be due specifically to the initiation of a regular physical exercise regimen. Weight loss in hypertensive persons has been shown to dramatically reduce, and in many cases eliminate, antihypertensive medication requirements. It is estimated that in up to 50% of the adults in the United States whose hypertension is being pharmacologically managed, the need for drug therapy could be alleviated with only modest reductions in body weight.

Blood Pressure↗

PubMed1995

Calcium intake and blood pressure: epidemiology revisited.

Despite years of investigative effort, the role of calcium in preventing or treating hypertension remains unclear. Comprehensive analyses have provided inconclusive results due to variations in methodology and/or design and, similar to the individual studies, to inconsistent, often conflicting results. However, what these studies have shown is that there are individuals or certain population groups who will benefit from increased calcium use, and that although it may not be the solution to the high prevalence of hypertension or a first-line treatment for hypertension, adequate calcium intake, in conjunction with other nutrients, may be associated with a reduced risk of developing hypertension. Further, based on the available data, it can be recommended that clinical and investigative efforts should be directed at identifying those persons at greater risk who will benefit from increased intake of dietary calcium.

Blood Pressure Determination↗

PubMed1994

Micronutrient effects on blood pressure regulation.

Five micronutrients have been shown to directly influence blood pressure: sodium, calcium, potassium, magnesium, and chloride. The data presented here are based on accumulated findings from epidemiologic, laboratory, and clinical investigations, many of which focused primarily on a single nutrient. However, as also discussed here, nutrients are not consumed in isolation, and their physiologic interactions and combined effects on blood pressure are the subjects of much of the current research in the area of diet and hypertension.

Animals↗

PubMed1986

Estimates of iron sufficiency in the US population.

Traditionally the iron status of a population is assessed by estimating the prevalence of iron deficiency anemia. This approach is inadequate in countries where the diet is heavily fortified with iron because it conveys no information about the iron-replete segment of the population. In the present study iron status of a US adult population was evaluated using data collected in the second National Health and Nutrition Examination Survey (NHANES II). Body iron was estimated in each of 2,829 individuals from measurements of hemoglobin concentration, serum ferritin, transferrin saturation, and erythrocyte protoporphyrin. When individuals between 18 and 64 years of age were divided on the basis of sex and menstrual status, body iron reserves were normally distributed and averaged 309 mg in women 18 to 44 years, 608 mg in women 45 to 64 years, and 776 mg in men 18 to 64 years. The dispersion of storage iron in these groups was similar, with standard deviations of 346, 372, and 313 mg, respectively. The prevalence of iron deficiency anemia was surprisingly low, ranging from only 0.2% in adult men to 2.6% and 1.9% in pre- and postmenopausal women, respectively. Epidemiologic methods that examine iron status in the entire population assume importance in light of evidence that in certain segments of the US population, iron deficiency anemia is now less common than the homozygous state for hereditary hemochromatosis.

Adult↗

PubMed1983

Iron fortification: an update.

Iron fortification is the optimal approach to reducing the high prevalence of iron deficiency in developing countries. Selection of the iron source entails a compromise between the use of inert compounds which are poorly absorbed and chemically reactive forms with high bioavailability. Although the vehicle and fortification compound must be chosen in tandem because most iron compounds cause discoloration or rancidity, the emphasis in this review is on the food vehicle. Technology for fortifying wheat flour and bread is well established and the use of these vehicles has probably had a significant impact on iron status in Western countries. Recent studies in India indicate that the fortification of common salt is technically feasible and field trials have shown a good hematological response. Similar success has been achieved by fortifying refined sugar with NaFeEDTA in Guatemala. Rice has advantages as a vehicle in those areas where it is the staple food but the technology requires further development. Fish-based condiments have been successfully fortified with NaFeEDTA and show promise as a vehicle in East Asian countries. The fortification of infant foods poses no technical problems and should be encouraged. Additional work is needed to identify other fortification options and to develop targeted fortification programs that will direct iron to those segments of a population in greatest need.

Anemia, Hypochromic↗

PubMedDate not supplied

Nonpharmacologic therapy in hypertension: from single components to overall dietary management.

Improved lifestyle and dietary practices are now recognized as essential factors in the optimal management of high blood pressure. This chapter discusses the nonpharmacologic approaches that are generally recommended for hypertension treatment as well as prevention, including summaries of the evidence on which these recommendations are based. For many of these approaches, specifically dietary modifications, the evidence is strong but not yet definitive. Potential sources of the conflicting data and the lack of scientific consensus are addressed, as well as recent findings of the effects of the total diet and dietary patterns that may ultimately resolve much of the controversy regarding nonpharmacologic means of treating and preventing hypertension.

Feeding Behavior↗