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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThis article discusses whether there is a role for the Dietary Guidelines for Americans (DGA) in weight management with respect to either prevention of weight gain or in sustaining weight loss.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EObesity\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ENutrition Physiology\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ENutrition\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EObesity\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ENutrition Physiology\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003ESusan B. Roberts, PhD, Tufts University, Medford, Massachusetts, USA, discussed whether there is a role for the Dietary Guidelines for Americans (DGA) in weight management with respect to either prevention of weight gain or in sustaining weight loss.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThe DGAs already contain recommendations concerning weight management [United States Department of Agriculture (USDA)\/Department of Health and Human Services. \u003Cem\u003EDietary Guidelines for Americans\u003C\/em\u003E, 7th Edition, Washington, DC: US Government Printing Office, December 2010]. Key among these are the maintenance of an appropriate calorie balance (account for all consumption) and, for those who are overweight or obese, consumption of fewer calories, increasing physical activity, and reducing the time spent on sedentary behaviors. The USDAs Center for Nutrition Policy and Promotion website offers a variety of tools to achieve these goals [\u003Ca href=\u0022http:\/\/www.choosemyplate.gov\u0022\u003Ewww.choosemyplate.gov\u003C\/a\u003E]. Among these are MyPlate, an illustrated selection of low fat, low energy dense foods that shows portion sizes for various calorie levels; the 10 Tips Nutrition Education series, which offers easy-to-follow suggestions on getting started toward a healthy diet, sample menus and recipes; and SuperTracker, an online program that allows individuals to plan, analyze, and track their diet and physical activity. The USDA also supports several public health campaigns such as Drink Up and Let\u0027s Move.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EDespite years of effort the simple instructions and government sponsored programs have not had much impact on the obesity epidemic. Today, nearly 33% of adult Americans are overweight and 36% are obese [Centers for Disease Control and Prevention, National Center for Health Statistics. \u003Cem\u003EPrevalence of Overweight, Obesity, and Extreme Obesity Among Adults: United States, Trends 1960\u20131962 Through 2009\u20132010\u003C\/em\u003E September 2012]. If this trend continues, by 2030 we can expect to see 50% of Americans classified as obese, and within 10 years a 10-fold increase in new cases of diabetes, cardiovascular disease, and arthritis [Trust for America\u0027s Health. \u003Cem\u003EF as in Fat: How Obesity Threatens America\u0027s Future\u003C\/em\u003E 2013; 2012]. Dr. Roberts voiced a need for more effective approaches to prevention and sustainable treatment options.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EStandard-of-care lifestyle interventions have also not been very effective. In the absence of prescribed dietary change, exercise leads to very small changes in body fat, with 1 hour of jogging a day leading to a 3.5% loss of body fat or about 6 lbs in 6 months. Managing caloric intake based on energy derived from protein, fat, or carbohydrates amounts also makes little difference as to the amount of weight loss at 6 months (\u223c7% of initial weight) [Sacks FM et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2009].\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EIn the CALERIE Trial a low-glycemic load diet facilitated greater weight loss in overweight adults with high insulin secretion but not in overweight adults with low insulin secretion (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E) [Pittas AG et al. \u003Cem\u003EDiabetes Care\u003C\/em\u003E 2005]. Other studies have reported similar findings, that is, high protein plus low glycemic index carbohydrates prevent weight regain [Larsen TM et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2010].\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/21\/19\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Mean Weight Change Stratified by Baseline Insulin Secretion\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1986810759\u0022 data-figure-caption=\u0022Mean Weight Change Stratified by Baseline Insulin Secretion\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/21\/19\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/21\/19\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/21\/19\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/13409\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003EMean Weight Change Stratified by Baseline Insulin Secretion\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EINS=insulin; OGTT=oral glucose tolerance test.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003EReproduced from Pittas AG et al. A low-glycemic load diet facilitates greater weight loss in overweight adults with high insulin secretion but not in overweight adults with low insulin secretion in the CALERIE Trial. \u003Cem\u003EDiabetes Care\u003C\/em\u003E 2005; 28(12):2939\u20132941. With permission from the American Diabetes Association.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-8\u0022\u003EOther weight loss approaches include efforts to change behavior and facilitate the formation of new habits around eating and exercise. Tufts Healthy Weight for Living Worksite study [Salinardi TC et al. \u003Cem\u003EAm J Clin Nutr\u003C\/em\u003E 2013] examined the effects of a multicomponent lifestyle intervention on weight loss and prevention of regain in overweight and obese employees. A reduced-energy, low-glycemic, high-fiber diet supported by a behavioral change education program was the primary focus. Additional support was provided at both the worksite level (nutrition education, newsletters, and monthly seminars) and through employee support groups. The individual support groups participated in 16 weekly and 4 biweekly sessions for weight loss and 6 monthly sessions on weight management. The mean weight loss was a substantial \u22128.0 kg in intervention participants, whereas control subjects gained weight (+0.9 kg; p\u0026lt;0.001).\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EIn summary, noted Dr. Roberts, what does not work for weight management is relying on willpower-based strategies without dramatic changes in the food environment, emphasizing self-monitoring of calories, telling people to never eat out, and promoting exercise as a primary approach to weight loss. What should improve effectiveness is different advice for preventing weight gain versus sustaining weight loss with appropriate attention to dietary composition and exercise included; addressing issues that dieters say are barriers like hunger and missing familiar foods; annual updates on guidelines that are competitive with commercial options; and inclusion a Cultural Guidance component within DGA that addresses the need for cultural shifts and\/or policies over time (ie, meal size, restrained food culture).\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/13\/21\/19.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzl561\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzl561\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}