Saturday 28 December 2013

Diet and physical activity behaviors among Americans trying to lose weight

In the study to investigate the Behavioral Risk Factor Surveillance System, a state-based telephone survey of adults > or =18 years of age (N = 184,450) conducted in the 50 states, the District of Columbia, and Puerto Rico in 2000, showed that the prevalence of trying to lose weight was 46% (women) and 33% (men). Women reported trying to lose weight at a lower BMI than did men; 60% of overweight women were trying to lose weight, but men did not reach this level until they were obese. Adults who had a routine physician checkup in the previous year and reported medical advice to lose weight vs. checkup and no medical advice to lose weight had a higher prevalence of trying to lose weight (81% women and 77% men vs. 41% women and 28% men, respectively). The odds of trying to lose weight increased as years of education increased. Among respondents who were trying to lose weight, approximately 19% of women and 22% of men reported using fewer calories and > or =150 min/wk leisure-time physical activity(1).

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(1) " Diet and physical activity behaviors among Americans trying to lose weight: 2000 Behavioral Risk Factor Surveillance System" by Bish CL, Blanck HM, Serdula MK, Marcus M, Kohl HW 3rd, Khan LK.

Methods for voluntary weight loss and control

In a study of "Methods for voluntary weight loss and control",  found that participants who remain in weight loss programs usually lose approximately 10% of their weight. However, one third to two thirds of the weight is regained within 1 year, and almost all is regained within 5 years. For many overweight persons, achieving and maintaining a healthy weight is a lifelong challenge. Successful weight loss improves several cardiovascular risk factors and diabetic control; effects on mortality are not clear. Several epidemiologic studies have found that weight loss is associated with increased mortality but the reasons for weight loss were not known. Survey data also confirm that many Americans who are not overweight, particularly young women, are trying to lose weight, which may have adverse physical and psychological consequences. Because of the importance of these issues, research on weight and on weight loss and control should assume a high priority on the nation's health agenda(1).

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(1) "Methods for voluntary weight loss and control. NIH Technology Assessment Conference Panel. Consensus Development Conference, 30 March to 1 April 1992" by [No authors listed]

Descriptive epidemiology of body weight and weight change in U.S. adults

In the review of data on body weight and weight change collected from nationally representative samples of U.S. adults, showed that between 1960 and 1980, the prevalence of overweight among whites increased by 3% in women and by 6% in men. In blacks, however, the prevalence of overweight increased by 7% in women and by 28% in men. Longitudinal body weight measurements taken 10 years apart show that adults younger than 55 years tend to gain weight, whereas those 55 years and older tend to lose weight. The youngest adults gain the most weight, and the oldest adults lose the most weight. In all age groups, women have substantially greater variation in their 10-year weight change than do men(1).

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(1) "Descriptive epidemiology of body weight and weight change in U.S. adults" by Williamson DF.

Health-related quality of life and weight loss practices among overweight and obese US adults

In the study to examine the prevalence and association of HRQOL measures as independent moderators of weight loss practices among overweight and obese men and women, showed that Among men with BMI 25-34.9 kg/m2, the odds of trying to lose weight increased for the moderate vs best category of HRQOL but not for the poorest vs best category, and no associations were noted for men with BMI > or = 35 kg/m2. Women with BMI 25-34.9 kg/m2 had reduced odds and decreasing associated trends in the prevalence of trying to lose weight with poorer general health, increased physically unhealthy days, and increased activity limitation days. Conversely, women with 1-13 vs 0 mentally unhealthy days had greater odds of trying to lose weight. Among those trying to lose weight, reducing calories was common (52%-69%, men; 56%-69%, women). Among men, with the exception of recent mental health, poorer levels of HRQOL measures were associated with diminished attainment of recommended physical activity levels. Among women, poorer general health status was associated with diminished attainment of recommended physical activity levels(1).

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(1) "Health-related quality of life and weight loss practices among overweight and obese US adults, 2003 behavioral risk factor surveillance system" By Bish CL, Blanck HM, Maynard LM, Serdula MK, Thompson NJ, Khan LK.

Employment, work hours and weight gain among middle-aged women

In the study to investigate the influence of employment and work hours on weight gain and weight loss among middle-aged women, Dr. Au N, and the scientists at the Monash University, found that among the employed, working longer hours was associated with more weight gain, especially at the higher levels of weight gain where the health consequences are more serious. These findings suggest that as women work longer hours they are more likely to make lifestyle choices that are associated with weight gain.International Journal of Obesity advance online publication, 19 June 2012(1).

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(1) "Employment, work hours and weight gain among middle-aged women" by Au N, Hauck K, Hollingsworth B.

Friday 27 December 2013

Women and Osteoporosis

Osteoporosis is defined as a condition in which the bone minerals density including calcium, is deteriorate with the amounts of protein in the bone is alter,that lead to bone weakening, causing the increased risk of fracture. In women, osteoporosis happens in the stage of menopause, as the result of the reduction of hormones which protects the bones from calcium and are at increased risk bone fracture related to osteoporosis. In the US, more than 24 million women in the United States are affected by this disease.
Types of osteoporosis
Osteoporosis can be divided to 3 subtypes
1. Primary type 1
Postmenopausal osteoporosis occurs after the women enter the stage of menopause.
2. Primary type 2
Senile osteoporosis occurs after the age of 75, with the risk ratio of 2-1 in women and men.
3. Secondary osteoporosis
The disease can occurs to any age regardless of genders. Secondary osteoporosis mostly caused by prolonged use of certain medication, or results from chronic predisposing medical problems or disease.



Symptoms
In the beginning of the disease, there is no specific symptoms, but when the the disease progress due to the loss certain amount of minerals, some women might experience certain symptoms, including
1. Fragility Fracture
Fragility fractures occur in the vertebral column, rib, hip and wrist is very common for women with osteoporosis, as the result of the bone have become more fragile due to the loss of calcium and certain minerals.

2. Loss of height over time
As a result from the articular cartilage damage

3. Back pain
It may be result from the fracture of the vertebra, wrist, hip.

4. Stooped posture
Such as rounding of the upper back, caved shoulders and leaning forward while standing, etc. due to the bone no longer can support the body weight normally.

5. Etc.

Causes and risk factors
The causes of osteoporosis are unknown, but the process of osteoporosis are caused by remolding disruption.
1. Lack of calcium
Lack of calcium, in women is caused by levels of estrogen. Under normal circumstance, as the depletion of numbers of egg in the ovaries causes the ovaries not responding to the estrogen stimulating hormones as the women enter the stage of menopause.

2. Lack of exercise
According to the artcle of Exercise and Osteoporosis - How exercise helps maintain bone health By Elizabeth Quinn, the author wrote, a survey of 350 middle-aged women found that those who were most active in their daily lives had significantly greater bone density in their spines, femurs and forearms than less active women. Another study from found that running strengthens the leg bones of both older and younger women.
Exercise also enhances muscle power, synthesis, and balance and reduces the likelihood of falls in the elderly.

3. Age
In women, estrogen reduction increase with age, that can cause the loss of bone density, resulting of osteoporosis.
4. Smoking
smoking inhibits osteoblasts which are mononucleate cells that are responsible for bone formation, In an article of The effects of smoking on bone health by Peter K. K. WONG, Jemma J. CHRISTIE and John D. WARK, researchers indicated that Compared with non-smokers, smokers are weaker, have poorer balance and impaired neuromuscular performance. In the study by Nelson et al., smokers had a decrease in physical and neuromuscular function, compared with non-smokers, 50–100% as great as that associated with a 5 year increase in age

5. Hyperthyriodism
Hyperthyroidism can increase loss of calcium and phosphorous in the urine and stool excretion, that can lead to loss of bone mineral.

6. Medications
Certain medications such as Steroid-induced osteoporosis (SIOP), Barbiturates, phenytoin and some other enzyme-inducing antiepileptics, etc can cause the loss of bone minerals density.

7. Low levels of estrogen
Estrogen is best known for its protection against the loss of calcium of bone. The levels of estrogen is lower naturally with aging, that is the reason that osteoporosis happens most frequent in the women after entering stage of menopause. Excessive exercise can also disrupt the levels of estrogen, leading to abnormal menstrual cycle that can lead to increased risk of osteoporosis.

8. Alcohol
Excessive consumption of alcohol increases the risk of posteriors. In an article of Association Between Alcohol Consumption and Both Osteoporosis Fracture and Bone Density by Karina M. Berg, MD, MS, Hillary V. Kunins, MD, MS, MPH, Jeffrey L. Jackson, MD, MPH, Shadi Nahvi, MD, Amina Chaudhry, MD, MPH, Kenneth A. Harris Jr. MD, MPH, Rubina Malik, MD, MS, Julia H. Arnsten, MD, MPH., researchers found that compared with abstainers and heavier drinkers, persons who consume 0.5 to 1.0 drink per day have a lower risk of hip fracture. Although available evidence suggests a favorable effect of alcohol consumption on bone density, a precise range of beneficial alcohol consumption cannot be determined.

9. Medical conditions
Chronic predisposing medical problems or disease requires the use of certain medication can increase the risk of osteoporosis, such as Steroids and Corticosteroids used to treat inflammatory intestinal illness, asthma and rheumatoid arthritis; prescription drugs used to treat heartburn, acid reflux, indigestion, excess stomach acid and ulcers:, etc.

10. Gender
Women are at higher risk in developing osteoporosis than men.

11. Family history
Increased risk of osteoporosis if a woman has a history of bone fracture.

12. Gene
In a study of Pathogenesis of osteoporosis: concepts, conflicts, and prospects by Lawrence G. Raisz; University of Connecticut Health Center, Musculoskeletal Institute, Farmington, Connecticut, USA. researcher found that Gene deletion studies have shown that absence of runt-related transcription factor 2 (Runx2) or a downstream factor, osterix, are critical for osteoblast differentiation. Interestingly, overexpression of Runx2 leads to a decrease in bone mass....

13. Vitamin D deficiency
In an article of Osteoporosis: the role of micronutrients American Journal of Clinical Nutrition, Vol. 81, No. 5, 1232S-1239S, May 2005 © 2005 American Society for Clinical Nutrition indicated that Adults with vitamin D deficiency have muscle weakness and are more likely to fall. In a meta-analysis, vitamin D supplementation appeared to reduce falls by 20%, and furthermore if 15 patients were treated with vitamin D, fall could be prevented.

14. Etc.

Diagnosis and tests
1. Blood test
Blood test for calcium and vitamin D in the sample withdrawn from your vein will be helpful to determine the metabolic process of bone breakdown.

2. Bone mineral density (BMD)
Bone mineral density (BMD) is a test to measure the amount of matter per cubic centimeter of bones used as an indicator of osteoporosis and fracture risk with a special X ray or computed tomography (CT) scan.

3. Bone density scan
Bone density scan also known as dual-energy x-ray absorptiometry (DXA) or bone densitometry,
is test to measure amount of bone loss by exposing a part of the body to a small dose of ionizing radiation with the use of X ray to take image of the inside of the body.

4. Etc.

Preventions
No women can prevent the loss of calcium due to aging, but women always can reduce the loss of calcium to a minimum and prevent the onset of osteroporosis.
1. How to reduce the loss of calcium and minerals
a. Quit smoking
b. Reduce intake of alcohol
c. Moderate exercise
d. Eating healthy
e. Maintain a healthy style
f. Taking calcium, vitamin D, and C.
g. Etc.

2. Diet
A balance diet is always helpful in maintaining an optimal health, reduce the risk of diseases
a. Whole grains
b. Beans and legumes
c. Vegetables and fruits
d. Nuts and seeds
e. Lean meats and sea foods
For more information and details of above healthy foods, please visit http://healthy-foods-index.blogspot.com/

3. Nutritional supplements
a. Calcium
Calcium is important in maintaining the strong bond and reduce the risk of osteoporosis. unfortunately, the loss of calcium is inevitable as a result of reduced levels of estrogen due to aging, intake of calcium may be helpful to replace it.

b. Vitamin D
Vitamin D is important in enhancing the absorption of the calcium, thus taking vitamin D and calcium together will reduce the risk of the diseases.

c. Vitamin C
Vitamin C not only enhances the absorption of other vitamins and minerals but also promotes higher calcium uptakes. In an article of Vitamin C reverses osteoporosis in mice, published in the recent issue of the Journal of Clinical Investigation, experiments on mice showed that antioxidants, and the enzymes responsible for maintaining them in a reduced state, fell substantially in rodent bone marrow after ovariectomy. Bone loss was however entirely preventable by giving the mice 20mg of vitamin C per day.

d. Phosphate and Alendronate
In an article, Phosphate and Alendronate Helpful in Adult Growth Hormone Deficiency published in Reuters Health, New york, regarded to the study of studied 44 patients.
Those who were previously naive to GH were randomized to receive GH
replacement alone or with alendronate or phosphate. After a year, patients receiving phosphate had significantly greater increases in nephrogenous cAMP (a marker of renal PTH activity) than
those on GH alone. There was also a significantly greater increase in BMD.

e. Phytoestrogen from soy and wolfberry
Phytoestrogen contain plant base estrogen which can occupy the estrogen receptor site to replace the loss of estrogen produced by ovaries due to aging, thus reducing the risk of osteoporosis.

f. Vitamin K
vitamin K is important to prevent bone loss caused by estrogen deficiency.

g. Etc.

4. Herbs
a. Alfalfa
Alfalfa is a source of vitamins A, C, E, and K and of the minerals, calcium, potassium, phosphorus, and iron, which is important for osreroporosis caused lack of nutrients and nutrients deficiency.

b. Horny Goat Weed (Epimedium)
The flavonoids in Epimedium were shown to prevent bone loss in postmenopausal women, according to a study of Epimedium-derived phytoestrogen flavonoids exert beneficial effect on preventing bone loss in late postmenopausal women: a 24-month randomized, double-blind and placebo-controlled trial, by Zhang G, Qin L, Shi Y.

c. Black Cohosh
Black cohosh has beeen used in herbal medicine as a dietary supplement to relieve the symptoms of menopause caused by estrogen deficiency. It has antiosteoporotic effects, according to the study of Effects of black cohosh (Cimicifuga racemosa) on bone turnover, vaginal mucosa, and various blood parameters in postmenopausal women: a double-blind, placebo-controlled, and conjugated estrogens-controlled study by Wuttke W, Gorkow C, Seidlová-Wuttke D.
and has been shown to enhance bone formation in a study of Ethanolic extract of Actaea racemosa (black cohosh) potentiates bone nodule formation in MC3T3-E1 preosteoblast cells.
Chan BY, Lau KS, Jiang B, Kennelly EJ, Kronenberg F, Kung AW.

d. Red clover
Red clover contains compounds known as isoflavones that helps to replace lost estrogen in the female body. Also known for its uses before menopause as it can delay the natural progression. according to a study of Clinical effects of a proprietary combination isoflavone nutritional supplement in menopausal women: a pilot trial by Lukaczer D, Darland G, Tripp M, Liska D, Lerman RH, Schiltz B, Bland JS.

e. Etc

5. Chinese herbs
1. Chinese engleica roots (Dang Qui or dong quai)
Dang Qui is considered as a queen herb in traditional Chinese medicine to treat menstrual and menopausal symptoms. Dang Qui exhibits estrogenic activity in vitro, according to the study of Evaluation of estrogenic activity of plant extracts for the potential treatment of menopausal symptoms by Liu J, Burdette JE, Xu H, Gu C, van Breemen RB, Bhat KP, Booth N, Constantinou AI, Pezzuto JM, Fong HH, Farnsworth NR, Bolton JL.

2.Rehmannia glutinosa (Shu di huang)
It is one of the good herb for tonifying blood, nourishing yin and blood and enriching kidney essence.

3. Ligustrum lucidum (Nu zhen zi)
Nu zhen zi is good for liver and kidney tonification and clearing heat due to yin deficiency.

4. Morus Albus (Sang shen)
The herbs is most used in nourishing yin, tonifying blood and promoting the generation of body fluids.

5. Etc.

Treatments
The main objective of the treatments is to prevent or reduce bone fractures and maintain or increase bone density
1. Hormone-replacement therapies (HRTs)
a. Hormone-replacement therapies (HRTs) are used to prevent the symptoms caused by diminished circulating estrogen and progesterone hormones for women in the stage of menopause and peri-menopause and have an effect in reduce bone loss when are used.
b. Risks and side effects
b.1. Thrombophlebitis
b.2. Pulmonary embolism
b.3. Heart disease
b.4. Strokes
b.5. Breast cancer
b.6. Endometrial cancer
b.7. Etc

2. Bisphosphonates
a. Bisphosphonates are a group of drugs that are used to prevent the loss of bone mass and to treat osteoporosis by reducing the risk of osteoporotic fracture in those who have had previous fractures, but not those who have not previously had a fracture, including alendronate, etidronate, risedronate, zoledronic acid, etc. Avvording to the study of Risedronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women by
George A Wells, Ann Cranney, Joan Peterson, Michel Boucher, Beverley Shea, Vivian Welch, Doug Coyle, Peter Tugwell.
b. Risks and side effects
b.1. Upset Stomach
b.2. Esophogeal Inflammation
b.3. Unusual femur fractures
b.4. Bone, Joint, and Muscle Pain
b.5. Etc.

3. Calcitonin
a. Calcitonin, a hormone produced by the thyroid gland in our body belonging to belongs to the calcitonin-like protein family, can help to reduce blood calcium and strengthen bone by inhibiting umbilical absorption by the intestines and osteoclast activity in bones, according to the report of Sect. 5, Ch. 6: Effects of CT on the Small Intestine". Medical College of Georgia. Retrieved 2008-08-07.
b. Risks and side effects
b.1. Runny nose
b.2. Sores, or
b.3. Redness.
b.4. Nose bleeding
b.5. Swelling
b.6. Etc.

4. Selective estrogen receptor modulators (SERMs)
a. Selective estrogen receptor modulators are a group of compounds that act on the estrogen receptor, including lasofoxifene, femarelle, raloxifene, etc.. Most SERMs used to treat postmenopausal osteoporosis with a favorably respond and may be used as replacements for hormone replacement therapy (HRT).
b. Risks and side effects
1. Uterine cancer
2. Blood clots
3. Endometrial cancer and
4. Stroke
5. Dizziness
6. Severe headaches
7. Hot flashes
8. Fatigue
9. Mood swings
10. Etc.

5. Denosumab
a. Denosumab, a medicine manufactured by Amgen is given as an injection and used to treat osteoporosis to induce bone loss, bone metastases, rheumatoid arthritis, etc. according to the study of Denosumab in Postmenopausal Women with Low Bone Mineral Density by
Michael R. McClung, M.D., E. Michael Lewiecki, M.D., Stanley B. Cohen, M.D.,Michael A. Bolognese, M.D., Grattan C. Woodson, M.D., Alfred H. Moffett, M.D.,Munro Peacock, M.D., Paul D. Miller, M.D., Samuel N. Lederman, M.D.,Charles H. Chesnut, M.D., Douglas Lain, M.D., Alan J. Kivitz, M.D.,Donna L. Holloway, Ph.D., Charlie Zhang, Ph.D., Mark C. Peterson, Ph.D.,and Pirow J. Bekker, M.D., Ph.D., for the AMG 162 Bone Loss Study Group.
b. Risks and side effects
b.1. Persistent, or severe infection
b.2. Spasms
b.3. Nervous tension such as depression, confusion and irritability
b.4. Arrhythmia
b.5. Unexplained swelling
b.6. Difficult breathing
b.7. Etc.
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Green tea catechins, caffeine and body-weight regulation

In the study to evaluate the tools for obesity management including caffeine, and green tea have been proposed as strategies for weight loss and weight maintenance found that these ingredients may increase energy expenditure and have been proposed to counteract the decrease in metabolic rate that is present during weight loss. Positive effects on body-weight management have been shown using green tea mixtures. Green tea, by containing both tea catechins and caffeine, may act through inhibition of catechol O-methyl-transferase, and inhibition of phosphodiesterase. Here the mechanisms may also operate synergistically. A green tea-caffeine mixture improves weight maintenance, through thermogenesis, fat oxidation, and sparing fat free mass. The sympathetic nervous system is involved in the regulation of lipolysis, and the sympathetic innervation of white adipose tissue may play an important role in the regulation of total body fat in general. Taken together, these functional ingredients have the potential to produce significant effects on metabolic targets such as thermogenesis, and fat oxidation. An ethnic or genetic effect, and habitual caffeine or green tea catechin intake may act as confounders; this remains to be revealed(1).


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(1) "Green tea catechins, caffeine and body-weight regulation" by Westerterp-Plantenga MS.

Body weight loss and weight maintenance in relation to habitual caffeine intake and green tea supplementation

In the Investigation of the effect of a green tea-caffeine mixture on weight maintenance after body weight loss in moderately obese subjects in relation to habitual caffeine intake, indicated that High caffeine intake was associated with weight loss through thermogenesis and fat oxidation and with suppressed leptin in women. In habitual low caffeine consumers, the green tea-caffeine mixture improved WM, partly through thermogenesis and fat oxidation(1).


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(1) "Body weight loss and weight maintenance in relation to habitual caffeine intake and green tea supplementation" by Westerterp-Plantenga MS, Lejeune MP, Kovacs EM.

The effects of green tea on weight loss and weight maintenance

In the study to elucidate by meta-analysis whether green tea indeed has a function in body weight regulation, showed that Catechins significantly decreased body weight and significantly maintained body weight after a period of WL (microcirc=-1.31 kg; P<0.001). Inhibition of this effect by high habitual caffeine intake (>300 mg per day) failed to reach significance (microcirc=-0.27 kg for high and microcirc=-1.60 kg for low habitual caffeine intake; P=0.09). Also, the seemingly smaller effect of catechins in Caucasian (microcirc=-0.82 kg) subjects compared with Asians (microcirc=-1.51 kg; P=0.37) did not reach significance. Interaction of ethnicity and caffeine intake was a significant moderator (P=0.04)(1).

 
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(1) "The effects of green tea on weight loss and weight maintenance: a meta-analysis" by Hursel R, Viechtbauer W, Westerterp-Plantenga MS.

Effectiveness of green tea on weight reduction in obese Thais

In the study  to investigate the effects of green tea on weight reduction in obese Thais, a randomized, controlled trial involving 60 obese subjects (body mass index, BMI > 25 kg/m2) was conducted. All subjects consumed a Thai diet containing 3 meals (8373.6 kJ/day) for 12 weeks, prepared by the Nutritional Unit at Srinagarind Hospital, showed that the diet contained 65% carbohydrates, 15% protein, and 20% fat. Body weight, BMI, body composition, resting energy expenditure, and substrate oxidation were measured at baseline, and during weeks 4, 8, and 12 of the study. Serum levels of leptin and urine VMA were measured at baseline and during the 12th week. Differences over time and between the treatments (green tea or placebo) over time were determined using two-factor ANOVA with repeated measures. In comparing the two groups, differences in weight loss were 2.70, 5.10, and 3.3 kg during the 4th, 8th, and 12th weeks of the study, respectively. At the 8th and 12th weeks of the study, body weight loss was significantly different (P < 0.05). At the 8th week, the difference in resting energy expenditure was 183.38 kJ/day (P < 0.001), the difference in the respiratory quotient was 0.02 (P < 0.05), and no significant differences existed in satiety score, food intake, or physical activity. Urine VMA was significantly different in the 12th week of the study (P < 0.05)(1).


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(1) "Effectiveness of green tea on weight reduction in obese Thais: A randomized, controlled trial" by

Low glycaemic index or low glycaemic load diets for overweight and obesity

In the study to assess the effects of low glycaemic index or load diets for weight loss in overweight or obese people, showed that overweight or obese people on LGI lost more weight and had more improvement in lipid profiles than those receiving Cdiets. Body mass, total fat mass, body mass index, total cholesterol and LDL-cholesterol all decreased significantly more in the LGI group. In studies comparing ad libitum LGI diets to conventional restricted energy low-fat diets, participants fared as well or better on th LGI diet, even though they could eat as much as desired. Lowering the glycaemic load of the diet appears to be an effective method of promoting weight loss and improving lipid profiles and can be simply incorporated into a person's lifestyle. Further research with longer term follow-up will determine whether improvement continues long-term and improves quality of life(1).


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(1) "Low glycaemic index or low glycaemic load diets for overweight and obesity" by Thomas DE, Elliott EJ, Baur L.

Women and Heart Disease (Coronary Microvascular Disease (MVD))

Heart disease is defined as a condition in which the heart's inner lining of blood vessels is served damage that can impede the function of transportation of oxygen and nutrition of the heart to other cells and organ in the body. Everyday, more than 2,000 Americans die as a result of heart diseases. Approximately 60 million Americans have heart disease.
Believe or not, 1 in 4 women in US dies from the heart diseases and coronary heart disease (CHD) is the most common type of heart disease in women and men.

What is coronary heart disease
Coronary heart disease is a result of plague build up in the inner lining wall of the arteries, by mostly cholesterol, fat and other minerals. In a prolonged period of time, these build up can block and impeded the inner lining wall, leading to the narrower blood flow to the muscles of the heart. In some case, the rupture of plague can cause blood clots blocking the flow of blood to the blood muscle, causing heart attack.

What is coronary microvascular disease (MVD)
Instead of affects the arteries, coronary microvascular disease (MVD) affects the heart's smallest coronary arteries. according to findings from the National Heart, Lung, and Blood Institute’s (NHLBI) Women’s Ischemia Syndrome Evaluation (WISE) study, In women with this condition, called coronary microvascular syndrome, plaque accumulates in very small arteries of the heart, causing narrowing, reduced oxygen flow to the heart, and pain that can be similar to that of people with blocked arteries, but the plaque does not show up when physicians use standard tests. As a result, many women go undiagnosed.

Symptoms
1. Leg cramps during walking
Leg cramps during exercise might be caused by dehydration. It is important to drink a lot of fluid during exercise. Leg cramps occur when the muscle suddenly and forcefully contracts. The most common muscles to contract in this manner are muscles that cross two joints. Leg cramps during walking might be an indication of heart disease caused by arteries in your leg being clogged up by cholesterol as a result of not enough oxygen being delivered to the cells in your leg. If this symptom persists, please consult with your doctor.

2. Chest pain
Chest pain is caused by blood vessels in the heart temporarily blocked up or by inadequate oxygen supply to the heart muscle or coronary . The persistence of chest pain would be an early indication of heart diseases.

3. Shortness of breath
Shortness of breath (dyspnea) is the major symptom of the left ventricular insufficiency. People with shortness of breath are four times more likely to die from a heart disease related cause than individuals without any symptoms.

4. Headaches
People see sparkling zigzag lines or loss of vision before a migraine attack may be at particular risk of future cardiovascular problems. Generally headaches do not cause heart diseases but a sudden, explosive onset of great pain might be.

5. Dizziness
Dizziness can have many causes including low blood count, low iron in the blood stream and other blood disorders, dehydration, and viral illnesses. Since there are many different conditions that can produce these symptoms, anybody experiencing episodes of severe headaches or dizziness ought to be checked by your doctor.

6. Palpitations
Palpitations is an extremely common symptom of heart disease. Palpitations are skips in the heart beats and irregular heart beats.

7. Loss of consciousness
It is a common symptom, most people pass out at least once in their lives. However, sometimes loss of consciousness indicates a dangerous or even life-threatening condition such as heart disease so when loss of consciousness occurs it is important to figure out the cause.

8. Etc.

Causes and risk factors
1. Diet high in saturated and trans fat
Diet high in saturated and trans fat increases the risk of cholesterol build up in the arteries and accumulated in very small arteries of the heart, causing narrowing, reduced oxygen flow to the heart.

2. High blood pressure
Blood pressure is the force of blood pushing against the walls of the arteries to regulate the blow flow for transporting oxygen and nutrients to the body's cell and organs. if plague build-up over prolong period of time, it can narrow the arteries and very small arteries of the heart, causing high blood pressure that can lead to heart disease.

3. Diabetes
Diabetes can increase diabetes-related fatty material deposite in the walls of coronary arteries as a result od prolonged period of high blood glucose in the blood stream. According to the article of Diabetes Overview by National Diabetes Information Clearinghouse (NDIC) indicated that women who have not gone through menopause usually have less risk of heart disease than men of the same age. But women of all ages with diabetes have an increased risk of heart disease because diabetes cancels out the protective effects of being a woman in her child-bearing years.

4. Insulin resistance
In a study of Relationship of glucose tolerance and plasma insulin to the incidence of coronary heart disease by Pyorala K. 1979 researcher found that hyperinsulinemia is a predictor of coronary artery disease (CAD).

5. Central waist Obesity
Abdominal fat accumulated to the central waist area can increase the production of bad cholesterol, causing plague deposited on the inner lining of blood vessel walls.

6. Age
The decreased levels of estrogen due to aging are associated with increased risk of coronary microvascular disease.

7. Lack of physical exercise
In astudy of studied 223 children -- 123 boys and 100 girls -- with an average age of 9.8 years, assessing their physical activity levels over four days from a team of researchers from Sweden and Denmark found that children who were more physically active had a lower composite risk factor score for cardiovascular disease (CVD) than the children with lower amounts of moderate to vigorous physical activity and vigorous physical activity.

8. Family history
Increased risk of developing the disease if one of the direct family member have the disease

9. Heredity
Inherited heart muscle diseases may increase the risk of coronary microvascular disease (MVD).

10. Smoking
Cigarette contains high amount of harmful chemical substances attacked to the arterial wall, causing plague build-up, hardening the arterial wall that can lead to coronary microvascular disease.

Preventions
A. How to avoid
1. Stop smoking
2. Reduce intake of saturated and trans fat
3. Moderate exercise
4. Diabetes controlled
5. Life style change
6. Eating a health diet (see over 100 Healthy Foods List)
7. Etc.

B. Diet
1. Fresh water algae
Fresh water algae contains chlorophyII-rich foods that is a powerful antioxidant for protection of build up of free radicals and restoring DNA of damaged cells. It also contains high amounts of Omega 3 and 6 fatty acids that can help to maintain normal blood pressure as well as cholesterol levels. Omega 3 and 6 fatty acids also inhibit blood clotting that causes the blockage of arteries and heart diseases.

2. Onions and garlic
Garlic and onions contain high amounts of sulfur compounds that not only help to improve circulation of blood but also help to keep your platelets from clumping together. Daily consumption of both garlic and onions help to keep blood pressure and cholesterol levels in healthy range. Be sure to talk to your doctor if you are taking any blood thinner medicines.

3. Nuts and seeds
Nuts and seeds contain high amounts of unsaturated fat and vitamin E. Unsaturated fat helps to prevent clots of arteries and lower cholesterol levels. Vitamin E, and the antioxidants beta varotene on the other hand stops bad cholesterol LDL from building up in the arteries, decreasing the risk of heart attacks.

4. Vegetables and fruits
Vegetable and fruits contain high amounts vitamins A, E, C and B. Vitamin E, the antioxidants beta carotene and vitamin C help to strengthen your small blood vessels and thins your blood so it can flow smoothly in result of lowering the risk of heart disease and strokes. Plums, tomatoes, and watercress are the best choices.

5. See over 100 Healthy Foods List), Etc.

C. Nutritional supplements
1. L-Arginine
L-Arginine helps to increase the production of nitric oxide in our body, this has an anti-angina and anti-stress effect upon the arteries enabling the muscles in the arterial walls to relax. L-Arginine also helps to prevent the build up of plaque on the arterial walls. L- Arginne taken either orally or intravenously has been found to prevent and reverse atherosclerosis, improving the functional status of heart failure and increasing blood flow in heart disease patients.

2. L- Carnitine
L-Carnitine working with vitamin E will help the body to recover quickly from fatigue. L-Carnitine helps the body convert fatty acids into energy, which is used primarily for muscular activities throughout the body. When working with vitamin E, L-carnitine will help the body to recover quickly from fatigue and combat heart diseases.

3. Lecithin
Lecithin supplies the body with needed inositol, choline and phosphatidyl choline that help to maintain healthy arteries. Lecithin also helps to reduce plaque in the arteries, lower blood pressure and ameliorate angina pectoris.

4. Niacin
Niacin a B3 vitamin, helps decreases blood levels of cholesterol and triglycerides which may reduce the risk of atherosclerosis. Niacin can only be taken under medical supervision because of it's side effects.

5. Selenium
Selenium deficiency will cause increase in high blood pressure.

6. Taurine
Taurine is an amino acid that acts as an antioxidant helping to fortify cardiac contraction and enhance the outflow of blood from the heart. Intake of taurine will reduce the risk of congestive heart failure and arteriosclerosis.

7. Calcium and potassium
Calcium and potassium deficiency may result in heart palpitation.

8. Magnesium
Magnesium helps to improve blood circulation by permitting the muscles in the arterial wall to rest.

9. Lutein
Lutein is one of the carotenoids, yellow and orange pigments found in many fruits and vegetables. Lutein supplementation has already been proven in helping prevent muscular degeneration, the most common cause of irreversible blindness in the elderly. Study shows that increased dietary intake of lutein may protect against the development of early atherosclerosis. It also helps explain why diets rich in fruits and vegetables are associated with reduced risk of heart disease.

D. Herbs

1. Flax seeds
Flax seeds contain high amounts of alpha-linoenic acid that helps to lower high blood pressure and the risk of stroke. Eating too much flax seeds will cause gas to build up if you are not used to it.

2. Ginkgo biloba
Ginkgo biloba helps to to make blood less sticky and prevents blood clotting and stroke. Unlike aspirin, Ginkgo biloba will not cause upset stomach and internal bleeding. Also, Ginkgo biloba can improve blood circulation. Be sure not to take Ginkgo seeds because they are toxic and can cause seizures.

3. Cayenne
Cayenne stimulates blood flow, and strengthens the heart's metabolism. It also helps to improve blood circulation as well as the digestive and immune systems. Cayenne contains high amounts of beta-carotene, cobalt, essential fatty acids, niacin and zinc that helps circulatory stimulation, blood purification, detoxification and fatigue.

4. Mistletoe
Mistletoe can stimulate the heartbeat and increase cardiac output. It can help to relieve heart strain, stimulate circulation, and lower blood pressure. Do not overdose and eat mistletoe berriea, because it is toxic.

5. Hawthorn berry
Hawthorn berry contains high amount of flavonoids that help to provide direct nourishment to the heart as well as dilate the coronary arteries.

6.Bugleweeds
Bugleweeds help to alleviate heart palpitation and high blood pressure. Study shows that bugleweeds act chiefly on the blood vessels, and is especially useful in plethoric and inflammatory states, particularly internal inflammations, and cardiac diseases.

7 Motherwort
Motherwort can be used in secure cardiac electrical rhythm. Be sure to talk to your doctor before taking motherwort supplements.

8. Tansy
Tansy is used to help heart palpitations and also helps to improve blood circulation.
Remember that herbs help to lower high blood pressure and cholesterol levels will also help to prevent heart diseases and stroke.

F. Chinese herbs
1. Nu zhen zi (privet fruit):
Nu zhen zi is the ying kidney and liver tonic that is the significant immune enhancement agent. Nu zhen zi also helps ying deficiency such as dizziness, floater, weak knee and enhancing heart blood.

2. Hong hua (safflower):
Hong hua is one of the Chinese herbs that have been used to break up blood stagnation and improve blood circulation. It is also used to unblock uterine stagnation.

3. Ru xiang (frankincense)
Ru xiang is used for thousand of years in treating joint pain, alleviating chest pain as well as breaking up blood stagnation and improving blood flow to the heart.

4. Mao yao (myzzh)
Mao yao contain elements that help to break up stagnation of blood resulting in improved blood circulation in our body.

5. Fu ling (poria)
Fu ling is a fungus that helps to enhance the immune system's ability to fight off viruses. It is used in Chinese medication for heart calming and palpitation smoothing.

6. Yin yang hou horney (goat weed)
Goat weed helps to lower high blood pressure and heart calming.

7. Du zhong (rubber tree bark)
Du zhong is consider the primary herb used to increase the yang function in the body resulting in benefits of the heart.

There are many more Chinese herbs that can help to lower bad cholesterol levels and high blood pressure as well as preventing and curing heart diseases such as Xian Fu, Wu Wei Zhi, and Da Zhao.


Treatments in conventional medicine
The main goal of the treatment is to reduce the risk factors which have contributed to the diseases
1. Improve cholesterol levels
Medine statins are the types of drugs used to lower cholesterol levels by inhibiting the enzyme HMG-CoA reductase, which plays a central role in the regulation of the production of cholesterol by the liver.

2. Angiotensin-converting enzyme (ACE) inhibitors (captopril, enalapril, lisinopril, and ramipril)
Angiotensin-converting enzyme (ACE) inhibitors are a group of drugs used to inhibit the renin-angiotensin system (RAS) is a hormone system that regulates blood pressure and water balance.

3. Beta blockers
A study of beta Blockade after myocardial infarction: systematic review and meta regression analysis" by Freemantle N, Cleland J, Young P, Mason J, Harrison J (June 1999), researchers ofund that β Blockers are effective in long term secondary prevention after myocardial infarction, but they are underused in such cases and lead to avoidable mortality and morbidity.
In other study of "Beta blockers in hypertension" by Cruickshank JM (August 2010), researcher found that β blockers, at least in non-smokers (70% of whole), have been shown to reduce the risk of myocardial infarction by about 35—50% in men (MRC mild hypertension, IPPPSH, MAPHY studies). Also, as Webb and colleagues indicate, the risks of myocardial infarction and heart failure are related to the difference and not the variation in SBP, and the most effective way to lower SBP in younger or middle-aged people with hypertension is via β1 blockade (bisoprolol)
to lower blood pressure and decrease the heart's workload.

4. Aspirin, copy frommy previous article "Heart Diseases---Aspirin: Friend or Foe ?"
a. Aspirin indeed helps your blood from clotting. If you suffer any bleeding, taking aspirin will make bleeding harder to stop. Study show that aspirin might increase the bleeding complication. If you are taking any blood thinner medication or you have an ulcer, please consult with your doctor before taking aspirin. For people suffering from hemorrhages (this is the loss of blood from the circulatory system or internal bleeding taking aspirin) they would do more harm than good.

b. Aspirin increases the risk of bleeding and hemorrhagic strokes that are caused by blood vessels bursting in or around your brain. Therefore do not assume that taking an aspirin a day would do no harm. Please consult with with your doctor before starting aspirin therapy.

c. Study shows that aspirin does not work well with people with high cholesterol levels. People with cholesterol levels over 220 respond poorly to aspirin therapy. Therefore, if your cholesterol level is over 220 you might need to find some other therapy to lower the risk of heart diseases.
Aspirin also causes some side affects such as heartburn, indigestion and mild-to-moderate abdominal or stomach cramps.

5. Nitroglycerin
Nitroglycerin is also used medically as a vasodilator to treat heart conditions, such as angina and chronic heart failure by relaxing the blood vessels, improving blood flow to the heart muscle, etc..

6. Etc.

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Psychological interventions for overweight or obesity

In the study to assess the effects of psychological interventions for overweight or obesity as a means of achieving sustained weight loss, indicated that people who are overweight or obese benefit from psychological interventions, particularly behavioural and cognitive-behavioural strategies, to enhance weight reduction. They are predominantly useful when combined with dietary and exercise strategies. The bulk of the evidence supports the use of behavioural and cognitive-behavioural strategies. Other psychological interventions are less rigorously evaluated for their efficacy as weight loss treatments(1).


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(1) "Psychological interventions for overweight or obesity" by Shaw K, O'Rourke P, Del Mar C, Kenardy J.

A green tea extract high in catechins reduces body fat and cardiovascular risks in humans


In the study to investigate the effects of  a green tea extract (GTE)   in the body fat reducing effect and reduction of risks for cardiovascular disease by a green tea extract (GTE) high in catechins, Data were analyzed using per-protocol samples of 240 subjects (catechin group; n = 123, control group; n = 117). Decreases in body weight, body mass index, body fat ratio, body fat mass, waist circumference, hip circumference, visceral fat area, and subcutaneous fat area were found to be greater in the catechin group than in the control group. A greater decrease in systolic blood pressure (SBP) was found in the catechin group compared with the control group for subjects whose initial SBP was 130 mm Hg or higher. Low-density lipoprotein (LDL) cholesterol was also decreased to a greater extent in the catechin group. No adverse effect was found(1).


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(1) "A green tea extract high in catechins reduces body fat and cardiovascular risks in humans"by Nagao T, Hase T, Tokimitsu I.

Drinking water is associated with weight loss in overweight dieting women


In the study to test for associations between absolute and relative increases in drinking water and weight loss over 12 months, secondary analyses were conducted on data from the Stanford A TO Z weight loss intervention on 173 premenopausal overweight women (aged 25-50 years) who reported <1 l/day drinking water at baseline. Diet, physical activity, body weight, percent body fat (dual-energy X-ray absorptiometry), and waist circumference were assessed at baseline, 2, 6, and 12 months. At each time point, mean daily intakes of drinking water, noncaloric, unsweetened caloric (e.g., 100% fruit juice, milk) and sweetened caloric beverages, and food energy and nutrients were estimated using three unannounced 24-h diet recalls. Beverage intake was expressed in absolute (g) and relative terms (% of beverages). Mixed models were used to test for effects of absolute and relative increases in drinking water on changes in weight and body composition, controlling for baseline status, diet group, and changes in other beverage intake, the amount and composition of foods consumed and physical activity(1).


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(1) "Drinking water is associated with weight loss in overweight dieting women independent of diet and activity" by Stookey JD, Constant F, Popkin BM, Gardner CD.

Impact of water intake on energy intake and weight status

In the study to review of studies reported in the English-language literature was performed to compare the effects of drinking water and various beverage alternatives on energy intake and/or weight status, studies comparing non-nutritive sweeteners with water were also relatively consistent and found no impact on energy intake among adults (DeltaTEI, -1.3; range, -9 to 13.8). Much less conclusive evidence was found in studies replacing water with milk and juice, with estimated increases in TEI of 14.9% (range, 10.9 to 23.9%). These findings from clinical trials, along with those from epidemiologic and intervention studies, suggest water has a potentially important role to play in reducing energy intake, and consequently in obesity prevention. A need for randomized-controlled trials to confirm this role exists(1).

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(1) "Impact of water intake on energy intake and weight status: a systematic review" by Daniels MC, Popkin BM.

Dietary tea catechins increase fecal energy

In the study to investigate the role of tea catechins on the utilization of dietary energy sources in rats, suggesting that tea catechins increased the fecal excretion of these energy nutrients. Of the gross energy that the rats consumed from their respective diets during the fecal collection period, 1.6% (for control diet) and 5.8% (for tea catechin diet) were estimated to be excreted in feces. The energy loss originating from carbohydrate should contribute to the overall amount of energy in the feces, followed by protein. Intake of tea catechins suppressed the intestinal absorption of energy nutrients via the inhibition of digestive enzymes, which may at least partially influence the body fat reduction by tea catechins(1).

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(1) "Dietary tea catechins increase fecal energy in rats" by Unno T, Osada C, Motoo Y, Suzuki Y, Kobayashi M, Nozawa A.

Beverage consumption and adult weight management

In the review of  the effect of beverage consumption on short-term (i.e., meal) energy intake, as well as longer-term effects on body weight. Specific beverages addressed include water, other energy-free beverages (diet soft drinks, coffee and tea), and energy-containing beverages (soft drinks, juices and juice drinks, milk and soy beverages, alcohol), suggested that suggests that encouraging water consumption, and substituting water and other energy-free beverages (diet soft drinks, coffee and tea) for energy-containing beverages may facilitate weight management. Energy-containing beverages acutely increase energy intake, however long-term effects on body weight are uncertain. While there may be health benefits for some beverage categories, additional energy provided by beverages should be compensated for by reduced consumption of other foods in the diet(1).

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(1) "Beverage consumption and adult weight management: A review" by Dennis EA, Flack KD, Davy BM.

Green tea catechin consumption enhances exercise-induced abdominal fat loss

In the study to evaluate the influence of a green tea catechin beverage on body composition and fat distribution in overweight and obese adults during exercise-induced weight loss, participants (n = 132 with 107 completers) were randomly assigned to receive a beverage containing approximately 625 mg of catechins with 39 mg caffeine or a control beverage (39 mg caffeine, no catechins) for 12 wk. Participants were asked to maintain constant energy intake and engage in >or=180 min/wk moderate intensity exercise, including >or=3 supervised sessions per week. Body composition (dual X-ray absorptiometry), abdominal fat areas (computed tomography), and clinical laboratory tests were measured at baseline and wk 12. There was a trend (P = 0.079) toward greater loss of body weight in the catechin group compared with the control group; least squares mean (95% CI) changes, adjusted for baseline value, age, and sex, were -2.2 (-3.1, -1.3) and -1.0 (-1.9, -0.1) kg, respectively. Percentage changes in fat mass did not differ between the catechin [5.2 (-7.0, -3.4)] and control groups [-3.5 (-5.4, 1.6)] (P = 0.208). However, percentage changes in total abdominal fat area [-7.7 (-11.7, -3.8) vs. -0.3 (-4.4, 3.9); P = 0.013], subcutaneous abdominal fat area [-6.2 (-10.2, -2.2) vs. 0.8 (-3.3, 4.9); P = 0.019], and fasting serum triglycerides (TG) [-11.2 (-18.8, -3.6) vs. 1.9 (-5.9, 9.7); P = 0.023] were greater in the catechin group(1).
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(1) "Green tea catechin consumption enhances exercise-induced abdominal fat loss in overweight and obese adults" by Maki KC, Reeves MS, Farmer M, Yasunaga K, Matsuo N, Katsuragi Y, Komikado M, Tokimitsu I, Wilder D, Jones F, Blumberg JB, Cartwright Y.

Beverage intake among preschool children and its effect on weight status

In the study to evaluate the beverage intake among preschool children who participated in the National Health and Nutrition Examination Survey 1999-2002 and investigate associations between types and amounts of beverages consumed and weight status in preschool-aged children. Dr. O'Connor TM, and the research team at Baylor College of Medicine showed that On average, preschool children drank less milk than the 2005 Dietary Guidelines for Americans recommendation of 16 oz/day. Only 8.6% drank low-fat or skim milk, as recommended for children who are older than 2 years. On average, preschool children drank < 6 oz/day 100% fruit juice. Increased beverage consumption was associated with an increase in the total energy intake of the children but not with their BMI. Prospectively studying preschool children beyond 2 to 5 years of age, through their adiposity rebound (approximately 5.5-6 years) to determine whether there is a trajectory increase in their BMI, may help to clarify the role of beverage consumption in total energy intake and weight status(1).
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(1) "Beverage intake among preschool children and its effect on weight status" by O'Connor TM, Yang SJ, Nicklas TA.

Association between 100% juice consumption and nutrient intake and weight of children aged 2 to 11 years


In the study to investigate the associations between 4 categories of daily 100% juice consumption (0 fl oz, > 0 to < or = 6 fl oz; > 6 to < 12 fl oz; and > or = 12 fl oz) and nutrient and food group intake and weight in children, Dr. Nicklas TA, and the scientists at the Baylor College of Medicine indicated that on average, children consumed less than the maximum amounts of 100% juice recommended by the American Academy of Pediatrics. One hundred percent juice consumption was associated with better nutrient intake than in the nonconsumption group and was not associated with weight status or the likelihood of being overweight in children 2 to 11 years of age(1).

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(1) "Association between 100% juice consumption and nutrient intake and weight of children aged 2 to 11 years" by Nicklas TA, O'Neil CE, Kleinman R.

Excess fruit juice consumption by preschool-aged children is associated with short stature and obesity

In the study to evaluate, in a population-based sample of healthy children, fruit juice consumption and its effects on growth parameters during early childhood, Dr. Dennison BA, and the research team at the Mary Imogene Bassett Research Institute, Cooperstown found that Consumption of > or = 12 fl oz/day of fruit juice by young children was associated with short stature and with obesity. Parents and care takers should limit young children's consumption of fruit juice to less than 12 fl oz/day(1).

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(1) "Excess fruit juice consumption by preschool-aged children is associated with short stature and obesity" by Dennison BA, Rockwell HL, Baker SL.