Dietary patterns are associated with overweight and obesity in Mexican school-age children

In Mexico, about one third of school-age population is overweight or obese and the diet is one of the main determinants. The purpose of this study was to identify the dietary patterns of Mexican school-age children and to determine their association with the risk of overweight/obesity. This study included 8252 school-age children who participated in the 2006 National Health and Nutrition Survey (ENSANUT-2006). Dietary data were collected using a 7-day Food Frequency Questionnaire (FFQ). Foods were classified into 25 groups and dietary patterns were defined by cluster analysis. Body Mass Index and prevalence of overweight/obesity were calculated. Logistic regression models were used to evaluate the association between dietary patterns and overweight/obesity. Five dietary patterns were identified: Rural dietary pattern (high intake of tortilla and legumes), sweet cereal and corn dishes pattern (high intake of sugary cereals, tortilla, and maize products); diverse pattern (intake of several food groups); western pattern (high intake of sweetened beverages, fried snacks, industrial snack cakes, and sugary cereals), and whole milk and sweet pattern (high intake of whole milk and sweets). We found that children with sweet cereal and corn dishes and western dietary patterns showed an association with overweight and obesity (prevalence ratio 1.29 and 1.35, respectively, using as reference the rural dietary pattern). Patterns characterized by high intakes of sugary cereals, sweetened beverages, industrial snack, cakes, whole milk, and sweets were associated with a higher risk of overweight/obesity among in Mexican school-age children.     

Dietary intake of Senegalese adults

The aim of this work is to identify major food sources and dietary constituents of Senegalese adults. We conducted a cross-sectional study, using a single 24-hour dietary recall interview. Foods were classified into food groups based on similarities in nutrient content or use. Food groups included foods consumed individually, or as part of food mixtures such as stews, soups, or sandwiches. Median consumption (amount/day) of each food was determined and examined by relevant subgroups. Participants were 50 healthy Senegalese men, aged 20-62 years recruited at the Hôpital Général de Grand Yoff in Dakar, Senegal and from Sendou village, a rural area outside Dakar. A total of 90 foods and beverages were identified and classified into 11 groups. Sixty-five percent of foods identified could be classified as meats, grains, or fruits/vegetables. Fruits and vegetables comprised 42% (38/90) of all foods; meats 12% (11/90); and grains 11% (10/90). Sauces (6%, 5/90), sweets (4%, 4/90), and desserts (4%, 4/90) were also reported. The most common fruits/vegetables reported were potato, carrot, mango, and lettuce; commonly reported grains were bread and rice; and commonly reported meats were fish, beef, and ox. There were no differences in reported daily intake of each food by age, ethnicity, education, or residence. Most foods reported were traditional to the Senegalese diet, despite the increasing availability of Western foods in Senegal.     

Trans-Fettsäuren in Lebensmitteln

Trans Fatty Acids in Foods The fatty acid compositions of the fat in 196 german food samples were analyzed with emphasis on trans components by gas liquid chromatograghy. The range of trans fatty acids (weight percent of methyl esters) in several foods was: margarines 0.6 - 23.5%, shortenings 0.1 - 31.8%, french fried potatoes 508 - 32.8%, cakes and cookies 0 - 15.5%, candies and frostings 0.2 - 15.7%, Crisps and other snacks 0.1 - 20.2%, animal and dairy fats from ruminants. 1.5 - 10.6%, other meat products animals and sausages less than 1%. Teh composition of trans fatty acids differed between hydrogenated fats and ruminant fats. Food processing (except hydrogenation) did not substantially alter the fatty acid composition. The daily intake of trans fatty acids in Germany was estimated by the National Consumption Assay. women consumed 3.4 g/day and men 4.1 g/day. Hydrogenated fats and ruminant fats contributed to the consumption nearly equally. Trans fatty acids influence the plasma lipoprotein levels similarly to saturated fatty acids. The trans fatty acids appear mostly as monounsaturated fatty acids in food composition tables. It seems necessary to distinguish between cis and trans isomers.     

Evaluating the <Emphasis Type="Italic">trans</Emphasis> Fatty Acid,CLA, PUFA and Erucic Acid Diversity in Human Milk from Five Regions in China

Human milk was obtained from 97 healthy lactating women from five different regions in China. Twenty-four hour dietary questionnaire identified the foods consumed that showed distinct differences in food types between cities. The southern and central regions had higher levels of total trans fatty acids (TFA) and conjugated linoleic acids (CLA) in human milk than the northern region. The major isomers in human milk from the northern region were vaccenic and rumenic acids, whereas the other regions had a random distribution of these isomers. This was consistent with the isomer distribution in the refined vegetable oils used and their increased formation during high temperature stir-frying. The human milk composition showed little evidence that partially hydrogenated fats were consumed, except eight mothers in Guangzhou who reported eating crackers, plus four other mothers. The TFA concentration in these human milk samples was higher (2.06–3.96%). The amount of n-6 (1.70–2.24%) and n-3 (0.60–1.47%) highly unsaturated fatty acids (HUFA) in human milk and the resultant ratio (1.43–2.95) showed all mothers in China had an adequate supply of HUFA in their diet. Rapeseed oil was consumed evidenced by erucic acids in human milk. The levels of erucic acid were below internationally accepted limits for human consumption. The levels of undesirable TFA and CLA isomers in human milk are a concern. Efforts to decrease the practice of high temperature stir-frying using unsaturated oils, and a promotion to increase consumption of dairy and ruminant products should be considered in China.     

Food habits of high school graduates in the metropolitan area of Santiago, Chile

The purpose of this study was to determine the food habits of Chilean high-school graduates, and measure the effect that socioeconomic level (SEL), type of school (public and private school), sex and age exerts on those habits. A random and stratified sample of 283 schoolers, according to type of school, sex and SEL, measured through the Graffar Modified Scale was selected for the study. Food habits were defined by the frequency of consumption of food, expressed as days per week and were compared with the Model Allowance established by the Ministry of Health of Chile. A food habits questionnaire was administered to students by duly trained interviewers, and were defined by the frequency of consumption of food groups. Data were analyzed by the chi-square procedure, analysis of variance and Student's "t" test. In accordance with the results, the most consumed foods (over 90% of students) were meat, poultry, eggs, potatoes, apples, bread, rice, oil and butter or margarine. On the other hand, the most disliked foods (40% and more of students) were fresh cheese, viscera, radish and chickpeas. The high SEL students showed a significantly greater frequency of consumption of dairy products, and of meat products and eggs (p less than 0.001). No differences were found according to type of school, sex and age of students. We conclude, therefore, that SEL exerts a significant effect on food habits, in spite of which they were adequate according to the Model Allowance.     

Determination vitamin A source foods by pregnant women,using a simplified dietary assessment (SDA)

The International Vitamin A Consultative Group (IVACG) developed a research instrument based on consumption of vitamin-A food sources to classify populations into groups of high, moderate and low deficiency risk in the consumption of this nutrient. The instrument was tested on a population of 91 pregnant women who attended prenatal health care service run by School of Public Health of the University of S?o Paulo. Such instrument was termed Simplified Dietary Assessment (SDA) and it is comprised of a 24-hour dietary recall--Consumption Index (CI) and consumption frequency questionnaire--Usual Food Pattern (UFP). SDA pointed out the most consumed daily and weekly foods as being milk in liquid form, tomato, lettuce, margarine and banana. All these food sources belong to groups of low and moderate vitamin A content. Assignment in risk groups was based on the recommended dietary intake proposed by the Food and Agriculture Organization of the United Nations--(FAO/OMS--1991) and two-thirds of the recommended intake was considered the cutting off point. According to data obtained by the SDA, more than 50% of the population interviewed was assigned to the High and Moderate risk groups for deficiency in vitamin A intake. Statistical analysis of the data revealed a significant statistical correlation r = 0.50 (p > 0.005) and a weighted Kappa value of (kw = 0.207), which suggests that the SDA is a useful instrument and is a reasonable means for risk assignment of vitamin A deficiency among groups with inadequate levels of intake of foods as sources of this nutrient. However, the results suggest that in order to evaluate vitamin A intake appropriately, a larger number of applications of the IC questionnaires would be required.     

Possibility of Breast Cancer Prevention: Use of Soy Isoflavones and Fermented Soy Beverage Produced Using Probiotics

The various beneficial effects of soybeans, which are rich in phytochemicals, have received much attention because of increasing health awareness. Soy milk that has been fermented using lactic acid bacteria has been used to prepare cheese-like products, tofu (bean-curd), and yogurt-type products. However, the distinct odor of soybeans has limited the acceptance of such foods, particularly in Western countries. In Japan, while tofu and soy milk have long been habitually consumed, the development of novel, palatable food products has not been easy. The unpleasant odor of soy milk and the absorption efficiency for isoflavones can be improved using a recently developed fermented soy milk beverage. Cancer has been the leading cause of death, and breast cancer is the most common malignancy among women. The most common type of breast cancer is estrogen-dependent, and the anti-estrogenic effects of isoflavones are known. The present review focuses on the characteristics of soy milk fermented using probiotics, an epidemiological study examining the incidence of breast cancer and soy isoflavone consumption, and a non-clinical study examining breast cancer prevention using fermented soy milk beverage.     

Breast milk consumption in rural Costa Rica

Breast milk consumption was measured in 20 breast-feeding infants, aged two days to six months. This was achieved by test-weighing infants before and after every feeding over a 24-hour period. Infant length, weight, number of breast-feedings, and time spent sucking were also measured. The mean consumption among 10 full breast-feeders (no supplementation) was 639 +/- 214 ml/day at a mean age of 42 +/- 36 days, and 396 +/- 249 ml/day at a mean age of 95 +/- 53 days for ten breast-feeders receiving supplements (partial breast-feeders). Significant correlations were found between the number of feedings per day and breast milk consumption (ml/day) when examining all twenty infants (r = 0.788, p less than 0.01) and the ten partial breast-feeders (r = 0.903, p less than 0.01), but not the ten full breast-feeders (r = 0.431). Correlations between the time sucking per day (min/day), and breast milk consumption (ml/day), were again significant for all twenty infants (r = 0.576 p less than 0.01) and partial breast-feeders (r = 0.728, p less than 0.02), but not for full breast-feeders (r = 0.357). The weight-for-length ratio for full breast-feeders ranged from 94 to 135% of the 50th percentile of the National Center for Health Statistics (NCHS) curves, while for partial breast-feeders it ranged from 103 to 141%. Both groups show adequate growth in this poor, rural area of Costa Rica.     

The influence of calcium and phosphorus intake on bone mineral density in young women

The threat of osteoporosis in later life means that the bone mass women achieve during their youth is important. Eighty seven women aged 18-35 y from the Madrid region were studied to determine the relationship between their calcium, phosphorus and milk product intakes and bone mineral density (BMD). Intakes of these items were moniroed using a three day food intake record. BMD was measured by double photonic densitometry of the lumbar region, hip and right forearm. Mean calcium intake (802.1+/-258.7 mg/day) was less than that recommended for 45% of women. A linear, positive correlation was seen between calcium intake and BMD at the hip (r=0.23) and greater trochanter (r=0.24) (p<0.05). Women whose calcium intake was >1000 mg/day had greater hip BMDs than those whose intake was below this level (0.97+/-0.11 g/cm2 compared to 0.90+/-0.10 g/cm2). Similar results were seen for the femur head and greater trochanter in subjects whose Ca/P ratio was >0.74 (50th percentile). In addition, an intake of more than two rations of milk per day was optimum for achieving adequate bone mass in different areas of the hip. These results show that greater calcium consumption and a Ca/P ratio of >0.74 are associated with better BMD values in young women, and that milk is the lactic product best associated with good bone health.     

Soy proteins for foods centering around soy sauce and tofu

In the Orient, soy proteins have been used for human consumption for centuries, during which various kinds of unique soy protein foods have been established. Some of these products, such as tofu, have a bland flavor, but there are also those products having a distinctive flavor and an aroma like fermented soy sauce. Both types are acceptable for worldwide populations. In earlier times, the consumption of these soy protein foods in the U.S. was mostly confined to Orientals. Recently, however, the koikuchi type of soy sauce has been consumed widely by non-Orientals through nationwide supermarkets. Annual production in the U.S. has reached more than 16,500 kl. Tofu has also become popular in the U.S. because of its bland flavor which enables it to be used in many dishes. Fermented soy sauce is completely different in the constituents of aroma and flavor from chemical soy sauce. Koikuchi shoyu is a typical Japanese type of fermented soy sauce characterized by a strong, appetizing aroma. The fermentation process consists of koji fermentation byAspergillus species and the subsequent brine fermentation, which contains lactic acid and alcoholic fermentations. Miso is a paste product produced through a similar fermentation. Tofu is a soy milk curd product made through a nonfermented process from soy milk.     

Gauging food and nutritional care quality in hospitals

ABSTRACT: BACKGROUND: Food and nutritional care quality must be assessed and scored, so as to improve health institution efficacy. This study aimed to detect and compare actions related to food and nutritional care quality in public and private hospitals. METHODS: Investigation of the Hospital Food and Nutrition Service (HFNS) of 37 hospitals by means of structured interviews assessing two quality control corpora, namely nutritional care quality (NCQ) and hospital food service quality (FSQ). HFNS was also evaluated with respect to human resources per hospital bed and per produced meal. RESULTS: Comparison between public and private institutions revealed that there was a statistically significant difference between the number of hospital beds per HFNS staff member (p = 0.02) and per dietitian (p < 0.01). The mean compliance with NCQ criteria in public and private institutions was 51.8% and 41.6%, respectively. The percentage of public and private health institutions in conformity with FSQ criteria was 42.4% and 49.1%, respectively. Most of the actions comprising each corpus, NCQ and FSQ, varied considerably between the two types of institution. NCQ was positively influenced by hospital type (general) and presence of a clinical dietitian. FSQ was affected by institution size: large and medium-sized hospitals were significantly better than small ones. CONCLUSIONS: Food and nutritional care in hospital is still incipient, and actions concerning both nutritional care and food service take place on an irregular basis. It is clear that the design of food and nutritional care in hospital indicators is mandatory, and that guidelines for the development of actions as well as qualification and assessment of nutritional care are urgent.     

Total content and dialyzable iron and zinc in foods from northern and Southern Mexico

Developing countries diets are based on a variety of plant foods that often are the main suppliers of important amounts of iron (Fe) and zinc (Zn). The objectives of this study were 1) to measure the total and dialyzable amounts of Fe and Zn in foods from Northern Mexico (Sonora) and from Southern Mexico (Oaxaca) and 2) to evaluate the effect of meat content of diets on the dialyzable amount of Fe and Zn. Methods to calculate the total dialyzable amount of Fe and Zn, were those of the AOAC and of Shen et al. Total Fe in e northern Mexican foods went from 0.78 +/- 0.0 to 11.59 +/- to 0.03 mg/ 100g (dry weight, DW); in southern Mexican foods the same micronutrient amounts were 0.86 +/- 0.18 to 8.8 +/- 0.57 mg/100 g (BS). Total Zn values were 0.91 +/- 0.00 to 13.58 +/- 0.05 mg/100 g (DW) in Sonora, and 0.64 +/- 0.18 to 20.80 +/- 0.33 mg/100 g (DW) in Oaxaca. In northern Mexico, foods dialyzable Fe had values from 0.1 +/- 0.04% to 10.6 +/- 0.36% and for Zn from 4.0 +/- 0.21% to 55.32 +/- 0.14%. Meanwhile, the range of values of dialyzable Fe for foods from Oaxaca were from 0.22 +/- 0.06% to 9.40 +/- 0.14% for and from 2.41 +/- 0.26% to 54.27 +/- 1.49% for dialyzable Zn. The average value for dialyzable Fe was higher in the foods that contained meat or meat products (p= 0.001).     

Eating characteristics of Chilean indigenous and non-indigenous adolescent girls

During childhood and adolescence, eating habits become established which are instrumental in determining eating behavior later in life. Various authors have described the acculturation of the Mapuche people toward Western culture. The objective of this study was to analyze the eating characteristics of indigenous and non-indigenous adolescent girls in the Araucania Region of Chile. A cross-sectional design was used with a probabilistic sample of 281 adolescents comprised of 139 indigenous and 142 non-indigenous girls attending 168 elementary schools. A modified food frequency questionnaire was applied, designed to obtain information about eating habits and consumption of Mapuche foods. The eating schedules are similar in both ethnic groups, with dinner being the meal that is least consumed. Total snack consumption per week has a mean of 7 with an interquartile range (IQR) of 5 to 10 without any differences between ethnic groups; of these snacks, only 2 were healthy (IQR = 1 to 3). The indigenous girls had a higher probability of consumption of native foods including mote (boiled wheat) (OR = 2.00; IC = 0.93-4.29), muday (fermented cereal alcohol) (OR = 3.45; IC = 1.90-6.27), and yuyo (field mustard) (OR = 4.40; IC = 2.06-9.39). The study's conclusion is that the the eating habits and behavior of indigenous adolescents are similar to those of non-indigenous girls, though the former still consume more indigenous foods.     

Blending of low‐density polyethylene with vanillin for improved barrier and aroma‐releasing properties in food packaging

Modification of low‐density polyethylene (LDPE) with vanillin to obtain flavored packaging film with improved gas barrier and flavor‐releasing properties has been studied. The modification of LDPE with vanillin was monitored by Fourier transform infrared spectroscopy, wherein the appearance of new peaks at 1704.7, 1673.6, and 1597.2 cm^?1 indicates the incorporation of vanillin into LDPE matrix. Films of uniform thickness were obtained by the extrusion of modified LDPE. Modified LDPE was found to have significantly higher gas barrier properties and grease resistance. Sensory quality of food products viz, doodhpeda (milk‐based solid soft sweet), biscuit, and skimmed milk powder packed in LDPE‐vanillin film showed that the doodhpeda sample had clearly perceptible vanilla aroma, whereas biscuit had marginal aroma and skimmed milk powder did not have noticeable aroma. When viewed in the light of imparting desirable vanilla aroma, results of the study indicated that LDPE‐vanillin film has better prospects as a packaging material for solid sweets with considerable fat content when stored under ambient conditions. The release of vanilla aroma was further confirmed by gas chromatography–mass spectrometery analysis. © 2009 Wiley Periodicals, Inc. J Appl Polym Sci, 2009     

Trans fatty acids: foods and effects on health

Trans fatty acids can be found in foods derived from ruminant animals and foods that contain partially hydrogenated fat such as fast foods. The consumption of trans fatty acids is larger in the United States, Canada, and some European countries than in Japan and Mediterranean countries. The incidence of coronary heart diseases is higher in countries where the consumption of trans fatty is high. Studies show that trans fatty acids can contribute to increase LDL and lipoprotein [a], and to reduce the levels of HDL. In addition, trans isomeric seems to inhibit the action of desaturase enzymes of essential fatty acids (A5- and A6-desaturase) by holding back the biosynthesis of important fatty acids such as arachidonic acid and docosahexaenoic acid (DHA). With respect to pregnant women's and infant's health, concentrations of trans fatty acids ingested by the mother are associated to concentrations found in the maternal milk. Besides the milk, the trans fatty acids can be transferred to the newly born through the placenta. Studies suggest that trans fatty acids can affect intrauterine growth due to the inhibition of the conversion of essential fatty acids by desaturase enzymes. The inhibition of DHA can also cause early atherosclerosis lesion. However, studies on the effects of trans fatty acids on health are still inconclusive and there are no current recommendations on their consumption. Additionally, in Brazil, studies to determine the composition of trans isomeric in foods are still incipient, which indicates a great need of research in this area.     

Dietary patterns and its relation with overweight and obesity in Chilean girls of medium-high socioeconomic level

The aim of the present study was to identify dietary patterns in girls and to assess their association with obesity or overweight. A school-based sample of 108 girls between 8 and 11 years of medium-high socioeconomic level was selected in Santiago, Chile. The body mass index was calculated and a quantified food frequency and physical activity questionnaires (validated in the FAO/MINEDUC/INTA Project Nutritional Education in primary schools) were applied. Four distinct dietary factors or patterns were obtained explaining 54% of the total variation using factorial analysis. The first factor was characterized by an energy-dense diet (high consumption of fat foods, ice creams, chocolates, French fries, snacks). The second factor represented a healthy diet (dairy products, fruits and salads). The third factor represented intake of soft drinks (either with or without sugar). The fourth factor represented a diet rich in calories and sugars (bread, sausages, sweets). The association between the four dietary factors and overweight/obesity was assessed through logistic regression models. The first factor, energy-dense foods, was the only one significantly associated with the presence of obesity (OR = 1.86; 95% CI: 1.12 - 3.09). The results of this research about dietary patterns are consistent with studies carried out in other countries.     

Sweet proteins – Potential replacement for artificial low calorie sweeteners

Exponential growth in the number of patients suffering from diseases caused by the consumption of sugar has become a threat to mankind's health. Artificial low calorie sweeteners available in the market may have severe side effects. It takes time to figure out the long term side effects and by the time these are established, they are replaced by a new low calorie sweetener. Saccharine has been used for centuries to sweeten foods and beverages without calories or carbohydrate. It was also used on a large scale during the sugar shortage of the two world wars but was abandoned as soon as it was linked with development of bladder cancer. Naturally occurring sweet and taste modifying proteins are being seen as potential replacements for the currently available artificial low calorie sweeteners. Interaction aspects of sweet proteins and the human sweet taste receptor are being investigated.     

A short training program improves the accuracy of portion-size estimates in future dietitians

The objective of this study was to determine whether a short training program, using real foods, would decreased their portion-size estimation errors after training. 90 student volunteers (20.18+/-0.44 y old) of the University of the Basque Country (Spain) were trained in observational techniques and tested in food-weight estimation during and after a 3-hour training period. The program included 57 commonly consumed foods that represent a variety of forms (125 different shapes). Estimates of food weight were compared with actual weights. Effectiveness of training was determined by examining change in the absolute percentage error for all observers and over all foods over time. Data were analyzed using SPSS vs. 13.0. The portion-size errors decreased after training for most of the foods. Additionally, the accuracy of their estimates clearly varies by food group and forms. Amorphous was the food type estimated least accurately both before and after training. Our findings suggest that future dietitians can be trained to estimate quantities by direct observation across a wide range of foods. However this training may have been too brief for participants to fully assimilate the application.     

Iron and zinc in vitro potential availability in an infant diet with fortified bread with different iron sources or with the addition of different iron absorption promoters

Home-made diets are the most frequently used complementary foods. In the present work we evaluated iron and zinc availability in a usually consumed infant diet containing either iron-fortified bread with different iron sources: ferrous sulfate, ferrous bisglycinate, NaFeEDTA. We also used non-fortified bread with absorption promoters: ascorbic acid, sodium citrate, Na2EDTA, combined with different beverages. The diet (potato, pumpkin, grits, bread, and apple) was combined with water, milk, tea, a soft drink and an orange-based artificial drink. Mineral dialyzability (D) as an indicator of potential availability was determined using an in vitro method. Statistical analysis was performed by ANOVA, and a posteriori Tukey test. There were no significant differences in FeD between diets with ferrous sulfate or ferrous bisglycinate fortified bread; in NaFeEDTA fortified bread it increased significantly (p<0.05). Iron D increase was greater in diets with bread containing absorption promoters than in those with fortified bread. The orange-based artificial drink increased FeD, while tea and milk decreased it significantly (p < 0.05). Zinc D increased significantly when the bread was fortified either with ferrous sulfate or NaFeEDTA, but remained unchanged in diets with ferrous bisglycinate fortified bread. The addition of tea or milk decreased ZnD while the orange-based artificial drink increased it significantly (p < 0.05). Regarding absorption promoters, the greater values both in FeD and ZnD were observed in diets with iron nonfortified bread containing Na2EDTA.     

Relationships between glucose, energy intake and dietary composition in obese adults with type 2 diabetes receiving the cannabinoid 1 (CB1) receptor antagonist, rimonabant

ABSTRACT: BACKGROUND: Weight loss is often difficult to achieve in individuals with type 2 diabetes and anti-obesity drugs are often advocated to support dietary intervention. Despite the extensive use of centrally acting anti-obesity drugs, there is little evidence of how they affect dietary composition. We investigated changes in energy intake and dietary composition of macro- and micronutrients following therapy with the endocannabinoid receptor blocker, rimonabant. METHODS: 20 obese patients with type 2 diabetes were studied before and after 6 months dietary intervention with rimonabant. Dietary intervention was supervised by a diabetes dietician. Five-day food diaries were completed at baseline and at 6 months and dietary analysis was performed using computer software (Dietplan 6). RESULTS: After 6 months, (compared with baseline) there were reductions in weight (107+/-21Kg versus 112+/-21, p<0.001, 4% body weight reduction), and improvements in HbA1c (7.4+/-1.7 versus 8.0+/-1.6%, p<0.05) and HDL cholesterol. Intake of energy (1589+/-384 versus 2225+/-1109kcal, p<0.01), carbohydrate (199+/-74 versus 273+/-194g, p<0.05), protein (78+/-23 versus 98+/-36g, p<0.05), fats (55+/-18 versus 84+/-39g, p<0.01) and several micronutrients were reduced. However, relative macronutrient composition of the diet was unchanged. Improvement in blood glucose was strongly correlated with a reduction in carbohydrate intake (r = 0.76, p<0.001). CONCLUSIONS: In obese patients with type 2 diabetes, rimonabant in combination with dietary intervention led to reduced intake of energy and most macronutrients. Despite this, macronutrient composition of the diet was unaltered. These dietary changes (especially carbohydrate restriction) were associated with weight loss and favourable metabolic effects.