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Journal of the American College of Nutrition, Vol. 26, No. 4, 350-355 (2007)
Published by the American College of Nutrition

The Influence of Calcium Consumption on Weight and Fat Following 9 Months of Exercise in Men and Women

Bruce W. Bailey, PhD, Debra K. Sullivan, PhD, RD, Erik P. Kirk, PhD, Sandra Hall, PhD and Joseph E. Donnelly, EdD

Energy Balance Laboratory (B.W.B., E.P.K., J.E.D.), University of Kansas, Lawrence
Department of Dietetics and Nutrition (D.K.S.)
Preventive Medicine and Public Health (S.H.), University of Kansas Medical Center, Kansas City, Kansas

Address reprint requests to: Bruce W Bailey, PhD, Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard Boston, MA 02125-3393. E-mail: bruce.baily{at}umb.edu


   ABSTRACT
TOP
 ABSTRACT
INTRODUCTION
 METHODS
 RESULTS
 CONCLUSION
 ACKNOWLEDGMENTS
 REFERENCES
 
Background: There is some evidence that calcium consumption improves weight loss during energy restriction but the effects of calcium consumption in conjunction with chronic exercise are unknown.

Objective: The purpose of the study was to determine the degree to which calcium consumption influences weight and fat weight change as a result of 9 months of verified supervised exercise in the absence of energy restriction.

Methods: Participants were 50 previously sedentary, overweight and moderately obese men (n=20) and women (n=30). Exercise of moderate intensity was performed for 45 min/d, 5 d/wk, under supervision. Diet intake was ad libitum and was measured for energy, macronutrient and micronutrient composition at baseline, 4 and 9 months by use of observer recorded weighed plate waste and multiple-pass 24-h dietary recall procedures.

Results: Average calcium consumption was 987 ± 389 mg/day for men and 786 ± 276 mg/day for women. Weight change over the 9 months was –4.6 ± 4.6 kg for men and 0.2 ± 3.3 kg for women. Calcium consumption was associated with weight change (r =–0.47, p<0.05) in men. The calcium to protein ratio was associated with weight change (r=0.56) and fat weight change (r=–0.53) in men. There was no observed association between calcium and weight or fat weight change in women.

Conclusion: Weight and fat weight loss as a result of nine months of moderate intensity exercise may be improved by increased calcium consumption in men but was not observed in women.

Key words: exercise, dairy, calcium, adiposity, body composition and weight-loss


   INTRODUCTION
TOP
 ABSTRACT
 INTRODUCTION
METHODS
 RESULTS
 CONCLUSION
 ACKNOWLEDGMENTS
 REFERENCES
 
Nutritional status contributes substantially to preventable illness and premature death in the United States [1]. The influence of macronutrients on weight has been extensively studied. What has not been as well studied is the influence of micronutrients on weight and fat weight. Recently there have been a number of studies suggesting a role for calcium and dairy products in the regulation of weight and fat weight. While energy balance is likely the most important factor in weight regulation, recent studies have suggested a role for calcium and possibly other components of dairy products in shifting energy balance, resulting in lower body weight and body fat weight [2–7].

Evidence from several studies has demonstrated an inverse association between dietary calcium and body weight and fat weight [2–6,8,9]. It has been suggested that a lower level of calcium consumption creates an environment within the adipose cell that is conducive for lipid storage, promoting synthesis and inhibiting degradation of stored fat [7,10]. Thus, in a state of energy imbalance it is possible that a high or low calcium diet may alter how much fat is stored resulting in more or less weight change [11]. This may be especially important for people who are trying to lose weight, given the high amount of fat turnover seen during this time [12,13].

Exercise is one method of altering energy balance [14]. It has been consistently shown that exercise has a beneficial impact on body composition, decreasing body fat and preserving lean tissue [14]. Although exercise has a positive influence on body composition, the magnitude of the impact is usually small and there seems to be a large amount of variation between individuals [14]. Thus, it may be beneficial to determine factors that potentiate the impact of exercise on weight loss.

Calcium consumption may improve the impact of exercise on weight and body composition by increasing the amount and rate of fat turnover within the adipose tissues during and possibly after exercise [11,15]. The impact of calcium on weight and fat weight as a result of exercise training has not been well studied, despite the potential for both to promote lipolysis and fat oxidation. Thus, the purpose of this study was to determine the influence of calcium on weight and fat weight in participants who have taken part in 9 months of supervised aerobic exercise.


   METHODS
TOP
 ABSTRACT
 INTRODUCTION
 METHODS
RESULTS
 CONCLUSION
 ACKNOWLEDGMENTS
 REFERENCES
 
This study is a secondary analysis of data from an 18 month randomized controlled exercise trial (The Midwest Exercise Trial (MET)) [16]. Nine month data were used for this investigation based on previously reported findings from MET, that showed there was little further influence of exercise on weight and fat weight after 9 months [17]. Detailed methods for MET have been previously reported and will be briefly reviewed here [16–18].

Participants
Twenty men and 30 women took part in 9-months of supervised verified exercise. The participants were between the ages of 17 and 35, sedentary, and had a BMI between 25.0 and 34.9 kg/m2. Participants were healthy with no history of chronic disease. Participants were excluded from the study if they took medications known to alter metabolism (i.e. beta blockers, thyroid, steroids) or could not participate in moderate intensity exercise. All participants gave informed consent. Approval for the study was obtained from the Institutional Review Boards at the University of Kansas and University of Nebraska, Kearney.

Exercise Intervention
Exercise consisted primarily of walking on motor-driven treadmills; however, alternate activities such as stationary biking and walking on stationary elliptical trainers were allowed for 20% of the total exercise sessions (1 out of 5 days). The participant's exercise prescription was calculated from a maximal treadmill test at baseline and updated by a maximal treadmill test at 4-month intervals. Duration of the exercise progressed from 20 minutes at baseline to 45 minutes at 6 months and the intensity of exercise progressed from 60% of the heart rate reserve at baseline to 75% at 6 months. The targeted, minimum energy equivalent of exercise was {approx}400 kcal per session ({approx}2,000 kcal/week) and this was gradually achieved during the first 6 months and then maintained for the remainder of the study. This level of energy expenditure of exercise is in agreement with the recommendations of the American College of Sports Medicine for exercise programs designed for weight reduction as well as the recent position statement regarding appropriate strategies for weight loss and prevention of weight regain for adults [19]. All exercise was performed under direct supervision of research personnel.

Assessments
Body Weight.
Body weight was assessed at baseline, 4, and 9 months between the hours of 7a.m. and 9a.m. using a digital scale accurate to ± 0.1 kg. The participants were weighed prior to breakfast, after attempting to void, and wearing a standardized hospital gown.

Body Composition.
Body composition was estimated by hydrostatic weighing. Underwater weight was recorded to the nearest ± 25 g. Residual volume was assessed in duplicate immediately preceding the body density measurement by the method of Wilmore et al. [20]. Body density was calculated by using the equation of Goldman and Buskirk [21], and percent body fat was calculated with the equation of Brozek et al. [22]

Energy Intake.
Diet intake was ad libitum and was assessed for energy and macronutrient composition at baseline, 4 months and 9 months. Each assessment consisted of a 2-week period where the participants ate ad libitum in the university cafeteria. Based on repeated measures analysis and t-tests there was no difference between nutrient intakes at any assessment time. Thus, a mean dietary intake was determined for each participant over the 9 month period for all nutrients of interest. This mean intake was thus a result of 42 days of observed diet intake.

All food and beverages consumed in the cafeteria were measured using observer-recorded weighed plate waste [23]. Food consumption outside the cafeteria (i.e. snacks) was assessed by multiple pass 24-hour recall procedures that used food models and standardized, neutral probing questions [24]. We have previously shown this technique to be accurate for total energy intake when compared to doubly labeled water with mean energy intake representing 97% and 103% of the calculated energy expenditure for women and men, respectively [25]. Results from the weigh and measure approach and from diet recalls were entered into a computerized nutrition data base for analysis (ESHA, Research, Version 7.1, Salem, OR).

Data Analysis
Means and standard deviations were calculated for all independent and dependent variables. Regression analysis was performed using average calcium intake over the 9-month period and change in body weight and body fat. Pearson product moment correlation coefficients were calculated between diet variables and body composition variables. Significance was set at p < 0.05. Statistical analysis was performed using SAS version 8.2.


   RESULTS
TOP
 ABSTRACT
 INTRODUCTION
 METHODS
 RESULTS
CONCLUSION
 ACKNOWLEDGMENTS
 REFERENCES
 
Physical characteristics of the participants are shown in Table 1. After 9 months of exercise, body weight, fat weight and abdominal circumference was significantly lower in men (see Table 1). There was no observed change in weight or fat weight for women.


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  		Table 1. Anthropometric Changes Over 9 Months for Men and Women

 
Average macronutrient and micronutrient intake for men and women is shown in Table 2. The mean intake of calcium was 993 ± 390 mg for men and 787 ± 276 mg for women. Calcium consumption was negatively associated with change in weight and abdominal circumference in men, while there was no significant association between calcium consumption and any outcome in women (see Table 3). Men lost 6.7 ± 4.6 kg verses 2.9 ± 4.2 kg when divided by those who did (n=12) and did not (n=8) meet the Adequate Intake (AI) of calcium (1000 mg) (p<0.05). There was no difference between women who did (n=7) and did not (n=23) meet the AI for calcium (–0.79 ± 3.4 kg and +0.5 ± 3.3 kg, respectively). The calcium to protein ratio was negatively associated to change in weight, fat weight, and waist circumference in men but did not alter any of the associations in women (see Figs. 1 and 2). The calcium to protein ratio accounted for 31% of the variance in weight change, 28% of the variance in fat weight change, and 27% of the variance in abdominal circumference change in men (p< 0.05)(see Table 3). Total energy intake was not associated with weight change.


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  		Table 2. Average Dietary Intake Over 9-Months of Exercise

 

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  		Table 3. Correlations of Nutrients and Change in Body Composition (r)

 

Figure 1
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  		Fig. 1. Calcium consumption and change in weight after 9 months of exercise in men and women.

 

Figure 2
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  		Fig. 2. Calcium consumption and change in fat weight after 9 months of exercise in men and women.

 
To further investigate the influence of calcium on weight and fat weight a number of potential confounding variables were examined, such as exercise energy expenditure, total energy intake, dietary macronutrient composition and initial body weight, body fat and BMI. Baseline weight, body fat and BMI were the only variables that were significantly associated with change in body weight and body fat in men (p<0.05). While initial weight, body fat and BMI were associated with change in weight and body fat for men, these variables did not significantly alter the association of calcium on weight and body fat. Calcium continued to be negatively associated with weight change independent of baseline weight, body fat and BMI. In addition, baseline weight and BMI were not associated with change in fat weight. The only variables significantly associated with change in fat weight for men were baseline body fat and the calcium to protein ratio.


   DISCUSSION
 
The present investigation demonstrated that calcium was associated with weight and fat weight loss as a result of exercise in men, while this was not observed in women. These results for men cannot be attributed to energy consumption, exercise energy expenditure or initial body weight or body fat, since these variables did not alter the influence of calcium consumption on weight and fat mass. Initial body weight was associated with weight change (heavier individuals tended to loss more weight) but was not associated with change in fat weight.

There is a growing body of literature demonstrating the potential beneficial role of calcium and calcium rich foods on weight and body composition. The basis of the theory proposes a roll for calcium in the regulation of adipose tissue metabolism [11,26]. There are several studies that have indicated that calcium and/or dairy consumption may improve weight and fat weight loss during energy restricted diets [11,27,28]. In contrast, there is very little information regarding the influence of calcium consumption on weight and fat weight alterations as a result of exercise.

Elevated levels of calcium consumption may influence substrate utilization during exercise, thus altering how much and how quickly stored fat can be utilized for energy. As mentioned previously, elevated calcium consumption increases lipolysis during a negative energy balance [11]. This increase in lipolysis from calcium consumption can potentially impact body composition during exercise in several ways. Increased lipolysis elevates the amount of stored fat made available for energy during exercise, thus directly lowering body fat. This increased availability of stored fat can also have a glycogen sparing effect, allowing a person to maintain a higher intensity of exercise for a longer period of time. Higher intensity activities expend more energy, effectively generating a larger energy deficit [29].

The influence of calcium consumption and alterations in weight and body fat during two years of exercise was investigated in young, normal weight women by Lin et al [4]. While elevated calcium consumption was associated with lower body weight and fat, exercise did not change this relationship. Elevated calcium consumption had a similar impact on body weight and fat in women who did and did not exercise. Although it was observed that elevated calcium consumption did not improve weight loss during exercise, it should be pointed out that the original purpose of the study was to determine the impact of exercise on bone density rather than promoting weight loss. The exercise prescription employed high impact activities (jumping rope and weight lifting) and the overall compliance of the study was 45%. Thus, the energy expended from exercise may not have been sufficient to see alterations in body weight and fat. A more rigorous aerobic exercise routine, such as the one employed in the present study, may be needed to increase fat turnover to the extent necessary for elevated calcium consumption to have a meaningful impact on changes in body weight and fat as a result of exercise.

The calcium to protein ratio seems to be more strongly associated with body weight and fat weight changes than calcium alone [2,8], and this was seen in the present study. There was a stronger association between the calcium to protein ratio and change in body weight, fat weight and waist circumference compared to calcium by itself. In the present study the calcium to protein ratio was particularly important when investigating the change in fat weight. The relationship between the calcium to protein ratio and body weight and adiposity has been discussed previously [8,30]. Using the calcium to protein ratio may result in a clearer picture of the influence of calcium on body weight and fat due to the countervailing effect of the two nutrients [30]. It seems that protein consumption increases urinary calcium excretion [31,32]. This loss of calcium in the urine may attenuate the impact of calcium on weight and adiposity. In addition, the calcium to protein ratio may be beneficial by providing a more accurate relative calcium consumption than total calories, since protein seems to be less underreported than fat or carbohydrate [33]. This may be important in the present study, which enrolled exclusively overweight and obese men and women, since overweight and obese individuals have been shown to be at greater risk of underreporting energy consumption than normal weight individuals [33].

This study significantly adds to existing literature as there is only one study, that we are aware of, that has investigated the influence of calcium on changes in weight and fat weight in individuals who exercise [4]. The current study adds evidence supporting a positive influence of calcium on weight and fat weight in men. Although the association was not seen in women, previous research indicate that consuming elevated energy may override any effect seen by calcium [4]. This may help explain the results of the present study since only 3 women consumed less than 7853 kJ, which was the energy intake reported by Lin et al. above which the relationship between calcium and weight disappeared. In addition it should be mentioned that on average the women remained weight and fat stable, while the men lost weight. It may be that calcium is more influential in a state of energy imbalance given the higher rate of fat turnover within the adipose tissue cells during this time [35,37].

The results from this study should be interpreted with a degree of caution. The relationship of calcium to weight loss was a secondary analysis, and the original study was powered to detect changes for body weight as a result of exercise. Changes in body weight in men were related to calcium intake, while changes for women were not. The latter could be related to inadequate power. However, this is not likely since the observed Pearson correlation between calcium and weight was extremely low for women (r = 0.01), suggesting that there was no relationship between calcium consumption and change in weight and adiposity in this sample of women.

There have been numerous studies examining the impact of exercise on weight and body composition [16,34,35]. These studies have used a variety of exercise prescriptions, but the overriding theme has been that exercise and physical activity have a positive impact on energy balance and body composition. While the impact of exercise on energy balance and body composition is almost always positive, exercise seldom has a large impact on weight loss, especially when compared to diet [34,36]. In addition, there seems to be a large amount of variation in weight change between participants, suggesting that there may be other factors that alter how exercise influences body weight and composition [16]. In men, one of the factors that seems to alter the impact of exercise on body weight and composition is calcium consumption.


   CONCLUSION
TOP
 ABSTRACT
 INTRODUCTION
 METHODS
 RESULTS
 CONCLUSION
ACKNOWLEDGMENTS
 REFERENCES
 
Calcium consumption was negatively associated to change in weight and body fat in men; however, calcium was not associated to change in weight or body fat in women. It seems that calcium may potentiate the effects of exercise on weight and fat loss in men. Thus, the effects of exercise on weight and body fat may be greater for men who have diets that are high in calcium rich foods.


   ACKNOWLEDGMENTS
TOP
 ABSTRACT
 INTRODUCTION
 METHODS
 RESULTS
 CONCLUSION
 ACKNOWLEDGMENTS
REFERENCES
 
This study was supported by grant NIHDK49181 from the National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md, and by grant M01 RR0051 from the Clinical Research Center of the University of Colorado Health Sciences Center.

Received April 11, 2006. Accepted August 14, 2006.


   REFERENCES
TOP
 ABSTRACT
 INTRODUCTION
 METHODS
 RESULTS
 CONCLUSION
 ACKNOWLEDGMENTS
 REFERENCES
 

  1. Frazao E: The high costs of poor eating patterns in the United States. In Frazao, E (ed): "America's Eating Habits: Changes and Consequences." Washington, DC: US Department of Agriculture (USDA), Economic Research Service (ERS), AIB-750,1999 .
  2. Heaney RP, Davies KM, Barger-Lux MJ: Calcium and weight: clinical studies. J Am Coll Nutr21 :152S –155S,2002 .[Abstract/Free Full Text]
  3. Jacqmain M, Doucet E, Despres JP, Bouchard C and Tremblay A: Calcium intake, body composition, and lipoprotein-lipid concentrations in adults. Am J Clin Nutr77 :1448 –1452,2003 .[Abstract/Free Full Text]
  4. Lin YC, Lyle RM, McCabe LD, McCabe GP, Weaver CM, Teegarden D: Dairy calcium is related to changes in body composition during a two-year exercise intervention in young women. J Am Coll Nutr19 :754 –760,2000 .[Abstract/Free Full Text]
  5. Shi H, Norman AW, Okamura WH, Sen A, Zemel MB: 1alpha,25-dihydroxyvitamin D3 inhibits uncoupling protein 2 expression in human adipocytes. Faseb J16 :1808 –1810,2002 .[Abstract/Free Full Text]
  6. Teegarden D: Calcium intake and reduction in weight or fat mass. J Nutr133 :249S –251S,2003 .[Abstract/Free Full Text]
  7. Zemel MB: Role of dietary calcium and dairy products in modulating adiposity. Lipids38 :139 –146,2003 .[Medline]
  8. Davies KM, Heaney RP, Recker RR, Lappe JM, Barger-Lux MJ, Rafferty K, Hinders S: Calcium intake and body weight. J Clin Endocrinol Metab85 :4635 –4638,2000 .[Abstract/Free Full Text]
  9. Pereira MA, Jacobs DR, Jr.,Van Horn L, Slattery ML, Kartashov AI, Ludwig DS: Dairy consumption, obesity, and the insulin resistance syndrome in young adults: the CARDIA Study. Jama287 :2081 –2089,2002 .
  10. Zemel MB, Shi H, Greer B, Dirienzo D, Zemel PC: Regulation of adiposity by dietary calcium. FASEB J14 :1132 –1138,2000 .[Abstract/Free Full Text]
  11. Zemel MB: Role of calcium and dairy products in energy partitioning and weight management. Am J Clin Nutr79 :907S –912S,2004 .[Abstract/Free Full Text]
  12. Stich V, Harant I, De Glisezinski I, Crampes F, Berlan M, Kunesova M, Hainer V, Dauzats M, Riviere D, Garrigues M, Holm C, Lafontan M, Langin D: Adipose tissue lipolysis and hormone-sensitive lipase expression during very-low-calorie diet in obese female identical twins. J Clin Endocrinol Metab82 :739 –744,1997 .[Abstract/Free Full Text]
  13. Tremblay A, Despres JP, Bouchard C: The effects of exercise-training on energy balance and adipose tissue morphology and metabolism. Sports Med2 :223 –233,1985 .[Medline]
  14. DiPietro L: Physical activity, body weight, and adiposity: an epidemiologic perspective. Exerc Sport Sci Rev.23 :275 –303,1995 .[Medline]
  15. Blaak EE, Saris WH: Substrate oxidation, obesity and exercise training. Best Pract Res Clin Endocrinol Metab16 :667 –678,2002 .[Medline]
  16. Donnelly JE, Hill JO, Jacobsen DJ, Potteiger J, Sullivan DK, Johnson SL, Heelan K, Hise M, Fennessey PV, Sonko B, Sharp T, Jakicic JM, Blair SN, Tran ZV, Mayo M, Gibson C, Washburn RA: Effects of a 16-month randomized controlled exercise trial on body weight and composition in young, overweight men and women: the Midwest Exercise Trial. Arch Intern Med163 :1343 –1350,2003 .[Abstract/Free Full Text]
  17. Kirk EP, Jacobsen DJ, Gibson C, Hill JO, Donnelly JE: Time course for changes in aerobic capacity and body composition in overweight men and women in response to long-term exercise: the Midwest Exercise Trial (MET). Int J Obes Relat Metab Disord27 :912 –919,2003 .[Medline]
  18. Donnelly JE, Kirk EP, Jacobsen DJ, Hill JO, Sullivan DK, Johnson SL: Effects of 16 mo of verified, supervised aerobic exercise on macronutrient intake in overweight men and women: the Midwest Exercise Trial. Am J Clin Nutr78 :950 –956,2003 .[Abstract/Free Full Text]
  19. Jakicic JM, Clark K, Coleman E, Donnelly JE, Foreyt J, Melanson E, Volek J, Volpe SL: American College of Sports Medicine position stand. Appropriate intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc33 :2145 –2156,2001 .
  20. Wilmore JH, Vodak PA, Parr RB, Girandola RN, Billing JE: Further simplification of a method for determination of residual lung volume. Med Sci Sports Exerc12 :216 –218,1980 .
  21. Goldman R, Buskirk E: Body volume measurement by under-water weighing: description of a method. In Brozek J, Henschel A (eds): "Techniques for Measuring Body Composition." Bethesda: National Academy of Sciences and National Research Council, pp78 –89,1961 .
  22. Brozek J, Grande F, Anderson JT, Keys A: Densitometric Analysis Of Body Composition: Revision Of Some Quantitative Assumptions. Ann N Y Acad Sci110 :113 –140,1963 .[Medline]
  23. USDA: "General Guidelines for Determining Food Acceptability (Procedures for Plate Waste Studies)." Washington, D.C.: USDA, Food and Nutrition Service,1975 .
  24. Gibson RS. Principles of Nutrition Assessment. Oxford: Oxford University Press,1990 .
  25. Hise ME, Sullivan DK, Jacobsen DJ, Johnson SL, Donnelly JE: Validation of energy intake measurements determined from observer-recorded food records and recall methods compared with the doubly labeled water method in overweight and obese individuals. Am J Clin Nutr75 :263 –267,2002 .[Abstract/Free Full Text]
  26. Zemel MB: Mechanisms of dairy modulation of adiposity. J Nutr133 :252S –256S,2003 .[Abstract/Free Full Text]
  27. Zemel MB, Thompson W, Milstead A, Morris K, Campbell P: Calcium and dairy acceleration of weight and fat loss during energy restriction in obese adults. Obes Res12 :582 –590,2004 .[Medline]
  28. Shapses SA, Heshka S, Heymsfield SB: Effect of calcium supplementation on weight and fat loss in women. J Clin Endocrinol Metab89 :632 –637,2004 .[Abstract/Free Full Text]
  29. Treuth MS, Hunter GR, Williams M: Effects of exercise intensity on 24-h energy expenditure and substrate oxidation. Med Sci Sports Exerc28 :1138 –1143,1996 .
  30. Church C: "Bowes & Church's Food Values of Portions Commonly Used, 12th ed. Philadelphia: Lippincott,1975 .
  31. Institute of Medicine, Food and Nutrition Board: "Dietary Reference intakes for calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride." Washington, DC: National Academy Press,1997 .
  32. Linkswiler HM, Zemel MB, Hegsted M, Schuette S: Protein-induced hypercalciuria. Fed Proc40 :2429 –2433,1981 .[Medline]
  33. Heitmann BL, Lissner L: Dietary underreporting by obese individuals--is it specific or non-specific? BMJ311 :986 –989,1995 .[Abstract/Free Full Text]
  34. Miller WC, Koceja DM, Hamilton EJ: A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int J Obes Relat Metab Disord21 :941 –947,1997 .[Medline]
  35. Poirier P, Despres JP: Exercise in weight management of obesity. Cardiol Clin19 :459 –470,2001 .[Medline]
  36. Orzano AJ, Scott JG: Diagnosis and treatment of obesity in adults: an applied evidence-based review. J Am Board Fam Pract17 :359 –369,2004 .[Medline]
  37. Schrager S: Dietary calcium intake and obesity. J Am Board Fam Pract18 :205 –210,2005 . hypercalciuria. Fed Proc 40:2429–2433, 1981.[Medline]



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