Aaron M. Altschul

Double-blind controlled trial of the Garren-Edwards gastric bubble: An adjunctive treatment for exogenous obesity

Since its approval by the Food and Drug Administration in September 1985, the Garren-Edwards gastric bubble has been extensively used as an adjunct to diet and behavioral modification in the treatment of exogenous obesity. In an attempt to evaluate the efficacy of the Garren-Edwards gastric bubble, a double-blind crossover study was undertaken. Ninety patients were randomized into three groups: bubble-sham, sham-bubble, and bubble-bubble in two successive 12-wk periods. Sixty-one patients completed the entire 24-wk study. All groups participated in ongoing diet and behavioral modification therapy in a free-standing obesity program, the members of which were blinded to randomization arms. All patient groups lost weight during this study. The mean cumulative weight loss in pounds at 12 wk was as follows: bubble-sham = 19, sham-bubble = 12, and bubble-bubble = 8; and at 24 wk: bubble-sham = 23, sham-bubble = 16, and bubble-bubble = 18. The mean cumulative change in body mass index (kg/m2) at 12 wk was as follows: bubble-sham = -3.1, sham-bubble = -2.3, and bubble-bubble = -2.9; and at 24 wk: bubble-sham = -3.1, sham-bubble = -3.0, and bubble-bubble = -3.3. Although weight loss occurred more consistently in patients with a Garren-Edwards gastric bubble, there were no significant differences between any of the three groups at 12 or 24 wk with respect to weight loss or change in body mass index. The major part of the weight loss noted during this study occurred during the first 12-wk period, irrespective of therapy (bubble or sham). Side effects observed during this study included gastric erosions (26%), gastric ulcers (14%), small bowel obstruction (2%), Mallory-Weiss tears (11%), and esophageal laceration (1%). We conclude that, in this study, the use of a Garren-Edwards gastric bubble did not result in significantly more weight loss than diet and behavioral modification alone in the management of exogenous obesity, and it may result in significant morbidity.

Studies in community nutrition: estimation of sodium output.

Abstract A practical procedure for estimating dietary intake of salt would facilitate examination of the possible relationship between salt intake and hypertension and could provide feedback to aid persons in changing salt intake when such is recommended. This is a study with 19 subjects of a sampling procedure of estimating sodium output which requires less patient cooperation than that needed for a 24-hr urine sample. Each subject provided timed urine samples for portions of the entire 24-hr period for three consecutive days. Sodium excretion for any one of the entire 24-hr periods correlated well with the mean 24-hr excretion for the 3-day period. The mean sodium excretion of the three 9-hr overnight urine samples correlated equally well with the mean 24-hr excretion for the entire 3-day period. This latter procedure, which puts far less a burden of compliance on the subjects, is suggested as preferable to obtaining a 24-hr urine sample. For purposes of checking compliance with dietary suggestions, it is possible to replace the analysis for sodium with a simple titrator strip that measures chloride.

Towards accurate assessment of children's food consumption

A descriptive study of the food habits of elementary school aged children was conducted in an urban southeastern American city. The results suggest that the way in which food consumption data about children is conventionally collected may not accurately reflect consumption patterns necessary to ensure proper analysis. The study documents the large contribution to total food intake of casual eating both inside and outside the home and over which children exert considerable autonomy. This suggests that assessing patterns of food consumption among children in an urban population, whose day offers many opportunities for casual eating, may be more appropriately performed by using selected ethnographic techniques alone or in tandem with more traditional methods.

New Protein Foods: a Study of a Treatise

Publisher Summary There was a time when any emphasis on protein foods was taken to mean that the world food problem was considered to be primarily a protein problem. Cereals are the major source of calories and protein for most of the world. Where animal products are scarce or less plentiful, cereals may account for 60% of the daily protein intake. The numbers of livestock and wild animals in relation to feed supplies and the competition between humans and animal for the energy and protein resources were discussed by Eyerly. If edible sources of energy and nutrients are to be spared for humans, then either the animal population decreases or nonagricultural and recycled agricultural products must substitute in part for the edible grains. The production of animals and their marketing is highly industrialized and, in fact, is no different than the production and marketing of nonfood industrial products. Cereals are the major source of protein worldwide. When a new product replaces all or a part of a well-known and accepted food and begins to make a significant contribution to the diet, it becomes necessary to be sure that nutritional status does not suffer or, better yet, that flexibility for improved nutrition is enhanced. New technologies affect how people eat by changing the relative price of some methods or their attractability relative to others.

The potential for vegetable proteins in prudent diet foods

Abstract A major problem in designing diets of any sort, be they the “prudent diet”, or for reducing weight, or otherwise, is that the participant is faced with many restrictions and few alternatives. But now it is possible, with the aid of modern food science, to fabricate foods with changed nutrient compositions which might make dieting easier. For example, protein foods are generally associated with a high degree of sensory satisfaction; this is true particularly of meats and the like. The problem is that the high degree of sensory satisfaction and the high quality of protein and micronutrient mix brings with it cholesterol and saturated fats, both of which are restricted in the prudent diet. The virtue of vegetable proteins is that it is now possible, because of the methods of texturizing, to fabricate analogs which approach the animal foods in sensory quality, yet contain a nutrient mix that is more satisfactory in terms of caloric intake and the nature and quantity of the lipids.