If postprandial fat oxidation rates are higher after high MUFA, rather than SFA meals, then a simple change to the type of dietary fat consumed might have beneficial effects in curbing weight gain in men consuming a relatively high-fat diet. This may be particularly evident in men with a large waist circumference.

A randomised crossover study of eight overweight or obese men (aged 24 -49 years, BMI 25·5-31·3 kg/m 2 ), who followed two diets for 4 weeks each, was performed to determine whether substitution of saturated fat with monounsaturated fat affects body weight and composition. Subjects were provided with all food and beverages as modules (selected ad libitum) of constant macronutrient composition, but differing energy content. The % total energy from saturated fat, monounsaturated fat and polyunsaturated fat was 24, 13 and 3 % respectively on the saturated fatty acid (SFA)-rich diet and 11, 22 and 7 % respectively on the monounsaturated fatty acid (MUFA)-rich diet. MUFA accounted for about 80 % of the unsaturated fats consumed on both diets. Body composition, blood pressure, energy expenditure (resting and postprandial metabolic rates, substrate oxidation rate, physical activity), serum lipids, the fatty acid profile of serum cholesteryl esters and plasma glucose and insulin concentrations were measured before and after each diet period. Significant (P#0·05) differences in total cholesterol and the fatty acid composition of serum cholesteryl esters provided evidence of dietary adherence. The men had a lower weight (22·1 (SE 0·4) kg, P¼ 0·0015) and fat mass (2 2·6 (SE 0·6) kg, P¼0·0034) at the end of the MUFA-rich diet as compared with values at the end of the SFA-rich diet. No significant differences were detected in energy or fat intake, energy expenditure, substrate oxidation rates or self-reported physical activity. Substituting dietary saturated with unsaturated fat, predominantly MUFA, can induce a small but significant loss of body weight and fat mass without a significant change in total energy or fat intake. Despite their established health benefits, diets with a high monounsaturated fatty acid (MUFA) content are often not promoted due to concerns that their relatively high dietary total fat content might promote obesity (Garg, 1994;deLorgeril & Salen, 2000), as fat per se not only forms highly palatable and energy-rich foods (Blundell & MacDiarmid, 1997), but is also efficiently stored in the body (Stubbs, 1998). Although population and intervention studies have suggested the importance of high-fat diets in the promotion of obesity (Lissner & Heitmann, 1995), a consensus establishing the relationship between a high fat intake and obesity has not yet been established (Bray & Popkin, 1998;Willet, 2002). Recent evidence implicates saturated fatty acids (SFA), rather than the unsaturated fats, in the development of obesity, due to the greater propensity for SFA to be stored in adipose tissue rather than being oxidised (Storlien et al. 1998(Storlien et al. , 2001. Studies using indirect calorimetry in human volunteers have indicated that polyunsaturated fatty acids (PUFA) are better oxidised than SFA in both normal weight (Jones & Schoeller, 1988) and obese men (Jones et al. 1992). Fewer studies, however, examine the fate of the nutritionally important MUFA. Jones et al. (1985), using stable isotope-labelled fat...

Objective Using burden of disease methodology, estimate the health risks of intimate partner violence (IPV) among women in Victoria, Australia. Methods We calculated population attributable fractions (from survey data on the prevalence of IPV and the relative risks of associated health problems in Australia) and determined health outcomes by applying them to disability-adjusted life year estimates for the relevant disease and injury categories for Victoria, Australia for 2001. Findings For women of all ages IPV accounted for 2.9% (95% uncertainty interval 2.4-3.4%) of the total disease and injury burden. Among women 18-44 years of age, IPV was associated with 7.9% (95% uncertainty interval 6.4-9.5%) of the overall disease burden and was a larger risk to health than risk factors traditionally included in burden of disease studies, such as raised blood pressure, tobacco use and increased body weight. Poor mental health contributed 73% and substance abuse 22% to the disease burden attributed to IPV. Conclusion Our findings suggest that IPV constitutes a significant risk to women's health. Mental health policy-makers and health workers treating common mental health problems need to be aware that IPV is an important risk factor. Future research should concentrate on evaluating effective interventions to prevent women being exposed to violence, and identifying the most appropriate mental health care for victims to reduce short-and long-term disability. Voir page 743 le résumé en français. En la página 743 figura un resumen en español. IntroductionReliable and comparable analysis of risks to health is essential for informing efforts to prevent disease and injury. 1 The burd d den of disease methodology provides a tool for estimating the impact of health problems and risky behaviours across a population, taking into account both illness and premature death. 2 Previous burden of disease studies have been criticized for failing to provide an accurate and comprehensive picture of the burden of disease and injury among women by excluding some red d productive health conditions associated with significant rates of morbidity, and by omitting to measure the contribution of important risk factors, such as intid d mate partner violence (IPV), to burden of disease. 3,4 Increasing evidence indicates that IPV is highly prevalent globally and has serious and longdlasting health consed d To decrease gender disparities in health outcomes it is essential that the associd d ated risk factors be clearly identified, measured and recognized as a priority for intervention.Globally, evidence on the prevad d lence and the health consequences of IPV is growing steadily but, to date, the contribution of IPV to the burden of disease has not been estimated. The overall aim of our study was to estimate the contribution of IPV to the total burden of disease for women living in Victoria, Australia, in 2001. We were able to carry out this study due to the availability of good prevalence data on exposure to IPV and survey data on the health consequenc...

To determine whether the age-related reduction in basal metabolic rate (BMR) is explained by a quantitative and/or qualitative change in the components of lean tissue, we conducted a cross-sectional study in groups of young (n = 38, 18-35 yr) and older (n = 24, 50-77 yr) healthy individuals. BMR was measured by indirect calorimetry. Body composition was obtained by using dual-energy X-ray absorptiometry (DEXA), which permitted four compartments to be quantified [bone mineral mass, fat mass (FM), appendicular lean tissue mass (ALTM), and nonappendicular lean tissue mass (NALTM)]. Absolute BMR and ALTM were lower, whereas FM was significantly higher in the older, compared with young, subjects. BMR, adjusted for differences in FM, ALTM, and NALTM, was significantly lower in the older subjects by 644 kJ/day. In separate regression analyses of BMR on body compartments, older subjects had significantly lower regression coefficients for ALTM and NALTM, compared with young subjects. Hence, the age-related decline in BMR is partly explained by a reduction in the quantity, as well as the metabolic activity, of DEXA-derived lean tissue components.