Design: In the DM trial, 48,835 women aged 50-79 y were randomly assigned to intervention (40%) or comparison (60%) groups. We studied a subset with whole-body dual-energy X-ray absorptiometry scans at baseline and during follow-up. Changes in fat mass (FM), lean mass (LM), and percentage GDC-973 body fat between the intervention (n = 1580) and comparison (n = 2731) groups at years 1, 3, and 6 were compared. By using generalized estimating equations, we calculated overall differences between groups and tested for interactions with age, diabetes, race-ethnicity (white, black, and Hispanic), body mass index (BMI), and hormone therapy (HT).

Results: The

intervention women experienced significantly greater reductions in percentage body fat, FM, and LM at years 1 and 3 than did women in the comparison group (all P < 0.05). At year 6, only the FM change was significantly different between groups. Overall, the intervention was associated with reductions in percentage body fat (-0.8%; 95% CI: -1.0%, -0.6%), FM (-1.1 kg; 95% CI: -1.3, -0.8 kg), and LM (-0.17 kg; 95% CI: -0.28, -0.06 kg) during follow-up (all P < 0.003). Intervention selleck inhibitor associations varied by race-ethnicity, BMI, diabetes, and HT and remained significant after adjustment for physical activity.

Conclusion: This intervention was associated with modest long-term body-composition changes; the findings

were more robust in years 1 and 3. This trial was registered buy AL3818 at clinicaltrials. gov as NCT00000611. Am J Clin Nutr 2011;93:516-24.”
“QUESTIONS UNDER STUDY/PRINCIPLES: In most centers, Upper Gastrointestinal series (UGI) following Roux-en-Y Gastric Bypass (RYGB) is performed to rule out GJ anastomotic leak. According to the introduction of robotic technology associated with a hypothetical decrease of anastomotic complications, we aim to assess

the validity and cost effectiveness of early routine UGI following robot-assisted RYGB.

METHODS: Between July 2006 and December 2010, 167 robot-assisted RYGB were performed at a single institution. All data were collected prospectively in a computerised database and reviewed retrospectively. Patients underwent a gastrografin UGI at postoperative day 2 to exclude anastomotic leak or stenosis.

RESULTS: None of the 167 patients who underwent an early UGI experienced leak radiologically and clinically. The only radiological abnormalities were two GJ edema (1.2%) and one jejunojenunostomy stenosis (0.6%), all treated conservatively with success. The total cost for the 167 UGI was CHF 93,520 (= USD 96,886).

CONCLUSIONS: In most centres, the risk of anastomotic leak has been the rationale for obtaining an UGI following RYGB. However, provided low leak rates as for our experience with robotic RYGB, the authors show this exam to be expensive and of limited value.