text:
Prescott sharp again as Cowboys take division lead
Sports // Pro Team Sports
Prescott sharp again, Dallas takes division lead
Mike Finger Oct. 9, 2016 Updated: Oct. 9, 2016 10:21 p.m.
1of3Dallas Cowboys quarterback Dak Prescott (4) scrambles out of the pocket under pressure from Cincinnati Bengals defensive end Carlos Dunlap (96) in the first half of an NFL football game, Sunday, Oct. 9, 2016, in Arlington, Texas.Photo: Michael Ainsworth, AP
2of3Dallas Cowboys quarterback Dak Prescott (4) throws a pass as guard Ronald Leary (65) blocks against pressure from Cincinnati Bengals defensive tackle Geno Atkins (97) in the first half of an NFL football game, Sunday, Oct. 9, 2016, in Arlington, Texas.Photo: Ron Jenkins, AP
3of3Dallas Cowboys wide receiver Cole Beasley (11) leaps into the end zone for a touchdown after catching a pass as Cincinnati Bengals free safety George Iloka (43) defends in the first half of an NFL football game, Sunday, Oct. 9, 2016, in Arlington, Texas.Photo: Ron Jenkins, AP
ARLINGTON — Jerry Jones said the identity of his No. 1 quarterback still hasn't changed. But Sunday proved once again that other things have.
No longer are the Dallas Cowboys helpless without Tony Romo. No longer are fans clamoring for their injured star to hurry back. And no longer does it seem reasonable to dismiss Dak Prescott as a flash in the pan.
In perhaps the most impressive performance of his stellar first five weeks as an NFL quarterback, Prescott passed for 227 yards and accounted for two touchdowns while leading the Cowboys to a 28-14 victory over the Cincinnati Bengals at AT&T Stadium on Sunday.
And the biggest compliment Prescott's teammates paid him wasn't that they were blown away by his record-breaking aversion to interceptions or his impeccable poise. It was that they never anticipated anything different from him.
"It's just the same old Dak," wide receiver Cole Beasley said. "You expect it from him every game now. It's kind of hard to live up to these kinds of expectations, but, shoot, he's been doing it for five games straight."
In vaulting the Cowboys (4-1) back to the top of the NFC East standings, Prescott extended his NFL rookie record of passes without an interception to 155. That puts him only seven shy of Tom Brady's league mark of 162 interception-free throws to start a career.
Prescott, who completed 18 of 24 attempts against the Bengals, downplayed his own role in flying through the record books.
"Some good fortune goes into that," Prescott said.
And as he pointed out, some help from teammates goes into it, too.
Sunday, against a formidable Bengals team that was supposed to present the Cowboys with one of their stiffest tests of the year, Ezekiel Elliott rushed 15 times for 134 yards. Dallas' offensive line gave Prescott so much time more time than he knew what to do with.
And the Cowboys' defense held the Bengals (2-3) off the scoreboard until the fourth quarter. They did an especially good job limiting Cincinnati wide receiver A.J. Green, who caught only four passes for 50 yards.
"That was our goal during the week, to pretty much try to take him away from them," Morris Claiborne said. "If they were going to beat us, make somebody else beat us."
Meanwhile, the Cowboys gave themselves plenty of options, even with Romo still out with a compression fracture in his back and receiver Dez Bryant out with a fracture near his right knee.
Against a Cincinnati defense that hadn't given up a rushing touchdown all year and hadn't allowed an opposing running back to gain more than 37 yards in the previous two weeks, Elliott found big lanes and took advantage of them.
Elliott, who has more rushing yards through five games than any rookie in franchise history, finished Dallas' first drive with a 13-yard touchdown run, and scored on a 60-yard dash on the first play of the second half.
"Give Zeke credit," tight end Jason Witten said. "Not just anyone can run through those holes."
Everyone from Witten to Jones to coach Jason Garrett was giving plenty of credit to Prescott, too. Garrett raved about the rookie quarterback's work during the week, saying "his preparation is off the charts."
"Our team has embraced Dak," Garrett said. "He's come in and done what we've asked him to do."
Again, Prescott didn't see what the big deal was.
"I've been comfortable all year," Prescott said. "I don't think tonight was any different from the (first) game."
As for how long he'll keep the job? Garrett danced around the question of what will happen when Romo makes his return, which could happen in the next few weeks. Jones said Romo has another MRI scheduled for Monday, and that the team expects a positive report.
So, Jones was asked, will Romo get the starting job when he's cleared to play?
"I'm not avoiding that," Jones said. "Tony's our No. 1 quarterback and we're going to have the luxury of being able to I think see them both."
And as tough as sorting out that dilemma might sound, Jones pointed out, he's had worse ones when it comes to quarterbacks.
"I'll show you some hard days around here without a quarterback if you want to know, if you want one that'll really make you pout," Jones said. "That's not a problem to have (this) one."
mfinger@express-news.net
Twitter: @mikefinger
Mike Finger
Mike Finger has worked for the Express-News since 1999, writing about the Texas Longhorns, the Big 12, the NBA and the NFL before becoming a sports columnist. He's covered 13 Spurs postseasons, six Final Fours and more than a dozen college bowl games.
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text:
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MNL17-2ND
Driers and Metallic Soaps
Published: Jan 2012
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METALLIC SOAPS ARE COMPOUNDS OF ALKALINE metals or heavy metals and monobasic carboxylic acids containing from 7 to 22 carbon atoms. The water-insoluble metallic soaps are of particular interest to the coatings industry, although potassium and lithium soaps have limited water solubility. Basically, the known techniques for preparation of metallic soaps are divided in two processes—a fusion process and a double decomposition process. The fusion process involves reacting a metal oxide or hydroxide with a fused fatty acid such as a triglyceride in the presence of water [1]. The process yields the desired metallic soap and glycerin. The double decomposition process involves reacting an alkali soap that is comprised of an alkaline metal salt or an ammonium salt of a fatty acid with an inorganic metal salt. Both processes are usually carried out in a batch mode; and, as a result, a product contaminated with unreacted starting materials and by-products that must be further purified is formed. To obtain a product essentially free of contamination, a continuous process [2] involving the double decomposition scheme has been devised. An aqueous solution of the alkali soap and an inorganic metal salt are separately fed onto a rotating impeller surface whereon they are instantaneously mixed. The resulting aqueous slurry is rapidly discharged and a contamination-free metallic soap results. Recently, a process for making basic zirconium carboxylates of branchedchain, five- to ten-carbon, aliphatic monocarboxylic acids has been described [3]. The compounds are useful as driers for paints and inks. The applications of metallic soaps in coatings include their use as driers, catalysts, stabilizers, biocides, bodying agents, and flatting agents. An overview of metallic soap applications is presented in Table 1. An interesting particular end-use for metallic soaps is in the formation of a thin metallic oxide coating on a substrate [4]. A solution of the metallic soap is applied by reverse roll coating and then baked in a manner such that a thin, about 1–10 μm, film of the metallic oxide is formed. Although this chapter concentrates primarily on metallic soaps used as driers, a brief review of bodying and flatting applications for these materials is included.
Author Information:
Schnall, Marvin J.
Coatings Consultant, Chapel Hill, NC
Committee/Subcommittee: D01.32
DOI: 10.1520/MNL12185M

redpajama_set_name: RedPajamaCommonCrawl


text:
Franklin's book on moral leadership explores urgent public need
Robert Franklin, Emory's James T. and Berta R. Laney Professor in Moral Leadership, has published his latest book, "Moral Leadership: Integrity, Courage, Imagination."
Robert Franklin is used to answering questions about being a professor in moral leadership. Among the reactions that most amuse him is the observation, "Moral leadership, is that a thing?"
Franklin, who is in fact the James T. and Berta R. Laney Professor in Moral Leadership at Emory's Candler School of Theology, relishes the chance to explain that not only is moral leadership indeed a thing, but "it might actually be a welcome response to an urgent public and private need."
Franklin's sense of that need has been affirmed by his experiences as a leader (he also is president emeritus of Morehouse College), by his students and by the COVID-19 pandemic. His latest book, "Moral Leadership: Integrity, Courage, Imagination," is particularly prescient, given the current moment.
As Franklin defines it, moral leadership is not solely focused on personal goodness or religious piety, although those qualities may be present, but on leadership for the common good that invites others to join in.
"Throughout our history, when human communities have faced seemingly insurmountable challenges, women and men with integrity, courage and imagination have emerged to help lead them forward," he says.
Among the leaders Franklin references are four individuals he returns to throughout the book who not only worked for the common good, but invited and inspired others to get involved: The Rev. Martin Luther King Jr., King colleague and civil rights activist Ella Baker and farmworker activists Dolores Huerta and Cesar Chaves.
Lest his readers or students think otherwise, Franklin doesn't claim that effective moral leaders are without fault. "These are red-blooded people," he says. "They make mistakes."
They also confront failure. Franklin tells the story of Benjamin Mays, the iconic 6th president of Morehouse, civil rights leader and mentor to Martin Luther King Jr., who gave a final speech as president of Morehouse in which he talked about not only his successes, but his failures. "Mays reminds us that it is possible to work hard, accomplish much in a career and still feel unfulfilled relative to the dreams and expectations one had for oneself."
In Franklin's course this semester titled "Religion, Ethics and Public Intellectuals," his students have been looking at "periods in American history where there was significant crisis and upheaval, and how public intellectuals of various stripes and vocations emerged to speak to that chaos and tried to recalibrate the moral compass."
So far the class has studied the founding of the republic, the crisis surrounding the Civil War and the Great Depression. "Ironically," he says, "this is the point in the semester where we planned to deal with our current period, which I had titled, 'Our Zeitgeist.'" And what a zeitgeist it is.
In the classroom, Franklin is himself a sought-after moral leader and mentor — his foundational courses in the Laney Program in Moral Leadership at Candler draw students pursuing careers not only in theology, but education, health care and beyond.
With his students, Franklin is quick to dispel the notion that only people who feel specially appointed to lead are capable of this, when in fact "opportunities for leadership can occur for all of us at any time."
He tells the story of his grandmother, Martha Battle McCann, with whom his family lived in a house on the south side of Chicago in the 1960s. It was a time during Franklin's boyhood that witnessed the civil rights movement — and street gang conflicts.
"One day, two groups of young men were about to have a fight in the street in front of our house. She heard the escalation, ran out of the kitchen and down the stairs, aprons flying, and began to talk to them.
"She said, 'I have a garden here next door. I've grown fruits and vegetables and prepared food to feed your families. No mother wants to receive that phone call that her son is shot and wounded. I received that call when my son was shot in Italy during the war.'
"They backed away," says Franklin. "Her act was a metaphor for observing courage, integrity and imagination." He dedicates the book's prologue to her and to other change agents and moral leaders responsible for much of the good we see around us.
"Moral leadership is on the rebound," says Franklin. "Social crisis, polarization, fear and a deeper hunger for a more just society create conditions for moral leaders to emerge."
Beyond the classroom, Franklin is extending an invitation to those who seek moral leadership. "This book has a very practical goal: To stimulate conversations about the nature of moral leadership and why we need more of it now."
Emory's Candler School of Theology
Theology students visit Haiti to explore moral leadership
Emory names Franklin to lead Laney Legacy in Moral Leadership


The Firewater Grille – цей ресторан пропонує сніданок, обід і вечерю.
This was an Anniversary hotel treat. As a local you rarely stay in your own city area. This was well placed and one of the best hotel stays we've had. It has a convenience store directly across the road and well placed for location within the cbd.


Ms. Settenbrino received overwhelming responses to her inquiry announced here, on DivorceCorp. She wants to thank you for all of your responses and to let you know that she will be addressing them accordingly. Ms.Settenbrino and Greg Roberts have created Uncheckedpower.org, to address unchecked power in the government and court system as a whole.
Please contact Susan Settenbrino at www.uncheckedpower.org if you have any questions. She and other team members from Uncheckedpower.org will be addressing the emails and compiling information (or requesting more information) in order to assess whether there appears to be a pattern of abuses of power within the ethics committees for judges and attorneys. Please be patient and let's work together as a team to truly address the problems within our court system in a constructive manner.
Again, please follow up on this. It promises to be not only a great outlet for parents' frustrations, but an excellent resource for advocates for family court reform.


For the first time on one stage: People's Artist of the USSR Ada Rogovtseva and writer Viktor Shenderovich!
Duration of the performance: 2 hours, with one intermission.
The premiere of the performance took place on May 9, 2018 in London.
Yes, I would sell my soul to ... Even once in our lives each of us said this phrase. To correct mistakes, to realize a dream, in exchange for one's soul or souls of the closest. High price? The answer can be found in the company of the mother, her three adult children and the Devil himself.
We propose to do this at the premiere of the comedy "What the heck" after the play by Irina Ioannesyan and Natella Boltyanskaya. Sparkling dialogues and unexpected turns of the plot.
"This play is light, sparkling, akin to a glass of good champagne. From every scene, every dialogue, you get a huge pleasure and a long aftertaste. The first joint work of Irina Ioannesyan and Natella Boltyanskaya, witty, ironic, she is simply doomed to success. "
"The play deserves attention unconditionally. The role of the line is frankly good, I would gladly have played it myself. As for the topic, I am sure that any viewer will receive it with interest, because in each of us there is a need to correct mistakes of the past, and many are ready to sell the soul in order to fulfill cherished desires. A lot of temptations are enough. "


The preoperative preparation of the bowel with sulfonamides and antibiotics, the prophylactic use of antibiotics after operation, and modern advances in surgical technic have contribued materially to the safety of operations on the colon. As a result of these advances it is possible today to perform with relative safety operations which prior to 1940 were deemed hazardous; to preserve the rectal sphincter when formerly it was often necessary to sacrifice it, and to perform primary end-to-end anastomoses in situations which at one time appeared to demand obstructive resections or complementary colostomies with their attendant inconvenience and morbidity. The purpose of this study is to evaluate the present status of the various types of operations in colon surgery.
Prior to 1942 patients to be subjected to resections of the colon were prepared by the use of magnesium sulfate and a low residue diet. Occasionally sulfonamides were given after operation, but these were used therapeutically in the treatment of established complications and not prophylactically.
Since the war (1946) we have prepared the bowel by administration of sulfasuxidine given in doses of 3 Gm. four times daily for 7 days before operation and sometimes supplemented by streptomycin, 1 Gm. given twice daily for the last 2 days. More recently aureomycin has been used in doses of 500 to 750 mg. four times daily for 3 days. The latter is not only the most effective means of reducing the bacterial count in the stool,1 but is also absorbed and. . .


That Thing Rich People Do offers the easiest way yet to learn the principles of investing. Weighing in at just 136 pages, it conveys more knowledge than books twice as long, with charm and humor that makes it a pleasure to read.
Go Roth! offers clear, practical advice on using a Roth IRA or a Roth account in a 401k or other employer plan to build retirement wealth.
The 2015 edition is currently available.
Capital Gains, Minimal Taxes is a complete, authoritative guide to tax consequences and strategies for people who buy, hold and sell stocks, mutual funds and market-traded stock options.
The 2015 edition is now available.
Consider Your Options is our plain language guide to the opportunities — and pitfalls — in handling stock options and other forms of equity compensation.
The 2019 edition, published December 2018, is currently available.
Equity Compensation Strategies offers a course of study and reference for investment advisors and tax professionals who offer advice on how to handle stock options and other forms of equity compensation.
The 2014 edition, published November 2013, is currently available.


If you are paying by credit card please do NOT log out of the PayPal site before they return you to the membership form to complete your registration. Otherwise there will be a longer delay.
Helping YOU to fulfill your destiny!


text:
Sportschool is de benaming die in Nederland wordt gebruikt om een (privé-)centrum aan te duiden waar iedereen kan sporten op fitnessapparaten en met behulp van grote ballen kan er ook worden gesport. Vaak kan er ook aan bodybuilding  worden gedaan.

Ook zijn er speciale sportscholen waar men kan revalideren met behulp van medische trainingstherapie. Meestal kan dit met hulp van een fysiotherapeut. In Vlaanderen spreekt men eerder van een Fitness-centrum of kortweg "Fitness" (ook als er geen specifieke Fitness lessen aangeboden worden).

Dergelijke sportscholen stellen meestal voor de mensen die er trainen een persoonsgebonden trainingsprogramma op. Hiermee kunnen zij dan aan de slag op de verschillende apparaten in de trainingszaal van de sportschool.

Er zijn ook sportscholen waar les in vechtsporten worden gegeven, soms een aparte zaal, los van de fitness- en krachttraining, soms een hele sportschool gewijd aan alleen een of meerdere vechtsporten (of kunsten). Ook worden groepslessen aangeboden in bijvoorbeeld bodypump, BOMmen, aerobics en pilates.

Oost-Europa
In oost-Europa is een sportschool een basis- en/of secundaire school waar het vak lichamelijke opvoeding en sport een groot deel van het lessenpakket inneemt. Dergelijke scholen werden op grote schaal opgezet in de Sovjet-Unie (Детско-Юношеская Спортивная Школа; Detsko-Joenosjeskaja Sportivnaja Sjkola of ДЮСШ; DJoeSSj) en het Oostblok (leeftijd: 8-14 jaar), waar met name de Kinder- en Jeugdsportscholen uit de DDR bekend waren. Een aantal kinderen stroomden door naar de Olympische Spelen. Op basis van het sovjetsysteem werden ook sportscholen in de Volksrepubliek China opgericht. Ook in het huidige Rusland zijn deze instellingen voor jeugdsport voortgezet.

In Vlaanderen worden dergelijke scholen doorgaans topsportschool genoemd, wat soms een misleidende term is, want niet alle sportscholen aldaar zijn topsportscholen.

Zie ook
Sportklas

Fitness
Sportterminologie
Schooltype

redpajama_set_name: RedPajamaWikipedia


text:
1982 Asian American Film Festival
[archiveorg cbpf_000010 width=560 height=384 frameborder=0 webkitallowfullscreen=true mozallowfullscreen=true]
Pacific Film Archive
californialightandsound, Motion picture producers and directors--California--San Francisco Bay Area--Interviews, Asian American motion picture producers and directors, Asian American art--20th century, Film festivals--United States, National Asian American Telecommunications Association, Wang, Wayne, Omori, Emiko, Dong, Arthur, Yang, Ruby, Muramoto, Jane
Alternate Title: Chan is Missing: Wayne Wang in person
Description: Q&A's from the very first Asian American Film Festival in the Bay Area are captured, including talks by Wayne Wang (discussing CHAN IS MISSING), Emiko Omori (TATTOO CITY and MANONGS), Arthur Dong (SEWING WOMAN), and Ruby Yang (MIRROR POINTS). Moderated by KQED's Jane Muramoto.
Collection Guide: Pacific Film Archive Audio Recordings Collection
Accession Number: 4000-01-560
Rights: Copyright status unknown. This work may be protected by the U.S. Copyright Law (Title 17, U.S.C.). In addition, its reproduction may be restricted by terms of gift or purchase agreements, donor restrictions, privacy and publicity rights, licensing and trademarks. This work is accessible for purposes of education and research. Transmission or reproduction of works protected by copyright beyond that allowed by fair use requires the written permission of the copyright owners. Works not in the public domain cannot be commercially exploited without permission of the copyright owner. Responsibility for any use rests exclusively with the user. Pacific Film Archive attempted to find rights owners without success but is eager to hear from them so that we may obtain permission, if needed. Upon request to bampfa@berkeley.edu, digitized works can be removed from public view if there are rights issues that need to be resolved.
Digitized by the California Audiovisual Preservation Project (CAVPP).
Speakers: Wang, Wayne; Omori, Emiko; Dong, Arthur; Yang, Ruby; Muramoto, Jane
Berkeley Art Museum and Pacific Film Archive, 2625 Durant Avenue #2250, Berkeley, CA 94720-2250, Telephone: (510) 642-1437, email: bampfa@berkeley.edu, http://bampfa.berkeley.edu
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1 Tape of 1: 1/8 inch audio cassette
Stream playlist
( VBR )
University of California, Berkeley Art Museum and Pacific Film Archive
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California Revealed
Uploaded by California Revealed on April 8, 2013


The Greene County Chamber of Commerce welcomes you to join us as a promotional partner in our inaugural Greene County Restaurant Week, April 6th-15th.
Greene County Restaurant Week will be an opportunity for sponsors and participating restaurants to showcase and expose themselves to a new and motivated dining audience. The mission of restaurant week is to encourage the Greene County and surrounding region's dining public to explore and experience new restaurants and rediscover past favorites while showcasing the high quality and diverse dining destinations of Greene County.
The Chamber will be conducting an aggressive media campaign in support of Restaurant Week. This campaign is planned to include social media, print, radio, TV and email campaigns. Additionally there will be the all new dineingreene.com website which will feature sponsors and participating restaurants as well as all the promotional information for the event. The website will remain active on a year-round basis and all sponsor logos and participants will remain posted until the following year's campaign.
The pricing of Restaurant Week will be $25,$15 or $10 per person excluding tax, tip and beverages. This pricing will feature a preselected, three-course prix fixe menu at each participating restaurant.
We would be pleased and honored to have you become a partner with us in showcasing the wonderfully diverse Greene County restaurant community!
Contact: Rebecca Howard or Jeff Friedman at info@greenecountychamber.com or 518-943-4222.
Large prominent company name and logo displayed on ALL advertising including TV, print, social media, emails, flyers and posters promoting the event.
50 word description to promote your product or service on www.dineingreene.com.
Logo inclusion on promotional posters.
Logo inclusion and link on www.dineingreene.com website.
Sponsor mentions on all weekly Chamber e-newsletters, email blasts, social media and press releases about the event.
Sponsor mention in all "Thank You" promotions.
Distribution of any collateral material to participating restaurants.
Prominent company name and logo displayed on ALL advertising including TV, print, social media, emails, flyers and posters promoting the event.
30 word description to promote your product or service on www.dineingreene.com.
25 word description to promote your product or service on www.dineingreene.com.
10 word description to promote your product or service on www.dineingreene.com.
Company name listed on promotional posters.
Sponsor mentions in all social media outlets and Chamber e-newsletters.
Contact: Rebecca Gray or Jeff Friedman at info@greenecountychamber.com or 518-943-4222.


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Enid High School assistant band director Adrian Gomez conducts the symphonic band during a free spring concert Thursday at Enid Event Center. (Billy Hefton / Enid News & Eagle)
Billy Hefton / Enid News & Eagle
Members of Enid High School jazz ensemble II perform during a free spring concert Thursday ,March 31, 2016, at Enid Event Center. (Billy Hefton / Enid News & Eagle)
editor's pick featured top story
All meals for band students paid for D.C. trip
By Emily Summars Staff Writer
Sounds of toe-tapping jazz and symphonic smoothness could be heard from the Enid High School Big Blue Band at Enid Event Center on Thursday.
The band hosted a free spring concert to raise money for its upcoming trip to Washington, D.C., where it will represent the state in the 2016 National Memorial Day Parade in the nation's capital on May 30.
Thom Bushman, president of Enid High Big Blue Band Booster Club, said there will be 162 students, plus sponsors, on the trip.
The trip will cost $1,000 per student, which includes transportation — driving 18 hours in motor coaches — sightseeing, lodging and some meals, although students will be responsible for some of their own meals.
Or at least they were going to be responsible for their own meals.
No April Fool's joke, Bushman announced Thursday the booster club helped raise $20,000 to cover the cost of student meals.
"We felt like we needed to ramp up our efforts," Bushman said. "The budgets in statewide education have been very tight."
Bushman met with several community leaders, including Kegan Tuohy with NBC Bank. Bushman said Tuohy approached Bushman with several ideas.
"Asking for full sponsorship is a generic approach," Bushman said. "These kids have been working all year long — selling Blue and Gold sausage, hosting car washes, selling mattresses — you name it. We realized the kids would have to buy 10 meals on the trip. At about $12.50 per meal, that's about $2,000."
Bushman recognized those who donated to pay for meals, including: Security National Bank, NBC Bank, Central National Bank, Park Avenue Thrift, Central Christian Church, Enid Public Schools, Enid Public Schools Athletic Department and Integris Bass Baptist Health Center. Jumbo Foods and the Blevins family will provide drinks and snacks for the trip.
"But, fundraising continues," Bushman said. "These funds don't only pay for trips, but they pay for uniform upkeep, contest marching events and new instruments. This year the band has 178 students. Next year it will have 210."
Bushman did not have an updated total of funds raised for the trip, except that fundraising will continue to be an ongoing effort.
The group will take bus and walking tours of the nation's capital, visit the U.S. Holocaust Memorial Museum, see the Lincoln, Korean, Martin Luther King Jr. and Vietnam memorials, tour Arlington National Cemetery and Smithsonian Institution Museum before performing in the parade.
The wind ensemble, symphonic band and jazz bands all performed. Admission was free but donations were welcomed to fund the group's trip.
All donations are tax deductible and can be sent to the EHS Big Blue Band Booster Club, 610 S. Cleveland St., PBM# 437, Enid, OK 73703.
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Wight, Carol
The funeral for Carol Ann Wight, 88-year-old Enid resident, is 1:00 p.m. today in the Henninger-Hinson Chapel. Burial will follow in Memorial Park Cemetery.
CAULK, Dorothy May 28, 1926 - Jan 26, 2022
May 28, 1926 - January 26, 2022 Dorothy M. (Alexander) Caulk was born to James and Viola (Rutz) Alexander in Longdale, Oklahoma, on May 28, 1926, and died peacefully on January 26, 2022, at the age of 95. Dorothy grew up on a farm southeast of Canton, Oklahoma, and graduated from Canton Publ…
Wallace, Opal
Services for Opal "Dess" Wallace, age 85, of Lahoma, will be 10:00 a.m. Friday, February 4, 2022, at Ladusau-Evans Chapel. Burial will follow in the Cherokee Cemetery Cherokee, OK, under the direction of Ladusau-Evans Funeral Home.
SCHADLER, Rodney Oct 29, 1961 - Jan 26, 2022
FINCH, Judith Oct 11, 1950 - Jan 21, 2022
October 11, 1950 - January 21, 2022 Judith Ann Finch passed away January 21st, 2022, surrounded by family at her home in Enid, Oklahoma. Judi was born October 11th, 1950, in Shattuck, Oklahoma, second of three children to Marguerite (Brown) and John J. Vallaster, Jr. On her father's return f…
Hideaway offers sneak peek ahead of Monday grand opening
Oklahomans face paying $1.37 billion for ONG February storm costs
Lawyers long critical of OSSAA planning to challenge lack of open-transfer change
Enid, area schools close, delay classes due to winter weather conditions
UPDATED: Oklahoma AG says 'zero complications' in nation's first 2022 execution of OSP inmate Grant
Stillwater woman killed in Sunday crash that blocked portion of I-35
As medical marijuana industry booms, regulators struggle to keep up
EPd arrest man on 2nd-degree rape complaint
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OSDH: Active COVID-19 cases in Garfield County rise to 1,386 as EPS cases go down
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Cohen Place leads north from Little Bourke Street in Chinatown, between Russell and Exhibition streets. It was probably named for either Cohen's Pawnbroker in Little Lonsdale Street, or the Cohen Brothers Upholsterers in Lonsdale Street. In 1895, the lane was known as Browns Place, and the entrance was flanked by a Chinese Mission Hall and the Minister Arms Hotel. This site has since become the Cohen Place Plaza, where a pair of marble lions sit before the replica of a Ming Dynasty archway donated by the People's Republic of China. Another pair of lions guard the Museum of Chinese Australian History, which resides further up the lane, acknowledging the contribution of the long time residents of Cohen Place and its surrounds.
In 1920, Cohen Place contained the Taxi Cab Company, the Star Cigar Company, and the workshops of Her Majesty's Theatre. In 1999, the Heritage Council and the museum embarked on an excavation of a site in Cohen Place, under what has since become the Chifley Hotel. The excavation unearthed thousands of historic artifacts and significant architectural remains pertaining to the nineteenth-century residents of Cohen Place, including children's toys such as jacks, marbles, china dolls and children's miniature tea sets. Other artifacts included quality china tableware in matching sets.


Eat Your Comics gives us their thoughts on Hooch from Talon Strikes Studios in this new article.
Whenever a new game comes into your path, you cannot help but feel nervous. Playing a new game is like making a new friend. Will I like this game? Will this game and I get along well? Will the game have a problem with my religious affiliations? Will the game be upset with me because I voted for Romney as a registered Democrat? Okay, the last was a little extreme, but a new game can either be fun or a waste of time. I'm happy to say that HOOCH the card game from Phoenix based designers Talon Strikes Studios was a game that got along with me from beginning to bittersweet end. This game is in publishing stages after a two year process of development, design, and play-testing. Their Kickstarter campaign is in full motion and will end on October 20th. Their campaign comes with a myriad of options to encourage a great level of support.


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Phellandrium dodonaei är en flockblommig växtart som beskrevs av Pietro Bubani. Phellandrium dodonaei ingår i släktet Phellandrium och familjen flockblommiga växter. Inga underarter finns listade i Catalogue of Life.

Källor

Flockblommiga växter
dodonaei


Conversion of National Historic Register BMA Tower into luxury condominiums; with GWH architects.
The rotunda is a dramatic pivot point for all ground floor common spaces and lobbies.
Gymnasium and athletics building; renovation of classroom and administration facilities; with GWH architects.
The Grande Salle connects the new athletic and fine arts wings to the original school buildings. A great room indeed.
Historic renovation of National Register property into corporate offices, restoration of the Walnut Street banking lobby, and computer server farm installation; with GWH architects.
Lightwell infill created a magnificent two-storey gathering space.
Surface parking addition, native stone retaining walls, bio-swales, and native plantings; with GWH architects.
Structured parking, streetscape, and 20,000 SF grade-level retail shell; with GWH architects. This charming fountain provides public water and respite within the Plaza bustle.


We are pleased to announce the 2014 TVC Recognition Award goes to Dale and Kathy Worthington.
Dale & Kathy started dancing in 1972. Dale was in the Army and they danced in numerous states as well as in Belgium & Germany.
In 1992 they became very involved with the Boy Scouts and held numerous positions as they moved around. They are still active with the area Cub Scout Day Camp Program and have been awarded the Silver Beaver. Dale still makes craft items for the Summer Camp.
That same year they took square dance lessons again to remove the rust. They then joined the Hayshakers in Astoria/Seaside. They have been Club President at least 6 years apiece along with many other offices. They served on the Sunset Area Council as Delegate and Secretary. They represented the Council as delegates to the State Federation.
Dale & Kathy have been Oregon Federation Delegates to the USDA for the past 6 years. They served on the boards for the 2005 and 2012 National Conventions.
They have been co-Chairs for the Seaside Sashay for 13 years. They have been very active in their club and Council. Kathy is currently the TVC State Delegate. For the last 7 years they have been Grange Officers to ensure that the Grange stays open and the club has a place to dance.
Dale has been State Federation Recording Secretary, 2nd Vice-President followed by 1st Vice-President and currently State Federation, President.
It's my pleasure to award this TVC Presidents Recognition Plaque to this deserving couple, Dale & Kathy Worthington.


Ladies and Germs... and all others dying for some football... Rejoice!!!
NFL fall camps open for all rookies and veterans by the end of this month, (July)!
Won't be long before the pigskin flies!
Welcome to the house of rock!
That will be nice. My Tigers are pretty much done in the AL central race so my summer sports viewing has really opened up.
"Find the best player on the field and outwork him"
Oh for the days of Al Kaline, Mickey Lolich, Denny McLain and John Hiller.
That was the time when baseball was worth watching. You knew the team and followed the players. Today, I just don't care.
The Big Red Machine. The Amazing Mets. The National pass time of yesteryear.
All-star break is over, downhill to football from here.
Yup. Time to start taking inventory of our Buckeyes in the NFL.


Due to problems encountered with Suddenlink Cable, Aggieland RV Park is no longer offering cable to RV'ers staying under 30 days in length.
*Rates subject to seasonal change. Home Game Weekend daily rates are $60/night Thursday/Friday and Saturday. With a two night minimum. Prices include two adults($4 per person per day for guests over 12) **RV's over 10 years old require prior approval by management ***SORRY, no utility trailers allowed in the park.


Dilution Solutions has named Lori Donnell as a technical sales representative. Donnell brings 20 years of experience working in industrial distribution. Ten of those years were focused on power transmission and fluid power. She has a bachelor's degree in mechanical engineering, is a certified fluid power specialist, and is NAHAD Level 3-certified in industrial and hydraulic hose.
As a technical sales representative, Donnell will focus on the Etatron line of electric pumps, industrial controls and metering devices, moving customers to the next level in production.
In her free time, Donnell enjoys running and has participated in several marathons.


- Archimedes; Ancient Greek Mathematician and Inventor; 287 BC - 212 BC.
The Greeks invented leverage more than 2,200 years ago. Sure, it might have started with "physical" leverage, but it didn't take long to apply the magic to money. "Give me enough bank debt and I shall move the world" -- and move it they have.


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Printed from https://ideas.repec.org/p/red/sed004/868.html
Enforcement and Firm Finance
Anne Villamil
Stefan Krasa
Tridib Sharma
The power to enforce rights and obligations in a society is essential. For simplicity, economists have focused on two extreme forms of enforcement: perfect ex-post enforcement of contracts by an exogenous un-modeled authority (a ``court'') or contracts that are ``self-enforcing.'' Models that assume perfect ex-post enforcement have focused on ability to pay -- a borrower fails to repay only when assets are below the promised amount. Otherwise, the borrower honors the promise. In contrast, when judicial enforcement is not possible the problem of willingness to pay arises. We consider the intermediate case where enforcement is possible, but not all assets can be seized. In this case the twin problems of ability and willingness to pay arise. We model enforcement as a technology with two key parameters. (i) The efficiency of enforcement is the cost paid to secure rights in court. This cost varies across countries due to different institutions (e.g., legal and accounting systems and corruption). (ii)Creditor protection is the percentage of total assets that a court can seize; debtor protection is the remainder. The amount of protection is determined by factors such as the level of exemptions permitted by the bankruptcy code, inflation, the length of bankruptcy proceedings, and the debtor's ability to ``hide'' assets. The paper provides a complete characterization of the effect of these enforcement parameters on the contract interest rate and the bankruptcy probability. The most striking result is that the enforcement parameters have a highly non-linear influence on firm finance. The theoretical characterization and quantitative analysis show that for some parameter values finance is not sensitive to the legal structure. For other values, after a critical threshold is reached, finance is severely compromised. The paper provides a (positive) theory with quantitative implications that can explain the observed relationship between legal systems and firm finance. We take the legal system as given and consider the opportunity to relieve firm distress by both liquidation and renegotiation. In the U.S. there are five types of bankruptcy. We focus on Chapter 7, often called liquidation. When bankruptcy occurs under Chapter~7, the debtor gives up all non-exempt property owned at the time the bankruptcy petition is filed. If the court grants a discharge, the debtor is not liable for any other pre-bankruptcy debts and no claims can be made against future earnings. Thus, Chapter 7 simultaneously liquidates all non-exempt assets for the benefit of creditors and protects the insolvent debtor. We model this protection via parameter eta and the cost of enforcement by c. Underlying the computable contract problem is a dynamic game with incomplete information and our stylized description of the enforcement technology. In the initial period the entrepreneur and lender share common beliefs about the possible returns from a risky investment project. The realization is the entrepreneur's private information unless costly bankruptcy occurs. We explicitly model agents' sequential decisions. First, agents write a contract. Next, the entrepreneur has the opportunity to default or to voluntarily make a contract payment. The lender then optimally chooses whether to request enforcement, given the information revealed by the entrepreneur's default decision. Finally, agents have rational expectations in the sense that all decisions are time consistent. Limited commitment is an essential feature of the model because the lender can revise the enforcement strategy after information is revealed by the entrepreneur's default decision. This leads to a sharp non-linearity in firm finance with respect to enforcement costs. The model also distinguishes between default and bankruptcy. Default means that the borrower (optimally) chooses not to make a payment. If default occurs, the lender then (optimally) chooses whether to invoke bankruptcy proceedings to liquidate the firm. We show how the legal code affects agents' incentives to default and pursue bankruptcy
Anne Villamil & Stefan Krasa & Tridib Sharma, 2004. "Enforcement and Firm Finance," 2004 Meeting Papers 868, Society for Economic Dynamics.
Handle: RePEc:red:sed004:868
File URL: http://www.econ.uiuc.edu/~skrasa/debt.pdf
File Function: main text
Kehoe, Patrick J. & Perri, Fabrizio, 2004. "Competitive equilibria with limited enforcement," Journal of Economic Theory, Elsevier, vol. 119(1), pages 184-206, November.
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Stephen D. Williamson, 1987. "Costly Monitoring, Loan Contracts, and Equilibrium Credit Rationing," The Quarterly Journal of Economics, Oxford University Press, vol. 102(1), pages 135-145.
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Mella-Barral, Pierre & Perraudin, William, 1997. "Strategic Debt Service," Journal of Finance, American Finance Association, vol. 52(2), pages 531-556, June.
Pierre Mella-Barral & William R M Perraudin, 1993. "Strategic Debt Service," CEPR Financial Markets Paper 0039, European Science Foundation Network in Financial Markets, c/o C.E.P.R, 33 Great Sutton Street, London EC1V 0DX..
Khalil, Fahad & Parigi, Bruno M, 1998. "Loan Size as a Commitment Device," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 39(1), pages 135-150, February.
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Khalil, F & Parigi, B-M, 1997. "The Loan Size as a Commitment Device," Discussion Papers in Economics at the University of Washington 97-08, Department of Economics at the University of Washington.
Anderson, Ronald W & Sundaresan, Suresh, 1996. "Design and Valuation of Debt Contracts," Review of Financial Studies, Society for Financial Studies, vol. 9(1), pages 37-68.
Calomiris, Charles W & Kahn, Charles M, 1991. "The Role of Demandable Debt in Structuring Optimal Banking Arrangements," American Economic Review, American Economic Association, vol. 81(3), pages 497-513, June.
Alston, Lee J, 1984. "Farm Foreclosure Moratorium Legislation: A Lesson from the Past," American Economic Review, American Economic Association, vol. 74(3), pages 445-457, June.
Stefan Krasa & Anne P. Villamil, 2000. "Optimal Contracts when Enforcement Is a Decision Variable," Econometrica, Econometric Society, vol. 68(1), pages 119-134, January.
Stefan Krasa & Anne P. Villamil, 2003. "Optimal Contracts when Enforcement is a Decision Variable: A Reply," Econometrica, Econometric Society, vol. 71(1), pages 391-393, January.
Tridib Sharma, 2003. "Optimal Contracts when Enforcement is a Decision Variable: A Comment," Econometrica, Econometric Society, vol. 71(1), pages 387-390, January.
Kydland, Finn E & Prescott, Edward C, 1977. "Rules Rather Than Discretion: The Inconsistency of Optimal Plans," Journal of Political Economy, University of Chicago Press, vol. 85(3), pages 473-491, June.
Hans K. Hvide & Todd Kaplan, 2003. "A Theory of Capital Structure with Strategic Defaults and Priority Violations," Microeconomics 0311001, University Library of Munich, Germany.
Hans K. Hvide & Tore Leite, 2003. "A Theory of Capital Structure with Strategic Defaults and Priority Violations," Finance 0311003, University Library of Munich, Germany.
Villamil, Anne P., 2003. "Introduction to capital accumulation and allocation in economic growth," The Quarterly Review of Economics and Finance, Elsevier, vol. 43(4), pages 583-591.
Krasa, Stefan & Sharma, Tridib & Villamil, Anne P., 2005. "Debt contracts and cooperative improvements," Journal of Mathematical Economics, Elsevier, vol. 41(7), pages 857-874, November.
Karel Janda, 2007. "Optimal Debt Contracts in Emerging Markets with Multiple Investors," Prague Economic Papers, Prague University of Economics and Business, vol. 2007(2), pages 115-129.
Attar, Andrea & Campioni, Eloisa, 2003. "Costly state verification and debt contracts: a critical resume," Research in Economics, Elsevier, vol. 57(4), pages 315-343, December.
ATTAR, Andrea & CAMPIONI, Eloisa, 2003. "Costly state verification and debt contracts: a critical resume," LIDAM Reprints CORE 1712, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
Hans Hvide & Tore Leite, 2010. "Optimal debt contracts under costly enforcement," Economic Theory, Springer;Society for the Advancement of Economic Theory (SAET), vol. 44(1), pages 149-165, July.
Hvide, Hans K & Leite, Tore, 2007. "Optimal Debt Contracts under Costly Enforcement," CEPR Discussion Papers 6040, C.E.P.R. Discussion Papers.
Correia, Ricardo & Población, Javier, 2015. "A structural model with Explicit Distress," Journal of Banking & Finance, Elsevier, vol. 58(C), pages 112-130.
Hvide, Hans K., 2005. "Optimal contracts under imperfect enforcement revisited," Discussion Papers 2005/4, Norwegian School of Economics, Department of Business and Management Science.
Dangl, Thomas & Zechner, Josef, 2016. "Debt maturity and the dynamics of leverage," CFS Working Paper Series 547, Center for Financial Studies (CFS).
Latchezar Popov, 2014. "Enforcement frictions and optimal lending contracts," Economic Theory, Springer;Society for the Advancement of Economic Theory (SAET), vol. 57(1), pages 195-222, September.
Michiel Bijlsma & Wim Suyker, 2008. "The credit crisis and the Dutch economy... in eight frequently asked questions," CPB Memorandum 210.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
Gertler, M.*Rose,Thomas A., 1991. "Finance, growth, and public policy," Policy Research Working Paper Series 814, The World Bank.
Michiel Bijlsma & Jeroen Klomp & Sijmen Duineveld, 2010. "Systemic risk in the financial sector; a review and synthesis," CPB Document 210.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
Stijn Claessens & M Ayhan Kose, 2018. "Frontiers of macrofinancial linkages," BIS Papers, Bank for International Settlements, number 95, April.
Koziol, Christian & Lawrenz, Jochen, 2012. "Contingent convertibles. Solving or seeding the next banking crisis?," Journal of Banking & Finance, Elsevier, vol. 36(1), pages 90-104.
Kox, Henk L.M. & Leeuwen, George van, 2012. "Dynamic market selection in EU business services," MPRA Paper 41016, University Library of Munich, Germany.
Henk Kox & George van Leeuwen, 2012. "Dynamic market selection in EU business services," CPB Discussion Paper 210.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
Li, Yuanyuan & Wigniolle, Bertrand, 2017. "Endogenous information revelation in a competitive credit market and credit crunch," Journal of Mathematical Economics, Elsevier, vol. 68(C), pages 127-141.
Yuanyuan Li & Bertrand Wigniolle, 2016. "Endogenous information revelation in a competitive credit market and credit crunch," Université Paris1 Panthéon-Sorbonne (Post-Print and Working Papers) halshs-01277539, HAL.
Yuanyuan Li & Bertrand Wigniolle, 2017. "Endogenous information revelation in a competitive credit market and credit crunch," PSE-Ecole d'économie de Paris (Postprint) halshs-01509773, HAL.
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Yuanyuan Li & Bertrand Wigniolle, 2016. "Endogenous information revelation in a competitive credit market and credit crunch," Documents de travail du Centre d'Economie de la Sorbonne 16001, Université Panthéon-Sorbonne (Paris 1), Centre d'Economie de la Sorbonne.
Acharya, Viral V. & Skeie, David, 2011. "A model of liquidity hoarding and term premia in inter-bank markets," Journal of Monetary Economics, Elsevier, vol. 58(5), pages 436-447.
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Acharya, Viral V & Skeie, David, 2011. "A Model of Liquidity Hoarding and Term Premia in Inter-Bank Markets," CEPR Discussion Papers 8705, C.E.P.R. Discussion Papers.
Suarez, Javier & Sánchez Serrano, Antonio, 2018. "Approaching non-performing loans from a macroprudential angle," Report of the Advisory Scientific Committee 7, European Systemic Risk Board.
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Dennis, Richard & Kirsanova, Tatiana, 2014. "Computing Markov-Perfect Optimal Policies in Business-Cycle Models," SIRE Discussion Papers 2015-64, Scottish Institute for Research in Economics (SIRE).
Gabriel Madeira, 2014. "Legal enforcement, default and heterogeneity of project-financing contracts," Annals of Finance, Springer, vol. 10(4), pages 569-602, November.
Gabriel de Abreu Madeira, 2012. "Legal Enforcement, Default and Heterogeneity of Project Financing Contracts," Working Papers, Department of Economics 2012_31, University of São Paulo (FEA-USP).
Agliardi, Elettra & Andergassen, Rainer, 2009. "Last resort gambles, risky debt and liquidation policy," Review of Financial Economics, Elsevier, vol. 18(3), pages 142-155, August.
Elettra Agliardi & Rainer Andergassen, 2009. "Last resort gambles, risky debt and liquidation policy," Review of Financial Economics, John Wiley & Sons, vol. 18(3), pages 142-155, August.
E. Agliardi & R. Andergassen, 2006. "Last Resort Gambles, Risky Debt and Liquidation Policy," Working Papers 577, Dipartimento Scienze Economiche, Universita' di Bologna.
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enforcement;
G31 - Financial Economics - - Corporate Finance and Governance - - - Capital Budgeting; Fixed Investment and Inventory Studies
NEP-CFN-2004-08-02 (Corporate Finance)
NEP-REG-2004-08-02 (Regulation)
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Q: Additivity of Lebesgue integral Let $P$ and $C$ measurable sets such that  $D = P \cup C$ for some set $D$, suppose $m (P \cap C)= 0$, show the Lebesgue integral over $D$ is equal to the sum of the integrals over $P$ and $C$.
When $P \cap C$ is empty, the result is easy defining proper characteristic functions, the problem is when I suppose it is not and my plan is to define a set $A$ of the elements of the intersection so $A$ has measure zero from there I have not found the form to develop the problem.

A: Let $E=P \cap C$. It follows that $P-E$ and $C-E$ are disjoint.
Then, by the result you have proven about the additivity of the integral when the intersection is empty it follows that $\int_{D-E} f   d\mu =\int_{P-E} f d\mu +\int_{C-E} f d\mu$.
Now introduce $1_A$, which satisfies $1_A(x)=1$ iff $x \in A$.
Therefore, we have $\int_{X} f1_{D-E}   d\mu =\int_{X} f1_{P-E} d\mu +\int_{X} f1_{C-E} d\mu$.
You may now use the Theorem that changing the values of a function on a negligible set does not affect the measurability of a function nor the value of the integral (This might be worth proving) to deduce that: $\int_{X} f1_{D}   d\mu =\int_{X} f1_{P} d\mu +\int_{X} f1_{C} d\mu$, which gives $\int_{D} f   d\mu =\int_{P} f d\mu +\int_{C} f d\mu$

redpajama_set_name: RedPajamaStackExchange


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The Effect of High-, Moderate-, and Low-Fat Diets on Weight Loss and Cardiovascular Disease Risk Factors
Preventive Cardiology 5(2002):110.
by Richard M. Fleming, MD
Richard M. Fleming, MD, FICA, FACA, FASNC is the Director of Cardiovascular and Breast Cancer research at the Not For Profit Camelot Foundation and the Fleming Heart & Health Institute located in Omaha, Nebraska, USA. Dr. Fleming is an internist and nuclear cardiologist. He is a member of the National Credentials Committee for the American Society of Nuclear Cardiology.
Dr. Fleming has authored three books, written six chapters for medical textbooks, chaired and co-chaired at numerous meetings, presented more than 30 papers at American, European and Asian meetings and has published more than 25 papers on Nuclear Cardiology, Stenosis Flow Reserve, the Reversal of Heart Disease, Congestive Heart Failure, comparisons of Echocardio-graphic and Nuclear Imaging, and Breast Cancer.
Over 60% of Americans are overweight and a number of popular diets have been advocated, often without evidence, to alleviate this public health hazard. This study was designed to investigate the effects of several diets on weight loss, serum lipids, and other cardiovascular disease risk factors. One hundred men and women followed one of four dietary programs for 1 year: a moderate-fat (MF) program without calorie restriction (28 patients); a low-fat (LF) diet (phase I) (16 patients); a MF, calorie-controlled (phase II) diet (38 patients); and a high-fat (HF) diet (38 subjects). Weight, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), homocysteine (Ho), and lipoprotein(a) [Lp(a)], were measured every 4th month. The TC/HDL-C ratio was calculated and fibrinogen levels were measured at baseline and after one year. The MF diet resulted in a 2.6% (NS) decrease in weight compared with 18.4% (p=0.045) decrease in patients on phase I, 12.6% (p=0.0085) decrease in patients on phase II, and 13.7% (p=0.025) decrease in those on the HF diet. TC was reduced by 5% (NS) in the MF group, 39.1% (p=0.0005) in the phase I group, and 30.4% (p=0.0001) in the phase II group. HF group had a 4.3% (NS) increase in TC. LDL-C was reduced by 6.1% (NS) on MF, 52.0% (p=0.0001) on phase I , and 38.8% (p=0.0001) on phase II. Patients on HF had a 6.0% (NS) increase in LDL-C. There were nonsignificant reductions in HDL-C in those on MF (-1.5%) and HF (-5.8%). Patients on phase I showed an increase in HDL-C of 9.0% (NS), while those on phase II diet had a 3.6% increase (NS) in HDL-C. TC/HDL-C increased (9.8%) only in patients following the high-fat diets (NS). Patients on MF had a 5.3% (NS) reduction in TC/HDL-C, while those on LF had significant reductions on the phase I (-45.8%; p=0.0001) diet and phase II diet (-34.7%; p=0.0001). TG levels increased on both the MF (1.0%) and HF (5.5%) diets, although neither was statistically significant. People following the phase I and II diets showed reductions of 37.3% and 36.9%, respectively. Ho levels increased by 9.7% when people followed the MF diet and by 12.4% when they followed the HF diet. Patients following the phase I and phase II diets showed reductions of 13.6% and 14.6%, respectively. Only those following phase II diets showed a tendency toward significant improvement (p=0.061). Lp(a) levels increased by 4.7% following the MF (NS) diet and by 31.0% (NS) on the HF diet. Patients following phase I showed a 7.4% (NS) reduction and a 10.8% reduction (NS) following phase II. Fibrinogen levels increased only in individuals following HF diets (11.9%), while patients following MF (-0.6%), phase I (-11.0%), and phase II (-6.3%) diets showed nonsignificant reductions in fibrinogen. Patients on MF demonstrated nonsignificant reductions in weight, LDL-C, TC, HDL-C, TC/HDL-C ratios, and fibrinogen and nonsignificant increases in TGs, Lp(a), and homocysteine. There was significant weight loss in patients on phase I and II and HF diets after 1 year. Reductions in TC, LDL-C, TGs, and TC/HDL ratios were significant only in patients either following a LF diet or a MF, calorically reduced diet. Only patients following HF diets showed a worsening of each cardiovascular disease risk factor (LDL-C, TG, TC, HDL-C, TC/HDL ratio, Ho, Lp(a), and fibrinogen), despite achieving statistically significant weight loss.
The subject of obesity and related health problems[1-3] has become more of an issue in the United States during the last several decades. The problem has increased sufficiently during the last 10 years,[4,5] to result in 61% of Americans being classified as overweight. This is not just an American epidemic, but a worldwide problem as the American diet and lifestyle are exported throughout the world, with 54% of Russian citizens, 51% of UK residents, 50% of Germans, 36% of Brazilians, and even 15% of the Chinese population[6] being affected.
With so many people being overweight, almost three quarters of Americans surveyed have admitted to trying to lose weight through dietary means and/or increased exercise; however, patient expectations of weight loss[7] are not consistent with outcomes. Perhaps more important is the issue that the majority of Americans are not trying to lose weight for health reasons, but rather to improve their physical appearance and/or comfort. As a result, several popular weight loss programs have appeared that promise weight loss but do not address potential health concerns associated with these dietary programs.
Any dietary program that reduces the number of calories a person eats to fewer than what he or she needs will result in weight loss. A dietary program may be viewed as helpful as long as it results in weight loss without significant adverse side effects. Some research has looked at the effect of dietary and lifestyle changes on serum cholesterol levels[8-12] both with and without the additional use of cholesterol-lowering medications. Other research has also been published regarding the effect of increased dietary fat consumption on forearm blood flow,[13] coronary blood flow,[14,15] blood pressure,[16] plasma lipids,[17] and other concerns.[18] Still other research has demonstrated that low-fat diets can reverse coronary artery disease,[19,20] as long as caloric consumption is controlled.
While there are many ways to characterize the different dietary programs available, most can be classified into one of three groups: 1) high-fat, low-carbohydrate, high-protein; 2) moderate-fat, high-carbohydrate, moderate-protein; and 3) low-fat, high-carbohydrate, moderate-protein diets. Despite decades of discussion of these various dietary approaches, little if any comparative information exists about the long-term effects of these diets, the duration of time necessary for individuals to lose weight on these diets, and their subsequent effects on risk factors associated with heart disease and other health problems. In an effort to study the effect of these diets, we followed 100 people who remained on one of four dietary programs for a minimum of 1 year. Throughout this time, we measured weight loss as well as changes in lipids, homocysteine, lipoprotein(a) [Lp(a)], and fibrinogen levels.
Patients were selected for this study following their presentation to the institute for weight loss concerns. Patients had to be following no specific dietary program for the 6 months prior to enrolling in this study and could not be taking any dietary supplements for weight loss. They were allowed to participate only if they had no other active medical problems, including documented coronary artery disease, juvenile-onset diabetes mellitus, hypertension, cancer, or were pregnant. Patients had to commit to staying on the dietary regimen for a minimum of 1 year and were randomly assigned to one of the four dietary regimens based upon dietary preferences.
Dietary Regimens
High-Fat (HF) Diet. This diet is defined as one in which patients consume 55%-65% of their daily caloric intake in the form of fat calories. Less than 100 g of carbohydrates (RCHO) were consumed daily and protein intake constituted 25%-30% of the total caloric intake. Patients ate until satiated.
Moderate-Fat (MF) Diet. Patients following this dietary program consumed 20%-30% of their calories in the form of fat. Approximately 60% of their calories were from carbohydrate sources and the remaining calories were derived from protein. Patients consumed 10-12 calories per pound per day on this diet.
MF, Calorie-Controlled (Phase II) Diet. Patients following this program were asked to consume 350-500 fewer kilocalories per day than required[15,20] to maintain body weight. This was determined by multiplying their current weight in pounds by 10 kcal/lb to determine the required kcal intake per day; 350-500 was subtracted from this figure to determine the desired daily intake of calories. Of these calories, 15% were protein and 70% were carbohydrate, with an emphasis on complex carbohydrates vs. simple sugars. The remaining 15% of the calories could be consumed as fat in a 2:1 ratio of nonsaturated (polyunsaturated and monosaturated) to saturated fat, with no more than 5 g of saturated fat intake per day.
Low-Fat (LF) (Phase I) Diet. The LF diet consisted of fruits, vegetables, a limited amount of grain/ cereals for breakfast and a multiple vitamin that included 100% of the US Department of Agriculture recommended daily intake of vitamins and minerals. Patients ate until satiated. Of the caloric intake, 10% was fat, 15% was protein, and 75% was carbohydrate, with an emphasis on complex vs. simple carbohydrates as shown in Table I.
Exercise Regimen
Each individual was instructed to exercise an average of 3-5 times per week, beginning with stretching for 15 minutes, followed by walking for 30 minutes, and then relaxing and stretching for an additional 15 minutes.
Patients returned on a monthly basis to review their progress, answer any questions regarding dietary habits, and determine if they were having any medical problems, which would require removal from the study. Weights were recorded at the beginning of the study and at the end of months 4, 8, and 12. Fasting venous blood was drawn at the beginning of the study and at the end of months 4, 8, and 12. The tests included total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), homocysteine, and Lp(a). The TC/HDL-C ratio was calculated for each of these intervals. Fibrinogen levels were measured at the beginning and end of the year.
The results for each of the independent variables (weight, TC, LDL-C, HDL-C, TG, homocysteine, Lp[a], TC/HDL, and fibrinogen) were determined at baseline and at 4, 8, and 12 months for each dietary group. The final independent variable, fibrinogen, was measured at baseline and 12 months for each dietary group. Analysis of differences between groups was determined by two-tailed nonmatched t tests. Graphic representation of percent change from baseline was displayed as bar graphs.
The study population consisted of 53 women and 47 men between the ages of 23 and 67 (43±8) years. No statistical differences existed between groups for either age or sex. Patients reported that they exercised for at least three sessions per week for an average of 30 minutes each, although the level of intensity varied from person to person. Patients following the phase I and II programs tended to exercise more frequently; however, the duration of time was not significantly different from that in the other groups. The average weight for patients entering the study was 283±74 pounds in the phase I (LF) group, 243±56 pounds for those beginning the MF diet, 232±43 pounds for those beginning the HF diet, and 226±54 pounds for those beginning the phase II (MF, calorie-controlled) diet. Those entering the phase I group were statistically (p=0.010) heavier than those beginning the phase II dietary program. There were no other significant differences between groups and their initial weights.
Subjects following the MF diet showed a 2.6% reduction in weight from the beginning to the end of the study. This was not statistically significant and represented a change from 243±56 to 237±47 pounds – an average weight loss of 1.9 ounces per week. Those people following the phase I (LF) diet showed the greatest weight loss, reducing from 283±74 to 231±66 pounds at the end of 1 year. This represented a loss of 1 pound per week. The reduction of 18.4%, as shown in the Figure, was statistically significant (p=0.045), but only at the end of the year. At 8 months, the difference between baseline and the end of the 8th month had not yet reached statistical significance (p=0.12).
Figure. Bar graphs of percent change of different independent variables over time. Each bar graph depicts the percent change from baseline for each independent variable for patients following 1) the moderate-fat diet (solid black bars); 2) the low-fat (Fleming phase I) diet (black with white strips); 3) the moderate-fat, calorie-controlled (Fleming phase II) diet (gray bars); and 4) the high-fat, low-carbohydrate (HF) diet (white bars with black strips). *Statistically significant changes compared with baseline values. LDL-C/HDL-C=low-density/high-density lipoprotein cholesterol; Lp(a)=lipoprotein(a); TC=total cholesterol
Patients following the phase II diet showed a statistically significant (p=0.0085) weight loss at the end of 1 year of dieting, beginning at 226±54 pounds and ending at a weight of 197±36 pounds, which, as shown in the Figure and Table II, represented a 12.6% reduction in weight, at the rate of 0.55 pounds per week. Those individuals following the HF diet showed a statistically significant (p=0.025) weight loss of 13.7% (Figure), beginning at 232±43 pounds and ending at 200±38 pounds. This represented a weight loss of 0.6 pounds per week. Like those following the phase I diet, reductions in weight for people following phase II and the HF diets were statistically significant only at the end of 1 year of dieting, as shown in the Figure. In each case, the total daily caloric intake for people following the phase I and II diets and the HF diet was 1600 or fewer calories per day.
Individuals following the MF diet showed increases in TC during the first 8 months of the study (p=NS), which peaked at 4 months with a 3% increase. By the end of the study, people following the MF diet showed a 5% reduction in TC, which was not significant. Patients following the MF, calorie-controlled diet (phase II) showed statistically significant (p=0.0009) reductions in TC during the first 4 months, with a 14.0% reduction in TC, which continued to drop throughout the study to a 24.7% reduction at 8 months (p=0.0001) and a 30.4% (p=0.0001) reduction at 12 months. Despite the continued drop in TC from baseline, there was no significant difference (p=0.18) between the 8- and 12-month results.
Patients following the LF (phase I) diet showed the greatest reductions in TC, beginning with a 24.5% reduction (p=0.0073) at 4 months, a 37.9% reduction (p=0.0001) at 8 months, and a 39.1% reduction (p=0.0001) at 12 months. The reduction was statistically significant for each 4-month period, except for the 4 months between the months 8 and 12, when the decrease in TC persisted but was statistically insignificant (p=0.80). Those patients following the HF diet demonstrated increased TC levels from the beginning to the end of the study, with a 0.7% increase at 4 months, a 1.5% increase at 8 months, and a 4.3% increase at 12 months. This increase in TC was not statistically significant.
Further differentiation of lipid components included evaluation of changes in "bad" (LDL-C) cholesterol. Individuals following the MF diet showed a nonsignificant increase (+2.6%) in LDL-C during the first 8 months of their dietary regimen, with a subsequent reduction (p=0.38) in LDL-C by the end of the 12th month of dieting, which was 6.1% below baseline levels. Patients following the phase II diet (MF, calorie-controlled) showed an initial reduction of 17.7% (p=0.0014) during the first 4 months, which continued to improve during the next 4 months, with a 31.1% (p=0.0001) reduction at 8 months, compared with baseline values. Further improvement was noted during the last 4 months, with a 38.8% reduction compared with baseline (p=0.0001) values; however, these values were not statistically different (p=0.16) from those seen at the end of the 8th month of dieting.
Patients following the LF (phase I) diet showed the greatest reduction in LDL-C, with a 35.2% drop (p=0.0018) during the first 4 months. At the end of the 8th month of dieting, patients following phase I showed a 51.2% reduction (p=0.0001) in LDL-C, compared with baseline values. By the end of the 12th month of dieting, phase I patients had a 52.0% reduction (p=0.0001) from baseline values, which was essentially unchanged from the end of the 8th month of dieting (p=0.92).
Finally, patients following the HF diet showed a progressive increase in LDL-C throughout the 12 months of dieting, which was 6.0% higher than baseline values (p=NS).
Assessment of "good" (HDL-C) cholesterol showed an initial increase of 3.4% during the first 4 months on the HF diet. This increase was not statistically significant (p=0.72). During the remaining 8 months of the HF diet, the HDL-C levels decreased by 1.9% at the end of the 8th month, and by 5.8% by the end of the study, compared with baseline values. Neither decrease was statistically significant. Patients following the MF diet showed a steady and persistent decrease in HDL-C, with reductions of 0.8% at the end of the 4th month, 3.4% at the end of the 8th month, and 1.5% at the end of the 12th month, relative to baseline values. This decrease in HDL-C was not statistically significant (p=0.81). Increased HDL-C levels were seen in patients on both the phase I and phase II diets, as shown in Table II. These increases were not statistically significant for either group, although the greatest increase (+9.0%) in HDL-C was seen in those following the phase I diet.
Based upon the TC and HDL-C values measured for each individual, the TC/HDL-C ratios were calculated. The initial (baseline) and final (month 12) ratios for each group are shown in Table III. Patients following the HF diet initially demonstrated a 1.4% decrease, going from a ratio of 6.13 to a ratio of 6.04. This was not statistically significant, and the ratio increased to 6.24 at the end of the 8th month, representing a 1.8% increase above baseline values. By the end of the 12th month of dieting, those following the HF diet showed a 9.8% increase in TC/HDL ratios from baseline values. The ratio at the end of the 12th month was 6.73, which was not statistically significant (p=0.44).
Patients following the MF diet showed an initial increase at the end of both the 4th and 8th month of their dieting. The baseline ratio of 7.16 increased by 2.1%, to 7.31 by the end of the 4th month, followed by a 3.8% reduction from baseline, to 7.43 at the end of the 8th month. However, by the end of month 12, patients following the MF diet showed a 5.3% decrease compared with baseline values. This ratio of 6.78 was not significantly different from the baseline value.
Reductions in TC/HDL-C ratios were seen in patients following both the LF (phase I) and MF, calorie-controlled (phase II) diets. Those following the LF diet had an initial ratio of 7.23, which was significantly lower (p=0.0076) at the end of the 4th month. This was a 29.2% reduction, as shown in Table II. This decrease continued and was 4.02 at the end of the 8th month, representing a 44.3% reduction, which was significant (p=0.0001). A slight improvement was seen during the remaining 4 months on the LF diet, with a final ratio of 3.92, which was not significantly different (p=0.78) from the ratio seen at the end of the 8th month on the LF diet. Patients on the phase II diet showed a 13.8% reduction at the end of the 4th month of dieting, beginning with a ratio of 5.87. By the end of their 4th month, the ratio was 5.04 (p=0.034). By the end of the 8th month, the ratio had dropped by 27.4% from baseline values, to a ratio of 4.25. This change was statistically significant (p=0.0001). At the end of the 12th month, the ratio had decreased further to 3.82, representing a 34.7% drop from baseline (p=0.0001). This value was not significantly different (p=0.78) from the value seen after 8 months of phase II dieting.
The final component of lipid assessment consisted of TG measurements. Those individuals who followed HF diets showed an initial improvement during the first 4 months, dropping their TG levels by 3.5%; however, their TG levels increased above baseline values, by 3.3% and 5.5%, by the end of the 8th and 12th months, respectively. These increases were not statistically significant. Patients following the MF diet without calorie control showed initial increases in TGs of 6.5% after 4 months of dieting, 6.0% after 8 months of dieting, and 1.0% above baseline values following 12 months on the MF diet. These changes were not statistically significant.
Significant reductions in TG levels were seen in people following both phase I and phase II diets. Those following LF diets (phase I) showed a 37.3% reduction by the 12th month of dieting, which approached significance (p=0.051). People following phase II diets demonstrated a 36.9% reduction by the end of the 12th month of dieting which was statistically significant (p=0.0095).
The remaining three independent variables represented markers of inflammatory and clotting changes associated with coronary artery disease.[21] The first of these was homocysteine, which increased in individuals following both the MF and HF diets. While neither increase was statistically significant, those following the MF diet showed a 9.7% increase after 12 months of dieting, while those following a HF diet had a 12.4% increase. People following phase I and II diets showed 13.6% and 14.6% reductions from baseline values, respectively. Those on the phase II diet approached significantly (p=0.061) reduced levels.
Lp(a) levels increased only in individuals following a MF or HF diet, with the MF group showing a 4.7% increase at the end of the 12th month of dieting. The increase was greater (+31.0%) for those consuming the HF diet, but these increases were not statistically significant. A reduction in Lp(a) was seen in patients following either the phase I or II diet. These decreases, of 7.4% and 10.8%, respectively, were not statistically significant.
Finally, changes in fibrinogen levels were documented, with reductions in fibrinogen seen for all diets except the HF diet, which showed an 11.9% increase by the end of 12th month of dieting. Neither this increase, nor the decreases seen in people following the MF (-0.6%), phase I (-11.0%), or phase II (-6.3%) diets were statistically significant. Changes were not due to supplemental estrogen intake and could not be accounted for on the basis of gender.
Patients who enrolled in this study included a relatively even number of men and women who, for the most part, would be considered to be middle-aged or slightly younger. The average weight entering the study was 241 pounds. Only those following the LF diet (phase I) were significantly heavier than the other groups; however, there were no differences in cardiovascular disease risk factor levels.
Despite the beliefs, practices, and desires of many people who want to lose weight suddenly, this research clearly shows that long-term weight loss requires a time commitment. For a variety of reasons, including water loss, weight loss can and does occur in the first few weeks to months; however, sustained and significant reduction in weight requires a persistent change in dietary and lifestyle habits. These reductions in weight were "statistically significant" only at the end of the year. The MF diet without caloric reduction, which is typical of or slightly better than the current American diet, did not result in weight loss, but did show worsening of some of the cardiovascular disease risk factors in as little as 1 year.
While patients following the MF diet demonstrated initial increases in TC, there was a 5% decrease by the end of the study, which was not significant. Similarly, people following HF diets showed initial increases in TC, which persisted. These increases amounted to a 4.3% increase in TC by the end of the study. Patients following both the MF, calorie-controlled diet (phase II) and the LF (phase I) diet showed significant reductions in their TC levels, which were most pronounced by the end of the 8th month of dieting. Further improvement was noted throughout the study, but was less pronounced during the last 4 months of the diets, suggesting that most of the TC reduction occurs during the first 8 months of dietary change.
Like TC, changes in LDL-C were initially worse during the first 8 months on a MF diet without calorie control; however, by the end of the 12th month, there was a nonsignificant improvement in relation to baseline values. This is in contrast to people following HF diets, where LDL-C continued to increase throughout the dieting period, with an overall 6.0 percent increase, which was not statistically significant. Those individuals who followed the MF, calorie-controlled (phase II) diet showed improvement throughout the 12 months of dieting, and like those following the LF (phase I) diet, showed most of the lipid improvement during the first 8 months of dieting, with little (but some) additional benefit occurring during the last 4 months.
Changes in HDL-C were not significantly different for any of the groups in this study despite dietary changes and recommended exercise regimens. The greatest amount of weight loss and the greatest increase in HDL-C was seen in those following the LF (phase I diet). It is possible that further increases in exercise recommendations could further augment HDL-C changes.
People who followed the phase I (LF) diet had the greatest initial TC/HDL-C ratio of 7.23. They were also the most overweight and potentially the least active. As a group, they demonstrated not only the greatest weight loss, but the greatest decrease in TC and LDL-C and the greatest increase in HDL-C, and thus the greatest decrease in the TC/HDL-C ratio. While they started with the greatest ratio (greatest risk), they ended up with the next-to-lowest ratio of 3.92. Only those following the phase II diet had a lower ratio (3.82) at the end of the 12th month of dieting. Only those individuals following the HF diet ended up with a TC/HDL-C ratio greater than what they started with, as shown in Table III.
Significant reductions in TG levels were seen only in individuals who were on calorie-controlled diets. There was no association between weight loss and actual reductions in lipid levels, including TC, LDL-C, HDL, TC/HDL ratios, and TGs. Homocysteine levels increased in individuals following HF and MF diets, which might have been due to the increased protein load on these diets, a deficiency in folate or vitamins B6 or B12, or all of the above. Those individuals on phase I and II diets, with lower protein intake, demonstrated actual reductions in homocysteine levels. In the phase I group, part of this could have been due to folic acid or vitamin B6 and B12 supplementation; however, the phase II group, which had the greatest reduction in homocysteine, did not have vitamin or mineral supplementation, although their protein intake was less than that seen on either the MF, HF, or typical American diet.
Individuals consuming an HF or MF diet without caloric reduction showed increases in their Lp(a) levels, which were not statistically significant. Improvements/reductions in Lp(a) were seen in individuals following phase I and II diets. Of the four diets, only the HF diets resulted in an increase in fibrinogen levels.
Efforts to lose weight have become a national concern, with more than 60% of all Americans being classified as overweight. These concerns are translated into major health problems not only for us but also for our children, as more and more of our children and teenagers are diagnosed with weight problems.[1-6] A search of the literature now reveals more than 1200 books dealing with the issue of weight loss, with almost 90% of them published during the last 5 years. Most experts would agree that caloric restriction would result in weight loss.
Recent work that we and others have published[13,14,19-21] address not only certain causes of heart disease but also the risk[15] associated with certain popular dieting methods. Still other work[8-10] has described the effects of medical and dietary changes on lipids. This is the first longitudinal study using dietary changes without medications to determine the effect of dieting on weight loss as well as assessment of risk factors known to be associated with heart disease, strokes, and peripheral vascular disease.
Each of the diets employed in this study, including MF, HF, LF (phase I), and MF, calorie-controlled (phase II) diets resulted in some degree of weight loss, although the weight loss on the MF diet was negligible. The greatest weight loss was seen in individuals following the phase I diet (1.0 lb/wk), whose caloric intake was 1300-1400 calories per day, as shown in Table I. The group that lost the second greatest amount of weight (0.6 lb/wk) were those following the HF (ketogenic) diet, with caloric intake of 1400-1500 calories per day. The group with the third greatest weight loss (0.55 lb/wk) were individuals following the phase II diet, whose caloric intakes ranged from 1500-1600 calories per day. The group with the least amount of weight loss (1.9 oz/wk) was the group following the MF diet without caloric control, who consumed an average of 2000-2200 calories per day. Regardless of the dietary program used, the key is the same; one must reduce caloric intake to lose weight. The second law of thermodynamics still applies!
However, weight loss is not the only issue that concerns us. Clearly, everyone knows someone who has been overweight and lived into his 90s without a heart attack or stroke, and everyone knows someone who was the picture of health (lean, strong, athletic) and died in his 30s while jogging, walking, or participating in some other healthful activity. Therefore, the issue of weight and weight loss alone cannot be the only factor considered as dietary programs are applied for weight loss, as we have already seen.[13-15,19-21]
In this study, significant weight loss occurred in three of the four groups. Each group kept their caloric intake to 1600 calories per day or less. As a group, the results of weight loss were significant only at the end of the year. Hence, weight loss, like weight gain, is not a sudden process but a long-term, sustained reduction in calories that takes time. Significant reductions in TC, LDL-C, and TGs were seen only in those individuals following phase I (LF) and phase II (MF, calorie-controlled) diets. The majority of the effect was seen by the end of the 8th month on the diets. Improvement seen after that was still present, but lessened. Despite continued weight loss, there was not an associated decrease in lipids. Similarly, improvements in HDL-C were seen only in people following phase I or II diets. However, these changes were minimal, suggesting little, if any, dietary effect. The greatest improvement was seen in individuals who were more active and lost the most weight.
Phase I and II individuals also demonstrated an expected improvement in TC/HDL ratios, since they had the greatest reductions in TC and improvements in HDL-C. These changes subsequently changed their risk ratios, as shown in Table III. Perhaps most interesting were the increased levels of homocysteine, Lp(a), and fibrinogen seen in patients following HF diets. These factors appeared to be more dietary and less related to vitamin and mineral supplementation, as suggested by comparing the results in patients following the phase II diet and those following the HF diet, none of whom took additional supplements, as did those following the phase I diet.
In the end, people following an MF diet without caloric restrictions neither gained nor lost weight. They also appeared to have little appreciable change in their risk factors for heart disease, although the cumulative effect of each of these risk factors would confer an increased risk of heart disease, later if not sooner. People following either LF or MF, calorie-controlled diets not only showed weight loss but experienced reductions in all of the risk factors for heart disease, strokes, and peripheral vascular disease. Those following HF diets may have lost weight, but at the price of increased cardiovascular risk factors, including increased LDL-C, increased TGs, increased TC, decreased HDL-C, increased TC/HDL ratios, and increased homocysteine, Lp(a), and fibrinogen levels. These increased risk factors not only increase the risk of heart disease, but also the risk of strokes, peripheral vascular disease, and blood clots.
Allison DB, Fontaine KR, Manson JE, et al. Annual deaths attributable to obesity in the United States. JAMA. 1999;282:1530-1538.
Must A, Spadano J, Coakley EH, et al. The disease burden associated with overweight and obesity. JAMA. 1999;282:1523-1529.
National Institutes of Health, National Heart, Lung, and Blood Institute. Obesity education initiative. Clinical Guidelines on the Identification, Evaluation and Treatment of Overweight and Obesity in Adults. Bethesda, MD: National Institutes of Health. Obesity Res. 1998;6:S2.
Flegal KM, Carroll MD, Kuczmarski RJ, et al. Overweight and obesity in the United States: prevalence and trends, 1960-1994. Int J Obes. 1998;22:39-47.
Mokdad AH, Serdula MK, Dietz WH, et al. The spread of the obesity epidemic in the United States, 1991-1998. JAMA. 1999;282:1519-1522.
Fleming RM. Obesity and related health problems are the result of too many calories and too much saturated fat regardless of the misconceptions promoted by many popular weight loss diets. USDA Research program on health and nutrition effects of popular weight-loss diets. Washington, DC: US Government Printing Office; 2001.
Foster GD, Wadden TA, Vogt RA, et al. What is reasonable weight loss? Patients' expectations and evaluations of obesity treatment outcomes. J Consul Clin Psychol. 1997;65:79-85.
Hunninghake DB, Stein EA, Dujovne CA, et al. The efficacy of intensive dietary therapy alone or combined with lovastatin in outpatients with hypercholesterolemia. N Engl J Med. 1992;328:1213-1219.
Fleming RM, Ketchum K, Fleming DM, et al. Treating hyperlipidemia in the elderly. Angiology. 1995;46:1075-1083.
Fleming RM, Ketchum K, Fleming DM, et al. Assessing the independent effect of dietary counseling and hypolipidemic medications on serum lipids. Angiology. 1996;47:831-840.
Bernard RJ. Pritikin approach to cardiac rehabilitation. In: Goodgold, J, ed. Rehabilitation Medicine. St. Louis, MO: CV Mosby Co.; 1988.
Barnard RJ. Effects of life-style modification on serum lipids. Arch Intern Med. 1991;151:1389-1394.
Vogel RA, Corretti MC, Plotnick GD. Effect of a single high-fat meal on endothelial function in healthy subjects. Am J Cardiol. 1997;79:350-354.
Fleming RM. The natural progression of atherosclerosis in an untreated patient with hyperlipidemia: assessment via cardiac PET. Int J Angiol. 2000;9:70-73.
Fleming RM. The effect of high protein diets on coronary blood flow. Angiology. 2000;51:817-826.
Puska P, Iacono JM, Nissinen A, et al. Controlled, randomised trial of the effect of dietary fat on blood pressure. Lancet. 1983;1:1-5.
LaRosa JC, Gordon A, Muesing R, et al. Effects of high-protein, low-carbohydrate dieting on plasma lipoproteins and body weight. J Am Diet Assoc. 1980;77:264-270.
Council on Foods and Nutrition. A critique of low-carbohydrate ketogenic weight reduction regimens. A review of Dr. Atkins' diet revolution. JAMA. 1973;224:1415-1419.
Ornish D, Brown SE, Scherwitz, et al. Can lifestyle changes reverse coronary artery heart disease? Lancet. 1990;336:129-133.
Fleming RM, Boyd L, Forster M. Reversing heart disease in the new millennium-the Fleming unified theory. Angiology. 2000;51:617-629.
Fleming RM. The Pathogenesis of Vascular Disease. In: Chang JC, ed. The Textbook of Angiology. New York, NY: Springer-Verlag; 1999:787-798.