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Participants completed original and adapted forms of validated assessments (see Supplemental document)

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After 16 weeks of intervention, the COM group exhibited significantly greater reductions in body weight, BMI, and waist-to-hip ratio (WHR) compared to the MET group (all P 2.5 times the upper limit of normal, estimated glomerular filtration rate [eGFR] 0.05) (Table 4)

Since the 1960s, the dollar cost per unit of energy in food has decreased dramatically for processed foods (Drewnowski, 2003), resulting in a 20% increase in the per capita availability of sugar and fat since 1977 (Drewnowski, 2003)