|
|
Hepatic
injury in 12 patients taking the herbal weight loss supplement Chaso
or Onshido.
The Chinese herbal dietary supplements Chaso and Onshido are marketed
for weight loss in Japan. However, the safety of these weight loss aids
is unknown. This study was designed to describe patients who developed
liver injury while taking Chaso or Onshido.
The study found 12 patients who developed acute liver injury
characterized by a marked increase in serum liver chemistry values after
ingesting these products. Two patients developed hepatic failure: one
patient required liver transplantation, and the other patient died. N-nitroso-fenfluramine,
a variant of the appetite-depressant drug fenfluramine, was present in
these products.
Conclusions from the study: The use of the weight loss aids Chaso and
Onshido may be associated with acute liver injury.
Source: Adachi, et al, Ann Intern Med, 2003 Sep 16;139(6):488-92.
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When snacks attack your daily intake
You grab a cinnamon roll for the morning commute, chips from a vending
machine for the mid-afternoon slump, a few cookies before bed . . . and
you may have consumed more calories from "snacks" than from your day's
actual meals.
To avoid this diet downfall, and still satisfy your hunger between meals
and on the go, try some of the foods listed below. Include protein for a
snack that will carry you through until the next meal.
Quick nutritious snacks
- Breakfast cereal, dry or with
milk and fruit. Try low sugar, multigrain kinds. Keep single serving
boxes on hand.
- No-sugar-added applesauce,
sliced peaches in their own juice, and other single serving fruits.
- Fresh fruit, such as pears,
apples, oranges, nectarines, peaches, kiwi, grapes, strawberries, and
bananas.
- Mixed nuts and a single serving
can of tomato juice.
- Dried apricots, apples,
nectarines, etc.
- Low-fat milk and a homemade or
store-bought low-fat, whole grain muffin. Avoid jumbo-sized muffins.
- Popcorn (3 cups, low-fat)
- Wholegrain, low fat crackers
(4) and part-skim mozzarella cheese (1 oz.)
- A turkey kabob: turkey &
low-fat cheese cubes (.5 oz. each) with pretzel sticks and low-fat
milk (8 oz.).
- Packaged, ready-to-eat
vegetables such as baby carrots, broccoli florets, and cauliflower
pieces with a low-fat dip (2 tbs.)
- Chopped vegetables from your
own kitchen such as red and green bell peppers, jicama, carrot and
celery sticks, snow peas, button mushrooms, and/or broccoli with
non-fat ranch dressing.
Boost the nutritional value of any
snack with single-serving beverages such as canned or boxed fruit juices
(look for 100% juice) or boxed low-fat milk
Posted December 2003
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Effect of weight changes on bone mass in female adolescents
The purpose of this study was to examine changes in bone mineral
density/bone mineral content (BMD/BMC) in obese female adolescents
(Tanner stages 2 to 4) pursuing a weight reduction program. This was an
investigation involving 92 obese females screened to meet inclusion
criteria and required to participate in a 6 month weight loss
intervention. Baseline, 6 months, and 12 months measurements were taken
for total body/lumbar spine BMD/BMC and percentage body fat. Assessments
included: calcium food frequency/24 hour dietary recall, physical
activity, and psychological assessments for anxiety/self esteem.
Changes in bone measurements were compared with changes in body weight
measurements using multiple linear regressions. Other variables which
the researchers controlled for include: bone area, calcium intake,
baseline Tanner stage, activity level, and height.
In this study, weight changes were strongly related to bone measurement
changes in an obese adolescent female population.
Bottom line: young girls who are trying to lose weight need to be
encouraged to emphasize a healthy weight loss program along with optimal
calcium intake and weight bearing exercises.
Source: Journal of the American Dietetic Association. March 2003, Volume
103, number 3, 369-372
Posted January 2004
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Dietary supplements for weight loss: Do they work and are they safe?
As a nation, we are struggling with our growing obesity problem, since
more than half of the U.S. adult population is either overweight or
obese. It is not surprising that dietary supplements for weight loss are
big business and it is estimated that people in the U.S. spent nearly 2
billion dollars on weight less supplements in 2001 alone. As the sales
of dietary weight loss supplements soar, so do the health concerns
associated with the marketing, sale, and use of these products by
consumers.
Dieting is hard and requires changing lifestyle behaviors. Consumers
have a right to know if any of the supplements on the market work and
what health risks might be associated with their use but unfortunately
there is little scientific data to support the effectiveness of most
weight loss supplements. Taking a supplement to reduce appetite, speed
up metabolism, or decrease the absorption of nutrients is not a long
term solution to our obesity problem. For obese individuals or
individuals with underlying health problems, these supplements can have
dangerous interactions with prescription and over the counter drugs.
Other safety issues associated with weight loss supplements are
contamination, variation of content, and multiple ingredients, all of
which can pose significant health risks. Variation in the content of the
supplement means that what is listed on the label may not be what is in
the bottle; there may be too much or too little of something, or there
may be something different altogether.
Conclusion: There is no substitution for changes in lifestyle behaviors
that support a good diet and exercise program. Research shows that
individuals who successfully maintain weight loss do the following three
things: exercise, monitor their energy intake, and consume low fat,
nutritious diets. At the moment, there are no effective weight loss
supplements that can be recommended to support these goals.
Incorporating good food and exercise into your lifestyle is a sage
weight loss recommendation we can all make. To see more information on
various supplements, check out this website: www.sensiblenutrition.com
Source: American College of Sports Medicine’s Health and Fitness
Journal, Vol. 7, No. 4.
Posted March 2004
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Spotting
a fad diet
Does it sound too good to be true? Then it probably is. When choosing a
diet plan, look for the following warning signs to help you stay fad
free.
- Promise of rapid weight loss,
greater than 2 pounds in one week.
- Severe calorie restriction,
less than 1200 calories each day. Many diets do not list the calories
and this is for a reason. They want you to think all the other fancy
combinations, eliminations or planning is the source of the weight
loss.
- Endorsements or testimonies by
celebrities, sales people, health gurus.
- Diets linked to food products
only available through their diet program.
- Meal replacers like pills,
supplements, drinks, etc.
- Restrictions of certain foods.
- Food limited to certain times
of the day or days of the week.
- “Magic or miracle” foods that
burn fat.
- Bizarre quantities of food or
type of food.
- Rigid menus.
- Specific food combinations.
- No mention of need for physical
activity.
- Source of diet information
vague and/or criticism of scientifically proven nutrition practices
Over the years, promoters of
weight loss schemes have described their claims with words and phrases
like these: ancient, breakthrough, cure, easy, effortless, guaranteed,
magical, miraculous, quick, new discovery. Don’t be fooled.
Posted March 2004
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Carb-curbers tend to be crabby according to new
research
During the current low-carb/pro-protein diet craze, carbohydrates have
been demonized -- accused of causing weight gain and blamed as the
reason people can't lose weight. Do they deserve this stigma? Not
according to MIT researcher Judith Wurtman.
Wurtman, director of the Program in Women's Health at the MIT Clinical
Research Center, and colleagues have found that when you stop eating
carbohydrates, your brain stops regulating serotonin, a chemical that
elevates mood and suppresses appetite. And only carbohydrate consumption
naturally stimulates production of serotonin.
"When serotonin is made and becomes active in your brain, its effect on
your appetite is to make you feel full before your stomach is stuffed
and stretched," said Wurtman. "Serotonin is crucial not only to control
your appetite and stop you from overeating; it's essential to keep your
moods regulated."
Antidepressant medications are designed to make serotonin more active in
the brain and extend that activity for longer periods of time to assist
in regulating moods. Carbohydrates raise serotonin levels naturally and
act like a natural tranquilizer. Wurtman's husband, Richard Wurtman, the
Cecil H. Green Distinguished Professor at MIT and the director of the
Clinical Research Center, along with former graduate student John
Fernstrom, discovered that the brain makes serotonin only after a person
consumes sweet or starchy carbohydrates. But the kicker is that these
carbohydrates must be eaten in combination with very little or no
protein, the Wurtmans' combined research determined.
So a meal like pasta or a snack of graham crackers will allow the brain
to make serotonin, but eating chicken and potatoes or snacking on beef
jerky will actually prevent serotonin from being made. This can explain
why people may still feel hungry even after they have eaten a 20-ounce
steak. Their stomachs are full but their brains may not be making enough
serotonin to shut off their appetites.
And what do protein dieters (especially women) miss most after the
second week? Carbohydrates. Women have much less serotonin in their
brains than men, so a serotonin-depleting diet will make women feel
irritable. "There are people we call carbohydrate cravers who need to
eat a certain amount of carbohydrates to keep their moods steady," said,
Wurtman, co-founder of Adara, a weight-management company whose programs
are based on her research. "Carbohydrate cravers experience a change in
their mood, usually in the late afternoon or mid-evening. And with this
mood change comes a yearning to eat something sweet or starchy."
Thus, it's not just a matter of will power or mind over matter; the
brain is in control and sends out signals to eat carbohydrates.
According to Wurtman's clinical studies, if the carbohydrate craver eats
protein instead, he or she will become grumpy, irritable or restless.
Furthermore, filling up on fatty foods like bacon or cheese makes you
tired, lethargic and apathetic. Eating a lot of fat, she said, will make
you an emotional zombie.
"When you take away the carbohydrates, it's like taking away water from
someone hiking in the desert," Wurtman said. "If fat is the only
alternative for a no- or low-carb dieter to consume to satiate the
cravings, it's like giving a beer to the parched hiker to relieve the
thirst -- temporary relief, but ultimately not effective."
Source: MIT News Office, Nov. 4, 2002
Posted March 2004
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HHS unveils New FDA strategy to help reduce obesity
The Secretary of the US Department of Health & Human
Services (HHS), Tommy G. Thompson, released a new Food and
Drug Administration (FDA) report outlining another element in
HHS' comprehensive strategy for combating the epidemic of
obesity that threatens the health of millions of Americans
with a focus on the message, "calories count."
The report by FDA's Obesity Working Group includes
recommendations to:
- strengthen food labeling educate consumers about
maintaining a healthy diet and weight
- encourage restaurants to provide calorie and nutrition
information.
- ensure food labels accurately portray serving size
- revise and reissue guidance on developing obesity drugs
- strengthening coordinated scientific research to reduce
obesity and
- develop foods that are healthier and low in calories.
"Counting calories is critical for people trying to achieve
and maintain a healthy weight," Secretary Thompson said. "This
new report highlights FDA's overall strategy for getting
consumers accurate, helpful information that allows them to
make wise food choices at home, at supermarkets and in
restaurants.
Taking
small steps to eat a more balanced diet and to stay physically
active can go a long way to reversing the epidemic of obesity
that harms far too many Americans."
The FDA report comes on the heels of a new study from HHS'
Centers for Disease Control and Prevention (CDC) that shows
poor diet and inactivity are poised to become the leading
preventable cause of death among Americans -- causing an
estimated 400,000 deaths in 2000. CDC estimates that 64
percent of all Americans are overweight, including more than
30 percent who are considered obese. About 15 percent of
children and adolescents, aged 6 to 19, are overweight --
almost double the rate of two decades ago.
Secretary Thompson unveiled a new national education
campaign to encourage Americans to take small steps to fight
obesity and a new obesity research strategy at the National
Institutes of Health. Today's report builds on those
initiatives by highlighting actions that FDA, which regulates
many foods and their labels, can take to enable consumers to
make smart choices about their diet and maintain a healthy
weight.
"Our report concludes that there is no substitute for the
simple formula that 'calories in must equal calories out' in
order to control weight," said FDA Deputy Commissioner Lester
M. Crawford, D.V.M., Ph.D. "We're going back to basics,
designing a comprehensive effort to attack obesity through an
aggressive, science-based, consumer-friendly program with the
simple message that 'Calories Count.'"
The report's recommendations include:
- Evaluating how the "Nutrition Facts" panel on food
labels can be revised to highlight the critical role
calories play in consumers' diets -- such as increasing type
size and adding a column to list quantitative amounts of
calories as a Percent Daily Value for the entire package.
The report recommends FDA issue an advance notice of
proposed rulemaking to gain public input on approaches to
effectively revise food labels.
- Considering the authorization of health claims on
certain foods that meet FDA's definition of "reduced" or
"low" calorie. An example of such a health claim might be:
"Diets low in calories may reduce the risk of obesity, which
is associated with type 2 diabetes, heart disease, and
certain cancers." The report recommends an advance notice of
proposed rulemaking to obtain public input on the approach.
- Encouraging manufacturers to use dietary guidance
statements, such as, "To manage your weight, balance the
calories you eat with your physical activity; have a carrot,
not the carrot cake; or have cherry yogurt, not cherry pie."
- Defining such terms as "low," "reduced," or "free"
carbohydrates, as well as providing guidance for the use of
the term "net" in relation to carbohydrate content of food,
in light of increasing consumer interest in low carbohydrate
diets and in response to petitions asking FDA to define
these terms.
- Focusing FDA's consumer education strategy on
influencing behavior and promoting healthy eating choices
with the basic message that "Calories Count." FDA will work
with private and public sector partners, including
youth-oriented organizations, to give consumers a better
understanding of the food label and how to use it to make
healthier food choices.
- Encouraging the restaurant industry to launch a
national, voluntary effort to include nutritional
information for consumers at the point of sale. Such
information would help consumers make healthier and
lower-calorie choices outside the home, where Americans now
spend nearly half their total food budget. The report
recommends that FDA seek restaurants to participate in a
pilot program to study effective options for simple,
voluntary, standardized nutritional information at the point
of sale in restaurants.
- Increasing FDA's focus on enforcing accurate serving
size declarations on food labels and advising manufacturers
when the agency identifies apparent errors in declared
serving sizes. FDA is issuing a letter to encourage the food
industry to review its nutrition information and ensure that
the serving size declared is appropriate for the food
product in question.
Source:
www.fda.gov
Posted March 2004
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Are you heavier now than you were 10 years ago but still
wearing the same "size" clothing? Here's why.
In today's day and age the emphasis is growing for people to be thin.
Everyone wants to be able to fit into the same size clothes as
they did when they were younger. The clothing industry has
made that dream seem like a reality by making the clothes seem
smaller than they actually are.
The trend of obesity in Americans rises each year.
Currently 60% of adults and 20% of children are obese. This
is largely due to the increase of sedentary lifestyles and the
emergence of large portion sizes. Portion sizes for foods have
grown to be three times that of what they used to be. They
also are higher in calories and fat.
With the emergence of such diets as the Atkins diet which
restricts the amount of carbohydrates that one can eat, but
allows you to eat plenty of fat and protein it is a wonder how
these people actually lose weight. The people who go on those
diets eat less food than one not following a diet. This
relates back to the theory if you eat less calories and
exercise more, you will lose weight.
With the decreased activity and the presence of high
calorie food in not only the home, but also the schools for
children, primarily fast foods, the ongoing epidemic of
obesity does not show nay hopes of becoming less of a problem.
Obesity is not something that is going to solve itself. The
only way to decrease obesity is to start making an example and
change the way in which you eat as well.
Source: The Widening of America or How Size 4 Became a Size
0. The New York Times, January 20, 2004. Posted May 2004
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The hidden cost of eating out
Imagine a restaurant
menu without prices. You'd have no idea what you owe until the
bill comes.
Today's menus keep other costs secret. You have no idea
what a meal will do to your waistline and arteries until the
medical bills come . . . years later.
Over the last twenty years, obesity rates have doubled in
American adults and tripled in teens. Restaurant food deserves
some of the blame. About a third of our calories are now eaten
outside the home - nearly double the percentage in 1978. And
when people dine out, they typically swallow more calories
than when they eat at home. Women who eat out more than five
times a week consume nearly 300 more calories per day than
women who eat out less often. Children consume almost double
the 440 calories they usually eat in a home-cooked meal.
This
should come as no surprise. Typical restaurant meals - like
linguine with clam sauce, Szechwan shrimp, or chicken tacos
with beans and rice - provide roughly 1,000 calories. And
dishes like Fettuccine Alfredo, kung pao chicken, or chicken
fajitas can hit 1,600 calories. Shouldn't diners be able to
take that into account before they decide what to order?
Some members of Congress think so. Last November,
Democratic Representative Rosa DeLauro of Connecticut
introduced the Menu Education and Labeling (MEAL) bill (H.R.
3444). Democrat Tom Harkin of Iowa has introduced a similar
bill (S. 2108) in the Senate. Both would require calorie
counts on fast-food menu boards and calories,
saturated-plus-trans fat, and sodium on table service
restaurant menus.
The bills apply only to standard menu items - not custom
orders or daily specials - and only to chains with 20 or more
outlets. Similar bills are being considered in Maine, New
Hampshire, New York, Pennsylvania, and Washington D.C.
Two-thirds of Americans want calorie labeling at
restaurants, according to a CSPI National poll. Who could
disagree? It's one thing to splurge because you want
to... but it's another to splurge without knowing it.
There are no easy solutions to America's obesity epidemic.
But the government should help by giving diners a fighting
chance.
You Can Help
Please urge your Senators and Representatives to cosponsor the
MEAL bill (go to
http://actionnetwork.org/campaign/mealbill or call
the Congressional swithchboard at 202-224-3121).
A free copy of our report, Anyone's Guess- The Need for
Nutrition Labeling at Restaurants, is available at
www.cspinet.org/restaurantreport.
Source: Nutrition Action Healthletter, April 2004 Posted
August 2004
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Emotional Eating
It's a vicious cycle when you rely
on food to heal what ails you, especially since chances are
the food you choose in this instance, is often not of the
healthy kind. Junk food makes great comfort food, but it won't
help you in your quest to lose weight. What you need to do is
break yourself out of the pattern of emotional eating.
Emotional Eating Emotional eating is the practice of
consuming large quantities of food -- usually "comfort" or
junk foods -- in response to feelings instead of hunger.
Experts estimate that 75% of overeating is caused by emotions.
Many of us learn that food can bring comfort, at least in
the short-term. As a result, we often turn to food to heal
emotional problems. Eating becomes a habit preventing us from
learning skills that can effectively resolve our emotional
distress.
Depression, boredom, loneliness, chronic anger, anxiety,
frustration, stress, problems with interpersonal relationships
and poor self-esteem can result in overeating and unwanted
weight gain. By identifying what triggers our eating, we can
substitute more appropriate techniques to manage our emotional
problems and take food and weight gain out of the equation.
How can I identify eating triggers?
Situations and emotions that trigger us to eat fall into
five main categories:
- Social: Eating when around other people. For
example, excessive eating can result from being encouraged
by others to eat; eating to fit in; arguing; or feelings of
inadequacy around other people.
- Emotional: Eating in response to boredom, stress,
fatigue, tension, depression, anger, anxiety or loneliness
as a way to "fill the void."
- Situational: Eating because the opportunity is
there. For example, at a restaurant, seeing an advertisement
for a particular food, passing by a bakery. Eating may also
be associated with certain activities such as watching TV,
going to the movies or a sporting event, etc.
- Thoughts: Eating as a result of negative
self-worth or making excuses for eating. For example,
scolding oneself for looks or a lack of will power.
- Physiological: Eating in response to physical
cues. For example, increased hunger due to skipping meals or
eating to cure headaches or other pain.
To identify what triggers excessive eating in you, keep a
food diary that records what and when you eat as well as what
stressors, thoughts, or emotions you identify as you eat. You
should begin to identify patterns to your excessive eating
fairly quickly.
How do I break myself of the habit?
Identifying eating triggers is the first step; however, this
alone is not sufficient to alter eating behavior. Usually, by
the time you have identified a pattern, eating in response to
emotions or certain situations has become a pattern. Now you
have to break the habit.
Developing alternatives to eating is the second step. When
you start to reach for food in response to a trigger, try one
of the following activities instead:
- Watch television
- Read a good book or magazine or listen to music
- Go for a walk or jog
- Take a bubble bath
- Do deep breathing exercises
- Play cards or a board game
- Talk to a friend
- Do housework, laundry or yard work
- Wash the car
- Write a letter
- Or do any other pleasurable or necessary activity until
the urge to eat passes
What if distracting myself isn't enough to keep me
from eating?
Sometimes simply distracting yourself from eating and
developing alternative habits is not enough to manage the
emotional distress that leads to excessive eating. To more
effectively cope with emotional stress, try:
- Relaxation exercises
- Meditation
- Individual or group counseling
These techniques address the underlying emotional problems
and help resolve the original problem as well as teach you to
cope in more effective and healthier ways.
For more information on these techniques, contact your
doctor.
As you learn to incorporate more appropriate coping
strategies and to curb excessive eating, remember to reward
yourself for a job well done. We tend to repeat behaviors that
have been reinforced, so reward yourself when you meet your
nutrition management goals. Buy that blouse, take that
vacation, or get that massage to reward yourself to increase
the likelihood that you will maintain your new healthy habits.
Source: The Cleveland Clinic. For additional health
information, contact The Cleveland Clinic, (216) 444-3771. Posted
October 2004
Return to Weight Management
Menu Stopping that
rebound in weight
Ask U.S. adults if they're trying to lose weight, and three
out of four say "yes," polls show. More than 60 percent of
Americans are overweight, and the numbers are getting higher.
Weight loss is a major industry, from support programs to diet
books to special foods.
With all this dieting, why are so many people still
unsuccessful at controlling their weight? One reason is that
although many people manage to lose weight, they usually don't
keep it off. Even in medically supervised weight-loss
programs, people often regain, says Eva Obarzanek, a
nutritionist for the U.S. government's National Heart, Lung,
and Blood Institute of the National Institutes of Health (NIH)
and project officer of a new study on maintaining weight loss.
"In a period after weight loss, usually about six months, the
weight starts going back up," she says.
Even in the best medically supervised programs, nearly
two-thirds of participants are back where they started within
three years and 80 to 90 percent within five years, says Gary
Foster, Ph.D., clinical director of the Weight and Eating
Disorders Program at the University of Pennsylvania. For
people who lose weight on their own, the relapse rate may be
even higher.
Why weight bounces back
Why is it so difficult to avoid putting those pounds back on?
Biology, environment and the pressures of everyday life all
play a role.
- Biology - The body's metabolism, programmed for survival
in times of food shortage, works against dieters. "Your
metabolism slows down because it's trying to conserve
energy," Obarzanek says. "So you get hungry, your body
doesn't expend as many calories as before doing the same
things, and you have to reduce calories even more."
- Environment - "It's tougher to lose weight and keep
weight off now than it was 20 years ago because there are so
many incentives to eat more and move less," Foster says.
"The cheapest foods are often the unhealthiest." Activity is
reduced by labor-saving devices, sit-down entertainment such
as television, and the growing number of people in desk
jobs.
- Life pressures - "Weight control takes a lot of work,
hard work," Foster says. "If life gets in the way
- a spouse
gets ill, your child is going through behavioral problems - the disposable energy that you have for any project,
including weight control, gets diverted." So you go back to
old habits, and you regain weight.
You can succeed
Is it possible to lose weight and keep it off for a long time?
Plenty of highly motivated people have succeeded. Now,
research is starting to provide a clearer picture of how they
do it. Some of the most detailed information comes from a
national long-term study. The National Weight Control Registry
contains information on 3,000 people who have lost 30 to 100
pounds (average, 60 pounds) and then kept their weight stable
for at least one year (average, five years). They lost weight
using many different diets or programs, says James Hill,
Ph.D., co-director of the study along with Rena Wing, Ph.D.,
of Brown University. But those who keep it off have several
things in common, he says.
Exercise
People in the weight-control registry, on average, burn up
about 2,700 calories a week in physical activity, says Hill,
director of the Center for Human Nutrition at the University
of Colorado Health Sciences Center in Denver. That's equal to
about one hour of moderately intense activity every day - for
example, five miles of walking. "I think this is the most
important [factor]," Hill says. It's not clear if people who
lose smaller amounts of weight need to exercise this much.
Still, a large body of research agrees that exercise is
essential in counteracting the body's tendency to regain
weight. "Without exercise, the other efforts are simply
temporary," says Harold Solomon, M.D., director of the Weight
Loss and Lifestyle Enhancement program at Beth Israel
Deaconess Medical Center in Boston. "There are very few people
who can lose weight and keep it off without changing the
amount of energy they expend."
Guidelines from the National Heart, Lung, and Blood
Institute, part of the NIH, make the following recommendations
about exercise to prevent weight gain:
- Consult your doctor and start slowly to avoid injury.
- If you have been inactive, start with 10 to 30 minutes
of moderately intense activity, such as walking, three days
a week. Build up to 30 to 45 minutes on most or all days of
the week
- Reduce sedentary activities such as watching television.
Build more activity into your day by parking farther from
your destination, taking the stairs instead of the elevator,
gardening, walking a dog, etc.
- Schedule your physical activity a week in advance,
budget the time to do it, and use a diary to record the
amount of time you spend exercising. Record the type of
activity as well as the intensity.
Self-monitoring
People in the weight-control registry are highly disciplined
about this, Hill says. "They weigh themselves a lot and they
record what they eat on a regular basis."
Foster says his own experience with patients also shows that
self-monitoring is
important because it allows you to notice weight fluctuations
early and to take action. "This doesn't mean you get crazy
about every pound you go up or down," he says, "but it does
mean that this is a chronic problem and when you gain weight
what are you going to do about it? The way you reverse small
weight gains is to have a specific plan."
Sustainable, healthy diet
Although people in the registry originally lost weight using a
variety of diets, the vast majority kept the weight off by
following a low-fat, high-carbohydrate diet, Hill says.
Although new research indicates that low-carbohydrate regimes
such as the Atkins diet can produce significant weight loss,
very few people in the weight-control registry were following
Atkins long-term, Hill says.
Another important rule is to control portion size,
Obarzanek says. And, she says, "I still believe that reducing
dietary fat is the most efficient way of reducing calories."
Dr. Solomon, a clinical assistant professor of medicine at
Harvard Medical School, says his own patients who are
successful at long-term weight control make rules for
themselves about eating. Then, he says, they make those rules
second nature.
For example, he says, someone who eats a salad every day,
but longs for a cheeseburger, at some point will give up and
eat the burger. In contrast, people who permanently lose
weight often say they don't do anything special to keep it off
because they have made a permanent change in how they think
about food, he says. "They have sort of drummed the
cheeseburger out of their minds," he says. "They have a new
reality."
Breakfast
This is another important element for people in the National
Weight Control Registry. "They eat breakfast, so they're
spreading out their calories over the day," Hill says. This
pattern is important to reduce hunger and bingeing, Dr.
Solomon says. "You have to eat breakfast. You have to spread
your calories out and eat at least three or four times a day."
The role of support
It's difficult to keep weight off, but research indicates that
it helps to have some outside support. "We know that frequent
contact with a health provider or some other entity that's
looking after them - that would include a support group - is
helpful," Obarzanek says. "We find in our clinic sessions that
people who attend the most sessions lose the most weight."
"Unfortunately, we don't know cause and effect. If you force
people to go to sessions, would you get the same effect? Maybe
people who are successful are proud, so they show up."
The new NIH study on keeping weight off will explore
whether certain ways of providing support are helpful. After
participants lose weight, they will be randomly assigned to
one of three groups. Members of the "self-directed" group will
meet once with a health counselor and will receive educational
materials, but no other support. A second group will receive
monthly telephone calls from a counselor and occasional
visits. The third group will use an Internet-based program
that includes weekly e-mails with messages related to their
progress and automated phone reminders to use the system.
The form of support you need may depend on your
personality, Foster says. "My sense is that in an attempt to
find out what works we generalize too much. Some people are
solo dieters and some like buddies. The most consistent data
show that consistent contact with a professional improves the
long-term outcome."
But ultimately what matters is individual vigilance, he says.
"Maintenance is a very active process. If you go with the
tide, you will gain weight."
Source:
http://www.intelihealth.com
Posted
November 2004
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Step Counter Practical Tips
America on the Move is a
national initiative to encourage children and adults to move a
little more and eat a little less. Pilot tested in Colorado,
the approach was effective in preventing weight gain. The free
Web site provides information, links, a place to log physical
activity, and many more helpful features. Visit
www.americaonthemove.org
Counting your steps is one method used to promote physical
activity in children and adults. How much daily activity do
you get outside of the gym? Here's how to tell.
Although using a step counter is easy and fairly intuitive,
here are a few practical suggestions to help you make the most
of using a step counter. Please note that step counters will
not work effectively when riding a bike, using an elliptical
trainer, and, of course, in the pool!
- Choose a basic step counter. Many step counters (also
known as pedometers) count steps and then convert the steps
to miles walked and calories burned. As recent research
indicates, the step counter feature is the most accurate
component of pedometers. Simple step counters are also
easier to use because you don't have to program them with
your personal information. Look for a step counter that has
a cover protecting the reset button from getting punched
accidentally.
- Skip the cheap step counters. There are many cheap step
counters out there, and you often get what you pay for.
Inexpensive step counters tend to be inaccurate, fragile,
wear out quickly, and are not backed by a long-term
warranty. Expect to pay $20-$50 for a good-quality step
counter.
- Put it on a leash. One end of the leash attaches to the
step counter, and the other end usually has a clip to attach
to a belt loop, waistband, or undergarments. Step counters
will occasionally fall off, so a leash prevents it from
getting lost. If your step counter doesn't have a leash,
simply attach a string and use a safety pin to clip it to
your clothes.
- Where to wear it. Most step counters operate best when
placed on the waistband in line with the center of your
kneecap. Make sure it is parallel to the ground. You may
have to adjust it to find the right spot for you (see next
bullet). If you are not wearing a waistband, you can attach
it to undergarments.
- Test it out. Everyone has a different stride and gait.
Clip your step counter on your waist, according to the
manufacturer's instructions, reset the counter to zero, and
walk for 50 steps counting the number of steps in you head.
Stop. Look at the number on your step counter. If it is +/-
three steps, then take note of the placement of the step
counter on your waistband. This is where you should place it
each morning. If the error is more than three steps, move
the step counter slightly on your waist, re-zero, and repeat
the test. Continue to adjust the step counter placement
until you find a spot where the error is within +/- three
steps. If you don't get satisfactory test run results, try
putting it on the other side of your waist, replacing the
battery. If these suggestions don't work, return it to the
retailer to get a refund.
Step counter resources
Vendors
There are many step counter makers. Here are Web sites for two
companies that carry several of the step counters that have
been tested to be valid and accurate in scientific trials.
Books
- Steps to Better Health by The Cooper Institute.
This is a 48-page practical guide to optimizing step counter
use. 2003. Available at
www.cooperinst.org
- Manpo-kei: The Art and Science of Step Counting: How
to be Naturally Active and Lose Weight! By Catrine
Tudor-Locke. Victoria, British Columbia: Trafford
Publishing. 2003. Available at
www.trafford.com .
Source: Weight Management Newsletter, Spring 2004, 1(4).
Posted
November 2004
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Burn Baby Burn: Exactly How Long Does it Take to Burn 350
Calories?
30 Minutes: Step aerobics, 10-12 inch step
45 Minutes: Stationary bike, moderate effort
45 Minutes: Tennis
50 Minutes: Trail hiking
55 Minutes: Lawn mowing
70 Minutes: Golf, walking, and carrying bags
90 Minutes: Moderate walking, 3 mph
Based on a 150-pound woman
Source: Amanda Fox, Living Well, July 2004.
Posted
November 2004
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