Archives for posts tagged ‘overweight’
Sunday, 20 November 2011
Friday, 18 November 2011
NBC Nightly News recently reported that a new study gives us clues of “why it’s so hard to keep weight off once you have lost it.”
Thursday, 8 September 2011
If you could do four things to dramatically reduce your risk of brain shrinkage (especially that caused by dementia, vascular dementia, Alzheimer’s disease, or stroke), would that be of interest to you?
Sunday, 24 July 2011
It turns out that there are some specific foods that may be the biggest culprits behind weight gain according to a study published in the New England Journal of Medicine.
Tuesday, 12 July 2011
Thursday, 7 July 2011
In my 2005 book, SuperSized Kids: How to protect your child from the obesity threat, I published this the then shocking statement, “If we don’t get a handle on (childhood obesity), this generation of kids coming up will have a shorter life span than their parents. That’s scandalous!” Now, we’re seeing some data indicating this unfortunate prediction may indeed be happening.
Thursday, 16 June 2011
‘Night owls’ take in an average of 248 more calories per day, a recent study found. As such, folks who consistently stay up late may be putting themselves at higher odds for weight gain and obesity.
Sunday, 5 June 2011
If kids get fewer hours of sleep, they may start packing on the pounds, researchers say in a new study. In fact, each additional hour of sleep per night was associated with a 63% reduction in body mass index (BMI) for children age 3 to 7 years.
Thursday, 2 June 2011
Family meals have long been an American tradition. During the past several decades, however, the American family has undergone radical changes—and family meals have changed at the same time. And as family meals have decreased, so has the physical, emotional, relational, and spiritual health of our children.
Thursday, 2 June 2011
Monday, 14 March 2011
If you hate enforcing bedtime with your kids, here’s another good reason why you should. A new study published in the journal Pediatrics suggests that younger children who get more regular sleep are less likely to be obese.
Wednesday, 9 March 2011
In my book, SuperSized Kids: How to protect your child from the obesity threat, I made the then startling claim that childhood obesity was associated with a lack of sleep. And, in a clinical study, we showed that families who make wise nutrition choices, activity choices, AND increase the amount of sleep children get, can prevent or treat childhood obesity.
Since the publication of the book, study after study (many reviewed in this blog) have demonstrated the association between poor sleep or inadequate sleep and childhood obesity. Now, a new study suggests that sleeping in on the weekend may help children fight obesity. Here are some details from HealthDay News:
Too little sleep puts kids at risk of obesity and other health conditions, but “catch-up” sleep on weekends and holidays can mitigate the effects of weekday sleep deprivation, researchers say.
“In the United States, the sleep of our children is clearly not enough,” said lead researcher Dr. David Gozal, chair of pediatrics at Comer Children’s Hospital at the University of Chicago.
Gozal’s team monitored the sleep patterns of 308 children for a week and compared their sleep patterns with their body mass index (BMI), which is a measurement that takes into account height and weight. The children, who were 4 to 10 years old, averaged eight hours of sleep a night.
“This is way lower than the recommended amount of sleep that kids should get, which is about 9.5 to 10 hours at this age,” Gozal said.
Among the children who got the recommended amount of sleep, the risk of obesity, diabetes and cardiovascular problems was nil, Gozal said.
“But, as the amount of sleep became shorter and the regularity of sleep became less organized, the risk for obesity increased,” he said.
“Kids who had the shortest sleep and had a more disorganized sleep schedule had more than a fourfold increase in the risk of being obese,” he noted.
These children also had increased risk for cardiovascular problems and pre-diabetes, Gozal said.
However, if these children consistently slept longer on weekends to compensate, the risk for obesity and metabolic problems was reduced to a 2.8-fold increase. “It did not normalize it. It’s still a risk but not as much as keeping your crazy short sleep schedule even during weekends,” Gozal said.
It is this combination of less sleep and irregular sleep that appears to result in metabolic problems, such as high blood sugar, Gozal said.
The report is published online Jan. 24 in advance of print publication in the journal Pediatrics.
Gozal says that other studies have shown that inadequate sleep has biological effects, including high blood sugar and cravings for sweet and high-fat foods. Insufficient sleep also makes it harder to lose weight, he said.
“All this would suggest that sleep is an important regulator of metabolism,” Gozal said. “If we abuse our sleep by not sleeping enough, then we are likely to pay the price by being heavy and being at risk for cardiovascular and all the other metabolic complications,” he said.
Children are sleeping less for various reasons, Gozal said. Busy family schedules and electronic media — cell phones, computers and TV — interfere with healthy bedtime routines. The result is that sleep suffers, he said, noting that while bedtime can be extended, we still have to get up at the same time.
“Children should follow a regular [sleep] schedule,” Gozal said. “Follow the rule of sleep and you will be happy,” he urged.
Frederick J. Zimmerman, of the department of health services at the University of California Los Angeles, said the study largely confirms earlier research that found inadequate sleep is a risk factor for obesity among children.
The new research offers a “tantalizing suggestion that sleep that is inadequate both in duration and in consistency may have adverse metabolic effects,” he added. However, it does not explain why obesity and sleep are related, Zimmerman said.
“It could be that obesity causes disturbed sleep or that inadequate sleep increases the risk of obesity. It could also be that a third factor, such as nighttime television, may lead both to obesity and to poor sleep,” he said.
Despite these uncertainties, the consensus is that parents should create an environment in which children can consistently get adequate, restful sleep, Zimmerman said.
“As difficult as it is for parents to consistently enforce early bedtimes, it may still be one of the easiest ways to promote happy, healthy children,” he added.
So, watch the clock, these experts say. The study found that parents tend to overestimate the amount of sleep their kids get, usually by 60 to 90 minutes, Gozal said.
For more information on children and sleep, visit the Nemours Foundation. Or, purchase a copy of my book, SuperSized Kids: How to protect your child from the obesity threat. It’s on sale at my website. The hardcover is on sale for $3.99 here, and the soft cover for $1.99 here (plus shipping).
Wednesday, 2 March 2011
Wednesday, 29 December 2010
Like many physicians who care for children and teens, I’m acutely aware of and concerned about the epidemic, the tsunami, of childhood overweight and obesity. Because of that, I headed a research project at Florida Hospital in Orlando, Florida, that resulted in the book SuperSized Kids: How to protect your child from the obesity threat. The book is currently on sale in HARDCOVER for $4.99 here (save $18) and in SOFTCOVER for $1.99 here (save $11).
If you have children or teens who are overweight, NOW is the time to make some changes. And, my book has an 8-week plan your family can put into action to start the New Year. The reason to do so is that to NOT act is to doom your kids to a shorter life with lower quality.
USA Today reports, ”Heavy teenagers are often destined for skyrocketing weight gain in their 20s,” according to a study published in the Journal of the American Medical Association. After reviewing “national data on the height and weight records of almost 9,000 people ages 12 to 21 who were followed for 13 years,” researchers found that “about half of obese teenage girls and about a third of obese teen boys become severely obese by the time they are 30 — meaning they are 80 to 100 pounds over a healthy weight.”
“By the time they reach their late 20s to early 30s, people who were obese between 12 and 21 are more than seven times more likely than normal-weight or overweight peers to develop severe obesity — defined as having a body mass index, or BMI, of 40 or more,” the Los Angeles Times reports. “The result not only confers profound health risks for teens whose excess weight follows them and accelerates into adulthood, it also spells a looming public health disaster in a country where almost one in five adolescents is obese, experts say.”
The CNN “The Chart” blog reported, ”The researchers also found that [among] teens who were overweight but not obese when the study started, more than 15 percent of the girls and six percent of the boys went on to become severely obese adults.” In particular, “overweight African-American girls were more likely than their white peers to bump up to the highest weight category.”
HealthDay reported, ”Severe obesity … heightens the risk for a number of health complications, including type 2 diabetes, high blood pressure, high cholesterol, asthma, and arthritis. In addition, people who are severely obese can expect significant reductions in life expectancy, according to background information in the study.”
In light of the finding that “teens who were obese at the beginning of the study were 16 times more likely to become severely obese adults compared to normal-weight or overweight teens,” study author Penny Gordon-Larsen, PhD, of the Gillings School of Global Public Health, University of North Carolina-Chapel Hill, stated, “This is really setting these kids up to have significant health challenges later in life.”
According to a report from WebMD, “Gordon-Larsen tells parents of all children to ‘keep an eye on the weight gain.’”
Gordon-Larsen suggested that “parents have a goal of ‘keeping a healthy household.’ That means focusing on healthy food options and building physical activity into the day, encouraging kids to walk more and move more.”
Parents called upon to be role models in helping to fight childhood obesity. In a related article, USA Today reports that “obesity is proving to be a heavy burden for the nation’s kids and teens,” as evidenced by “a study in the Journal of the American Medical Association finds that heavy teens often gain a lot more weight in their 20s,” many of whom go on to become “morbidly obese … by their early 30s.”
Dietitians point out that children watch what their parents each, and that “getting healthier should be a family affair.”
To that end, parents should consider having meals together as a family as often as possible, not keeping soda and an array of snacks at home, becoming more physically active as a family unit, and encouraging the kids to take part in planning healthy meals.
You can find hundreds of practical tips on helping your kids in my book, SuperSized Kids: How to protect your child from the obesity threat. It’s on sale, so get one today and make a life-long difference with your children and their health.
Friday, 26 November 2010
Well, it’s the day after Thanksgiving, and there are at least two or three things on most people’s minds: (1) Black Friday shopping, (2) Football, and/or (3) Weight Loss. Have you ever wondered which of the weight loss plans cost you the most for each pound dropped? Well, here you have the answer, provided by ABC News:
- $500 per pound with Liposuction
- $300 to $400 per pound with Gastric Band Surgery
- $235 to $353 per pound with Duodenal Switch Surgery
- $237.56 per pound with One-on-One with Jenny Craig
- $173 per pound with Non-prescription Weigh Loss Aids when paired with a Low-Fat Diet
- SAVE $12.50 per pound by just Kickin’ It Old School
Here are the details:
1) One-on-One With Jenny Craig
Bottom-Line Estimate: $237.56 per pound for one-on-one weight loss support and special food products
Jenny Craig is a weight-loss program that centers around an individualized diet plan, pre-prepared foods, and one-on-one support from a consultant either in person at one of their centers, or via phone or internet communication.
Jenny Craigers are told that they can expect an average weight loss of one to two pounds per week, a figure Jenny Craig spokesperson Cheryl Overton says is derived from third party analysis. A recent study of women on the Jenny Craig in-centre program, subjects saw a more modest average weight loss per week of about three quarters of a pound in the first six months. Soon after six months, weight loss generally plateaued but maintained over the next year and a half.
Though participants in the study received the program and food for free, lead author Cheryl Rock, professor of family and preventive medicine at University of California, San Diego, lays out the estimated cost to consumer of a year on the program: Enrollment fee for a year runs $359 plus the cost of special Jenny Craig food — the average participant spends about $100 per week. Given an average 23.4 pounds lost over the course of a year, this works out to $237.56 per pound.
A bit pricey, but Rock points out that the program does a good job of training people in the habits that will help them maintain the weigh loss, which most study participants did over the course of two years.
2) Going Under the Knife: Weight Loss Surgery
Bottom-Line Estimate: for the surgery alone, anywhere from $235 to $400 per pound if paying out of pocket.
When other diet plans fail and excess weight becomes a pressing health concern, thousands of consumers a year are turning to weight loss surgery for help. These surgeries shrink the digestive track using a gastric band, which pinches off a portion of the stomach, or by removing a portion of the stomach and sometimes the small intestines. After surgery, the amount of food the patient can physically eat in one sitting will be significantly reduced.
These surgeries are only recommended for those with a BMI of 40 and above or those with a BMI of 35 and above who have health complications due to excess weight. The surgeries can run anywhere from $15,000 to $35,000 if paid out of pocket, though under many insurance policies, those that qualify for surgery will have full or partial coverage of the procedure. The most common weight loss procedure is gastric banding. According to the website for Lap-Band, the top selling adjustable gastric band system, the procedure costs $15,000 to $20,000, and the average patients loses one and a half to two pounds per week post-op. Patients generally lose about 50 percent of his or her excess weight, says Dr. John Morton, director of Bariatric Surgery at Stanford University.
Duodenal switch is a less common but more effective procedure, according to Dr. Mitch Roslin, a bariatric surgeon at Lenox Hill Hospital. The procedure involves cutting away a portion of the stomach and small intestines while preserving the duodenal valve that is the gateway between the stomach and the intestines. Roslin says that with a duodenal switch, patients lose 85 percent of excess weight by three years out.
For a 250 pound patient whose ideal weight is 150, a 50 percent excess weight loss with the band would be 50 pounds, which works out to $300 to $400 per pound. A duodenal switch is generally $20,000 to $30,000 so for a 85 percent excess weight loss in the same 250 pound patient, that would work out to $235 to $353 per pound.
Considering post-operative costs of medical care, cost of food, and varied insurance coverage, however, it’s nearly impossible to assign a cost per pound for weight loss surgeries.
3) Liposuction: Sculpting Out Fat
Though liposuction is not a weight-loss technique by any means, it does provide a means for getting rid of fat from targeted areas.
Bottom-Line Estimate: $500 per pound.
With some diets, especailly any diet that leads to more than two pounds a week, weight loss is in part the result of a loss of other things besides fat, such as water or muscle mass, says Dr. Keith Ayoob, director of the Nutrition Clinic at Albert Einstein School of Medicine. With liposuction, up to six to eight pounds of fat can be removed immediately from specific areas on the body, for the purpose of body contouring.
The average cost of procedure runs around $4,000 and up depending on which areas are worked on. Given a low price estimate, that works out to $500 per pound.
The downsides of liposuction, as compared to losing weight naturally, are many. While the fat removal takes place in one sitting, the full results of the procedure take months to see.
“Most patients will see 90 percent of their ultimate liposuction results with in one to three months after surgery. For the first few weeks after surgery there is postoperative swelling. When the surgeon closes the incisions with stitches, swelling usually resolves within 8 to 12 weeks,” according to Liposuction.com, a consumer information website.
Patients can also be left with an irregular skin surface or dimpling following the procedure and as with any surgery, there are medical risks such as blood clot and in rare cases, death, associated with going under the knife.
4) Non-prescription Weigh Loss Aids — Adding Oomph to A Diet
Bottom-Line Estimate: $173 per pound when paired with low-fat diet.
When paired with a calorie-restricted diet and exercise, some diet pills can boost weight loss. Unfortuantely, most of the diet pills on the market have not been evaluated and approved by the Food and Drug Administration. In fact, the only FDA-approved over-the-counter diet drug at this time is GlaxoSmithKline’s Alli, a lower-dose version of the prescription weight loss drug Xenical.
Orlistat, the chemical name for the active ingredient in both Xenical and Alli, works by attaching itself to enzymes in the digestive tract to stop about 25 percent of the fat intake from each meal. That fat later passes through the body undigested, which can lead to gastrointestinal problems such as diarrhea.
At its prescription strength, clinical trials show that Orlistat helped those on a fat-restricted diet lost 13.4 pounds over the course of a year compared with 5.8 pounds in those who only dieted. That makes for twice the weight loss, but only a real increase in loss of about eight pounds. Non-prescription strength Alli provides half the dose of Xenical, but comparable results with those using the product experiencing a similar doubling in weight loss compared to those on placebo.
Alli costs about $1.20 per pill, or $1,314 a year if taken with every main meal. Given given Orlistat’s 7.6 pound average increase in weight loss in a year, that works out to $172.90 a pound.
Alli’s side effects should be taken into consideration: users can experience “gas with oily spotting”, “loose stools”, “difficulty controlling bowel movements” according to the product website. A recent FDA safety review has also found that Orlistat can lead to severe liver damage in rare cases. The company advises that those who experience yellow eyes or skin, dark urine or loss of appetite should stop taking Alli because of possible liver damage.
Alli and Xenical also absorb some necessary fat soluble vitamins from each meal, which can result in nutritional deficiency.
5) Kickin’ It Old School
Bottom-Line Estimate: You SAVE $12.50 per pound you lose.
Losing weight the old fashioned way, by just eating less, is the cheapest “diet plan” yet. Though most diet plans are geared towards limiting certain foods and boosting other, healthier options, you can also lose weight by simply eating a bit less of what you already eat, diet experts say.
Nutritionist Mark Haub, an associate professor of nutrition at Kansas State University, proved this point recently when he experimented with limiting his caloric intake while incorporating snack cakes such as Twinkies and Nutter Butters in his daily fare. Even with two to three sweet treats a day alongside things like steak, whole milk, fruits and veggies, he made sure to eat only 1,800 calories a day and he lost 15 pounds in a month.
That’s not to say that “simply” eating less is a simple feat, but if you can manage it, you could actually save money by dieting. Haub’s Twinkie-heavy dietis not recommended, but as long as you cut back on what you normally eat by about 25 percent, you can expect to lose about a pound a week, says Ayoob.
“A pound of fat is 3,500 calories so to lose a pound of week, you’d need to trim off 500 calories a day from what you eat. Based on the standard 2,000 calorie intake per day, that would amount to a 25 percent decrease in caloric intake overall,” Ayoob says.
While you may choose to eat healthier food, which could make your grocery bill a little higher, if you’re cooking at home as opposed to eating out and overall buying less food, this would be the cheapest diet yet, he adds. In fact, that diet could actually pay you to be on it.
For a rough estimate: The Consumer Expidenture Survey estimates that the average U.S. consumer spends about $50 a week on food. So if you cut your caloric intake by 25 percent, you could be spending about 25 percent less on food in general (if you’re buying less of the same stuff), so you could save $12.50 a week, or $650 a year! If you stick to the plan and lose a pound a week, this works out to being paid $12.50 per pound you lose.
Friday, 12 November 2010
There’s been a lot of debate about mammograms for breast cancer screening, but an even more important health promotion exercise would be for women to everything they can to prevent breast cancer. And now experts are reporting that women can do three things to dramatically reduce their risk of getting breast cancer — especially if they have a strong family history of breast cancer:
- Exercise (20 minutes of heart-rate raising exercise at least five times a week),
- Maintain a healthy weight (BMI of 18.5 to under 25), and
- Watch alcohol intake (fewer than seven drinks per week).
Here are the details in a report from HealthDay News:
Women who maintain certain “breast-healthy” habits can lower their risk of breast cancer, even if a close relative has had the disease, a new study finds.
Engaging in regular physical activity, maintaining a healthy weight and drinking alcohol in moderation, if at all, was shown in a large study to help protect against breast cancer in postmenopausal women, the researchers said.
“Whether or not you have a family history, the risk of breast cancer was lower for women engaged in these three sets of behavior compared to women who were not,” said study leader Dr. Robert Gramling, associate professor of family medicine at the University of Rochester Medical Center in New York. The study was published in the journal Breast Cancer Research.
Gramling wanted to look at the effects of lifestyle habits on breast cancer risk because he suspects some women with a family history may believe their risk is out of their control.
He analyzed data on U.S. women aged 50 to 79 from the Women’s Health Initiative study starting in 1993. During 5.4 years of follow-up, 1,997 women were diagnosed with invasive breast cancer.
Gramling excluded women with a personal history of breast cancer or with a family history of early-onset cancer (diagnosed before age 45), then observed the impact of the healthy habits.
Excluding those with an early-onset family history makes sense, because a stronger genetic (versus environmental) component is thought to play a role in early-onset, experts say.
Following all three habits reduced the risk of breast cancer for women with and without a late-onset family history. “For women who had a family history and adhered to all these behaviors, about six of every 1,000 women got breast cancer over a year’s time,” he said.
In comparison, about seven of every 1,000 women developed breast cancer each year if they had a late-onset family history and followed none of the behaviors.
Among women without a family history who followed all three habits, about 3.5 of every 1,000 were diagnosed with breast cancer annually, compared to about 4.6 per 1,000 per year for those without a family history who followed none of the habits.
For his study, Gramling considered regular physical activity to be 20 minutes of heart-rate raising exercise at least five times a week. Moderate alcohol intake was defined as fewer than seven drinks a week. A healthy body weight was defined in the standard way, having a body mass index, or BMI, of 18.5 to under 25.
Gramling hopes his research will reverse the thinking of women whose mother or sister had breast cancer who sometimes believe they are doomed to develop the disease, too.
The findings echo what other experts have known, said Dr. Susan Gapstur, vice president of the epidemiology research program at the American Cancer Society, who reviewed the study findings.
“The results of this study show that both women with a family history [late-onset] and without will benefit from maintaining a healthy weight and exercising, and consuming lower amounts of alcohol, limiting their alcohol consumption,” she said.
The American Cancer Society guidelines for reducing breast cancer risk include limiting alcohol to no more than a drink a day, maintaining a healthy weight and engaging in 45 to 60 minutes of “intentional physical activity” five or more days a week.
The risk reduction effects found in the Gramling study may actually increase if women follow the more intense exercise guidelines of the ACS, Gapstur said.
To learn more about breast cancer risk factors, visit the American Cancer Society web site here.
Monday, 1 November 2010
Sitting down to eat a real meal three times a day may be a better strategy for weight loss than grazing on several smaller “mini-meals,” new research shows. Here are the details in a report from Reuters Health:
Overweight and obese men on low-calorie, high-protein diets felt more satisfied and less hungry when they ate three times a day compared to when they ate six times a day, Dr. Heather J. Leidy and colleagues from Purdue University in West Lafayette, Indiana, found.
“There’s a lot of lay press about eating frequency,” Leidy, who is now at The University of Missouri in Columbia, told Reuters Health.
While there’s a widespread perception that it’s better to eat little meals more often, she added, “these mini-meals everyone is talking about don’t seem to be as beneficial as far as appetite control.”
Studies on whether eating frequency affects appetite control have had “conflicting” results, she and her colleagues note in the journal Obesity. To investigate further, they randomly assigned 27 men who were overweight or obese to eat either a high-protein diet or a normal-protein diet for 12 weeks.
Diets contained 750 fewer calories than each man needed to maintain his current weight. Starting at week seven of the study, the men either ate their assigned diet in three meals spaced five hours apart, or in six meals eaten every two hours, for three days in a row. The study participants then switched to the other eating pattern for an additional three consecutive days.
Men eating the higher protein diet (25 percent of total calories from protein) felt fuller throughout the day, didn’t want to eat as much late at night, and were less preoccupied with thoughts of food than the men who were consuming 14 percent of their energy as protein. While eating frequency didn’t influence appetite in the men on the normal-protein diet, the researchers did find that men in the high protein group felt fuller in the evening and late at night after eating just three meals a day.
It’s already been established, Leidy said, that high protein diets are better for appetite control. The diet men followed in her study “is not Atkins by any means,” she added. “We very clearly want people to know that this is not an Atkins-style diet. You’re still getting an adequate amount of fiber and fruits and vegetables with these diets.”
Monday, 18 October 2010
A recent Harris Interactive/HealthDay poll found that 30 percent of overweight Americans mistakenly think they’re normal size. Do you think you’re normal weight, overweight, or obese? you might be surprised. You can find out for sure here. In the meantime, here are the details from HealthDay News:
Many Americans have skewed perceptions when it comes to their weight, often believing they are thinner than they really are, even when the scales are shouting otherwise, a new poll finds.
As part of the Harris Interactive/HealthDay survey, respondents were asked to provide their height and weight, from which pollsters calculated their body-mass index (BMI), a ratio of weight to height. Respondents were then asked which category of weight they thought they fell into.
Thirty percent of those in the “overweight” class believed they were actually normal size, while 70 percent of those classified as obese felt they were simply overweight. Among the heaviest group, the morbidly obese, almost 60 percent pegged themselves as obese, while another 39 percent considered themselves merely overweight.
These findings may help to explain why overweight and obesity rates in the United States continue to go up, experts say.
“While there are some people who have body images in line with their actual BMI, for many people they are not, and this may be where part of the problem lies,” said Regina Corso, vice president of Harris Poll Solutions. “If they do not recognize the problem or don’t recognize the severity of the problem, they are less likely to do something about it.”
And that means that obesity may be becoming the new norm, raising the specter of increasing rates of health threats such as diabetes, heart disease and certain cancers.
“I think too many people are unsure of what they should actually weigh,” said Keri Gans, a registered dietician and spokeswoman for the American Dietetic Association. “For many, they have grown up in a culture were most people are overweight and that is the norm, or they have been surrounded by too many celebrities and fashion in the media and think very thin is the norm.”
According to the U.S. Centers for Disease Control and Prevention, 34 percent of adults aged 20 and older are obese, and 34 percent are overweight. Among children, 18 percent of teens aged 12 to 19 are obese, 20 percent of children aged 6 to 11 are obese, as are 10 percent of kids aged 2 to 5.
Most respondents to the poll who felt they were heavier than they should be blamed sloth, rather than poor eating habits, for their predicament.
“In the mindset of most Americans, they’re not looking at this as a food problem as much as an exercise problem,” Corso said.
According to the poll, 52 percent of overweight people and 75 percent of both the obese and morbidly obese felt they didn’t exercise enough.
“We’re seeing the couch potato stigma [syndrome],” Corso said. “Three out of five Americans overall are saying they don’t exercise as much as they should.”
Added Gans: “It is sad that 59 percent of people who responded know they should be getting more exercise but yet aren’t. Maybe they set the bar too high and forget that simply walking counts as exercise.”
Food appeared to be a lesser culprit than lack of exercise in people’s minds, with 36 percent of overweight respondents, 48 percent of obese respondents and 27 percent of those morbidly obese feeling they ate more than they “should in general.”
A third of overweight people, 55 percent of obese people and 59 percent of morbidly obese people felt they ate too much of the wrong types of food.
As for weight-loss interventions, the respondents deemed surgery the most effective method, followed by prescription drugs, then drugs and diet-food supplements obtained over-the-counter.
About half felt that procedures such as gastric bypass and stomach stapling were either very or fairly effective in helping people shrink their girth. Faith in these remedies seemed similar, regardless of the respondents’ weight.
“Americans like the quick fix and that’s what they think the surgery is even though there are so many other things” that work, Corso said. “And so many people reverse their own surgery. These numbers are staggering.”
Dr. Mitchell Roslin, chief of obesity surgery at Lenox Hill Hospital in New York City, noted that “when [Dr. Everett Coop, surgeon general in the 1980s] wrote ‘Shape Up America,’ he said the biggest health problem facing America was not AIDS, not cancer, it’s obesity and a sedentary lifestyle. Since then … we’ve seen nothing but a rise in obesity despite all of these efforts that have gone on now since the 1980s.”
“The American public knows this but it’s hard and it’s something that they’re not quite ready to do,” Corso added. “This wake-up call still isn’t ringing as loudly as it could.”
The poll included 2,418 adults (aged 18 and over) who were surveyed online between Aug. 17 and 19.
Friday, 27 August 2010
FOR most of us, the formula for losing weight is a simple one: eat less, exercise more. But humans are anything but simple, and the majority of Americans struggle endlessly with losing pounds and keeping them off. Consuming fewer calories is perhaps the most difficult part of the weight-loss equation; many dieters are daunted by the prospect of tabulating their daily intake. That’s why many experts and consumers are excited about the new weight-loss programs available for iPhone, BlackBerry and other smartphones. Here’s a story from the New York Times on how to do it:
“We really haven’t come up with one good weight-loss solution,” said Dr. James A. Levine, an endocrinologist at the Mayo Clinic. “If we had, everyone would be using it.”
The apps — which are simple, fun and often free — help users track the number of calories and nutrients they consume, as well as the number of calories they burn. Users learn to balance calorie intake and activity in real time. (see my blog, Four Recommended Apps for Losing Weight)
Though there is no data on whether mobile apps are more effective than joining a traditional dieting program (apps are too new for long-term studies), their popularity is telling. Since LoseIt, now one of the most highly rated free apps, hit the iTunes store in November 2008, more than five million people have downloaded the program.
“We’re linking weight loss to the coolest gadgets in the world,” said Dr. Levine, who helped develop the Walk n’ Play app, which calculates the total calories one burns each day.
Dennis Dodge, 67, and his wife, Carolyn, 68, recently started using LoseIt to shed weight and control their diabetes. The retired couple, who live in Hampden, Me., tapped their age, weight and goals into their iPod Touches, and the app told them how many calories they should eat each day. Every day they record what they eat and how much they exercise.
The couple, who are using LoseIt as part of a diabetes program run by a local hospital, said they were intimidated at first by the technology but had found the app remarkably easy and even fun to use. “I am now more cognizant of my habits,” Mr. Dodge said.
Mrs. Dodge added: “With other diets you follow their regimen. With this, you set your own goal.”
When you track calories closely, you lose more weight, said Dr. Lawrence Cheskin, associate professor of health, behavior and society at Johns Hopkins Bloomberg School of Public Health. But dieters who simply write down their intake at the end of each day tend to underestimate the calories they have consumed (call it wishful thinking).
The beauty of mobile apps is that they work in real time. You eat lunch and immediately log in your meal on your phone. The apps rely on databases to record the calorie counts of thousands of foods, whether a single item like an apple or a prepared meal like a sub sandwich, which takes the guesswork out of totaling calories.
Weight-loss experts are hopeful that apps will help turn chronic dieters into healthy eaters. If you’re looking at a menu wondering whether to order pasta primavera or a Caesar salad, an app can tell you on the spot which option has fewer calories.
Over time, this information becomes part of your own internal database and, the thought is, dieters begin to make healthier choices.
Dana Green, a diabetes specialist at St. Joseph Healthcare Diabetes Institute of Behavioral Medicine in Bangor, Me., has been testing the LoseIt program with a small group of his patients, including the Dodges. Since April, almost all of the 17 patients, ranging in age from 48 to 76, have lost weight and lowered their blood sugar. One man lost six pounds; two of the women in the program were able to reduce their insulin intake by 20 percent, Mr. Green said.
“Patients begin to see their patterns and habits and so make better decisions,” he said. “I’m extremely optimistic.”
With mobile apps, dieters also can better visualize the relationship between exercise and eating. A 30-minute walk burns about 100 calories, they learn, while jogging for the same time at 6 miles per hour burns four times that.
When the user realizes she’s almost hit her daily calorie limit, she can opt to go to the gym — or to eat carrots for dinner. “We’re teaching people to think like economic consumers,” says Charles Teague, the chief executive of FitNow, which produces LoseIt.
If want to give a weight-loss app a try, there are a few things to bear in mind before you get started.
A HUMAN PERSPECTIVE
It is always a good idea to check with your doctor before beginning a weight-loss plan. Your primary care physician can help you set reasonable goals and also take a look at the app you’ve chosen to make sure it seems legitimate and reasonable.
“Apps are not regulated,” said Dr. Joseph Kim, founder of the Medical Smartphones blog. “There is no certification process to vet which weight-loss apps are better than others.”
Opt for an app that is basic and intuitive. “The interactive part of these programs is what makes them successful,” said Mr. Green, the diabetes specialist.
Losing weight is hard enough — you don’t also need to contend with a program that has an annoying interface, is slow or too complicated.
SHARE YOUR PROGESS
Some apps, like LoseIt, let you share your dieting progress with friends or other users via Facebook or Twitter. Many apps are linked to Web sites where users can chat on forums and blogs. If human support is important to you, choose an app that has social networking built in.
Not all experts are convinced that will be enough, however. “What we’ve learned over the years is that support from a real human, face-to-face, is essential to keeping weight off over the long term,” said Dr. Cheskin of Johns Hopkins.
“It’s worth trying something new,” he added, “but don’t expect miracles.”
Friday, 27 August 2010
Here are a few well-regarded weight-loss programs to consider, courtesy of a report in the New York Times.
- LOSEIT (iPod Touch, iPad and iPhone; free): Tell the app how much weight you want to lose and how many pounds per week you want to take off, and it calculates the amount of calories you can consume each day. LoseIt has a database of 40,000 food items and can also calculate how many calories your daily exercise burns up.
- CALORIE COUNTER by FatSecret (works on all platforms; free): This program works much like LoseIt. But one advantage is that when you enter your basic information, you can sync up with the FatSecret Web site. The site has forums where users can swap ideas about diets, recipes and working out.
- TAP & TRACK (iPhone, iPod Touch and iPad; $3.99): This app costs $4, but users say it’s worth every penny. The program helps you come up with a daily calorie goal and features a large food and exercise database.
- WEIGHT WATCHERS MOBILE (iPhone, iPod Touch and iPad, BlackBerry and Windows Mobile 6; subscription required): If you already follow Weight Watchers or Weight Watchers Online, consider their app or one that can track the points used in their diets. Free for online subscribers, Weight Watchers Mobile lets you track and calculate points and see your weight loss history.
Wednesday, 25 August 2010
CNN reports, “Overweight women who experience hot flashes — the uncomfortable flushing and sweating spells that accompany menopause — may be able to cool those symptoms by losing weight,” according to a study published in the the Archives of Internal Medicine.
HealthDay explained that study participants “were encouraged to exercise at least 200 minutes a week and reduce caloric intake to 1,200-1,500 calories per day.” Meanwhile, matched controls “received monthly group education classes for the first four months.”
WebMD pointed out that participants all “had a BMI of 25 or higher” at the study’s start.
Six months later, “compared with those in the health education program, women who were in the weight loss program and were bothered by hot flashes had more than twice the odds of reporting a measurable improvement after six months.”
What’s more, those women also lost weight, had a smaller waist size, and a decreased BMI.
Of course, the weight
Friday, 23 July 2010
In a past blog of mine (Partnership Between Family Physicians and Coca-Cola Poses Ethical Problem) I wrote, “What does my national academy of family physicians, the AAFP (American Academy of Family Physicians), and Coca-Cola have in common? The common sense answer should be, ‘Nothing.’ The actual answer is, ‘$500,000.’ Ouch!”
Now, the family medicine professor I featured in the previous blog has written the following to me. I’d be interested in your take, dear reader, on this issue:
As a fellow family physician, I am sure you know about the AAFP’s decision to accept money from Coca Cola to develop “health education materials” regarding beverages, hydration and sweeteners on familydoctor.org.
True to their word, they have done this. What disturbs me most, now, is that the AAFP has allowed Coke to post (an article) The Lowdown about Low Calorie Sweeteners.
This biased monograph does not address the fact that low-calorie beverages, although they may not contribute as much to obesity or tooth decay, nonetheless fill up the stomach, displacing milk and healthier foods in the diet.
There are additional concerns that hyperintensely sweeteners (1000x sweeter than sugar) may alter children’s palates to favor extremely sweet tastes over less sweet (fruit) or unsweet (vegetable) foods.
Thus, even if sweeteners are weight neutral – o even if they promote modest weight loss – o er the long term they may contribute to poor dietary intake.
(Another) interesting factoid is that in rats, saccharine has been shown to be preferred over cocaine even among cocaine addicted rats.
Finally, the monograph is not evidence based, does not include search items; study design evaluation; strength of evidence; or stength of recommendaiton.
Since the AAFP’s own journal (AFP, for which you used to write) now requires this approach in review articles, it borders on shady ethics to for the AAFP to paid off, essentially, to bypass their own standards
Anyway, you can spread these ideas far and wide. Public shame might have a slim chance of working.
John Spangler, MD, MPH
Professor of Family Medicine
Wake Forest University School of Medicine
Friday, 4 June 2010
In my book, SuperSized Kids: How to protect your child from the obesity threat, I discuss the studies showing that if your child is overweight or obese, he or she is significantly more likely to be bullied or to become a bully. Now, a new study has found that being overweight is PRIME factor regardless of race or family income for being bullied. In other words, for kids, a few extra pounds may invite trouble from the schoolyard bully.
HealthDay News reports the details: New research suggests that just being overweight increases the risk of being bullied.
And factors that usually play a role in the risk of being bullied, such as gender, race, and family income levels, don’t seem to matter if you’re overweight — being overweight or obese trumps all those other factors when it comes to aggressive behavior from other children.
The study found that being overweight increased the risk of being the target of bullying by 63 percent.
I have several resources designed to help you prevent or reduce overweight or obesity in your family:
- My book, SuperSized Kids: How to protect your child from the obesity threat. Copies can be ordered at a number of sites online.
- A computer-based tool to assess your family’s diet, activity, and rest habits (SuperSized Kids Quiz) available here at no cost.
- 8-Week Family Fitness Plan (SuperSized Kids 8-Week Plan) available here at no cost. The tool is also available in Spanish here.
Here are more details on the study from HealthDay News:
“One of the reasons we started this study is that obesity is so much more common today. Now that about half of kids are overweight or obese, it doesn’t make you such an outlier anymore, so we thought maybe kids wouldn’t be bullied for being overweight anymore,” said study author Dr. Julie Lumeng, an assistant research scientist at the Center for Human Growth and Development at the University of Michigan in Ann Arbor.
She added that the researchers also hoped they might be able to find some protective factors against being bullied, such as doing well in school.
“What we found, much to our dismay, was that nothing seemed to matter. If you were obese, you were more likely to be bullied, no matter what,” she said.
The study included 821 boys and girls from a nationally representative sample of children selected from 10 sites around the United States. Bullying behaviors were assessed in third, fifth and sixth grades. The youngsters were mostly white, half of them were male and 15 percent were overweight in the third grade.
By sixth grade, teachers reported that 34 percent of the study children had been bullied, and mothers reported that 45 percent of the children had been bullied, while 25 percent of the children themselves said they had been bullied.
Previous research has shown that boys, minorities and children from low-income groups are more likely to be bullied, so the researchers took these factors into account to see if they made a difference. The study authors also considered a child’s social skills and academic achievement in their analysis.
“No matter how much we retested, the findings were very robust. Obese kids are more likely to be bullied,” said Lumeng.
She said that one of the reasons she believes the findings were so consistent is that prejudice against overweight or obese people is “so pervasive that it’s acceptable.” But, she added, “Obesity is really complex. It’s not all about willpower. It’s a brain-based disorder, and I hope that message becomes clearer.”
Dana Rofey, an assistant professor with the Weight Management and Wellness Center at Children’s Hospital of Pittsburgh, said she wasn’t surprised by the findings. “Bullying is the most common psychosocial complaint that our patients present with,” she said.
“For parents and pediatricians, one of the issues our study raises is that if you’re caring for a child who’s overweight, you need to be alert to this and you might want to gently bring it up with the child. Ask, ‘How are things at school going?’ or ‘Does anyone ever say something that makes you feel bad?’ because this may be an issue that’s difficult for kids to bring up,” said Lumeng.
If your child lets you know that he or she is being bullied, Lumeng said your first response should be to validate your child’s feelings and let them know that it’s not OK for someone to treat them like that.
What to do next can be tricky, agreed both experts.
“Be supportive, and let your child know that you’ll help them. Consult with your child and ask how he or she would like you to get involved,” advised Rofey. Many youngsters may ask their parents to take a hands-off approach, she said. But she recommends setting some guidelines. “Say something like, ‘It seems you have this under control right now, but let’s keep talking and checking in about it.’”
Rofey also recommends teaching your child how to avoid situations that might lead to teasing or bullying, and talking with your child about how to reach out to adults if they need to. Depending on the situation, she said that parents may need to step in and advocate for their children at the school. But, she advised always letting your children know what steps you’ll be taking.
Friday, 15 January 2010
Irvingia gabonensis is becoming a popular natural ingredient for weight loss. It is now showing up in several weight loss products such as Integra Lean Irvingia, Vitagetics Vita Lean, Dr. Sears Private Label Primal Force Primal Lean, and others. But, does it work, and is it safe?
Irvingia gabonensis, also known as “African mango” or “bush mango,” is a tree from Africa that produces a mango-like fruit. The seeds have high soluble fiber content and function as a bulk-forming laxative.
According to the Natural Medicines Comprehensive Database (NMCD, one of my most favorite web sites for trustworthy information on herbs, vitamins, and supplements), there is some research that suggests that a seed extract from the plant reduces the accumulation of fat in fat cells called adipocytes.
Clinical research shows that taking a standardized seed extract, (IGOB131) 150 mg twice daily for 10 weeks, reduces weight by about 13 kilograms compared to 0.7 kilograms in overweight patients taking placebo.
According to the NMCD, “this is promising, but very preliminary. More evidence is needed about long-term safety and effectiveness.”
Wednesday, 6 January 2010
As soon as the holiday goodies are gone, people begin to try various products to try to lose weight. Why? Because most of us gain weight over the holidays.
So, pharmacies report a run on the over-the-counter (OTC) weight loss products. However, people typically lose just 5 to 10 pounds in a year with OTC orlistat (Alli, etc), or even with prescription sibutramine (Meridia) … phentermine … or diethylpropion. And, there are new concerns about increased cardiac risk with sibutramine … possibly due to increased blood pressure and pulse.
So many people are looking for new options. Here’s a brief review of these products by the experts at the Natural Medicines Comprehensive Database – an evidence-based source of information I’ve frequently recommended to you:
Human chorionic gonadotropin (HCG, Pregnyl, etc).
Proponents say this pregnancy hormone and fertility drug redistributes fat … decreases hunger … and improves mood in women. But there’s NO proof to these claims. Any weight loss is likely from the low-calorie diet that’s used with HCG. This diet was debunked by excellent research a long time ago. Read my blog on the HCG diet here.
Byetta (exenatide) and Symlin (pramlintide).
Diabetes patients on these prescription medications can lose 4 to 5 pounds … and sometimes much more. Now these drugs are being tested to see if they can help patients WITHOUT diabetes lose weight. But, I wouldn’t try these drugs just yet. It’s too soon to say whether it’s safe.
Many people are tempted to take thyroid hormone to boost their metabolism … but this isn’t safe – and can be dangerous – even life threatening. Too much can lead to heart palpitations, bone loss, heart attack, etc. I also recommend staying away from “thyroid booster” supplements that contain iodine, kelp, or animal glands.
New combos in the pipeline.
- These contain phentermine or bupropion which are already used for weight loss … plus a second drug to try to enhance the effect.
- Qnexa (phentermine/topiramate SR) uses topiramate to further decrease appetite …
- Empatic (bupropion SR/zonisamide SR) adds the anticonvulsant zonisamide … and
- Contrave (bupropion SR/naltrexone SR) will add naltrexone to decrease cravings.
Don’t jump on these bandwagons … at least until we know more.
Sensa (maltodextrin plus flavorings).
Sensa claims to trick the body into thinking it’s full … by intensifying flavor when it’s sprinkled onto food. But there’s no reliable evidence it works. For now, I’m telling patients to save their $60/month.
Unfortunately, no current supplement is a magic bullet for weight loss. But, we still have the three techniques that seem to work for most people who apply them wisely and consistently:
- Good nutrition,
- Good exercise, and
- A good night’s sleep.
You can learn more about making health decisions about diet, exercise, and sleep in my books:
Wednesday, 25 November 2009
According to a report from Fox News, “The food at movie theaters is scarier than ‘Nightmare on Elm Street,’ a frightening new study reveals.”
The double-features of artery-clogging tubs of fatty-fried popcorn and sugary, super-sized drinks — not to mention high-calorie candy — is nothing short of a health hazard, according to a study from the Center for Science in the Public Interest called, “‘Two Thumbs Down’ for Movie Theater Popcorn.”
The CSPI sent food from three national theater chains to a lab and found they may have to soon start installing extra-wide seats.
The worst offender, the study found, was Regal Cinemas, where a medium popcorn contains 1,200 calories oozing with coconut oil and saturated fat.
The lab calorie counts were higher than claimed by Regal. The company said its medium popcorn has 720 calories.
“Oh, well. What’s an extra 200 to 500 calories when your snack hovers around the 1,000 calorie mark? They don’t call them tubs for nothing,” the study said.
The analysis doesn’t include the buttery-like soybean oil topping that packs on an additional 200 calories. A medium, 44-ounce soda at Regal includes 400 calories and 26 teaspoons of sugar.
A medium popcorn and soda pack on 1,610 calories. That’s like eating six scrambled eggs with cheddar cheese, four bacon strips and four sausage links.
“Suggestion: Move your cardiologist’s phone number to your speed-dial before the lights go down,” said Jayne Hurley, the group’s senior nutritionist.
My suggestion? Just bring healthy snacks from home and enjoy them as you enjoy the movie.
Monday, 23 November 2009
What does my national academy of family physicians, the AAFP (American Academy of Family Physicians) and Coca-Cola have in common? The common sense answer should be, “Nothing.” The actual answer is, “$500,000.” Ouch!
Here’s the story and an opinion about this type of relationship from a family physician that was posted on the ABC News web site:
In theory, this program seeks “to develop robust new programs and educational materials” to help patients and health care providers make “better choices … to achieve a healthy lifestyle.”
According to its Consumer Alliance Web site, the Academy recognizes the “significant influence” that corporations have over consumer choices in seeking to make decisions about diet and other health behaviors.
The chief scientific and regulatory officer of the Coca-Cola Company stated that “[o]ur partnership [with AAFP and FamilyDoctor.org] will help provide Americans with credible information on beverages and enable consumers to make informed decisions about what they drink based on individual need.”
It is hard for me, as a family physician, to see the “individual need” to drink high fructose corn syrup. This might be an individual desire. It might be an individual choice. But there is no “need” here.
The Academy proudly presents its “Sweetener Education Program” using language eerily similar to Coca-Cola’s: “to help consumers make informed decisions about certain natural and artificial sweeteners.”
Contrary to what Coke and the AAFP contend, the “informed decision” seems pretty straightforward.
According to a study by the University of North Carolina in 2004, high fructose corn syrup alters the body metabolism in such a way as to increase weight relative to other sugars.
Based on this type of evidence, the American Heart Association put out a statement in September noting that intake of all types of sugars has increased dramatically over the past decade. Consumption is 22 teaspoons per day on average, and a whopping 34 teaspoons per day among adolescents.
For adolescents, that’s 170 grams — 6 ounces — or about ¾ of a cup! Can you imagine sitting down and eating, teaspoon by teaspoon, all that sugar?
The AHA recommends that calories from sugar intake by Americans be cut down by 70 percent. In addition to these studies, however, there is the very real epidemic of overweight and obesity in the United States. According to a report by the Centers for Disease Control and Prevention, one-third of American adults are overweight, one-third are obese, and 6 percent are very obese.
The CDC has an astounding graphic depicting state-by-state and year-by-year how overweight and obesity have increased over the past decade.
Indeed, excess weight is now the second leading cause of preventable death in the United States, responsible for approximately 300,000 deaths — or 17 percent of all deaths according to a report in JAMA.
In this context, I am extremely disappointed in the American Academy of Family Physician’s decision to accept funding from Coca-Cola to help patients “make informed decisions … about sweeteners.”
As if there were a decision to make.
Americans must cut down on sugar intake, especially high fructose corn syrup sweeteners found in soft drinks. I am a family physician and counsel my patients daily about diet, exercise and weight management. My Academy’s decision to partner with Coca-Cola sends exactly the wrong message to my patients at exactly the wrong time.
I have also received funding from the National Cancer Institute to train medical students in weight management counseling. So I know firsthand, how little we as physicians know about diet and exercise — and how to counsel patients regarding these health behaviors.
It does not help me as a teacher of family medicine to have Coca-Cola as the resource of health information for both patients and family doctors.
Many of us in family medicine feel we cannot defend this situation. In fact, a good number of family physicians have quit the Academy because of this decision.
If you struggle with your weight,
- try cutting out about 500 calories a day.
- Increase your physical activity; walking is an excellent choice.
- The CDC has excellent resources to help you make the “informed decisions” you need to make in order to control your weight.
- You do not have to starve yourself or train for a triathlon to be healthy.
But it would definitely help to cut out soft drinks.
And it would help if the American Academy of Family Physicians to give the $500,000 donation back in recognition of the terrible health message this sends to our nation.
Forgoing that money would be an excellent informed decision, indeed.
Monday, 7 September 2009
Late-night snacks or after dark refrigerator raids may have worse consequences than heartburn.
Monday, 31 August 2009
In my newest book, 10 Essentials of Happy, Healthy People, I teach people how to utilize the ten essentials that are necessary to live a happy and highly healthy life. Under The Essential of Self-Care, I’ve developed a list of what I call “The 10 Commandments of Preventive Medicine.” Here’s the second installment of this ten-part series.
Friday, 3 July 2009
As we head into the July 4th holiday weekend, readers may not be thinking too much about their waist circumference or those excess pounds. But, given a recent report showing that the number of overweight and obese people in the United States is soaring, I’ve found some good news for those who are just a few pounds overweight.