Tag Archives: weight loss

Diet, weight loss reduce knee joint pain in osteoarthritis patients

HealthDay reports, “A diet consisting of eight weeks of protein shakes and soup followed by adding low-calorie, high-protein foods can help people with knee osteoarthritis (knee OA) lose weight, which may lessen joint pain and improve their quality of life,” according to a study in the European Journal of Clinical Nutrition. Continue reading

Some women still using dangerous weight-loss supplements

One of the most potentially dangerous category of supplements to take, at least in the U.S., is the category of weight loss supplements. Now there’s news that an over-the-counter diet pill and tea that were banned from the market nearly two years ago because of contamination with dangerous chemicals remain widely available. Continue reading

Less stress and more sleep may help you lose weight

If you or someone you love is overweight or obese, here’s some good news on a couple of other ways (other than better nutrition and exercise) you could consider to lose weight. The Los Angeles Times “Booster Shots” reported, “Getting a healthy amount of sleep, avoiding stress, and complying with specific elements of a weight-loss plan (such as keeping a food diary) seem to boost the odds of” losing weight.” Continue reading

Comparing Weight Loss Plans, Dollars Per Pound

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:

  1. $500 per pound with Liposuction
  2. $300 to $400 per pound with Gastric Band Surgery
  3. $235 to $353 per pound with Duodenal Switch Surgery
  4. $237.56 per pound with One-on-One with Jenny Craig
  5. $173 per pound with Non-prescription Weigh Loss Aids when paired with a Low-Fat Diet
  6. 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.

Three Healthy Habits Cut Breast Cancer Risk, Study Finds

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.

8 Tips for Eating Healthy During Menopause

Good news! Aging does not have to equal weight gain. Women do tend to put on a pound a year in their 40s and 50s, but it’s more likely due to a drop in activity rather than hormones. However, hormonal changes can shift your body composition, so any pounds you do gain tend to land in your middle. Here are some tips from Rachel Meltzer Warren, MS, RD, that were first published on Health.com:

Here are some ways to stay slim, reduce menopausal symptoms, and cut the health risks that can rise after menopause.

1) Go fish

Heart disease risk is likely to rise after menopause, so you should try to eat at least two servings of fish per week (preferably those with healthy fats like salmon or trout).

“Women may want to give [fish oil] supplements a try if having two servings of fish a week is problematic,” says JoAnn Manson, MD, chief of preventive medicine at Brigham and Women’s Hospital, in Boston.

Preliminary research suggests that fish oil may also help prevent breast cancer.

Aim for two servings of fish a week—and talk to your doctor about whether or not you should try a supplement.

2) Slim down

If you’re overweight you can minimize menopausal symptoms and reduce the long-term risks of declining hormones by losing weight, says Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology, and reproductive sciences at Yale University School of Medicine, in New Haven, Conn.

Slimming down not only reduces the risks of heart disease and breast cancer, both of which go up after menopause, says Dr. Minkin, but new research shows that it may also help obese or overweight women cut down on hot flashes.

3) Bone up on calcium

Your calcium needs go up after age 50, from 1,000 milligrams per day to 1,200 mg. “With less estrogen on board, your bones don’t absorb calcium as well,” says Dr. Minkin.

If you have a cup of low-fat milk, one latte, and one 8-ounce yogurt, you’re getting around 1,100 mg calcium. This means you need to take only an additional 100 mg of supplements a day—less than one caplet’s worth—to make up the difference.

If you’re eating dairy, choose low-fat products. These have roughly the same amount of calcium as their full-fat counterparts, but with fewer calories.

4) Ease bloating

“About 100% of my patients going through menopause complain of bloating,” says Dr. Minkin. Although the reasons aren’t clear, fluctuating hormones during perimenopause may play a role.

Dr. Minkin recommends cutting the amount of salt and processed carbohydrates in your diet, as they can make you retain water. But don’t skimp on whole grains, which are rich in heart-healthy fiber, as well as fruits and vegetables.

If healthy food, such as apples and broccoli, make you feel bloated, Dr. Minkin suggests taking Mylanta or Gas-X to combat gas buildup.

5) Rethink that drink

Red wine gets a lot of press for its impact on heart health, but for menopausal women the drawbacks of alcohol might outweigh the benefits.

“One drink a day has been linked to an increased risk of breast cancer,” says Dr. Manson. “So while it has been linked to a reduced risk of heart disease, it really is a trade-off for women.”

If you enjoy a glass of Pinot, try watering it down with seltzer to make a spritzer (you’ll cut calories too). Also keep in mind that red wine and other drinks may bring on hot flashes as a result of the increase in blood-vessel dilation caused by alcohol.

6) Say yes to soy

Soy contains plant estrogens, so many women think it can increase their breast cancer risk, says Dr. Minkin. However, there is little data to support this. The misconception likely comes from studies of high-dose soy supplements, which may stimulate the growth of estrogen-sensitive tumors.

Soy foods like tofu, soy nuts, and soy milk may offer relief from mild hot flashes and are not thought to increase breast cancer risk. “Women in Japan have the highest soy intake and the lowest risk of breast cancer, but Japanese women who move to the U.S. and eat less soy have a higher risk,” adds Dr. Minkin.

7) Try iced herbal tea

A warm cup of joe might be as much a part of your a.m. routine as brushing your teeth. Still, starting your day with a piping-hot drink may not be the best idea during menopause.

“In general, warm beverages seem to trigger hot flashes,” says Dr. Manson. “And the caffeine in coffee and tea could also be having an effect.”

Cover your bases by swapping your morning cup with something cool and decaffeinated—like a Tazo Shaken Iced Passion Tea at Starbucks or a decaf iced coffee.

8) Find a diet that fits

If you need to shed pounds, weight loss is no different during menopause than before it. “If you take in less calories than you burn for a long period of time, you’re going to lose weight,” says Dr. Minkin.

Any balanced diet that cuts calories—and that you can stick with in the long run—will do the job.

However, one study found that postmenopausal women who were on a diet that was low in fat and high in carbohydrates from vegetables, fruits, and grain were less likely to gain weight than women who ate more fat. Consider the new CarbLovers Diet which is rich in whole grains and other figure-friendly foods.

Three Meals A Day May Beat ‘Mini-meals’ For Weight Loss

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.”

Losing Weight the Smartphone Way, With a Nutritionist in Your Pocket

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.


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.


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.”

Four Recommended Apps for Losing Weight

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.

Women interested in preventing age-related weight gain should take up biking or walking

USA Today reports, “Women who want to prevent weight gain as they age should hop on a bike or take a brisk walk,” discoveries that add “to mounting evidence of the importance of moderate to vigorous exercise for weight control.”

Those who participated in the Harvard study “gained an average of 20½ pounds over 16 years,” but “those who regularly biked or walked briskly were less likely to gain as much.”

The “findings are based on the second Harvard Nurses’ Health Study, which is tracking 116,608 female nurses who periodically fill out questionnaires about their health, weight, diet and behavior,” the New York Times Vital Signs reports.

The “new analysis, published in the Archives of Internal Medicine, looked at weight change and behavior from 1989 (when the nurses were 25 to 42 years old) to 2005; to isolate the effects of exercise, the researchers controlled for other obesity risk factors.”

And, of course, losing weight can reduce the hot flashes of menopause as well as cardiovascular risk. It’s a great strategy for becoming both more physically and emotionally healthy.

You can read more about improving your health in my book 10 Essentials of Happy, Healthy People: Becoming and staying highly healthy. Autographed copies are available, along with my other books, here.

Letter from Professor about the Family Physician Academy and Coke

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:

Dear Walt,

Partnership Between Family Physicians and Coca-Cola Poses Ethical Problem

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

Could African Mango Help With Weight Loss?

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.”

The latest drugs and supplements used for weight loss. Are any worth trying?

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.

Thyroid hormone.

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:

How Much Water Per Day Do You Really Need?

This is not an infrequent question for me to be asked. And, a very nice article by Mara Betsch at Health.com will give you the information you need to answer this question for yourself, your family, and your friends:

You’ve heard it before: Drink eight glasses of water a day to keep your body trim, healthy, and happy. Though water is vital in a variety of bodily functions and processes, you may not have to drink as much as you think.

Unlike other vital nutrients, water doesn’t have specific daily requirements. Just like everyone has different caloric needs, a person’s water intake is affected by age, weight, activity level, and environment.

In a report from the Food and Nutrition Board at the Institute of Medicine, the group offers a ballpark estimation:

  • Women should drink approximately 2.7 liters (about 11 cups) and men approximately 3.7 liters (more than 15 cups) of total water a day.

However, the key word in this sentence is total.

In fact, your morning coffee and that Gala apple you packed for lunch can count toward your total. Liquids can include water, juice, milk, plus all of the juicy fruits and veggies you eat each day. Eighty percent of our water intake comes from beverages, but the other 20% comes from food.

Fruits such as strawberries, cantaloupe, and grapefruit, and vegetables such as broccoli, cucumber, and spinach are more than 90% water. Including a lot of fresh produce in your diet will put you closer to your water goals without causing you to constantly circle the water cooler.

And although water is a cheap and calorie-free option, coffee, tea, and even beer and soda can count toward your total. But keep in mind that while you’re getting water in beer, soda, and Frappachinos, you’re also consuming calories and other not-so-nutritious ingredients like refined sugar.

What about water for weight loss?

Plenty of diet books will tell you that guzzling water is the secret to fighting the battle of the bulge. While this may be true, the research often conflicts.

Two studies (one done in 2003 and the other in 2007) showed that consuming lots of water boosted the number of calories burned in a day, and a popular 2008 study published in Obesity suggested that drinking water may lower energy intake or alter metabolism.

However, a 2006 study cast doubt on this theory by showing that water had no effect on energy expenditure. And it can’t be clear if the reason for weight loss can be attributed to drinking less calorie-laden beverages or the water itself.

It is true that certain individuals need more water—some endurance athletes can lose up to three quarts of sweat per hour! So if you are sick, live in a hot or high-altitude environment, have extended sweat sessions at the gym, or are pregnant or breast-feeding, you may have to adjust your fluid intake accordingly.

The bottom line?

Drink plenty of water and other low-calorie, nutritious beverages, eat fresh fruits and veggies, and be sure to rehydrate after trips to the gym or time in the sun. If you do this, chances are you’ll get enough fluids.

Partnership Between Family Physicians and Coca-Cola Poses Ethical Problem

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:

The American Academy of Family Physicians announced this month that it has received a $500,000 donation from Coca-Cola as part of their Consumer Alliance Program.

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.

Study points to chewing gum as weight loss aid

The Washington Post http://www.washingtonpost.com/wp-dyn/content/article/2009/11/10/AR2009111001029.html reports that for anybody trying to lose weight, “taking up gum-chewing might not be a bad idea,” as “there’s actually a bit of scientific evidence showing that chewing gum helps fight fat in a number of ways.”
The research, sponsored by the Wrigley Science Institute, has suggested “that chewing gum may help reduce cravings, particularly for sweet snacks, and spur people to cut their daily intake by about 50 calories.”
The findings were presented at the annual scientific meeting of the Obesity Society last month, and “showed that gum-chewing people consumed 67 fewer calories at lunch and didn’t compensate by eating more later in the day.”

For anybody trying to lose weight, a new report says that “taking up gum-chewing might not be a bad idea,” as “there’s actually a bit of scientific evidence showing that chewing gum helps fight fat in a number of ways.”

The research, sponsored by the Wrigley Science Institute, has suggested “that chewing gum may help reduce cravings, particularly for sweet snacks, and spur people to cut their daily intake by about 50 calories.”

According to a report in the Washington Post, the findings were presented at the annual scientific meeting of the Obesity Society last month, and “showed that gum-chewing people consumed 67 fewer calories at lunch and didn’t compensate by eating more later in the day.”

Although I’m always skeptical about research on gum financed by a gum manufacturer, this is an inexpensive intervention and may be worthy of considering. Just be sure to throw your gum away in a trash can when you’re done!

HCG injections and diet for weight loss discredited long ago

I’ve just completed a three week road trip, speaking dozens of times to doctor and student groups in Michigan and Oklahoma. A question that came up several times was what I thought about HCG injections and the “HCG diet” for weight loss. I promised the doctors I’d do a blog on the topic, so, here it is. Continue reading

Acai Berry Supplements. Super fruit or super rip off?

A reader wrote, “I would like to see Dr. Walt do a blog topic on the claimed health benefits, to include weight loss, from taking Acai Berry supplements. There seems to be a lot of controversy and confusion about the Acai berry and it would be helpful to get Dr. Walt’s unbiased opinion.” Here it is: Continue reading

Federal health officials target sugary drinks as largest driver of obesity epidemic

The Boston Globe is reporting that, according to federal disease investigators, “the cost of treating obesity has doubled in the past decade,” and “sugar-laden beverages” are “a prime culprit.” So, what’s this mean to you? Could this story lead to a “first step” for you and your family to lose weight?

More Information: Continue reading

Vibrate yourself to a leaner, healthier you

Reuters Health is reporting  that vibrating exercise platforms, which are increasingly found in commercial gyms in Europe and elsewhere, may indeed help people lose a particularly harmful deep “hidden” fat that surrounds the abdominal organs and is linked to type 2 diabetes, high blood pressure, and heart disease.

More Information: Continue reading

Study indicates cutting calories may help people lose weight regardless of diet

A new study confirms that the type of diet you pick doesn’t matter so much for weight loss; it’s sticking to it that counts.  Researchers compared a low-fat, average protein diet, a low-fat, high protein diet, a high-fat, average protein diet, and a high-fat, high protein diet in 811 middle-aged obese people.  They found that, despite different diets, the groups lost pretty much the same amount of weight (average 13 lbs after 1 year) and slowly started gaining again in the second year.  Risk factors for heart disease improved for all diet groups.

More Information: Continue reading

5 Ways to Avoid Winter Weight Gain

The weather is getting cooler and the days are getting shorter. As seasonal changes begin, it’s easy for people to get into a rut when it comes to dieting and exercise. And that rut can translate into extra pounds once the holiday parties start rolling around.

My Recommendations: Continue reading

Red yeast rice, fish oil fight high cholesterol

Reuters Health is reporting new research showing that a regimen of supplements and lifestyle coaching is just as effective as a statin medication for reducing levels of low-density lipoprotein (LDL) or “lethal” cholesterol. Not only that, the combination was shown to be more effective in helping people lose weight.

My Take? Continue reading