Health Education: weight loss

Showing posts with label weight loss. Show all posts

Will you really burn off those extra calories?

In a recent Nutrition Notes Daily, published by the American Society for Nutrition, a professor from UCLA School of Medicine was quoted as saying, "it takes a lot of exercise to make up for a little dietary indiscretion."   A vast body of research supports his assertion. Even so, many of us believe that an extra 30 minute walk will erase the damage of a 500 calorie donut, piece of cake or holiday cookies.  It is not so.  In this <a href="http://yourhealtheducator.blogspot.com/search?q=METs" target="_blank">past post</a>, I introduced the MET or metabolic equivalent as one way to determine how many calories you might burn doing a certain activity at a certain intensity for a certain amount of time.  For example, I found that I burned less than 500 calories by running at a ten minute per mile pace for just over an hour. In a more recent post, I talked about the belief we have in the self control of our future self.  For example, the belief that tomorrow you will walk twice as long as usual in order to burn off the extra calories you ate today.  Often tomorrow comes and well, its today, so there you are... pinning your hopes on the next tomorrow.  This is especially important from Thanksgiving to New Years.  One or two days of indulgence can be self corrected, four to six weeks of eating more calories than you need, will lead to weight gain and extra weight is hard to lose.  (And when you start seeing weight loss ads in January remember that the only way to lose weight or to maintain a weight that is healthy for you, is to make a change that you can stick with - forever.  A short term plan will get you a short term fix and whatever trick you try will only work as long as you use it.)

Will you really burn off those extra calories?

In a recent Nutrition Notes Daily, published by the American Society for Nutrition, a professor from UCLA School of Medicine was quoted as s...

7:27 PM

A blog post on weight loss worth a share

I read a post today and shared it on Facebook and twitter, but I really like it so I am going to share it here also.    I am familiar with the science and the scientists that this blogger refers to, and I trust her interpretation. I want to add 3 things. <ul><li>Exercise, as I say every chance I get, is essential for good health. One cannot live well without it - and just like medicine, it only works when you 'take it' and you should 'take it' every day.</li><li>Pay attention to tip number 5.  They are talking about Volumetrics and my personal style of eating (but they don't call it that or refer to me!!}.   Note that there is evidence that what you eat matters to your overall health, if not your waistline.</li><li>Remember, science is not about facts.  We observe, test, interpret and trust the evidence that we have today.  Someone can observe something different tomorrow.  Science is supposed to be a work in progress, and it is.</li></ul><div>Review the post on weight loss tips that are supported by science written by Alice G. Walton <a href="http://www.forbes.com/sites/alicegwalton/2013/09/04/the-6-weight-loss-tips-that-science-actually-knows-work/">HERE.</a></div> PS< I am still here!  My dissertation writing is the most insane hardest thing I may have ever done (to be fair, I collected and analyzed my own data  - twice (2 studies) (but can you believe I lack skill in making written arguments!)... anyways, I will be back, sporadically at first and more consistently in the future.

A blog post on weight loss worth a share

I read a post today and shared it on Facebook and twitter, but I really like it so I am going to share it here also. I am familiar with t...

4:55 PM

Fat in food vs Fat on your body

I was frustrated by the research study on M&Ms. I was frustrated because it is 2013 and I thought we had learned that low fat is not the answer to our collective weight problem.    Studies that continue to focus on promoting low fat choices add to the confusion. As someone who has expertise in public health nutrition, health education and health promotion, I must try to clear this up.     Fat in food does not equal fat on your body.    Too many calories from any source does. When a person regularly consumes more calories than their body needs, the extra is stored as body fat.  (Note: Over indulging every weekend is regularly consuming too much.)  There are ways to increase your intake to build lean body mass but that is not the focus here. YES it is true that there are more calories in a gram of fat than there are in a gram of carbohydrate, protein or alcohol.   (9,4,4,7)   YES it is true that some foods are more nutritious than other foods.  It is recommended that we fill our plates with nutrient dense, not energy dense, foods      Foods that are especially important are complex carbohydrates (vegetables and many fruits), whole grains and so called 'healthy' oils or fats (like those in olive oils and salmon). Complex carbohydrates contain phytochemicals, flavinoids, and antioxidants.  These substances have been associated with reduced risk of many chronic diseases. And YES it is true that refined or simple carbs, like sugar, white flour (rice, pasta, bread) baked goods, sugary or starchy fruits with little fiber, and all sugar sweetened beverages have more calories than they do nutrients. AND Yes, it is true that some sources of fat just like some sources of carbs are believed to be harmful. (e.g., red and processed meats are associated with colon cancer).    The reason some foods are calorically (energy) dense is because they are full of sugar or fried in grease.      Too many calories from either  = fat storage.  ********************     And because its politically palatable to promote, physical activity as a solution to the country's obesity 'problem,'  I have to address that too.  Initiatives to build more parks and alert people to "take the stairs" are only going to work (for weight control) if two things happen.  TWO things. 1) people actually start using the stairs and parks, and 2) they stop eating too much It does not matter how many stairs a person climbs (Mayor Bloomberg), if he or she eats more calories than needed - weight loss will not occur if 'we' keep eating too much. There are people (fewer than the drug/genetic companies would have us think) who fall outside these generalities.  In other words, some people do not gain weight no matter how much they eat and others do not lose weight not matter how much they restrict.  These are very unusual people and I suspect you are not one of them.  Disclaimer: I am not a nutritionist or a dietitian who can give individual diet advice.   I share information based on research and public health recommendations. <div> </div>

Fat in food vs Fat on your body

I was frustrated by the research study on M&Ms. I was frustrated because it is 2013 and I thought we had learned that low fat is not...

7:53 PM

Is a cold office the next new diet fad?

A recent study by Chen et al, suggests that a slight decrease in the air temperature increases calorie burn.  See the abstract from the study <a href="http://jcem.endojournals.org/content/early/2013/06/18/jc.2012-4213.short" target="_blank">here</a>. Brief background: Our bodies contain two types of fat - or adipose tissue - brown and white. Brown fat is the kind that keeps us warm and is found in much greater abundance in babies and children than in adults.  It is referred to as BAT sometimes. Adults have small amounts of BAT and when it is activated - to keep us warm - BAT takes its energy from white fat.  White fat is the kind that most of us are trying to lose. In their small experiment, the scientists were able to measure this 'under the skin' BAT activity with a PET scan.  They found that when the temperature was lowered by just a few degrees, the volunteers' brown fat cells went into action.  The volunteers burned more calories (energy) under the lowered temperature than the 'normal' temperature. As a person who never enters a building without a sweater and one who cannot afford to lose any of her white fat, I was not so happy with the authors comment.... <blockquote class="tr_bq">this may represent a novel environmental strategy in obesity treatment.</blockquote> I stay amazed at the lengths people go to in order to lose weight without having to eat less or move more..

Is a cold office the next new diet fad?

A recent study by Chen et al, suggests that a slight decrease in the air temperature increases calorie burn. See the abstract from the stud...

8:29 PM

Does it Matter if you Walk or Run?

Several studies addressing the benefits of both forms of exercise and the comparison between them, were recently noted in a list serv I subscribe to.  The name of the list serv is Obesity and Energetic Offerings.  It provides a weekly list of current research on specific obesity related topics.  If you would like to subscribe, click here <a href="http://www.soph.uab.edu/energetics/subscribe">http://www.soph.uab.edu/energetics/subscribe</a>.    Many people ask me which is better, walking or running.  So I wanted to share the upshot of the recent findings. Which is, it depends on your goal. Is it to maintain your health, your weight, or to lose weight?  Running has been found to be better for weight loss, but there are more things to consider.      Which can you do several times a week?  Which can you do several times a week for ... well .. ever(ish)?     Either activity will improve your health.  Certainly this is so if you are engaging in little to no activity right now.  If your primary goal is weight loss, minute for minute, running burns more calories than walking. It is very important that you consider consistency and frequency.  Whether it is walking or running, the benefit only occurs as long as you keep doing it.  More of either one is better than less.     You might read this and think you should become a runner. Not necessarily so.  If you cannot sustain that vigorous level of activity (for what ever reason (even mental)), than it isn't right for you.    In the end, it is physical activity that matters most for your health.  Yes, I am saying it.  I know is anathema and blaspheme... but it is better to be a little overweight and active than normal weight or low weight and inactive.

Does it Matter if you Walk or Run?

Several studies addressi ng the benefits of both forms of exercise and the comparis on be tween them , were recently noted in a list s e...

7:51 PM

Lipozene is not YOUR solution

Do you want to lose weight or maintain a healthy one?  Monitor your calories and eat a nutritious, plant based diet that is low in energy density, solid fats and added sugars as recommended in the current Dietary Guidelines for Americans.  To lose weight, it is necessary to upset the energy in energy out balance that you currently maintain.  If you can figure out the amount of calories you are consuming on average right now you will know the amount you are currently burning - on average.  Talk to a nutritionist and consider the Weight Watchers program to design a weight loss program to meet your needs. Exercising more than you are now will add a little to the energy expended(used) side, but it takes a lot of effort to burn a few calories from exercise.  Reducing your intake is sometimes easier and quicker.   Get to know calories:   If you understand that a soda has 200 calories, a tablespoon of oil has 120 and whole milk (1 cup =150 cals) and cheese are calorie dense, you can make adjustments that reduce calories without much pain. A great many apps and websites can help you to learn the calorie content of foods.  You do not need to know everything, or count everything, but you must become familiar with the amount of calories in foods because you may be eating much more than you realize.  Soon the calorie labeling law will help you assess your meals away from home.  <a href="http://ndb.nal.usda.gov/ndb/foods/list" target="_blank">Here</a> is the website that I visit the most often. Avoid Gimmicks When ads tell you that you can lose weight without changing anything - it is A LIE.  It is NOT POSSIBLE.  Especially avoid fiber supplements, such as Lipozene.  Though the advertisement states that clinical trials have proved weight loss, no details or publication of this research exists. And if you read the fine print, the average pounds lost in two months is less than 4. Supplements such as this are not regulated by the FDA and we can't judge their safety or efficacy without this protection. In a research review of 14 scientific studies of the main ingredient of Lipozene, glucomannan, the average weight loss was less than 2 pounds.  Yes - it worked, but for how long?  Lipozene pills cost about 60 dollars for a months supply and they are just water soluble fiber tablets.  They make a person feel full but come without the health benefits of fiber that is found in a plant based, whole grain, fruits and vegetable diet. As I researced for this blog, I reviewed the Dietary Guidelines, which recommend at least 25 grams of dietary fiber a day.  I also read this <a href="http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fiber-full-story/index.html" target="_blank">FANTASTIC post</a> on the Harvard Nutrition Source website.  Please read. <table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; text-align: right;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjMdUYb8VFria5uZuiUP-CpVE9MbSOdUoQrCFNg3w6oc2NKD829w0H-kjWUsqFpFvw6Fbso0Rw2mkIMD9enzRLYHJtsAiHjdVbvj_u5J_rUOEsPVl8or3SvFxNqSIuU_IIUf6mQ1Ek7umra/s1600/fiber.JPG" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjMdUYb8VFria5uZuiUP-CpVE9MbSOdUoQrCFNg3w6oc2NKD829w0H-kjWUsqFpFvw6Fbso0Rw2mkIMD9enzRLYHJtsAiHjdVbvj_u5J_rUOEsPVl8or3SvFxNqSIuU_IIUf6mQ1Ek7umra/s640/fiber.JPG" width="200" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">HSPH Nutrition Source. Fiber: Start Roughing It!  Accessed 1-1-2013. www.hsph.harvard.edu </td></tr></tbody></table>To the right is a chart from that website.  It lists the two types of fiber and foods that are good sources of them.  The recommendations for fiber intake do not specify amount by type.  Intuitively, it seems best to have a diet rich in both. Health studies involving fiber sometimes differentiate between the two.  You can learn about disease prevention from fiber intake by clicking on the link provided above.

Lipozene is not YOUR solution

Do you want to lose w eight or maintain a healthy one? Mon itor your calories and eat a nutritious, plant based diet that is low in energ ...

7:32 PM

Myths about snacking

This brief post is my reaction to the worst billboard EVER. The billboard is along a busy multi lane road in Greensboro NC.  It shows a man with an odd look on his face - possibly the ad makers were going for a look of surprise.  The man is only shown from about the chest up.  I have only driven by the billboard a few times and was mainly focused on driving, but I believe the man is at a table and is eating chocolate chip cookies (with a glass of milk).   The caption over the scene of the surprised looking man is, "snacking between meals is guaranteed to lead to weight gain."    NO IT ISN'T.  Eating more calories than one needs to maintain their weight is what leads to weight gain (99% of the time).  It doesn't matter when you eat those calories or what you call them (meals or snacks) - too many calories are too many calories. As far as the quality of calories goes, yes, we are more likely to over consume when foods  are energy dense, like sweets. But it has nothing to do with 'snacking' unless the snacking puts a person over the amount of calories their body needs.    The billboard message I'm highlighting is NOT a public health communication.  It is an advertisement.  It is an ad for a weight loss center.      My research and promotion focus is prevention of overweight and I find a lot of treatment venues to be misleading and in some cases, they promote complete untruths.

Myths about snacking

This brief post is my reac tion to the worst bil lboard EVER. The billboard is along a busy multi lane r oad in Greens boro NC. It shows...

7:00 PM

Excess Body Fat

If you are concerned with excess body fat please consider the quality of your diet, calorie modification and exercise.    The attached article (<a href="http://www.usatoday.com/story/money/2012/12/10/cosmetic-surgery-laws-effect-debated/1759839/" target="_blank">click here</a>) concerns the lack of regulation for cosmetic surgery.  It also highlights adverse consequences because of it.  The article shares serious misfortunes of persons who have had liposuction.       This is not the recommended way to rid yourself of fat.  A health promoting lifestyle is just that - a lifestyle.  It is something you do every day because every day you are worth it. Don't Lipo...

Excess Body Fat

If you are concerned with excess body fat please consider the quality of yo ur diet, calorie m odificati on and exercise. The att ache...

7:09 PM

It's what you eat

I strongly advocate exercise and physical activity for the benefit it provides.  Exercise reduces the incidence of disease, leads to a longer, active life and improves mood.  Even though I do not promote exercise as a means of weight loss, people often ask me what form of exercise (e.g., running vs swimming) is better for burning calories and whether intensity or duration is better.  People are also interested in what type of exercise will burn fat.  I don't have an answer.  Exercise is an important part of a healthy lifestyle.  If a person is really interested in their weight and excess calories - then I suggest they consider what they are eating. A month or so ago, my stance was vindicated in an article about exercise.  A kinesiology professor from McMasters University was asked about High Intensity Interval Training, or HIT.  Someone asked the exercise specialist if HIT was better for losing weight than other forms of exercise and Dr. Gibala replied,  <blockquote class="tr_bq">The main way to lose weight is by what we put in our mouth, not by exercising to burn calories. </blockquote>

It's what you eat

I strongly advocate exercise and physical activity for the benef it i t provides . Exe rcise reduces the incidence of disease, leads to a l...

7:45 PM

Weight Watchers Australia & Access

Weight Watchers International has asked the Australian government to subsidize its program so that more overweight and obese persons can benefit from its evidence based community weight loss program. They are asking for tax dollars to cover most of the 12 week cost  ($202) - the attendee would pay 30 dollars out of pocket.  I certainly support efforts to make this program accessible to more people, but I have an issue.  As is often the case, after we find evidence of an effect (efficacy), an intervention is given to the public under another condition or in a different dose. The real intervention is not replicated, the results are not replicated, and the program itself is found to be ineffective.   That could happen here because the research study which found that Weight Watchers participants lost twice as much weight as similar persons who received assistance from their physician lasted 12 MONTHS not 12 weeks. In addition, I agree with the Obesity Policy Coalition spokesperson, Craig Sinclair, who said that an environmental approach was needed.  The government should consider nutrition labeling laws, limits on junk food advertising and cost supports for healthy foods or increased taxes on junk foods.  YES!

Weight Watchers Australia & Access

W eight Watchers I nternational has asked the Australian g overn ment to subsidi z e its program so that m ore overweight and obese perso n...

6:58 PM

The Best Way to Lose Weight

I want to be sure that I didn't  mislead or confuse you, by referring to this old NHIS question in the last post. In your opinion which of these are the 2 best ways to lose weight <blockquote class="tr_bq"> Eat fewer calories  Take diet pills  Increase physical activity  Eat NO fat  Don't eat at bedtime  Eat grapefruit with each meal</blockquote>My point was to draw your attention to how things have changed in the last 40 years and what we know today. In the above list and in any list, the best way to lose weight is to reduce the number of calories consumed.  You must eat less to lose weight - and not because you took a diet pill or because there was grapefruit on your plate.  Limiting saturated fat is a good idea, avoiding trans fat is important. Including healthy oils from plant and fish sources is essential.  The only right answer in that list was related to calories.  BTW, the body doesn't know what time you eat.  But about the physical activity: A person who is physically active is less likely to become overweight than a person who is inactive.  A person who is physically active is more likely to keep lost weight from returning than someone who does not engage in physical activity. A person who meets the recommended levels of physical activity is less likely to die from any cause (over a set time period) than those who do not.  People who exercise regularly are also less likely to become ill from heart disease and some cancers.

The Best Way to Lose Weight

I want to be sure that I didn't mislead or confuse you, by referring to this old NHIS question in the last post. In your opinion which ...

7:22 PM

NHIS in the 1960s

Yes its me again.  I have not been searching for blog topics but in my studies today I came across some old health reports that I just have to share.      I have introduced you to the National Health Information Survey and shared a few of the reports with you.  I did not realize until today that the survey has been in place since the 1960s.  Most of the first surveys had to do with illness and medical treatment.     I was browsing the National Center for Health Statistics website looking for early reports of physical activity.  They did not begin until 1985.      I did open up a few documents from 1964-65 and copied these two gems for you:   A data report from the 1960s..... <blockquote class="tr_bq">Fifty percent of young mothers, 18-24 years of age, with less than 12 years of education had smoked in the year preceding the birth of their last child.</blockquote>A sample question from one of the NHIS in the 60s.  In your opinion which of these are the 2 best ways to lose weight <blockquote class="tr_bq"> Eat fewer calories  Take diet pills  Increase physical activity  Eat NO fat  Don't eat at bedtime  Eat grapefruit with each meal</blockquote> Go to the website and scroll to the very bottom to get to the old reports... the questions they asked and the answers received are illuminating.  Click <a href="http://www.cdc.gov/nchs/products/series/series10.htm" target="_blank">HERE</a>

NHIS in the 1960s

Yes its me again. I have not been searching for blog topics but in my studies today I came across some old health reports that I just h...

7:14 PM

Why I Keep Loving Weight Watchers

The first page of the search results below will link you to 4 previous posts that address the importance of moving your body (being active) throughout every day.    I am very passionate about this health behavior.  The upshot is that sitting for more than one hour at a time, no matter how active you are otherwise, no matter what you weigh, is linked to higher rates of several diseases (e.g. heart disease, diabetes), disease risk factors (e.g. abnormal blood sugars, high blood pressure) and all causes of death (all cause mortality).  The amount of increased risk is different based on your general health, weight and exercise level but extended periods of sitting are bad for everyone.      Remember when I taught my first college under grad course last fall?  On the first day of class (they were 3 hour classes) I explained this sitting/disease risk to the students.  Then I made sure that we always took two stand up and move breaks every class - even when we had guest speakers. {traditionally three hour classes contain one 15 minute break}  If the only thing my students took away from class was the need to limit sitting time - I have done them a very big favor.    That brings me to Weight Watchers.  The program is also doing their customers a very big favor.  My sister, who is a successful loser/maintainer (almost 5 years now) attends Weight Watchers - more to support others than herself, I think.  Today she told me that her meeting leader gave a great, graphical presentation on this very topic.  And as is true, the leader emphasized that the "not sitting" is important for HEALTH above and beyond anything it might do for calorie burn or weight.  To be clear, sitting doesn't make you fat.  Eating more food than your body needs is the cause of weight gain.  Sitting DOES make you unhealthy if you do a lot of it.  We are learning that a lot doesn't mean the number of hours you sit in a day, but the number of minutes you go without standing.   Search Results on Sitting from this blog, with research links.  <a href="http://yourhealtheducator.blogspot.com/#uds-search-results" target="_blank">HERE</a>

Why I Keep Loving Weight Watchers

The first page of the search results below will link you to 4 previous posts that address the importance of moving your body (being acti...

7:23 PM

Self-Monitoring and Weight Loss

I have reviewed the following three research articles, one of which I have read several times because I am critiquing the study for a class assignment.  One of the articles refers to a main clinical weight loss trial that is called PREFER, another refers to a specific study on self monitoring as part of that trial and a third used interviews with select participants after the first two parts were complete.  It is the last one that I am reviewing for class.  Both ancillary studies are of interest to many of you, I would suspect.  They are also entwined. The rationale for self monitoring of meals,(calories and fat content) and of exercise is provided in the studies. The major study used education, monitoring and group support as the factors involved in weight loss.  The smaller study involved reflections of keeping a food diary. The main points to share, with the limited time that I have, follow: There are certain characteristics that people who adhere to self monitoring share.   When self-monitoring is consistent, complete and timely it usually correlates to weight loss.  This reminds me of my sister's friend who I mentioned before - every bite, lick and taste.  It is important to get everything but also to record the meals in real time.  Successful losers record on the same day that the intake occurs and within minutes of consumption.  It makes sense.  If you wait until the end of the day, the ability to see and attend to over consumption will be lost.  Persons who keep their record and make the connections between too many calories and weight gain are also more likely to be successful weight losers. In the article, there were quotations of persons who were astonished about the amount of calories they had been consuming.  I think that this is very important and is related to the passive over consumption that I have mentioned lately. Persons who self monitor, make connections and lose weight are rewarded with increased self-efficacy.  This self-efficacy is empowering and leads to long term monitoring adherence.  Successful loser/maintainers may not continue to keep food diaries into perpetuity, though some do, but, they employ the strategy at times, or as needed.   Successful self-monitors also use the information to plan ahead.  They aim to eat a certain amount of calories a day and if they are like me, they like to eat many times a day.   It is this planning that leads the weight loser to decline more caloric foods that they might be offered throughout the day (you know from the food pushers :)).   Other identified components of success included group support, support from spouses (which was hard to come by) and not having been in numerous weight loss programs prior to the study. <div style="margin-left: .5in; text-indent: -.5in;"> Burke, L. E., Choo, J., Music, E., Warziski, M., Styn, M. A., Kim, Y., & Sevick, M. A. (2006). PREFER study: a randomized clinical trial testing treatment preference and two dietary options in behavioral weight management--rationale, design and baseline characteristics Contemp Clin Trials (Vol. 27, pp. 34-48). United States.</div> <div style="margin-left: .5in; text-indent: -.5in;"> Burke, L. E., Sereika, S. M., Music, E., Warziski, M., Styn, M. A., & Stone, A. (2008). Using instrumented paper diaries to document self-monitoring patterns in weight loss. Contemporary Clinical Trials, 29(2), 182-193. doi: 10.1016/j.cct.2007.07.004</div> <div style="margin-left: .5in; text-indent: -.5in;"> Burke, L. E., Swigart, V., Warziski Turk, M., Derro, N., & Ewing, L. J. (2009). Experiences of Self-Monitoring: Successes and Struggles During Treatment for Weight Loss. Qualitative Health Research, 19(6), 815-828. doi: 10.1177/1049732309335395</div>

Self-Monitoring and Weight Loss

I have reviewed the following three research articles, one of which I have read several times because I am critiquing the study for a class ...

7:35 PM

Take the Combo - but know the difference

<div class="MsoNormal" style="margin: 0in 0in 0pt;">Prentice, A., & Jebb, S. (2004). Energy intake/physical activity interactions in the homeostasis of body weight regulation. Nutrition Reviews, 62(7 part 2), S98-104.</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"> </div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: "Garamond", "serif"; font-size: 11pt; mso-ansi-language: EN-US; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;">Foster-Schubert, K. E., Alfano, C. M., Duggan, C. R., Xiao, L., Campbell, K. L., Kong, A., . . . McTiernan, A. (2011). Effect of Diet and Exercise, Alone or Combined, on Weight and Body Composition in Overweight-to-Obese Postmenopausal Women. Obesity.</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"> </div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: "Garamond", "serif"; font-size: 11pt; mso-ansi-language: EN-US; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;">Cox, T. L., Malpede, C. Z., Desmond, R. A., Faulk, L. E., Myer, R. A., Henson, C. S., . . . Ard, J. D. (2007). Physical Activity Patterns During Weight Maintenance Following a Low-energy Density Dietary Intervention[ast]. Obesity, 15(5), 1226-1232. </div> The articles referenced above and others that I have read support what I am about to tell you.  My assertion is NOT new, but research continues to support it. Most importantly:  <a href="http://www.health.gov/paguidelines/factsheetprof.aspx">Physical activity is essential to health</a>, the prevention of disease and disability, and the ability to bounce back from injury or illness.  Physical activity is proven to boost mood and reduce frailty.  Exercise and weight or resistance training can also improve metabolism. Everyone benefits from physical activity and everyone needs it.  Current recommendations are anywhere from 45 minutes 5 days a week to 60 minutes every day. When we are looking at weight loss and maintenance, the studies above show a differential impact by method.  Persons who combine diet and exercise lose the most weight, but in the second study above, the group that only exercised lost about 2% of their body weight while the group that only changed their diet (less calories) lost over 8% of their starting weight.  The combined group did the best at over 10%.  That study was specific to post menopausal women who were predominantly (85%) White.  I found it amazing that the women all weighed over 180 pounds, had BMIs of 30 and above, waist circumferences over 37 inches,  fat percents in the 40s, ate over 1800 calories a day and exercised less than 40 minutes a week.  Actually, the reasons they have high weights and BMIs is explained by their lack of activity and high calorie intake.  I.e. I exercise about 420 minutes a week (10 times more than those women) and eat less than 1800 cals a day.  The first article listed above was not a research study in and of itself but a discussion of weight gain in Americans as a result of consuming incredibly high calorie, high fat foods and doing very little activity in regards to catching, growing or otherwise obtaining those foods.  The researchers in that piece suggest that the body's physiology has become impaired due to the types of foods that we eat.  Research studies on weight loss are noted in this article and "exercise alone is not an effective means of losing weight."  The reason for this may be, and I have said this before, that it is easier to reduce a certain amount of calories than it is to burn them.  It is also said in this article that low activity can drive the imbalance, but does not cause obesity.  The problem is that we are doing less but eating as if we were not.  But - they contend- the body's ability to tell us to eat less is ineffective.  That being said, as an individual, you have to override the brain and eat what you need, not what you want. Lastly, the EatRight study followed women who had lost weight during an intervention and found that the majority were able to maintain the weight loss and to do so by eating less calories with low energy dense foods (my Volumetric :)).  The study looked at those who maintained their weight loss compared to do those that did not.  Between the two groups, the amount of exercise was the same. I understand that the idea of cutting calories is overwhelming and that many people think of restriction and fight to avoid it - but if you learn about food and change the way you cook, it is possible to eat MORE food but less calories.  Exercise, which is necessary for good health, will assist your weight loss efforts.  I do not have statistics to back up this assertion, but what I have read and heard is that people prefer exercise over reducing calories - but in practice, they do neither. None of this is going to work if you do not do it.

Take the Combo - but know the difference

Prentice, A., & Jebb, S. (2004). Energy intake/physical activity interactions in the homeostasis of body weight regulation. Nutrition Re...

7:24 PM

Fidget Theory

I usually agree with information that comes from the Mayo Clinic, but this as of yet unpublished study by James Levin has left me scratching my head AND anxious to see the actual data on this small (18) sample study that was completed in 2007. Three years ago, hmmmm, why so long unpublished? I learned about the study from a news piece written by HealthDay reporter, Alan Mozes. In this study, Dr. Levin and assistants were able to modify a work setting in an office that agreed to be in the project. This of course would mean that the worksite was able to have all these embellishments for FREE. Dr. Levine proposed in his study that by making the worksite as active as possible - in little ways, like fidgeting ways - enough extra calories would be burned to promote weight loss. The workers had their landlines removed so they could walk about while talking, and a path was put in so that workers could walk laps while having meetings. Now this was NOT to be exercise - but strolling (very leisurely pace) about while also doing other things. You might have heard the concept before and I do not for one minute dispute that moving about burns more calories than not moving about, but Dr. Levine is credited with saying that these little things - moving meetings, standing telephone calls, stairs instead of elevators can burn an extra 400-500 calories a day - where as an hour at the gym is going to burn about 70, says he. My margin note for that paragraph was "bullshit." True, we do not burn 100s of calories in our aerobic classes or even while running, but the true benefit of exercise is a reduction in disease risk. The person who burns an extra 400 calories a day with the suggestions Dr. Levine made is the person who a) weighs A LOT and b) was completely sedentary before adding these things. I am more compelled to move more at work based on the studies that suggest adverse health consequences from being still - not from this very small study of 18 people who lost weight during the six month intervention. BTW, the participants were able to wear those uber expensive activity monitors as well -these technical devices can track all activity and metabolism - (you think a pedometer is motivating?). The activity monitors would be nearly impossible for any of us to purchase - probably make the IPAD look cheap. It is interesting too, that the short public news piece doesn't tell us much about the nutritional counseling that the staff was offered. Did the 18 people actually start eating less calories? It is quite likely their weight loss would be most attributed to that behavior. I do want to be clear - I one hundred percent agree that we sit down too much and that any time you can get up and walk around at work - to go to the copier, to go ask a question, to get your lunch box out of your car because you CHOSE not to bring it in in the morning, to mail a letter, to help someone carry things to their car - anything -anytime- is GOOD FOR YOU - I just don't think it should be your weight loss/maintenance strategy nor that it can take the place of 30-60 minutes of continuous exercise as that has cardiorespiratory benefits that fidgeting just isn't going to equal.

Fidget Theory

I usually agree with information that comes from the Mayo Clinic, but this as of yet unpublished study by James Levin has left me scratching...

4:37 PM

We Were Wrong

I don't expect you have heard this yet and if you have, you are probably peeved and a little discouraged - but that whole 3500 calories makes or breaks a pound, um - not so true (over time anyways). Now don't throw your hands up and claim that all science is flawed and should therefore be dismissed - look at it this way. If science does NOT improve over time - if we don't know any more today than we did 50 years ago, then, SOME ONE has been wasting time. Of course, we know more today and thank goodness we do. It is not something to use to dismiss health promotion but to elevate it! I first heard about the clamour from journalist Carl Bialik and though I have not read the research that supports the idea that we need new math, I have no problem whatsovever believing it. In a nutshell, whether it is gaining or losing, after a few months - or a year, the body adapts to the change we have made and either stops gaining or stops losing weight. Hey, read that first part again. So it isn't all bad! If you add a teaspoon of peanut butter to your day , every day, who will gain maybe four pounds a year, at first, but then it will level off. Same is true if you cut calories, and EVERYONE knows this - at first you lose weight and then you plateau. Now we have science to say oh, it is a matter of the body being adaptive - and I want to be clear that this does not support a set point theory as much as it explains one. We do not have set points, that is a cop out. Instead, this means that our efforts to achieve and maintain a healthy weight must be dynamic. We have to do due diligence in this regard and approach our health strategically. Surprised? Why? Haven't we been told for years from exercise physiologists that our muscles adapt to the loads we apply and that if we do not adjust our weight training regimens we will cease to see progress? Same principle. I would use this new information - which portends very individualized outcomes - to discount all those commercials that tell you how much weight you'll lose and calories you'll burn using their product or device. It cannot be stated that way with any veracity. This new science should not be used to argue against calorie content information or soda taxes either, as the math may be askew, the concept is still one of empowerment. The calorie equation may be off, but the calorie is still the deciding factor. Might I add that Mr. Bialik's article in the WSJ noted that a woman a woman is trying to gain weight for a Guinness Book of World Records contest. Her intent is to eat 12,000 calories a day - 10,000 more than nearly any of us need- in order to gain 400 plus pounds. Her goal weight - 1000 pounds. My thought on this one is simple, "that lady is in serious need of a Psych. consult."

We Were Wrong

I don't expect you have heard this yet and if you have, you are probably peeved and a little discouraged - but that whole 3500 calories...

5:06 PM

The Biggest Loser is Often Not the Smartest Loser

I scanned over some negative press last night regarding the TV show, The Biggest Loser. The arguments made against the program were ones that made perfect sense to me. Some of the following points were in the news piece though I added things that I have learned through various workshops and research studies, as well. First the TV show is NOT real life! Very few of us can put our jobs, families and other commitments on hold and dedicate full days every day for weeks or months to engage in such a rigorous program. Second, the TV show ends, but the struggle to maintain a health promoting weight does not. Third, the competition is more likely to have a negative psychological impact on the "contestants" than a positive one. And I don't know about you, but when something upsets my psyche I am hard pressed to engage in positive coping skills - and if you are new to a behavior, the relapse potential is at least orange, if not RED. (I.e. high or severe threat!) Then there is the science behind weight loss and physical activity. Losing weight fast can cause health complications, including gall bladder problems and anemia. Going from being sedentary to engaging in vigorous physical activity most days of the week for hours at a time, can and probably will lead to muscle and joint injury. It is also a good way to get someone to hate exercise. The real weight loss winners are the ones who work with a physician and dietitian to determine the right caloric intake for them and then to follow the guidelines of health experts. For instance, Canada has this <a href="http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php">food guide </a>for its citizens to follow. And the USA has <a href="http://www.mypyramid.gov/">this one</a>. I promote Dr. Walter Willett and Dr. Barabara Rolls, as well as the Cooper Institute. I am perfectly comfortable with both the DHHS Nutrition and Physical Activity Guidelines. Oh and the website for <a href="http://www.nutritionaustralia.org/">Australians </a>is especially colorful. You get the idea. There is a lot of evidenced based information out there that you can access and apply to your own life. And as I like to say in my own classes - this stuff only works if YOU WORK IT! Do set goals - reasonable, achievable, smart - do engage in physical activity and do get support from friends. Health challenges are GREAT - nationally broadcast competitions, not so smart.

The Biggest Loser is Often Not the Smartest Loser

I scanned over some negative press last night regarding the TV show, The Biggest Loser. The arguments made against the program were ones tha...

4:17 PM

WLS

When a disease or a treatment gets initialized and recognized by those initials, I guess we can consider it as having arrived. In this case, the initials stand for one of the treatments I am most disturbed by and that is Weight Loss Surgery. I have been writing about it for years. I don't mean to restate my opinion today. I do have a most dear friend who has had gastric bypass surgery and so far, so far as I know, she has not had to go back to the hospital for post surgery complications. She promises to do a guest blog in the future and will share her story with us. I am very much looking forward to that day. Okay, I can't stop myself - just this tiny bit of rehashing. There are a few different techniques for bariatric surgery. There is stapling and then two different types for rerouting the food by changing the size of the stomach and or the length or sectioning of the small intestine... Clearly this is one of the most invasive surgeries one can have. It is supposed to be reserved for the severely obese, but candidates must be able to ambulate and are often encouraged to lose some weight even before the operation. The adverse event risks are high and complications common. It is a LIFE CHANGING procedure. After surgery a person must eat very very small meals, ounces at a time. The stapling and banding type of procedure can be reversed, but I do not think the others can. I tell you all of this because I just saw a story in the popular press which tells the recommendations recently made by the National Library of Medicine on who would be the best candidate for this surgery - the bypass surgery. Candidates are: Obese (morbidly so, with a BMI of 40+ or a BMI of 35+ w/ a serious health problem that weight loss might attenuate, like diabetes 2) and unable to lose weight from diet and exercise and People who are determined and can commit to a diet and exercise program (?) and People without mental illness and People without a substance abuse disorder My concern has always been and remains - if a person can commit to the rigors of consistent healthy eating and daily exercise, they can lose the weight without such an EXTREME measure and if they cannot, then they are NOT really candidates for this still rigorous program.. In fact, I just had some information sent to my work email regarding programs offered by USF College of Medicine and Health . They have weekly support groups for WLS patients. It is just such a huge undertaking and I fear for people who under go it. All that said, I support my friend 100% and if this saves her life than I will be quick to tell you that too. Now, I am one of millions of LOST fans, so I gotta get going...

WLS

When a disease or a treatment gets initialized and recognized by those initials, I guess we can consider it as having arrived. In this cas...

4:55 PM

Weight Loss

Earlier this evening, someone said something in a conversation that reminded me of a research study I had read earlier in the week and about something that has been said in the blog pretty often. Obviously, it bears repeating. And to be fair, this is something that science is supporting NOW, but something we didn't realize so much ten or twenty years ago, and it is hard to let go of old beliefs. The belief that I am referring to is that exercise alone is a weight loss strategy. It is not. In order to lose the extra weight you've put on over the holidays or the weight you have carried for years which is putting you at risk for high blood pressure, heart disease, diabetes, arthritis and disability - you MUST eat less. Exercise is vital to improve health and will have a positive impact on resting heart rate, blood pressure, functionality, cholesterol levels, and blood sugar, but it will not take the pounds off and until you take them off (if indeed you need to) the risk for all of the above conditions will still be greater for YOU than for people of normal weights. We can debate which measure determines "normal" whether it be BMI, WHR or Waist Circumference, but instead let us say, it is the weight at which you do not have the symptoms of disease. This information is NOT meant to deter or dissuade you but to prompt you into action. What we do have in the 00s that we didn't have in the 90s is the Internet and the explosion of web based programs and tools that are FREE and full of information that can help you to first understand caloric need and balance and then to do something about it. I have done some exploring in order to write the post and I refer you again to the Cooper Institute's Stand Up and Eat site which can help you determine the <a href="http://www.standupandeat.org/index.aspx?id=tools">amount of calories you need </a>to maintain or lose weight (BTW I need LESS than 1700 and I am considered VERY active, so chances are you are overestimating your needs. A moderately active woman who is 5ft 5 and weighs 150 pounds only needs 1860. A moderately active 180 lb man who is 5ft 10 needs about 2100) Learn what you need and then you can use some of the tools on the MyPyramid site to <a href="http://www.mypyramidtracker.gov/default.htm">track activity and track calories </a>consumed. But as always, my favorite is the data base of the <a href="http://www.nal.usda.gov/fnic/foodcomp/search/">USDA</a>. Of course, label reading is a must! I do think you should bookmark the links in this section. I mentioned a few people earlier this week who said they lost weight by tracking their calories. If you are not losing weight ,and need to, this is something that you might try. Well - now is as good a time as any.....

Weight Loss

Earlier this evening, someone said something in a conversation that reminded me of a research study I had read earlier in the week and about...

4:58 PM

Health Education

Will you really burn off those extra calories?

A blog post on weight loss worth a share

Fat in food vs Fat on your body

Is a cold office the next new diet fad?

Does it Matter if you Walk or Run?

Lipozene is not YOUR solution

Myths about snacking

Excess Body Fat

It's what you eat

Weight Watchers Australia & Access

The Best Way to Lose Weight

NHIS in the 1960s

Why I Keep Loving Weight Watchers

Self-Monitoring and Weight Loss

Take the Combo - but know the difference

Fidget Theory

We Were Wrong

The Biggest Loser is Often Not the Smartest Loser

WLS

Weight Loss

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