Losing Weight Is Like Riding A Bike

Losing weight and saving money are the top New Year’s resolutions expected to challenge Americans this year, experts say.

“People need a motivation to lose weight and the new year is an opportunity to start fresh,” said Dr. Jessica Bartfield, internal medicine and medical weight-loss specialist at Gottlieb Memorial Hospital, part of the Loyola University Health System.

“Maybe it was the shock of seeing oneself in recent holiday photos, or not being able to fit into desired party attire that causes a vow to lose weight, and for many more it is a medical event such as a heart attack, the threat of diabetes or high blood pressure,” she said.

For Chicago-area newlywed Aaron Villarreal, it was seeing his wedding video.

“Who’s that fat guy?’ I thought at first, and then was literally stunned and heartbroken when I realized it was me,” said the former high school football player. He joined the Gottlieb Medical Weight-Loss Program, a 12-week integrated regimen in which physicians, nutritionists, psychologists and exercise physiologists partner with participants who need to lose large amounts of weight.

“Behavior change is the cornerstone of healthy, successful weight loss and it takes about three months to establish a new behavior,” said Bartfield, a physician in the Gottlieb Medical Weight Loss Program. “At Gottlieb, a team of tried-and-true medical experts can teach you the skills you need to achieve and maintain behavior change.”

According to the Centers for Disease Control, two-thirds, or 66 percent, of American adults are overweight or obese. “We are a large nation,” Bartfield said. Despite a huge, billion-dollar weight-loss industry, it’s estimated only 20 percent of Americans who try to lose weight successfully keep it off after one year.

“Changing behavior is tough – it is actually a skill and needs to be approached that way,” Bartfield said. “When you learn to ride a bike, you expect that you will fall down a couple times and are prepared to try again and get back on; you need to have the same expectation with weight loss and to plan accordingly.”

The National Weight Control Registry (NWCR) consists of about 4,000 Americans who have lost, on average, about 30 pounds and have maintained this loss for five years. “This registry provides a tremendous source of information about the behaviors associated with successful weight-loss maintenance. I often help my patients identify and incorporate these same behaviors into their own lives,” Bartfield said.

What to do - Top weight-loss behaviors from Dr. Bartfield and the NWCR

• Eat breakfast – “Eating within one hour of awakening can boost your metabolism up to 20 percent for the rest of the day,” Bartfield said. Seventy-eight percent of NWCR members start the day off with breakfast. “Eating something is better than eating nothing, but ideally try to incorporate protein for longer-lasting fuel.” Villarreal, 33, used to routinely skip breakfast. “I thought I was being smart by creating extra room for the calorie overspill from my lunch and dinner,” he said. “Now I will eat protein bars, a slice of vegetarian pizza, almost anything to jump-start my heart and metabolism in the morning.”

• Weigh yourself once per week - “Monitoring your weight on a weekly basis provides a fairly accurate weight trend and, more importantly, an early detection of any weight regain, which allows you to adjust behaviors accordingly,” Bartfield said of the 75 percent of NWCR members who weigh in weekly.

• Get in one hour of moderate physical activity each day - “Snow shoveling, vacuuming, taking the stairs – you don’t have to run like a hamster on a wheel for 60 minutes. Take three, 20-minute brisk walks, or compile the one hour based on a series of activities,” Bartfield said. More than 90 percent of NWCR members engage in one hour of moderate exercise daily.

• Watch fewer than 10 hours of TV per week - “Many argue they don’t have time to exercise, but when I ask them to count the hours they spend watching TV or surfing the Net, they are able to find the time for activities where they are moving instead of sitting,” Bartfield said. Sixty-two percent of NWCR members watch fewer than 10 hours per week.

What not to do:

• Overestimate amount of physical activity -“Park your car farther away, take the stairs, manually change TV channels – these are all simple ways to get more physical activity and you need to write them down as they are performed to keep yourself honest,” Bartfield said. “Also wearing a pedometer can help accurately document and track your progress.”

• Underestimate caloric intake - “I was ordering the No. 1 meal, not the 4,500-calorie meal, and so was everyone else in line at the fast-food restaurant,” Villarreal said. “When I began keeping a food journal, and documenting the calories, I was shocked to learn I was eating more than my daily requirement for calories in my lunch alone.”

• Set unrealistic goals - “Patients often set vague and outcome-related goals such as “weigh 150 pounds by summer” or “exercise more.” Goals need to be specific and attainable. Instead of trying to get to a certain weight, start by trying to lose 10 percent of your weight – that amount has been shown to have a statistically significant improvement in health and reduction in risk of obesity-related disease. “Success in meeting initial goals will foster additional weight-loss behavior,” Bartfield said. “I love cola and used to drink it all day; I substituted diet cola in my diet,” Villarreal said. “I was shocked to see that one simple change actually helped me to lose weight. That success motivated me to put forth more effort.”

• Lack of consistency - “Eat at regular intervals seven days per week,” she said. “Being ‘good’ on the weekdays and then splurging on the weekend creates a harmful cycle that discourages weight loss.”

• Failure to plan for setbacks - “When you learn to drive, or learn a sport or musical instrument, you make mistakes and you have an experienced instructor – maybe even several – to help correct the mistakes and prevent repeats. Enlist a trusted friend, or enroll in a program to learn and master the rules of weight loss,” Bartfield said.

And for teens who want to lose weight? “Treating child and adolescent obesity needs to be a family effort; families need to change behaviors,” Bartfield said. “Research shows that families – and even couples – who change behavior together are the most successful.”

How to Avoid Holiday Weight Gain in 2011

It's that time of year when extra calories lurk around every corner – baked goods at the office, cocktails and snacks at holiday parties, chocolates in stockings and holiday meals that can average more than 4,500 calories and 220 grams of fat, according to the Calorie Control Council. All these extras can add up to weight gain during the holiday season.

Fortunately, more than 186 million American adults – or eight out of ten men and women – say they have been "weight conscious" this year, according to a national survey conducted by the Calorie Control Council. Five out of ten (54%) have been trying to reduce their weight, and noted that exercise, cutting back on sugar, using low calorie or reduced sugar products, and restricting the size of meal portions are the most common tactics.

The good news is that it is possible to celebrate the holiday season without putting on a single pound.

"By making simple substitutions, being physically active and eating smarter, you can enjoy the holidays without weight gain,” said Beth Hubrich, a registered dietitian with the Council. “The trick is to budget calories, keep portion sizes in check and remember that fruits and vegetables can fill you up without extra calories."

Here are some helpful tips from the Calorie Control Council:

• Exercise: There are a number of ways to be active including keeping track of steps per day with holiday shopping, ice skating, playing active video games, decorating, lawn work, and house cleaning. Exercise not only burns calories but also releases endorphins that help reduce stress and keep people in good spirits.

• Fuel Up before Heading Out: Try to have a healthy snack before leaving the house – whether going shopping or to dinner. Never go anywhere famished – it can lead to overindulgence and diet derailing.

• Portion Control: Save calories by choosing a smaller plate and taking a tablespoon or less of each holiday dish. Think of it like free samples – try one of each without going overboard. Desserts can even be served sample sized.

• Classics with Fewer Calories: Find and fix lower-calorie versions of your favorite dishes, desserts and beverages. Create healthier versions of holiday favorites by using skim milk instead of whole milk, applesauce in place of oil, or a sugar substitute in place of the sugar in a recipe. To thicken a liquid without adding fat, use one of the following: flour, cornstarch, potato flakes, yogurt, non-fat evaporated milk. Just by using zero-calorie sweeteners and lower-calorie ingredients, you can enjoy delicious food without feeling guilty.

• Socialize Away from Food: So often people find themselves socially snacking before and after meals. Try to strike up a conversation where food is out of sight. If there is a bountiful buffet, take a survey first. Skip foods that can be had “anytime” and opt for small portions of favorite holiday foods. Make the first trip to the buffet also the last.

• Lighten up Leftovers: Skip the turkey sandwich with bread and gravy and instead go for turkey with leftover veggies. There are even salads, soups and other dishes that can be made with leftovers that are lighter on calories and help avoid holiday food burnout.

• The Buddy System: Don’t wait until New Year’s to make resolutions with a buddy – find a friend or family member before the holidays to exercise with and compare healthy eating notes with every day. A little competition can help both stay focused on their goals.

For more sensible holiday eating tips, including an assortment of recipes for a lighter holiday menu, visit the recipe section of www.caloriecontrol.org.

Dieters Should Eat Foods Rich in Protein, Mostly Dairy

Ω

New research suggests that a calorie-restricted diet higher in protein—mostly from dairy foods—and lower in carbohydrates coupled with daily exercise has a major positive impact on bone health in overweight and obese young women.

The study, published online in the Journal of Clinical Endocrinology and Metabolism, found bone health improvements were particularly evident due to the high density of bone-supporting nutrients such as calcium, vitamin D and dairy-based protein.

For 16 weeks, three groups of overweight and obese, but otherwise healthy, premenopausal women each consumed either low, medium or high amounts of dairy foods coupled with higher or lower amounts of protein and carbohydrates. Calcium and vitamin D levels were also graded from low to high across the groups in conjunction with the dairy foods they consumed.

The women exercised seven days per week, a routine that included aerobic exercise every day and two additional workouts of circuit weightlifting per week.

“Our findings demonstrate the importance of diet composition to the maintenance of bone health status during weight loss,” said Andrea Josse, of the Department of Kinesiology at McMaster and lead author of the study. “Our data clearly show dairy-source protein is important when aiming to avoid harmful consequences such as accelerated bone loss during weight loss. In our view, young women attempting to lose weight should consume a diet higher in dairy-source protein.”

A previous study from the same team in the same subjects showed that there were identical total weight losses across the groups, but very different results for body composition change with the higher-protein, high-dairy group experiencing greater whole-body fat and abdomen fat losses and greater lean mass gains.

The same subjects consuming higher-protein and high-dairy diets for this study also showed the greatest improvements in markers of bone formation, no change in bone loss, an increase in circulating vitamin D levels, and a decrease in levels of parathyroid hormone, which when elevated is typically associated with bone loss.

Maintaining or even improving bone health in young women, particularly in those trying to lose weight, is important for overall health, and may have great implications for decreasing the risk of diseases like osteoporosis later in life, say the researchers.

“Our data provide further rationale to recommend consumption of dairy foods to aid in ‘high quality’ weight loss, which we defined as loss of fat and sparing of muscle, and the promotion of bone health in young women,” says Stuart Phillips, senior author and a professor in the Department of Kinesiology. “These women are not only at the age when achieving and maintaining peak bone mass is of great importance, but in whom adequate dairy consumption would offset sub-optimal intakes of calcium and vitamin D.”

Subjects undergoing weight loss while consuming marginally adequate protein without dairy foods showed markedly elevated levels of markers of bone loss indicating that following such a diet in the long-run would weaken bones.

Ω

Mid-morning snacking may sabotage weight-loss efforts

Ω


Finding may not relate to time of day, but to the short interval between breakfast and lunch

Women dieters who grab a snack between breakfast and lunch lose less weight compared to those who abstain from a mid-morning snack, according to a study led by researchers at Fred Hutchinson Cancer Research Center.

The results of this randomized trial, led by Anne McTiernan, M.D., Ph.D., a member of the Hutchinson Center’s Public Health Sciences Division and director of its Prevention Center, will be published in the December issue of the Journal of the American Dietetic Association.

In the course of the year-long study, the researchers found that mid-morning snackers lost an average of 7 percent of their total body weight while those who ate a healthy breakfast but did not snack before lunch lost more than 11 percent of their body weight. For the study, a snack was defined as any food or drink that was consumed between main meals.

“We think this finding may not relate necessarily to the time of day one snacks, but rather to the short interval between breakfast and lunch. Mid-morning snacking therefore might be a reflection of recreational or mindless eating habits rather than eating to satisfy true hunger,” said McTiernan, the corresponding author of the paper.

While snacking too close to a main meal may be detrimental to weight loss, waiting too long between meals also may sabotage dieting efforts, she said. “Snacking could be part of a dieter’s toolkit if they’re eating in response to true hunger. Individuals should determine if they experience long intervals – such as more than five hours – between meals. Adding a snack might help people deal better with hunger and ultimately help them to make more sound choices at their next meal.”

The study also revealed that women who reported eating more than two snacks a day had higher fiber intake than those who snacked less frequently, and afternoon nibblers ate more fruits and vegetables compared to women who didn’t snack between lunch and dinner.

The ancillary study, part of a larger randomized clinical trial designed to test the effects of nutrition and exercise on breast cancer risk, involved 123 overweight-to-obese postmenopausal Seattle-area women, ages 50 to 75, who were randomly assigned to either a diet-alone intervention (goal: 1,200 to 2,000 calories a day, depending on starting weight, and fewer than 30 percent of daily calories from fat), or diet plus exercise (same calorie and fat restrictions plus 45 minutes of moderate-to-vigorous exercise per day, five days a week). While the women received nutrition counseling they were not given any specific instructions or recommendations about snacking behavior.

At the end of the study the women were asked to record the time, type and frequency of meals consumed on a normal day. Percent of calories from fat, fiber and fruit and vegetable intake were also estimated using a food-frequency questionnaire.

“Many people think that a weight-loss program has to mean always feeling hungry,” McTiernan said. “Our study suggests that snacking may actually help with weight loss if not done too close to another meal, particularly if the snacks are healthy foods that can help you feel full without adding too many calories.”

Nationwide surveys indicate that 97 percent of U.S. adults report snacking, and such behavior is consistent across age groups. One study that surveyed a national random sample of more than 1,500 adults found that the most commonly preferred snacks were salty and crunchy items such as potato chips, pretzels and nuts; baked goods such as cookies and cakes; fruits; and ice cream.

Not all snacks are created equal, however. Foods less conducive to weight loss include empty-calorie items that contribute fat, salt, sugar and little nutritional value, such as potato chips and sugar-sweetened beverages.

For a woman on a weight-loss diet, a healthy snack should pack a nutritional wallop without breaking the calorie bank. “Since women on a weight-loss program only have a limited number of calories to spend each day, it is important for them to incorporate nutrient-dense foods that are no more than 200 calories per serving,” McTiernan said. “The best snacks for a weight-loss program are proteins such as low-fat yogurt, string cheese, or a small handful of nuts; non-starchy vegetables; fresh fruits; whole-grain crackers; and non-calorie beverages such as water, coffee and tea.”

The National Cancer Institute funded the research and participated in the study, which also involved investigators from the University of Washington and the University of Illinois at Chicago.

Willpower no match for cheap food, big portions

Ω

Ditching the diet for Thanksgiving? Turkey with all the fixings isn't the only temptation causing would-be dieters to miss their goals, according to a new Cornell University review article that finds powerful environmental cues are subconsciously bending willpower every day.

"We're slaves to our environment," said David Levitsky, professor of nutritional sciences and of psychology at Cornell, who co-authored the article with graduate student Carly Pacanowski.

The article, "Free Will and the Obesity Epidemic," will be published in an upcoming print edition of the journal Public Health Nutrition (http://bit.ly/sYl5hJ).

Levitsky and Pacanowski analyzed hundreds of articles on eating behavior and found forces that individuals have no control over are heavily influencing the obesity epidemic in the United States. These forces include cheap food prices and ease of access to unhealthy food. Social factors such as seeing others eat are also strong stimulants, Levitsky said, and have taken on more strength in the past 50 to 60 years, as restaurant dining becomes more frequent.

The article finds portion size emerged as one of the most powerful links to overeating. "And it's not just the amount you put on your plate, but also the package size from which the food comes determines how much you will eat," Levitsky said.

The article suggests dieters can weigh themselves and graph the results on a daily basis to counter these forces because it boosts one's awareness of unconscious eating. It also suggests that the government plays a role in combating the obesity epidemic by subsidizing fruits and vegetables, making low-calorie foods cheaper.

Big Holiday Meals OK If Effect Isn't Prolonged

Failing to get back on a healthy eating plan soon after the big holiday feast can lead to serious weight gain and most likely a New Year’s resolution to get in shape.

“Most of us will eat snacks and sweets the week leading up to Thanksgiving or Christmas, then continue for days and weeks afterwards,” said Gaye Lynn Hicks, R.D., L.D., a dietitian with the Methodist Weight Management Center in Houston. “This often leads to a whole season of eating and before you know it you have put on a lot of weight in a short amount of time.”

Hicks said this type of behavior can spiral out of control very quickly, so adopting a healthy lifestyle becomes more important than dieting. Concentrate on eating healthy when not at holiday gatherings and exercising at least three days a week. Once you get into the “lifestyle mentality” it will be easier for to eat healthier after indulging in fattening foods usually offered around the holidays.

“Look at your calendar and mark down the parties where you will want to eat more and others that will be more diet friendly,” Hicks said. “If you focus and plan ahead it will be easier to avoid the inevitable pitfalls of wanting to eat more at holiday gatherings.”

“Most of the time it’s all in our head. We think we’ve blown our diet when that is simply not true,” Hicks said. “The bottom line is if you want to eat mashed potatoes, lathered in all kinds of stuff, during your holiday meal, do it. It will be easier to keep the holiday pounds off if you remember that your annual feast is just one meal.”

Proper Protein Intake Crucial for Moderating Energy Intake, Keeping Obesity at Bay

Ω

Obesity is a growing problem worldwide, but proper protein consumption can help keep it at bay, according to a paper published Oct. 12 in the online journal PLoS ONE.

Researchers found that, when subjects were fed a 10% protein diet, they consumed 12% more energy over four days than they did on a 15% protein diet. Moreover, 70% of the increased energy intake on the lower protein diet was attributed to snacking. When the protein content was further increased to 25%, however, the researchers observed no change in behavior relative to the 15% protein diet.

It had previously been suggested that protein content plays an important role in determining overall energy intake, and thus affects obesity, but until this study, experimental verification had been lacking. To test the hypothesis, the researchers tested 16 female and 6 male participants, all lean and in good health. The subjects spent four days on each of the three diets, which were made as similar as possible in factors such as palatability, availability, variety, and appearance, and their intake was monitored.

According to Dr. Alison Gosby, "the results show that humans have a particularly strong appetite for protein, and when the proportion of protein in the diet is low this appetite can drive excess energy intake. Our findings have considerable implications for bodyweight management in the current nutritional environment, where foods rich in fat and carbohydrate are cheap, palatable and available to an extent unprecedented in our history."

Participants in the Weight Watchers group lost twice as much weight as did those in the standard medical care

In this parallel group, non-blinded, randomised controlled trial, 772 overweight and obese adults were recruited by primary care practices in Australia, Germany, and the UK. Participants were randomly assigned with a computer-generated simple randomisation sequence to receive either 12 months of standard care as defined by national treatment guidelines, or 12 months of free membership to a commercial programme (Weight Watchers), and followed up for 12 months. The primary outcome was weight change over 12 months.

Findings

377 participants were assigned to the commercial programme, of whom 230 (61%) completed the 12-month assessment; and 395 were assigned to standard care, of whom 214 (54%) completed the 12-month assessment. In all analyses, participants in the Weight Watchers group lost twice as much weight as did those in the standard care.

Complete report available here

Habit makes bad food too easy to swallow

Study reveals why people eat out of habit — even when they are eating stale food — and suggests a way to combat mindless eating

Do you always get popcorn at the movies? Or snack while you're on the couch watching television? A new paper by USC researchers reveals why bad eating habits persist even when the food we're eating doesn't taste good. The study also reveals the surprisingly simple ways we can counter our habits to gain control over what we eat.

In an ingenious experiment, researchers gave people about to enter a movie theater a bucket of either just-popped, fresh popcorn or stale, week-old popcorn.

Moviegoers who didn't usually eat popcorn at the movies ate much less stale popcorn than fresh popcorn. The week-old popcorn just didn't taste as good.

But moviegoers who indicated that they typically had popcorn at the movies ate about the same amount of popcorn whether it was fresh or stale. In other words, for those in the habit of having popcorn at the movies, it made no difference whether the popcorn tasted good or not.

"When we've repeatedly eaten a particular food in a particular environment, our brain comes to associate the food with that environment and make us keep eating as long as those environmental cues are present," said lead author David Neal, who was a psychology professor at USC when the research was conducted and now heads a social and consumer research firm.

The study, in the current issue of the journal Personality and Social Psychology Bulletin, has important implications for understanding overeating and the conditions that may cause people to eat even when they are not hungry or do not like the food.

"People believe their eating behavior is largely activated by how food tastes. Nobody likes cold, spongy, week-old popcorn," said corresponding author Wendy Wood, Provost Professor of Psychology and Business at USC. "But once we've formed an eating habit, we no longer care whether the food tastes good. We'll eat exactly the same amount, whether it's fresh or stale."

The researchers controlled for hunger and whether the participants liked the popcorn they received. The researchers also gave popcorn to a control group watching movie clips in a meeting room, rather than in a movie theater.

In the meeting room, a space not usually associated with popcorn, it mattered a lot if the popcorn tasted good. Outside of the movie theater context, even habitual movie popcorn eaters ate much less stale popcorn than fresh popcorn, demonstrating the extent to which environmental cues can trigger automatic eating behavior.

"The results show just how powerful our environment can be in triggering unhealthy behavior," Neal said. "Sometimes willpower and good intentions are not enough, and we need to trick our brains by controlling the environment instead."

In another movie theater experiment, the researchers tested a simple disruption of automatic eating habits. Once again using stale and fresh popcorn, the researchers asked participants about to enter a film screening to eat popcorn either with their dominant or non-dominant hand.

Using the non-dominant hand seemed to disrupt eating habits and cause people to pay attention to what they were eating. When using the non-dominant hand, moviegoers ate much less of the stale than the fresh popcorn, and this worked even for those with strong eating habits.

"It's not always feasible for dieters to avoid or alter the environments in which they typically overeat," Wood said. "More feasible, perhaps, is for dieters top actively disrupt the established patterns of how they eat through simple techniques, such as switching the hand they use to eat."

Foods rich in protein, dairy products help dieters preserve muscle and lose belly fat: study

Ω

New research suggests a higher-protein, lower-carbohydrate energy-restricted diet has a major positive impact on body composition, trimming belly fat and increasing lean muscle, particularly when the proteins come from dairy products.

The study, published in the September issue of the Journal of Nutrition, compared three groups of overweight and obese, but otherwise healthy, premenopausal women. Each consumed either low, medium or high amounts of dairy foods coupled with higher or lower amounts of protein and carbohydrates.

The women exercised seven days per week for four months, a routine that included five days of aerobic exercise and two days of circuit weightlifting.

According to the researchers, there were identical total weight losses among the groups, but the higher-protein, high-dairy group experienced greater whole-body fat and abdomen fat losses, greater lean mass gains and greater increases in strength.

The tissue composition, exclusively fat, of the weight the women lost has profound implications for longer-term health, say the researchers.

"One hundred per cent of the weight lost in the higher-protein, high-dairy group was fat. And the participants gained muscle mass, which is a major change in body composition," says Andrea Josse, lead author of the study and a graduate student in the Department of Kinesiology at McMaster University. "The preservation or even gain of muscle is very important for maintaining metabolic rate and preventing weight regain, which can be major problem for many seeking to lose weight."

Researchers found the lower-protein, low-dairy group lost about a pound and half of muscle whereas the lower-protein, medium dairy group lost almost no muscle. In marked contrast, the higher-protein, high-dairy group actually gained a pound and half of muscle, representing a three-pound difference between the low- and high-dairy groups.

On top of the muscle mass differences, the higher-protein, high-dairy group lost twice as much belly fat than the lower-protein, low-dairy group.

"Fat in the abdomen is thought to be especially bad for cardiovascular and metabolic health, and it seems—according to what we found in this study—increasing calcium and protein in the diet may help to further promote loss of fat from the worst storage area in the body," says Josse.

"A very important point is that these changes were not captured by simple measures of body weight or body mass index, which are the most commonly used measures of dietary 'success'" adds Stuart Phillips, a professor in the Department of Kinesiology. "These women also got fitter and stronger, which greatly reduces their risk of disease."

Weight loss without the hunger: eat a lighter lunch

Ω

Losing weight without a grumbling stomach or expensive liquid diet can be as simple as eating a lighter lunch, finds a new Cornell University study to be published in the October issue of the journal Appetite.

Participants who ate portion-controlled lunches did not compensate by eating more calories later in the day, leading researchers to believe the human body does not possess the mechanisms necessary to notice a small drop in energy intake.

"Making small reductions in energy intake to compensate for the increasing number of calories available in our food environment may help prevent further weight gain, and one way of doing this could be to consume portion-controlled lunches a few times a week," said doctoral student Carly Pacanowski, who co-authored the study with David Levitsky, Cornell professor of nutritional sciences and of psychology.

The study closely monitored the food intake of 17 volunteers who ate whatever they wanted from a buffet for one week. For the next two weeks, half the group selected their lunch by choosing from one of six commercially available, portion-controlled foods, such as Chef Boyardee Pasta or Campbell's Soup at Hand, but could eat as much as they wished at other meals or snacks. For the final two weeks, the other half of volunteers followed the same regimen.

While eating portion-controlled lunches, each participant consumed 250 fewer calories per day and lost, on average, 1.1 pounds.

"The results confirm that humans do not regulate energy intake with any precision. Over a year, such a regimen would result in losing at least 25 pounds," said Levitsky, who adds the study demonstrates one simple, low-cost way to consume fewer calories.

Large weight gains most likely for men after divorce, women after marriage

LAS VEGAS — Both marriage and divorce can act as "weight shocks," leading people to add a few extra pounds—especially among those over age 30—according to new research to be presented at the 106th Annual Meeting of the American Sociological Association.

But when it comes to large weight gains, the effects of marital transitions are quite different for men than they are for women.

For men, the risk of a large weight gain increased most prominently after a divorce. But for women, the risk of a large weight gain was most likely after marriage.

"Clearly, the effect of marital transitions on weight changes differs by gender," said Dmitry Tumin, lead author of the study and doctoral student in sociology at Ohio State University.

"Divorces for men and, to some extent, marriages for women promote weight gains that may be large enough to pose a health risk."

The probability of large weight gains following marital transitions increased the most for people past age 30.

"For someone in their mid-20s, there is not much of a difference in the probability of gaining weight between someone who just got married and someone who never married. But later in life, there is much more of a difference," he said.

Tumin conducted the study with Zhenchao Qian, a professor of sociology at Ohio State University.

While there have been many studies about weight gain after marriage or divorce, most of them look at average changes in weight and find very small increases in weight after marriage and often small decreases in weight after divorce.

But these results may mask the fact that some people actually lose weight, while some stay the same, and some have large weight increases, Qian said.

"We estimated the effects of marital transitions on the likelihood of weight gains or losses for different categories of people, allowing for the possibility that not everyone who goes through a marital transition has the same kind of experience," Qian said.

Tumin and Qian used data from the National Longitudinal Survey of Youth '79, a nationally representative sample of men and women aged 14 to 22 in 1979. The same people were surveyed every year up to 1994 and every other year since then.

In this study, the researchers used data on 10,071 people surveyed from 1986 to 2008 to determine weight gain in the two years following a marriage or divorce.

The NLSY included data on Body Mass Index (BMI), a common health measure of weight relative to height.

The researchers separated people into four groups: those who had a BMI decrease of at least 1 kg/m2 (about 7 pounds for a person 5'10" tall) in the two-year period after a marital transition; those who had a small BMI gain (7-20 pounds for the 5'10" person); a large BMI gain (more than about 21 pounds); or no weight gain or loss (net change of less than 7 pounds).

The researchers took into account a wide variety of other factors that may influence weight gain or loss, including pregnancy for women, poverty, socioeconomic status, and education.

Both men and women who married or divorced were more likely than never-married people to have a small weight gain in the two years following their marital transition.

"For most people, the weight gain we see after a marital transition is relatively small, not something we would see as a serious health threat," Tumin said.

However, most other studies have suggested divorce actually leads to weight loss, at least in the first years after the marriage ends. Again, this may be because other studies have not separated people into age and gender groups, and only used average changes in weight, Tumin said.

The data in this study can't reveal why men are more likely to have large weight gains after divorce, while marriage is more likely to cause large weight gains for women.

However, these results fit with other research on how marriage affects men and women.

"Married women often have a larger role around the house than men do, and they may have less time to exercise and stay fit than similar unmarried women," Qian said.

"On the other hand, studies show that married men get a health benefit from marriage, and they lose that benefit once they get divorced, which may lead to their weight gain."

The probability of weight gain becomes more pronounced for men and women who marry or divorce after age 30 and the changes only grow larger as people get older, the study found.

"From age 22 to 30, the effect of marital transitions on weight is not very clear," Qian said.

"But both marriages and divorces increase the risk of weight changes from about age 30 to 50, and the effect is stronger at later ages."

Tumin said that it may be that people settle into certain patterns of physical activity and diet over time. "As you get older, having a sudden change in your life like a marriage or a divorce is a bigger shock than it would have been when you were younger, and that can really impact your weight."

The researchers noted that this study only looked at people for two years after a marital transition, and results may change over the years.

"This study really looks at the shock of a marital transition and how it affects weight," Tumin said.

Lifestyle Change Imperative for Keeping Off Weight

Ω

According to the American Counsel on Exercise only five percent of dieters are successful in keeping off the weight they lost. In fact, one-third of the weight people initially lost is usually gained back within the first year. People who want to lose weight and keep it off have to not only change their ways, but their way of thinking about food, exercise and lifestyle behaviors.
“Diet is only one component of leading a healthy life. To lose and keep weight off, a person needs to stop focusing on the scale and start focusing on becoming a healthier person,” said Valerie Walkowiak, medical integration coordinator at the Loyola Center for Fitness.

The Change Your Weigh program at the Loyola Center for Fitness emphasizes three components needed for a healthier lifestyle: nutrition, behavior modification and exercise. Each component is led by a licensed professional who has received extensive education and training.

Participants meet twice a week. One session is focused on teaching and providing the tools participants need to make healthy choices. The other is a hands-on exercise session.

A registered dietitian teaches participants to shop healthfully, read labels and understand portion control and nutrition labels.

“Many people have the misconception that they have to feel deprived in order to lose weight when that is untrue. People need to learn to eat well, not starve themselves,” said Cris Harder, registered dietician and leader of the Change Your Weigh nutrition program. “Eating right is only one part of losing weight. Diet and exercise need to go hand-in-hand and lifestyle behaviors need to be addressed. Many of us have emotional ties to food and to make a real lifestyle change people need to start thinking about the reason why they eat.”

Licensed clinical social workers lead discussions on topics such as goal-setting, emotional attachment to food and how to overcome barriers.

“Behavior modification helps people to look at the issues that stand in the way of healthy eating and exercise,” said Terri Lee, LCSW. “We help people create personalized strategies for addressing these barriers and obtaining success in their weight loss and lifestyle goals.”

Exercise is the third component for making lifestyle changes. Often, people don’t exercise because they don’t know how or where to start. Each week a personal trainer meets with the group to help participants cross this hurdle.

The personal trainer demonstrates different types of exercise, gives tips on incorporating exercise into daily living, explains exercise guidelines and helps participants learn how to get the most out of their exercise routine. Each week the personal trainer takes participants through a complete workout.

“This is not just a diet program, an exercise class or support group, it’s a combination of all three components.

This program allows participants to gain control of their health because they are given the tools they need to be successful,” said Walkowiak.

Protein preserves muscle and physical function in dieting postmenopausal women

Ω

Dieting postmenopausal women who want to avoid losing muscle as they lose fat should pay attention to a new University of Illinois study. Adding protein throughout the day not only holds hunger pangs at bay so that dieters lose more weight, it keeps body composition—the amount of fat relative to muscle—in better proportion.

"A higher-protein weight-loss diet is more protective of muscle," said Ellen Evans, a former U of I associate professor of kinesiology and community health and member of the university's Division of Nutritional Sciences.

Scientists in Evans's Illinois lab wanted to study the way body composition relates to physical function because older women who diet risk losing muscle as well as fat.

"That loss can affect their strength, balance, and how well they perform everyday tasks, such as climbing stairs and getting up out of a chair," said Mina Mojtahedi, a researcher in Evans's laboratory.

The study shows that higher protein intake during weight loss can offset negative effects on muscle mass by maintaining more muscle relative to the amount of weight lost. Women who ate more protein lost 3.9 percent more weight and had a relative gain of 5.8 percent more thigh muscle volume than woman who did not, she said.

"When a woman has less weight to carry, even if she's lost a bit of lean mass in her legs, the effect is that she has better physical function," she said.

It's likely that such women will be better able to maintain their mobility and independence as they age, she added.

In the six-month double-blind study, 31 healthy, postmenopausal obese women were divided into two groups. Each group followed a 1,400-calorie weight-loss diet based on USDA's My Pyramid, but one group received a powdered whey protein supplement in the morning and again in the afternoon or evening; the other received a placebo that contained carbohydrates.

"We believe it's important to eat protein in the morning and through the day so those amino acids are always available. Unfortunately, American women tend not to eat much protein, especially when they're trying to cut calories. But it's easy to add protein powder into a smoothie or eat a high-protein snack and incorporate a healthier diet into a busy lifestyle," she said.

Both groups were encouraged to engage in light exercise (walking and stretching) and given diet education, including examples of healthy daily menus and a scale to measure portion size.

Before and after the study, participants were assessed for strength, balance, and the ability to perform such physical tasks as walking 50 feet, standing up five times from a chair, and lifting a book 12 inches above shoulder height.

Magnetic resonance imaging (MRI) was used at the beginning and end of the study to measure muscle volume of the right thigh, the amount of fat around the thigh, and the amount of fat within the thigh muscle.

In both groups, strength decreased as weight decreased. However, the study suggests that an increase in the amount of muscle relative to fat had beneficial effects on balance and performance, Evans noted.

And, even though weight loss in these older women had a negative effect on strength, their reduced weight helped with other aspects of physical function, she said.

"We hypothesize that more vigorous exercise—in particular, resistance training—would preserve even more muscle," she said.

Losing weight without thinking about it

Smaller plates, slimmer glasses, linked to weight loss success

Dieters may not need as much willpower as they think, if they make simple changes in their surroundings that can result in eating healthier without a second thought, said a consumer psychologist at the American Psychological Association's 119th Annual Convention.

"Our homes are filled with hidden eating traps," said Brian Wansink, PhD, who presented his findings and strategies for a healthier lifestyle in a plenary address entitled "Modifying the Food Environment: From Mindless Eating to Mindlessly Eating Better."

"Most of us have too much chaos going on in our lives to consciously focus on every bite we eat, and then ask ourselves if we're full. The secret is to change your environment so it works for you rather than against you," Wansink said

Wansink identified several myths about eating behaviors as a way to explain why Americans, on average, have been getting fatter. "People don't think that something as simple as the size of a bowl would influence how much an informed person eats," he said.

However, several studies show exactly that, including Wansink's study of 168 moviegoers, who ate either fresh or stale popcorn from different size containers. People ate 45 percent more fresh popcorn from extra-large containers than large ones and the people who were eating stale popcorn ate 34 percent more from the extra-large buckets than people eating fresh popcorn, according to the study.

They just don't realize they're doing it," said Wansink. This strategy also applies to what we drink. His research found that people pour about 37 percent more liquid in short, wide glasses than in tall, skinny ones of the same volume.

Even a kid's cereal bowl can be a trap, according to Wansink. One study showed children of different weights who were given a 16 ounce bowl were more likely to serve themselves twice as much cereal than children given an 8 ounce bowl.

Another myth, according to Wansink, is that people know when they are full and stop before they overeat. His Food and Brand Lab at Cornell University tested this by designing a "bottomless bowl." They brought in 60 people for a free lunch and gave 22 ounce bowls of soup to half, while the other half unknowingly got 22 ounce bowls that were pressure-fed under the table and slowly refilled. The results: people with bottomless bowls ate 73 percent more than those with normal bowls, yet when asked, they didn't realize they had eaten more. "The lesson is, don't rely on your stomach to tell you when you're full. It can lie," Wansink said.

Simply being aware of such findings can help people make healthier choices, especially those who are already trying to eat healthier foods, according to Wansink. One of his studies showed that people lost up to two pounds a month after making several simple changes in their environment, including:

- eating off salad plates instead of large dinner plates.
- keeping unhealthy foods out of immediate line of sight and moving healthier foods to - eye-level in the cupboard and refrigerator.
- eating in the kitchen or dining room, not in front of the television.

"These simple strategies are far more likely to succeed than willpower alone. It's easier to change your environment than to change your mind," Wansink concluded.

Does food act physiologically like a 'drug of choice' for some?

Variety is considered the "spice of life," but does today's unprecedented level of dietary variety help explain skyrocketing rates of obesity? Some researchers think it might.

According to ASN Spokesperson Shelley McGuire, PhD: "We've known for years that foods- even eating, itself- can trigger release of various brain chemicals, some of which are also involved in what happens with drug addiction and withdrawal. And, as can happen with substance abusers, tolerance or "habituation" can occur, meaning that repeated use (in this case, exposure to a food) is sometimes accompanied by a lack of response (in this case, disinterest in the food). The results of the study by Epstein and colleagues provides a very interesting new piece to the obesity puzzle by suggesting that meal monotony may actually lead to reduced calorie consumption. The trick will be balancing this concept with the importance of variety to good nutrition."

Studies have shown that many people become disinterested in a particular food when they are repeatedly exposed to it. This response, called habituation, can decrease caloric intake in the short-run. Conversely, when presented with a variety of foods, caloric intake can increase. The "food addiction hypothesis" purports that some people may overeat because they are insensitive to the normal habituation response and thus need even more exposure to a food to trigger a disinterest. However, there has been no rigorous research investigating whether healthy-weight and overweight individuals have different habituation responses, and little is known about what patterns of food exposure are most powerful in triggering habituation. To help close these research gaps, researchers studied long-term habituation in obese and nonobese women. Their results, and an accompanying editorial by Nicole Avena and Mark Gold, are published in the August 2011 issue of The American Journal of Clinical Nutrition.

Sixteen nonobese [BMI (in kg/m2) < 30] and 16 obese (BMI  30) women were randomly assigned to 1 of 2 groups: the "weekly group" participated in weekly experimental food exposure sessions for 5 wk, whereas the "daily group" were studied daily for 5 consecutive days. During each 28-min experimental session, subjects were asked to complete a variety of tasks after which they were "rewarded" by being given a 125-kcal portion of macaroni and cheese. Participants could work for as much food as they wanted. The researchers then evaluated total energy intake.

Whereas weekly food exposure increased total caloric intake by approximately 30 kcal/d, daily exposure decreased energy consumption by ~100 kcal/d. This supports long-term habituation in terms of caloric intake. Very few differences were found between how obese and nonobese individuals responded.

The authors concluded that reducing variety in food choices may represent an important strategy for those trying to lose weight. Moreover, having a person even remember that they have eaten a certain food recently may be effective in this regard. In their accompanying editorial, Avena and Gold compare physiologic components of the food addiction hypothesis to the body's addictive responses to drugs. They also ponder whether school-lunch planners and public health officials should note that diversity in the menu is not necessarily a virtue" but might instead "be associated with promoting excess food intake and increased body mass index." Provocative food for thought.

'Love your body' to lose weight

Almost a quarter of men and women in England and over a third of adults in America are obese. Obesity increases the risk of diabetes and heart disease and can significantly shorten a person's life expectancy. New research published by BioMed Central's open access journal International Journal of Behavioral Nutrition and Physical Activity shows that improving body image can enhance the effectiveness of weight loss programs based on diet and exercise.

Researchers from the Technical University of Lisbon and Bangor University enrolled overweight and obese women on a year-long weight loss program. Half the women were given general health information about good nutrition, stress management, and the importance of looking after yourself. The other half attended 30 weekly group sessions (the intervention plan) where issues such as exercise, emotional eating, improving body image and the recognition of, and how to overcome, personal barriers to weight loss and lapses from the diet were discussed.

On the behavioral intervention plan women found that the way they thought about their body improved and that concerns about body shape and size were reduced. Compared to the control group they were better able to self-regulate their eating and they lost much more weight, losing on average 7% of their starting weight compared to less than 2% for the control group.

Dr Teixeira from Technical University of Lisbon, who led the research, said, "Body image problems are very common amongst overweight and obese people, often leading to comfort eating and more rigid eating patterns, and are obstacles to losing weight. Our results showed a strong correlation between improvements in body image, especially in reducing anxiety about other peoples' opinions, and positive changes in eating behavior. From this we believe that learning to relate to your body in healthier ways is an important aspect of maintaining weight loss and should be addressed in every weight control program."

Personality plays role in body weight, according to study

Ω


Impulsivity strongest predictor of obesity


People with personality traits of high neuroticism and low conscientiousness are likely to go through cycles of gaining and losing weight throughout their lives, according to an examination of 50 years of data in a study published by the American Psychological Association.

Impulsivity was the strongest predictor of who would be overweight, the researchers found. Study participants who scored in the top 10 percent on impulsivity weighed an average of 22 lbs. more than those in the bottom 10 percent, according to the study.

"Individuals with this constellation of traits tend to give in to temptation and lack the discipline to stay on track amid difficulties or frustration," the researchers wrote. "To maintain a healthy weight, it is typically necessary to have a healthy diet and a sustained program of physical activity, both of which require commitment and restraint. Such control may be difficult for highly impulsive individuals."

The researchers, from the National Institute on Aging, looked at data from a longitudinal study of 1,988 people to determine how personality traits are associated with weight and body mass index. Their conclusions were published online in the APA's Journal of Personality and Social Psychology.

"To the best of our knowledge, we are the first to examine whether personality is associated with fluctuations in weight over time," they wrote. "Interestingly, our pattern of associations fits nicely with the characteristics of these traits."

Participants were drawn from the Baltimore Longitudinal Study of Aging, an ongoing multidisciplinary study of normal aging administered by the National Institute on Aging. Subjects were generally healthy and highly educated, with an average of 16.53 years of education. The sample was 71 percent white, 22 percent black, 7 percent other ethnicity; 50 percent were women. All were assessed on what's known as the "Big Five" personality traits – openness, conscientiousness, extraversion, agreeableness and neuroticism -- as well as on 30 subcategories of these personality traits. Subjects were weighed and measured over time. This resulted in a total of 14,531 assessments across the 50 years of the study.

Although weight tends to increase gradually as people age, the researchers, led by Angelina R. Sutin, PhD, found greater weight gain among impulsive people; those who enjoy taking risks; and those who are antagonistic – especially those who are cynical, competitive and aggressive.

"Previous research has found that impulsive individuals are prone to binge eating and alcohol consumption," Sutin said. "These behavioral patterns may contribute to weight gain over time."

Among their other findings: Conscientious participants tended to be leaner and weight did not contribute to changes in personality across adulthood.

"The pathway from personality traits to weight gain is complex and probably includes physiological mechanisms, in addition to behavioral ones," Sutin said. "We hope that by more clearly identifying the association between personality and obesity, more tailored treatments will be developed. For example, lifestyle and exercise interventions that are done in a group setting may be more effective for extroverts than for introverts."

Why do people eat less when they have big forks?

Larger portion sizes usually mean we eat more food, but according to new study in the Journal of Consumer Research, bigger bites lead to eating less—in restaurant settings.

"In this research we examined the influence of small versus large bite-sizes on overall quantity of food consumed," write authors Arul Mishra, Himanshu Mishra, and Tamara M. Masters (all University of Utah, Salt Lake City).

The authors conducted a field study in a popular Italian restaurant. They used two sizes of forks to manipulate bite sizes and found that diners who used large forks ate less than those with small forks.

The authors then began to investigate why this finding seems to contradict earlier research on portion sizes. "We observe that diners visit the restaurant with a well-defined goal of satiating their hunger and because of this well-defined goal they are willing to invest effort and resources to satiate their hunger goal," the authors write. Diners can satisfy their hunger by choosing, eating, and paying for their food—all of which involve effort.

"The fork size provided the diners with a means to observe their goal progress," the authors explain. "The physiological feedback of feeling full or the satiation signal comes with a time lag. In its absence diners focus on the visual cue of whether they are making any dent on the food on their plate to assess goal progress."

The authors tested this conclusion by varying the quantities of food. They found that when the initial quantity of food was more (a well-loaded plate) diners with small forks ate significantly more than those with large forks. When customers were served small servings, the fork size did not affect the amount of food. Interestingly, in a lab experiment the authors found that participants with small forks consumed less than those with large forks. The authors believe that the participants did not have the same goals of satiating hunger as the restaurant customers did.

To avoid overeating, the authors suggest consumers learn to better understand hunger cues. "People do not have clear internal cues about the appropriate quantity to consume," the authors write. "They allow external cues, such as fork size, to determine the amount they should consume."

Smoking Does Not Keep You Slim, Research Shows

You might think that you will gain weight if you quit smoking. But it's not that simple. A master's thesis from the Nordic School of Public Health (NHV) in Sweden shows that smoking doesn't help you get thinner.

While cigarette smoking has decreased in western countries, obesity has increased. Recent studies have suggested that today's smokers may have less weight problems than non-smokers. "That's why I wanted to study whether the relationship between smoking and overweight has changed over time," said Lisa Webb, Master of Public Health at NHV.

Approximately 6,000 people have participated in a study on the relationship between smoking and obesity. Two measure of body fat have been used: BMI (body mass index) and WHR (waist hip ratio). The master's thesis "Smoking in the age of obesity: an investigation of secular trends in body fat and cigarette smoking" shows higher WHR for male and female smokers but lower BMI for female smokers, as compared with non-smokers.

A particularly noteworthy finding was that the difference between WHR among female smokers and never-smokers increased during the study.

Top 10 Things That Are Eating Away at Your Ideal Body

You may not be entirely to blame for your diet woes. So say brother and sister Dian Griesel, Ph.D. (Nutrition) and Tom Griesel.

After spending 30 years working with scientific researchers while continuously experimenting with various diets, the Griesels explain why all other diet and exercise advice to date is inherently designed to contribute to the growing epidemic of chronic obesity. “The best of diet intentions fail in late afternoon and evening because dieters fall for certain traps that sabotage success,” says Dr. Griesel. Those traps, say the authors, include:

10. Commercials could make anyone hungry. “They are designed to be enticing—even though we all know a fast-food burger tastes like a hockey puck! (Not that we’ve eaten hockey pucks...),” say the authors.
9. Manufacturers make foods addictive with chemicals and preservatives.
8. Manufacturers make foods addictive by using sugar/fat/salt combos.
7. Hanging out with an overeating, unimaginative crowd. (There ARE other things more interesting than eating...)
6. Boredom.
5. Dieting and aerobic exercising together reduce calories, so primitive starvation-survival mechanisms kick in making the brain scream for food.
4. Burning the candle too late, is counter productive to fat burning. A good night’s sleep burns fat and keeps us from eating!
3. We eat when we are really thirsty.
2. Motivation is misdirected. The choice needs to be: Which do I value more? A chocolate bar now or a longer and healthier life with my family
1. Traditional diet and exercise advice is all wrong.

Higher-protein diets can improve appetite control and satiety

A new study demonstrates that higher-protein meals improve perceived appetite and satiety in overweight and obese men during weight loss.(1) According to the research, published in Obesity, higher-protein intake led to greater satiety throughout the day as well as reductions in both late-night and morning appetite compared to a normal protein diet.

"Research has shown that higher-protein diets, those containing 18 to 35 percent of daily calorie intake from dietary protein, are associated with reductions in hunger and increased fullness throughout the day and into the evening hours," said Heather Leidy, Ph.D., study author and professor in the Department of Nutrition and Exercise Physiology at the University of Missouri. "In our study, the two groups ate either 25 or 14 percent of calories from protein, while the total calories and percent of calories from fat stayed the same between the higher-protein and normal-protein diet patterns. "

During the study, Dr. Leidy and associates also conducted an eating frequency substudy in which the 27 participants on both normal- and higher-protein diets consumed either three meals or six meals per day. The researchers found that eating frequency had no effect on appetite and satiety on the normal-protein diet. However, subjects on the higher-protein diet who ate three meals per day experienced greater evening and late-night fullness than those who ate six meals per day.

Dietary Protein and Reduced Calorie Consumption

This study supports previous research that demonstrates higher-protein diets, including egg breakfasts, are associated with decreased calorie consumption. A study published last year in Nutrition Research showed that men ate roughly 112 fewer calories at a buffet lunch and 400 fewer calories in the 24-hour period following a protein-rich egg breakfast compared to a bagel breakfast. (2) Another study demonstrated that overweight dieters who ate eggs for breakfast lost 65 percent more weight and felt more energetic than those who ate a bagel breakfast of equal calories and volume. (3)

References

(1)Leidy HJ, Tang M, Armstrong CLH, Martin CB, Cambell WW.The effects of consuming frequent, higher protein meals on appetite and satiety during weight loss in overweight/obese men. Obesity. 2011;19:818-824.

(2) Ratliff J, Leite JO, de Ogburn R, Puglisi MJ, VanHeest J, Fernandez ML. Consuming eggs for breakfast influences plasma glucose and ghrelin, while reducing energy intake during the next 24 hours in adult men. Nutrition Research 2010;30:96-103.

(3)Vander Wal JS, Gupta A, Khosla P, Dhurandhar NV. Egg breakfast enhances weight loss. International Journal of Obesity. 2008;32:1545-1551.

Food, Not Diet Soda, Makes You Fat

You are making a healthier choice when opting for a diet soda instead of a calorie-laden drink, but beware that you don’t sabotage your good behavior by indulging in fat-adding foods. “I suspect that people are likely drinking those diet sodas to wash down high fat and high-calorie fast food or take-out meals, not as a complement to a healthy meal prepared at home or to quench a thirst after a tough workout, ” says Jessica Bartfield, MD, internal medicine who specializes in weight and nutrition at Gottlieb Memorial Hospital.

Dr. Bartfield takes issue with two recent studies were presented at the American Diabetes Association in June that conclude that diet soda negatively impacts your waistline.

One study tracked 474 people, all 65 to 74 years old, for nearly a decade. It measured height, weight, waist circumference and diet soda intake every 3.6 years. The waists of those who drank soft drinks grew 70 percent more than those who did not.

Another study found that after three months of eating food containing aspartame, mice had higher blood sugar levels than rodents who ate regular food. Researchers concluded that aspartame could trigger the appetite but not satisfy it, leading you to eat more in general.

“The association studies are significant and provocative, but don’t prove cause and effect,” says Bartfield who counsels weight-loss patients at the Chicago-area Loyola University Health System. “Although these studies controlled for many factors, such as age, physical activity, calories consumed and smoking, there are still a tremendous number of factors such as dietary patters, sleep, genetics, and medication use that account for the metabolic syndome/weight gain.”

For people trying to lose weight, switiching from sugar-sweetened beverages to diet soda can have a tremendous impact on calorie reduction but Dr. Bartfield feels it comes down to one basic principle. “It still comes down to moderation,” she says. “I caution patients to keep it to one or two diet sodas per day.”

Losing Weight, Keeping It Off Might Require Distinct Skill Sets

Source: Health Behavior News Service

A new study indicates that the practices that help people to lose weight and the practices that help them keep it off do not overlap much.

“No one announces to a dieter, ‘You’re moving into the weight-maintenance stage. You’ll have to do things differently,’ said lead author Christopher Sciamanna, M.D. His group investigated whether two distinct sets of behaviors and thought patterns were involved in weight loss and its maintenance.

Practices associated with successful weight loss only were:
•Participate in a weight–loss program
•Look for information about weight loss, nutrition or exercise
•Eat healthy snacks
•Limit the amount of sugar you eat or drink
•Plan what you’ll eat ahead of time
•Avoid skipping a meal, including breakfast
•Do different kinds of exercise
•Do exercise that you enjoy
•Think about how much better you feel when you are thinner

Practices significantly associated with successful maintenance only were:
•Eat plenty of low-fat sources of protein
•Follow a consistent exercise routine
•Reward yourself for sticking to your diet or exercise plan
•Remind yourself why you need to control your weight

If the two stages do demand different practices, then weight loss programs might need to guide people about key strategies for each phase explicitly, said Sciamanna, a professor of medicine and public health sciences at the Penn State College of Medicine. The study appears online and in the August issue of the American Journal of Preventive Medicine.

Lawrence Cheskin, M.D., director of the Weight Management Center at Johns Hopkins Bloomberg School of Public Health, said, “We do often tell patients about the different skills that are needed and the different approaches to take to achieve weight loss and weight maintenance. This work adds substance to that general statement.” Cheskin has no affiliation with the study.

Sciamanna’s group surveyed a random sample of 1,165 adults by telephone. Some had been successful at losing weight; some had also maintained a weight loss. They asked them about 36 things they might do and think about to lose weight and keep it off. The researchers defined long-term success as losing at least 30 pounds and keeping if off for a year.

Fourteen practices were associated with either successful loss or successful weight loss maintenance, but not both. The overlap between practices associated with weight loss and those associated with weight loss maintenance was 61 percent, not much higher than that expected by chance.

“Some people are ‘black and white,’” Cheskin said. “They’ll diet strictly, eating nothing they’re not meant to eat, or they won’t be careful at all. Maintenance requires something in between. This research could have implications for what we should emphasize when we are trying to help people lose versus maintain their weight.”

If the two stages do demand different practices, then weight loss programs might need to guide people about key strategies for each phase explicitly, said Sciamanna, a professor of medicine and public health sciences at the Penn State College of Medicine. The study appears online and in the August issue of the American Journal of Preventive Medicine.

Lawrence Cheskin, M.D., director of the Weight Management Center at Johns Hopkins Bloomberg School of Public Health, said, “We do often tell patients about the different skills that are needed and the different approaches to take to achieve weight loss and weight maintenance. This work adds substance to that general statement.” Cheskin has no affiliation with the study.

Sciamanna’s group surveyed a random sample of 1,165 adults by telephone. Some had been successful at losing weight; some had also maintained a weight loss. They asked them about 36 things they might do and think about to lose weight and keep it off. The researchers defined long-term success as losing at least 30 pounds and keeping if off for a year.

Fourteen practices were associated with either successful loss or successful weight loss maintenance, but not both. The overlap between practices associated with weight loss and those associated with weight loss maintenance was 61 percent, not much higher than that expected by chance.

“Some people are ‘black and white,’” Cheskin said. “They’ll diet strictly, eating nothing they’re not meant to eat, or they won’t be careful at all. Maintenance requires something in between. This research could have implications for what we should emphasize when we are trying to help people lose versus maintain their weight.”

Obese dieters' brain chemistry works against their weight-loss efforts

If you've been trying to lose weight and suspect your body's working against you, you may be right, according to a University of Illinois study published in Obesity.

"When obese persons reduce their food intake too drastically, their bodies appear to resist their weight loss efforts. They may have to work harder and go slower in order to outsmart their brain chemistry," said Gregory G. Freund, a professor in the U of I College of Medicine and a member of U of I's Division of Nutritional Sciences.

He particularly cautions against beginning a diet with a fast or cleansing day, which appears to trigger significant alterations in the immune system that work against weight loss. "Take smaller steps to start your weight loss and keep it going," he said.

In the study, the scientist compared the effects of a short-term fast on two groups of mice. For 12 weeks, one group consumed a low-fat diet (10 percent fat); the other group was fed a high-fat (60 percent fat) and had become obese. The mice were then fasted for 24 hours. In that time, the leaner mice lost 18 percent of their body weight compared to 5 percent for the obese mice.

Freund said that there is an immune component to weight loss that has not been recognized. "Our data show that fasting induces an anti-inflammatory effect on a lean animal's neuroimmune system, and that effect is inhibited by a high-fat diet. Some of the brain-based chemical changes that occur in a lean animal simply don't occur in an obese animal," he said.

This breakdown occurs because obese animals resist downregulation of genes that activate the interleukin-1 (IL-1) system and associated anti-inflammatory cytokines, he said.

The scientist also studied differences in the behavior of the two groups of mice, monitoring how much they moved, administering tests to discern the animals' ability to learn and remember, and noting whether the mice exhibited signs of depression or anxiety.

The results suggest that beginning a diet with a fast or near-fast may alter brain chemistry in a way that adversely affects mood and motivation, undermining the person's weight-loss efforts.

"The obese mice simply didn't move as much as the other mice. Not only was there reduced locomotion generally, they didn't burrow in the way that mice normally do, and that's associated with depression and anxiety," he said.

Beginning a weight-loss program in a depressed frame of mind and with decreased motivation doesn't bode well for the diet's success, he noted.

Fat substitutes linked to weight gain

Synthetic fat substitutes used in low-calorie potato chips and other foods could backfire and contribute to weight gain and obesity, according to a study published by the American Psychological Association.

The study, by researchers at Purdue University, challenges the conventional wisdom that foods made with fat substitutes help with weight loss. "Our research showed that fat substitutes can interfere with the body's ability to regulate food intake, which can lead to inefficient use of calories and weight gain," said Susan E. Swithers, PhD, the lead researcher and a Purdue psychology professor. The study was published online in the APA journal Behavioral Neuroscience.

The study used laboratory rats that were fed either a high-fat or low-fat diet of chow. Half of the rats in each group also were fed Pringles potato chips that are high in fat and calories. The remaining rats in each group were fed high-calorie Pringles chips on some days and low-calorie Pringles Light chips on other days. The Pringles Light chips are made with olestra, a synthetic fat substitute that has zero calories and passes through the body undigested.

For rats on the high-fat diet, the group that ate both types of potato chips consumed more food, gained more weight and developed more fatty tissue than the rats that ate only the high-calorie chips. The fat rats also didn't lose the extra weight even after the potato chips were removed from their diet. "Based on this data, a diet that is low in fat and calories might be a better strategy for weight loss than using fat substitutes," Swithers said. However, she warned that it can be difficult to extrapolate laboratory findings about rats to people, even though their biological responses to food are similar. The study was conducted by Swithers along with Purdue psychology professor Terry L. Davidson, PhD, and former Purdue undergraduate student Sean Ogden.

Why would a fat substitute confuse the body? Food with a sweet or fatty taste usually indicates a large number of calories, and the taste triggers various responses by the body, including salivation, hormonal secretions and metabolic reactions. Fat substitutes can interfere with that relationship when the body expects to receive a large burst of calories but is fooled by a fat substitute.

There is some good news if a diet is naturally low in fat. The rats that were fed a low-fat diet didn't experience significant weight gain from either type of potato chips. However, when those same rats were switched to a high-fat diet, the rats that had eaten both types of potato chips ate more food and gained more weight and body fat than the rats that had eaten only the high-calorie chips.

Swithers and Davidson have reported similar findings in previous rat studies that showed saccharin and other artificial sweeteners also can promote weight gain and increased body fat. The use of artificial sweeteners and fat substitutes has increased dramatically over the past 30 years, mirroring the increase in obesity in America. Dieters have turned to these artificial means to lower calories while still eating foods that taste sweet or fatty. So what is a dieter supposed to do to drop a size?

"Unfortunately, there is no silver bullet," Swithers said. "Eating food which is naturally low in fat and calories may be a better route than relying on fat substitutes or artificial sweeteners."

Magical thinking helps dieters cope with unrealistic expectations

Ω

Magical thinking, usually dismissed as naïve and irrational, can actually help consumers cope with stressful situations like trying to lose weight, according to a new study in the Journal of Consumer Research.

"Magical thinking occurs when an individual invokes mystical, supernatural forces to understand, predict, or even influence events to overcome these stressful situations," write authors Yannik St. James (HEC Montreal), Jay M. Handelman, and Shirley F. Taylor (both Queen's University, Kingston, Canada).

"Weight loss activities are stressful for a number of reasons: being overweight is associated with several negative health consequences as well as considerable social stigma," the authors write. "Consumers are expected to conform to unrealistic cultural ideals of slenderness and they are simultaneously enticed to indulge in abundant, highly caloric, processed food."

To cope with these conflicting pressures and expectations, consumers engage in various forms of magical thinking. They describe weight loss as being influenced by mysterious forces, such as a body that "conspires" against them or food that "seduces" them. They also hope that good deeds will be rewarded (like eating chips without consequences after eating cabbage soup all day) and resort to "magical solutions" like fad diets. Finally, they try to fool the scale by changing to lighter clothing or exercising before being weighed.

These magical thinkers are not misinformed, the authors emphasize. "By invoking and negotiating with mystical forces, consumers actively work to create uncertainty and ambiguity as a way to generate hope and possibility in a cultural domain where they otherwise experience very little," the authors write.

The authors believe their findings should be of interest to consumer advocates and policy makers. "Programs directed at correcting fallacious consumer knowledge and enjoining consumers to exert greater self-control might be of limited value," the authors write. "Indeed, these approaches eliminate certain consumer coping strategies without affecting the source of stress—the cultural expectation to be thin in a culture that entices consumers with endless unhealthy food and lifestyle alternatives."

###

Sleepiness may impair the brain's inhibitory control when viewing high-calorie foods

Study suggests that daytime sleepiness may affect eating behavior by influencing the brain's response to food


Daytime sleepiness may affect inhibitory control in the brain when viewing tantalizing, high-calorie foods, suggests a research abstract.

Results show that greater daytime sleepiness was associated with decreased activation in the prefrontal cortex during visual presentations of enticing, high-calorie food images. The prefrontal cortex is a brain region that plays an important role in inhibitory processing.

"Self-reported daytime sleepiness among healthy, normally rested individuals correlated with reduced responsiveness of inhibitory brain regions when confronted with images of highly appetizing foods," said principal investigator William Killgore, PhD, assistant professor of psychology at Harvard Medical School and McLean Hospital in Belmont, Mass. "It suggests that even normal fluctuations in sleepiness may be capable of altering brain responses that are important for regulating dietary intake, potentially affecting the types of choices that individuals make when selecting whether and what to eat."

The research team of Killgore, lead author Melissa Weiner, and Zachary Schwab studied 12 healthy men and women between the ages of 19 and 45 years. The participants underwent functional magnetic resonance imaging (fMRI) while viewing pictures of high-calorie foods, low-calorie foods, and control images of plants and rocks. Subjective, self-reported daytime sleepiness was measured with the Epworth Sleepiness Scale, which evaluates how likely an individual is to doze off or fall asleep during certain situations such as while sitting and reading or watching TV.

According to the authors, prior evidence suggests that healthy adults activate inhibitory regions of the prefrontal cortex in response to high-calorie food images. However, insufficient sleep is often associated with reduced metabolic activity within these same prefrontal regions.

Killgore noted that the rapidly rising rate of obesity makes it important to understand the relationship between sleep-related factors, brain responses to food, and eating behavior.

"Given the chronic level of sleep restriction in our society, such relationships could have epidemiologic implications regarding the current increase in obesity in westernized countries," he said.

In a previous study published in Neuroreport in 2010, Killgore also found sex differences in cerebral responses to the caloric content of food images. Results of that study indicate that when viewing high-calorie food images, women showed significantly greater activation than men in brain regions that are involved in behavioral control and self-referential cognition.

Obesity is a risk factor for Alzheimer's disease

But weight loss due to bariatric surgery may reduce the risk of this common dementia

Obesity is a risk factor for Alzheimer's disease, but weight loss due to bariatric surgery may reduce the risk of this common dementia, a new study suggests. The results will be presented Sunday at The Endocrine Society's 93rd Annual Meeting in Boston.

"Our study shows for the first time that weight loss resulting from bariatric surgery leads to a reduction in the expression of genes related to Alzheimer's disease," said the study's main author, Paresh Dandona, MD, PhD, professor at State University of New York (SUNY) at Buffalo.

Past research has shown that obesity and Type 2 diabetes increase the chance of getting Alzheimer's disease. In this study, 15 morbidly obese patients with Type 2 diabetes had Roux-en-Y gastric bypass surgery and lost nearly 86 pounds, on average, over six months. The patients gave blood samples before surgery and six months later.

Dandona and co-workers recently found that white blood cells in the circulatjavascript:void(0)ing blood, called peripheral blood mononuclear cells, express amyloid precursor protein. This APP is the precursor of beta-amyloid, protein pieces that form plaques in the brain, one of the key brain abnormalities in Alzheimer's disease.

In this study, the researchers measured the expression of APP, and it fell by 22 percent after weight loss. Expression of the messenger RNA that carries genetic information for APP decreased by an average of 31 percent, the data showed.

After weight loss there also was reduced expression in other genes related to risk of Alzheimer's disease, according to the authors. They included the presenilin-2 gene, which mediates the conversion of APP into beta-amyloid. Also reduced in expression was the gene for an enzyme known as glycogen synthase kinase-3-beta (GSK-3-beta), which phosphorylates, or abnormally modifies, tau protein to form the neurofibrillary tangles in the brains of people with Alzheimer's disease. Tangles are a main suspect in the death of nerve cells in this disease.

Dandona said that their clinical study cannot prove that these effects are also occurring in the brain. If it is true, he said, "this may have implications for the treatment of Alzheimer's disease."

"It is relevant that cognitive function has previously been shown to improve with weight loss following bariatric surgery," Dandona said.

Also, inflammation is another brain abnormality seen in Alzheimer's disease, and in this study, the gene expression changes paralleled the reductions in the blood of mediators of inflammation, he said.

Cut down on 'carbs' to reduce body fat

A modest reduction in consumption of carbohydrate foods may promote loss of deep belly fat, even with little or no change in weight, a new study finds. Presentation of the study results will be Sunday at The Endocrine Society's 93rd Annual Meeting in Boston.

When paired with weight loss, consumption of a moderately reduced carbohydrate diet can help achieve a reduction of total body fat, according to principal author Barbara Gower, PhD, a professor of nutrition sciences at the University of Alabama at Birmingham.

"These changes could help reduce the risk of developing Type 2 diabetes, stroke and coronary artery disease," Gower said, noting that excess visceral, or intra-abdominal, fat raises the risk of these diseases.

Gower and her colleagues conducted the study, with funding from the National Institutes of Health, in 69 overweight but healthy men and women. Subjects received food for two consecutive eight-week periods: first a weight maintenance intervention, and then a weight loss intervention, which cut the number of calories that each person ate by 1,000 each day.

Subjects received either a standard lower-fat diet or a diet with a modest reduction in carbohydrates, or "carbs," but slightly higher in fat than the standard diet. The moderately carb-restricted diet contained foods that had a relatively low glycemic index, a measure of the extent to which the food raises blood glucose levels. This diet consisted of 43 percent calories from carbohydrates and 39 percent calories from fat, whereas the standard diet contained 55 percent of calories from carbohydrates and 27 percent from fat. Protein made up the other 18 percent of each diet.

At the beginning and end of each study phase, the researchers measured the subjects' fat deep inside the abdomen and their total body fat using computed tomography (CT) and dual-energy x-ray absorptiometry (DXA) scans.

After the weight maintenance phase, subjects who consumed the moderately carb-restricted diet had 11 percent less deep abdominal fat than those who ate the standard diet. However, when the researchers analyzed results by race, they found it was exclusive to whites. Whites have more deep abdominal fat than Blacks even when matched for body weight or percent body fat, and may benefit from loss of this metabolically harmful depot, Gower said.

During the weight loss phase, subjects on both diets lost weight. However, the moderately carb-restricted diet promoted a 4 percent greater loss of total body fat, Gower said. "For individuals willing to go on a weight-loss diet, a modest reduction in carbohydrate-containing foods may help them preferentially lose fat, rather than lean tissue," she said. "The moderately reduced carbohydrate diet allows a variety of foods to meet personal preferences."

The DASH Diet Predicts Weight Gain

Adherence to dietary pattern associated with lower BMI in adolescent girls

Adolescent girls whose diet resembles one recommended for adults with hypertension appear to have smaller gains in overall body mass index (BMI) over 10 years, according to a report in the June issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

"Excess weight during childhood leads to numerous health problems and is even associated with premature death as an adult," the authors write as background information in the article. However, the authors note that examinations of food-based dietary patterns acknowledge that consuming various nutrients together can have positive influences on health. One such diet pattern, the Dietary Approach to Stop Hypertension (DASH), was originally studied as a treatment for adults with hypertension, according to background in the article.

Jonathan P. B. Berz, M.D., M.Sc., of Boston University Medical Center, and colleagues evaluated the effects of a DASH-style eating plan on BMI (calculated as weight in kilograms divided by height in meters squared) in a racially diverse sample of adolescent girls. The authors examined data from 2,237 girls 9 years of age who participated in the National Growth and Health Study from 1987-1988 and were followed up for 10 years. Data were gathered annually and each participant was given a DASH food group score based on individual adherence to dietary requirements.

Higher DASH scores were associated with higher total energy intake, as well as higher average intake from each food group (whole grains, vegetables, fruits, lean meats, low-fat dairy and nuts/seeds/legumes). Girls in the highest quintile of DASH scores had the smallest gains in BMI during the study, and had the lowest BMIs at the end of follow-up. Conversely, at age 19 years, girls in the lowest DASH score quintile had an average BMI that was greater than the threshold for overweight as defined by the 85th percentile for age.

"In particular, higher consumption of fruits, whole grains and low-fat dairy products led to less weight gain," the authors noted. Participants who consumed two or more servings of fruit per day had the smallest gains in BMI during the study years and had the lowest BMI at the end of follow-up. Compared with participants consuming the least amount of whole grains, those who consumed the most had lower BMI scores over time and a lower BMI at the end of follow-up. The same results were seen for girls consuming higher amounts of low-fat dairy products.

"We found that higher adherence to a DASH-style diet resulted in a consistently lower BMI between the ages of 9 and 19 years," the authors conclude. "Such an eating pattern may help prevent excess weight gain during adolescence."

Arch Pediatr Adolesc Med. 2011;165[6]:540-546

Editorial: The DASH Diet Predicts Weight Gain

In an accompanying editorial, Robert C. Klesges, Ph.D. and Marion Hare, M.D., of the University of Tennessee Health Science Center, Memphis, Tenn., comment on the findings of this study. "As Berz et al point out, the DASH diet has been well validated in adults, and there is absolutely no reason for it to not work in children," they write. "The DASH diet is flexible and should meet the food preferences of most children. However, interventions for children need to be simplified; therefore, it make sense to specifically recommend increased consumption of fruits and low-fat dairy products."

"In summary, Berz et al add to a growing body of literature that will eventually help us to understand and hopefully treat pediatric obesity. A logical step in this literature is to test the DASH diet in children along with other efficacious adult obesity interventions."

Arch Pediatr Adolesc Med. 2011;165[6]:567-568.

Surgically shrinking the stomach when conservative weight-loss treatments fail

The treatment of obesity still needs improvement. In the current issue of Deutsches Ärzteblatt International, Norbert Runkel and colleagues present a new, interdisciplinary S3 guideline entitled "Bariatric Surgery" (Dtsch Arztebl Int 2011; 108[20]: 341𔃄).

One in two persons in Germany is overweight, and every fifth one is obese. Conservative treatment is considered to have been exhausted when it fails to bring about a 10% to 20% loss of weight in one year in a patient whose initial body-mass index was between 35 and 40 kg/m2.

In this situation, bariatric surgery is much more effective than conservative treatment for lowering weight and reducing the frequency of other medical problems due to obesity. The goal of surgery is to make the stomach smaller or shorten the passage of food through the gastrointestinal tract, so that the body takes up a smaller amount of nutrients. The currently established types of bariatric surgery in Germany are gastric banding, gastric bypass, sleeve gastrectomy, and biliopancreatic diversion. In the new guideline, the authors discuss the choice of the operative procedure, surgical complications, and postoperative care.

The guideline was produced according to the method specified by the Association of Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlich-medizinischen Fachgesellschaften, AWMF). Its evidence-based recommendations are intended to aid in the further development of bariatric surgery in Germany along with the necessary quality assurance.

Yo-yo dieting appears to be healthier than lifelong obesity

A new study comparing lifelong obesity with the weight fluctuations of "yo-yo dieting" suggests it is better to attempt to lose weight despite repeated failures at keeping the weight off than to not diet and remain obese. The results will be presented Monday at The Endocrine Society's 93rd Annual Meeting in Boston.

"It is clear that remaining on a stable, healthy diet provides the best outcome for health and longevity," said the study's principal investigator, Edward List, PhD, a scientist at Ohio University, Athens. "However, obese individuals commonly weight cycle—they have repeated intentional weight loss followed by weight regain, often called yo-yo dieting. While yo-yo dieting is thought to be harmful, there is little hard scientific evidence to support that."

To determine the long-term health effects of yo-yo dieting, List and his collaborators performed what they call "the first controlled study of a yo-yo diet regimen used for an entire life span." Because of the challenges of performing a long-term controlled feeding study in humans, they used mice to test whether weight fluctuation due to yo-yo dieting is as unhealthy as lifelong obesity.

Thirty mice, in groups of 10 each, received one of three diets: high fat, low fat or a yo-yo diet, consisting of four weeks of the high-fat diet followed by four weeks of the low-fat diet. The mice stayed on their respective diets throughout their life span. Measures of health, including body weight, body fat and blood glucose (sugar) levels, were obtained.

List said the yo-yo diet resulted in large fluctuations in these health measures, decreasing during the low-fat diet and increasing to a diabetic state during the high-fat diet. When health measures during the high-fat and low-fat diet regimens of the yo-yo diet group were averaged, their "average health" was improved compared with obese mice that stayed on the high-fat diet, he reported. Compared with the mice fed the high-fat diet, mice on the yo-yo diet lived nearly 35 percent longer.

"Surprisingly, the mice on the yo-yo diet had a similar life span to that of the low-fat-fed group," List said.

These findings are important in light of the growing epidemic of obesity around the world, he stated.

"The fear of negative health consequences due to weight cycling may be overemphasized," List concluded. "From our study, it appears that it is better to continue to encourage weight loss regardless of the number of attempts and failures."

Desserts With a Low Glycemic Index May Benefit Weight-Loss Efforts

Overweight girls lose more weight and can better stay on a healthy diet if they eat sugar-free, low-fat desserts several times weekly, as opposed to any dessert once a week, a new study finds.

"Dieters commonly splurge on dessert once a week, usually choosing fattening items," said lead investigator Antonia Dastamani, MD, PhD, a pediatrician and research fellow at Athens University School of Medicine in Athens, Greece. "However, we found a positive effect of more frequent consumption of desserts that have a low glycemic index and low glycemic load."

Carbohydrates have a low glycemic index (GI) if they raise glucose, or blood sugar, levels more slowly than other carbohydrates do. The glycemic load (GL), which depends on serving size, is the food's total effect on blood sugar.

"Studies suggest that low GI/GL diets have a positive effect on weight control and improving insulin resistance," Dastamani said.

Obesity can cause insulin resistance, in which the body does not properly use the hormone insulin. This results in high blood sugar levels and sets the stage for development of diabetes.

Dastamani and her colleagues tested the effects of incorporating into a balanced diet certain low-calorie, low-GI/GL desserts containing sugar substitutes such as sucralose. The products are made by the Giotis Company, a food production company in Athens, which donated the desserts and helped fund the study.

The investigators studied the effects of two diets in 29 girls, ages 10 to 14 years, who had a body mass index (BMI) in the 85th percentile or above, considered overweight or obese. A group of 15 girls ate a diet consisting of 45 percent carbohydrates, 35 percent fats and 20 percent proteins, including the low-GI/GL desserts four times a week. The other group of 14 girls followed the same diet except, instead of the low-GI/GL desserts, they ate desserts of their choice once a week.

After three months on the diet, both groups improved their BMI (body composition). Compared with the second group, however, the group that ate the low-GI/GL desserts lost significantly more weight and had better average BMI and systolic blood pressure (the first number in a blood pressure reading), the authors reported.

Girls who ate the low-GI/GL desserts also had significantly improved levels of the appetite-suppressing hormone leptin, the researchers found. They also had better improvements in biochemical markers of insulin resistance (fasting insulin levels in the blood and the homeostatic model assessment, or HOMA, index).

"Childhood obesity is pandemic, and dietary changes among overweight and obese children must be a priority," Dastamani said. "Desserts with a low glycemic index and glycemic load, when eaten in moderation, are valuable tools in the treatment of pediatric obesity."