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HealthStyles
May, 2008
Is Physical Activity Without Weight Loss a Useful Strategy for Obesity Reduction?
Every day at
CNC I see patients trying so hard to lose weight by increasing
exercise. Often times, these same people find that weight loss is
a struggle in spite of these high levels of physical activity.
Unfortunately, if weight loss is the only goal of exercise, the failure
to lose weight often results in discontinuation of an otherwise sound
exercise plan.
In fact,
several lines of evidence suggest that weight loss is not necessary to
observe substantial exercise-induced health benefits. First,
there is now overwhelming evidence that abdominal obesity conveys the
greatest health risk, and that exercise often decreases abdominal
obesity, even in the absence of weight loss. Second, short and
long-term exercise are associated with substantial reduction in insulin
resistance despite minimal change in body weight. Third,
increasing activity leads to improved fitness and reduction in the risk
of both heart disease and diabetes, independant of changes in weight.
As Spring
rolls in and you consider the role exercise plays in your life,
remember all the health benefits of exercise: decreasing
abdominal fat, decreasing waist size, increasing skeletal muscle mass,
increasing heart/lung fitness, and improving insulin sensitivity.
Focus on these benefits, and stay active!
Ethan Lazarus, M.D., adapted from "Obesity Management, April 2008"
Normal Weight Obesity
As if the
obesity epidemic wasn't serious enough already, it turns out that more
than 1/2 of individuals with normal BMI have a condition called
normal-weight obesity. This is defined as a high percentage of
body fat with BMI in normal range (18.5-24.9).
According to Dr. Romero-Corral of the Mayo Clinic, these patients are
at a higher risk of heart disease. In a large study of 2127
adults with normal BMI but elevated body fat percentage, these patients
had elevated risk of high cholesterol, high blood pressure, high blood
sugar, low HDL cholesterol (good cholesterol), and pre-diabetes.
So, what's the
take home message? Like we've always recommended at CNC, the
scale only tells you so much. Have our staff do a body fat
measurement!
adapted from Family Practice News, April 15th, 2008
Book Report: "Mindless Eating"
There
are so many "diet" books hitting the shelves these days, sometimes it's
hard to keep up. Most new diet books continue to recommend fad
diets for rapid weight loss. Unfortunately, this tends to give
short-term results and not lead to meaningful lifestyle changes.
When
I saw "Mindless Eating" at the bookstore, the title caught my
eye. This book is written by Brian Wansink, Ph.D. Rather
than focusing on what to eat and what not to eat, Dr. Wansink studies
how the environment influences our food decisions. He states,
"Traditional diet books focus on what dieticians and health
practitioners know. This book focuses on what psychologists and
marketers know."
He
then introduces a series of ideas regarding how our environments
influence the amount we eat, and backs them up with clinical
studies. I found this to be a fascinating read, and couldn't help
from laughing at times at the ingenious study designs. For
example, in one study he invites 4 people at a time to lunch, and feeds
them soup. What the diners don't know is that for 2 of them, the
soup bowls are "rigged" so that as they eat, more soup is pumped in to
the bowl through a hidden hole in the bottom. He calls these the
"bottomless soup bowls." The people with the rigged bowls ate
nearly twice as much, because they did not get the visual queue to stop
eating, i.e., the empty bowl. Yet, the people with normal bowls
reported the same level of "fullness" as the diners with the rigged
bowls, who ate twice as much. He further does studies on plate
size, serving size, perceptions of variety, glass size, and on and
on. He compellingly argues that "hunger" and "fullness" are not simply caused by the amount of food in our stomaches, but by our environment.
I would highly
recommend this book to anyone seeking more insight in to how our
environments shape our eating habits, and how the media uses this
regularly to their advantage.
Ethan Lazarus, M.D.
Nutrition trends for 2008 - Eating "Green"
It is popular to be "green" these days. Hybrid vehicles
are popular; "organic" foods are increasingly available; 90% of
Americans recycle; 83% reduce energy use, 83% use less water; 83% avoid
environmentally harmful products, and 73% buy environmentally
beneficial products.
We are becoming aware that the
choices people make at the dinner table can impact the health of the
planet. The Food and Agriculture Organization of the United Nations announced that livestock production was responsible for more than 18% of the greenhouse gas emissions - more damage than transportation causes. Our decisions about what to eat can take its toll.
Eating locally grown or raised food
is usually more cost effective, nutritious, and saves on fuel - it
doesn't have to travel across the country to get to the dinner
table. Eating vegetarian meals - plant based foods, such as beans
- instead of meat several times per week is environmentally
friendly. Reducing meat intake saves on livestock emissions,
feed, waste products, fuel, and cost. Plant proteins are
nutritious, containing fiber and many nutrients, in addition to protein.
Paying attention to how foods are
packaged - trying to reduce over-packaging by purchasing foods that
require minimal or no packaging - is another way to go green.
Other nutrition trends for 2008 -
looking at foods as prescriptions for health; customized meal plans by
dietitians; focusing on staying healthy instead of treating illnesses
(reduces health care costs and use of medications); finding convenience
foods that are nutritious; increasing use of ethnic cuisines (including
the flavors of Spain, Portugal, the Caribbean, Ecuador, Honduras, Argentina, and Cuba);
interest in food safety; increased use of Internet information - but be
careful to obtain valid information; and, seeking sensible weight loss
plans.
Tanja Bugas, MS, RD, adapted from "Today's Dietitian"
The Top Eight Indications of Successful Weight Maintenance
The National Weight Control
Registry has listed 8 common behaviors most often reported by people
who have successfully lost substantial amounts of weight and kept it
off long-term. The Top 8 are:
1. Intake of a low-fat/low-lt;orie meal plan
2. Increased physical activity (60-75 minutes / day)
3. Limited television viewing (less than 10 hours / week)
4. Frequent weigh-ins
5. Limited variety in day-to-day food choices
6. Limited fast food intake
7. Low-lt;orie, healthy "meal replacements" - such as our protein drinks and bars
8. Eating breakfast every day
Suzanne Boos, R.D., adapted from the National Weight Control Registry
Thank you!
Sincerely,
Dr. Lazarus, and the Staff at CNC
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