Clinical Nutrition Center
 
HealthStyles e-Newsletter
Ethan Lazarus, M.D.               Heather Thomas, P.A. -C
7555 E. Hampden Ave, Ste 301
phone:  303-750-9454
fax:  303-750-1996
Denver, CO  80231
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 receive 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, independent 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 stomachs, 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-calorie 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-calorie, 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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Ethan Lazarus, M.D.     Heather Thomas, P.A. -C
 
Clinical Nutrition Center
7555 E. Hampden Ave Ste 301,
Denver, CO  80231, Tel: (303) 750-9454

http://www.clinicalnutritioncenter.com