Calories, Not Carbs or Protein Key to Weight Management

Curbing calories is the key ingredient for diabetics seeking to lose weight, and low-fat diets that are either high in protein or high in carbs are equally effective, researchers say.

"I think there are two key messages from this study," said study lead author Jeremy D. Krebs, a senior lecturer with the school of medicine and health sciences at the University of Otago in Wellington, New Zealand. "The first is that no matter what diet we prescribe, people find it extremely difficult to sustain the changes from their habitual diet over a long time. But if they are able to follow either a high-protein diet or a high-carbohydrate diet, they can achieve modest weight loss."

Krebs said this first message conveys flexibility and allows people to choose the approach that best suits them and "even to swap between dietary approaches when they get bored."

The second point "is that for people with diabetes, if they can adhere to either diet and achieve weight loss, then they do get benefits in terms of their diabetes control and cardiovascular risk," he added.

Krebs and his colleagues are scheduled to report their findings Sunday in San Diego at the American Diabetes Association meeting.

To compare the potential benefits of two popular dietetic approaches, the authors tracked nearly 300 overweight men and women between the ages of 35 and 75 who were on a new, two-year nutritional program.

To start, all the participants had a body mass index greater than 27, meaning they were moderately overweight, and all had type 2 diabetes.

The researchers randomly assigned the participants to one of two groups: a low-fat/high-protein group or a low-fat/high-carb group.

For the first half year, all attended twice-weekly group sessions led by a dietitian; for the following six months, sessions took place monthly.

Weight and waist circumference were measured at six months, one year, and two years. Kidney function and lipid (blood fats) profiles were also assessed throughout.

Food diaries indicated that total calorie intake went down in both groups. Ultimately, both groups lost a similar amount of weight and reduced their waist size in similar measure, the investigators found. And by the end of the two-year period, both groups had similar blood fat profiles.

Krebs and his colleagues concluded that their "real-world" experiment demonstrated that both approaches afford similar benefits, with the principal driving factor behind sustained weight loss being calorie reduction rather than either high-carb or high-protein consumption.

Lona Sandon, a registered dietitian and assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center at Dallas, said the observations were "not at all surprising."

"This is pretty consistent with other research out there that has conducted other long-term comparisons in the general population," she said. "In the first six months you might see a little better benefit from a high-protein approach. But long-term, the initial benefits from a high-protein diet seem to diminish over time, and the two diets end up being essentially equivalent," Sandon explained.

"The bottom-line is that the issue for weight loss is calories," Sandon added. "Not where those calories come from. You need to create an energy deficit to lead to weight loss, and that happens by decreasing those calories. That's just been shown again and again."

Experts note that research presented at medical meetings is considered preliminary because it has not been subjected to the rigorous scrutiny required for publication in a peer-reviewed medical journal.

Source: 6/26/11 Health Day News

Athletic Trainers Safe Weight Loss Statement

The National Athletic Trainers' Association (NATA) issued a statement Monday of recommendations for coaches, players, and athletic trainers regarding safe weight
loss and maintenance practices for athletes. The group hopes its recommendations will help reduce a disturbing prevalence of eating disorders and unsafe weight-maintenance habits that affect up to 62% of athletes.

NATA's statement emphasizes the importance of a well-rounded diet to an
athlete's performance and weight maintenance, the dangers of unsafe practices to long-term health, and the need for including medical professionals when
deciding on a safe weight.

Former LSU gymnast Ashleigh Clare-Kearney addressed NATA members at their
annual convention Monday in New Orleans.Clare-Kearney, one of the most decorated
gymnasts in LSU women's gymnastics history, was the physical and emotional
exception in the gymnastics world during her career. At 5-foot-5 and 150 pounds, the
two-time NCAA champion outsized most of her fellow gymnasts who she says are
traditionally around five feet, 100 pounds.

Emotionally, Clare-Kearney's self-esteem and comfort with her weight were also
rarities in a culture she describes as "very high up there with sports like wrestling with the number of eating disorders and issuesof that nature relative to other sports."

"I definitely saw a lot of people who either didn't eat at all or ate and threw it up
because they were trying to fulfill this image …" says Clare-Kearney, who went on to
become an assistant coach at LSU after graduating in 2008. "They needed to
understand that food is fuel for your body and they were actually hurting themselves
…You can't perform if you don't eat."

According to Paula Turocy, chair at the John G. Rangos Sr. School of Health Sciences at Duquesne University and chair of the group that wrote the NATA statement, the goal is to dispel common misconceptions that lead to unsafe weight maintenance practices like the ones Clare-Kearney described. Particularly dangerous is the idea that adjustments to an athlete's weight can be achieved quickly,says LSU senior associate athletic trainer Shelley Mullenix.
Source: USA Today 6/21/11

Food Choices Matter

If there was ever any suggestion that French fries are good for you, it’s now dispelled in stark detail. An analysis of data from three lengthy surveys that assigns actual pounds of weight gain to foods finds that fries, sodas and several other guilty pleasures are among the most potent waist expanders.

On the bright side, researchers attribute weight loss to eating yogurt, fruit, nuts and vegetables. The report appears in the June 23 New England Journal of Medicine.

“Conventional wisdom often recommends ‘everything in moderation’ with a focus only on total calories consumed, rather than the quality of what is consumed,” says study coauthor Dariush Mozaffarian, a cardiologist at Harvard Medical School and Brigham and Women’s Hospital in Boston. “Our results demonstrate that the quality of the diet — the types of foods and beverages that one consumes — are strongly linked to weight gain.”

Mozaffarian and his colleagues combined data from three long-term surveys conducted between 1986 and 2006 that included more than 22,000 men and nearly 100,000 women. The weight, diet and lifestyle information collected in those surveys enabled the researchers to calculate an effect for specific foods.

None of the participants was obese or had any serious medical problems at the study’s outset, and no one was asked to go on a diet. Starting with each volunteer’s weight at the outset, the researchers monitored any gain or loss at four-year intervals. On average, participants had gained 3.35 pounds at each four-year point.

Potatoes stood out as a culprit. A single-serving bag of potato chips added to one’s daily intake tacked on 1.69 pounds over four years by this calculation. Potatoes prepared as boiled, mashed or baked, added about half a pound, while French fries larded on 3.35 pounds. A single sugar-containing soft drink per day tacked on 1 pound every four years. Butter, refined grains, desserts, processed or red meats, fruit juice, fried food or foods containing trans fats added somewhat less weight.

Other foods seemed to lower weight. Adding a daily serving of yogurt knocked off nearly a pound over four years, while adding a serving of nuts or fruit was associated with a loss of about half a pound each. An extra serving of whole grains, vegetables or diet soft drinks reduced weight slightly.

Changes in intake of dairy products other than butter and yogurt, whether low-fat or not, appeared to have little effect on weight.

A pound here and a pound there might not seem worth worrying about, but weight gain in middle age is often so gradual that people don’t notice it until they have already gained a substantial amount, Mozaffarian says. “These ‘small amounts’ are exactly what is causing the obesity epidemic,” he says.

Specifying which foods may lessen or prevent weight gain is highly practical, says nutrition scientist Christopher Gardner of Stanford University, who wasn’t involved in this study. “When you choose one of these foods, you choose not to consume something else,” he says. The strength of the study, he says, is that it demonstrates that “these are achievable differences because real, live people did them.”

Source: Science News 6/22/11

Some Multi Vitamins Don't Live Up To Label Claims

A new review of popular multivitamins found that one in three did not contain the amount of nutrients claimed in their labels or improperly listed ingredients.

After testing 38 multivitamins for a new report published online this week, researchers at ConsumerLab.com discovered that eight contained too little of specific nutrients, two contained more nutrient than claimed and three improperly listed ingredients. The good news: some of the best vitamins were also the cheapest.

"We found a wide range in the quality of multivitamins," said Dr. Tod Cooperman, president of the company. "Interestingly, the more expensive products didn't fare any better than those that are just a few cents a day."

While medications are closely overseen by the federal Food and Drug Administration, supplements like vitamins don’t get regular testing by any government agency. So there’s no way of knowing — outside of independent testing — whether a bottle of supplements contains what it’s supposed to.

The problems with quality control found by ConsumerLab don’t surprise Dan Hurley, a medical journalist and author of “Natural Causes,” a book on the supplement industry.

“That’s really pretty average for supplements. It’s a real crapshoot,” Hurley said. If a drug company had these kinds of lapses, it would be shut down, he said.

Although low levels of certain nutrients can be a problem, doses that exceed recommendations are especially worrisome. Several products evaluated by ConsumerLab, including some designed for children, had this issue. For the report, ConsumerLab used the recommended daily allowances and upper tolerable limits established by the Institutes of Medicine.

ConsumerLab is a Westchester, N.Y., company that independently evaluates hundreds of health and nutrition products and periodically publishes reviews. For this test, ConsumerLab purchased a selection of multivitamins and sent them, without labels to a lab for testing. If a problem was found, the product was sent to a second lab for confirmation.

ConsumerLab focused on some of the more important ingredients, such as folic acid, calcium, vitamin A (retinol and beta-carotene), zinc, and iron. Cooperman and his colleagues also looked to see how quickly vitamin tablets broke down in liquid. If a pill doesn’t break down fast enough, the body won’t be able to absorb as much of the various nutrients.

Among the supplements that had too little of a particular nutrient were Trader Joe’s Vitamin Crusade (just 59 percent of the vitamin A advertised on the label), Melaleuca Vitality Multivitamin & Mineral (just 42 percent of the touted vitamin A) and All One Active Seniors (less than 2 percent of the beta-carotene, 73 percent of the retinol and 49 percent of the vitamin A listed on the label).

Centrum Chewables had the opposite problem, with 173 percent of the vitamin A listed on the label. This is of particular concern because too much vitamin A can spell trouble.

“If you get too much vitamin A it can be toxic to your liver,” explained Dr. Michael Cirigliano, an associate professor of medicine at the Perelman School of Medicine at the University of Pennsylvania. “People don’t realize that everything they put in their mouths is bioactive. Whether it’s baby aspirin or food, it has an effect on the body. People think that if you can get it without a prescription it’s safe — that’s baloney.”

One product, Alpha Betic, took twice as long as it should have to break apart in solution, found ConsumerLab. The supplement also contained less vitamin A than it should have.

Particularly worrisome were high levels of certain nutrients in some of the children’s multivitamins.

Hero Nutritionals Yummi Bears, if given to children at the suggested dose, would exceed recommendations by the Institute for Medicine for Vitamin A in youngsters aged 1 to 3. However, the multivitamins were found to be in compliance with the standards set by the FDA. ConsumerLab considers the FDA’s standards to be outdated.

ConsumerLab found almost no connection between price and quality. Many of the cheaper pills (prices ranging between $0.03 and $0.14 per day) passed all the tests, while some of the most expensive ones (priced as high as $1 per day) failed.

Among the supplements that passed testing were several very inexpensive options, such as Equate Mature Multivitamin, at $0.03/day, Kirkland Signature Mature Multivitamins and Minerals Adult 50+ at $0.03/day and Flintstones Plus Bone Building Support at $0.14/day.

ConsumerLab also tested several pet supplements, one of which, Pet-Tabs Complete Daily Vitamin Mineral Supplement for Dogs contained lead at unhealthy levels.

Ultimately the new report is a strong argument for more regulation of the supplement industry, both Cirigliano and Hurley said.

“People are using these products more and more,” Cirigliano explained. “There needs to be more regulation.”

Source: MSNBC 6/20/11

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Food Allergies Affect 1 in 12 Children

One in 12 kids in the United States may have a food allergy, according to new findings based on an online survey.

The study, published June 20th in Pediatrics, also showed that more than one third of those kids had severe allergies, and that allergies were more common in minority kids.

Allergies are a particularly difficult chronic condition because kids can't escape food in any part of their daily lives, said lead author Dr. Ruchi Gupta, from the Northwestern University Feinberg School of Medicine in Chicago.

"What I hope this paper will do is open this awareness to how common (food allergy) is and how severe it can be, and develop policies for schools and sporting events and any activities that kids participate in to make it clear that everybody is looking out for these kids," she told Reuters Health.

Previous studies have estimated that anywhere between 2 and 8 of every 100 kids in the U.S. has a food allergy.

But most of those reports are based on studies that asked participants many different health questions, including only a few related to allergies, Gupta said. Other studies have also looked at emergency room trips for allergic reactions, or evaluated doctors' diagnoses in medical records.

Gupta and her colleagues instead wanted to design a study focused solely on the rate and severity of food allergies. They surveyed a nationally representative sample of almost 40,000 U.S. adults who lived with a child under 18.

Those adults filled out an online questionnaire about allergies based on a single kid in their household, reporting whether or not the child had any signs and symptoms of a food allergy, had ever been diagnosed with an allergy by a doctor, and had ever had a severe allergic reaction to food.

The results, published today in Pediatrics, showed that 8 percent of kids had a diagnosed food allergy or convincing symptoms that indicated an allergy - almost 6 million U.S. kids, the researchers said. Kids were most commonly allergic to peanuts, milk, and shellfish.

What was interesting was not just how many kids had allergies, Gupta said, but how many of those allergies were severe - cutting off a kid's airway or causing blood pressure to drop.

"One of our big findings was that 2 in 5 kids who had allergies had a severe reaction or a life-threatening reaction," Gupta said.

"There are a lot of misconceptions of what allergies are," she added. "When you think of allergies, you don't think of life-threatening."

Severe reactions were more common in older kids, possibly because young kids with allergies are more likely to be monitored by parents to make sure they stay away from potential allergy triggers, Gupta explained.

She and her colleagues also found that black and Asian kids had higher chances of having a food allergy than white kids - but that they were less likely to have that allergy diagnosed by a doctor.

That disparity "needs to be addressed," Dr. Scott Sicherer, an allergy researcher at the Mount Sinai School of Medicine in New York, told Reuters Health.

"The family is saying that their child had convincing reactions and yet they weren't really evaluated to confirm that with a doctor," said Sicherer, who was not involved in the study.

"Is that because they're not getting the health care they need? Is that because there's not an appropriate amount of concern? I would be worried that the next reaction could be severe and they're not prepared for it."

While the findings can't show whether or not food allergies are on the rise, Gupta thinks that's the case.

"As a clinician, I see it a lot more," Gupta said. Sicherer agreed that he thinks food allergies are becoming more frequent, but said that researchers aren't sure why that is.

The next question, Gupta said, is whether there is something going on in the environment that is driving that increase.

SOURCE: bit.ly/jsoh2P Pediatrics, online June 20, 2011.

Boys As Young As 10 May Be Bulemic

Doctors said an increasing number of young boys are making themselves sick after eating to avoid being bullied about their weight, despite the condition traditionally being associated with girls.

Some are even developing the disorder – which can be fatal – because they want to be able to fit into fashionable "skinny" jeans, while others are using laxatives to get a similar effect.

There are 5,000 reported cases of boys aged below 16 in Britain suffering from eating disorders according to NHS figures, but the real figure is thought to be significantly higher because many cases are likely to be undocumented.

A separate study of 16,000 children in Taiwan, published in Britain in the Journal of Clinical Nursing, found that sixteen per cent of boys aged 10 to 12 admitted inducing vomiting to lose weight after being bullied, compared with just ten per cent of girls.

Dr Yiing Mei Liou, who led the research, said these were likely to be "sedentary" children who spend large amounts of time watching television, surfing the internet or playing computer games.

A third study from the Centers for Disease Control and Prevention in America reported that four per cent of schoolchildren admitted having used laxatives in the past month.

A spokesman for Beat, the eating disorders charity, said bulimia is more common than anorexia but is harder to spot because sufferers' weight remains more stable.

The condition is most commonly developed in the late teens or early 20s, especially when other attempts to lose weight have been unsuccessful.

A number of celebrities and public figures have admitted to suffering from the condition, including former Labour minister John Prescott, who developed the eating disorder in his younger years.

A Beat spokesperson told The Sun the findings were "very disturbing", adding: "An imbalance or dangerously low levels of essential minerals in the body can significantly, even fatally affect the working of vital internal organs."

Source:The Telegraph (UK) 6/21/11