Monday, February 21, 2011

Go to Health: Strategies that work for weight loss

Researchers at Brown Medical School and the University of Colorado have established the National Weight Control Registry to follow people who have successfully lost 30 pounds or more and have kept it off for long periods of time. These people’s approaches are diverse and inspiring. Given the obesity epidemic among adults and children in the US, with an associated rise in diabetes and health care costs, the subject is important for all of us. Here are some salient findings from people who joined the registry:
*Weight losses range from 30 to 300 pounds.
*Duration of successful loss: 1-66 yrs.
*Some lost weight rapidly, others very slowly – over as many as 14 years.
*55% lost weight with the help of a program or support group.
*98% modified their food intake
*94% increased physical activity, most frequently by walking.
*78% eat breakfast every day
*75% weigh themselves at least once a week
*62% watch less than 10 hours of TV per week
*90% exercise about 1 hour a day

Mayo Clinic on Weight Loss: Here are some ideas from the Mayo Clinic Diet Book, which is sensible and pays attention to motivation as well as food and exercise. Permanent weight loss takes time and effort, and is a lifelong commitment. Address the other stresses in your life, so that you can focus on changing your habits. Find your inner motivation – looking better, or getting healthier. Pick people to support you in positive ways. Set realistic goals, such as losing 1-2 pounds a week, or walking at least 30 minutes a day. Enjoy healthier food – fruits, vegetables, whole grains, olive oil, nut butters, low-fat dairy products. Cut back on sugars, and limit meat consumption. Stay physically active. Work out a way to gradually change the habits and attitudes that have sabotaged your past efforts.

Childhood Obesity: 20% of children are now overweight or obese, mainly due to lack of physical activity and unhealthy eating patterns. Michelle Obama has put forth an action plan – “Let’s Move” to solve the problem of childhood obesity within a generation. Her plan includes getting parents more informed about nutrition and exercise, improving the quality of food in schools, making healthy foods more accessible in poor neighborhoods, and focusing on physical education. The American Academy of Pediatrics recommends that children under 2 not watch any TV, and those older than 2 watch no more than 1-2 hours a day of quality programming. Children who consistently watch more TV and computer screens – including computer games - are more likely to be overweight. Here are some other tips for parents to keep their children healthy and slim: don’t drink soda, and don’t have it at home. Keep kid-friendly snacks in the house: fruit, nuts, low fat yogurt, nut butters, whole grain bread and pre-cut vegetables. Avoid storing cakes, chips, full-fat cheese, white crackers and most lunch-meats. Make healthier versions of favorite recipes, like cookies and pizza. Be active together – get everyone out for a bike ride or hike. Don’t make it about losing weight; make it about being healthy. Be a good example!

Sleep: getting too little sleep adds to weight gain in children and adults. The relationship in children is strongest, and may be related to disrupted levels of the hormones – gherlin and leptin – that regulate hunger. Sleep deficits also elevate levels of cortisol from the adrenal glands, raising blood sugar levels. Catching up on lost sleep on weekends is not as effective as maintaining a consistent pattern of sleep. If you are working on weight control, regular and adequate sleep will help you.

Some Extra Exercise Ideas: Get a pedometer in order to measure your steps every day, and slowly increase your walking. I recommend a Digi-walker SW - 200, available on-line. Put bricks under your desk, so that the top is at elbow height. You then have a standing desk – used by Benjamin Franklin and Thomas Jefferson among other enlightenment thinkers. Standing will increase your strength as you work on your computer, or pay bills, or write your poems. Put a stationary bike or other exercise equipment in front of your television, and pedal as you watch your favorite programs. You can easily get to that hour a day recommended by the people who successfully lost weight. Get an exercise pal – who could be a dog.
Sadja Greenwood, MD, MPH back issues on this blog

Wednesday, February 9, 2011

Updates on Brains, Vitamin D and Green Vegetables

Your brain on weights: You’ve probably heard that running, brisk walking and other aerobics increase blood flow to the brain and may be linked to the creation of new brain cells. Recent research shows that weight training may do the same. Rats with weights tied to their tails (!) who climbed ladders, or rats on loaded running wheels, packed on muscle mass and had higher levels of ‘brain derived neurotropic factor’, which is thought to spark the growth of new brain cells. Older women who lifted weights did better on tests of cognitive functioning than women in toning classes. Teresa Liu-Ambrose at the University of British Columbia speculates that resistance training, by strengthening the heart, improves blood flow to the brain, which is associated with better cognition.

Confusion on Vitamin D: A recent report from the Institute of Medicine (IOM) recommended that adults get 600 IUs of Vitamin D daily, and those over 71 get 800. They said that most people get this amount from foods (fatty fish and fortified milk) and sun exposure, and do not need supplements. These recommendations were contrary to the more widespread view in recent years that considered the importance of Vitamin D for bone health and other benefits, including protection against certain cancers and auto-immune diseases. Beth Dawson-Hughes, a vitamin D researcher at Tufts University, criticized the IOM recommendations as insufficient for the following groups:
*people with little sun exposure, including winter residents at higher latitudes, shut-ins, those who use sunscreen, those with dark skin (absorbs less D).
*osteoporosis patients
*obese people – it is thought that vitamin D is deposited in body fat and is less available from skin or dietary sources.
*people with gastrointestinal disorders that affect absorption.

Dawson-Hughes, as well as other vitamin D researchers, said that a laboratory level of 30 ng/mL (rather than the 20 ng suggested by the IOM) is good insurance, and is difficult to achieve by diet alone. Most adults need 1000 to 2000IU daily in supplement form, depending on their blood levels.

More benefits of Green Vegetables
Nitrate (NO-3) is found in vegetables such as red beets and spinach, and has been considered either without nutritional value or potentially toxic. Researchers at the Karolinska Institute in Sweden have found, however, that dietary nitrate is transformed by friendly bacteria in the mouth into nitric oxide (NO) – an important molecule in our bodies. NO helps blood vessels relax, lowering blood pressure and promoting more blood flow. It also makes the mitochondria that power our cells perform more efficiently. A high intake of vegetables and fruits has been found to protect against diabetes and heart disease. Boosting the nitrate to NO pathway may be one mechanism by which vegetables exert their protective effect. Readers may recall that dark chocolate also results in NO production in the body. But – try leafy greens first! And – think twice about using a strong mouthwash – we need oral bacteria for the system to work.
Sadja Greenwood, MD back issues on this blog. Leave a message or question.