The Yo-Yo Diet Returns Again (and Again)

Have you struggled with yo-yo dieting and weight-loss frustrations?  Are you concerned about your weight but are not sure what to do?

Millions of Americans share your struggle to shed the extra pounds gained so easily in the age of fast and processed food, supersized proportions, and sugar laden beverages.  We are a society that has uncovered the link between obesity and diabetes as a result of our prosperity and dietary indulgences.

Diets come and go and so does the weight.  Rapidly losing pounds through radical and unsustainable diets inevitably fails and often leads to a return to the same or higher weight.  In fact, over 90% of dieters regain lost weight within one year.

Experts have analyzed the situation and have lucid explanations for the yo-yo effect.  I’m going to give you my opinion built only on my own experience.

First, short-term extreme dieting can’t be sustained and therefore does not lead to a change in eating, sleeping and exercise habits.  The same behaviors that led to long-term weight gain return unless new patterns are formed.  In particular, the use of food to deal with stress or as the basis for social interactions is deeply rooted and difficult to modify unless done in a purposeful manner with long-term health in view.

Second, crash dieting often involves severe calorie restrictions which leads to a reduced base metabolic rate (BMR), according to recent studies.  In other words, your body automatically adapts to low calorie situations by using less energy.  As a result, after an initial diet induction phase, often associated with rapid weight-loss, progress is slow.  And, a return to former daily calorie intake may (I’m theorizing) lead to a greater energy imbalance resulting in rapid weight gain.  The equation for fat gain looks something like:  (calories stored as fat) = (consumed calories) – BMR – (calories used during activity).  So, reducuing your BMR increases the likelihood of future weight gain if old habits return.

Short-term dieting for the sole purpose of weight loss is one dimensional and does not necessarily have long-term health as its objective.  Weight or BMI may be associated with risk factors but these are not a comprehensive health metric.  Overall health should be in view which may actually preclude some weight-loss strategies.

Over the past year I have had success that was built on a change in eating habits, a reduction in processed and fast foods, the introduction of sustainable exercise programs and consideration of sleeping patterns.  I’m working on a post outlining the choices that were particularly helpful and some that were not… stay tuned.

 

Forever Fat?

I understand that maintaining a healthy weight following a successful weightless diet is difficult but this seems overly pessimistic:

Researchers claim that fat people, who lose weight either by dieting or exercising, will put it all back on again within a year.

The article does back off from the overarching generalization but claims that those of us who lose weight don’t have a chance to keep it off long term. Something tells me there is a great opportunity for a service industry to help dieters meet this daunting challenge. Anyone interested?

Diet Soda’s Unintended Deleterious Effect?

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In the every evolving world of medical research, reports that diet soda is linked to weight gain and increased fasting glucose level have periodically been reported. At the same time, contradictory articles suggest that as an alternative to sugar laden (fully leaded) soda, diet soft drinks have an advantage.

One of the reasons this topic interests me is that diet soda remains one of the few vices left in my daily nutritional regimen. Out of the picture are fast foods, deserts, simple carbs, chips, potato/French fries and alcohol. However, I partake in diet cola through-out the day.

New research is being reported at the 2011 American Diabetes Association’s Scientific Sessions by epidemiologists from the School of Medicine at The University of Texas Health Science Center San Antonio that suggests diet soda is no friend to those pre-disposed to Type 2 Diabetes:

In the constant battle to lose inches or at least stay the same, we reach for the diet soda. Two studies presented Saturday [June 25] at the American Diabetes Association’s Scientific Sessions suggest this might be self-defeating behavior.

Epidemiologists from the School of Medicine at The University of Texas Health Science Center San Antonio reported data showing that diet soft drink consumption is associated with increased waist circumference in humans, and a second study that found aspartame raised fasting glucose (blood sugar) in diabetes-prone mice.

To their statistically based results, the authors added comment and drama:

“Data from this and other prospective studies suggest that the promotion of diet sodas and artificial sweeteners as healthy alternatives may be ill-advised,” said Helen P. Hazuda, Ph.D., professor and chief of the Division of Clinical Epidemiology in the School of Medicine. “They may be free of calories but not of consequences.”

Here are the details

Human study: The San Antonio Longitudinal Study of Aging

To examine the relationship between diet soft drink consumption and long-term change in waist circumference, the Health Science Center team assessed data from 474 participants in the San Antonio Longitudinal Study of Aging, or SALSA. This is a large, population-based study of the disablement process in elderly Mexican Americans and European Americans. Dr. Hazuda, senior author of the presentation, is SALSA’s principal investigator and has led the study for two decades.

Measures of height, weight, waist circumference and diet soda intake were recorded at SALSA enrollment and at three follow-up exams that took place over the next decade. The average follow-up time was 9.5 years. The researchers compared long-term change in waist circumference for diet soda users versus non-users in all follow-up periods. The results were adjusted for waist circumference, diabetes status, leisure-time physical activity level, neighborhood of residence, age and smoking status at the beginning of each interval, as well as sex, ethnicity and years of education.

Diet soft drink users, as a group, experienced 70 percent greater increases in waist circumference compared with non-users. Frequent users, who said they consumed two or more diet sodas a day, experienced waist circumference increases that were 500 percent greater than those of non-users.

Abdominal fat is a major risk factor for diabetes, cardiovascular disease, cancer and other chronic conditions. “These results suggest that, amidst the national drive to reduce consumption of sugar-sweetened drinks, policies that would promote the consumption of diet soft drinks may have unintended deleterious effects,” the authors wrote.

Co-authors include Sharon P. Fowler, M.P.H., faculty associate, and Ken Williams, M.S., P.Stat., adjunct assistant professor and biostatistician, in the Division of Clinical Epidemiology.

Mouse study: Aspartame consumption in diabetes-prone mice

In the related project, Ganesh Halade, Ph.D., Gabriel Fernandes, Ph.D., the senior author and professor of rheumatology and clinical immunology, and Fowler studied the relationship between oral exposure to aspartame and fasting glucose and insulin levels in 40 diabetes-prone mice. Aspartame is an artificial sweetener widely used in diet sodas and other products.

One group of the mice ate chow to which both aspartame and corn oil were added; the other group ate chow with the corn oil added but not the aspartame. After three months on this high-fat diet, the mice in the aspartame group showed elevated fasting glucose levels but equal or diminished insulin levels, consistent with early declines in pancreatic beta-cell function. The difference in insulin levels between the groups was not statistically significant. Beta cells make insulin, the hormone that lowers blood sugar after a meal. Imbalance ultimately leads to diabetes.

“These results suggest that heavy aspartame exposure might potentially directly contribute to increased blood glucose levels, and thus contribute to the associations observed between diet soda consumption and the risk of diabetes in humans,” Dr. Fernandes said.

These two translational research studies resulted from collaboration between Fowler and Drs. Hazuda and Fernandes and their research teams. The Institute for the Integration of Medicine and Science (IIMS) funded the work. IIMS is the Health Science Center entity that oversees the university’s Clinical and Translational Science Award (CTSA), a National Institutes of Health-funded program to encourage the rapid translation of scientific discoveries from the laboratory through the testing process and to practical application for the health of communities.

I’m not a medical expert in the field but wonder if (1) there are assumptions related to outcomes revealed by the following, “might potentially directly contribute” and “may have unintended deleterious effects”. In addition, the human study did not establish causality or an underlying mechanism which would conclusively reveal diet soda consumption causes weight gain (or waist circumference increase).

Never-the-less, it does seem clear that there is a strong relationship between obesity and diet soda and that there is an unintended physiological response associated with aspartame consumption that is both unintended and undesirable.

Now, will this lead to a change in your consumption of diet soda?

As for me, I’m going to eliminate the drink from my diet and report back to you the impact.

 

Who has the worst eating habits?

When I think about bad eating habits the following immediately come to mind:

  1. Skipping Breakfast
  2. Fast Food and, in particular, supersizing
  3. Fried Food
  4. Soda
  5. Unbalanced emphasis on simply carbohydrates
  6. Snacking late at night, especially on sweets
  7. Lack of fruits and vegetables
  8. Eating to relieve stress
  9. Overeating

Poor eating habits often are influenced by one’s access to quality food, as suggested by USDA reports to congress.

In the U.S., this is really not an excuse for an unhealthy lifestyle but does mean we have to work a little harder to improve our health through the right nutritional choices.  Only a small percentage of Americans are actually constrained to the point that they cannot obtain healthy and nutritious food.

And, it is poor eating habits – our choices – that are leading to obesity and related health problems, such as Type 2 Diabetes, stroke, cancer and coronary artery disease.   The overall spending related to our choices is quoted in the $147 billion range.

The nutritional portion could be measured by the amount of soda, fast food and sweets consumed, which is exactly what a recent report did last month that lists the 10 states with the worst eating habits.

10. New Mexico

Amount Spent on Fast Food Per Capita: $737 (8th most)

Gallons of Soft Drinks Purchased Per Capita: 58 (12th least)

Pounds of Sweet Snacks Purchased Per Capita: 111 (13th least)

[Read more...]

Gastric Bypass Surgery Reverses Heart Ailments!

gastric-bypass-surgery.jpgThis is fairly significant news…. gastric bypass does help lose weight and treat diabetes (more here):

Well- who is a candidate for these procedures? Usually patients with a BMI of over 40 or over 35 with health consequences that are obesity related. Does gastric bypass have any effect on diabetes? In a series of 1000 patients, 150 of whom had diabetes, 83% experienced resolution of their diabetes (defined by a normalization of A1c and coming of medications for diabetes) after the surgery

However, there now appears to be additional benefits:

A new report from the Journal of the American College of Cardiology reports that patients who had received gastric bypass surgery not only lost weight but had maintained healthier cardiac health, while also reducing previous cardiac complications spurred by obesity.

Often times when a patient is obese, an increase in the largest portion of the heart, the left ventricle can become larger in mass causing the heart to work harder to pump blood into the body. According to the study, echocardiograms, or ultrasounds of the heart showed a remodeling of the heart structure which included a reduction of left ventricular mass and right ventricular cavity area in patients that had received Gastric Bypass Surgery, a procedure Texas Bariatric Specialists performs.

“Patients now have another reason to add to their check-off list of the benefits of a gastric bypass. Why would anyone severely obese wait any longer when the health risks are too high,” says Texas Bariatric Specialists founder Dr. Nilesh A Patel.
A gastric bypass is a bariatric procedure that is the single largest contributor to these findings and is offered at Texas Bariatric Specialists. In the Laparoscopic gastric bypass surgery procedure, the surgeon makes a small stomach pouch at the top of the stomach, the pouch is later connected to the small intestine bypassing the larger stomach. The gastric bypass can result in complete resolution in type 2 diabetes, hypertension, high blood pressure, sleep apnea, and the loss of 65 percent of excess body fat.

Source: press release