Posts Tagged ‘weight loss’

Men Left Out of Weight-Loss Market

Even though men are more likely to be overweight than women, men are not getting the weight-loss services they need.

Recent data from Britain is easily applied to the US, and around the world.

Using a Freedom of Information request, the Men’s Health Forum in Britain asked local authorities how many people had been helped by their weight-loss programs in 2013-2014.

The results show 110,324 women as compared with 29,919 men, suggesting that a woman is 277% (3½ times) more likely to get help with weight loss than a man, according to a news release.

Two-thirds of men in Britain are overweight or obese as compared with 57% of women.

Shocking Figures

“These figures are pretty shocking,” said Martin Tod, CEO of Men’s Health Forum.

“We want to see local councils making much bigger efforts to design their services to work for men.

This is particularly important because men account for three-quarters of premature deaths from coronary heart disease—and middle-aged men are twice as likely as women to get diabetes.”

According to a recent publication from the Men’s Health Forum, How To Make Weight-Loss Services Work For Men, there are several reasons for the gender gap.

These include poor advertising or marketing, services that are inappropriate or unattractive to men, and unsuitable venues or times.

Here is a summary of the highlights from the forum guide on what works with weight-loss for men:

Key lessons

1. Obesity prevention and treatment should take into account sex and gender-related differences.

2. Weight reduction for men is best achieved and maintained with the combination of a reducing diet, advice on physical activity, and behavior change techniques.

Men prefer more factual information on how to lose weight and more emphasis on physical activity than women.

3. Men-only groups may enhance effectiveness.

Group-based interventions should also provide some individual tailoring and individual feedback to male participants.

4. Weight-loss programs for men may be better provided in social settings, such as sports clubs and workplaces, which may be more successful at engaging men.

No Strict Diets, Please

In general, men express a dislike of “strict” diets.

Intermittent periods of dieting may be more effective for men than regular periods of dieting.

► Men particularly enjoy the use of pedometers to monitor their physical activity.

► Men prefer interventions that are individualized, fact-based, flexible, use business-like language, and include simple to understand information.

► Men are less likely than women to do well using the drug Orlistat to help long-term weight-loss maintenance.

► Men differ from women when it comes to encouraging them and maintaining participation in weight-loss programs.

Men are significantly less likely than women to join a weight-loss program, but once recruited they are less likely than women to drop out.

► Middle-aged men in particular, are more motivated to lose weight once they become aware that they have a health problem, for example, being diagnosed as “obese” by a health care professional.

Understanding the health benefits of losing weight can act as a motivator for men, for example, knowing that weight loss may prevent the development of type 2 diabetes mellitus or that weight reduction may improve erectile function.

Lifestyle Measures Cut Cardiovascular Deaths in Prediabetes

Weight loss and other lifestyle interventions can reduce the risk of long-term cardiovascular consequences of diabetes, according to the results of a clinical trial.

This is the first randomized clinical trial to show that lifestyle intervention in those with impaired glucose tolerance reduces all-cause and cardiovascular disease mortality.

Lifestyle intervention delays the onset of diabetes and reduces the incidence of diabetes.

We had assessed how mortality was affected by the time free from diabetes, which was defined as the time between randomization and onset of diabetes.

We found that the increased delay in the onset of diabetes was associated with significantly lower all-cause and cardiovascular disease mortality,” said lead author Professor Guangwei Li of the China-Japan Friendship Hospital, Beijing, China.

“After inclusion of time to onset of diabetes in the multivariable models the intervention variable was no longer statistically significant, suggesting that the reduction in mortality associated with the intervention is mediated by its effect in delaying the onset of diabetes,” he noted.

The researchers published their results online on April 3, 2014 in The Lancet Diabetes & Endocrinology.

LIFESTYLE INTERVENTIONS PREVENT DEATHS

Many research studies have shown that lifestyle interventions, such as exercise programs or weight loss, in persons with impaired glucose tolerance can prevent progression to overt type 2 diabetes.

However, until now, there has been a lack of high-quality, randomized controlled trial evidence to prove that lifestyle interventions prevent deaths from cardiovascular disease, such as heart attacks and stroke, in these patients.

Dr. Li and colleagues enrolled 438 patients assigned to the intervention arm and 138 patients who were assigned to the control arm.

The study intervention lasted for 6 years, and patients were then monitored for 23 years.

At the end of the follow-up period, cumulative incidence of death from cardiovascular disease was 11.9% in the lifestyle intervention group versus 19.6% in the control group.

Death from all causes was 28.1% in the lifestyle group versus 38.4% in the control group.

The difference between groups for both outcomes was statistically significant.

“Although the association between duration of diabetes and mortality is well established, serious chronic complications and excess mortality typically only occur after at least 10 years of having diabetes,” Dr. Li said.

“In the present study, a difference in mortality between the intervention and control group started to emerge 12 years after the study began, slowly increased to a 17% difference by the 20-year follow-up, but became statistically significant only after 23 years.”

“TYPE 2 DIABETES CAN BE PREVENTED”

Dr. Li noted that a key difference between previous other studies and the Da Qing Diabetes Prevention Study is the length of follow-up.

In previous studies, the length of follow-up might have been insufficient to detect an effect of intervention on mortality.

Dr. Li’s bottom-line message: “Type 2 diabetes can be prevented.

Group-based lifestyle interventions over a 6-year period have long-term effects on prevention of diabetes beyond the period of active intervention.

The benefits of the intervention extended to a significantly favorable reduction of mortality.

These results emphasize the long-term benefits of the intervention and reinforce the overall value and importance of lifestyle interventions as public health strategies to prevent diabetes.”

Choosing the Diet that Will Work for You

Scores of weight-loss diets have been in the limelight over the years.

But relatively few have been carefully studied.

What do the data say about the effectiveness of diets and how can you use that information to choose a weight loss approach that will work for you?

In the February 7 issue of Healthbeat newsletter from Harvard Medical School, I was pleased to see the answer is that no one diet works for everyone.

You have to figure out the best eating plan for you.

“The take-home lesson is that it is okay to experiment on yourself,” states the newsletter.

“If you give a diet your best shot and it doesn’t work, maybe it wasn’t the right one for you, your metabolism, or your situation.

Don’t get too discouraged or beat yourself up because a diet that ‘worked for everybody’ didn’t pay off for you.

Try another.”

Here’s the newsletter’s take on the diet studies and what they mean.

The bottom line is you have to reduce the amount of calories you take in (and also burn off calories through exercise) to lose weight.

The diet studies

The reality is that when it comes to shedding pounds, the key is cutting calories — and it doesn’t really matter whether those calories come mainly from steak, bread, or vegetables.

A study led by Harvard researchers published in 2009 in The New England Journal of Medicine compared four different low-calorie diets (high fat, high protein; high fat, average protein; low fat, high protein; and low fat, average protein) in 811 overweight adults.

Although all the participants lost an average of about 13 pounds in the first six months (about 7% of their initial weight), they started to regain at the one-year mark.

After two years, average weight loss was the same in all groups.

An earlier study in The Journal of the American Medical Association suggested that it’s whether you stick with whatever diet you choose that makes the difference.

In this study, overweight and obese adults were assigned to follow the Atkins diet, the Ornish diet, Weight Watchers, or the “Zone” diet.

After one year, nearly half of the participants had dropped out of the study.

But those who didn’t lost similar amounts of weight (about 5 to 7 pounds each, on average).

People assigned to the Atkins and Ornish diets were more likely to drop out of the study, suggesting that many people found these plans too extreme.

But for certain people, the structure of a restricted plan may be helpful.

Experts advise people to keep the percentage of their calories from major nutrients within the recommended federal guidelines:

Protein: 10% to 35%
Carbohydrate: 45% to 65%
Fat: 20% to 35%

Note that diets that are less than 45% carbohydrate or more than 35% protein are hard to follow, and they’re no more effective than other diets.

In addition to possibly increasing the risk of heart disease, diets with very low carbohydrate levels may have a negative effect on mood, according to several studies.

Low-fat: Doesn’t taste great … and is less filling

Once the main strategy for losing weight, low-fat diets were shoved aside by the low-carb frenzy.

But healthy fats can actually promote weight loss, and some fats are good for the heart; eliminating them from the diet can cause problems.

Since fat contains 9 calories per gram while carbohydrates contain 4, you can theoretically double your food intake without taking in more calories by cutting back on fatty foods and eating more that are full of carbohydrates, especially water-rich fruits and vegetables.

Still, such a diet tends to be less filling and flavorful than other diets, which lessens its long-term appeal.

Low-carbohydrate: Quick weight loss but long-term safety questions

The low-carb eating strategy is based on the biological fact that eating carbohydrates raises blood sugar levels, which triggers an outpouring of insulin from the pancreas.

The theory goes a step further, claiming that high insulin levels produce hunger, so people who eat carbohydrates take in more calories and gain weight.

Low-carbohydrate diets tend to cause dehydration.

To make up for the lack of carbohydrates in the diet, the body mobilizes its own carbohydrate stores from liver and muscle tissue.

In the process, the body also mobilizes water, meaning that the pounds shed are water weight.

The result is rapid weight loss, but after a few months, weight loss tends to slow and reverse, just as happens with other diets.

The American Heart Association cautions people against the Atkins diet, because it is too high in saturated fat and protein, which can be hard on the heart, kidneys, and bones.

The lack of fruits and vegetables is also worrisome, because eating these foods tends to lower the risk of stroke, dementia, and certain cancers.

Most experts believe South Beach and other, less restrictive low-carbohydrate diets offer a more reasonable approach.

Mediterranean-style: Healthy fats and carbs with a big side of fruits and vegetables

Mediterranean-style diets emphasize good fats and “good” carbs.

Saturated fat, trans fat, and cholesterol are the bad guys.

Good fats are monounsaturated (found in olive oil, for example) and polyunsaturated (found in such foods as fish, canola oil, and walnuts).

Mediterranean diets tend to have a moderate amount of fat, but much of it comes from healthful monounsaturated fats and unsaturated omega-3 fats.

It is high in carbohydrates, but most of the carbs come from unrefined, fiber-rich foods.

It is also high in fruits and vegetables, nuts, seeds, and fish, with only modest amounts of meat and cheese.

People living in Mediterranean countries have a lower-than-expected rate of heart disease.

But the traditional lifestyle in the region also includes lots of physical activity, regular meal patterns, wine, and good social support.

It’s hard to know what relative role these different factors play — but there is growing evidence that in and of itself, the diet can reduce cardiovascular risk and the development of diabetes.

Exercise Can Help You Eat a Healthy Diet

Calories in, calories out.

That’s the tried and true way to lose weight – eat less, exercise more.

A new compilation of epidemiological evidence of weight loss shows that exercise can, in fact, help you eat a more healthy diet, say Harvard researchers.

“Physical exercise seems to encourage a healthy diet.

In fact, when exercise is added to a weight-loss diet, treatment of obesity is more successful and the diet is adhered to in the long run,” says the lead Harvard researcher Miguel Alonso Alonso.

His study was published in the October issue of Obesity Reviews.

Regular physical exercise also causes changes in the working and structure of the brain, in particular, in executive functions, which include inhibitory control.

“In time, exercise produces a potentiating effect of executive functions including the ability for inhibitory control, which can help us to resist the many temptations that we are faced with everyday in a society where food, especially hypercaloric food, is more and more omnipresent,” says Alonso Alonso.

Basically, that means that exercise also helps your brain know when your belly is full so you can better control your appetite.

So go out and exercise.

Your brain, and your belly, will thank you for it.

Healthy Solutions to Lose Weight and Keep it Off

Successful weight loss depends largely on becoming more aware of your habits and behaviors and starting to change them.

In the classic book, Changing for Good, lead author James Prochaska describes the six stages of change:

1. Pre-Contemplation – Resisting change

2. Contemplation – Change on the horizon

3. Preparation – Getting ready

4. Action – Time to move

5. Maintenance – Staying there

6. Recycling – Learning from relapse

Once you determine which stage of change you’re in, you can create a climate where positive change can occur, maintain motivation, turn setbacks into progress, and make your new habits a permanent part of your life.

A newly updated Harvard Medical School Special Health Report entitled “Healthy Solutions to Lose Weight and Keep it Off” offers a range of solutions that you can tailor to your specific needs and help you change your habits to make weight loss more manageable.

Here are some of the habits described in the report’s Special Section that target the common reasons people are overweight:

Set small, specific, realistic goals. Set a realistic goal of losing 5-10% of body weight, and allowing plenty of time and some flexibility to reach the goal. Focus on specific goals like, “I will bring lunch from home 3 times a week and walk Monday and Wednesdays after work.”

Start self-monitoring. Writing down what you eat and how often you exercise can help you gain awareness of your behaviors and track your changes toward goals.

Cultivate a support network. Find at least one weight-loss buddy to help motivate and hold you accountable.

Adjust your attitude toward exercise. Reinvigorate your exercise routine: Take a brisk walk, try a new exercise, or plan an active outing.

Eat breakfast slowly and mindfully. Get up 15 minutes earlier and practice eating slowly.

Shop smarter. Never shop when you are hungry and use a list to avoid impulse buys. Your list should have healthy dinner and snack options.

Reward yourself with non-food pleasures. Treat yourself for working on one of these steps.

As the report suggests, don’t try to change all your habits at once. Choose one or two ideas that seem the most manageable, and see if you can stick with them for a week or so. Then add another one the next week. Small successes help you change your behavior, and little by little you will lose weight.