Annie’s Healthy Weight & Eating Blog

Last month’s journal of the ADA (American Dietetic Association) had an interesting meta-analysis of weight-loss interventions. A meta-analysis pulls together a large number of studies that investigate the same thing, and try to pull stronger conclusions from them. This sort of study can be great to get an overall status of the literature on the primary outcomes of particular topic, but the strengths, weaknesses and bias and secondary outcomes of particular studies get washed out.

Get a better look at this chart & others in the pdf of the article, below.

The meta-analysis looked at outcomes from weight-loss clinical trials with a minimum of one-year follow-up. Eighty studies were included, representing eight interventions – diet alone, diet and exercise, exercise alone, meal replacement, very-low-energy diets, weight-loss medications (orlistat and sibutramine) and advice alone. A mean weight loss of 5 to 8.5 kg (that’s 11 to 18.7 lbs) was noted during the first 6 months from intervention involving a reduced-energy diet and/or weight-loss medications with weight plateaus at approximately 6 months. In studies extending to 48 months, a means 3 to 6 kg (6.6-13.2) of weight loss was maintained with every approach with the exception of advice-only and exercise-only, and none of the groups experiencing weight regain to baseline. In contrast, advice-only and exercise-alone groups experienced minimal weight loss. Very low calorie diets resulted in rapid loss and regain, with a gaining trend at the time when follow-up ended.

Annie’s thoughts: The biggest take-home message is that again we see that combining a weight-conscious diet with physical activity is the way to go if you are interested in long-term weight management. While the losses presented may not look to be much for the effort, keep in mind that for those who are overweight or obese, even moderate weight loss can result in significant reductions in chronic disease. Meal replacements and very low calorie diets seem to be short-term solutions. As far as the weight-loss drug outcomes, orlistat (a drug that blocks the absorption of fat), and sibutamine (an appetite suppressant) both have pretty significant and unpleasant side effects. I want to take a closer look at the diet drug studies to see who sponsored those particular studies, what side effects were tolerated for the extra pound or two of loss and what happened over the longer term.

Here’s a copy of the article:
Article - Comparison of Interventions

All the best -

Annie BK

Here’s a neat free assessment. You can do a lifestyle questionnaire at Real Age (the website of Oprah darling Dr. Oz and his partner Dr. Roizen), that will tell you what your body’s age is based on things like your diet, how often you exercises, your stress management, health history and on and on. It takes 10-15 minutes to do. You’ll get a pitch to sign up for their program once you’ve completed the assessment. But, just for the assessment information, it’s worth the time, and maybe you’ll learn a little something.

If you are interested in the cultural issues that underlie the obesity epidemic, the Rudd Center at Yale’s website is required reading. They have done some great research on the social stigmatization around weight, and in my opinion have some of the most progressive and comprehensive ideas on making real change at the national level.

Here’s some info from their site on the shift in public opinion around obesity. Interesting reading!

There has been an interesting trajectory of public opinion about obesity. The majority of Americans are clearly concerned with obesity and there is growing support for obesity-targeted policies. The following table presents the changes that have been found in support of strategies that influence the environment in order to promote better nutrition.

Source: Brownell KD. The chronicling of obesity: Growing awareness of its social, economic, and political contexts. J of Health Politics and Law. 2005; 955-64.

I’m home from BEA (and from a quickie follow up to Harvard graduation – my smarty nieces & nephews all graduated the same year – 4 of them!).

While traveling to NYC can be stressful, if you’re braced for it, there’s just no other place to get a great overview of trends in the world of books and publishing. It’s a big circus of the latest & greatest, and a marketing extravaganza.

One trend that I was delighted to see was that there is a growing collection of authors excavating the topic of mind-body eating with a nod to yogic and spiritual principles, the laws of attraction, and the gut brain-head brain relationship. If you’ve read my book, you know that’s my approach, so I felt that I found some dietary family members there.

One discovery was Pierre Pallardy, who has a book out from Rodale has called Gut Instinct. He is a French osteopath/dietitian who has been working the two-brain theory (that we have a second brain center in the abdomen, and through relaxation and other techniques we can improve digestion) for decades. His method entails belly breathing, abdominal massage (it reminded me of Japanese Do-in massage), abdominal meditations, mindful eating (eating slowing and in a relaxed way, enjoying your food– in essence the way you’d envision they eat in France!). Nutritionally, I like his approach too – he abhors reducing diets, fasting, or other manipulations to the diet, and just goes for balanced normal eating. He’s not into a vegan diet, which is one area that I disagree – I think vegans can be very healthy if they take their diet in wholesome, hearty way.

If you are dietitian exploring how the recent science on the gut brain may impact daily lifestyle, this is a great book for you – you won’t agree with every nutritional guideline, but Pallardy gives us lots to think about, and has a truly innovative approach that has merit.

If you are a yoga teacher, this book illustrates how desperately those who struggle with weight and eating (in essence the entire US population) need yoga. And it will give you some new tools for your therapeutic yoga toolbox.

Enjoy!

Kudos to the Physician’s Committee for Responsible Medicine (PCRM), who were the driving force behind the Federal Trade Commission (FTC)’s new ban on the touting of dairy products as weight-loss foods. The FTC decision was based on the overwhelming lack of scientific evidence to support the claim. The dairy industry’s huge-budget, celebrity-starred campaign around milk and dairy for weight loss was based on a tiny study funded by the industry. Most health researchers clearly agree that most dairy products are more closely linked to weight gain than loss. Dairy fat is one of the most highly saturated fats in all the foods we eat.

Unfortunately, I think the damage is done. That was a huge campaign, and targeted nutritionists as well as women via beautiful big print and TV ads over several years. They were convincing, and I’m sure that most Americans would say that dairy products will help them lose weight.

If only we got the message that it’s the fat in dairy that’s the culprit. But unfortunately, since the dairy industry didn’t want to speak badly of the bulk of its products, we never fully got that message. In the end, I’m afraid; dieters are more confused than ever.

Can dairy fit into a healthy diet? Sure, if you look for low fat and fat free options, and are conscious of your overall caloric intake. The PCRM doesn’t agree with me on that, though – they prescribe to a vegan diet, no dairy or animal products at all. A vegan diet, featuring lots of fruits and vegetables, whole grains and vegetable proteins, is likely the healthiest one we can eat. (What other type of vegan diet is there? I know many teens that are vegans but don’t like fruit or vegetables and eat pure junk food.) A nutrition nightmare and part of the reason that teen girls have the worst diets of any age or gender group (they average something close to 30% of their needs for calcium, this during their prime bone-building years). But anyway, I personally and professionally feel that if someone is not interested or able to go vegan, that organic low fat dairy can certainly be part of a very healthy diet.

Anyway, the message is: dairy fat, found in dairy foods, is not part of a winning weight-loss (or maintenance) strategy.

Read the PCRM’s May 11^th announcement on the issue here.

For those of you who’ve known for years (and years and years) that I’ve been working on a book combining yoga and nutrition for weight management, hang tight because it’s very very close to being available.

At this point, books will be available to ship in early November. The book cover is beautiful to look at (thanks for designer Peri Poloni-Gabriel of Knockout Books, www.knockoutbooks.com), and the whole package came together with the help of many many people, but Ellen Reid, (www.bookshep.com) really helped launch the project into the world. I’m eternally grateful to these women, and to many more folks whom helped me along the long road to beautiful-book-in-hand.

You can see some of the artwork and read the introduction on my website, www.anniekbay.com. And you can pre-order the book - we’ll pick up the shipping and handling of books you order now, and you won’t be charged until they actually ship. Please note that our site is soon to be up and running…as of this writing, it’s not quite up…

Much more to come…

Annie