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

Another sticker on the book! USA Book News has announced their results from thousands of new books, and Every Bite Is Divine was a finalist in the diet & health category. This is our second award: we were also a finalist for the 2007 Nautilus Awards, honoring books on conscious living and positive social change. Here’s the Best Books 2007 press release.

For those who attended the two workshops I did in Arlington and Gloucester, there are the slides I’d mentioned.

Every Bite Is Divine - talk slides - 10-071.pdf

Regards,

Annie

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.

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.

Here it is. The holiday season. Party time, candy and cookie time, rich food time. Estimates for how much Americans gain during this season range from 5 to 15 pounds, depending on who’s doing the reporting. I suspect that the weight gain phenomenon is more prevalent in New England and the northern climes, but I’d love to hear stories and strategies from those in warmer places as to their strategies for maintaining a healthy weight (and healthy habits) through this time.
Here are few survival tips:

Accept the fact that you won’t be losing weight this month. Regardless if you are a party momma or a stay-at-homer, there is just more high-calorie food around. Just maintaining is a feat this time of year.

Keep on moving. Practice stress management. Tie them together. Keep physical activity top-of-mind this month, and squeeze in extra workouts, try some of the TV workouts on cable (if you have comcast on demand, check out the fitness TV - there are yoga, Pilate’s, walking and many other workouts - that’s what’s kept me moving through the last month or two when the weather has been less reliable here on Nantucket). Physical activity is great stress management, so if you didn’t get your packages in the mail on time, didn’t get to cards this year, or whatever, move a little to release the emotion that sits in your body as a result of not being perfect.

Focus on the peeps, not the table. Food traditions this time of year carry deep resonance and a strong pull. For me, it’s my mom’s cookies, and anything resembling eggnog. It’s not always easy to remember that the reason for the season is really love, hope and connectedness. I know that many family relationships can be challenging, and that can drive us to seek comfort from seasonal goodies in unhealthy quantities. There’s a Buddhist practice that may be helpful in working with relationships this season. The Dali Lama describes a practice of bowing down to the difficult people in your life, and thanking them for the opportunity they have provided to help you to experience spiritual growth. Love and honor them! For me, this practice a) cracks me up a little, and b) opens me up to another way to seeing things beyond the way my conditioned judgemental mind does. Somehow, it makes it easier for me to step back and see the people who challenge me differently, and to forgive them for the pain they cause me.

Whoever you are, no matter how lonely or difficult your life is, the world opens itself to you this season. My wish for you is to feel that magic. My wish for you is that someone does the Buddhist practice of loving you when you cause them pain. And I wish you peace.

Namaste
Annie

The New York Times has been covering the social stigmatization of weight recently. Gina Kolata reported in an October Week in Review (their weekly OpEd section), that there is an ever- louder beat of the drum from researchers (and of course amplified by the media), blaming obese individuals for everything from higher gas prices to global warming. There was another piece more recently on the growth of fat-discrimination as a college study topic.

In essence, Kolata’s piece notes that social stigmatization of overweight is at an all-time high. But, while the great tide of disapproval helped stem other unhealthy behaviors like smoking or drinking, unfortunately it doesn’t work that way with our most ubiquitous coping mechanisms: comfort food and inactivity. All that self-loathing and fear of weight just makes us gain more.

Evidence mounts that it’s the healthy behaviors (being physically active and following a healthy diet) that determine health to a greater extent than the number on the scale. Remember that CDC report that noted that people slightly overweight lived longer? So, a thin person who under eats or overexercises is less healthy than an overweight individual following a healthy lifestyle.

But does that help us to exhale around accepting our body size? No! Why?

I think that food and fashion industries have just been wildly successful at sending messages to shape the culture and ensure our insecurity. An unhappy person is a great consumer, after all. Want to see what I mean? take a look at some of the ads on www.about-face.org. To learn more about this topic and connect with others around it, check out the International Association of Size Acceptance. The have lots of downloads, reviews of the science around size acceptance, pod casts and links. Just tons of great information.

I think the way out of the hatred and stigmatization of weight is simple education. Kids now really need media literacy in order to become conscious of what they can do to live healthy lives today. And for adults, I think there is more support to renounce the unhealthy aspects of our culture - look at the popularity of yoga! Yoga, of course, is a wonderful way of doing the mental work around releasing some of the underlying issues that cause all the suffering around poor body image, and waking up to the truth that each and everyone of us is perfect, and is divine.

This morning I checked out YouTube - I admit, I hadn’t checked it and wanted to see what all the fuss was about.

I did a search of nutrition, and one of the first clips I watched was Steve from The Office’s video, “Slimming down with Steve”.

Note that the same day I linked to this video on YouTube, it was taken off. This link goes to another place I saw the video. If the link stops working, you can probably google it…

If you want a lift and think Steve’s funny, spend a five of your precious minues watching this.

Have a healthy week.

Annie

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