Kaiser Permanente study finds keeping a food diary doubles diet weight loss

Tuesday, July 8, 2008  9:14 am

Nobody. And I mean nobody, likes to keep a food journal. It’s time consuming, and requires you to face up in a big way to what, how much and when you eat. But, if you really want to improve your diet, it’s a terrific tool and worth the temporary discomfort. Think of it as growing-conscious pains. What I tell people is to remember that it’s not forever, but to take a few days, particularly if you are going to work with a nutritionist, and dive in.

Here’s the link to the Kaiser Study, which was funded by the National Heart, Lung and Blood Institute of the NIH, and will be published in the American Journal of Preventive Medicine.

Interesting Comparison of Weight-loss Interventions

Saturday, November 24, 2007  7:34 am

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

The Rudd Center and Public Opinion Attitude Shifts on Obesity

Friday, July 6, 2007  7:47 am

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.

Spring Cleanse, Part 1: Why Cleanse?

Tuesday, May 8, 2007  7:54 am

Spring is the season to open up the house, empty out the closets, and clear out the clutter and cobwebs. It’s also the time when those in northern climes might wince as they uncover their bodies (winter is such a great time to cover-up, burrow in and just forget about it, right?). I wish you just a momentary wince or none at all.

As a dietitian and yoga teacher, the idea of nutritional cleansing fascinates me. Each time I cleanse (I don’t fast and I only do very gentle cleanses, by the way. I think fasting and harsher cleansing can do more harm than good – more on this later) I reaffirm my everyday cleansing diet – that is, cleaning up my diet as a way of life. My spring cleanse this year was more about being strong in my own wellness than about nutritional goals per se. I have a tendency to allow stress from others’ poor lifestyle habits influence how I take care of myself. Since my fruit & vegetable cleanse with herbal support (I used Yerba Prima support products this time), I’ve worked harder to resist being swayed by well-meaning loved ones gifting me treats.

For the next couple months, I’ll tease this topic of nutritional cleansing and detox, let you what I’m thinking about it, and the resources that I have found helpful.

So first, why even do it?

Our environment has changed for the worse in the past 100 years. The EPA estimates a grand total of 4.3 billion pounds of the 650 toxic chemicals they follow were released into the environment in 2005. Other groups estimate that 1,000 newly synthesized compounds are introduced each year.

Toxic chemicals enter into our bodies through the air we breathe, the food we eat and the water we drink. While our bodies have an elegant system of removing toxic chemicals from the body (via the work of the liver, kidneys, lungs, skin and digestive system), there has been an increase of toxins in the environment, and at the same time a decrease in the nutritional quality of the average American’s diet. The deterioration of our diet (through eating large amounts of processed foods, chemicals and hormones, and not enough healthy fruits, vegetables and unadulterated whole grains and clean proteins) impairs the ability of our body to effectively detox. That’s the basic rationale for learning a little about detoxing and occasionally focusing on it as a means of maintaining overall health.

Here is the EPA’s brochure from their Toxic Release Inventory (TCI), and a more detailed report. You can find loads more information at www.epa.gov.

EPA 2005 Toxic Chemical Inventory (TCI) – overview brochure

You can find the full eReport on the EPA website.

In future postings, we’ll review the basics of nutritional cleansing, the mental aspects of cleansing, safe vs. not-so-safe cleansing, resources available to you, products I know of, and some non-nutritional cleansings.

May you be happy

May you be healthy

And may you stand in the light of your own truest self

Annie