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Total rethink needed on dieting: scientists

  • Posted on February 22, 2012 at 1:49 pm

Everything you know about dieting is wrong, say US scientists who have devised a new formula for calculating calories and weight loss that they hope will revolutionize the way people tackle obesity.

Obesity rates have doubled worldwide in the past 30 years, coinciding with a growing food surplus, and the ensuing epidemic has sparked a multibillion dollar weight loss industry that has largely failed to curb the problem.

Current standards in the United States, where two thirds of people are overweight or obese, advise people that cutting calories by a certain amount will result in a slow and steady weight loss over time.

But that advice fails to account for how the body changes as it slims down, burning less energy and acquiring a slower metabolism, researchers told the American Association for the Advancement of Science meeting in Vancouver.

The result is a plateau effect that ends up discouraging dieters and sending them back into harmful patterns of overeating.

As an example, researcher Kevin Hall offered up his large vanilla latte, purchased at a popular coffee shop. When he asked, the barista told him it contained about 240 calories.

“The notion was if I drank one of these every day and then I replaced it with just black coffee no sugar, then over the course of a year I should lose about 25 pounds, and that should just keep going,” Hall told reporters.

“People have used this sort of rule of thumb to predict how much people should lose for decades now, and it turns out to be completely wrong.”

Hall, a scientist with the US National Institutes of Health, said his work aims to “come up with better rules and better predictions of what is going to happen when an individual changes their diet.”

He and colleagues said their scientific model is aimed to help doctors and policymakers, while a “back-of-the-envelope calculation” for consumers means cutting small amounts of daily calories, but expecting to cut more over time.

“If I want to lose 10 pounds of weight eventually, I have to cut 100 calories per day out of my diet,” Hall explained.

“You’ll get halfway there in about a year, and then you will eventually plateau, (reaching the goal) after about three years,” he added.

“For folks abroad that works out to about 100 kilojoules per day per kilogram. The contrast is the old rule of thumb predicts twice as much weight loss after a year, and it gets worse after that.”

The new model gives dieters one calorie goal for short term weight loss and another for permanent weight loss. Exercise is also calculated in to help set realistic goals.

Tests on small numbers of adults who were fed strictly controlled diets showed the model was accurate, though real-life situations are harder to predict.

Study co-author Carson Chow, also with NIH, said the daily calorie cut needed for weight loss was actually smaller than researchers anticipated.

“It is essentially one cookie different a day, so a 150 calorie cookie leads to a seven kilogram (15 pound) difference in weight. That is huge in my opinion,” Chow said.

Their model was first published in The Lancet in August 2011, and a link is available at http://bwsimulator.niddk.nih.gov.

“People can plug in some information about their initial age, their height, their weight, some estimate of their physical activity level,” Hall said.

Add in a goal weight and the “model will simulate what changes of diet or exercise that person would have to do to achieve that goal weight, and then even more importantly what they need to do permanently maintain that weight loss.”

Since The Lancet article appeared, the notion has not exactly taken the world by storm, in part because it’s not primed for public use, but is mainly aimed at doctors and researchers with adult American patients for now.

Also, if a dieter enters an extreme weight goal, the number of calories the model returns may be much too low to be realistic or healthy, so it needs an expert’s interpretation.

“It’s not particularly user friendly… but it is still relatively informative,” said Hall, who maintains hope that some day his message will be heard.

“There is a lot of inertia behind these old rules of thumb,” he said, adding that he was heartened by an editorial in December in the journal of the American Dietetic Association that commented on the idea of a weight loss plateau and mentioned the new simulator.

“It’s going to take some time to get the public and the professional community aware that there is a new way of doing things, and we actually have some tools that weren’t available before.”

Article source: http://uk.news.yahoo.com/total-rethink-needed-dieting-scientists-030545445.html

Is fructose being blamed unfairly for obesity epidemic?

  • Posted on February 22, 2012 at 1:49 pm

ScienceDaily (Feb. 21, 2012) — Is fructose being unfairly blamed for the obesity epidemic? Or do we just eat and drink too many calories?

Researchers from St. Michael’s Hospital reviewed more than 40 published studies on whether the fructose molecule itself causes weight gain.

In 31 “isocaloric” trials they reviewed, participants ate a similar number of calories, but one group ate pure fructose and the other ate non-fructose carbohydrates. The fructose group did not gain weight.

In 10 “hypercaloric” trials, one group consumed their usual diet and the other added excess calories in the form of pure fructose to their usual diet or a control diet. Those who consumed the extra calories as fructose did gain weight.

However, all that could mean is that one calorie is simply the same as another, and when we consume too many calories we gain weight, said the lead author, Dr. John Sievenpiper.

His research was recently published in the Annals of Internal Medicine.

“Fructose may not be to blame for obesity,” he said. “It may just be calories from any food source. Overconsumption is the issue.”

Fructose is naturally found in fruits, vegetables and honey. Participants in the studies examined by Dr. Sievenpiper ate fructose in the form of free crystalline fructose, which was either baked into food or sprinkled on cereals or beverages.

The studies did not look at high-fructose corn syrup, which has been singled out as the main culprit for weight gain. It is only 55 per cent fructose, along with water and glucose.

Dr. Sievenpiper said the majority of studies they examined were small, of short-duration and of poor quality, so there is a need for larger, longer and better quality studies.

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The above story is reprinted from materials provided by St. Michael’s Hospital.

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Journal Reference:

  1. John L. Sievenpiper, Russell J. de Souza, Arash Mirrahimi, Matthew E. Yu, Amanda J. Carleton, Joseph Beyene, Laura Chiavaroli, Marco Di Buono, Alexandra L. Jenkins, Lawrence A. Leiter, Thomas M. S. Wolever, Cyril W. C. Kendall, David J. A. Jenkins. Effect of Fructose on Body Weight in Controlled Feeding Trials A Systematic Review and Meta-analysis. Annals of Internal Medicine, 2012; 156 (4): 291-304 [link]

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Article source: http://www.sciencedaily.com/releases/2012/02/120221125020.htm

FDA Weighs Fate of Qnexa for Weight Loss, Again

  • Posted on February 22, 2012 at 1:49 pm

TUESDAY, Feb. 21 (HealthDay News) — The U.S. Food and Drug
Administration plans to take a second look at the weight loss pill Qnexa
on Wednesday, after initially rejecting it because of concerns about heart
problems and possible birth defects.

While effective at reducing weight, the drug, manufactured by Vivus
Inc., was denied approval in 2010 because of its potential side effects.
An FDA advisory panel will now review two years of data; when advisers
last voted on Qnexa, only one year’s worth of follow-up data was
available.

The drug combines the appetite suppressant phentermine and the
anti-seizure/migraine drug topiramate. Phentermine was once widely
prescribed as the “phen” part of the fen-phen weight loss drug. This combo
was withdrawn from the market after its use was linked to high blood
pressure in the lungs and heart valve disease. The problems were related
to the “fen” or fenfluramine part of the combination, not the
phentermine.

No new weight-loss drug has been approved in the United States in the
past 13 years, according to published reports. As it stands, Xenical is
the only FDA-approved drug specifically for long-term use — up to a
year — for weight loss. Xenical is sold over-the-counter as Alli.
However, other drugs may be used off label to promote weight loss.

Last April, a study funded by Vivus found that obese patients taking
Qnexa lost an average 22 pounds over a year, while also lowering their
blood pressure and cholesterol levels.

Dr. Louis Aronne, founder and director of the Comprehensive Weight
Control Program at New York-Presbyterian Hospital/Weill Cornell Medical
Center in New York City, is cautiously optimistic that Vivus did a good
job responding to FDA safety concerns, and that the FDA will give the drug
its nod of approval, with some caveats. Aronne was not involved in the
trials but has been an adviser to Vivus and other companies developing
weight loss medications.

“I am not as pessimistic as most people,” he said.

Vivus has reported that Qnexa may increase the risk of cleft lip in
babies of women who use the drug while pregnant. Aronne said the birth
defect concern could be addressed through education on who should and
should not use the new drug.

“We have learned our lessons with weight loss drugs,” he said. “They
need to be used in the right people under the right circumstances.” The
heart risks need to be weighed against reductions in heart disease risk
factors that come with weight loss, he said.

Qnexa is not any riskier than bariatric surgery, according to Aronne.
“The problem is that it can be distributed more widely,” he said. He hopes
for a compromise that allows the new compound to be prescribed, but not
misused. “Once new medications are approved, local medical boards will
need to enforce rules and make sure these medications are prescribed
appropriately to the right candidates,” he said. “We don’t want to open up
pill mills.”

One thing is clear, he said: More options to treat obesity are needed.
“For hypertension, there are 120 medications in nine categories,” Aronne
said. “We need new options and we need to get physicians thinking about
obesity and obesity treatments.”

Dr. Scott Kahan, an obesity expert at Johns Hopkins University in
Baltimore and director of the National Center for Weight and Wellness in
Washington, D.C., agreed. He is optimistic about the FDA’s upcoming
decision on Qnexa. “The weight loss effects are striking and approaching
the amount of weight loss over two years that we get with bariatric
surgery,” he said. “This is really impressive.”

More information

Learn more about weight loss medications at the U.S. National Institutes
of Health.

Article source: http://news.yahoo.com/fda-weighs-fate-qnexa-weight-loss-again-140205970.html