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[see obesity symposium July, 2005]

[See new research on weight loss study]

Please see the article on the Weight Loss Study page 1, page 2 by Nutrition Investigator

Weight loss and nutrition

Here's some data to show how important weight control is. Your waist circumference is a key predictor of diabetes, increasing your risk 12-fold is you are fat.

It is very important to exercise while losing weight, to avoid losing muscle mass instead of fat. "especially in older men, significantly more lean mass was lost with weight loss "

Angelo Tremblay et al, Modifications in food-group consumption are related to long-term body-weight changes
Am J Clin Nutr 2004 80: 29-37

Results: A self-reported decrease in the consumption of food in the fat group or an increase in consumption in the fruit group from the food-based questionnaire predicted a lower increase in body weight and adiposity indicators over time. A more detailed examination of the change in food groups between diet records revealed that increases in the consumption of whole fruit as well as skimmed milk and partly skimmed milk were the 2 food patterns that negatively correlated with the changes of each body weight–related indicator.

James O Hill Obesity treatment: does one size fit all? Am J Clin Nutr 2005 81: 1253-1254

Those trying to lose weight are quick to embrace the latest popular diet but are almost as quick to abandon it...Several randomized controlled studies have shown that these diets are effective in producing weight loss and metabolic improvements over 6 mo in obese patients (1-5)...Because low-fat and low-carbohydrate diets have already been popular choices, one good possibility is that a high-protein diet will be the next popular diet (6)...Two important messages emerged from this study. First, Noakes et al found that the hypocaloric HP diet produced weight loss comparable to that of the HC diet and provided nutritional and metabolic benefits that were equal to or in some cases greater than those seen with the HC diet. Second, in a post hoc analysis, they found that obese subjects in the top 50% of blood triacylglycerol concentrations at baseline lost more weight with the hypocaloric HP diet than with the hypocaloric HC diet. Thus, the study is noteworthy in that it suggests that high-protein diets are effective at both producing weight loss and improving risk factors for diabetes and heart disease and that it may be possible to identify persons who do particularly well with high-protein diets... It may be useful to consider weight management as consisting of 2 different phases: achieving weight loss and maintaining weight loss. The strategies that work for losing weight may not be effective for keeping weight off. We have found this to be the case in a review of the National Weight Control Registry, which follows 5000 people who have succeeded in maintaining weight loss in the long term (8). When it comes to choosing a hypocaloric diet, one size may not fit all. However, keeping weight off requires the achievement of a permanent balance between energy intake and energy expenditure. Here is where physical activity becomes critically important (8) and may even be more important than diet composition.

Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men Youfa Wang et al

“Conclusions: Both overall and abdominal adiposity strongly and independently predict risk of type 2 diabetes. WC waist circumference is a better predictor than is WHR waist to hip ratio . The currently recommended cutoff for WC of 102 cm for men may need to be reevaluated; a lower cutoff may be more appropriate.”

Waist Circumference Quintile

As of April, 2004, note that dietary supplements do not work for weight loss! Dietary supplements for body-weight reduction: a systematic review Max H Pittler and Edzard Ernst Am. J. Clinical Nutrition,  Apr 2004;  79:  529 - 536. Conclusions: The evidence for most dietary supplements as aids in reducing body weight is not convincing. None of the reviewed dietary supplements can be recommended for over-the-counter use.

Below may be useful links and references to help control weight gain.

See Diets; see milk which appears to be one key to weight loss (Dec 2004)

COMPOUNDS OF POSSIBLE BENEFIT: Carnitine, alpha-lipoic acid; conjugated linoleic acid (CLA)

COMPOUNDS ADVERTISED AS USEFUL OF QUESTIONABLE VALUE AND POSSIBLE DANGER: Chromium, stimulants like caffeine.

 FIBER REDUCES WEIGHT GAIN:http://www.ajcn.org/cgi/content/abstract/80/5/1237

The increased consumption of whole grains was inversely related to weight gain, and the associations persisted after changes in added bran or fiber intakes were accounted for. This suggests that additional components in whole grains may contribute to favorable metabolic alterations that may reduce long-term weight gain

WEIGHT LOSS: Evaluation of tips from The Little Book of Willpower, supplement to Prevention
Setting goals - start with 1 or 2 mini-goals; realistic; be flexible
Work with body - take it slow, avoid pasta, salt, get fish, seeds, yoghurt; try grazing - smaller meals more often;
Eat mindfully - plan snacks sensibly; drink water; eat veggies except potatoes, corn, peas
Emotional eating - choose boredom foods wisely; keep a food journal; soothing foods
Planning meals - When you start cheating, be creative; don't shop when you are hungry
Finding time - eat breakfast;
Eating and greeting - buddy up; drink water for every alcoholic drink
Having a drink - drink 8 glasses water (Nutrition Investigator note: There is actually no evidence I can find that 8 glasses of water are useful. That is a common myth unsupported by research)

KEY REFERENCES

1. Acetyl-carnitine - see pg 81-2, Balz Frei, Natural Antioxidants

2. INFORM, Vol 9 pg 69-72 (1998), "Scientific Forum Explores CLA Knowledge"

"One three-month preliminary study with 20 healthy volunteers showed that 3.6 grams of CLA a day decreased body fat from 21.3% to 17%. Atkinson described a longer study with more subjects which he is undertaking to determine if this reducttion in fat is repeatable"

3. Klein, R. and Garreau, J., "Fat City: An Exploration of American Obesity", The New Republic, pg. 24-38 (19 September 1994)

"One-third of Americans [from 1980 to 1991] up from one-quarter, are overweight. The richest nation in the world is the fattest and growing fatter." This series of articles explores many of the American attitudes toward weight gain, and problems with FDA labelling. The new labels mean, "for example, that although the twenty fat calories in a serving of regular Fig Newtons have been removed in their fat-free version, extra sugars add ten calories." Thus, one is more likely to gain weight by eating "fat-free" Fig Newtons.