Added weight: The challenge of obesity in older patients
The combination of overweight and comorbid conditions takes a serious toll on older Americans. Addressing the problem requires sensitivity and specific strategies.
By Stephanie Stapleton, amednews staff. Nov. 15, 2004.
The patient is a 78-year-old woman with severe osteoarthritis in her knees, hypercholesterolemia and hypertension. She is severely overweight. And her physician has been working with her to address her excess bulk.
Has the effort resulted in any success?
"Yes and no," said Melvyn Sterling, MD, an internist in Orange County, Calif. He has been able to stop the progressive rise in her weight. But as of yet, the scales haven't started registering downward momentum.
Like Dr. Sterling, many physicians are well aware of the hard-fought nature of such small victories when treating older, overweight patients who often present with a lifetime of bad habits and a range of complex chronic conditions. After all, the problems related to obesity are both widespread and insidious.
About two out of three Americans are overweight or obese. Incidence rates for older Americans follow close behind. According to the National Heart, Lung and Blood Institute, an estimated 18% of U.S. adults older than 65 are obese. Another 40% are overweight, putting them at substantially increased risk for diabetes, hypertension, heart disease and other illnesses.
In July, the Centers for Medicare & Medicaid Services announced a change in Medicare rules designed to remove barriers to covering anti-obesity treatments. The agency changed language that had stated that obesity was not a disease. As a result, coverage decisions now can be made on treatments, with the exception of weight loss drugs, if an advisory panel determines that enough evidence exists to demonstrate effectiveness in improving beneficiaries' health outcomes. Many doctors hope that this step ultimately will enable Medicare to be more proactive in paying for interventions before comorbidities take hold. For now, though, the added attention doesn't ease the burdens physicians face as they struggle to develop strategies to make a difference.
"There are some things that are common sense when dealing with older people and weight issues," said Dr. Sterling, also chair of the AMA Council on Scientific Affairs. "But it can be much more difficult to change their behavior, and the stakes are much higher, because the secondary medical problems are more common."
More than one epidemic
Many experts talk about the problem in terms of twin epidemics: obesity and inactivity. Between 28% to 34% of adults ages 65 to 74 and 35% to 44% of adults older than 75 engage in no leisure-time physical activity at all, according to the Centers for Disease Control and Prevention. This fact further complicates this demographic group's weight-control efforts. Not only are these patients more likely to be sedentary, but as people age, their metabolisms slow. Interventions, therefore, have to operate on two tracks. 18% of U.S. adults older than 65 are obese; another 40% are overweight. "I don't just think in terms of weight loss anymore," said Howard Eisenson, MD, a family physician who is the director of the Duke Diet and Fitness Center in Durham, N.C. Instead, diet and nutrition as well as physical activity are two sides of the same coin, he said.
But the stumbling blocks are many. Physicians often recommend walking. However, wear-and-tear joint pain can limit a patient's ability to follow through, explained Denise Bruner, MD, a bariatrician in private practice in Arlington, Va., and a former president of the American Society of Bariatric Physicians. They might fear walking outside because of crime or a lack of sidewalks. People also sometimes have vision or balance problems that put them at risk of falling.
When it comes to eating habits, older patients can have diminished taste buds, which tend to lure them toward the sweet and salty. Their negative patterns are well-established. And often, they live on fixed incomes, and healthy food choices are usually more expensive.
And some patients are on medications that either drive their weight up or prevent losses. "In the bariatric world, we know that beta-blockers can cause weight gain," Dr. Bruner said. Steroids also fall into this category.
But the news isn't all bad, because some factors actually work in these patients' favor. Many are retired, meaning they have time to commit to making changes. They also have a different state of mind. 28% to 34% of adults ages 65 to 74 and 35% to 44% of older adults engage in no leisure-time physical activity.
Once patients are in their 40s or beyond, they've been on a multitude of diets and lost and gained a multitude of pounds, said Joel Posner, MD, an Audrey Meyer Mars Professor of Gerontologic Research at Drexel University College of Medicine in Philadelphia. "By laying out right at the beginning that we are talking about a two, three- or four-year process where we're really going to change behavior to make [the patient] more healthy, compliance actually tends to be pretty good, and unreasonable expectations usually aren't there."
Conventional wisdom about making necessary adjustments also has changed.
"The thinking used to be if you got to be 60, 70, or 80 and you were overweight, it wasn't going to hurt you," said Edward Saltzman, MD, chief of the division of nutrition at Tufts Medical Center in Boston. "That really isn't true."
Still, helping define a patient's notion of what he or she is working toward is no easy task.
According to Dr. Bruner, success in weight reduction is generally viewed as losing and maintaining a 5% to 10% reduction in body weight. For someone who weighs 300 lbs, that's only 30 lbs. With her older patients, she tries to emphasize "the benefits that result instead of the discomfort of making a change." Younger people have more external motivation, she added. "In these people, it has to come from the heart." Successful weight loss is losing and maintaining a 5% to 10% reduction in body weight.But the cards seem stacked against older patients. It's the arthritis that makes it hard to exercise, the habits ingrained over many years that are difficult to break, and the reality that older folks simply tend to lose weight more slowly. "One of the limitations to a weight-control effort -- particularly if it is non-surgical -- is people want to hop on the scale every few days and see the needle dropping. If they don't, it can derail their efforts," Dr. Eisenson said. Thus, keeping these patients focused on the prize is critical.
"We have a number of older people who are really very overweight," Dr. Posner said. Though these patients slim down a bit, their main accomplishment is improved health. "You have to applaud that, even though you may never get the person down to the weight they want."
Dr. Eisenson thinks of it as moving their frame of reference beyond the scale. "I like to grab at the moment and say, 'Hey, hold on a second. How have you felt over this week? How are your clothes fitting? Are you starting to move better?' If you can get them to say, 'Oh yeah, that's better,' that can give them the motivation to stick with it."
Tips for doctors in the trenches
Physicians who either specialize in diet and nutrition or have significant experience dealing with older patients offer a number of specific tips.
"The first thing is to take heart -- don't write these people off," Dr. Eisenson said. "I would avoid assuming that older patients are either uninterested or unable to modify their eating habits or activity levels."
Once the issue is on the table, one of the most basic messages to convey to patients is not to gain more weight.
In terms of cutting calories, experts generally agree that patients should avoid radical diets and instead incorporate small changes sustainable over the long term. These include staying away from refined products, processed food, white sugars, white flours and white rice, as well as avoiding saturated fats and transfatty acids. Meanwhile, they should emphasize fruits, vegetables, whole grains and enough protein to build and maintain muscle.
In terms of exercise, the mantra is start low and go slow.
Goals should be geared to individual patients. "We have some people who are almost crippled, and we have some people who are in very good shape," Dr. Posner said. But it is always important to focus on flexibility; aerobic exercise, based on the patient's fitness; and muscle work to build strength and increase metabolism.
Specialists note the daunting time constraints primary care doctors face when trying to advance these kinds of lifestyle changes.
Being familiar with local resources and encouraging patients to take advantage of them can help. For instance, senior or community centers or YMCAs often have senior fitness classes, pool exercise -- great for those who have joint pain -- or walking groups.
"If somebody is limited, they can start with walking 10 minutes a day and add a few minutes a week to that regimen," Dr. Eisenson said. And if they are afraid or unable to go outside, they should still have an ultimate goal of 30 minutes of activity -- even if it is accomplished indoors on a stationary bike or by walking around the dining room table, said Barry Fabius, MD, medical director of geriatrics at the Holy Redeemer Health System in suburban Philadelphia. He also notes the importance of putting patients through some basic tests to ensure that they are medically ready.
Most also agree that referring patients with orthopedic issues to a physical therapist, which is often covered by insurance, can be helpful. Physicians also can send patients to diet and nutrition programs.
Dr. Sterling said his patients are most successful when involved in a program that meets a minimum of once every other week. Depending on the patient's financial resources, he recommends, for example, Overeaters Anonymous or Weight Watchers as affordable options. His patients have also been very successful working with a registered dietician.
Meanwhile, Dr. Bruner reminds physicians to review patient medications to ensure that they are "weight neutral" if possible. She also recommends advising patients to stay well-hydrated. "Dehydration can be mistaken for hunger." Another tip: Eat a main meal at the noon hour and eat lighter in the evening. "It's a metabolic rate issue," she said.
Bottom line: Experts agree that obesity is a long-term problem and should be treated as such. "Applying a chronic disease model makes a great deal of sense," Dr. Eisenson said. "Too often we don't do that."
He encourages physicians to bring up often the issues of weight, eating habits and exercise. And over time, patients will need encouragement, support and even problem solving. But healthier lifestyles are certainly within reach.
"I don't think there's an age limit on people's interest in improving their health, becoming more active, losing weight," Dr. Eisenson added. "Nor do I think the ability to be successful ends at a certain age."
Ref: http://www.ama-assn.org/amednews/2004/11/15/hlsa1115.htm
Dr. Owens has extensive experience with bariatric surgery on senior patients. Please refer to the Coastal's website on more information on Coastal's Center for Obesity Bariatric Surgery for Seniors.
Tuesday, June 26, 2012
Wednesday, October 20, 2010
Exercise and Well-Being: A Review of Mental and Physical Health Benefits Associated With Physical Activity
Abstract
Purpose of Review: This review highlights recent work evaluating the relationship between exercise, physical activity and physical and mental health. Both cross-sectional and longitudinal studies, as well as randomized clinical trials, are included. Special attention is given to physical conditions, including obesity, cancer, cardiovascular disease and sexual dysfunction. Furthermore, studies relating physical activity to depression and other mood states are reviewed. The studies include diverse ethnic populations, including men and women, as well as several age groups (e.g. adolescents, middle-aged and older adults).
Recent Findings: Results of the studies continue to support a growing literature suggesting that exercise, physical activity and physical-activity interventions have beneficial effects across several physical and mental-health outcomes. Generally, participants engaging in regular physical activity display more desirable health outcomes across a variety of physical conditions. Similarly, participants in randomized clinical trials of physical-activity interventions show better health outcomes, including better general and health-related quality of life, better functional capacity and better mood states.
Summary: The studies have several implications for clinical practice and research. Most work suggests that exercise and physical activity are associated with better quality of life and health outcomes. Therefore, assessment and promotion of exercise and physical activity may be beneficial in achieving desired benefits across several populations. Several limitations were noted, particularly in research involving randomized clinical trials. These trials tend to involve limited sample sizes with short follow-up periods, thus limiting the clinical implications of the benefits associated with physical activity.
Click on article URL link below to continue reading.
Article URL: http://www.medscape.com/viewarticle/500789
Source(s): Medscape. Frank J. Penedo (a), Jason R. Dahn (a,b)
a Department of Psychology and Sylvester Comprehensive Cancer Center, University of Miami, Coral Gables
b Miami Veteran's Affairs Medical Center, Miami, Florida, USA
Article Date: April 15, 2005
Purpose of Review: This review highlights recent work evaluating the relationship between exercise, physical activity and physical and mental health. Both cross-sectional and longitudinal studies, as well as randomized clinical trials, are included. Special attention is given to physical conditions, including obesity, cancer, cardiovascular disease and sexual dysfunction. Furthermore, studies relating physical activity to depression and other mood states are reviewed. The studies include diverse ethnic populations, including men and women, as well as several age groups (e.g. adolescents, middle-aged and older adults).
Recent Findings: Results of the studies continue to support a growing literature suggesting that exercise, physical activity and physical-activity interventions have beneficial effects across several physical and mental-health outcomes. Generally, participants engaging in regular physical activity display more desirable health outcomes across a variety of physical conditions. Similarly, participants in randomized clinical trials of physical-activity interventions show better health outcomes, including better general and health-related quality of life, better functional capacity and better mood states.
Summary: The studies have several implications for clinical practice and research. Most work suggests that exercise and physical activity are associated with better quality of life and health outcomes. Therefore, assessment and promotion of exercise and physical activity may be beneficial in achieving desired benefits across several populations. Several limitations were noted, particularly in research involving randomized clinical trials. These trials tend to involve limited sample sizes with short follow-up periods, thus limiting the clinical implications of the benefits associated with physical activity.
Click on article URL link below to continue reading.
Article URL: http://www.medscape.com/viewarticle/500789
Source(s): Medscape. Frank J. Penedo (a), Jason R. Dahn (a,b)
a Department of Psychology and Sylvester Comprehensive Cancer Center, University of Miami, Coral Gables
b Miami Veteran's Affairs Medical Center, Miami, Florida, USA
Article Date: April 15, 2005
Tuesday, October 19, 2010
Lift Weights – Why You Should Lift Weights if You’re a Woman
Over the last decade, researchers have made extremely compelling arguments for the benefits of weight training for women and those over the age of fifty. Still, the number of women who take this recommendation to heart is still quite low. Most women who exercise are spending most of their gym time on cardiovascular exercise. Whatever your reasons for avoiding the weights, if you are a woman, here are ten reasons why you need to take strength training seriously.
1. You Will Be Physically Stronger.
Increasing your strength will make you far less dependent upon others for assistance in daily living. Chores will be easier, lifting kids, groceries and laundry will no longer push you to the max. If your maximum strength is increased, daily tasks and routine exercise will be far less likely to cause injury. Research studies conclude that even moderate weight training can increase a woman's strength by 30 to 50 percent. Research also shows that women can develop their strength at the same rate as men.
2. You Will Lose Body Fat.
Studies performed by Wayne Westcott, PhD, from the South Shore YMCA in Quincy, Massachusetts, found that the average woman who strength trains two to three times a week for two months will gain nearly two pounds of muscle and will lose 3.5 pounds of fat. As your lean muscle increases so does your resting metabolism, and you burn more calories all day long. Generally speaking, for each pound of muscle you gain, you burn 35 to 50 more calories each day. That can really add up.
3. You Will Gain Strength Without Bulk.
Researchers also found that unlike men, women typically don't gain size from strength training, because compared to men, women have 10 to 30 times less of the hormones that cause muscle hypertrophy. You will, however, develop muscle tone and definition. This is a bonus.
4. You Decrease Your Risk Of Osteoporosis.
Research has found that weight training can increase spinal bone mineral density (and enhance bone modeling) by 13 percent in six months. This, coupled with an adequate amount of dietary calcium, can be a women's best defense against osteoporosis.
5. You Will Improve Your Athletic Performance.
Over and over research concludes that strength training improves athletic ability in all but the very elite athletes (See Article). Golfers can significantly increase their driving power. Cyclists are able to continue for longer periods of time with less fatigue. Skiers improve technique and reduce injury. Whatever sport you play, strength training has been shown to improve overall performance as well as decrease the risk of injury.
6. You Will Reduce Your Risk Of Injury, Back Pain and Arthritis.
Strength training not only builds stronger muscles, but also builds stronger connective tissues and increases joint stability. This acts as reinforcement for the joints and helps prevent injury. A recent 12-year study showed that strengthening the low-back muscles had an 80 percent success rate in eliminating or alleviating low-back pain. Other studies have indicated that weight training can ease the pain of osteoarthritis and strengthen joints.
7. You Will Reduce Your Risk of Heart Disease.
According to Dr. Barry A. Franklin, of William Beaumont Hospital in Royal Oak, Michigan, weight training can improve cardiovascular health in several ways, including lowering LDL ("bad") cholesterol, increasing HDL ("good") cholesterol and lowering blood pressure. When cardiovascular exercise is added, these benefits are maximized.
8. You Will Reduce Your Risk of Diabetes.
In addition, Dr. Franklin noted that weight training may improve the way the body processes sugar, which may reduce the risk of diabetes. Adult-onset diabetes is a growing problem for women and men. Research indicates that weight training can increase glucose utilization in the body by 23 percent in four months.
9. It Is Never Too Late To Benefit.
Women in their 70s and 80s have built up significant strength through weight training and studies show that strength improvements are possible at any age. Note, however, that a strength training professional should always supervise older participants.
10. You Will Improve Your Attitude And Fight Depression.
A Harvard study found that 10 weeks of strength training reduced clinical depression symptoms more successfully than standard counseling did. Women who strength train commonly report feeling more confident and capable as a result of their program, all important factors in fighting depression.
You can learn more about strength training tips and tricks here: About Strength Training.
Article URL: http://sportsmedicine.about.com/cs/women/a/aa051601a.htm
Source(s): Elizabeth Quinn, About.com Guide.
Article Date: December 08, 2008
1. You Will Be Physically Stronger.
Increasing your strength will make you far less dependent upon others for assistance in daily living. Chores will be easier, lifting kids, groceries and laundry will no longer push you to the max. If your maximum strength is increased, daily tasks and routine exercise will be far less likely to cause injury. Research studies conclude that even moderate weight training can increase a woman's strength by 30 to 50 percent. Research also shows that women can develop their strength at the same rate as men.
2. You Will Lose Body Fat.
Studies performed by Wayne Westcott, PhD, from the South Shore YMCA in Quincy, Massachusetts, found that the average woman who strength trains two to three times a week for two months will gain nearly two pounds of muscle and will lose 3.5 pounds of fat. As your lean muscle increases so does your resting metabolism, and you burn more calories all day long. Generally speaking, for each pound of muscle you gain, you burn 35 to 50 more calories each day. That can really add up.
3. You Will Gain Strength Without Bulk.
Researchers also found that unlike men, women typically don't gain size from strength training, because compared to men, women have 10 to 30 times less of the hormones that cause muscle hypertrophy. You will, however, develop muscle tone and definition. This is a bonus.
4. You Decrease Your Risk Of Osteoporosis.
Research has found that weight training can increase spinal bone mineral density (and enhance bone modeling) by 13 percent in six months. This, coupled with an adequate amount of dietary calcium, can be a women's best defense against osteoporosis.
5. You Will Improve Your Athletic Performance.
Over and over research concludes that strength training improves athletic ability in all but the very elite athletes (See Article). Golfers can significantly increase their driving power. Cyclists are able to continue for longer periods of time with less fatigue. Skiers improve technique and reduce injury. Whatever sport you play, strength training has been shown to improve overall performance as well as decrease the risk of injury.
6. You Will Reduce Your Risk Of Injury, Back Pain and Arthritis.
Strength training not only builds stronger muscles, but also builds stronger connective tissues and increases joint stability. This acts as reinforcement for the joints and helps prevent injury. A recent 12-year study showed that strengthening the low-back muscles had an 80 percent success rate in eliminating or alleviating low-back pain. Other studies have indicated that weight training can ease the pain of osteoarthritis and strengthen joints.
7. You Will Reduce Your Risk of Heart Disease.
According to Dr. Barry A. Franklin, of William Beaumont Hospital in Royal Oak, Michigan, weight training can improve cardiovascular health in several ways, including lowering LDL ("bad") cholesterol, increasing HDL ("good") cholesterol and lowering blood pressure. When cardiovascular exercise is added, these benefits are maximized.
8. You Will Reduce Your Risk of Diabetes.
In addition, Dr. Franklin noted that weight training may improve the way the body processes sugar, which may reduce the risk of diabetes. Adult-onset diabetes is a growing problem for women and men. Research indicates that weight training can increase glucose utilization in the body by 23 percent in four months.
9. It Is Never Too Late To Benefit.
Women in their 70s and 80s have built up significant strength through weight training and studies show that strength improvements are possible at any age. Note, however, that a strength training professional should always supervise older participants.
10. You Will Improve Your Attitude And Fight Depression.
A Harvard study found that 10 weeks of strength training reduced clinical depression symptoms more successfully than standard counseling did. Women who strength train commonly report feeling more confident and capable as a result of their program, all important factors in fighting depression.
You can learn more about strength training tips and tricks here: About Strength Training.
Article URL: http://sportsmedicine.about.com/cs/women/a/aa051601a.htm
Source(s): Elizabeth Quinn, About.com Guide.
Article Date: December 08, 2008
Monday, October 18, 2010
Top Ten Foods You Should Never Eat
1. Quaker 100% Natural Oats & Honey Granola
A half cup of these is coated with three teaspoons of sugar and laden with more artery clogging fat than you'd get in a McDonald's hamburger. Better choices are, Grape Nuts, Wheaties, Kellogg's All-Bran, Post 100% Bran,shredded wheat, or oatmeal.
2. Bugles
These are fried in highly saturated coconut oil. This is about twice as saturated as lard. One serving (just over a cup) gives you 40% of your daily limit of saturated fat. Baked Bugles or tortilla chips are a much better choice.
3. Buitoni Contadina Alfredo Sauce
Does a third of a stick of butter sound good for you? That is how much is in this sauce.Try Classico Spicy Red Pepper, Tomato & Basil, Fire Roasted Tomato & Garlic, or any sauces from Healthy Choice or Ragu Light. Your arteries will thank you.
4. Pizza Hut's Big New Yorker Pizza
Is bigger really better? NO! Two slices of this pizza gives you almost a full day's saturated fat (17grams) and sodium(2.200mg), and 790 calories. And that's without sausage, pepperoni, or anything else. An entire Healthy Choice Supreme French Bread Pizza will only get you 1.5 grams of saturated fat, 580 mg of sodium and 330 calories.
5. Entenmann's Rich Frosted Donut (Variety pack size)
Is it possible than such a yummy snack can have as much artery clogging saturated and trans fat (10grams) as nine strips of bacon? It sure is! The Entenmann's Light Donuts are a better choice, with anywhere from six to nine grams of fat per donut. Though certainly not a healthy food, they are better than the regular ones.
6. Nissin Cup Noodles with Shrimp
These are pre-fried in palm oil, and will clog your arteries up the same as one and a half cups of whole milk. Fantastic Foods Chicken Free Ramen Noodles are a better pick in this department.
7. Burger King French Fries
This franchise makes some of the worst french fries you can buy at a fast food restaurant.They are even worse than McDonald's Super Size Fries. The salty coating allows more oil to be absorbed. A king size order of BK fries packs a punch with 590 calories and 30 grams of fat, 12 of them artery clogging.
8. Campbell's red and white label condensed soups
Nothing like a hot bowl of soup on a cold day? True, but these have 1,100mg of sodium, about half the ideal quota for one day. Healthy Choice and Campbell's Healthy Request have less than half as much sodium without sacrificing any taste.
9. Frito Lay's Wow! Potato Chips
These are fried in Olean, the indigestible fat substitute. It doesn't provide any calories, but many have suffered such severe cramps or diarrhea that they had to go to the emergency room! It also prevents the body's absorption of carotenoids.Again, try baked potato or tortilla chips.
10. Denny's Grand Slam
2 eggs, 2 sausage links, 2 strips of bacon, and 2 pancakes. Sounds delicious right? Well, just listen to this. It contains three quarters of a day's total fat (50 grams) and saturated fat (14 grams), nearly a full day's sodium (2,240mg) and one and a half day's cholesterol (460mg). In contrast, the Denny's Slim Slam slashes the calories to 600, the fat to 12 grams, the saturated fat to 3 grams, and the cholesterol to a mere 35 mg.
Does any of this make you want to change your eating habits? Will you pay closer attention to just what the food you eat contains? Join the conversation in the Netscape community forums.
Article URL: Netscape Community Forum
Article Date: March 3, 2005
A half cup of these is coated with three teaspoons of sugar and laden with more artery clogging fat than you'd get in a McDonald's hamburger. Better choices are, Grape Nuts, Wheaties, Kellogg's All-Bran, Post 100% Bran,shredded wheat, or oatmeal.
2. Bugles
These are fried in highly saturated coconut oil. This is about twice as saturated as lard. One serving (just over a cup) gives you 40% of your daily limit of saturated fat. Baked Bugles or tortilla chips are a much better choice.
3. Buitoni Contadina Alfredo Sauce
Does a third of a stick of butter sound good for you? That is how much is in this sauce.Try Classico Spicy Red Pepper, Tomato & Basil, Fire Roasted Tomato & Garlic, or any sauces from Healthy Choice or Ragu Light. Your arteries will thank you.
4. Pizza Hut's Big New Yorker Pizza
Is bigger really better? NO! Two slices of this pizza gives you almost a full day's saturated fat (17grams) and sodium(2.200mg), and 790 calories. And that's without sausage, pepperoni, or anything else. An entire Healthy Choice Supreme French Bread Pizza will only get you 1.5 grams of saturated fat, 580 mg of sodium and 330 calories.
5. Entenmann's Rich Frosted Donut (Variety pack size)
Is it possible than such a yummy snack can have as much artery clogging saturated and trans fat (10grams) as nine strips of bacon? It sure is! The Entenmann's Light Donuts are a better choice, with anywhere from six to nine grams of fat per donut. Though certainly not a healthy food, they are better than the regular ones.
6. Nissin Cup Noodles with Shrimp
These are pre-fried in palm oil, and will clog your arteries up the same as one and a half cups of whole milk. Fantastic Foods Chicken Free Ramen Noodles are a better pick in this department.
7. Burger King French Fries
This franchise makes some of the worst french fries you can buy at a fast food restaurant.They are even worse than McDonald's Super Size Fries. The salty coating allows more oil to be absorbed. A king size order of BK fries packs a punch with 590 calories and 30 grams of fat, 12 of them artery clogging.
8. Campbell's red and white label condensed soups
Nothing like a hot bowl of soup on a cold day? True, but these have 1,100mg of sodium, about half the ideal quota for one day. Healthy Choice and Campbell's Healthy Request have less than half as much sodium without sacrificing any taste.
9. Frito Lay's Wow! Potato Chips
These are fried in Olean, the indigestible fat substitute. It doesn't provide any calories, but many have suffered such severe cramps or diarrhea that they had to go to the emergency room! It also prevents the body's absorption of carotenoids.Again, try baked potato or tortilla chips.
10. Denny's Grand Slam
2 eggs, 2 sausage links, 2 strips of bacon, and 2 pancakes. Sounds delicious right? Well, just listen to this. It contains three quarters of a day's total fat (50 grams) and saturated fat (14 grams), nearly a full day's sodium (2,240mg) and one and a half day's cholesterol (460mg). In contrast, the Denny's Slim Slam slashes the calories to 600, the fat to 12 grams, the saturated fat to 3 grams, and the cholesterol to a mere 35 mg.
Does any of this make you want to change your eating habits? Will you pay closer attention to just what the food you eat contains? Join the conversation in the Netscape community forums.
Article URL: Netscape Community Forum
Article Date: March 3, 2005
Friday, October 15, 2010
Heavy? You may live three to 10 years less.
LONDON — Being obese can take years off your life and in some cases may be as dangerous as smoking, a new study says.
British researchers at the University of Oxford analyzed 57 studies mostly in Europe and North America, following nearly one million people for an average of 10 to 15 years. During that time, about 100,000 of those people died.
The studies used Body Mass Index (BMI), a measurement that divides a person's weight in kilograms by their height squared in meters to determine obesity. Researchers found that death rates were lowest in people who had a BMI of 23 to 24, on the high side of the normal range.
Health officials generally define overweight people as those with a BMI from 25 to 29, and obese people as those with a BMI above 30.
The study was published online Wednesday in the medical journal, Lancet. It was paid for by Britain's Medical Research Council, the British Heart Foundation, Cancer Research UK and others.
"If you are heading towards obesity, it may be a good idea to lose weight," said Sir Richard Peto, the study's main statistician and a professor at Oxford University.
Moderately heavy people lost 3 years of life
Peto and colleagues found that people who were moderately fat, with a BMI from 30 to 35, lost about three years of life. People who were morbidly fat — those with a BMI above 40 — lost about 10 years off their expected lifespan, similar to the effect of lifelong smoking.
BMI calculator
Moderately obese people were 50 percent more likely to die prematurely than normal-weight people, said Gary Whitlock, the Oxford University epidemiologist who led the study.
He said that obese people were also two thirds more likely to die of a heart attack or stroke, and up to four times more likely to die of diabetes, kidney or liver problems. They were one sixth more likely to die of cancer.
"This really emphasizes the importance of weight gain," said Dr. Arne Astrup, a professor of nutrition at the University of Copenhagen who was not linked to the Lancet study. "Even a small increase in your BMI is enough to increase your risks for cardiovascular disease and cancer."
Previous studies have found that death rates increase both above and below a normal BMI score, and that people who are moderately overweight live longer than underweight or normal-weight people.
Other experts said that because the papers used in the study mostly started between 1975 and 1985, their conclusions were not as relevant today.
Astrup worried that rising obesity rates may reverse the steep drops in heart disease seen in the West.
"Obesity is the new dark horse for public health officials," he said. "People need to be aware of the risks they're taking when they gain weight."
Article URL: http://www.msnbc.msn.com/id/29739036/from/ET/
Source(s): The Associated Press. MSNBC.
Article Date: March 17, 2009
British researchers at the University of Oxford analyzed 57 studies mostly in Europe and North America, following nearly one million people for an average of 10 to 15 years. During that time, about 100,000 of those people died.
The studies used Body Mass Index (BMI), a measurement that divides a person's weight in kilograms by their height squared in meters to determine obesity. Researchers found that death rates were lowest in people who had a BMI of 23 to 24, on the high side of the normal range.
Health officials generally define overweight people as those with a BMI from 25 to 29, and obese people as those with a BMI above 30.
The study was published online Wednesday in the medical journal, Lancet. It was paid for by Britain's Medical Research Council, the British Heart Foundation, Cancer Research UK and others.
"If you are heading towards obesity, it may be a good idea to lose weight," said Sir Richard Peto, the study's main statistician and a professor at Oxford University.
Moderately heavy people lost 3 years of life
Peto and colleagues found that people who were moderately fat, with a BMI from 30 to 35, lost about three years of life. People who were morbidly fat — those with a BMI above 40 — lost about 10 years off their expected lifespan, similar to the effect of lifelong smoking.
BMI calculator
Moderately obese people were 50 percent more likely to die prematurely than normal-weight people, said Gary Whitlock, the Oxford University epidemiologist who led the study.
He said that obese people were also two thirds more likely to die of a heart attack or stroke, and up to four times more likely to die of diabetes, kidney or liver problems. They were one sixth more likely to die of cancer.
"This really emphasizes the importance of weight gain," said Dr. Arne Astrup, a professor of nutrition at the University of Copenhagen who was not linked to the Lancet study. "Even a small increase in your BMI is enough to increase your risks for cardiovascular disease and cancer."
Previous studies have found that death rates increase both above and below a normal BMI score, and that people who are moderately overweight live longer than underweight or normal-weight people.
Other experts said that because the papers used in the study mostly started between 1975 and 1985, their conclusions were not as relevant today.
Astrup worried that rising obesity rates may reverse the steep drops in heart disease seen in the West.
"Obesity is the new dark horse for public health officials," he said. "People need to be aware of the risks they're taking when they gain weight."
Article URL: http://www.msnbc.msn.com/id/29739036/from/ET/
Source(s): The Associated Press. MSNBC.
Article Date: March 17, 2009
Thursday, October 14, 2010
Common Obesity Gene Linked To Brain Tissue Loss, Raising Alzheimer's Risk
New research from the US reveals that a common variant of the FTO obesity gene carried by more than one third of Americans that causes them to gain weight and puts them at risk for obesity, also leads to loss of brain tissue, thereby increasing their risk of developing neurodegenerative diseases like Alzheimer's later in life.
The study, which was funded by the National Institutes of Health and private industry, appears in the early online issue of the Proceedings of the National Academy of Sciences and was led by researchers at the University of California Los Angeles (UCLA).
About three years ago we learned of a startling discovery: nearly half of Americans descended from Europeans carry a variant of the fat mass and obesity associated (FTO) gene that causes them to put on a few extra pounds of weight, measure one inch more around the waist, and even more alarmingly, also puts them at higher risk of obesity compared to non-carriers.
Now UCLA researchers have found that the same FTO variant, which is also present in around one quarter of US Hispanics and in 15 per cent of African Americans and Asian Americans, is linked with a loss of brain tissue, placing around one third of the American population at higher risk of diseases like Alzheimer's.
Senior author Dr Paul Thompson, a UCLA professor of neurology, and two graduate students from his lab, lead authors April Ho and Jason Stein, and colleagues. used magnetic resonance imaging to make 3D maps of the brains of 206 healthy elderly people from 58 US locations participating in the Alzheimer's Disease Neuroimaging Initiative, a large 5 year project that is looking at what helps the aging brain resist disease.
They found that participants who had the FTO variant had consistently less brain tissue than the noncarriers: 8 per cent less in frontal lobe tissue (the brain's command and control centre) and 12 per cent less in occipital lobe tissue (the back part of the brain that controls vision and perception).
They also established that other obesity-related factors like cholesterol, diabetes and high blood pressure could not account for these differences.
Thompson, who is also a member of the Brain Research Institute and the Laboratory of Neuro Imaging at UCLA, described the results as "curious". He told the press that:
"If you have the bad FTO gene, your weight affects your brain adversely in terms of tissue loss."
And yet:
"If you don't carry FTO, higher body weight doesn't translate into brain deficits; in fact, it has nothing to do with it. This is a very mysterious, widespread gene," said Thompson.
Thompson said half of the world's population has this gene variant, and thus for them, any loss of brain tissue puts them at higher risk of functional decline.
But, shocking as this news is, it does not mean carriers of the variant are doomed, because as Thompson pointed out, they can still exercise and eat healthily to reduce their chances of developing obesity and brain decline: "a healthy lifestyle will counteract the risk of brain loss, whether you carry the gene or not," he explained.
"So it's vital to boost your brain health by being physically active and eating a balanced diet," said Thompson.
Thompson also said that the discovery "will help to develop and fine tune the anti-dementia drugs being developed to combat brain aging".
"A commonly carried allele of the obesity-related FTO gene is associated with reduced brain volume in the healthy elderly."
Article URL: http://www.medicalnewstoday.com/articles/186070.php
Source(s): UCLA. PNAS, published ahead of print 19 April 2010. DOI:10.1073/pnas.0910878107. Catharine Paddock, PhD, Medical News Today.
Article Date: April 20, 2010
The study, which was funded by the National Institutes of Health and private industry, appears in the early online issue of the Proceedings of the National Academy of Sciences and was led by researchers at the University of California Los Angeles (UCLA).
About three years ago we learned of a startling discovery: nearly half of Americans descended from Europeans carry a variant of the fat mass and obesity associated (FTO) gene that causes them to put on a few extra pounds of weight, measure one inch more around the waist, and even more alarmingly, also puts them at higher risk of obesity compared to non-carriers.
Now UCLA researchers have found that the same FTO variant, which is also present in around one quarter of US Hispanics and in 15 per cent of African Americans and Asian Americans, is linked with a loss of brain tissue, placing around one third of the American population at higher risk of diseases like Alzheimer's.
Senior author Dr Paul Thompson, a UCLA professor of neurology, and two graduate students from his lab, lead authors April Ho and Jason Stein, and colleagues. used magnetic resonance imaging to make 3D maps of the brains of 206 healthy elderly people from 58 US locations participating in the Alzheimer's Disease Neuroimaging Initiative, a large 5 year project that is looking at what helps the aging brain resist disease.
They found that participants who had the FTO variant had consistently less brain tissue than the noncarriers: 8 per cent less in frontal lobe tissue (the brain's command and control centre) and 12 per cent less in occipital lobe tissue (the back part of the brain that controls vision and perception).
They also established that other obesity-related factors like cholesterol, diabetes and high blood pressure could not account for these differences.
Thompson, who is also a member of the Brain Research Institute and the Laboratory of Neuro Imaging at UCLA, described the results as "curious". He told the press that:
"If you have the bad FTO gene, your weight affects your brain adversely in terms of tissue loss."
And yet:
"If you don't carry FTO, higher body weight doesn't translate into brain deficits; in fact, it has nothing to do with it. This is a very mysterious, widespread gene," said Thompson.
Thompson said half of the world's population has this gene variant, and thus for them, any loss of brain tissue puts them at higher risk of functional decline.
But, shocking as this news is, it does not mean carriers of the variant are doomed, because as Thompson pointed out, they can still exercise and eat healthily to reduce their chances of developing obesity and brain decline: "a healthy lifestyle will counteract the risk of brain loss, whether you carry the gene or not," he explained.
"So it's vital to boost your brain health by being physically active and eating a balanced diet," said Thompson.
Thompson also said that the discovery "will help to develop and fine tune the anti-dementia drugs being developed to combat brain aging".
"A commonly carried allele of the obesity-related FTO gene is associated with reduced brain volume in the healthy elderly."
Article URL: http://www.medicalnewstoday.com/articles/186070.php
Source(s): UCLA. PNAS, published ahead of print 19 April 2010. DOI:10.1073/pnas.0910878107. Catharine Paddock, PhD, Medical News Today.
Article Date: April 20, 2010
Wednesday, October 13, 2010
Gastric Bypass Surgery–Related Weight Loss Greater for Those With Family Support
Patients who undergo gastric bypass surgery with the support of family members tend to lose significantly greater amounts of excess weight and have greater resolution of comorbidities than those who have the surgery on their own, according to a study presented here at the American Society for Metabolic and Bariatric Surgery 27th Annual Meeting.
With obesity commonly running in families, it is not unusual for 2 or more members of a family to have bariatric surgery at the same time to lend each other support.
"I'd say about 8% to 10% of our bariatric surgery patients are family members," said lead author of the study Gus J. Slotman, MD, clinical professor of surgery at the University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School in Newark.
"The patients seemed to appreciate being able to go through the experience with a sibling or family member, and we decided to investigate whether there are measurable benefits to the outcome when the procedure is done with a family member," Dr. Slotman explained.
The investigators evaluated the office records of 91 patients from 41 families having 2 or more Roux-en-Y gastric bypass surgeries in the family and compared them with the records of 91 other gastric bypass patients, case-matching the patients by age (±5 years), sex, and body mass index (±5 kg/m2).
Patients in the families group included 75 women (82%) and 16 men (18%) who were siblings, parent and child, spouses, cousins, grandmother and granddaughter, in-laws, or aunt or uncle and nephew or niece.
Six of the families had more than 2 gastric bypass patients, and 1 family had 5.
The rates of diabetes, sleep apnea, hypertension, and gastroesophageal reflux disease were equal in the family and control groups before the surgery.
In looking at complications, medical follow-up, body mass index, percentage of weight loss, and resolution of comorbidities at 6 months, 1 year, and 2 years postsurgery, the researchers found significant differences between the groups.
The percentage of excess weight loss at 6 months was 55% for family members and 48.5% for control participants (P = .003). At 1 year, excess weight loss was 81% among family members and 60% among control participants (P = .002). Furthermore, 45% of family members had an excess weight loss of more than 80% compared with 19% of control participants (P = .002).
In the subgroup of siblings, the rate of excess weight loss at 1 year was particularly high, at 86% for siblings compared with 60% in control participants — a weight loss that was about 40% greater for those with family involvement than for individuals (P < .0001).
In addition to greater weight loss, the family members also showed greater improvements in obesity-related diseases. About 65% of family members experienced resolution of type 2 diabetes after a year compared with 31% of control participants, and 60% of family members had a resolution of hypertension compared with 33% of control participants.
Resolution of sleep apnea among family members was 70%, and resolution of gastroesophageal reflux disease was 63%, compared with 23% and 41%, respectively, for the control group.
"I was surprised by how dramatic the differences in weight loss were, and that the improvement in comorbidities was even more dramatic than the weight loss," Dr. Slotman told Medscape General Surgery. "The resolution among family members was nearly double the rate of resolution for the controls in type 2 diabetes, hypertension, and sleep apnea."
Younger adults were likely to lose more weight than their parents.
Importantly, family member adherence to office follow-up visits was also higher than that of control participants, with a rate of 89% among family members at 6 months compared with 83% among control participants, and a rate of 83.5% at 1 year compared with just 58% among control participants (P = .002).
Dr. Slotman speculated that one of the reasons for the higher weight loss seen among siblings may have to do with the simple factor of sibling rivalry. "I've had siblings tell me it really came down to competition."
Bariatric surgeon Marina Kurian, MD, who moderated the session, said she has also seen benefits from family members going through surgeries together, but time can often take its toll in undermining the momentum.
"The study did show that after 2 years, some of the differences in improvement declined, and I think that suggests that sibling rivalry sometimes only goes so far," said Dr. Kurian, who is medical director of the New York University Weight Management Program in New York City.
"People will be either competitive against each other or supportive of each other, and you can be on track for a certain amount of time. But then life happens, like a death, a loss of a job, a stressful job, or a relationship issue, and patients can wind up going back to their prior food-related coping mechanisms."
That's where the compliance issues can be particularly important, she added. "The patients who I think ultimately do better are the ones who continue to come back to see either their surgeon or their dietician, and try to get [long-term] counseling."
The findings also help underscore the benefits that have previously been suggested in data on support groups in general — family or otherwise — Dr. Kurian said.
"I think most data shows that when you attend support groups, your weight loss is improved," she said. "It's not just a matter of being among other people who 'get' you, but of being exposed to other patients' experiences and getting ideas on different methods that may work for you."
Dr. Slotman and Dr. Kurian have disclosed no relevant financial relationships.
Source(s): Nancy Melville (Las Vegas, Nevada), Medscape. American Society for Metabolic and Bariatric Surgery 27th Annual Meeting: Abstract PL-207. Presented June 25, 2010.
Post Date: June 28, 2010
With obesity commonly running in families, it is not unusual for 2 or more members of a family to have bariatric surgery at the same time to lend each other support.
"I'd say about 8% to 10% of our bariatric surgery patients are family members," said lead author of the study Gus J. Slotman, MD, clinical professor of surgery at the University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School in Newark.
"The patients seemed to appreciate being able to go through the experience with a sibling or family member, and we decided to investigate whether there are measurable benefits to the outcome when the procedure is done with a family member," Dr. Slotman explained.
The investigators evaluated the office records of 91 patients from 41 families having 2 or more Roux-en-Y gastric bypass surgeries in the family and compared them with the records of 91 other gastric bypass patients, case-matching the patients by age (±5 years), sex, and body mass index (±5 kg/m2).
Patients in the families group included 75 women (82%) and 16 men (18%) who were siblings, parent and child, spouses, cousins, grandmother and granddaughter, in-laws, or aunt or uncle and nephew or niece.
Six of the families had more than 2 gastric bypass patients, and 1 family had 5.
The rates of diabetes, sleep apnea, hypertension, and gastroesophageal reflux disease were equal in the family and control groups before the surgery.
In looking at complications, medical follow-up, body mass index, percentage of weight loss, and resolution of comorbidities at 6 months, 1 year, and 2 years postsurgery, the researchers found significant differences between the groups.
The percentage of excess weight loss at 6 months was 55% for family members and 48.5% for control participants (P = .003). At 1 year, excess weight loss was 81% among family members and 60% among control participants (P = .002). Furthermore, 45% of family members had an excess weight loss of more than 80% compared with 19% of control participants (P = .002).
In the subgroup of siblings, the rate of excess weight loss at 1 year was particularly high, at 86% for siblings compared with 60% in control participants — a weight loss that was about 40% greater for those with family involvement than for individuals (P < .0001).
In addition to greater weight loss, the family members also showed greater improvements in obesity-related diseases. About 65% of family members experienced resolution of type 2 diabetes after a year compared with 31% of control participants, and 60% of family members had a resolution of hypertension compared with 33% of control participants.
Resolution of sleep apnea among family members was 70%, and resolution of gastroesophageal reflux disease was 63%, compared with 23% and 41%, respectively, for the control group.
"I was surprised by how dramatic the differences in weight loss were, and that the improvement in comorbidities was even more dramatic than the weight loss," Dr. Slotman told Medscape General Surgery. "The resolution among family members was nearly double the rate of resolution for the controls in type 2 diabetes, hypertension, and sleep apnea."
Younger adults were likely to lose more weight than their parents.
Importantly, family member adherence to office follow-up visits was also higher than that of control participants, with a rate of 89% among family members at 6 months compared with 83% among control participants, and a rate of 83.5% at 1 year compared with just 58% among control participants (P = .002).
Dr. Slotman speculated that one of the reasons for the higher weight loss seen among siblings may have to do with the simple factor of sibling rivalry. "I've had siblings tell me it really came down to competition."
Bariatric surgeon Marina Kurian, MD, who moderated the session, said she has also seen benefits from family members going through surgeries together, but time can often take its toll in undermining the momentum.
"The study did show that after 2 years, some of the differences in improvement declined, and I think that suggests that sibling rivalry sometimes only goes so far," said Dr. Kurian, who is medical director of the New York University Weight Management Program in New York City.
"People will be either competitive against each other or supportive of each other, and you can be on track for a certain amount of time. But then life happens, like a death, a loss of a job, a stressful job, or a relationship issue, and patients can wind up going back to their prior food-related coping mechanisms."
That's where the compliance issues can be particularly important, she added. "The patients who I think ultimately do better are the ones who continue to come back to see either their surgeon or their dietician, and try to get [long-term] counseling."
The findings also help underscore the benefits that have previously been suggested in data on support groups in general — family or otherwise — Dr. Kurian said.
"I think most data shows that when you attend support groups, your weight loss is improved," she said. "It's not just a matter of being among other people who 'get' you, but of being exposed to other patients' experiences and getting ideas on different methods that may work for you."
Dr. Slotman and Dr. Kurian have disclosed no relevant financial relationships.
Source(s): Nancy Melville (Las Vegas, Nevada), Medscape. American Society for Metabolic and Bariatric Surgery 27th Annual Meeting: Abstract PL-207. Presented June 25, 2010.
Post Date: June 28, 2010
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