Make Exercise A Lifetime Habit!

Numerous research studies have shown us the importance of regular exercise for both weight loss and the maintenance of a healthy body weight.  However the vast majority of these studies have typically been relatively short-term, running anywhere from 3 months to 3 years.  From these studies, we typically infer that maintaining a lifelong habit of regular exercise is important for the maintenance of a healthy body weight; however, few studies have actually tested this.

A new research study published a couple of weeks ago in the Journal of the American Medical Association tested the impact of long-term exercise on long-term weight maintenance.  For this study, researchers collected information from more than 3,500 men and women who took part in the Coronary Artery Risk Development in Young Adults and who were 18 - 30 years of age at the start of the study.  Study volunteers were classified as maintaining either a high, moderate, or low level of physical activity based on activity scores at the start of the study.  The study investigators collected information on body weight, waist size, and physical activity at regular intervals during a 20-year follow-up period.  The results of this study showed that:

• Men who maintained a high level of physical activity during the 20-year follow-up period gained nearly 6 fewer pounds on average than men who maintained only a low level of physical activity.
• On average, men maintaining a high level of regular exercise also gained about 1 inch less around their waist than men with a low physical activity level.
• Women with a high level of physical activity over the 20-year period gained about 13 fewer pounds than women who did not exercise at a high level.
• Women who maintained a high level of regular exercise also gained about 1.5 fewer inches compared to women with a low level of physical activity.

While not unexpected, the results of this new study confirm the importance of maintaining a high level of physical activity throughout our lives.  This particular study shows that starting a regular exercise program as a young adult and maintaining it for 20 years helps reduce weight gain, reducing their risk of becoming overweight during their middle-aged years, a time where many of us tend to start gaining unwanted pounds.  However, this does not mean that it is too late to start exercising if you are already in your middle-age years or older.  It is never to late to start exercising and receiving the benefits of that exercise.  So, no matter how old you are, develop a healthy exercise plan, make it something you enjoy so that you can stick to it long-term, and get moving!

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BCAAs Linked to Reduced Obesity Risk

Branched-chain amino acids (BCAAs) receive a lot of hype in the sports performance industry because it has been reported that these amino acids (leucine, isoleucine, and valine) might improve muscle protein synthesis, act as a muscle 'fuel' during exercise, and aid in post-exercise muscle repair.  This hype is not totally unwarranted because a number of research studies support some of these concepts.  In fact, one recent review paper (free to download) reports that BCAAs might help suppress the natural muscle loss associated with aging.  However, little research has examined the relationship between BCAA consumption and obesity risk.

A new population-based study published online ahead of print in the Journal of Nutrition examined the possible link between dietary BCAA intake and the prevalence of being overweight or obese.  Diet information and overweight/obesity status were determined in over 4,000 individuals taking part in the International Study of Macro-/Micronutrients and Blood Pressure.  BCAA intake was determined by country-specific food tables and dietary recall questionnaires.  The researchers reported that the risk of being overweight was reduced by 30% in individuals in the highest quarter of BCAA dietary intake.  Additionally, the risk for obesity was decreased with increasing levels of BCAA consumption.

The results of this study suggest that adequate dietary intake of BCAAs can help reduce one's risk of becoming overweight or obese.  These benefits were seen across all the study populations examined, which included groups in China, Japan, the UK, and the US.  The BCAAs, leucine, isoleucine, and valine, are three of the nine essential amino acids and therefore must be obtained from the diet.  It has been reported that one can obtain BCAAs from numerous dietary sources.  For example, leucine is prevalent in red meat, nuts, beans, whole wheat and soy flour.  Foods such as chicken, fish, eggs, almonds, cashews, and soy protein are good sources of isoleucine, and meat, mushrooms, diary products, grains, and soy protein are good sources of valine.  When choosing foods rich in BCAAs, make sure to choose foods low in saturated fat, so lean meats, non-fat dairy, whole grains, and soy protein would make good choices.

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Eat Three Meals Per Day

Many diet plans suggest eating small meals every 2-3 hours throughout the day instead of simply eating the three 'big' meals, breakfast, lunch, and dinner.  Eating like this can mean eating as many as 5-6 total meals per day, though the meals are smaller.  The concept behind this eating pattern is that it will assist in our weight loss efforts by boosting our metabolism, reducing our appetite, and helping to support normal blood sugar health.  Although this approach is well accepted by many, the science behind the theory remains open for debate.  Additionally, the impact of eating frequency on the amount of total calories consumed and appetite control remain unclear.

A review of the science behind this issue was recently published in the Journal of Nutrition.  The review primarily examined published feeding studies that focused on the effect of eating frequency on appetite and food intake with the 3 meals/day eating pattern used for comparison.  The study investigators reported that...

Eating more than 3 meals per day:

• Reduced the highest level of feelings of hunger,
• Suppressed the highest level of feelings of fullness, 
• Reduced peak levels of some appetite-related hormones, but
• Had no effects on feelings of hunger or fullness when measured throughout the course of the day.

Eating less than 3 meals per day:

• Increased subjects perceptions of appetite (felt hungrier) and
• Reduced their feelings of fullness.

Overall, this review suggests that eating more than 3 meals per day has only a minimal impact on hunger and hunger-linked hormones.  This suggests that eating smaller amounts of food more frequently probably has little impact on appetite control and probably does not reduce the overall amount of food one eats.  Nonetheless, the study investigators did report that actual studies on eating frequency and food intake are inconsistent and conflicting to date, so additional research is needed to determine if eating more than 3 meals per day has any real benefit on reducing overall caloric intake.  In contrast, this current review of the science clearly indicates that eating fewer than 3 meals per day has a negative impact on feelings of hunger and fullness, suggesting that over time we might lose control over our appetite if we try to stick to a diet plan that recommends eating fewer than 3 meals per day.   In general, this study appears to suggest that eating 3 meals per day remains the preferred eating pattern in regards to its effect on our appetite and food intake.  If we choose to eat smaller meals more closely together over the course of the day, it is important for us to keep close track of our total food intake.  Following an eating pattern that includes fewer than 3 meals per day appears to be a poor choice and likely should be avoided.

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Plan Your Weight Loss

Most of us that need to lose weight, no matter how much, realize it and have every intention to lose those unwanted pounds.  For many of us those intentions are expressed most loudly at the beginning of each year when we make our New Year's resolutions.  Each and every year, weight loss is listed as one of our most common and popular resolutions.  While our intentions are great, we often fail to follow those intentions with actions.

Researchers at the Teagasc Food Research Centre, the Irish Agriculture & Food Development Authority, have been exploring what we need to do in order to realize our good intentions when it comes to developing healthier eating habits. According to their Winter TResearch newsletter, 80 adults who took part in the National Adult Nutrition Survey were further interviewed regarding their food choice strategies and goals and their successful/failed attempts to make changes.  Based on these interviews, the nutrition researchers identified three factors that effect our ability to turn intentions into actual behaviors.  These factors are:

Planning - making actual, specific plans on how a person was going to begin and follow a healthier eating plan was considered to be extremely important in achieving the goal of eating healthier.

Monitoring - keeping track of one's progress helped individuals become more aware of positive progress, which reinforced motivation and resulted in additional progress.

Coping/Control - It was clear that obstacles get in the way of developing healthier eating habits and can result in failure.  However, deciding how one was going to cope with those obstacles or correct those failures helped individuals realize they were able to maintain their commitment and achieve final success.

Overall, this research showed that individuals who planned ahead had greater success at turning their good intentions into improved behaviors.  Planning ahead not only has to do with planning meals in advance, but also things like shopping for those planned meals and planning in advance how you intend to cope with obstacles.  It is also important to plan how you intend to monitor your progress and make sure you continue the monitoring process.  Good examples of this is keeping a food record, keeping a physical activity log, or monitoring your weight on a specific day each week.  Previous research has also reported that individuals who monitor their dietary habits and track their overall progress have greater weight loss success.  Therefore, it appears clear that forming a plan before diving into a new weight loss plan or healthier eating plan will go a long way towards ensuring long-term success.  While planning your weight loss strategy is of great importance, don't forget to put your plan into action.  Like the cartoonist Walt Kelly once said "It is not good enough for things to be planned - they still have to be done; for the intention to become a reality, energy has to be launched into operation".

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Healthy, Hunger-Free Kids Act Signed!

As I have mentioned in several previous blogs, childhood nutrition is in need of some major improvements.  This is particularly true in regards to the foods provided to children as part of their lunch, vending machine, and a la carte options offered at schools and daycare facilities.  On Monday, the Healthy, Hunger-Free Kids Act of 2010 was officially approved and signed.  Hopefully, this will be a major step in the right direction towards improving childhood nutrition and decreasing childhood obesity.

The Healthy, Hunger-Free Kids Act sets forth a number of goals and guidelines, some of which include:

• Giving the U.S. Dept. of Agriculture (USDA) the authority to set nutritional standards for all foods sold in schools during the day.  This includes school meals, vending machine options, and a la carte options.
• Aids in the establishment of local 'farm-to-school' networks and school gardens in an attempt to focus on fresh, locally grown foods.
• Sets basic standards for school wellness programs that include nutrition education and physical activity.
• Requires school districts to be reviewed every three years to see if they have met new nutritional standards.
• Requires schools to make nutritional information on school meals more available to parents.
• Provides additional funding to schools that meet the updated nutritional standards.

While updated nutritional standards do not appear to have been developed or released yet, a sample menu suggests that healthier options like more fruits and vegetables, more whole grain foods (whole wheat spaghetti, whole wheat dinner rolls, etc.), more low-fat replacements (low-fat salad dressing rather than regular salad dressings), and leaner protein products (turkey, fish, etc) will be emphasized. Although changes will not appear overnight, this new piece of legislation has the potential to make real improvements in childhood nutrition and wellness that will hopefully lead to reductions in childhood obesity.  You can download a fact sheet that provides more information as well as a sample menu at Let's Move.

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Avoid Distractions During Meals

There are many things we can do to improve our eating habits that can help us improve the nutritional quality of our meals while reducing the amount we eat to a healthier level.  Making fruits and vegetables a much bigger part of our meals, choosing foods that keep us feeling fuller longer, and eating at a slower pace are all things each of us can do that will help us develop better eating habits.

According to a new study published online ahead of print in the American Journal of Clinical Nutrition, removing distractions during our meal times might also improve our eating habits.  While previous studies have shown that mealtime distractions can lead to greater amounts of food consumed during one's meal, this new study examined the impact of mealtime distraction on later appetite and food memory.  For this eating study, investigators instructed 44 volunteers to consume a fixed lunch within a specified amount of time while playing computer solitaire or without any distraction.  30 minutes after the meal, study subjects took part in taste test.  Interestingly, the study investigators reported:

• Distracted volunteers, those playing solitaire, reported being less full after lunch compared to non-distracted volunteers.
• Volunteers that played computer solitaire during their lunch ate nearly 2 times as much during the post-meal taste test.
• Recall of the 9 food items provided during lunch was less accurate in the game-playing group compared to the non-distracted study volunteers.

Although small, this is an interesting study that further supports the concept that mealtime distractions can affect our food consumption.  While previous studies indicated that mealtime distractions cause us to eat larger meals, this current study suggests distractions during meals can results in greater post-meal appetite and greater post-meal snacking.  This has the potential to result in overall greater food consumption throughout the day.  Considering our tendencies for eating on the run, watching television while eating, or sitting in front of a computer while eating, the effect of mealtime distractions on eating habits is important to keep in mind.  Minimizing mealtime distractions is one easy step we can all take towards developing better eating habits and fighting obesity.

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New Diet Pill Gets Lukewarm Backing

On Wednesday, it was reported in numerous media outlets that an FDA advisory panel recommended the new weight loss pill, Contrave, for approval.  According to the FDA Advisory Committee briefing document, Contrave is a combination weight loss drug that includes both bupropion, a drug used to treat depression and reduce nicotine cravings, and naltrexone, a drug used to treat some addictive behaviors.  The lukewarm backing of the FDA Advisory Committee was clearly represented by the 13-7 vote to back Contrave’s approval.  This unenthusiastic appearing recommendation seems to partly be based upon Contrave’s modest weight loss benefits.

In the two primary weight loss studies described in the briefing documents and one published research article, obese men and women were asked to follow a reduced-calorie diet (reduced by 500 Calories/day), were given advice on lifestyle changes that included physical activity, and were asked to take Contrave or a placebo pill daily for slightly more than one year (56 weeks).  Individuals taking Contrave were divided into two groups, one group taking a low dose (16 mg naltrexone + 360 mg bupropion) and one group taking a higher dose (32 mg naltrexone + 360 mg bupropion). In these studies, individuals lost approximately 6% of their initial body weight after 56 weeks when taking the 32 mg version of Contrave and about 5% of their initial body weight after taking the 16 mg version of Contrave for 56 weeks.  According to the published research article, this amounted to a weight loss of about 11 pounds in the lose-dose group and 13 pounds in the high-dose group after 56 weeks in study volunteers who weighed about 220 pounds on average at the start of the study.  Additionally, only about half (48% in one study and 50% in the second study) successfully lost more than 5% of their starting body weight.  According to some of the news stories, some members of the FDA Advisory Committee apparently supported approval for Contrave, despite the modest weight loss benefits, due to concerns about suppressing the development of future weight loss pills during a time when about two-thirds of Americans are overweight or obese.

Unlike weight loss pills that appear to provide only modest weight loss benefits, a well-structured weight loss plan that is easy to follow and includes adequate amounts of regular exercise can help nearly anyone lose the weight they want.  During a 16-week study, dieters lost about two times more weight on my diet eating and physical activity plan when compared to the dieters in the two main Contrave studies. Dieters in my diet study consumed approximately 1,200 calories per day, and participated in physical activity six days per week, while dieters in the weight loss pill study were instructed to consume a 500-calorie per day deficit diet. Dieters lost an average of 26 to 29 pounds on my plan compared to only about 11 pounds on the diet pill plan after 16 weeks. Average starting weight of study participants on my diet plan was 210 pounds, which was similar to the average starting weight of about 220 pounds in the Contrave weight loss pill studies.

Overall, it appears that dieters lost about 200% more weight on my diet and physical activity plan when compared to dieters using the Contrave weight loss diet pill. Therefore, you can lose more weight in less time on my diet plan...without diet pills.

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Dance Your Way To A Healthier You!

Exercise is an important part of a healthy lifestyle and is essential for maintaining or losing weight.  However, most of us have a difficult time adopting a regular exercise program.  Even those of us that start a regular exercise program with the best of intentions have difficulty in sticking with it over the long-term.  A new research study (free to download) explored the use of a combination of Latin dancing and educational information on healthy eating as a way to enhance physical activity and improve dietary habits.

In this study, adult overweight women who reported low levels of leisure time physical activity and low consumption of fruits and vegetables were subjected to two interventions: (1) 4 weeks of Latin dance lessons twice weekly and (2) internet-based education.  Group 1 women were asked to dance during the first 4 weeks and were provided education materials during the second 4 weeks of the study.  Women in Group 2 received educational materials first, followed by 4 weeks of dance lessons.  Dance lessons consisted of 8 one-hour lessons during which study participants learned the Salsa, Merengue, Bachata, and Cha Cha from a professional dance instructor.  Physical activity and heart rate were monitored during the dance lessons.  Educational material on improving dietary habits by increasing fruit and vegetable consumption was provided via an interactive website that was updated with new material on a weekly basis.  The results of this small pilot study showed that:

• Based on heart rate, women obtained about 30 minutes of moderate-intensity physical activity during their one-hour dance lessons.
• All study participants reported an increase in leisure time physical activity from about 10 minutes per week at the start of the study to about 30 minutes per week at the end of the study on average.
• Fruit and vegetable consumption remained stable throughout the study in women receiving educational material first and dancing second, while women who danced first and received educational material second showed a reduction in fruit and vegetable consumption.
• Group 2 women (education first) showed decreased consumption of dietary fats compared to Group 1 women (dance first)
• Body mass index (BMI) did not change significantly in either group

This is an interesting study that should be followed up with a larger, longer study.  In this study, the volunteers participated in over half of the dance lessons, suggesting that Latin dance might be a form of exercise that many individuals might find enjoyable enough to stick to on a long-term basis.  Additionally, this study suggests that learning about healthy eating habits before taking dance lessons might provide the best long-term results in regards to developing and maintaining healthier eating habits.  While no changes in BMI were observed in this study, it is important to remember that this was not a weight loss study and did not include any form of weight loss program.  Without the inclusion of a weight loss program, it would likely be difficult to lose much weight with moderate-intensity physical activity just twice per week for 4 weeks.  Nonetheless, no weight gain was observed suggesting that this intervention of education and dance might help maintain body weight or reduce weight gain.  It would be interesting to see if studies that include a weight loss program with the dance intervention, are of longer duration, and perhaps provide both education and dance over the same time frames would provide additional benefits like weight loss.

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Boost After-Meal Fullness With Green Tea

Over the last couple of years, green tea has become one of the more popular weight loss aids.  This is because several research studies in animals and people have suggested that green tea might aid with weight loss efforts by suppressing appetite, increasing body metabolism, and decreasing fat absorption.  These weight loss benefits of green tea are thought to be primarily due to the catechins, anti-oxidant compounds, found in green tea, though the exact mechanism(s) is still under investigation.

A new research study designed to examine the possible benefits of green tea on blood sugar health and weight loss was recently published in Nutrition Journal (free to download).  For this study, investigators asked 14 healthy volunteers to consume a meal with either green tea or water at two different times.  Each meal consisted of white bread with sliced turkey and 300 ml of the assigned drink. Green tea was brewed and served hot with the meal.  Blood samples were taken prior to eating the meal and at several time points after eating the meal.  During these time points, study volunteers were also asked to fill out questionnaires related to feelings of fullness.  The study investigators reported:

• Green tea consumed with a meal had no effect on markers of blood sugar health.
• Consumption of green tea with the meal resulted in greater feelings of fullness at 15, 45, 60, and 90 minutes after the meal compared to drinking water with the meal.
• Study volunteers had stronger feelings of having consumed enough after the meal with green tea compared to the meal with water.
• The desire to eat one's favorite food was lower after consuming green tea compared to water.

This new study continues to suggest that green tea might have a role in our weight loss efforts by reducing our hunger.  While other studies have reported that green tea might aid in weight loss by increasing metabolism or increasing fat oxidation, this study indicates that green tea, particularly brewed green tea, might help suppress appetite.  Suppression of appetite has the potential of reducing the amount we consume, an important aspect of any weight loss plan.  The green tea consumed in this study provided about 150 milligrams of catechins (plus about 80 mg of caffeine).  It is important to remember that the amount of green tea catechins will vary widely from product to product and is likely to be lower in ready-to-drink green teas than in freshly brewed green teas.  Nonetheless, for individuals looking to control their weight, drinking green tea with one's meal might be one easy, potentially beneficial change to make.

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Is There An "Ideal" Body Mass Index?

Despite its limitations, the Body Mass Index (BMI) is still one of the easiest and must utilized tools for determing an individual's healthy body weight range.  Currently, a BMI ranging from 18.5 - 24.9 is considered normal or healthy.  A person with a BMI below 18.5 is considered to be underweight while a BMI of 25 - 29.9 is considered overweight and a BMI of 30 or more is defined as obese.  Numerous research studies have clearly shown us that a high BMI, particularly an obese BMI, is linked to poor health and increased risk of death from certain conditions.  However, the full relationship between BMI and overall mortality have remained unclear.

A group of investigators from around the world, including the National Institutes of Health, recently published the results of their examination of the link between BMI and death due to any cause.  In order to analyze this relationship, the researchers pooled data from 19 studies that included a total of 1.46 million adults.  During an average follow-up period of 10 years (ranging from 5 to 28 years), slightly more than 160,000 deaths were recorded.  After adjusting for multiple factors (age, exercise, alcohol consumption, etc.) and using a reference BMI of 22.5 - 24.9, the researchers revealed that among healthy, non-smoking women there were specific relationships between BMI and risk of overall death as outlined below:

• BMI of 15 - 18.4...  risk of death increased by 47%
• BMI of 18.5 - 19.9... risk of death increased by 14%
• BMI of 20 - 22.4... no increased risk of death was observed
• BMI of 25 - 29.9... risk of death increased by 13%
• BMI of 30 - 34.9... risk of death increased by 44%
• BMI of 35 - 39.9... risk of death increased by 88%
• BMI of 40 - 49.9... risk of death increased by 251%

The study investigators further reported that these relationships were also similar for the men in the study.  According to a related NIH press release, this study also showed that for all participants, every 5-unit increase in BMI was linked to a 31% increased risk of death due to any cause and that while a BMI of 25 or more was linked to an increase risk of death in all age groups, the risk was greatest for those who were overweight or obese before 50 years of age.

This is a truly fascinating and important study.  While it was probably not unexpected to see an increased risk of death for BMI levels over 30, the dramatic increase observed is astonishing.  The relatively high risk of death linked to being underweight is also an important observation.  Due to a variety of pressures (media, peers, etc.), many individuals strive for a body weight that is an unhealthy, excessively low body weight.  Hopefully, this observation will help these individuals realize the importance of staying within a healthy body weight range.

Interestingly, the risk of death is actually increased within the low part of what is currently considered a healthy BMI.  According to this study, individuals with a BMI between 18.5 - 19.9, while within the normal BMI range, are at a 14% increased risk of dying due to any cause.  While this level of risk is not on par with the risk observed with being obese, it clearly suggests that even within a normal BMI range, there appears to be an 'ideal' BMI range.  Based on these analyses, the risk of death is lowest for those with a BMI ranging from 20 - 24.9, which encompasses the mid- to high-range of the normal BMI range.  This is potentially important information for individuals looking to set weight loss goals or optimize their overall health.

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Lose Weight Successfully With High Protein, Low Glycemic Foods

Diets come and go through the years, each of them generally suggesting a specific amount of macronutrients.  These include low carb diets, low fat diets, high protein diets, and more.  While each of these diets have been reported to support weight loss in the short term, most of us find it difficult to maintain our weight loss for longer than 1 year.  Therefore, the overall success of many of these diets, particularly in comparison to each other, is often debated.

The Diogenes Study, a large, multicentered, pan-European weight loss study, has attempted to determine which type of diet is best in regards to successfully maintaining weight loss.  For this study, 773 adult men and women who successfully completed an 8-week weight loss phase were randomly assigned to one of five weight maintenance diets:

1. Low protein (13%) + low glycemic index
2. Low protein + high glycemic index
3. High protein (25%) + low glycemic index
4. High protein + high glycemic index
5. Control diet that followed each country's dietary guidelines

Each diet was moderate in fat content (25-30%) and study volunteers were directed to eat as much as they wanted while aiming to maintain their current body weight during the 26-week weight maintenance phase.  The results of this weight loss study, which were recently published online ahead of print in the New England Journal of Medicine, showed that:

• The high protein, low glycemic index diet was easier to stick to than the low protein, high glycemic index diet.
• Consumption of the low protein, high glycemic index diet resulted in a significant increase in body weight by about 3 - 4 pounds on average.  Weight re-gain was not observed on average in the other diet groups.
• Diet groups high in protein, regardless of glycemic index status, re-gained 2 lbs less than diet groups low in protein.
• Use of low glycemic index diet plans, regardless of protein level, resulted in about 2 lbs less weight re-gain than diets with a high glycemic index.
• The high protein groups and the low glycemic index groups were more likely to continue losing weight compared to the low protein and high glycemic index groups.  This was particularly true for the high protein, low glycemic index group.

This is an excellent study that shows us what might be the most effective way at maintaining weight loss for the long-term.  In this new weight maintenance study, a small increase in dietary protein intake and a small reduction in the glycemic index of foods consumed were of substantial help in either continuing modest weight loss or maintaining the weight volunteers lost in the weight loss phase of the study.  This study was also conducted in the children of the adult volunteers.  The childhood arm of the study reported similar benefits with the high protein, low glycemic index group showing a substantial decrease in the percent of overweight/obese children.  In contrast, children consuming the low protein, high glycemic index diet showed an increase in body fat.

The benefits of increasing dietary protein and decreasing the glycemic index are likely due to their effects on appetite and blood sugar metabolism.  Protein has been reported to increase our feelings of fullness and help maintain that feeling longer.  Foods with a low glycemic index have been shown to have little impact on blood sugar, helping us to avoid cravings and spikes in hunger.  These aspects of protein and low glycemic foods might be why individuals found it easier to stay on the high protein, low glycemic index diet plan compared to the other diet plans.

My Slim & Beautiful Diet bars and shakes are high in protein (20 grams each) and have a low glycemic index, making them an excellent and delicious addition to any high protein, low glycemic weight loss program you might choose to follow.

Start losing pounds now with my easy diet plan using delicious, low glycemic, protein-packed bars and shakes to satisfy your hunger. Please recommend to anyone who wants to lose weight using a clinically tested diet plan and weight loss program.