Care Needed with OTC Diet Pills

Thu. Nov 06, 2008

Over-the-counter weight-loss pills are no quick fix to melt away extra pounds. Many local drugstores sell diet pills, and even more choices are available on the Internet. But most diet pills haven't been proved safe or effective, and some are downright dangerous, according to a special report in the November issue of Mayo Clinic Women's HealthSource.

The report looks at popular weight-loss diets, eating plans and strategies, including diet pills.

Pills containing ephedra are touted to decrease appetite. But they can cause dangerous side effects, including heart attacks, seizures, strokes and sudden death. Ephedra, although banned by the U.S. Food and Drug Administration (FDA), can be purchased online. Herbal supplements that contain the plant-derived chemical ephedrine also are available online and can cause similar health problems.

Other weight-loss pills can contain a cocktail of ingredients, including herbs, botanicals, vitamins, minerals, caffeine or laxatives. It's too often unknown how these ingredients, individually or in combination, could affect individuals. The risk of adverse reactions increases when diet pills are taken with other medications.
The FDA has approved the weight-loss drug Alli, a reduced-strength version of the prescription drug orlistat (Xenical). Alli is taken with meals and promotes weight loss by decreasing absorption of fat by the intestines. It's intended for use as part of a reduced-calorie, low-fat diet. When individuals don't reduce fat in the diet, diarrhea and gas with oily spotting can be significant side effects.

While diet pill claims may be tempting, weight loss only happens when more calories are burned than consumed.

SOURCE: Mayo Clinic

Immunize against weight gain

Thu. Oct 30, 2008

Far fetched as it may sound, scientists at Scripps Research are working on immunizing against weight gain.

The theory behind the research is that antibodies working against the hormone ghrelin could provide an effective method for suppressing appetite and modifying how the body uses energy.

Grehlin, the hormone released by the body in response to calorie restriction, promotes eating and fat storage. Higher levels of ghrelin are produced before meals and fall away after eating.  During weight loss, higher levels of ghrelin are produced in an attempt to stimulate hunger and end food deprivation.

Immunizing with anti-ghrelin antibodies, such as GHR-11E11, could decrease levels of ghrelin and reduce its effect on appetite and fat storage role.

"The reason we looked at passive immunopharmacotherapy to treat obesity was because agonist/antagonist types of drugs have been remarkably unsuccessful," says Ely J Callaway, a Professor of Chemistry at the Skaggs Institute for Chemical Biology. "They are effective only while treatment is maintained and when treatment stops, weight returns. For obesity treatments to work, they must affect food intake and energy expenditure or storage - which is what this new catalytic antibody does by degrading ghrelin. Some people have the idea that because ghrelin is an endogenous hormone there might be too many adverse side effects if you eliminate it, but there is new evidence that the body itself produces antibodies against ghrelin."

Because obesity is such a complex disease, any antibody-based treatment would be just one part of a comprehensive treatment plan including nutrition, exercise, and lifestyle modification.  However, with focused research and development of more effective grehlin antibodies, weight control could be just an injection away.

SOURCE: Proceedings of the National Academy of Sciences

Government cash programs linked to adult obesity

Thu. Oct 23, 2008

Government programs aimed at improving health and cognitive outcomes in children have an unforeseen downside for adults say researchers from the University of California at Berkeley.

The programs, originating in Mexico, have spread to the United States, and over 20 other countries around the world. They provide money for impoverished families on the condition that they participate in health checkups and other activities such as hygiene and nutrition seminars.

While the impact of these programs has proved positive for children, participation has shown an increase in obesity and hypertension for adult participants.

"It's a controversial finding because it suggests that adults are not necessarily spending the money wisely for themselves," said the studies author, Lia Fernald. "It's not clear why the cash is having this effect, but it could be because people who suddenly have more cash are able to buy more high-calorie soft drinks, alcohol or snacks that they couldn't afford before, though we did not analyze how the money was spent in our study. This result could also reflect trends in the developing world, particularly in rapidly changing economies, of increased availability of foods high in fat and sugar in place of healthier cereals, fruits and vegetables."

The assistance program called "Oportunidades," shows great benefit in early stages, but this latest research suggests that the longer that families are involved, and the more money they receive cumulatively, the poorer the outcomes for adults become. The study links larger amounts of cash given to families with higher body mass index, higher diastolic blood pressure and a higher prevalence of overweight and moderate to severe obesity in adults.

The researchers note that the central aims of the Oportunidades program is health promotion in children and in this regard the program is successful.  They say that it is not unusual for adults to make better health and nutrition decisions for their children than for themselves and that the strong focus on health education and prevention is a critical part of any cash transfer or welfare program targeting adults.

SOURCE: Journal of Nutrition

Parents often wrong estimating weight of their children

Wed. Oct 22, 2008

Think you know if your child is in an average weight range? It may surprise you to learn that your perception of your child's weight is probably wrong. Dr Pene Schmidt from the University of Melbourne says that nearly half of parents mistakenly believe their child is in an average weight range when, in fact, they are overweight or underweight for their age.

"Parents are unlikely to take the necessary preventative actions if the perception of their child's weight - whether underweight or overweight - is incorrect,'' she says.

Under or over estimating weight is more likely for children outside the average range. For parents of average weight children, 80 percent correctly identified their child's weight range. However, this number dropped to 49 percent for overweight, and 43 percent for underweight children.

It also appears that our perception of weight is at least partially dependent on the sex of our child.  Parents of boys were more likely to report them as underweight and, as a result, less likely to identify them as overweight. Concern about children being overweight was twice as likely as concern about children being underweight.

Dr Schmidt said the study showed that parents and children were struggling to determine whether they were the correct weight. She said this showed there needed to be more research to determine how to best define children's weight status - and how to communicate this to children and parents.

"This study also suggests a strong social bias among both parents and children towards thinness,'' she said. "While public health campaigns are directed towards the prevention of obesity, it's also important that the messages are getting through to the right groups."

"In particular we need to make sure that the focus on reducing the number of overweight children does not have the adverse impact of increasing the number of underweight children."

SOURCE: University of Melbourne

Reduced rewards from food may lead to weight gain

Mon. Oct 20, 2008

Overweight people may receive less pleasure from eating food then normal weight people say researchers from the University of Texas.  Reduced activity of the brain's rewards system while eating may cause people to eat greater quantities, or select calorie dense foods to get more pleasure from eating.

When a person eats, their brain's reward centre responds by releasing the messenger molecule dopamine.

Using Functional Magnetic Resonance Imaging, researchers observed brain activity of lean and overweight people as they drank chocolate milkshakes and compared this with brain activity while drinking tasteless liquids.  They also tested each participant in the study to identify those with a lower than average number of dopamine receptors.

Compared to the brains of lean people, the brains of obese people showed less activation in the part of the brain associated with reward while drinking the milkshake.

Eric Stice, a psychology researcher who has studied obesity for nearly 20 years, says that people with fewer dopamine receptors: "Need to take in more of a rewarding substance -- such as food or drugs -- to experience the same level of pleasure as other people." He concludes that overeating may compensate for the reward deficit in people with fewer dopamine receptors

After following the study participants for 12 months, Stice and his colleagues found that participants with fewer dopamine receptors and showed less brain activation during eating were the ones most likely to gain weight during the follow up period.

Stice said understanding how the dopamine receptor deficit affects the brain's reward circuits and their response to eating is important for the development of treatment options that could target this effect in people at higher risk of unhealthy weight gain.

SOURCE: Science

Parental love is blind

Tue. Oct 07, 2008

As parents, most of us tend to view our children as perfect in every way. We overlook behavioral and physical issues in our children that others have little difficulty seeing.  The extent to which parents are oblivious to apparently obvious issues with their children may pose a health risk according to Rona L. Levy, Ph.D. from the University of Washington in Seattle. Measuring parental perceptions of their children's current weight and perceived risk for developing obesity as an adult, Levy found that few parents recognized obesity problems in their children.

During the study, Levy measured height and weight of children in the 5-9 age group at a routine medical visit. Parents of children with elevated body mass index, indicating increased risk of obesity related illness, were mailed a series of questionnaires. The questionnaires were designed to elicit information about the parent's perception of their child's current weight and potential future risk.

Less than 13 percent of the parents of overweight kids reported their child as currently overweight. Fewer than one-third perceived that their child's risk for adult obesity was above average or very high.

"Clearly there is a significant misperception by parents of their child's weight and risk for obesity,' said Dr. Levy. "If we are going to address the growing epidemic of childhood obesity, parents' description and awareness of their children's overweight will have to be much more accurate," said Dr. Levy.

SOURCE: American Journal of Gastroenterology

Helping obese children manage their weight

Thu. Oct 02, 2008

Participating in medium to high-intensity behavioral management programs helps school-age kids and teens lose weight and prevent further weight gain.

A report released by the US Department of Health and human Services said programs teaching techniques to improve dietary and physical activity habits, along with strategies such as goal setting, problem solving and relapse prevention were the most effective.

"Effective prevention is the best way to stem the childhood obesity epidemic, but we also have to find effective and healthy ways of helping our children and teens who already are obese get to a healthier weight," said Carolyn M. Clancy, M.D., Director of the Agency for Health Research and Quality (AHRQ)

About 17 percent of U.S. children and teenagers are obese.  Obese children and adolescents are at higher risk for asthma, type 2 diabetes, fatty liver disease, sleep apnea and other weight-related medical problems. They may also suffer psychological harm from being stigmatized because of their appearance.

"Obese children and their families may be discouraged about their weight, but our review found there are programs out there that can help kids to either gain weight more slowly as they grow or, where appropriate, lose weight," said Evelyn Whitlock, M.D., a co-author of the report.  
AHRQ's review found that intensive, health care-based programs generally had greater effects than school-based programs and that adding prescription drugs to a behavioral weight management program helped extremely obese adolescents lose weight. However, no studies evaluated maintenance of weight loss after drug treatment ended.

SOURCE: US Department of Health and Human Services

Higher weight gains during pregnancy for dieters

Wed. Oct 01, 2008

Low birth rate and preterm birth complications are often avoided when women gain appropriate amounts of weight during pregnancy.  However, women who diet regularly, or restrict their eating in other ways, are more susceptible to excessive weight gain during pregnancy and may require additional counseling and support.

The Institute of Medicine suggests that the amount of weight a woman should gain during pregnancy is based on her prepregnancy weight. Weight gain for underweight women should be 28 to 40 lbs while normal weight women should gain 25 to 35 lbs and overweight and obese woman should gain at15 to 25 lbs and 15 lbs respectively

Researchers at the University of North Carolina found that the practice of repeatedly gaining and losing weight, known as weight cycling, or habitually restricting dietary intake were associated with weight gains above the Institute of Medicine recommendations

Anna Maria Siega-Riz, PhD, RD, suggests that these findings "could potentially be used by dietitians and health care providers at a preconception care visit or during family planning to identify women at risk for unhealthy eating behaviors. Women who are identified, particularly those who are underweight, should be followed up for potential eating disorders. For women who are not underweight, counseling and extra support could be given on healthy eating behaviors, increasing physical activity levels, and ways to eliminate stress which may increase the consumption of foods in certain social settings or in reaction to life events. During pregnancy it would be useful to target these women with similar nutritional and physical activity strategies in order to avoid excessive weight gain and adverse pregnancy outcomes such as caesarean sections, Macrosomia, and large-for-gestational age (LGA) as well as shorter duration of breastfeeding and higher weight retention in the postpartum period."

SOURCE: Journal of the American Dietetic Association

Exercising your liver cuts fat and helps your heart

Mon. Sep 29, 2008

People with type 2 diabetes can reduce their risk of developing fatty liver disease by following a program of moderate aerobic exercise says exercise physiologist Kerry Stewart, Ed.D from Johns Hopkins University.

High liver fat is common among people with type 2 diabetes and may lead to heart disease. The condition can develop into nonalcoholic fatty liver, also called hepatic steatosis, which is associated with cirrhosis, liver failure and liver cancer.

"People with type 2 diabetes have added reason to be active and to exercise, not just because it is good for their overall health, but also because our study results pinpoint a key benefit to trimming the fatty liver that complicates their illness and which could accelerate heart disease and liver failure," says Stewart

Following the current physical fitness guidelines from the American College of Sports Medicine, Stewart studied the effect that moderate exercise along with light weight lifting three times weekly had on liver fat. Magnetic resonance imaging scans showed much lower levels of liver fat in study participants who exercised compared with another group who did not.

A majority of the quarter-million people who die each year from all kinds of diabetes do so as a result of some form of heart disease or stroke. And excess body fat is known to increase the likelihood of potentially life-threatening illness because the fat leads to more inflammation in the artery walls, high blood pressure and elevated blood cholesterol levels.

Stewart concludes, "The benefits in improved fitness and fatness are clear, and physicians should really have all people with type 2 diabetes actively engaged in an exercise program."

SOURCE: John Hopkins University

Thinking may be bad for your weight

Thu. Sep 25, 2008

Intellectual work causes people to consume more calories say Canadian researchers from Laval University. The more thinking a person has to do, the more calories they are inclined to eat, regardless of the number of calories actually used during intellectual activities.

Observing the spontaneous food intake of student volunteers, the researchers found that the students consumed almost 30% more calories after activities requiring heavy thought than they did when they simply rested.  This equated to about 250 more calories after intellectual work even though the difference between energy required to think and that needed to rest on a couch was a mere three calories.

Blood tests taken during the study showed that sessions of intellectual work caused greater fluctuations in blood sugar and insulin levels than were seen during rest. 

These fluctuations could be caused by the stress of intellectual work or may demonstrate a biological adaptation during glucose combustion by the brain say the researchers.  Appetite stimulation may be a response to restore the glucose balance.

"Caloric overcompensation following intellectual work, combined with the fact that we are less physically active when doing intellectual tasks, could contribute to the obesity epidemic currently observed in industrialized countries," said Jean-Philippe Chaput, the study's main author. "This is a factor that should not be ignored, considering that more and more people hold jobs of an intellectual nature."

SOURCE: Psychosomatic Medicine