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Healthnotes Newswire (July 17, 2008)—A new study has shown that education, combined with healthy behaviors such as eating fruits and vegetables each day, exercising, and keeping a food diary, are key ingredients for maintaining weight loss. While it is well known that such behaviors can help a heavy person lose weight, few large studies have looked at behavioral interventions for keeping weight off, which is critical for overweight people with high blood pressure or high cholesterol.

Healthy habits are key

The study, known as the Weight Loss Maintenance Trial, compared various strategies for maintaining weight loss over a 30-month period. All 1,684 participants were 25 years or older and were overweight or obese and taking medication for high blood pressure and/or high cholesterol. Each participant was encouraged to attend 20 weekly group educational sessions, restrict calories, use a daily food diary, exercise daily at a moderate to intense level, and follow the Dietary Approaches to Stop Hypertension (DASH) diet, which is rich in fruits, vegetables, and low-fat dairy foods, and limits saturated fat, total fat, and cholesterol.

After two and a half years, people who lost the most weight (18.7 pounds [8.5 kg] or more) had, on average, attended more weekly educational sessions (15), exercised more (159 minutes per week), kept more food diary records (4.2 records per week), and eaten more fruits and vegetables (3.6 servings per day).

“A combined emphasis on dietary intake and physical activity is important to both short- and long-term weight loss goals,” said the study’s author, Jack Hollis, PhD, from the Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon. “Behavioral strategies to modify these health behaviors are important components of weight-loss interventions because they emphasize the individual’s ability to monitor and regulate behavior, and target the barriers to both initial weight loss and long-term maintenance.”

Smart slimming strategies

People with high blood pressure, high cholesterol, and diabetes are at high risk for cardiovascular diseases such as stroke or heart attack, but weight control can help prevent and treat these conditions. There is no quick fix for losing weight or maintaining weight loss. If you are overweight, start by eating right, exercising, keeping stress in check and seeing your doctor.

Here are some tips for losing weight and keeping it off:

• Eat an abundance of fruits and vegetables based on recommendations from your healthcare provider. Limit saturated fat and sugar and avoid “empty” calories that provide little or no nutrition such as some processed foods, snacks, and beverages.

• Get enough exercise. A report from the Institute of Medicine suggests that adults need 60 minutes of moderate physical activity every day in order to optimize health and prevent disease; children need a minimum of 90 minutes.

• Keep a diary to track your daily food and calorie intake and help you learn how to identify eating patterns and make healthy choices throughout the day.

• Join a support group for health lifestyle behaviors or share the experience with friends and family, which can help improve your chances for success.

(Am J Prev Med 2008;35:118–26)

Healthnotes Newswire (June 26, 2008)—Yet more proof points to the importance of exercise and healthy eating to reduce the chance of developing diabetes in people at risk for the disease. With the onset of type 2 diabetes, the body’s ability to keep blood sugar (glucose) levels in check begins to diminish. Losing weight, exercising regularly, and eating well can help improve insulin sensitivity, protecting against diabetes or possibly halting its progression.

“In people with impaired glucose tolerance, group-based interventions targeting lifestyle changes such as diet and exercise produce a durable and long-lasting reduction in incidence of type 2 diabetes,” said the authors of a new study in the Lancet.

As part of the 20-year study, 577 people with impaired glucose tolerance (a prediabetic condition) were assigned to a control group (no intervention), or to one of three lifestyle intervention groups (diet, exercise, or diet plus exercise). The dietary intervention focused on eating more vegetables and consuming less sugar and alcohol. The exercise intervention concentrated on increasing leisure time physical activity.

The interventions lasted for 6 years; then the people were followed for 14 more to determine the long-term effects of the lifestyle changes on the risk of developing diabetes and related complications, including heart disease.

During the first 6 years, the people in the intervention groups had a 51% lower incidence of diabetes than did people in the control group. After 20 years, the intervention groups sustained a 43% lower diabetes incidence, and people in the intervention groups were diabetes-free for almost 4 years longer than people in the control group. The interventions did not seem to affect the risk of cardiovascular disease and other diabetic complications.

The World Health Organization estimates that at least 180 million people worldwide are living with diabetes. The risk of type 2 diabetes is higher in people with a family history of the disease; being overweight, having high triglycerides (a fat in the blood), and high blood pressure also raise risk.

Simple steps to protect your blood sugar

Dr. Leon Hecht, a New Hampshire naturopathic doctor specializing in diabetes, offers these tips for stabilizing blood sugar and avoiding diabetes and related problems.

• Focus your diet on whole foods, including vegetables, fruits, whole grains, lean animal proteins, legumes, nuts, and seeds.

• Eat a larger breakfast and a smaller dinner.

• Each day, make one meal a large salad with all the fixings.

• Decrease foods with flour in them—this means all cakes, cookies, and breads—as these foods will raise your need for insulin, causing you to store fat.

• Aim to lose abdominal fat, as weight in this area is a principal risk factor for type 2 diabetes.

(Lancet 2008;371:1783–9)

Healthnotes Newswire (June 19, 2008)—Childhood and teen obesity has leveled out, according to statistics from 2006. But it’s not time to celebrate yet—there is work to be done to reverse the trend and help kids become healthier. A new study reports that overweight and obesity rates in kids have not changed since 1999, giving us reason for both optimism and concern.

The study, published in the Journal of the American Medical Association, included data from the National Health and Nutrition Examination Survey, which has been conducted in multiple stages by the National Center for Health Statistics and the Centers for Disease Control and Prevention (CDC) since the 1960s. The researchers used health information collected from 2003 to 2006 for 8,165 children and adolescents ages 2 to 19. Body mass index (BMI) was calculated for each child and placed on the percentile graphs for boys and girls established in 2000 by the CDC.

What researchers found when the children weighed in

The surveys found:

• 11.3% of children and adolescents had an extremely high BMI, falling at or above the 97th percentile for their age

• 16.3% were obese, with BMI at or above the 95th percentile

• 31.9% were overweight, having BMI at or above the 85th percentile

• Children between 12 and 19 years old were more likely to have high BMI than younger children

• Mexican–American boys and girls and non-Hispanic black girls had higher BMI than non-Hispanic white boys and girls

When the researchers compared these percentages to those from previous surveys, no real change was seen since nearly a decade ago.

Based on data from older surveys, the trend in childhood overweight and obesity was clearly upward from 1980, when only 6.5% of children ages 6 to 11 were obese. By 1994 that number had risen to more than 11%, and by 2002, it had climbed to more than 16%, where it seems to have reached a plateau.

An opportunity to outpace obesity

Although the reasons for the change in trend is not yet known, we do know that some behaviors can help children avoid becoming overweight and obese. Taking steps when your children are young will help them develop positive habits that will keep them healthy into adulthood.

• Avoid fast foods, which are high in calories and fat. Home-cooked meals made with whole grains and lots of vegetables will help your family stay healthy.

• Watch the portions. Portion sizes of prepared foods are large and growing. Eat at home and try letting your children serve themselves. We tend to eat what’s put in front of us, but left to dish out their own food, children tend to take and eat smaller portions.

• Skip sugary soft drinks. These add empty calories in the form of high-fructose corn syrup, implicated in the rising trends in overweight, obesity, and type 2 diabetes.

• Keep kids active and limit screen time—including television, movies, and computers.

Healthcare professionals who work with children agree that these rates need to come down before we can breathe a sigh of relief. Said Cynthia Ogden, PhD, the study’s lead author and an epidemiologist at the National Center for Health Statistics, “It doesn’t mean we’ve solved it, but maybe there is some opportunity for some optimism here.”

(JAMA 2008;299:2401–5)

Healthnotes Newswire (June 12, 2008)—A cup of ginger tea is often just the thing to settle an upset stomach—but little is known about how it actually works. A new study, published in the European Journal of Gastroenterology and Hepatology, found that ginger stimulates digestion by speeding up the movement of food from the stomach into the upper small intestine.

Soothing to the stomach

After having nothing to eat or drink for eight hours, the 24 healthy men in the study were given either 1,200 mg of ginger or placebo, and then ate a bowl of soup. They answered questions about their digestive comfort, and digestive activity was measured by ultrasound. One week later, they repeated the test, but the ginger and placebo groups were reversed.

Muscle contractions in the stomach, which help to move food into the upper small intestine, were more frequent and the stomach emptied more quickly after ginger than placebo. After eating the soup, mild digestive discomfort was reported in those who had placebo but not ginger.

From the kitchen to your medicine cabinet

Ginger (Zingiber officinale) is popular as a culinary spice and as a medicinal herb. It is used all over the world to treat indigestion, gas and bloating, nausea, diarrhea, and irritable bowel syndrome. A well-known remedy for nausea during pregnancy and motion sickness, ginger has also has anti-inflammatory effects that make it a good choice for treating arthritis.

“Since low gastric motility has been associated with the digestive symptoms for which ginger is frequently used, if ginger improves the movement of food through the upper digestive tract in people with digestive problems, this could help to explain how it exerts its benefits,” said Dr. Rebecca Chollet, a naturopathic doctor who practices in New Hampshire and Vermont.

Ginger is often taken as tea, prepared by simmering the cut root in a covered pot. It can also be used as tincture (an alcohol-based extract), in capsules (as in this study), or added to common gas-producing foods like beans and lentils to prevent gas. At times when nausea makes eating or drinking difficult, crystallized ginger can be used like a lozenge.

A multifaceted approach may help your digestion

Other methods for preventing indigestion include eating slowly and being careful not to overeat. Like ginger, caraway, cumin, and fennel can be added to foods to reduce the chance of developing gas after eating. Digestive enzyme supplements are sometimes helpful when these measures are not enough.

(Eur J Gastroenterol Hepatol 2008;20:436–40)

Healthnotes Newswire (June 12, 2008)—A study in the Journal of Clinical Oncology found that cancer survivors who practiced the positive lifestyle behaviors recommended by the American Cancer Society had a higher quality of life than those who made fewer changes.

Over ten million Americans have had some form of cancer; fortunately, certain lifestyle behaviors can help beat it and keep it from coming back. For example, physical activity helps prevent many types of cancer. The American Cancer Society recommends that cancer survivors get at least 150 minutes of moderate to strenuous or 60 minutes of strenuous exercise per week. They also recommend eating “5-A-Day”—five daily servings of fruits and vegetables—and not smoking.

The new study surveyed 9,105 survivors of six different kinds of cancer—breast, prostate, colorectal, uterine, skin melanoma, and bladder—to see the extent to which the survivors followed the American Cancer Society’s recommendations and how their habits affected their health-related quality of life.

A range of healthy habits is the key

Physical activity goals were met by 30 to 47% of the survivors, while only 15 to 19% met the 5-A-Day fruit and vegetable recommendation. Most survivors (up to 92%) did not smoke. “This suggests that it may be important to develop a multibehavioral lifestyle intervention rather than develop single behavior interventions,” the study’s authors commented.

Survivors of breast, prostate, and colorectal cancers who met the 5-A-Day or not smoking recommendations had a significantly higher quality of life than those who didn’t, and survivors of all types of cancer who were more physically active reported a higher quality of life. “Physical activity is a key lifestyle behavior that should be incorporated into all the interventions to improve health-related quality of life,” concluded the authors.

Dr. Lise Alschuler, author of Definitive Guide to Cancer: An Integrated Approach to Prevention, Treatment and Healing, said, “It seems to me that the main reason for the low rate of healthier lifestyle adoption is the difficulty of the changes themselves. It is hard for anyone to change their diet and equally as difficult to increase exercise. People who are successful in making positive changes to their dietary and exercise patterns feel better. As a result of eating differently and exercising regularly, people become more engaged in the process of living and as a result have more vitality and wellness.”

(J Clin Oncol 2008;26:2198–204)