proHealth Diet and Weight Loss

Lessons from Losers: How People Who Lose Weight Keep it Off
prohealth.com

12-15-2003

Since 1993, nearly 3,000 women and men have joined the National Weight Control Registry. This select club includes only people who lost more than 30 pounds and kept them off for at least a year. What was their secret

a They exercised. Registry participants burn an average of 400 calories per day in physical activity. Thats the equivalent of about an hour of brisk walking.

a They ate fewer calories. On average, registry volunteers consume about 1,400 calories a day. Thats significantly less than the calories consumed by the average American. This doesnt mean, however, that you should aim for 1,400 calories a day. Whats right for you is based on your weight, height, and activity level.

a They switched to lower-fat diets, cut back on sugars and sweets, and ate more fruits and vegetables.

Keep in mind that these are commonly used strategies, not hard and fast rules. In fact, one of the main take-home messages is that successful weight loss is very much a do it your way endeavor.

These findings are echoed in a survey of more than 32,000 dieters reported in the June 2002 issue of Consumer Reports. Nearly one-quarter had lost at least 10 percent of their starting body weight and kept it off for at least a year. Most chalked up their success to eating less and exercising more. The vast majority did it on their own, without utilizing commercial weight-loss programs or resorting to weight-loss drugs. Interestingly, the successful losers in the Consumer Reports survey tended to adopt low-carbohydrate/high-protein diets rather than low-fat diets.

What these two groups have in common is a focus on exercise and daily calories. In other words, theyve learned to balance energy in and energy out in a way that leads to weight loss or weight maintenance. So despite all the pessimistic prognostications about the impossibility of sticking with a weight-loss plan, these two surveys show that its possible to lose weight and keep it off.

Unfortunately, only a minority of people who try to lose weight follow the simple, tried-and-true strategy of eating fewer calories and exercising daily. For weight control, an hour of exercise a day may be needed.

General Strategies for Regaining or Maintaining a Healthy Weight Its easy to gain weight in what Yale psychologist Kelly Brownell calls our toxic food environment. How, then, can you lose weight if you need to Here are some suggestions that work:

Set a realistic goal. Many people pick weight goals theyll have a hard time achieving, like fitting into a size 8 dress or a wedding tuxedo from 20 years ago. A better initial goal is 5-10 percent of your current weight. This may not put you in league with the beautiful people profiled in popular magazines, but it can lead to important improvements in weight-related conditions such as high blood pressure and diabetes. You dont have to stop there, of course.

You can keep aiming for another 5-10 percent until youre happy with your weight. By breaking weight loss into more manageable chunks, youll be more likely to reach your goal.

Slow and steady wins the race. Dieting implies privation and hunger. You dont need either to lose weight if youre willing to take the time to do it right. If you cut out just 100 calories a day, the equivalent of a single can of soda or a bedtime snack, you would weigh 10 pounds less after a year. If, at the same time, you added a brisk 30-minute walk 5 days a week, you could be at least 20 pounds lighter.

Exercise more. The amount of energy the body uses to breathe, pump blood, keep muscles ready for action, and other mundane but vital tasks is called resting metabolism. It accounts for two-thirds of your daily energy expenditure. The more you work your muscles--especially with strength training exercises--the more blood sugar they sponge from the blood and the more calories they burn even when you arent active. If you dont exercise, try a walking program.

Start out with something simple--get off your bus a stop early and walk the rest of the way to work, park your car at the far end of the company or mall parking lot, or take a brisk walk at lunch or when you come home. Gradually increase the amount of time you walk each day until you do 30 or more minutes a day. A pedometer can help you keep track of your daily activity. These watch-like devices hang from a belt and record how many steps you take. A good goal is 10,000 steps a day. If you already exercise, try to increase its intensity or duration.

Keep track. Its easy to eat more than you plan to. A daily food diary can make you more aware of exactly how much you are eating. Include everything, no matter how small or insignificant it seems. Small noshes and drinks of juice add up to real calories.

Tame your blood sugar. Eating foods that make your blood sugar and insulin levels shoot up and then crash may contribute to weight gain. Such foods include white bread, white rice, and other highly processed grain products. As an alternative, choose foods that have a gentler effect on blood sugar (whats called a lower glycemic index). These include whole grains such as wheat berries, steel-cut oats, and whole-grain breads and pasta, as well as beans, nuts, fruits, and vegetables.

Dont be afraid of good fats. Fat in a meal or in snacks such as nuts or corn chips helps you feel full. Good fats such as olive or canola oil can also help improve your cholesterol levels when you eat them in place of saturated or trans fats or highly processed carbohydrates.

Bring on the water. When you are thirsty, reach for water. Drinking juice or sugared soda can give you several hundred calories a day without even realizing it.

The longest journey starts with a single step. Most people dont suddenly decide to lose weight and head straight for their goal. Its a trial and error process. The more you learn and the more support you can get, the more likely youll be to reach your target.

Defensive Eating
In our society, food is everywhere--the mall and gas station, the ballpark and drug store. Super size meals in fast food restaurants are almost too good a bargain to pass up, and servings in all but the most trendy restaurants are often enough to feed two. In the face of such plenty, its important to learn how to avoid overeating. Here are some strategies that help defend against eating too much:

a Stop before you are stuffed. Learn your bodys signals and practice stopping before you feel full.

a Be selective. Its easy to eat food just because its put in front of you. Be mindful of what you are eating, and make sure that you are choosing what to eat.

a Select small portions. Portions in most restaurants are over-sized. If you are eating with someone else, try sharing an entrAe, or order two appetizers instead of an entree. If youre eating alone, eat half and take the rest home for another meal.

a Beware of desserts. A single slice of The Cheesecake Factorys Original Cheesecake packs almost 800 calories and an incredible 49 grams of fat (28 of them saturated, or 50 percent more than is recommended maximum per day). Either share such a rich dessert several ways or skip it altogether and finish your meal with a piece of fruit or other lower-calorie option.

a Slow down. Eating fast short-circuits the signals that your digestive system generates to signal that its getting full. Slowing down gives your stomach and intestines time to send these messages to your brain.

a Spoil your appetite. Having a snack or appetizer before a meal can dull your hunger and help you eat less at the meal.

a Be aware of why you are eating. Sometime we eat when were bored, anxious, or angry. Try not to soothe your negative feelings with food. Dealing with them in other ways --talking to friends, listening to music, taking a walk, meditating, or working--can help you relieve stress without gaining weight.

Summary
Whats sometimes lost in the dire predictions about overweight and obesity in America are the enormous benefits of staying lean or working toward a healthier weight. Maintaining a healthy weight throughout life is associated with lower rates of premature death and heart disease, some cancers, and other chronic conditions. What if youre past that point Losing 5-10 percent of your weight can substantially improve your immediate health and will decrease your risk of developing such problems. The best time to start losing weight is with the first signs that your weight is straying upward.

Gastrointestinal Surgery for Severe Obesity
prohealth.com

06-20-2003

Severe obesity is a chronic condition that is difficult to treat through diet and exercise alone. Gastrointestinal surgery may be the best option for people who are severely obese and cannot lose weight by traditional means or who suffer from serious obesity-related health problems. The surgery promotes weight loss by restricting food intake and, in some operations, interrupting the digestive process. As in other treatments for obesity, the best results are achieved with healthy eating behaviors and regular physical activity. People who may consider gastrointestinal surgery include those with a body mass index (BMI) above 40aabout 100 pounds of overweight for men and 80 pounds for women (see table 1 for a BMI conversion chart). People with a BMI between 35 and 40 who suffer from type 2 diabetes or life-threatening cardiopulmonary problems such as severe sleep apnea or obesity-related heart disease may also be candidates for surgery.

The concept of gastrointestinal surgery to control obesity grew out of results of operations for cancer or severe ulcers that removed large portions of the stomach or small intestine. Because patients undergoing these procedures tended to lose weight after surgery, some physicians began to use such operations to treat severe obesity. The first operation that was widely used for severe obesity was the intestinal bypass.

This operation, first used 40 years ago, produced weight loss by causing malabsorption. The idea was that patients could eat large amounts of food, which would be poorly digested or passed along too fast for the body to absorb many calories. The problem with this surgery was that it caused a loss of essential nutrients and its side effects were unpredictable and sometimes fatal. The original form of the intestinal bypass operation is no longer used.

The Normal Digestive Process
Normally, as food moves along the digestive tract, digestive juices and enzymes digest and absorb calories and nutrients. After we chew and swallow our food, it moves down the esophagus to the stomach, where a strong acid continues the digestive process. The stomach can hold about 3 pints of food at one time. When the stomach contents move to the duodenum, the first segment of the small intestine, bile and pancreatic juice speed up digestion.

Most of the iron and calcium in the foods we eat is absorbed in the duodenum. The jejunum and ileum, the remaining two segments of the nearly 20 feet of small intestine, complete the absorption of almost all calories and nutrients. The food particles that cannot be digested in the small intestine are stored in the large intestine until eliminated.

How Does Surgery Promote Weight Loss
Gastrointestinal surgery for obesity, also called bariatric surgery, alters the digestive process. The operations promote weight loss by closing off parts of the stomach to make it smaller. Operations that only reduce stomach size are known as arestrictive operationsa because they restrict the amount of food the stomach can hold.

Some operations combine stomach restriction with a partial bypass of the small intestine. These procedures create a direct connection from the stomach to the lower segment of the small intestine, literally bypassing portions of the digestive tract that absorb calories and nutrients. These are known as malabsorptive operations.

What Are the Surgical Options
There are several types of restrictive and malabsorptive operations. Each one carries its own benefits and risks.

Restrictive Operations
Restrictive operations serve only to restrict food intake and do not interfere with the normal digestive process. To perform the surgery, doctors create a small pouch at the top of the stomach where food enters from the esophagus. Initially, the pouch holds about 1 ounce of food and later expands to 2-3 ounces. The lower outlet of the pouch usually has a diameter of only about A inch. This small outlet delays the emptying of food from the pouch and causes a feeling of fullness.

As a result of this surgery, most people lose the ability to eat large amounts of food at one time. After an operation, the person usually can eat only A to 1 cup of food without discomfort or nausea. Also, food has to be well chewed.

Restrictive operations for obesity include adjustable gastric banding (AGB) and vertical banded gastroplasty (VBG).

Adjustable gastric banding. In this procedure, a hollow band made of special material is placed around the stomach near its upper end, creating a small pouch and a narrow passage into the larger remainder of the stomach. The band is then inflated with a salt solution. It can be tightened or loosened over time to change the size of the passage by increasing or decreasing the amount of salt solution.

Vertical banded gastroplasty. VBG has been the most common restrictive operation for weight control. Both a band and staples are used to create a small stomach pouch.

Although restrictive operations lead to weight loss in almost all patients, they are less successful than malabsorptive operations in achieving substantial, long-term weight loss. About 30 percent of those who undergo VBG achieve normal weight, and about 80 percent achieve some degree of weight loss. Some patients regain weight. Others are unable to adjust their eating habits and fail to lose the desired weight. Successful results depend on the patientas willingness to adopt a long-term plan of healthy eating and regular physical activity.

A common risk of restrictive operations is vomiting, which is caused when the small stomach is overly stretched by food particles that have not been chewed well. Band slippage and saline leakage have been reported after AGB. Risks of VBG include wearing away of the band and breakdown of the staple line. In a small number of cases, stomach juices may leak into the abdomen, requiring an emergency operation. In less than 1 percent of all cases, infection or death from complications may occur.

Malabsorptive Operations
Malabsorptive operations are the most common gastrointestinal surgeries for weight loss. They restrict both food intake and the amount of calories and nutrients the body absorbs.

Roux-en-Y gastric bypass (RGB). This operation is the most common and successful malabsorptive surgery. First, a small stomach pouch is created to restrict food intake. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum (the first segment of the small intestine), and the first portion of the jejunum (the second segment of the small intestine). This bypass reduces the amount of calories and nutrients the body absorbs.

Biliopancreatic diversion (BPD). In this more complicated malabsorptive operation, portions of the stomach are removed. The small pouch that remains is connected directly to the final segment of the small intestine, completely bypassing the duodenum and the jejunum. Although this procedure successfully promotes weight loss, it is less frequently used than other types of surgery because of the high risk for nutritional deficiencies. A variation of BPD includes a duodenal switch, which leaves a larger portion of the stomach intact, including the pyloric valve that regulates the release of stomach contents into the small intestine. It also keeps a small part of the duodenum in the digestive pathway.

Malabsorptive operations produce more weight loss than restrictive operations, and are more effective in reversing the health problems associated with severe obesity. Patients who have malabsorptive operations generally lose two-thirds of their excess weight within 2 years.

In addition to the risks of restrictive surgeries, malabsorptive operations also carry greater risk for nutritional deficiencies. This is because the procedure causes food to bypass the duodenum and jejunum, where most iron and calcium are absorbed. Menstruating women may develop anemia because not enough vitamin B12 and iron are absorbed. Decreased absorption of calcium may also bring on osteoporosis and metabolic bone disease. Patients are required to take nutritional supplements that usually prevent these deficiencies. Patients who have the biliopancreatic diversion surgery must also take fat-soluble (dissolved by fat) vitamins A, D, E, and K supplements.

RGB and BPD operations may also cause adumping syndrome.a This means that stomach contents move too rapidly through the small intestine. Symptoms include nausea, weakness, sweating, faintness, and sometimes diarrhea after eating. Because the duodenal switch operation keeps the pyloric valve intact, it may reduce the likelihood of dumping syndrome.

The more extensive the bypass, the greater the risk for complications and nutritional deficiencies. Patients with extensive bypasses of the normal digestive process require close monitoring and life-long use of special foods, supplements, and medications.

Explore Benefits and Risks
Surgery to produce weight loss is a serious undertaking. Anyone thinking about surgery should understand what the operation involves. Patients and physicians should carefully consider the following benefits and risks:

Benefits
aRight after surgery, most patients lose weight quickly and continue to lose for 18 to 24 months after the procedure. Although most patients regain 5 to 10 percent of the weight they lost, many maintain a long-term weight loss of about 100 pounds. aSurgery improves most obesity-related conditions. For example, in one study blood sugar levels of 83 percent of obese patients with diabetes returned to normal after surgery. Nearly all patients whose blood sugar levels did not return to normal were older or had lived with diabetes for a long time.

Risks
a Ten to 20 percent of patients who have weight-loss surgery require follow-up operations to correct complications. Abdominal hernia was the most common complication requiring follow-up surgery, but laparoscopic techniques seem to have solved this problem. In laparoscopy, the surgeon makes one or more small incisions through which slender surgical instruments are passed. This technique eliminates the need for a large incision and creates less tissue damage.

Patients who are superobese (andgt;350 pounds) or have had previous abdominal surgery may not be good candidates for laparoscopy, however. Less common complications include breakdown of the staple line and stretched stomach outlets.

a Some obese patients who have weight-loss surgery develop gallstones. Gallstones are clumps of cholesterol and other matter that form in the gallbladder. During rapid or substantial weight loss, a personas risk of developing gallstones increases. Taking supplemental bile salts for the first 6 months after surgery can prevent gallstones.

a Nearly 30 percent of patients who have weight-loss surgery develop nutritional deficiencies such as anemia, osteoporosis, and metabolic bone disease. These deficiencies usually can be avoided if vitamin and mineral intakes are high enough.

a Women of childbearing age should avoid pregnancy until their weight becomes stable because rapid weight loss and nutritional deficiencies can harm a developing fetus.

Medical Costs
Gastrointestinal surgery costs about USD 15,000. Medical insurance coverage varies by state and insurance provider. If you are considering gastrointestinal surgery, contact your regional Medicare or Medicaid office or insurance plan to find out if the procedure is covered.

Is the Surgery for You
Gastrointestinal surgery may be the next step for people who remain severely obese after trying nonsurgical approaches, or for people who have an obesity-related disease. Candidates for surgery have:

a a BMI of 40 or more
a a life-threatening obesity-related health problem such as diabetes, severe sleep apnea, or heart disease and a BMI of 35 or more
a obesity-related physical problems that interfere with employment, walking, or family function.

If you fit the profile for surgery, answers to the following questions may help you decide whether weight-loss surgery is appropriate for you.

Researchers Review Efficacy and Safety of Low Carbohydrate Diets
prohealth.com

04-23-2003

People who go on low carbohydrate diets typically lose weight, but restricted caloric intake and longer diet duration are the biggest reasons why, according to a study from Stanford University Medical Center and collaborators at Yale University. The sweeping review of literature on this popular diet also found there are no short-term adverse effects of the diet, but also that there is insufficient evidence on the diets long-term effects and impact on people over the age of 53.

Low-carbohydrate diets have been extremely popular as of late, and the lay press has suggested theyre a safe and effective means of weight loss, said lead author Dena Bravata, MD, social science research associate at Stanfords Center for Primary Care and Outcomes Research. While these diets are effective in the short term, weight loss results from reduced calories, not carbohydrate restriction.

The study - the first review of its kind - appears in the April 9, 2003 issue of the Journal of the American Medical Association.

Books on low-carbohydrate/ high-protein diets - such as the popular Atkins diet - have sold in the millions, and proponents say these diets cause rapid weight loss without adverse side effects. Numerous medical associations and physicians, however, have expressed concern that these diets are too high in fat and can lead to kidney and liver problems and other health risks.

Despite their popularity - and the concern of some in the medical community - Bravata said little evidence exists on the efficacy and safety of low-carbohydrate diets. Bravata and her colleagues, many of whom are practicing internists, said they wanted to know what to tell their patients about these diets. The aim of their study was to synthesize the current literature and evaluate any changes in weight and cholesterol, glucose, insulin and blood pressure levels.

Bravata and the researchers collected literature on low-carbohydrate diets published between 1966 and 2003. They reviewed a total of 107 diet studies, which involved 3,268 people from around the world. The studies were small and heterogeneous, with carbohydrate and caloric intake, diet duration and participant characteristics varying greatly. The studies did have two things in common: none of the studies had participants with a mean age over 53 and none of the randomized and controlled studies lasted longer than 90 days. Information on older adults and long-term results are scarce at best, and this should be kept in mind when looking at our findings, noted Bravata.

The researchers meta-analysis found that people on diets of 60 or fewer grams of carbohydrates a day (a threshold used in some of the popular low-carbohydrate diets) did lose weight. But the weight loss was associated with restriction of caloric intake and longer diet duration, not with reduced carbohydrate intake. It also found that the greatest weight loss occurred among those participants on diets with the highest baseline weight and lowest caloric content.

The greatest predictors of weight loss appear to be caloric intake and diet duration, she said. The findings suggest that if you want to lose weight, you should eat fewer calories and do so over a long time period.

The researchers found no significant adverse effects on cholesterol, glucose, insulin and blood-pressure levels among participants on the diets. But, Bravata stressed, the adverse effects may not have shown up within the short period of the studies. She also said losing weight typically leads to an improvement in some of these levels, so this could have had an impact on the numbers.

While Bravata is pleased to be able to provide her patients with the most current evidence on these diets, she and the researchers concluded that there is insufficient evidence overall to make recommendations for or against using the diets. She said studies are now needed on the role of exercise in weight loss (as exercise information was excluded from this analysis), the long-term effects of these diets and the effectiveness and safety of these diets for people over the age of 53.

Co-author Christopher Gardner, PhD, assistant professor of medicine with the Stanford Center for Research in Disease Prevention, agreed that more studies on low-carbohydrate diets are needed. The team did a phenomenal job of synthesizing all thats out there, but there wasnt a lot of information from well-designed, randomized controlled trials to begin with, he said. The obesity epidemic involves people having weight problems for years or decades, and we need long-term data on these diets effectiveness and safety.

Weight Cycling: Questions and Answers
prohealth.com

03-26-2003

What Is Weight Cycling
Weight cycling is the repeated loss and regain of body weight. When weight cycling is the result of dieting, it is often called yo-yo dieting. A weight cycle can range from small weight losses and gains (5-10 lbs. per cycle) to large changes in weight (50 lbs. or more per cycle).

Some research links weight cycling with certain health risks. To avoid potential risks, most experts recommend that obese adults adopt healthy eating and regular physical activity habits to achieve and maintain a healthier weight for life. Non-obese adults should try to maintain their weight through healthy eating and regular physical activity.

If I regain lost weight, wont losing it again be even harder
A person who repeatedly loses and gains weight should not have more trouble trying to reach and maintain a healthy weight than a person attempting to lose weight for the first time. Most studies show that weight cycling does not affect oneas metabolic rateathe rate at which the body burns fuel (food) for energy. Based on these findings, weight cycling should not affect the success of future weight-loss efforts. Metabolism does, however, slow down as a person ages. In addition, older people are often less physically active than when they were younger. Regardless of your age, making regular physical activity as well as healthy eating habits a part of your life will aid weight loss and improve health overall.

Will weight cycling leave me with more fat and less muscle than if I had not dieted at all
Weight cycling has not been proven to increase the amount of fat tissue in people who lose and regain weight. Researchers have found that after a weight cycle, those who return to their original weights have the same amount of fat and lean tissue (muscle) as they did prior to weight cycling. People who exercise during a weight cycle may actually gain muscle.

Some people are concerned that weight cycling can put more fat around their abdominal (stomach) area. People who tend to carry excess fat in the stomach area (apple-shaped), instead of in the hips, thighs, and buttocks (pear-shaped), are more likely to develop type 2 diabetes, heart disease, and high blood pressure. Studies have not found, however, that after a weight cycle, people have more fat around their stomachs than they did before weight cycling.

Is weight cycling harmful to my health
Some studies suggest that weight cycling may increase the risk for certain health problems. These include high blood pressure, high cholesterol, and gallbladder disease. For adults who are not obese and do not have weight-related health problems, experts recommend maintaining a stable weight to avoid any potential health risks associated with weight cycling. Obese adults, however, should continue to try to achieve modest weight loss to improve overall health and reduce the risk of developing obesity-related diseases.

Losing and regaining weight may have a negative psychological effect if you let yourself become discouraged or depressed. Weight cycling should not be a reason to afeel like a failure.a Instead it is a reason to refocus on making long-term changes in your diet and level of physical activity to help you keep off the pounds you lose.

Is staying overweight healthier than weight cycling
It is not known for certain whether weight cycling causes health problems. The diseases associated with being obese, however, are well known. These include:

High blood pressure Heart disease Stroke Type 2 diabetes Certain types of cancer Arthritis Gallbladder disease.

Not every adult who is overweight or obese has the same risk for disease. Whether you are a man or woman, the amount and location of your fat, and your family history of disease all play a role in determining your disease risk. Experts agree, however, that even a modest weight loss of 10 percent of body weight over a period of six months or more can improve the health of an adult who is overweight or obese.

Conclusions
Further research on the effects of weight cycling is needed. In the meantime, if you are obese or are overweight and suffer from weight-related health problems, try to improve your health by achieving a modest weight loss. Although weight cycling may have some effect on disease risk, the serious health problems resulting from obesity are clearly understood. If you need to lose weight, you should be ready to commit to lifelong changes in your eating and physical activity behaviors.

If you are not obese or overweight with weight-related health problems, maintain your weight. Focus on adopting healthful eating habits and enjoying regular physical activity to manage weight and promote health for life.

(Source: Weight Control Information Network)

NHLBI Study Tests Novel Ways To Help Americans Keep Weight Off
prohealth.com

08-04-2003

Source: National Heart, Lung, and Blood Institute (NHLBI)

The National Heart, Lung, and Blood Institute (NHLBI) today announced the launch of a major study that could help solve one of the hardest aspects of weight lossakeeping off lost pounds. The study, called the aWeight Loss Maintenance Trial,a will be done in two phases at four clinical sites.

The study will include 1,600 men and women in its first phase, and 800 in its second. Phase I is a 5-month weight loss program; phase II will try to help those who lose 9 or more pounds in phase I keep the weight off for 2A years.

The study has begun seeking participants, who must be overweight or obese, age 25 or older, and taking medication to control high blood pressure and/or high blood cholesterol. About 60 percent will be women and 40 percent will be African American.

aMaintaining weight loss is a critical element in the struggle against overweight and obesity, which have reached epidemic proportions in the United States,a said NHLBI Director Dr. Claude Lenfant. aTwo of every three adults are overweight or obese. This study could yield answers that can help many Americans lead healthier lives.a

aAmericans have shown that they can lose weight in the short-term,a said Dr. Laura Svetkey, Director of the Duke Hypertension Center and of Clinical Research at the Sarah Stedman Nutrition and Metabolism Center at Duke University in Durham, NC, and lead investigator in the study. aYet, only a small proportion of them achieve long-term weight control. To successfully fight the obesity epidemic, clinicians and other health care providers must have options that are effective and feasible for a broad range of people.

aThe best weight-loss strategy will not only lead to long-term weight control, but also achieve it by establishing a healthy dietary pattern and physical activity routine that lasts a lifetime,a she added.

Overweight/obesity is the second leading cause of preventable death in the United States. Overweight and obesity increase the risk of heart disease and other conditions, including high blood pressure, high blood cholesterol, diabetes, stroke, and some cancers.

About 65 percent of American adultsaabout 129 million personsaare overweight or obese, and the prevalence is increasing. In 1988-94, almost 60 percent of American adults were overweight or obese, while in 1999-2000, nearly 65 percent were overweight or obese.

The four centers involved in the Weight Loss Maintenance study are: Duke University; Pennington Biomedical Research Center at Louisiana State University in Baton Rouge; Kaiser Permanente Center for Health Research (KPCHR) in Portland, OR; and The Johns Hopkins Medical Institutions in Baltimore, MD. KPCHR also serves as the studyas coordinating center.

In the studyas first phase, participants will receive counseling to help them make lifestyle changes to reduce their weight. These lifestyle changes will include reducing calories and increasing physical activity. Participants will be encouraged to follow the DASH eating plan, which has been shown to reduce blood pressure and cholesterol. DASH is high in fiber and low in saturated fat, cholesterol, and total fat, and emphasizes fruits, vegetables, and lowfat dairy foods. Phase I participants will keep food and fitness diaries to monitor their diet and physical activity. Those who lose 9 or more pounds after 5 months will be eligible to enroll in phase II.

In phase II, participants will be randomly assigned to one of three weight-maintenance strategies: self-directed/usual care (SD/UC); personal contact (PC); and interactive technology (IT). The SD/UC group will meet once with a health counselor for advice on how to maintain their weight loss and to discuss their own weight loss plans. They also will receive educational materials about diet and physical activity.

Those in the PC group will receive personal guidance and counseling on how to maintain their weight loss through monthly telephone calls and occasional visits with a health counselor.

Participants in the IT group will use an Internet-based, individually tailored, interactive computer program to help them keep their weight off. They can use the program as often as they wish and can log on anywhere they have Internet access: at home, work, a school, or a public library. They also will receive weekly e-mails with tailored messages on their progress that include links to the Web site.

Further, they will receive reminders by an interactive voice phone system to log onto the studyas Web site and respond to e-mail.

aThe study will compare these two methods with the self-directed/usual care group,a said Svetkey. aThe study involves a large, diverse group of overweight and obese people, and will determine the impact of these maintenance strategies on their weight and heart disease risk factors. It also will see if the strategies have other effects, such as on participantsa quality of life.a

aThe Surgeon General, the Secretary of Health and Human Services, the medical communityaeveryone recommends that Americans maintain a healthy weight,a said Dr. Eva Obarzanek, NHLBI nutritionist and project officer for the Weight Loss Maintenance study. aBut very few people become asuccessful long-term losers.a This study will test two behavioral methods to help people keep lost weight off for the rest of their lives, especially people who are at a high risk of developing heart disease and other serious conditions.

Five Weight Loss Blunders - and Solutions
prohealth.com

10-13-2003

Stop sabotaging yourself! Losing weight can be a frustrating, anxiety-inducing process, but it doesnt have to be. Find out about some common weight loss mistakes you may be making and stop sabotaging yourself.

1. Giving Up Too Soon. Falling off the exercise and diet wagon happens to everyone. Its tempting to give up on exercise after weeks (or months) of failing to stick with a program or skip workouts completely if you run out of time. Its also tempting to ditch healthy eating after a massive Oreo-fest, but renewing your commitment after a boo-boo is the most important thing you can do to succeed.

Solution. No matter how long its been since youve exercised, do something active right away, like a quick walk, to help you take control. If you dont have time for your regular workout, use whatever time you have to be active. Ask yourself which is better: exercising for 10 minutes or not doing anything at all. If you ate too much, admit your mistake and move on. One mistake (or two...or three...) doesnt equal failure!

2. Expecting Immediate Weight Loss. After weeks of exercise and healthy eating, frustration often sets in when the scale doesnt move. Remember, you didnt gain weight overnight and you wont lose it overnight either. Spending too much time scale-watching might lead to a maddening desire to quit exercise forever.

Solution. Focus on the immediate benefits of exercise. Pay attention to how you feel while youre working out. You should feel energetic and alert. You may notice you sleep better, your body feels stronger and youre less stressed. The benefits of exercise go way beyond weight loss and appearance!

3. Doing The Same Thing and Expecting Different Results. Its important to do exercises that you enjoy, but if youve been doing the same ones for months (or even years), youve probably reached a weight loss plateau and, even worse, complete boredom with your workouts.

Solution. Change what youre doing. It can be as simple as choosing a different walking route or changing the amount of weight youre using. Try something new and do it every six weeks. Your body needs regular challenges and so does your mind, so dont allow yourself to get into a rut.

Six Strategies for Successful Weight Loss
prohealth.com

09-01-2003

By Mayo Clinic staff

By now youve heard this weight-loss mantra many times: Eat less, exercise more. Its a simple concept that many find difficult to put into practice. Every day, you find yourself in all kinds of situations in which its difficult to eat less.

And who has time to exercise It seems you can barely get through a normal day, running kids to school, putting in long hours at your job, getting dinner together and tossing in a load of laundry.

Exercise Havent you done enough already

If youre like many people, youve thought about how you can make it all work. You really do want to lose that extra weight, but you still have to find a way that works in your own situation. Otherwise, youll just slip back and find more excuses. And any weight you may have lost will jump right back on the minute you give up.

You also probably know that virtually hundreds of different fad diets, weight-loss programs and outright scams promise quick and easy weight loss. But the foundation of every successful weight-loss program still remains a healthy diet combined with exercise. You must make permanent changes in your lifestyle and health habits to lose significant weight and then keep it off.

Here are six effective strategies to help you meet and maintain your weight-loss goals.

1. Make a commitment

Achieving and maintaining your healthy weight requires a lifelong commitment. It requires concentration, time and effort. Make sure that youre ready to make the necessary permanent changes and that you do so for the right reasons.

No one else can make you lose weight. In fact, external pressure a often from people closest to you a may actually make matters worse. You must want to make diet and exercise changes to please yourself.

As youre planning to launch new weight-related lifestyle changes, try to resolve any other problems that may be in your life. It takes considerable mental and physical energy to change your habits. So make sure you arent distracted by other major issues in your life, such as marital or financial problems. Timing is key to success. You need to be at a point in your life when youre ready to take on the challenges of serious weight loss.

Keep in mind that no matter how prepared you may be, youll occasionally overeat or eat foods that you should avoid. Rather than let a setback derail your efforts, accept that it happened and get back on track. Dont expect to be perfect a and never give up.

Motivate yourself by focusing on all of the benefits of losing weight, such as having more energy and improving your health. Then look at the negatives, such as finding the time to exercise, and come up with creative solutions.

2. Draw on support from others

Ultimately, only you can help yourself lose weight, so you have to take responsibility for your own behavior. But that doesnt mean that you have to do everything alone. Seek support from your spouse, family and friends.

Pick people who you know want only the best for you and who will encourage you. Your support person or persons should be available to listen to your thoughts and feelings and encourage you, perhaps spend time exercising with you, and share the priority youve placed on developing a healthier lifestyle. An ideal support person might be someone who also is participating in a weight-loss program.

Some people fare better with professional support, such as from a dietitian or personal trainer. Others benefit from the group support they receive from organizations such as Weight Watchers or Overeaters Anonymous.

If you do join a group, keep in mind that what you get out of it will be in proportion to what you put into it. If you sit in a corner and just listen, you may hear some good suggestions. But if you actively participate, youare more likely to reap the potential rewards of the group, such as support, encouragement, feeling that youre not alone and helpful suggestions specific to your concerns

3. Set a realistic goal

When youre thinking about what you expect from your new eating and exercise plan, be realistic. Healthy weight loss occurs slowly and steadily. Aim to lose 1 to 2 pounds a week. To do this, you need to burn 500 to 1,000 calories a day through a low-calorie diet and regular exercise. Losing weight more rapidly means losing water weight or muscle tissue, rather than fat.

Set weekly or monthly goals and track your progress. Remember that youre in this for the long haul. Anything you undertake too intensely or too vigorously quickly becomes too onerous, so youre more likely to give up.

In addition, make your goals process goals, such as eating judiciously and exercising regularly, rather than outcome goals, such as losing 50 pounds. Changing your process a your habits a is the key to weight loss. Make sure that your process goals are realistic, specific and measurable a youll walk for 30 minutes a day, five days a week.

Work out a strategy that gradually changes the habits and attitudes that may have undermined your past efforts to lose weight. Choose a definite start date. Consider where, how often and how long youll exercise. Determine a realistic eating plan that factors in plenty of water, fruits and vegetables. Write everything down. Find the potential roadblocks, and make plans to deal with them.

Ask your doctor how much weight you can safely lose. Your doctor may refer you to a dietitian or someone else who specializes in weight loss.

4. Learn to enjoy healthier foods

Liquid meals, diet pills and unusual combinations of foods arent the key to long-term weight control and better health. Instead, learn how to eat a variety of healthy foods.

Adopting a new eating style that promotes a healthy weight for you must include lowering your total calorie intake. But decreasing calories need not mean decreasing taste, satisfaction or even ease of meal preparation. One way you can lower your calorie intake is by eating more plant-based foods a fruits, vegetables and whole grains.

Strive for variety to help you achieve your goals without compromising taste or nutrition. Cutting back on calories is easier if you focus on limiting fat.

To lose weight, talk to your doctor about setting these daily calorie goals:

Your weight in pounds:

250 or less: Daily calorie goal for women: 1,200; for men: 1,400

251 to 300: Daily calorie goal for women: 1,400; for men; 1,600

301 or more: Daily calorie goal for women: 1,600; for men 1,800

Over time, your calorie needs may change based on your health risks, the rate of weight loss desired or needed, and your personal goals and preferences. You can adjust your calories if youre too hungry or if you have reached your target weight and want to stop losing.

Very-low-calorie diets arent a healthy long-term strategy. Fewer than 1,200 calories a day for women and 1,400 calories for men arent generally recommended. If your calories are too low, you run the risk of not getting all of the nutrients you need for good health.

Its usually best to talk to your doctor or a registered dietitian before starting any weight-loss plan. A weight-loss specialist can help guide you in making the healthiest, most effective and safest food choices based on your individual needs.

5. Get active, stay active

Dieting alone can help you lose weight. Cutting 250 calories from your daily diet can help you lose about half a pound a week: 3,500 calories equals 1 pound of fat. But add a 30-minute brisk walk four days a week, and you can double your rate of weight loss.

The goal of exercise for weight loss is to burn more calories, although exercise offers many other benefits as well. How many calories you burn depends on the frequency, duration and intensity of your activities. For many people its easier to keep a routine of longer-duration, lower-intensity aerobic exercises. One of the best ways to lose body fat is through steady aerobic exercise a such as walking a for more than 30 minutes most days of the week.

Strength-training exercises, such as weight training, also are important since they help counteract muscle loss associated with aging. And since muscle tissue burns more calories, muscle mass is a key factor in helping maintain a healthy weight. The more lean muscle mass you preserve, the bigger engine in which to burn more calories.

Exercise sensibly by starting out slowly and gradually increasing both its duration and intensity. Walking is an ideal choice as are swimming, bicycling, jogging and dancing. Decide, too, if you prefer to exercise alone or with others. Often, having a buddy helps you stick to your schedule.

Even though regularly scheduled aerobic exercise is best for losing fat, any extra movement helps burn calories. Lifestyle activities may be easier to incorporate into your day. Think about ways you could increase your physical activity throughout the day. For example, make several trips up and down stairs instead of using the elevator, or park at the far end of the lot. Stair climbing, walking, gardening, lawn mowing and even housework all help burn calories.

6. Change your lifestyle

Its not enough to eat healthy foods and exercise for only a few weeks or even several months. You have to incorporate these behaviors into your life. To do that, you have to change the behaviors that helped make you overweight in the first place. Lifestyle changes start with taking an honest look at your eating habits and daily routine.

To assess your eating behaviors, ask yourself if you tend to eat when youre bored, angry, tired, anxious, depressed or socially pressured. Look at your eating style and shopping and cooking techniques. Were you taught to clean your plate Do you eat too fast Do you eat while watching TV See if any patterns emerge to identify possible triggers for overeating.

After assessing your personal challenges to weight loss, try working out a strategy to gradually change habits and attitudes that have sabotaged your past efforts. Simply admitting your own challenges wont get you past them entirely. But it helps in planning how youll deal with them and whether youre going to succeed in losing weight once and for all.

You likely will have an occasional setback. But instead of giving up entirely, simply start fresh the next day. Remember that youre planning to change your life. It wont happen all at once, but stick to your healthy lifestyle and the results will be worth it.

A team of researchers studying nearly 1,000 men and women participating in a randomized trial evaluating three weight-loss programs in Minnesota found that associations between gastrointestinal symptoms, diet and exercise may have implications for the treatment of both obesity and gastrointestinal problems. The physiological mechanisms linking gastrointestinal symptoms, obesity and exercise still need to be determined, said psychologist Rona Levy, lead author of the study and a University of Washington professor of social work whose research focuses on common gastrointestinal disorders such as irritable bowel syndrome in adults.

Our main finding is that the amount of exercise people in a weight loss program do is related to gastrointestinal symptoms. In statistical terms, this means exercise is protective against gastrointestinal symptoms. This isnt surprising, but it has not been demonstrated before with this population. Science has now validated what people have been guessing, she said.

But we dont know if this is a did the chicken or the egg come first kind of a thing. We are not sure which is the key, exercise or gastrointestinal symptoms. It is plausible that if a physician put a patient on an exercise program to lose weight the GI problems experienced might hamper the patients ability to exercise.

People in the study reported experiencing a variety of problems: 19 percent said they had abdominal pain, 13 percent had irritable bowel syndrome, 25 percent had diarrhea and 20 percent had bloating.

Data were collected from a larger two-year study evaluating telephone- and mail-based interventions for weight loss. Seventy percent of the 983 participants were women and all were classified as obese or overweight. Participants ranged in age from 20 to 89.

Levy said the more people weighed the more gastrointestinal symptoms they tended to report. People who began limiting their dietary intake of fat and increased their amount of fiber by eating more vegetables and fruit reported lower levels of GI symptoms. However, when the researchers looked at all the factors together, rather than comparing two of them, these relationships did not come out as the most significant ones.

This study is another argument for exercise. Even though anyone engaging in a weight-loss program should know that gastrointestinal symptoms may impede their ability to exercise, those symptoms may also be alleviated by exercise, said Levy.

Recipe for Weight Loss
prohealth.com

11-08-2004

(Ivanhoe Newswire) -- Doctors publishing in this weeks Circulation offer a recipe for weight loss they believe could help many overweight and obese people shed pounds and reduce their risk of heart disease.

The common sense plan calls for people with a body mass index between 25 and 29.9 to watch their diets, exercise regularly, and make some behavioral changes. Those changes include setting weight loss goals, getting help with stress, and finding social support. People in this weight range are generally considered overweight but not obese.

Researchers say people with BMIs that top 30 should also consider drug therapy along with diet, exercise, and behavioral changes. Those with BMIs of 35 or higher who have been unable to lose weight using these more conventional strategies should be evaluated for gastric bypass surgery or other weight loss operations.

The authors note losing even a small amount of weight -- about 5 percent to 10 percent of body weight -- can significantly improve measures of metabolic syndrome, which is known to lead to heart problems. Risk factors for metabolic syndrome include high cholesterol, high blood pressure, higher-than-normal blood sugar, and being overweight.

Whatas the best way to reach your weight loss goals The authors suggest a slow and steady approach. aMaking lifelong dietary and physical activity changes is key for successful weight management,a says author Robert H. Eckel, M.D. aSo, itas important that people select a healthy diet that they can follow for the rest of their lives,a he says. For most people, that means reducing calories to the point where they can lose a pound or two a week.

The authors also call for doctors to work more closely with their overweight and obese patients to achieve these goals.

Six Strategies for Successful Weight Loss
prohealth.com

01-03-2005

By now youve heard this weight-loss mantra many times: Eat less, exercise more. Its a simple concept that many find difficult to put into practice. Every day, you find yourself in all kinds of situations in which its difficult to eat less.

And who has time to exercise It seems you can barely get through a normal day, running kids to school, putting in long hours at your job, getting dinner together and tossing in a load of laundry.

Exercise Havent you done enough already

If youre like many people, youve thought about how you can make it all work. You really do want to lose that extra weight, but you still have to find a way that works in your own situation. Otherwise, youll just slip back and find more excuses. And any weight you may have lost will jump right back on the minute you give up.

You also probably know that virtually hundreds of different fad diets, weight-loss programs and outright scams promise quick and easy weight loss. But the foundation of every successful weight-loss program still remains a healthy diet combined with exercise. You must make permanent changes in your lifestyle and health habits to lose significant weight and then keep it off.

Here are six effective strategies to help you meet and maintain your weight-loss goals.

1. Make a commitment

Achieving and maintaining your healthy weight requires a lifelong commitment. It requires concentration, time and effort. Make sure that youre ready to make the necessary permanent changes and that you do so for the right reasons.

No one else can make you lose weight. In fact, external pressure a often from people closest to you a may actually make matters worse. You must want to make diet and exercise changes to please yourself.

As youre planning to launch new weight-related lifestyle changes, try to resolve any other problems that may be in your life. It takes considerable mental and physical energy to change your habits. So make sure you arent distracted by other major issues in your life, such as marital or financial problems. Timing is key to success. You need to be at a point in your life when youre ready to take on the challenges of serious weight loss.

Keep in mind that no matter how prepared you may be, youll occasionally overeat or eat foods that you should avoid. Rather than let a setback derail your efforts, accept that it happened and get back on track. Dont expect to be perfect a and never give up. Motivate yourself by focusing on all of the benefits of losing weight, such as having more energy and improving your health. Then look at the negatives, such as finding the time to exercise, and come up with creative solutions.

2. Draw on support from others

Ultimately, only you can help yourself lose weight, so you have to take responsibility for your own behavior. But that doesnt mean that you have to do everything alone. Seek support from your spouse, family and friends.

Pick people who you know want only the best for you and who will encourage you. Your support person or persons should be available to listen to your thoughts and feelings and encourage you, perhaps spend time exercising with you, and share the priority youve placed on developing a healthier lifestyle. An ideal support person might be someone who also is participating in a weight-loss program.

Some people fare better with professional support, such as from a dietitian or personal trainer. Others benefit from the group support they receive from organizations such as Weight Watchers or Overeaters Anonymous.

If you do join a group, keep in mind that what you get out of it will be in proportion to what you put into it. If you sit in a corner and just listen, you may hear some good suggestions. But if you actively participate, youare more likely to reap the potential rewards of the group, such as support, encouragement, feeling that youre not alone and helpful suggestions specific to your concerns.

3. Set a realistic goal

When youre thinking about what you expect from your new eating and exercise plan, be realistic. Healthy weight loss occurs slowly and steadily. Aim to lose 1 to 2 pounds a week. To do this, you need to burn 500 to 1,000 calories a day through a low-calorie diet and regular exercise. Losing weight more rapidly means losing water weight or muscle tissue, rather than fat.

Set weekly or monthly goals and track your progress. Remember that youre in this for the long haul. Anything you undertake too intensely or too vigorously quickly becomes too onerous, so youre more likely to give up.

In addition, make your goals process goals, such as eating judiciously and exercising regularly, rather than outcome goals, such as losing 50 pounds. Changing your process a your habits a is the key to weight loss. Make sure that your process goals are realistic, specific and measurable a youll walk for 30 minutes a day, five days a week.

Work out a strategy that gradually changes the habits and attitudes that may have undermined your past efforts to lose weight. Choose a definite start date. Consider where, how often and how long youll exercise. Determine a realistic eating plan that factors in plenty of water, fruits and vegetables. Write everything down. Find the potential roadblocks, and make plans to deal with them.

Ask your doctor how much weight you can safely lose. Your doctor may refer you to a dietitian or someone else who specializes in weight loss.

4. Learn to enjoy healthier foods

Liquid meals, diet pills and unusual combinations of foods arent the key to long-term weight control and better health. Instead, learn how to eat a variety of healthy foods.

Adopting a new eating style that promotes a healthy weight for you must include lowering your total calorie intake. But decreasing calories need not mean decreasing taste, satisfaction or even ease of meal preparation. One way you can lower your calorie intake is by eating more plant-based foods a fruits, vegetables and whole grains.

Strive for variety to help you achieve your goals without compromising taste or nutrition. Cutting back on calories is easier if you focus on limiting fat.

To lose weight, talk to your doctor about setting these daily calorie goals:

Your weight in pounds -- daily calorie goal

250 or less: Women: 1,200 Men: 1,400
251 to 300: Women: 1,400 Men: 1,600
301 or more: Women: 1,600 Men: 1,800

Over time, your calorie needs may change based on your health risks, the rate of weight loss desired or needed, and your personal goals and preferences. You can adjust your calories if youre too hungry or if you have reached your target weight and want to stop losing.

Very-low-calorie diets arent a healthy long-term strategy. Fewer than 1,200 calories a day for women and 1,400 calories for men arent generally recommended. If your calories are too low, you run the risk of not getting all of the nutrients you need for good health.

Its usually best to talk to your doctor or a registered dietitian before starting any weight-loss plan. A weight-loss specialist can help guide you in making the healthiest, most effective and safest food choices based on your individual needs.

5. Get active, stay active

Dieting alone can help you lose weight. Cutting 250 calories from your daily diet can help you lose about half a pound a week: 3,500 calories equals 1 pound of fat. But add a 30-minute brisk walk four days a week, and you can double your rate of weight loss.

The goal of exercise for weight loss is to burn more calories, although exercise offers many other benefits as well. How many calories you burn depends on the frequency, duration and intensity of your activities. For many people its easier to keep a routine of longer-duration, lower-intensity aerobic exercises. One of the best ways to lose body fat is through steady aerobic exercise a such as walking a for more than 30 minutes most days of the week.

Strength-training exercises, such as weight training, also are important since they help counteract muscle loss associated with aging. And since muscle tissue burns more calories, muscle mass is a key factor in helping maintain a healthy weight. The more lean muscle mass you preserve, the bigger engine in which to burn more calories.

Exercise sensibly by starting out slowly and gradually increasing both its duration and intensity. Walking is an ideal choice as are swimming, bicycling, jogging and dancing. Decide, too, if you prefer to exercise alone or with others. Often, having a buddy helps you stick to your schedule.

Even though regularly scheduled aerobic exercise is best for losing fat, any extra movement helps burn calories. Lifestyle activities may be easier to incorporate into your day. Think about ways you could increase your physical activity throughout the day. For example, make several trips up and down stairs instead of using the elevator, or park at the far end of the lot. Stair climbing, walking, gardening, lawn mowing and even housework all help burn calories.

6. Change your lifestyle

Its not enough to eat healthy foods and exercise for only a few weeks or even several months. You have to incorporate these behaviors into your life. To do that, you have to change the behaviors that helped make you overweight in the first place. Lifestyle changes start with taking an honest look at your eating habits and daily routine.

To assess your eating behaviors, ask yourself if you tend to eat when youre bored, angry, tired, anxious, depressed or socially pressured. Look at your eating style and shopping and cooking techniques. Were you taught to clean your plate Do you eat too fast Do you eat while watching TV See if any patterns emerge to identify possible triggers for overeating.

After assessing your personal challenges to weight loss, try working out a strategy to gradually change habits and attitudes that have sabotaged your past efforts. Simply admitting your own challenges wont get you past them entirely. But it helps in planning how youll deal with them and whether youre going to succeed in losing weight once and for all.

You likely will have an occasional setback. But instead of giving up entirely, simply start fresh the next day. Remember that youre planning to change your life. It wont happen all at once, but stick to your healthy lifestyle and the results will be worth it.

Potential Weight Loss and Vision Benefits Found in Eggs: Amino Acid Leucine
prohealth.com

12-06-2004

Research Published in December Journal of the American College of Nutrition (JACN) Supplement

NEW YORK, Dec. 1 /PRNewswire/ -- A scientific review article published in todays 12/01/04 Journal of the American College of Nutrition supplement reports that leucine, an essential amino acid found in high quality protein like eggs, potentially provides a weight loss advantage during dieting by helping to reduce loss of lean tissue, promote loss of body fat, and stabilize blood glucose levels.

In another paper published in the JACN supplement, research shows that two antioxidants, lutein and zeaxanthin, may significantly reduce the risk of cataract and age-related macular degeneration (AMD).

In the research, eggs are cited as an important dietary source of leucine as well as lutein and zeaxanthin and, in the case of the latter two, research shows lutein and zeaxanthin in eggs to be more bioavailable than from other food sources.

High Quality Protein Promotes Weight Loss

We found that increasing high-quality protein in the diet, like that found in eggs, dairy products and meats, provides a metabolic advantage due to a high content of the branched chain amino acid (BCAA) leucine, says article author Donald K. Layman, Ph.D., Professor of Nutrition, Department of Food Science and Human Nutrition and Department of Internal Medicine, College of Medicine, University of Illinois at Urbana-Champaign. According to Layman, both the amount of high quality protein consumed, as well as the time of day it is consumed, may play an important role in weight loss.

Layman found that unlike other essential amino acids, leucine plays several key roles in metabolism. Leucine is key to the metabolic advantage of a higher protein diet because of its unique roles in regulation of muscle protein synthesis and insulin signaling, says Layman. According to his research, eating more protein rich foods like eggs and limiting carbohydrates helps burn body fat and control hunger and cravings, leading to weight loss.

When limiting calories, Layman recommends daily intake of protein above 1.5 g/kg of body weight (or above 102 grams of protein daily for a 150-pound person); whereas the current Dietary Reference Intake (DRI) for protein is about half that, set at 0.8 g/kg of body weight (or 55 grams of protein daily for a 150-pound person).

Laymans research also suggests that increased use of high quality protein at breakfast, in particular, maybe important for the weight loss advantage of a higher protein diet. In a 10-week study, Layman showed that eating a high quality protein breakfast while losing weight helps maintain lean muscle mass, which is critical to long-term weight loss and maintenance.

The study, which investigated the efficacy of two 1,700-calorie weight loss diets among women aged 45 to 57 years, found that women who ate the higher protein breakfast foods including eggs, low fat dairy and lean meats (containing 10 grams leucine daily) lost slightly more weight, but of the weight lost, nearly twice as much was fat compared to those eating a carbohydrate rich breakfast (containing 5 grams leucine daily).

Researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University discovered that a diets overall glycemic load may be an important determinant of weight loss, but only for some people.

Senior author Susan Roberts, PhD, director of the Energy Metabolism Laboratory at the Center says, Our results suggest that in the future there may be a way to predict who will do best on a low glycemic load diet. The key, they have found, may be in knowing a persons level of insulin secretion.

Insulin is a hormone that is important in glucose (sugar) metabolism, explains senior author Andrew Greenberg, MD, director of the Obesity and Metabolism Laboratory at the Center. The regulation of body weight is, at least in part, influenced by how much insulin a person secretes in response to a load of glucose, as well as by how sensitive that person is to insulins glucose-lowering effects.

In our study, says first author Anastassios Pittas, MD, assistant professor at Tufts University School of Medicine, everyone lost some weight as a result of restricting calories, but people who had high levels of insulin secretion and ate a diet with a low glycemic load lost the most weight.

As part of the ongoing Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) trial at Tufts, the authors studied 32 healthy overweight adults on a reduced-calorie diet for six months. Half of the subjects were randomly assigned to a low glycemic load diet, and the other half followed a diet with a high glycemic load.

A foods glycemic load is a relative measure of how much carbohydrate is in the diet and how quickly that food is converted in the body to blood sugar. Foods with lower numbers typically have a greater proportion of protein and fat, which usually result in a smaller rise in blood glucose following a meal. Examples of low glycemic load foods include salads with oil and vinegar dressing, high fat granola cereal, and most fresh fruits and vegetables.

Glycemic load may not be the be-all, end-all of weight-loss diets for everyone, says Roberts, who is also a professor at the Friedman School of Nutrition Science and Policy at Tufts, but it significantly enhanced weight loss in our high-insulin-secreting subjects.

Our findings may eventually have implications for individualizing weight-loss diets, says Roberts. We need to confirm our results with further studies of larger groups of subjects first, but measuring insulin secretion might be a simple way to target dietary recommendations that help enhance successful weight loss. Greenberg, who is also an assistant professor at the Friedman School, notes that only when we have completed these future studies can we determine whether these tests will be useful for making recommendations for the general public.

Pittas AG, Das SK, Hajduk, CL, Golden J, Saltzman E, Stark PC, Greenberg AS, Roberts SB. Diabetes Care, (December) 2005; 28: 2939-2941. A Low-Glycemic Load Diet Facilitates Greater Weight Loss in Overweight Adults With High Insulin Secretion but Not in Overweight Adults With Low Insulin Secretion in the CALERIE Trial.