Category: Diet and Weight Loss

Has the long-sought magic potion in society's "battle with the bulge" finally arrived? An appetite-control agent that requires no prescription, has no common side effects, and costs almost nothing? Scientists report results of a new clinical trial confirming that just two 8-ounce glasses of the stuff, taken before meals, enables people to shed pounds. The weight-loss elixir, they told the 240th National Meeting of the American Chemical Society (ACS), is ordinary water.

"We are presenting results of the first randomized controlled intervention trial demonstrating that increased water consumption is an effective weight loss strategy," said Brenda Davy, Ph.D., senior author on the study. "We found in earlier studies that middle aged and older people who drank two cups of water right before eating a meal ate between 75 and 90 fewer calories during that meal. In this recent study, we found that over the course of 12 weeks, dieters who drank water before meals, three times per day, lost about 5 pounds more than dieters who did not increase their water intake."

"People should drink more water and less sugary, high-calorie drinks. It's a simple way to facilitate weight management."

Davy pointed out that folklore and everyday experience long have suggested that water can help promote weight loss. But there has been surprisingly little scientific information on the topic. Previous studies hinted that drinking water before meals reduces intake of calories. Lacking until now, however, has been the "gold-standard" evidence from a randomized, controlled clinical trial that compares weight loss among dieters who drink water before meals with those who do not.

The study included 48 adults aged 55-75 years, divided into two groups. One group drank 2 cups of water prior to their meals and the other did not. All of the subjects ate a low-calorie diet during the study. Over the course of 12 weeks, water drinkers lost about 15.5 pounds, while the non-water drinkers lost about 11 pounds.

Davy said water may be so effective simply because it fills up the stomach with a substance that has zero calories. People feel fuller as a result, and eat less calorie-containing food during the meal. Increased water consumption may also help people lose weight if they drink it in place of sweetened calorie-containing beverages, said Davy, who is with Virginia Tech in Blacksburg, Va.

Diet soda pop and other beverages with artificial sweeteners may also help people reduce their calorie intake and lose weight, Davy said. However, she advised against using beverages sweetened with sugar and high-fructose corn syrup because they are high in calories. A 12-ounce can of regular soda pop, for instance, contains about 10 teaspoons of sugar.

Davy noted that that nobody knows exactly how much water people should drink daily. The Institute of Medicine, an agency of The National Academies, which advises the Federal Government on science, says that most healthy people can simply let thirst be their guide. It does not specify exact requirements for water, but set general recommendations for women at about 9 cups of fluids — from all beverages including water — each day, and men at about 13 cups of fluids.

And it is possible to drink too much water, a situation that can lead to a rare, but serious, condition known as water intoxication, Davy pointed out.

NewsPsychology (Aug. 12, 2010) — Most weight loss programs try to motivate individuals with warnings of the long-term health consequences of obesity: increased risk for cancer, diabetes, hypertension, heart disease and asthma. New research suggests the immediate health benefits — such as reduced pain — may be the most effective motivator for helping obese individuals shed extra weight and commit to keeping it off.

In a pilot research study,…

Most weight loss programs try to motivate individuals with warnings of the long-term health consequences of obesity: increased risk for cancer, diabetes, hypertension, heart disease and asthma. New research suggests the immediate health benefits — such as reduced pain — may be the most effective motivator for helping obese individuals shed extra weight and commit to keeping it off.

In a pilot research study, University of Cincinnati (UC) researchers found that 21 percent of participants in a local dietary weight loss program reported significantly less pain in the lower extremities and back after losing an average of 10 pounds. Additionally, study participants reported a 20 to 30 percent reduction in overall bodily pain after weight loss.

Researchers say their results indicate that even small weight loss can relieve pain and reduce the burden excessive weight puts on the musculoskeletal system.

"By focusing on an immediate benefit that can be felt — like pain reduction — instead of the future health impact of obesity, weight loss programs may be able to inspire overweight individuals to lose weight," says Susan Kotowski, PhD, study collaborator and director of the Gait and Movement Analysis Laboratory in the UC College of Allied Health Sciences.

Kotowski and colleague Kermit Davis, PhD, report their findings in the August 2010 issue of the journal Work.

According to the Centers for Disease Control and Prevention (CDC), 44 million Americans are considered clinically obese. Since 1975, the number of obese Americans has risen from 47 percent to 66.3 percent. Previous studies have estimated obesity-attributable medical expenditures in the United States at $75 billion, with half of these costs financed by Medicare or Medicaid.

"Obesity has become a national health crisis, but compliance for weight loss programs is notoriously poor. One potential reason for this is that current programs target long-term diseases, with little direct relevance to the person's current health status," adds Davis, senior author of the study and director of the Low Back Biomechanics and Workplace Stress Laboratory at the UC College of Medicine's environmental health department. "Our study results challenge people to rethink the way they structure weight loss programs."

For this pilot study, UC researchers partnered with a Cincinnati-based weight loss clinic to recruit study volunteers. Thirty two women between the ages of 22 and 76 participated in the study and data was collected over the course of a 12-week dietary weight loss regimen.

Researchers collected baseline individual weight and musculoskeletal pain data related to nine body regions: neck, shoulders, elbows, hands and wrists, upper back, lower back, hips, knees and lower legs and feet. Participants were then tracked each week to record any weight loss and asked to rate their pain on a scale of zero to 10 every other week.

Significant associations were found between weight loss and overall pain reduction, as well as pain reduction in the elbow, hip region and upper and lower back.

Researchers say these preliminary results could have ramifications for companies with a high prevalence of overweight workers with musculoskeletal problems — particularly in industries that require manual or repetitive weight-bearing labor.

"From an ergonomics perspective, we can only do so much to alter the work environment to remove body stressors," explains Kotowski. "Excess weight adds additional stress to the musculoskeletal system and that can only be relieved through weight loss."

 Researchers watched two groups of mice, both nearing the end of a two-day fast. One group was quietly huddled together, but the other group was active and alert. The difference? The second set of mice had been engineered so their brains produced more SIRT1, a protein known to play a role in aging and longevity.

"This result surprised us," says the study's senior author Shin-ichiro Imai, MD, PhD, an expert in aging research at Washington University School of Medicine in St. Louis. "It demonstrates that SIRT1 in the brain is tied into a mechanism that allows animals to survive when food is scarce. And this might be involved with the lifespan-increasing effect of low-calorie diets."

Imai explains that the mice with increased brain SIRT1 have internal mechanisms that make them use energy more efficiently, which helps them move around in search of food even after a long fast. This increased energy-efficiency could help delay aging and extend lifespan.

The research findings are published in the July 28 issue of the Journal of Neuroscience.

Imai's past research demonstrated that SIRT1 is at the center of a network that connects metabolism and aging. A form of the gene is found in every organism on earth. The gene coordinates metabolic reactions throughout the body and manages the body's response to nutrition. SIRT1 is activated under low-calorie conditions, which have been shown to extend the life spans of laboratory animals.

The researchers found that the key to the mice's extra activity lies in a small region of the brain called the hypothalamus, which controls basic life functions such as hunger, body temperature, stress response and sleep-wake cycles.

At the start of the research project, the study's lead author Akiko Satoh, PhD, a postdoctoral research associate in developmental biology, saw that mice on low-calorie diets had increased amounts of SIRT1 in specific regions of the hypothalamus and that neurons in the same regions were activated.

So the research team developed mice that continually produced higher amounts of SIRT1 in their brains to see what the effect would be. That's when Satoh observed the mice's unusual level of activity under fasting conditions.

"This is the first time that it has been demonstrated that SIRT1 is a central mediator for behavior adaptation to low-calorie conditions," Satoh says.

Interestingly, these mice, called BRASTO (brain-specific SIRT1-overexpressing) mice, also maintained higher body temperatures after a 48-hour fast than ordinary mice, which experience a drop in body temperature during fasting.

"The BRASTO mice have a better capability to come up with energy to achieve a higher body temperature and increased activity level when food is restricted," says Imai, associate professor of developmental biology and of medicine.

The team also examined mice that had no ability to produce SIRT1 in their brains. During diet-restricting conditions, these mice did not increase their activity, and their body temperature dropped more than normal, giving further evidence that SIRT1 was essential for high-activity, high-temperature responses.

As the researchers looked further into the role of SIRT1 in the hypothalamus, they found that during diet restriction, SIRT1 enhanced the production of a specific neural receptor in the hypothalamus involved in regulating metabolic rate, food intake and insulin sensitivity. Furthermore, mice with increased brain SIRT1 had a higher neural response to the gut hormone, ghrelin, which is known to stimulate the hypothalamus during low-calorie conditions. Both findings add weight to a significant role for SIRT1 in the hypothalamic response to a restricted diet.

The scientists are continuing to study the BRASTO mice to see if they live longer than ordinary mice.

Their work suggests that the brain, and particularly the hypothalamus, might play a dominant role in governing the pace of aging. They believe their studies could eventually provide clues for increasing productive aging in people.

"If we can enhance the function of the human hypothalamus by manipulating SIRT1, we could potentially overcome some health problems associated with aging," Imai says. "One example is anorexia of aging in which elderly people lose the drive to eat. It is possible that enhancing SIRT1 could alleviate behavioral problems like this."

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Journal Reference:

1. Satoh A, Brace CS, Ben-Josef G, West T, Wozniak DF, Holtzman DM, Herzog ED, Imai S. SIRT1 promotes the central adaptive response to diet restriction through activation of the dorsomedial and lateral nuclei of the hypothalamus. Journal of Neuroscience, July 28, 2010

An experimental compound appears to improve metabolic abnormalities associated with obesity, according to a preliminary study led by researchers at the National Institutes of Health.

A report of the study, which was conducted with obese mice, appears online in the Journal of Clinical Investigation.

"This is a promising early step toward a treatment for some of the serious health consequences of obesity," says Kenneth R. Warren, Ph.D., acting director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the NIH.

"Our results suggest that this compound could perhaps provide clinical benefits for obese individuals without the liabilities seen thus far with similar compounds," adds senior author and NIAAA Scientific Director, George Kunos, M.D., Ph.D.

Previous studies have shown that similar compounds block the activity of endocannabinoids, natural messengers in the body that are chemically similar to the active compound in marijuana, and help regulate many biological functions. These compounds can help promote weight loss and improve metabolic complications of obesity, such as diabetes and insulin resistance, changes in blood lipid composition, and fatty liver. However, the clinical advancement of such compounds has been stymied by behavioral side effects associated with their use, such as anxiety, depression and suicidal thoughts.

Dr. Kunos and first author Joseph Tam, D.D.S., Ph.D., of the NIAAA Laboratory of Physiologic Studies, collaborated with a team of scientists within and outside NIH to investigate a compound designed to avoid those side effects while preserving the beneficial effects of blocking endocannabinoid activity.

"Endocannabinoid receptors are present in the brain, as well as in peripheral tissues including the liver, skeletal muscles, pancreas, and fatty tissues," explained Dr. Kunos. "Activation of peripheral endocannabinoid receptors contributes to obesity-related metabolic and hormonal abnormalities."

The researchers reasoned that a compound that is unable to penetrate into the brain would selectively block the activity of endocannabinoid receptors in peripheral tissues, and therefore might alleviate metabolic and hormonal problems related to obesity. All while avoiding the behavioral problems that result from blocking endocannabinoid receptors in the brain.

They developed such a compound, tested it in obese mice, and found that the mice showed improvements in glucose regulation, fatty liver, and plasma lipid profiles. They also found that the compound did not affect behavioral responses, such as cannabinoid-induced immobility and hypothermia, that are mediated by endocannabinoid receptors in the brain, and that it reduced weight in mice with diet-induced obesity by about 12 percent, but did not affect weight in mice with a genetic predisposition for obesity.

"These preliminary findings are very encouraging and warrant further testing of this compound as a potential pharmacotherapy for the metabolic syndrome associated with obesity," said Dr. Tam.

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Journal References:

1. Joseph Tam, V. Kiran Vemuri, Jie Liu, Sándor Bátkai, Bani Mukhopadhyay, Grzegorz Godlewski, Douglas Osei-Hyiaman, Shinobu Ohnuma, Suresh V. Ambudkar, James Pickel, Alexandros Makriyannis and George Kunos. Peripheral CB1 cannabinoid receptor blockade improves cardiometabolic risk in mouse models of obesity. Journal of Clinical Investigation, 2010; DOI: 10.1172/JCI42551
2. Mary-Elizabeth Patti. Rehashing endocannabinoid antagonists: can we selectively target the periphery to safely treat obesity and type 2 diabetes?Journal of Clinical Investigation, 2010; DOI: 10.1172/JCI44099

Obese people support lifestyle-change interventions, rather than those that purely promote weight loss. Researchers writing in BioMed Central's open access journal BMC Public Health interviewed 142 obese people about their opinions on interventions ranging from gastric bands to legal regulation, finding that non-commercial, non-stigmatizing techniques were preferred.

Dr Samantha Thomas, from Monash University, Melbourne, Australia, worked with a team of researchers to conduct the semi-structured telephone interviews. She said, "This study provides a number of new insights into how and why obese individuals support and uptake different interventions. Importantly, participants supported public health interventions which they perceived were non-judgmental, non-stigmatizing and empowered individuals to improve their lifestyles rather than focusing on weight loss per se. Participants in this study were less likely to view interventions as effective if they thought they were stigmatizing, or blamed and shamed individuals for being overweight."

The researchers asked people how they felt about government regulation, large-scale public health initiatives, media campaigns, personalised fitness programmes, gastric banding surgery and commercial diet groups. None of the interventions were supported by more than two thirds of the participants. Commercial dieting and media campaigns were perceived particularly badly, particularly the use of 'scare tactics' to encourage weight loss.

The dieting industry was seen as "greedy," "a scam" and "a rip-off" but, according to Thomas, "Ironically, many participants still said that they would turn to commercial dieting to help lose weight and improve their health. This was because they had very little other support available to them. There is a need for greater attention to be dedicated to interventions that support and empower individuals to improve their lifestyle. At the individual level, personalised care planning and long term support systems must be developed to assist obese individuals. At the population level, anti-stigma campaigns and regulation should both be explored."

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Journal Reference:

1. Samantha L Thomas, Sophie Lewis, Jim Hyde, David Castle and Paul Komesaroff. The solution needs to be complex". Obese adults' attitudes about the effectiveness of individual and population based interventions for obesity. BMC Public Health, 2010; (in press)

The more an older woman weighs, the worse her memory, according to new research from Northwestern Medicine. The effect is more pronounced in women who carry excess weight around their hips, known as pear shapes, than women who carry it around their waists, called apple shapes.

The study of 8,745 cognitively normal, post-menopausal women ages 65 to 79 from the Women's Health Initiative hormone trials is the first in the United States to link obesity to poorer memory and brain function in women and to identify the body-shape connection.

"The message is obesity and a higher Body Mass Index (BMI) are not good for your cognition and your memory," said lead author Diana Kerwin, M.D., an assistant professor of medicine and a physician at Northwestern Medicine. "While the women's scores were still in the normal range, the added weight definitely had a detrimental effect."

For every one-point increase in a woman's BMI, her memory score dropped by one point. The women were scored on a 100-point memory test, called the Modified Mini-Mental Status Examination. The study controlled for such variables as diabetes, heart disease and stroke.

The study will be published July 14 in the Journal of the American Geriatric Society.

The reason pear-shaped women experienced more memory and brain function deterioration than apple-shaped women is likely related to the type of fat deposited around the hips versus the waist.

"Obesity is bad, but its effects are worse depending on where the fat is located," Kerwin said.

Cytokines, hormones released by the predominant kind of fat in the body that can cause inflammation, likely affect cognition, Kerwin said. Scientists already know different kinds of fat release different cytokines and have different effects on insulin resistance, lipids and blood pressure.

"We need to find out if one kind of fat is more detrimental than the other, and how it affects brain function," she said. "The fat may contribute to the formation of plaques associated with Alzheimer's disease or a restricted blood flow to the brain."

In the meantime, the new findings provide guidance to physicians with overweight, older female patients.

"The study tells us if we have a woman in our office, and we know from her waist-to-hip ratio that she's carrying excess fat on her hips, we might be more aggressive with weight loss," Kerwin said. "We can't change where your fat is located, but having less of it is better."

Kerwin's research is funded by the T. Franklin Williams Award from Atlantic Philanthropies and Association of Specialty Professors and the Wisconsin Women's Health Foundation Faculty Scholar Award. The Women's Health Initiative was funded by a grant from the National Heart, Lung and Blood Institute.

— Women who attend programmes with ongoing support about healthy eating are less likely to gain weight and be more physically active than women who receive a one-off information session on dietary guidelines, finds an Australian study published online in the British Medical Journal.

Health problems related to obesity are major issues in developed countries. In Australia 60% of adults are overweight or obese. The World Health Organisation has recommended that weight management initiatives should include efforts to try and help adults from gaining weight, even if they are in an acceptable range.

The study investigated whether women who attended the HeLP-her community lifestyle programme gained more or less weight than women who attended a single thirty minute group lecture about the benefits of following dietary and physical activity guidelines.

Women of reproductive age are an important target group, says the study, as they are prone to weight gain and they also have a strong influence on what their partners and children eat.

Two hundred and fifty adult women with an average age of 40 took part in the research, led by Professor Helena Teede from the Jean Hailes Foundation Research Group at Monash University in Melbourne. Women within the healthy weight range were included as well as overweight and obese women.

One group (intervention) of 127 women attended the HeLP-her programme. This consisted of four one hour group sessions of 10-30 participants at a local primary school. The women were weighed, measured and completed questionnaires. Simple messages about food intake and physical activity were discussed, as were behavioural strategies such as problem solving, relapse prevention, self monitoring and personal goals. Follow-up support included regular personalised text messages. Participants returned after 12 months and were weighed and measured again.

The other group (control) consisted of 123 women who attended a lecture about healthy eating and the benefits of physical activity. No individual advice was given but participants were weighed and measured. The women were given a pedometer to use if they wanted to but were not set any personal goals. The participants were measured again 12 months later.

The results show that on average the control group gained 0.83kg (nearly 2 pounds) and this was not seen in the intervention group. Participants in the control group who were less than 40 with a healthy body mass index gained the most weight (1.72kg or over 3.5 pounds). In contrast, young participants in the intervention group lost around 0.27kg (half a pound).

After 12 months, the intervention group reported more vigorous physical activity than the control group. This group also had better results for tests linked to heart disease, such as cholesterol levels.

In conclusion, the researchers say: "Our findings suggest that excess weight gain in women may be prevented by using a low intensity community based programme that promotes self management and includes personal contact with ongoing remote support."

They add: "The HeLP-her intervention potentially bridges the gap between intensive treatment programmes and broad population health strategies."