Best ways to achieve weight loss - DW interview

Dr. Carsten Lekutat presents the DW health program and although not as famous as Dr. Oz he does a better job selecting experts for interview and sharing evidence-based information. In this video, the director of the German Institute for Human Nutrition, Dr. Hans-Georg Joost, speaks about being overweight, the risks of dieting, and what you should know about belly fat.



Deutsche Welle (DW) is Germany's international broadcaster. The service is aimed at the overseas market. It broadcasts news and information on shortwave, Internet and satellite radio in 30 languages.

References:

In Good Shape program - DW http://buff.ly/1igxuzV

Comments from Twitter:

Heidi Allen @dreamingspires: Great interview

Unintentional Weight Loss in Older Adults - 2014 review of Am Fam Physician

Unintentional weight loss in persons older than 65 years is associated with increased morbidity and mortality.

What are the causes?

The most common etiologies are:

- malignancy
- nonmalignant gastrointestinal (GI) disease
- psychiatric conditions

Overall, nonmalignant diseases are more common causes of unintentional weight loss in this population than malignancy.

Medication use and polypharmacy can interfere with taste or cause nausea and should not be overlooked. Social factors may contribute to unintentional weight loss.

A readily identifiable cause is not found in 16% to 28% of cases.

What tests may be done?

Recommended tests include a complete blood count, basic metabolic panel, liver function tests, thyroid function tests, C-reactive protein levels, erythrocyte sedimentation rate, glucose measurement, lactate dehydrogenase measurement, and urinalysis.

Chest radiography and fecal occult blood testing should be performed. Abdominal ultrasonography may also be considered.

When baseline evaluation is unremarkable, a three- to six-month observation period is justified.

What are the treatment options?

Treatment focuses on the underlying cause. Nutritional supplements and flavor enhancers, and dietary modification that takes into account patient preferences and chewing or swallowing disabilities may be considered. Appetite stimulants may increase weight but have serious adverse effects and no evidence of decreased mortality.

References:

Unintentional Weight Loss in Older Adults. Gaddey HL1, Holder K2. Am Fam Physician. 2014 May 1;89(9):718-722.
http://www.ncbi.nlm.nih.gov/pubmed/24784334

Image source: Wikipedia, public domain.

Nonsurgical Weight Loss with a Liquid Meal Program - Mayo Clinic Video

"Surgery may be an option for some people, but for those who don't want surgery or can't have it for medical reasons, there is another option. Doctors at Mayo Clinic developed a liquid meal program geared toward people who need to lose a lot of weight."

Childhood diabetes associated with increasing birth weight - 7% increase in risk for every 1000 g in weight

Childhood onset diabetes is associated with increasing birth weight, equivalent to a 7% increase in risk for every 1000 g in weight.

Caesarean section increases the risk by around 20%.

The risk of childhood onset diabetes increases with maternal age: 5% for each five years of age.

References:
Maternal age and diabetes in childhood. BMJ 2010;340:c623.

Image source: Wikipedia, GNU Free Documentation License.

18% tax on pizza and soda can decrease U.S. adults' weight by 5 pounds (2 kg) per year

Nearly a third of American children are overweight or obese. In our inner cities a prevalence of obesity of more than 50% is not uncommon. Too many calories in, too little energy out.

With two-thirds of Americans either overweight or obese, policymakers are increasingly looking at taxing as a way to address obesity on a population level.

The tobacco experience showed that education is not enough: regulation, litigation, and legislation are needed too. Increasing taxes on cigarettes has been the single most effective strategy in reducing smoking.

An important part of the obesity story is clearly the huge increase in consumption of sugar sweetened beverages (SSBs): carbonated sodas, sweet teas, energy drinks, flavoured water, and sports drinks. Their use has more than doubled in recent years.

"Sadly, we are currently subsidizing the wrong things including the product of corn, which makes the corn syrup in sweetened beverages so inexpensive."

Instead, the agricultural subsidies should be used to make healthful foods such as locally grown vegetables, fruits and whole grains less expensive.

Danish government imposed 25% tax on ice cream, chocolate, sweets, and will increase taxes on soft drinks, tobacco, alcohols to combat obesity, heart disease, and other illnesses. BMJ. http://goo.gl/ixc0

 Some pizzas are 'saltier than the sea' (NHS blog).

References:
Tax soda, pizza to cut obesity, researchers say | Reuters.

The case of the sugar sweetened beverage tax. BMJ 2010;341:c3719.

Image source: Soft drinks, Wikipedia, public domain.

30 minutes is not enough - middle-aged need full hour of exercise to avoid gaining weight as they age

Prticipation in sport is associated with a with a 20—40% reduction in all-cause mortality compared with non-participation. Exercise might also be considered as a fifth vital sign, according to the Lancet: http://goo.gl/gyxYf

Middle-aged women need to get at least an hour a day of moderate exercise if they hope to ward off the creep of extra pounds that comes with aging.

According to JAMA, among women consuming a usual diet, physical activity was associated with less weight gain only among women whose BMI was lower than 25. Women successful in maintaining normal weight and gaining fewer than 2.3 kg over 13 years averaged approximately 60 minutes a day of moderate-intensity activity throughout the study.

Already, two-thirds of U.S. adults and nearly one in three children are overweight or obese.

Sheila Anderson, 50, works out at the fitness center three to four times a week, doing 45 minutes of cardiovascular training and a couple of hours a week of weight training.

"Does it strike me as too much?" she said of the finding. "Maybe. It sure is hard to fit in an hour each day. I could not come to the gym seven days a week," she said.

One hour per day of exercise is difficult to achieve. However, even 30 minutes is better than no exercise at all.



Dr. Michael Roizen, Cleveland Clinic Chief Wellness Officer, answers the question "How much exercise is enough?"

Three parts of exercise have been shown to be beneficial to health:

1. Moving the equivalent to 10,000 steps a day.
2. Resistance exercise for 30 minutes a week.
3. 20 minutes of cardiovascular exercise.

References:

Hour of exercise may be too much for busy U.S. women | Reuters.

JAMA 2010;303[12]:1173-1179

Innovative Weight Loss Surgery at Cleveland Clinic

Innovative Weight Loss Surgery at Cleveland Clinic: The new method reduces stomach volume by 2/3 without removing any part of the stomach. A major difference between this procedure and others is that it may potentially be reversible.

New schizophrenia drug lurasidone (Latuda) does not cause significant weight gain

Lurasidone (Latuda) was approved for the treatment of schizophrenia in adults in October 2010. Lurasidone acts as a D2, 5-HT2A, 5-HT7, and α2C-adrenergic receptor antagonist, and 5-HT1A receptor agonist.

Once-daily lurasidone did not cause significant weight gain, a common side effect of other schizophrenia drugs. Possible treatment side effects do include drowsiness, agitation, tremors, and nausea.

Lurasidone will carry a boxed warning - required of all atypical antipsychotics - about the increased risk for stroke and death when used off-label to treat dementia-related psychosis in older patients.

Other severe but rare side effects include neuroleptic malignant syndrome and tardive dyskinesia.

References:
New Schizophrenia Drug Approved. Journal Watch.

Image source: Lurasidone, Wikipedia, public domain.

Weight lifters turning to human growth hormone - and that's just the tip of the iceberg

From WebMD and the American Journal on Addictions:

In the study of 230 male weight lifters aged 18 to 40:

- 12% reported use of human growth hormone (HGH) or a similar supplement known as insulin-like growth factor-1

- all weight lifters reported use of anabolic steroids

- 56% percent had a current or past dependence on opioids, cocaine, and/or Ecstasy

HGH was prohibitively expensive in the 1990s, but now pills, powders, and injections can be purchased at low cost on the Internet.

Weight lifters who already take steroids add HGH as a "turbo boost". “You can always tell which elite athletes are on HGH because their bones are growing at a faster rate and their faces look distorted.”

References:
Weight Lifters Turning to Human Growth Hormone. WebMD.

Image source: OpenClipart, public domain