How to lose weight

Many people resolve to go on a diet and adopt a healthier lifestyle, only to give up a few weeks later. Good intentions are often hard to put into practice and sustain. Here are a few suggestions to help you move towards and maintain a healthier weight:

1. Be realistic

Many people set themselves goals they find hard to achieve, such as fitting into a size 8 dress or a dinner jacket from 25 years ago. It is far better to begin by aiming to reduce your weight by 5 to 10 percent of your current weight. This may not turn you into a glamour model in a hurry, but it can lead to important improvements in weight-related conditions such as high blood pressure and diabetes. Once you have achieved this goal, you can always continue and aim to lose another 5 to 10 per cent until you are happy with your weight. Breaking the target down into manageable stages increases your chance of success.

2. Be gentle on yourself

Crash diets may work in the short-term but typically people regain all the weight they have lost and even add some more. Crash diets can also be dangerous. Not only this, but it is usually miserable being on a diet. Depriving yourself of food and feeling hungry sets up cravings which can lead to binge-eating followed by feelings of guilt. Neither deprivation nor hunger are necessary to lose weight if you are willing to take time and do the right things. If you cut out just 100 calories per day, the equivalent of a single can of fizzy drink or a bedtime snack, you could lose about 10 lb (4.5 kg) in a year. If you also added a brisk walk for half an hour a day five days per week, the weight loss could increase to 20 lb (9 Kg) in a year.

3. Keep moving

Next to not smoking, regular physical activity is arguably the best thing you can do for your health. It lowers the risk of heart disease, diabetes, stroke, high blood pressure, osteoporosis, and certain cancers, and can help to control stress and boost mood. Contrary to popular belief, the evidence for a simple relationship between physical activity and weight loss is equivocal, with some studies showing that exercise helps and others suggesting that it does not, possibly due to complex interactions between physical activity, diet and genes. If moderate to vigorous over an extended period, physical activity can help to maintain a healthy weight, provided you do not compensate by eating more as a self-reward. You would have to walk for 98 minutes to burn off the calories in one Mars Bar or swim for 45 minutes to burn off one slice of a pepperoni pizza, for example. For general health, any amount of exercise is better than none. The more you do, though, the better. This does not have to mean joining a gym or jogging. Many activities count as exercise: dancing, skating, gardening, cycling, scrubbing floors, washing the car by hand, or playing with children. Incorporate activity into your day by taking the stairs rather than the escalator, getting off the bus one stop before your destination and walking the rest, cycling to do errands rather than taking the car, and cutting back on watching television, playing computer games and other sedentary activities. Start slowly and gradually build up to more vigorous activity when your fitness increases.

4. Keep track

Many of us eat without thinking and have no idea how much we have consumed. Such lack of awareness can result in us eating and drinking more than we plan to. Try keeping a daily food diary for a while. List everything that you eat or drink, no matter how insignificant it seems. The calories can really add up, even just with drinks – one can of Coca Cola contains 142 calories, for example.

5. Eat food as nature intended

Research shows that people who eat at fast-food restaurants more than twice a week are more likely to gain weight and show early signs of diabetes than those who only occasionally eat fast food.

Our bodies were designed to consume food in the form that nature provides, with nothing added and nothing taken away.

Vegetables, fruit, nuts, seeds and whole grains all contain protein, carbohydrates, essential fats, vitamins, minerals and fibre. Fibre makes the food bulkier and less nutrient dense than highly processed food. This means that you have to eat a greater quantity of unprocessed food, like vegetables, to obtain the same amount of calories as highly processed foods, such as ice cream.

In the stomach and the gut, there are stretch receptors and nutrient receptors which signal to the body that it has enough food and to stop eating. If you eat highly processed foods, which are rich in calories but poor in vitamins, minerals and essential fats, such as white sugar and white bread, your body’s mechanism for signaling that it is full does not work properly – the gut is neither fully stretched nor receives the nutrients the body needs – so you carry on eating. This increases the chance of you consuming too many calories and becoming overweight, whilst not obtaining enough vitamins, minerals and essential fats.

The more unprocessed foods, like whole grains, vegetables, nuts and seeds, you include in your diet, the easier it is for your body to obtain the nutrients it needs without over-eating. Even if all you do is have porridge for breakfast instead of eating a sugary cereal or drinking strong coffee, you will find it easier to lose weight.

6. Keep your blood sugar stable

Another advantage of a food like porridge is that it has a gentle effect on blood sugar, or what’s called a low glycaemic index. When you eat porridge, glucose is released slowly and steadily into the bloodstream which helps to maintain energy levels over a longer period of time. This reduces hunger and cravings, so you tend to eat less. Other examples include whole grains such as brown rice (especially basmati), quinoa and whole-grain breads and pasta, as well as beans, nuts, fruits, and vegetables.

Eating foods that make your blood sugar and insulin levels shoot up and then crash may contribute to weight gain. Insulin tells the body to store surplus glucose as fat, so constantly excessive levels of glucose and insulin in the blood lead to weight gain. Such foods include white bread, white rice, and other highly processed grain products. So this is another good reason to increase the amount of unprocessed whole foods in your diet and reduce the amount of processed foods rich in calories.

7. Do not be afraid of good fats

Fat in a meal or in snacks such as nuts gives the food taste and helps you to feel full. Good fats, such as olive oil, have many benefits for health, including helping to improve your cholesterol levels when you eat them in place of saturated or trans fats or highly processed carbohydrates, like sugar and white flour products.

8. Drink water rather than fizzy drinks

Drinking juice or cans of sugary drinks can give you several hundred calories a day without even realising it. Several studies show that children and adults who consume sugar-sweetened beverages are more likely to gain weight than those who don’t, and that switching from these to water can reduce weight.

Using artificial sweeteners in soft drinks instead of sugar or high-fructose corn syrup seems like it would sidestep any problems with weight or diabetes. Artificial sweeteners deliver zero carbohydrates, fat, and protein, so they can’t directly influence calorie intake or blood sugar. Over the short term, switching from sugar-sweetened soft drinks to diet drinks cuts calories and leads to weight loss. Long-term use, though, may be a different story.

Some long-term studies show that regular consumption of artificially sweetened beverages reduces the intake of calories and promotes weight loss or maintenance. Others show no effect, while some show weight gain.

One concern about artificial sweeteners is that they uncouple sweetness and energy. Until recently, sweet taste meant sugar, and thus energy. Glucose is critical for the human brain to function, so the body has delicate feedback mechanisms involving the brain, stomach, nerves and hormones, to ensure that there is always a steady supply. When we eat something sweet, the human brain responds with signals – first with signals to eat more, and then with signals to slow down and stop eating. By providing a sweet taste without any calories, artificial sweeteners could confuse these intricate feedback loops. This could potentially throw off the body’s ability accurately to gauge how many calories are being taken in. Studies in rats support this idea. Researchers at Purdue University have shown that rats eating food sweetened with saccharin took in more calories and gained more weight than rats fed sugar-sweetened food. In addition, a long-term study of nearly 3,700 residents of San Antonio, Texas, showed that those who averaged three or more artificially sweetened beverages a day were more likely to have gained weight over an eight-year period than those who didn’t drink artificially sweetened beverages. At present, research findings are mixed, but there is a possibility that diet drinks may lead to weight gain in the longer term.

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References

Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. National Institutes of Health, National Heart, Lung, and Blood Institute, Obesity Education Initiative

Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007; 39:1423–34

Pronk NP, Wing RR. Physical activity and long-term maintenance of weight loss. Obes Res. 1994 Nov;2(6):587-99

Fogelhom M, Kukkonen-Harjula K. Does physical activity prevent weight gain – a systematic review Obesity Reviews, Volume 1, Issue 2, 95–111, October 2000

Pereira MA, Kartashov AI, Ebbeling CB, et al. Fast–food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis. Lancet. 2005; 365:36–42

Bellisle F, Drewnowski A. Intense sweeteners, energy intake and the control of body weight. European Journal of Clinical Nutrition. 2007; 61:691-700

Swithers SE, Davidson TL. A role for sweet taste: calorie predictive relations in energy regulation by rats. Behavioral Neuroscience. 2008; 122:161-173

Fowler SP, Williams K, Resendez RG, Hunt KJ, Hazuda HP, Stern MP. Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain. Obesity (Silver Spring). 2008; 16:1894-1900

Frank GK, Oberndorfer TA, Simmons AN, et al. Sucrose activates human taste pathways differently from artificial sweetener. Neuroimage. 2008; 39:1559-1569

Willett, W. Eat, drink and be healthy. Harvard Medical School Guide to Healthy Eating. The Free Press; Free Press Trade Pbk. Ed edition (April 2005). ISBN: 978-0743266420.

Lisle D, Goldhamer A. The Pleasure Trap – Mastering the Hidden Force that Undermines Health and Happiness.  Healthy Living Publications, 30 March 2006

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Life expectancy continues to increase

Harry Patch lived to 111 years old

A recent paper by Professor David Leon, an epidemiologist at the London School of Hygiene and Tropical Medicine, in the International Journal of Epidemiology reports that Western Europeans are living longer than ever before despite concerns about obesity and health problems.  Average life expectancy in Western Europe is now six to eight years higher than in the 1970s.

The report used mortality data from the WHO Health for All Database and the Human Mortality Database, and its findings are likely to be reliable.

Data from 2007 indicate that average life expectancy for the UK was 80 years (for males 77.9 and women, 82), compared with 78 in the US.

The report also discusses life expectancy in Eastern Europe.  Between 1970 and the end of the 1980s, life expectancy in eastern European countries stagnated or declined, but after the fall of the Berlin Wall in 1989, life expectancy started to rapidly rise in the countries of the CEE (Czech Republic, Hungary, Poland and Slovakia).  This rise is still continuing but on a “parallel trajectory to Western Europe” that makes it difficult to close the gap between east and west.

Russia and the Baltic states have seen a decline in life expectancy that is only recently being reversed.  Russia in particular has had some dramatic fluctuations in recent years – its life expectancy in 2008 was just 68 years (men 61.8 and women 74.2) – the same age as 40 years previously.  Prior to this, Russia also saw a sharp decline in life expectancy between 1990 and 1994, when male life expectancy fell by six years to a low of 57 years.

The report discusses the possible causes of the trends in different countries.

The decline in cardiovascular disease is seen as an important contributor to the rise in life expectancy in Western Europe. According to the author,

Deaths from cardiovascular disease in the UK have seen some of the largest and most rapid falls of any Western European country, partly due to improvements in treatment as well as reductions in smoking and other risk factors.

The fact that US life expectancy lags behind the UK, he says, underlines that

GDP and health care expenditure per capita are not good predictors of population health within high income countries.

The rises in life expectancy seen in central Europe since the collapse of the Berlin Wall in 1989 reportedly illustrate that mortality can fluctuate rapidly in response to social, political and economic change.

The study’s author believes that the dramatic fluctuations in life expectancy in Russia are associated with the “stress and chaos” after the collapse of communism, as well as high rates of alcoholism. The recent upward trend in life expectancy in Russia and the Baltic states is probably due to recent reductions in alcohol-related deaths, rather than overall health improvements.

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Long term health is affected by maternal nutrition

This month, the British Medical Association (BMA) Board of Science has published a report on Early Life Nutrition and Lifelong Health.  The report reviews the evidence that the diets of women of reproductive age, and those of their foetuses and young children, are significant factors in influencing the risk of chronic diseases such as heart disease, diabetes, obesity, brittle bone disease and even some forms of cancer and mental illness, later in those children’s lives.

Lead author Professor Mark Hanson, director of the Centre for the Developmental Origins of Health and Disease at the University of Southampton, comments:

“Society and public health organisations need to pay much greater attention to these issues if the rising epidemic of these diseases is to be prevented. Tackling the diseases once children reach adulthood is often too late. By taking steps to improve maternal nutrition we could save many people from a lifetime of ill health.”

obese-kids1

Unbalanced nutrition can result from both inadequate and excessive dietary intakes, and both can exist at the same time in many populations. Moreover diets which lead to over-nutrition (e.g., excess calories) are often micronutrient poor.

There is strong evidence that undernutrition (stunting or wasting) during the first two years of life leads to impaired adult cognitive, physical and economic capacity, which cannot be repaired even if nutrition improves later in childhood.

Improved availability of energy-rich foods has however, enabled large numbers of people to escape from hunger. This has brought considerable benefits, but is already giving rise to obesity and obesity-related disease. Developing countries are reporting high rates of coronary heart disease (CHD) and type 2 diabetes that have appeared in one or two generations to become leading causes of morbidity and mortality. These epidemics are expected to intensify.  By the year 2030, the prevalence of diabetes is predicted to rise by over 100 per cent in India, China, sub-Saharan Africa, Latin America, the Caribbean and the Middle East; an increase far exceeding that in high-income countries (54%).

There is good evidence that an increased deposition of fat tissue in foetuses and babies is an outcome of both undernutrition and excessive nutrition.  Low birth weight babies born to underweight women in India have proportionately more fat than would be expected for their body weight.  Maternal obesity, another form of maternal malnutrition, also increases the fat tissue of the foetus and newborn baby. This phenomenon is exacerbated further if maternal obesity is complicated by gestational diabetes.

Extremes of maternal body composition, either excessive thinness or obesity, are associated with adverse patterns of foetal and infant development leading to poorer long-term health.

“It’s not only women who need to be careful about the quality of their food intake. Prospective fathers should also eat well and steps need to be taken to ensure that young people understand the importance of good nutrition as part of their lifestyle choices.”

The numbers of women who breastfeed their infants is still too low, with many women starting to breastfeed but then stopping too soon, and many infants being fed inappropriate foods at the weaning stage.  Breastfeeding rates in the UK are much lower than in many European countries. Less than1 per cent of mothers in the UK are exclusively breastfeeding at six months.

breastfeeding1

While there are gaps in the evidence about the long-term consequences of poor maternal and infant nutrition, and we do not as yet understand the mechanisms fully, it is clear that steps need to be taken to promote healthy diets in young women and their families, to encourage breastfeeding and the use of appropriate complementary foods.

More advice could be given to people with young children about the importance of a balanced diet for those children and more support could be given to women to help them start breastfeeding and to continue with it.

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