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Words from the weight-wise

Posted - Sep. 9, 2004 at 9:40 a.m.



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Sep 09, 2004 (United Press International via COMTEX) -- UPI surveyed 84 specialists for a 15-part series weighing in on the causes, consequences and costs of a global gain in girth and measures to curtail the corpulence. Part 13 sizzles with dietary suggestions.

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SAN FRANCISCO (UPI) -- As with any good recipe, the one for weight management should start from scratch, suit individual tastes and retain its flavor. The final proof is in the longevity pudding.

"Anyone can lose weight by restricting calorie intake and increasing physical activity, but only about 5 percent can keep the weight off," said Joanne Ikeda, a nutrition specialist at the University of California, Berkeley.

Though far from easy as pie, sustaining the slimmed silhouette is not an impossibly tall order, as members of The National Weight Control Registry can attest. The research study, developed by scientists from Brown University, the University of Pittsburgh and the University of Colorado, has identified more than 4,000 men and women who have diminished and contained their obesity.

"Some characteristics of successful losers and maintainers (in the registry): persistence, exercise regularly, eat a low-fat diet, avoid quick fixes/pills, weigh yourself regularly," said Dr. Lawrence Cheskin, director of the Johns Hopkins Weight Management Center in Baltimore.

The trick is to pick a pragmatic, personalized plan that remains enduringly palatable.

"In general ... I don't think there is any 'one size fits all' or quick-fix diet plan," said Leon Rappoport, emeritus professor of psychology at Kansas State University in Manhattan. "Our diets should vary depending upon our activity levels, our individual metabolism and digestive systems (and) we learn, or should learn, by trial and error, if nothing else, what the most suitable eating practices are for ourselves."

To slice through some of the uncertainty, many experts advocate cutting a customized course to weight control, preferably with the assistance of a doctor, nutritionist and/or registered dietitian, in particular for the severely overweight.

"Plans that are specifically tailored to an individual's needs and schedule would probably be the best method," suggested Linda Dong, a UC Berkeley graduate in epidemiology now at the University of Washington in Seattle.

Experts warn against dieting too early -- studies show potentially serious health and weight consequences in women who began before age 14 -- but they stress it is never too late to start.

In one study, of 4,087 men and women ages 70 and older, University of Michigan researchers found weight-conscious seniors enjoyed more active, independent lifestyles than their obese counterparts, who had far greater trouble dressing, bathing, eating and getting out of bed and were twice as likely to develop problems with strength (including rising from a chair) and lower-body mobility (including walking and climbing stairs).

"You're never too old to enjoy the benefits of a healthy weight," said Kristi Rahrig Jenkins, author of the report, published in the April issue of The Gerontologist.

You may, however, be too lonely. Researchers from Aston University in Birmingham, England, found women who whittled weight by themselves experienced higher stress levels and lower cognitive skills than those who took on the excess pounds in a group.

"Given that some weight-loss strategies are more successful than others, and that some types of diet cause increased depression, low self-esteem and impairments in mental performance, it's obviously very important to try and find weight-loss strategies that avoid these negative consequences," said lead author Dr. Mike Green.

The uphill struggle to downsize takes on particularly challenging proportions for those caught up in a speed-seduced society, whose harried pace has converted convenience foods into a culinary cornerstone.

"Lifestyle change requires people to be ready to change and to have the social and psychological support to be able to make those changes in the face of environmental temptations," said Sylvia Moore, director of medical education and public health at the University of Wyoming in Laramie.

Resisting the tasty temptations that beckon from frozen-food packages and take-out-meal display panels may require a re-adjustment in personal behavior and a turn in public thinking.

Rappoport suggests self-awareness-boosting practices, such as yoga and meditation, to beef up defenses in a culture plumped with weight-boosting traps that outlaw restraint and outmode mobility.

"We have to shift the focus from weight to health and a healthy-body image," Moore said.

Although many women no longer subscribe to a universal notion of what constitutes physical beauty, most continue to view a thin body type as the epitome of attractiveness, University of Arizona sociologists observed in a study of volunteers ages 22 to 35.

Even the Hispanic and African-American participants -- traditionally thought to appreciate a more voluptuous figure -- complained of their weight as a spoiler of their appearance, said lead author Louise Roth, assistant professor of sociology.

"Distorted body image and past dieting failures take their toll," Moore remarked. "Women, especially, have come to believe in an unrealistic standard for body size, but men are beginning to fall victims to the advertised image of the lean, highly muscled 'hard body.'"

Extravagant expectations and grandiose goals can knock the stuffing out of a diet plan.

"We all want a quick fix and instant results," Dong said. "I think it may be difficult to achieve a healthy weight because many people become discouraged with the little progress they make."

Selecting a diet that will remain appetizing becomes a matter of personal taste.

"There are many versions of healthy diets, but all should include more fruits and vegetables, whole-grain cereal products, oils from plants or fish and protein from lean meat or complementary vegetable sources," advised Nancy Amy, associate professor of Nutrition at UC Berkeley. "Balance is important."

In addition to checking product labels to ensure modest amounts of sugar, fat, calories and salt, shoppers also should select foods with a variety of colors and textures, Moore recommends. She advocates simple meals that are light on rich sauces and salad dressings -- but not overly light.

Heart-harming saturated fats and trans-fatty acids aside, fat figures prominently in promoting the body's absorption of certain cancer-fighting vegetable compounds. Left undressed or undipped, salads or carrot sticks are stripped of these benefits, researchers discovered in an Iowa State University study, reported in the July 22 issue of the American Journal of Clinical Nutrition.

"We're certainly not advocating a high-fat diet, or one filled with full-fat salad dressing," said lead author Wendy White, associate professor of food science and nutrition. "If you'd like to stick with fat-free dressing, the addition of small amounts of avocado or cheese in a salad may help along the absorption."

Calcium-rich dairy products, pronounced helpful pound peelers, also should be tossed into the weight-reduction mix, said Dr. Linda Stern, clinical assistant professor of medicine at the University of Pennsylvania in Philadelphia.

Calcium deficits can trigger a cascade of events that inhibits the breakdown of fat, researcher Susan Lawlor of Marigot Ireland Ltd., developer of natural mineral products used in foods, dietary supplements and cosmetics, told a meeting of the Institute of Food Technologists in Las Vegas in July.

Emphasizing the quality of foods may be easier to swallow than subscribing to a hard line on their proportions, surmised Dr. Frederick Samaha, chief of the Cardiovascular Section at the Philadelphia Veterans Affairs Medical Center.

"Certainly all fats and carbohydrates are not created equal," he said.

He places sugar-sweetened foods and drinks on the "to-curtail" list, and to be avoided altogether between meals.

A report by Jim Mann of the University of Otago in New Zealand, published in March in the British journal The Lancet, suggests sucrose and other added sugars may contribute to the global epidemic of severe overweight.

Likewise, a study of more than 140,000 women, published Aug. 26 in the Journal of the American Medical Association, proposes a link between higher consumption of sugar-sweetened beverages and greater risk for obesity, which has swelled to one-third of the U.S. population, and type 2 diabetes, which affects some 17 million Americans.

"Public health strategies to prevent obesity and type 2 diabetes should focus on reducing sugar-sweetened beverage consumption," the authors wrote.

In an accompanying editorial, Dr. Caroline Apovian, of Boston Medical Center and Boston University School of Medicine, called on the U.S. Department of Agriculture to redefine guidelines for sugar consumption, in particular in soft drinks.

Filling up on diet sodas carries its own risk, however, reveals a Purdue University study, reported in the July issue of International Journal of Obesity. Psychologists Terry Davidson and Susan Swithers found artificial sweeteners may disrupt the body's natural ability to "count" calories based on a food's sugary taste.

The sugars floating in soft drinks belong to the quickly-digested class of carbohydrates most experts deride as containing empty calories. Better to satisfy one's sweet tooth by biting into a piece of fruit, a complex, fiber-rich carb most mainstream nutritionists deem an essential part of a healthy diet.

The contrast was underscored in a study, published Aug. 26 in The Lancet, which piled up evidence of the health benefits of a low-glycemic-index diet, which includes carbohydrates low or slow in the release of sugar.

"What the study shows is that glycemic index is an independent factor that can have dramatic effects on the major chronic diseases plaguing developed nations -- obesity, diabetes and heart disease," said Dr. David Ludwig, director of the Optimal Weight for Life obesity program at Children's Hospital in Boston.

The regimen, shown to lead to weight loss, reduced body fat and decreased disease risk, distinguishes among carbs, excluding foods with a high glycemic index, such as white bread, refined breakfast cereals and concentrated sugars, and embracing low-GI ones.

"All carbohydrates should not be lumped together," Moore said. "Simple sugars and low-fiber products that often are baked into products with significant amounts of fat simply are not the same as whole-grain cereals, whole-grain breads, legumes, fruits and vegetables."

One key difference lies in their calorie counts, an important measure for weight watchers.

As a rule of thumb, women need at least 1,200 calories daily and men 1,500 to supply their bodies with essential nutrients and prevent malnutrition.

In counting calories, consumers must account for the energy coming in through eating and going out through exercising. A balanced flow leaves weight constant. An incoming deficit results in lost girth. Those wishing to strip off a pound a week must cut 500 calories a day.

A Harvard University study, reported June 20, documented significant benefits from expending 700 to 2,000 calories a week. The amount of calories burned depends on a person's weight and the intensity and duration of the workout.

To help with the count, acting Food and Drug Administration Commissioner Lester Crawford said his agency is pondering new food-label guidelines, including a more prominent listing of the calorie content on packaging and an indication of the total as a percentage of daily allowance.

Internet users also can click onto a new calorie counter on the Web site MayoClinic.com, announced Aug. 18, to keep tabs on their daily sum.

For those who find counting, contrasting, comparing and calculating overly complicated, UC Berkeley's Amy has some final words of advice.

"Completely forget about the whole 'diet' idea," she recommends. "Eat a nutritious diet. Eat delicious food ... but not too much of it. Forget about the greasy junk. Have fun. Do things that require you to move your body. Balance the amount of food that you consume with the amount of energy that you expend. This is the perfect plan for you."

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Next: Obesity epidemic spreads to the young

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UPI Science News welcomes comments on this series. E-mail lwasowicz@upi.com

Copyright 2004 by United Press International.

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