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Archive for May, 2009

Small Changes Will Lead to Small Results

Friday, May 29th, 2009

Earlier this year, the Joint Task Force of the American Society for Nutrition proposed that it would help reduce weight gain to focus not on achieving weight loss, but on promoting small changes in diet and physical activity to prevent further weight gain (American Journal of Clinical Nutrition, 2009;89:477-484). Suggested changes include increasing activity by 2000 steps per day (i.e., walking an extra mile) or saving 150 calories per day by substituting diet for regular soda. In their rebuttal to this suggestion, Drs. Rigby and Muller argued persuasively, “It would be a bold claim for even seasoned nutritionists to suggest that they could monitor their personal energy equilibrium [energy consumed vs. energy expended] with such accuracy.” (Obesity Facts, 2;63-66).

Rigby and Muller argue that the obesity epidemic demands that we work toward reducing obesity now, not just preventing a worsening of the problem. They assert that “Settling for small steps, rather than significant strategies to counteract obesity, can only guarantee that the problem will get bigger and worse.”

These researchers make an excellent point. Now is not the time for settling for what is, without working to change what we can. Even more importantly, very little evidence supports the viability of the small steps approach. In all likelihood, the body’s remarkable adaptability will render such steps completely meaningless. Moreover, this writer cannot imagine that weight controllers themselves would ever embrace this goal. Having worked with thousands of overweight people, it seems to strain credibility to suggest that these individuals would work, make consistent changes of the sort suggested, without the promise of notable improvements in their weight status. If that is all that science has to sell, overweight people simply won’t buy it.

Weight Loss for Teenagers: It’s All in the Family

Friday, May 1st, 2009

Family involvement and support can have a huge impact on the success of young weight controllers in the long-run. In one study completed last year, Wellspring researchers evaluated whether parents of highly successful campers (those who continued losing weight one year after camp) followed the program more completely compared to parents of campers who regained some weight after camp.

The answer was yes. Parents who used the Wellspring Plan to change their own lifestyles were far more likely to have very successful campers compared to parents who did not follow the program.

We were reminded of this study a few weeks ago when we read a University of Arizona study that demonstrated the converse proposition, namely that in families where parents do not work to make lifestyle changes when necessary to improve health and wellness, children probably won’t change either.

The Arizona study evaluated couples in which both members were smokers, or in which only one member was a smoker. The smoking couples felt closer when they were both smoking, whereas the mixed smoking couples felt more distant when only one member was smoking.

The researchers concluded that having a partner who also smokes makes a huge difference in how smoking fits the couple’s relationship (e.g. as an irritant or an ally), which in turn has implications for helping one or both partners quit.

As the authors stated, human issues like smoking or being overweight rarely occur in a vacuum, but persist as part of ongoing social interaction in which causes and effects are interwoven. One person’s behavior can set the stage for what another does.

It’s worth noting that the smoking-overweight link also made two appearances last week in two very well publicized studies. One published by researchers from the University of Oxford analyzed prior studies that involved 900,000 people and concluded that obesity reduces life expectancy by three years, while extreme obesity (100 lbs. or more) reduces lifespan by as much as 10 years. Researchers noted that the only other known issue that reduces life expectancy by 10 years is smoking: “If you continue to smoke, it takes an average of 10 years off your life. Being very obese has about the same effect.” Perhaps even more disconcerting were the findings from a Swedish study published in the British Medical Journal. Martin Neovius and his associates studied the risk of premature death (death prior to age 60) among 49,920 Swedish men born between 1949-1951 (the heart of the baby boomer years). The men who smoked cigarettes (a half pack or more per day) and the obese men had identical risks of dying young: more than twice the risk of non-smokers of normal weight.

The good news is that establishing a major shift in lifestyle at home can go a long way toward improving weight control in the entire family, helping to create successful weight controlling children and teens – right along side of their weight controlling parents.

In another illustration of this point, a study in the Journal of Nutrition, Education and Behavior out of the School of Public Health, University of Minnesota demonstrated that teens who participated in regular family meals reported more healthful diets and meal patterns compared to adolescents without regular family meals.

Specifically, having regular family meals in the period of early to mid adolescence (11-15) was associated with much healthier eating five years later.

This is good news for Latinos. Although Latinos have among the highest rates of childhood and adolescent obesity, a new census report reveals that both Latino and Asian families are well ahead of Caucasian and African-American families in sitting down and having breakfast and dinner with their children.

Between the ages 6 to 11, 83% of Latinos have dinner with their children every day, compared to 70 percent among non-Latinos. Asians had the next highest rate of sit-down evening meals in that age group, with 79 percent. Those two groups led in meal participation with children under 6 years old, and Hispanics led among those with children ages 12 to 17.

So here’s an action item for this week: Do your best to sit down and have dinner with your child every night if possible.

The path to weight control is extremely challenging and varies from child to child, family to family. But in every case, families that work on this challenge together, even one meal at a time, have a much better chance of making progress together.

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