Introduction:
This educational program uses the science of weight loss to teach individuals how to avoid weight loss fads so as to prevent recurrent weight gain by the yo-yo effect. Use this program to address weight loss with education and top research for long term results. Obesity is a widespread health problem in the United States which is associated with heart disease, type 2 diabetes, stroke, arthritis, and pulmonary disease. According to the World Cancer Research Fund, obesity is the leading cause of cancer after tobacco smoking, and is responsible for about one third of all cancers. Physical activity supports weight loss by increasing metabolism or by maintaining metabolism when combined with lowering caloric intake. In addition to weight control, physical activity helps prevent heart disease and control the lipid profile and diabetes. The evidence-based research on the most effective weight control interventions are reviewed here. This 26 page ebook reviews the important research needed for long term sustained weight loss for all individuals. Read further to review a comprehensive scientific overview of weight management programs and home remedies to lose weight. The topic headings included may be reviewed in the outline to the left.
In the most basic terms caloric expenditure greater than caloric intake will result in weight loss. In turn, caloric intake greater than caloric expenditure will result in weight gain. If caloric intake remains unchanged, physical activity resulting in more calories burned will also result in weight loss. In this case, weight loss will occur more slowly than reducing caloric intake but still be effective over the long term. Unfortunately, reducing caloric intake lowers the metabolism as the body attempts to store more energy. In order to lose weight effectively, it is best to combine the two: consume less calories while exercising to maintain or increase metabolism. Metabolic rate will be higher during and after any type of exercise.
According to the American College of Sports Medicine Position Stand, exercise positively impacts weight loss, muscle tone, and allows individuals to maintain an appropriate weight (1). Aerobic exercise results in a higher metabolism than baseline for several hours after the activity. Anaerobic exercise such as resistance training, increases muscle mass and lean body composition over time leading to a sustained increase in metabolic rate. Combining both types of exercise will result in greater and more rapid weight loss as well as better insulin sensitivity especially useful in diabetes. Women typically do not generally perform anaerobic exercise as often as men but benefit from it just as much as men do. Resistance training is falsely believed to add bulk to a women’s appearance. This is especially not the case if caloric intake remains the same, or unless powerlifting type training is used. Please see the aerobic and resistance training sections. There are also many natural supplements that may assist with weight loss including Garcinia cambogia, glucomannan, pycnogenol, guar gum, green tea, and saffron. Any supplements are most effective when used in conjunction with diet and exercise programs.
Health risk defined by body mass index (BMI):
Overweight, obesity, diabetes, high cholesterol, and high blood pressure: Overweight and obese individuals run the risk of having type-2 diabetes, high cholesterol, and high blood pressure according to a study published by Nature Clinical Practice Gastroenterology & Hepatology in 2008. Individuals suffering from these ailments can reverse some of the effects of these conditions simply by losing 8%-10% of body weight. Even a small 5% weight loss maintained over the long term can have beneficial effects on cholesterol and blood glucose levels. (2)
The American College of Sports Medicine Position Stand on obesity: According to the The American College of Sports Medicine Position Stand, regular monitoring of weight, height, and waist circumference (WC) with body mass index (BMI) are recommended to determine overweight/obesity risk. BMI can be calculated from the basic formula: Weight (lb) / [Inches of height]² x 703. BMI may also be calculated using a commonly available BMI calculator such as that available here: http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm from the NIH National Heart, Lung and Blood Institute. It has been found that people with central obesity have a 3-fold increase in the risk of low back pain, decreased physical functioning, type-2 diabetes and cardiovascular disease. The following guidelines defined by The American College of Sports Medicine Position Stand more accurately defines obesity risk based on BMI and WC: (1)
Patients with BMI greater than 30 require a physical exam and exercise stress test with special attention paid to gait, respiratory and cardiovascular status. Obese patients with a BMI greater than 30 need to start diet and exercise therapy with follow up on a regular basis, starting at every 2 weeks, then every 4 to 6 weeks. Men with a waist circumference (WC) greater than 102 cm (42.5 in) and women with a WC greater than 88 cm (36.5 in) have a greater risk of heart disease, diabetes, osteoarthritis, sleep apnea, smoking related disease, stroke, gallstones, and gout than those with a lower WC especially in men over 40 or women over 50 years of age.
Patients with a BMI 25-29.9 with a WC greater or less than 102 cm for men and 88 cm or women, require diet and exercise. Those who have a WC greater than 102 cm for men and 99 cm for women should be monitored every 6 months up to a year for individuals without any heart risk factors. Those with two or more risk factors should be monitored every 3-6 months.
Individuals with a BMI 19-24.9 with a WC less than 102 cm for men and less than 88 cm for women, with risk factors require treatment that includes education as well as a directed diet and exercise regimen to help them reach a proper weight.
BMI and the risk of death:
A prospective study of a large participant pool of 404,576 men and 495,477 women examined the association between body mass index and the risk of death from cancer at specific sites. After 16 years of follow-up, there were 32,303 deaths from cancer in men and 24,842 deaths from cancer in women. For most individual cancer sites, there was an association between body mass index and mortality. There was a positive linear trend in death rates with increasing body mass index for all cancers. Men in the highest body mass index group (>40) were 52% more likely to die of all cancers than men in the lowest body mass index group (18.8 – 24.9). For women the risk was even greater, at 62%. In conclusion, the proportion of all deaths from cancer that is attributable to overweight and obesity in U.S adults 50 years of age or older may be as high as 14% for men and 20% for women. The author stressed that more than 90,000 deaths per year from cancer might be avoided if everyone in the adult population could maintain a body mass index under 25 throughout life. (3)
Excess bodyweight and other risks: Kent et al retrospectively analyzed medical and questionnaire data from 3.1 million patients screened with ultrasound for abdominal aortic aneurysm (AAA) from 2003 to 2008. The analysis affirmed well-known risk factors—male, age, family history, cardiovascular disease, and past smoker—but also discovered new markers of higher or lower risk. Excess weight was found to be associated with an increased risk of an AAA. (4)
A Review of Weight Loss Programs and Diet Plans:
Weight Loss through Fasting
Weight loss is a goal of countless number of people in the United States today. More and more people are turning to fasting in order to jumpstart their programs or to gain a firmer control over their eating habits. People who wish to attempt fasting should learn as much about it as possible prior to starting. And, most importantly, should clear that program with their primary care physician who can evaluate the impact that it could have on any underlying medical conditions from which they suffer or any medications that the patient may currently be taking.
Fasting can be undertaken for as short as one day or as long as 30 days depending upon the type of fast and the overall health of the individual at the beginning of the fast. Making an informed decision about plans based on current health, fitness and medications is important to increase potential for success. Fasting can be an effective way to lose some initial unnecessary body fat.
The reality is that weight loss happens through a negative calorie balance. This means that an individual will lose weight when they burn more calories than they eat. This negative balance can occur when an individual decreases their intake or increases their burn (exercise). Individuals who attempt to use fasting for weight loss may find that it gives them a healthy way to jumpstart their program but is definitely not a way of managing their weight loss long-term.
Weight management is not an endless journey of weight gain and weight loss but instead should be achieved through maintaining a specific weight. This can be done by changing eating habits to maintain a lifelong lifestyle change. Individuals who have an underlying emotional eating habit may find that fasting can lead to an unhealthy conversion to binging or anorexia. Either one of those eating disorders are very dangerous to health. Those with an underlying emotional eating habit should seek the advice of a primary care physician or a psychologist to assist the person in developing a program which will address underlying emotional needs prior to attempting a negative calorie balance.
For those who will attempt fasting for one to 30 days there are three different types of fast. They are-water-only, juice or a fruit. A water-only fast is pretty self-explanatory; the participant will only drink water until the fast is broken. Individuals who experience the juice fast will drink freshly squeezed juices that are included but not limited to, carrots, apples, vegetables and fruits. A fruit only fast will allow the participants to only eat fruit, of any kind and in any amount as well as drink water.
Most individuals who look to fasting to jumpstart their diet will start with a water-only fast. This fast should last no longer than three days and then should move to either a juice only fast or back to eating healthy well-balanced meals. Juice only fast should be fresh squeezed at home using a juicing machine. Fresh squeezed juice is imperative in order to gain the most benefit. Similar juices sold in the grocery stores will have more benefits than soda, but will have some degradation from their time sitting on the shelf.
Once an individual has reached their time goal for the juice-only fast they can move into the fruit only portion of the fast. During this phase of fasting, individuals should use organic produce if they prefer. This phase should be half the length of time of the water and juice phase combined. If fasting with water alone for a total of 10 days then only fruit should be used for a total of five days. Once the juice phase is completed the individuals can move into a raw food diet of vegetables and fruit for the same length of time as the fruit phase and rapid weight loss should continue. A secondary benefit of this diet is adding an increased amount of fiber.
Once the individual finalizes the last days of the diet they should transition to continue raw foods to enhance nutrition. Many individuals find that fasting has fantastic spiritual and weight-loss benefits and, with the right motivation and support individuals can use fasting to jumpstart their weight loss and benefit their overall health.
The LA Weight Loss Program:
For many individuals who are searching for a weight-loss option, center-based programs appear to fit the bill. The LA Weight Loss Program has been a popular center-based weight-loss choice for individuals who come from middle to upper income socioeconomic levels for over 10 years. However, most know the secret to weight loss is commitment, motivation and negative calorie balance. Why do we also need outside help?
The LA Weight Loss Program offers specific motivational plans and continued commitment that is required for successful weight loss. They do not offer a magic pill or a silver bullet, but instead have success with individuals who are willing to put in the effort and the work to lose weight. Once enrolled in the program, trained counselors individualize your weight loss program through a series of questions and evaluations. These evaluations attempt to fit your lifestyle as best as possible. Many times exercise or fitness programs are also incorporated into the plan. A counselor will outline the best possible food and exercise program with lifestyle choices in attempt to achieve success.
Weight loss is not an inert activity. In other words, there is actual work to be done and commitments to be made before weight loss can be achieved. The LA Weight Loss program attempts to help change lifestyle choices, and use proven motivational and supportive methods. Before choosing a weight-loss program one should first do a personal inventory of needs around weight-loss. If the program does not provide enough tools, the rate of success will be significantly reduced before you have actually even started. For instance, if the client requires an accountability partner to stay away from chocolate cake in the refrigerator at 8 pm, then the program should have an accountability partner program built-in.
Weight loss programs should not be designed around a quick fix for a long-term problem. In other words, individuals who are realistic about their weight-loss goal and understand they are making lifetime changes will have a higher rate of success. Unfortunately, the media and manufacturers often entice short-term desires to lose weight quickly. The actual weight program will not be successful if it promises immediate and gratifying results. Instead, it should promise support, motivation and the help needed to change years of poor diet choices.
The LA Weight Loss Program offers a variety of counseling, behavior modification and programs that reportedly are personalize to each client. The promise of no strenuous exercise is often what draws the majority of people to the program. Although they are proponents of exercise, the program teaches that moderate exercise can be easily done by most people should be enough to help you lose weight.
There are three distinct drawback to the program. The first is there a price. The upfront joining fee usually ranges between $400 and $800 depending upon other purchases. The second drawback is their supplementation program. The LA Weight Loss program highly recommends the use of their shakes and bars to be incorporated into a meal plan. These are actually convenience foods only and not really an integral part of a weight-loss program, except that they are sold on commission.
The third drawback to this program is that they are a franchise operation so that the actual program can vary from site to site. In fact, an LA Weight Loss Program in New York City was fined by the Attorney General for making false claims. These claims were not being made by other LA Weight Loss sites.
If the LA Weight Program fits a person’s specific needs, but the client cannot afford the upfront costs each month, individual franchises may be able to finance the program. However, it is important to look at the interest rate being charged and determine which paymeny method is best. It is important to know the final price before signing on the dotted line. Although the LA Weight Loss Program has great benefits through personalized and customized programs, it is important to ensure that the program is reasonable for your lifestyle.
The MediFast Diet
The Medifast diet plan has joined the huge number of available weight loss programs which aim to satisfy the needs of those who want to lose weight. It is sometimes difficult to figure out which programs use accurate advertising or inflated claims, which are dangerous and which really work. Sifting through these plans can sometimes be frustrating and overwhelming. The premise behind the Medifast diet plan is fairly simple. But, any diet plan should be simple for a variety of reasons, not the least of which is that weight loss is actually fairly simple. Weight loss is a result of negative calorie balance – you must eat less calories than you burn.
The premise behind the Medifast diet program is eating frequent small meals with high levels of protein and low levels of carbohydrates. Eating in this manner puts the body into a state of ketoacidosis or ketosis. In this metabolic state the body uses its own fat stores for energy. By eating frequent meals (usually six times each day) the diet plan helps to keep you from feeling hungry, so there is less of a chance of eating foods which are not on the plan.
Originally, the program was only available through physicians. Today it is now available through local and online distributors. Their most popular plan is called the five and one plan. Basically, this involves eating one meal replacement daily and then having one main “lean and green” meal that you prepare for yourself once a day. The meal should be high in protein with lots of vegetables and could contain a juicy cheeseburger.
The MediFast program also has three phases. The first phase is the five and one where the individual takes five meal replacements and has one meal he’s made at home. The second phase is transition where the individual gradually reintroduces regular food into the diet. The third phase, maintenance, is a long-term eating program in which participants learn to eat no more calories than they expand each day. The theory is that by the time the participant has reached the maintenance phase taste buds have become accustomed to eating healthier foods and poor eating habits have been replaced.
The meal plan also has a comprehensive and helpful support structure. If the MediFast diet program is desired, one must first seek the advice of a primary care physician in order to determine if this program will interfere with any medications or any underlying medical conditions.
The concept of using ketoacidosis or ketosis in order to encourage the body to lose weight is one that is also used in the South Beach diet and other high protein low carbohydrate diet plans. Unfortunately, this process also places a high degree of stress on the body’s kidneys and is not the best plan for individuals who also suffer from diabetes or may be prediabetic. The MediFast diet plan can work for men and women. They have specific diet plans that are prepared for men, women and diabetics. Each program appears to meet the needs of the individual and help them to lose weight.
The Weight Watchers Program
Weight Watchers Diet Plan has been the gold standard for successful weight loss programs since the early 1960’s. And there is good reason for the long success of the program. It is a weight loss program based science that addresses the lifestyle of an individual as a whole and is free of most gimmicks. The Weight Watcher diet plan fully understands a negative calorie balance (eating less calories than burned), how to integrate it into an individual’s life and how to provide support systems to the individual to ensure the best possible rate of success. While they may have had several versions of their diet plan in the past 40 odd years, each one of them has been based on science and good psychology.
Weight Watchers helps to teach individuals to follow a weight loss plan and sustain control of their eating habits. They teach eating smaller portions and making healthier, more filling choices. Their goal has always been long-term weight management and a commitment to a healthy lifestyle, as opposed to short-term, quick weight loss based on the latest fad.
Instead of being told what to eat or eating given a frozen food selection, individuals are taught how to control hunger pangs. They are educated on how to avoid eating out of emotional need and how to make every calorie count. Members of the Weight Watchers plan can find support online, from other members were from the weight watchers counselors.
When an individual enrolls in the Weight Watchers diet plan, their goal is evaluated and counseled on the amount of time it will take to reasonably lose the weight they want. At this point the counselor will also give the member a targeted daily range of points (calories) that they will be able to use on a daily basis. The points system is designed to teach you how to make healthier food choices. For example, one cup of broccoli is equal to zero points, which means that an individual can eat as much broccoli as they wish. On the other hand, an ounce of chocolate is worth four points or a quarter cup of creamy salad dressing is worth eight points. As enticing as the creamy salad dressing may be, the points system will encourage the individual to make the choices necessary in order to eat the foods they wish during the day.
Amazingly this multimillion dollar business began in a living room where women would gather to support one another while losing weight. The company has remains an innovative brand and has taken a plan online in the past several years in order to accommodate individuals who may not be able to make meetings or who are intimidated by meeting other women. Today, the company also has a plan designed specifically for men and another one to teach people how to eat and stay full longer.
Some find that counting points is time consuming for them and that they would rather have their meals completely prepared and frozen. Using the online program also detracts from the traditional support mechanism offered during meetings. While research continues to support the fact that exercise should be an integral part of a weight loss program, it is only the online program that provides for fitness and the in person meetings do not stress it as much.
Weight Watchers gives individuals a variety of methods to choose from, for both men and women, in order to successfully lose weight. They provide guidance in many aspects of weight loss and teach clients how to make healthier food choices. They provide their members with thousands of different recipes which can continue to be used long after one has graduated. Weight Watchers receives a thumbs up from many of their participants. While it may not be the exact program that is perfect for every individual, Weight Watchers has achieved a level of success in the weight loss industry over a number of years that is second to none.
The Jenny Craig Diet Plan
Jenny Craig is a weight loss program which started in 1983. It began in Australia and moved to US operations in 1985. The core idea behind the Jenny Craig method is a three-level food-mind-body plan to help people lose weight and keep it off. The first level focuses on how to eat the foods, the second level on how to increase energy levels and in the third level the program teaches how to build balance into an individual’s life.
Participants in a Jenny Craig program either are center based or use an at-home direct program through phone and mail. The keystone to the diet is the prepackaged meals. For the most part, they follow the USDA food pyramid and clients are encouraged to supplement this with fresh fruits, vegetables, whole grains and reduced fat dairy products.
The program focuses on teaching individuals how to eat a balanced diet in moderation while getting enough exercise. And, built into the program are occasional splurges that allow an individual to indulge themselves in foods they really enjoy. The Jenny Craig diet plan is basically a calorie based program that gives the individual a greater amount of structure by sending the food prepackaged and frozen.
One of their programs is called volumetrics. Volumetrics is advertised as the principle behind eating more while still taking in less calories. The company teaches that individuals are “able to eat more healthy food”, feel full and achieve all of this with less calories. However, what they are describing is teaching individuals to eat more fruits and vegetables which contain complex carbohydrates and help the individual to feel full for longer periods of time. This takes advantage of the lower calorie dense foods in the fruits and vegetable category.
The program also advertises that counseling is available for individuals who join their program. However, counselors are given very short 2-5 day training program during which many of them role-play with other new counselors. These counselors are really there to help the individual double check whether they drink enough water or ate enough of their food for the day. They are not trained to answer any individualized questions or offer motivation to the clients.
In side-by-side cost comparisons, Jenny Craig comes out well ahead of other diet plan programs which provide prepackaged foods. In other words, Jenny Craig charges to not only join their program, but they also charge a higher cost than other programs for the prepackaged frozen foods delivered directly to the home. Another caveat is that individuals who are paying a higher cost for food than they would be normally, are also being asked to supplement these foods with fresh fruits and vegetables from their produce department in large enough quantities to keep themselves full.
Research has shown that individuals who achieve a greater rate of success for weight loss have sought the assistance of a mentor, coach or accountability partner. Jenny Craig does not offer these options. And, inherent in the program is the question of whether individuals are able to learn portion control by using prepackaged foods. Once going off the packaged meals it is difficult to translate the portions of food received in the mail to real meals prepared at home. Another problem with the program is that it is does not assist the individual with a re-integration back to normal eating habits.
The South Beach Diet Plan
The South Beach Diet incorporates functions from other diets into a new healthier version of a low carbohydrate diet plan. It was founded by a respected cardiologist who was searching for a diet to help his heart patients live a healthier lifestyle. His book was released in 2003 and the diet has remained consistently popular. The South Beach Diet reportedly does not cut out entire food groups or ask clients to starve themselves. The distinct advantage to the South Beach diet is that it teaches people how foods work in the body, and how to lose weight for a lifetime.
This particular diet plan was founded by a physician who uses it with his cardiovascular patients. Patients should consult with their own primary care physician to determine if this particular plan will have negative effects on current health status, medications, or medical problems. Low carbohydrate diets, like the South Beach diet, places a considerable stress on the kidneys while the body is in ketoacidosis. If your current health status will not withstand the stress it can lead to more complications than it solves.
The South Beach diet plan uses the glycemic index as an indicator of the types of sugars and carbohydrates that are acceptable in the diet. Foods that are rated with a lower glycemic index number will keep you feeling fuller for a longer period of time and will result in a lower spike of your blood glucose. This means that the foods will not cause a large release of insulin into the blood stream to take care of the larger load of glucose. When a large amount of insulin is released it can lead to a sugar ‘low’ many feel mid-afternoon.
Using the South Beach diet plan consists of three different stages. In the first stage, which takes approximately 2 weeks, the diet will severely limit the number of carbohydrates that the participant is able to eat. This initial phase is often very challenging and many are not able to complete it. During this phase one may be faced with cravings and is limited by the number of foods normally eaten. Water weight is the majority of weight lost during this time so weight may fluctuate during these weeks.
Before beginning the South Beach diet it is helpful to go through the house and eliminate all the foods that are not allowed in the first two weeks. This works only if the client is the only one living in the house or if everyone is on the same plan. More realistically, foods that are off-limits may need to be placed on a special shelf in the refrigerator or in cabinets in the kitchen that are designated off-limits.
After the initial two weeks of the South Beach diet plan, clients focus on controlling cravings. This is important in order to reintroduce foods that clients enjoy but will eat them in moderation. The theory is that these particular foods may not be healthy on their own, but eaten in moderation and in combination with other foods, they are not damaging to health. Clients will also learn how to make permanent changes in their everyday diet. These changes lead to diet choices for years and will help maintain healthy eating habits that lead to a healthier weight.
The human body cannot go without carbohydrates and fiber for long. There are healthy carbohydrates and fiber choices available but, during the initial few weeks, participants are limited in the number that they are allowed. This unfortunately also limits vitamins and minerals as well. Although this is a temporary restriction, clients should take a multivitamin and fiber supplement to offset these limitations. Using a vitamin and mineral supplement following the introduction of other foods is optional and, although recommended, it is difficult for most people to eat all the foods necessary to receive the vitamins and minerals for healthy life.
Weight loss is challenging to most people and necessary for some. The South Beach diet plan is a structured diet option that allows for some flexibility while losing weight and learning healthy lifestyle choices. Although weight loss can happen on any diet using a negative calorie balance, for some the added structure as a way to add strength to their struggle and teach them good healthy lifestyle choices.
The Nutrisystem Weight Loss System
Nutrisystem is a weight-loss program built around teaching individuals how to eat smaller portions by providing those smaller portions through pre-packaged frozen food. Clients select the plan from the Nutrisystem website and create an individualized 28 day menu which includes breakfast, lunch, dinner and a dessert for each day. Clents may also start with a preselected favorite foods package. Once completed, the client orders a 28 day program or can select an auto delivery for recurring monthly deliveries at a significant discount.
The keystone to Nutrisystem is that it is a supposed “no-brainer” meal plan which does not teach the individual to count calories, carbs or points but instead uses a predetermined, pre-portions meal delivered directly to one’s doorstep. The plan also comes with a grocery list for produce and fruits to augment the frozen meal. Nutrisystem has an online community and weight-loss tracking system for support and motivation.
In essence the entire program is about convenience and, in an incredibly fast-paced world, convenience may be a benefit to patients. For the prize of approximately $10 a day with free food every four weeks, the final cost is around eight dollars per day. Up against Jenny Craig, also a prepackaged and portion control weight loss program, Nutrisystem has no membership or contract fee.
However, as with any pre-portioned and prepackaged weight-loss program it is very useful for getting back on track but is not a permanent answer to either weight loss or weight maintenance. After finishing a number of weeks eating the Nutrisystem diet the client must go back to preparing their own meals, learning portion control and figuring out how to deal with snacks and food cravings.
The program itself is designed around the glycemic index. This index measures the amount of insulin a particular food will require in order to be digested. Those foods which require a higher amount of insulin also set the body up for insulin resistance and increased amount of fat cell growth. This is because with an increased amount of insulin floating around in the body, the body’s cells are not able to absorb as much energy as efficiently as before. This energy is then stored in the fat cells of the body which encourages weight gain as opposed to weight-loss.
The Nutrisystem diet has options for men, women, diabetics and vegetarians, which is typical of most prepackaged meal programs. Their typical daily calorie allowance will vary between 1200 and 1500 calories and most days consist of three meals and two snacks. Doctors recommend that patients should never lower calorie intake more than 1200 calories per day because the body enters into a starvation mode which then slows metabolism and decreases the rate of success for any weight loss.
Following a low calorie weight-loss diet such as Nutrisystem causes most individuals to lose weight. Weight loss has always been a negative calorie balance affair. This means that a client will lose weight when eating less than the client is burning. How long the weight will remain off can only be answered on an individual basis since the challenge of reestablishing normal eating habits after the program is finalized remains difficult for most individuals.
Individuals have the choice of up to 120 different entrées and desserts that are made up of 55% carbohydrates, 25% protein and 20% fat. Most meals are lower in saturated fat, lower in trans fat, and rich in whole grains. The meals which are supplied are meant to be supplemented with six servings of fruits and vegetables each day. However, even though the program offers 120 different diet choices, consumer affairs.com continues to occasionally receive complaints about Nutrisystem program. The complaints are not about the lack of results but rather a complaint about the taste of the food and the lack of variety in the diet. Many of the complainants said that the food was salty and unpalatable.
Nutrisystem does have a program that allows individuals to choose the foods that they would like to eat. Although this adds price to the program many individuals choose to go this route so they are able to pick the foods they will find most edible. Unfortunately the consumer affairs.com site has received complaints as far back as November 2005.
Most of those who will to follow at 1200 to 1500 calorie diet will lose weight, whether that food is prepackaged and frozen shipped from Nutrisystem or purchased from the grocery store in the frozen food section. For those individuals who require a bit more structure in their lives in order to achieve their goals, Nutrisystem is definitely a better cost advantage than Jenny Craig. However, there is no substitute for understanding the value in each a regular healthy food and learning portion control. For this reason Nutrisystem may be an excellent option for the first eight to 10 weeks of a long-term lifestyle choice in order to jumpstart a diet program but should be evaluated further if an individual wishes to maintain their weight loss while still learning to eat appropriate portions off the program.
Weight Loss and Vitamins
The human body works best with an optimum intake of vitamins and minerals mainly through the daily intake of a wide variety of foods. There really isn’t one vitamin that is thought to be “best” for weight loss regimens. However, it is important to recognize that anybody operating on less than optimal vitamins and minerals may be prone to disease and illness. All vitamins and minerals play a significant role in maintaining proficient body metabolism. Individuals should receive a well-balanced diet or consider a vitamin and mineral supplement to make up the deficiencies they experience while attempting to lose weight.
Weight loss diets:
This review may be used to assist in choosing an individualized diet.
American College of Sports Medicine (ACSM) guidelines on weight loss: According to the American College of Sports Medicine (ACSM) guidelines on weight loss, a normal adult should not consume less than 1,200 kilocalories per day. A weight-reduction program should include consumption of less food (calories) that will gradual lead to losing weight. In addition to changing diet, endurance exercise at a minimum of 65% of maximum heart rate should occur most days of the week for 20-60 minutes. Finally, the diet and exercise program should be designed on an individual basis such that they can be maintained for life. (5)
A review of various diets:
According to an article by Peter M. Clifton entitled “Dietary treatment for obesity,” today’s dieter has many options for successful weight loss. He states that there are five basic dietary strategies, which include 1) low-fat diets, 2) low calorie diets, 3) very-low calorie diets, 4) carbohydrate-restricted diets, and 5) low-glycemic-index diets. Clifton explained that long-term weight loss is defined as losing at least 10% of initial body weight and keeping it off for at least a year. The author stated that maintenance can be achieved by eating a low-fat diet, making sure one eats breakfast almost every day, obtain body weight regularly, engage in physical activity for around an hour every day, and maintaining a consistent eating pattern. Clifton mentioned that a final effort in the fight to lose weight may include surgical treatment such as gastric banding, or gastric bypass and after the first year of treatment 19-25% of individuals who chose surgery reduced their mortality. The author unfortunately found that after considering all weight loss options, only 20% of obese individuals that used weight-loss measures were able to maintain a weight loss of 10% or more after a 3 year period. (6)
Low fat diets were reviewed by Clifton in a meta-analysis of 13 studies that contained 1,728 individuals. Comparing a low-fat diet to a control diet, the average weight loss is 5.4 kg at 12 months. He stated that a low fat diet has been beneficial in reducing diabetes and high blood presser for up to 3 years in the research reviewed.
Clifton explained that low-calorie diets usually limit intake to 1100-1600 kcal per day. One kcal is equal to 1 calorie as typically discussed in layman’s terms. The author described this diet to have slightly better results to that of a low-fat diet, however the difference in outcome is very small. Clifton expressed that a low-calorie diet combined with moderate fat intake has proven superior results when compared to the low-fat diet. The most common form of this diet is achieved through meal replacements whereby one or two meals per day is replaced with a low-calorie drink and can result in an 8.6% reduction in weight within 12 months. According to Clifton, those on carbohydrate-restricted diets typically feel satisfied longer on this diet because of the increased amount of protein. The success of this diet is attributed to the reduction in appetite. He stated that dieters using this method tend to lose more weight than those on low-fat diets when evaluated after 6 months, but after 12 months the difference is no longer obvious.
According to Anderson JW et al a very low calorie diet refers to an intake less than 1000 kcal per day. The difference in weight loss between this diet and a low-calorie diet of about 1100-1600 kcal per day becomes small in the long term. Also, those subjects who exercised maintained the weight loss longer. (7)
According to Clifton, carbohydrate-restricted diet influenced weight loss, but if not combined with protein, then there is also a loss of lean body muscle mass. Clifton mentioned that a protein intake of more than 1.05g/kg of body weight increased retention of lean body muscle mass.
Clifton described low-glycemic index diets as inclusion of all complex carbohydrates with no simple sugars, similar to a diabetic diet. According to this author, low-glycemic-index and low-glycemic load diets lead to both weight loss and the lowering of LDL cholesterol.
Beans, legumes, weight loss:
Consumption of beans and obesity risk: Papanikolaou and Fulgoni reported on the association of consumption of beans with dietary quality and obesity risk in 1,475 adult participants in the NHANES 1999–2002 in this cross-sectional study. They found that bean consumers had a higher consumption of dietary fiber, potassium, magnesium, iron, and copper (p< 0.05), lower body weight (p = 0.008), and a smaller waist size (p = 0.043) relative to non-consumers. Additionally, they had a significantly reduced their risk of increased waist size and obesity by 23% and 22%, respectively. This study showed that bean consumption is associated with an overall dietary pattern and lifestyle that tends to be associated with relative leanness. (8)
Low fat legume-free compared to legume-based diet:
Researchers randomly assigned 30 obese to two low calorie diets: calorie-restricted legume-free diet and calorie-restricted legume-based diet, prescribing 4 weekly different cooked-servings (160-235 g) of lentils, chickpeas, peas or beans. At the end of 8 weeks, people in both groups lost weight but weight loss was greater in the subjects in the legume-based diet (-7.8% vs. -5.3%; p = 0.024). The legume-based diet also resulted in a significantly higher reduction (% change from baseline values) in C-reactive protein (CRP) (~40% vs ~5%) and complement C(C3) (~80% vs ~40%) both inflammatory markers. Even after the researchers controlled for the effects of weight loss on these markers, subjects in the legume-based diet had less apparent inflammation. (9)
Low Carb Diets
The Low Carb Diet has been made popular by Atkins and South Beach diets. These programs are not concerned with the number of calories but rather the amount of sugar and carbohydrates consumed. This diet plan essentially places the body into ketoacidosis, during which it burns more calories quickly. However, there are also significant side effects which can include lower mental acuity, stress on the kidneys, feelings of being tired, increased blood pressure, high cholesterol, diarrhea and severe headaches (45,46). They have also been associated with a higher mortality rate in 2 studies (10,11).
Individuals who wish to start a diet plan which is outside the bounds of the food pyramid must consult with their primary care physician to determine if their current health can withstand stresses of ketoacidosis. Patients should also consider the medications they are currently taking, current blood glucose tolerance as well as any underlying medical conditions.
There are several things that individuals can do to help increase the success rate of using a low carbohydrate diet plan. Plenty of water is advised with at least 10, 8 ounce glasses per day, but limit the amount of caffeine. The the fluids should always be water, not soda, not coffee and not tea. Patients should take additional vitamins and fiber supplements to make up for the nutritional deficits they may experience.
Exercise will help decrease some of the side effects from ketoacidosis. Core to this diet plan is to monitor sugar levels and carbohydrates. Individuals who start a low carbohydrate diet plan report that they initially feel cravings for foods they can no longer eat. To increase the chances of success those foods should be taken out of the house altogether, and people should not go shopping when hungry.
A low carbohydrate diet plan requires menus with organized meals and a plan to address cravings. Using a low carbohydrate diet plan individuals are often able to lose weight quickly. To ensure total success take the advice of the physician about how long one should stay on the diet before transitioning to a healthy diet that can be maintained over years.
Low carbohydrate, high protein diet and mortality:
A low carb, high protein diet much like the Atkins style diet, was associated with an increased risk of cardiovascular deaths in women. This finding was based on a study conducted in Sweden during 1991-1992, and included a 12-year follow-up. It included 42,237 women, ages 30-49. The study associates mortality with varying degrees of increased protein with a stable decreased carbohydrate intake. It was found that the greater the ratio of protein to carbohydrates consumed, the greater the number deaths occurred from cardiovascular and cancer related causes. When the women were noted to decrease carbohydrate intake by 10%, the total mortality increased by 6%. When the women were noted to increase protein intake by 10%, the total mortality increased by 2%. For those women in the study who were 40-49 years old, the increase in cardiovascular mortality was 13% for those who decreased their carbohydrate intake by 10%. Cardiovascular mortality increased 16% in women that increased their protein intake by 10%. (10)
Based on a study by the Department of Hygiene and Epidemiology, School of Medicine, University of Athens, Greece, dieters considering a low carbohydrate, high protein consumption should be aware of the risks. A questionnaire based population study showed that long-term low-carb, high protein diets are associated with an increase in deaths caused by cardiovascular diseases and cancer (participants were 22,944 healthy adults). On the other hand, higher intake of carbohydrates was shown to reduce risk of mortality. (11)
Diets for weight loss and treatment of diabetes mellitus:
In general, any weight loss by diabetes mellitus type 2 patients will result in an improvement of glycemic control and insulin sensitivity proportional to the weight loss. Several effective dietary programs are represented below specific to goals of diabetic patients.
Low-carbohydrate diet and glycemic control:
Several previous studies have proven that a low-carbohydrate diet improves glycemic control. In this study, 84 obese patients with type 2 diabetes were randomly placed on 2 separate diets. The first diet was a low-carbohydrate diet with less than 20 grams of carbs per day expressed as ketogenic (resulting in protein breakdown). The other diet was a low glycemic, reduced calorie diet which included 500 kcal (kcal is a.k.a. calories) under their weight maintenance kcal. About 58.3% of the test group completed the study. Both groups led to improved glycemic control and medication reduction or elimination. However, within the lower carb group, a greater improvement was evident. Both diets led to reduction in hemoglobin A1C (a blood test that measures long term glucose control). The low carb diet resulted in the best improvement of -1.5% and the reduced calorie improved by -0.5%. Body weight improved by -11.1 kg and -6.9 kg respectively. HDL improved by 5.6 points in the low carb diet and did not improve in the other diet. Also, diabetes medications were reduced or eliminated in 95.2% and 62% in each of the diets respectively. (12)
Diet and insulin sensitivity:
A study included a summary of the effect of dietary adjustments on insulin resistance (IR) and diabetes risk. IR is mainly caused by excessive energy intake leading to obesity. A sustained energy-reduced diet has a strong benefit on short-term weight loss (up to 2 years), insulin resistance, and diabetes risk. Reduction in total fat intake (<30%) has a modest benefit on weight loss (though it is less effective than low-carbohydrate, high-protein (HP) diets) and insulin resistance (fat intake >37% increased IR) and probably reduces diabetes risk. Additionally, it lowers LDL (“bad”) cholesterol and reduces the risk of cardiovascular disease (CVD). Increase in monounsaturated fatty acids (>10%) has a modest benefit on IR and lowers LDL-C, triglycerides, and blood pressure. N-6 polyunsaturated fatty acids have been found to have a modest effect on IR. Low-carbohydrate diets (a minimum of 130 g/day is recommended) have a modest benefit on weight lost, in the short term and have beneficial effects on HDL (“good”) cholesterol and triglycerides. HP intake was reported to increase satiety, has a weight lost benefit in the short term and has beneficial effects on HDL, LDL cholesterol, and blood pressure. Low glycemic index (GI) diets have a modest benefit on weight loss, improve LDL cholesterol, inflammatory markers, and probably reduced cardiovascular risk. Dietary fiber >14 g/1000 kcal and day has a modest benefit on weight loss and is beneficial on IR. Soluble fiber (fruit and vegetables) has a modest benefit on weight loss, lowers GI, LDL cholesterol, and triglycerides. Insoluble cereal fiber (cereals, wheat bran and whole grain products) has a modest benefit on weight loss and a strong benefit on IR. Lastly, Mediterranean style diets have a modest benefit on weight loss and have beneficial effects on IR and diabetes risk. Additionally, Mediterranean style diets are associated with reduced risk for CVD, lower inflammatory cytokines, improved lipid profiles and increased survival. (13)
Low fat vegan diet helped diabetics lose weight, control blood sugar, and lower cholesterol: A prospective clinical intervention study of diet and its effects on body weight and other cardiovascular risk factors recruited 113 workers aged 21 to 65 years with a BMI≥25 kg/m2 or with a diagnosis of type 2 diabetes. Workers at the intervention site were instructed to follow a low-fat vegan diet. At the end of the 22 weeks, the intervention group lost on average 5.1 kg (vs a gain of 0.1 kg in the control group; P<0.0001) as well as an average of 4.7 cm from their waist (vs gain of 0.8 cm in the control group). Among the intervention group, 48.5% had a weight loss of 5% body weight compared to only 11.1% among the control group. The treatment group had lower total cholesterol, lower HDL and lower bp than the control groups but these findings were not statistically significant. (14)
Taking Calcium for Weight Loss
New research, sponsored by the dairy industry, has suggested that including calcium in the diet has a positive effect on weight loss. In fact, the dairy industry has produced an entire advertising campaign around the concept of increasing calcium through dairy products and weight loss (47). Many of the studies which the American Dairy Association rely on in their advertising have found a link between the amount of calcium an individual consumes during the day and the type of weight which is lost in the body.
Advertising campaigns point to research which showed a relationship between eating three to four servings of low-fat dairy products each day and a decrease in the amount of fat stores in the body. This research suggested that calcium increases the amount of fat in the body converts to energy by increasing the body’s core temperature. The theory is that by increasing the core temperature the body will burn more calories at a faster rate. (48)
The study also suggests that individuals who have the highest amount of stored fat will also show the lowest amount of calcium stored in the body. Conversely, popular diets that promise a quick weight loss are often very low in dairy products, the foods containing the highest amounts of calcium. These popular fad diets also affects the ability of the body to absorb calcium which can lead to bone loss and osteoporosis. Women who control their calories each day can be at risk for a number of deficiencies because they miss vital vitamins and minerals necessary for overall health.
Foods that are high in calcium include milk, cheese, yogurt, ice cream, baked beans, dried figs, broccoli and most dark leafy vegetables. The research funded by the American Dairy Association did not include vegetable sources of calcium in their study.
Dr. Reed Mangels from the Vegetarian Resource Group commented on the influence of a high amount of animal protein has on the body. Quoting a study published in the Journal of Nutrition in 2003 he states that “Some studies show that diets that are high in protein, especially animal protein, do cause increased losses of calcium in the urine…” this means that the amount of calcium in the Recommended Daily Allowance may fluctuate for individuals based on the amount of animal protein they consume. (49,50)
The current recommended dose for calcium is 800 to 1000 mg per day. Most Americans typically consume between 500 and 700 mg of calcium. Unless a diet is high in foods that contain calcium, many Americans may find that supplementation is necessary to avoid the increased loss of bone and osteoporosis while taking advantage of the potential for weight loss. However, it is also important to note that the production of bone does not rely exclusively on the amount of calcium in the body. Several other vitamins and minerals are necessary in order for the body to adequately manufacture bone.
Unfortunately, this promotion of calcium may result in a convenience to believe that increasing the amount of calcium in the diet will also increase the amount of weight that people can lose. Weight loss is always dependent on the number of calories eaten versus the number of calories burned. The number of calories burned by increasing the core temperature of the body through stored calcium may not be great enough to offset the potential risk for the development of kidney stones. The American Journal of Clinical Nutrition, April 2005, carried reports of research which contradicts the reported weight loss by calcium intake which other studies had shown. (51)
Before beginning any weight loss program, a new exercise regimen or changing your diet significantly, one should consult a physician especially for those under 18, pregnant, nursing or have a pre-existing health problem. Before increasing the amount of calcium, establish the amount of current calcium intake as well as other vital vitamins and minerals. At that point, working with a nutritionist, a specific diet may be developed that meets caloric needs, nutritional needs, in order to attain the desired goals. The current results of studies which link calcium and weight loss are not conclusive and much more research is required before a judgment can be drawn.
Emotional Eating
Many patients will eat in response to an emotional trigger. This means that when people become happy, sad, celebrating, depressed, angry, frustrated or scared the first thing that most people reach for is either food or drink. It is not unusual to be unaware of the factors that impact emotional eating. Through years of conditioning and exposure to family and friends and advertising, people are subconsciously conditioned to believe that food will just make them feel good. Food does fill a real biological need providing us with energy to burn. However, in the case of emotional eating individuals are often using food to fill another void in their lives. (1)
Emotional eating is actually one of the beginning stages of a full-blown eating disorder. Many people will never progress to having an eating disorder but there is sometimes a fine line between emotional eating and illness. How can you tell the difference between a compulsive eater or an emotional eater? Individuals who suffer from full-blown eating disorders will show specific characteristics of those disorders. They usually binge on large amounts of food very rapidly. They also express that they feel out of control about food or they feel they are obsessed with food.
Other behaviors that distinguish the two disorders include hiding food around the house or eating in hiding away from the rest of the family. For instance, the primary shopper may purchase foods that remain hidden from the rest of the family and either eaten before they get home from the store or after everyone else is gone to bed. Most individuals who exhibit an eating disorder or who have a problem with emotional eating will also have experienced dramatic events in their lives, such as physical or sexual abuse.
Individuals who suffer from binge eating or compulsive eating will face several challenges, not the least of which is the lack of education in both the public and medical arenas. These conditions are not nearly as well popularized as anorexia or bulimia. In fact, individuals may not even know they have a medical disorder. People who experienced this type of eating disorder should never attempt to “go on a diet” but should instead seek the advice of a trained licensed therapist. (2)
Even though there is a direct correlation between the number of calories eaten and the amount of weight which is lost, individuals who suffer from compulsive eating disorders require support and understanding about their disorder before any type of weight loss can be successful. And, while people who have significant emotional eating habits aren’t as any medical or psychological risk, they suffer just as much. People who want to take control of their emotional eating habits must start with self-awareness of the problem and lead into self-management. Self-awareness is one of the most difficult steps taken in any self-destructive behavior since it involves acceptance that there is a weakness which has led to the problem with obesity.
Individuals can begin to evaluate their own emotional eating habits by keeping it short four to five day diary. Write down each time any bite of food goes into your mouth. Individuals shoudl record the time of the day and emotional feelings each time you reach for another bite of food. Patients will use this tool as a lead to self discovery.
After the 5 day record is complete, patients may note how many times they ate because they were, or thought they were hungry. Compare that number of emotionally driven eating episodes to the automatic reach for food due to actual hunger. By being completely honest, patients may learn to change habits and increase success with weight loss.
Patients will need to learn how to manage eating with a mindframe that the problem did not happen overnight. Greater rate of success is possible if enlisting the help of a partner, a program or even a calendar. Patients should continue to write down the times they eat and the emotional reasons they eat so that they are encouraged to put the food down when angry, depressed or on an emotional high. The process of emotional eating should actually decrease as a response to this type of self training and encouragement by the patient’s support network.
Exercise and weight loss:
Annual statistics kept by the Centers for Disease Control and Prevention indicate that the number of individuals in the United States who are overweight and obese is increasing at an alarming rate. New theories appear regularly about the reason that people have difficulty managing a healthy weight. These theories include suggestions of genetic abnormalities, a heavy bone structure, defected metabolism or viruses.
But the cold hard truth is that everyone can lose weight when they are in a negative calorie balance. This means that an individual must eat less calories than they burn or, said another way, they burn more calories than they eat. Achieving a negative calorie burn can be accomplished using several different techniques. The most common way to achieve this is to eat less and exercise more. But, before undertaking any fitness program to achieve weight-loss goals, the primary care physician should be consulted to determine the level of exercise intensity and the length of time at which to begin. The primary care physician will make suggestions based on current health, fitness level and any interactions that exercise may have with current medications and any underlying medical conditions.
As the body continues to age, less food will be required in order to maintain body weight or conversely, require less food in order to gain weight. Many individuals find that their basal metabolic rate changes drastically when they hit the age of 30, again at 40 and once again at 60. Basal metabolic rate or BMR is the number of calories required to keep the body alive if one is lying in bed all day. It is the number of calories burned by digestion, muscle and breathing. This number can be estimated using current height, weight, age and gender. There are other factors as well, but these four are the most commonly used in BMR calculators. The older the person, the less calories needed to maintain body weight.
Using a healthy weight loss plan to achieve a negative calorie balance requires both fitness and a healthy diet. Although the need for exercise and fitness has been well publicized to achieve a negative calorie burn and raise their metabolism for long-term weight loss, many people may not be aware of the equally important benefits to health and wellness.
By increasing the heart rate and respiratory rate through exercise, patients are able to increase blood flow through the circulatory system, increase the efficiency of the heart, decrease blood glucose and improve lung function. For diabetics regular exercise will help to maintain blood glucose levels and often times decrease the amount of insulin required.
Achieving fitness increases flexibility and strength which helps patients to perform their daily routine with less discomfort. It increases energy levels, self-esteem and self-awareness of the body. Many report that they feel muscles they’d forgotten they even had. For these benefits to take effect it is important that the routine have both intensity and duration. The intensity of the fitness routine will equal how fast the heart rate goes and for how long.
The duration describes just how long you’re doing the exercise routine. Although both intensity and duration are important factors, if the initial level of fitness doesn’t allow the individual to exercise for more than 10 minutes then incorporating a 10 minute fitness plans three times throughout the day will give similar benefits to doing 30 minutes all at once. Then, as the fitness level improves, you will be able to maintain a greater intensity for a longer length of time.
The goal in any fitness program designed for weight loss is to do a moderate amount of exercise while maintaining that intensity level for 45 minutes to an hour and a half. The amount of time (duration) which is chosen for the exercise program will relate to an individual’s lifestyle, overall health, amount of weight required for loss and the motivation of the individual. The individual should also be working to add a greater intensity level that results in producing sweat for at least half the work out and slightly out of breath when completed.
For those who are moderately to severely overweight only use low-impact aerobic activities to decrease the potential for damage to the joints. These types of activities include swimming, running in the pool, roller blading and walking. They are great exercises that continue to increase the heart rate while not damaging the joints.
Fitness weight-loss programs will improve quality of life, lower risk of heart attack, stroke, peripheral vascular disease, heart disease, vascular disease, inflammatory disease and cancer. It is a gentle way of making changes to lifestyle and should increase success rate for any weight-loss program.
Walking to Help Weight Loss Efforts
One of the most commonly recommended exercises for individuals who are overweight is walking because it is not only gentle, but also is a nonthreatening way of including exercise into a lifestyle that thus far has not had any. Some people find the thought of exercising totally debilitating. They watch others sweating profusely while pumping iron, running were doing aerobics and it is enough to make them turn and walk away. But, one of the greatest, simplest and most convenient type of exercise doesn’t require sweating, extra equipment or even the gym. Walking is a means of weight loss exercise will meet the goals of any weight loss program, while gently easing you into a routine that will improve your overall fitness and trim your waistline.
Walking is something that in easy to do each and every day. But, learning to walk as an exercise routine and to improve fitness is different than the standard walk around the block. For example, a walking weight loss routine should be a sustained activity over 30 minutes. Walking outside or Mall walking are both options but the latter is just as effective and sometimes more social. Sustained walking, with arms swinging and blood moving faster than the sound of sludge, can sometimes place more stress on joints and muscles if you change your regular gait.
Supportive shoes to protect the feet, knees and hips is an important addition to a walking program. Old sneakers in the back of the closet may lead to injury. Use well padded socks to prevent blisters and sores. Wear loose fitting clothing to avoid restriction of arms and legs. Walking may bring to mind creative and inventive solutions to problems as the blood flow increases under quiet and calm conditions. Walk with friends or a support partner or use music to enhance motivation. Walking with music helps to pass the time more quickly, takes the mind off the task at hand and helps to keep a good pace. Use a good pair of headphones that remain comfortable for least 30 minutes.
Pace should be increased comfortably yet a person should work to become slightly out of breath so metabolism continues to increase. Do not reach the point where rapid breathing makes conversation too difficult.
Exercise alone vs. exercise with diet vs. sedentary lifestyle:
A study done by Barnard et al compared 51 to 64 year old subjects from an exercise group that did a consistent exercise program for at least 10 years, a diet plus exercise group who did a consistent diet and exercise program for at least 10 years, and a sedentary group with poor diet. Based on this used as a comparison, if someone began to exercise 5 days per week for one hour in their 50s for 10 years without a change in diet, they should expect to decrease their body mass index (BMI) about 11.5 kg/m^2, reduce total cholesterol by about 11 points, and reduce their triglycerides by about 105 mg/dl. There was no large benefit in LDL and HDL seen in this group likely from no change in diet. If someone began to exercise 4-6 days per week for one hour in their 50s for 10 years with eating a low fat, high fiber and complex carbohydrates diet along with exercise they would attain the following average benefit. A decrease in their BMI by about 16.5 kg/m^2, reduce total cholesterol by about 33 points, reduce LDL by about 20 points, and reduce their triglycerides by about 109 mg/dl. There was no large benefit in HDL seen in this study. (15)
American College of Sports Medicine Position Stand on exercise:
According to the American College of Sports Medicine Position Stand, exercise will positively impact weight loss, muscle tone, and allow individuals to maintain an appropriate weight. Aerobic training 3-5 days per week for 20 -60 minutes a day is recommended. The exercise program can be carried out in ten-minute increments, with an intensity ranging from 55 -65 % of the heart rate (HR) max. Individuals wanting more results can exercise at 65% of maximum heart rate. Muscle development is best achieved using heavier weights with few repetitions while muscular endurance is best developed by using lighter weights with a greater number of repetitions For a well-balanced program an individual should perform 8 -10 upper and lower body exercises 2-3 days a week with sets containing 8-12 repetitions. Additionally stretching held for 10-30 seconds, with at-least four repetitions per muscle group, 2-3 days per week is advised. Holding stretches for the recommended duration enhances flexibility. (1)
Chronic illness and exercise:
Chronically ill patients may benefit from exercise with improved function, and increased strength and endurance. Before prescribing exercise, the medical condition (medications and potential physical limitations) of a chronically ill individual needs to be assessed. If the patient is well enough, perform an exercise test. Based on medical status, educate a patient on warning signs and risk of exercises and provide any exercise aids they may need. Chronically ill patients should warm up for at least 3 minutes before exercising. A workout should start at a heart rate of less than 20 beats per minute over resting heart rate, or normal walking. Exercise should include walking or similar aerobic activity, resistance training, and stretching exercises based on the patient’s status for a cumulative period of 20 to 30 minutes daily. Proper safety precautions should be taken. A patient should be educated on injury prevention (adequate hydration, appropriate clothing and footwear, walking-with or without walker as appropriate). A home visit to determine hazards may be considered. A patient’s health status should be assessed every 1-2 months initially then every 3 months. (16)
Exercise, weight loss, and osteoarthritis:
Researchers gathered data on the effectiveness of exercise and weight loss for 35 patients, aged 25 or older, with hip osteoarthritis (OA) who were overweight or obese. They participated in an 8-month exercise and weight-loss program. Over the course of the study, self-reported physical function, pain, and walking tests were used to measure the success of treatment. The program resulted in a 32.6% improvement in physical function after 8 months, along with significant improvements in pain and on walking tests. Therefore, the results suggest weight loss and exercise may be used as a treatment for hip OA. (17)
Diet, exercise, and breast cancer risk factors:
Overweight and obese postmenopausal women were observe over a 2-week period in a study by Barnard, R.J. et al which looked at the relationship between diet and exercise on breast cancer risk factors such as estrogen, obesity, insulin and insulin-like growth factor-I or IGF-I. In this study women were put on a low-fat (10-15% kcal), high-fiber (30-40 g per 1,000 kcal/day) diet and attended daily exercise classes. Blood drawn before and after the diet was examined for each individual for the presence of breast cancer cell lines including MCF-7, ZR-75-1, and T-47D. Researchers found that growth of breast cancer cell lines was reduced by 6.6% for the MCF-7 cells, 9.9% for the ZR-75-1 cells, and 18.5% for the T-47D cells. Cell self-destruction, or apoptosis, increased by 20% in the ZR-75-1 cells, 23% in theMCF-7 cells, and 30% in the T-47D cells. This study suggests that a low-fat, high-fiber diet and exercise may reduce the presence of breast cancer among overweight and obese postmenopausal women. (18)
Acupuncture and weight loss:
Acupuncture is one of the most commonly used medical procedures in the world, and has origins in ancient China. Using acupuncture to attain weight loss became popular in 2003 when CNN reported success stories from weight loss clinics in China.
China has experienced an increase in obesity with the introduction and popularity of Western diet choices. The Standard American Diet often consists of too much protein, too much fat, too much sugar and not enough fruits and vegetables. Even when Americans eat fruits and vegetables they are frequently canned and over cooked leaving them without any nutritional value and no live enzymes.
The Asian cultures routinely practiced acupuncture medicine before it was made popular in the West, also used it to assist with weight loss. Chinese medical theory says that overweight people have an unbalanced digestive system, and through the use of fine needles to open blocked energy pathways, they are able to rebalance the system with the final result of weight loss.
Acupuncture has been shown to strengthen the digestive system, control the appetite and may also improve metabolism causing you to burn calories more quickly. Weight loss has always been a balance between burning more calories than you eat. Acupuncture offers another system to decrease intake and burn more calories.
During the procedure a trained practitioner will use thin stainless steel needles under sterile conditions. The needles are sometimes combined with lasers or electrical stimulation. Other times the practitioner will manipulate the needles manually to produce the desired results. The needles are then left in place for up to 30 minutes while the client relaxes in the practitioner’s office.
Clients often report feeling heat, tingling and perhaps some numbness in the area where the needles are inserted. Other common side effects are dizziness, headaches and nausea. These side effects are minimal compared to the potential side effects of using other drug related diet supplements to help with appetite suppression and boost metabolism.
Along with the acupuncture treatments, a trained practitioner may recommend some herbal supplements. These treatments are not believed to be enough to maintain weight loss but rather jump start sound nutritional dietary changes. Clients are able to experience immediate results which will often help them make better choices. Medical studies show that daily exercise, diet choices and dealing with food issues are also an important part of the process.
It can take some time for the body to adjust to acupuncture for weight loss but clients report that with patience, food cravings and overeating do disappear. Acupuncture also helps to reduce stress which can be a huge boost to stress eaters.
Before going to a practitioner do your homework. Look for referrals from people who are satisfied with their experience. Practitioners should be certified doctors who hold certifications through the National Certification Commission For Acupuncture and Oriental Medicine. The costs will vary with the area of the country and the experience of the practitioner. Not all insurance companies will cover the costs.
Acupuncture for weight loss is becoming more popular as a weight loss option to diet supplements and making it on your own. It appears to have the least number of side effects of any of the diet ‘helpers’ and has thousands of years of documentation and case study to prove the effectiveness.
Weight Loss Supplement Interventions:
Hydroxycitric acid (HCA) and weight loss:
Hydroxycitric acid (HCA), derived from the Garcinia cambogia fruit, is safe, and may be an effective tool for weight management. Super Citrimax (HCA-SX), a novel calcium-potassium salt of HCA, has been shown by prior laboratory studies to be safe and absorbed well by the body. In a clinical study, subjects (n=60) took 4,666.7 mg/day HCA-SX (containing 2,800 mg HCA) in 3 equal doses or a placebo for 8 weeks. Participants were also put on a 2,000 kcal diet/day and a 30 min walking exercise program 5 days/week. At the end of the study, a 5.4% and 5.2%, reduction in weight and body mass index, respectively, was reported. Food consumption, total cholesterol, LDL ‘bad’ cholesterol, triglyceride, and leptin levels (regulate appetite and metabolism) were significantly reduced. Additionally, HDL ‘good’ cholesterol, serotonin, and markers indicating fat burning increased significantly. No side-effects were reported. (19)
A 2-week laboratory study of fat cells from obese women found that low dose HCA-SX, a weight loss product containing hydroxycitric acid (HCA, derived from the Garcinia cambogia fruit) may induce lipolysis or the breakdown of fats/lipids. Additionally, HCA-SX had a positive effect on leptin, a molecule responsible for appetite regulation and metabolism. (20)
Mattes RD reported in a double-blind placebo controlled randomized trial that Garcinia cambogia (2.4 g/d, containing 1.2 g/day hydroxycitric acid) administered to overweight women (restricted to a 5020 kJ diet) had no effect on food intake or appetite suppression in a 12-week study. However, women taking G. cambogia (n=42) or placebo (n=47) both reported weight loss, though those taking G. cambogia had significantly greater weight loss (3.7 kg vs 2.4 kg). The study supports that weight loss did not occur by appetite suppression. (21)
The results of animal studies and double blind, placebo controlled human clinical studies, reveal that hydroxycitric acid (HCA) not only reduces weight, but also is safe. No treatment-related side-effects were reported in these studies. Furthermore, the authors conclude that HCA at a dose of up to 2800 mg/d is safe for human consumption. (22)
A laboratory evaluation of rats supplemented with 0, 0.2, 2.0 and 5.0% HCA-SX (Hydroxycitric acid Super CitriMax, derived from the Garcinia cambogia fruit), a popular supplement for weight loss, revealed that HCA-SX reduced body weight without affecting major organs, blood results, or tissue diagnosis of disease. (23)
Hydroxycitric acid (HCA), derived from the Garcinia cambogia fruit and often used to achieve weight loss, failed to provide significant weight reduction or fat mass loss in a group of overweight individuals. For 12-weeks, in addition to following a high-fiber/low-energy diet, participants were administered either 1500 mg/day of HCA (n=66) or placebo (n=69). At the end of the study, participants in both groups lost a significant amount of weight (average loss: -3.2 kg vs -4.1 kg). However, there was no significant difference between the groups for either weight or fat reduction, indicating that HCA had no additional benefit when compared to placebo. (24)
Green tea and weight loss:
Green tea weight loss supplements have become popular because they reportedly assist people with their weight loss goals. Most experts agree that supplements can significantly help to curb appetite and decrease intake, both of which are needed to lose weight. Many weight loss products that are purchased over the counter may contain green tea among combinations of other supplements. Green tea weight loss supplements have both caffeine and the chemical EGCG. These two chemicals (part of the production of the supplement) may increase metabolism.
There have not been an extensive number of long-term studies using green tea weight loss supplements to document the effectiveness and side effects. It is important to consult a physician to ensure that green tea will not interfere with any other medications, over the counter medications or health conditions. Green tea contains less caffeine than coffee and does not usually cause the same degree of anxiety or increase in heart rate. Green tea weight loss supplements also contain catechins, an anti-oxidant. These catechins are unfermented in green tea and in their natural state and are believed by some to suppress fat absorption from the diet.
Theanine is an amino acid found in green tea which has been found to induce relaxation and the release of dopamine which helps to provide a feeling of well-being. Theanine helps to reduce the effects of caffeine. Green tea extract weight loss supplements are not recommended due to reports of liver toxicity. Green tea itself up to 4 cups per day results in weight loss and appears to be safe, but does come without risk. Preventive Health Advisor recommends that liver function tests be obtained for green tea consumption of 4 cups per day or greater at baseline, after 3 months, at 6 months, and then at the physician’s discretion due to high a variability in green tea catechin content. Green tea extract is not recommended due to increased risk of hepatotoxicity with a higher concentration of catechins which it provides. While drinking green tea, patients should be advised to avoid drugs metabolized by the liver such as acetaminophen.
For further information, please see green tea in Preventive Health Advisor.
Effectiveness of green tea in weight loss:
Our review of the research has revealed that an average person can expect to lose about 2-4 pounds of weight with consistent intake of about 4 cups of green tea daily for 12 weeks.
The weight loss effect of green tea was confirmed in a double-blind, placebo controlled, randomized trial. Green tea was consumed daily for 12 weeks with 609.3 mg catechins and 68.7 mg caffeine by 104 subjects with an approximate BMI of 30 and excess abdominal visceral fat. It was found that the treatment group lost 2.2 lbs more weight on average than the controls. (25)
For further information, please see green tea in Preventive Health Advisor.
Green tea, inulin, weight loss, and blood pressure:
Green tea plus inulin resulted in weight loss and lowered systolic blood pressure. The effect of green tea plus inulin (a type of dietary soluble fiber) on body weight and fat mass in overweight adults was examined. 30 subjects were divided into a control group and an experimental group who received 650 ml (about 3-4 cups) of regular tea or catechin-rich green tea plus inulin (534 mg catechins and 11.7 g inulin). A reduction in body weight of approximately 4-5 pounds and an improvement by 7-8 points in systolic blood pressure among those drinking catechin-rich green tea plus inulin was found after 6 weeks, and no adverse effects were observed. In conclusion, sustained intake of catechin-rich green tea in combination with inulin for more than 3 weeks may contribute to weight loss and lower blood pressure. (26)
Green tea, cardiovascular disease, and obesity:
A randomized double-blind, controlled parallel multi-center trial consisting of a 2-week run-in period and a 12-week treatment period was conducted to investigate the effects of green tea extract (GTE) high in catechins on body fat reduction and reduction in the risks for cardiovascular disease in obese individuals. Data consisted of 240 subjects 25 to 55 years of age (catechin group; n = 123, control group; n = 117). Participants in the treatment group had an intake of 583 mg catechin (equivalent of about 4-5 cups of green tea), while those in the control group had an intake of 96 mg catechin. Decreases in body weight, body mass index, body fat ratio, body fat mass, waist circumference, hip circumference, visceral fat area, and subcutaneous fat area were found to be greater in the catechin group than in the control group. Those in the treatment group experienced a loss of about 4 pounds after 12 weeks. A greater decrease in systolic blood pressure (SBP) was found in the catechin group compared with the control group for subjects whose initial SBP was 130 mm Hg or higher. A reduction of 9.0 mm Hg vs 2.9 mm Hg was seen. Low-density lipoprotein (LDL) cholesterol was also decreased to a greater extent in the catechin group. No adverse effect was found. In conclusion, catechins, especially in high amounts, reduce body fat, cholesterol levels, and blood pressure in women and men. (27)
Pycnogenol, weight loss, and blood pressure:
Pycnogenol, French maritime pine bark extract, may be helpful to those suffering from metabolic syndrome. Study participants (n=58) were split into two groups. Both groups were being treated with Ramipril (5mg twice daily), an anti-hypertensive medication, and were instructed to follow a healthier lifestyle. One group was given Pycnogenol (50 mg 3 times/day) in addition to ramipril. Results show that Pycnogenol plus Ramipril significantly further lowered blood pressure (BP) when compared to the group taking Ramipril alone. After 6 months of treatment, average BP in the Ramipril group was lowered to an almost high value of 128.2/90.2 mmHg, while the value in the group taking Pycnogenol with Ramipril reached near normal levels (122.2/85.3 mmHg). Kidney function improved in both groups. With Ramipril alone, urinary protein decreased by 22% but with the addition of Pycnogenol it decreased by 52.7%. The group taking Pycnogenol also had a lowered fasting blood glucose level, which was reduced from high values to healthy values after 6 months of treatment. Only the group taking Pycnogenol was found to significantly lost weight after 6 months from average BMI 26.5 to 25.0. (28)
Fiber supplements and weight loss:
Glucomannan and weight loss:
Cairella M et al found that glucomannan, a water-soluble dietary fiber that is derived from the konjac root, and a low-calorie diet (1200 kcal) was more effective than placebo and a low calorie diet for improvement in body weight, total cholesterol, and hunger/satiety in a 60-day study that included 30 participants. (29)
Glucomannan appears to be an effective fiber for weight loss by adding volume to the stomach and satiety. The fiber supplements (Chrombalance [contains Glucomannan 1240 mg], Appe-Trim [contains Glucomannan and Guar 420 mg of each] and Glucosahl [containes Glucomannan 4320 mg, Guar 900 mg, and Alginat 900 mg]) may reduce body weight according to researchers. In this study, participants (n=176) received the fiber supplement or a placebo while adhering to a balanced 1200 kcal diet for five weeks. Scientists discovered that compared to the placebo group, participants taking any of these fiber supplements containg glucomannan experienced decreases in body weight of about 0.8 kg/week (range 3.8 – 4.4 kg) in the Chrombalance, Appe-Trim and Glucosahl group, respectively). According to the author, glucomannan was likely the effective ingredient of the supplements mentioned since guar gum and alginate showed no additional effect on body weight reductions. (30)
Psyllium fiber, guar gum, and weight loss:
According to a study by Cicero AF et al, psyllium fiber and guar gum reduced body mass index, plasma glucose, plasma insulin levels and LDL cholesterol. Additionally, psyllium reduced blood pressure but guar gum did not. Psyllium fiber supplementation in overweight individuals with high blood pressure significantly reduced systolic and diastolic blood pressure (BP) in a 6-month study (n=141). Participants were administered either oral psyllium power or guar gum (3.5 grams 3 times a day). After administration, both supplements significantly improved body mass index, fasting plasma glucose, fasting plasma insulin, and LDL cholesterol. However, only psyllium significantly lowered systolic and diastolic BP. (31)
Guar gum and weight loss in patients with type 2 diabetes:
Fiber-containing nutrition bars containing guar gum viscous fiber were found to decreased hunger and increased fullness in type 2 diabetics in this study (n=99). Participants ate 300-calorie candy bars for lunch and reported a 27.1% increase in fullness, a 15.8% decrease in food intake, and a 14.2% decrease in hunger two to four hours after the fiber-containing nutrition bars. Results indicate that guar gum may be a useful for managing type 2 diabetes by promoting weight loss. (32)
Saffron and weight loss:
A study by Gout B et al found that Satiereal, commonly known as saffron extract, can act as an appetite suppressant. It was examined as a weight loss aid in a randomized placebo-controlled study. The study was designed to look at two primary outcomes: actual weight lost and how much the participants snacked. The researchers divided 60 mildly overweight women into two randomized groups. Twice daily during an 8-week period, one group was given a Satiereal extract supplement at a dose of 88.5 mg oral twice per day and the other group an identical appearing placebo. At the end of the study period, the researchers found that the saffron group had less snacking and lost an average of 2.2 lbs in body weight compared to the women in the placebo group. They believe Satiereal can contribute to eventual weight loss as a supplement to a weight loss program and/or diet. (33)
Calcium and fecal fat excretion:
Consumption of dairy products containing calcium can contribute to enhanced fecal fat excretion, which may be a relevant intervention for weight loss. A meta-analysis of randomized controlled studies with consistent trial outcomes found that an increase in dairy calcium intake by 1241 mg/day leads to 5.2 g/day extra fecal fat excretion. (34)
Soy, whey protein, and resistance training:
Soy and whey protein combined with resistance training improved body composition and the cholesterol profile: Overweight hypercholesterolemic men with serum cholesterol >200 mg/dl were randomly divided into 3 groups (placebo (n = 9), soy (n = 9) or whey (n = 10) supplementation) and participated in supervised resistance training for 12 weeks. Total serum cholesterol decreased significantly (average=5.8%) for all groups (mean reduction = 12.6 mg/dL), with no differences among groups. Specifically, total cholesterol reduction was 10.4 mg/dL for placebo, 11.2 mg/dL for soy, and 15.9 mg/dL for whey. Participation in a 12 week resistance exercise training program significantly reduced serum cholesterol, increased strength, and improved body composition in overweight, hypercholesterolemic men. Whey protein improved cholesterol a small amount more than placebo or soy protein but additional added benefit from protein (soy or whey) supplementation was not otherwise seen in this particular study. (35)
Areca-nut chewing and obesity:
The areca-nut provides a mild stimulant, causing a warming sensation in the body and slightly heightened alertness. Research by the College of Dentistry at King Saud University, Saudi Arabia between 1991 and 2010 shows that chewing areca-nuts is associated with hyperglycemia and type 2 diabetes, metabolic syndrome, obesity, increased body mass, and higher triglyceride levels. (36)
Assessment and Plan: Weight Loss, Weight Control, Overweight, Obesity
- Calculate BMI to determine intervention based on American College of Sports Medicine Position Stand. (1) The formula is Weight (lb) / [Inches of height]² x 703 or a BMI calculator is available here: http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm
- BMI over 30 requires a physical exam and exercise stress test with special attention paid to gait, respiratory and cardiovascular status. Obese patients with a BMI greater than 30 need to start diet and exercise therapy with follow up starting at every 2 weeks, then every 4 to 6 weeks. Men with a waist circumference (WC) greater than 102 cm (42.5 in) and women with a WC greater than 88 cm (36.5 in) have a greater risk of heart disease, diabetes, osteoarthritis, sleep apnea, smoking related disease, stroke, gallstones, and gout.
- Patients with a BMI 25-29.9 with a WC greater or less than 102 cm for men and 88 cm or women, require diet and exercise. Those who have a WC greater than 102 cm for men and 99 cm for women should be monitored every 6 months up to a year for individuals without any heart risk factors. Those with two or more risk factors should be monitored every 3-6 months.
- Individuals with a normal BMI 19-24.9 with a WC less than 102 cm for men and less than 88 cm for women, with risk factors require treatment that includes education as well as a directed diet and exercise regimen to help them maintain proper weight.
- A positive linear trend in death rates with increasing body mass index was found for all cancers (3). Excess weight was found to be associated with an increased risk of heart disease, diabetes, osteoarthritis, sleep apnea, smoking related diseases, stroke, gallstones, abdominal aortic aneurysm, and gout.
- According to the meta-analysis by Clifton, a low-fat diet has an average weight loss is 5.4 kg at 12 months and improves diabetes and high blood pressure control (6).
- Clifton stated that a low-calorie diet results in slightly better weight loss than a low fat diet, but a low calorie diet of 1100-1600 calories including moderate fat intake is superior to the low-fat diet for weight loss. A protein intake of more than 1.05g/kg of body weight aided retention of lean body muscle mass during the diet (6).
- Anderson JW et al described that a very low calorie diet with less than 1000 kcal per day may yield somewhat better weight loss than a low-calorie diet of 1100-1600 kcal per day but the difference between these 2 diets becomes smaller in the long term.
- A very low calorie diet risks greater loss of lean body composition compared to low calorie or other diets.
- Clifton stated that those on carbohydrate-restricted diets are satisfied more from the increased protein which may aide compliance. He stated that dieters using this method tend to lose more weight than those on low-fat diets when evaluated after 6 months, but after 12 months the difference is not obvious (6). A concerning finding was that 2 studies reviewed showed that a low-carbohydrate, high protein diet increased the risk of mortality from cardiovascular diseases and cancer (10,11).
- Including 4 servings of beans as part of a low calorie diet (160-235 grams per day of lentils, chickpeas, peas or beans) resulted in greater weight loss than a low calorie diet without legumes. The legumes also reduced markers of inflammation in the blood, CRP (C-reactive protein) and C3 (complement).
- Low-glycemic-index or low-glycemic load diets contain all complex carbohydrates, eliminate concentrated sweets, simple sugars, and are ideal for diabetes control. This diet leads to both weight loss, improved blood sugar, and the lowering of LDL cholesterol.
- A study done at the Department of Medicine, Duke University Medical Center, Durham, NC found that both a low-carbohydrate diet with less than 20 grams of carbs per day and a low glycemic, reduced calorie diet with 500 kcal under their weight maintenance kcal improved glycemic control plus reduced or eliminated the need for diabetes medication. The low carb diet reduced hemoglobin A1C by 1.5%, reduced weight by 11.1 kg, improved HDL by 5.6, and reduced or eliminated medication in 95.2% of subjects. The reduced calorie diet reduced hemoglobin A1C by 0.5%, reduced weight by 6.9 kg, left HDL unchanged, and reduced or eliminated medication in 62% of subjects. (12)
- For patients with hip osteoarthritis, an 8-month exercise and weight loss program was an effective treatment for patients resulting in a 32.6% improvement of physical function, reduced pain and better walking tests.
- Our review of the research has revealed that an average person can expect to lose about 2-4 pounds of weight with consisted intake of about 4 cups of green tea daily.
- Hydroxycitric acid (HCA), derived from the Garcinia cambogia fruit in a dose up to 2,800 mg of HCA divided in 3 equal doses per day taken for weight loss has been described as safe without side effects in 2 reviews focused on safety of the agent. However, results from the research reviewed has shown mixed results. 1 review and 1 double-blind randomized placebo controlled clinical trial found HCA did not differ significantly compared to a diet and exercise program alone. This result provided more credibility to diet and exercise than the HCA. 1 randomized placebo controlled clinical trial by Mattes RD reported a greater weight loss of 3.7 kg vs 2.4 kg with 1200 mg of HCA per day vs. placebo in obese patients but weight loss did not occur by appetite suppression, a hypothesis promoted by other research as the mechanism for action. The remaining research reviewed was less credible for supporting HCA for use in weight loss. More research is needed on HCA.
- 2 double-blind, placebo-controlled, randomized trials and 1 trial with both an experimental and control group found that 3-5 cups of green tea per day taken over the course of 6-12 weeks resulted in a 2.2-5 lb. weight loss. 2 of these trials found a reduction in systolic bp by 7.8-9 points during the same time period. 1 of the trials also showed a reduction in LDL cholesterol.
- Fiber supplements add volume to the stomach to curb hunger, bind fats and cholesterol to reduce absorption, and overall reduce calorie density in the gastrointestinal tract. Glucomannan at a dose of 1240 mg to 4320 mg per day in 3 different brands of this supplement plus a low-calorie diet (1200 kcal) was more effective than placebo and a low calorie diet for improvement in body weight, total cholesterol, and hunger/satiety. The range of weight loss over 5 weeks was 3.8 – 4.4 kg with the 3 different glucomannan containing supplements. In a 6 month study, overweight patients were given oral psyllium power or guar gum (3.5 g 3 times a day) and both significantly improved body mass index, fasting plasma glucose, fasting plasma insulin, and LDL cholesterol. Psyllium also significantly lowered systolic and diastolic BP. Fiber supplements may be dangerous if taken without adequate volume of water which can result in gastrointestinal obstruction. They may also bind medications in the GI tract and reduce absorption.
- In a randomized placebo-controlled study Saffron in the form of Satiereal extract at a dose of 88.5 mg oral twice per day or placebo was given to mildly obese women for 8 weeks. The saffron group had less snacking and lost an average of 2.2 pounds compared to the placebo group.
- Whey protein, when combined with resistance training, improved body composition and cholesterol better than soy protein and placebo in overweight men.
- Low fat dairy products may be useful in promotion of weight loss. A meta-analysis of randomized controlled studies found that an increase in dairy calcium intake by 1241 mg/day leads to 5.2 g/day extra fecal fat excretion.
- Areca-nut chewing is common in the Middle East and use should be avoided chronically for its association with hyperglycemia, type 2 diabetes, metabolic syndrome, obesity, increased body mass, and higher triglyceride levels.
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