Weight control: What the research says

Weight Control – Mayo Clinic nutritionists

Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.


Anyone who has begun or is on a weight loss journey knows that weight control — losing weight and keeping it off — can be a daily challenge. Weight control is a complex. It’s about living a healthy lifestyle and making smart choices, despite the many hurdles life throws at you, whether they’re physical, emotional or social.

It’s easy to feel overwhelmed when you’re looking for advice on weight control. Every week a new diet appears on bookshelves, magazine racks or online. Even when you go to the scientific and medical journals, there’s debate about which diet is best for weight control. Teasing out all the variables can frustrate even the most dedicated researcher. So I thought I’d cut to the chase and offer some practical advice on weight control.

The bottom line really is that you must control calories through portion control, appropriate food choices and physical activity. However, there are few weight control tricks that can be culled from the diet research:

  • Eat some protein. Protein is cited as the most satiating nutrient. No need to overdo it, but include 1 to 3 ounces (28 to 85 grams) of a protein-rich food at meals. Protein, beyond its basic function of building and repair, moderates the rise of blood glucose. This steadies your hunger and energy levels.
  • Go low on the glycemic index. Foods with a low glycemic index — most fruits, veggies and whole grains — are part of any healthy diet. They contain fiber and water that give them bulk without the calories, making them filling foods. These properties also play a positive role in your body’s metabolism and insulin response.
  • Choose the right carbs. Carbs are packed with nutrients that are essential to feeling good each day, and they likely play a strong role in disease prevention. Most of your choices here should be whole foods or as close to it as possible.
  • Be selective about fats. Fat plays a key role in our health. Fat also aids hunger control because it is slowly digested. Moderating the amount you eat will reduce your calories. Choosing healthier fats — nuts, oils and avocado, for instance — instead of saturated fats can improve your heart health and may have a role preserving good mental and physical health.

Study ties blood protein ApoE to Alzheimer’s brain abnormalities

In NIH-supported Alzheimer’s study, blood test in symptom-free volunteers links levels of specific protein with beta amyloid deposits

Scientists are seeking ways to detect the earliest stages of Alzheimer’s disease, since harmful changes may be taking place in the brain years before symptoms appear. Now, researchers report that a blood test detecting a specific protein in blood samples from cognitively normal older people may reflect the levels of beta-amyloid protein in the brain — a hallmark of the disease. Supported in part by the National Institutes of Health, the findings may eventually lead to a blood test that helps predict risk for Alzheimer’s disease and who may be a good candidate for participating in clinical trials.

Madhav Thambisetty, M.D., Ph.D., of the Intramural Research Program at the National Institute on Aging (NIA), part of the NIH, was the lead author on the study with collaborators from the Institute of Psychiatry at King’s College, London, and the Department of Radiology at Johns Hopkins University, Baltimore. The study appears in the Dec. 20, 2010, issue of the Journal of Alzheimer’s Disease.

“Recent advances in imaging and biomarkers that help track the onset and progression of Alzheimer’s disease show promise for early detection of the disease process, and for tracking the effectiveness of early interventions,” said NIA Director Richard J. Hodes, M.D. “This is critically important in streamlining and conducting trials more efficiently so that we can find out about possible therapies that much sooner.”

Using proteomics technology, a method of studying hundreds of proteins from a small blood sample, the researchers analyzed blood samples of 57 older and symptom-free volunteers to determine whether specific proteins were associated with amyloid burden in the brain. They measured brain amyloid using PET (positron emission tomography) scans with Pittsburgh Compound B, a tracer that binds to amyloid plaques. The volunteers are participating in the NIA’s Baltimore Longitudinal Study of Aging (BLSA), America’s longest-running scientific study of human aging.

The researchers found the amount of a specific protein called apolipoprotein E, or ApoE, in the blood samples was strongly associated with the level of beta amyloid in the brain. Those with high blood levels of the protein had significantly greater deposits of amyloid in the medial temporal lobe, the region of the brain important to memory function.

“These results are especially intriguing as this protein is made by the APOE gene, the most robust genetic risk factor for late-onset Alzheimer’s,” Thambisetty said. Late-onset Alzheimer’s is the most common form of the disease and occurs around age 65 or later.

He now plans to test these findings in serial blood samples collected every year in BLSA volunteers to determine how changing blood levels of ApoE protein may relate to pathological changes in the brain over time.

“If the results are equally positive, we may be able to develop a blood test that provides a less invasive, inexpensive method that helps to detect the early pathological changes of Alzheimer’s disease,” he said.

The NIA leads the federal government effort conducting and supporting research on aging and the health and well being of older people. For more on health and on aging generally, go to www.nia.nih.gov. The NIA provides information on age-related cognitive change and neurodegenerative disease specifically at its Alzheimer’s Disease Education and Referral (ADEAR) Center at www.nia.nih.gov/Alzheimers. To sign up for e-mail alerts about new findings or publications, please visit either website. To learn more about the BLSA, go to http://www.grc.nia.nih.gov/branches/blsa/blsanew.htm.

Obesity patients are not victims

by David Gratzer, MD

Call it the McVictim syndrome. Too many pundits, public health experts and politicians are working overtime to find scapegoats for America’s obesity epidemic.

In his latest book, former FDA Commissioner David A. Kessler argues that modern food is addictive. In it, he recounts how he was once helpless to stop himself from eating a cookie. In a paper in this month’s Journal of Health Economics, University of Illinois researchers join a long list of analysts who blame urban sprawl for obesity. In November, former Carter administration advisor Amitai Etzioni argued that it’s so hard for Americans to keep weight off that adults should simply give up and focus attention on the young instead.

The peak of the trend: A recently released Ohio study, using mice, suggests “fine-particulate air pollution” could be causing a rise in obesity rates.

How long before we’re told that the devil made us eat it?

The McVictim syndrome spins a convenient — and unhealthy — narrative on America’s emerging preventable disease crisis. McVictimization teaches Americans to think that obesity is someone else’s fault — and therefore, someone else’s problem to solve.

The truth: In the vast majority of cases, obesity is a preventable condition. So those of us in the medical community must be candid with overweight patients about the risks they face and the rewards of better health choices. But it’s also time for American policymakers to show the same level of candor.

All things being equal, the simplest explanation is often the right one. And the simplest explanation for the dramatic rise in obesity rates — roughly doubling as a percentage of the total population in just a quarter-century — is the surge in our daily caloric intake. Excess food now, excess weight later. And Americans won’t make better choices if the McVictim syndrome provides a convenient excuse to carry on as before.

Obesity is preventable, but its consequences seem difficult to avoid. Consider that the cost of treating resulting conditions such as diabetes is about 7% of all U.S. healthcare spending — and a significant drain on federal and state budgets. Obesity is a national security threat because it severely limits the pool of military recruits; in 2009, the Pentagon indicated that since 2005, 48,000 potential troops had flunked their basic physical exams because they weighed too much. Most important, obesity is a human threat, destroying otherwise healthy lives and increasing personal health costs, all for the sake of a few daily moments of instant gratification.

For these reasons, there is a role for government to play in attacking obesity. Public policy can help. School lunch programs shouldn’t push our children toward obesity at taxpayers’ expense. We should stop subsidizing agribusinesses; many are using taxpayer dollars to produce and market unhealthful foods. We should promote insurance reforms that support preventive medicine.

But we must also launch a direct attack on the philosophy behind the McVictim syndrome. Policymakers must accept the fact that a poor diet is almost always a poor personal choice.

Yes, it’s fair to say that many Americans try to choose better — and fail because they’ve chosen quack drugs or crash diets as the solution. Yes, it’s fair to say that losing weight solely for appearance’s sake isn’t a healthful choice. Yes, it’s fair to say we shouldn’t crush the self-esteem of those who’ve tried, and failed, to keep off excess weight. In other words, our society makes healthful choices tougher.

But even so, encouraging Americans to cut their dietary health risks is a responsible act of citizenship. And it’s absurd to pretend that Americans are helpless to make that choice — or that it’s too late for them to reap the benefits. Contrary to claims like Etzioni’s, even a modest, voluntary improvement in the average American diet could pay huge dividends.

Just as a little more weight causes more damage over time (to joints, to cardiovascular systems, to organs), a little less weight can produce dramatic health benefits. To take one example, a study cited in the Journal of the American College of Cardiology found that obese patients on a program of mild weight loss and modest exercise cut their odds of getting diabetes by as much as 60%. Imagine the benefits that would flow from keeping millions of future Medicare recipients from ever needing an insulin prescription.

The McVictim syndrome is far too prevalent, which promotes the notion that regulations and laws are the primary solution to the problem. But governments can’t micromanage your waistline for you. Even if governments could magically walk you to work, ban food advertising, regulate sugar out of food and suck those fat particles out of the air, in a free society you would still have the power to drive to the nearest restaurant, shake your salt shaker and order a second piece of pie.

That’s why understanding — and rejecting — the McVictim culture is crucial to obesity reduction policy. And the first step in that process is to reject the temptation to find an easy scapegoat.

David Gratzer is a physician and senior fellow at the Manhattan Institute. He is author of The Cure: How Capitalism Can Save American Health Care.

Cholera in Haiti Outbreak

Cholera in Haiti
Cholera in Haiti - news.nationalpost image

An epidemic cholera strain has been confirmed in Haiti, causing the first cholera outbreak in Haiti in many years. Cholera is a potentially fatal bacterial infection that causes severe diarrhea and dehydration.

The disease is most often spread through the ingestion of contaminated food or drinking water. Water may be contaminated by the feces of an infected person or by untreated sewage. Food is often contaminated by water containing cholera bacteria or because it was handled by a person ill with cholera.

The majority of cases have been reported in the Artibonite Departmente, approximately 50 miles north of Port-au-Prince. Affected hospitals are being strained by the large number of people who are ill.

This outbreak is of particular concern given the current conditions in Haiti, including poor water and sanitation, a strained public health infrastructure, and large numbers of people displaced by the January earthquake and more recent flooding.

The World Health Organization, along with a number of international agencies, is mobilizing to assist local and national response efforts.

Advice for Travelers


At this time, CDC and the U.S. Department of State maintain travel warnings for Haiti. These warnings recommend that U.S. citizens avoid all nonessential travel to Haiti. For more information, see Travel Health Warning: Major Earthquake in Port-au-Prince, Haiti on the CDC website.

Most travelers are not at high risk for getting cholera, but people who are traveling to Haiti should still take their own supplies to help prevent the disease and to treat it. Items to pack include

  • A prescription antibiotic to take in case of travelers’ diarrhea
  • Water purification tablets*
  • Oral rehydration salts*

*In the United States, these products can be purchased at stores that sell equipment for camping or other outdoor activities.

Although no cholera vaccine is available in the United States, travelers can prevent cholera by following these 5 basic steps:

1) Drink and use safe water*

  • Bottled water with unbroken seals and canned/bottled carbonated beverages are safe to drink and use.
  • Use safe water to brush your teeth, wash and prepare food, and make ice.
  • Clean food preparation areas and kitchenware with soap and safe water and let dry completely before reuse.

*Piped water sources, drinks sold in cups or bags, or ice may not be safe. All drinking water and water used to make ice should be boiled or treated with chlorine.

To be sure water is safe to drink and use:

  • Boil it or treat it with water purification tablets, a chlorine product or household bleach.
  • Bring your water to a complete boil for at least 1 minute.
  • To treat your water, use water purification tablets, if you brought some with you from the United States, or one of the locally available treatment products, and follow the instructions.
  • If a chlorine treatment product is not available, you can treat your water with household bleach. Add 8 drops of household bleach for every 1 gallon of water (or 2 drops of household bleach for every 1 liter of water) and wait 30 minutes before drinking
  • Always store your treated water in a clean, covered container.

2) Wash your hands often with soap and safe water*

  • Before you eat or prepare food
  • Before feeding your children
  • After using the latrine or toilet
  • After cleaning your child’s bottom
  • After taking care of someone ill with diarrhea

* If no soap is available, scrub hands often with ash or sand and rinse with safe water.

3) Use latrines or bury your feces (poop); do not defecate in any body of water

  • Use latrines or other sanitation systems, like chemical toilets, to dispose of feces.
  • Wash hands with soap and safe water after using toilets or latrines.
  • Clean latrines and surfaces contaminated with feces using a solution of 1 part household bleach to 9 parts water.

What if I don’t have a latrine or chemical toilet?

  • Defecate at least 30 meters away from any body of water and then bury your feces.
  • Dispose of plastic bags containing feces in latrines, at collection points if available, or bury it in the ground. Do not put plastic bags in chemical toilets.
  • Dig new latrines or temporary pit toilets at least a half-meter deep and at least 30 meters away from any body of water.

4) Cook food well (especially seafood), keep it covered, eat it hot, and peel fruits and vegetables*

  • Boil it, cook it, peel it, or leave it
  • Be sure to cook shellfish (like crabs and crayfish) until they are very hot all the way through.
  • Do not bring perishable seafood back to the United States.

* Avoid raw foods other than fruits and vegetables you have peeled yourself.

5) Clean up safely—in the kitchen and in places where the family bathes and washes clothes

  • Wash yourself, your children, diapers, and clothes at least 30 meters away from drinking water sources.

Before departing for Haiti, talk to your doctor about getting a prescription for an antibiotic to treat travelers’ diarrhea. If you are traveling in Haiti and have severe watery diarrhea, seek medical care right away. Remember to drink fluids and use oral rehydration salts (ORS) to prevent dehydration.

Medical care facilities are strained with the high number of people who are ill. If you will be traveling to Haiti, CDC recommends that you purchase medical evacuation insurance in the event that you become ill while in Haiti. (See the U.S. Department of State list of U.S.-Based Air Ambulance or Medical Evacuation Companies.) If you are in Haiti and need medical care and you do not have access to medical evacuation, you can contact the Embassy of the United States in Port-au-Prince, Haiti, (American Citizens Services Unit office hours are 7:00 a.m. to 3:30 p.m., Monday through Friday. The Consular Section is closed on U.S. and local holidays.):

Boulevard du 15 October, Tabarre 41, Tabarre, Haiti
Telephone: (509) (2) 229-8000
Facsimile: (509) (2) 229-8027
Email: [email protected]

Advice about Cholera for Travelers Arriving in the U.S. from Haiti

Five Basic Cholera Prevention Messages

Info for Healthcare Professionals

Acute Watery Diarrhea & Cholera: Pre-decision Brief

Cholera Outbreak in Haiti

General Cholera Info

Haiti Earthquake and Travel

Facial exercises that firm the muscles in your chin and face

I don’t usually write about vanity issues, but I have to make an exception in this case, because it works. I have practiced a similar routine since I first noticed my “Adam’s Apple” starting to disappear when I was in my late thirties.

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