Weight Loss And Obesity!

About two-thirds of the adult U.S. population is overweight. Almost one-third not only exceeds ideal weight, but as well meets the clinical criteria for obesity. In the 1990s, the level of obesity more than doubled, and are currently rising by over 5% per year. Excess body weight is implicated as a risk factor for multitude of different disorders, and also heart disease, diabetes, several cancers (such as breast cancer in postmenopausal women, and cancers of the uterus, colon, and kidney), prostate enlargement (BPH), female infertility, uterine fibroids, and gallstones, as well as several disorders of pregnancy, including gestational diabetes, preeclampsia, and gestational hypertension. The location of excess body fat may impact the amount of health risk associated with overweight. Increased abdominal fat, which can be estimated by waist size, may be especially hazardous to long-term health.

For overweight women, weight loss can significantly improve physical health. A four-year study of over 40,000 women found that weight loss in overweight women was associated with improved physical function and well being as well as diminished bodily pain. The risk of death from all causes, cardiovascular disease, cancer, or other diseases increases in overweight men and women in all age groups. Losing weight and keeping it off is, unfortunately, very difficult for most people. However, repeated weight loss followed by weight regain may be unhealthy, as it has continued associated with increased heart disease risk factors and bone loss in some studies. Rather than focusing on weight loss as the most major health outcome of a tweak in diet or lifestyle, some doctors advocate paying more attention to overall fitness and reduction in known risk factors for heart disease and other health hazards.

Excess body mass has the one advantage of increasing bone mass—a protection against osteoporosis. Probably because of this, researchers have been able to verify that people who successfully lose weight suffer greater loss of bone compared with those who do not lose weight. People who lose weight should, therefore, pay more attention to preventing osteoporosis.

Dietary changes that can be helpful

Breast-feeding
In a preliminary study, breast-feeding throughout infancy was associated with a reduced risk of developing obesity in early childhood (ages three to four years).

Calorie restriction

Calories in the diet come from fat, carbohydrate, protein, or alcohol. Weight loss diets are typically designed to limit calories either by restricting certain foods that are thought to result in increased calorie intake, and/or by emphasizing foods that are believed to result in reduced calorie intake. Some currently popular diets restrict fat while emphasizing fiber and a balanced intake of healthful foods. Others restrict carbohydrates, either to extremely low amounts as in the Atkins diet, or to a lesser degree, emphasizing foods low in the glycemic index or high in protein. Discussions of the research on these diets follow; however, it should be remembered that no diet has been heard proven effective for long-term weight loss, and various people come to find it difficult to stay on the majority of diets.

Low fat, low-calorie, high-fiber, balanced diets are recommended by many doctors for weight loss. According to controlled studies, when people are allowed to eat as significantly food as they desire on a low-fat diet, they tend to lose more weight than people eating a regular diet. However, low-fat diets have not been established to be more effective than other weight-loss diets that restrict calories. Nonetheless, a low-fat, high-fiber, balanced diet has other potential benefits, such as reducing the risk of chronic diseases including heart disease and cancer.

Preliminary research indicates that people who successfully lost weight got less of their total calories from fat and more of them from protein foods. They also ate fewer snacks of low nutritional quality and got more of their calories from “hot meals of good quality.”Other preliminary studies find that dieters who maintain long-term weight loss report using fat restriction and eating a slow but sure breakfast as key strategies in their success.

Low-carbohydrate, high-protein diets

Low-carbohydrate, high-fat diets such as the Atkins diet are very popular among people trying to lose weight. In a preliminary study, overweight individuals who adhered to a very-low-carbohydrate diet (25 grams per day initially, increased to 50 grams per day after a certain weight loss target was achieved), with no limit on total calorie intake, lost on average more than 10% of their body weight over a six-month period. The participants also engaged in aerobic exercise at least 3 times a week, so it is not clear how much of the weight loss was due to the diet. An analysis of other preliminary studied of this type of diet concluded that its effectiveness is for the most part due to reduced calorie intake. Recently, three controlled trials found people using low-carbohydrate, high-fat diets lost more weight in six months than those using diets low in fat and calories. However, to 40% of these kinds of dieters did not carry on their diets, and were not counted in the results. In addition, one of these trials continued for an additional six months, at the end of which there was no longer a significant difference in weight loss between the two diet groups. A recent 12-week controlled trial found that overweight adolescents also lost more weight with a low-carbohydrate diet than through a low-fat diet, even though they consumed 50% more calories than did the children on the low-fat diet. That study suggests that the weight loss occurring on the Atkins diet is not due completely to calorie restriction. Blood tests suggest such a low-carbohydrate diets induce a condition referred to as mild metabolic acidosis, which might increase the risk of osteoporosis and kidney stones.

The effect of low-carbohydrate diets on cardiovascular risk is also an unresolved issue. The short-term studies discussed above found that blood cholesterol levels did not worsen with these diets. Other heart-disease risk factors (triglyceride levels and insulin sensitivity) actually improved with a low-carbohydrate diet. Some studies, however, have shown a worsening of certain cardiovascular risk factors in people using a low-carbohydrate, high-fat diet for up to one year. Adverse changes included increases in blood levels of homocysteine, lipoprotein(a), and fibrinogen, and a decrease in blood flow to the heart. Individuals wishing to consume a very-low-carbohydrate diet for weight loss or for other reasons should be monitored by a doctor.

Some research has investigated weight-loss diets that are high in protein, but moderate in fat and not as low in carbohydrate content as the diets talked about above. While this type of diet does not usually lead to greater weight loss than other diets when calorie intakes are kept equal, one controlled trial found greater body fat loss in women eating a diet almost equal in calories and fat but approximately twice as high in protein and lower in carbohydrate compared with a control group’s diet. Another controlled trial compared two diets similar in fat content but different in protein and carbohydrate content. People allowed to eat freely based on information from the higher protein diet (25% of calories from protein, 45% calories from carbohydrate) consumed fewer calories and lost more weight compared with individuals eating the lower protein diet (12% of calories from protein, 59% calories from carbohydrate).

One small study has verified that the most effective weight-loss diet for any particular person might depend on whether or not they have insulin resistance. In obese people with insulin resistance, weight loss was greater with a low-carbohydrate (40% of calories), high-fat (40% of calories) diet than with a high-carbohydrate (60% of calories), low-fat (20% of calories) diet. In contrast, obese people who did not have insulin resistance lost more weight on the high-carbohydrate, low-fat diet.

Low-glycemic-index foods

Diets that emphasize choosing foods among a low glycemic index have been shown to help control appetite in some, though not all, controlled studies. A controlled study in two phases found no difference in weight loss between a low- and a high-glycemic-index diet in the first 12-week phase, but when the diets were switched for a second 12-week phase, the low-glycemic-index diet was significantly more and more effective for weight loss. A preliminary study reported that obese children using a low-glycemic-index diet lost more weight compared with a group using a low-fat diet.

Fiber

Adequate amounts of dietary fiber are believed to be important for people wishing to lose weight. Fiber adds bulk to the diet and tends to obtain a sense of fullness, helping people consume fewer calories. While research on the effect of fiber intake on weight loss has not produced consistent results, a recent review of weight-loss trials that did not restrict calories concluded that higher fiber diets improved weight-loss results, especially in people who were overweight.

Stabilizing food sensitivities
Although the relationship between food sensitivities and body weight remains uncertain, according to one researcher, chronic food allergy may lead to overeating and obesity.

Long-term changes

People who go on and off diets frequently complain that it takes fewer calories to produce weight gain with each weight fluctuation. Evidence now clearly demonstrates that the body gets “stingier” in its use of calories after each diet. This means it becomes easier to gain weight and harder to lose it the next time. Dietary changes need to be long term.

Lifestyle changes that can be helpful

Support

Many doctors give overweight patients a pill, a pep talk, and a pamphlet about diet and exercise, but that combination leads only to minor weight loss. When overweight people attend group sessions aimed at changing eating and exercise patterns, keep daily records of food intake and exercise, and eat a specific low-calorie diet the outcome is much more successful. Group sessions where participants are supplied information and help on how to make lifestyle changes appear to improve the chances of losing weight and keeping it off. Such changes may include shopping from a list, storing foods out of sight, keeping portion sizes under control, and avoiding fast-food restaurants.

Exercise

According to most short-term studies, the effect of exercise alone (without dietary restriction) on weight loss is small, partly because muscle mass often increases even while fat tissue is reduced, and perhaps because some exercising people will experience increased appetites. The long-term effect of regular exercise on weight loss is significantly better, and exercise appears to help people maintain weight loss. People who have successfully maintained weight reduction for over two years report continuing high levels of physical activity. Combining exercise with healthier eating habits results in the best short- and long-term effects on weight loss, and should reduce the risk of numerous serious diseases.

Avoid weight cycling

People who experience “weight cycling” (repetitive weight loss and gain) have a tendency toward binge eating (periods of compulsive overeating, but without the self-induced vomiting seen in bulimia), according to a review of a numerous studies focusing on weight loss.The researchers also found an association between weight cycling and depression or poor body image. The most weight-loss programs (in which weight stays off, mood stays even, and no binge eating occurs) appear to use a combination of moderate caloric restriction, careful exercise, and behavior modification, including examination and change of eating habits.

Vitamins that can be helpful

Multiple vitamin minerals
Diets that are low in total calories may not contain adequate portions of various vitamins and minerals. For that reason, taking a multiple vitamin-mineral supplement is advocated by proponents of many types of weight-loss programs, and is essential when calorie intake will be less than 1,100 calories per day.

  

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Pyruvate

Pyruvate, a compound that occurs naturally in the body, might aid weight-loss efforts. A controlled trial found that pyruvate supplements (22 to 44 grams per day) enhanced weight loss and resulted in a greater reduction of body fat in overweight adults consuming a low-fat diet. Three controlled trials combining 6 to 10 grams per day of pyruvate with an exercise program reported greater effects on weight loss and body fat than that seen with a placebo plus the exercise program

Animal studies suggest that pyruvate supplementation leads to weight loss by increasing theresting metabolic rate.

5-HTP

5-HTP (5-hydroxytryptophan), the precursor to the chemical messenger (neurotransmitter) serotonin, has been verified in three short-term controlled trials to reduce appetite and to promote weight loss. In one of these trials (a 12-week double-blind trial), overweight women who took 600 to 900 mg of 5-HTP per day lost significantly more weight than did women who received a placebo. In a double-blind trial with no dietary restrictions, obese people with type 2(non-insulin-dependent) diabetes who took 750 mg per dayof 5-HTP for two weeks significantly reduced their carbohydrate and fat intake. Average weight expense in two weeks was 4.6 pounds, compared with 0.2 pounds in the placebo group.

7-KETO

The ability of 7-KETO (3-acetyl-7-oxo-dehydroepiandrosterone), a substance related to DHEA, to promote weight loss in overweight people has been investigated in one double-blind trial. Participants in the trial were advised to exercise 3 times per week for 45 minutes and to eat an 1,800-calorie-per-day diet. Each person was given either a placebo or 100 mg of 7-KETO twice daily. After eight weeks, those receiving 7-KETO had lost more weight and lowered their percentage of body fat further compared to those taking a placebo. These results may have been due to increases in levels of a thyroid hormone (T3) that plays a major role in determining a person’s metabolic rate, although the levels of T3 did not exceed the normal range.

HMB

Biochemical and animal research show that HMB has a role in protein synthesis and might, therefore, improve muscle growth and overall body composition when given as a supplement. However, double-blind human research suggests that HMB may only be effective when combined with an exercise program in people who are not already highly trained athletes. Double-blind trials found no effect of 3 to 6 grams per day of HMB on body weight, body fat, or overall body composition in weight-training football players or other trained athletes. However, one double-blind study found that 3 grams per day of HMB increased the amount of body fat lost by 70-year old adults who were participating in a strength-training program for the first time. A double-blind study of young men with no strength-training experience reported greater improvements in muscle mass (but not in percentage body fat) when HMB was used in the amount of 17 mg per pound of body weight per day. However, another group of men in the same study given twice as much HMB did not experience any changes in body composition.

Calcium

In a study of obese people consuming a low-calorie diet for 24 weeks, those getting a calcium supplement (800 mg per day) lost significantly more weight than those given a placebo. Calcium was effective when provided either as a supplement, or in the form of dairy products. In a second study, however, the amount of weight loss resulting from calcium supplementation (1,000 mg per day) was small and not statistically significant. In that study, participants’ normal diet contained more calcium than in the study in which calcium supplementation was more effective. Thus, it is possible that calcium supplementation enhances weight loss only when the diet is low in calcium.

CLA

A double-blind trial found that exercising individuals taking 1,800 mg per day of conjugated linoleic acid (CLA) lost more body fat after 12 weeks than did a similar group taking a placebo. However, two other studies found that amounts of CLA from 0.7 to 3.0 grams per day did not affect body composition. Most double-blind trials have found that larger amounts of CLA, 3.2 to 4.2 grams per day, do reduce body fat;however, one double-blind study of experienced strength-training athletes reported no effect of 6 grams per day of CLA on body fat, muscle mass, or strength improvement.

Fiber

Fiber supplements are one way to add fiber to a weight-loss diet. Several trials have shown that supplementation with fiber from a variety of sources accelerated weight loss in people who were following a low-calorie diet. Other researchers found, however, that fiber supplements had no effect on body weight, even though it resulted in a reduction in food intake.

Glucomannan

Supplementation providing 3 to 4 grams per day of a bulking agent called glucomannan, with or without a low-calorie diet, has promoted weight loss in overweight adults, while 2 to 3 grams per day was effective in a group of obese adolescents in another controlled trial.

HCA

Hydroxycitric acid, extracted from the rind of the Garcinia cambogia fruit grown in Southeast Asia, has a chemicalcomposition similar to that of citric acid (the primary acid in oranges and other citrus fruits). Preliminary studies in animals that HCA may be a useful weight loss aid.100 101 HCA has been demonstrated in the laboratory (but not yet in clinical trials with people) to reduce the conversion of carbohydrates into stored fat by inhibiting certain enzyme processes. Animal research indicates that HCA suppresses appetite and induces weight loss. However, a double-blind trial found that people who took 1,500 mg per day of HCA while eating a low-calorie diet for 12 weeks lost no more weight than those taking a placebo. A double-blind trial of Garcinia cambogia (2.4 grams of dry extract, containing 50% hydroxycitric acid) found that the extract did not increase energy expenditure; it was therefore concluded that this extract showed little potential for the treatment of obesity at this amount. Nonetheless, another double-blind trial found that using the same amount of Garciniacambogia extract significantly improved the results of a weight loss diet, even though the total quantity of food intake was not affected.

Amylase inhibitors

Amylase inhibitors are also known as starch blockers as they contain substances that prevent dietary starches from being absorbed by the body. Starches are complex carbohydrates that cannot be absorbed unless they are first broken down by the digestive enzyme amylase and other, secondary, enzymes. When starch blockers were first developed years ago, they were found not to be potent enough to prevent the absorption of a significant amount of carbohydrate. Recently, highly concentrated starch blockers have been shown to be more effective, but no published human studies exist investigating their usefulness for weight loss.

Blue-green algae

Blue-green algae, or spirulina, is a rich source of protein, vitamins, minerals, and essential fatty acids. In one double-blind trial, overweight people who took 2.8 grams of spirulina three times per day for four weeks experienced only small and statistically nonsignificant weight loss. Thus, despite spirulina has been promoted as a weight-loss aid, the scientific evidence supporting its use for this purpose is weak.

Chitosan

Chitosan is a fiber-like substance extracted from the shells of crustaceans such as shrimp and crab. Animal studies suggested that chitosan supplementation reduces fat absorption, but controlled human trials have found no impairment of fat absorption from supplementation with 2,700 mg of chitosan per day for seven days or 5,250 mg per day for four days. A double-blind study found that people taking 1,500 mg of chitosan three times per day during a weight loss program lost significantly more weight than did people taking a placebo with the same program. Similar benefits were seen in another double-blind study that used 3,000 mg of chitosan per day. Other studies using minor numbers of chitosan have reported no effects on weight loss.

Chromium

The mineral chromium plays an essential role in the metabolism of carbohydrates and fats and in the action of insulin. Chromium, usually in a form called chromium picolinate, has been studied for its potential role in altering body composition. Chromium has primarily been studied in body builders, with conflicting results. In people trying to lose weight, a double-blind study found that 600 mcg per day of niacin-bound chromium helped some participants lose more fat and less muscle. However, three other double-blind trials have found no effect of chromium picolinate on weight loss, though in one of these trials lean body mass that was lost during a weight loss diet was restored by continuing to supplement chromium after the diet. A recent comprehensive review combining the results of ten published and unpublished double-blind studies concluded that chromium picolinate supplementation may have a small beneficial effect on weight loss.

DHEA

One double-blind trial found 100 mg per day of DHEA was effective for decreasing body fat in older men,134 and another double-blind trial found 1,600 mg per day decreased body fat and increased muscle mass in younger men. However, DHEA has not been effective for improving body composition in women or in other studies of men.

Guar gum

Guar gum, another type of fiber supplement, has not been effective in controlled studies for weight loss or weight maintenance.

L-carnitine

The amino acid L-carnitine is thought to be potentially helpful for weight loss because of its role in fat metabolism. In a preliminary study of overweight adolescents participating in a diet and exercise program, those who took 1,000mg of L-carnitine per day for three months lost significantly more weight than those who took a placebo. A weakness of this trial, however, was the fact that the average starting body weight differed considerably between the two groups. A double-blind trial found that adding 4,000 mg of L-carnitine per day to an exercise program did not result in weight loss in overweight women.

Sesamin

Sesamin is substance present in sesame oil that manufacturers claim may enhance fat burning by increasing the activity of several liver enzymes that break down fatty acids. It is believed that optimizing the liver’s fat burning capacity may promote fat loss; however, Healthnotes has not seen published research to support the claims.

Soy

Animal and human studies have suggested that when soy is used as a source of dietary protein, it may have several biological effects on the body that might help with weight loss. A preliminary study found that people trying to lose weight using a meal-replacement formula containing soy protein lost more weight than a group not using any formula. However, controlled studies comparing soy protein with other protein sources in weight loss diets have not found any advantage of soy. When soy protein is used for other health benefits, typical daily intake is 20 grams per day or more.

Whey protein

Whey protein may aid weight loss due to its effect on appetite. In a preliminary study, people were given 48 grams of either whey protein or milk protein (casein). Whey consumption resulted in more hunger satisfaction and reduced the amount of food eaten 90 minutes later compared with casein consumption. However, a double-blind study found that men taking 1.5 grams per 2.2 lbs body weight per day of whey protein for 12 weeks along with a low calorie diet and a strength training exercise program lost the same amount of weight and body fat as did a control group that followed a similar program, but took a casein supplement instead of whey protein.

   

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