Archive for February, 2009

It takes a village to impact obesity epidemic

February 27, 2009

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The results of the latest (and so far best) research on diets are in:  most people won’t stick to them. The New England Journal of Medicine (2/26/09) published the study which has now been widely reported in the news.  Over 800 men and women were followed on various diets for 2 years; the average weight loss was modest (about 9 pounds) and those who attended counseling sessions (an indirect measure of motivation) lost the most.  No one adhered to the diet closely, despite frequent monitoring and much support.  The conclusion is that eating less (calories) is what matters, not the specific content of the diet (in terms of low fat, high protein, low carbohydrate, etc).

These findings are not surprising, but what is most interesting is the accompanying editorial which describes a study in France where entire villages were used to counteract the obesity epidemic.  Here is the summary from the NEJM editorial:

A community-based effort to prevent overweight in schoolchildren began in two small towns in France in 2000. Everyone from the mayor to shop owners, schoolteachers, doctors, pharmacists, caterers, restaurant owners, sports associations, the media, scientists, and various branches of town government joined in an effort to encourage children to eat better and move around more. The towns built sporting facilities and playgrounds, mapped out walking itineraries, and hired sports instructors. Families were offered cooking workshops, and families at risk were offered individual counseling.

Though this was not a formal randomized trial, the results were remarkable. By 2005 the prevalence of overweight in children had fallen to 8.8%, whereas it had risen to 17.8% in the neighboring comparison towns, in line with the national trend.11 This total-community approach is now being extended to 200 towns in Europe, under the name EPODE (Ensemble, prévenons l’obésité des enfants [Together, let’s prevent obesity in children]).12

Like cholera, obesity may be a problem that cannot be solved by individual persons but that requires community action. Evidence for the efficacy of the EPODE12 approach is only tentative,11 and what works for small towns in France may not work for Mexico City or rural Louisiana. However, the apparent success of such community interventions suggests that we may need a new approach to preventing and to treating obesity and that it must be a total-environment approach that involves and activates entire neighborhoods and communities. It is an approach that deserves serious investigation, because the only effective alternative that we have at present for halting the obesity epidemic is large-scale gastric surgery.

The NEJM research article is here: http://content.nejm.org/cgi/content/full/360/9/859.

The editorial is here: http://content.nejm.org/cgi/content/full/360/9/923.

FDA Warns Consumers About Weight Loss Pills

February 27, 2009

The FDA has issued an updated warning about tainted weight loss pills. See the details here.

Become a “lessmeatatarian” and help the planet

February 3, 2009

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One thing we can easily do now to help ourselves and others is:  eat less meat and dairy. Meat (especially beef) and dairy farming generate a huge amount of greenhouse gas and are unsustainable.  Like food writer Mark Bittman, we should all become “lessmeatatarians,” and try going vegan daily until 6 pm (dinnertime).  Bittman discusses this and related topics on public radio here.

Mark Bittman: Conscious Eating

Food writer and home cooking guide Mark Bittman is a hero in many American kitchens. His “How to Cook Everything” has put a lot of meals on a lot of family tables.

Now, Bittman is taking up a bigger cause than dinner: The way Americans eat, he says, is killing themselves and the planet. Too much meat. Too much junk food. Too big a footprint.

Just a little change, he says — vegan ‘til 6pm, ‘til dinner — could save our waistlines, our health, and the planet.

This hour, On Point: A save-the-Earth manifesto — with recipes — from food maven Mark Bittman.

Academy awards

February 1, 2009

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I have seen all five movies nominated for best picture, so will post my impressions of them (in alphabetical order).

The Curious Case of Benjamin Button.  Very entertaining and a good stimulus for thinking about aging, life and death.  Pretty well-acted, but for me it is a distraction when superstars are in movies.  Not Brad Pitt’s fault, though.

Frost/Nixon. About much more than a particular slice of history (with modern day implications).  Also about a life/death struggle between two interesting and flawed men.

Milk.  Excellent docudrama with superb acting by Penn.  In this case, his star status did not detract (or distract) from the movie.  It is about historical events (which are well worth knowing about), but also about a very hot current issue.

The Reader.  Superb acting by the main characters, and gave me a lot to think about —  such as the consequences of our decisions to act, or to not act, in certain ways.

Slumdog Millionaire.  Entertaining and, for me, a bit jarring, with the rapid pace, time shifts, and intrusive (but excellent) soundtrack.  A gritty look at a very important social problem, with a silly romantic story to help the medicine go down.

My personal preference for the winner:  Milk. All of the others were also excellent and worth seeing.