Posts Tagged ‘Diabetes’

Weight loss strategies

July 16, 2008

This research report appeared in the current news summary from medscape.com. The study only shows associations and not cause and effect, but is worth noting because of the large number of people surveyed.  Though not conclusive, the report reinforces the advice to self-weigh regularly, eat breakfast daily, and avoid fast-food.

July 8, 2008 — Overweight or obese adult patients with type 2 diabetes who followed various weight-loss interventions had lower body mass indexes (BMIs), according to the results of the Action for Health in Diabetes (Look AHEAD) clinical trial reported in the July issue of Diabetes Care [2008;31:1299-1304].

This is a cross-sectional study within an ethnically diverse population with type 2 diabetes from 16 US centers (the Look AHEAD study) to correlate eating patterns with BMI and to describe the most common weight-control strategies in patients with type 2 diabetes.

“Intentional weight loss is recommended for those with type 2 diabetes, but the strategies patients attempt and their effectiveness for weight management are unknown,” write Hollie A. Raynor, PhD, RD, from the Brown Medical School/The Miriam Hospital in Providence, Rhode Island, and colleagues from the Look AHEAD Research Group. “In this investigation we describe intentional weight loss strategies used and those related to BMI in a diverse sample of overweight participants with type 2 diabetes at enrollment in the Look AHEAD. . . clinical trial.”

Study Highlights

  • The Look AHEAD study included 5145 patients aged 45 to 74 years with type 2 diabetes with a BMI of 25 kg/m2 or more (or 27 kg/m2 or more for those receiving insulin), with 33% of participants from ethnic minority groups.
  • Excluded from this analysis were those with inadequate control of diabetes and with underlying diseases that influenced lifespan.
  • Weight-control practices included a list of 23 behaviors that participants chose from, expressed as a percentage of participants using each practice and duration of use of each practice, up to 52 weeks.
  • Those who self-weighed weekly had a lower BMI (35.3 kg/m2) vs those who weighed themselves once a month.
  • Those who consumed 6 or more breakfasts weekly had a lower BMI of 35.6 kg/m2 vs those who consumed 3 to 6 days per week (36.7 kg/m2).
  • Overall, participants consumed 1.9 fast-food meals per week.
  • BMI was 35.1 kg/m2 for those reporting no fast food per week vs 36.9 for those reporting 3 or more fast-food meals per week.
  • The 3 most prevalent weight-control practices by duration of use were increasing fruit and vegetable intake, cutting out sweets and junk foods, and reducing consumption of high-carbohydrate foods, with duration of practice from 20.3 to 26.5 weeks.
  • Overall, a larger amount of intentional weight loss, self-weighing less than once weekly, and more fast-food meals consumed were associated with a higher BMI, whereas consuming more breakfasts was associated with a lower BMI.
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Body shape is as important as weight

May 31, 2008

Are you an Apple, or a Pear?

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Several recent studies and articles have highlighted how important WHERE we store fat is to our health. Excess weight is generally stored either in the abdominal area or in the hips, thighs, and buttocks, giving rise to the descriptive terms “Apple” and “Pear.” If you are an Apple (and these shapes appear to be partly determined by genes), you tend to have more visceral fat (fat around the abdominal organs) and this can lead to various diseases (type 2 diabetes, some types of cancer, heart problems, urinary problems, dementia, hypertension, and stroke). The only benefit to the Apple shape is lower risk of osteoporosis. Overweight men and post-menopausal women tend to be Apples. Also, smoking is associated with abdominal fat accumulation.

Pears are not as much at risk for the serious diseases listed above, but are more likely to suffer from osteoporosis, varicose veins, and cellulite. While a Pear can become an Apple, Apples do not morph into Pears.

The good news? Here is a quote from an excellent article on this topic in the U. C. Berkeley Wellness Letter (June, 2008):

While abdominal fat tends to accumulate faster than other fat, it also tends to come off faster. [More good news:] losing just 2 inches from the waist reduces coronary risk by 11% in men and 15% in women, according to one recent study.

Further information from Weight Management for Your Life:

Some research indicates that elevated waist circumference (Men: equal to or greater than 40 inches; Women: equal to or greater than 35 inches) is a more specific risk factor for some diseases, such as prediabetes, than weight or BMI. An increasing waist-to-hip ratio may be a better indicator of coronary artery calcification than either waist circumference or BMI.  Therefore, weight distribution, as opposed to weight alone or BMI, must be taken into consideration; belly weight (abdominal obesity, “visceral fat,” or “central adiposity”) is of most concern. [see also here]