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Meal replacements may not help teens keep weight off

A new study at the Children's Hospital of Philadelphia found that meal replacements like shakes, bars and prepackaged entrees aren't a good long-term solution for obese teens. For the new study, researchers randomly assigned 113 obese teens and their families to different diets for a year. One group of teens ate self-selected low-calorie meals not exceeding 1,300 to 1,500 total calories per day. The other group ate meal replacements (three SlimFast shakes and one prepackaged entree), along with five servings of fruits and vegetables. Four months into the study, participants in second group were randomized to a second-phase diet: some were put on the low-calorie self-selected diet, while the rest stayed on meal replacements.

At the four-month mark, all participants had lost weight, but the teens on meal replacements lost more — a 6.3% reduction in body mass index (BMI) versus 3.8% for the low-calorie group. But by the end of the one-year study, many participants had regained much of the weight they had lost, resulting in no significant differences in weight loss between the groups: on average, the teens had reduced their BMI 3.4% since the beginning of the study.

The results underscore one of the many difficulties of dieting: keeping the weight off long term. Many dieters regain weight because they can't stick to rigid eating programs for long: one-third of the participants in the current study dropped out before its conclusion. The monotony of the meal-replacement diet couldn't have helped either: teens in the meal-replacement group started out drinking SlimFasts 5.6 days a week (in Month 2); by the end of the study, they were only able to tolerate the shakes 1.6 days each week.

“The potential benefit of (meal replacement) in maintaining weight loss was not supported,” the researchers concluded. So for those of you who are gearing up to begin a weight-loss program in the New Year, it helps to remember that austerity isn't the best strategy long-term. Focus on variety — both with your diet and your exercise regimen — and manageability instead. A regular visit with Nastaran can ensure that you stay on track and keep the weight off long term.

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Vitamin E May Reduce Dementia Risk

The prospective Rotterdam Study involved 5,395 people over age 55 with no dementia at baseline. All of the participants, who lived in one section of the Rotterdam area, provided dietary information when the study began in 1990.

The researchers previously reported a similar association of vitamin E intake with a lower risk of dementia and Alzheimer's disease over six years of follow-up among the cohort.

The current study found that after 9.6 years of follow-up, 465 of the participants had developed dementia; 365 of these cases were classified as Alzheimer's disease.

Higher baseline vitamin E consumption correlated with lower long-term risk of dementia in models minimally adjusted for age only and those adjusted for age, education, apolipoprotein genotype, total caloric intake, alcohol and smoking habits, body mass index, and use of supplements (both P=0.02 for trend).

Dietary surveys indicated that margarine was by far the biggest contributor to vitamin E intake at 43.4%, followed by sunflower oil at 18.5%, butter at 3.8%, and cooking fats at 3.4%.

Participants with vitamin E intakes in the top third, averaging 18.5 mg per day, were 25% less likely to develop dementia of any kind over almost 10 years of follow-up than those in the bottom third, who averaged only 9.0 mg per day. Higher baseline vitamin E consumption correlated with lower long-term risk of dementia (both P=0.02 for trend).

While the top versus bottom tertile comparison was significant, the middle group with vitamin E intake averaging 13.5 mg per day was no less likely to develop dementia than the lowest intake group.

For Alzheimer's disease alone, the multivariate-adjusted risk was 26% lower among those with the highest intake compared with the lowest (95% confidence interval 3% to 44%, P=0.03 for trend). But intermediate intake again appeared to have no impact.

Other antioxidants — vitamin C, beta-carotene, and flavonoids — held no significant associations with dementia or Alzheimer's disease risk (multivariate adjusted P=0.50 to >0.99 for trend).

Sensitivity analyses excluding participants who reported taking supplements at baseline showed similar results.

The researchers noted that the vitamin intakes seen in the study were consistent with a typical Western diet but cautioned about the possibility of residual confounding in the observational results.

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Behaviour therapy can calm irritable bowels

Lead researcher Dr. Jeffrey M. Lackner from the State University of New York, Buffalo said cognitive behavioral therapy was known to be a very promising treatment for IBS, with the current findings helping to identify which patients would likely maintain a positive response.

Lackner and his colleagues are conducting a larger, longer-term study, as the current study being a small one, it remains unclear how long the benefits of cognitive behavioral therapy may last i. e. do they carry over to 9 months, a year or more.

IBS symptoms include bouts of abdominal cramps, bloating and changes in bowel habits i. e. diarrhoea or constipation, or alternating episodes of both. While, no one knows the exact cause of the disorder, there are certain symptom triggers like particular foods, large meals and emotional stress.

Cognitive behavioral therapy helps IBS patients to recognize their symptom triggers and manage them. Other treatment options include general diet changes, like reducing gas-producing foods; fibre supplements, if constipation is a primary symptom; and anti-diarrhoeal medications, when diarrhoea is a primary symptom.

There are two prescription medications for specific IBS cases: Lotronex, for women with diarrhoea dominant IBS not responding to other treatments; and Amitiza, for constipation dominant IBS.

Around 20% of people have IBS symptoms, with women affected at about twice the rate of men

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