Weight control difficult in rural communities

Mon. Dec 22, 2008

Rural adults have higher levels of obesity and are less active in their leisure time than urban and suburban U.S. adults, says Ross Brownson, Ph.D., a researcher at Washington University in St. Louis

"It's not that people don't want to get physical activity or eat healthy foods, but we've made it difficult in many communities," says. Brownson. "People in small towns spend a great deal of time in cars, and they also may not have easy access to fresh fruits and vegetables in their markets."

Thirty percent of U.S. adults are obese, which increases their risk for health conditions such as hypertension, type 2 diabetes, heart disease and stroke.

In a survey of 1,258 randomly selected adults in 12 rural communities in Missouri, Arkansas and Tennessee, Brownson found that respondents who ate out often, especially at buffets, cafeterias and fast food restaurants, were more likely to be obese. Those with a high school education or less reported limited access to fruits and vegetables and were more likely to shop at convenience stores

Additionally, obese participants tended to have less education and lower annual incomes than normal weight respondents. They also were more likely to view their community as unpleasant for physical activity, such as lacking sidewalks for walking or biking or to have few places to be active.

Brownson points out that a lot of travel planning focuses on how to increase the numbers of automobiles on our roadways, not on how to make travel friendly by foot or bicycle.

Possible interventions to enhance safety for people who want to walk or bicycle along rural roads include widening the shoulders, using signage to identify pedestrian and cycle areas and reducing speed limits. Options to increase availability and affordability of healthy foods could involve working with food outlet owners and changes in state or federal taxation and agricultural policies to reduce the relative price of healthy foods compared to unhealthy foods.

Society, Brownson stresses, will be better off finding ways to prevent obesity instead of trying to treat the condition. "We need to take these issues into account when we're making transportation and city planning decisions," he says. "Everyone will benefit if we make the healthy choice the easy choice."

SOURCE: American Journal of Preventive Medicine

Beware of truffles in jewelry stores

Tue. Dec 16, 2008

A single truffle can pack more of punch than the 180 calories it provides.  According to researchers from the University of Miami, a single truffle can induce cravings for more unhealthy foods and even lead to a desire for other indulgences like clothes, computers, and jewelry.

When allowed to eat a seemingly harmless truffle, study participants desired ice cream, pizza, and potato chips more than people who were told to resist eating the truffle.

The study authors explain that eating a truffle unconsciously activated a goal of indulgence, while those who were asked to resist the treat activated health goals.

However, once people felt their goals were met, they tended to reverse their behaviors. For example, when people who resisted the truffle were told they did a good job, they indicated that they desired fatty foods more than healthy foods.

Interestingly, people who were allowed to eat the truffle also reported a greater desire for status products like computers and watches, than people who were told to resist the truffle.

The implications of this reversal may be important for health conscious people who think that one small indulgence may be enough to curb a craving. This research shows that not only is the craving unsatisfied, additional cravings for even more indulgences may be triggered.

This behavior is well known in consumer marketing where free samples are offered to motivate consumers to buy.  However, the implication that a sample of chocolate could lead to an unconscious desire for luxury merchandise may lead some upscale stores to try truffle inducements more frequently.

SOURCE: Journal of Consumer Research

Reduce Your Appetite with Aerobic Activity

Mon. Dec 15, 2008

A brisk walk for 60 minutes appears to work better at suppressing appetite than 90 minutes of non-aerobic activity such as weight lifting. Researchers have found that aerobic activity affects the level of hunger hormones grehlin and peptide YY, while non-aerobic activity only affects grehlin. Understanding this difference may allow researchers find more effective exercise strategies for weight control.

There are several hormones that help regulate appetite, but the researchers looked at two of the major ones, ghrelin and peptide YY. Ghrelin is the only hormone known to stimulate appetite. Peptide YY suppresses appetite.

Ghrelin was discovered by researchers in Japan only about 10 years ago and was originally identified for its role as a growth hormone. Only later did its role in stimulating appetite become known. Peptide YY was discovered less than 25 years ago.

David J. Stensel of Loughborough University in the United Kingdom, says that the results of the study are consistent with previous studies showing that aerobic exercise provides a short term reduction in appetite. However, previous studies had inconclusive results about whether grehlin levels were affected.  This study will help explain the mixed results.

While the study showed that exercise suppresses appetite hormones, the next step is to establish whether this change actually causes the suppression of eating.

SOURCE: American Journal of Physiology - Regulatory, Integrative and Comparative Physiology

New Physical Activity Guidelines

Tue. Nov 25, 2008

The Department of Health and Human Services (HHS), released new Physical Activity Guidelines for Americans this month with recommendations for how much activity we should engage in for improved health.

Guideline Summary

Children, aged 6-17, should aim for one hour or more of physical activity per day, incorporating vigorous exercise at least three days per week. The guidelines call for muscle strengthening and bone strengthening exercises at least three days per week. The advisory committee cited "strong evidence" showing physically active children have less body fat and are at lower risk for cardiovascular and metabolic diseases. Activities for children should be developmentally appropriate.

Healthy adults, aged 18-64 should do 2 hours and 30 minutes per week of moderate-intensity physical activity like brisk walking and water aerobics or 1 hour and 15 minutes per week of vigorous intensity physical activity such as jogging and swimming laps or a combination of the two. Adults should include muscle strengthening activities in their work-outs 2 days per week.

Healthy pregnant and postpartum women should do moderate-intensity physical at least 2 hours and 30 minutes per week. Women who engaged in vigorous-intensity physical activity prior to pregnancy can continue with the permission of their health care providers.

Older adults, aged 65 and older, should follow an activity plan based on their abilities and if they are at risk for falling should include a balance training program.

Adults and children with disabilities should be as physically active as possible.

Advisory Board Comments

Tufts University's Miriam E. Nelson, PhD, a member of the advisory board making the new recommendations notes that, while aerobic exercise is the most important part of the equation, "it's also important for adults and children to supplement their workouts with strength exercises. Activities like push-ups and sit-ups build muscle and bone strength. In older adults, strength training can help improve functionality and reduce the risk of falls."

It remains unclear whether there is a minimum dose of exercise that will yield health benefits. "There is mounting scientific evidence that one hour per week of moderate intensity physical activity is associated with improved health and reduced risk for heart disease," Nelson said. "While not ideal, even limited physical activity appears to be better than none at all."

SOURCE: US Department of Health and Human Services

Text messaging improves diet adherence

Mon. Nov 24, 2008

Taking advantage of the latest technology may do more than just help you communicate. It might even help you stick with your diet.

Researchers at University of North Carolina at Chapel Hill say that text messaging can help young people adhere to diet and lifestyle change and decrease the chances of becoming overweight or obese later in life. 

"Self-monitoring of calorie intake and expenditure and of body weight is extremely important for the long-term success of weight loss and weight control," said Jennifer R. Shapiro, Ph.D., assistant professor of psychiatry in the UNC School of Medicine.

"Unfortunately, both children and adults who are trying to lose weight often do not adhere to self-monitoring," Shapiro said. "They tend to be good about self-monitoring at the start of a weight-loss effort, but then their adherence drops off over time."

In an attempt to correct this drop in interest over time, the researchers compared using paper diaries and text messaging of critical adherence information to not recording this information at all.

Each day, researchers prompted the text messaging group for adherence information and gave immediate feedback on the results. At the end of the study, they found children in the text messaging group had a lower attrition rate from the study (28 percent) than both the paper diary (61 percent) and those not recording (50 percent). They also had a significantly greater adherence to self-monitoring than the paper diary group, 43 percent versus 19 percent.

"Cell phone text messaging is something that's very familiar to most children now, since they've grown up with it," Shapiro said. "By using this technology, we were hoping to make self-monitoring seem more like fun to them and less like work."

The researchers conclude that cell phone text messaging may be a useful tool for self-monitoring of healthy behaviors in children, and suggests more broadly that novel technologies may play a role in improving health.

SOURCE: Journal of Nutrition Education and Behavior

Reduce advertising to curb childhood obesity

Thu. Nov 20, 2008

Banning fast food advertising on television could reduce the incidence of childhood obesity by as much as 18% say researchers from the National Bureau of Economic Research (NBER)

In the largest study of its kind, researchers measured the number of hours children were exposed to fast food advertising each week.

They found that eliminating fast food advertising during children's programs would reduce the number of overweight children by up to 18 percent, with the effect being more pronounced in girls.

Similar bans have already been implemented by Sweden, Norway, and Finland.

"We have known for some time that childhood obesity has gripped our culture, but little empirical research has been done that identifies television advertising as a possible cause," Shin-Yi Chou of Lehigh University. "Hopefully, this line of research can lead to a serious discussion about the type of policies that can curb America's obesity epidemic."

While other studies have provided compelling evidence linking food advertising with childhood obesity, they have not proven to be definitive and action has been delayed as a result.   According to study co-author Michael Grossman of City University of New York Graduate Center, "Our study provides evidence of that link."

The Centers for Disease Control estimate that, between 1970 and 1999, the percentage of overweight children ages 6-11 more than tripled to 13 percent. Adolescents between the ages of 12 and 19 also saw a significant increase, reaching 14 percent.

Research indicates that there is an 80 percent chance an overweight adolescent will be an obese adult and that over 300,000 deaths can be attributed to obesity and weight in the United States every year.

SOURCE: Journal of Law and Economics

Tempting times for children

Wed. Nov 19, 2008

Keeping the excitement and joy of the holidays alive while restricting your diet to combat a weight problem, diabetes, high blood pressure, or a host of other conditions treated with diet, can be difficult -especially if you are a child.

Parents have a key role to play in helping their children cope with the temptations of too many treats, skipped meals, and loafing around. University of Rochester Medical Center eating disorders and childhood obesity experts, alike, say we should be careful not to lose our healthy eating habits during the holiday season.

"Focus on being with family, friends and loved ones, rather than 'what's to eat, '" says Richard E. Kreipe, M.D., a professor of the pediatrics Golisano Children's Hospital and an eating disorders expert. Model healthy eating and promote family activities to ensure a happy and healthy holiday environment for kids and their families.

Model Healthy Eating

Healthy eating is a lifestyle. "Kids who are taught from a young age to eat well and note their hunger level are much more prepared to make healthy choices later in life," says Stephen R. Cook, M.D., M.P.H. Bring the kids into the kitchen while preparing healthy holiday meals. By watching adults prepare foods, kids can get some tips on healthy eating and engage in a family activity.

At the dinner table, adults should encourage small portions of a variety of foods and lots of fruits and vegetables. "Encourage water as the beverage of choice between meals," said Kreipe. Milk is another nutrient-rich beverage.

Express Excitement

It is important not to overemphasize healthy habits. Pressuring kids to eat things they do not like and prohibiting certain foods can be frustrating and stressful to kids. "Talk with children ahead of time about taking small portions, eating single-servings and sharing desserts," advised Cook.

"The single most important thing that parents can do is lead by example," stresses Kreipe. "Listen twice as much as you talk and don't talk about food in the same breath as calories, guilt, or 'paying the price.'" Turn healthy eating into a positive experience by showing excitement about trying a variety of healthy foods in small portions.

Be Active

Cold weather doesn't have to limit activity during holiday seasons. There is plenty that families can do to get off the couch and enjoy one another's company. "Going for a nice brisk walk, especially after eating a heavy meal, can be refreshing and relaxing," Kreipe says.

"Play family games together, play music and dance," encouraged Cook. "Engaging in activities that don't center on food invites everyone to participate. Plus, it is a healthier alternative to watching the game with a bowl of chips." Make the holidays about more than just eating and gift-giving. Get creative and carve out fun activities to do with the entire family for a fulfilling and memorable holiday season.

SOURCE: University of Rochester Medical Center

Keeping it lite these holidays

Tue. Nov 18, 2008

Holiday food. You dig in, savoring every bite. Now the meal is over and you are going through that terrible cycle of holiday remorse. Sure, it's great to be able to indulge in some festive food favorites, but there is always that guilt afterward.

Wahida Karmally, Dr.P.H., R.D., C.D.E., a registered dietitian on the Nutrition Advisory Committee at NewYork-Presbyterian Hospital/Columbia University Medical Center, says you can avoid this psychological turmoil by adopting a more sensible approach to holiday eating and exercise. "You will not gain weight from one meal by itself. Consistency is the key; if you eat healthful meals during the months before the holidays, a splurge or two can be fit in."

"Don't deny yourself the occasional treat. What people need to realize is that everybody can eat something of everything it's just a question of how much," she adds.

The following is the holiday feast survival guide a road map of sorts to keep you and your diet from straying too far this year.

• Plan ahead. Remember the "calorie bank" concept. Save calories the week before to give yourself more calories to eat during the holidays.
• Never go to a party hungry. Snack on fruit, non-fat yogurt or vegetables before you leave for the party. You will be less tempted to overindulge while you're there.
• Take control of your environment whenever possible. Never engage in conversation while sitting next to a platter of your favorite cookies.
• Bring a low-fat dish to the party. Share with other guests.
• Fill your plate with vegetables and lean protein foods then add small "tastes" of high-fat dishes.
• Eat slowly and savor every bite. It takes 20 minutes for the stomach to signal to your brain that you are full.
• Decide in advance how you will handle gifts of cookies and candy. Don't leave them out in the open so that you will be tempted to binge. Keep one or two and give the rest away.
• Limit alcohol consumption. Not only does alcohol contain many calories, but it can also stimulate your appetite and reduce your willpower. Try a wine spritzer, or, better yet, avoid alcohol completely and drink seltzer or mineral water with a twist of lime, or a non-alcoholic tomato juice cocktail.
• Don't allow holiday activity to slow down your exercise program. Exercise can help burn off extra calories and make you feel good about yourself.

SOURCE: NewYork-Presbyterian Hospital

Keeping the Holidays Healthy

Sat. Nov 01, 2008

The holidays are once again upon us - and for many that means extra calories. Whether it's turkey with all the dressing, holiday pies or parties with lots of snacks and drinks, overeating can lead to extra pounds that can be difficult to get rid of in the new year.

Luckily, it doesn't have to be that way if you follow a few simple tips from University of Maryland Nutritionist and Registered Dietician Jane Jakubczak who also happens to be the team nutritionist for the Washington Redskins!

Super sizing, restaurant servings and the membership warehouse stores have caused us to lose perspective. Several strategies to help control portion distortion without going hungry include sharing your meal with a friend when you eat out or taking half home to enjoy the next day for lunch. Also, avoid eating snacks out of the bottomless bag or box; instead take a handful out and eat from a small bowl. Try using smaller plates for meals. These simple changes can really work.

Liquid calories don't fill us up like solid calories do, so it is very easy to consume extra calories without knowing it. Limit caloric beverages. They include regular sodas, fruit juice drinks, some specialty coffee drinks, lemonades and sweetened tea, energy drinks and alcohol. If you're looking for some flavor, choose diet soda, unsweetened teas, coffee drinks made with low-fat milk and sweeteners, light beer, wine spritzers or mixed drinks made with diet mixers.

Unfortunately, along with gifts, many of us receive an extra 10 pounds between Thanksgiving and New Year's Day. Use your calories wisely by choosing foods that you don't have a chance to enjoy the rest of the year. Don't waste calories on cheese platters, potato chips or chocolate chip cookies - these foods are around all year long.

At this time of year, it's imperative to expend more calories. Add an extra workout to your weekly routine. Plan fun physical activities such as ice skating, family football games or hiking. Include small activities in your daily routine such as taking the steps, parking further away or taking laps around the mall before starting to shop.

If 80 percent of the time you choose nutrient dense foods (whole grains, lean proteins, fresh fruit and vegetables, or low fat dairy) then 20 percent of the time you can choose "fun" food. Balance this with daily physical activity.

SOURCE: University of Maryland

View from space predicts obesity

Tue. Oct 28, 2008

Using satellites to identify children at risk of becoming overweight seems an unusual diagnostic technique, but it is yielding some surprising information that may help with early interventions for at risk populations.

Researchers using satellite imaging say that children living in inner city neighborhoods with higher "greenness" experience lower weight gains compared to those in areas with less green space. Previous studies that examined residential density, found a relationship between the amount of physical activity adults received and the degree of urbanization in their local area.  This relationship was not seen in children, leading researchers to believe children and youth in urban environments may be active in a wider variety of open spaces (e.g., yards, parks, vacant lots) and less likely to constrain activity to streets and sidewalks. Greenness might indicate proximity to parks, playfields or other open spaces that promote either physical activity or increased time spent outdoors in active play.

Whatever the reason, the researchers say that higher greenness is significantly associated with lower body mass index (BMI) changes in children living in these areas.

According to Janice F. Bell, PhD, MPH, from the University of Washington, "This study's findings align with previous research linking exposure to green landscapes with health improvements. Among adults, greenness is associated with less stress and lower BMI, improved self-reported health and shorter post-operative recovery periods. Among children and youth, the positive health effects of green landscapes include improved cognitive functioning and reduced attention deficit hyperactivity disorder symptoms. Ideally, future research in this area will be multidisciplinary - involving city planners, architects, geographers, psychologists and public health researchers - and will consider the ways children live and play in urban environments."

SOURCE: American Journal of Preventive Medicine