No replies to this topic

[maineman]

Well, since we were just chatting about obesity, thought the review article in the January 2007 Mayo Clinic Proceedings which just came this afternoon was relevant to share.

BTW, Mayo Clinics is a pretty heady journal, this article no exception. This review was jointly done by the Mayo departments of Aerospace medicine, Internal Medicine, Endocrinology, Diabetes, Metabolism and Nutrition. (sounds like a fun group of guys, huh?)

Anyway, they reviewed all the current diet literature first and found no difference between high carb/low carb, high glycemic/low glycemic and the currently "hot" topic of dairy and high calcium diets. They discuss the fact that several very small studies have shown very small variations in weight loss over short periods of time, but no differences at 1 year.

They get way deep into the concept of fat reduction in the diet and the concept of reduction in "energy density" , simply put foods with low "energy density" (like fruits and vegetables) provide more bulk with less energy (i.e. "calorie") intake (in other words, more filling - less fattening).

THey conclude that weight loss should be achieved by a combination of reduced fat intake, reduced portion size, reduced "energy density", more fruits and vegetables.

Next they review currently available medications for weight loss and basically suggest that they are all worthless. (Note to the TTHQ paranoid group who keep telling me that "medicine" and "Pharma" are "in it together")

Next they review exercise and yes, sadly, it confirms what we've been talking about here recently. Frequent, vigorous exercise. Once again they explore the "volume" of exercise (quality over time), and again confirm that exercise is NOT a good way to lose weight (eating less is) but constant exercise over time is the best predictor of those who maintain weight loss. Sorry, no short cuts here.

Next they talk about NEAT or non-exerrcise activity thermogenesis, or the idea of how we can burn up some extra energy during the day. For instance, spending 2 minutes an hour sending emails rather than 2 minutes walking down the hall to talk to a colleague results in 10 pound weight gain over 10 years. In other words, its good to fidget, use the stairs (not the elevator), park far away from the store, etc. Have a desk job? Get a treadmill at your work site (they admit this sounds silly but would be a wise investment in employee health).

THe bulk of the article is then dedicated to behavioral modification strategies and techniques and is too long to get into here, but is mostly common sense, spelled out, in a way that physicians can spend clear time counseling, with proper, concise goals and ideas. THis includes:
self-monitoring
Environmental modification
Change in thinking patterns (set clear goals, don't focus on guilt, plan ahead, etc)
Self-efficacy (focus on success, not failure)
Social supports (friends, family, physicians)

Anyway, thought this was fun inlight of recent obesity chat here on the board.

mm