The program provides you with statistics that include the percentage of clients who drop out, the average percentage of weight loss and the average weight loss sustained following completion of their maintenance program.
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Is Weight Loss the Optimal Target?
Physical Activity in the Treatment of Obesity-related Health Risk
by P.M. Janiszewski
GIVEN THAT A NEW YEAR JUST BEGAN, one can’t help but notice the gym being a bit busier; many people are embarking on a journey to become fitter, leaner, and ultimately healthier. Because obesity is defined by excess weight – in absolute or relative terms (as in body mass index; weight relative to height), most overweight or obese people who are becoming more active will inevitably gauge the success of their new lifestyle on a drop in pounds on the bathroom scale. Unfortunately, many of these same individuals will also likely quit their new exercise program if no significant loss in weight is achieved within a short time-period.
However, as Dr. Ross and I have argued in a recently published paper in the Canadian Journal of Cardiology, several lines of evidence suggest that weight loss is not absolutely necessary to observe substantial health benefit from exercise. Thus, an apparent resistance to weight-loss should never be a reason for stopping an exercise program – read on to find out why.
First, it is well established that increasing physical activity and associated improvement in cardiorespiratory fitness are associated with profound reductions in coronary heart disease and related mortality independent of weight or BMI. Second, exercise (even a single session, as I had previously discussed) is associated with substantial reduction in several cardiometabolic risk factors (such as blood pressure, glucose tolerance, blood lipids, etc.) despite minimal or no change in body weight. Third, waist circumference and abdominal fat (arguably, the most dangerous fat) can be substantively reduced (10-20%) in response to exercise with minimal or no weight loss. In fact, significant reductions in fat mass often occur concurrent with equal increases in muscle mass in response to physical activity - equal but opposite (and beneficial!) changes which are not detected by alterations in body weight on the bathroom scale.
Indeed, as illustrated in a Figure taken from our recent publication, we propose three distinct scenarios for which an increase in physical activity is associated with substantial reduction in obesity related health risk with or without weight loss. That all three scenarios described are associated with attenuated CVD risk should be encouraging for both the patient and the clinician.
From Ross and Janiszewski, 2008.
Benefits of increasing physical activity levels in obese individuals: 3 possible scenarios.
Note the benefits in scenarios 2 and 3 where BMI or weight does not change.
BMI – body mass index, WC – waist circumference, CRF – cardiorespiratory fitness.
In all, these observations bring to question whether weight loss is the optimal outcome for determining the efficacy of treatment strategies designed to reduce obesity related co-morbidities. We suggest that overweight/obese individuals and clinicians alike look beyond weight loss as the only indicator of treatment success when targeting obesity-related health risk. Remember that increasing physical activity levels will lead to substantial health benefits – even if the scale doesn’t budge.
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Spring Cleaning: to eat or not to eat
WITH THE FRESH SCENT OF SPRING in the air, it's a time when many Canadians get the itch to organize their homes — and that often includes a good clean-out of the kitchen pantry and fridge.
The need to dispose of unrecognizable leftovers in plastic tubs, now masquerading as penicillin grow-ops, is a no-brainer. Ditto for anything well-past its best-before or consume-by date on the label.
But in the absence of such information, deciding what food items are still safe to eat and what should be chucked can be a confusing task.
Just how long have those half-filled bottles of salad dressing and jam been lining the back of the refrigerator shelves? And exactly when were those cans of soup, kidney beans and tomato paste, which somehow migrated to the rear of the cupboard, actually purchased?
"We always have this expression that's used in the food area, that 'When in doubt, throw it out,"' says Massimo Marcone, a food scientist at Ontario's University of Guelph.
"And that's what we tell people, that it's safer to be overly careful than to go the other way," says Marcone, noting that the amount of money saved isn't worth the risk of food poisoning.
Still, he says, there are a few rules of thumb that can help consumers gauge how long various food products are safe to eat.
Let's start with the refrigerator and the ubiquitous bottle of ketchup.
Because ketchup contains vinegar, which acts as a preservative, the product can maintain its quality after being opened for at least a couple of months, Marcone advises.
"It doesn't mean that you can't keep it longer ... it depends on how many times you're taking it out of (the fridge). The more you take it out — if you're taking it out every month and putting it on your table (versus) once a week, that makes a big difference in how long it's going to last."
Removing it from the fridge and letting it warm up to room temperature can lead to bacterial growth, he says.
Other condiments that contain vinegar, such as pickles and relish, should also maintain their quality for at least two months, says Marcone. "It's hard to give the exact time on it because it depends on the way it was handled."
Even though mayonnaise also contains vinegar, it must be refrigerated once opened and spend as little time as possible in room-temperature air, as the eggs it contains make a perfect breeding ground for bacteria.
Foods packed in oil, such as sun-dried tomatoes, can last a year because bacteria don't grow well in oil, Marcone says. But it's crucial that any foods be kept below the oil line.
Margarine, which is 80 per cent oil, can last four to five months in the fridge; butter lasts about four months refrigerated, although it may get an unpleasant-tasting surface oxidation, which Marcone says can be scraped off.
As for jams and jellies, the acidity of the fruit and the sugar content act as preservatives that should keep them edible for up to eight months.
In the pantry, unopened glass jars of jam will maintain their quality for 12 to 18 months, as long as they are kept away from the light, which can cause oxidation, Marcone cautions.
Other pantry items, such as canned foods, have varying shelf lives depending on the contents.
Eat Right Ontario, a service of the provincial government, suggests consumers practise the "first in, first out" rule when stocking their pantry, bringing previously purchased items to the front and putting recent purchases behind them.
While manufacturers generally recommend that canned goods be stored for no longer than one year for best quality, "tomato products, canned fruits and other high-acid foods should be used within 18 months," Eat Right Ontario advises on its website. "Low-acid foods (such as canned vegetables) have a shelf life of two to five years." (Some food-science groups say a maximum three years.)
Cans should be stored in a cool, dry place — away from hot-water pipes, the stove, home-heating sources and sunlight — and should be kept dry to prevent rusting, which causes cans to leak and food to spoil.
And any can that has been dented should be pitched.
"People have to be careful with cans that have been dinged because as soon as a can has been dinged, it puts stress on the seams, which can permit air or contamination to come in," warns Marcone.
"Really they can be quite dangerous."
As to the age of a canned product, that can be difficult to determine if it's been languishing in the back of a cupboard and the consumer doesn't remember how long ago it was purchased.
Most cans will be stamped with a coded packaging date that looks like a series of numbers and/or letters, but they differ from one company to another and should not be mistaken as best-before dates.
Some manufacturers stamp the lid with a code that includes the production date, and that can be interpreted by consumers, says the Food & Consumer Products of Canada (FCPC).
"The first digit, a letter, denotes the month the product was made — A is for January, B is for February, C is for March and so on," an statement from the group says. "The second digit, a number, denotes the year the product was made — 8 stands for 2008, 9 stands for 2009 and so on."
When in doubt, consumers are advised to call the manufacturer.
But Marcone believes producers could make life a lot easier if bottled and canned foods were dated.
"With regards to the labelling of this information on the products to assist the consumer in determining the shelf life of their product, they could do a whole lot more," he says, suggesting that if consumers pushed for that packaging addition, industry would "soon respond."
Government regulations do not require packaged-on or best-before dates on such foods, says Peter Travers, a program officer at the Canadian Food Inspection Agency in Ottawa.
Only foods that have a "durable life" of 90 days or less must have a best-before or consume-by date, including fresh meats, eggs and sole-source-nutrition products such as liquid meal-replacements or power bars, he says.
As for Ottawa requiring that food producers provide information for consumers on longer-life canned or bottled foods, Travers says he has seen only a couple of letters over the years asking: "How come we don't have some dating on cans?"
"We haven't really identified a strong need for it."
Consumers could adopt their own tracking system, Marcone suggests, by writing the date on the lid of an item indicating when it was purchased or opened and stored in the fridge.
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Warning: Cancer Explosion Coming!
The current generation of children faces a far higher risk of cancer later in life due to their unhealthy habits, a specialist has warned.
Professor Kathy Pritchard-Jones said western countries should prepare for an "explosion" of weight-related cancers.
The president of the European Society for Paediatric Oncology said governments should act now.
An estimated 300 million adults worldwide are currently clinically obese.
Professor Pritchard-Jones, Senior Lecturer and Honorary Consultant Paediatric Oncologist at the Institute for Cancer Research in Sutton, Surrey, made her comments to mark World Cancer Day.
She said that while children with poor lifestyles were no more likely to suffer from cancers in childhood, they were storing up trouble for later life.
"Childhood is the time when the habits of a lifetime are established. If you want healthy adults you have to start by making healthy children.
"If we don't do something about tackling how much exercise our young people take and how concerned they are about what they eat and their weight, we are going to have another explosion of cancers, to which unhealthy lifestyles will be a significant, contributory factor."
She said that the western world had just started to make an impact on smoking-related cancer, but this would be cancelled out by the rise in obesity related illness.
At present, poor diets, lack of exercise, and people being overweight or obese accounts for approximately a third of cancers in western countries, and approximately a fifth in developing countries.
The International Obesity Taskforce estimates that one in ten school age children is overweight, and about 30 to 45 million worldwide are said to be obese.
Not well known
Professor Pritchard-Jones called on families, health professionals, teachers and governments to do more.
"I think World Cancer Day should make governments and the world's policy makers take a look at what is happening in their own populations, and this may stimulate them into action."
Tam Fry, from the Child Growth Foundation, said there had been "unacceptable" delay on the part of the UK government.
He said: "This government has been putting off the day on which it is going to have to take on the food industry and say: 'Enough is enough'.
"The cancer campaigners are right in saying that a whole generation is now at risk of being affected."
Professor Alexander Eggermont, the president of the European cancer organisation ECCO, said that the rise in obesity-related cancers was not as well-known as some of the other health effects.
He said: "The focus on overweight and obesity is very important and timely. Making people aware of the dangers of smoking, as well as the dangers of unhealthy eating, should be part of all public awareness programmes and national cancer plans."
A spokesman for the Department of Health said: "We continue to work closely with the food industry on labelling, advertising and reducing salt and saturated fat.
"Ofcom reported in December that new rules on advertising have had an impact on reducing children's exposure to junk food advertising.
"The UK is leading the world when it comes to facing up to the problem and tackling obesity.
"We are aiming to change the way we all live our lives through Change4Life, which will help us all to change the way we eat, the way we exercise and the way we raise our children so we can prevent obesity and related diseases."
:: Story from BBC NEWS
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Low-Carb? Low-Fat? Study Finds Calories Count More!
LOW-FAT, LOW-CARB OR HIGH-PROTEIN? The kind of diet doesn't matter, scientists say. All that really counts is cutting calories and sticking with it, according to a federal study that followed people for two years. However, participants had trouble staying with a single approach that long and the weight loss was modest for most.
As the world grapples with rising obesity, millions have turned to popular diets like Atkins, Zone and Ornish that tout the benefits of one nutrient over another.
Some previous studies have found that low carbohydrate diets like Atkins work better than a traditional low-fat diet. But the new research found that the key to losing weight boiled down to a basic rule — calories in, calories out.
"The hidden secret is it doesn't matter if you focus on low-fat or low-carb," said Dr. Elizabeth Nabel, director of the National Heart, Lung and Blood Institute, which funded the research.
Limiting the calories you consume and burning off more calories with exercise is key, she said.
The study, which appears in the February 26 issue of New England Journal of Medicine, was led by Harvard School of Public Health and Pennington Biomedical Research Center in Louisiana.
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