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Weight Management Update

Recently I've had the opportunity to attend some conferences that have addressed weight management issues. The following nutrition news compiles some of the latest thinking about weight management, be you too fat or too thin.

What's the best way to lose weight?
Whether you want to lose 10 pounds or 100, the burning question remains unanswered: What's the best way to lose weight? Many dieters and health conscious people choose to lose weight by attempting to reduce their dietary fat intake. Yet, they commonly have trouble adhering to a low fat diet. According to a report from the Women's Health Initiative (a national study of diet and health interactions in 98,700 women), the biggest challenges with maintaining a low fat diet relate to eating out, celebrations, travel and holidays.

One strategy that can help you maintain a low(er) fat diet is to plan ahead and visualize yourself managing social situations appropriately. For example, if you will be traveling to holiday gatherings, be sure to:

1) arrive not very hungry. If you arrive too hungry, you may succumb to the intense drive to eat and eat everything in site--including too many high fat goodies.

2) eat special treats slowly and mindfully. By chewing slowly, tasting each mouthful and savoring the food's wonderful flavor and texture, you'll be content to eat less. Yet, you'll enjoy more pleasure than if you'd gobbled the food mindlessly.

Low fat diets offer one approach to weight loss; high protein diets offer another. Researchers at Ball State University in Muncie IN studied 59 overweight and obese women who ate either
1) a high protein, high fat diet (similar to that promoted by Dr. Atkins),
2) a high carb, low fat diet, or
3) a 1,200 calorie diet with standard proportions of protein, carbs and fat.

All three diet groups lost about 9 pounds in 12 weeks, with no significant difference among the groups. As happens in "real life," the number of dieters who dropped out of the study was high; only 54% of the women completed the study. (The drop out rate was similar among the 3 groups.) These results, reported at the American Dietetic Association's annual convention, indicate a high protein diet is NOT more effective than a high carb, low fat diet.

The bottom line: to lose weight, you simply need to create a calorie deficit by eating slightly smaller portions of your standard foods. You can do the math: One pound of fat equates to 3,500 calories. By eating only 100 fewer calories per day, you can save 36,500 calories per year...and lose 10 pounds of body fat by simply eating the equivalent of 2 fewer Oreos per day. Sound reasonable?

Is there good weight management info on the Internet?
Internet diets are gaining in popularity because the participants enjoy being anonymous and feel freedom from the shame and guilt that often accompanies talking about weight issues in public (such as happens at group meetings). Yet, Internet drop out rates are still high. Shape up American (www.shapeup.org) sponsored a weight loss program. The majority of participants who registered were sedentary, obese, ages 45-54, and joined because they "wanted to feel more attractive." The drop out rate was huge (93% in one week). When iVillage.com (a large website devoted to women's issues) sponsored a 6-week "Lose it for Good" challenge that included menus, exercise plans and motivational tips, over 32,500 people participated in the program. Yet, the group lost only 7,000 pounds--less than 1/4 lb. per person in 6 weeks. This raises questions about the effectiveness of the program or the readiness of the participants to lose weight.

Remember: Everyone always wants to lose weight--but are you ready to lose weight? That is, you need energy to eat less and/or exercise a little more to create a calorie deficit. If your energy is going towards coping with terrorism, worrying about job layoffs or suffering from illness or injury, you may lack the energy you need to push yourself away from the dinner table. Food, after all, has a calming effect.

When you overeat because you are stressed, you are only trying to be nice to yourself; food alters your brain chemistry and this can put you in a happier mood--for the moment, that is. In long run, this inappropriate coping skill will leave you even more stressed and depressed from the weight gain. Hence, learning how to manage stress without food is the obvious solution.

Instructors from the Mind/Body Medical Institute in Boston suggest taking three deep, slow breaths--breathe in peace, breathe out stress--to dissipate stress. Meditation can also be helpful. Calm your mind by sitting in a comfortable position and focusing on the word ocean. Slowly inhale on O and exhale on CEAN. Soon the calm vision of ocean waves can help soothe your nerves--and perhaps save you some calories.

I'm worried about my daughter who runs a lot and has gotten too thin, to the point she has stopped menstruating. Is this unhealthy?

Loss of menstrual periods (amenorrhea) is indeed an abnormal and unhealthy condition associated with eating too little to support normal body functioning. Amenorrhea leads to poor bone health. (The hormones involved in regular menstruation are important for optimizing bone density.) Amenorrheic athletes commonly have low bone density --and a 4.5 higher risk of suffering a stress fracture because their bones are weakened. Plus, these athletes face a grim future as they age. When a teenage athlete has the bones of a 60 year old woman, severe osteoporosis looms in the near future....

Although taking birth control pills has been deemed a way to protect bone health, the current research indicates otherwise. Speaking at a conference sponsored by Massachusetts General Hospital's Eating Disorders Program, Karen Miller MD shared the results of her bone research: the birth control pill has little impact on bone health in very thin women with amenorrhea. The better solution is to eat enough to support normal body functions. Female athletes who seek "the perfectly lean body" fail to understand that the thinnest athlete is not the best athlete. Thin athletes with stress fractures are not helpful to their team.

Nancy Clark, MS, RD is Director of Nutrition Services at SportsMedicine Associates in Brookline MA. She is author of Nancy Clark's Sports Nutrition Guidebook, Second Edition ($23) and her new Food Guide for Marathoners: Tips for Everyday Champions ($20). Both are available via www.nancyclarkrd.com or by sending a check to Sports Nutrition Materials, 830 Boylston St #205, Brookline MA 02467.