European study reinforces importance of eating breakfast for children's health

The message that 'breakfast is the most important meal of the day' is familiar to many of us. And now a European study of Cypriot children has revealed that choosing the right kind of breakfast each morning can have a direct impact on their weight and overall health.
The paper, published online in the International Journal of Food Science and Nutrition, investigates the significance of breakfast food choices in child health and the association between eating breakfast and Body Mass Index (BMI), which is an indicator of healthy weight.

The analysis is based on a sample of 1558 children aged between four and eight from Pafos and Strovolos in Cyprus, and examines the relationship between breakfast consumption with children's diet quality and cardio-metabolic risk factors. The research shows that amongst girls, those who eat breakfast on a daily basis tend to have lower mean BMI scores. They are also less likely to have high cholesterol and diastolic blood pressure, regardless of their parents' BMI and their own levels of physical activity. Furthermore, amongst both boys and girls who ate breakfast regularly, breakfast cereals were found to be the most nutritious choice, compared to other breakfast alternatives. Children who consumed pastry products for breakfast had the least favourable nutrient profile.

Paper author Stalo Papoutsou, Clinical Dietician & Nutritionist and Associate Investigator at the Research and Educational Institute of Child Health in Cyprus, is keen to stress the importance of delivering public health messages to encourage good breakfast habits in children. She said: "We want to encourage health professionals to promote the benefits of daily breakfast consumption, and educate parents and children to make the right breakfast choices in order to ensure higher consumption of micronutrients and fibres, whilst reducing intake of sugar and fat."
The recently published paper - titled "The combination of daily breakfast consumption and optimal breakfast choices in childhood is an important public health message" - draws on data from the EC-funded IDEFICS Study (2006 - 2012), which is now being followed-up by the EC-funded I.Family research project (2012 - 2017). I.Family is investigating the relationship between family behaviours and children's breakfast habits, and observing changes to these habits as children move into adolescence.

Source: medicalnewstoday.com

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Obese patients who feel judged by doctors less likely to shed pounds, study shows

Overweight and obese people who feel their physicians are judgmental of their size are more likely to try to shed pounds but are less likely to succeed, according to results of a study by Johns Hopkins researchers.

The findings, reported online last week in the journal Preventive Medicine, suggest that primary care doctors should lose the negative attitudes their patients can sense if the goal is to get patients with obesity to lose 10 percent or more of their body weight -- an amount typically large enough to reduce blood pressure, cholesterol and diabetes risk.

"Negative encounters can prompt a weight loss attempt, but our study shows they do not translate into success," says study leader Kimberly A. Gudzune, M.D., M.P.H., an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine. "Ideally, we need to talk about weight loss without making patients feel they are being judged. It's a fine line to walk, but if we can do it with sensitivity, a lot of patients would benefit."

The U.S. Preventive Services Task Force has recommended that health care providers counsel obese patients to lose weight, and the Centers for Medicare and Medicaid Services now covers some behavioral counseling related to weight loss. But Gudzune and her team suspected the pervasiveness of negative provider attitudes and weight stigma may be limiting the effectiveness of advice from primary care providers for these patients.

To test that idea, the researchers conducted a national Internet-based survey of 600 adults with a body mass index of 25 or more who regularly see their primary care doctors. The participants were asked, "In the last 12 months, did you ever feel that this doctor judged you because of your weight?" Twenty one percent of participants said they believed they had been.

Further, 96 percent of those who felt judged did report attempting to lose weight in the previous year, compared to 84 percent who did not. But only 14 percent of those who felt judged and who also discussed weight loss with their doctor lost 10 percent or more of their body weight, while 20 percent who did not feel judged and also discussed shedding pounds lost a similar amount.

Having a weight loss conversation clearly helped people lose more weight, the study found. Only 9 percent of those who felt judged but did not discuss weight loss with their doctor lost more than 10 percent of their body weight, while 6 percent of those who neither felt judged nor discussed weight loss with their doctor did.

Overall, just two-thirds of participants reported that their doctors brought up weight loss.

"Many doctors avoid the conversation because they don't want to make anyone feel bad, worrying they'll create a rift with their patients if they even bring it up. But that is not in the patients' best interest in terms of their long-term health," Gudzune says.

Gudzune, whose own practice focuses on obesity, says that doctors may need to be taught how to talk about the topic in ways that make patients feel understood and supported.

She says it is also helpful to start with smaller weight loss steps, such as a 10 percent reduction in weight. A larger long-term goal of, say, losing 70 or 100 pounds can be a setup for frustration and failure when tackled all at once.

"We don't want to overwhelm them," she says. "If we are their advocates in this process -- and not their critics -- we can really help patients to be healthier through weight loss."

Source: sciencedaily.com

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5 Signs You're Taking Your Diet Too Far

When I first started out in private practice, clients came to me because something was wrong. Most of them struggled with their weight, or were newly diagnosed with a condition like high cholesterol or elevated blood pressure. Today, healthy, fit clients schedule appointments with me simply to pick my brain. Many describe themselves as health enthusiasts who want to learn all they can about optimal nutrition, the hottest superfoods, and latest trends. I love that nutrition is now considered exciting—even sexy.

But I sometimes see healthy eating and weight loss taken to extremes, which can actually worsen physical and emotional wellbeing and negatively impact quality of life. (Case in point: a recent study highlighted how obese teens trying to lose weight are in danger of developing eating disorders.) This topic is especially timely given the social media uproar following Tuesday's finale of The Biggest Loser, where winner Rachel Frederickson lost so much weight that Time.com reported she wouldn't be allowed to model in some countries based on her BMI, and in advance of National Eating Disorders Awareness Week from February 23 to March 1.

While this post is certainly not meant to diagnose anyone, here are five indications that your healthy efforts may have morphed into detrimental patterns.

You've become scale-obsessed

I actually believe it's perfectly okay—and for some people, even healthier—not to weigh themselves. But if you do, treat weighing in as a simple reality check to help you understand your body's patterns and to see if you're moving in the right direction. It's also important to put the numbers in proper perspective.

Weight fluctuations from day to day, and even hour to hour, are completely normal, because when you step on a scale, you're weighing not just muscle and body fat, but also: fluid, food inside your GI tract that hasn't been digested and absorbed; waste that hasn't been eliminated; and glycogen, the storage form of carbohydrate you carry in your liver and muscles. The latter three can shift considerably and quickly, whereas changes in muscle and fat tissue happen more slowly. Also, you can be retaining water or building muscle as you're losing body fat, which means the number on the scale might stay the same, even though you're getting leaner.

For all of these reasons, weight alone doesn't tell you much. Yet many people become fixated on the number and they feel angry or depressed if it doesn't go down, or if it's not declining fast enough.

If you find yourself weighing in more than once a day, or if your mood is seriously affected by the number, or if you undereat or overexercise because your weight hasn't decreased, your relationship with weight has likely become unhealthy. Consider letting go of the scale and focusing on how your body feels instead—and talking to a health professional about reasonable weight expectations.

You're secretive about your diet

When you're trying to eat healthfully and lose weight, there's no reason to tell everyone and their mom about your personal regime. But if you feel the need to avoid the subject because you're afraid you'll be judged for being too strict, you may be crossing into disordered territory. This is especially the case if your own gut instinct is telling you that you're overly restricting but you can't or don't want to stop.

In my experience, a big red flag is a willingness to stick to a restrictive plan despite unhealthy side effects like fatigue, moodiness and irritability, sleep disturbances, poor immunity, and constant hunger. Even if you are losing weight or you're eating ultra healthy foods, if you aren't keeping yourself nourished, I promise you're doing a lot more harm than good. Throughout my 15+ years working with clients, I've found that creating more balance (and often adding food to a plan) leads to much better results, not just for weight control, but also for emotional well-being and a healthy social life.

Your self-esteem is tied to your weight or eating habits

Even clients who know I'm not at all a food cop are sometimes afraid to tell me what they've eaten. It's typically because they're judging themselves: they've developed a pattern of feeling happy and empowered when they've been "good" and beating themselves up when they've been "bad." Unfortunately, these associations can stall your progress, because they don't allow you to examine why you get off track. And when you don't know why you're doing something, it's very difficult to change.

The truth is, you may slip up because your diet is too strict and your hunger hormones are raging. If that's the case, the fix lies in balancing out what you're eating, not berating yourself. Or, if you tend to eat due to stress or anxiety, addressing your emotions is the key to ending the cycle, not trying to have more willpower. So if you gained a pound or two this week, or your kale rotted in the crisper while you ordered takeout again, banish the harsh self-talk and criticism. Instead, take an objective look at your triggers, focus your energy there, and remind yourself that health is about progress, not perfection.

Most of your mental energy is spent thinking about your diet or weight

Some of my clients love food apps and other tools that help them record what they ate and track their weight. Others don't. But one thing's for certain: for some people, these tools can become an obsession. If you find yourself constantly thinking about what you've eaten (or what you're going to eat) and worrying about your weight to the point where you're distracted from other activities, your weight-loss goals may have eclipsed your healthy lifestyle goals.

In my years of counseling clients, I've seen this pattern lead to burnout and trigger a rebound right back to old, unhealthy patterns. Fortunately, you don't have to be preoccupied with your diet and weight in order to see results. Simply focusing on the basics—like eating at consistent times; eating balanced meals that include plenty of veggies, along with lean protein, healthy fat, and small portions of "good" carbs; and stopping when you're full—can allow you to see real and lasting results, while also having the time and energy for other parts of your life.

If you're afraid to let go of thinking about or recording your every effort, ask yourself if you can honestly envision continuing to do so six weeks or six months from now. If the thought makes you cringe, make an effort to create some balance. Letting go a bit doesn't have to mean sacrificing results.

Your diet distances you from your family and friends

I've had clients tell me that they stopped spending time with friends and avoided family functions because their devotion to their diet outweighed their desire to engage in social situations. Some of this is normal for anyone who's adopting healthy habits because the cultural norm is to overindulge. But if you find yourself becoming isolated and avoiding the people you care about, things may have gone too far.

If you're on a quest to eat healthfully and the people in your social circles aren't healthy eaters, there are ways to enjoy getting together that won't require you to eat junk food. For example: at a party, bring a healthy dish to share, to serve as your personal go-to; choose restaurants where you know you can get a healthy meal, and opt for non-food centered ways of spending time together, like going for a walk or a hike, rather than meeting for drinks or frozen yogurt.

If you feel like you're not getting the support you need and you want to have a heart-to-heart, check out my advice on how to deal with food pushers http://news.health.com/2013/12/24/holiday-eating-peer-pressure-6-diet-dos-and-donts/. But if you're finding yourself prioritizing your diet before your loved ones completely, consider talking to a health professional. To find a psychologist, visit the American Psychological Association. And to find a nutritionist, go to the Academy of Nutrition and Dietetics, click on Find a Registered Dietitian on the upper right corner, choose Expertise Area, and check Eating Disorders.

Cynthia Sass is a registered dietitian with master's degrees in both nutrition science and public health. Frequently seen on national TV, she's Health's contributing nutrition editor, and privately counsels clients in New York, Los Angeles, and long distance. Cynthia is currently the sports nutrition consultant to the New York Rangers NHL team and the Tampa Bay Rays MLB team, and is board certified as a specialist in sports dietetics. Her latest New York Times best seller is S.A.S.S! Yourself Slim: Conquer Cravings, Drop Pounds and Lose Inches.

Source: abcnews.go.com

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Health plans don't cover weight loss surgery

Like 78 million other Americans, MaryJane Harrison is obese.

And like many critically overweight Americans, Harrison cannot afford to have weight loss surgery because her health insurance doesn't cover it. The financial burden makes it nearly impossible for her to follow the advice of three physicians who have prescribed the stomach-shrinking procedure for Harrison, who is four-feet, 10 inches and weighs 265 pounds.

Harrison's health insurance plan, provided by UnitedHealth, excludes coverage of any surgical procedures for weight loss. As a result, she and her family are trying to raise $15,000 to pay for the surgery that she thinks will save her life.

"I am now 53 and I don't think I'm going to live to be 55," says Harrison, 53, who lives outside of San Antonio and has tried for years to lose weight through dieting and exercise. . "When you feel your health deteriorating this fast, you know it."

UnitedHealth said it can't legally comment on Harrison's health plan unless she signs a privacy waiver. But Harrison declined to sign one due to concerns about how the company might use the information.

Harrison's case underscores a surprising trend: While the number of obese Americans persists at record levels, the number of patients undergoing weight loss surgery hasn't budged in a decade.

Last year, about 160,000 U.S. patients underwent weight loss surgery — roughly the same number as in 2004. That's only about 1 percent of the estimated 18 million adults who qualify nationwide for the surgery, according to the American Society for Metabolic and Bariatric Surgery.

"If we were talking about breast cancer, no one would be content with having only one percent of that population treated," says Dr. John Morton, professor of surgery at Stanford University. "Yet if you look at the impact of obesity on life expectancy, it's by far one of the most dangerous conditions we have in public health."

Surgeons blame a combination of factors for the stagnating numbers, including the economic downturn and a social stigma against resorting to surgery to treat weight problems. But insurance coverage is the largest hurdle, they say.

Nearly two-thirds of health plans sponsored by employers don't cover weight loss surgery, which can cost between $15,000 and $25,000. Those that do often mandate that patients meet a number of requirements, including special diets and psychological evaluations, before they can get the procedure covered.

And early signs indicate many of the same challenges seen in the private market have carried over to the new, state-run insurance exchanges that are part of the health care overhaul: Only 24 states require insurers to cover weight loss surgery for patients. And when the procedure is covered, many plans require patients to pay up to 50 percent of the cost out of pocket.

Insurers have said for years that bariatric surgery should only be used as a last resort, hence the many preliminary requirements and evaluations.

"All major surgeries are risky. This one is life altering, and if there is an approach that's less invasive and less risky for the patient, you want to try that one first," says, Susan Pisano, a spokeswoman for America's Health Insurance Plans, an insurance industry trade group.

But the insurance hurdles are pushing up against new medical guidelines urging doctors to more aggressively address obesity, including referring patients for surgery. Guidelines issued in November by the American Heart Association, the American College of Cardiology and the Obesity Society call on doctors to calculate a patient's body mass index — an estimate of body fat based on weight and height — each year, and recommend surgery for those who face the most serious health problems.

More than a third of U.S. adults are obese — defined as someone with a BMI of 30 or higher — and that's been the case since the middle of the last decade. Weight loss surgery is recommended for those with a BMI of 40 or those with a BMI of 35 who have other risk factors for heart disease such as diabetes or high blood pressure. A 5-foot-9 person would be obese at 203 pounds.

The most popular procedure is gastric bypass, which involves stapling off a small pouch from the rest of the stomach and connecting it to the small intestine. Patients eat less because the pouch holds little food, and they absorb fewer calories because much of the intestine is bypassed. Another procedure called gastric banding places an inflatable ring over the top of the stomach to restrict how much food it can hold.

The latest long-term studies show that the typical patient loses about 30 percent of their excess weight with the bypass procedure and 17 percent with the band after three years. That compares with weight loss of just 2 to 8 percent with diet and lifestyle changes. Researchers estimate the initial costs of surgery are recouped within 2 to 9 years, as patients cut down on prescriptions, trips to the doctor and emergency hospital care.

On top of all that, two groundbreaking 2012 studies suggest bypass surgery can reverse and possibly cure diabetes.

But only 37 percent of health plans that are sponsored by employers cover weight loss surgery, according to benefits consulting firm Mercer. At large corporations, the coverage rate is higher at 58 percent, but most Americans work for smaller businesses.

The benefit is often hardest to find in states that have the highest levels of obesity, such as Mississippi and Arkansas, where less than 25 percent of employers cover weight loss surgery. Both states have obesity rates over 34 percent, the highest in the country.

When insurers cover weight-loss surgery, it often comes with a number of requirements. Patients must first pass a psychological evaluation, showing that their obesity is not due to an eating disorder or other mental problems that can contribute to weight gain. Most insurers then require six to 12 months of doctor-supervised dieting, in which patients keep a journal of their eating habits and visit their physicians for regular weigh-ins and check-ups.

Surgeons say many patients are unable to keep up with the appointments and never qualify for surgery — a fact which they say helps insurers control costs.

"Half of the people I see drop out because they can't commit to the time away from their jobs," says Dr. Carson Liu, a bariatric surgeon in Los Angeles. "Insurers know that 50 percent of patients will drop out."

America's Health Insurance Plans, the industry trade group, says companies are simply following federal guidelines that recommend surgery for "carefully selected patients" who have failed other methods.

But the National Institutes of Health guidelines insurers point to were issued in 1998, when weight loss surgery was still an emerging field with serious risks. At the time, about 1 in 100 patients died in surgery. The death rate today is 1 in 1,000, making it as safe as a hip replacement, according to surgeons.

Weight loss surgery is now nearly universally accepted in American medicine. Still, the approach is not an easy fix.

Patients must dramatically cut the amount and variety of food they consume, otherwise they will experience cramps, diarrhea and other unpleasant side effects. Additionally, about 20 percent of patients who get the gastric band regain nearly all of their weight within three years — a fact that has led to a decline in popularity for that procedure. Only a small percentage of bypass patients regain their weight.

Doctors who support weight-loss surgery warn that it's not a cost-effective solution for America's obesity epidemic in the long run. Dr. David Katz of Yale University's Prevention Research Center says a smarter approach lies in educating children and adolescents early on about healthy eating and exercise habits.

"We created the problem of severe obesity and we have to deal with it, but scalpels aren't the only solution," he says. "There is a better way."

But for Harrison, who takes 11 medications to control conditions related to her weight, surgery increasingly seems like her only hope.

"I spend every day worrying about how much time I have left. Everything hurts and my health issues get worse all the time," Harrison says.

Source: yahoo.com

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Conflicting and Misinformation About Weight Loss

We continue each year to confuse people about the benefits of exercise as it relates to weight loss. In a nutshell, the healthcare system’s bland and undocumented recommendation to be active is a simplistic and ineffective approach to obesity. Please note: Exercise will only accelerate fat loss if the diet keeps insulin levels low so that fatty acids are released into the blood stream for use as energy.

Activity in and of itself is not exercise, and general activity does not use up much energy. The reason we eat everyday is to satisfy our basic metabolic needs and the needs of general activity for the day. Using up this energy each day through activity may only keep us in a state of homeostasis, not gaining or losing weight.

Exercise is activity challenging enough, or of sufficient effort, that some aspect of our physiology goes into an adaptive phase. This adaption may result in an increase in strength, speed, endurance, enzymes that buffer fatigue, etc. Exercise requires much more energy than general activity and has a much greater post-metabolic burn that taps into the fatty acids for recovery if insulin levels are kept low.

Once we understand that losing weight (fat) is primarily impacted by what we eat, not necessarily by how much we eat, then exercise can be put into perspective. We can identify how much is needed, how much time is required per session and, most importantly, what kind of exercise will address the needs of a non-athletic person only interested in weight loss and general fitness.
It is important to note that weight loss and athletic enhancement are separate and distinct goals. This is one of the reasons exercise has become overcomplicated for the purpose of weight loss. It is also important to realize that time is a relative factor for most people when trying to make exercise fit into a chaotic and hectic lifestyle.

For the last two decades, my 2DF (Two Days to Fitness) program developed for the overweight population has proven that these strategically designed workouts just two days a week work. I’ve also concluded that there is a general overemphasis of endurance training (running and aerobics) for the obese and deconditioned population. This kind of training is not appropriate or prudent and typically results in low compliance rates. It tends to be physically and mentally drudgery, does little to develop muscle, and provides little post-metabolic stimulation.

Knowing that non-athletic Americans will never spend 4,5, or even 6 days a week in the gym, I ask my students: if you only had two days a week to exercise which would you do? Walk on the treadmill for an hour or perform resistance training for an hour?

The answer should be a no brainer because the benefits of resistance training are numerous and well documented. Resistance training provides strength, joint integrity, stability, flexibility, cardio, and more. It’s safe and effective. Most importantly, fats and sugars are metabolized in the muscle. With just two workouts a week, the overweight population can easily maintain and build muscle, and create a starting point to normalize blood sugars every day of the week.

This is the key to my program: matching the training approach with the clients’ goals and the ease of two workouts a week. Both of these methods dramatically increase the chances of sticking with a program.

Source: naturalnews.com

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Top 5 Weight Loss Tips To Fight Cravings

Yes, it is well into the New Year and your degree of self-control is probably being tested. How are you doing?

Do you have conscious control over your natural impulse to eat the certain foods which lead to weight gain? Can you avoid eating inappropriate foods that will prevent you from reaching your weight loss goals?

Well, no matter how you change your lifestyle dynamics, if you want to lose body fat and add some muscle to your body, there will be some foods you will have to avoid, at least for a while.

According to published research, people who have higher levels of self-control have a much better chance at restraining themselves and are more successful at losing and maintaining normal body weights. In addition, those who think or perceive that they have high levels of self-control and regulation are better at controlling their weight. It has also been established that people who have scored higher in the area of self-control and are successful dieters do not necessarily eat fewer tempting foods than do unsuccessful dieters.

What this tells us is that people who are successful at losing weight believe that they have a great deal of control over their choices and can lose weight regardless if they stray from their diet or not.

What other related research has indicated is that those folks who are successful dieters and have measurements of high self-control also have lower levels of self-impulsiveness. These people are much more likely to be more successful at managing their food intake.

Those people who have problems with their self-control and act impulsively regarding food or display addictive behaviors regarding food intake may want to have some security measures in place.

The first measure is when you go grocery shopping, do so after you have eaten a meal. Never go to the grocery store hungry. The second measure is to take a list of healthy food items you need and buy them only. Stay on the outside aisles of the store and avoid the aisles containing the foods you are not allowed to eat. The third measure is to not allow any of the banned foods into your home from any source. If they are accessible to you, you will want to eat them. The fourth measure is to cook all of your own food and do not go out for food unless the menu contains food you can eat and is prepared properly. Checking the menu before you go into the establishment is a requirement. The fifth measure is keeping a detailed lifestyle diary containing your food intake, exercise program, and how you felt each day. Do not weigh yourself.

After you have reached your weight loss goal, you can have a cheat meal once per week. This meal must contain normal-sized servings. This meal can consist of whatever you want.

As long as you are doing well with your new program, this strategy will not hurt your efforts, but you can only have this cheat meal if you have been successful throughout the week.

Source: naturalblaze.com

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High sodium intake correlates with obesity, inflammation

Most adolescents consume as much salt as adults - some more than twice the recommended daily allowance - and that high sodium intake correlates with fatness and inflammation regardless of how many calories they consume, researchers report.

In a study of 766 healthy teens, 97 percent self-reported exceeding the American Heart Association's recommendation of consuming less than 1,500 milligrams of sodium daily, according to a study in the journal Pediatrics.
"The majority of studies in humans show the more food you eat, the more salt you consume, the fatter you are," said Dr. Haidong Zhu, molecular geneticist at the Medical College of Georgia and Institute of Public and Preventive Health at Georgia Regents University.

"Our study adjusted for what these young people ate and drank and there was still a correlation between salt intake and obesity," Zhu said.
These high-sodium consumers also had high levels of tumor necrosis factor alpha, which is secreted by immune cells and contributes to chronic inflammation as well as autoimmune diseases like lupus and arthritis. Additionally, the adolescents had high levels of leptin, a hormone produced by fat cells that normally suppresses appetite and burns fat, but at chronically high levels can have the opposite effects.

"Losing weight is difficult, but hopefully more people can be successful at reducing their sodium intake," said Zhu, the study's corresponding author. Reductions would result from not automatically adding salt to food and choosing fresh fruits and vegetables over French fries and processed meats and snacks.
"We hope these findings will reinforce for parents and pediatricians alike that daily decisions about how much salt children consume can set the stage for fatness, chronic inflammation and a host of associated diseases like hypertension and diabetes," said study co-author Dr. Gregory Harshfield, Director of the Georgia Prevention Center at the GRU institute.
High sodium intake has been linked to higher weight, possibly because of increased water retention. While the new study does not prove a causal effect, it contributes to mounting evidence that high sodium could be a direct cause of obesity and inflammation, Zhu and her colleagues report. Longitudinal or randomized clinical trials are needed to clarify the relationships, the researchers said.

"Obesity has a lot of contributing factors, including physical inactivity," Zhu said. "We think that high sodium intake could be one of those factors." Evidence suggests one direct cause may be increasing the size of fat cells.
The MCG study appears to be the first to use several robust measures of fatness to improve accuracy, including magnetic resonance imaging and dual-energy X-ray absorptiometry, which also measures bone density.

Source: medicalnewstoday.com

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