Effect of three common diets on energy expenditure following weight loss detailed

ScienceDaily (June 26, 2012) — In an examination of the effect on energy expenditure and components of the metabolic syndrome of 3 types of commonly consumed diets following weight loss, decreases in resting energy expenditure and total energy expenditure were greatest with a low-fat diet, intermediate with a low-glycemic index diet, and least with a very low-carbohydrate diet, suggesting that a low-fat diet may increase the risk for weight regain compared to the other diets, according to preliminary research published in the June 27 issue of JAMA.

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"Many people can lose weight for a few months, but most have difficulty maintaining clinically significant weight loss over the long term. According to data from the National Health and Nutrition Examination Survey (1999-2006), only 1 in 6 overweight and obese adults report ever having maintained weight loss of at least 10 percent for 1 year," according to background information in the article. One explanation for the poor long-term outcome is that weight loss elicits biological adaptations -- specifically a decline in energy expenditure and an increase in hunger -- that promote weight. According to the authors, the effect of dietary composition on energy expenditure during weight-loss maintenance has not been studied.

Cara B. Ebbeling, Ph.D., of Children's Hospital Boston, and colleagues conducted a study to evaluate the effects of 3 weight-loss maintenance diets on energy expenditure, hormones, and components of the metabolic syndrome. The study, conducted between June 2006 and June 2010, included 21 overweight and obese young adults. After achieving 10 percent to 15 percent weight loss while consuming a run-in diet, participants consumed an isocaloric low-fat diet (60 percent of energy from carbohydrate, 20 percent from fat, 20 percent from protein; high glycemic load), low-glycemic index diet (40 percent from carbohydrate, 40 percent from fat, and 20 percent from protein; moderate glycemic load), and very low-carbohydrate diet (10 percent from carbohydrate, 60 percent from fat, and 30 percent from protein; low glycemic load) in random order, each for 4 weeks. The primary outcome measured was resting energy expenditure (REE), with secondary outcomes of total energy expenditure (TEE), hormone levels, and metabolic syndrome components.

The researchers found that energy expenditure during weight-loss maintenance differed significantly among the 3 diets. The decrease in REE from pre-weight-loss levels, measured by indirect calorimetry in the fasting state, was greatest for the low-fat diet (average relative to baseline, -205 kcal/d), intermediate with the low-glycemic index diet (-166 kcal/d), and least for the very low-carbohydrate diet (-138 kcal/d). The decrease in TEE also differed significantly by diet (average -423 kcal/d for low fat; -297 kcal/d for low glycemic index; and -97 kcal/d for very low carbohydrate).

"Hormone levels and metabolic syndrome components also varied during weight maintenance by diet (leptin; 24-hour urinary cortisol; indexes of peripheral and hepatic insulin sensitivity; high-density lipoprotein

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Significant cardiovascular risk with Atkins-style diets, experts warn

ScienceDaily (June 27, 2012) — Women who regularly eat a low carbohydrate, high protein diet are at greater risk of cardiovascular disease (such as heart disease and stroke) than those who do not, a study just published on the British Medical Journal website suggests.

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Although the actual numbers are small (an extra 4-5 cases of cardiovascular disease per 10,000 women per year) the authors say that this is a 28% increase in the number of cases and that these results are worrying in a population of young women who may be exposed to these dietary patterns and face the excess risk for many years.

Low carbohydrate-high protein diets are frequently used for body weight control. Although they may be nutritionally acceptable if the protein is mainly of plant origin (e.g. nuts) and the reduction of carbohydrates applies mainly to simple and refined ones (i.e. unhealthy sweeteners, drinks and snacks), the general public do not always recognise and act on this guidance.

Studies on the long term consequences of these diets on cardiovascular health have generated inconsistent results. So a team of international authors carried out a study on just under 44,000 Swedish women aged between 30 and 49 years from 1991-92 (with an average follow-up of 15 years).

Women completed an extensive dietary and lifestyle questionnaire and diet was measured on the low carbohydrate-high protein (LCHP) score where a score of two would equal very high carbohydrate and low protein consumption through to 20 which would equal very low carbohydrate and high protein consumption.

Factors likely to influence the results were taken into account including smoking, alcohol use, diagnosis of hypertension, overall level of activity and saturated / unsaturated fat intake.

After these variables were included, results showed that 1270 cardiovascular events took place in the 43,396 women (55% ischaemic heart disease, 23% ischaemic stroke, 6% haemorrhagic stroke, 10% subarachnoid haemorrhage and 6% peripheral arterial disease) over 15 years.

The incidence of cardiovascular outcomes increased with an increasing LCHP score.

Unadjusted figures show that, compared with an LCHP score of six or less, cardiovascular diseases increased by 13% for women with a score from 7 to 9, to 23% for those with a score from 10 to 12, to 54% for those with a score from 13 to 15, and to 60% for those with a score of 16 or higher.

After adjusting for other cardiovascular risk factors, there was still a significant 5% increase in the likelihood of a cardiovascular event or death with every two point increase in the LCHP score. The 5% increase resulted from a daily decrease of 20g of carbohydrates (equivalent to a small bread roll) and a daily increase of 5g of protein (equivalent to one boiled egg).

In absolute terms, the adjusted figures represent an additional four to five cases of cardiovascular diseases per 10,000 women per year compared with those who did not regularly eat a low carbohydrate, high protein diet.

Increasing level of education and physical activity reduced the risk of cardiovascular disease whilst increasing levels of smoking increased the risk.

The authors conclude that LCHP diets "used on a regular basis and without consideration of the nature of carbohydrates or the source of proteins" are associated with cardiovascular risk. This study doesn't, however, address the questions concerning the possible benefit of short-term effects of LCHP diets that can be used to control weight or insulin resistance, which the authors say needs further investigation.

An accompanying editorial argues that the short term benefits of weight loss seem outweighed by longer term cardiovascular harms. Anna Floegel from the German Institute of Human Nutrition and Tobias Pischon from the Max Delbrück Center for Molecular Medicine in Germany, say that the discrepancy between conclusions from different types of studies in this field "need to be resolved before low carbohydrate-high protein diets can be safely recommended to patients."

In the meantime, they suggest that any benefits gained from these diets in the short-term "seem irrelevant in the face of increasing evidence of higher morbidity and mortality from cardiovascular diseases in the long term."

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Kids who cook are hungrier for healthy food choices

ScienceDaily (June 27, 2012) — Getting kids to pass up junk food in favour of healthier fruits and veggies has led to many a mealtime meltdown for parents everywhere. Now, researchers from the University of Alberta offer a simple solution: give them an apron.

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A province-wide survey of Grade 5 students in Alberta suggests the best way to get your child to eat healthier foods -- and actually enjoy them -- is to have them help with meal preparation.

"Kids who like fruits and vegetables more tend to eat them more frequently and have better diets," said lead author Yen Li Chu, a post-doctoral fellow in the School of Public Health. "These data show that encouraging kids to get involved in meal preparation could be an effective health promotion strategy for schools and parents."

Published last month by Public Health Nutrition in an early online release, the study involved a survey of students in 151 schools across Alberta to learn about kids' experiences with cooking and food choices.

Nearly one-third of children reported helping with meal prep at least once a day; another one-third said they helped one to three times a week. A quarter of children helped once a month, and 12.4 per cent avoided the kitchen completely.

In general, children preferred fruits to veggies, but children who helped with cooking showed a greater preference for both. Vegetable preference was also 10 per cent higher among children who helped cook.

The data also showed that kids who did meal prep and cooking were more confident about the importance of making healthier food choices.

Paul Veugelers, co-author and Canada Research Chair in Population Health at the U of A, said getting children to eat healthier food promotes bone and muscle development, learning and self-esteem.

"Good food is important for us. It keeps weight gain away -- and more important than that, it keeps chronic disease away," Veugelers said. "The overarching objective of our work is to lower the burden of chronic disease in our society. A healthy diet is right at the top."

Chu said the results underscore the value of getting kids interested in mealtime activities in the home, but added there could be room for schools to get involved, too.

"You can go into schools and have cooking classes and cooking clubs to help them boost their fruit and vegetable intake and make healthier choices," she said.

Though this survey dealt with Grade 5 students, the lessons are equally applicable to older youth, including post-secondary students, added Veugelers.

"For many of them, it may be the first time they leave home, the first time in their lives they're responsible for their own diets," he said. "There are lessons here for them too, to form groups and take turns cooking, and pay attention to good meal preparation."

This work was part of the Real Kids Alberta evaluation funded by Alberta Health. Real Kids Alberta is a collaborative initiative between the School of Public Health and Alberta Health to provide directions to improve eating habits and activity levels in Alberta children and youth.

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'War on drugs' is fueling HIV epidemic: report

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Rapid HIV Test Could Reduce Stigma and Curtail Disease

The Centers for Disease Control and Prevention has launched an initiative to motivate people to get tested for HIV. A free rapid test is being offered in select pharmacies nationwide, within their small clinics, which involves a swab test that renders results in approximately 20 minutes, the Associated Press reports. If the result is positive, the patient is sent to a department of health or other clinic to have the result confirmed by blood test.

With an estimated 1.1 million Americans infected with the disease and an estimated 20 percent of them unaware, this is a wise move to help to curtail the spread of the disease. So many people are unaware of the facts about HIV and AIDS that perhaps being confronted by the testing center and the information offered there will prompt people to know more. In the back of so many minds is the fear the possibility of infection exists.

Too many people still believe HIV and AIDS are the disease of gay men and drug users. While statistics still confirm these groups are still at higher risk, the truth is the condition is increasing in women, particularly minority women. HIV is more easily spread from man to woman because the virus exists in a man's semen, which can live inside the vagina for several days. But the female bodily fluids from which a man can contract the virus through intercourse with a woman have more limited means to enter the penis and infect a man's body.

In order for this condition to be dealt with, the stigma must decrease. There have been tremendous strides made in regard to treating the disease, making it possible for those infected to live productive and happy lives, to enjoy careers and have families. In fact, with treatment, the chances of a woman passing along the virus to her unborn child are reduced to as low as 2 percent.

Symptoms of the illness often don't appear for nearly 10 years in many patients. It is important to be tested for this virus, regardless of whether any sexual partners "appear" to be ill and whether a person has had few or several partners. It's better to know early. Though there is no cure, treatment is possible to help to maintain a normal life.

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Walgreen, others offer free HIV tests in CDC pilot

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Bacterial Vaginosis Increases Female-to-Male HIV Transmission Risk

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German court bans circumcision of young boys

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Wednesday Is National HIV Testing Day

HealthDay – 32 mins ago TUESDAY, June 26 (HealthDay News) -- More than 1 million people in the United States are living with HIV, the virus that causes AIDS, but 20 percent of them don't know they're infected.

Federal health officials are urging everyone between the ages of 13 and 64 to get tested for HIV at least once as part of routine health care.

And there's no better time to start than Wednesday, June 27 -- National HIV Testing Day.

The U.S. Centers for Disease Control and Prevention recommends annual testing for people at higher risk of HIV infection, including intravenous drug users, gay and bisexual men, or people who have multiple sex partners. Sexually active gay and bisexual men may benefit from even more frequent testing -- perhaps every three to six months, the CDC said.

The CDC also urges pregnant women to get tested early in their pregnancy so they can take the steps necessary to keep from passing HIV to their babies.

As part of National HIV Testing Day, the CDC recommends:

Asking your doctor for an HIV test or finding a place to get tested in your community. For help in finding a testing place, go to www.hivtest.org, call 1-800-CDC-INFO or text your zip code to "KNOW IT" (566948). Getting tested once a year, or more often if you have more than one sex partner, inject drugs, or are a gay or bisexual man. Lowering your HIV risk by having sex with only one partner -- someone you know is uninfected. Or using a condom every time you have anal, vaginal, or oral sex. Getting medical care as soon as possible if you have HIV to stay healthier longer and to keep from passing the virus to others.

More information

To learn more about HIV/AIDS, visit the U.S. Centers for Disease Control and Prevention.

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Surgeons Seek Repeal of Transplant Ban Between HIV-Positive People

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Failed IVF attempt tied to depression, anxiety

Reuters – 1 hr 40 mins ago NEW YORK (Reuters Health) - Women who are stressed and anxious before in vitro fertilization (IVF) are no less likely to have a baby, new research suggests. But if the treatment fails, it may take a toll on their mental health.

In two separate studies in the journal Fertility and Sterility, researchers found women with anxiety or depression symptoms were just as likely as others to become pregnant.

One study focused on women undergoing IVF and the other followed women trying to conceive naturally.

"Our findings are consistent with the most recent research," said Lauri A. Pasch, a clinical psychologist at the University of California, San Francisco Center for Reproductive Health, and the lead researcher on the IVF study.

Based on that body of research, she told Reuters Health, "I think we can safely say to women,

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FDA Approves Weight Loss Drug Belviq

a foot in the door for pharmacological treatment of obesity," said Dr. Robert Eckel, a professor of medicine at the University of Colorado -- Denver. "However, the effects are moderate at best."

Obesity is becoming an epidemic of massive proportions. According to the World Health Organization, by 2015 2.3 billion adults will be overweight, and more than 700 million will be obese. Obesity is associated with a host of health problems, including high blood pressure, diabetes, heart attacks, asthma, cancers and strokes. Indeed, obesity, along with tobacco, is a leading cause of preventable death.

The main treatments for obesity are diet and exercise. If those interventions are not effective, then a person can consider medical therapy or bariatric surgery. However, bariatric surgery, though effective in leading to weight loss, is also a surgical procedure with serious risks.

"Clearly

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