Takeaways from the Biggest Loser study

chow_050616-466368885I recently heard some discouraging news about the prospects of losing weight and keeping it off. What is the best course for people like me, who had a lifelong battle with weight?

You’re likely talking about the study that followed 14 “Biggest Loser” contestants six years after they competed on the TV show. The study, in the journal Obesity, has received wide media coverage.

One of the participants actually weighs less than she did at the end of the competition, but the other 13 regained some or all of the weight they had lost. While more than half retained at least a 10 percent weight loss six years later, five now weigh as much or more as they did before the Biggest Loser. Their level of physical activity had not changed significantly since the end of the competition.

What surprised the researchers most were the measurements of the participants’ “resting metabolic rate,” or the calories a person burns while at rest. It’s generally known that when people diet and they trim down, their metabolism slows and they don’t burn as many calories. But researchers found that as these participants regained pounds, their metabolic rates did not increase as expected. In order to maintain their weight, most Biggest Loser graduates must eat 200 to 800 fewer calories per day than other people who weigh exactly the same as they do.

In addition to that hurdle, researchers found that the participants continue to have significantly lower levels of the hormone leptin. Less leptin triggers hunger and cravings, and is normal when you diet. The participants had normal levels of leptin when they started the Biggest Loser competition and almost none when they finished. Six years later, the participants’ leptin levels had not returned to normal. They were hungry, all the time.

So, what does this mean for you? Since everyone is different, it’s difficult to say. But here are some things to consider:

  • Focus on health, not the scale. Eat 2 to 2.5 cups of vegetables and 1 to 1.5 cups of fruit every day, and round out your diet by focusing on whole grains, lean protein and healthy oils. And get plenty of physical activity: Make it your goal to walk, play sports or work out for at least 30 minutes five days a week. Even if the pounds don’t drop, regular physical activity lessens the risk of chronic disease.
  • Take guidance from the National Weight Control Registry, www.nwcr.ws, a database of more than 10,000 people who have lost 30 pounds or more and have kept it off for at least a year. Most report they have had success by maintaining a low-calorie, low-fat diet, and 90 percent say they exercise an average of an hour a day. But understand the hunger pangs you will likely feel are real, and you will have to work harder to maintain your weight than your lean friends.
  • Shed any shame or guilt you feel about your weight. As science learns more about individual differences in metabolism as well as leptin and other hormones that affect hunger and appetite, it’s easier to understand the biological underpinnings of why so many of us struggle with weight issues. Self-blame doesn’t help.

Chow Line is a service of the College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, Ohio State University Extension and the Ohio Agricultural Research and Development Center. Send questions to Chow Line, c/o Martha Filipic, 2021 Coffey Road, Columbus, OH 43210-1043, or filipic.3@osu.edu.

Editor: This column was reviewed by Dan Remley, field specialist in Food, Nutrition and Wellness with Ohio State University Extension.

Making the ‘see food’ diet work for you

chow_080715_99185593I started keeping a bowl of fruit on the kitchen counter to encourage my family to eat more produce. It works. What are some other ideas to help us eat more healthfully?

Putting healthful food within arm’s reach is a tried-and-true technique for helping make good food choices. There’s plenty of research to back that up ­— and it works both ways.

A recent study at The Ohio State University found that compared with normal-weight people, obese people tended to keep more food visible not only in the kitchen, but throughout the house. They also generally ate more sweets and other less healthful foods than their counterparts. It’s as if that old (not funny) joke were true: “I’m on the ‘see food’ diet. If I see food, I eat it.” Clearly, the food environment around us matters.

Cornell University’s Brian Wansink has been called the eating behavior guru. In a recent article in the journal Psychology and Marketing, he analyzed 112 studies and concluded that most people make food-related decisions based on three elements: They select foods that are convenient, attractive and “normal.” So, when a bowl of fruit is the first thing you see when you enter the kitchen, and it’s attractively displayed in a nice bowl, you will more likely choose to eat fruit rather than the stale corn chips on a shelf in a back corner of the pantry.

There’s a bit of overlap in the three aspects of food choice, but they’re all worth knowing more about:

  • Convenient. The concept of convenience includes both physical and mental effort. Put healthful foods at the front of the refrigerator, ready to grab and go. Buy 100-calorie packages of snacks instead of trying to guess what a reasonable portion is. Find restaurants that, as their standard options, serve fruit or vegetables on the side instead of fries or onion rings and include bottled water, unsweetened ice tea or even milk with meals instead of soft drinks.
  • Attractive. Making food attractive has to do with all manner of presentation, from how it is served to how much it costs to what it is called. Wansink’s research shows that more children will eat broccoli when it’s called “Dinosaur Trees.” The same is true when vegetarian burritos are served as “Big Bad Bean Burritos.” And, serving foods on china increases the value people place on it, compared with normal dishes or paper plates.
  • Normal. People lean toward food choices that they perceive as the norm. One example of “normalizing” healthy eating is to always put salad bowls on the dinner table, even on days when salad isn’t being served. That makes it seem like salad is a standard part of every dinner, rather than as an infrequent side dish.

Wansink calls this the CAN approach — short for “convenient, attractive, normal” — and he says the opposite is also true: Making less-healthy food less convenient, less attractive and less normal can decrease its consumption. Put less-healthful snacks in a cupboard in the laundry room, he suggests, or try the cupboard above the refrigerator. Learn more at his website at foodpsychology.cornell.edu.

Chow Line is a service of the College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, Ohio State University Extension and the Ohio Agricultural Research and Development Center. Send questions to Chow Line, c/o Martha Filipic, 2021 Coffey Road, Columbus, OH 43210-1043, or filipic.3@osu.edu.

Editor: This column was reviewed by Dan Remley, Ohio State University Extension specialist in Food, Nutrition and Wellness.

For a PDF of this column, please click here.

Eat fruit, veggies for health, not weight

467006435I was hoping that eating more fruits and vegetables this summer would help me lose a few pounds, but so far, no luck. Am I missing something?

A lot of people think that eating more healthfully will automatically help them slim down. And no wonder: Most weight-loss plans emphasize the importance of incorporating more fruit and vegetables into the diet.

That’s advice worth following for most Americans. According to the Centers for Disease Control and Prevention, adults in the U.S. consume fruit only 1.1 times per day on average, and vegetables only 1.6 times per day. At the same time, U.S. Dietary Guidelines recommend adults eat 1.5 to 2 cups of fruit daily, along with 2 to 3 cups of vegetables. Boosting fruit and vegetable consumption is a good idea for just about everyone.

But for most people, unfortunately, that’s not the only change in diet required for weight loss.

A meta-analysis published recently in the American Journal of Clinical Nutrition examined the effect of fruit and vegetable consumption on weight. Researchers reviewed seven studies conducted between 1998 and 2013 involving more than 1,200 people. All of the studies were randomized and lasted for at least eight weeks, and all focused on fruit and vegetable intake and weight loss or gain.

The authors found that, across the board, increased fruit and vegetable consumption had no effect on weight loss in those studies.

From one perspective, it might sound like there’s no reason to focus on fruits and vegetables if you want to lose weight. But as the authors noted, in these studies, eating more produce didn’t cause weight gain, either. And there are plenty of reasons to eat more fruits and vegetables. According to the CDC:

  • A healthful diet rich in fruits and vegetables may reduce the risk of cancer and other chronic diseases.
  • Fruits and vegetables provide essential vitamins and minerals, fiber, and phytochemicals that contribute to good health.
  • Most fruits and vegetables are naturally low in fat and calories and can help you feel full without resorting to less-healthful choices.

The CDC offers links to additional resources to help you get the fruits and vegetables you need each day on its “Nutrition for Everyone” website. Included is a link with ideas on how to incorporate more produce in your weight-loss effort. For more information, see cdc.gov/nutrition/everyone/fruitsvegetables.

Chow Line is a service of Ohio State University’s College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, Ohio State University Extension and the Ohio Agricultural Research and Development Center. Send questions to Chow Line, c/o Martha Filipic, 2021 Coffey Road, Columbus, OH, 43210-1043, or filipic.3@osu.edu.

Water, weight loss link needs research

609_3640759I heard about a study that showed drinking more water can help people lose weight. But I thought that was a myth that had been debunked a long time ago. Can you clarify?

You probably heard something about a recent review of previous studies on this topic, published ahead of print online in late June in the American Journal of Clinical Nutrition.

Researchers searched through nearly 5,000 records of research in online databases for studies that reported on an association between daily water consumption and any weight-related outcome. They found just 11 original studies and two other systematic reviews. Of the 11 original studies, only three specifically focused on people trying to lose weight or maintain weight loss.

Those three studies did, in fact, show a relation between increased water consumption and increased weight loss, the reviewers said. But two other short-term studies that included mixed-weight populations that weren’t necessarily dieting didn’t show a relation between drinking water
and weight loss. Other studies reported on water consumption and current body weight status, and results were inconsistent. In fact, some showed obese people tended to drink more water.

Still, nutritionists and other professionals specializing in weight loss often recommend that their clients drink more water, which some believe can help reduce hunger pangs and increase a feeling of fullness with absolutely no calories. In comparison, juices and sweetened beverages often have 160 calories per serving.

There’s also speculation that drinking enough water helps the body’s metabolism and increases energy expenditure, but solid research on that is hard to find.

But water does help the body in countless other ways, including:

  • The functioning of every cell and organ in the body.
  • Regulation of body temperature through perspiration. (You need more water when you exercise — at the gym, in the garden or any other time you work yourself into a sweat.)
  • Prevention and relief of constipation by helping food move through the intestines.
  • Lubrication and cushioning of joints.

The Institute of Medicine recommends that women consume 91 ounces (about 11.5 cups) and men consume 125 ounces (about 15.5 cups) of water a day, but that includes water from other beverages and from food. The institute says on average, people get about 20 percent of their water intake from food.

No need to ‘detox’ with special diet

161914255Every once in a while I hear someone mention that they have either fasted or gone on a restricted diet to “detox” — and, of course, to lose a lot of weight relatively quickly. Is this a good practice? Is it safe?

You’re right to be skeptical. Any diet that promises a quick fix, encourages a severe restriction of calories, advises you to eat only certain foods or requires that foods be eaten only in specific combinations screams “fad diet.”

Detox diets claim to “detoxify” the body, allowing toxins and contaminants that have accumulated over time to flush out. You can find many versions of the detox diet, but they usually start with a very low calorie fast followed by drinking juice and eating small amounts of fresh produce. Many detox diets recommend an enema or some other type of physical cleansing of the colon.

Here’s the thing: The body already has some perfectly good systems in place to detoxify the body. They’re called the liver, the kidneys and the colon. Although supporters of detox diets disagree, there’s no evidence to support the idea that those systems need a substantial restriction of food and calories to help them remove harmful substances from the body.

Some people claim the detox diet helps them feel healthier and more energetic, but there could be several explanations for this. For example, their normal diet might be heavy in saturated fats, refined grains and heavily processed foods. Taking a break from those foods would certainly make your body feel different. Eating fruits and vegetables after severely restricting food intake for an extended period might also make someone feel better.

But putting yourself on any very low calorie diet has its downsides. One is that you may lose muscle, which would cause your metabolism to dip and make it easier to gain weight. The only way to build that muscle back would be to start a regimen of weight-bearing exercise — not a bad thing in and of itself, but probably not the result you were hoping for.

Instead of detox or other fad diets, nutritionists recommend eating a balanced diet centered on lean proteins, vegetables and whole fruits, whole grains, and a modest amount of healthy (unsaturated) fats. Also, don’t skip meals, especially breakfast, and limit portions to a sensible size. Finally, if you are thinking of making drastic changes to your diet, it’s always a good idea to talk with your doctor first.

Healthy eating tips the easy way

78036797I’m interested in eating more healthfully and hopefully losing a few pounds, but I don’t want to track everything I eat or count calories. Do you have any general tips that could help?

Many people do find that keeping a food log helps them lose weight, but if you’re not interested in doing that right now, yes, of course you can take other steps. Here are some tips:

  • The Harvard Medical School suggests cutting back on carbohydrates, particularly from sugar-sweetened beverages such as soft drinks, sports drinks and energy drinks and from refined-carbohydrate foods, including many types of bread, cereal, pasta, snack foods, and French fries and other types of fried potatoes. Instead, choose water or unsweetened beverages, and whole-grain foods that offer fiber and other nutrients. Look for at least 2 grams of fiber per serving.
  • Pay special attention to portion sizes, even if you’re eating something you consider to be good for you. A study recently published in the International Journal of Obesity showed that people tend to eat more of a food if it’s labeled as “healthy,” even if it has the same number of calories as similar options.
  • Similarly, don’t assume cutting fat is always healthier. Some low- or no-fat food products replace the fat with added refined-carbohydrate ingredients — not necessarily a benefit. And, research has shown a little fat, such as that in dressings or avocados, helps the body absorb nutrients in leafy greens. Instead, focus on limiting saturated fat and eliminating trans fat, opting instead for unsaturated fats.
  • Eat a wide variety of produce, whole grains, and beans and other legumes to get a broad range of nutrients. In particular, choose fruits and vegetables of many colors, especially green, red, yellow, orange and dark purple. The pigments in colorful produce contain vitamins and phytochemicals that are linked with a lower risk of certain cancers and heart disease.
  • Incorporate more fish and small amounts of nuts into your diet. They are good sources of protein and healthy fats, and Americans tend to not get enough of them.
  • Never shop for groceries on an empty stomach. A study recently published in JAMA Internal Medicine, a journal of the American Medical Association, provided compelling evidence supporting what you probably already know: People tend to choose more high-calorie foods if they shop when they’re hungry. Eat first and you’ll be healthier for it.

Protein guidance can be confusing

161863082How much protein should I eat every day?

Determining how much protein an adult should consume each day might seem confusing. According to the Institute of Medicine, which sets nutrition recommendations, a healthy adult should consume anywhere from 10 to 35 percent of total calories in protein per day. That’s a big range. The average American diet amounts to about 15 percent protein, or about 75 grams a day for those on a 2,000 calorie-a-day diet.

Additionally, the Institute of Medicine advises that adults should eat a minimum of 0.8 grams of protein per kilogram (or 0.37 grams per pound) of ideal body weight. For a person whose ideal weight is 160 pounds, for example, that would be a minimum of about 60 grams of protein.

Paying attention to both pieces of guidance is important — particularly if you’re severely restricting calories for weight loss. If you’re eating, say, 1,200 calories a day, and you’re keeping your protein to the minimum of 10 percent of total calories, you’d only be consuming 30 grams of protein a day (each gram of protein has 4 calories). That’s not nearly enough for most adults. You’ll want to eat a higher percentage of protein and trim back one or both of the other macronutrients, carbohydrates and fat.

Note that when you make shifts in one macronutrient, it affects the percentages you’re consuming in the whole diet. Total fat should be limited to 30 percent of total calories, with most coming from healthier unsaturated types. For carbohydrates, the recommended range is 45 to 65 percent of total calories, with half coming from healthier whole grains. A minimum intake of 130 grams of carbohydrates per day is necessary for normal brain function.

For protein, the best choices include meats with relatively little fat, including lean beef, pork and poultry; fish, including salmon, trout and other choices high in omega-3 fatty acids; and beans, peas, soy products and unsalted nuts. For more detail, see the advice for protein in the 2010 Dietary Guidelines for Americans at http://bit.ly/chooseprotein.

If you’re trying to lose weight, you might have noticed that many mainstream diet plans recommend a higher proportion of dietary protein. And it’s true that protein helps with satiety, that feeling of fullness after eating. So, if you’re stuck in your attempt at losing weight, you might consider bumping up your lean protein intake while reducing carbohydrates, as long as you stay in the overall guidelines. That said, a 2009 study published in the New England Journal of Medicine comparing different regimens showed restricting calories overall was the key to weight loss, not where the calories come from.

 

Limit trans fats, boost heart health

What has been the effect from the ban on trans fats in New York City restaurants?

Restrictions on the use of partially hydrogenated vegetable oils at restaurants in New York City appear to have slashed the amount of trans fat that their patrons consume.

First, some background: Both saturated fat and trans fat increase blood cholesterol levels. High cholesterol increases the risk of heart disease, so health officials have long looked for ways to reduce such fats in the diet.

Trans fat has a far more negative effect than saturated fat. It’s estimated that an increase of just 2 percent of total calorie intake from trans fat — the equivalent of 40 calories in a 2,000-calorie-a-day diet, or 4.5 grams of trans fat — increases the risk of heart disease by as much as 23 percent.

Some of the trans fat we consume comes from milk, meat and other natural sources, but most of it is from partially hydrogenated oils — widely used because they improve the texture, shelf-life and flavor stability of processed foods.

When the Food and Drug Administration mandated in 2006 that trans fat amounts be listed on Nutrition Facts labels, many products were reformulated to reduce or eliminate trans fat. But meals from restaurants and other food-service establishments make up about one-third of the American diet. That’s why New York City and some other localities decided to put restrictions in place.

A study of lunches purchased at New York fast-food restaurants before and after the ban took effect found trans fat consumption decreased considerably, from almost 3 grams per meal to about a half-gram.

Interestingly, other research has found that Americans’ blood cholesterol levels have dropped from an average of 206 in 1988-94 to 196 in 2007-2010, and levels of LDL (the “bad”) cholesterol have dropped from 129 to 116. While no one can be certain what is causing the decline, researchers believe the decreased consumption of trans fat certainly has played a role.

To reduce trans fat in your diet:

  • Read labels. Foods with less than 0.5 grams of trans fat per serving will say “0” trans fat on Nutrition Facts labels. Also look at ingredient listings. Foods with “partially hydrogenated” oils contain at least some trans fat.
  • When eating out or buying foods at bakeries or other places that might not provide a label, inquire about use of partially hydrogenated oils. And, before going to a chain restaurant, visithttp://www.calorieking.com or a similar website to look up nutrition information on menu items.
  • Even better: Set a weekly goal to eat out less, and prepare food at home with healthy ingredients.

Behavior changes key in weight loss

What are some of the things people do (besides eating less) to help them lose weight successfully?

That’s an interesting question. Most people, for obvious reasons, focus on food when trying to lose weight or maintain a healthy weight.

But behavioral scientists studying successful weight loss have found a few strategies beyond cutting calories that seem to work for many who have lost weight and kept it off.

In a recent study in the International Journal of Behavioral Nutrition and Physical Activity, researchers at the University of Minnesota studied behaviors of more than 400 people who successfully lost at least 10 percent of their body weight in the past year. The researchers grouped the behaviors in four major categories:

  • Regularity of meals: People who tended to eat breakfast, lunch and dinner routinely were more likely to have better success at weight loss during the past year. They were also more likely to eat more fruits and vegetables.
  • TV-related viewing and eating: Participants were asked how often they ate snacks or meals in front of the television, how much TV they watched on an average day, and how often they ate after 7 p.m. Those who were more likely to engage in those behaviors tended to have a higher BMI (or body mass index, a standard measure of body fat based on height and weight) and higher fat and sugar intake.
  • Eating away from home: These behaviors include eating out at a restaurant (sit down or fast food); eating food provided by an employer or another employee at work; purchasing food at a convenience store or a gas station; and purchasing food items for a fundraiser. People who did these things more often had a higher fat and sugar intake and a lower fruit and vegetable intake, and engaged in less physical activity.
  • Intentional strategies for weight control: Participants were asked how often they wrote down the amount and type of exercise they engaged in, as well as the calorie content of the food they ate; how often they planned meals and exercise in order to manage their weight; and how often they used meal replacements. Those who did these things more often saw many benefits: they tended to have a lower BMI; they experienced greater weight loss in the last year; they had a lower fat and sugar intake; they ate more fruits and vegetables; and they engaged in more physical activity.

Take a look at the behaviors and see if any of them make sense to incorporate in your life. Adopting a few healthy strategies can make a big difference.

Estimate portion sizes with ‘handy’ tool

I want to make sure I’m eating the proper portion sizes, but I don’t want to weigh and measure everything I eat. Is there an easy way to estimate servings of different foods?

Actually, there are a number of ways to do this, and one is right at your fingertips.

The 2012 Complete Food and Nutrition Guide from the Academy of Nutrition and Dietetics (formerly the American Dietetic Association) includes a “Visual Guide to Amounts,” using an average-sized hand to help you estimate. It’s an important topic, as portion sizes have swelled (along with the average waist) over the years.

You can use these tips to make sure you eat enough (or more) of:

  • Vegetables, fruit, cereal, or cooked beans, rice or pasta: A cup is about the size of your fist.
  • Nuts, seeds or dried fruit: An ounce fits in a small cupped handful.
  • Seafood: Three ounces of cooked seafood is about the size of your palm (no fingers).

And use similar guides to limit these servings:

  • Meat and poultry: Three ounces is about the size of your palm.
  • Cheese: An ounce is about the size of your thumb, from the tip to the base.
  • Peanut butter: A tablespoon is about the size of the tip of your thumb, down to the first joint.
  • Butter, margarine, mayonnaise, oil or sugar: A teaspoon is about the size of a fingertip, from the tip to the first joint.

Of course, your hand size may vary, so you might want to weigh or measure a few items after you do an initial estimate. That way you will know if you can choose a pork chop, for example, that’s slightly larger than the palm of your hand, or if you should take one that’s a bit smaller.

The “plate method” is another way to estimate portion sizes. All you do is imagine your dinner plate is divided in half, and then one side is divided in halfagain. Use the first half for non-starchy vegetables — broccoli, zucchini or salad, for example. Use one-fourth of the plate for lean meat, fish, poultry or other lean protein. And use one-fourth for starchy vegetables, such as potatoes, corn or peas, or other starchy foods, including beans and such grains as rice or pasta.

You can find another good visual guide on WebMD at http://bit.ly/WebMDvisual. It uses common household objects to help estimate appropriate portion sizes (for example, a small potato is about the size of a computer mouse; 1.5 ounces of hard cheese is about the size of three dice). Take a look and see if that’s even more helpful (if not as handy) as the other methods.