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.

Science behind appetite complex

I’ve been overweight all my life. Recently, I’ve read a little about what controls hunger and appetite. Are there foods I can eat that will help me feel fuller sooner, so I eat less?

As you suspect, the connection between eating and feeling full isn’t as simple as most people think. Scientists are still uncovering new information about the mechanisms involved.

For example, we’ve known for a while that eating foods high in protein may help us feel full more than when we eat carbohydrates or fats. Scientists are just now figuring out why. A French study published online in early July 2012 in the journal Cell shed some light: Apparently, peptides — the product of digested proteins — block the activity of certain nerve receptors in the gut. Blocking those receptors sends signals to the brain that in turn stimulates the intestine to release glucose, which suppresses the appetite. Knowing this provides more evidence for the benefits of including at least some lean protein in every meal.

A little fat in the food we eat also tends to help us feel fuller after eating. That’s one reason why dietitians caution us about blindly choosing low-fat versions of foods: The calorie difference between low-fat and “regular” foods may not be as great as you think, and if you don’t feel as satisfied after eating a low-fat food, you may end up eating more of it. Keep that in mind as you make your food choices.

High-fiber foods are other good choices. Fiber passes through the body undigested, so it provides bulk with few calories. Opt for naturally occurring fiber — different types of fiber now added to some foods and beverages don’t have the same satiating effect.

Other things to consider include:

  • Eat slowly. It takes about 20 minutes for the signals between your stomach and brain to make the connection that you’ve eaten enough.
  • Stop when you feel satisfied — don’t wait until you feel full. Try to gauge that internally, not by whether anything is left on your plate. If you can’t help but join the “clean-plate club” at most meals, serve yourself smaller portions. Pause before you serve yourself another helping, and do an internal check before making the decision.
  • Eat breakfast. People who eat breakfast tend to be less likely to be overweight, although it’s not clear why. It could help you feel satisfied as you start the day, making impulse eating less likely. Good choices include high-fiber cereals or an egg — both will help you feel satisfied and start your day off right.

Tips can help senior who loses appetite

My mother is in her 80s and seems to have lost her appetite. She is losing quite a bit of weight, and her doctor is concerned. How can we encourage her to eat more?

First, it’s good that your mother’s doctor is involved. Malnutrition caused by a poor diet can lead to other health problems, including a weakened immune system, problems with wound healing and muscle weakness (which can lead to falls and fractures). In addition, unexplained weight loss often is due to underlying health issues or the use of certain medications. So, keeping health professionals in the loop is essential.

Loss of appetite in seniors could have other causes, too. Your mother might be lonely or depressed. She might be experiencing a reduced sense of taste or smell, which can affect appetite, or of sight, which could make it more difficult to prepare food. She might have dental problems that cause discomfort when she eats. If you can identify an underlying problem, try to address it and you might find your mother’s appetite returns.

In the meantime, there are other things that can help. First, focus on protein, which is especially important to prevent malnutrition in the elderly. Canned salmon and tuna are versatile sources of protein that can be used in or added to a number of dishes. Add extra milk to mashed potatoes to increase protein. Or, ask your mother’s doctor if adding a high-protein supplement to soups, stews or other foods might be worthwhile.

You also could make your mother single-serving homemade frozen dinners that she can easily pull out of the freezer and microwave.

Both the Academy of Nutrition and Dietetics and the Mayo Clinic offer other ideas, including:

  • Encourage your mom to eat five or six small meals a day. This is especially helpful if your mother fills up quickly during a meal.
  • Keep nutritious, easy snack foods readily available, including nuts, peanut butter, cheese, crackers, milk, yogurt, fruit, raw vegetables and ice cream. Keep nonperishable items on the counter or otherwise out in the open as a visual reminder for your mother to have a snack.
  • Add cheese, 2 percent milk, beans, vegetables, rice and pasta to stews, soups and other dishes.
  • Try using new herbs and spices, especially if your mom is on a low-salt diet.
  • Drink milk, juice or even hot chocolate more often than coffee and tea, which provide few calories.
  • When possible, make mealtime a social event. Eating with others often sparks the appetite.

For more ideas, see “Senior health: How to prevent and detect malnutrition” from the Mayo Clinic at http://tinyurl.com/Mayo-senior/.