Myth of Fact? Weight Gain.

Posted by & filed under Aspartame, Health Professionals, Myths.

Myth: Low-calorie sweeteners, such as aspartame, cause weight gain.

FACT: Trial after trial consistently demonstrates that substituting aspartame and other low cal sweeteners for caloric sweeteners are associated with modest weight loss.

 

HUMAN CLINICAL TRIALS — Modest weight loss with substitution of diet products/beverages

Blackburn et al, AJCN, 1997 (http://ajcn.nutrition.org/content/65/2/409.long)
Overview
  • Landmark study (RCT), n=163 obese women (Harvard Med. School)
  • Randomly assigned to consume vs. abstain from aspartame
  • Research question:  Does the addition of aspartame to a multidisciplinary weight-control program improve weight loss and long-term control of body weight?
 Results Aspartame group lost significantly more weight overall and regained significantly less weight during maintenance [1-yr] and follow-up [2-yrs] than non-aspartame group.
Conclusion excerpt “These data suggest that participation in a multidisciplinary weight-control program that includes aspartame may facilitate the long-term maintenance of reduced body weight.”
Peters et al, Obesity, 2014 (http://onlinelibrary.wiley.com/doi/10.1002/oby.20737/epdf)
 Overview
  • 12-week Prospective Study, (RCT); two sites (N=303) (Univ. CO, Temple Univ.)
  • Comparison of water vs. NNS beverages (including aspartame) on weight loss
 Results
  • Diet Beverage group ↓ 13 lbs
  • Water group ↓ 9 lbs
Conclusion excerpt “These results strongly suggest that NNS beverages can be part of an effective weight loss strategy and individuals who desire to consume them should not be discouraged from doing so because of concerns that they will undermine short-term weight loss efforts.”
 Tate et al. AJCN, 2012 (“CHOICE” RCT) (http://ajcn.nutrition.org/content/95/3/555.full)
 Overview
  • 6 month, n= 318 (UNC/Chapel Hill)
  • Research question: Will substituting diet beverages or water for caloric beverages aid in weight loss comparable to a basic weight loss support program? (LCS not defined)
 Results Myth 1

  • Answer: “Yes”
  • Average weight losses:
    • Counseling (AC) group – lost ~1.75% bw
    • Water (WA) substitution group — lost ~2% bw
    • Diet beverage (DB) substitution – lost ~2.5% bw
  • Water or diet beverage group doubled their odds of achieving a 5% weight loss.
  • Preference for sweet foods/beverages did NOT increase.
Conclusion excerpt “This strategy could have public health significance and is a simple, straightforward message.”
 de Ruyter et al, NEJM, 2012 (http://www.nejm.org/doi/full/10.1056/NEJMoa1203034#t=article)
 Overview
  • 18-month Double-Blind, Placebo Control, (RCT) (Univ. Amsterdam)
  • (n=641, normal weight children, 4.8 years – 11.9 years of age)
  • Replaced sugar-containing beverages w/ LCS beverages (including sucralose + Ace K)
 Results BMI, body weight, skin-fold thickness, waist-to-hip ratio, and fat mass increased significantly less in the sugar-free group.
Conclusion excerpt “Masked replacement of sugar-containing beverages with non-caloric beverages reduced weight gain and fat accumulation in normal-weight children.”
 Ebbeling et al, NEJM, 2012  (http://www.nejm.org/doi/full/10.1056/NEJMoa1203388#t=article)
 Overview
  • One-year intervention (RCT) to assess the effect on weight gain by overweight and obese adolescents (Multi-center, Boston)
  • Substituted non-caloric beverages; reduce consumption of sugar-sw. beverages (LCS not specified).
Results
  • Smaller increase in BMI and greater decrease body weight at 1 year intervention with substitution of water or diet beverage.
  • Effect was neutral at year 2 (1 year post intervention)
Conclusion excerpt “Replacement of sugar-sweetened beverages with non-caloric beverages did not improve body weight over a 2-year period, but group differences in dietary quality and body weight were observed at the end of the 1-year intervention period.”

LITERATURE REVIEWS – Body of human trials confirm potential benefit

 Zheng et al, JAND 2015 (http://www.andjrnl.org/article/S2212-2672(15)00112-4/abstract)
 Overview Systematic review of prospective cohort and RCT’s examining effects of substituting beverage alternatives for SSBs on long-term health outcomes in children and adults.
 Conclusion excerpt “The overall consensus of our review was that SSB substitution with beverage alternatives such as water and low-calorie beverages may have beneficial effects on long-term body weight management.”
 Academy of Nutrition and Dietetics EAL 2009; Reiterated JAND Position Paper 2012 (http://bit.ly/1L6SRXx ) 
 Question In adults, does using foods or beverages with aspartame in an energy restricted or ad libitum diet affect energy balance (weight)?
Conclusion statement
(Grade 1)		 “Use of aspartame and aspartame-sweetened products as part of a comprehensive weight loss or maintenance program by individuals may be associated with greater weight loss and may assist individuals with weight maintenance over time.”
 Miller & Perez, AJCN, 2014  (http://ajcn.nutrition.org/content/early/2014/06/18/ajcn.113.082826.full.pdf+html)
 Overview Meta-analysis of 15 RCT and 9 prospective cohort studies examined the relation between low-calorie sweeteners (from foods, beverages, or table top sweeteners) and body weight and composition.
 Findings
  • In RCTs, LCS modestly, but significantly reduced all outcomes examined, including body weight, BMI, fat mass and waist circumference.
  • Observational studies showed no association between LCS intake and body weight or fat mass and a small positive association with BMI.
Conclusion excerpt “Data from RCT’s, which provide the highest quality of evidence for examining the potentially causal effects of LCS intake, indicate that substituting LCS options for their regular-calorie versions results in a modest weight loss, and may be a useful dietary tool to improve compliance with weight loss or weight maintenance plans.”
 Mattes and Popkin, AJCN, 2009  (http://ajcn.nutrition.org/content/89/1/1.full.pdf+html)
 Overview Comprehensive review on appetite, food intake and related mechanisms. (224 research studies referenced)
 Results
  • Nonnutritive sweeteners were not found to heighten appetite when ingested in conjunction with other energy sources.
  • Addition of NNS to diets poses no benefit for weight loss/ reduced weight gain w/out energy restriction.
  • Mechanisms by which NNS are purported to promote energy intake and contribute to obesity are not supported by the available evidence.
Conclusion excerpt “. . . if nonnutritive sweeteners are used as substitutes for higher-energy-yielding sweeteners, they have the potential to aid in weight management.”
 De la Hunty et al, Brit Nutr J, 2006 (http://bit.ly/1qDGepO)
Overview Meta-analysis (16 studies) on the effect of aspartame on weight loss, weight maintenance and energy intakes in adults; addresses the question of energy compensation and whether the use of aspartame-sweetened foods and drinks is an effective way to lose weight.
 Results The meta-analysis demonstrates that using foods and drinks sweetened with aspartame instead of sucrose results in a significant reduction in both energy intakes and bodyweight.
Conclusion excerpt “This review has shown that using foods and drinks sweetened with aspartame instead of those sweetened with sucrose is an effective way to maintain and lose weight without reducing the palatability of the diet.”

 OBSERVATIONAL

 Mozaffarian et al, NEJM, 2011 (http://bit.ly/1OjsXAH)
Overview
  • Prospective investigations, 3 separate cohorts (n=120,877 women and men free of chronic disease and not obese at baseline): Nurses’ Health Study (1986-2006) and NHS 11 (1991-2003), Health Professionals Follow-up Study (1986-2006)
  • The relationships between lifestyle factors and weight change were evaluated at 4-year intervals
 Results Large scale epidemiological studies that controlled for reverse causality; showed neutral to beneficial effect of diet soda on body weight.

Myth 1.2

Conclusion excerpt “Our findings suggest that both individual and population-based strategies to help people consume fewer calories may be most effective when particular foods and beverages are targeted for decreased (or increased) consumption.”

OTHER

National Weight Control Registry Catenacci et al, Obesity J, 2014 (http://onlinelibrary.wiley.com/doi/10.1002/oby.20834/abstract)
 Overview
  • Cross-sectional study to evaluate prevalence of and strategies behind low/no calorie sweetened beverage consumption in successful weight loss maintainers.
  • Online survey administered to 434 members of the National Weight Control Registry individuals who had  lost > 13.6 kg (6 lbs) and maintained weight loss for > 1 year
Results Regular consumption of low/no calorie sweetened beverages is common in successful weight loss maintainers for various reasons including helping individuals to limit total energy intake.
Conclusion excerpt ”Changing beverage consumption patterns was felt to be very important for weight loss and maintenance by a substantial percentage of successful weight loss maintainers in the National Weight Control Registry.”

 

Presented at: Academy of Nutrition and Dietetics FNCE 2015

TLC for Fruit: Take Care of Your Fruit and It Will Take Care of You!

Posted by & filed under Fructose, Lifestyle Articles.

By: Ellen Stokes, MS, RD, LD —

Fruit is such a happy part of life!  It adds color, fiber, and the sweet taste of fructose to meals and snacks. Fruit also has other goodies like antioxidants, vitamins, and minerals. But, like any perishable food, fresh fruit needs a helping of TLC (tender loving care) to preserve its nutrients.  So, here are some purchasing, handling, and storage tips to keep fruit wholesome and delicious.

Your friends can be old and wrinkly — your fruit shouldn’t be.

Buy fruit that is firm, plump, and, if possible, grown close to home because the nutrients in fruit decline over time. Heat is also destructive to nutrients, so fruit sold at open air markets during hot summer months may not be the best choice.

Always choose fruit that is blemish-free without any bruises or cuts that can let spoilage bacteria — or even pathogenic bacteria — into the flesh. Once pathogenic bacteria have invaded, cutting away the bad part on the fruit and eating the rest isn’t a food-safe option and the fruit should be discarded.

A bowl of fruit looks pretty sitting on your kitchen counter, but most fruits should be refrigerated.

Fruit, except avocados and underripe bananas, should be stored, covered, in a refrigerator set below 40 °F. Refrigeration slows down the action of the fruit’s natural enzymes that cause fruit to decay and lose nutrients.

Covering the fruit helps keep the moisture in, cuts down the fruit’s exposure to air, and also protects fruit from cross-contamination with other foods in the refrigerator. As an added precaution, store fruit on the upper shelves of the refrigerator, so that any refrigerator spills won’t rain down on the fruit.

Watch when — and how — you wash.

Fruit should be washed just before it’s eaten which means that when you store fruit in the refrigerator for later use, it should not be washed first.  That’s because any moisture left on the fruit after washing will encourage decay and the growth of mold.  Wash fruit by gently rubbing it with your fingers under cool, running water without using any detergent or bleach and dry thoroughly. Commercially available fruit and veggie washes are not recommended.

Fruit has more nutrients when it’s eaten raw and unpeeled, but, even if a fruit is going to be eaten without the peel, it still needs to be washed before peeling. Otherwise, when you’re cutting off the peel, the knife blade can carry any bacteria on the outside of the fruit to the inside.

 

 

Ellen Stokes, MS, RD, LD is an award-winning video producer, director, and writer in addition to being a registered dietitian. Ellen writes and creates videos about nutrition education, food safety, menu planning, grocery shopping, and healthful cooking on a budget. Ellen has worked with organizations and companies including WebMD, the Partnership for Food Safety Education, and the University of Georgia Food Science Department. Ellen formerly worked for CNN as a writer and producer and teaches food safety and nutrition for Georgia State University. Check her out on Twitter @EllenS_RD.

The post TLC for Fruit: Take Care of Your Fruit and It Will Take Care of You! appeared first on FructoseFacts.

Is “Skinny Fat” real?

Posted by & filed under Healthy Lifestyle, Weight Management.

What is “skinny fat”?

“Skinny Fat” is a term that seems to have been picking up in popularity in the last few years. So, what is it to be “skinny fat” anyway? It is when you are normal weight, or maybe even underweight, but lack muscle tone and are ultimately unfit. “Skinny fat” is metabolically obese normal weight, meaning that someone has a seemingly healthy look on the outside but they have risks for a number of health problems that are related to obesity. This is mainly due to a poor diet and lack of exercise. This body type can be seen in men and women.

Certified weight loss management professional, Lauren Klein, based out of New York City told Shape that “at first, (these patients) they look normal, sometimes even skinny, with a low or average body mass index. But upon further evaluation, they fall victim to the same diagnostic markers of diabetic patients: high blood sugar, low good cholesterol, high triglycerides, inflammation, and/or high blood pressure.” These “metabolically unhealthy” individuals that are not obese may have similar cardiovascular risk as obese individuals with abnormal metabolic profile.

That is a scary dose of reality for outwardly skinny people. Thin does not equal healthy even though that seems to be what the media teaches us. This is an important fact to understand.

 

Achieve a Healthy Weight with these Tips

HEALTHY WEIGHT TIPS

 

So how do we combat that “skinny fat”?

Ultimately, diet and physical activity are two factors we can control that can impact our health.

The saying “you are what you eat” has some validity it turns out! Regardless of body size, it is important to consume the appropriate amount of food and ensure you are eating all of the important nutrients. The updated  Dietary Guidelines for Americans focus on reducing our added sugar intake and increasing intake of calcium, potassium, dietary fiber, and vitamin D because low intakes are associated with health concerns. Another topic that experts talk about is that portion control is something that Americans need to get in check as well. Size does matter! Choose My Plate is a great source for the recommended portion sizes for different food groups.

Don’t ignore the importance of physical activity! Both men and women – of any age – should be lifting weights at least two times per week to gain muscle mass as well as doing cardio three to four times a week at the least for heart health. You can learn more about these recommendations on the Physical Activity Guidelines for Americans. Now men and women will lift different amounts of weight and have different reps.  And someone 18 years old will not lift the same as someone in their 60s. Keep in mind any health issues you may have and make sure to speak to your trusted health professional before starting any sort of new exercise or eating program. Know your body and listen to your body but if you need help getting started, this article provides useful information if you are new to weight training. Someone who is skinny fat and has less muscle mass and tone should expect to start out with lighter weights at the beginning but progress will help you get healthier by increasing muscle mass. Between your doctor and googling workouts and meal prep – you will have all the tools you need to get started on any new regiment to a healthier and fit you!

Hot Cross Buns

Posted by & filed under Bread, Recipes, Saccharin.

Makes 18 Servings

Ingredients

Hot Cross Buns

1/4 cup sugar
1 egg white
2 teaspoons grated orange peel
1/3 cup currants
1 egg
1 cup skim milk
1/2 cup margarine
4-5 cups all-purpose flour, divided
1 package active dry yeast
1/2 teaspoon ground cinnamon
1/2 teaspoon salt
1 teaspoon Sweet ‘N Low zero calorie sweetener

Icing

1/4 teaspoon vanilla extract
1/4 cup confectioners’ sugar
3/4 teaspoon skim milk

Directions

In large bowl, mix sugar, Sweet ‘N Low, salt, cinnamon, yeast and 1 cup flour. In

In small saucepan over low heat, heat margarine and 1 cup skim milk until warm (120-130F). With mixer at low speed, gradually beat milk mixture into yeast mixture. Increase speed to medium; beat 2 minutes. Beat in egg and 1 cup flour; continue beating 2 minutes. With wooden spoon, stir in enough additional flour to make soft dough (about 2 cups). Add currants and orange peel. Turn dough onto lightly floured surface. Knead until smooth and elastic, about 10 minutes, kneading in additional flour if necessary. Shape into ball. Spray large bowl with non-stick cooking spray. Place dough in bowl, turning to coat top. Cover and let rise in warm place until dough is doubled, about 1-1/2 hours.

Spray two 8- or 9-inch square baking pans with non-stick cooking spray. Punch down dough. Divide dough into 18 pieces. Shape each piece into a ball. Arrange balls in pans. Cover and let rise in warm place until doubled, about 1 hour. Preheat oven to 375F. Lightly beat egg white; use to brush buns. Bake 20 to 25 minutes or until golden. Remove buns from pan; cool on wire racks 15 minutes.

Meanwhile, prepare icing: In small bowl, stir confectioners’ sugar, vanilla and 3/4 teaspoon skim milk until smooth. Drizzle icing over buns, forming a cross.

Nutritional Information

Calories 190
Total Fat 6g
Cholesterol 12mg
Sodium 147mg
Carbohydrates 30g
Protein 4g

Recipe courtesy of SweetNLow.com.

Having Effective Conversations with Patients Regarding Weight

Posted by & filed under Health Professionals.

By: Dr. Keri Peterson, MD —

Health care providers are in an ideal position to talk to patients about the important topic of weight management because of the many health consequences associated with overweight and obesity.   Keri Peterson, MD and scientific advisor for the Calorie Control Council noted that “While physicians may feel time constraints during the visit, counseling a patient on their weight has been found to be a key factor in promoting behavioral changes.”  And while it’s sometimes easier to manage the health symptoms rather than addressing lifestyle changes, it is important to understand if your patient is ready to address their weight and what support they need.

Open the discussion in a caring and respectful way and assess whether the patient is comfortable discussing their weight.  After assessing your patient’s comfort, it may be helpful to understand your patient’s opinion of how excess weight has affected his or her life. Expressing your concerns about health risks and how this is affecting the patient can provide additional context to establish their level of interest in weight management.

Asking for a recall of food intake and physical activity can also help initiate dialogue on recommendations and setting goals.  Patients will need resources to discuss setbacks as well as to provide inspiration to maintain behaviors and continue establishment of new achievable goals.

If your patient is interested in modifying their weight, they may need help establishing a support system of appropriate healthcare professionals. Identifying other issues that may be affecting their physical or emotional health can help establish the right support network of healthcare professionals which might include dietitians, physical therapists or exercise trainers, psychologists, bariatric surgeons, and others.

Remember that effective weight management requires skillful and empathetic communication between practitioners and patients.  Even if a patient is not ready to lose weight, providing advice on healthy eating and regular physical activity may still be of benefit.

Additional References

Stop Obesity Alliance Discussion Tool for Healthcare Providers: A Guide to Discussing Obesity & Health With Your Patients

About Keri Peterson, MD

Dr. Keri Peterson, MD is a medical contributor and columnist for Women’s Health and a frequent guest on NBC’s Today, ABC’s Good Morning America, Fox News and CNN. Based in New York City, Dr. Peterson has been in private practice since 1999 and holds appointments at Lenox Hill Hospital and Mount Sinai Medical Center.   With a BA from Cornell University and a Medical Degree from Mount Sinai School of Medicine, she completed post-graduate training in Internal Medicine at New York’s Mount Sinai Medical Center and is board certified in Internal Medicine. Dr. Peterson is a member of the American College of Physicians and the American Medical Association, and serves as medical advisor for the Calorie Control Council.

The Spring Break Souvenir Nobody Wants

Posted by & filed under Healthy Diet, Healthy Lifestyle, Lifestyle Articles, Spring Break, Weight Management.

When college students return to campus after their winter break most of them can’t tell you exactly when they’ll be taking their final exams, but they all know the dates for spring break. Reservations are booked long before anyone cracks open a book at the start of the semester. Escaping to someplace tropical for fun in the sun is standard fare, but for many there is a souvenir that can linger long after the tan marks have faded. It’s called creeping obesity.

Just like holiday weight gain that isn’t lost from one year to the next, weight gained while on vacation can contribute to creeping obesity – or gradual weight gain over time – if those extra pounds aren’t lost when you get home.  A recent study found the average weight gain for vacations of one to three weeks was .7 pounds, with some subjects gaining as much as 7 pounds.

Another finding in that study was that weight was gained despite the slight increase in physical activity reported during vacations. Apparently snorkeling and beach volleyball aren’t enough to offset the increased caloric intake, especially from alcoholic drinks which tended to double while on vacation!

Gaining a small amount of weight may seem like no big deal, but as I said in my book Fighting the Freshman Fifteen, if you don’t deal with the ounces they’ll turn into pounds by the time you graduate.  And since it’s much easier to lose one or two pounds than five or ten, why not make it part of your vacation plans to drop those unwanted pounds as quickly as you gained them?   Here’s how to do it.

5 Ways to Spring Back From a Spring Break!

Know Your Number

Before you go on vacation use a customized program, like SuperTracker, to determine the number of calories you consume each day to maintain your present weight with your usual amount of physical activity. This is number your baseline calorie allowance.

Step on the Scale

Weigh yourself before you leave for vacation and again on the morning after you return to see if you’ve gained weight and how much you need to lose to get back to your pre-vacation weight. Weigh yourself daily while following the steps below until you reach your goal.

Keep a Record

Start recording everything you eat and drink, and the amounts, so you can tally your daily caloric intake. Keep it 200 calories below your maintenance number, calculated in #1. One way to drop 200 calories a day is to replace sugar-sweetened drinks with diet drinks and to use no- and low-calorie sweeteners in place of sugar.

Up Your Activity

Increase your usual time spent in physical activity by at least one hour per week by adding a single 60-minute workout or an additional 15 minutes to four regular workouts.

Monitor Your Maintenance

You can stop the calorie counting and extra hour of exercise once you return to your pre-vacation weight, but continue to weigh yourself weekly. Resume the food records and added exercise time if you see your weight going up before your next vacation.

References
Robyn Flipse. Fighting the Freshman Fifteen. Three Rivers Press, 2002.

 

Robyn FlipseRobyn Flipse, MS, MA, RDN is a registered dietitian, cultural anthropologist and scientific advisor to the Calorie Control Council, whose 30+ year career includes maintaining a busy nutrition counseling practice, teaching food and nutrition courses at the university level, and authoring 2 popular diet books and numerous articles and blogs on health and fitness. Her ability to make sense out of confusing and sometimes controversial nutrition news has made her a frequent guest on major media outlets, including CNBC, FOX News and USA Today. Her passion is communicating practical nutrition information that empowers people to make the best food decisions they can in their everyday diets. Reach her on Twitter @EverydayRD and check out her blog The Everyday RD.

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