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Archive for the ‘Weight Loss’ Category

 

The Not –So- Sweet Truth about What You’re Drinking

Friday, December 4th, 2015
soda

fig 1

By Liz Aziz, PharmD Student Cedarville University School of Pharmacy

Many Americans have grasped the warning on excessive sugar intake. The problem is, these sugary calories often creep into the average American’s diet through drink, not food. Sugary drinks have already been tied to an increased risk of Type 2 diabetes as well as weight gain.­1 But just this month, a study published by the British Medical Journal has now found that sweetened beverages can also be associated with increase heart failure.2  Life with heart failure is nothing to take lightly, that’s why this gives the nation all the more reason to twist the cap shut on sweetened beverages and to choose healthier habits.

Increased prevalence of heart failure and other heart complications.chf As mentioned above, the recent study found a correlation between frequent consumption of sugary drinks and heart failure.2 These drinks include any beverage sweetened by sugar including soda, fruit juice/punch, lemonade, powdered drinks, or energy drinks.2 The study was a 12-year long population based study on 42,000 men ages 45-79. Researchers tracked incidents of heart failure between 1998 through 2010. Using food-frequency questionnaires, they found that men who drink two or more drinks a day were 23% more likely to develop heart failure. 2 Men who did not consume such beverages did not experience as many incidents of heart failure.2 Though the study has its limitations, such as survey bias and outside variables affecting study subjects, there are other literature that support the declining heart health of sugary-drink consumers.

In a similar study published by Circulation, researchers discovered a 20% increase in coronary heart disease in those who drink sweetened beverages.3  This study took into account age and family history when considering the correlation.3 They also concluded that the association had to do with sugar-sweetened drinks, not artificially-sweetened drinks (no-calorie sugary drinks).3  The study found sugar to be the underlying problem. Women are not excluded from this risk. The Nurses’ Health Study tracked the health of over 90,000 women during a time period of twenty years.4 They found similar results as the studies done on men, however the results were even more severe. Women who drank more than two servings of sugary drinks each day had a 40 % higher risk of heart attacks or death from heart disease in comparison to women who were rare consumers.4

So what is heart failure and heart disease? Heart failure is essentially when the heart is too exhausted or damaged to pump blood and oxygen to the rest of the body.5 Those that suffer from heart failure live a very difficult and limited life.5 Daily tasks become a struggle due to shortness of breath.5 This can further result in a sedentary lifestyle which is associated with its own health problems.5 Illnesses that can lead to heart failure are coronary heart disease as well as diabetes.5 The issue with excess sugar is that the build-up of the glucose metabolite in the body and frequent insulin spikes can cause significant damage and stress to the heart, leading to heart failure and heart disease.5 According to the Center of Disease Control, there are already 5 million Americans suffering from heart failure and more and more each year are adopting habits that put them at risk. soda

Sugary drinks overload your diet with sugar. A statement made by the American Heart Association recommended that the average adult should not consume more than 5 to 9 teaspoons of sugar. 7 However, the average 20-ounce bottle of a sugary drink contains 16 teaspoons of sugar.8 That almost TRIPLES the amount of sugar a person should consume in one day. With individuals having two or more of these drinks a day, it’s no wonder it is having a detrimental impact on Americans’ health.

What is the take home message? Those that regularly consume sugary drinks should set goals and limit their consumption.9 Though this is not the answer to all heart-related problems; it is definitely a start. There is plenty of research that supports this recommendation not only when it comes to heart failure but also diabetes and obesity. However, the question remains: Is this enough to get Americans to put down that can?

 

References

  1. Malik VS, Schulze MB, Hu FB. Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr. 2006;84:274–288.
  2. Rahman I, Wolk A, Larsson SC. The relationship between sweetened beverage consumption and risk of heart failure in men. Heart. 2015;
  3. De koning L, Malik VS, Kellogg MD, Rimm EB, Willett WC, Hu FB. Sweetened beverage consumption, incident coronary heart disease, and biomarkers of risk in men. Circulation. 2012;125(14):1735-41, S1.
  4. Fung TT, Malik V, Rexrode KM, Manson JE, Willett WC, Hu FB. Sweetened beverage consumption and risk of coronary heart disease in women. Am J Clin Nutr. 2009;89:1037-42.
  5. nih.gov. What Is Heart Failure? – NHLBI, NIH. 2015. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/hf. Accessed November 11, 2015.
  6. en S, Kundu B, Wu H et al. Glucose Regulation of Load-Induced mTOR Signaling and ER Stress in Mammalian Heart. Journal of the American Heart Association. 2013;2(3):e004796-e004796. doi:10.1161/jaha.113.004796.
  7. Johnson RK, Appel LJ, Brands M, et al. Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association.Circulation. 2009;120(11):1011-1020.
  8. Wang YC, Coxson P, Shen YM, Goldman L, Bibbins-Domingo K. A penny-per-ounce tax on sugar-sweetened beverages would cut health and cost burdens of diabetes.Health Aff (Millwood). 2012;31(1):199-207.
  9. Sandee LaMotte C. Study links sweetened soda and heart failure – CNN.com. CNN. 2015. Available at: http://www.cnn.com/2015/11/03/health/soda-heart-failure-study/. Accessed November 11, 2015.
  10. Sugary Drinks.; 2014. Available at: http://www.rethinksugarydrink.org.au/go-free. Accessed November 11, 2015.
  11. CHF.; 2015. Available at: http://pharmacologycorner.com/drug-therapy-heart-failure-ppt/. Accessed November 11, 2015.
  12. Creative Commons. Vending Machine.; 2015. Available at: http://www.wikihow.com/Buy-Something-from-a-Vending-Machine-That-Demands-Exact-Change-when-All-You-Have-Is-Bills#/Image:Vending-Step-2.jpg. Accessed November 11, 2015.

 

Skipping Breakfast: Do the Benefits “Outweigh” the Risks?

Friday, October 16th, 2015

By Vineeta Rao, PharmD Student Cedarville University

You have heard the concept all over the news and social media: Skipping breakfast leads to weight gain. Nutritionists and researchers have long speculated that when one skips breakfast, his hunger and lack of energy will cause a rebound-effect in which he will consume more calories by snacking than he would have if he had eaten breakfast.2 But a recent study published by the American Journal of Clinical Nutrition has found that when men and women skip breakfast, they actually consume far fewer calories compared to the days when they do eat breakfast.1

Breakfastpic

In this traditional crossover study, participants were allowed to eat as they pleased and report their own eating habits to the study investigators. Investigators consulted the same patients on various occasions to obtain a report of how many meals they had eaten, what they had eaten for each meal, and what time of day they had eaten. Then, investigators examined each person’s data individually; they compared the participant’s calorie intake on the days when he or she ate breakfast to a day when he or she did not eat breakfast. Researchers also included any snacking between meals in the total calorie count. On average, men in the study consumed 247 kcal more on a breakfast day than a non-breakfast day, and women consumed 187 kcal more on a breakfast day than on a non-breakfast day.1 Apparently, snacking was not enough to make up the calories lost from skipping breakfast! If participants regularly ate a few hundred fewer calories a day, then over time, breakfast skipping actually led to weight loss rather than weight gain.

Overall, the participant’s choices in food were similar between breakfast days and non-breakfast days, with breakfast days containing more whole grains, fruits, and dairy.1 One limitation of this study is that participants reported their own diet choices.1 Thus, if a patient forgot to report a snack item, the calorie deficit calculated above would not be correct. Additionally, participants tend to change their food choices when they know that they are being monitored.

Researchers all over the world cannot seem to agree on this matter. Skipping breakfast goes against the current standard of care, but it shows compelling evidence that it may actually assist in weight loss. Although many researchers have suspected that skipping breakfast will cause people to snack more frequently and to choose unhealthy snacks that lead to weight gain, very few research studies have shown this to be true. For example, one study that expected this to be true examined the effects of skipping breakfast in children in Taiwan and did not find any connections between skipping breakfast and obesity.2

So, does this mean that we should encourage breakfast skipping as a weight-loss strategy? An editorial response to this research study says yes! Because obesity and weight gain is associated with risks for chronic diseases such as heart disease, high blood pressure, diabetes, and stroke, getting rid of this small but significant calorie intake could help to prevent such diseases.3

However, other researchers are not convinced. The study in Taiwanese children found that breakfast-skipping may not be suitable for all people. For example, this study found that children who ate breakfast regularly had better cognitive ability and academic performance than children who did not eat breakfast regularly.2

Additionally, some research studies have shown that skipping breakfast can actually increase the risk of developing Type II diabetes by decreasing insulin tolerance and raising blood sugar. When three universities in China examined the risk factors that lead to Type II diabetic patients’ condition, they found skipping breakfast was associated with an increased risk for the disease.4

So what can we learn from all these findings? In short, skipping breakfast does not appear to lead to weight gain, but the current research on other health risks and benefits of skipping breakfast is controversial. You most likely won’t have to worry about gaining weight from missing breakfast now and then due to a busy schedule, but the research is too gray to conclude that skipping breakfast is safe and healthy for everyone. One fact that remains true across all these studies is that the quality of the food you eat matters. Whether you eat breakfast or not, it is important to eat a balanced diet with whole foods, good sources of protein, and a focus on non-starchy vegetables. Nutrient-rich diets are important in healthy weight management and prevention of disease states.5

What do you think? Does the benefit of weight loss “outweigh” the possibility of potentially contributing to the development of chronic diseases?

References:

  1. Kant AK, Graubard BI. Within-person comparison of eating behaviors, time of eating, and dietary intake on days with and without breakfast: NHANES 2005-2010. Am J Clin Nutr. 2015;102(3):661-70.
  2. Ho C, Huang Y, Lo YC, Wahlqvist ML, Lee M. Breakfast is associated with the metabolic syndrome and school performance among taiwanese children. Res Dev Disabil. 2015;43–44:179-188.
  3. Levitsky DA. Breaking the feast. Am J Clin Nutr. 2015;102(3):531-2.
  4. Bi H, Gan Y, Yang C, Chen Y, Tong X, Lu Z. Breakfast skipping and the risk of type 2 diabetes: a meta-analysis of observational studies. Public Health Nutr. 2015:1-7.
  5. United States Department of Agriculture. Scientific Report of Dietary Guidelines 2015 Advisory Committee. <http://health.gov/dietaryguidelines/2015-scientific-report/PDFs/Scientific-Report-of-the-2015-Dietary-Guidelines-Advisory-Committee.pdf>

Eat more, lose more?

Tuesday, November 18th, 2014

By Stephanie Cailor, PharmD Student

You have probably heard the common dietary recommendation that you should eat more fruits and vegetables as a part of a healthy diet. WebMD provides some simple diet tips including one that correlates specifically with this theme. They explain that by “eating more fruits and vegetables, you shouldn’t feel as hungry because these nutrient-rich foods are also high in fiber and water, which can give you a feeling of fullness,” a claim that is supported by much research.1, 2 So how exactly does fiber play a role? Fiber is a component of food that is difficult for the body to digest. Two types of fiber exist: soluble fiber, such as that found in citrus fruits, strawberries, celery, and green beans, and insoluble fiber, found in foods such as broccoli, cabbage, and grapes. Soluble fiber retains water and slows digestion in the stomach and intestines; whereas, insoluble fiber works by adding bulk to the stool in order to speed up the passage of food through the stomach and intestines.3 For this reason,  among others, the World Health Organization recommends that adults eat a minimum of 400 grams of fruit and vegetables per day to prevent health conditions such as obesity.4 To bring this number into perspective, roughly half of each plate should be filled with fruits and vegetables. Further examples and information regarding serving sizes can be viewed at www.choosemyplate.gov/food-groups/.5 While the task of eating more fruits and vegetables may seem simple, is this general recommendation to help lose weight failing to tell us the whole story?

The claim that adding fruits and vegetables to the diet can help with weight management may be correct, but only increasing fruit and vegetable consumption may not lead to weight loss. A recently published meta-analysis reviewed the results of 7 research studies on this subject.6 Each of these studies looked at the impact of increased dietary intake of fruits and vegetables on weight loss; however, none saw a significant effect. One study involving 90 adults utilized an 8 week intervention that added either 0 grams, 300 grams, or 600 grams of fruits and vegetables to daily diet. The study concluded that groups increasing their fruit and vegetable intake lost some additional weight, but the amount was not statistically significant.7 Another study looked at adult women who increased the intake of their fruits and vegetables to 9 servings a day. The body weight of these patients changed very little, with no statistically significant reduction in weight loss over the course of the study.8 There are a few reasons why the included research studies may show the shared conclusion of no significant weight loss due to eating more fruits and vegetables. Some of the studies may not have looked long enough to see the effects of eating more fruits and vegetables on body weight. Others may have not had a large enough increase in fruits and vegetables in the diet to show any weight loss effects. Accordingly, more research needs to be done on this topic before a definitive statement can be made.

Overall, this meta-analysis concludes by stating that while eating more fruits and vegetables does promote a healthy lifestyle, in order to lose weight, other efforts are necessary to achieve desired outcomes.6 For example, adding fruits and vegetables without cutting out other unhealthy foods, primarily those with high calorie counts, will not provide desired weight loss effects.9 Other supporting research emphasizes that significant weight loss results can be seen by reducing caloric intake and balancing the diet with fruits and vegetables.4, 10

As a future pharmacist, I believe that eating more fruits and vegetables as a part of a healthy diet is beneficial due to their overall low caloric content and the fiber they contain. To lose weight, though, it is important to reduce the amount of unhealthy foods in the diet. Being healthy is a lifelong pursuit that does not consist of simply changing one bad habit. Alongside a healthier diet, it is also important to be physically active. For physical activity to provide health benefits, adults should spend 150 minutes per week doing moderate intensity aerobic activity (such as walking) and at minimum 2 days per week completing muscle strengthening activities, which includes strength training or endurance exercises.11 Small steps towards a healthy lifestyle for some people could mean adding one new vegetable to their plate tomorrow or not buying chips at their next trip to the grocery store. Others may choose to take a walk around their neighborhood every day for the next week. What are some unhealthy lifestyle and diet habits that you could change today to help you get on track for weight loss?

References

  1. Smith, M. W. (2014). 15 Best diet tips ever. Available from: http://www.webmd.com/diet/ss/slideshow-best-diet-tips-ever. Accessed on October 17, 2014.
  2. Tohill, B. C. (2005). Dietary intake of fruits and vegetables and management of body weight. World Health Organization.
  3. Dugdale, D. (2012, September 2). Soluble and insoluble fiber: MedlinePlus Medical Encyclopedia Image. Retrieved November 1, 2014.
  4. Amine, E., Baba, N., Belhadj, M., Deurenbery-Yap, M., Djazayery, A., Forrester, T & Yoshiike, N. (2002). Diet, nutrition and the prevention of chronic diseases: report of a Joint WHO/FAO Expert Consultation. World Health Organization.
  5. Dietary guidelines for Americans, 2010. (2010). Washington, D.C.: U.S. Dept. of Health and Human Services, U.S. Dept. of Agriculture.
  6. Kaiser, K. A., Brown, A. W., Brown, M. M. B., Shikany, J. M., Mattes, R. D., & Allison, D. B. (2014). Increased fruit and vegetable intake has no discernible effect on weight loss: a systematic review and meta-analysis. The American journal of clinical nutrition, 100(2), 567-576.
  7. Whybrow S, Harrison CL, Mayer C, James SR. Effects of added fruits and vegetables on dietary intakes and body weight in Scottish adults. Br J Nutr 2006;95:496–
  8. Maskarinec G, Chan CL, Meng L, Franke AA, Cooney RV. Exploring the feasibility and effects of a high-fruit and -vegetable diet in healthy women. Cancer Epidemiol Biomarkers Prev 1999;8:919–
  9. Sacks, F. M., Bray, G. A., Carey, V. J., Smith, S. R., Ryan, D. H., Anton, S. D., … & Williamson, D. A. (2009). Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. New England Journal of Medicine, 360(9), 859-873.
  10. Wing, R. R., Hill, J. O. (2001). Successful weight loss maintenance. Annal Review of Nutrition, 21(1):323-341.
  11. Physical Activity Guidelines Advisory Committee. (2008). Physical activity guidelines advisory committee report, 2008. Washington, DC: US Department of Health and Human Services, 2008, A1-H14.

Melting Away the Pounds: The Cold Facts

Monday, November 17th, 2014

By: Sara Hill, PharmD Student

As the holidays rapidly approach, more and more people start to think about losing weight for their family functions or maintaining their current weight throughout a food-laden season. However, despite the urge to snap up the first weight loss supplement that we hear advertised, we have to remember the importance of evaluating each product to decide if it is our best option. One supplement that fits that description is Garcinia cambogia, a growingly popular herbal supplement that Dr. Oz and others believe to be a good choice to help us lose weight.

In June, a journal called Phytotherapy Research published a study that researched Garcinia cambogia to determine how effective it truly is. (In case you are wondering, phytotherapy is the use of plants and plant products for medicinal purposes.) The researchers wanted to see if Garcinia cambogia made a difference in several health values, including weight, body mass index (BMI), waist-hip ratio, and percentage of fat mass in the body. The study involved two groups of women whose BMI values were greater than 25 (BMI >25 is considered obese). The first group of women was given Garcinia cambogia for 60 days and put on a diet that reduced their calorie intake. The second group of women was given a placebo and put on a diet that reduced their calorie intake in the same way as the first group of women. After 60 days, the researchers compared the health values of the women who had taken the supplement and those who hadn’t. Although the study identified that G. cambogia helped to lower the women’s triglycerides (a cholesterol marker), the weight, BMI, waist-hip ratio, and percentage of fat mass was not significantly different between the two groups of women.1 Although the study provided useful information, it did not account for ways that different groups of people gain and lose weight. Men and women gain weight differently, as do young people and elderly people. Furthermore, the study only accounts for the lifestyle and diet of a particular geographic location. The diet the researchers chose may not be reasonable for women (or men) in other parts of the world.

This study only contributes to a growing collection of studies examining Garcinia cambogia. Several studies have been conducted on the benefits of taking G. cambogia, but they do not always come to the same conclusion. Studies published in the late 90’s found that G. cambogia did not cause significant weight loss.2 However, studies from 2000 and 2004 shows that G. cambogia actually does lead to weight loss.2

Our decision to take or not to take Garcinia cambogia involves several things. First, we have to know that G. camgobia has not been proven save, although no studies have seen any harmful effects­­3. However, G. cambogia has been on the market before as a part of other weight loss supplements that caused safety concerns. It was one of the key ingredients in several versions of Hydroxycut that were removed from the market because of safety concerns. Furthermore, multiple cases of liver damage have led to concerns that G. cambogia is poisonous to the liver. Yet another case reported that G. cambogia interacts with some prescription medications (like antidepressants) and causes harmful levels of certain compounds in the body. Finally, we must remember that no one has conducted an extensive safety study on G. cambogia to identify the risks that go along with taking it. Without being fully aware how likely we are to be harmed, we cannot compare the risks and benefits and therefore make a fully educated decision.

Second, we have to know if G. cambogia is effective. As we have already discussed, the studies that tested how effective the supplement is do not agree with each other. One possible explanation suggests that some forms of G. cambogia work better because your body can absorb it better than the other forms. When more of the supplement makes it into your body, it can actually have its full effect. The scientists who proposed this reasoning recommend looking for bottles that list G. cambogia in the potassium and calcium salt forms instead of simply one or the other, or a completely different salt altogether. (Please note that the term “salt” here does not refer to standard table salt but to the chemical structure that allows the compound to get into your body. You should look for a product like this one that lists calcium and potassium as the salt forms.) The scientists who evaluated the calcium/potassium form of G. cambogia found positive results, indicating that G. cambogia does lead to significant weight loss.

Finally, our decision to take G. cambogia should include a comparison to standard weight loss methods. Our primary study compared women taking G. cambogia to women not taking it, but both groups of women decreased the number of calories in their diet, and both groups of women lost weight. The standard weight loss methods of diet and exercise should always be our first approach (although they are certainly difficult to accomplish during the holidays). By focusing on eating healthier foods (fewer fatty and fried foods, fewer carbs, and less sugar) in appropriate quantities and spending more time being physically active, you may find that additional weight loss techniques are no longer needed. Supplements like G. cambogia should only become an option once you’ve tried these other weight loss techniques and should be used carefully to meet your specific physical needs.

Because weight loss is often such a pressing concern, we are usually tempted to choose what seems to be the easiest, fastest option. However, due to the concerns presented above, G. cambogia does not seem like the best option. Until further tests examine the safety of the supplement as well as the effectiveness of the particular salt forms, you are probably better off staying away from it.

But what do you think? Would you feel comfortable taking Garcinia cambogia to supplement your weight loss efforts? Would you expect it to be effective?

Works Cited:

  1. Vasques, C.A.R.; Schneider, R.; Klein-Junior, L.C.; Falavigna, A.; Piazza, I.; Rossetto, S. Hypolipemic Effect of Garcinia cambogia in Obese Women. Phytotherapy Research. 2014;28(6):887-891.
  1. Downs, B.W.; Bagchi, M.; Subbaraju, G.V.; Shara, M.A.; Preuss, H.G.; Bagchi, D. Bioefficacy of a novel calcium-potassium salt of (-)-hydroxycitric acid. Mutat Res 2005;579: 149-162.
  1. Chuah, L.O.; Yeap, S.K.; Ho, W.Y; Beh, B.K.; Alitheen, N.B. In Vitro and In Vivo Toxicity of Garcinia or Hydroxycitric Acid: A Review. Evidence-Based Complementary and Alternative Medicine. 2012;1155(10) 12 pages.