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Written by Alexandra Sifferlin and posted on healthandtime.com on April 22, 2013
When it comes to making healthy lifestyle changes, which should come first — changing your diet or becoming more physically active?
Researchers from Stanford University School of Medicine report in the Annals of Behavioral Medicine that neither strategy was likely to help individuals meet healthy eating and fitness recommendations and stick with them for a year. For the best results, the scientists found that changing diet and fitness habits simultaneously made the most sense.
Previous studies suggested that providing people with too much information about nutrition and physical activity at once can be overwhelming, and tends to discourage, rather than motivate them to improve their habits. That, say the researchers, has led to the popularity of advising people to make incremental changes, and set smaller, more achievable goals to eat healthier meals and to become less sedentary. But, say some experts, continually making new changes can also drain energy and motivation, and lead to a drop in compliance over time.
So to assess how the two strategies fared in a head-to-head comparison, the scientists recruited 200 inactive participants who were age 45 or older and randomly assigned them to one of four groups that provided nutrition and exercise coaching over the phone. One group was instructed about making diet and fitness changes at the same time, the second group were taught about diet changes first, then fitness changes four months later, the third group changed their exercise habits first and made changes in their eating habits four months later, and the final, control group were not instructed about either diet or fitness changes but about how to manage their stress.
The researchers tracked the groups for a full year to determine which strategy was more successful in helping participants achieve the nationally recommended goals of 150 minutes of exercise per week, eating five to nine servings of fruits and vegetables daily and keeping saturated fat intake at less than 10%.
Compared to the group that did not receive any dietary or exercise advice, the three intervention groups made healthy changes in their diet. Those that changed their fitness regimen first also significantly increased the amount of exercise they received daily compared to the other groups after four months. However, at the end of the year, the group that changed both diet and exercise at the same time was the only one that met the nationally recommended targets for both exercise and nutrition levels, while those who worked on improving their nutrition first were unable to meet the recommended levels of fitness after a year.
The results raise interesting questions about behavior changes and compliance. The researches suspect that modifications to diet are easier to make than changes to physical activity, since meals are already part of a daily schedule, and exercise requires more effort to incorporate into an already busy day.
The findings show, however, that pairing dietary and exercise changes may help to overcome some of the barriers people face in adding more physical activity into their lives. If folks change diet and exercise sequentially, the scientists say, they may end up placing more importance on the first set of behavior changes and feel less pressured to address the second set. Paying attention to both healthy behaviors at the beginning of a program, on the other hand, could help to give them equal priority, and therefore make it more likely that people will be able to maintain the habits over a longer period of time.
Posted by Jacque Wilson on CNN.com/health on April 23rd, 2013
You walk into a fast food restaurant and examine the menu. You could get a salad with grilled chicken and dressing on the side. Or you could get a double cheeseburger.
Seeing the calories listed next to each item isn't likely to affect your decision, according to a new study being presented at the Experimental Biology 2013 meeting this week. But seeing the amount of time it would take you to work those calories off at the gym just might.
Researchers at Texas Christian University asked 300 men and women aged 18 to 30 years to purchase food from one of three fast food menus. All of the menus contained the same options, including burgers, chicken tenders, salad, French fries and desserts.
One group's menu had no labels of any kind. The second group's menu was labeled with the total calories in each item. The third group's menu was labeled with the number of minutes of brisk walking it would take someone to burn off the calories in the meal.
People who ordered off the activity-labeled menu ordered 139 fewer calories and consumed 97 fewer calories on average than those who ordered off the menu without labels.
There was no significant difference in the number of calories ordered or consumed between the group that ordered off the calorie-labeled menu and the group that saw no labels. There was also no significant difference between the group that ordered off the activity-labeled menu and the group that ordered off the calorie-labeled menu.
If consumers are aware of the number of minutes they'd have to exercise to work off the calories they are eating, they are more likely to order lower-calorie options. Although the difference in the study results was small, "a 100-calorie reduction on a daily basis could lead to some weight loss over the long term," senior researcher Meena Shah said in an e-mail. Shah mentored the study, conducted by graduate student Ashlei James.
Shah stresses that the results of this study need to be verified by other studies with a more diverse group of participants before policy recommendations can be made about restaurant menu labeling.
Do your research before ordering. "Readers should become aware of the amount of exercise it would take to burn the food calories consumed and make appropriate food choices," Shah said. "It would not be feasible for most people to exercise for one to two hours a day in order to burn the calories from a very high-calorie food item."
Denying certain foods to children or pressuring them to eat every bit of a meal are common practices among many parents. But researchers at the University of Minnesota found parents who restricted foods were more likely to have overweight or obese children. And while those who pressured children to eat all of their meals mostly had children of normal weight, it adversely affected the way those children ate as they grew older, according to the study published Monday in the journal Pediatrics.
Investigators combined data from two separate research studies. The first, EAT 2010 (Eating and Activity in Teens), studied around 2,800 middle and high school students from public schools in Minneapolis and St. Paul, Minnesota. Participants in the project responded to survey questionnaires designed to examine dietary intake and weight status.
Researchers combined that data with information from the Project F-EAT (Families and Eating and Activity Among Teens), a study designed to examine factors within the family environment on weight in adolescents.
From the combined information, researchers were able to gain a better understanding of how parents' approach to food and feeding is related to adolescents' weight. According to the Centers for Disease Control and Prevention, obesity now affects 17% of all children and adolescents in the United States - triple the rate from just a generation ago.
“We found that between 50 and 60% of parents from our sample reported requiring that their child eat all of the food on their plate at a meal," said researcher Katie Loth, the study's lead author. "Further, we found that between 30-40% of parents from within our sample reported encouraging their child to continue eating even after their child stated that they were full.
"While these pressure-to-eat behaviors were more frequent among parents of non-overweight adolescents, they were still endorsed quite frequently by parents of overweight and obese adolescents, indicating that many parents endorse these behaviors regardless of their child's current weight status," she said.
Researchers also found dads were more likely than moms to pressure their sons and daughters to eat, and adolescent boys were pressured more than adolescent girls.
“Parental pressure to eat can be detrimental to children because it takes away from a child's ability to respond naturally to their own hunger," said Loth. “Instead, (it) encourages them to respond to cues in their environment which can lead to unhealthy weight gain over time.”
The data also showed that restricting food from kids was a common practice of either parent, in both boys and girls.
“Research has shown that when a parent places a restriction on a particular food item (i.e. no treats) that a child becomes more interested in consuming that food item and will often overeat that food when given the opportunity,” Loth continued. “Instead, parents should be encouraged to allow their children to eat all foods in moderation.”
Investigators believe that parents should keep an eye on their child's weight and make an effort to better understand good eating practices, instead of worrying about whether their kids clean their plates or have a cookie now and then.
Study authors recommended such practices as eating regular family meals, having nutritious snacks at home, choosing healthy foods and encouraging young people to make better food choices as a way to fight weight problems, Loth said.
And most importantly, “parents should also work hard to model healthy eating and a healthy relationship with food to their child" by eating a well-balanced diet, Loth said
How Exercise And Other Activities Beat Back Dementia
Posted by Patti Neighmond on npr.org on April 15th
The numbers are pretty grim: More than half of all 85-year-olds suffer some form of dementia.
But here's the good news: Brain researchers say there are ways to boost brain power and stave off problems in memory and thinking.
In other words, brain decline is not necessarily an inevitable part of aging. "It's simply not pre-destined for all human beings," Bryan James tells Shots. He's an epidemiologist at the Rush Alzheimer's Disease Center in Chicago. "Lots of people live into their 90s and even 100s with no symptoms of dementia."
So what can you do to increase the odds? Neuroscientist Art Kramer, who directs the Beckman Institute for Advanced Science and Technology at the University of Illinois, has a number of suggestions. First and foremost, Kramer says, is to exercise. Research shows it's the best thing you can do for your brain.
Kramer did a study in which he scanned the brains of 120 older adults, half of whom started a program of moderate aerobic exercise — just 45 minutes, three days a week, mostly walking. After a year, the MRI scans showed that for the aerobic group, the volume of their brains actually increased
What's more, individuals in the control group lost about 1.5 percent of their brain volume, adding up to a 3.5 percent difference between individuals who took part in aerobic exercise and those who did not. Further tests showed that increased brain volume translated into better memory.
The findings support earlier animal research in which rodents that were exercised had a number of favorable physiological changes, Kramer says. They had more new neurons, stronger connections between neurons, and increased blood supply to a number of regions in the brain.
Rachel Whitmer, a researcher at Kaiser Permanente in Northern California, agrees that it's important to exercise your body to ensure the health of your brain. It's not just getting adequate exercise, Whitmer says, it's also "maintaining good blood pressure, levels of cholesterol and a healthy weight," and remembering that "what's good for the heart is good for the brain."
What about mental exercises? Kramer says the evidence isn't nearly as conclusive, but keeping your brain active can't hurt.
The brain loves novelty, so if you do crossword puzzles, try shifting to a different type of puzzle — Sudoku, for example, he says. Or learn a new language. Play a new instrument.
And go out with friends. James recently published a study looking at the social lives of about 1,100 adults over 80. He asked them about going to restaurants and sporting events, playing bingo, doing volunteer work and other activities.
Individuals were followed for up to 12 years. Those with busy social lives were half as likely to develop dementia, compared with those with minimal social activities.
In another study, James looked at a different measure of activity — something he calls "life space." He added up how often people got out of their bedroom, went out of their house, traveled out of their neighborhood or out of town. "The people who never left their home — even though they didn't seem to have any cognitive problems when we started following them — were twice as likely to develop Alzheimer's disease" over five years, James says.
And finally, there's the popular notion of brain food. There's some evidence suggesting that omega-3 fatty acids, found in fish, and antioxidants, like vitamins C and E, found in vegetables, may help nourish the brain.
Putting it all together, Kramer jokingly suggests that the best advice might be to join a book group that walks and drinks red wine while talking about the book. Red wine contains antioxidants, Kramer notes. You'd be discussing a stimulating topic with good friends while exercising your body. "How can you beat it?" he says. "It's got all four!"
Eat Fish And Prosper?
Written by Audrey Carlsen and posted on npr.org/blogs/thesalt on April 1st, 2013
Now here's some more good news: A study published Monday in the Annals of Internal Medicine suggests that eating oily fish once or twice a week could maybe – just maybe — add a few years to your life.
Oily fish like salmon, trout and herring are, of course, a good source of omega-3 fatty acids, which are essential to numerous bodily functions. Researchers at Harvard School of Public Health and the University of Washington wanted to know how eating fish high in omega-3s affected health. So over the course of 16 years, they monitored a group of almost 2,700 healthy adults aged 65 years or older.
But unlike most studies that have looked at the question, the researchers didn't want to rely on study subjects to accurately recall what they ate, so they measured blood levels of omega-3s instead. And since they were interested in dietary intake only, they excluded participants who took fish oil supplements.
After controlling for factors like age, sex and lifestyle, the researchers found that, on average, adults with the highest blood levels of omega-3 fatty acids lived 2.2 years longer. In particular, these adults had a 35 percent lower risk of dying from cardiovascular disease – which is in line with other studies that have tied omega-3s to cardiovascular benefits.
Higher levels of fatty acids were most strongly associated with decreased risk of coronary heart disease and stroke.
"Omega-3 fatty acids are very unique in that, at very small levels in the diet, they have pretty powerful effects on a range of body functions," says Dr. Dariush Mozaffarian, lead author of the study.
According to Mozaffarian, the main reason why omega-3s are important is because of their role in building cell membranes. "Our cell membranes are 95 percent fat," he explains. "If we didn't have fatty acids, we wouldn't have cells."
How'd you like to get paid to lose weight? Financial incentives can help improve your odds of dropping pounds, according to a new study.
Researchers at the Mayo Clinic followed 100 Mayo employees over the course of a year as they took educational classes on how to eat healthy and lose weight.
The employees were broken up into several groups - some of which got financial incentives to shed the pounds and others that just got the classes.
"We found that people who receive financial incentives tended to stick with the healthy behaviors we all wish we would do more often," said lead study author Dr. Stephen Driver, an internal medicine resident at Mayo Clinic.
"At 52 weeks, those in the financial arm of the study had lost an average of about 9 pounds," he said, "as compared to those who didn't receive financial incentives, who lost about 2 pounds."
Each participant received $20 for every pound they lost, but they also had to pay $20 for every pound they gained. Driver says the move wasn't just punitive; it was both an added incentive to lose weight and a way to fund the program.
"About 86% of large employers are already offering some kind of financial incentives to help employees reach their health goals," Driver said. "But one problem employers run into with financial incentives is that they can be expensive. Part of our model was to allow the so-called 'losers' to fund the 'winners,' and I think that can help things to be more sustainable."
This study is not the first to show the link between financial incentives and improved weight loss, but with one year of follow up, it is the longest.
Driver did point out one limitation of this particularly study design:
"Because it was research, everybody knew which group they were in," he said. "There may have been a higher proportion of dropouts in the non-incentive group."
Why? Because they knew there was no pot of gold at the end of the rainbow, which may prove the point of the study even more.
"I think the message is financial incentives can be an important part of the puzzle, and an important tool to help keep you motivated.
Healthy Eating: Tips and Tricks for a Nutrition Transition Spring is in the air bringing changes to weather, wardrobes and waistlines. With the holidays and cold weather months behind you and plans for spring break trips, pool time lounging and outdoor activities in the near future, this is the perfect time to focus on healthy eating. In light of National Nutrition...
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Reducing salt consumption below the currently recommended 2,300 milligrams – about 1 1/2 teaspoons– per day maybe unnecessary, according to a new report released Tuesday by the Institute of Medicine (IOM).
The news follows a decades-long push to get Americans to reduce the amount of salt in their diet because of strong links between high sodium consumption and hypertension, a known risk factor for heart disease.
The IOM, at the request of the Centers for Disease Control and Prevention, reviewed recent studies published through 2012 that explored ties between salt consumption and direct health outcomes like cardiovascular disease and death. The organization describes itself as "an independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice to decision makers and the public."
Researchers determined there wasn't enough evidence to say whether lowering salt consumption to levels between 1,500 and 2,300 mg per day could increase or decrease your risk of heart disease and mortality. But lowering sodium intake might adversely affect your health, the panel found.
"These new studies support previous findings that reducing sodium from very high intake levels to moderate levels improves health," said committee chair Brian Strom, the George S. Pepper professor of public health and preventive medicine at the University of Pennsylvania's Perelman School of Medicine. "But they also suggest that lowering sodium intake too much may actually increase a person's risk of some health problems."
Those problems, he said, could include heart attack or death.
The current Dietary Guidelines for Americans recommend that a sub-group of people - anyone older than 51, African Americans, and people with high blood pressure, diabetes or chronic kidney disease - limit their salt intake to 1,500 mg a day.
The IOM committee found no benefit, but possibly a risk of poor health outcomes with lower salt intake in people with these pre-existing conditions, but said that evidence is inconsistent and limited.
"While the current literature provides some evidence for adverse health effects of low sodium intake among individuals with diabetes, CKD (kidney disease), or pre-existing CVD (cardiovascular disease), the evidence on both the benefit and harm is not strong enough to indicate that these subgroups should be treated differently from the general U.S. population," the report said.
"Thus, the committee concluded that the evidence on direct health outcomes does not support recommendations to lower sodium intake within these subgroups to, or even below, 1,500 mg per day."
American adults eat on average 3,400 mg of salt a day, according to the IOM. Groups like the American Heart Association (AHA) support reducing that number. In 2011, the AHA called for a reduction in daily consumption, recommending all Americans eat no more than 1,500 mg a day.
The IOM report, the AHA said Tuesday, does not accurately assess salt impact on health. "While the American Heart Association commends the IOM for taking on the challenging topic of sodium consumption, we disagree with key conclusions," said the association's CEO, Nancy Brown. "The report is missing a critical component – a comprehensive review of well-established evidence which links too much sodium to high blood pressure and heart disease."
The Salt Institute says it welcomes the IOM study, calling it a major breakthrough in the salt debate.
"This whole thing has been blood pressure-driven and this study finally looks at overall health outcomes," said Morton Satin, vice president of science and research for the institute.
"The study makes it very, very clear that the level of 1,500 mg that has been recommended in the dietary guidelines is not warranted, despite this full-throated cry for these levels by some organizations ... We hope this is the opening of the much broader review of the available evidence and a devotion to ensuring that our guidelines reflect the science."
The IOM panel was not asked to make recommendations on what a healthy range should be. It says more research is needed to help shed light on how lower sodium levels affect health in all Americans.
On Monday, the Center For Science In The Public Interest published results of a new investigation on what they call the food industry's failed efforts to reduce sodium levels in pre-packaged and restaurant foods. It called for phased-in limits in an effort to prevent heart disease. The group tracked nearly 500 food products between 2005 and 2011.
"The strategy of relying on the food industry to voluntarily reduce sodium has proven to be a public health disaster," said CSPI executive director Michael F. Jacobson. "Inaction on the part of industry and the federal government is condemning too many Americans to entirely preventable heart attacks, strokes, and deaths each year."