Weight Loss Blog

Obesity and depression often go hand-in-hand in middle-aged women, a new U.S. study found.

The research collected information on the height, weight, dietary and exercise habits, and body image of 4,641 women, ages 40 to 65, enrolled in a health plan. The women also completed a questionnaire used to measure depression symptoms.

Women with clinical depression were more than twice as likely to be obese (a body mass index of 30 or more), and obese women were more than twice as likely to be depressed, the study found.

It also found that women with BMIs of 30 or higher exercised the least, had the poorest body image, and consumed 20 percent more calories than women with lower BMIs.

The link between obesity and depression remained intact even when the researchers factored in marital status, education, tobacco use and antidepressant use.

The study was published in the January/February issue of the journal General Hospital Psychiatry.

It’s likely that depression and obesity fuel one another, said lead author Dr. Gregory Simon, a psychiatrist and researcher at Group Health Cooperative in Seattle.

“When people gain weight, they’re more likely to become depressed, and when they get depressed, they have more trouble losing weight,” he said in a prepared statement.

The stigma of being overweight can damage self-esteem and efforts to lose weight.

“It’s not that these women are clueless. It’s that they’re hopeless,” said Simon, who suggested that if obese women focus on rebuilding their self esteem, it may help them lose weight.

According to the National Institute of Mental Health, more than 19 million people in the United States — 1 in 10 adults — experience depression each year. Women are twice as likely as men to experience depression. In fact, more than 6 million women experience depression each year.

Study finds a clear link between obesity and mood disorders

There is a clear link between obesity and depression, anxiety and other mood disorders, according to a new Group Health Center for Health Studies report.

“People who are overweight or obese are more likely to have anxiety or depression problems. They’re really stigmatized,” said Dr. Gregory Simon, a psychiatrist and researcher at Group Health.

“There had been previous research saying there appeared to be a link between obesity and depression — the results weren’t surprising — but this study made it clearer,” Simon said.

Kathleen Tate once embodied that. A year ago, her body mass index, or BMI, indicated she was on the verge of obesity. She also had a history of depression. But after participating in the Weight Management Program at Swedish Medical Center and making lifestyle changes, she’s now in the normal range. She also feels much better.

“There are so many factors that contribute to why someone might have depression. Weight loss might help, but it’s part of a process,” Tate said. “I think it’s possible to be thin and terribly depressed.”

The findings weren’t surprising to Carol Birch, a nurse practitioner in the Center for Medical Weight Management at Swedish Medical Center. Working with weight management patients for the past three years, she’s learned that obesity and mood disorders are “definitely linked.”

But it’s not always easy to see.

“Patients might not even recognize they’re depressed,” Birch said. “They may be in denial. They might do a lot of work, or mask it. But when tested on a depression scale, it becomes evident. A score of 10-15 (of a possible 63 points) raises a red flag. If the score is in the 30s, they’d better be in counseling.”

Simon was leader of the Group Health study, published in the July Archives of General Psychiatry. He said the team used data from a large national survey of mental disorders conducted by Harvard University between 2001 and 2003.

Simon, who specializes in research on depression and mood disorders, said the survey gave his team information on 9,125 participants to analyze. Average age was 44.8. By applying standard definitions of depression, they could use a participant’s responses to determine anxiety, depression and mood disorders.

Obesity was measured by BMI. His research also found that well-educated obese caucasians were even more likely to be depressed, a likelihood that could be as high as 44 percent.

Do people who are depressed become overweight, or do they become overweight and then depressed? Simon said he’s studying this.

If people lose weight, does depression improve? “We don’t have the answer to that. But it does go both ways, at least if you talk to people — people say they’d be less depressed if they were able to lose weight, for example.”

Birch said one reason white, educated obese people may be more prone to depression is that they set a high standard for achievement. If obesity impinges on their abilities to achieve, it could lead to depression.

She’s also learned that some people aren’t willing to give up their lifestyles, to set aside time to take care of themselves. Only when their health starts to fail will they seek help.

To obese adults already at higher risk for diabetes, heart disease and other life-altering conditions, this study isn’t good news.

“What we believe is that people who are depressed have much more trouble losing weight, changing diet and increasing activity level,” Simon said.

“Since there’s an overlap between obesity and depression, what kind of special programs do we need to develop to help them? That’s a question we’re working on. I can’t say I have the answer.”

But there is a bright note. Simon’s study found that obese people had a lower prevalence of substance abuse disorders.

What are the symptoms of depression?

Doctors continue to learn about how women are affected by depression, but there are some common symptoms. If you’re depressed, you may have some of these symptoms nearly every day, all day, for 2 weeks or longer:

• Feeling sad or crying a lot
• Losing interest or pleasure in things you used to enjoy (including sex)
• Feeling guilty, hopeless or worthless
• Thinking about death or suicide
• Sleeping too much, or not being able to go to sleep or stay asleep
• Losing your appetite and losing weight (or eating too much and gaining weight)
• Feeling very tired or slowed down
• Having trouble paying attention and making decisions
• Having aches and pains that don’t get better with treatment

What causes depression?
Depression seems to be related to a chemical imbalance in the brain that makes it hard for the cells to communicate with one another. Stressful life events, such as the death of a loved one, a divorce or moving (such as leaving home to go to college), may lead to depression. Taking certain medicines, abusing drugs or alcohol, or having other illnesses can also cause depression.

Women with premenstrual syndrome (PMS) are more likely to become depressed. Depression is more common a week before a woman’s period and in the weeks after a woman gives birth (this is called postpartum depression). In some women, taking birth control pills may cause symptoms of depression.

Walking can help people lose weight, especially if they use a pedometer to make sure they are going far enough, U.S. researchers reported on Tuesday.

People who added 20 to 40 minutes of walking a day lost a small but steady amount of weight, the team at the University of Michigan found.

“The increase in physical activity can be expected to result in health benefits that are independent of weight loss,” said Dr. Caroline Richardson, who led the study.

“Increasing physical activity reduces the risk of cardiovascular problems, lowers blood pressure and helps dieters maintain lean muscle tissue when they are dieting.”

Writing in the Annals of Family Medicine, Richardson and colleagues said they reviewed nine studies involving 307 men and women. They took part in studies of pedometer use that ranged from four weeks to a year.

The volunteers in all the studies but one lost some weight — about 0.1 pound (0.05 kg) a week on average, Richardson’s team found. She found that the weight loss was “remarkably consistent” across all of the studies.

Over a year this added up to five pounds (2.25 kg). Changing eating habits could help even more, Richardson said.

People were able to add between 2,000 steps per day to more than 4,000 steps per day. For the average person, 2,000 steps equals about a mile.

What is a pedometer?

A pedometer (also known as a Tomish-meter) or step counter is a device, usually portable and electronic, which counts each step a person makes.

Used originally by sports and physical fitness enthusiasts, pedometers are now becoming popular as an everyday exercise measurer and motivator. Often worn on the belt and kept on all day, it can record how many steps the wearer has walked that day, and thus the kilometres/miles (Distance = number of steps x step length). Some pedometers will also record movements other than walking, such as bending to tie one’s shoes, though the most advanced devices record fewer of these ‘false steps’. Step counters can give encouragement to compete with oneself in getting fit and losing weight. A total of 10,000 steps per day (equivalent of 5 miles or 8 km) is recommended by some to be the benchmark for an active lifestyle, though this point is debated among experts. Step counters are being integrated in an increasing number of portable consumer electronic devices such as music players and mobile phones.

Pedometers can be a motivation tool for people wanting to increase their physical activity. Pedometers have been shown in clinical studies to increase physical activity, and reduce blood pressure levels and Body Mass Index. A study published in the Journal of The American Medical Association Nov. 2007 concluded, “The results suggest that the use of a pedometer is associated with significant increases in physical activity and significant decreases in body mass index and blood pressure.”

Multi-function Pedometers
All pedometers count steps, although they may use different methods to do so. These include (in general order of accuracy): piezo-electric accelerometers, a coiled spring mechanism, and a hairspring mechanism. Beyond showing the step total and/or calculating the distance, features abound. The top features are: Calorie estimates, clocks, timers, stopwatches and speed estimators, 7-day memory, pulse rate readers.

Simple Step Counting Pedometers
The simplest pedometers only count your steps and display steps and/or distance. This is all you need to track to keep yourself motivated. Set a goal of distance or steps for each day. The recommended number of steps is 6000 for health, 10,000 for weight loss when you count all steps during the day. For weight loss, an uninterrupted walk each day of 4000-6000 steps is recommended.

Pedometer Accuracy
The current generation of pedometers uses turned pendulum technology, accelerometers, and/or electronics to count your steps. The unit should be accurate in its count when you wear it correctly - you may have to experiment with where to wear it. Distance accuracy depends on setting your stride length correctly.

How to Wear Your Pedometer
A pedometer should be comfortable to wear all day and be held securely by its clip, an extra safety leash is almost required. The display should be easy to read without removing the unit from your waistband. It should be protected so that bumps don’t punch a button and reset the count. It should easy and intuitive to move between functions.

As adult obesity balloons in the United States, being overweight has become less of a health hazard and more of a lifestyle choice, the author of a new book argues.

“Obesity is a natural extension of an advancing economy. As you become a First World economy and you get all these labor-saving devices and low-cost, easily accessible foods, people are going to eat more and exercise less,” health economist Eric Finkelstein told AFP.

In “The Fattening of America”, published this month, Finkelstein says that adult obesity more than doubled in the United States between 1960 and 2004, rising from 13 percent to around 33 percent.

Globally, only Saudi Arabia fares worse than the United States in terms of the percentage of adults with a severe weight problem — 35 percent of people in the oil-rich desert kingdom are classified as obese, the book says, citing data from the World Health Organization and Organization for Economic Cooperation and Development.

With the rising tide of obesity come health problems and an increased burden on the healthcare system and industry.

“But the nasty side-effects of obesity aren’t as nasty as they used to be,” Finkelstein said.

“When you have a first-rate medical system that can cure the diseases that obesity promotes, you no longer need to worry so much about being obese,” he told AFP.

“With our ever-advancing modern medicine there helping to save the day (at least for many people), are government and the media blowing the magnitude of the ‘obesity crisis’ out of proportion?” his book says.

A study in which Finkelstein and colleagues at the RTI International, an independent research institute in North Carolina that works on social and scientific problems, asked overweight, obese and normal weight people to predict their life expectancy came up with a total difference of four years.

Normal weight respondents predicted they would live to 78, the obese to 74, and the overweight 75.5.

Other studies that looked at death data back the conclusion that people who carry excess weight tend to die slightly earlier, the book says, and draws the conclusion that “many individuals are making a conscious decision to engage in a lifestyle that is obesity-promoting.”

“People make choices, and some people will choose a weight that the public health community might be unhappy about. Why should we try to make them thinner?” Finkelstein said.

Linda Gotthelf, a doctor who heads research at Health Management Resources, a private, nationwide firm that specializes in weight loss and management, agreed that Americans now live longer but stressed that quality of life declines with age.

“People are living longer but with more chronic diseases,” Gotthelf told AFP.

“That brings a diminished quality of life, especially for the obese who have more functional limitations as they age and tend to be on multiple medications.”

Obesity is not a choice for Alley English, a 28-year-old mother from Missouri who has struggled with a weight problem all her life.

“If you knew that you could be what society considers normal, why would you not choose to do that?” English told AFP.

“As we get older, life does get more rushed and we do tend to make the easier choices sometimes,” English, who currently weighs 392 pounds (178 kilograms), told AFP.

“But you can’t say if you quit going to the drive-through, exercise more and eat more vegetables, you’ll lose weight. There are so many more factors involved.”

Gotthelf also disagreed that people choose to be obese.

“There are studies in which people have said they would rather lose a limb or be blind than obese. Being obese is not a desire,” she said.

“For many, this is a problem they have struggled with for many years… it gets discouraging after a while,” she said.

“I would not doubt that if you asked obese people if they could push a button and not be obese, close to 100 percent would say they would push the button.”

Finkelstein says he wrote “The Fattening of America” to “encourage discussion of what I understand is probably an uncomfortable position for a lot of people.”

Even if private industry and government take steps to protect society against the costs of obesity, many Americans “will likely continue to choose a diet and exercise regimen that leads to excess weight,” because losing weight requires too many lifestyle sacrifices, his book warns.

Meanwhile, frustrated by years of unsuccessful dieting and weight loss programs, English has opted to join a growing number of Americans who have gastric bypass surgery — hailed in Finkelstein’s book as “the best-known treatment for severe obesity.”

“I have a higher risk of developing diabetes or hypertension if I don’t have the surgery,” English said.

“I don’t care if I end up with a body like whoever-in-the-media thinks I should look like; I just want to be healthy and able to participate in my daughter’s life,” she said.

Obesity and Life Styles: Is it the Hamburger or your House?

In a sustained effort to undermine America’s preference for suburban living and promote land use regulations that force families into higher density housing, anti-suburban activists have attempted to link the suburbs with whatever social or health concerns are in the news.

Several years ago writer Neal Peirce blamed the Columbine murders on sprawl, while others have attempted to link sprawl to the rising incidence of asthma, teen alienation, serial killers, air pollution, high taxes, and, more recently, obesity.

Unlike the other unsupportable allegations, the obesity link has sustained a longer shelf life than the others, and recent reports have received widespread media attention. On October 2, 2003, several of these anti-sprawl advocates will attempt to make their case to Congress in a panel discussion in the Dirksen Senate Office Building.

As the articles below demonstrate, the advocate’s case is a very weak one and receives little support from the evidence. But exaggeration and misrepresentation might be the least of their failings.

There is no question that the apparent rise in obesity poses serious health threats, but to claim that the cause is land use patterns, as opposed to… oh say… poor diet, does a grotesque disservice to those at risk of obesity and its related health problems.

By distracting those who need to lose weight for health reasons away from meaningful solutions – a better diet, more exercise – to inconsequential influences that have more to do with advancing questionable social agendas, these misrepresentations will ultimately undermine the nation’s health.

Participating in physical activities in and out of school more than two times a week protects adolescents from becoming overweight young adults, according to new research.

“The message for policy makers is that the failure to offer physical education is ‘penny wise and pound foolish,”‘ study investigator Dr. Robert Wm. Blum from Johns Hopkins University, Baltimore, told Reuters Health.

“For parents, the evidence is compelling that placing an emphasis on high-energy recreational activity such as biking and roller-blading will benefit their children and are activities that they can do together as a family,” he added.

The study, published in the Archives of Pediatrics and Adolescent Medicine, involved 3,345 adolescents who reported their school-based and extracurricular physical activities in 1996 when they were in the 8th through 12th grades. Body weight was assessed at this time and again 5 years later.

During the 5-year period, the number of adolescents who were overweight - defined as having a body mass index (BMI) of 25 or greater — nearly doubled from about 28 percent to 51 percent, the investigators report. BMI is the ratio between height and weight, which is commonly used to assess an individual’s weight.

“Of 941 overweight adolescents, only 103 (11 percent) transitioned to normal weight as young adults,” the researchers report. Of the 2,404 normal-weight adolescents, 855 (roughly 36 percent) became overweight young adults.

For the entire study population, the likelihood of being an overweight adult was reduced 48 percent by participating extracurricular “wheel-related” activities, such as roller-blading, skateboarding, or bicycling more than 4 times per week and 20 percent by participating in school-based sports activities, such as baseball, softball, basketball, soccer, swimming or football 3 to 4 times per week.

Moreover, for every weekday an adolescent participated in physical education classes, the odds of becoming an overweight adult decreased by 5 percent. Participating in physical education classes everyday decreased the odds of becoming an overweight adult by 28 percent.

“With obesity at epidemic proportions, an intervention which appears to hold as much promise as daily physical education does in maintaining normal weight into adulthood should be given highest priority,” Blum said.

The apparent protective effect of physical activity against becoming overweight was more marked in adolescents who started out at a normal weight, suggesting that physical activity may be a more effective strategy for maintaining normal weight than for losing excess body weight, the researchers point out.

The study results also highlight the importance of preventing a child from becoming overweight in the first place, they add.

Teen Obesity Reaching Epidemic Proportions!

Obesity among teens has become a major epidemic. More teens are overweight now than at any time in history. A January 2000 report to the Centers for Disease Control and Prevention (CDC) identified the single most powerful change teens can make to bring their weight under control. “Of all the ways of tackling this problem, TV reduction appears to be the most effective measure in reducing weight gain in this population,” Dr. William Dietz, Director of the Division of Nutrition and Physical Activity, told the CDC Advisory Board. Bike, dance, play ball - have fun being active!

Women need to exercise more to prevent obesity

Researchers think that women should more than double their daily exercise time in order to control their weight. Presently, we are advised to aim for 35 minutes a day// of moderate exercise for health and weight control. But scientists at the University of Alabama at Birmingham now warn that this may not be enough.

They have studied a group of women who reported a tendency to gain weight. Physical inactivity alone accounted for 60 per cent of the weight gain - with food intake becoming a minor factor. But the researchers think that the current guidelines need to be increased. They suggest that 80 minutes a day might be needed, rather than 35, to make a real impact on obesity problems.

Certainly the sedentary lifestyle of the United States plays a big part in the growing national problem of obesity. Rather than thinking of calorie cutting, it may be better to consider how to squeeze more physical activity into your day.

Yes, high-fat, high-carb meals are much more harmful to obese people and - of course - kids.

Eating a high-fat, high-carb fast food meal produces damaging cellular changes that are greater and longer-lasting in obese people than in normal-weight people, a new study shows.

Dr. Paresh Dandona and colleagues from Kaleida Health in Buffalo, New York looked at inflammation and oxidative stress, which occurs when levels of normal byproducts of metabolism known as free radicals exceed the body’s ability to neutralize them.

In previous research they found that obese individuals have higher levels of oxidative stress and inflammation than normal-weight individuals. They also demonstrated that eating a high-fat, high-carb meal increased oxidative stress and inflammation in normal-weight people.

To test whether these increases might be greater in obese people, Dandona and his team had 10 normal-weight and 8 obese people eat a 1,800-calorie meal consisting of a large hamburger, a large serving of fries, a large cola, and a slice of apple pie.

Both groups showed increases in oxidative stress two hours after eating the meal. By three hours, oxidative stress had returned to baseline levels in the normal-weight individuals, but it continued to climb in the obese individuals. The same pattern was seen for inflammation.

“If obese people who already have oxidative and inflammatory stress take the same meal, they get far greater and more prolonged levels of oxidative and inflammatory stress,” Dandona told Reuters Health. “Since oxidative and inflammatory stress predispose you to atherosclerosis (hardening of the arteries), heart attack and stroke, this risk is far greater in obese people.”

In another study, Dandona and his colleagues demonstrated that a high-fruit, high-fiber meal with the same calorie content as the fast food meal tested in the current study produced no increase in oxidative or inflammatory stress.

The findings provide yet more evidence that people should avoid high-fat, high carb fast food meals and consume as much fruit and vegetables as possible, Dandona said.

The Super-sizing of America: Are Fast Food Chains to Blame for the Nation’s Obesity?

Americans are getting fatter and fatter every year. It is estimated that as many as one in five Americans is obese, a condition defined as being more than 30 percent above the ideal weight based on height. Even more alarming is that fact that obesity rates for children have doubled over the past 20 years, and overweight children are being diagnosed with obesity-related illnesses such as diabetes, sleep apnea and respiratory illnesses that in the past have only afflicted adults.

As the health care costs of treating obesity-related illnesses mount, some are looking to place the blame for increasing obesity rates on the purveyors of fast food. Facing fierce competition for customer loyalty, fast food chains such as McDonalds, Burger King and Wendy’s have promoted their over-sized burgers, extra-large servings for fries, and buckets of soda, all at low prices. Busy and cash-strapped families increasingly rely on take-out food for family dinners, and regular consumption of over-sized portions of fatty foods can leads to widespread obesity.

Some trial lawyers, fresh from a $90 million (and growing) windfall from the tobacco lawsuits, have set their sites on fast food companies. Following the tobacco lawsuit model, some argue that these companies should be held liable for the health care costs of treating illnesses associated with obesity, since they peddle dangerously unhealthy foods to unwitting consumers. The combination of the staggering number of obese Americans and the fat wallets of the fast food companies makes such lawsuits a tantalizing prospect for many trial lawyers and their potential clients.

On One Hand

The portions served by fast food chains and other restaurants are far larger than the recommended portion size for most foods. Food costs for restaurants are relatively low, compared to the costs of rent and labor, so it makes sense for them to offer larger portions that make their customers feel like they are getting a bang for the buck.

As American eat out more and more frequently, they become accustomed to those oversized portion, and think that such portions are normal. The high caloric content of these large servings leads to weight gain for regular fast food customers, and obesity can lead to many dangerous health problems.

Fast food chains do not alert their customers to the hazardously high calorie and fat content of the food they offer. They deserve some of the blame for the epidemic of obesity, and lawsuits brought by victims of their toxic food would force these companies to take some responsibility for their dangerous products.

On the Other Hand

Cigarettes contain substances that are addictive to smokers, and tobacco companies have been made to pay the price for selling a product that is dangerous to the health of their customers. But no one can claim that a Big Mac or a Whopper is addictive. They may be tasty, and people may eat too many of them, but McDonalds and Burger King are not responsible for their customers’ lack of self-control.

Lawsuits against fast food companies on behalf of obese “victims” would say more about the greed of trial lawyers than about any real danger posed by fast food. Most people choose to eat fast food even though they know it’s bad for them. Individuals have to take responsibility for that choice, not the company that provides the food.

• The US Department of Agriculture estimates the cost at more than $ 71 billion a year in added health-care and related expenses.
• In 1991, one in eight Americans were obese. In 1999, the number had increased to one in five.
• A study by Policy Analysis Inc. concluded that overweight people cost their employers $12.7 billion in sick time and insurance coverage in 1994 alone.
• It is estimated that kids get up to 40 percent of their meals from fast-food chains, convenience stores and restaurants.
• There are fast-food franchise outlets in 13 percent of the nation’s schools.
• One American Medical Association study estimates that 300,000 Americans die each year from obesity-related causes such as heart disease, diabetes and stroke.
• Obesity levels are sky-rocketing despite the fact that $33 billion a year is spent on weight-loss aids.

A startling number of parents may be in denial about their youngsters’ weight.

A survey found that many Americans whose children are obese do not see them that way.

That is worrisome because obese children run the risk of diabetes, high blood pressure, cholesterol problems and other ailments more commonly found in adults. And overweight children are likely to grow up to be overweight adults.

“It suggests to me that parents of younger kids believe that their children will grow out of their obesity, or something will change at older ages,” said Dr. Matthew M. Davis, a University of Michigan professor of pediatrics and internal medicine who led the study, released earlier this month.

“When I see a child that is obese at these younger ages, I take that as a sign of ways nutrition can be improved, a child’s activity level can be improved.”

Among parents with an obese, or extremely overweight, child ages 6 to 11, 43 percent said their child was “about the right weight,” 37 percent responded “slightly overweight,” and 13 percent said “very overweight.” Others said “slightly underweight.”

For those with an obese child ages 12 to 17, the survey found more awareness that weight was a problem. Fifty-six percent said their child was “slightly overweight,” 31 percent responded “very overweight,” 11 percent said “about the right weight” and others said “slightly underweight.”

Dr. Goutham Rao, clinical director of the Weight Management and Wellness Center at Children’s Hospital of Pittsburgh, said obesity in children isn’t as easy to identify as in adults. “Plus, because of the social stigma, it’s not something that parents are willing to admit to readily,” Rao said.

The survey of 2,060 adults, conducted over the summer by Internet research firm Knowledge Networks, collected height and weight measurements on the children from their parents, then used that to calculate body mass index.

When a child’s BMI was higher than the 95th percentile for children who are the same age and gender, the child was considered obese.

Based on what the parents reported, 15 percent of the children ages 6 to 11, and 10 percent of the children ages 12 to 17, were obese.

The Michigan researchers said that, too, suggests parents underestimate their children’s weight. National estimates indicate about 17 percent of U.S. children are obese under the standard used by the researchers.

Dr. Reginald Washington, a member of the American Academy of Pediatrics and part of the AAP’s committee on childhood obesity, noted that in about half of cases where a child is obese, one or both parents are overweight, too — and parents can take a pediatrician’s concerns as a personal affront.

Experts said doctors need to help parents better understand the health risks of childhood obesity.

“Obesity isn’t just something that affects the clothes that you buy or how you are perceived by your friends and your schoolmates,” Davis said. “It is something that can have health effects, not only in adulthood but in childhood.”

Defining Obesity in Children and Adolescents

Obesity is defined as an excessive accumulation of body fat. Obesity is present when total body weight is more than 25 percent fat in boys and more than 32 percent fat in girls (Lohman, 1987). Although childhood obesity is often defined as a weight-for-height in excess of 120 percent of the ideal, skinfold measures are more accurate determinants of fatness (Dietz, 1983; Lohman, 1987).

A trained technician may obtain skinfold measures relatively easily in either a school or clinical setting. The triceps alone, triceps and subscapular, triceps and calf, and calf alone have been used with children and adolescents. When the triceps and calf are used, a sum of skinfolds of 10-25mm is considered optimal for boys, and 16-30mm is optimal for girls (Lohman, 1987).

The Problem With Childhood Obesity

One in 10 six-year-olds is obese. The total number of obese children has doubled since 1982. On present trends half of all children in England in 2020 could be obese. So is this just harmless puppy fat or something more serious?

What is the problem?
If a child becomes obese their body processes can change. Some of these may be difficult or even impossible to alter in adulthood.

Fat cells are laid down in the first few years of life. If fat is stored quickly, more fat cells are created. So an obese child can have up to three times as many as a normal child. Eventually, fat cells stop multiplying and an adult has a fixed number for the rest of their life. The existing cells simply swell or shrink to accommodate more fat.

The amount of fat the body wants to store is thought to be proportional to the total number of fat cells. So if you were overweight as a child, your body is programmed to carry more fat. This doesn’t mean that you can’t lose weight through diet and exercise, but it will be harder.

Health problems for kids
Few health problems are observed in obese children. But they may develop conditions that cause problems later in life, such as high blood pressure.

They may also suffer from ’sleep apnoea’. When this happens, soft tissue in the throat blocks the airways during sleep. This can stop their breathing for up to a minute. This process can happen hundreds of times a night, leading to cardiovascular disease, memory problems, headaches and fatigue.

Diabetes risk
Some obese children may develop type II diabetes. Normally this condition only starts much later in life. When it strikes, the body stops being able to process sugar properly and the cells are starved of energy. Type II diabetes cannot be cured, but it can be treated. It may lead to complications such as nerve damage, heart disease, kidney disease and blindness. Children with this condition will have to live with it all their lives, increasing the chance of complications.

Negative body image can cause depression and social problems - overweight children are often teased. Low self-esteem may not directly affect physical health, but it is the biggest problem encountered. It may even lead to ‘comfort eating’, exacerbating the situation. If our culture placed less emphasis on the ‘perfect body’, then at least one set of issues associated with obesity would vanish.

Obese children in the United States

The percentage of overweight children in the United States is growing at an alarming rate. On the whole, kids are spending less time exercising and more time in front of the TV, computer, or video-game console. And today’s busy families have fewer free moments to prepare nutritious, home-cooked meals, day in and day out. From fast food to electronics, quick and easy seems to be the mindset of many people, young and old, in the new millennium.

Since the 1970s, the percentage of overweight kids and adolescents in the United States has more than doubled. Today, 10% of 2- to 5-year-olds and more than 15% of children between the ages of 6 and 19 are overweight. If you combine the percent of kids who are overweight with the percent of kids who are at risk of becoming overweight, about one out of three children are affected.

Preventing your children from becoming overweight means adapting the way you and your family eat and exercise and the way you spend time together. Helping your children lead healthy lifestyles begins with you, the parent, and leading by example.
Is Your Child Overweight?

A child with a body mass index at or above the 95th percentile for age and sex is considered overweight. BMI uses height and weight measurements to estimate how much body fat a person has. To calculate your child’s BMI, divide his or her weight by his or her height squared, or wt/ht2. (Important: To use this formula for BMI, the child’s weight and height measurements must be in kilograms and meters, respectively. If you use pounds and inches, multiply the result by the conversion factor 703.)

An easier way to get your child’s BMI is to use a BMI calculator. Once you know your child’s BMI, it can be plotted on a standard BMI chart. Your child will fall into one of 4 categories:

• Underweight: BMI below the 5th percentile
• Normal weight: BMI falls between the 5th and the 85th percentiles
• At risk for overweight: BMI between the 85th and 95th percentiles
• Overweight: BMI at or above 95th percentile

BMI is not a perfect measure of body fat and there are situations where BMI may be misleading. For example, a very muscular person may have a high BMI without being overweight (because extra muscle adds to a person’s body weight - but not fatness). In addition, BMI may be difficult to interpret during puberty when kids are experiencing periods of rapid growth. It’s important to remember that BMI is usually a good indicator - but is not a direct measurement - of body fat.

These days, you may be hearing more about BMI. Doctors are using BMI during routine check-ups and many school districts are including BMI in their annual health assessments.

If you’re worried that your child or teen may be overweight, make an appointment with your child’s doctor. If your child is overweight, your doctor may ask about your child’s eating and activity habits and make suggestions on how to make positive changes. He or she may also decide to screen for some of the medical conditions that can be associated with obesity (see below). Depending on the child’s BMI, age, and health, the doctor may refer you to a registered dietitian for additional advice. For some overweight children, your doctor may recommend a comprehensive weight management program.

The Effects of Overweight

Overweight children are at risk for serious health conditions like type 2 diabetes, high blood pressure, and high cholesterol - all once considered exclusively adult diseases. But overweight children may also be prone to low self-esteem that stems from being teased, bullied, or rejected by peers. Overweight children are often the last to be chosen as playmates, even as early as preschool. Children who are unhappy with their weight may be more likely than average-weight children to develop unhealthy dieting habits and eating disorders, such as anorexia nervosa and bulimia, and they may be more prone to depression, as well as substance abuse.

Overweight children are at risk of developing medical problems that affect a child’s present and future health and have direct impact on quality of life including:

• high blood pressure, high cholesterol and abnormal blood lipid levels, insulin resistance, and type 2 diabetes
• bone and joint problems
• shortness of breath that makes exercise, sports, or any physical activity more difficult and may aggravate the symptoms or increase the chances of developing asthma
• restless or disordered sleep patterns
• tendency to mature earlier (overweight kids may be taller and more sexually mature than their peers, raising expectations that they should act as old as they look, not as old as they are; overweight girls may have irregular menstrual cycles and have fertility problems in adulthood)
• liver and gall bladder disease
• depression

Risk factors present in childhood (including high blood pressure, high cholesterol, and diabetes) can lead to serious adult medical conditions like heart disease, heart failure, and stroke. Preventing or treating obesity in children may reduce the risk of developing these conditions as they get older.

What Causes Overweight?

There are a number of factors that contribute to becoming overweight, either alone or together. Genetic factors, lifestyle habits, or both may be involved. In some instances, endocrine problems, genetic syndromes, and medications can be associated with excessive weight gain.

Much of what we eat is quick and easy - from fat-laden fast food to microwave and prepackaged meals. Daily schedules are so jam-packed that there’s little time to prepare healthier meals or to squeeze in some exercise. Portion sizes, in the home and out, have drastically increased.

Plus, now, more than ever, life is sedentary - children spend more time playing with electronic devices, from computers to handheld video game systems, than actively playing outside. Television is a major culprit.

Kids younger than 8 spend an average of 2.5 hours watching TV or playing video games, and kids 8 and up spend 4.5 hours plopped in front of the TV or wriggling a joystick. Kids who watch more than 4 hours a day are more likely to be overweight compared with kids who watch 2 hours or less. Not surprisingly, TV in the bedroom is also linked to increased likelihood of being overweight. In other words, once many kids get home from school, virtually all of their free time before dinner, doing homework, and getting ready for bed is spent in front of one screen or another!

And although physical education (PE) in schools can help kids get up and moving, more and more schools are cutting PE programs altogether or cutting down on the amount of time spent actually doing fitness-building physical activities. One study showed that gym classes offered third graders just 25 minutes of vigorous activity each week.

Genetics also plays a role - genes help determine your body type and how your body stores and burns fat just like they help determine other traits. Because both genes and habits can be passed down from one generation to the next, multiple members of a family may struggle with weight.

A greater reliance on “food fixes” to deal with emotions can also contribute to weight gain. Some people tend to eat more when they’re feeling sad, stressed, or bored. People in the same family tend to have similar eating patterns, maintain the same levels of physical activity, and adopt the same attitudes toward being overweight. Studies have shown that a child’s risk of obesity greatly increases if one or more parent is overweight or obese.
Overcoming Overweight and Obesity in Your Child

The key to keeping kids of all ages at a healthy weight is taking a whole-family approach. It’s the “practice what you preach” mentality. Make eating and exercise a family affair. Get your children involved by letting them help you plan and prepare healthy meals, and take them along when you go grocery shopping, so they can learn how to make good food choices.

Avoid falling into some common food/eating behavior traps:

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The balance between calorie intake and energy expenditure determines a person’s weight. If a person eats more calories than he or she burns, the person gains weight (the body will store the excess energy as fat). If a person eats fewer calories than he or she burns, he or she will lose weight. Therefore the most common causes of obesity are overeating and physical inactivity. At present, we know that there are many factors that contribute to obesity, some of which have a genetic component:

Genetics. A person is more likely to develop obesity if one or both parents are obese. Genetics also affect hormones involved in fat regulation. For example, one genetic cause of obesity is leptin deficiency. Leptin is a hormone produced in fat cells, and also in the placenta. Leptin controls weight by signaling the brain to eat less when body fat stores are too high. If, for some reason the body cannot produce enough leptin, or leptin cannot signal the brain to eat less, this control is lost, and obesity occurs. The role of leptin replacement as a treatment for obesity is currently being explored.
Overeating. Overeating leads to weight gain, especially if the diet is high in fat. Foods high in fat or sugar (e.g., fast food, fried food and sweets,) have high energy density (foods that have a lot of calories in small amount of food). Epidemiology studies have shown that diets high in fat contribute to weight gain.

A diet high in simple carbohydrates. The role of carbohydrates in weight gain is not clear. Carbohydrates increase blood glucose levels, which in turn stimulate insulin release by the pancreas, and insulin promotes the growth of fat tissue and can cause weight gain. Some scientists believe that simple carbohydrates (sugars, fructose, desserts, soft drinks, beer, wine, etc.) contribute to weight gain because they are more rapidly absorbed into the blood stream than complex carbohydrates (pasta, brown rice, grains, vegetables, raw fruits, etc.) and thus cause a more pronounced insulin release after meals than complex carbohydrates. This higher insulin release, some scientists believe, contribute to weight gain.

Frequency of eating. The relationship between frequency of eating (how often you eat) and weight is somewhat controversial. There are many reports of overweight people eating less often than people with normal weight. Scientists have observed that people who eat small meals four or five times daily, have lower cholesterol levels and lower and/or more stable blood sugar levels than people who eat less frequently (two or three) large meals daily. One possible explanation is that small frequent meals produce stable insulin levels, whereas large meals cause large spikes of insulin after meals.

Slow metabolism. Women have less muscle than men. Muscle burns more calories than other tissue (which includes fat). As a result, women have a slower metabolism than men, and hence, have a tendency to put on more weight than men, and weight loss is more difficult for women. As we age, we tend to lose muscle and our metabolism slows, therefore, we tend to gain weight as we get older particularly if we do not reduce our daily caloric intake.
Physical inactivity. Sedentary people burn fewer calories than people who are active. The National Health and Examination Survey (NHANES) showed that physical inactivity was strongly correlated with weight gain in both sexes.

Medications. Medications associated with weight gain include certain antidepressants (medications used in treating depression), anti-convulsants (medications used in controlling seizures such as carbamazepine and valproate), diabetes medications (medications used in lowering blood sugar such as insulin, sulfonylureas and thiazolidinediones), certain hormones such as oral contraceptives and most corticosteroids such as Prednisone. Weight gain may also be seen with some high blood pressure medications and antihistamines.

Psychological factors. For some people, emotions influence eating habits. Many people eat excessively in response to emotions such as boredom, sadness, stress or anger. While most overweight people have no more psychological disturbances than normal weight people, about 30 percent of the people who seek treatment for serious weight problems have difficulties with binge eating.
Diseases such as hypothyroidism, insulin resistance, polycystic ovary syndrome and Cushing’s syndrome are also contributors to obesity.

Why Are Some People Obese? - Trends in Obesity Research

Endocrine researchers are actively investigating the root causes of obesity. Recent trends currently being studied aim to identify why obesity affects some people, but not others. The trends of why obesity affects some people include:

Investigating obesity as an energy imbalance: Over an extended period of time, some people may ingest more carbon- and nitrogen-containing compounds from the food they eat than they need for energy (ideally, energy in = energy out), causing them to gain weight. This finding has led to ongoing research to determine how energy imbalance relates to such important overweight and obesity issues such as how food intake is regulated, where fat is stored and how genes control these processes.

Exploring the epidemiological model of obesity: An epidemiological model is a model that includes an environmental agent that acts on a host to produce a disease. In the case of obesity, the environmental agent is food and the host is the obese individual. In affluent societies, such as those of the Western world, foods, particularly foods high in fat, are abundant and physical activity has gradually been reduced. For the individual who may also be genetically susceptible to developing obesity, this excess of food energy leads to an accumulation of fat in cells, and, eventually to obesity. Some endocrine researchers believe that an epidemiological model may be a more comprehensive way to look at obesity than the energy balance model to conceptualize obesity as a disease.

Identifying the impact of select environmental agents on obesity:Environmental agents that have been shown to impact an individual’s risk for gaining and maintaining weight, resulting in overweight or obesity issues include:

• Intrauterine factors such as maternal diabetes, maternal smoking and intra-uterine nutrition;
• Neonatal environmental factors, such as breast-feeding; infants breast fed for more than 3 months may have a reduced risk of future obesity;
• Adiposity rebound, or the age in childhood when body mass index (BMI) stops falling and begins to rise. Early adiposity rebound predicts future obesity;
• Medications; drug-induced weight gain has been linked to many medications that are designed to treat various diseases such as psychosis, depression, allergies and diabetes;
• Portion size, fat intake and high fructose corn syrup; all have been implicated as contributors to obesity. Research has found a correlation between the consumption of soft drinks and future weight gain in children and adults;
• Activity; low levels of physical activity have been shown to correlate with weight gain and the issue of obesity;
• Smoking; smokers tend to have a lower body weight, and cessation of smoking is generally associated with weight gain (Note: Smoking is discouraged. Research addresses why the weight correlation exists and how to aid patients in quitting without weight gain.); and
• Viruses and obesity; one laboratory has reported that obese humans have higher antibody levels to one strain of adenovirus (AD-36), a viral infection possibly linked to obesity.

Researching host agents and obesity: Host agents, or characteristics, have been found through research to impact an individual’s risk for gaining and maintaining weight, and therefore may affect overweight and obesity issues. They include genetic causes and physiological factors.

Obese people find it harder to fight infections, and a weakened immune response may be to blame, suggests a new study from Boston University researchers.

In experiments with mice infected with the bacteria Porphyromonas gingivalis, obese mice had less ability to battle gum infection than their normal-weight counterparts, according to the report in this week’s early online edition of the Proceedings of the National Academy of Sciences.

“For years, we have had difficulty understanding why obese people have difficulty clearing an infection,” said lead researcher Dr. Salomon Amar, associate dean for research at the university’s School of Dental Medicine.

“Now we understand that dysfunction in some of the mechanisms, as a result of the obesity, explain difficulty in clearing the infection and also the difficulty in wound healing,” Amar said.

In the study, Amar’s team tied silk threads infected with the bacteria around the molars of obese and normal-weight mice. They then compared the animals’ responses to infection, by measuring both the amount of bone loss and the growth of the bacteria around their teeth.

The researchers found that the obese mice had a compromised immune response to the bacteria, which made the animals more susceptible to the infection.

Amar’s group also looked at the animals’ white blood cells, which are the main line of defense against infection. The white cells of obese mice had lower levels of an important signaling molecule, and some of the genes that fight inflammation were altered, the researchers found.

Why obesity has this effect isn’t clear, but the researchers think it may involve a signaling pathway that controls a protein called NF-kB. Alterations in this protein may be caused by constant exposure to food, Amar explained. “At some point, the body doesn’t respond properly to infection,” he said.

The same mechanism is at work in humans, Amar added. In fact, studies in obese people have shown they are more likely to have gum disease than non-obese people. The disease is caused by bacteria, which causes inflammation and destruction of the bone underlying teeth.

Amar thinks that obese people need to be treated differently to help them fight infections. “We need to be more aggressive in the use of targeted antibiotics in infections among obese people,” he said. “Also, we need to boost the immune response.”

One expert agreed the finding sheds light on the connection between obesity and infection.

“Very interesting paper,” said Dr. Sara G. Grossi, a senior research scientist at the Brody School of Medicine of East Carolina University. “This is a study that needed to be done, with very interesting results and implications for both obesity and periodontal disease — two diseases that are easier to prevent than to treat.”

Obesity linked to weaker immunity in animals

Obese mice are less able to fight off bacterial infection than lean mice, according to a study released Monday that supports emerging evidence of a link between obesity and a dysfunctional immune system.

In a study on laboratory mice infected with a bug that causes periodontal disease, obese mice had a blunted immune response to the infection and increased susceptibility to gum disease compared to lean mice.

The obese mice also had much higher rates of bone loss.

When researchers examined the rodents 10 days after they were infected with the bacterium Porphyromonas gingivalis, the heavier mice had a 40 percent increase in alveolar bone loss than the lean mice.

The alveolar bone is the bone or ridge that contains the tooth sockets on the upper and lower jaw.

Previous studies have shown that obese people are more likely to suffer from periodontal disease than their leaner counterparts and this study provided some clues as to why that is.

Blood tests on mice that had been infected with the bacterium P. gingivalis revealed irregularities in the production of cytokines in the obese mice, compared to the “control” or lean mice.

Cytokines are proteins or peptides that signal immune cells such as T-cells and macrophages to travel to the site of infection.

Researchers also analysed the macrophages, the white blood cells that form a major line of antibacterial defense.

They found that levels of key signaling molecules were significantly lower in the macrophages from the obese rodents and the expression profile of inflammation-related genes was altered compared to the control mice.

The researchers said it’s not clear how obesity compromises the immune system, but they suspect a particular signaling pathway involving a transcription factor NF-kB may be involved. NF-kB plays a key role in the immune response to infection.

The study appears in the journal, The Proceedings of the National Academy of Sciences, and was conducted by scientists in the School of Dental Medicine at the University of Boston Medical Center.

Emotional eaters — people who eat when they are lonely or blue — tend to lose the least amount of weight and have the hardest time keeping it off, U.S. researchers said.

They said the study may explain why so many people who lose weight gain it all back.

“We found that the more people report eating in response to thoughts and feelings, the less weight they lost,” Heather Niemeier, an obesity researcher at The Miriam Hospital and The Warren Alpert Medical School of Brown University, said in a statement.

“Amongst successful weight losers, those who report emotional eating are more likely to regain,” said Niemeier, whose study appears in the journal Obesity.

The study included 286 overweight men and women who were participating in a behavioral weight loss program.

A second group consisted of more than 3,300 adults who have lost at least 30 pounds and kept it off for at least one year.

Niemeier and her team analyzed responses to an eating inventory questionnaire.

Emotion Eaters are often at a loss to explain why the pounds they’ve lost creep back again, and they may blame themselves for their lack of willpower. But, in truth, it’s really a lack of self-awareness that’s to blame — not being aware of what it is that drives them to eat so much.

Here are the characteristics:

The Emotion Eater only overeats when she’s feeling a strong emotion, such as anger or depression.

The Emotion Eater frequently overeats immediately after getting home from work.

The Emotion Eater tends to eat whenever she is bored.

Sometimes, out of the blue, the Emotion Eater finds that she is incredibly hungry, and she almost feels as if she’s starving for food.
The Emotion Eater usually feels uncomfortable openly displaying or talking about her feelings.

The metaphysical basis of emotion eating is a belief that other people keep interfering with her attempts to fulfill her life purpose. She believes that if only her children, neighbors, boss, co-workers, teachers, parents, and lover would cooperate, she could get to work on her purpose.

The affirmation for the Emotion Eater is:

“I am the sole creator of my life. I choose now to put loving, creative, and consistent energy and enthusiastic effort into discovering and fulfilling my life purpose. I take total responsibility for structuring my time.”

One of the main “problems” that Emotion Eaters face is that they feel hungry a great deal of the time. Their solution in the past has been to eat every time they felt hungry. Unfortunately, since they were often so hungry, this meant that they would eat a lot of food and gain a lot of weight in the process.

They focused on people who ate because of external influences, such as people who eat too much at parties, and people who ate because of internal influences, such as feeling lonely or as a reward.

What they found is that the more a person ate for internal reasons, the less weight they lost over time.

“Our results suggest that we need to pay more attention to eating triggered by emotions or thoughts as they clearly play a significant role in weight loss,” Niemeier said.

Emotion Eaters must become acutely aware of their motivations for wanting to eat. You need this awareness in order to tell whether your stomach’s actually empty or you’re upset about something and just want to eat to feel better. First, spend the next week analyzing the feelings you have when you’re hungry. The best way to do this is to keep a journal recording how you feel before, during, and after you eat. The journal is a black-and-white way of finding patterns in the emotional reasons why you overeat.

Second, the next time you feel like eating, ask yourself if you could possibly be upset instead of hungry. Don’t go to the kitchen automatically when you feel hunger pangs. Instead — and this is important — give yourself a mandatory 15-minute “time out” whenever you think you’re hungry.

The high-fat, high-protein and low-carbohydrate Atkins diet may put practitioners at risk for heart disease in as little as one month, a new study suggests.

When individuals followed the maintenance phase of the diet — without weight loss — they experienced increased “bad” cholesterol and other markers for heart disease, experts report.

“I think the Atkins diet is potentially detrimental for cardiovascular health, if maintained for a long duration and without attempts to lose weight,” said lead researcher Dr. Michael Miller, lead author of the study, director of preventive cardiology at the University of Maryland Medical Center and associate professor of medicine at the University of Maryland School of Medicine in Baltimore. “A stabilizing Atkins diet is not the way to go,” he said.

It’s also unclear if the popular South Beach or Ornish diets, also studied in the trial, actually promote heart health.

This was just one of several studies involving diet and nutrition slated for presentation at this week’s annual meeting of the American Heart Association in Orlando, Fla.

A second study, conducted primarily among Mormons in Utah, found that routine fasting was associated with a lower risk of coronary artery disease.

And yet another trial found that moderate drinking might help ward off angina after heart attack.

“Nutrition continues to be an area of interest, and, clearly, there is conflicting information out there,” said Dr. Robert Bonow, immediate past president of the American Heart Association. “With the Atkins diet, you do lose weight and experience a short-term beneficial effect on lipid parameters, but the concern would be long-term. Saturated fats are not good for heart health, and many people experience rebound weight gain which is not good.”

Although much research has been done on the Atkins diet, no one has yet looked at the effects of the diet when the person is not losing weight.

“During the process of weight loss, we would expect to see a benefit on various [cardiovascular] parameters,” Miller said. In other words, the weight loss that can come with these diets will help the heart.

But how does the cardiovascular system fare on a high-fat regimen when weight remains stable? “Weight loss confounds the results, and we wanted to compare these diets without that possible confounder,” Miller explained.

For this trial, 18 healthy adults completed four weeks each on the Atkins (50 percent fat), South Beach (30 percent fat) and Ornish (10 percent fat) diets.

People on the Atkins diet had increased levels of LDL (”bad”) cholesterol, more constricted blood vessels and an increase in blood markers for inflammation, some by as much as 30 percent or 40 percent, the researchers said.

The results were less clear for the Ornish or South Beach regimens. In those diets, markers for inflammation remained stable or dipped by up to 20 percent, the researchers found.

Another study followed up on reports from the 1970s that Mormons experience fewer deaths from heart disease.

Previous researchers had assumed that a prohibition on tobacco use among Mormons was the reason, but the current researchers hypothesized that there were additional factors at play.

Indeed, people who reported fasting regularly had a lower risk of developing coronary artery disease. The study adjusted for various factors including resting on the Sabbath, avoiding tea and tobacco, and age and body mass index.

The study did not put a time limit on fasting, but the religious teachings of Mormons do include fasting once a month for about 24 hours.

It could be that self-proclaimed fasters have better control of their diet in general, or fasting may prompt some kind of protective biological mechanism, said Benjamin Horne, senior author of the study, director of cardiovascular and genetic epidemiology at Intermountain Medical Center and adjunct assistant professor of biomedical informatics at the University of Utah in Salt Lake City.

Still, the study has raised more questions than it has answered, including whether to fast at all and for how long, he said. Horne warned that diabetics, in particular, should not start fasting until more is known.

A final study, this one of almost 2,500 individuals, confirmed that moderate alcohol consumption (one to two drinks daily) was associated with a reduced risk of angina one year after having a heart attack, compared to both abstinence or heavy alcohol consumption. Drinking too much (more than four drinks a day) was associated with an increased risk of angina, said researchers from St. Luke’s Hospital in Kansas City.

How does one find the healthiest lifestyle in the midst of all this information?

“We recommend weight loss in a slow and consistent manner rather than a crash course,” said Bonow, who is also Goldberg Distinguished professor at Northwestern University Feinberg School of Medicine, and chief of the division of cardiology at Northwestern Memorial Hospital in Chicago.

Bonow offered what he believes is a quick nutritional checklist for health: “Exercise and paying attention to calories in and out, lots of fruits and vegetables, less saturated fat, milk products should be skim, fried foods are bad, omega-3 fatty acids are good.”

What is Atkins diet?

The Atkins Nutritional Approach, popularly known as the Atkins Diet or just Atkins, is the most marketed and well-known low-carbohydrate diet. It was adapted by Dr. Robert Atkins in the 1960s from a diet he read in the Journal of the American Medical Association and utilized to resolve his own overweight condition following medical school and graduate medical training. After successfully treating over ten thousand patients, he popularized the Atkins diet in a series of books, starting with Dr. Atkins’ Diet Revolution in 1972. In his revised book, Dr. Atkins’ New Diet Revolution, Atkins updated some of his ideas, but remained faithful to the original concepts.

The Atkins franchise, a business formed that provides products to those individuals on the diet, has been highly successful due to the popularity of the diet, and is considered the iconic and driving entity of the larger “low-carb craze”. However, various factors have led to its dwindling success and the company founded by Dr. Atkins in 1989, Atkins Nutritionals of Ronkonkoma, New York, filed for Chapter 11 bankruptcy in July of 2005, two years after the death of Dr. Atkins. The company re-emerged in January 2006, and the Atkins logo is still highly visible through licensed-proprietary branding for food products and related merchandise.

The Atkins Diet represents a departure from prevailing theories. Atkins claimed there are two main unrecognized factors about Western eating habits, arguing firstly that the main cause of obesity is eating refined carbohydrates, particularly sugar, flour, and high-fructose corn syrups; and secondly, that saturated fat is overrated as a nutritional problem, and that only trans fats from sources such as hydrogenated oils need to be avoided. Consequently, Dr. Atkins rejects the advice of the food pyramid, instead asserting that the tremendous increase in refined carbohydrates is responsible for the rise in metabolic disorders of the 20th century, and that the focus on the detrimental effects of dietary fat has actually contributed to the obesity problem by increasing the proportion of insulin-inducing foods in the diet. While most of the emphasis in Atkins is on the diet, nutritional supplements and exercise are considered equally important elements.

Atkins involves the restriction of carbohydrates in order to switch the body’s metabolism from burning glucose to burning stored body fat. This process (called lipolysis) begins when the body enters the state of ketosis as a consequence of running out of excess carbohydrates to burn. Dr. Atkins in his book New Diet Revolution claimed that the low-carb diet produces a “metabolic advantage” where the body burns more calories, overall, than on normal diets, and also expels some unused calories. He cited one study where he estimated this advantage to be 950 calories a day.

Atkins restricts “net carbs”, or carbs that have an effect on blood sugar. Net carbohydrates can be calculated from a food source by subtracting sugar alcohols and fiber (which are shown to have a negligible effect on blood sugar levels) from total carbohydrates. Sugar alcohols need to be treated with caution, because while they may be slower to convert to glucose, they can be a significant source of glycemic load and can stall weight loss. Fructose (eg, as found in many industrial sweeteners) also contributes to caloric intake, though outside of the glucose-insulin control loop.

Preferred foods in all categories are whole, unprocessed foods with a low glycemic load. Atkins Nutritionals, the company responsible for marketing the Atkins Diet, recommends that no more than 20% of calories eaten while on the diet come from saturated fat.

Bad news

When Dr. Atkins Diet Revolution was first published, the President of the American College of Nutrition said, “Of all the bizarre diets that have been proposed in the last 50 years, this is the most dangerous to the public if followed for any length of time.”

When the chief health officer for the State of Maryland, was asked “What’s wrong with the Atkins Diet?” He replied “What’s wrong with… taking an overdose of sleeping pills? You are placing your body in jeopardy.” He continued “Although you can lose weight on these nutritionally unsound diets, you do so at the risk of your health and even your life.”

The Chair of Harvard’s nutrition department went on record before a 1973 U.S. Senate Select Committee investigating fad diets: “The Atkins Diet is nonsense… Any book that recommends unlimited amounts of meat, butter, and eggs, as this one does, in my opinion is dangerous. The author who makes the suggestion is guilty of malpractice.”

The Chair of the American Medical Association’s Council on Food and Nutrition testified before the Senate Subcommittee as to why the AMA felt they had to formally publish an official condemnation of the Atkins Diet: “A careful scientific appraisal was carried out by several council and staff members, aided by outside consultants. It became apparent that the [Atkins] diet as recommended poses a serious threat to health.

The warnings from medical authorities continue to this day. “People need to wake up to the reality,” former U.S. Surgeon General C. Everett Koop writes, that the Atkins Diet is “unhealthy and can be dangerous.”

The world’s largest organization of food and nutrition professionals, calls the Atkins Diet “a nightmare of a diet.” The official spokesperson of the American Dietetic Association elaborated: “The Atkins Diet and its ilk–any eating regimen that encourages gorging on bacon, cream and butter while shunning apples, all in the name of weight loss–are a dietitian’s nightmare.” The ADA has been warning Americans about the potential hazards of the Atkins Diet for almost 30 years now. Atkins dismissed such criticism as “dietician talk”. “My English sheepdog,” Atkins once said, “will figure out nutrition before the dieticians do.”

The problem for Atkins (and his sheepdog), though, is that the National Academy of Sciences, the most prestigious scientific body in the United States, agrees with the AMA and the ADA in opposing the Atkins Diet. So does the American Cancer Society; and the American Heart Association; and the Cleveland Clinic; and Johns Hopkins; and the American Kidney Fund; and the American College of Sports Medicine; and the National Institutes of Health.

In fact there does not seem to be a single major governmental or nonprofit medical, nutrition, or science-based organization in the world that supports the Atkins Diet. As a 2004 medical journal review concluded, the Atkins Diet “runs counter to all the current evidence-based dietary recommendations.”

A 2003 review of Atkins “theories” in the Journal of the American College of Nutrition concluded: “When properly evaluated, the theories and arguments of popular low carbohydrate diet books… rely on poorly controlled, non-peer-reviewed studies, anecdotes and non-science rhetoric. This review illustrates the complexity of nutrition misinformation perpetrated by some popular press diet books. A closer look at the science behind the claims made for [these books] reveals nothing more than a modern twist on an antique food fad.”

“Massive Health Risk”

The downfall of the Atkins Diet is also its one saving grace–people may not be able to tolerate the diet for long enough to suffer the long-term consequences. The American Heart Association states: “Individuals who follow these diets are therefore at risk for compromised vitamin and mineral intake, as well as potential cardiac, renal [kidney], bone, and liver abnormalities overall.” Low carb diets like the Atkins diet may also hasten the onset of type II diabetes. In short, concluded the September 2004 review in The Lancet, “low-carbohydrate diets cannot be recommended.”

In Europe, hospitals have already started banning the Atkins Diet after the British government’s Medical Research Council, backed up by the British Nutrition Foundation and the British Dietetic Association, condemned the Atkins Diet as “negligent” “nonsense and pseudo-science” posing a “massive health risk.”

An article out of the Cleveland Clinic Journal of Medicine entitled “Physician’s Guide to Popular Low Carbohydrate Weight-Loss Diets” noted that the Atkins Diet “can jeopardize health in a variety of ways.” Let us count the ways.

Cancer

Atkins’ followers also risk cancer. Studies at Harvard and elsewhere involving tens of thousands of women and men have shown that regular meat consumption may increase colon cancer risk as much as 300 percent. As one Harvard School of Public health researcher noted, because of the meat content, two years on the Atkins Diet “could initiate a cancer. It could show up as a polyp in 7 years and as colon cancer in ten.” Another Harvard study showed that women with the highest intake of animal fat seem to have over a 75% greater risk of developing breast cancer.

It’s tragically ironic that after McDonalds’ CEO apparently dropped dead of a heart attack in 2004, their new CEO was in the operating room with colo-rectal cancer only 16 days later.

The most comprehensive report on diet and cancer in history was published in 1997. It took over four years to complete, reviewing 4500 studies from thousands of researchers across the globe–a landmark scientific consensus document written by the top cancer researchers in the world. After all that work, what was their number one recommendation? “Choose a diet that is predominantly plant based, rich in a variety of fruits, vegetables, nuts, and beans with minimally processed starchy foods.” In other words, essentially the opposite of the Atkins Diet.

In the January issue of Scientific American it was noted: “Cancer is most frequent among those branches of the human race where carnivorous habits prevail.” That was the January issue in 1892! This is nothing new. What’s the number one recommendation of the American Institute for Cancer Research? Plant based diets. The number one recommendation of the World Cancer Research Fund? Plant-based diets. The number one recommendation of the National Cancer Institute, the World Health Organization and the Food and Agriculture Organization of the United Nations? More fruits and vegetables. The number one recommendation of the American Cancer Society? More plants, less meat. In fact the American Cancer Society has officially condemned diets high in animal grease, concluding that “a low carb diet can be a high-risk option when it comes to health.”

Peeing Your Bones Down the Toilet

A 2003 review of the safety of low carbohydrate diets reeled off an alarming list of potential problems: “Complications such as heart arrhythmias, cardiac contractile function impairment, sudden death, osteoporosis, kidney damage, increased cancer risk, impairment of physical activity and lipid [cholesterol] abnormalities can all be linked to long-term restriction of carbohydrates in the diet.”

There is a particular concern that children who go on the Atkins Diet might suffer permanent physical and mental damage as a result of starving their bodies of critical nutrients. As one U.S. child nutrition specialist explained, “The effect can be to dull the mind, stunt growth, and soften bones…I wouldn’t want to risk it by putting my child on a low carbohydrate diet.”

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