Diets lead to improved health

In this study, 146 overweight or obese veterans (72% men) were randomly assigned to follow a low-carbohydrate diet (initially less than 20 grams per day) or daily orlistat therapy plus a low-fat (less than 30% of daily energy), reduced-calorie diet. During the 48-week study, both groups attended small group sessions every 2 to 4 weeks where they were counseled about their diet and other nutritional topics. All participants were instructed to exercise at least 30 minutes three times a week. The study examined the effects of each diet on body weight and metabolism. Results showed:

• Weight loss was similar in both groups: an average of about 9.6 kg to 11.4 kg
• Participants who attended 80% or more of the group counselling sessions lost considerably more weight than those who attended less, regardless of the diet they followed
• The low-carb diet had a more beneficial effect on blood pressure compared with the orlistat therapy plus low-fat, reduced calorie diet
• HDL (“good”) cholesterol and triglyceride levels improved in both groups
• LDL (“bad”) cholesterol improved within the orlistat-plus-low-fat, reduced-calorie diet
• A number of adverse side effects were reported by both groups including gastroinstestinal disturbances such as increased wind, constipation, and diarrhoea

Optimize weight through a healthy lifestyle

If you need to lose weight or maintain weight loss, here are some important tips:

• Talk with a doctor. Being overweight increases a person’s risk of a number of medical conditions such as type 2 diabetes, high blood pressure, and high cholesterol. If you are overweight, talk with a knowledgeable doctor to come up with a good programme for you, and work with a nutritionist who can educate you about what to eat and help you stay motivated and on track for a healthy weight. As this study showed, people who attended more dietary counselling sessions lost greater amounts of weight than those who attended less.
• Identify triggers that lead to cravings or overeating. It is important to ask yourself questions such as “Why do I choose foods that are not healthy for me?” and “What feelings or circumstances lead me to crave unhealthy foods or to overeat?” Answering such questions can help you learn how to manage the cravings and feelings that lead to overeating, and help you plan ahead with healthier alternatives in situations where you might normally make unhealthy choices.
• Choose the right foods. You know the recommendations by now, but have you taken specific steps to improve your diet? The body needs an abundance of fruits and vegetables—at least 5 servings every day—and a source of protein every day in order to optimize health and prevent disease. Eating foods high in sugar increases cravings, so reach for low-sugar, low-fat, nutrient-dense foods when eating regular meals and when snacking.
• Plan ahead. Sit down and plan your meals for the week. Try grocery shopping on a Sunday in order to stock the refrigerator with healthy foods to get you through the week. Don’t bring high-sugar, high-fat foods into the house, which may increase the temptation for overeating, but keep looking for healthy foods that you really enjoy so you have options if a snack attack hits.
• Exercise regularly. Guidelines recommend 60 minutes of exercise every day for healthy adults and 90 minutes for children. Exercise helps reduce cravings and overeating and also improves risk factors for chronic disease such as high blood pressure, glucose and cholesterol levels. If the optimal amount is too overwhelming either because of your schedule or fitness level, remember that everything helps. Get the all-clear from your doctor, and then start slowly and build over time. As your fitness improves, you will naturally enjoy longer exercise sessions, rather than slogging through. Exercise buddies and cross-training are also good tricks for keeping yourself going.

(Arch Intern Med 2010;170:136–45.)