News to EmPower You!

We are starting a feature series that will highlight news that can truly EmPower you to a healthier life. Science is moving ahead at an incredible pace--the challenge is keeping up without feeling overwhelmed and being able to look at what can be personally helpful. So what has hit the presses recently?

“Active Lifestyle Appears as Beneficial as Structured Exercise”

(American Journal of Health Promotion, 2013;27:143-51)

Exercise, exercise, exercise! We have all heard this advice, that physical activity keeps us healthy, helps manage chronic conditions such as diabetes, helps prevent heart disease. But just what type of exercise is the best, or how much should one do, for how long? Surprisingly, scientific data to answer these questions is sparse! A recent study by Loprinzi and Cardinal suggests that short and small amounts of physical activity that add up to 30 minutes per day may be just as beneficial as a more defined or structured physical workout. Using data from the NHANES (National Health and Nutrition Examination Survey) 2003-2006, the researchers looked at results including 6,321 people, ages 18-65 years. The researchers defined a “bout” as 10 minutes of activity or more and a “non-bout” as less than 10 minutes of activity. “Non-bout” included activities such as walking or pacing while speaking on the phone, or taking the stairs rather than the elevator. Analysis of results based on NHANES data and a questionnaire on current health status showed that an accumulation of “non-bout” short bursts of physical activity totaling 30 minutes daily can be as beneficial as “bouts” or structured activity, with respect to health.

So what can you do to get those 30 minutes accumulated?

  • Take the stairs, skip the elevator
  • Dance while you talk on the phone
  • Stand and march in place while you check e-mails
  • Get up at each commercial break while watching TV, then bend over and try to touch your toes, stand and repeat, until the commercial break finishes
  • Pack your groceries to just half full in bags, then just take in two bags at a time,

It all adds up!

“Myths, Presumptions, and Facts About Obesity”

(New England Journal of Medicine 2013;368:446-54)

Myths are what we believe and have no facts to support the beliefs. Presumptions are what we assume, with no facts to support. And facts, well, facts--at least in science--have some backing. This article on myths, presumptions and facts about obesity focused on whether we really know what we think we know.

The seven myths reviewed included that small but persistent lifestyle changes will, over time, result in large, long-term weight loss; that setting small goals for weight loss is more successful than setting large goals; that rapid, large weight loss is more likely to be associated with weight being regained; that a sense of feeling ready to lose weight is associated with better success at weight loss; that participation in physical education as is currently available in schools will prevent weight gain in childhood; that breast feeding prevents obesity; and that sexual activity can burn a significant amount of calories.

Surprised? The authors note that with weight loss, the energy requirements of the body change, so continued lifestyle changes are required to adapt to the changing energy requirements with weight loss. In setting goals of weight loss, actually there are studies that suggest that more ambitious weight loss goals may actually be linked to better success at weight loss! Looking at comparisons of rates of weight loss, there have been no differences noted with regard to keeping weight off, whether the loss has been fast or slow. Diet readiness might seem like a “no brainer”- losing weight should be more likely to occur if we feel ready to lose weight, but this does not seem to make a difference. The authors state that the explanation might just be that people who start a weight loss program are, by definition, ready. Physical education classes do not prevent childhood obesity, at least as currently provided in schools. Breast feeding does not act as a prevention of childhood obesity. And finally, sexual activity, although calorie burning, is not a significant calorie-burning activity. The example given is that a 154-pound man might burn the same amount of calories per minute in sexual activity as he would walking a moderate pace-2.5 miles per hour. Left to the reader is preference of activity!

Presumptions noted in the article include that eating breakfast is protective against obesity-not supported by the two studies reviewed, which showed no effect, whether breakfast is eaten or not. However, one of these studies might have been biased by assigning people to either the breakfast eaters or non-eaters group by whether they already ate or did not eat breakfast-not a true random set-up that, by definition, is needed for a study to be considered a good study. Additionally, there is no data to support that what we learn in early childhood as to habits of exercise and eating cannot be changed as we age. And while fruits and vegetables are recognized as being part of a healthy diet, they do not by themselves protect against weight gain. We have all heard about “yo-yo” dieting, but it is not at all clear that this is bad. Although there are reports linking this weight variation with higher risk of death, it has been difficult to separate the dieting from other health conditions present. So, is it the diet or illness?

And surprisingly, no study has clearly shown that snacking is an automatic way to gain weight. Finally, does having ready access to parks in the neighborhood guarantee less obesity? Certainly not, if they are there but not used!

Discouraged? Do not know what to believe or not believe? Has science failed us in providing any solid information about weight management and, more specifically, about weight loss? The authors do come through with helpful information!

The authors review studies that suggest changing one’s lifestyle can make a big difference and weight loss can be achieved-we are not prisoners of our genetic makeup. Reducing food intake and increasing physical activity works! Physical activity in particular is needed, and to lose weight, a substantial amount of it, beyond just that for good health maintenance. Obesity needs to be accepted as a chronic condition needing ongoing attention, just as does having a chronic condition such as high blood pressure or diabetes. For children who are overweight, not just school or out-of-home places need to be supportive of and emphasize how to develop a healthier lifestyle, but support in the home and active involvement in the home is critical to success in weight loss and weight management. Finally, pre-prepared meals, meal replacements, weight loss drugs and weight loss surgery are options that can and do work in helping to lose and maintain weight loss. They are not for everyone. There are costs and potential side effects to consider.

So what should you take away from this article, if you want to lose weight?

  • Be aware of how many calories you eat (and eat less if you want to lose weight)
  • Increase physical activity to use up those calories (and be even more active, if you want to lose weight)
  • Be aware that achieving and then maintaining weight loss will be an ongoing challenge (but one that you can win!)