Diet and Weight Loss

Howard LeWine, M.D.

New trial muddies the water about diet, exercise, and diabetes

Howard LeWine, M.D., Chief Medical Editor
Internet Publishing, Harvard Health Publications

Long-awaited results from a nearly 10-year trial exploring the effect of changes in diet and exercise among people with diabetes weren’t what most people expected. The Look AHEAD trial found that intensive efforts to lose weight by eating less and exercising more didn’t provide any more protection against heart disease—a common co-traveler with diabetes—than standard diabetes support and education. The spin from some media reports is that weight loss doesn’t reduce heart disease risk among people with type 2 diabetes, but I think that’s the wrong interpretation. The results of the Look AHEAD trial don’t contradict the value of lifestyle changes. People in the intensive change group improved their blood sugar with fewer drugs, saving an estimated $600 per year, they were also less likely to have developed chronic kidney disease and less self-reported vision problems. The Look AHEAD results reinforce for me that diabetes care needs to be tailored to the individual.

Daniel DeNoon

Cities can learn lessons about diabetes from rural areas

Daniel DeNoon, Executive Editor, Harvard Heart Letter

City dwellers often think of rural America as a throwback to past “good old days.” But when it comes to obesity and diabetes, people living outside urban areas offer a frightening glimpse of the future. While more than 8% of Americans now have diabetes, in some rural counties 20% of the residents have diabetes. Those counties also tend to have high rates of obesity. Barriers to healthy living contribute to both obesity and diabetes. So does lack of primary care physicians. One answer may be greater reliance on community health workers—lay people trained to provide diabetes education and outreach. In Birmingham, Alabama, the Cities for Life program has doctors refer people with diabetes to “patient navigators” who help them find local resources such as nearby exercise classes or mobile farmers’ markets.

Heidi Godman

Move over Mediterranean—a vegetarian diet is equally good for health

Heidi Godman, Executive Editor, Harvard Health Letter

The Mediterranean diet has been getting a lot of press as being the very best for health. But there’s another diet that appears to be equally good: a vegetarian diet. A study published in JAMA Internal Medicine found that people who ate a vegetarian diet were 12% less likely to have died over the course of the five-year study than nonvegetarians. The benefits were especially good for men, who had a significant reduction in heart disease. This study underscores the idea that meat consumption influences long-term health, and not in a good way. Should you consider ditching the Mediterranean diet and becoming a vegetarian instead? Either one is healthier than the typical American diet, so it’s really a matter of personal choice.

Howard LeWine, M.D.

Gov. Christie’s weight-loss surgery: a good idea for health

Howard LeWine, M.D., Chief Medical Editor
Internet Publishing, Harvard Health Publications

New Jersey Governor Chris Christie’s revelation yesterday that he had secretly undergone weight-loss surgery back in February shouldn’t come as a big surprise. He has been publicly (and privately) struggling with his weight for years and fits the profile of a good candidate for this kind of operation. In general, weight-loss surgery is appropriate for people with a body mass index (BMI) of 40 or higher, as well as for those with a BMI of 35 to 39.9 and a severe, treatment-resistant medical condition such as diabetes, heart disease, and sleep apnea, who had tried to lose weight other ways. Christie had a BMI of at least 41. He also acknowledged trying to lose weight many times, using different weight loss programs. He underwent laparoscopic gastric banding, also known as lap banding. There are also two other types of weight-loss surgery, gastric bypass and the gastric sleeve procedure.

Heidi Godman

Extra protein is a decent dietary choice, but don’t overdo it

Heidi Godman, Executive Editor, Harvard Health Letter

Adding more protein to the diet and cutting back on carbohydrates, especially highly processed carbs, is an eating strategy adopted by a growing number of people. A new study in the Journal of Nutrition Education and Behavior found that 43% of women surveyed are using the practice of eating more protein to prevent weight gain, and this strategy was associated with weight loss. It isn’t necessary to eliminate all carbohydrates and focus only on protein. Such an eating strategy may have a short-term payoff for weight loss, but it may also come with some long-term risks. Tips for getting a healthful mix of nutrients include adding the healthful trio of fat, fiber, and protein to each meal; avoiding highly processed foods; and choosing the most healthful sources of protein, such as fish, poultry, eggs, beans, legumes, nuts, tofu, and low-fat or non-fat dairy products.

Daniel DeNoon

Benefit to improving diet and exercise at the same time

Daniel DeNoon, Executive Editor, Harvard Heart Letter

When you decide it’s time to live a healthier lifestyle, you’re likely to get better long-term results if you start improving your diet and increasing physical activity at the same time. It may seem better to improve just one thing at a time.  But while you don’t have to make drastic changes overnight, a new […]

Howard LeWine, M.D.

Distracted eating may add to weight gain

Howard LeWine, M.D., Chief Medical Editor
Internet Publishing, Harvard Health Publications

If you are worried about your weight, paying more attention to what you eat, not less, could help keep you from overeating. Multitasking—like eating while watching television or working—and distracted or hurried eating can prompt you to eat more. Slowing down and savoring your food can help you control your intake. That’s the bottom line from a report published in the April issue of the American Journal of Clinical Nutrition. It offers two key conclusions: 1) Being distracted or not paying attention to a meal tended to make people eat more at that meal. 2) Paying attention to a meal was linked to eating less later on. Mindful eating is a good solution. It can reduce daily calorie intake, help make healthier food choices, and add to the enjoyment of eating.

Anthony Komaroff, M.D.

Many miss prediabetes wake-up call

Anthony Komaroff, M.D., Editor in Chief, Harvard Health Publications

Type 2 diabetes doesn’t usually appear all of a sudden. Many people have a long, slow, invisible lead-in to it called prediabetes. During this period, blood sugar levels are higher than normal. However, they’re not high enough to cause symptoms or to be classified as diabetes. It’s still possible at this stage to prevent the slide into full-blown diabetes. Think of prediabetes as a wake-up call. Unfortunately, few people ever hear the alarm. A new report from the Centers for Disease Control and Prevention shows that among Americans age 20 and older, only 10% of those with prediabetes know they have it. Given that as many as 73 million Americans have prediabetes, that’s a lot of missed opportunities to prevent the ravages of diabetes. One reason many people don’t know that they may be headed toward diabetes is they’ve never had their blood sugar tested. This simple test isn’t part of routine preventive care, but perhaps it should be.

Patrick J. Skerrett

12 tips for holiday eating

Patrick J. Skerrett, Executive Editor, Harvard Health

It’s easy to get swept up in the holiday season. This combination of religious and national celebrations can help keep the cold winter away. But the feasts and parties that mark it can tax the arteries and strain the waistline. By eating just 200 extra calories a day — a piece of pecan pie and a tumbler of eggnog here, a couple latkes and some butter cookies there — you could pack on two to three pounds over this five- to six-week period. That doesn’t sound like much, except few people shed that extra weight in the following months and years. You don’t need to deprive yourself, eat only boring foods, or take your treats with a side order of guilt. Instead, by practicing a bit of defensive eating and cooking, you can come through the holidays without making “go on a diet” one of your New Year’s resolutions.

Heidi Godman

Losing weight and belly fat improves sleep

Heidi Godman, Executive Editor, Harvard Health Letter

Do you have trouble sleeping? If you’re carrying extra pounds, especially around your belly, losing weight and some of that muffin top may help you get better ZZZs. So say researchers from Johns Hopkins University School of Medicine, who presented their findings at this year’s annual meeting of the American Heart Association. In a six-month trial that included 77 overweight volunteers, weight loss through diet plus exercise or diet alone improved sleep. A reduction in belly fat was the best predictor of improved sleep. Among people who are overweight, weight loss can reduce sleep apnea, a nighttime breathing problem that leads to frequent awakenings. Exercise has also been shown to improve sleep quality. Despite what thousands of websites want you to believe, there are no exercises or potions that “melt away” belly fat. Instead, the solution is old-fashioned exercise and a healthy diet.