Diet and Weight Loss

Howard LeWine, M.D.

Surprises from science

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

Many medical studies confirm what we know or suspect. Every once in a while, though, one surprises us, turning “conventional wisdom” on its head. That just happened with the sudden shutdown of a long-running diabetes trial called Look AHEAD (Action for Health in Diabetes). Begun in 2001 and scheduled to last another two years, Look AHEAD was designed to see if an intensive diet and weight loss program could reduce the number of heart attacks, strokes, and other cardiovascular problems in people with type 2 diabetes. An early peek at the data showed that the program had little apparent effect, and the investigators concluded it would be futile to continue. This does not mean that we should ignore diet and exercise in treating of type 2 diabetes. Instead, the details of the study results, which haven’t yet been published, are likely to reveal other explanations.

Howard LeWine, M.D.

Diabetes can strike—hard—even when weight is normal

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

We tend to think of type 2 diabetes as a disease that afflicts people who are overweight. But it can also appear in people with perfectly healthy weights—and be more deadly in them. A study published in the Journal of the American Medical Association indicates that normal-weight people diagnosed with type 2 diabetes have double the risk of dying from heart disease and other causes than overweight people with diabetes. Such apparent “protection” by excess weight has been called the obesity paradox. It’s been seen with other conditions, like heart failure and end-stage kidney disease. That doesn’t mean gaining weight is a healthy strategy. Instead, it probably means that something else besides weight—like the amount of fat around the waist—may be contributing to the onset and severity of type 2 diabetes. These new findings underscore the importance of strength training for everyone, no matter what their weight.

Trade sports drinks for water

Patrick J. Skerrett, Former Executive Editor, Harvard Health

Nicely timed for the 2012 Olympic Games in London, the British Medical Journal (BMJ) has published several articles revealing the “truth about sports drinks.” That truth is this: drink when you are thirsty and don’t waste your money or calories on sports drinks—choose water instead. Before the rise of sports drinks, athletes (and the rest of us) drank water when we exercised or got sweaty. How did we know when to drink, or how much? The way humans have known for eons—thirst. But as the BMJ team describes, sports drink makers spent a lot of money sponsoring less-than-rigorous research damning thirst as a guide to hydration and casting doubt on water as the beverage for staying hydrated. The bottom line is that thirst remains an excellent gauge of hydration, and plain old water is still the best way to replace lost fluid.

Artificial sweeteners: sugar-free, but at what cost?

Holly Strawbridge, Former Editor, Harvard Health

By offering the taste of sweetness without any calories, artificial sweeteners seem like they could be one answer to effective weight loss. The American Heart Association (AHA) and American Diabetes Association (ADA) have given a cautious nod to the use of artificial sweeteners in place of sugar to combat obesity, metabolic syndrome, and diabetes, all risk factors for heart disease. As with everything, there’s more to the artificial sweetener story than their effect on weight. One concern is that people who use artificial sweeteners may replace the lost calories through other sources, possibly offsetting weight loss or health benefits. It’s also possible that these products change the way we taste food. Research also suggests they may prevent us from associating sweetness with caloric intake. In addition, the long-term effects of artificial sweeteners on health have not been fully determined.

Heidi Godman

Don’t gauge exercise benefits on weight loss alone

Heidi Godman, Executive Editor, Harvard Health Letter

If you start an exercise program, it only seems fair that you should see your hard work reflected in lower numbers on the scale. If it isn’t, don’t despair—or quit exercising. You are still helping your heart, lungs, and every other part of your body. A study in the Journal of the American College of Cardiology looked at the effects of exercise and/or weight loss on cardiovascular health among more than 3,000 men and women who were initially overweight. As I write in the July issue of the Harvard Health Letter, those who exercised consistently and lost weight had the biggest reduction in heart attack risk over six years of follow-up. Exercising without losing weight and losing weight without exercising offered smaller benefits. Although exercise and weight don’t always move in the same direction, they are both important for health.

Howard LeWine, M.D.

Alcohol abuse linked to weight-loss surgery

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

For people who are obese, the operation known as gastric bypass surgery has been hailed as something of a miracle. In addition to rapid weight loss, it can reverse diabetes and reduce the risk of heart disease. A new study reveals potential darker side—an increase in alcohol abuse. In a presentation at yesterday’s annual meeting of the American Society for Metabolic and Bariatric Surgery, researchers reported that almost 11% of nearly 2,000 men and women who underwent gastric bypass surgery (the most common type of obesity surgery) got in trouble with drinking by the second year after surgery. About 7% drank too much before the operation, representing a 50% increase. This finding shouldn’t steer people who could benefit from gastric bypass surgery away from the procedure. But it should prompt them—and their doctors—to be on the lookout for changes in alcohol use or abuse afterward.

Daniel Pendick

6 healthy protein choices when cutting back on red meat

Red meat hasn’t been getting very good press lately. Meat-heavy diets have been linked to increased risks of developing heart disease, diabetes, and some cancers. New findings from two long-term studies now indicate that eating lots of meat, especially processed meat, may also shorten your life. The new research involved nearly 125,000 female nurses and male health professionals, whose diet and health have been followed by Harvard School of Public Health researchers for more than two decades. Compared to eating less than one serving a day of red meat, adding one daily serving increased the chances of dying during the study period by 13%. (A serving is three ounces, about the size of a deck of cards). Red meat meant beef, pork, lamb, and hamburger. For every extra serving of processed meat (foods like hot dogs, bacon, and cold cuts), the increase was 20%.

Heidi Godman

Natural “exercise” hormone transforms fat cells

Heidi Godman, Executive Editor, Harvard Health Letter

Exercise makes cells burn extra energy—that’s one way it helps control weight. It also generates a newly discovered hormone, called irisin, that transforms energy-storing white fat cells into energy-burning brown fat cells. Irisin also appears to help prevent or overcome cellular changes that lead to type 2 diabetes. The hormone does this by helping transform energy-storing white fat cells into energy-burning brown fat cells. White adipose tissue, more commonly known as body fat, is the tissue that dimples thighs, enlarges waists and derrieres, and pads internal organs. Each white fat cell stores a large droplet of fat. Brown fat, in comparison, is chock full of energy-burning mitochondria. Its main function is to generate body heat by burning fat. A team led by Dr. Bruce Spiegelman, professor of cell biology and medicine at Harvard Medical School, has identified irisin in mice and humans and showed how irisin transforms white fat cells into brown ones, at least in mice.

Heidi Godman

Eating for pleasure easier to overdo than eating when hungry

Heidi Godman, Executive Editor, Harvard Health Letter

When you polish off a piece of chocolate cake and immediately start thinking about having another, you might suspect that eating for pleasure may trigger overeating. A new study out of Italy, where they know a thing or two about good food, supports this notion. Researchers from Naples and Salerno found that eating for enjoyment […]

Anthony Komaroff, M.D.

Are artificial sweeteners a healthy substitute for sugar?

Anthony Komaroff, M.D., Executive Editor, Harvard Health Letter

Although short-term studies suggest that switching from sugar to calorie-free sweeteners can help people lose weight, the December 2011 Harvard Health Letter explores the possibility that it may actually promote weight gain. Use of super-sweet artificial sweeteners may desensitize users to sweetness. Healthful foods like fruits and vegetables may become unappetizing by comparison. As a result, the overall quality of the diet may decline. The calories removed from the diet by the sugar-for-sweetener swap may sneak back in, in the form of refined carbohydrates and low-quality fats. Another concern is that artificial sweeteners could cause weight gain by directly stimulating the development of new fat cells.