Diet & Weight Loss Archive

The type and amount of fat, carbohydrate, sugar, and salt in our food supply has changed over the years — for better and for worse.

Remember when packaged foods emblazoned with the words "fat free" seemed to be everywhere? Then came labels boasting "zero grams of trans fat." "Sugar free" and "low sodium" claims soon joined the chorus. These days, gluten-free foods are all the rage.

For the most part, these food industry trends echoed the nutritional mantras of the time and were designed to improve our health — especially cardiovascular health. Not only is heart disease the nation's leading killer, there's overwhelming evidence that better dietary choices could prevent many heart attacks and strokes. But just how successful have these efforts been?

A Netflix original movie about a young woman’s struggle with anorexia nervosa is raising questions among parents about whether the movie might glamorize the disorder, and how best to talk to children about this topic.

News briefs

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Unless you have celiac disease, banning gluten from your diet won't boost your heart health—and may actually hurt it, suggests an observational study published May 2, 2017, in The BMJ. Gluten is a protein in wheat, barley, and rye. In people with celiac disease, eating gluten triggers the body to attack the small intestine, causing inflammation and leading to malnutrition and gastrointestinal distress. The inflammation, in turn, can increase heart disease risk. In these people, eliminating gluten stops the attack on the small intestine, reduces inflammation, and helps reduce heart disease risk.

A Harvard research team wondered whether people without celiac disease might also lower their heart disease risk by eliminating gluten from their diets. In a study of more than 110,000 healthy men and women followed for about 25 years, the researchers did not find a clear difference in the number of heart attacks that occurred among people who ate the most gluten each day, compared with people who ate the least. However, in people who avoided gluten by avoiding whole grains — which contain valuable nutrients — the risk of heart disease rose. So, if you're among the great majority of people who don't have celiac disease, avoiding gluten won't reduce your risk of heart disease, and it might increase the risk if it means you cut back on whole grains.

Research we're watching

While obesity presents a number of health risks for older adults, weight loss is often accompanied by a reduction in muscle tissue and loss of strength. A team led by researchers at Baylor College of Medicine set out to determine whether more exercise or specific types of exercise would help preserve muscle during weight loss.

The researchers randomly assigned 103 obese women and 57 obese men over age 65 to one of four groups. Three groups participated in a reduced-calorie diet plus one of three exercise programs — aerobic training, resistance training, or combined aerobic and resistance training — while the fourth, a control group, only received information on healthful eating.

Stomach balloons and other devices may help people eat (or absorb) less food. But does the weight loss last?

For the millions of Americans who have obesity, the burden of excess weight is much more than meets the eye. This chronic, debilitating condition leaves people prone to many serious illnesses, including heart disease. But for many, diet and exercise often prove frustratingly futile (see "What's a healthy weight?")

Research we're watching

Previous studies have suggested that being somewhat overweight or even slightly obese may not be associated with a shortened life span. Some studies have suggested that being a bit overweight might even be healthier than being at normal weight. This has been referred to as the "obesity paradox."

A recent analysis of data from the Nurses' Health Studies I and II and the Health Professionals Follow-up Study has helped bring clarity to this paradox. Researchers from the Harvard T.H. Chan School of Public Health and Boston University School of Public Health assessed the maximum body mass index (BMI) over 16 years for more than 190,000 postmenopausal women and 35,000 senior men. They then tracked who died over a follow-up period averaging 12 years. They found that people with a maximum BMI in the normal range (18.5 to 24.9 kg/m2) throughout life had the lowest risk of death. Those whose highest recorded BMI fell into the overweight or obese category were at elevated risk of dying from any cause, as well as dying specifically from cardiovascular disease, cancer, or respiratory disease, during the follow-up period.

Those extra inches around the middle may signal increased fat around abdominal organs and rising health risks.

It's a rare woman over age 50 who has the same waist measurement she had as a teenager. But in the past decade or so, women's waistlines have been expanding regardless of age. A 2014 report from the National Health and Nutrition Examination Survey found that from 1999 to 2012, the average body mass index (BMI) for women age 20 or older held steady. But during the same period, the average female waistline grew slowly and steadily, from 36.2 inches to 37.8 inches. Researchers are still searching for an explanation for this phenomenon, but they do know one thing: increasing waistlines are linked to greater risks for heart disease, diabetes, and osteoporosis.

What's in a waistline?

Regardless of whether your weight has changed over the years, your height is likely to have decreased, the result of declining volume in the intervertebral discs of the spine. As your torso shortens, your abdominal organs have less vertical space to inhabit, so they move horizontally. If you haven't gained weight, an increase of an inch or two around the waist may simply reflect lost height.

Ask the doctor

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Q. To lose weight, should I focus more on my calorie count or the amount of time I spend exercising?

A. It is very, very hard to lose weight without both watching your calories and regularly exercising. But it's not that simple. For years, doctors (including me) told patients: "You've got to burn off more calories through exercise than the calories that you eat. If you do that, you'll maintain a healthy weight." We even implied that not being able to maintain a healthy weight, since it was so simple, reflected a weakness of character.

News briefs

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Carrying around extra weight is a known risk factor for developing some cancers. But exactly which kinds of cancer are associated with obesity is debated. A study published Feb. 28, 2017, in The BMJ aimed to narrow it down. European researchers combed through about 100 large reviews of observational studies that looked for links between being overweight and getting cancer.

Out of 36 kinds of cancer evaluated, the researchers found strong evidence for a link to obesity for 11—in the colon, rectum, biliary tract (liver and gallbladder), pancreas, breast, endometrium (uterine lining), ovary, kidney, and the gastric cardia (the junction of the esophagus and stomach); a certain type of esophageal cancer (adenocarcinoma); and one type of bone marrow cancer (multiple myeloma). The researchers said there may be links between obesity and other cancers, but so far the evidence is relatively weak.

For people with diabetes, eating out — whether at a restaurant, a social function, or a friend's home — can be a challenge. Portions can be hefty and packed with calories and saturated fat. When you eat out, it may help to follow these simple guidelines:

• Ask how entrées are prepared, and avoid fried foods or dishes served in heavy sauces or gravies.
• Choose skinless chicken, fish, or lean meat that's broiled, poached, baked, or grilled.
• Get the server's advice to help you select healthy, low-fat dishes. Restaurants are used to dealing with special diets.
• Don't feel obliged to clean your plate. Eat a reasonable portion, and take the remainder home.
• Choose steamed vegetables and salads to accompany your meals. Request low-calorie dressings and toppings, and if they're not available, ask for all dressings, butter, and sauces to be served on the side so you can use them sparingly.
• If you take insulin and you know your meal will be delayed, time your injection appropriately. You may need to eat a roll or piece of fruit to tide you over.
• If you're craving dessert, have some — but split it with someone else.

For more information on the essentials for a healthy diet and managing type 2 diabetes, buy Healthy Eating for Type 2 Diabetes, a Special Health Report from Harvard Medical School.