DIET AND EXERCISE STRATEGIES FOR WEIGHT LOSS AND WEIGHT MAINTENANCE

Size: px
Start display at page:

Download "DIET AND EXERCISE STRATEGIES FOR WEIGHT LOSS AND WEIGHT MAINTENANCE"

Transcription

1 DIET AND EXERCISE STRATEGIES FOR WEIGHT LOSS AND WEIGHT MAINTENANCE 40 yo woman, BMI 36. Motivated to begin diet therapy. Which of the following is contraindicated: Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine Declaration of full disclosure: No conflict of interest 1. Meal replacement, very low calorie diet 2 Atkins diet 3 Ornish diet 4. Zone diet 5. All are contraindicated 6. None are contraindicated COMPARISON OF ATKINS, ORNISH, WEIGHT WATCHERS, AND ZONE 160 patients, randomly assigned Intention to treat at 1 year Atkins Ornish WW Zone Wt Loss (kg) Completers (%) Completers at 1 year Atkins Ornish WW Zone Wt Loss (kg) COMPARISON OF ATKINS, ORNISH, WEIGHT WATCHERS, AND ZONE Weight loss associated with adherence, but not diet type Each group: 25% lost 5%, 10% lost 10% of initial weight Each diet reduced LDL/HDL by 10% No significant effects on BP or glucose CRP and insulin reductions associated with weight loss, but not diet Dansinger, JAMA 2005 Dansinger, JAMA,

2 META ANALYSIS OF LOW CARB STUDIES 5 studies, 447 subjects 6 months 12 months Favors low-carb Wt Loss (kg) -3.3* -1.0 Yes LDL-C (mg/dl) 8.9* 10.1* No HDL-C (mg/dl) 4.6* 3.1 Yes Triglycerides mg/dl -22.1* -31.0* Yes SBP (mm Hg) Yes DBP (mm Hg) Yes Yellow = favors low carb * p < 0.5 Nordmann, Arch Int Med 2006 COMPARISON OF ATKINS, ZONE, ORNISH, AND LEARN 311 patients, randomly assigned Intention to treat at 1 year Atkins Zone LEARN Ornish Wt Loss (kg) 4.7 * LDL-C (mg/dl) HDL-C (mg/dl) 4.9* Glucose (mg/dl) SBP (mm Hg) -7.6* DBP (mm Hg) -4.4* * p < 0.5 Gardner, JAMA 2007 Heterogeneity of Response to Weight Loss Diets: Insulin Resistance Insulin sensitive: low carb and high carb both effective for weight loss Insulin resistant: low carb more effective COMPARISON OF DIETS WITH DIFFERENT MACRONUTRIENTS RCT of 811 patients, 4 diets: fat/protein/carbs 20/15/65; 20/25/55; 40/15/45; 40/25/35 6 months: 6kg, 7% weight; at 2 years: completers lost 4kg; 15% lost 10% of weight Results similar for: 15% pro v. 25% pro 20% fat v. 40% fat 35% carbs v. 65% carbs Attendance highly correlated with weight loss; satiety, hunger, attendance, lipids, insulin all equal Sacks, NEJM,

3 Which Diet Works Best? Low-fat, Low-carb or Mediterranean 322 moderately obese subjects (40-65 y) randomized to 1 of 3 diets for 2 years Low-carb (Atkins) - no calorie restriction Low fat cal/day Mediterranean cal/day Workplace-based study in Israel Self-service cafeteria with labeled food Many resources (18 dietician sessions) High adherence: 95% at 1 y; 85% at 2 y Shai et al. NEJM 2008 Which Diet Works Best? Low-fat, Low-carb or Mediterranean Greatest weight lost with lowcarb and Mediterranean Greatest reduction in lipids with low-carb Best glycemic control with Mediterranean Shai I et al. NEJM 2008;359: yo woman, BMI 36. Motivated to begin diet therapy. Which of the following is contraindicated: 1. Meal replacement, very low calorie diet 2 Atkins diet 3 Ornish diet 4. Zone diet 5. All are contraindicated 6. None are contraindicated 3

4 VLCD s vs LCD s: Meta-analysis of 6 RCTs Trials with direct comparisons Short-term: mean 12.7 weeks Long-term: mean 1.9 years Weight loss (as % of initial weight): short-term long-term LCDs VLCDs (p) (0.001) (0.2) 40 yo woman, BMI 33. Which abnormality best predicts her 10 year mortality? 1. Waist circumference: 36 inches 2 Fasting blood sugar: 110 mg/dl 3 Systolic BP: 140 mm Hg 4. Triglycerides: 185 mg/dl 5. Exercise test: early stage 2 (fatigue) Tsai and Wadden, Obesity, 2006 FITNESS AND MORTALITY Aerobics Center Longitudinal Study 25,714 men, 44 years old, 14 year observational study CV death (RR) normal overweight obese Fit Not fit Total death (RR) normal overweight obese Fit Not fit Wei, JAMA 1999 Relative Risk* of Death According to Body Mass and Physical Activity Multivariate relative risk of death Physical activity level > 3.5 hours/week hours/week < 1 hour/week ** < > 30 Body mass index (BMI) * RR s adjusted for age, smoking status, family history, menopausal status, hormone use, and other factors ** Reference group = women with 3.5 or > hours/week of physical activity and BMI of 25 or less Hu FB, et al. N Engl J Med 2004;351:

5 40 yo woman, BMI 33. Which abnormality best predicts 10 year all cause mortality? 1. Waist circumference: 36 inches 2 Fasting blood sugar: Systolic BP: Triglycerides: Exercise test: early stage 2 (fatigue) 60% US adults don t exercise regularly 25% are sedentary Epidemic of Inactivity EXERCISE FOR OBESITY Meta-analysis of 43 RCTs: 3476 participants Exercise vs no Rx small weight losses Exercise plus diet vs diet alone -1.1 kg Increased intensity of exercise -1.5 kg Exercise without weight loss -BP, -TG, -FBS Benefits of Physical Activity Increases cardio-respiratory fitness Decreases risk of chronic diseases Heart disease, high blood pressure, diabetes, some cancers, osteoporosis Promotes psychological well-being Improves functional independence Decreases abdominal fat Improves cognition, dementia Reduces mortality Shaw, Cochrane,

6 40 yo woman, BMI 36. Much to your surprise (and satisfaction), she has lost 35 pounds. In order to maintain her new weight, her lifelong daily calorie intake should be: kcals kcals kcals kcals kcals SUCCESSFUL WEIGHT LOSS MAINTENANCE 3000 subjects in National Weight Control Registry: 30-lb weight loss for 1-year Average weight loss 33 kg (10 BMI units less), average weight maintenance 5.5 years 45 years old, 80% women, 97% Caucasian 46% overweight as child, 46% one parent obese, 27% both parents Wing, Am J Clin Nutr, 2005 SUCCESSFUL WEIGHT LOSS MAINTENANCE High levels of physical activity Women 2545 kcal/week, men 3293 kcal/week (1-hour moderate intensity per day Only 9% report no physical activity Diet low in fat, high in carbohydrate 1381 kcal day, 24% fat, 19% protein, 56% CHO 4.87 meals or snacks/day Fast food 0.74/week Regular self-monitoring of weight 44% weigh once per day; 31% once per week META ANALYSIS OF WEIGHT LOSS MAINTENANCE: 42 RCTs Medications and diet modification (especially after VLCD) Lower fat diets Continued contact Problem-solving therapy Increased caffeine intake Acupressure Wing, Am J Clin Nutr, 2005 Turk, J Cardiovasc Nursing

7 Why It s Hard to Lose/Maintain Weight as We Age We lose 0.33% muscle mass/year starting in our mid-20 s, which results in a 5% decline/decade in resting metabolic rate This reduces # of calories needed to maintain our weight Age 20: 2000 calories/day Age 30: 1900 calories/day Age 40: 1805 calories/day When we lose weight, we need fewer calories Most adults become > sedentary as they age 40 yo woman, BMI 36. Much to your surprise, she has lost 35 pounds. In order to maintain her new weight, her lifelong daily calorie intake should be: kcals kcals kcals kcals kcals Outcomes of Obesity Treatment in Activated Patients Pharmacotherapy: 4-5% Commercial programs (Jenny Craig, Weight Watchers): 5-7% Intensive programs in AMCs: 7-10% Medically supervised programs (Optifast, HMR): 15-25% (but not all sustained) GOALS OF MANAGEMENT Be as fit as possible at current weight Prevent further weight gain If successful at 1 and 2, begin weight loss Surgery: 15% (banding) - 25% (bypass) Tsai, JGIM,

8 The Magic Formula 8

Robert B. Baron MD MS

Robert B. Baron MD MS 40 yo woman, BMI 36. Motivated to begin diet therapy. Which of the following is contraindicated: DIET AND EXERCISE STRATEGIES FOR WEIGHT LOSS AND WEIGHT Robert B. Baron MD MS Professor and Associate Dean

More information

MANAGEMENT OF OBESITY: A SYSTEMATIC APPROACH

MANAGEMENT OF OBESITY: A SYSTEMATIC APPROACH MANAGEMENT OF OBESITY: A SYSTEMATIC APPROACH Robert B. Baron MD MS Professor of Medicine Associate Dean for GME and CME Director, UCSF Weight Management Program You are serving as a delegate at the AMA

More information

Review of common weight loss diets. September 15, 2016 Karmella Thomas, RDN, LD,CDE

Review of common weight loss diets. September 15, 2016 Karmella Thomas, RDN, LD,CDE Review of common weight loss diets September 15, 2016 Karmella Thomas, RDN, LD,CDE Development of Obesity Obesity can develop only from an excess of energy intake over expenditure.» N Engl J Med 1997;337:396-407

More information

Disclosure 2/13/ Things to Know About Managing Obesity in Clinical Practice. relation to this program/presentation.

Disclosure 2/13/ Things to Know About Managing Obesity in Clinical Practice. relation to this program/presentation. 5 Things to Know About Managing Obesity in Clinical Practice Taraneh Soleymani, MD, FTOS Assistant Professor Department of Nutrition Sciences University of Alabama at Birmingham soltar@uab.edu Disclosure

More information

Popular Weight Loss Diets: From Evidence to Practice No conflicts of interest or disclosures

Popular Weight Loss Diets: From Evidence to Practice No conflicts of interest or disclosures Popular Weight Loss Diets: From Evidence to Practice No conflicts of interest or disclosures Vasanti Malik, ScD Research Scientist Department of Nutrition Harvard School of Public Health Cardiovascular

More information

Case Presentation 33 yo AAF with BMI 40 No other medical problems Family history of heart disease Wants advice on losing weight Low carb diets?

Case Presentation 33 yo AAF with BMI 40 No other medical problems Family history of heart disease Wants advice on losing weight Low carb diets? Low Carb Diets Gretchen Shaughnessy, MD PGY 3 Case Presentation 33 yo AAF with BMI 40 No other medical problems Family history of heart disease Wants advice on losing weight Low carb diets? Background

More information

COMPARISON OF COMP WEIGHT-LOSS DIETS Wednesday Ambulatory Conference Liz Thomas, MD March 11, 2009

COMPARISON OF COMP WEIGHT-LOSS DIETS Wednesday Ambulatory Conference Liz Thomas, MD March 11, 2009 COMPARISON OF WEIGHT-LOSS DIETS Wednesday Ambulatory Conference Liz Thomas, MD March 11, 2009 Case Scenario You are seeing gyour patient as a routine follow up visit in your clinic. She is a 45 yo female

More information

Clinical Research on Lifestyle Interventions to Treat Obesity and Asthma in Primary Care Jun Ma, M.D., Ph.D.

Clinical Research on Lifestyle Interventions to Treat Obesity and Asthma in Primary Care Jun Ma, M.D., Ph.D. Clinical Research on Lifestyle Interventions to Treat Obesity and Asthma in Primary Care Jun Ma, M.D., Ph.D. Associate Investigator Palo Alto Medical Foundation Research Institute Consulting Assistant

More information

Metabolic Syndrome: Veronica Piziak MD, PhD Professor of Medicine Texas A&M HSC

Metabolic Syndrome: Veronica Piziak MD, PhD Professor of Medicine Texas A&M HSC Metabolic Syndrome: Veronica Piziak MD, PhD Professor of Medicine Texas A&M HSC Objectives: Medical Implications of Metabolic Syndrome Diagnosis and Therapy of Metabolic Syndrome Disclosures:None AHA/NHLBI

More information

Screening and Treatment of Adolescents to Prevent Adult Cardiovascular Disease

Screening and Treatment of Adolescents to Prevent Adult Cardiovascular Disease Screening and Treatment of Adolescents to Prevent Adult Cardiovascular Disease Marc S. Jacobson MD Director, Center for Atherosclerosis Prevention Schneider Children s s Hospital Professor of Pediatrics,

More information

MANAGEMENT OF LIPID DISORDERS: IMPLICATIONS OF THE NEW GUIDELINES

MANAGEMENT OF LIPID DISORDERS: IMPLICATIONS OF THE NEW GUIDELINES MANAGEMENT OF LIPID DISORDERS: IMPLICATIONS OF THE NEW GUIDELINES Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine Declaration of full disclosure: No conflict of interest EXPLAINING

More information

Dietary Composition for Weight Loss and Weight Loss Maintenance

Dietary Composition for Weight Loss and Weight Loss Maintenance Dietary Composition for Weight Loss and Weight Loss Maintenance Bridget M. Hron, MD Instructor in Pediatrics, Harvard Medical School Staff Physician in Gastroenterology & Nutrition and New Balance Foundation

More information

Obesity and Metabolic Syndrome

Obesity and Metabolic Syndrome Obesity and Metabolic Syndrome Obesity Increasing rates of obesity in developed countries Increasing rates of sedentary behavior Adverse effects on quality of life Limits mobility, impairing physical capacity

More information

Body Composition & Longevity. Ohan Karatoprak, MD, AAFP Clinical Assistant Professor, UMDNJ

Body Composition & Longevity. Ohan Karatoprak, MD, AAFP Clinical Assistant Professor, UMDNJ Body Composition & Longevity Ohan Karatoprak, MD, AAFP Clinical Assistant Professor, UMDNJ LONGEVITY Genetic 25% Environmental Lifestyle Stress 75% BMI >30 OBESE 25-30 OVERWEIGHT 18-25 NORMAL WEIGHT 18

More information

Cholesterol - New Guidelines and Treatment Protocols

Cholesterol - New Guidelines and Treatment Protocols Cholesterol - New Guidelines and Treatment Protocols By: James L. Holly, MD The New Year brings new opportunities to improve our health. Many of us receive gifts which we can't use because there's too

More information

Leveraging online and in-pharmacy support to enhance weight loss: a population based analysis

Leveraging online and in-pharmacy support to enhance weight loss: a population based analysis Griffith University Leveraging online and in-pharmacy support to enhance weight loss: a population based analysis Professor Lauren Williams Discipline Head, Nutrition and Dietetics Professor Allan Cripps

More information

NUTRITION AND WEIGHT LOSS IN ADULTS

NUTRITION AND WEIGHT LOSS IN ADULTS NUTRITION AND WEIGHT LOSS IN ADULTS Jonathan Baalman, MD, PG1 University of Kansas School of Medicine- Wichita Family Medicine Residency at Wesley Medical Center 2016 Annual Meeting Kansas Grown: Strong,

More information

Chapter (9) Non-Pharmacologic Treatment of Low HDL-C

Chapter (9) Non-Pharmacologic Treatment of Low HDL-C Chapter (9) Non-Pharmacologic Treatment of Low HDL-C I. LIFESTYLE INTERVENTIONS ARE AN INTEGRAL PART OF ANY MANAGEMENT PLAN The National Cholesterol Education Program NCEP, and many other international

More information

Obesity protocol. Mw. J. Mentink, medical student. Drs. W.E. Schrader, general practitioner. Drs. D.M. Keesenberg, health scientist

Obesity protocol. Mw. J. Mentink, medical student. Drs. W.E. Schrader, general practitioner. Drs. D.M. Keesenberg, health scientist Obesity protocol Mw. J. Mentink, medical student Drs. W.E. Schrader, general practitioner Drs. D.M. Keesenberg, health scientist BMI and abdominal circumference Diagnostics Causes of obesity Risk factors

More information

The Link Between Obesity and Diabetes The Rapid Evolution and Positive Results of Bariatric Surgery

The Link Between Obesity and Diabetes The Rapid Evolution and Positive Results of Bariatric Surgery The Link Between Obesity and Diabetes The Rapid Evolution and Positive Results of Bariatric Surgery Michael E. Farkouh, MD, MSc Peter Munk Chair in Multinational Clinical Trials Director, Heart and Stroke

More information

Low-Carb and Mediterranean Diets Beat Low-Fat for Weight Loss, Lipid Changes at 2 Years CME

Low-Carb and Mediterranean Diets Beat Low-Fat for Weight Loss, Lipid Changes at 2 Years CME Page 1 of 5 Medscape emedicine Medscape CME Physician Connect The Medscape Journal All Medscape emedicine Drug Reference MEDLINE Dr. Z Jedlickova Account Settings Log Out Newsletters LATEST NEWS CONFERENCES

More information

Chapter 5 DASH Your Way to Weight Loss

Chapter 5 DASH Your Way to Weight Loss Chapter 5 DASH Your Way to Weight Loss The DASH diet makes it easy to lose weight. A healthy diet, one that is based on fruits, vegetables, and other key DASH foods, will help you have satisfying meals,

More information

LIFESTYLE CHOICES FOR PREVENTION AND INTERVENTION IN DIABETES. Gregory Hand, PhD MPH School of Public Health West Virginia University

LIFESTYLE CHOICES FOR PREVENTION AND INTERVENTION IN DIABETES. Gregory Hand, PhD MPH School of Public Health West Virginia University LIFESTYLE CHOICES FOR PREVENTION AND INTERVENTION IN DIABETES Gregory Hand, PhD MPH School of Public Health West Virginia University LEARNING OBJECTIVES Participants will review the epidemiological evidence

More information

A Calorie is a Calorie Or is It? 6 th Biennial Childhood Obesity Conference, June 30, 2011

A Calorie is a Calorie Or is It? 6 th Biennial Childhood Obesity Conference, June 30, 2011 A Calorie is a Calorie Or is It? 6 th Biennial Childhood Obesity Conference, June 30, 2011 Jeff S. Volek, Ph.D., R.D. Human Performance Laboratory Department of Kinesiology University of Connecticut Storrs,

More information

Obesity Reduction in Older Adults: Does Exercise Modality Matter?

Obesity Reduction in Older Adults: Does Exercise Modality Matter? Risky Business A Geriatric Education Day Ottawa, May 5 th, 2014. Obesity Reduction in Older Adults: Does Modality Matter? Robert Ross PhD, FACSM, FAHA School of Kinesiology and Health Studies Medicine,

More information

Metformin: Its Non-Glycemic Effects and Cardiovascular Risk Reduction. J. M. Miles, MD

Metformin: Its Non-Glycemic Effects and Cardiovascular Risk Reduction. J. M. Miles, MD Metformin: Its Non-Glycemic Effects and Cardiovascular Risk Reduction J. M. Miles, MD Case Study 73 y. o. woman, followed closely for Type 2 DM of 25 y duration. She has NYHA class 3 CHF. Echo shows HFpEF

More information

FROM ATKINS TO ZONE LOW CARB DIETS-FAD OR FUTURE?

FROM ATKINS TO ZONE LOW CARB DIETS-FAD OR FUTURE? FROM ATKINS TO ZONE LOW CARB DIETS-FAD OR FUTURE? Robert C. Oh, MD, MPH, CAQSM LTC, MC, US Army The views expressed in this presentation are those of the presenter and do not reflect the official policy

More information

Take Care of Yourself. Take Part in a Free Heart Health Screening.

Take Care of Yourself. Take Part in a Free Heart Health Screening. Take Care of Yourself. Take Part in a Free Heart Health Screening. One Hundred Oaks WOMEN AND HEART HEALTH Vanderbilt Heart is proud to offer free heart health screenings to women to help identify risk

More information

It s a Matter of Heart Ways to Reduce Your Risk for Heart Disease

It s a Matter of Heart Ways to Reduce Your Risk for Heart Disease It s a Matter of Heart Ways to Reduce Your Risk for Heart Disease Tiffany Lipsey, M. Ed. ACSM Clinical Exercise Physiologist Exercise is Medicine Credential Level III Director, Heart Disease Prevention

More information

Recommendations for Prescribing Exercise to Overweight and Obese Patients

Recommendations for Prescribing Exercise to Overweight and Obese Patients 10 Recommendations for Prescribing Exercise to Overweight and Obese Patients 10 10 Recommendations for Prescribing Exercise to Overweight and Obese Patients Effects of Exercise The increasing prevalence

More information

Healthy Approaches to Weight Loss

Healthy Approaches to Weight Loss Healthy Approaches to Weight Loss Christopher Gardner, PhD Stanford Prevention Research Center Stanford University, Department of Medicine Clinical Guidelines on the Identification, Evaluation, and Treatment

More information

Weight loss in people with type 2 diabetes

Weight loss in people with type 2 diabetes Weight loss in people with type 2 diabetes Prevalence of type 2 diabetes Currently, the estimated global prevalence of diabetes is over 285 million and this figure is expected to increase to 438 million

More information

Management of the severly obese patients: diet, lifestyle, behavioral modication and non-surgical treatments A. Lang (IL)

Management of the severly obese patients: diet, lifestyle, behavioral modication and non-surgical treatments A. Lang (IL) ESPEN Congress Geneva 2014 LLL LIVE COURSE: NUTRITION IN OBESITY Management of the severly obese patients: diet, lifestyle, behavioral modication and non-surgical treatments A. Lang (IL) Non Surgical Interventions

More information

ESPEN Congress Brussels 2005

ESPEN Congress Brussels 2005 ESPEN Congress Brussels 2005 Low carbohydrate or low fat diet to loose weight: Pro Low Fat Diets Arne Astrup 27th ESPEN Congress 28 August 2005 Low carbohydrate or low fat diet to loose weight: Pro Low

More information

Objectives. Who faces a higher mortality from cardiovascular related illness? Epidemiology of CVD. Cardiovascular Disease Management in Women

Objectives. Who faces a higher mortality from cardiovascular related illness? Epidemiology of CVD. Cardiovascular Disease Management in Women Cardiovascular Disease Management in Objectives. Epidemiology 2. Risk Stratification 3. Depression Screening in 4. Aspirin Use in 5. Summary Lisa Ward, MD, MSPH, MS Associate Clinical Professor Santa Rosa

More information

Sugar-Sweetened Beverages and Health: Studies in Adults. Frank M. Sacks, M.D. Nutrition Department, Harvard School of Public Health

Sugar-Sweetened Beverages and Health: Studies in Adults. Frank M. Sacks, M.D. Nutrition Department, Harvard School of Public Health Sugar-Sweetened Beverages and Health: Studies in Adults Frank M. Sacks, M.D. Nutrition Department, Harvard School of Public Health Acknowledgments Cara Ebbeling: Children s Hospital, Boston Frank Hu: Harvard

More information

Popular Weight Loss Diet Fads and Obesity Guidelines: Is there an Ideal Diet for Weight Reduction?

Popular Weight Loss Diet Fads and Obesity Guidelines: Is there an Ideal Diet for Weight Reduction? Popular Weight Loss Diet Fads and Obesity Guidelines: Is there an Ideal Diet for Weight Reduction? Geeta Sikand, MA, RDN,FAND,CDE,CLS,FNLA Associate Clinical Professor: Cardiology Director of Nutrition

More information

Blood Pressure Weight BMI. Numbers KNOW YOUR LDL/HDL. Triglycerides. holesterol

Blood Pressure Weight BMI. Numbers KNOW YOUR LDL/HDL. Triglycerides. holesterol Blood Pressure Weight BMI Blood Sugar KNOW YOUR holesterol LDLHDL Numbers Triglycerides Your health truly is the most important thing in your life. Knowing your medical history and getting annual checkups

More information

Results of a Structured Diet, Exercise, & Behavior Modification Intervention in Post-Menopausal Breast Cancer Survivors: Quality of Life

Results of a Structured Diet, Exercise, & Behavior Modification Intervention in Post-Menopausal Breast Cancer Survivors: Quality of Life Results of a Structured Diet, Exercise, & Behavior Modification Intervention in Post-Menopausal Breast Cancer Survivors: Quality of Life Jennifer Klemp PhD, MPH Assistant Professor of Medicine Division

More information

CHM 132 Spring 2011 NAME

CHM 132 Spring 2011 NAME CHM 132 Spring 2011 NAME Exam #3 100 points 1. Which of the following makes up about 60 percent of the body s weight? C a. major minerals b. protein c. water d. trace mineral 2. The most beneficial source

More information

Paleo and low-carbohydrate diets for diabetes: today's fads or tomorrow s advice?

Paleo and low-carbohydrate diets for diabetes: today's fads or tomorrow s advice? Paleo and low-carbohydrate diets for diabetes: today's fads or tomorrow s advice? Associate Professor Tim Crowe School of Exercise and Nutrition Sciences Deakin University www.facebook.com/thinkingnutrition

More information

Achieve your health and activity goals

Achieve your health and activity goals Achieve your health and activity goals Need help meeting weight and exercise goals? Learn the right whey to do it. Brought to you by WHEY PROTEIN is a natural, complete high quality dairy protein with

More information

Adult Weight Management Training Summary

Adult Weight Management Training Summary Adult Weight Management Training Summary The Commission on Dietetic Registration, the credentialing agency for the Academy of Nutrition and Dietetics Marilyn Holmes, MS, RDN, LDN About This Presentation

More information

YOUR LAST DIET IDEAL PROTEIN

YOUR LAST DIET IDEAL PROTEIN YOUR LAST DIET IDEAL PROTEIN OBJECTIVES Explain the science and history that supports the Ideal Protein Diet method. Describe the risks and benefits of diet participation. Give you the details of what

More information

Metabolic Syndrome Overview: Easy Living, Bitter Harvest. Sabrina Gill MD MPH FRCPC Caroline Stigant MD FRCPC BC Nephrology Days, October 2007

Metabolic Syndrome Overview: Easy Living, Bitter Harvest. Sabrina Gill MD MPH FRCPC Caroline Stigant MD FRCPC BC Nephrology Days, October 2007 Metabolic Syndrome Overview: Easy Living, Bitter Harvest Sabrina Gill MD MPH FRCPC Caroline Stigant MD FRCPC BC Nephrology Days, October 2007 Evolution of Metabolic Syndrome 1923: Kylin describes clustering

More information

Impact of Metabolically Healthy Obesity vs. Non-Obese but Metabolic Syndrome on CVD

Impact of Metabolically Healthy Obesity vs. Non-Obese but Metabolic Syndrome on CVD Impact of Metabolically Healthy Obesity vs. Non-Obese but Metabolic Syndrome on CVD Seong Hwan Kim, MD, PhD Division of Cardiology Korea University Ansan Hospital Presenter Disclosure Information Seong

More information

Garth L. Nicolson, PhD, Rita Ellithrope, MD and Robert Settineri, MS

Garth L. Nicolson, PhD, Rita Ellithrope, MD and Robert Settineri, MS Journal of IiME 2009; 3(1): 39-48. Presented at The 4 th Invest in ME International ME/Chronic Fatigue Syndrome Conference, London, UK, May 28-29, 2009. DIETARY SUPPLEMENT HEALTHY CURB FOR REDUCING WEIGHT,

More information

SLIDES ARE POSTED NEW GUIDELINES FOR TREATMENT OF CHOLESTEROL: IMPLICATIONS FOR THE PREVENTION OF HEART DISEASE AND STROKE

SLIDES ARE POSTED NEW GUIDELINES FOR TREATMENT OF CHOLESTEROL: IMPLICATIONS FOR THE PREVENTION OF HEART DISEASE AND STROKE NEW GUIDELINES FOR TREATMENT OF CHOLESTEROL: IMPLICATIONS FOR THE PREVENTION OF HEART DISEASE AND STROKE Robert B. Baron MD MS I have no relevant conflicts of interest Professor of Medicine Associate Dean

More information

The Need for an Integrative Approach to Pediatric Obesity

The Need for an Integrative Approach to Pediatric Obesity The Need for an Integrative Approach to Pediatric Obesity David S. Ludwig, MD, PhD Associate Director, Clinical & Translational Studies Unit Director, Optimal Weight for Life (OWL) Program Children s Hospital

More information

Effects of the Curves fitness and weight loss program in senior-aged women: body composition M Galbreath, R Chandran, J Wismann, K Beavers, G Hudson,

Effects of the Curves fitness and weight loss program in senior-aged women: body composition M Galbreath, R Chandran, J Wismann, K Beavers, G Hudson, Effects of the Curves fitness and weight loss program in senior-aged women: body composition M Galbreath, R Chandran, J Wismann, K Beavers, G Hudson, M Serra, R Li, J Jitomir, B Shelmadine, E Deike, E

More information

Preventing Diabetes Mellitus

Preventing Diabetes Mellitus Preventing Diabetes Mellitus By: James L. Holly, MD What is your risk of developing Diabetes? There are six risk factors for developing Type II Diabetes Mellitus. There is a seventh with female patients.

More information

WEIGHT LOSS SURGERY. Pre-Clinic Conference Jennifer Kinley, MD 12/15/2010

WEIGHT LOSS SURGERY. Pre-Clinic Conference Jennifer Kinley, MD 12/15/2010 WEIGHT LOSS SURGERY Pre-Clinic Conference Jennifer Kinley, MD 12/15/2010 EDUCATIONAL OBJECTIVES: Discuss the available pharmaceutical options for weight loss and risks of these medications Explain the

More information

WIN Weight. Weight-control Information Network. Life

WIN Weight. Weight-control Information Network. Life WIN Weight Loss for Weight-control Information Network Life Weight Loss for Life TThere are many ways to lose weight, but it is not always easy to keep the weight off. The key to successful weight loss

More information

Meal replacements and Medical Nutrition Therapy for Weight Management

Meal replacements and Medical Nutrition Therapy for Weight Management Meal replacements and Medical Nutrition Therapy for Weight Management Body weight management involves multiple inter-related factors Figure adapted from: http://www.shiftn.com/obesity/full-map.html Potential

More information

COGNITIVE IMPAIRMENT

COGNITIVE IMPAIRMENT PREVENTING DEMENTIA AND COGNITIVE IMPAIRMENT VASCULAR FACTORS, DIABETES, AND OBESITY: OBSERVATIONAL EVIDENCE Rebecca Gottesman, MD PhD Associate Professor of Neurology and Epidemiology Johns Hopkins University

More information

The Glycemic Index. Professor, Pediatrics, Harvard Medical School Professor, Nutrition, Harvard School of Public Health

The Glycemic Index. Professor, Pediatrics, Harvard Medical School Professor, Nutrition, Harvard School of Public Health The Glycemic Index David S. Ludwig, MD, PhD Director, Optimal Weight for Life (OWL) Program Director, New Balance Foundation Obesity Prevention Center Children s Hospital Boston Professor, Pediatrics,

More information

Teens and Heart Disease. Suzie Mookherjee, MD FACC Assistant Professor of Medicine Division of Cardiology

Teens and Heart Disease. Suzie Mookherjee, MD FACC Assistant Professor of Medicine Division of Cardiology Teens and Heart Disease Suzie Mookherjee, MD FACC Assistant Professor of Medicine Division of Cardiology Why Should Teens be Concerned About Heart Disease? Heart disease is the #1 cause of death in men

More information

Epidemiology and Prevention of Cardiovascular Disease in South Asian Indians

Epidemiology and Prevention of Cardiovascular Disease in South Asian Indians Epidemiology and Prevention of Cardiovascular Disease in South Asian Indians Latha Palaniappan, M.D., M.S. Assistant Investigator, Palo Alto Medical Foundation Research Institute Adjunct Assistant Professor,

More information

Prevention of and the Screening for Diabetes Part I Insulin Resistance By James L. Holly, MD Your Life Your Health The Examiner January 19, 2012

Prevention of and the Screening for Diabetes Part I Insulin Resistance By James L. Holly, MD Your Life Your Health The Examiner January 19, 2012 Prevention of and the Screening for Diabetes Part I Insulin Resistance By James L. Holly, MD Your Life Your Health The Examiner January 19, 2012 In 2002, SETMA began a relationship with Joslin Diabetes

More information

Insulin Resistance and Pre-diabetes

Insulin Resistance and Pre-diabetes 1 of 6 11/17/2009 9:38 PM Insulin Resistance and Pre-diabetes What is insulin resistance? What causes insulin resistance? Metabolic Syndrome What is pre-diabetes? What are the symptoms of insulin resistance

More information

Farris VAMC Farris VAMC 2015

Farris VAMC Farris VAMC 2015 New Guidelines for Cholesterol Overview Current cholesterol guidelines (ATP III) used at the VA New cholesterol guidelines presented in 2013 by the American College of Cardiology and the American Heart

More information

Sources of consumer nutrition info - TV 67% - Magazines 41% - Internet 40% - Newspapers 20% - Doctors 16% - Family and Friends 16%

Sources of consumer nutrition info - TV 67% - Magazines 41% - Internet 40% - Newspapers 20% - Doctors 16% - Family and Friends 16% Nutrition Facts and Myths Tammy Randall, MS, RDN, LD, CDE, FAND Endocrinology and Metabolism Institute Where did you hear that? Sources of consumer nutrition info - TV 67% - Magazines 41% - Internet 40%

More information

ESPEN Congress Prague 2007

ESPEN Congress Prague 2007 ESPEN Congress Prague 2007 Nutrition implication of obesity and Type II Diabetes Nutritional management of obesity & type 2 diabetes Luiza Kent-Smith NUTRITIONAL MANAGEMENT OF OBESITY & TYPE 2 DIABETES

More information

County of Sonoma Health Screenings Basic Preventive Screening Summary

County of Sonoma Health Screenings Basic Preventive Screening Summary County of Sonoma Health Screenings Basic Preventive Screening Summary Presented to: County of Sonoma Presented by: HealthFair Date: June 04, 2010 1 Table of Contents General Summary... 3 Basic Preventive

More information

DIETARY ISSUES IN DIABETES

DIETARY ISSUES IN DIABETES DIETARY ISSUES IN DIABETES Elizabeth J Mayer Davis, PhD Department of Nutrition, Gillings School of Global Public Health Department of Medicine, School of Medicine University of North Carolina at Chapel

More information

Long term Weight Management in Obese Diabetic Patients Osama Hamdy, MD, PhD, FACE

Long term Weight Management in Obese Diabetic Patients Osama Hamdy, MD, PhD, FACE Long term Weight Management in Obese Diabetic Patients Osama Hamdy, MD, PhD, FACE Medical Director, Obesity Clinical Program, Director of Inpatient Diabetes Management, Joslin Diabetes Center Assistant

More information

Impact of Exercise on Patients with Diabetes Mellitus. Learning Objectives. Two Main Types of Diabetes Mellitus

Impact of Exercise on Patients with Diabetes Mellitus. Learning Objectives. Two Main Types of Diabetes Mellitus Impact of Exercise on Patients with Diabetes Mellitus Bret Goodpaster, Ph.D. Exercise Physiologist Assistant Professor of Medicine University of Pittsburgh Division of Endocrinology and Metabolism Learning

More information

The South Asian Indian Women s s Weight Loss Study. Latha Palaniappan, MD, MS BIRCWH Scholar October 20, 2005

The South Asian Indian Women s s Weight Loss Study. Latha Palaniappan, MD, MS BIRCWH Scholar October 20, 2005 The South Asian Indian Women s s Weight Loss Study Latha Palaniappan, MD, MS BIRCWH Scholar October 20, 2005 South Asian Emigrants and second generation from India Bhutan Bangladesh Maldives Nepal Pakistan

More information

Diabetes and Obesity in Women of Childbearing Age. Dr Ketan Dhatariya Consultant in Diabetes and Endocrinology, NNUH

Diabetes and Obesity in Women of Childbearing Age. Dr Ketan Dhatariya Consultant in Diabetes and Endocrinology, NNUH Diabetes and Obesity in Women of Childbearing Age Dr Ketan Dhatariya Consultant in Diabetes and Endocrinology, NNUH A Few Perceptions What causes obesity? Your lifestyle has changed thus you have put on

More information

Who typically has Metabolic Syndrome? According to the American Heart Association, three groups of people often have metabolic syndrome:

Who typically has Metabolic Syndrome? According to the American Heart Association, three groups of people often have metabolic syndrome: Metabolic Syndrome By Seth Bilazarian, MD, FACC, FSCAI, RPVI Clinical and Intervential Cardiologist What is the Metabolic Syndrome? The Metabolic Syndrome is a collection of five problems that greatly

More information

YOUR GUIDE TO. Lowering The Risk of Heart Attack and Stroke

YOUR GUIDE TO. Lowering The Risk of Heart Attack and Stroke YOUR GUIDE TO Lowering The Risk of Heart Attack and Stroke The Mercy Health Heart Institute team is focused on helping you keep your heart healthy. As part of this effort, it s important for you to know

More information

Does beer consumption cause beer belly?

Does beer consumption cause beer belly? Does beer consumption cause beer belly? Nathalie Tommerup Bendsen, PhD Department of Human Nutrition Faculty of Life Sciences University of Copenhagen 8 April 2011 [1] Beer belly myth or fact? Does beer

More information

Nutrition: Knowing Your Total Cholesterol

Nutrition: Knowing Your Total Cholesterol Nutrition: Knowing Your Total Cholesterol A number of factors can increase your risk for coronary heart disease. To make an accurate assessment your doctor will determine your lipid profile, overall health,

More information

Therapeutic Approaches to Obesity Treatment

Therapeutic Approaches to Obesity Treatment Therapeutic Approaches to Obesity Treatment Sherif Hafez MD, FACP CONTENTS Summary. Aim. Aim of weight reduction and target body mass index. o Optimal weight for cardiovascular health Outline of therapeutic

More information

Causes, incidence, and risk factors

Causes, incidence, and risk factors Causes, incidence, and risk factors Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. To understand diabetes,

More information

All About Body Mass Index (BMI)

All About Body Mass Index (BMI) All About Body Mass Index for Adults What is BMI? Body Mass Index is a number calculated from a person's weight and height. BMI is a fairly reliable indicator of body fat for most people. BMI does not

More information

Myths, Presumptions and Facts about Obesity

Myths, Presumptions and Facts about Obesity 1 Myths, Presumptions and Facts about Obesity Cátia Martins Associate Professor Medical Faculty, IKM NTNU Researcher RSSO St. Olavs Hospital 2 Myth believe held true despite the existence of substantial

More information

Q1: Which of these is added to the food label because people sometimes don t eat ENOUGH of this? Cholesterol

Q1: Which of these is added to the food label because people sometimes don t eat ENOUGH of this? Cholesterol Trivia Challenge Q1: Which of these is added to the food label because people sometimes don t eat ENOUGH of this? (C) (D) Fat Calcium Sodium Cholesterol Answer: Calcium Q2: Why do experts recommend losing

More information

Watching Carbs: Healthful or Harmful?

Watching Carbs: Healthful or Harmful? Watching Carbs: Healthful or Harmful? Marjorie Sawicki, MS, RD, LDN Assistant Professor Department of Nutrition & Dietetics, School of Allied Health Professions Carbohydrate in the Diet Carbohydrate comprises

More information

Protein Intake in Potentially Insulin Resistant Adults: Impact on Glycemic and Lipoprotein Profiles - NPB #01-075

Protein Intake in Potentially Insulin Resistant Adults: Impact on Glycemic and Lipoprotein Profiles - NPB #01-075 Title: Protein Intake in Potentially Insulin Resistant Adults: Impact on Glycemic and Lipoprotein Profiles - NPB #01-075 Investigator: Institution: Gail Gates, PhD, RD/LD Oklahoma State University Date

More information

Getting Off the Chronic Disease Merry-Go-Round: What s the Weight of the Research?

Getting Off the Chronic Disease Merry-Go-Round: What s the Weight of the Research? Getting Off the Chronic Disease Merry-Go-Round: What s the Weight of the Research? Jody Dushay, MD MMSc Beth Israel Deaconess Medical Center Boston, MA Session 445 No disclosures Disclosure Jody Dushay,

More information

Pediatric Metabolic Syndrome

Pediatric Metabolic Syndrome University of Michigan Hospitals and Health Centers Pediatric Metabolic Syndrome A growing epidemic Shannon Russell Dietetic Intern June 2012 Overview Causes Risk Factors Signs and Symptoms Identification/Diagnosis

More information

Prediabetes: A Woman s Perspective

Prediabetes: A Woman s Perspective Prediabetes: A Woman s Perspective AMERICAN COLLEGE OF ENDOCRINOLOGY CONSENSUS STATEMENT ON THE DIAGNOSIS AND MANAGEMENT OF PRE-DIABETES IN THE CONTINUUM OF HYPERGLYCEMIA Joanne Kaiser-Smith, D.O., FACOI,

More information

Diabetes mellitus is a chronic condition that occurs as a result of problems with the production and/or action of insulin in the body.

Diabetes mellitus is a chronic condition that occurs as a result of problems with the production and/or action of insulin in the body. International Diabetes Federation Diabetes Background Information Diabetes mellitus is a chronic condition that occurs as a result of problems with the production and/or action of insulin in the body.

More information

Involving Support Partners in Obesity Treatment

Involving Support Partners in Obesity Treatment Involving Support Partners in Obesity Treatment Amy Gorin, The Miriam Hospital/Brown Medical School, Providence, RI, US, Suzanne Phelan, The Miriam Hospital/Brown Medical School, Providence, RI, US Deborah

More information

Patricia Dubbert, Ph.D. University of Arkansas for Medical Sciences South Central VA Mental Illness Research Education & Clinical Center VISN 16

Patricia Dubbert, Ph.D. University of Arkansas for Medical Sciences South Central VA Mental Illness Research Education & Clinical Center VISN 16 Patricia Dubbert, Ph.D. University of Arkansas for Medical Sciences South Central VA Mental Illness Research Education & Clinical Center VISN 16 Geriatric Research Education Clinical Center Objectives

More information

24-May-16. Nutrition and PCOS. Professor Peter Brukner OAM La Trobe University Australian cricket team doctor living in UK Professor Tim Noakes

24-May-16. Nutrition and PCOS. Professor Peter Brukner OAM La Trobe University Australian cricket team doctor living in UK Professor Tim Noakes Nutrition and PCOS Professor Peter Brukner OAM La Trobe University Australian cricket team doctor 2012 living in UK Professor Tim Noakes 1 2012 Healthy 60 year old Low fat diet Regular exercise Normal

More information

Stephen P Juraschek; Edgar R Miller III; Elizabeth Selvin; Vincent J

Stephen P Juraschek; Edgar R Miller III; Elizabeth Selvin; Vincent J The effect of type and amount of dietary carbohydrate on biomarkers of glucose homeostasis and inflammation in healthy adults: Results from the OmniCarb trial Stephen P Juraschek; Edgar R Miller III; Elizabeth

More information

Weight management in patients with severe mental illness

Weight management in patients with severe mental illness Weight management in patients with severe mental illness Xiaoduo Fan, MD, MPH, MS Associate Professor of Psychiatry Director, Psychotic Disorders Program UMass Memorial Medical Center UMass Medical School

More information

Critical Contribution of Fitness to the Obesity Prognosis and to the Obesity Paradox

Critical Contribution of Fitness to the Obesity Prognosis and to the Obesity Paradox Critical Contribution of Fitness to the Obesity Prognosis and to the Obesity Paradox Carl J. Lavie, MD, FACC, FACP, FCCP Professor of Medicine Medical Director, Cardiac Rehabilitation and Preventive Cardiology

More information

What is the best diet to lose weight

What is the best diet to lose weight Challenging Cases in Obesity Management (What me worry?) Ken Fujioka, M.D. Director of Nutrition and Metabolic Research Center for Weight Management Scripps Clinic Dept. of Endocrine Panama Boca Del Toro

More information

Write your name here. Weight. Matters. A guide to losing weight. Health Improvement Service

Write your name here. Weight. Matters. A guide to losing weight. Health Improvement Service Write your name here Weight Matters A guide to losing weight Health Improvement Service Contents Introduction...4 Are you ready to get started...5 Why is 10% important...6 How to measure your waist...7

More information

Diabetes mellitus is a metabolic disorder of glucose metabolism with many causes and forms.

Diabetes mellitus is a metabolic disorder of glucose metabolism with many causes and forms. Chapter 20 Diabetes Mellitus Chapter 20 Lesson 20.1 Key Concept Diabetes mellitus is a metabolic disorder of glucose metabolism with many causes and forms. About Diabetes 20.8 million Americans have diabetes

More information

Improving Diabetes Outcomes through Nutrition and Lifestyle Change: Translating Research to Practice References:

Improving Diabetes Outcomes through Nutrition and Lifestyle Change: Translating Research to Practice References: Improving Diabetes Outcomes through Nutrition and Lifestyle Change: Translating Research to Practice Linda M. Delahanty, MS, RDN Saturday, March 5, 2016 9:30 a.m. 10:15 a.m. Treating diabetes from a provider

More information

Controversies in Primary Care: Treating Pre-Diabetes

Controversies in Primary Care: Treating Pre-Diabetes Controversies in Primary Care: Treating Pre-Diabetes Disclosures I have no disclosures regarding the content of this lecture today. Kevin J. Goist, MD Assistant Professor of Clinical Medicine Lead Physician,

More information

Weight Management as Treatment for Diabetes

Weight Management as Treatment for Diabetes Weight Management as Treatment for Diabetes Age-Adjusted Relative Risk Relationship Between Increasing BMI and Risk of Type 2 Diabetes 100 Men 93.2 75 Women 54.0 50 40.3 42.1 25 0 1.0 2.9 1.0 4.3 1.0

More information

Weight Management how to lose it and keep it off. By Dominique Wakefield Oct. 4, 2011

Weight Management how to lose it and keep it off. By Dominique Wakefield Oct. 4, 2011 Weight Management how to lose it and keep it off By Dominique Wakefield Oct. 4, 2011 2 Today s objectives Why discuss weight management? What does weight management refer to? Methods of measurement and

More information

Low Carbohydrate Diets for Weight Loss: A brief review for Les Mills International Ltd September 2012 Compiled by: Jennifer Fleming, MS, RD

Low Carbohydrate Diets for Weight Loss: A brief review for Les Mills International Ltd September 2012 Compiled by: Jennifer Fleming, MS, RD Low Carbohydrate Diets for Weight Loss: A brief review for Les Mills International Ltd September 2012 Compiled by: Jennifer Fleming, MS, RD 1 Introduction Dietary approaches that promote weight loss, decrease

More information

Yes, it does, but should it?

Yes, it does, but should it? Does Gender Make a Difference When Managing CVD in General Practice? Does Gender Make a difference in the Treatment of CHD? Dr Jennifer Johns MBBS, FRACP, FCSANZ Cardiologist Austin Health Cardiologist

More information