Healthy Approaches to Weight Loss

Transcription

1 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 of Overweight and Obesity in Adults The Evidence Report. National Institutes of Health. Obes Res 1998;6(Suppl)2:1S-29S. ~1% <3% % energy from carbohydrate 3% energy from fat and approximately 1% energy from protein >% Months Foster et al, NEJM 23;348:282-9 Low carb High carb Change in percent body weight % -2% -4% -6% -8% -1% -12% LEARN Sample size LEARN 17 2 Attrition (13) (13) Brehm, JCEM 23;88(4): Change in percent body weight % -2% -4% -6% -8% -1% Months Randomized n=27 n=26 p<.1 Completed n=2 (74%) n=22 (8%) p<.1 Yancy, Ann Int Med 24;14: Change in percent body weight % -2% -4% -6% -8% -1% -12% -14% Months Randomized n=6 n=9 p<.1 Completed n=34 (7%) n=4 (76%)

2 A tkins T raditional (L.E.A.R.N.) O rnish A Weight Loss Diet Z one From Low- to High Percent weight change across time, by group % Energy ohydrate Weight change as % of baseline Baseline 8 weeks 6 months 1 year Zone Ornish LEARN Gardner et al. JAMA 27;297: month net weight change (kg): Individual results 1 year % 32% 46% Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults The Evidence Report. National Institutes of Health. Obes Res 1998;6(Suppl)2:1S-29S. ~1% <3% >% Ornish 19% 29% 2%

3 Ornish 1 year 22% 32% 46% Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults The Evidence Report. National Institutes of Health. Obes Res 1998;6(Suppl)2:1S-29S. ~1% <3% >% 19% 29% 2% Favored (Weight) HDL-C SBP DBP Dietary Macronutrients Low vs. High Overly simplistic Dietary Macronutrients ohydrates Glycemic Index / Load Complex vs. Refined Fiber-rich Amount Calories s (g) Fiber MUFA / PUFA / Saturated Omega-3 vs. Omega-6 Marine vs. Plant Omega-3 Brown rice g Plant, Marine, Animal g White rice ohydrates s Amount Calories s (g) Fiber Amount Calories (g) Sat. (g) Omega-3 (g) (g) Fiber (g) 1 slice ~12 ~4 g ~1 ~3 ~3 ~ ~6 ~11 Whole wheat ozs ~3 ~36 ~3.4 ~8 ~4 1 slice ~12 ~1 g ~6 ozs ~3 ~17 ~3 ~3 ~43 White, enriched ~3 ozs ~3 7 ~18 ~ 1

4 The USDA Food Guide Pyramid Amount Calories (g) (g) Sat. (g) Omega-3 (g) Fiber (g) ~1 cup 4 ~14 ~8 ~4 ozs ~31 ~12 ~3-1/2 ~17 ~? ~3 ozs ~18 ~18 ~7 ~ ohydrates Amount Calories s (g) (g) (g) Sat. (g) Fiber 6 ~3 ~1 g ~1 slice ~ ~4 g ~4 8 ~4 ~8 g -1/2c ~1 ~8 g ~7. ~12 ~7 ~1 ~4 g Eliminate foods rich in refined/added sugar 4

5 Low fat yogurt Plain Raspberry Organic evaporated cane juice Organic raspberries Natural flavors Elderberry juice concentrate (for color) Locust bean gum Calories 9 Cal. 2 Total 2. g 4% Sat 1. g 8% Cholest. 1 mg 4% Sodium 11 mg 4% Total. 11 g 4% Dietary Fiber g % Sugars 11 g 7 g 1% Calories 13 Cal. 2 Total 2. g 3% Sat 1. g 7% Cholest. 1 mg 3% Sodium 9 mg 4% Total. 23 g 8% Dietary Fiber g % Sugars 22 g 6 g 12% Raspberries (1/2 c) Organic evaporated cane juice Organic raspberries Natural flavors Elderberry juice concentrate (for color) Locust bean gum Calories 12 Cal. 2 Total 3. g 4% Sat 1. g 8% Cholest. 1 mg 4% Sodium 11 mg 4% Total. 18 g 4% Dietary Fiber 4 g 16% Sugars 14 g 8 g 1% Calories 13 Cal. 2 Total 2. g 3% Sat 1. g 7% Cholest. 1 mg 3% Sodium 9 mg 4% Total. 23 g 8% Dietary Fiber g % Sugars 22 g 6 g 12% Kcal = 12 Yogurt: 17 grams Raspberries: 6 grams Total = 23 grams Energy Density = ~. Kcal/g Kcal = 13 Yogurt Mix: 17 grams Energy Density = ~.7 Kcal/g

6 Less sugar CARBOHYDRATES: High fiber, low glycemic index, complex, bulky, high-water content More fiber More filling (bigger portion) Kcal = 12 Yogurt: 17 grams Raspberries: 6 grams Total = 23 grams Energy Density =. Kcal/g Lower Energy Density FATS: Mono- & polyunsaturated, omega-3 PROTEIN: Marine (with omega-3), plant (with fiber), lean animal (low in saturated fat) Portion size and Energy Density N=24 young women, provided with meals and snacks for 2 days, ad libitum. Cross-over study. No significant differences in ratings of hunger of fullness. Kcal/day 2, 2, 1, 1, Portion size Energy Density 1% 1% 7% 1% -2 1% 7% 7% 7% -8 Rolls et al., Am J Clin Nutr 26;83:11-7 Ongoing Research Studies Antioxidant Omega-3 UPBEAT vs. vs. Understanding Pine Bark Extract as an Alternative Treatment

7 Ongoing Research Studies Antioxidant Omega-3 UPBEAT