Certain Factors Associated With Weight Regain After Weight Loss

News Author: Laurie Barclay, MD
CME Author: Laurie Barclay, MD

une 12, 2007 — Factors associated with weight regain after substantial weight loss are identified in a study in which data from the 1999 - 2002 National Health and Nutrition Examination Survey (NHANES) were analyzed. The study is published online June 5 and will appear in the July print issue of the American Journal of Preventive Medicine.

"The finding that nearly 6 in 10 adults who had experienced substantial weight loss maintained their weight within 5% in the past year is encouraging," lead author Edward C. Weiss, MD, MPH, a medical epidemiologist at the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention in Atlanta, Georgia, told Medscape. "Weight loss as little as 10% in an overweight or obese individual can reduce risk factors for diabetes and cardiovascular disease. To be successful at reducing these risk factors in the long term, weight loss must be maintained."

"Mexican Americans had higher odds of weight regain than non-Hispanic whites, and those who were sedentary or not meeting physical activity recommendations and those who reported greater daily screen time, such as TV, video, or computer use, had higher odds of weight regain," Dr. Weiss said. "Regular physical activity has been consistently associated with long-term weight loss maintenance; however, weight regulation depends both upon caloric intake as well caloric expenditure. Balancing caloric intake with activity level works on energy balance from both sides, what is taken in, as well as how much is used; in addition, eating a healthy diet and being physically active can reduce the risk of chronic diseases, such as heart disease or diabetes."

Pearls for Practice

• Compared with their weight 1 year before they were surveyed, 7.6% of 1999 - 2002 NHANES participants with substantial weight loss had continued to lose more than 5% of their body weight, 58.9% had maintained their weight within 5%, and 33.5% had regained more than 5% of their body weight.
• Factors associated with weight regain, as opposed to weight maintenance or loss, included Mexican-American ethnicity, loss of a greater percentage of maximum weight, fewer years elapsed since reaching maximum weight, reporting greater television or screen viewing time, attempting to control weight, sedentary lifestyle, and not meeting public health recommendations for physical activity.

Trying to lose weight? Watch what you drink

I'm trying to lose weight. To keep from snacking between meals, I've been drinking lots of juice and milk. But the scale isn't showing much progress. Am I doing something wrong?- John / Washington

Mayo Clinic dietitian Katherine Zeratsky, R.D., L.D., and colleagues answer select questions from readers.

You have the right idea. Drinking beverages can satisfy your urge to nibble when you're trying to lose weight. Although juice and milk have many important nutrients, they also contain a lot of calories. A calorie in liquid form is the same as a calorie in solid food, so it's important to keep track of the calories in the beverages you drink.

A balanced diet includes at least two servings from the milk group and two servings from the fruit group daily. In terms of beverages, the suggested serving size is 8 ounces for milk and 6 ounces for fruit juice. If you drink more than the recommended daily servings, you could easily be getting unwanted calories.

To help cut calories, switch to low-fat or fat-free milk and reduced-calorie ("light") juices. Diluting juices with plain or sparkling water can reduce calories, too.

That said, water is still the best bet overall when it comes to satisfying thirst and trying to cut the urge to snack. Water has no calories and is very cheap if taken from the tap. Try adding a twist of lemon or lime for a change of pace, or try sparkling water if you just don't like plain water.

Calories in common beverages
Beverage	Serving size	Average calories*
Water	8 ounces (oz.)	0
Coffee or tea (plain)	8 oz.	2
Tea, hot or cold, brewed with tap water	8 oz.	2
Lipton Brisk iced tea, ready to drink	12 oz.	128
Milk, whole	8 oz.	146
Milk, 2 percent	8 oz.	122
Milk, fat-free	8 oz.	86
Fruit juice, frozen concentrate	8 oz.	114
Fruit drinks	8 oz.	134
Regular soda	12 oz.	152
Diet soda with aspartame	12 oz.	0
Regular beer	12 oz.	153
Light beer	12 oz.	103
Wine	5 oz.	124

Source: USDA National Nutrient Database for Standard Reference, 2005

*When calorie values varied among like beverages, the average value was used. Actual calories may vary by brand.

Exercise for weight loss: Calories burned in 1 hour

Being active — either through physical activity or through a formal exercise program — is an essential component of a weight-loss program. When you're active, your body uses energy (calories) to work, helping to burn the calories you take in with food you eat.

Whatever activity you choose, the key is to commit to doing it regularly. Aim for 30 to 60 minutes of moderately intense physical activity most days of the week. Moderately intense activity or exercise should increase your heart and breathing rates and possibly lead to a light sweat.

This chart shows the estimated number of calories burned while performing a variety of exercises for one hour. Calorie expenditure varies widely depending on the exercise, intensity level and individual.

Activity (one-hour duration)	Weight of person and calories burned
	160 pounds (73 kilograms)	200 pounds (91 kilograms)	240 pounds (109 kilograms)
Aerobics, high impact	511	637	763
Aerobics, low impact	365	455	545
Aerobics, water	292	364	436
Backpacking	511	637	763
Basketball game	584	728	872
Bicycling, <>	292	364	436
Bowling	219	273	327
Canoeing	256	319	382
Dancing, ballroom	219	273	327
Football, touch, flag, general	584	728	872
Golfing, carrying clubs	329	410	491
Hiking	438	546	654
Ice skating	511	637	763
Jogging, 5 mph	584	728	872
Racquetball, casual, general	511	637	763
Rollerblading	913	1,138	1,363
Rope jumping	730	910	1,090
Rowing, stationary	511	637	763
Running, 8 mph	986	1,229	1,472
Skiing, cross-country	511	637	763
Skiing, downhill	365	455	545
Skiing, water	438	546	654
Softball or baseball	365	455	545
Stair treadmill	657	819	981
Swimming, laps	511	637	763
Tae kwon do	730	910	1,090
Tai chi	292	364	436
Tennis, singles	584	728	872
Volleyball	292	364	436
Walking, 2 mph	183	228	273
Walking, 3.5 mph	277	346	414
Weightlifting, free weight, Nautilus or universal type	219	273	327

Source: Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, O'Brien, WL, Bassett DR Jr, Schmitz KH, Emplaincourt PO, Jacobs DR Jr, Leon AS. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000 Sep;32(9 Suppl):S498-504.

source: http://www.mayoclinic.com/health/exercise/SM00109

Eating habits: To lose weight, explore why you overeat

Successful weight loss begins with understanding your eating habits. Start with these steps.

http://www.mayoclinic.com/health/eating-habits/WT00022

If you eat only when you feel hungry, chances are you'll have less trouble reaching and maintaining a healthy weight. Most people are not in touch with their hunger signals, though, and instead eat in response to triggers such as stress, anxiety and boredom.

To successfully lose weight, you've got to get in touch with the powerful forces that shape your eating habits — how you think and feel about food and why you eat when you're not hungry.

Here are four steps that can help.

Step 1: Know your habits

To become aware of your eating habits, keep track of situations in which you find yourself craving unhealthy foods. Write them down in a notebook or on your weekly menus. Keep a list of what, when and why you eat for a few days. See if any relationships or patterns emerge. Ask yourself if you tend to eat when you're bored, angry, tired, anxious, stressed, depressed or socially pressured. If you do, try these tips:

• Before eating anything, ask yourself if you're really hungry. If the answer is no, consider having a glass of water. You may find that you're just thirsty.
• Learn to refuse gracefully when people offer food that doesn't fit into your menu plan such as treats at coffee breaks.
• Do something to distract yourself from your desire to eat — call a friend or run an errand.
• Direct emotional energy from stress or anger outward. Think about taking a walk, sorting through files, or cleaning out a cluttered drawer or closet. The urge to eat will pass.
• If you find that you absolutely can't find an alternative strategy, don't try to restrain yourself too much — that may lead to bingeing. In that case, eat some vegetables or a piece of fruit. You won't have to feel guilty, and it may satisfy your craving.

Step 2: Change gradually

When you've identified an eating habit that you'd like to change, remember that gradual changes work best. Consider this example. Marty works as a customer service manager for a retail department store. Her job is often stressful. She prides herself on meeting the needs of customers and sometimes finds herself juggling the needs of customers with the needs of management. When she feels overwhelmed by stress, she walks to the vending machine for a high-fat, high-calorie snack.

Marty recognized that this was one eating habit preventing her from reaching a healthy weight. She decided to start dealing with on-the-job stress by taking a brisk, 10-minute walk at break time and by eating fruit for snacks.

Like Marty, you, too, can prevent thoughts and feelings about food from standing in the way of your weight-loss program. Choose one area at a time and be specific about how you're going to change. When you feel you've successfully changed one eating habit, work on another.

Step 3: Plan ahead

Your old eating habits may be so ingrained that you're not aware of them. Mentally rehearsing healthier habits can help. Imagine this: You're at a graduation party. The buffet table is packed with all of your favorite treats. Now imagine this: You take a small portion of a few items from the buffet table, leaving space between them on your plate, or you take only fresh fruits and vegetables. Mentally rehearse this plan until you're more likely to remember it — and do it — the next time you need it most.

Step 4: Think positively

Don't dwell on what you're giving up to reach a healthy weight. Concentrate instead on what you're gaining. Instead of thinking, "I really miss eating a doughnut at breakfast," tell yourself, "I feel a lot better when I eat oatmeal and fresh fruit in the morning."

Believe it or not, the process of making changes to your eating habits can be enjoyable and the health benefits will soon become evident.

Belly Fats - how to make it scram

YOU Docs Daily The online edition of their daily newspaper column

6 Things You Didn’t Know About Belly Fat -- And How to Make it Scram

Politicians, gossip columnists, doctors, your best friend -- they’re all talking about the same thing: fat. Especially belly fat. The great thing about belly fat is that the better you get to know it, the easier it is to make it vanish (if only spam e-mail worked the same way!). Digest these stomach-flattening facts.

1. All fat is not alike. Eat more calories than you burn and the extras get packed away in one of two places -- long-term storage depots beneath the skin (subcutaneous fat) or short-term bins deep in the abdomen (visceral fat). Visceral fat is what we call omental fat -- that is, fat in your omentum, a piece of webbing that hangs off your stomach just beneath your ab muscles, sort of like a mesh apron.

2. The fat you don’t see is the most dangerous. The soft, superficial stuff that ripples your thighs and tummy may be a bikini spoiler, but if you can pinch it, it probably won’t kill you. However, if you have a solid “beer belly" . . . well, you’re likely headed for more trouble than a politician hooked up to a polygraph. That’s because too much deep fat churns out supersize amounts of hormones and proteins, which can lead to big hazards. Among them: lousy LDL cholesterol and triglyceride levels; high blood sugar and blood pressure; insulin resistance; and widespread inflammation. All are instigators of many diseases -- including dementia, cancer, heart disease, and diabetes. But often you can get a “do over,” and it doesn’t take that long and isn’t that hard, if you know what you’re doing. So don’t stop reading!

First, don’t rely on your scale. As you start to reduce risky belly fat, your weight may temporarily go up. So ditch the scale in favor of the tape measure. If you’re a woman, your waist should be 32.5 inches; if you’re a man, 35 inches. Creep past 37 inches for women or 40 for men, and the health dangers increase.

3. Stress makes you fat. Not only does stress lead you to eat Haagen-Dazs straight from the carton, but it also triggers the release of cortisol, a stress hormone. When stress becomes unrelenting, the omentum attempts to control cortisol flow by sucking it out of the bloodstream. Nice try, but cortisol fights back once it’s in the omentum and turbocharges fat there. That sets off other chemical reactions that leave you feeling hungry . . . and looking for the Haagen-Dazs again. Fortunately, any kind of stress reduction, especially exercise, will help short-circuit this stress/fat cycle. Feeling tense right now? Go for a walk the minute you finish this column.

4. The fat you eat affects the fat you get. When monkeys munched on trans-fat laced diets for 6 years, they developed more deep-belly fat than those who went trans-fat-free, even though both ate the same number of calories. Physiologically, we’re close enough to monkeys to extrapolate that trans fat doesn’t do anything good for your waist or your arteries.

5. Blasting belly fat isn’t hard. If you’re not overweight but still have an oversized waist, the fastest way to shrink your omentum is by walking. Taking a brisk 30-minute walk each day will keep those fat cells from expanding. Pick up the pace some, walk a little longer, and you can give your omentum a makeover, turning a flabby apron of omental fat into sheer mesh again. After 30 days of walking, start doing resistance exercises as well to add muscle and lose inches -- otherwise you’ll hit a plateau. No dumbbells? No gym? No problem. You can get an excellent workout in 20 minutes by using your own body as a weight to stretch and strengthen all of your major muscle groups. Find examples at www.realage.com/ct/shape-up-slim-down/.

6. Whole grains scare away belly fat. If you and a friend go on a diet but you eat whole grains (meaning brown rice, steel-cut oats, and whole-wheat pasta, not whole-grain Pop Tarts) and your friend eats processed grains (anything made with white/enriched grains and flours, cupcakes to noodles), you both might lose the same amount of weight, but you’ll shed more belly fat and lower your levels of C-reactive protein, a marker of damaging inflammation. And your food will taste better, and you’ll feel full longer. AND you’ll have a flat stomach!

4 Foods for Better Immunity

Your immune system is responsible for helping fight off everything from the common cold to cancer. A tall order!

Send in some reinforcements so it doesn't get battle fatigue. Here are four foods your immune system loves.

Sweet, Creamy, Steamy, Crunchy . . .
Oranges, yogurt, tea, and pumpkin seeds are the order of the day when it comes to giving your immune system a treat, according to RealAge experts Michael Roizen, MD, and Mehmet Oz, MD, authors of the best-selling (and now newly expanded and updated) YOU: The Owner's Manual. Here's how these four superfoods help:

1. Oranges are chock-full of vitamin C, an antioxidant vitamin that helps your immune system fend off disease-causing invaders. Other good C options: bell peppers, strawberries, cantaloupe, and broccoli. Or take 400 milligrams of vitamin C three times daily. (Look up more C sources.)
2. Yogurt (unpasteurized) contains Lactobacillus acidophilus -- a healthy bacterium that helps thwart fungus-related infections. Or take a 20-milligram acidophilus supplement twice daily. (Here's another great natural fungicide.)
3. Tea is full of flavonoids, powerful vitamin-like substances that reduce immune-system aging. You'll also find them in oats, onions, broccoli, tomatoes, apples, and berries. (Boost your berry intake with this Triple Berry Blender Blast.)
4. Pumpkin seeds are great year round, not just at Halloween, because they contain zinc -- a nutrient that's been shown to help reduce the average length of the common cold. (Find out how zinc can make exercise easier, too.)

Are your immunizations current? Get a checklist with this vaccine assessment.

RealAge Benefit: Protecting your immune system can make your RealAge as much as 6 years younger.

References RealAge - Published on 06/13/2008.

Earthquake - Safety Tips

EXTRACT FROM DOUG COPP'S ARTICLE ON THE:

'TRIANGLE OF LIFE'

My name is Doug Copp. I am the Rescue Chief and Disaster Manager of the American Rescue Team International (ARTI), the world's most experienced rescue team. The information in this article will save lives in an earthquake.

I have crawled inside 875 collapsed buildings, worked with rescue teams from 60 countries, founded rescue teams in several countries, and I am a member of many rescue teams from many countries.

I was the United Nations expert in Disaster Mitigation for two years. I have worked at every major disaster in the world since 1985, except for simultaneous disasters.

The first building I ever crawled inside of was a school in Mexico City during the 1985 earthquake. Every child was under its desk. Every child was crushed to the thickness of their bones. They could have survived by lying down next to their desks in the aisles. It was obscene, unnecessary and I wondered why the children were not in the aisles. I didn't at the time know that the children were told to hide under something.

Simply stated, when buildings collapse, the weight of the ceilings falling upon the objects or furniture inside crushes these objects, leaving a space or void next to them. This space is what I call the 'triangle of life'. The larger the object, the stronger, the less it will compact. The less the object compacts, the larger the void, the greater the probability that the person who is using this void for safety will not be injured. The next time you watch collapsed buildings, on television, count the 'triangles' you see formed. They are everywhere. It is the most common shape, you will see, in a collapsed building.

TIPS FOR EARTHQUAKE SAFETY

1) Most everyone who simply 'ducks and covers' WHEN BUILDINGS COLLAPSE are crushed to death. People who get under objects, like desks or cars, are crushed.

2) Cats, dogs and babies often naturally curl up in the fetal position. You should too in an earthquake. It is a natural safety/survival instinct. You can survive in a smaller void. Get next to an object, next to a sofa, next to a large bulky object that will compress slightly but leave a void next to it.

3) Wooden buildings are the safest type of construction to be in during an earthquake. Wood is flexible and moves with the force of the earthquake. If the wooden building does collapse, large survival voids are created. Also, the wooden building has less concentrated, crushing weight. Brick buildings will break into individual bricks. Bricks will cause many injuries but less squashed bodies than concrete slabs.

4) If you are in bed during the night and an earthquake occurs, simply roll off the bed. A safe void will exist around the bed. Hotels can achieve a much greater survival rate in earthquakes, simply by posting a sign on the back of the door of every room telling occupants to lie down on the floor, next to the bottom of the bed during an earthquake.

5) If an earthquake happens and you cannot easily escape by getting out the door or window, then lie down and curl up in the fetal position next to a sofa, or large chair.

6) Most everyone who gets under a doorway when buildings collapse is killed. How? If you stand under a doorway and the doorjamb falls forward or backward you will be crushed by the ceiling above. If the door jam falls sideways you will be cut in half by the doorway. In either case, you will be killed!

7) Never go to the stairs. The stairs have a different 'moment of frequency' (they swing separately from the main part of the building). The stairs and remainder of the building continuously bump into each other until structural failure of the stairs takes place. The people who get on stairs before they fail are chopped up by the stair treads - horribly mutilated. Even if the building doesn't collapse, stay away from the stairs. The stairs are a likely part of the building to be damaged. Even if the stairs are not collapsed by the earthquake, they may collapse later when overloaded by fleeing people. They should always be checked for safety, even when the rest of the building is not damaged.

8) Get Near the Outer Walls Of Buildings Or Outside Of Them If Possible - It is much better to be near the outside of the building rather than the interior. The farther inside you are from the outside perimeter of the building the greater the probability that your escape route will be blocked.

9) People inside of their vehicles are crushed when the road above falls in an earthquake and crushes their vehicles; which is exactly what happened with the slabs between the decks of the Nimitz Freeway. The victims of the San Francisco earthquake all stayed inside of their vehicles. They were all killed. They could have easily survived by getting out and sitting or lying next to their vehicles. Everyone killed would have survived if they had been able to get out of their cars and sit or lie next to them. All the crushed cars had voids 3 feet high next to them, except for the cars that had columns fall directly across them.

10) I discovered, while crawling inside of collapsed newspaper offices and other offices with a lot of paper, that paper does not compact. Large voids are found surrounding stacks of paper.

Spread the word and save someone's life... The Entire world is experiencing natural calamities so be prepared!

'We are but angels with one wing, it takes two to fly'

In 1996 we made a film, which proved my survival methodology to be correct. The Turkish Federal Government, City of Istanbul , University of Istanbul Case Productions and ARTI cooperated to film this practical, scientific test. We collapsed a school and a home with 20 mannequins inside. Ten mannequins did 'duck and cover,' and ten mannequins I used in my 'triangle of life' survival method. After the simulated earthquake collapse we crawled through the rubble and entered the building to film and document the results. The film, in which I practiced my survival techniques under directly observable, scientific conditions , relevant to building collapse, showed there would have been zero percent survival for those doing duck and cover.

There would likely have been 100 percent survivability for people using my method of the 'triangle of life.' This film has been seen by millions of viewers on television in Turkey and the rest of Europe , and it was seen in the USA , Canada and Latin America on the TV program Real TV.

Morning-after pill: Emergency birth control

The morning-after pill — a form of emergency birth control — is used to prevent a woman from becoming pregnant after she has had unprotected vaginal intercourse. Morning-after pills are generally considered safe, but many women are unaware that they exist.

Here's how the morning-after pill works. Human conception rarely occurs immediately after intercourse. Instead, it occurs as long as several days later, after ovulation. During the time between intercourse and conception, sperm continue to travel through the fallopian tube until the egg appears. So taking emergency birth control the "morning after" isn't too late to prevent pregnancy.

The active ingredients in morning-after pills are similar to those in birth control pills, except in higher doses. Some morning-after pills contain only one hormone, levonorgestrel (Plan B), and others contain two, progestin and estrogen. Progestin prevents the sperm from reaching the egg and keeps a fertilized egg from attaching to the wall of the uterus (implantation). Estrogen stops the ovaries from releasing eggs (ovulation) that can be fertilized by sperm.

The morning-after pill is designed to be taken within 72 hours of intercourse with a second dose taken 12 hours later. Side effects may include nausea, vomiting, abdominal pain, fatigue, dizziness, menstrual changes and headache. According to the manufacturer, the morning-after pill is more than 80 percent effective in preventing pregnancy after a single act of unprotected sex.

Morning-after pills aren't the same as mifepristone (Mifeprex), the so-called abortion pill. Emergency contraceptive pills such as Plan B prevent pregnancy. The abortion pill terminates an established pregnancy — one in which the fertilized egg has attached to the uterine wall and has already begun to develop.

Plan B is available to women 18 years and older without a prescription at most pharmacies. Women must show proof of age to purchase Plan B. For women 17 years old and younger, Plan B is available only with a doctor's prescription.

http://www.mayoclinic.com/health/morning-after-pill/AN00592