tag:theconversation.com,2011:/uk/topics/weight-loss-684/articlesWeight loss – The Conversation2024-03-12T23:31:26Ztag:theconversation.com,2011:article/2255672024-03-12T23:31:26Z2024-03-12T23:31:26ZAn apple cider vinegar drink a day? New study shows it might help weight loss<figure><img src="https://images.theconversation.com/files/581225/original/file-20240312-16-pgd6kq.jpg?ixlib=rb-1.1.0&rect=8%2C8%2C5742%2C3819&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/glass-healthy-cloudy-fermented-apple-cider-1133317064">Shutterstock</a></span></figcaption></figure><p>Made from fermented apples and naturally high in acetic acid, apple cider vinegar has been popular in recent years for its <a href="https://www.healthline.com/nutrition/6-proven-health-benefits-of-apple-cider-vinegar#blood-sugar">purported health benefits</a> – from antibacterial properties to antioxidant effects and potential for helping manage blood sugars. </p>
<p>Its <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8136602/">origins as a health tonic</a> stretch much further back. Hippocrates used it to treat wounds, fever and skin sores.</p>
<p>An experimental <a href="https://nutrition.bmj.com/content/early/2024/01/18/bmjnph-2023-000823">study</a>, released today, looks into whether apple cider vinegar could be effective for weight loss, reduce blood glucose levels and reduce blood lipids (cholesterol and triglycerides). </p>
<p>The results suggest it could reduce all three – but it might not be as simple as downing an apple cider vinegar drink a day.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/is-apple-cider-vinegar-really-a-wonder-food-86551">Is apple cider vinegar really a wonder food?</a>
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</em>
</p>
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<h2>What did they do?</h2>
<p>A group of scientists in Lebanon did a double-blinded, randomised, clinical trial in a group of overweight and obese young people aged from 12–25 years. </p>
<p>Researchers randomly placed 30 participants in one of four groups. The participants were instructed to consume either 5, 10 or 15ml of apple cider vinegar diluted into 250ml of water each morning before they ate anything for 12 weeks. A control group consumed an inactive drink (a placebo) made (from lactic acid added to water) to look and taste the same. </p>
<p>Typically this sort of study provides <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124652/#:%7E:text=Both%20systems%20place%20randomized%20controlled,less%20risk%20of%20systematic%20errors.">high quality evidence</a> as it can show cause and effect – that is the intervention (apple cider vinegar in this case) leads to a certain outcome. The study was also double-blinded, which means neither the participants or the scientists involved with collecting the data knew who was in which group.</p>
<h2>So, what did they find?</h2>
<p>After a period of three months apple cider vinegar consumption was linked with significant falls in body weight and body mass index (BMI). On average, those who drank apple cider vinegar during that period lost 6–8kg in weight and reduced their BMI by 2.7–3 points, depending on the dose. They also showed significant decreases in the waist and hip circumference.</p>
<p>The authors also report significant decreases in levels of blood glucose, triglycerides, and cholesterol in the apple cider groups. This finding echoes <a href="https://link.springer.com/article/10.1186/s12906-021-03351-w">previous studies</a>. The placebo group, who were given water with lactic acid, had much smaller decreases in weight and BMI. There were also no significant decreases in blood glucose and blood lipids. </p>
<p>From animal studies, it is thought the acetic acid in apple cider vinegar may affect the expression of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8136602/">genes involved in burning fats for energy</a>. The new study did not explore whether this mechanism was involved in any weight loss.</p>
<h2>Is this good news?</h2>
<p>While the study appears promising, there are also reasons for caution. </p>
<p>Firstly, study participants were aged from 12 to 25, so we can’t say whether the results could apply to everyone.</p>
<p>The statistical methods used in the study don’t allow us to confidently say the same amount of weight loss would occur again if the study was done again.</p>
<p>And while the researchers kept records of the participants’ diet and exercise during the study, these were not published in the paper. This makes it difficult to determine if diet or exercise may have had an impact. We don’t know whether participants changed the amount they ate or the types of food they ate, or whether they changed their exercise levels. </p>
<p>The study used a placebo which they tried to make identical in appearance and taste to the active treatment. But people may still be able to determine differences. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308085/">Researchers may ask participants</a> at the end of a study to guess which group they were in to test the integrity of the placebo. Unfortunately this was not done in this study, so we can’t be certain if the participants knew or not.</p>
<p>Finally, the authors do not report whether anyone dropped out of the study. This could be important and influence results if people who did not lose weight quit due to lack of motivation.</p>
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<a href="https://images.theconversation.com/files/581231/original/file-20240312-28-rsj49.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="open glass of liquid with cloudy substance at bottom, surrounded by apples" src="https://images.theconversation.com/files/581231/original/file-20240312-28-rsj49.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/581231/original/file-20240312-28-rsj49.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/581231/original/file-20240312-28-rsj49.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/581231/original/file-20240312-28-rsj49.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/581231/original/file-20240312-28-rsj49.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/581231/original/file-20240312-28-rsj49.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/581231/original/file-20240312-28-rsj49.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Is that you mother? The enzymes in apple cider vinegar might be health-giving.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/fresh-apples-bowl-raw-unfiltered-organic-257388970">Shutterstock</a></span>
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Read more:
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<h2>Any other concerns?</h2>
<p>Apple cider vinegar is acidic and there are concerns it may erode tooth enamel. This can be a problem with any acidic beverages, including fizzy drinks, <a href="https://theconversation.com/lemon-water-wont-detox-or-energise-you-but-it-may-affect-your-body-in-other-ways-180035">lemon water</a> and orange juice.</p>
<p>To minimise the risk of <a href="https://theconversation.com/health-check-whats-eating-your-teeth-37096">acid erosion</a> some dentists recommend the following after drinking acidic drinks: </p>
<ul>
<li>rinsing out your mouth with tap water afterwards</li>
<li>chewing sugar-free gum afterwards to stimulate saliva production</li>
<li>avoiding brushing your teeth immediately after drinking because it might damage the teeth’s softened top layer</li>
<li>drink with a straw to minimise contact with the teeth.</li>
</ul>
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<a href="https://images.theconversation.com/files/581235/original/file-20240312-28-1jzy3o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="woman holds glass of water and has full cheeks" src="https://images.theconversation.com/files/581235/original/file-20240312-28-1jzy3o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/581235/original/file-20240312-28-1jzy3o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/581235/original/file-20240312-28-1jzy3o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/581235/original/file-20240312-28-1jzy3o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/581235/original/file-20240312-28-1jzy3o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/581235/original/file-20240312-28-1jzy3o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/581235/original/file-20240312-28-1jzy3o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Rinsing with water could prevent acid damaging your teeth.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-rinsing-gargling-while-using-mouthwash-644616745">Shutterstock</a></span>
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Read more:
<a href="https://theconversation.com/apple-cider-vinegar-is-drinking-this-popular-home-remedy-bad-for-your-teeth-a-dentist-explains-197297">Apple cider vinegar: is drinking this popular home remedy bad for your teeth? A dentist explains</a>
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</em>
</p>
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<h2>Down the hatch?</h2>
<p>This study provides us with some evidence of a link between apple cider vinegar and weight loss. But before health professionals can recommend this as a weight loss strategy we need bigger and better conducted studies across a wider age range. </p>
<p>Such research would need to be done alongside a controlled background diet and exercise across all the participants. This would provide more robust evidence that apple cider vinegar could be a useful aid for weight loss. </p>
<p>Still, if you don’t mind the taste of apple cider vinegar then you could try drinking some for weight loss, alongside a <a href="https://www.eatforhealth.gov.au/">healthy balanced and varied dietary intake</a>. This study does not suggest people can eat whatever they like and drink apple cider vinegar as a way to control weight. </p>
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Read more:
<a href="https://theconversation.com/great-time-to-try-pickling-135052">Great time to try: pickling</a>
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</p>
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<img src="https://counter.theconversation.com/content/225567/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Evangeline Mantzioris is affiliated with Alliance for Research in Nutrition, Exercise and Activity (ARENA) at the University of South Australia. Evangeline Mantzioris has received funding from the National Health and Medical Research Council, and has been appointed to the National Health and Medical Research Council Dietary Guideline Expert Committee.</span></em></p>Researchers gave people in the study 5, 10 or 15ml doses of apple cider vinegar and found they lost more weight than those taking a placebo. But the findings need a closer look.Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2231492024-03-01T17:24:46Z2024-03-01T17:24:46ZLosing weight associated with an increased cancer risk – a closer look at the study<p>Being overweight is linked to many health issues, including cancer. Studies have shown that obesity is associated with at least <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314462/">13 types of cancer</a>. And in some regions, such as North America, Europe and the Middle East, obesity contributes to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9857053/#:%7E:text=Globally%2C%20it%20is%20estimated%20that,cancer%20in%20women%20%5B8%5D.">up to 9% of all cancer cases</a>. It might even become the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0091743519301318">top cause of cancer in UK women</a> in the next 25 years. So losing weight is clearly an important health goal.</p>
<p>However, a <a href="https://jamanetwork.com/journals/jama/article-abstract/2814132?resultClick=1">recent study</a> produced an unexpected result. It found that weight loss was associated with a significantly higher rate of cancer during the 12 months following the weight loss, compared with those who hadn’t lost weight.</p>
<p>The study used data from nearly 160,000 health professionals who have been studied for an average of 28 years. These people reported their health and lifestyle details every two years up to 2016. The researchers paid special attention to their weight changes.</p>
<p>Participants were divided into three groups based on how intentional their weight loss was: “high” for those enhancing both diet and exercise, “medium” for improvements in diet or exercise, and “low” for no notable improvements in either. </p>
<p>Among the participants, a striking finding emerged: people who lost more than 10% of their body weight had a significantly higher risk of cancer diagnoses in the following year. </p>
<p>But not all cancers were equally linked to weight loss. The study found a strong connection between weight loss and cancers of the upper digestive system (gullet and stomach), liver, pancreas and bile ducts. </p>
<p>For these types, the risk was much higher, with chances increasing between three to over seven times. The link was weaker for colorectal and lung cancer, though, and didn’t seem to affect the likelihood of getting breast, prostate and cancers that affect just women. </p>
<h2>Some limits</h2>
<p>The study’s authors are careful, though. They know their research has some limits. For one, they relied on people’s own reports of their weight, which might not always be accurate. Also, they only checked in on participants every two years, which meant some details could be missed. Plus, the study was mostly on US health professionals, who might be more aware of cancer and have better access to healthcare.</p>
<p>Notably, the risk was highest in those who made the least effort to lose weight (those classified as “low intentionality for weight loss”). So, on closer examination, this study may back up what we knew already: if you’re losing weight without trying, it’s <a href="https://www.nhs.uk/conditions/unintentional-weight-loss/">important</a> to look into why. </p>
<p>What’s new here is that the study helps point out which cancers might be the reason for this unexpected weight loss. This means when someone loses weight without a clear reason, doctors might focus more on checking for certain cancers, like those in the stomach area or liver, to find out what’s going on.</p>
<p>On the other hand, there’s a lot of evidence showing the benefits of losing weight on purpose. For instance, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8855671/#:%7E:text=Data%20from%20the%20Look%20AHEAD,diabetes%20support%20and%20education%20(DSE)">a study</a> published in 2022 found that people who made significant lifestyle changes had a 16% lower risk of obesity-related cancers. Another <a href="https://jamanetwork.com/journals/jama/fullarticle/2793220">study</a> from the same year found that weight-loss surgery greatly reduced the risk of getting cancer and dying from it.</p>
<p>So it’s important to remember the proven benefits of managing weight and staying active to prevent cancer. </p>
<p>Weight management is a complex field that includes medication, surgery and lifestyle changes. In the future, we may tailor weight goals to fit individual health needs better, thanks to a deeper understanding of what truly contributes to wellbeing. </p>
<p>Research suggests that being slightly overweight in older age might not be as bad as we once thought and could even be linked to <a href="https://www.sciencedirect.com/science/article/pii/S1047279721000090">living longer</a>. As we face a global obesity epidemic, this information helps tailor approaches to weight management and cancer prevention.</p><img src="https://counter.theconversation.com/content/223149/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gianmacro Contino receives funding from Cancer Research UK. </span></em></p>Losing weight through diet or exercise is good for your health, but a new study suggests that the risk of some cancers goes up too.Gianmarco Contino, University of BirminghamLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2237312024-02-28T19:15:27Z2024-02-28T19:15:27Z‘Naked carbs’ and ‘net carbs’ – what are they and should you count them?<figure><img src="https://images.theconversation.com/files/578191/original/file-20240227-30-zvycnf.jpg?ixlib=rb-1.1.0&rect=9%2C18%2C6097%2C4001&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.pexels.com/photo/tasty-soft-buns-in-wicker-basket-4197986/">Pexels/Karolina Grabowska</a></span></figcaption></figure><p>According to <a href="https://www.tiktok.com/channel/carbs?lang=en">social media</a>, carbs come in various guises: naked carbs, net carbs, complex carbs and more. </p>
<p>You might be wondering what these terms mean or if all carbs are really the same. If you are into “carb counting” or “cutting carbs”, it’s important to make informed decisions about what you eat. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/stop-hating-on-pasta-it-actually-has-a-healthy-ratio-of-carbs-protein-and-fat-197416">Stop hating on pasta – it actually has a healthy ratio of carbs, protein and fat</a>
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</em>
</p>
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<h2>What are carbs?</h2>
<p>Carbohydrates, or “carbs” for short, are one of the main sources of <a href="https://www.tandfonline.com/doi/full/10.1080/10408398.2017.1392287">energy</a> we need for brain function, muscle movement, digestion and pretty much everything our bodies do. </p>
<p>There are two classifications of carbs, <a href="https://www.ncbi.nlm.nih.gov/books/NBK459280/">simple and complex</a>. Simple carbs have one or two sugar molecules, while complex carbs are three or more sugar molecules joined together. For example, table sugar is a simple carb, but starch in potatoes is a complex carb. </p>
<p>All carbs need to be broken down into individual molecules by our digestive enzymes to be absorbed. Digestion of complex carbs is a much slower process than simple carbs, leading to a more gradual blood sugar increase. </p>
<p>Fibre is also considered a complex carb, but it has a structure our body is not capable of digesting. This means we don’t absorb it, but it helps with the movement of our <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1467-3010.2007.00616.x">stool and prevents constipation</a>. Our good gut bacteria also love fibre as they can digest it and use it for energy – important for a healthy gut. </p>
<h2>What about ‘naked carbs’?</h2>
<p>“Naked carbs” is a popular term usually used to refer to foods that are mostly simple carbs, without fibre or accompanying protein or fat. White bread, sugary drinks, jams, sweets, white rice, white flour, crackers and fruit juice are examples of these foods. Ultra-processed foods, where the grains are stripped of their outer layers (including fibre and most nutrients) leaving “refined carbs”, also fall into this category.</p>
<p>One of the problems with naked carbs or refined carbs is they <a href="https://link.springer.com/article/10.1007/s11033-020-05611-3">digest and absorb quickly</a>, causing an immediate rise in blood sugar. This is followed by a rapid spike in <a href="https://diabetesjournals.org/diabetes/article/25/9/741/4132/Plasma-Glucose-and-Insulin-Responses-to-Orally">insulin</a> (a hormone that signals cells to remove sugar from blood) and then a drop in blood sugar. This can lead to hunger and cravings – a vicious cycle that only gets worse with eating more of the same foods. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/i-want-to-eat-healthily-so-why-do-i-crave-sugar-salt-and-carbs-212114">I want to eat healthily. So why do I crave sugar, salt and carbs?</a>
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</em>
</p>
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<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/578193/original/file-20240227-24-ibtpni.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="donut with sprinkles in close up" src="https://images.theconversation.com/files/578193/original/file-20240227-24-ibtpni.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/578193/original/file-20240227-24-ibtpni.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/578193/original/file-20240227-24-ibtpni.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/578193/original/file-20240227-24-ibtpni.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/578193/original/file-20240227-24-ibtpni.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/578193/original/file-20240227-24-ibtpni.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/578193/original/file-20240227-24-ibtpni.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Naked carbs can make blood sugars spike then crash.</span>
<span class="attribution"><a class="source" href="https://www.pexels.com/photo/pink-doughnut-with-colorful-sprinkles-intilt-shift-lens-3784440/">Pexels/Alexander Grey</a></span>
</figcaption>
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<h2>What about ‘net carbs’?</h2>
<p>This is another popular term tossed around in dieting discussions. Net carbs refer to the part of the carb food that we actually absorb. </p>
<p>Again, fibre is not easily digestible. And some carb-rich foods contain sugar alcohols, such as sweeteners (like xylitol and sorbitol) that have limited absorption and little to no effect on blood sugar. Deducting the value of fibre and sugar alcohols from the total carbohydrate content of a food gives what’s considered its net carb value. </p>
<p>For example, canned pear in juice has around <a href="https://afcd.foodstandards.gov.au/fooddetails.aspx?PFKID=F006593">12.3g of “total carbohydrates” per 100g</a>, including 1.7g carb + 1.7g fibre + 1.9g sugar alcohol. So its net carb is 12.3g – 1.7g – 1.9g = 8.7g. This means 8.7g of the 12.3g total carbs impacts blood sugar.</p>
<p>The nutrition labels on packaged foods in Australia and New Zealand usually list fibre separately to carbohydrates, so the net carbs have already been calculated. This is not the case in other countries, where “total carbohydrates” are listed.</p>
<p><div data-react-class="TiktokEmbed" data-react-props="{"url":"https://www.tiktok.com/@andydoeshealthy/video/7040499646451502342"}"></div></p>
<h2>Does it matter though?</h2>
<p>Whether or not you should care about net or naked carbs depends on your dietary preferences, health goals, food accessibility and overall nutritional needs. Generally speaking, we should try to limit our consumption of simple and refined carbs. </p>
<p>The latest <a href="https://iris.who.int/bitstream/handle/10665/370420/9789240073593-eng.pdf?sequence=1">World Health Organization guidelines</a> recommend our carbohydrate intake should ideally come primarily from whole grains, vegetables, fruits and pulses, which are rich in complex carbs and fibre. This can have significant health benefits (to <a href="https://pubmed.ncbi.nlm.nih.gov/33096647/">regulate hunger, improve cholesterol or help with weight management</a>) and reduce the risk of conditions <a href="https://pubmed.ncbi.nlm.nih.gov/33096647/">such as heart disease, obesity and colon cancer</a>.</p>
<p>In moderation, naked carbs aren’t necessarily bad. But pairing them with fats, protein or fibre <a href="https://www.thelancet.com/article/S0140-6736(18)31809-9/fulltext">can slow down the digestion</a> and absorption of sugar. This can help to stabilise blood sugar levels, prevent spikes and crashes and <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1467-3010.2007.00616.x">support personal weight management goals</a>. If you’re managing diabetes or insulin resistance, paying attention to the composition of your meals, and the quality of your carbohydrate sources is essential.</p>
<p>A <a href="https://theconversation.com/what-are-ketogenic-diets-can-they-treat-epilepsy-and-brain-cancer-83401">ketogenic (high fat, low carb) diet</a> typically restricts carb intake to between 20 and 50g each day. But this carb amount refers to net carbs – so it is possible to eat more carbs from high-fibre sources.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/578196/original/file-20240227-24-vpjsg8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="salad with quinoa and vegetables" src="https://images.theconversation.com/files/578196/original/file-20240227-24-vpjsg8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/578196/original/file-20240227-24-vpjsg8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/578196/original/file-20240227-24-vpjsg8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/578196/original/file-20240227-24-vpjsg8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/578196/original/file-20240227-24-vpjsg8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/578196/original/file-20240227-24-vpjsg8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/578196/original/file-20240227-24-vpjsg8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Choose complex carbohydrates with lots of fibre.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/healthy-salad-spinachquinoa-roasted-vegetables-201536141">Shutterstock</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-much-protein-do-i-need-as-i-get-older-and-do-i-need-supplements-to-get-enough-215695">How much protein do I need as I get older? And do I need supplements to get enough?</a>
</strong>
</em>
</p>
<hr>
<h2>Some tips to try</h2>
<p>Some simple strategies can help you get the most out of your carb intake:</p>
<ul>
<li><p>reduce your intake of naked carbs and foods high in sugar and white flour, such as white bread, table sugar, honey, lollies, maple syrup, jam, and fruit juice</p></li>
<li><p>opt for protein- and fibre-rich carbs. These include oats, sweet potatoes, nuts, avocados, beans, whole grains and broccoli</p></li>
<li><p>if you are eating naked carbs, dress them up with some protein, fat and fibre. For example, top white bread with a nut butter rather than jam </p></li>
<li><p>if you are trying to reduce the carb content in your diet, be wary of any <a href="https://link.springer.com/article/10.1007/s12603-020-1417-1">symptoms of low blood glucose</a>, including headaches, nausea, and dizziness </p></li>
<li><p>working with a health-care professional such as an accredited practising dietitian or your GP can help develop an individualised diet plan that meets your specific needs and goals.</p></li>
</ul>
<hr>
<p><em>Correction: this article has been updated to indicate how carbohydrates are listed on food nutrition labels in Australia and New Zealand.</em></p><img src="https://counter.theconversation.com/content/223731/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>All carbs need to be broken down by our digestive enzymes to be absorbed. Digestion of complex carbs is a much slower process than simple carbs, leading to a more gradual blood sugar increase.Saman Khalesi, Senior Lecturer and Discipline Lead in Nutrition, School of Health, Medical and Applied Sciences, CQUniversity AustraliaAnna Balzer, Lecturer, Medical Science School of Health, Medical and Applied Sciences, CQUniversity AustraliaCharlotte Gupta, Postdoctoral research fellow, CQUniversity AustraliaChris Irwin, Senior Lecturer in Nutrition and Dietetics, School of Health Sciences & Social Work, Griffith UniversityGrace Vincent, Senior Lecturer, Appleton Institute, CQUniversity AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2212682024-02-27T16:31:21Z2024-02-27T16:31:21Z‘Budget Ozempic’: five ways this dangerous TikTok weight loss trend will harm your health<figure><img src="https://images.theconversation.com/files/578279/original/file-20240227-28-vnqnu5.jpg?ixlib=rb-1.1.0&rect=7%2C7%2C5168%2C3430&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">'Budget Ozempic' usually refers to laxatives or stool softeners.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/diarrhea-concept-treatment-stomach-intestinal-constipation-1354249349">goffkein.pro/ Shutterstock</a></span></figcaption></figure><p>Social media is obsessed with the <a href="https://www.bjd-abcd.com/bjdvd/index.php/bjd/article/view/1155">type 2 diabetes drug</a> Ozempic. But Ozempic’s ability to control blood sugar isn’t the reason it’s so popular online. Instead, the drug is trending because it has been shown in <a href="https://www.bjd-abcd.com/bjdvd/index.php/bjd/article/view/1155">clinical trials</a> to cause weight loss in diabetic patients taking it.</p>
<p>This has led to an uptick in the number of people trying to get their hands on Ozempic in the hopes of losing weight – even though the Ozempic is <a href="https://www.novomedlink.com/diabetes/products/treatments/ozempic/efficacy-safety/ozempic-and-weight.htm">not recommended for weight loss</a>. The drug’s soaring popularity online has not only contributed to shortages and <a href="https://www.cbsnews.com/news/ozempic-wegovy-fake-weight-loss-drugs-fda-investigating-trade-group-warns/">bootleg versions</a> of the drug, it’s also led to an influx of harmful diet trends. </p>
<p>One of these diet trends circulating on social media is what some have dubbed “Budget Ozempic”. Budget Ozempic is in fact not at all related to Ozempic, nor does it contain semaglutide – the drug component which is the active ingredient in Ozempic. In most cases, what people online are calling “budget Ozempic”, actually refers to laxatives and stool softeners. </p>
<p>There are many reasons why you should avoid using “budget Ozempic” if you’re trying to lose weight – least of which is because they only have a small, short-term effect on weight loss. Laxatives and stool softeners are not designed to be used long-term, nor are they indicated for weight loss. Using them improperly can be harmful for many reasons.</p>
<h2>Dehydration</h2>
<p>Some types of laxatives work by bringing water from elsewhere in the body into the intestines in order to soften the stool and make it easier to pass. But abuse of laxatives and stool softeners can lead to <a href="https://link.springer.com/article/10.2165/11898640-000000000-00000">water loss</a> and dehydration. This may lead to short-term symptoms such as feeling more tired or thirsty than usual, as well as dizziness and lightheadedness.</p>
<p>Water loss can also trigger the body’s <a href="https://www.ncbi.nlm.nih.gov/books/NBK470410/">renin-angiotensen response</a>. The key function of this response is to keep fluids and blood pressure balanced. If too much water is lost in a short period of time, it will eventually cause fluid retention. This temporary <a href="https://cypf.berkshirehealthcare.nhs.uk/media/109513512/laxative-misuse.pdf">fluid retention</a> happens due to your body overcompensating for the dehydration. Chronic dehydration may lead to <a href="https://portlandpress.com/clinsci/article-abstract/137/9/755/233060/Revisiting-blood-pressure-and-body-fluid-status">hypertension</a> and other <a href="https://www.ncbi.nlm.nih.gov/books/NBK470410">cardiovascular problems</a>. </p>
<figure class="align-center ">
<img alt="A dehydrated man with a headache holds his head in pain while holding a glass of water." src="https://images.theconversation.com/files/578281/original/file-20240227-24-wb98m9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/578281/original/file-20240227-24-wb98m9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/578281/original/file-20240227-24-wb98m9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/578281/original/file-20240227-24-wb98m9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/578281/original/file-20240227-24-wb98m9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/578281/original/file-20240227-24-wb98m9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/578281/original/file-20240227-24-wb98m9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Short-term symptoms of dehydration include tiredness, thirst and dizziness.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-man-suffering-strong-headache-migraine-1095874334">fizkes/ Shutterstock</a></span>
</figcaption>
</figure>
<p>But while laxative use causes water loss, it does not lead to fat loss. This means that any weight a person loses from using laxatives is only temporary – and any water lost will be regained.</p>
<h2>Electrolyte imbalance</h2>
<p>Using laxatives irresponsibly may also cause you to lose electrolytes.</p>
<p>Electrolytes (such as sodium, potassium and chloride) are essential for the body to function. They help to balance your fluid levels and keep your muscles and <a href="https://link.springer.com/chapter/10.1007/978-3-031-31244-1_14">nervous system working</a>. But when our body loses water or we become dehydrated, our body’s electrolyte balance is thrown out of whack. </p>
<p>In the short-term, electrolyte imbalance can cause muscle cramps and spasm, nausea, fatigue, headaches and even numbness in the limbs. But chronic, long-term electrolyte imbalance can be more dangerous – increasing risk of <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jcpt.13204">heart problems</a>. </p>
<h2>Poor nutrient intake</h2>
<p>Our body requires many nutrients in order to function properly – including vitamins, minerals, carbohydrates and protein. These nutrients come from the foods we consume, and are mainly absorbed in the small intestine.</p>
<p>Using <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/%28SICI%291098-108X%28199703%2921%3A2%3C115%3A%3AAID-EAT2%3E3.0.CO%3B2-O?saml_referrer">laxatives and purging</a> (as is sometimes seen in cases of bulimia nervosa) can lead to poor quality nutrient intake. One study even found that the use of laxatives led to <a href="https://www.acpjournals.org/doi/10.7326/0003-4819-99-1-14">12% less absorption</a> of essential nutrients.</p>
<h2>Gastrointestinal issues</h2>
<p>Laxative use affects the <a href="https://www.nhs.uk/conditions/laxatives/#:%7E:text=Ask%20a%20GP%20for%20advice,and%20minerals%20in%20your%20body.">gastrointestinal system</a>. If you use them for a long period of time, it can cause <a href="https://pubmed.ncbi.nlm.nih.gov/8712767/">diarrhoea</a>. </p>
<p>The reason this <a href="https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/laxative">causes diarrhoea</a> is because laxatives work to move waste quickly through the intestine and secrete water into the bowel. This can also, in turn, lead to an imbalance in mineral and salt levels in your body.</p>
<h2>Health considerations</h2>
<p>Although use of laxatives and stool softeners could temporarily lead to weight loss, this is only due to a loss of water weight, the detrimental effects of laxative misuse far outweigh any temporary weight loss you may achieve. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5411570/">Misuse of laxatives</a> could also increase risk of eating disorders, such as bulimia nervosa. </p>
<p>Anyone who wants to lose weight should try to follow a structured weight loss programme that includes a healthy, balanced diet paired with exercise. Laxatives should only be used to treat constipation if other methods haven’t worked and after speaking with your GP.</p><img src="https://counter.theconversation.com/content/221268/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Swrajit Sarkar does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Laxatives and stool softeners are not designed to be used for weight loss.Swrajit Sarkar, Senior Lecturer in Nutrition, City, University of LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2219682024-02-22T13:42:36Z2024-02-22T13:42:36ZMothers’ dieting habits and self-talk have profound impact on daughters − 2 psychologists explain how to cultivate healthy behaviors and body image<figure><img src="https://images.theconversation.com/files/576104/original/file-20240216-20-r6kakd.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C6000%2C3724&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Mothers play an outsized role in the formation of their daughters' dietary habits.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/happy-mother-and-daughter-bonding-at-home-royalty-free-image/1429136148?phrase=mothers+and+daughters+in+kitchen&adppopup=true">andresr/E+ via Getty Images</a></span></figcaption></figure><p>Weight loss is one of the most common health and appearance-related goals.</p>
<p>Women and <a href="https://www.cdc.gov/nchs/products/databriefs/db340.htm">teen girls</a> are <a href="https://www.cdc.gov/nchs/products/databriefs/db313.htm">especially likely to pursue dieting</a> to achieve weight loss goals even though a great deal of research shows that <a href="https://theconversation.com/what-thin-people-dont-understand-about-dieting-86604">dieting doesn’t work over the long term</a>. </p>
<p>We are a <a href="https://www.duck-lab.com/people">developmental psychologist</a> and a <a href="https://psy.uncg.edu/directory/ashleigh-gallagher/">social psychologist</a> who together wrote a forthcoming book, “Beyond Body Positive: A Mother’s Evidence-Based Guide for Helping Girls Build a Healthy Body Image.”</p>
<p>In the book, we address topics such as the effects of maternal dieting behaviors on daughters’ health and well-being. We provide information on how to build a foundation for healthy body image beginning in girlhood. </p>
<h2>Culturally defined body ideals</h2>
<p>Given the strong influence of social media and other cultural influences on body ideals, it’s understandable that so many people pursue diets aimed at weight loss. <a href="https://communityhealth.mayoclinic.org/featured-stories/tiktok-diets">TikTok</a>, YouTube, Instagram and celebrity websites feature slim influencers and “how-tos” for achieving those same results in no time. </p>
<p>For example, women and teens are engaging in rigid and extreme forms of exercise such as 54D, a program to <a href="https://54d.com/">achieve body transformation in 54 days</a>, or the <a href="https://health.clevelandclinic.org/75-hard-challenge-and-rules">75 Hard Challenge</a>, which is to follow five strict rules for 75 days.</p>
<p>For teens, these pursuits are likely fueled by trendy body preoccupations such as the desire for “<a href="https://www.nytimes.com/2024/02/06/well/move/tiktok-legging-legs-eating-disorders.html?">legging legs</a>.” </p>
<p>Women and teens have also been been inundated with recent messaging around <a href="https://theconversation.com/drugs-that-melt-away-pounds-still-present-more-questions-than-answers-but-ozempic-wegovy-and-mounjaro-could-be-key-tools-in-reducing-the-obesity-epidemic-205549">quick-fix weight loss drugs</a>, which come with a lot of caveats. </p>
<p>Dieting and weight loss goals are highly individual, and when people are intensely self-focused, it is <a href="https://doi.org/10.1521/jscp.2000.19.1.70">possible to lose sight of the bigger picture</a>. Although women might wonder what the harm is in trying the latest diet, science shows that dieting behavior doesn’t just affect the dieter. In particular, for women who are mothers or who have other girls in their lives, these behaviors affect girls’ emerging body image and their health and well-being. </p>
<h2>The profound effect of maternal role models</h2>
<p>Research shows that mothers and maternal figures <a href="https://doi.org/10.1016/j.brat.2017.11.001">have a profound influence on their daughters’ body image</a>. </p>
<p>The opportunity to influence girls’ body image comes far earlier than adolescence. In fact, research shows that these influences on body image <a href="https://www.teenvogue.com/story/how-toxic-diet-culture-is-passed-from-moms-to-daughters">begin very early in life</a> – <a href="https://doi.org/10.1016/bs.acdb.2016.10.006">during the preschool years</a>. </p>
<p>Mothers may feel that they are being discreet about their dieting behavior, but little girls are watching and listening, and they are far more observant of us than many might think. </p>
<p>For example, one study revealed that compared with daughters of nondieting women, 5-year-old girls whose mothers dieted <a href="https://doi.org/10.1016/S0002-8223(00)00339-4">were aware of the connection between dieting and thinness</a>. </p>
<p>Mothers’ eating behavior does not just affect girls’ ideas about dieting, but also their daughters’ eating behavior. The amount of food that mothers eat <a href="https://doi.org/10.1016/j.appet.2018.04.018">predicts how much their daughters will eat</a>. In addition, daughters whose mothers are dieters are <a href="https://doi.org/10.1016/j.appet.2018.04.018">more likely to become dieters themselves</a> and are also <a href="https://doi.org/10.1016/j.eatbeh.2007.03.001">more likely to have a negative body image</a>. </p>
<p>Negative body image is <a href="https://theconversation.com/mounting-research-documents-the-harmful-effects-of-social-media-use-on-mental-health-including-body-image-and-development-of-eating-disorders-206170">not a trivial matter</a>. It affects girls’ and women’s mental and physical well-being in a <a href="https://doi.org/10.1177/1359105317710815">host of ways</a> and <a href="https://doi.org/10.1016/j.brat.2011.06.009">can predict the emergence of eating disorders</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/577135/original/file-20240221-18-wdo3e8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Food choice concept of young girl comparing fast food to natural and organic products." src="https://images.theconversation.com/files/577135/original/file-20240221-18-wdo3e8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/577135/original/file-20240221-18-wdo3e8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=473&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577135/original/file-20240221-18-wdo3e8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=473&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577135/original/file-20240221-18-wdo3e8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=473&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577135/original/file-20240221-18-wdo3e8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=595&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577135/original/file-20240221-18-wdo3e8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=595&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577135/original/file-20240221-18-wdo3e8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=595&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">It’s important to avoid labeling foods as good or bad, instead focusing on a balanced diet.</span>
<span class="attribution"><span class="source">Rudzhan Nagiev/iStock via Getty Images</span></span>
</figcaption>
</figure>
<h2>Avoiding ‘fat talk’</h2>
<p>What can moms do, then, to serve their daughters’ and their own health? </p>
<p>They can focus on small steps. And although it is best to begin these efforts early in life – in girlhood – it is never too late to do so. </p>
<p>For example, mothers can consider how they think about and talk about themselves around their daughters. Engaging in “fat talk” may inadvertently send their daughters the message that larger bodies are bad, <a href="https://doi.org/10.1016/j.bodyim.2020.07.004">contributing to weight bias</a> and negative self-image. Mothers’ fat talk also <a href="https://doi.org/10.1080/15267431.2021.1908294">predicts later body dissatisfaction in daughters</a>. </p>
<p>And negative self-talk isn’t good for mothers, either; it is associated with <a href="https://doi.org/10.1177/1359105318781943">lower motivation and unhealthful eating</a>. Mothers can instead practice and model self-compassion, which involves treating oneself the way <a href="https://doi.org/10.1016/j.bodyim.2016.03.003">a loving friend might treat you</a>. </p>
<p>In discussions about food and eating behavior, it is important to avoid moralizing certain kinds of food by labeling them as “good” or “bad,” as girls may extend these labels to their personal worth. For example, a young girl may feel that she is being “bad” if she eats dessert, if that is what she has learned from observing the women around her. In contrast, she may feel that she has to eat a salad to be “good.” </p>
<p>Moms and other female role models can make sure that the dinner plate sends a healthy message to their daughters by showing instead that all foods can fit into a balanced diet when the time is right. Intuitive eating, which emphasizes paying attention to hunger and satiety and allows flexibility in eating behavior, is associated with <a href="https://doi.org/10.1007/s40519-020-00852-4">better physical and mental health in adolescence</a>.</p>
<p>Another way that women and especially moms can buffer girls’ body image is by helping their daughters <a href="https://doi.org/10.1016/j.bodyim.2021.12.009">to develop media literacy</a> and to think critically about the nature and purpose of media. For example, moms can discuss the misrepresentation and distortion of bodies, such as the use of filters to enhance physical appearance, on social media. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/577137/original/file-20240221-18-yucv2s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Three young girls sitting close together, each holding a smart phone." src="https://images.theconversation.com/files/577137/original/file-20240221-18-yucv2s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/577137/original/file-20240221-18-yucv2s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577137/original/file-20240221-18-yucv2s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577137/original/file-20240221-18-yucv2s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577137/original/file-20240221-18-yucv2s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577137/original/file-20240221-18-yucv2s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577137/original/file-20240221-18-yucv2s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Social media filters can lead to distorted body ideals.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/group-of-friends-using-their-phones-royalty-free-image/843840202?phrase=social+media+young+girls&adppopup=true">Flashpop/DigitalVision via Getty Images</a></span>
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<h2>Focusing on healthful behaviors</h2>
<p>One way to begin to focus on health behaviors rather than dieting behaviors is to develop respect for the body and to <a href="https://theconversation.com/body-neutrality-what-it-is-and-how-it-can-help-lead-to-more-positive-body-image-191799">consider body neutrality</a>. In other words, prize body function rather than appearance and spend less time thinking about your body’s appearance. Accept that there are times when you may not feel great about your body, and that this is OK. </p>
<p>To feel and look their best, mothers can aim to stick to a <a href="https://theconversation.com/whats-the-best-diet-for-healthy-sleep-a-nutritional-epidemiologist-explains-what-food-choices-will-help-you-get-more-restful-zs-219955">healthy sleep schedule</a>, manage their stress levels, <a href="https://theconversation.com/fiber-is-your-bodys-natural-guide-to-weight-management-rather-than-cutting-carbs-out-of-your-diet-eat-them-in-their-original-fiber-packaging-instead-205159">eat a varied diet</a> that includes all of the foods that they enjoy, and <a href="https://theconversation.com/the-runners-high-may-result-from-molecules-called-cannabinoids-the-bodys-own-version-of-thc-and-cbd-170796">move and exercise their bodies regularly</a> as lifelong practices, rather than engaging in quick-fix trends. </p>
<p>Although many of these tips sound familiar, and perhaps even simple, they become effective when we recognize their importance and begin acting on them. Mothers can work toward modeling these behaviors and tailor each of them to their daughter’s developmental level. It’s never too early to start. </p>
<h2>Promoting healthy body image</h2>
<p>Science shows that several personal characteristics are associated with body image concerns among women. </p>
<p>For example, research shows that women who are <a href="https://doi.org/10.1016/j.bodyim.2020.02.001">higher in neuroticism</a> <a href="https://doi.org/10.1186/2050-2974-1-2">and perfectionism</a>, <a href="https://doi.org/10.3389/fpsyg.2022.983534">lower in self-compassion</a> or <a href="https://doi.org/10.1016/j.bodyim.2013.08.001">lower in self-efficacy</a> are all more likely to struggle with negative body image. </p>
<p>Personality is frequently defined as a person’s characteristic pattern of thoughts, feelings and behaviors. But if they wish, <a href="https://doi.org/10.1002/per.1945">mothers can change personality characteristics</a> that they feel aren’t serving them well. </p>
<p>For example, perfectionist tendencies – such as setting unrealistic, inflexible goals – can be examined, challenged and replaced with more rational thoughts and behaviors. A woman who believes she must work out every day can practice being more flexible in her thinking. One who thinks of dessert as “cheating” can practice resisting moral judgments about food. </p>
<p>Changing habitual ways of thinking, feeling and behaving certainly takes effort and time, but it is far more likely than diet trends to bring about sustainable, long-term change. And taking the first steps to modify even a few of these habits can positively affect daughters.</p>
<p>In spite of all the noise from media and other cultural influences, mothers can feel empowered knowing that they have a significant influence on their daughters’ feelings about, and treatment of, their bodies. </p>
<p>In this way, mothers’ modeling of healthier attitudes and behaviors is a sound investment – for both their own body image and that of the girls they love.</p><img src="https://counter.theconversation.com/content/221968/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Adopting healthy behaviors and thought patterns around food and nutrition takes time and intentional effort. But it will lead to more lasting change and positive outcomes than quick-fix dieting will.Janet J. Boseovski, Professor of Psychology, University of North Carolina – GreensboroAshleigh Gallagher, Senior Lecturer, University of North Carolina – GreensboroLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2213802024-02-13T16:08:44Z2024-02-13T16:08:44ZMillions of older people don’t get enough nutrients – how to spot it and what to do about it<figure><img src="https://images.theconversation.com/files/574978/original/file-20240212-16-xw8sc6.jpg?ixlib=rb-1.1.0&rect=29%2C9%2C6581%2C4390&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.gettyimages.co.uk/detail/photo/osteoporosis-good-food-for-our-good-health-royalty-free-image/1475431573?phrase=healthy+older+adults+eating+dairy&adppopup=true">Erdark</a></span></figcaption></figure><p>By 2050, approximately a quarter of the UK population is <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/articles/overviewoftheukpopulation/january2021">expected to be over the age of 65</a>. With this in mind, the World Health Organization (WHO) has put “<a href="https://cdn.who.int/media/docs/default-source/decade-of-healthy-ageing/decade-proposal-final-apr2020-en.pdf?sfvrsn=b4b75ebc_28">healthy ageing</a>” on its agenda. This means finding ways to maintain health, wellbeing and functional ability in order to have a good quality of life and enjoy the later years. </p>
<p>Everyone ages at a different rate – but there are some things that can influence how well we age, such as by making changes to the types of activity we do and the foods we eat. </p>
<p>Older adults are <a href="https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/research-report-2019--one-step-at-a-time.pdf">generally less physically active</a> than they were when they were younger and because of this, their energy intake requirement may decrease. However, there is a difference between energy requirements and nutrient requirements, and nutrient requirements actually remain the same, if not increase, as we get older. </p>
<p>This means we need to get more nutrients into less energy which can be tricky as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4589891/#:%7E:text=The%20physiological%20changes%20that%20occur,can%20contribute%20to%20declining%20appetite.">older adults often have lower appetites</a>. This is why <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971894/">scientists suggest</a> that it may be necessary to enrich the food of older people to maintain the nutrient intake. </p>
<h2>How to spot when someone isn’t eating enough?</h2>
<p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8399049/">Several studies have shown</a> that undernutrition affects one in ten older people living independently at home. However, it affects five in ten older people living in nursing homes, and seven in ten older people in hospital. </p>
<p>Being overweight, even obese, <a href="https://link.springer.com/article/10.1007/s40520-023-02650-1">does not protect</a> against undernutrition. And when older adults lose weight, they lose muscle, meaning that they are more likely to lose their <a href="https://www.frontiersin.org/articles/10.3389/fnut.2022.892675/full?&utm_source=Email_to_authors_&utm_medium=Email&utm_content=T1_11.5e1_author&utm_campaign=Email_publication&field=&journalName=Frontiers_in_Nutrition&id=892675">abilities to do daily tasks</a>.</p>
<p>Weight loss in older adults is a key sign of malnutrition that needs to be addressed – but it can be easily missed, especially when many older adults associate the idea of thinness <a href="https://www.sciencedirect.com/science/article/pii/S0195666319307603?casa_token=iU5UIdNwGDgAAAAA:I81EKDJ2T0oBsOsZunpPBk6uI-TcgiCr-5gPJE1tz4-Tq3w8pK4Yi_mv22AhVHHpRpiv1Bvz0RI">with good health</a>. But clothing that’s too loose or a watchstrap that floats on the wrist are all warning signs of undernourishment.</p>
<p>Similarly, if someone you care for has started to say things like, “Oh, I don’t want much food today, I’m not hungry”, “I’m not hungry, it’s natural, I’m getting older”, or “I’d rather just have a biscuit to be honest,” then these could be warning signs. An effective way to keep on top of this is regular weighing at least once per month which enables a quick response to potential indicators of malnutrition.</p>
<h2>Getting more nutrients into less food</h2>
<p>If people are eating small amounts of food, it is important to think about how to add more nutrients into it. A very effective technique, “fortification” is commonly done with pre-made products such as breakfast cereals, plant-based milk and bread in the UK. </p>
<p>Fortification (adding foods, ingredients or nutrients into to existing foods or meals) is easy to do at home as well and can provide a flexible approach for older adults as it allows them to continue eating the foods that they most enjoy.</p>
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<p>For older adults in particular, protein is a very important nutrient, because of muscle loss (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4066461/#:%7E:text=Sarcopenia%20has%20been%20defined%20as,decade%20of%20life%20%5B1%5D.">sarcopenia)</a> which is a natural part of ageing. This could be slowed down or even reversed by <a href="https://www.medicalnewstoday.com/articles/could-a-higher-protein-intake-lead-to-healthier-eating">eating enough protein</a> at regular intervals throughout the day. A few ways to increase protein include: </p>
<p>• Adding dairy ingredients such as milk, high-protein yoghurt, Quark (soft cheese), milk powders, eggs and cheese into meals – even into simple foods like mashed potato.</p>
<p>• Nuts are a great source of protein, try adding ground almonds to savoury or sweet meals (beware of nut allergies).</p>
<p>• Soy protein can be a convenient and cost-effective option, either for vegetarians or to further fortify minced-meat meals.</p>
<p>• Look in the sports section of supermarkets to find <a href="https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/whey-powder#:%7E:text=Whey%20powders%20are%20characterized%20as,of%20products%20obtained%20from%20milk.">whey protein</a> powders. These are marketed to gym enthusiasts, but actually whey is one of the <a href="https://www.mdpi.com/2072-6643/15/15/3424">best proteins to stimulate muscle growth</a>. This versatile ingredient can be mixed into porridge before cooking or used it as a substitute for other powdered ingredients in baking.</p>
<h2>Importance of physical activity and strength exercises</h2>
<p>Physical activity and nutrition go hand-in-hand – both are equally important. As we age, being physically active becomes <a href="https://link.springer.com/article/10.1007/s12603-021-1665-8?fbclid=IwAR3dJkeHjgcSrR9Xq5kBfN-HLrbpli8WcAnz7AeY5Nu9XcGCHEB07Sd2z1w">even more essential</a> as it helps to prevent disease, maintains independence, decreases risk of falls, improves cognitive function, mental health and sleep. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/574972/original/file-20240212-30-g71g12.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/574972/original/file-20240212-30-g71g12.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/574972/original/file-20240212-30-g71g12.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/574972/original/file-20240212-30-g71g12.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/574972/original/file-20240212-30-g71g12.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/574972/original/file-20240212-30-g71g12.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/574972/original/file-20240212-30-g71g12.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Balance and strength training are more important than ever in later life.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.co.uk/detail/photo/senior-women-taking-a-yoga-class-in-beautiful-royalty-free-image/1487712999">MoMo Productions</a></span>
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<p>Exercise can also <a href="https://academic.oup.com/ageing/article/48/4/476/5423796?login=false">combat isolation and loneliness</a> which has also been <a href="https://www.bda.uk.com/resource/loneliness-and-malnutrition.html">linked to decreased appetite</a> in older adults. Often strength training gets ignored when we think of being active but to keep independence and prevent falls, older adults should do varied physical activity that emphasises balance and strength training at moderate or greater intensity on three or more days a week.</p>
<p>Ultimately, it’s essential to contact a doctor or dietician with any worries or concerns about malnutrition or unintentional weight loss. There are, however, <a href="https://www.futurelearn.com/courses/ageing-well-nutrition-and-exercise-for-older-adults">some excellent resources</a> to learn more about ageing healthily and maintaining a good quality of life in later years.</p><img src="https://counter.theconversation.com/content/221380/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Miriam Clegg receives funding from the Medical Research Council, Biotechnology and Biological Sciences Research Council, EIT Food, Horizon 2020, Apetito, and Tanita Healthy Weight Community Trust. She is affiliated with Association for Nutrition.</span></em></p><p class="fine-print"><em><span>Rachel Smith does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Want to stay active and healthy in later life? Food fortification and strength and balance training could help improve quality of life for older adultsMiriam Clegg, Senior Lecturer in Human Nutrition, University College CorkRachel Smith, Sensory and Consumer Scientist, University of ReadingLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2205362024-02-06T13:31:20Z2024-02-06T13:31:20ZDietary supplements and protein powders fall under a ‘wild west’ of products that necessitate caveats and caution<figure><img src="https://images.theconversation.com/files/573557/original/file-20240205-19-q8vbm4.jpg?ixlib=rb-1.1.0&rect=0%2C14%2C4927%2C3272&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Dietary supplement labels can be misleading.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/only-natural-for-her-royalty-free-image/1068340648?phrase=dietary%2Bsupplements">Charday Penn/iStock via Getty Images</a></span></figcaption></figure><p>Dietary supplements are a big business. The industry made <a href="https://www.ibisworld.com/industry-statistics/market-size/vitamin-supplement-manufacturing-united-states/">almost US$39 billion in revenue</a> in 2022, and with <a href="https://doi.org/10.1177/1060028019900504">very little regulation and oversight</a>, it stands to keep growing. </p>
<p>The marketing of dietary supplements has been quite effective, with 77% of Americans reporting feeling <a href="https://www.crnusa.org/resources/2022-crn-consumer-survey-dietary-supplements-0">that the supplement industry is trustworthy</a>. The idea of taking your health into your own hands is appealing, and supplements are popular with athletes, parents and people trying to recover more quickly from a cold or flu, just to name a few.</p>
<p>A 2024 study found that approximately 1 in 10 adolescents have used <a href="https://doi.org/10.1001/jamanetworkopen.2023.50940">nonprescribed weight loss and weight control products</a>, including dietary supplements. </p>
<p>Notably, that systematic review found that nonprescribed diet pill use was significantly higher than the use of nonprescribed laxatives and diuretics for weight management. These types of unhealthy weight control behaviors are associated with <a href="https://doi.org/10.1016/j.jadohealth.2005.05.019">both worsened mental health and physical health outcomes</a>. </p>
<p>As a <a href="https://som.cuanschutz.edu/Profiles/Faculty/Profile/29092">licensed clinical social worker</a> specializing in treating anxiety disorders and eating disorders and a <a href="https://www.acsh.org/profile/katie-suleta">biomedical research director</a>, we’ve seen firsthand the harm that these supplements can do based on unfounded beliefs. The underregulated market of dietary supplements is setting consumers up to be misled and potentially seriously harmed by these products. </p>
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<figcaption><span class="caption">How the use of an over-the-counter herbal supplement took a deadly turn for a lawmaker’s wife.</span></figcaption>
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<h2>The wild west</h2>
<p>The <a href="https://www.fda.gov/food/information-consumers-using-dietary-supplements/questions-and-answers-dietary-supplements">Food and Drug Administration</a> specifies that supplements must contain a “dietary ingredient” such as vitamins, minerals, herbs, amino acids, enzymes, live microbials, concentrates and extracts, among others. </p>
<p>Unfortunately, manufacturers can claim that a product is a supplement even when it doesn’t meet those criteria, such as <a href="https://theconversation.com/popularly-known-as-gas-station-heroin-tianeptine-is-being-sold-as-a-dietary-supplement-with-deadly-outcomes-221379">products containing the drug tianeptine</a>, a highly addictive drug that can mimic the biological action of opioids. Some of these products are labeled as dietary supplements but are anything but. </p>
<p>Products containing <a href="https://theconversation.com/the-dangers-and-potential-of-natural-opioid-kratom-87581?gclid=Cj0KCQiAn-2tBhDVARIsAGmStVk6onJqs6vRIbYthHTDhpjDVyKF812Ks5A3nan-g5kKtZT3Q2Auc9UaAua2EALw_wcB">kratom, a substance with opioidlike effects</a>, which are sold over the counter in many gas stations, <a href="https://www.fda.gov/news-events/public-health-focus/fda-and-kratom#">claim to be herbal supplements but are mislabeled</a>.</p>
<p>Under <a href="https://ods.od.nih.gov/About/DSHEA_Wording.aspx">a 1994 law</a>, dietary supplements are classified as food, not as drugs. This means dietary supplements are not required to prove efficacy, unlike drugs. Regulators also don’t take action on a product <a href="https://sgp.fas.org/crs/misc/R43062.pdf">until it is shown to cause harm</a>.</p>
<p>However, <a href="https://www.fda.gov/consumers/consumer-updates/dietary-supplements">the FDA’s website states that</a> “many dietary supplements contain ingredients that have strong biological effects which may conflict with a medicine you are taking or a medical condition you may have. Products containing hidden drugs are also sometimes falsely marketed as dietary supplements, putting consumers at even greater risk.”</p>
<p>In other words, supplements are regulated as food instead of drugs, even though they can interact with medications and may be laced with hidden drugs not included on the label.</p>
<p>Manufacturers of <a href="https://www.fda.gov/food/food-labeling-nutrition/label-claims-conventional-foods-and-dietary-supplements">dietary supplements can make claims</a> about their products that fall into three categories: health claims, nutrient content claims and claims about the product’s function, structure or both, <a href="https://www.health.harvard.edu/alternative-and-integrative-health/the-arguments-against-dietary-supplements">all without needing to provide supporting evidence</a>.</p>
<p>Misbranding and false advertising <a href="https://doi.org/10.1080/15563650.2022.2036751">are rampant with dietary supplements</a>, including false claims of <a href="https://www.fda.gov/consumers/consumer-updates/products-claiming-cure-cancer-are-cruel-deception">curing cancer</a>, <a href="https://doi.org/10.1001/jamanetworkopen.2022.26040">improving immune health</a>, <a href="https://www.fda.gov/news-events/press-announcements/fda-takes-action-against-17-companies-illegally-selling-products-claiming-treat-alzheimers-disease">improving cognitive functioning</a>, <a href="https://www.fda.gov/consumers/consumer-updates/watch-out-false-promises-some-dietary-supplements">improving fertility</a>, <a href="https://www.health.harvard.edu/staying-healthy/watch-out-for-bogus-supplement-claims">improving cardiovascular health</a> and, of course, <a href="https://dos.ny.gov/news/nys-division-consumer-protection-warns-consumers-health-and-weight-loss-scams">promoting weight loss and weight control</a>. </p>
<h2>The FDA is cracking down</h2>
<p>You can find supplements that claim to be good for just about every health condition, concern or goal, so it should be no surprise that there are supplements marketed for weight loss.</p>
<p>In August 2021, the <a href="https://www.fda.gov/drugs/frequently-asked-questions-popular-topics/questions-and-answers-about-fdas-initiative-against-contaminated-weight-loss-products">FDA cracked down</a> on some of these weight loss products because of the presence of undeclared drugs. For example, of the 72 products recalled, <a href="https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-recommends-against-continued-use-meridia-sibutramine">the drug sibutramine, sold as Meridia</a>, was found in 68 of them. </p>
<p>While the FDA may take further action beyond the recalls, the agency <a href="https://www.fda.gov/drugs/frequently-asked-questions-popular-topics/questions-and-answers-about-fdas-initiative-against-contaminated-weight-loss-products">acknowledged that it is not able to test</a> every weight loss supplement for contamination with drugs.</p>
<p>These crackdowns demonstrate some progress, though several issues remain. Warning label placement, ingredients and beliefs based on misleading or false advertising <a href="https://doi.org/10.1016/j.foodcont.2023.109673">are still highly problematic</a>. </p>
<p>Some weight loss supplements may have FDA warnings on them. Of those that do, <a href="https://doi.org/10.1016/j.pmedr.2021.101504">the disclaimers are rarely displayed</a> on the front of the product label, so consumers are less likely to see them.</p>
<p>Ingredients in weight loss supplements can and do have adverse effects. They have caused people to be <a href="https://doi.org/10.1056/NEJMsa1504267">admitted to the emergency room</a> for cardiovascular and swallowing problems, including in young, seemingly healthy people. </p>
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<figcaption><span class="caption">Dangers may lurk within the ingredients of some dietary supplements.</span></figcaption>
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<h2>Eating disorders</h2>
<p>Mental health concerns and <a href="https://theconversation.com/eating-disorders-among-teens-have-more-than-doubled-during-the-covid-19-pandemic-heres-what-to-watch-for-201067">eating disorders are on the rise</a>. As a result, researchers are examining unhealthy weight control behaviors, including the use of dietary supplements and how accessible they are to adolescents and children.</p>
<p>People who have eating disorders often suffer related health issues such as <a href="https://eatingdisordersreview.com/bone-loss-in-anorexia-nervosa-mechanisms-and-treatment-options/">bone loss, osteoporosis</a> and vitamin deficiencies. In response, their doctors may prescribe dietary supplements like <a href="https://doi.org/10.1097/YCO.0000000000000653">calcium, vitamin D</a> and <a href="http://dx.doi.org/10.1007/978-3-642-45378-6_23">nutritional supplement shakes</a>. But these are not the dietary supplements of concern.</p>
<p>The concern is with supplements that promote weight loss, muscle building or both.</p>
<p>People with eating disorders may be attracted to dietary supplements that claim quick and pain-free weight loss or muscle gain. Additionally, dietary supplement users may struggle with an increase in <a href="https://doi.org/10.1080/10640266.2020.1712637">compulsive exercise</a> or <a href="https://doi.org/10.1016/j.jaac.2018.09.437">other unhealthy weight control behaviors</a>.</p>
<p>Diet pill and supplement use has also been associated with increased risk for <a href="https://doi.org/10.2105/AJPH.2019.305390">developing eating disorders and disordered eating</a>, as well as low self-esteem, depression and <a href="https://doi.org/10.1002/eat.20520">substance use</a>. While dietary supplements do not solely cause eating disorders or disordered eating, <a href="https://doi.org/10.1007/s40519-022-01364-z">they are one contributing factor</a> that may be addressed with preventive measures and regulations.</p>
<h2>The allure of protein powders and fitness supplements</h2>
<p>Protein powders and other fitness supplements also have wide appeal. Research shows that <a href="https://www.statnews.com/2024/01/10/weight-loss-products-adolescents/">girls are more at risk than boys</a> for using weight loss supplements. But a growing problem in boys is <a href="https://doi.org/10.1542/pir.2021-005452">the use of fitness supplements</a> such as protein powder and <a href="https://www.webmd.com/vitamins-and-supplements/creatine">creatine products</a>, a compound that supplies energy to the muscles.</p>
<p>Use of fitness supplements <a href="https://doi.org/10.1016/j.jadohealth.2019.03.005">sometimes signifies a preoccupation</a> with body shape and size. For example, a 2022 study found that protein powder consumption in adolescence was associated with <a href="https://doi.org/10.1016/j.pmedr.2022.101778">future use of steroids in emerging adulthood</a>.</p>
<p>Protein powders make claims of building lean muscles, while creatine boasts providing energy for short-term, intense exercise.</p>
<p>Protein itself is not <a href="https://ods.od.nih.gov/factsheets/ExerciseAndAthleticPerformance-HealthProfessional/">harmful at recommended doses</a>. However, protein powders may contain unknown ingredients, such as <a href="https://www.health.harvard.edu/staying-healthy/the-hidden-dangers-of-protein-powders">certain toxins or extra and excessive sugar</a>. They can also be <a href="https://www.healthline.com/health/childrens-health/protein-powder-for-kids#safety">dangerous when used in excess</a> and to replace other foods that possess vital nutrients. </p>
<p>And while creatine can usually be safely used in adults, overuse can <a href="https://www.verywellhealth.com/creatine-uses-side-effects-and-more-7556683">lead to health problems</a> and is <a href="https://www.npr.org/sections/health-shots/2017/01/02/507478762/is-the-warning-that-creatines-not-for-teens-getting-through">not recommended for minors</a>. Ultimately, the impact of <a href="https://www.nytimes.com/2020/05/21/well/family/teenage-boys-supplements-protein-creatine.html">long-term use of these supplements</a>, especially in adolescents, is unstudied.</p>
<h2>Possible solutions</h2>
<p>One proposed regulation by <a href="https://www.hsph.harvard.edu/striped/">researchers at Harvard University</a> includes <a href="https://doi.org/10.1017/amj.2022.12">taxing dietary supplements</a> whose labels tout weight loss benefits. </p>
<p><a href="https://www.hsph.harvard.edu/striped/out-of-kids-hands/">Another policy recommendation</a> involves banning the sale of dietary supplements and other weight loss products to protect minors from these underregulated and potentially dangerous products. </p>
<p>In 2023, <a href="https://www.hsph.harvard.edu/news/features/new-york-diet-supplements-ban/">New York successfully passed legislation</a> that banned the sale of these products to minors, <a href="https://www.goodmorningamerica.com/wellness/story/bills-seek-ban-sale-diet-pills-children-parents-89945169">while states</a> including Colorado, California and Massachusetts have considered or are considering similar action. </p>
<p>Ultimately, medical professionals recommend that parents and caregivers encourage their children to <a href="https://www.nytimes.com/2020/05/21/well/family/teenage-boys-supplements-protein-creatine.html">get protein and vitamins from whole foods</a> instead of turning to supplements and powders. They also recommend encouraging teens to focus on balanced nutrition, sleep and recovery, and a variety of resistance, strength and conditioning training.</p><img src="https://counter.theconversation.com/content/220536/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Although most Americans believe dietary supplements are safe, these products often make health claims that are unproven or downright false.Emily Hemendinger, Assistant Professor of Psychiatry, University of Colorado Anschutz Medical CampusKatie Suleta, PhD Candidate in Medicine and Health, George Washington UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2172872024-02-04T19:09:37Z2024-02-04T19:09:37ZHow much weight do you actually need to lose? It might be a lot less than you think<figure><img src="https://images.theconversation.com/files/572339/original/file-20240131-15-eetcro.jpg?ixlib=rb-1.1.0&rect=81%2C0%2C5381%2C3260&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/overweight-woman-drink-water-during-morning-1079331911">Flotsam/Shutterstock</a></span></figcaption></figure><p>If you’re one of the <a href="https://www.finder.com.au/new-years-resolutions-statistics">one in three</a> Australians whose New Year’s resolution involved losing weight, it’s likely you’re now contemplating what weight-loss goal you should actually be working towards. </p>
<p>But type “setting a weight loss goal” into any online search engine and you’ll likely be left with more questions than answers.</p>
<p>Sure, the many weight-loss apps and calculators available will make setting this goal seem easy. They’ll typically use a body mass index (BMI) calculator to confirm a “healthy” weight and provide a goal weight based on this range.</p>
<p>Your screen will fill with trim-looking influencers touting diets that will help you drop ten kilos in a month, or ads for diets, pills and exercise regimens promising to help you effortlessly and rapidly lose weight. </p>
<p>Most sales pitches will suggest you need to lose substantial amounts of weight to be healthy – making weight loss seem an impossible task. But the research shows you don’t need to lose a lot of weight to achieve health benefits. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/can-you-be-overweight-and-healthy-182219">Can you be overweight and healthy?</a>
</strong>
</em>
</p>
<hr>
<h2>Using BMI to define our target weight is flawed</h2>
<p>We’re a society fixated on numbers. So it’s no surprise we use measurements and equations to score our weight. The most popular is BMI, a measure of our body weight-to-height ratio. </p>
<p>BMI classifies bodies as underweight, normal (healthy) weight, overweight or obese and can be a useful tool for weight and health screening. </p>
<p>But it shouldn’t be used as the single measure of what it means to be a healthy weight when we set our weight-loss goals. This is <a href="https://theconversation.com/using-bmi-to-measure-your-health-is-nonsense-heres-why-180412">because</a> it: </p>
<ul>
<li><p>fails to consider two critical factors related to body weight and health – body fat percentage and distribution</p></li>
<li><p>does not account for significant differences in body composition based on gender, ethnicity and age.</p></li>
</ul>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1520959736476274690"}"></div></p>
<h2>How does losing weight benefit our health?</h2>
<p>Losing just 5–10% of our body weight – between 6 and 12kg for someone weighing 120kg – can significantly improve our health in four key ways.</p>
<p><strong>1. Reducing cholesterol</strong></p>
<p>Obesity increases the chances of having too much low-density lipoprotein (LDL) cholesterol – also known as bad cholesterol – because carrying excess weight changes how our bodies produce and manage lipoproteins and triglycerides, another fat molecule we use for energy.</p>
<p>Having too much bad cholesterol and high triglyceride levels is not good, narrowing our arteries and limiting blood flow, which increases the risk of heart disease, heart attack and stroke.</p>
<p>But <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4987606/">research</a> shows improvements in total cholesterol, LDL cholesterol and triglyceride levels are evident with just 5% weight loss.</p>
<p><strong>2. Lowering blood pressure</strong></p>
<p>Our blood pressure is considered high if it reads more than 140/90 on at least two occasions. </p>
<p>Excess weight is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082272/">linked to</a> high blood pressure in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082272/">several ways</a>, including changing how our sympathetic nervous system, blood vessels and hormones regulate our blood pressure.</p>
<p>Essentially, high blood pressure makes our heart and blood vessels work harder and less efficiently, damaging our arteries over time and increasing our risk of heart disease, heart attack and stroke. </p>
<figure class="align-center ">
<img alt="Older man takes his blood pressure at home" src="https://images.theconversation.com/files/572342/original/file-20240131-17-x809b1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/572342/original/file-20240131-17-x809b1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/572342/original/file-20240131-17-x809b1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/572342/original/file-20240131-17-x809b1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/572342/original/file-20240131-17-x809b1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/572342/original/file-20240131-17-x809b1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/572342/original/file-20240131-17-x809b1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Losing weight can lower your blood pressure.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/hypertension-older-age-senior-black-man-2066841269">Prostock-studio/Shutterstock</a></span>
</figcaption>
</figure>
<p>Like the improvements in cholesterol, a 5% weight loss <a href="https://onlinelibrary.wiley.com/doi/10.1002/oby.21358">improves</a> both systolic blood pressure (the first number in the reading) and diastolic blood pressure (the second number). </p>
<p>A <a href="https://www.ahajournals.org/doi/10.1161/01.hyp.0000094221.86888.ae">meta-analysis of 25 trials</a> on the influence of weight reduction on blood pressure also found every kilo of weight loss improved blood pressure by one point.</p>
<p><strong>3. Reducing risk for type 2 diabetes</strong></p>
<p>Excess body weight is the primary manageable risk factor for type 2 diabetes, particularly for people carrying a lot of visceral fat around the abdomen (belly fat).</p>
<p>Carrying this excess weight can cause fat cells to release pro-inflammatory chemicals that disrupt how our bodies regulate and use the insulin produced by our pancreas, leading to high blood sugar levels. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/can-i-actually-target-areas-to-lose-fat-like-my-belly-205203">Can I actually target areas to lose fat, like my belly?</a>
</strong>
</em>
</p>
<hr>
<p>Type 2 diabetes can lead to serious medical conditions if it’s not carefully managed, including damaging our heart, blood vessels, major organs, eyes and nervous system.</p>
<p><a href="https://www.nejm.org/doi/full/10.1056/nejmoa012512">Research</a> shows just 7% weight loss reduces risk of developing type 2 diabetes by 58%.</p>
<p><strong>4. Reducing joint pain and the risk of osteoarthritis</strong></p>
<p>Carrying excess weight can cause our joints to become inflamed and damaged, making us more prone to osteoarthritis. </p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/21425246/">Observational studies</a> show being overweight doubles a person’s risk of developing osteoarthritis, while obesity increases the risk fourfold.</p>
<p>Small amounts of weight loss alleviate this stress on our joints. <a href="https://pubmed.ncbi.nlm.nih.gov/15986358/">In one study</a> each kilogram of weight loss resulted in a fourfold decrease in the load exerted on the knee in each step taken during daily activities.</p>
<figure class="align-center ">
<img alt="Man on bathroom scales" src="https://images.theconversation.com/files/572344/original/file-20240131-17-5phiyx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/572344/original/file-20240131-17-5phiyx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/572344/original/file-20240131-17-5phiyx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/572344/original/file-20240131-17-5phiyx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/572344/original/file-20240131-17-5phiyx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/572344/original/file-20240131-17-5phiyx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/572344/original/file-20240131-17-5phiyx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Losing weight eases stress on joints.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/male-feet-on-scale-bathroom-1030174888">Shutterstock/Rostislav_Sedlacek</a></span>
</figcaption>
</figure>
<h2>Focus on long-term habits</h2>
<p>If you’ve ever tried to lose weight but found the kilos return almost as quickly as they left, you’re not alone.</p>
<p>An <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/">analysis</a> of 29 long-term weight-loss studies found participants regained more than half of the weight lost within two years. Within five years, they regained more than 80%.</p>
<p>When we lose weight, we take our body out of its comfort zone and trigger its survival response. It then counteracts weight loss, triggering several <a href="https://pubmed.ncbi.nlm.nih.gov/25896063/">physiological responses</a> to defend our body weight and “survive” starvation. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/whats-the-weight-set-point-and-why-does-it-make-it-so-hard-to-keep-weight-off-195724">What's the 'weight set point', and why does it make it so hard to keep weight off?</a>
</strong>
</em>
</p>
<hr>
<p>Just as the problem is evolutionary, the solution is evolutionary too. Successfully losing weight long-term comes down to:</p>
<ul>
<li><p>losing weight in small manageable chunks you can sustain, specifically periods of weight loss, followed by periods of weight maintenance, and so on, until you achieve your goal weight </p></li>
<li><p>making gradual changes to your lifestyle to ensure you form habits that last a lifetime.</p></li>
</ul>
<p>Setting a goal to reach a healthy weight can feel daunting. But it doesn’t have to be a pre-defined weight according to a “healthy” BMI range. Losing 5–10% of our body weight will result in immediate health benefits.</p>
<p><em>At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.</em></p><img src="https://counter.theconversation.com/content/217287/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dr Nick Fuller works for the University of Sydney and has received external funding for projects relating to the treatment of overweight and obesity. He is the author and founder of the Interval Weight Loss program.</span></em></p>Weight loss can seem like an impossible, unachievable task. But you don’t need to lose a lot of weight to start noticing the health benefits.Nick Fuller, Charles Perkins Centre Research Program Leader, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2215142024-02-01T21:21:20Z2024-02-01T21:21:20ZHow dieting, weight suppression and even misuse of drugs like Ozempic can contribute to eating disorders<figure><img src="https://images.theconversation.com/files/572540/original/file-20240131-15-o0m6p8.jpg?ixlib=rb-1.1.0&rect=147%2C78%2C6271%2C4030&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Although semaglutide drugs like Ozempic are indicated to treat Type 2 diabetes, they are increasingly prescribed off-label because of their observed effectiveness at inducing weight loss.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/how-dieting-weight-suppression-and-even-misuse-of-drugs-like-ozempic-can-contribute-to-eating-disorders" width="100%" height="400"></iframe>
<p>Up to 72 per cent of women and 61 per cent of men are dissatisfied with their weight or <a href="https://doi.org/10.1016/j.eatbeh.2014.04.010">body image</a>, according to a U.S. study. Globally, millions of people <a href="https://doi.org/10.1111%2Fobr.12466">attempt to lose weight</a> every year with the hope that weight loss will have positive effects on their body image, health and quality of life. </p>
<p>However, these motivated individuals often struggle to maintain new diets or exercise regimens. The rise of medications such as semaglutides, like <a href="https://dhpp.hpfb-dgpsa.ca/dhpp/resource/101298">Ozempic</a> or <a href="https://dhpp.hpfb-dgpsa.ca/dhpp/resource/101765">Wegovy</a>, <a href="https://www.cbc.ca/news/health/ozempic-weight-loss-1.6772021">might be viewed as an appealing “quick fix”</a> alternative to meet weight loss goals. </p>
<p>Research led by our team and others suggests that such attempts to lose weight often do more harm than good, and even increase the risk of <a href="https://osf.io/9stq2">developing an eating disorder</a>.</p>
<h2>Weight loss and eating disorders</h2>
<p>Eating disorders are <a href="https://doi.org/10.1002/eat.20589">serious mental health conditions</a> primarily characterized by extreme patterns of under- or over-eating, concerns about one’s shape or body weight or other behaviours intended to influence body shape or weight such as exercising excessively or self-inducing vomiting. </p>
<p>Although once thought to only affect young, white adolescent girls, eating disorders do not discriminate; eating disorders can develop in people of <a href="https://doi.org/10.1002/erv.2553">any age, sex, gender or racial/ethnic background</a>, with an estimated <a href="https://nedic.ca/general-information/">one million Canadians</a> suffering from an eating disorder at any given time. Feb. 1 to 7 is <a href="https://nedic.ca/edaw/">National Eating Disorders Awareness Week</a>.</p>
<p>As a clinical psychologist and clinical psychology graduate student, our research has focused on how eating disorders develop and what keeps them going. Pertinent to society’s focus on weight-related goals, our research has examined associations between weight loss and eating disorder symptoms.</p>
<h2>Eating disorders and ‘weight suppression’</h2>
<p>In eating disorders research, the state of maintaining weight loss is referred to as “weight suppression.” Weight suppression is typically defined as the difference between a person’s current weight and their highest lifetime weight (excluding pregnancy). </p>
<p>Despite the belief that weight loss will improve body satisfaction, we found that in a sample of over 600 men and women, weight loss had no impact on women’s negative body image and was associated with increased body dissatisfaction in <a href="https://doi.org/10.1016/j.bodyim.2023.01.011">men</a>. Importantly, being more weight suppressed has been associated with the <a href="https://doi.org/10.1093/ajcn/nqaa146">onset of eating disorders</a>, including anorexia nervosa and bulimia nervosa. </p>
<p><a href="https://doi.org/10.1007/s11920-018-0955-2">One proposed explanation</a> for the relationship between weight suppression and eating disorders is that maintaining weight loss becomes increasingly difficult as body systems that <a href="https://doi.org/10.3945/ajcn.110.010025">reduce metabolic rate and energy expenditure, and increase appetite</a>, are activated to promote weight gain.</p>
<p>There is growing awareness that <a href="https://doi.org/10.1136/bmj.g2646">weight regain is highly likely following conventional diet programs</a>. This might lead people to engage in more and more extreme behaviours to control their weight, or they might shift between extreme restriction of food intake and episodes of overeating or binge eating, the characteristic symptoms of bulimia nervosa.</p>
<h2>Ozempic and other semaglutide drugs</h2>
<p>Semaglutide drugs like Ozempic and Wegovy are part of a class of drug called <a href="https://pdf.hres.ca/dpd_pm/00067924.PDF">glucagon-like peptide-1 agonists (GLP-1As)</a>. These drugs work by mimicking the hormone GLP-1 to interact with neural pathways that signal satiety (fullness) and slow stomach emptying, leading to reduced food intake. </p>
<figure class="align-center ">
<img alt="A white plate with a weight scale in it, with knife and fork, against an orange background" src="https://images.theconversation.com/files/572541/original/file-20240131-25-y3r386.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/572541/original/file-20240131-25-y3r386.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=425&fit=crop&dpr=1 600w, https://images.theconversation.com/files/572541/original/file-20240131-25-y3r386.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=425&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/572541/original/file-20240131-25-y3r386.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=425&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/572541/original/file-20240131-25-y3r386.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=534&fit=crop&dpr=1 754w, https://images.theconversation.com/files/572541/original/file-20240131-25-y3r386.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=534&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/572541/original/file-20240131-25-y3r386.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=534&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Popular weight-loss methods, whether they involve pills or ‘crash diets,’ often mimic symptoms of eating disorders.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Although GLP-1As are indicated to treat Type 2 diabetes, <a href="https://www.cbc.ca/news/canada/london/ozempic-off-label-1.6884141">they are increasingly prescribed off-label</a> or being <a href="https://www.bbc.com/news/health-67414203">illegally purchased</a> without a prescription because of their observed effectiveness at inducing weight loss. Although medications like Ozempic do often lead to weight loss, the rate of weight loss may <a href="https://doi.org/10.1001/jama.2021.3224">slow down or stop over time</a>.</p>
<p>Research by Lindsay Bodell, one of the authors of this story, and her colleagues on weight suppression may help explain why effects of semaglutides diminish over time, as <a href="https://doi.org/10.1016/j.physbeh.2019.112565">weight suppression is associated with reduced GLP-1 response</a>. This means those suppressing their weight could become less responsive to the satiety signals activated by GLP-1As. </p>
<p>Additionally, weight loss effects are only seen for as long as the medication is taken, meaning those who take these drugs to achieve some weight loss goal are <a href="https://doi.org/10.1111/dom.14725">likely to regain most, if not all, weight lost</a> when they stop taking the medication.</p>
<h2>Risks of dieting and weight-loss drugs</h2>
<p>The growing market for off-label weight loss drugs is concerning, because of the exacerbation of <a href="https://theconversation.com/ozempic-the-miracle-drug-and-the-harmful-idea-of-a-future-without-fat-211661">weight stigma</a> and the serious <a href="https://doi.org/10.1016/j.jand.2022.01.004">health risks</a> associated with unsupervised weight loss, including developing eating disorders. </p>
<p>Researchers and health professionals are already raising the alarm about the use of GLP-1As in children and adolescents, due to concerns about their possible <a href="https://doi.org/10.1017/cts.2023.612">impact on growth and development</a>.</p>
<p>Moreover, popular weight-loss methods, whether they involve pills or “crash diets,” often mimic symptoms of eating disorders. For example, intermittent fasting diets that involve long periods of fasting followed by short periods of food consumption may mimic and <a href="https://doi.org/10.1016/j.eatbeh.2022.101681">increase the risk of developing binge eating problems</a>. </p>
<p>The use of diet pills or laxatives to lose weight has been found to increase the risk of <a href="https://doi.org/10.2105/AJPH.2019.305390">being diagnosed with an eating disorder in the next one to three years</a>. Drugs like Ozempic may also be <a href="https://doi.org/10.1002/eat.24109">misused by individuals already struggling with an eating disorder</a> to suppress their appetite, compensate for binge eating episodes or manage fear of weight gain. </p>
<p>Individuals who are already showing signs of an eating disorder, such as limiting their food intake and intense concerns about their weight, may be most at risk of spiralling from a weight loss diet or medication into an eating disorder, <a href="https://doi.org/10.1002/eat.24116">even if they only lose a moderate amount of weight</a>.</p>
<p>People who are dissatisfied with their weight or have made multiple attempts to lose weight often feel pressured to try increasingly drastic methods. However, any diet, exercise program or weight-loss medication promising a quick fix for weight loss should be treated with extreme caution. At best, you may gain the weight back; at worst, you put yourself at risk for much more serious eating disorders and other health problems.</p><img src="https://counter.theconversation.com/content/221514/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Samantha Withnell receives funding from the Social Sciences and Humanities Research Council of Canada. </span></em></p><p class="fine-print"><em><span>Lindsay Bodell receives (or has previously received) funding from the Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, Brain Canada Foundation, and Banting Research Foundation. </span></em></p>The demand for off-label weight loss drugs like Ozempic is concerning, because of the impact on weight stigma and the health risks of unsupervised weight loss, including developing eating disorders.Samantha Withnell, PhD Candidate, Clinical Psychology, Western UniversityLindsay Bodell, Assistant Professor of Psychology, Western UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2219502024-01-26T17:58:04Z2024-01-26T17:58:04ZIs diabetes remission really as hard to achieve as a new study suggests?<figure><img src="https://images.theconversation.com/files/571619/original/file-20240126-23-wfibhz.jpg?ixlib=rb-1.1.0&rect=50%2C70%2C6710%2C4267&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/world-diabetes-day-awareness-concept-diabetic-1832275786">siam pukkato/Shutterstock</a></span></figcaption></figure><p>In 2017, a <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33102-1/fulltext">landmark study</a> was published in The Lancet showing that type 2 diabetes could be reversed by diet alone. </p>
<p>The <a href="https://www.directclinicaltrial.org.uk/">Direct study</a>, as it is known, seemed to change everything. With an intensive weight-loss programme and support throughout the study, 46% of participants were able to put their diabetes in remission after one year. </p>
<p>This has led to <a href="https://www.england.nhs.uk/diabetes/treatment-care/low-calorie-diets/">“path to remission”</a> diabetes remission programmes being rolled out across the NHS. But how likely is it that this treatment will work outside of the carefully controlled environment of a clinical trial?</p>
<p>A new study from <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004327">Hong Kong</a> suggests that remission of type 2 diabetes is far less common in the real world. This led to headlines suggesting remission from type 2 diabetes was rare (occurring in 6% of people in the study), and expert media comments that it was <a href="https://www.healthline.com/health-news/only-6-of-people-can-achieve-type-2-diabetes-remission-via-weight-loss">“a little bit depressing”</a>.</p>
<p>We have known about cases of type 2 diabetes going into remission, or glucose levels going back to normal, since <a href="https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/572819">the 1960s</a>. These observations were first made decades before the first internationally agreed definition of what remission is. </p>
<h2>Remission finally defined</h2>
<p>In 2021, type 2 diabetes remission was defined as an HbA1c (a measure of average glucose levels in blood over two to three months) of <a href="https://www.diabetes.org.uk/about-us/news-and-views/remission-new-definition">less than 48 mmol/mol or 6.5%</a> for at least three months without taking any diabetes drugs. </p>
<p>So, is it true that this method of achieving remission is less likely in the messy world outside of clinical trials where people aren’t carefully selected for likeness to each other and where researchers aren’t fussing over participants? </p>
<p>It seems that remission may be harder to attain and sustain in the real-world setting, but the news is perhaps not quite as gloomy as the Hong Kong study suggests. </p>
<p>Also, it might depend on how patients are cared for in the real world. For example, Dr David Unwin, a UK-based GP, has helped <a href="https://nutrition.bmj.com/content/6/1/46">20% of his type 2 diabetes patients</a> achieve remission by advising them on the type of low-carbohydrate diet to follow and offering one-to-one support over the phone.</p>
<p>It should be noted, though, that achieving remission is <a href="https://onlinelibrary.wiley.com/doi/10.1111/jhn.12938">easier for some</a>, namely men, people who lose more than 15kg of body weight, and people who have been diagnosed with type 2 diabetes fairly recently. However, this shouldn’t discourage people who don’t meet these criteria. Any weight loss and improvement in diabetes control will improve a person’s health and should always be encouraged.</p>
<p>And weight loss doesn’t have to be achieved through something as radical as the “total diet replacement” – usually milkshakes – that many clinical trials use. <a href="https://onlinelibrary.wiley.com/doi/10.1111/jhn.12938">Our review </a> found that it is possible to achieve remission with low carbohydrate diets, and, to a lesser extent, with Mediterranean and vegan diets. </p>
<p>The key is to find a diet that people will stick with in the long run.</p>
<figure class="align-center ">
<img alt="Greek salad" src="https://images.theconversation.com/files/571623/original/file-20240126-31-76fn8s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/571623/original/file-20240126-31-76fn8s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/571623/original/file-20240126-31-76fn8s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/571623/original/file-20240126-31-76fn8s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/571623/original/file-20240126-31-76fn8s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/571623/original/file-20240126-31-76fn8s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/571623/original/file-20240126-31-76fn8s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Weight loss for remission doesn’t have to be meal-replacement drinks.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/caprese-italian-mediterranean-salad-tomato-mozzarella-291753935">Marian Weyo/Shutterstock</a></span>
</figcaption>
</figure>
<h2>Why the Hong Kong patients failed</h2>
<p>Unlike the Direct trial and the previously mentioned UK GP’s programme, the Hong Kong data was not a programme aimed at achieving remission. And, of course, you are unlikely to achieve something if you do not plan to do it.</p>
<p>Changing diet and lifestyle in a supportive environment could have been what was missing in the Hong Kong study. The researchers only reported data on clinical checks that the people with type 2 diabetes had.</p>
<p>The chances of remission are increased in people who lose a substantial <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9284579/">amount of weight</a>, whether through <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8311476/">bariatric surgery</a> or <a href="https://onlinelibrary.wiley.com/doi/10.1111/jhn.12938">diet</a>. These interventions were not supported and were therefore uncommon in the Hong Kong data.</p>
<p>If this new study proves one thing, it’s that it’s not enough to merely monitor people with type 2 diabetes. To achieve remission, they need advice, support and encouragement – both initially and in the long term.</p><img src="https://counter.theconversation.com/content/221950/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Duane Mellor is a member of the British Dietetic Association, including membership of the Diabetes Specialist Interest Group committeee and Professional Committee. </span></em></p><p class="fine-print"><em><span>Srikanth Bellary has received honoraria and speaker fees from Astrazeneca, Eli Lilly, Boehringer Ingelheim.</span></em></p><p class="fine-print"><em><span>Craig Russell does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A new study from Hong Kong shows that reversing type 2 diabetes is much harder than clinical trials suggest. However, all is not lost.Duane Mellor, Lead for Evidence-Based Medicine and Nutrition, Aston Medical School, Aston UniversityCraig Russell, Lecturer, Pharmacy, Aston UniversitySrikanth Bellary, Clinical Associate Professor, Diabetes and Endocrinology, Aston UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2202722024-01-16T13:40:52Z2024-01-16T13:40:52ZYour body already has a built-in weight loss system that works like Wegovy, Ozempic and Mounjaro – food and your gut microbiome<figure><img src="https://images.theconversation.com/files/568472/original/file-20240109-26-7fx8si.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2039%2C1467&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Weight loss pills aren't a replacement for a healthy diet and lifestyle.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/capsules-and-pills-in-shape-of-hamburger-royalty-free-image/89127926">JW LTD/Stone via Getty Images</a></span></figcaption></figure><p><a href="https://theconversation.com/drugs-that-melt-away-pounds-still-present-more-questions-than-answers-but-ozempic-wegovy-and-mounjaro-could-be-key-tools-in-reducing-the-obesity-epidemic-205549">Wegovy, Ozempic and Mounjaro</a> are weight loss and diabetes drugs that have made quite a splash in <a href="https://www.nytimes.com/2023/08/17/health/weight-loss-drugs-obesity-ozempic-wegovy.html">health news</a>. They target regulatory pathways involved in both <a href="https://doi.org/10.1111/dom.14496">obesity and diabetes</a> and are widely considered breakthroughs for weight loss and blood sugar control. </p>
<p>But do these drugs point toward a root cause of metabolic disease? <a href="https://doi.org/10.1111/obr.12421">What inspired</a> their development in the first place?</p>
<p>It turns out your body produces natural versions of these drugs – also known as <a href="https://doi.org/10.1111/dom.13129">incretin hormones</a> – in your gut. It may not be surprising that <a href="https://doi.org/10.3390%2Fijms22126623">nutrients in food</a> help regulate these hormones. But it may intrigue you to know that the trillions of <a href="https://theconversation.com/hangry-bacteria-in-your-gut-microbiome-are-linked-to-chronic-disease-feeding-them-what-they-need-could-lead-to-happier-cells-and-a-healthier-body-199486">microbes in your gut</a> are key for orchestrating this process.</p>
<p><a href="https://gastro.uw.edu/people/faculty/damman-c">I am a gastroenterologist</a> at the University of Washington who studies how <a href="https://gutbites.org/">food and your gut microbiome</a> affect health and disease. Here’s an inside-out perspective on the role natural gut hormones and healthy food play in metabolism and weight loss.</p>
<h2>A broken gut</h2>
<p>Specialized bacteria in your lower gut take the components of food you can’t digest like <a href="https://doi.org/10.3390/microorganisms10122507">fiber</a> and <a href="https://doi.org/10.1016/j.cofs.2020.03.001">polyphenols</a> – the elements of plants that are removed in many processed foods – and transforms them into molecules that stimulate hormones to control your <a href="https://doi.org/10.1016/j.advnut.2023.03.016">appetite and metabolism</a>. These include GLP-1, a natural version of Wegovy and Ozempic.</p>
<p><a href="https://doi.org/10.3389/fendo.2021.721135">GLP-1</a> and other hormones like <a href="https://doi.org/10.1113%2Fjphysiol.2008.164269">PYY</a> help regulate blood sugar through the pancreas. They also tell your brain that you’ve had enough to eat and your stomach and intestines to slow the movement of food along the digestive tract to allow for digestion. This system even has a name: the <a href="https://doi.org/10.1136/gut.34.9.1171">colonic brake</a>. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/568486/original/file-20240109-23-4av9qx.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Diagram showing the effects of GLP-1 on various organs of the body" src="https://images.theconversation.com/files/568486/original/file-20240109-23-4av9qx.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/568486/original/file-20240109-23-4av9qx.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=475&fit=crop&dpr=1 600w, https://images.theconversation.com/files/568486/original/file-20240109-23-4av9qx.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=475&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/568486/original/file-20240109-23-4av9qx.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=475&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/568486/original/file-20240109-23-4av9qx.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=597&fit=crop&dpr=1 754w, https://images.theconversation.com/files/568486/original/file-20240109-23-4av9qx.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=597&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/568486/original/file-20240109-23-4av9qx.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=597&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">GLP-1 serves many functions in the body.</span>
<span class="attribution"><a class="source" href="https://en.wikipedia.org/wiki/File:FunctionsOfGLP-1.png">Lthoms11/Wikimedia Commons</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Prior to modern processed foods, metabolic regulatory pathways were under the direction of a <a href="https://doi.org/10.1038/ncomms4654">diverse healthy gut microbiome</a> that used these hormones to naturally regulate your metabolism and appetite. However, <a href="https://doi.org/10.1186/s12963-017-0119-3">food processing</a>, aimed at improving shelf stability and enhancing taste, removes the bioactive molecules like <a href="https://doi.org/10.1177/1559827615588079">fiber</a> and <a href="https://doi.org/10.3390/molecules26030703">polyphenols</a> that help regulate this system. </p>
<p>Removal of these key food components and the resulting decrease in gut microbiome diversity may be an important factor contributing to the rise in <a href="https://doi.org/10.1016/j.advnut.2023.03.016">obesity and diabetes</a>.</p>
<h2>A short track to metabolic health</h2>
<p>Wegovy and Ozempic reinvigorate the colonic brake downstream of food and microbes with molecules similar to GLP-1. Researchers have demonstrated their effectiveness at <a href="https://doi.org/10.1001/jama.2023.2438">weight loss and blood sugar control</a>. </p>
<p>Mounjaro has gone a step further and combined GLP-1 with a second hormone analogue derived from the upper gut called GIP, and studies are showing this combination therapy to be even more effective at <a href="https://doi.org/10.1056/NEJMoa2206038">promoting weight loss</a> than GLP-1-only therapies like Wegovy and Ozempic. </p>
<p>These drugs complement other measures like <a href="https://doi.org/10.1001/jama.2020.12567">gastric bypass surgery</a> that are used in the most extreme cases of metabolic disease. These surgeries may in part <a href="https://doi.org/10.1210/en.2017-00564">work much like Wegovy and Ozempic</a> by bypassing digestion in segments of the gastrointestinal tract and bathing your <a href="https://doi.org/10.1007/s11695-017-2595-8">gut microbes</a> in less digested food. This awakens the microbes to stimulate your gut cells to produce <a href="https://doi.org/10.1080/00365521.2017.1293154">GLP-1</a> and <a href="https://doi.org/10.1016/j.ebiom.2018.12.040">PYY</a>, effectively regulating appetite and metabolism. </p>
<p>Many patients have seen significant improvements to not only their weight and blood glucose but also reductions in important cardiovascular outcomes like <a href="https://doi.org/10.1056/NEJMoa2307563">strokes and heart attacks</a>. <a href="https://doi.org/10.1161/CIRCULATIONAHA.122.059595">Medical guidelines</a> support the use of new incretin-based medications like Wegovy, Ozempic and Mounjaro to manage the interrelated metabolic conditions of diabetes, obesity and cardiovascular disease.</p>
<p>Considering the effects incretin-based medications have on the brain and cravings, medical researchers are also evaluating their potential to treat nonmetabolic conditions like <a href="https://doi.org/10.1172/jci.insight.170671">alcohol abuse</a>, <a href="https://doi.org/10.1126/science.adk5498">drug addiction</a> and <a href="https://doi.org/10.1016/j.jpsychires.2023.05.041">depression</a>.</p>
<h2>A near-magic bullet – for the right folks</h2>
<p>Despite the success and prospect of these drugs to help populations that may benefit most from them, current <a href="https://doi.org/10.1155/2023/9946924">prescribing practices</a> have raised some questions. Should people who are only a little overweight use these drugs? What are the risks of prescribing these drugs to <a href="https://time.com/6285055/wegovy-teenagers-weight-loss-risks/">children and adolescents</a> for lifelong weight management?</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/568488/original/file-20240109-25-jarss4.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Close-up of a person's socked feet stepping on a scale" src="https://images.theconversation.com/files/568488/original/file-20240109-25-jarss4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/568488/original/file-20240109-25-jarss4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/568488/original/file-20240109-25-jarss4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/568488/original/file-20240109-25-jarss4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/568488/original/file-20240109-25-jarss4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/568488/original/file-20240109-25-jarss4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/568488/original/file-20240109-25-jarss4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Some people regain weight after stopping incretin-based drugs.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/mid-adult-man-step-on-weight-scales-at-home-royalty-free-image/1468770376?adppopup=true">Oleksandra Troian/Moment via Getty Images</a></span>
</figcaption>
</figure>
<p>While incretin-based therapies seem close to magic bullets, they are not without gastrointestinal side effects like <a href="https://doi.org/10.1517/14740338.2015.987122">nausea, vomiting, diarrhea and constipation</a>. These symptoms are related to how the drugs work to slow the gastrointestinal tract. Other more severe, but rare, side effects include <a href="https://doi.org/10.1001/jama.2023.19574">pancreatitis and irreversible gastroparesis</a>, or inflammation of the pancreas and stomach paralysis.</p>
<p>These drugs can also lead to a <a href="https://doi.org/10.3803/EnM.2019.34.3.247">loss of healthy lean muscle mass</a> in addition to fat, particularly in the absence of exercise. Significant <a href="https://doi.org/10.1111/dom.14725">weight gain</a> after stopping the drugs raises further questions about <a href="https://doi.org/10.2337/dc09-1902">long-term effects</a> and whether it’s possible to transition back to using only lifestyle measures to manage weight.</p>
<h2>All roads lead to lifestyle</h2>
<p>Despite our greatest aspirations for quick fixes, it’s very possible that a <a href="https://gutbites.org/2022/05/18/the-pillars-of-health/">healthy lifestyle</a> remains the most important way to manage metabolic disease and overall health. This includes regular exercise, stress management, sleep, getting outdoors and a balanced diet.</p>
<p>For the majority of the population who don’t yet have obesity or diabetes, restarting the gut’s built-in appetite and metabolism control by reintroducing whole foods and awaking the gut microbiome may be the best approach to promote healthy metabolism.</p>
<p>Adding minimally processed foods back to your diet, and specifically those replete in <a href="https://theconversation.com/fiber-is-your-bodys-natural-guide-to-weight-management-rather-than-cutting-carbs-out-of-your-diet-eat-them-in-their-original-fiber-packaging-instead-205159">fiber</a> and <a href="https://gutbites.org/2024/01/10/like-fiber-polyphenols-in-food-boost-glp-1-ignite-mitochondria-help-coordinate-metabolic-health/">polyphenols</a> like flavonoids and carotenoids, can play an important and complementary role to help address the epidemic of obesity and metabolic disease at one of its deepest roots.</p><img src="https://counter.theconversation.com/content/220272/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Christopher Damman is on the scientific advisory board at One BIO and Supergut.</span></em></p>Weight loss and diabetes drugs target regulatory pathways involved in metabolism that the microbes in your gut and certain molecules from food already play a key role in regulating.Christopher Damman, Associate Professor of Gastroenterology, School of Medicine, University of WashingtonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2190842024-01-10T13:31:56Z2024-01-10T13:31:56ZAs Zepbound dominates headlines as a new obesity-fighting drug, a nutritionist warns that weight loss shouldn’t be the only goal<figure><img src="https://images.theconversation.com/files/568084/original/file-20240105-19-zvx4x7.jpg?ixlib=rb-1.1.0&rect=52%2C30%2C4979%2C3319&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Overall health and well-being are about much more than just weight management.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/anatomical-heart-made-of-felt-textile-in-red-royalty-free-image/1437430537?phrase=healthy+lifestyle&searchscope=image%2Cfilm&adppopup=true">Carol Yepes/Moment via Getty Images</a></span></figcaption></figure><p>If the buzz surrounding a medication could elevate it to celebrity status, then <a href="https://www.zepbound.lilly.com/">Zepbound</a> is reaching Taylor Swift rank. </p>
<p>Zepbound is the newest addition to the weight loss drug arena. In November 2023, it joined the list of obesity-fighting drugs – administered as an injection – to be <a href="https://www.fda.gov/news-events/press-announcements/fda-approves-new-medication-chronic-weight-management">approved by the U.S. Food and Drug Administration</a>. </p>
<p>The key to Zepbound’s weight loss potential is its active ingredient, <a href="https://doi.org/10.1056/NEJMoa2206038">tirzepatide</a>. This is the same active ingredient found in the drug <a href="https://www.mounjaro.com/">Mounjaro</a>, which is approved to treat Type 2 diabetes. </p>
<p>The relationship between Zepbound and Mounjaro is similar to two other popular drugs making headlines, <a href="https://www.wegovy.com/">Wegovy</a> and <a href="https://www.ozempic.com/">Ozempic</a>. Both Wegovy and Ozempic contain the active ingredient <a href="https://www.mayoclinic.org/drugs-supplements/semaglutide-subcutaneous-route/description/drg-20406730#">semaglutide</a>, with Ozempic approved for the treatment of Type 2 diabetes and Wegovy approved for the treatment of obesity. </p>
<p>Tirzepatide and semaglutide both mimic the <a href="https://doi.org/10.1007/s005920050116">digestive hormone GLP-1</a>, which is released by the intestines when we eat to stimulate insulin production and help regulate blood sugar. GLP-1 also suppresses appetite while promoting a sensation of fullness. </p>
<p>Weight loss medications are intended to be used in conjunction with lifestyle changes, such as exercise and <a href="https://theconversation.com/fiber-is-your-bodys-natural-guide-to-weight-management-rather-than-cutting-carbs-out-of-your-diet-eat-them-in-their-original-fiber-packaging-instead-205159">a healthy diet</a>. But too often, people view them as a silver bullet for weight loss. And <a href="https://www.kff.org/health-costs/press-release/drugs-used-for-weight-loss-could-cost-americans-much-more-than-people-in-peer-countries/">the high price tag</a> and <a href="https://www.nbcnews.com/health/health-news/insurance-cover-weight-loss-drugs-take-rcna120091">variable insurance coverage</a> for these popular weight loss drugs create a barrier for many people. </p>
<p>I am a registered dietitian and <a href="https://www.fsnhp.msstate.edu/associate.php?id=182">dietetics educator</a>. Whether I am counseling patients, teaching students or working in my community to address food access challenges and healthy eating, I focus on overall well-being. I am passionate about helping people make informed and realistic health decisions based on their circumstances and helping them see opportunities to overcome the barriers they may encounter.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/x2eHh9ChBB4?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">A doctor outlines the differences between Zepbound and other weight loss drugs.</span></figcaption>
</figure>
<h2>Health risks of obesity</h2>
<p>The potential impact of these drugs is staggering, since <a href="https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity#">more than 2 in 5 American adults are obese</a>, according to the National Institutes of Health. </p>
<p>Obesity is not just an American issue, nor is it going away. The <a href="https://www.worldobesity.org/news/one-billion-people-globally-estimated-to-be-living-with-obesity-by-2030">World Obesity Federation</a> estimates that by 2030, 1 in 5 women and 1 in 7 men will be living with obesity worldwide.</p>
<p>Many serious health conditions are associated with obesity, including <a href="https://doi.org/10.1161/CIR.0000000000000973">heart disease</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3066828/">diabetes</a>, <a href="https://doi.org/10.21037/gs.2019.12.03">high blood pressure</a>, <a href="https://doi.org/10.21037/atm-20-4387">stroke</a>, <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet#what-is-known-about-the-relationship-between-obesity-and-cancer-">certain cancers</a> and <a href="https://doi.org/10.3389/fimmu.2022.907750">osteoarthritis</a>. By treating obesity, a person can reduce or reverse obesity-related disease and improve both their health and quality of life.</p>
<p>However, long-term weight management depends on a number of complex factors. Meal timing and <a href="https://www.ncbi.nlm.nih.gov/books/NBK232454/">types of foods eaten</a> can affect energy levels, satisfaction and <a href="https://doi.org/10.1371/journal.pone.0174820">hunger levels</a>. A person’s typical schedule, culture and preferences, activity level and health history must be taken into consideration as well. No single “best strategy” for weight management has been identified, and research indicates that strategies for weight loss and maintenance <a href="https://doi.org/10.7570/jomes20065">need to be individualized</a>.</p>
<p>In addition, it is critical to note that <a href="https://doi.org/10.1111/dom.14725">research on the long-term effects</a> of these newer weight loss drugs is limited. The available research has focused specifically on weight loss, heart health and metabolism and has found that <a href="https://www.tctmd.com/news/stopping-tirzepatide-leads-rebound-weight-cardiometabolic-risk#">ongoing use of these new medications</a> is necessary to maintain improvements in weight and related health benefits. </p>
<p>Common side effects and the emotional toll experienced by those who regain weight once they stop taking the drugs are <a href="https://chicago.suntimes.com/well/2023/4/7/23671762/experts-worry-new-weight-loss-medications-carry-longterm-risks">trade-offs that need to be considered</a>. More research is needed to better understand the long-term impact of both direct and indirect health consequences of taking drugs for weight loss.</p>
<h2>It’s not just what you see on the scale</h2>
<p>Throughout my years working as a registered dietitian, I have counseled numerous people about their weight loss goals. I often see a hyperfocus on weight loss, with much less attention being placed on the right nutrients to eat.</p>
<p>Societal standards and <a href="https://doi.org/10.1371/journal.pone.0251566">weight stigma in the health care setting</a> can negatively affect patients’ health and can lead them to obsess about the number on a scale rather than on the health outcome.</p>
<p>Weight loss may be necessary to reduce risks and promote health. But weight loss alone should not be the end goal: Rather, the focus should be on overall health. Tactics to reduce intake and suppress appetite require intention to ensure that the body receives the nutrients it needs to support health.</p>
<p>Additionally, I remind people that <a href="https://www.washingtonpost.com/opinions/2024/01/03/obesity-ozempic-wegovy-weight-loss-health/">long-term results require attention to diet and lifestyle</a>. When a person stops taking a medication, the condition it’s meant to treat can often return. If you stop taking your high blood pressure pills without altering your diet and lifestyle, your blood pressure goes back up. The same effects can happen with medications used to treat cholesterol and obesity.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/567792/original/file-20240103-19-3k2s6o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Tape measure lying on top of a scale on a white tile background." src="https://images.theconversation.com/files/567792/original/file-20240103-19-3k2s6o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567792/original/file-20240103-19-3k2s6o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=449&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567792/original/file-20240103-19-3k2s6o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=449&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567792/original/file-20240103-19-3k2s6o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=449&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567792/original/file-20240103-19-3k2s6o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=565&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567792/original/file-20240103-19-3k2s6o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=565&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567792/original/file-20240103-19-3k2s6o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=565&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Weight management plans should take into consideration a person’s schedule, lifestyle and health history.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/tape-measure-on-scales-close-up-royalty-free-image/sb10068935i-001">Peter Dazeley/The Image Bank via Getty Images</a></span>
</figcaption>
</figure>
<h2>Nourish your body with nutrients</h2>
<p>Despite the prevalence of obesity and the emergence of newer drugs to treat it, 95% of the world’s population doesn’t get enough of <a href="https://doi.org/10.3390/nu12061735">at least one nutrient</a>. According to one study, nearly one-third of Americans have been found to be at risk of <a href="https://doi.org/10.3390/nu9070655">at least one nutrient deficiency</a>. Additional research indicates that those actively trying to lose weight are more prone to <a href="https://doi.org/10.29333/ejgm/12675">nutrient deficiencies and inadequate intake</a>. </p>
<p>For instance, a decline in iron intake can lead to <a href="https://doi.org/10.1093/jn/nxab064">iron deficiency anemia</a>, which can cause fatigue as well as an increased risk of many conditions. Adequate intake of calcium and Vitamin D <a href="https://doi.org/10.1007/s10195-017-0474-7">reduce the risk of bone fractures</a>, yet many people get less than the recommended amounts of these nutrients. </p>
<p>It is true that a healthy body weight is associated with reduced health risks and conditions. But if a person loses weight in a manner that does not provide their body with adequate nourishment, then they may develop new health concerns. For example, when a person follows a diet that severely restricts carbohydrates, such as the <a href="https://www.ncbi.nlm.nih.gov/books/NBK499830/">ketogenic diet</a>, intake of many vitamins, minerals, <a href="https://www.uclahealth.org/news/what-are-phytochemicals-and-why-should-you-eat-more-them">phytochemicals</a> – or biologically active compounds found in plants – and fiber are reduced. This can increase risk of nutrient deficiencies and <a href="https://doi.org/10.3389/fnut.2021.702802">impair the health of bacteria in our gut</a> that are important for nutrient absorption and immune function.</p>
<p><a href="https://ods.od.nih.gov/HealthInformation/nutrientrecommendations.aspx">Nutrition recommendations</a> set by the Food and Nutrition Board of the National Academies of Sciences, Engineering, and Medicine and the <a href="https://health.gov/our-work/nutrition-physical-activity/dietary-guidelines">Dietary Guidelines for Americans</a> provide guidance and <a href="https://www.nutrition.gov/">resources</a> to help meet nutrient needs to promote health and prevent disease, regardless of the strategy used to lose weight.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/HloP7XR3Y24?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">His transformation began with a wake-up call from the doctor.</span></figcaption>
</figure>
<h2>Optimizing health</h2>
<p>There is no doubt that striving for a healthy body weight can reduce certain health risks and prevent chronic disease. Whether a person strives to maintain a healthy body weight through diet alone or with medications to treat obesity, the following tips can help optimize health while attempting to lose weight.</p>
<ol>
<li><p>Adopt an individualized approach to healthy behaviors that promote weight loss while considering personal preferences, environmental challenges, health conditions and nutrient needs.</p></li>
<li><p>Focus on nutrient-dense foods to ensure the body is getting required nutrients for disease prevention and optimal function. If medications reduce your appetite, it is crucial to maximize the amount of nutrients in the foods you do consume.</p></li>
<li><p>Include <a href="https://theconversation.com/cardio-or-weights-first-a-kinesiologist-explains-how-to-optimize-the-order-of-your-exercise-routine-217431">exercise in your program</a>. Weight loss as a result of reduced calorie intake can decrease both fat and lean body mass, or muscle. An exercise routine that <a href="https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/strength-training/art-20046670">includes strength training</a> will <a href="https://www.forbes.com/health/fitness/benefits-of-strength-training/">help improve muscle strength</a> and preserve muscle during weight loss. </p></li>
<li><p>Seek professional help. If you are uncertain about how to adopt an individualized approach while ensuring adequate intake of essential nutrients, talk to a registered dietitian. They can learn about your individual needs based on preferences, health conditions and goals to make dietary recommendations that support health.</p></li>
</ol>
<p><em>This article has been corrected to clarify that Ozempic is approved for the treatment of Type 2 diabetes and Wegovy is approved for the treatment of obesity.</em></p><img src="https://counter.theconversation.com/content/219084/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Mandy Conrad does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Medications can play an important role in weight management, but not at the expense of overall nutrition. And healthy lifestyle habits are also key.Mandy Conrad, Assistant Clinical Professor in Nutrition and Dietetics, Mississippi State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2188812024-01-04T20:46:52Z2024-01-04T20:46:52ZFor cancer patients, maintaining muscle is vital to health and treatment, but staying strong is complicated<figure><img src="https://images.theconversation.com/files/567306/original/file-20231222-19-bbnx0m.jpg?ixlib=rb-1.1.0&rect=308%2C44%2C7040%2C4638&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">With cachexia, a patient loses a significant amount of weight due to their disease, with considerable losses of muscle mass.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/for-cancer-patients-maintaining-muscle-is-vital-to-health-and-treatment-but-staying-strong-is-complicated" width="100%" height="400"></iframe>
<p>Nearly <a href="https://www.cancer.gov/about-cancer/treatment/research/cachexia">one-third of cancer patients die</a> from a side-effect you’ve likely never heard of: cancer cachexia. </p>
<p>With cachexia, a patient loses a significant amount of weight due to their disease, with considerable losses of muscle mass. Muscle plays essential roles in movement, exercise and metabolism. Simple things like walking up the stairs, doing laundry and taking a breath are only possible because of muscles.</p>
<p>Despite the significance of cachexia for cancer patients, there has been very little progress in treating the condition. </p>
<h2>What exactly is cancer cachexia?</h2>
<p>Cancer cachexia is an unintentional loss of body weight that mainly affects muscle. It is diagnosed when a cancer patient loses more than five per cent of their body weight over six months. For a 180-pound (82-kilogram) person, this would equate to nine pounds, or four kilograms, lost. </p>
<p>Skeletal muscle is a remarkable organ that can repair and rebuild itself regularly. Muscle experiences periods of breakdown and rebuilding every day. When we exercise, we induce muscle damage, that is then repaired, to make even stronger muscles. In a healthy person, this keeps muscle mass balanced and relatively unchanged day-to-day. However, in a condition like cachexia, <a href="https://doi.org/10.1152/japplphysiol.91375.2008">this system is no longer balanced</a>. </p>
<p>During cachexia, we see increases in the pathways responsible for muscle breakdown and decreases in the pathways responsible for <a href="https://doi.org/10.1152/japplphysiol.00622.2019">muscle rebuilding</a>. These changes result in gradual and consistent muscle tissue breakdown, resulting in muscle loss. This muscle loss also means lost strength and increased fatigue. Excessive muscle loss can eventually cause the heart and lungs to stop working properly, causing death.</p>
<p>Cancer cachexia is complex, and is likely caused by many factors working together. Inflammation from cancer or chemotherapy, reduced appetite and food intake, or even specific interactions between a tumour and muscle <a href="https://doi.org/10.1186/s13045-023-01454-0">could all play a role</a>.</p>
<h2>The impact of cachexia on patients</h2>
<figure class="align-center ">
<img alt="A grey-haired man with an IV in his arm and a younger woman in scrubs" src="https://images.theconversation.com/files/567308/original/file-20231222-21-4evj3f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567308/original/file-20231222-21-4evj3f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567308/original/file-20231222-21-4evj3f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567308/original/file-20231222-21-4evj3f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567308/original/file-20231222-21-4evj3f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567308/original/file-20231222-21-4evj3f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567308/original/file-20231222-21-4evj3f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Cachexia can affect how chemotherapies work.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Cancer cachexia can have a significant impact on a patient’s quality of life and prognosis. While muscle wasting is not typically painful, the general loss of strength, muscle function and, ultimately, independence can be jarring. </p>
<p>Many everyday tasks are impacted by loss of strength and increased fatigue. Activities like exercise, gardening, showering or getting dressed all grow increasingly difficult as muscle disappears. Cachexia can also influence how well certain chemotherapies work. Patients with cachexia tend to have <a href="https://doi.org/10.1200/EDBK_389942">lower treatment tolerances</a> than those of healthy body composition. </p>
<p>Emotionally, cachexia can be extremely difficult to manage. Cachexia patients report struggling with body image, loss of independence and becoming a <a href="https://doi.org/10.1007/s13539-014-0142-1">burden to their loved ones</a>. They also tend to have higher rates of <a href="http://dx.doi.org/10.1136/bmjspcare-2019-002176">anxiety and depression</a>.</p>
<h2>Treating cachexia</h2>
<p>Unfortunately, Canada lacks standardized options for treating patients with cancer cachexia. </p>
<p>Research suggests that treating cachexia should use a <a href="https://doi.org/10.1186/s13045-023-01454-0">multi-targeted approach</a>. Nutritional interventions are essential for combating cachexia and should be started as soon as possible with consultation from a registered dietitian. </p>
<figure class="align-center ">
<img alt="A seated woman lifting a small dumbbell with assistance from a woman in scrubs standing behind her" src="https://images.theconversation.com/files/567307/original/file-20231222-19-efnd63.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567307/original/file-20231222-19-efnd63.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=446&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567307/original/file-20231222-19-efnd63.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=446&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567307/original/file-20231222-19-efnd63.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=446&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567307/original/file-20231222-19-efnd63.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=560&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567307/original/file-20231222-19-efnd63.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=560&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567307/original/file-20231222-19-efnd63.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=560&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Exercise could be a powerful tool to treat cachexia.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Exercise could be a very powerful tool to <a href="https://doi.org/10.3390/cancers14102512">treat cachexia</a>. A combination of aerobic and strength exercises is likely most beneficial. Exercise can also improve general quality of life and mental <a href="https://doi.org/10.1186/s12904-022-00948-x">health of cancer patients.</a>. It is important that any exercise interventions are accompanied by nutritional support and supervision, so that muscles have adequate material and energy to rebuild, and patients can have safe and adapted programs. </p>
<p>Studies on pharmacological compounds to treat cachexia have produced varied results, and many are still in early phase <a href="https://doi.org/10.%201200/JCO.20.00611">clinical trials</a>. While this is a promising area of research, patients cannot currently access cachexia-specific drugs outside of clinical trials.</p>
<h2>Diagnosing and detecting cachexia</h2>
<p>Perhaps the biggest limitation in treating cachexia is detecting it early enough to intervene. Diagnosing cachexia is largely based on weight-related measures. Unfortunately, many health-care professionals are not performing these basic diagnostic assessments. </p>
<p>An international study found that only about half of health-care professionals surveyed thought newly diagnosed cancer patients <a href="https://doi.org/10.1002/jcsm.13105">should be weighed</a>. Cachexia is likely underdiagnosed and, therefore, under-addressed among Canadians. </p>
<p>Further, using weight loss as the standard diagnostic criteria may not be an accurate or sensitive tool. Conditions like obesity may mask the detection of muscle loss when only weighing patients. Studies have also found that <a href="https://doi.org/10.1172/jci.insight.155147">strength</a> and <a href="https://doi.org/10.1152/japplphysiol.00622.2019">muscle integrity</a> changes are apparent before weight loss. </p>
<p>Integrating strength assessments as well as body composition scans across all points of the cancer journey could help capture the whole picture of cachexia development and progression. </p>
<h2>Where to go from here</h2>
<p>Cachexia has a massive impact on cancer outcomes and patient quality of life. The sooner it is detected, the better chance there is to manage it. Management should involve a multi-disciplinary team that can help with diet, exercise and psycho-social aspects of the condition.</p>
<p>Current research is focusing on developing medications that can specifically target the pathways of muscle wasting. It will likely be years before these reach the clinic, so early interventions with nutrition, exercise and regular monitoring are critical. More robust diagnostic criteria, such as imaging as well as strength and functional assessments, could help. </p>
<p>Cancer is a life-changing disease, and it’s important to ensure that patients can stay as strong as possible during the process. </p>
<p>Understanding cancer cachexia means prolonging both quantity and quality of life for Canadians.</p><img src="https://counter.theconversation.com/content/218881/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Meghan McCue receives funding from the Canadian Cancer Society and the Canadian Partnership Against Cancer. </span></em></p>Cachexia — significant loss of weight and muscle mass — has a massive impact on cancer outcomes and patient quality of life. The sooner it is detected, the better chance there is to manage it.Meghan McCue, PhD Candidate, Biomolecular Sciences, Laurentian UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2194442024-01-03T13:19:03Z2024-01-03T13:19:03ZWeight loss: why listening to your circadian rhythm may be important<figure><img src="https://images.theconversation.com/files/565755/original/file-20231214-15-b5yrah.jpg?ixlib=rb-1.1.0&rect=0%2C8%2C5690%2C3779&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Evidence from the field of chrono-nutrition shows that eating more in line with your circadian rhythm may be good for health.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/intermittent-fasting-ketogenic-diet-concept-8hour-1926524876">Chinnapong/ Shutterstock</a></span></figcaption></figure><p>When it comes to losing weight, many people want to know what the best diet is. But increasing research shows that when you eat may just as important for your health and weight as what you eat. </p>
<p>The importance of when we eat is tied to our internal 24-hour biological timing system, called the circadian system. This is controlled by a master clock in the brain which helps regulate many metabolic processes in the body – including digestion, the release of hormones, and blood sugar levels, as well as when we sleep, wake up and eat. Regular circadian rhythms (our eating and sleeping times) help to <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jne.12886">maintain normal body functions</a>.</p>
<p>From a <a href="https://pubmed.ncbi.nlm.nih.gov/32662577/">physiological perspective</a> – for humans and many other mammals, at least – the body is used to us eating when it’s light and sleeping when it’s dark. This is in sync with our circadian rhythm.</p>
<p>Emerging evidence from the field of <a href="https://onlinelibrary.wiley.com/doi/10.1111/jnc.15246">chrono-nutrition</a> shows that eating more in line with this natural biological rhythm may help boost your health and wellbeing, and potentially help with weight loss. </p>
<h2>Timing your meals</h2>
<p>If you prefer to skip breakfast in favour of eating later in the day, you’re not alone. The majority of <a href="https://pubmed.ncbi.nlm.nih.gov/27327252/">people in the UK</a> consume most of their day’s calories in the evening. But given our body’s preference for daylight, there may be some advantage to eating breakfast – or at least, getting more of our day’s calories into our diets earlier on.</p>
<p>Most evidence from the field of chrono-nutrition suggests eating breakfast regularly may protect against <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5969247/">gaining body fat</a>. Research also shows that eating most of your calories a couple of hours before bedtime may <a href="https://www.cell.com/cell-metabolism/pdfExtended/S1550-4131(22)00397-7">increase hunger</a> and reduce your metabolism to favour fat storage in the body’s fat tissue. Habitually skipping breakfast and eating mostly in the evening is associated with a <a href="https://pubmed.ncbi.nlm.nih.gov/31918985/">greater risk of weight gain</a> as well.</p>
<p>Having irregular mealtimes can also affect your body weight. <a href="https://doi.org/10.1093/ije/dyy079">Shift workers</a>, for example, are predisposed to weight gain and metabolic disorders such as type 2 diabetes, cardiovascular disease and some cancers. It’s been suggested that the reason for this, in part, is circadian misalignment, which is when your sleep and wake cycle is misaligned with your mealtimes. <a href="https://academic.oup.com/pmj/article/94/1117/653/6959223">Jet lag</a> can affect digestion and sleep patterns too.</p>
<p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3763921/">Sleep loss</a> has also been shown to alter food desire – with studies showing that people crave high-calorie foods after a night of poor sleep. This may further result in weight gain.</p>
<p>However, if you’re someone who finds it hard to eat breakfast in the morning, don’t despair. Research by myself and colleagues shows that when it comes to weight loss, the timing of your meals doesn’t affect <a href="https://www.cell.com/cell-metabolism/pdfExtended/S1550-4131(22)00344-8">your ability to lose weight</a> – though early eating may have some advantages. </p>
<p>Our study compared the effect of eating calories predominantly in the morning versus in the evening. In one group, participants ate 45% of their day’s calories at breakfast, 35% at lunch and 20% at dinner. The other group had the opposite eating pattern, with 45% of their day’s calories consumed at dinner.</p>
<p>We found that adults in both groups had similar weight loss regardless of when they ate the bulk of their day’s calories. This result might be particularly reassuring for people who work shifts.</p>
<figure class="align-center ">
<img alt="A person eats a healthy breakfast." src="https://images.theconversation.com/files/565757/original/file-20231214-17-crn595.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/565757/original/file-20231214-17-crn595.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/565757/original/file-20231214-17-crn595.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/565757/original/file-20231214-17-crn595.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/565757/original/file-20231214-17-crn595.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/565757/original/file-20231214-17-crn595.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/565757/original/file-20231214-17-crn595.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Consider putting breakfast back on the menu.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-eating-healthy-morning-meal-breakfast-2313432341">Dulin/ Shutterstock</a></span>
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<p>One thing we did find, though, was that eating a big breakfast was most beneficial for appetite control. This may be useful when sticking to a strict calorie limit in order to lose weight.</p>
<p>The type of breakfast you eat is also important. <a href="https://pubmed.ncbi.nlm.nih.gov/22397883/">Another study</a> we conducted shows that appetite and satiety (feeling full) are influenced by the macronutrients (fat, protein and carbohydrates) in your meal. For example, high-protein meals were shown to make participants feel fuller for longer. And because these meals were satisfying, it also made participants less likely to give into cravings later on. </p>
<p>Some good examples of high-protein breakfasts include yoghurts, eggs, baked beans and toast, kedgeree (smoked fish, boiled egg and rice) or a fruit and vegetable smoothie with added quark or tofu.</p>
<p>So, based on the available evidence, it appears that eating most of your meals during the earlier daylight hours may be beneficial for your health and body weight.</p>
<h2>Timing your workouts</h2>
<p>Exercise is also important when it comes to our health. However, it’s not yet clear whether exercising at a certain time of day is more beneficial.</p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/30426166/">One study</a>, which compared the effect of high-intensity interval training (HIIT) on blood sugar levels in men with type 2 diabetes, found that exercising in the afternoon was better than exercising in the morning when it came to improving blood sugar levels. This may be important in managing the condition in the long term. </p>
<p>However, a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4095658/">separate study</a> conducted in people who did not have any health conditions found the timing of your workout was less important than when you ate. </p>
<p>The researchers found that participants who consumed around 700 calories before 11am were more physically active and had more stable blood sugar throughout the day, compared with participants who fasted until noon. Both of these factors may help to prevent weight gain in the long run. </p>
<p>So, while the timing of your workout may be personal preference, when you have your pre-workout meal does matter when it comes to health.</p>
<p>In general, by taking lessons from chrono-nutrition and tuning back into our body clocks, it may be possible to better look after our health in a way that’s more aligned with our biology.</p><img src="https://counter.theconversation.com/content/219444/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alex Johnstone receives funding from UKRI, The Scottish Government, NHS, Chief Scientist Office and European Community. She acts as a consultant for the food sector. </span></em></p>You may want to re-think skipping breakfast if you’re someone who does it often.Alex Johnstone, Personal Chair in Nutrition, The Rowett Institute, University of AberdeenLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2190452024-01-02T16:50:08Z2024-01-02T16:50:08ZCrash diets may work against you – and could have permanent consequences<figure><img src="https://images.theconversation.com/files/565315/original/file-20231212-21-1c45qh.jpg?ixlib=rb-1.1.0&rect=11%2C0%2C7928%2C5297&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Drastically lowering calories may damage your metabolism.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/starving-caucasian-fat-obese-woman-on-1950906280">Inside Creative House/ Shutterstock</a></span></figcaption></figure><p>Those trying to kick-start their weight loss or perhaps wanting to lose a few pounds before a big event or holiday may be tempted to try a crash diet. While it’s true that in order to lose weight you need to eat fewer calories than your body uses each day, in reality crash diets may actually work against you – and may make weight loss more difficult.</p>
<p>Crash diets have been around for years, but have stayed popular more recently thanks to <a href="https://www.independent.co.uk/life-style/celebrity-diets-kim-kardashian-friends-b2212946.html">influencers</a> and social media. Typically, these diets involve drastically reducing calorie intake to <a href="https://theconversation.com/crash-diets-are-highly-effective-new-evidence-95106#:%7E:text=Some%20people%20opt%20for%20a,a%20man%20it%27s%202%2C500%20calories.">800-1,200 calories</a> a day for a few weeks at a time. Proponents of these diets claim it can lead to rapid <a href="https://www.stylecraze.com/articles/how-to-lose-weight-in-one-week-by-crash-dieting/">weight loss</a>, which may explain why they have such a significant appeal. </p>
<p>Indeed, research has shown these diets can actually be very effective for certain people.</p>
<p>In a study of 278 adults with obesity, a <a href="https://www.bmj.com/content/362/bmj.k3760">12-week crash diet</a> of 810 calories a day led to greater weight loss after 12 months than people who only reduced their calories by portion control. The crash diet group lost an average of nearly 11kg versus only 3kg in the moderate diet group.</p>
<p>Similarly, <a href="https://link.springer.com/article/10.1007/s00125-011-2204-7?correlationId=4d9ea02c-da9a-44df-a279-bfae59b39531">one study showed</a> that very low-calorie diets may be beneficial for people with type 2 diabetes. The researchers found that 60% of participants who ate 600 calories a day for eight weeks were able to put their type 2 diabetes into remission. They also lost around 15kg on average.</p>
<p>A follow up at 12 weeks showed participants put around 3kg back on – but, importantly, their blood sugar levels remained similar. </p>
<p>But while these diets may lead to short-term weight loss success in some people, they can have the long-term consequence of damaging your metabolism. This may explain why around 80% of diets fail – with the person ultimately putting all the <a href="https://www.sciencedirect.com/science/article/pii/S0002916523295362?via%3Dihub">weight they lost back on</a>, or even <a href="https://onlinelibrary.wiley.com/doi/10.1002/oby.21538">gaining more weight than they lost</a>.</p>
<h2>Crash diets and metabolism</h2>
<p>Your metabolism is the sum of all chemical reactions in the body. It’s responsible for converting the food we eat into energy, and storing any surplus energy as fat. Your metabolism is affected by many things – including diet, exercise and your hormones. Crash diets affect all these components.</p>
<p>With a crash diet, you consume far less food than normal. This means your body doesn’t need to use as much energy (calories) to digest and absorb the foods you’ve eaten. You also <a href="https://journals.humankinetics.com/view/journals/ijsnem/6/3/article-p285.xml">lose muscle</a>. All of these factors <a href="https://journals.humankinetics.com/view/journals/ijsnem/6/3/article-p285.xml">lower metabolic rate</a> – meaning the body will burn fewer calories when not exercising.</p>
<p>In the short-term, crash diets can lead to <a href="https://www.ion.ac.uk/news/the-truth-about-crash-diets">feelings of tiredness</a>, which makes doing any activity (let alone a workout) challenging. This is because less energy is available – and what is available is prioritised for life-sustaining reactions. </p>
<figure class="align-center ">
<img alt="A tired man sleeps on his couch using a yoga mat for a pillow and holding a dumbbell." src="https://images.theconversation.com/files/565316/original/file-20231212-23-llkmlk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/565316/original/file-20231212-23-llkmlk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/565316/original/file-20231212-23-llkmlk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/565316/original/file-20231212-23-llkmlk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/565316/original/file-20231212-23-llkmlk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/565316/original/file-20231212-23-llkmlk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/565316/original/file-20231212-23-llkmlk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Crash diets may make you have less energy.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/tired-young-man-sleeping-on-sofa-1915162345">Westock Productions/ Shutterstock</a></span>
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<p>In the long term, crash diets can change the hormone makeup of our bodies. They increase our stress hormones, such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895000/">cortisol</a>. And over an extended period of time, typically months, high cortisol levels can cause our body to <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/oby.21733">store more fat</a>. </p>
<p>Crash diets can also reduce levels of the <a href="https://pubmed.ncbi.nlm.nih.gov/2341229/">hormone T3</a>, which is produced by the thyroid gland. It’s critical in regulating our basal metabolic rate (the number of calories your body needs in order to sustain itself). Long-term changes in T3 levels can lead to hypothyroidism and <a href="https://www.mayoclinicproceedings.org/article/S0025-6196(18)30582-2/fulltext">weight gain</a>. </p>
<p>Together, all these changes make the body more adept at putting on weight when you begin consuming more calories again. And these changes may exist for months, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989512/#:%7E:text=Mean%20RMR%20after%206%20years,weight%20loss%20during%20an%20intervention.">if not years</a>.</p>
<h2>Gradual dieting</h2>
<p>If you’re trying to lose weight, the best strategy to use is following a long-term, gradual weight loss diet. </p>
<p>Gradual diets have been shown to be more sustainable and have a less negative impact on your <a href="https://www.sciencedirect.com/science/article/pii/S0261561417301474?via%3Dihub">metabolic rate</a> compared with crash diets. Gradual diets can also help maintain energy levels enough to <a href="https://academic.oup.com/jcem/article/92/3/865/2597148">exercise</a>, which can help you lose weight. </p>
<p>These types of diet also preserve the function of our <a href="https://pubmed.ncbi.nlm.nih.gov/18252894/">mitochondria</a> – the calorie-burning powerhouses in our muscles. This creates a greater capacity for burning calories even after we finish dieting.</p>
<p>The ideal diet is one that reduces body weight by <a href="https://www.ncbi.nlm.nih.gov/books/NBK572145/">around 0.5 to 1kg a week</a>. The number of calories you’ll need to eat per day will depend on your starting weight and how physically active you are.</p>
<p>Eating certain foods can also help maintain your metabolism while dieting.</p>
<p>Fats and carbohydrates use fewer calories to power digestion, compared with protein. Indeed, high-protein diets increase your metabolic rate <a href="https://www.nature.com/articles/1600578">11-14% above normal levels</a>, whereas diets high in carbohydrates or fats can only do this by <a href="https://www.nature.com/articles/0800810">4-8%</a>. As such, try to ensure around <a href="https://www.verywellfit.com/is-a-high-protein-diet-best-for-weight-loss-3495768">30% of your day’s calories</a> are made up of protein when trying to lose weight. </p>
<p>High-protein diets also help you feel fuller for longer. One study found that when a participant’s diet consisted of 30% protein, they consumed <a href="https://pubmed.ncbi.nlm.nih.gov/16002798/">441 calories</a> less over the 12-week study period compared with a 15% protein diet. This ultimately led to 5kg weight loss, of which 3.7kg was fat loss. </p>
<p>While it may be tempting to crash diet if you’re trying to lose weight fast, it could have long-term consequences for your metabolism. The best way to lose weight is to slightly reduce the number of calories you need per day, exercise, and eat plenty of protein.</p><img src="https://counter.theconversation.com/content/219045/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Christopher Gaffney receives research funding from Omega EFA Limited. </span></em></p>Slow, gradual weight loss is more advantageous for your health in the long run.Christopher Gaffney, Senior Lecturer in Integrative Physiology, Lancaster UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2145802023-12-26T20:30:36Z2023-12-26T20:30:36ZYou can’t reverse the ageing process but these 5 things can help you live longer<figure><img src="https://images.theconversation.com/files/565071/original/file-20231212-19-m904rz.jpg?ixlib=rb-1.1.0&rect=0%2C437%2C6500%2C3746&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/seniors-enjoying-breakfast-1105683980">Rawpixel.com/Shutterstock</a></span></figcaption></figure><p>At this time of year many of us resolve to prioritise our health. So it is no surprise there’s a <a href="https://digiday.com/marketing/health-food-brands-ramp-up-marketing-efforts-around-consumers-new-years-resolutions/">roaring trade</a> of products purporting to guarantee you live longer, be healthier and look more youthful. </p>
<p>While an <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4822264/">estimated</a> 25% of longevity is determined by our genes, the rest is determined by what we do, day to day. </p>
<p>There are no quick fixes or short cuts to living longer and healthier lives, but the science is clear on the key principles. Here are five things you can do to extend your lifespan and improve your health.</p>
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Read more:
<a href="https://theconversation.com/no-you-cant-reverse-ageing-by-injecting-young-blood-and-fasting-but-that-doesnt-stop-people-trying-207038">No, you can't reverse ageing by injecting 'young blood' and fasting. But that doesn't stop people trying</a>
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<h2>1. Eat a predominantly plant-based diet</h2>
<p>What you eat has a huge impact on your health. The evidence overwhelmingly <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8210981/#:%7E:text=According%20to%20an%20expansive%20review,13%20Given%20that%20so%20many">shows</a> eating a diet high in plant-based foods is associated with health and longevity. </p>
<p>If you eat more plant-based foods and less meat, processed foods, sugar and salt, you reduce your risk of a range of illnesses that shorten our lives, including heart disease and cancer. </p>
<figure class="align-center ">
<img alt="Delicious Mediterranean serving platter." src="https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=371&fit=crop&dpr=1 600w, https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=371&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=371&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=466&fit=crop&dpr=1 754w, https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=466&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=466&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">The Mediterranean diet is one of the healthiest and most studied eating patterns.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/tray-of-food-on-white-surface-K47107aP8UU">Louis Hansel/Unsplash</a></span>
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<p>Plant-based foods <a href="https://www.nature.com/articles/s41398-019-0552-0">are rich</a> in nutrients, phytochemicals, antioxidants and fibre. They’re also anti-inflammatory. All of this protects against damage to our cells as we age, which helps prevent disease. </p>
<p>No particular diet is right for everyone but one of the most studied and <a href="https://www.hsph.harvard.edu/nutritionsource/healthy-weight/diet-reviews/mediterranean-diet/#:%7E:text=%5B6%5D%20Those%20who%20had%20the,who%20had%20the%20lowest%20adherence.">healthiest</a> is the <a href="https://www.eatingwell.com/article/291120/mediterranean-diet-for-beginners-everything-you-need-to-get-started/">Mediterranean diet</a>. It’s based on the eating patterns of people who live in countries around the Mediterranean Sea and emphases vegetables, fruits, wholegrains, legumes, nuts and seeds, fish and seafood, and olive oil.</p>
<h2>2. Aim for a healthy weight</h2>
<p>Another important way you can be healthier is to try and achieve a healthy weight, as obesity <a href="https://www.healthline.com/health/obesity/how-obesity-affects-body">increases the risk</a> of a number of health problems that shorten our lives.</p>
<p>Obesity puts strain on all of our body systems and has a whole myriad of physiological effects including causing inflammation and hormonal disturbances. These <a href="https://www.ncbi.nlm.nih.gov/books/NBK572076/">increase your chances</a> of a number of diseases, including heart disease, stroke, high blood pressure, diabetes and a number of cancers.</p>
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Read more:
<a href="https://theconversation.com/the-body-mass-index-cant-tell-us-if-were-healthy-heres-what-we-should-use-instead-211190">The body mass index can't tell us if we're healthy. Here's what we should use instead</a>
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<p>In addition to affecting us physically, obesity is also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6052856/">associated with</a> poorer psychological health. It’s linked to depression, low self-esteem and stress.</p>
<p>One of the biggest challenges we face in the developed world is that we live in an <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6817492/">environment</a> that promotes obesity. The ubiquitous marketing and the easy availability of high-calorie foods our bodies are hard-wired to crave mean it’s easy to consume too many calories.</p>
<h2>3. Exercise regularly</h2>
<p>We all know that exercise is good for us – the <a href="https://www.insurancebusinessmag.com/au/news/breaking-news/hcf-reveals-australias-most-popular-new-years-resolutions-for-2023-431665.aspx">most common resolution</a> we make this time of year is to do more exercise and to get fitter. Regular exercise <a href="https://www.who.int/news-room/fact-sheets/detail/physical-activity">protects</a> against chronic illness, lowers your stress and improves your mental health. </p>
<p>While one of the ways exercising helps you is by supporting you to control your weight and lowering your body fat levels, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1402378/#:%7E:text=For%20instance%2C%20routine%20physical%20activity,HDL%5D%20cholesterol%20levels%20and%20decreased">effects</a> are broader and include improving your glucose (blood sugar) use, lowering your blood pressure, reducing inflammation and improving blood flow and heart function.</p>
<figure class="align-center ">
<img alt="Woman with grey hair does yoga outside" src="https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Do the types of exercise you enjoy.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/woman-in-black-tank-top-and-gray-denim-jeans-sitting-on-green-grass-field-during-daytime-FGQQho5XXn4">Kelly Newton/Unsplash</a></span>
</figcaption>
</figure>
<p>While it’s easy to get caught up in all of the hype about different exercise strategies, the evidence <a href="https://www.medicalnewstoday.com/articles/320760">suggests</a> that any way you can include physical activity in your day has health benefits. You don’t have to run marathons or go to the gym for hours every day. Build movement into your day in any way that you can and do things that you enjoy.</p>
<hr>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/cant-afford-a-gym-membership-or-fitness-class-3-things-to-include-in-a-diy-exercise-program-206204">Can't afford a gym membership or fitness class? 3 things to include in a DIY exercise program</a>
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<h2>4. Don’t smoke</h2>
<p>If you want to be healthier and live longer then don’t smoke or vape. </p>
<p>Smoking cigarettes affects almost every organ in the body and is associated with both a shorter and lower quality of life. There is no safe level of smoking – every cigarette increases your <a href="https://theconthatkills.org.au/?utm_source=googlesearch&utm_medium=search&utm_campaign=theconthatkills23&utm_content=RSA&gclid=Cj0KCQjwqP2pBhDMARIsAJQ0Czrlep6EQHC-8_9xUhpz0h9v2ZglMF-6-k7_65awq8FxVaIL5HRoivwaAqJwEALw_wcB&gclsrc=aw.ds">chances of developing</a> a range of cancers, heart disease and diabetes. </p>
<p>Even if you have been smoking for years, by giving up smoking at any age you can experience <a href="https://www.cdc.gov/tobacco/quit_smoking/how_to_quit/benefits/index.htm">health benefits</a> almost immediately, and you can reverse many of the harmful effects of smoking.</p>
<p>If you’re thinking of switching to vapes as a healthy long term option, <a href="https://theconversation.com/can-vaping-help-people-quit-smoking-its-unlikely-204812">think again</a>. The long term health effects of vaping are not fully understood and they come with their own <a href="https://theconversation.com/no-vapes-arent-95-less-harmful-than-cigarettes-heres-how-this-decade-old-myth-took-off-203039">health risks</a>.</p>
<h2>5. Prioritise social connection</h2>
<figure class="align-center ">
<img alt="Older men play chess outdoors." src="https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Don’t forget about friendship and socialising.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/two-men-playing-chess-ItphH2lGzuI">Vlad Sargu/Unsplash</a></span>
</figcaption>
</figure>
<p>When we talk about living healthier and longer, we tend to focus on what we do to our physical bodies. But one of the most important discoveries over the past decade has been the recognition of the importance of spiritual and psychological health. </p>
<p>People who are lonely and socially isolated have a much higher risk of dying early and are <a href="https://healthnews.com/longevity/healthspan/social-connection-and-longevity/#:%7E:text=One%20of%20the%20biggest%20benefits,the%20following%20factors%20and%20influences.">more likely</a> to suffer from heart disease, stroke, dementia as well as anxiety and depression. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/are-you-part-of-a-social-group-making-sure-you-are-will-improve-your-health-81996">Are you part of a social group? Making sure you are will improve your health</a>
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</em>
</p>
<hr>
<p>Although we don’t fully understand the mechanisms, it’s likely due to both behavioural and biological factors. While people who are more socially connected are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150158/">more likely</a> to engage in healthy behaviours, there also seems to be a more direct physiological effect of loneliness on the body. </p>
<p>So if you want to be healthier and live longer, build and maintain your connections to others.</p><img src="https://counter.theconversation.com/content/214580/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Hassan Vally does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Don’t believe the hype about products claiming they can help you live longer. Here are five lifestyle changes to prioritise instead.Hassan Vally, Associate Professor, Epidemiology, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2195852023-12-22T12:18:59Z2023-12-22T12:18:59ZWegovy: why half the people taking the weight loss drug stop within a year – and what happens when they do<figure><img src="https://images.theconversation.com/files/566935/original/file-20231220-21-tsodht.jpg?ixlib=rb-1.1.0&rect=745%2C454%2C4876%2C3231&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/obese-fat-man-preparing-semaglutide-ozempic-2172980955">myskin/Shutterstock</a></span></figcaption></figure><p>Despite the effectiveness of the newer generation of anti-obesity drugs – called GLP-1 receptor agonists – few can tolerate them in the long run. A <a href="https://onlinelibrary.wiley.com/doi/10.1002/oby.23952">new study</a>, published in the journal Obesity, reveals that of people prescribed weight-loss drugs, just 44% were still taking them after three months and only 19% after one year. </p>
<p>Greater adherence to these drugs, such as Wegovy, which make you feel fuller faster and longer, is associated with <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/oby.23952">greater weight loss</a>. So why do people not persist with it? </p>
<p>Actually, it’s not that unusual. Not persisting with medication is a well known phenomenon with other conditions, such as <a href="https://pubmed.ncbi.nlm.nih.gov/29302934/">type 2 diabetes</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388782/#:%7E:text=Persistence%20is%20therefore%20also%20an,in%20handling%20the%20inhaler%20device.">chronic obstructive pulmonary disease</a> and hypertension. Studies have shown that by the end of one year, almost <a href="https://www.bmj.com/content/336/7653/1114.long">half of the people</a> on blood pressure pills stop taking them. </p>
<p>The willingness to keep taking medication can be influenced by the symptoms (or lack of) of the condition being treated; by aspects of the healthcare system (such as the ability to be seen by a doctor or the <a href="https://link.springer.com/article/10.1007/s13300-021-01053-7#Sec13">cost of medication</a>); as well as by characteristics of the treatment itself (such as how frequently it needs to be taken, or how tolerable the side-effects are). </p>
<p>Indeed, the frequency of GLP-1 dosing has been shown to be important for people with diabetes. Those who take GLP-1 drugs once a week are more likely to stick with it than those who have a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5485056/pdf/DOM-19-953.pdf">daily injection</a>. </p>
<p>The potential side-effects of GLP-1 medication have attracted attention. In clinical trials, the proportion withdrawing from GLP-1 treatment ranges <a href="https://www.sciencedirect.com/science/article/pii/S2212877820301769#bib175">from 15% to 25%</a>. About half of people who stopped taking the drug did so as a result of side-effects – mostly gastrointestinal problems. </p>
<p>Yet, on the whole, side-effects of GLP-1 drugs tend to be mild or moderate. Some people experience bouts of nausea in the first four weeks of using the drug, but this can become worse if the dose is escalated. Diarrhoea, constipation, fatigue and sulphurous burping can <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032183">also occur</a>. </p>
<p>However, it’s worth noting persistence with GLP-1 drugs appears <a href="https://onlinelibrary.wiley.com/doi/10.1002/oby.23952">much greater</a> than with other weight loss drugs. </p>
<p>Clinical trials have shown that maximal weight loss with GLP-1 drugs is not achieved until about <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032183">one year</a> and it may be that some people wish to see a more rapid response. However, <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032183">about 6% weight loss can be achieved within 12 weeks</a>, which would be an incentive to persist with treatment. </p>
<p>There is a well reported global <a href="https://www.forbes.com/sites/ariannajohnson/2023/05/05/wegovy-shortage-drug-maker-limits-distribution-heres-when-supplies-should-improve/">shortage of GLP-1 drugs</a>. This has occurred partly due to the very success of these drugs, and the lack of availability may result in patients being unable to persist with the drug.</p>
<h2>What happens when people stop taking the drug?</h2>
<p>While there is some debate as to how sustainable GLP-1 drugs are for weight loss, a more pertinent question is what happens when people stop this treatment.</p>
<p>These drugs may be heralded as <a href="https://pubmed.ncbi.nlm.nih.gov/38044481/">gamechangers</a> when it comes to getting people to lose weight, but several trials have shown clear weight regain when treatment is withdrawn. For example, participants who withdrew once-a-week treatment with Wegovy in the international <a href="https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.14725">Step-1 trial</a>, regained more than half the weight lost over the course of a year. </p>
<p>A more <a href="https://jamanetwork.com/journals/jama/fullarticle/2812936">recent study</a> showed that those who stopped treatment with Mounjaro (another GLP-1 drug) similarly regained around 60% of their lost weight. </p>
<p>The take home from these studies, and others like them, is that weight loss can be maintained, provided you don’t stop the medication. </p>
<p>We have long known that, regardless of the means of losing weight, once the intervention is stopped, it is common for people to <a href="https://pubmed.ncbi.nlm.nih.gov/17469900/">put weight back on</a>. </p>
<p>Several <a href="https://pubmed.ncbi.nlm.nih.gov/21677272/">biological</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/35103583/">energetic</a> changes happen as a result of weight loss that may make you healthier, but equally drive you to restore your lost weight – as discussed in a <a href="https://theconversation.com/dieting-may-slow-metabolism-but-it-doesnt-ruin-it-154620">previous Conversation piece</a>. </p>
<p>Yet the way these new weight-loss drugs work may mean the likelihood of putting lost weight back on is even higher. The artificial GLP-1 you inject is not the same as your own homegrown GLP-1, also known as “endogenous GLP-1”. </p>
<p>Ordinarily, <a href="https://pubmed.ncbi.nlm.nih.gov/36539382/">you release GLP-1</a> after a meal, but it doesn’t last long because it is rapidly broken down.</p>
<p>In contrast, injecting artificial GLP-1 gives you a much higher dose, that also lasts a lot longer. Equivalent to [ten times] normal active GLP-1. Such levels are only ever seen naturally right after eating a massive blowout meal, but with these drugs are present in the blood all the time. </p>
<figure class="align-center ">
<img alt="A feast" src="https://images.theconversation.com/files/567072/original/file-20231221-15-rsac02.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567072/original/file-20231221-15-rsac02.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567072/original/file-20231221-15-rsac02.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567072/original/file-20231221-15-rsac02.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567072/original/file-20231221-15-rsac02.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567072/original/file-20231221-15-rsac02.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567072/original/file-20231221-15-rsac02.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The level of GLP-1 generated by weight-loss jabs is similar to what your body would naturally produce after a massive, blowout meal.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/thanksgiving-feast-soul-food-ribs-fried-2213237029">IA Fillm Group/Shutterstock</a></span>
</figcaption>
</figure>
<p>Despite this being comparable to you overdosing on GLP-1, you may become no less sensitive to its effects, as seen in <a href="https://pubmed.ncbi.nlm.nih.gov/15561912/">animal studies</a>, at least. All good news as this will not only make you feel full but <a href="https://www.jci.org/articles/view/174597">sustain this fullness</a> despite your body’s attempts to make you hungrier. </p>
<p>However, sustaining such high levels of “fake” GLP-1 could cause you to produce less of your own endogenous GLP-1.</p>
<h2>Cold turkey</h2>
<p>All this is no issue, presuming you continue keeping GLP-1 levels artificially high. But like any addict will tell you, bad things can happen when you go “cold turkey”. </p>
<p>In this case, when you stop taking these drugs, active GLP-1 levels will go off a cliff. No longer <a href="https://pubmed.ncbi.nlm.nih.gov/37961449/">shackled</a>, hunger and appetite may well return with a vengeance. </p>
<p>Combine this with <a href="https://pubmed.ncbi.nlm.nih.gov/37696920/">all the other factors</a> conspiring to put the lost weight back on, and you can end up potentially becoming <a href="https://onlinelibrary.wiley.com/doi/10.1111/obr.12253">even fatter</a> than they were to begin with.</p>
<p>The realisation is that these “gamechanger” drugs are now making weight loss even easier, but as always our focus should be on the major <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/obr.12322#obr12322-fig-0001">challenge of weight maintenance</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/wegovy-was-inspired-by-gila-monster-venom-here-are-some-other-drugs-with-surprising-origins-208630">Wegovy was inspired by Gila monster venom – here are some other drugs with surprising origins</a>
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<img src="https://counter.theconversation.com/content/219585/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>When people stopped taking one of the new weight-loss jabs they regained around 60% of their lost weight.Adam Collins, Associate Professor of Nutrition, University of SurreyMartin Whyte, Associate Professor of Metabolic Medicine, University of SurreyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2191142023-12-18T19:09:51Z2023-12-18T19:09:51Z5 ways to avoid weight gain and save money on food this Christmas<p>As Christmas approaches, so does the challenge of healthy eating and maintaining weight-related goals. The season’s many social gatherings can easily tempt us to indulge in calorie-rich food and celebratory drinks. It’s why we typically <a href="https://www.nejm.org/doi/full/10.1056/NEJMc1602012">gain weight</a> over Christmas and then struggle to take it off for the <a href="https://www.sciencedirect.com/science/article/pii/S0031938414001528">remainder of the year</a>.</p>
<p>Christmas 2023 is also exacerbating cost-of-living pressures, prompting some to rethink their food choices. Throughout the year, <a href="https://dvh1deh6tagwk.cloudfront.net/finder-au/wp-uploads/2023/03/Cost-of-Living-Report-2023.pdf">71% of Australians</a> – or 14.2 million people – <a href="https://retailworldmagazine.com.au/rising-cost-of-living-forces-aussies-to-change-diets/">adapted</a> their eating behaviour in response to rising costs.</p>
<p>Fortunately, there are some simple, science-backed hacks for the festive season to help you celebrate with the food traditions you love without impacting your healthy eating habits, weight, or hip pocket.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/when-christmas-comes-so-do-the-kilos-new-research-tracks-australians-yo-yo-weight-gain-210709">When Christmas comes so do the kilos. New research tracks Australians' yo-yo weight gain</a>
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<hr>
<h2>1. Fill up on healthy pre-party snacks before heading out</h2>
<p>If your festive season is filled with end-of-year parties likely to tempt you to fill up on finger foods and meals high in fat, salt, and sugar and low in nutritional value, have a healthy pre-event snack before you head out.</p>
<p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015032/#sec-a.g.atitle">Research</a> shows carefully selected snack foods can impact satiety (feelings of fullness after eating), potentially reducing the calories you eat later. High-protein, high-fibre snack foods have the strongest effect: because they take longer to digest, our hunger is satisfied for longer.</p>
<figure class="align-center ">
<img alt="Person pours a handful of mixed nuts" src="https://images.theconversation.com/files/565710/original/file-20231214-31-zsoyv0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/565710/original/file-20231214-31-zsoyv0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/565710/original/file-20231214-31-zsoyv0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/565710/original/file-20231214-31-zsoyv0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/565710/original/file-20231214-31-zsoyv0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/565710/original/file-20231214-31-zsoyv0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/565710/original/file-20231214-31-zsoyv0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Nuts are a good option.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/hands-holding-jar-nuts-dried-fruits-1112521214">Shutterstock/NazarBazar</a></span>
</figcaption>
</figure>
<p>So enjoy a handful of nuts, a tub of yoghurt, or a serving of hummus with veggie sticks before you head out to help keep your healthy eating plan on track.</p>
<h2>2. Skip the low-carb drinks and enjoy your favourites in moderation</h2>
<p>Despite the marketing promises, low-carb alcoholic drinks <a href="https://onlinelibrary.wiley.com/doi/10.1002/hpja.531">aren’t better for our health or waistlines</a>.</p>
<p>Many low-carb options have a similar amount of carbohydrates as regular options but lull us into thinking they’re better, so we drink more. A <a href="https://www.vichealth.vic.gov.au/sites/default/files/K-013_Low-carb-beer_FactSheet_FINAL.pdf">survey</a> found 15% of low-carb beer drinkers drank more beer than they usually would because they believed it was healthier for them.</p>
<p>A typical lager or ale will contain less than 1.5 grams of carbohydrate per 100 ml while the “lower-carb” variety can range anywhere from 0.5 grams to 2.0 grams. The calories in drinks come from the alcohol itself, not the carbohydrate content. </p>
<p>Next time you go to order, think about the quantity of alcohol you’re drinking rather than the carbs. Make sure you sip lots of water in between drinks to stay hydrated, too.</p>
<h2>3. Don’t skimp on healthy food for Christmas Day – it’s actually cheaper</h2>
<p>There’s a perception that healthy eating is more expensive. But studies show this is a misconception. A <a href="https://southwesthealthcare.com.au/swh-study-finds-eating-a-healthier-diet-is-actually-cheaper-at-the-checkout/#:%7E:text=A%20recent%20study%20from%20the,does%20not%20meet%20the%20guidelines">recent analysis</a> in Victoria, for example, found following the Australian Dietary Guidelines cost the average family A$156 less a fortnight than the cost of the average diet, which incorporates packaged processed foods and alcohol.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/trying-to-spend-less-on-food-following-the-dietary-guidelines-might-save-you-160-a-fortnight-216749">Trying to spend less on food? Following the dietary guidelines might save you $160 a fortnight</a>
</strong>
</em>
</p>
<hr>
<p>So when you’re planning your Christmas Day meal, give the pre-prepared, processed food a miss and swap in healthier ingredients:</p>
<ul>
<li><p>swap the heavy, salted ham for leaner and lighter meats such as fresh seafood. Some seafood, such as prawns, is also tipped to be cheaper this year thanks to <a href="https://www.smh.com.au/goodfood/lobsters-up-prawns-stable-a-buying-guide-to-seafood-this-christmas-20231208-p5eq3m.html">favourable weather conditions</a> boosting local supplies</p></li>
<li><p>for side dishes, opt for fresh salads incorporating seasonal ingredients such as mango, watermelon, peach, cucumber and tomatoes. This will save you money and ensure you’re eating foods when they’re freshest and most flavoursome</p></li>
</ul>
<figure class="align-center ">
<img alt="Woman holds platter at Summer Christmas lunch outdoors" src="https://images.theconversation.com/files/565716/original/file-20231214-17-kdrjv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/565716/original/file-20231214-17-kdrjv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/565716/original/file-20231214-17-kdrjv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/565716/original/file-20231214-17-kdrjv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/565716/original/file-20231214-17-kdrjv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/565716/original/file-20231214-17-kdrjv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/565716/original/file-20231214-17-kdrjv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Swap in healthier ingredients.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/be-jolly-fill-your-belly-cropped-2146240039">PeopleImages.com - Yuri A/Shutterstock</a></span>
</figcaption>
</figure>
<ul>
<li><p>if you’re roasting veggies, use healthier cooking oils like olive as opposed to vegetable oil, and use flavourful herbs instead of salt</p></li>
<li><p>if there’s an out-of-season vegetable you want to include, look for frozen and canned substitutes. They’re cheaper, and <a href="https://www.sciencedirect.com/science/article/pii/S0889157517300418">just as nutritious</a> and tasty because the produce is usually frozen or canned at its best. Watch the sodium content of canned foods, though, and give them a quick rinse to remove any salty water</p></li>
<li><p>give store-bought sauces and dressings a miss, making your own from scratch using fresh ingredients.</p></li>
</ul>
<h2>4. Plan your Christmas food shop with military precision</h2>
<p>Before heading to the supermarket to shop for your Christmas Day meal, create a detailed meal plan and shopping list, and don’t forget to check your pantry and fridge for things you already have. </p>
<p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4586574/">Eating beforehand</a> and shopping with a plan in hand means you’ll only buy what you need and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8206473/">avoid impulse purchasing</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/bring-a-plate-what-to-take-to-christmas-lunch-that-looks-impressive-but-wont-break-the-bank-196565">Bring a plate! What to take to Christmas lunch that looks impressive (but won't break the bank)</a>
</strong>
</em>
</p>
<hr>
<p>When you’re shopping, price check everything. Comparing the cost per 100 grams is the most effective way to save money and get the best value. Check prices on products sold in different ways and places, too, such as nuts you scoop yourself versus prepacked options.</p>
<h2>5. Don’t skip breakfast on Christmas Day</h2>
<p>We’ve all been tempted to skip or have a small breakfast on Christmas morning to “save” the calories for later. But this plan will fail when you sit down at lunch hungry and find yourself eating far more calories than you’d “saved” for. </p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/32073608/">Research</a> shows a low-calorie or small breakfast leads to increased feelings of hunger, specifically appetite for sweets, across the course of the day. </p>
<p>What you eat for breakfast on Christmas morning is just as important too – choosing the right foods will <a href="https://theconversation.com/im-trying-to-lose-weight-and-eat-healthily-why-do-i-feel-so-hungry-all-the-time-what-can-i-do-about-it-215808">help you manage your appetite</a> and avoid the temptation to overindulge later in the day. </p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/24703415/">Studies</a> show a breakfast containing protein-rich foods, such as eggs, will leave us feeling fuller for longer. </p>
<p>So before you head out to the Christmas lunch, have a large, nutritionally balanced breakfast, such as eggs on wholegrain toast with avocado.</p>
<p><em>At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.</em> </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/5-ways-to-make-christmas-lunch-more-ethical-this-year-218351">5 ways to make Christmas lunch more ethical this year</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/219114/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nick Fuller works for the University of Sydney and has received external funding for projects relating to the treatment of overweight and obesity. He is the author and founder of the Interval Weight Loss program.</span></em></p>Many of us gain weight over Christmas and spend more than we’d like entertaining. Here’s how to keep both in check.Nick Fuller, Charles Perkins Centre Research Program Leader, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2158082023-12-10T19:07:34Z2023-12-10T19:07:34ZI’m trying to lose weight and eat healthily. Why do I feel so hungry all the time? What can I do about it?<p>Benjamin Franklin, one of the founding fathers of the United States, famously said nothing is certain except death and taxes. But I think we can include “you’ll feel hungry when you’re trying to lose weight” as another certainty. </p>
<p>The reason is basic biology. So how does this work – and what can you do about it?</p>
<h2>Hormones control our feelings of hunger</h2>
<p>Several hormones play an essential role in regulating our feelings of hunger and fullness. The most important are ghrelin – often called the hunger hormone – and leptin.</p>
<p>When we’re hungry, <a href="https://pubmed.ncbi.nlm.nih.gov/11739476/">ghrelin</a> is released by our stomach, lighting up a part of our brain called the hypothalamus to tell us to eat. </p>
<p>When it’s time to stop eating, hormones, including <a href="https://pubmed.ncbi.nlm.nih.gov/8717038/">leptin</a>, are released from different organs, such as our gut and fat tissue, to signal to the brain that we’re full.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/chemical-messengers-how-hormones-make-us-feel-hungry-and-full-35545">Chemical messengers: how hormones make us feel hungry and full</a>
</strong>
</em>
</p>
<hr>
<h2>Dieting disrupts the process</h2>
<p>But when we change our diet and start losing weight, we disrupt how these <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4766925/">appetite hormones function</a>. </p>
<p>This triggers a process that stems from our hunter-gatherer ancestors. Their bodies developed this mechanism as a survival response to adapt to periods of deprivation and protect against starvation. </p>
<p>The levels of hormones <a href="https://pubmed.ncbi.nlm.nih.gov/23126426/">managing our hunger increase</a>, making us feel hungrier to tell us to eat more, while the ones responsible for signalling we’re full decrease their levels, intensifying our feelings of hunger.</p>
<p>We end up increasing our calorie consumption so we eat more to regain the weight we lost. </p>
<p>But worse, even after the kilos creep back on, <a href="https://pubmed.ncbi.nlm.nih.gov/22029981/">our appetite hormones don’t restore</a> to their normal levels – they keep telling us to eat more so we put on a little extra fat. This is our body’s way of preparing for the next bout of starvation we will impose through dieting. </p>
<p>Fortunately, there are things we can do to manage our appetite, including:</p>
<h2>1. Eating a large, healthy breakfast every day</h2>
<p>One of the easiest ways to manage our feelings of hunger throughout the day is to eat most of our food earlier in the day and taper our meal sizes so dinner is the smallest meal.</p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/32073608/">Research</a> shows a low-calorie or small breakfast leads to increased feelings of hunger, specifically appetite for sweets, across the course of the day. </p>
<figure class="align-center ">
<img alt="Man spreads avocado" src="https://images.theconversation.com/files/563857/original/file-20231206-16-2c5mdc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/563857/original/file-20231206-16-2c5mdc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/563857/original/file-20231206-16-2c5mdc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/563857/original/file-20231206-16-2c5mdc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/563857/original/file-20231206-16-2c5mdc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/563857/original/file-20231206-16-2c5mdc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/563857/original/file-20231206-16-2c5mdc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Prioritise breakfast over dinner.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/soft-focus-shot-man-having-delicious-759322450">Shutterstock</a></span>
</figcaption>
</figure>
<p><a href="https://www.cell.com/cell-metabolism/fulltext/S1550-4131(22)00344-8">Another study</a> found the same effect. Participants went on a calorie-controlled diet for two months, where they ate 45% of their calories for breakfast, 35% at lunch and 20% at dinner for the first month, before switching to eat their largest meal in the evening and their smallest in the morning. Eating the largest meal at breakfast resulted in decreased hunger throughout the day.</p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/32073608/">Research</a> also shows we burn the calories from a meal 2.5-times more efficiently in the morning than the evening. So emphasising breakfast over dinner is good not just for hunger control, but also weight management.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/should-we-eat-breakfast-like-a-king-lunch-like-a-prince-and-dinner-like-a-pauper-86840">Should we eat breakfast like a king, lunch like a prince, and dinner like a pauper?</a>
</strong>
</em>
</p>
<hr>
<h2>2. Prioritising protein</h2>
<p>Protein helps contain feelings of hunger. This is because protein-rich foods such as lean meats, tofu and beans suppress the appetite-stimulating ghrelin and stimulate another hormone called <a href="https://www.sciencedirect.com/science/article/pii/S1550413106002713">peptide YY</a> that makes you feel full. </p>
<p>And just as eating a breakfast is vital to managing our hunger, what we eat is important too, with <a href="https://pubmed.ncbi.nlm.nih.gov/24703415/">research</a> confirming a breakfast containing protein-rich foods, such as eggs, will leave us feeling fuller for longer. </p>
<p>But this doesn’t mean just eating foods with protein. Meals need to be balanced and include a source of protein, wholegrain carb and healthy fat to meet our dietary needs. For example, eggs on wholegrain toast with avocado.</p>
<h2>3. Filling up with nuts and foods high in good fats and fibre</h2>
<p>Nuts often get a bad rap – thanks to the misconception they cause weight gain – but nuts can help us manage our hunger and weight. The filling fibre and good fats found in nuts take longer to digest, meaning our hunger is satisfied for longer. </p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/12791613/">Studies</a> suggest you can include up to 68 grams per day of nuts without affecting your weight. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-will-eating-nuts-make-you-gain-weight-108491">Health check: will eating nuts make you gain weight?</a>
</strong>
</em>
</p>
<hr>
<p>Avocados are also high in fibre and heart-healthy monounsaturated fats, making them another excellent food for managing feelings of fullness. This is backed by a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567160/">study</a> confirming participants who ate a breakfast incorporating avocado felt more satisfied and less hungry than participants who ate a meal containing the same calories but with lower fat and fibre content. </p>
<p>Similarly, eating foods that are high in soluble fibre – such as <a href="https://pubmed.ncbi.nlm.nih.gov/24820437/">beans</a> and vegetables – make us feel fuller. This type of fibre attracts water from our gut, forming a gel that slows digestion. </p>
<figure class="align-center ">
<img alt="Couple cook together" src="https://images.theconversation.com/files/563854/original/file-20231206-25-s2excn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/563854/original/file-20231206-25-s2excn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/563854/original/file-20231206-25-s2excn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/563854/original/file-20231206-25-s2excn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/563854/original/file-20231206-25-s2excn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/563854/original/file-20231206-25-s2excn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/563854/original/file-20231206-25-s2excn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Fibre helps us feel fuller for longer.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/a-man-and-a-woman-preparing-food-in-a-kitchen-hQocGyy0unQ">Sweet Life/Unsplash</a></span>
</figcaption>
</figure>
<h2>4. Eating mindfully</h2>
<p>When we take time to really be aware of and enjoy the food we’re eating, we slow down and eat far less. </p>
<p>A <a href="https://pubmed.ncbi.nlm.nih.gov/28718396/">review</a> of 68 studies found eating mindfully helps us better recognise feelings of fullness. Mindful eating provides our brain enough time to recognise and adapt to the signals from our stomach telling us we’re full.</p>
<p>Slow down your food consumption by sitting at the dinner table and use smaller utensils to reduce the volume of food you eat with each mouthful.</p>
<h2>5. Getting enough sleep</h2>
<p>Sleep deprivation disturbs our <a href="https://www.sciencedirect.com/science/article/abs/pii/S1389945708700133">appetite hormones</a>, increasing our feelings of hunger and <a href="https://www.nature.com/articles/ncomms3259">triggering cravings</a>. So aim to get at least seven hours of uninterrupted sleep a night.</p>
<p>Try switching off your devices <a href="https://journals.sagepub.com/doi/full/10.1177/1477153515584979">two hours before bed</a> to boost your body’s secretion of sleep-inducing hormones like melatonin.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-our-brain-needs-sleep-and-what-happens-if-we-dont-get-enough-of-it-83145">Why our brain needs sleep, and what happens if we don’t get enough of it</a>
</strong>
</em>
</p>
<hr>
<h2>6. Managing stress</h2>
<p>Stress increases our <a href="https://pubmed.ncbi.nlm.nih.gov/18568078/">body’s production of cortisol</a> and triggers food cravings.</p>
<p>So take time out when you need it and set aside time for stress-relieving activities. This can be as simple as getting outdoors. A <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00722/full">2019 study</a> found sitting or walking outdoors at least three times a week could reduce cortisol levels by 21%. </p>
<figure class="align-center ">
<img alt="Person walks in house, next to grey dog" src="https://images.theconversation.com/files/563849/original/file-20231206-23-4atw7u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/563849/original/file-20231206-23-4atw7u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/563849/original/file-20231206-23-4atw7u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/563849/original/file-20231206-23-4atw7u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/563849/original/file-20231206-23-4atw7u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/563849/original/file-20231206-23-4atw7u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/563849/original/file-20231206-23-4atw7u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Take time out to reduce your stress levels.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/gray-dog-looking-at-the-person-qqpfqFwAyDQ">Evieanna Santiago/Unsplash</a></span>
</figcaption>
</figure>
<h2>7. Avoiding depriving ourselves</h2>
<p>When we change our diet to lose weight or eat healthier, we typically restrict certain foods or food groups. </p>
<p>However, this <a href="https://pubmed.ncbi.nlm.nih.gov/18568078/">heightens activity</a> in our mesocorticolimbic circuit – the reward system part of the brain – often resulting in us craving the foods we’re trying to avoid. Foods that give us pleasure release feel-good chemicals called endorphins and learning chemicals called dopamine, which enable us to remember – and give in to – that feel-good response.</p>
<p>When we change our diet, activity in our hypothalamus – the clever part of the brain that regulates emotions and food intake – <a href="https://pubmed.ncbi.nlm.nih.gov/18568078/">also reduces</a>, decreasing our control and judgement. It often triggers a psychological response dubbed the “what-the-hell effect”, when we indulge in something we think we shouldn’t feel guilty about and then go back for even more.</p>
<p>Don’t completely cut out your favourite foods when you go on a diet or deprive yourself if you’re hungry. It will take the pleasure out of eating and eventually you’ll give into your cravings. </p>
<p><em>At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.</em></p><img src="https://counter.theconversation.com/content/215808/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dr Nick Fuller works for the University of Sydney and has received external funding for projects relating to the treatment of overweight and obesity. He is the author and founder of the Interval Weight Loss program.</span></em></p>When we change our diet, we disrupt our appetite hormones. Here’s how it works – and how small changes to our diet can help us feel fuller for longer.Nick Fuller, Charles Perkins Centre Research Program Leader, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2174672023-11-16T10:35:15Z2023-11-16T10:35:15ZLord Byron vinegar diet can have a series of harmful health effects<figure><img src="https://images.theconversation.com/files/558799/original/file-20231102-28-1tp153.jpg?ixlib=rb-1.1.0&rect=221%2C115%2C6802%2C4822&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Lord Byron on his death bed, by
Joseph Denis Odevaere. </span> <span class="attribution"><a class="source" href="https://es.wikipedia.org/wiki/Lord_Byron#/media/Archivo:Lord_Byron_on_his_Death-bed_c._1826.jpg">Groeningemuseum / Wikimedia Commons</a></span></figcaption></figure><p>Romantic poet <a href="https://es.wikipedia.org/wiki/Lord_Byron">Lord Byron</a> – famed for his rich and expressive portrayal of landscape and human emotions – is considered to be one of the key figures of English literature.</p>
<p>Over the course of his life, however, he suffered from a raft of health problems, ranging from <a href="https://journals.sagepub.com/doi/abs/10.1177/147827159802800109">vertigo, clubfoot and gonhorrea</a> to <a href="https://www.infezmed.it/media/journal/Vol_23_3_2015_16.pdf">malaria</a> and even <a href="https://www.liverpooluniversitypress.co.uk/doi/10.3828/BJ.2003.12">bulimia and anorexia</a>. </p>
<p>The dubious treatment methods of the time were recorded in his writings, including the well known burlesque epic poem <a href="https://ia800301.us.archive.org/27/items/lordbyronsdonjua00byrouoft/lordbyronsdonjua00byrouoft.pdf">Don Juan</a>. Here he mentions the consumption of <a href="https://brill.com/display/book/edcoll/9789004418288/B9789004418288_s002.xml">Epsom salts</a>, which were used as a laxative, or as a muscle relaxer when dissolved in bathwater. They were also combined with other strong diuretics and cathartics to purge the body and induce vomiting.</p>
<h2>Demanding diets</h2>
<p>In his youth, <a href="https://www.liverpooluniversitypress.co.uk/doi/10.3828/bj.2023.7">Byron followed strict diets</a> to avoid the problems suffered by his mother as a consequence of being overweight. At one point, he experimented with consuming only a quarter pound (113g) of meat per day alongside small amounts of wine. </p>
<p>In his later years he turned to vinegar, believing the sour liquid could reduce his appetite. The resulting weight loss was dramatically successful, but it took its toll: dental problems, vomiting and diarrhoea became constant features of his life. He ingested it only with water and rice, as he thought this would enhance its cleansing effects. </p>
<p>As a result of this and other extreme diets, the writer managed to reduce his Body Mass Index (BMI) <a href="https://link.springer.com/chapter/10.1057/9780230611047_7">from 29.7 to 22.1 kg/m² at least twice in his life, in 1806 and in 1822</a>. While in Venice, before his second substantial weight loss, <a href="https://archive.org/details/byronlifelegend0000macc/page/n7/mode/2up">his lawyer reported being troubled by his pale, bloated and sickly appearance</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/555839/original/file-20231025-17-h3m2i1.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/555839/original/file-20231025-17-h3m2i1.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/555839/original/file-20231025-17-h3m2i1.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=336&fit=crop&dpr=1 600w, https://images.theconversation.com/files/555839/original/file-20231025-17-h3m2i1.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=336&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/555839/original/file-20231025-17-h3m2i1.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=336&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/555839/original/file-20231025-17-h3m2i1.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=423&fit=crop&dpr=1 754w, https://images.theconversation.com/files/555839/original/file-20231025-17-h3m2i1.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=423&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/555839/original/file-20231025-17-h3m2i1.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=423&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Lord Byron, on his death bed. Painting by Joseph Dionysius Odevaere (1775-1830).</span>
<span class="attribution"><a class="source" href="https://es.m.wikipedia.org/wiki/Archivo:Lord_Byron_on_his_Death-bed_c._1826.jpg">Wikimedia Commons</a></span>
</figcaption>
</figure>
<h2>Other victims of vinegar</h2>
<p>Byron was not alone in using vinegar for slimming purposes in his time, as various tragic events show. One of the <a href="https://archive.org/details/dissertationsurl00desa">earliest published cases of this</a> involved a French woman called Mademoiselle Lapaneterie in 1773. Worried by her physique and the red colour of her skin, she followed her neighbour’s advice of drinking a small cup of vinegar per day to lose weight and achieve a fairer complexion. </p>
<p>As the doctor Pierre Desault reported, Lapaneterie followed this recommendation for over a month. She saw her weight decrease and her vivid complexion – considered undesirable for women at the time – became paler. However, she soon developed a cough, night sweats, nausea, swollen feet and legs, and diarrhoea, and she eventually died. </p>
<p>A <a href="https://www.gutenberg.org/files/22741/22741-h/22741-h.htm">second case</a> was reported in 1826, two years after Lord Byron’s death. Louise, a young women from Dijon, took to drinking vinegar because “the young people where she lived were making fun of her”. The diet also led her to an early grave. </p>
<p>Despite cases such as these, the commonplace cooking ingredient formed the basis of slimming diets across Europe – especially in France – throughout the 18th century and remained popular until the mid-19th century.</p>
<h2>The serious health effects of drinking vinegar</h2>
<p>In 1998, a group of researchers at the Department of Internal Medicine at the Medical University of Innsbruck (Austria) <a href="https://karger.com/nef/article-abstract/80/2/242/209061">observed that high vinegar consumption can have three main harmful effects</a>:</p>
<ul>
<li><p>Hypocalcaemia: Low levels of calcium in the blood serum, which can cause muscle spasms. </p></li>
<li><p>Hyperreninaemia: Excessive levels of renin (a hormone produced by the kidneys) in the blood. The body’s homeostatic response to this results in high blood pressure and kidney failure.</p></li>
<li><p>Osteoporosis: A condition that weakens bones, making them brittle and more prone to break or fracture.</p></li>
</ul>
<h2>The effects of vinegar on teeth</h2>
<p>In 2012, a <a href="https://pubmed.ncbi.nlm.nih.gov/23373303/">clinical report</a> was published of a 15 year old girl who was suffering from eroded teeth caused by drinking a glass of cider vinegar each day. Curiously, <a href="https://www.jstor.org/stable/48604053">Byron was also troubled by his teeth</a>. He chewed and smoked tobacco in the belief that it would preserve his dental health and, in later years, to stave off hunger. At the end of his life, he still had some white teeth remaining, but they had become somewhat loose. </p>
<p>At least <a href="https://pubmed.ncbi.nlm.nih.gov/25571718/">one study</a> has shown that white vinegar, cider vinegar and hydrogen peroxide can both whiten and weaken teeth. Additionally, in 2016 it was observed that white vinegar may cause greater levels of damage to the hardness and quality of tooth enamel.</p>
<p>However, according to <a href="https://www.quintessence-publishing.com/deu/en/article/840922">a study led by Philipp Kanzow</a>, the presence and severity of these erosive defects also depend on several factors including nutrition, saliva composition, disease and abrasive stress. </p>
<h2>Appetite suppressant</h2>
<p>The slimming effect that Byron attributed to vinegar most likely came from its ability to suppress the appetite. In 1998 <a href="https://www.nature.com/articles/1600572">it was shown</a> that acetic acid – the chemical that gives vinegar its characteristic taste and smell – significantly reduces glucose and insulin response after eating, perhaps due to a reduced digestion rate.</p>
<p>This suggests that the spike in blood sugar levels after a meal can be reduced by consuming vinegar. This is because it causes the body to take longer to digest food, meaning carbohydrates are broken down more slowly.</p>
<p><a href="https://www.liverpooluniversitypress.co.uk/doi/10.3828/bj.2023.7">Our study</a> suggests that Lord Byron’s vinegar diet did help him to lose weight and give him a paler complexion. However, its long term consumption may have contributed significantly to the anorexia nervosa – complicated by episodes of bulimia – from which he suffered.</p><img src="https://counter.theconversation.com/content/217467/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Las personas firmantes no son asalariadas, ni consultoras, ni poseen acciones, ni reciben financiación de ninguna compañía u organización que pueda obtener beneficio de este artículo, y han declarado carecer de vínculos relevantes más allá del cargo académico citado anteriormente.</span></em></p>Lord Byron’s drank vinegar for weight loss, with catastrophic health effects. His eating disorders were reflected across 18th century Europe.Jose Miguel Soriano del Castillo, Catedrático de Nutrición y Bromatología del Departamento de Medicina Preventiva y Salud Pública, Universitat de ValènciaMª Inmaculada Zarzo Llobell, Estudiante de Doctorado en Medicina, Universitat de ValènciaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2174132023-11-15T12:15:57Z2023-11-15T12:15:57ZMounjaro has been authorised for weight loss in the UK – here’s how it compares to Wegovy<figure><img src="https://images.theconversation.com/files/559336/original/file-20231114-21-it77q9.jpg?ixlib=rb-1.1.0&rect=58%2C38%2C6497%2C4260&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Mounjaro has already been approved in the UK to manage type 2 diabetes.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/basra-iraq-september-14-2023-photo-2367391483">Mohammed_Al_Ali/ Shutterstock</a></span></figcaption></figure><p>The type 2 diabetes drug tirzepatide (better known by its brand name Mounjaro) has recently been authorised by the UK’s medicines regulation authority for use in <a href="https://www.gov.uk/government/news/mhra-authorises-diabetes-drug-mounjaro-tirzepatide-for-weight-management-and-weight-loss">weight loss and weight management</a>. The decision was made on the same day the US Food and Drug Administration (FDA) approved a version of tirzepatide called Zepbound for <a href="https://www.fda.gov/news-events/press-announcements/fda-approves-new-medication-chronic-weight-management">weight management</a>.</p>
<p>At the moment, Mounjaro has only been authorised for weight management in people who are obese, or those who are overweight and have weight-related health problems (such as high blood pressure or pre-diabetes). The drug is to be used in combination with lifestyle changes to aid in weight loss.</p>
<h2>How does tirzepatide work?</h2>
<p>The active ingredient in Mounjaro (which is prescribed for diabetes treatment) is tirzepatide. The tirzepatide formulation for obesity will be given another name. Tirzepatide works in a similar way as semaglutide, which is the active ingredient in Ozempic and Wegovy. </p>
<p>Both semaglutide and tirzepatide are drugs that are modelled on naturally occurring gut hormones called incretins. Incretins are produced by the gut in response to eating. They have a <a href="https://pubmed.ncbi.nlm.nih.gov/29364588/">range of effects</a>, including slowing emptying of food from the stomach and increasing insulin levels. </p>
<p>These effects are useful for controlling blood sugar levels in people with diabetes, which is why both drugs have already been licensed to manage type 2 diabetes.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/mounjaro-type-2-diabetes-drug-more-effective-than-ozempic-to-launch-in-the-uk-heres-what-you-need-to-know-213195">Mounjaro: type 2 diabetes drug more effective than Ozempic to launch in the UK — here’s what you need to know</a>
</strong>
</em>
</p>
<hr>
<p>But the reason incretin hormones have garnered so much interest for weight management is because they also produce a sense of fullness after a meal. They do this by signalling to a brain region called the hypothalamus. The hypothalamus then passes the signal on to other areas of the brain, leading to a person feeling full.</p>
<p>Drugs that mimic the action of incretins may cause weight loss because they make a person <a href="https://www.sciencedirect.com/science/article/pii/S1550413118301797">feel full</a> – making them want to eat less.</p>
<h2>How is Mounjaro different from Wegovy?</h2>
<p>There are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4020673/">several types</a> of naturally occurring incretin hormones – including glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). </p>
<figure class="align-center ">
<img alt="A person holds a prescription vial of Saxenda." src="https://images.theconversation.com/files/559337/original/file-20231114-23-zykp4t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/559337/original/file-20231114-23-zykp4t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=395&fit=crop&dpr=1 600w, https://images.theconversation.com/files/559337/original/file-20231114-23-zykp4t.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=395&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/559337/original/file-20231114-23-zykp4t.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=395&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/559337/original/file-20231114-23-zykp4t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=496&fit=crop&dpr=1 754w, https://images.theconversation.com/files/559337/original/file-20231114-23-zykp4t.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=496&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/559337/original/file-20231114-23-zykp4t.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=496&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Saxenda was the first GLP-1 drug approved for obesity.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/basra-iraq-july-6-2023-photo-2328366277">Mohammed_Al_Ali/ Shutterstock</a></span>
</figcaption>
</figure>
<p>Drugs that act on GLP-1 receptors have been very successful in treating diabetes since their launch in 2006. In 2020, Saxenda (liraglutide) was the first GLP-1 receptor drug approved to <a href="https://www.nice.org.uk/guidance/ta664">manage obesity</a>. The most recent addition to the family of medicines that act on GLP-1 receptors has been semaglutide, which has been licensed to both manage type 2 diabetes (Ozempic) and obesity (Wegovy). </p>
<p>What makes tirzepatide different is that it acts not just on the body’s GLP-1 receptors, but also on its GIP receptors. This makes tirzepatide a “dual incretin”. Both GLP-1 and GIP release insulin. It’s thought that the two work together, which is why tirzepatide may lead to a greater therapeutic effect. </p>
<h2>Is tirzepatide more effective than semaglutide?</h2>
<p>Based on data the data we have so far from clinical trials, it appears tirzepatide may lead to greater weight loss when compared to semaglutide.</p>
<p>Trials have shown that a once-weekly injection of 2.4 mg of semaglutide in people who are overweight or obese can lead to an <a href="https://www.nature.com/articles/s41591-022-02026-4#Sec2">average loss of 15% body weight</a> which persisted for the 104 weeks of medication use.</p>
<p>In comparison, <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2206038">clinical trials</a> of tirzepatide have shown that in people who are obese, a once-weekly injection of the lowest dose of tirzepatide (5mg) leads to a 15% loss of body weight after just 72 weeks. Even more impressively, a once-weekly injection of the highest dose of tirzepatide (20mg) is shown to lead to approximately 20% body weight loss. </p>
<p>Over one-third of participants using tirzepatide achieved weight loss of 25% or more. This is impressive – and greater than the amount of weight loss seen with semaglutide. This degree of weight loss is comparable to that achieved by <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001925#sec022">gastric band surgery</a>.</p>
<h2>Other considerations</h2>
<p>Patients who are prescribed Mounjaro will be given a one-weekly injection of 2.5mg for four weeks to begin with. After this, the patient’s doctor may then decide to <a href="https://www.gov.uk/government/news/mhra-authorises-diabetes-drug-mounjaro-tirzepatide-for-weight-management-and-weight-loss">increase their dosage</a> in 5mg increments every four weeks or so, up to a maximum 15mg dosage.</p>
<p>As with other incretin drugs, tirzepatide comes with <a href="https://www.gov.uk/government/news/mhra-authorises-diabetes-drug-mounjaro-tirzepatide-for-weight-management-and-weight-loss">potential side effects</a>. The most commonly reported ones are constipation, diarrhoea, nausea and vomiting. </p>
<p>Another important consideration with all incretin drugs is that the effects only last as long as the drug is being used. <a href="https://pace-cme.org/2023/10/16/discontinuation-of-dual-gip-and-glp-1-receptor-agonist-leads-to-weight-regain-in-people-with-obesity-or-overweight/">Any weight lost</a> while using the drug may be <a href="https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.14725">fully regained</a> within a year of stopping it. Maintaining a healthy lifestyle may help mitigate weight regain somewhat after stopping the drug. </p>
<p>Mounjaro is due to become available early in 2024. It’s authorisation for weight management will be welcome news for many who have struggled to lose weight in the past and those who have weight-related health problems. </p>
<p>What remains to be seen is whether there will be enough supply of tirzepatide to meet demand, which has been an <a href="https://www.diabetes.org.uk/about_us/news/our-response-serious-supply-issues-drugs-people-living-type-2-diabetes#:%7E:text=The%20company%20that%20makes%20semaglutide,clinicians%20on%20what%20to%20do.">issue with semaglutide</a> over the past year.</p><img src="https://counter.theconversation.com/content/217413/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Martin Whyte does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>People who are obese, as well as those who are overweight and have weight-related issues, may soon be able to ask their doctor for a prescription.Martin Whyte, Associate Professor of Metabolic Medicine, University of SurreyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2052032023-10-31T19:18:21Z2023-10-31T19:18:21ZCan I actually target areas to lose fat, like my belly?<figure><img src="https://images.theconversation.com/files/555196/original/file-20231023-17-dj2vz1.jpg?ixlib=rb-1.1.0&rect=16%2C74%2C5481%2C3585&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/full-male-runs-on-treadmill-gym-1456626641">Shutterstock</a></span></figcaption></figure><p>Spend some time scrolling social media and you’re all-but-guaranteed to see an ad promising to help you with targeted fat loss. These ads promote a concept known as “spot reduction”, claiming you can burn fat in a specific body area, usually the belly, with specially designed exercises or workouts. </p>
<p>It’s also common to see ads touting special diets, pills and supplements that will blast fat in targeted areas. These ads – which often feature impressive before and after photos taken weeks apart – can seem believable. </p>
<p>Unfortunately, spot reduction is another weight-loss myth. It’s simply not possible to target the location of fat loss. Here’s why. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/using-bmi-to-measure-your-health-is-nonsense-heres-why-180412">Using BMI to measure your health is nonsense. Here's why</a>
</strong>
</em>
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<h2>1. Our bodies are hardwired to access and burn all our fat stores for energy</h2>
<p>To understand why spot reduction is a myth, it’s important to understand how body fat is stored and used.</p>
<p>The fat stored in our bodies takes the form of triglycerides, which are a type of lipid or fat molecule we can use for energy. Around 95% of the dietary fats <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/triglycerides">we consume are triglycerides</a>, and when we eat, our bodies also convert any unused energy consumed into triglycerides.</p>
<p>Triglycerides are stored in special fat cells called adipocytes, and they’re released into our bloodstream and transported to adipose tissue – tissue we more commonly refer to as body fat.</p>
<p>This body fat is found all over our bodies, but it’s primarily stored as subcutaneous fat under our skin and as visceral fat around our internal organs.</p>
<p>These fat stores serve as a vital energy reserve, with our bodies mobilising to access stored triglycerides to provide energy during periods of prolonged exercise. We also draw on these reserves when we’re dieting and fasting.</p>
<figure class="align-center ">
<img alt="Person does button up on tight jeans" src="https://images.theconversation.com/files/555199/original/file-20231023-21-rf34fu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/555199/original/file-20231023-21-rf34fu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/555199/original/file-20231023-21-rf34fu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/555199/original/file-20231023-21-rf34fu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/555199/original/file-20231023-21-rf34fu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/555199/original/file-20231023-21-rf34fu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/555199/original/file-20231023-21-rf34fu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The fat stores we use for energy come from everywhere on our bodies, not just the belly.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-trying-put-on-tight-light-1521248603">Shutterstock</a></span>
</figcaption>
</figure>
<p>However, contrary to what many spot-reduction ads would have us think, our muscles can’t directly access and burn specific fat stores when we exercise. </p>
<p>Instead, they use a process called lipolysis to convert triglycerides into free fatty acids and a compound called glycerol, which then travels to our muscles via our bloodstream.</p>
<p>As a result, the fat stores we’re using for energy when we exercise come from everywhere in our bodies – not just the areas we’re targeting for fat loss. </p>
<p>Research reinforces how our bodies burn fat when we exercise, confirming spot reduction is a weight-loss myth. This includes a randomised <a href="https://pubmed.ncbi.nlm.nih.gov/25766455/">12-week clinical trial</a> which found no greater improvement in reducing belly fat between people who undertook an abdominal resistance program in addition to changes in diet compared to those in the diet-only group. </p>
<p>Further, <a href="https://www.termedia.pl/A-proposed-model-to-test-the-hypothesis-of-exerciseinduced-localized-fat-reduction-spot-reduction-including-a-systematic-review-with-meta-analysis,129,45538,0,1.html">a 2021 meta-analysis</a> of 13 studies involving more than 1,100 participants found that localised muscle training had no effect on localised fat deposits. That is, exercising a specific part of the body did not reduce fat in that part of the body.</p>
<p><a href="https://www.mdpi.com/1660-4601/18/7/3845">Studies</a> purporting to show spot-reduction benefits have small numbers of participants with results that aren’t clinically meaningful. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/does-exercise-help-you-lose-weight-198292">Does exercise help you lose weight?</a>
</strong>
</em>
</p>
<hr>
<h2>2. Our bodies decide where we store fat and where we lose it from first</h2>
<p>Factors outside of our control influence the areas and order in which our bodies store and lose fat, namely:</p>
<ul>
<li><p>our genes. Just as DNA prescribes whether we’re short or tall, genetics plays a significant role in how our fat stores are managed. Research shows our genes can account for <a href="https://pubmed.ncbi.nlm.nih.gov/24632736/">60% of where fat is distributed</a>. So, if your mum tends to store and lose weight from her face first, there’s a good chance you will, too</p></li>
<li><p>our gender. Our bodies, by nature, have distinct fat storage characteristics <a href="https://pubmed.ncbi.nlm.nih.gov/11706283/">driven by our gender</a>, including females having more fat mass than males. This is primarily because the female body is designed to hold fat reserves to support pregnancy and nursing, with women tending to lose weight from their face, calves and arms first because they impact childbearing the least, while holding onto fat stored around the hips, thighs and buttocks</p></li>
<li><p>our age. The ageing process triggers changes in muscle mass, metabolism, and hormone levels, which can impact where and how quickly fat is lost. Post-menopausal <a href="https://theconversation.com/is-menopause-making-me-put-on-weight-no-but-its-complicated-198308">women</a> and middle-aged <a href="https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/sex-differences-in-fat-storage-fat-metabolism-and-the-health-risks-from-obesity-possible-evolutionary-origins/00950AD6710FB3D0414B13EAA67D4327">men</a> tend to store visceral fat around the midsection and find it a stubborn place to shift fat from. </p></li>
</ul>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/is-menopause-making-me-put-on-weight-no-but-its-complicated-198308">Is menopause making me put on weight? No, but it's complicated</a>
</strong>
</em>
</p>
<hr>
<h2>3. Over-the-counter pills and supplements cannot effectively target fat loss</h2>
<p>Most advertising for these pills and dietary supplements – including products claiming to be “the best way to lose belly fat” – will also proudly claim their product’s results are backed by “clinical trials” and “scientific evidence”.</p>
<p>But the reality is a host of independent studies don’t support these claims. </p>
<p>This includes two recent studies by the University of Sydney that examined data from more than 120 placebo-controlled trials of <a href="https://pubmed.ncbi.nlm.nih.gov/31984610/">herbal</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/33976376/">dietary</a> supplements. None of the supplements examined provided a clinically meaningful reduction in body weight among overweight or obese people.</p>
<figure class="align-center ">
<img alt="Woman takes diet pill" src="https://images.theconversation.com/files/555202/original/file-20231023-29-7dt3ul.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/555202/original/file-20231023-29-7dt3ul.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/555202/original/file-20231023-29-7dt3ul.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/555202/original/file-20231023-29-7dt3ul.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/555202/original/file-20231023-29-7dt3ul.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/555202/original/file-20231023-29-7dt3ul.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/555202/original/file-20231023-29-7dt3ul.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Supplements won’t help you target ares weight-loss either.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/senior-woman-taking-tablet-glass-water-1498026977">Shutterstock</a></span>
</figcaption>
</figure>
<h2>The bottom line</h2>
<p>Spot reduction is a myth – we can’t control where our bodies lose fat. But we can achieve the results we’re seeking in specific areas by targeting overall fat loss. </p>
<p>While you may not lose the weight in a specific spot when exercising, all physical activity helps to burn body fat and preserve muscle mass. This will lead to a change in your body shape over time and it will also help you with long-term weight management. </p>
<p>This is because your metabolic rate – how much energy you burn at rest – is determined by how much muscle and fat you carry. As muscle is more metabolically active than fat (meaning it burns more energy than fat), a person with a higher muscle mass will have a faster metabolic rate than someone of the same body weight with a higher fat mass. </p>
<p>Successfully losing fat long term comes down to losing weight in small, manageable chunks you can sustain – periods of weight loss, followed by periods of weight maintenance, and so on, until you achieve your goal weight.</p>
<p>It also requires gradual changes to your lifestyle (diet, exercise and sleep) to ensure you form habits that last a lifetime.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/is-it-true-the-faster-you-lose-weight-the-quicker-it-comes-back-heres-what-we-know-about-slow-and-fast-weight-loss-198301">Is it true the faster you lose weight the quicker it comes back? Here's what we know about slow and fast weight loss</a>
</strong>
</em>
</p>
<hr>
<p><em>At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.</em></p><img src="https://counter.theconversation.com/content/205203/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nick Fuller works for the University of Sydney and has received external funding for projects relating to the treatment of overweight and obesity. He is the author and founder of the Interval Weight Loss program.</span></em></p>Ads for targeted fat loss, especially
for belly fat, are everywhere on social media. But is there any evidence to support this type of ‘spot reduction’?Nick Fuller, Charles Perkins Centre Research Program Leader, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2149542023-10-12T19:02:36Z2023-10-12T19:02:36ZCan coffee help you avoid weight gain? Here’s what the science says<figure><img src="https://images.theconversation.com/files/553392/original/file-20231011-22-7g3lmc.jpg?ixlib=rb-1.1.0&rect=44%2C260%2C5928%2C3727&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.pexels.com/photo/person-holding-yellow-ceramic-cup-724668/">Valeria Boltneva/Pexels</a></span></figcaption></figure><p>Coffee is well recognised as having a positive impact on long-term health. Drinking the equivalent of three to four cups of instant coffee a day <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5696634/">reduces the risk</a> of many health conditions including heart disease, type 2 diabetes and some cancers.</p>
<p>Most people gain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4984841/">small amounts of weight</a> each year as they age. But can coffee help prevent this gradual weight gain? </p>
<p>A group of researchers examined whether drinking an extra cup of coffee a day – or adding sugar, cream or a non-dairy alternative – resulted in more or less weight gain than those who didn’t adjust their intake. </p>
<p>Their <a href="https://www.sciencedirect.com/science/article/abs/pii/S0002916523661702">research</a> (currently a pre-proof, which means it has been peer reviewed but is yet to undergo the final formatting and copyediting) found a modest link between coffee and gaining less weight than expected. </p>
<p>People who drank an extra cup of coffee a day gained 0.12 kg less weight than expected over four years. Adding sugar resulted in a fraction more (0.09 kg) weight gain than expected over four years.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-four-reasons-to-have-another-cup-of-coffee-40390">Health Check: four reasons to have another cup of coffee</a>
</strong>
</em>
</p>
<hr>
<h2>How was the study conducted? What did it find?</h2>
<p>Researchers combined data from three large studies from the United States: two <a href="https://nurseshealthstudy.org">Nurses’ Health Studies</a> from 1986 to 2010, and from 1991 to 2015, and a <a href="https://www.hsph.harvard.edu/hpfs/about-the-study/">Health Professional Follow-up study</a> from 1991 to 2014. </p>
<p>The Nurses’ Health Studies are two of the largest cohort studies, with more 230,000 participants, and investigates chronic disease risks for women. The Health Professional Follow-up study involves more than 50,000 male health professionals and investigates the relationship between diet and health outcomes. </p>
<p>Participants in all three studies completed a baseline questionnaire, and another questionnaire every four years to assess their food and drink intake. Using the combined datasets, researchers analysed changes in coffee intake and changes in the participants’ self-reported weight at four-year intervals. </p>
<figure class="align-center ">
<img alt="Woman holds coffee cup" src="https://images.theconversation.com/files/553397/original/file-20231011-15-1e5x6f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/553397/original/file-20231011-15-1e5x6f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=405&fit=crop&dpr=1 600w, https://images.theconversation.com/files/553397/original/file-20231011-15-1e5x6f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=405&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/553397/original/file-20231011-15-1e5x6f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=405&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/553397/original/file-20231011-15-1e5x6f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=508&fit=crop&dpr=1 754w, https://images.theconversation.com/files/553397/original/file-20231011-15-1e5x6f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=508&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/553397/original/file-20231011-15-1e5x6f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=508&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The study looked at associations between coffee intake and weight.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/gv1I7bYLLDI">Unsplash/Annie Spratt</a></span>
</figcaption>
</figure>
<p>The average four year weight-gains for the nurses’ studies were 1.2kg and 1.7kg, while participants in the health professionals study gained an average of 0.8kg.</p>
<p>The researchers found that increasing unsweetened caffeinated or decaffeinated coffee intake by one cup a day was associated with a weight gain that was 0.12 kg less than expected over four years.</p>
<p>Adding creamer (milk) or a non-dairy alternative did not significantly affect this weight change. </p>
<p>However, adding sugar (one teaspoon) to coffee was associated with a weight gain that was 0.09 kg more than expected over four years.</p>
<p>These associations were stronger in participants who were younger and had a higher body mass index at the beginning of the studies.</p>
<h2>What are the pros and cons of the study?</h2>
<p>This study is unique in two ways. It had a very large sample size and followed participants for many years. This adds confidence that the associations were real and can likely be applied to other populations.</p>
<p>However, there are three reasons to be cautious.</p>
<p>First, the findings represent an <em>association</em>, not <em>causation</em>. This means the study does not prove that coffee intake is the true reason for the weight change. Rather, it shows the two changes were observed together over time. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/clearing-up-confusion-between-correlation-and-causation-30761">Clearing up confusion between correlation and causation</a>
</strong>
</em>
</p>
<hr>
<p>Second, the findings around weight were very modest. The average four-year weight gain averted, based on one cup of coffee, was 0.12 kilograms, which is about 30 grams per year. This amount may not be a meaningful change for most people looking to manage weight. </p>
<p>Finally, this analysis did not consider the variability in the amount of caffeine in coffee (which we <a href="https://pubmed.ncbi.nlm.nih.gov/17412475/">know can be high</a>), it just assumed a standard amount of caffeine per cup.</p>
<h2>How could coffee help with weight management?</h2>
<p>Caffeine is a natural stimulant which has been <a href="https://www.sciencedirect.com/science/article/pii/S0149763416300690">shown to</a> temporarily reduce appetite and increase alertness. This may help to feel less hungry for a short period, potentially leading to reduced energy intake. </p>
<p>Some people consume coffee before exercise as a stimulant to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777221/">improve their workout performance</a> – if a workout is more effective, more energy may be expended. However, the benefit is largely thought to be short-lived, rather than long-term.</p>
<figure class="align-center ">
<img alt="Pouring coffee" src="https://images.theconversation.com/files/553388/original/file-20231011-24-lnybke.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/553388/original/file-20231011-24-lnybke.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/553388/original/file-20231011-24-lnybke.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/553388/original/file-20231011-24-lnybke.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/553388/original/file-20231011-24-lnybke.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/553388/original/file-20231011-24-lnybke.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/553388/original/file-20231011-24-lnybke.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Coffee has a small impact on metabolism.</span>
<span class="attribution"><a class="source" href="https://www.pexels.com/photo/close-up-of-woman-holding-coffee-cup-at-cafe-312420/">Chevanon Photography/Pexels</a></span>
</figcaption>
</figure>
<p>Caffeine has also been <a href="https://www.sciencedirect.com/science/article/pii/S0271531720304449">shown to</a> speed up our metabolism, causing more energy to be burned while resting. However, this effect is relatively small and is not a suitable substitute for regular physical activity and a healthy diet.</p>
<p>Finally, coffee has a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725310/">mild diuretic effect</a>, which can lead to temporary water weight loss. This is water loss, not fat loss, and the weight is quickly regained when you re-hydrate.</p>
<h2>Is it worth trying coffee for weight loss?</h2>
<p>Losing weight can be influenced by various factors, so don’t get too enthusiastic about the coffee-weight link highlighted in this new study, or increase your coffee intake to unreasonable levels.</p>
<p>Most adults can safely consume around <a href="https://www.healthdirect.gov.au/caffeine">400mg</a> of caffeine a day. That’s the equivalent of two espressos or four cups of instant coffee or eight cups of tea.</p>
<p>If you are pregnant or breastfeeding, it is important to talk to your doctor before increasing your caffeine intake, because caffeine can be passed through to your growing baby.</p>
<p>If you need individualised weight guidance, talk to your GP or visit an <a href="https://member.dietitiansaustralia.org.au/Portal/Portal/Search-Directories/Find-a-Dietitian.aspx">accredited practising dietitian</a>. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/what-can-you-do-to-speed-up-your-metabolism-204811">What can you do to speed up your metabolism?</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/214954/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lauren Ball works for The University of Queensland and receives funding from the National Health and Medical Research Council, Queensland Health and Mater Misericordia. She is a Director of Dietitians Australia, a Director of the Darling Downs and West Moreton Primary Health Network and an Associate Member of the Australian Academy of Health and Medical Sciences.</span></em></p><p class="fine-print"><em><span>Emily Burch works for Southern Cross University.</span></em></p>A new study shows people who drank an extra cup of coffee a day gained less weight than expected over four years.Lauren Ball, Professor of Community Health and Wellbeing, The University of QueenslandEmily Burch, Dietitian, Researcher & Lecturer, Southern Cross UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2077232023-10-10T21:43:33Z2023-10-10T21:43:33ZWhat is the OMAD diet? Is one meal a day actually good for weight loss? And is it safe?<figure><img src="https://images.theconversation.com/files/551627/original/file-20231003-26-odr3p8.jpg?ixlib=rb-1.1.0&rect=152%2C26%2C5838%2C3449&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/female-bare-feet-weight-scale-bathroom-785794792">Shutterstock</a></span></figcaption></figure><p>What do British Prime Minister <a href="https://www.sciencefocus.com/the-human-body/one-meal-a-day-diet-omad">Rishi Sunak</a> and singer <a href="https://theconversation.com/one-meal-a-day-diet-popular-with-celebrities-could-do-more-harm-than-good-heres-why-203086">Bruce Springsteen</a> have in common?</p>
<p>They’re among an ever-growing group of public figures touting the benefits of eating just one meal a day.</p>
<p>As a result, the one meal a day (OMAD) diet is the latest attention-grabbing weight loss trend. Advocates claim it leads to fast, long-term weight loss success and better health, including delaying the ageing process. </p>
<p>Like most weight-loss programs, the OMAD diet makes big and bold promises. Here’s what you need to know about eating one meal a day and what it means for weight loss.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/whats-the-weight-set-point-and-why-does-it-make-it-so-hard-to-keep-weight-off-195724">What's the 'weight set point', and why does it make it so hard to keep weight off?</a>
</strong>
</em>
</p>
<hr>
<h2>The OMAD diet explained</h2>
<p>Essentially, the OMAD diet is a type of intermittent fasting, where you fast for 23 hours and consume all your daily calories in one meal eaten within one hour.</p>
<p>The OMAD diet rules are presented as simple and easy to follow:</p>
<ol>
<li><p>You can eat whatever you want, provided it fits on a standard dinner plate, with no calorie restrictions or nutritional guidelines to follow. </p></li>
<li><p>You can drink calorie-free drinks throughout the day (water, black tea and coffee). </p></li>
<li><p>You must follow a consistent meal schedule, eating your one meal around the same time each day.</p></li>
</ol>
<figure class="align-center ">
<img alt="Plate of chicken and veggies, next to a cup of dried fruit" src="https://images.theconversation.com/files/551622/original/file-20231003-25-n2lo07.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/551622/original/file-20231003-25-n2lo07.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/551622/original/file-20231003-25-n2lo07.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/551622/original/file-20231003-25-n2lo07.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/551622/original/file-20231003-25-n2lo07.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/551622/original/file-20231003-25-n2lo07.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/551622/original/file-20231003-25-n2lo07.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The one meal a day diet significantly restricts your calorie intake.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/ZjEeMnDiq00">Ella Olsson/Unsplash</a></span>
</figcaption>
</figure>
<p>Along with creating a calorie deficit, resulting in weight loss, advocates believe the OMAD diet’s extended fasting period <a href="https://www.frontiersin.org/articles/10.3389/fphys.2021.771944/full">leads to physiological changes</a> in the body that promote better health, including boosting your metabolism by triggering a process called ketosis, where your body burns stored fat for energy instead of glucose. </p>
<h2>What does the evidence say?</h2>
<p>Unfortunately, research into the OMAD diet is limited. Most studies have examined its impact on <a href="https://www.cell.com/cell-metabolism/pdf/S1550-4131(18)30512-6.pdf">animals</a>, and the <a href="https://pubmed.ncbi.nlm.nih.gov/35087416/">primary study</a> with humans involved 11 lean, young people following the OMAD diet for a mere 11 days.</p>
<p>Claims about the OMAD diet typically rely on research into intermittent fasting, rather than on the OMAD diet itself. There is <a href="https://www.cfp.ca/content/66/2/117.short">evidence</a> backing the efficacy of intermittent fasting to achieve weight loss. However, <a href="https://www.nature.com/articles/s41574-022-00638-x">most studies</a> have focused on short-term results only, typically considering the results achieved across 12 weeks or less.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/does-it-matter-what-time-of-day-i-eat-and-can-intermittent-fasting-improve-my-health-heres-what-the-science-says-203762">Does it matter what time of day I eat? And can intermittent fasting improve my health? Here's what the science says</a>
</strong>
</em>
</p>
<hr>
<p>One <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2114833">longer-term study from 2022</a> randomly assigned 139 patients with obesity to either a calorie-restricted diet with time-restricted eating between 8am and 4pm daily, or to a diet with daily calorie restriction alone for 12 months.</p>
<p>After 12 months, both groups had lost around the same weight and experienced similar changes in body fat, blood sugar, cholesterol and blood pressure. This indicates long-term weight loss achieved with intermittent fasting is not superior and on a par with that achieved by traditional dieting approaches (daily calorie restriction).</p>
<h2>So what are the problems with the OMAD diet?</h2>
<p><strong>1. It can cause nutritional deficiencies and health issues.</strong></p>
<p>The OMAD diet’s lack of nutritional guidance on what to eat for that one meal a day raises many red flags. </p>
<p>The meals we eat every day should include a source of protein balanced with wholegrain carbs, vegetables, fruits, protein and good fats to support <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071223/">optimum health, disease prevention and weight management</a>.</p>
<figure class="align-center ">
<img alt="Woman shops for groceries" src="https://images.theconversation.com/files/551625/original/file-20231003-15-4yrdir.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/551625/original/file-20231003-15-4yrdir.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/551625/original/file-20231003-15-4yrdir.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/551625/original/file-20231003-15-4yrdir.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/551625/original/file-20231003-15-4yrdir.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/551625/original/file-20231003-15-4yrdir.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/551625/original/file-20231003-15-4yrdir.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">We’re likely to miss out on key nutrients if we eat one meal a day.</span>
<span class="attribution"><a class="source" href="https://www.pexels.com/photo/woman-in-green-shirt-looking-at-her-grocery-list-8422685/">Kampus Production/Pexels</a></span>
</figcaption>
</figure>
<p>Not eating a balanced diet will result in nutritional deficiencies that can result in poor immune function, fatigue and a decrease in bone density, leading to osteoporosis. </p>
<p>Fasting for 23 hours a day is also likely to lead to extreme feelings of hunger and uncontrollable cravings, which may mean you consistently eat foods that are not good for you when it’s time to eat. </p>
<p><strong>2. It’s unlikely to be sustainable.</strong></p>
<p>You might be able to stick with the OMAD diet initially, but it will wear thin over time. </p>
<p>Extreme diets – especially ones prescribing extended periods of fasting – aren’t enjoyable, leading to feelings of deprivation and social isolation during meal times. It’s hard enough to refuse a piece of office birthday cake at the best of times, imagine how this would feel when you haven’t eaten for 23 hours!</p>
<p>Restrictive eating can also lead to an unhealthy relationship with food, making it even harder to achieve and maintain a healthy weight. </p>
<p><strong>3. Quick fixes don’t work.</strong></p>
<p>Like other popular intermittent fasting methods, the OMAD diet appeals because it’s easy to digest, and the results appear fast. </p>
<p>But the OMAD diet is just another fancy way of cutting calories to achieve a quick drop on the scales. </p>
<p>As your weight falls, things will quickly go downhill when your <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4766925/">body activates its defence mechanisms</a> to defend your weight loss. In fact, it will regain weight – a response that stems from our hunter-gatherer ancestors’ need to survive periods of deprivation when food was scarce.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/is-it-true-the-faster-you-lose-weight-the-quicker-it-comes-back-heres-what-we-know-about-slow-and-fast-weight-loss-198301">Is it true the faster you lose weight the quicker it comes back? Here's what we know about slow and fast weight loss</a>
</strong>
</em>
</p>
<hr>
<h2>The bottom line</h2>
<p>Despite the hype, the OMAD diet is unsustainable, and it doesn’t result in better weight-loss outcomes than its predecessors. Our old habits creep back in and we find ourselves fighting a cascade of physiological changes to ensure we regain the weight we lost.</p>
<p>Successfully losing weight long-term comes down to:</p>
<ul>
<li><p>losing weight in small manageable chunks you can sustain, specifically periods of weight loss, followed by periods of weight maintenance, and so on, until you achieve your goal weight</p></li>
<li><p>making gradual changes to your lifestyle to ensure you form habits that last a lifetime.</p></li>
</ul>
<p><em>At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.</em></p><img src="https://counter.theconversation.com/content/207723/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dr Nick Fuller works for the University of Sydney and has received external funding for projects relating to the treatment of overweight and obesity. He is the author and founder of the Interval Weight Loss program.</span></em></p>Like most weight-loss programs, the OMAD diet makes bold promises – and comes with risks.Nick Fuller, Charles Perkins Centre Research Program Leader, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2048112023-09-12T20:09:46Z2023-09-12T20:09:46ZWhat can you do to speed up your metabolism?<figure><img src="https://images.theconversation.com/files/546284/original/file-20230905-23-oi6es0.jpg?ixlib=rb-1.1.0&rect=0%2C10%2C6720%2C4446&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Our metabolism is the force inside our bodies that mysteriously decides whether to convert the food we eat into a burst of energy, or extra kilos on the scales. </p>
<p>A “slow” or “sluggish” metabolism is often the first thing we blame when we struggle to lose weight. </p>
<p>As a result, a <a href="https://www.grandviewresearch.com/industry-analysis/weight-loss-supplements-market-report">US$33 billion</a> industry offers thousands of products promising to speed up our metabolic rate for weight-loss success. </p>
<p>But rather than reaching for a supplement, there are things you can do to speed your metabolism up. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/ever-wonder-how-your-body-turns-food-into-fuel-we-tracked-atoms-to-find-out-211047">Ever wonder how your body turns food into fuel? We tracked atoms to find out</a>
</strong>
</em>
</p>
<hr>
<h2>What is metabolism and how does it work?</h2>
<p>Metabolism is the term describing all the chemical reactions in our bodies that keep us alive. It provides the energy needed for essential functions like breathing and digestion.</p>
<p>When we refer to metabolism in the context of our weight, we’re actually describing our basal metabolic rate – the number of calories the body burns at rest, determined by how much muscle and fat we have.</p>
<p>Many factors can affect your metabolism, including gender, age, weight and lifestyle. It naturally slows down <a href="https://www.hindawi.com/journals/jobe/2019/8031705/">as we age</a> and becomes dysfunctional <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989512/">after dieting</a>. </p>
<h2>Why does our metabolism slow with age?</h2>
<p>As our bodies age, they stop working as efficiently as before. Around the age of 40, our muscle mass starts <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6431367/">naturally declining</a>, and the ratio of body fat to muscle increases.</p>
<p>Because muscle mass helps determine the body’s metabolic rate, this decrease in muscle means our bodies start to burn fewer calories at rest, decreasing our metabolic rate.</p>
<figure class="align-center ">
<img alt="Fit man looks at smartwatch" src="https://images.theconversation.com/files/546287/original/file-20230905-19-6vzs81.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/546287/original/file-20230905-19-6vzs81.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/546287/original/file-20230905-19-6vzs81.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/546287/original/file-20230905-19-6vzs81.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/546287/original/file-20230905-19-6vzs81.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/546287/original/file-20230905-19-6vzs81.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/546287/original/file-20230905-19-6vzs81.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Muscle mass helps determine the body’s metabolic rate.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/smart-watch-on-sporty-african-man-2069217704">Shutterstock</a></span>
</figcaption>
</figure>
<h2>Why does our metabolism become dysfunctional after dieting?</h2>
<p>When you lose large amounts of weight, you’re likely to have lowered your metabolic rate, and it <a href="https://pubmed.ncbi.nlm.nih.gov/22535969/">doesn’t recover</a> to the level it was pre-dieting – even if you regain weight. </p>
<p>This is because, typically, when we diet to lose weight, we lose both fat and muscle, and the decrease in our calorie-burning muscle mass slows our metabolism. </p>
<p>We can account for the expected decrease in metabolic rate from the decrease in body mass, but even after we regain lost weight our metabolism doesn’t recover. </p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/27136388/">Research</a> shows that for every diet you attempt, the rate at which you burn food slows by a further 15% that can’t be accounted for. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/is-it-true-the-faster-you-lose-weight-the-quicker-it-comes-back-heres-what-we-know-about-slow-and-fast-weight-loss-198301">Is it true the faster you lose weight the quicker it comes back? Here's what we know about slow and fast weight loss</a>
</strong>
</em>
</p>
<hr>
<h2>3 ways to speed up our metabolism (and 1 thing to avoid)</h2>
<p><strong>1) Pay attention to what you eat</strong></p>
<p>Consider the types of food you eat because your diet will influence the amount of energy your body expends to digest, absorb and metabolise food. This process is called <a href="https://nutritionandmetabolism.biomedcentral.com/articles/10.1186/1743-7075-1-5">diet-induced thermogenesis</a>, or the thermic effect of food, and it equates to about 10% of our daily energy expenditure.</p>
<p><a href="https://nutritionandmetabolism.biomedcentral.com/articles/10.1186/1743-7075-1-5">Research</a> shows the thermic effect of food is highest for protein-rich foods because our bodies need to use more energy to break down and digest proteins. Eating protein-rich foods will increase your metabolic rate by about 15% (compared to the average of 10% from all foods). In contrast, carbs will increase it 10% and fats by less than 5%.</p>
<figure class="align-center ">
<img alt="Person stands on scales in their living room" src="https://images.theconversation.com/files/546288/original/file-20230905-15-oi6es0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/546288/original/file-20230905-15-oi6es0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/546288/original/file-20230905-15-oi6es0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/546288/original/file-20230905-15-oi6es0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/546288/original/file-20230905-15-oi6es0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/546288/original/file-20230905-15-oi6es0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/546288/original/file-20230905-15-oi6es0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">If you’re trying to lose weight, aim for balanced meals rather than avoiding whole food groups.</span>
<span class="attribution"><a class="source" href="https://www.pexels.com/photo/a-person-standing-on-a-weighing-scale-7801341/">Pexels/Pavel Danilyuk</a></span>
</figcaption>
</figure>
<p>But this doesn’t mean you should switch to a protein-only diet to boost your metabolism. Rather, meals should include vegetables and a source of protein, balanced with wholegrain carbs and good fats to support optimum <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071223/">health, disease prevention and weight loss</a>. </p>
<p><strong>2) Get moving</strong></p>
<p>Regular physical activity will boost muscle mass and <a href="https://link.springer.com/article/10.1007/s00125-020-05177-6">speed up your metabolism</a>. Increasing your muscle mass raises your basal metabolic rate, meaning you’ll burn more calories at rest. </p>
<p>You can achieve this by incorporating 30 minutes of physical activity into your daily routine, supplemented with two days of gym or strength work each week.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/does-exercise-help-you-lose-weight-198292">Does exercise help you lose weight?</a>
</strong>
</em>
</p>
<hr>
<p>It’s also important to mix things up, as following the same routine every day can quickly lead to boredom and exercise avoidance.</p>
<p>Neglecting exercise will just as quickly result in a decline in muscle mass, and your lost muscle will slow your metabolism and hamper your efforts to lose weight.</p>
<p><strong>3) Get enough sleep</strong></p>
<p>A growing body of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2929498/">research</a> confirms sleep deprivation can significantly impact your metabolism. </p>
<p>A lack of sleep disturbs the body’s energy balance. This causes our appetite hormones to <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/oby.23616">increase feelings of hunger</a> and trigger food cravings, while altering our <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2084401/">sugar metabolism</a> and decreasing our <a href="https://www.sciencedirect.com/science/article/pii/S0002916523129534">energy expenditure</a>. </p>
<p>If you want to boost your metabolism, set yourself a goal of getting <a href="https://www.sleephealthjournal.org/article/S2352-7218(15)00015-7/fulltext">seven hours</a> of uninterrupted sleep each night. </p>
<p>A simple way to achieve this is to avoid screens for at least one hour before bed. Screens are a big sleep disruptor because they suppress melatonin production in the brain, telling us it’s daytime instead of nighttime.</p>
<figure class="align-center ">
<img alt="Woman stretches after waking up" src="https://images.theconversation.com/files/546290/original/file-20230905-23-c77bn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/546290/original/file-20230905-23-c77bn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=429&fit=crop&dpr=1 600w, https://images.theconversation.com/files/546290/original/file-20230905-23-c77bn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=429&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/546290/original/file-20230905-23-c77bn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=429&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/546290/original/file-20230905-23-c77bn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=539&fit=crop&dpr=1 754w, https://images.theconversation.com/files/546290/original/file-20230905-23-c77bn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=539&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/546290/original/file-20230905-23-c77bn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=539&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Poor sleep can impact your metabolism.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/kqDEH7M2tGk">Unsplash/Kinga Howard</a></span>
</figcaption>
</figure>
<p><strong>4) Don’t waste your money on diet pills and supplements</strong></p>
<p>Thousands of products promise to activate your metabolism and speed up your weight loss. While some may have ingredients that will boost your metabolism immediately after you take them, such as caffeine and capsaicin (the component which gives chillies their heat), <a href="https://www.nature.com/articles/ijo201682">research</a> confirms the effect is temporary – they don’t support long-term weight loss.</p>
<p>Most products promising to help you speed up your metabolism to help you lose weight don’t offer any scientific evidence to back their efficacy. <a href="https://pubmed.ncbi.nlm.nih.gov/33976376/">Two</a> extensive <a href="https://pubmed.ncbi.nlm.nih.gov/31984610/">reviews</a> published recently examined around 120 studies of weight-loss supplements and found they just don’t work, despite the bold marketing claims.</p>
<p>So leave the pills, potions and powders on the shelf and focus on the things that work. Your metabolism – and your hip pocket – will thank you.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/its-time-to-bust-the-calories-in-calories-out-weight-loss-myth-199092">It's time to bust the 'calories in, calories out' weight-loss myth</a>
</strong>
</em>
</p>
<hr>
<p><em>At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can register <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">here</a> to express your interest.</em></p><img src="https://counter.theconversation.com/content/204811/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dr Nick Fuller works for the University of Sydney and has received external funding for projects relating to the treatment of overweight and obesity. He is the author and founder of the Interval Weight Loss program.</span></em></p>Our metabolism naturally slows down as we age and becomes dysfunctional after dieting. Here’s what you can do to give yours a boost.Nick Fuller, Charles Perkins Centre Research Program Leader, University of SydneyLicensed as Creative Commons – attribution, no derivatives.