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Clinical Trials, NIH, Nutrition, Obesity, Research, Stanford News

Stanford seeks participants for weight-loss study

Stanford seeks participants for weight-loss study

Should diets come in different shapes and sizes? Stanford researchers are exploring that question and are seeking participants for a year-long weight-loss study that aims to understand why people may respond differently to the same diet. Titled “One Diet Does Not Fit All,” the study will examine how factors such as genetic influences and eating and sleeping habits have an impact on a diet’s effectiveness.

From a release:

Participants will be assigned randomly to either a very low-fat or very low-carbohydrate diet for 12 months. They will be required to attend weekly classes at Stanford for the first three months, once every other week for the following three months, and once a month for the remainder of the study. Participants must also be willing to have fasting blood samples drawn four times during the 12-month period and participate in online and written surveys. They will receive all test results at the end of the study.

The study is part of a five-year project funded by the National Institutes of Health and the Nutrition Science Initiative. Following an enrollment last year of 200, this spring researchers hope to enroll at least 135 men and women (pre-menopausal only) between the ages of 18 and 50 who are overweight or obese and are generally in good health.

For a complete list of inclusion criteria, click here. To determine eligibility for this study, complete a brief online survey. For more information, contact Jennifer Robinson at

Previously: How physicians address obesity may affect patients’ success in losing weight, To meet weight loss goals, start exercise and healthy eating programs at the same time, The trouble with the current calorie-counting system, Smaller plates may not be helpful tools for dieters, study suggests and Losing vitamins – along with weight – on a diet

Behavioral Science, Nutrition, Obesity, Research, Women's Health

Obesity and smoking together may decrease taste of fat and sweet but increase consumption

puddingA study from Washington University School of Medicine in St. Louis and Philadelphia’s Monell Center has found that obese women who smoke cigarettes may have reduced sensitivity to the tastes of sweetness and fat in food and may be more likely to eat more calories.

Researchers engaged 47 female participants ages 21 to 41, grouped as follows: obese smokers, obese nonsmokers, normal-weight smokers, and normal-weight nonsmokers. All of the participants tasted vanilla puddings and were asked to rate the sweetness and creaminess of each one. The researchers found that the women who were obese and smokers rated less creaminess and sweetness in the puddings than the other three groups did.

From a release:

[Study author Yanina Pepino, PhD,] cautioned that the study only identified associations between smoking and taste rather than definitive reasons why obese smokers were less likely to detect fat and sweetness. But the findings imply that the ability to perceive fat and sweetness — and to derive pleasure from food — is compromised in female smokers who are obese, which could contribute to the consumption of more calories.

“Obese people often crave high-fat foods,” she said. “Our findings suggest that having this intense craving but not perceiving fat and sweetness in food may lead these women to eat more. Since smoking and obesity are risk factors for cardiovascular and metabolic diseases, the additional burden of craving more fats and sugars, while not fully tasting them, could be detrimental to health.”

The results were published in the journal Obesity.

Previously: Obesity is a disease – so now what?How eating motivated by pleasure affects the brain’s reward system and may fuel obesity and The brain’s control tower for pleasure
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Health and Fitness, In the News, Obesity, Public Health

In Boston, doctor’s orders may include discounted bike-share memberships

Some Boston docs are delivering a dose of preventive care the old-fashioned way. Encouraging physical exercise under the city’s new “Prescribe-a-Bike” program, physicians at Boston Medical Center can refer low-income patients to a $5 bike-share membership, complete with helmet.

Common Health reports:

“Obesity is a significant and growing health concern for our city, particularly among low-income Boston residents,” BMC President and CEO Kate Walsh said in a statement. “Regular exercise is key to combating this trend, and Prescribe-a-Bike is one important way our caregivers can help patients get the exercise they need to be healthy.”

Previously: A bike helmet that doubles as a stress-o-meter and Modest increases in bike ridership could yield major economic, health benefits

Obesity, Parenting, Pediatrics, Research

Feeding practices and activity patterns for babies vary with families’ race and ethnicity, study shows

Feeding practices and activity patterns for babies vary with families' race and ethnicity, study shows

4361756526_774638516a_zWhen and how does childhood obesity begin? The question is a big challenge for researchers, who have observed that more than a quarter of US children aged 2 to 5 are now obese. That’s worrying because of links between obesity, heart disease and diabetes.

To help find answers, a new study is following babies and their parents from age 2 months to 2 years, tracking the babies’ growth and the families’ habits around feeding and activity for their little ones. Researchers at four centers around the country have recruited more than 800 baby-parent pairs to participate. The subjects are ethnically diverse and come mostly from low-income households, with 86 percent receiving Medicaid.

Today in Pediatrics, the scientists report the first findings from the project, an analysis of baseline data collected when the babies were 2 months old. The researchers found striking differences in feeding practices and activity patterns along racial and ethnic lines, suggesting that perhaps future efforts to prevent childhood obesity should be culturally tailored for different groups. Stanford’s Lee Sanders, MD, is one of the authors of the new paper, though none of the data was collected at Stanford.

Among the findings, Hispanic parents were more likely to encourage babies to finish a bottle and reported less tummy time than white parents; black parents were more likely to put babies to bed with a bottle, prop a bottle in front of a baby with a blanket (instead of holding it as the baby ate), and reported more TV watching for their babies than white parents. The differences persisted after the data was adjusted for possible confounding factors such as family income. It’s not clear whether all of these behaviors will be connected to higher obesity rates, but later reports from the same study will give more information about that.

In the study’s discussion, the researchers write:

If these behaviors are truly “obesogenic,” however, families from all races and ethnicities studied need early counseling, and the findings here also underscore the likely need for culturally sensitive health behavior counseling during early infancy. Particularly actionable are the specific behaviors that may be most sensitive to culturally adapted interventions: (1) infant exposure to television and other visual media; (2) breastfeeding initiation and exclusivity; and (3) encouraging infants to finish bottles.

Previously: Childhood obesity a risk for imminent heart problems, research shows, Sugar intake, diabetes and kids: Q&A with a pediatric obesity expert and Nutrition and fitness programs help East Palo Alto turn the tide on childhood obesity
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Nutrition, Obesity, Patient Care, Research

How physicians address obesity may affect patients’ success in losing weight

How physicians address obesity may affect patients' success in losing weight

docvisitFor some patients, the need to begin a weight-loss program to lower health risks connected with obesity is urgent. But losing weight and keeping it off for the long term can be a challenging journey for a person – and patient-doctor conversations about weight loss can be complex.

study (purchase required) recently published online in Preventive Medicine looked at the way patients perceive their physicians’ attitudes about obesity, and the patients’ change in weight following the delivery of weight-loss advice. For their work, the researchers conducted Internet-based surveys in 500 adults with a body-mass index of 25 or more.

As explained in a Johns Hopkins release:

The participants were asked, “In the last 12 months, did you ever feel that this doctor judged you because of your weight?” Twenty one percent of participants said they believed they had been.

Further, 96 percent of those who felt judged did report attempting to lose weight in the previous year, compared to 84 percent who did not. But only 14 percent of those who felt judged and who also discussed weight loss with their doctor lost 10 percent or more of their body weight, while 20 percent who did not feel judged and also discussed shedding pounds lost a similar amount.

“Negative encounters can prompt a weight loss attempt, but our study shows they do not translate into success,” study leader Kimberly Gudzune, MD, MPH, an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine, said in the release. “If we are their advocates in this process — and not their critics — we can really help patients to be healthier through weight loss.”

Previously: Study: When discussing childhood obesity, words carry weight and A medical student calls for increased nutrition education for doctor
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Nutrition, Obesity, Pediatrics, Stanford News

Using a traffic light system to encourage healthier eating habits

Using a traffic light system to encourage healthier eating habits

A couple of traffic lights installations with the red ones turned on and the green and yellow off captured against a blue sky with several white clouds scattered over.

Imagine going to your favorite restaurant and discovering that high-calorie foods and sugar drinks were now listed in a red section on the menu, slightly healthier options were contained in a yellow box and nutrient-dense dishes were labeled green. Would you order differently?

The answer is “yes,” according to findings (.pdf) published earlier this week. In the study, researchers analyzed data collected at the Massachusetts General Hospital cafeteria before and after implementing such a traffic light system. Results showed that color-coding foods and beverages “sustained healthier choices over two years.”

At the Center for Healthy Weight at Lucile Packard Children’s Hospital, Stanford pediatrician Thomas Robinson, MD, and colleagues have also experienced notable success with the traffic light system, which they’ve used to classify foods in their pediatric weight control program for more than 15 years.

The key to the traffic light system, explains Robinson, is its lack of ambiguity and simplicity. He says, “Every food has a color (red, yellow or green) and you can count the foods you eat and set goals based on the colors. Because each food has a color there is a lot less room for rationalization or negotiation — it is what it is. We know it is much more difficult to count calories or balance types of nutrients, such as carbohydrates, protein and fat.”

When I asked Robinson about potential pitfalls of the method, such as the problem of people categorizing foods differently, he told me:

Although the traffic light categories are usually defined based on nutritional characteristics of foods, the traffic light approach is a behavioral strategy rather than a specific diet. A traffic light approach can be created to fit with any nutritional goal and simplifies it to a point that one can keep track and count. A lot of my patients, students and colleagues have heard me say, “If you can’t count it, you can’t change it.”

In our program we use traffic light categories based mainly on calorie (i.e. energy) density along with some additional characteristics of foods. It would be possible for others to create traffic light categories based on different food characteristics. But changing one’s diet and weight control depends much more on learning to changes one’s behavior than about learning about nutrition.

Previously:  To meet weight loss goals, start exercise and healthy eating programs at the same timeSugar intake, diabetes and kids: Q&A with a pediatric obesity expert and Can dish color influence how much you eat?
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Nutrition, Obesity, Public Health

Localizing healthy-eating education

secondburgerA one-size-fits-all approach to addressing unhealthy eating habits in the United States may not be a realistic fit for most. And so, much conversation at the American Public Health Association’s annual meeting this year has centered on conducting healthy-eating education at the local level.

An APHA blog post describes some noteworthy nutrition advocacy initiatives taking place in rural, urban and diverse socioeconomic communities and reports on their effects so far. Efforts have included engaging local media, such as editors of rural newspapers, to comment on the reach of nutrition-related stories. Other programs look to restaurants to encourage healthier eating behaviors. As described in the post:

[Michelle Ramos, MPH,] and her colleagues set out to bring healthier diets to East Harlem, a low-income neighborhood with some of the highest rates of obesity and diabetes in New York City. The community also has an extremely high density of fast food and take-out restaurants.

Researchers attempted to change attitudes with the Healthy Plate for a Healthy Weight initiative, in which restaurant owners were asked to give instructional, bilingual plates — inscribed with nutritional guidelines — to each customer. While many customers didn’t use the plate, 75 percent of those who did reported eating smaller portions, while 100 percent reported eating more vegetables.

A second part of the initiative, called Save Half For Later, called upon restaurant servers to ask customers: “Would you like to save half your meal for later?” If customers answered yes, servers would wrap half the selection in a to-go box.

The entire entry is worth a read.

Previously: Using hip hop to teach children about healthy habits, Nutrition and fitness programs help East Palo Alto turn the tide on childhood obesity, Should the lack of access to good food be blamed for America’s poor eating habits?, Can moderate behavior revisions add up to better health? and Could food taxes or subsidies promote healthy eating habits?
Photo by SteFou!

Nutrition, Obesity, Pediatrics, Research

Classroom cupcakes: Should “party foods” at schools be limited?

Classroom cupcakes: Should "party foods" at schools be limited?

6122378506_67ab69fb80As one-third of American kids are overweight or obese, efforts to promote exercise and healthy eating habits have included Michelle Obama’s Let’s Move! campaign and discussion about limiting the sale of junk food and soda in school vending machines. But the issue of cupcakes in the classroom – or other sweets frequently present, if not officially sold or provided, during school – is trickier to treat, as party foods don’t fall under the guidance of U.S. Department of Agriculture nationwide standards for school food and beverages.

As previously written about on Scope, sweets for a class-full of birthdays, plus holidays, add up quickly to more than once-in-a-while. Classroom cupcakes have not escaped the notice of researchers at the University of Illinois at Chicago who surveyed more than 1,200 elementary schools in 47 states during the 2009-2010 and 2010-2011 school years on the topic. Authors of the study, which is published in the Journal of Nutrition Education and Behavior, examined links between policy at the state, district or school level discouraging or restricting sugary foods and beverages, and the likelihood that a school would address classroom parties.

From a release:

The researchers collected corresponding district policies and state laws and examined whether they addressed classroom parties. When policies addressed parties, most were written as recommendations, not as outright restrictions. Forty-nine percent of schools were located in districts recommending limits on sweets, and 18.5 percent of schools were subject to recommendations at both the district and state levels.

Approximately half the schools had either no restrictions or left the decision to teachers; one-third had school-wide policies discouraging sugary items; and fewer than 10 percent actually banned sweets during holiday parties or did not allow parties.

The release also notes that national recommendations include limiting the number of parties or the types of food served at them, or holding parties that do not involve food.

Previously: How should parents talk to their kids about weight control?Nutrition expert praises First Lady’s anti-obesity campaign and Should kids get cupcakes at school?
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Cardiovascular Medicine, Obesity, Pediatrics, Research

Childhood obesity a risk for imminent heart problems, research shows

Childhood obesity a risk for imminent heart problems, research shows

2188725886_860d60d92dChildhood obesity, a risk factor for cardiovascular disease in adulthood, may also contribute to cardiovascular damage and dysfunction during childhood, according to a recent review (subscription required) in the Journal of the American College of Cardiology.

A release summarizes findings by scientists at the University of British Columbia:

Among the alarming clinical studies, obese children:

Missing from the evidence is a clear understanding of what is normal in children and what can be expected as they grow and develop, Devlin and colleagues reported.

Previously: Sugar intake, diabetes and kids: Q&A with a pediatric obesity expert, Using hip hop to teach children about healthy habits, Community violence can increase risk of heart disease and Study says nearly 40 percent of American children’s diet consists of empty calories
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Nutrition, Obesity, Research, Sleep

Want to curb junk food cravings? Get more sleep

Want to curb junk food cravings? Get more sleep

hamburger_080713More than a third of adult Americans are obese and, coincidentally, roughly a third of men and women in the United States are sleep-deprived. Or, maybe it’s not such a coincidence?

Past studies have linked inadequate sleep to obesity, and now new research from University of California, Berkeley offers insights into how not getting enough shut-eye can trigger poor nutritional choices.

In the small study, researchers used functional magnetic resonance imaging (fMRI) to scan the brains of healthy young adults after both a normal night’s sleep and a sleepless night. Study results showed impaired activity in areas of the brain’s frontal lobe that regulate complex decision-making and a boost in deeper brain centers, which respond to rewards. Additionally, sleep-deprived participants favored unhealthy snack and junk foods.

A recent PsychCentral story highlights the significance of the findings:

Previous studies have linked poor sleep to greater appetites, particularly for sweet and salty foods, but the latest findings provide a specific brain mechanism explaining why food choices change for the worse following a sleepless night.

“These results shed light on how the brain becomes impaired by sleep deprivation, leading to the selection of more unhealthy foods and, ultimately, higher rates of obesity,” said Stephanie Greer, a doctoral student and lead author of the paper.

Previously: Want teens to eat healthy? Make sure they get a good night’s sleep, More evidence linking sleep deprivation and obesity, How lack of sleep affects the brain and may increase appetite, weight gain and Study shows link between lack of sleep
Photo by Christian Newton

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