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If you want to lose weight, don’t diet

I do not advocate crash dieting as a weight reduction strategy because—as you yourself can attest to—it is fairly easy to lose as much as 25 to 30 lbs. in a rather short time by severely limiting ones food intake, but it is hard to keep the weight off. This is because dieters revert to their old eating habits soon after they stop their “crash diet.” Sooner or later, people like you who keep trying to reduce by crash dieting acquire the vicious habit of yo-yo dieting, i.e., cyclical loss and gain of weight by crash dieting.

What yo-yo dieting does to your body

Each time you go on a crash diet, you are at risk of developing fluid and electrolyte imbalance and protein, calorie, and micronutrient deficiency, which could compromise and irreparably damage your vital organs. Furthermore, some studies suggestthat yo-yo dieting may increase your risk for certain health problems including high blood pressure, high cholesterol, and gallbladder disease.

What you need to do to lose excess weight permanently

If you wish to lose weight permanently, do not crash diet. Instead, adopt these two lifestyle measures: shift to a maintenance diet and increase your physical activity level. Remember, however, that the key to a desirable body weight is discipline—the ability to practice these suggested lifestyle changes religiously.

Determining your maintenance diet without counting calories

Your maintenance diet refers to the food regimen that will bring your weight down to your desirable level then keep it there. If you are overweight, how do you determine your maintenance diet?

Very simple, first find out the percentage of body weight you want to eventually lose. For example, if you are 150 lbs. now and would like to go down to 120 lbs. you need to lose 30 lbs. or about 15 percent of your body weight. Hence, your maintenance diet equals your current diet minus 15 percent. This simply means that every meal time, you must set aside, for all food items, what you think is about 15 percent of what you used to take. If you are able to religiously do this, you will notice that you will gradually lose weight and that over a period of a several months you will go down to 120 lbs. Why? Because your maintenance diet can only sustain a 120-pound body and consequently, the fat cells that are responsible for you excess weight will gradually shrink. By the way, whenever you get hungry during the first few days to weeks of your maintenance diet, you can eat as much boiled leafy vegetables as you want. Once you have attained your desirable body weight there is no need to change your diet, because you are already on your maintenance diet in the first place.

Why you should exercise

To give some flexibility to your “maintenance” diet, you need to increase your physical activity. This will enable you to occasionally indulge yourself with your favorite dessert.

A regular exercise program that has aerobic value will go a long way in maintaining your desirable body weight because aside from increasing your energy expenditureit will also increase your basal metabolic rate. An exercise program has other benefits too—it will keep your muscles and cardiovascular system in shape. There are many exercise activities with high aerobic value (jogging, swimming, aerobic dancing, etc.) but I suggest you choose one that you find enjoyable so you don’t get bored doing the activity day in and day out.

source: Manila Bulletin
http://www.mb.com.ph/if-you-want-to-lose-weight-dont-diet/

Senior drivers taking opioid painkillers have higher crash risk

Seniors who get behind the wheel soon after starting to use narcotic pain relievers have twice the risk of getting into a serious car crash as their peers who use non-opioid painkillers, Swedish researchers say.

Senior drivers who’d been using opioid painkillers regularly for several months also had higher odds of getting into accidents, but not as high as the new users did, according to Joel Monarrez-Espino of Karolinska Institute in Stockholm and colleagues.

Their study included 4,445 drivers between the ages of 50 and 80 who had been involved in a single car crash between 2005 and 2009 in which at least one person suffered an injury that required medical care, plus more than 17,000 similar drivers who had not been in crashes.

As reported in the journal Age and Aging, study participants were considered new to opioid painkillers if they had been given a prescription within one month before the crash. Regular users were those given at least three prescriptions in the last six months, with at least one prescription within a month of the crash.

“New, but also frequent opioid analgesic use, resulted in an increased probability of single vehicle crashes,” the research team wrote.

Specifically, the risk was 100 percent higher for the new opioid users, and 60 to 70 percent higher for the regular users, compared to the risk in people of the same age taking one or two non-opioid painkillers.

“While more epidemiologic evidence is needed, patients could be advised to refrain from driving when using opioid analgesics,” the authors wrote.

They did not respond to a request for comment.

Whether the “regular users” in this study had a lower risk because their bodies were accustomed to the opioids is hard to know, said Dr. Thomas Meuser, a specialist in aging at the University of Missouri who was not involved with the study.

“The study doesn’t show if the participants took their medications consistently,” Meuser told Reuters Health by phone.

“Another reason for the drop in risk (among regular users) could be that some stopped or reduced taking their medications due to side effects, even though they continued being prescribed,” said Meuser.

Paul Atchley, who studies the human brain, vision and attention to driving at the University of Kansas, told Reuters Health the findings should serve as a wake-up call for doctors to have better conversations with their patients about the true risks of taking these medications.

“Driving is the riskiest thing we do on a daily basis,” said Atchley, who wasn’t involved in the study.

“We need to understand what’s at risk, so that we as drivers can make better choices,” he said.

“What’s unique about this study isn’t just painkiller use, but the pattern of use,” Atchley pointed out.

The risk of being injured or killed in a car crash increases with age, according to the Centers for Disease Control and Prevention (CDC).

Meuser noted that older adults generally have more diagnoses and take more medications than younger adults. “There’s always a risk for side effects for someone taking five or more medications,” he said. “Side effects that affect the brain and nervous system are especially worrisome for older drivers.”

source: Reuters Health
http://www.reuters.com/article/us-health-seniors-driving-idUSKCN10N28E

Briefly standing, or being active, reduces blood sugar across the day

For obese people who sit for most of the day, replacing some sitting time with standing, slow walking or slow cycling reduces average blood sugar across the day and into the night, a small study finds.

“Anything you can do to bring down glucose readings throughout the day is a good thing,” said senior author Glenn Gaesser of the School of Nutrition and Health Promotion at Arizona State University in Phoenix. 

“We chose a typical workday because a large number of Americans spend a lot of time sitting at an office desk, and a number of (studies) indicate sitting is a health hazard, so we reckoned that trying to alleviate that by either standing or walking or cycling would help,” Gaesser told Reuters Health.

The researchers studied nine overweight or obese adults who wore continuous blood sugar monitors and blood pressure monitors during their regular, mostly-sitting eight-hour workday. One week later, participants gradually replaced some of that sitting time with standing, in intervals of 10 to 30 minutes for a total of two and half hours per day.

The following week, the same amount of sitting time was replaced with walking at a treadmill desk at a pace of one mile per hour. In the fourth week, the intervals were spent cycling on a stationary bike retrofitted to a workstation, also at an extremely slow pace with low energy expenditure.

Average 24-hour glucose was lower for standing and walking than for sitting, and was lowest on the cycling days, the researchers report in Medicine and Science in Sports and Exercise.

There was a similar pattern during the hours right after eating and even during overnight hours, with people having sustained lower blood sugar overnight after days they had cycled.

This is “not wholly surprising," because other research in the last few years has shown that breaking up prolonged sitting has benefits on glucose over the course of a day, said Dr. Daniel Bailey of the University of Bedforshire in the U.K., who was not part of the study.

It’s uncertain if the difference in blood sugar would have clinical significance or reduce metabolic risk, but that would be more likely for walking and cycling than for standing, which only resulted in a small reduction, Bailey told Reuters Health by email.

“Studies with larger groups would be needed before we could say these findings would apply to overweight people in general,” he said. But it’s likely that overweight or prediabetic people may benefit more from breaking up periods of sitting than healthy-weight people, he said.

“We found that the overall reduction in blood sugar throughout the 24-hour day was typically 5 percent to 12 percent, with the greatest effect being in cycling,” Gaesser said.

After a meal of carbohydrates, most blood sugar is disposed of in skeletal muscle, and muscle contractions increase insulin activity and glucose uptake, which helps to lower blood sugar, he said.

“For low-level activity throughout the workday, the effect lasts well after the last exercise bout at 4:30 or 5:00 in the afternoon,” continuing into sleep, he said.

Breaks in sedentary time are good, even if you don’t have access to a walking or cycling workstation, Gaesser said.

source: Reuters Health
http://www.reuters.com/article/us-health-activity-glucose-sitting-idUSKCN10N21R

Mothers with HIV urged to receive ART for infants

WHO said infected mothers who are on ART and adherent to therapy “should breastfeed exclusively for the first six months, and then add complementary feeding until 12 moth of age.

Breastfeeding with complementary feeding may continue until 24 months of age or beyond.

In its previous guidelines, WHO advice was to breastfeed for 12 months but then stop breastfeeding if a nutritionally adequate and safe diet could be provided.

“The new guideline is based on scientific evidence that shows ART is very effective at preventing HIV transmission through breastfeeding as long as the mother is adherent to therapy,” it noted.

WHO added the new evidence means “that mothers living with HIV and their children can benefit from the many advantages of breastfeeding – such as improved growth and development – in the same way as mothers who do not have HIV and their children.”

WHO recommendations emphasize the need for health system to “qualify HIV services that reliably provide ART and continue to care mother living with HIV.”

According to WHO, mixed feeding is better than no breastfeeding at all if the mother is on HIV treatment.

“Mother living with HIV can be reduces the risk of post-natal HIV transmission even when the baby is on mixed feeding. Although exclusive breastfeeding is recommended for the first six months, mixed feeding is better than no breastfeeding,” WHO said.

WHO added that such infected mothers should be encouraged to breastfeed exclusively because it benefits the infant in many ways including, “reduced illness, and improved growth and development.”

source: Philippine Star
Health & Medicine

Pain drugs in pregnancy tied to behavior issues in kids Print

Women who take the common pain reliever acetaminophen during pregnancy may be more likely to have children with behavior problems than those who don’t use the drug, a British study suggests.

Researchers analyzed survey data from about 7,800 mothers and found more than half of them took acetaminophen at some point during pregnancy.

Overall, about 5 percent of their children had behavior problems by age 7. The odds of hyperactivity, conduct issues and emotional problems were all higher among the offspring of women who reported using acetaminophen while pregnant, the study found.

This doesn’t necessarily mean pregnant women should avoid taking acetaminophen, however, said lead study author Evie Stergiakouli of the University of Bristol in the U.K.

“It is still appropriate to use acetaminophen during pregnancy because there is a risk of not treating fever or pain during pregnancy,” Stergiakouli said by email. “Other pain medications are not considered safe to use during pregnancy.”

The study doesn’t prove acetaminophen, also known as paracetamol, directly causes developmental issues in children, noted Dr. Hal Lawrence, executive vice president and chief executive of the American College of Obstetricians and Gynecologists (ACOG).

"Behavioral disorders are multifactorial and very difficult to associate with a singular cause,” Lawrence, who wasn’t involved in the study, said by email. “The brain does not stop developing until at least 15 months of age, which leaves room for children to be exposed to a number of factors that could potentially lead to behavioral issues.”

To explore the connection between prenatal acetaminophen use and behavior issues in children, researchers examined data on how many women reported taking the drug at 18 weeks and 32 weeks of pregnancy as well as when their children were 5 years old. They also looked at acetaminophen use by the women’s partners.

At 18 weeks of pregnancy, 4,415 mothers, or 53 percent of them, reported using acetaminophen, as did 3,381 mothers, or 42 percent, at 32 weeks.

When the kids were 5 years old, more than 80 percent of the women and their partners used acetaminophen.

The study didn’t find any association between postnatal use of the drug by either parent and behavior issues in children, or any link based on whether the partners took the drug while women were pregnant.

Because the associations weren’t observed in these instances, the authors conclude that behavioral difficulties in children might not be explained by unmeasured behavioral or social factors linked to acetaminophen use.

Limitations of the study include the lack of data on the dosage or duration of acetaminophen use, the authors note in JAMA Pediatrics. The study also relied on parents to accurately recall and report on their acetaminophen use and on any behavior issues observed in their kids.

While there are a few other studies that have also suggested a possible association between prenatal acetaminophen use and neurological and developmental issues in children, none of this research offers conclusive proof that the drug is the cause of the problems, noted Dr. Aisling Murphy, a researcher in obstetrics and gynecology at the University of California, Los Angeles.

“Having said that, generally, our advice would be to avoid any unnecessary exposure to medications, including acetaminophen during pregnancy,” Murphy, who wasn’t involved in the current study, said by email.

“If treatment with acetaminophen is needed for pain control then taking the minimum effective dose and avoiding multiple prolonged exposures is the prudent thing to do,” Murphy added. “If pain is more severe then talking to your doctor is the next best step.”

source: Reuters Health
http://www.reuters.com/article/us-health-acetaminophen-pregnancy-behavi-idUSKCN10Q1H5