Fad diets can work, but experts find no magic slimming bullet

January 13, 2014

Resolutions to lose weight are often made in January yet almost as frequently abandoned as heavy hopefuls find diets that demand fasting, virtually no carbs or liquid food shakes notoriously hard to stick to. But even "fad" diets can lead to a slimmer, lighter New Year for those whose resolve remains robust, according to doctors and nutritionists analysing them.

Gathering for a London conference to review evidence behind popular weight loss diets - at just the time of year when slimming ideas are in peak demand - specialists concluded that food fads such as the hunter-gatherer "Paleo" plan or the 5:2 diet can deliver. But it's hard work. "If it was easy, our species would have died out years ago. As humans we have a default to eat," said Gary Frost, a professor and chair of nutrition and dietetics at Imperial College London. The results of that default are looming large in a global "wave of obesity", he said. According to the World Health Organisation, worldwide obesity - defined as having a body mass index of more than 30 - has nearly doubled since 1980. The latest global figure is that in 2008, more than 1.4 billion adults were overweight.

WAVE OF OBESITY

According to the US Centers for Disease Control and Prevention, almost 36% of American adults are obese and almost 70% are either obese or overweight. In Britain, a government health study predicts 60% of men, 50% of women and 25% of children will be obese by 2050. Against this background, experts say the search for effective diets must always take account of how easy it is for people to understand and follow, and how likely they are to abide by its restrictions.

Michelle Harvie, a research dietician from the Genesis Prevention Centre at Britain's University Hospital of South Manchester, said that on this front, fasting diets - sometimes called intermittent diets - can be successful. "Energy restriction is difficult to maintain over the long term and people tend to find it easier to follow a diet with intermittent energy restriction," she said. She said that while a regular weight loss plan might require the dieter to take in 25% fewer calories, intermittent diets may suggest two days of a 75% calorie cut interspersed with five days of normal healthy eating. But the key to these diets - such as the 5:2 diet in which followers eat as little as 400 calories on two "fasting" days per week - is that dieters won't succeed if they "pig out" and eat whatever they want on non-fasting days.

Harvie's research shows those who succeed in losing weigh on these diets find the fasting days lead them to also have a lower food intake on normal days - leading to lower calorie intake overall.

HUNTING FOR FOOD

Mark Berry, head of plant biology and biochemistry at the consumer company Unilever's research and development unit, says there are also positive signs in data from studies of "Palaeolithic" or stone-age diets - plans designed to mimic the diet of pre-agricultural hunter-gatherers of that era. A sign of its current popularity is that "Paleo diet" was one of the most "Googled" terms of 2013.

The idea is based around foods that can be hunted, fished or foraged for - meat, seafood, eggs, nuts, seeds, fruits and vegetables. Berry said his research showed little impact on glucose response in the body in people eating a Palaeolithic diet, but did find a significant impact on hormones that signal satiety and tell the brain the eater is full. Alexandra Johnstone of the Rowett Institute of Nutrition and Health, who has been looking into high protein and low carbohydrate diets such as the Atkins diet, said these also had a significant impact on fullness feelings - giving them the potential to help dieters control appetite and lose weight. "The high satiety effects of increased protein in the diet seems to be a contributing factor to the success of high-protein, low-carbohydrate diets," she said.

Johnstone cited data showing the amount of weight lost on high-protein diets is around double that lost on a comparable low-fat diet at the six-month mark. But there is little difference in weight loss after one year, as dieters often lose momentum and their resolve to slim down fades. "There's no magic bullet," she said. Judy Buttriss, head of the British Nutrition Foundation, said the evidence for popular diets was clearly nuanced. While there are several that can be used as tools for effective weight loss and maintenance, she said "there's currently no evidence that one is any better than another in the long term".

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Agencies
June 4,2020

The World Health Organisation on Wednesday said that anti-malarial drug hydroxychloroquine (HCQ) will return to the solidarity trial for the potential treatment of coronavirus disease.

At a press conference in the WHO headquarters in Geneva, Director General Tedros Adhanom Ghebreyesus said: "On the basis of the available mortality data, the members of the committee recommended that there are no reasons to modify the trial protocol. The Executive Group received this recommendation and endorsed continuation of all arms of the solidarity trial, including hydroxychloroquine."

The world health body had temporarily suspended the usage of HCQ from the solidarity trial for coronavirus treatment on May 25 soon after a study published in one of the most reliable medical journals, which had suggested that the drug could cause more fatalities among COVID-19 patients.

However, the WHO chief said that the decision was taken as a precaution while the safety data was reviewed.

Ghebreyesus also said that the Data Safety and Monitoring Committee will continue to closely monitor the safety of all therapeutics being tested in the solidarity trial.

"So far, more than 3,500 patients have been recruited in 35 countries. WHO is committed to accelerating the development of effective therapeutics, vaccines and diagnostics as part of our commitment to serving the world with science, solutions and solidarity," he said.

Soon after HCQ was suspended from the trial, the Indian government had said that the antimalarial drug has been known for its benefits for a long time and its usage will be continued on the frontline workers, including police and healthcare professionals, as prophylaxis. The government had also said that studies were being conducted and the drug would be included in the clinical trial also for the treatment of coronavirus disease.

US President Donald Trump also had strongly advocated the use of HCQ and called it a "game-changer". He went to the extent of saying that he had taken the medicine.

Launched by WHO and partners, solidarity trial is an international clinical trial to find an effective treatment for COVID-19, including drugs to slow the progression of the disease or improve survival. The trial, which enrols patients from different countries, "will compare four treatment options against standard of care to assess their relative effectiveness against COVID-19", said WHO. 

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Agencies
July 8,2020

Probiotics that broaden the mix of helpful bacteria in the gut may help to ease depression, say researchers.

Foods that broaden the profile of helpful bacteria in the gut are collectively known as probiotics. These "good bacteria" can be taken as supplements, or found naturally in yoghurts or fermented foods.

For the findings, the research team from the University of Brighton in the UK searched for relevant studies published in English between 2003 and 2019, which looked at the potential therapeutic contribution of pre-and probiotics in adults with depression and/or anxiety disorders.

Out of an initial haul of 71 studies, just seven met all the criteria for inclusion. All 7 investigated at least one probiotic strain; four looked at the effect of combinations of multiple strains.In all, 12 probiotic strains featured in the selected studies, primarily Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium bifidium.

One study looked at combined pre-probiotic treatment, while one looked at prebiotic therapy by itself. The studies varied considerably in their design, methods used, and clinical considerations, but all of them concluded that probiotic supplements either alone or in combination with prebiotics may be linked to measurable reductions in depression.

And every study showed a significant fall or improvement in anxiety symptoms and clinically relevant changes in biochemical measures of anxiety or depression with probiotic or combined pre-probiotic use.

Of the 12 different probiotics investigated, 11 were potentially useful, the findings showed.'Probiotics may help reduce the production of inflammatory chemicals, such as cytokines, as is the case in inflammatory bowel disease, the researchers suggested.

"They may help direct the action of tryptophan, a chemical thought to be important in the gut-brain axis in psychiatric disorders," they added.

In this way, with a better understanding of the mechanisms, probiotics may prove to be a useful tool across a wide range of conditions," the authors wrote.

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Agencies
June 29,2020

Washington DC, Jun 29: Young children with narrow retinal artery diameters were more likely to develop higher blood pressure, and children with higher blood pressure levels were more likely to develop retinal microvascular impairment during early childhood, according to a new study.

The first study to show this connection in children was published today in Hypertension, an American Heart Association journal.

High blood pressure, the main risk factor for the development of cardiovascular disease (CVD), can manifest as early as childhood, and the prevalence of high blood pressure among children continues to rise. In previous studies, analysis of blood vessels in the retina has shown promise as a predictor of CVD risk among adults. In the study titled, "Retinal Vessel Diameters and Blood Pressure Progression in Children," researchers sought to predict the development of high blood pressure in children over four years based on retinal blood vessel measurements.

"Hypertension continues as the main risk factor for the development of cardiovascular diseases and mortality," says Henner Hanssen, M.D., the study's lead author and a professor in the department of sport, exercise and health at the University of Basel in Switzerland. 

"Primary prevention strategies are needed to focus on screening retinal microvascular health and blood pressure in young children in order to identify those at increased risk of developing hypertension. The earlier we can provide treatment and implement lifestyle changes to reduce hypertension, the greater the benefit for these children."

Researchers screened 262 children ages six to eight from 26 schools in Basel, Switzerland, in 2014, for baseline blood pressure and retinal arterial measurements. Both measures were taken again in 2018. Blood pressure measurements at both baseline and follow-up were performed in a sitting position after a minimum of five minutes of rest and were categorized based on the American Academy of Pediatrics' blood pressure guidelines. These guidelines utilize the same measurements as the American Heart Association/American College of Cardiology 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults.

Results from the analysis indicate: children with narrower retinal vessel diameters at baseline developed higher systolic blood pressure at follow-up; retinal vessel diameters could explain 29 -31 per cent of the changes in systolic blood pressure progression between 2014 and 2018; children with higher blood pressure levels at baseline developed significantly narrower arteriolar diameters at follow-up, depending on weight and cardiorespiratory fitness; and initial blood pressure measures explained 66-69 per cent of the change in retinal arteriolar diameter from baseline to follow-up.

"Early childhood assessments of retinal microvascular health and blood pressure monitoring can improve cardiovascular risk classification. Timely primary prevention strategies for children at risk of developing hypertension could potentially counteract its growing burden among both children and adults," said Hanssen.

Researchers noted limitations of their study include that they could not confirm blood pressure measurements over a single 24-hour period, so they would not account for "white coat" hypertension, a condition where patients have high blood pressure readings when measured in a medical setting.

Developmental stage including puberty status of each child was not accounted for in the study, as well as genetic factors or birth weight - variables that could impact blood pressure development and microvascular health.

In addition, reference values for appropriate retinal vessel diameters in children do not currently exist, so future studies are needed to determine age-related normal values during childhood.

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