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
February 6,2020

Researchers have found the rates of lung cancer are higher in young women than men.

The study, published in the journal Pediatrics, examined lung cancer rates in young adults in 40 countries across five continents and uncovered a trend of higher lung cancer rates in women compared with men in recent years.

The emerging trend was widespread, affecting countries across varied geographic locations and income levels.

The changes appeared to be driven by a rising rate of adenocarcinoma lung cancer among women, said the study researchers from University of Calgary in Canada.

Lung cancer rates have been higher among men than women because men started smoking in large numbers earlier and smoked at higher rates; however, recent studies have reported converging lung cancer incidence rates between sexes.

Among men, age specific lung cancer incidence rates generally decreased in all countries, while in women the rates varied across countries with the trends in most countries stable or declining, albeit at a slower pace compared to those in men.

For the findings, lung and bronchial cancer cases between 30-64 age group from 1993-2012 were extracted from cancer incidence in five continents.

The study found the higher emerging rates of lung cancer in young women compared to young men.

According to the researchers, future studies are needed to identify reasons for the elevated incidence of lung cancer among young women.

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Agencies
June 24,2020

New Delhi, Jun 24: Expanding the testing criterion for coronavirus, the Indian Council of Medical Research has said it should be made widely available to all symptomatic individuals across the country.

"Since test, track and treat' is the only way to prevent spread of infection and save lives, it is imperative that testing should be made widely available to all symptomatic individuals in every part of the country and contact tracing mechanisms for containment of infection are further strengthened," it said in an advisory on 'Newer Additional Strategies for COVID-19 Testing' on Tuesday.

In its revised testing strategy for COVID-19 issued on May 18, the Indian Council of Medical Research (ICMR) had advised testing for all symptomatic Influenza-like illness (ILI) among returnees and migrants within seven days of illness.

All hospitalised patients who develop ILI symptoms, symptomatic individuals living within hotspots or containment zones and healthcare and frontline workers involved in containment and mitigation of coronavirus were also advised testing.

The apex health research body has also advised authorities to enable all government and private hospitals, offices and public sector units to perform antibody-based COVID-19 testing for surveillance to help allay fears and anxiety of healthcare workers and office employees.

The earlier advisories on rapid antibody testing advisories had focused on areas reporting clusters (containment zones), large migration gatherings/evacuees centers and testing of symptomatic ILI individuals at facility level.

Besides, the ICMR on Tuesday also recommended deployment of rapid antigen detection tests for COVID-19 in combination with RT-PCR tests in all containment zones, all central and state government medical colleges and government hospitals, all private hospitals approved by the National Accreditation Board for Hospitals and Healthcare (NABH), all NABL-accredited and ICMR approved private labs, for COVID-19 testing.

All hospitals, laboratories and state governments intending to perform the point-of-care antigen tests need to register with ICMR to obtain the login credentials for data entry.

"ICMR advises all state governments, public and private institutions concerned to take required steps to scale up testing for COVID-19 by deploying combination of various tests as advised," the advisory added.

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Agencies
June 17,2020

Leading physicians are celebrating a small dose of good news that arrived Tuesday about dexamethasone, a cheap and widely used steroid shown to be able to save lives among COVID-19 patients, but also cautioning against releasing study results by press release during a global health emergency, like in the case of the latest dexamethasone study by University of Oxford.

"It will be great news if dexamethasone, a cheap steroid, really does cut deaths by one-third in ventilated patients with COVID19, but after all the retractions and walk backs, it is unacceptable to tout study results by press release without releasing the paper", Atul Gawande, surgeon and CEO of Haven Healthcare, tweeted.

"Bottom line is, good news," Dr. Fauci, America's foremost infectious diseases expert told a US newswire on Tuesday, soon after the dexamethasone results were announced in the UK.

Fauci, who has long championed the therapeutics-first view said that dexamethasone is a "significant improvement" in the available therapeutic options currently available.

On Medical Twitter and Facebook, doctors broadly agree that dexamethasone use aligns well with the way COVID19 attacks the body's immune system. Fauci said the results in the Oxford study make "perfect sense" in that context.

"We should see the number of people who actually survive go up, if the study holds up," virologist and epidemiologist Dr. Joseph Fair told a television network.

Global coronavirus cases crossed 8 million on Tuesday. In the US, Texas and Florida are facing a new wave of cases after lifting lockdown orders earlier than medical experts recommended. Amidst the relentless graph upwards, the dexamethasone study results injected hope for better survival rates among those most seriously ill.

World Health Organization chief scientist Soumya Swaminathan welcomed the results from the randomised control trial.

Dr Eugene Gu, Founder and CEO of CoolQuit tweeted that he is "genuinely impressed" with the UK dexamethasone trial. This may be a "game changer", he wrote.

"There's no conflict of interest as dexamethasone is a generic steroid. The mechanism of action makes sense because steroids can reduce cytokine storms and overactive immune systems that makes COVID-19 so deadly. The number needed to treat is 8 ventilated patients which is great."

The Oxford study found that dexamethasone reduced deaths by 35 percent in patients who needed treatment with breathing machines and by 20 percent in those only needing supplemental oxygen. Dexamethasone was one of 5 drugs studied in a large clinical trial in the United Kingdom named RECOVERY, short for Randomised Evaluation of COVID-19 Therapy.

Peter Horby, chief investigator of the University of Oxford clinical trial, said dexamethasone is the first drug to be shown to improve survival in COVID-19. Details of the study have not been released. The trial organisers said they made their announcement via a news release because of "the public health importance of these results." According to Horby's public comments, there was a lot of initial resistance to studying steroids.

During the study, 2,104 patients were randomly selected to be given 6 milligrams of dexamethasone once a day (either by mouth or by intravenous injection) for 10 days. That group was compared with 4,321 patients who received the usual care alone.

Researchers estimated that dexamethasone would prevent one death for every eight patients treated while on ventilators and one for every 25 patients on extra oxygen alone.

UK experts have called the study results a breakthrough in the fight against the virus. The researchers have promised they would publish the results soon.

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