Childhood obesity has tripled in the past 30 years. More than one out of every three children and adolescents are overweight or obese. Overweight and obese youth are at substantially increased risk for serious health issues, including cardiovascular disease, diabetes, bone and joint problems and stroke, according to the Centers for Disease Control and Prevention.
Once again, research points clearly to policy and behavior changes. We know that diet and physical activity can make a real difference in reducing obesity and that, for young people, school-based interventions can be particularly effective.
Coloradans agree with the research. A statewide survey conducted by the national polling firm American Viewpoint revealed overwhelming support among Coloradans — regardless of political affiliation — for higher nutrition standards in our schools. Eighty-eight percent of Coloradans said it was "very or somewhat important" for schools in Colorado to limit the availability of high fat and high sugar foods; 94 percent would either strongly or somewhat support "an effort to increase nutritional standards for school lunches reducing high fat and high caloric foods in favor of more fresh fruits, fresh vegetables and other health choices."
It was in this environment — an obesity epidemic, a growing body of research about the solutions to obesity, and sky-high public support for a stronger response — that the U.S. Department of Agriculture (USDA) earlier this year prudently proposed reasonable, evidence-based changes to incorporate more fruits and green vegetables into the nation's $11 billion school lunch program. The proposed changes to the school meal programs are based on sound nutritional science and the Institute of Medicine's recommendations.
Yet it was in this same environment that an influential segment of the food industry that included Coca-Cola, Del Monte Foods and ConAgra was recently able to persuade Congress to block federal funding from being used by the USDA to implement those proposed rules. Their arguments against the rules devolved into the absurd — suggesting, for example, that 2 ounces of tomato paste on a piece of pizza should count as a vegetable serving.
The forces behind evidenced-based policies to reverse obesity trends in Colorado and nationally have powerful allies: the facts and a growing recognition of the enormous public health consequences of this epidemic.
Wilkinson lost 30 pounds in 40 days, grazing on fresh vegetables and a daily portion of meat no bigger than a bar of soap. In two rounds of the diet, she lost a total of 48 pounds.
Another believer, Lisa Kolodziej of Nashville, went on the diet in August and lost 35 pounds in 40 days.
“I never would have tried a 500-calorie diet,” Kolodziej said. “They say it’s not healthy to do that, but I was flabbergasted at how the weight was just coming off.”
Proponents say the hormone, used for years as a fertility treatment, spurs stored fat cells to release their energy, which curbs fatigue and hunger during the low-calorie diet.
A version of the HCG (human chorionic gonadotropin) diet has been around for at least four decades but started growing in popularity after TV Dr. Mehmet Oz devoted a show to it in February. The hormone, derived from the urine of pregnant women, is produced in the hypothalamus, the area of the brain that controls appetite.
HCG is the marker that pregnancy tests check for, but men also can produce it. Physicians check for elevated levels in men when diagnosing testicular cancer, although Dr. David Penson, a urologic oncologist with Vanderbilt University Medical Center, said HCG doesn’t cause that cancer.
The weight-loss boost from HCG is more psychological than pharmacological, according to Roger Cone, who is chairman of the molecular physiology and biophysics departments at Vanderbilt University.
“There is absolutely no scientific or medical evidence to believe that it works,” Cone said, and any weight loss users experience is due to the low-calorie plan.
'Easy' lures people
But many Americans can’t help themselves when it comes to popular diets, said Ellen Granberg, a Clemson University sociology professor who has studied people who shed pounds and kept them off. They told her it took time to develop the discipline, effort, organization and maturity to stop looking for easy fixes.
“We are taught to believe that it should be easy to sustain a normal weight and it should be easy to lose weight, so if it is difficult, then something must be wrong,” Granberg said. “The first thing we think is ‘Something is wrong with this diet.’ ”
So Americans keep looking for a low-calorie diet with “sort of a gimmick on top of it,” or some other quick fix, Granberg said. Those gimmicks have included the African herb hoodia, the Amazon River Valley fruit acai and even tapeworms.
“One of my favorites is obesity soap,” she said. “This was from the early 20th century. You could see advertisements marketing obesity soap that would wash the pounds away.”
She said the first “pregnant pee” diet became popular in the 1970s and is now back as HCG. The Atkins diet followed a similar cycle: Dr. Robert Atkins published his first book in the 1970s and updated it in 2002. The diet plan became an industry, with retailers specializing in trademarked foods popping up.
For the HCG plan, the biggest expense is prescription-strength dosages of the hormone, which typically cost $300 to $900 for a 40-day supply — a cost that sometimes includes the medical exam.
Over-the-counter, weaker versions of the hormone are available at retailers for around $20. They come in oral drops.
Just a starting point
Despite the diet’s detractors, Dr. Marshelya Wilson of Nashville says it’s less risky and expensive than bariatric surgeries, which do have the FDA’s approval in certain cases of obesity.
“People have got to find other options that are not as invasive,” said Wilson, the prescribing physician for BYou Weightloss and Wellness in Green Hills.
She emphasizes that the diet is intended to be a starting point, not a long-term solution.
“We recommend it for people who are already thinking about making a lifestyle change,” Wilson said. “It is like any other lifestyle change that people embark on.”
But Dr. Tim Dibble, an internal medicine specialist who just opened Nashville Medical Weight Loss, decided not to offer the hormone even though his patients are asking for it.
“I didn’t want to anything that had a faddish component to it whatsoever,” said Dibble, who offers no easy fixes or quick starts for weight loss.
His program is based on individualized diets and helping people make lifestyle changes — what most physicians and registered dietitians recommend.
The quick weight loss at the front end of HCG is an indicator it won’t last, said Sarah-Jane Bedwell of Nashville, a registered dietitian in private practice. She expects HCG to have a short shelf life in the American public.
No comments:
Post a Comment