Healthy Frog

Diet and nutrition counseling for virtually all overweight and obese women of childbearing age can reduce health risks linked to excess weight for mothers and children alike, as per a newly released position paper from the American Dietetic Association and the American Society of Nutrition.

The position, reported in the recent issue of the Journal of the American Dietetic Association, represents the associations' official stance on obesity, reproduction and pregnancy outcomes:

Given the detrimental influence of maternal overweight and obesity on reproductive and pregnancy outcomes for the mother and child, it is the position of the American Dietetic Association and the American Society for Nutrition that all overweight and obese women of reproductive age should receive counseling previous to pregnancy, during pregnancy and in the interconceptional period on the roles of diet and physical activity in reproductive health, in order to ameliorate these adverse outcomes.

The joint ADA/ASN position and accompanying paper were written by Anna Maria Siega-Riz, PhD, RD, LDN, assistant professor of maternal and child health at the University of North Carolina; and Janet C. King, PhD, senior scientist at Children's Hospital and Research Center, Oakland, Calif.

An estimated 33 percent of U.S. women are obese, as per the authors, who write that a long-term goal of health professionals must be to reduce the number of women who become pregnant while obese. They add that the effect of a woman's nutritional status previous to pregnancy is an issue of great public health importance.

"Among obese women, who already have aberrations in glucose and lipid metabolism, the further adjustments induced by hormonal changes in pregnancy create a metabolic milieu that enhances the risk for metabolic disorders such as gestational diabetes mellitus and preeclampsia," as per the position paper.

Infants born to obese mothers have "a higher prevalence of congenital anomalies than do offspring of normal-weight women, suggesting that maternal (obesity) alters development in the sensitive embryonic period." The authors note neural tube defects such as spina bifida and anencephaly are about twice as common among children of obese women. "Other birth defects more frequent in offspring of obese women include oral clefts, heart anomalies, hydrocephaly and abdominal wall abnormalities."

Objectives of the new ADA/ASN position are to provide guidance to nutrition professionals in becoming aware of risks and possible complications of excess weight and obesity for fertility, course of pregnancy, birth outcomes and short and long-term maternal and child health; and to commit ADA and ASN to identifying gaps in scientific research needed to improve knowledge of risks and complications and develop effective strategies "that can be implemented before and during pregnancy as well as during the interconceptional period," the authors write.

The American Dietetic Association is the world's largest organization of food and nutrition professionals. ADA is committed to improving the nation's health and advancing the profession of dietetics through research, education and advocacy. Visit the American Dietetic Association at www.eatright.org/.


Posted by: Evelyn    Source

Questions for Health/Fitness experts:

First, I had bet $100 with a friend that I could lose 18 pounds in 19 days. After a week now, I realised it was a foolish bet and paid him off.
What started this bet was my cholesterol was at a extremely high level of 270 and I’m only 30 years old. In the process of this bet, I have lost 6 pounds over the last 7 days and want to continue to lose those last 12 pounds in a healthy way.

My first question is, I’ve been jogging/running 2-3 miles per day five times a week. I want to slowly bring that up to 5 miles per day. Problem is, after my runs my shin’s start to act up and become sore for a few hours. I’ve only been doing this for a week, so I’m not sure if this is a normal feeling after a running a few miles. Or is it my body trying to tell me I’m doing too much too soon. Should I cut back a little on my running to maybe 4 times a week?

Second question, is my diet and nutrition. I’ve cut out all sweets and junk food from my diet. But I wanted to know if anyone had a link to a good diet/nutrition web site? Basically looking for a healthy diet that would help me lose the most stored up extra fat on my body in the quickest time. (FYI, I’m 182 pounds now and looking to drop to 165-170 range).

Final question, with two small kids at home I don’t have time to hit the gym. Outside of jogging/running, I’ve also been doing 100 situps and 40 pushups per day. Does anyone have any other exercises I could do at home to help lose weight in my waist and mid section? Thanks for any help, it’s much appricated.

Answer 1: You’ve got a case of shin splints - don’t run on a hard surface…. get new running shoes. I always thought running or walking backwards helped shin splints, but that might be just an old wives tale.

Also don’t do too much running. Combine aerobic training with some weight training other days (even just dumbells at home). There are no specific exercises to reduce waist really, just have to increase your metabolism and decrease intake.

You can’t spot reduce so no excercise will help you lose inches of your midsection(despite what the commercials say). Your midsection gets smaller from overall weightloss, not sit ups, crunches or any other core training exercise.

Answer 2: According to my doctor running intervals will burn more calories in the long run than jogging. Also, I used to get shin splints, and a buddy of mine showed me a trick he used. After running, run an ice cube up and down each shin until the cube melts. Sounds simple, but it worked for me. It also might be your shoes. Go to a real running store (Fleet Feet, Road Runners, etc), and have them identify your gait. They can then show you which shoes are best for your running style. Good luck, and keep it up!

Answer 3: If I were you I would not jump right in and run that frequently. That is probably the reason you are getting shin splints. also, running on a track or grass is much better than pavement in that regard. As far as waistline reduction, you need to just reduce calories so you burn fat. As other posters have said, you can’t spot reduce.

One great way to incorporate more exercises into your aerobic activity is with conjugate training. One circuit might be, sprint 50 yards, drop do 20 pushups, sprint another 50, do some bodyweight squats, sprint 50 do some situps.

That will work you more efficiently than running for distance and is actually more effective at burning fat. Good luck and good health.

P.S. You could also purchase a doorway pull-up bar and some dumbbells for variety.

Answer 4: Your diet is good so far - eliminate sugars and simple carbs. Be mindful that you get alot of that with what you drink, even gatorade. Try drinking only water for 2 or more weeks (no alcohol, no juice). Take a B-complex and Calcium supps to aid your metabolism and lost nutrients from working out. Consume lots of high fiber foods (mainly green veggies) and take probiotics to help your digestion.

For your cholesterol, garlic as a supplement is highly recommended. Add it to your food too. Use only regular butter or extra virgin olive oil for cooking (no margarine or substitutes). If you want to eat eggs only eat the white. Other than that, read labels and watch your calories and you could lose the weight pretty fast.

Answer 5: I do Cross fit. I started with Body for Life, then went through several iterations of sports related workouts (Hockey player, so I did hockey related workouts) Now I’m doing crossfit (see link) It’s advanced, so you have to be very careful with how you do it, but it is an intense workout. BFL will give you a good idea about how to deal with diet, and is probably one of the best diet/exorcize combo’s I’ve seen because it preaches balance, which is key to long-term results. Shin-splits: Ice them down post run. run every other day rather than stacking one day on top of another. In between days do some wieght training, or resistance training (pushups, pull ups, body-weight squats, sit ups to start) your body will adjust, but also be sure you have good shoes- watch for arch support- key to avoiding shin splits…

Also, you can help get rid of shin splints by strengthening the muscles in the front of your lower leg. The exercise movement would be the same as hanging a bucket filled with sand off of your toes and moving your foot slowly up and down. This is an easy exercise to do just by creating resistance with your other foot or using an object.

Answer 6: Running first thing in the morning is a plan, but be advised if you have any possibility of cardiac problems this can have a fatal outcome. I forget each and every physiologic reason but something to the effect of the tendency of clots to form and spread to the heart is significantly increased in exerciseing on a empty stomech in the morning. A running guru of the eighties Jim Fixx was thought to have this as a contributory factor in his death of cardiac arrest during a early morning no breakfast run.

Answer 7: To maximize caloric burn relative to what your body can handle use a form of circuit training. I know this because, as a type II diabetic, my goal is often to burn as many carbs as I can in a given time period, in order to drop my blood sugar. I test before and after, so I know what works.

The way to do this is to 1)get your heartbeat up to your target range and keep it there; 2) use as many different sets of muscles as you can; and 3) minimize the risk that you will suffer an overuse injury relative to what your body can handle, as you obviously just did.

So, do a broad series of exercizes, without too severe pressure on your body, and no more than 30 seconds of rest in between. This can include intervals on the treadmill, pushups, abs/gluts on the exercize ball, no weight squats agains a wall, light dumbells, Therabands, etc. Several days a week, you can add somewhat heavier weights as well.

Stretch before and after. Since you aren’t straining any specific body segments, this type of routine can be done more than once a day. A half hour of this twice a day can work wonders. A link below to one example. (Btw, when you first posted and talked about what you intended to do with jogging to win your bet, my first response was: tendonitus. No one can go from zero to that much training overnight.)

Great article here on some exercises and stretches you can do to avoid injuring (prehab) your shoulder. A lot of people end up with damaged shoulders as they continue exercising due to focusing too much on the bigger lifts and not enough on the support muscles.

I especially like the 3 stretches. Admittedly I haven’t tried the exercises yet, but I will now after reading that doing pullups without working on the shoulders can lead to injury since shoulders are active on your way down.

Young children who do not display an ability to regulate their behavior or to delay gratification in exchange for a larger reward appear predisposed to gain extra weight by their pre-teen years, as per two reports reported in the recent issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

"Obesity in childhood and adolescence appears to track into adulthood, increasing the risk of developing cardiovascular disease, diabetes mellitus and certain cancers in adulthood," the authors write as background information in one of the articles. "To mount effective preventive efforts, we need better information regarding the factors involved in the etiology of childhood overweight and obesity".

In one study, Lori A. Francis, Ph.D., and Elizabeth J. Susman, Ph.D., of Pennsylvania State University, State College, assessed self-regulation behavior in 1,061 children. Data were collected when children were ages 3, 5, 7, 9, 11 and 12 years old. At age 3, the children participated in a self-control evaluation that involved sitting alone in a room with a toy for 150 seconds. Those who waited at least 75 seconds to play with the toy were classified as high in self-regulation. At age 5, the children participated in an exercise in delayed gratification that involved choosing a smaller portion of a favorite food immediately or a larger portion several minutes later. High self-regulation was defined as waiting at least 210 seconds to eat the food.

Compared with children who showed high self-control on both tests, those who were unable to regulate their behavior at both ages had the highest body mass index (BMI) scores for their age at 12 years and the most rapid increases in BMI over the nine-year follow-up.

"The findings reported herein have potential for early prevention of obesity," the authors write. "The implication is that interventions to enhance energy-balance regulation in young children will benefit from efforts to encourage self-regulation in other domains, such as encouraging self-control and delay of gratification, both of which are important factors in regulating energy intake".

In another study, Desiree M. Seeyave, M.B.B.S., of the University of Michigan, Ann Arbor, and his colleagues used a similar self-imposed waiting task to gauge 4-year-olds' ability to delay gratification. The children were asked to choose candy, animal crackers or pretzels as their preferred food and then left alone with two plates of different quantities of the food. "The child was told that he would be allowed to eat the large quantity of the chosen food if he waited until the examiner returned," the authors write. "If he could not wait until the examiner returned, he could ring a bell to summon the examiner back into the room, at which time he could eat the small quantity".

Of the 805 children who participated, 47 percent failed the test, either by ringing the bell before the seven-minute waiting period elapsed, spontaneously beginning to eat the food, becoming distressed, going to the door or calling for a parent or the examiner.

Those who displayed a limited ability to delay gratification were 29 percent more likely to be overweight at age 11. The association was partially explained by mothers' weight status. "The influence of maternal weight status on child weight reflects genetic as well as environmental factors, such as feeding patterns and availability of food," the authors write.

Parenting techniques appears to be available to help children develop an ability to delay gratification, the authors note. "Some strategies that have been described in previous studies have been keeping the desired item (in this case, food) out of sight (and therefore out of mind) or distracting the child's attention from the food to another engaging activity. Another possibility is simply providing a logical structure to snacks and mealtimes such that the child learns that food is not to be eaten the moment it is desired, but to wait until the next snack or meal time," the authors write.

(Arch Pediatr Adolesc Med. 2009;163[4]:297-302, 303-308. Available pre-embargo to the media at www.jamamedia.org.).

Editor's Note: Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.


Editorial: Possibilities Exist for Improving Children's Self-Control
"Can a child's self-regulation capacity be changed or is it an innate and immutable human trait?" write Robert C. Whitaker, M.D., M.P.H., and Rachel A. Gooze, B.A., of Temple University, Philadelphia, in an accompanying editorial. "Self-regulation is shaped by both nature and nurture; it is influenced by environments and experiences during early childhood".

"There are still not any tested 'office-based' interventions for improving children's capacity for self-regulation," they write. "However, there are promising results from randomized controlled trials showing that interventions in preschools can increase children's positive social behaviors".

(Arch Pediatr Adolesc Med. 2009;163[4]: 386-387. Available pre-embargo to the media at www.jamamedia.org.).

Editor's Note: Please see the article for additional information, including author contributions and affiliations, financial disclosures, funding and support, etc.


Posted by: Evelyn    Source

Factors identified early in childhood could predict obesity in the teen years and beyond, and scientists continue to assess methods to prevent and treat excess weight gain and its consequences in children and teens, as per several reports reported in the recent issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

The issuea theme issue on childhood obesity and diabetesis being published in conjunction with a JAMA theme issue on diabetes. The recent issue of Archives of Ophthalmology and Archives of Neurology, along with the April issues of Archives of Dermatology and Archives of Surgery, also feature research on diabetes, obesity and their related co-morbidities.

Studies featured in this issue include the following:


School-Based Intervention Changes Some, But Not All, Behaviors and Measures of Obesity
An interdisciplinary program designed to increase awareness of obesity and change the behaviors of Dutch school children appears to have reduced the amount of sugary beverages consumed by boys and girls and also improved body composition in girls alone, but did not seem to affect other behaviors. Amika S. Singh, Ph.D., and his colleagues at VU University Medical Center, EMGO Institute, Amsterdam, the Netherlands, assessed the effectiveness of the intervention among 1,108 adolescents (average age 12.7). The program included 11 lessons in biology, physical education and changes in lifestyle over eight months.

Students at the 10 schools that participated in the program drank fewer sugar-sweetened beverages at the end of the intervention (287 milliliters per day less for boys and 249 milliliters per day less for girls) and 12 months later (233 milliliters per day less for boys and 271 milliliters per day less for girls) than did those in the eight schools that did not participate. In addition, at a 20-month follow-up, the intervention remained effective in preventing unfavorable increases in the sum of all skinfold measurements (taken at the triceps, biceps, below the shoulder and between the hip joint and ribcage) in girls. However, no changes were seen in consumption of snacks or in walking or biking to school.

"Hence, our results do not show consistently positive findings on all anthropometric and behavioral outcome measures. Our findings are important, particularly when considering the need for evidence on the long-term effectiveness of interventions in the field of obesity prevention," the authors write. "Reducing intake of sugar-containing beverages should therefore be considered a good behavioral target for future interventions aimed at the prevention of overweight among adolescents".

Schools remain "an obvious and important channel for providing obesity-prevention programs, as the vast majority of youth spend a great deal of time each week throughout their development from childhood to young adulthood in schools," writes Leslie A. Lytle, Ph.D., of the University of Minnesota, Minneapolis, in an accompanying editorial. "However, as the extent of the published research in this field is substantial and the findings consistently mixed and modest, it appears to be time to re-evaluate where the research needs to move".

(Arch Pediatr Adolesc Med. 2009;163[4]:309-317, 388-389. Available pre-embargo to the media at www.jamamedia.org. To contact Amika S. Singh, Ph.D., e-mail a.singh@vumc.nl. To contact Leslie A. Lytle, Ph.D., call Laura Stroup at 612-624-5680 or e-mail stro0481@umn.edu.)




Replacing Sugary Beverages With Water Is Associated With Decreases in Children and Teens' Calorie Intake

Encouraging children and teens to drink water instead of sugary beverages is linked to decreases in their total calorie intake of an average of 235 per day. Y. Claire Wang, M.D., Sc.D., of Columbia Mailman School of Public Health, New York, and his colleagues assessed data from 3,098 children and teens (age 2 to 19) participating in the 2003-2004 National Health and Nutritional Examination Survey. The participants reported which beverages they consumed during two separate 24-hour periods.

Every additional 8-ounce serving of sugary beverages the children and teens drank corresponded to an additional 106 calories in their daily dietsimilar to the amount of calories in each beverage, suggesting that individuals do not compensate for these calories by eating less. "Our results also indicate that replacing sugar-sweetened beverages with water is linked to a significant decrease in total energy intake," the authors write. "Each 1 percent of beverage replacement was linked to a 6.6-calorie lower total energy intake, a reduction not negated by compensatory increases in other food or beverages".

The results suggest that reducing the amount of sugary beverages children drink could reduce their risk for obesity, but only if those beverages are replaced with water instead of milk or juice, the authors note.

(Arch Pediatr Adolesc Med. 2009;163[4]:336-343. Available pre-embargo to the media at www.jamamedia.org. To contact Y. Claire Wang, M.D., Sc.D., call Stephanie Berger at 212-305-4372 or e-mail sb2247@columbia.edu.)




Study Identifies Racial Disparities in Childhood Obesity

Obesity appears twice as common among American Indian and Native Alaskan children than non-Hispanic white or Asian children at age 4. Sarah E. Anderson, Ph.D., of The Ohio State University College of Public Health, Columbus, and Robert C. Whitaker, M.D., M.P.H., of Temple University, Philadelphia, studied a nationally representative sample of 8,550 U.S. children born in 2001. In 2005, 18.4 percent of the 4-year-olds were obese, including 31.2 percent of American Indian/Native Alaskan children, 22 percent of Hispanic children, 20.8 percent of non-Hispanic black children, 15.9 percent of non-Hispanic white children and 12.8 percent of Asian children.

"To help arrest the trends in childhood obesity, both the Surgeon General and the Institute of Medicine have recommended that obesity-prevention efforts begin early in life," the authors write. "These efforts might benefit from a better understanding of how differences in obesity risk between racial/ethnic groups emerge early in the life course. Because families are the social units with the greatest influence on very young children, future research might focus on racial/ethnic differences in household behaviors that affect obesity and how these behaviors are influenced by the community context".

(Arch Pediatr Adolesc Med. 2009;163[4]:344-348. Available pre-embargo to the media at www.jamamedia.org. To contact Sarah E. Anderson, Ph.D., call Christine O'Malley at 614-293-9406 or e-mail comalley@cph.osu.edu.)




Teens Who Give Birth More Likely to Be Overweight

Girls who give birth between ages 15 and 19 appear to be substantially heavier, with more abdominal fat, regardless of their childhood weight or of other risk factors for weight gain. Erica P. Gunderson, Ph.D., of Kaiser Permanente, Oakland, Calif., and his colleagues studied 1,890 girls (983 black and 907 white) who were age 9 to 10 at the beginning of the study in 1987-1988. After nine to 10 yearsin 1996-199731 percent of black girls and 10 percent of white girls had given birth during adolescence or young adulthood. Those who did were more likely to experience increases in weight, body mass index, hip circumference and percentage of body fat. The association was stronger among black women than white women.

"Our findings are potentially important because adolescence has been identified as one of the critical periods of development that set the stage for the onset of obesity during the later part of life," the authors write. "Earlier age at a first birth (younger than 20 years) has been linked to increased rates of coronary heart disease in women. Thus, the influence of gestational weight gain on changes in growth and adiposity during adolescence is an important aspect for future investigation".

(Arch Pediatr Adolesc Med. 2009;163[4]:349-356. Available pre-embargo to the media at www.jamamedia.org. To contact Erica P. Gunderson, Ph.D., call Danielle Cass at 510-267-5354 or e-mail danielle.x.cass@kp.org.)




Diabetes and Blood Pressure Medication Prescriptions Increase Among Children and Teens

The number of children and teens prescribed medicine to treat hypertension or diabetes appears to have increased between 2004 and 2007. Joshua N. Liberman, Ph.D., of CVS Caremark in Hunt Valley, Md., and his colleagues analyzed the prescription records of more than 5 million commercially insured individuals ages 6 to 18 covered by a pharmacy benefits manager.

The prevalence of children and teens who were prescribed medications for high blood pressure (high blood pressure), dyslipidemia (abnormal cholesterol) or diabetes (including insulin) increased 15.2 percent, from 3.3 per 1,000 youths in November 2004 to 3.8 per 1,000 youths in June 2007. "The increasing use of oral anti-diabetic and antihypertensive pharmacotherapy among children and adolescents, particularly in the younger age group, indicates either an increased awareness of therapy needs or increased occurence rate of cardiovascular risk factors typically linked to adult populations," the authors write.

When assessed separately, cholesterol-controlling treatment was uncommon (prescribed to 0.2 per 1,000 youths overall) and declined 22.9 percent during the study period. "The decrease in therapy of dyslipidemia may reflect the ongoing controversy regarding statin use," the authors conclude.

The results indicate that these drugs are not currently being overused in this population, writes Stephen R. Daniels, M.D., Ph.D., of the University of Colorado Denver School of Medicine, in an accompanying editorial. "While the potential for misuse of these medications remains, that does not appear to be happening at this time. Nevertheless, it will be important to collect data in an ongoing manner to monitor use of these medications but also to identify appropriateness of use and ultimate reduction of risk factor levels in children and adolescents".

(Arch Pediatr Adolesc Med. 2009;163[4]:357-364, 389-391. Available pre-embargo to the media at www.jamamedia.org. To contact Joshua N. Liberman, Ph.D., call Christine K. Cramer at 401-770-3317 or e-mail ckcramer@cvs.com. To contact Stephen R. Daniels, M.D., Ph.D., call Susan Hotchkiss at 720-777-2766 or e-mail hotchkiss.susan@tchden.org, or call Jim Spencer at 303-724-5377 or e-mail jim.spencer@ucdenver.edu.)

Editor's Note: Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.


Posted by: Evelyn    Source