Category Archives: Weight Loss

The Joe Biden Diet

Dietitian Experiments With Low-Carb Eating for Five Years: Results?

Sous vide chicken and sautéed sugar snap peas

Registered Dietitian Joy Kiddie has a blog post summarizing the results of her five-year low-carb journey.

It starts thusly:

Tomorrow is March 5th [2022] and it is five years since I began my personal health and weight recovery journey that I’ve dubbed “A Dietitian’s Journey“.  While it began in 2017, in a way it still continues today and that is the point behind this post. 

Five years ago, I was obese, had type 2 diabetes for the previous 8 years, and had developed dangerously high blood pressure. 

Recommended. You’ll find out if low-carb eating put her diabetes into remission.

Steve Parker, M.D.

front cover of Conquer Diabetes and Prediabetes

Click to purchase at Amazon.com. E-book also available at Smashwords.com.

Weight-Loss Drugs: Semaglutide Versus Liraglutide

How much does it cost?

Semaglutide and liraglutide are drugs that were developed to treat diabetes and are FDA-approved for that. They are given by subcutaneous injection. Semaglutide is also FDA-approved for weight loss in non-diabetics if certain conditions are met.

Once-weekly semaglutide outperformed daily liraglutide in overweight and obese non-diabetics.

From JAMA Network:

Question  Among adults with overweight or obesity without diabetes, what is the effect of once-weekly subcutaneous semaglutide, 2.4 mg, vs once-daily subcutaneous liraglutide, 3.0 mg, on weight loss when each is added to counseling for diet and physical activity?

Findings  In this randomized clinical trial that included 338 participants, mean body weight change from baseline to 68 weeks was –15.8% with semaglutide vs –6.4% with liraglutide, a statistically significant difference.

Meaning  Among adults with overweight or obesity without diabetes, once-weekly subcutaneous semaglutide, compared with once-daily subcutaneous liraglutide, added to counseling for diet and physical activity resulted in significantly greater weight loss at 68 weeks.

For prevention or improvement of overweight- and obesity-related illnesses, aim for loss of at least 5 to 10% of body weight. Assuming you’re overweight or obese in the first place. 16% body weight change is significant. 16% of 300 pounds (136 kg) would be 48 pounds (22 kg).

Steve Parker, M.D.

PS: Needle-phobic? Try this instead:

Mediterranean Ranked Diet #1 Again

Grapes are a time-honored component of the Mediterranean diet

From CNN:

It’s a winning streak that just won’t quit. For the fifth year in a row, the Mediterranean diet was first across the finish line in the annual race for best diet, according to ratings announced Tuesday by U.S. News & World Report.

Coming in a close second, in a tie: The DASH diet, which stands for dietary approaches to stop hypertension and emphasizes reducing salt intake; and the flexitarian diet, which encourages being a vegetarian most of the time — but is flexible enough to allow a burger once in a while

All three of these diets reduce or eliminate processed foods, and stress packing your plate with fruits, vegetables, beans, lentils, whole grains, nuts and seeds.

I’m surprised they ranked Atkins as the “Best Fast Weight-Loss Diet.” Looks like we’re getting over our collective phobia about saturated fat. “Keto Diet” ranked #4 in that category.

Now that you’ve blown your New Year’s weight-loss resolution, resolve to do better and try one of my diets! February 1 is a good start date.

Steve Parker, M.D.

Who Says the Mediterranean Diet Is Best?

U.S. News and World Report once again ranks the Mediterranean diet #1 in Best Overall Diets:

It’s generally accepted that the folks in countries bordering the Mediterranean Sea live longer and suffer less than most Americans from cancer and cardiovascular ailments. The not-so-surprising secret is an active lifestyle, weight control, and a diet low in red meat, sugar and saturated fat and high in produce, nuts and other healthful foods. The Mediterranean Diet may offer a host of health benefits, including weight loss, heart and brain health, cancer prevention, and diabetes prevention and control. By following the Mediterranean Diet, you could also keep that weight off while avoiding chronic disease.

Source: What is the Mediterranean Diet? Best Diet Overall | U.S. News

I can’t find a date at the source URL but I think it was January , 2021,

Steve Parker, M.D.

front cover of Conquer Diabetes and Prediabetes

Click to purchase at Amazon.com. E-book also available at Smashwords.com.

Semaglutide Now Available to Help With Weight Loss

Potential customers

Semaglutide was originally FDA-approved as a treatment for type 2 diabetes. The drug mimics a natural hormone called glucagon-like peptide-1 (GLP-1). It will be sold under the trade name Wegovy. The dose of this injectable medication must be increased gradually over 16 to 20 weeks to 2.4 mg once weekly to reduce gastrointestinal side effects. I have no idea how much it will cost. From the FDA:

Today, the U.S. Food and Drug Administration approved Wegovy (semaglutide) injection (2.4 mg once weekly) for chronic weight management in adults with obesity or overweight with at least one weight-related condition (such as high blood pressure, type 2 diabetes, or high cholesterol), for use in addition to a reduced calorie diet and increased physical activity. This under-the-skin injection is the first approved drug for chronic weight management in adults with general obesity or overweight since 2014. The drug is indicated for chronic weight management in patients with a body mass index (BMI) of 27 kg/m2 or greater who have at least one weight-related ailment or in patients with a BMI of 30 kg/m2 or greater. 

Click for the FDA news release.

The most common side effects of semaglutide include nausea, diarrhea, vomiting, constipation, abdominal (stomach) pain, headache, fatigue, dyspepsia (indigestion), dizziness, abdominal distension, eructation (belching), hypoglycemia (low blood sugar) in patients with type 2 diabetes, flatulence (gas buildup), gastroenteritis (an intestinal infection) and gastroesophageal reflux disease (a type of digestive disorder).  

Steve Parker, M.D.

What’s the Best Type of Exercise to Reduce Obesity?

Steve Parker MD
Resistance training on left; treadmill on right can be high intensity

From Obesity Reviews:

Current international guidelines recommend people living with obesity should be prescribed a minimum of 300 min of moderately intense activity per week for weight loss. However, the most efficacious exercise prescription to improve anthropometry [measurements and proportions of the body], cardiorespiratory fitness (CRF) and metabolic health in this population remains unknown. Thus, this network meta‐analysis was conducted to assess and rank comparative efficacy of different exercise interventions on anthropometry, CRF and other metabolic risk factors.

* * *

Results reveal that while any type of exercise intervention is more effective than control [no particular exercise, if any], weight loss induced is modest. Interventions that combine high‐intensity aerobic and high‐load resistance training exert beneficial effects that are superior to any other exercise modality at decreasing abdominal adiposity, improving lean body mass and increasing cardiorespiratory fitness. Clinicians should consider this evidence when prescribing exercise for adults living with obesity, to ensure optimal effectiveness.

Source: What exercise prescription is optimal to improve body composition and cardiorespiratory fitness in adults living with obesity? A network meta‐analysis – O’Donoghue – – Obesity Reviews – Wiley Online Library

So, “combine high‐intensity aerobic and high‐load resistance training” to reduce body fat and increase fitness.

Steve Parker, M.D.

 

Ketogenic Diet More Effective Than Low-Fat for Obesity and Diabetes

One of many ketogenic salads

From The Journal of Nutrition:

For >50 y, dietary guidelines in the United States have focused on reducing intakes of saturated and total fat. However, rates of obesity and diabetes rose markedly throughout this period, with potentially catastrophic implications for public health and the economy. Recently, ketogenic diets have received substantial attention from the general public and nutrition research community. These very-low-carbohydrate diets, with fat comprising >70% of calories, have been dismissed as fads. However, they have a long history in clinical medicine and human evolution. Ketogenic diets appear to be more effective than low-fat diets for treatment of obesity and diabetes. In addition to the reductions in blood glucose and insulin achievable through carbohydrate restriction, chronic ketosis might confer unique metabolic benefits of relevance to cancer, neurodegenerative conditions, and other diseases associated with insulin resistance. Based on available evidence, a well-formulated ketogenic diet does not appear to have major safety concerns for the general public and can be considered a first-line approach for obesity and diabetes. High-quality clinical trials of ketogenic diets will be needed to assess important questions about their long-term effects and full potential in clinical medicine.

Source: Ketogenic Diet: Evidence for Optimism but High-Quality Research Needed | The Journal of Nutrition | Oxford Academic

     Steve Parker, M.D.

PS: A ketogenic diet is one of the options in The Advanced Mediterranean Diet, 2nd edition.

Despite Pasta, You Can Still Lose Weight With a Mediterranean Diet

spaghetti squash, spaghetti
Spaghetti squash is an alternative to pasta

The title above sums it up. If you’re eating pasta frequently and trying to lose weight, you do have to be careful not to over-eat. In other words, you generally have to restrict calories. In the study at hand, I don’t know how many daily calories were allowed since I haven’t read the full report. Here’s the abstract:

Background & aims

The effect of pasta consumption within a low-energy [read: calorie-restricted] Mediterranean diet on body weight regulation has been scarcely explored. This paper investigates the effect of two Mediterranean diets, which differed for lower or higher pasta intake, on body weight change in individuals with obesity.

Methods & Results

Forty-nine volunteers finished a quasi-experimental 6-month two–parallel group dietary intervention. Participants were assigned to a low-energy high pasta (HP) or to a low-energy low Pasta (LP) group on the basis of their pasta intake (HP ≥ 5 or LP ≤ 3 times/week). Anthropometrics, blood pressure and heart rate were measured every month. Weight maintenance was checked at month 12. Body composition (bioelectrical impedance analysis, BIA), food intake (24-h recall plus a 7-day carbohydrate record) and the perceived quality of life (36-item short-form health survey, SF-36) were assessed at baseline, 3 and 6 months. Blood samples were collected at baseline and month 6 to assess glucose and lipid metabolism. After 6-month intervention, body weight reduction was −10 ± 8% and −7 ± 4% in HP and LP diet, respectively, and it remained similar at month 12. Both dietary interventions improved anthropometric parameters, body composition, glucose and lipid metabolism, but no significant differences were observed between treatment groups. No differences were observed for blood pressure and heart rate between treatments and among times. HP diet significantly improved perception of quality of life for the physical component.

Conclusions

Independent of pasta consumption frequency, low-energy Mediterranean diets were successful in improving anthropometrics, physiological parameters and dietary habits after a 6-month weight-loss intervention.

Source: Body weight of individuals with obesity decreases after a 6-month high pasta or low pasta Mediterranean diet weight-loss intervention – Nutrition, Metabolism and Cardiovascular Diseases

Steve Parker, M.D.

No Big Difference Among Popular Diets

The french fries and 40 diet

From MedPage Today:

When it comes to choosing among popular diets, patients might as well choose the one they like. The diets all result in modest weight loss and their differences generally disappear at 12 months, scientists said.

The meta-analysis of 121 randomized clinical trials comparing 14 popular diets found that the top three in terms of mean weight loss and blood pressure reductions at 6 months were Atkins (5.5 kg, 5.1 mm Hg systolic); Zone (4.1 kg, 3.5 mm Hg); and DASH (3.6 kg, 4.7 mm Hg), reported Bradley Johnston, PhD, of McMaster University in Hamilton, Ontario, and colleagues.

However, as shown in the study online in The BMJ, the other popular diets were associated with some degree of weight loss and blood pressure improvement at 6 months, on the order of 2-3 kg for body weight and 3-4 mm Hg for systolic blood pressure.

By 12 months, the effects had diminished to the degree that the differences between diets were negligible, the team said.

None of the popular diets were associated with significant reductions in lipids, with the notable exception of the Mediterranean diet, for which there was a mean 4.59 mg/dL reduction in low-density lipoprotein (LDL) cholesterol at 6 months. The Mediterranean diet was also notable in that this effect did not diminish at 12 months, the researchers said.

Source: Study: No Big Difference Among Popular Diets | MedPage Today

Diets don’t work if you don’t follow them. Compliance drops off dramatically after 6-12 months. People go back to their old ways of eating and regain the last weight.

Steve Parker, M.D.

PS: The Advanced Mediterranean Diet is not popular. But if you don’t follow it, you’ll gain back the lost weight.