Monday, April 14, 2014

Can Video Games Make You Eat Too Much?

sharma-obesity-videogame-pacmanGenerally, TV viewing and playing video games are blamed for weight gain because of their sedentary nature (as opposed to more active recreational activities).

However, as has been argued before, the key impact of TV viewing and video gaming on body weight may well lie in their effect on food intake.

An elegant randomised controlled trial by Jason Gan and colleagues, published in APPETITE shows that vide0 gaming can lead to an increased intake of foods, particularly sweets.

The study involved 72 overweight/obese adult males, divided into three equal groups, randomised either to one hour of (i) watching TV; or playing (ii) a non-violent video game; or (iii) a violent video game.

This was followed by a 25 minute rest period with free access to a selection of sweet and savoury snacks/drinks. D

Heart rate, blood pressure, and stress measured by visual analogue scale (VAS)) were all significantly higher when playing video games compared to watching TV.

This increase in stress levels was associated with a 170 higher caloric intake and a preference for sweets and fatty foods in the video game group compared to the TV watchers.

In addition, the violent video games led to even higher stress levels with an even stronger preference for sweet foods.

Thus, the authors conclude that, compared to TV viewing, playing video games (especially violent ones) is associated with a stress response, and increased calorie intake.

This phenomenon may well confound previous findings that show associations between playing video games and weight gain, leading to the assumption that it is the sedentariness of video gaming that promotes weight gain, when it fact it may well be the associated impact on snacking.

@DrSharma
Edmonton, AB

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Friday, April 11, 2014

Does Eating More Protein Help Keep The Pounds Off?

sharma-obesity-diogeneslogoAs a regular reader, you may remember the DIOGENES trial, which studied the impact of different levels of protein intake on sustaining a weight-loss induced by eight weeks of a low-calorie formula diet (800 Kcal resulting in an average weight loss of about 11 Kg).

The original paper showed that individuals on a high-protein diet (providing 12 % more energy from protein that the low-protein diet) were about half as likely to discontinue the 26 week trial than those on a low-protein intake.

Now, a new paper from DIOGENES, published in the International Journal of Obesity, reports on the weight outcomes in participants, who were followed for up to 12 months in two of the participating centres (n=256).

The five ad libitum diets (no caloric restrictions) that followed the low-calorie diet (resulting in an average weight loss of about 11 Kg) were:

1) a low-protein and low-glycemic index diet,

2) a low-protein and high-glycemic-index diet,

3) a high-protein and low-glycemic-index diet,

4) a high-protein and high-glycemic-index diet,

5) a control diet.

While average weight regain over the 12-months was about 4 Kg (of the 11 Kg lost initially), the subjects on the high-protein diets kept off almost twice as much weight as those on the low-protien diets (glycemic index did not appear to make any significant difference).

Thus, the authors conclude that following a higher-protein ad libitum diet improves weight loss maintenance in overweight and obese adults over 12 months.

Clinicians may wish to stress the importance of maintaining a high-normal protein intake to clients trying to avoid regaining pounds that they have lost.

@DrSharma
Edmonton, AB

 

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Friday, April 4, 2014

Will Vitamin D Help You Lose Weight?

Vitamin D

Vitamin D

As a regular reader, you may well be aware of the discussions regarding a potential role of calcium and vitamin D in promoting weight loss.

Now, this issue was examined by Mason and colleagues in a 12 month randomised controlled trial, published in the American Journal of Clinical Nutrition.

The study involved 218 overweight/obese women (50-75 y of age) with moderate vitamin D deficiency (serum 25-hydroxyvitamin D [25(OH)D] ≥10 ng/mL but

The weight-loss intervention included a reduced-calorie diet (10% weight loss goal) and 225 min/wk of moderate-to-vigorous aerobic activity.

A total of 86% of participants completed the 12-mo measurements losing on average about 7 Kg, with no significant differences between the two groups.

There were also no significant differences in the reduction in BMI, waist circumference, percentage body fat, trunk fat, insulin or CRP levels.

At best, there was a slight trend towards greater benefits in women, who became replete with vitamin D supplementation compared to those who did not.

Thus, in summary, simply adding vitamin D to a weight loss regimen does little (if anything) to aid weight loss.

This is not to say that vitamin D supplementation in people with vitamin D deficiency may not be a good thing – it just does not appear to have much effect on body weight.

@DrSharma
Halifax, NS

ResearchBlogging.orgMason C, Xiao L, Imayama I, Duggan C, Wang CY, Korde L, & McTiernan A (2014). Vitamin D3 supplementation during weight loss: a double-blind randomized controlled trial. The American journal of clinical nutrition PMID: 24622804

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Friday, March 7, 2014

Leipzig Forging Its Way As Leaders in Obesity Research

Seal Faculty of Medicine, University of Leipzig, GermanyThis week, for the 5th consecutive year, I have had the privilege of participating in an extensive review of the obesity research program at the University of Leipzig.

I believe that it is fair to say, that starting from scratch, this centre has certainly shown a most remarkable growth and advancement in both fundamental and clinical aspects of obesity research.

It is indeed an honour to have had the opportunity to help evaluate and guide this world-class research program over the past five years.

It is particularly heartwarming to see how much emphasis this program has placed on supporting the career development of the next generation of obesity researchers in Germany.

As the program goes into the renewal phase for hopefully acquiring funding for the next five years, here is a link to past posts on their achievements.

@DrSharma
Leipzig, Germany

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Tuesday, March 4, 2014

Can Eating More Fat Make You Leaner?

sharma-obesity-visceral-fat-mriYes, if the excess fat is poly-unsaturated – no, if it is saturated.

At least this was the finding in an overfeeding study conducted by Fredrik Rosqvist and colleagues from the Uppsala University, Sweden, published in DIABETES.

The study with the memorable acronym LIPOGAIN, was a double-blind, parallel-group, randomized trial involving 39 young normal-weight individuals who were overfed muffins either high in saturated fats (palm oil) or in n-6 poly-unsaturated fats (sunflower oil) for seven weeks.

The number of muffins that each subject had to consume were individually adjusted to ensure that each subject increased their body weight by about 1.5 Kg (or 3%). To achieve this, the subjects consumed on average three muffins or about an extra 750 kcals/day.

However, where the excess calories went was quite different.

While the subjects eating saturated fat markedly increased their liver fat and gained almost twice as much visceral fat as those in the poly-unsaturated fat group, the latter experienced a nearly three-fold larger increase in lean tissue than the saturated fat group.

The two diets also had quite different effects on the expression of genes regulating energy dissipation, insulin resistance, body composition and fat cell differentiation in subcutaneous fat tissue.

Thus, the authors conclude that while overeating saturated fat promotes liver and visceral fat storage, the excess energy from poly-unsaturated fat may instead promote the growth of lean tissue.

What I learnt from this study is that there are indeed important differences in how the body handles excess calories depending on where they come from.

In that respect at least, not all calories are equal.

@DrSharma
Edmonton, AB

Fat Jokes Are Not Funny! Help publish this anti-bullying children’s book

ResearchBlogging.orgRosqvist F, Iggman D, Kullberg J, Jonathan Cedernaes J, Johansson HE, Larsson A, Johansson L, Ahlström H, Arner P, Dahlman I, & Risérus U (2014). Overfeeding Polyunsaturated and Saturated Fat Causes Distinct Effects on Liver and Visceral Fat Accumulation in Humans. Diabetes PMID: 24550191

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In The News

Diabetics in most need of bariatric surgery, university study finds

Oct. 18, 2013 – Ottawa Citizen: "Encouraging more men to consider bariatric surgery is also important, since it's the best treatment and can stop diabetic patients from needing insulin, said Dr. Arya Sharma, chair in obesity research and management at the University of Alberta." Read article

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