Seasonal Affective Disorder; Sunlight Affects Weight, Appetite, Leptin, Ghrelin

Patients have been asking about SAD/Seasonal Affective Disorder and the effect of daylight on appetite and weight. The days are finally starting to get longer - thank goodness - but many people are still feeling the effects of the long nights and short days. Those who work indoors can suffer even more, heading to work in the morning in the dark, and then heading home at night in the dark; we can feel like cave dwellers! Some can even have Seasonal Affective Disorder (learn more here: http://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/basics/symptoms/con-20021047 )

Can we lose weight by getting morning sunlight?  Well, the jury is still out on this one, but research suggests that there may be a connection between bright morning light and lower weight:

"Timing and Intensity of Light Correlate With Body Weight In Adults"  http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0092251

And here is a good article with an interview with the lead researcher:  http://healthyliving.msn.com/health-wellness/the-morning-light-may-help-you-stay-slim-1  

"We were very interested in looking at the relationship between lighting and how that may be affecting your weight," explained study senior author Dr. Phyllis Zee, director of the sleep disorders center at Northwestern University Feinberg School of Medicine inChicago….Zee said the strongest association was seen in people exposed to light that was at least 500 lux, which is the equivalent of a well-lit indoor room. Outside on a sunny day provides 1,000 lux or higher, while most indoor rooms are about 200 to 250 lux, according to Zee...But, the timing of the light also mattered. Those who were exposed to brighter light earlier in the day were the slimmest."

Previous studies have also shown a connection between light, appetite, metabolism, and weight.  From the PLOS ONE research article:  "Several studies now indicate that morning light exposure influences body fat [3], [4] as well as the level of appetite regulating hormones... leptin and ghrelin [5]...The results of this study demonstrate that the timing of even moderate intensity light exposure is independently associated with BMI….Our findings, similar to those from two different animal models [7], [8] found that changes in the timing of light exposure were associated with body weight independent of caloric intake. One possible mechanism linking light directly to BMI, rather than caloric intake may be the influence of light on the expression and secretion of hormones, such as melatonin."

So, the research is still in early stages, we are not quite sure which hormones are being affected, and how the light might lead to lower weight.  From a practical standpoint, should we do anything?

Well, it can't hurt to get out and get a morning walk in the sunlight.  Heck, it might even help! You may want to consider Light Therapy Lights for Seasonal Affective Disorder, such as: Sunbox, Apollo, Verilux, and Northern Lights. Learn more about light therapy: http://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/in-depth/seasonal-affective-disorder-treatment/art-20048298

• Danilenko KV, Mustafina SV, Pechenkina EA (2013) Bright light for weight loss: results of a controlled crossover trial. Obes Facts 6: 28–38. doi: 10.1159/000348549

Dunai A, Novak M, Chung SA, Kayumov L, Keszei A, et al. (2007) Moderate exercise and bright light treatment in overweight and obese individuals. Obesity (Silver Spring) 15: 1749–1757. doi: 10.1038/oby.2007.208

Figueiro MG, Plitnick B, Rea MS (2012) Light modulates leptin and ghrelin in sleep-restricted adults. Int J Endocrinol 2012: 530726. doi: 10.1155/2012/530726

How much caffeine in chocolate covered coffee beans? Death by caffeine?

Caffeine was the topic of my first post back in 2009: (http://healthyweightcenter.blogspot.com/2009/01/caffeine-confusion.html), and a family member just asked me how much caffeine is in various drinks and food - including those popular chocolate-covered coffee beans.   Great question, since excess caffeine can cause insomnia, anxiety, racing heart/palpitations, elevated blood pressure, and even death (there have been some tragic cases over the last year:  http://www.dailymail.co.uk/news/article-2867551/Dead-teens-parents-seek-ban-caffeine-powder.html )

Caffeine can be safe for many people, however, when consumed in small amounts. Studies have found that there may be some benefit with small amounts of caffeine, including increased alertness and mental focus, and ability to 'multitask' or switch tasks:  http://www.sciencedirect.com/science/article/pii/S0301051106000330  But too much of a 'good thing', and mental confusion and agitation can occur.  Each person must monitor his/her own response to caffeine, become educated about side effects and proper usage, and 'be smart' about it! Caffeine withdrawal - which includes headache, fatigue, and irritability - can be avoided by keeping daily caffeine intake stable, consuming small amounts at about the same time, in the same dose, every day. http://www.sciencedaily.com/releases/2009/05/090501162805.htm

So, how much is too much?  Here is a great resource about caffeine use in kids, for parents:  http://www.bced.gov.bc.ca/health/caffeine.pdf
It turns out that THREE little chocolate-covered coffee beans have 36 mg of caffeine.  Yikes!   That's as much as a cup of regular tea, or a can of regular or diet cola!  Eight ounces of coffee can vary considerably in caffeine content - from 75-200 mg of caffeine:  http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/in-depth/caffeine/art-20049372

Want to calculate how much caffeine it would take to kill you?  Turns out there's an app for that:  http://www.caffeineinformer.com/death-by-caffeine
Also a list of caffeine content for drinks by brand:  http://www.caffeineinformer.com/the-caffeine-database

So, for now, I think we'll keep it to three coffee beans per day!

For more information from the CDC on the dangers of caffeine and alcohol consumption:  http://www.cdc.gov/alcohol/fact-sheets/caffeine-and-alcohol.htm
For more on caffeine use by children and teens:  http://www.medicalnewstoday.com/articles/272426.php

Train Your Brain to Crave Healthy Food instead of Junk Food: MRI Research at Tufts

Can we actually change how our brain responds junk food - actually switch OFF our cravings for junk food, and switch ON our cravings for healthy food?  The answer is yes - and this is pretty big news, since many people are afraid they will forever struggle with junk food cravings, and this fear may prevent them from undertaking a healthy weight program.  The good news is that we've seen this clinically in our patients for many years  - that structure, coaching, support, specific planning, and time spent practicing a new healthy pattern - can lead to FREEDOM from junk food cravings.  (Some have even been alarmed/shocked that they developed a craving for fresh salads, and an aversion to junk food).  Now new preliminary MRI research from Tufts shows this very phenomenon is VISIBLE on brain scans, after six months of behavioral training!  We can actually CHANGE our brains, to prefer, even crave, healthy food over junk food.  http://www.nature.com/nutd/journal/v4/n9/abs/nutd201426a.html *  

The article notes the connection between junk cravings in the brain, and obesity: "Obesity is associated with hyperactivation of the reward system for high-calorie (HC) versus low-calorie (LC) food cues, which encourages unhealthy food selection and overeating."

Those in the behavioral intervention group lost an average of almost 14 pounds after six months of training (vs. those in the control group, who actually gained an average of almost 5 pounds), AND those who lost weight through the behavioral program actually changed their brains toward healthier responses - their brain activation on the MRI showed that their "reward areas" in the brain now preferred healthy food. "This study provides the first demonstration of a positive shift in activation of the reward system toward healthy versus unhealthy food."

According to the news release from Tufts: “Although other studies have shown that surgical procedures like gastric bypass surgery can decrease how much people enjoy food generally, this is not very satisfactory because it takes away food enjoyment generally rather than making healthier foods more appealing,” said first author and co-corresponding author Thilo Deckersbach, Ph.D., a psychologist at Massachusetts General Hospital. “We show here that it is possible to shift preferences from unhealthy food to healthy food without surgery, and that MRI is an important technique for exploring the brain’s role in food cues.” The diet the patients were coached on, compared to the standard American diet, was lower in glycemic index, and higher in protein and fiber.  

http://now.tufts.edu/news-releases/training-your-brain-prefer-healthy-foods

It is pretty remarkable that researchers were actually able to see on brain scans, what we have observed in our clinic - that behavioral interventions/healthy lifestyle training and support, can change people's preferences to healthy food, and away from junk food.  The editor notes that more research is needed, but that "individuals on a structured behavioral weight loss program had a change in brain activation on MRI towards low calorie vs high calorie foods at the end of a six month period…this study is the first to show that brain activation can be altered toward healthy vs unhealthy foods by a behavioral intervention."

This is pretty big news, since many people are afraid that they will always struggle with intense cravings for junk food - and this fear of suffering, and failure, can prevent them from ever starting a healthy weight program!

We employ a comprehensive, whole-person approach at our clinic, and individualize our care to meet each person's unique circumstances.  We look at the individual, their current lifestyle, their challenges, and them create specific strategies to create a healthy plan for nutrition, exercise/activity, lifestyle, and we also address medical issues that may be contributing to unhealthy weight, or caused by unhealthy weight.  Unlike mere lifestyle programs, we can also address medical factors, and discuss options for medical assistance with weight, as well (there are multiple new medications, in addition to older medications, which can help control food cravings while we work behaviorally on strategies which may ultimately help control cravings without medication.)   Read more about our program: http://www.physicianshealthyweightcenter.com   

You can call or email us today for more information: (603) 379-6500.  

*Citation: Nutrition & Diabetes (2014) 4, e129; doi:10.1038/nutd.2014.26

Published online 1 September 2014

"Pilot randomized trial demonstrating reversal of obesity-related abnormalities in reward system responsivity to food cues with a behavioral intervention"

T Deckersbach1, S K Das2, L E Urban2, T Salinardi2, P Batra2, A M Rodman1, A R Arulpragasam1, D D Dougherty1 and S B Roberts2

• 1Division of Neurotherapeutics, Department of Psychiatry, Harvard Medical School, Boston, MA, USA
• 2Energy Metabolism and Obesity Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA

Correspondence: Dr T Deckersbach, Division of Neurotherapeutics, Department of Psychiatry, Massachusetts General Hospital, 73 High St. Charlestown, Boston, MA 02129, USAE-mail:Deckersbach.Thilo@mgh.harvard.edu; Dr S Roberts, Energy Metabolism and Obesity Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington St. Boston, MA 02111, USA. E-mail: Susan.Roberts@tufts.edu

http://time.com/3256618/brain-training-healthy-food/

Flashback Thursday: Seasonal Eating Challenges ("Seasonal Eating Disorder"!)

Seasonal Eating Challenges

If you are finding yourself nibbling before dinner, and craving sweets after dinner, you are not alone!  The short days and long nights can lead to what we call ‘Seasonal Eating Disorder’ - you can feel like a bear packing on the weight to get ready for hibernation!  Researchers believe the cravings are tied to a drop in serotonin levels, due to the decreased daylight.  You can feel tired, cranky, and out-of-control, and all that extra snacking can add up to hundreds of extra calories, and “weight creep.”

In addition to appetite changes, holiday meals and treats make the challenge even tougher.  If you are in charge of preparing a holiday meal, or even tonight’s dinner, you probably know how easy it is to taste and snack while you are cooking.  You can end up eating  hundreds of extra calories before you even start the official meal.  Even worse, if you are hungry while preparing the meal, and try to hold off on snacking, you may find you are starving and ‘out of control’ by the time you serve dinner, and end up eating FAR more than you meant to!  Fortunately, there is an easy fix for both of these problems.  

A high-protein, tasty, low calorie snack can really ‘save the day’ while you are cooking or  waiting for the big meal.  Studies show that protein can calm your appetite, quell your cravings, and put you back in control. Protein can actually raise your metabolism slightly, and help you eat fewer calories at dinner and afterward (and studies show that eating snacks with liquid volume such as soup before dinner can result in the consumption of 20 % fewer calories.) Try pairing 'finger fruits' and vegetables such as red grapes, cherry tomatoes, sliced peppers, with a good high protein/low fat complement, such as low fat cheese (try Cabot 75 % fat free, or low fat cheese sticks) or 0% fat Greek yogurt turned into a 'dip'. We also have a variety of easy, delicious treats that meet the requirement - with  only 80 calories and 15 grams of protein.  Our special  high-protein (low sodium) soups, hot chocolate, and high-protein decaf cappuccinos, are simple ways to meet the need. Sip while you cook, before dinner. If you're interested you can see some options on seacoastnutrition.com .

The same tactics are also useful to stop after-dinner cravings. With the short days, and long nights, many people notice that they find themselves wandering around the kitchen looking for something sweet or ‘carby’ after they’ve finished supper.  They try to fight the urge, but end up eating hundreds of calories of sweet treats.  What to do?   When it comes to cravings: “Don’t join them, beat them!”  You can still treat yourself to a snack and not sabotage all of your hard work.  Satisfy your ‘need for sweet’, while giving yourself the boost of protein (studies show it has a mental stimulant effect, as well as a metabolic stimulant effect), and save yourself calories. Instead of binging on Double Stuff Oreos, choose one of our delicious, sweet, high-protein lower calorie bars or snacks.  We have had many creative suggestions and recipes from our patients - read on for ideas.

1. Cut a protein bar into bite-sized pieces (cookie-sized, instead of cookies!)

2. Try one of our new fun snacks - Protein Party Mix (like Chex mix - only low calorie, and high protein), crispy Pizza snacks, and our new Cinnamon Swirls and Chocolate Bites!  So delicious, fun, and healthful.

3. Cut one of your protein bars into bite size pieces, then crumble it, and mix with air popped popcorn.

4. Pair our delicious high-protein hot chocolate with air-popped popcorn  - satisfying, fun, and it takes a while to eat and drink!

Other evening tips:  try to keep yourself busy, instead of eating!  Try a short exercise session before or after dinner.  Find a new hobby to occupy yourself (it’s hard to eat while knitting.)  Remove any tempting junk food from the house, or at least hide it on a top shelf, out of reach. Try reading a book with a nice cup of herbal tea. Find something creative to do with your partner.  And if all else fails, post a note on your refrigerator which says:  “Go to Bed, Instead!” (Beth’s quote!)

You can also try these easy, satisfying, tasty treats on Snow Days.  After playing outdoors with kids or friends, treat yourself to Protein Hot Chocolate, or Protein Cappuccino, or our delicious low-sodium high-protein soups.  A warm and tasty way to meet your nutritional and taste needs. You can find my favorite protein snacks at our store: http://www.seacoastnutrition.com

References

1.   N Engl J Med. 2010 Nov 25;363(22):2102-13. doi: 10.1056/NEJMoa1007137. Diets with high or low protein content and glycemic index for weight-loss maintenance. “ In this large European study, a modest increase in protein content and a modest reduction in the glycemic index led to an improvement in study completion and maintenance of weight loss.”  (Funded by the European Commission; ClinicalTrials.gov number, NCT00390637.). http://www.ncbi.nlm.nih.gov/pubmed/21105792

2.. 1990;39 Suppl 3:49-52. Carbohydrate craving. Relationship between carbohydrate intake and disorders of mood. “ The brain neurotransmitter, serotonin, seems to be involved in the abnormal regulation of mood and food intake that underlies diet failures or weight gain in individuals who suffer from carbohydrate craving obesity (CCO), premenstrual syndrome (PMS) and seasonal affective disorder (SAD). All 3 syndromes are characterized by episodic bouts of increased carbohydrate consumption and depressed mood.”

Wurtman JJ., MIT  http://www.ncbi.nlm.nih.gov/pubmed/2197075

Drugs.

3.. American Society for Nutrition, Effects of dietary glycemic index on brain regions related to reward and craving in men1,2,3,4Belinda S Lennerz, et al “Compared with an isocaloric low-GI meal, a high-GI meal...increased hunger, and selectively stimulated brain regions associated with reward and craving in the late postprandial (after-meal) period, which is a time with special significance to eating behavior at the next meal.” This trial was registered at clinicaltrials.gov as NCT01064778.

.http://ajcn.nutrition.org/content/early/2013/06/26/ajcn.113.064113.abstract

4.Int J Obes (Lond). 2009 Mar;33(3):296-304. doi: 10.1038/ijo.2008.278. Epub 2009 Jan 20.  Claessens M, van Baak MA, Monsheimer S, Saris WH.

The effect of a low-fat, high-protein or high-carbohydrate ad libitum diet on weight loss maintenance and metabolic risk factors.  “These results show that low-fat, high-casein or whey protein weight maintenance diets are more effective for weight control than low-fat, HC (high carb) diets and do not adversely affect metabolic and cardiovascular risk factors in weight-reduced moderately obese subjects without metabolic or cardiovascular complications.”

http://www.ncbi.nlm.nih.gov/pubmed/19153580

5. Eating Soup Will Help Cut Calories At Meals Science Daily, May 2, 2007"Consuming a first-course of low-calorie soup, in a variety of forms, can help with managing weight, as is shown in this research and earlier studies.”

http://www.sciencedaily.com/releases/2007/05/070501142326.htm

6. Cara B. Ebbeling et al. Effects of Dietary Composition on Energy Expenditure During Weight-Loss Maintenance.JAMA, June 27, 2012 DOI: 10.1001/jama.2012.6607

Weight Critics Only Make Things Worse!

Weight critics - we may run into them during the holidays, when getting together with well-meaning family and friends.  If you've ever experienced weight criticism yourself, you know how lousy it makes you feel.  Well, next time it happens, you can answer them back with the latest science - that research shows that their well-meaning advice is not only NOT going to help,  it will only make things worse!  New research from Professor Christine Logel from Renison University College at the University of Waterloo, just released  Dec 19, suggests that our family and friends can have very positive - or negative - effects on young women in particular.  Here is the link you can send them:  "A little acceptance is good for your health: Interpersonal messages and weight change over time"  http://onlinelibrary.wiley.com/doi/10.1111/pere.12050/abstract

If they REALLY want to help, the research shows that family and friends CAN help by giving positive "acceptance messages" - telling their loved one that they ACCEPT their body AS IT IS.  These positive acceptance messages actually lead to better weight maintenance, even weight loss.  Researchers suspect that the supportive messages help reduce stress, and inspire self-confidence - which then help the person struggling with weight to adopt healthier behaviors.  Makes sense, doesn't it?  If we feel good about ourselves, relaxed and confident, we are more likely to have the energy to take action for healthy, self-care behaviors.  

Here is a link to a great little article about the research, which you can pass along to your helpful relatives/friends, if the original research abstract is a bit too abstract for them:  http://www.examiner.com/article/criticism-of-weight-can-cause-more-weight-problems

From the article:   "women who were given a higher number of what the researchers have referred to as acceptance messages dealing with their weight had better weight maintenance. These women even had more weight loss than their counterparts who didn't get positive messaging from the loved ones in their lives...when women who are concerned about their weight were informed that their loved ones accepted them as they are, they had more positive feelings about their bodies...Logel sees feeling that our loved ones are accepting us just the way we are is a significant part of social support. It has been suggested by this study that feeling better about themselves lead the women to be more active or to adhere to more healthy diets. It appears that being given unconditional acceptance might have decreased their stress which is a known cause of weight gain."

If the family member/friend ignores the science, and persists in the criticism, you can explain that their behavior is a form of 'concern-trolling', a passive-aggressive form of sabotage, and you would appreciate it if they would stop that behavior.  (A "concern troll" has been defined as person who is posing as a helpful ally, but in reality is merely a critic and bully, trying to stir things up.)  That may well confuse them, which is okay - they are likely to give up at that point!  The important thing is that you feel good about yourself - and don't let anyone take that away from you!  

'Tis the Season - for Sugar Addiction?

Why is it so darn hard to control ourselves around holiday sweets?  Why can't we 'just stop at one'?!  Are we just weak-willed, or is there a neurochemical basis that is driving  addiction-like cravings?  

Seems like my patients are not the only ones asking these questions - the New York Times just ran an Op-Ed article called:  "Sugar Season.  It's Everywhere, and Addictive".  The story discusses the theory that humans, until recently, faced food scarcity, and those who were 'wired' to like, love, or REALLY love sweets, tended to be those who survived - and passed those genes along to us 'moderns'.  

Unfortunately these genes - which can turn our brains into carb-craving machines - can really backfire in the modern world, where we are surrounded by an abundance (overabundance?) of super-delicious, 'hyper-palatable' treats.

The constant temptation of sweets everywhere - easy to reach, easy to eat -  can really 'light the fire' of cravings, and set that fire blazing.  The more we see/smell/eat, the more we want of the same.  And it's all there, in our neurochemistry.

This review article ( http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2235907/) states that "Based on the observed behavioral and neurochemical similarities between the effects of intermittent sugar access and drugs of abuse, we suggest that sugar, as common as it is, nonetheless meets the criteria for a substance of abuse and may be “addictive” for some individuals when consumed in a “binge-like” manner. This conclusion is reinforced by the changes in limbic system neurochemistry that are similar for the drugs and for sugar. "

This more recent  2013 review study (http://www.ncbi.nlm.nih.gov/pubmed/?term=Sugar+addiction%3A+pushing+the+drug-sugar+analogy+to+the+limit) states that "evidence in humans shows that sugar and sweetness can induce reward and craving that are comparable in magnitude to those induced by addictive drugs."  Furthermore, "At the neurobiological level, the neural substrates of sugar and sweet reward appear to be more robust than those of cocaine."  Yes, you read that correctly, more addictive than cocaine!  And it concludes that the "biological robustness in the neural substrates of sugar and sweet reward may be sufficient to explain why many people can have difficultly to control the consumption of foods high in sugar when continuously exposed to them."  I'd say so!

So, what to do to control cravings?  The answer is not a simple, single trick - as much as we would love that - but the good news is that there ARE strategies to control cravings.  First it's important to identify our individual 'triggers".  Next it's important to REMOVE these triggers from our immediate environment (you can't eat something if it's not there). And next we must REPLACE those treats with healthier, but still tasty, treats.  You can't take something away, without putting something else back in its place - or the change simply won't be sustainable. We help our patients come up with specific ways to do this, every day.   Our goal is to help patients create - and SUSTAIN - successful healthy lifestyles.

There are additional strategies that can be very effective to help control cravings, which are beyond the scope of today's blog. And the best success comes from the creation of individualized strategies to address each person's unique needs. Lifestyle change can be tough - be we can make it easier, and help improve success - through education, problem-solving, coaching, and support.  

Weight management medications can also sometimes be helpful when ESTABLISHING new, healthy habits, and can even be useful to help SUSTAIN healthy lifestyle (more on this in future blogs, including using a modified Finnish Sinclair Method of intermittent medication to help control addictive responses to triggers.)  But again, that is too much to discuss in today's blog!

If you are struggling with cravings, and would like help, we'd love to help you!  Give us a call at (603) 379-6500, and read more about our program and strategies at healthyweightcenter.com .

http://www.nytimes.com/2014/12/23/opinion/sugar-season-its-everywhere-and-addictive.html?smid=tw-share&_r=0&utm_content=buffercd6ae&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer

New Weight Management Medication Just Approved: Saxenda (liraglutide) - same active ingredient as Victoza

Big news: a FOURTH new weight management medication has just been approved, called liraglutide (brand name Saxenda). The active ingredient is the same as that in the diabetes drug Victoza. It's a glucagon-like peptide-1 (GLP-1) receptor agonist, and is taken as a once a day injection. As with ALL weight management medication, Saxenda is NEVER to be used to REPLACE healthy diet, exercise, and behavioral strategies, it is used to help SUPPORT healthy lifestyle as an 'adjunctive' (add-on, supportive) treatment for those who need help to achieve a healthier weight.

It is not recommended for certain people - those with a personal or family history of medullary thyroid carcinoma (MTC), or in patients with multiple endocrine neoplasia syndrome type 2.

4,800 patients have been studied in three clinical trials, with these results: "Results from a clinical trial that enrolled patients without diabetes showed that patients had an average weight loss of 4.5 percent from baseline compared to treatment with a placebo (inactive pill) at one year. In this trial, 62 percent of patients treated with Saxenda lost at least 5 percent of their body weight compared with 34 percent of patients treated with placebo. Results from another clinical trial that enrolled patients with type 2 diabetes showed that patients had an average weight loss of 3.7 percent from baseline compared to treatment with placebo at one year. In this trial, 49 percent of patients treated with Saxenda lost at least 5 percent of their body weight compared with 16 percent of patients treated with placebo."

The most common side effects in patients treated with Saxenda were nausea, diarrhea, constipation, vomiting, low blood sugar (hypoglycemia, when used with certain other medications) - and decreased appetite (the last is a side effect we WANT to see!)

Saxenda's serious possible side effects  include pancreatitis, gallbladder disease, renal impairment, and suicidal thoughts. The medication can also raise heart rate and patients should be monitored and the medication should be discontinued in those who experience a sustained increase in resting heart rate.

Risks and benefits must always be weighed when utilizing ANY medication, and patients and their medical providers must work together as a TEAM when deciding on therapies!


http://www.fda.gov/…/Newsr…/PressAnnouncements/ucm427913.htm
Additional information:  http://finance.yahoo.com/news/fda-approves-novo-nordisks-injection-221411771.html 

Strategy to get through the holidays: lead with the PROTEIN!

We've all seen those silly pop-up advertisements encouraging us to "click here for one simple trick to lose weight".  Most of them are ridiculous gimmicks and scams. Would you like some real science to help you instead?

I recently attended the international obesity conference called ObesityWeek in Boston.  There were over 100 sessions,  and over 5000 researchers, physicians, and other weight management professionals participated.   (Check out the schedule here:  https://obesityweek.com/program/)  There was an astounding amount of information presented on nutrition, exercise, lifestyle counseling and medication, but out of the thousands of slides I saw, one simple slide stood out in my mind above all others.  It showed the effect of starting a meal with protein, instead of starting a meal with carbohydrate.

Long story short -  when we begin a meal with bread, our blood sugar spikes up - and stays up - which is unhealthy.  When we begin a meal with protein, our blood sugar stays smooth and controlled.  The ‘simple trick’ of starting a meal (or snack) with protein can help control blood sugar - AND can help control appetite, improve our energy level, even help our mood!   

Benefits of protein for those trying to lose weight:

1. Raises Basal Metabolic Rate (BMR, also called REE/Resting Energy Expenditure)  - you ‘burn’ more calories even when you’re not exercising - simply by increasing the ratio of protein to carbohydrate in your diet.  Research suggests that higher protein diets can help  ‘burn off’ 350 extra calories per day.

2. Improves Satiety/Fullness/Satisfaction - protein helps you feel more full on fewer calories, so it’s easier to stay on a lower calorie diet!  Protein can prevent the fatigue, and ‘hypoglycemia’ that people can feel on ‘old school’ higher-carbohydrate diets.   The ‘SAD’ Diet (Standard American Diet) - contains a mere 12% of calories from protein on average. Try raising your protein percentage to 20-35% and you’ll feel more satisfied.

3. Improves Blood Sugar after meals.   The effect is strongest when you START A MEAL WITH PROTEIN!  Protein has the functional effect of lowering the glycemic index.  The A.U.C. (Area Under the Curve) of the post-prandial (after meal) blood sugar stays ‘low and smooth’ if you start a meal with PROTEIN.

4. Preserves Muscle during weight loss - AND helps you build muscle more effectively during/after workouts, compared to a higher carb, lower protein diet.  In other words - protein helps you create and keep your healthy muscle during weight loss (which maintains strength, metabolism, bone strength, coordination, prevent falls, helps smooth the appearance of cellulite, etc.)

5. Improves mental alertness and sustained cognitive performance - as opposed to sugar/carbohydrate-heavy snacks, which give a temporary ‘burst’ followed by a ‘crash’.  Wake up in the afternoon with a PROTEIN snack.

6. Heal more quickly after surgical procedures - After surgery, our protein needs increase, and we will heal more quickly if we make sure our protein intake is adequate.

What kinds of problems can arise from a blood sugar level which spikes up - and stays up - after a meal?  All sorts of issues may be connected: insulin resistance, metabolic syndrome, inflammation, etc.   Forty percent of American adults have prediabetes or diabetes now - think about that for a second - 4 out of every 10 Americans have a problem with their blood sugar!  Controlling blood sugar through diet, exercise, and weight management is becoming more important than ever!  

So, back to “one simple trick”:  starting off a meal with  protein can help us control our weight, appetite, blood sugar - even our mood -  through the holidays and beyond.   

Many people find themselves strapped for time, and end up neglecting themselves while taking care of others.  Don't forget to take care of yourself!  If you need help improving your protein intake, give us a call.  You can also try our tasty protein supplements to help make it easier to stay healthy - and even lose weight - through the holidays!   (Visit SeacoastNutrition.com and HealthyWeightCenter.com) seacoastnutrition.com


Updated research link - the preliminary research I reported on was finally published July 2015: 

Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels

Alpana P. Shukla⇑, 

Radu G. Iliescu, 

Catherine E. Thomas and

Louis J. Aronne

:  http://care.diabetesjournals.org/content/38/7/e98.full