::TRISTAR CLINIC NEWS

2008-10-30

Lose More Weight with Meal Replacements

-Dr. Anton Steiner

 

"Meal replacement" is not exactly a new concept in weight loss, but it is one that is gaining more respect from the medical community and more interest from consumers in recent years.  Why? Because it works.

Data show that people using meal replacements lose more weight-twice as much weight-as those following traditional diets.  Moreover, patients who participate in a meal replacement program that offers medical supervision and supportive coaching are much more likely to maintain their lower weight long-term.

"Meal replacements" are portion and calorie-controlled food products that give you an excellent balance of nutrition.  They can be shakes, soups, bars or even packaged entrees.  The meal replacement products you will find at a medical weight loss office are generally better-tasting and more nutritionally complete than the ones you find at the grocery store, but they all follow the same basic principle:  the fewer decisions you have to make about what to eat, the better.

When you use meal replacements, there is no guess-work.  You don't have to think about how many calories or grams of carbohydrate or fat you're eating, because it's all been done for you.  You have automatic portion control, and you can stop obsessing all day about what and how much you are going to eat. This makes it easier to gain a new perspective on your eating habits and to focus on other things, like getting more walking into your routine. 

Meal replacement programs are ideal for people who are concerned about their blood pressure, cholesterol, or blood sugar levels.  Recent studies demonstrate that patients on structured food programs achieve superior results when it comes to reducing their health risks.  At TriStar Medical Clinic, we have seen dozens of patients who have been able to reduce or even discontinue their blood pressure, cholesterol and diabetes medications.  All this, and weight loss, too!

You may be wondering about the cost of a meal replacement program. The good news is that most people find that they are actually saving money on food while they are on the program.  A typical meal replacement "week" might cost $80-115.  If you really look closely, you will probably see that you are spending more than that on groceries and meals and snacks "out." Then, consider the heavy tolls, both financial and physical, you will avoid by getting your weight and health under control now, and preventing major problems down the road.

If you have questions, or are ready to find out how a meal replacement plan will work for you, please give us a call for a free consultation, 310-568-2400. 

If you live outside the Los Angeles area, call 1-888-512-3438 for a free guide booklet on how to use our products on your own.

 

 

2008-06-12

Losing Weight - Again

-Lesley Ward

 

The hard truth is: weight loss is not a one-time deal.  It's never "over." There is no "cure" for being overweight.  There is only paying attention to what you eat, every day, for the rest of your life. 

It is not an easy pill to swallow, and it's why there IS no easy pill that will take the weight off permanently.  Maintaining weight loss long-term takes constant effort and vigilance, and an acceptance of this reality.

This is why, every year, many people find themselves having to lose weight - again.  Because even though they did lose weight, and they felt all the benefits of losing weight, and they vowed they would not put it back on again-they did.  Somewhere along the way the old habits crept back in, and the weight came back on.

So, now what?  Well, you've done it once, you can do it again. 

Sometimes, in our experience, when a person has lost a lot of weight--say, more than 50 lbs--the second time can be harder.  There was something about the initial weight loss that was so dramatic and exciting-what we call "the honeymoon phase"-that it kept you going.  The second time around, there is a sense of familiarity that may not be altogether pleasant, especially if you have a lingering sense of failure over the fact that you did this before, and you regained every pound and more. 

You can't let those feelings stop you!  You can lose the weight again, and you can keep it off.  It just means doing the work, and working a little bit differently this time, focusing more on the long-term.

Here are some things to keep in mind:

Get Support - We all know it is very difficult to lose weight on our own.  You need someone to give you some outside accountability and perspective.  Otherwise, it is all too easy to get caught up in the tiny fluctuations on the scale, or give in to the kind of temptations that spring from our rationalizing self-talk.  If you do not have access to a supervised program such as the one at TriStar Medical Clinic, consider joining a weight loss group, starting a pool with co-workers, or signing up for an online tracking system.  Find some structure outside yourself, and make your commitment that much stronger.

Self-Monitoring - Keep track of your food intake and physical activity.  It can be a little notebook you keep in your bag, or a spreadsheet on your computer, but writing down what you're actually doing is the best way for you to see things as they really are.  People who do this are much more successful long-term!

Eat More Protein and Restrict Carbohydrates - You know that eating more protein helps you feel more satisfied, which is a good reason to eat plenty while you are losing weight.  Even more important, it also helps ensure that while you are losing weight, you are losing fat, not muscle.  When dieters lose muscle mass because they're eating less but not paying attention to protein or resistance activity, they are in effect slowing down their metabolism--which makes it that much easier for you to regain your weight.

Set Boundaries - Sure, we like to say that in Maintenance, you can eat anything you want; it just has be portion-controlled.  The trouble is, most people have some foods that they simply cannot eat in a controlled way.  Whatever that is for you-it's probably flashing through your mind right now.  And that may mean that, in order for you to keep your weight off, you really have to decide that you're never going to eat a Krispy Kreme, or a Double-Double, or whatever it is, ever again, because to even go there is to fall right back into all the habits that keep you heavy.

Think Forever - It's scary to realize-"You mean I have to watch what I eat all the time, for the rest of my life?!"

But the reality is-yes, you do.  If you are going to stay at a healthy weight, you do have to be aware of what you are putting in your mouth every day.  It doesn't mean that you will not occasionally choose to have a piece of birthday cake, or a slice of prime rib.  The key word is "choose."  You have it, not because everyone else is, or it's expected, or you're hungry, or it looks good, or it's there, but because you've thought about how you're going to feel two hours from now, and tomorrow, and next week, and you choose to have it.  Because you know you're in control.  And you're NOT gaining your weight back AGAIN.

2008-02-29

Fitness Extends Longevity in Seniors More than Weight Control

-Dr. Anton Steiner

As people age, they tend to be less physically active and, as a result, have a lower ability to perform aerobic activities.  Some researchers have suggested inactivity reduces lifespan because people gain weight and develop health problems.

A 12-year long study designed to answer questions about the effect low activity has on longevity was recently published.  To the surprise of many experts, the study showed that low fitness was more likely than obesity to cause early death.  A high BMI, smoking, and a large waist circumference, indicating excess abdominal fat, also contributed to early death, but not as much as being inactive did.

Other studies have shown that even in overweight people, modest exercise - a 30-minute walk each day- reduces accumulation of fat around the abdominal organs and thus cuts various serious health risks associated with this condition. If you are a couch potato, routine gentle activities like walking can improve your health and extend your life while making it easier to control your weight.

2008-02-29

Genetic Breakthroughs May Improve Cholesterol Control and Weight Management

-Dr. Anton Steiner

Nature Genetics, a leading science journal, reported two important genetic breakthroughs in its first issue for 2008. Researchers from Michigan, Harvard, and North Carolina Universities conducted a study using samples of genetic material from nearly twenty-thousand people living in Italy, Finland and Sweden.  They found seven new cholesterol regulating genes some of which may influence the risk of heart disease by regulating LDL (bad) cholesterol levels. A separate paper appearing in the same journal reported that investigators have found the long sought "thrifty" gene believed to contribute to weight gain.  As predicted, the thrifty gene stimulates body fat synthesis from extra blood glucose contributing to obesity.

One goal of genetic research is to develop gene specific treatments for common chronic conditions.  While new treatments stemming from these recent genetic discoveries may be years in the future, the research does confirm that some people are genetically prone to high cholesterol and weight gain, which puts them at added risk of heart disease. By expanding our understanding of how cholesterol is regulated and fat synthesis is promoted, the research allows us to make better use of current treatments.

The cholesterol gene research demonstrated that only changes in LDL level seemed to influence a person's risk of heart disease. This means, current therapies that help lower LDL may be the best approach for reducing plaque build up in the arteries and lowering heart disease risk.

The function of the thrifty gene suggests that adopting a diet that maintains blood sugar levels in the moderate range may be a good way to improve weight control for many people. The high-carbohydrate, low-fat diets popular in the 1980s and ‘90s may have inadvertently promoted the current obesity epidemic by causing carriers of the thrifty gene to gain extra weight. Both weight gain and high LDL cholesterol levels contribute to heart disease.

Regular exercise, dietary change, and weight loss provides a variety of benefits.  Together they can reduce blood cholesterol levels and help prevent diabetes and weight gain by reducing blood sugar levels. The combination of blood sugar control and cholesterol management can protect against heart disease.

2008-01-31

Carbohydrate-Restriction May Improve Weight and Blood Sugar Control In Type 2 Diabetics

-Dr. Anton Steiner

Many diets that have become popular since the late 1990s advocate limiting the amount and type of carbohydrate consumed as a way to modulate blood insulin levels and improve weight loss. In theory, keeping blood sugar and insulin levels in a moderate range reduces the amount of carbohydrate converted to fat thereby aiding weight loss as well as diabetes control.

The effect of carbohydrate-restricted diets on the health of people with type 2 diabetes was recently investigated by researchers who reviewed 56 studies on the subject and combined data from 13 of them for further analysis.

Low-carbohydrate diets led to greater improvements in the percent of hemoglobin A1c (a measure of blood sugar control in people with diabetes), the level of fasting blood sugar, and some blood fats such as triglycerides than did typical weight loss diets. However, the effect of carbohydrate-restricted diets on weight loss was inconsistent.  Additional properly designed and controlled studies examining the effects of low-carbohydrate diets in people with type 2 diabetes are needed to confirm the safety and long-term effectiveness of these diets and clarify the impact on weight loss.

2008-01-31

What Causes People to Underestimate Their Calorie Intake?

-Dr. Anton Steiner

According to the National Weight Control Registry Data, self-monitoring skills such as routinely weighing oneself, counting calories consumed, and tracking exercise help people achieve and maintain a lower body weight. However, several well-regarded studies have shown people underestimate the number of calories they eat each day by as much as 30% which can dramatically affect their success. A new study has identified some of the factors that contribute to miss-estimation of calorie consumption by overweight women.

Years of education, degree of athletic skill, body weight goals, and body image were identified as factors that contribute to routinely underestimating the number of calories eaten and the amount of exercise performed.  Inaccurate estimation probably accounts for the confusion that people often express over failure to lose weight even though they believe they are exercising more and eating less.

Learning methods for portion size estimation and tracking food and exercise in a diary or log can make instant improvements in reporting accuracy. Knowing how many calories you consume and use each day, is a crucial skill for weight management.

2007-12-31

Number of Obese Americans Leveled off, but Didn’t Fall

-Dr. Anton Steiner

The Centers for Disease Control (CDC) recently reported some progress in the nationwide battle of the bulge. Although the number of American adults classified as obese remains alarming high, the latest national health survey found that the number of new cases of obesity seems to be leveling off. During 2005-2006, 33% of men and 35% of women were obese. This is equivalent to 72 million obese Americans and represents roughly the same number found to be obese during the 2003-2004 survey.

The CDC began formally tracking obesity rates 20 years ago as part of the state by state Behaviors and Risk Factor Surveillance System (BRFSS). Each state collects a variety of health-related data and passes it on to the CDC for compilation and analysis. The BRFSS data demonstrates that about 15% of American adults were obese in the early 1990s. That rate grew rapidly until 1999 and has been slowing since then.

While examining the latest BFRSS data, the CDC researchers noted other important trends. Specifically, the percentage of obese people aged 40-59 hovered around 40%-a rate significantly higher than was found in younger adults. Also, there are large racial/ethnic differences in the obesity rates. About 53% of non-Hispanic black women and 51% of Mexican-American women ages 40-59 are obese, compared to about 39% of non-Hispanic white women of the same age.

The latest BFRSS data is a good news-bad news situation. True, the increase in the rate of obesity is slowing, but, it's also not falling. Also, the percentage of severely obese Americans is continuing to climb. The latest BRFSS data can help the CDC and other health providers target audiences that are most at risk for developing obesity, or who are already obese and need the greatest degree of treatment. Clearly new and more dramatic efforts are needed to reverse the body weight trend. Interventions such as reducing the cost of lean proteins, fruits, and vegetables through government subsidies, and offering people cash or benefit incentives to lose weight are examples of such interventions.

On a personal level, you should have a good understanding of where your body weight falls on the BMI scale, the repercussions of your body weight and, if necessary, how to take action to improve your weight status. Taking charge of your weight is a smart investment in your future health and happiness.

2007-12-08

Lifestyle Changes Are the Best Way To Reduce Diabetes Risk

-Dr, Steiner

The obesity epidemic in the US has lead to an increase in many lifestyle-related diseases and conditions, including type 2 diabetes. Several of the key factors for developing type 2 diabetes-a higher than normal fasting blood glucose level, excess body fat, and a sedentary lifestyle-can be modified by lifestyle change. However, getting people to change their behaviors is challenging, so physicians often prescribe metformin and other, newer medications that reduce blood sugar, for people at risk for developing diabetes.  Concerns about the side effects of blood sugar lowering drugs prompted attendees at the recent American Diabetes Association Meeting to revisit a key study published a few years ago by the Diabetes Prevention Program researchers.

The study involving 3,234 people found that lifestyle changes that included losing weight and 2.5 hours of physical activity each week reduced an at-risk individual's chances of developing type 2 diabetes much more effectively than use of the prescription drug metformin. Other studies have found that weight loss and increased physical activity provide significant health benefits beyond reducing the risk of diabetes. For example, weight loss and regular exercise can decrease the risk of some cancers and of conditions like high blood pressure that promote heart diseases.

Since lifestyle change is more effective and less costly than metformin and has health benefits that reach far beyond decreasing your risk of developing type 2 diabetes, you should strive to make lasting healthy changes in our habits. The results of those changes will result in a variety of healthy changes that mere medicine cannot produce.

2007-11-20

5 Simple ways to reduce your risk of heart attack

-Dr. Steiner

After menopause, the risk of heart disease in women is equal to the risk of heart disease in men of the same age. However, a woman suffering a heart attack has a higher likelihood of dying from the attack than a man. Heart disease is now the number one health risk for women and is responsible for the deaths of more women than all forms of cancer put together.

Most of us have heard the typical wellness advice: eat a healthy diet, avoid tobacco, exercise regularly, and use alcohol in moderation. But the degree to which these behaviors actually reduce our risk of various chronic diseases like heart disease has not been well quantified.

Recently Swedish researchers completed a six-year study of 24,444 postmenopausal women in which they looked at heart disease risk factors and disease prevalence. At the beginning of the investigation, the women were free of cardiovascular disease, cancer and diabetes. During the six-year, two-month long study, 308 heart attacks were recorded. By carefully reviewing the diet, activity, and body measurement information collected on the study participants and comparing these data with the women's development of cardiovascular disease, researchers were able to identify 5 traits that reduced a woman's risk of having a first heart attack by almost 60%.

The 5 heart healthy traits were:

• Don't smoke
• Drink less than a quarter ounce of alcohol each day
• Be physically active for at least 40 minutes daily and engage in purposeful exercise at least once each week
• Maintain a waist-to-hip ratio less than 0.85
• Eat a heart healthy diet containing lots of whole grains, legumes, fruits, vegetables, and fish

Not only will following a lifestyle that incorporates these 5 healthy traits significantly lower your heart disease risk, it will also make long-term control of your weight considerably easier.

2007-11-20

Reducing your waist can improve your health

-Dr.Steiner

People involved in weight loss often develop a preoccupation with using their bathroom scales as an indicator of weight loss success. While it has been shown that one of the keys to successful long-term weight maintenance is regularly checking your weight, there are other indicators, such as your waist circumference, that may also help you track your weight loss and maintenance success.

Overweight or obese people are commonly described as being either pear- or apple-shaped. This is a simple analogy for describing fat distribution on the body.  Body fat distribution patterns may be just as important as your body weight in assessing weight-related health risks. There is a significant evidence to suggest that apple-shaped people are at higher risk of heart disease and other health issues such as high blood pressure and diabetes.

Apple-shaped people tend to carry their fat above the waistline on their abdomen, while pear-shaped people carry it on their hips, thighs and buttocks.  Abdominal obesity, often appearing in a "pot belly," a "beer belly" or in the form of "love handles" is clustered along with diabetes and high cholesterol into a condition called metabolic syndrome. People with metabolic syndrome are twice as likely to die of heart attack or stroke as people who do not have it.

A recent French study of about 4,000 people, ranging in age from 30-64, showed that women who managed to lose an inch from their waists were able to reduce their incidence of metabolic syndrome. While the same did not hold true for men, an increase of only three inches around the waist increased the rates of metabolic syndrome, diabetes and other heart disease risks factors in both men and women.

If you tend to carry excess weight around your waist, the message from this study is that reducing your waist measurement, or at least preventing further gain in inches, may be as important to your long-term health as reducing your weight.

2007-12-08

Low-Carb Ketogenic Diets Decrease Desire To Exercise

-Dr. Steiner

During the late 1990s and early 2000s, Americans showed a renewed interest in very low-carbohydrate ketogenic diets such as Atkins diet that promised people they can eat all their favorite fatty foods and still lose weight as long as they shunned starchy and sugary carbs. These types of diets became so popular that many restaurant chains began offering Atkins-style meals and researchers began looking at the benefits and possible drawbacks of these diets in earnest.

One area of interest to investigators was the impact of low-carb, ketogenic diets on physical performance. Ketogenic diets are very low in carbs but high in protein and fat. They lead to the accumulation of partly metabolized fat molecules known as ketone bodies in the blood stream. Carbohydrates are the body's preferred source of fuel for aerobic activities. By shunning carbohydrates, many dieters following an Atkins meal plan felt too tired to exercise.

The results of a two-week long pilot study confirmed that people who follow a low-carb, ketogenic diet feel more fatigue and are less likely to want to exercise than people who follow a low-carb, non-ketogenic diet. The two types of low-carb diets produced the same percentages of weight loss and percent body fat loss. Since exercise has many health benefits beyond weight loss, following a non-ketogenic diet may help overweight people establish the lifestyle habits they need to keep weight off in the long term more effectively than if they lose weight using a ketongenic approach.

2007-10-10

An Intensive Weight Loss Program May Help People Lose Over 100 Pounds

-Dr. Anton Steiner

With soaring obesity rates and increasing interest in bariatric (weight loss) surgery to provide long-term solutions, many people are frustrated that, while they are significantly overweight, they are not eligible for surgery based on the currently accepted criteria. One aspect of surgical procedures that is often overlooked is that many bariatric surgeons will use a meal replacement formula diet in combination with behavioral therapy in preparation for surgery. This meal replacement program serves a variety of functions. The first is that it reduces the complication rate of bariatric surgery by reducing pre-surgical weight and liver size which, in turn, makes the surgery easier. Secondly, your ability to conform to a pre-surgical diet may be a predictor of your ability to conform to the post-surgical diet restrictions that you will face. 

Considerable weight loss is possible on the same diet that many surgeons use preoperatively. In fact, when patients are able to lose over 100 lbs on a meal replacement formula and maintain the weight loss through behavioral therapy, the need for surgery diminishes.

In a recent study of 118 morbidly obese people with an average starting weight of over 370 pounds, an average of 145 lbs was lost after 44 weeks. That's less than one year using a meal replacement formula, medical monitoring and behavioral therapy.

These results compare very favorably with bariatric surgery and have minimal risk when monitored by an appropriately trained physician. People who do not qualify for bariatric surgery, are financially unable to afford surgery or are not prepared for the additional risk, this research shows that a comprehensive weight loss program is an extremely viable alternative.

2007-10-10

Large hip-to-waist ratio linked to early CVD

-Dr. Anton Steiner

For many years, the accepted way to establish weight-related risk was to use Body Mass Index (BMI). BMI is a measure of body fat based on height and weight that applies to both adult men and women. Last year, a study from the Mayo Clinic that used the BMI of patients with heart disease to calculate their risk of death shocked many people when their results appeared to indicate that overweight individuals were less likely to die from heart disease and that there was even a measure of protection gained by being overweight. The researchers indicated that the cause of the unexpected results more likely originated from the BMI calculation than from an actual protective quality of obesity.

The study questioned the accuracy of BMI when applied to an individual rather than when used as a calculation for a large population. Since most people are more concerned with their own risk rather than the risk of an entire population, an alternative measurement which provided a more accurate assessment of risk for the individual was required. 

The hip-waist ratio appears to be the leading candidate for this more accurate measurement, and its position is strengthened even further by a recent study that showed the hip-to-waist ratio was a more accurate predictor of heart disease than several other standard measures, including BMI.

The hip-to-waist ratio is easily measured with a tape measure:

• For your waist, measure around the narrowest part of your waist or, if this is difficult to find, just above your belly button.
• For your hip size, measure around the widest part of your hips.

Then simply divide the waist measurement by the hip measurement.

The risk of heart disease is considered high if your ratio is higher than 0.8 for women or 1.0 for men. In other words, if your stomach protrudes further than your hips, it is time to consider a serious weight loss program.