GP referral to Weight Watchers avoided type 2 diabetes in third of patients (UK)

More than a third of patients at risk of developing type 2 diabetes who reside in the UK avoided developing the condition after they were referred by their family doctor (GP) to a diabetes prevention program delivered by the commercial weight management provider, Weight Watchers, finds research published in BMJ Open Diabetes Research & Care.

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The initiative also helped more than half of those referred either to reduce their risk of developing diabetes or to get their blood sugar levels back to normal. The number of people diagnosed with type 2 diabetes in the UK has increased from 1.4 to 2.9 million since 1996. An even more substantial increase can be seen in the United States (U.S.) with a rise from 7.6 to 23.4 million. A new diagnosis is made every 2 minutes, and by 2025, an estimated 5 million people in the UK and 53 million in the U.S. will have the condition. Horrifying statistics! Risk of developing type 2 diabetes is strongly influenced by lifestyle factors but can be significantly reduced by weight loss, achieved by eating less and exercising more.

The UK’s national health and social care guidance organization, the National Institute for Health and Care Excellence (NICE) says that certain commercial weight management providers, such as Weight Watchers, can help obese people shed pounds. A U.S. study showed that participation in a commercial weight management program succeeded in reversing progression to type 2 diabetes. However, the effectiveness of this approach in UK primary care has not been thoroughly evaluated. Therefore, the researchers identified 166 patients from 14 general practice surgeries at high risk of developing type 2 diabetes: Those with impaired glucose regulation known as pre-diabetes or non-diabetic hyperglycemia and with a body mass index (BMI) above 30 kg/m2.

These patients were then invited to contact Weight Watchers to book a place on their diabetes prevention program, which included a 90-minute induction session followed by 48 weekly group meetings. From among the 166 primary care referrals, 149 patients were eligible. Some 117 attended the induction, and 115 started the weekly sessions, representing a take-up rate of 70%, which is high for a lifestyle intervention, according to the researchers. The program focused on improving diet quality, reducing portion size, increasing physical activity levels, as well as boosting confidence in the ability to change and a commitment to the process.

Blood tests were repeated at 6 and 12 months to check risk factors, and any changes in weight were recorded by trained Weight Watcher staff. Analysis of the results showed that the initiative led to an average fall in HbA1c (a measure of average blood glucose levels over several weeks) of 2.84 mmol/mol after 12 months to levels regarded as standard. Blood glucose levels also returned to normal in more than a third (38%) of the patients and only 3% developed type 2 diabetes after 12 months. The average weight loss amounted to 10 kg (22lb) at the 12 month time point (a reduction in BMI of 3.2kg/m2).

The researchers acknowledge that not all patients at high risk go on to develop type 2 diabetes, added to which the referral numbers were low, based on the funding available, with few black or minority ethnic participants, men, or those on low incomes. Nevertheless, they conclude that the initiative has the potential to have considerable impact. “A UK primary care referral route partnered with this commercial weight management provider can deliver an effective diabetes prevention programme,” they write. “The lifestyle changes and weight loss achieved in the intervention translated into considerable reductions in diabetes risk, with an immediate and significant public health impact.”

Adapted from: Carolyn Piper, Agnes Marossy, Zoe Griffiths, Amanda Adegboye. Evaluation of a type 2 diabetes prevention program using a commercial weight management provider for non-diabetic hyperglycemic patients referred by primary care in the UKBMJ Open Diabetes Research & Care, 2017; 5 (1): e000418 DOI: 10.1136/bmjdrc-2017-000418

*If you are looking to knock $30.00 off of your next wine purchase, check out Bright Cellars! You can also find the link posted on the right side of the blog. Happy sippen! 

Daily Nutrition Nugget

Add Protein To Your Breakfast! A protein-packed breakfast will reduce hunger later in the day. This doesn’t mean load up on three kinds of breakfast meats, instead add a hard-boiled egg or some Greek yogurt to your first meal of the day. Try a cup of plain Greek yogurt with some sliced almonds, mixed berries, honey and chia seeds mixed together.

Daily Inspiration Nugget 

People change for two main reasons: either their minds have been opened, or their hearts have been broken.

 

World will have more obese children and adolescents than underweight by 2022

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The number of obese children and adolescents (aged 5 to 19 years) worldwide has risen tenfold in the past four decades, according to a new study led by Imperial College London and the World Health Organization (WHO). If current trends continue, more children and adolescents will be obese than moderately or severely underweight by 2022. The study is published in The Lancet. It analyzed weight and height measurements from nearly 130 million people aged over five (31.5 million people aged 5 to 19, and 97.4 million aged 20 and older), the largest number of participants ever involved in an epidemiological study. More than 1000 researchers contributed to the study, which looked at body mass index (BMI) and how obesity has changed worldwide from 1975 to 2016.

During this period, obesity rates in the world’s children and adolescents increased from less than 1% (equivalent to five million girls and six million boys) in 1975 to nearly 6% in girls (50 million) and nearly 8% in boys (74 million) in 2016. Combined, the number of obese 5 to 19-year-olds rose more than tenfold globally, from 11 million in 1975 to 124 million in 2016. An additional 213 million were overweight in 2016 but fell below the threshold for obesity. Lead author Professor Majid Ezzati, of Imperial’s School of Public Health, said: “Over the past four decades, obesity rates in children and adolescents have soared globally, and continue to do so in low-and-middle-income countries. More recently, they have plateaued in higher income countries, although obesity levels remain unacceptably high.”

Professor Ezzati adds: “These worrying trends reflect the impact of food marketing and policies across the globe, with healthy nutritious foods too expensive for poor families and communities. The trend predicts a generation of children and adolescents growing up obese and also malnourished. We need ways to make healthy, nutritious food more available at home and school, especially in poor families and communities, and regulations and taxes to protect children from unhealthy foods.”

More obese than underweight 5 to 19-year-olds by 2022

The authors say that if post-2000 trends continue, global levels of child and adolescent obesity will surpass those for moderately and severely underweight for the same age group by 2022. Nevertheless, the large number of moderately or severely underweight children and adolescents in 2016 (75 million girls and 117 boys) still represents a major public health challenge, especially in the poorest parts of the world. This reflects the threat posed by malnutrition in all its forms, with there being underweight and overweight young people living in the same communities. Children and adolescents have rapidly transitioned from mostly underweight to mostly overweight in many middle-income countries, including in East Asia, Latin America, and the Caribbean. The authors say this could reflect an increase in the consumption of energy-dense foods, especially highly processed carbohydrates, which lead to weight gain and poor lifelong health outcomes.

Dr. Fiona Bull, the programme coordinator for surveillance and population-based prevention of noncommunicable diseases (NCDs) at WHO, said: “These data highlights, remind and reinforce that overweight and obesity is a global health crisis today, and threatens to worsen in coming years unless we start taking drastic action.”

Global data for obesity and underweight

In 2016, there were 50 million obese girls and 74 million obese boys in the world, while the global number of moderately or severely underweight girls and boys was 75 million and 117 million respectively. The number of obese adults increased from 100 million in 1975 (69 million women, 31 million men) to 671 million in 2016 (390 million women, 281 million men). Another 1.3 billion adults were overweight but fell below the threshold for obesity.

Regional/Country data for obesity, BMI and underweight

Obesity:

The rise in childhood and adolescent obesity in low- and middle-income countries, especially in Asia, has accelerated since 1975. Conversely, the rise in high-income countries has slowed and plateaued. The largest increase in the number of obese children and adolescents was seen in East Asia, the high-income English-speaking region (USA, Canada, Australia, New Zealand, Ireland and the UK), and the Middle East and North Africa. In 2016, obesity rates were highest overall in Polynesia and Micronesia, at 25.4% in girls and 22.4% in boys, followed by the high-income English-speaking region. Nauru had the highest prevalence of obesity for girls (33.4%), and the Cook Islands had the highest for boys (33.3%).

In Europe, girls in Malta and boys in Greece had the highest obesity rates, at 11.3% and 16.7% of the population respectively. Girls and boys in Moldova had the lowest obesity rates, at 3.2% and 5% of the population respectively. Girls in the UK had the 73rd highest obesity rate in the world (6th in Europe), and boys in the UK had the 84th highest obesity in the world (18th in Europe). Girls in the USA had the 15th highest obesity rate in the world, and boys had the 12th highest obesity in the world. Among high-income countries, the USA had the highest obesity rates for girls and boys.

BMI:

The largest rise in BMI of children and adolescents since 1975 was in Polynesia and Micronesia for both sexes, and in central Latin America for girls. The smallest rise in the BMI of children and adolescents during the four decades covered by the study was seen in Eastern Europe. The country with the biggest rise in BMI for girls was Samoa, which rose by 5.6 kg/m2, and for boys was the Cook Islands, which rose by 4.4 kg/m2.

Underweight:

India had the highest prevalence of moderately and severely underweight (BMI <19) throughout these four decades (24.4% of girls and 39.3% of boys were moderately or severely underweight in 1975, and 22.7% and 30.7% in 2016). 97 million of the world’s moderately or severely underweight children and adolescents lived in India in 2016.

Solutions exist to reduce child and adolescent obesity

In conjunction with the release of the new obesity estimates, WHO is publishing a summary of the Ending Childhood Obesity (ECHO) Implementation Plan. The plan gives countries clear guidance on effective actions to curb childhood and adolescent obesity. WHO has also released guidelines calling on frontline healthcare workers to actively identify and manage children who are overweight or obese. Dr. Bull added: “WHO encourages countries to implement efforts to address the environments that today are increasing our children’s chance of obesity. Countries should aim particularly to reduce consumption of cheap, ultra-processed, calorie dense, nutrient poor foods. They should also reduce the time children spend on screen-based and sedentary leisure activities by promoting greater participation in physical activity through active recreation and sports.”

Dr. Sophie Hawkesworth, from the Population Health team at Wellcome Trust, which co-funded the study, said: “Global population studies on this scale are hugely important in understanding and addressing modern health challenges. This study harnessed the power of big data to highlight worrying trends of both continuing high numbers of underweight children and teenagers and a concurrent stark rise in childhood obesity. Together with global health partners and the international research community, Wellcome is working to help identify new research opportunities that could help better understand all aspects of malnutrition and the long-term health consequences.”

My thoughts: The unfortunate and sad reality is that I was not surprised when I read the research. 😔 However, this is just more proof that we have to work together as a world, not a country, to fight this epidemic…..and not only obesity but eating disorders as a whole. We can win!

Adapted from: NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128*9 million children, adolescents, and adults. The Lancet, 2017 DOI: 10.1016/ S0140-6736(17)32129-3

Nutrition Tip of the Day

Schedule time each week to plan healthy meals! Keep your recipes, grocery list, and coupons in the same place to make planning and budgeting easier.

 

Daily Inspiration 

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Water: How Much Do Kids Need?

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Water is one of the body’s most essential nutrients. People may survive six weeks without any food, but they couldn’t live more than a week or so without water. That’s because water is the cornerstone for all body functions. It’s the most abundant substance in the body, averaging 60 percent of body weight. It helps keep body temperature constant at around 98.6 degrees Fahrenheit, and it transports nutrients and oxygen to all cells and carries waste products away. Water helps maintain blood volume, and it helps lubricate joints and body tissues such as those in the mouth, eyes and nose. And, water is truly a liquid asset for a healthy weight — it’s sugar-free, caffeine-free and calorie-free.

How Much Water Do Kids Need?

The daily amount of water that a child needs depends on factors such as age, weight and gender. Air temperature, humidity, activity level and a person’s overall health affect daily water requirements, too. The chart below can help you identify about how many cups of water your child or teen needs each day. These recommendations are set for generally healthy kids living in temperate climates; therefore, they might not be perfect for your child or teen.

The amount of water that your child or teen needs each day might seem like a lot, but keep in mind that the recommendations in the chart are for total water, which includes water from all sources: drinking water, other beverages and food. Notice that fruits and vegetables have a much higher water content than other solid foods. This high water content helps keep the calorie level of fruits and vegetables low while their nutrient level remains high — another perfectly great reason for kids to eat more from these food groups.

So how do you apply total water recommendations to your kid’s day? As a rule of thumb, to get enough water, your child or teen should drink at least six to eight cups of water a day and eat the recommended number of servings of fruits and vegetables every day. Also, pay special attention to your child’s or teen’s water consumption when they are physically active. Before, during and after any physical activity, kids need to drink plenty of water, especially in hot weather. The goal is to drink a half cup to two cups of water every 15 to 20 minutes while exercising.

Kids Total Daily Beverage and Drinking Water Requirements

Age Range Gender Total Water (Cups/Day)
4 to 8 years Girls and Boys 5
9 to 13 years Girls 7
Boys 8
14 to 18 years Girls 8
Boys 11

Data are from Institute of Medicine of the National Academies. Dietary Reference Intakes (DRIs) Tables. Recommended Daily Allowance and Adequate Intake Values: Total Water and Macronutrients.

Adapted from: Mary Mullen, MS, RD; Jo Ellen Shield, MED RD LD

Tip of the Day

Variety is key! Vary your protein food choices. Eat a variety of foods from the Protein Foods Group each week. Experiment with main dishes made with beans, peas, nuts, soy, seafood, or lean meats.

Daily Inspiration 

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Preventing Relative Energy Deficiency in Young Female Athletes

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It can start innocently enough. A young female athlete pushes herself harder than usual, training intensely to gain a competitive edge. While this increased output naturally requires consuming more calories to meet the total demands of training and recovery-not to mention growth and development-her diet does not change. The result is a condition known as “relative energy deficiency in sport,” or RED-S.

Coined by an expert panel convened by the International Olympic Committee, RED-S is a more comprehensive term that builds on the condition known as the “female athlete triad” to describe an energy deficiency gap that results when energy intake is insufficient to support activities of daily living, growth, health and functioning. This syndrome affects bone health, menstrual function, metabolic rate, immune system function, protein synthesis, cardiovascular health and psychological health. While more common in females, RED-S also affects young male athletes. RED-S can develop when there is pressure to change eating habits, especially in sports with an emphasis on appearance, low body weight and endurance. A desire to “eat healthy” or lose weight in hopes of improving athletic performance can increase susceptibility to willful food restriction and rigid dieting.

Girls simply may not understand how their energy needs translate into daily food choices. An eating disorder does not have to precede the development of RED-S, though some level of psychological factors can be present before, as well as after the syndrome develops. Regardless of the starting point, serious short-term and long-term health consequences can occur in young female athletes who develop RED-S.

The Effects of RED-S

First, bone health is a major concern as girls build 60 to 80 percent of their lifetime bone mass by age 18. When preteen and teenage girls restrict their eating, body systems important to bone growth may shut down. Restricted diets also can be low in calcium and vitamin D, which contributes to poor bone formation. If RED-S continues without being addressed, poor bone growth can lead to stress fractures and even early osteoporosis, in which bones become fragile and more likely to break.

Another concern is reproductive development. Important markers of insufficient energy and resulting low estrogen levels are delayed menstruation and irregular or missed cycles. Other potential effects of RED-S include increased risk of injury, decreased endurance and muscle strength. Additionally, it can reduce response to training, decrease coordination, impair judgment and increase irritability and depression — results that no athlete wants to have happen. The good news is correcting RED-S does not mean a sacrifice in athletic performance. In fact, it should result in an improvement in athletic performance.

Parents can play a significant role in preventing RED-S. First, educate your daughters on the energy demands of their training and the interconnected relationship of proper nutrition, bone health and menstruation, as well as risk of injury and impaired training from insufficient consumption. Second, keep an eye out for weight loss, changes in menstruation and changes in mood. Finally, create a supportive environment in which girls can consume three meals and one to three snacks per day. Even missing one meal on a regular basis can result in an energy deficit. Make sure your daughter has a regular breakfast and packs or eats a full lunch at school. Many girls train after school, and an easily digested snack prior to practice can provide energy for training. Good snack choices include an energy bar, cereal, crackers, banana, fruit and fruit juice, pretzels, and peanut butter and jelly sandwiches.

Adapted from: Monique Ryan, MS, RD, CSSD, LDN

Tip of the Day

Stock up! Stock up on frozen or canned veggies next time you spot a sale. Having some on hand makes it quick and easy to add veggies to meals.

Daily Inspiration 

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FITNESS ON THE FLY

No gym membership or fancy fitness equipment at home? No problem! Canned goods make great hand weights, or you can fill milk jugs with sand for some serious lifting. You can also make use of a step stool for step training or try a beach towel as a stretching assistant.

Try some alternative fitness equipment this week. Have fun with your usual workout, or shake it up by using items around your house to try something new.

By: HealthCorps