OSR Weight Management

Water Assisting with Weight Loss

Posted on October 26, 2015 by to press

Conventional wisdom advises drinking plenty of water, especially during a weight-loss program.  Now, there’s new evidence to support this recommendation. By drinking water throughout the day, you can avoid “bored eating” as well as all of the great benefits that come along with being hydrated! Water is essential in life and also in weight loss. A recent randomized…

Conventional wisdom advises drinking plenty of water, especially during a weight-loss program.  Now, there's new evidence to support this recommendation. By drinking water throughout the day, you can avoid "bored eating" as well as all of the great benefits that come along with being hydrated! Water is essential in life and also in weight loss.

A recent randomized controlled clinical trial in the journal Obesity examined the efficacy of water preloading before meals in two groups of dieters.  Participants were randomized to either drinking 500 ml of water 30 minutes before their meals, or to a control group where they were asked to simply imagine their stomach was full before meals.  What the researchers found was that 12 weeks later, the water preloading group had lost an average of 1.3 kg (2.86) pounds more than the control group.  It may not sound like a lot, but every pound adds up, leading one to wonder what would happen at 16, 24, and 36 week followup times.  Also, the mind is powerful - I'd also like to see a study where participants did both - imagined fullness AND drank water - would we see double the results compared to dieters who did nothing different at all?  

 

Read more here: http://www.ncbi.nlm.nih.gov/pubmed/26237305

Sleep Apnea Dangers for Women

Posted on October 26, 2015 by to press

If Hypertension is a ‘silent killer,’ sleep apnea is easily another less-discussed one.  Sleep apnea occurs when there are pauses or breaks in a person’s breathing during sleep, preventing air from entering the lungs and forcing the person to wake briefly to start breathing again, before falling back to sleep.  This interruption in breathing can…
If Hypertension is a ‘silent killer,’ sleep apnea is easily another less-discussed one.  Sleep apnea occurs when there are pauses or breaks in a person’s breathing during sleep, preventing air from entering the lungs and forcing the person to wake briefly to start breathing again, before falling back to sleep.  This interruption in breathing can happen hundreds of times nightly, resulting in very poor, fragmented sleep quality.  It is estimated that over 18 million Americans suffer from sleep apnea.  It can affect anyone at any age, however it is most commonly seen in those who are overweight or obese.  African Americans and Pacific Islanders are at higher risk than Caucasians – very relevant to our population in Hawai’i. Long linked to heart disease and sudden death in men, the effects on women of sleep apnea were less clearly defined until now.   A study just published in the journal Circulation now shows that women with sleep apnea are at much greater risk of heart failure, heart enlargement, and death from heart failure. It behooves us to greatly step up our screening for sleep apnea in Oahu’s women at risk!  If you are a woman with snoring, headaches, fatigue, concentration and/or memory difficulties and you carry excess weight, we can help you get screened for sleep apnea.  Come talk to us in our Kailua office.   Read more at: http://well.blogs.nytimes.com/2015/10/19/sleep-apnea-may-have-added-dangers-for-women/?_r=0

Is Obesity a Brain Disease?

Posted on October 8, 2015 by to press

You may have never imagined that what we eat can literally change our brains!  New research published this week raises questions about whether obesity is a truly metabolic vs. a neurologic phenomenon, or a little bit of both. Animal research done at Vanderbilt University this week headed by Dr. Aurelio Galli reveals a mechanism for…
You may have never imagined that what we eat can literally change our brains!  New research published this week raises questions about whether obesity is a truly metabolic vs. a neurologic phenomenon, or a little bit of both. Animal research done at Vanderbilt University this week headed by Dr. Aurelio Galli reveals a mechanism for how a high-fat diet can disrupt brain signals that regulate appetite.  The findings reveal a system designed to control the eating of highly rewarding high-fat and high-sugar foods.  Strangely enough, this system can be hijacked by the very foods that it is designed to keep under control.   Dr. Galli’s team found a group of specific proteins are responsible for the hijacking, and how they cause brain changes that lead to a vicious cycle of eating increasing amounts of high-fat and high-sugar foods that likely further cement these changes.   This can help explain why the more often we eat typical Hawaii plate lunches or malassadas, the more likely we are to continue craving them. Two other studies published this week also link obesity to the brain:
  • The first found the presence of obesity to increase the likelihood of to developing a common brain tumor (meningioma) by 50%
  • The second found a statistically significant risk for earlier onset of Alzheimer’s disease in middle-aged obese people.
It’s not yet clear however whether a healthy weight can delay the onset of dementia and/or other neurological problems in patients at risk.  But based on all these new findings, certainly this would be worth looking into. Read more at: http://conscienhealth.org/2015/09/relating-obesity-to-brain-health/

The Accelerating Obesity Epidemic in the Youngest Generation

Posted on October 7, 2015 by to press

Are Post-Millenials doomed to struggle with weight for life?  A new paper sounds the alarm that despite equal amounts of dietary restraint and exercise, those born more recently (Generation Z) will have a harder time maintaining a healthy BMI than those born in the 1980’s and earlier. Why is this occurring?  The study hints at multiple…

Are Post-Millenials doomed to struggle with weight for life?  A new paper sounds the alarm that despite equal amounts of dietary restraint and exercise, those born more recently (Generation Z) will have a harder time maintaining a healthy BMI than those born in the 1980's and earlier.

Why is this occurring?  The study hints at multiple other factors - endocrine disruptors, reduction in daily physical activity from technological innovations, changes in sleep patterns. 

The largest though may be the easy availability of carbohydrate-and sugar-laden junk foods. Tracing sugar consumption through the last century, we already know that there was a slow gradual rise in sugar ingestion, followed by a huge spike through the 80s-90s.  It is estimated that per capita, the average American consumed over 150 lbs of sugar per year in 2013.  Way back in 1900, that number was probably more like 5 lbs.   When you think about those numbers, the connection becomes obvious!

OSR Weight Management's philosophy is to reverse that trend and break sugar consumption habits, teaching our patients to eat healthy for life.  And when keiki see their parents changing, they change too.   Our kids CAN buck this trend - let's get ourselves and Hawaii's Generation Z back to being the fittest in the nation.

 

Read more at:

http://www.piercepioneer.com/can-we-do-anything-to-slow-the-obesity-epidemic/47510

 

Halloween Candy: A Treat or a Trick?

Posted on October 2, 2015 by to press

Fall is fast approaching, and when many of us think of this season of cooler temps and falling leaves, we think Halloween.  Some of your kids are probably already dreaming of their costumes, Halloween parties, trick-or-treating in Kailua – AND all the candy. Don’t let these little treats trick your body this Halloween season! What…
Fall is fast approaching, and when many of us think of this season of cooler temps and falling leaves, we think Halloween.  Some of your kids are probably already dreaming of their costumes, Halloween parties, trick-or-treating in Kailua – AND all the candy. Don't let these little treats trick your body this Halloween season! What is the best way for a parent to approach this season to maximize fun while minimizing the health issues caused by overdoses of sugar? First, how bad are Halloween treats for your health?  Let’s look at American Heart Association guidelines for sugar in the diet.  For children aged 4-8, the recommended daily intake is no more than 130 calories of added sugar, or 3 tsp daily.  For older children and pre teens, the maximum amount of daily sugar should be no more than 5-8 teaspoons.  These recommendations are made to not just limit daily calories.  Ingesting processed sugars causes our bodies’ insulin levels to spike, leading to increased hunger (leading kids to eat even more unhealthy sugars) and inflammation in the short term, and increased fat storage longer-term, fueling the childhood obesity epidemic and increasing our kids’ rates of obesity-related conditions like type II diabetes. Keeping those recommendations in mind, let’s look at some typical candies that are passed out to trick-or-treaters.  One single Snickers Fun Size contains 17g of added sugar.  A Jelly Belly Snack Pack contains 18g of added sugar.   It can get much worse, believe it or not:  one single Milky Way Mini contains 27g of sugar – nine times the recommended daily amount for a 4-8 year old, and 5 times the amount recommended for older children and preteens.  And let’s face it, most kids do not stop at just one piece of candy on Halloween night! How can we minimize the damage of overindulgence in sugars on this holiday, and maximize the fun?  Here are some tips for parents and families:
  1. Never send your child to a Halloween party with an empty stomach. Make sure she eats a high-protein meal beforehand with plenty of vegetables and fruits, which will minimize her desire to overindulge.
  2. Same for Halloween night: make sure everyone partakes in a nutritious, protein-rich meal before trick-or-treating.
  3. Come to an agreement beforehand with your child on how much Halloween candy is okay to eat at one sitting. Whether you feel comfortable with 2 bite-size bars or 5, when limits are set beforehand, kids tend not to overindulge.
  4. For Halloween parties, prepare healthier snacks and treats for kids. I love these Banana Ghosts and Pumpkin Tangerine snacks:  http://www.lovethispic.com/image/32864/healthy-halloween-treats
  5. Following the Halloween holiday, get your kids back on track by preparing protein and vegetable rich meals for several days after. This will help decrease insulin secretion by the pancreas to prevent continuous over-indulging long after the holiday is over.
  6. Check in with your local dental office. Many offer incentive programs for kids to turn in their Halloween candy, such as payment per pound, or small gifts.  Most kids will love getting rewarded in some way for making healthy choices!
Here at OSR Weight Management we offer a weight loss solution on Oahu! Our physician assisted diet is here to help you with you with a healthy dieting process!

“I don’t think I’m eating enough!”

Posted on September 30, 2015 by to press, Weight Management

We often hear this phrase from dieters during their first few days on Phase 1.  It’s true that before nutritional ketosis kicks in, one of the most common side effect of the new IP dieter is hunger.  But putting that aside, many have concerns that they just don’t seem to be eating enough to eat…
We often hear this phrase from dieters during their first few days on Phase 1.  It’s true that before nutritional ketosis kicks in, one of the most common side effect of the new IP dieter is hunger.  But putting that aside, many have concerns that they just don’t seem to be eating enough to eat (granted, part of that may be comparing the portion sizes of IP food vs. a typical local style Hawaii plate lunch!) Let’s do the math.  Plugging in the daily allotment of IP foods + protein and vegetables into a calorie calculator, most dieters come up with a number between 900-1100 for their daily calories, which we are told is “not enough food” and alarms many of us.   Does this drop in caloric intake truly lead to a nutritional deficiency, and is it harmful or dangerous? You’ve probably guessed that the answers are no, and no, and of course you are correct.  Here’s why:  even if dieters are taking in 900-1100 calories of IP food + vegetables + protein, remember that the body can generate up to an addition of 1000 calories per day from stored fat, once the dieter enters nutritional ketosis. So dieters are far from starving – they are just accessing stored calories in their body (from fat) rather than eating them.  In addition, the vitamins and supplements recommended by our program help bolster our dieters’ nutritional status so deficiencies do not develop. An interesting piece of just-published research on bariatric surgical patients also supports this conclusion.  It has long been assumed that nutritional deficiencies in the post-surgical bariatric patient were due to malabsorption of critical vitamins and minerals.  Turns out, this is only partly true.  When investigators at the Johns Hopkins School of Medicine did nutritional analysis on a pool of pre-surgical obese patients, they found a myriad of deficiencies, even before surgery ever occurred.  Most common were iron deficiencies (36% of all pre-surgical patients) and vitamin D deficiencies (71%), much higher than in the general population.  These results fly in the face of conventional wisdom which states that not eating enough (quantity) leads directly to nutritional deficiencies in dieters (quality).  Lead investigator Kimberly Steele MD states “Our results highlight the often-overlooked paradox that abundance of food and good nutrition are not one and the same.”  Here at OSR Weight Management in Kailua we couldn’t agree more!   Read more here: http://dgnews.docguide.com/nutritional-deficiencies-common-weight-loss-surgery?overlay=2&nl_ref=newsletter&pk_campaign=newsletter  

Obesity Rates

Posted on September 28, 2015 by to press

The 2014 obesity rate statistics in the USA have just been released, and the news is not good. Data released via the Centers for Disease Control and Prevention’s annual Behavioral Risk Factor Surveillance System show that nearly half of all states have a morbid obesity rate of 30% or more.   Obesity is defined as a body…

The 2014 obesity rate statistics in the USA have just been released, and the news is not good.

Data released via the Centers for Disease Control and Prevention's annual Behavioral Risk Factor Surveillance System show that nearly half of all states have a morbid obesity rate of 30% or more.   Obesity is defined as a body mass index of 30 or greater.

In addition, not one state had an obesity rate of less than 20%.  

The CDC collected this data based on self-reported height and weight in telephone interview surveys, not from actual physician office visits where height and weight are measured.  What is worrisome is that most of us probably under-report how much we weigh, likely making these data a gross underestimate of the true prevalence of obesity.  

Hawaii's overall obesity prevalence was calculated to be 22.1.   This is also likely an underestimate due to our large Asian and Pacific Island population, for which lower BMIs carry higher cardiometabolic risk.  BMI does not tell the whole story in our unique racial and ethnic mix here on Oahu. 

Bottom line:  we have a long way to go in fighting the obesity epidemic.  And it's well past time to stop blaming patients by telling them to simply "eat less and exercise more" to fix this.  We also must abandon the science of the 70s and 80s advocating low-fat (aka high carb and sugar) diets, which are feeding this escalating problem.

 

Read more at:

https://news.yahoo.com/nearly-half-states-obesity-rate-231150850.html

http://www.cdc.gov/obesity/data/prevalence-maps.html

Weight and Gut Microbiome

Posted on September 21, 2015 by to press

A hot topic in Kailua and the news concerns the role of our intestinal bacteria in maintaining optimal weight and health.  “Take a probiotic!” is becoming a popular refrain.  Is it really that simple though?  How much probiotic?  What kind?  Lactobacccilus? Acidophilus?  Bifidobacterium?  Saccharomyces?  Faecalibacterium? How should these be dosed, and when?   It’s all…

A hot topic in Kailua and the news concerns the role of our intestinal bacteria in maintaining optimal weight and health.  "Take a probiotic!" is becoming a popular refrain.  Is it really that simple though?  How much probiotic?  What kind?  Lactobacccilus? Acidophilus?  Bifidobacterium?  Saccharomyces?  Faecalibacterium? How should these be dosed, and when?  

It's all extremely confusing to say the least, and at this point, no one really knows.

Enter Shanghai-based microbiologist, Dr. Zhao Liping, whose laboratory is at the forefront of research in the field, although somewhat by serendipity.  His physicians had urged him to lose weight to fix a number of his metabolic problems, including hypertension and high cholesterol.  Dr. Liping adopted a regimen involving Chinese yam and bitter melon—fermented  foods that in traditional Chinese Medicine are believed to change the growth of bacteria in the digestive system—and monitored not just his weight loss but also the microbes in his gut.  

Using this regimen, Dr. Liping lost 20 kilograms (over 44 pounds) in 2 years. His blood pressure, heart rate, and cholesterol level came down as well.  The changes persuaded him to focus on the microbiome's role in his transformation. He started with mice but has since expanded his research to humans.  Using such techniques as DNA sequencing and spectroscopy of metabolites present in subjects' urine, Dr. Liping aims to find individual-specific strains of gut bacteria that can be tailored to aid in weight-loss and health goals. 

I had the great fortune of personally meeting with Dr. Liping at the John A. Burns School of Medicine just last week, when he visited to lecture us and to discuss his data and findings.  I truly hope he will be able to expand his research to Hawaii's unique, ethnically-diverse population!  We will all have much to learn from this visionary scientific leader.  

Read more here:

http://www.nature.com/nrmicro/journal/v11/n9/full/nrmicro3089.html

 

http://www.sciencemag.org/content/336/6086/1248

Take A Different Kind of Break

Posted on September 21, 2015 by to press

We often associate ‘taking a break’ with a chance to chill, put our feet up, or sit in front of the TV.  A just-published study in the journal Obesity shows that an entirely different type of break can have significant health benefits:  this is, a break in the time we spend being sedentary.     …

We often associate 'taking a break' with a chance to chill, put our feet up, or sit in front of the TV.  A just-published study in the journal Obesity shows that an entirely different type of break can have significant health benefits:  this is, a break in the time we spend being sedentary.   

 

This had already been an active area of research - there are over 845 papers published on this topic!  The new study examined pooled data from 13 of the most rigorously conducted research papers.  The authors found that blood sugars normalized in subjects who consistently took two minute breaks for every 20 minutes of continuous sitting.  Markers of inflammation (C-reactive protein) also seemed to improve.  The authors did not separate patients out by race or ethnicity, so it's not entirely clear how it would apply to Hawaii's multiracial population, but it seems reasonable to think results would be similar in studies conducted here.

 

This is certainly a wake-up call that clocking our 30 minutes on the treadmill each morning may not be enough to keep us healthy - we probably need to move in bits and pieces throughout our day.  So jump off from your chair whenever you can.  Even if it is just a few moments to stroll to the window to look outside (such as at the palm trees outside OSR's window), you are doing your body good.

 

Read more at:

http://onlinelibrary.wiley.com/doi/10.1002/oby.21180/full

Beat Oahu’s Heat Wave – Try Mall Walking

Posted on September 17, 2015 by to press

Many of us enjoy going to Ala Moana Center or to the Kahala Mall to shop, browse the bookstores, and to meet friends for coffee.  But are we overlooking them as fitness destinations as well?   The CDC has now officially recommended mall-walking as a highly effective form of physical exercise.  Brisk walking of 150 minutes…

Many of us enjoy going to Ala Moana Center or to the Kahala Mall to shop, browse the bookstores, and to meet friends for coffee.  But are we overlooking them as fitness destinations as well?

 

The CDC has now officially recommended mall-walking as a highly effective form of physical exercise.  Brisk walking of 150 minutes weekly (30 minutes 5 times a week) has been associated with reduced risk of some cancers, heart disease, diabetes, and stroke.  Malls can be a great alternative to outdoor activities particularly if your neighborhood is not that walkable, or less than perfectly safe.  Plus, malls are air conditioned - a great way to beat Oahu's current heat wave - and have restrooms and areas to sit and rest if needed.  And even though intense exercise is not advised on Phase 1 of Ideal Protein's protocol, walking is a great way to reap all the health benefits of physical activity while you lose weight.  It's best if you can walk as early as possible to beat the crowds, especially on weekends.

Eat a Phase 1 friendly meal at your house, before you go, as the mall is full of quick carb loaded junk food for you to eat! If you head to the mall full, you will be less likely to want the miserable mall junk good. Plan an afternoon at the mall with friends for some walking and talking time that is good for the soul and the body!

Read more at:

http://www.cdc.gov/physicalactivity/downloads/mallwalking-guide.pdf