Americans Watch Fat, Ignore Calories

CHICAGO (AP) October 13 - More than two-thirds of the nation's adults are trying to lose weight, but researchers reported today that many will fail because they aren't cutting calories and exercising at the same time.

Thirty-five percent of men and 40 percent of women who said they were trying to lose weight are not counting calories, according to a report in today's Journal of the American Medical Association.

Many are eating less fat, but they may be consuming as many or more calories from lower-fat foods, researchers said.

Even those who are combining exercise and calorie reduction often aren't exercising enough, researchers said. Only 42 percent of the men and 37 percent of the women who said they were trying to lose weight are meeting federal recommendations of at least 150 minutes of exercise each week.

The findings could help explain why obesity is increasing even though Americans spend $33 billion a year on weight loss products and services, said the study's lead author, Dr. Mary Serdula, a medical epidemiologist in the federal Centers for Disease Control and Prevention's Division of Nutrition and Physical Activity.

``It is a combination of factors,'' Serdula said. ``We're more likely to eat out, (eat) snack foods, and physical activity is not built into our daily life.''

The survey results from more than 107,000 men and women in 49 states were analyzed by researchers from the National Center for Chronic Disease Prevention and Health Promotion, an arm of the CDC.

Serdula said she was surprised that only 21.5 percent of the men and 19.4 percent of the women who said they were trying to lose weight reported following federal recommendations for both exercise and calorie reduction.

Following the recommendations is important for anyone trying to prevent weight gain, she said.

Reducing fat intake can be a good way to automatically reduce calories, but dieters must be careful not to consume more calories overall, Serdula said. She said the guidelines recommend people get 30 percent or fewer of their calories from fat and eat at least five servings each of fruits and vegetables daily.

``It is important for persons consuming no-fat or fat-free foods to check out the labels to see how many calories are in (the food),'' she said. ``If people feel reducing fat is synonymous with reducing calories, they have a tendency to reward themselves'' with sweets.

Depression, stress affect diabetic's blood sugar

According to the report, published in the October issue of the journal Applied Psychophysiology & Biofeedback, people with insulin-dependent diabetes who reported feeling depressed, anxious, or stressed-out were among the least likely to successfully lower their blood sugar levels, even after learning to practice relaxation techniques.

In the 4-week study of 18 adults with insulin dependent diabetes, half of the participants kept daily logs of their blood sugar levels and received standard medical care. In addition to standard medical care and keeping a daily log, the other half also learned how to perform biofeedback-aided relaxation techniques that they were encouraged to practice at home.

During biofeedback, a person is hooked up to a machine that measures the specific physical functions that he or she wants to control. Using feedback from the machine as guidance, people can learn how to control such functions (including blood sugar).

After 4 weeks, there was no difference in blood sugar among the two groups. However, the researchers found that relaxation therapy did benefit the people not suffering from depression or anxiety. Of 12 people who were not depressed, those who practiced the relaxation techniques lowered their blood sugar by an average of 9%. Of nine people without anxiety those who practiced the relaxation techniques reduced their blood sugar levels by about 12%, the investigators found.

``Patients with symptoms of depression and frequent daily hassles may have found the demands of the treatment plan too hard and may have not adhered to recommendations for home practice of relaxation,'' explains study co-author Dr. Angele McGrady of the Medical College of Ohio in Toledo, in a written statement.

``The findings from this study... suggest that specific subgroups of persons with (diabetes) have the potential to benefit from relaxation-based therapies,'' the authors conclude. If the new findings are confirmed by larger studies, some diabetic patients may benefit from antidepressant medication or therapy to facilitate a positive response to biofeedback, they write.

SOURCE: Applied Psychophysiology & Biofeedback October 1999.

Weekly weightlifting improves elderly strength and performance

In people over 65 years, resistance training ``is now recognized as a safe and effective method for strength development and an important contributor to maintaining independence and enhancing physical capabilities,'' according to Dr. Dennis Taaffe from the Veterans Affairs Medical Center in Palo Alto, California, and colleagues. Their report is published in the October issue of the Journal of the American Geriatrics Society.

The investigators assigned 19 women and 34 men to one of four 24-week regimens: three sets of eight muscle strength exercises once, twice, or three times weekly, or continuation of usual activity alone.

All three exercise groups increased their muscle strength -- ranging from 37% to 42% during the 24-week program -- significantly more than the control group (4%), the report indicates. The exercise groups also experienced an increase in lean body mass compared with the controls without an increase in fat mass.

Interestingly, the team found no difference among the three exercise groups for upper body, lower body, or whole body strength.

As tests of physical function, the exercise groups all performed more quickly in rising from a chair and in toe-to-heel backward walking for 6 meters (nearly 20 feet) compared with the control group, according to the results.

Thus, ``participation in resistance exercise twice, or even once, each week achieves substantial strength gains similar to those accomplished in a standard 3-day per week program, and these gains are accompanied by improved neuromuscular performance,'' the investigators conclude.

``As declining muscle strength and balance promote falls and fracture in older adults, we suggest that a high-intensity progressive resistance training program of only one session per week may prove useful in reducing the risk of falls and, hence, fracture,'' Taaffe and colleagues propose.

SOURCE: Journal of the American Geriatrics Society 1999;47:1208-1214.

Fatty acid may be key to new treatment for cystic fibrosis

Drs. Juan G. Alvarez and Steven D. Freedman, from the Beth Israel Deaconess Medical Center, Boston, Massachusetts, have shown that they can improve changes in organs affected by cystic fibrosis by supplementing the feed of cystic fibrosis mice with high levels of docosahexanoic acid (DHA), a common fatty acid.

Arachidonic acid levels (a different fatty acid than DHA) are ``dramatically increased'' in tissues from the pancreas, the lungs, and the intestine taken from cystic fibrosis mice -- the same organs that are most affected by the disease in human patients with cystic fibrosis, the researchers explain.

At the same time, DHA levels are significantly reduced. An increase in arachidonic acid means that the cell is at risk for inflammation and mucus secretion, ``which we observe in cystic fibrosis,'' they note. DHA in turn regulates both arachidonic acid and fluids coming in and out of the cell. ``A decrease in DHA would (therefore) be expected to leave the organ dysfunctional,'' Alvarez adds.

The fact that investigators were able to reverse abnormalities in both the pancreas and the intestine by restoring a more normal balance between the two fatty acids suggests that these abnormalities are responsible for what happens in cystic fibrosis, the team reports. High levels of inflammation usually seen in the lungs of cystic fibrosis mice also fell when animals were pretreated with the same high doses of DHA.

``Importantly,'' added Freedman, ``this lipid imbalance is present in tissues that are affected in the cystic fibrosis mouse and not in tissues not affected by cystic fibrosis.''

Preliminary results already indicate that tissues affected by cystic fibrosis in patients have the same fatty acid imbalance as those in cystic fibrosis mice, the investigators noted.

But Bob Bell, president and chief executive officer of the Cystic Fibrosis Foundation, stressed that patients with cystic fibrosis must not rush out and buy DHA from stores where it may be available ``as they could do themselves irreparable harm.''

If further tests show that DHA is an effective treatment for cystic fibrosis, then patients may be able to take an oral supplement, which would help treat problems in the pancreas, the intestine, and the lung with one therapy. This is not currently the case for some of the treatments used for cystic fibrosis he noted, in that they usually treat disease-related problems in only one organ.

Clinical trials evaluating the effect of oral DHA in patients with cystic fibrosis could start early next year.

Alternatives Gain in Arthritis Treatment

A new clinical study shows two-thirds of arthritis sufferers use some type of alternative treatments either alone or with more traditional drug therapy. The study in the Annals of Internal Medicine doesn't consider the effectiveness of such treatments but says 90 percent of arthritis patients surveyed use alternatives.

Study authors say using nontraditional treatments may interfere with other prescribed therapies or delay their use and physicians are concerned they may not know what their patients are doing. Nearly half of survey respondents say they discussed alternative treatments with their physician.

A patient's fear of doctor disapproval was considered a factor in the physician not knowing of alternative treatment use. But the most common reason for not informing the doctor was the physican's failure to ask, the study says.

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