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2018 UW Obesity Management Summit | UWMadison ICEP

Apr, 11th 2018 4:44 pm, Article Recommended by Dr. J. Smith

Friday, May 18, 2018

7:00 Registration, Continental Breakfast & Exhibits8:00 Welcome: The Scope of Severe Obesity in Wisconsin: A State-Level Perspective

I. The obesity epidemic: how did we get here?Moderator: Luke Funk, MD, MPH

8:15 The public health perspectiveLarry Hanrahan, MD

8:40 The spread of obesity through social networksMarlon Mundt, PhD, MS, MA

9:05 Human obesity and energy balance: the physiologic perspectiveDale Schoeller, PhD

9:30 Panel Discussion

9:45 Refreshment Break & Exhibits

II. Evidence-based dietary strategies for obesityModerator: Corrine Voils, PhD

10:00 Strategies to improve cardiometabolic risk using lifestyle modificationJamy Ard, MDVP

10:30 Low carbohydrate diet: Lessons learned over 15 yearsWilliam Yancy, MD, MHScVP

11:00 Maintaining dietary changes in the long-term: state of the evidenceCorrine Voils, PhD

11:20 Evidence-based exercise strategies in a primary care settingLisa Cadmus-Bertram, PhD

11:40 Panel Discussion

11:55 Lunch & Exhibits

III. Bariatric surgery and endoscopic options for obesity treatmentModerator: Anne Lidor, MD, MPH

1:15 Bariatric surgery options and outcomes in 2018Shanu Kothari, MD, FASMBS VP

1:45 Is bariatric surgery a cost-effective intervention?Luke Funk, MD

2:15 Endoscopic treatments for obesityBrad Needleman, MD, FASMBS VP

2:45 Panel Discussion

3:00 Refreshments &Exhibitors

IV. Bariatric Surgery: Multi-disciplinary team elementsModerator: Michael Garren, MD

3:15 Role of the primary care provider and timing of referral to a bariatric surgery programGurpreet Boparai, MD VP

3:45 Psychological evaluation of the bariatric surgery candidateLisa Nackers, PhD

4:15 Nutritional considerations for the bariatric surgery candidateSamantha Gollup, RD

4:45 Panel Discussion

5:00 Adjourn

7:00 Registration, Continental Breakfast & Exhibits

V. Pharmacologic treatment of obesity and diabetesModerator: Dawn Davis, MD, PhD

8:00 FDA-approved weight loss medicationsTimothy Yeh, PharmD

8:20 Treatment of diabetes and its impact on weightDawn Davis, MD, PhD

8:50 Metabolic syndrome/diabetes preventionSubarna Dhital, MD

9:20 Panel Discussion

9:35 Refreshment Break & Exhibits

VI. Pediatric obesity treatmentModerator: Jennifer Rehm, MD

9:50 2017 Endocrine Society pediatric obesity guidelinesEllen Connor, MD

10:20 Weight loss with exercise in a pediatric settingBlaise Nemeth, MD, MS

10:50 Bariatric surgery in adolescent patientsTammy Kindel, MD, PhD VP

11:20 Panel Discussion

11:35 Box Lunch

VII. Obesity management considerations in primary care and the communityModerator: Amy Meinen, MDH, RD

11:55 Racial disparities in obesity and obesity treatmentEva M Vivian, PharmD, MS

12:15 Development of a community health weight control programBrian Arndt, MD

12:15 Development of a community health weight control programMaggie J. Larson, DO

12:35 The Fruit and Vegetable Prescription ProgramNicholas Heckman

12:55 The Obesity Prevention InitiativeVince Cryns, MD, PhD

1:15 Panel Discussion

1:30 Closing Remarks and Adjourn

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2018 UW Obesity Management Summit | UWMadison ICEP

Long-term weight loss maintenance | The American Journal of Clinical …

Apr, 10th 2018 10:40 pm, Article Recommended by Dr. J. Smith

ABSTRACT

There is a general perception that almost no one succeeds in long-term maintenance of weight loss. However, research has shown that 20% of overweight individuals are successful at long-term weight loss when defined as losing at least 10% of initial body weight and maintaining the loss for at least 1 y. The National Weight Control Registry provides information about the strategies used by successful weight loss maintainers to achieve and maintain long-term weight loss. National Weight Control Registry members have lost an average of 33 kg and maintained the loss for more than 5 y. To maintain their weight loss, members report engaging in high levels of physical activity (1 h/d), eating a low-calorie, low-fat diet, eating breakfast regularly, self-monitoring weight, and maintaining a consistent eating pattern across weekdays and weekends. Moreover, weight loss maintenance may get easier over time; after individuals have successfully maintained their weight loss for 25 y, the chance of longer-term success greatly increases. Continued adherence to diet and exercise strategies, low levels of depression and disinhibition, and medical triggers for weight loss are also associated with long-term success. National Weight Control Registry members provide evidence that long-term weight loss maintenance is possible and help identify the specific approaches associated with long-term success.

The perception of the general public is that no one ever succeeds at long-term weight loss. This belief stems from Stunkard and McLaren-Humes 1959 study of 100 obese individuals, which indicated that, 2 y after treatment, only 2% maintained a weight loss of 9.1 kg (20 lb) or more (1). More recently, a New England Journal of Medicine editorial titled Losing Weight: An Ill-Fated New Years Resolution (2) echoed the same pessimistic message.

The purpose of this paper is to review the data on the prevalence of successful weight loss maintenance and then present some of the major findings from the National Weight Control Registry (NWCR), a database of more than 4000 individuals who have indeed been successful at long-term weight loss maintenance.

Wing and Hill (3) proposed that successful weight loss maintainers be defined as individuals who have intentionally lost at least 10% of their body weight and kept it off at least one year. Several aspects of this definition should be noted. First, the definition requires that the weight loss be intentional. Several recent studies indicate that unintentional weight loss occurs quite frequently and may have different causes and consequences than intentional weight loss (4,5). Thus, it is important to include intentionality in the definition. The 10% criterion was suggested because weight losses of this magnitude can produce substantial improvements in risk factors for diabetes and heart disease. Although a 10% weight loss may not return an obese to a non-obese state, the health impact of a 10% weight loss is well documented (6). Finally, the 1-y duration criterion was proposed in keeping with the Institute of Medicine criteria (7). Clearly, the most successful individuals have maintained their weight loss longer than 1 y, but selecting this criterion may stimulate research on the factors that enable individuals who have maintained their weight loss for 1 y to maintain it through longer intervals.

There are very few studies that have used this definition to estimate the prevalence of successful weight loss maintenance. McGuire et al (8) reported results of a random digit dialing survey of 500 adults, 228 of whom were overweight or obese [body mass index (BMI) 27 kg/m2] at their maximum nonpregnant weight. Of these 228, 47 (20.6%) met the criteria for successful weight loss maintenance: they had intentionally lost at least 10% of their body weight and maintained it for at least 1 y. On average, these 47 individuals had lost 20.7 14.4 kg (45.5 lb; 19.5 10.6% from maximum weight) and kept it off for 7.2 8.5 y; 28 of the 47 had reduced to normal weight (BMI

Survey data such as these have the perspective of a persons entire lifetime and thus may include many weight loss attempts, some which were successful and some unsuccessful. It is more typical to assess success during one specific weight loss bout. In standard behavioral weight loss programs, participants lose an average of 710% (710 kg) of their body weight at the end of the initial 6-mo treatment program and then maintain a weight loss of 56 kg (56%) at 1-y follow-up. Only a few studies have followed participants for longer intervals; in these studies, 1320% maintain a weight loss of 5 kg or more at 5 y. In the Diabetes Prevention Program (9), 1000 overweight individuals with impaired glucose tolerance were randomly assigned to an intensive lifestyle intervention. The average weight loss of these participants was 7 kg (7%) at 6 mo; after 1 y, participants maintained a weight loss of 6 kg (6%), and, at 3 y, they maintained a weight loss of 4 kg (4%). At the end of the study (follow-up ranging from 1.8 to 4.6 y; mean, 2.8 y), 37% maintained a weight loss of 7% or more.

Thus, although the data are limited and the definitions varied across studies, it appears that 20% of overweight individuals are successful weight losers.

Although it is often stated that no one ever succeeds in weight loss, we all know some people who have achieved this feat. In an effort to learn more about those individuals who have been successful at long-term weight loss, Wing and Hill (10) established the National Weight Control Registry in 1994. This registry is a self-selected population of more than 4000 individuals who are age 18 or older and have lost at least 13.6 kg (30 lb) and kept it off at least 1 y. Registry members are recruited primarily through newspaper and magazine articles. When individuals enroll in the registry, they are asked to complete a battery of questionnaires detailing how they originally lost the weight and how they now maintain this weight loss. They are subsequently followed annually to determine changes in their weight and their weight-related behaviors.

The demographic characteristics of registry members are as follows: 77% are women, 82% are college educated, 95% are Caucasian, and 64% are married. The average age at entry to the registry is 46.8 y. About one-half of registry members report having been overweight as a child, and almost 75% have one or two parents who are obese.

Participants self-report their current weight and their maximum weight. Previous studies suggest that such self-reported weights are fairly accurate (slightly underestimating actual weight) (11,12). In the NWCR, participants are asked to identify a physician or weight loss counselor who can provide verification of the weight data. When, in a subgroup of participants, the information provided by participants was compared with that given by the professional, the self-report information was found to be very accurate.

Participants in the registry report having lost an average of 33 kg and have maintained the minimum weight loss (13.6 kg) for an average of 5.7 y. Thirteen percent have maintained this minimum weight loss for more than 10 y. The participants have reduced from a BMI of 36.7 kg/m2 at their maximum to 25.1 kg/m2 currently. Thus, by any criterion, these individuals are clearly extremely successful.

Previously, we reported information about the way in which registry participants lost their weight (10); interestingly, about one-half (55.4%) reported receiving some type of help with weight loss (commercial program, physician, nutritionist), whereas the others (44.6%) reported losing the weight entirely on their own. Eighty-nine percent reported using both diet and physical activity for weight loss; only 10% reported using diet only, and 1% reported using exercise only for their weight loss. The most common dietary strategies for weight loss were to restrict certain foods (87.6%), limit quantities (44%), and count calories (43%). Approximately 25% counted fat grams, 20% used liquid formula, and 22% used an exchange system diet. Thus, there is variability in how the weight loss was achieved (except that it is almost always by diet plus physical activity).

The earliest publication regarding the registry documented the behaviors that the members (n = 784) were using to maintain their weight loss (10). Three strategies were reported very consistently: consuming a low-calorie, low-fat diet, doing high levels of physical activity, and weighing themselves frequently. Recently, a fourth behavior was identified: consuming breakfast daily (13). Each of these behaviors is described below. Registry members reported eating 1381 kcal/d, with 24% of calories from fat. In interpreting their data, it is important to recognize that 55% of registry members report that they are still trying to lose weight and to consider that dietary intake is typically underestimated by 2030%. Thus, registry members are probably eating closer to 1800 kcal/d. However, even with this adjustment, it is apparent that registry members maintain their weight loss by continuing to eat a low-calorie, low-fat diet.

More recently, we have examined other aspects of their diet. Of particular interest is the fact that 78% of registry members report eating breakfast every day of the week (13). Only 4% report never eating breakfast. The typical breakfast is cereal and fruit. Registry members also report consuming 2.5 meals/wk in restaurants and 0.74 meals/wk in fast food establishments.

Another characteristic of NWCR members is high levels of physical activity. Women in the registry reported expending an average of 2545 kcal/wk in physical activity, and men report an average of 3293 kcal/wk (10). These levels of activity would represent 1 h/d of moderate-intensity activity, such as brisk walking. The most common activity is walking, reported by 76% of the participants. Approximately 20% report weight lifting, 20% report cycling, and 18% report aerobics.

Registry members also reported frequent monitoring of their weight (10). More than 44% report weighing themselves at least once a day, and 31% report weighing themselves at least once a week. This frequent monitoring of weight would allow these individuals to catch small weight gains and hopefully initiate corrective behavior changes.

The vigilance regarding body weight can be seen as one aspect of the more general construct of cognitive restraint (ie, the degree of conscious control exerted over eating behaviors). Registry members are asked to complete the Three Factor Eating Inventory (14), which includes a measure of cognitive restraint. Registry members scored high on this measure (mean of 7.1), with levels similar to those seen in patients who have recently completed a treatment program for obesity, although not as high as eating-disordered patients. These findings suggest that successful weight loss maintainers continue to act like recently successful weight losers for many years after their weight loss.

Registry participants are followed over time to identify variables related to continued success at weight loss and maintenance. Findings from the initial follow-up study (15) indicated that, after 1 y, 35% gained 2.3 kg (5 lbs) or more (7 kg on average), 59% continued to maintain their body weight, and 6% continued to lose weight.

Participants who regained weight (>2.3 kg) were compared with those who continued to maintain their body weight to examine whether there were any baseline characteristics that could distinguish the two groups. The single best predictor of risk of regain was how long participants had successfully maintained their weight loss (Table 1). Individuals who had kept their weight off for 2 y or more had markedly increased odds of continuing to maintain their weight over the following year. This finding is encouraging because it suggests that, if individuals can succeed at maintaining their weight loss for 2 y, they can reduce their risk of subsequent regain by nearly 50%.

TABLE 1

Duration of weight loss maintenance and 1-y risk of weight regain among successful weight losers1

TABLE 1

Duration of weight loss maintenance and 1-y risk of weight regain among successful weight losers1

Another predictor of successful weight loss maintenance was a lower level of dietary disinhibition, which is a measure of periodic loss of control of eating. Participants who had fewer problems with disinhibition [ie, scores

Several key behavior changes that occurred over the year of follow-up also distinguished maintainers from regainers. Not surprisingly, those who regained weight reported significant decreases in their physical activity, increases in their percentage of calories from fat, and decreases in their dietary restraint. Thus, a large part of weight regain may be attributable to an inability to maintain healthy eating and exercise behaviors over time. The findings also underscore the importance of maintaining behavior changes in the long-term maintenance of weight loss.

Another variable that has been examined in the registry is the presence of a triggering event leading to participant successful weight loss. Most registry participants reported a trigger for their weight loss (83%). Medical triggers were the most common (23%), followed by reaching an all time high in weight (21.3%), and seeing a picture or reflection of themselves in the mirror (12.7%).

Because medical triggers have been shown to promote long-term behavior change in other areas of behavioral medicine (16), we examined whether individuals who reported medical triggers were more successful than those who reported nonmedical triggers or no triggers. A medical trigger was defined broadly and included, for example, a doctor telling the participant to lose weight and/or a family member having a heart attack. Findings indicated that people who had medical reasons for weight loss also had better initial weight losses and maintenance (17). Specifically, those who said they had a medical trigger lost 36 kg, whereas those who had no trigger (17.1%) or a nonmedical trigger (59.9%) lost 32 kg. Medical triggers were also associated with less regain over 2 y of follow-up. Those with medical triggers gained 4 kg (2 kg/y), whereas those with other or no medical triggers gained at a significantly faster rate, averaging 6 kg in both groups.

These findings are intriguing because they suggest that the period following a medical trigger may be an opportune time to initiate weight loss to optimize both initial and long-term weight loss outcomes.

The topic of dieting consistency was also recently examined in the registry. Participants were asked whether they maintained the same diet regimen across the week and year, or if they tended to diet more strictly on weekdays and/or nonholidays (18). Few people said they dieted more strictly on the weekend compared with the rest of the week (2%) or during holidays compared with the rest of the year (3%). Most participants reported that their eating was the same on weekends and weekdays (59%) and on holidays/vacations and the rest of the year (45%). The remaining groups reported that they were stricter during the week than on weekends (39%) and during nonholiday times compared with holidays (52%).

We evaluated whether maintaining a consistent diet was related to subsequent weight regain after 2 y. Interestingly, results indicated that participants who reported a consistent diet across the week were 1.5 times more likely to maintain their weight within 5 lb over the subsequent year than participants who dieted more strictly on weekdays. A similar relationship emerged between dieting consistency across the year and subsequent weight regain; individuals who allowed themselves more flexibility on holidays had greater risk of weight regain. Allowing for flexibility in the diet may increase exposure to high-risk situations, creating more opportunity for loss of control. In contrast, individuals who maintain a consistent diet regimen across the week and year appear more likely to maintain their weight loss over time.

We also examined different patterns of weight change among registry participants followed over time. We were particularly interested in evaluating whether participants who gained weight between baseline and year 1 were able to recover over the subsequent year. We found that few people (11%) recovered from even minor lapses of 12 kg. Similarly, magnitude of weight regain at year 1 was the strongest predictor of outcome from year 0 to 2. Participants who gained the most weight at year 1 were the least likely to re-lose weight the following year, both when recovery was defined as a return to baseline weight or as re-losing at least 50% of the year 1 gain.

Although participants gained weight and recovery was uncommon, the regains were modest (average of 4 kg at 2 y), and the vast majority of participants (96%) remained >10% below their maximum lifetime weight, which is considered successful by current obesity treatment standards.

These findings, nonetheless, suggest that reversing weight regain appears most likely among individuals who have gained the least amount of weight. Preventing small regains from turning into larger relapses appears critical to recovery among successful weight losers.

Results of random digit dial surveys indicate that 20% of people in the general population are successful at long-term weight loss maintenance. These data, along with findings from the National Weight Control Registry, underscore the fact that it is possible to achieve and maintain significant amounts of weight loss.

Findings from the registry suggest six key strategies for long-term success at weight loss: 1) engaging in high levels of physical activity; 2) eating a diet that is low in calories and fat; 3) eating breakfast; 4) self-monitoring weight on a regular basis; 5) maintaining a consistent eating pattern; and 6) catching slips before they turn into larger regains. Initiating weight loss after a medical event may also help facilitate long-term weight control.

Additional studies are needed to determine the factors responsible for registry participant apparent ability to adhere to these strategies for a long period of time in the context of a toxic environment that strongly encourages passive overeating and sedentary lifestyles.

RRW is the cofounder of the National Weight Control Registry (with James O Hill). RRW coauthored the manuscript with SP, who is a coinvestigator of the National Weight Control Registry. RRW and SP have no financial or personal interest in the organizations sponsoring this research.

1.

The results of treatment for obesity

Arch Int Med

1959

103

79

85

2.

Losing weightan ill-fated New Years resolution

N Engl J Med

1998

338

52

4

3.

Successful weight loss maintenance

Annu Rev Nutr

2001

21

323

41

4.

History of intentional and unintentional weight loss in a population-based sample of women aged 55 to 69 years

Obes Res

1995

3

163

70

5.

Prospective study of intentional weight loss and mortality in never-smoking overweight US white women aged 4064 years

Am J Epidemiol

1995

141

1128

41

6.

National Hearth, Lung, and Blood Institute

Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: The evidence report

Obes Res

1998

6

51S

210S

7.

Institute of Medicine

Weighing the options: criteria for evaluating weight management programs

Washington, DC

Government Printing Office

1995

8.

The prevalence of weight loss maintenance among American adults

Int J Obes

1999

23

1314

9

9.

Diabetes Prevention Program Research Group

Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin

N Engl J Med

2002

346

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Long-term weight loss maintenance | The American Journal of Clinical …

Fitness Sports Running, Walking & Tri Store – Established …

Apr, 8th 2018 4:45 pm, Article Recommended by Dr. J. Smith

No Capital Striders/Fitness Sports Training GroupRun this week (Apr. 7) as we produce the Loop the Lake Race at Grays lake miles.We’ll be back on April 14th at Meredith Hall.

April

Loop theLake, Des Moines

Beer& Bagel, Trail, Granger

ChamberChill, Ankeny

Osprey 5K Fun Run/Walk, Indianola

Run4 Missions, Des Moines

SpringvilleHill Climb , Pleasant Hill

RedShamrock Trail, I.C.

Backto the Fool’s 5K, Waterloo

Doc’sDash, Iowa City

March

IowaTrail Runs Series, Madrid

SpringThaw, Sioux City

EasterEgg Scramble,Davenport

FriendlySons St. Patrick, DSM

MotorMill Trail, Elkader

GaelicGallop, Dyersville

Potof Gold Shared Half & 5K. Oslaloosa

St.Patrick’s Day, Davenport

O;Roundthe Loch, Emmetsburg

St.Paddy’s Half and 5k DSM

JerseyFreeze 5k, Monroe

Lucky,North Liberty

LeprechaunChase, DSM

ShamrockShuffle, Iowa City

More archived RR & Tri results here

More XC results here

Striderland7 for 2016 (A review of Central Iowa happenings in the running world)

Article”Running On the Road in Des Moines, IA” from Runner’s World Magazine

Original post:
Fitness Sports Running, Walking & Tri Store – Established …

Organic Meal Delivery Service | Healthy Diet | Fresh n’ Lean

Apr, 8th 2018 4:42 pm, Article Recommended by Dr. J. Smith

Finding time to cook a healthy meal can be a challenge on a day-to-day basis.Save time and let our team of gourmet chefs prepare your meals that are always healthy and delicious.We believe in using premium ingredients that are always fresh in creating meals for you that are perfectly suited for healthy eating and weight loss.

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Are you trying to lose weight but you do not want to sacrifice the taste of your meals?Perhaps you are tired of looking up recipes that can help you lose weight and are struggling to find the time to buy all the ingredients and prepare them at home.Fresh n’ Lean’s weight loss meal plans is convenient where our meals are delivered fresh to your door!

Dieting?We do not have any secret ingredients or a pill that sheds the fat off your body, but instead we believe in a healthier lifestyle where our organic, plant-based meals will help you shed the unwanted weight by eating foods that are high in fiber, rich in antioxidants,and rich in nutrients.

Whether you are looking to eat healthier or shed a few pounds there is no need to sacrifice taste. Try our diet meal delivery service and start enjoying a fit and healthier lifestyle.

Fresh n’ Lean has a weekly menu that rotates so you get a variety of healthy meals that include breakfast, lunch, and dinner.We do the cooking so all you need to do is place an order with us and you will receive your prepared meals every week.If you are looking for a meal plan where you can pick and choose your dishes, we offer an a la carte option where you can stock up on your favorite dishes.

We cater to your specific needs. Our food delivery is great for people who are looking for any of the following options:

You no longer need to worry about waiting in a long line at the drive-thru after work or standing in long lines during your lunch break.Our prepared meals are fully cooked so all you need to do is heat it up in the microwave and you are ready to enjoy it.What can be easier than that?

Whether you are trying tosave time, start a healthier lifestyleor want to lose weight, we invite you to sign up for our plant-basedmeal delivery.

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Organic Meal Delivery Service | Healthy Diet | Fresh n’ Lean

Sermorelin Acetate Cost, Review of Benefits and Comparison to hGH – Fitness Edge

Apr, 8th 2018 1:46 am, Article Recommended by Dr. J. Smith

hGH Replacement Therapy has been a popular Anti-Aging and performance enhancing treatment since as early as 1990, but unfortunately, use of hGH does not come without risks.

Sermorelin acetate has become a popular alternative as it enables you to obtain the benefits of hGH Therapy, without the associated risks.

This article looks more closely at Sermorelin injections as a hGH alternative.

To begin with, it is a good idea to have an understanding of what sermorelin acetate is and what role it plays when administered via injection. Scientifically sermorelin acetate is referred to as growth hormone releasing factor 129 NH2-acetate, this is because it is a peptide which contains the first 29 amino acids that make up growth hormone produced in our bodies.

This contributes to sermorelins function as a growth hormone secretagogue (a substance which causes another substance to be secreted Wikipedia) in this case, the substance whose secretion is promoted is growth hormone. For this reason, sermorelin is often also referred to as an hGH stimulator and is considered an excellent alternative to hGH.

One important thing to understand about Sermorelin is that it promotes healthy function of the pituitary (the gland responsible for our bodys production of hGH) during the aging process. This is a far cry from aggressive administration of hGH which can, in fact, negatively impact normal pituitary function.

There are many advantages of using sermorelin for hGH replacement therapy rather than hGH itself, both in terms of safety as well as accessibility and sermorelin price.

With regards to safety, it has long been known that administration of hGH is associated with a range of adverse side-effects. These include, but are not limited to, bone and tissue growth abnormalities, diabetes, heart disease and even cancer.

Add to this the possibility of overdose, a shutting down of normal growth hormone production and the possibility of a sudden reduction in response to hGH injections (a phenomenon known as Tachyphylaxis) and you may start to wonder if hGH is worth the risk.

Sermorelin on the other hand, has not been associated with the same long list of side-effects as hGH. Overdose is considered to be very difficult, if not impossible, and administration of sermorelin results in a release of growth hormone more in line with our bodys natural process rather than having consistently high levels as is the case with hGH injections.

Sermorelin peptides do not shut down the bodys own production of hGH but instead supports pituitary function and promotes natural production of hGH. For this reason, increased hGH production is noted for a period even after sermorelin therapy has stopped.

Check out this table comparing Peptide Therapy and hGH

Then there are the safety concerns surrounding use of hGH which arise from its status as a controlled substance. Legally doctors can only prescribe hGH for children with human growth hormone deficiency, medically diagnosed hGH deficiency in adults and individuals with HIV. This makes accessing hGH very difficult and has contributed to the illegal sale of hGH.

As with any illegally produced and purchased drug, the consumer has no way of knowing the quality of drug they are injecting into their body. At best, you may inject inert (and therefore useless) hGH, at worst a lethal cocktail of contamination produced in somebodies garage. And even if you do find what appears to be a reputable seller of hGH outside of the US, import it and you face the legal implications of importing a controlled substance.

Sermorelin, by comparison, is not governed by the same strict laws of medical use and this is largely due to its safety profile. For this reason, sermorelin is much more accessible and is commonly prescribed by doctors in anti-aging and wellness clinics in conjunction with other growth hormone releasing peptides such as GHRP-2 and GHRP-6.

Sermorelin is still a pharmaceutical and therefore a prescription is required to purchase it but there are legitimate online portals which match patients and doctors making it very easy for you to purchase sermorelin and have it delivered to your home.

Another distinct advantage of using sermorelin instead of hGH is cost. hGH typically costs $1000+ per month of treatment, sermorelin is a much more affordable option with 3 months treatment of sermorelin costing significantly less than just one month on hGH.

Check the Cost of 1 Month and 3 Months Supply of Sermorelin

Besides the obvious advantages of sermorelin injections detailed above, you may want to know how you can benefit from using this therapy. Perhaps the easiest way to understand the potential benefits of hGh replacement therapy is to look at the symptoms of hGH decline and the effect hGH replacement has on those symptoms. These are detailed below:

1. Changes in Body Composition

Changes in body composition due to decreasing levels of hGH are reflected by a decrease in lean body mass (muscle) and an increase in fat mass. Correcting hGH levels has been shown to reverse this state by improving muscle mass and reducing fat.

2. Bone Mineral Density

Research indicates that hGH deficiency in adults contributes to a reduction in bone density and therefore increased risk of osteoporosis. It has also been shown that hGH replacement therapy for greater than 12 months results in improved bone mineral density and hence, lower risk of osteoporosis.

3. Muscle Strength

Due to changes in body composition detailed above, muscle strength is understandably compromised. As hGH therapy corrects body composition and improves muscle mass, muscle strength also improves. The best results are gained after 12 months of hGH therapy.

4. Joint Health

By improving bone mineral density and increasing muscle mass and strength, hGH therapy can help to prevent joint deterioration that is a feature of arthritis. Optimal growth hormone levels are also essential for health of connective tissue such as the synovium found in joints.

5. Exercise Performance

Exercise performance is reduced in individuals with growth hormone deficiency. This appears to be partially due to reductions in bone density and muscle mass but also in part due to a reduction in oxygen uptake. hGH therapy for 6 months has been shown to improve exercise performance by improving muscle mass and also oxygen uptake

6. Heart Health

There is evidence of a greater risk of heart disease in individuals with growth hormone deficiency and it has been hypothesized that this is due to a greater propensity to develop premature atherosclerosis (a build-up of plaque inside the arteries which increases risk of heart attack and stroke). Growth hormone deficiency also results in changes in heart size and function. These changes have been demonstrated to be reversed after 6 months hGH therapy.

7. Metabolism

Growth hormone deficiency results in a reduced resting metabolism and replacement therapy reverses this decrease. hGH therapy has also been shown to increase protein synthesis, increase fat oxidation, normalize carbohydrate metabolism and reduce LDL (bad) cholesterol. These favorable effects on metabolism may in part explain some of the other benefits of hGH including improved hearth health and body composition.

8. Skin Thickness

A reduction in skin thickness and all-important skin collagen is another result of growth hormone deficiency. Both conditions are improved by hGH therapy.

9. Immune Function

Although adults with growth hormone deficiency are not normally considered to have a compromised immune system, there is some evidence to suggest that hGH therapy can help regulate immune function.

10. Libido

It has been demonstrated that people with growth hormone deficiency have more difficulty with sexual relationships and reportedly, lower energy levels. Many individuals have found an improvement in energy, libido and sexual performance following hGH therapy, some men even claiming an improvement in problems with premature ejaculation.

11. Quality of Life

Reduced psychological well-being has been reported in individuals with growth hormone deficiency and hGH replacement has resulted in improvements in mood, energy and general feelings of well-being.

As discussed, sermorelin peptides are a pharmaceutical product requiring prescription and purchase from a pharmacy.

There are online portals which can connect you with a physician who specializes in prescribing hGH therapy via phone/internet chat. You can then purchase and be sent the sermorelin via the mail.

This is all done in one easy order that includes the consultation with the prescribing doctor (via phone or internet chat), your hGH replacement therapy and ongoing support all in the upfront sermorelin price.

Beware of websites that offer sermorelin for sale without a prescription. Chances are you are not getting the real deal and could be jeopardizing your health.

Compare Available Sermorelin Programs Here

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Sermorelin Acetate Cost, Review of Benefits and Comparison to hGH – Fitness Edge

hCG Diet Information – Johannesburg Based Diet Weight Loss …

Apr, 8th 2018 1:45 am, Article Recommended by Dr. J. Smith

There are many skeptics and critics who voice their opinions about HCG Dieters losing weight simply because of they are following a Low Calorie diet, so you can find all the hcg diet information right here.

Anyone that has tried dieting alone will tell you that this is simply not true.So many people eat healthy, follow a diet and exercise hard yet they simply cannot shift the weight.

The research and studies of Dr. Simeon’s proved this and dismissed any judgmental options aimed at those people who need extra help to lose weight quickly.

We are all unique individuals and our bodies all function differently, those “Skinny Folk” who can eat and drink what they want without picking up weight or drop weight whenever they decide, simply can’t understand the majority of people who have a constant battle to lose weight, having tried everything and finally realise that the body needs something else besides diet and exercise Alone, to lose weight.

From the years of studies and research, Dr Simeons results showed the hormone HCG made weight loss much more effective than dieting and exercise alone.

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hCG Diet Information – Johannesburg Based Diet Weight Loss …

How to Lose Weight in 5 Days | Men’s Fitness

Apr, 6th 2018 1:43 am, Article Recommended by Dr. J. Smith

Fat-burners are over-the-counter supplements that typically blend different kinds of herbs and stimulants to raise your core temperature, which can help you burn more calories at rest and during exercise, and suppress appetite. Common ingredients include green tea extract, caffeine, synephrine, capsicum, raspberry ketones, and garcinia cambogia.

Synephrine is a substance found in a variety of citrus foods, such as mandarin and clementines. Recent research suggests its safe for the heart and may increase resting metabolic rate. Capsicum, the chemical that makes hot peppers taste spicy, is generally used for pain relief, and a 2011 Chemical Senses review suggests capsicum consumption may benefit weight loss. Caffeine and garcinia cambogia act as appetite suppressants, which help you keep portions small and junk-food cravings at bay.

Fat-burners can increase your metabolism, give you more energy, suppress hunger, and increase your core temperature so you indirectly burn more calories. However, watch out for side effects of these ingredients and be sure to not combine them with other stimulants or medications. Here are 10 of the best supplements for weight loss.

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How to Lose Weight in 5 Days | Men’s Fitness

Medical Weight Loss | How to Lose Weight | Aurora Health Care

Apr, 6th 2018 1:41 am, Article Recommended by Dr. J. Smith

Hormonal and metabolic imbalances or even prescription medicine can interfere with your body’s ability to lose weight. Our personalized approach to weight loss begins with a complete evaluation, where we review your health, diet history, body composition, blood panel and EKG to better understand your total health profile. We also consult with your primary care provider as needed to assure optimal overall health.

From there, we tailor a personalized weight loss plan that will work for your body. Unlike rapid weight loss and fad diets that help you lose weight fast – only to regain it later – our safe weight loss program takes a multidisciplinary, holistic approach to set you up for long-term success. You’ll have frequent follow-ups that provide support, motivation and education, addressing the medical, emotional and physical aspects of your weight loss journey.

You can expect a positive, encouraging environment where we celebrate your successes and support you through any setbacks.

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Medical Weight Loss | How to Lose Weight | Aurora Health Care

Improving adherence to healthy dietary patterns, genetic …

Apr, 4th 2018 1:41 pm, Article Recommended by Dr. J. Smith

Abstract

Objective To investigate whether improving adherence to healthy dietary patterns interacts with the genetic predisposition to obesity in relation to long term changes in body mass index and body weight.

Design Prospective cohort study.

Setting Health professionals in the United States.

Participants 8828 women from the Nurses Health Study and 5218 men from the Health Professionals Follow-up Study.

Exposure Genetic predisposition score was calculated on the basis of 77 variants associated with body mass index. Dietary patterns were assessed by the Alternate Healthy Eating Index 2010 (AHEI-2010), Dietary Approach to Stop Hypertension (DASH), and Alternate Mediterranean Diet (AMED).

Main outcome measures Five repeated measurements of four year changes in body mass index and body weight over follow-up (1986 to 2006).

Results During a 20 year follow-up, genetic association with change in body mass index was significantly attenuated with increasing adherence to the AHEI-2010 in the Nurses Health Study (P=0.001 for interaction) and Health Professionals Follow-up Study (P=0.005 for interaction). In the combined cohorts, four year changes in body mass index per 10 risk allele increment were 0.07 (SE 0.02) among participants with decreased AHEI-2010 score and 0.01 (0.02) among those with increased AHEI-2010 score, corresponding to 0.16 (0.05) kg versus 0.02 (0.05) kg weight change every four years (P

Conclusions These data indicate that improving adherence to healthy dietary patterns could attenuate the genetic association with weight gain. Moreover, the beneficial effect of improved diet quality on weight management was particularly pronounced in people at high genetic risk for obesity.

Obesity is a multifactorial disorder that has a genetic predisposition but requires environmental influences for it to manifest.12 In the US, the past decades witnessed considerable transition of habitual dietary habits from a traditional pattern high in complex carbohydrates and fiber toward one high in sugar, fat, and animal products, which has played a key role in triggering the surge of obesity.34 Compelling evidence has shown that certain dietary factors such as sugar sweetened drinks, fried foods, and coffee might modify the genetic susceptibility to elevated body mass index, supporting potential interactions between genetic predisposition and overall dietary patterns on the risk of obesity.567

On the basis of scientific evidence and dietary recommendations, several diet quality scores have been developed to evaluate the healthfulness of dietary patterns.8910 One such score is the Alternate Healthy Eating Index 2010 (AHEI-2010), which has been consistently associated with lower risk of chronic disease in clinical and epidemiological investigations.8 The other two commonly studied scores are the Dietary Approach to Stop Hypertension (DASH), which represents the DASH-style diet aimed at reducing blood pressure,9 and the Alternate Mediterranean Diet (AMED), which focuses on a Mediterranean dietary pattern.10 Improving adherence to healthy dietary patterns, as assessed by these three diet quality scores, has been associated with less weight gain in previous studies.111213 However, no study has assessed the interactions between changes in adherence to healthy dietary patterns over time and genetic susceptibility to obesity on long term weight gain.

In this study, we prospectively examined the interactions of changes in the AHEI-2010, DASH, and AMED over up to 20 years with genetic predisposition to obesity, as evaluated by a genetic risk score based on 77 genetic variants associated with body mass index, on long term changes in body mass index and body weight in US men and women from two independent, prospective cohorts: the Nurses Health Study and the Health Professionals Follow-up Study.

The Nurses Health Study is a cohort of 121701 female registered nurses aged 30-55 years at enrollment in 1976.14 The Health Professionals Follow-up Study is a cohort of 51529 male health professionals aged 40-75 years at enrollment in 1986.15 Participants were followed with application of biennial validated questionnaires about medical history and lifestyle. For this study, the baseline year in both studies was 1986, when detailed information of diet and lifestyle was available. Between 1989 and 1990, 32826 women in the Nurses Health Study provided blood samples; likewise, between 1993 and 1995, a blood sample was obtained from 18225 men in the Health Professionals Follow-up Study. This analysis included 8828 women and 5218 men of European ancestry who had complete baseline information and available genotype data based on genome-wide association studies1617181920 and were free from diabetes, cancer, or cardiovascular at baseline.

Height was assessed by questionnaires administered at enrollment, and body weight was requested by questionnaires administered at enrollment and at each follow-up. Weights reported in questionnaires and measured by technicians were highly correlated (r=0.97 in both studies) in a validation subsample.21 Body mass index was calculated as weight in kilograms divided by the square of height in meters. Changes in body mass index and weight were evaluated every four years as the differences in body mass index and weight between the beginning and the end of each four year interval, with positive differences representing weight gain and negative differences weight loss.

Dietary intake information was collected by a validated 131 item semiquantitative food frequency questionnaire, administered in 1986 and every four years thereafter.22 Participants were asked how often on average they had consumed each food of a standard portion size over the previous 12 months. The responses had nine frequency categories ranging from never or less than once per month to six or more times per day. The reproducibility and validity of the food frequency questionnaire showed good correlation of food intake with that measured by multiple diet records.2324 Diet quality scores were calculated from the food frequency questionnaires every four years. Criteria for computation of each diet quality score are given in supplementary table A.

The AHEI-2010 score was based on 11 foods and nutrients predictive of chronic disease risk,8 emphasizing higher intake of vegetables (excluding potatoes), fruits, whole grains, nuts and legumes, long chain (n-3) fats, and polyunsaturated fatty acids; moderate intake of alcohol; and lower intake of sugar sweetened drinks and fruit juice, red and processed meats, trans fat, and sodium. Each component was scored from 0 (unhealthiest) to 10 (healthiest) points, with intermediate values scored proportionally. All component scores were summed to obtain a total score ranging from 0 (non-adherence) to 110 (best adherence) points.

The DASH score was based on eight foods and nutrients that were either emphasized or de-emphasized in the DASH-style diet.9 Each component was scored from 1 to 5 points according to fifths of intake, with 5 being the best score for higher intake of vegetables, fruits, nuts and legumes, whole grains, and low fat dairy products and for lower intake of sugar sweetened drinks, red and processed meats, and sodium. The total score ranged from 8 to 40 points.

The AMED score was modified and adapted to a Mediterranean diet in a Greek population.25 This score included nine components and awarded 1 point for an intake equal to or above the cohort specific median for vegetables, fruits, whole grains, nuts, legumes, fish, and ratio of monounsaturated to saturated fat and 1 point for an intake below the cohort specific median for red and processed meat and for alcohol intake 5-15 g/d for women and 10-25 g/d for men.10 The total score ranged from 0 to 9 points, with a higher score representing higher resemblance to the Mediterranean diet.

Changes in the diet quality scores were calculated as their differences between the beginning and the end of each four year interval. Therefore, positive differences represented increased adherence to a high quality diet and negative differences decreased adherence to a high quality diet.

We selected 77 single nucleotide polymorphisms (SNPs) that represent all 77 loci associated with body mass index identified in people of European descent (supplementary table B).26 The detailed information on SNP genotyping and imputation have been described previously.1617181920 Most of the SNPs were genotyped or had a high imputation quality score (r20.8), as assessed with the use of MACH software, version 1.0.16. No proxy SNPs were used.

Consistent with our previous study,27 we used a weighted method to calculate the genetic risk score on the basis of the 77 SNPs. Each SNP was recoded as 0, 1, or 2 according to the number of risk alleles (body mass index increasing alleles), and each SNP was weighted by its relative effect size ( coefficient) on body mass index obtained from the previous genome-wide association study.26 We calculated the genetic risk score by using the equation: GRS=(1SNP1+2SNP2++77SNP77) (77/sum of the coefficients), where SNPi is the risk allele number of each SNP. The genetic risk score ranges from 0 to 154, with each unit corresponding to one risk allele and higher scores indicating a higher genetic predisposition to obesity.

Information on demographics, lifestyle, and medical history came from the biennial questionnaires. We converted leisure time physical activity to metabolic equivalent hours (METs) per week.28 The reproducibility and validity of physical activity have been described previously.29 Alcohol intake was updated on the food frequency questionnaires every four years, and total energy intake was derived from these questionnaires.

In the Nurses Health Study and Health Professionals Follow-up Study, data were analyzed within five intervals of four years during a follow-up of 20 years from 1986 to 2006.27 We used multivariable generalized linear models with repeated measures analyses to assess the main associations of the genetic risk score and changes in the AHEI-2010, DASH, and AMED scores with change in body mass index within each four year interval, the associations between each additional 10 risk allele and change in body mass index according to thirds of changes in the three diet quality scores, and the associations between each 1 SD increase in diet scores and change in body mass index according to genetic risk subgroups. We classified genetic risk as low risk, intermediate risk, and high risk on the basis of thirds of the genetic risk score. We tested interactions of the genetic risk score with changes in the three diet quality scores and each dietary components on change in body mass index by including the respective interaction terms in the models (for example, change in the AHEI-2010genetic risk score), with the main effects included in the models as well. We also examined the genetic associations and interactions on weight change. We used multivariable models to adjust for age, genotyping source, baseline levels of body mass index, respective diet quality scores, physical activity, and other dietary and lifestyle factors at the beginning of each four year interval, as well as concurrent changes in these dietary and lifestyle factors within each four year interval. Missing values for diet, body mass index, and body weight were carried forward only once, and after that the follow-up was censored; for other variables, we coded missing data during any follow-up period as a missing indicator category for categorical variables (for example, smoking status) or used carried forward values for continuous variables.

In sensitivity analyses, considering potential confounding caused by age related or smoking related weight change, we assessed the genetic associations and interactions in participants younger than 65 years by censoring participants who were aged 65 years and in participants who had never smoked throughout the follow-up period. Moreover, we repeated the analyses of genetic association and interactions by using an extensive genetic risk score based on 97 SNPs comprising the 77 SNPs identified in people of European descent and 20 more SNPs identified in a combination of people of European and non-European descent (supplementary table B).26 We pooled the findings across the two cohorts by means of inverse variance weighted fixed effects meta-analysis. All reported P values are nominal and two sided. We used SAS software, version 9.4, for statistical analyses.

No patients were involved in setting the research question or the outcome measures, nor were they involved in recruitment or the design and implementation of the study. No patients were asked to advice on interpretation or writing up of results. There are no plans to disseminate the results of the research to study participants or the relevant patient community.

Table 1 shows characteristics at baseline and the first four year changes in characteristics of women in the Nurses Health Study and men in the Health Professionals Follow-up Study. Compared with participants with relatively stable adherence to diet quality scores, participants with the greatest increases in diet quality scores seemed to have lower diet quality scores at baseline and increased physical activity and less weight gain during the first four year period. The mean genetic risk score was 69.5 (SD 5.5) in the Nurses Health Study and 69.3 (SD 5.6) in the Health Professionals Follow-up Study; the genetic risk score was significantly correlated with body mass index and showed normal distributions across the two cohorts (supplementary figure A).

Characteristics according to first four year changes in three diet quality scores in thirds among 14046 US men and women in Nurses Health Study and Health Professional Follow-up Study

In general, the genetic risk score was associated with increases in body mass index and body weight every four years: in the two cohorts combined, each additional 10 risk allele was associated with 0.02 (SE 0.01) increase in body mass index and 0.05 (SE 0.03) kg increase in body weight (supplementary tables C and D). The difference in body mass index change between people at high genetic risk and those at low genetic risk was more prominent among participants with decreased adherence to the AHEI-2010 (0.12) than those with increased adherence to the AHEI-2010 (0.03); a similar pattern was observed for DASH but not for AMED (fig 1). When viewed jointly, the genetic associations with change in body mass index attenuated in participants who increased adherence to the AHEI-2010 and DASH; from another perspective, the inverse associations of increased adherence to the AHEI-2010 and DASH with change in body mass index were more prominent in participants at high genetic risk. Similar results were observed for weight change (supplementary figure B).

Pooled, multivariable adjusted means of change in body mass index (BMI) every four years, according to categories of genetic risk and changes in diet quality scores in thirds. AHEI-2010=Alternate Healthy Eating Index 2010; AMED=Alternate Mediterranean Diet; DASH=Dietary Approach to Stop Hypertension. Histograms and bars are means and SEs. Decreased, stable, and increased adherence to each diet quality score refers to third 1, 2, and 3 of each score, respectively. Data were derived from repeated measurements analyses for women in Nurses Health Study (five intervals of four years from 1986 to 2006) and men in Health Professionals Follow-up Study (five intervals of four years from 1986 to 2006). Results were adjusted for same set of variables as in table 2. Results for two cohorts were pooled by means of inverse variance weighted fixed effects meta-analysis

The genetic associations with change in body mass index were significantly attenuated with increased AHEI-2010 score in the Nurses Health Study (P=0.001 for interaction) and Health Professionals Follow-up Study (P=0.005 for interaction) (table 2). In the combined cohorts, changes in body mass index per 10 risk allele increment were 0.07 (SE 0.02) among participants in the lowest third with decreased AHEI-2010 score and 0.01 (0.02) among those in the highest third with increased AHEI-2010 score (P

Body mass index change every four years per 10 risk allele increment, according changes in diet quality scores in thirds*

Increase in each diet quality score was associated with decreases in body mass index and body weight every four years in total participants (supplementary tables C and D), and such association seemed to be more prominent in participants at high genetic risk (fig 2). Changes in body mass index per 1 SD increase in AHEI-2010 score were 0.12 (SE 0.01), 0.14 (0.01), and 0.18 (0.01) among participants at low, intermediate, and high genetic risk, respectively, corresponding to weight changes of 0.35 (0.03), 0.36 (0.04), and 0.50 (0.04) kg, respectively (supplementary figure C). Similarly, changes in body mass index per 1 SD increase in DASH score were 0.14 (0.01), 0.16 (0.01), and 0.19 (0.02) across these genetic risk subgroups. Differences in body mass index changes associated with change in the AMED across these subgroups were not evident. Similar results were observed for weight changes (supplementary figure C).

Pooled, multivariable adjusted body mass index (BMI) change every four years per 1 SD increment of each diet quality score, according to genetic risk. AHEI-2010=Alternate Healthy Eating Index 2010; AMED=Alternate Mediterranean Diet; DASH=Dietary Approach to Stop Hypertension. Histograms and bars are coefficients and SEs. Value of 1 SD: AHEI-2010: 8.38; DASH: 3.71; AMED: 1.72. Data were derived from repeated measurements analyses for women in Nurses Health Study (five intervals of four years from 1986 to 2006) and men in Health Professionals Follow-up Study (five intervals of four years from 1986 to 2006). Results were adjusted for same set of variables as in table 2. Results for two cohorts were pooled by means of inverse variance weighted fixed effects meta-analysis

In the combined cohorts, increases in AHEI-2010 and DASH scores significantly attenuated the genetic association with change in body mass index: each 1 SD increase in the AHEI-2010 and DASH score was associated with 0.05 (95% confidence interval 0.08 to 0.03; P

Interaction of genetic risk score with changes in diet quality scores and dietary components on change in body mass index (BMI) every four years. AHEI-2010=Alternate Healthy Eating Index 2010; AMED=Alternate Mediterranean Diet; DASH=Dietary Approach to Stop Hypertension; NHS=Nurses Health Study; HPFS=Health Professionals Follow-up Study. Histograms and bars are coefficients and 95% CIs for interactions between genetic risk score (per 10 risk allele) and changes in diet quality scores and dietary components (per 1 SD increment) on BMI change. Value of 1 SD: AHEI-2010: 8.38; DASH: 3.71; AMED: 1.72; fruits (servings/d): 1.12; vegetables (servings/d): 2.06; long chain (n-3) fats (mg/d): 300.7; whole grains (g/d): 17.34; low fat dairy (servings/d): 0.88; legumes (servings/d): 0.27; fish (servings/d): 0.38; alcohol (drinks/d): 0.70; sodium (mg/d): 3.10; red and processed meats (servings/d): 0.26; nuts (servings/d): 0.52; ratio of monounsaturated to saturated fat: 0.21; polyunsaturated fatty acids (% of energy): 1.68; sugar sweetened drinks and fruit juice (servings/d): 0.92; trans fat (% of energy): 0.01. Data were derived from repeated measurements analyses for women in Nurses Health Study (five intervals of four years from 1986 to 2006) and men in Health Professionals Follow-up Study (five intervals of four years from 1986 to 2006). Results were adjusted for same set of variables as in table 2. Results for two cohorts were pooled by means of inverse variance weighted fixed effects meta-analysis

In participants younger than 65 years and in those who had never smoked throughout the follow-up period, we observed similar but weaker results for genetic associations and interactions between the genetic risk score and changes in diet quality scores on change in body mass index (supplementary tables F and G). Moreover, analyses using the genetic risk score comprising 97 SNPs yielded consistent results (supplementary table H).

In this study, we found consistent interactions between changes in diet quality scores and genetic predisposition related to long term changes in body mass index and body weight in two independent prospective cohorts of US women and men. Our findings show that improving adherence to healthy dietary patterns assessed according to the AHEI-2010 and DASH could significantly attenuate the genetic association with increases in body mass index and body weight. Viewed differently, improving diet quality over time was associated with decreases in body mass index and body weight, and such favorable effect was more prominent in people at high genetic risk for obesity than in those with low genetic risk.

The dramatic alternations in dietary patterns over the past decades have paralleled the rapid rise in the prevalence of obesity in the US.34 Emerging evidence supports a protective effect of improved adherence to healthy dietary patterns on weight gain and other health outcomes such as cardiovascular disease and total and cardiovascular disease mortality.1112133031 In previous studies, we have shown that dietary factors such as sugar sweetened drinks and fried foods could amplify the genetic associations with elevated body mass index.56 Similar interactions have also been reported by another group.32 Our findings in this study are consistent with these previous reports and for the first time indicate that improving adherence to healthy dietary patterns might diminish the genetic association with weight gain. Here, we evaluated healthy dietary patterns by diet quality scores. Instead of considering individual diets in isolation, diet quality scores provide comprehensive measures of diets incorporating nutrients and foods and therefore represent a broader picture of dietary intake.3334 In this study, the AHEI-2010 showed the most significant interaction with genetic predisposition to obesity on changes in body mass index and body weight, and we also found a similar interaction pattern for DASH but not for AMED. When evaluating changes over time, the continuous scale and wider range of the AHEI-2010 may allow for greater sensitivity to differentiate dietary changes; in contrast, the wider scale and narrower range of AMED may limit its ability to detect the differences in dietary changes. Additionally, the AHEI-2010 captured all four dietary components (fruits, vegetables, long chain (n-3) fats, and trans fat) that contributed to significant interactions with the genetic risk score at a nominal significance threshold, whereas DASH and AMED each captured two, which might also account for the observed differences between the three diet quality scores.

From another point of view, our findings indicate that people with a greater genetic predisposition seem to be more susceptible to the favorable effect of improving diet quality on weight management. Our results are in line with the findings of a meta-analysis (including 6951 participants from 10 studies) showing that people carrying the homozygous FTO allele predisposing to obesity may lose more weight than non-carriers through diet and lifestyle interventions.35 In a more recent meta-analysis of 9563 participants from eight randomized controlled trials, each copy of the FTO obesity predisposing allele was associated with non-significant reductions in body mass index (0.02, 95% confidence interval 0.13 to 0.09) and body weight (0.04, 0.34 to 0.26, kg) (indicative of gene by treatment interactions) after weight loss intervention in the treatment versus control arm.36 Of note, the effect sizes of gene by treatment (dietary, physical activity, or drug based intervention) interaction in this meta-analysis are in similar ranges to the effect sizes of gene by dietary patterns interaction shown in our study, supporting the generalization of the effect sizes yielded by our study.

The precise mechanisms underlying the observed interactions remain unclear. The beneficial bioactivities of healthy dietary patterns, such as balancing energy intake, regulating metabolism, and reducing cardiometabolic risk,3738 may partly explain their modifying effect on genetic predisposition to weight gain. In addition, several genes associated with body mass index have been shown to be involved in central appetite regulation and energy homeostasis,26 which may also be responsible for the observed interactions. However, we cannot exclude the involvement of other biological pathways, and future functional studies are needed to provide biological insights into the gene by diet interactions on weight change.

The strengths of our study include the cross validation from two independent prospective cohorts of men and women, the well validated measures of dietary factors and body weight within five repeated four year periods of a 20 year follow-up, and the reliable findings improved by several sensitivity analyses. Notably, we evaluated changes in diet quality scores and changes in body mass index and body weight during the same four year intervals in discrete periods, because this change-on-change analytic approach has been shown to generate more robust, consistent, and biologically plausible relations between diet and long term weight change than the approaches of prevalent diet with weight change (prevalent analysis) or change in diet with weight change in the subsequent four years (lagged changes analysis).39

Our study also has several potential limitations. Firstly, although we have carefully controlled for baseline and concurrent changes of lifestyle and dietary factors in the analyses, unmeasured or unknown confounders may also exist. Secondly, because adherence to healthy dietary patterns was not randomized, the association between dietary factors and weight change may not imply a causal relation. Thirdly, the results could be underestimated by potential reverse causality; for example, people who gained weight might tend to adopt healthier eating patterns to lose weight. Fourthly, our study was restricted to health professionals of European descent in the US, and the generalizability of our findings should be tested in other demographic and racial/ethnic populations.

Our results suggest that weight gain associated with genetic predisposition can be at least partly counteracted by improving adherence to healthy dietary patterns. Importantly, for people who are genetically predisposed to obesity, improving adherence to a healthy diet is more likely to lead to greater weight loss. Our findings support recommendation of adherence to healthy dietary patterns,37 particularly for people at high genetic risk of obesity. The observed genetic effects were modest in magnitude, compared with lifestyle risk factors. Of note, the changes in body mass index and body weight reported in our study were changes per four years. Because changes in body mass index and body weight are essentially cumulative during the life course, the long term effect size would be substantial. Furthermore, long term, dramatic weight loss is difficult to achieve, even in the context of weight loss interventions. Therefore, even modest weight loss or simply maintaining weight from adulthood onward, compared with gaining weight, may have a substantial effect on population health.

Our study provides reproducible evidence from two prospective cohorts of US men and women that improving adherence to healthy dietary patterns could attenuate the genetic association with body mass index increment and weight gain, and the beneficial effect of improving diet quality on weight management was more prominent in people at high genetic risk. Our findings highlight the importance of improving adherence to a healthy diet in the prevention of weight gain, particularly in people genetically predisposed to obesity.

Improving adherence to healthy dietary patterns, as assessed by various diet scores, has been associated with weight loss in several studies

No study has assessed the interactions between changes in these diet quality scores and genetic predisposition to obesity in relation to long term changes in body mass index and body weight

Improving adherence to healthy dietary patterns as assessed by the Alternate Healthy Eating Index 2010 and Dietary Approach to Stop Hypertension can counteract part of gene related, long term weight gain

People at high genetic risk for obesity are more susceptible to the beneficial effect of improving diet quality on weight loss

This underlines the importance of improving adherence to healthy dietary patterns in the prevention of weight gain, especially in people with greater genetic predisposition to obesity

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Improving adherence to healthy dietary patterns, genetic …

Life Time Fitness Reviews | Glassdoor

Apr, 3rd 2018 7:41 am, Article Recommended by Dr. J. Smith

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