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Final Recommendation Statement: Obesity in Adults …

Jul, 8th 2018 9:44 am, Article Recommended by Dr. J. Smith

Burden of Disease

Since 1976 to 1980, the prevalence of obesity and overweight in the United States have increased by 134% and 48%, respectively.2 In 2007 to 2008, 40% of men and 28% of women in the United States were overweight and 32% of men and 36% of women were obese. The prevalence of obesity exceeds 30% in most age- and sex-specific groups, with approximately 1 in 20 Americans having a BMI greater than 40 kg/m2.3

Depending on age and race, obesity has been shown to be associated with a 6- to 20-year decrease in life expectancy. The leading causes of death in obese adults include ischemic heart disease, diabetes, certain types of cancer (for example, liver, kidney, breast, endometrial, prostate, and colon), and respiratory diseases.4

To update its 2003 recommendation on screening for obesity and overweight in adults 5, the USPSTF reviewed the current state of the evidence and identified new evidence that addresses previously identified gaps. The USPSTF reviewed new evidence on the benefits and harms of screening and primary carefeasible or referable weight-loss interventions.6 The focus of this update was on nonsurgical interventions.

In 2003, the USPSTF found adequate evidence that BMI is an acceptable measure for identifying adults with excess weight.5 Therefore, the USPSTF did not systematically address clinical screening tests for obesity and overweight in its review.

No new trials were identified that compared screening for obesity in adults with no screening. A total of 58 trials of weight-loss interventions were identified. Of these, 38 trials (13,495 participants) involved behavioral interventions, 18 trials (11,256 participants) involved orlistat plus behavioral interventions, and 3 trials (2652 participants) involved metformin plus behavioral interventions.4 In comparison with studies reviewed for the 2003 recommendation, there were 33 new trials of behavioral interventions, 16 new trials involving orlistat plus behavioral interventions, and 3 new trials involving metformin plus behavioral interventions.4

Behavioral interventions. Behavioral intervention trials were generally of high quality, with 24% rated as good quality. Behavioral trial participants had mean BMIs ranging from 25 to 39 kg/m2, with an average baseline BMI across all trials of 31.9 kg/m2. Fifty-five percent of behavioral trials had participants with clinical or subclinical cardiovascular risk factors, such as impaired glucose tolerance.1

Most of the trials showed that behavioral interventions had a statistically significant effect on weight loss at 12 to 18 months.6 Control group participants lost minimal or no weight, whereas intervention group participants lost 1.5 to 5 kg (3.3 to 11.0 lb), or 4% of baseline weight. Interventions with a greater number of sessions showed more weight loss. Patients who participated in 12 to 26 intervention sessions in the first year generally lost 4 to 7 kg (8.8 to 15.4 lb) (6% of baseline weight) compared with 1.5 to 4 kg (3.3 to 8.8 lb) (2.8% of baseline weight) in those who participated in fewer than 12 sessions.6

An increased number of sessions, or increased treatment intensity, was associated with greater weight loss. Most higher-intensity interventions included self-monitoring, setting weight-loss goals, addressing barriers to change, and strategizing about maintaining long-term changes in lifestyle. However, which of these components was associated with weight loss could not be determined.6 A minimum of 12 sessions was essential to realize BMI reduction and maintenance.

Because direct data from screening trials on long-term health outcomes (for example, death, cardiovascular disease, and hospitalizations) were lacking, the USPSTF examined physiologic risk factors for cardiovascular disease. Two good-quality trials showed that diabetes incidence decreased by 30% to 50% over 2 to 3 years (number needed to treat, 7) with behavioral weight-loss interventions among overweight and obese patients with elevated plasma glucose levels.7, 8 Behavioral weight-loss interventions had a minimal effect on lipid outcomes and showed small reductions in blood pressure and waist circumference.6

Combined pharmacologic and behavioral interventions. Fifty-five percent of behavioral trials and 57% of orlistat trials examined participants with clinical or subclinical cardiovascular risk factors. Metformin trials examined participants with diabetes risk factors.4

Combined behavioral and pharmacologic (orlistat or metformin) interventions resulted in weight loss and improvement in physiologic outcomes. Orlistat led to an average weight loss of about 2.6 kg (5.7 lb), a 1.9-cm decrease in waist circumference, and a decrease in fasting glucose level. Metformin led to a 1.5-cm greater decrease in waist circumference; however, its use for obesity is not approved by the FDA and is thus considered an off-label use. In addition, the USPSTF found no evidence on the maintenance of improvement after discontinuation of medications.6

Behavioral interventions. Possible harms of behavioral weight-loss interventions include decreased bone mineral density and increased fracture risk, serious injuries resulting from increased physical activity, and an increased risk for eating disorders. Although limited data suggest that weight loss may be associated with decreased bone density at the hip, the clinical significance of the bone loss is uncertain. The trials found no evidence that weight-loss interventions are associated with serious injuries or an increased risk for eating disorders, weight cycling, or depression.6

Combined pharmacologic and behavioral interventions. There are concerns about the possible harms of orlistat because of recent FDA reports of severe liver disease and a lack of long-term safety data.9 Orlistat has recently been associated with possible kidney and pancreas damage, but no evidence was found supporting these potential harms.10 Both orlistat and metformin caused mild to moderate gastrointestinal adverse effects that resulted in medication discontinuation.

The USPSTF found adequate evidence that intensive, multicomponent behavioral interventions for obese adults can lead to weight loss, as well as improved glucose tolerance and other physiologic risk factors for cardiovascular disease. Inadequate evidence was found about the effectiveness of these interventions on long-term health outcomes (for example, death, cardiovascular disease, and hospitalizations). Adequate evidence indicates that the harms of screening and behavioral interventions for obesity are small. Therefore, the USPSTF concluded that the net benefit of screening is moderate.

A draft of this recommendation statement was posted for public comment on the USPSTF Web site from 26 October to 23 November 2011. All comments received were reviewed during the creation of the final recommendation statement. Specifically, responses to these comments led to clarification of the definition of intensive and multicomponent in the Clinical Considerations and Discussion sections. The Implementation section was expanded to reflect referral to community-based programs. The Recommendations of Others section was expanded to include recommendations from other professional associations. The Clinical Considerations section was expanded to clarify why overweight was not included in the recommendation statement. The Scope of the Review section was refined to clarify the scope of the update. Some respondents asked about costs. The USPSTF does not consider costs in its appraisal of the effectiveness of a service.

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Final Recommendation Statement: Obesity in Adults …

$50 off – South Beach Diet Promo Code and Review

Jul, 8th 2018 9:42 am, Article Recommended by Dr. J. Smith

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With this South Beach Diet discount you will save $50. The South Beach Diet doesn’t have a coupon code to type in at checkout. Instead, it offers special discounts which you can access through special links, like the one you see above. The South Beach Diet is one of the few diets that has proven results. More than 11 million people have chosen the South Beach Diet over the past 10 years. The South Beach Diet promises it will get you to the best shape of your life. And they help you achieve this relatively fast. They do this not only by offering delicious, nutritious and healthy meals but also by teaching you how to maintain a healthy weight without feeling hungry or deprived. Now you can save $50 with this South Beach Diet promo code.

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Relevant Articles

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$50 off – South Beach Diet Promo Code and Review

The Paleo Diet: Lose Weight and Get Healthy by Eating the …

Jul, 7th 2018 2:43 am, Article Recommended by Dr. J. Smith

AT LAST, THE UPDATED EDITION OF THE BESTSELLING DIET BOOK!

“The Paleo Diet helps you lose fat, improve your health, and feel great. Why? Because the Paleo Diet works with your genetics to help you realize your natural birthright of vibrant health and wellness.”Robb Wolf, author of the bestselling The Paleo Solution

“Loren Cordain’s extensive research demonstrates how modern westernized diets drastically depart from the original diet humans consumed for millions of years. In The Paleo Diet and The Paleo Diet Cookbook, Dr. Cordain shows how diets high in grains, dairy, vegetable oils, salt, and refined sugars are at odds with our genetic legacy and then shares his uncomplicated strategy for losing weight and getting healthy.”Arthur De Vany, Ph.D., author of The New Evolution Diet

Healthy, delicious, and simple, the Paleo Diet is the diet you were designed to eat. If you want to lose weightup to seventy-five pounds in six monthsor if you want to attain optimal health, The Paleo Diet will change your life now. Dr. Loren Cordain, the world’s leading expert on Paleolithic nutrition, demonstrates how by eating all the lean meats and fish, fresh fruits, and nonstarchy vegetables you want, you can lose weight and prevent and treat heart disease, cancer, osteoporosis, metabolic syndrome, and many other illnesses. Incorporating all the latest breakthroughs in Paleo nutrition research, this new edition of the bestselling The Paleo Diet includes six weeks of meal plans to get you started on the Paleo path to weight loss, weight control, increased energy, and lifelong health.

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The Paleo Diet: Lose Weight and Get Healthy by Eating the …

South Beach Diet Phase 1 [2018 Update] Food List, Meal …

Jul, 6th 2018 8:47 am, Article Recommended by Dr. J. Smith

Friday, July 6th 2018 The South Beach Diet has been around for years now, during which time thousands of people have successfully used their program to lose weight and get healthier.

Phase 1 is one of the most important parts of the diet, and a period when you can lose those weight, but the diet actually rolls out in three key phases:

In years past, you had to follow the South Beach Plan, and do all of your own meal prep, but that all changed recently with the release of the new South Beach Diet Meal Delivery Plan. Now, you can have all of your Phase 1 South Beach Diet Meals shipped right to your door, which means you can reach your weight loss goals with virtually no trips to the grocery store.

With the new South Beach Diet Plan, you can lose more weight than ever during Phase 1 too. In fact, with their new meal plan, you can drop up to 9 pounds and 3 inches during these first two weeks of the program.

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Friday, July 6th 2018 UPDATE: The awesome folks at South Beach Diet are currently offering some pretty awesome deals for TheDietDynamo.com readers. CLICK HERE to Activate 40% discount, PLUS get FREE shipping.

With the brand new meal delivery system from the team at South Beach Diet, reaching your weight loss goals has never been easier. They deliver all of the food you need to be successfulright to your door every month, including everything you need to start Phase 1 of the program.

The meals youll receive during this first phase of the program should help give your body a reset, which means you will have fewer cravings for diet-killing substances like sugar and starches, and you will be getting your body ready for a period of sustained weight loss.

Your South Beach Diet meals will be low in carbohydratesbecause research has proven that reducing your carb intake is one of the most effective and fastest ways to lose weight, while also helping your body reset.

Once your body adjusts to your new carb-controlled diet you should have more control over your hunger cravingsand will start seeing the extra pounds fall off.

What Youll Eat Heres a Look at What the Kind of Meals Youll Enjoy:

If youre used to starving yourself when dieting, prepare yourself for a nice change of pace. While on the South Beach Diet you will be eating up to 6 times throughout the day.

You will get to enjoy 3 pre-made meals theyll send you for breakfast, lunch, and dinner, and then you can also eat 3 snacks that you will make yourself. Dont worry though they will send you a list of lean proteins, healthy fats, and approved vegetables that you can use for your snacks and side dishes.

On top of that, the South Beach food tastes great and is filling, so your hunger should be satisfied over the course of the day.

In addition to your snacks, you can also buy some of your own fresh foods. These can be used as tasty side dishes to your pre-made South Beach Diet foods.

The snack and homemade meals youll be adding have slightly different requirements for men and women, which are as follows:

Men

Can add up to 4 lean proteins, 3 healthy fats, and five approved veggies every day.

Women

Can add up to 3 lean proteins, 2 healthy fats, and 5 approved veggies every day.

In addition to these foods, you can also add approved condiments to your meals, and they also have a selection of Free Foods, which you can eat as much as you want every day.

If youre used to drinking soda or fruity drinks, its going to be time to ditch those if you really want to lose weight and get healthier. The South Beach Diet is water-focused, and youll be drinking a lot of it.

They suggest drinking at least 8 cups of water per day. Thats because drinking water helps fill you up, and even though this may sound weird, it also helps to reduce your water retention.

For the best results, you will want to get some form of exercise for a minimum of 30 minutes every day. This can include simple activities like going on a walk or bike ride, or more vigorous things like yoga, weight-lifting, or running. The activity choice will be up to you, so long as youre moving for at least half an hour each day, you should see measurable results.

When you sign up for South Beach Diet they will send you everything you need for success, including a planner for keeping track of what you eat, drink, and your activity each day. This will help keep you motivated, and aware of the things youre putting into your body.

As we mentioned above, youll be eating 3 pre-made South Beach meals every day, along with snacks and side dishes youll be preparing yourself.

Heres a quick sample of some of the South Beach foods youll be enjoying during Phase 1 of the diet:

Breakfast

Lunch

Dinner

As far as the snacks and side dishes are concerned, youll be selecting your ingredients for those from an approved list that they will send you with your order.

Heres a quick sampling of some of the foods that qualify:

Lean Proteins

Healthy Fats

Vegetables

This is just a small sampling of the foods they will send you a much more comprehensive list when you order, or you can view the full menu on their website too.

If youre ever wondering what foods to eat, how much exercise, or have any questions about any of the South Beach Diet phases, they have a step-by-step guide that walks your through the entire process.

You can download the PDF guide here.

The new South Beach Diet meal delivery system is an effective, healthy, and proven method for losing weight. They make everything easy for you by sending you most of the meals you need every month right to your doorand give you an exact guide for the other healthy foods you can eat each day.

Phase 1 of the diet is designed to get your body adjusted to a new way to eating, will help reduce your cravings for sugars and starches, and will put you on the path to sustained weight loss.

Friday, July 6th 2018 UPDATE: Ready to Start Your Weight Loss Journey? Follow this link to save 40% plus get FREE shipping on their auto-delivery orders!

Summary

Phase 1 of the South Beach Diet is a safe and effective way to “reboot” your body and put you on the path to sustained weight loss.

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South Beach Diet Phase 1 [2018 Update] Food List, Meal …

Emergency Management Institute (EMI) | Virtual Table Top …

Jul, 4th 2018 11:47 pm, Article Recommended by Dr. J. Smith

The Independent Study Exams are currently unavailable. There is no estimated time of recovery.

VTTX Testimonials:

Erik Hackmann, Senior ManagerSecurity Seattle Mariners

Leonard Davey, Senior Director of Security & TransportationSan Diego Padres

Background: The VTTX is a series of Virtual Tabletop Exercises that are offered monthly by the Emergency Management Institute (EMI). The VTTX program was launched in September of 2012 as an initiative to leverage technology and reach a large training audience.

Program Overview: The Emergency Management Institute (EMI) conducts a monthly series of Virtual Table Top Exercises (VTTX) using a video teleconference platform to reach community based training audiences around the country and provide a virtual forum for disaster training. The VTTX process involves key personnel from the emergency management community of practice reviewing a pre-packaged set of exercise materials then convening for a four hour table top exercise discussing a simulated disaster scenario. The event allows the connected sites to assess current plans, policies and procedures while learning from the other connected sites as they provide their perspective and practices facing a similar situation. A standard VTC system is required for participation.

Training Audience: The VTTX is limited to 10-15 remote “Participation” sites per event due to time constraints. The program also allows for some “Observation” sites for each event to become familiar with the VTTX process. The VTTX is designed for a community based group of 10 or more representatives from your local Emergency Management Community of Practice.

Training Cost: Free

Training Dates & Times: The VTTX is conducted monthly and advertised on the EMI Web Page with a training opportunity announcement, distributed via multiple FEMA distribution lists, and other Emergency Management professional forums. To accommodate participants from the West Coast, the VTTX is conducted from 12:00 EST to 4:00 p.m. EST. Participating sites will be required to sign on at 11:00 EST and be prepared to go to 4:30 p.m. EST. For a list of the current VTTX schedule, please contact the Program Manager below.

Select here for the FY18 Quarter 3 Program Information, dates and scenarios

Select here for the FY18 Quarter 4 Program Information, dates and scenarios

Requirements to Participate:

Exercise Documents: Exercise documents for this event will be provided to the lead remote site POC as soon as the final list is announced. VTTX documents will include

Program Manager contact information:Doug Kahn, Training SpecialistIntegrated Emergency Management BranchDHS/FEMA/Emergency Management Institute16825 S. Seton Ave., Emmitsburg, MD 21727Office Phone: 301-447-7645FAX: 301-447-1006Email: Douglas.Kahn@fema.dhs.gov

For General Inquires: fema-emi-iemb@fema.dhs.gov or call 301-447-1381

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Emergency Management Institute (EMI) | Virtual Table Top …

HGH Injections: Should they Be used For Anti Aging?

Jul, 4th 2018 11:47 pm, Article Recommended by Dr. J. Smith

Anti Aging Products

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HGH Injections: Should they Be used For Anti Aging?

The Fitness Center | University Hospitals Elyria Medical …

Jul, 4th 2018 11:47 pm, Article Recommended by Dr. J. Smith

When it comes to your health and wellness, the Fitness Center at University Hospitals Avon Health Center (formerly the EMH Center for Health & Fitness) has you covered. Our 60,000-square-foot, medically based fitness center offers outstanding customer service, degreed and certified staff, and cleanliness that has always set this facility apart from the rest.

Our members enjoy state-of-the-art fitness equipment, two pools, racquetball, a full-size gymnasium, tennis courts, more than 115 weekly group fitness classes, an indoor walking/running track, and so much more all with no long-term contracts to sign.

1997 Healthway DriveAvon, Ohio 44011Get Directions

Monday Thursday:5 a.m. 9 p.m.

Friday:5 a.m. 8 p.m.

Saturday:7 a.m. 6 p.m.

Sunday:8 a.m. 6 p.m.

New Years Day: CLOSEDEaster: CLOSEDMemorial Day: CLOSEDFourth of July: CLOSEDLabor Day: CLOSEDThanksgiving Eve: 5 a.m. 7 p.m.Thanksgiving: CLOSEDChristmas Eve: 7 a.m. 1 p.m.Christmas Day: CLOSEDNew Years Eve: 7 a.m. 1 p.m.

Call to schedule an appointment

For the fifth consecutive year, the Fitness Center at UH Avon Health Center has been voted the “Best of Lorain County” in the fitness center and day spa categories by readers of Pulse Lorain County’s Magazine. The Fitness Center was also awarded first place 2014 Program Innovation Award by the Medical Fitness Association for United We Sweat fitness initiative.

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The Fitness Center | University Hospitals Elyria Medical …

Membership Benefits | The Fitness Center | University …

Jul, 4th 2018 11:47 pm, Article Recommended by Dr. J. Smith

The Fitness Center at University Hospitals Avon Health Center offers over 150 pieces of interactively programmed commercial fitness equipment to meet the specific needs and ability level of each member. Our fitness specialists all have advanced degrees specializing in physical fitness and are available to assist and instruct members interested in individualized workout programs. Because correct form is essential for positive results and injury prevention, both new and existing members are encouraged to partake in complimentary fitness assessments and equipment orientations. Specialty day spa services are also available at the Fitness Center to pamper our members.

Members of the Fitness Center at UH Avon Health Center have access to:

The Fitness Center is a member of the IHRSA Passport Program which entitles our members to discounted guest privileges through a worldwide network of clubs. The IHRSA Passport interactive tool will search participating clubs near your travel destination.

For more information on monthly membership rates, request membership information online or call member services at 440-988-6801.

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Membership Benefits | The Fitness Center | University …

Health & Wellness | University Hospitals | Cleveland, OH

Jul, 4th 2018 11:47 pm, Article Recommended by Dr. J. Smith

University Hospitals Health & Wellness is your one-stop resource for information that can help you take control of your health. This section offers a wide array of educational materials and in-depth information on a variety of topics including classes and events, drug information, publications, support groups and Video libraries. Offering the latest and most up-to-date information on a range of health topics, Health & Wellness allows patients and their families to gain the knowledge they need to be active participants in their own medical care and overall wellbeing.

Stay informed about the health issues that affect you and your family. Browse our library of health articles that offer educational information and advice on a variety of health topics.

Our interactive health library offers the latest information on a wide range of conditions, tests, and treatments, as well as recipes and nutritional information, prevention guidelines, health quizzes, and much more.

Support groups are offered at many University Hospitals locations throughout Northeast Ohio. Our goal is to help patients and their families cope with the emotional and mental strain that an illness can cause.

The Connor Integrative Health Network offers a holistic approach to healing and well-being, with a focus on treating a persons mind, body and spirit with blended conventional and complimentary therapies. Our team of trained experts offer a wide variety of individual and group services, including acupuncture, hypnotherapy, meditation, reflexology, Reiki, and yoga.

The Center for Health and Fitness at UH Avon Health Center is Northeast Ohio’s premier medically-based fitness center. Learn more about services offered at this location.

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Health & Wellness | University Hospitals | Cleveland, OH

Buy HCG: Begin Your HCG Diet Journey with 1 Month HCG …

Jul, 4th 2018 11:45 pm, Article Recommended by Dr. J. Smith

100% HUMAN CHORIONIC GONADOTROPIN. REQUIRES MIXING BY CUSTOMER. TOP BRAND HUCOG OR EQUAL. HARD BOX SHIPPING.

We all know how hard it is to diet and sometimes we even add some light exercise but it simply is not enough! Food nowadays is simply loaded with calories and everything in our society makes it so easy and convenient to abuse delicious little treat (among many things ) seemingly available everywhere you look.

So you ask yourself what else can I do? Enter the hCG diet , a naturally occurring hormone produced during pregnancy , what is does ( and for good reasons ) is signal your body to release all the stored fat directly into your blood stream ( thinking there is a baby in you feeding off that highly caloric blood )

While in fact you are not pregnant ( or even a male as it will do the same reaction in a male body )

Now all this calories in your blood ends up being wasted naturally by the usual means ( mostly by urine )

All the while your metabolic rates will go up ( so any actions such as sitting down / walking around the house will burn 3x or 4x the amount of calories you normally spend for the same actions )

As you can see this has a twofold effect for maximum efficiency

Now couple that with the recommended 500-800 calories a day diet ( and you wont fell hunger as your blood will be thick with the nutriments from the fat looking to feed a none existing baby.

We will even add a free bonus of b12 injections most user report a boost in energy levels by administrating 0.5 ml to 1ml twice per week !

And please do not take our word for it google hCG diet and go in the forums see the THOUSANDS of reviews or go to social media ( facebook&youtube among many other ) there are thousands of success stories ( we even give 20% off for anyone willing to share before & after pic + their story )

In fact chances are you know about the hCG it and were looking for a stable source of quality hCG at a decent price, well look no further friends you found it !

How to store it : the unmixed freeze dry vacuum sealed bottle of hCG you will get can be kept at room temperature away from sunlight for as long as it says on it ( see its expiration date ) however once reconstructed ( mixed with the bacteriostatic water ) it is only good for up to SIXTY days and needs to be keep refrigerated at all times

Dosage : 200iu per day is the recommended dosage , if you missed a day skip it do not double dose ( or better yet try not to skip a day ) for more info read our FAQ

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Buy HCG: Begin Your HCG Diet Journey with 1 Month HCG …