When it comes to weight management, you are deemed a winner if you can successfully lose weight and keep it off. Unfortunately, this accomplishment eludes many; however, some individuals prevail and we can learn from their triumph. Weight loss maintainers have certain behavioral traits in common that play a role in weight control. Findings from the National Weight Control Registry (NWCR) shed light onto these successful characteristics.

The National Weight Control Registry is an ongoing investigation that began in 1994 under the direction of Rena Wing, Ph.D. of Brown Medical School and James O. Hill, Ph.D. of the University of Colorado. The goal of the NWCR is to identify traits associated with successful weight loss and its maintenance. To date, the registry has studied over 6,000 successful weight loss maintainers (i.e., individuals who have lost and maintained a minimum of 30 pounds for at least one year). Information regarding the health behaviors and demographics of NWCR participants have been obtained through questionnaires and annual follow-up surveys. Here is what has been found:

• Physical Activity: Approximately 54% of the participants expend more than 2,000 calories per week through exercise, with walking accounting for the physical activity mode of choice for 52.2 percent of NWCR enrollees. Other common activities include: biking, weight lifting and aerobics.
• Decreased Sedentary Time: NWCR participants spend less time engaging in sedentary pursuits, with 62% of members watching less than 10 hours of TV per week.
• Diet Composition: On average, weight loss maintainers consume a low-calorie (approximately 1,380 calories per day) and a low-fat (less than 30 percent of total daily intake from fat) diet. In fact, 92% of successful weight loss maintainers limit foods high in fat and sugar.
• Dietary Behaviors: Approximately 78% of NWCR participants eat breakfast. They also tend to eat regularly throughout the day (about 5 times compared to the average American who eats 2 to 3 times per day). In addition, individuals who are successful at weight loss maintenance prepare and eat most of their meals at home. Furthermore, they eat consistent diets that vary little and they adhere to the same pattern of eating even during weekends and on holidays.
• Self-Monitoring: NWCR members keep track of their progress. The majority of NWCR participants monitor the amount of fat and total calories consumed daily. Seventy-five percent weigh themselves at least once per week.

It should be noted that the NWCR is a fairly homogeneous group, with 77% of the participants being female, 95% white, 64% married and 82% college educated. The weight loss practices of these individuals may not necessarily provide the same benefit to individuals of different demographics.

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

References
The National Weight Control Registry

ACSM's Health & Fitness Journal; "The National Weight Control Registry: A Study of 'Successful Losers'"; J. Graham Thomas, Ph.D., et al.; March/April 2011

Negative energy balance -- that's the goal if you want to achieve weight loss. Some say you can facilitate this process by exercising on an empty stomach. The reasoning is that your glycogen stores are low from fasting; therefore, your body will have to tap into your fat stores to provide energy to fuel the exercise.  It seems plausible, but evidence from a small study conducted in Italy suggests the contrary.

Researchers evaluated the differences in fat metabolism between training in the fed and fasting states. Each subject underwent two testing conditions. They were randomly assigned to exercise either under the fasting or fed condition first. They then returned to be tested in the opposite circumstance, with an interval of one week between testing situations.

In the fasting scenario, subjects exercised in the morning after a 12 hour fast; they then ate a standard breakfast. In the fed condition, subjects ate a standard breakfast before exercising. In both testing conditions, all subjects exercised for 36 minutes on the treadmill at an energy expenditure that was equivalent to 65 percent of their heart rate reserve. Oxygen consumption was measured before, during and at 12 and 24 hours post exercise. Substrate utilization (e.g., fat versus carbohydrate metabolism) was estimated from the respiratory exchange ratio (i.e., the amount of carbon dioxide produced to oxygen consumed).

The results indicated that although an increase in carbohydrate metabolism occurred initially under the feeding condition compared to the fasting state, metabolism later shifted toward utilizing fat stores at 12 and 24 hours post exercise for the fed scenario. Furthermore, oxygen consumption values remained higher at 12 and 24 hours post exercise in the fed state, indicating that metabolism was faster.

The investigators concluded that eating prior to exercise will result in a greater improvement of fat utilization over long periods when compared to exercising on an empty stomach. It should be noted, however, that the subject sample of this study was quite small--only 8 men were tested. Further research with a larger sample size is warranted. 

An important point is that individuals react differently. You may need to experiment with the timing of meals and the type of foods consumed in order to find the weight management protocol that works best for you.


Note: Prior to beginning and exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults or those at risk for or who currently have chronic health conditions.

Reference
International Journal of Sport Nutrition and Exercise Metabolism, 21, 2011, 48-52, Antonio Paoli, et al.

It is a frustration to be doing everything "right" to lose weight, only to have the needle on the scale not budge, even just a bit, in reflection of your efforts.  This especially holds true if you are taking the time to exercise.  So what could be the problem?  You actually may not be expending as many calories in a day as you think. Recent research suggests that some individuals tend to compensate for the extra energy spent during an exercise session by decreasing their activity in other tasks throughout the rest of the day.  In the June 2010 issue of Medicine & Science in Sports & Exercise, researcher Eirini Manthou and colleagues reported findings that obese and overweight women who fell short of their weight loss goals despite participation in an exercise program were compensating for the intervention by being less active during tasks throughout the day; therefore, their total daily energy expenditure was not great enough to promote fat loss.

The investigators wanted to determine the role that nonexercise physical activity played in helping individuals who were involved in an exercise program to lose weight.  The subjects included 34 previously inactive women who were either overweight or obese.  All subjects participated in an eight week supervised exercise training program that included exercising for 150 minutes per week.  They were randomly assigned to one of two groups: exercising twice per week for 75 minutes per session or exercising for five days per week for 30 minutes per session.  Each participant wore a heart rate monitor and recorded her daily activities in a 24-hour physical activity diary and her energy intake in a food diary the week prior to the exercise intervention and during week 8 of the study.  Body composition of the subjects was determined by leg-to-leg bioelectrical impedance scales.

All subjects completed the 8-week exercise training program.  No significant changes in body fat for the group as a whole occurred, nor were there any significant differences in fat loss between the two exercise groups; however, there were significant individual changes in body fat noted.  Those women who lost body fat were classified as "responders" and those who did not were labeled "nonresponders."  Further examination revealed that the responders total daily energy expenditure was greater than the nonresponders; and, that this difference was the result of changes in physical activity performed outside of the supervised exercise sessions.  This behavioral change accounted for the 13 percent variance noted in fat loss between the responders and nonresponders.

The findings of this study highlight the important role that total daily energy expenditure plays in weight control.  Exercise can help, but if you view it as a license to take it easy the rest of the day, you can be mitigating its role in weight loss.  For weight management, the amount of energy that you expend during your daily tasks is as important as the amount you burn during an exercise session.

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

Source
Medicine & Science in Sports & Exercise; June 2010; pp. 1221-1228; "Behavioral Compensatory Adjustments to Exercise Training in Overweight Women," Manthou, E. et al.,.

A common sale's pitch made by many manufacturers of weight loss products is, "Fight Fat with ...[insert said product]."  These companies want you to believe that you can effortlessly lose weight by using their product.  It is interesting that the word "fight" is chosen regarding weight management.  In a way, it seems to undermine their message that weight loss can be effortless.  Personally, I have always defined "fight" as a struggle or a battle - something that takes effort in order to be triumphant.

The hope of effortless weight management is all too tempting, something that, ironically, many Americans have put more time and effort into trying to achieve than if they just did the physical work needed to manage body weight in the first place.  This wish for an "easy way out" has resulted in a major public health crisis that transcends many levels.  As a society, we are now faced with a true "fight," if not an all out war, against fat.

Earlier this week, the first National Physical Activity Plan was released.  This Plan, the first of its kind, is devoted to "[creating] a national culture that supports physically active lifestyles."  That is, the nature of work and school environments, neighborhoods, and cities will be changed to encourage physical activity, allowing it to be readily incorporated throughout the day.

The goal of the Plan is to enhance quality of life by preventing disease and disability and by promoting health.  Under the Plan, 8 areas of society (Business and Industry; Education; Healthcare; Mass Media; Parks, Recreation, Fitness and Sports; Public Health; Transportation, Urban Design and Community Planning; and Volunteer and Non-profit Organizations) will collaborate to implement strategies for change.

The fight against fat is truly that - a fight.  There are no quick fixes where weight management is concerned.  It requires the realization that the attainment of health and well-being requires effort.  Fortunately, with the implementation of the Plan, it will be a collaborative one.

To learn more about the National Physical Activity Plan visit www.physicalactivityplan.org.

Note:  Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

In regards to weight loss, both low-carb and low-fat diets seem to tip the scale the same after a year; but, to feel as if a load has been lifted from your shoulders, you may want to follow a low-fat diet, according to a new study published in the November 9, 2009 issue of Archives of Internal Medicine. After studying 106 overweight and obese individuals for one year, researchers found that those who followed a low-fat diet versus a low-carbohydrate diet experienced greater improvements on measures of mood, despite a similar net weight loss between the two groups. There was no difference between the two diet plans for effects on working memory and speed of processing measures of cognitive function.

During the year of study, investigators measured body weight, mood, and cognitive function of participants at weeks 8, 24, 40, and 52. Each participant met with a dietitian every two weeks for the first eight weeks and then once a month. During these meetings, dietary recommendations were given regarding meal plans and recipe information related to the diet (low-fat or low-carb) that the participant was to follow.

Mood was determined from the results of 3 questionnaires (Profile of Mood States, Beck Depression Inventory, and Spielberger State Anxiety Inventory). Both groups had similar scores on the questionnaires at baseline and both showed improvements in mood after the first 8 weeks of the study. As the investigation continued over the year, the mood scores of subjects following the low-fat diet continued to progress and stabilize, whereas the scores of those consuming the low-carb diet started to return back toward baseline.

The investigators offer the following explanations for the different effect on mood between the two diets:

• Subjects were randomly assigned to either the low-fat or low-carb diet groups without consideration of individual food preferences. Because the traditional dietary recommendations for the Western society is a high-carbohydrate diet, those delegated to the low-carb group may have found it to be more "isolating" to follow the dietary recommendations which would have negatively affected mood state.
• The low-carb diet could have resulted in negative physiological changes in serotonin and neurotrophic factors. Findings of other studies have established a link between low serotonin levels and the presence of depression and anxiety. The researchers explain that while a high intake of carbohydrates can increase serotonin levels, high intakes of fat and protein can decrease concentrations. Investigators also point to the exponential link between brain-derived neurotrophic levels and mood, noting that high-fat diets decrease brain-derived neurotrophic levels.

The authors of the study conclude that further investigation into the effects of the two diets on a wider range of cognitive function (e.g., attention, executive function, and short- and long-term memory) is needed.

Resource

Arch Intern Med. 2009:169(20):1873-1880