News 12: International Congress on Obesity Presentations

Ekaterina Belova and Hans Kuepper from Palitra Pitania, Center Personal Dietology, joined this international Congress. They had earlier also visited a comparable congresses in Budapest, Geneva and Bangkok.

These international congress allow scientific researchers and practitioners from all over the world to exchange the latest research results and findings and support each other in developing treatments to combat the plague of the 21th century – OBESITY – .

For us these congresses serve to receive new and up to date information to even further develop our unique nutritional program – Palitra Pitania – in order for our clients to have the best results, whether they want to learn about eating well or how to slim down.

At the congress lots of new information was exchanged and here on the site we like to publish some limited information about the best presentations. To learn more please join us at our Center.

Presentation 1: John Mullen Impact of weight in survival in patients undergoing non bariatric surgery

(small comment, bariatric surgery is all different types of surgery to reduce the stomach size in order to decrease calorie consumption)

In the United States 30% of the population is obese, as defined a body mass index (BMI)> 30, 5% are morbidly obese, a BMI > 40. Just to illustrate, a BMI of 30 is 87 kg for a 1.70 tall person and at 40 that person weights 116 kg.

10% of the US health spending is on obesity related illnesses and rising.

A so called obesity paradox though has been recorded. Obese people undertaking hospital operations do not have worse results as could be expected than normal weight persons. Up to today the paradox could not be scientifically explained as obesity in general has a very negative impact on health.

Presentation 2: The Wadd Society

As was stated in one presentation, people who can live with ambiguity, who understand that there is more than black and white in life do best when on a diet. So some of the key presenters in the conference, including the organizer Stephan Roessner, got together to see weight and nutrition from the lighter side. They founded the Wadd Society. The Wadd Society is a club for people who are interested in the history of nutrition, overweight and false advertising.

In very amusing presentations they showed that even thousands of years ago overweight already existed in many civilizations. They documented that there have been always people out to make a buck on the back of the people wanting to shed some weight – such as a US based sugar interest group promoting sugar as a means to lose weight, or a company selling a miracle product for weight loss which proved to be lard.

The Wadd Society is named after William Wadd.

en.wikipedia.org/wiki/William_Wadd
www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61065-3/fulltext

Already in 1810 he wrote about the negative impact of obesity on humans.

While obesity is a very serious issue today taking an historical look allows us to see a bit more on the development of this disease.

Presentation 3: Thomas Ellrott Randomized placebo controlled trial on the efficacy of OTC weight loss

Very simple message. Do not waste your time and money on any dietary supplement product (pills and other) sold in a pharmacy without a doctor description.

A randomized test of 9 such products in Germany showed that there are no results, except making the purse lighter.

www.medconnect.com.au/tabid/84/s21/Pulmonology/ct1/c337606/Nine-OTC-Weight-Loss-Agents-Work-No-Better-Than-Placebo/Default.aspx

The result of this study is not surprising, it is also not surprising that there are still buyers of these products. Because as was said so many times at the congress – the best weight loss approach – is to change your nutritional behavior and lifestyle – and that is without the support of a trained dietitian a hard challenge.

Presentation 4: Michael Rosenbaum Physiological adaptations preventing long term weight maintenance

For us one of the most fascinating and also challenging presentations about new scientific results.

Each human has a different energy balance, the amount of calories he needs to consume not to gain or lose weight. This energy balance is mostly driven off the weight of the fat free mass (FFM), basically your body weight less your fat. Between energy balance and FFM is close to a perfect linear correlation. The more you weigh the more calories you need.

Now though when reducing weight your body does not need less calories as a person with the same lower weight but 300-400 calories less than this comparable person. Somehow when you lose weight your body becomes more efficient in using the calories you take in with your food. And this is not just a temporary effect before your body adjusts to the lower weight. This effect has been seen six years after the weight loss. And as such the yo-yo effect of people losing weight and then gaining it back can be partially explained but this additional challenge for anyone having lost weight.

To make it though even more difficult for people having lost weight are psychological changes. People having lost weight feel more hungry, think they ate less than they actually do.

All of these very scientific results have been gained by patients spending up to 1 year inside a client, eating only standardized food and being constantly measured.

While, based on the experience with the unique Palitra Pitania nutrition program we do not agree with all findings it just shows how challenging weight loss is and that the best way to achieve results is to work with a trained nutritionist.

Presentation 5: Rena Wing Behavioral factors associated with long term weight loss maintenance

Rena Wing create an association of people who lost substantial amount of weight and did not regain it over a long time (National Weight Control Registry).

www.nwcr.ws

She then asked these people how they had achieved not to regain weight.

The findings were that the following characteristics were vital to achieve these results:

1. Eating a low calorie – low fat diet
2. Engaging in a high level of physical activity
3. Limit TV viewing
4. Frequent self weighting
5. Maintain dietary consistency (not overeat one day of the week)
6. Limit variety of food
7. Eat Breakfast
8. Limit fast food

Additionally she researched how to best achieve weight loss results. The findings were not surprising:

Best was an intensive life style intervention based on an individual program and person to person meetings. Online information, emails and news letters were also helpful but much less though.

And our unique Palitra Pitania program is in line with all the above guidance, except for the limitation of variety of food. This is why your Center is called Palitra Pitania, we want to teach our clients the wealth of available healthy foods!

Presentation 6: Jaakko Tuomilehto Long Term outcomes of diet and exercise programs for weight loss in obesity

In a big scientific stuffy Jaako Tuomilehto from the University of Helsinki showed that permanent lifestyle changes based on an behavioral change program can result in long term weight loss. The weight loss is substantially more than a weight loss only based on pills or just by sharing information.

The effects of the permanent weight loss also reduce substantially the diabetes 2 risk.

Presentation 7: Eric Ravussin Energy metabolism as a predictor of weight gain

A very complicated and scientific study. And a study that is not in line with what we see on a daily basis at our Center.

The study tried to analyze if the recent weight gain in the population is due to less physical activity or more calorie intake. Or a combination of both.

The results of the study are that nearly all of the weight gain is due to an increased calorie intake! Between 1970 and 2000 adults in the US increased their daily calorie intake by 500 Kcal, children by about 350 Kcal.

The findings are that in order to “burn” these additional calories each person should engage in additional activities, e.g. walking each day two hours more. As all this is not possible with our busy schedule the only way to reduce the overweight in the population is to decrease the energy intake sharply again and to increase where possible the physical activity.

Presentation 8: Franceso Branca Global Nutrition Trends in Pre-school children

Franceso Branca talked about the double burden. The double burden is that in many countries some children are overweight while others are eating less than they should. Both harming children for life.

In comparing countries from Easter Europe into Central Asia actually the sad result is that Russia has the highest percentage of overweight children in this region – about 21% just before Ukraine and Albania with 20%. And if you think this is bad and it will not get worse look e.g. at Italy. There the comparable number is 52% for boys. Other, especially northern European countries managed better with much lower rates.

This data from the World Health Organization, a United Nations Organization shows how careful Russia must be going forward and address the issue of Childhood obesity.

Some health oriented programs exist like www.takzdorovo.ru but any successful program must be long term, combine the government and the private sector and most of all be financed well.

Presentation 9: Margherita Caroli Preventive strategies of childhood obesity in the 5 continents

Margherita Caroli presented passionately that overweight and obesity are not about some statistics of children but about the very health of our children. Margherita showed how many different countries are trying to battle childhood obesity but have not yet found very successful approaches to reduce childhood obesity.

For Margherita the way forward is to:

1) Create and Support Consumer unions to promote and protect the consumer interests
2) Strengthen fruit and vegetable producers in how they market and promote their products
3) Strengthen international environmental organizations
4) Work with Mass Media so they become better aware of the issue
5) Pressure politicians to act

All of the above for Margherita is key to in principle to protect our children from the food industry, the marketing of the food industry and the flood of sugar, salts and fats in many of their products.

Presentation 10: Peidro Teixeira Psychological predictions of weight gain

A difficult and provocative presentation. The question was if weight gain can be explained by physiological reasons. The author performed a meta study. He in principle reviewed many other studies about the subject and tried to understand to what level all studies are supportive of each other.

In the view of the author there were very few psychological predictors of weight gain. For the author the main characteristics which predict low weight gain are:

Exercise:

– Exercise self efficacy
– Exercise intrinsic motivation

Eating:
– Flexible Constraint
– Low disinhibition / emotional eating

Cognitive and other psychological variables:

– Autonomous self regulation / motivation
– Low weight pre-occupation / concern
– Internal locus of control
– Dichotomous thinking

More interesting was his annotation about recent trends in research on weight loss maintainers that revealed that people pre-occupied by weight, who always try to follow rules and force themselves to shed weight are not the most successful. More successful is to focus on the wider topic of health, not to see everything white and black and to eat from time to time chocolate and Hamburgers and just to aim for some realistic results without forcing themselves to shed weight. Also all motivation to keep the lower weight should be internally and not pressured from the outside and treats and gratifications as a cake or so should not be postponed to achieve a certain result.

Overall findings that correlate very well to the Palitra Pitania program which also aims not to force people to lose a certain amount of weight per month but focuses on education, health aspects and the enjoyment of food and has as result potentially a weight loss if this is the objective.

Presentation 11: The end the of increased rates in the childhood obesity?

A heated discussion took place between two presenters if the increase in the childhood obesity rates had stopped or slowed down, though at a very high level. Both sides presented their views, and the statistical data that the increase in the rates had stopped were impressive. Impressive was though also the counterarguments that the statistical data is plainly false today since as people become aware of the issue of childhood obesity amongst other actions they try to avoid being counted as overweight and in the statistics we are not seeing the full picture any more.

When though the more than 500 specialist in the room were asked about their view the answer was clear. Childhood obesity is still on the rise. Sad news, since Childhood obesity will translate in more adults being obese. Or did you know that 70% of the obese children will be also obese as adults. And that obesity will cut 5 to 10 years of their lifespan and lower measurably their quality of life. Sad news when over 500 people and more than a decade into this epidemic the rates of childhood obesity are still rising.

Presentation 12: Ruth Loos Genetic Predictors of Obesity

With the deciphering of the DNA the big hope in the medical community was that an obesity gene could be found and a cure be developed. Many years later, lots of millions of research dollars spend the result is that there is no result. No genetic predictors of Obesity have been found. So when a friend tells you next time that he is overweight due to some genes just tell him to get his science right …..

Presentation 13: Neil King Interactions between physical activity and appetite

Did nobody ever tell you that doing sport does not help to lose weight since you get more hungry, and implying that maybe it is better just to relax and watch TV. Well if so there is the research for you.

Actually, above is partially true but on a net balance you still spend more energy on sports than you additionally consume. And actually the right balance of sport makes you feel less hungry, maybe you have also experienced this.

Presentation 14: Garry Egger Social Reasons for Failure

Garry Egger wrote a book called Planet Obesity.

www.amazon.com/Planet-Obesity-ebook/dp/B003U4WN58

He presented from the book and his views on the background of the obesity epidemic. In his view the obesity epidemic is a result of the industrialization of the world and the inability of mankind to say stop to good things.

He argues that a certain increase in the quality of food and the nutrition was good and resulted in a longer lifespan and more healthy lives. Over time though it did not stop and people consumed more and more of this “good thing”. And too much good can turn into bad.
As such obesity is not an illness but a sign that something is wrong in the overall set up of our materialistic society. He argued convincingly that it is futile to do something about obesity as long as root causes are not addressed, being form him the striving for continuous economic growth. Climate change is for him another sign that the balance for life on the planet is in danger.

He showed a very funny example where it said that 20 % are obese and 39 % are overweight in the UK, and then only said that these statistics applied to dogs. And the risk factors were about the same as for humans snacks and low exercise.

Also he argued with different slides that our bodies are starting to rebel against food they do not know, an environment which becomes more and more unhealthy and also our unhealthy lifestyle.

In a different part of the presentation he detailed the more wealthy a country is and the more uneven the income is distributed with few rich and many poor the more overweight this country is. While there might not be a direct correlation between these facts the reason is most likely that in countries where the wealth is spread more evenly a more social and more active government is in place try to reduce obesity.

While his main argument is to end the focus on economic growth which few people agree with other aspects of the presentation are much more agreeable. Such as more local food should be consumed, less pollution of the environment is key for health and that industrialization has resulted in a lifestyle change which is dangerous if not controlled perfectly.

Provocative thoughts, but what today are provocative thoughts can be in some years accepted truth.

Presentation 15: Jean Philippe Chaput Work less and sleep more

Some presentations even had a great title. How can it get better than work less and sleep more!

The reader might wonder where is the link to obesity! And yes there is a big one.

The young scientist and his team had documented that working more (defined as sitting at the computer and working instead of sitting on a couch and doing nothing) makes you fatter.

And now the reader might wonder how so? Working on a computer makes one fat? And yes, it is not the computer work but the results of it. Sitting on a couch or working at a computer consume nearly the same amount of calories but when the work is done the person having worked eats on average 250 Kcal more than the person just sitting on the couch. And that difference will not be compensate by eating less later in the day.

In the second part of the presentation talked about the correlation of sleep time and weight. As we sleep less and less we get heavier. And yes there are statistics out that show that just about 8 hours of sleep are optimal. Less and more are bad and result in a higher BMI. The reasons for the higher BMI due to shorter sleep were shown such as, just more time to eat, lots of late night snacks, less energy and less sports etc.

Isn’t this a great message – sleep more, work less and you lose weight!

And there were many more other presentations.

Resume:

Overall a very interesting congress with many new interesting thoughts and ideas. It though was a bit surprising that so many presenters talked about behavioral change and education to be the best method to control weight. And so little – to be precise – nobody talked about how to teach this know how to interested parties. And without a good teaching of how to change ones behavior and to live more healthy even such a congress with all the good information and intend can not share the message how to life more healthy.

We at Palitra Pitania are happy that we have our successful, standardized and well developed and tested method how to work with our clients to achieve this behavioral change to life a more healthy and fulfilled life. And that we can integrate some of the findings learned at the congress into our Palita Pitania program to make it even better.

Come and visit us at our new office, and learn about what we can do for you!

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