Bariatric Times

AUG 2017

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

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40 News and Trends Bariatric Times • August 2017 DIET QUALITY MATTERS NOT JUST QUANTITY IN MID-TO-LATE ADULTHOOD SILVER SPRING, Maryland—A new study in Obesity investigated the impact of diet quality in mid-to- l ate-adulthood on visceral and liver fat not solely relying on Body Mass Index (BMI). Four different measures of diet quality were used to evaluate dietary intake of the multiethnic population over a 20- year span. Maintaining a high quality diet during mid-to-late adulthood may prevent adverse metabolic consequences related to visceral adipose tissue (VAT) and non-alcoholic fatty liver (NAFL). The study examined close to 2,000 participants of the Multiethnic Cohort living in Hawaii and Los Angeles from five ethnic groups (White, African American, Native Hawaiian, Japanese American and Latino). The participants completed food frequency questionnaires at cohort entry from 1993-96 and at clinic visits in 2013-2016. Participants also underwent whole-body DXA and abdominal MRI scans. All four science-based diet quality scores predicted lower VAT and NAFL. Individuals with the best (highest) diet quality scores were 35 to 59 percent less likely to have high VAT and were also 22 to 43 percent less likely to have NAFL than those with the lowest scores after accounting for total body fat. A long-term healthy, quality diet can reduce the risk of cardiometabolic conditions. Gertraud Maskarinec, MD, PhD, Professor of Epidemiology at University of Hawaii Cancer Center said, "The message that diet quality, not just quantity, matters is important for everyone who wants to maintain both a healthy body weight and a healthy metabolism." TOS Spokesperson Catherine M. Champagne, PhD, RDN, LDN, FADA, FAND, FTOS, Professor and Chief Nutritional Epidemiology/Dietary Assessment and Nutrition Counseling at Pennington Biomedical Research Center LSU said, "All healthcare p roviders should care about this research if their goal is to improve the health status of their patient population. There is benefit associated with both long-term a dherence to a healthy diet and to encouraging individuals with poor diets to adapt a healthier diet." Overall, the management of excess body weight suggests that body fat distribution beyond BMI is a critical feature to consider when advising individuals with overweight about the health effects of their regular diets, as the metabolic consequences of visceral adiposity may lead to chronic conditions. About The Obesity Society. The Obesity Society (TOS) is the leading professional society dedicated to better understanding, preventing and treating obesity. Through research, education and advocacy, TOS is committed to improving the lives of those affected by the disease of obesity. For more information, visit www.Obesity.org. OVERWEIGHT CHILDREN AND ADULTS GET SIGNIFICANTLY HEALTHIER AND QUICKLY WITH LESS SUGAR—EVEN IF THEY DON'T LOSE WEIGHT Research in The Journal of the American Osteopathic Association Suggests Cutting Fructose Quickly Improves Metabolic Function Chicago, Illinois—Osteopathic physicians suggest shifting the conversation from weight to health for overweight children and adults, asking patients to reduce their sugar intake to see measurable improvements in metabolic function. Improved measures of health can be seen in less than two weeks of sugar reduction, according to a review published in the August edition of The Journal of the American Osteopathic Association (JAOA). Keeping the simple sugar fructose, particularly high-fructose corn syrup, off the menu can help avert health issues including obesity, fatty liver disease and type 2 diabetes. Fructose accelerates the conversion of sugar to fat, researchers noted. Their JAOA review summarized the results of several carefully controlled studies, f inding a link between high consumption of sugar, in particular fructose, and increased fat synthesis in the liver. "Fructose provides no nutritional value and isn't metabolized in the brain. Your body converts it to fat, but doesn't recognize that you've eaten, so the hunger doesn't go away," explains Tyree Winters, DO, an osteopathic pediatrician focused on childhood obesity. "Many young patients tell me they're always hungry, which makes sense because what they're eating isn't helping their bodies function." Overfed and undernourished. The JAOA review identified fructose as a particularly damaging type of simple sugar. Compared to glucose, which metabolizes 20 percent in the liver and 80 percent throughout the rest of the body, fructose is 90 percent metabolized in the liver and converts to fat up to 18.9 times faster than glucose. HFCS is found in 75 percent of packaged foods and drinks, mainly because it is cheaper and 20 percent sweeter than raw sugar. Fructose turns on the metabolic pathways that converts it to fat and stores it in the body, adding weight. At the same time, the brain thinks the body is starving and becomes lethargic and less inclined to exercise. "If we cut out the HFCS and make way for food that the body can properly metabolize, the hunger and sugar cravings fade. At the same time, patients are getting healthier without dieting or counting calories," Dr. Winters says. "This one change has the potential to prevent serious diseases and help restore health." Fighting back. Once people have put on a significant amount of weight and developed eating habits that rely on packaged and processed foods with HFCS, change can be daunting. Historically, p hysicians have told patients to restructure their diet and start exercising heavily, with a plan to check back after a month or more. That approach rarely works, as seen b y the ever-growing obesity epidemic. Instead, Dr. Winters suggests checking blood work about two weeks after patients agree to begin limiting their sugar intake to help patients see clear benefits for their effort. "That single change in diet improves metabolic results in less than two weeks. Imagine the power of doing a 'before and after' comparison with a patient, so they can see for themselves that their health is improving. Seeing those results, instead of just stepping on a scale, can motivate them to keep going," Dr. Winters explains. About The Journal of the American Osteopathic Association. The Journal of the American Osteopathic Association (JAOA) is the official scientific publication of the American Osteopathic Association. Edited by Robert Orenstein, DO, it is the premier scholarly peer- reviewed publication of the osteopathic medical profession. The JAOA's mission is to advance medicine through the publication of peer-reviewed osteopathic research. CHILDHOOD OBESITY HISTORICALLY HIGH IN LOW INCOME COMMUNITIES SILVER SPRING, Maryland— Childhood obesity rates are at historically high levels especially among racial/ethnic minorities and low-income families. In the July issue of Obesity, three papers present outcomes from the Massachusetts Childhood Obesity Research Demonstration Project (MA-CORD), a comprehensive, systematic intervention to prevent and reduce childhood obesity among low-income children ages 2– 12 years old in two selected cities in Massachusetts. Childhood Obesity Prevention in News and Trends AUGUST 2017

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