How Women Can Keep the Weight Off After Menopause

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September 7th, 2012

The deck is stacked against women hoping to keep slim after menopause, but researchers say some simple eating habits can keep weight down
By Alexandra Sifferlin

There’s no denying that losing weight is tough, and keeping it off is even harder. We tend to be less physically active as we get older, which is why women tend to gain weight after menopause. But a four-year study published in the Journal of the Academy of Nutrition and Dietetics says there are ways that women can keep the pounds off as they age.

“As women move through menopause, it’s thought that without decreasing calories or increasing exercise, [they] may be prone to gaining weight,” said lead study author Bethany Barone Gibbs of the University of Pittsburgh Department of Health and Physical Activity, discussing the study in a podcast. Americans live in an environment that makes weight gain easy thanks to the availability of cheap and calorie-dense foods, and aging women also have a host of physiological changes working against them.

For instance, after menopause women experience a natural decline in energy expenditure coupled with a lower resting metabolic rate and an increase in appetite-related hormones. It’s not exactly a recipe for a slim figure. Add in the fact that when people lose weight, their brain’s reward system is revved up and increases their desire to eat and it’s a wonder anyone can lose weight and keep pounds at bay.

In the study, the researchers followed 508 post-menopausal and overweight women for four years between 2002 and 2008. They examined their early and long-term weight loss in order to identify any eating behaviors that distinguished women who were successful in keeping their weight down and women who weren’t. The women were assessed at six months and again at the four year mark and filled out questionnaires detailing their food consumption at both check-ins.

The volunteers were split into two groups. Half participated in a Lifestyle Change group and met with nutritionists, exercise physiologists and psychologists while the remainder were in the Health Education group, which simply listened to general seminars about a variety of issues involving women’s health . The Lifestyle Change group also attempted to reduce their fat and overall calorie intake, increase their consumption of fruits, vegetables and whole grains and exercised regularly.

In the short term, the researchers found that at six months the eating behaviors associated with weight loss included eating fewer desserts and fried foods, drinking less sugary beverages, eating more fish and eating less at restaurants, a trend that continued at the four year mark.

“That means that eating less as restaurants and eating less fried foods were either not effective in the long term, or were unsustainable,” said Gibbs in the podcast. “Eating more fruits and vegetables did not predict weight change at six months, but was one of the most important predictors for long-term weight change. That means if you increase your fruit and vegetable intake you may not see a big result at six months, but it may be a very sustainable behavior change that can help you with long-term weight control.”

The authors speculate that the sustainability of various weight loss strategies are what make some better than others in the long run. “People are so motivated when they start a weight loss program. You can say, ‘I’m never going to eat another piece of pie,’ and you see the pounds coming off,” said Gibbs in the podcast. “Eating fruits and vegetables may not make a big difference in your caloric intake. But that small change can build up and give you a better long-term result, because it’s not as hard to do as giving up French fries forever.”

The authors say that slashing dessert and sugary drink consumption is consistently effective for short and long-term weight loss and more fruits and veggies and less meat and cheese are best for long-term pound-shedding. “If the goal is to reduce the burden of obesity, the focus must be on long-term strategies because changes in eating behaviors only associated with short-term weight loss are likely ineffective and not sustainable, they write. That seems to make sense for anyone hoping to keep their weight in check, not just for women after menopause.

Stress may harm brain – but it recovers

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September 4th, 2012

We all know stress is bad for you, but just how bad?

It would be unethical to intentionally subject people to extreme psychological duress in the name of science. But ongoing military operations offer opportunities to see what happens to people exposed to stressful situations.

Researchers in the Netherlands found the brains of soldiers who go into combat show impairment in function and structure upon returning, but that these effects largely go away over time.

The study
A new study published in the journal Proceedings of the National Academy of Sciences looked at 33 healthy Dutch soldiers deployed to Afghanistan for four months. It was the first military deployment for all of them, part of a NATO peacekeeping operation.

Researchers compared these participants to 26 soldiers who were never deployed.

The soldiers who were deployed experienced armed combat and exposure to enemy fire, as well as other common combat stressors. But this did not appear to aggravate stress symptoms; researchers did not find significant differences in post-traumatic stress disorder, anxiety and mood scores between the deployed and non-deployed groups.

But despite no apparent trends in psychological symptoms, the two groups of participants did display marked brain differences.

The combat group showed reduced functioning in the midbrain, as well as structural differences in that area. These soldiers who had gone to Afghanistan tended to perform worse on cognitive tests than those who were not deployed.

Follow-up

Those effects were seen less than two months after the soldiers returned from combat.

But a year and a half later, researchers found that the soldiers who had been deployed had, on average, returned to normal with respect to both brain structure and cognitive performance.

The combat group still showed some brain impairment: Imaging tests showed that there was less connectivity between particular brain regions among these soldiers than those who had not been deployed.

“Although there are some subtle changes, it doesn’t really directly translate into impaired performance,” said Guido van Wingen of the Brain Imaging Center in Amsterdam, who was the lead author of the study.

Although cognitive performance may suffer, a different brain function may be enhanced in soldiers with recent combat experience: vigilance. Previous research from van Wingen’s group shows that the amygdala, a part of the brain important for detecting potential danger, has heightened activity in soldiers who have returned recently from combat. That effect also normalizes over time.

Study drawbacks

The sample size of the study began small, and got smaller over time. Nine people from the combat group and nine people from the non-deployed group did not complete the long-term follow-up.

Also, this study deals only with people from the Netherlands.

Recommendations

The research is too preliminary to make recommendations, van Wingen said.

But it makes sense that soldiers would benefit from time to recuperate in between deployments, so that the brain can re-adapt to a non-combat situation, he said.

Bottom line

“What the results collectively show is the brain is able to restore (itself) from the adverse effects of stress, if you give it at least enough time,” van Wingen said.

More from the Chart: City stress may be bad for brain
Post by: Elizabeth Landau – CNN.com Health Writer/Producer
Filed under: Mental Health • Psychology • PTSD

Why Being Thin Doesn’t Always Mean Being Healthy

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September 4th, 2012

If there’s a universal truth in health news lately, it’s that being overweight isn’t good for your health. Extra weight, especially in the form of fat, can lead to heart disease, diabetes and high blood pressure, among other problems.

But a new study hints that being lean doesn’t get you entirely off the health hook either. In a genetic analysis involving more than 75,000 people, an international group of scientists led by Ruth Loos at the Medical Research Council in the U.K. found that lean people with a specific genetic variant were at higher risk of developing type 2 diabetes and heart disease despite their lower body fat.

MORE: Study: Baked, Broiled — But Not Fried — Fish Is Good for the Heart

The key, say the scientists, is to focus on not just the amount of fat, but the type of fat that you might have. A growing body of evidence shows that fat deposited just under the skin doesn’t contribute that much to the development of metabolic disorders such as diabetes or heart problems. But fat accumulated in deeper tissues and organs, within muscle and embedded in organs like the liver, for example, can put you at greater risk of these diseases. And that goes for lean people too: they might not have much visible fat under the skin, but may be sequestering so-called visceral fat inside their body.

What regulates where you store fat? Unfortunately, says Loos, much of it is out of your control — it’s largely genetic and gender based. Women tend to store fat under the skin, while men are more likely to deposit it deeper in tissues. As for the genetic factor, in the current study, the researchers identified one variant out of more than 2.5 million candidate sites on the genome linked to body fat. This genetic variant seems to predispose people to depositing visceral fat as opposed to the more benign subcutaneous fat. “We think the gene we found causes an error such that it’s harder for these people to store fat under the skin,” she says. “So the fat is stored elsewhere, around the organs and in muscle where it disturbs the normal function of these organs.”

What surprised the scientists was the power of this genetic abnormality on metabolic factors such as cholesterol and triglyceride levels and insulin resistance. Even people with low body fat but who possessed this version of the gene, consistently had higher levels of blood cholesterol and were more likely to show some resistance to processing insulin, one of the first signs of diabetes. Many of these individuals showed normal body mass index or BMI readings, which assess weight but don’t take into account the percentage of body fat.

GRAPHIC: A Look Inside the Heart

The findings highlight the importance of refining our understanding of the relationship between weight, body fat and disease, says Loos. Many people who look lean may assume they are healthy and may not be as likely to get regular blood tests to check their cholesterol and blood glucose levels. That may put them at higher risk of having a heart attack or suffering from tissue and organ damage due to diabetes because they never knew they were at risk. Getting regular checkups, regardless of your weight, she says, may help more people to stay healthy and avoid diabetes and heart problems.

Read more: http://healthland.time.com/2011/06/27/why-being-thin-doesnt-always-mean-being-healthy/#ixzz25U855tY8

Does Weekly Marijuana Use By Teens Really Cause a Drop in IQ?

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September 3rd, 2012

A new study suggests marijuana use could have an impact on America’s IQ, but how great is the effect?
By Maia Szalavitz

Heavy marijuana use is associated with cognitive decline in about 5% of teens, according to a new study, which suggests that the heaviest users could lose 8 IQ points.

In the report, published in the Proceedings of the National Academy of Sciences, research conducted in New Zealand showed that teens who started smoking marijuana before age 18 and were diagnosed as being addicted to cannabis by age 38 experienced an IQ drop in early adulthood. But users who began smoking after age 18—even if they used heavily— did not show a significant decline.

“The effect of cannabis on IQ is really confined to adolescent users,” says lead author Madeline Meier, a postdoctoral researcher at Duke University, “Our hypothesis is that we see this IQ decline in adolescence because the adolescent brain is still developing and if you introduce cannabis, it might interrupt these critical developmental processes.”

The authors followed 1037 children born in the town of Dunedin, New Zealand in 1972 and 1973, virtually every child. They defined adolescent use as at least weekly use before turning 18. In looking at the relationship between marijuana use and IQ, they controlled for factors like years of education, schizophrenia and use of alcohol or other drugs that might also have an effect on IQ. While education weakened the relationship, it still did not eliminate it.

Researchers also had family members and friends of the participants confidentially rate them on attention and memory skills and those who had lost IQ points showed problems in these areas. Meier notes that an 8 point decline in IQ for someone with average intelligence (an IQ score of 100; the 50th percentile) would move that person down to the 29th percentile. “It’s fairly substantial but it does depend on where you start out,” she says.

“I think this is the cleanest study I’ve ever read” exploring the long term effects of marijuana use, Dr. Nora Volkow, director of the National Institute on Drug Abuse, told the Associated Press.

(MORE: Can Addictive Behaviors Be Predicted in Preschool?)

“The overall implication is that when you’re talking about marijuana, you have to take into account age of onset of use and dealing with developing, growing brains,” says Meier.

Not all experts agree, however. “Scientifically, these are extremely preliminary findings,” cautions Carl Hart, associate professor of psychology at Columbia University, who has studied the cognitive effects of marijuana in humans in the lab and was not associated with the research. (Disclosure: he and I are working on a book project together).

Hart notes that because only 38 people in the study— around 8% of those who ever tried marijuana— used it heavily enough to get diagnosed with dependence during several follow-up periods, he is skeptical about how generalizable the results are. He says that in his studies of people who smoke at least three times a week, “When you compare these people’s scores to a normative database on a wide range of domains including executive function, memory, and inhibitory control, they score dead smack in the middle, in the 50th percentile.”

He explains, “They are normal when not intoxicated. We test them when they are not intoxicated and when they are intoxicated. When they are intoxicated, there is some slowing of certain cognitive acts, but their accuracy doesn’t not change.” The New Zealand study, for example, did not identify whether the participants are employed or whether they are able to function in their families, which would be an important indicator of whether the drop in IQ has any real world impact.

There are also other factors—such as child abuse or other trauma —that might lead people to seek escape in heavy marijuana use and could also affect brain function. Meier and her colleagues did not examine these factors but say it’s possible that such elements could explain the results better than marijuana itself.

If the link is real, the effects on cognition could be dramatic. But intelligence and cognition is affected by a plethora of other factors, including genetic, social and environmental influences that may supersede any influence from drug use. Despite the fact that the average marijuana user starts at age 17 in the U.S and nearly 7% of high school seniors currently smoke pot every day, IQ scores have risen tremendously over time in all developed countries in recent years. Most of those same countries also experienced a massive increase in marijuana use between the 1950s and today.

Maia Szalavitz is a health writer for TIME.com. Find her on Twitter at @maiasz. You can also continue the discussion on TIME Healthland‘s Facebook page and on Twitter at @TIMEHealthland.