“Preloading" With Water Before Meals May Help Reduce Calorie Intake

Advancing age is associated with weight gain, and obesity is common in older adults (≥60 years of age). Numerous factors likely contribute to age-related weight gain, including a reduction in energy expenditure, a reduction in energy requirements, and an increased susceptibility to energy overconsumption.

Although it is often thought of as an inevitable consequence of the aging process, weight gain leading to overweight and obesity in older adults has serious consequences, including increased morbidity and mortality, decreased mobility, and increased health care utilization and costs.

Older adults trying to eat less may benefit from drinking a large glass of water before meals, suggest two studies from the USA.

Scientists from Virginia Polytechnic Institute and State University recruited 50 people to test whether drinking a large glass of water 30 minutes before lunch can reduce caloric intake at lunch. Aiming to compare the effects also regarding age, their sample consisted of 29 young adults (21 to 35 years old, 14 men and 15 women) and 21 older ones (60 to 80 years old, 10 men and 11 women), all of whom were healthy and non-obese.

The participants reported to the laboratory for two lunches (on separate days and in random order), one with a water-preload 30 minutes before the meal and another without water preload. Women received 375 ml and men 500 ml water. The participants freely selected their meals from a buffet and rated their fullness, hunger and thirst every 30 minutes, starting from 30 minutes before lunch - prior to the pre-load - till 120 minutes after lunch. Additionally, energy intake at the two lunch meals was recorded.

The water preload reduced energy intake in older adults by ~9% (58 kcal), but had no effect in younger adults.

Similarly, the older adults reported significantly higher satiety and fullness and lower hunger ratings than the young adults. Slower stomach emptying and altered sensations of fullness and satiety in the elderly may have accounted for the differences between the age groups.

Based on these findings, a research team from the same university decided to test the impact of a water preload specifically on overweight and obese older adults (55 to 75 years old, mean body mass index, BMI, around 34 kg/m2).

The procedure in this study was almost the same as in the previous one: 7 men and 27 women consumed two breakfast meals, one with and one without water preload (500 ml). This time only the amount of food eaten and the energy intake were measured. In line with the previous study, meal energy intake decreased significantly by approximately 13% (74 kcal) in the water preload group compared to the breakfast-only group.

These researchers aren't sure why drinking water before meals encourages weight loss, but the main reason appears to be that it helps fill your stomach, making you less hungry and less likely to overeat.

In addition, drinking more water may discourage you from guzzling soda and other calorie-laden beverages. Even the routine of drinking water before meals may have a beneficial effect because it's a reminder that you're trying to lose weight, the researchers suggest.

In conclusion, these studies suggest that water consumption before a meal may help reduce energy intake in the elderly. Whether this would prevent weight gain or even lead to weight loss in the long term remains to be shown in larger studies over a prolonged period of time.

References:

Davy B, Dennis E, Dengo A, Davy K. Water Consumption Reduces Energy Intake at a Breakfast Meal in Obese Older Adults. J Am Diet Assoc. 2008 July; 108(7): 1236–1239. CLICK HERE to read the full article.

Van Walleghen EL, Orr JS, Gentile CL, Davy BM. Pre-meal water consumption reduces meal energy intake in older but not younger subjects. Obesity (Silver Spring). 2007 Jan;15(1):93-9. CLICK HERE to read the full article.

Let Your Child Sleep And Play Their Way To A Healthy Weight

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Watching Less TV, Being More Active and Sleeping More Is Linked to a Healthy Body Weight in Young Children

Getting enough sleep can help children maintain a healthy weight, reveals the EU funded project IDEFICS (Identification and prevention of lifestyle- and Diet-induced health EFfects In Children and infantS). Similarly, the more time children spend in front of the TV or their computers (screen time), the higher their body weight. These results were presented at the 11^th European Nutrition Conference in Madrid on Thursday 27 October 2011, ahead of the IDEFICS final meeting mid November in Bremen.

Getting enough sleep is essential

The length of time children sleep varies significantly between European countries (ranging from 9-10 hours in Estonia to more than 11 hours in Belgium). Children from Southern and Eastern Europe tend to get less sleep than children in the North. Children sleeping less than 9 hours a night were twice as likely to be overweight compared to children sleeping 11 hours, and children sleeping 9-10 hours had a 1.3-fold higher chance. The project did not find that time spent sleeping was influenced by season, daylight duration, parental education level, other lifestyle factors, or whether the child was already overweight. Sleep duration may be underpinned by cultural or environmental factors such as unstructured and flexible bedtime routines, not assessed in this study.

TV-viewing centrally linked to body weight

Researchers of IDEFICS identified clusters of ‘obesogenic’ behaviours (promoting obesity) and found that those behaviours which included TV viewing most related to weight. Notably, children’s waist circumference also increased with the time spent in sedentary behaviour in general (i.e. engaging in activity of low energy expenditure, such as sitting). It is still not clear whether the association of screen time with obesity is due to less physical activity or more so, to food intake. The internet as a channel for communicating about food and drinks deserves further attention in this regard.

Link between screen time and diet

Across all countries, almost half of the children sometimes or often watch TV during meals. Children viewing more TV consumed higher-fat and particularly higher-sugar diets. This finding was independent of the child’s individual taste preferences for fatty or sugary foods, which were objectively measured in a controlled taste experiment. Professor Wolfgang Ahrens, who coordinates IDEFICS, advises: “Eating in front of the screen should be minimised, and emphasis should be placed on nutritious snacks such as fruit and vegetables. First choice for quenching thirst should be water and other non-caloric drinks. Consumption can be encouraged by enhancing availability at kindergarten, school and home. Parents and caretakers need to be aware they are important role models.”

Promoting a healthy environment

Children who are active in their leisure time, have lower screen time and are more likely to eat healthily. Since the built environment impacts activity and diet, policy makers and urban planners should ensure children find enough safe and enticing spaces to move and play, e.g. playgrounds, green spaces and play streets. Where these structures don’t exist, parents can check with their community for organising play streets every now and then in the neighbourhood.

Says Professor Ahrens, “it’s not right to blame just the parents if their children are overweight. It’s time to fully acknowledge the environmental impact on health behaviour. The more effectively policy makers, teachers, caretakers and parents work together in creating a healthy environment, the easier it will be for children to learn healthy living.” IDEFICS has made start - let’s take it from here.

The IDEFICS Study

Currently in its fifth and final year, the IDEFICS Study has accomplished a huge cross-sectional baseline survey in over 16,000 children aged 2-9 years from eight European countries. This was followed by a targeted intervention and a follow-up survey to assess the impact of dietary and lifestyle changes on body weight and other health parameters. Specifically for this project, IDEFICS researchers have developed standardised data collecting methods for identifying dietary, lifestyle, psychosocial, physical, biochemical and genetic factors for overweight, obesity, metabolic syndrome and impaired bone health in children. Such validated standards are of great value for future research and monitoring as they would allow data comparability across different contexts.

Evaluation of the follow-up survey will show whether the IDEFICS intervention was effective, in which countries it was effective and what the main factors were that contributed to a possible intervention effect. Concludes Professor Ahrens, “hopefully from that basis we will be able to develop guidelines and recommendations in the future, but this is ongoing research.”

For more information about the IDEFICS Study visit the project website www.ideficsstudy.eu or

Story Source:

The above story is reprinted from materials provided by EUFIC - European Food Information Council.

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November 11, 2011 : Malaysian Pharmacy and The Pharmacist

Friday November 11, 2011: Wisma MPA (Malaysian Pharmaceutical Society) was officially declared opened by the Minister of Health.

Friday November 11, 2011 is also the 96^th birthday of a humble, unassuming pharmacist, Mr Tan Yap.

But Tan Yap is no ordinary pharmacist.

In the early 1960s Tan Yap sacrificed his pay as a state pharmacist in Johor Baru for one year to study American Sign Language (ASL) at Gallaudet University in USA. On his return, he introduced sign language to educate the deaf in Malaysia and was instrumental in establishing deaf schools in several states, despite much objection and scepticism.

Dubbed the Father of the Deaf, Tan Yap is still active as adviser to The Society of Interpreters For The Deaf in Selangor and Federal Territory.

Tan Yap has received a few awards in recognition of his work, including being the first Asian to get the Edward Miner Gallaudet and Toko Pendidikan Cacat awards.

While other pharmacists went on to collect knighthoods from the state and the Federal governments in recognition of their physical, and sometimes basic monetary, contribition, the people in authority appear to be ‘deaf’ to the sacrifice Tan Yap has made to improve the quality of life of several generations of deaf Malaysians.

Tan Yap was the 1973-1974 President of the Malaysian Pharmaceutical Society. We hope the Malaysian Pharmaceutical Society did the honour of inviting Tan Yap to the opening ceremony of their Wisma MPS and had made every effort to ensure his comfort at their auspicious event.

Happy Birthday Mr Tan Yap! May this birthday offer you as much joy and happiness as you give to all Malaysians.

Sources:

The Star Online

Hurlbut, Hope M. A preliminary survey of the signed languages of Malaysia. 2003. Signum Verlag.

Dirt Prevents Allergy

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If infants encounter a wide range of bacteria they are less at risk of developing allergic disease later in life. This is the conclusion of research from the University of Copenhagen, which suggests completely new factors in many modern lifestyle diseases.

Oversensitivity diseases, or allergies, now affect 25 per cent of the population of Denmark. The figure has been on the increase in recent decades and now researchers at the Dansk BørneAstma Center [COPSAC, Copenhagen Prospective Studies on Asthma in Childhood], University of Copenhagen, are at last able to partly explain the reasons.

A variety of bacteria offers protection

"In our study of over 400 children we observed a direct link between the number of different bacteria in their rectums and the risk of development of allergic disease later in life," says Professor Hans Bisgaard, consultant at Gentofte Hospital, head of the Copenhagen Prospective Studies on Asthma in Childhood, and professor of children's diseases at the Faculty of Health Sciences, University of Copenhagen.

"Reduced diversity of the intestinal microbiota during infancy was associated with increased risk of allergic disease at school age, he continues. But if there was considerable diversity, the risk was reduced, and the greater the variation, the lower the risk.

"So it makes a difference if the baby is born vaginally, encountering the first bacteria from its mother's rectum, or by caesarean section, which exposes the new-born baby to a completely different, reduced variety of bacteria. This may be why far more children born by caesarean section develop allergies."

There is no allergy-causing bacteria

In the womb and during the first six months of life, the mother's immune defences protect the infant. Bacteria flora in infants are therefore probably affected by any antibiotics the mother has taken and any artificial substances she has been exposed to.

"I must emphasise that there is not one single allergy bacteria," Professor Bisgaard points out.

"We have studied staphylococci and coli bacteria thoroughly, and there is no relation. What matters is to encounter a large number of different bacteria early in life when the immune system is developing and 'learning'. The window during which the infant is immunologically immature and can be influenced by bacteria is brief, and closes a few months after birth.

"Our new findings match the large number of discoveries we have also made in the fields of asthma and hay fever," Professor Bisgaard explains. Like allergies, they are triggered by various factors early in life.

The researchers gathered their data from a unique material consisting of 411 children whose mothers have asthma. This cohort was monitored, interviewed and tested continually from when the children were born 12 years ago, and the COPSAC group has published articles at regular intervals with new knowledge about allergy and asthma ever since.

These findings could be relevant for other modern diseases

Professor Bisgaard acknowledges the irony of something that used to be perceived as a threat to public health, namely bacteria, now turning out to be a fundamental part of a healthy life. He also points out that there may be other couplings, such as between intestinal flora and diabetes or obesity and other lifestyle diseases affecting modern man in the West.

"I think that a mechanism that affects the immune system will affect more than just allergies, he concludes. It would surprise me if diseases such as obesity and diabetes are not also laid down very early in life and depend on how our immune defences are primed by encountering the bacterial cultures surrounding us."

<<< * >>>

The above story is reprinted (with editorial adaptations by The Zestfulness Team) from materials in the by University of Copenhagen news release of November 2, 2011

The article has been published in the Journal of Allergy and Clinical Immunology: Bisgaard H, Li N, Bonnelykke K, Chawes BL, Skov T, Paludan-Müller G, Stokholm J, Smith B, Krogfelt KA. Reduced diversity of the intestinal microbiota during infancy is associated with increased risk of allergic disease at school age. J Allergy Clin Immunol. 2011 Sep;128(3):646-52.e1-5. Epub 2011 Jul 22.

Lose the Fat and Improve the Gums

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Case Western Reserve University School of Dental Medicine researchers found the human body is better at fighting gum disease when fat cells, which trigger inflammation, disappear.

Findings come from a pilot study of 31 obese people with gum disease. Half of the group with an average body mass index (BMI) of 39 had gastric bypass surgery and had fat cells from the abdomen removed. That half fared better than a control group of obese people with a BMI of 35 who also were treated for gum disease but did not have the gastric bypass surgery or fat removed.

What intrigued the researchers is that the majority of those who underwent surgery had a drop in their glucose levels after the procedure, a result that bodes well for overweight people predisposed to diabetes and insulin-related problems.

All study participants underwent nonsurgical periodontal treatments of scaling/root planing and oral hygiene instructions for home care. While both groups showed improvement, the surgery group did even better on the measures for periodontal attachment, bleeding, probing depths and plaque levels.

Inflammation that continues to brew in the body can have harmful effects over time, and inflammation from gum disease can erode bone and cause tooth loss. It can also cause breaks in the gums where harmful oral bacteria can enter the blood stream. Such bacteria have been linked to preterm birth, fetal death, heart disease, diabetes and arthritis, said Nabil Bissada, chair of the department of periodontics at Case Western Reserve School of Dental Medicine.

Bissada is the lead author of the study, “Response to periodontal therapy in subjects who had weight loss following bariatric surgery and obese counterparts: a pilot study,” published in the Journal of Periodontology.

This study raises two hypotheses about why the surgery group improved.

The first theory is that excessive fat cells (adipocytes) secrete more cytokines (such as TNF and IL-6), which make insulin more resistant to doing its function.
As a result, more accumulation of sugar in the blood (hyperglycemia) occurs. Losing weight, therefore, makes insulin less resistant and improves the diabetic status. This in turn helps in the response to periodontal treatment.

The other theory relates to the presence of the leptin hormone that regulates appetite. Leptin plays a role in regulating metabolism and has been linked to inflammation by increasing the production of cytokines and the –C-reactive protein, which is also linked to inflammation. Bissada said leptin production was reduced after bariatric surgery and may be one explanation for the better outcomes in the periodontal treatment.

As the researchers look to the further their research, their next step will be to conduct a longitudinal study to support their preliminary findings.

Contributing to the study were Dima Lakkis, Sena Narendran and Leena Palomo, Case Western Reserve School of Dental Medicine; Alan Saber and Leena Khaitan, University Hospital Case Medical Center; and Mohammad Al-Zahrani, King Abdulaziz University.

<<< * >>>

The above story is reprinted (with editorial adaptations by The Zestfulness Team) from materials in the by Case Western Reserve University news release of November 9, 2011

The article has been published ahead of print: Dima Lakkis, Nabil F. Bissada, Alan Saber, Leena Khaitan, Leena Palomo, Sena Narendran, Mohammad S. Al-Zahrani. Response to Periodontal Therapy in Subjects Who Had Weight Loss Following Bariatric Surgery and Obese Counterparts: A Pilot Study. J Periodontol. 2011; 1 DOI: 10.1902/jop.2011.110230

Cholesterol-Lowering Effects of Oat β-Glucan.

Elevated total and low-density lipoprotein (LDL) cholesterol levels are considered major risk factors for cardiovascular disease.

Lifestyle modifications to reduce cardiovascular disease risk include the recommendation to increase consumption of viscous soluble dietary fiber to lower LDL cholesterol.

Oat β-glucan, a soluble dietary fiber that is found in the endosperm cell walls of oats, has generated considerable interest due to its cholesterol-lowering properties.

Several regulatory bodies have approved a health claim on the cholesterol-lowering effects of oat β-glucan at levels of 3.0 gram daily

The United States Food and Drug Administration (FDA) approved a health claim for β-glucan soluble fiber from oats for reducing plasma cholesterol levels and risk of heart disease in 1997. Similarly, our Ministry of Health together the United Kingdom Joint Health Claims Initiative (JHCI) and the European Food Safety Authority allowed a cholesterol-lowering health claim for oat β-glucan.

Clinical evidence for the cholesterol lowering effects of β-glucan soluble fiber comes from over 1400 studies ranging over 40 years.

Most recent ones include the study by Karen Charlton et al on the effect of β-glucan-rich oat products on cholesterol levels in mildly hypercholesterolaemic overweight adults which was reported in the August 2011 issue of the British Journal of Nutrition (1).

The ability of oat β-glucan to reduce serum cholesterol depends on its ability to increase the viscosity of intestinal contents. The viscosity of β-glucan solutions is determined by its molecular weight (MW) and solubility, both of which can be altered by normal methods of processing and storage.

Putative effects have been attributed to an influence on the sequestering of bile acids in the gut, reducing re-absorption and return to the liver for further synthesis. This reduces the amount of bile acids returning to the liver and forces the liver to produce more bile acids to replace the bile acids lost in the stool. In order to produce more bile acids, the liver converts more cholesterol into bile acids, which lowers the level of cholesterol in the blood (2).

Oat β-glucan has been shown to decrease postprandial plasma glucose and serum insulin responses (3). To help lower the rise of blood glucose, the Minsitry of Health recommends that Oat β-glucan be taken on its own and not together with other food.

Oat β-glucan is also know to increase immune function and decrease risk of infection (4).

References:

1. Charlton KE, Tapsell LC, Batterham MJ, O'Shea J, Thorne R, Beck E, Tosh SM. Effect of 6 weeks' consumption of β-glucan-rich oat products on cholesterol levels in mildly hypercholesterolaemic overweight adults. Br J Nutr. 2011 Aug 3:1-11. [Epub ahead of print] You can refer to the full text HERE

2. Wolever TMS, Tosh SM, Gibbs AL, et al. (2010) Physicochemical properties of oat {beta}-glucan influence its ability to reduce serum LDL cholesterol in humans: a randomized clinical trial. Am J Clin Nutr 92, 723–732. You can refer to the full text HERE

3. Juvonen KR, Salmenkallio-Marttila M, Lyly M, Liukkonen KH, Lähteenmäki L, Laaksonen DE, Uusitupa MI, Herzig KH, Poutanen KS, Karhunen LJ. Semisolid meal enriched in oat bran decreases plasma glucose and insulin levels, but does not change gastrointestinal peptide responses or short-term appetite in healthy subjects. Nutr Metab Cardiovasc Dis. 2011 Sep;21(9):748-56. Epub 2010 Jun 4.

4. Davis JM, Murphy EA, Brown AS, Carmichael MD, Ghaffar A, Mayer EP. Effects of moderate exercise and oat beta-glucan on innate immune function and susceptibility to respiratory infection. Am J Physiol Regul Integr Comp Physiol. 2004 Feb;286(2):R366-72.

Oat β-Glucan