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Going to Canada to Get Thin

April 26th, 2012 by Lyndsey Lovinger

At Camp Shane weight loss camps, our goal is to equip our campers with the proper tools needed to make better choices for long-term weight loss and a healthy lifestyle. However, some people – impatient for weight loss – have been venturing to Canada for a “quick fix.” An April 10, 2012 article in the New York Times reports on the use and risks of the intra-gastric balloon.

Tammy Kwarciak, a 44-year-old nurse whose weight had been creeping up for years, was determined to lose 50 pounds. So in February, she drove from her home in Port Huron (MI) across the border into Canada and had a small balloon-like device inserted into her stomach.

The intra-gastric balloon, filled with liquid and left in the stomach for up to six months, is not approved for use in the United States, though it’s available in Europe, South America and other parts of the world. Clinical trials required to win federal Food and Drug Administration approval are being initiated, but many Americans are not waiting.

Since the balloon’s introduction in Canada in 2006, people have been streaming north in growing numbers. Drawn by the relative ease of balloon placement, Americans account for nearly a third of patients undergoing the procedures in Canadian clinics just over the border. “The nice thing about the balloon is that you have such a sense of satiety,” said Mrs. Kwarciak, who has lost 25 pounds since she had the procedure. “I feel full all the time.”

During the procedure, the patient is anesthetized, and the intra-gastric balloon is inserted through the esophagus. It is then removed after six months or so. This procedure appeals to people who have a significant amount of weight to lose but are not heavy enough to qualify for bariatric surgery like gastric bypass surgery and adjustable gastric band surgery. The balloon may also be an option for extremely obese people who need to lose enough weight to be considered for bariatric surgery.

But, just because the placement doesn’t involve surgery doesn’t mean it’s risk-free. Patients can suffer severe nausea and vomiting during the first few days or week after placement. On rare occasions, it can deflate and obstruct the intestines, or it can perforate the abdomen, which can be life-threatening. Perhaps as significant, the weight loss that patients can expect is modest at best. “That’s the most common complication — not losing as much weight as the patient would like,” said Dr. Sanjeev Kaila, the plastic surgeon who pioneered the intra-gastric balloon program in Canada. Some return for a second balloon after taking a short break, he added.

Though Mrs. Kwarciak said she lost 25 pounds in the first two months, studies say most patients experience the bulk of their weight loss during the first three to four months after the balloon’s insertion. Studies of the balloon have reported weight loss ranging from 13 to 34 pounds on average, with some individuals losing up to 50 pounds. Patients often gain weight again after the device is removed, though long-term studies are limited.

But a scathing review by The Cochrane Collaboration in 2007 noted the possibility of serious complications, and concluded that “compared with conventional management, the intra-gastric balloon did not show convincing evidence of greater weight loss.” Another review suggested the device was a waste of money, saying that its use “only to reduce weight has no medical and economic justification.”

The combination of potential risks and little benefit is the main reason there is no intra-gastric balloon on the market in the United States. An earlier version called the Garren-Edwards Gastric Bubble was approved in 1985. But officials at the Food and Drug Administration soon became concerned about the severe and frequent complications associated with the device. By 1988, the manufacturer, American Edwards Laboratories, stopped selling it, voluntarily withdrawing the balloon from the market entirely in 1992. In the interim, randomized clinical trials comparing the bubble with a sham or placebo device found that diet and exercise were equally effective for weight loss.

Getting the new intra-gastric balloon is not cheap. In Canada, an outpatient procedure that takes less than an hour costs $8,000. The fee includes removal of the device after six months, as well as physician follow-up and support services from a nutritionist and dietitian, usually provided over the phone and online.

FDA officials would not comment on the current balloons, which are made of new, sophisticated materials, but said generally that the agency “reviews medical devices to assure American patients that they are safe and effective. Many countries will approve medical devices without first having to demonstrate that the technology is effective.”

Dr. Robin Blackstone, a bariatric surgeon in Scottsdale (AZ) and president of the American Society for Metabolic and Bariatric Surgery, who is involved in a clinical trial of a balloon in the United States, said that people who need to lose a modest amount of weight may do just as well with a more conventional approach, given the risk of complications. “Patients who are obese are very vulnerable,” she said. “They’re desperate to find something that works, and it’s important for people not to offer things that are not well established.”

For those who insist on trying the procedure despite its lackluster record, some cautions are in order. The balloon is an option only for those who have less than 50 pounds to lose – Canadian clinics may accept patients with a body mass index as low as 27, if they also have weight-related health problems – or for extremely obese people who need to lose weight to be accepted for bariatric surgery.

Potential patients should consult with a primary-care physician. The metabolic and bariatric surgery organization recommends establishing a relationship with a local gastroenterologist able to remove the balloon endoscopically should a complication occur.

The balloon, usually filled with blue liquid, can rupture. The liquid will turn patients’ urine green, which is how they are alerted to the problem. A ruptured balloon may pass through the intestines on its own or require endoscopic or surgical removal if it obstructs the intestines. The most serious complication is a rupture in the abdomen, which can be life-threatening. Other complications include infections and ulcers. Patients should not have the balloon implanted if they are pregnant or planning a pregnancy, have a hiatus hernia, or history of gastric ulcers, other gastrointestinal disease or previous abdominal surgery.

Successful weight loss with the intra-gastric balloon depends on lifestyle changes, including a better diet and increased physical activity, and maintaining those changes is critical to maintaining the weight loss after the balloon is removed. Many balloon programs have a team of providers, often a gastroenterologist, endocrinologist, nutritionist or dietitian, personal trainer and psychologist involved in weekly follow-up with patients.

Source: www.nytimes.com, Impatience to Get Thin Sends Some to Canada

http://query.nytimes.com/gst/fullpage.html?res=9E01E2DA1F3EF933A25757C0A9649D8B63&pagewanted=all

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Can Exercise Lead to a Better Brain?

April 23rd, 2012 by Lyndsey Lovinger

At Camp Shane weight loss camps for kids, we try to make physical fitness fun for everyone, and we offer all types of events and activities designed to get even the most reluctant camper involved. We know that exercise is crucial to effective weight loss and optimum physical health, but now scientists have shown that there is also an essential relationship between exercise and building a better brain.

In the quest to make ourselves smarter, there may now be an easy-to-achieve, scientifically-proven way to become more intelligent: Go for a walk or a swim. For more than a decade, neuroscientists and physiologists have been gathering evidence of the beneficial relationship between exercise and brainpower. But the newest findings make it clear that this isn’t just any relationship; it is THE relationship. Using sophisticated technologies to examine the workings of individual neurons – and the makeup of brain matter itself – scientists in just the past few months have discovered that exercise appears to build a brain that resists physical shrinkage and enhance cognitive flexibility.

Last year a team of researchers led by Justin S. Rhodes, a psychology professor at the Beckman Institute for Advanced Science and Technology at the University of Illinois, gathered four groups of mice and set them into four distinct living arrangements. One group lived in a world of sensual and gustatory plenty, dining on nuts, fruits and cheeses, their food occasionally dusted with cinnamon, all of it washed down with variously flavored waters. Their “beds” were colorful plastic igloos occupying one corner of the cage. Neon-hued balls, plastic tunnels, nibble-able blocks, mirrors and seesaws filled other parts of the cage. Group 2 had access to all of these “enrichments”, plus small disc-shaped running wheels in their cages. Group 3’s cages held no embellishments, and they received standard kibble. Group 4’s homes contained the running wheels, but no other toys or treats.

All the animals completed a series of cognitive tests at the start of the study and were injected with a substance that allows scientists to track changes in their brain structures. Over the next few months, they then they ran, played, or (if their environment was un-enriched) lolled about in their cages. Afterwards, Rhodes’s team put the mice through the same cognitive tests and examined brain tissues.

“Only one thing had mattered,” Rhodes says, “and that’s whether they had a running wheel.” Animals who exercised, whether or not they any enrichments in their cages, had healthier brains and performed significantly better on cognitive tests than the other mice. Animals that didn’t exercise, no matter how enriched their world was, did not improve their brainpower in complex, lasting ways.It turned out that the toys and tastes, no matter how stimulating, had not improved the animals’ brains.

Why would exercise build brainpower in ways that thinking might not? Like all muscles and organs, the brain is a tissue, and its function declines with underuse and age. Beginning in our late 20s, most of us will lose about 1% annually of the volume of the hippocampus, a key portion of the brain related to memory and certain types of learning. Exercise seems to slow or reverse the brain’s physical decay, much as it does with muscles. Even more encouraging, scientists also found that exercise jump-starts neurogenesis – the creation of new brain cells. Mice and rats that ran for a few weeks generally had about twice as many new neurons as sedentary animals. Like other muscles, their brains were bulking up.

Additionally, exercise seems to make neurons nimble. When researchers in a separate study had mice run a maze, the animals’ brains readily wired many new neurons into their existing network. Those neurons only fired during running, and also when the animals practiced cognitive skills, like exploring unfamiliar environments. In the mice, running created brain cells that could multitask.

Research suggests that exercise prompts increases in something called brain-derived neurotropic factor, or BDNF, a substance that strengthens cells and axons, and fortifies the connections among neurons and sparks neurogenesis. Scientists have found that after workouts, most people display higher BDNF levels in their bloodstreams.

Few if any researchers think that more BDNF explains all of the brain changes associated with exercise. Any whether any type of exercise will produce these desirable effects is another unanswered and intriguing issue. “It’s not clear if the activity has to be endurance exercise,” says the psychologist and neuroscientist Arthur F. Kramer, director of the Beckman Institute at the University of Illinois and a pre-eminent expert on exercise and the brain. A limited number of past studies have found cognitive benefits among older people who lifted weights for a year and did not otherwise exercise, but most studies to date, (and all animal experiments) have involved running or other aerobic activities.

Whatever the activity, though, an emerging message from the most recent science is that exercise does not need to be exhausting to be effective for the brain. When a group of 120 older men and women were assigned to walking or stretching programs for a major 2011 study, the walkers wound up with larger hippocampi after a year, while the stretchers lost volume to normal atrophy. The walkers also displayed higher levels of BDNF in their bloodstreams than the stretching group, and performed better on cognitive tests.

Source: www.nytimes.com, How Exercise Could Lead to a Better Brain

http://www.nytimes.com/2012/04/22/magazine/how-exercise-could-lead-to-a-better-brain.html?pagewanted=all

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Nutrition News: 15 Biggest Food Myths

April 18th, 2012 by Lyndsey Lovinger

It is easy to become overwhelmed with the amount of information available today about healthy diet, weight loss, and nutrition. Fitness trends make their way into the scene, and just as quickly disappear. Fad diets promising weight loss constantly appear and fade away. But when it comes to eating healthily, there really are just a few rules to follow, and some “rules” that are purely myth. Camp Shane, a leading weight loss camp for kids, gives our campers the tools they need to make healthy diet choices. Check out the 15 biggest nutrition myths from “Fitbie” online.

Myth #1: High fructose corn syrup is worse than table sugar High fructose has gotten lots of media attention recently for being unhealthier than your average table sugar. Here are the facts: HFCS and table sugar are both built with roughly a 50-50 blend of two sugars, fructose and glucose. Most likely, your body cannot tell one from the other. However, since HFCS is very cheap, many foods (even ones you might not suspect) are made with the product and it may be affecting your health in ways not yet fully understood by the scientific community. As a rule, the less sugar you eat, the better. The best solution is to minimize the amount of HFCS by reading the ingredient list on nutrition labels.

Myth #2: Sea salt is a healthier version of regular salt

Table salt comes from a mine and contains about 2,300 milligrams of sodium per teaspoon. Sea salt comes from evaporated seawater and also contains about 2,300 milligrams of sodium. That makes both of them roughly identical. Sea salt does contains compounds like magnesium and iron, but they exist only in trace amounts, meaning you would have to ingest extremely high and potentially dangerous levels of sodium to obtain a meaningful dose. Table salt is regularly fortified with iodine, which plays an important role in regulating the hormones in your body. Sea salt provides virtually zero iodine. The solution: don’t rush to switch out your table salt for sea salt, as table salt may have the slight edge. In general, it’s best to avoid excess sodium in your diet altogether.

Myth #3: Energy drinks are less harmful than soda

Energy drinks, such as Red Bull and Monster, attempt to boost your energy with B vitamins, herbal extracts, and amino acids. However, their big ingredient is sugar. A 16-ounce can delivers as much as 280 calories of pure sugar, which is about 80 calories more than the same amount of Pepsi. A University of Maryland study also found energy drinks to be 11% more corrosive to your teeth than regular soda. The only proven, significant energy boost comes from caffeine. The best energy boost is a cup of coffee.

Myth #4: Diet soda is harmless

Diet soda is sweet due to artificial sweeteners, and the obesity-research community is becoming increasingly aware that these sweeteners can lead to hard-to-control food urges later in the day. A University of Texas study found that people who consume just three diet sodas per week were more than 40% more likely to be obese. Try to wean yourself off soda altogether by switching to carbonated water and flavoring with lemon, cucumber, or fresh herbs.

Myth #5: Low-fat foods are better for you

In food marketing lingo, “low fat” is often synonymous with “loaded with salt and cheap carbohydrates.” For example, Smucker’s Reduced Fat Peanut Butter contains a fast-digesting carbohydrate called maltodextrin to replace the fat taken out. That is not going to help you lose weight. A New England Journal of Medicine study found that over a 2-year span, people on low-carb diets lost 62 percent more body weight than those trying to cut fat. Be careful when purchasing foods that claim to be “low fat” and check the nutrition label to see that it’s not loaded with carbohydrates.

Myth #6: “Trans-fat free” foods are actually trans-fat free

If a food contains no more than .5 grams of trans-fat per serving, they are allowed by FDA guidelines to claim that it has 0 grams of trans-fat. However, due to a link to heart disease, the World Health Organization advises people to keep trans-fat intake as low as possible, maxing out at about 1 gram per 2,000 calories consumed. If you’re not aware that many foods have almost half a gram of trans-fat, you could be exceeding that number every day. The American Journal of Health Promotion recently published an article urging the FDA to rethink its lax regulations. Meanwhile, avoid all foods with “partially hydrogenated oil” (meaning trans-fat) on their ingredients list.

Myth #7: Foods labeled “natural” are healthier

The FDA does not make a serious effort to control the use of the word “natural” on nutrition labels. For example, 7UP advertises that it is made with “100% Natural Flavors”. In reality, the soda is sweetened with an unnaturally high dose of high fructose corn syrup. Other “natural” label abuses include Natural Cheetos (made with maltodextrin and disodium phosphate), and Post’s “natural advantage” Raisin Bran, which uses excessive sugar and corn syrup. Again, read nutrition labels very carefully and don’t be fooled into paying more for these so-called “premium” foods!

Myth #8: Egg yolks raise your cholesterol

Yes, egg yolks do contain dietary cholesterol. However, research has proven that dietary cholesterol has almost nothing to do with serum cholesterol, the substance in your blood. Researchers at Wake Forest University reviewed more than 30 egg studies and found no link between egg consumption and heart disease. Another study in Saint Louis found that eating eggs for breakfast could decrease your calorie intake for the remainder of the day. An added bonus is that eggs are not very expensive and available in any supermarket, so be sure to stock up the next time you are grocery shopping.

Myth #9: Eating junk food helps battle stress

We all deal with stress in different ways. Many choose to battle their stress by eating junk food. It can be momentarily comforting, but a study published in the British Journal of Psychiatry found that people who consumed the most highly processed foods were 58% more likely to be depressed than those who ate the least. The next time you’re feeling stressed, find a healthy snack like peanut butter and Triscuits to satisfy the craving.

Myth #10: Chocolate is bad for you

Cocoa is a plant-based food replete with flavonoids that increase blood flow and release feel-good endorphins. It also contains a healthy type of saturated fat called stearic acid, which research has shown can increase your good HDL cholesterol. Here is the catch: when most people think of chocolate, their mind jumps to milk chocolate, which has far more sugar than actual cocoa. Try dark chocolate instead, specifically, those versions that tell you exactly how much cocoa they contain. Aim for a chocolate bar with 60 percent cocoa, but the more cocoa it contains, the greater the health effects.

Myth #11: Granola is good for you

Granola is a very sneaky food that seems like it should be healthy. Although it is made of oats (which ARE good for you), they are blanketed in sugar and baked in oil. After processing, granola is likely to contain more fat and sugar than a bowl of regular cereal. The best bet is to stick with a reasonably healthy cereal, or (better yet) switch to oatmeal.

Myth #12: Bananas are the best source of potassium

Potassium keeps your nerves and muscles working efficiently, and can also blunt sodium’s effect on blood pressure. A 2009 study found that a 2:1 ratio of potassium to sodium could halve your risk of heart disease. The average American consumes about 3,400 milligrams of sodium each day, so your goal should be 6,800 milligrams of daily potassium. It is highly unlikely you will reach that mark, and never with bananas alone. One banana has 422 milligrams and 105 calories. Some alternate sources of potassium that also have fewer calories are:

Potato- 80 calories in half a medium spud
Apricots- 80 calories in 5 whole fruits
Cantaloupe- 55 calories in 1 cup of cubes
Broccoli- 50 calories in 1 full stalk
Sun-dried tomatoes- 35 calories in a quarter cup

Myth #13: Oranges are the best source of Vitamin C

Vitamin C is an antioxidant that plays a host of important roles in your body, and also boosts the immune system. It strengthens skin by helping to build collagen, improves mood by increasing the flow of norepinephrine, and bolsters metabolic efficiency by helping transport fat cells into the body’s enery-burning mitochondria. However, the body cannot create or store this vitamin, so you need to provide a constant supply. An orange is the most famous vitamin-C food, and although it is a good source, it’s not the best. An orange has 70 calories and 70 micrograms of vitamin C. Other sources with the same amount of vitamin C and fewer calories are:

Papaya- 50 calories in ¾ cup
Brussel’s sprouts- 40 calories in 1 cup
Strawberries- 40 calories in 7 large fruits
Broccoli- 25 calories in ½ stalk
Red Bell Pepper- 20 calories in ½ medium pepper

Myth #14: Organic is always better

Organic products are often better, but not always. In fact, organic produce is almost nutritionally identical to its conventional counterpart. The issue here is pesticide exposure, which some studies have linked to an increased risk of obesity. However, many conventionally grown fruits and vegetables are very low in pesticides. For example, the conventional onion has the lowest pesticide load of 45 fruits and vegetables tested by the Environmental Working Group. Other safe-to-eat conventional produce include avocados, sweet corn, and pineapple. In general, conventional fruits and vegetables with impermeable skins are safe to buy, while organic produce like celery, peaches, apples, and blueberries are better.

Myth #15: Meat is bad for you

Meat is a great source of protein – pork, beef, and lamb are among the world’s best sources. A Danish study found that dieting with 25 percent of calories from protein can help you lose twice as much weight as dieting with 12 percent protein. Also, Vitamin B12 is only prevalent in animal-based foods. B12 is essential to your body’s ability to decode DNA and build red blood cells. Don’t be concerned that meat will increase your risk for heart disease. A Harvard University review examined 20 studies and found that meat’s link to heart disease exists only with processed meats like bacon, sausage and deli cuts. Stick with unprocessed meats, those that are not smoked, cured, or chemically preserved.

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Lose Weight with Whole Grains

April 17th, 2012 by Lyndsey Lovinger

At Camp Shane, a leading weight loss camp for kids, we educate our campers on nutrition so they can make healthy diet choices when they return home.

Lots of people are starting to make the switch from white bread to wheat. But why are whole grains a healthier choice for a weight loss diet than other sources of carbohydrates?

There are three parts of a grain: the endosperm, bran, and germ. The bran is the shell of the grain, and protects it from damage. It is made mostly of fiber. The germ can be best described as the seed, and it contains all the vitamins and minerals. The endosperm is the starch, and provides energy. When a grain is processed, the bran and the germ are thrown away, leaving only the starchy, sugary part of the grain. The grain is then bleached to give it the white color.

This happened in America for years, until people started developing B vitamin deficiencies, such as beriberi, pellagra, and neural tube defects. At that point, there was a major movement to start “enriching” the processed grains. This meant that the companies that processed the grains started adding spray on vitamins. This change helped with deficiencies, but still did not make white flour any more fibrous.

Another issue that arises with bleached, enriched grains is food additives. Many brands of white breads contain high fructose corn syrup to make it sweeter, and a high salt content to make it more shelf-stable. Although it may taste better and lasts longer in your cupboard than other breads, it is not the best choice for your healthy diet.

All in all, whole grains keep you full for longer because your body uses the energy more slowly. The added sugars and the lack of fiber in white bread gives you an initial sugar high and crash after, leaving you hungry for more calories soon after eating. If you eat whole grains, you are less likely to over consume, which can lead to weight gain and obesity. But always remember to check the label, because some whole wheat breads aren’t 100%, and can contain high fructose corn syrup, too!

Written by Amanda Yazbek, Nutritionist at Camp Shane weight loss camp for children

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The Effect of Sugar on Weight Loss

April 11th, 2012 by Lyndsey Lovinger

As a leading weight loss camp for kids, Camp Shane does not obsess over dieting – we work with our campers on learning about nutrition so they can make healthy diet choices at home.

One of the leading causes of weight gain for most Americans is the over consumption of added sugar. Statistics state that the average American obtains over 20 teaspoons of sugar which rounds out to about 400 calories.

Junk Food in School

According to the USDA guidelines of the American Heart Association, 20 teaspoons of sugar per day exceeds recommendations. These added sugars include any form of sweetener that is loaded with calories and not naturally found in nature. Fruit sugar, also known as fructose, is a type of sugar that is converted into energy differently and does not present immediate health concerns. These are okay to include in your healthy diet.

Most sugar added to food unnaturally is in the form of sucrose and should not be included in your weight loss diet. It is lurking in most desserts and sports drinks, as well as all sodas. Sugar does not benefit the body in any way; it only adds useless calories which will ultimately lead to weight gain and even obesity. Being overweight or obese is also a contributing factor for many diseases.

The main role of sugar is to boost flavor and appeal to most Americans’ taste buds. This is why it is marketed and formulated in most junk foods, along with those foods you would not normally associate as sweet like ketchup. Steer clear of cookies, cakes and snack foods with more than seven grams of added sugar, and limit your intake of sweetened beverages. This will ensure you maintain a healthy weight and decrease your chances of heart disease and related diseases.

Written by Adrienne Pellechia, Nutritionist at Camp Shane weight loss camp for kids

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