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Prediabetes Lifestyle Interventions Shown Cost Effective

Sunday, July 3rd, 2011

Few medical interventions both improve health and save money. Treating prediabetes with metformin is one of them, according to 10-year follow-up data from the Diabetes Prevention Program.

Intensive lifestyle intervention,  did an even better job at improving health and quality of life, and at a favorable cost when compared with some common medical interventions for other diagnoses, Dr. William H. Herman and his associates reported at the annual scientific sessions of the American Diabetes Association.

In this study, the cost per quality-adjusted life-year gained with the intensive lifestyle intervention compared with the placebo group was $12,000. That $12,000 is on the low end of a $10,000-$50,000 range that’s widely accepted for medical interventions, including the use of beta-blockers after MI, the use of antihypertensive therapy for patients with very high diastolic blood pressure (greater than 105 mm Hg), or the use of statins for secondary prevention of cardiovascular disease in patients who’ve had an MI. Dialysis for end-stage renal disease costs $50,000-$100,000 per quality-adjusted life-year gained.

TAGS // Lifestyle Change: The Parts & Process, On The News | No Comments

Choose High-Protein, Low-Carb Diet To Keep The Weight Off

Monday, December 27th, 2010

Diets with High or Low Protein Content and Glycemic Index for Weight-Loss Maintenance

In a recent large European study (published in N Engl J Med 2010; 363:2102-2113 on November 25, 2010 ) by Larsen and colleagues, 1209 adults who had lost at least 8% of their initial weight using a low-calories diet were randomly assigned to various “maintenance” diets. These diets included a low-protein and low-glycemic-index diet, a low-protein and high-glycemic-index diet, a high-protein and low-glycemic-index diet, a high-protein and high-glycemic-index diet, or a control diet. In the analysis of participants who completed the study, only the low-protein–high-glycemic-index diet was associated with subsequent significant weight REGAIN. The authors concluded that even a modest increase in protein content and a modest reduction in the glycemic index led to an improvement in study completion and maintenance of weight loss.

This study is further validation of our approach to weight loss: the kind of foods we consume has more impact on our metabolism and thus our weight than calories. Of course, consuming too many calories leads to relapse and weight regain. However, within a caloric target, cutting back on carbohydrates (starches and sugar) and increasing lean protein yield better results both for weight loss and maintenance.

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A “Cheesy” Matter

Tuesday, November 9th, 2010

I found today’s New York Times front-page article about cheese consumption in the US worthy of discussion. The article “While Warning About Fat, U.S. Pushes Cheese Sales” by Michael Moss (New York Times, Sunday 11.07.2010) shows how government agencies such as the USDA and a non-profit organization called Dairy Management – a firm with a budget upwards of a hundred million dollars – have been promoting increased cheese sales by retail fast-food chains such as Domino’s, Taco Bell, Pizza Hut, etc.

As a result of these marketing efforts Americans are now eating over 30 lbs of cheese a year – up from about 10 lbs. Worse, there has been no effort to promote low-fat cheeses. No wonder Americans are now getting more saturated fat from cheese than any other food source such as beef or butter.

Interestingly, Dairy Management and the USDA licensed and promoted the work of a nutrition professor showing that dairy consumption would help lose weight. No other researcher was able to prove this claim. In spite of lack of evidence, these two government agencies continued to promote the claim for several years before dismissing the claim in 2005.

My take on this is the following. While the protein in dairy (basically whey) is very rich in branch-chained amino acids and thus boosts muscle metabolism, the excess fat in most dairy products precludes it from being used in excess or for weight loss purposes. We recommend 0% to 1% cheese and yogurt products as a source of protein. We do not recommend milk for adults – not even skim milk. Milk is for growing babies and children not for adults!! As for the government’s role in helping the dairy industry, that is a whole different “cheesy” matter…

Sunday Market in Paris

TAGS // All About Food & Nutrition, On The News | No Comments

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dr yavari

Dr. Reza Yavari M.D. is a Board Certified Endocrinologist and founder of Beyond Care®, a leading preventive care and obesity center located in Guilford, CT. Learn More

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