Obesity Watch

Pharmacy TimesMarch 2011 Central Nervous System
Volume 77
Issue 3

Big Breakfast May Be Detrimental to Losing Weight

Can a hearty breakfast be detrimental to effective weight loss? Scientists from Technical University of Munich, Germany, suggest that a high-calorie breakfast simply boosts one’s daily calorie intake, and that the amount of calories one consumes at lunch and dinner will likely not be lessened by the amount of calories consumed at breakfast.

The study, published in January 2011 in the Nutrition Journal, enrolled 100 normal weight and 280 obese volunteers who wanted to lose weight. All volunteers were asked to keep food diaries that included all calories consumed over 10 days for the obese volunteers and 14 days for the normal weight volunteers. Participants were not consistent with their calorie intake at breakfast, consuming many calories one morning and skipping breakfast entirely the next. Although big breakfasts were associated with less late morning snacking for both groups, they had no impact on extra calories consumed by the end of the day.

Previous research has shown that those who eat breakfast generally weigh less than those who do not, and eating a big breakfast leads to less calorie intake throughout the day. The researchers suggest that cutting back on the calories consumed during the first meal of the day “can be helpful to lower daily intake and improve the energy balance during treatment of obesity.” Whether or not decreasing caloric intake in the morning truly promotes weight loss needs to be examined in further studies. PT

The Fight Against Childhood Obesity

At a forum attended in January 2011 by more than 200 health leaders at the National Press Club in Washington, DC, the issues of childhood obesity and poor mental health were addressed and potential solutions were discussed by a group of expert panelists. Almost one-third of American children are overweight, and more than half of this group is obese. Children and adolescents who are overweight more often experience psychological problems that result in poor academic performance, depression, and suicide attempts.

The panelists agreed that the main solution to the problem of childhood obesity and poor mental health is a reinforced focus on primary care. Because many overweight children also suffer from depression and anxiety disorders, these comorbidities need to be addressed when healthy lifestyle changes are recommended. Bernadette Melnyk, PhD, RN, dean of the Arizona State University College of Nursing & Health Innovation in Phoenix, said that cognitive-behavioral therapy (CBT) is an important pillar of treating mental health problems and obesity that is often missed.

Although the panelists agreed that the problem of child obesity must be addressed, they also warned that children who are overweight or obese must not be identified as a “special group,” lest they feel ostracized and develop more mental health issues. Instead, the problems of child obesity and the importance of healthy nutrition and physical activity should be ingrained in school programs for all children, much like awareness of tobacco use.

Vitamin Deficiency May Cause Metabolic Syndrome

An epidemiologic study published in Public Health Nutrition online ahead of print in October 2010 shows that deficiencies in certain micronutrients may cause or worsen metabolic syndrome, a combination of medical disorders that increases the risk of developing cardiovascular disease and diabetes. Metabolic syndrome affects up to 25% of the US population.

Researchers designed a cross-sectional study that enrolled 225 women and 127 men 65 years and older living in lowincome neighborhoods in Quito, Ecuador. The relationship, if any, between micronutrients and metabolic syndrome was examined by interviewing participants on food intake and taking blood samples biweekly. Deficiencies in vitamin C, vitamin B12, zinc, and folate were prevalent among participants, and concentrations of vitamin C (odds ratio [OR] = 0.78; 95% confidence interval [CI], 0.71-0.86) and vitamin E (OR = 0.16; 95% CI, 0.03-0.81) were found to be inversely associated with metabolic syndrome, adjusted for age and sex. Because the participants did not have low levels of vitamin E, the researchers suggest that having higher levels of vitamin E may protect against metabolic syndrome. This is not seen with vitamin C; 82% of participants with metabolic syndrome had low levels of vitamin C.

Because diet of low-income Ecuadorians, which mostly consisted of white rice, potatoes, sugar, and white bread, may be different from other patient groups, these results need to be carefully extrapolated to other populations before definitive associations between vitamins C and E and metabolic syndrome are made. Nonetheless, the results do show that among lowincome Ecuadorians dietary modifications that focus on increasing portions of micronutrient-rich foods should be recommended in order to decrease risks for developing metabolic syndrome.

Fast Fact: Colorado, District of Columbia, Connecticut, Massachusetts, and Hawaii have the lowest obesity rates in the country.

Recent Videos
Practice Pearl #1 Active Surveillance vs Treatment in Patients with NETs