U.S. Department of
Health and Human Services

National Institutes of Health

WIN Notes

Summer 2006

WIN Notes is a quarterly newsletter produced by the Weight-control Information Network (WIN), a project of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH), U.S. Department of Health and Human Services (DHHS). WIN provides consumers, health professionals, and the media with up-to-date, science-based information on obesity, weight control, physical activity, and nutrition.

In This Issue:

Cover Article

WIN Creates New Materials and Visits New Venues

The rising prevalence of obesity and its associated health risks have attracted a lot of attention in American news outlets. Despite the media coverage, many people still need guidance on how to safely and effectively control weight. Aware of the need to provide the public with up-to-date, science-based information, the Weight-control Information Network (WIN) has created the following educational materials:

Talking With Patients About Weight Loss
This six-page fact sheet addresses the role of primary care professionals in patients’ weight control, providing guidance on how to communicate with patients and set reasonable weight-loss goals. It includes dialogue samples and helpful tips on healthy eating and physical activity. Along with the fact sheet, WIN also developed a magnet that displays the publication’s weight-control suggestions.

Tips to Help You Get Active
This 20-page brochure offers guidance on how to incorporate physical activity into one’s day, listing common workout barriers and suggesting ways to overcome them. It includes sections in which readers can write down personal exercise barriers and possible solutions.

Besides developing these materials, WIN has spread its word by exhibiting at health conferences across the country. Some of this year’s conferences included the Virginia Dietetic Association’s 2006 Annual Meeting, Howard University’s “Prevention is the Best Medicine” health fair, Empowerment Temple African Methodist Episcopal Church’s 3rd Annual Wellness Walk, and a local TOPS (Take Off Pounds Sensibly) meeting. These events gave WIN the opportunity to share educational materials and information with health professionals and members of the general public.

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Research Notes

Studies Suggest Low-calorie Diets Could Slow Aging

Previous research has shown that calorie restriction may slow aging and increase lifespan in small mammals. But would the same apply to humans? Two recent studies supported by the National Institutes of Health indicate this may be the case.

At Washington University in St. Louis, researchers assessed the diastolic function--how well the heart relaxes between beats--of 25 healthy adults on calorie-restricted (CR) diets and 25 control subjects on typical Western diets (WD). Diastolic function was measured by transmitral flow, Doppler tissue imaging, and model-based image processing of E waves. Subjects in this cross-sectional study also had their C-reactive protein, tumor necrosis factor-alpha, and transforming growth factor-beta1 measured.

Since aging normally causes a decline in cardiac performance, researchers hypothesized that any improvement in diastolic function associated with a CR diet would provide evidence of the diet’s anti-aging benefits.

For 6.5 years, the CR group ate a nutritionally balanced diet providing approximately 1,671 calories per day and at least 100 percent of the recommended daily intake for nutrients. Twenty three percent of the diet’s daily calories came from protein, 49 percent from complex carbohydrates, 28 percent from fat, and 6 percent from saturated fat. The CR diet was low in sodium.

During the same period, the WD group ate a typical diet providing approximately 2,445 calories per day, with 17 percent of its energy coming from protein, 52 percent from carbohydrates, 31 percent from fat, and 11 percent from saturated fat.

Results indicated that long-term CR with optimal nutrition may improve some aging-associated changes in cardiac performance. Specifically, the CR diet improved subjects’ diastolic function by lowering blood pressure and decreasing systemic inflammation and myocardial fibrosis.

Another recent study also suggested that low-calorie diets may affect aging-related factors. Researchers in the Pennington Biomedical Research Center’s Comprehensive Assessment of the Long Term Effects of Reducing Intake of Energy (CALERIE) study conducted a randomized controlled trial to examine the impact of 6 months of calorie restriction on longevity. The CALERIE study, which took place between March 2002 and August 2004, included 48 overweight (non-obese) men and women. Participants were divided into four groups: 1) a control group on a weight-maintenance diet; 2) a group on a 25 percent CR diet; 3) a group on a 12.5 percent CR diet and an exercise program leading to a 12.5 percent increase in energy expenditure; and 4) a very low-calorie diet group.

After 6 months, participants in the three intervention groups had reduced fasting insulin levels and core temperature, two markers associated with increased longevity in humans. In addition, researchers observed a “metabolic adaptation” developed in response to the energy deficit and a possible decline in DNA damage.

Article Information
Meyer T, Kovács S, Ehsani A, et al. Long-term Caloric Restriction Ameliorates the Decline in Diastolic Function in Humans. Journal of the American College of Cardiology. 2006;47(2):398-402.

Heilbronn L, Jonge L, Frisard M, et al. Effect of 6-month Calorie Restriction on Biomarkers of Longevity, Metabolic Adaptation, and Oxidative Stress in Overweight Individuals. Journal of the American Medical Association. 2006;295(13):1539-1548.

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Night Eating Syndrome Tied to Obesity

People suffering from night eating syndrome are at higher risk than normal for obesity and substance abuse, according to recent research. The study also found that night eating syndrome is a common condition among psychiatric patients.

Characterized by excessive eating in the evening (hyperphagia) and nocturnal awakening with ingestion of food, night eating syndrome affects approximately 1.5 percent of the U.S. population. The condition was first observed among obese patients, but it also affects people who are not obese.

In a study partly supported by the National Institute of Diabetes and Digestive and Kidney Diseases, 399 psychiatric outpatients were screened for the eating disorder via a night eating questionnaire. Investigators inquired about hunger and craving patterns, percentage of calories consumed after the evening meal, insomnia and awakenings, nocturnal food cravings and ingestions, and mood. Participants who scored above cutoff on the questionnaire were interviewed by phone and received a night eating syndrome diagnosis if they reported having evening hyperphagia or nocturnal awakenings with ingestions of food three or more times a week.

Results placed the prevalence of night eating syndrome at 12.3 percent. Further, investigators noted that obese psychiatric patients were five times more likely to suffer from night eating syndrome than normal-weight patients, with obesity present in 57.1 percent of diagnosed night eaters. Although this study found an association between obesity and night eating syndrome, investigators did not conclude that night eating syndrome might lead to obesity, or vice-versa. Approximately 79 percent of the obese patients enrolled in this study were not night eaters.

Substance abuse was another behavior associated with night eating syndrome, and alcohol was noted as the most commonly abused substance. The investigators observed that mental health professionals will probably encounter patients suffering from night eating syndrome in their practice, and should be aware of available treatment options.

Article Information
Lundgren J, Allison K, Crow S, et al. Prevalence of the Night Eating Syndrome in a Psychiatric Population. American Journal of Psychiatry. 2006;163(1):156-158.

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Weight Gains Noted Among Men, Children, and Adolescents

A recent Government report showed that overweight and obesity rates continue to rise, especially among men, children, and adolescents.

Using the latest data from the National Health and Nutrition Examination Survey (NHANES), researchers analyzed the height and weight measurements of 3,958 children and adolescents aged 2 to 19 years, as well as 4,431 adults aged 20 years or older. This new report used data from 2003 and 2004 and compared it with information NHANES obtained in 1999 to 2000 and 2001 to 2002.

Researchers found that the incidence of overweight among children has increased significantly, from 13.9 percent in 2000 to 17.1 percent in 2004. Similarly, obesity prevalence among men reached 31.1 percent in 2004, compared with 27.5 percent in 2000.

The report found no significant increases in the prevalence of obesity among women, leading investigators to conclude that increases in body weight may be leveling off in this group.

Article Information
Ogden C, Carroll M, Curtin L, et al. Prevalence of Overweight and Obesity in the United States, 1999-2004. Journal of the American Medical Association. 2006;295(13):1549-1555.

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Physical Fitness Important Before and During Pregnancy

Recent research has highlighted the importance of weight control and physical activity both before and during pregnancy.

An NIH-supported study showed that children whose mothers were overweight or obese before becoming pregnant were more likely to be overweight at age 2 or 3. Using a sample of 3,022 children from the National Longitudinal Survey of Youth’s Child-Mother file, researchers analyzed information on the children’s race and ethnicity, as well as their mothers’ pre-pregnancy weight, smoking status, and breastfeeding habits. Each child was weighed at ages 3, 5, and 7.

If a woman was overweight before her pregnancy, her child was nearly three times more likely to be overweight at age 7 than children whose mothers were not overweight or obese, researchers found. The children’s overweight risk at young ages increased with the degree of the mothers’ obesity.

Other findings showed that children whose mothers smoked during pregnancy were more likely to be heavy at all age intervals. In addition, 4 to 6 percent more black and Hispanic children were overweight than white children.

Another NIH-supported study found that engaging in regular physical activity before and during pregnancy may reduce a woman’s risk for gestational diabetes (GD). Analyzing data from a Washington State 1998 through 2002 case-control study, and a 1996 through 2002 prospective cohort study, researchers assessed the relation between GD and “perceived exertion” in lean and overweight women. In determining perceived exertion, researchers used the Borg scale, a measure of exertion that allows women to rate the intensity of their physical effort subjectively. Exertion was classified as none to weak (0 to 2), moderate (3 or 4), strenuous (5 or 6), and very strenuous to maximal (7 to 10).

Results showed that the risk for GD was lower for women who reported very strenuous to maximal exertion during usual exercise in the year before becoming pregnant. Participants who reported very strenuous exertion were 81 percent less likely to develop GD, compared with those who reported negligible or minimal exertion. In addition, women who reported moderate exertion had a 59-percent risk reduction.

These results are consistent with other studies that suggest efforts to increase maternal physical activity before and during pregnancy may reduce GD risk. In response to these findings, the National Diabetes Education Program (NDEP) has launched a campaign to inform the public about the risk for type 2 diabetes faced by women with a history of GD and their offspring. Titled It’s Never Too Early to Prevent Diabetes, the campaign offers materials in English and Spanish with information on how to prevent and delay type 2 diabetes. NDEP materials are available at www.ndep.nih.gov.

Article Information
Salsberry P, Reagan P. Dynamics of Early Childhood Overweight. Pediatrics. 2005;116(6):1329-1338.

Rudra C, Williams M, Lee I, et al. Perceived Exertion in Physical Activity and Risk of Gestational Diabetes Mellitus. Epidemiology. 2006;17(1):31-37.

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Mother’s Attitude May Affect Teenager’s Dieting Habits

Teenagers whose mothers value thinness tend to be frequent dieters and think frequently about being slimmer, according to recent research.

In a study partially funded by the National Institutes of Health, investigators assessed the weight concerns and dieting habits of 9,200 teenagers and their mothers. Among other things, teenagers were asked for their thoughts on their mothers’ attitudes toward weight, and mothers were asked how important it was that their son or daughter be thin or “not be fat.”

Results showed that substantially more girls than boys thought about wanting to be thinner (33 percent versus 8.1 percent). Girls who thought their mothers valued thinness were more likely to think frequently about losing weight, as did boys who accurately perceived that it was important to their mothers that they “not be fat.” These girls and boys were more likely to be frequent dieters than teenagers whose mothers didn’t think weight status was important.

Despite these findings, researchers noted that the perceived importance of thinness to peers were stronger determinants of girls’ dieting and thoughts about wanting to be thin. Also, boys and girls who wanted to look like same-sex figures in the media were even more likely to diet and want to be thinner than those whose mothers or peers valued thinness.

In another study on adolescents, researchers examined the effect of calcium supplementation on body weight and body fat in young girls. Using a food frequency questionnaire given at recruitment, baseline, and after 1 year, investigators estimated the daily calcium intake of 110 12-year-old girls. Participants were divided into a median-calcium group, consuming up to 1,304 mg of calcium per day, and a low-calcium group, consuming less than 713 mg. Girls from both groups were randomly assigned to receive 500 mg per day of a calcium supplement or placebo tablets for a year.

Results showed that although girls who normally consume a significant amount of calcium-rich foods tend to have less body fat than their peers, those who take calcium supplements do not necessarily lose fat or weight. The researchers speculated that the effect of calcium on body weight may only be exerted if it is ingested as part of a meal, or that the effect could be due to other ingredients in dairy products.

Article Information
Field A, Austin S, Striegel-Moore R, et al. Weight Concerns and Weight Control Behaviors of Adolescents and Their Mothers. Archives of Pediatrics & Adolescent Medicine. 2005;159:1121-1126.

Lorenzen J, Molgaard C, Michaelsen K, Astrup A. Calcium Supplementation for 1 Y Does Not Reduce Body Weight or Fat Mass in Young Girls. American Journal of Clinical Nutrition. 2006;83:18-23.

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NIH News

Lecture Addresses the Dangers of Physical Inactivity

During a recent lecture at the National Institutes of Health (NIH), health experts reviewed strategies for dealing with the growing problem of physical inactivity.

Guest lecturer Steven N. Blair, P.E.D., president and CEO of the Cooper Institute, described the country’s sedentary tendencies as the “biggest public health problem of the 21st century” and cited recent research to prove his point.

Nearly 50 million Americans lead sedentary lifestyles, according to Dr. Blair, which places them at higher risk for various health conditions. One study showed that moderately fit men may live 6 years longer than unfit men, while highly fit men could live 3 years longer than their moderately fit counterparts. The 9-year difference in average longevity between unfit and extremely fit men emphasizes the magnitude of this public health problem, Dr. Blair said.

This lecture was part of the 2006 Robert S. Gordon, Jr. Award Lecture in epidemiology, an honor bestowed annually on scientists who have contributed significantly to research in the field of epidemiology or clinical trials. The lectureship is awarded by the NIH on the advice of the Office of Disease Prevention, Office of the Director, and the recommendation of the Epidemiology and Clinical Trials Interest Group’s advisory committee of epidemiologists.

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NIDDK Director Becomes Dean of Albert Einstein College of Medicine

Allen M. Spiegel, M.D., former director of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), has been named dean of the Albert Einstein College of Medicine of the Yeshiva University, effective June 1. He stepped down from his role at the NIDDK on March 3.

National Institutes of Health (NIH) Director Elias Zerhouni appointed Griffin P. Rodgers, M.D., as NIDDK’s acting director. Dr. Rodgers has been the deputy director of NIDDK since 2001, while also serving as chief of the Institute’s molecular and clinical hematology branch. He has worked at the NIH since 1982 and brings scientific expertise and administrative experience to his new role.

For more NIDDK news, please visit www.niddk.nih.gov/welcome/releases.htm.

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DHHS News

DHHS Releases Health Education Toolkit

The U.S. Department of Health and Human Services Office on Women’s Health will soon release a new health education toolkit to the public. Titled BodyWorks, this new health information resource is designed to help the parents and caregivers of young adolescent girls (ages 9 to 13) improve family eating and physical activity habits.

The toolkit is part of a program that focuses on parents as role models and provides them with hands-on tools to create positive behavior changes. It was developed after a 2-year formative research phase that included a literature review, 16 focus groups, and telephone interviews with health care providers. Toolkit components include publications for parents and teens, food and fitness journals, a video on shopping and cooking strategies, a recipe book, and other planning tools. These resources will be distributed through community-based organizations, State health agencies, nonprofit organizations, social service organizations, and health clinics and hospitals. Trained facilitators from these organizations will distribute kits to parents and hold support meetings.

Organizations interested in being part of the BodyWorks program should email bodyworks@hagersharp.com for more information. Nonprofit organizations and corporations interested in reprinting and distributing BodyWorks toolkits should contact Jonelle Rowe, M.D., M.A., at (202) 205-2373 or jrowe@osophs.dhhs.gov.

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Program Notes

WIN Reaches Out to the Media

Since the last WIN Notes issue, the Weight-control Information Network (WIN) has embarked on several media outreach projects.

This past winter, WIN sent public service announcements (PSAs) about healthy eating during the holiday season to more than 150 urban and adult contemporary radio stations. The PSAs aired in places ranging from the stretches of Colorado to the shores of New Jersey, and resulted in many radio stations providing listeners with WIN publications at special events. WIN also produced similar radio scripts in English and Spanish for XM Satellite Radio. The scripts were part of the National Institutes of Health’s “Spanish Language Initiative,” which aims to raise awareness of various health conditions affecting the Hispanic population, including overweight and obesity.

Around the same time, WIN wrote and placed an article addressing childhood overweight in the December/January issue of Urban Influence magazine. Urban Influence is a National Urban League (NUL) publication, and targets emerging African-American leaders with messages of community empowerment and social change. Distributed bimonthly, Urban Influence also provides information about the work of NUL and its affiliates.

Other recent WIN outreach activities included emails to targeted media outlets containing information about WIN and its publications. Members of the media wishing to know more about WIN and its services should call 1-877-946-4627 or email WIN@info.niddk.nih.gov.

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WIN Travels the Country

WIN will be exhibiting at the following conferences this year:

Bronner Brothers Hair Show
August 5-7
Atlanta, GA
American Association of Diabetes Educators Annual Meeting
August 9-12
Los Angeles, CA
American Dietetic Association Conference
September 16-19
Honolulu, HI
American Academy of Family Physicians
September 27-October 1
Washington, DC

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Cyber Notes

New Materials Added to MyPyramid for Kids Website

As reported in the last issue of WIN Notes, the U.S. Department of Agriculture unveiled a child-friendly version of MyPyramid on September 28, 2005. Named “MyPyramid for Kids,” this complementary food guidance system provides age-appropriate information about the 2005 Dietary Guidelines for Americans and MyPyramid.

Since then, new materials have been added to the MyPyramid for Kids website. One example is the site’s classroom materials, developed at the elementary school level to help child care providers and school teachers introduce children to the food guidance system. Downloadable lesson plans can be found at www.teamnutrition.usda.gov/resources/mypyramidclassroom.html.

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Resource Notes

Materials From NIH/NIDDK

Updated WIN Publications

WIN has updated the following fact sheets to incorporate the latest research and development in the field:
Choosing a Safe and Successful Weight-loss Program
Dieting and Gallstones
Understanding Adult Obesity
Weight Cycling
Very Low-calorie Diets

These updates will not be printed. To obtain reproducible master copies contact WIN at 1-877-946-4627 or WIN@info.niddk.nih.gov. You can also download PDF copies at www.win.niddk.nih.gov.

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Materials From Other Organizations

If Your Child Is Overweight:
A Guide for Parents

Published by the American Dietetic Association (ADA), this publication provides guidance for parents of children ages 4 to 12. It addresses the importance of physical activity and good nutrition, and includes sample menus for each age group that reflect culturally diverse food practices.

This publication is available online at www.eatright.org.

The ADA-member price is $10 plus shipping and handling; nonmembers pay $13 plus shipping and handling.

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Editor’s Notes

Please send questions or comments, including information you would like to see included in future issues of WIN Notes, to:

Editor
Weight-control Information Network
1 WIN Way
Bethesda, MD 20892-3665
Telephone: (202) 828-1025
Toll-free: 1-877-946-4627
Fax: (202) 828-1028
Email: WIN@info.niddk.nih.gov

WIN publications are not under copyright restrictions. Readers may make unlimited copies. To view WIN publications, visit our website at www.win.niddk.nih.gov.

WIN Offers Public Information
The Weight-control Information Network (WIN) is a national information service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH), which is the Federal Government’s lead agency responsible for biomedical research on nutrition and obesity. Authorized by Congress (Public Law 103-43), WIN provides the general public, health professionals, the media, and Congress with up-to-date, science-based health information on weight control, obesity, physical activity, and related nutritional issues.