It has started raining again and it has become a little cooler however, a month off going to the gym or breaking your healthy diet to comfort binge will affect your body and produce long lasting results. Dr Torbjorn Lindstrom from the faculty of health sciences at the University of Linkoping, and his team of Swedish researchers discovered that shorter periods of overeating will have longer term effects.

The current issue of Nutrition and Metabolism details their research methods. They took 18 individuals of the same age and all of a normal weight including 12 men and six women. All were placed on a minimum daily exercise routine which did not allow them to take more than 5,000 steps per day. To put this into perspective, generally people who are concerned about their fitness aim to take 10,000 steps per day. The average person wearing a pedometer while going about their daily activities may note that they are walking on average 4,000 and 6,000 steps per day not including sport. You can double this number by doing approximately half an hour to forty minutes of walking outside your daily routine.

The participants also had to increase their daily intake of calories by 70%, bringing their consumption to 5750 calories per day. In order to consume this number of calories, one would have to eat something like 8 meals per day at approximately 700 calories per meal. These individuals put on 14 pounds in one month. Another group of the same age and of normal weights did not change their diet or physical activity.

After 6 months, the group that increased their calorific intake lost 10 pounds on average but after one year they noticed that they still had a 3 pound gain of fat mass. This weight remained despite returning to their low calorie diets and physically active lifestyles.

Two and a half years later, the gain in fat mass on the same individuals was even greater. The average gain was approximately 7 pounds. This was not the case for those who had kept their original dietary habits. They remained the same weight.

The results show that a brief period of binge eating and cutting out recommended levels of physical activity simultaneously, can actually change the composition of the body and make it more difficult to get rid of the weight gained.

Virginia Tech researchers have discovered a safe and successful way of losing extra pounds while maintaining a low calorie diet. They suggest that drinking an 8 ounce glasses of water before each meal will cause fewer calories to be consumed.

The study was carried out for 12 weeks on two groups of overweight people whose ages ranged between 55 and 75 years. One group did not drink water prior to their meals but were also on a low calorie diet. At the end of the 12 weeks, the group not drinking water succeeded in losing 11 pounds whereas the water drinking group lost 15.5 pounds by the end. Unfortunately, the same method of weight loss cannot be used for those aged between 18 and 35 as within this age group water is not so easily retained and goes straight through the stomach.

The researchers had thought that by drinking the 2 glasses of water before the meal, the participants would compensate for the reduced calorie intake at another stage during the day but this was not the case. One year later, it also proved to be a successful way of keeping the weight off over a period of time. These dieters kept on losing weight.

Barry Popkin of the University of North Carolina Nutrition Obesity Research Centre, pleased with the results, whose past research has shown that those who drink more water drink and less sugary/ calorific drinks and eat more fruits and vegetables thus have an overall lower calorie consumption than those who do not drink as much water. Americans drink a staggering 300 calories more per day drinking sugary drinks than they did 30 years ago. They are one of the worst perpetuators in the junk calorie consumption league table but we Brits are not far behind.

More obesity news and this time it is not about suppressing our hunger with medical treatments but actually about what we feed ourselves that may be the answer to beating obesity. Researchers are investigating the effects of certain types of fibre found in particular vegetables and how they help suppress hunger.

Most will be happy to hear that the fibres in question are found in asparagus, artichoke, garlic and chicory – so nothing too vile-tasting! These fermentable carbohydrates in these vegetables activate hormones in the gut which suppress appetite. Due to their ability to produce additional sensitivity to insulin, the fermentable carbohydrates have a positive effect on glucose levels. Finding out more about how these foods affect our bodies may help us to prevent the onset of Type 2 diabetes according to Nicola Guess of Imperial College. The carbohydrates will be given to the participants of the study in the form of a daily supplement.

Dr. Iain Frame of Diabetes UK, states that although it is unlikely that any one preventative measure will be successful, the research being carried out at Imperial College is important and that they may result in innovative ways of preventing Type 2 diabetes.

The scientists of The Institute of Food research have made progress concerning the breakdown of certain fats and satiety. They believe to have found a synergy to break down fat thus allowing paving the way for the possibility of finding ways to slow down the process by which we digest fat and even to create food structures that will make us feel full. Dr Peter Wilde from The Institute of Food Research explains that most of the fat found in processed food is presented in the form of emulsions like ice creams, mayonnaise and yoghurts. Using the knowledge we have of our bodies and how they break down these fats, future research can help us discover how to make fats which break down at a slower rate.

By slowing the digestion of fats, the fatty acids then reach the ileum where they can stimulate hormones that induce satiety. Scientists at The Institute of Food Research are experimenting with the use of protein layers to stabilise the emulsions. The results showed that a normally stable whey protein gets broken down only partially whereas when a surfactant is introduced to the emulsion, the protein layer is broken down more substantially, opening the way for enzymes to break down the fat.

The Institute of Food Research is the only institution carrying out studies on the digestion of emulsions and how they may induce satiety.

Researchers from the University of Cincinnati, in a study they carried out earlier this month, have found that the best way to motivate obese individuals is to emphasise the immediate benefits they will enjoy from exercise and eating right rather than warning them about the more long term effects they are leaving themselves open to by not changing their diets and amending their lifestyle choices.

One of the greatest sources of pain for those who suffer from obesity is the immense strain of weight on the musculoskeletol system. According to Susan Kotowski, study collaborator, increasing the level of focus on the pain reduction benefits associated with exercise and a change in diet, the more motivated sufferers become.

The researchers found that of those involved in the local weight loss programme, 21% felt a considerable relief from pain in the back and lower part of the body after losing ten pounds. Furthermore, the results showed that even the smallest amount of could benefit those who experience great pain daily. The researchers believe that this will influence an entirely different approach to weight loss programs.

So, what is the best way to approach diet and exercise? The media is full of different potions and lotions but how do we pick which one is best for us? Doing a little bit every day and making small changes is the best approach and fad diets do not keep the weight off.

It is said that we should be pumping money into the preservation of ‘wellness’ as well as obesity. An estimated £3 billion is spent by the NHS each year on obesity. By funding anti-obesity campaigns and programs, we are not getting rid of the problem, we are maintaining it. According to Dr. Weiler of Imperial College Healthcare Trust, London, only 1 in 20 people are exercising the recommended daily amount and yet most of the money goes into helping those who already have a weight problem.

A recent survey revealed that one in five children do not receive any encouragement from their parents to join in with after school sports or other physical activities outside of the mandatory physical education classes. But so many factors affect this type of behaviour like psychological factors relating to the parents’ own level of activity, physical situations- such as distance from after school activities, attitudes, socioeconomic status…. the list goes on. This is why campaigns which seek to teach healthy youngsters on a large scale are making giant steps in the eventual combat of obesity.

Vegetarians have reason to feel smug today, after a new study was published showing that eating less meat could be the key to losing weight.

The study, of almost 400,000 adults living in Europe, linked weight gain to eating meat, though the participants were all consuming the same amount of calories. This was particularly noticeable when the participants consumed processed meats such as hams and sausages.

Participants came from 10 different European countries, including the UK. They were weighed and measured at the start of the 5-year study and then filled in a detailed questionnaire on their food habits. They then reported their weight at the end of the study.

Overall, even when calorie intake, physical activity and other factors for weight were taken into account, meat still seemed strongly associated with weight gain. The researchers say that those eating an extra 250g of meat a day, or a small steak, gained an extra 5lb over the course of the study.

The leader of the study, Dr Anne-Claire Vergnaud, said that she would recommend people to ‘control their consumption of meat’ in order to stay a healthy weight, though she did also warn that cutting out meat alone would not on its own be an adequate weight-loss program.

The study seems to debunk the popular Atkins diet, which recommends eating a meat-heavy diet but cutting out carbohydrates.

The scientists have theorised that as meat is high in energy, it alters how the body regulates appetite control, causing the extra weight gain.

The Medical Research Council has said that making the diet club Weight Watchers available on the NHS could be an effective and cheap way of tackling obesity in Britain.

In trials, the program was shown to have a greater impact on changing people’s eating habits than the normal advice and care a GP would provide. 2/3s of Primary Health Care Trusts already offer a 12-week Weight Watchers course to patients, which normally would cost £5 a week.

While the research was paid for by Weight Watchers it was conducted by the MRC and included an assessment of 30,000 people who were  sent on the 12-week course and a trial comparing Weight Watchers with GP-lead services.

Those who took part in the weight loss program lost on average 2.8 kg. In the trial, involving 800 people, after a year those on the program lost on average 7kg, compared with 3.9kg for those who did not. The program participants were also more likely to continue with their diet.

Weight Watchers is thought to be such a success because the companionship and group mentality of it gives dieters extra support and motivation to continue with their diet, as well as encouraging them even if they fall off the wagon occasionally.

The leader of the study, Dr Susan Jebb, said the results were very encouraging. She pointed out that if current obesity trends continue, by 2020 we could be footing an annual bill of £46 billion to deal with the condition, making the program a relatively cost-effective solution.

We have just heard that Novo Nordisk is to reinitiate Phase III clinical trials for Liraglutide as an anti-obesity drug. Liraglutide is already licensed as a treatment for diabetes and has shown great promise as an anti-obesity agent.  A trial in 2009 appeared to demonstrate efficacy and safety. A wider trial of 5000 people is to begin in 2011. The company behind the new drug wanted to wait until they had a marketing authorization for the drug as a treatment for diabetes in the US before it pursued further obesity trials.

Liraglutide is marketed under the name Victoza and is a glugogonlike peptide (GLP-1). Liraglutide appears to be highly effective as a weight loss drug but one likely drawback is that it cannot be taken in tablet or capsule form – it must be injected subcutaneously. This could lead to patient compliance issues but studies are afoot to determine whether the administration regimen can be reduced to once a week.

The study into Liraglutide as a weight loss medication is an exciting development but do not expect it to be licensed before 2013.

A test scheme has shown that dieters who are paid to lose weight are far more likely to succeed than those who are not.

The scheme is called Weight Wins and so far has paid dieters tens of thousands of pounds in a bid to tackle obesity. Dieters sign up for a pound-for-pound scheme, where they get paid for every pound they lose and then are given a cash bonus after a certain number of months if they manage to keep the weight off.

The scheme is supported by the NHS, which means that dieters have access to NHS dieticians and are given help choosing how they want to lose weight.

Those taking part see their rewards vary depending on how long their weight-loss plan is. Monies received ranged from £80 to £3,000. When the program was audited by the independent University of Hertfordshire, it was discovered that the 745 people taking part in the scheme lost 1 stone on average, compared with the 5lb 4 oz lost by those following traditional diet methods without monetary compensation.

45% of patients lost 5% or more of their body weight – the benchmark regulators use to judge whether a scheme or medication is effective – and 1 participant lost 8 stone.

However, a spokesperson for the NHS Eastern and Coastal Kent said that ¾ of participants dropped out of the scheme before it was completed. 

The scheme may seem fairly repellent, but it is likely that if participants do keep the weight off, the taxpayer would actually be better off. The cost of treating obesity-related illnesses is huge and it has been suggested that within 20 years obesity could cripple the NHS.

The Department of Health strategy for tackling obesity has already suggested that financial incentives to lose weight could be introduced. America has already brought in similar schemes and many U.S businesses are giving staff bonuses if they manage to lose weight.

In a statement, a DoH spokesperson said that any nationwide scheme to pay people to lose weight would only be introduced with ‘sound evidence’ to back it up.

Health experts have warned that British women have dangerous diets, with teenagers relying on faddy food plans and pensioners not getting the necessary nutrients.

Scientists reviewed 110 different sets of research into how British women eat and discovered that women in the prime of life are routinely not getting the right nutrition. Girls of school age are also very likely to be missing out on crucial vitamins, with over half of girls aged between 11-18 not getting the recommended intake of minerals.

30% of teenage girls are not getting enough potassium, 16% are lacking iodine and nearly 50% are not getting enough iron.

In older women, zinc deficiency and a lack of vitamin D was a particular problem. Pregnant women need vitamin D to strengthen their unborn child’s bones and ensure that they are not born underweight.

Even as women approach retirement, their diets do not improve. As women get older, they need more vitamin D to prevent brittle bones but the collective research seems to suggest that only a third of women over 65 are getting their recommended daily allowance.

The team behind the review are from the Manchester Metropolitan University and began the study after being commissioned by the Health Supplements Information Service, a independent body.

They concluded that women need to make better food choices to ensure that they are taking in their daily recommended vitamins and suggested that those not following sensible diet plans should round out their diet with daily multivitamins.

There may be a link between weight gain in middle age and dementia, according to scientists from the Boston School of Medicine.

They believe that a paunch in middle age can make otherwise healthy people more likely to develop the condition, which the World Health Organisation estimate is affecting 24.3 people worldwide. They think that there is a link between excess weight and lower total brain volume.

The team studied over 700 volunteers, whose average age was 60. They compared their BMI, waist-to-hip ratio and waist circumference with measures of their brain volume and brain density, amongst other measurements.

The Alzheimer’s Society has said that they are not overly surprised by the research, as it is already known that dementia is related to high blood pressure, cholesterol and diabetes. All three conditions are themselves associated with having a middle-aged spread.

The results are published in the journal, Annals of Neurology.

They have called for more work to be done to be done to investigate the link between obesity and dementia, and further said that research into dementia is ‘drastically underfunded’. In a press release, they called for sufficient research to ‘make the advances necessary’.

Tragic news for the legions of women who have been squeezing themselves into the corset-like anti-cellulite pants which have become so popular – they don’t work.

Nicknamed ‘magic pants’ they promised to help women look thinner, with no extra exercise. Packaging claims that the pants, stocked by M and S, “smooths, slims and shapes’. The company saw customers flock to buy them and sell three times as many as regular pants. John Lewis and Debenhams also stock versions of the knickers.

Which? magazine however say that women are being misled by the packaging. They consulted two plastic surgeons and a dermatologist to see whether the pants, with their special ingredients of aloe vera and caffeine embedded in the fabric, could actually banish cellulite as promised.

They concluded that it was doubtful that the knickers were actually effective and said that any underwear as tight as them would in any case smooth skin. They also questioned whether the magic ingredients were present in sufficient qualities to have any effect.

A spokesperson for Marks and Spencer pointed out that the packaging did not claim to get rid of the cellulite itself, but rather diminish its appearance. She added that the ingredients are widely used in anti-cellulite creams.

If anyone saw the ravaging hoards of women buying up the pants when they were first released, there is no doubt that this will be a huge blow to women eager to look slimmer. Personally, the horror of trying to cram myself into them only to see something in the mirror strongly resembling an over-stuffed sausage skin will live with me for a very long time. I’d take cellulite and giant granny pants over revisiting that particular trauma anytime.

Three health charities have launched a new campaign to raise awareness of the dangers of the ‘spare tyre’, or the area of fat around the waist.

A survey of 2,085 people showed that 97% of people were unaware that there is a link between an over-large waistline and heart disease, although nearly three quarters of those surveyed said they had noticed their own waistlines expanding.

The survey also showed that people generally overestimated the point at which an expanding waistline becomes a risk to health. For women, measurements over over 31.5 inches are a cause for concern, while for men this is 37 inches.

Though a series of studies have been done showing that waist size can be a key indicator of someone’s risk factor for developing a host of diseases, including cancer and diabetes, it is clear that the message has not yet filtered through to the wider public.

Diabetes UK, the British Heart Foundation and Cancer Research are now working together to try to change this. They are hoping to persuade food manufacturers to label food as standard with the ‘traffic light’ labelling system.

They have also launched a series of viral adverts, featuring a rather unpleasant character called ‘Fat’ who apparently enjoys messing with the lives of the overweight (the little evil eyes are particularly disturbing and seems to be modelled on Ross Kemp). Anyone needing a little extra motivation with their diet can see it here

Scientists have discovered that short bursts of exercise are better for our health and weight that long periods of intensive training.

Researchers say that they hope their study will ‘blow away’ the belief that people need to spend long periods of time exercising to stay in shape and shed the pounds.

The results come from a study into ‘high intensity interval training’, done at the McMaster University in Ontario, Canda. Participants were asked to run or cycle at maximum effort for a minute and then rest for a minute, repeating the routine about 10 times.

Volunteers cycled for 60 seconds as fast as possible to reach maximum heart rate. After the exercise, tests showed that their muscles had improved as much as if they had been performing endurance training.  To achieve the same results through endurance training participants would have needed to do 10 hours of moderate-intensity cycling over two weeks.

Professor Martin Gibala, whose findings have been published in the Journal of Physiology, said that it was possible for those trying to stay healthy to achieve more by doing less.

He said it was not clear why high intensity interval training was so productive but said that it seemed to stimuli many of the ‘same cellular pathways’ as other more traditional exercise regimes.

Those trying to lose weight are generally told to avoid alcohol, due to its high calorie content. However scientists from the Brigham and Women’s Hospital in Boston in the U.S have claimed that women who drink moderate amounts of wine are less likely to gain weight than those who stick to mineral water.

Studying data provided by over 19,000 women the scientists discovered over 13 years, all the women tended to gain weight but the 37% of respondents who said they never drank tended to gain the most weight.

The women’s weight also went up or down according to which alcohol they preferred, with those drinking red wine gaining the most weight and those choosing beer and spirits putting on the most.

The results from the study suggest that calories from alcohol are less detrimental to weight than those in other foods. It also could mean that our body’s mechanism for digesting alcohol is more complex than scientists previously realised.

Some researchers have posited the theory that people who regularly drink alcohol will see their liver’s develop a separate pathway to break down alcohol, turning excess energy into heat rather than fat.

The report has been published in the Archives of Internal Medicine. To celebrate its publication, I will be opening a bottle of Merlot, safe in the knowledge that with every slug I’m getting thinner.

An American man who for 30 years sold diet pills he promised would lead to effortless weight loss has been sentenced to 20 years in prison.

During his career, Frank Sarcona was served with orders from numerous judges across America but continued to pay for lurid adverts in newspapers and magazines claiming the pills would make fat just disappear.

Copy included promised like, “Blast up to 49 pounds off you in only 29 days!” and “Amazing Fat-Fighting Super Pill Devours Fat!” and while thousands desperate to lose weight believed the fabulous claims, they were based on nothing but lies.

Sentencing Sarcona, U.S District Judge said that the number of people taken in by the fraud was ‘astronomical’. District Attorney Kerry Baron described how Sarcona and his partner made over $10,000,000 from 130,000 people between 2000 and 2004. Some people were promised they would be part of a clinical study, while his adverts for the Lipoban Clinic featured a Mexican doctor unliscensed in the U.S.

Mr. Sarcona claims that despite his 62 charges of fraud and the lengthy jail term, he is the victim of the government, who do not share his belief in diet pills, describing himself as a ‘champion’ for dietary supplements.

Investigators previously convicted him for a massive fraud involving pills called ‘Slim America’, where the doctor touted as his spokesperson was actually revealed to be suffering from dementia in a nursing home.

Then, Sarcona was ordered to post a $5m bond, but it was never done. However eventually the millions he made was discovered in a Bahaman bank account and the money was returned to consumers.

We at the Online Clinic think the significant jail term is an excellent step towards cracking down on the criminals who raise hopes and create false beliefs in obese patients when they promise ‘magic’ solutions. No diet pill can melt fat away and with any slimming pill, diet and exercise will always be needed for the pill to work.

This week we have posted a number of news stories on The Online Clinic blog which may have raised a few eyebrows: fast food outlets being opening in the same NHS hospitals that are dealing with the obesity epidemic and the fact that a patient’s access to a weight loss operation may well depend more on his or her postcode than the level of need.

A story reported in the Daily Mail newspaper may, however, be the most surprising yet. It says that GPs are telling obese patients to eat more to increase their body mass index so that they become entitled to weight loss surgery. Any patient who has a BMI of 40 or over (that is around double what it should be) has the right to surgical assessment if their doctor feels that all other methods of treatment, diet and drugs, have failed.

The Royal College of Surgeons have said, however, that some primary health care trusts will only refer a patient for surgery if their BMI is over 50 and that some patients are being told to eat more in order to be referred: the it will get worse before it gets better scenario. The spokesman for the Royal College, Mr Simon Toh, said that surgery is a cheaper option than long-term care for obese patients, which at the moment costs the NHS £7.2 billion a year.

To be honest, we do not believe this story in the Daily Mail but if you have personal experience of such advice from a GP, please feel free to add a comment to this article.

As January came around, many people’s thoughts turned with vim and determination to sales shopping. Off half the nation trotted, sharp elbows out, to battle their way through the department stores to get that discounted magimix or the perfect pair of boots.

Whether or not you managed to find the perfect buy or came home with a top three sizes too small you’re planning on ‘dieting into’, just the act of shopping could be good for your health. It has been worked out that walking between shops and lifting heavy shopping bags is like doing a workout, burning 385 calories a week for the average British woman.

The figures come from Debenhams, who tested 10 shoppers, half of whom were women and half who were men, and then carried out a further survey of 2,000 shoppers. They discovered that women browsing the shops cover an average of nearly 3 miles during a standard 2.5 hour shopping session.

Men however are less determined when they shop, spending just 50 minutes in the stores and covering only 1.5 miles.

The NHS recommends that people should take 10,000 steps everyday and a vigorous buying session comes close to meeting this target, with women taking an average of 7,300 steps per trip. The large number of steps is explained in the results of the shopper questionaire, where nearly half of the women who took part said that they ‘shop till they drop’, not stopping for a rest until they have found that they are looking for.

Debenhams said that the survey shows that not only that Britons ‘love to shop’ but that the health benefits mean that exercise and weight loss are easily achievable through everyday activities. Admittedly the statement is slightly flawed as unless you are a millionaire with no job, a 2.5 hour shopping session is not exactly an ‘everyday’ (or even ‘every week’) activity, but it’s still nice to know that searching for the perfect outfit is making you healthier!

A leading obesity charity has issued a warning against fad diets, saying that they are ‘unsustainable’ and can lead to dangerous weight regain around the internal organs.

The National Obesity Forum said that quick-fix diets can actually cause more harm than good, putting people at risk of developing visceral fat,hidden fat that develops around the abdominal organs.

When present excessively, it can put people at greater risk of developing heart disease and other conditions, such as type 2 diabetes. In a survey commissioned by the pharmaceutical firm GlaxoSmithKline, of the 2,000 adults questioned in Britain 90% did not know what visceral fat was.

The survey was part of a Europe-wide poll, which showed that across Europe people were not aware they needed to watch out for fat around their waist, an early indicator of visceral fat.

The survey also showed that 64% of people were determined to lose weight in the new year, but 86% if those who had previously resolved to do so failed. However, there was good news when 2 of out of 3 people said that learning more about the associated dangers of viseceral fat had motivated them to shed the pounds.

One of the authors of the report, Professor David Haslam of the National Obesity Forum, advised that steady and sustainable weight loss was the key to reducing the risks. He said that crash diets ‘can do more harm than good’, while his co-author Dr. Terry Maguire from Queens University Belfast said that overweight people needed to understand the health benefits as well as the cosmetic impact of weight loss.

How’s this for a diet that is guaranteed to work – become a minor celebrity, try to revive your career by going to the jungle for a couple of weeks, subsist on a diet of kangaroo anuses (anusi?) and bugs and lose pounds.

Yes, those tragic has-beens on I’m a Celebrity, Get Me Out of Here have reported that they are losing weight extremely quickly thanks to the measly rations they’ve been receiving. On average each of the –erm – stars has lost an average of 19 lbs, or over a stone, in 18 days.

Snooker player Jimmy White has been the biggest loser, going from 15st 10lb to 14st 2lb during his time in the camp. He has vowed to keep the weight off, while interior designer Justin Ryan has dropped 1st 7lb. He squeaked, “Oh my God, have you any idea how much I’ve spent on milkshake drinks!”. Mazel tov to both of them. Solidly-built Kim Woodburn, whose claim to fame is that she really likes cleaning and talking about poo (maybe my mum has a glittering career ahead of her), lost the same amount.

Sadly however the minimal calories are playing havoc with the contestant’s sanity. After they won a cream tea for answering a ‘celebrity chest question’ they were distraught to discover they were meant to share THREE SCONES BETWEEN FIVE OF THEM. . Good god, the injustice. Their distress was so great a mutiny was threatened. Chef Gino D’Acampo impassionedly declaimed, “ I want my five scones with jam and cream and I want tea. If I don’t get that I will convince everybody to take the mike off...and you know I have the power to do that.’ Powerful rhetoric there, unknown TV chef person.

So, if the diet sounds appealing, we have some suggestions as to how you can get into the jungle in time for the next series. Clean a lot and talk about cleaning a lot. Get some enormous boob implants and flash them at people in sleazy clubs. Chase the money in your twilight years, when by rights you should be watching Antiques Road Show with a nice gin and tonic. Get hair extensions. Fake tan. Hook up with a footballer and then trash him in the papers. Um....

Well, before we all go off to fulfil our dreams of global fame, in breaking news – the terrible injustice was rectified and they all got a scone. Phew, I was really worried for them.

Sudoku lovers rejoice – apparently an hour’s worth or mental exercises can burn up to 90 calories. Mental health expert Tim Forrester, from the brain exercise website cannyminds.com, claims that giving the brain a workout burns calories in the same way that a physical exercise session does.

He said that our brains require 0.1 calories every minute just to function, so when they are being challenged we burn 1.5 calories a minute.  The brain requires chemicals called neurotransmitters to relay signals to neurons that communicate with each other, sending messages to the body. The neurons extract glucose sugar to send their messages, so when they are working particularly hard more calories are used up.

According to Mr. Forrester’s calculations, a nice hour spent puzzling over the crossword could therefore burn off 1 ½ chocolate chip cookies, with each providing 56 calories, or a jammy dodger, at 86 calories. Which perhaps doesn’t give much license for a huge blow-out, but crosswords are definitely more fun with a nice cup of tea and a custard cream to help the cogitations.

Sadly the calories involved are so small that the news is unlikely to rock the dieting world, and it seems unlikely that weight-loss gurus are going to be advocating the ‘suduku diet’ any time soon. Those serious about losing weight are still much better off spending an hour going for a run, but still – its a nice fact to keep in mind next time you’re doing the cryptic crossword

The president of the British Society of Gastroenterology has said that followers of fad diets are developing a ‘quasi-religious’ attitude towards the right foods to eat, despite their being little to no scientific evidence that they are beneficial.

Speaking at the Gastro 2009 conference, Professor Chris Hawkey drew attention to over a dozen diets that have hit the headlines, such as the alkaline diet, which advocates eating certain foods to maintain the slightly alkaline nature of the blood, rawism, which believes that eating uncooked food is more nutritious, and the ‘chewing diet’, which claims that chewing each mouthful 32 times aids digestion.

He warned especially that the grapefruit diet, beloved by celebrities like Kylie Minogue, in all likelihood didn’t work as the enzyme in the fruit that has been proven to aid weightloss would probably be broken down in the gut before it had time to break down body fat.

He said that since the start of time, food has been ‘shrouded in myths and fairy tales’ but warned that despite the different diets which were gaining popularity, the country was still losing its battle against the obesity epidemic.

He added that the obesity problem was not a result of the kinds of food being eaten but the quantities they were being consumed in. He recommended that ‘quirky’ diets be abandoned in favour of increased exercise and sensible eating to prevent long-term conditions.

The Online Clinic is prepared to help those for whom normal dieting and exercising has not assisted with a noticable weight loss. We can presribe medication but only after a sensible weight loss plan has not worked.

Confusing news for dieters this week, after the recommended daily calorie intake was increased by up to 16%. The Scientific Advisory Committee on Nutrition announced in a report that they believe the current calorie count given to guide people on healthy diets was too low and have suggested it should be bumped up by about 400 calories, the equivalent to a cheeseburger or two packs of crisps.

The report was leaked to The Times newspaper and The Grocer magazine.

Previously it was recommended that women eat 2,000 calories a day and men 2,500 but in their draft report, the SACN said that nutrition experts had underestimated the levels of physical activity in Britain and therefore misjudged their advice on energy intake. The existing guidelines were created in 1991.

The report is not yet official and is due to go through a 14-week consultation period before any final recommendations are made. If it is given the go-ahead, some foods which are marked as red or orange under the ‘traffic light’ system, meaning they take up a significant part of a person’s daily calorie intake, could be downgraded to receive a healthier rating.

However the report has been criticised, with the National Obesity Forum warning that it was a ‘dangerous assumption’ that adults could consume more calories each day. It is also thought that the Government and the Food Standards Agency will not be pleased, as it could be seen to send out a dangerous message when obesity levels are rising across Britain.

The criticism seems fair enough. There are so many mixed messages about dieting and weight loss coming from every quarter and lowering the calorie count will only serve to make the situation more confusing. With obesity being the burgeoning medical time bomb that it is, the last message that we should be giving out is that people should be eating more.  It may well be that physical activity is higher than originally estimated but we are not overweight as a nation because people are eating too little. This is quite a ridiculous proposal and should be dismissed out of hand given what we know about the nation's eating habits as a whole!

More news on the potential of tomatoes to help dieters cut calories, which we have already covered in previous blogs. Now scientists from the University of Reading have produced research confirming their new status as a superfood for slimmers.

The researchers gave 17 women of normal weight a variety of sandwiches, either filled with cream cheese or name with bread enriched with carrot or tomato. The women were then asked to record how full they felt afterwards.

They discovered that the tomato bread was the most filling, though they had expected the carrot bread to have the best results, as it contained additional fibre. The team admitted that it was a small study but believe the results were ‘statistically significant’. They did not feel able to say why the tomato was more filling.

However previous studies have shown that tomatoes are filling because they contain lycopene. This is the chemical that makes tomatoes red and is thought to be linked to the low rates of heart disease, dementia and diabetes amongst those who follow a Mediterranean diet.

Tomatoes contain compounds which make people feel more satisfied and therefore reduce the urge to snack.

The team are planning to do further research into the compounds contained by the fruit which alter appetite levels, including the hormone ghrelin, a lower level of which makes people feel fuller.

Look at any of the slew of adverts for perfume, make-up or clothes and the message coming across is very clear – thin equals sexy, erotic and desirable. However, good news has been announced for everyone packing a few extra pounds – bigger men and women are apparently better in bed.

The newspapers have been using this as a fantastic excuse to compare skinny and curvier celebrities, with the Mirror running the headline, “Kelly Brooke is better in bed than Cheryl Cole!” (conjuring up images of a staff writer desperately trying to kid himself his knowledge is based on personal experience rather than lustful conjecture).

In a study commissioned by bedmakers Silentnight, 89% of men said that they preferred curvier sexual partners to  thin women. Of those men, 56% of them said that they thought partners with curves were more considerate about pleasing them when in bed.

Furthermore, when the romping is over, you’re more likely to sleep better if your partner is curvy. During the two-year study, it was discovered that thin people toss and turn up to 10 times a night on average, whereas those who are heavier only turn over twice.

It is thought that this is due to thin people suffering more from their pressure points being triggered while they sleep, decreasing their circulation and forcing them to turn more often to relieve the pressure.

The company’s sleep scientist Iftikhar Mirza commented that curvy men and women ought to be ‘feeling pretty happy right now’ as not only were they considered good in bed but were also better to sleep next to.

Danish researchers believe that they have developed a new ‘diet injection’ which as well as being much more effective than current slimming pills on the market could also project against type II diabetes.

Patient were injected with liraglutide to combat diabetes but the results from the trials indicated that the drug makes patients twice as likely to lose weight as those who are taking orlistat, or Xenical.

Published in the journal the Lancet the results showed that the drug curbed hunger pangs as well as reducing risk factors for diabetes. However while  Xenical is in pill form, making it convenient to take, liraglutide needs to be injected daily as in pill form it would be broken down by the gut. It is also an expensive drug, costing £500 for six months of treatment.

In the trial, lead by a paid consultant of the pharmaceutical firm manufacturing the drug Professor Arne Astrup, three groups of patients in 19 hospitals were put on a diet which reduced their calorie content by 500 calories a day and told to exercise. One group were given orlistat, one group given liraglutide, and one group given a placebo.

Professor Astrup said that the drug mimics the action of a hormone found in the gut, GLP-1, which is released into the body after someone has eaten. It then tells the body to produce more insulin and acts as a satiety hormone, telling the brain to stop eating.

Over 20 weeks, over 3/4s of those given the injections lost more than 5% of their body weight, weight loss experienced by 44% of those taking orlistat and 30% of those taking the placebo.

Further tests are planned as the trial ran for a relatively short period, and the researchers need to establish the longer term ratio between risks and benefit. Health charity Weight Concern have said that while the development of good weight loss drugs is important, emphasis still needs to be on supporting people in changing their lifestyle and diet. Dr. George Bray from Louisana State University, who wrote the accompanying editorial in the Lancet,  said that it was not yet clear whether an injection would prove a “palatable” means of delivering weight loss medication but said he was optimistic that the potential of the new generation of weight loss medications would be fulfilled.

TV companies have long been under pressure from campaigners for allowing companies like Domino’s, Pizza Hut and Cadburys to sponsor their most popular programs, buying the time before and after every adbreak to promote their products to an often young and impressionable audience.

Now however one of the most popular programs for under-15s is to have an critic-proof sponsor – the government’s Change 4 Life campaign.  The government have decided to sponsor episodes of the satirical cartoon in an attempt to make children more aware of their message promoting healthy eating.

The cartoon features Homer Simpson, famous for his doughnut addiction and habit of chugging down can after can of beer. Officials apparently hope that families zoning out in front of the TV will see the Simpson family as a reflection of themselves and be pushed to take better care of their health.

They also approve of the way the animated family, despite their fairly dysfunctional ways, eat together round the kitchen table and support each other through their various tribulations (the episode when they get lost in the woods and nearly eaten by slavering wolves springs to mind there).

After the show was analysed, the health experts said that they thought skateboarding Simpson son Bart achieved the recommended 60 minutes of exercise a day, while his vegetarian sister Lisa probably consumed at least 5 fruits or vegetables a day.

The officials plan to use the slots to show a set of cartoon characters, created by the same company that made Wallace and Gromit, pretending to be the Simpson family. They will be sitting on the sofa eating pizza and junk food, which will ultimately disappear, to be replaced by fruit and vegetablesThe positive and negative aspects of the Simpson family have been acknowledged in the slogan for the £640,000 campaign, “Supporting the Simpsons: Sometimes.”

Many people who are dieting will often say that eating out can be their downfall. Restaurant menus with no calorie counts make choosing healthy dishes difficult, while the social aspect of a restaurant meal can often encourage people to ‘treat themselves’ and throw all their caution to the winds.

Now a new study has suggested that who we eat with can also have a big impact on the calorific impact of the food we choose. Apparently, eating out with fat friends is more likely to make people eat smaller portions, while slim friends with big appetites encourage dieters to copy their eating habits.

One of the authors of the report, a young woman weighing 8 stone, arranged meetings with 200 university students at a staged cinema screening. The students thought research was being done into their food tastes.

With each individual she opted for either a small or large snack and then offered her companion the same choice.

However, while meeting some of the students she donned  a fat suit that made her look 5 stone heavier. She discovered the students mimicked her food choices, which did not differ whether she was fat or thin, though the amount they ate did.

When dining with a fat person who ordered the larger snack, the companion was less likely to finish their meal. However when eating with a thin person the companion would finish the entire meal.

The research team have published their findings in the Journal of Consumer Research and say that there is clear evidence that our eating choices are affected by whether our eating companions are fat or thin.

Following on from the Weight Watchers survey into fat blindness, another slimming club, Slimming World, has published a survey indicating that up to 10 million Brits are unwilling or unable to acknowledge their weight issues.

In a survey carried out by the polling service, YouGov, fewer than one in ten people believed their extra pounds were a problem – but more than one in 4 people were clinically obese when measured.

More than 52% of the obese people surveyed said they thought they ate a healthy diet, further indicating that many people’s flawed perception of what constitutes a healthy weight or lifestyle extends to their food habits. Many people are so blind to their weight and body shape that they are not aware that they actually need to be on a weight loss diet rather than just maintaining the diet that they already have.

Slimming World has warned that the data shows that 1 in 4 obese people do not realise that their weight is putting their health at risk. Dr Jaqui Lavin, the head of nutrition at Slimming World, said that perceptions of what constitutes a weight problem were changing as the UK population got heavier.

She added that this was especially worrying as being obese was far more likely to cause someone to experience ill-health, citing statistics that the morbidly obese were 10 times more likely than someone of a healthy weight to describe their health as very poor, and that more than a third of the morbidly obese had high blood pressure.

That hard-to-lose fat around your waist tends to be a bit of a nightmare to shed, as well as being an early indicator for health problems such as diabetes. Now, for those women who’ve always dreamed of boosting their boobs, hate their muffin tops and have a few grand to splash about, the perfect solution seems to have come along.

A new cosmetic procedure has been developed which sees fat taken from around the waist and inject into the breasts.  Described as a “two for one” procedure, the operation has been greeted by cosmetic surgeons as the new breakthrough in surgery.

The president of the British Association of Aesthetic Plastic Surgeons, Nigel Mercer, said that the new procedure was on the agenda for the annual meeting this week in Cardiff of the top plastic surgeons in the world.

Mr. Mercer added that fat grafting techniques have been around for a while but previously were not widely offered due to concerns over safety and whether the body would accept the fat. He added that the Association was not yet sure whether the procedure could be widely offered to the public. There are also concerns that the fat might calcify and be mistaken for a tumour during a routine mammogram.

The Harley Medical Group chain of plastic surgeons is planning to offer the treatment and Mel Braham, their chairman, described trials of the technique as “astonishingly successful”. He said that it offered the opportunity to provide patients with two procedures while other surgeons have said that fat taken from the body would act as a more natural implant.

Its not often we get to write about being heavier as a good thing, but scientists have said that those dreaded tree-trunk thighs may in fact be protecting you from major health problems. The new research discovered that people with thinner-than-average thighs may have a higher chance of developing heart problems or dying early.

The scientists from Copenhagen Univesity said that on average, most people’s thighs have a circumference of 22 inches, or 55 centimetres. People were most at risk if they had a thigh measurement of less than 18 inches, or 46.5 centimetres, while there was no added risk if the thighs were larger than 60 cm. The results held true even when the researchers took into account other risk factors, such as cholesterol levels.

The study, published in the British Medical Journal, followed a group of Danish men and women for over 10 years. The participants had their height, weight, hips and waistline measured and the researchers calculated their overall body fat.

They also looked into their exercise levels, whether they smoked, blood pressure and cholesterol levels. During the ten years, the scientists recorded the incidence of heart disease and death. 257 men and 155 women died, 263 men and 140 women developed cardiovascular disease while 103 men and 34 developed heart disease.

The scientists said that those with the smallest thighs had twice as high a risk of developing heart problems. They suggested that this could be due to narrow thighs being associated with too little muscle mass, leading to the body not responding to insulin properly and therefore making Type 2 diabetes more likely, itself associated with heart disease. Low fat levels can also lead to adverse reactions to how the body breaks down food.

Various charities, such as the British Heart Foundation and the National Obesity Forum, have agreed that the research is interesting but that more research needs to be done.

New research has suggested that weight loss surgeries like gastric banding can also stop 8 out of 10 patients experiencing diabetes symptoms. It has been claimed that bariatric procedures, which include gastric bands, stomach stapling and gastric bypasses, can drastically cut the number of patients with obvious signs of Type 2 Diabetes.

Scientists from the University of Minnisota reported that 78.1% of patients with diabetes had ‘complete resolution’, while in 86.6% of patients their diabetes was improved or resolved.

The patients studied lost on average 38.5kg after the surgery, which they maintained for two years or more. The weight lost came to about 55.9% of their excess weight.

The study, which was presented at the International Federation for the Surgery of Obesity and Metabolic Disorders conference in Paris, is the largest of its kind into the potential benefits of bariatric surgery.

However a leading charity Diabetes UK  has warned that people should not get too excited about the research. The care advisor for the charity Zoe Harrison said that though it showed bariatric surgery could have good results, any surgery was potentially risky.

She added that dramatic weight loss could lead to a reduction in people needing to take medicine to treat their diabetes and even to some people not needed their medication at all. However she denied that bariatric surgery could cure diabetes, as those people would still need to eat a balanced diet and exercise to manage their condition.

Charities also warned that diabetes patients might be tempted to look to weight-loss surgeries as a quick fix, rather than using diet and exercise to control the condition.

After the Federal Food and Drug Administration said that they were looking into reports earlier this year that orlistat could be linked to liver problems, they have now said that they are investigating 32 cases of liver damage.

Orlistat is sold in two forms, as the over-the-counter pill Alli or in a stronger-dose, prescription-only version Xenical. Xenical has been available in the UK for ten years and generally it has been considered a safe medication, though some patients have reported unpleasant side effects such as extreme flatulence.

When Alli, manufactured by GlaxoSmithKline, went over the counter, the medication received a great deal of attention from the media. It has proved to be a massive seller for the drugs company; since it hit the pharmacies in April, 200,000 people have bought the product.

The FDA said that they are looking into 32 reports of liver problems received between 1999 and 2008, nearly all of which occurred outside the U.S. Of those who fell ill, 27 of them required hospitalisation.

Compared with the number of people taking the medicine worldwide, the number of reports is extremely small and experts have said that those who are obese are at greater risk of liver damage in any case.

The FDA have said that patients should continue taking the medication as normal while the European Medicines Agency have said that they have no current plans to change the product information, though this is being reviewed.

GlaxoSmithKline responded to the inquiry by citing patient safety as their top priority and promised that reports of side effects were carefully monitored. They reminded patients that Orlistat had had extensive clinical trials and said that as orlistat is a non-systemically acting drug, minimally absorbed into the blood, there was no ‘obvious biological mechanism’ to suggest it was associated with liver damage.

Data has shown that people are waiting for longer before seeking to lose weight. According to the slimming group Weight Watchers, the average weight at which people seek out their services has risen by 11% over the last two decades.

The report has lead to Britons being described as ‘fat blind’, as over the last two decades they have put on 18lbs more before deciding they need help to lose weight. The organisation said that Brits are less aware of how heavy they are getting and increasingly do not know how their weight could be affecting their health.

The slimming club records the starting weight of all new members who sign up to one of their weight-loss schemes. Over the time period on record, weight at the beginning has been steadily rising from 12.3 stones in 1989 to today’s average of 13.7 stones.

When read in terms of body mass index, the figure doctors use to decide whether someone is dangerously overweight, it has risen from 29.2 to 32, meaning that the average Weight Watchers member is already clinically obese by the time they join.

Weight Watchers themselves said that 90% of Brits were unable to identify a body that is obese, while 68% of those who are obese are unaware of their condition.

Their vice president, Mads Ryder, said the statistics showed that if people were unable to identify what an overweight or obese person looks like, it marked that we as a society are out of touch with healthy weights and body shapes.

A mother who had a gastric band operation to protect her daughter has tragically died. 30-year old Kerry Greaves wanted to stop her daughter being bullied due to her mother’s weight when she was picked up at the school gates. At 18-stone, she was desperate to shed the weight.

However severe complications after the surgery meant that her stomach failed to heal after the procedure and in spite of 14 further operations to save her life, she died of organ failure.

Her mother, Anne, said that Kerry was encouraged to have the procedure after she learnt that friends had had it done with success. Anne said that though her daughter had tried Weight Watchers, Slim Fast and other diets, she only ever lost a bit.

With her 3-year old Melissa starting school next year, though she herself had never been teased for her weight she was concerned her daughter might be “picked on” for having a big mum, her number one reason for getting the extreme procedure done.

Each year, thousands of obese people get some kind of bariatric surgery done. These can rang from gastric banding, where a band is fitted around the upper part of the stomach to shrink it, to gastric balloon insertion, where a balloon is inflated in the belly, again to reduce its size.

The mortality rate for the operation is 1 in 2,000. While some NHS trusts will pay for the procedure, some people are so desperate to lose weight they are willing to pay privately or even go abroad.

Anne Greaves said that if anyone was thinking of getting the procedure done, she would say to them, “Find more pride in yourself and don’t do it.”

Following on from the news that grapefruit could hold the key to a new slimming pill, scientists are now saying that beetroot juice could boost people’s ability to exercise.

A UK study has suggested that drinking the juice could help people work out for 16% longer. The team, from the University of Exeter, discovered that a nitrate found in the red vegetable helps reduce oxygen uptake, making exercise less exhausting.

Focusing on 8 men aged between 19-38, the volunteers were given 500ml of the juice for 6 consecutive days, before being asked to perform a series of tests while cycling or using an exercise bike.

They were then given a placebo of blackcurrent juice for 6 consecutive days before taking part in the same cycling tests.

The tests performed after the men had been given beetroot showed that they were able to work out for an average of 11.25 minutes longer. The researchers say that while they are not sure why this effect was observed, they believe it is due to the nitrate turning into nitric oxide in the body, diminuishing the amount of oxygen used up during exercise.

The discovery could be used to help people with cardiovascular, respiratory or metabolic diseases, as well as endurance athletes. It could also be of particular use in helping obese people exercise more to boost weight loss.

The overweight often find it difficult to exercise as their weight means they get quickly exhausted. Ways to boost the length of time someone can exercise could have a big impact on their energy levels, which would in turn allow them to burn more calories.

Over the past 10 years, American-style coffee houses have popped up on every single high street in Britain. Skinny lattes, frappucinos, chai lattes - they have become a common part of British life, whether you prefer Starbucks, Nero or Costa.

In the summer, iced coffees are some of the biggest sellers for the coffee chains. However a charity has warned that the seemingly harmless cold drinks can contain as many calories as a full meal. The World Cancer Research Fund conducted a survey into the iced coffees sold by the most popular chains and discovered that the majority of iced drinks contained over 200 calories.

The worst offender was the new venti dark berry mocha frappuncino, which Starbucks started selling this summer. It has 561 calories in it, over a quarter of a woman’s recommended daily calorie intake and over a third of what dieters should be aiming for.

Dr Rachel Thompson, the science program manager at the WCRF, called the calorie content of the drink “alarming”. The WTCF launched the survey in response to the growing evidence that obesity is a leading cause of cancer in the Western world. They have estimated that 19,000 cases of cancer each year could be avoided if people shed their excess weight.

Dr. Thompson said that while the occasional iced coffee was fine as a treat, drinkers should opt for unsweetened coffee, ask for skimmed milk and avoid the creams and syrups that the coffee houses offer.

In 2007 Starbucks changed the milk it uses by default from full-fat to 2% fat and has begun tests into a low-calorie frappucino recipe. Both Costa and Nero offer the full calorie content of their products on their websites.

A grandfather who was warned he would die unless he lost enough weight to make him eligible for life-saving surgery has astonished doctors by losing 11stone in 6 months. Idris Lewis weighed almost 27 stone and in January was told that due to his weight, surgeons could not perform heart surgery, without which they gave him a year to live.

Mr Lewis was so determined to give himself a fighting chance at survival that he embarked on an extreme diet, where he stopped eating solids and lived on fluids entirely. He has subsisted on nothing but mineral water and nutritionally-balanced milkshakes for the past six months in an effort to reach the target weight set by his surgeon in time for the end of July.

He explained that he decided to take such dramatic steps after his doctor made him realise he only had two choices – “diet or die”. He said that learning this was the only incentive he needed to lose the extra weight.

Amazingly, Mr. Lewis said he had not missed solid food, though sometimes he sees an advert for roast chicken or steak and thinks it looks good. He said this was just ‘desire’, not need. Rather depressingly, he told journalists that he got variation in his diet by alternating between mineral and tap water.

He is overjoyed that he has now been told that he can have the operation in October and plans to end the diet in two weeks, when he will slowly start to reintroduce food into his life.

While this story has shown what people can do with determination, it also is fairly scary that it took the prospect of death to convince Mr. Lewis to shed the extra pounds. With 1 in 3 Brits expected to be dangerously overweight by 2012, it seems probably that many of those people will not be able to show the same determination – and their stories will not end so happily.

The pharmaceutical company Orexigen Therapeutics Inc today issued a statement saying that late-stage trials of their new weight loss pill Contrave have showed that the medication definitely could help obese people lose weight.

There had previously been questions over whether the pills, previously called Excalia,would meet the standards set by the Federal Food and Drug administration for public sale. However the company say the latest set of trial results exceeded the FDA benchmarks. 48% of patients taking the high dose of Contrave lost at least 5% of their body weight, compared to 16.4% taking the placebo.

The FDA say that there needs to be at least a 5% difference between the weightloss noted in the group taking the medication and the group taking the placebo.

Over a year, the trial saw 3,800 patients take either the medication, a combination of the anti-depressant Wellbutrin and the anti-addiction drug naltrexone, or the placebo. The pills were given at three different levels, the high dose, the medium dose and the low dose. While Orexigen say they will not be continuing the low dose trials as the results were negligible, at a medium dose patients had a mean weight loss of 6.1% of their total body fat compared to the 1.6 loss of the placebo group.

Orexigen say that they plan to file for FDA regulatory approval in the first half of 2010.

A new scheme being launched with a pilot project in Essex will see dieters paid a pound for every pound they manage to lose in weight. Following the example of a similar, successful American scheme, health officials have decided to give those taking part in the scheme £1 shopping vouchers to encourage weight loss and sticking to an exercise program.

The pilot is set to begin in September and will involve 100 volunteers who have been invited to take part. NHS South West Essex will fund it and it will be run by Basildon Council, as part of an ongoing drive to reduce obesity in the area. A quarter of the area’s population is obese and they have been ranked as having markedly worse obesity levels compared with the national average.

Participants in the scheme will receive advice on how to live healthily and will be required to return every three months for a weigh-in.  It is hoped that the programme will be better value for money than current schemes, which has seen the primary health care trust pay for gym memberships that are rarely used.

The programme will culminate with a glamorous photo shoot, allowing the participants to appreciate the difference that their weight loss has made. 

It is hoped that if the Essex pilot is successful then other primary health care trusts will also adopt it.

When you are dieting, salad seems like the angelic, if maybe less satisfying, option for a meal. Especially when it comes to lunch, when the supermarkets and shops sell pre-packaged options for the health conscious as an alternative to sandwiches or fatty burgers.  However, new research indicates that some salads on the market may be barely healthier than a Big Mac.

In a study of 20 pre-packaged salads, the consumer magazine Which? discovered that on average they contained 20.3 grams of fat, only a small amount less than the fat in a Big Mac, 24 grams. One salad, Morrison’s 300g Smedleys Atlantic Prawn Marie Rose Salad, contained 66.3g of fat and 855 calories, more than a Big Mac and medium fries and nearly 100% of a women’s daily recommended fat allowance. Asda’s Chicken Caesar Pasta Salad was the equivalent of eating 6 Cadbury’s Cream Eggs in terms of fat content.

Which? magazine said that the reason salads were often surprisingly high in calories was that their dressings contained mayonnaise or creamy sauce, in “generous” quantities. They also warned that some salads claimed to contain “no mayonnaise” while containing all the ingredients for mayonnaise.

The magazine has asked food companies to consider adopting one universal label indicating fat, sugar and salt content to make it easier for shoppers to see at a glance exactly what they are eating.

A team of experimental psychologists have warned that imposing tougher regulations on the sale of junk food and the promotion of diet foods could lead to an increase in binge eating. The researchers from Bristol University found that when people were offered special low calorie food, they were more likely to help themselves to larger portions.

Scientists believe they have developed a way to make common foods like cake and bread make us feel fuller for longer. The process is extremely simple and the team from the Institute of Food Research at Nottingham University say that all is needed is to modify a commonly-found ingredient present in nearly all processed foods.

Most processed foods used emulsifiers and stabilisers to prevent fat and water in products from separating. Some of those additives break down when they mix with stomach acids, but researchers believe that by choosing the stable version of the ingredient, the stomach will take double the time to break down the food, meaning that it will take double the time for people to feed hungry again.

Volunteers were fed a test meal of a coffee-milkshake style drink made from olive oil and water, of the same volume as a conventional meal. One group’s drink contained a stabiliser called Tween 60, often found in cakes and pastries , while the others were given Span 80, which allows water and oil to break up in the stomach.

The volunteers were monitored to see how full their stomachs were, how full they felt and how hungry they were every hour for twelve hours, with scanners and interviews.  After one hour, the volunteers who had taken the Tween 60 had twice as much volume in their stomachs and overall reported feeling fuller, less hungry and with a reduced appetite.

Gastric banding is usually seen as the extreme end of the different solutions for weight management. Any surgery is invasive and carries with it dangers, so any kind of bariatric surgery, from gastric bands to gastric balloons, is usually only recommended as a last resort for morbidly obese patients. But what if you could have the band put in with no surgery and no danger?

Improbable as it sounds, this is what Marion Corns, 35, has had ‘done’. She visited a hypnotherapist who hypnotised her into believing that she had a gastric band put into place. Her hypnotist put her under and then talked her through every stage of the operation, from the anaesthetic to the feel of the surgeon’s knife on her stomach. She even said she could smell the scents of the operating room.

Ms. Corns paid £780 for a course of 5 treatments with the specialist hypnotherapist, but she says it was money well spent. Since the treatment in a clinic in Marbella, she has dropped about 11st and her dress size has gone from a 22 to a 14. She says that the hypnosis is the only thing that has worked for her, after she tried diet plans like Atkins, Weight Watchers and slimming tablets, and that now she is able to lose three pounds a week and feels full if she eats more than a small food portion. There have been other reports of people finding success in losing weight through hypnotherapy, though usually the focus has been on changing someone’s relationship with food.

A new study has indicated that those who sleep for longer are more likely to be slim than shorter sleepers. Monitoring the weight of a group of nurses from the U.S, the team from the Walter Reed Army Medical Centre in Washington discovered that shorter sleepers had an average BMI of 28.3, 3.8 points higher than the average BMI of longer sleepers.

Previous studies in the U.S had suggested that people sleeping less that 7 to 9 hours a night were up to 75% more likely to be overweight. It is believed the link between sleep and excessive weight is caused by the release of hormones that affect hunger and a person’s rate of metabolism.

Dr Eliasson, who led the study, believes that not only may too little sleep be affecting hormone levels but also thinks that stress may be affecting time spent asleep, the quality of sleep and different modes of behaviour. He explained that if stress was affecting sleep, then it might combine with someone feeling less rested and cause them to be less organised than someone at a normal weight. They therefore might be taking more steps and trips in order to accomplish the same tasks as someone at a normal weight. Overweight people do tend to take more steps and be more active than those without weight problems, walking 14,000 steps a day compared to 11,300. All these different factors could also combine to push someone towards other behaviours, like stress eating that would damage their health.

Dr Eliasson now hopes that time can now be spent on discovering more about what was driving the difference in weight between the two groups. They are eager to start a study which would allow for the variety of known influences on weight gain and are planning on doing further research into the role stress plays on sleep and metabolism.

Further news on the proposals to get fast-food chains to put the number of calories visibly in their restaurants – eighteen restaurant and catering chains have started doing it. The chains include Pizza Hut, KFC and the sandwich makers Pret a Manger, who will include the calorie count on all food and drink items of menu boards, shelves and paper menus. The websites of most fast-food chains already contain information on the calorie content of their food.

The move is a triumph for the Department of Health and the Food Standards Agency (FSA) who have long been pushing for the move. The chief executive of the FSA, Tim Smith, explained why they believed the change was important: “Our aim is to ensure that consumers have better information so they can make informed choices to improve their diet when eating out, whether that is a snack on the go, a meal in a staff restaurant or at a table being served by a waiter”.

In the U.S a similar scheme running since 2007 has had some success and was shown to change customer’s behaviours, leading to 50 to 100 less calories being consumed. However the restaurant industry still has some reservations about the move. Bob Cotton, chief executive of the British Hospitality Industry (which represents 30,000 restaurants and catering firms) felt that the current economic climate made the move risky. "The sector is having its most difficult trading in 40 years and the last thing we want is anything that is an added cost to the business."The next 12 months is not the time for anything like this. We are looking to protect jobs."

Chef, Antony Worrell Thomson – who has first-hand experience of the difficulties facing his industry, after his restaurant empire collapsed amid reports he had failed to react fast enough to the economic downturn – has been very critical of the move, seeing it as a further example of the nanny state. “Why not let people eat their meals in peace?” he asked.

Gastric surgery is without doubt the most extreme solution to obesity, as any surgery is risky and difficult to reverse. There are various different surgical options from gastric banding, which reduces the size of the stomach by making it into two pouches, to the gastric balloon, which is a silicone balloon that is passed into the stomach and filled up with water, making you feel more full.

Previously, the only non-surgical medical options to promote weight loss were slimming pills, but there is apparently now a new possibility that is being trialled - a plastic sleeve that lines a section of the gut and blocks the absorption of calories. As the sleeve is inserted through the mouth in a process that lasts less than half an hour, this removes the associated dangers of surgery. The sleeve is contained inside a capsule which is put in place via an endoscope. A catheter then pulls the flexible sleeve out and it is fixed using a spiked attachment. Should it be necessary to take out the device this can be done in only ten minutes.

The sleeve acts an impermeable barrier to stop food coming into contact with the intestinal wall, which limits the amount of sugar, calories and nutrients that the patient can absorb. Described variously as a ‘sock’, ‘plastic bag’ and ‘stomach condom’, it is hoped that as well as promoting weight loss it may also be of benefit to sufferers of type 2 diabetes. It is believed that due to changes in neural and hormonal signals sent from the gut, patients with this strain of diabetes will experience a rapid reversal of their condition even before they notice any weight loss.

The device is manufactured by GI Dynamics, a U.S company. They have just finished clinical trials involving 26 morbidly obese people who lost on average 3 times more weight than those who were not fitted with the sleeve and trials are continuing to see the more long term effects.

Now safer and more effective devices to encourage weight loss is always great news. However, personally I think the mere idea of having a big bag-sock-thing in my tummy would probably just put me off my food anyway, regardless of its calorie-blocking effects. And imagine the awkwardness of the conversations that might result; someone compliments you on your new slim-line shape and you get to respond, “Ah, yes - it’s all thanks to my giant new stomach condom, doncha know…”

As part of the government drive to tackle obesity, the Food Standards Agency has introduced a new plan to get high-street cafes, restaurants and shops to show the calorie count on food packaging. While the scheme is voluntary, six major high-street food chains have signed up and from later this year will be showing the calories contained in their food on menus and packaging. It is believed that a further 40 food manufacturers are considering following suit.

The Food Standards Agency is even hopeful that eventually, even high-end restaurants will let customers know the fat content of the food they are ordering. The Chief Executive of the FSA, Tim Smith, said: “I don’t see any compelling reason why we shouldn’t provide that information. If consumers want to ignore it they could, but we would be giving consumers a real choice.”

A survey by a Surrey trading standards agency in 2007 discovered that one in three pub or restaurant meals contained 1,500 calories per serving. Bearing in mind women are recommended to consume 2000 calories per day, it’s quite a hefty amount. There has been growing concern that consumers do not realise how fattening eating out, particularly when picking up something for lunch, can be. Currently around 30% of a household budget is spent on food items bought out, like takeaways or lunches. Many consumers believe that a lunchtime sandwich bought from a shop like Pret a Manger is a healthy option, when in fact some sandwiches can have an enormous salt and fat content. Most firms currently only display calorie content on their websites, if at all.

Pizza Hut has confirmed that it will be trialling calories counters in some restaurants and Macdonald’s – who show the calories on the bottom of their tray liners – have promised to discuss the proposal. It will be interesting to see just how many firms do eventually sign up and whether having the calories more visibly displayed may prompt them to research healthier recipes.

Round about now is when we really start to regret all the chocolate, booze and oddly-named cheese that was consumed with such wild abandon over the last two weeks. Christmas may be long gone but the guilt and hangover can contrive to make you feel like half a chestnut-stuffed turkey is still churning around your insides. This is why detox manufacturers do so well in January; they promise to make us all shiny and squeaky-clean again, cleansed of all our glutinous sins.

However, if you are one of thousands balefully contemplating a week spent imbibing nothing but seaweed, water and dandelion extract, it might be wise to think again. New research has just revealed that actually, the majority of detox products and programs clean out nothing but your wallet. A group of biologists, chemists and physicists representing the Voice of Young Scientists, a organisation made up of younger scientists, researched the properties of products and treatments that use the word ‘detox’. These can range from dietary supplements to body creams that all promise to wash out toxins from the body.

The group found that companies were unable to provide a reliable or proven definition of what ‘detox’ means, with no two companies having the same definition. Helen Berry, one of the report’s authors, said: “'Detox is marketed as the idea that modern living fills us with invisible nasties our bodies can't cope with unless we buy the latest jargon-filled remedy. Our investigation has convinced us there is little or no proof these products work.”

A controversial new study has cast doubts on the effectiveness of the sweetener Splenda saying that, far from being an aid in weight loss, it causes those using it to gain weight. Scientists also said that the sweetener could interfere with bacteria which live in the gut and in so doing, dampen the effect of certain medicines.

This week marks the publication of a book called The Anti-Aging Protocol: How to Live for Up To 30 Years Extra. It is by a scientist called Dr Malcolm H. Goyns and is based on research conducted by The University of Liverpool’s School Of Biological Science.  In it he claims that by following two steps you will be able to add many years to your life and, and this is where it gets really good, lose a significant amount of weight and then be able to eat a normal calorie diet without putting it back on!

Is it thirty minutes three times a week or forty for four? Perhaps it is thirty minutes four times or is it forty minutes three times? We all have a vague idea of how much exercise we are supposed to take to maintain a healthy weight and heart. It is one of those recommendations that has been made by a government advisory group and is announced on the news but is, for most of the population, no more than just that, a feature on the news.

If you read back over the obesity news articles on The Online Clinic website an interesting through line emerges, that of who is to blame for the obesity epidemic in this country.  Obese people have had blame laid upon them and some have, themselves, blamed others for their weight problems. The British press and many obese people vilified Fern Britton for not admitting to the fact that she had undergone gastric bypass surgery. It was felt in many quarters that she had somehow ‘let down’ obese and overweight people who saw her as role models for themselves.

The number of times that an anti-obesity treatment has made front page news could be counted on one hand, possibly on one finger, but looking at the covers of the national press in the UK last week - it was the story that dominated. Fern Britton, the popular presenter of ITV’s This Morning, it was revealed, had been fitted with a gastric band two years ago but had not made her decision public. The band is fitted around the stomach and reduces the amount of food required to give the sensation of feeling full.

Diets, like hemlines and haircuts, fall out of fashion almost as quickly as they are ushered in. The latest diet, it seems, is always the one which is going to make you lose the most weight in the shortest amount of time, and far exceeds the results obtained by all previous diets. In the seventies there was the cabbage soup diet, in the eighties food combination, in the nineties the Atkins and now the diet to follow is the GI (glycemic index).

Scientists at a Swedish University have just published a new study, which, on first reading, might be depressing for anyone trying to lose weight. The report from the Karolinska Institute says that the number of fat cells that a person holds in their body is determined during adolescence. They also suggest that no amount of dieting or exercise will reduce the number of these cells. The actual volume of the individual cells, however, can be altered.

Research published in the February edition of Cell Metabolism has shown that pumping iron burns fat. Obese mice were genetically altered to make their muscles bulk up as though they had been weight training. These mice were found to lose fat and to show other significant signs of metabolic improvement throughout their bodies even though they continued being fed a diet that was high in fat and sugar and had absolutely no increase in physical activity.

This is an extremely significant result in that it goes against the widely held belief that cardio-vascular training is the most significant exercise component in losing weight. And while cardio-vascular exercise does increase the body’s metabolic rate, it now seems that gaining muscle mass might be more significant in allowing the body to metabolize fat cells.

This result has surprised the researchers. Whilst they expected the mice to become stronger due to having more muscle mass they did not expect their body fat to decrease; they expected fat and strong ‘sumo mice’.

Kenneth Walsh, who conducted the research, said that the increase in ‘energy burn’ in muscle can actually cause weight loss and prevent metabolic dysfunction.

"We've shown muscle does more than allow you to pick up heavy objects," said Walsh. "It is also important in controlling whole-body metabolism."

“These findings indicate that type II muscle has a previously unappreciated role in regulating whole-body metabolism through its ability to alter the metabolic properties of remote tissues. "These data also suggest that strength training, in addition to the widely prescribed therapy of endurance training, may be of particular benefit to overweight individuals” concluded Walsh.

The results suggest that weight training to increase muscle mass will be of huge benefit to obese humans and will also help obesity-related illnesses such as diabetes, heart disease, stroke, hypertension, and cancer.

Contrary to popular belief, scientists in the United States now think that consuming low-calorie drinks may actually increase the risk of putting on weight. They have discovered that people who regularly consume diet drinks may, due to the fact that the drinks themselves contain negligible calories, over compensate in other areas of their calorific intake.

They found that rats fed on yoghurt sweetened with saccharine ate more calories, gained more weight and put on more body fat than rats that were given yoghurt sweetened with glucose.

The scientists who conducted the report in Behavioural Neuroscience, Susan Swithers and Terry Davidson, concluded that “The data clearly indicate that consuming a food sweetened with no-calorie saccharine can lead to greater body-weight gain and adiposity than would consuming the same food sweetened with a higher-calorie sugar.”

They also say in the report that their findings match emerging evidence that people who drink more diet drinks are at higher risk of obesity and metabolic syndrome, a collection of medical problems such as abdominal fat, high blood pressure and insulin resistance that put people at greater risk of heart disease and diabetes.

The researchers say that, normally, sweet foods stimulate the brain into thinking that a lot of calories are about to be ingested and that the digestive system steps up a gear ready for that intake. When, however, ‘false’ sweetness is not followed by lots of calories, the system gets confused actually making the body burn calories that need to be replaced. If the scientists are correct, then artificial sweeteners such as aspartame, sucralose and acesulfame K, which taste sweet but do not provide calories, could have similar effects.

The report suggests that people who chose low-calorie drinks tend to consume more calories. People who know they are ‘banking some goodness’ by taking, say diet drinks, are inclined to overindulge.

With so many diets out there it very difficult for aspiring slimmers to make a decision as to which one will work best of all.  There has been a lot of anecdotal evidence around to suggest that diets high in proteins and low in carbohydrates worked best.  Until now there has been no scientific data or even rationale to back any of this up.  We have just seen a report which appeared in the Journal of Clinical Endocrinology and Metabolism which provides some scientific evidence that might help to substantiate the anecdotal evidence.

The only known appetite stimulating hormone is something called ghrelin, which is secreted by the stomach. Levels of ghrelin increase before a meal and then subside after the ingestion of food.  The longer that ghrelin levels can be suppressed, the longer someone will go without feeling hunger pangs.  When diets containing a mixture of macronutrients of fats, proteins and carbohydrates were compared, it was revealed that the diet rich in proteins appeared to keep the ghrelin levels low for the longest period of time. Meals high in carbohydrates had the effect of suppressing ghrelin levels substantially but for a short period of time only. Fatty meals had the least impact of all on ghrelin levels which could help to explain why those on high fat diets are able to pack away so much food!

The latest study on British dieting habits carried out for Tesco, the supermarket chain, by YouGov suggests that around a third of the UK adult population is on a diet at any one time.  The most health conscious appear to be those over the age of 55 as concern over the middle age spread takes its toll.

According to the latest projections, around 60% of us Brits will be overweight by the year 2050 if current obesity trends continue.  Apparently 15% of us spend at least 30 minutes of every day worrying about our weight.  Bizarrely, around 5% of women in the UK spend 3 hours or more worrying about their weight every day!  Perhaps if they spent less time worrying about it and more time doing something about it then they would not need to waste so much time worrying!  Everyone is looking for a quick fix.  While we are prepared to prescribe slimming pills based on individual circumstances, a lot of people think that they can pop a pill and then eat all their favourite foods, take no exercise and the pounds will melt away!  This is simply not possible.  Slimming pills should only ever be used as an adjunct to diet and exercise.  When they are used in combination with conventional methods it is possible to achieve above average results - in some cases double what you could expect from diet and exercise alone.

Everyone has their own reasons for wanting to lose weight.  According to the survey 20% of men thought that losing weight would make them more appealing to women and 10% of both men and women thought that a drop in weight would lead to better relations in the bedroom.

If you are based in London and you are looking for a personal training service to help you achieve your goals for your body shape, The Online Clinic is very happy to recommend Lawrence Farncombe.  Lawrence is an excellent personal trainer and he takes an holistic approach to getting his clients where they want to be.  Visit Lawrence’s website to find out more about his services.

A team of Japanese researchers have reported that a study conducted by them has revealed that people are likely to burn more fat if they sit down for 20 minutes between two 30 minute exercise periods than people who exercise continuously for one hour.

The researchers tested the blood of the participants during and after exercise.  The workout that was split into two half hour segments resulted in more fat being broken down than the workout that continued without a break.  The second half hour workout also demonstrated a greater boost to epinephrine and a decrease in insulin as a result of lower plasma concentrations of glucose.  The researchers are assuming that these chemical events are related to fat breakdown but this will require further study.

The study was based on a small sample but it might be worth giving it a go – apart from a lot of pounds, what have you got to lose!

Fat and unfit NHS patients are to be prescribed country walks rather than be prescribed anti-obesity drugs.  A pilot scheme is being run from six London GP practices where GPs will send patients on health walks and collect data to gauge how this improves their fitness.  The findings will be submitted to the National Institute for Clinical Excellence; the formal approval of this body is required if the scheme is to be rolled out nationally.

The Department of Health is working with the British Heart Foundation and Natural England, the newly created government conservation watchdog, the brief of which includes encouraging the use of the countryside and green spaces. The idea is that doctors will write a prescription for walks or cycle rides, tailored to the needs and physical fitness of the individual patient.  Patients would take the prescription to charities such as the Ramblers Association or local authority agencies who would record that the patient had attended and report back to the prescribing GP.

The financial cost to the NHS of inactivity is huge.  It is believed that obesity and related conditions such as heart disease and diabetes cost the NHS around £29 billion a year.  The ultimate intention is that this sort of prescription will be used in tandem with dietary advice, replacing anti-obesity drugs which cost the NHS millions each year.