Tagged Weight

Weekly Health Quiz: Exercise, Body Temperature and a Covid Vaccine Mystery

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An 11-minute program of calisthenics and rest, done three times a week for six weeeks, had this effect on out-of-shape young men and women:

It increased their fitness levels

It improved their endurance by 7 percent

It increased their leg power slightly

All of the above

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Which statement about body temperatures is not true?

Worldwide, average body temperatures seem to be decreasing

Body temperatures tend to rise during and after exercise

Older people tend to have lower body temperatures than younger people

Body temperature tends to be higher in the morning than in the evening

3 of 7

Health authorities are investigating the death of a 56-year-old doctor in Florida who developed this blood clotting disorder days after receiving the Covid vaccine:

Hemophilia

Pernicious anemia

Acute immune thrombocytopenia

Myelodysplastic syndrome

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Creutzfeldt-Jakob disease, sometimes called mad cow disease, is thought to be caused by this type of infectious organism:

Bacteria

Virus

Fungus

Prion

5 of 7

Which statement about throat cancers is not true?

Most throat cancers are caused by human papillomavirus, or HPV

Having oral sex at a young age increases the risk of developing throat cancer

HPV-associated throat cancers are more common in women than men

HPV-associated throat cancers are more common in whites than in African-Americans

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Being overweight during pregnancy was tied to this fertility issue, Danish researchers report:

Mothers who are overweight during their first pregnancy are at increased risk of fertility problems during subsequent pregnancies

Daughters born to overweight mothers were at increased risk of having fertility problems

Sons born to overweight mothers were at increased risk of being infertile

All of the above

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Diets rich in this vitamin were tied to a lower risk of developing Parkinson’s disease:

Vitamin A

B vitamins

Vitamins C and E

Vitamin D

How the Right Foods May Lead to a Healthier Gut, and Better Health

How the Right Foods May Lead to a Healthier Gut, and Better Health

A diet full of highly processed foods with added sugars and salt promoted gut microbes linked to obesity, heart disease and diabetes.

Credit…Getty Images
Anahad O’Connor

  • Jan. 11, 2021, 11:00 a.m. ET

Scientists know that the trillions of bacteria and other microbes that live in our guts play an important role in health, influencing our risk of developing obesity, heart disease, Type 2 diabetes and a wide range of other conditions. But now a large new international study has found that the composition of these microorganisms, collectively known as our microbiomes, is largely shaped by what we eat.

By analyzing the diets, health and microbiomes of more than a thousand people, researchers found that a diet rich in nutrient-dense, whole foods supported the growth of beneficial microbes that promoted good health. But eating a diet full of highly processed foods with added sugars, salt and other additives had the opposite effect, promoting gut microbes that were linked to worse cardiovascular and metabolic health.

The researchers found that what people ate had a more powerful impact on the makeup of their microbiomes than their genes. They also discovered that a variety of plant and animal foods were linked to a more favorable microbiome.

One critical factor was whether people ate foods that were highly processed or not. People who tended to eat minimally processed foods like vegetables, nuts, eggs and seafood were more likely to harbor beneficial gut bacteria. Consuming large amounts of juices, sweetened beverages, white bread, refined grains, and processed meats, on the other hand, was associated with microbes linked to poor metabolic health.

“It goes back to the age-old message of eating as many whole and unprocessed foods as possible,” said Dr. Sarah E. Berry, a nutrition scientist at King’s College London and a co-author of the new study, which was published Monday in Nature Medicine. “What this research shows for the first time is the link between the quality of the food we’re eating, the quality of our microbiomes and ultimately our health outcomes.”

The findings could one day help doctors and nutritionists prevent or perhaps even treat some diet-related diseases, allowing them to prescribe personalized diets to people based on the unique makeup of their microbiomes and other factors.

Many studies suggest that there is no one-size-fits-all diet that works for everyone. The new study, for example, found that while some foods were generally better for health than others, different people could have wildly different metabolic responses to the same foods, mediated in part by the kinds of microbes residing in their guts.

“What we found in our study was that the same diet in two different individuals does not lead to the same microbiome, and it does not lead to the same metabolic response,” said Dr. Andrew T. Chan, a co-author of the study and a professor of medicine at Harvard Medical School and Massachusetts General Hospital. “There is a lot of variation.”

The new findings stem from an international study of personalized nutrition called Predict, which is the world’s largest research project designed to look at individual responses to food. Started in 2018 by the British epidemiologist Tim Spector, the study has followed over 1,100 mostly healthy adults in the United States and Britain, including hundreds of identical and nonidentical twins.

The researchers collected data on a wide range of factors that influence metabolism and disease risk. They analyzed the participants’ diets, microbiomes and body fat. They took blood samples before and after meals to look at their blood sugar, hormones, cholesterol and inflammation levels. They monitored their sleep and physical activity. And for two weeks they had them wear continuous glucose monitors that tracked their blood sugar responses to different meals.

The researchers were surprised to discover that genetics played only a minor role in shaping a person’s microbiome. Identical twins were found to share just 34 percent of the same gut microbes, while people who were unrelated shared about 30 percent of the same microbes. The composition of each person’s microbiome appeared instead to be driven more by what they ate, and the types of microbes in their guts played a strong role in their metabolic health.

The researchers identified clusters of so-called good gut bugs, which were more common in people who ate a diverse diet rich in high-fiber plants — like spinach, broccoli, tomatoes, nuts and seeds — as well as minimally processed animal foods such as fish and full-fat yogurt. They also found clusters of “bad” gut bugs that were common in people who regularly consumed foods that were highly processed. One common denominator among heavily processed foods is that they tend to contain very little fiber, a macronutrient that helps to nourish good microbes in the gut, the researchers said.

Among the “good” strains of gut microbes were Prevotella copri and Blastocystis, both of which were associated with lower levels of visceral fat, the kind that accumulates around internal organs and that increases the risk of heart disease. These microbes also appeared to improve blood sugar control, an indicator of diabetes risk. Other beneficial microbes were associated with reduced inflammation and lower spikes in blood fat and cholesterol levels after meals, all of which play a role in cardiovascular health.

The new study was funded and supported by Zoe Global, a health science company, as well as by the Wellcome Trust, a British nonprofit, and several public health groups.

Dr. Berry said the findings suggest that by looking at microbiome profiles they can identify people at high risk of developing metabolic diseases and intervene early on. She and her colleagues are now planning a clinical trial that will test whether telling people to change specific foods in their diets can alter levels of good and bad microbes in their guts and subsequently improve their health.

“We think there are lots of small changes that people can make that can have a big impact on their health that might be mediated through the microbiome,” she said.

To Create a Healthy Habit, Find an Accountability Buddy

Well Challenge Day 6

To Create a Healthy Habit, Find an Accountability Buddy

Whether it’s a person or an app that sends us reminders, we make better choices when we’re being watched (even by ourselves.)

Credit…Andrew B Myers
Tara Parker-Pope

  • Jan. 8, 2021, 5:00 a.m. ET

If you want to make positive changes in your life, try building on a lesson many of us learned in 2020: Hold yourself accountable.

The notion of accountability — to yourself and to others — has been an important part of pandemic living. To avoid spreading the virus, we’ve needed to be accountable for wearing a mask, limiting our contacts and keeping our distance.

But accountability can also help you achieve your health goals. Gretchen Rubin, author of “Better Than Before,” a book about forming healthy habits, says that accountability is an important tool for making and breaking habits.

Accountability works best when it comes from the outside. You can create accountability by checking in with a friend every day to talk about healthful eating. You’re more likely to exercise if you’ve made a plan to walk with a friend or scheduled a workout with a personal trainer. You can create public accountability by declaring your intention on social media.

If you prefer to stay accountable only to yourself, you can create accountability by using an app that sends you daily reminders or by wearing a Fitbit or smart watch to track your exercise habits. You can even hold yourself accountable through a daily journal entry.

“We do better when someone’s watching,” Ms. Rubin said. “Even when we’re the ones doing the watching!”

A 2018 North Carolina State University study of 704 people enrolled in a 15-week online weight-loss program found that participants with buddies lost more weight and waist inches than those who took the course without buddy support.

So for today’s Well challenge, think about a health goal you want to achieve and focus on how you can hold yourself accountable. I’ve included a few suggestions for how to do it. Sign up for the Well newsletter to get the 7-Day Well Challenge in your inbox.

Day 6

Create an Accountability Plan

What is your goal for 2021? Do you want to improve your eating habits, lose weight or exercise more? Or maybe you just want to finish that screenplay you’ve been working on? You’re more likely to succeed if you get some help.

Find an accountability buddy. Choose a friend who wants to achieve a similar goal and make a plan. Accountability might mean meeting each other once or twice a week for a walking date. Or it could be a daily text check-in to see how you’re doing on a diet or a Zoom call to work on a decluttering project together.

“Some people are very accountable to themselves, but not most people,” said Dr. Tim Church, a well-known exercise and obesity expert and chief medical officer for Naturally Slim, an app-based behavioral health program in Dallas. “In my years of working with thousands of people, there’s one thing that drives accountability more than anything else: If you want to keep people doing a behavior, get a buddy.”

While the presence of an accountability buddy adds some gentle peer pressure, the key is to focus on the behavior, not success or failure. For instance, if a person is trying to lose weight, don’t focus on the scale. Instead, check in and remind them to log what they ate, encourage them to eat more fruits and vegetables and remind them of the benefits of a regular weigh-in (but you don’t need to ask them the result). If they’re beating themselves up for eating two desserts, talk about what might have triggered an emotional eating binge.

“An accountability partner is there to support you, to problem-solve and to celebrate even the small victories,” Dr. Church said. “Judgment is the quickest way to destroy all that. People are so hard on themselves. You don’t need to be hard on them.”

Use an app. An app is a great way to add accountability to your day. Meditation apps like Headspace and Calm will send daily reminders and track your progress. The weight-loss app Noom asks you to check in for a few minutes each day, complete mini-health courses and track what you’ve eaten. The Fitbit app counts your steps, will sync with your smart scale and vibrates to remind you to get up and move.

Set reminders. Once you set a health goal, hold yourself accountable by creating calendar reminders to help you achieve it. Schedule walk breaks or daily or weekly check-ins with your accountability buddy.

Declare it on social media. Telling your friends on social media that you’re cutting back on packaged foods, or sending a tweet every time you finish a class on your exercise bike creates virtual accountability. Commit to posting on Facebook, Instagram, Twitter or another platform every time you complete a goal, or share your feelings on days you’re struggling. When you declare your goals on social media, you’re likely to find a like-minded friend who will want to join your journey and offer words of support.

Weekly Health Quiz: Body Fat, Pulse Oximeters and a New Strain of Coronavirus

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Cold weather is hitting many parts of the country, posing challenges for social distancing during the pandemic. Which statement about acclimating to cold weather is not true?

People over 60 tend to be less tolerant of cold than younger people

Carrying extra body fat helps protect against cold

Heat loss tends to be greater in men than women

Being physically active helps protect against cold

2 of 7

A new variant of the novel coronavirus that is sweeping through the United Kingdom appears to be:

Far deadlier than existing strains

Resistant to current vaccines

More contagious than existing strains

All of the above

3 of 7

Pulse oximeters, which measure blood oxygen levels and can be a lifesaving tool for monitoring Covid-19 symptoms, may be less accurate in this group:

People who are sedentary

Athletes

Adults over 70

People with darker skin

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A Norweigan study found that older men and women were less likely to die prematurely when they incorporated which of the following into their weekly workouts?

A moderate 50-minute walk

Strength training

Short bursts of intense exercise

All types of exercise showed a similar impact on longevity

5 of 7

Some localities are banning elective surgery because of rising coronavirus case counts. Elective surgery refers to surgery that is:

Optional

Not urgent

Performed in a non-hospital setting

All of the above

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Prospective fathers with this medical condition were more likely to sire a pregnancy that did not reach full term:

Diabetes

Hypertension

Obesity

All of the above

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Consumption of this beverage was tied to an increased risk of frailty in older women:

Coffee

Tea

Wine

Sugary or artificially sweetened drinks

Weekly Health Quiz: Exercise, Weight and Covid Deaths

1 of 7

Overweight men and women had to work out about this many minutes a week to lose weight, researchers at the University of Kentucky report:

100 minutes

200 minutes

300 minutes

600 minutes

2 of 7

Karl A. Pillemer, a family sociologist and professor at Cornell, found that about this percentage of the population was living with an active family rift:

5 percent

10 percent

25 percent

50 percent

3 of 7

A global survey found that in the early months of the pandemic, many of us were stress eating, gaining weight and sleeping poorly, with this group particularly affected:

Children

People over 65

Obese people

Unmarried people

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The United States saw a shocking new milestone, exceeding this many deaths per day from Covid:

1,000

2,000

3,000

6,000

5 of 7

Total reported deaths from Covid are approaching 300,000 in the United States. This country has the second highest number of reported Covid deaths, with nearly 200,000:

Brazil

India

Russia

China

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A single dose of Pfizer’s coronavirus vaccine appeared to offer good protection regardless of age, race or weight after about how many days?

One day

Five days

10 days

30 days

7 of 7

Young women who used tanning beds were at increased risk of this disorder, which can sometimes lead to infertility:

Amenorrhea

Ovarian cysts

Endometriosis

Type 1 diabetes

Amazon Halo Review: The Fitness Gadget We Don’t Deserve or Need

tech fix

Amazon Halo Review: The Fitness Gadget We Don’t Deserve or Need

The retail giant claims that its health product is extremely precise at scanning body fat. I found otherwise.

Credit…Glenn Harvey
Brian X. Chen

By

  • Dec. 9, 2020, 5:00 a.m. ET

Many of us are in the same boat these days. With the coronavirus killing more people by the day, we are increasingly stress-eating and drinking more alcohol. At the same time, with gyms shut down, we are sitting around more and glued to screens.

So you may be wondering what I’m wondering: How is the pandemic affecting my body? Because we can’t easily leave the house to see doctors for nonemergencies, we are largely left to figure this out on our own.

Enter the Halo, a new fitness-tracking bracelet from Amazon with a novel twist: It claims that by using a smartphone app to scan images of your body, it can tell you how much body fat you have much more precisely than past technologies. The bracelet also has a microphone to listen to your tone of voice and tell you how your mood sounds to other people. (The masochist inside me said, “Sign me up!”)

The Halo is Amazon’s foray into so-called wearable computers that keep an eye on our health, following in the footsteps of Apple and Fitbit. Amazon is selling the Halo for $65 on an invitation-only basis, meaning you have to get on a waiting list to buy it. I volunteered to be a guinea pig and received mine in October.

When the Halo arrived, I installed the app, removed my T-shirt and propped up my phone camera. Here’s what happened next: The Halo said I was fatter than I thought — with 25 percent body fat, which the app said was “too high.”

I was skeptical. I’m a relatively slim person who has put on two pounds since last year. I usually cook healthy meals and do light exercises outdoors. My clothes still fit.

I felt body-shamed and confused by the Halo. So I sent my Halo data and body scans to Dr. Lawrence Cheskin, a professor of nutrition and food studies at George Mason University and founder of the Johns Hopkins Weight Management Center.

After reviewing my results, Dr. Cheskin jotted down my height and weight to calculate my body mass index, which is a metric used to estimate obesity. A man my age (36) with my body mass index, he said, is highly unlikely to have 25 percent body fat.

“Unless you were a couch potato and ate a very poor diet, I have my doubts about the Halo’s diagnosis,” he said.

Dr. Cheskin encouraged me to gather more data by measuring my body fat with other devices, and to do the same with at least one other person. So I did and found that the Halo’s body fat readings consistently skewed higher than other tools for myself and my test subject.

I concluded that the Halo’s body analysis was questionable. More important, it felt like a negative experience that failed to motivate me to get fit. I’ve had much more uplifting experiences with other products like the Apple Watch and Fitbit bands, as laid out below.

Measuring Body Fat

The Amazon Halo bracelet and app.
The Amazon Halo bracelet and app.Credit…Amazon

Body fat measurement can be complicated because the traditional methods available to consumers are not always accurate.

Smart bathroom scales that measure body fat use bioelectrical impedance analysis, which sends a small current through your bare feet. Skin calipers, a more dated method, are essentially rulers that pinch down on skin folds to measure thickness.

These techniques are not perfectly reliable. If people step on smart scales at different times of day or with different levels of hydration, their results may vary. Calipers can measure skin folds incorrectly if you pinch in the wrong areas.

Amazon said the Halo’s technology was much more precise. To scan your body, you use the smartphone’s front-facing camera to take photos of your body from the front, sides and rear. Then Amazon stitches the images together into a 3-D model to analyze your body composition and calculate the percentage of fat.

I decided to record consistent body fat measurements for myself and a friend using the Halo, a Fitbit bathroom scale and a highly rated skin caliper. In November and December, I took early-morning measurements with the Halo and bathroom scale; my wife pinched my skin folds in four areas with the caliper. I measured my test subject’s body fat once with each device.

Our results were remarkably similar for two men with very different body compositions:

  • The Amazon product estimated that my friend, a 6-foot-3 man weighing 198 pounds, had 24 percent body fat, the Fitbit scale read 19 percent, and the skin-fold measurements added up to 20 percent.

  • For myself — 5-foot-6 and about 140 pounds — the Halo said in November that I had 25 percent body fat, the Fitbit scale said 19 percent, and the skin-fold measurements added up to 20 percent. In December, the Halo said I had 26 percent body fat (alas, I had more Thanksgiving leftovers than usual), the Fitbit scale said 20 percent, and the skin-fold measurements added up to 21 percent.

Dr. Cheskin speculated that the Halo might have an overestimating bias in its algorithm because underestimating body fat for an obese person would be more problematic.

Dr. Maulik Majmudar, Amazon’s medical officer, who worked on the Halo, said people should expect the device’s results to be different because the method was more accurate than body fat scales and calipers.

Amazon developed its body-measuring algorithm from a sample set of tens of thousands of images of people’s bodies from across a wide range of demographics, he said. Amazon then did internal tests measuring people’s body fat using the Halo scanner, smart bathroom scales and DEXA, a technique that uses X-rays to scan for bone density, which studies have found to be a reliable measure for body fat. It found that the Halo method was twice as accurate as bathroom scales.

Still, Dr. Cheskin was unconvinced by Amazon’s accuracy claims. He said a valid study would involve a clinical trial measuring body fat of many human subjects with each method — the Halo, DEXA, bioelectrical impedance scales and calipers — and comparing the results side by side.

Accurate or not, the most disappointing part of Amazon’s body fat analysis was that it lacked important context. Even though the app asked for my ethnicity, age and sex, it said my 25 percent body fat level was too high and well outside the “Healthy” zone (roughly 12 to 18 percent). It also said healthy results were associated with longer life and lower risks of heart disease.

Dr. Cheskin offered a more nuanced analysis. Body fat levels may have different health implications depending on your age, ethnicity, sex, cholesterol levels and family history. Waist circumference matters, too, because severe abdominal fat can be associated with health problems.

For an Asian man my age with a 34-inch waistline, whose family has not had a history of diabetes or heart problems, and whose blood tests recently showed normal cholesterol levels, even a 25 percent body fat reading would probably not be alarming, he said.

That context, combined with my body mass index along with the measurements taken with a body fat scale and caliper, led Dr. Cheskin to doubt Halo’s analysis.

He worried about the technology’s potential consequences.

“Does it potentially create eating disorders?” he said. “You’re taking a bunch of people with normal weight and B.M.I. and telling them they’re too fatty. What are they going to do with that? Some of them are going to be more compulsive and start doing things that are going to be inappropriate.”

Bottom Line

This experiment raised another question: What in the world was Amazon thinking releasing a product like this now? It has been impossible for us to move around as much as we used to this year. If anything, we should accept that our bodies will be imperfect during this time.

Dr. Majmudar said he felt the opposite. As a clinician, he said, he would encourage patients to mitigate the health risks of gaining weight and being more sedentary in the pandemic. The goal of the Halo was to drive behavioral change with education and awareness, he said.

“The desire or intention was never to body-shame people,” he added.

In my experience, there are better fitness-tracking products that offer more positive motivation.

The Apple Watch, for one, lets you set goals for how much you want to move or exercise each day, and those goals are symbolized by colorful rings that are shown on the watch face. Once a ring is completed, you have met your goal. Fitbit devices send notifications to your phone, egging you on when you are nearing your step goal. Neither device comes anywhere close to giving you body dysmorphia.

Another of Halo’s unique features is Tone, which uses the bracelet’s microphone to periodically eavesdrop on your conversations to tell you what your mood sounds like. I turned the feature off after two days because it felt like a creepy invasion of privacy. But I left it on long enough to complain to my wife about what a bad idea it was.

After analyzing the conversation, the Halo app said I sounded irritated and disgusted. That, at least, was accurate.

Exercise for Weight Loss: Aim for 300 Minutes a Week

Phys Ed

To Lose Weight With Exercise, Aim for 300 Minutes a Week

Overweight men and women who exercised six days a week lost weight; those who worked out twice a week did not.

Credit…Getty Images
Gretchen Reynolds

By

  • Dec. 9, 2020, 5:00 a.m. ET

Can exercise help us shed pounds? An interesting new study involving overweight men and women found that working out can help us lose weight, in part by remodeling appetite hormones. But to benefit, the study suggests, we most likely have to exercise a lot — burning at least 3,000 calories a week. In the study, that meant working out six days a week for up to an hour, or around 300 minutes a week.

The relationship between working out and our waistlines is famously snarled. The process seems as if it should straightforward: We exercise, expend calories and, if life and metabolisms were just, develop an energy deficit. At that point, we would start to use stored fat to fuel our bodies’ continuing operations, leaving us leaner.

But our bodies are not always cooperative. Primed by evolution to maintain energy stores in case of famine, our bodies tend to undermine our attempts to drop pounds. Start working out and your appetite rises, so you consume more calories, compensating for those lost.

The upshot, according to many past studies of exercise and weight loss, is that most people who start a new exercise program without also strictly monitoring what they eat do not lose as much weight as they expect — and some pack on pounds.

But Kyle Flack, an assistant professor of nutrition at the University of Kentucky, began to wonder a few years ago if this outcome was inevitable. Maybe, he speculated, there was a ceiling to people’s caloric compensations after exercise, meaning that if they upped their exercise hours, they would compensate for fewer of the lost calories and lose weight.

For a study published in 2018, he and his colleagues explored that idea, asking overweight, sedentary men and women to start exercising enough that they burned either 1,500 or 3,000 calories a week during their workouts. After three months, the researchers checked everyone’s weight loss, if any, and used metabolic calculations to determine how many calories the volunteers had consumed in compensation for their exertions.

The total, it turned out, was an average of about 1,000 calories a week of compensatory eating, no matter how much people had worked out. By that math, the men and women who had burned 1,500 calories a week with exercise had clawed back all but about 500 calories a week of their expenditures, while those burning through 3,000 calories with exercise ended up with a net weekly deficit of about 2,000 calories. (No one’s overall metabolic rate changed much.)

Unsurprisingly, the group exercising the most lost weight; the others did not.

But that study left many questions unanswered, Dr. Flack felt. The participants had performed similar, supervised workouts, walking moderately for 30 or 60 minutes, five times a week. Would varying lengths or frequencies of workouts matter to people’s caloric compensation? And what was driving people’s eating? Did the differing amounts of exercise affect people’s appetite hormones differently?

To find out, he and his colleagues decided to repeat much of the earlier experiment, but with novel exercise schedules this time. So, for the new study, which was published in November in Medicine & Science in Sports & Exercise, they gathered another group of 44 sedentary, overweight men and women, checked their body compositions, and asked half of them to start exercising twice a week, for at least 90 minutes, until they had burned about 750 calories a session, or 1,500 for the week. They could work out however they wished — many chose to walk, but some chose other activities — and they wore a heart rate monitor to track their efforts.

The rest of the volunteers began exercising six times a week for about 40 to 60 minutes, burning close to 500 calories a session, for a weekly total of about 3,000 a week. The researchers also drew blood, to check on the levels of certain hormones that can affect people’s appetites.

After 12 weeks, everyone returned to the lab, where the researchers refigured body compositions, repeated the blood draws and began calculating compensations.

And again, they found a compensatory threshold of about 1,000 calories. As a consequence, only the men and women in the group that had exercised the most — six days a week, for a total of 3,000 calories — had shed much weight, dropping about four pounds of body fat.

Interestingly, the researchers did uncover one unexpected difference between the groups. Those burning about 3,000 calories a week showed changes now in their bodies’ levels of leptin, an appetite hormone that can reduce appetite. These alterations suggested that exercise had increased the exercisers’ sensitivity to the hormone, enabling them to better regulate their desire to eat. There were no comparable hormonal changes in the men and women working out less.

In essence, Dr. Flack says, the new experiment “reinforces the earlier finding” that most of us will eat more if we exercise, but only up to about the 1,000-calories-a-week inflection point. If we somehow can manage to burn more than that amount with exercise, we probably can drop weight.

But, of course, burning thousands of calories a week with exercise is daunting, Dr. Flack says. Plus, this study lasted only a few months, and cannot tell us whether later changes to our appetites or metabolisms would augment or undercut any subsequent fat declines.

Still, for those of us hoping that exercise might help us trim our waistlines during the coming holidays, the more we can move, it seems, the better.

Yes, Many of Us Are Stress-Eating and Gaining Weight in the Pandemic

Yes, Many of Us Are Stress-Eating and Gaining Weight in the Pandemic

A global study confirms that during the pandemic, many of us ate more junk food, exercised less, were more anxious and got less sleep.

Credit…Lorenzo Gritti
Anahad O’Connor

By

  • Dec. 4, 2020, 5:00 a.m. ET

Not long ago, Stephen Loy had a lot of healthy habits. He went to exercise classes three or four times a week, cooked nutritious dinners for his family, and snacked on healthy foods like hummus and bell peppers.

But that all changed when the pandemic struck. During the lockdowns, when he was stuck at home, his anxiety levels went up. He stopped exercising and started stress eating. Gone were the hummus and vegetables; instead, he snacked on cookies, sweets and Lay’s potato chips. He ate more fried foods and ordered takeout from local restaurants.

“We were feeding the soul more than feeding the stomach,” said Mr. Loy, 49, who lives in Baton Rouge and is the executive director of a tech incubator. “We were making sure to eat things that made us feel better — not just nutritional items.”

Now a global survey conducted earlier this year confirms what Mr. Loy and many others experienced firsthand: The coronavirus pandemic and resulting lockdowns led to dramatic changes in health behaviors, prompting people around the world to cut back on physical activity and eat more junk foods. It drove anxiety levels higher and disrupted sleep. And those who are obese, who already face increased health risks, may have fared the worst, the researchers found. While they tended to experience improvements in some aspects of their diets, such as cooking at home more and eating out less, they were also the most likely to report struggling with their weight and mental health.

The findings, published in the journal Obesity, offer a cautionary lesson for many of us as coronavirus cases continue to surge and renewed calls for lockdowns and other restrictions again take hold. With months to go before a vaccine becomes widely available and we can safely resume our pre-pandemic routines, now might be a good time to assess the healthy habits we may have let slip and to find new ways to be proactive about our physical and mental health.

The study, carried out by researchers at the Pennington Biomedical Research Center in Louisiana, surveyed almost 8,000 adults across the globe, including people from 50 different countries and every state in America. The researchers found that the decline in healthy behaviors during the pandemic and widespread lockdowns was fairly common regardless of geography.

“Individuals with obesity were impacted the most — and that’s what we were afraid of,” said Emily Flanagan, an author of the study and postdoctoral fellow at the Pennington Biomedical Research Center. “They not only started off with higher anxiety levels before the pandemic, but they also had the largest increase in anxiety levels throughout the pandemic.”

The findings shed light on exactly how people altered their routines and behaviors in response to the lockdowns that were implemented in countries around the world this year to slow the spread of the virus. The pandemic disrupted everyday life, isolated people from friends and family, and spawned an economic crisis, with tens of millions of people losing jobs or finding their incomes sharply reduced.

Dr. Flanagan and her colleagues assumed many people were experiencing enormous levels of stress. But they were not sure how the pandemic and stay-at-home orders were impacting how people slept, how much they exercised and what they ate. So they designed an extensive survey and recruited people on social media to answer questions about how their mental and physical health had been affected.

“This was such a drastic and abrupt change to everyone’s daily life that we needed to see what was going on,” said Dr. Flanagan. “We wanted to put some data to the anecdotal behaviors we were seeing.”

From April through early May, about 7,750 people, most of them from the United States but also from countries such as Canada, Australia and Britain, completed the survey. The average age of the respondents was 51, and a majority were women. Based on their body mass indexes, about a third of the people were overweight, a third were obese, and a third were considered normal weight.

The researchers found that most people became more sedentary, which they said was probably related to less daily commuting and more time spent indoors. But even when people did engage in structured exercise, it tended to be at lower intensity levels compared to before the pandemic. Many people also said they had given in to their food cravings: Consumption of sugar sweetened beverages and other sugary snack foods, for example, went up.

That might explain another finding: About 27 percent of people said they had gained weight after the initial lockdowns went into effect. The figure was even higher among people classified as obese: About 33 percent said that they had gained weight, compared to 24.7 percent of people considered normal weight. People who gained weight also had the largest declines in physical activity.

There were some bright spots in the findings. About 17 percent of the study population actually lost weight during the pandemic; perhaps not surprisingly, they tended to be people who increased their physical activity levels and improved their diets. And despite snacking on more junk foods, many people showed an increase in their “healthy eating scores,” a measure of their overall diet quality, which includes things like eating more fruits and fewer fried foods. The researchers said that the overall improvements in diet appeared to be driven by the fact that the lockdowns prompted people to cook, bake and prepare more food at home. Other recent surveys have also shown a sharp rise in home cooking and baking this year, with many people saying they are discovering new ingredients and looking for ways to make healthier foods.

But social isolation can take a toll on mental wellness, and that was evident in the findings. On average, people reported significantly higher anxiety levels. About 20 percent said that their symptoms, such as experiencing dread and not being able to control or stop their worrying, were severe enough to interfere with their daily activities. About 44 percent of people said that their sleep had also worsened during the pandemic. People on average reported going to bed about an hour later than usual and waking up roughly an hour later than usual. Only 10 percent of people said that their sleep had improved since the pandemic began.

The greatest spikes in anxiety occurred among people who are obese. It was unclear why exactly, but one reason may have been concerns about the virus. The survey took place at a time when studies were first beginning to show that excess weight puts people at a much higher risk of being hospitalized with Covid-19. “We don’t have data to back this up, but our hypothesis is there was a lot more anxiety about their own health,” Dr. Flanagan said. “A heightened fear of the virus would most certainly increase their anxiety levels.”

Dr. Flanagan said it was perhaps not surprising that people tended to engage in less healthful habits during the pandemic, as so many aspects of health are intertwined. Stress can lead to poor sleep, which can cause people to exercise less, consume more junk foods, and then gain weight, and so on. But she said she hoped that the findings might inspire people to take steps to be more proactive about their health, such as seeking out mental health specialists, prioritizing sleep and finding ways to exercise at home and cook more, in the event of future lockdowns.

“Being aware of how our health behaviors change during these stay-at-home orders could help us combat that if another lockdown is enforced,” she said. “Being aware is really the No. 1 thing here.”

Attention, Teenagers: Nobody Really Looks Like That

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Credit Anna Parini

The universal truth of puberty and adolescence is body change, and relatively rapid body change. Teenagers have to cope with all kinds of comparisons, with their peers, with the childhood bodies they leave behind, and with the altered images used in advertising and in the self-advertising on social media.

It may be that the rapid way the body changes during these years can help adolescents believe in other kinds of change, including the false promises that various products can significantly modify their size and shape. A study published last month in the journal Pediatrics looked at two kinds of risky behavior that are increasingly common over adolescence: the use of laxatives for weight loss and the use of muscle-building products.

It used data from an ongoing study of more than 13,000 American children, the Growing Up Today Study (GUTS). The participants’ mothers took part in the Nurses’ Health Study II, and the children were recruited in 1996, when they were 9 to 14 years old, and surveyed about a variety of topics as they grew up.

By age 23 to 25, 10.5 percent of the women in this large sample reported using laxatives in the past year to lose weight; the practice increased over adolescence in the girls, but was virtually absent among the boys. Conversely, by young adulthood, about 12 percent of the men reported use of a muscle-building product in the past year, and again, this increased during adolescence.

So a lot of young women are taking laxatives to try to become very thin, and a lot of young men are using products to help them bulk up and become more muscular. The researchers were interested in how these practices were associated with traditional ideas of masculinity and femininity. They found that, regardless of sexual orientation, kids who described themselves as more gender conforming were more likely to use laxatives (the girls) or muscle-building products (the boys).

“The link is the perception that they are going to alter your weight, shape, appearance,” said Rachel Rodgers, a counseling psychology researcher who studies body image and eating concerns and is an associate professor of applied psychology at Northeastern University.

“The representations of ideal appearance in society are very restrictive and very unrealistic both for men and for women,” she said. “They portray bodies that are unattainable by healthy means.”

Jerel Calzo, a developmental psychologist who is an assistant professor at Harvard Medical School, and the lead author on the study, said that one important aspect of this research was the way it highlighted the vulnerability of those who identify with traditional gender ideals.

“Usually in research we tend to focus on youth who are nonconforming, who we might focus on as more at risk for negative health outcomes, depression, who might be ostracized or victimized,” he said. But there are risks as well for those who are trying to measure up to what they see as the conventional standard.

The GUTS participants were asked to describe themselves as children in terms of the games they liked and the movie and TV characters they imitated, and this was used to score them as more or less “gender conforming.”

The early patterns of gender conformity were significant, Dr. Calzo said, because they were linked to behaviors that lasted through adolescence and into young adulthood. “Laxative use increases with age, muscle-building product use increases with age,” he said. “There is a need for early intervention.”

Chronic use of laxatives can affect the motility of the bowel so that it can be hard to do without them, and overdoses can alter the body’s balance of electrolytes, to a really dangerous extent.

“There’s a lot of shame and guilt for laxative abuse,” said Sara Forman, an adolescent medicine specialist who is the director of the outpatient eating disorders program at Boston Children’s Hospital. And many products marketed as cleanses or herbal teas are not labeled as laxatives, though they contain strong laxative ingredients.

The muscle-building products in the study included steroids, creatine and several others. The risks of steroids are well known, from hormonal imbalances and shrinking testicles to acne and aggression. With other commercial muscle-building products, the risks may have more to do with the lack of regulation, Dr. Calzo said. The products can contain banned substances or analogues of banned substances, like the amphetamine analogue found in popular diet and workout supplements last year.

And of course, the muscle-building products won’t reshape you into the photoshopped model any more than the laxatives will.

As Dr. Calzo says, we need to worry about the vulnerabilities of children who are growing up with issues of gender identity and sexuality. But don’t assume that more “mainstream” or “conforming” kids have it easy when it comes to body image. Parents can help by keeping the lines of communication open and starting these conversations when children are young. We should be talking about the images that our children see, about how real people look and how images are altered.

And that conversation should extend to social media as well; in a review by Dr. Rodgers, increased social media use was correlated with body image worries. “Teenagers are looking at their friends on social media and seeing photos that have been modified and viewing them as something real.”

The other message for parents is about helping to model healthy eating, family meals, realistic moderation around eating and exercising, and to refrain from any kind of negative comments or teasing about a child’s body. “Research has shown people who have more body satisfaction actually take care of themselves better, which suggests that the approach of making them feel bad is actually not helpful,” Dr. Rodgers said.

Every adolescent, across gender, gender identity, gender conformity, and sexuality, lives with a changing body and the need to navigate body image and identity. There are a lot of unrealistic images out there to measure yourself against, and a lot of false promises about how you might get there.

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Cancer in the Family: Compliments on Being Thin

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Credit The author with her daughter, Devon.

“I’m so jealous. You’ve lost so much weight, you look amazing,” a friend says to me. “I’d love to catch the stomach bug this year and lose a few pounds myself.”

I smile. I don’t know what to say.

Since January, one of my 12-year-old twin daughters, Devon, has been in isolation in a Boise, Idaho, pediatric oncology unit receiving chemotherapy for acute myeloid leukemia. Her sister, Gracie, remains behind, in a little town south of Sun Valley. To cope, she has assigned herself as captain of Devo’s Fight Club, a band of peer supporters started with a sweatshirt she designed in the first 36 hours of her sister’s diagnosis.

Their dad and I have been driving the two and a half hours between home and hospital, splitting the week between our daughters, our jobs, middle school’s demands, puberty’s capriciousness, sports, music and running a household that includes cats, dogs, horses, cows and fish.

Devon’s cancer was as random as a dice roll. She had swollen gums for a week and then, a simple blood test to rule out mono instead declared that this sleek, athletic, freckle-faced cowgirl had a rare and often fatal leukemia.

My husband says he has gained weight since Devon’s diagnosis. I have lost weight. A lot. Neither one of us notices the other because we relate over phone or email mostly, and offer a country-style, four-finger half wave from the steering wheel as we blow past each other on the highway between towns.

Over the next 120-mile drive I am perplexed and obsessive.

“I’m so jealous. You look amazing.”

I’m nearly 51 years old and was prepared for the idea that menopause would keep me round despite my best efforts. How much weight have I lost? Was I really that fat before? Should I eat before I get to the hospital or after? The smell of food makes Devon sick. Eating in front of her seems torturous and unfair.

After I arrived at the hospital, a friend stopped by to visit. Before acknowledging Devon, she looked at me. With purrs of envy, she commented on how thin I looked. Again, I was at a loss for words. My daughter was not.

“My mom is not skinny because she worked at it,” Devon told our visitor. “It’s because I’m sick.”

The friend waved it off in the way that one deflects praise of a nice outfit with “this old thing,” and we all moved on. But every time someone notices my weight loss with a tinge of envy it makes me cringe.

Please, I want to tell them, do not admire how thin I have become since my daughter’s diagnosis — unless you are suggesting I look undernourished and want to give me a cupcake. My weight loss is not a goal you should aspire to, nor should it be confused with health and well-being. I was perfectly happy and fit in my pre-cancer-kid size, and a little hurt to hear that this shrinkage that could cost me a lot more than new pants makes me more beautiful than ever.

But what is most painful for me is the collateral damage to my daughters. When they hear that Mom is enviably thin, they hear that this is a reward, a take away for the suffering. That thin is best no matter the circumstances.

Gracie, a minute ahead of her twin, but always an inch and a pound behind, is now getting stretch marks from growing so fast. When her peers note how she “swims” in her choir dress, her mind begins the dance with body consciousness. Weight fluctuations are somewhat inevitable in adolescence and during menopause, but certainly magnified under the circumstances.

Devon’s physical changes are pushed to the bottom of most people’s thoughts now, because in this setting of a hospital room, she’s supposed to look wan and pale. Instead, her inner beauty and sense of humor are noted.

I’ve been sick and thin enough times to know I don’t want to be either. But my girls are facing this for the first time, and the ripple effects of this entire traumatic episode will surface the farther we get from the cancer. Hospital social workers are preparing us to watch for anxiety, regression, depression, eating disorders, apathy and sleeping issues. And signs of cancer returning, of course. And survivor’s guilt in Gracie, which could carve out a whole new emotional journey.

Devon, thankfully, is home now. But I’ve just been told that five months in the hospital have cost Devon nearly a third of her body mass. That her overall strength is that of a 90-year-old, and that after the chemo, her heart, which once pounded fearlessly, is in danger of failing. Her brain is wobbly from the lack of nutrition and her skin is translucent and cold where it once was earthy and warm.

When she returns to school next year, navigating the social riddle of middle school — now half a year behind her peers — and still mostly bald, and undoubtedly still thin, she will return with a self-consciousness she has never known.

Do not covet her thinness. Admire her resilience, and tenacity, and sheer will to live.

And, if you look into her eyes and you can see they are dim from the struggle, a happy-to-see-you smile or just saying nothing at all will do more than you know to help her find her way to loving herself as life has created her in this moment.

If you want to know how someone is, look in their eyes, because their size is not where the information is.

An Early Bedtime for Kids May Fight Weight Gain

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Preschool children who are in bed by 8 p.m. are far less likely to be obese during adolescence than children who stay up late, a study has found. Their risk of teenage obesity is half the risk faced by preschoolers who stay up past 9 p.m.

The research analyzed data gathered on nearly 1,000 children born in 1991 whose bedtimes were recorded when they were 4½ years old, and whose height and weight were recorded at age 15. The children were part of the Study of Early Child Care and Youth Development, done under the auspices of the National Institute of Health’s Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Among the children who were in bed by 8 p.m., 10 percent were obese as teens, compared to 16 percent of those who went to bed between 8 and 9 and 23 percent of those who went to bed after 9, according to the study, published in The Journal of Pediatrics.

The researchers adjusted for such factors as socioeconomic status, maternal obesity and parenting style and still found that the children who went to bed by 8 p.m. were at less than half the risk of teenage obesity as those who were up past 9, said Sarah E. Anderson, the paper’s lead author and an associate professor of epidemiology at the Ohio State University College of Public Health in Columbus.

Although the study does not prove that early bedtimes protect against obesity, Dr. Anderson said, “there is a great deal of evidence linking poor sleep, and particularly short sleep duration, to obesity, and it’s possible the timing of sleep may be important, above and beyond the duration of sleep.”

“This provides more evidence that having an early regular bedtime and bedtime routine for young children is helpful,” she said.

To Stem Obesity, Start Before Birth

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Credit Paul Rogers

To stem the current epidemic of obesity, there’s no arguing with the adage that an ounce of prevention is worth a pound of cure. As every overweight adult knows too well, shedding excess pounds and keeping them off is far harder than putting them on in the first place.

But assuring a leaner, healthier younger generation may often require starting even before a baby is born.

The overwhelming majority of babies are lean at birth, but by the time they reach kindergarten, many have acquired excess body fat that sets the stage for a lifelong weight problem.

Recent studies indicate that the reason so many American children become overweight is far more complicated than consuming more calories than they burn, although this is certainly an important factor. Rather, preventing children from acquiring excess body fat may have to start even before their mothers become pregnant.

Researchers are tracing the origins of being overweight and obese as far back as the pre-pregnancy weight of a child’s mother and father, and their explanations go beyond simple genetic inheritance. Twenty-three genes are known to increase the risk of becoming obese. These genes can act very early in development to accelerate weight gain in infancy and during middle childhood.

In the usual weight trajectory, children are born lean, get chubby during infancy, then become lean again as toddlers when they grow taller and become more active. Then, at or before age 10 or so, body fat increases in preparation for puberty – a phenomenon called adiposity rebound.

In children with obesity genes, “adiposity rebound occurs earlier and higher,” said Dr. Daniel W. Belsky, an epidemiologist at Duke University School of Medicine. “They stop getting leaner sooner and start putting on fat earlier and put on more of it.”

Still, twin and family studies have shown that many children with these genes remain lean. Furthermore, these same genes were undoubtedly around in the 1960s and 1970s when the obesity rate in children was a fraction of what it is today.

So what is different about the 2000s? Children today are surrounded by a surfeit of unwholesome, easy-to-consume calorie-dense foods and snacks accompanied by a deficit of opportunities to expend those extra calories through regular physical activity. And countering a calorie-rich, sedentary environment is now harder than it should be, with the current heavy emphasis on academics, parental reluctance to let children play outside unattended, and intense competition from electronics. All these circumstances may give obesity genes a greater chance to express themselves.

“There is no going back to a world in which calories are scarce and obtaining them is physically demanding,” Dr. Belsky wrote in an editorial in JAMA Pediatrics. “And governments and their publics have shown little enthusiasm for regulations restricting access to palatable, calorie-dense foods.”

Curbing consumption of sugar-sweetened beverages and keeping calorie-dense junk food out of the house and other settings where young children spend time is crucial. This is especially important for infants and children with large appetites that are not easily satisfied.

It’s also essential that parents model good eating habits, experts agree. “If you do it, they’ll do it,” David S. Ludwig, an obesity specialist at Children’s Hospital Boston, said. “Young children are like ducklings, they want to do what their mothers do.”

Equally important, Dr. Belsky said, is “allowing children in institutional settings – in day care, preschool and elementary school – to be as active as they choose to be rather than forcing them to sit quietly in chairs most of the day. Being physically active encourages a healthy metabolism. Active children are not constantly hungry.”

He added, “In the face of the obesity epidemic, eliminating the handful of opportunities for kids to be active during the day is a shame. Sedentary behavior becomes a life pattern.”

Another critical issue is the vicious cycle of overweight that starts with future mothers and fathers who are overweight or obese. “If we want healthy kids, we need healthy moms before pregnancy and during pregnancy,” Dr. Belsky said. “There are multiple pathways by which unhealthy levels of weight before and during pregnancy can influence a child’s weight going forward.”

As Dr. Ludwig explained, “Although genes are not modifiable, the weight of the mother before and during pregnancy is. Excessive weight gain during pregnancy predicts not just the baby’s birth weight but also the likelihood of obesity in middle childhood.”

The father’s weight is also turning out to be important, Dr. Ludwig said. “Acquired factors influence gene expression,” he said. “Being heavy alters DNA in the father’s sperm that changes gene expression and can be passed down to the next generation.”

Most, though not all, studies have linked a longer duration of breast-feeding to a reduced risk of overweight in children. Although Dr. Ludwig said that the effect “is not dramatic,” a more important benefit of breast-feeding may be “exposing the baby to a wider range of tastes based on what a mother is eating. If a breast-feeding mom eats a large variety of nutritious foods, the child is more likely to like them.”

Antibiotics given early in life, however, may counter any potential benefits of breast-feeding for weight gain, a new study found. Researchers at the University of Helsinki in Finland reported that when breast-fed infants are treated with antibiotics, the antibiotics kill off health-promoting bacteria that live in the gut. “The protective effects of breast-feeding against infections and overweight were weakened or completely eliminated by early-life antibiotic use,” the team wrote in JAMA Pediatrics last month.

Even if children have already started on a path of poor eating habits and excess weight gain, Dr. Ludwig said it is not too late to make healthful changes. As founder of the Optimal Weight for Life program and author of “Ending the Food Fight: Guide Your Child to a Healthy Weight in a Fast Food/Fake Food World,” he advocates an authoritative, but not an authoritarian, parenting style that eliminates stress and conflict over what and when a child eats.

“Never force food on a child,” he insists. “Stand your ground in a gentle but firm way and be prepared to do a little negotiating. When a child refuses to eat the dinner that’s served, put it away in the fridge to be eaten later. If the child says ‘I’m not going to eat it,’ the response should be, ‘Fine, just go to bed,’ not ‘O.K., I’ll make you mac and cheese.’

“Children should be allowed to control their bodies, but parents have to provide the guidance and control the environment,” Dr. Ludwig said.

This is the second of two columns on childhood obesity. Read the first: “The Urgency in Fighting Childhood Obesity.”

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The Urgency in Fighting Childhood Obesity

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Credit Paul Rogers

Life-threatening ailments like heart disease, cancer, stroke and Type 2 diabetes most often afflict adults. But they are often consequences of childhood obesity.

Two new studies, conducted among more than half a million children in Denmark who were followed for many years, linked a high body mass index in children to an increased risk of developing colon cancer and suffering an early stroke as adults. The studies, presented at the European Obesity Summit in Gothenburg, Sweden, this spring, underscore the importance of preventing and reversing undue weight gain in young children and teenagers.

One study, of more than 257,623 people, by Dr. Britt Wang Jensen and colleagues at the Institute of Preventive Medicine, in Bispebjerg, Denmark, and Frederiksberg Hospital in Copenhagen, grouped children according to standard deviations from a mean B.M.I., adjusted for a child’s age and sex.

They found that each unit of increase in being overweight at age 13, generally corresponding to a two- to three-point increase in B.M.I., increased the risk of developing colon cancer by 9 percent and rectal cancer by 11 percent.

The second study, involving 307,677 Danish people born from 1930 to 1987, used a similar grouping of B.M.I. The risk of developing a clot-related stroke in early adult life increased by 26 percent in women and 21 percent in men for each unit of increase in being overweight at all stages of childhood, but especially at age 13.

Although neither study proves that excess weight in childhood itself, as opposed to being overweight as an adult, is responsible for the higher rates of cancer and stroke, overweight children are much more likely to become overweight adults — unless they adopt and maintain healthier patterns of eating and exercise.

According to the American Academy of Child and Adolescent Psychiatry, obesity most often develops from ages 5 to 6 or during the teen years, and “studies have shown that a child who is obese between the ages of 10 and 13 has an 80 percent chance of becoming an obese adult.”

In a study published in 2014 in The New England Journal of Medicine, Solveig A. Cunningham and colleagues at Emory University found that “overweight 5-year-olds were four times as likely as normal-weight children to become obese by age 14.” The study, which involved a representative sample of 7,738 kindergartners, found that the risk of becoming obese did not differ by socioeconomic status, race or ethnic group, or birth weight. Rather, it showed that excess weight gain early in life is a risk factor for obesity later in childhood across the entire population.

Children are generally considered obese when their B.M.I. is at or above the 95th percentile for others of the same age and sex. Currently, about one-third of American children are overweight or obese. By 2012, the Centers for Disease Control and Prevention reports, 18 percent of children and 21 percent of adolescents were obese.

The adverse effects of excess weight in childhood and adolescence don’t necessarily wait to show up later in life. In a review of complications resulting from youthful obesity, Dr. Stephen R. Daniels, a pediatrician at the University of Colorado School of Medicine and the Children’s Hospital in Denver, found that problems in many organ systems were often apparent long before adulthood. They include high blood pressure; insulin resistance and Type 2 diabetes; high blood levels of heart-damaging triglycerides and low levels of protective high-density lipoprotein (HDL) cholesterol; nonalcoholic fatty liver disease; obstructive sleep apnea; asthma; and excess stress on the musculoskeletal system resulting in abnormal bone development, knee and hip pain, and difficulty walking.

Problems of youthful obesity go beyond physical ones. Obese adolescents have higher rates of depression, which in itself may foster poor eating and exercise patterns that add to their weight problem and result in a poor quality of life that persists into adulthood.

In a study conducted in Singapore, researchers reported that “individuals who were obese in childhood are more likely to have poor body image and low self-esteem and confidence, even more so than those with adult onset obesity.”

Another study by Dr. Jeffrey B. Schwimmer of the University of California, San Diego, and colleagues found that obese children and adolescents reported a diminished quality of life that was comparable to that of children with cancer.

Taken together, the data speak to the critical importance of preventing undue weight gain in young children, a task that depends largely on parents, who are responsible for what and how much children eat and how much physical activity they engage in. As researchers from the University Medical Center Groningen in the Netherlands put it, “Early recognition of overweight or obesity in children by their parents is of utmost importance, allowing interventions to start at a young age.” Yet, they found in a study of the parents of 2,203 5-year-olds, “parents underestimated their overweight child in 85 percent of the cases.”

Though it seems logical that parents who think their children are overweight would make a special effort to assure they would “grow into” their weight as they get older, research has shown the opposite. Such children tend to get even fatter, according to findings from the Longitudinal Study of Australian Children reported in April in the journal Pediatrics by Eric Robinson of the University of Liverpool and Angelina R. Sutin of Florida State University College of Medicine.

Even being labeled overweight can itself be damaging and make it harder for children to avoid bad habits, the authors suggested. A 2014 study of girls aged 10 to 19 found that “regardless of actual weight, adolescents who reported having been labeled ‘too fat’ by a family member or peer were more likely to become obese nearly a decade later.”

“I encourage parents to change the environment at home,” Dr. Daniels of the University of Colorado said in an interview. “Without being authoritarian, they should limit high-calorie-dense foods, keep sugar-sweetened beverages out of the house and assure that kids eat the right amount of fruits and vegetables and fewer calorie-dense snacks. Parents also need to be tuned into opportunities for physical activity and set hard-and-fast rules about television and time spent on electronics.”

Following the “5210” daily program endorsed by the American Academy of Pediatrics can help: Aim for five fruits and vegetables a day; keep recreational screen time to two hours or less; include at least one hour of active play: and skip sugar-sweetened beverages and drink water.

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Fat Dad: The Coffee and Cigarette Diet

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Credit Andrew Scrivani for The New York Times

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The author’s parents, summer-ready.

The author’s parents, summer-ready.Credit

My dad’s face lit up as he placed the engraved linen envelope on the table. We were to be guests at the annual pool party at his boss’s home in East Hampton, N.Y. Not only were we invited for dinner, we were invited to stay for the whole glorious weekend.

Our host was my dad’s boss at the McCann Erickson ad agency, where he was a new creative director. Getting an invitation to his house was more than a polite formality; it was an honor. His family lived on Park Avenue, summered in the Hamptons, and lived by the Emily Post school of etiquette. My family never summered anywhere. We didn’t dress for dinner, we didn’t play golf or tennis, and no one in my family had ever studied Latin or carried a monogrammed bag.

While my dad was flattered, the pressure that accompanied the invitation was huge. His weight had ballooned to almost 400 pounds since landing the job, thanks in part to the decadent three-course client lunches and late-night strategy dinners. In the office, people were focused on my dad’s marketing ideas, but in the Hamptons, my dad said appearances were everything, and there was no hiding behind his creative storyboards and well-thought-out campaigns. He would be presenting my mom, my little sister, April, and me, and showing himself in a more vulnerable setting.

The month leading up to the Hamptons trip was filled with anxiety. My mom and I rushed around shopping for the perfect outfits, and my dad, determined to fit into a bathing suit, starved himself, declaring he was on the “Super Model Diet,” which consisted of hot coffee, cold coffee, coffee shakes, coffee bread, unlimited cigarettes and water.

Even at 10 years old, I knew this was not healthy. I had read the many nutrition and diet books that filled every bookshelf in our house. Each week a new diet, a new promise for miracle results.

“All the actresses and dancers in my commercials swear by this one,” my dad said. “They say substituting a zero-calorie cigarette for lunch helps them stay camera-ready,” he added.

Seeing how worried I was, my dad declared he had never had so much energy, begging my sister and me to try to tag him while he ran up and down the halls of our apartment — not even tempted to take a peek at the diet bread I had just baked for him — adding the required three-quarters of a cup of coffee to my ingredient list.

After successfully losing over 20 pounds on the coffee and cigarette diet in a couple of weeks, my dad headed to Mr. Big & Tall on Eighth Avenue for a couple of items before picking up the Hertz Rent-a-Car. My dad was proud of his new lime-green Bermuda shorts with pictures of palm trees. As we drove to the Hamptons in our beach clothes, my parents argued because my mom, who was in charge of directions, kept navigating us the wrong way. When we finally made it off the highway, my parents became calmer, admiring the quaint churches, old houses and windmills planted on village greens.

Arriving hot and disheveled after our long drive, we were greeted by my father’s boss’s wife, who was wearing a neatly pressed blue Pucci cocktail dress, adorned with a single strand of pearls. Tucking her coiffed blond hair behind her ears, she offered us iced tea with orange slices and led us to the back yard. It was like no pool party I had ever been to, and I wondered if anyone was actually planning to swim.

The tables had crystal candlesticks, and waiters were passing around trays of delicious appetizers that I couldn’t pronounce. Among them were rumaki  — chicken livers wrapped with chestnuts — and soufflés — puffy omelets loaded with cream. There were plates stacked on top of plates and more silverware than I had ever seen. For dinner, we each had our own one-and-a-half-pound lobster with a side of mussels and white sweet corn from the local farm stand. The kids and the grown-ups were served the same food, but we were not seated at the same table. Parents and kids sitting together was a no-no, according to our host’s son, whom I was placed next to.

The boy, who was wearing a jacket and a tie, was only a year older than I was but had the demeanor of a grown man. When I asked, “Aren’t you hot in that stuffy outfit?” he said that the men in their family “always wear a tie and a blazer at dinner each and every night.” He motioned to me to unfold my napkin and place it over my bare legs, dangling above the ground.

I tried to follow his lead as I saw my dad covered in melted butter and lobster juice. He seemed to be enjoying himself immensely, not shy about asking for seconds and thirds of potatoes au gratin as he forfeited the salad and green beans. “I need to leave room for the good stuff,” he exclaimed, loosening his belt buckle, as the table howled in laughter, watching my dad joyfully dash to the dessert table.

“Go for the gusto, Lerman!” my dad’s boss bellowed, pleased that all the guests started chanting my dad’s award-winning slogan for Schlitz beer.

“You Only Go Around Once in Life, So Grab the Gusto,” they yelled out, encouraging my father to load and re-load his plate.

While I knew that the next day my dad would have regrets, and his vicious cycle of yo-yo dieting would begin again, that night I relaxed, savoring every bite of the succulent meat — hoping my first lobster dinner would not be my last.

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Swimsuit-Ready Iced Coffee Shake


Dawn Lerman is a Manhattan-based nutrition expert and the author of “My Fat Dad: A Memoir of Food, Love and Family, With Recipes,” from which this essay is adapted. Her series on growing up with a fat father appears occasionally on Well. Follow her @DawnLerman.

Putting Breast Cancer on a Diet

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Linda Guinee, 60, a survivor of breast cancer, particpated in an earlier trial to see if weight-loss could improve her outcome. She lost 15 pounds and increase her physical activity.

Linda Guinee, 60, a survivor of breast cancer, particpated in an earlier trial to see if weight-loss could improve her outcome. She lost 15 pounds and increase her physical activity.Credit Shiho Fukada for The New York Times

Should weight loss be prescribed as a treatment for breast cancer?

Scientists are recruiting thousands of women for a large clinical trial to find out. The plan is to put heavy women age 18 and older who were recently given diagnoses of breast cancer on diets to see if losing weight will keep their cancer from coming back.

“We have been telling women to do this for years, but we don’t really have definitive proof,” said Dr. Jennifer Ligibel, the principal investigator of the Breast Cancer Weight Loss study, who is a breast oncologist in the Susan F. Smith Center for Women’s Cancers at Dana-Farber Cancer Institute in Boston.

“If it shows that losing weight by increasing physical activity and reducing calories improves survival, weight loss and physical activity could become a standard part of treatment for millions of breast cancer patients around the world,” Dr. Ligibel said.

In a sense, the clinical trial is long overdue. Once a woman is given a breast cancer diagnosis, obesity is associated with a higher risk for recurrence and lower likelihood of survival in women of all ages, Dr. Ligibel said.

Studies showing that obese and overweight women are more likely to die of their breast cancer date back decades. Just two years ago, a meta-analysis crunched the numbers from more than 80 studies involving more than 200,000 women with breast cancer, and reported that women who were obese when diagnosed had a 41 percent greater risk of death, while women who were overweight but whose body mass index was under 30 had a 7 percent greater risk.

But while those studies showed an association between weight and breast cancer mortality, they weren’t designed to find out if weight loss after diagnosis improves survival or reduces the chance of a recurrence.

“Nobody understands biologically why that is,” Dr. Ligibel said, adding that researchers will be collecting blood samples throughout the trial to track metabolic changes that occur with weight loss. Exercise is also part of the program, and participants will work with health coaches. Fitbit is donating all the products that will be used to track their activity and weight.

The researchers will look at markers of inflammation and metabolism, including levels of insulin, insulinlike growth factor and hormones that regulate fat storage.

“There’s a physiology of obesity that happens in everybody, but many of the changes we see in obesity actually are factors that influence the growth of cancer,” said Dr. Pamela Goodwin, one of the study’s investigators and a professor of medicine at Mount Sinai Hospital in Toronto.

These changes include higher insulin and glucose levels, inflammation and an increase in certain proteins, all of which appear to fuel cancer growth, Dr. Goodwin said.

Obesity “makes a great environment for cancer to get a foothold and progress,” said Barbara Gower, a professor of nutrition at the University of Alabama at Birmingham, who is running a small short-term trial to see what happens when women with ovarian cancer remove all sugar and starches from their diet. “The hormonal messages getting through to cancer cells are that it’s a good time to grow, and the nutrition they need is there, too.”

While a drug may target one of the factors, Dr. Ligibel said, weight loss and exercise may be a more powerful intervention because they lead to a combination of changes. “You have something that can potentially change all of them to a metabolically healthy low inflammatory state,” Dr. Ligibel said.

The trial, which will get underway this summer, will cost an estimated $15 million to $20 million. It’s sponsored by the National Cancer Institute and the Alliance for Clinical Trials in Oncology.

Researchers are recruiting 3,200 women from across the United States and Canada who have a recent diagnosis of Stage 2 or Stage 3 breast cancer. Participants must be overweight, with a body mass index of at least 27, and have hormone receptor positive or triple negative tumors. (Women with another type of breast cancer, known as HER2-positive, will not be included because their prognosis does not appear to be associated with weight, researchers said.)

Participants must be 18 but there is no upper age limit, though they must be able to walk “a couple of city blocks and have a life expectancy of at least five years for other causes,” Dr. Ligibel said.

Volunteers will be randomly assigned to either a telephone-based weight loss program or to a control group for comparison. The goal for those in the intervention is to lose 10 percent of their body weight over two years. Participants will continue to be followed for 10 years to see whether their cancer progresses or not.

Weight loss is challenging, and some cancer treatments cause weight gain. But an earlier trial that tested a similar telephone-based weight loss intervention on a smaller scale found that women with breast cancer lost 4 to 5 percent of their body weight, Dr. Goodwin said.

“Breast cancer is a teachable moment,” she added.

The new trial might help doctors identify which patients will benefit most from losing weight, and whether even moderate weight loss is helpful, said Dr. Clifford Hudis, the new chief executive officer of the American Society of Clinical Oncology and former chief of Memorial Sloan Kettering Cancer Center’s breast medicine service, who was involved in the design of the Breast Cancer Weight Loss trial.

“If I tell patients they need to lose 20 pounds, they just roll their eyes and say it’s impossible,” Dr. Hudis said. “But if we could say they only need to lose 3 percent of their body weight, that wouldn’t be so scary. That’s more manageable.”

How Many Calories We Burn When We Sit, Stand or Walk

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There are many compelling reasons to get up out of your desk chair and stand more at work. But weight control is probably not one of them, according to a new study that precisely measured how many calories people burn during everyday office activities.

The new study’s results suggest that engaging frequently in one type of activity while at work may help many of us avoid weight gain. But that activity is not standing up.

Most of us sit more than we should, and a majority of our sitting time occurs at work, since many modern professions are sedentary. Many of us spend six or seven hours tied to our desks each day.

These long, uninterrupted periods of physical lethargy have been linked with increased risks for diabetes, heart disease, premature mortality and, not least, weight gain.

In response, many people, including me, have begun to look for ways to break up our sitting time. We download smartphone apps that chirp and tell us to stand up several times every hour. Health-minded supervisors organize walking meetings, in which employees discuss business while hoofing along hallways. And standing desks have become so popular that the satirical website The Onion has poked fun at users, declaring “Standing at Work Can Increase Coworkers’ Disdain Up to 70 Percent.”

Recent studies indicate that measures that get us off our seats can help us better regulate blood sugar and lessen the risks for diabetes and chronic disease. But more to the point, many of us are rising from our chairs in the hopes that sitting less will help keep our waistlines and nether quarters from spreading.

Surprisingly few studies, however, have closely tracked how many additional calories we burn if we stand up or walk around our offices.

So for the new experiment, which was published this month in the Journal of Physical Activity and Health, researchers affiliated with the Physical Activity and Weight Management Research Center at the University of Pittsburgh rounded up 74 healthy volunteers. Most were in their mid-20s, of normal weight, and with some acquaintance with office life.

These volunteers were randomly assigned to four different groups. One group was asked to sit and type at a computer for 15 minutes and then stand up for 15 minutes, moving around and fidgeting as little as possible.

Another group also sat for 15 minutes, but watched a television screen and didn’t type. Afterward, they immediately moved to a treadmill and walked for 15 minutes at a gentle, strolling pace.

The third group stood up for 15 minutes and then sat down for 15 minutes.

And the final group walked on the treadmills for 15 minutes and then sat.

Throughout, the volunteers wore masks that precisely measured their energy expenditure, which means how many calories they were using.

Unsurprisingly, sitting was not very taxing. The volunteers generally burned about 20 calories during their 15 minutes of sitting, whether they were typing or staring at a television screen.

More unexpected, standing up was barely more demanding. While standing for 15 minutes, the volunteers burned about 2 additional calories compared to when they sat down. It didn’t matter whether they stood up and then sat down or sat down and then stood up. The total caloric expenditure was about the same and was not sizable.

Over all, in fact, the researchers concluded, someone who stood up while working instead of sitting would burn about 8 or 9 extra calories per hour. (Just for comparison, a single cup of coffee with cream and sugar contains around 50 calories.)

But walking was a different matter. When the volunteers walked for 15 minutes, even at a fairly easy pace, they burned about three times as many calories as when they sat or stood. If they walked for an hour, the researchers calculated, they would incinerate about 130 more calories than if they stayed in their chairs or stood up at their desks, an added energy expenditure that might be sufficient, they write, to help people avoid creeping, yearly weight gain.

The upshot of this experiment is that if your goal is to control your weight at work, then “standing up may not be enough,” said Seth Creasy, a graduate student at the University of Pittsburgh and the lead author of the new study.

You probably need to also incorporate walking into your office routine, he said. Maybe “put the printer at the other end of the hallway, or get up to walk to the water fountain every hour or so” instead of keeping a water bottle at your desk.

“Brief periods of walking can add up to make a big difference” in energy expenditure, he said, while standing barely budges your caloric burn.

Of course, standing up almost certainly has other health benefits apart from weight management, Mr. Creasy said, including better blood sugar control and less back and shoulder pain associated with hunching in a chair all day. So don’t dismantle or abandon your stand-up desk just yet. But don’t expect it to counteract that extra cookie with lunch.

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Parents Should Avoid Comments on a Child’s Weight

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Credit Stuart Bradford

Should parents talk to an overweight child about weight? Or should they just keep their mouths shut?

Parents in this situation are understandably torn. Say something, and they risk shaming a child or worse, triggering an eating disorder. Say nothing, and they worry they’re missing an opportunity to help their child with what could become a serious long-term health problem.

Now a new study offers some guidance: Don’t make comments about a child’s weight.

The study, published in the journal Eating & Weight Disorders, is one of many finding that parents’ careless — though usually well-meaning — comments about a child’s weight are often predictors of unhealthy dieting behaviors, binge eating and other eating disorders, and may inadvertently reinforce negative stereotypes about weight that children internalize. A parent’s comments on a daughter’s weight can have repercussions for years afterward, contributing to a young woman’s chronic dissatisfaction with her body – even if she is not overweight.

“Parents who have a child who’s identified as having obesity may be worried, but the way those concerns are discussed and communicated can be really damaging,” said Rebecca Puhl, deputy director of the Rudd Center for Food Policy and Obesity at the University of Connecticut. “The longitudinal research shows it can have a lasting impact.”

The impact on girls may be especially destructive, she said, because “girls are exposed to so many messages about thinness and body weight, and oftentimes women’s value is closely linked to their appearance. If parents don’t challenge those messages, they can be internalized.”

The new study included over 500 women in their 20s and early 30s who were asked questions about their body image and also asked to recall how often their parents commented about their weight. Whether the young women were overweight or not, those who recalled parents’ comments were much more likely to think they needed to lose 10 or 20 pounds, even when they weren’t overweight.

The study’s lead author, Dr. Brian Wansink, a professor and the director of Cornell University’s Food and Brand Lab, characterized the parents’ critical comments as having a “scarring influence.”

“We asked the women to recall how frequently parents commented, but the telling thing was that if they recalled it happening at all, it had as bad an influence as if it happened all the time,” said Dr. Wansink, author of the book “Slim by Design.” “A few comments were the same as commenting all the time. It seems to make a profound impression.”

Some studies have actually linked parents’ critical comments to an increased risk of obesity. One large government-funded study that followed thousands of 10-year-old girls found that, at the start of the study, nearly 60 percent of the girls said someone — a parent, sibling, teacher or peer – had told them they were “too fat.” By age 19, those who had been labeled “too fat” were more likely to be obese, regardless of whether they were heavy at age 10 or not.

Comments made by family members had even stronger effects than comments made by unrelated people.

Several studies have found that when parents encourage overweight teenagers to diet, the teenagers are at higher risk of lower self-esteem and depression and of being overweight five years later.

Research by Dianne Neumark-Sztainer, a professor at the University of Minnesota, found that when parents talked to their teens about losing weight, teenagers were more likely to diet, use unhealthy weight-control behaviors and binge eat. Those behaviors are less likely to develop when conversations with parents focused on healthy eating behaviors, rather than weight per se.

Harsh comments about weight can send the message that parents are “tying weight to some kind of perception about how the child is valued,” Dr. Puhl said, and that can trigger negative feelings. “The children are internalizing that, and thinking they’re not O.K. as a person. And that is what’s leading to other outcomes, like disordered eating.”

So what’s a parent to do? Do they just stand by while their child gains weight?

Dr. Neumark-Sztainer was besieged by parents asking her this question, and wondering, “How do I prevent them from getting overweight and still feel good about themselves?”

In her book, called “I’m, Like, SO Fat: Helping Your Teen Make Health Choices About Eating and Exercise in a Weight-Obsessed World,” she notes that parents can influence a child’s eating habits without talking about them. “I try to promote the idea of talking less and doing more — doing more to make your home a place where it’s easy to make healthy eating and physical activity choices, and talking less about weight.”

For parents, that means keeping healthy food in the house and not buying soda. It means sitting down to enjoy family dinners together, and also setting an example by being physically active and rallying the family to go for walks or bike rides together. Modeling also means not carping about your own weight. “Those actions speak louder than words,” Dr. Puhl said.

While your children are young, “there doesn’t need to be a conversation at all – it really is just about what’s being done at home,” Dr. Neumark-Sztainer said.

If an older child is overweight, “wait for your child to bring it up, and be there to support them when they do,” she said. “Say, ‘Look, I love you no matter what size you are, but if you would like, I will support you. I suggest we focus not so much on your weight but on your eating patterns and behaviors. What would be helpful for you?’”

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Walkable Neighborhoods Cut Obesity and Diabetes Rates

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Credit Bryan Anselm for The New York Times

Neighborhoods designed for walking may decrease the rates of being overweight or obese and having diabetes by more than 10 percent, a new study concludes.

Canadian researchers studied more than three million people in 8,777 neighborhoods in urbanized areas of Ontario, ranking them for “walkability” on a 100-point scale that measures population density, numbers of facilities within walking distance of residences and how well connected their webs of streets are.

The study, published in JAMA, adjusted for age, sex, income and other factors, and found that the prevalence of being overweight and obese was more than 10 percent lower in the one-fifth of neighborhoods rated highest for walkability than in the one-fifth rated lowest. Over the 12-year study period, being obese and overweight increased by as much as 9.2 percent in the three-fifths of neighborhoods rated lowest, with no change in the two-fifths rated highest.

The incidence of diabetes was also lowest in the most walkable neighborhoods, a difference that persisted throughout the study.

The authors acknowledge that this was not a randomized trial and does not prove causation. Still, the senior author, Dr. Gillian L. Booth, a physician at St. Michael’s Hospital in Toronto, said that the healthiest neighborhoods seem to be those where cars are not a necessity.

“Walking, cycling and public transit rates were much higher in walkable neighborhoods,” she said, “and that leads to better health outcomes.”

Diet Soda in Pregnancy Is Linked to Overweight Babies

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Drinking diet soda and other artificially sweetened beverages during pregnancy is associated with having overweight 1-year-olds, according to a new report.

Canadian researchers studied 3,003 mothers who delivered healthy singletons between 2009 and 2012 and had completed diet questionnaires during their pregnancies. They then examined the babies when they were a year old. Almost 30 percent of the women drank artificially sweetened beverages during pregnancy.

After controlling for maternal body mass index, age, breastfeeding duration, maternal smoking, maternal diabetes, timing of the introduction of solid foods and other factors, they found that compared with women who drank no diet beverages, those who drank, on average, one can of diet soda a day doubled the risk of having an overweight 1-year-old.

The study, in JAMA Pediatrics, found no association with infant birth weight, suggesting that the effect is on postnatal, not fetal, growth. The mother’s consumption of sugar-sweetened drinks was not associated with increased risk for overweight babies.

“This is an association, and not a causal link,” said the lead author, Meghan B. Azad, an assistant professor at the University of Manitoba. “But it certainly raises the question of whether artificial sweeteners are harmless. It’s not time to ban them or tell everyone not to consume them, but there’s no great benefit to consuming these drinks, so there’s no harm in avoiding them.”

Heavier People Don’t Die Young

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Being “overweight” may not be as bad for you as you thought.

People who have a body mass index of 27 — overweight by current guidelines — have the lowest risk of dying early from any cause, according to a new report. That B.M.I. number is higher than in earlier decades.

Danish researchers used data from three time periods: 1976-78, 1991-94 and 2003-13, to calculate B.M.I. and mortality in more than 120,000 people.

In the earliest group, mortality was lowest among those with a B.M.I. of 23.7, within the normal range. In the 1991-94 group, the lowest mortality was in those with a B.M.I. of 24.6, the high end of normal. But in the 2003-13 cohort, a B.M.I. of 27, well into the overweight range by current standards, was associated with the lowest all-cause mortality. The study was published in JAMA.

“The data are straightforward,” said the senior author, Dr. Borge G. Nordestgaard, a clinical professor at the University of Copenhagen. “Thinking about why is more complicated. It may be that we’ve become better at treating cardiovascular risk factors. But I have no data to support this belief.”

In any case, this does not mean that a person of normal weight should aim to gain weight. “If you’re at 27, then maybe you don’t have to worry as much as you did,” Dr. Nordestgaard said. “But that doesn’t mean ‘now I can eat as much as I want.’”

Can High-Intensity Exercise Help Me Lose Weight? And Other Questions, Answered

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I recently wrote about a study showing that one minute of intense interval training, tucked into a workout that was, in total, 10 minutes long, produced comparable health and fitness benefits to 45 minutes of more moderate, uninterrupted endurance training.

Readers posted almost 400 comments to the article and flooded the Internet and my inbox with questions and sentiments about extremely short workouts. Given the extent of the response and the astuteness of the questions, I thought I would address some of the issues that arose over and over.

Q. Are high-intensity interval workouts actually better for you than longer, endurance-style workouts — or just shorter?

A. Better is such a subjective word. At the moment, the two types of workouts appear to be largely equivalent to each other in terms of a wide variety of health and fitness benefits.

In the study that I wrote about, “1 Minute of All-Out Exercise May Equal 45 Minutes of Moderate Exertion,” for instance, three months of high-intensity interval training practiced three times per week led to approximately the same improvements in aerobic endurance, insulin resistance and muscular health as far longer sessions of moderate pedaling on a stationary bicycle.

One type of workout was not more beneficial than the other, in other words, but one required much, much less time.

Other studies have generally produced similar results, although, to be honest, the science related to interval training for health purposes and not simply for athletic performance remains scant. An interesting new review of past research to be published in June did conclude that, for overweight and obese children, short sessions of intense intervals may lead to greater improvements in endurance and blood pressure than longer bouts of moderate exercise, although the authors did not discuss how best to get children to complete frequent interval sessions.

The upshot of the available science is that if you currently have the time and inclination to complete long-ish, moderate workouts — if you enjoy running, cycling, swimming, walking or rowing for 30 minutes or more, for instance — by all means, continue.

If, on the other hand, you frequently skip workouts because you feel that you do not have enough time to exercise, then very brief, high-intensity intervals may be ideal for you. They can robustly improve health and fitness without overcrowding schedules.

Q.

What about combining brief high-intensity workouts with longer, endurance workouts?

A.

Alternating high-intensity workouts with endurance-style workouts may yield the greatest health and fitness gains of all.

In a 2014 study, a group of sedentary adults began either a standard endurance-training program, in which they pedaled a bicycle moderately for 30 minutes five times a week, or swapped one of those bike rides for an interval session. All of the participants wound up significantly more aerobically fit after 12 weeks.

But the men and women who had completed one interval session per week had developed slightly more overall endurance than the other volunteers. As a result, they had lowered their risk for premature death by about an additional 18 percent, the study’s authors conclude.

Q.

Do I have to use a stationary bicycle for interval training?

A.

Most recent studies of high-intensity intervals have involved computerized stationary bicycles because scientists can easily monitor the riders’ pace and intensity. But there is nothing magical about the equipment. The key to high-intensity interval training is the intensity, which most of us can gauge either with a heart rate monitor or our own honest judgment.

For moderate exercise, your heart rate typically should be between 70 and 85 percent of your maximum. (I recently wrote about how to determine your individual maximum heart rate.) This intensity would feel like about an 8 on an arduousness scale of 1 to 10.

During an intense interval, however, your heart rate should rise to 90 percent of your maximum heart rate, or above. Think of this as feeling like about a 9.5 on the 10-point scale. You maintain that intensity for only 10 or 20 seconds at a time, however, followed by several minutes of very easy exercise before repeating the intense work.

Almost any type of exercise can be used for interval training, including running up the stairs in your office’s stairwell during your lunch hour, said Martin Gibala, a professor of kinesiology at McMaster University in Hamilton, Ontario, and an expert on intervals. (His book about the science and practical implications of high-intensity interval training will be published in early 2017.)

Q.

Will high-intensity intervals help me to lose weight?

A.

Few studies have yet looked at the long-term effects on body weight of exercising exclusively with high-intensity intervals, although some experiments do hint that high-intensity interval training can reduce body fat, at least in the short term.

In a 2015 study, for example, overweight, out-of-shape men who began either to jog or otherwise exercise moderately for an hour five days per week for six weeks or to complete intensive interval training for a few minutes per week all dropped body fat and about the same percentages of fat, despite very different amounts of exercise. Likewise, a group of women recovering from breast cancer who were assigned either to moderate exercise or brief interval training for three weeks lost comparable amounts of body fat during the study.

But these were small-scale, brief experiments. Whether interval training helps or hinders long-term weight control is still unknown.

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To Keep Obesity at Bay, Exercise May Trump Diet

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Young rats prone to obesity are much less likely to fulfill that unhappy destiny if they run during adolescence than if they do not, according to a provocative new animal study of exercise and weight. They also were metabolically healthier, and had different gut microbes, than rats that keep the weight off by cutting back on food, the study found. The experiment was done in rodents, not people, but it does raise interesting questions about just what role exercise may play in keeping obesity at bay.

For some time, many scientists, dieting gurus and I have been pointing out that exercise by itself tends to be ineffective for weight loss. Study after study has found that if overweight people start working out but do not also reduce their caloric intake, they shed little if any poundage and may gain weight.

The problem, most scientists agree, is that exercise increases appetite, especially in people who are overweight, and also can cause compensatory inactivity, meaning that people move less over all on days when they exercise. Consequently, they wind up burning fewer daily calories, while also eating more. You do the math.

But those discouraging studies involved weight loss. There has been much less examination of whether exercise might help to prevent weight gain in the first place and, if it does, how it compares to calorie restriction for that purpose.

So for the new study, which was published last week in Medicine & Science in Sports & Exercise, researchers at the University of Missouri in Columbia and other schools first gathered rats from a strain that has an inborn tendency to become obese, starting in adolescence. (Adolescence is also when many young people begin to add weight.)

These rats were young enough, though, that they were not yet overweight.

After weighing them, the researchers divided the animals into three groups.

One group was allowed to eat as much kibble as they wished and to remain sedentary in their cages. These were the controls.

Another group, the exercise group, also was able to eat at will, but these animals were provided with running wheels in their cages. Rats like to run, and the animals willingly hopped on the wheels, exercising every day.

The final group, the dieting group, was put on a calorie-restricted meal plan. Their daily kibble helpings were about 20 percent smaller than the amount that the runners ate, a portion size designed to keep them at about the same weight as the runners, so that extreme differences in body size would not affect the final results.

After 11 weeks, all of the animals were moved to specialized cages that could measure their metabolisms and how much they moved around. They then returned to their assigned cages for several more weeks, by which time they were effectively middle-aged.

At that point, the control animals were obese, their physiques larded with fat.

The runners and the lower-calorie groups, however, although they also had gained ounces, had put on far less weight than the controls. None were obese.

Both exercise and portion control, in other words, had effectively protected the animals against their fated fatness.

But beneath the skin, the runners and the dieters looked very unalike. By almost all measures, the runners were metabolically healthier, with better insulin sensitivity and lower levels of bad cholesterol than the dieters. They also burned more fat each day for fuel, according to their metabolic readings, and had more cellular markers related to metabolic activity within their brown fat than the dieting group. Brown fat, unlike the white variety, can be quite metabolically active, helping the body to burn additional calories.

Interestingly, the runners also had developed different gut microbes than the dieters, even though they ate the same food. The runners had greater percentages of some bacteria and smaller populations of others than the dieters or the control group; these particular proportions of gut bugs have been associated in a few previous studies with long-term leanness in both animals and people.

Perhaps most striking, “the runners showed no signs of compensatory eating or compensatory inactivity,” said Victoria Vieira-Potter, an assistant professor of nutrition and exercise physiology at the University of Missouri who oversaw the study. They didn’t scarf down more food than the control group, despite running several miles every day and, according to the specialized cages, actually moved around more when not exercising than either of the other groups of rats.

In essence, the runners, while weighing the same as the dieters at the end of the study, seemed better set up to avoid weight gain in the future.

Of course, these were rats, which do not share our human biology or our tangled psychological relationships with food and body fat.

This study also involved young, normal-weight rodents and cannot tell us whether exercise or dieting alone or in combination would aid or hinder weight loss in people (or animals) who already are overweight, Dr. Vieira-Potter said. Metabolisms change once a body contains large amounts of fat, and it becomes increasingly difficult to permanently drop those extra pounds.

So better to avoid weight gain in the first place, if possible. And in that context, she said, “restricting calories can be effective,” but exercise is likely to be more potent in the long term and, of course, as common sense would tell us, doing both—watching what you eat and exercising—is best of all.

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For a New Mom, Relentless Fatigue Could Signal a Thyroid Problem

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Credit Stuart Bradford

For six weeks after delivering my son, I had postpartum thyroiditis. Every afternoon around the same time, I would shake uncontrollably. Anxiety about night feedings and colic (which my son didn’t have) plagued my thoughts all evening. One night while my husband put our son, Jackson, to sleep, my sister put me to sleep. We watched “Romancing the Stone” and she rubbed my back until I drifted off — as if I were the baby.

Moreover, I lost all the baby weight within weeks. At my two-week checkup with my obstetrician, I had lost over 25 pounds. I left that appointment proud, feeling like I could be on the cover of Us Weekly. It must be the breast-feeding, pumping and healthy eating. But I was kidding myself. I breast-fed for all of three days. Sure, I pumped a few bottles, but Jackson got mostly formula. And I wasn’t eating healthfully. I was eating takeout.

About two months after Jackson’s birth, my thyroid burnt out. I didn’t know it at the time, but I later learned that mild hyperthyroidism had given way to Hashimoto’s disease, a potentially more serious, and chronic, thyroid condition in which the thyroid becomes underactive. Over the next few months, I gained about 30 pounds and became extremely lethargic. When I woke each morning, my first thought was: When can I take a nap today?

My body was just transitioning, I thought. And I had a baby now. Most new moms were tired, right? Still I sensed that something intense was happening: I was a different person.

My husband and I had some traumatic fights during those months. I feared that our marriage, the very foundation for loving this new child, was falling apart. He said things like “you’ve changed and “I can’t live like this anymore.” And the truth was that we really couldn’t live like this anymore.

To make matters worse, I felt that my internist largely dismissed my concerns. He ran my blood work for virtually everything except my thyroid hormone level. We spent the follow-up appointment discussing my elevated cholesterol (also a symptom of hypothyroidism). He offered me Xanax and suggested I talk to a therapist about postpartum depression. Even most friends and family members chalked up these physical changes to the stresses of being a new mom.

Finally, when Jackson was 6 months old, I saw my O.B. again. She, too, bet on postpartum depression but ran thyroid tests to rule it out. I vividly remember when the doctor called with the results, “I’m surprised you can get out of bed in the morning, much less work full-time and take care of a baby.” When I hung up, I wept. I wasn’t losing my mind. I wasn’t just having a hard time adjusting. My thyroid, this little butterfly-shaped gland in my throat that I last worried about in high school biology, was having a hard time keeping my body up and running.

The synthetic thyroid hormone Synthroid helped with losing weight and energy levels. And ever since, I’ve had routine blood work and sonograms to monitor my hormone levels and the small lumps on my thyroid. During my second pregnancy, I saw an endocrinologist and had blood taken every month. My endocrinologist told me that it was important that I have my medication adjusted every month during the pregnancy since the thyroid helps the body stay pregnant.

I was surprised to find that several of my women friends also turned out to have thyroid problems. They tell the same story about discovering their condition either later in life or surrounding a pregnancy. Toni had three miscarriages in one year because of a mismanaged thyroid. Lisa was diagnosed accidentally at 41 when she saw a doctor for a double ear infection and bronchitis. “He felt my neck and noticed that my thyroid was quite enlarged,” she writes.

All the women had weight troubles. Eat less carbs. Exercise more. Take the baby out for walks. You’re getting older so it’s harder. That was the advice I got, along with speeches about the American diet of processed foods and sedentary lifestyle. But I’ve never been sedentary, and becoming a mother certainly didn’t have me sitting on the couch eating potato chips. My friend Jen remembers being patronized at her doctor’s office. “I was literally patted on the leg and told it’s just going to be hard for you to lose weight, dear,” she said. Her endocrinologist prescribed her a medication for diabetes and told her to eat 1,100 calories a day.

My takeaway from those six months is this: Even amid the huge life change that is motherhood, I knew something was really wrong with my body. And if I had put my health first, I would’ve figured it out much faster and with much less heartache. But prioritizing yourself isn’t something many new moms do very well.

Of course the early weeks with a newborn are exhausting for all parents, but if you don’t start to feel normal once the baby’s sleep schedule stabilizes, it’s worth getting your thyroid checked. A simple blood test can make all the difference.

Kristin Sample is a writer, teacher and dancer. Her novel “North Shore South Shore” is available on Kindle. Follow her on Twitter and Instagram @kristinsample or check out her blog, kristinsample.com.

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