Americans Underestimate Weight Gain

Even though the average adult weight rose in 2008-2009, most surveyed thought they'd dropped pounds

If you've ever stepped on the scales and been shocked at the number you see, then you're not alone: a large new study finds that Americans routinely underestimate the amount of extra pounds they pack on.

The finding could have real implications for the U.S. obesity epidemic, the researchers said.

The study's lead author, Catherine Wetmore, said in an institute news release. "If people aren't in touch with their weight and changes in their weight over time, they might not be motivated to lose weight." The study was based on national survey data involving 775,000 American adults from 2008 and 2009.

Wetmore's team notes that many adults thought they had actually lost weight when they hadn't. That's important to note, Wetmore said, because data that underestimate the growing obesity epidemic could have serious public health consequences.

For example, she said, "If we had relied on the reported data about weight change between 2008 and 2009, we would have undercounted approximately 4.4 million obese adults in the U.S."

Karen Congro, nutritionist and director of the Wellness for Life Program at the Brooklyn Hospital Center, New York City said, "I see this in the clinic every single day; people think they are a certain weight, and they are totally wrong. There is a disconnect between perception and reality when it comes to weight." "When it comes to weight, there is a lot of magical thinking going on."

In the surveys used in the study, participants were asked about their weight at the time of the survey, as well as how much they weighed one year ago.

The researchers report that, on average, American adults gained weight in 2008. However, even though the average reported weights rose between the two surveys, Americans polled typically thought they had lost weight in the past year.

Since the prevalence of obesity actually increased slightly between 2008 and 2009 (from 26 to 26.5 percent) and the average weight increased by about 1 pound, the researchers concluded that those surveyed were unclear about the change in their weight over the course of the year.

"We all know on some level that people can be dishonest about their weight," IHME professor Ali Mokdad said in the news release. "But now we know that they can be misreporting annual changes in their weight, to the extent of more than 2 pounds per year among adults over the age of 50, or more than 4 pounds per year among those with diabetes. On average, American adults were off by about a pound, which, over time, can really add up and have a significant health impact."

The researchers noted that women seemed more aware of fluctuations in their weight than men. Younger people were also better at judging fluctuations in their weight compared to older Americans.

The study's authors pointed out that not all participants thought they lost weight. They added that certain groups were more likely to report unintentional weight gain, including people under 40 years of age, smokers, minorities, and people with sedentary lifestyles and/or less-than-ideal diets.

American Diabetes Association's New Clinical Practice Recommendations Promote A1c as Diagnostic Test for Diabetes and Pre-Diabetes

Faster, easier test could help reduce number of undiagnosed with diabetes and pre-diabetes.

The American Diabetes Association's (ADA) new Clinical Practice Recommendations being published as a supplement to the January issue of Diabetes Care call for the addition of the A1c test as a means of diagnosing diabetes and identifying pre-diabetes. The test has been recommended for years as a measure of how well people are doing to keep their blood glucose levels under control.

"We believe that use of the A1c, because it doesn't require fasting, will encourage more people to get tested for Type 2 diabetes and help further reduce the number of people who are undiagnosed but living with this chronic and potentially life-threatening disease. Additionally, early detection can make an enormous difference in a person's quality of life," said Richard M. Bergenstal, MD, President-Elect, Medicine & Science, ADA.

"Unlike many chronic diseases, Type 2 diabetes actually can be prevented, as long as lifestyle changes are made while blood glucose levels are still in the pre-diabetes range."

A1c is measured in terms of percentages. The test measures a person's average blood glucose levels over a period of up to three months and previously had been used only to determine how well people were maintaining control of their diabetes over time. A person without diabetes would have an A1c of about 5 percent.

Under the new recommendations, which are revised every year to reflect the most current available scientific research, an A1c of 5.7 -- 6.4 percent would indicate that blood glucose levels were in the pre-diabetic range, meaning higher than normal but not yet high enough for a diagnosis of diabetes. That diagnosis would occur once levels rose to an A1c of 6.5 percent or higher.

The ADA recommends that most people with diabetes maintain a goal of keeping A1c levels at or below 7 percent in order to properly manage their disease. Research shows that controlling blood glucose levels helps to prevent serious diabetes-related complications, such as kidney disease, nerve damage and problems with the eyes and gums.

The A1c would join two previous diagnostic tests for diabetes, Fasting Plasma Glucose (FPG) and the Oral Glucose Tolerance Test (OGTT), both of which require overnight fasting. Because the A1c is a simple blood test and does not require fasting, allowing patients this option could increase willingness to get tested, thereby reducing the number of people who have Type 2 diabetes but don't yet know it.

According to the Centers for Disease Control and Prevention, one-fourth of all Americans with diabetes, or 5.7 million people, don't realize they have it. Another 57 million have pre-diabetes and 1.6 million new diagnoses are made every year.

Easy Steps to Reduce Diabetes Risk

From walking more to getting your blood sugar checked, you can reduce your chances of getting diabetes by following just a few easy steps.

Being overweight, not getting enough physical activity, and constantly being stressed out are all strong risk factors for type 2 diabetes. These are problems that many people face, but the good news is that you can make a few simple changes to your life to create a diabetes prevention program and reduce your diabetes risk.
Think diabetes prevention at the start of every day. “Eat a breakfast of protein and complex carbohydrates,” says Suzanne Steinbaum, DO, a cardiologist and director of Women and Heart Disease at Lenox Hill Hospital in New York City. “Eating a meal like this prevents the sugar highs and lows that often come with a breakfast of simple carbohydrates and sugars, like a bagel or a donut, which can cause those feelings of fatigue and lethargy that make you crave sugar again to increase your energy.”

Fred Pescatore, MD, an author and physician who practices nutritional medicine in New York City, says one of your best overall strategies for diabetes prevention is to steer clear of most foods that are white — white bread, white rice, and white pasta top the list. “These simple carbohydrates can cause blood sugar to spike even more than regular sugar,” he says. “This may lead to a blood sugar dip, resulting in additional sugar cravings. Avoiding white foods will help to stop this vicious cycle.”

One of the biggest causes of diabetes in this country is overeating that leads to obesity. A basic strategy for avoiding overeating is to reduce your portions by using smaller dishes than you usually would for all your meals, according to Dr. Steinbaum. “Rather than worrying about servings, pay attention to cups and tablespoons,” she says. “To help with this, instead of using a large dinner plate, use a salad plate for dinner.”

Most people think it’s okay to drink soda as long as they stick to diet soda instead of the regular sugary kind. But Steinbaum cautions that water might be the better choice for diabetes prevention. “Studies have shown that even diet soda can increase the incidence of metabolic syndrome, a pre-diabetic condition associated with insulin resistance,” she says.

A basic lifestyle strategy to assist with diabetes prevention is to keep a detailed food journal. You can use paper or a Web site or mobile phone application like My Calorie Counter, but whatever you choose, don’t spare any details. “If you write down everything you eat, you are less apt to overeat or to unconsciously pick at food or ‘graze,’” says Steinbaum. “It also lets you look back at what you’ve eaten, so you can more easily modify your behavior.”

Some people get frustrated by constantly monitoring a scale while trying to lose weight. Steven Joyal, MD, author of What Your Doctor May Not Tell You About Diabetes, says that measuring your waistline might be a better way to foster diabetes prevention. “Greater than 40 inches for men or greater than 35 inches for women means you’re at an increased risk,” he says.

Remember that inactivity is a diabetes cause and activity is a key to diabetes prevention. When it comes to exercise, some people use time constraints or other commitments as excuses not to work out. If you think that not doing a long workout means you shouldn’t bother at all, Dr. Joyal respectfully begs to differ. “A power-packed, yet short-duration exercise program of 12 minutes every other day can have a tremendous impact on your body,” he says.

Another simple way to fit more diabetes prevention strategies into your everyday, daily routine is to find ways to add more activity to everything you do. For example, when you pull into a parking lot, Dr. Pescatore suggests parking as far away from your destination as possible and walking the rest of the way. “Walking burns calories, builds muscle, and utilizes blood sugar,” he says. Other steps include taking the stairs instead of the elevator and doing sit-ups, push-ups, or even stretches while watching TV.

Stress is a risk factor for type 2 diabetes. So while focusing on eating less and exercising more, it’s important not to overlook stress reduction. “Take a yoga class, try meditation, and set boundaries around family and friends,” says Robyn Webb, MS, food editor of Diabetes Forecast magazine and author of 13 cookbooks published by the American Diabetes Association. “Seek professional therapy for issues in your life that you feel you need help with.”

Finally, if you have a family history of diabetes or are at risk, you should get your blood checked once a year to truly know your status. Pescatore says the two most important tests your doctor should perform are checking your hemoglobin A1C levels and your fasting insulin levels. If you commit to making all the previous suggestions, your efforts should show in your lab results.

Insulin and Weight Gain?

Q: I take insulin and it's very hard for me to lose weight. I've read that this can happen — that insulin can contribute to weight gain. What can I do? I try to watch what I eat and have recently joined a fitness club, but I haven't had much success yet. Any advice?

— Susan

A:Insulin can, in fact, lead to weight gain. Here's how it works:
Insulin is a potent hormone that regulates glucose, fat, and protein metabolism. In many cases, people with type 2 diabetes start insulin therapy when oral medicines cannot or no longer control their glucose levels. This means that blood glucose levels in the body have been elevated for an extended period of time. In this state, the body does not metabolize glucose, fat, or protein in a well-regulated or efficient way. Cells that require glucose to function properly begin starving because of inadequate amounts of circulating insulin. Fat metabolism becomes abnormal, which can lead to high triglyceride levels. The body's metabolic rate then increases as it tries to convert this fat into a source of energy.

These abnormalities are usually corrected when you begin insulin therapy. The body begins using glucose better, and the metabolic rate declines by about five percent. Insulin also helps the body gain fat-free mass, but on the flip side, it also helps it store fat more efficiently. Therefore, efficient glucose and fat metabolism and the reduction in metabolic rate cause most people to gain four to six pounds during the first two to three years of insulin therapy. Individuals who had poor glucose control, or who lost significant amounts of weight before beginning insulin treatment, usually experience the most weight gain.

Losing weight in general requires persistent attention to energy balance — that is, the number of calories you take in versus the number you burn. During insulin therapy, the body does not need as much food to get the energy it requires, so reducing your caloric intake is quite important. This should be accompanied by an exercise regimen, as you have begun, to expend at least 200 to 300 calories a day.

In addition, you should consult with your doctor to consider other kinds of diabetes treatments that could mitigate the weight gain. These include metformin, an oral medication that prevents weight gain; an insulin analogue called detemir, which has been shown to cause less weight gain than NPH insulin; and exenatide, an antidiabetes injection that can lead to weight loss.

Whole-Fat Milk and Cheese Can Lower Diabetes Risk

The incidence of Type 2 diabetes declined significantly as levels of a fatty acid found in whole-fat dairy products increased....

Adults with the highest levels of trans-palmitoleic acid had a 60% lower diabetes incidence compared with individuals who had the lowest levels. Higher levels of the fatty acid also were associated with a more favorable metabolic profile.

Multivariate analyses of demographic, clinical, and lifestyle factors showed that whole-fat dairy consumption had the strongest association with levels of trans-palmitoleate. However, the authors remained circumspect about the association.

Dariush Mozaffarian, MD, DrPH, of the Harvard School of Public Health, and coauthors wrote in conclusion that, "Our results demonstrate an inverse relationship between levels of trans-palmitoleate and metabolic risk factors and diabetes incidence."

"The small differences in trans-palmitoleate levels raise questions about whether this is the active compound or a marker for some other, unknown protective constituent of dairy or other ruminant foods."

The findings support previous evidence of favorable associations between whole-fat dairy consumption and metabolic factors. The authors speculated that trans-palmitoleate could exert effects on pathways related to insulin resistance, dyslipidemia, and hepatic fat synthesis.

A product of endogenous fat synthesis, circulating palmitoleic acid has been associated with protection against insulin resistance and metabolic dysregulation in experimental models. Studies in humans, however, have yielded mixed results, the authors wrote in the introduction to their findings.

Efforts to study circulating palmitoleic acid have been confounded by the effects of endogenous synthesis and metabolism. The trans isomer of palmitoleate represents an endogenous source of the fatty acid and avoids confounding endogenous effects. Derived primarily from naturally occurring dairy and other ruminant trans fats, trans-palmitoleate is not associated with increased cardiovascular risk, in contrast to trans fats derived from partially hydrogenated oils.

"In fact, several studies have demonstrated inverse associations between dairy consumption and risk for insulin resistance, the metabolic syndrome, or diabetes," the authors continued. "To our knowledge, no previous studies have evaluated a potential role of trans-palmitoleate in metabolic risk."

The patient cohort of the Cardiovascular Health Study provided an opportunity to examine associations between trans-palmitoleate, metabolic risk factors, and risk of Type 2 diabetes. Mozaffarian and coauthors analyzed data on 3,736 study participants, all of whom were 65 or older and were identified from Medicare eligibility lists.

Baseline assessments included physical examination, diagnostic testing, questionnaires about health status, and laboratory evaluation that included measurement of 45 different fatty acids. Study participants were followed for 10 years, including annual clinic visits and interim telephone calls.

Laboratory results showed that trans-palmitoleate accounted for an average of 0.18% of total fatty acid. Levels had a strong correlation with known biomarkers of dairy-fat consumption but a weak correlation with biomarkers of partially hydrogenated oils.

Whole-fat dairy consumption had the strongest association with trans-palmitoleate levels. Separate analyses of different types of dairy foods further refined the association by showing that levels of the fatty acid were most closely associated with whole-milk consumption. Levels of trans-palmitoleate were not significantly related to consumption of carbohydrates, protein, red meat, or low-fat dairy foods.

In multivariate analyses, higher trans-palmitoleate levels were significantly associated with:

Lower body mass index (-1.8%, P=0.058)
Smaller waist circumference (-1.8%, P=0.009)
Higher levels of HDL cholesterol (1.9%, P=0.043)
Lower triglyceride levels (-19.0%, P<0.001)
Lower total cholesterol:HDL ratio (-4.7%, P<0.001)
Lower levels of C-reactive protein (-13.8%, P=0.050)
Lower fasting insulin levels (-13.3%, P=0.001)
Less insulin resistance by homeostasis model (-16.7%, P<0.001)
During follow-up, 304 study participants developed new-onset diabetes. In adjusted analyses, comparison of trans-palmitoleate quintiles showed that participants in quintiles 4 and 5 had diabetes hazard ratios of 0.44 and 0.36, respectively, compared with quintile 1 (P<0.001 for trend).

"Each higher standard deviation of trans-palmitoleate was associated with a 28% lower risk of diabetes," the authors wrote.

Acknowledging limitations of the study, Mozaffarian and colleagues noted that trans-palmitoleate levels were measured at a single point in time and that food intake was based on self-reports. They also pointed out that causality cannot be determined due to the possibility of residual confounding and that "the small differences in trans palmitoleate levels raise questions about whether this is the active compound or a marker for some other, unknown protective constituent of dairy or other ruminant foods."

Can Diabetes Be Cured?

Q: I'm 47 years old and was recently diagnosed with diabetes. I'm about 25 pounds overweight and lead a sedentary lifestyle, but I'm starting a diet and an exercise program. Will my diabetes go away if I lose weight, watch my diet, and exercise regularly?

— Mary, Kansas City


A: It is wonderful that you are changing your lifestyle to become healthier! This will benefit you greatly, not only in controlling your blood sugar but also in improving your cholesterol levels, strengthening your bones, and improving your heart function. These changes come with a long list of health benefits, but whether they will allow you to stop taking medicines completely depends on several factors:

The primary cause of your diabetes

The length of time that you had undiscovered, or "hidden," diabetes

The length of time you've had diagnosed diabetes

How well your pancreas is functioning, including how much insulin it is producing, and the extent of insulin resistance associated with excess weight

As you probably know, the cause of diabetes among most adults is twofold. It's caused by insulin resistance resulting from excess weight, and inadequate insulin production in the pancreas. These two causes are also interrelated. Many people whose diabetes is primarily the result of excess weight and insulin resistance can potentially reduce their glucose levels by losing a significant amount of weight and controlling their sugar levels through diet and exercise alone. This assumes that their pancreas is still producing an adequate amount of insulin.
A good number of diabetics, however, have the illness but don't know it for at least five years before diagnosis. This is crucial because over time, the insulin-producing cells in the pancreas decline in function. Often, by the time a patient is diagnosed, a critical number of cells have stopped producing insulin entirely. There is no way to reverse this. If your diabetes is diagnosed early in the disease process, however, aggressive management may help you prevent further loss of function in those cells. This means maintaining your fasting glucose levels below 100mg/dl and your after-meal (two hours after) levels below 140 mg/dl. This is the same for morning and evening glucose levels.

It is also entirely possible for some people to control their blood glucose with diet alone. I have a few patients who have been able to do so. All are producing adequate insulin, have lost weight or are within their ideal body-weight range, and watch their diets.

The 15 Worst Health & Diet Myths

15 Worst Health and Diet Myths not to follow my friend told me over lunch recently. We were sitting in a great new Italian restaurant near my office.

“I know,” I replied, scanning the menu. “Everything looks terrific!”

“Yeah, but everything is bad for you!” she exclaimed, practically in tears. “I’m passing on the veal—red meat causes cancer. And the eggplant parmesan—cheese has fat, which gives you high cholesterol. And the bread plate—carbs give you diabetes. I can’t eat anything! And I’m really hungry!”

With those kinds of fears, it’s a wonder my “health-conscious” friend didn’t die of starvation: no protein, and no fat, and no carbs? What’s left? Fortunately, as author of Eat This, Not That!, I was able to calm her lunch plate panic, and explain that most of what we consider “bad for you” foods aren’t bad for you at all—they’re just innocent victims of well-intentioned misinformation. A well-balanced diet, combined with some smart choices, is all you need to lose pounds and keep most of our greatest health worries at bay. But many food and nutrition “myths” persist, confusing our food choices and making weight-loss harder and eating less enjoyable. So relax, and start enjoying food again: Here are 15 food fallacies you can forget for good.

Myth #1: Too much protein hurts your kidneys
Reality: Protein helps burn fat, build muscle, and won’t harm your kidneys at all

Way back in 1983, researchers discovered that eating more protein increases the amount of blood your kidneys filter per minute. Many scientists immediately made the leap that a high-protein diet places your kidneys under greater stress. They were proven wrong. Over the past two decades, several studies have found that while protein-rich meals do increase blood flow to the kidneys, this doesn't have an adverse effect on overall kidney function.

Put the Truth to Work for You: Eat your target body weight in grams of protein daily. For example, if you're a chubby 180-pound woman and want to be a lean 160, have 160 grams of protein a day. If you're a 160-pound guy hoping to pack on 20 pounds of muscle, aim for 180 grams each day.

Bonus Tip: Lose weight fast. Build muscle. Get out of debt. Whatever your resolution for 2011, here's your plan.


Myth #2: Sweet potatoes are healthier than white potatoes
Reality: They’re both healthy!

Sweet potatoes have more fiber and vitamin A, but white potatoes are higher in essential minerals such as iron, magnesium, and potassium. As for the glycemic index, sweet potatoes are lower on the scale, but baked white potatoes typically aren't eaten without cheese, sour cream, or butter—all toppings that contain fat, which lowers the glycemic index of a meal.

Put the Truth to Work for You: The form in which you consume a potato—for instance, a whole baked potato versus a processed potato that's used to make chips—is more important than the type of spud.

Myth #3: Red meat causes cancer
Reality: Research says enjoy the steak!

In a 1986 study, Japanese researchers discovered cancer developing in rats that were fed "heterocyclic amines," compounds that are generated from overcooking meat under high heat. Since then, some studies of large populations have suggested a potential link between meat and cancer. Yet no study has ever found a direct cause-and-effect relationship between red-meat consumption and cancer. The population studies are far from conclusive. They relied on broad surveys of people's eating habits and health afflictions—numbers that illuminate trends, not causes.

Put the Truth to Work for You: Don't stop grilling. Meat lovers who are worried about the supposed risks of grilled meat don't need to avoid burgers and steak—just trim off the burned or overcooked sections of the meat before eating.

Myth #4: High-fructose corn syrup (HFCS) is more fattening than regular sugar
Reality: They’re equally fattening. Beware!

Recent research has show that fructose may cause an increase in weight by interfering with leptin, the hormone that tells us when we’re full. But both HFCS and sucrose—better known as table sugar—contain similar amounts of fructose. There's no evidence to show any differences in these two types of sugar. Both will cause weight gain when consumed in excess. The only particular evil regarding HFCS is that it’s cheaper, and commonly shows up everywhere from bread to ketchup to soda.

Put the Truth to Work for You: HFCS and regular sugar are empty-calorie carbohydrates that should be consumed in limited amounts. How? By keeping soft drinks, sweetened fruit juices, and prepackaged desserts to a minimum.

Myth #5: Too much salt causes high blood pressure
Reality: Perhaps, but too little potassium causes high blood pressure too

Large-scale scientific reviews have determined there's no reason for people with normal blood pressure to restrict their sodium intake. Now, if you already have high blood pressure, you may be "salt sensitive." As a result, reducing the amount of salt you eat could be helpful. However, people with high blood pressure who don't want to lower their salt intake can simply consume more potassium-containing foods—it's really the balance of the two minerals that matters. In fact, Dutch researchers determined that a low potassium intake has the same impact on your blood pressure as high salt consumption does. And it turns out, the average person consumes 3,100 milligrams (mg) of potassium a day—1,600 mg less than recommended.

Put the Truth to Work for You: Strive for a potassium-rich diet—which you can achieve by eating a wide variety of fruits, vegetables, and legumes—and your salt intake won't matter as much. For instance, spinach, broccoli, bananas, white potatoes, and most types of beans each contain more than 400 mg potassium per serving.

Myth #6: Chocolate bars are empty calories
Reality: Dark chocolate is a health food

Cocoa is rich in flavonoids—the same heart-healthy compounds found in red wine and green tea. Its most potent form is dark chocolate. In a recent study, Greek researchers found that consuming dark chocolate containing 100 milligrams (mg) of flavonoids relaxes your blood vessels, improving bloodflow to your heart. And remember: Milk chocolate isn't as rich in flavonoids as dark, so develop a taste for the latter.

Put the Truth to Work for You: Now that you know which "bad" foods aren't actually so awful, you need to know which deceptively dangerous diet-destroying foods to avoid. Check out our must-see slideshow of 25 "Healthy" Foods that Aren’t.

Myth #7: Gas station snacks are nutritional nightmares
Reality: Even at filling stations, you’ll find food that isn’t filling

Beef jerky is high in protein and doesn't raise your level of insulin—a hormone that signals your body to store fat. That makes it an ideal between-meals snack, especially when you're trying to lose weight. And while some beef-jerky brands are packed with high-sodium ingredients such as MSG and sodium nitrate, chemical-free products are available.

Put the Truth to Work for You: Sometimes, the service station is a healthier rest stop than a fast food joint. Heck, even pork rinds are better than you’d think: A 1-ounce serving contains zero carbohydrates, 17 grams (g) of protein, and 9 g fat. That's nine times the protein and less fat than you'll find in a serving of carb-packed potato chips.

Myth #8: Restaurants comply with nutrition disclosure regulations
Reality: Most restaurants would rather load you up with additional cheap calories

Even though many restaurants offer healthy alternatives, you could still be at the whim of the kitchen's cook. A recent E.W. Scripps lab investigation found that "responsible" menu items at chains ranging from Chili's to Taco Bell may have up to twice the calories and eight times the fat published in the restaurants' nutritional information.

Put the Truth to Work for You: Restaurants run from us, but they can't hide. Discover their secrets every day by signing up for our free Eat This, Not That! newsletter or by following me right here on Twitter, and you'll make 2011 the year of your flatter, toner belly!

Myth #9: Sports drinks are ideal after-workout refreshment
Reality: You need more than that to keep your muscles growing

Carb-loaded drinks like Vitaminwater and Gatorade are a great way to rehydrate and reenergize; they help replenish glycogen, your body's stored energy. But they don't always supply the amino acids needed for muscle repair. To maximize post-workout recovery, a protein-carb combination—which those drinks may not offer—can help.

Put the Truth to Work for You: After you suck down that sports drink, eat a bowl of 100 percent whole-grain cereal with nonfat milk, suggests a 2009 study in the Journal of the International Society of Sports Nutrition. A glass of low-fat chocolate milk is a good choice as well.

Myth #10: You need 38 grams of fiber a day
Reality: More fiber is better, but 38 is nearly impossible

That's the recommendation from the Institute of Medicine. And it's a lot, equaling nine apples or more than a half dozen bowls of instant oatmeal. (Most people eat about 15 grams of fiber daily.) The studies found a correlation between high fiber intake and lower incidence of heart disease. But none of the high-fiber-eating groups in those studies averaged as high as 38 grams, and, in fact, people saw maximum benefits with a daily gram intake averaging from the high 20s to the low 30s.

Put the Truth to Work for You: Just eat sensibilty. Favor whole, unprocessed foods. Make sure the carbs you eat are fiber-rich—that means produce, legumes, and whole grains—because they'll help slow the aborption of sugar into your bloodstream.

Myth #11: Saturated fat will clog your heart
Reality: Fat has gotten a bum rap

Most people consider turkey, chicken, and fish healthy, yet think they should avoid red meat—or only choose very lean cuts—since they've always been told that it's high in saturated fat. But a closer look at beef reveals the truth: Almost half of its fat is a monounsaturated fat called oleic acid—the same heart-healthy fat that's found in olive oil. Second, most of the saturated fat in beef actually decreases your heart-disease risk—either by lowering LDL (bad) cholesterol, or by reducing your ratio of total cholesterol to HDL (good) cholesterol.

Put the Truth to Work for You: We're not giving you permission to gorge on butter, bacon, and cheese. No, our point is this: Don't freak out about saturated fat. There's no scientific reason that natural foods containing saturated fat can't, or shouldn't, be part of a healthy diet.

Myth #12: Reduced-fat foods are healthier alternatives
Reality: Less fat often means more sugar

Peanut butter is a representative example for busting this myth. A tub of reduced-fat peanut butter indeed comes with a fraction less fat than the full-fat variety—they’re not lying about that. But what the food companies don’t tell you is that they’ve replaced that healthy fat with maltodextrin, a carbohydrate used as a filler in many processed foods. This means you’re trading the healthy fat from peanuts for empty carbs, double the sugar, and a savings of a meager 10 calories.

Put the Truth to Work for You: When you're shopping, don't just read the nutritional data. Look at the ingredients list as well. Here's a guideline that never fails: The fewer ingredients, the healthier the food.

Myth #13: Diet soda is better for you
Reality: It may lead to even greater weight gain

Just because diet soda is low in calories doesn’t mean it can’t lead to weight gain. It may have only 5 or fewer calories per serving, but emerging research suggests that consuming sugary-tasting beverages—even if they’re artificially sweetened—may lead to a high preference for sweetness overall. That means sweeter (and more caloric) cereal, bread, dessert—everything. In fact, new research found that people who drink diet soda on a daily basis have an increased risk of developing type 2 diabetes and metabolic syndrome.

Put the Truth to Work for You: These days, the world of food is full of nasty surprises like this one, and knowledge is power. Check out Eat This, Not That! 2011 and Cook This, Not That! for the best food, nutrition and health secrets, and avoid shocking waistline expanders with our slideshow of 20 Salads Worse Than a Whopper.

Myth #14: Skipping meals helps you lose weight
Reality: Skipping meals, especially breakfast, can make you fat

Not eating can mess with your body's ability to control your appetite. And it also destroys willpower, which is just as damaging. If you skip breakfast or a healthy snack, your brain doesn't have the energy to say no to the inevitable chowfest. The consequences can be heavy: In a 2005 study, breakfast eaters were 30 percent less likely to be overweight or obese.

Put the Truth to Work for You: The perfect breakfast? Eggs, bacon, and toast. It's a nice balance of all the nutritional building blocks—protein, fiber, carbs—that will jumpstart your day. The worst? Waffles or pancakes with syrup. All those carbs and sugars are likely to put you into a food coma by 10 a.m.

Myth #15: You should eat three times a day
Reality: Three meals and two or three snacks is ideal

Most diet plans portray snacking as a failure. But by snacking on the right foods at strategic times, you'll keep your energy levels stoked all day. Spreading six smaller meals across your day operates on the simple principle of satisfaction: Frequent meals tame the slavering beast of hunger.

Warding Off Muscle Cramps As We Age

If you're over 65, you probably know what a "charley horse" is. You may have gotten them during strenuous exercise as a younger person. But in older age, muscle cramps can be unlike any you've ever had before. That's because like so many other things in our bodies, our muscles and nerves wear out and function less effectively as we age.

"A cramp is a sudden painful contraction of a muscle that becomes rock hard," says Dr. Robert Miller, a neurologist who specializes in muscle cramps at the California Pacific Medical Center and teaches at University of California, San Francisco. "The muscle goes into a spasm and squeezes all the little nerve endings inside the muscle, and creates pain, and definitely ... gets your attention until you do something about it."

Uncontrollable Muscle Spasms

For Ken Holladay, 71, his muscle cramps started off mild and irregular. At first, he got them once every few weeks, but then they started to get more frequent. Eventually, they occurred every single night — often twice, between 2 a.m. and 6 a.m. It was a painful version of a charley horse, only it was in his feet and toes: "The big toe was at 90 degrees to the bottom of the foot; put your foot on the floor, and this big toe would be pointing straight up toward the ceiling; and I don't believe you can voluntarily pull a big toe that high."

Keeping Your Feet Happy
But as it turns out, your muscles can, all on their own. Holladay says that one time his toe actually curled down, "and I leapt out of bed to try and get rid of the pain and landed on that toe and broke the toe, broke the bone underneath that big toe, broke the toenail off." It was terrible, he says.

And since the cramps typically occurred twice every night, it was impossible to get a good night's sleep or feel well-rested during the day. But that's not what drove Holladay to seek treatment. What really scared him, he says, was the possibility that, as he got older, he might become bedridden due to disease or injury. If that happened, Holladay says, he wouldn't be able to get out of bed and walk, stretch and flex his muscles. He would just have to lie there, in terrible pain.

It was too scary a thought.

Searching For Treatment
So, Holladay went searching for help and treatment. First his doctor had to determine whether the spasms were an indicator of any other muscle or nerve degenerative disease, like ALS. With that established, Holladay tried a number of potential treatments: acupuncture, and then prescription quinine, which has since been taken off the market as a treatment for muscle cramps due to concerns about side effects. Neither one worked.

Finally he drove over an hour to see Dr. Yuen So, director of the neurology clinic at Stanford University. As it turned out, So and colleagues had just finished an evidence-based review of treatments for muscle cramps. Unfortunately, they turned up little. There were hundreds of studies but no conclusive or compelling evidence that any particular treatment would work for all or even most patients.

Dr. Hans Katzberg headed the review. Katzberg says some treatments held promise, including a certain type of calcium channel blocker used to treat blood pressure, as well as Vitamin B complex. Even with them, however, results were not convincing. "We were surprised to find out how little is documented in the treatment of cramps," says So. "A lot we do in medicine is based on anecdotal experience, and in this case, a lot of the treatments we use fall into the unproven category."

For Holladay, So ended up prescribing an anti-seizure medication. The meds worked.

"After a week or two, no cramps. After a month or two, no cramps," Holladay says. It was miraculous, he says, and he can't speak highly enough of the neurology department at Stanford or of Dr. So.

Keeping Spasms At Bay
Even though things eventually worked out for Holladay, that's not the case for many patients who suffer severe nighttime muscle cramps. According to UCSF neurologist Miller, older people are at greater risk for cramps simply because of their age. Nerves control muscles, and nerves just wear out.

"As we age, there are changes in both nerves and muscles. Muscles get more weak and small. And nerves undergo some decay, with the tissue becoming thin. And when that happens, the connections that the nerves make to the muscle become less secure."

And cramps occur at the place where nerves meet muscle, says Miller. When the brain sends the signal for the muscle to move, "the signal does have to cross through tiny nerve twigs, or nerve terminals." Excessive signaling, excessive irritability — which may result from thinning and weakened nerves — seems to be the generator for cramping.

At 68, Miller is a candidate for cramps himself. But he keeps them at bay, he says, by eating a banana a day and drinking lots of water. The banana provides electrolytes with its magnesium, potassium and calcium. The water provides fluid. Fluid and electrolytes, says Miller, while not proved to decrease muscle cramps, do seem to help by keeping nerve pathways healthy.

And Miller also benefits from stretching, doing weekly yoga and daily bike riding. Every day, he traverses San Francisco's hills for a total of two hours back and forth to work, "stretching my calf muscles and hamstring muscles by standing up on the pedals and stretching first one and then the other." Stretching is a tried-and-true cure for muscle cramps by pretty much any sufferer's description, says Miller, despite the lack of scientific evidence.

In U.S., Obesity Afflicts Even Some of the Tiniest Tots

American kids are becoming obese, or nearly so, at an increasingly young age, with about one-third of them falling into that category by the time they're 9 months old, researchers have found.

There are some caveats about the research, however. The infants were not studied recently: They were born about a decade ago. And it's not clear how excess weight in babies may affect their health later in their lives. The study found no guarantee that a baby who's overweight at 9 months will stay flabby when his or her second birthday rolls around.

Still, the study -- in the January-February 2011 issue of the American Journal of Health Promotion -- does present a picture of babies and infants who are carrying around a lot of extra weight.

The findings also suggest that small changes in an infant's diet can make a big difference, said Dr. Wendy Slusser, medical director of a children's weight program at Mattel Children's Hospital at the University of California, Los Angeles. For example, she said, "if you don't give your kid juice and have them eat the fruit instead, suddenly there's 150 calories less a day that can make a big difference in weight gain over a long term."

The researchers examined federal data about 16,400 children in the United States who were born in 2001. After adjusting the statistics so they wouldn't be thrown off by such factors as high numbers of certain kinds of kids, the study authors found that 17 percent of 9-month-olds were obese and 15 percent were at risk for obesity, for a total of 32 percent.

At two years, 21 percent were obese and 14 percent were at risk of becoming obese, the investigators found.

"It seems like there tends to be a shift to kids getting heavier" over time, said the study's lead author, Brian G. Moss, an adjunct faculty member at Wayne State University School of Social Work. And their weight gain, he said, is beyond that which would be expected as youngsters grow.

Hispanics and poor kids as a whole were at highest risk, the study found, whereas girls and Asian/Pacific Islanders had the lowest risk.

But why are young children so heavy and getting heavier, as a whole, over time? The study didn't examine the reasons. Moss said the changes could have something to do with changes in their lives, such as entering daycare or starting to eat regular food, but the precise causes are not clear.

However, the research does suggest that infants aren't doomed to be overweight once they put on extra pounds, said Slusser, the children's hospital medical director. "There's this fluidity," she said, "a lot of movement back and forth into these categories."

So what is her advice for those who have an infant or one on the way? "You really need to reflect on the habits you have with your child," Slusser said. For instance, make sure the infant gets regular meals and snacks along with a good night's sleep and naps, she said. And pick a daycare center that offers healthy foods and opportunities for moving around.

And breast-feeding, she said, is ideal -- especially during the first six months, when specialists recommend that breast milk should be the exclusive source of food for babies.

How Will You Stop Diabetes®? The Future Is in Your Hands.

During the holidays, we joke that our belts are a little tight around the waist. But for PJ, his tight belt was no laughing matter.

"I kept thinking 'I ought to lose weight,'" he shared.

Returning home from a baseball game one day, PJ experienced tingling in his hands and feet. "I thought that was odd. So the next day, I checked my blood glucose and my jaw dropped because it was so high. I checked the next day in disbelief, and it was still elevated."

"Right then and there, I thought 'My toes at 60. There is NO WAY I was going to lose my toes at 60.'"

Once PJ was diagnosed with type 2 diabetes, the tight belt became the focus of his attention. "I sucked it up, started to exercise and eat right and lost 30 pounds over 4 months. My glucose dropped and has remained low for 5 years. I even had to put a new hole in my belt!"

"Now I watch my diet and exercise 4 days a week. Keeping my 30 pounds off is challenging. I hate it, but it works! I do it for my toes. I do it for my brain, heart, kidneys, eyes and ultimately, my family. I thank God for the kick in the butt to check my blood glucose that day."

Developing and maintaining a healthy lifestyle can be a challenge any time of the year, but especially during the holidays. During American Diabetes Month® this November, join the movement to Stop Diabetes® and download your very own Celebrations Survival Guide. Get tips to handle the holidays and avoid tight belts this Thanksgiving season.

Number of Births Increases Diabetes Risk

Number of births increases the risk of developing gestational diabetes in pregnant women with a history of the condition, a new study has revealed…

Pregnant women with a history of pregnancy-related diabetes, also called gestational diabetes, have a good chance of developing diabetes by up to 57%, suggests a large new study. With Hispanics, Asians and Pacific Islanders having approximately double the risk of gestational diabetes compared with white women.

Researchers found that the risk of having gestational diabetes during a future pregnancy increases with each previously affected one -- from 41 percent after the first to 57 percent after two pregnancies complicated by gestational diabetes.

Gestational diabetes typically strikes during late pregnancy and is characterized by high blood sugar that results from the body's impaired use of insulin. While it rarely causes birth defects, complications can arise that threaten the health of both mom and baby.

Lead researcher Dr. Darios Getahun of Kaiser Permanente Southern California Medical Group, stated that, "Because of the silent nature of gestational diabetes, it is important to identify early those who are at risk and watch them closely during their prenatal care."

In an attempt to distinguish factors that put women at risk, Getahun and his colleagues studied the first two pregnancies of about 65,000 women and the first three pregnancies of about 13,000 women who sought care at their health center between 1991 and 2008. Approximately 4 percent of the women developed gestational diabetes during their first pregnancy, they report in the American Journal of Obstetrics and Gynecology. This matches the U.S. rate estimated by the American Diabetes Association.

The team found that these women were about 13 times more likely to develop it again in their second pregnancy, compared to women without previous gestational diabetes. Among third pregnancies, the risk of diabetes for women who had two previous cases rose to 26 times that of women without any history of gestational diabetes.

Looking more closely at the data, it appeared that the most recent case of gestational diabetes was the most influential: about 44 percent of women with a diagnosis in their second but not first pregnancy developed gestational diabetes, compared to 23 percent of those with the condition in their first but not second pregnancy.

Hispanics, Asians and Pacific Islanders had approximately double the risk of gestational diabetes compared with white women, after taking into account factors such as age and education. The researchers guess that the relatively high consumption of rice in the latter two groups may cause elevated sugar and insulin levels, potentially triggering the condition.

The study, which was supported by funds from Kaiser Permanente, did not take into account lifestyle factors such as weight. This, the researchers say, limits the findings' applicability given that overweight and obesity -- now affecting approximately one out of every three women of childbearing age -- is thought to contribute to the recurrence of gestational diabetes.

The American College of Obstetrics and Gynecology and the American Diabetes Association both recommend that women at risk of Type 2 diabetes be counseled on the benefits of modifying their diet, exercising and weight loss. This group includes those with a history of gestational diabetes.

Getahun stated that, "Early identification of at-risk populations and the timely initiation of a (post-delivery) lifestyle intervention may help to prevent gestational diabetes and related adverse pregnancy outcomes."