Reference Material on AIDS/H.I.V.

Reference Material on AIDS/H.I.V.

Acronym for acquired immune deficiency syndrome, a fatal disease caused by the human immunodeficiency virus, or HIV. Believed to have originated in Africa, AIDS has become an epidemic, infecting tens of millions of people worldwide. The virus, which is transmitted from one individual to another through the exchange of body fluids (such as blood or semen), attacks white blood cells, thereby causing the body to lose its capacity to ward off infection. As a result, many AIDS patients die of opportunistic infections that strike their debilitated bodies. AIDS first appeared in the United States in 1981, primarily among homosexuals and intravenous drug users who shared needles, but throughout the world, it is also transmitted by heterosexual contact. Today, scientists are hopeful that AIDS can be managed by new drugs, such as protease inhibitors, and need not be fatal. (See AZT.)

http://
topics.nytimes.com/top/news/health/
diseasesconditionsandhealthtopics/aids/index.html?inline=nyt-classifier

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HIV

HIV
From Wikipedia, the free encyclopedia

Human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS, a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections). Previous names for the virus include human T-lymphotropic virus-III (HTLV-III), lymphadenopathy-associated virus (LAV), and AIDS-associated retrovirus (ARV).[1][2]

HIV
From Wikipedia, the free encyclopedia

Human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS, a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections). Previous names for the virus include human T-lymphotropic virus-III (HTLV-III), lymphadenopathy-associated virus (LAV), and AIDS-associated retrovirus (ARV).[1][2]

Infection with HIV occurs by the transfer of blood, semen, vaginal fluid, pre-ejaculate, or breast milk. Within these bodily fluids, HIV is present as both free virus particles and virus within infected immune cells. The three major routes of transmission are unprotected sexual intercourse, contaminated needles, and transmission from an infected mother to her baby at birth, or through breast milk. Screening of blood products for HIV in the developed world has largely eliminated transmission through blood transfusions or infected blood products in these countries.

HIV infection in humans is now pandemic. As of January 2006, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) estimate that AIDS has killed more than 25 million people since it was first recognized on December 1, 1981, making it one of the most destructive pandemics in recorded history. In 2005 alone, AIDS claimed an estimated 2.4–3.3 million lives, of which more than 570,000 were children. It is estimated that about 0.6% of the world's living population is infected with HIV.[3] A third of these deaths are occurring in sub-Saharan Africa, retarding economic growth and increasing poverty.[4] According to current estimates, HIV is set to infect 90 million people in Africa, resulting in a minimum estimate of 18 million orphans.[5] Antiretroviral treatment reduces both the mortality and the morbidity of HIV infection, but routine access to antiretroviral medication is not available in all countries.[6]

HIV primarily infects vital cells in the human immune system such as helper T cells (specifically CD4+ T cells), macrophages and dendritic cells. HIV infection leads to low levels of CD4+ T cells through three main mechanisms: firstly, direct viral killing of infected cells; secondly, increased rates of apoptosis in infected cells; and thirdly, killing of infected CD4+ T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4+ T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections. If untreated, eventually most HIV-infected individuals develop AIDS (Acquired Immunodeficiency Syndrome) and die; however about one in ten remain healthy for many years, with no noticeable symptoms.[7] Treatment with anti-retrovirals, where available, increases the life expectancy of people infected with HIV. It is hoped that current and future treatments may allow HIV-infected individuals to achieve a life expectancy approaching that of the general public (see Treatment).

http://en.wikipedia.org/wiki/HIV

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Yoga and World Peace

Yoga and World PeaceBy Megan McDonough © 2003 Megan McDonough

Last week my husband and I went to war with each other. It was nothing as dramatic as a divorce or separation; just a commonplace marital spat with intense emotion behind it. It all started with what should have been a joyous occasion: a trip to the maternity ward to visit a nephew and his wife who had just given birth to their new son.
After holding the baby and congratulating the parents, my husband went on to rib my nephew who had gained some weight. Women know that it is absolutely taboo to tell another woman how much weight she appears to have put on, and even worse, to proceed, as my husband did, to give instructions about how to get rid of the unwanted paunch. I tried to divert the conversation to safer grounds. I failed.


Last week my husband and I went to war with each other. It was nothing as dramatic as a divorce or separation; just a commonplace marital spat with intense emotion behind it. It all started with what should have been a joyous occasion: a trip to the maternity ward to visit a nephew and his wife who had just given birth to their new son.
After holding the baby and congratulating the parents, my husband went on to rib my nephew who had gained some weight. Women know that it is absolutely taboo to tell another woman how much weight she appears to have put on, and even worse, to proceed, as my husband did, to give instructions about how to get rid of the unwanted paunch. I tried to divert the conversation to safer grounds. I failed.
After we left the maternity ward, we had a monumental argument over the issue. I thought the weight discussion was inappropriate. He thought I was making a big deal over nothing.
Marital peace seems as unlikely as world peace at times. Whether we're struggling with the fear of a terrorist attack or the need to re-establish family harmony, the ancient wisdom of Yoga can shed light on the roots of warfare.

ACTION

Work can be like a battleground at times. One woman related a story to me about a tense situation at work where she had to constantly practice patience. During a private Yoga session, she had a revelation. Eyes closed, combining movement with breath, she exclaimed, "I think I'm confusing patience with passivity."
When it comes to working for peace it's easy to mistake passivity for patience. The typical yogic caricature is of a serene, enlightened being that is impervious to disturbances. That, however, is not the picture Krishna paints for Arjuna on the epic battlefield in the Bhagavad-Gita. While Arjuna wants to throw down his weapons, preferring to acquiesce rather than to kill friends and family, Krishna urges a call to action. There is a time for peaceful patience and a time for passionate convictions.
Examining the difference between patience and passivity requires self-reflection. They can look the same externally, but internally they can have subtle yet important differences. Someone waiting under a porch roof for a driving rain to stop can be practicing patience or passivity; the only one who knows is the doer. Yoga cultivates an inner awareness designed to ferret out the truth of passivity masquerading as patience.
Passivity can come with a feeling of resignation, helplessness and hopelessness. Patience, on the other hand, comes with a feeling of simply waiting, knowing that the circumstances will change and the time for action will reveal itself in due course.
Taking action is as basic as life itself. The Bhagavad-Gita says, "No one, not even for an instant, can exist without acting." The very process of breathing, the primordial process of simply existing, demands action. Even if we wanted to stop all action, the Gita proclaims, "It is hard to renounce all action without engaging in action."
Action begets creation, and it is through this process that we create our reality. As Krishna informed Arjuna on the battlefield, peace is not in conflict with strong action. However, most of us run into trouble when we remain unconscious of the automatic, habitual assumptions that drive our actions.
With my husband, the action I took immediately upon leaving the maternity ward was to point out the error of his ways. Well, of course, who wants to hear that? I was taking action based on a limited perspective: mine. Rather than point out his error, I would have been well-advised to take action upon my own mental model before attacking his.
This war -- as with any other war since the beginning of time -- had begun in the mind first.

ATTENTION

Attention comes before action, whether we are conscious of it or not. When my husband was giving my nephew tips for a thinner body, I was placing my attention on my judgments. My thoughts ran a course like Miss Manners reciting culturally acceptable norms. "He shouldn't be giving advice about weight. That's inappropriate. He should just be focused on the joy of a new baby. A woman would never say this to another woman."
According to Patanjali, the result of my thought pattern was predictable. War ensued. In the Yoga-Sutra, Patanjali describes three components of the mind. These components construct the framework through which we interpret the world, mentally creating war or peace. The first component records the experience (Manas); another classifies the experience (Buddhi); and the last component (Ahamkar) relates that experience to your person.
Here's how the components played out in my mind. I heard my husband giving advice on how to lose weight, as reported by Manas. Buddhi classified the information, drawing the conclusion that it was inappropriate behavior. Ahamkar related this information to me, making the case that his behavior was embarrassing me, personally. Based on this framing, I made a decision to call him on it after we left the maternity ward.
Put another way, my thoughts caused my suffering, not my husband's behavior.
Using our attention in a conscious and aware manner can circumvent the destructive thoughts before they get a strong hold. As Georg Feuerstein writes in The Shambhala Guide to Yoga, "The yogins are very careful about where they place their attention, for the mind creates patterns of energy, causing habits of thought and behavior that can be detrimental to the pursuit of genuine happiness."
The impact of attention can be demonstrated while performing asanas as well. Take, for example, Virabhadrasana III (Warrior III). The tendency many people have is to focus the majority of their attention on the foot that is on the floor, thinking that balance is found by concentrating hard on that one point of connection. In fact, the opposite is true. If you allow your awareness to spread to your outstretched hands and extend fully through the raised leg, the balance naturally occurs. Shifting the focus from one small point and spreading attention to the edges of the pose itself, creates, paradoxically, less stress and more ease.
When it came to the war with my husband, my attention was focused on my own framework, which I considered "right," without questioning the validity of that assumption. How many wars have been fought because they are right and just?

ACCEPTANCE

The other day my son was playing with an exercise ball that was as big as he was. He had great fun running to the ball and then rolling right over the top. Most of the time he just rolled onto the bedroom floor. One time, however, he misjudged and hit his head on the bed. He kicked the ball and cried, calling it "stupid" in an outraged four-year-old voice.
It is the nature of the ball to be round, and it cannot be anything else but round in this moment. The ball just is as it is. This roundness may change in the future if it deflates, but right now, as my son is playing with it, it's round. As such, there is an inherent risk of rolling off the ball if you choose to play with it. It's fruitless to kick the ball and call it "stupid" when the ball is just being a ball.
As I watched his tirade, I realized how often, as an adult, I have rebelled against the reality of something or someone. For example, I can fume about my husband's perceived lack of sensitivity around the weight discussion, but that doesn't change the reality of the discussion itself.
War breaks out when we fight what is, thinking it should be something else. A round ball should not roll me on my head. My husband should follow my interpretation of socially acceptable rules. The stories we tell ourselves conflict with reality, and suffering arises. Then we perpetuate the story by elaborately constructing scenarios of how to right a wrong. It's not to say we can't take action, since it's impossible not to take action, as described previously. It's just helpful to see clearly how much of our angst comes from reality and how much comes from the story in our head about what "should" be.
Accepting what is doesn't mean you agree or endorse the act. It just means you stop the impossible task of fighting reality. How do you know the wind is blowing? Because it is.
A verse in the Brihadaranyaka Upanishad states, "That is perfect, this is perfect. What comes from such perfection truly is perfect. What remains after perfection from perfection is yet perfect. May there be peace." That's a whole lot of perfection for an apparently imperfect world.
What if we were to accept the premise that perfection is everywhere? How would that change our view of events and our part in them? It takes trust to believe in perfection when we can't accept what reality dishes out. When times are tough, where do you place your trust? Do you trust your own mental models without question? Do you trust the support of loved ones? Do you trust some unseen, greater force?
Whether it's the pain of war that forces us to see the need for peace, or the pain of death that shows us the value of life, trust can be something to hold onto until the calmer waters of peace are reached. Trust, in its broadest sense, implies acceptance of the present moment.

IT'S MINE

When you say that something or someone is mine, what effect does it have on your behavior? If someone hit my car in the parking lot, you might not get too upset. If someone hit your car, though, that might be a different story. If the budget at work is about to be cut, it's not such a bad thing if it's a different department. If it's your department, however, and layoffs are imminent, anxiety rises.
What encompasses me and mine sets the boundaries, judgments and attitudes towards a given situation.
Whether the situation is simply a heated budgetary debate at work, or the threat of war, it is helpful to look at where the lines of yours and mine are being drawn and decide for yourself if these boundaries help or hinder the situation.
Here is an exercise to consider. Grab a handful of sand in your fist and squeeze it tightly. How much sand can you hold on to? Next, open your fist, cup your fingers slightly and scoop sand into the bowl of your palm. How much sand is now yours? As you move through your day, just notice when you are labeling something as yours. Explore how that affects your relationship to it, and see if you can play the situation in such a way that it allows for an open palm approach rather than a tight fist.
What is mine versus what is yours sets the stage for war. My thoughts about how my husband should behave were different than his. Since I held onto the thought that my view took preference over his, the battle lines were drawn.
Ultimately, the idea of "mine and yours" is just a concept. As Krishna said to Arjuna in the first chapter of the Brahma-Gîtâ, "The thought "I am connected with such-and-such" or "I have lost such-and-such" merely torments you, subjecting you to joy and sorrow all round."
Exploring how we define the concept of mine and yours for ourselves promises freedom. As the Brahma-Gîtâ states, "He who is defiled by the impure idea of "mineness" toward the body, Consciousness does not shine forth. He who is patient, devoid of the idea of "I" and "mine," the same in joy and sorrow, he, though performing obligatory and nonobligatory actions, is not stained by his deeds."
Because of the concept of me and mine, world peace is inseparable from family peace, which is inseparable from individual peace.

THE PAIN OF PEACE

After teaching yoga this week, a new student came up and asked me if she should be feeling pain during class. My immediate answer was no. Then another student joined the conversation. She had been practicing with me for quite a while, so I was surprised when she said, "I always feel pain when I practice."
The medical establishment has long grappled with how to assess pain. It's so subjective. A measurement like your pulse rate is straightforward: a black and white number that can be benchmarked against a given norm. This is not the case with measuring pain. Some howl in agony while another with the same injury only has a slight grimace.
According to Patanjali's Yoga Sutra, thoughts can be divided into two groups: painful and not painful. Painful thoughts are those that may feel great when they arise, but are detrimental to you over the long haul. Thoughts that are classified as not painful may feel downright miserable at first blush, but work towards your best interest over time.
Going through a major life transition-like a divorce, the loss of a job, or the death of a loved one-can have the devastating impact of a war. Beliefs are shattered, and rubble reigns. Pain can be a constant companion during such times. Over the years, though, you can see how the pain of one event can foster growth and possibly even pleasure over the course of time. The same holds true for those things that seem so pleasurable in one moment only to haunt you in the next-like chocolate cake. Rich dessert can feel great in one moment, but soon afterwards the pain of overeating overshadows the momentary pleasure.
Pain and pleasure are not that separate, are they? Could it be that war and peace are also connected?
The war with my husband was the impetus I needed to explore my own detrimental and painful thought patterns. This war, it seems, was a factor for peace.

WORLD PEACE

The other morning my son looked out the window and exclaimed, "The whole world is snow!" There was a storm the night before and the landscape had completely changed into a winter wonderland. To his young mind, since all he could see and know was snow, then the world was snow.
In today's troubled times, many of us are experiencing a blizzard. Layoffs, increasing workloads, and fear of terrorism can lead to increased anxiety, uncertainty and sleepless nights. When you pick up a paper, hear the television news, and talk with others, it can seem like the whole world is covered with bad news. Peace, it seems, is a scarce commodity.
When it feels like the whole world is covered with snow, and bad news is everywhere, make like Picabo Street and ski. As she flies down the mountain, she follows a blue line painted on the slope weaving snake-like through the course. The lines help Picabo and the other skiers see the course in shady areas. It keeps them on track.
Yoga is like a line that keeps us on track for personal peace when a blizzard obstructs our view. Yoga philosophy can be complicated. Yoga practice, though, can be simple. Just as Picabo followed the blue line down the hill, Yoga is just following the line of life as it's presented in each moment.

World peace can be complicated. Practicing world peace, though, can be simple. One mind at a time, one thought at a time, peace or war is cultivated.
From my own little corner of the world, my husband and I have laid the marital spat to rest and are at peace for the time being. With each encounter, if I'm willing to be the yogic observer, I discover more about myself. With such perspective, I can see the possibilities of my own creations, making my own choice for war or peace one moment at a time.
**********************************************

Author of "Infinity in a Box, Using Yoga to Live With Ease", Megan McDonough takes yoga philosophy outside of the traditional hatha yoga class, speaking internationally at diverse conferences from banking to healthcare. As a business yogini, she teaches business techniques to yogis and yoga techniques to business people. Combining the quiet art of yoga with the pragmatic demands of everyday work, Megan provides people with practical and simple tools to make life easier. Her website is www.urinfinityinabox.com.
Megan is editor of "A Minute for Me" and moderator of "Mindful Marketing". This article on Yoga and World Peace won the 2003 Yoga Research and Education Center essay contest.
***********************************************

Sources: Feuerstein, Georg. The Shambhala Guide to Yoga. Boston, MA: Shambhala, 1996. Prabhavanda, Swami and Christopher Isherwood. How to Know God, The Yoga Aphorisms of Patanjali. The Vedanta Society of Southern California: Vedanta Press, 1981. Stephen Mitchell. Bhagavad Gita, a New Translation. New York, New York: Three Rivers Press, 2000. Georg Feuerstein. Brahma-Gîtâ, http://www.yrec.org/brahmagita.html. June 16, 2002.

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Diabetes

Diabetes
Dr Beckie Lang


Over 2 million people in the UK are known to have diabetes and an estimated 1 million people have the disease without knowing about it. Whether you have type 1 or 2, it will have a marked effect on your diet.
In this article



Over 2 million people in the UK are known to have diabetes and an estimated 1 million people have the disease without knowing about it. Whether you have type 1 or 2, it will have a marked effect on your diet.
In this article

Type 1
Type 1, which used to be called insulin-dependent diabetes, occurs when the body fails to produce insulin, the hormone required for controlling blood sugar levels. Sufferers require insulin injections to correct this. There is no known dietary cause of type 1 diabetes.
However, for those who have type 1 diabetes, diet is an important part of their clinical care. All type 1 patients should have access to a qualified dietician.

Type 2

Type 2 diabetes often develops later in life although cases in obese children and young adults are becoming more common. This type of diabetes is usually associated with being overweight. In this case, too much insulin is produced by the body but it still has little or no effect on blood sugar.
This type can often be treated with diet alone, although in the later stages of the disease insulin production may decline and some people will need tablets or insulin injections.
The risk of type 2 diabetes rises as body fat increases. If you're an obese man, your risk of developing diabetes is 40 times higher than if you are a healthy weight. This risk more than doubles in obese women.
You can reduce your risk of developing type 2 diabetes by achieving and maintaining a healthy weight. It's worth noting that despite diabetes being a condition of sugar regulation, specific restriction of sugars isn't necessary, except as part of ensuring a balanced diet overall.
Diabetes UK is a national charity for people with Type 1 and Type 2 diabetes. They offer a range of excellent resources and information. Visit their website at www.diabetes.org.uk
This article was last medically reviewed by Dr Rob Hicks in September 2005.
First published in March 2001.

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Be a Fit Kid

Be a Fit Kid

There's a lot of discussion these days about fit kids. People who care (parents, doctors, teachers, and others) want to know how to help kids be more fit. Being fit is a way of saying a person eats well, gets a lot of physical activity (exercise), and has a healthy weight. If you're fit, your body works well, feels good, and can do all the things you want to do, like run around with your friends.






There's a lot of discussion these days about fit kids. People who care (parents, doctors, teachers, and others) want to know how to help kids be more fit. Being fit is a way of saying a person eats well, gets a lot of physical activity (exercise), and has a healthy weight. If you're fit, your body works well, feels good, and can do all the things you want to do, like run around with your friends.

Some steps only parents can take - such as serving healthy meals or deciding to take the family on a nature hike. But kids can take charge, too, when it comes to health. Here are five rules to live by, if you're a kid who wants to be fit. The trick is to follow these rules most of the time, knowing that some days (like your birthday) might call for cake and ice cream.



1. Eat a variety of foods, especially fruits and vegetables. You may have a favorite food, but the best choice is to eat a variety. If you eat different foods, you're more likely to get the nutrients your body needs. Taste new foods and old ones you haven't tried for a while. Some foods, such as green veggies, are more pleasing the older you get. Shoot for five servings of fruits and vegetables a day - two fruits and three vegetables. Here's one combination that might work for you:

1/2 cup (113 grams) strawberries on breakfast cereal

10 baby carrots

2 broccoli spears

3/4 cup (170 grams) fruit juice

1/2 cup (113 grams) salsa with chips



2. Drink water and milk most often. When you're really thirsty, cold water is the No. 1 thirst-quencher. And there's a reason your school cafeteria offers cartons of milk. Kids need calcium to grow strong bones, and milk is a great source of this mineral. How much do kids need? About 800 milligrams each day if you're 6 to 8 and 1,300 milligrams if you're 9 or older. To give you an idea, here's a list of foods and drinks that would add up to the 1,300-milligram daily goal:

2 cups (about half a liter) of milk (600 milligrams of calcium)

2 ounces (57 grams) of cheese (300 milligrams of calcium)

1 cup (227 grams) of yogurt (315 milligrams of calcium)

1/2 cup (113 grams) cooked white beans (120 milligrams of calcium)



You probably will want something other than milk or water once in a while, so it's OK to have 100% juice, too. But try to limit sugary drinks, like sodas, juice cocktails, and fruit punches. They contain a lot of added sugar. Sugar just adds calories, not important nutrients.



3. Listen to your body. What does it feel like to be full? When you're eating, notice how your body feels and when your stomach feels comfortably full. Sometimes, people eat too much because they don't notice when they need to stop eating. Eating too much can make you feel uncomfortable, and over a period of time, it can lead to unhealthy weight gain.



4. Limit screen time. What's screen time? It's the amount of time you spend watching TV, DVDs, and videos, playing handheld computer games, and using the computer. The more time you spend on these sitting-down activities, the less time available for active stuff, like basketball, bike riding, and swimming. Try to spend no more than 2 hours a day on screen time, not counting computer use related to school work.



5. Be active. One job you have as a kid - and it's a fun one - is that you get to figure out which activities you like best. Not everyone loves baseball or soccer. Maybe your passion is karate, or kickball, or dancing. Ask your parents to help you do your favorite activities regularly. Find ways to be active every day. You might even write down a list of fun stuff to do, so you can refer to it when your mom or dad says it's time to stop watching TV or playing computer games!



Speaking of parents, they can be a big help if you want to be a fit kid. For instance, they can stock the house with healthy foods and plan physical activities for the family. Tell your parents about these five steps you want to take and maybe you can teach them a thing or two. If you're a fit kid, why shouldn't you have a fit mom and a fit dad?



Reviewed by: Mary L. Gavin, MD

Date reviewed: May 2004

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Fast Facts for Your Health: Pelvic Adhesions

Fast Facts for Your Health: Pelvic Adhesions

Pelvic adhesions are gynecologic surgery side effects that can lead to infertility, pain and more surgeries. But, your surgeon can reduce your risks for developing adhesions following surgery in a number of ways. Learn more in this free publication.



Pelvic adhesions are gynecologic surgery side effects that can lead to infertility, pain and more surgeries. But, your surgeon can reduce your risks for developing adhesions following surgery in a number of ways. Learn more in this free publication.


Fast Facts for Your Health: Pelvic Adhesions
Author: National Women's Health Resource Center
Published by: National Women's Health Resource Center, Inc., April 2007


Pelvic adhesions are gynecologic surgery side effect that can lead to infertility, pain and more surgeries. But, your surgeon can reduce your risks for developing adhesions following surgery in a number of ways including using adhesion prevention barriers. Fast Facts for Your Health: Pelvic Adhesions explains what you should discuss with your health care team before your surgery.

This publication was produced with support from Ethicon Women's Health & Urology, a division of ETHICON, Inc.

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HealthyWomen Take 10: "The Latest Dish on Diet Plans"

HealthyWomen Take 10: "The Latest Dish on Diet Plans"

Find out what's cooking with weight loss in this month's HealthyWomen Take 10 feature article. Not yet a subscriber? Click here to get your free subscription.

www.healthywomen.org April 2007

The following article is excerpted from the April 2007 issue of HealthyWomen Take 10. For full access to future issues, please subscribe via the link at the bottom of this article.

Feature Article
The Latest Dish on Diet Plans
by Robin Warshaw

When it comes to dieting, you can choose from a smorgasbord of ways to lose weight. Every year, it seems, some new method grabs attention. At the same time, long-standing commercial programs and diet book plans continue to win followers.





HealthyWomen Take 10: "The Latest Dish on Diet Plans"

Find out what's cooking with weight loss in this month's HealthyWomen Take 10 feature article. Not yet a subscriber? Click here to get your free subscription.

www.healthywomen.org April 2007

The following article is excerpted from the April 2007 issue of HealthyWomen Take 10. For full access to future issues, please subscribe via the link at the bottom of this article.

Feature Article
The Latest Dish on Diet Plans
by Robin Warshaw

When it comes to dieting, you can choose from a smorgasbord of ways to lose weight. Every year, it seems, some new method grabs attention. At the same time, long-standing commercial programs and diet book plans continue to win followers.




With more than 66 percent of Americans overweight or obese, there's an eager audience for advice—many of whom have tried more than one program. Indeed, it's not unusual to hear someone who's struggled with her weight say something like, "I did Atkins, South Beach and Jenny Craig."

Thinking about dieting? To see if you're at a healthy weight, go here: www.healthywomen.org

Low carb, low fat or what?

If you're ready to lose excess pounds, you've probably heard conflicting reports about the best way to get the weight off.

Is it by following a low-carb, low-fat or liquid diet? Should you take special herbal or vitamin supplements, eat foods in combination, get prescription medication from your doctor, buy prepackaged meals or mix your own version of the latest trendy concoction promoted as helping you drop pounds by "cleansing" your system?

The answer may surprise you. "All of them—if not one of the harsh ones— probably can work for some of us to get the weight off," says Susan Moores, MS, RD, a spokesperson for the American Dietetic Association and a consulting dietitian in St. Paul, MN. "But the kicker is, how do they help you move from weight loss to keeping it off? That's where most of these fall flat."

Analyzing popular diet programs

Until recently, there was little scientific evidence about either short- or long-term results of the various popular diet plans.

TOne survey noted that lack and looked for studies of four program types: commercial weight loss (specifically, Weight Watchers, Jenny Craig and LA Weight Loss); very low-calorie, medically based (Health Management Resources and OPTIFAST); commercial Internet-based (eDiets); and nonprofit self-help (TOPS and Overeaters Anonymous). Some had no quality research.

The largest Weight Watchers study showed that after two years, dieters had a 3.2 percent loss from their original weight. That translates to five pounds for a 160-pound woman. The very low-calorie, medically based plans posted bigger losses—15 percent to 25 percent of initial weight—but were costly, had many drop-outs and had "a high probability of regaining 50 percent or more of lost weight in one to two years." The Internet and self-help plans yielded "minimal weight loss."

In a head-to-head comparison, very low-calorie (less than 800 calories per day), medically-administered diets knocked off more pounds in the short-term than did low-calorie plans, but both had similar long-term results.

When dieters were placed on popular diet programs—Atkins, Ornish, Weight Watchers, Zone—all groups lost a small amount of weight (about 4.6 to 7.6 pounds) after one year. But here's the part that's hard for fans of specific diets to swallow: Greater weight loss was associated with how faithfully dieters kept to their plan, not with the type of diet they ate.

Last month, another shot appeared to be fired in the diet program battle. A Stanford University study of Atkins, Ornish, Zone and LEARN (based on national dietary guidelines) plans showed that all produced modest weight loss, but Atkins (low-carb) dieters lost the most (just over 10 pounds) after one year. Long-term health impact of the low-carbohydrate, high-protein, high-fat diet is still a question.

Confused? Maybe it's time to change how you think about dieting.

"The biggest stumbling block (to diet success), in my opinion, is for people who are trying to lose weight to realize that food is not a bad thing. People really need to work on changing their relationship with food," says Stella L. Volpe, PhD, RD, LDN, FACSM, Miriam Stirl Term Endowed Chair in Nutrition, University of Pennsylvania, School of Nursing. "Once they have a positive relationship with food, then decreasing portion sizes or only having a small piece of cake will not be a negative thing to them."

What's a safe diet?

In theory, weight loss is simple: When you reduce energy intake (calories), you lose weight. And when you couple that with increased energy output (physical activity), you'll do even better. "Exercise is equally important, both for weight maintenance and for decreasing stress," Dr. Volpe says.

You can reduce the calories you take in through a healthful diet program, which usually provides gradual weight loss (up to two pounds per week). If choosing a commercial program, the American Heart Association recommends looking for one that includes:
Patient information and a description of program components
Health risk screening
Individualized nutrition, physical activity and behavioral elements
Qualified, trained and certified staff
Disclosure of risks and evaluation of long-term effectiveness and safety
Reasonable weight loss goals
At least a two-year maintenance program

To see quicker results, many people go the fad diet route, severely limiting many or even most foods. Fad diets that are highly restrictive are hard for most people to stay on for more than a day or two. Some people, though, stick longer. "Those are the ones really putting themselves at greater health risk," because they're not getting adequate nutrition, says Ms. Moores.

She also points out that fad diets are counterproductive: They cause you to lose water weight, but that also means muscle breakdown, since muscles contain water. "Muscle is the active or calorie-burning tissue in the body," she says. "So when you lose that, you're not allowing yourself to burn as many calories as you otherwise would…and you're also losing tone and strength."

Yet dieters continue to look for the magic formula, food or pill that will make excess weight melt away. One recent fad diet, touted by some celebrities, is a mixture of lemon juice and maple syrup, promoted as working wonders by "cleansing" the dieter's system. "I'd group that with pretty harsh, pretty dramatic diets—you, by and large, are eating very little and risk dehydration, not to mention missing out on a substantial amount of nutrition," Ms. Moores says. If you are "eating a healthful amount of food and drinking an adequate amount of fluid, your body is pretty smart in its ability to clear out the bad stuff and keep the good," she adds.

Losing for the long haul

It's not impossible to keep the weight off. The National Weight Control Registry (www.nwcr.ws) conducts ongoing research about long-term weight loss maintenance with people who have lost 30 pounds or more and have kept it off for more than a year. About 20 percent of us are successful at maintaining weight loss, according to Suzanne Phelan, PhD, a Registry coinvestigator and assistant professor of psychiatry and human behavior at Brown University.

Among dieters being tracked by the Registry, 55 percent reduced by using commercial weight loss programs. The rest lost on their own. "There were a lot of different strategies they used to lose the weight," says Dr. Phelan.

And what were their secrets for keeping lost weight off? Registry research shows that many successful maintainers share these approaches:
Continue to eat a low-fat, low-calorie diet
Do a lot of physical activity (equal to one hour of brisk walking per day)
Limit the amount of fast food they eat
Eat five times a day
Eat breakfast every day
Watch less than 10 hours of television per week
Weigh themselves once a week or more

Although we used to be told to ignore the scales, monitoring your weight frequently seems to work better for weight-loss maintenance. "If you get on the scale and you're up a little bit, then you can quickly make changes to reverse it," Dr. Phelan says.

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