Even if that coach helps out by phone, with no face-to-face contact, it can translate to more weight loss, the experts found. Either approach results in more weight loss than going solo. The studies will be presented this week at the American Heart Association annual meeting in Orlando, Fla., and published online in the New England Journal of Medicine.

“The ‘remote’ intervention, to me, is very exciting,” said Dr. Lawrence Appel, a professor of medicine and director of the Welch Center for Prevention, Epidemiology and Clinical Research at the Johns Hopkins University School of Medicine and Bloomberg School of Public Health. He led one of the studies.

Weight loss tips

Weight-loss support and education delivered over the phone or a website, he said, was effective. “We don’t discourage in-person,” Appel said. “Going in, we thought it would be the best intervention.” The researchers found otherwise. “Given their druthers, the people said, ‘I prefer not to come in,’ ‘I prefer to use the phone, the Internet.’”

In the study, Appel and his colleagues assigned 415 obese men and women, average age 54, all with at least one cardiovascular risk factor such as high blood pressure, to one of two programs. In one, patients got weight loss support remotely — by phone, a website and email. In the second, they got in-person support during group and individual sessions, along with remote support.

A third comparison group met with a weight-loss coach at the study start. They could also meet with the coach at the end. In between, they were on their own, referred to websites on weight loss and given brochures.

Those in the self-directed group lost less weight. On average, the self-directed group shed 1.7 pounds, the remote group lost 10.1 pounds, and the in-person group 11.2 pounds over the two-year study.

A higher proportion of those in the intervention groups lost 5 % or more of their starting weight. That may not sound like much, but experts agree it is enough to make a difference to your health.

In the second study, Dr. Thomas Wadden, at the University of Pennsylvania, and his team assigned 390 obese adults to one of three types of programs. One group was termed ”usual care” and saw their doctors for weight-loss education and support every three months. One group received brief lifestyle counseling, including visits with their doctor every three months and monthly sessions with lifestyle coaches. One group received enhanced lifestyle counseling, which included everything the brief lifestyle counseling group got, along with being offered a choice of meal replacements or weight-loss medications.
The weight-loss medicines were either orlistat or sibutramine. Orlistat now carries a warning about potential liver damage. Sibutramine is not available in the United States now, after reports of an increased risk of heart attacks and strokes with its use. By the end of the study, most were using the meal replacements, not the medicines.

At the end of the two years, 86 percent were still participating. Those who received the enhanced lifestyle counseling lost the most: 10.1 pounds. Those in the usual care group lost just 3.7 pounds and those in the brief lifestyle counseling group lost 6.4 pounds.

Those in the enhanced lifestyle group were more likely to drop 5 percent of their starting weight, according to the report.

Both studies suggest a model using primary care doctors works, said Wadden, professor of psychology and psychiatry and director of the Center for Weight and Eating Disorders at the university. That model is recommended by the U.S. Preventive Services Task Force, which makes recommendations based on evidence of benefits and harms.

In an accompanying editorial, Dr. Susan Yanovski of the U.S. National Institutes of Health pointed out that the participants got the meal replacement and medicines at no cost. “Whether patients would be willing to pay for these therapies, or insurers would be willing to reimburse for them, is not known,” she said.

Appel estimates his program would cost less than $500 for the two years and speculates that employers might pay. Wadden said his program would cost about $1,300 for the two years. He said employers or insurers might pay in the future.

One in three U.S. adults is obese. Both studies were funded by the U.S. National Heart, Lung, and Blood Institute. The study led by Appel was also supported by other sources, including Healthways, a disease-management company that has a consulting agreement with Johns Hopkins. One study author has received consulting fees from Bristol-Myers Squibb and Merck and royalties from Taylor & Francis Publishing.

More Information

For information about healthy food choices, visit the U.S. Department of Agriculture.

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Instead of using the heat as another excuse to skip my workout, I get creative with my summertime activities so I can keep up my fitness goals.

Running outside

Stretch with the sun

On days when I know it’s going to be a scorcher, I set my alarm for an early morning yoga session.

It’s a win-win for me: I get my workout done before it gets too hot and I start my day on the right foot.

Take your toughest workouts inside

I love training outdoors whenever possible, but exercising in an air-conditioned gym (or house) is the best way to keep me cool.

I pick my toughest workout of the week (usually running intervals on the treadmill) to do indoors. I don’t even bother attempting them outside in the summer!

Pick up a racket

I love a good game of tennis in the summertime, but when it’s too hot outside on the courts, I swap my racket for a different type.

Racquetball and squash are typically played indoors, so I stay cool while getting in my workout.

Exercise indoors and get moving

Run in the rain

I love running outdoors, but the summer heat doesn’t always make it easy for me. When rain is in the forecast, I like to plan my run during the showers. A little rain cools me off, and it’s a nice change of pace from my usual super-sweaty runs.

Plus, just the thought of running in the rain is fun and exciting, which prevents me from skipping my workout all together!

Get a wet workout

This one might seem like a no-brainer, but exercising in a pool or lake is an instant way to cool off.

Try a new activity like paddle-boarding, check out your local gym for a water aerobics class, or round up some friends for a competitive game of water volleyball. Whatever you decide to do, you’ll get a great workout!

Cool off like kids

When it’s boiling outside, play some of those fun games from your childhood.

Run through the sprinkler or have a squirt-gun and water-balloon fight. When the sun sets, plan a late-night game of flashlight tag. These games are a guaranteed good time. I mean, isn’t running around with a big smile on your face the best type of exercise?!

Plan a day at the water park

Water parks aren’t just for kids!

Spending the day at a water park will keep you cool and active all day long. Play in the wave pools and ride the slides, and you’ll keep moving for hours. I promise, it won’t even seem like exercise!

Plan a mini triathlon

Have a free morning on the weekend? Plan a mini triathlon for you and a friend, but finish with the swimming part so you can cool off at the end of your workout.

Try this: Run for 20 minutes, bike for 30 minutes, and then swim a few laps in your favorite watering hole.

Hit the mall

Too hot to take a lunchtime walk outside? Take your workout to a nearby mall with air conditioning. Lace up your sneakers and get your heart pumping without overheating!

Find a cool spot

Wherever you happen to live, there are probably certain areas where joggers, walkers, and bikers flock because they are cooler—literally.

Maybe it’s a boardwalk near the ocean or just a shady path in a local park. Seek out the least hot places to exercise and become a frequent visitor.

Swim to cool down

Join a night league

It’s much more enjoyable to exercise without the sun blazing down on you.

Stay motivated to exercise once the sun sets by joining a team that meets in the evenings. From softball to kickball to running groups, there’s something for everyone.

End your day with a walk

When the sun is low in the sky, I like to take an evening stroll around the neighborhood with my husband and dog. It’s a nice way for us to get in some exercise when the temperatures aren’t as high, and also to relax after a long day.
Source: Health.com

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Eat Slim! Stay Trim!

During the free-form days of summer, vacations, picnics, and carefree attitudes can all get in the way of healthy eating and weight control. January may be the traditional time to start a weight loss program, but with kids back in school and routines becoming more structured, fall is the perfect time to launch a diet and fitness regimen.

Even the fall weather can serve as an inspiration to be active and eat more healthfully. It’s the perfect time of year to hit the hiking trail, or bite into a crisp, delicious apple. Just breathing the fresh fall air makes you feel healthier.

In fact, in a survey of 1,500 moms conducted by the National Dairy Council’s “3-A-Day of Dairy” program, participants said fall is the ideal season to jump-start healthy eating and exercise programs.

The moms said they look forward to getting back to their regular routines (53%) and having more time to focus on themselves (41%) when their kids go back to school. They ranked summer second (behind the winter holidays) as the time of year when they tended to put on the most weight.

“Routines are ideal for helping people, especially moms, find time to fit in fitness, prepare healthier meals and make sure they take care of their own personal health needs,” says Cynthia Sass, MPH, MA, RD, an American Dietetic Association spokeswoman.

“The combination of more free time, regular routines, and the beautiful fall weather is an inspiration to eat better and be more active outdoors.”
A Bounty of Fall Foods

Sass suggests seeking out farmers’ markets to select from the nutritious bounty of fall produce.

“Eating foods in season tastes best because of the peak flavors,” she says. “Find a new recipe, or use a food in a different way than before.”

For example, pumpkin is great for far more than pie. How about pumpkin soup, toasted pumpkin seeds, or even a pumpkin smoothie?

“Toss some pumpkin, skim milk, and pumpkin pie spices into a blender for a nutritious breakfast or snack loaded with protein and lots of nutrients,” suggests Sass.

More suggestions: Stir apples into garden or chicken salads. Or make a mock cobbler by mixing cut-up apples (leave the peel on for more fiber), a teaspoon of brown sugar, a squeeze of lemon juice, and a pinch of cinnamon into the microwave for 5 minutes – it makes a delicious treat or oatmeal topping.

Weight Loss

Also, hearty soups are a terrific vehicle for all sorts of nutritious and delicious fall vegetables.

“Soups are super-filling, easy to make and freeze well,” says Ellie Krieger, RD, host of the Food Network’s Healthy Appetite show. “Make them with lots of vegetables and broth, instead of cream, for satisfying meals the whole family will enjoy.”

f you need help getting started, here are seven expert tips to help you jump-start your weight loss this fall:

1. Control your cravings. In the 3-A-Day survey, 52% of the moms said cravings were their biggest challenge in losing weight. Eating every few hours will prevent hunger, keep your blood sugar stable, and reduce cravings, says Sass. “Moms are so busy they tend to go too long without eating, then end up eating too fast, or the wrong kind of foods,” she says. One trick is to plan ahead: Bring along a baggie full of unsalted nuts and dried fruit for when hunger strikes. If sweet cravings are your downfall, Sass recommends chocolate – a few small pieces, that is. Let it melt slowly in your mouth so you can really savor the taste. Don’t avoid the foods you crave; just eat them in small portions.

2. Lace up your sneakers. Half the surveyed moms wanted to lose more than 20 pounds but 72% said they had 30 minutes or less to devote to exercise each day. “Something is better than nothing … even if it is 10 minutes in the morning and 10 minutes at night,” says Sass. “It does not need to be formal; just find ways to add more steps into your day.” If you make exercise social (such as walking with a neighbor), it’s more fun, less of a chore, and more likely to become routine. Owning a dog is another great way to get more exercise, as they need to be taken on walks regularly.

3. Don’t fail to plan. Write down your master plan for how you’ll fit in fitness and eat healthier and factor it in as you plan schedules for the new school year. “It is not enough to say you are going to exercise daily; you need to be more specific, such as going to the gym on the way to work Monday, Wednesday, and Friday,” says Elisa Zied, RD, author of So What Can I Eat?. And don’t forget to include snacks in your planning: “If you think of them as random eating, they are less likely to be healthy,” says Krieger. She suggests buying portable snacks such as fruit, nuts, single-serving yogurts, and low-fat cheese so they’ll always be handy. Snacks high in fiber and lean protein will keep you feeling full between meals.

4. Stock your kitchen with healthy choices. Having nutritious foods readily available makes it easier to work them into your diet. Always have cut-up fruits and vegetables on hand; pair them with low-fat yogurt dip for an instant snack or side dish. “Make it a rule to have some fruit or vegetables before you have a treat, like chocolate, and this way you are less likely to overdo the treat,” suggests Zied.

5. Start each day with breakfast. “Having breakfast gets your engine started during those critical morning hours when you are busy at school or work,” says Zied. “Skipping breakfast is an invitation for over-consumption of less nutritious foods later in the day.” Try to work fiber, lean protein, and fruits or vegetables into your breakfast. If you’re not a breakfast person, you don’t have to have much: A low-fat yogurt and a piece of fruit is enough to get your day started and control your appetite.

6. Strive for progress, not perfection. If you follow healthy food and fitness guidelines 80% of the time, the new habits will become a part of your life without overwhelming you. “Many people think in terms of black and white when they think about eating and fitness habits,” says Zied. “In reality, we should get comfortable living in gray, somewhere in between. Doing even 20 minutes of exercise, cutting portions by even a few bites, and switching from 2% milk to 1% milk — these small things can have a big impact on your health and on your life.”

7. Don’t forget portion control. As you get back into a more structured routine, it is a great time to get more detail-oriented. “Just like sharpening your pencils to get ready for school, break out the measuring cups and see how much food you have been putting on your plate,” says Krieger. “Portions have a tendency to get larger, so keep portion sizes in check by measuring the quantity once in a while.”

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Eat Slim. Stay Trim.

1. Eat a variety of nutrient-rich foods. You need more than 40 different nutrients for good health, and no single food supplies them all. Your daily food selection should include bread and other whole-grain products; fruits; vegetables; dairy products; and meat, poultry, fish and other protein foods. How much you should eat depends on your calorie needs. Use the Food Guide Pyramid and the Nutrition Facts panel on food labels as handy references.
2. Enjoy plenty of whole grains, fruits and vegetables. Surveys show most Americans don’t eat enough of these foods. Do you eat 6-11 servings from the bread, rice, cereal and pasta group, 3 of which should be whole grains? Do you eat 2-4 servings of fruit and 3-5 servings of vegetables? If you don’t enjoy some of these at first, give them another chance. Look through cookbooks for tasty ways to prepare unfamiliar foods.
3. Maintain a healthy weight. The weight that’s right for you depends on many factors including your sex, height, age and heredity. Excess body fat increases your chances for high blood pressure, heart disease, stroke, diabetes, some types of cancer and other illnesses. But being too thin can increase your risk for osteoporosis, menstrual irregularities and other health problems. If you’re constantly losing and regaining weight, a registered dietitian can help you develop sensible eating habits for successful weight management. Regular exercise is also important to maintaining a healthy weight.
4. Eat moderate portions. If you keep portion sizes reasonable, it’s easier to eat the foods you want and stay healthy. Did you know the recommended serving of cooked meat is 3 ounces, similar in size to a deck of playing cards? A medium piece of fruit is 1 serving and a cup of pasta equals 2 servings. A pint of ice cream contains 4 servings. Refer to the Food Guide Pyramid for information on recommended serving sizes.
5. Eat regular meals. Skipping meals can lead to out-of-control hunger, often resulting in overeating. When you’re very hungry, it’s also tempting to forget about good nutrition. Snacking between meals can help curb hunger, but don’t eat so much that your snack becomes an entire meal.
6. Reduce, don’t eliminate certain foods. Most people eat for pleasure as well as nutrition. If your favorite foods are high in fat, salt or sugar, the key is moderating how much of these foods you eat and how often you eat them. Identify major sources of these ingredients in your diet and make changes, if necessary. Adults who eat high-fat meats or whole-milk dairy products at every meal are probably eating too much fat. Use the Nutrition Facts panel on the food label to help balance your choices.

   Choosing skim or low-fat dairy products and lean cuts of meat such as flank steak and beef round can reduce fat intake significantly.

   If you love fried chicken, however, you don’t have to give it up. Just eat it less often. When dining out, share it with a friend, ask for a take-home bag or a smaller portion.

7. Balance your food choices over time. Not every food has to be “perfect.” When eating a food high in fat, salt or sugar, select other foods that are low in these ingredients. If you miss out on any food group one day, make up for it the next. Your food choices over several days should fit together into a healthy pattern.
8. Know your diet pitfalls. To improve your eating habits, you first have to know what’s wrong with them. Write down everything you eat for three days. Then check your list according to the rest of these tips. Do you add a lot of butter, creamy sauces or salad dressings? Rather than eliminating these foods, just cut back your portions. Are you getting enough fruits and vegetables? If not, you may be missing out on vital nutrients.
9. Make changes gradually. Just as there are no “superfoods” or easy answers to a healthy diet, don’t expect to totally revamp your eating habits overnight. Changing too much, too fast can get in the way of success. Begin to remedy excesses or deficiencies with modest changes that can add up to positive, lifelong eating habits. For instance, if you don’t like the taste of skim milk, try low-fat. Eventually you may find you like skim, too.
10. Remember, foods are not good or bad. Select foods based on your total eating patterns, not whether any individual food is “good” or “bad.” Don’t feel guilty if you love foods such as apple pie, potato chips, candy bars or ice cream. Eat them in moderation, and choose other foods to provide the balance and variety that are vital to good health.

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Healthy eating to all…

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