Supportive Weigh-In Program Keeps Pounds Off

Women maintained losses with biweekly checks and counseling, study finds

MONDAY, May 11 (HealthDay News) -- The struggle to keep the pounds off that one has just lost can be aided effectively and inexpensively with a simple five-minute weigh-in with a nurse every couple of weeks.

New Zealand researchers, writing in the medical journal CMAJ, found that the biweekly weigh-in, along with a call from the same nurse during the intervening weeks, helped women maintain their weight loss as well as a more expensive and intensive program using dietitians and exercise specialists.

The study, which followed most of 200 women for two years, randomly divided the participants into one group that had the weigh-ins and supportive phones calls with a nurse and another that followed a more comprehensive diabetes prevention program that included regular exercise programs. At the study's start, all the women -- aged 25 to 70 -- had recently lost at least 5 percent of their total body weight.

While intensive programs used for the one group had already been proven successfully in weight maintenance, "the costs to implement these programs are considerable and well beyond the means of health budgets in many countries," wrote the study authors, from the Edgar National Centre for Diabetes Research in Dunedin, New Zealand.

The authors reported that attendance for weigh-ins was excellent, while the other group did not do nearly as well with showing up for its exercise classes. By the second year of the study, attendance at the exercise program declined even further.

"Many participants reported that the weigh-ins and the enthusiastic support provided by the nurse on those occasions and on the telephone were key determinants of their success," wrote the researchers.

While the authors highly supported hospitals adding nurse-led weigh-in programs, Robert Ross of Queens University in Kingston, Ontario, wrote in a related commentary in the same issue of CMAJ that adding such programs may not be possible in places where nurses are in short supply. But, he added, that other people -- including exercise specialists and dietitians -- may be just as effective in such a support-oriented program, as he noted that the nurses used for the study were enthusiastic but not trained in nutrition and exercise.

More information

The U.S. Department of Health and Human Services has more about maintaining a healthy weight.

-- Kevin McKeever

Antioxidants Blunt Exercise Benefit, Study Shows

Vitamins C, E block creation of free radicals that promote insulin sensitivity, researchers say

By Steven Reinberg

HealthDay Reporter

MONDAY, May 11 (HealthDay News) -- Exercise helps increase insulin sensitivity and ward off diabetes, but taking supplemental antioxidants such as vitamins C and E actually blunts that benefit, researchers report.

Exercise helps increase the body's sensitivity to insulin by making reactive oxygen species, or "free radicals," which antioxidants work against. These free radicals are thought to damage cells and speed the aging process, but they are also used by the body to prevent cell damage after exercising, the researchers say.

"When you exercise you do improve your insulin sensitivity, and if you are at risk for diabetes improving insulin sensitivity is good," said researcher Dr. C. Ronald Kahn, the Mary K. Iacocca Professor at the Joslin Diabetes Center and Harvard Medical School.

Part of the reason that exercise improves insulin sensitivity is that it causes oxidative stress on the muscles. The muscles respond to this stress by creating free radicals, Kahn said.

"If you take antioxidants like vitamins C and E, you block the oxidative stress response, but you also block the beneficial effects of exercise on insulin sensitivity," he said.

The report is published in this week's online edition of the Proceedings of the National Academy of Sciences.

For the study, Kahn's team looked at the benefit of exercise in increasing insulin resistance in 39 young men, roughly half of whom were taking supplemental vitamins C and E.

Kahn's group found that men taking vitamin supplements had no change in their insulin resistance, but men not taking vitamins had an increase in free radicals, which increases insulin resistance. A month after stopping the vitamin supplements insulin sensitivity was restored, the researchers noted.

"If you are exercising, in part, to reduce diabetes risk, you shouldn't take vitamin C and E, because you are going to block some of the beneficial effect of the exercise to prevent the diabetes," Kahn said.

Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, thinks this study raises doubts about the benefits of taking antioxidant supplements, but not about the value of these vitamins in the foods people eat.

"We have long held out hope that antioxidant supplements, among them vitamin C, vitamin E, beta carotene, and more recently lycopene and others, would help prevent diseases from the common cold to cancer, heart disease to diabetes," Katz said. "But to date, virtually all of the best research evidence is contrary to this hope."

This study has a counter-intuitive conclusion, namely that antioxidant supplements may actually interfere with the beneficial effects of exercise on insulin sensitivity, Katz said.

"This is a small and short-term study, and thus cannot tell us definitively that antioxidant supplements are harmful in diabetes or the insulin-resistant state that often precedes it. But that is precisely what the study suggests may be true," Katz said.

For now, there is substantial uncertainty about any health benefits and the potential harms of antioxidants as supplements, Katz said. "But we have no such confusion about the powerful health-promoting effects of wholesome, mostly plant-based diets and regular physical activity."

More information

For more information on antioxidants, visit the U.S. National Library of Medicine.

SOURCES: C. Ronald Kahn, M.D., Mary K. Iacocca Professor, Joslin Diabetes Center and Harvard Medical School, Boston; David L. Katz, M.D., M.P.H., director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; May 11-15, 2009, Proceedings of the National Academy of Sciences, online

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