Tuesday, January 26, 2010

The "Dash Diet" and Orlistat - Low Carbs mean Lower Blood Pressure?

"There are many paths to weight loss." --- Registered dietitian Karen Congro, director of the "Wellness for Life" Program at The Brooklyn Hospital Center, NYC

Researchers at the Duke University Medical Center just announced the results of a new important study. They've found that a low-carbohydrate diet helps people shed as many pounds as a low-fat diet plus the powerful weight-loss drug Orlistat.

(Orlistat is marketed as Xenical, a prescription medication, and Alli, available over-the-counter.)

The low-carb plan could definitely help lower blood pressure, the researchers reported. The Duke scientists compared the DASH (Dietary Approaches to Stop Hypertension) diet alone, and in combination with exercise and weight management.

Their study (published in the Jan. 25 issue of the Archives of Internal Medicine), says both diets are weight-effective--- both helped participants lose almost 10 percent of their body weight!

Researcher Dr. William Yancy is an associate professor of medicine at Duke University Medical Center, and a staff physician at the Department of Veterans Affairs Medical Center in Durham, N.C.

He said he believes that both diet plans can work well against the many ills of obesity, if the plan chosen were followed. Two other studies (in the same issue of the journal) compare the effectiveness of the anti-hypertension DASH diet, and a physician-supervised plan.

Dr Yancy said, "Weight loss was similar but substantial in both groups we studied, but blood pressure improved more in the low-carb dieters. There are options out there. Pick a diet you think you could stick to better, and work with your physician to help you target the right intervention for you."

An editorial in the same journal, by Dr. Robert Kushner of Northwestern University's Feinberg School of Medicine, pointed to obesity as the cause of many illnesses, including heart disease, stroke, diabetes and a long list of cancers.

Dr Kushner said that over one-third of American adults are obese--- worse, the incidence of obesity has gone up 140 percent over the past decade alone!

Dr Yancy's researchers studied 146 overweight or obese adults. Some were randomly assigned to a low-carb diet.

Others were assigned to treatment with Orlistat and a low-fat diet. The average age of the study participants was 52. Their average BMI was 39 (over 30 is considered obese).

The low-carb diet group began with a carb intake under 20 grams/day. The group taking Orlistat received a 120-milligram dose 3 times daily; they also were limited in diet to 30 percent calories from fat.

Over 48 weeks, the low-carbohydrate group lost 9.5 percent of their body weight, while the Orlistat group lost 8.5 percent. "Good" cholesterol (HDL) and triglyceride levels improved in both groups.

However, LDL, or "bad" cholesterol, was only reduced in the Orlistat group.

Insulin and glucose markers improved only in the low-carb group.

Blood pressure improved in the low-carb group, compared to the Orlistat group.

Also, researchers combining the DASH diet with weight management and exercise, got results in a 16.1 mm Hg drop in systolic blood pressure--- compared to 11.2 mm Hg on the DASH diet alone.

Combining the exercise, weight management and DASH plan, brought an average weight loss of 19 pounds over four months! This result is amazing, compared to less than one pound for the DASH diet alone.

Another every more proactive third study compared an Internet weight-management program, with a physician-managed program, for extremely obese people. This included a liquid diet component, followed by a structured diet, behavioral counseling and diet medications.

The more intensive intervention was even more successful--- 31 percent of the group dropped more than 5 percent of their body weight, compared to just 9 percent of the Internet group.

What often makes the difference in whether or not a diet is successful, one researcher stated, is whether or not there's a counseling and support component to the plan.

Bottom line, these studies show that you don't necessarily need to get to your "ideal body weight" to make substantial improvements to your health. Losing 5 percent to 10 percent of your body weight can make life-saving changes in blood pressure, in cholesterol and in glucose control.

So which diet plan is most effective and best suited for endangered individuals?

Regular exercise, a low-carb diet, the medication Orlistat?

"If it can make you a healthier person, then a diet is a success," said Registered dietitian Karen Congro, director of the "Wellness for Life" Program at The Brooklyn Hospital Center, NYC.

There are many paths to weight loss, yes. But the plan you follow is always the best plan. On this all researchers AGREE!

(SOURCES: William Yancy Jr., M.D., M.H.S., associate professor, medicine, Duke University Medical Center, and staff physician, Department of Veterans Affairs Medical Center, Durham, N.C.; Karen Congro, R.D., C.D.N., director, Wellness for Life Program, The Brooklyn Hospital Center, New York City; Jan. 25, 2010, Archives of Internal Medicine)


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