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[check mark] Alcohol and Gastric Bypass Patients


[check mark] Alli Crazy


[check mark] Food Marketing and Kids


Alli Feeding Frenzy

There is a feeding frenzy under way for the weight-loss aid Alli, according to the Wall Street Journal. At a Walgreens in Santa Monica, Calif, the nonprescription fat blocker from GlaxoSmithKline was almost sold out in the first 4 hours it was on the shelf, the Los Angeles Times reported. The Food and Drug Administration approved GlaxoSmithKline's petition to market its over-the-counter version of orlistat, the active ingredient in its weight-loss drug Xenical. Alli is sold in 60-capsule and 90-capsule starter packs and a 120-capsule refill pack costing approximately 60 cents a capsule or $1.80 per day. A 90-pill starter kit costs $62.99 at, and Glaxo says the medicine will be available in major drug, grocery, and discount stores across the country today.


As a lipase inhibitor, the drug acts by blocking the digestion of fat in foods, resulting in as much as a 25% reduction in fat absorption from the diet. This is somewhat less than the prescription version, which blocks as much as 33%. Alli works best with a defined regimen of a low-energy diet and physical activity. Adverse effects can occur, especially when a great deal of dietary fat is consumed as when eating high-fat foods, resulting in the urge to go to the bathroom and oily stools.




Gastric Bypass Alters Alcohol's Effects

Gastric bypass surgery alters alcohol absorption and also metabolism-as many surgeons and patients have long suspected-leading to faster peaks of alcohol in the blood and prolonged effects without an increase in symptoms, researchers found. In a case-control study, blood alcohol concentration peaked approximately 0.03% higher and took 40 minutes longer to dissipate among patients who had undergone bariatric surgery than in those who had not. Although some of the factors involved in alcohol metabolism-weight, liver function, food intake, and production of the enzyme alcohol dehydrogenase-are greatly altered by gastric bypass surgery, only a small number of patients have been studied, 11 women in Sweden and, in this study, 19 patients who had undergone gastric bypass surgery at least a year before and 17 volunteers matched for age, sex, and weight, who had not had bariatric surgery, who had the same drinking histories and patterns. Approximately 20% of participants in both groups were male. However, the surgery group was older (average, 47 vs 37 years) and heavier (200.8 vs 149.8 lb). After fasting for at least 2 hours, participants drank 5 oz of red wine for 15 minutes. Investigators measured their breath alcohol level initially then every 5 minutes until it reached zero and found that the patients who had undergone bariatric surgery had higher peak breath alcohol levels, at 0.08%-which is legally drunk in some states-compared with 0.05% in the control group. Also, the gastric bypass group took almost 40 minutes longer to completely metabolize the alcohol (108 vs 72 minutes). Age- and weight-adjusted breath alcohol curves showed significantly higher levels at each time point for the gastric bypass patients compared with the controls. Gastric bypass surgery was by far the most significant predictor for breath alcohol to go to zero compared with the other significant predictors (sex, body mass index, and starting level).


The bypass patients did not report more symptoms. The bottom line is that those who are undergoing gastric bypass surgery need to approach alcohol with caution and to skip that second drink.


Source: Med Page Today/American Society for Bariatric Surgeons Meeting 2007


Can Americans Maintain Weight Loss? Yes They Can!!

Every so often, another study comes out depicting the average American as an incorrigible yo-yo dieter and committed couch potato; however, nearly 6 in 10 people maintained their weight loss to within 5% over a year's time in a new study that analyzed data gleaned from the National Health and Nutrition Examination Survey on 1,310 adults ages 20 to 84 years who had experienced "substantial" weight loss-10% of their initial weight in this population-based study that is representative of the United States for race, sex, and age. Only 7.6% of survey participants were still losing weight after 1 year, and 33.5% regained weight. Unfortunately, those with more weight to lose were those more likely to put those pounds back on; however, one possible explanation is that those who lost larger percentages of their maximum weight may have had to make greater lifestyle changes, and these are difficult to incorporate and sustain. Hispanic dieters want to lose. They are more successful with a culturally attuned program that allows for larger meals at lunchtime and incorporates familiar food. But they need to be especially careful about regaining weight because in this study, they seemed to be at special risk.


Source: American Journal of Preventive Medicine


What's in Foods Marketed to Kids?

When buying foods for children, it is reasonable to reach for those that feature extra nutrition information on the front of the package. Marketing labels that highlight, for example, "good source of nutrient x, y or z" seem to offer a nutritional home run to many parents. But research presented at the 2007 Experimental Biology conference explains that more than half of the kids' foods that feature such information in the 6 major grocery stores in their local area were found to also be high in saturated fat, sodium, and/or added sugar. Researchers at the US Department of Agriculture's Human Nutrition Research Center at Grand Forks North Dakota surveyed nearly 57,000 food labels from the major grocery stores within the Grand Forks metropolitan area. Of those, 9,105 seemed to be marketed toward children, based on qualifiers such as graphics, lettering, and promotion designs. Nearly 80% of those foods marketed toward children-approximately 7,284-carried some nutrition marketing information on the package. But 60% of the kid-oriented foods that were packaged with nutrition marketing-approximately 4,370 foods-were also high in saturated fat, sodium, and/or added sugar, when compared with the levels recommended in the 2005 Dietary Guidelines for Americans. So there is plenty of room for healthy innovations in the child food area!


Source: USDA ARS News Service


Fiber and Magnesium Intake Protects Against Developing Type 2 Diabetes

Higher cereal fiber and magnesium intake may decrease risk for type 2 diabetes, according to the results of a cohort that was followed from 1994 to 2005 to evaluate the association between total, cereal, fruit, and vegetable fibers, as well as soluble and insoluble fiber and magnesium intake.


Investigators in the European Prospective Investigation Into Cancer and Nutrition-Potsdam study estimated dietary intake of fiber and magnesium using a food frequency questionnaire and followed 9,702 men and 15,365 women 35 to 65 years old at entry to see if they developed diabetes. The investigators also did a meta-analysis of other similar studies on fiber, magnesium, and type 2 diabetes; they found 9 cohort studies of fiber and 8 studies of magnesium intake since 2006 and then calculated relative risks using a random-effects model. During 176,117 person-years of follow-up, 844 people developed type 2 diabetes. Higher cereal fiber intake was associated with lower diabetes risk, but the fruit fiber and vegetable fiber were not, nor was magnesium in the European Prospective Investigation Into Cancer and Nutrition-Potsdam study, and in the larger analysis, both higher magnesium and higher cereal fiber intakes were associated with lower risk. Although the authors concluded that higher cereal fiber and magnesium intakes may decrease risk, cohort studies need to be followed up with randomized clinical trials to make sure the findings are actually due to these nutrients.


Source: Archives of Internal Medicine


Study Shows Chromium Picolinate Plus Biotin Significantly Improves Blood Sugar Control in People With Type 2 Diabetes

Lowering hemoglobin A1c, the standard measurement of blood sugar levels, especially in patients with poor blood sugar control, can delay or prevent serious complications, reduce diabetes-related deaths, and reduce healthcare costs. A 447-person, randomized, double-blind, placebo-controlled clinical study of patients with diabetes who were already being treated with oral antidiabetic medications showed that supplementing with chromium picolinate plus biotin significantly lowered hemoglobin A1c levels and improved glycemic control in patients with poorly controlled blood sugar levels. The greatest improvement was among those who had an additional absolute A1c decrease of 1.76% in the study group despite the fact that they were taking one or more oral antidiabetic. Fasting glucose levels were also reduced in the entire treatment group (-9.8 mg/dL) compared with placebo (0.7 mg/dL), and the decrease was greater for the patients with highest risk when compared with placebo (-35.8 vs 16.2 mg/dL). The treatment was well tolerated, and adverse effects and the clinical safety profile for the active group were not significantly different from placebo.


Those individuals receiving chromium picolinate plus biotin, in the form of Diachrome, also experienced a significant decrease in ratio of triglycerides to high-density lipoprotein compared with the placebo group (P = .05 vs placebo).


Source: Diabetes/Metabolism Research and Reviews


In last issue's newsbreak section the article, "Phone Counseling to Improve Eating and Exercise" came from the May issue of American Journal of Preventative Medicine, not J Am Geriatrics.