Intermittent fasting: No advantage over conventional weight loss diets

Intermittent fasting helps lose weight and promotes health. However, it is not superior to conventional calorie restriction diets, scientists from the German Cancer Research Center (DKFZ) and Heidelberg University Hospital have found out in a study called HELENA -- the largest investigation on intermittent fasting to date.The scientists conclude that there are many paths leading to a healthier weight. Everybody must find a diet plan that fits them best and then just do it!

Feasting eight hours and then fasting the following 16 hours? Or is it even better to fast two whole days a week and then enjoy eating without regrets for the rest of the week? Intermittent fasting, also known as 16:8 diet or 5:2 diet, is trendy. Numerous popular self-help books on this topic promise weight loss without yo-yo effect as well as sustained changes in metabolism and resulting health benefits. The German Nutrition Society (DGE), on the other hand, warns that intermittent fasting is not suitable for long-term weight regulation. In addition, according to DGE, there is not enough scientific evidence on the long-term effects of this dieting method.

"There are in fact only a few smaller studies on intermittent fasting so far, but they have come up with strikingly positive effects for metabolic health," says DKFZ's Ruth Schübel. "This made us curious and we intended to find out whether these effects can also be proven in a larger patient group and over a prolonged period."

In collaboration with a team of DKFZ researchers and scientists from Heidelberg University Hospital, Schübel examined 150 overweight and obese study participants over one year as part of the HELENA study. At the start of the study, they were randomly classified in three groups: One third followed a conventional calorie restriction diet that reduced daily calorie intake by 20 percent. The second group kept to a 5:2 dietary plan that also saved 20 percent of calorie intake over the whole week. The control group followed no specific diet plan but was advised, like all other participants, to eat a well-balanced diet as recommended by DGE. Following the actual dieting phase, the investigators documented the participants' weight and health status for another 38 weeks.

The result may be as surprising as it is sobering for all followers of intermittent fasting. The HELENA researchers found that improvements in health status were the same with both dietary methods. "In participants of both group, body weight and, along with it, visceral fat, or unhealthy belly fat, were lost and extra fat in the liver reduced," Schübel reported.

The changes in body weight distribution in the study participants were exactly determined using special MRT imaging executed by Johanna Nattenmüller at Heidelberg University Hospital. The good news is: a small dieting success is already a big gain for health. Those who reduce their body weight by only five percent, lose about 20 percent of dangerous visceral fat and more than a third of fat in the liver -- no matter which dietary method they have used.

The investigators also did not find any difference between the two dieting methods in any other metabolic values that were analyzed or biomarkers and gene activities under investigation.

Although the HELENA study does not confirm the euphoric expectations placed in intermittent fasting, it also shows that this method is not less beneficial than conventional weight loss diets. "In addition, for some people it seems to be easier to be very disciplined on two days instead of counting calories and limiting food every day," explained Tilman Kühn, leading scientist of the trial. "But in order to keep the new body weight, people must also permanently switch to a balanced diet following DGE recommendations," he added.

According to Kühn, the study results show that it is not primarily the dietary method that matters but that it is more important to decide on a method and then follow through with it. "The same evidence is also suggested in a current study comparing low-carb and low-fat diets, that is, reducing carbohydrates versus reducing fat intake while otherwise having a balanced diet," said Kühn. In this study, participants also achieved comparable results with both methods.

The scientists' credo is therefore: "Just do it!" Body and health will benefit from weight loss in any case, as long as it is achieved by a reliable dieting method and on the basis of a well-balanced diet.

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Story Source:

Materials provided by German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ). Note: Content may be edited for style and length.

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Journal Reference:

1. Ruth Schübel, Johanna Nattenmüller, Disorn Sookthai, Tobias Nonnenmacher, Mirja E Graf, Lena Riedl, Christopher L Schlett, Oyunbileg von Stackelberg, Theron Johnson, Diana Nabers, Romy Kirsten, Mario Kratz, Hans-Ulrich Kauczor, Cornelia M Ulrich, Rudolf Kaaks, Tilman Kühn. Effects of intermittent and continuous calorie restriction on body weight and metabolism over 50 wk: a randomized controlled trial. The American Journal of Clinical Nutrition, 2018; 108 (5): 933 DOI: 10.1093/ajcn/nqy19

First risk genes for ADHD found

A major international collaboration headed by researchers from the Danish iPSYCH project, the Broad Institute of Harvard and MIT, Massachusetts General Hospital, SUNY Upstate Medical University, and the Psychiatric Genomics Consortium has for the first time identified genetic variants which increase the risk of ADHD. The new findings provide a completely new insight into the biology behind ADHD.

Our genes are very important for the development of mental disorders -- including ADHD, where genetic factors capture up to 75% of the risk. Until now, the search for these genes had yet to deliver clear results. Researchers from the Psychiatric Genomics Consortium have compared genetic variation across the entire genome for over 20,000 people with ADHD and 35,000 who do not suffer from it -- finding twelve locations where people with a particular genetic variant have an increased risk of ADHD compared to those who do not have the variant.

The results of the study have just been published in the scientific journal Nature Genetics.

"The large amount of data enabled us to find, for the first time, locations in the genome where people with ADHD stand out from those who are healthy. The search for such genetic risk variants for ADHD has spanned decades but without obtaining robust results. This time we really expanded the number of study subjects substantially, increasing the power to obtain conclusive results significantly. In particular, we included a large number from the Danish iPSYCH cohort representing more than 2/3 of the total international study sample," explains Associate Professor Ditte Demontis from Aarhus University.

She along with Raymond Walters of Massachusetts General Hospital are the lead authors of the study, working as part of the ADHD group of the Psychiatric Genomics Consortium, an international consortium of researchers dedicated to uncovering the genetics factors that give rise to ADHD.

These genetic discoveries provide new insights into the biology behind developing ADHD. For example, some of the genes have significance for how brain cells communicate with each other, while others are important for cognitive functions such as language and learning.

"Overall, the results show that the risk variants typically regulate how much a gene is expressed, and that the genes affected are primarily expressed in the brain," explains Professor Demontis.

The same genes affect impulsivity in healthy people

In the study, the researchers have also compared the new results with those from a genetic study of continuous measures of ADHD behaviours in the general population. The researchers discovered that the same genetic variants that give rise to an ADHD diagnosis also affect inattention and impulsivity in the general population.

"The risk variants are thus widespread in the population. The more risk variants you have, the greater your tendency to have ADHD-like characteristics will be as well as your risk of developing ADHD," says Professor Anders Børglum from Aarhus University. He is research head at iPSYCH and one of the leading researchers who directed the study along with Professors Stephen Faraone of SUNY Upstate Medical University and Benjamin Neale of Massachusetts General Hospital and the Broad Institute.

"We also studied the genetic overlap with other diseases and traits. Through this we found a strong negative genetic correlation between ADHD and education. This means that on average genetic variants which increase the risk of ADHD also influence performance in the education system negatively for people in the general population who carry these variants without having ADHD," says Ditte Demontis.

Conversely, the study found a positive correlation between ADHD and obesity, increased BMI and type-2 diabetes, which is to say that variants that increase the risk of ADHD also increase the risk of overweight and type-2 diabetes in the population.

"These findings and results also underscore the importance of collaboration to advance discovery efforts. It is only through data sharing and working together that we were able to find these regions of the genome," explains Dr. Benjamin Neale.

"The new findings mean that we now -- after many years of research -- finally have robust genetic findings that can inform about the underlying biology and what role genetics plays in the diseases and traits that are often cooccurring with ADHD. In addition, the study is an important foundation for further research into ADHD. We can now target our studies, so we can achieve a deeper understanding of how the risk genes affect the development of ADHD with the aim of ultimately providing better help for people with ADHD," says Anders Børglum.

"We have laid the foundation for future work that will clarify how genetic risks combine with environmental risks to cause ADHD. When the pieces of that puzzle come together, researchers will be able to improve the diagnosis and treatment of ADHD" says Professor Stephen Faraone.

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Materials provided by Aarhus University. Original written by Annette Bang Rasmussen. Note: Content may be edited for style and length.

Weight cycling is associated with a higher risk of death

Weight cycling is associated with a higher risk of death, according to a new study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.

Weight cycling, or the constant losing and gaining of weight (usually from diet), leads to adverse health outcomes. By some estimates, 80 percent of people who lose weight will gradually regain it to end up at the same weight or even heavier than they were before they went on a diet. The Endocrine Society's Scientific Statement on the causes of obesity found this was because once an individual loses weight, the body typically reduces the amount of energy expended at rest, during exercise and daily activities while increasing hunger. This combination of lower energy expenditure and hunger creates a "perfect metabolic storm" of conditions for weight gain.

"This study shows that weight cycling can heighten a person's risk of death," said lead study author Hak C. Jang, M.D., Ph.D., Professor, Seoul National University (SNU) College of Medicine and Seoul National University Bundang Hospital in Seongnam, Korea. "However, we also concluded that weight loss as a result of weight cycling can ultimately reduce the risk of developing diabetes in people with obesity."

In the 16-year prospective cohort study, researchers examined 3,678 men and women from the Korean Genome and Epidemiology Study and found weight cycling was associated with a higher risk of death. Interestingly, people with obesity who experienced more weight cycling were less likely to develop diabetes than other study participants. The health benefits of weight loss overshadowed the adverse effects of weight cycling for individuals with obesity looking to lower their diabetes risk.

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Materials provided by The Endocrine Society. Note: Content may be edited for style and length.

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Journal Reference:

1. Tae Jung Oh, Jae Hoon Moon, Sung Hee Choi, Soo Lim, Kyong Soo Park, Nam H Cho, Hak Chul Jang. Body-weight fluctuation and incident diabetes mellitus, cardiovascular disease, and mortality: a 16-year prospective cohort study. The Journal of Clinical Endocrinology & Metabolism, 2018; DOI: 10.1210/jc.2018-01239

How to Recover From a Hernia

Getting a hernia from lifting weights or being athletic is a horrible experience. Hernia surgery involves a long road to recovery — one that’s effective as long as you stick to the process and take your time through it. As a lifter and coach who’s undergone hernia surgery, I’ll tell you what you need to know if you find yourself in similar shoes.

But First, What Is a Hernia?

Truthfully, hernias can come in different forms. Umbilical hernias are located around the midstomach region, and inguinal hernias are located in the lower pelvic region. In each case, the lining of the abdominal wall is compromised, allowing for tissue underneath to push through. Depending on the severity and nature of the injury, this can be painful and even require emergency surgery.

The urgency of the hernia really depends not only on its location but also the tissue type that’s escaped. When the abdominal lining is torn, often a fatty tissue known as the omentum is what causes the protrusion. Often, this can create a bulge with minimal pain symptoms (as was the case with my own inguinal hernia). This generally means you can still carefully function while you prepare for surgical repair in the coming weeks or months. In other cases, organ tissue can begin to fall through and surgery needs to be arranged as soon as possible to put the organ (in the case of inguinal hernias, usually the intestine) back into place.

Whatever the nature, surgery is the ultimate answer. Naturally, most people who go under the knife wonder whether they’ll ever be able to return to the same level of capability they had before getting injured.

You Can!

And that is good news. I had my strongest PRs in major lifts well after my surgery in 2011. If you’re recovering from hernia surgery, these guidelines will set you on the right path to positive results without setbacks. On a similar note, many of these points can benefit a lifter who’s healthy and trying to avoid a hernia.

Ask Your Parents

Like many aliments, potential for getting a hernia from exercise is heightened depending on whether you’re genetically inclined to get one. Ask your parents if they’ve ever had any, and if yes, you’ll know you’re probably more susceptible to one than the next guy is. With that said, training smart matters tenfold.

Everybody, Breathe!

Like the subheading suggests, this one applies to both recovering hernia patients and healthy individuals who have never been injured. Improper breathing technique is one major player in exercise that can be a huge cause of hernias. Understand the importance of exhaling on the exertion phase of your lifts, remaining braced, creating intra-abdominal pressure and limiting the amount of strain you place on areas like your pelvic floor. All exercise starts with good breathing. Practice it under light weight and get used to it. If you’ve been injured, it will only matter that much more.

Be Careful With Anti-Extension Work

It took me a long time before I could get back to exercises like ab wheel rollouts, hand walkouts and barbell strict presses. The common thing among these movements is the anti-extension capacity of the abdominals. They place the abdominal tissue into a stretch that a strong contraction negates (in order to keep the spine neutral and intact).

Remember, you’ve been stitched up because your abdominal wall was torn open. With that in mind, you can easily reinjure yourself if you’re not careful. Start your abdominal work in a neutral position and not an extended one. Work with short plank variations before pushing the envelope. If you’re healthy, pay special attention to your spine position during heavy overhead presses and rollouts. Just because it doesn’t “hurt” to fall into extension, don’t try to be a hero. Lower your load on presses (or range of motion on rollouts) and do what you can with your glutes and abs remaining engaged.

Take a Closer Look at Your Hip Complex

Don’t forget that many muscles cross through the core junction, and the hip joint is a complex one. The iliacus, psoas, transverse abdominal muscle, rectus abdominis and more are all part of the region between the bellybutton and the upper thigh. When you’ve had a hernia repair, regardless of its location, plenty of scar tissue will be a byproduct of the healing process, which will severely limit your range of motion to start. You’ll be limited in what you can do at the beginning, but creating more flexibility within your bounds is key.

Gentle stretching and rolling can do your body good, especially focusing on muscles that surround the site (think quads, glutes, IT band). You risk reinjury if you get right back into weight training without paying attention to your mobility and flexibility.

Listen to the Doc

In conclusion, no one wants to go under the knife. In the training community, everyone who does seems to want to set a world record for recovery time, and then post their exploits on social media with trite motivational quotes. Instead, let recovery be the name of the game and take the time you need to get better. No one’s trying to be a hero — especially not a recreational lifter with a day job. 

Response to daily stressors could affect brain health in older adults

Taking typical daily annoyances such as a long wait at the doctor's office or a traffic jam on the freeway in stride may help preserve brain health in older adults, while emotional reactions could contribute to declines in cognition, a new study from Oregon State University has found.

"These results confirm that people's daily emotions and how they respond to their stressors play an important role in cognitive health," said Robert Stawski, an associate professor in OSU's College of Public Health and Human Sciences and the study's lead author. "It's not the stressor itself that contributes to mental declines but how a person responds that affects the brain."

The findings contribute to a growing body of research that focused on daily stress as a risk factor for compromised mental, physical and cognitive health. The findings have vital real-world applications, given that the world's fastest growing age group is adults 80 and over, said Stawski, who studies how stressful experiences influence health, well-being and cognition.

Brain health and cognition are important as we age. They contribute to one ability to function in day-to-day life and can reflect diseases including dementias and Alzheimer's. The findings were recently published online in Psychosomatic Medicine, the journal of American Psychosomatic Society. Co-authors include OSU students Eric Cerino and Dakota Witzel, and Stuart W.S. MacDonald of the University of Victoria.

For the study, researchers followed 111 older adults, ranging in age from 65 to 95, for 2½ years. Every six months, they participated in a series of cognitive assessments for six days over a two-week period.

During the assessments, participants looked at a series of two strings of numbers and were asked whether the same numbers appeared in the two strings, regardless of order. Past studies have linked fluctuations in how quickly people can do this exercise with decreased mental focus, cognitive aging and risk for dementia as well as structural and functional brain changes that reflect poor cognitive health. Each participant completed the numbers exercises for up to 30 sessions over the 2½-year period.

The participants also were asked about stressors experienced that day by themselves, a family member or a close friend; rated how they felt right at that moment, choosing from an array of positive and negative emotions and a range of intensity; and filled out a checklist of physical symptoms. In the overall comparison, those who responded to stressful events with more negative emotions and reported a more dour mood in general showed greater fluctuations in their performance, which suggests worse mental focus and cognitive health among the more strongly negative and reactive people.

But by following each person over time, the scientists also could track what happened on an individual basis, and striking age differences emerged. For the oldest participants -- late 70s to mid-90s -- being more reactive to stressors than usual also contributed to worse cognitive performance.

In contrast, people in their late 60s to mid-70s actually did better on the test if they reported more stressors. "These relatively younger participants may have a more active lifestyle to begin with, more social and professional engagement, which could sharpen their mental functioning," Stawski said.

Older adults should be aware of their emotional reactions to stressful events and explore stress-lowering strategies, if needed, to preserve brain health and cognitive function, he said.

"We can't get rid of daily stressors completely," Stawski said. "But endowing people with the skills to weather stressors when they happen could pay dividends in cognitive health."

The research was supported by the National Institute on Aging at the National Institutes of Health, the Natural Sciences and Engineering Research Council of Canada, and the Michael Smith Foundation for Health Research.

Story Source:

Materials provided by Oregon State University. Note: Content may be edited for style and length.

Journal Reference:

Robert S. Stawski, Eric S. Cerino, Dakota D. Witzel, Stuart W.S. MacDonald. Daily Stress Processes as Contributors to and Targets for Promoting Cognitive Health in Later Life. Psychosomatic Medicine, 2018; 1 DOI: 10.1097/PSY.0000000000000643

Different types of physical activity offer varying protection against heart disease

While it is well known that physical activity is important for heart health, neither research nor recommendations consistently differentiate between the benefits of different types of physical activity. New research, presented at the ACC Latin America Conference 2018 in Lima, Peru, found that while all physical activity is beneficial, static activities -- such as strength training -- were more strongly associated with reducing heart disease risks than dynamic activities like walking and cycling.

"Both strength training and aerobic activity appeared to be heart healthy, even in small amounts, at the population level," said Maia P. Smith, PhD, MS, statistical epidemiologist and assistant professor in the Department of Public Health and Preventive Medicine at St. George's University in St. George's, Grenada. "Clinicians should counsel patients to exercise regardless -- both activity types were beneficial. However, static activity appeared more beneficial than dynamic, and patients who did both types of physical activity fared better than patients who simply increased the level of one type of activity."

Researchers analyzed cardiovascular risk factors, such as high blood pressure, overweight, diabetes and high cholesterol, as a function of self-reported static and/or dynamic activity (strength training or walking/biking) in 4,086 American adults using data from the 2005-2006 National Health and Nutrition Examination Survey. The researchers then adjusted for age, ethnicity, gender and smoking and stratified by age: 21 to 44 years old or over 45 years old.

In total, 36 percent of younger and 25 percent of older adults engaged in static activity, and 28 percent of younger and 21 percent of older adults engaged in dynamic activity. Researchers found engaging in either type of activity was associated with 30 to 70 percent lower rates of cardiovascular disease risk factors, but associations were strongest for static activity and in youth.

"One interesting takeaway was that both static and dynamic activity were almost as popular in older people as younger," Smith said. "I believe this gives clinicians the opportunity to counsel their older patients that they will fit into the gym or the road race just fine. The important thing is to make sure they are engaging in physical activity."

Smith said future research and data collection should use definitions of physical activity that separate static from dynamic activity to further investigate independent effects.

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Materials provided by American College of Cardiology. Note: Content may be edited for style and length.

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American College of Cardiology. "Different types of physical activity offer varying protection against heart disease: Static activity, such as strength training, appears more beneficial." ScienceDaily. ScienceDaily, 16 November 2018. .

Antioxidants may prevent cognitive impairment in diabetes

Cognitive difficulties in patients with diabetes, caused by repeated episodes of low blood sugar, could be reduced with antioxidants, according to a new study presented at the Society for Endocrinology annual conference in Glasgow. The study findings suggest that stimulating antioxidant defences in mice reduces cognitive impairments caused by low blood sugar, which could help to improve the quality of life for diabetic patients.

Long-term decline in cognitive function, with everyday learning and memory tasks becoming harder and taking longer to complete, is a common consequence for patients who frequently experience low blood sugar levels when using insulin to manage their diabetes. Previous studies in mice have shown that reoccurring episodes of low blood sugar leads an accumulation of cell damaging free radicals in the brain. Whether this build-up of free radical stress directly effects cognitive function, and if the body's own antioxidative systems, which can remove free radicals, can be harnessed to counteract these changes and improve quality of life is not known.

In this study, Dr Alison McNeilly and colleagues at the University of Dundee used insulin to induce repeated bouts of low blood sugar in a mouse model of type-1 diabetes. In the experiment, one group of mice were also dosed with the vegetable derived antioxidant sulforaphane (SFN). Mice treated with SFN showed increased expression of antioxidant markers, decreased free radical cell damage and had significantly improved cognitive ability in memory tasks.

Dr McNeilly commented, "Low blood sugar is an almost unavoidable consequence of insulin therapy. This work demonstrates that by improving the body's own antioxidant defence system we can reverse some of the side effects associated with diabetes, such as poor cognitive function."

Dr McNeilly and her colleagues now intend to find out if boosting the body's antioxidative system can minimise cognitive decline associated with low blood sugar in humans, by using drugs based on the chemical structure of SFN.

Dr McNeilly said, "The concentration of SFN used in this study would not be attainable in a normal diet rich in vegetables. However, there are numerous highly potent compounds in clinical trials which may prevent cognitive impairments caused by free radicals to help diabetes patients."

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Materials provided by Society for Endocrinology. Note: Content may be edited for style and length.