Healthy Waist Measurement

Carrying excess body fat is known to raise the risk of developing type 2 diabetes, high blood pressure, heart disease and some cancers, and doubles the chance of complications from Covid-19.

Fat around the waist is especially harmful and waist size is increasingly regarded as a more important measurement than body mass index (BMI). 

Waist measurement for all women should be less than 80 cm (about 31.5 in).

Waist measurement for most men should be less than 94 cm (about 37 in).

Waist measurement for men of South Asian descent should be less than 90 cm (around 35 in), who are more at risk of developing type 2 diabetes.

END

Eating for Health

A new book advises (among other facts) that you:

1. Don't skip breakfast.
There is no evidence that this helps weight loss.

2. It's not just what we eat, but when we eat.
Our body metabolism is more active in the morning, so we burn more calories early in the day.

3. Eat porridge
Eating porridge for breakfast keeps you feeling fuller for longer, so you'll eat less at lunch (for some it could be a lot less).

4. Activate your 'BAT' signal.
The white fat in our belly stores fat. But brown fat (brown adipose tissue - BAT) found high in our chests, in the neck and shoulder areas, burns fat. The more active it is, the thinner you tend to be. One way to activate it is to feel a bit chilly - so turn down your heating thermostat a bit.

5. Drink tea or coffee without milk.
It's thought that tea without milk activates the BAT signal and coffee without milk raises metabolic rate slightly (having milk stops this).

6. Eat a tomato before every meal.
Tomatoes are anti-inflammatory, helpful for artery function. Eating a large ripe, tomato before lunch means you are filling up a fist sized portion of your stomach with something that is 95% water and only about 15 calories right before a meal.

7. Nuts
Nuts are high in calories but eaten in moderation they lessen the appetite. So a mid-morning snack of nuts means you are likely to eat less at lunch. They also have health benefits.

8. Use Black Cumin (nigella seeds).
Add some nigella seeds to your pepper grinder along with the peppercorns. It seems to be helpful in reducing bad cholesterol as well as helping with weight loss.

9. Use vinegar in salad dressing.
Vinegar acts as a wake-up call to the body to switch from storing fat to burning fat. Don't drink it straight (it can damage your oesophogus), but use in salad dressings (and pickled onions and gherkins, etc.)

10. Eat boiled potatoes.
This is the most filling food - so including in a meal means you'll eat less of the other items.

11. Everyday activity is better than exercise regimes.
It takes five minutes of snacking to wipe out a whole hour of exercise. Concentrate on regular activities like standing, moving and fidgeting. Take the stairs, get laughing, singing, cleaning, cooking and gardening.

12. Embrace the scales.
The best device for monitoring weight loss remains the bathroom scales. Doing it twice a day (on waking and right before bed) seems to have the best effect.

Source: Article in Daily Mail, featuring How Not To Diet: the groundbreaking science of healthy, permanent weight loss, by Dr Michael Gregor (£20, Bluebird).

Managing Human Hunger Appetites

Studies over a 30 year period have discovered new facts about human nutrition, that changes how we understand appetite, explains the obesity epidemic and suggests a way to solve that. Here are the main points of their theory.

Appetite balancing is common across the animal kingdom, including slime molds, cockroaches, spiders, cats, dogs, mink and non-human primates. Some species turn out to have two appetites. Others have five appetites for specific nutritional requirements: three for the main macro-nutrients (protein, carbohydrates and fat) and two for specific micro-nutrients (sodium and calcium).

If a species were to have a separate appetite for each necessary nutrient, they would need complex biological  systems. Species have evolved to focus on the nutrients that are needed in very specific quantities. For other things, natural diets were rich enough for them to automatically get enough of the other nutrients needed. In a food environment that is poor in one of the essential nutrients, individuals will eat more of other items in order to keep up the calorie requirements.

Humans are among the five appetite species. People typically need 15% to 20% of daily calories from protein. It turns out that humans are living in a protein dilute, energy-rich environment. Between 1961 and 2000, the proportion of protein in an average US diet fell from 14% to 12.5%, with the balance made up fats and carbohydrates.That shift was the only way people could maintain target protein consumption was to increase total calories intake by 13% - more than enough to create an obesity epidemic.

Experiments have shown that most of the extra calories eaten by those on a low protein diet came from savoury snacks, especially those tasting of umami, the signature flavour of protein. The protein-deprived were craving things that tasted of protein, even though composed of carbohydrates.

Ultra-processed foods are designed to be irresistable, and tend to be low in protein (expensive) and high in cheap carbs and fats. Such foods include pizzas, crisps, breakfast cereals, sweets, bread, cakes, mayonnaise, ketchup and ice cream, items which make up more than half of a typical US and UK diet - with some people eating these almost to the exclusion of everything else.

Our appetite for protein is stronger than our ability to limit carb and fat intake, so when protein is scarce, our appetite for it overwhelms the mechanisms that normally tell us to stop eating fats and carbs. Ultra-processed foods also contain very little fibre, which is filling and puts a brake on our intake.

How to manage your appetites

1. Calculate your protein target by looking up the daily energy requirement for your age, sex and level of activity. (This is can be done with the Harris Benedict equation calculator, available on many websites).
2. Work our the proportion that should come from protein by multiplying that figure by 0.15 (to give the 15% of energy from protein). Depending on age, you might need to use the multiplier of 0.18 (for 18% needed by 18 to 30 year olds), 0.17 (for the 17% needed by those in their 30s, or 0.2 (for those over 65 who need 65%).
3. Divide the resulting number by 4 to get the number of grams of protein a day you should eat. ( gram of protein contains 4 kilocaolories of energy.)
4. Then work out how to obtain that protein from protein-rich foods such as meat, fish, eggs, dairy, pulses, nuts and seeds. The protein content is often listed on food labels, or available online.
5. If you eat this amount of protein, it will satisfy your protein appetite and automatically ensure you don't overeat carbs and fats you won't need to track these at all).
6. Make sure you supplement the high-protein foods with mostly wholefoods, mainly plant-based, which will also supply your fibre needs.
7. Most importantly, avoid ultra-processed foods by keeping them out of the house.

Source: article: In perfect balance by David Raubenheimer and Stephen Simpson, New Scientist 23 May 2020.

Time Restricted Eating

More people now tend to eat soon after getting up in the morning, snack through the day and on into the evening, so the eating 'window' is often 14 hours or longer. Researchers say that this way of eating, even if you are a healthy weight, disrupts the body's 24 hour body clock (circadian rhythm). The body clock governs the sleep/wake pattern, the digestive system and every cell in the body.

The gut is better at digesting and absorbing food during the day, because at night it is primed to repair itself, so the production of saliva and digestive enzymes slows down and food moves more slowly through the digestive tract. If you eat food late at night, food sits there. All this puts us at bigger risk of obesity, type 2 diabetes, high blood pressure and heart disease.

Time restricted eating means consuming food within a daily period of 12 hours or less. This effectively extends the time you are 'fasting' or not eating (i.e. while asleep). So you could choose to eat between 7am and 7pm, or 8am and 8pm, or go for a shorter eating window (say 7am to 5pm, so 10 hours). If this is not possible, just aim to finish eating at least 3 hours before going to bed, or by 7pm or 8pm.

Because you are not required to change what you eat, only when you eat, it can be done whatever your lifestyle or food preferences. However, this is not a licence to eat whatever you want; focus on fruit, vegetables, beans, wholegrains, lentils, fish, olive oil and nuts.

While not a weight loss diet, many people find they do reduce their calorie intake and lose some weight, either because they feel less hungry, or have fewer opportunities to eat. people also report feeling less hungry, more energetic and sleeping better.

Your body switches from digestion to focusing on repair. Killing off old cells and regenerating new ones, allows the cells of your liver, pancreas and gut  cope better with the food you ingest. You are then less likely to have blood sugar spikes and cholesterol imbalances.

Is this ok for everyone? The feature noted 'avoid the plan if pregnant or breast-feeding' and advised consulting a doctor before you begin if you have a medical condition (e.g. heart disease or diabetes) or a history of eating disorders.

Source: feature in Good Housekeeping, July 2019.

Why Teens Put on Excess Weight

A rise in obesity in adolescents may be down to a sharp drop in the amount of calories they burn while resting. A 10 year study in the International Journal of Diabetes found energy used at rest was 25% lower in 15-year-olds compared with when they were 10 - a fall of 500 calories a day. This is equivalent to cutting out an hour's strenuous exercise every day.

Most of the energy we burn is just to keep our bodies ticking over - using the brain, heart, liver and kidneys - rather than through physical activity.

The study found that the number of calories the children burned at rest fell sharply during puberty, even though this is a period of rapid growth, which usually uses up lots of calories. It was only around the age of 16 that the number of calories burned at rest started to rise again. During puberty there was also a noticeable drop in the amount of exercise, particularly among girls.

With about a third of school children aged 10-11 in England overweight or obese, the challenge is how to address the issue. Researchers said that the findings showed there was an even greater need to improve children's diets and protect them from the heavy marketing of junk food and sugary drinks.

"Last month's government strategy on childhood obesity confirmed the duty on sugary drinks, but was otherwise a disastrous missed opportunity. We need much tougher regulation around the marketing of junk food to children - particularly on TV and online."

BBC News item: Calorie burn fall 'could explain obesity rise' 8th Sept. 2016.

Menopause

Fat cells of men and women are, and act, differently. Women’s fat cells are:

• 5 times larger
• Have twice the number of fat-storing (lipogenic) enzymes
• Have half the number of fat-releasing (lipolytic) enzymes

Puberty - fat levels to support menstruation and survive famine.

Pregnancy - fat levels to protect and cushion foetus.

Menopause - fat cells produce oestrogen to ease transitio.

Around 35: oestrogen levels begin to dip, increase in weight, larger breasts.
Around 45: calorie needs drop by up to 400 calories per day.
Around 55: fat cells show some decrease in size; food 'cravings' tend to favour protein and vegetables.

Some mid-life weight gain is healthy (between 5 and 15 lbs). Fitness not thinness is key to long life.

The fat cells at waistline are better equipped to produce oestrogen than those at hips, buttocks or thighs. Post-menopause, fat cells in thighs, buttocks, waist and arms shrink somewhat, but those in the breasts do not.

Menopause is occurring earlier, and taking longer, probably due to a combination of factors; not having children, having few children at a later age (35+), oral contraceptive use, stress, earlier puberty and dieting.

Dieting during the menopause is unlikely to be successfull; the body sees this as famine, so the fat cells store more. It is not realistic to weigh what you did at age 20, or before you had children. Dieting thins the hair, muscle, skin, bones and thinking capacity.

Take a patchwork approach to exercise:

• Aerobic - 4 hours per week. Walking, cycling, swimming. Stimulates fat release.
• Strength - 1 hour per week. Gardening, cleaning, weight lifting, dancing, walking, jogging. Speeds up metabolism and conditions muscles to burn released fat.

Exercise also stimulates muscles to manufacture c.25% of the oestrogen you need after the menopause.

Eat smaller meals and eat more often. Try 5 meals a day. Largest meal at lunch, smallest in evening as metabolism dips at 6pm.

When you ignore hunger, after c.30 mins the body intensifies hunger signals. After a further 30 mins survival mechanism kicks in and slows metabolism, releases glucase from muscles and stimultes fat storage enzymes for when you do eat.

Your stomach is the size of your fist. A good-sized handful of food, when chewed, is about a fistful. Eat a healthy, balanced, mixed diet. All fruit and vegetables contain some phyto-oestrogens.

Source: Menopause Without Weight Gain by Debra Waterhouse. Thorsons, 1999. ISBN:0-7225-3449-3

Childhood Obesity in UK 2016

One in five children is obese by the time they finish primary school. Include those classed as overweight and the figure jumps to one in three.

In January 2016, researchers at the Food Foundation produced a model of the typical family's diet.
Every member of the average family consumed too much sugar and saturated fat and too little of the good stuff - fibre, fruit and vegetables and oily fish. All but the youngest members were eating too much red and processed meat and salt and children consume three times as much sugar as they should - with a third of that coming from fizzy drinks.



Food promotions in advertising and instore are heavily weighted towards unhealthy products. About 40% of expenditure on food goes on promotions, causing us to purchase a fifth more than we would have otherwise, according to Public Health England. In Mexico, consumption fell by 6% after a sugar tax of 10% was introduced.

The government in England was expected to publish its child obesity strategy in February 2016. Predictions were that it might include a sugar tax and a crackdown on shop promotions and advertising, and a sustained drive to reduce the sugar content of food. While there will be measures to get people more active too, the emphasis will be on diet as there is an acknowledgement that without curbing calories there is a limit to what physical activity can do. NHS bosses have already announced they will impose 20% "sugar tax" in hospital cafes.

In March 2016, the Chancellor George Osbourne announced a new tax on the soft drinks industry to be introduved in two years' time (2018), squarely aimed at high-sugar drinks, particularly fizzy drinks, which are popular among teenagers. Pure fruit juices and milk-based drinks will be excluded and the smallest producers will have an exemption from the scheme. It will be imposed on companies according to the volume of the sugar-sweetened drinks they produce or import.


There will be two bands - one for total sugar content above 5g per 100 millilitres and a second, higher band for the most sugary drinks with more than 8g per 100 millilitres. Analysis by the Office for Budgetary Responsibility suggests they will be levied at 18p and 24p per litre. [Examples of drinks which would currently fall under the higher rate of the sugar tax include full-strength Coca-Cola and Pepsi, Lucozade Energy and Irn-Bru. The lower rate would catch drinks such as Dr Pepper, Fanta, Sprite, Schweppes Indian tonic water and alcohol-free shandy.]

Why go for a sugar tax on drinks?  Unlike a chocolate bar or slice of cake, they are not automatically seen as a treat and tend to be consumed every day. Some of the drinks are incredibly high in sugar. A typical can contains enough sugar - about nine teaspoons - to take someone over their recommended sugar intake in one hit. For teenagers they are the number one source of sugar intake while overall, children get a third of their daily sugar intake from them. They are "empty calories" as they have no nutritional benefit.

While the tax applies to the whole of the UK, Mr Osborne's announcement on where the money is spent applies solely to England. The devolved administrations in Scotland, Wales and Northern Ireland are free to decide how to spend their share.


[Government reports and policies can be found at: https://www.gov.uk/government/policies/obesity-and-healthy-eating ]

Various sources in January to February 2016.

Artificial Sweeteners

Sweeteners such as saccharin, sucralose, aspartame and stevia are found in most low-sugar or ‘diet’ products, as well as many ‘normal sugar’ foods and drinks, so we ma eat them without knowing it.

A small study (2014) showed that artificial sweeteners disrupted the gut bacteria of mice, and that saccharin did the same for 4 out of the 7 people tested, as well as making their blood sugar levels less healthy. Many studies show that people using more artificial sweeteners tend to have a higher BMI and waist circumference.

For the Trust Me, I'm a Doctor programme, 15 volunteers, who did not normally take artificial sweeteners, all had their blood sugar levels measured (having fasted for 12 hours), and then were split into two groups. For 7 days, one group took the daily safe level of saccharin, and the other group the daily safe level of stevia. Each also gave a stool sample, for gut bacteria analysis.

When retested at the end of the week, the blood sugar levels of the volunteers taking stevia had not changed significantly but 4 of those who had taken saccharin had significantly higher blood sugar levels, which is bad for health, and indicates that saccharin, in a large proportion of people, is doing the opposite of what it promises. The gut bacteria tests showed that those who reacted to saccharin all had a similar bacterial composition to start with, and that they all changed in a similar way. Those who didn’t respond to the saccharin showed much less of a change. Those taking stevia did have a bacterial change, but it was in the opposite direction from those who had a bad response to saccharin.

While the BBC2 study, and the one that preceded it, were both on small numbers of people, the consistent results – alongside results found previously in mice – suggest that saccharin is bad for some people, but no evidence that stevia is. As there is no easy way to find out if you are someone with the specific gut bacteria composition that saccharin affects, it is best to avoid it. The evidence in mice is that aspartame and sucralose may have a similar effect. The only results for stevia are from the BBC2 study and do not show a negative effect, so stevia seems to be the best sugar alternative. On packaging it is sometimes called ‘steviol glycosides’, which are the sweet-tasting compounds in the Stevia plant

BBC2 Trust Me, I'm a Doctor January 2016

The Role of Gut Bacteria in Response to Food

While some people seem to be able to eat what they want, others struggle with their weight, no matter what diet they try. A new study the Weizmann Institute in Rehovot, Israel, led by Prof Eran Segal and Dr Eran Elinav is looking at the role of gut bacteria.

Nearly 1000 people filled in detailed health and medical data before taking part in a week-long study of how their blood sugar levels reacted to different foods. During the week, their blood sugar levels were measured constantly by a glucometer placed under the skin, their sleep and activity levels monitored by a wrist-band, and they were given an app to record their mood, feelings, sleep and exercise regimes and what they ate. Throughout the week, their meals were planned: some are standard foods that everyone tries, while others they can choose, but they had to weigh it all accurately, and record it in precise detail. Each person in the study has also given a stool (poo) sample. From this, the researchers analyse the gut bacteria living inside each person. Our gut bacteria are unique to us – it is almost like a ‘fingerprint’ of a person – but, crucially, they can change.

The researchers at the Institute have found several startling things during their study:

Firstly, every person reacts differently to specific foods. This contradicts the theory that some foods give everyone a sudden blood sugar ‘spike’ while other foods give less of a spike - the high GI or low GI rating - but up till now these foods have only been tested on a standard group of 12 people.

Secondly, the huge amounts of data mean the team could make firm links between a person’s individual response to food, and to the gut bacteria that they have. They have developed a computer algorithm that can take a person’s individual gut bacteria composition, and from it, predict how their blood sugar levels will react to a whole range of foods.

Thirdly, in a small study 25 people had a ‘good’ and ‘bad’ diet predicted for each of them by the algorithm.  They ate only the ‘good’ for one week and then the ‘bad’ for another – without knowing which was which. Their blood sugar reacted as predicted to the different foods, but there were also changes in their gut bacteria over just the week. The changes seen in the 'good' food week appeared to be beneficial. So we may be able to personalise our diets for health and and may be able to change our responses to food.

Dr Saleyha Ahsan of Trust Me, I'm a Doctor took part in the study. Foods that were found to be good for Saleyha’s blood sugar levels included: avocado, croissant, yoghurt & granola, banana & walnuts, omelette, chocolate, ice cream & cola. Foods that were found to be bad for Saleyha’s blood sugar levels included: grapes, cereal with milk, pizza, pasta, tomato soup, chicken sandwich (on wholemeal bread), orange juice and sushi. These are very individual to Saleyha.

Another volunteer of the same age and sex, eating the same meals alongside Saleyha for the week had the opposite blood sugar reaction to pizza, pasta, banana & nuts, yoghurt & granola and croissant. They also responded in the opposite way to white bread, and white bread with butter.

Saleyha then spent two weeks of eating only the foods identified as ‘good’ and avoiding the ‘bad’. In just this short time, her gut bacteria changed – and some of those changes were associated with a more ‘beneficial’ gut microbe composition. This short and uncontrolled trial did fit with the results the team saw in their own controlled trials of a similar diet.

The team hope that they will in the future be able to take stool samples, sent through the post, and provide a personalised diet plan in return – listing foods predicted to give that person an unhealthy blood sugar spike, and those likely to maintain more stable, healthy blood sugar levels. These will, of course, have to be eaten within a normally balanced diet – it doesn’t mean that if chocolate turns out to be on your ‘good food’ list, you can live on it and be healthy! The fact that ‘good’ foods for particular individuals usually seem to include some that people very much like, means that such personalised diets would be easier for people to adopt than traditional restrictive ones.

The team are also now studying the longer-term effects of diet on gut bacteria. It is possible that as the gut bacteria change in response to the diet (which happens within days or weeks), that the diet could then be modified, or relaxed.

Feature on Trust Me, I'm a Doctor, BBC2 on 27 Jan. 2016

Handy Portion Control

A lack of portion control is one of the main reasons people are overweight. Here is a foolproof guide to serving sizes - using just your hand.

Fist = carbs and fruit. A portion of carbs (e.g. potatoes, rice or pasta) should be no bigger than your closed fist, or a tennis ball. Fruit portions should be a similar size.

Palm = protein. Protein portions (meat, fish, poultry, tofu) should be about the size ofyour cupped palm.

Thumb = cheese and nuts. Match portions of cheese and nuts to your thumb size.

Fingertips = fats. A slice of toast should have no more than a fingertip sized amount of butter.

Hand = veg. Open your hand and spread your fingers as wide as you can - that is a good vegetable portion.

Item in Good Housekeeping, July 2015

Declutter to Eat Healthily

US researchers found that making a few simple changes to your kitchen means you need less willpower to eat healthily.

1. People with a bowl of fruit on the worktop or table weigh, on average, 8 lb less than those who don't have one.
2. Messy kitchens prompted people to eat 44% more snacks than those that were ordered and clutter free. So put away unnecessary gadgets, chopping boards and utensils.
3. Moved biscuits, baked goods and crisps off worktops and tables. Those who had unhealthy snacks on view weighed 10 lb more than those who didn't.
4. Make healthier foods more visible. Move fruit and veg from the salad drawer to a shelf in the fridge, and put less healthy foods in the drawer.
5. Don't dish up at the table. People eat 19% less food when served from the bowls on the worktop or stove instead of bowls on the table.

Item in Good Housekeeping, July 2015

Best Diet Advice Tips

 Here are some simple tips to help you move to healthy eating habits.

• Stick to the rule of three. When faced with a large choice - say at a buffet - opt for just 2 or 3 foods.
• Dim lighting and soft music leads diners to eat less (175 calories less) and enjoy their meal more. You eat more slowly in a relaxed environment so recognise when you are full.
• Recalling a previous meal or keeping a food diary could help reduce the amount you eat, especially if people rememebred their last meal as filling and satisfying. Being distracted while eating - e.g. while watching TV or reading - leads to overeating.
• Eat three fewer bites of your meal - that's one less biscuit, or one less glass of orange juice - can save around 100 calories a day or the 2 pounds weight most people put on in a year.
• Choose full-fat instead of fat-free dairy. Full-fat dairy satisfies hunger better and means fewer calories in the long run.
• Ditch fruit juices and smoothies as they can contain as much sugar as fizzy drinks. Juicing removes tge fibre - the filling part of the fruit that helps reduce its impact on blood sugar. Studies show consuming one or more daily servings of fruit juice raised the risk of type 2 diabetes by 21%. Eat whole fruit and opt for water, sugar-free drinks or tea instead.
• Start your meal with a 100 calorie salad, a broth-based soup or an apple; this reduces the amount you eat in the next course.
• Don't cut out treats entirely. 
• Out of sight, out of mouth. Hide the biscuit tin and put treats or trigger foods on the highest shelf to make it easier to resist temptation.
• A 20 minute walk before dinner reduces appetite and increases sensations of fullness as effectively as simply having a light meal.
• Whole grain foods prolong the digestion process, so sugar is released over a longer period of time. If you can't eat gluten, alternatives are brown rice, amaranth, buckwheat and quinoa.

Feature in Good Housekeeping October 2014

Diet Tribes

A quarter of the UK population is obese, and the message of eat less and exercise more is falling on deaf ears. A BBC Horizon documentary examines the idea of personalised dieting. Using ground-breaking research they looked at how genetics and neuroscience help us understand what drives us to eat too much and put on weight, and how hormones affect how we feel. A group of overweightvolunteers underwent a range of tests (genetic, hormone and psychological (attitudes and emotions around food) tests), and were found to fall into one of three groups. After more tests and diet related actvities and advice, the volunteers then followed at home a three-month eating plan specially devised for their group. The aim was for the group to lose 67 stone overall, five per cent of their body weight. The results were impressive; between them they lost 103 stone. Even better, the volunteers agreed almost unanimously that they had found the right diet.

Feasters
Once feasters start eating they find it hard to stop. They never really feel full, so carry on eating. They produce less of a gut hormone GLP-1 that sends signals to the brain to tell us we feel full, so they eat far more before their brains get the message 'Enough'.

They need to eat food that takes longer to digest and keeps them fuller for longer - a high protein, low Glycaemic Index (GI) diet, without any portion restrictions. That means more lean meat like chicken, fish, eggs, nuts and pulses like lentils and beans, but fewer sugary foods, potatoes, bread and pastry. Feasters swapped them for pasta and grains like bulgar wheat that take longer to digest. The GLP-1 hormone is produced low down in the gut and is released in higher amounts by food that is digested more slowly. Eating slowly can also keep GLP-1 levels up. Try eating your meal over half an hour. Eat something you'd normally bite into (a burger, sandwich, banana) on a plate with a knife and fork. Try to have all meals sitting at the table (you'll eat faster if you are standing up).

Emotional Eaters
This group has problems with eating because of psychological issues. They turn to food when anxious, depressed and stressed to try to manage their emotions, in the way other people might have a drink. Stress and anxiety boost levels of hormones like cortisol, which in turn makes us feel panicky. 'Self-medicating' with sugary, fatty, salty foods in particular can stimulate our 'feelgood' response. But that triggers 'catastrophic thinking' - I've blown the diet, so why bother?

They need support to overcome fears and to believe they can resist temptation. They will benefit from joining a weight loss group or using online tools and social media to track progress and keep motivated. They also need to accept occasionally failing with the diet is not the end, and simply start again.

Constant Cravers
They are hungry the whole time and like to snack on things high in sugar and salt. They enjoy food and think about it a lot, grazing throughout the day. Certain genes interfere with the brain's understanding of our fat reserves. If it thinks we have less fat than we actually do, it tells us to keep eating. All the volunteers in this group tested postive for these genes.

Losing weight is hardest for this group. The answer is intermittent fasting - better known as the 5:2 diet, when you eat normally (but healthily) for five days a week, and the reduce calorie intake substantially on the other two days (Horizon volunteers cut down to 800 calories on these days but 500 or 600 calories is usually advised.) This makes the body burn up its fat stores.

Plateau effect
Most of the volunteers (and pretty well everyone following any diet) finds that weight loss tails off around week 8; this is due to metabolic changes. Those who are overweight have a faster metabolic rate than those of ordinary weight just for everyday activities. When weight loss goes below a certain level, the body slows its metabolism to stay at that weight. That is the time you need to do a bit more exercise to 'kick-start' the weight loss process again. 

BBC2 Horizon: What's the right Diet for You?: a 3-programme documentary broadcast on 12, 13 and 14 Jan. 2014

Slim by Design

Recent research co-ordinated by psychologist Brian Warsink has revealed that your kitchen may not be helping you to stay a healthy weight and that the way we perceive things may not help either.

The Kitchen

• What is in the kitchen makes a difference, not the size of the kitchen. Women are more susceptible to this than men (this may be because women spend longer in the kitchen).
• Don't leave food lying around on the counter. This does not just apply to crisps and biscuits - but also breakfast cereals. They may have 'healthy' messages on the packaging but are typically calorie heavy.

Serving food

• If you serve the main parts of a meal at the stove or counter, people will eat 19% less in total than if they serve themselves at the table. But to encorage salad and veg eating, put these in bowls on the table.
• If plate colour is similar to food colour, you'll serve yourself more (e.g. white starches - potatoes, pasta, rice on a white plate). Try to use contrasting plate colours.

Eating out

• People seem to order healthier food if sat by a window or in a well-lit part of a restaurant. If sat at a dark table or booth, then tended to order fattier, calorie laden food and more of it. Those sat farthest from the door ate the fewest salads and were 73% more likely to order dessert.
• Those at tables close to the bar drank more alcohol than those seated 3 or more tables away from the bar.
• The closer the TV screen, the more fried food was ordered.
• Those at high-top bar tables ordered more salads and fewer desserts.

Acohol

• People pour 12% more into a wide glass than a tall glass of the same capacity. Even bartenders do this with cocktails, etc.: The survey showed that bartenders poured 32% more into wide glasses, and continued to do so even when the experimenters explained why it happens. (The brain registers the height of the liquid and not the volume.)
• Pour standing up - people pour less into a glass when looking down into it, as it appears fuller.
• Red wine is easier to see, so we pour about 9% less than white.

Quick checklist

• Do you serve salad or vegetables before a main meal?
• Do you put the main course on plates at the stove or counter?
• Are your dinner plates no more than 22 to 25 cm across?
• Do you eat at the table with the TV off?
• Do you have a maximum of two cans of soft drinks in the fridge at any time?
• Are your kitchen counters clean and organised?
• Do you pre-prepare fruit and veg and keep on the middle shelf of the fridge where it is easily seen?
• Do you have a minimum of six servings of protein in the fridge (e.g. tofu, yoghurts, eggs)?
• Do you keep all snacks in one inconveniently placed cupbaord?
• Is fruit the only food on the kitchen counter?

From an article (on his new book Slim by Design) by Brian Warsink in New Scientist, 10 January 2015

Simple Way to Lose 1lb a Week

Carol Sarler finally accepted the need to lose weight after a health check showed blood sugar levels close to tipping her into diabetes. Although she had tried diets in the past, this time she decided to lose weight - but nor using a diet. She needed to lose three stones, and aimed to lose 1 pound a week to reach her target weight. So how did she do it?

While she cannot properly tell anybody else how to do it, here are her rules for herself. She didn't count calories or weigh any foods, but relied on more, less and sometimes none. If the pound refused to budge, she would revise the more to less. The none was pragmatism. While some pleasures remained in her eating plan (e.g. butter, Yorkshire pudding, red wine), others were so difficult to restrict that she cut them out entirely (e.g. cheese, beer, sugar). She accepted that food might be dull and repetitive. Breakfasts were usually yoghurt with seeds, nuts and fruit, lunches a small sandwich and dinner a piece of meat of chicken with lots of vegetables. If you try Carol's way, you'll have your own non-negotiables and banishments.

The weight loss is slow, and she as she was doing it for health reasons, she kept track of progress on a BMI chart. Even better was the realisation every now and again that she could do something again that the excess weight had prevented. And clothes started fitting better, then not at all, while her shoe size dropped, her ankles stopped swelling and her puffing stopped.

And having achieved her target weight after 42 weeks, she stopped trying to lose weight. Not a pound has gone back on, as she has retrained her eating habits to a healthier way of eating.

Carol Sarler in Good Housekeeping, April 2014