Appetite-Related Hormone Levels May Predict Weight Regain After Dieting

[Guest guest]

In keeping with the recent discussion concerning weight loss I found the

following article to be very interesting.

Comments?

Ralph Giarnella MD

Southington Ct. USA

*******************************************

Appetite-Related Hormone Levels May Predict Weight Regain After Dieting

http://cme.medscape.com/viewarticle/728453?src=cmemp & uac=38122MX

News Author: Laurie Barclay, MD

CME Author: P. Vega, MD

September 14, 2010 — Baseline levels of the appetite-related hormones leptin

and

ghrelin may help predict weight regain after dieting, according to the results

of a study published online September 9 and will appear in the November print

issue of the Journal of Clinical Endocrinology & Metabolism.

" Treating obesity with drugs or dietary programs can be very effective in the

short-term, but the long-term success of maintaining the weight lost is usually

poor, " lead author Ana B. Crujeiras, PhD, from Compejo Hospitalario

Universitario de Santiago in Spain, said in a news release. " Our study sheds

light on how the appetite hormones leptin and ghrelin affect weight regain after

weight loss. This knowledge could be used as a tool to personalize weight-loss

programs that could guarantee success in keeping off the weight. "

The study goal was to determine the potential role of ghrelin, leptin, and

insulin plasma levels in weight regain after following a therapeutic,

low-calorie diet. Obese or overweight volunteers followed an 8-week, hypocaloric

diet (-30% energy expenditure) and were assessed again at 32 weeks after

treatment. Mean age was 35 ± 7 years; mean body mass index was 30.7 ± 2.4

kg/m2;

49 participants were women and 55 were men. At baseline, week 8, and week 32,

participants underwent measurement of body weight and fasting plasma

concentrations of ghrelin, leptin, and insulin.

Average weight loss after the 8-week hypocaloric diet was -5.0% ± 2.2% (P <

..001). Although plasma leptin and insulin concentrations decreased

significantly, ghrelin levels remained relatively stable. Compared with

participants who maintained their weight loss, those that regained more than 10%

of weight loss had higher leptin levels (P < .01), lower ghrelin levels (P <

..05), and similar insulin levels. Weight regain at week 32 was negatively

correlated with baseline levels and ghrelin levels at week 8 and positively

correlated with baseline levels and leptin levels at week 8.

Gender affected these associations, which were statistically significant for

ghrelin in men and for leptin in women. Decreased ghrelin levels after the

8-week hypocaloric diet predicted greater risk for weight regain (odds ratio

[OR], 3.109; P =.008), whereas decreased leptin levels predicted maintenance of

weight loss (OR, 0.141; P = .001).

“Subjects with higher plasma leptin and lower ghrelin levels at baseline could

be more prone to regain weight lost and these hormones levels could be proposed

as biomarkers for predicting obesity-treatment outcomes,†the study authors

write.

Limitations of this study include use of only fasting hormone levels because

insulin, leptin, and ghrelin concentrations can be markedly affected by food

intake as well as by several metabolic conditions.

" We believe this research is of foremost relevance in clinical terms as it may

indicate that the outcome of weight therapy may be pre-conditioned, " Dr.

Crujeiras said. " Furthermore, our findings may provide endocrinology and

nutrition professionals a tool to identify individuals in need of specialized

weight-loss programs that first target appetite hormone levels before beginning

conventional dietary treatment. "

Linea Especial about Nutrition, obesity and Health and CIBERobn , an ISCIII

initiative, supported this study. Dr. AB Crujeiras is funded by the Instituto de

Salud III and the Xunta de Galicia (SERGAS). Another author (M.C.

Carreira) is funded by the Xunta de Galicia. The study authors have disclosed no

relevant financial relationships.

J Clin Endocrinol Metab. Publihsed online September 9, 2010.

Clinical Context- commentary on study: by reviewers

Research has highlighted how certain hormones have an important effect in

determining appetite and, in turn, regulating body weight. Leptin is produced

primarily by adipocytes and works to inhibit appetite. Conversely, ghrelin is a

hormone which is mostly derived from the stomach and which stimulates appetite.

One of the most difficult and frustrating elements of treatment for obesity is

maintaining initial weight loss. The authors of the current study investigate

whether appetite-related hormones such as leptin and ghrelin may be useful as

biomarkers for patients at risk for weight regain.

Study Highlights

* Study participants were overweight and obese adults from Spain.

Individuals with diabetes, hypertension, hyperlipidemia, or recent weight change

were excluded from study participation, as were those who regularly used

prescription medications or supplements.

* All participants underwent an 8-week hypocaloric diet designed to produce

a 30% energy restriction on subjects’ normal daily caloric intake. The diet

was

composed of 55% carbohydrates, 15% protein, and 30% fat. Participants did not

change their exercise habits during these 8 weeks.

* At the end of the dietary intervention, participants were given

instructions regarding maintaining weight loss, but no specific diet. They were

then assessed at 32 weeks for study outcomes.

* Participants underwent a routine medical examination plus laboratory

testing at baseline. Laboratory testing and body weight measurement were

repeated at study weeks 8 and 32.

* The main study outcome was the relationship between weight loss

maintenance at week 32 and fasting levels of ghrelin, leptin, and insulin.

* 79 women and 83 men began the diet intervention. The mean age of

participants was 35 years, and the mean body mass index of the group was 31.1

kg/m2.

* Women had lower body weight but higher leptin and ghrelin levels compared

with men throughout the study.

* During the 8-week diet intervention, participants lost an average of 5% of

their body weight. The decline in body weight was associated with reductions in

leptin and insulin levels, but ghrelin levels remained similar to baseline.

Reductions in leptin and insulin appeared proportional to the reduction in body

weight.

* 104 individuals completed the follow-up testing at 32 weeks. 55

participants had maintained their weight loss from 8 weeks, and 49 subjects had

regained 10% or more of the lost weight.

* There were gender-related differences in the relationship between weight

regain and plasma hormone levels. Among women, participants with weight regain

had higher leptin levels at baseline, week 8, and week 32 compared with women

who maintained weight loss. However, there was no difference in leptin levels

among men who maintained or regained their weight loss.

* Among men, lower levels of ghrelin were associated with weight regain, but

this was not observed among women.

* Plasma insulin levels failed to significantly affect the risk of weight

regain.

* A significant reduction in ghrelin during the dietary intervention itself

increased the risk for weight regain, as did a diet-induced increase in leptin

levels.

Clinical Implications

* Leptin is a hormone produced primarily by adipocytes and works to inhibit

appetite. Conversely, ghrelin is produced in the stomach and functions in

stimulating appetite.

* In the current study, adults with higher plasma leptin levels and lower

plasma ghrelin levels were more likely to regain weight lost through dieting.

Insulin levels were not associated with weight regain.

[Guest guest]

With all due respect to Dr. Giarnella,

this article below whoich he shares with us, well ok, yes it's interesting.

It's interesting in that it shows us exactly what NOT to do, and what NOT to

conclude. The author shortchanges the roles of leptin and ghrelin, vastly

oversimplying their multi-layered endocrinologic roles.

Also, nowhere is cholecytokinin mentioned, which upon the initial stages

of fat emulsification, initiate a negative hypothalamic feedback re satiety,

thus significantly downregulating hunger. Of course, with a diet which is

55% ( for gods sake!! ) carbs - what planet are these people on? - one can

see how that becomes less relevant.

The report is just too easy to dissect into it's layers of bad science.

I will defer to each of you all to do that at your leisure.

Einhorn

Miami

Stamford

_____

From: Supertraining [mailto:Supertraining ]

On Behalf Of Ralph Giarnella

Sent: Wednesday, October 13, 2010 8:15 AM

Supertraining

Subject: Appetite-Related Hormone Levels May Predict Weight

Regain After Dieting

In keeping with the recent discussion concerning weight loss I found the

following article to be very interesting.

Comments?

Ralph Giarnella MD

Southington Ct. USA

*******************************************

Appetite-Related Hormone Levels May Predict Weight Regain After Dieting

http://cme.medscape.com/viewarticle/728453?src=cmemp

<http://cme.medscape.com/viewarticle/728453?src=cmemp & uac=38122MX>

& uac=38122MX

News Author: Laurie Barclay, MD

CME Author: P. Vega, MD

September 14, 2010 — Baseline levels of the appetite-related hormones leptin

and

ghrelin may help predict weight regain after dieting, according to the

results

of a study published online September 9 and will appear in the November

print

issue of the Journal of Clinical Endocrinology & Metabolism.

" Treating obesity with drugs or dietary programs can be very effective in

the

short-term, but the long-term success of maintaining the weight lost is

usually

poor, " lead author Ana B. Crujeiras, PhD, from Compejo Hospitalario

Universitario de Santiago in Spain, said in a news release. " Our study sheds

light on how the appetite hormones leptin and ghrelin affect weight regain

after

weight loss. This knowledge could be used as a tool to personalize

weight-loss

programs that could guarantee success in keeping off the weight. "

The study goal was to determine the potential role of ghrelin, leptin, and

insulin plasma levels in weight regain after following a therapeutic,

low-calorie diet. Obese or overweight volunteers followed an 8-week,

hypocaloric

diet (-30% energy expenditure) and were assessed again at 32 weeks after

treatment. Mean age was 35 ± 7 years; mean body mass index was 30.7 ± 2.4

kg/m2;

49 participants were women and 55 were men. At baseline, week 8, and week

32,

participants underwent measurement of body weight and fasting plasma

concentrations of ghrelin, leptin, and insulin.

Average weight loss after the 8-week hypocaloric diet was -5.0% ± 2.2% (P <

..001). Although plasma leptin and insulin concentrations decreased

significantly, ghrelin levels remained relatively stable. Compared with

participants who maintained their weight loss, those that regained more than

10%

of weight loss had higher leptin levels (P < .01), lower ghrelin levels (P <

..05), and similar insulin levels. Weight regain at week 32 was negatively

correlated with baseline levels and ghrelin levels at week 8 and positively

correlated with baseline levels and leptin levels at week 8.

Gender affected these associations, which were statistically significant for

ghrelin in men and for leptin in women. Decreased ghrelin levels after the

8-week hypocaloric diet predicted greater risk for weight regain (odds ratio

[OR], 3.109; P =.008), whereas decreased leptin levels predicted maintenance

of

weight loss (OR, 0.141; P = .001).

“Subjects with higher plasma leptin and lower ghrelin levels at baseline

could

be more prone to regain weight lost and these hormones levels could be

proposed

as biomarkers for predicting obesity-treatment outcomes,” the study authors

write.

Limitations of this study include use of only fasting hormone levels because

insulin, leptin, and ghrelin concentrations can be markedly affected by food

intake as well as by several metabolic conditions.

" We believe this research is of foremost relevance in clinical terms as it

may

indicate that the outcome of weight therapy may be pre-conditioned, " Dr.

Crujeiras said. " Furthermore, our findings may provide endocrinology and

nutrition professionals a tool to identify individuals in need of

specialized

weight-loss programs that first target appetite hormone levels before

beginning

conventional dietary treatment. "

Linea Especial about Nutrition, obesity and Health and CIBERobn , an ISCIII

initiative, supported this study. Dr. AB Crujeiras is funded by the

Instituto de

Salud III and the Xunta de Galicia (SERGAS). Another author (M.C.

Carreira) is funded by the Xunta de Galicia. The study authors have

disclosed no

relevant financial relationships.

J Clin Endocrinol Metab. Publihsed online September 9, 2010.

Clinical Context- commentary on study: by reviewers

Research has highlighted how certain hormones have an important effect in

determining appetite and, in turn, regulating body weight. Leptin is

produced

primarily by adipocytes and works to inhibit appetite. Conversely, ghrelin

is a

hormone which is mostly derived from the stomach and which stimulates

appetite.

One of the most difficult and frustrating elements of treatment for obesity

is

maintaining initial weight loss. The authors of the current study

investigate

whether appetite-related hormones such as leptin and ghrelin may be useful

as

biomarkers for patients at risk for weight regain.

Study Highlights

* Study participants were overweight and obese adults from Spain.

Individuals with diabetes, hypertension, hyperlipidemia, or recent weight

change

were excluded from study participation, as were those who regularly used

prescription medications or supplements.

* All participants underwent an 8-week hypocaloric diet designed to produce

a 30% energy restriction on subjects’ normal daily caloric intake. The diet

was

composed of 55% carbohydrates, 15% protein, and 30% fat. Participants did

not

change their exercise habits during these 8 weeks.

* At the end of the dietary intervention, participants were given

instructions regarding maintaining weight loss, but no specific diet. They

were

then assessed at 32 weeks for study outcomes.

* Participants underwent a routine medical examination plus laboratory

testing at baseline. Laboratory testing and body weight measurement were

repeated at study weeks 8 and 32.

* The main study outcome was the relationship between weight loss

maintenance at week 32 and fasting levels of ghrelin, leptin, and insulin.

* 79 women and 83 men began the diet intervention. The mean age of

participants was 35 years, and the mean body mass index of the group was

31.1

kg/m2.

* Women had lower body weight but higher leptin and ghrelin levels compared

with men throughout the study.

* During the 8-week diet intervention, participants lost an average of 5% of

their body weight. The decline in body weight was associated with reductions

in

leptin and insulin levels, but ghrelin levels remained similar to baseline.

Reductions in leptin and insulin appeared proportional to the reduction in

body

weight.

* 104 individuals completed the follow-up testing at 32 weeks. 55

participants had maintained their weight loss from 8 weeks, and 49 subjects

had

regained 10% or more of the lost weight.

* There were gender-related differences in the relationship between weight

regain and plasma hormone levels. Among women, participants with weight

regain

had higher leptin levels at baseline, week 8, and week 32 compared with

women

who maintained weight loss. However, there was no difference in leptin

levels

among men who maintained or regained their weight loss.

* Among men, lower levels of ghrelin were associated with weight regain, but

this was not observed among women.

* Plasma insulin levels failed to significantly affect the risk of weight

regain.

* A significant reduction in ghrelin during the dietary intervention itself

increased the risk for weight regain, as did a diet-induced increase in

leptin

levels.

Clinical Implications

* Leptin is a hormone produced primarily by adipocytes and works to inhibit

appetite. Conversely, ghrelin is produced in the stomach and functions in

stimulating appetite.

* In the current study, adults with higher plasma leptin levels and lower

plasma ghrelin levels were more likely to regain weight lost through

dieting.

Insulin levels were not associated with weight regain.

[Guest guest]

Hi ,

I am not an endocrinologist or a dietician, but can you explain this

sentence

" Of course, with a diet which is 55% ( for gods sake!! ) carbs - what planet

are these people on? - one can see how that becomes less relevant. "

Do you want more or less carbs in the diet, what form of carbs?

If you go back through the archives the level of carbohydrate in diets has

been debated, with some offering the Kenyan and Ethiopian middle and long

distance runners as higher carb diets from 70 up to 90% in some of the cases

sited and they are world class athletes with not much fat problem. Others

will site much lower carb diets e.g. some body builder who will have as low

as 20% and some who strive for none - except that is for the green veggies

that they eat which have carbs in them. Can you add to the debate at all?

Perhaps you can explain what in your opinion makes a study relevant and that

to which it is made relevant?

Best Regards

Nick Tatalias

Johannesburg

South Africa

On 13 October 2010 21:57, scott einhorn <docak@...> wrote:

>

>

> With all due respect to Dr. Giarnella,

> this article below whoich he shares with us, well ok, yes it's interesting.

> It's interesting in that it shows us exactly what NOT to do, and what NOT

> to

> conclude. The author shortchanges the roles of leptin and ghrelin, vastly

> oversimplying their multi-layered endocrinologic roles.

> Also, nowhere is cholecytokinin mentioned, which upon the initial stages

> of fat emulsification, initiate a negative hypothalamic feedback re

> satiety,

> thus significantly downregulating hunger. Of course, with a diet which is

> 55% ( for gods sake!! ) carbs - what planet are these people on? - one can

> see how that becomes less relevant.

> The report is just too easy to dissect into it's layers of bad science.

> I will defer to each of you all to do that at your leisure.

> Einhorn

> Miami

> Stamford

>

> _____

>

> From: Supertraining <Supertraining%40>[mailto:

> Supertraining <Supertraining%40>]

> On Behalf Of Ralph Giarnella

> Sent: Wednesday, October 13, 2010 8:15 AM

> Supertraining <Supertraining%40>

> Subject: Appetite-Related Hormone Levels May Predict Weight

>

> Regain After Dieting

>

> In keeping with the recent discussion concerning weight loss I found the

> following article to be very interesting.

> Comments?

> Ralph Giarnella MD

> Southington Ct. USA

> *******************************************

> Appetite-Related Hormone Levels May Predict Weight Regain After Dieting

> http://cme.medscape.com/viewarticle/728453?src=cmemp

> <http://cme.medscape.com/viewarticle/728453?src=cmemp & uac=38122MX>

> & uac=38122MX

> News Author: Laurie Barclay, MD

> CME Author: P. Vega, MD

>

> September 14, 2010 — Baseline levels of the appetite-related hormones

> leptin

> and

> ghrelin may help predict weight regain after dieting, according to the

> results

> of a study published online September 9 and will appear in the November

> print

> issue of the Journal of Clinical Endocrinology & Metabolism.

>

> " Treating obesity with drugs or dietary programs can be very effective in

> the

> short-term, but the long-term success of maintaining the weight lost is

> usually

> poor, " lead author Ana B. Crujeiras, PhD, from Compejo Hospitalario

> Universitario de Santiago in Spain, said in a news release. " Our study

> sheds

>

> light on how the appetite hormones leptin and ghrelin affect weight regain

> after

> weight loss. This knowledge could be used as a tool to personalize

> weight-loss

> programs that could guarantee success in keeping off the weight. "

>

> The study goal was to determine the potential role of ghrelin, leptin, and

> insulin plasma levels in weight regain after following a therapeutic,

> low-calorie diet. Obese or overweight volunteers followed an 8-week,

> hypocaloric

> diet (-30% energy expenditure) and were assessed again at 32 weeks after

> treatment. Mean age was 35 ± 7 years; mean body mass index was 30.7 ± 2.4

> kg/m2;

> 49 participants were women and 55 were men. At baseline, week 8, and week

> 32,

> participants underwent measurement of body weight and fasting plasma

> concentrations of ghrelin, leptin, and insulin.

>

> Average weight loss after the 8-week hypocaloric diet was -5.0% ± 2.2% (P <

>

> .001). Although plasma leptin and insulin concentrations decreased

> significantly, ghrelin levels remained relatively stable. Compared with

> participants who maintained their weight loss, those that regained more

> than

> 10%

> of weight loss had higher leptin levels (P < .01), lower ghrelin levels (P

> <

>

> .05), and similar insulin levels. Weight regain at week 32 was negatively

> correlated with baseline levels and ghrelin levels at week 8 and positively

>

> correlated with baseline levels and leptin levels at week 8.

>

> Gender affected these associations, which were statistically significant

> for

>

> ghrelin in men and for leptin in women. Decreased ghrelin levels after the

> 8-week hypocaloric diet predicted greater risk for weight regain (odds

> ratio

>

> [OR], 3.109; P =.008), whereas decreased leptin levels predicted

> maintenance

> of

> weight loss (OR, 0.141; P = .001).

>

> “Subjects with higher plasma leptin and lower ghrelin levels at baseline

> could

> be more prone to regain weight lost and these hormones levels could be

> proposed

> as biomarkers for predicting obesity-treatment outcomes,” the study authors

>

> write.

>

> Limitations of this study include use of only fasting hormone levels

> because

>

> insulin, leptin, and ghrelin concentrations can be markedly affected by

> food

>

> intake as well as by several metabolic conditions.

>

> " We believe this research is of foremost relevance in clinical terms as it

> may

> indicate that the outcome of weight therapy may be pre-conditioned, " Dr.

> Crujeiras said. " Furthermore, our findings may provide endocrinology and

> nutrition professionals a tool to identify individuals in need of

> specialized

> weight-loss programs that first target appetite hormone levels before

> beginning

> conventional dietary treatment. "

>

> Linea Especial about Nutrition, obesity and Health and CIBERobn , an ISCIII

>

> initiative, supported this study. Dr. AB Crujeiras is funded by the

> Instituto de

> Salud III and the Xunta de Galicia (SERGAS). Another author (M.C.

> Carreira) is funded by the Xunta de Galicia. The study authors have

> disclosed no

> relevant financial relationships.

>

> J Clin Endocrinol Metab. Publihsed online September 9, 2010.

> Clinical Context- commentary on study: by reviewers

>

> Research has highlighted how certain hormones have an important effect in

> determining appetite and, in turn, regulating body weight. Leptin is

> produced

> primarily by adipocytes and works to inhibit appetite. Conversely, ghrelin

> is a

> hormone which is mostly derived from the stomach and which stimulates

> appetite.

>

> One of the most difficult and frustrating elements of treatment for obesity

> is

> maintaining initial weight loss. The authors of the current study

> investigate

> whether appetite-related hormones such as leptin and ghrelin may be useful

> as

> biomarkers for patients at risk for weight regain.

> Study Highlights

>

> * Study participants were overweight and obese adults from Spain.

> Individuals with diabetes, hypertension, hyperlipidemia, or recent weight

> change

> were excluded from study participation, as were those who regularly used

> prescription medications or supplements.

> * All participants underwent an 8-week hypocaloric diet designed to produce

>

> a 30% energy restriction on subjects’ normal daily caloric intake. The diet

> was

> composed of 55% carbohydrates, 15% protein, and 30% fat. Participants did

> not

> change their exercise habits during these 8 weeks.

> * At the end of the dietary intervention, participants were given

> instructions regarding maintaining weight loss, but no specific diet. They

> were

> then assessed at 32 weeks for study outcomes.

> * Participants underwent a routine medical examination plus laboratory

> testing at baseline. Laboratory testing and body weight measurement were

> repeated at study weeks 8 and 32.

> * The main study outcome was the relationship between weight loss

> maintenance at week 32 and fasting levels of ghrelin, leptin, and insulin.

> * 79 women and 83 men began the diet intervention. The mean age of

> participants was 35 years, and the mean body mass index of the group was

> 31.1

> kg/m2.

> * Women had lower body weight but higher leptin and ghrelin levels compared

>

> with men throughout the study.

> * During the 8-week diet intervention, participants lost an average of 5%

> of

>

> their body weight. The decline in body weight was associated with

> reductions

> in

> leptin and insulin levels, but ghrelin levels remained similar to baseline.

>

> Reductions in leptin and insulin appeared proportional to the reduction in

> body

> weight.

> * 104 individuals completed the follow-up testing at 32 weeks. 55

> participants had maintained their weight loss from 8 weeks, and 49 subjects

> had

> regained 10% or more of the lost weight.

> * There were gender-related differences in the relationship between weight

> regain and plasma hormone levels. Among women, participants with weight

> regain

> had higher leptin levels at baseline, week 8, and week 32 compared with

> women

> who maintained weight loss. However, there was no difference in leptin

> levels

> among men who maintained or regained their weight loss.

> * Among men, lower levels of ghrelin were associated with weight regain,

> but

>

> this was not observed among women.

> * Plasma insulin levels failed to significantly affect the risk of weight

> regain.

> * A significant reduction in ghrelin during the dietary intervention itself

>

> increased the risk for weight regain, as did a diet-induced increase in

> leptin

> levels.

>

> Clinical Implications

>

> * Leptin is a hormone produced primarily by adipocytes and works to inhibit

>

> appetite. Conversely, ghrelin is produced in the stomach and functions in

> stimulating appetite.

> * In the current study, adults with higher plasma leptin levels and lower

> plasma ghrelin levels were more likely to regain weight lost through

> dieting.

> Insulin levels were not associated with weight regain.

>

>

[Guest guest]

Nick, there are different kinds of carbs, obviously. Problem comes when

when 'authorities' talk about it in generalities.

That is a slippery slope. Also the kenyans are running there proverbial

assses off. That makes a huge difference. Native africans, being tall and

thing, are morphophologically designed to easily shed heat.

More detail later, gotta prepare for work.

Einhorn

Miami

Stamford

Appetite-Related Hormone Levels May Predict

> Weight

>

> Regain After Dieting

>

> In keeping with the recent discussion concerning weight loss I found

> the following article to be very interesting.

> Comments?

> Ralph Giarnella MD

> Southington Ct. USA

> *******************************************

> Appetite-Related Hormone Levels May Predict Weight Regain After

> Dieting http://cme.medscape.com/viewarticle/728453?src=cmemp

> <http://cme.medscape.com/viewarticle/728453?src=cmemp & uac=38122MX>

> & uac=38122MX

> News Author: Laurie Barclay, MD

> CME Author: P. Vega, MD

>

> September 14, 2010 — Baseline levels of the appetite-related hormones

> leptin and ghrelin may help predict weight regain after dieting,

> according to the results of a study published online September 9 and

> will appear in the November print issue of the Journal of Clinical

> Endocrinology & Metabolism.

>

> " Treating obesity with drugs or dietary programs can be very effective

> in the short-term, but the long-term success of maintaining the weight

> lost is usually poor, " lead author Ana B. Crujeiras, PhD, from Compejo

> Hospitalario Universitario de Santiago in Spain, said in a news

> release. " Our study sheds

>

> light on how the appetite hormones leptin and ghrelin affect weight

> regain after weight loss. This knowledge could be used as a tool to

> personalize weight-loss programs that could guarantee success in

> keeping off the weight. "

>

> The study goal was to determine the potential role of ghrelin, leptin,

> and insulin plasma levels in weight regain after following a

> therapeutic, low-calorie diet. Obese or overweight volunteers followed

> an 8-week, hypocaloric diet (-30% energy expenditure) and were

> assessed again at 32 weeks after treatment. Mean age was 35 ± 7 years;

> mean body mass index was 30.7 ± 2.4 kg/m2;

> 49 participants were women and 55 were men. At baseline, week 8, and

> week 32, participants underwent measurement of body weight and fasting

> plasma concentrations of ghrelin, leptin, and insulin.

>

> Average weight loss after the 8-week hypocaloric diet was -5.0% ± 2.2%

> (P <

>

> .001). Although plasma leptin and insulin concentrations decreased

> significantly, ghrelin levels remained relatively stable. Compared

> with participants who maintained their weight loss, those that

> regained more than 10% of weight loss had higher leptin levels (P <

> .01), lower ghrelin levels (P <

>

> .05), and similar insulin levels. Weight regain at week 32 was

> negatively correlated with baseline levels and ghrelin levels at week

> 8 and positively

>

> correlated with baseline levels and leptin levels at week 8.

>

> Gender affected these associations, which were statistically

> significant for

>

> ghrelin in men and for leptin in women. Decreased ghrelin levels after

> the 8-week hypocaloric diet predicted greater risk for weight regain

> (odds ratio

>

> [OR], 3.109; P =.008), whereas decreased leptin levels predicted

> maintenance of weight loss (OR, 0.141; P = .001).

>

> “Subjects with higher plasma leptin and lower ghrelin levels at

> baseline could be more prone to regain weight lost and these hormones

> levels could be proposed as biomarkers for predicting

> obesity-treatment outcomes,” the study authors

>

> write.

>

> Limitations of this study include use of only fasting hormone levels

> because

>

> insulin, leptin, and ghrelin concentrations can be markedly affected

> by food

>

> intake as well as by several metabolic conditions.

>

> " We believe this research is of foremost relevance in clinical terms

> as it may indicate that the outcome of weight therapy may be

> pre-conditioned, " Dr.

> Crujeiras said. " Furthermore, our findings may provide endocrinology

> and nutrition professionals a tool to identify individuals in need of

> specialized weight-loss programs that first target appetite hormone

> levels before beginning conventional dietary treatment. "

>

> Linea Especial about Nutrition, obesity and Health and CIBERobn , an

> ISCIII

>

> initiative, supported this study. Dr. AB Crujeiras is funded by the

> Instituto de Salud III and the Xunta de Galicia (SERGAS).

> Another author (M.C.

> Carreira) is funded by the Xunta de Galicia. The study authors have

> disclosed no relevant financial relationships.

>

> J Clin Endocrinol Metab. Publihsed online September 9, 2010.

> Clinical Context- commentary on study: by reviewers

>

> Research has highlighted how certain hormones have an important effect

> in determining appetite and, in turn, regulating body weight. Leptin

> is produced primarily by adipocytes and works to inhibit appetite.

> Conversely, ghrelin is a hormone which is mostly derived from the

> stomach and which stimulates appetite.

>

> One of the most difficult and frustrating elements of treatment for

> obesity is maintaining initial weight loss. The authors of the current

> study investigate whether appetite-related hormones such as leptin and

> ghrelin may be useful as biomarkers for patients at risk for weight

> regain.

> Study Highlights

>

> * Study participants were overweight and obese adults from Spain.

> Individuals with diabetes, hypertension, hyperlipidemia, or recent

> weight change were excluded from study participation, as were those

> who regularly used prescription medications or supplements.

> * All participants underwent an 8-week hypocaloric diet designed to

> produce

>

> a 30% energy restriction on subjects’ normal daily caloric intake. The

> diet was composed of 55% carbohydrates, 15% protein, and 30% fat.

> Participants did not change their exercise habits during these 8

> weeks.

> * At the end of the dietary intervention, participants were given

> instructions regarding maintaining weight loss, but no specific diet.

> They were then assessed at 32 weeks for study outcomes.

> * Participants underwent a routine medical examination plus laboratory

> testing at baseline. Laboratory testing and body weight measurement

> were repeated at study weeks 8 and 32.

> * The main study outcome was the relationship between weight loss

> maintenance at week 32 and fasting levels of ghrelin, leptin, and insulin.

> * 79 women and 83 men began the diet intervention. The mean age of

> participants was 35 years, and the mean body mass index of the group

> was

> 31.1

> kg/m2.

> * Women had lower body weight but higher leptin and ghrelin levels

> compared

>

> with men throughout the study.

> * During the 8-week diet intervention, participants lost an average of

> 5% of

>

> their body weight. The decline in body weight was associated with

> reductions in leptin and insulin levels, but ghrelin levels remained

> similar to baseline.

>

> Reductions in leptin and insulin appeared proportional to the

> reduction in body weight.

> * 104 individuals completed the follow-up testing at 32 weeks. 55

> participants had maintained their weight loss from 8 weeks, and 49

> subjects had regained 10% or more of the lost weight.

> * There were gender-related differences in the relationship between

> weight regain and plasma hormone levels. Among women, participants

> with weight regain had higher leptin levels at baseline, week 8, and

> week 32 compared with women who maintained weight loss. However, there

> was no difference in leptin levels among men who maintained or

> regained their weight loss.

> * Among men, lower levels of ghrelin were associated with weight

> regain, but

>

> this was not observed among women.

> * Plasma insulin levels failed to significantly affect the risk of

> weight regain.

> * A significant reduction in ghrelin during the dietary intervention

> itself

>

> increased the risk for weight regain, as did a diet-induced increase

> in leptin levels.

>

> Clinical Implications

>

> * Leptin is a hormone produced primarily by adipocytes and works to

> inhibit

>

> appetite. Conversely, ghrelin is produced in the stomach and functions

> in stimulating appetite.

> * In the current study, adults with higher plasma leptin levels and

> lower plasma ghrelin levels were more likely to regain weight lost

> through dieting.

> Insulin levels were not associated with weight regain.

>

>

[Guest guest]

,

I think it's a generalization that " Native Africans, are tall and thin " . It

depends on the ethnic group within Africa you are considering. The Kenyans

you are referring to (and many Ethiopians) belong to a particular ethnic

group, which probably has on average physical features better suited to

endurance running. But there are many other ethnic groups in Africa that do

not have those characteristics. There are several pygmy ethnic groups too.

Giovanni Ciriani - West Hartford, CT - USA

On Fri, Oct 15, 2010 at 8:58 AM, scott einhorn <docak@...> wrote:

>

>

> Nick, there are different kinds of carbs, obviously. Problem comes when

> when 'authorities' talk about it in generalities.

> That is a slippery slope. Also the kenyans are running there proverbial

> assses off. That makes a huge difference. Native africans, being tall and

> thing, are morphophologically designed to easily shed heat.

> More detail later, gotta prepare for work.

>

> Einhorn

> Miami

> Stamford

>

> Appetite-Related Hormone Levels May Predict

> > Weight

> >

> > Regain After Dieting

> >

> > In keeping with the recent discussion concerning weight loss I found

> > the following article to be very interesting.

> > Comments?

> > Ralph Giarnella MD

> > Southington Ct. USA

> > *******************************************

> > Appetite-Related Hormone Levels May Predict Weight Regain After

> > Dieting http://cme.medscape.com/viewarticle/728453?src=cmemp

> > <http://cme.medscape.com/viewarticle/728453?src=cmemp & uac=38122MX>

> > & uac=38122MX

> > News Author: Laurie Barclay, MD

> > CME Author: P. Vega, MD

> >

> > September 14, 2010 — Baseline levels of the appetite-related hormones

> > leptin and ghrelin may help predict weight regain after dieting,

> > according to the results of a study published online September 9 and

> > will appear in the November print issue of the Journal of Clinical

> > Endocrinology & Metabolism.

> >

> > " Treating obesity with drugs or dietary programs can be very effective

> > in the short-term, but the long-term success of maintaining the weight

> > lost is usually poor, " lead author Ana B. Crujeiras, PhD, from Compejo

> > Hospitalario Universitario de Santiago in Spain, said in a news

> > release. " Our study sheds

> >

> > light on how the appetite hormones leptin and ghrelin affect weight

> > regain after weight loss. This knowledge could be used as a tool to

> > personalize weight-loss programs that could guarantee success in

> > keeping off the weight. "

> >

> > The study goal was to determine the potential role of ghrelin, leptin,

> > and insulin plasma levels in weight regain after following a

> > therapeutic, low-calorie diet. Obese or overweight volunteers followed

> > an 8-week, hypocaloric diet (-30% energy expenditure) and were

> > assessed again at 32 weeks after treatment. Mean age was 35 ± 7 years;

> > mean body mass index was 30.7 ± 2.4 kg/m2;

> > 49 participants were women and 55 were men. At baseline, week 8, and

> > week 32, participants underwent measurement of body weight and fasting

> > plasma concentrations of ghrelin, leptin, and insulin.

> >

> > Average weight loss after the 8-week hypocaloric diet was -5.0% ± 2.2%

> > (P <

> >

> > .001). Although plasma leptin and insulin concentrations decreased

> > significantly, ghrelin levels remained relatively stable. Compared

> > with participants who maintained their weight loss, those that

> > regained more than 10% of weight loss had higher leptin levels (P <

> > .01), lower ghrelin levels (P <

> >

> > .05), and similar insulin levels. Weight regain at week 32 was

> > negatively correlated with baseline levels and ghrelin levels at week

> > 8 and positively

> >

> > correlated with baseline levels and leptin levels at week 8.

> >

> > Gender affected these associations, which were statistically

> > significant for

> >

> > ghrelin in men and for leptin in women. Decreased ghrelin levels after

> > the 8-week hypocaloric diet predicted greater risk for weight regain

> > (odds ratio

> >

> > [OR], 3.109; P =.008), whereas decreased leptin levels predicted

> > maintenance of weight loss (OR, 0.141; P = .001).

> >

> > “Subjects with higher plasma leptin and lower ghrelin levels at

> > baseline could be more prone to regain weight lost and these hormones

> > levels could be proposed as biomarkers for predicting

> > obesity-treatment outcomes,” the study authors

> >

> > write.

> >

> > Limitations of this study include use of only fasting hormone levels

> > because

> >

> > insulin, leptin, and ghrelin concentrations can be markedly affected

> > by food

> >

> > intake as well as by several metabolic conditions.

> >

> > " We believe this research is of foremost relevance in clinical terms

> > as it may indicate that the outcome of weight therapy may be

> > pre-conditioned, " Dr.

> > Crujeiras said. " Furthermore, our findings may provide endocrinology

> > and nutrition professionals a tool to identify individuals in need of

> > specialized weight-loss programs that first target appetite hormone

> > levels before beginning conventional dietary treatment. "

> >

> > Linea Especial about Nutrition, obesity and Health and CIBERobn , an

> > ISCIII

> >

> > initiative, supported this study. Dr. AB Crujeiras is funded by the

> > Instituto de Salud III and the Xunta de Galicia (SERGAS).

> > Another author (M.C.

> > Carreira) is funded by the Xunta de Galicia. The study authors have

> > disclosed no relevant financial relationships.

> >

> > J Clin Endocrinol Metab. Publihsed online September 9, 2010.

> > Clinical Context- commentary on study: by reviewers

> >

> > Research has highlighted how certain hormones have an important effect

> > in determining appetite and, in turn, regulating body weight. Leptin

> > is produced primarily by adipocytes and works to inhibit appetite.

> > Conversely, ghrelin is a hormone which is mostly derived from the

> > stomach and which stimulates appetite.

> >

> > One of the most difficult and frustrating elements of treatment for

> > obesity is maintaining initial weight loss. The authors of the current

> > study investigate whether appetite-related hormones such as leptin and

> > ghrelin may be useful as biomarkers for patients at risk for weight

> > regain.

> > Study Highlights

> >

> > * Study participants were overweight and obese adults from Spain.

> > Individuals with diabetes, hypertension, hyperlipidemia, or recent

> > weight change were excluded from study participation, as were those

> > who regularly used prescription medications or supplements.

> > * All participants underwent an 8-week hypocaloric diet designed to

> > produce

> >

> > a 30% energy restriction on subjects’ normal daily caloric intake. The

> > diet was composed of 55% carbohydrates, 15% protein, and 30% fat.

> > Participants did not change their exercise habits during these 8

> > weeks.

> > * At the end of the dietary intervention, participants were given

> > instructions regarding maintaining weight loss, but no specific diet.

> > They were then assessed at 32 weeks for study outcomes.

> > * Participants underwent a routine medical examination plus laboratory

> > testing at baseline. Laboratory testing and body weight measurement

> > were repeated at study weeks 8 and 32.

> > * The main study outcome was the relationship between weight loss

> > maintenance at week 32 and fasting levels of ghrelin, leptin, and

> insulin.

> > * 79 women and 83 men began the diet intervention. The mean age of

> > participants was 35 years, and the mean body mass index of the group

> > was

> > 31.1

> > kg/m2.

> > * Women had lower body weight but higher leptin and ghrelin levels

> > compared

> >

> > with men throughout the study.

> > * During the 8-week diet intervention, participants lost an average of

> > 5% of

> >

> > their body weight. The decline in body weight was associated with

> > reductions in leptin and insulin levels, but ghrelin levels remained

> > similar to baseline.

> >

> > Reductions in leptin and insulin appeared proportional to the

> > reduction in body weight.

> > * 104 individuals completed the follow-up testing at 32 weeks. 55

> > participants had maintained their weight loss from 8 weeks, and 49

> > subjects had regained 10% or more of the lost weight.

> > * There were gender-related differences in the relationship between

> > weight regain and plasma hormone levels. Among women, participants

> > with weight regain had higher leptin levels at baseline, week 8, and

> > week 32 compared with women who maintained weight loss. However, there

> > was no difference in leptin levels among men who maintained or

> > regained their weight loss.

> > * Among men, lower levels of ghrelin were associated with weight

> > regain, but

> >

> > this was not observed among women.

> > * Plasma insulin levels failed to significantly affect the risk of

> > weight regain.

> > * A significant reduction in ghrelin during the dietary intervention

> > itself

> >

> > increased the risk for weight regain, as did a diet-induced increase

> > in leptin levels.

> >

> > Clinical Implications

> >

> > * Leptin is a hormone produced primarily by adipocytes and works to

> > inhibit

> >

> > appetite. Conversely, ghrelin is produced in the stomach and functions

> > in stimulating appetite.

> > * In the current study, adults with higher plasma leptin levels and

> > lower plasma ghrelin levels were more likely to regain weight lost

> > through dieting.

> > Insulin levels were not associated with weight regain.

> >

> >

[Guest guest]

I agree Giovanni,

In South Africa alone we have 11 official languages which represent 11 major

groups in a country the size (geographically) of Texas. Although many are

similar in build, but within single groups there are variations, but the

range (to stereotype) is from big muscular Zulus through to small

bushman, Khoisan. The Kenyans also have big muscular guys who play rugby

not only middle and long distance runners. South Africa have athletes from

the same ethnic group who have won Olympic and world medals at 800m, long

jump, won ultra-marathons (Comrades Marathon) play front row rugby, back

line rugby, soccer and other sports that require very different body builds

and at world class level. I don't think that any country really has

single homogeneous group of people even though we do tend to stereotype.

However the discussion is about carbohydrates and the use there of.

Regards

Nick Tatalias

Johannesburg

South Africa

On 15 October 2010 23:42, Giovanni Ciriani <Giovanni.Ciriani@...>wrote:

> ,

> I think it's a generalization that " Native Africans, are tall and thin " . It

> depends on the ethnic group within Africa you are considering. The Kenyans

> you are referring to (and many Ethiopians) belong to a particular ethnic

> group, which probably has on average physical features better suited to

> endurance running. But there are many other ethnic groups in Africa that do

> not have those characteristics. There are several pygmy ethnic groups too.

>

> Giovanni Ciriani - West Hartford, CT - USA

>

> On Fri, Oct 15, 2010 at 8:58 AM, scott einhorn <docak@...> wrote:

>

> >

> >

> > Nick, there are different kinds of carbs, obviously. Problem comes when

> > when 'authorities' talk about it in generalities.

> > That is a slippery slope. Also the kenyans are running there proverbial

> > assses off. That makes a huge difference. Native africans, being tall and

> > thing, are morphophologically designed to easily shed heat.

> > More detail later, gotta prepare for work.

> >

> > Einhorn

> > Miami

> > Stamford

> >

> >

>