Below is my response to two articles that appeared in Herald Sun, and the Age on Monday, August 1.

Dr Leon Massage
Founder of the BMI weight loss program
AMA Vic spokesperson on weight and nutrition

Weight loss a war that never ends (Herald Sun, Monday, August 1 AAP)

Obesity campaigns 'waste of cash' - Melbourne Age, Monday, August 1. by Kate Morgan, Health Reporter.

It is a sad day when the weight loss experts announce that it is impossible for the obese to lose weight. What makes the matter even more distressing is the fact that they are WRONG.

Professor of Medicine at Melbourne University, Joseph Proietto, was quoted in an article in the Melbourne Age on Monday by Kate Hagan, the Age health reporter, stating that the obese population was unlikely to benefit from health messages encouraging them to eat healthy foods and to exercise. He went on to say that the answer lay in making gastric banding more widely available.

That is a horrible defeatist thought that is likely to dishearten many obese individuals. And it is one that I totally disagree with it.

My experience, with thousands of overweight and obese patients who I have treated in my clinic, tells me that the opposite is true. Many people can succeed in losing their excess weight, while simultaneously improving their health. And they can keep the weight off - permanently.

Professor Proietto said; "You can't convince someone not to eat who's hungry." Well of course you can't. And nor should you.

In order to lose weight, it is not necessary to be hungry. This terrible stereotype of weight loss being all about pain and self-denial is totally wrong. It is disappointing to hear the experts perpetuating the myth.

The answer to successful weight loss is not new drugs. And it is not more lap-band surgery. Invasive procedures of this type should be a last resort.

The answer lies in empowering patients with the right information and the motivation to enable them to take control of their weight and their health.

Avoiding fats, sugars or salt requires careful checking.
The ingredient list on any given product is obliged to specify the contents of that product. However, if you are trying to avoid fat, sugar or salt, you should be aware of the fact that they may be added in many other forms that are a little harder to identify. These ingredients can be scattered all over the ingredients list.

It is posible that the medications you are taking are causing you to gain weight?

Unfortunately the answer is yes

There are quite a few medications that can cause you to gain weight.

For your information, these drugs, and the drug classes they belong to, are listed in the table below. Some of these classes of drugs are more notorious for weight gain than others.

But please note, you must not cease these medications without consulting your doctor.

The medications that your are taking have been prescribed for you for a specific medical reason and it could be detrimental to your health if you suddenly stop taking them.

You should always ask your doctor's advice about stopping any medication or even decreasing the dosage of a prescribed medication.

Those of you who reside in Australia would have seen the television advertisement that promotes meat eating with the slogan: “Feed the man meat”. The question we need to ask is whether this recommendation to eat more meat is a good idea in the first place? And, the question that follows next: is eating meat a healthy food choice?

Meat is often promoted as a food that is an excellent source of protein, iron, zinc and vitamin B12. This is basically correct. Meat does contain high concentrations of these nutrients.

Does it mean, however, that there are no other ways, or even better ways, of getting these nutrients? No. I don’t think it means that at all.

Does it mean that because meat has high levels of these nutrients, it is healthy and good for you? No, it does not mean anything of the sort.

There are many other sources of these nutrients in the food that we eat. Iron, for example, can be found in high concentrations in many other sources of animal proteins. Examples include: liver, eggs, salmon, tuna and oysters.

White meat also contains some iron but, admittedly, not nearly as much as red meat.

Most people immediately think of beef or lamb when considering red meat; however kangaroo meat is a much better source of iron, zinc and vitamin B12 than either lamb or beef.

Iron can also be found in many non-animal sources, such as lentils, grains, beans, soy and green leafy vegetables like spinach and broccoli.

Other excellent sources of iron include whole wheat bread and soy products such as tofu, as well as dried fruit.

What are the adverse health effects of red meat?

The World Cancer Research Fund released a very important report in 1997. That report said: “Diets containing substantial amounts of red meat probably increase the risk of colorectal cancer”.

The report went on to say that there is a possibility that such diets also increase the risk of other cancers, such as cancer of the pancreas, breast, prostate and kidney.

The World Cancer Research Fund released a further report in 2007. This report was even more damning of red meat. The report stated the following: “The evidence is now convincing that red meats and processed meats are a cause of bowel cancer”.

The report also recommended avoiding processed meat. It stated that there was no level of intake of processed meat that could be confidently shown not to increase risk.

What constitutes red meat?

According to the World Cancer Research Fund the following are classified as red meat: Lamb, beef, pork or goat meat.

The World Cancer Research Fund defines processed meat as: Any meat that is preserved by: salting, curing, smoking or adding chemical preservatives Examples include: ham, bacon, hot dogs and sausages.

There is even more bad news for red meat eaters who are concerned about its impact on health. Recent studies show that eating red meat increases mortality rates. The increase in mortality was mainly due to an increase in heart disease and cardiovascular risk, but cancers were not far behind.

It is important to emphasise that these problems have not been found with white meats such as chicken and fish.

How much red meat is too much?

It appears that the body can cope with small quantities of red meat, and most health authorities have not recommended that you have to give up red meat all together.

The current Australian healthy eating guidelines recommend 3-4 servings per week of red meat. But it is important to note that the size of these servings is quite small. The recommended amount is 65–100 gm, after cooking. Personally, I would recommend less.

The popular CSIRO weight loss diet recommends 200 gm portions of red meat, 4-5 times per week for dinner, and allows even more processed red meat for lunch, up to 4 times per week. I believe that these are dangerous and excessive levels of red meat intake.

Red Meat and weight loss

When considering red meat intake for a weight loss diet, it is important to take into account the energy density of the meal. Red meat has a very high energy density.

A high energy density means that there are a lot of calories in a small piece of the food concerned. For example, a 120 gm serving of red meat contains 340 Calories, or 1420 Kilojoules. That is an enormous amount of energy when you consider that the average male would easily consume a 375-500 gm steak in one sitting.

That is one reason why, in my BMI Boost Metabolism System, I highly recommend a significant decrease in the intake of red meat for anyone trying to lose weight.

I was interviewed on Dr Ross Walker’s program, on radio station 2UE in Sydney, a few weeks ago and they asked me a few interesting questions that I thought I would share with you.

The first question I was asked was about the current statistics on overweight and obesity in Australia. And, I suspect, you will find the statistics quite astounding. So here they are, for your information:

The percentage of overweight females in Australia is 55% and the percentage of overweight males is a staggering 67%. It is also worth making a note of the fact that this year Australia has had the unique privilege of overtaking the USA as the fattest country in the world. There goes the image of the athletic, bronzed, Australian male.

Another question was: Why do we have such a problem with the obesity in our country?

I believe that there is not one simple answer to that question. There are many reasons why obesity has become such a problem, not only in Australia, but all across the Western World. The three main reasons are:

1. We have become a very inactive society. We walk less, we have too many labour saving devices and we exercise less. In the last 100 years the daily energy output by the average office worker has decreased by about 60%.
2. Our energy intake, that is the number of calories we consume in the food we eat, has not dropped at all; and in many cases it has probably increased. This has caused an energy imbalance that has created a tendency towards weight gain and obesity.
3. We eat the wrong foods. We eat too much fast-food and junk food. Too many of the foods we eat are high in fat and energy density. The food is too highly processed and the quality of the ingredients in our food has diminished.

Another question related to why most weight loss programs are initially effective but after following most people for up to three years, they are either the same weight or are even heavier.

The short answer to this is that most diets go for the quick fix and focus on only one minor aspect of a very complex problem. Many people are given a very simple diet to follow for a short period of time. They either cut portion size or they provide some meal substitutes, such as protein powders, to eat instead of a meal.

These techniques result in short term weight loss but they are always doomed to failure in the long term. No one has taken the time to learn what they were doing wrong in the first place or to determine their underlying metabolic profile and any metabolic problems. The end result is that when the majority of people stop following the written instructions or stop drinking the meal substitutes, they go back to their old eating habits.

At last, I can deliver a bit of good news to those people who are always bemoaning their body shape and keep complaining that their pear shape body fat distribution is less than ideal.

If that is something that you can identify with, you will be pleased to learn that recent Danish research has revealed that if you have larger thighs than the average, you finally have a reason to celebrate. The Danish study found that having bigger thighs than the average person protects you against cardiovascular disease and premature death.

The research, which was performed on 2800 men and women, found that people with a thigh circumference of 60 centimetres or less had an increased risk of premature death, as well as heart and cardiovascular disease. As a matter of fact, those with the smallest thighs – measuring 46 cm or less in circumference – had double the mortality risk of those with a thigh circumference of 55 cm. According to the researchers, having too little muscle or subcutaneous fat in the lower limbs, is likely to cause a problem with sugar and fat metabolism and this leads on to chronic disease and higher risk.

We have known for quite some time that extra fat, when it is deposited mainly around the waist and causes the so called ‘apple shape’ obesity, is bad for you and increases your risk of heart disease and of cardiovascular disease. But although this was never shown to be the case in people with the more ‘pear shape’ distribution of body fat, there was no research, until now, to suggest that it was actually beneficial.

Further research will be necessary to see if increasing the thigh muscle mass through exercise creates similar health benefits.

Successful weight loss is not just about calories. Nor is it just about focusing on healthy foods and exercise. There is often a significant emotional basis to losing weight and keeping it off.

There are many people who have read all the weight loss books and believe that they have all the knowledge they need to lose weight, but all that knowledge just never seems to be quite enough to get them to succeed at losing weight. They seem to be lacking some vital ingredient to keep them on track and focused.

The truth of the matter is that in order to lose weight effectively and successfully, you need certain mental and emotional resources to help you stay focused, optimistic and committed. Although it is likely that you have the potential to do this, the potential is often buried somewhere deep inside and most people need help to bring this potential out.

If you are looking for some guidance and help to deal with emotional eating or binge eating, the Body Metabolism Institute has created 3 powerful audio CDs, with accompanying books and worksheets to help you succeed with preventing emotional eating and putting a stop to binge eating.

Now there is a way you can do just that.

If you are a BMI Member you already have access to these modules.

We are all familiar with our own coping strategies – they are the techniques we use to get us through whenever we are under stress or just having emotional problems and not coping very well. Unfortunately, the strategies that we use are often the wrong strategies; they can be ineffective strategies or, worse still, totally inappropriate strategies.

When the strategies we use don’t work or end up causing a bad outcome, doctors call these "maladaptive strategies". This means that we have adapted to a situation, but the adaptation is causing more trouble and was therefore a poor choice.

At these times we need to change or modify the strategies we are using. An excellent way to do this is to highlight the trigger points that motivate you best, write them down and review them on a regular basis. If you keep returning to them, you will often find something new and powerful enough to trigger a change in your attitude.

Here is a useful fact to remember:

It takes 3 weeks to break a habit
It takes 3 months to establish a new one
So persevere. Do not be discouraged.

I hope you are enjoying and getting benefit from this newsletter. If you are looking for more in depth information you can get it by becoming a member of the BMI Boost Insider’s Club.

In the meantime, if you have any special topics you would like me to cover in future newsletters, please contact me at: info@bmiweight.com.au

Best Wishes for Your Continued Success
Dr Leon

As a general guide, you should look for foods that contain the following:

How to compare nutrient content

To compare nutrient content in products, you should look at the 'per 100g column' in the nutrition information panel, on the food package.

Serve size is not as useful. This is because the manufacturer determines the serve size and this may not be the same as your serve size, and can vary across products.

Daily Intake Guide

You may have noticed new labels on foods in supermarkets and food outlets called Percent Daily Intake or %DI. This shows you the percentage of energy and nutrients in a serve of the product. It is present on the front of the food packaging and therefore it is easy to see, and can be a useful guide to choosing foods to best meeting your nutrient needs.

What is the Daily Intake Guide?
The Daily Intake Guide, or %DI, is a set of reference values for an acceptable intake of a set of nutrients including:

Energy; Fat; Protein; Saturated Fat; Carbohydrate; Sugars; Sodium & Dietary fibre.

%DI is based on the recommended amounts of energy and nutrients needed for an average adult diet to meet their nutritional needs. The percentages are calculated based on the below figures:

For adults only
As these figures are based on an average adult diet, you may need more or less than the above figures and this will vary based on your age, height, weight, sex and how much activity or exercise you do.

How do I use the Daily Intake Guide
You can use %DI labels to find out what is in a serve and the percentage that the serve will contribute to your daily intake. You can also use the %DI to compare similar products so that you can choose the product that more closely matches the nutrients that you need. For example, if you were trying to lose weight, you would choose the product with the lowest percent for energy, highest fibre and lowest saturated fat.

What is Low GI?

Glycemic Index (GI) is a ranking given to foods to describe how quickly the carbohydrate they contain is digested and absorbed and raises blood sugar levels.

Carbohydrates are an important energy source for the body and carbohydrate containing foods are an important part of a healthy diet.

Foods that are quickly digested and absorbed have a high GI whilst those that are slowly digested and absorbed have a low GI. Foods with a high GI lead to glucose being absorbed into the blood quickly while those with a low GI have the opposite effect.

Recent studies also show that eating low GI foods may help to prevent some diseases.

Some foods contain the Glycemic Index symbol. Glycemic Index Ltd runs the GI Symbol program. It is a non profit organisation formed by the University of Sydney, Diabetes Australia and the Juvenile Diabetes Research Foundation. For more information on the GI Symbol Program go to: www.gisymbol.com.au

Resources and further reading in Australia:

Food Standards Australia New Zealand – www.foodstandards.gov.au

Food Standards Australia New Zealand (FSANZ) is an independent statutory agency established by the Food Standards Australia New Zealand Act 1991. The website has an Interactive Label Poster to explain the NIP and product packaging, as well as poster version and a recorded explanation from Lydia Buchtmann, Communications Manager from Food Standards Australia and New Zealand.
http://www.foodstandards.gov.au/_srcfiles/Food%20Labels%20Posterfinal%20.pdf

Food for Kids is produced by Choice, Australia's leading consumer organization. Choice uses a smiling face rating system to help parents make informed choices about food for their family. www.choicefoodforkids.com.au

Dietitians Association of Australia: Food Labeling Page - www.daa.asn.au

The Heart Foundation: Reading Food Labels - www.heartfoundation.org.au

Healthy Kids School Canteen Association, South Australia - www.healthy-kids.com.au