Tuesday, June 09, 2009

9 June, 2009

Can crash diets be good for you?

New research appears to show that crash diets can be a safe and effective way of keeping the pounds off. But for how long?

We all know the nutritional rules, don’t we? Crash dieting is just a code for losing muscle and water. As soon as we stop, we’ll simply regain the weight — and, likely, plus some. Yo-yo dieting will merely mess up your metabolism.

In spite of this, we’ve kept doing the crazy diets. The bottom line was that we were thin. So what if we fasted for 48 hours, drinking only water, diet cola and black coffee, then munched a 400-calorie meal, then fasted again for 48 hours more? We lost 1st in four days — even if it was dangerously extreme.

My own life has borne witness to the Scarsdale diet: I had a green salad and no cake for dinner on my 16th birthday. I lived through “Smashgate”, a regime of Smash mashed potato, for days, until I realised that it was about 10 times as calorific as I’d thought. At university, it was all about calorie counting — anything from 700 to 1,200 calories a day. In my first job, I worked through a haze of starvation on the simple but deadly “stone in four days” plan. I picked Thursdays for the first night of a fast, so I could offset dinner hunger pangs by late-night shopping at Topshop.

Sooner or later, most of us say goodbye to this miserable way of life. When sensible women want to lose weight, we rethink emotional eating patterns, up the exercise and get sustainably healthy, losing 1lb per week tops, right?

Maybe not. We could all be about to head back to the weird world of crash dieting. For new research from Tufts University in Massachusetts says that crash diets can actually work better than slow weight loss. Susan Roberts, professor of nutrition and psychiatry at Tufts, says the latest research from her lab shows that “sensible, healthy crash diets actually do as well for long-term success as slow diets and, for some people, can actually work better”.

She distinguishes between good and bad crash diets, however. The one she advocates goes further than the usual 1,500 calories a day typically advised for women to lose 1lb per week, but is not extreme, never dipping below 1,200 calories for women (or 1,800 for men). “We studied two groups, in which we cut either 10% or 30% of calories, and tried to keep them at it for a year,” she explains. “In the end, they were in a similar place — the 30-percenters definitely did not do worse, despite having a more stringent programme.”

What is more, she adds, people who get tempted easily may be better candidates for fast, strict diets than gentle weight loss: “A small calorie cut can work for the sensible crowd, but seems to almost backfire for people who get tempted by food. Disinhibited eaters [a psychological term referring to people who give up on diets easily when presented with food opportunities] actually did really badly on the 10% diet.”

Certainly, if you’re addicted to overeating, it can be easier dramatically to cut out all your favourites, rather than learn moderation, which is perhaps why meal-replacement diets have been found to be one of the most successful ways to lose weight (see Simon Glazin, above). “Despite the hype about slow diets being better, there has actually been very little research into whether losing weight fast or slowly works better in the long run,” argues Roberts. “The trouble with slow diets is people tend to feel they are getting nowhere and give up. Fast keeps you excited and feeling like you’re making progress.” Other experts take a very different view and insist any kind of diet is bunkum. “Diets depend on failure,” says the psychotherapist Susie Orbach, who has explored women’s attitudes to eating in such books as Bodies. “They need to fail, otherwise there would be no repeat customers.”

Others, such as Dr Peter Rowan, an eating-disorder consultant from the Cygnet hospital in London, warn that dieting and eating disorders go hand in hand. “The large majority of patients with anorexia and bulimia have the illnesses triggered by weight loss. Even a sensible weight-loss diet can trigger an eating disorder in someone who is vulnerable, but there is evidence to suggest that the more severe the weight loss, the more likely the diet is to trigger an eating disorder.”

Roberts dismisses extreme crash diets that promise huge losses, as well as fasting, as “snake oil”, but says that to lose as much as 20lb in eight weeks on 1,200 calories a day, plus 30 minutes’ daily exercise, is safe, provided the diet is balanced, with plenty of low-GI, high-protein foods to keep you full. And the weight loss will last, she says, if you “change what you eat permanently” to generally healthy habits.

Dr Shahrad Taheri, director of the weight-management clinic at the Heart of England NHS Foundation Trust, agrees that 1,200 nutritious, low-GI calories per day is the lowest a woman should go, but warns: “Most people’s weight problems occur over a number of years and reflect a lifestyle of selecting calorie-dense foods combined with reduced physical activity — this needs time to change.”


The bug that can blast away cancer: Drug made from virus extends patients' lives

Sounds plausible and the initial results sound hopeful

A common virus which causes stomach upsets is giving hope to cancer patients - by boosting their immune system and blasting away tumours. Almost 80 patients with advanced forms of liver cancer, head and neck tumours and breast cancer are taking part in trials using a drug made from the reovirus. A number, who have struggled to benefit from chemotherapy, have seen astonishing results, with tumours shrinking and in one case disappearing altogether.

Experts say it is too soon to say if Reolysin is the 'magic bullet' that will kill off cancer, but they believe it may offer a way of extending the life of patients given a short time to live. Reolysin appears to kill off cancer cells by rupturing their walls, creating a chain reaction of 'explosions' which rip through tumours. As the tumours shrink they become less harmful and more easily treatable by chemotherapy. At the same time, Reolysin seems to 'wake up' the immune system so it can recognise cancer cells as invaders, prompting the body to mount an attack on harmful cells.

One liver cancer patient, Andrew McManus, 65, said last night: 'To put it bluntly, I could well be dead by now without this treatment.'

Reovirus infection occurs often in humans, but most cases are mild - causing a stomach upset. Its role in human disease is uncertain. Canadian firm Oncolytics Biotech Inc, which created Reolysin, is working on trials with researchers from St James's Hospital in Leeds, the Royal Marsden Hospital in London and the Royal Surrey County Hospital. The drug is administered intravenously via a drip, with a patient receiving eight fiveday courses of treatment spread over six months. The only side-effects appear to be a flu-like ache and a raised temperature.

Lead researcher Professor Alan Melcher said: 'We have had a few dramatic responses to Reolysin but we still have to be very cautious about getting up too much hope. We cannot say people have been cured. However, it is exciting and has got real potential.'

One man, Henry Nelson, 74, of Halifax, with cancer of the head and neck saw a lump the size of a tennis ball in his neck almost disappear after chemotherapy plus Reolysin.

Professor Melcher said: 'It is a completely different approach to treating cancer. It is not just another drug. It is a virus and it seems to be very well tolerated in combination with chemotherapy. 'There is no magic bullet with cancer, but these combinations seem to be working.'

Experts say larger trials are needed before Reolysin can be widely available to patients. That could take up to five years. In UK trials, 15 head and neck cancer patients have been treated so far. Of 12 for whom results were available, five have had a partial shrinkage of their tumours and in four the disease stabilised for between two to six months. Oncolytics also announced positive results from its other UK trials, for patients who have tumours which have failed to respond to standard therapy. Of 17, 15 experienced stable disease or better.

Liz Woolf, of Cancer Research UK, said 'If it proves successful in larger trials, the reovirus could one day become an effective new treatment to be used alongside chemotherapy, radiotherapy and surgery to benefit people with some types of cancer.


1 comment:

John A said...

So, a "fast" diet (aka crash diet) may be easier to do. Well, to some extent that seems likely. And once the requisite weight has been lost, is there a follow-up difference? Or does one never stop dieting. and if so how to keep from becoming underweight?