Managing and Preventing Obesity

Timothy Gill, Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney

"Overall, I enjoyed this book. I appreciate that although it offers the resources and references that a textbook does, it serves health professionals more like a reference. The style makes it a fairly easy read. Score: 82 - 3 Stars" --Doody's

• List of contributorsWoodhead Publishing Series in Food Science, Technology and NutritionPrefaceIntroduction: an overview of the key drivers of obesity and their influence on diet1 Introduction2 Behavioural factors3 Environmental and structural factors4 Biological factors5 Summary and conclusions Part One: General issues1: Trends in understanding patterns of obesity and health outcomes1.1 Introduction1.2 The importance of abdominal obesity1.3 Global trends in obesity1.4 Economic development and obesity1.5 Social class differences in obesity1.6 Obesity in women and its implications for maternal and infant health1.7 Childhood obesity1.8 Conclusions 2: Overview of the key current population-level strategies used to prevent obesity2.1 Introduction2.2 Physical activity strategies2.3 Food and beverage strategies2.4 School strategies2.5 Healthcare and workplace strategies2.6 Messaging strategies2.7 Conclusion: integrating approaches Part Two: The role of different dietary components in obesity management3: The role of high sugar foods and sugar-sweetened beverages in weight gain and obesity3.1 Introduction3.2 Sugar in our food supply3.3 Biological mechanisms for some effects of sugar in beverages3.4 Randomized clinical trials and longitudinal cohort studies link intake of sugar-sweetened beverages to the risk of obesity3.5 Fruit juice and weight gain3.6 Future trends 4: The impact of fruit and vegetable intake on weight management4.1 Introduction4.2 Importance of fruits and vegetables (FV)4.3 FV and obesity prevention4.4 Future trends 5: High protein diets in obesity management and weight control5.1 Introduction5.2 Internationally popular higher-protein diets5.3 The Commonwealth Scientific and Industrial Research Organisation (CSIRO) Total Wellbeing Diet5.4 Evidence from meta-analyses and selected randomised control trials for the efficacy of higher-protein diets for weight control and metabolic health5.5 Potential risks of high protein dietary patterns5.6 Strategies to improve compliance to higher protein diets5.7 Conclusions 6: Low-fat diets in obesity management and weight control6.1 Introduction: overview of dietary fat and body weight6.2 Total fat: mechanisms for association with body weight regulation6.3 Type of fat: biological mechanisms for effects on energy balance6.4 Sustainability of weight loss on low-fat diets6.5 Conclusions6.6 Future trends 7: The ‘Mediterranean diet’ and weight management7.1 Introduction: the Mediterranean diet and other dietary patterns in the context of obesity7.2 Definition of a Mediterranean dietary pattern7.3 Epidemiological evidence on Mediterranean diet and weight management7.4 Dietary and lifestyle intervention based on Mediterranean diet7.5 Conclusions and future trends 8: Breastfeeding and weight in mothers and infants8.1 Introduction8.2 Energetic cost of breastfeeding8.3 Postpartum weight change8.4 Breastfeeding benefits for infants8.5 Commentary on studies into the effect of breastfeeding on the weight of mothers and infants8.6 Future trends Part Three: The role of eating patterns and other behavioural factors in obesity management9: The role of dietary energy density in weight management9.1 Introduction9.2 Energy density explained9.3 Controlled studies demonstrate the influence of dietary energy density on satiety, satiation, and energy intake9.4 Dietary energy density and weight management9.5 Strategies to reduce dietary energy density9.6 Future trends9.8 Acknowledgements 10: Controlling appetite and food intake by regulating eating frequency and timing10.1 Introduction10.2 The relationship between motivation to eat and eating behaviour10.3 Eating frequency and energy balance – observational studies of free-living adults consuming self-selected diets10.4 Eating frequency and energy balance – intervention studies10.5 Eating frequency and energy balance – controlled feeding studies10.6 Small inter-meal ingestive events10.7 Timing of eating within a habitual diurnal rhythm10.8 Timing of eating and disruption of diurnal rhythms10.9 Summary and future trends 11: Managing food portion size and its effect on weight control11.1 Introduction: trends in food portion sizes11.2 Effects of food portion size on energy intake11.3 Explanations for the effects of portion size on energy intake11.4 Environmental strategies influencing portion control behaviors11.5 Self-regulation strategies to control portion sizes11.6 Summary and conclusions11.7 Acknowledgement 12: Eating in response to external cues12.1 Introduction12.2 Effects of food cues12.3 Potential moderators influencing responding to food cues12.4 How plentiful food cues affect dieters/overweight individuals12.5 Factors influencing overweight/obese people and restrained eaters to respond more to salient food cues12.6 Psychological processes governing eating behavior12.7 Implications for obesity management 13: The interaction of diet and physical activity in managing obesity13.1 Introduction13.2 The independent and combined roles of physical activity and diet in prevention of weight gain13.3 Physical activity and diet during weight reduction programmes13.4 The roles of physical activity and diet in maintenance of reduced body weight13.5 Conclusions Part Four: Structured dietary interventions in the treatment of obesity14: Defined energy deficit diets for the treatment of obesity14.1 Introduction14.2 History of defined energy prescriptions14.3 Terminology and definitions14.4 Estimating total energy requirements14.5 Magnitude of energy deficit14.6 Practical worked example of prescribed energy calculations14.7 Conclusion 15: Meal replacements for the treatment of obesity15.1 Introduction15.2 Very low calorie diet (VLCD) versus partial meal replacement or controlled diet15.3 Meal replacement as part of a low calorie diet (LCD) versus conventional diet15.4 Type 2 diabetes15.5 Composition of meal replacements15.6 Summary 16: Very-low-calorie diets (VLCDs) for the treatment of obesity16.1 Introduction16.2 Indications and contraindications for the use of very-low-calorie diets (VLCDs)16.3 How to use VLCDs16.4 Efficacy of VLCDs16.5 Safety of VLCDs16.6 Monitoring required during the diet16.7 Future trends 17: Commercial weight loss programs and their effectiveness in managing obesity17.1 Introduction17.2 Commonly available commercial weight loss programs17.3 Efficacy of commercial weight loss programs: a summary of available evidence17.4 Internet-based weight loss programs17.5 The cost-effectiveness of commercial weight loss programs17.6 Applications in the treatment of overweight and obesity17.7 Conclusions 18: Popular diets and over-the-counter dietary aids and their effectiveness in managing obesity18.1 Introduction: why diets are best sellers18.2 Claims that ‘the science is wrong’18.3 All or nothing approaches18.4 Claims to more moderate diets18.5 Unconventional diets18.6 Evaluation of promised time-scales18.7 Evaluation of claims to simplicity18.8 Over-the-counter weight loss aids18.9 Discussion18.10 Sourcing unbiased information Part Five: Government and industry interventions in the prevention of obesity19: Regulatory strategies for preventing obesity and improving public health19.1 Introduction19.2 Restricting child-targeted food marketing19.3 Improving the school environment19.4 Food and beverage taxes19.5 Nutrition labeling19.6 Limiting portion sizes of sugar-sweetened beverages19.7 Conclusion 20: Fiscal strategies to influence diet and weight management20.1 Introduction20.2 Evidence to support fiscal strategies as an intervention20.3 Evidence for differential effects of fiscal strategies20.4 Evidence for cost-effectiveness of fiscal interventions20.5 Evidence for interplay with other interventions20.6 Existing strategies and policies in place20.7 Politics and practicalities of taxing unhealthy food20.8 Conclusion 21: Consumer responses to government dietary guidelines in the management and prevention of obesity21.1 Introduction21.2 History of dietary guidelines21.3 Effectiveness of dietary guidelines in preventing obesity21.4 Effectiveness of dietary guidelines in promoting healthier food choices21.5 Effectiveness of dietary guidelines in promoting dietary behaviour change21.6 Conclusion 22: The impact of marketing of ‘junk’ foods on children’s diet and weight22.1 Introduction22.2 Extent of children’s exposure to food and beverage marketing22.3 International policy to reduce the impact of unhealthy food and beverage marketing to children22.4 Food marketing effects on food consumption and nutrition and weight outcomes22.5 Future trends 23: Front-of-pack and point-of-purchase labelling schemes designed for obesity prevention23.1 Introduction23.2 Definitions and scope23.3 Current status of front-of-pack and point-of-purchase labelling schemes23.4 Impact of front-of-pack and point-of-purchase labelling schemes and interventions involving such schemes23.5 Future trends in front-of-pack and point-of-purchase labelling schemes Index