Atkins is out, slim is always in and calories count

JUDY GERSTEL

OUT: Atkins

IN: Weight Watchers

A review of 10 of the most popular weight-loss programs published in this week's Annals Of Internal Medicine found there was not enough evidence to support the claims many of them make about helping people shed pounds and keep them off.

Only Weight Watchers had strong documentation that it worked — with one study showing that participants lost around five per cent (about 10 pounds) of their initial weight in six months and kept off about half of it two years later.

Researchers found insufficient evidence to prove the effectiveness of self-help programs like Overeaters Anonymous, Take Off Pounds Sensibly and two doctor-supervised diets in the U.S., including Optifast, which costs around $2,000 U.S. for three months.

But dieters are bored with carb cutting and dietitians maintain there's insufficient proof that low-carb, high-protein diets are healthy in the long term, with warnings about increased risk of cancer, kidney stones and high cholesterol.

Atkins plans to lay off 40 per cent of its employees and cut its marketing budget by half in 2005, reports the New York Times.

Early in 2004, 9 per cent of Americans were following a low-carb diet but by the end of the year, the number dropped to 4.5 per cent. And while thousands of new low-carb products hit the shelves last year, they're not selling. Kellogg's couldn't sell its low-carb inventories.

OUT: Arthritis drugs Vioxx, Celebrex, naproxen.

IN: Exercise, weight loss, topical pain relievers.

First, Vioxx was pulled at the end of September. Then, Celebrex was connected with a higher risk of heart disease.

Finally, naproxen, sold as Anaprox and Naprosyn — and maybe even all the non-steroidal anti-inflammatory drugs — was found to lead to fluid retention and elevated blood pressure with prolonged use.

And so, it's back to basics for arthritis sufferers: aspirin and ibuprofen (not without their own risks and side effects) and exercise and weight loss.

What about topical pain relief products? They're being heavily promoted nowthe high-profile drugs are losing their lustre, but there's no clinical proof topicals do the job to any significant extent. Still, for mild pain, it's a worth a try, even if only for the placebo effect.

Among the products: O24 essential oil pain reliever, from Toronto-based Swiss Medica, and Relief Matrix, made with capsaicin, the hot substance found in chili peppers, from Canadian company Relief Healthcare Inc.

OUT: Big Pharma

IN: Beverages

Big Pharma has been blacklisted for pushing lifestyle drugs so heavily and for promoting meds beyond the narrow target group of people who can benefit from them when the cost-risk benefit is calculated.

In an article posted online this week by the Journal Of The American Medical Association, Cleveland Clinic cardiology chief Eric Topol, who blew the whistle on Vioxx, calls for less aggressive advertising by Big Pharma and better safety assurances for approved drugs.

"The combination of mass promotion of a medicine with an unknown and suspect safety profile cannot be tolerated in the future," he warns.

With distrust building for Big Pharma and its pill-pushing, the medicinal properties found in food and drink are gaining attention.

This year, more studies showed moderate consumption of red wine confers cardiovascular and cancer prevention benefits. The journal Thorax recently reported that each daily glass of red wine — but not rosé, white, beer or spirits — gives 13 per cent protection against cancer when compared with non-drinkers.

Resveratrol in the skin of red grapes even stifles tumour development in some patients with lung cancer, the study shows.

"We have known for a while that drinking a little red wine can protect against a number of conditions, ranging from the common cold to coronary heart disease," said Dr. Andrew Peacock of the British Thoracic Society. "This new research suggests that red wine, in moderation, could also protect against lung cancer."

Does this mean you can swig a bottle of merlot with impunity tonight or any other night?

Uh-uh. The key to culling benefits is keeping the intake to a glass or two.

And while a study in the British Medical Journal a few months ago showed that people who drank no alcohol had an increased risk of mild mental difficulties in later life, the same study also found that drinking alcohol frequently in your 40s and 50s was linked to mental impairment in old age.

Besides, non-alcholic drinks such as green tea, grape juice and cranberry juice have also been found to contribute significantly to good health and to prevent disease.

OUT: Estrogen

IN: Testosterone

Estrogen and its feminizing effect is no longer au courant. In a testy world that demands ballsy behaviour, the hormone du jour is testosterone.

Estrogen replacement for menopausal women is now taking its rightful role as a minimal, short-term, stop-gap measure only for women suffering from severe change-of-life symptoms. At the same time, testosterone patches are being tested as a possible boost to sexual satisfaction for middle-age women.

Men, of course, are making every effort to hike their testosterone levels, smearing on the testosterone cream, slapping on patches — whether they're athletes who want an edge, middle-age men who won't accept waning levels of the male hormone, or young studs who want to enhance what they've got.

OUT: Flu panic

IN: Diabetes prevention

Yes, the World Health Organization keeps warning about the possibility of a devastating pandemic evolving from avian flu, but with SARS disappearing from the radar and other catastrophes impinging on our consciousness, nobody is panicking about a pandemic. A year or two down the road, who knows?

However, we are already be in the midst of a diabetes epidemic, says Toronto endocrinologist Bernard Zinman. The disease kills thousands of Canadians each year and more than 2 million have this condition, with 3 million predicted to have it by the end of the decade, the Star reported last month. "We're heading for disaster," St. Michael's Hospital endocrinologist Lawrence Leiter told Star editorial writer Leslie Papp.

What to do? More money is urged for education, screening and exercise programs.

And weight loss is mandatory.

Losing as little as 10 pounds can prevent type 2 diabetes from becoming full-blown in people at risk.

OUT: Running

IN: Spinning, Pilates, Yoga

Remember when running a marathon or a half, or even a 10k, was a test of mettle, a badge of honour, proof that you were fit and with it?

Well, no more. Bad knees and aching backs have taken their toll and pounding the joints on the pavement is no longer proof of anything except a penchant for punishment. Besides, now that everybody's done a run, it doesn't have the same cachet anymore.

But spinning — it's easier on the knees and the back and you still get boasting rights about keeping up with the instructor during an endurance class. Combine the aerobic, cardiovascular and stamina benefits of spinning with Pilates for abs and back strengthening and yoga for overall physical strengthening and emotional healing and you can't help but be a paragon of health.

It's even more important if you're middle-aged or older. A six-month program of aerobic exercise and weighlifting — with three 60-minute sessions a week — can reduce risk factors for heart disease and diabetes in people 55 to 75 years old by 41 per cent, reports the January issue of the American Journal Of Preventive Medicine.

OUT: Genome project

IN: Social Determinants of Health

Was it just a couple of years ago that the genome project was going to be the big breakthrough in curing everything that ails humankind?

The genome project may have had the glitz, the sex appeal and the superstar scientists, but public health researchers toiling away with their statistics may be pointing the way to a better, healthier world.

Social scientists like York University's Dennis Raphael demonstrate again and again that people living in socioeconomically deprived communities are more likely to develop diabetes and cardiovascular disease, are at considerably higher risk of further and more rapid disease progression, and have the fewest resources and most barriers to subsequent health improvement.

They remind us that the primary modifiable behavioural risk factors for diabetes and cardiovascular disease are heavily determined by social conditions.

In fact, a new Austrian study appearing in yesterday's online edition of the journal Stroke shows that low income was associated with a 60 to 70 per cent increased risk of dying from a stroke compared with stroke patients in the highest income group.

Genomics? In 2005, let's pay attention instead to economics.

OUT: Sex enhancers

IN: Chocolate

Yeah, Canadian men like their Levitra, Viagra and Cialis — they spent about $135 million on the erectile dysfunction drugs in the past year. And more young men with normal, average function are using the pills to get to above average, or even A-plus-plus-plus.

But some sobering news last month suggested men might want to think carefully about what they do with what an ED drug does for them.

A British study found men who are sexually promiscuous when they're young could be increasing their risk of contracting prostate cancer later in life.

The study suggests sex with lots of partners increases the risk of exposure to the human papilloma virus (HPV) and that such infections may kick-start the chain of genetic mutations that lead to cancer, often decades later.

HPV is already linked to cervical cancer in women, but connecting it to prostate cancer in men is new and, if confirmed, could explain why rates of the disease have surged in the Western world.

Meanwhile, an Italian study showed that women who eat chocolate regularly had the highest levels of desire, arousal and satisfaction from sex. What all this means is that men should stop spending so much money on Viagra and start spending more on Godiva.

As for what happens later in life, here's some interesting information courtesy of The Times of London. A large, unpublished survey carried out 35 years ago revealed that after 20 years of marriage there was virtually no sexual activity in almost a quarter of marriages.

The twist to this figure, reports The Times, is that there was no statistically relevant relationship between the sex life at this stage of the marriage and the happiness rating of the marriage.

The further twist: There was, a small, albeit statistically insignificant, chance of the sexless marriage being happier than those enjoying an "uproarious" sex life.

So, yes, chocolate, by all means, and lots of it.

OUT: Antibiotics

IN: Fish Oil

Exactly that. In 2005, you need fewer antibiotics in your life, both those you consume internally and those you wash your hands with, and you need more fish oil in your body.

The omega-3 essential fatty acids in fish oil, from such fish as sardines, mackerel or from fish oil supplements, are health food superstars now entering mainstream nutrition: Studies show people who consume more omega-3 are at less risk of suffering heart attacks.

Also, fish oil supplements appear to ward off asthma symptoms in young children with a family history of allergies, Australian researchers found.

Children who consumed higher amounts of omega-3 fatty acids from birth were 10 per cent less likely to experience coughing and wheezing at the age of 3.

There's more.

A number of randomized trials have confirmed that fish oil supplementation can benefit patients with rheumatoid arthritis. The effects of the omega-3 fatty acids in fish oil include direct anti-inflammatory activity in joints.

Australian researchers also say the supplement could be one of the few biological treatments for postpartum depression and could halve the rate of baby blues in new mothers.

In addition, they believe that not only does the supplement act as a natural antidepressant, it may also boost brain functioning in unborn babies.

And so, go open a can of sardines, uncork a bottle of cabernet sauvignon and select some good dark chocolate — the dark is rich in antioxidant compounds known as flavonoids that enhance cardiovascular health and immune system function — to welcome the New Year and a healthier, happier you.